Risk stratification in secondary cardiovascular prevention.

Science.gov (United States)

Lazzeroni, Davide; Coruzzi, Paolo

2018-02-19

Worldwide, more than 7 million people experience acute myocardial infarction (AMI) every year (1), and although substantial reduction in mortality has been obtained in recent decades, one-year mortality rates are still in the range of 10%. Among patients who survive AMI, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of AMI (2). Despite the evidence that lifestyle changes and risk factors management strongly improve long-term prognosis, preventive care post-AMI remains sub-optimal. Cross-sectional data from the serially conducted EUROASPIRE surveys in patients with established ischemic heart disease (IHD) and people at high cardiovascular risk have demonstrated a high prevalence of unhealthy lifestyle, modifiable risk factors and inadequate use of drug therapies to achieve blood pressure and lipid goals (3). Secondary prevention programmes, defined as the level of preventive care focusing on early risk stratification, are highly recommended in all IHD patients, to restore quality of life, maintain or improve functional capacity and prevent recurrence.

Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

Science.gov (United States)

Chatterjee, Susmita; Sarkar, Anupam; Rao, Krishna D

2016-01-01

Postpartum heammorrhage (PPH), defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment) in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg). An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention. This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach. The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1) per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6) million to the government to implement the primary prevention compared to the secondary prevention strategy. As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary prevention

Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

Directory of Open Access Journals (Sweden)

Susmita Chatterjee

Full Text Available Postpartum heammorrhage (PPH, defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg. An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention.This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach.The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1 per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6 million to the government to implement the primary prevention compared to the secondary prevention strategy.As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems.

LENUS (Irish Health Repository)

Corrrigan, Mairead

2006-01-01

BACKGROUND: Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. METHODS: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis. RESULTS: Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

Directory of Open Access Journals (Sweden)

Leathem Claire S

2006-07-01

Full Text Available Abstract Background Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD. It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. Methods In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23 and four with staff (N = 29 informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients and 10 interviews (staff. The data were analysed using thematic analysis. Results Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems.

Science.gov (United States)

Corrrigan, Mairead; Cupples, Margaret E; Smith, Susan M; Byrne, Molly; Leathem, Claire S; Clerkin, Pauline; Murphy, Andrew W

2006-07-18

Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis. Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour

Optimise the microbial flora with milk and yoghurt to prevent disease.

Science.gov (United States)

Morris, James A

2018-05-01

Pathogenic bacteria, which are temporary or permanent members of our microbial flora, cause or contribute to a wide range of human disease at all ages. Conditions include Alzheimer's disease, atherosclerosis, diabetes mellitus, obesity, cancer, autoimmunity and psychosis, amongst others. The mechanism of damage is inflammation which can be chronic or acute. An optimal microbial flora includes a wide range of pathogenic bacteria in low dose. This allows specific immunity to be developed and maintained with minimal inflammatory damage. Human milk has evolved to deliver an optimal microbial flora to the infant. Cow's milk has the potential, following appropriate fortification, to maintain an optimal human microbial flora throughout life. Yoghurt is a fermented milk product in which bacteria normally present in milk convert sugars to lactic acid. The acid suppresses the growth of pathogens in the oral cavity, oropharynx and oesophagus. Thus yoghurt can restore an optimal flora in these regions in the short term. Since bacteria are transported between epithelial surfaces, yoghurt will also optimise the flora elsewhere. The judicious use of milk and yogurt could prevent a high proportion of human disease. Copyright © 2018 The Author. Published by Elsevier Ltd.. All rights reserved.

Optimising ICT effectiveness in instruction and learning: Multilevel transformation theory and a pilot project in secondary education

NARCIS (Netherlands)

Mooij, Ton

2016-01-01

Specific combinations of educational and ICT conditions including computer use may optimise learning processes, particularly for learners at risk. This position paper asks which curricular, instructional, and ICT characteristics can be expected to optimise learning processes and outcomes,and how to

Esophageal variceal ligation in the secondary prevention of variceal ...

African Journals Online (AJOL)

Pan African Medical Journal ... Introduction: Long-term outcome of patients after band ligation have been poorly defined. ... endoscopic band ligation, liver cirrhosis, complication of band ligation, esophageal varices, secondary prevention ...

Secondary stroke prevention: challenges and solutions

OpenAIRE

Esenwa, Charles; Gutierrez, Jose

2015-01-01

Charles Esenwa, Jose GutierrezDepartment of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USAAbstract: Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dy...

Old and new oral anticoagulants for secondary stroke prevention in atrial fibrillation

Directory of Open Access Journals (Sweden)

Tommaso Sacquegna

2015-12-01

Full Text Available Vitamin K antagonists, such as warfarin, used in oral anticoagulation therapy currently represent the standard drugs for the primary and secondary prevention of stroke in non-valvular atrial fibrillation (AF, with a relative risk reduction close to 70%. Newer oral anticoagulants, such as direct thrombin inhibitors (i.e., dabigatran and direct factor Xa inhibitors (i.e., apixaban and rivaroxaban have been recently compared with warfarin in large randomized trials for stroke prevention in AF. The new oral anticoagulants showed, compared with warfarin, no statistically significant difference in the rate of stroke or systemic embolism in secondary prevention (patients with previous transient ischemic attack or stroke subgroups. With regard to safety, the risk of intracranial bleeding was reduced with new anticoagulants compared with warfarin. Indirect treatment comparisons of clinical trials on secondary prevention cohorts showed no significant difference in efficacy among apixaban, rivaroxaban, and dabigatran; but dabigatran 110 mg was associated with less intracranial bleedings than rivaroxaban.

Secondary prevention for coronary artery disease: are we following the guidelines?

LENUS (Irish Health Repository)

Syed, I A A

2012-02-01

BACKGROUND: Secondary prevention pharmacotherapy in post-myocardial infarction (MI) patients reduces the risk of subsequent coronary events and overall mortality. International guidelines recommend use of aspirin, beta-blockers, ACE inhibitors and statins in post-MI patients. AIMS: We performed this audit to review the compliance of prescribing practices, in a regional hospital in Ireland, with international guidelines for secondary prevention of coronary artery disease. METHODS: We performed a retrospective case review of 172 patients diagnosed with MI during a 1-year period between January and December 2007. RESULTS: A total of 134 patients fulfilled the inclusion criteria. On discharge, aspirin was prescribed to 131 (97.76%) patients, clopidogrel to 126 (94%), beta-blockers to 117 (87%), ACE inhibitor to 87 (65%), ARB to 10 (7%) and statins to 116 (87%). CONCLUSION: Our audit shows that targets for prescription of secondary prevention medications were not met in a small but significant proportion of patients and calls for review of discharge practices and education to improve compliance with guidelines.

Implantable Cardioverter-defibrillator Therapy for Hypertrophic Cardiomyopathy: Usefulness in Primary and Secondary Prevention.

Science.gov (United States)

Sarrias, Axel; Galve, Enrique; Sabaté, Xavier; Moya, Àngel; Anguera, Ignacio; Núñez, Elaine; Villuendas, Roger; Alcalde, Óscar; García-Dorado, David

2015-06-01

Hypertrophic cardiomyopathy is a frequent cause of sudden death. Clinical practice guidelines indicate defibrillator implantation for primary prevention in patients with 1 or more risk factors and for secondary prevention in patients with a history of aborted sudden death or sustained ventricular arrhythmias. The aim of the present study was to analyze the follow-up of patients who received an implantable defibrillator following the current guidelines in nonreferral centers for this disease. This retrospective observational study included all patients who underwent defibrillator implantation between January 1996 and December 2012 in 3 centers in the province of Barcelona. The study included 69 patients (mean age [standard deviation], 44.8 [17] years; 79.3% men), 48 in primary prevention and 21 in secondary prevention. The mean number of risk factors per patient was 1.8 in the primary prevention group and 0.5 in the secondary prevention group (P=.029). The median follow-up duration was 40.5 months. The appropriate therapy rate was 32.7/100 patient-years in secondary prevention and 1.7/100 patient-years in primary prevention (P<.001). Overall mortality was 10.1%. Implant-related complications were experienced by 8.7% of patients, and 13% had inappropriate defibrillator discharges. In patients with a defibrillator for primary prevention, the appropriate therapy rate is extremely low, indicating the low predictive power of the current risk stratification criteria. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Multiobjective optimisation of bogie suspension to boost speed on curves

Science.gov (United States)

Milad Mousavi-Bideleh, Seyed; Berbyuk, Viktor

2016-01-01

To improve safety and maximum admissible speed on different operational scenarios, multiobjective optimisation of bogie suspension components of a one-car railway vehicle model is considered. The vehicle model has 50 degrees of freedom and is developed in multibody dynamics software SIMPACK. Track shift force, running stability, and risk of derailment are selected as safety objective functions. The improved maximum admissible speeds of the vehicle on curves are determined based on the track plane accelerations up to 1.5 m/s2. To attenuate the number of design parameters for optimisation and improve the computational efficiency, a global sensitivity analysis is accomplished using the multiplicative dimensional reduction method (M-DRM). A multistep optimisation routine based on genetic algorithm (GA) and MATLAB/SIMPACK co-simulation is executed at three levels. The bogie conventional secondary and primary suspension components are chosen as the design parameters in the first two steps, respectively. In the last step semi-active suspension is in focus. The input electrical current to magnetorheological yaw dampers is optimised to guarantee an appropriate safety level. Semi-active controllers are also applied and the respective effects on bogie dynamics are explored. The safety Pareto optimised results are compared with those associated with in-service values. The global sensitivity analysis and multistep approach significantly reduced the number of design parameters and improved the computational efficiency of the optimisation. Furthermore, using the optimised values of design parameters give the possibility to run the vehicle up to 13% faster on curves while a satisfactory safety level is guaranteed. The results obtained can be used in Pareto optimisation and active bogie suspension design problems.

Optimisation in radiotherapy II: Programmed and inversion optimisation algorithms

International Nuclear Information System (INIS)

Ebert, M.

1997-01-01

This is the second article in a three part examination of optimisation in radiotherapy. The previous article established the bases of optimisation in radiotherapy, and the formulation of the optimisation problem. This paper outlines several algorithms that have been used in radiotherapy, for searching for the best irradiation strategy within the full set of possible strategies. Two principle classes of algorithm are considered - those associated with mathematical programming which employ specific search techniques, linear programming type searches or artificial intelligence - and those which seek to perform a numerical inversion of the optimisation problem, finishing with deterministic iterative inversion. (author)

Identifying strategies to maximise recruitment and retention of practices and patients in a multicentre randomised controlled trial of an intervention to optimise secondary prevention for coronary heart disease in primary care.

LENUS (Irish Health Repository)

Leathem, Claire S

2009-01-01

BACKGROUND: Recruitment and retention of patients and healthcare providers in randomised controlled trials (RCTs) is important in order to determine the effectiveness of interventions. However, failure to achieve recruitment targets is common and reasons why a particular recruitment strategy works for one study and not another remain unclear. We sought to describe a strategy used in a multicentre RCT in primary care, to report researchers\\' and participants\\' experiences of its implementation and to inform future strategies to maximise recruitment and retention. METHODS: In total 48 general practices and 903 patients were recruited from three different areas of Ireland to a RCT of an intervention designed to optimise secondary prevention of coronary heart disease. The recruitment process involved telephoning practices, posting information, visiting practices, identifying potential participants, posting invitations and obtaining consent. Retention involved patients attending reviews and responding to questionnaires and practices facilitating data collection. RESULTS: We achieved high retention rates for practices (100%) and for patients (85%) over an 18-month intervention period. Pilot work, knowledge of the setting, awareness of change in staff and organisation amongst participant sites, rapid responses to queries and acknowledgement of practitioners\\' contributions were identified as being important. Minor variations in protocol and research support helped to meet varied, complex and changing individual needs of practitioners and patients and encouraged retention in the trial. A collaborative relationship between researcher and practice staff which required time to develop was perceived as vital for both recruitment and retention. CONCLUSION: Recruiting and retaining the numbers of practices and patients estimated as required to provide findings with adequate power contributes to increased confidence in the validity and generalisability of RCT results. A

Identifying strategies to maximise recruitment and retention of practices and patients in a multicentre randomised controlled trial of an intervention to optimise secondary prevention for coronary heart disease in primary care

Directory of Open Access Journals (Sweden)

Houlihan Ailish

2009-06-01

Full Text Available Abstract Background Recruitment and retention of patients and healthcare providers in randomised controlled trials (RCTs is important in order to determine the effectiveness of interventions. However, failure to achieve recruitment targets is common and reasons why a particular recruitment strategy works for one study and not another remain unclear. We sought to describe a strategy used in a multicentre RCT in primary care, to report researchers' and participants' experiences of its implementation and to inform future strategies to maximise recruitment and retention. Methods In total 48 general practices and 903 patients were recruited from three different areas of Ireland to a RCT of an intervention designed to optimise secondary prevention of coronary heart disease. The recruitment process involved telephoning practices, posting information, visiting practices, identifying potential participants, posting invitations and obtaining consent. Retention involved patients attending reviews and responding to questionnaires and practices facilitating data collection. Results We achieved high retention rates for practices (100% and for patients (85% over an 18-month intervention period. Pilot work, knowledge of the setting, awareness of change in staff and organisation amongst participant sites, rapid responses to queries and acknowledgement of practitioners' contributions were identified as being important. Minor variations in protocol and research support helped to meet varied, complex and changing individual needs of practitioners and patients and encouraged retention in the trial. A collaborative relationship between researcher and practice staff which required time to develop was perceived as vital for both recruitment and retention. Conclusion Recruiting and retaining the numbers of practices and patients estimated as required to provide findings with adequate power contributes to increased confidence in the validity and generalisability of RCT

Violence Prevention in United States Society of Jesus Secondary Schools

Science.gov (United States)

Simonds, Thomas Andrew

2009-01-01

Using data from a representative number of Society of Jesus secondary schools, the researcher reports what these schools are doing to prevent violence, and tests an explanatory model of school violence he created. The researcher proposes that this model can be used to explain and prevent school violence by identifying and addressing the…

Primary and secondary prevention in cardiovascular disease : an old-fashioned concept?

NARCIS (Netherlands)

van Venrooij, FV; Stolk, RP; Banga, JD; Erkelens, DW; Grobbee, DE

Objective. Is the concept of primary and secondary cardiovascular prevention an old-fashioned concept that needs to be re-defined? Design. Discussion paper. Results. Cardiovascular prevention means reduction of absolute risk for cardiovascular disease (CVD), irrespective of clinical stage.

Long-term secondary prevention of acute myocardial infarction (SEPAT) - guidelines adherence and outcome.

Science.gov (United States)

Ergatoudes, Constantinos; Thunström, Erik; Rosengren, Annika; Björck, Lena; Bengtsson Boström, Kristina; Falk, Kristin; Fu, Michael

2016-11-17

A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden. All patients who agreed to participate in the study (16.2%) were invited for a structured interview, physical examinations and laboratory analysis 2 years after AMI. Guideline-directed secondary preventive goals were defined as optimally controlled blood pressure, serum cholesterol, glucose, regular physical activity, smoking cessation and pharmacological treatment. The mean age of the study cohort (n = 200) at the index AMI was 63.0 ± 9.7 years, 79% were men. Only 3.5% of the cohort achieved all six guideline-directed secondary preventive goals 2 years after infarction. LDL therapy was used by 97% of the patients, beta-blockers by 83.0%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers by 76.5% and statins by 88.5%. During follow-up, non-fatal adverse cardiovascular events (cardiac hospitalization, recurrent acute coronary syndrome, angina pectoris, new percutaneous coronary intervention, new onset of atrial fibrillation, post-infarct heart failure, pacemaker implantation, stroke/transient ischemic attack (TIA), cardiac surgery and cardiac arrest) occurred in 47% of the cohort and readmission due to cardiac causes in 30%. Our data showed the failure of secondary prevention in our daily clinical practice and high rate of non-fatal adverse cardiovascular events 2 years after AMI.

Challenges in secondary prevention after acute myocardial infarction

DEFF Research Database (Denmark)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul

2017-01-01

in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence...... document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings...

Robustness analysis of bogie suspension components Pareto optimised values

Science.gov (United States)

Mousavi Bideleh, Seyed Milad

2017-08-01

Bogie suspension system of high speed trains can significantly affect vehicle performance. Multiobjective optimisation problems are often formulated and solved to find the Pareto optimised values of the suspension components and improve cost efficiency in railway operations from different perspectives. Uncertainties in the design parameters of suspension system can negatively influence the dynamics behaviour of railway vehicles. In this regard, robustness analysis of a bogie dynamics response with respect to uncertainties in the suspension design parameters is considered. A one-car railway vehicle model with 50 degrees of freedom and wear/comfort Pareto optimised values of bogie suspension components is chosen for the analysis. Longitudinal and lateral primary stiffnesses, longitudinal and vertical secondary stiffnesses, as well as yaw damping are considered as five design parameters. The effects of parameter uncertainties on wear, ride comfort, track shift force, stability, and risk of derailment are studied by varying the design parameters around their respective Pareto optimised values according to a lognormal distribution with different coefficient of variations (COVs). The robustness analysis is carried out based on the maximum entropy concept. The multiplicative dimensional reduction method is utilised to simplify the calculation of fractional moments and improve the computational efficiency. The results showed that the dynamics response of the vehicle with wear/comfort Pareto optimised values of bogie suspension is robust against uncertainties in the design parameters and the probability of failure is small for parameter uncertainties with COV up to 0.1.

Randomised controlled trial of a secondary prevention program for myocardial infarction patients ('ProActive Heart': study protocol. Secondary prevention program for myocardial infarction patients

Directory of Open Access Journals (Sweden)

Taylor C Barr

2009-05-01

Full Text Available Abstract Background Coronary heart disease (CHD is a significant cause of health and economic burden. Secondary prevention programs play a pivotal role in the treatment and management of those affected by CHD although participation rates are poor due to patient, provider, health system and societal-level barriers. As such, there is a need to develop innovative secondary prevention programs to address the treatment gap. Telephone-delivered care is convenient, flexible and has been shown to improve behavioural and clinical outcomes following myocardial infarction (MI. This paper presents the design of a randomised controlled trial to evaluate the efficacy of a six-month telephone-delivered secondary prevention program for MI patients (ProActive Heart. Methods 550 adult MI patients have been recruited over a 14 month period (December 2007 to January 2009 through two Brisbane metropolitan hospitals, and randomised to an intervention or control group (n = 225 per group. The intervention commences within two weeks of hospital discharge delivered by study-trained health professionals ('health coaches' during up to 10 × 30 minute scripted telephone health coaching sessions. Participants also receive a ProActive Heart handbook and an educational resource to use during the health coaching sessions. The intervention focuses on appropriate modification of CHD risk factors, compliance with pharmacological management, and management of psychosocial issues. Data collection occurs at baseline or prior to commencement of the intervention (Time 1, six months follow-up or the completion of the intervention (Time 2, and at 12 months follow-up for longer term outcomes (Time 3. Primary outcome measures include quality of life (Short Form-36 and physical activity (Active Australia Survey. A cost-effective analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the

Optimising cluster survey design for planning schistosomiasis preventive chemotherapy.

Directory of Open Access Journals (Sweden)

Sarah C L Knowles

2017-05-01

Full Text Available The cornerstone of current schistosomiasis control programmes is delivery of praziquantel to at-risk populations. Such preventive chemotherapy requires accurate information on the geographic distribution of infection, yet the performance of alternative survey designs for estimating prevalence and converting this into treatment decisions has not been thoroughly evaluated.We used baseline schistosomiasis mapping surveys from three countries (Malawi, Côte d'Ivoire and Liberia to generate spatially realistic gold standard datasets, against which we tested alternative two-stage cluster survey designs. We assessed how sampling different numbers of schools per district (2-20 and children per school (10-50 influences the accuracy of prevalence estimates and treatment class assignment, and we compared survey cost-efficiency using data from Malawi. Due to the focal nature of schistosomiasis, up to 53% simulated surveys involving 2-5 schools per district failed to detect schistosomiasis in low endemicity areas (1-10% prevalence. Increasing the number of schools surveyed per district improved treatment class assignment far more than increasing the number of children sampled per school. For Malawi, surveys of 15 schools per district and 20-30 children per school reliably detected endemic schistosomiasis and maximised cost-efficiency. In sensitivity analyses where treatment costs and the country considered were varied, optimal survey size was remarkably consistent, with cost-efficiency maximised at 15-20 schools per district.Among two-stage cluster surveys for schistosomiasis, our simulations indicated that surveying 15-20 schools per district and 20-30 children per school optimised cost-efficiency and minimised the risk of under-treatment, with surveys involving more schools of greater cost-efficiency as treatment costs rose.

Optimising the Target and Capture Sections of the Neutrino Factory

CERN Document Server

Hansen, Ole Martin; Stapnes, Steinar

The Neutrino Factory is designed to produce an intense high energy neutrino beam from stored muons. The majority of the muons are obtained from the decay of pions, produced by a proton beam impinging on a free-flowing mercury-jet target and captured by a high magnetic field. It is important to capture a large fraction of the produced pions to maximize the intensity of the neutrino beam. Various optimisation studies have been performed with the aim of maximising the muon influx to the accelerator and thus the neutrino beam intensity. The optimisation studies were performed with the use of Monte Carlo simulation tools. The production of secondary particles, by interactions between the incoming proton beam and the mercury target, was optimised by varying the proton beam impact position and impact angles on the target. The proton beam and target interaction region was studied and showed to be off the central axis of the capture section in the baseline configuration. The off-centred interaction region resulted in ...

Regulation of Hypertension for Secondary Prevention of Stroke: The Possible 'Bridging Function' of Acupuncture.

Science.gov (United States)

Zheng, Haizhen; Han, Yuhui; Du, Yuzheng; Shi, Xuemin; Huang, Huiyuan; Yu, Xiaoyang; Tan, Xiaochan; Hu, Chunxiao; Wang, Yue; Zhou, Shiyuan

2018-01-01

Worldwide, stroke is the leading cause of mortality and disability, with hypertension being an independent risk factor for a secondary stroke. Acupuncture for the treatment of hypertension gains more attention in alternative and complementary medicine, but the results are inconsistent. Few studies regarding the secondary prevention of stroke by managing hypertension with acupuncture have been carried out as there are some problems regarding the antihypertensive drug status in the secondary prevention of stroke. Still, the potential of acupuncture in regulating the blood pressure for secondary stroke prevention deserves our focus. This review is based on papers recorded in the PubMed, Embase, and Web of Science databases, from their inception until March 28, 2017, and retrieved with the following search terms: hypertension and acupuncture, limited in spontaneously hypertensive rats (SHRs), stress-induced (or cold-induced) hypertensive or pre-hypertensive models. We find that, in these hypertensive animals, acupuncture could mainly influence factors related to the nervous system, oxidative stress, the endocrine system, cardiovascular function, and hemorheology, which are closely associated with the stroke outcome. This trend may give us a hint that acupuncture might well participate in the secondary prevention of stroke through these pathways when used in the management of hypertension. © 2018 S. Karger GmbH, Freiburg.

Role of depression in secondary prevention of Chinese coronary heart disease patients receiving percutaneous coronary intervention.

Directory of Open Access Journals (Sweden)

Can Feng

Full Text Available Coronary heart disease (CHD patients who have undergone percutaneous coronary intervention (PCI have higher rates of depression than the general population. However, few researchers have assessed the impact of depression on the secondary prevention of CHD in China.The main purpose of this investigation was to explore the relationship between depression and secondary prevention of CHD in Chinese patients after PCI.This descriptive, cross-sectional one-site study recruited both elective and emergency PCI patients one year after discharge. Data from 1934 patients were collected in the clinic using questionnaires and medical history records between August 2013 and September 2015. Depression was evaluated by the 9-item Patient Health Questionnaire. Secondary prevention of CHD was compared between depression and non-depression groups.We found that depression affected secondary prevention of CHD in the following aspects: lipid levels, blood glucose levels, smoking status, physical activity, BMI, and rates of medication use.Depressive patients with CHD are at increased risk of not achieving the lifestyle and risk factor control goals recommended in the 2006 AHA guidelines. Screening should focus on patients after PCI because treating depression can improve outcomes by improving secondary prevention of CHD.

Platelet aggregation inhibitors in primary and secondary prevention of ischemic stroke

Directory of Open Access Journals (Sweden)

von der Schulenburg, Johann-Matthias

2006-04-01

Full Text Available Background: The ischaemic stroke (IS is one of the most frequent cause of death in Germany. Besides of non-drug many drug-based interventions are used in primary or secondary prevention of IS, among them the thrombocyte aggregation inhibitors (TAI. Objectives: The evaluation addresses the questions on medical efficacy and cost-effectiveness of the TAI administration in the prevention of IS as compared to the management of risk factors alone as well as to the use of anticoagulant drugs. Methods: The literature search for articles published after 1997 was conducted in December 2003 in the most important medical and economic databases. The medical analysis was performed on the basis of the most up-to date meta-analyses of randomised controlled trials (RCT as well as of new published RCT. The data from the studies for stroke, bleeding complications as well as for the combined endpoint "severe vascular events" (SVE: death or stroke or myocardial infarction were summarised in meta-analyses.In order to include grey literature contact has been taken up with the pharmaceutical manufacturers of TAI. Results are presented in a descriptive way. Results: The medical analysis included data from 184 RCT (vs. placebo and from 22 RCT (vs. anticoagulant drugs. The absolute reduction of IS (4.8% vs. 6.6%; p<0,00001 and SVE (10.0% vs. 12.4%; p<0,00001 were definitely higher than the absolute increase of bleeding complications (1.6% vs. 0.9%; p<0,00001, but relatively similar to this absolute increase in a subpopulation with a low risk for SVE. With regard to the stroke prevention, evidence of efficacy could be yielded for acetylsalicil acid (ASA, dipyridamole, cilostazol, ridogrel and the combination ASA with dipyridamole. ASA is less effective than anticoagulants in the prevention of ischaemic stroke in atrial fibrillation, however, it causes fewer bleeding complications.Low dosed ASA can be considered cost-effective in secondary prevention of ischemic stroke

Current issues of preventing tobacco use in secondary school graduates

Directory of Open Access Journals (Sweden)

Florova N.B.

2013-09-01

Full Text Available Here is identified the tendency to reduce the effectiveness of anti-tobacco prevention work among graduating students of secondary school. This decline may be due to psychological and social reasons. It is shown that risk factors of involving in chemical dependency are meaningfully disclosed in longitudinal studies, whereas the dynamics of personal change during the formation of anti-addictive prevention skills are more fully disclosed in the comparative age sections. The typical phenomena, accompanying the downward trend in prevention, are the growth of problem behavior and the crisis of mass dropout. Such phenomena are so great that they are recognized as a crisis at a state level.

Dabigatran experience in primary and secondary prevention of cardioembolic stroke

Directory of Open Access Journals (Sweden)

Maksim Alekseyevich Domashenko

2013-01-01

Full Text Available The review of novel oral anticoagulants (dabigatran, rivaroxaban and apixaban in stroke prevention and also own data of administration of dabigatran in primary and secondary prevention of ischemic stroke in 45 patients with cerebrovascular diseases are presented. Most patients received dabigatran 14 days after the first stroke associated with nonvalvular atrial fibrillation. In other cases dabigatran was used for primary prevention of stroke in patients with chronic forms of cerebrovascular diseases and nonvalvular atrial fibrillation. Dabigatran shows good tolerability and efficacy. Recurrent strokes were diagnosed in 2 patients. The reasons for these events were arterial hypertension in one case and symptomatic atherosclerotic plaque in the other case.

Fixed-dose combination therapy for the prevention of cardiovascular disease

Science.gov (United States)

de Cates, Angharad N; Farr, Matthew RB; Rees, Karen; Casas, Juan P; Huffman, Mark

2014-01-01

This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the effectiveness of fixed-dose combination therapy on optimising CVD risk factors and reducing CVD fatal and non-fatal events for both primary and secondary prevention of CVD. Details of CVD events and risk factors included are listed in the methods. We will also determine any adverse events associated with taking fixed-dose combination therapy. This will include studies conducted in both developed and developing regions of the world. PMID:25267903

Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population

Science.gov (United States)

There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demo...

Effectiveness of recommended drug classes in secondary prevention of acute coronary syndrome in France

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf; Ali, Sanni; Lassalle, Régis; De Boer, Anthonius; Moore, Nicholas; Klungel, Olaf; Pariente, Antoine

Background: Guidelines for cardiovascular secondary prevention are based on evidence from relatively old clinical trials and need to be evaluated in daily clinical practice. Objectives: To evaluate effectiveness of the recommended drug classes after an acute coronary syndrome (ACS) for secondary

Beam position optimisation for IMRT

International Nuclear Information System (INIS)

Holloway, L.; Hoban, P.

2001-01-01

Full text: The introduction of IMRT has not generally resulted in the use of optimised beam positions because to find the global solution of the problem a time consuming stochastic optimisation method must be used. Although a deterministic method may not achieve the global minimum it should achieve a superior dose distribution compared to no optimisation. This study aimed to develop and test such a method. The beam optimisation method developed relies on an iterative process to achieve the desired number of beams from a large initial number of beams. The number of beams is reduced in a 'weeding-out' process based on the total fluence which each beam delivers. The process is gradual, with only three beams removed each time (following a small number of iterations), ensuring that the reduction in beams does not dramatically affect the fluence maps of those remaining. A comparison was made between the dose distributions achieved when the beams positions were optimised in this fashion and when the beams positions were evenly distributed. The method has been shown to work quite effectively and efficiently. The Figure shows a comparison in dose distribution with optimised and non optimised beam positions for 5 beams. It can be clearly seen that there is an improvement in the dose distribution delivered to the tumour and a reduction in the dose to the critical structure with beam position optimisation. A method for beam position optimisation for use in IMRT optimisations has been developed. This method although not necessarily achieving the global minimum in beam position still achieves quite a dramatic improvement compared with no beam position optimisation and is very efficiently achieved. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

Advanced optimisation - coal fired power plant operations

Energy Technology Data Exchange (ETDEWEB)

Turney, D.M.; Mayes, I. [E.ON UK, Nottingham (United Kingdom)

2005-03-01

The purpose of this unit optimization project is to develop an integrated approach to unit optimisation and develop an overall optimiser that is able to resolve any conflicts between the individual optimisers. The individual optimisers have been considered during this project are: on-line thermal efficiency package, GNOCIS boiler optimiser, GNOCIS steam side optimiser, ESP optimisation, and intelligent sootblowing system. 6 refs., 7 figs., 3 tabs.

Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality.

Science.gov (United States)

Maxwell, Giliana M; Radzilani-Makatu, Makondelele; Takalani, James F

2016-04-01

Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education) suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP) in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS) software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. The conclusion drawn was that learners are aware of the measures for preventing TP.

Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality

Directory of Open Access Journals (Sweden)

Giliana M. Maxwell

2016-04-01

Full Text Available Background: Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. Aim: The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Setting: The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. Methodology: A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Results: Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. Conclusion: The conclusion drawn was that learners are aware of the measures for preventing TP. Keywords

HIV, other STD, and pregnancy prevention education in public secondary schools -- 45 states, 2008-2010.

Science.gov (United States)

2012-04-06

In the United States, 46% of high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and pregnancy. The National HIV/AIDS Strategy for the United States recommends educating young persons about HIV before they begin engaging in behaviors that place them at risk for HIV infection. The Community Preventive Services Task Force (CPSTF) also recommends risk reduction interventions to prevent HIV, other STDs, and pregnancy among adolescents. To estimate changes in the percentage of secondary schools that teach specific HIV, other STD, and pregnancy risk reduction topics, a key intervention consistent with those supported by the National HIV/AIDS Strategy and CPSTF, CDC analyzed 2008 and 2010 School Health Profiles data for public secondary schools in 45 states. This report summarizes the results of those analyses, which indicated that in 2010, compared with 2008, the percentage of secondary schools teaching 11 topics on HIV, other STD, and pregnancy prevention in a required course in grades 6, 7, or 8 was significantly lower in 11 states and significantly higher in none; the percentage of secondary schools teaching eight topics in a required course in grades 9, 10, 11, or 12 was significantly lower in one state and significantly higher in two states; and the percentage of secondary schools teaching three condom-related topics in a required course in grades 9, 10, 11, or 12 was significantly lower in eight states and significantly higher in three states. Secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics to help reduce risk behaviors among students.

Internal Medicine Hospitalists' Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures.

Science.gov (United States)

Tan, Eng Keong; Loh, Kah Poh; Goff, Sarah L

2017-12-01

Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center. The interviews were analyzed with directed content analysis. Internal medicine hospitalists consider secondary osteoporotic hip fracture prevention as the responsibility of outpatient physicians. Identified barriers were stratified based on themes including physicians' perception, patients' characteristics, risks and benefits of osteoporosis treatment, healthcare delivery system, and patient care transition from the inpatient to the outpatient setting. Some of the recommendations include building an integrated system that involves a multidisciplinary team such as the fracture liaison service, initiating a change to the hospital policy to facilitate inpatient care and management of osteoporosis, and creating a smooth patient care transition to the outpatient setting. Our study highlighted how internal medicine hospitalists perceive their role in the secondary prevention of osteoporotic hip fractures and what they perceive as barriers to initiating preventive measures in the hospital. Inconsistency in patient care transition and the fragmented nature of the existing healthcare system were identified as major barriers. A fracture liaison service could remove some of these barriers.

Combining simulation and multi-objective optimisation for equipment quantity optimisation in container terminals

OpenAIRE

Lin, Zhougeng

2013-01-01

This thesis proposes a combination framework to integrate simulation and multi-objective optimisation (MOO) for container terminal equipment optimisation. It addresses how the strengths of simulation and multi-objective optimisation can be integrated to find high quality solutions for multiple objectives with low computational cost. Three structures for the combination framework are proposed respectively: pre-MOO structure, integrated MOO structure and post-MOO structure. The applications of ...

Optimisation of the Laser Cutting Process

DEFF Research Database (Denmark)

Dragsted, Birgitte; Olsen, Flemmming Ove

1996-01-01

The problem in optimising the laser cutting process is outlined. Basic optimisation criteria and principles for adapting an optimisation method, the simplex method, are presented. The results of implementing a response function in the optimisation are discussed with respect to the quality as well...

Use of secondary prevention pharmacotherapy after first myocardial infarction in patients with diabetes mellitus

DEFF Research Database (Denmark)

Jørgensen, Casper H.; Gislason, Gunnar H.; Ahlehoff, Ole

2014-01-01

BACKGROUND: Despite recommended pharmacotherapies the use of secondary prevention therapy after myocardial infarction (MI) remains suboptimal. Patients with diabetes mellitus (DM) have worse prognosis after MI compared to patients without DM and aggressive secondary prevention pharmacotherapy......-blockers, and clopidogrel within 90 days, and statins within 180 days of discharge, respectively. RESULTS: A total of 78,230 patients were included, the mean age was 68.3 years (SD 13.0), 63.5% were men and 9,797 (12.5%) had diabetes. Comparison of claimed prescriptions in the period 1997-2002 and 2003-2006 showed...

Challenges in secondary prevention after acute myocardial infarction

DEFF Research Database (Denmark)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul

2016-01-01

-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus...... document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings...

Challenges in secondary prevention after acute myocardial infarction

DEFF Research Database (Denmark)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul

2017-01-01

-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus...... document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings...

Optimisation of NMR dynamic models II. A new methodology for the dual optimisation of the model-free parameters and the Brownian rotational diffusion tensor

International Nuclear Information System (INIS)

D'Auvergne, Edward J.; Gooley, Paul R.

2008-01-01

Finding the dynamics of an entire macromolecule is a complex problem as the model-free parameter values are intricately linked to the Brownian rotational diffusion of the molecule, mathematically through the autocorrelation function of the motion and statistically through model selection. The solution to this problem was formulated using set theory as an element of the universal set U-the union of all model-free spaces (d'Auvergne EJ and Gooley PR (2007) Mol BioSyst 3(7), 483-494). The current procedure commonly used to find the universal solution is to initially estimate the diffusion tensor parameters, to optimise the model-free parameters of numerous models, and then to choose the best model via model selection. The global model is then optimised and the procedure repeated until convergence. In this paper a new methodology is presented which takes a different approach to this diffusion seeded model-free paradigm. Rather than starting with the diffusion tensor this iterative protocol begins by optimising the model-free parameters in the absence of any global model parameters, selecting between all the model-free models, and finally optimising the diffusion tensor. The new model-free optimisation protocol will be validated using synthetic data from Schurr JM et al. (1994) J Magn Reson B 105(3), 211-224 and the relaxation data of the bacteriorhodopsin (1-36)BR fragment from Orekhov VY (1999) J Biomol NMR 14(4), 345-356. To demonstrate the importance of this new procedure the NMR relaxation data of the Olfactory Marker Protein (OMP) of Gitti R et al. (2005) Biochem 44(28), 9673-9679 is reanalysed. The result is that the dynamics for certain secondary structural elements is very different from those originally reported

ERECTA-family receptor kinase genes redundantly prevent premature progression of secondary growth in the Arabidopsis hypocotyl.

Science.gov (United States)

Ikematsu, Shuka; Tasaka, Masao; Torii, Keiko U; Uchida, Naoyuki

2017-03-01

Secondary growth is driven by continuous cell proliferation and differentiation of the cambium that acts as vascular stem cells, producing xylem and phloem to expand vascular tissues laterally. During secondary growth of hypocotyls in Arabidopsis thaliana, the xylem undergoes a drastic phase transition from a parenchyma-producing phase to a fiber-producing phase at the appropriate time. However, it remains to be fully elucidated how progression of secondary growth is properly controlled. We focused on phenotypes of hypocotyl vasculatures caused by double mutation in ERECTA (ER) and ER-LIKE1 (ERL1) receptor-kinase genes to elucidate their roles in secondary growth. ER and ERL1 redundantly suppressed excessive radial growth of the hypocotyl vasculature during secondary growth. ER and ERL1 also prevented premature initiation of the fiber differentiation process mediated by the NAC SECONDARY WALL THICKENING PROMOTING FACTORs in the hypocotyl xylem. Upon floral transition, the hypocotyl xylem gained a competency to respond to GA in a BREVIPEDICELLUS-dependent manner, which was a prerequisite for fiber differentiation. However, even after the floral transition, ER and ERL1 prevented precocious initiation of the GA-mediated fiber formation. Collectively, our findings reveal that ER and ERL1 redundantly prevent premature progression of sequential events in secondary growth. © 2016 The Authors. New Phytologist © 2016 New Phytologist Trust.

Challenges and opportunities for primary, secondary, and tertiary prevention of Chagas' disease.

Science.gov (United States)

Rassi, A; Dias, J C P; Marin-Neto, J A; Rassi, A

2009-04-01

A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.

Simulation optimisation

International Nuclear Information System (INIS)

Anon

2010-01-01

Over the past decade there has been a significant advance in flotation circuit optimisation through performance benchmarking using metallurgical modelling and steady-state computer simulation. This benchmarking includes traditional measures, such as grade and recovery, as well as new flotation measures, such as ore floatability, bubble surface area flux and froth recovery. To further this optimisation, Outotec has released its HSC Chemistry software with simulation modules. The flotation model developed by the AMIRA P9 Project, of which Outotec is a sponsor, is regarded by industry as the most suitable flotation model to use for circuit optimisation. This model incorporates ore floatability with flotation cell pulp and froth parameters, residence time, entrainment and water recovery. Outotec's HSC Sim enables you to simulate mineral processes in different levels, from comminution circuits with sizes and no composition, through to flotation processes with minerals by size by floatability components, to full processes with true particles with MLA data.

Risk of misclassification with a non-fasting lipid profile in secondary cardiovascular prevention.

Science.gov (United States)

Klop, Boudewijn; Hartong, Simone C C; Vermeer, Henricus J; Schoofs, Mariette W C J; Kofflard, Marcel J M

2017-09-01

Routinely fasting is not necessary for measuring the lipid profile according to the latest European consensus. However, LDL-C tends to be lower in the non-fasting state with risk of misclassification. The extent of misclassification in secondary cardiovascular prevention with a non-fasting lipid profile was investigated. 329 patients on lipid lowering therapy for secondary cardiovascular prevention measured a fasting and non-fasting lipid profile. Cut-off values for LDL-C, non-HDL-C and apolipoprotein B were set at fasting LDL-C (calculated using the Friedewald formula), direct LDL-C, non-HDL-C and apolipoprotein B. Net misclassification fasting measurements resulted in lower LDL-C (-0.2±0.4mmol/l, Pfasting LDL-C target of fasting state. In the non-fasting state net misclassification with direct LDL-C was 5.7% (95% CI 2.1-9.2%), 4.0% (95% CI 1.0-7.4%) with non-HDL-C and 4.1% (95% CI 1.1-9.1%) with apolipoprotein B. Use of non-fasting LDL-C as treatment target in secondary cardiovascular prevention resulted in significant misclassification with subsequent risk of undertreatment, whereas non-fasting direct LDL-C, non-HDL-C and apolipoprotein B are reliable parameters. Copyright © 2017 Elsevier B.V. All rights reserved.

Primary and Secondary Prevention Trials in Alzheimer Disease: Looking Back, Moving Forward

Science.gov (United States)

Hsu, David C.; Marshall, Gad A.

2015-01-01

The field of Alzheimer disease (AD) prevention has been a culmination of basic science, clinical, and translational research. In the past three years since the new 2011 AD diagnostic guidelines, large-scale collaborative efforts have embarked on new clinical trials with the hope of someday preventing AD. This review will shed light on the historical and scientific contexts in which these trials were based on, as well as discuss potential challenges these trials may face in the coming years. Primary preventive measures, such as lifestyle, multidomain, medication, and supplemental interventions, will be analyzed. Secondary prevention as represented by disease-modifying interventions, such as anti-amyloid therapy and pioglitazone, will also be reviewed. Finally, hypotheses on future directions for AD prevention trials will be proposed. PMID:27697063

An empirical study on website usability elements and how they affect search engine optimisation

Directory of Open Access Journals (Sweden)

Eugene B. Visser

2011-03-01

Full Text Available The primary objective of this research project was to identify and investigate the website usability attributes which are in contradiction with search engine optimisation elements. The secondary objective was to determine if these usability attributes affect conversion. Although the literature review identifies the contradictions, experts disagree about their existence.An experiment was conducted, whereby the conversion and/or traffic ratio results of an existing control website were compared to a usability-designed version of the control website,namely the experimental website. All optimisation elements were ignored, thus implementing only usability. The results clearly show that inclusion of the usability attributes positively affect conversion,indicating that usability is a prerequisite for effective website design. Search engine optimisation is also a prerequisite for the very reason that if a website does not rank on the first page of the search engine result page for a given keyword, then that website might as well not exist. According to this empirical work, usability is in contradiction to search engine optimisation best practices. Therefore the two need to be weighed up in terms of importance towards search engines and visitors.

Use of artificial intelligence techniques for optimisation of co-combustion of coal with biomass

Energy Technology Data Exchange (ETDEWEB)

Tan, C.K.; Wilcox, S.J.; Ward, J. [University of Glamorgan, Pontypridd (United Kingdom). Division of Mechanical Engineering

2006-03-15

The optimisation of burner operation in conventional pulverised-coal-fired boilers for co-combustion applications represents a significant challenge This paper describes a strategic framework in which Artificial Intelligence (AI) techniques can be applied to solve such an optimisation problem. The effectiveness of the proposed system is demonstrated by a case study that simulates the co-combustion of coal with sewage sludge in a 500-kW pilot-scale combustion rig equipped with a swirl stabilised low-NOx burner. A series of Computational Fluid Dynamics (CFD) simulations were performed to generate data for different operating conditions, which were then used to train several Artificial Neural Networks (ANNs) to predict the co-combustion performance. Once trained, the ANNs were able to make estimations of unseen situations in a fraction of the time taken by the CFD simulation. Consequently, the networks were capable of representing the underlying physics of the CFD models and could be executed efficiently for a large number of iterations as required by optimisation techniques based on Evolutionary Algorithms (EAs). Four operating parameters of the burner, namely the swirl angles and flow rates of the secondary and tertiary combustion air were optimised with the objective of minimising the NOx and CO emissions as well as the unburned carbon at the furnace exit. The results suggest that ANNs combined with EAs provide a useful tool for optimising co-combustion processes.

New insights into secondary prevention in post-traumatic stress disorder

Science.gov (United States)

Zohar, Joseph; Juven-Wetzler, Alzbeta; Sonnino, Rachel; Cwikel-Hamzany, Shlomit; Balaban, Evgenya; Cohen, Hagit

2011-01-01

Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies. PMID:22033784

Using "get with the guidelines" to improve cardiovascular secondary prevention.

Science.gov (United States)

LaBresh, Kenneth A; Gliklich, Richard; Liljestrand, James; Peto, Randolph; Ellrodt, A Gray

2003-10-01

"Get With The Guidelines (GWTG)" was developed and piloted by the American Heart Association (AHA), New England Affiliate; MassPRO, Inc.; and other organizations to reduce the gap in the application of secondary prevention guidelines in hospitalized cardiovascular disease patients. Collaborative learning programs and technology solutions were created for the project. The interactive Web-based patient management tool (PMT) was developed using quality measures derived from the AHA/American College of Cardiology secondary prevention guidelines. It provided data entry, embedded reminders and guideline summaries, and online reports of quality measure performance, including comparisons with the aggregate performance of all hospitals. Multidisciplinary teams from 24 hospitals participated in the 2000-2001 pilot. Four collaborative learning sessions and monthly conference calls supported team interaction. Best-practices sharing and the use of an Internet tool enabled hospitals to change systems and collect data on 1,738 patients. The GWTG program, a template of learning sessions with didactic presentations, best-practices sharing, and collaborative multidisciplinary team meetings supported by the Internet-based data collection and reporting system, can be extended to multiple regions without requiring additional development. Following the completion of the pilot, the AHA adopted GWTG as a national program.

Secondary prevention after minor stroke and TIA - usual care and development of a support program.

Directory of Open Access Journals (Sweden)

Stefanie Leistner

Full Text Available Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program.Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU. Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed.168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP: 155/84 mmHg and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg were assessed at 6 months. Proportions of patients with BP according to guidelines were 50% in usual-care and 77% in the support program (p<0.01. LDL<100 mg/dl was measured in 62 versus 71% (p = 0.12. Proportions of patients who stopped smoking were 50 versus 79% (p<0.01. 72 versus 89% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09.Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-vascular recurrence rates are going to be assessed in a multicenter randomized trial.

Decline in Coronary Mortality in Sweden between 1986 and 2002: Comparing Contributions from Primary and Secondary Prevention.

Directory of Open Access Journals (Sweden)

Lena Björck

Full Text Available The relative importance of risk factor reduction in healthy people (primary prevention versus that in patients with coronary heart disease (secondary prevention has been debated. We aimed to quantify the contribution of the two.We used the previously validated IMPACT model to estimate contributions from primary prevention (reducing risk factors in the population, particularly smoking, cholesterol and systolic blood pressure and from secondary prevention (reducing risk factors in coronary heart disease patients in the Swedish population.Between 1986 and 2002, about 8,690 fewer deaths were related to changes in the three major risk factors. Population cholesterol fell by 0.64 mmol/L, with approximately 5,210 fewer deaths attributable to diet changes (4,470 in healthy people740 in patients. plus 810 to statin treatment (200 in healthy people, 610 in patients. Overall smoking prevalence decreased by 10.3%, resulting in 1,195 fewer deaths, attributable to smoking cessation (595 in healthy people, 600 in patients. Mean population systolic blood pressure fell by 2.6 mmHg, resulting in 900 fewer deaths (865 in healthy people, 35 in patients, plus 575 fewer deaths attributable to antihypertensive medication in healthy people. The majority of falls in deaths attributable to risk factors occurred in people without known heart disease: 6,705 fewer deaths compared with 1,985 fewer deaths in patients (secondary prevention, emphasizing the importance of promoting health interventions in the general population.The largest effects on mortality came from primary prevention, giving markedly larger mortality reductions than secondary prevention.

Optimised Renormalisation Group Flows

CERN Document Server

Litim, Daniel F

2001-01-01

Exact renormalisation group (ERG) flows interpolate between a microscopic or classical theory and the corresponding macroscopic or quantum effective theory. For most problems of physical interest, the efficiency of the ERG is constrained due to unavoidable approximations. Approximate solutions of ERG flows depend spuriously on the regularisation scheme which is determined by a regulator function. This is similar to the spurious dependence on the ultraviolet regularisation known from perturbative QCD. Providing a good control over approximated ERG flows is at the root for reliable physical predictions. We explain why the convergence of approximate solutions towards the physical theory is optimised by appropriate choices of the regulator. We study specific optimised regulators for bosonic and fermionic fields and compare the optimised ERG flows with generic ones. This is done up to second order in the derivative expansion at both vanishing and non-vanishing temperature. An optimised flow for a ``proper-time ren...

Computer Based Optimisation Rutines

DEFF Research Database (Denmark)

Dragsted, Birgitte; Olsen, Flemmming Ove

1996-01-01

In this paper the need for optimisation methods for the laser cutting process has been identified as three different situations. Demands on the optimisation methods for these situations are presented, and one method for each situation is suggested. The adaptation and implementation of the methods...

Optimal Optimisation in Chemometrics

NARCIS (Netherlands)

Hageman, J.A.

2004-01-01

The use of global optimisation methods is not straightforward, especially for the more difficult optimisation problems. Solutions have to be found for items such as the evaluation function, representation, step function and meta-parameters, before any useful results can be obtained. This thesis aims

Cranialization of the frontal sinus for secondary mucocele prevention following open surgery for benign frontal lesions.

Directory of Open Access Journals (Sweden)

Gilad Horowitz

Full Text Available OBJECTIVE: To compare frontal sinus cranialization to obliteration for future prevention of secondary mucocele formation following open surgery for benign lesions of the frontal sinus. STUDY DESIGN: Retrospective case series. SETTING: Tertiary academic medical center. PATIENTS: Sixty-nine patients operated for benign frontal sinus pathology between 1994 and 2011. INTERVENTIONS: Open excision of benign frontal sinus pathology followed by either frontal obliteration (n = 41, 59% or frontal cranialization (n = 28, 41%. MAIN OUTCOME MEASURES: The prevalence of post-surgical complications and secondary mucocele formation were compiled. RESULTS: Pathologies included osteoma (n = 34, 49%, mucocele (n = 27, 39%, fibrous dysplasia (n = 6, 9%, and encephalocele (n = 2, 3%. Complications included skin infections (n = 6, postoperative cutaneous fistula (n = 1, telecanthus (n = 4, diplopia (n = 3, nasal deformity (n = 2 and epiphora (n = 1. None of the patients suffered from postoperative CSF leak, meningitis or pneumocephalus. Six patients, all of whom had previously undergone frontal sinus obliteration, required revision surgery due to secondary mucocele formation. Statistical analysis using non-inferiority test reveal that cranialization of the frontal sinus is non-inferior to obliteration for preventing secondary mucocele formation (P<0.0001. CONCLUSION: Cranialization of the frontal sinus appears to be a good option for prevention of secondary mucocele development after open excision of benign frontal sinus lesions.

Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review

Directory of Open Access Journals (Sweden)

Lynne V. McFarland

2015-04-01

Full Text Available Clostridium difficile infections are a global clinical concern and are one of the leading causes of nosocomial outbreaks. Preventing these infections has benefited from multidisciplinary infection control strategies and new antibiotics, but the problem persists. Probiotics are effective in preventing antibiotic-associated diarrhea and may also be a beneficial strategy for C. difficile infections, but randomized controlled trials are scarce. This meta-analysis pools 21 randomized, controlled trials for primary prevention of C. difficile infections (CDI and four trials for secondary prevention of C. difficile recurrences and assesses the efficacy of specific probiotic strains. Four probiotics significantly improved primary CDI prevention: (Saccharomyces boulardii, Lactobacillus casei DN114001, a mixture of L. acidophilus and Bifidobacterium bifidum, and a mixture of L. acidophilus, L. casei and L. rhamnosus. None of the tested probiotics significantly improved secondary prevention of CDI. More confirmatory randomized trials are needed to establish if probiotics are useful for preventing C. difficile infections. v

Secondary water treatment optimization in French PWRs: Recent ways of investigation and policy

Energy Technology Data Exchange (ETDEWEB)

Millet, L.; Serres, F. [Electricite de France, Group des Laboratoires (France); Vermeeren, D. [Electricite de France, Groupe Ingenierie Process (France); Moreaux, D. [Electricite de France, Groupe Environnement (France)

2002-07-01

In French nuclear power plants, the secondary water conditioning is essentially based on the use of a volatile amine and a reducing reagent. The additional use of a corrosion inhibitor is limited to units with secondary side corrosion of Alloy 600 MA SG tubes. The main aim of secondary water treatment optimisation is to achieve the best compromise as follows: to minimize the different types of corrosion of the different PWRs materials (copper corrosion, flow assisted corrosion, SG fouling and secondary side corrosion), to reduce operation and maintenance costs (short term and long term), to minimise the impacts on the environment, to protect workers health. In a first part, this paper describes the studies recently carried out to try to optimise the secondary water treatment in French PWRs. They concern the possibility to use ethanolamine (ETA) in replacement of morpholine and ammonia and the possibility to use carbohydrazide (CBH) in replacement of hydrazine. In a second part, this paper presents the French secondary water treatment policy established in 2000, which is depending on the presence or not of copper alloys. (authors)

Secondary water treatment optimization in French PWRs: Recent ways of investigation and policy

International Nuclear Information System (INIS)

Millet, L.; Serres, F.; Vermeeren, D.; Moreaux, D.

2002-01-01

In French nuclear power plants, the secondary water conditioning is essentially based on the use of a volatile amine and a reducing reagent. The additional use of a corrosion inhibitor is limited to units with secondary side corrosion of Alloy 600 MA SG tubes. The main aim of secondary water treatment optimisation is to achieve the best compromise as follows: to minimize the different types of corrosion of the different PWRs materials (copper corrosion, flow assisted corrosion, SG fouling and secondary side corrosion), to reduce operation and maintenance costs (short term and long term), to minimise the impacts on the environment, to protect workers health. In a first part, this paper describes the studies recently carried out to try to optimise the secondary water treatment in French PWRs. They concern the possibility to use ethanolamine (ETA) in replacement of morpholine and ammonia and the possibility to use carbohydrazide (CBH) in replacement of hydrazine. In a second part, this paper presents the French secondary water treatment policy established in 2000, which is depending on the presence or not of copper alloys. (authors)

The effects of a three-year smoking prevention programme in secondary schools in Helsinki.

Science.gov (United States)

Vartiainen, Erkki; Pennanen, Marjaana; Haukkala, Ari; Dijk, Froukje; Lehtovuori, Riku; De Vries, Hein

2007-06-01

This study evaluates the effects of a 3-year smoking prevention programme in secondary schools in Helsinki. The study is part of the European Smoking prevention Framework Approach (ESFA), in which Denmark, Finland, the Netherlands, Portugal, Spain and the UK participated. A total of 27 secondary schools in Finland participated in the programme (n = 1821). Schools were randomised into experimental (13) and control groups (14). The programme included 14 information lessons about smoking and refusal skills training. The 3-year smoking prevention programme was also integrated into the standard curriculum. The community-element of the programme included parents, parish confirmation camps and dentists. The schools in the experimental group received the prevention programme and the schools in the control group received the standard health education curriculum. Among baseline never smokers (60.8%), the programme had a significant effect on the onset of weekly smoking in the experimental group [OR = 0.63 (0.45-0.90) P = 0.009] when compared with the control group. Being female, doing poorly at school, having parents and best friends who smoke and more pocket money to spend compared with others were associated with an increased likelihood of daily and weekly smoking onset. These predictors did not have an interaction effect with the experimental condition. This study shows that a school- and community-based smoking prevention programme can prevent smoking onset among adolescents.

Lifestyle and precision diabetes medicine: will genomics help optimise the prediction, prevention and treatment of type 2 diabetes through lifestyle therapy?

Science.gov (United States)

Franks, Paul W; Poveda, Alaitz

2017-05-01

Precision diabetes medicine, the optimisation of therapy using patient-level biomarker data, has stimulated enormous interest throughout society as it provides hope of more effective, less costly and safer ways of preventing, treating, and perhaps even curing the disease. While precision diabetes medicine is often framed in the context of pharmacotherapy, using biomarkers to personalise lifestyle recommendations, intended to lower type 2 diabetes risk or to slow progression, is also conceivable. There are at least four ways in which this might work: (1) by helping to predict a person's susceptibility to adverse lifestyle exposures; (2) by facilitating the stratification of type 2 diabetes into subclasses, some of which may be prevented or treated optimally with specific lifestyle interventions; (3) by aiding the discovery of prognostic biomarkers that help guide timing and intensity of lifestyle interventions; (4) by predicting treatment response. In this review we overview the rationale for precision diabetes medicine, specifically as it relates to lifestyle; we also scrutinise existing evidence, discuss the barriers germane to research in this field and consider how this work is likely to proceed.

Pharmacoepidemiological analysis of the drugs used for secondary prevention of brain infarction on dispensary stage

Directory of Open Access Journals (Sweden)

Miheyeva N.V.

2014-03-01

Full Text Available Aim. The secondary prevention of cerebral infarction on dispensary stage to current clinical guidelines was analyzed. Adherence of patients to prescribe medications was evaluated. Material and methods. 106 patients of hospital neurologic department with brain infarction were included in prospective pharmacoepidemiological study of the drugs used for secondary prevention of brain infarction on dispensary stage since 1 January 2009 to 31 December 2009. Duration of outpatient observation was 3 years. Results. All of the patients were of 64,9 ± 10,3 years old. Hypertension was diagnosed in 102 of them (96.2%, atrial fibrillation — in 33 (31.1% patients. 39 (36.8% patients died during 3 years after discharge from the hospital. ACE inhibitors/angiotensin II receptor antagonist were prescribed for 83 (78.3% patients, antiplatelet- 76 (71,7%, statins — 16 (15,1% patients in discharge from hospital. Warfarin was prescribed only for 1 (3.05% patient with atrial fibrillation and ischemic stroke.consumption of drugs with evidence efficiency were diminished already after one year of observation in outpatient clinics. Conclusion.Therapy for secondary stroke prevention is not fully comply with current clinical guidelines

Availability of human immunodeficiency virus prevention services in secondary schools in Kabarole District, Uganda

Directory of Open Access Journals (Sweden)

Jane Namuddu

2015-08-01

Full Text Available The aim of this study was to assess the level of availability of HIV prevention strategies in secondary schools in Kabarole district, Uganda in order to inform the design of interventions to strengthen HIV Prevention and psychosocial support. Quantitative and qualitative research methods were used in eight secondary schools in Kabarole district to establish available HIV prevention and psychosocial support services. Questionnaires were administered to 355 students 12-24 years old. In addition, 20 Key Informant interviews were held with education service providers. Quantitative data was analyzed using Epi-data and qualitative data were analyzed by thematic content analysis. Seven of the eight schools had at least one HIV prevention strategy. Two teachers in each of the five schools had been trained in HIV prevention. No school had a nurse trained in HIV prevention, care and support. Education service providers had limited knowledge of HIV prevention support and care of students living with HIV. We found out that students had knowledge on how one can acquire HIV. HIV prevention services reported by students in schools included: talks from teachers and guests (19%, drama with HIV prevention related messages (16%, peer education clubs (15%, workshops and seminars on HIV (8%, sensitization about HIV/AIDS (7%, guidance and counseling (6%, talking compounds- (5%, abstinence talks (6%, keeping students busy in sports (4%, straight talk (4%. Sixty three percent reported receiving HIV reading materials from various sources. Preventing HIV infection among students in schools is still demanding with limited interventions for students. Efforts to support school interventions should focus on including HIV Prevention in the school curriculum, working with peer educators as well as education service providers who spend much of the time with the students while at school.

Achieving secondary prevention low-density lipoprotein particle concentration goals using lipoprotein cholesterol-based data.

Directory of Open Access Journals (Sweden)

Simon C Mathews

Full Text Available BACKGROUND: Epidemiologic studies suggest that LDL particle concentration (LDL-P may remain elevated at guideline recommended LDL cholesterol goals, representing a source of residual risk. We examined the following seven separate lipid parameters in achieving the LDL-P goal of <1000 nmol/L goal for very high risk secondary prevention: total cholesterol to HDL cholesterol ratio, TC/HDL, <3; a composite of ATP-III very high risk targets, LDL-C<70 mg/dL, non-HDL-C<100 mg/dL and TG<150 mg/dL; a composite of standard secondary risk targets, LDL-C<100, non-HDL-C<130, TG<150; LDL phenotype; HDL-C ≥ 40; TG<150; and TG/HDL-C<3. METHODS: We measured ApoB, ApoAI, ultracentrifugation lipoprotein cholesterol and NMR lipoprotein particle concentration in 148 unselected primary and secondary prevention patients. RESULTS: TC/HDL-C<3 effectively discriminated subjects by LDL-P goal (F = 84.1, p<10(-6. The ATP-III very high risk composite target (LDL-C<70, nonHDL-C<100, TG<150 was also effective (F = 42.8, p<10(-5. However, the standard secondary prevention composite (LDL-C<100, non-HDL-C<130, TG<150 was also effective but yielded higher LDL-P than the very high risk composite (F = 42.0, p<10(-5 with upper 95% confidence interval of LDL-P less than 1000 nmol/L. TG<150 and TG/HDL-C<3 cutpoints both significantly discriminated subjects but the LDL-P upper 95% confidence intervals fell above goal of 1000 nmol/L (F = 15.8, p = 0.0001 and F = 9.7, p = 0.002 respectively. LDL density phenotype neared significance (F = 2.85, p = 0.094 and the HDL-C cutpoint of 40 mg/dL did not discriminate (F = 0.53, p = 0.47 alone or add discriminatory power to ATP-III targets. CONCLUSIONS: A simple composite of ATP-III very high risk lipoprotein cholesterol based treatment targets or TC/HDL-C ratio <3 most effectively identified subjects meeting the secondary prevention target level of LDL-P<1000 nmol/L, providing a potential alternative to advanced lipid testing in many clinical

Multi-Optimisation Consensus Clustering

Science.gov (United States)

Li, Jian; Swift, Stephen; Liu, Xiaohui

Ensemble Clustering has been developed to provide an alternative way of obtaining more stable and accurate clustering results. It aims to avoid the biases of individual clustering algorithms. However, it is still a challenge to develop an efficient and robust method for Ensemble Clustering. Based on an existing ensemble clustering method, Consensus Clustering (CC), this paper introduces an advanced Consensus Clustering algorithm called Multi-Optimisation Consensus Clustering (MOCC), which utilises an optimised Agreement Separation criterion and a Multi-Optimisation framework to improve the performance of CC. Fifteen different data sets are used for evaluating the performance of MOCC. The results reveal that MOCC can generate more accurate clustering results than the original CC algorithm.

Particle swarm optimisation classical and quantum perspectives

CERN Document Server

Sun, Jun; Wu, Xiao-Jun

2016-01-01

IntroductionOptimisation Problems and Optimisation MethodsRandom Search TechniquesMetaheuristic MethodsSwarm IntelligenceParticle Swarm OptimisationOverviewMotivationsPSO Algorithm: Basic Concepts and the ProcedureParadigm: How to Use PSO to Solve Optimisation ProblemsSome Harder Examples Some Variants of Particle Swarm Optimisation Why Does the PSO Algorithm Need to Be Improved? Inertia and Constriction-Acceleration Techniques for PSOLocal Best ModelProbabilistic AlgorithmsOther Variants of PSO Quantum-Behaved Particle Swarm Optimisation OverviewMotivation: From Classical Dynamics to Quantum MechanicsQuantum Model: Fundamentals of QPSOQPSO AlgorithmSome Essential ApplicationsSome Variants of QPSOSummary Advanced Topics Behaviour Analysis of Individual ParticlesConvergence Analysis of the AlgorithmTime Complexity and Rate of ConvergenceParameter Selection and PerformanceSummaryIndustrial Applications Inverse Problems for Partial Differential EquationsInverse Problems for Non-Linear Dynamical SystemsOptimal De...

Obstacles to the Primary and Secondary Prevention of Breast Cancer in African-American Women

National Research Council Canada - National Science Library

Hargreaves, Margaret

1997-01-01

Study objectives are to develop a quantitative assessment tool to describe barriers to primary and secondary prevention of breast cancer, to use this tool to establish preliminary norms in an urban...

The Centers for Disease Control program to prevent primary and secondary disabilities in the United States.

OpenAIRE

Houk, V N; Thacker, S B

1989-01-01

The Disabilities Prevention Program builds on traditional Centers for Disease Control (CDC) strengths in public health surveillance, epidemiology, and technology transfer to State and local governments in translating the findings of research into prevention programs. The objectives of the CDC program are to provide a national focus for the prevention of primary and secondary disabilities, build capacity at the State and community levels to maintain programs to prevent disabilities, and increa...

Evolutionary programming for neutron instrument optimisation

Energy Technology Data Exchange (ETDEWEB)

Bentley, Phillip M. [Hahn-Meitner Institut, Glienicker Strasse 100, D-14109 Berlin (Germany)]. E-mail: phillip.bentley@hmi.de; Pappas, Catherine [Hahn-Meitner Institut, Glienicker Strasse 100, D-14109 Berlin (Germany); Habicht, Klaus [Hahn-Meitner Institut, Glienicker Strasse 100, D-14109 Berlin (Germany); Lelievre-Berna, Eddy [Institut Laue-Langevin, 6 rue Jules Horowitz, BP 156, 38042 Grenoble Cedex 9 (France)

2006-11-15

Virtual instruments based on Monte-Carlo techniques are now integral part of novel instrumentation development and the existing codes (McSTAS and Vitess) are extensively used to define and optimise novel instrumental concepts. Neutron spectrometers, however, involve a large number of parameters and their optimisation is often a complex and tedious procedure. Artificial intelligence algorithms are proving increasingly useful in such situations. Here, we present an automatic, reliable and scalable numerical optimisation concept based on the canonical genetic algorithm (GA). The algorithm was used to optimise the 3D magnetic field profile of the NSE spectrometer SPAN, at the HMI. We discuss the potential of the GA which combined with the existing Monte-Carlo codes (Vitess, McSTAS, etc.) leads to a very powerful tool for automated global optimisation of a general neutron scattering instrument, avoiding local optimum configurations.

Evolutionary programming for neutron instrument optimisation

International Nuclear Information System (INIS)

Bentley, Phillip M.; Pappas, Catherine; Habicht, Klaus; Lelievre-Berna, Eddy

2006-01-01

Virtual instruments based on Monte-Carlo techniques are now integral part of novel instrumentation development and the existing codes (McSTAS and Vitess) are extensively used to define and optimise novel instrumental concepts. Neutron spectrometers, however, involve a large number of parameters and their optimisation is often a complex and tedious procedure. Artificial intelligence algorithms are proving increasingly useful in such situations. Here, we present an automatic, reliable and scalable numerical optimisation concept based on the canonical genetic algorithm (GA). The algorithm was used to optimise the 3D magnetic field profile of the NSE spectrometer SPAN, at the HMI. We discuss the potential of the GA which combined with the existing Monte-Carlo codes (Vitess, McSTAS, etc.) leads to a very powerful tool for automated global optimisation of a general neutron scattering instrument, avoiding local optimum configurations

Topology optimised wavelength dependent splitters

DEFF Research Database (Denmark)

Hede, K. K.; Burgos Leon, J.; Frandsen, Lars Hagedorn

A photonic crystal wavelength dependent splitter has been constructed by utilising topology optimisation1. The splitter has been fabricated in a silicon-on-insulator material (Fig. 1). The topology optimised wavelength dependent splitter demonstrates promising 3D FDTD simulation results....... This complex photonic crystal structure is very sensitive against small fabrication variations from the expected topology optimised design. A wavelength dependent splitter is an important basic building block for high-performance nanophotonic circuits. 1J. S. Jensen and O. Sigmund, App. Phys. Lett. 84, 2022...

Fibrates for secondary prevention of cardiovascular disease and stroke.

Science.gov (United States)

Wang, Deren; Liu, Bian; Tao, Wendan; Hao, Zilong; Liu, Ming

2015-10-25

Fibrates are a class of drugs characterised by mainly lowering high triglyceride, raising high-density lipoprotein (HDL) cholesterol, and lowering the small dense fraction of low-density lipoprotein (LDL) cholesterol. Their efficacy for secondary prevention of serious vascular events is unclear, and to date no systematic review focusing on secondary prevention has been undertaken. To assess the efficacy and safety of fibrates for the prevention of serious vascular events in people with previous cardiovascular disease (CVD), including coronary heart disease and stroke. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 9, 2014) on the Cochrane Library, MEDLINE (OVID, 1946 to October week 1 2014), EMBASE (OVID, 1980 to 2014 week 41), the China Biological Medicine Database (CBM) (1978 to 2014), the Chinese National Knowledge Infrastructure (CNKI) (1979 to 2014), Chinese Science and Technique Journals Database (VIP) (1989 to 2014). We also searched other resources, such as ongoing trials registers and databases of conference abstracts, to identify further published, unpublished, and ongoing studies. We included randomised controlled trials (RCTs) in which a fibrate (for example gemfibrozil, fenofibrate) was compared with placebo or no treatment. We excluded RCTs with only laboratory outcomes. We also excluded trials comparing two different fibrates without a placebo or no-treatment control. Two review authors independently selected trials for inclusion, assessed risk of bias, and extracted the data. We contacted authors of trials for missing data. We included 13 trials involving a total of 16,112 participants. Eleven trials recruited participants with history of coronary heart disease, two trials recruited participants with history of stroke, and one trial recruited participants with a mix of people with CVD. We judged overall risk of bias to be moderate. The meta-analysis (including all fibrate trials) showed evidence for a protective

Secondary prevention at 360°: the important role of diagnostic imaging.

Science.gov (United States)

Ciarrapico, Anna Micaela; Manenti, Guglielmo; Pistolese, Chiara; Fabiano, Sebastiano; Fiori, Roberto; Romagnoli, Andrea; Sergiacomi, Gianluigi; Stefanini, Matteo; Simonetti, Giovanni

2015-06-01

The aim of this paper is to underline the importance of the role of general practitioners (GPs) in distributing vital information about prevention to citizens, to highlight the importance of the so-called voluntary prevention programmes, both for conditions for which no organised screening programmes exist and for those for which they do exist but may well be obsolete or inefficient. Nowadays, voluntary prevention is made more effective thanks to the new sophisticated diagnostic technologies applied worldwide by diagnostic imaging. Epidemiological data about the incidence and causes of death among the Italian population have shown that screening programmes should be aimed first at fighting the following diseases: prostatic carcinoma, lung cancer, colorectal carcinoma, breast cancer, cardiovascular disease, cerebrovascular disease, aortic and peripheral vascular disease. GPs do not generally give good or adequate instructions concerning voluntary prevention programmes; GPs may not even be aware of this type of prevention which could represent a valuable option together with the existing mass screening programmes. Therefore, in the following analysis, we aim to outline the correct diagnostic pathway for the prevention of diseases having the highest incidence in our country and which represent the most frequent causes of death. If used correctly, these screening programmes may contribute to the success of secondary prevention, limiting the use of tertiary prevention and thus producing savings for the Italian National Health System.

Optimising Magnetostatic Assemblies

DEFF Research Database (Denmark)

Insinga, Andrea Roberto; Smith, Anders

theorem. This theorem formulates an energy equivalence principle with several implications concerning the optimisation of objective functionals that are linear with respect to the magnetic field. Linear functionals represent different optimisation goals, e.g. maximising a certain component of the field...... approached employing a heuristic algorithm, which led to new design concepts. Some of the procedures developed for linear objective functionals have been extended to non-linear objectives, by employing iterative techniques. Even though most the optimality results discussed in this work have been derived...

Measuring Promotion and Prevention Orientations of Secondary School Students: It Is More Than Meets the Eye

Science.gov (United States)

Hodis, Flaviu A.; Hattie, John A. C.; Hodis, Georgeta M.

2016-01-01

The General Regulatory Focus Measure has been used extensively in psychological research to gauge promotion and prevention orientations. Findings of this research show that for New Zealand secondary school students, the General Regulatory Focus Measure does not measure promotion and prevention as theoretically independent constructs.

Primary and Secondary Prevention of Colorectal Cancer

Directory of Open Access Journals (Sweden)

Pedro J. Tárraga López

2014-07-01

Full Text Available Introduction Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. Colorectal cancer (CRC is the third most frequent cancer in men, after lung and prostate cancer, and is the second most frequent cancer in women after breast cancer. It is also the third cause of death in men and women separately, and is the second most frequent cause of death by cancer if both genders are considered together. CRC represents approximately 10% of deaths by cancer. Modifiable risk factors of CRC include smoking, physical inactivity, being overweight and obesity, eating processed meat, and drinking alcohol excessively. CRC screening programs are possible only in economically developed countries. However, attention should be paid in the future to geographical areas with ageing populations and a western lifestyle. 19 , 20 Sigmoidoscopy screening done with people aged 55-64 years has been demonstrated to reduce the incidence of CRC by 33% and mortality by CRC by 43%. Objective To assess the effect on the incidence and mortality of CRC diet and lifestyle and to determine the effect of secondary prevention through early diagnosis of CRC. Methodology A comprehensive search of Medline and Pubmed articles related to primary and secondary prevention of CRC and subsequently, a meta-analysis of the same blocks are performed. Results 225 articles related to primary or secondary prevention of CRC were retrieved. Of these 145 were considered valid on meta-analysis: 12 on epidemiology, 56 on diet and lifestyle, and over 77 different screenings for early detection of CRC. Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. There is no doubt whatsoever which environmental factors, probably diet, may account for these cancer rates. Excessive alcohol consumption and cholesterol-rich diet are associated with a high risk of colon cancer. A diet poor in folic acid and vitamin

[Preventive dentistry 5. Secondary caries].

NARCIS (Netherlands)

Hollanders, A.C.C.; Kuper, N.K.; Opdam, N.J.M.; Huysmans, M.C.D.N.J.M.

2017-01-01

Secondary caries is reported as one of the most important reasons for replacing restorations. The patient's general caries risk plays an important role in the development of secondary caries. The connection, at the patient level, between various factors, the risk of caries and restoration factors,

Primary and secondary prevention of skin cancer in mountain guides: attitude and motivation for or against participation.

Science.gov (United States)

Zink, Alexander; Thome, Frank; Schielein, Maximilian; Spinner, Christoph D; Biedermann, Tilo; Tizek, Linda

2018-05-30

Outdoor professionals such as mountain guides are at a substantial risk of developing non-melanoma skin cancer (NMSC) due to solar ultraviolet radiation (UVR) exposure. Despite major recent primary prevention efforts, studies on secondary skin cancer prevention efforts are limited and corresponding data on outdoor workers scarce. To assess the sun-protective behavior and individual motivations for or against skin cancer screening examinations in the German mountain guide population to aid in the development of effective awareness and prevention strategies. A cross-sectional study among all registered mountain guides in Germany was conducted using a 35-item online questionnaire on primary and secondary prevention of NMSC as well as perceived barriers for prevention. A total of 145 mountain guides participated in the study in January 2017. Of these, 86.2% reported using sunscreen often or always, 62.1% with a sun protection factor (SPF) of 30-50; and 60.7% had undergone dermatological examination by a medical professional. The most common reasons for using secondary prevention efforts were hope of an early diagnosis (77.3%), fear of skin cancer (73.9%), and the intention to be aware of one's own health (70.5%). The main reasons for not doing so were absence of conspicuous skin conditions (63.2%), and feeling healthy (59.6%). Awareness of prevention strategies recommended by the scientific community is low among affected occupationally high-risk mountain guide populations. Understanding the specific needs of this high-risk group is essential for the development of sustainable awareness and prevention strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A qualitative assessment of program characteristics for preventing secondary conditions in individuals with fetal alcohol spectrum disorders.

Science.gov (United States)

Patrenko, Christie L M; Tahir, Naira; Mahoney, Erin C; Chin, Nancy P

2014-01-01

Fetal alcohol spectrum disorders (FASD) are a major public health problem that affects 2 to 5 percent of the population. Individuals with FASD are at high risk for secondary conditions, such as mental health problems, school disruptions, and trouble with the law. Evidence-based intervention programs are needed to prevent and treat secondary conditions in this population. The purpose of this study was to identify intervention program characteristics for preventing secondary conditions in individuals with FASD from the perspectives of parents and service providers. This qualitative study utilized a phenomenological approach to identify program characteristics for preventing secondary conditions. Twenty-five parents of children (ages 3 to 33) with FASD and 18 service providers participated in focus groups or individual interviews. Data was systematically analyzed using a framework approach. Themes did not differ by participant type. Participants emphasized five primary characteristics of intervention programs for individuals with FASD. Programs need to 1) be available to individuals across the lifespan, 2) have a prevention focus, 3) be individualized, 4) be comprehensive, and 5) be coordinated across systems and developmental stages. Participants discussed a variety of specific intervention strategies for each developmental stage and setting. Program characteristics identified in this study are consistent with a positive behavior support framework. This framework is discussed in the context of research on existing interventions for individuals with FASD, and recommendations for future intervention development and evaluation are highlighted.

Optimising Shovel-Truck Fuel Consumption using Stochastic ...

African Journals Online (AJOL)

Optimising the fuel consumption and truck waiting time can result in significant fuel savings. The paper demonstrates that stochastic simulation is an effective tool for optimising the utilisation of fossil-based fuels in mining and related industries. Keywords: Stochastic, Simulation Modelling, Mining, Optimisation, Shovel-Truck ...

Optimisation of technical specifications using probabilistic methods

International Nuclear Information System (INIS)

Ericsson, G.; Knochenhauer, M.; Hultqvist, G.

1986-01-01

During the last few years the development of methods for modifying and optimising nuclear power plant Technical Specifications (TS) for plant operations has received increased attention. Probalistic methods in general, and the plant and system models of probabilistic safety assessment (PSA) in particular, seem to provide the most forceful tools for optimisation. This paper first gives some general comments on optimisation, identifying important parameters and then gives a description of recent Swedish experiences from the use of nuclear power plant PSA models and results for TS optimisation

A joint spare part and maintenance inspection optimisation model using the Delay-Time concept

International Nuclear Information System (INIS)

Wang Wenbin

2011-01-01

Spare parts and maintenance are closely related logistics activities where maintenance generates the need for spare parts. When preventive maintenance is present, it may need more spare parts at one time because of the planned preventive maintenance activities. This paper considers the joint optimisation of three decision variables, e.g., the ordering quantity, ordering interval and inspection interval. The model is constructed using the well-known Delay-Time concept where the failure process is divided into a two-stage process. The objective function is the long run expected cost per unit time in terms of the three decision variables to be optimised. Here we use a block-based inspection policy where all components are inspected at the same time regardless of the ages of the components. This creates a situation that the time to failure since the immediate previous inspection is random and has to be modelled by a distribution. This time is called the forward time and a limiting but closed form of such distribution is obtained. We develop an algorithm for the optimal solution of the decision process using a combination of analytical and enumeration approaches. The model is demonstrated by a numerical example. - Highlights: → Joint optimisation of maintenance and spare part inventory. → The use of the Delay-Time concept. → Block-based inspection. → Fixed order interval but variable order quantity.

Turbulence optimisation in stellarator experiments

Energy Technology Data Exchange (ETDEWEB)

Proll, Josefine H.E. [Max-Planck/Princeton Center for Plasma Physics (Germany); Max-Planck-Institut fuer Plasmaphysik, Wendelsteinstr. 1, 17491 Greifswald (Germany); Faber, Benjamin J. [HSX Plasma Laboratory, University of Wisconsin-Madison, Madison, WI 53706 (United States); Helander, Per; Xanthopoulos, Pavlos [Max-Planck/Princeton Center for Plasma Physics (Germany); Lazerson, Samuel A.; Mynick, Harry E. [Plasma Physics Laboratory, Princeton University, P.O. Box 451 Princeton, New Jersey 08543-0451 (United States)

2015-05-01

Stellarators, the twisted siblings of the axisymmetric fusion experiments called tokamaks, have historically suffered from confining the heat of the plasma insufficiently compared with tokamaks and were therefore considered to be less promising candidates for a fusion reactor. This has changed, however, with the advent of stellarators in which the laminar transport is reduced to levels below that of tokamaks by shaping the magnetic field accordingly. As in tokamaks, the turbulent transport remains as the now dominant transport channel. Recent analytical theory suggests that the large configuration space of stellarators allows for an additional optimisation of the magnetic field to also reduce the turbulent transport. In this talk, the idea behind the turbulence optimisation is explained. We also present how an optimised equilibrium is obtained and how it might differ from the equilibrium field of an already existing device, and we compare experimental turbulence measurements in different configurations of the HSX stellarator in order to test the optimisation procedure.

Fire hazard analysis at the first unit of the Ignalina nuclear power plant: 1. Analysis of fire prevention and ventilation systems and secondary effects

International Nuclear Information System (INIS)

Poskas, P.; Simonis, V.; Zujus, R. and others

2004-01-01

Evaluation of the fire prevention and ventilation systems and the secondary effects on safety at the Ignalina NPP from the point of view of fire hazard using computerized system is presented. Simplified screening algorithms for fire prevention, ventilation and the evaluation of secondary effects are developed, which allow accelerating fire hazard analysis at the Ignalina NPP. The analysis indicated that the fire prevention systems practically meet the national requirements and international recommendations for fire prevention. But it is necessary to introduce in separate rooms the measures improving fire prevention to guarantee the effective functioning of the ventilation systems and the reduction of the influence of secondary effects on safety. Computerized system of fire prevention and ventilation systems and evaluation of secondary effects on safety can be easily applied for fire hazard analysis at different big plants. (author)

Economic Evaluation of Lipid-Lowering Therapy in the Secondary Prevention Setting in the Philippines.

Science.gov (United States)

Tumanan-Mendoza, Bernadette A; Mendoza, Victor L

2013-05-01

To determine the cost-effectiveness of lipid-lowering therapy in the secondary prevention of cardiovascular events in the Philippines. A cost-utility analysis was performed by using Markov modeling in the secondary prevention setting. The models incorporated efficacy of lipid-lowering therapy demonstrated in randomized controlled trials and mortality rates obtained from local life tables. Average and incremental cost-effectiveness ratios were obtained for simvastatin, atorvastatin, pravastatin, and gemfibrozil. The costs of the following were included: medications, laboratory examinations, consultation and related expenses, and production losses. The costs were expressed in current or nominal prices as of the first quarter of 2010 (Philippine peso). Utility was expressed in quality-adjusted life-years gained. Sensitivity analyses were performed by using variations in the cost centers, discount rates, starting age, and differences in utility weights for stroke. In the analysis using the lower-priced generic counterparts, therapy using 40 mg simvastatin daily was the most cost-effective option compared with the other therapies, while pravastatin 40 mg daily was the most cost-effective alternative if the higher-priced innovator drugs were used. In all sensitivity analyses, gemfibrozil was strongly dominated by the statins. In secondary prevention, simvastatin or pravastatin were the most cost-effective options compared with atorvastatin and gemfibrozil in the Philippines. Gemfibrozil was strongly dominated by the statins. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Layout Optimisation of Wave Energy Converter Arrays

DEFF Research Database (Denmark)

Ruiz, Pau Mercadé; Nava, Vincenzo; Topper, Mathew B. R.

2017-01-01

This paper proposes an optimisation strategy for the layout design of wave energy converter (WEC) arrays. Optimal layouts are sought so as to maximise the absorbed power given a minimum q-factor, the minimum distance between WECs, and an area of deployment. To guarantee an efficient optimisation......, a four-parameter layout description is proposed. Three different optimisation algorithms are further compared in terms of performance and computational cost. These are the covariance matrix adaptation evolution strategy (CMA), a genetic algorithm (GA) and the glowworm swarm optimisation (GSO) algorithm...

Topology optimisation of natural convection problems

DEFF Research Database (Denmark)

Alexandersen, Joe; Aage, Niels; Andreasen, Casper Schousboe

2014-01-01

This paper demonstrates the application of the density-based topology optimisation approach for the design of heat sinks and micropumps based on natural convection effects. The problems are modelled under the assumptions of steady-state laminar flow using the incompressible Navier-Stokes equations...... coupled to the convection-diffusion equation through the Boussinesq approximation. In order to facilitate topology optimisation, the Brinkman approach is taken to penalise velocities inside the solid domain and the effective thermal conductivity is interpolated in order to accommodate differences...... in thermal conductivity of the solid and fluid phases. The governing equations are discretised using stabilised finite elements and topology optimisation is performed for two different problems using discrete adjoint sensitivity analysis. The study shows that topology optimisation is a viable approach...

Use of a computerized decision support system for primary and secondary prevention of work-related MSD disability.

Science.gov (United States)

Womack, Sarah K; Armstrong, Thomas J

2005-09-01

The present study evaluates the effectiveness of a decision support system used to evaluate and control physical job stresses and prevent re-injury of workers who have experienced or are concerned about work-related musculoskeletal disorders. The software program is a database that stores detailed job information such as standardized work data, videos, and upper-extremity physical stress ratings for over 400 jobs in the plant. Additionally, the database users were able to record comments about the jobs and related control issues. The researchers investigated the utility and effectiveness of the software by analyzing its use over a 20-month period. Of the 197 comments entered by the users, 25% pertained to primary prevention, 75% pertained to secondary prevention, and 94 comments (47.7%) described ergonomic interventions. Use of the software tool improved primary and secondary prevention by improving the quality and efficiency of the ergonomic job analysis process.

Dose optimisation in single plane interstitial brachytherapy

DEFF Research Database (Denmark)

Tanderup, Kari; Hellebust, Taran Paulsen; Honoré, Henriette Benedicte

2006-01-01

patients,       treated for recurrent rectal and cervical cancer, flexible catheters were       sutured intra-operatively to the tumour bed in areas with compromised       surgical margin. Both non-optimised, geometrically and graphically       optimised CT -based dose plans were made. The overdose index...... on the       regularity of the implant, such that the benefit of optimisation was       larger for irregular implants. OI and HI correlated strongly with target       volume limiting the usability of these parameters for comparison of dose       plans between patients. CONCLUSIONS: Dwell time optimisation significantly......BACKGROUND AND PURPOSE: Brachytherapy dose distributions can be optimised       by modulation of source dwell times. In this study dose optimisation in       single planar interstitial implants was evaluated in order to quantify the       potential benefit in patients. MATERIAL AND METHODS: In 14...

An empirical study on website usability elements and how they affect search engine optimisation

OpenAIRE

Eugene B. Visser; Melius Weideman

2011-01-01

The primary objective of this research project was to identify and investigate the website usability attributes which are in contradiction with search engine optimisation elements. The secondary objective was to determine if these usability attributes affect conversion. Although the literature review identifies the contradictions, experts disagree about their existence.An experiment was conducted, whereby the conversion and/or traffic ratio results of an existing control website were compared...

Operation, optimisation, and performance of the DELPHI RICH detectors

CERN Document Server

Albrecht, E; Augustinus, A; Baillon, Paul; Battaglia, Marco; Bloch, D; Boudinov, E; Brunet, J M; Carrié, P; Cavalli, P; Christophel, E; Davenport, M; Dracos, M; Eklund, L; Erzen, B; Fischer, P A; Fokitis, E; Fontanelli, F; Gracco, Valerio; Hallgren, A; Joram, C; Juillot, P; Kjaer, N J; Kluit, P M; Lenzen, G; Liko, D; Mahon, J R; Maltezos, S; Markou, A; Neufeld, N; Nielsen, B S; Petrolini, A; Podobnik, T; Polok, G; Sajot, G; Sannino, M; Schyns, E; Strub, R; Tegenfeldt, F; Thadome, J; Tristram, G; Ullaland, O; Vulpen, I V

1999-01-01

The Ring Imaging Cherenkov detectors of DELPHI represent a large-scale particle identification system which covers almost the full angular acceptance of DELPHI. The combination of liquid and gas radiators (C sub 4 F sub 1 sub 0 , C sub 5 F sub 1 sub 2 , and C sub 6 F sub 1 sub 4) provides particle identification over the whole secondary particle momentum spectrum at LEP I and LEP II. Continuing optimisation on the hardware as well as on the online and offline software level have resulted in a stable operation of the complete detector system for more than five years at full physics performance.

Topology Optimisation for Coupled Convection Problems

DEFF Research Database (Denmark)

Alexandersen, Joe

This thesis deals with topology optimisation for coupled convection problems. The aim is to extend and apply topology optimisation to steady-state conjugate heat transfer problems, where the heat conduction equation governs the heat transfer in a solid and is coupled to thermal transport...... in a surrounding uid, governed by a convection-diffusion equation, where the convective velocity field is found from solving the isothermal incompressible steady-state Navier-Stokes equations. Topology optimisation is also applied to steady-state natural convection problems. The modelling is done using stabilised...... finite elements, the formulation and implementation of which was done partly during a special course as prepatory work for this thesis. The formulation is extended with a Brinkman friction term in order to facilitate the topology optimisation of fluid flow and convective cooling problems. The derived...

Comparing primary prevention with secondary prevention to explain decreasing coronary heart disease death rates in Ireland, 1985-2000.

LENUS (Irish Health Repository)

Kabir, Zubair

2007-01-01

BACKGROUND: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)). METHODS: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD. RESULTS: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland. Overall smoking prevalence declined by 14% between 1985 and 2000, resulting in about 685 fewer deaths (minimum estimate 330, maximum estimate 1,285) attributable to smoking cessation: about 275 in healthy people and 410 in known CHD patients. Population total cholesterol concentrations fell by 4.6%, resulting in approximately 1,300 (minimum estimate 1,115, maximum estimate 1,660) fewer deaths attributable to dietary changes(1,185 in healthy people and 115 in CHD patients) plus 305 fewer deaths attributable to statin treatment (45 in people without CHD and 260 in CHD patients). Mean population diastolic blood pressure fell by 7.2%, resulting in approximately 170 (minimum estimate 105, maximum estimate 300) fewer deaths attributable to secular falls in blood pressure (140 in healthy people and 30 in CHD patients), plus approximately 70 fewer deaths attributable to antihypertensive treatments in people without CHD. Of all the deaths attributable to risk factor falls, some 1,715 (68%) occurred in people without recognized CHD and 815(32%) in CHD patients. CONCLUSION: Compared with secondary prevention, primary prevention achieved a two-fold larger reduction in CHD deaths. Future national CHD policies should therefore prioritize nationwide interventions to promote healthy diets and reduce smoking.

Partnership for fragility bone fracture care provision and prevention program (P4Bones: study protocol for a secondary fracture prevention pragmatic controlled trial

Directory of Open Access Journals (Sweden)

Gaboury Isabelle

2013-01-01

Full Text Available Abstract Background Fractures associated with bone fragility in older adults signal the potential for secondary fracture. Fragility fractures often precipitate further decline in health and loss of mobility, with high associated costs for patients, families, society and the healthcare system. Promptly initiating a coordinated, comprehensive pharmacological bone health and falls prevention program post-fracture may improve osteoporosis treatment compliance; and reduce rates of falls and secondary fractures, and associated morbidity, mortality and costs. Methods/design This pragmatic, controlled trial at 11 hospital sites in eight regions in Quebec, Canada, will recruit community-dwelling patients over age 50 who have sustained a fragility fracture to an intervention coordinated program or to standard care, according to the site. Site study coordinators will identify and recruit 1,596 participants for each study arm. Coordinators at intervention sites will facilitate continuity of care for bone health, and arrange fall prevention programs including physical exercise. The intervention teams include medical bone specialists, primary care physicians, pharmacists, nurses, rehabilitation clinicians, and community program organizers. The primary outcome of this study is the incidence of secondary fragility fractures within an 18-month follow-up period. Secondary outcomes include initiation and compliance with bone health medication; time to first fall and number of clinically significant falls; fall-related hospitalization and mortality; physical activity; quality of life; fragility fracture-related costs; admission to a long term care facility; participants’ perceptions of care integration, expectations and satisfaction with the program; and participants’ compliance with the fall prevention program. Finally, professionals at intervention sites will participate in focus groups to identify barriers and facilitating factors for the integrated

Improving secondary prevention screening in clinical encounters using mhealth among prelicensure master's entry clinical nursing students.

Science.gov (United States)

FitzGerald, Leah Z; Rorie, Anne; Salem, Benissa E

2015-04-01

To determine the feasibility and acceptability of a mHealth application among nursing students for health promotion and secondary prevention health recommendations for hospitalized adult patients. A pretest-posttest design with a convenience sample of 169 prelicensure master's entry clinical nursing students in a large urban public university. Survey questions assessed intention to use, perceived usefulness, perceived ease of use, subjective norm, voluntariness, clinical area relevance, output quality, and result demonstrability of the United States Preventive Services Task Force (USPSTF) evidence-based practice guidelines via the mHealth application. Descriptive statistics and frequencies were used to explore sociodemographics; paired t-tests were used to evaluate pre- and posttest differences. Pre- and posttest significant differences (p technology among prelicensure master's entry clinical nursing students in order to engage and foster translational learning and improve dissemination of secondary prevention screening guidelines among hospitalized patients. © 2015 Sigma Theta Tau International.

Real-time optimisation of the Hoa Binh reservoir, Vietnam

DEFF Research Database (Denmark)

Richaud, Bertrand; Madsen, Henrik; Rosbjerg, Dan

2011-01-01

-time optimisation. First, the simulation-optimisation framework is applied for optimising reservoir operating rules. Secondly, real-time and forecast information is used for on-line optimisation that focuses on short-term goals, such as flood control or hydropower generation, without compromising the deviation...... in the downstream part of the Red River, and at the same time to increase hydropower generation and to save water for the dry season. The real-time optimisation procedure further improves the efficiency of the reservoir operation and enhances the flexibility for the decision-making. Finally, the quality......Multi-purpose reservoirs often have to be managed according to conflicting objectives, which requires efficient tools for trading-off the objectives. This paper proposes a multi-objective simulation-optimisation approach that couples off-line rule curve optimisation with on-line real...

How do stroke survivors and their carers use practitioners' advice on secondary prevention medications? Qualitative study of an online forum.

Science.gov (United States)

Izuka, Nkeonye J; Alexander, Matthew A W; Balasooriya-Smeekens, Chantal; Mant, Jonathan; De Simoni, Anna

2017-09-01

Secondary prevention medications reduce risk of stroke recurrence, yet many people do not receive recommended treatment, nor take medications optimally. Exploring how patients report making use of practitioners' advice on secondary prevention medicines on an online forum and what feedback was received from other participants. Thematic analysis of the archive of Talkstroke (2004-2011), UK. Posts including any secondary prevention medication terms, General Practitioner (GP) and their replies were identified. Fifity participants talked about practitioners' advice on secondary prevention medications in 43 discussion threads. Patients consulted practitioners for reassurance and dealing with side effects. Practitioners' advice varied from altering to maintaining current treatment. Three main themes emerged from the use of practitioners' advice: patients following advice (reassured, happy when side effects made tolerable, or still retaining anxiety about treatment); patients not following advice (admitting adherence on-off or stopping medications as side effects still not tolerable); asking other participants for feedback on advice received. Practitioners' advice was disregarded mainly when related to dealing with statin side effects, after one or two consultations. Themes for feedback involved sharing experience, directing back to practitioners, or to external evidence. Side effects of secondary prevention medications and statins in particular, cause anxiety and resentment in some patients, and their concerns are not always addressed by practitioners. Practitioners could consider more proactive strategies to manage such side effects. Forum feedback was appropriate and supportive of the practitioners' advice received. Our findings from peer-to-peer online conversations confirm and widen previous research. © The Author 2017. Published by Oxford University Press.

Efficient topology optimisation of multiscale and multiphysics problems

DEFF Research Database (Denmark)

Alexandersen, Joe

The aim of this Thesis is to present efficient methods for optimising high-resolution problems of a multiscale and multiphysics nature. The Thesis consists of two parts: one treating topology optimisation of microstructural details and the other treating topology optimisation of conjugate heat...

Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk

OpenAIRE

Halkes, P.H.A.; Gray, Laura J.; Bath, Philip M.W.; Diener, Hans-Christoph; Guiraud-Chaumeil, B.

2008-01-01

Objectives: Our aim was to study the effect of combination therapy with aspirin and dipyridamole (A+D) over aspirin alone (ASA) in secondary prevention after transient \\ud ischemic attack or minor stroke of presumed arterial origin and to perform subgroup analyses to identify patients that might benefit most from secondary prevention with A+D.\\ud Data sources: The previously published meta-analysis of individual patient data was updated with data from ESPRIT (N=2,739); trials without data on ...

Methods for Optimisation of the Laser Cutting Process

DEFF Research Database (Denmark)

Dragsted, Birgitte

This thesis deals with the adaptation and implementation of various optimisation methods, in the field of experimental design, for the laser cutting process. The problem in optimising the laser cutting process has been defined and a structure for at Decision Support System (DSS......) for the optimisation of the laser cutting process has been suggested. The DSS consists of a database with the currently used and old parameter settings. Also one of the optimisation methods has been implemented in the DSS in order to facilitate the optimisation procedure for the laser operator. The Simplex Method has...... been adapted in two versions. A qualitative one, that by comparing the laser cut items optimise the process and a quantitative one that uses a weighted quality response in order to achieve a satisfactory quality and after that maximises the cutting speed thus increasing the productivity of the process...

[Nurse involvement in primary care: it is the key to improve the outcomes in primary and secondary prevention?].

Science.gov (United States)

Scardi, Sabino; Gori, Pierpaolo; Umari, Paolo

2010-06-01

Difficulties in management of risk factors, lifestyle and medications adherence to achieve secondary prevention of ischemic heart disease were described. Many studies indicate that the benefit of cardiac rehabilitation therapy after acute coronary events is only partially maintained during the following year. Thereafter, new strategies of medical care are needed to improve the long-term outcomes in coronary patients. Nurse co-ordinated, multidisciplinary cardiac rehabilitative programme could help patients to improve their lifestyle, to control their risk factors and to achieve their therapeutic goals for secondary prevention of ischemic heart disease.

Design of optimised backstepping controller for the synchronisation ...

Indian Academy of Sciences (India)

Ehsan Fouladi

2017-12-18

Dec 18, 2017 ... for the proposed optimised method compared to PSO optimised controller or any non-optimised backstepping controller. Keywords. Colpitts oscillator; backstepping controller; chaos synchronisation; shark smell algorithm; particle .... The velocity model is based on the gradient of the objective function, tilting ...

Extending Particle Swarm Optimisers with Self-Organized Criticality

DEFF Research Database (Denmark)

Løvbjerg, Morten; Krink, Thiemo

2002-01-01

Particle swarm optimisers (PSOs) show potential in function optimisation, but still have room for improvement. Self-organized criticality (SOC) can help control the PSO and add diversity. Extending the PSO with SOC seems promising reaching faster convergence and better solutions.......Particle swarm optimisers (PSOs) show potential in function optimisation, but still have room for improvement. Self-organized criticality (SOC) can help control the PSO and add diversity. Extending the PSO with SOC seems promising reaching faster convergence and better solutions....

Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: International Insights From the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin).

Science.gov (United States)

Pagidipati, Neha J; Navar, Ann Marie; Pieper, Karen S; Green, Jennifer B; Bethel, M Angelyn; Armstrong, Paul W; Josse, Robert G; McGuire, Darren K; Lokhnygina, Yuliya; Cornel, Jan H; Halvorsen, Sigrun; Strandberg, Timo E; Delibasi, Tuncay; Holman, Rury R; Peterson, Eric D

2017-09-26

Intensive risk factor modification significantly improves outcomes for patients with diabetes mellitus and cardiovascular disease. However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol diabetes mellitus and known cardiovascular disease at entry into TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). Logistic regression was used to evaluate the association between individual and regional factors and secondary prevention achievement at baseline. Cox proportional hazards regression analysis was used to determine the association between baseline secondary prevention achievement and cardiovascular death, myocardial infarction, or stroke. Overall, 29.9% of patients with diabetes mellitus and cardiovascular disease achieved all 5 secondary prevention parameters at baseline, although 71.8% achieved at least 4 parameters. North America had the highest proportion (41.2%), whereas Western Europe, Eastern Europe, and Latin America had proportions of ≈25%. Individually, blood pressure control (57.9%) had the lowest overall attainment, whereas nonsmoking status had the highest (89%). Over a median 3.0 years of follow-up, a higher baseline secondary prevention score was associated with improved outcomes in a step-wise graded relationship (adjusted hazard ratio, 0.60; 95% confidence interval, 0.47-0.77 for those patients achieving all 5 measures versus those achieving ≤2). In an international trial population, significant opportunities exist to improve the quality of cardiovascular secondary prevention care among patients with diabetes mellitus and cardiovascular disease, which in turn could lead to reduced risk of downstream cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00790205. © 2017 American Heart Association, Inc.

School Violence in Secondary Education in the Governorate of Mafraq: Forms, Causes and Prevention--A Case Study

Science.gov (United States)

Khaled, Mohammad S. Bani

2014-01-01

This study considers school violence. It was investigated in secondary schools in the governorate of Mafraq. The aim is to identify the forms and causes of the phenomenon; hence to come out with the preventive and remedial measures, accordingly. The study was conducted in one of the secondary schools selected randomly in the city of Mafraq in the…

Implementation of Telephone-Based Secondary Preventive Intervention after Stroke and Transient Ischemic Attack - Participation Rate, Reasons for Nonparticipation and One-Year Mortality

Directory of Open Access Journals (Sweden)

Anna-Lotta Irewall

2014-02-01

Full Text Available Background and Purpose: Patients who experience a stroke or transient ischemic attack (TIA are known to be at high risk of subsequent vascular events, underscoring the need for secondary preventive intervention. However, previous studies have indicated insufficiency in the implementation of secondary prevention, emphasizing the need to develop effective methods of follow-up. In the present study, we examined the potential of implementing a telephone-based, nurse-led, secondary preventive follow-up in stroke and TIA patients on a population level by analyzing the participation rate, reasons for nonparticipation, and one-year mortality. Methods: Between January 1, 2010 and December 31, 2011, all patients admitted to Östersund hospital, Sweden, and diagnosed with either stroke or TIA were considered for inclusion into the secondary preventive follow-up. Baseline data were collected at the hospital, and reasons for nonparticipation were documented. Multivariate logistic regression was performed to identify predictors of the patient decision not to participate and to explore independent associations between baseline characteristics and exclusion. A one-year follow-up of mortality was also performed; the survival functions of the three groups (included, excluded, declining participation was calculated using the Kaplan-Meier estimator. Results: From a total of 810 identified patients, 430 (53.1% were included in the secondary preventive follow-up, 289 (35.7% were excluded mainly due to physical or cognitive disability, and 91 (11.2% declined participation. Age ≥85 years, ischemic and hemorrhagic stroke, modified Rankin scale score >3, body mass index ≥25, congestive heart failure, and lower education level were independently associated with exclusion, whereas lower education level was the only factor independently associated with the patient decision not to participate. Exclusion was associated with a more than 12 times higher risk of mortality

Improving Vector Evaluated Particle Swarm Optimisation by incorporating nondominated solutions.

Science.gov (United States)

Lim, Kian Sheng; Ibrahim, Zuwairie; Buyamin, Salinda; Ahmad, Anita; Naim, Faradila; Ghazali, Kamarul Hawari; Mokhtar, Norrima

2013-01-01

The Vector Evaluated Particle Swarm Optimisation algorithm is widely used to solve multiobjective optimisation problems. This algorithm optimises one objective using a swarm of particles where their movements are guided by the best solution found by another swarm. However, the best solution of a swarm is only updated when a newly generated solution has better fitness than the best solution at the objective function optimised by that swarm, yielding poor solutions for the multiobjective optimisation problems. Thus, an improved Vector Evaluated Particle Swarm Optimisation algorithm is introduced by incorporating the nondominated solutions as the guidance for a swarm rather than using the best solution from another swarm. In this paper, the performance of improved Vector Evaluated Particle Swarm Optimisation algorithm is investigated using performance measures such as the number of nondominated solutions found, the generational distance, the spread, and the hypervolume. The results suggest that the improved Vector Evaluated Particle Swarm Optimisation algorithm has impressive performance compared with the conventional Vector Evaluated Particle Swarm Optimisation algorithm.

Layout Optimisation of Wave Energy Converter Arrays

Directory of Open Access Journals (Sweden)

Pau Mercadé Ruiz

2017-08-01

Full Text Available This paper proposes an optimisation strategy for the layout design of wave energy converter (WEC arrays. Optimal layouts are sought so as to maximise the absorbed power given a minimum q-factor, the minimum distance between WECs, and an area of deployment. To guarantee an efficient optimisation, a four-parameter layout description is proposed. Three different optimisation algorithms are further compared in terms of performance and computational cost. These are the covariance matrix adaptation evolution strategy (CMA, a genetic algorithm (GA and the glowworm swarm optimisation (GSO algorithm. The results show slightly higher performances for the latter two algorithms; however, the first turns out to be significantly less computationally demanding.

[Primary and secondary prevention procedures of temporo-mandibular joint disease in the evolutive age].

Science.gov (United States)

Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Campisi, G; Di Cosola, M; Suriano, M; Lo Muzio, L

2009-02-01

In the last years prevention of temporomandiboular joint (TMJ) disease had acquired great importance. According to the neuro-occlusal rehabilitation (RNO) it is possible to say that TMJ disease starts since first years of life. So it is important both for dentist and for pediatric know what are the conditions and the atypical functions which predispose to this pathology. The aim of this work was to show how it is possible to intercept since primary teeth and the correct norms of primary and secondary prevention.

New developments in secondary stroke prevention: impact of the European/Australasian Stroke Prevention in Reversible Ischemia Trial (ESPRIT) on clinical management.

Science.gov (United States)

Lutsep, Helmi L

2007-01-01

Secondary stroke prevention is an important goal of poststroke patient treatment. Various pharmacologic approaches have been advocated, but the relative efficacy and safety of these regimens has remained the subject of much debate. Recently released data from the European/Australasian Stroke Prevention in Reversible Ischemia Trial (ESPRIT) indicated that combination therapy with aspirin and extended-release dipyridamole was more effective than aspirin monotherapy, and probably more effective than anticoagulants, for the prevention of cerebrovascular events after a stroke or transient ischemic attack. When viewed in light of results of earlier trials, these findings confirmed that combination aspirin plus extended-release dipyridamole therapy improved outcomes in these patients and is a recommended option for poststroke patient treatment.

Interventions for improving modifiable risk factor control in the secondary prevention of stroke.

Science.gov (United States)

Lager, Kate E; Mistri, Amit K; Khunti, Kamlesh; Haunton, Victoria J; Sett, Aung K; Wilson, Andrew D

2014-05-02

People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control, including patient adherence to prescribed medications, and the occurrence of secondary cardiovascular events. We searched the Cochrane Stroke Group Trials Register (April 2013), the Cochrane Effective Practice and Organisation of Care Group Trials Register (April 2013), CENTRAL (The Cochrane Library 2013, issue 3), MEDLINE (1950 to April 2013), EMBASE (1981 to April 2013) and 10 additional databases. We located further studies by searching reference lists of articles and contacting authors of included studies. We included randomised controlled trials (RCTs) that evaluated the effects of organisational or educational and behavioural interventions (compared with usual care) on modifiable risk factor control for secondary stroke prevention. Two review authors selected studies for inclusion and independently extracted data. One review author assessed the risk of bias for the included studies. We sought missing data from trialists. This review included 26 studies involving 8021 participants. Overall the studies were of reasonable quality, but one study was considered at high risk of bias. Fifteen studies evaluated predominantly organisational interventions and 11 studies evaluated educational and behavioural interventions for patients. Results were pooled where appropriate, although some clinical and methodological heterogeneity was present. The estimated effects of organisational interventions were compatible with improvements and no differences in the modifiable risk factors mean systolic blood pressure (mean difference (MD) -2.57 mmHg; 95% confidence

Risk factors for secondary transmission of Shigella infection within households: implications for current prevention policy

NARCIS (Netherlands)

Boveé, Lian; Whelan, Jane; Sonder, Gerard J. B.; van Dam, Alje P.; van den Hoek, Anneke

2012-01-01

Background: Internationally, guidelines to prevent secondary transmission of Shigella infection vary widely. Cases, their contacts with diarrhoea, and those in certain occupational groups are frequently excluded from work, school, or daycare. In the Netherlands, all contacts attending pre-school

Variation in CAD Secondary Prevention Prescription among Outpatient Cardiology Practices: Insights from the NCDR®

Science.gov (United States)

Maddox, Thomas M.; Chan, Paul S.; Spertus, John A.; Tang, Fengming; Jones, Phil; Ho, P. Michael; Bradley, Steven M.; Tsai, Thomas T.; Bhatt, Deepak L.; Peterson, Pamela N.

2014-01-01

Objectives This study assesses practice variation of secondary prevention medication prescription among coronary artery disease (CAD) patients treated in outpatient practices participating in the NCDR® PINNACLE Registry®. Background Among patients with CAD, secondary prevention with a combination of beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and statins reduces cardiac mortality and myocardial infarction (MI). Accordingly, every CAD patient should receive the combination of these medications for which they are eligible. However, little is known about current prescription patterns of these medications and the variation in use among outpatient cardiology clinics. Methods Using data from NCDR® PINNACLE Registry®, a national outpatient cardiology practice registry, we assessed medication prescription patterns among eligible CAD patients between July 2008 and December 2010. Overall rates of prescription and variation by practice were calculated, adjusting for patient characteristics. Results Among 156,145 CAD patients in 58 practices, 103,830 (66.5%) were prescribed the optimal combination of medications for which they were eligible. The median rate of optimal combined prescription by practice was 73.5% and varied from 28.8% to 100%. After adjustment for patient factors, the practice median rate ratio for prescription was 1.25 (95% CI 1.2,1.32), indicating a 25% likelihood that 2 random practices would differ in treating identical CAD patients. Conclusions Among a national registry of CAD patients treated in outpatient cardiology practices, over one-third of patients failed to receive their optimal combination of secondary prevention medications. Significant variation was observed across practices, even after adjusting for patient characteristics, suggesting that quality improvement efforts may be needed to support more uniform practice. PMID:24184238

Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

DEFF Research Database (Denmark)

Corrà, Ugo; Piepoli, Massimo F; Carré, François

2010-01-01

of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction...... and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention...... and Rehabilitation) has recently completed a Position Paper, entitled 'Secondary prevention through cardiac rehabilitation: A condition-oriented approach'. Components of multidisciplinary CR for seven clinical presentations have been addressed. Components include patient assessment, physical activity counselling...

Predicting and preventing the future: actively managing multiple sclerosis.

LENUS (Irish Health Repository)

Hutchinson, Michael

2012-02-01

Relapsing-remitting multiple sclerosis (MS) has a highly variable clinical course but a number of demographic, clinical and MRI features can guide the clinician in the assessment of disease activity and likely disability outcome. It is also clear that the inflammatory activity in the first five years of relapsing-remitting MS results in the neurodegenerative changes seen in secondary progressive MS 10-15 years later. While conventional first-line disease modifying therapy has an effect on relapses, about one third of patients have a suboptimal response to treatment. With the advent of highly active second-line therapies with their evident marked suppression of inflammation, the clinician now has the tools to manage the course of relapsing-remitting MS more effectively. The development of treatment optimisation recommendations based on the clinical response to first-line therapies can guide the neurologist in more active management of the early course of relapsing-remitting MS, with the aim of preventing both acute inflammatory axonal injury and the neurodegenerative process which leads to secondary progressive MS.

What imaging techniques should be used in primary versus secondary prevention for further risk stratification?

Science.gov (United States)

Schiele, François; Navarese, Eliano Pio; Visoná, Adriana; Ray, Kausik

2017-04-01

An accurate assessment of the cardiovascular (CV) risk of an individual is key for guiding the appropriate treatment strategy for cardiovascular disease (CVD). Although conventional risk factors for CVD are well established, there can be substantial variation in the extent of atherosclerosis between patients. The use of a variety of imaging modalities can be beneficial in the primary prevention stage and in the classification of an individual's CV risk. Therefore, appropriate implementation of these imaging techniques for risk assessment purposes, in line with clinical guidelines, can influence the outcomes of CVD prevention. The expert working group collaborated to review current invasive and non-invasive imaging techniques available to healthcare practitioners and how they can be used in the measurement of preclinical vascular damage and CV risk assessment. After evaluation of the current guideline recommendations and clinical data available, the expert working group collaborated to produce recommendations regarding the use of imaging in the risk stratification in primary prevention, CV risk in peri-acute coronary syndrome and CV risk assessment in secondary prevention. Overall, a variety of both invasive and non-invasive imaging modalities were highlighted by the expert working group as having the potential to assist in the risk assessments of patients at risk of CVD. These imaging techniques can be utilised in both primary and secondary prevention strategies and have the potential to be important risk modifiers, improving the outcome of CV risk assessment. Copyright © 2017 Elsevier B.V. All rights reserved.

A comparison of forward planning and optimised inverse planning

International Nuclear Information System (INIS)

Oldham, Mark; Neal, Anthony; Webb, Steve

1995-01-01

A radiotherapy treatment plan optimisation algorithm has been applied to 48 prostate plans and the results compared with those of an experienced human planner. Twelve patients were used in the study, and a 3, 4, 6 and 8 field plan (with standard coplanar beam angles for each plan type) were optimised by both the human planner and the optimisation algorithm. The human planner 'optimised' the plan by conventional forward planning techniques. The optimisation algorithm was based on fast-simulated-annealing. 'Importance factors' assigned to different regions of the patient provide a method for controlling the algorithm, and it was found that the same values gave good results for almost all plans. The plans were compared on the basis of dose statistics and normal-tissue-complication-probability (NTCP) and tumour-control-probability (TCP). The results show that the optimisation algorithm yielded results that were at least as good as the human planner for all plan types, and on the whole slightly better. A study of the beam-weights chosen by the optimisation algorithm and the planner will be presented. The optimisation algorithm showed greater variation, in response to individual patient geometry. For simple (e.g. 3 field) plans it was found to consistently achieve slightly higher TCP and lower NTCP values. For more complicated (e.g. 8 fields) plans the optimisation also achieved slightly better results with generally less numbers of beams. The optimisation time was always ≤5 minutes; a factor of up to 20 times faster than the human planner

Improving Vector Evaluated Particle Swarm Optimisation by Incorporating Nondominated Solutions

Directory of Open Access Journals (Sweden)

Kian Sheng Lim

2013-01-01

Full Text Available The Vector Evaluated Particle Swarm Optimisation algorithm is widely used to solve multiobjective optimisation problems. This algorithm optimises one objective using a swarm of particles where their movements are guided by the best solution found by another swarm. However, the best solution of a swarm is only updated when a newly generated solution has better fitness than the best solution at the objective function optimised by that swarm, yielding poor solutions for the multiobjective optimisation problems. Thus, an improved Vector Evaluated Particle Swarm Optimisation algorithm is introduced by incorporating the nondominated solutions as the guidance for a swarm rather than using the best solution from another swarm. In this paper, the performance of improved Vector Evaluated Particle Swarm Optimisation algorithm is investigated using performance measures such as the number of nondominated solutions found, the generational distance, the spread, and the hypervolume. The results suggest that the improved Vector Evaluated Particle Swarm Optimisation algorithm has impressive performance compared with the conventional Vector Evaluated Particle Swarm Optimisation algorithm.

An Analysis of Family-School Collaboration in Preventing Adolescent Violence in Urban Secondary Schools

Science.gov (United States)

Bender, C. J. Gerda; Emslie, Annemarie

2010-01-01

The purpose of this article is to describe how school staff members, learners and parents collaborate to prevent adolescent learner violence in two different urban secondary schools. The increase in acts of interpersonal learner violence has a destructive effect on the safe and positive development of young people. Empirical evidence indicates…

Satellite Vibration Testing: Angle optimisation method to Reduce Overtesting

Science.gov (United States)

Knight, Charly; Remedia, Marcello; Aglietti, Guglielmo S.; Richardson, Guy

2018-06-01

Spacecraft overtesting is a long running problem, and the main focus of most attempts to reduce it has been to adjust the base vibration input (i.e. notching). Instead this paper examines testing alternatives for secondary structures (equipment) coupled to the main structure (satellite) when they are tested separately. Even if the vibration source is applied along one of the orthogonal axes at the base of the coupled system (satellite plus equipment), the dynamics of the system and potentially the interface configuration mean the vibration at the interface may not occur all along one axis much less the corresponding orthogonal axis of the base excitation. This paper proposes an alternative testing methodology in which the testing of a piece of equipment occurs at an offset angle. This Angle Optimisation method may have multiple tests but each with an altered input direction allowing for the best match between all specified equipment system responses with coupled system tests. An optimisation process that compares the calculated equipment RMS values for a range of inputs with the maximum coupled system RMS values, and is used to find the optimal testing configuration for the given parameters. A case study was performed to find the best testing angles to match the acceleration responses of the centre of mass and sum of interface forces for all three axes, as well as the von Mises stress for an element by a fastening point. The angle optimisation method resulted in RMS values and PSD responses that were much closer to the coupled system when compared with traditional testing. The optimum testing configuration resulted in an overall average error significantly smaller than the traditional method. Crucially, this case study shows that the optimum test campaign could be a single equipment level test opposed to the traditional three orthogonal direction tests.

An Optimisation Approach for Room Acoustics Design

DEFF Research Database (Denmark)

Holm-Jørgensen, Kristian; Kirkegaard, Poul Henning; Andersen, Lars

2005-01-01

This paper discuss on a conceptual level the value of optimisation techniques in architectural acoustics room design from a practical point of view. It is chosen to optimise one objective room acoustics design criterium estimated from the sound field inside the room. The sound field is modeled...... using the boundary element method where absorption is incorporated. An example is given where the geometry of a room is defined by four design modes. The room geometry is optimised to get a uniform sound pressure....

Optimisation: how to develop stake holder involvement

International Nuclear Information System (INIS)

Weiss, W.

2003-01-01

The Precautionary Principle is an internationally recognised approach for dealing with risk situations characterised by uncertainties and potential irreversible damages. Since the late fifties, ICRP has adopted this prudent attitude because of the lack of scientific evidence concerning the existence of a threshold at low doses for stochastic effects. The 'linear, no-threshold' model and the 'optimisation of protection' principle have been developed as a pragmatic response for the management of the risk. The progress in epidemiology and radiobiology over the last decades have affirmed the initial assumption and the optimisation remains the appropriate response for the application of the precautionary principle in the context of radiological protection. The basic objective of optimisation is, for any source within the system of radiological protection, to maintain the level of exposure as low as reasonably achievable, taking into account social and economical factors. Methods tools and procedures have been developed over the last two decades to put into practice the optimisation principle with a central role given to the cost-benefit analysis as a means to determine the optimised level of protection. However, with the advancement in the implementation of the principle more emphasis was progressively given to good practice, as well as on the importance of controlling individual levels of exposure through the optimisation process. In the context of the revision of its present recommendations, the Commission is reenforcing the emphasis on protection of the individual with the adoption of an equity-based system that recognizes individual rights and a basic level of health protection. Another advancement is the role that is now recognised to 'stakeholders involvement' in the optimisation process as a mean to improve the quality of the decision aiding process for identifying and selecting protection actions considered as being accepted by all those involved. The paper

Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

DEFF Research Database (Denmark)

Piepoli, Massimo Francesco; Corrà, Ugo; Benzer, Werner

2010-01-01

Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to card......Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR......) to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic...... makers and consumers in the recognition of the comprehensive nature of CR. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, national or individual centre level, need to consider where and how structured programmes of CR can be delivered to all...

Results of the 2010 IGSC Topical Session on Optimisation

International Nuclear Information System (INIS)

Bailey, Lucy

2014-01-01

Document available in abstract form only. Full text follows: The 2010 IGSC topical session on optimisation explored a wide range of issues concerning optimisation throughout the radioactive waste management process. Philosophical and ethical questions were discussed, such as: - To what extent is the process of optimisation more important than the end result? - How do we balance long-term environmental safety with near-term operational safety? - For how long should options be kept open? - In balancing safety and excessive cost, when is BAT achieved and who decides on this? * How should we balance the needs of current society with those of future generations? It was clear that optimisation is about getting the right balance between a range of issues that cover: radiation protection, environmental protection, operational safety, operational requirements, social expectations and cost. The optimisation process will also need to respect various constraints, which are likely to include: regulatory requirements, site restrictions, community-imposed requirements or restrictions and resource constraints. These issues were explored through a number of presentations that discussed practical cases of optimisation occurring at different stages of international radioactive waste management programmes. These covered: - Operations and decommissioning - management of large disused components, from the findings of an international study, presented by WPDD; - Concept option selection, prior to site selection - upstream and disposal system optioneering in the UK; - Siting decisions - examples from both Germany and France, explaining how optimisation is being used to support site comparisons and communicate siting decisions; - Repository design decisions - comparison of KBS-3 horizontal and vertical deposition options in Finland; and - On-going optimisation during repository operation - operational experience from WIPP in the US. The variety of the remarks and views expressed during the

Optimisation on processing parameters for minimising warpage on side arm using response surface methodology (RSM) and particle swarm optimisation (PSO)

Science.gov (United States)

Rayhana, N.; Fathullah, M.; Shayfull, Z.; Nasir, S. M.; Hazwan, M. H. M.; Sazli, M.; Yahya, Z. R.

2017-09-01

This study presents the application of optimisation method to reduce the warpage of side arm part. Autodesk Moldflow Insight software was integrated into this study to analyse the warpage. The design of Experiment (DOE) for Response Surface Methodology (RSM) was constructed and by using the equation from RSM, Particle Swarm Optimisation (PSO) was applied. The optimisation method will result in optimised processing parameters with minimum warpage. Mould temperature, melt temperature, packing pressure, packing time and cooling time was selected as the variable parameters. Parameters selection was based on most significant factor affecting warpage stated by previous researchers. The results show that warpage was improved by 28.16% for RSM and 28.17% for PSO. The warpage improvement in PSO from RSM is only by 0.01 %. Thus, the optimisation using RSM is already efficient to give the best combination parameters and optimum warpage value for side arm part. The most significant parameters affecting warpage are packing pressure.

Endoscopic therapy and beta-blockers for secondary prevention in adults with cirrhosis and oesophageal varices

DEFF Research Database (Denmark)

Gluud, Lise Lotte; Morgan, Marsha Y.

2017-01-01

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the beneficial and harmful effects of endoscopic therapy and beta-blockers used as a combination therapy versus monotherapy with either endoscopic therapy or beta-blockers for secondary prevention...

(MBO) algorithm in multi-reservoir system optimisation

African Journals Online (AJOL)

A comparative study of marriage in honey bees optimisation (MBO) algorithm in ... A practical application of the marriage in honey bees optimisation (MBO) ... to those of other evolutionary algorithms, such as the genetic algorithm (GA), ant ...

Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials.

Science.gov (United States)

Katsanos, Aristeidis H; Filippatou, Angeliki; Manios, Efstathios; Deftereos, Spyridon; Parissis, John; Frogoudaki, Alexandra; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Pikilidou, Maria; Kargiotis, Odysseas; Voumvourakis, Konstantinos; Alexandrov, Anne W; Alexandrov, Andrei V; Tsivgoulis, Georgios

2017-01-01

Current recommendations do not specifically address the optimal blood pressure (BP) reduction for secondary stroke prevention in patients with previous cerebrovascular events. We conducted a systematic review and metaregression analysis on the association of BP reduction with recurrent stroke and cardiovascular events using data from randomized controlled clinical trials of secondary stroke prevention. For all reported events during each eligible study period, we calculated the corresponding risk ratios to express the comparison of event occurrence risk between patients randomized to antihypertensive treatment and those randomized to placebo. On the basis of the reported BP values, we performed univariate metaregression analyses according to the achieved BP values under the random-effects model (Method of Moments) for those adverse events reported in ≥10 total subgroups of included randomized controlled clinical trials. In pairwise meta-analyses, antihypertensive treatment lowered the risk for recurrent stroke (risk ratio, 0.73; 95% confidence interval, 0.62-0.87; Psecondary stroke prevention. © 2016 American Heart Association, Inc.

Mechatronic System Design Based On An Optimisation Approach

DEFF Research Database (Denmark)

Andersen, Torben Ole; Pedersen, Henrik Clemmensen; Hansen, Michael Rygaard

The envisaged objective of this paper project is to extend the current state of the art regarding the design of complex mechatronic systems utilizing an optimisation approach. We propose to investigate a novel framework for mechatronic system design. The novelty and originality being the use...... of optimisation techniques. The methods used to optimise/design within the classical disciplines will be identified and extended to mechatronic system design....

Joint optimisation of spare part inventory, maintenance frequency and repair capacity for k-out-of-N systems

NARCIS (Netherlands)

de Smidt-Destombes, Karin S.; van der Heijden, Matthijs C.; van Harten, Aart

2009-01-01

To achieve a high system availability at minimal costs, relevant decisions include the choice of preventive maintenance frequency, spare part inventory levels and spare part repair capacity. We develop heuristics for the joint optimisation of these variables for (a) a single k-out-of-N system under

Optimisation of Investment Resources at Small Enterprises

Directory of Open Access Journals (Sweden)

Shvets Iryna B.

2014-03-01

Full Text Available The goal of the article lies in the study of the process of optimisation of the structure of investment resources, development of criteria and stages of optimisation of volumes of investment resources for small enterprises by types of economic activity. The article characterises the process of transformation of investment resources into assets and liabilities of the balances of small enterprises and conducts calculation of the structure of sources of formation of investment resources in Ukraine at small enterprises by types of economic activity in 2011. On the basis of the conducted analysis of the structure of investment resources of small enterprises the article forms main groups of criteria of optimisation in the context of individual small enterprises by types of economic activity. The article offers an algorithm and step-by-step scheme of optimisation of investment resources at small enterprises in the form of a multi-stage process of management of investment resources in the context of increase of their mobility and rate of transformation of existing resources into investments. The prospect of further studies in this direction is development of a structural and logic scheme of optimisation of volumes of investment resources at small enterprises.

Warpage optimisation on the moulded part with straight-drilled and conformal cooling channels using response surface methodology (RSM) and glowworm swarm optimisation (GSO)

Science.gov (United States)

Hazwan, M. H. M.; Shayfull, Z.; Sharif, S.; Nasir, S. M.; Zainal, N.

2017-09-01

In injection moulding process, quality and productivity are notably important and must be controlled for each product type produced. Quality is measured as the extent of warpage of moulded parts while productivity is measured as a duration of moulding cycle time. To control the quality, many researchers have introduced various of optimisation approaches which have been proven enhanced the quality of the moulded part produced. In order to improve the productivity of injection moulding process, some of researches have proposed the application of conformal cooling channels which have been proven reduced the duration of moulding cycle time. Therefore, this paper presents an application of alternative optimisation approach which is Response Surface Methodology (RSM) with Glowworm Swarm Optimisation (GSO) on the moulded part with straight-drilled and conformal cooling channels mould. This study examined the warpage condition of the moulded parts before and after optimisation work applied for both cooling channels. A front panel housing have been selected as a specimen and the performance of proposed optimisation approach have been analysed on the conventional straight-drilled cooling channels compared to the Milled Groove Square Shape (MGSS) conformal cooling channels by simulation analysis using Autodesk Moldflow Insight (AMI) 2013. Based on the results, melt temperature is the most significant factor contribute to the warpage condition and warpage have optimised by 39.1% after optimisation for straight-drilled cooling channels and cooling time is the most significant factor contribute to the warpage condition and warpage have optimised by 38.7% after optimisation for MGSS conformal cooling channels. In addition, the finding shows that the application of optimisation work on the conformal cooling channels offers the better quality and productivity of the moulded part produced.

Outcome of Secondary Stroke Prevention in Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants.

Science.gov (United States)

Nakase, Taizen; Moroi, Junta; Ishikawa, Tatsuya

2018-05-01

Since non-vitamin K antagonist oral anticoagulants (NOACs) were released for clinical use, many studies have investigated its effectiveness in stroke prevention. In this study, to determine whether or not there is a difference in outcome in secondary stroke prevention between warfarin and NOACs, patients with embolic stroke with newly prescribed anticoagulants were prospectively analyzed. Patients with acute ischemic stroke, who newly started anticoagulant therapy, were consecutively asked to participate in this study. Enrolled patients (76.3 ± 11.0 years old) were classified into warfarin (n = 48), dabigatran (n = 73), rivaroxaban (n = 49), and apixaban (n = 65). The outcome in 1 year was prospectively investigated at outpatient clinic or telephone interview. Recurrence of stroke and death was considered as the critical incidence. The prevalence of risk factors was not different among all medicines. Patients with dabigatran showed significantly younger onset age (P incident rates were 7.1%, 15.3%, 19.0%, and 29.7% for dabigatran, apixaban, rivaroxaban, and warfarin, respectively. Dabigatran showed relatively better outcome compared with warfarin (P = .069) and rivaroxaban (P = .055). All patients on NOACs presented lower cumulative stroke recurrence compared with warfarin. Even in the situation of secondary stroke prevention, noninferiority of NOACs to warfarin might be demonstrated. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Stroke Care 1 Medical treatment in acute and long-term secondary prevention after transient ischaemic attack and ischaemic stroke

NARCIS (Netherlands)

Rothwell, Peter M.; Algra, Ale; Amarenco, Pierre

2011-01-01

Stroke is a major cause of death and disability worldwide. Without improvements in prevention, the burden will increase during the next 20 years because of the ageing population, especially in developing countries. Major advances have occurred in secondary prevention during the past three decades,

Agent-Based Decision Control—How to Appreciate Multivariate Optimisation in Architecture

DEFF Research Database (Denmark)

Negendahl, Kristoffer; Perkov, Thomas Holmer; Kolarik, Jakub

2015-01-01

, the method is applied to a multivariate optimisation problem. The aim is specifically to demonstrate optimisation for entire building energy consumption, daylight distribution and capital cost. Based on the demonstrations Moth’s ability to find local minima is discussed. It is concluded that agent-based...... in the early design stage. The main focus is to demonstrate the optimisation method, which is done in two ways. Firstly, the newly developed agent-based optimisation algorithm named Moth is tested on three different single objective search spaces. Here Moth is compared to two evolutionary algorithms. Secondly...... optimisation algorithms like Moth open up for new uses of optimisation in the early design stage. With Moth the final outcome is less dependent on pre- and post-processing, and Moth allows user intervention during optimisation. Therefore, agent-based models for optimisation such as Moth can be a powerful...

A supportive architecture for CFD-based design optimisation

Science.gov (United States)

Li, Ni; Su, Zeya; Bi, Zhuming; Tian, Chao; Ren, Zhiming; Gong, Guanghong

2014-03-01

Multi-disciplinary design optimisation (MDO) is one of critical methodologies to the implementation of enterprise systems (ES). MDO requiring the analysis of fluid dynamics raises a special challenge due to its extremely intensive computation. The rapid development of computational fluid dynamic (CFD) technique has caused a rise of its applications in various fields. Especially for the exterior designs of vehicles, CFD has become one of the three main design tools comparable to analytical approaches and wind tunnel experiments. CFD-based design optimisation is an effective way to achieve the desired performance under the given constraints. However, due to the complexity of CFD, integrating with CFD analysis in an intelligent optimisation algorithm is not straightforward. It is a challenge to solve a CFD-based design problem, which is usually with high dimensions, and multiple objectives and constraints. It is desirable to have an integrated architecture for CFD-based design optimisation. However, our review on existing works has found that very few researchers have studied on the assistive tools to facilitate CFD-based design optimisation. In the paper, a multi-layer architecture and a general procedure are proposed to integrate different CFD toolsets with intelligent optimisation algorithms, parallel computing technique and other techniques for efficient computation. In the proposed architecture, the integration is performed either at the code level or data level to fully utilise the capabilities of different assistive tools. Two intelligent algorithms are developed and embedded with parallel computing. These algorithms, together with the supportive architecture, lay a solid foundation for various applications of CFD-based design optimisation. To illustrate the effectiveness of the proposed architecture and algorithms, the case studies on aerodynamic shape design of a hypersonic cruising vehicle are provided, and the result has shown that the proposed architecture

Effectiveness of secondary and tertiary prevention for violence against women in low and low-middle income countries: a systematic review.

Science.gov (United States)

Kirk, Lucy; Terry, Samantha; Lokuge, Kamalini; Watterson, Jessica L

2017-07-04

Violence against women (VAW) is a major problem worldwide, with one in three women experiencing violence in their lifetime. While interventions to prevent violence (primary prevention) are extremely important, they can take many years. This review focuses on secondary and tertiary prevention interventions that address the needs of survivors of violence and aim to prevent recurrence. This review also focuses on studies taking place in low and low-middle income countries, where rates of VAW are highest. Searches of peer-reviewed and grey literature took place from March-June 2016 through databases (Embase, CINAHL, WHO Global Index Medicus, Medline, PsychINFO, Web of Science, Cochrane Library, Applied Social Sciences Index and Abstracts and Sociological Abstracts) and by consulting experts in the field. Only primary research was eligible for inclusion and studies had to focus on secondary or tertiary prevention for survivors of VAW in low or low-middle income countries. All study designs were eligible, as long as the study examined client-related outcome measures (e.g., incidence of violence, health outcomes or client satisfaction). Data were extracted and quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies and a qualitative quality assessment tool developed by Mays and Pope. Due to the low number of results and heterogeneity of the study populations and outcomes, a narrative synthesis was conducted and evidence was summarized. One thousand two hundred fifteen studies were identified through the search strategy and 22 of these met the eligibility criteria. Overall, the evidence for interventions is weak and study limitations prevent definitive conclusions on what works. There is some evidence that interventions targeting alcohol use, both among perpetrators and survivors, may be effective at reducing VAW through secondary prevention, and that psychotherapy might be effective for

Comparative effectiveness of recommended versus less intensive drug combinations in secondary prevention of acute coronary syndrome

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf; Ali, M Sanni; Lassalle, Régis; Robinson, Philip; de Boer, Anthonius; Moore, Nicholas; Klungel, Olaf H; Pariente, Antoine

2017-01-01

PURPOSE: The secondary prevention treatment for acute coronary syndrome (ACS) is based on the combined use of drugs from four therapeutic classes (beta-blockers, antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). The objective of this study

Comparative effectiveness of recommended versus less intensive drug combinations in secondary prevention of acute coronary syndrome

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf H H; Ali, M. Sanni; Lassalle, Régis; Robinson, Philip; de Boer, A.; Moore, Nicholas; Klungel, Olaf H.; Pariente, Antoine

Purpose: The secondary prevention treatment for acute coronary syndrome (ACS) is based on the combined use of drugs from four therapeutic classes (beta-blockers, antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). The objective of this study

Risk based test interval and maintenance optimisation - Application and uses

International Nuclear Information System (INIS)

Sparre, E.

1999-10-01

The project is part of an IAEA co-ordinated Research Project (CRP) on 'Development of Methodologies for Optimisation of Surveillance Testing and Maintenance of Safety Related Equipment at NPPs'. The purpose of the project is to investigate the sensitivity of the results obtained when performing risk based optimisation of the technical specifications. Previous projects have shown that complete LPSA models can be created and that these models allow optimisation of technical specifications. However, these optimisations did not include any in depth check of the result sensitivity with regards to methods, model completeness etc. Four different test intervals have been investigated in this study. Aside from an original, nominal, optimisation a set of sensitivity analyses has been performed and the results from these analyses have been compared to the original optimisation. The analyses indicate that the result of an optimisation is rather stable. However, it is not possible to draw any certain conclusions without performing a number of sensitivity analyses. Significant differences in the optimisation result were discovered when analysing an alternative configuration. Also deterministic uncertainties seem to affect the result of an optimisation largely. The sensitivity of failure data uncertainties is important to investigate in detail since the methodology is based on the assumption that the unavailability of a component is dependent on the length of the test interval

Optimisation of X-ray examinations: General principles and an Irish perspective

International Nuclear Information System (INIS)

Matthews, Kate; Brennan, Patrick C.

2009-01-01

In Ireland, the European Medical Exposures Directive [Council Directive 97/43] was enacted into national law in Statutory Instrument 478 of 2002. This series of three review articles discusses the status of justification and optimisation of X-ray examinations nationally, and progress with the establishment of Irish diagnostic reference levels. In this second article, literature relating to optimisation issues arising in SI 478 of 2002 is reviewed. Optimisation associated with X-ray equipment and optimisation during day-to-day practice are considered. Optimisation proposals found in published research are summarised, and indicate the complex nature of optimisation. A paucity of current, research-based guidance documentation is identified. This is needed in order to support a range of professional staff in their practical implementation of optimisation.

Examining the Effectiveness of the Smoking Prevention Program "I Do Not Smoke, I Exercise" in Elementary and Secondary School Settings.

Science.gov (United States)

Kolovelonis, Athanasios; Goudas, Marios; Theodorakis, Yannis

2016-11-01

The aim of the study was to examine the effectiveness of the smoking prevention program "I do not smoke, I exercise" implemented with elementary and secondary school students. "I do not smoke, I exercise" is a theory-based smoking prevention program that promotes exercise as an alternative of smoking. The program consists of eight sessions implemented weekly. Participants were 338 Greek students (135 elementary and 203 secondary students) who were pre- and posttested in smoking, program, and exercise-related measures. The results showed that the program had significant effects on elementary students' attitudes toward smoking, intention to smoke, subjective norms, attitudes toward the application of the program, and knowledge about the health consequences of smoking. For secondary students, significant effects were found on students' perceived behavioral control and knowledge about the health consequences of smoking, while very few students reported a smoking experience before and after the intervention. Therefore the program "I do not smoke, I exercise" may have positive effects on variables related with smoking behavior. Differences in the program's impact on elementary and secondary students were identified. All these are discussed with reference to the need of implementing smoking prevention programs in schools contexts. © 2016 Society for Public Health Education.

Mutual information-based LPI optimisation for radar network

Science.gov (United States)

Shi, Chenguang; Zhou, Jianjiang; Wang, Fei; Chen, Jun

2015-07-01

Radar network can offer significant performance improvement for target detection and information extraction employing spatial diversity. For a fixed number of radars, the achievable mutual information (MI) for estimating the target parameters may extend beyond a predefined threshold with full power transmission. In this paper, an effective low probability of intercept (LPI) optimisation algorithm is presented to improve LPI performance for radar network. Based on radar network system model, we first provide Schleher intercept factor for radar network as an optimisation metric for LPI performance. Then, a novel LPI optimisation algorithm is presented, where for a predefined MI threshold, Schleher intercept factor for radar network is minimised by optimising the transmission power allocation among radars in the network such that the enhanced LPI performance for radar network can be achieved. The genetic algorithm based on nonlinear programming (GA-NP) is employed to solve the resulting nonconvex and nonlinear optimisation problem. Some simulations demonstrate that the proposed algorithm is valuable and effective to improve the LPI performance for radar network.

Multicriteria Optimisation in Logistics Forwarder Activities

Directory of Open Access Journals (Sweden)

Tanja Poletan Jugović

2007-05-01

Full Text Available Logistics forwarder, as organizer and planner of coordinationand integration of all the transport and logistics chains elements,uses adequate ways and methods in the process of planningand decision-making. One of these methods, analysed inthis paper, which could be used in optimisation of transportand logistics processes and activities of logistics forwarder, isthe multicriteria optimisation method. Using that method, inthis paper is suggested model of multicriteria optimisation of logisticsforwarder activities. The suggested model of optimisationis justified in keeping with method principles of multicriteriaoptimization, which is included in operation researchmethods and it represents the process of multicriteria optimizationof variants. Among many different processes of multicriteriaoptimization, PROMETHEE (Preference Ranking OrganizationMethod for Enrichment Evaluations and Promcalc& Gaia V. 3.2., computer program of multicriteria programming,which is based on the mentioned process, were used.

Secondary stroke prevention: challenges and solutions.

Science.gov (United States)

Esenwa, Charles; Gutierrez, Jose

2015-01-01

Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies.

Barriers to medication adherence for the secondary prevention of stroke: a qualitative interview study in primary care.

Science.gov (United States)

Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

2016-08-01

Medications are highly effective at reducing risk of recurrent stroke, but success is influenced by adherence to treatment. Among survivors of stroke and transient ischaemic attack (TIA), adherence to medication is known to be suboptimal. To identify and report barriers to medication adherence for the secondary prevention of stroke/TIA. A qualitative interview study was conducted within general practice surgeries in the East of England, UK. Patients were approached by letter and invited to take part in a qualitative research study. Semi-structured interviews were undertaken with survivors of stroke, caregivers, and GPs to explore their perspectives and views around secondary prevention and perceived barriers to medication adherence. Key themes were identified using a grounded theory approach. Verbatim quotes describing the themes are presented here. In total, 28 survivors of stroke, including 14 accompanying caregivers and five GPs, were interviewed. Two key themes were identified. Patient level barriers included ability to self-care, the importance people attach to a stroke event, and knowledge of stroke and medication. Medication level barriers included beliefs about medication and beliefs about how pills work, medication routines, changing medications, and regimen complexity and burden of treatment. Patients who have had a stroke are faced with multiple barriers to taking secondary prevention medications in UK general practice. This research suggests that a collaborative approach between caregivers, survivors, and healthcare professionals is needed to address these barriers and facilitate medication-taking behaviour. © British Journal of General Practice 2016.

Modified cuckoo search: A new gradient free optimisation algorithm

International Nuclear Information System (INIS)

Walton, S.; Hassan, O.; Morgan, K.; Brown, M.R.

2011-01-01

Highlights: → Modified cuckoo search (MCS) is a new gradient free optimisation algorithm. → MCS shows a high convergence rate, able to outperform other optimisers. → MCS is particularly strong at high dimension objective functions. → MCS performs well when applied to engineering problems. - Abstract: A new robust optimisation algorithm, which can be regarded as a modification of the recently developed cuckoo search, is presented. The modification involves the addition of information exchange between the top eggs, or the best solutions. Standard optimisation benchmarking functions are used to test the effects of these modifications and it is demonstrated that, in most cases, the modified cuckoo search performs as well as, or better than, the standard cuckoo search, a particle swarm optimiser, and a differential evolution strategy. In particular the modified cuckoo search shows a high convergence rate to the true global minimum even at high numbers of dimensions.

Incorporating Primary and Secondary Prevention Approaches To Address Childhood Obesity Prevention and Treatment in a Low-Income, Ethnically Diverse Population: Study Design and Demographic Data from the Texas Childhood Obesity Research Demonstration (TX CORD) Study

Science.gov (United States)

Butte, Nancy F.; Barlow, Sarah; Vandewater, Elizabeth A.; Sharma, Shreela V.; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O.; Durand, Casey; Li, Linlin; Kelder, Steven H.

2015-01-01

Abstract Background: There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2–12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Methods: Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Results: Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3–83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Conclusions: Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity. PMID:25555188

Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study.

Science.gov (United States)

Hoelscher, Deanna M; Butte, Nancy F; Barlow, Sarah; Vandewater, Elizabeth A; Sharma, Shreela V; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O; Durand, Casey; Li, Linlin; Kelder, Steven H

2015-02-01

There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.

Cardiovascular disease risk and secondary prevention of cardiovascular disease among patients with low health literacy.

Science.gov (United States)

van Schaik, T M; Jørstad, H T; Twickler, T B; Peters, R J G; Tijssen, J P G; Essink-Bot, M L; Fransen, M P

2017-07-01

To explore the association between health literacy and the risk of cardiovascular disease (CVD), and to assess the differential effects by health literacy level of a nurse-coordinated secondary prevention program (NCPP) in patients with coronary artery disease (CAD). Data were collected in two medical centres participating in the RESPONSE trial (Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists). CVD risk profiles were assessed at baseline and 12-month follow-up using the Systematic Coronary Risk Evaluation (SCORE). Health literacy was assessed by the short Rapid Estimate of Adult Literacy in Medicine (REALM-D) and the Newest Vital Sign (NVS-D); self-reported health literacy was evaluated by the Set of Brief Screening Questions (SBSQ-D). Among 201 CAD patients, 18% exhibited reading difficulties, 52% had difficulty understanding and applying written information, and 5% scored low on self-reported health literacy. Patients with low NVS-D scores had a higher CVD risk [mean SCORE 5.2 (SD 4.8) versus 3.3 (SD 4.1), p literacy levels without significant differences. Inadequate health literacy is prevalent in CAD patients in the Netherlands, and is associated with less favourable CVD risk profiles. Where many other forms of CVD prevention fail, nurse-coordinated care seems to be effective among patients with inadequate health literacy.

Secondary Prevention of Chronic PTSD by Early and Short-Term Administration of Escitalopram: A Prospective Randomized, Placebo-Controlled, Double-Blind Trial.

Science.gov (United States)

Zohar, Joseph; Fostick, Leah; Juven-Wetzler, Alzabeta; Kaplan, Zeev; Shalev, Hadar; Schreiber, Gavriel; Miroshnik, Natalie; Shalev, Arieh Y; Stein, Dan J; Seedat, Soraya; Suliman, Sharain; Klein, Ehud

Prospective studies have not identified a viable pharmacologic strategy for secondary prevention of posttraumatic stress disorder (PTSD). The authors examined whether preventive intervention via early and short-term administration of a selective serotonin reuptake inhibitor (SSRI), within 1 month of exposure to a traumatic event (before diagnosis of PTSD could be made), may reduce the severity of PTSD symptoms according to DSM-IV at 13 months' follow-up. Over 25,000 screening calls to patients referred to an emergency department for a traumatic event performed between June 2006 and December 2008 yielded 353 participants who were recruited within the month following a traumatic event . Participants were randomly assigned in a double-blind design to escitalopram (n = 176) or placebo (n = 177). The per-protocol analysis comprised 198 participants (escitalopram, n = 102; placebo, n = 96) who received treatment for 12 to 24 weeks and were available for follow-up at week 56. The primary outcome measure, the Clinician Administered PTSD Scale (CAPS), revealed no prevention effect. However, a secondary outcome, the Pittsburgh Sleep Quality Inventory (PSQI), showed better results for the SSRI group than for the placebo group. For a subset of participants who experienced intentional trauma (missile attacks, rape, or physical assault; n = 50), the prevention effect was found on both primary and secondary measures (CAPS, PSQI and measures of depression and global illness severity). Early and short-term administration of escitalopram was not shown to prevent PTSD, although it did improve sleep quality. In a subgroup of participants who experienced intentional trauma, however, this early-treatment approach may be effective as secondary prevention. This large study is the first to investigate the preventive effect of early administration of escitalopram on PTSD. It highlights the relevance of the type of trauma (intentional vs unintentional) to the outcome. Clinical

[Treatment of pubic osteomyelitis secondary to pressure sores].

Science.gov (United States)

Brunel, Anne-Sophie; Téot, Luc; Lamy, Brigitte; Masson, Raphaël; Morquin, David; Reynes, Jacques; Le Moing, Vincent

2014-01-01

There is no consensus regarding the diagnostic and therapeutic strategy for pubic osteomyelitis secondary to pelvic pressure sores. Diagnosis is often difficult and bone biopsies with microbiological and anatomical-pathological examination remain the gold standard. The rate of cicatrisation of pressure sores is low. Cleansing and negative pressure treatment are key elements of the treatment. Optimising the care management with medical-surgical collaboration is being studied in the Ostear protocol.

Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study.

Science.gov (United States)

Murphy, Adrianna; Palafox, Benjamin; O'Donnell, Owen; Stuckler, David; Perel, Pablo; AlHabib, Khalid F; Avezum, Alvaro; Bai, Xiulin; Chifamba, Jephat; Chow, Clara K; Corsi, Daniel J; Dagenais, Gilles R; Dans, Antonio L; Diaz, Rafael; Erbakan, Ayse N; Ismail, Noorhassim; Iqbal, Romaina; Kelishadi, Roya; Khatib, Rasha; Lanas, Fernando; Lear, Scott A; Li, Wei; Liu, Jia; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Monsef, Nahed; Mony, Prem K; Puoane, Thandi; Rangarajan, Sumathy; Rosengren, Annika; Schutte, Aletta E; Sintaha, Mariz; Teo, Koon K; Wielgosz, Andreas; Yeates, Karen; Yin, Lu; Yusoff, Khalid; Zatońska, Katarzyna; Yusuf, Salim; McKee, Martin

2018-03-01

There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE) study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from -1 (pro-poor) to 1 (pro-rich), standardised by age and sex. Correlations between inequalities and national health-related indicators were estimated. The proportion of patients with cardiovascular disease on three medications ranged from 0% in South Africa (95% CI 0-1·7), Tanzania (0-3·6), and Zimbabwe (0-5·1), to 49·3% in Canada (44·4-54·3). Proportions receiving at least one drug varied from 2·0% (95% CI 0·5-6·9) in Tanzania to 91·4% (86·6-94·6) in Sweden. There was significant (pSaudi Arabia, China, Colombia, India, Pakistan, and Zimbabwe. Pro-poor distributions were observed in Sweden, Brazil, Chile, Poland, and the occupied Palestinian territory. The strongest predictors of inequality were public expenditure on health and overall use of secondary prevention medicines. Use of medication for secondary prevention of cardiovascular disease is alarmingly low. In many countries with the lowest use, pro-rich inequality is greatest. Policies associated with an equal or pro-poor distribution include free medications and community health programmes to support adherence to medications. Full funding sources listed at the end of the paper (see Acknowledgments). Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0. license. Published by Elsevier Ltd.. All rights reserved.

Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study

Directory of Open Access Journals (Sweden)

Adrianna Murphy, PhD

2018-03-01

Full Text Available Summary: Background: There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. Methods: We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from −1 (pro-poor to 1 (pro-rich, standardised by age and sex. Correlations between inequalities and national health-related indicators were estimated. Findings: The proportion of patients with cardiovascular disease on three medications ranged from 0% in South Africa (95% CI 0–1·7, Tanzania (0–3·6, and Zimbabwe (0–5·1, to 49·3% in Canada (44·4–54·3. Proportions receiving at least one drug varied from 2·0% (95% CI 0·5–6·9 in Tanzania to 91·4% (86·6–94·6 in Sweden. There was significant (p<0·05 pro-rich inequality in Saudi Arabia, China, Colombia, India, Pakistan, and Zimbabwe. Pro-poor distributions were observed in Sweden, Brazil, Chile, Poland, and the occupied Palestinian territory. The strongest predictors of inequality were public expenditure on health and overall use of secondary prevention medicines. Interpretation: Use of medication for secondary prevention of cardiovascular disease is alarmingly low. In many countries with the lowest use, pro-rich inequality is greatest. Policies associated with an equal or pro-poor distribution include free medications and community health programmes to support adherence to medications. Funding: Full funding sources listed at the end of the paper (see Acknowledgments.

A methodological approach to the design of optimising control strategies for sewer systems

DEFF Research Database (Denmark)

Mollerup, Ane Loft; Mikkelsen, Peter Steen; Sin, Gürkan

2016-01-01

This study focuses on designing an optimisation based control for sewer system in a methodological way and linking itto a regulatory control. Optimisation based design is found to depend on proper choice of a model, formulation of objective function and tuning of optimisation parameters. Accordin......This study focuses on designing an optimisation based control for sewer system in a methodological way and linking itto a regulatory control. Optimisation based design is found to depend on proper choice of a model, formulation of objective function and tuning of optimisation parameters....... Accordingly, two novel optimisation configurations are developed, where the optimisation either acts on the actuators or acts on the regulatory control layer. These two optimisation designs are evaluated on a sub-catchment of the sewer system in Copenhagen, and found to perform better than the existing...

Automatic optimisation of gamma dose rate sensor networks: The DETECT Optimisation Tool

DEFF Research Database (Denmark)

Helle, K.B.; Müller, T.O.; Astrup, Poul

2014-01-01

of the EU FP 7 project DETECT. It evaluates the gamma dose rates that a proposed set of sensors might measure in an emergency and uses this information to optimise the sensor locations. The gamma dose rates are taken from a comprehensive library of simulations of atmospheric radioactive plumes from 64......Fast delivery of comprehensive information on the radiological situation is essential for decision-making in nuclear emergencies. Most national radiological agencies in Europe employ gamma dose rate sensor networks to monitor radioactive pollution of the atmosphere. Sensor locations were often...... source locations. These simulations cover the whole European Union, so the DOT allows evaluation and optimisation of sensor networks for all EU countries, as well as evaluation of fencing sensors around possible sources. Users can choose from seven cost functions to evaluate the capability of a given...

The Office Guidelines Applied to Practice program improves secondary prevention of heart disease in Federally Qualified Healthcare Centers

Directory of Open Access Journals (Sweden)

Adesuwa Olomu

2016-12-01

Office-GAP resulted in increased use of guideline-based medications for secondary CVD prevention in underserved populations. The Office-GAP program could serve as a model for implementing guideline-based care for other chronic diseases.

Spatial-structural interaction and strain energy structural optimisation

NARCIS (Netherlands)

Hofmeyer, H.; Davila Delgado, J.M.; Borrmann, A.; Geyer, P.; Rafiq, Y.; Wilde, de P.

2012-01-01

A research engine iteratively transforms spatial designs into structural designs and vice versa. Furthermore, spatial and structural designs are optimised. It is suggested to optimise a structural design by evaluating the strain energy of its elements and by then removing, adding, or changing the

Energy Savings from Optimised In-Field Route Planning for Agricultural Machinery

Directory of Open Access Journals (Sweden)

Efthymios Rodias

2017-10-01

Full Text Available Various types of sensors technologies, such as machine vision and global positioning system (GPS have been implemented in navigation of agricultural vehicles. Automated navigation systems have proved the potential for the execution of optimised route plans for field area coverage. This paper presents an assessment of the reduction of the energy requirements derived from the implementation of optimised field area coverage planning. The assessment regards the analysis of the energy requirements and the comparison between the non-optimised and optimised plans for field area coverage in the whole sequence of operations required in two different cropping systems: Miscanthus and Switchgrass production. An algorithmic approach for the simulation of the executed field operations by following both non-optimised and optimised field-work patterns was developed. As a result, the corresponding time requirements were estimated as the basis of the subsequent energy cost analysis. Based on the results, the optimised routes reduce the fuel energy consumption up to 8%, the embodied energy consumption up to 7%, and the total energy consumption from 3% up to 8%.

Profile control studies for JET optimised shear regime

Energy Technology Data Exchange (ETDEWEB)

Litaudon, X.; Becoulet, A.; Eriksson, L.G.; Fuchs, V.; Huysmans, G.; How, J.; Moreau, D.; Rochard, F.; Tresset, G.; Zwingmann, W. [Association Euratom-CEA, CEA/Cadarache, Dept. de Recherches sur la Fusion Controlee, DRFC, 13 - Saint-Paul-lez-Durance (France); Bayetti, P.; Joffrin, E.; Maget, P.; Mayorat, M.L.; Mazon, D.; Sarazin, Y. [JET Abingdon, Oxfordshire (United Kingdom); Voitsekhovitch, I. [Universite de Provence, LPIIM, Aix-Marseille 1, 13 (France)

2000-03-01

This report summarises the profile control studies, i.e. preparation and analysis of JET Optimised Shear plasmas, carried out during the year 1999 within the framework of the Task-Agreement (RF/CEA/02) between JET and the Association Euratom-CEA/Cadarache. We report on our participation in the preparation of the JET Optimised Shear experiments together with their comprehensive analyses and the modelling. Emphasis is put on the various aspects of pressure profile control (core and edge pressure) together with detailed studies of current profile control by non-inductive means, in the prospects of achieving steady, high performance, Optimised Shear plasmas. (authors)

Primary care organisational interventions for secondary prevention of ischaemic heart disease: a systematic review and meta-analysis.

Science.gov (United States)

Murphy, Edel; Vellinga, Akke; Byrne, Molly; Cupples, Margaret E; Murphy, Andrew W; Buckley, Brian; Smith, Susan M

2015-07-01

Ischaemic heart disease (IHD) is the most common cause of death worldwide. To determine the long-term impact of organisational interventions for secondary prevention of IHD. Systematic review and meta-analysis of studies from CENTRAL, MEDLINE(®), Embase, and CINAHL published January 2007 to January 2013. Searches were conducted for randomised controlled trials of patients with established IHD, with long-term follow-up, of cardiac secondary prevention programmes targeting organisational change in primary care or community settings. A random-effects model was used and risk ratios were calculated. Five studies were included with 4005 participants. Meta-analysis of four studies with mortality data at 4.7-6 years showed that organisational interventions were associated with approximately 20% reduced mortality, with a risk ratio (RR) for all-cause mortality of 0.79 (95% confidence interval [CI] = 0.66 to 0.93), and a RR for cardiac-related mortality of 0.74 (95% CI = 0.58 to 0.94). Two studies reported mortality data at 10 years. Analysis of these data showed no significant differences between groups. There were insufficient data to conduct a meta-analysis on the effect of interventions on hospital admissions. Additional analyses showed no significant association between organisational interventions and risk factor management or appropriate prescribing at 4.7-6 years. Cardiac secondary prevention programmes targeting organisational change are associated with a reduced risk of death for at least 4-6 years. There is insufficient evidence to conclude whether this beneficial effect is maintained indefinitely. © British Journal of General Practice 2015.

Optimisation of radiation protection

International Nuclear Information System (INIS)

1988-01-01

Optimisation of radiation protection is one of the key elements in the current radiation protection philosophy. The present system of dose limitation was issued in 1977 by the International Commission on Radiological Protection (ICRP) and includes, in addition to the requirements of justification of practices and limitation of individual doses, the requirement that all exposures be kept as low as is reasonably achievable, taking social and economic factors into account. This last principle is usually referred to as optimisation of radiation protection, or the ALARA principle. The NEA Committee on Radiation Protection and Public Health (CRPPH) organised an ad hoc meeting, in liaison with the NEA committees on the safety of nuclear installations and radioactive waste management. Separate abstracts were prepared for individual papers presented at the meeting

Mass media and marketing communication promoting primary and secondary cancer prevention.

Science.gov (United States)

Hannon, Peggy; Lloyd, Gareth P; Viswanath, K; Smith, Tenbroeck; Basen-Engquist, Karen; Vernon, Sally W; Turner, Gina; Hesse, Bradford W; Crammer, Corinne; von Wagner, Christian; Backinger, Cathy L

2009-01-01

People often seek and receive cancer information from mass media (including television, radio, print media, and the Internet), and marketing strategies often inform cancer information needs assessment, message development, and channel selection. In this article, we present the discussion of a 2-hour working group convened for a cancer communications workshop held at the 2008 Society of Behavioral Medicine meeting in San Diego, CA. During the session, an interdisciplinary group of investigators discussed the current state of the science for mass media and marketing communication promoting primary and secondary cancer prevention. We discussed current research, new research areas, methodologies and theories needed to move the field forward, and critical areas and disciplines for future research.

Is clopidogrel superior to aspirin in secondary prevention of vascular disease?

Directory of Open Access Journals (Sweden)

Algra Ale

2000-11-01

Full Text Available Abstract The cornerstone in clinical evidence of the relative efficacy of thienopyridines (clopidogrel, ticlopidine versus aspirin in the secondary prevention of vascular disease is the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events trial. This trial showed a modest benefit in the reduction of vascular events by clopidogrel. The results differed according to qualifying disorder: myocardial infarction, -3.7%; ischaemic stroke, +7.3%; and peripheral arterial disease, +23.8% (P = 0.042. Similar results were found for ticlopidine after brain ischaemia. The safety of clopidogrel appears to be similar to that of aspirin and better than that of ticlopidine. However, the recent report of thrombotic thrombocytopenic purpura in association with clopidogrel causes concern.

Preventing Dropout in Secondary Schools. Educator's Practice Guide. What Works Clearinghouse. NCEE 2017-4028

Science.gov (United States)

Rumberger, Russell W.; Addis, Howard; Allensworth, Elaine; Balfanz, Robert; Bruch, Julie; Dillon, Erin; Duardo, Debra; Dynarski, Mark; Furgeson, Joshua; Jayanthi, Madhavi; Newman-Gonchar, Rebecca; Place, Kate; Tuttle, Christina

2017-01-01

The goal of this practice guide is to offer educators specific, evidence-based recommendations that address the challenges of preventing dropout in secondary schools. This guide synthesizes the best publicly available research and shares practices that are supported by evidence. It is intended to be practical and easy for teachers and school…

TEM turbulence optimisation in stellarators

Science.gov (United States)

Proll, J. H. E.; Mynick, H. E.; Xanthopoulos, P.; Lazerson, S. A.; Faber, B. J.

2016-01-01

With the advent of neoclassically optimised stellarators, optimising stellarators for turbulent transport is an important next step. The reduction of ion-temperature-gradient-driven turbulence has been achieved via shaping of the magnetic field, and the reduction of trapped-electron mode (TEM) turbulence is addressed in the present paper. Recent analytical and numerical findings suggest TEMs are stabilised when a large fraction of trapped particles experiences favourable bounce-averaged curvature. This is the case for example in Wendelstein 7-X (Beidler et al 1990 Fusion Technol. 17 148) and other Helias-type stellarators. Using this knowledge, a proxy function was designed to estimate the TEM dynamics, allowing optimal configurations for TEM stability to be determined with the STELLOPT (Spong et al 2001 Nucl. Fusion 41 711) code without extensive turbulence simulations. A first proof-of-principle optimised equilibrium stemming from the TEM-dominated stellarator experiment HSX (Anderson et al 1995 Fusion Technol. 27 273) is presented for which a reduction of the linear growth rates is achieved over a broad range of the operational parameter space. As an important consequence of this property, the turbulent heat flux levels are reduced compared with the initial configuration.

Analysis and optimisation of heterogeneous real-time embedded systems

DEFF Research Database (Denmark)

Pop, Paul; Eles, Petru; Peng, Zebo

2005-01-01

. The success of such new design methods depends on the availability of analysis and optimisation techniques. Analysis and optimisation techniques for heterogeneous real-time embedded systems are presented in the paper. The authors address in more detail a particular class of such systems called multi...... of application messages to frames. Optimisation heuristics for frame packing aimed at producing a schedulable system are presented. Extensive experiments and a real-life example show the efficiency of the frame-packing approach....

Analysis and optimisation of heterogeneous real-time embedded systems

DEFF Research Database (Denmark)

Pop, Paul; Eles, Petru; Peng, Zebo

2006-01-01

. The success of such new design methods depends on the availability of analysis and optimisation techniques. Analysis and optimisation techniques for heterogeneous real-time embedded systems are presented in the paper. The authors address in more detail a particular class of such systems called multi...... of application messages to frames. Optimisation heuristics for frame packing aimed at producing a schedulable system are presented. Extensive experiments and a real-life example show the efficiency of the frame-packing approach....

Isogeometric Analysis and Shape Optimisation

DEFF Research Database (Denmark)

Gravesen, Jens; Evgrafov, Anton; Gersborg, Allan Roulund

of the whole domain. So in every optimisation cycle we need to extend a parametrisation of the boundary of a domain to the whole domain. It has to be fast in order not to slow the optimisation down but it also has to be robust and give a parametrisation of high quality. These are conflicting requirements so we...... will explain how the validity of a parametrisation can be checked and we will describe various ways to parametrise a domain. We will in particular study the Winslow functional which turns out to have some desirable properties. Other problems we touch upon is clustering of boundary control points (design...

HIV/AIDS prevention: knowledge, attitudes and education practices of secondary school health personnel in 14 cities of China.

Science.gov (United States)

Chen, J Q; Dunne, M P; Zhao, D C

2004-01-01

This study assessed the preparedness of school health personnel to develop and deliver HIV/AIDS prevention education programmes for young people in China. A survey of 653 personnel working in secondary schools in 14 cities was conducted. More than 90% had basic knowledge of ways in which HIV can be transmitted, but knowledge of ways in which the virus is not transmitted needs improvement. Substantial numbers of teachers were not sure whether there was an effective preventive vaccine (42%) or did not know whether AIDS was a curable illness or not (32%). The great majority approved of AIDS prevention programmes in universities (98%) and secondary schools (91%), although fewer (58%) agreed that the topic was appropriate for primary schools. Currently, most classroom activities focuses on teaching facts about HIV/AIDS transmission, while less than half are taught about HIV/AIDS related discrimination and life skills to reduce peer pressure. Personnel with some prior training on HIV/ AIDS education (53%) had better factual knowledge, more tolerant attitudes and more confidence in teaching about HIV/AIDS than those without training. The majority of teachers indicated a need for more resource books, audiovisual products, expert guidance, school principal support and dissemination of national AIDS prevention education guidelines to schools.

Time varying acceleration coefficients particle swarm optimisation (TVACPSO): A new optimisation algorithm for estimating parameters of PV cells and modules

International Nuclear Information System (INIS)

Jordehi, Ahmad Rezaee

2016-01-01

Highlights: • A modified PSO has been proposed for parameter estimation of PV cells and modules. • In the proposed modified PSO, acceleration coefficients are changed during run. • The proposed modified PSO mitigates premature convergence problem. • Parameter estimation problem has been solved for both PV cells and PV modules. • The results show that proposed PSO outperforms other state of the art algorithms. - Abstract: Estimating circuit model parameters of PV cells/modules represents a challenging problem. PV cell/module parameter estimation problem is typically translated into an optimisation problem and is solved by metaheuristic optimisation problems. Particle swarm optimisation (PSO) is considered as a popular and well-established optimisation algorithm. Despite all its advantages, PSO suffers from premature convergence problem meaning that it may get trapped in local optima. Personal and social acceleration coefficients are two control parameters that, due to their effect on explorative and exploitative capabilities, play important roles in computational behavior of PSO. In this paper, in an attempt toward premature convergence mitigation in PSO, its personal acceleration coefficient is decreased during the course of run, while its social acceleration coefficient is increased. In this way, an appropriate tradeoff between explorative and exploitative capabilities of PSO is established during the course of run and premature convergence problem is significantly mitigated. The results vividly show that in parameter estimation of PV cells and modules, the proposed time varying acceleration coefficients PSO (TVACPSO) offers more accurate parameters than conventional PSO, teaching learning-based optimisation (TLBO) algorithm, imperialistic competitive algorithm (ICA), grey wolf optimisation (GWO), water cycle algorithm (WCA), pattern search (PS) and Newton algorithm. For validation of the proposed methodology, parameter estimation has been done both for

Dual Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke: A Ghost from the Past or a New Frontier?

Directory of Open Access Journals (Sweden)

Clotilde Balucani

2010-01-01

Full Text Available With majority of ischemic strokes attributable to atherothrombosis and many being predictable after transient ischemic attacks (TIA, the role of early secondary prevention with antiplatelet agents is under renewed investigation. Prior major clinical trials of various secondary stroke prevention regimens pointed to a greater efficacy of dual antiplatelet agents if initiated early from symptom onset. This paper examines data and rationale behind dual antiplatelet regimens across the completed clinical trials. The safety of dual antiplatelets approach is of concern, but it could be outweighed, at least in early management, by a greater reduction in recurrence of ischemic events since this risk is “front loaded” after minor stroke or TIA. Aspirin monotherapy, though considered standard of care, is compared to aspirin-extended release dipiridamole and its combination with clopidogrel in early-phase completed and efficacy-phase ongoing clinical trials.

Share-of-Surplus Product Line Optimisation with Price Levels

Directory of Open Access Journals (Sweden)

X. G. Luo

2014-01-01

Full Text Available Kraus and Yano (2003 established the share-of-surplus product line optimisation model and developed a heuristic procedure for this nonlinear mixed-integer optimisation model. In their model, price of a product is defined as a continuous decision variable. However, because product line optimisation is a planning process in the early stage of product development, pricing decisions usually are not very precise. In this research, a nonlinear integer programming share-of-surplus product line optimization model that allows the selection of candidate price levels for products is established. The model is further transformed into an equivalent linear mixed-integer optimisation model by applying linearisation techniques. Experimental results in different market scenarios show that the computation time of the transformed model is much less than that of the original model.

Effectiveness of nurse-led patient-centered care behavioral risk modification on secondary prevention of coronary heart disease: A systematic review.

Science.gov (United States)

Chiang, Chung-Yan; Choi, Kai-Chow; Ho, Ka-Ming; Yu, Sau-Fung

2018-04-22

Despite establishment of advocacies centered on using patient-centered care to improve disease-related behavioral changes and health outcomes, studies have seldom discussed incorporation of patient-centered care concept in the design of secondary cardiac prevention. This review aimed to identify, appraise, and examine existing evidence on the effectiveness of nurse-led patient-centered care for secondary cardiac prevention in patients with coronary heart disease. A systematic review of randomized controlled trials focusing on nurse-led patient-centered care for secondary cardiac prevention was conducted. Primary outcomes were behavioral risks (e.g. smoking, physical activity), secondary outcomes were clinically relevant physiological parameters (e.g. body weight, blood pressure, blood glucose, blood lipoproteins), health-related quality of life, mortality, and self efficacy. Twenty-three English and seven Chinese electronic databases were searched to identify the trials. The studies' eligibility and methodological quality were assessed by two reviewers independently according to the Joanna Briggs Institute guidelines. Statistical heterogeneities of the included studies were assessed by Higgins I2 and quantitative pooling was performed when studies showed sufficient comparability. 15 articles on 12 randomized controlled trials were included in this review. Methodological quality of the included studies was fair. Based on the Joanna Briggs Institute critical appraisal tool for experimental studies, the included studies had met a mean of six criteria out the ten in this appraisal tool. The meta-analyses of the included studies revealed that nurse-led patient-centered care had significantly improved patients' smoking habits, adherence toward physical activity advices, and total cholesterol level with medical regime optimization, in short- to medium-term. The intervention was also favorable in improving the patients' health-related quality of life in several domains of

A systematic review of published interventions for primary and secondary prevention of ischaemic heart disease (IHD in rural populations of Australia

Directory of Open Access Journals (Sweden)

Laura V. Alston

2016-08-01

Full Text Available Abstract Background Rural Australians are known to experience a higher burden of ischaemic heart disease (IHD than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood. It is not clear what interventions and prevention efforts have occurred specifically in rural Australia in terms of IHD. A summary of this evidence could have implications for future action and research in improving the health of rural communities. The aim of this study was to review all published interventions conducted in rural Australia that were aimed at the primary and/or secondary prevention of ischaemic heart disease (IHD in adults. Methods Systematic review of the peer-reviewed literature published between January 1990 and December 2015. Search terms were derived from four major topics: (1 rural; (2 ischaemic heart disease; (3 Australia and; (4 intervention/prevention. Terms were adapted for six databases and three independent researchers screened results. Studies were included if the published work described an intervention focussed on the prevention or reduction of IHD or risk factors, specifically in a rural population of Australia, with outcomes specific to participants including, but not limited to, changes in diet, exercise, cholesterol or blood pressure levels. Results Of 791 papers identified in the search, seven studies met the inclusion criteria, and one further study was retrieved from searching reference lists of screened abstracts. Typically, excluded studies focused on cardiovascular diseases without specific reference to IHD, or presented intervention results without stratification by rurality. Larger trials that included metropolitan residents without stratification were excluded due to differences in the specific needs, characteristics and health service access challenges of rural populations. Six interventions were primary prevention studies, one was secondary prevention only and one included both

Establishing Local Reference Dose Values and Optimisation Strategies

International Nuclear Information System (INIS)

Connolly, P.; Moores, B.M.

2000-01-01

The revised EC Patient Directive 97/43 EURATOM introduces the concepts of clinical audit, diagnostic reference levels and optimisation of radiation protection in diagnostic radiology. The application of reference dose levels in practice involves the establishment of reference dose values as actual measurable operational quantities. These values should then form part of an ongoing optimisation and audit programme against which routine performance can be compared. The CEC Quality Criteria for Radiographic Images provides guidance reference dose values against which local performance can be compared. In many cases these values can be improved upon quite considerably. This paper presents the results of a local initiative in the North West of the UK aimed at establishing local reference dose values for a number of major hospital sites. The purpose of this initiative is to establish a foundation for both optimisation strategies and clinical audit as an ongoing and routine practice. The paper presents results from an ongoing trial involving patient dose measurements for several radiological examinations upon the sites. The results of an attempt to establish local reference dose values from measured dose values and to employ them in optimisation strategies are presented. In particular emphasis is placed on the routine quality control programmes necessary to underpin this strategy including the effective data management of results from such programmes and how they can be employed to optimisation practices. (author)

SECONDARY PREVENTION OF STROKE IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION: THE CLINICIANS’ VIEWPOINT

Directory of Open Access Journals (Sweden)

E. A. Drozdova

2015-09-01

Full Text Available Atrial fibrillation is one of the main risk factor of ischemic stroke. Current problems of the management of patients with stroke due to non-valvular atrial fibrillation and secondary stroke prevention in these patients are considered. Data of own author’s observation for patients of this type during 6 months after discharge from the hospital are presented. The problems which patients faced with are analyzed. Comparative assessment of warfarin and dabigatran therapies is given.

Single room control for user-optimised room air conditions; Einzelraumregelung fuer nutzungsoptimiertes Raumklima

Energy Technology Data Exchange (ETDEWEB)

Lezius, A. [Staefa Control System GmbH, Leinfelden-Echterdingen (Germany)

1995-12-31

In chapter 14 of the anthology about building control the single room control for achieving user-optimised room air conditions is described. The following aspects are discussed: What is comfort? What is economic efficiency? Systems for secondary air treatment, adapted functions of the measurement and control technique, management functions, orientation of the demand at the use, investment and amortisation. (BWI) [Deutsch] Kapitel 14 des Sammelbandes ueber Building control ist dem Thema der Einzelraumregelung zur Erzielung eines nutzungsoptimierten Raumklimas gewidmet. In diesem Zusammenhang werden folgende Themenbereiche angesprochen: Was ist Komfort? Was ist Wirtschaftlichkeit? Systeme fuer sekundaere Luftbehandlung; Angepasste Funktionen der MSR-Technik; Managementfunktionen; Bedarfsorientierung an der Nutzung; Investition und Amortisation. (BWI)

For Time-Continuous Optimisation

DEFF Research Database (Denmark)

Heinrich, Mary Katherine; Ayres, Phil

2016-01-01

Strategies for optimisation in design normatively assume an artefact end-point, disallowing continuous architecture that engages living systems, dynamic behaviour, and complex systems. In our Flora Robotica investigations of symbiotic plant-robot bio-hybrids, we re- quire computational tools...

Utility of electronic patient records in primary care for stroke secondary prevention trials

Directory of Open Access Journals (Sweden)

Ashworth Mark

2011-02-01

Full Text Available Abstract Background This study aimed to inform the design of a pragmatic trial of stroke prevention in primary care by evaluating data recorded in electronic patient records (EPRs as potential outcome measures. The study also evaluated achievement of recommended standards of care; variation between family practices; and changes in risk factor values from before to after stroke. Methods Data from the UK General Practice Research Database (GPRD were analysed for 22,730 participants with an index first stroke between 2003 and 2006 from 414 family practices. For each subject, the EPR was evaluated for the 12 months before and after stroke. Measures relevant to stroke secondary prevention were analysed including blood pressure (BP, cholesterol, smoking, alcohol use, body mass index (BMI, atrial fibrillation, utilisation of antihypertensive, antiplatelet and cholesterol lowering drugs. Intraclass correlation coefficients (ICC were estimated by family practice. Random effects models were fitted to evaluate changes in risk factor values over time. Results In the 12 months following stroke, BP was recorded for 90%, cholesterol for 70% and body mass index (BMI for 47%. ICCs by family practice ranged from 0.02 for BP and BMI to 0.05 for LDL and HDL cholesterol. For subjects with records available both before and after stroke, the mean reductions from before to after stroke were: mean systolic BP, 6.02 mm Hg; diastolic BP, 2.78 mm Hg; total cholesterol, 0.60 mmol/l; BMI, 0.34 Kg/m2. There was an absolute reduction in smokers of 5% and heavy drinkers of 4%. The proportion of stroke patients within the recommended guidelines varied from less than a third (29% for systolic BP, just over half for BMI (54%, and over 90% (92% on alcohol consumption. Conclusions Electronic patient records have potential for evaluation of outcomes in pragmatic trials of stroke secondary prevention. Stroke prevention interventions in primary care remain suboptimal but important

Preventing secondary cases of invasive meningococcal capsular group B (MenB) disease using a recently-licensed, multi-component, protein-based vaccine (Bexsero(®)).

Science.gov (United States)

Ladhani, Shamez N; Cordery, Rebecca; Mandal, Sema; Christensen, Hannah; Campbell, Helen; Borrow, Ray; Ramsay, Mary E

2014-11-01

To assess the potential use of a protein-based meningococcal group B (MenB) vaccine (Bexsero(®)) in addition to antibiotic chemoprophylaxis for preventing secondary cases. Published studies on the risk of secondary meningococcal infections were used to estimate the numbers needed to vaccinate (NNV) with Bexsero(®) to prevent a secondary case in household and educational settings. Most secondary cases occur within a few days of diagnosis in the index case. Unlike conjugate vaccines, early protection offered after a single dose of Bexsero(®) is likely to be low, particularly in young children, who are at higher risk of secondary infection. NNV was dependent on predicted meningococcal strain coverage, estimated onset of protection after one Bexsero(®) dose and estimated vaccine efficacy. Even in the most favourable scenario where we assume the vaccine is administered within 4 days of the index case and prevents 90% of cases occurring after 14 days, the NNV for household contacts was >1000. NNV in educational settings was much higher. The estimated NNV should be taken into account when deciding policy to recommend Bexsero(®) for close contacts of single cases in household or educational settings. Bexsero(®) may have a protective role in clusters and outbreaks. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Secondary stroke prevention: challenges and solutions

Directory of Open Access Journals (Sweden)

Esenwa C

2015-08-01

Full Text Available Charles Esenwa, Jose GutierrezDepartment of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USAAbstract: Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke, the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies.Keywords: stroke mechanisms, stroke risk, hypertension, diabetes, dyslipidemia

Optimisation in X-ray and Molecular Imaging 2015

International Nuclear Information System (INIS)

Baath, Magnus; Hoeschen, Christoph; Mattsson, Soeren; Mansson, Lars Gunnar

2016-01-01

This issue of Radiation Protection Dosimetry is based on contributions to Optimisation in X-ray and Molecular Imaging 2015 - the 4. Malmoe Conference on Medical Imaging (OXMI 2015). The conference was jointly organised by members of former and current research projects supported by the European Commission EURATOM Radiation Protection Research Programme, in cooperation with the Swedish Society for Radiation Physics. The conference brought together over 150 researchers and other professionals from hospitals, universities and industries with interests in different aspects of the optimisation of medical imaging. More than 100 presentations were given at this international gathering of medical physicists, radiologists, engineers, technicians, nurses and educational researchers. Additionally, invited talks were offered by world-renowned experts on radiation protection, spectral imaging and medical image perception, thus covering several important aspects of the generation and interpretation of medical images. The conference consisted of 13 oral sessions and a poster session, as reflected by the conference title connected by their focus on the optimisation of the use ionising radiation in medical imaging. The conference included technology-specific topics such as computed tomography and tomosynthesis, but also generic issues of interest for the optimisation of all medical imaging, such as image perception and quality assurance. Radiation protection was covered by e.g. sessions on patient dose benchmarking and occupational exposure. Technically-advanced topics such as modelling, Monte Carlo simulation, reconstruction, classification, and segmentation were seen taking advantage of recent developments of hardware and software, showing that the optimisation community is at the forefront of technology and adapts well to new requirements. These peer-reviewed proceedings, representing a continuation of a series of selected reports from meetings in the field of medical imaging

User perspectives in public transport timetable optimisation

DEFF Research Database (Denmark)

Jensen, Jens Parbo; Nielsen, Otto Anker; Prato, Carlo Giacomo

2014-01-01

The present paper deals with timetable optimisation from the perspective of minimising the waiting time experienced by passengers when transferring either to or from a bus. Due to its inherent complexity, this bi-level minimisation problem is extremely difficult to solve mathematically, since tim...... on the large-scale public transport network in Denmark. The timetable optimisation approach yielded a yearly reduction in weighted waiting time equivalent to approximately 45 million Danish kroner (9 million USD)....

Optimising of Steel Fiber Reinforced Concrete Mix Design | Beddar ...

African Journals Online (AJOL)

Optimising of Steel Fiber Reinforced Concrete Mix Design. ... as a result of the loss of mixture workability that will be translated into a difficult concrete casting in site. ... An experimental study of an optimisation method of fibres in reinforced ...

Challenges in secondary prevention after acute myocardial infarction: A call for action.

Science.gov (United States)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul; Frederix, Ines; Prescott, Eva; Schmid, Jean Paul; Cupples, Margaret; Deaton, Christi; Doherty, Patrick; Giannuzzi, Pantaleo; Graham, Ian; Hansen, Tina Birgitte; Jennings, Catriona; Landmesser, Ulf; Marques-Vidal, Pedro; Vrints, Christiaan; Walker, David; Bueno, Héctor; Fitzsimons, Donna; Pelliccia, Antonio

2016-12-01

Worldwide, each year more than 7 million people experience myocardial infarction, in which one-year mortality rates are now in the range of 10%, but vary with patient characteristics. The consequences are even more dramatic: among patients who survive, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings are endorsed.

Effect of ginkgo capsules combined with secondary preventive drugs on the endothelial injury and plaque properties of patients with hypertension complicated by carotid atherosclerosis

Directory of Open Access Journals (Sweden)

Wei Li

2017-10-01

Full Text Available Objective: To study the effect of ginkgo capsules combined with secondary preventive drugs on the endothelial injury and plaque properties of patients with hypertension complicated by carotid atherosclerosis. Methods: A total of 178 patients with hypertension complicated by carotid atherosclerosis who were treated in Chengyue Community Health Service Center of Xisaishan District Huangshi City Hubei Province between February 2015 and January 2017 were collected and randomly divided into two groups. Control group were treated with conventional secondary preventive drugs, and observation group were treated with ginkgo capsules combined with secondary preventive drugs. The differences in serum endothelial injury indexes and lipid metabolism indexes as well as carotid artery ultrasound parameters were compared between the two groups before and after treatment. Results: Before treatment, endothelial injury indexes and lipid metabolism indexes as well as carotid artery ultrasound parameters were not significantly different between two groups. After treatment, serum ET, AngⅡ, TC, LDL-C and LpA contents as well as carotid artery ultrasound parameters DS and AS levels of observation group were lower than those of control group while serum NO and HDL-C contents as well as carotid artery ultrasound parameter MLD level were higher than those of control group. Conclusion: Ginkgo capsule combined with secondary preventive drugs can effectively reduce the endothelial injury and stabilize the plaques in patients with hypertension complicated by carotid atherosclerosis.

Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population

NARCIS (Netherlands)

Kaasenbrood, Lotte; Boekholdt, S. Matthijs; van der Graaf, Yolanda; Ray, Kausik K.; Peters, Ron J. G.; Kastelein, John J. P.; Amarenco, Pierre; LaRosa, John C.; Cramer, Maarten J. M.; Westerink, Jan; Kappelle, L. Jaap; de Borst, Gert J.; Visseren, Frank L. J.

2016-01-01

Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction and residual

Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population

NARCIS (Netherlands)

Kaasenbrood, Lotte; Boekholdt, S. Matthijs; Van Der Graaf, Yolanda; Ray, Kausik K.; Peters, Ron J G; Kastelein, John J P; Amarenco, Pierre; Larosa, John C.; Cramer, Maarten J M; Westerink, Jan; Kappelle, L. Jaap; De Borst, Gert J.; Visseren, Frank L J

2016-01-01

Background: Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction and

Methodological principles for optimising functional MRI experiments

International Nuclear Information System (INIS)

Wuestenberg, T.; Giesel, F.L.; Strasburger, H.

2005-01-01

Functional magnetic resonance imaging (fMRI) is one of the most common methods for localising neuronal activity in the brain. Even though the sensitivity of fMRI is comparatively low, the optimisation of certain experimental parameters allows obtaining reliable results. In this article, approaches for optimising the experimental design, imaging parameters and analytic strategies will be discussed. Clinical neuroscientists and interested physicians will receive practical rules of thumb for improving the efficiency of brain imaging experiments. (orig.) [de

Noise aspects at aerodynamic blade optimisation projects

International Nuclear Information System (INIS)

Schepers, J.G.

1997-06-01

The Netherlands Energy Research Foundation (ECN) has often been involved in industrial projects, in which blade geometries are created automatic by means of numerical optimisation. Usually, these projects aim at the determination of the aerodynamic optimal wind turbine blade, i.e. the goal is to design a blade which is optimal with regard to energy yield. In other cases, blades have been designed which are optimal with regard to cost of generated energy. However, it is obvious that the wind turbine blade designs which result from these optimisations, are not necessarily optimal with regard to noise emission. In this paper an example is shown of an aerodynamic blade optimisation, using the ECN-program PVOPT. PVOPT calculates the optimal wind turbine blade geometry such that the maximum energy yield is obtained. Using the aerodynamic optimal blade design as a basis, the possibilities of noise reduction are investigated. 11 figs., 8 refs

DACIA LOGAN LIVE AXLE OPTIMISATION USING COMPUTER GRAPHICS

Directory of Open Access Journals (Sweden)

KIRALY Andrei

2017-05-01

Full Text Available The paper presents some contributions to the calculus and optimisation of a live axle used at Dacia Logan using computer graphics software for creating the model and afterwards using FEA evaluation to determine the effectiveness of the optimisation. Thus using specialized computer software, a simulation is made and the results were compared to the measured real prototype.

Mesh dependence in PDE-constrained optimisation an application in tidal turbine array layouts

CERN Document Server

Schwedes, Tobias; Funke, Simon W; Piggott, Matthew D

2017-01-01

This book provides an introduction to PDE-constrained optimisation using finite elements and the adjoint approach. The practical impact of the mathematical insights presented here are demonstrated using the realistic scenario of the optimal placement of marine power turbines, thereby illustrating the real-world relevance of best-practice Hilbert space aware approaches to PDE-constrained optimisation problems. Many optimisation problems that arise in a real-world context are constrained by partial differential equations (PDEs). That is, the system whose configuration is to be optimised follows physical laws given by PDEs. This book describes general Hilbert space formulations of optimisation algorithms, thereby facilitating optimisations whose controls are functions of space. It demonstrates the importance of methods that respect the Hilbert space structure of the problem by analysing the mathematical drawbacks of failing to do so. The approaches considered are illustrated using the optimisation problem arisin...

CLIC crab cavity design optimisation for maximum luminosity

Energy Technology Data Exchange (ETDEWEB)

Dexter, A.C., E-mail: a.dexter@lancaster.ac.uk [Lancaster University, Lancaster, LA1 4YR (United Kingdom); Cockcroft Institute, Daresbury, Warrington, WA4 4AD (United Kingdom); Burt, G.; Ambattu, P.K. [Lancaster University, Lancaster, LA1 4YR (United Kingdom); Cockcroft Institute, Daresbury, Warrington, WA4 4AD (United Kingdom); Dolgashev, V. [SLAC, Menlo Park, CA 94025 (United States); Jones, R. [University of Manchester, Manchester, M13 9PL (United Kingdom)

2011-11-21

The bunch size and crossing angle planned for CERN's compact linear collider CLIC dictate that crab cavities on opposing linacs will be needed to rotate bunches of particles into alignment at the interaction point if the desired luminosity is to be achieved. Wakefield effects, RF phase errors between crab cavities on opposing linacs and unpredictable beam loading can each act to reduce luminosity below that anticipated for bunches colliding in perfect alignment. Unlike acceleration cavities, which are normally optimised for gradient, crab cavities must be optimised primarily for luminosity. Accepting the crab cavity technology choice of a 12 GHz, normal conducting, travelling wave structure as explained in the text, this paper develops an analytical approach to optimise cell number and iris diameter.

A conceptual optimisation strategy for radiography in a digital environment

International Nuclear Information System (INIS)

Baath, M.; Haakansson, M.; Hansson, J.; Maansson, L. G.

2005-01-01

Using a completely digital environment for the entire imaging process leads to new possibilities for optimisation of radiography since many restrictions of screen/film systems, such as the small dynamic range and the lack of possibilities for image processing, do not apply any longer. However, at the same time these new possibilities lead to a more complicated optimisation process, since more freedom is given to alter parameters. This paper focuses on describing an optimisation strategy that concentrates on taking advantage of the conceptual differences between digital systems and screen/film systems. The strategy can be summarised as: (a) always include the anatomical background during the optimisation, (b) perform all comparisons at a constant effective dose and (c) separate the image display stage from the image collection stage. A three-step process is proposed where the optimal setting of the technique parameters is determined at first, followed by an optimisation of the image processing. In the final step the optimal dose level - given the optimal settings of the image collection and image display stages - is determined. (authors)

Optimisation of a novel trailing edge concept for a high lift device

CSIR Research Space (South Africa)

Botha, JDM

2014-09-01

Full Text Available A novel concept (referred to as the flap extension) is implemented on the leading edge of the flap of a three element high lift device. The concept is optimised using two optimisation approaches based on Genetic Algorithm optimisations. A zero order...

Distributed optimisation problem with communication delay and external disturbance

Science.gov (United States)

Tran, Ngoc-Tu; Xiao, Jiang-Wen; Wang, Yan-Wu; Yang, Wu

2017-12-01

This paper investigates the distributed optimisation problem for the multi-agent systems (MASs) with the simultaneous presence of external disturbance and the communication delay. To solve this problem, a two-step design scheme is introduced. In the first step, based on the internal model principle, the internal model term is constructed to compensate the disturbance asymptotically. In the second step, a distributed optimisation algorithm is designed to solve the distributed optimisation problem based on the MASs with the simultaneous presence of disturbance and communication delay. Moreover, in the proposed algorithm, each agent interacts with its neighbours through the connected topology and the delay occurs during the information exchange. By utilising Lyapunov-Krasovskii functional, the delay-dependent conditions are derived for both slowly and fast time-varying delay, respectively, to ensure the convergence of the algorithm to the optimal solution of the optimisation problem. Several numerical simulation examples are provided to illustrate the effectiveness of the theoretical results.

A Bayesian Approach for Sensor Optimisation in Impact Identification

Directory of Open Access Journals (Sweden)

Vincenzo Mallardo

2016-11-01

Full Text Available This paper presents a Bayesian approach for optimizing the position of sensors aimed at impact identification in composite structures under operational conditions. The uncertainty in the sensor data has been represented by statistical distributions of the recorded signals. An optimisation strategy based on the genetic algorithm is proposed to find the best sensor combination aimed at locating impacts on composite structures. A Bayesian-based objective function is adopted in the optimisation procedure as an indicator of the performance of meta-models developed for different sensor combinations to locate various impact events. To represent a real structure under operational load and to increase the reliability of the Structural Health Monitoring (SHM system, the probability of malfunctioning sensors is included in the optimisation. The reliability and the robustness of the procedure is tested with experimental and numerical examples. Finally, the proposed optimisation algorithm is applied to a composite stiffened panel for both the uniform and non-uniform probability of impact occurrence.

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

Science.gov (United States)

DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William

2013-06-01

Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed.

Gender roles, physical and sexual violence prevention in primary extend to secondary school in Samutsakorn Province, Thailand.

Science.gov (United States)

Chamroonsawasdi, Kanittha; Suparp, Jarueyporn; Kittipichai, Wirin; Khajornchaikul, Piyathida

2010-03-01

To enhance positive attitude and life skills on gender roles to prevent physical and sexual violence. A whole school-based participatory learning program using a quasi-experimental study with pre and post test design was conducted among 2 schools during June-September, 2005. The experimental group, were 134 students in a primary school and 179 students in a secondary school. While the control group, were 122 students in a primary school and 95 students in a secondary school. Means score of attitude toward gender roles before implementation in the experimental group was significantly lower than the control group (p 0.05). Means paired different score (after-before) between the two groups was significantly different (p = 0.002). A whole school-based program on gender roles and violence prevention is suitable for youths and should be merged as school curricula and expanded as a nationwide program at all level of education. Gender equity should be taught at an early childhood. Parental involvement in school-based activities should be negotiated.

SINGLE FIXED CRANE OPTIMISATION WITHIN A DISTRIBUTION CENTRE

Directory of Open Access Journals (Sweden)

J. Matthews

2012-01-01

Full Text Available

ENGLISH ABSTRACT: This paper considersthe optimisation of the movement of a fixed crane operating in a single aisle of a distribution centre. The crane must move pallets in inventory between docking bays, storage locations, and picking lines. Both a static and a dynamic approach to the problem are presented. The optimisation is performed by means of tabu search, ant colony metaheuristics,and hybrids of these two methods. All these solution approaches were tested on real life data obtained from an operational distribution centre. Results indicate that the hybrid methods outperform the other approaches.

AFRIKAANSE OPSOMMING: Die optimisering van die beweging van 'n vaste hyskraan in 'n enkele gang van 'n distribusiesentrum word in hierdie artikel beskou. Die hyskraan moet pallette vervoer tussen dokhokke, stoorposisies, en opmaaklyne. Beide 'n statiese en 'n dinamiese benadering tot die probleem word aangebied. Die optimisering word gedoen met behulp van tabu-soektogte, mierkolonieoptimisering,en hibriede van hierdie twee metodes. Al die oplossingsbenaderings is getoets met werklike data wat van 'n operasionele distribusiesentrum verkry is. Die resultate toon aan dat die hibriedmetodes die beste oplossings lewer.

Algorithme intelligent d'optimisation d'un design structurel de grande envergure

Science.gov (United States)

Dominique, Stephane

genetic algorithm that prevents new individuals to be born too close to previously evaluated solutions. The restricted area becomes smaller or larger during the optimisation to allow global or local search when necessary. Also, a new search operator named Substitution Operator is incorporated in GATE. This operator allows an ANN surrogate model to guide the algorithm toward the most promising areas of the design space. The suggested CBR approach and GATE were tested on several simple test problems, as well as on the industrial problem of designing a gas turbine engine rotor's disc. These results are compared to other results obtained for the same problems by many other popular optimisation algorithms, such as (depending of the problem) gradient algorithms, binary genetic algorithm, real number genetic algorithm, genetic algorithm using multiple parents crossovers, differential evolution genetic algorithm, Hookes & Jeeves generalized pattern search method and POINTER from the software I-SIGHT 3.5. Results show that GATE is quite competitive, giving the best results for 5 of the 6 constrained optimisation problem. GATE also provided the best results of all on problem produced by a Maximum Set Gaussian landscape generator. Finally, GATE provided a disc 4.3% lighter than the best other tested algorithm (POINTER) for the gas turbine engine rotor's disc problem. One drawback of GATE is a lesser efficiency for highly multimodal unconstrained problems, for which he gave quite poor results with respect to its implementation cost. To conclude, according to the preliminary results obtained during this thesis, the suggested CBR process, combined with GATE, seems to be a very good candidate to automate and accelerate the structural design of mechanical devices, potentially reducing significantly the cost of industrial preliminary design processes.

Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study

NARCIS (Netherlands)

A. Murphy (Adrianna); Palafox, B. (Benjamin); O.A. O'Donnell (Owen); D. Stuckler (David); P. Perel (Pablo); AlHabib, K.F. (Khalid F); Avezum, A. (Alvaro); Bai, X. (Xiulin); Chifamba, J. (Jephat); Chow, C.K. (Clara K); Corsi, D.J. (Daniel J); G.R. Dagenais (Gilles R); Dans, A.L. (Antonio L); R. Díaz (Rafael); Erbakan, A.N. (Ayse N); Ismail, N. (Noorhassim); Iqbal, R. (Romaina); Kelishadi, R. (Roya); Khatib, R. (Rasha); Lanas, F. (Fernando); Lear, S.A. (Scott A); Li, W. (Wei); Liu, J. (Jia); Lopez-Jaramillo, P. (Patricio); Mohan, V. (Viswanathan); Monsef, N. (Nahed); Mony, P.K. (Prem K); Puoane, T. (Thandi); Rangarajan, S. (Sumathy); A. Rosengren (Annika); Schutte, A.E. (Aletta E); Sintaha, M. (Mariz); Teo, K.K. (Koon K); Wielgosz, A. (Andreas); Yeates, K. (Karen); Yin, L. (Lu); Yusoff, K. (Khalid); Zatońska, K. (Katarzyna); S. Yusuf (Salim); M. McKee (Martin)

2018-01-01

textabstractBackground: There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. Methods: We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492

Multi-objective evolutionary optimisation for product design and manufacturing

CERN Document Server

2011-01-01

Presents state-of-the-art research in the area of multi-objective evolutionary optimisation for integrated product design and manufacturing Provides a comprehensive review of the literature Gives in-depth descriptions of recently developed innovative and novel methodologies, algorithms and systems in the area of modelling, simulation and optimisation

Natural Erosion of Sandstone as Shape Optimisation.

Science.gov (United States)

Ostanin, Igor; Safonov, Alexander; Oseledets, Ivan

2017-12-11

Natural arches, pillars and other exotic sandstone formations have always been attracting attention for their unusual shapes and amazing mechanical balance that leave a strong impression of intelligent design rather than the result of a stochastic process. It has been recently demonstrated that these shapes could have been the result of the negative feedback between stress and erosion that originates in fundamental laws of friction between the rock's constituent particles. Here we present a deeper analysis of this idea and bridge it with the approaches utilized in shape and topology optimisation. It appears that the processes of natural erosion, driven by stochastic surface forces and Mohr-Coulomb law of dry friction, can be viewed within the framework of local optimisation for minimum elastic strain energy. Our hypothesis is confirmed by numerical simulations of the erosion using the topological-shape optimisation model. Our work contributes to a better understanding of stochastic erosion and feasible landscape formations that could be found on Earth and beyond.

Techno-economic optimisation of energy systems; Contribution a l'optimisation technico-economique de systemes energetiques

Energy Technology Data Exchange (ETDEWEB)

Mansilla Pellen, Ch

2006-07-15

The traditional approach currently used to assess the economic interest of energy systems is based on a defined flow-sheet. Some studies have shown that the flow-sheets corresponding to the best thermodynamic efficiencies do not necessarily lead to the best production costs. A method called techno-economic optimisation was proposed. This method aims at minimising the production cost of a given energy system, including both investment and operating costs. It was implemented using genetic algorithms. This approach was compared to the heat integration method on two different examples, thus validating its interest. Techno-economic optimisation was then applied to different energy systems dealing with hydrogen as well as electricity production. (author)

Secondary prevention lifestyle interventions initiated within 90 days after TIA or 'minor' stroke: a systematic review and meta-analysis of rehabilitation programmes.

Science.gov (United States)

Heron, Neil; Kee, Frank; Cardwell, Christopher; Tully, Mark A; Donnelly, Michael; Cupples, Margaret E

2017-01-01

Strokes are often preceded by a transient ischaemic attack (TIA) or 'minor' stroke. The immediate period after a TIA/minor stroke is a crucial time to initiate secondary prevention. However, the optimal approach to prevention, including non-pharmacological measures, after TIA is not clear. To systematically review evidence about the effectiveness of delivering secondary prevention, with lifestyle interventions, in comprehensive rehabilitation programmes, initiated within 90 days of a TIA/minor stroke. Also, to categorise the specific behaviour change techniques used. The review identified randomised controlled trials by searching the Cochrane Library, Ovid MEDLINE, Ovid EMBASE, Web of Science, EBSCO CINAHL and Ovid PsycINFO. Two review authors independently screened titles and abstracts for eligibility (programmes initiated within 90 days of event; outcomes reported for TIA/minor stroke) and extracted relevant data from appraised studies; a meta-analysis was used to synthesise the results. A total of 31 potentially eligible papers were identified and four studies, comprising 774 patients post-TIA or minor stroke, met the inclusion criteria; two had poor methodological quality. Individual studies reported increased aerobic capacity but meta-analysis found no significant change in resting and peak systolic blood pressure, resting heart rate, aerobic capacity, falls, or mortality. The main behaviour change techniques were goal setting and instructions about how to perform given behaviours. There is limited evidence of the effectiveness of early post-TIA rehabilitation programmes with preventive lifestyle interventions. Further robust randomised controlled trials of comprehensive rehabilitation programmes that promote secondary prevention and lifestyle modification immediately after a TIA are needed. © British Journal of General Practice 2017.

Application of Surpac and Whittle Software in Open Pit Optimisation ...

African Journals Online (AJOL)

Application of Surpac and Whittle Software in Open Pit Optimisation and Design. ... This paper studies the Surpac and Whittle software and their application in designing an optimised pit. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Topology Optimisation of Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Thike Aye Min

2016-01-01

Full Text Available Wireless sensor networks are widely used in a variety of fields including industrial environments. In case of a clustered network the location of cluster head affects the reliability of the network operation. Finding of the optimum location of the cluster head, therefore, is critical for the design of a network. This paper discusses the optimisation approach, based on the brute force algorithm, in the context of topology optimisation of a cluster structure centralised wireless sensor network. Two examples are given to verify the approach that demonstrate the implementation of the brute force algorithm to find an optimum location of the cluster head.

Application of ant colony optimisation in distribution transformer sizing

African Journals Online (AJOL)

This study proposes an optimisation method for transformer sizing in power system using ant colony optimisation and a verification of the process by MATLAB software. The aim is to address the issue of transformer sizing which is a major challenge affecting its effective performance, longevity, huge capital cost and power ...

Microcapsule-Type Self-Healing Protective Coating for Cementitious Composites with Secondary Crack Preventing Ability.

Science.gov (United States)

Kim, Dong-Min; Yu, Hwan-Chul; Yang, Hye-In; Cho, Yu-Jin; Lee, Kwang-Myong; Chung, Chan-Moon

2017-01-26

A microcapsule-type self-healing protective coating with secondary crack preventing capability has been developed using a silanol-terminated polydimethylsiloxane (STP)/dibutyltin dilaurate (DD) healing agent. STP undergoes condensation reaction in the presence of DD to give a viscoelastic substance. STP- and DD-containing microcapsules were prepared by in-situ polymerization and interfacial polymerization methods, respectively. The microcapsules were characterized by Fourier-transform infrared (FT-IR) spectroscopy, optical microscopy, and scanning electron microscopy (SEM). The microcapsules were integrated into commercial enamel paint or epoxy coating formulations, which were applied on silicon wafers, steel panels, and mortar specimens to make dual-capsule self-healing protective coatings. When the STP/DD-based coating was scratched, self-healing of the damaged region occurred, which was demonstrated by SEM, electrochemical test, and water permeability test. It was also confirmed that secondary crack did not occur in the healed region upon application of vigorous vibration to the self-healing coating.

Microcapsule-Type Self-Healing Protective Coating for Cementitious Composites with Secondary Crack Preventing Ability

Directory of Open Access Journals (Sweden)

Dong-Min Kim

2017-01-01

Full Text Available A microcapsule-type self-healing protective coating with secondary crack preventing capability has been developed using a silanol-terminated polydimethylsiloxane (STP/dibutyltin dilaurate (DD healing agent. STP undergoes condensation reaction in the presence of DD to give a viscoelastic substance. STP- and DD-containing microcapsules were prepared by in-situ polymerization and interfacial polymerization methods, respectively. The microcapsules were characterized by Fourier-transform infrared (FT-IR spectroscopy, optical microscopy, and scanning electron microscopy (SEM. The microcapsules were integrated into commercial enamel paint or epoxy coating formulations, which were applied on silicon wafers, steel panels, and mortar specimens to make dual-capsule self-healing protective coatings. When the STP/DD-based coating was scratched, self-healing of the damaged region occurred, which was demonstrated by SEM, electrochemical test, and water permeability test. It was also confirmed that secondary crack did not occur in the healed region upon application of vigorous vibration to the self-healing coating.

A hybrid Constraint Programming/Mixed Integer Programming framework for the preventive signaling maintenance crew scheduling problem

DEFF Research Database (Denmark)

Pour, Shahrzad M.; Drake, John H.; Ejlertsen, Lena Secher

2017-01-01

A railway signaling system is a complex and interdependent system which should ensure the safe operation of trains. We introduce and address a mixed integer optimisation model for the preventive signal maintenance crew scheduling problem in the Danish railway system. The problem contains many...... to feed as ‘warm start’ solutions to a Mixed Integer Programming (MIP) solver for further optimisation. We apply the CP/MIP framework to a section of the Danish rail network and benchmark our results against both direct application of a MIP solver and modelling the problem as a Constraint Optimisation...

Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a programme for preventing smoking in secondary schools delivered by medical students: a study protocol.

Science.gov (United States)

Brinker, Titus J; Stamm-Balderjahn, Sabine; Seeger, Werner; Groneberg, David A

2014-07-24

A survey conducted by the German Federal Centre for Health Education in 2012 showed that 35.2% of all young adults (18-25 years) and 12.0% of all adolescents (12-17 years) in Germany are regular cigarette smokers. Most smoked their first cigarette in early adolescence. We recently reported a significantly positive short-term effect of a physician-delivered school-based smoking prevention programme on the smoking behaviour of schoolchildren in Germany. However, physician-based programmes are usually very expensive. Therefore, we will evaluate and optimise Education against Tobacco (EAT), a widespread, low-cost programme delivered by about 400 medical students from 16 universities in Germany. A prospective quasi-experimental study design with two measurements at baseline (t1) and 6 months post-intervention (t2) to investigate an intervention in 10-15-year-olds in grades 6-8 at German secondary schools. The intervention programme consists of two 60-min school-based medical-student-delivered modules with (module 1) and without the involvement of patients with tobacco-related diseases and control groups (no intervention). The study questionnaire measuring smoking status (water pipe and cigarette smoking), smoking-related cognitions, and gender, social and cultural aspects was designed and pre-tested in advance. The primary end point is the prevalence of smokers and non-smokers in the two study arms at 6 months after the intervention. The percentage of former smokers and new smokers in the two groups and the measures of smoking behaviour will be studied as secondary outcome measures. In accordance with Good Epidemiologic Practice (GEP) guidelines, the study protocol was submitted for approval by the responsible ethics committee, which decided that the study does not need ethical approval (Goethe University, Frankfurt-Main, Germany). Findings will be disseminated in peer-reviewed journals, at conferences, within our scientific advisory board and through medical

Optimisation of Software-Defined Networks Performance Using a Hybrid Intelligent System

Directory of Open Access Journals (Sweden)

Ann Sabih

2017-06-01

Full Text Available This paper proposes a novel intelligent technique that has been designed to optimise the performance of Software Defined Networks (SDN. The proposed hybrid intelligent system has employed integration of intelligence-based optimisation approaches with the artificial neural network. These heuristic optimisation methods include Genetic Algorithms (GA and Particle Swarm Optimisation (PSO. These methods were utilised separately in order to select the best inputs to maximise SDN performance. In order to identify SDN behaviour, the neural network model is trained and applied. The maximal optimisation approach has been identified using an analytical approach that considered SDN performance and the computational time as objective functions. Initially, the general model of the neural network was tested with unseen data before implementing the model using GA and PSO to determine the optimal performance of SDN. The results showed that the SDN represented by Artificial Neural Network ANN, and optmised by PSO, generated a better configuration with regards to computational efficiency and performance index.

Operation planning for a pondage power station chain by means of linear programming and genetic optimisation; Einsatzplanung fuer eine Flusskraftwerkskette im Schwellbetrieb mittels LP und genetischer Optimierung

Energy Technology Data Exchange (ETDEWEB)

Mueller, H.; Huelsemann, M.

1997-12-31

This paper presents a system package which serves as a simulation and optimisation tool for daily operation planning for a hydroelectric cascade. The purpose of the planning is to maximise (the differentially weighted) production of electrical energy given a certain set of specifications and secondary conditions. Optimal operation management is achieved using a two-stage approach: first pre-optimisation by means of linear programming, followed by detail optimisation using a Genetic Algorithm based on a non-linear, dynamic model of the power station and reservoir chain. [Deutsch] Im Beitrag wird ein Systempaket als Simulations- und Optimierungswerkzeug zur taeglichen Betriebsplanung einer Wasserkraftwerkskaskade vorgestellt. Ziel der Wasserbewirtschaftung ist es, unter den gegebenen Vorgaben und Randbedingungen die (bewertete) Erzeugung elektrischer Energie zu maximieren. Das optimale Fahrplanmanagement wird durch einen zweistufigen Loesungsansatz realisiert: Mit einer Vor-Optimierung mittels Linearer Programmierung (LP), gefolgt von einer detaillierten Optimierung mit einem Genetischen Algorithmus, der auf ein nichtlineares, dynamisches Simulationsmodell fuer die Kette aus Kraftwerken und Stauraeumen zugreift. (orig./RHM)

Level of knowledge the teenagers in secondary schools about addiction, and its prevention

Directory of Open Access Journals (Sweden)

Dorota Maciąg

2012-12-01

Full Text Available Background: Narcotics have been present in the world for thousands of years. People have been trying to change their psyche by means of psychoactive drugs. At the very beginning drugs were used as the element of religious cult, helpful in varying social meetings. With time, they were used as medicinal substances. The phenomenon of narcosis among children and teenagers by means of various narcotics is one of the most serious aspects of social aberration and it is a very difficult educational problem all over the world. Drug abuse among teenagers is becoming more and more serious and is increasing, which puts health and life in danger. There are as many reasons of drug abuse as narcotics. Young people do not appreciate their health, as in their opinion illnesses are directly related to an old age. They do not understand the consequences of drug abuse which is just a good fun for them. The aim of drug prevention strategy is, first of all, the reduction of drugs availability. The prevention strategies concentrated on costs aim at helping the individuals to develop and keep the healthy way of life. The strategies concentrated on society should include the environmental factors, such as legal, economical, family, cultural, political and religious aspects. The aim of this work was to specify the awareness of secondary school students concerning drug abuse, its reasons, health effects and prevention. Materials and methods: The research was conducted among 80 students of 1–3 grade of secondary schools from Opatów province. The questionnaire was the research tool, which consisted of 21 questions concerning the students’ knowledge about the reasons for reaching for drugs, the possibilities of getting drugs at school, the health reasons of drug abuse as well as the drug prevention conducted by the teachers and school educationalists. Results: Only 25% of the students believed drug abuse to be a socially pathological phenomenon. 65% claimed that lately

Ants Colony Optimisation of a Measuring Path of Prismatic Parts on a CMM

Directory of Open Access Journals (Sweden)

Stojadinovic Slavenko M.

2016-03-01

Full Text Available This paper presents optimisation of a measuring probe path in inspecting the prismatic parts on a CMM. The optimisation model is based on: (i the mathematical model that establishes an initial collision-free path presented by a set of points, and (ii the solution of Travelling Salesman Problem (TSP obtained with Ant Colony Optimisation (ACO. In order to solve TSP, an ACO algorithm that aims to find the shortest path of ant colony movement (i.e. the optimised path is applied. Then, the optimised path is compared with the measuring path obtained with online programming on CMM ZEISS UMM500 and with the measuring path obtained in the CMM inspection module of Pro/ENGINEER® software. The results of comparing the optimised path with the other two generated paths show that the optimised path is at least 20% shorter than the path obtained by on-line programming on CMM ZEISS UMM500, and at least 10% shorter than the path obtained by using the CMM module in Pro/ENGINEER®.

PHYSICAL-MATEMATICALSCIENCE MECHANICS SIMULATION CHALLENGES IN OPTIMISING THEORETICAL METAL CUTTING TASKS

Directory of Open Access Journals (Sweden)

Rasul V. Guseynov

2017-01-01

Full Text Available Abstract. Objectives In the article, problems in the optimising of machining operations, which provide end-unit production of the required quality with a minimum processing cost, are addressed. Methods Increasing the effectiveness of experimental research was achieved through the use of mathematical methods for planning experiments for optimising metal cutting tasks. The minimal processing cost model, in which the objective function is polynomial, is adopted as a criterion for the selection of optimal parameters. Results Polynomial models of the influence of angles φ, α, γ on the torque applied when cutting threads in various steels are constructed. Optimum values of the geometrical tool parameters were obtained using the criterion of minimum cutting forces during processing. The high stability of tools having optimal geometric parameters is determined. It is shown that the use of experimental planning methods allows the optimisation of cutting parameters. In optimising solutions to metal cutting problems, it is found to be expedient to use multifactor experimental planning methods and to select the cutting force as the optimisation parameter when determining tool geometry. Conclusion The joint use of geometric programming and experiment planning methods in order to optimise the parameters of cutting significantly increases the efficiency of technological metal processing approaches. 

Optimisation of searches for Supersymmetry with the ATLAS detector

Energy Technology Data Exchange (ETDEWEB)

Zvolsky, Milan

2012-01-15

The ATLAS experiment is one of the four large experiments at the Large Hadron Collider which is specifically designed to search for the Higgs boson and physics beyond the Standard Model. The aim of this thesis is the optimisation of searches for Supersymmetry in decays with two leptons and missing transverse energy in the final state. Two different optimisation studies have been performed for two important analysis aspects: The final signal region selection and the choice of the trigger selection. In the first part of the analysis, a cut-based optimisation of signal regions is performed, maximising the signal for a minimal background contamination. By this, the signal yield can in parts be more than doubled. The second approach is to introduce di-lepton triggers which allow to lower the lepton transverse momentum threshold, thus enhancing the number of selected signal events significantly. The signal region optimisation was considered for the choice of the final event selection in the ATLAS di-lepton analyses. The trigger study contributed to the incorporation of di-lepton triggers to the ATLAS trigger menu. (orig.)

Data for TROTS – The Radiotherapy Optimisation Test Set

Directory of Open Access Journals (Sweden)

Sebastiaan Breedveld

2017-06-01

Full Text Available The Radiotherapy Optimisation Test Set (TROTS is an extensive set of problems originating from radiotherapy (radiation therapy treatment planning. This dataset is created for 2 purposes: (1 to supply a large-scale dense dataset to measure performance and quality of mathematical solvers, and (2 to supply a dataset to investigate the multi-criteria optimisation and decision-making nature of the radiotherapy problem. The dataset contains 120 problems (patients, divided over 6 different treatment protocols/tumour types. Each problem contains numerical data, a configuration for the optimisation problem, and data required to visualise and interpret the results. The data is stored as HDF5 compatible Matlab files, and includes scripts to work with the dataset.

The optimisation of wedge filters in radiotherapy of the prostate

International Nuclear Information System (INIS)

Oldham, Mark; Neal, Anthony J.; Webb, Steve

1995-01-01

A treatment plan optimisation algorithm has been applied to 12 patients with early prostate cancer in order to determine the optimum beam-weights and wedge angles for a standard conformal three-field treatment technique. The optimisation algorithm was based on fast-simulated-annealing using a cost function designed to achieve a uniform dose in the planning-target-volume (PTV) and to minimise the integral doses to the organs-at-risk. The algorithm has been applied to standard conformal three-field plans created by an experienced human planner, and run in three PLAN MODES: (1) where the wedge angles were fixed by the human planner and only the beam-weights were optimised; (2) where both the wedge angles and beam-weights were optimised; and (3) where both the wedge angles and beam-weights were optimised and a non-uniform dose was prescribed to the PTV. In the latter PLAN MODE, a uniform 100% dose was prescribed to all of the PTV except for that region that overlaps with the rectum where a lower (e.g., 90%) dose was prescribed. The resulting optimised plans have been compared with those of the human planner who found beam-weights by conventional forward planning techniques. Plans were compared on the basis of dose statistics, normal-tissue-complication-probability (NTCP) and tumour-control-probability (TCP). The results of the comparison showed that all three PLAN MODES produced plans with slightly higher TCP for the same rectal NTCP, than the human planner. The best results were observed for PLAN MODE 3, where an average increase in TCP of 0.73% (± 0.20, 95% confidence interval) was predicted by the biological models. This increase arises from a beneficial dose gradient which is produced across the tumour. Although the TCP gain is small it comes with no increase in treatment complexity, and could translate into increased cures given the large numbers of patients being referred. A study of the beam-weights and wedge angles chosen by the optimisation algorithm revealed

GAOS: Spatial optimisation of crop and nature within agricultural fields

NARCIS (Netherlands)

Bruin, de S.; Janssen, H.; Klompe, A.; Lerink, P.; Vanmeulebrouk, B.

2010-01-01

This paper proposes and demonstrates a spatial optimiser that allocates areas of inefficient machine manoeuvring to field margins thus improving the use of available space and supporting map-based Controlled Traffic Farming. A prototype web service (GAOS) allows farmers to optimise tracks within

Techno-economic optimisation of energy systems

International Nuclear Information System (INIS)

Mansilla Pellen, Ch.

2006-07-01

The traditional approach currently used to assess the economic interest of energy systems is based on a defined flow-sheet. Some studies have shown that the flow-sheets corresponding to the best thermodynamic efficiencies do not necessarily lead to the best production costs. A method called techno-economic optimisation was proposed. This method aims at minimising the production cost of a given energy system, including both investment and operating costs. It was implemented using genetic algorithms. This approach was compared to the heat integration method on two different examples, thus validating its interest. Techno-economic optimisation was then applied to different energy systems dealing with hydrogen as well as electricity production. (author)

Cost-Effectiveness Analysis of Atorvastatin versus Rosuvastatin in Primary and Secondary Cardiovascular Prevention Populations in Brazil and Columbia.

Science.gov (United States)

Mould-Quevedo, Joaquín F; Gutiérrez-Ardila, Magda Vianey; Ordóñez Molina, Jaime Eduardo; Pinsky, Brett; Vargas Zea, Nicolás

2014-12-01

Latin America has witnessed a marked increase in cardiovascular (CV) disease, the leading cause of death in many countries. The benefits of lipid-lowering therapy to reduce CV-related events are widely accepted. Clinical evidence suggests that rosuvastatin is associated with slightly greater reductions in low-density lipoprotein cholesterol levels than is atorvastatin at comparable doses. Rosuvastatin, however, is often priced at a premium. Our objective was to examine the cost-effectiveness of using atorvastatin versus rosuvastatin in reducing CV events in Brazil and Colombia using real-world prices. A global Markov cohort model of primary and secondary CV prevention was developed and adapted to Brazilian and Colombian settings. The risks and costs of major CV events and efficacy, adherence, and costs of statins were considered. Total gains in life-years, quality-adjusted life-years, major CV events avoided, and costs over the lifetime horizon were estimated. Several dose comparisons were considered. In the Colombian analyses, differences in drug costs between therapies were considerable while outcomes were similar. The incremental cost per quality-adjusted life-year gained for rosuvastatin versus atorvastatin was more than $700,000 and $200,000 in primary and secondary prevention, respectively. Brazilian analyses found lower incremental cost-effectiveness ratios for rosuvastatin at some dose comparisons due to similar pricing between statins. Sensitivity analyses revealed that changes in treatment efficacy and adherence had the largest impact on results. In primary and secondary CV prevention, the efficacy advantage of rosuvastatin was minimal, while its acquisition cost was higher, particularly in Colombia. The incremental cost-effectiveness ratios were, therefore, generally in favor of atorvastatin being the cost-effective option. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights

Design optimisation of a flywheel hybrid vehicle

Energy Technology Data Exchange (ETDEWEB)

Kok, D.B.

1999-11-04

during the engine start-up and shutdown periods. Correct throttle valve control ensures that hydrocarbon emissions are not critical for legislative emission limits, but the engine's standard lambda control cannot prevent an increase of nitric oxides. In order to improve tailpipe emissions, the thermo-chemical behaviour of the catalytic converter is investigated and adapted for hybrid vehicle application. In cold-start situations, the fuel consumption and exhaust gas emissions of a mechanical driveline with internal combustion engine increase. A detailed numerical investigation of the thermal behaviour of the hybrid driveline showed that the energy-efficient operation of the engine decreases thermal waste energy that is available to warm up driveline components. Therefore, a redesign of the cooling circuitry and thermal management of the driveline was required to improve system warm-up. A computer model has been developed that combines the functional description of the flywheel hybrid vehicle with the calculation of energy losses. Apart from standardised European drive cycles, velocity profiles that represent more realistic vehicle utilisation are used to assess and optimise the hybrid vehicle's fuel economy, exhaust gas emission and acceleration performance. Subdivision of energy consumption enabled the classification of those systems and components that have a major effect on fuel consumption. Of these, the optimised flywheel system, the hydraulic system, and the transmission consume energy of comparable magnitude in city driving. It is shown that the system's fuel economy is mainly a result of the improved engine operation. Regenerative braking has only limited effect on vehicle fuel consumption. Experiments with an early prototype of the hybrid driveline yielded no gains in fuel consumption when compared to a conventional CVT reference vehicle due to high storage losses in the flywheel system. However, the improved prototype of the flywheel hybrid

Operational Radiological Protection and Aspects of Optimisation

International Nuclear Information System (INIS)

Lazo, E.; Lindvall, C.G.

2005-01-01

Since 1992, the Nuclear Energy Agency (NEA), along with the International Atomic Energy Agency (IAEA), has sponsored the Information System on Occupational Exposure (ISOE). ISOE collects and analyses occupational exposure data and experience from over 400 nuclear power plants around the world and is a forum for radiological protection experts from both nuclear power plants and regulatory authorities to share lessons learned and best practices in the management of worker radiation exposures. In connection to the ongoing work of the International Commission on Radiological Protection (ICRP) to develop new recommendations, the ISOE programme has been interested in how the new recommendations would affect operational radiological protection application at nuclear power plants. Bearing in mind that the ICRP is developing, in addition to new general recommendations, a new recommendation specifically on optimisation, the ISOE programme created a working group to study the operational aspects of optimisation, and to identify the key factors in optimisation that could usefully be reflected in ICRP recommendations. In addition, the Group identified areas where further ICRP clarification and guidance would be of assistance to practitioners, both at the plant and the regulatory authority. The specific objective of this ISOE work was to provide operational radiological protection input, based on practical experience, to the development of new ICRP recommendations, particularly in the area of optimisation. This will help assure that new recommendations will best serve the needs of those implementing radiation protection standards, for the public and for workers, at both national and international levels. (author)

Optimising polarised neutron scattering measurements--XYZ and polarimetry analysis

International Nuclear Information System (INIS)

Cussen, L.D.; Goossens, D.J.

2002-01-01

The analytic optimisation of neutron scattering measurements made using XYZ polarisation analysis and neutron polarimetry techniques is discussed. Expressions for the 'quality factor' and the optimum division of counting time for the XYZ technique are presented. For neutron polarimetry the optimisation is identified as analogous to that for measuring the flipping ratio and reference is made to the results already in the literature

Optimising polarised neutron scattering measurements--XYZ and polarimetry analysis

CERN Document Server

Cussen, L D

2002-01-01

The analytic optimisation of neutron scattering measurements made using XYZ polarisation analysis and neutron polarimetry techniques is discussed. Expressions for the 'quality factor' and the optimum division of counting time for the XYZ technique are presented. For neutron polarimetry the optimisation is identified as analogous to that for measuring the flipping ratio and reference is made to the results already in the literature.

Design Optimisation and Conrol of a Pilot Operated Seat Valve

DEFF Research Database (Denmark)

Nielsen, Brian; Andersen, Torben Ole; Hansen, Michael Rygaard

2004-01-01

The paper gives an approach for optimisation of the bandwidth of a pilot operated seat valve for mobile applications. Physical dimensions as well as parameters of the implemented control loop are optimised simultaneously. The frequency response of the valve varies as a function of the pressure drop...

Adjoint Optimisation of the Turbulent Flow in an Annular Diffuser

DEFF Research Database (Denmark)

Gotfredsen, Erik; Agular Knudsen, Christian; Kunoy, Jens Dahl

2017-01-01

In the present study, a numerical optimisation of guide vanes in an annular diffuser, is performed. The optimisation is preformed for the purpose of improving the following two parameters simultaneously; the first parameter is the uniformity perpen-dicular to the flow direction, a 1/3 diameter do...

Helpers in Distress: Preventing Secondary Trauma

Science.gov (United States)

Whitfield, Natasha; Kanter, Deborah

2014-01-01

Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…

Secondary prevention of work-related upper extremity disorders: recommendations from the Annapolis conference.

Science.gov (United States)

Feuerstein, Michael; Harrington, Cherise B

2006-09-01

Efforts to improve the secondary prevention of work-related upper extremity (WRUE) symptoms continue to present a challenge. As with many occupational musculoskeletal pain disorders no single, direct cause-effect relationship exists among specific exposures, pathologic processes, and symptoms. The field has yet to create truly effective and efficient interventions for these problems that are based on current epidemiological and clinical knowledge. A working conference was held in Annapolis, Maryland on September 23rd and 24th, 2005 with leaders in research and application related to upper extremity disorders to address this challenge. The intent of the meeting was to review "state of the art" evidence in epidemiology and intervention research in order to develop suggestions regarding next steps in intervention research and application. On day 2 a number of stakeholders were present to discuss what they perceived as the missing pieces in both epidemiological research and applied intervention research in order to generate more effective workplace interventions. The papers in this series of the Journal of Occupational Rehabilitation indicate that scientifically sound progress has been made over the past decade in identifying ergonomic, workplace psychosocial, and individual factors in both the etiology and exacerbation of these symptoms/disorders. However, there is a gap between this knowledge and the development and practical implementation of comprehensive interventions for these problems. The conference also highlighted the paucity of economic analyses of the impact of these disorders as well as the economic study of the impact of intervention. Approaches for such evaluations were presented and are included in this special section of the journal. This series of papers and the summary of the invited group's discussions provided in this paper clearly emphasize the need for innovative ways to think about these problems and specific research topics that can help

Optimisation of Protection as applicable to geological disposal: the ICRP view

International Nuclear Information System (INIS)

Weiss, W.

2010-01-01

Wolfgang Weiss (BfS), vice-chair of ICRP Committee 4, recalled that the role of optimisation is to select the best protection options under the prevailing circumstances based on scientific considerations, societal concerns and ethical aspects as well as considerations of transparency. An important role of the concept of optimisation of protection is to foster a 'safety culture' and thereby to engender a state of thinking in everyone responsible for control of radiation exposures, such that they are continuously asking themselves the question, 'Have I done all that I reasonably can to avoid or reduce these doses?' Clearly, the answer to this question is a matter of judgement and necessitates co-operation between all parties involved and, as a minimum, the operating management and the regulatory agencies, but the dialogue would be more complete if other stakeholders were also involved. What kinds of checks and balances or factors would be needed to be considered for an 'optimal' system? Can indicators be identified? Quantitative methods may provide input to this dialogue but they should never be the sole input. The ICRP considers that the parameters to take into account include also social considerations and values, environmental considerations, as well as technical and economic considerations. Wolfgang Weiss approached the question of the distinction to be made between system optimisation (in the sense of taking account of social and economic as well as of all types of hazards) and optimisation of radiological protection. The position of the ICRP is that the system of protection that it proposes is based on both science (quantification of the health risk) and value judgement (what is an acceptable risk?) and optimisation is the recommended process to integrate both aspects. Indeed, there has been evolution since the old system of intervention levels to the new system, whereby, even if the level of the dose or risk (which is called constraint in ICRP-81 ) is met

Pharmacotherapy in Patients after Acute Myocardial Infarction - the Basis for Effective Secondary Prevention. Data from a Pilot Registry in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Grünfeldová, H.; Tomečková, Marie; Monhart, Z.; Faltus, Václav; Peleška, Jan

2007-01-01

Roč. 30 (2007), s. 372-372 ISSN 1420-4096. [Central European Meeting on Hypertension and Cardiovascular Disease Prevention. 11.10.2007-13.10.2007, Kraków] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : acute myocardial ifraction * pilot registry * secondary prevention Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery

[Compliance with recommendations in secondary prevention of stroke in primary care].

Science.gov (United States)

Tamayo-Ojeda, Carmen; Parellada-Esquius, Neus; Salvador-González, Betlem; Oriol-Torón, Pilar Ángeles; Rodríguez-Garrido, M Dolores; Muñoz-Segura, Dolores

Knowing compliance with secondary prevention recommendations of stroke in primary care and to identify factors associated with compliance. Multi-centre cross-sectional. Health primary care centres in a metropolitan area (944,280 inhabitants). Patients aged 18years and over with ischemic brain disease diagnosis prior to 6months before the study. Clinical history records of demographic variables, risk factors and cardiovascular comorbidity, drugs, blood pressure values (BP), LDL-cholesterol and medical visits by doctor and nurses after the event. Good adherence was considered when BP <140/90 mmHg, LDL-cholesterol <100 mg/dL, smoking abstention and preventive drugs prescription (anti-platelet/anticoagulants, statins and angiotensin-converting-enzyme inhibitors/angiotensin-receptor-antagonists or diuretics) during the last 18months. A total of 21,976 patients, mean age 73.12 years (SD: 12.13), 48% women, 72.7% with stroke. Co-morbidity: hypertension 70.8%, dyslipidemia 55.1%, DM 30.9%, atrial fibrillation 14.1%, ischemic heart disease 13.5%, chronic renal failure 12.5%, heart failure 8.8%, peripheral arterial disease 6.2%, dementia 7.8%. No record was found for smoking in 3.7%, for BP in 3.5% and for LDL in 6.5%. Optimal control: abstention smoking in 3.7%, BP <140/90 in 65.7% and LDL <100 mg/dL in 41.0%. 86.2% anti-platelet/anticoagulants, 61.3% statins and 61.8% angiotensin-converting-enzyme inhibitors, angiotensin-receptor-antagonists or diuretic. Registration and risk factors control was higher in 66-79years aged and lower in 18-40years aged. The implementation of clinical guidelines recommendations for stroke prevention in primary care must be improved, especially among younger population. Organizational changes and more active involvement by professionals and strategies against therapeutic inertia must be taken. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Study on the evolutionary optimisation of the topology of network control systems

Science.gov (United States)

Zhou, Zude; Chen, Benyuan; Wang, Hong; Fan, Zhun

2010-08-01

Computer networks have been very popular in enterprise applications. However, optimisation of network designs that allows networks to be used more efficiently in industrial environment and enterprise applications remains an interesting research topic. This article mainly discusses the topology optimisation theory and methods of the network control system based on switched Ethernet in an industrial context. Factors that affect the real-time performance of the industrial control network are presented in detail, and optimisation criteria with their internal relations are analysed. After the definition of performance parameters, the normalised indices for the evaluation of the topology optimisation are proposed. The topology optimisation problem is formulated as a multi-objective optimisation problem and the evolutionary algorithm is applied to solve it. Special communication characteristics of the industrial control network are considered in the optimisation process. In respect to the evolutionary algorithm design, an improved arena algorithm is proposed for the construction of the non-dominated set of the population. In addition, for the evaluation of individuals, the integrated use of the dominative relation method and the objective function combination method, for reducing the computational cost of the algorithm, are given. Simulation tests show that the performance of the proposed algorithm is preferable and superior compared to other algorithms. The final solution greatly improves the following indices: traffic localisation, traffic balance and utilisation rate balance of switches. In addition, a new performance index with its estimation process is proposed.

Optimising neutron polarizers--measuring the flipping ratio and related quantities

CERN Document Server

Goossens, D J

2002-01-01

The continuing development of gaseous spin polarized sup 3 He transmission filters for use as neutron polarizers makes the choice of optimum thickness for these filters an important consideration. The 'quality factors' derived for the optimisation of transmission filters for particular measurements are general to all neutron polarizers. In this work optimisation conditions for neutron polarizers are derived and discussed for the family of studies related to measuring the flipping ratio from samples. The application of the optimisation conditions to sup 3 He transmission filters and other types of neutron polarizers is discussed. Absolute comparisons are made between the effectiveness of different types of polarizers for this sort of work.

Cultural-based particle swarm for dynamic optimisation problems

Science.gov (United States)

Daneshyari, Moayed; Yen, Gary G.

2012-07-01

Many practical optimisation problems are with the existence of uncertainties, among which a significant number belong to the dynamic optimisation problem (DOP) category in which the fitness function changes through time. In this study, we propose the cultural-based particle swarm optimisation (PSO) to solve DOP problems. A cultural framework is adopted incorporating the required information from the PSO into five sections of the belief space, namely situational, temporal, domain, normative and spatial knowledge. The stored information will be adopted to detect the changes in the environment and assists response to the change through a diversity-based repulsion among particles and migration among swarms in the population space, and also helps in selecting the leading particles in three different levels, personal, swarm and global levels. Comparison of the proposed heuristics over several difficult dynamic benchmark problems demonstrates the better or equal performance with respect to most of other selected state-of-the-art dynamic PSO heuristics.

[Secondary prevention of coronary heart disease is less agressive in patients over 64 years].

Science.gov (United States)

Muñoz, Miguel A; Marrugat, Jaume

2003-06-01

Although elderly people has a higher incidence of coronary heart disease, this group is seldom included in clinical trials. Studies performed in Spain on elderly coronary heart disease patients have been conducted in hospital settings. The aim of our study was to analyse wether the management of coronary heart disease patients over 64 years of age cared by family physicians differed from that of the rest. Cross-sectional multicentre study embedded in a clinical trial on 1,022 patients with stable coronary heart disease in which socio-demographic variables, comorbidity, treatment and cardiovascular risk- factor control were collected. Mean age was 64 10, 74.0% were men and 53.8% of subjects were over 64 years. Patients over 64 years had a greater cardiovascular comorbidity (87.7 vs 82.6%; p = 0.002) and received lower number of drugs than the rest in the prevention of recurrences (60.4 vs 70.9%; p < 0.001). Probability to receive less than two drugs on secondary prevention by subjects over 64 years was 0.45 (95% CI, 0.30-0.68) despite comorbidity, sex and cardiovascular risk profile.Conclusions. Coronary heart disease patients over 64 years receive less drugs for coronary event recurrence prevention than their younger counterparts despite their worse cardiovascular risk profile.

Solving dynamic multi-objective problems with vector evaluated particle swarm optimisation

CSIR Research Space (South Africa)

Greeff, M

2008-06-01

Full Text Available Many optimisation problems are multi-objective and change dynamically. Many methods use a weighted average approach to the multiple objectives. This paper introduces the usage of the vector evaluated particle swarm optimiser (VEPSO) to solve dynamic...

Exploration of automatic optimisation for CUDA programming

KAUST Repository

Al-Mouhamed, Mayez; Khan, Ayaz ul Hassan

2014-01-01

© 2014 Taylor & Francis. Writing optimised compute unified device architecture (CUDA) program for graphic processing units (GPUs) is complex even for experts. We present a design methodology for a restructuring tool that converts C-loops into optimised CUDA kernels based on a three-step algorithm which are loop tiling, coalesced memory access and resource optimisation. A method for finding possible loop tiling solutions with coalesced memory access is developed and a simplified algorithm for restructuring C-loops into an efficient CUDA kernel is presented. In the evaluation, we implement matrix multiply (MM), matrix transpose (M-transpose), matrix scaling (M-scaling) and matrix vector multiply (MV) using the proposed algorithm. We present the analysis of the execution time and GPU throughput for the above applications, which favourably compare to other proposals. Evaluation is carried out while scaling the problem size and running under a variety of kernel configurations. The obtained speedup is about 28-35% for M-transpose compared to NVIDIA Software Development Kit, 33% speedup for MV compared to general purpose computation on graphics processing unit compiler, and more than 80% speedup for MM and M-scaling compared to CUDA-lite.

Exploration of automatic optimisation for CUDA programming

KAUST Repository

Al-Mouhamed, Mayez

2014-09-16

© 2014 Taylor & Francis. Writing optimised compute unified device architecture (CUDA) program for graphic processing units (GPUs) is complex even for experts. We present a design methodology for a restructuring tool that converts C-loops into optimised CUDA kernels based on a three-step algorithm which are loop tiling, coalesced memory access and resource optimisation. A method for finding possible loop tiling solutions with coalesced memory access is developed and a simplified algorithm for restructuring C-loops into an efficient CUDA kernel is presented. In the evaluation, we implement matrix multiply (MM), matrix transpose (M-transpose), matrix scaling (M-scaling) and matrix vector multiply (MV) using the proposed algorithm. We present the analysis of the execution time and GPU throughput for the above applications, which favourably compare to other proposals. Evaluation is carried out while scaling the problem size and running under a variety of kernel configurations. The obtained speedup is about 28-35% for M-transpose compared to NVIDIA Software Development Kit, 33% speedup for MV compared to general purpose computation on graphics processing unit compiler, and more than 80% speedup for MM and M-scaling compared to CUDA-lite.

Optimisation of BPMN Business Models via Model Checking

DEFF Research Database (Denmark)

Herbert, Luke Thomas; Sharp, Robin

2013-01-01

We present a framework for the optimisation of business processes modelled in the business process modelling language BPMN, which builds upon earlier work, where we developed a model checking based method for the analysis of BPMN models. We define a structure for expressing optimisation goals...... for synthesized BPMN components, based on probabilistic computation tree logic and real-valued reward structures of the BPMN model, allowing for the specification of complex quantitative goals. We here present a simple algorithm, inspired by concepts from evolutionary algorithms, which iteratively generates...

Intelligent Support for a Computer Aided Design Optimisation Cycle

OpenAIRE

B. Dolšak; M. Novak; J. Kaljun

2006-01-01

It is becoming more and more evident that  adding intelligence  to existing computer aids, such as computer aided design systems, can lead to significant improvements in the effective and reliable performance of various engineering tasks, including design optimisation. This paper presents three different intelligent modules to be applied within a computer aided design optimisation cycle to enable more intelligent and less experience-dependent design performance. 

Optimisation of logistics processes of energy grass collection

Science.gov (United States)

Bányai, Tamás.

2010-05-01

The collection of energy grass is a logistics-intensive process [1]. The optimal design and control of transportation and collection subprocesses is a critical point of the supply chain. To avoid irresponsible decisions by right of experience and intuition, the optimisation and analysis of collection processes based on mathematical models and methods is the scientific suggestible way. Within the frame of this work, the author focuses on the optimisation possibilities of the collection processes, especially from the point of view transportation and related warehousing operations. However the developed optimisation methods in the literature [2] take into account the harvesting processes, county-specific yields, transportation distances, erosion constraints, machinery specifications, and other key variables, but the possibility of more collection points and the multi-level collection were not taken into consideration. The possible areas of using energy grass is very wide (energetically use, biogas and bio alcohol production, paper and textile industry, industrial fibre material, foddering purposes, biological soil protection [3], etc.), so not only a single level but also a multi-level collection system with more collection and production facilities has to be taken into consideration. The input parameters of the optimisation problem are the followings: total amount of energy grass to be harvested in each region; specific facility costs of collection, warehousing and production units; specific costs of transportation resources; pre-scheduling of harvesting process; specific transportation and warehousing costs; pre-scheduling of processing of energy grass at each facility (exclusive warehousing). The model take into consideration the following assumptions: (1) cooperative relation among processing and production facilties, (2) capacity constraints are not ignored, (3) the cost function of transportation is non-linear, (4) the drivers conditions are ignored. The

The principle of optimisation: reasons for success and legal criticism

International Nuclear Information System (INIS)

Fernandez Regalado, Luis

2008-01-01

The International Commission on Radiological Protection (ICRP) has adopted new recommendations in 2007. In broad outlines they fundamentally continue the recommendations already approved in 1990 and later on. The principle of optimisation of protection, together with the principles of justification and dose limits, remains playing a key role of the ICRP recommendations, and it has so been for the last few years. This principle, somehow reinforced in the 2007 ICRP recommendations, has been incorporated into norms and legislation which have peacefully been in force in many countries all over the world. There are three main reasons to explain the success in the application of the principle of optimisation in radiological protection: First, the subjectivity of the sentence that embraces the principle of optimisation, 'As low as reasonably achievable' (ALARA), that allows different valid interpretations under different circumstances. Second, the pragmatism and adaptability of ALARA to all exposure situations. And third, the scientific humbleness which is behind the principle of optimisation, which makes a clear contrast with the old fashioned scientific positivism that enshrined scientist opinions. Nevertheless, from a legal point of view, there is some criticism cast over the principle of optimisation in radiological protection, where it has been transformed in compulsory norm. This criticism is based on two arguments: The lack of democratic participation in the process of elaboration of the norm, and the legal uncertainty associated to its application. Both arguments are somehow known by the ICRP which, on the one hand, has broadened the participation of experts, associations and the professional radiological protection community, increasing the transparency on how decisions on recommendations have been taken, and on the other hand, the ICRP has warned about the need for authorities to specify general criteria to develop the principle of optimisation in national

Simulation and optimisation modelling approach for operation of the Hoa Binh Reservoir, Vietnam

DEFF Research Database (Denmark)

Ngo, Long le; Madsen, Henrik; Rosbjerg, Dan

2007-01-01

Hoa Binh, the largest reservoir in Vietnam, plays an important role in flood control for the Red River delta and hydropower generation. Due to its multi-purpose character, conflicts and disputes in operating the reservoir have been ongoing since its construction, particularly in the flood season....... This paper proposes to optimise the control strategies for the Hoa Binh reservoir operation by applying a combination of simulation and optimisation models. The control strategies are set up in the MIKE 11 simulation model to guide the releases of the reservoir system according to the current storage level......, the hydro-meteorological conditions, and the time of the year. A heuristic global optimisation tool, the shuffled complex evolution (SCE) algorithm, is adopted for optimising the reservoir operation. The optimisation puts focus on the trade-off between flood control and hydropower generation for the Hoa...

Risk-informed optimisation of railway tracks inspection and maintenance procedures

International Nuclear Information System (INIS)

Podofillini, Luca; Zio, Enrico; Vatn, Jorn

2006-01-01

Nowadays, efforts are being made by the railway industry for the application of reliability-based and risk-informed approaches to maintenance optimisation of railway infrastructures, with the aim of reducing the operation and maintenance expenditures while still assuring high safety standards. In particular, in this paper, we address the use of ultrasonic inspection cars and develop a methodology for the determination of an optimal strategy for their use. A model is developed to calculate the risks and costs associated with an inspection strategy, giving credit to the realistic issues of the rail failure process and including the actual inspection and maintenance procedures followed by the railway company. A multi-objective optimisation viewpoint is adopted in an effort to optimise inspection and maintenance procedures with respect to both economical and safety-related aspects. More precisely, the objective functions here considered are such to drive the search towards solutions characterized by low expenditures and low derailment probability. The optimisation is performed by means of a genetic algorithm. The work has been carried out within a study of the Norwegian National Rail Administration (Jernbaneverket)

MIMO-Radar Waveform Design for Beampattern Using Particle-Swarm-Optimisation

KAUST Repository

Ahmed, Sajid

2012-07-31

Multiple input multiple output (MIMO) radars have many advantages over their phased-array counterparts: improved spatial resolution; better parametric identifiably and greater flexibility to acheive the desired transmit beampattern. The desired transmit beampatterns using MIMO-radar requires the waveforms to have arbitrary auto- and cross-correlations. To design such waveforms, generally a waveform covariance matrix, R, is synthesised first then the actual waveforms are designed. Synthesis of the covariance matrix, R, is a constrained optimisation problem, which requires R to be positive semidefinite and all of its diagonal elements to be equal. To simplify the first constraint the covariance matrix is synthesised indirectly from its square-root matrix U, while for the second constraint the elements of the m-th column of U are parameterised using the coordinates of the m-hypersphere. This implicitly fulfils both of the constraints and enables us to write the cost-function in closed form. Then the cost-function is optimised using a simple particle-swarm-optimisation (PSO) technique, which requires only the cost-function and can optimise any choice of norm cost-function. © 2012 IEEE.

Design of optimised backstepping controller for the synchronisation of chaotic Colpitts oscillator using shark smell algorithm

Science.gov (United States)

Fouladi, Ehsan; Mojallali, Hamed

2018-01-01

In this paper, an adaptive backstepping controller has been tuned to synchronise two chaotic Colpitts oscillators in a master-slave configuration. The parameters of the controller are determined using shark smell optimisation (SSO) algorithm. Numerical results are presented and compared with those of particle swarm optimisation (PSO) algorithm. Simulation results show better performance in terms of accuracy and convergence for the proposed optimised method compared to PSO optimised controller or any non-optimised backstepping controller.

Pre-exercise screening and health coaching in CHD secondary prevention: a qualitative study of the patient experience.

Science.gov (United States)

Shaw, R; Gillies, M; Barber, J; MacIntyre, K; Harkins, C; Findlay, I N; McCloy, K; Gillie, A; Scoular, A; MacIntyre, P D

2012-06-01

Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly variable. In order to explore patients' experiences of a pre-exercise screening and health coaching programme (involving one-to-one consultations to support exercise behaviour change), semi-structured telephone interviews were undertaken with 84 CHD patients recruited from primary care. The interviews focused on patients' experiences of the intervention including referral and any recommendations for improvement. A thematic analysis of transcribed interviews showed that the majority of patients were positive about referral. However, patients also identified a number of barriers to attending and completing the programme, including a belief they were sufficiently active already, the existence of other health problems, feeling unsupported in community-based exercise classes and competing demands. Our findings highlight important issues around the choice of an appropriate point of intervention for programmes of this kind as well as the importance of appropriate patient selection, suggesting that the effectiveness of health coaching may be under-reported as a result of including patients who are not yet ready to change their behaviours.

DOGMAS AND UPDATES ON THE USE OF BETA-BLOCKERS IN SECONDARY PREVENTION. FIRST PART.

Directory of Open Access Journals (Sweden)

Alberto Morales Salinas

2011-08-01

Full Text Available There is consensus on clinical guidelines that beta-blockers (BB provide unquestionable benefits in several environments of secondary prevention, such as heart failure and myocardial infarction. However, in everyday practice they are underused in contexts where they are not contraindicated. Such is the case of heart failure with ejection fraction. This article presents an analysis on the available evidence of beta blockers’ effectiveness in heart failure with ejection fraction. It is concluded that overwhelming evidence favours the use of beta-blockers in chronic heart failure with ejection fraction, whereas in episodes of acute decompensated heart failure, their suspension should be avoided whenever it is possible.

Separative power of an optimised concurrent gas centrifuge

Energy Technology Data Exchange (ETDEWEB)

Bogovalov, Sergey; Boman, Vladimir [National Research Nuclear University (MEPHI), Moscow (Russian Federation)

2016-06-15

The problem of separation of isotopes in a concurrent gas centrifuge is solved analytically for an arbitrary binary mixture of isotopes. The separative power of the optimised concurrent gas centrifuges for the uranium isotopes equals to δU = 12.7 (V/700 m/s)2(300 K/T)(L/1 m) kg·SWU/yr, where L and V are the length and linear velocity of the rotor of the gas centrifuge and T is the temperature. This equation agrees well with the empirically determined separative power of optimised counter-current gas centrifuges.

Compliance of an elderly hip fracture population with secondary preventative measures. Efficacy of a simple clinical practice intervention.

LENUS (Irish Health Repository)

Street, John

2012-02-03

Secondary pharmaceutical measures are effective in all age groups for the prevention of osteoporotic fractures. This prospective study determines the demographics of 566 consecutive osteoporotic hip fractures presenting to a Level 1 Trauma Center. We examine the efficacy of simple treatment recommendations for pharmaceutical treatment of osteoporosis and the factors determining general practitioner and patient compliance with these recommendations in a community setting. One out of four patients (24.5%) had sustained a previous fragility fracture. Mean age was 80 years. Twenty five percent were resident in a nursing home and only 10% were taking anti-resorptive therapy preoperatively. In hospital mortality was 6%, and 39% of recruited patients were dead at 12 months. By this time more than half the survivors were resident in a nursing home. The compliance with anti-resorptive therapy had increased to over 70% consequent to our simple recommendations. Significant differences in GP and patient compliance were observed between nursing home and own residence dwellers. This study demonstrates the efficacy of a simple clinical practice intervention in increasing patient and GP compliance with secondary fracture prevention measures. We also discuss many of the confounding issues determining this compliance.

Edetate Disodium-Based Treatment for Secondary Prevention in Post-Myocardial Infarction Patients.

Science.gov (United States)

Lamas, Gervasio A; Issa, Omar M

2016-02-01

An abundance of data, known for decades, is available linking metals, such as lead and cadmium, with cardiovascular disease. However, the idea that these toxic metals could be a modifiable risk factor for atherosclerosis did not become apparent clinically until the completion of the Trial to Assess Chelation Therapy in 2012. This pivotal study was the first double-blind, randomized, controlled trial of its kind to demonstrate a clear improvement in cardiovascular outcomes with edetate disodium therapy in a secondary prevention, post-myocardial infarction population. This effect size was most striking in diabetic patients, where the efficacy of edetate disodium was comparable, if not superior, to that of current guideline-based therapies. Given the economic burden of diabetes and cardiovascular disease, the potential impact of this therapy could be enormous if the results of this study are replicated.

Auto-optimisation for three-dimensional conformal radiotherapy of nasopharyngeal carcinoma

Energy Technology Data Exchange (ETDEWEB)

Wu, V.W.C. E-mail: orvinwu@polyu.edu.hk; Kwong, D.W.L.; Sham, J.S.T.; Mui, A.W.L

2003-08-01

Purpose: The purpose of this study was to evaluate the application of auto-optimisation in the treatment planning of three-dimensional conformal radiotherapy (3DCRT) of nasopharyngeal carcinoma (NPC). Methods: Twenty-nine NPC patients were planned by both forward planning and auto-optimisation methods. The forward plans, which consisted of three coplanar facial fields, were produced according to the routine planning criteria. The auto-optimised plans, which consisted of 5-15 (median 9) fields, were generated by the planning system after prescribing the dose requirements and the importance weightings of the planning target volume and organs at risk. Plans produced by the two planning methods were compared by the dose volume histogram, tumour control probability (TCP), conformity index and normal tissue complication probability (NTCP). Results: The auto-optimised plans reduced the average planner's time by over 35 min. It demonstrated better TCP and conformity index than the forward plans (P=0.03 and 0.04, respectively). Besides, the parotid gland and temporo-mandibular (TM) joint were better spared with the mean dose reduction of 31.8 and 17.7%, respectively. The slight trade off was the mild dose increase in spinal cord and brain stem with their maximum doses remaining within the tolerance limits. Conclusions: The findings demonstrated the potentials of auto-optimisation for improving target dose and parotid sparing in the 3DCRT of NPC with saving of the planner's time.

Auto-optimisation for three-dimensional conformal radiotherapy of nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wu, V.W.C.; Kwong, D.W.L.; Sham, J.S.T.; Mui, A.W.L.

2003-01-01

Purpose: The purpose of this study was to evaluate the application of auto-optimisation in the treatment planning of three-dimensional conformal radiotherapy (3DCRT) of nasopharyngeal carcinoma (NPC). Methods: Twenty-nine NPC patients were planned by both forward planning and auto-optimisation methods. The forward plans, which consisted of three coplanar facial fields, were produced according to the routine planning criteria. The auto-optimised plans, which consisted of 5-15 (median 9) fields, were generated by the planning system after prescribing the dose requirements and the importance weightings of the planning target volume and organs at risk. Plans produced by the two planning methods were compared by the dose volume histogram, tumour control probability (TCP), conformity index and normal tissue complication probability (NTCP). Results: The auto-optimised plans reduced the average planner's time by over 35 min. It demonstrated better TCP and conformity index than the forward plans (P=0.03 and 0.04, respectively). Besides, the parotid gland and temporo-mandibular (TM) joint were better spared with the mean dose reduction of 31.8 and 17.7%, respectively. The slight trade off was the mild dose increase in spinal cord and brain stem with their maximum doses remaining within the tolerance limits. Conclusions: The findings demonstrated the potentials of auto-optimisation for improving target dose and parotid sparing in the 3DCRT of NPC with saving of the planner's time

Interpretation of optimisation in the context of a disposal facility for long-lived radioactive waste

International Nuclear Information System (INIS)

1999-01-01

Full text: Guidance on the Requirements for Authorisation (the GRA) issued by the Environment Agency for England and Wales requires that all disposals of radioactive waste are undertaken in a manner consistent with four principles for the protection of the public. Among these is a principle of Optimisation, that: 'The radiological detriment to members of the public that may result from the disposal of radioactive waste shall be as low as reasonably achievable, economic and social factors being taken into account'. The principle of optimisation is widely accepted and has been discussed in both UK national policy and guidance and in documents from international organisations. The practical interpretation of optimisation in the context of post-closure safety of radioactive waste repositories is, however, still open to question. In particular, the strategies and procedures that a developer might employ to implement optimisation in the siting and development of a repository, and demonstrate optimisation in a safety case, are not defined. In preparation for its role of regulatory review, the Agency has undertaken a pilot study to explore the possible interpretations of optimisation stemming from the GRA, and to identify possible strategies and procedures that a developer might follow. A review has been undertaken of UK regulatory guidance and related documents, and also international guidance, referring to optimisation in relation to radioactive waste disposal facilities. In addition, diverse examples of the application of optimisation have been identified in the international and UK performance assessment literature. A one-day meeting was organised bringing together Agency staff and technical experts with different experiences and perspectives on the subject of optimisation in the context of disposal facilities for radioactive waste. This meeting identified and discussed key issues and possible approaches to optimisation, and specifically: (1) The meaning of

Application of Three Existing Stope Boundary Optimisation Methods in an Operating Underground Mine

Science.gov (United States)

Erdogan, Gamze; Yavuz, Mahmut

2017-12-01

The underground mine planning and design optimisation process have received little attention because of complexity and variability of problems in underground mines. Although a number of optimisation studies and software tools are available and some of them, in special, have been implemented effectively to determine the ultimate-pit limits in an open pit mine, there is still a lack of studies for optimisation of ultimate stope boundaries in underground mines. The proposed approaches for this purpose aim at maximizing the economic profit by selecting the best possible layout under operational, technical and physical constraints. In this paper, the existing three heuristic techniques including Floating Stope Algorithm, Maximum Value Algorithm and Mineable Shape Optimiser (MSO) are examined for optimisation of stope layout in a case study. Each technique is assessed in terms of applicability, algorithm capabilities and limitations considering the underground mine planning challenges. Finally, the results are evaluated and compared.

Benchmarks for dynamic multi-objective optimisation

CSIR Research Space (South Africa)

Helbig, M

2013-06-01

Full Text Available When algorithms solve dynamic multi-objective optimisation problems (DMOOPs), benchmark functions should be used to determine whether the algorithm can overcome specific difficulties that can occur in real-world problems. However, for dynamic multi...

Visual grading characteristics and ordinal regression analysis during optimisation of CT head examinations.

Science.gov (United States)

Zarb, Francis; McEntee, Mark F; Rainford, Louise

2015-06-01

To evaluate visual grading characteristics (VGC) and ordinal regression analysis during head CT optimisation as a potential alternative to visual grading assessment (VGA), traditionally employed to score anatomical visualisation. Patient images (n = 66) were obtained using current and optimised imaging protocols from two CT suites: a 16-slice scanner at the national Maltese centre for trauma and a 64-slice scanner in a private centre. Local resident radiologists (n = 6) performed VGA followed by VGC and ordinal regression analysis. VGC alone indicated that optimised protocols had similar image quality as current protocols. Ordinal logistic regression analysis provided an in-depth evaluation, criterion by criterion allowing the selective implementation of the protocols. The local radiology review panel supported the implementation of optimised protocols for brain CT examinations (including trauma) in one centre, achieving radiation dose reductions ranging from 24 % to 36 %. In the second centre a 29 % reduction in radiation dose was achieved for follow-up cases. The combined use of VGC and ordinal logistic regression analysis led to clinical decisions being taken on the implementation of the optimised protocols. This improved method of image quality analysis provided the evidence to support imaging protocol optimisation, resulting in significant radiation dose savings. • There is need for scientifically based image quality evaluation during CT optimisation. • VGC and ordinal regression analysis in combination led to better informed clinical decisions. • VGC and ordinal regression analysis led to dose reductions without compromising diagnostic efficacy.

Risk factors and prognostic role of an electrical storm in patients after myocardial infarction with an implanted ICD for secondary prevention.

Science.gov (United States)

Kwaśniewski, Wojciech; Filipecki, Artur; Orszulak, Michał; Orszulak, Witold; Urbańczyk, Dagmara; Roczniok, Robert; Trusz-Gluza, Maria; Mizia-Stec, Katarzyna

2018-04-01

The aim of our study was to determine the risk factors for electrical storm (ES) and to assess the impact of ES on the long-term prognosis in patients after myocardial infarction (MI) with an implantable cardioverter-defibrillator (ICD) for secondary prevention of sudden cardiac death (SCD). We retrospectively analyzed 416 patients with coronary artery disease after MI who had an implanted ICD for secondary prevention of SCD. Fifty (12%) patients had one or more incidents of an electrical storm - the ES (+) group. We matched the reference group of 47 patients from 366 ES (-) patients. We analyzed 3,408 episodes of ventricular arrhythmias: 3,148 ventricular tachyarrhythmic episodes in the ES (+) group (including 187 episodes of ES) and 260 in the ES (-) group. Multivariate logistic regression showed that inferior wall MI (RR = 3.98, 95% CI: 1.52-10.41) and the absence of coronary revascularization (RR = 2.92, 95% CI: 1.18-7.21) were independent predictors of ES ( p = 0.0014). During 6-year observation of 97 patients, there were 39 (40%) deaths: 25 (50%) subjects in the ES (+) group and 14 (30%) in the ES (-) group ( p = 0.036). Independent predictors of death were: the occurrence of ES (HR = 1.93), older age (HR = 1.06), and lower left ventricular ejection fraction (HR = 0.95) (for all p storm in patients after MI with ICD for secondary prevention is a relatively common phenomenon and has a negative prognostic significance. Myocardial infarction of the inferior wall and the absence of coronary revascularization are predisposing factors for the occurrence of an ES.

Optimisation and symmetry in experimental radiation physics

International Nuclear Information System (INIS)

Ghose, A.

1988-01-01

The present monograph is concerned with the optimisation of geometric factors in radiation physics experiments. The discussions are essentially confined to those systems in which optimisation is equivalent to symmetrical configurations of the measurement systems. They include, measurements of interaction cross section of diverse types, determination of polarisations, development of detectors with almost ideal characteristics, production of radiations with continuously variable energies and development of high efficiency spectrometers etc. The monograph is intended for use by experimental physicists investigating primary interactions of radiations with matter and associated technologies. We have illustrated the various optimisation procedures by considering the cases of the so-called ''14 MeV'' on d-t neutrons and gamma rays with energies less than 3 MeV. Developments in fusion technology are critically dependent on the availability accurate cross sections of nuclei for fast neutrons of energies at least as high as d-t neutrons. In this monograph we have discussed various techniques which can be used to improve the accuracy of such measurements and have also presented a method for generating almost monoenergetic neutrons in the 8 MeV to 13 MeV energy range which can be used to measure cross sections in this sparingly investigated region

Credit price optimisation within retail banking

African Journals Online (AJOL)

2014-02-14

Feb 14, 2014 ... cost based pricing, where the price of a product or service is based on the .... function obtained from fitting a logistic regression model .... Note that the proposed optimisation approach below will allow us to also incorporate.

Gaining Insight from Flexible Models - Assessment of the Secondary Prevention Trial of CHD in the Czech Male Population with MI History

Czech Academy of Sciences Publication Activity Database

Valenta, Zdeněk; Pitha, J.; Podrapská, I.; Poledne, R.

2006-01-01

Roč. 45, č. 2 (2006), s. 186-190 ISSN 0026-1270 R&D Projects: GA MŠk LN00B107 Keywords : coronary heart disease * non-proportional hazards * secondary prevention * survival Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.684, year: 2006

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol.

Science.gov (United States)

Sharif Ishak, Sharifah Intan Zainun; Chin, Yit Siew; Mohd Taib, Mohd Nasir; Mohd Shariff, Zalilah

2016-10-20

Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely 'Eat Right, Be Positive About Your Body and Live Actively' (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13-14 years old. Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13-14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).

Theoretical Risk and Prevention Model for Secondary Health Conditions and Mortality After SCI: 15 Years of Research

Science.gov (United States)

Krause, James S.; Saunders, Lee L.; DiPiro, Nicole D.; Reed, Karla S.

2013-01-01

Background: To successfully prevent secondary health conditions (SHCs) and promote longevity after spinal cord injury (SCI), we must first understand the risk factors precipitating their occurrence and develop strategies to address these risk factors. Conceptual models may aid in identifying the nature of SHCs and guide research, clinical practice, and the development of prevention strategies. Objective: Our purpose is to review and refine an existing theoretical risk and prevention model (TRPM) as a means of classifying risk and protective factors for SHCs and mortality after SCI and for identifying points of intervention. Methods: We describe conceptual work within the field of SCI research and SHCs, including a description of the TRPM, a review of research using the TRPM, and conceptual enhancements to the TRPM based on previous research. Conclusions: The enhanced TRPM directs research to the timing and chronicity of the SHCs and their relationship with overall health and physiologic decline. Future research should identify differences in the nature of SHCs, the extent to which they relate to risk and protective factors, and the degree to which they may be prevented with appropriate research-based strategies. PMID:23459002

Alternatives for optimisation of rumen fermentation in ruminants

Directory of Open Access Journals (Sweden)

T. Slavov

2017-06-01

Full Text Available Abstract. The proper knowledge on the variety of events occurring in the rumen makes possible their optimisation with respect to the complete feed conversion and increasing the productive performance of ruminants. The inclusion of various dietary additives (supplements, biologically active substances, nutritional antibiotics, probiotics, enzymatic preparations, plant extracts etc. has an effect on the intensity and specific pathway of fermentation, and thus, on the general digestion and systemic metabolism. The optimisation of rumen digestion is a method with substantial potential for improving the efficiency of ruminant husbandry, increasing of quality of their produce and health maintenance.

Optimising a shaft's geometry by applying genetic algorithms

Directory of Open Access Journals (Sweden)

María Alejandra Guzmán

2005-05-01

Full Text Available Many engnieering design tasks involve optimising several conflicting goals; these types of problem are known as Multiobjective Optimisation Problems (MOPs. Evolutionary techniques have proved to be an effective tool for finding solutions to these MOPs during the last decade, Variations on the basic generic algorithm have been particulary proposed by different researchers for finding rapid optimal solutions to MOPs. The NSGA (Non-dominated Sorting Generic Algorithm has been implemented in this paper for finding an optimal design for a shaft subjected to cyclic loads, the conflycting goals being minimum weight and minimum lateral deflection.

Secondary benefit of maintaining normal transcranial Doppler velocities when using hydroxyurea for prevention of severe sickle cell anemia.

Science.gov (United States)

Ghafuri, Djamila Labib; Chaturvedi, Shruti; Rodeghier, Mark; Stimpson, Sarah-Jo; McClain, Brandi; Byrd, Jeannie; DeBaun, Michael R

2017-07-01

In a retrospective cohort study, we tested the hypothesis that when prescribing hydroxyurea (HU) to children with sickle cell anemia (SCA) to prevent vaso-occlusive events, there will be a secondary benefit of maintaining low transcranial Doppler (TCD) velocity, measured by imaging technique (TCDi). HU was prescribed for 90.9% (110 of 120) of children with SCA ≥5 years of age and followed for a median of 4.4 years, with 70% (n = 77) receiving at least one TCDi evaluation after starting HU. No child prescribed HU had a conditional or abnormal TCDi measurement. HU initiation for disease severity prevention decreases the prevalence of abnormal TCDi velocities. © 2016 Wiley Periodicals, Inc.

Coil optimisation for transcranial magnetic stimulation in realistic head geometry.

Science.gov (United States)

Koponen, Lari M; Nieminen, Jaakko O; Mutanen, Tuomas P; Stenroos, Matti; Ilmoniemi, Risto J

Transcranial magnetic stimulation (TMS) allows focal, non-invasive stimulation of the cortex. A TMS pulse is inherently weakly coupled to the cortex; thus, magnetic stimulation requires both high current and high voltage to reach sufficient intensity. These requirements limit, for example, the maximum repetition rate and the maximum number of consecutive pulses with the same coil due to the rise of its temperature. To develop methods to optimise, design, and manufacture energy-efficient TMS coils in realistic head geometry with an arbitrary overall coil shape. We derive a semi-analytical integration scheme for computing the magnetic field energy of an arbitrary surface current distribution, compute the electric field induced by this distribution with a boundary element method, and optimise a TMS coil for focal stimulation. Additionally, we introduce a method for manufacturing such a coil by using Litz wire and a coil former machined from polyvinyl chloride. We designed, manufactured, and validated an optimised TMS coil and applied it to brain stimulation. Our simulations indicate that this coil requires less than half the power of a commercial figure-of-eight coil, with a 41% reduction due to the optimised winding geometry and a partial contribution due to our thinner coil former and reduced conductor height. With the optimised coil, the resting motor threshold of abductor pollicis brevis was reached with the capacitor voltage below 600 V and peak current below 3000 A. The described method allows designing practical TMS coils that have considerably higher efficiency than conventional figure-of-eight coils. Copyright © 2017 Elsevier Inc. All rights reserved.

Reduction environmental effects of civil aircraft through multi-objective flight plan optimisation

International Nuclear Information System (INIS)

Lee, D S; Gonzalez, L F; Walker, R; Periaux, J; Onate, E

2010-01-01

With rising environmental alarm, the reduction of critical aircraft emissions including carbon dioxides (CO 2 ) and nitrogen oxides (NO x ) is one of most important aeronautical problems. There can be many possible attempts to solve such problem by designing new wing/aircraft shape, new efficient engine, etc. The paper rather provides a set of acceptable flight plans as a first step besides replacing current aircrafts. The paper investigates a green aircraft design optimisation in terms of aircraft range, mission fuel weight (CO 2 ) and NO x using advanced Evolutionary Algorithms coupled to flight optimisation system software. Two multi-objective design optimisations are conducted to find the best set of flight plans for current aircrafts considering discretised altitude and Mach numbers without designing aircraft shape and engine types. The objectives of first optimisation are to maximise range of aircraft while minimising NO x with constant mission fuel weight. The second optimisation considers minimisation of mission fuel weight and NO x with fixed aircraft range. Numerical results show that the method is able to capture a set of useful trade-offs that reduce NO x and CO 2 (minimum mission fuel weight).

Topology optimisation of passive coolers for light-emitting diode lamps

DEFF Research Database (Denmark)

Alexandersen, Joe

2015-01-01

This work applies topology optimisation to the design of passive coolers for light-emitting diode (LED) lamps. The heat sinks are cooled by the natural convection currents arising from the temperature difference between the LED lamp and the surrounding air. A large scale parallel computational....... The optimisation results show interesting features that are currently being incorporated into industrial designs for enhanced passive cooling abilities....

Effective secondary fracture prevention: implementation of a global benchmarking of clinical quality using the IOF Capture the Fracture® Best Practice Framework tool.

Science.gov (United States)

Javaid, M K; Kyer, C; Mitchell, P J; Chana, J; Moss, C; Edwards, M H; McLellan, A R; Stenmark, J; Pierroz, D D; Schneider, M C; Kanis, J A; Akesson, K; Cooper, C

2015-11-01

Fracture Liaison Services are the best model to prevent secondary fractures. The International Osteoporosis Foundation developed a Best Practice Framework to provide a quality benchmark. After a year of implementation, we confirmed that a single framework with set criteria is able to benchmark services across healthcare systems worldwide. Despite evidence for the clinical effectiveness of secondary fracture prevention, translation in the real-world setting remains disappointing. Where implemented, a wide variety of service models are used to deliver effective secondary fracture prevention. To support use of effective models of care across the globe, the International Osteoporosis Foundation's Capture the Fracture® programme developed a Best Practice Framework (BPF) tool of criteria and standards to provide a quality benchmark. We now report findings after the first 12 months of implementation. A questionnaire for the BPF was created and made available to institutions on the Capture the Fracture website. Responses from institutions were used to assign gold, silver, bronze or black (insufficient) level of achievements mapped across five domains. Through an interactive process with the institution, a final score was determined and published on the Capture the Fracture website Fracture Liaison Service (FLS) map. Sixty hospitals across six continents submitted their questionnaires. The hospitals served populations from 20,000 to 15 million and were a mix of private and publicly funded. Each FLS managed 146 to 6200 fragility fracture patients per year with a total of 55,160 patients across all sites. Overall, 27 hospitals scored gold, 23 silver and 10 bronze. The pathway for the hip fracture patients had the highest proportion of gold grading while vertebral fracture the lowest. In the first 12 months, we have successfully tested the BPF tool in a range of health settings across the globe. Initial findings confirm a significant heterogeneity in service provision and

Optimising parallel R correlation matrix calculations on gene expression data using MapReduce.

Science.gov (United States)

Wang, Shicai; Pandis, Ioannis; Johnson, David; Emam, Ibrahim; Guitton, Florian; Oehmichen, Axel; Guo, Yike

2014-11-05

High-throughput molecular profiling data has been used to improve clinical decision making by stratifying subjects based on their molecular profiles. Unsupervised clustering algorithms can be used for stratification purposes. However, the current speed of the clustering algorithms cannot meet the requirement of large-scale molecular data due to poor performance of the correlation matrix calculation. With high-throughput sequencing technologies promising to produce even larger datasets per subject, we expect the performance of the state-of-the-art statistical algorithms to be further impacted unless efforts towards optimisation are carried out. MapReduce is a widely used high performance parallel framework that can solve the problem. In this paper, we evaluate the current parallel modes for correlation calculation methods and introduce an efficient data distribution and parallel calculation algorithm based on MapReduce to optimise the correlation calculation. We studied the performance of our algorithm using two gene expression benchmarks. In the micro-benchmark, our implementation using MapReduce, based on the R package RHIPE, demonstrates a 3.26-5.83 fold increase compared to the default Snowfall and 1.56-1.64 fold increase compared to the basic RHIPE in the Euclidean, Pearson and Spearman correlations. Though vanilla R and the optimised Snowfall outperforms our optimised RHIPE in the micro-benchmark, they do not scale well with the macro-benchmark. In the macro-benchmark the optimised RHIPE performs 2.03-16.56 times faster than vanilla R. Benefiting from the 3.30-5.13 times faster data preparation, the optimised RHIPE performs 1.22-1.71 times faster than the optimised Snowfall. Both the optimised RHIPE and the optimised Snowfall successfully performs the Kendall correlation with TCGA dataset within 7 hours. Both of them conduct more than 30 times faster than the estimated vanilla R. The performance evaluation found that the new MapReduce algorithm and its

Crystal structure optimisation using an auxiliary equation of state

Science.gov (United States)

Jackson, Adam J.; Skelton, Jonathan M.; Hendon, Christopher H.; Butler, Keith T.; Walsh, Aron

2015-11-01

Standard procedures for local crystal-structure optimisation involve numerous energy and force calculations. It is common to calculate an energy-volume curve, fitting an equation of state around the equilibrium cell volume. This is a computationally intensive process, in particular, for low-symmetry crystal structures where each isochoric optimisation involves energy minimisation over many degrees of freedom. Such procedures can be prohibitive for non-local exchange-correlation functionals or other "beyond" density functional theory electronic structure techniques, particularly where analytical gradients are not available. We present a simple approach for efficient optimisation of crystal structures based on a known equation of state. The equilibrium volume can be predicted from one single-point calculation and refined with successive calculations if required. The approach is validated for PbS, PbTe, ZnS, and ZnTe using nine density functionals and applied to the quaternary semiconductor Cu2ZnSnS4 and the magnetic metal-organic framework HKUST-1.

Crystal structure optimisation using an auxiliary equation of state

International Nuclear Information System (INIS)

Jackson, Adam J.; Skelton, Jonathan M.; Hendon, Christopher H.; Butler, Keith T.; 3 Institute and Department of Materials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of))" data-affiliation=" (Centre for Sustainable Chemical Technologies and Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Global E3 Institute and Department of Materials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of))" >Walsh, Aron

2015-01-01

Standard procedures for local crystal-structure optimisation involve numerous energy and force calculations. It is common to calculate an energy–volume curve, fitting an equation of state around the equilibrium cell volume. This is a computationally intensive process, in particular, for low-symmetry crystal structures where each isochoric optimisation involves energy minimisation over many degrees of freedom. Such procedures can be prohibitive for non-local exchange-correlation functionals or other “beyond” density functional theory electronic structure techniques, particularly where analytical gradients are not available. We present a simple approach for efficient optimisation of crystal structures based on a known equation of state. The equilibrium volume can be predicted from one single-point calculation and refined with successive calculations if required. The approach is validated for PbS, PbTe, ZnS, and ZnTe using nine density functionals and applied to the quaternary semiconductor Cu 2 ZnSnS 4 and the magnetic metal-organic framework HKUST-1

Crystal structure optimisation using an auxiliary equation of state

Energy Technology Data Exchange (ETDEWEB)

Jackson, Adam J.; Skelton, Jonathan M.; Hendon, Christopher H.; Butler, Keith T. [Centre for Sustainable Chemical Technologies and Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Walsh, Aron, E-mail: a.walsh@bath.ac.uk [Centre for Sustainable Chemical Technologies and Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Global E" 3 Institute and Department of Materials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of)

2015-11-14

Standard procedures for local crystal-structure optimisation involve numerous energy and force calculations. It is common to calculate an energy–volume curve, fitting an equation of state around the equilibrium cell volume. This is a computationally intensive process, in particular, for low-symmetry crystal structures where each isochoric optimisation involves energy minimisation over many degrees of freedom. Such procedures can be prohibitive for non-local exchange-correlation functionals or other “beyond” density functional theory electronic structure techniques, particularly where analytical gradients are not available. We present a simple approach for efficient optimisation of crystal structures based on a known equation of state. The equilibrium volume can be predicted from one single-point calculation and refined with successive calculations if required. The approach is validated for PbS, PbTe, ZnS, and ZnTe using nine density functionals and applied to the quaternary semiconductor Cu{sub 2}ZnSnS{sub 4} and the magnetic metal-organic framework HKUST-1.

Cogeneration technologies, optimisation and implementation

CERN Document Server

Frangopoulos, Christos A

2017-01-01

Cogeneration refers to the use of a power station to deliver two or more useful forms of energy, for example, to generate electricity and heat at the same time. This book provides an integrated treatment of cogeneration, including a tour of the available technologies and their features, and how these systems can be analysed and optimised.

High prevalence of missed opportunities for secondary fracture prevention in a regional general hospital setting in Singapore.

Science.gov (United States)

Gani, Linsey; Reddy, Saripalli K; Alsuwaigh, Rayan; Khoo, Joan; King, Thomas F J

2017-12-01

This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our population. Secondary fracture prevention services are not routine in Singapore; we seek to assess the treatment gap that exists in the lack of diagnosis and treatment of osteoporosis in fragility fracture patients. We performed a retrospective analysis of all admissions for fragility fractures between December 2013 and December 2014. Demographic data, rates of BMD performance, serum vitamin D investigation and calcium and vitamin D supplementation as well as antiresorptive initiation 1 year post admission were analysed. There were 125 fragility fractures in patients below 65 and 615 fractures in older patients. There was a slightly higher proportion of males in the younger population, whereas females predominated in the older population. Median vitamin D levels were low in both younger (19.1 μg/L) and older (22.0 μg/L) groups, but supplementation was lower in younger patients (4.8 versus 16.6%, p = 0.003). Rate of BMD performance was lower in younger patients (34.4 versus 64.6%, p Singapore. Male osteoporosis remains inadequately investigated and treated in both age groups.

Adherence to oral anticoagulant therapy in secondary stroke prevention – impact of the novel oral anticoagulants

Directory of Open Access Journals (Sweden)

Luger S

2015-11-01

Full Text Available Sebastian Luger,1 Carina Hohmann,2 Daniela Niemann,1 Peter Kraft,3 Ignaz Gunreben,3 Tobias Neumann-Haefelin,2 Christoph Kleinschnitz,3 Helmuth Steinmetz,1 Christian Foerch,1 Waltraud Pfeilschifter1 1Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, 2Department of Neurology, Klinikum Fulda gAG, Fulda, 3Department of Neurology, University Hospital Würzburg, Würzburg, Germany Background: Oral anticoagulant therapy (OAT potently prevents strokes in patients with atrial fibrillation. Vitamin K antagonists (VKA have been the standard of care for long-term OAT for decades, but non-VKA oral anticoagulants (NOAC have recently been approved for this indication, and raised many questions, among them their influence on medication adherence. We assessed adherence to VKA and NOAC in secondary stroke prevention. Methods: All patients treated from October 2011 to September 2012 for ischemic stroke or transient ischemic attack with a subsequent indication for OAT, at three academic hospitals were entered into a prospective registry, and baseline data and antithrombotic treatment at discharge were recorded. At the 1-year follow-up, we assessed the adherence to different OAT strategies and patients’ adherence to their respective OAT. We noted OAT changes, reasons to change treatment, and factors that influence persistence to the prescribed OAT. Results: In patients discharged on OAT, we achieved a fatality corrected response rate of 73.3% (n=209. A total of 92% of these patients received OAT at the 1-year follow-up. We observed good adherence to both VKA and NOAC (VKA, 80.9%; NOAC, 74.8%; P=0.243 with a statistically nonsignificant tendency toward a weaker adherence to dabigatran. Disability at 1-year follow-up was an independent predictor of lower adherence to any OAT after multivariate analysis, whereas the choice of OAT did not have a relevant influence. Conclusion: One-year adherence to OAT after stroke is strong (>90% and patients

Prevention Of Stroke

Directory of Open Access Journals (Sweden)

Nagaraja D

2005-01-01

Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.

Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients (INSPiRE-TMS: a protocol for a randomised controlled trial

Directory of Open Access Journals (Sweden)

Leistner Stefanie

2013-01-01

Full Text Available Abstract Background Patients with recent stroke or TIA are at high risk for new vascular events. Several evidence based strategies in secondary prevention of stroke are available but frequently underused. Support programs with multifactorial risk factor modifications after stroke or TIA have not been investigated in large-scale prospective controlled trials so far. INSPiRE-TMS is a prospective, multi-center, randomized open intervention trial for intensified secondary prevention after minor stroke and TIA. Methods/design Patients with acute TIA or minor stroke admitted to the participating stroke centers are screened and recruited during in-hospital stay. Patients are randomised in a 1:1 ratio to intervention (support program and control (usual care arms. Inclusion of 2.082 patients is planned. The support program includes cardiovascular risk factor measurement and feedback, monitoring of medication adherence, coaching in lifestyle modifications, and active involvement of relatives. Standardized motivational interviewing is used to assess and enhance patients’ motivation. Primary objective is a reduction of new major vascular events defined as nonfatal stroke and myocardial infarction or vascular death. Recruitment time is planned for 3.5 years, follow up time is at least 2 years for every patient resulting in a total study time of 5 years (first patient in to last patient out. Discussion Given the high risk for vascular re-events in acute stroke and the available effective strategies in secondary prevention, the INSPIRE-TMS support program has the potential to lead to a relevant reduction of recurrent events and a prolongation of the event-free survival time. The trial will provide the basis for the decision whether an intensified secondary prevention program after stroke should be implemented into regular care. A cost-effectiveness evaluation will be performed. Trial registration clinicaltrials.gov: 01586702

Energy balance of the optimised CVT-hybrid-driveline

Energy Technology Data Exchange (ETDEWEB)

Hoehn, Bernd-Robert; Pflaum, Hermann; Lechner, Claus [Forschungsstelle fuer Zahnraeder und Getriebebau, Technische Univ. Muenchen, Garching (Germany)

2009-07-01

Funded by the DFG (German Research Foundation) and some industry partners like GM Powertrain Europe, ZF, EPCOS the Optimised CVT-Hybrid was developed at Technische Universitaet Muenchen in close collaboration with the industry and is currently under scientific investigation. Designed as a parallel hybrid vehicle the Optimised CVT-Hybrid combines a series-production diesel engine with a small electric motor. The core element of the driveline is a two range continuously variable transmission (i{radical}i-transmission), which is based on a chain variator. By a special shifting process without interruption of traction force the ratio range of the chain variator is used twice; thereby a wide transmission-ratio spread is achieved by low complexity. Thus the transmission provides a large pull-away ratio for the small electric motor and a fuel-efficient overdrive ratio for the ic-engine. Instead of heavy and space-consuming accumulators a small efficient package of double layer capacitors (UltraCaps) is used for electric energy and power storage. The driveline management is done by an optimised vehicle controller. Within the scope of the research project two prototype drivelines were manufactured. One driveline is integrated into an Opel Vectra Caravan and is available for investigations at the roller dynamometer and in the actual road traffic. The second hybrid driveline is assembled at the powertrain test rig of the FZG for detailed analysis of system behaviour and fuel consumption. Based on measurements of standardised driving cycles system behaviour, fuel consumption and a detailed energy balance of the Optimised CVT-Hybrid are presented. In comparison to the series-production vehicle the fuel savings are shown. (orig.)

Energy thermal management in commercial bread-baking using a multi-objective optimisation framework

International Nuclear Information System (INIS)

Khatir, Zinedine; Taherkhani, A.R.; Paton, Joe; Thompson, Harvey; Kapur, Nik; Toropov, Vassili

2015-01-01

In response to increasing energy costs and legislative requirements energy efficient high-speed air impingement jet baking systems are now being developed. In this paper, a multi-objective optimisation framework for oven designs is presented which uses experimentally verified heat transfer correlations and high fidelity Computational Fluid Dynamics (CFD) analyses to identify optimal combinations of design features which maximise desirable characteristics such as temperature uniformity in the oven and overall energy efficiency of baking. A surrogate-assisted multi-objective optimisation framework is proposed and used to explore a range of practical oven designs, providing information on overall temperature uniformity within the oven together with ensuing energy usage and potential savings. - Highlights: • A multi-objective optimisation framework to design commercial ovens is presented. • High fidelity CFD embeds experimentally calibrated heat transfer inputs. • The optimum oven design minimises specific energy and bake time. • The Pareto front outlining the surrogate-assisted optimisation framework is built. • Optimisation of industrial bread-baking ovens reveals an energy saving of 637.6 GWh

Brazilian status in blood irradiation in Graft-Versus-Host Disease (GVHD) prevention

International Nuclear Information System (INIS)

Goes, E.G. de; Borges, J.C.; Ghilardi Netto, T.

1996-01-01

A short overview of the Brazilian reality concerning Graft-Versus-Host Disease (GVHD) is presented. Suggestions of policies and procedures to optimise GVHD prevention are reported. A national irradiator device using cobalt teletherapy unit is proposed for irradiation of blood and cellular components

Efficacy of standard and intensive statin treatment for the secondary prevention of cardiovascular and cerebrovascular events in diabetes patients : A meta-analysis

NARCIS (Netherlands)

De Vries, Folgerdiena M.; Kolthof, Johan; Postma, Maarten J.; Denig, Petra; Hak, Eelko

2014-01-01

Aims: To estimate the efficacy of standard and intensive statin treatment in the secondary prevention of major cardiovascular and cerebrovascular events in diabetes patients. Methods: A systematic search was conducted in Medline over the years 1990 to September 2013. Randomized, double-blind,

Décomposition-coordination en optimisation déterministe et stochastique

CERN Document Server

Carpentier, Pierre

2017-01-01

Ce livre considère le traitement de problèmes d'optimisation de grande taille. L'idée est d'éclater le problème d'optimisation global en sous-problèmes plus petits, donc plus faciles à résoudre, chacun impliquant l'un des sous-systèmes (décomposition), mais sans renoncer à obtenir l'optimum global, ce qui nécessite d'utiliser une procédure itérative (coordination). Ce sujet a fait l'objet de plusieurs livres publiés dans les années 70 dans le contexte de l'optimisation déterministe. Nous présentans ici les principes essentiels et méthodes de décomposition-coordination au travers de situations typiques, puis nous proposons un cadre général qui permet de construire des algorithmes corrects et d'étudier leur convergence. Cette théorie est présentée aussi bien dans le contexte de l'optimisation déterministe que stochastique. Ce matériel a été enseigné par les auteurs dans divers cours de 3ème cycle et également mis en œuvre dans de nombreuses applications industrielles. Des exerc...

Thickness Optimisation of Textiles Subjected to Heat and Mass Transport during Ironing

Directory of Open Access Journals (Sweden)

Korycki Ryszard

2016-09-01

Full Text Available Let us next analyse the coupled problem during ironing of textiles, that is, the heat is transported with mass whereas the mass transport with heat is negligible. It is necessary to define both physical and mathematical models. Introducing two-phase system of mass sorption by fibres, the transport equations are introduced and accompanied by the set of boundary and initial conditions. Optimisation of material thickness during ironing is gradient oriented. The first-order sensitivity of an arbitrary objective functional is analysed and included in optimisation procedure. Numerical example is the thickness optimisation of different textile materials in ironing device.

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol

Directory of Open Access Journals (Sweden)

Sharifah Intan Zainun Sharif Ishak

2016-10-01

Full Text Available Abstract Background Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL, a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13–14 years old. Methods/Design Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13–14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity, body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. Discussion It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. Trial registration UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016

ATLAS software configuration and build tool optimisation

Science.gov (United States)

Rybkin, Grigory; Atlas Collaboration

2014-06-01

ATLAS software code base is over 6 million lines organised in about 2000 packages. It makes use of some 100 external software packages, is developed by more than 400 developers and used by more than 2500 physicists from over 200 universities and laboratories in 6 continents. To meet the challenge of configuration and building of this software, the Configuration Management Tool (CMT) is used. CMT expects each package to describe its build targets, build and environment setup parameters, dependencies on other packages in a text file called requirements, and each project (group of packages) to describe its policies and dependencies on other projects in a text project file. Based on the effective set of configuration parameters read from the requirements files of dependent packages and project files, CMT commands build the packages, generate the environment for their use, or query the packages. The main focus was on build time performance that was optimised within several approaches: reduction of the number of reads of requirements files that are now read once per package by a CMT build command that generates cached requirements files for subsequent CMT build commands; introduction of more fine-grained build parallelism at package task level, i.e., dependent applications and libraries are compiled in parallel; code optimisation of CMT commands used for build; introduction of package level build parallelism, i. e., parallelise the build of independent packages. By default, CMT launches NUMBER-OF-PROCESSORS build commands in parallel. The other focus was on CMT commands optimisation in general that made them approximately 2 times faster. CMT can generate a cached requirements file for the environment setup command, which is especially useful for deployment on distributed file systems like AFS or CERN VMFS. The use of parallelism, caching and code optimisation significantly-by several times-reduced software build time, environment setup time, increased the efficiency of

Optimisation of efficiency of axial fans

NARCIS (Netherlands)

Kruyt, Nicolaas P.; Pennings, P.C.; Faasen, R.

2014-01-01

A three-stage research project has been executed to develop ducted axial-fans with increased efficiency. In the first stage a design method has been developed in which various conflicting design criteria can be incorporated. Based on this design method, an optimised design has been determined

MANAGEMENT OPTIMISATION OF MASS CUSTOMISATION MANUFACTURING USING COMPUTATIONAL INTELLIGENCE

Directory of Open Access Journals (Sweden)

Louwrens Butler

2018-05-01

Full Text Available Computational intelligence paradigms can be used for advanced manufacturing system optimisation. A static simulation model of an advanced manufacturing system was developed in order to simulate a manufacturing system. The purpose of this advanced manufacturing system was to mass-produce a customisable product range at a competitive cost. The aim of this study was to determine whether this new algorithm could produce a better performance than traditional optimisation methods. The algorithm produced a lower cost plan than that for a simulated annealing algorithm, and had a lower impact on the workforce.

Optimising Job-Shop Functions Utilising the Score-Function Method

DEFF Research Database (Denmark)

Nielsen, Erland Hejn

2000-01-01

During the last 1-2 decades, simulation optimisation of discrete event dynamic systems (DEDS) has made considerable theoretical progress with respect to computational efficiency. The score-function (SF) method and the infinitesimal perturbation analysis (IPA) are two candidates belonging to this ......During the last 1-2 decades, simulation optimisation of discrete event dynamic systems (DEDS) has made considerable theoretical progress with respect to computational efficiency. The score-function (SF) method and the infinitesimal perturbation analysis (IPA) are two candidates belonging...... of a Job-Shop can be handled by the SF method....

The SPHERE Study. Secondary prevention of heart disease in general practice: protocol of a randomised controlled trial of tailored practice and patient care plans with parallel qualitative, economic and policy analyses. [ISRCTN24081411].

LENUS (Irish Health Repository)

Murphy, Andrew W

2005-07-29

BACKGROUND: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. METHODS: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to

HVAC system optimisation-in-building section

Energy Technology Data Exchange (ETDEWEB)

Lu, L.; Cai, W.; Xie, L.; Li, S.; Soh, Y.C. [School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore (Singapore)

2004-07-01

This paper presents a practical method to optimise in-building section of centralised Heating, Ventilation and Air-Conditioning (HVAC) systems which consist of indoor air loops and chilled water loops. First, through component characteristic analysis, mathematical models associated with cooling loads and energy consumption for heat exchangers and energy consuming devices are established. By considering variation of cooling load of each end user, adaptive neuro-fuzzy inference system (ANFIS) is employed to model duct and pipe networks and obtain optimal differential pressure (DP) set points based on limited sensor information. A mix-integer nonlinear constraint optimization of system energy is formulated and solved by a modified genetic algorithm. The main feature of our paper is a systematic approach in optimizing the overall system energy consumption rather than that of individual component. A simulation study for a typical centralized HVAC system is provided to compare the proposed optimisation method with traditional ones. The results show that the proposed method indeed improves the system performance significantly. (author)

Pre-operative optimisation of lung function

Directory of Open Access Journals (Sweden)

Naheed Azhar

2015-01-01

Full Text Available The anaesthetic management of patients with pre-existing pulmonary disease is a challenging task. It is associated with increased morbidity in the form of post-operative pulmonary complications. Pre-operative optimisation of lung function helps in reducing these complications. Patients are advised to stop smoking for a period of 4–6 weeks. This reduces airway reactivity, improves mucociliary function and decreases carboxy-haemoglobin. The widely used incentive spirometry may be useful only when combined with other respiratory muscle exercises. Volume-based inspiratory devices have the best results. Pharmacotherapy of asthma and chronic obstructive pulmonary disease must be optimised before considering the patient for elective surgery. Beta 2 agonists, inhaled corticosteroids and systemic corticosteroids, are the main drugs used for this and several drugs play an adjunctive role in medical therapy. A graded approach has been suggested to manage these patients for elective surgery with an aim to achieve optimal pulmonary function.

Acoustic Resonator Optimisation for Airborne Particle Manipulation

Science.gov (United States)

Devendran, Citsabehsan; Billson, Duncan R.; Hutchins, David A.; Alan, Tuncay; Neild, Adrian

Advances in micro-electromechanical systems (MEMS) technology and biomedical research necessitate micro-machined manipulators to capture, handle and position delicate micron-sized particles. To this end, a parallel plate acoustic resonator system has been investigated for the purposes of manipulation and entrapment of micron sized particles in air. Numerical and finite element modelling was performed to optimise the design of the layered acoustic resonator. To obtain an optimised resonator design, careful considerations of the effect of thickness and material properties are required. Furthermore, the effect of acoustic attenuation which is dependent on frequency is also considered within this study, leading to an optimum operational frequency range. Finally, experimental results demonstrated good particle levitation and capture of various particle properties and sizes ranging to as small as 14.8 μm.

Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease

Science.gov (United States)

Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

2017-01-01

Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation. This is an update of a Cochrane Review first published in 2002, and last updated in 2013. Objectives To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). Search methods We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Selection criteria Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease. Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion. Two trials compared the drug

Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.

Science.gov (United States)

Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

2017-01-17

Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation.This is an update of a Cochrane Review first published in 2002, and last updated in 2013. To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Two authors independently assessed trial eligibility and the risk of bias and extracted data. We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease.Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion.Two trials compared the drug hydroxyurea (hydroxycarbamide) and phlebotomy to long-term transfusions and iron chelation therapy: one in

Optimisation of electrical system for offshore wind farms via genetic algorithm

DEFF Research Database (Denmark)

Chen, Zhe; Zhao, Menghua; Blaabjerg, Frede

2009-01-01

An optimisation platform based on genetic algorithm (GA) is presented, where the main components of a wind farm and key technical specifications are used as input parameters and the electrical system design of the wind farm is optimised in terms of both production cost and system reliability....... The power losses, wind power production, initial investment and maintenance costs are considered in the production cost. The availability of components and network redundancy are included in the reliability evaluation. The method of coding an electrical system to a binary string, which is processed by GA......, is developed. Different GA techniques are investigated based on a real example offshore wind farm. This optimisation platform has been demonstrated as a powerful tool for offshore wind farm design and evaluation....

Modification and optimisation measures on the demineralisation plant of the Boxberg Power Station; Umbau und Optimierung der Vollentsalzungsanlage im Kraftwerk Boxberg

Energy Technology Data Exchange (ETDEWEB)

Leidich, F.U. [ALSTOM Power Generation AG, Mannheim (Germany); Markert, A. [Vattenfall Europe Generation AG Co KG, E-KT, Cottbus (Germany); Hajdamowicz, S. [Vattenfall Europe Generation AG Co KG, E-GBB, Boxberg (Germany); Kleespies, W. [RoKa GmbH, Butzbach (Germany)

2006-07-01

The demineralisation plant at the Boxberg Power Station, Unit AQ (Plant IV), owned by Vattenfall Europe Generation AG and Co KG, officially started its operation in 2000. In the course of the operation, technical shortcomings became apparent that rendered the quality of the deionised water inadequate and did prevent the plant from being operated in a normal, fully-automatic mode. Due to the insolvency of the supplier, it had not been possible to eliminate a series of problems and optimise the processes in such a way that the plant could be operated as planned. Nevertheless, thanks to measures like retrofitting the system with lowering loops, replacing the regenerating stations by frequency-controlled excenter-screw propeller pumps, installing automatic vents, and optimising the control concept of the plant, it finally was possible to solve some of the main problems. Longer intervals between regenerating procedures came as an additional benefit. (orig.)

OPTIMISATION OF COMPRESSIVE STRENGTH OF PERIWINKLE ...

African Journals Online (AJOL)

In this paper, a regression model is developed to predict and optimise the compressive strength of periwinkle shell aggregate concrete using Scheffe's regression theory. The results obtained from the derived regression model agreed favourably with the experimental data. The model was tested for adequacy using a student ...

Self-optimising control of sewer systems

DEFF Research Database (Denmark)

Mauricio Iglesias, Miguel; Montero-Castro, Ignacio; Mollerup, Ane Loft

2013-01-01

. The definition of an optimal performance was carried out by through a two-stage optimisation (stochastic and deterministic) to take into account both the overflow during the current rain event as well as the expected overflow, given the probability of a future rain event. The methodology is successfully applied...

Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

Science.gov (United States)

Woller, Scott C; Stevens, Scott M; Kaplan, David A; Branch, D Ware; Aston, Valerie T; Wilson, Emily L; Gallo, Heather M; Johnson, Eric G; Rondina, Matthew T; Lloyd, James F; Evans, R Scott; Elliott, C Gregory

2016-04-01

Antiphospholipid syndrome (APS) is an acquired thrombophilia characterized by thrombosis, pregnancy morbidity, and the presence of characteristic antibodies. Current therapy for patients having APS with a history of thrombosis necessitates anticoagulation with the vitamin K antagonist warfarin, a challenging drug to manage. Apixaban, approved for the treatment and prevention of venous thrombosis with a low rate of bleeding observed, has never been studied among patients with APS. We report study rationale and design of Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome (ASTRO-APS), a prospective randomized open-label blinded event pilot study that will randomize patients with a clinical diagnosis of APS receiving therapeutic anticoagulation to either adjusted-dose warfarin or apixaban 2.5 mg twice a day. We aim to report our ability to identify, recruit, randomize, and retain patients with APS randomized to apixaban compared with warfarin. We will report clinically important outcomes of thrombosis and bleeding. All clinical outcomes will be adjudicated by a panel blinded to the treatment arm. A unique aspect of this study is the enrollment of patients with an established clinical diagnosis of APS. Also unique is our use of electronic medical record interrogation techniques to identify patients who would likely meet our inclusion criteria and use of an electronic portal for follow-up visit data capture. ASTRO-APS will be the largest prospective study to date comparing a direct oral anticoagulant with warfarin among patients with APS for the secondary prevention of thrombosis. Our inclusion criteria assure that outcomes obtained will be clinically applicable to the routine management of patients with APS receiving indefinite anticoagulation. © The Author(s) 2015.

Multimodal secondary prevention behavioral interventions for TIA and stroke: a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Maggie Lawrence

Full Text Available Guidelines recommend implementation of multimodal interventions to help prevent recurrent TIA/stroke. We undertook a systematic review to assess the effectiveness of behavioral secondary prevention interventions.Searches were conducted in 14 databases, including MEDLINE (1980-January 2014. We included randomized controlled trials (RCTs testing multimodal interventions against usual care/modified usual care. All review processes were conducted in accordance with Cochrane guidelines.Twenty-three papers reporting 20 RCTs (6,373 participants of a range of multimodal behavioral interventions were included. Methodological quality was generally low. Meta-analyses were possible for physiological, lifestyle, psychosocial and mortality/recurrence outcomes. Note: all reported confidence intervals are 95%. Systolic blood pressure was reduced by 4.21 mmHg (mean (-6.24 to -2.18, P = 0.01 I2 = 58%, 1,407 participants; diastolic blood pressure by 2.03 mmHg (mean (-3.19 to -0.87, P = 0.004, I2 = 52%, 1,407 participants. No significant changes were found for HDL, LDL, total cholesterol, fasting blood glucose, high sensitivity-CR, BMI, weight or waist:hip ratio, although there was a significant reduction in waist circumference (-6.69 cm, -11.44 to -1.93, P = 0.006, I2 = 0%, 96 participants. There was no significant difference in smoking continuance, or improved fruit and vegetable consumption. There was a significant difference in compliance with antithrombotic medication (OR 1.45, 1.21 to 1.75, P<0.0001, I2 = 0%, 2,792 participants and with statins (OR 2.53, 2.15 to 2.97, P< 0.00001, I2 = 0%, 2,636 participants; however, there was no significant difference in compliance with antihypertensives. There was a significant reduction in anxiety (-1.20, -1.77 to -0.63, P<0.0001, I2 = 85%, 143 participants. Although there was no significant difference in odds of death or recurrent TIA/stroke, there was a significant reduction in the odds of cardiac events (OR 0.38, 0

Multiobjective optimisation of energy systems and building envelope retrofit in a residential community

International Nuclear Information System (INIS)

Wu, Raphael; Mavromatidis, Georgios; Orehounig, Kristina; Carmeliet, Jan

2017-01-01

Highlights: • Simultaneous optimisation of building envelope retrofit and energy systems. • Retrofit and energy systems change interact and should be considered simultaneously. • Case study quantifies cost-GHG emission tradeoffs for different retrofit options. - Abstract: In this paper, a method for a multi-objective and simultaneous optimisation of building energy systems and retrofit is presented. Tailored to be suitable for the diverse range of existing buildings in terms of age, size, and use, it combines dynamic energy demand simulation to explore individual retrofit scenarios with an energy hub optimisation. Implemented as an epsilon-constrained mixed integer linear program (MILP), the optimisation matches envelope retrofit with renewable and high efficiency energy supply technologies such as biomass boilers, heat pumps, photovoltaic and solar thermal panels to minimise life cycle cost and greenhouse gas (GHG) emissions. Due to its multi-objective, integrated assessment of building transformation options and its ability to capture both individual building characteristics and trends within a neighbourhood, this method is aimed to provide developers, neighbourhood and town policy makers with the necessary information to make adequate decisions. Our method is deployed in a case study of typical residential buildings in the Swiss village of Zernez, simulating energy demands in EnergyPlus and solving the optimisation problem with CPLEX. Although common trade-offs in energy system and retrofit choice can be observed, optimisation results suggest that the diversity in building age and size leads to optimal strategies for retrofitting and building system solutions, which are specific to different categories. With this method, GHG emissions of the entire community can be reduced by up to 76% at a cost increase of 3% compared to the current emission levels, if an optimised solution is selected for each building category.

Optimised low-dose multidetector CT protocol for children with cranial deformity

Energy Technology Data Exchange (ETDEWEB)

Vazquez, Jose Luis [Complejo Hospitalario Universitario de Vigo, Department of Radiology, Vigo, Pontevedra (Spain); Pombar, Miguel Angel [Complejo Hospitalario Universitario de Santiago, Department of Radiophysics, Santiago de Compostela, La Coruna (Spain); Pumar, Jose Manuel [Complejo Hospitalario Universitario de Santiago, Department of Radiology, Santiago de Compostela, La Coruna (Spain); Campo, Victor Miguel del [Complejo Hospitalario Universitario de Vigo, Department of Public Health, Vigo, Pontevedra (Spain)

2013-08-15

To present an optimised low-dose multidetector computed tomography (MDCT) protocol for the study of children with cranial deformity. Ninety-one consecutive MDCT studies were performed in 80 children. Studies were performed with either our standard head CT protocol (group 1, n = 20) or a low-dose cranial deformity protocol (groups 2 and 3). Group 2 (n = 38), initial, and group 3 (n = 33), final and more optimised. All studies were performed in the same 64-MDCT equipment. Cranial deformity protocol was gradationally optimised decreasing kVp, limiting mA range, using automatic exposure control (AEC) and increasing the noise index (NI). Image quality was assessed. Dose indicators such us CT dose index volume (CTDIvol), dose-length product (DLP) and effective dose (E) were used. The optimised low-dose protocol reached the following values: 80 kVp, mA range: 50-150 and NI = 23. We achieved a maximum dose reduction of 10-22 times in the 1- to 12-month-old cranium in regard to the 2004 European guidelines for MDCT. A low-dose MDCT protocol that may be used as the first diagnostic imaging option in clinically selected patients with skull abnormalities. (orig.)

Optimisation of the PCR-invA primers for the detection of Salmonella ...

African Journals Online (AJOL)

A polymerase chain reaction (PCR)-based method for the detection of Salmonella species in water samples was optimised and evaluated for speed, specificity and sensitivity. Optimisation of Mg2+ and primer concentrations and cycling parameters increased the sensitivity and limit of detection of PCR to 2.6 x 104 cfu/m.

Thermodynamic optimisation of a heat exchanger

NARCIS (Netherlands)

Cornelissen, Rene; Hirs, Gerard

1999-01-01

The objective of this paper is to show that for the optimal design of an energy system, where there is a trade-off between exergy saving during operation and exergy use during construction of the energy system, exergy analysis and life cycle analysis should be combined. An exergy optimisation of a

Prevention of Graves' ophthalmopathy.

Science.gov (United States)

Bartalena, Luigi

2012-06-01

Smoking is the most important risk factor for the occurrence/progression of Graves' ophthalmopathy (GO), as well as for its lower/slower response to immunosuppression. Accordingly, refrain from smoking should be urged, both as primary prevention (removal of risk factors in Graves' patients without GO), secondary prevention (early detection and treatment of asymptomatic/very mild GO) and tertiary prevention (reduction of complications/disability of overt GO). A 6-month course of 200 μg/day sodium selenite can prevent progression of mild GO to more severe GO and is, therefore, a form of secondary prevention and, probably, primary prevention. Correction of thyroid dysfunction and stable maintenance of euthyroidism are important preventive measures. The optimal treatment for hyperthyroidism in patients with GO is uncertain, because evidence demonstrating the superiority of antithyroid drugs over thyroid ablation (radioiodine, thyroidectomy, or both) is lacking. If radioiodine is used, low-dose steroid prophylaxis is recommended, particularly in smokers, to prevent radioiodine-associated GO progression. Copyright © 2011 Elsevier Ltd. All rights reserved.

Advantages of Task-Specific Multi-Objective Optimisation in Evolutionary Robotics.

Science.gov (United States)

Trianni, Vito; López-Ibáñez, Manuel

2015-01-01

The application of multi-objective optimisation to evolutionary robotics is receiving increasing attention. A survey of the literature reveals the different possibilities it offers to improve the automatic design of efficient and adaptive robotic systems, and points to the successful demonstrations available for both task-specific and task-agnostic approaches (i.e., with or without reference to the specific design problem to be tackled). However, the advantages of multi-objective approaches over single-objective ones have not been clearly spelled out and experimentally demonstrated. This paper fills this gap for task-specific approaches: starting from well-known results in multi-objective optimisation, we discuss how to tackle commonly recognised problems in evolutionary robotics. In particular, we show that multi-objective optimisation (i) allows evolving a more varied set of behaviours by exploring multiple trade-offs of the objectives to optimise, (ii) supports the evolution of the desired behaviour through the introduction of objectives as proxies, (iii) avoids the premature convergence to local optima possibly introduced by multi-component fitness functions, and (iv) solves the bootstrap problem exploiting ancillary objectives to guide evolution in the early phases. We present an experimental demonstration of these benefits in three different case studies: maze navigation in a single robot domain, flocking in a swarm robotics context, and a strictly collaborative task in collective robotics.

Advantages of Task-Specific Multi-Objective Optimisation in Evolutionary Robotics.

Directory of Open Access Journals (Sweden)

Vito Trianni

Full Text Available The application of multi-objective optimisation to evolutionary robotics is receiving increasing attention. A survey of the literature reveals the different possibilities it offers to improve the automatic design of efficient and adaptive robotic systems, and points to the successful demonstrations available for both task-specific and task-agnostic approaches (i.e., with or without reference to the specific design problem to be tackled. However, the advantages of multi-objective approaches over single-objective ones have not been clearly spelled out and experimentally demonstrated. This paper fills this gap for task-specific approaches: starting from well-known results in multi-objective optimisation, we discuss how to tackle commonly recognised problems in evolutionary robotics. In particular, we show that multi-objective optimisation (i allows evolving a more varied set of behaviours by exploring multiple trade-offs of the objectives to optimise, (ii supports the evolution of the desired behaviour through the introduction of objectives as proxies, (iii avoids the premature convergence to local optima possibly introduced by multi-component fitness functions, and (iv solves the bootstrap problem exploiting ancillary objectives to guide evolution in the early phases. We present an experimental demonstration of these benefits in three different case studies: maze navigation in a single robot domain, flocking in a swarm robotics context, and a strictly collaborative task in collective robotics.

Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology.

Science.gov (United States)

Piepoli, Massimo F; Corrà, Ugo; Adamopoulos, Stamatis; Benzer, Werner; Bjarnason-Wehrens, Birna; Cupples, Margaret; Dendale, Paul; Doherty, Patrick; Gaita, Dan; Höfer, Stefan; McGee, Hannah; Mendes, Miguel; Niebauer, Josef; Pogosova, Nana; Garcia-Porrero, Esteban; Rauch, Bernhard; Schmid, Jean Paul; Giannuzzi, Pantaleo

2014-06-01

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorly implemented in clinical practice, often only on selected populations and over a limited period of time. The development of systematic and full comprehensive preventive programmes is warranted, integrated in the organization of national health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity. Cardiology and secondary prevention, including cardiac rehabilitation, have evolved almost independently of each other and although each makes a unique contribution it is now time to join forces under the banner of preventive cardiology and create a comprehensive model that optimizes long term outcomes for patients and reduces the future burden on health care services. These are the aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen to promote secondary preventive cardiology in clinical practice. © The European Society of Cardiology 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Discussion on Implementation of ICRP Recommendations Concerning Reference Levels and Optimisation

International Nuclear Information System (INIS)

2013-02-01

International Commission on Radiological Protection (ICRP) Publication 103, 'The 2007 Recommendations of the International Commission on Radiological Protection', issued in 2007, defines emergency exposure situations as unexpected situations that may require the implementation of urgent protective actions and perhaps longer term protective actions. The ICRP continues to recommend optimisation and the use of reference levels to ensure an adequate degree of protection in regard to exposure to ionising radiation in emergency exposure situations. Reference levels represent the level of dose or risk above which it is judged to be inappropriate to plan to allow exposures to occur and for which protective actions should therefore be planned and optimised. National authorities are responsible for establishing reference levels. The Expert Group on the Implementation of New International Recommendations for Emergency Exposure Situations (EGIRES) performed a survey to analyse the established processes for optimisation of the protection strategy for emergency exposure situations and for practical implementation of the reference level concept in several member states of the Nuclear Energy Agency (NEA). The EGIRES collected information on several national optimisation strategy definitions, on optimisation of protection for different protective actions, and also on optimisation of urgent protective actions. In addition, national criteria for setting reference levels, their use, and relevant processes, including specific triggers and dosimetric quantifies in setting reference levels, are focus points that the EGIRES also evaluated. The analysis of national responses to this 2011 survey shows many differences in the interpretation and application of the established processes and suggests that most countries are still in the early stages of implementing these processes. Since 2011, national authorities have continued their study of the ICRP recommendations to incorporate them into

Shape optimisation and performance analysis of flapping wings

KAUST Repository

Ghommem, Mehdi

2012-09-04

In this paper, shape optimisation of flapping wings in forward flight is considered. This analysis is performed by combining a local gradient-based optimizer with the unsteady vortex lattice method (UVLM). Although the UVLM applies only to incompressible, inviscid flows where the separation lines are known a priori, Persson et al. [1] showed through a detailed comparison between UVLM and higher-fidelity computational fluid dynamics methods for flapping flight that the UVLM schemes produce accurate results for attached flow cases and even remain trend-relevant in the presence of flow separation. As such, they recommended the use of an aerodynamic model based on UVLM to perform preliminary design studies of flapping wing vehicles Unlike standard computational fluid dynamics schemes, this method requires meshing of the wing surface only and not of the whole flow domain [2]. From the design or optimisation perspective taken in our work, it is fairly common (and sometimes entirely necessary, as a result of the excessive computational cost of the highest fidelity tools such as Navier-Stokes solvers) to rely upon such a moderate level of modelling fidelity to traverse the design space in an economical manner. The objective of the work, described in this paper, is to identify a set of optimised shapes that maximise the propulsive efficiency, defined as the ratio of the propulsive power over the aerodynamic power, under lift, thrust, and area constraints. The shape of the wings is modelled using B-splines, a technology used in the computer-aided design (CAD) field for decades. This basis can be used to smoothly discretize wing shapes with few degrees of freedom, referred to as control points. The locations of the control points constitute the design variables. The results suggest that changing the shape yields significant improvement in the performance of the flapping wings. The optimisation pushes the design to "bird-like" shapes with substantial increase in the time

OPTIMISATION OF A DRIVE SYSTEM AND ITS EPICYCLIC GEAR SET

OpenAIRE

Bellegarde , Nicolas; Dessante , Philippe; Vidal , Pierre; Vannier , Jean-Claude

2007-01-01

International audience; This paper describes the design of a drive consisting of a DC motor, a speed reducer, a lead screw transformation system, a power converter and its associated DC source. The objective is to reduce the mass of the system. Indeed, the volume and weight optimisation of an electrical drive is an important issue for embedded applications. Here, we present an analytical model of the system in a specific application and afterwards an optimisation of the motor and speed reduce...

Optimisation of gas-cooled reactors with the aid of mathematical computers

Energy Technology Data Exchange (ETDEWEB)

Margen, P H

1959-04-15

Reactor optimisation is the task of finding the combination of values of the independent variables in a reactor design producing the lowest cost of electricity. In a gas-cooled reactor the number of independent variables is particularly large and the optimisation process is, therefore, laborious. The present note describes a procedure for performing the entire optimisation procedure with the aid of a mathematical computer in a single operation, thus saving time for the design staff. Detailed equations and numerical constants are proposed for the thermal and cost relations involved. The reactor physics equations, on the other hand are merely stated as general functions of the relevant variables. The task of expressing these functions as detailed equations will be covered by separate documents prepared by the reactor physics department.

Optimisation of gas-cooled reactors with the aid of mathematical computers

International Nuclear Information System (INIS)

Margen, P.H.

1959-04-01

Reactor optimisation is the task of finding the combination of values of the independent variables in a reactor design producing the lowest cost of electricity. In a gas-cooled reactor the number of independent variables is particularly large and the optimisation process is, therefore, laborious. The present note describes a procedure for performing the entire optimisation procedure with the aid of a mathematical computer in a single operation, thus saving time for the design staff. Detailed equations and numerical constants are proposed for the thermal and cost relations involved. The reactor physics equations, on the other hand are merely stated as general functions of the relevant variables. The task of expressing these functions as detailed equations will be covered by separate documents prepared by the reactor physics department

Efficacy of an Optimised Bacteriophage Cocktail to Clear Clostridium difficile in a Batch Fermentation Model

Directory of Open Access Journals (Sweden)

Janet Y. Nale

2018-02-01

Full Text Available Clostridium difficile infection (CDI is a major cause of infectious diarrhea. Conventional antibiotics are not universally effective for all ribotypes, and can trigger dysbiosis, resistance and recurrent infection. Thus, novel therapeutics are needed to replace and/or supplement the current antibiotics. Here, we describe the activity of an optimised 4-phage cocktail to clear cultures of a clinical ribotype 014/020 strain in fermentation vessels spiked with combined fecal slurries from four healthy volunteers. After 5 h, we observed ~6-log reductions in C. difficile abundance in the prophylaxis regimen and complete C. difficile eradication after 24 h following prophylactic or remedial regimens. Viability assays revealed that commensal enterococci, bifidobacteria, lactobacilli, total anaerobes, and enterobacteria were not affected by either regimens, but a ~2-log increase in the enterobacteria, lactobacilli, and total anaerobe abundance was seen in the phage-only-treated vessel compared to other treatments. The impact of the phage treatments on components of the microbiota was further assayed using metagenomic analysis. Together, our data supports the therapeutic application of our optimised phage cocktail to treat CDI. Also, the increase in specific commensals observed in the phage-treated control could prevent further colonisation of C. difficile, and thus provide protection from infection being able to establish.

Water distribution systems design optimisation using metaheuristics ...

African Journals Online (AJOL)

The topic of multi-objective water distribution systems (WDS) design optimisation using metaheuristics is investigated, comparing numerous modern metaheuristics, including several multi-objective evolutionary algorithms, an estimation of distribution algorithm and a recent hyperheuristic named AMALGAM (an evolutionary ...

A national optimisation model for energy wood streams; Energiapuuvirtojen valtakunnallinen optimointimalli

Energy Technology Data Exchange (ETDEWEB)

Iikkanen, P.; Keskinen, S.; Korpilahti, A.; Raesaenen, T.; Sirkiae, A.

2011-07-01

In 2010 a total of 12,5 terawatt hours of forest energy was used in Finland's heat and power plants. According to studies by Metsaeteho and Poeyry, use of energy wood will nearly double to 21.6 terawatt hours by 2020. There are also plans to use energy wood as a raw material for biofuel plants. The techno-ecological supply potential of energy wood in 2020 is estimated at 42.9 terawatt hours. Energy wood has been transported almost entirely by road. The situation is changing, however, because growing demand for energy wood will expand raw wood procurement areas and lengthen transport distances. A cost-effective transport system therefore also requires the use of rail and waterway transports. In Finland, however, there is almost a complete absence of the terminals required for the use of rail and waterway transports; where energy wood is chipped, temporarily stored and loaded onto railway wagons and vessels for further transport. A national optimisation model for energy wood has been developed to serve transport system planning in particular. The linear optimisation model optimises, on a national level, goods streams between supply points and usage points based on forest energy procurement costs. The model simultaneously covers deliveries of forest chips, stumps and small-sized thinning wood. The procurement costs used in the optimisation include the costs of the energy wood's roadside price, chipping, transport and terminal handling. The transport system described in the optimisation model consists of wood supply points (2007 municipality precision), wood usage points, railway terminals and the connections between them along the main road and rail network. Elements required for the examination of waterway transports can also be easily added to the model. The optimisation model can be used to examine, for example, the effects of changes of energy wood demand and supply as well as transport costs on energy wood goods streams, the relative use of different

Use of Low-dose Aspirin as Secondary Prevention of Atherosclerotic Cardiovascular Disease Among US Adults (From the National Health Interview Survey, 2012)

Science.gov (United States)

Fang, Jing; George, Mary G.; Gindi, Renee M.; Hong, Yuling; Yang, Quanhe; Ayala, Carma; Ward, Brian W.; Loustalot, Fleetwood

2015-01-01

Current guidelines recommend that adults with atherosclerotic cardiovascular disease take low-dose aspirin or other antiplatelet medications as secondary prevention of recurrent cardiovascular events. Yet, no national level assessment of low-dose aspirin use for secondary prevention of cardiovascular disease has been reported among a community-based population. Using data from the 2012 National Health Interview Survey, we assessed low-dose aspirin use among those with atherosclerotic cardiovascular disease. We estimated the prevalence ratios of low-dose aspirin use, adjusting for sociodemographic status, health insurance, and cardiovascular risk factors. Among those with atherosclerotic cardiovascular disease (n=3,068), 76% had been instructed to take aspirin, and 88% of those were following this advice. Of those not advised, 11% took aspirin on this own. Overall, 70% were taking aspirin (including those who followed their health care provider's advice and those who were not advised but took aspirin on their own). Logistic regression models showed that women, non-Hispanic blacks and Hispanics, those aged 40–64 years, with a high school education or with some college, or with fewer cardiovascular disease risk factors were less likely to take aspirin than men, non-Hispanic whites, those aged ≥65 years, with a college education or higher, or with all four selected cardiovascular disease risk factors, respectively. Additional analyses conducted among those with coronary heart disease only (n=2,007) showed similar patterns. In conclusion, use of low-dose aspirin for secondary prevention was 70%, with high reported adherence to health care providers' advice to take low-dose aspirin (88%), and significant variability within subgroups. PMID:25670639

Optimisation of window settings for traditional and noise-optimised virtual monoenergetic imaging in dual-energy computed tomography pulmonary angiography

International Nuclear Information System (INIS)

D'Angelo, Tommaso; ''G. Martino'' University Hospital, Messina; Bucher, Andreas M.; Lenga, Lukas; Arendt, Christophe T.; Peterke, Julia L.; Martin, Simon S.; Leithner, Doris; Vogl, Thomas J.; Wichmann, Julian L.; Caruso, Damiano; University Hospital, Latina; Mazziotti, Silvio; Blandino, Alfredo; Ascenti, Giorgio; University Hospital, Messina; Othman, Ahmed E.

2018-01-01

To define optimal window settings for displaying virtual monoenergetic images (VMI) of dual-energy CT pulmonary angiography (DE-CTPA). Forty-five patients who underwent clinically-indicated third-generation dual-source DE-CTPA were retrospectively evaluated. Standard linearly-blended (M 0 .6), 70-keV traditional VMI (M70), and 40-keV noise-optimised VMI (M40+) reconstructions were analysed. For M70 and M40+ datasets, the subjectively best window setting (width and level, B-W/L) was independently determined by two observers and subsequently related with pulmonary artery attenuation to calculate separate optimised values (O-W/L) using linear regression. Subjective evaluation of image quality (IQ) between W/L settings were assessed by two additional readers. Repeated measures of variance were performed to compare W/L settings and IQ indices between M 0 .6, M70, and M40+. B-W/L and O-W/L for M70 were 460/140 and 450/140, and were 1100/380 and 1070/380 for M40+, respectively, differing from standard DE-CTPA W/L settings (450/100). Highest subjective scores were observed for M40+ regarding vascular contrast, embolism demarcation, and overall IQ (all p<0.001). Application of O-W/L settings is beneficial to optimise subjective IQ of VMI reconstructions of DE-CTPA. A width slightly less than two times the pulmonary trunk attenuation and a level approximately of overall pulmonary vessel attenuation are recommended. (orig.)

[Control of major cardiovascular risk factors of ischemic heart disease in secondary prevention in Aragón: COCINA study].

Science.gov (United States)

Cucalon Arenal, J M; Buisac Ramón, C; Marin Ibáñez, A; Castan Ruiz, S; Blay Cortes, M G; Barrasa Villar, J I

2016-01-01

Ischemic heart disease remains a leading cause of death in Spain. According to the American Heart Association/American College of Cardiology (AHA/ACC) and European national societies, secondary prevention for these patients consists of control of major cardiovascular risk factors (CVRF) and suitable lifestyle habits. To determine the degree of control of CVRF in the Aragonese population in secondary prevention. Cross-sectional study of a sample of 705 patients of Aragon who had suffered a cardiac event, selected opportunistically in consultations of family physicians participating in the 3 provinces of Aragon. The study was conducted in the second half of 2012. To measure the degree of control of different FRVC and lifestyle habits in this population. Anthropometric, different cardiovascular risk factors, treatment and lifestyle. 58% of men and 52% of women met criteria for monitoring of measured variables. The best result was obtained with smoking cessation and the worst with BMI. Hypertension, Dyslipidemia and Diabetes Mellitus achieve poor control results. The results show that the degree of control of CVRF is still low, especially in variables such as dyslipidemia and Diabetes Mellitus. Only 16.5% of control patients met criteria given the pharmacologically-modifiable cardiovascular risk factors. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

Using Intervention Mapping to Develop an Oral Health e-Curriculum for Secondary Prevention of Eating Disorders.

Science.gov (United States)

DeBate, Rita D; Bleck, Jennifer R; Raven, Jessica; Severson, Herb

2017-06-01

Preventing oral-systemic health issues relies on evidence-based interventions across various system-level target groups. Although the use of theory- and evidence-based approaches has been encouraged in developing oral health behavior change programs, the translation of theoretical constructs and principles to behavior change interventions has not been well described. Based on a series of six systematic steps, Intervention Mapping provides a framework for effective decision making with regard to developing, implementing, and evaluating theory- and evidence-informed, system-based behavior change programs. This article describes the application of the Intervention Mapping framework to develop the EAT (evaluating, assessing, and treating) evidence-based intervention with the goal of increasing the capacity of oral health providers to engage in secondary prevention of oral-systemic issues associated with disordered eating behaviors. Examples of data and deliverables for each step are described. In addition, results from evaluation of the intervention via randomized control trial are described, with statistically significant differences observed in behavioral outcomes in the intervention group with effect sizes ranging from r=0.62 to 0.83. These results suggest that intervention mapping, via the six systematic steps, can be useful as a framework for continued development of preventive interventions.

Ankles back in randomized controlled trial (ABrCt): braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial.

Science.gov (United States)

Janssen, Kasper W; van Mechelen, Willem; Verhagen, Evert Alm

2011-09-27

Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training) against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. The ABrCt is the first randomized controlled trial to directly compare the secondary preventive effect of the combined use of braces and neuromuscular training

Prevalence, risk factors and secondary prevention of stroke recurrence in eight countries from south, east and southeast asia: a scoping review.

Science.gov (United States)

Chin, Y Y; Sakinah, H; Aryati, A; Hassan, B M

2018-04-01

In most Asian countries, stroke is one of the major causes of mortality. A stroke event is life-changing for stroke survivors, which results in either mortality or disability. Therefore, this study comprehensively focuses on prevalence, risk factors, and secondary prevention for stroke recurrence identified in South, East, and Southeast Asian countries. This scoping review uses the methodological framework of Arksey and O'Malley. A comprehensive search of academic journals (English) on this topic published from 2007 to 2017 was conducted. A total of 22 studies were selected from 585 studies screened from the electronic databases. First-year stroke recurrence rates are in the range of 2.2% to 25.4%. Besides that, modifiable risk factors are significantly associated with pathophysiological factors (hypertension, ankle-brachial pressure index, atherogenic dyslipidaemia, diabetes mellitus, metabolic syndrome, and atrial fibrillation) and lifestyle factors (obesity, smoking, physical inactivity, and high salt intake). Furthermore, age, previous history of cerebrovascular events, and stroke subtype are also significant influence risk factors for recurrence. A strategic secondary prevention method for recurrent stroke is health education along with managing risk factors through a combination of appropriate lifestyle intervention and pharmacological therapy. To prevent recurrent stroke, health intervention should be geared towards changing lifestyle to embody a healthier approach to life. This is of great importance to public health and stroke survivors' quality of life.

Optimisation of surgical care for rectal cancer

NARCIS (Netherlands)

Borstlap, W.A.A.

2017-01-01

Optimisation of surgical care means weighing the risk of treatment related morbidity against the patients’ potential benefits of a surgical intervention. The first part of this thesis focusses on the anaemic patient undergoing colorectal surgery. Hypothesizing that a more profound haemoglobin

An efficient optimisation method in groundwater resource ...

African Journals Online (AJOL)

DRINIE

2003-10-04

Oct 4, 2003 ... theories developed in the field of stochastic subsurface hydrology. In reality, many ... Recently, some researchers have applied the multi-stage ... Then a robust solution of the optimisation problem given by Eqs. (1) to (3) is as ...

Risk factors for secondary substance use disorders in people with childhood and adolescent-onset bipolar disorder: opportunities for prevention.

Science.gov (United States)

Kenneson, Aileen; Funderburk, Jennifer S; Maisto, Stephen A

2013-07-01

Compared to other mental illnesses, bipolar disorder is associated with a disproportionately high rate of substance use disorders (SUDs), and the co-occurrence is associated with significant morbidity and mortality. Early diagnosis of primary bipolar disorder may provide opportunities for SUD prevention, but little is known about the risk factors for secondary SUD among individuals with bipolar disorder. The purposes of this study were to describe the population of people with childhood and adolescent-onset primary bipolar disorder, and to identify risk factors for secondary SUD in this population. Using data collected from the National Comorbidity Survey Replication study, we identified 158 individuals with childhood-onset (adolescent-onset (13-18 years) primary bipolar disorder (I, II or subthreshold). Survival analysis was used to identify risk factors for SUD. Compared to adolescent-onset, people with childhood-onset bipolar disorder had increased likelihoods of attention deficit hyperactivity disorder (ADHD) (adjusted odds ratio=2.81) and suicide attempt (aOR=3.61). Males were more likely than females to develop SUD, and did so at a faster rate. Hazard ratios of risk factors for SUD were: lifetime oppositional defiant disorder (2.048), any lifetime anxiety disorder (3.077), adolescent-onset bipolar disorder (1.653), and suicide attempt (15.424). SUD was not predicted by bipolar disorder type, family history of bipolar disorder, hospitalization for a mood episode, ADHD or conduct disorder. As clinicians struggle to help individuals with bipolar disorder, this study provides information that might be useful in identifying individuals at higher risk for SUD. Future research can examine whether targeting these risk factors may help prevent secondary SUD. Published by Elsevier Inc.

Thermodynamic optimisation and analysis of four Kalina cycle layouts for high temperature applications

International Nuclear Information System (INIS)

Modi, Anish; Haglind, Fredrik

2015-01-01

The Kalina cycle has seen increased interest in the last few years as an efficient alternative to the conventional steam Rankine cycle. However, the available literature gives little information on the algorithms to solve or optimise this inherently complex cycle. This paper presents a detailed approach to solve and optimise a Kalina cycle for high temperature (a turbine inlet temperature of 500 °C) and high pressure (over 100 bar) applications using a computationally efficient solution algorithm. A central receiver solar thermal power plant with direct steam generation was considered as a case study. Four different layouts for the Kalina cycle based on the number and/or placement of the recuperators in the cycle were optimised and compared based on performance parameters such as the cycle efficiency and the cooling water requirement. The cycles were modelled in steady state and optimised with the maximisation of the cycle efficiency as the objective function. It is observed that the different cycle layouts result in different regions for the optimal value of the turbine inlet ammonia mass fraction. Out of the four compared layouts, the most complex layout KC1234 gives the highest efficiency. The cooling water requirement is closely related to the cycle efficiency, i.e., the better the efficiency, the lower is the cooling water requirement. - Highlights: • Detailed methodology for solving and optimising Kalina cycle for high temperature applications. • A central receiver solar thermal power plant with direct steam generation considered as a case study. • Four Kalina cycle layouts based on the placement of recuperators optimised and compared

[Secondary glaucoma in Paraguay. Etiology and incidence].

Science.gov (United States)

Strohl, A; Pozzi, S; Wattiez, R; Roesen, B; Miño de Kaspar, H; Klauss, V

1999-06-01

Glaucoma is the third-most-frequent cause of blindness in the world, with a total of 5.2 million blind people as a result of this disease; 80% live in developing countries. In Paraguay, after cataract it is the second-most-frequent-cause. Early detection of the risk factors and groups can help to avoid progress of this disease. Trauma, cataract and infectious uveitis represent special risks for developing secondary glaucoma, which is a more frequent cause of blindness in third-world countries than in industrialized nations. Until now there has been little data regarding the causes, disease course, and options for therapy. Therefore, secondary glaucoma was examined in Paraguay to obtain information on the situation in Latin America. The aim of the study was to explore the causes of secondary glaucoma for programs concerning prevention and therapy. From November 1996 to February 1997 patients with secondary glaucoma were examined at the University Hospital of Asunción, Paraguay. After the clinical examination the secondary glaucomas were classified. Patients with primary glaucoma were included in the same period of time as well in order to get the rate of secondary glaucoma. Altogether 293 patients were examined: 61 with secondary and 232 with primary glaucoma. The causes of secondary glaucoma in 73 eyes were: 20 (27%) with pseudoexfoliation glaucoma, 19 (26%) with post-traumatic glaucoma, 16 (22%) with neovascular glaucoma, 4 (5%) with lens-related glaucoma, 3 (4%) with glaucoma associated with ocular surgery, 2 (3%) with pigmentary and 2 (3%) with corticoid-induced glaucoma. A ratio of 4:1 primary glaucomas to secondary glaucomas was found. The development of special measures for prevention and early therapy is only possible if the causes of this severe disease are explored. The results of this study represent basic information and could help to introduce of prevention programs.

Use of cardiovascular polypills for the secondary prevention of cerebrovascular disease.

Science.gov (United States)

Masjuan, J; Gállego, J; Aguilera, J M; Arenillas, J F; Castellanos, M; Díaz, F; Portilla, J C; Purroy, F

2018-01-08

There is little control of cardiovascular (CV) risk factors in secondary prevention after an ischaemic stroke, in part due to a lack of adherence to treatment. The CV polypill may contribute to proper treatment adherence, which is necessary for CV disease prevention. This study aimed to establish how and in what cases the CV polypill should be administered. A group of 8 neurologists drafted consensus recommendations using structured brainstorming and based on their experience and a literature review. These recommendations are based on the opinion of the participating experts. The use of the CV polypill is beneficial for patients, healthcare professionals, and the health system. Its use is most appropriate for atherothrombotic stroke, lacunar stroke, stroke associated with cognitive impairment, cryptogenic stroke with CV risk factors, and silent cerebrovascular disease. It is the preferred treatment in cases of suspected poor adherence, polymedicated patients, elderly people, patients with polyvascular disease or severe atherothrombosis, young patients in active work, and patients who express a preference for the CV polypill. Administration options include switching from individual drugs to the CV polypill, starting treatment with the CV polypill in the acute phase in particular cases, use in patients receiving another statin or an angiotensin ii receptor antagonist, or de novo use if there is suspicion of poor adherence. Nevertheless, use of the CV polypill requires follow-up on the achievement of the therapeutic objectives to make dose adjustments. This document is the first to establish recommendations for the use of the CV polypill in cerebrovascular disease, beyond its advantages in terms of treatment adherence. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Secondary Prevention of Esophageal Squamous Cell Carcinoma in Areas Where Smoking, Alcohol, and Betel Quid Chewing are Prevalent

Directory of Open Access Journals (Sweden)

Chen-Shuan Chung

2010-06-01

Full Text Available Esophageal cancer is ranked as the sixth most common cause of cancer death worldwide and has a substantial effect on public health. In contrast to adenocarcinoma arising from Barrett's esophagus in Western countries, the major disease phenotype in the Asia-Pacific region is esophageal squamous cell carcinoma which is attributed to the prevalence of smoking, alcohol, and betel quid chewing. Despite a multidisciplinary approach to treating esophageal cancer, the outcome remains poor. Moreover, field cancerization reveals that esophageal squamous cell carcinoma is closely linked with the development of head and neck cancers that further sub-optimize the treatment of patients. Therefore, preventive strategies are of paramount importance to improve the prognosis of this dismal disease. Since obstacles exist for primary prevention via risk factor elimination, the current rationale for esophageal cancer prevention is to identify high-risk groups at earlier stages of the disease, and encourage them to get a confirmatory diagnosis, prompt treatment, and intensive surveillance for secondary prevention. Novel biomarkers for identifying specific at-risk populations are under extensive investigation. Advances in image-enhanced endoscopy do not just substantially improve our ability to identify small precancerous or cancerous foci, but can also accurately predict their invasiveness. Research input from the basic sciences should be translated into preventive measures in order to decrease the disease burden of esophageal cancer.

Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a multinational medical-student-delivered smoking prevention programme for secondary schools in Germany.

Science.gov (United States)

Brinker, Titus J; Stamm-Balderjahn, Sabine; Seeger, Werner; Klingelhöfer, Doris; Groneberg, David A

2015-09-18

To evaluate the multinational medical-student-delivered tobacco prevention programme for secondary schools for its effectiveness to reduce the smoking prevalence among adolescents aged 11-15 years in Germany at half year follow-up. We used a prospective quasi-experimental study design with measurements at baseline (t1) and 6 months postintervention (t2) to investigate an intervention in 8 German secondary schools. The participants were split into intervention and control classes in the same schools and grades. A total of 1474 eligible participants of both genders at the age of 11-15 years were involved within the survey for baseline assessment of which 1200 completed the questionnaire at 6-month follow-up (=longitudinal sample). The schools participated voluntarily. The inclusion criteria were age (10-15 years), grade (6-8) and school type (regular secondary schools). Two 60 min school-based modules delivered by medical students. The primary end point was the difference from t1 to t2 of the smoking prevalence in the control group versus the difference from t1 to t2 in the intervention group (difference of differences approach). The percentage of former smokers and new smokers in the two groups were studied as secondary outcome measures. In the control group, the percentage of students who claimed to be smokers doubled from 4.2% (t1) to 8.1% (t2), whereas it remained almost the same in the intervention group (7.1% (t1) to 7.4% (t2); p=0.01). The likelihood of quitting smoking was almost six times higher in the intervention group (total of 67 smokers at t1; 27 (4.6%) and 7 (1.1%) in the control group; OR 5.63; 95% CI 2.01 to 15.79; p<0.01). However, no primary preventive effect was found. We report a significant secondary preventive (smoking cessation) effect at 6-month follow-up. Long-term evaluation is planned. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Aspects of approximate optimisation: overcoming the curse of dimensionality and design of experiments

NARCIS (Netherlands)

Trichon, Sophie; Bonte, M.H.A.; Ponthot, Jean-Philippe; van den Boogaard, Antonius H.

2007-01-01

Coupling optimisation algorithms to Finite Element Methods (FEM) is a very promising way to achieve optimal metal forming processes. However, many optimisation algorithms exist and it is not clear which of these algorithms to use. This paper investigates the sensitivity of a Sequential Approximate

Cluster randomized trial in the general practice research database: 2. Secondary prevention after first stroke (eCRT study: study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Dregan Alex

2012-10-01

Full Text Available Abstract Background The purpose of this research is to develop and evaluate methods for conducting pragmatic cluster randomized trials in a primary care electronic database. The proposal describes one application, in a less frequent chronic condition of public health importance, secondary prevention of stroke. A related protocol in antibiotic prescribing was reported previously. Methods/Design The study aims to implement a cluster randomized trial (CRT using the electronic patient records of the General Practice Research Database (GPRD as a sampling frame and data source. The specific objective of the trial is to evaluate the effectiveness of a computer-delivered intervention at enhancing the delivery of stroke secondary prevention in primary care. GPRD family practices will be allocated to the intervention or usual care. The intervention promotes the use of electronic prompts to support adherence with the recommendations of the UK Intercollegiate Stroke Working Party and NICE guidelines for the secondary prevention of stroke in primary care. Primary outcome measure will be the difference in systolic blood pressure between intervention and control trial arms at 12-month follow-up. Secondary outcomes will be differences in serum cholesterol, prescribing of antihypertensive drugs, statins, and antiplatelet therapy. The intervention will continue for 12 months. Information on the utilization of the decision-support tools will also be analyzed. Discussion The CRT will investigate the effectiveness of using a computer-delivered intervention to reduce the risk of stroke recurrence following a first stroke event. The study will provide methodological guidance on the implementation of CRTs in electronic databases in primary care. Trial registration Current Controlled Trials ISRCTN35701810

Approaches and challenges to optimising primary care teams’ electronic health record usage

Directory of Open Access Journals (Sweden)

Nancy Pandhi

2014-07-01

Full Text Available Background Although the presence of an electronic health record (EHR alone does not ensure high quality, efficient care, few studies have focused on the work of those charged with optimising use of existing EHR functionality.Objective To examine the approaches used and challenges perceived by analysts supporting the optimisation of primary care teams’ EHR use at a large U.S. academic health care system.Methods A qualitative study was conducted. Optimisation analysts and their supervisor were interviewed and data were analysed for themes.Results Analysts needed to reconcile the tension created by organisational mandates focused on the standardisation of EHR processes with the primary care teams’ demand for EHR customisation. They gained an understanding of health information technology (HIT leadership’s and primary care team’s goals through attending meetings, reading meeting minutes and visiting with clinical teams. Within what was organisationally possible, EHR education could then be tailored to fit team needs. Major challenges were related to organisational attempts to standardise EHR use despite varied clinic contexts, personnel readiness and technical issues with the EHR platform. Forcing standardisation upon clinical needs that current EHR functionality could not satisfy was difficult.Conclusions Dedicated optimisation analysts can add value to health systems through playing a mediating role between HIT leadership and care teams. Our findings imply that EHR optimisation should be performed with an in-depth understanding of the workflow, cognitive and interactional activities in primary care.

Pre-segmented 2-Step IMRT with subsequent direct machine parameter optimisation – a planning study

International Nuclear Information System (INIS)

Bratengeier, Klaus; Meyer, Jürgen; Flentje, Michael

2008-01-01

Modern intensity modulated radiotherapy (IMRT) mostly uses iterative optimisation methods. The integration of machine parameters into the optimisation process of step and shoot leaf positions has been shown to be successful. For IMRT segmentation algorithms based on the analysis of the geometrical structure of the planning target volumes (PTV) and the organs at risk (OAR), the potential of such procedures has not yet been fully explored. In this work, 2-Step IMRT was combined with subsequent direct machine parameter optimisation (DMPO-Raysearch Laboratories, Sweden) to investigate this potential. In a planning study DMPO on a commercial planning system was compared with manual primary 2-Step IMRT segment generation followed by DMPO optimisation. 15 clinical cases and the ESTRO Quasimodo phantom were employed. Both the same number of optimisation steps and the same set of objective values were used. The plans were compared with a clinical DMPO reference plan and a traditional IMRT plan based on fluence optimisation and consequent segmentation. The composite objective value (the weighted sum of quadratic deviations of the objective values and the related points in the dose volume histogram) was used as a measure for the plan quality. Additionally, a more extended set of parameters was used for the breast cases to compare the plans. The plans with segments pre-defined with 2-Step IMRT were slightly superior to DMPO alone in the majority of cases. The composite objective value tended to be even lower for a smaller number of segments. The total number of monitor units was slightly higher than for the DMPO-plans. Traditional IMRT fluence optimisation with subsequent segmentation could not compete. 2-Step IMRT segmentation is suitable as starting point for further DMPO optimisation and, in general, results in less complex plans which are equal or superior to plans generated by DMPO alone

A method to derive fixed budget results from expected optimisation times

DEFF Research Database (Denmark)

Doerr, Benjamin; Jansen, Thomas; Witt, Carsten

2013-01-01

At last year's GECCO a novel perspective for theoretical performance analysis of evolutionary algorithms and other randomised search heuristics was introduced that concentrates on the expected function value after a pre-defined number of steps, called budget. This is significantly different from...... the common perspective where the expected optimisation time is analysed. While there is a huge body of work and a large collection of tools for the analysis of the expected optimisation time the new fixed budget perspective introduces new analytical challenges. Here it is shown how results on the expected...... optimisation time that are strengthened by deviation bounds can be systematically turned into fixed budget results. We demonstrate our approach by considering the (1+1) EA on LeadingOnes and significantly improving previous results. We prove that deviating from the expected time by an additive term of ω(n3...

Optimisation of imaging technique used in direct digital radiography

International Nuclear Information System (INIS)

Roberts, J A; Evans, S C; Rees, M

2006-01-01

The purpose of the study was to optimise the technique employed for AP shoulder and lateral cervical spine examinations following an investigation into image quality, based on clinical assessment, and effective dose, calculated from patient entrance surface dose measurements. A study was therefore conducted in an attempt to determine whether the increased radiation dose to the patient following the introduction of an anti-scatter grid was justified by the level of improvement in image quality. The study, involving 100 patients, was able to demonstrate that the increase in radiation dose to the patient when using an anti-scatter grid for AP shoulder examinations is not justified by the improved image quality. A poor level of inter-rater reliability between the consultants scoring the lateral cervical spine images prevented a firm conclusion from being reached. The fact that all images were of diagnostic quality, however, suggested that the use of the anti-scatter grid was unnecessary. Following completion of the project the hospital involved was informed of all findings

The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

NARCIS (Netherlands)

Overbeek, M.M.; de Schipper, J.C.; Lamers-Winkelman, F.; Schuengel, C.

2012-01-01

Background: Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has

The 'diet heart' hypothesis in secondary prevention of coronary heart disease.

Science.gov (United States)

de Lorgeril, M; Salen, P; Monjaud, I; Delaye, J

1997-01-01

From this detailed analysis of the main dietary trials conducted over the last 30 years in the secondary prevention of coronary heart disease, it can be said that the older trials were conducted on low risk patients and used high fat diets (about 40% of energy as lipids), comprising low saturated fat and cholesterol intake but very high (15 to 20% of energy) polyunsaturated fat intake, particularly from the omega-6 fatty acid family. These experimental diets were designed to reduce blood cholesterol and failed to improve prognosis. By contrast, recent trials were not primarily designed to reduce cholesterol, were conducted in medium- and high-risk patients and used low fat diets supplemented by omega-3 fatty acids from various sources. In two of these trials, the consumption of natural antioxidants, oligoelements and vegetable proteins was increased. Recurrence rate was reduced in the range of 30 to 70%. One conclusion from these well-conducted recent experiments on more than 3000 patients is that new and more specific dietary recommendations are clearly warranted in secondary prevention of coronary heart disease. They should be more specific and more clearly defined and therefore different from those generally provided in the U.S.A. and Europe at present. In a recent Consensus Panel statement, authors wrote less than one line to describe a cardioprotective diet in patients with coronary heart disease, summarized as diet and coronary heart disease is more complex than the current cholesterol hypothesis. They identified at least seven major dietary factors, including fibres, although the evidence of an effect on coronary heart disease is weak. However, they did not mention vegetable and fish proteins which are rich in arginine and L-glutamine, major regulators of cardiovascular function. Thus, new dietary advice should include: reduce intake of total (not more than 30% of energy) and saturated (less than 10%) fats maintain intake at least minimally, of the essential

Shape optimisation and performance analysis of flapping wings

KAUST Repository

Ghommem, Mehdi; Collier, Nathan; Niemi, Antti; Calo, Victor M.

2012-01-01

optimised shapes produce efficient flapping flights, the wake pattern and its vorticity strength are examined. This work described in this paper should facilitate better guidance for shape design of engineered flying systems.

Differentiated Approach to the Treatment and Secondary Prevention of Asthma on the Background of Persistent Infections in Children

Directory of Open Access Journals (Sweden)

O.Ye. Chernyshova

2016-11-01

Full Text Available Thе article describes a differentiated approach to the treatment and secondary prevention of asthma occurring on the background of intracellular infections caused by the herpes simplex virus types I and II, cytomegalovirus, Epstein-Barr virus in children. The results confirmed the need for addition to the basic therapy of asthma the etiopathogenetic treatment, in particular, administration of acyclic nucleosides or macrolides depending on diagnosed infection, immunomodulators and alpha-2b-interferon (Laferobion to decrease the severity of disease and to reduce disability.

Numerical optimisation of friction stir welding: review of future challenges

DEFF Research Database (Denmark)

Tutum, Cem Celal; Hattel, Jesper Henri

2011-01-01

During the last decade, the combination of increasingly more advanced numerical simulation software with high computational power has resulted in models for friction stir welding (FSW), which have improved the understanding of the determining physical phenomena behind the process substantially....... This has made optimisation of certain process parameters possible and has in turn led to better performing friction stir welded products, thus contributing to a general increase in the popularity of the process and its applications. However, most of these optimisation studies do not go well beyond manual...

Optimising Comprehensibility in Interlingual Translation

DEFF Research Database (Denmark)

Nisbeth Jensen, Matilde

2015-01-01

The increasing demand for citizen engagement in areas traditionally belonging exclusively to experts, such as health, law and technology has given rise to the necessity of making expert knowledge available to the general public through genres such as instruction manuals for consumer goods, patien...... the functional text type of Patient Information Leaflet. Finally, the usefulness of applying the principles of Plain Language and intralingual translation for optimising comprehensibility in interlingual translation is discussed....

On optimal development and becoming an optimiser

NARCIS (Netherlands)

de Ruyter, D.J.

2012-01-01

The article aims to provide a justification for the claim that optimal development and becoming an optimiser are educational ideals that parents should pursue in raising their children. Optimal development is conceptualised as enabling children to grow into flourishing persons, that is persons who

Day-ahead economic optimisation of energy storage

NARCIS (Netherlands)

Lampropoulos, I.; Garoufalis, P.; Bosch, van den P.P.J.; Groot, de R.J.W.; Kling, W.L.

2014-01-01

This article addresses the day-ahead economic optimisation of energy storage systems within the setting of electricity spot markets. The case study is about a lithium-ion battery system integrated in a low voltage distribution grid with residential customers and photovoltaic generation in the

Optimisation of the formulation of a bubble bath by a chemometric approach market segmentation and optimisation.

Science.gov (United States)

Marengo, Emilio; Robotti, Elisa; Gennaro, Maria Carla; Bertetto, Mariella

2003-03-01

The optimisation of the formulation of a commercial bubble bath was performed by chemometric analysis of Panel Tests results. A first Panel Test was performed to choose the best essence, among four proposed to the consumers; the best essence chosen was used in the revised commercial bubble bath. Afterwards, the effect of changing the amount of four components (the amount of primary surfactant, the essence, the hydratant and the colouring agent) of the bubble bath was studied by a fractional factorial design. The segmentation of the bubble bath market was performed by a second Panel Test, in which the consumers were requested to evaluate the samples coming from the experimental design. The results were then treated by Principal Component Analysis. The market had two segments: people preferring a product with a rich formulation and people preferring a poor product. The final target, i.e. the optimisation of the formulation for each segment, was obtained by the calculation of regression models relating the subjective evaluations given by the Panel and the compositions of the samples. The regression models allowed to identify the best formulations for the two segments ofthe market.

Post-breakdown secondary discharges at the electrode/dielectric interface of a cylindrical barrier discharge

Science.gov (United States)

Carman, Robert; Ward, Barry; Kane, Deborah

2011-10-01

The electrical breakdown characteristics of a double-walled cylindrical dielectric barrier discharge (DBD) lamp with a neon buffer gas under pulsed voltage excitation have been investigated. Following the formation of plasma in the main discharge gap, we have observed secondary breakdown phenomena at the inner and outer mesh electrode/dielectric interfaces under specific operating conditions. Plasma formation at these interfaces is investigated by monitoring the Ozone production rate in controlled flows of ultra high purity oxygen together with the overall electrical voltage-charge characteristics of the lamp. The results show that this secondary breakdown only occurs after the main discharge plasma has been established, and that significant electrical power may be dissipated in generating these spurious secondary plasmas. The results are important with regards to optimising the design and identifying efficient operating regimes of DBD based devices that employ mesh-type or wire/strip electrodes.

The optimization of treatment and management of schizophrenia in Europe (OPTiMiSE) trial

DEFF Research Database (Denmark)

Leucht, Stefan; Winter-van Rossum, Inge; Heres, Stephan

2015-01-01

Commission sponsored "Optimization of Treatment and Management of Schizophrenia in Europe" (OPTiMiSE) trial which aims to provide a treatment algorithm for patients with a first episode of schizophrenia. METHODS: We searched Pubmed (October 29, 2014) for randomized controlled trials (RCTs) that examined...... switching the drug in nonresponders to another antipsychotic. We described important methodological choices of the OPTiMiSE trial. RESULTS: We found 10 RCTs on switching antipsychotic drugs. No trial was conclusive and none was concerned with first-episode schizophrenia. In OPTiMiSE, 500 first episode...

Exploring resilience and mindfulness as preventative factors for psychological distress burnout and secondary traumatic stress among human service professionals.

Science.gov (United States)

Harker, Rachel; Pidgeon, Aileen M; Klaassen, Frances; King, Steven

2016-06-08

Human service professionals are concerned with the intervention and empowerment of vulnerable social populations. The human service industry is laden with employment-related stressors and emotionally demanding interactions, which can lead to deleterious effects, such as burnout and secondary traumatic stress. Little attention has been given to developing knowledge of what might enable human service workers to persist and thrive. Cultivating and sustaining resilience can buffer the impact of occupational stressors on human service professionals. One of the psychological factors associated with cultivating resilience is mindfulness. The aim of this current research is to improve our understanding of the relationship between resilience, mindfulness, burnout, secondary traumatic stress, and psychological distress among human service professionals. The current study surveyed 133 human service professionals working in the fields of psychology, social work, counseling, youth and foster care work to explore the predictive relationship between resilience, mindfulness, and psychological distress. The results showed that higher levels of resilience were a significant predictor of lower levels of psychological distress, burnout and secondary traumatic stress. In addition, higher levels of mindfulness were a significant predictor of lower levels of psychological distress and burnout. The findings suggest that cultivating resilience and mindfulness in human service professionals may assist in preventing psychological distress burnout and secondary traumatic stress. Limitations of this study are discussed together with implications for future research.

Model-based monitoring, optimisation and cogeneration plant billing in heating power stations; Modellgestuetzte Ueberwachung, Optimierung und KWK Abrechnung in Heizkraftwerken

Energy Technology Data Exchange (ETDEWEB)

Deeskow, P. [STEAG KETEK IT GmbH, Oberhausen (Germany); Pawellek, R. [Sofbid GmbH, Zwingenberg (Germany)

2005-07-01

On the basis of thermodynamic modelling, efficient online systems can be constructed which provide multiple commercial uses for plant operation. Incipient failures are recognized earlier, so that countermeasures can be taken at an early stage and long-term maintenance measures can be planned. Performance can be optimised, and - last but not least - the multitude of processed data enables workflow analysis, e.g. for simplifying billing processes in secondary relational databases. Performance data are presented of two coal power plants with 350 MWel/250MWth and 450MWel/50MWth in which systems of this type have been in use for several years now. (orig.)

Optimisation of the Management of Higher Activity Waste in the UK - 13537

Energy Technology Data Exchange (ETDEWEB)

Walsh, Ciara; Buckley, Matthew [Nuclear Decommissioning Authority, Building 587, Curie Avenue, Harwell Oxford, Didcot, Oxfordshire, OX11 0RH (United Kingdom)

2013-07-01

The Upstream Optioneering project was created in the Nuclear Decommissioning Authority (UK) to support the development and implementation of significant opportunities to optimise activities across all the phases of the Higher Activity Waste management life cycle (i.e. retrieval, characterisation, conditioning, packaging, storage, transport and disposal). The objective of the Upstream Optioneering project is to work in conjunction with other functions within NDA and the waste producers to identify and deliver solutions to optimise the management of higher activity waste. Historically, optimisation may have occurred on aspects of the waste life cycle (considered here to include retrieval, conditioning, treatment, packaging, interim storage, transport to final end state, which may be geological disposal). By considering the waste life cycle as a whole, critical analysis of assumed constraints may lead to cost savings for the UK Tax Payer. For example, it may be possible to challenge the requirements for packaging wastes for disposal to deliver an optimised waste life cycle. It is likely that the challenges faced in the UK are shared in other countries. It is therefore likely that the opportunities identified may also apply elsewhere, with the potential for sharing information to enable value to be shared. (authors)

Optimisation of the level-1 calorimeter trigger at ATLAS for Run II

Energy Technology Data Exchange (ETDEWEB)

Suchek, Stanislav [Kirchhoff-Institute for Physics, Im Neuenheimer Feld 227, 69120 Heidelberg (Germany); Collaboration: ATLAS-Collaboration

2015-07-01

The Level-1 Calorimeter Trigger (L1Calo) is a central part of the ATLAS Level-1 Trigger system, designed to identify jet, electron, photon, and hadronic tau candidates, and to measure their transverse energies, as well total transverse energy and missing transverse energy. The optimisation of the jet energy resolution is an important part of the L1Calo upgrade for Run II. A Look-Up Table (LUT) is used to translate the electronic signal from each trigger tower to its transverse energy. By optimising the LUT calibration we can achieve better jet energy resolution and better performance of the jet transverse energy triggers, which are vital for many physics analyses. In addition, the improved energy calibration leads to significant improvements of the missing transverse energy resolution. A new Multi-Chip Module (MCM), as a part of the L1Calo upgrade, provides two separate LUTs for jets and electrons/photons/taus, allowing to optimise jet transverse energy and missing transverse energy separately from the electromagnetic objects. The optimisation is validated using jet transverse energy and missing transverse energy triggers turn-on curves and rates.

Balanced the Trade-offs problem of ANFIS Using Particle Swarm Optimisation

Directory of Open Access Journals (Sweden)

Dian Palupi Rini

2013-11-01

Full Text Available Improving the approximation accuracy and interpretability of fuzzy systems is an important issue either in fuzzy systems theory or in its applications . It is known that simultaneous optimisation both issues was the trade-offs problem, but it will improve performance of the system and avoid overtraining of data. Particle swarm optimisation (PSO is part of evolutionary algorithm that is good candidate algorithms to solve multiple optimal solution and better global search space. This paper introduces an integration of PSO dan ANFIS for optimise its learning especially for tuning membership function parameters and finding the optimal rule for better classification. The proposed method has been tested on four standard dataset from UCI machine learning i.e. Iris Flower, Habermans Survival Data, Balloon and Thyroid dataset. The results have shown better classification using the proposed PSO-ANFIS and the time complexity has reduced accordingly.

Portfolio optimisation for hydropower producers that balances riverine ecosystem protection and producer needs

Science.gov (United States)

Yin, X. A.; Yang, Z. F.; Liu, C. L.

2014-04-01

In deregulated electricity markets, hydropower portfolio design has become an essential task for producers. The previous research on hydropower portfolio optimisation focused mainly on the maximisation of profits but did not take into account riverine ecosystem protection. Although profit maximisation is the major objective for producers in deregulated markets, protection of riverine ecosystems must be incorporated into the process of hydropower portfolio optimisation, especially against a background of increasing attention to environmental protection and stronger opposition to hydropower generation. This research seeks mainly to remind hydropower producers of the requirement of river protection when they design portfolios and help shift portfolio optimisation from economically oriented to ecologically friendly. We establish a framework to determine the optimal portfolio for a hydropower reservoir, accounting for both economic benefits and ecological needs. In this framework, the degree of natural flow regime alteration is adopted as a constraint on hydropower generation to protect riverine ecosystems, and the maximisation of mean annual revenue is set as the optimisation objective. The electricity volumes assigned in different electricity submarkets are optimised by the noisy genetic algorithm. The proposed framework is applied to China's Wangkuai Reservoir to test its effectiveness. The results show that the new framework could help to design eco-friendly portfolios that can ensure a planned profit and reduce alteration of the natural flow regime.

Optimised performance of industrial high resolution computerised tomography

International Nuclear Information System (INIS)

Maangaard, M.

2000-01-01

The purpose of non-destructive evaluation (NDE) is to acquire knowledge of the investigated sample. Digital x-ray imaging techniques such as radiography or computerised tomography (CT) produce images of the interior of a sample. The obtained image quality determines the possibility of detecting sample related features, e.g. details and flaws. This thesis presents a method of optimising the performance of industrial X-ray equipment for the imaging task at issue in order to obtain images with high quality. CT produces maps of the X-ray linear attenuation of the sample's interior. CT can produce two dimensional cross-section images or three-dimensional images with volumetric information on the investigated sample. The image contrast and noise depend on both the investigated sample and the equipment and settings used (X-ray tube potential, X-ray filtration, exposure time, etc.). Hence, it is vital to find the optimal equipment settings in order to obtain images of high quality. To be able to mathematically optimise the image quality, it is necessary to have a model of the X-ray imaging system together with an appropriate measure of image quality. The optimisation is performed with a developed model for an X-ray image-intensifier-based radiography system. The model predicts the mean value and variance of the measured signal level in the collected radiographic images. The traditionally used measure of physical image quality is the signal-to-noise ratio (SNR). To calculate the signal-to-noise ratio, a well-defined detail (flaw) is required. It was found that maximising the SNR leads to ambiguities, the optimised settings found by maximising the SNR were dependent on the material in the detail. When CT is performed on irregular shaped samples containing density and compositional variations, it is difficult to define which SNR to use for optimisation. This difficulty is solved by the measures of physical image quality proposed here, the ratios geometry

Optimised cantilever biosensor with piezoresistive read-out

DEFF Research Database (Denmark)

Rasmussen, Peter; Thaysen, J.; Hansen, Ole

2003-01-01

We present a cantilever-based biochemical sensor with piezoresistive read-out which has been optimised for measuring surface stress. The resistors and the electrical wiring on the chip are encapsulated in low-pressure chemical vapor deposition (LPCVD) silicon nitride, so that the chip is well sui...

Melatonin prevents secondary intra-abdominal hypertension in rats possibly through inhibition of the p38 MAPK pathway.

Science.gov (United States)

Chang, Mingtao; Li, Yang; Liu, Dong; Zhang, Lianyang; Zhang, Hongguang; Tang, Hao; Zhang, Huayu

2016-08-01

Exogenous administration of melatonin has been demonstrated to down-regulate inflammatory responses and attenuate organ damage in various models. However, the salutary effect of melatonin against secondary intra-abdominal hypertension (IAH) remains unclear. This study sought to test the influence of melatonin on secondary IAH in a pathophysiological rat model and the underlying mechanisms involved. Before resuscitation, male rats underwent a combination of induced portal hypertension, applying an abdominal restraint device, and hemorrhaging to mean arterial pressure (MAP) of 40mmHg for 2h. After blood reinfusion, the rats were treated with lactated Ringer solution (LR) (30mL/h), melatonin (50mg/kg) +LR, and SB-203580 (10μmol/kg)+LR. LR was continuously infused for 6h. MAP, the inferior vena cava pressure and urine output were monitored. Histopathological examination, immunofluorescence of tight junction proteins, and transmission electron microscopy were administered. Intestinal permeability, myeloperoxidase activity, malondialdehyde, glutathione peroxidase, and levels of TNF-a, IL-2, and IL-6, were assessed. The expression of extracellular signal-regulated kinase, p38, c-Jun NH2-terminal kinase, translocation of nuclear factor kappa B subunit, signal transducers and activators of transcription and tight junction proteins were detected by Western blot. We found that melatonin inhibited the inflammatory responses, decreased expression of p38 MAPK, attenuated intestinal injury, and prevented secondary IAH. Moreover, administration of SB203580 abolished the increase in p38 MAPK and also attenuated intestinal injury. These data indicate that melatonin exerts a protective effect in intestine in secondary IAH primarily by attenuating the inflammatory responses which are in part attributable to p38 MAPK inhibition. Copyright © 2016 Elsevier Inc. All rights reserved.

The national clinical audit of falls and bone health-secondary prevention of falls and fractures: a physiotherapy perspective.

Science.gov (United States)

Goodwin, Victoria; Martin, Finbarr C; Husk, Janet; Lowe, Derek; Grant, Robert; Potter, Jonathan

2010-03-01

To establish current physiotherapy practice in the secondary management of falls and fragility fractures compared with national guidance. Web-based national clinical audit. Acute trusts (n=157) and primary care trusts (n=146) in England, Wales and Northern Ireland. Data were collected on 5642 patients with non-hip fragility fractures and 3184 patients with a hip fracture. Those patients who were bedbound or who declined assessment or rehabilitation were excluded from the analysis. Results indicate that of those with non-hip fractures, 28% received a gait and balance assessment, 22% participated in an exercise programme, and 3% were shown how to get up from the floor. For those with a hip fracture, the results were 68%, 44% and 7%, respectively. Physiotherapists have a significant role to play in the secondary prevention of falls and fractures. However, along with managers and professional bodies, more must be done to ensure that clinical practice reflects the evidence base and professional standards.

Optimised operation of an off-grid hybrid wind-diesel-battery system using genetic algorithm

International Nuclear Information System (INIS)

Gan, Leong Kit; Shek, Jonathan K.H.; Mueller, Markus A.

2016-01-01

Highlights: • Diesel generator’s operation is optimised in a hybrid wind-diesel-battery system. • Optimisation is performed using wind speed and load demand forecasts. • The objective is to maximise wind energy utilisation with limited battery storage. • Physical modelling approach (Simscape) is used to verify mathematical model. • Sensitivity analyses are performed with synthesised wind and load forecast errors. - Abstract: In an off-grid hybrid wind-diesel-battery system, the diesel generator is often not utilised efficiently, therefore compromising its lifetime. In particular, the general rule of thumb of running the diesel generator at more than 40% of its rated capacity is often unmet. This is due to the variation in power demand and wind speed which needs to be supplied by the diesel generator. In addition, the frequent start-stop of the diesel generator leads to additional mechanical wear and fuel wastage. This research paper proposes a novel control algorithm which optimises the operation of a diesel generator, using genetic algorithm. With a given day-ahead forecast of local renewable energy resource and load demand, it is possible to optimise the operation of a diesel generator, subjected to other pre-defined constraints. Thus, the utilisation of the renewable energy sources to supply electricity can be maximised. Usually, the optimisation studies of a hybrid system are being conducted through simple analytical modelling, coupled with a selected optimisation algorithm to seek the optimised solution. The obtained solution is not verified using a more realistic system model, for instance the physical modelling approach. This often led to the question of the applicability of such optimised operation being used in reality. In order to take a step further, model-based design using Simulink is employed in this research to perform a comparison through a physical modelling approach. The Simulink model has the capability to incorporate the electrical

Optimisation Study on the Production of Anaerobic Digestate ...

African Journals Online (AJOL)

DR. AMIN

optimise the production of ADC from organic fractions of domestic wastes and the effects of ADC amendments on soil .... (22%), cooked meat (9%), lettuce (11%), carrots. (3%), potato (44%) ... seed was obtained from a mesophilic anaerobic.

Optimisation of decision making under uncertainty throughout field lifetime: A fractured reservoir example

Science.gov (United States)

Arnold, Dan; Demyanov, Vasily; Christie, Mike; Bakay, Alexander; Gopa, Konstantin

2016-10-01

Assessing the change in uncertainty in reservoir production forecasts over field lifetime is rarely undertaken because of the complexity of joining together the individual workflows. This becomes particularly important in complex fields such as naturally fractured reservoirs. The impact of this problem has been identified in previous and many solutions have been proposed but never implemented on complex reservoir problems due to the computational cost of quantifying uncertainty and optimising the reservoir development, specifically knowing how many and what kind of simulations to run. This paper demonstrates a workflow that propagates uncertainty throughout field lifetime, and into the decision making process by a combination of a metric-based approach, multi-objective optimisation and Bayesian estimation of uncertainty. The workflow propagates uncertainty estimates from appraisal into initial development optimisation, then updates uncertainty through history matching and finally propagates it into late-life optimisation. The combination of techniques applied, namely the metric approach and multi-objective optimisation, help evaluate development options under uncertainty. This was achieved with a significantly reduced number of flow simulations, such that the combined workflow is computationally feasible to run for a real-field problem. This workflow is applied to two synthetic naturally fractured reservoir (NFR) case studies in appraisal, field development, history matching and mid-life EOR stages. The first is a simple sector model, while the second is a more complex full field example based on a real life analogue. This study infers geological uncertainty from an ensemble of models that are based on the carbonate Brazilian outcrop which are propagated through the field lifetime, before and after the start of production, with the inclusion of production data significantly collapsing the spread of P10-P90 in reservoir forecasts. The workflow links uncertainty

Geometrical exploration of a flux-optimised sodium receiver through multi-objective optimisation

Science.gov (United States)

Asselineau, Charles-Alexis; Corsi, Clothilde; Coventry, Joe; Pye, John

2017-06-01

A stochastic multi-objective optimisation method is used to determine receiver geometries with maximum second law efficiency, minimal average temperature and minimal surface area. The method is able to identify a set of Pareto optimal candidates that show advantageous geometrical features, mainly in being able to maximise the intercepted flux within the geometrical boundaries set. Receivers with first law thermal efficiencies ranging from 87% to 91% are also evaluated using the second law of thermodynamics and found to have similar efficiencies of over 60%, highlighting the influence that the geometry can play in the maximisation of the work output of receivers by influencing the distribution of the flux from the concentrator.

Particle Swarm Optimisation with Spatial Particle Extension

DEFF Research Database (Denmark)

Krink, Thiemo; Vesterstrøm, Jakob Svaneborg; Riget, Jacques

2002-01-01

In this paper, we introduce spatial extension to particles in the PSO model in order to overcome premature convergence in iterative optimisation. The standard PSO and the new model (SEPSO) are compared w.r.t. performance on well-studied benchmark problems. We show that the SEPSO indeed managed...

Ankles back in randomized controlled trial (ABrCt: braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial

Directory of Open Access Journals (Sweden)

Verhagen Evert ALM

2011-09-01

Full Text Available Abstract Background Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. Methods/Design This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. Discussion The ABrCt is the first randomized controlled trial to directly compare the secondary preventive

Protection against natural radiation: Optimisation and decision exercises

International Nuclear Information System (INIS)

O'Riordan, M.C.

1984-02-01

Six easy exercises are presented in which cost-benefit analysis is used to optimise protection against natural radiation or to decide whether protection is appropriate. The exercises are illustrative only and do not commit the Board. (author)

Modulation aware cluster size optimisation in wireless sensor networks

Science.gov (United States)

Sriram Naik, M.; Kumar, Vinay

2017-07-01

Wireless sensor networks (WSNs) play a great role because of their numerous advantages to the mankind. The main challenge with WSNs is the energy efficiency. In this paper, we have focused on the energy minimisation with the help of cluster size optimisation along with consideration of modulation effect when the nodes are not able to communicate using baseband communication technique. Cluster size optimisations is important technique to improve the performance of WSNs. It provides improvement in energy efficiency, network scalability, network lifetime and latency. We have proposed analytical expression for cluster size optimisation using traditional sensing model of nodes for square sensing field with consideration of modulation effects. Energy minimisation can be achieved by changing the modulation schemes such as BPSK, 16-QAM, QPSK, 64-QAM, etc., so we are considering the effect of different modulation techniques in the cluster formation. The nodes in the sensing fields are random and uniformly deployed. It is also observed that placement of base station at centre of scenario enables very less number of modulation schemes to work in energy efficient manner but when base station placed at the corner of the sensing field, it enable large number of modulation schemes to work in energy efficient manner.

Optimisation of wire-cut EDM process parameter by Grey-based response surface methodology

Science.gov (United States)

Kumar, Amit; Soota, Tarun; Kumar, Jitendra

2018-03-01

Wire electric discharge machining (WEDM) is one of the advanced machining processes. Response surface methodology coupled with Grey relation analysis method has been proposed and used to optimise the machining parameters of WEDM. A face centred cubic design is used for conducting experiments on high speed steel (HSS) M2 grade workpiece material. The regression model of significant factors such as pulse-on time, pulse-off time, peak current, and wire feed is considered for optimising the responses variables material removal rate (MRR), surface roughness and Kerf width. The optimal condition of the machining parameter was obtained using the Grey relation grade. ANOVA is applied to determine significance of the input parameters for optimising the Grey relation grade.

A constriction factor based particle swarm optimisation algorithm to solve the economic dispatch problem including losses

Energy Technology Data Exchange (ETDEWEB)

Young, Steven; Montakhab, Mohammad; Nouri, Hassan

2011-07-15

Economic dispatch (ED) is one of the most important problems to be solved in power generation as fractional percentage fuel reductions represent significant cost savings. ED wishes to optimise the power generated by each generating unit in a system in order to find the minimum operating cost at a required load demand, whilst ensuring both equality and inequality constraints are met. For the process of optimisation, a model must be created for each generating unit. The particle swarm optimisation technique is an evolutionary computation technique with one of the most powerful methods for solving global optimisation problems. The aim of this paper is to add in a constriction factor to the particle swarm optimisation algorithm (CFBPSO). Results show that the algorithm is very good at solving the ED problem and that CFBPSO must be able to work in a practical environment and so a valve point effect with transmission losses should be included in future work.

Navigating catastrophes: Local but not global optimisation allows for macro-economic navigation of crises

Science.gov (United States)

Harré, Michael S.

2013-02-01

Two aspects of modern economic theory have dominated the recent discussion on the state of the global economy: Crashes in financial markets and whether or not traditional notions of economic equilibrium have any validity. We have all seen the consequences of market crashes: plummeting share prices, businesses collapsing and considerable uncertainty throughout the global economy. This seems contrary to what might be expected of a system in equilibrium where growth dominates the relatively minor fluctuations in prices. Recent work from within economics as well as by physicists, psychologists and computational scientists has significantly improved our understanding of the more complex aspects of these systems. With this interdisciplinary approach in mind, a behavioural economics model of local optimisation is introduced and three general properties are proven. The first is that under very specific conditions local optimisation leads to a conventional macro-economic notion of a global equilibrium. The second is that if both global optimisation and economic growth are required then under very mild assumptions market catastrophes are an unavoidable consequence. Third, if only local optimisation and economic growth are required then there is sufficient parametric freedom for macro-economic policy makers to steer an economy around catastrophes without overtly disrupting local optimisation.

Optimising culture medium for producing the yeast Pichia onychis (Lv027

Directory of Open Access Journals (Sweden)

Andrés Díaz

2005-01-01

Full Text Available Optimising Pichia onychis yeast biomass production was evaluated using different substrates and different physicochemical conditions for liquid fermentation. The Plackett-Burman statistical design was initially applied for screening the most important nutritional variables (three carbon sources and eight nitrogen sources affecting yeast biomass production. Four nutritional sources and two physicochemical variables were subsequently evaluated using a factorial fractionated design as the starting point for optimising the process by applying a central composite rotational design. The results obtained f rom employing a polynomial regression model using the experimental data showed that biomass production was strongly affected by nutritional and physicochemical conditions. The highest yield was obtained in the following conditions: 43,42 g/L carbon source, 0,261 g/L nitrogen organic source, shaking at 110 rpm, 6,0 pH, 48 h total fermentation time during which 8,95 XlO9 cells/mL were obtained, equivalent to 6,30 g/L dry biomass. Key words: Pichia onychis, optimisation, liquid fermentation.

Design of passive coolers for light-emitting diode lamps using topology optimisation

DEFF Research Database (Denmark)

Alexandersen, Joe; Sigmund, Ole; Meyer, Knud Erik

2018-01-01

Topology optimised designs for passive cooling of light-emitting diode (LED) lamps are investigated through extensive numerical parameter studies. The designs are optimised for either horizontal or vertical orientations and are compared to a lattice-fin design as well as a simple parameter......, while maintaining low sensitivity to orientation. Furthermore, they exhibit several defining features and provide insight and general guidelines for the design of passive coolers for LED lamps....

Statistical optimisation techniques in fatigue signal editing problem

International Nuclear Information System (INIS)

Nopiah, Z. M.; Osman, M. H.; Baharin, N.; Abdullah, S.

2015-01-01

Success in fatigue signal editing is determined by the level of length reduction without compromising statistical constraints. A great reduction rate can be achieved by removing small amplitude cycles from the recorded signal. The long recorded signal sometimes renders the cycle-to-cycle editing process daunting. This has encouraged researchers to focus on the segment-based approach. This paper discusses joint application of the Running Damage Extraction (RDE) technique and single constrained Genetic Algorithm (GA) in fatigue signal editing optimisation.. In the first section, the RDE technique is used to restructure and summarise the fatigue strain. This technique combines the overlapping window and fatigue strain-life models. It is designed to identify and isolate the fatigue events that exist in the variable amplitude strain data into different segments whereby the retention of statistical parameters and the vibration energy are considered. In the second section, the fatigue data editing problem is formulated as a constrained single optimisation problem that can be solved using GA method. The GA produces the shortest edited fatigue signal by selecting appropriate segments from a pool of labelling segments. Challenges arise due to constraints on the segment selection by deviation level over three signal properties, namely cumulative fatigue damage, root mean square and kurtosis values. Experimental results over several case studies show that the idea of solving fatigue signal editing within a framework of optimisation is effective and automatic, and that the GA is robust for constrained segment selection

Module detection in complex networks using integer optimisation

Directory of Open Access Journals (Sweden)

Tsoka Sophia

2010-11-01

Full Text Available Abstract Background The detection of modules or community structure is widely used to reveal the underlying properties of complex networks in biology, as well as physical and social sciences. Since the adoption of modularity as a measure of network topological properties, several methodologies for the discovery of community structure based on modularity maximisation have been developed. However, satisfactory partitions of large graphs with modest computational resources are particularly challenging due to the NP-hard nature of the related optimisation problem. Furthermore, it has been suggested that optimising the modularity metric can reach a resolution limit whereby the algorithm fails to detect smaller communities than a specific size in large networks. Results We present a novel solution approach to identify community structure in large complex networks and address resolution limitations in module detection. The proposed algorithm employs modularity to express network community structure and it is based on mixed integer optimisation models. The solution procedure is extended through an iterative procedure to diminish effects that tend to agglomerate smaller modules (resolution limitations. Conclusions A comprehensive comparative analysis of methodologies for module detection based on modularity maximisation shows that our approach outperforms previously reported methods. Furthermore, in contrast to previous reports, we propose a strategy to handle resolution limitations in modularity maximisation. Overall, we illustrate ways to improve existing methodologies for community structure identification so as to increase its efficiency and applicability.

Statistical optimisation techniques in fatigue signal editing problem

Energy Technology Data Exchange (ETDEWEB)

Nopiah, Z. M.; Osman, M. H. [Fundamental Engineering Studies Unit Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600 UKM (Malaysia); Baharin, N.; Abdullah, S. [Department of Mechanical and Materials Engineering Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600 UKM (Malaysia)

2015-02-03

Success in fatigue signal editing is determined by the level of length reduction without compromising statistical constraints. A great reduction rate can be achieved by removing small amplitude cycles from the recorded signal. The long recorded signal sometimes renders the cycle-to-cycle editing process daunting. This has encouraged researchers to focus on the segment-based approach. This paper discusses joint application of the Running Damage Extraction (RDE) technique and single constrained Genetic Algorithm (GA) in fatigue signal editing optimisation.. In the first section, the RDE technique is used to restructure and summarise the fatigue strain. This technique combines the overlapping window and fatigue strain-life models. It is designed to identify and isolate the fatigue events that exist in the variable amplitude strain data into different segments whereby the retention of statistical parameters and the vibration energy are considered. In the second section, the fatigue data editing problem is formulated as a constrained single optimisation problem that can be solved using GA method. The GA produces the shortest edited fatigue signal by selecting appropriate segments from a pool of labelling segments. Challenges arise due to constraints on the segment selection by deviation level over three signal properties, namely cumulative fatigue damage, root mean square and kurtosis values. Experimental results over several case studies show that the idea of solving fatigue signal editing within a framework of optimisation is effective and automatic, and that the GA is robust for constrained segment selection.

The current regulatory requirements on optimisation and BAT in Sweden in the context of geological disposal

International Nuclear Information System (INIS)

Dverstorp, B.

2010-01-01

Bjorn Dverstorp, Swedish Radiation Safety authority (SSM) presented 'The current regulatory requirements on optimisation and BAT in Sweden in the context of geological disposal'. In Sweden, a nuclear waste repository will be evaluated according to both to general environmental legislation (the Environmental Code, SFS, 1998:808) and according to more specific requirements in the Act on Nuclear Activities (SFS, 1984:3) and the Radiation Protection Act (SFS, 1988:220). The evaluations according to these laws will be carried out according to two separate, but coordinated, legal-review and decision-making processes. This will be a basis for the siting process. Although the requirements on BAT and siting in the Environmental Code apply to radiological protection, they aim at a broader system optimisation. The more specific requirements on optimisation and BAT of radiological protection of geological disposal systems are given in the regulations associated with the Radiation Protection Act. The Swedish radiation protection regulations (SSM, 2009) comprise three corner stones: a risk target, environmental protection goals and the use of optimisation and BAT. In SSM' s guidance optimisation is defined as a means to reduce risk, guided by the results of risk calculations. In case of a conflict between BAT and optimisation, measures satisfying BAT should have priority. Application of optimisation and BAT on different timescales are described as well as for human intrusion scenarios. B. Dverstorp explained that because of uncertainties in the long term there is a need for additional arguments in the safety case in support of decision making. It is in this context that the requirements on optimisation and BAT should be seen as supplementary to the risk target, in providing evidence that the developer has taken into consideration, as far as reasonably possible, measures and options for reducing future doses and risks. Both principles focus on the proponent's work on developing

Optimised Design and Analysis of All-Optical Networks

DEFF Research Database (Denmark)

Glenstrup, Arne John

2002-01-01

through various experiments and is shown to produce good results and to be able to scale up to networks of realistic sizes. A novel method, subpath wavelength grouping, for routing connections in a multigranular all-optical network where several wavelengths can be grouped and switched at band and fibre......This PhD thesis presents a suite of methods for optimising design and for analysing blocking probabilities of all-optical networks. It thus contributes methodical knowledge to the field of computer assisted planning of optical networks. A two-stage greenfield optical network design optimiser...... is developed, based on shortest-path algorithms and a comparatively new metaheuristic called simulated allocation. It is able to handle design of all-optical mesh networks with optical cross-connects, considers duct as well as fibre and node costs, and can also design protected networks. The method is assessed...

FISHRENT; Bio-economic simulation and optimisation model

NARCIS (Netherlands)

Salz, P.; Buisman, F.C.; Soma, K.; Frost, H.; Accadia, P.; Prellezo, R.

2011-01-01

Key findings: The FISHRENT model is a major step forward in bio-economic model-ling, combining features that have not been fully integrated in earlier models: 1- Incorporation of any number of species (or stock) and/or fleets 2- Integration of simulation and optimisation over a period of 25 years 3-

Design of Circularly-Polarised, Crossed Drooping Dipole, Phased Array Antenna Using Genetic Algorithm Optimisation

DEFF Research Database (Denmark)

Larsen, Niels Vesterdal

2007-01-01

A printed drooping dipole array is designed and constructed. The design is based on a genetic algorithm optimisation procedure used in conjunction with the software programme AWAS. By optimising the array G/T for specific combinations of scan angles and frequencies an optimum design is obtained...

Optimisation-based worst-case analysis and anti-windup synthesis for uncertain nonlinear systems

Science.gov (United States)

Menon, Prathyush Purushothama

This thesis describes the development and application of optimisation-based methods for worst-case analysis and anti-windup synthesis for uncertain nonlinear systems. The worst-case analysis methods developed in the thesis are applied to the problem of nonlinear flight control law clearance for highly augmented aircraft. Local, global and hybrid optimisation algorithms are employed to evaluate worst-case violations of a nonlinear response clearance criterion, for a highly realistic aircraft simulation model and flight control law. The reliability and computational overheads associated with different opti misation algorithms are compared, and the capability of optimisation-based approaches to clear flight control laws over continuous regions of the flight envelope is demonstrated. An optimisation-based method for computing worst-case pilot inputs is also developed, and compared with current industrial approaches for this problem. The importance of explicitly considering uncertainty in aircraft parameters when computing worst-case pilot demands is clearly demonstrated. Preliminary results on extending the proposed framework to the problems of limit-cycle analysis and robustness analysis in the pres ence of time-varying uncertainties are also included. A new method for the design of anti-windup compensators for nonlinear constrained systems controlled using nonlinear dynamics inversion control schemes is presented and successfully applied to some simple examples. An algorithm based on the use of global optimisation is proposed to design the anti-windup compensator. Some conclusions are drawn from the results of the research presented in the thesis, and directions for future work are identified.

Contemporary Reflections on the Safety of Long-Term Aspirin Treatment for the Secondary Prevention of Cardiovascular Disease

Science.gov (United States)

Fanaroff, Alexander C.; Roe, Matthew T.

2018-01-01

Aspirin has been the cornerstone of therapy for the secondary prevention treatment of patients with cardiovascular disease since landmark trials were completed in the late 1970s and early 1980s that demonstrated the efficacy of aspirin for reducing the risk of ischemic events. Notwithstanding the consistent benefits demonstrated with apirin for both acute and chronic cardiovascular disease, there are a number of toxicities associated with aspirin that have been showcased by recent long-term clinical trials that have included an aspirin monotherapy arm. As an inhibitor of cyclooxygenase, aspirin impairs gastric mucosal protective mechanisms. Prior trials have shown that up to 15–20% of patients developed gastrointestinal symptoms with aspirin monotherapy and roughly 1% of patients per year had a clinically significant bleeding event, including 1 in 1000 patients who suffered an intracranial or fatal bleed. These risks have been shown to be compounded for patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary intervention (PCI), who are also treated with other anti-thrombotic agents during the acute care/procedural period, as well as for an extended time period afterwards. Given observations of substantial increases in bleeding rates from many prior long-term clinical trials that have evaluated aspirin together with other oral platelet inhibitors or oral anti-coagulants, the focus of contemporary research has pivoted towards tailored anti-thrombotic regimens that attempt to either shorten the duration of exposure to aspirin or replace aspirin with an alternative anti-thrombotic agent. While these shifts are occurring, the safety profile of aspirin when used for the secondary prevention treatment of patients with established cardiovascular disease deserves further consideration. PMID:27028617

Evaluation and optimisation of current milrinone prescribing for the treatment and prevention of low cardiac output syndrome in paediatric patients after open heart surgery using a physiology-based pharmacokinetic drug-disease model.

Science.gov (United States)

Vogt, Winnie

2014-01-01

Milrinone is the drug of choice for the treatment and prevention of low cardiac output syndrome (LCOS) in paediatric patients after open heart surgery across Europe. Discrepancies, however, among prescribing guidance, clinical studies and practice pattern require clarification to ensure safe and effective prescribing. However, the clearance prediction equations derived from classical pharmacokinetic modelling provide limited support as they have recently failed a clinical practice evaluation. Therefore, the objective of this study was to evaluate current milrinone dosing using physiology-based pharmacokinetic (PBPK) modelling and simulation to complement the existing pharmacokinetic knowledge and propose optimised dosing regimens as a basis for improving the standard of care for paediatric patients. A PBPK drug-disease model using a population approach was developed in three steps from healthy young adults to adult patients and paediatric patients with and without LCOS after open heart surgery. Pre- and postoperative organ function values from adult and paediatric patients were collected from literature and integrated into a disease model as factorial changes from the reference values in healthy adults aged 20-40 years. The disease model was combined with the PBPK drug model and evaluated against existing pharmacokinetic data. Model robustness was assessed by parametric sensitivity analysis. In the next step, virtual patient populations were created, each with 1,000 subjects reflecting the average adult and paediatric patient characteristics with regard to age, sex, bodyweight and height. They were integrated into the PBPK drug-disease model to evaluate the effectiveness of current milrinone dosing in achieving the therapeutic target range of 100-300 ng/mL milrinone in plasma. Optimised dosing regimens were subsequently developed. The pharmacokinetics of milrinone in healthy young adults as well as adult and paediatric patients were accurately described with an

Traditional preventive treatment options

DEFF Research Database (Denmark)

Longbottom, C; Ekstrand, K; Zero, D

2009-01-01

Preventive treatment options can be divided into primary, secondary and tertiary prevention techniques, which can involve patient- or professionally applied methods. These include: oral hygiene (instruction), pit and fissure sealants ('temporary' or 'permanent'), fluoride applications (patient...... options....

Sizing Combined Heat and Power Units and Domestic Building Energy Cost Optimisation

Directory of Open Access Journals (Sweden)

Dongmin Yu

2017-06-01

Full Text Available Many combined heat and power (CHP units have been installed in domestic buildings to increase energy efficiency and reduce energy costs. However, inappropriate sizing of a CHP may actually increase energy costs and reduce energy efficiency. Moreover, the high manufacturing cost of batteries makes batteries less affordable. Therefore, this paper will attempt to size the capacity of CHP and optimise daily energy costs for a domestic building with only CHP installed. In this paper, electricity and heat loads are firstly used as sizing criteria in finding the best capacities of different types of CHP with the help of the maximum rectangle (MR method. Subsequently, the genetic algorithm (GA will be used to optimise the daily energy costs of the different cases. Then, heat and electricity loads are jointly considered for sizing different types of CHP and for optimising the daily energy costs through the GA method. The optimisation results show that the GA sizing method gives a higher average daily energy cost saving, which is 13% reduction compared to a building without installing CHP. However, to achieve this, there will be about 3% energy efficiency reduction and 7% input power to rated power ratio reduction compared to using the MR method and heat demand in sizing CHP.

Eating Disorders: Prevention through Education.

Science.gov (United States)

Nagel, K. L.; Jones, Karen H.

1993-01-01

School prevention programs for teenage eating disorders should emphasize nutrition education (knowledge, attitudes, behavior) and living skills (self-concept, coping). Secondary prevention involves identifying early warning signs and places for referral; tertiary prevention creates a supportive school environment for recoverers with teachers as…

Formulation des betons autopla~ants : Optimisation du squelette ...

African Journals Online (AJOL)

Formulation des betons autopla~ants : Optimisation du squelette granulaire par la methode graphique de Dreux - Gorisse. Fatiha Boumaza - Zeraoulia* & Mourad Behim. Laboratoire Materiaux, Geo - Materiaux et Environnement - Departement de Genie Civil. Universite Badji Mokhtar Annaba - BP 12, 23000 Annaba - ...

Genetic algorithms and artificial neural networks for loading pattern optimisation of advanced gas-cooled reactors

Energy Technology Data Exchange (ETDEWEB)

Ziver, A.K. E-mail: a.k.ziver@imperial.ac.uk; Pain, C.C; Carter, J.N.; Oliveira, C.R.E. de; Goddard, A.J.H.; Overton, R.S

2004-03-01

A non-generational genetic algorithm (GA) has been developed for fuel management optimisation of Advanced Gas-Cooled Reactors, which are operated by British Energy and produce around 20% of the UK's electricity requirements. An evolutionary search is coded using the genetic operators; namely selection by tournament, two-point crossover, mutation and random assessment of population for multi-cycle loading pattern (LP) optimisation. A detailed description of the chromosomes in the genetic algorithm coded is presented. Artificial Neural Networks (ANNs) have been constructed and trained to accelerate the GA-based search during the optimisation process. The whole package, called GAOPT, is linked to the reactor analysis code PANTHER, which performs fresh fuel loading, burn-up and power shaping calculations for each reactor cycle by imposing station-specific safety and operational constraints. GAOPT has been verified by performing a number of tests, which are applied to the Hinkley Point B and Hartlepool reactors. The test results giving loading pattern (LP) scenarios obtained from single and multi-cycle optimisation calculations applied to realistic reactor states of the Hartlepool and Hinkley Point B reactors are discussed. The results have shown that the GA/ANN algorithms developed can help the fuel engineer to optimise loading patterns in an efficient and more profitable way than currently available for multi-cycle refuelling of AGRs. Research leading to parallel GAs applied to LP optimisation are outlined, which can be adapted to present day LWR fuel management problems.

Manufacturing footprint optimisation: a necessity for manufacturing network in changing business environment

DEFF Research Database (Denmark)

Yang, Cheng; Farooq, Sami; Johansen, John

2010-01-01

Facing the unpredictable financial crisis, optimising the footprint can be the biggest and most important transformation a manufacturer can undertake. In order to realise the optimisation, fundamental understanding on manufacturing footprint is required. Different elements of manufacturing...... footprint have been investigated independently in the existing literature. In this paper, for the purpose of relationship exploration between different elements, manufacturing footprints of three industrial companies are traced historically. Based on them, four reasons for the transformation...

Stochastic Optimisation of Battery System Operation Strategy under different Utility Tariff Structures

OpenAIRE

Erdal, Jørgen Sørgård

2017-01-01

This master thesis develops a stochastic optimisation software for household grid-connected batteries combined with PV-systems. The objective of the optimisation is to operate the battery system in order to minimise the costs of the consumer, and it was implemented in MATLAB using a self-written stochastic dynamic programming algorithm. Load was considered as a stochastic variable and modelled as a Markov Chain. Transition probabilities between time steps were calculated using historic load p...

Economic and Mathematical Modelling of Optimisation of Transaction Expenses of Engineering Enterprises

OpenAIRE

Makaliuk Iryna V.

2014-01-01

The article identifies stages of the process of optimisation of transaction expenses. It develops an economic and mathematical model of optimisation of transaction expenses of engineering enterprises by the criterion of maximisation of income from realisation of products and system of restrictions, which envisages exceeding income growth rate over the expenses growth rate. The article offers to use types of expenses by accounting accounts as indicators of transaction expenses. In the result o...

Cultural values and secondary prevention of breast cancer in african american women.

Science.gov (United States)

Beckjord, Ellen Burke; Klassen, Ann C

2008-01-01

Improving mammography initiation and maintenance among African American women has been suggested as a strategy for reducing breast cancer mortality in this population. We examined cultural values in relation to self-reported breast cancer screening among 572 low-income, urban, African American women. Cultural values examined included time orientation, family authority, employment aspirations, value of past vs modern life, and reliance on medical professionals. Also, implications for continued development of culturally tailored health interventions and opportunities for the consideration of cultural values in health communication are discussed. Bivariate analyses showed that more traditional values were associated with worse screening histories and lower intentions for future screening. In multivariate analyses, two interactions were observed between cultural values and age: for younger women, more traditional values were associated with lower odds of having ever received a mammogram, and for older women, more traditional values were associated with lower odds of intentions to receive a mammogram in the next 2 years. This study adds to the evidence that cultural constructs, such as values, are associated with secondary prevention of breast cancer and supports the consideration of cultural constructs as important in increasing mammography and reducing breast cancer disparities for African American women.

Research on Duct Flow Field Optimisation of a Robot Vacuum Cleaner

Directory of Open Access Journals (Sweden)

Xiao-bo Lai

2011-11-01

Full Text Available The duct of a robot vacuum cleaner is the length of the flow channel between the inlet of the rolling brush blower and the outlet of the vacuum blower. To cope with the pressure drop problem of the duct flow field in a robot vacuum cleaner, a method based on Pressure Implicit with Splitting of Operators (PRISO algorithm is introduced and the optimisation design of the duct flow field is implemented. Firstly, the duct structure in a robot vacuum cleaner is taken as a research object, with the computational fluid dynamics (CFD theories adopted; a three-dimensional fluid model of the duct is established by means of the FLUENT solver of the CFD software. Secondly, with the k-∊ turbulence model of three-dimensional incompressible fluid considered and the PRISO pressure modification algorithm employed, the flow field numerical simulations inside the duct of the robot vacuum cleaner are carried out. Then, the velocity vector plots on the arbitrary plane of the duct flow field are obtained. Finally, an investigation of the dynamic characteristics of the duct flow field is done and defects of the original duct flow field are analysed, the optimisation of the original flow field has then been conducted. Experimental results show that the duct flow field after optimisation can effectively reduce pressure drop, the feasibility as well as the correctness of the theoretical modelling and optimisation approaches are validated.

Research on Duct Flow Field Optimisation of a Robot Vacuum Cleaner

Directory of Open Access Journals (Sweden)

Xiao-bo Lai

2011-11-01

Full Text Available The duct of a robot vacuum cleaner is the length of the flow channel between the inlet of the rolling brush blower and the outlet of the vacuum blower. To cope with the pressure drop problem of the duct flow field in a robot vacuum cleaner, a method based on Pressure Implicit with Splitting of Operators (PRISO algorithm is introduced and the optimisation design of the duct flow field is implemented. Firstly, the duct structure in a robot vacuum cleaner is taken as a research object, with the computational fluid dynamics (CFD theories adopted; a three‐dimensional fluid model of the duct is established by means of the FLUENT solver of the CFD software. Secondly, with the k‐ε turbulence model of three‐ dimensional incompressible fluid considered and the PRISO pressure modification algorithm employed, the flow field numerical simulations inside the duct of the robot vacuum cleaner are carried out. Then, the velocity vector plots on the arbitrary plane of the duct flow field are obtained. Finally, an investigation of the dynamic characteristics of the duct flow field is done and defects of the original duct flow field are analysed, the optimisation of the original flow field has then been conducted. Experimental results show that the duct flow field after optimisation can effectively reduce pressure drop, the feasibility as well as the correctness of the theoretical modelling and optimisation approaches are validated.

Multigrid Implementation of Cellular Automata for Topology Optimisation of Continuum Structures with Design Dependent loads

NARCIS (Netherlands)

Zakhama, R.

2009-01-01

Topology optimisation of continuum structures has become mature enough to be often applied in industry and continues to attract the attention of researchers and software companies in various engineering fields. Traditionally, most available algorithms for solving topology optimisation problems are

The optimisation study of tbp synthesis process by phosphoric acid

International Nuclear Information System (INIS)

Amedjkouh, A.; Attou, M.; Azzouz, A.; Zaoui, B.

1995-07-01

The present work deals with the optimisation study of TBP synthesis process by phosphoric acid. This way of synthesis is more advantageous than POCL3 or P2O5 as phosphatant agents. these latters are toxic and dangerous for the environnement. The optimisation study is based on a series of 16 experiences taking into account the range of variation of the following parameters : temperature, pressure, reagents mole ratio, promoter content. the yield calculation is based on the randomisation of an equation including all parameters. the resolution of this equation gave a 30% TBP molar ratio. this value is in agreement with that of experimental data

Flotation process control optimisation at Prominent Hill

International Nuclear Information System (INIS)

Lombardi, Josephine; Muhamad, Nur; Weidenbach, M.

2012-01-01

OZ Minerals' Prominent Hill copper- gold concentrator is located 130 km south east of the town of Coober Pedy in the Gawler Craton of South Australia. The concentrator was built in 2008 and commenced commercial production in early 2009. The Prominent Hill concentrator is comprised of a conventional grinding and flotation processing plant with a 9.6 Mtpa ore throughput capacity. The flotation circuit includes six rougher cells, an IseMill for regrinding the rougher concentrate and a Jameson cell heading up the three stage conventional cell cleaner circuit. In total there are four level controllers in the rougher train and ten level controllers in the cleaning circuit for 18 cells. Generic proportional — integral and derivative (PID) control used on the level controllers alone propagated any disturbances downstream in the circuit that were generated from the grinding circuit, hoppers, between cells and interconnected banks of cells, having a negative impact on plant performance. To better control such disturbances, FloatStar level stabiliser was selected for installation on the flotation circuit to account for the interaction between the cells. Multivariable control was also installed on the five concentrate hoppers to maintain consistent feed to the cells and to the IsaMill. An additional area identified for optimisation in the flotation circuit was the mass pull rate from the rougher cells. FloatStar flow optimiser was selected to be installed subsequent to the FloatStar level stabiliser. This allowed for a unified, consistent and optimal approach to running the rougher circuit. This paper describes the improvement in the stabilisation of the circuit achieved by the FloatStar level stabiliser by using the interaction matrix between cell level controllers and the results and benefits of implementing the FloatStar flow optimiser on the rougher train.

Optimisation of monochrome images

International Nuclear Information System (INIS)

Potter, R.

1983-01-01

Gamma cameras with modern imaging systems usually digitize the signals to allow storage and processing of the image in a computer. Although such computer systems are widely used for the extraction of quantitative uptake estimates and the analysis of time variant data, the vast majority of nuclear medicine images is still interpreted on the basis of an observer's visual assessment of a photographic hardcopy image. The optimisation of hardcopy devices is therefore vital and factors such as resolution, uniformity, noise grey scales and display matrices are discussed. Once optimum display parameters have been determined, routine procedures for quality control need to be established; suitable procedures are discussed. (U.K.)

Optimisation of active suspension control inputs for improved performance of active safety systems

Science.gov (United States)

Čorić, Mirko; Deur, Joško; Xu, Li; Tseng, H. Eric; Hrovat, Davor

2018-01-01

A collocation-type control variable optimisation method is used to investigate the extent to which the fully active suspension (FAS) can be applied to improve the vehicle electronic stability control (ESC) performance and reduce the braking distance. First, the optimisation approach is applied to the scenario of vehicle stabilisation during the sine-with-dwell manoeuvre. The results are used to provide insights into different FAS control mechanisms for vehicle performance improvements related to responsiveness and yaw rate error reduction indices. The FAS control performance is compared to performances of the standard ESC system, optimal active brake system and combined FAS and ESC configuration. Second, the optimisation approach is employed to the task of FAS-based braking distance reduction for straight-line vehicle motion. Here, the scenarios of uniform and longitudinally or laterally non-uniform tyre-road friction coefficient are considered. The influences of limited anti-lock braking system (ABS) actuator bandwidth and limit-cycle ABS behaviour are also analysed. The optimisation results indicate that the FAS can provide competitive stabilisation performance and improved agility when compared to the ESC system, and that it can reduce the braking distance by up to 5% for distinctively non-uniform friction conditions.

Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

Directory of Open Access Journals (Sweden)

Byeon HJ

2016-02-01

Full Text Available Hee Ja Byeon,1,* Young-Mo Yang,2,* Eun Joo Choi21Department of Pharmacy, Chosun University Hospital, 2Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, South Korea*These authors contributed equally to this workBackground: Acute coronary syndrome (ACS is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months.Methods: This study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record.Results: Among 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71% patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69% unstable angina patients, 44 (70.97% non-ST-segment elevation myocardial infarction patients, and 153 (85.96% ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21% and 18 (n=105, 21.26% months after discharge tended to be gradually

A knowledge representation model for the optimisation of electricity generation mixes

International Nuclear Information System (INIS)

Chee Tahir, Aidid; Bañares-Alcántara, René

2012-01-01

Highlights: ► Prototype energy model which uses semantic representation (ontologies). ► Model accepts both quantitative and qualitative based energy policy goals. ► Uses logic inference to formulate equations for linear optimisation. ► Proposes electricity generation mix based on energy policy goals. -- Abstract: Energy models such as MARKAL, MESSAGE and DNE-21 are optimisation tools which aid in the formulation of energy policies. The strength of these models lie in their solid theoretical foundations built on rigorous mathematical equations designed to process numerical (quantitative) data related to economics and the environment. Nevertheless, a complete consideration of energy policy issues also requires the consideration of the political and social aspects of energy. These political and social issues are often associated with non-numerical (qualitative) information. To enable the evaluation of these aspects in a computer model, we hypothesise that a different approach to energy model optimisation design is required. A prototype energy model that is based on a semantic representation using ontologies and is integrated to engineering models implemented in Java has been developed. The model provides both quantitative and qualitative evaluation capabilities through the use of logical inference. The semantic representation of energy policy goals is used (i) to translate a set of energy policy goals into a set of logic queries which is then used to determine the preferred electricity generation mix and (ii) to assist in the formulation of a set of equations which is then solved in order to obtain a proposed electricity generation mix. Scenario case studies have been developed and tested on the prototype energy model to determine its capabilities. Knowledge queries were made on the semantic representation to determine an electricity generation mix which fulfilled a set of energy policy goals (e.g. CO 2 emissions reduction, water conservation, energy supply

Biomass supply chain optimisation for Organosolv-based biorefineries.

Science.gov (United States)

Giarola, Sara; Patel, Mayank; Shah, Nilay

2014-05-01

This work aims at providing a Mixed Integer Linear Programming modelling framework to help define planning strategies for the development of sustainable biorefineries. The up-scaling of an Organosolv biorefinery was addressed via optimisation of the whole system economics. Three real world case studies were addressed to show the high-level flexibility and wide applicability of the tool to model different biomass typologies (i.e. forest fellings, cereal residues and energy crops) and supply strategies. Model outcomes have revealed how supply chain optimisation techniques could help shed light on the development of sustainable biorefineries. Feedstock quality, quantity, temporal and geographical availability are crucial to determine biorefinery location and the cost-efficient way to supply the feedstock to the plant. Storage costs are relevant for biorefineries based on cereal stubble, while wood supply chains present dominant pretreatment operations costs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Utility systems operation: Optimisation-based decision making

International Nuclear Information System (INIS)

Velasco-Garcia, Patricia; Varbanov, Petar Sabev; Arellano-Garcia, Harvey; Wozny, Guenter

2011-01-01

Utility systems provide heat and power to industrial sites. The importance of operating these systems in an optimal way has increased significantly due to the unstable and in the long term rising prices of fossil fuels as well as the need for reducing the greenhouse gas emissions. This paper presents an analysis of the problem for supporting operator decision making under conditions of variable steam demands from the production processes on an industrial site. An optimisation model has been developed, where besides for running the utility system, also the costs associated with starting-up the operating units have been modelled. The illustrative case study shows that accounting for the shut-downs and start-ups of utility operating units can bring significant cost savings. - Highlights: → Optimisation methodology for decision making on running utility systems. → Accounting for varying steam demands. → Optimal operating specifications when a demand change occurs. → Operating costs include start-up costs of boilers and other units. → Validated on a real-life case study. Up to 20% cost savings are possible.

Optimisation of the performance of a novel rotationally asymmetrical optical concentrator design for building integrated photovoltaic system

International Nuclear Information System (INIS)

Abu-Bakar, Siti Hawa; Muhammad-Sukki, Firdaus; Freier, Daria; Ramirez-Iniguez, Roberto; Mallick, Tapas Kumar; Munir, Abu Bakar; Mohd Yasin, Siti Hajar; Abubakar Mas'ud, Abdullahi; Md Yunus, Norhidayah

2015-01-01

Solar energy is one of the renewable energy sources that has shown promising potential in addressing the world's energy needs, particularly via the solar PV (photovoltaic) technology. However, the high cost of installation is still being considered as the main obstacle to the widespread adoption of solar PV system. The use of solar concentrators is one of the solutions that could help to produce lower cost solar PV systems. One of the existing concentrator designs is known as the RADTIRC (rotationally asymmetrical dielectric totally internally reflecting concentrator) which was developed in GCU (Glasgow Caledonian University) since 2010. This paper aims at optimising the existing RADTIRC prototype by increasing its electrical output whilst keeping the cost of the system at minimum. This is achieved by adopting a better material and a different technique to fabricate the concentrator. The optimised RADTIRC prototype was fabricated from PMMA (polymethyl-methacrylate) using injection moulding. It was found that the optimised RADTIRC-PV prototype generated an opto-electronic gain of 4.48 when compared with the bare cell under STC (standard test conditions). A comparison with the old prototype showed that the optimised RADTIRC-PV prototype increased the short circuit current by 13.57% under STC. - Highlights: • An optimisation of the performance of the RADTIRC was presented. • The optimised prototype was fabricated from PMMA using injection moulding. • The electrical and optical performances were investigated. • The optimised prototype generated an opto-electronic gain of 4.48x

Technical specifications for PWR secondary water chemistry

International Nuclear Information System (INIS)

Weeks, J.R.; van Rooyen, D.

1977-08-01

The bases for establishing Technical Specifications for PWR secondary water chemistry are reviewed. Whereas extremely stringent control of secondary water needs to be maintained to prevent denting in some units, sound bases for establishing limits that will prevent stress corrosion, wastage, and denting do not exist at the present time. This area is being examined very thoroughly by industry-sponsored research programs. Based on the evidence available to date, short term control limits are suggested; establishment of these or other limits as Technical Specifications is not recommended until the results of the research programs have been obtained and evaluated

Optimising resource management in neurorehabilitation.

Science.gov (United States)

Wood, Richard M; Griffiths, Jeff D; Williams, Janet E; Brouwers, Jakko

2014-01-01

To date, little research has been published regarding the effective and efficient management of resources (beds and staff) in neurorehabilitation, despite being an expensive service in limited supply. To demonstrate how mathematical modelling can be used to optimise service delivery, by way of a case study at a major 21 bed neurorehabilitation unit in the UK. An automated computer program for assigning weekly treatment sessions is developed. Queue modelling is used to construct a mathematical model of the hospital in terms of referral submissions to a waiting list, admission and treatment, and ultimately discharge. This is used to analyse the impact of hypothetical strategic decisions on a variety of performance measures and costs. The project culminates in a hybridised model of these two approaches, since a relationship is found between the number of therapy hours received each week (scheduling output) and length of stay (queuing model input). The introduction of the treatment scheduling program has substantially improved timetable quality (meaning a better and fairer service to patients) and has reduced employee time expended in its creation by approximately six hours each week (freeing up time for clinical work). The queuing model has been used to assess the effect of potential strategies, such as increasing the number of beds or employing more therapists. The use of mathematical modelling has not only optimised resources in the short term, but has allowed the optimality of longer term strategic decisions to be assessed.

Analysis of optimisation method for a two-stroke piston ring using the Finite Element Method and the Simulated Annealing Method

Science.gov (United States)

Kaliszewski, M.; Mazuro, P.

2016-09-01

Simulated Annealing Method of optimisation for the sealing piston ring geometry is tested. The aim of optimisation is to develop ring geometry which would exert demanded pressure on a cylinder just while being bended to fit the cylinder. Method of FEM analysis of an arbitrary piston ring geometry is applied in an ANSYS software. The demanded pressure function (basing on formulae presented by A. Iskra) as well as objective function are introduced. Geometry definition constructed by polynomials in radial coordinate system is delivered and discussed. Possible application of Simulated Annealing Method in a piston ring optimisation task is proposed and visualised. Difficulties leading to possible lack of convergence of optimisation are presented. An example of an unsuccessful optimisation performed in APDL is discussed. Possible line of further optimisation improvement is proposed.

Validation of a large-scale audit technique for CT dose optimisation

International Nuclear Information System (INIS)

Wood, T. J.; Davis, A. W.; Moore, C. S.; Beavis, A. W.; Saunderson, J. R.

2008-01-01

The expansion and increasing availability of computed tomography (CT) imaging means that there is a greater need for the development of efficient optimisation strategies that are able to inform clinical practice, without placing a significant burden on limited departmental resources. One of the most fundamental aspects to any optimisation programme is the collection of patient dose information, which can be compared with appropriate diagnostic reference levels. This study has investigated the implementation of a large-scale audit technique, which utilises data that already exist in the radiology information system, to determine typical doses for a range of examinations on four CT scanners. This method has been validated against what is considered the 'gold standard' technique for patient dose audits, and it has been demonstrated that results equivalent to the 'standard-sized patient' can be inferred from this much larger data set. This is particularly valuable where CT optimisation is concerned as it is considered a 'high dose' technique, and hence close monitoring of patient dose is particularly important. (authors)

Optimisation of the alcoholic fermentation of aqueous jerivá pulp extract

Directory of Open Access Journals (Sweden)

Guilherme Arielo Rodrigues Maia

2014-05-01

Full Text Available The objective of this research is to determinate the optimum conditions for the alcoholic fermentation process of aqueous jerivá pulp extract using the response surface methodology and simplex optimisation technique. The incomplete factorial design 3³ was applied with the yeast extract, NH4H2PO4 and yeast as the independent variables and the alcohol production yield as the response. The regression analysis indicated that the model is predictive, and the simplex optimisation generated a formulation containing 0.35 g L-1 yeast extract, 6.33 g L-1 yeast and 0.30 g L-1NH4H2PO4 for an optimum yield of 85.40% ethanol. To validate the predictive equation, the experiment was carried out in triplicate under optimum conditions, and an average yield of 87.15% was obtained. According to a t-test, no significant difference was observed (on the order of 5% between the average value obtained and the value indicated by the simplex optimisation technique.

Stroke Prevention: Managing Modifiable Risk Factors

Directory of Open Access Journals (Sweden)

Silvia Di Legge

2012-01-01

Full Text Available Prevention plays a crucial role in counteracting morbidity and mortality related to ischemic stroke. It has been estimated that 50% of stroke are preventable through control of modifiable risk factors and lifestyle changes. Antihypertensive treatment is recommended for both prevention of recurrent stroke and other vascular events. The use of antiplatelets and statins has been shown to reduce the risk of recurrent stroke and other vascular events. Angiotensin-converting enzyme inhibitors (ACEIs and angiotensin II receptor blockers (ARBs are indicated in stroke prevention because they also promote vascular health. Effective secondary-prevention strategies for selected patients include carotid revascularization for high-grade carotid stenosis and vitamin K antagonist treatment for atrial fibrillation. The results of recent clinical trials investigating new anticoagulants (factor Xa inhibitors and direct thrombin inhibitors clearly indicate alternative strategies in stroke prevention for patients with atrial fibrillation. This paper describes the current landscape and developments in stroke prevention with special reference to medical treatment in secondary prevention of ischemic stroke.

Optimisation de modèles de propagation à partir des données de ...

African Journals Online (AJOL)

optimisation radio dans les réseaux mobiles. Le présent article présente une étude comparative de cinq méthodes d'optimisation de modèles de propagation à savoir : La régression linéaire, la méthode de Newton de second ordre, le recuit ...

Parallel unstructured mesh optimisation for 3D radiation transport and fluids modelling

International Nuclear Information System (INIS)

Gorman, G.J.; Pain, Ch. C.; Oliveira, C.R.E. de; Umpleby, A.P.; Goddard, A.J.H.

2003-01-01

In this paper we describe the theory and application of a parallel mesh optimisation procedure to obtain self-adapting finite element solutions on unstructured tetrahedral grids. The optimisation procedure adapts the tetrahedral mesh to the solution of a radiation transport or fluid flow problem without sacrificing the integrity of the boundary (geometry), or internal boundaries (regions) of the domain. The objective is to obtain a mesh which has both a uniform interpolation error in any direction and the element shapes are of good quality. This is accomplished with use of a non-Euclidean (anisotropic) metric which is related to the Hessian of the solution field. Appropriate scaling of the metric enables the resolution of multi-scale phenomena as encountered in transient incompressible fluids and multigroup transport calculations. The resulting metric is used to calculate element size and shape quality. The mesh optimisation method is based on a series of mesh connectivity and node position searches of the landscape defining mesh quality which is gauged by a functional. The mesh modification thus fits the solution field(s) in an optimal manner. The parallel mesh optimisation/adaptivity procedure presented in this paper is of general applicability. We illustrate this by applying it to a transient CFD (computational fluid dynamics) problem. Incompressible flow past a cylinder at moderate Reynolds numbers is modelled to demonstrate that the mesh can follow transient flow features. (authors)

Secondary prevention of epidemic gastric cancer in the model of Helicobacter pylori-associated gastritis.

Science.gov (United States)

Pizzi, Marco; Saraggi, Deborah; Fassan, Matteo; Megraud, Francis; Di Mario, Francesco; Rugge, Massimo

2014-01-01

Irrespective of its etiology, long-standing, non-self-limiting gastric inflammation (mostly in Helicobacter pylori-associated cases) is the cancerization ground on which epidemic (intestinal-type) gastric carcinoma (GC) can develop. The natural history of invasive gastric adenocarcinoma encompasses gastritis, atrophic mucosal changes, and intraepithelial neoplasia (IEN). The topography, the extent and the severity of the atrophic changes significantly correlate with the risk of developing both IEN and GC. In recent years, both noninvasive (serological) tests and invasive (endoscopy/biopsy) procedures have been proposed to stratify patients according to different classes of GC risk. As a consequence, different patient-tailored GC secondary prevention strategies have been put forward. This review summarizes the histological features of H. pylori-related gastritis and the natural history of the disease. Histological and serological strategies to assess GC risk as well as the clinical management of atrophic gastritis patients are also discussed. © 2014 S. Karger AG, Basel.

Structural-electrical coupling optimisation for radiating and scattering performances of active phased array antenna

Science.gov (United States)

Wang, Congsi; Wang, Yan; Wang, Zhihai; Wang, Meng; Yuan, Shuai; Wang, Weifeng

2018-04-01

It is well known that calculating and reducing of radar cross section (RCS) of the active phased array antenna (APAA) are both difficult and complicated. It remains unresolved to balance the performance of the radiating and scattering when the RCS is reduced. Therefore, this paper develops a structure and scattering array factor coupling model of APAA based on the phase errors of radiated elements generated by structural distortion and installation error of the array. To obtain the optimal radiating and scattering performance, an integrated optimisation model is built to optimise the installation height of all the radiated elements in normal direction of the array, in which the particle swarm optimisation method is adopted and the gain loss and scattering array factor are selected as the fitness function. The simulation indicates that the proposed coupling model and integrated optimisation method can effectively decrease the RCS and that the necessary radiating performance can be simultaneously guaranteed, which demonstrate an important application value in engineering design and structural evaluation of APAA.

An effective approach to reducing strategy space for maintenance optimisation of multistate series–parallel systems

International Nuclear Information System (INIS)

Zhou, Yifan; Lin, Tian Ran; Sun, Yong; Bian, Yangqing; Ma, Lin

2015-01-01

Maintenance optimisation of series–parallel systems is a research topic of practical significance. Nevertheless, a cost-effective maintenance strategy is difficult to obtain due to the large strategy space for maintenance optimisation of such systems. The heuristic algorithm is often employed to deal with this problem. However, the solution obtained by the heuristic algorithm is not always the global optimum and the algorithm itself can be very time consuming. An alternative method based on linear programming is thus developed in this paper to overcome such difficulties by reducing strategy space of maintenance optimisation. A theoretical proof is provided in the paper to verify that the proposed method is at least as effective as the existing methods for strategy space reduction. Numerical examples for maintenance optimisation of series–parallel systems having multistate components and considering both economic dependence among components and multiple-level imperfect maintenance are also presented. The simulation results confirm that the proposed method is more effective than the existing methods in removing inappropriate maintenance strategies of multistate series–parallel systems. - Highlights: • A new method using linear programming is developed to reduce the strategy space. • The effectiveness of the new method for strategy reduction is theoretically proved. • Imperfect maintenance and economic dependence are considered during optimisation

Optimisation of patient and staff exposure in interventional cardiology

International Nuclear Information System (INIS)

Padovani, R.; Malisan, M.R.; Bernardi, G.; Vano, E.; Neofotistou, V.

2001-01-01

The Council Directive of the European Community 97/43/Euratom (MED) deals with the health protection of individuals against dangers of ionising radiation in relation to medical exposure, and also focuses attention on some special practices (Art. 9), including interventional radiology, a technique involving high doses to the patient. The paper presents the European approach to optimisation of exposure in interventional cardiology. The DIMOND research consortium (DIMOND: Digital Imaging: Measures for Optimising Radiological Information Content and Dose) is working to develop quality criteria for cineangiographic images, to develop procedures for the classification of complexity of therapeutic and diagnostic procedures and to derive reference levels, related also to procedure complexity. DIMOND project also includes aspects of equipment characteristics and performance and content of training in radiation protection of personnel working in interventional radiology field. (author)

Optimisation of the LHCb detector

CERN Document Server

Hierck, R H

2003-01-01

This thesis describes a comparison of the LHCb classic and LHCb light concept from a tracking perspective. The comparison includes the detector occupancies, the various pattern recognition algorithms and the reconstruction performance. The final optimised LHCb setup is used to study the physics performance of LHCb for the Bs->DsK and Bs->DsPi decay channels. This includes both the event selection and a study of the sensitivity for the Bs oscillation frequency, delta m_s, the Bs lifetime difference, DGamma_s, and the CP parameter gamma-2delta gamma.

Energy efficiency optimisation for distillation column using artificial neural network models

International Nuclear Information System (INIS)

Osuolale, Funmilayo N.; Zhang, Jie

2016-01-01

This paper presents a neural network based strategy for the modelling and optimisation of energy efficiency in distillation columns incorporating the second law of thermodynamics. Real-time optimisation of distillation columns based on mechanistic models is often infeasible due to the effort in model development and the large computation effort associated with mechanistic model computation. This issue can be addressed by using neural network models which can be quickly developed from process operation data. The computation time in neural network model evaluation is very short making them ideal for real-time optimisation. Bootstrap aggregated neural networks are used in this study for enhanced model accuracy and reliability. Aspen HYSYS is used for the simulation of the distillation systems. Neural network models for exergy efficiency and product compositions are developed from simulated process operation data and are used to maximise exergy efficiency while satisfying products qualities constraints. Applications to binary systems of methanol-water and benzene-toluene separations culminate in a reduction of utility consumption of 8.2% and 28.2% respectively. Application to multi-component separation columns also demonstrate the effectiveness of the proposed method with a 32.4% improvement in the exergy efficiency. - Highlights: • Neural networks can accurately model exergy efficiency in distillation columns. • Bootstrap aggregated neural network offers improved model prediction accuracy. • Improved exergy efficiency is obtained through model based optimisation. • Reductions of utility consumption by 8.2% and 28.2% were achieved for binary systems. • The exergy efficiency for multi-component distillation is increased by 32.4%.

Optimised dipper fine tunes shovel performance

Energy Technology Data Exchange (ETDEWEB)

Fiscor, S.

2005-06-01

Joint efforts between mine operators, OEMs, and researchers yields unexpected benefits from dippers for shovels for coal, oil, or hardrock mining that can now be tailored to meet site-specific conditions. The article outlines a process being developed by CRCMining and P & H MIning Equipment to optimise the dipper that involves rapid prototyping and scale modelling of the dipper and the mine conditions. Scale models have been successfully field tested. 2 photos.

Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial.

Science.gov (United States)

Zipfel, Stephan; Wild, Beate; Groß, Gaby; Friederich, Hans-Christoph; Teufel, Martin; Schellberg, Dieter; Giel, Katrin E; de Zwaan, Martina; Dinkel, Andreas; Herpertz, Stephan; Burgmer, Markus; Löwe, Bernd; Tagay, Sefik; von Wietersheim, Jörn; Zeeck, Almut; Schade-Brittinger, Carmen; Schauenburg, Henning; Herzog, Wolfgang

2014-01-11

Psychotherapy is the treatment of choice for patients with anorexia nervosa, although evidence of efficacy is weak. The Anorexia Nervosa Treatment of OutPatients (ANTOP) study aimed to assess the efficacy and safety of two manual-based outpatient treatments for anorexia nervosa--focal psychodynamic therapy and enhanced cognitive behaviour therapy--versus optimised treatment as usual. The ANTOP study is a multicentre, randomised controlled efficacy trial in adults with anorexia nervosa. We recruited patients from ten university hospitals in Germany. Participants were randomly allocated to 10 months of treatment with either focal psychodynamic therapy, enhanced cognitive behaviour therapy, or optimised treatment as usual (including outpatient psychotherapy and structured care from a family doctor). The primary outcome was weight gain, measured as increased body-mass index (BMI) at the end of treatment. A key secondary outcome was rate of recovery (based on a combination of weight gain and eating disorder-specific psychopathology). Analysis was by intention to treat. This trial is registered at http://isrctn.org, number ISRCTN72809357. Of 727 adults screened for inclusion, 242 underwent randomisation: 80 to focal psychodynamic therapy, 80 to enhanced cognitive behaviour therapy, and 82 to optimised treatment as usual. At the end of treatment, 54 patients (22%) were lost to follow-up, and at 12-month follow-up a total of 73 (30%) had dropped out. At the end of treatment, BMI had increased in all study groups (focal psychodynamic therapy 0·73 kg/m(2), enhanced cognitive behaviour therapy 0·93 kg/m(2), optimised treatment as usual 0·69 kg/m(2)); no differences were noted between groups (mean difference between focal psychodynamic therapy and enhanced cognitive behaviour therapy -0·45, 95% CI -0·96 to 0·07; focal psychodynamic therapy vs optimised treatment as usual -0·14, -0·68 to 0·39; enhanced cognitive behaviour therapy vs optimised treatment as usual -0·30

Statistical Optimisation of Fermentation Conditions for Citric Acid ...

African Journals Online (AJOL)

This study investigated the optimisation of fermentation conditions during citric acid production via solid state fermentation (SSF) of pineapple peels using Aspergillus niger. A three-variable, three-level Box-Behnken design (BBD) comprising 17 experimental runs was used to develop a statistical model for the fermentation ...

optimisation of compressive strength of periwinkle shell aggregate

African Journals Online (AJOL)

user

2017-01-01

Jan 1, 2017 ... In this paper, a regression model is developed to predict and optimise the compressive strength of periwinkle shell aggregate concrete using Scheffe's regression theory. The results obtained from the derived regression model agreed favourably with the experimental data. The model was tested for ...

Design of optimised backstepping controller for the synchronisation

Indian Academy of Sciences (India)

In this paper, an adaptive backstepping controller has been tuned to synchronise two chaotic Colpitts oscillators in a master–slave configuration. The parameters of the controller are determined using shark smell optimisation (SSO) algorithm. Numerical results are presented and compared with those of particle swarm ...

The optimisation of a water distribution system using Bentley WaterGEMS software

Directory of Open Access Journals (Sweden)

Świtnicka Karolina

2017-01-01

Full Text Available The proper maintenance of water distribution systems (WDSs requires from operators multiple actions in order to ensure optimal functioning. Usually, all requirements should be adjusted simultaneously. Therefore, the decision-making process is often supported by multi-criteria optimisation methods. Significant improvements of exploitation conditions of WDSs functioning can be achieved by connecting small water supply networks into group systems. Among many potential tools supporting advanced maintenance and management of WDSs, significant improvements have tools that can find the optimal solution by the implemented mechanism of metaheuristic methods, such as the genetic algorithm. In this paper, an exemplary WDS functioning optimisation is presented, in relevance to a group water supply system. The action range of optimised parameters included: maximisation of water flow velocity, regulation of pressure head, minimisation of water retention time in a network (water age and minimisation of pump energy consumption. All simulations were performed in Bentley WaterGEMS software.

Methodology implementation for multi objective optimisation for nuclear fleet evolution scenarios

International Nuclear Information System (INIS)

Freynet, David

2016-01-01

The issue of the evolution French nuclear fleet can be considered through the study of nuclear transition scenarios. These studies are of paramount importance as their results can greatly affect the decision making process, given that they take into account industrial concerns, investments, time, and nuclear system complexity. Such studies can be performed with the COSI code (developed at the CEA/DEN), which enables the calculation of matter inventories and fluxes across the fuel cycle (nuclear reactors and associated facilities), especially when coupled with the CESAR depletion code. The studies today performed with COSI require the definition of the various scenarios' input parameters, in order to fulfil different objectives such as minimising natural uranium consumption, waste production and so on. These parameters concern the quantities and the scheduling of spent fuel destined for reprocessing, and the number, the type and the commissioning dates of deployed reactors.This work aims to develop, validate and apply an optimisation methodology coupled with COSI, in order to determine optimal nuclear transition scenarios for a multi-objective platform. Firstly, this methodology is based on the acceleration of scenario evaluation, enabling the use of optimisation methods in a reasonable time-frame. With this goal in mind, artificial neural network irradiation surrogate models are created with the URANIE platform (developed at the CEA/DEN) and are implemented within COSI. The next step in this work is to use, adapt and compare different optimisation methods, such as URANIE's genetic algorithm and particle swarm methods, in order to define a methodology suited to this type of study. This methodology development is based on an incremental approach which progressively adds objectives, constraints and decision variables to the optimisation problem definition. The variables added, which are related to reactor deployment and spent fuel reprocessing strategies, are chosen

Engineering of secondary metabolite production in streptomycetes

DEFF Research Database (Denmark)

Robertsen, Helene Lunde; Gram, Lone

Streptomycetes are known for their ability to produce a range of different secondary metabolites, including antibiotics, immunosuppressive, anti-fungals, and anti-cancer compounds. Of these compounds, antibiotics play an important role in the clinics for treatment of both mild and severe bacterial...... the computational prediction of suitable 20 bp protospacers for the single guide RNAs and a USER-cloning method for construction of the CRISPR plasmids. Additional improvement to the system was achieved through the development of an optimised USER assembly workflow for cheaper and faster plasmid construction....... The workflow was verified by manual knock-down of two biosynthetic gene clusters in model organism Streptomyces coelicolor A3(2), which confirmed the applicability of the system. A second part of the thesis was devoted to engineering of Streptomyces collinus Tü 365, which is a known producer of the narrow...

Optimisation of occupational exposure

International Nuclear Information System (INIS)

Webb, G.A.M.; Fleishman, A.B.

1982-01-01

The general concept of the optimisation of protection of the public is briefly described. Some ideas being developed for extending the cost benefit framework to include radiation workers with full implementation of the ALARA criterion are described. The role of cost benefit analysis in radiological protection and the valuation of health detriment including the derivation of monetary values and practical implications are discussed. Cost benefit analysis can lay out for inspection the doses, the associated health detriment costs and the costs of protection for alternative courses of action. However it is emphasised that the cost benefit process is an input to decisions on what is 'as low as reasonably achievable' and not a prescription for making them. (U.K.)

Optimisation of wheat-sprouted soybean flour bread using response ...

African Journals Online (AJOL)

STORAGESEVER

2009-11-16

Nov 16, 2009 ... Full Length Research Paper. Optimisation of ... Victoria A. Jideani1* and Felix C. Onwubali2. 1Department of Food Technology, Cape Peninsula University of Technology, P. O. Box 652, Cape Town 8000, South. Africa.

Issues with performance measures for dynamic multi-objective optimisation

CSIR Research Space (South Africa)

Helbig, M

2013-06-01

Full Text Available Symposium on Computational Intelligence in Dynamic and Uncertain Environments (CIDUE), Mexico, 20-23 June 2013 Issues with Performance Measures for Dynamic Multi-objective Optimisation Mard´e Helbig CSIR: Meraka Institute Brummeria, South Africa...

Web-Based Prevention of Parenting Difficulties in Young, Urban Mothers Enrolled in Post-Secondary Education.

Science.gov (United States)

Ehrensaft, Miriam K; Knous-Westfall, Heather M; Alonso, Thailyn Lopez

2016-12-01

Research consistently indicates that young mothers are at elevated risk for adverse social and economic risks. Recent attention has been paid to the value of maternal educational attainment for their children's economic and social outcomes. Pursuit of post-secondary education requires mothers to balance multiple roles, potentially stressing the parent-child relationship. Yet, almost no studies have addressed parenting and associated stress in young mothers enrolled in post-secondary education, and no preventive intervention trials have been conducted. We screened young mothers (parenting stress, and participated in a randomized controlled trial to assess the efficacy of a web-based parenting intervention (Triple P Online) in reducing parenting stress and dysfunctional discipline (N = 52). Mothers were randomly assigned to the web-based parenting program condition or to a waitlist control condition. Mothers who completed at least the first four core modules of the online program had lower scores on the Parenting Scale's subscales (Overreactivity, Verbosity, and Laxness), compared to those who did not complete four or more modules. No intervention effects were obtained for parenting stress. The current study provides preliminary evidence of the efficacy of this online parenting program for reducing risk for dysfunctional discipline in student mothers. Future research is warranted to replicate these findings, and to test whether provision of supplemental support for implementation, or briefer program formats may promote both program compliance and outcomes related to reducing parenting stress.

Internet-based interventions for the secondary prevention of coronary heart disease.

Science.gov (United States)

Devi, Reena; Singh, Sally J; Powell, John; Fulton, Emily A; Igbinedion, Ewemade; Rees, Karen

2015-12-22

The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease (CHD). To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, in December 2014. We also searched six other databases in October 2014, and three trials registers in January 2015 together with reference checking and handsearching to identify additional studies. Randomised controlled trials (RCTs) evaluating Internet-delivered secondary prevention interventions aimed at people with CHD. Two review authors independently assessed risk of bias and extracted data according to the Cochrane Handbook for Systematic Reviews of Interventions. We assessed evidence quality using the GRADE approach and presented this in a 'Summary of findings' table. Eighteen trials met our inclusion criteria. Eleven studies are complete (1392 participants), and seven are ongoing. Of the completed studies, seven interventions are broad, targeting the lifestyle management of CHD, and four focused on physical activity promotion. The comparison group in trials was usual care (n = 6), minimal intervention (n = 3), or traditional cardiac rehabilitation (n = 2).We found no effects of Internet-based interventions for all-cause mortality (odds ratio (OR) 0.27, 95% confidence interval (CI) 0.04 to 1.63; participants = 895; studies = 6; low-quality evidence). There was only one case of cardiovascular mortality in a control group (participants = 895; studies = 6). No incidences of non-fatal re-infarction were reported across any of the studies. We found no effects for revascularisation (OR 0.69, 95% CI 0.37 to 1.27; participants = 895; studies = 6; low-quality evidence).We found no effects for total cholesterol (mean difference (MD) 0.00, 95% CI -0.27 to 0.28; participants = 439; studies = 4; low

Process and Economic Optimisation of a Milk Processing Plant with Solar Thermal Energy

DEFF Research Database (Denmark)

Bühler, Fabian; Nguyen, Tuong-Van; Elmegaard, Brian

2016-01-01

. Based on the case study of a dairy factory, where first a heat integration is performed to optimise the system, a model for solar thermal process integration is developed. The detailed model is based on annual hourly global direct and diffuse solar radiation, from which the radiation on a defined......This work investigates the integration of solar thermal systems for process energy use. A shift from fossil fuels to renewable energy could be beneficial both from environmental and economic perspectives, after the process itself has been optimised and efficiency measures have been implemented...... surface is calculated. Based on hourly process stream data from the dairy factory, the optimal streams for solar thermal process integration are found, with an optimal thermal storagetank volume. The last step consists of an economic optimisation of the problem to determine the optimal size...

Development of an Optimised Losartan Potassium Press-Coated ...

African Journals Online (AJOL)

The optimised formulation was further characterized with Fourier-transform infrared spectroscopy (FTIR) and powder X-ray diffractometry (PXRD) to investigate any drug/excipient modifications/interactions. Results: The tensile strength values of all the PCT were between 1.12 and 1.23MNm-2 and friability was < 0.36 %.

Carbon steel corrosion prevention during chemical cleaning of steam generator secondary side components

International Nuclear Information System (INIS)

Fulger, M.; Lucan, D.; Velciu, L.

2009-01-01

During operation of a nuclear power plant, many contaminants, such as solid particles or dissolved species are formed in the secondary circuit, go into steam generator and deposit as scales on heat transfer tubing, support plate or as sludge on tube sheet. By accumulation of these impurities, heat transfer is reduced and the integrity of the steam generator tubing is influenced. Chemical cleaning is a qualified, efficient measure to improve steam generator corrosion performance. The corrosion mechanism can be counteracted by the chemical cleaning of the deposits on the tube sheet and the scales on the heat transfer tubing. The major component of the scales is magnetite, which can be dissolved using an organic chelating agent (ethylenediaminetetraacetic acid, EDTA) in combination with a complexing agent such as citric acid in an alkaline reducing environment. As the secondary side of SG is a conglomerate of alloys it is necessary to choose an optimal chemical cleaning solution for an efficient cleaning properties and at the same time with capability of corrosion prevention of carbon steel components during the process. The paper presents laboratory tests initiated to confirm the ability of this process to clean the SG components. The experiments followed two paths: - first, carbon steel samples have been autoclavized in specific secondary circuit solutions of steam generator to simulate the deposits constituted during operation of this equipment; - secondly, autoclavized samples have been cleaned with a solvent composed of EDTA citric acid, hydrazine of pH = 5 and temperature of 85 deg. C. Before chemical cleaning, the oxide films were characterized by surface analysis techniques including optical microscopy, scanning electron microscopy (SEM) and electrochemical impedance spectroscopy (EIS). Applied to dissolve corrosion products formed in a steam generator, the solvents based on chelating agents are aggressive toward carbon steels and corrosion inhibitors are

Lifetime sedentary living accelerates some aspects of secondary aging

DEFF Research Database (Denmark)

Booth, Frank W; Laye, Matthew J; Roberts, Michael D

2011-01-01

accelerates secondary aging (e.g., speeding the reduction in bone mineral density, maximal oxygen consumption, and skeletal muscle strength and power), but does not alter the primary aging of these systems. Third, a lifetime of physical activity to the age of ∼60-70 yr old totally prevents decrements in some...... role in the secondary aging of many essential physiological functions, and this aging can be prevented through a lifetime of physical activity.......Lifetime physical inactivity interacts with secondary aging (i.e., aging caused by diseases and environmental factors) in three patterns of response. First, lifetime physical inactivity confers no apparent effects on a given set of physiological functions. Second, lifetime physical inactivity...

Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia.

Science.gov (United States)

Hamilton, Sandra; Mills, Belynda; McRae, Shelley; Thompson, Sandra

2018-01-30

Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations. CR and Aboriginal Community Controlled Health Services were identified through the Directory of Western Australian Cardiac Rehabilitation and Secondary Prevention Services 2012. Structured interviews with CR coordinators included questions specific to program delivery, content, referral and attendance. Of the 38 CR services identified, 23 (61%) were located in rural (n = 11, 29%) and remote (n = 12, 32%) regions. Interviews with coordinators from 34 CR services (10 rural, 12 remote, 12 metropolitan) found 77% of rural/remote services were hospital-based, with no service providing a comprehensive home-based or alternative method of program delivery. The majority of rural (60%) and remote (80%) services provided CR through chronic condition exercise programs compared with 17% of metropolitan services; only 27% of rural/remote programs provided education classes. Rural/remote coordinators were overwhelmingly physiotherapists, and only 50% of rural and 33% of remote programs had face-to-face access to multidisciplinary support. Patient referral and attendance rates differed greatly across WA and referrals to rural/remote services generally numbered less than 5 per month. Program evaluation was reported by 33% of rural/remote coordinators. Geography, population density and service availability limits patient access to CR services in rural/remote WA. Current

SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES AMONG PATIENTS OF DIFFERENT AGE GROUPS WITH A HISTORY OF MYOCARDIAL INFARCTION BY THE EXAMPLE OF OUTPATIENT CARDIOLOGY INSTITUTION

Directory of Open Access Journals (Sweden)

S. B. Fitilev

2017-01-01

Full Text Available Aim. To study secondary prevention of cardiovascular diseases among patients of different age groups with a history of myocardial infarction by the example of outpatient cardiology institution.Material and methods. Retrospective pharmacoepidemiological study was conducted by analyzing the medical records of 825 patients with a history of myocardial infarction, who visited the outpatient cardiology institution for the first time in 2011. Patients were divided into two groups according to their age: younger than 60 years (n=308, and 60 years and older (n=517.Results. The population of elderly patients was more severe: significantly more often patients had disability and comorbidities. The prevalence of the main modifiable risk factors could not be assessed fully due to the lack of information in patients’ medical records. Elderly patients were significantly less likely to receive β-blockers (80.3% and statins (63.8%. No significant differences were found in daily doses of the main prescribed preventive drugs between two groups.Conclusion. Secondary prevention of cardiovascular diseases among patients of different age groups could not be considered proper, as there is low level of attention to the modifiable risk factors and recommendation on their correction. A tendency to under-prescription of angiotensin converting enzyme inhibitors was revealed, as well as significantly lower number of recommendations for taking statins and β-adrenoblockers in the group of elderly patients.

A fast alternative to core plug tests for optimising injection water salinity for EOR

DEFF Research Database (Denmark)

Hassenkam, Tue; Andersson, Martin Peter; Hilner, Emelie Kristin Margareta

2014-01-01

of the clays which would lead to permanent reservoir damage but evidence of effectiveness at moderate salinity would offer the opportunity to dispose of produced water. The goal is to define boundary conditions so injection water salinity is high enough to prevent reservoir damage and low enough to induce...... the low salinity effect while keeping costs and operational requirements at a minimum. Traditional core plug testing for optimising conditions has some limitations. Each test requires a fresh sample, core testing requires sophisticated and expensive equipment, and reliable core test data requires several...... experiments can be done relatively quickly on very little material, it gives the possibility of testing salinity response on samples from throughout a reservoir and for gathering statistics. Our approach provides a range of data that can be used to screen core plug testing conditions and to provide extra data...

A Survey about Protective Effect of Echinococcus Granulosus Protoscolices Surface Antigens in Preventing Secondary Hydatid Cyst

Directory of Open Access Journals (Sweden)

H Yousofi

2006-10-01

Full Text Available ABSTRACT: Introduction & Objective: Hydatid cyst is located in human and some animal visceral organs such as liver and lung. The disease is considered as a medical, veterinary and economical problem in endemic area. When the hydatid cyst is ruptured, protoscolices from inside the cyst may spread out to other parts of the body and develops a new cyst named secondary hydatid cyst. In this research in an attempt to prevent secondary hydatid cyst, protective potential of protoscolices surface antigens extracted with different detergents has been investigated in animal model. Materials & Methods: In this experimental study, groups of Balb/c mice were immunized intra-peritoneally with protoscolices homogenate and three detergent (SDS, Tween and Triton x–100 extracted protoscolices surface antigens and alum as adjuvant. These mice were then boosted two times with the same antigens fortnightly. Control mice were simultaneously injected with alum alone. Two weeks following the last injection all the mice in cases and control groups were challenged with live protoscolices. Three months afterward all the mice in case and control groups were sacrificed and their peritoneal cavities were explored for hydatid cysts. Results: The mean of developed cyst number in mice injected with protoscolices homogenate was 3±2, while in control group the mean of developed cysts number was 5.8 ± 1.7 (p< 0.02. The mean of developed cyst number in mice injected with SDS, Tween and Triton x–100 extracted protoscolices surface antigens was 3, 3.6 and 3.4, respectively, while the mean of developed cyst number in control group was 5.8. Conclusion: The mean of cyst number in cases and control groups was different and this difference was statistically significant. Results of this investigation revealed that protoscolices homogenate antigens and some detergent extracted antigens are protective against secondary hydatid cyst infection

Optimisation of VSC-HVDC Transmission for Wind Power Plants

DEFF Research Database (Denmark)

Silva, Rodrigo Da

Connection of Wind Power Plants (WPP), typically oshore, using VSCHVDC transmission is an emerging solution with many benefits compared to the traditional AC solution, especially concerning the impact on control architecture of the wind farms and the grid. The VSC-HVDC solution is likely to meet...... more stringent grid codes than a conventional AC transmission connection. The purpose of this project is to analyse how HVDC solution, considering the voltage-source converter based technology, for grid connection of large wind power plants can be designed and optimised. By optimisation, the project...... the robust control technique is applied is compared with the classical proportional-integral (PI) performance, by means of time domain simulation in a point-to-point HVDC connection. The three main parameters in the discussion are the wind power delivered from the offshore wind power plant, the variation...

Numerical Analysis and Geometry Optimisation of Vertical Vane of Room Air-conditioner

Directory of Open Access Journals (Sweden)

Al-Obaidi Abdulkareem Sh. Mahdi

2018-01-01

Full Text Available Vertical vanes of room air-conditioners are used to control and direct cold air. This paper aims to study vertical vane as one of the parameters that affect the efficiency of dissipating cold air to a given space. The vertical vane geometry is analysed and optimised for lower production cost using CFD. The optimised geometry of the vertical vane should have the same or increased efficiency of dissipating cold air and have lesser mass compared to the existing original design. The existing original design of vertical vane is simplified and analysed by using ANSYS Fluent. Efficiency of wind direction is define as how accurate the direction of airflow coming out from vertical vane. In order to calculate the efficiency of wind direction, 15° and 30° rotation of vertical vane inside room air-conditioner are simulated. The efficiency of wind direction for 15° rotation of vertical vane is 57.81% while efficiency of wind direction for 30° rotation of vertical vane is 47.54%. The results of the efficiency of wind direction are used as base reference for parametric study. The parameters investigated for optimisation of vertical vane are focused at length of long span, tip chord and short span. The design of 15% decreased in vane surface area at tip chord is the best optimised design of vertical vane because the efficiency of wind direction is the highest as 60.32%.

Influence of design improvements in optimising staffing of NPPs - an Indian experience

International Nuclear Information System (INIS)

Bhattacharya, A.S.

2001-01-01

Three decades of operating experience in India has led to sustained high performance of NPP's. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. The organisational factors that led to optimising of staff are described in the companion paper. This optimisation of manpower is a result of continuous learning - for (i) optimising quantum of workload and (ii) improving productivity. For the first category, design improvements over older Indian NPP's have increased reliability, operability, maintainability and human factors. Few examples: (i) improved man-machine interface in plant controls and on-power refuelling system with operator guidance, logging as well as diagnostic/health monitoring features; (ii) spread out layout for better access and ease of maintenance, separation of plant services for unit-1 from unit-2 and, removal of reactor auxiliaries out to separate buildings; (iii) reduction of maintenance tasks through redesigned equipment and improved condition monitoring means. However, design and procedural improvements also include additional equipment for upgradation of safety measures, e.g. larger number of safety related pumps separate switchyard control room and increased service system equipment. This paper outlines experience of design improvements in optimising staffing and uses a specific case illustration to establish the findings for better use of staff. (author)

Weight Optimisation of Steel Monopile Foundations for Offshore Windfarms

DEFF Research Database (Denmark)

Fog Gjersøe, Nils; Bouvin Pedersen, Erik; Kristensen, Brian

2015-01-01

The potential for mass reduction of monopiles in offshore windfarms using current design practice is investigated. Optimisation by sensitivity analysis is carried out for the following important parameters: wall thickness distribution between tower and monopile, soil stiffness, damping ratio...

Larval feeding inhibition assay – need for optimisation

DEFF Research Database (Denmark)

Azuhnwi, Blasius; Desrues, O.; Hoste, H.

2013-01-01

for this observed variation in results include: parasite (species/strain); material tested; or season. There is thus need to optimise LFIA to permit intra and inter-laboratory comparison of results. We investigate here, if changes in EC50 values occur over the patency phase of a nematode species using two test...

Optimisation Study on the Production of Anaerobic Digestate ...

African Journals Online (AJOL)

Organic fraction of municipal solid waste (OFMSW) is a rich substrate for biogas and compost production. Anaerobic Digestate compost (ADC) is an organic fertilizer produced from stabilized residuals of anaerobic digestion of OFMSW. This paper reports the result of studies carried out to optimise the production of ADC from ...

Hypokalemic periodic paralysis: Three rare secondary causes

Directory of Open Access Journals (Sweden)

Prasanna Eswaradass Venkatesan

2015-01-01

Full Text Available Periodic paralysis is a rare neuromuscular disorder, related to a defect in muscle ion channels, characterized by episodes of painless muscle weakness, which may be precipitated by heavy exercise, fasting, or high-carbohydrate meals. Hypokalemic periodic paralysis may be familial (primary or secondary. Here, we report three cases of secondary causes of hypokalemic periodic paralysis. On evaluation, case 1 had distal renal tubular acidosis (RTA due to Sjogren′s syndrome, case 2 had drug induced proximal RTA (Fanconi′s syndrome and case 3 had thyrotoxicosis. Clinician must be aware of causes of secondary PP as recognition and diagnosis can completely prevent further attacks of periodic paralysis. Each of the above case is rare, but completely treatable if diagnosed. Low dose steroids with bicarbonate replacement in case 1, stopping tenofovir in case 2 and carbimazole therapy in case 3 prevented further attacks of periodic paralysis and cardiopulmonary complications.

Transcatheter closure of patent foramen ovale for secondary prevention of ischemic stroke: Quantitative synthesis of pooled randomized trial data.

Science.gov (United States)

Hakeem, Abdul; Cilingiroglu, Mehmet; Katramados, Angelos; Boudoulas, Konstantinos Dean; Iliescu, Cezar; Gundogdu, Betul; Marmagkiolis, Konstantinos