Bentall Operation with Valved Homograft Conduit

Science.gov (United States)

Choudhary, Shiv K.; Talwar, Sachin; Kumar, A. Sampath

2000-01-01

Lesions of the ascending aorta associated with aortic valve disease are usually treated by implanting a prosthetic valved conduit (Bentall procedure). In this report, we present our experience in which a valved homograft conduit was used for the procedure. Six patients underwent a Bentall procedure with the use of a cryopreserved valved homograft conduit. Two of the patients had annuloaortic ectasia, 2 had Marfan syndrome, and 1 had an atherosclerotic aneurysm of the aorta. One patient had severe aortic stenosis due to a bicuspid aortic valve, along with an aneurysm and localized dissection of the ascending aorta. In all of the patients, the aortic annulus was substantially dilated, with accompanying moderate-to-severe aortic regurgitation. A standard procedure was performed with moderate hypothermia, cardiopulmonary bypass, and aortic and bicaval cannulation. The ascending aorta and the aortic valve were replaced with a cryopreserved valved homograft conduit (aortic in 5 patients and pulmonary in 1). The native coronary ostia were anastomosed directly to the homograft. Echocardiography, which was performed intraoperatively, before discharge from the hospital, and at follow-up visits (1 to 36 months), revealed good valve function without dilatation of the homograft conduits. There was 1 late death due to Aspergillus fumigatus endocarditis, 6 months postoperatively. In 1 patient, magnetic resonance imaging performed at 24 months revealed normal caliber of the homograft conduit. We conclude that the Bentall procedure can be performed, safely and with excellent results, using cryopreserved homograft conduits. PMID:11198310

Biological conduit small gap sleeve bridging method for peripheral nerve injury: regeneration law of nerve fibers in the conduit

Directory of Open Access Journals (Sweden)

Pei-xun Zhang

2015-01-01

Full Text Available The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair peripheral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good histocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve fibers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2-8 weeks, the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objective and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

Drill pipes and casings utilizing multi-conduit tubulars

Energy Technology Data Exchange (ETDEWEB)

Curlett, H.B.

1989-01-24

A seal adapted for use with a multi-conduit well tubular, or the like, is described which consists of: a plate with fluid passages, each passage corresponding to an opening of a conduit of the multiconduit tubular, and a groove on the plate around each passage; and elastomer means partially embeddable into each groove for sealing each conduit of a tubular to a corresponding conduit of another similar tubular.

Sealing a conduit end

International Nuclear Information System (INIS)

Mentz, R.M.

1993-01-01

An apparatus for sealing or blocking conduits, such as the primary nozzles of a nuclear steam generator is described. It includes an annular bracket sealingly attached to the open end of the nozzle, the bracket having a plurality of threaded holes therein. Mounted atop the bracket is a generally circular nozzle dam for covering the opening. Interposed between the nozzle dam and the bracket is an extrusion-resistant seal member having a plurality of apertures therethrough for receiving each bolt. The seal member is configured to resist extrusion by having laminated layers of differing hardnesses, so that the seal member will not laterally extrude away from each bolt in a manner that enlarges the aperture surrounding each bolt as the nozzle dam is bolted to the bracket. (author)

Design of barrier coatings on kink-resistant peripheral nerve conduits

Directory of Open Access Journals (Sweden)

Basak Acan Clements

2016-02-01

Full Text Available Here, we report on the design of braided peripheral nerve conduits with barrier coatings. Braiding of extruded polymer fibers generates nerve conduits with excellent mechanical properties, high flexibility, and significant kink-resistance. However, braiding also results in variable levels of porosity in the conduit wall, which can lead to the infiltration of fibrous tissue into the interior of the conduit. This problem can be controlled by the application of secondary barrier coatings. Using a critical size defect in a rat sciatic nerve model, the importance of controlling the porosity of the nerve conduit walls was explored. Braided conduits without barrier coatings allowed cellular infiltration that limited nerve recovery. Several types of secondary barrier coatings were tested in animal studies, including (1 electrospinning a layer of polymer fibers onto the surface of the conduit and (2 coating the conduit with a cross-linked hyaluronic acid-based hydrogel. Sixteen weeks after implantation, hyaluronic acid-coated conduits had higher axonal density, displayed higher muscle weight, and better electrophysiological signal recovery than uncoated conduits or conduits having an electrospun layer of polymer fibers. This study indicates that braiding is a promising method of fabrication to improve the mechanical properties of peripheral nerve conduits and demonstrates the need to control the porosity of the conduit wall to optimize functional nerve recovery.

Tile drainage as karst: Conduit flow and diffuse flow in a tile-drained watershed

Science.gov (United States)

Schilling, K.E.; Helmers, M.

2008-01-01

The similarity of tiled-drained watersheds to karst drainage basins can be used to improve understanding of watershed-scale nutrient losses from subsurface tile drainage networks. In this study, short-term variations in discharge and chemistry were examined from a tile outlet collecting subsurface tile flow from a 963 ha agricultural watershed. Study objectives were to apply analytical techniques from karst springs to tile discharge to evaluate water sources and estimate the loads of agricultural pollutants discharged from the tile with conduit, intermediate and diffuse flow regimes. A two-member mixing model using nitrate, chloride and specific conductance was used to distinguish rainwater versus groundwater inputs. Results indicated that groundwater comprised 75% of the discharge for a three-day storm period and rainwater was primarily concentrated during the hydrograph peak. A contrasting pattern of solute concentrations and export loads was observed in tile flow. During base flow periods, tile flow consisted of diffuse flow from groundwater sources and contained elevated levels of nitrate, chloride and specific conductance. During storm events, suspended solids and pollutants adhered to soil surfaces (phosphorus, ammonium and organic nitrogen) were concentrated and discharged during the rapid, conduit flow portion of the hydrograph. During a three-day period, conduit flow occurred for 5.6% of the time but accounted for 16.5% of the total flow. Nitrate and chloride were delivered primarily with diffuse flow (more than 70%), whereas 80-94% of total suspended sediment, phosphorus and ammonium were exported with conduit and intermediate flow regimes. Understanding the water sources contributing to tile drainage and the manner by which pollutant discharge occurs from these systems (conduit, intermediate or diffuse flow) may be useful for designing, implementing and evaluating non-point source reduction strategies in tile-drained landscapes. ?? 2007 Elsevier B.V. All

47 CFR 32.2441 - Conduit systems.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Conduit systems. 32.2441 Section 32.2441 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts § 32.2441 Conduit systems. (a...

Artificial urinary conduit construction using tissue engineering methods.

Science.gov (United States)

Kloskowski, Tomasz; Pokrywczyńska, Marta; Drewa, Tomasz

2015-01-01

Incontinent urinary diversion using an ileal conduit is the most popular method used by urologists after bladder cystectomy resulting from muscle invasive bladder cancer. The use of gastrointestinal tissue is related to a series of complications with the necessity of surgical procedure extension which increases the time of surgery. Regenerative medicine together with tissue engineering techniques gives hope for artificial urinary conduit construction de novo without affecting the ileum. In this review we analyzed history of urinary diversion together with current attempts in urinary conduit construction using tissue engineering methods. Based on literature and our own experience we presented future perspectives related to the artificial urinary conduit construction. A small number of papers in the field of tissue engineered urinary conduit construction indicates that this topic requires more attention. Three main factors can be distinguished to resolve this topic: proper scaffold construction along with proper regeneration of both the urothelium and smooth muscle layers. Artificial urinary conduit has a great chance to become the first commercially available product in urology constructed by regenerative medicine methods.

Flexible cryogenic conduit

International Nuclear Information System (INIS)

Brindza, P.D.; Wines, R.R.; Takacs, J.J.

1999-01-01

A flexible and relatively low cost cryogenic conduit is described. The flexible cryogenic conduit of the present invention comprises a first inner corrugated tube with single braided serving, a second outer corrugated tube with single braided serving concentric with the inner corrugated tube, and arranged outwardly about the periphery of the inner corrugated tube and between the inner and outer corrugated tubes: a superinsulation layer; a one half lap layer of polyester ribbon; a one half lap layer of copper ribbon; a spirally wound refrigeration tube; a second one half lap layer of copper ribbon; a second one half lap layer of polyester ribbon; a second superinsulation layer; a third one half lap layer of polyester ribbon; and a spirally wound stretchable and compressible filament

Conduit for regeneration of biological material

DEFF Research Database (Denmark)

2016-01-01

The present invention relates to a conduit comprising a first material, having 1) a through-going hole, 2) fibers aligned along the long-axis in the through-going hole, each fiber having a diameter in the range 200-2000 nm. The conduit is preferably for regeneration of biological material, even...

Drill pipes and casings utilizing multi-conduit tubular; Flerkanals roerstreng

Energy Technology Data Exchange (ETDEWEB)

Curlett, H.B.

1997-04-23

The invention relates to a multi-conduit tubular having fluid conduits and electrical conduits, with associated surface fluid and electrical commutators, and downhole sensors for providing surface monitors with instantaneous formation data. Each tubular includes a plurality of uniform linear conduits there through, with a gasket seal plate interposed between joined tubular for assuring a high pressure seal between joined conduits. the seal plate includes an intermediate electrical connector for connecting electrical conduit connectors of one tubular to another. A coupling collar with uniform diameter internal coarse and fine threads joins the tubular ends having similar threads by differential thread action without respective tubular rotation. Each tubular end includes an inter-engaging index recess and index lug, and drive recesses and lugs for maintaining angular registry of the tubular string and for driving one drill tubular with another. A fluid commutator includes a rotating shaft with passages connected to the tubular conduits, and rotating in a manifold having annular grooves in communication with the shaft passages and external fluid sources. An adaptor couples each commutator shaft passage to one or more tubular conduits. Slip rings on a quill shaft and stationary brush means provide electrical continuity from the electrical conduit wires to surface equipment. A cross-over sub includes formation parameter sensors and telemetry equipment in a blocked off portion of a fluid conduit. An annular accumulator connected with the well bore annulus applies a pressure thereto in response to downhole sensors to change the effective density of the drill mud. The multi-conduit tubular is further adapted for use as a well casing to provide downhole access of a plurality of fluids and electrical parameter sensors. 28 figs.

Water Flow in Karst Aquifer Considering Dynamically Variable Saturation Conduit

Science.gov (United States)

Tan, Chaoqun; Hu, Bill X.

2017-04-01

The karst system is generally conceptualized as dual-porosity system, which is characterized by low conductivity and high storage continuum matrix and high conductivity and quick flow conduit networks. And so far, a common numerical model for simulating flow in karst aquifer is MODFLOW2005-CFP, which is released by USGS in 2008. However, the steady-state approach for conduit flow in CFP is physically impractical when simulating very dynamic hydraulics with variable saturation conduit. So, we adopt the method proposed by Reimann et al. (2011) to improve current model, in which Saint-Venant equations are used to model the flow in conduit. Considering the actual background that the conduit is very big and varies along flow path and the Dirichlet boundary varies with rainfall in our study area in Southwest China, we further investigate the influence of conduit diameter and outflow boundary on numerical model. And we also analyze the hydraulic process in multi-precipitation events. We find that the numerical model here corresponds well with CFP for saturated conduit, and it could depict the interaction between matrix and conduit during very dynamic hydraulics pretty well compare with CFP.

3D-engineering of Cellularized Conduits for Peripheral Nerve Regeneration

Science.gov (United States)

Hu, Yu; Wu, Yao; Gou, Zhiyuan; Tao, Jie; Zhang, Jiumeng; Liu, Qianqi; Kang, Tianyi; Jiang, Shu; Huang, Siqing; He, Jiankang; Chen, Shaochen; Du, Yanan; Gou, Maling

2016-08-01

Tissue engineered conduits have great promise for bridging peripheral nerve defects by providing physical guiding and biological cues. A flexible method for integrating support cells into a conduit with desired architectures is wanted. Here, a 3D-printing technology is adopted to prepare a bio-conduit with designer structures for peripheral nerve regeneration. This bio-conduit is consisted of a cryopolymerized gelatin methacryloyl (cryoGelMA) gel cellularized with adipose-derived stem cells (ASCs). By modeling using 3D-printed “lock and key” moulds, the cryoGelMA gel is structured into conduits with different geometries, such as the designed multichannel or bifurcating and the personalized structures. The cryoGelMA conduit is degradable and could be completely degraded in 2-4 months in vivo. The cryoGelMA scaffold supports the attachment, proliferation and survival of the seeded ASCs, and up-regulates the expression of their neurotrophic factors mRNA in vitro. After implanted in a rat model, the bio-conduit is capable of supporting the re-innervation across a 10 mm sciatic nerve gap, with results close to that of the autografts in terms of functional and histological assessments. The study describes an indirect 3D-printing technology for fabricating cellularized designer conduits for peripheral nerve regeneration, and could lead to the development of future nerve bio-conduits for clinical use.

Geometry and Hydraulics of Englacial Conduits, Storglaciaren, Sweden

Science.gov (United States)

Fountain, A. G.; Schlichting, R.; Frodin, S.; Jacobel, R. W.

2001-12-01

Englacial conduits are the primary structure responsible for transporting surface water to the base of a glacier, where it supplies the subglacial hydraulic system and, in turn, affects glacier movement. Despite the well-known theoretical descriptions of englacial conduits, little direct evidence exists about their geometry and hydraulics. In July 2001, we initiated a field effort on Storglaciären, Sweden, to intersect englacial conduits by drilling into the glacier using a hot water drill. A companion project (Jacobel et al., this session) attempted to detect the englacial conduits using ground-penetrating radar. In a typical borehole, the water level remained at the surface while drilling through the impermeable ice. Once a connection was made, the water level dropped roughly 10 m and remained low despite continued water pumping. A small video camera was lowered, with attachments, to measure the geometry of the opening, and water flow speed. The water level in the hole provided a piezometric measure of the pressure. We drilled 22 holes at 3 separate locations and 17 (77%) connected englacially, the remaining 5 reached the bed without englacial connection, of which 2 drained at the bed. The geometry of the connections was highly irregular in cross-section with 1-2 cm openings, reminiscent of crevasse-like features rather than circular cross-sections as anticipated from the theoretical literature. Flow behavior was observed by tracking particle motion. The flow was complicated, in part by the inferred tangential intersection between the borehole and structure, and by the observed surging behavior. Flow speeds were low, on the order of 1 cm sec-1. Water level records from 3 different holes over several days exhibited highly correlated variations and large diurnal excursions. In contrast, records from holes drilled to the bed showed little variation. Based on these measurements, our conceptual picture of the englacial system is that of a sluggish flow system

In vitro evaluation of carbon-nanotube-reinforced bioprintable vascular conduits

International Nuclear Information System (INIS)

Dolati, Farzaneh; Yu, Yin; Zhang, Yahui; Ozbolat, Ibrahim T; Jesus, Aribet M De; Sander, Edward A

2014-01-01

Vascularization of thick engineered tissue and organ constructs like the heart, liver, pancreas or kidney remains a major challenge in tissue engineering. Vascularization is needed to supply oxygen and nutrients and remove waste in living tissues and organs through a network that should possess high perfusion ability and significant mechanical strength and elasticity. In this paper, we introduce a fabrication process to print vascular conduits directly, where conduits were reinforced with carbon nanotubes (CNTs) to enhance their mechanical properties and bioprintability. In vitro evaluation of printed conduits encapsulated in human coronary artery smooth muscle cells was performed to characterize the effects of CNT reinforcement on the mechanical, perfusion and biological performance of the conduits. Perfusion and permeability, cell viability, extracellular matrix formation and tissue histology were assessed and discussed, and it was concluded that CNT-reinforced vascular conduits provided a foundation for mechanically appealing constructs where CNTs could be replaced with natural protein nanofibers for further integration of these conduits in large-scale tissue fabrication. (paper)

In Vitro Study of Directly Bioprinted Perfusable Vasculature Conduits.

Science.gov (United States)

Zhang, Yahui; Yu, Yin; Akkouch, Adil; Dababneh, Amer; Dolati, Farzaneh; Ozbolat, Ibrahim T

2015-01-01

The ability to create three dimensional (3D) thick tissues is still a major tissue engineering challenge. It requires the development of a suitable vascular supply for an efficient media exchange. An integrated vasculature network is particularly needed when building thick functional tissues and/or organs with high metabolic activities, such as the heart, liver and pancreas. In this work, human umbilical vein smooth muscle cells (HUVSMCs) were encapsulated in sodium alginate and printed in the form of vasculature conduits using a coaxial deposition system. Detailed investigations were performed to understand the dehydration, swelling and degradation characteristics of printed conduits. In addition, because perfusional, permeable and mechanical properties are unique characteristics of natural blood vessels, for printed conduits these properties were also explored in this work. The results show that cells encapsulated in conduits had good proliferation activities and that their viability increased during prolonged in vitro culture. Deposition of smooth muscle matrix and collagen was observed around the peripheral and luminal surface in long-term cultured cellular vascular conduit through histology studies.

Pumped Storage and Potential Hydropower from Conduits

Energy Technology Data Exchange (ETDEWEB)

none,

2015-02-25

Th is Congressional Report, Pumped Storage Hydropower and Potential Hydropower from Conduits, addresses the technical flexibility that existing pumped storage facilities can provide to support intermittent renewable energy generation. This study considered potential upgrades or retrofit of these facilities, the technical potential of existing and new pumped storage facilities to provide grid reliability benefits, and the range of conduit hydropower opportunities available in the United States.

Engineering a multimodal nerve conduit for repair of injured peripheral nerve

Science.gov (United States)

Quigley, A. F.; Bulluss, K. J.; Kyratzis, I. L. B.; Gilmore, K.; Mysore, T.; Schirmer, K. S. U.; Kennedy, E. L.; O'Shea, M.; Truong, Y. B.; Edwards, S. L.; Peeters, G.; Herwig, P.; Razal, J. M.; Campbell, T. E.; Lowes, K. N.; Higgins, M. J.; Moulton, S. E.; Murphy, M. A.; Cook, M. J.; Clark, G. M.; Wallace, G. G.; Kapsa, R. M. I.

2013-02-01

Injury to nerve tissue in the peripheral nervous system (PNS) results in long-term impairment of limb function, dysaesthesia and pain, often with associated psychological effects. Whilst minor injuries can be left to regenerate without intervention and short gaps up to 2 cm can be sutured, larger or more severe injuries commonly require autogenous nerve grafts harvested from elsewhere in the body (usually sensory nerves). Functional recovery is often suboptimal and associated with loss of sensation from the tissue innervated by the harvested nerve. The challenges that persist with nerve repair have resulted in development of nerve guides or conduits from non-neural biological tissues and various polymers to improve the prognosis for the repair of damaged nerves in the PNS. This study describes the design and fabrication of a multimodal controlled pore size nerve regeneration conduit using polylactic acid (PLA) and (PLA):poly(lactic-co-glycolic) acid (PLGA) fibers within a neurotrophin-enriched alginate hydrogel. The nerve repair conduit design consists of two types of PLGA fibers selected specifically for promotion of axonal outgrowth and Schwann cell growth (75:25 for axons; 85:15 for Schwann cells). These aligned fibers are contained within the lumen of a knitted PLA sheath coated with electrospun PLA nanofibers to control pore size. The PLGA guidance fibers within the nerve repair conduit lumen are supported within an alginate hydrogel impregnated with neurotrophic factors (NT-3 or BDNF with LIF, SMDF and MGF-1) to provide neuroprotection, stimulation of axonal growth and Schwann cell migration. The conduit was used to promote repair of transected sciatic nerve in rats over a period of 4 weeks. Over this period, it was observed that over-grooming and self-mutilation (autotomy) of the limb implanted with the conduit was significantly reduced in rats implanted with the full-configuration conduit compared to rats implanted with conduits containing only an alginate

Degradation properties of the electrostatic assembly PDLLA/CS/CHS nerve conduit

Energy Technology Data Exchange (ETDEWEB)

Xu Haixing [School of Chemical Engineering, Wuhan University of Technology, Wuhan 430070 (China); Yan Yuhua; Wan Tao; Li Shipu, E-mail: yanyuhua8@126.co [Biomedical Materials and Engineering Research Center, Wuhan University of Technology, Wuhan 430070 (China)

2009-08-15

A poly(d,l-lactic acid)/chondroitin sulfate/chitosan (PDLLA/CS/CHS) nerve conduit for repairing nerve defects was prepared by electrostatic assembly and the thermally induced phase separation technique. The hydrophilic characteristics of the PDLLA/CS/CHS assembly nerve conduits were improved markedly. The degradation behavior of the nerve conduit with various assembly layers was evaluated by a pH change, weight loss rate and molecular weight change. The pH of the solution of the nerve conduit could be effectively adjusted by varying the layer numbers and overcoming the acidity-caused auto-acceleration of PDLLA; the nerve conduit can retain its integrity in a phosphate buffer solution after being degraded for 3 months. After such a conduit was implanted in the rat for 3 months, obvious degradation occurred, but the regenerated nerve was integrated and it grew successfully from the proximal to distal nerve stump. All these results implied that the degradation rate of the prepared conduit can adapt to the regeneration of the peripheral nerve, which might be a new derivative of PDLLA-based biodegradable materials for repairing nerve injuries without acidity-caused irritations and acidity-induced auto-accelerating degradation behavior as shown by PDLLA.

Opportunities for Energy Development in Water Conduits: A Report Prepared in Response to Section 7 of the Hydropower Regulatory Efficiency Act of 2013

Energy Technology Data Exchange (ETDEWEB)

Sale, Michael J. [BCS, Incorporated, Laurel, MD (United States); Bishop, Norman A. [Knight Piesold, Chicago, IL (United States); Reiser, Sonya L. [Knight Piesold, Chicago, IL (United States); Johnson, Kurt [Telluride Energy LLC, Grand Junction, CO (United States); Bailey, Andrea C. [BCS, Incorporated, Laurel, MD (United States); Frank, Anthony [BCS, Incorporated, Laurel, MD (United States); Smith, Brennan T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Environmental Sciences Division

2014-09-01

In Section 7 of the Hydropower Regulatory Efficiency Act (HREA) of 2013 (P.L. 113-23), Congress directed the U.S. Department of Energy (DOE) to prepare an analysis of conduit hydropower opportunities available in the United States and to present case studies that describe the potential energy generation from these types of hydropower projects. Those analyses have been included in a new DOE report to Congress, and this ORNL/TM provides additional technical details supporting that report. Conduit hydropower offers important new ways to enhance renewable energy portfolios in the United States, as well as to increase the energy efficiency of water delivery systems. Conduit hydropower projects are constructed on existing water-conveyance structures, such as irrigation canals or pressurized pipelines that deliver water to municipalities, industry, or agricultural water users. Although water conveyance infrastructures are usually designed for non-power purposes, new renewable energy can often be harvested from them without affecting their original purpose and without the need to construct new dams or diversions. Conduit hydropower differs from more conventional hydropower development in that it is generally not located on natural rivers or waterways and therefore does not involve the types of environmental impacts that are associated with hydropower. The addition of hydropower to existing water conduits can provide valuable new revenue sources from clean, renewable energy. The new energy can be used within the existing water distribution systems to offset other energy demands, or it can be sold into regional transmission systems.

Extreme loads seismic testing of conduit systems

International Nuclear Information System (INIS)

Howard, G.E.; Ibanez, P.; Harrison, S.; Shi, Z.T.

1991-01-01

Rigid steel conduit (thin-wall tubes with threaded connections) containing electrical cabling are a common feature in nuclear power plants. Conduit systems are in many cases classified in U.S.A. practice as Seismic Category I structures. this paper summarizes results and others aspects of a dynamic test program conducted to investigate conduit systems seismic performance under three-axis excitation for designs representative at a nuclear power plant sited near Ft. Worth, Texas (a moderate seismic zone), with a Safe Shutdown Earthquake (SSE) of 0.12 g. Test specimens where subjected to postulated seismic events, including excitation well in excess of Safe Shutdown Earthquake events typical for U.S.A. nuclear power stations. A total of 18 conduit systems of 9-meter nominal lengths were shake table mounted and subjected to a variety of tests. None of the specimens suffered loss of load capacity when subjected to a site-enveloping Safe Shutdown Earthquake (SSE). Clamp/attachment hardware failures only began to occur when earthquake input motion was scaled upward to minimum values of 2.3-4.6 times site enveloping SSE response spectra. Tensile and/or shear failure of clamp attachment bolts or studs was the failure mode in all case in which failure was induced. (author)

LOAD ON BURIED PRESSURE CONDUITS WITH REFERENCE TO ...

African Journals Online (AJOL)

width of conduit or trench; the shearing forces on the plane between the backfill and adjacent earth; for embankment condition, the amounL of relative settlement between the backfill and adjacent earth; the rigidity of the conduit support under embankment loading. Table 3. Selected values of c'' for use in Eq. 8. Sand and.

Autologous alternative veins may not provide better outcomes than prosthetic conduits for below-knee bypass when great saphenous vein is unavailable.

Science.gov (United States)

Avgerinos, Efthymios D; Sachdev, Ulka; Naddaf, Abdallah; Doucet, Dannielle R; Mohapatra, Abhisekh; Leers, Steven A; Chaer, Rabih A; Makaroun, Michel S

2015-08-01

There is a need to better define the role of alternative autologous vein (AAV) segments over contemporary prosthetic conduits in patients with critical limb ischemia when great saphenous vein (GSV) is not available for use as the bypass conduit. Consecutive patients who underwent bypass to infrageniculate targets between 2007 and 2011 were categorized in three groups: GSV, AAV, and prosthetic. The primary outcome was graft patency. The secondary outcome was limb salvage. Cox proportional hazards regression was used to adjust for baseline confounding variables. A total of 407 infrainguinal bypasses to below-knee targets were analyzed; 255 patients (63%) received a single-segment GSV, 106 patients (26%) received an AAV, and 46 patients (11%) received a prosthetic conduit. Baseline characteristics were similar among groups, with the exception of popliteal targets and anticoagulation use being more frequent in the prosthetic group. Primary patency at 2 and 5 years was estimated at 47% and 32%, respectively, for the GSV group; 24% and 23% for the AAV group; and 43% and 38% for the prosthetic group. Primary assisted patency at 2 and 5 years was estimated at 71% and 55%, respectively, for the GSV group; 53% and 51% for the AAV group; and 45% and 40% for the prosthetic group. Secondary patency at 2 and 5 years was estimated at 75% and 60%, respectively, for the GSV group; 57% and 55% for the AAV group; and 46% and 41% for the prosthetic group. In Cox analysis, primary patency (hazard ratio [HR], 0.55; P < .001; 95% confidence interval [CI], 0.404-0.758), primary assisted patency (HR, 0.57; P = .004; 95% CI, 0.388-0.831), and secondary patency (HR, 0.56; P = .005; 95% CI, 0.372-0.840) were predicted by GSV compared with AAV, but there was no difference between AAV and prosthetic grafts except for the primary patency, for which prosthetic was protective (HR, 0.38; P < .001; 95% CI, 0.224-0.629). Limb salvage was similar among groups. AAV conduits may not offer a significant

Small-sized conduits in the right ventricular outflow tract in young children: bicuspidalized homografts are a good alternative to standard conduits.

Science.gov (United States)

François, Katrien; De Groote, Katya; Vandekerckhove, Kristof; De Wilde, Hans; De Wolf, Daniel; Bové, Thierry

2017-10-03

Downsizing a homograft (HG) through bicuspidalization has been used for more than 2 decades to overcome the shortage of small-sized conduits for reconstruction of the right ventricular outflow tract (RVOT) in young children. Our goal was to investigate the durability of bicuspidalized HGs compared with other small HGs. A retrospective analysis of 93 conduits ≤20 mm, implanted over 23 years, was performed. The end-points were survival, structural valve degeneration and conduit replacement. The conduits comprised 40 pulmonary HGs, 12 aortic HGs, 17 bicuspidalized HGs and 24 xenografts. The median age, mean conduit diameter and z-value at implantation were 1.4 (interquartile range 0.3-3) years, 16.5 ± 2.7 mm and 2.8 ± 1.3, respectively. Valve position was heterotopic in 59 patients and orthotopic in 34 patients. At a mean follow-up period of 7.6 ± 5.9 years, the hospital survival rate was 89%. Freedom from explant at 5 and 10 years was 83 ± 5% and 52 ± 6%, respectively. Freedom from structural valve degeneration was 79 ± 5% at 5 years and 47 ± 6% at 10 years [68 ± 8% for pulmonary HG, 42 ± 16% for bicuspidalized HG, 31 ± 15% for aortic HG and 20 ± 9% for xenografts (log rank P right ventricular outflow tract conduit in young children. However, when a small pulmonary HG is unavailable, bicuspidalization offers a valid alternative, preferable to xenograft conduits, at mid-term follow-up. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

The Malnutrition-Related Increase in Early Visceralization of Leishmania donovani Is Associated with a Reduced Number of Lymph Node Phagocytes and Altered Conduit System Flow

Science.gov (United States)

Ibrahim, Marwa K.; Barnes, Jeffrey L.; Anstead, Gregory M.; Jimenez, Fabio; Travi, Bruno L.; Peniche, Alex G.; Osorio, E. Yaneth; Ahuja, Seema S.; Melby, Peter C.

2013-01-01

In a murine model of moderate childhood malnutrition we found that polynutrient deficiency led to a 4–5-fold increase in early visceralization of L. donovani (3 days post-infection) following cutaneous infection and a 16-fold decrease in lymph node barrier function (pmalnutrition-related parasite dissemination we analyzed the cellularity, architecture, and function of the skin-draining lymph node. There was no difference in the localization of multiple cell populations in the lymph node of polynutrient deficient (PND) mice, but there was reduced cellularity with fewer CD11c+dendritic cells (DCs), fibroblastic reticular cells (FRCs), MOMA-2+ macrophages, and CD169+ subcapsular sinus macrophage (p<0.05 for all) compared to the well-nourished (WN) mice. The parasites were equally co-localized with DCs associated with the lymph node conduit network in the WN and PND mice, and were found in the high endothelial venule into which the conduits drain. When a fluorescent low molecular weight (10 kD) dextran was delivered in the skin, there was greater efflux of the marker from the lymph node conduit system to the spleens of PND mice (p<0.04), indicating that flow through the conduit system was altered. There was no evidence of disruption of the conduit or subcapsular sinus architecture, indicating that the movement of parasites into the subcortical conduit region was due to an active process and not from passive movement through a leaking barrier. These results indicate that the impaired capacity of the lymph node to act as a barrier to dissemination of L. donovani infection is associated with a reduced number of lymph node phagocytes, which most likely leads to reduced capture of parasites as they transit through the sinuses and conduit system. PMID:23967356

Twenty years of cable-in-conduit conductors: 1975-1995

International Nuclear Information System (INIS)

Dresner, L.

1995-01-01

This paper reviews our progress during the last two decades in understanding cable-in-conduit conductors. The emphasis is on the physical principles governing the behavior of cable-in-conduit conductors, and no detailed mathematics is presented. The paper is constructed as a historical narrative

Short-term outcomes after incontinent conduit for gynecologic cancer: comparison of ileal, sigmoid, and transverse colon.

Science.gov (United States)

Tabbaa, Zaid M; Janco, Jo Marie T; Mariani, Andrea; Dowdy, Sean C; McGree, Michaela E; Weaver, Amy L; Cliby, William A

2014-06-01

The aim of this study is to estimate the overall rates of significant incontinent conduit-related complications and compare rates between conduit types. This was a retrospective review of 166 patients who underwent incontinent urinary diversion from April 1993 through April 2013. Patients were categorized by conduit type-ileal, sigmoid colon, and transverse colon. Significant conduit-related complications were assessed at 30 and 90days after surgery. Significant conduit-related complication was defined as any of the following: ureteral stricture, conduit leak, conduit obstruction, conduit ischemia, ureteral anastomotic leak, stent obstruction requiring intervention via interventional radiology procedure or reoperation, and renal failure. A total of 166 patients underwent formation of an incontinent urinary conduit, most commonly during exenteration for gynecologic malignancy. There were 129 ileal, 11 transverse colon, and 26 sigmoid conduits. The overall significant conduit-related complication rate within 30days was 15.1%. Complication rates for ileal, transverse and sigmoid conduits were 14.7%, 0%, and 23.1%, respectively (Fisher's exact test, p=0.24). By 90days, the Kaplan-Meier estimated rates of significant complications were 21.8% overall, and 22.3%, 0%, and 28.9%, respectively, by conduit type (log-rank test, p=0.19). The most common significant conduit-related complications were conduit or ureteral anastomotic leaks and conduit obstructions. By 1 and 2years following surgery, the Kaplan-Meier estimated overall rate of significant conduit-related complication increased to 26.5% and 30.1%, respectively. Our study suggests that there are multiple appropriate tissue sites for use in incontinent conduit formation, and surgical approach should be individualized. Most significant conduit-related complications occur within 90days after surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Novel technique for airless connection of artificial heart to vascular conduits.

Science.gov (United States)

Karimov, Jamshid H; Gao, Shengqiang; Dessoffy, Raymond; Sunagawa, Gengo; Sinkewich, Martin; Grady, Patrick; Sale, Shiva; Moazami, Nader; Fukamachi, Kiyotaka

2017-12-01

Successful implantation of a total artificial heart relies on multiple standardized procedures, primarily the resection of the native heart, and exacting preparation of the atrial and vascular conduits for pump implant and activation. Achieving secure pump connections to inflow/outflow conduits is critical to a successful outcome. During the connection process, however, air may be introduced into the circulation, traveling to the brain and multiple organs. Such air emboli block blood flow to these areas and are detrimental to long-term survival. A correctly managed pump-to-conduit connection prevents air from collecting in the pump and conduits. To further optimize pump-connection techniques, we have developed a novel connecting sleeve that enables airless connection of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) to the conduits. In this brief report, we describe the connecting sleeve design and our initial results from two acute in vivo implantations using a scaled-down version of the CFTAH.

Generation of Complex Karstic Conduit Networks with a Hydro-chemical Model

Science.gov (United States)

De Rooij, R.; Graham, W. D.

2016-12-01

The discrete-continuum approach is very well suited to simulate flow and solute transport within karst aquifers. Using this approach, discrete one-dimensional conduits are embedded within a three-dimensional continuum representative of the porous limestone matrix. Typically, however, little is known about the geometry of the karstic conduit network. As such the discrete-continuum approach is rarely used for practical applications. It may be argued, however, that the uncertainty associated with the geometry of the network could be handled by modeling an ensemble of possible karst conduit networks within a stochastic framework. We propose to generate stochastically realistic karst conduit networks by simulating the widening of conduits as caused by the dissolution of limestone over geological relevant timescales. We illustrate that advanced numerical techniques permit to solve the non-linear and coupled hydro-chemical processes efficiently, such that relatively large and complex networks can be generated in acceptable time frames. Instead of specifying flow boundary conditions on conduit cells to recharge the network as is typically done in classical speleogenesis models, we specify an effective rainfall rate over the land surface and let model physics determine the amount of water entering the network. This is advantageous since the amount of water entering the network is extremely difficult to reconstruct, whereas the effective rainfall rate may be quantified using paleoclimatic data. Furthermore, we show that poorly known flow conditions may be constrained by requiring a realistic flow field. Using our speleogenesis model we have investigated factors that influence the geometry of simulated conduit networks. We illustrate that our model generates typical branchwork, network and anastomotic conduit systems. Flow, solute transport and water ages in karst aquifers are simulated using a few illustrative networks.

A polymer foam conduit seeded with Schwann cells promotes guided peripheral nerve regeneration.

Science.gov (United States)

Hadlock, T; Sundback, C; Hunter, D; Cheney, M; Vacanti, J P

2000-04-01

Alternatives to autografts have long been sought for use in bridging neural gaps. Many entubulation materials have been studied, although with generally disappointing results in comparison with autografts. The purpose of this study was to design a more effective neural guidance conduit, to introduce Schwann cells into the conduit, and to determine regenerative capability through it in an in vivo model. A novel, fully biodegradable polymer conduit was designed and fabricated for use in peripheral nerve repair, which approximates the macro- and microarchitecture of native peripheral nerves. It comprised a series of longitudinally aligned channels, with diameters ranging from 60 to 550 microns. The lumenal surfaces promoted the adherence of Schwann cells, whose presence is known to play a key role in nerve regeneration. This unique channel architecture increased the surface area available for Schwann cell adherence up to five-fold over that available through a simple hollow conduit. The conduit was composed of a high-molecular-weight copolymer of lactic and glycolic acids (PLGA) (MW 130,000) in an 85:15 monomer ratio. A novel foam-processing technique, employing low-pressure injection molding, was used to create highly porous conduits (approximately 90% pore volume) with continuous longitudinal channels. Using this technique, conduits were constructed containing 1, 5, 16, 45, or more longitudinally aligned channels. Prior to cellular seeding of these conduits, the foams were prewet with 50% ethanol, flushed with physiologic saline, and coated with laminin solution (10 microg/mL). A Schwann cell suspension was dynamically introduced into these processed foams at a concentration of 5 X 10(5) cells/mL, using a simple bioreactor flow loop. In vivo regeneration studies were carried out in which cell-laden five-channel polymer conduits (individual channel ID 500 microm, total conduit OD 2.3 mm) were implanted across a 7-mm gap in the rat sciatic nerve (n = 4), and midgraft

Reverse Saphenous Conduit Flap in 19 Dogs and 1 Cat.

Science.gov (United States)

Cavalcanti, Jacqueline V J; Barry, Sabrina L; Lanz, Otto I; Barnes, Katherine; Coutin, Julia V

2018-05-14

The purpose of this retrospective study was to report the outcomes of 19 dogs and 1 cat undergoing reverse saphenous conduit flap between 1999 and 2016. Reverse saphenous conduit flap was used to treat traumatic wounds and wounds resulting from tumor excision in the hind limb; the majority of cases had medial shearing injuries. All animals had complete flap survival. In five animals (20%), minor donor site dehiscence occurred, which did not require surgery. Other postoperative complications included signs of severe venous congestion in one dog. Reverse saphenous conduit flap is a useful technique to repair skin defects of the distal hind limb.

Silk fibroin enhances peripheral nerve regeneration by improving vascularization within nerve conduits.

Science.gov (United States)

Wang, Chunyang; Jia, Yachao; Yang, Weichao; Zhang, Cheng; Zhang, Kuihua; Chai, Yimin

2018-07-01

Silk fibroin (SF)-based nerve conduits have been widely used to bridge peripheral nerve defects. Our previous study showed that nerve regeneration in a SF-blended poly (l-lactide-co-ɛ-caprolactone) [P(LLA-CL)] nerve conduit is better than that in a P(LLA-CL) conduit. However, the involved mechanisms remain unclarified. Because angiogenesis within a nerve conduit plays an important role in nerve regeneration, vascularization of SF/P(LLA-CL) and P(LLA-CL) conduits was compared both in vitro and in vivo. In the present study, we observed that SF/P(LLA-CL) nanofibers significantly promoted fibroblast proliferation, and vascular endothelial growth factor secreted by fibroblasts seeded in SF/P(LLA-CL) nanofibers was more than seven-fold higher than that in P(LLA-CL) nanofibers. Conditioned medium of fibroblasts in the SF/P(LLA-CL) group stimulated more human umbilical vein endothelial cells (HUVEC) to form capillary-like networks and promoted faster HUVEC migration. The two kinds of nerve conduits were used to bridge 10-mm-length nerve defects in rats. At 3 weeks of reparation, the blood vessel area in the SF/P(LLA-CL) group was significantly larger than that in the P(LLA-CL) group. More regenerated axons and Schwann cells were also observed in the SF/P(LLA-CL) group, which was consistent with the results of blood vessels. Collectively, our data revealed that the SF/P(LLA-CL) nerve conduit enhances peripheral nerve regeneration by improving angiogenesis within the conduit. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 2070-2077, 2018. © 2018 Wiley Periodicals, Inc.

Regenerative potential of silk conduits in repair of peripheral nerve injury in adult rats.

Science.gov (United States)

Huang, W; Begum, R; Barber, T; Ibba, V; Tee, N C H; Hussain, M; Arastoo, M; Yang, Q; Robson, L G; Lesage, S; Gheysens, T; Skaer, Nicholas J V; Knight, D P; Priestley, J V

2012-01-01

Various attempts have been made to develop artificial conduits for nerve repair, but with limited success. We describe here conduits made from Bombyx mori regenerated silk protein, and containing luminal fibres of Spidrex(®), a silk-based biomaterial with properties similar to those of spider silk. Assessment in vitro demonstrated that Spidrex(®) fibres support neurite outgrowth. For evaluation in vivo, silk conduits 10 mm in length and containing 0, 100, 200 or 300 luminal Spidrex(®) fibres, were implanted to bridge an 8 mm gap in the rat sciatic nerve. At 4 weeks, conduits containing 200 luminal Spidrex(®) fibres (PN200) supported 62% and 59% as much axon growth as autologous nerve graft controls at mid-conduit and distal nerve respectively. Furthermore, Spidrex(®) conduits displayed similar Schwann cell support and macrophage response to controls. At 12 weeks, animals implanted with PN200 conduits showed similar numbers of myelinated axons (81%) to controls, similar gastrocnemius muscle innervation, and similar hindpaw stance assessed by Catwalk footprint analysis. Plantar skin innervation was 73% of that of controls. PN200 Spidrex(®) conduits were also effective at bridging longer (11 and 13 mm) gaps. Our results show that Spidrex(®) conduits promote excellent axonal regeneration and function recovery, and may have potential for clinical application. Copyright © 2011 Elsevier Ltd. All rights reserved.

POROSITY OF THE WALL OF A NEUROLAC (R) NERVE CONDUIT HAMPERS NERVE REGENERATION

NARCIS (Netherlands)

Meek, Marcel F.; Den Dunnen, Wilfred F. A.

2009-01-01

One way to improve nerve regeneration and bridge longer nerve gaps may be the use of semipermeable/porous conduits. With porosity less biomaterial is used for the nerve conduit. We evaluated the short-term effects of porous Neurolac (R) nerve conduits for in vivo peripheral nerve regeneration. In 10

Experimental study on scale removal from special-shaped conduits through underwater electrical discharge

International Nuclear Information System (INIS)

Cao, Y; Wang, Z Q; Li, G F; Wu, Y; Zhou, J J

2013-01-01

Underwater electrical discharge technology is an innovative technique that can be used to enhance the stress intensity of water and improve the load addition. The technique enlarges the section area and compresses the surrounding water using a high-powered shock wave, which is induced by an underwater electrical discharge. This paper investigates the effectiveness of scale removal for special-shaped conduits employing underwater electrical discharge. Experimental results show that the pressure wave generated by underwater electrical discharge is capable of eliminating scale in special-shaped conduits. The data indicates that when the capacitance of the parallel-pulsed capacitors was 4 μF, the high pulsed power voltage was 33 kV and the primary discharge gap was 48 mm, the result of scale removal was remarkable. In laboratory tests, the scale of special equipment was removed to a great extent by this method. Because of its effectiveness and low cost, this method improves the practice and extends the lifetime of such equipment, and thus has potential application and economic value.

Frictional melting and stick-slip behavior in volcanic conduits

Science.gov (United States)

Kendrick, Jackie Evan; Lavallee, Yan; Hirose, Takehiro; di Toro, Giulio; Hornby, Adrian Jakob; Hess, Kai-Uwe; Dingwell, Donald Bruce

2013-04-01

Dome-building eruptions have catastrophic potential, with dome collapse leading to devastating pyroclastic flows with almost no precursory warning. During dome growth, the driving forces of the buoyant magma may be superseded by controls along conduit margins; where brittle fracture and sliding can lead to formation of lubricating cataclasite and gouge. Under extreme friction, pseudotachylyte may form at the conduit margin. Understanding the conduit margin processes is vital to understanding the continuation of an eruption and we postulate that pseudotachylyte generation could be the underlying cause of stick-slip motion and associated seismic "drumbeats", which are so commonly observed at dome-building volcanoes. This view is supported by field evidence in the form of pseudotachylytes identified in lava dome products at Soufrière Hills (Montserrat) and Mount St. Helens (USA). Both eruptions were characterised by repetitive, periodic seismicity and lava spine extrusion of highly viscous magma. High velocity rotary shear (HVR) experiments demonstrate the propensity for melting of the andesitic and dacitic material (from Soufrière Hills and Mount St. Helens respectively) at upper conduit stress conditions (HVR experiments which mimic rapid velocity fluctuations in stick-slip behavior demonstrate velocity-weakening behavior of melt, with a tendency for unstable slip. During ascent, magma may slip and undergo melting along the conduit margin. In the process the shear resistance of the slip zone is increased, acting as a viscous brake halting slip (the "stick" of stick-slip motion). Sufficient buoyancy-driven pressures from ascending magma below eventually overcome resistance to produce a rapid slip event (the "slip") along the melt-bearing slip zone, which is temporarily lubricated due to velocity-weakening. New magma below experiences the same slip event more slowly (as the magma decompresses) to produce a viscous brake and the process is repeated. This allows a

Polymeric Nerve Conduits with Contact Guidance Cues Used in Nerve Repair

Institute of Scientific and Technical Information of China (English)

G DAI; X NIU; J YIN

2016-01-01

In the modern life, the nerve injury frequently happens due to mechanical, chemical or thermal accidents. In the trivial injuries, the peripheral nerves can regenerate on their own; however, in most of the cases the clinical treatments are required, where relatively large nerve injury gaps are formed. Currently, the nerve repair can be accomplished by direct suture when the injury gap is not too large;while the autologous nerve graft working as the gold standard of peripheral nerve injury treatment for nerve injuries with larger gaps. However, the direct suture is limited by heavy tension at the suture sites, and the autologous nerve graft also has the drawbacks of donor site morbidity and insufifcient donor tissue. Recently, artiifcial nerve conduits have been developed as an alternative for clinical nerve repair to overcome the limitations associated with the above treatments. In order to further improve the efifciency of nerve conduits, various guidance cues are incorporated, including physical cues, biochemical signals, as well as support cells. First, this paper reviewed the contact guidance cues applied in nerve conduits, such as lumen ifllers, multi-channels and micro-patterns on the inner surface. Then, the paper focused on the polymeric nerve conduits with micro inner grooves. The polymeric nerve conduits were fabricated using the phase inversion-based ifber spinning techniques. The smart spinneret with grooved die was designed in the spinning platform, while different spinning conditions, including flow rates, air-gap distances, and polymer concentrations, were adjusted to investigate the inlfuence of fabrication conditions on the geometry of nerve conduits. The inner groove size in the nerve conduits can be precisely controlled in our hollow ifber spinning process, which can work as the efifcient contact guidance cue for nerve regeneration.

Fabrication and Optimization of Gelatin/ Nano Bioglass Conduits for Peripheral Nerve Regeneration

Directory of Open Access Journals (Sweden)

M. Foroutan Koudehi

2014-07-01

Full Text Available Introduction & Objective: Peripheral nerve injury is common in trauma patients and 4.5% of all soft-tissue injuries are accompanied by defects of peripheral nerve. Peripheral nerve injuries can lead to lifetime loss of function and permanent disfigurement. Designed conduits com-prised of natural and synthetic materials are now widely used in the construction of damaged tissues. The aim of this project was to prepare nanocomposite conduits from gelatin and bioglass for damaged peripheral nerve reconstruction. Materials & Methods: In this experimental study,compound water solution of gelatin and nano bioglass synthesized through sol gel method, was made. After preparing the solution, special mandrels were dipped in solution several times and freeze dried in order to be emptied of wa-ter via sublimation. The conduits had the following dimensions: internal diameter: 1.6 mm, outside diameter: 2.2 mm and length about 12 mm. In order to evaluate the biocompatibility of conduits we used cytotoxicity test by Chinese ovary cells and MTT assay by Miapaca-2 (pancreatic cancer cell line. Results: The prepared nano bioglass and conduits were characterized using transmission elec-tron microscopy, scanning electron microscopy, fourier transformed infrared spectroscopy and X-ray diffraction. Results of biocompatibility test showed no sign of cytotoxicity and cells were found to be attached to the pore walls offered by the conduits. Conclusion: According to the results, nano bioglass conduits could be a good candidate for peripheral nerve regeneration. (Sci J Hamadan Univ Med Sci 2014; 21 (2:152-160

Midterm performance of a novel restorative pulmonary valved conduit: preclinical results

NARCIS (Netherlands)

Soliman, Osama I.; Miyazaki, Yosuke; Abdelghani, Mohammad; Brugmans, Marieke; Witsenburg, Maarten; Onuma, Yoshinobu; Cox, Martijn; Serruys, Patrick W.

2017-01-01

Aims: The Xeltis bioabsorbable pulmonary valved conduit (XPV), designed to guide functional restoration of patients' own tissue, is potentially more durable than current pulmonary bioprosthetic valves/valved conduits. The aim of this study was to assess the haemodynamic performance of the novel XPV

Evaluation of primary care midwifery in The Netherlands: design and rationale of a dynamic cohort study (DELIVER).

Science.gov (United States)

Manniën, Judith; Klomp, Trudy; Wiegers, Therese; Pereboom, Monique; Brug, Johannes; de Jonge, Ank; van der Meijde, Margreeth; Hutton, Eileen; Schellevis, Francois; Spelten, Evelien

2012-03-20

In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. In total, 7685 clients completed at least one questionnaire, 136 midwives and

Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER

Directory of Open Access Journals (Sweden)

Manniën Judith

2012-03-01

Full Text Available Abstract Background In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Methods/Design Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle. These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. Discussion In total, 7685

Treatment of right ventricle to pulmonary artery conduit stenosis in infants with hypoplastic left heart syndrome.

Science.gov (United States)

Münsterer, Andrea; Kasnar-Samprec, Jelena; Hörer, Jürgen; Cleuziou, Julie; Eicken, Andreas; Malcic, Ivan; Lange, Rüdiger; Schreiber, Christian

2013-09-01

To determine the incidence of right ventricle-to-pulmonary artery (RV-PA) conduit stenosis after the Norwood I operation in patients with hypoplastic left heart syndrome (HLHS), and to determine whether the treatment strategy of RV-PA conduit stenosis has an influence on interstage and overall survival. Ninety-six patients had a Norwood operation with RV-PA conduit between 2002 and 2011. Details of reoperations/interventions due to conduit obstruction prior to bidirectional superior cavopulmonary anastomosis (BSCPA) were collected. Overall pre-BSCPA mortality was 17%, early mortality after Norwood, 6%. Early angiography was performed in 34 patients due to desaturation at a median of 8 days after the Norwood operation. Fifteen patients (16%) were diagnosed with RV-PA conduit stenosis that required treatment. The location of the conduit stenosis was significantly different in the patients with non-ringed (proximal) and the patients with ring-enforced conduit (distal), P = 0.004. In 6 patients, a surgical revision of the conduit was performed; 3 of them died prior to BSCPA. Another 6 patients had a stent implantation and 3 were treated with balloon dilatation followed by a BSCPA in the subsequent 2 weeks. All patients who were treated interventionally for RV-PA conduit obstruction had a successful BSCPA. Patients who received a surgical RV-PA conduit revision had a significantly higher interstage (P = 0.044) and overall mortality (P = 0.011) than those who received a stent or balloon dilatation of the stenosis followed by an early BSCPA. RV-PA conduit obstruction after Norwood I procedure in patients with HLHS can be safely and effectively treated by stent implantation, balloon dilatation and early BSCPA. Surgical revision of the RV-PA conduit can be reserved for patients in whom an interventional approach fails, and an early BSCPA is not an option.

Collagen-coated polylactic-glycolic acid (PLGA) seeded with neural-differentiated human mesenchymal stem cells as a potential nerve conduit.

Science.gov (United States)

Sulong, Ahmad Fadzli; Hassan, Nur Hidayah; Hwei, Ng Min; Lokanathan, Yogeswaran; Naicker, Amaramalar Selvi; Abdullah, Shalimar; Yusof, Mohd Reusmaazran; Htwe, Ohnmar; Idrus, Ruszymah Bt Hj; Haflah, Nor Hazla Mohamed

2014-01-01

Autologous nerve grafts to bridge nerve gaps pose various drawbacks. Nerve tissue engineering to promote nerve regeneration using artificial neural conduits has emerged as a promising alternative. To develop an artificial nerve conduit using collagen-coated polylactic-glycolic acid (PLGA) and to analyse the survivability and propagating ability of the neuro-differentiated human mesenchymal stem cells in this conduit. The PLGA conduit was constructed by dip-molding method and coated with collagen by immersing the conduit in collagen bath. The ultra structure of the conduits were examined before they were seeded with neural-differentiated human mesenchymal stem cells (nMSC) and implanted sub-muscularly on nude mice thighs. The non-collagen-coated PLGA conduit seeded with nMSC and non-seeded non-collagen-coated PLGA conduit were also implanted for comparison purposes. The survivability and propagation ability of nMSC was studied by histological and immunohistochemical analysis. The collagen-coated conduits had a smooth inner wall and a highly porous outer wall. Conduits coated with collagen and seeded with nMSCs produced the most number of cells after 3 weeks. The best conduit based on the number of cells contained within it after 3 weeks was the collagen-coated PLGA conduit seeded with neuro-transdifferentiated cells. The collagen-coated PLGA conduit found to be suitable for attachment, survival and proliferation of the nMSC. Minimal cell infiltration was found in the implanted conduits where nearly all of the cells found in the cell seeded conduits are non-mouse origin and have neural cell markers, which exhibit the biocompatibility of the conduits. The collagen-coated PLGA conduit is biocompatible, non-cytotoxic and suitable for use as artificial nerve conduits.

Development of a comprehensive inventory management system for underground fiber optic conduits.

Science.gov (United States)

2013-03-01

Major State Departments of Transportation operate and maintain networks of thousands of miles of conduits, many : carrying fiber optic cables that are vital to State communication systems. These conduits are located alongside or : across highways and...

Documentation of pain care processes does not accurately reflect pain management delivered in primary care.

Science.gov (United States)

Krebs, Erin E; Bair, Matthew J; Carey, Timothy S; Weinberger, Morris

2010-03-01

Researchers and quality improvement advocates sometimes use review of chart-documented pain care processes to assess the quality of pain management. Studies have found that primary care providers frequently fail to document pain assessment and management. To assess documentation of pain care processes in an academic primary care clinic and evaluate the validity of this documentation as a measure of pain care delivered. Prospective observational study. 237 adult patients at a university-affiliated internal medicine clinic who reported any pain in the last week. Immediately after a visit, we asked patients to report the pain treatment they received. Patients completed the Brief Pain Inventory (BPI) to assess pain severity at baseline and 1 month later. We extracted documentation of pain care processes from the medical record and used kappa statistics to assess agreement between documentation and patient report of pain treatment. Using multivariable linear regression, we modeled whether documented or patient-reported pain care predicted change in pain at 1 month. Participants' mean age was 53.7 years, 66% were female, and 74% had chronic pain. Physicians documented pain assessment for 83% of visits. Patients reported receiving pain treatment more often (67%) than was documented by physicians (54%). Agreement between documentation and patient report was moderate for receiving a new pain medication (k = 0.50) and slight for receiving pain management advice (k = 0.13). In multivariable models, documentation of new pain treatment was not associated with change in pain (p = 0.134). In contrast, patient-reported receipt of new pain treatment predicted pain improvement (p = 0.005). Chart documentation underestimated pain care delivered, compared with patient report. Documented pain care processes had no relationship with pain outcomes at 1 month, but patient report of receiving care predicted clinically significant improvement. Chart review measures may not accurately

In vivo visualization of microneedle conduits in human skin using laser scanning microscopy

International Nuclear Information System (INIS)

Bal, S; Kruithof, A C; Bouwstra, J; Liebl, H; Tomerius, M; Lademann, J; Meinke, M

2010-01-01

Solid microneedles enhance the penetration of drugs into the viable skin but little is known about the geometry of the conduits in vivo. Therefore, laser scanning microscopy was used to visualize the conduits of a microneedle system with needles at a length of 300 μm in 6 healthy subjects over a period of time. The model drug, a fluorescent dye was applied before and after piercing. Laser scanning microscopy was evaluated as being an excellent method to monitor the geometry and closure of the conduits over time. The used microneedle system was evaluated as suitable to enhance the transport of model drugs into the viable epidermis without bleeding and a short closure time of the conduits at the skin surface

In vivo visualization of microneedle conduits in human skin using laser scanning microscopy

Science.gov (United States)

Bal, S.; Kruithof, A. C.; Liebl, H.; Tomerius, M.; Bouwstra, J.; Lademann, J.; Meinke, M.

2010-03-01

Solid microneedles enhance the penetration of drugs into the viable skin but little is known about the geometry of the conduits in vivo. Therefore, laser scanning microscopy was used to visualize the conduits of a microneedle system with needles at a length of 300 μm in 6 healthy subjects over a period of time. The model drug, a fluorescent dye was applied before and after piercing. Laser scanning microscopy was evaluated as being an excellent method to monitor the geometry and closure of the conduits over time. The used microneedle system was evaluated as suitable to enhance the transport of model drugs into the viable epidermis without bleeding and a short closure time of the conduits at the skin surface.

Visualization of conduit-matrix conductivity differences in a karst aquifer using time-lapse electrical resistivity

Science.gov (United States)

Meyerhoff, Steven B.; Karaoulis, Marios; Fiebig, Florian; Maxwell, Reed M.; Revil, André; Martin, Jonathan B.; Graham, Wendy D.

2012-12-01

In the karstic upper Floridan aquifer, surface water flows into conduits of the groundwater system and may exchange with water in the aquifer matrix. This exchange has been hypothesized to occur based on differences in discharge at the Santa Fe River Sink-Rise system, north central Florida, but has yet to be visualized using any geophysical techniques. Using electrical resistivity tomography, we conducted a time-lapse study at two locations with mapped conduits connecting the Santa Fe River Sink to the Santa Fe River Rise to study changes of electrical conductivity during times of varying discharge over a six-week period. Our results show conductivity differences between matrix, conduit changes in resistivity occurring through time at the locations of mapped karst conduits, and changes in electrical conductivity during rainfall infiltration. These observations provide insight into time scales and matrix conduit conductivity differences, illustrating how surface water flow recharged to conduits may flow in a groundwater system in a karst aquifer.

Scientific Results of Conduit Drilling in the Unzen Scientific Drilling Project (USDP

Directory of Open Access Journals (Sweden)

Kozo Uto

2005-09-01

Full Text Available Abstract Directional drilling at Unzen Volcano in Japan duringmid of 2004 penetrated the magma conduit and successfullyrecovered samples of the lava dike that is believed to havefed the 1991–1995 eruption. The dike was sampled about1.3 km below the volcano’s summit vent and is intrudedinto a broader conduit zone that is 0.5 km wide. This zoneconsists of multiple older lava dikes and pyroclastic veinsand has cooled to less than 200˚C. The lava dike sample wasunexpectedly altered, suggesting that circulation of hydrothermalfluids rapidly cools the conduit region of even veryactive volcanoes. It is likely that seismic signals monitoredprior to emergence of the lava dome reflected fracturing ofthe country rocks, caused by veining as volatiles escapedpredominantly upward, not outward, from the rising magma.Geophysical and geological investigation of cuttings andcore samples from the conduit and of bore-hole logging datacontinues.

Explosive device of conduit using Ti Ni alloy

Directory of Open Access Journals (Sweden)

A. Yu. Kolobov

2014-01-01

Full Text Available Presently, materials have been developed which are capable at changing temperate to return significant inelastic deformations, exhibit rubber-like elasticity, convert heat into mechanical work, etc. The aggregate of these effects is usually called the shape memory effect.At present a great number of compounds and alloys with a shape memory effect has been known.These are alloys based on titanium nickelide (TiNi, copper-based alloys (Cu-Al, Cu-Sn, Cu-Al-Ni, Cu-Zn-Si, etc., gold and silver (Ag-Cd, Au-Ag-Cd, Au-Cd-Cu, Au-Zn-Cu, etc., manganese (Mn-Cr, Fe-Cu, Mn-Cu-Ni, Mn-Cu-Zr, Mn-Ni, etc., iron (Fe-Mn, Fe-Ni, Fe-Al, etc., and other compounds.The alloys based on titanium nickelide (nitinol are the most widely used.Alloys with shape memory effect find various applications in engineering and medicine, namely connecting devices, actuators, transformable design, multipurpose medical implants, etc.There is a task of breaking fuel conduit during separating the spacecraft from the rocket in space technology.The paper examines the procedure for design calculation of the separating device of conduit with the use of Ti-Ni alloy. This device can be used instead of the pyro-knives.The device contains two semi-rings from Ti-Ni alloy. In the place of break on the conduit an annular radius groove is made.At a temperature of martensite passage the semi-rings undergo deformation and in the strained state are set in the device. With heating to the temperature of the austenitic passage of bushing macro-deformation the energy stored by the nitinol bushing is great enough to break the conduit on the neck.The procedures of design calculation and response time of device are given.

Do accountable care organizations (ACOs) help or hinder primary care physicians' ability to deliver high-quality care?

Science.gov (United States)

Berenson, Robert A; Burton, Rachel A; McGrath, Megan

2016-09-01

Many view advanced primary care models such as the patient-centered medical home as foundational for accountable care organizations (ACOs), but it remains unclear how these two delivery reforms are complementary and how they may produce conflict. The objective of this study was to identify how joining an ACO could help or hinder a primary care practice's efforts to deliver high-quality care. This qualitative study involved interviews with a purposive sample of 32 early adopters of advanced primary care and/or ACO models, drawn from across the U.S. and conducted in mid-2014. Interview notes were coded using qualitative data analysis software, permitting topic-specific queries which were then summarized. Respondents perceived many potential benefits of joining an ACO, including care coordination staff, data analytics, and improved communication with other providers. However, respondents were also concerned about added "bureaucratic" requirements, referral restrictions, and a potential inability to recoup investments in practice improvements. Interviewees generally thought joining an ACO could complement a practice's efforts to deliver high-quality care, yet noted some concerns that could undermine these synergies. Both the advantages and disadvantages of joining an ACO seemed exacerbated for small practices, since they are most likely to benefit from additional resources yet are most likely to chafe under added bureaucratic requirements. Our identification of the potential pros and cons of joining an ACO may help providers identify areas to examine when weighing whether to enter into such an arrangement, and may help ACOs identify potential areas for improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

Free-boundary models of a meltwater conduit

KAUST Repository

Dallaston, Michael C.

2014-08-01

© 2014 AIP Publishing LLC. We analyse the cross-sectional evolution of an englacial meltwater conduit that contracts due to inward creep of the surrounding ice and expands due to melting. Making use of theoretical methods from free-boundary problems in Stokes flow and Hele-Shaw squeeze flow we construct an exact solution to the coupled problem of external viscous creep and internal heating, in which we adopt a Newtonian approximation for ice flow and an idealized uniform heat source in the conduit. This problem provides an interesting variant on standard free-boundary problems, coupling different internal and external problems through the kinematic condition at the interface. The boundary in the exact solution takes the form of an ellipse that may contract or expand (depending on the magnitudes of effective pressure and heating rate) around fixed focal points. Linear stability analysis reveals that without the melting this solution is unstable to perturbations in the shape. Melting can stabilize the interface unless the aspect ratio is too small; in that case, instabilities grow largest at the thin ends of the ellipse. The predictions are corroborated with numerical solutions using boundary integral techniques. Finally, a number of extensions to the idealized model are considered, showing that a contracting circular conduit is unstable to all modes of perturbation if melting occurs at a uniform rate around the boundary, or if the ice is modelled as a shear-thinning fluid.

A novel balloon assisted two-stents telescoping technique for repositioning an embolized stent in the pulmonary conduit.

Science.gov (United States)

Kobayashi, Daisuke; Gowda, Srinath T; Forbes, Thomas J

2014-08-01

A 9-year-old male, with history of pulmonary atresia and ventricular septal defect, status post complete repair with a 16 mm pulmonary homograft in the right ventricular outflow tract (RVOT) underwent 3110 Palmaz stent placement for conduit stenosis. Following deployment the stent embolized proximally into the right ventricle (RV). We undertook the choice of repositioning the embolized stent into the conduit with a transcatheter approach. Using a second venous access, the embolized stent was carefully maneuvered into the proximal part of conduit with an inflated Tyshak balloon catheter. A second Palmaz 4010 stent was deployed in the distal conduit telescoping through the embolized stent. The Tyshak balloon catheter was kept inflated in the RV to stabilize the embolized stent in the proximal conduit until it was successfully latched up against the conduit with the deployment of the overlapping second stent. One year later, he underwent Melody valve implantation in the pre-stented conduit relieving conduit insufficiency. This novel balloon assisted two-stents telescoping technique is a feasible transcatheter option to secure an embolized stent from the RV to the RVOT. © 2014 Wiley Periodicals, Inc.

Free-boundary models of a meltwater conduit

KAUST Repository

Dallaston, Michael C.; Hewitt, Ian J.

2014-01-01

© 2014 AIP Publishing LLC. We analyse the cross-sectional evolution of an englacial meltwater conduit that contracts due to inward creep of the surrounding ice and expands due to melting. Making use of theoretical methods from free-boundary problems

Phase separation phenomena in branching conduits. Topical report Dec 78-Dec 81

International Nuclear Information System (INIS)

Saba, N.; Lahey, R.T. Jr.

1982-03-01

The analysis of Light Water Reactor (LWR) Loss-of-Coolant Accidents (LOCA's) requires that one be able to accurately calculate the two-phase flow splits in complex, branching conduits. The purpose of this study is to provide a general method for calculating the phase separation in a branching conduit. The degree of phase separation of a two-phase (air/water) mixture flowing through a plexiglas tee test section was measured. In addition, flow visualization, using high speed photography, was performed. The experimental design considerations, error analysis and the dependence of the observed phase separation on global parameters, such as inlet quality, mass flux and separation angle, are discussed. The pressure gradients were measured along the various conduits and the differential pressure was obtained at the tee junction by extrapolation. It was found that the degree of phase separation was quite pronounced, with the vapor phase preferentially separating into the branch. Using these data, a physically-based empirical model was developed with which to calculate the phasic distribution of a subsonic two-phase mixture in the downstream branches of a branching conduit

Biocarbon urinary conduit: laboratory experience and clinical applications.

Science.gov (United States)

Kobashi, L I; Raible, D A

1980-07-01

A new urinary conduit utilizing pure vitreous carbon has been used successfully in dogs. Pure carbon appears to be inert with respect to urine and urothelium. Lack of urinary salt encrustation on the exposed surface provides a well-functioning urinary conduit for vesical drainage. Twenty-one vesicostomies were performed in dogs. Careful follow-up and histologic studies of removed specimens were done to establish the biocompatibility of pure carbon. All vesicostomies functioned well. A description of the device, protocol, and results of laboratory experimentation are outlined. The surgical procedure is explained in detail. Results encourage the clinical trial of these devices in humans. Indications include patients with neurogenic vesicla dysfunction and those with total urinary incontinence, both of which require permanent indwelling catheters.

Pulmonary artery reconstruction with a tailor-made bovine pericardial conduit following sleeve resection of a long segmental pulmonary artery for the treatment of lung cancer: technical details of the dog-ear method for adjusting diameter during vascular anastomosis.

Science.gov (United States)

Shimizu, Kimihiro; Nagashima, Toshiteru; Ohtaki, Yoichi; Takahashi, Toru; Mogi, Akira; Kuwano, Hiroyuki

2017-05-01

Sleeve resection of the pulmonary artery (PA) is always required for lung-sparing operations in which half or more of the vessel circumference is infiltrated by the primary tumor or metastatic hilar nodes. Following sleeve resection, conduit reconstruction may be indicated if there is excessive distance between the two vascular stumps, because there is a high degree of tension when repaired by direct anastomosis. We herein present a case of PA reconstruction using a tailor-made bovine pericardial conduit after sleeve resection of PA during lung cancer surgery. The length of resection was longer than 3 cm, and the difference in diameter between the conduit and peripheral PA stump was larger than 0.5 cm. We describe the surgical and oncological merits of a bovine pericardial conduit, and provide details of our reconstruction technique, focusing on adjustment of diameter between the conduit and peripheral PA (dog-ear method).

Uncovering Offshore Financial Centers: Conduits and Sinks in the Global Corporate Ownership Network.

Science.gov (United States)

Garcia-Bernardo, Javier; Fichtner, Jan; Takes, Frank W; Heemskerk, Eelke M

2017-07-24

Multinational corporations use highly complex structures of parents and subsidiaries to organize their operations and ownership. Offshore Financial Centers (OFCs) facilitate these structures through low taxation and lenient regulation, but are increasingly under scrutiny, for instance for enabling tax avoidance. Therefore, the identification of OFC jurisdictions has become a politicized and contested issue. We introduce a novel data-driven approach for identifying OFCs based on the global corporate ownership network, in which over 98 million firms (nodes) are connected through 71 million ownership relations. This granular firm-level network data uniquely allows identifying both sink-OFCs and conduit-OFCs. Sink-OFCs attract and retain foreign capital while conduit-OFCs are attractive intermediate destinations in the routing of international investments and enable the transfer of capital without taxation. We identify 24 sink-OFCs. In addition, a small set of five countries - the Netherlands, the United Kingdom, Ireland, Singapore and Switzerland - canalize the majority of corporate offshore investment as conduit-OFCs. Each conduit jurisdiction is specialized in a geographical area and there is significant specialization based on industrial sectors. Against the idea of OFCs as exotic small islands that cannot be regulated, we show that many sink and conduit-OFCs are highly developed countries.

Impact of a computer-assisted, provider-delivered intervention on sexual risk behaviors in HIV-positive men who have sex with men (MSM) in a primary care setting.

Science.gov (United States)

Bachmann, Laura H; Grimley, Diane M; Gao, Hongjiang; Aban, Inmaculada; Chen, Huey; Raper, James L; Saag, Michael S; Rhodes, Scott D; Hook, Edward W

2013-04-01

Innovative strategies are needed to assist providers with delivering secondary HIV prevention in the primary care setting. This longitudinal HIV clinic-based study conducted from 2004-2007 in a Birmingham, Alabama HIV primary care clinic tested a computer-assisted, provider-delivered intervention designed to increase condom use with oral, anal and vaginal sex, decrease numbers of sexual partners and increase HIV disclosure among HIV-positive men-who-have-sex-with-men (MSM). Significant declines were found for the number of unprotected insertive anal intercourse acts with HIV+ male partners during the intervention period (p = 0.0003) and with HIV-/UK male partners (p = 0.0007), as well as a 47% reduction in the number of male sexual partners within the preceding 6 months compared with baseline (p = 0.0008). These findings confirm and extend prior reports by demonstrating the effectiveness of computer-assisted, provider-delivered messaging to accomplish risk reduction in patients in the HIV primary care setting.

SQUG cable tray and conduit evaluation procedure

International Nuclear Information System (INIS)

Smith, P.D.; Eder, S.J.; Conoscente, J.P.

1990-01-01

Cable tray and conduit systems for electrical cables are a common feature and industrial facilities. They have an excellent performance history in past strong earthquake, even though they are rarely designed for earthquakes. Considerable data have been gathered on their performance in earthquakes and in shake table testing. The data have been used to develop a procedure for the verification of the seismic adequacy of cable tray and conduit systems in operating nuclear plants. The procedure is discussed in this paper. It will result in substantial savings, such as reduced engineering effort, fewer modifications of existing hardware, and simpler documentation, relative to alternate procedures like dynamic analysis of shake table testing. The procedure ensures safety-function in a unique manner since the methodology used to develop it (1) is based on a large body of historical data and (2) uses a relative approach of ensuring that nuclear plant systems will perform at least as well as systems that performed well in past earthquakes. (orig.)

Process evaluation of a technology-delivered screening and brief intervention for substance use in primary care.

Science.gov (United States)

Ondersma, Steven J; Gryczynski, Jan; Mitchell, Shannon Gwin; O'Grady, Kevin E; Schwartz, Robert P

2016-05-01

Psychotherapy process research examines the content of treatment sessions and their association with outcomes in an attempt to better understand the interactions between therapists and clients, and to elucidate mechanisms of behavior change. A similar approach is possible in technology-delivered interventions, which have an interaction process that is always perfectly preserved and rigorously definable. The present study sought to examine the process of participants' interactions with a computer-delivered brief intervention for drug use, from a study comparing computer- and therapist-delivered brief interventions among adults at two primary health care centers in New Mexico. Specifically, we sought to describe the pattern of participants' ( N =178) choices and reactions throughout the computer-delivered brief intervention, and to examine associations between that process and intervention response at 3-month follow-up. Participants were most likely to choose marijuana as the first substance they wished to discuss ( n = 114, 64.0%). Most participants indicated that they had not experienced any problems as a result of their drug use ( n = 108, 60.7%), but nearly a third of these ( n = 32, 29.6%) nevertheless indicated a desire to stop or reduce its use; participants who did report negative consequences were most likely to endorse financial or relationship concerns. However, participant ratings of the importance of change or of the helpfulness of personalized normed feedback were unrelated to changes in substance use frequency. Design of future e-interventions should consider emphasizing possible benefits of quitting rather than the negative consequences of drug use, and-when addressing consequences-should consider focusing on the impacts of substance use on relationship and financial aspects. These findings are an early but important step toward using process evaluation to optimize e-intervention content.

Process evaluation of a technology-delivered screening and brief intervention for substance use in primary care

Directory of Open Access Journals (Sweden)

Steven J. Ondersma

2016-05-01

Full Text Available Psychotherapy process research examines the content of treatment sessions and their association with outcomes in an attempt to better understand the interactions between therapists and clients, and to elucidate mechanisms of behavior change. A similar approach is possible in technology-delivered interventions, which have an interaction process that is always perfectly preserved and rigorously definable. The present study sought to examine the process of participants' interactions with a computer-delivered brief intervention for drug use, from a study comparing computer- and therapist-delivered brief interventions among adults at two primary health care centers in New Mexico. Specifically, we sought to describe the pattern of participants' (N = 178 choices and reactions throughout the computer-delivered brief intervention, and to examine associations between that process and intervention response at 3-month follow-up. Participants were most likely to choose marijuana as the first substance they wished to discuss (n = 114, 64.0%. Most participants indicated that they had not experienced any problems as a result of their drug use (n = 108, 60.7%, but nearly a third of these (n = 32, 29.6% nevertheless indicated a desire to stop or reduce its use; participants who did report negative consequences were most likely to endorse financial or relationship concerns. However, participant ratings of the importance of change or of the helpfulness of personalized normed feedback were unrelated to changes in substance use frequency. Design of future e-interventions should consider emphasizing possible benefits of quitting rather than the negative consequences of drug use, and—when addressing consequences—should consider focusing on the impacts of substance use on relationship and financial aspects. These findings are an early but important step toward using process evaluation to optimize e-intervention content.

Structures and lithofacies of inferred silicic conduits in the Paraná-Etendeka LIP, southernmost Brazil

Science.gov (United States)

Simões, M. S.; Lima, E. F.; Sommer, C. A.; Rossetti, L. M. M.

2018-04-01

Extensive silicic units in the Paraná-Etendeka LIP have been long interpreted as pyroclastic density currents (rheomorphic ignimbrites) derived from the Messum Complex in Namibia. In recent literature, however, they have been characterized as effusive lava flows and domes. In this paper we describe structures and lithofacies related to postulated silicic lava feeder conduits at Mato Perso, São Marcos and Jaquirana-Cambará do Sul areas in southern Brazil. Inferred conduits are at least 15-25 m in width and the lithofacies include variably vesicular monomictic welded and non-welded breccias in the margins to poorly vesicular, banded, spherulitic and microfractured vitrophyres in the central parts. Flat-lying coherent vitrophyres and massive obsidian are considered to be the subaerial equivalents of the conduits. Large-scale, regional tectonic structures in southern Brazil include the NE-SW aligned Porto Alegre Suture, Leão and Açotea faults besides the Antas Lineament, a curved tectonic feature accompanying the bed of Antas river. South of the Antas Lineament smaller-scale, NW-SE lineaments limit the exposure areas of the inferred conduits. NE-SW and subordinate NW-SE structures within this smaller-scale lineaments are represented by the main postulated conduit outcrops and are parallel to the dominant sub-vertical banding in the widespread banded vitrophyre lithofacies. Upper lava flows display flat-lying foliation, pipe-like and spherical vesicles and have better developed microlites. Petrographic characteristics of the silicic vitrophyres indicate that crystal-poor magmas underwent distinct cooling paths for each inferred conduit area. The vitrophyre chemical composition is defined by the evolution of trachydacitic/dacitic vitrophyres with 62-65 wt% SiO2 to rhyodacite and rhyolite with 66-68 wt% SiO2. The more evolved rocks are assigned to the latest intrusive grey vitrophyre outcropping in the center of the conduits. Degassing pathways formed during

Investigation of entrance length in circular and noncircular conduits by computational fluid dynamics simulation

Directory of Open Access Journals (Sweden)

Pimpun Tongpun

2014-08-01

Full Text Available This study estimated entrance length of circular and noncircular conduits, including circle, triangle, square and hexagon cross-sectional conduit, by using computational fluid dynamics (CFD. For simulation condition, the length of noncircular conduit was 10 m and the hydraulic diameter was 0.2 m. The laminar flow with Reynolds number of 500 and turbulent flow with Reynolds number of 50,000 were applied to investigate water flow in conduits. The governing equations were solved iteratively by using ANSYS FLUENT 14.0. For turbulent flow simulation, standard k-epsilon and RNG k-epsilon model were employed to simulate turbulence. The preliminary results were validated by comparison with theoretical data. At first, grid independency was evaluated to optimize the model. Norm* was employed to investigate the entrance length, which is related to velocity. The simulated results revealed that the entrance length for laminar flow was longer than turbulent flow.

A biosynthetic nerve guide conduit based on silk/SWNT/fibronectin nanocomposite for peripheral nerve regeneration.

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Fatemeh Mottaghitalab

Full Text Available As a contribution to the functionality of nerve guide conduits (NGCs in nerve tissue engineering, here we report a conduit processing technique through introduction and evaluation of topographical, physical and chemical cues. Porous structure of NGCs based on freeze-dried silk/single walled carbon nanotubes (SF/SWNTs has shown a uniform chemical and physical structure with suitable electrical conductivity. Moreover, fibronectin (FN containing nanofibers within the structure of SF/SWNT conduits produced through electrospinning process have shown aligned fashion with appropriate porosity and diameter. Moreover, fibronectin remained its bioactivity and influenced the adhesion and growth of U373 cell lines. The conduits were then implanted to 10 mm left sciatic nerve defects in rats. The histological assessment has shown that nerve regeneration has taken places in proximal region of implanted nerve after 5 weeks following surgery. Furthermore, nerve conduction velocities (NCV and more myelinated axons were observed in SF/SWNT and SF/SWNT/FN groups after 5 weeks post implantation, indicating a functional recovery for the injured nerves. With immunohistochemistry, the higher S-100 expression of Schwann cells in SF/SWNT/FN conduits in comparison to other groups was confirmed. In conclusion, an oriented conduit of biocompatible SF/SWNT/FN has been fabricated with acceptable structure that is particularly applicable in nerve grafts.

Detection of the normal zone with cowound sensors in cable-in conduit conductors

International Nuclear Information System (INIS)

Martovetsky, N.N.; Chaplin, M.R.

1996-01-01

Tokamaks in the future will use superconducting cable-in-conduit- conductors (CICC) in all poloidal field (PF) and toroidal field (TF) magnets. Conventional quench detection, the measurement of small resistive normal zone voltages ( 4 kV). In the quench detection design for TPX, we have considered several different locations for internal co-wound voltage sensors in the cable cross-section as the primary mechanism to cancel this inductive noise. The Noise Rejection Experiment (NRE) at LLNL has been designed to evaluate which internal locations will produce the best inductive- noise cancellation, and provide us with experimental data for comparison with previously developed theory. The details of the experiments and resulting data are presented and analyzed

VLP seismicity from resonant modes of acoustic-gravity waves in a conduit-crack system filled with multiphase magma

Science.gov (United States)

Liang, C.; Prochnow, B. N.; OReilly, O. J.; Dunham, E. M.; Karlstrom, L.

2016-12-01

Oscillation of magma in volcanic conduits connected to cracks (dikes and sills) has been suggested as an explanation for very long period (VLP) seismic signals recorded at active basaltic volcanoes such as. Kilauea, Hawaii, and Erebus, Antarctica. We investigate the VLP seismicity using a linearized model for waves in and associated eigenmodes of a coupled conduit-crack system filled with multiphase magma, an extension of the Karlstrom and Dunham (2016) model for acoustic-gravity waves in volcanic conduits. We find that the long period surface displacement (as recorded on broadband seismometers) is dominated by opening/closing of the crack rather than the deformation of the conduit conduit walls. While the fundamental eigenmode is sensitive to the fluid properties and the geometry of the magma plumbing system, a closer scrutiny of various resonant modes reveals that the surface displacement is often more sensitive to higher modes. Here we present a systematic analysis of various long period acoustic-gravity wave resonant modes of a coupled conduit-crack system that the surface displacement is most sensitive to. We extend our previous work on a quasi-one-dimensional conduit model with inviscid magma to a more general axisymmetric conduit model that properly accounts for viscous boundary layers near the conduit walls, based on the numerical method developed by Prochnow et al. (submitted to Computers and Fluids, 2016). The surface displacement is dominated by either the fundamental or higher eigenmodes, depending on magma properties and the geometry of conduit and crack. An examination of the energetics of these modes reveals the complex interplay of different restoring forces (magma compressibility in the conduit, gravity, and elasticity of the crack) driving the VLP oscillations. Both nonequilibrium bubble growth and resorption and viscosity contribute to the damping of VLP signals. Our models thus provide a means to infer properties of open-vent basaltic volcanoes

Biological conduits combining bone marrow mesenchymal stem cells and extracellular matrix to treat long-segment sciatic nerve defects

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Yang Wang

2015-01-01

Full Text Available The transplantation of polylactic glycolic acid conduits combining bone marrow mesenchymal stem cells and extracellular matrix gel for the repair of sciatic nerve injury is effective in some respects, but few data comparing the biomechanical factors related to the sciatic nerve are available. In the present study, rabbit models of 10-mm sciatic nerve defects were prepared. The rabbit models were repaired with autologous nerve, a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells, or a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel. After 24 weeks, mechanical testing was performed to determine the stress relaxation and creep parameters. Following sciatic nerve injury, the magnitudes of the stress decrease and strain increase at 7,200 seconds were largest in the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel group, followed by the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells group, and then the autologous nerve group. Hematoxylin-eosin staining demonstrated that compared with the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells group and the autologous nerve group, a more complete sciatic nerve regeneration was found, including good myelination, regularly arranged nerve fibers, and a completely degraded and resorbed conduit, in the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel group. These results indicate that bridging 10-mm sciatic nerve defects with a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel construct increases the stress relaxation under a constant strain, reducing anastomotic tension. Large elongations under a constant physiological load can limit the anastomotic opening and shift, which is beneficial for the regeneration and functional reconstruction of sciatic nerve. Better

Transcatheter Pulmonary Valve Replacement for Right Ventricular Outflow Tract Conduit Dysfunction After the Ross Procedure

DEFF Research Database (Denmark)

Gillespie, Matthew J; McElhinney, Doff B; Kreutzer, Jacqueline

2015-01-01

BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review of databa......BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review....... Of these, 56 (84%) received a Melody valve; in 5 of the 11 patients who did not, the implant was aborted due to concern for coronary artery compression, and 1 implanted patient required emergent surgery for left coronary compression. The RVOT gradient decreased from a median 38 mm Hg to 13.5 mm Hg (p

26 CFR 1.58-2 - General rules for conduit entities; partnerships and partners.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true General rules for conduit entities; partnerships...; partnerships and partners. (a) General rules for conduit entities. Sections 1.58-3 through 1.58-6 provide rules... example, if a trust has $100,000 of capital gains for the taxable year, all of which are distributed to A...

Polyurethane/Gelatin Nanofibrils Neural Guidance Conduit Containing Platelet-Rich Plasma and Melatonin for Transplantation of Schwann Cells.

Science.gov (United States)

Salehi, Majid; Naseri-Nosar, Mahdi; Ebrahimi-Barough, Somayeh; Nourani, Mohammdreza; Khojasteh, Arash; Farzamfar, Saeed; Mansouri, Korosh; Ai, Jafar

2018-04-01

The current study aimed to enhance the efficacy of peripheral nerve regeneration using a biodegradable porous neural guidance conduit as a carrier to transplant allogeneic Schwann cells (SCs). The conduit was prepared from polyurethane (PU) and gelatin nanofibrils (GNFs) using thermally induced phase separation technique and filled with melatonin (MLT) and platelet-rich plasma (PRP). The prepared conduit had the porosity of 87.17 ± 1.89%, the contact angle of 78.17 ± 5.30° and the ultimate tensile strength and Young's modulus of 5.40 ± 0.98 MPa and 3.13 ± 0.65 GPa, respectively. The conduit lost about 14% of its weight after 60 days in distilled water. The produced conduit enhanced the proliferation of SCs demonstrated by a tetrazolium salt-based assay. For functional analysis, the conduit was seeded with 1.50 × 10 4 SCs (PU/GNFs/PRP/MLT/SCs) and implanted into a 10-mm sciatic nerve defect of Wistar rat. Three control groups were used: (1) PU/GNFs/SCs, (2) PU/GNFs/PRP/SCs, and (3) Autograft. The results of sciatic functional index, hot plate latency, compound muscle action potential amplitude and latency, weight-loss percentage of wet gastrocnemius muscle and histopathological examination using hematoxylin-eosin and Luxol fast blue staining, demonstrated that using the PU/GNFs/PRP/MLT conduit to transplant SCs to the sciatic nerve defect resulted in a higher regenerative outcome than the PU/GNFs and PU/GNFs/PRP conduits.

The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.

Science.gov (United States)

Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; Bärnighausen, Till; Velasco-Mondragón, Héctor Eduardo; Darney, Blair Grant

2017-08-03

The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources. The comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P human resources in primary health facilities.

Brachial artery repair using the basilic vein as a reliable conduit in a 3-year-old child

Directory of Open Access Journals (Sweden)

Hyunyoung G. Kim

2017-04-01

Full Text Available A supracondylar fracture of the humerus is the most common upper extremity fracture in children with concurrent neurovascular complications. However, bypass grafting in the management of a pediatric open elbow dislocation with an arterial injury has rarely been reported in the literature. Hence, an adequate conduit for a vessel graft interposition remains questionable when a primary anastomosis is limited in an arterial reconstruction. The purpose of this study is to present a brachial artery reconstruction in a 3-year-old patient with an open supracondylar fracture of the humerus. In the clinical and surgical examination of the patient, an open wound in the left antecubital fossa presented with accompanying brachial artery injury. To repair the artery, a reverse end-to-end anastomosis was conducted using basilic vein graft from the ipsilateral arm under general anesthesia. The patient had palpable radial pulses in the postoperative clinical examination and was discharged without complications. The great saphenous vein (GSV has proven to be the most common and the best conduit for arterial reconstruction of the upper extremity in the adult patients. However, the GSV graft is known to have the propensity for becoming aneurysmal in pediatric patients. Some studies have demonstrated the basilic vein as a suitable conduit in pediatric patients, in that it has durable patency, fewer branches, size compatibility for anastomosis, and proximity to the brachial artery. Our case confirms the safety of using this autogenous vein from within the zone of injury for arterial reconstruction, after a supracondylar humeral fracture. The management of pediatric elbow fractures accompanying vascular injuries can be technically demanding due to relatively small, delicate structures and concurrent neurovascular network. Nonetheless, a vascular injury should be treated with high level of suspicion and immediate intervention to avoid any limb ischemia or loss. In

Mechanical cleaning of oil spills in seawater using circular conduits

Energy Technology Data Exchange (ETDEWEB)

Shedid, S.; Abou Kassem, J.; Zekri, A. [United Arab Emirates Univ., Al Ain City (United Arab Emirates). Dept. of Chemical and Petroleum Engineering

2005-10-15

Treatment of the crude oil pollution in seawater has attracted global attention during the last two decades. This study was undertaken using circular conduits as a mechanical means to clean oil spills in seawater under different conditions of temperature, oil gravity, shaking frequency, conduit diameter, and initial thickness of oil layer. An experimental model was designed and built to achieve the study. It consists of shaking water bath (to represent sea waves) fitted with temperature controller and glass tubes of different inside diameters of 0.3 cm, 0.5 cm, and 0.7 cm. Three crude oils of different oil gravity of 35{sup o}API, 38{sup o}API, and 47{sup o}API were investigated under different shaking frequencies of 20, 40, and 60 stroke/minute with different tube diameters. The results proved that application of mechanical cleaning of oil spills using circular conduits is a practical technique. The cleaning of black oil spills is more efficient than one of volatile oil. Furthermore, the results indicated that the increase of shaking frequency and/or water temperature provide(s) faster cleaning of oil spills while temperature increase recovers the maximum oil. (Author)

Tension layer winding of cable-in-conduit conductor

International Nuclear Information System (INIS)

Devernoe, A.; Ciancetta, G.; King, M.; Parizh, M.; Painter, T.; Miller, J.

1996-01-01

A 710 mm i.d. by 440 mm long, 6 layer Cable-in-Conduit (CIC) coil was precision tension layer wound with Incoloy 908 jacketed conductor to model winding technology that will be used for the Nb 3 Sn outsert coils of the 45 Tesla Hybrid Magnet Project at the US National High Magnetic Field Laboratory. This paper reports on the set up of a new winding facility with unique capabilities for insulating and winding long length CIC conductor and on special procedures which were developed to wind and support layer to layer transitions and to safely form conductor into and out of the winding. Analytical methods used to predict conduit keystoning, springback and back tensioning requirements before winding are reported in comparison to results obtained during winding and actual winding build-up dimensions on a layer by layer basis in comparison to design requirements

Delineating saturated conduit patterns and dimensions in the upper Floridan aquifer through numerical groundwater flow modeling (Invited)

Science.gov (United States)

Kincaid, T. R.; Meyer, B. A.

2009-12-01

In groundwater flow modeling, aquifer permeability is typically defined through model calibration. Since the pattern and size of conduits are part of a karstic permeability framework, those parameters should be constrainable through the same process given a sufficient density of measured conditions. H2H Associates has completed a dual-permeability steady-state model of groundwater flow through the western Santa Fe River Basin, Florida from which a 380.9 km network of saturated conduits was delineated through model calibration to heads and spring discharges. Two calibration datasets were compiled describing average high-water and average low-water conditions based on heads at 145 wells and discharge from 18 springs for the high-water scenario and heads at 188 wells and discharge from 9 springs for the low-water scenario. An initial conduit network was defined by assigning paths along mapped conduits and inferring paths along potentiometric troughs between springs and swallets that had been connected by groundwater tracing. These initial conduit assignments accounted for only 13.75 and 34.1 km of the final conduit network respectively. The model was setup using FEFLOW™ where conduits were described as discrete features embedded in a porous matrix. Flow in the conduits was described by the Manning-Strickler equation where variables for conduit area and roughness were used to adjust the volume and velocity of spring flows. Matrix flow was described by Darcy’s law where hydraulic conductivity variations were limited to three geologically defined internally homogeneous zones that ranged from ~2E-6 m/s to ~4E-3 m/s. Recharge for both the high-water and low-water periods was determined through a water budget analysis where variations were restricted to nine zones defined by land-use. All remaining variations in observed head were then assumed to be due to conduits. The model was iteratively calibrated to the high-water and low-water datasets wherein the location, size

26 CFR 1.7701(l)-1 - Conduit financing arrangements.

Science.gov (United States)

2010-04-01

... determines that such recharacterization is appropriate to prevent avoidance of any tax imposed by title 26 of...) INCOME TAX (CONTINUED) INCOME TAXES General Actuarial Valuations § 1.7701(l)-1 Conduit financing...

Interstage evaluation of homograft-valved right ventricle to pulmonary artery conduits for palliation of hypoplastic left heart syndrome.

Science.gov (United States)

Sandeep, Nefthi; Punn, Rajesh; Balasubramanian, Sowmya; Smith, Shea N; Reinhartz, Olaf; Zhang, Yulin; Wright, Gail E; Peng, Lynn F; Wise-Faberowski, Lisa; Hanley, Frank L; McElhinney, Doff B

2018-04-01

Palliation of hypoplastic left heart syndrome with a standard nonvalved right ventricle to pulmonary artery conduit results in an inefficient circulation in part due to diastolic regurgitation. A composite right ventricle pulmonary artery conduit with a homograft valve has a hypothetical advantage of reducing regurgitation, but may differ in the propensity for stenosis because of valve remodeling. This retrospective cohort study included 130 patients with hypoplastic left heart syndrome who underwent a modified stage 1 procedure with a right ventricle to pulmonary artery conduit from 2002 to 2015. A composite valved conduit (cryopreserved homograft valve anastomosed to a polytetrafluoroethylene tube) was placed in 100 patients (47 aortic, 32 pulmonary, 13 femoral/saphenous vein, 8 unknown), and a nonvalved conduit was used in 30 patients. Echocardiographic functional parameters were evaluated before and after stage 1 palliation and before the bidirectional Glenn procedure, and interstage interventions were assessed. On competing risk analysis, survival over time was better in the valved conduit group (P = .040), but this difference was no longer significant after adjustment for surgical era. There was no significant difference between groups in the cumulative incidence of bidirectional Glenn completion (P = .15). Patients with a valved conduit underwent more interventions for conduit obstruction in the interstage period, but this difference did not reach significance (P = .16). There were no differences between groups in echocardiographic parameters of right ventricle function at baseline or pre-Glenn. In this cohort of patients with hypoplastic left heart syndrome, inclusion of a valved right ventricle to pulmonary artery conduit was not associated with any difference in survival on adjusted analysis and did not confer an identifiable benefit on right ventricle function. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier

Challenges of using electrical resistivity method to locate karst conduits-A field case in the Inner Bluegrass Region, Kentucky

Science.gov (United States)

Zhu, J.; Currens, J.C.; Dinger, J.S.

2011-01-01

Conduits serve as major pathways for groundwater flow in karst aquifers. Locating them from the surface, however, is one of the most challenging tasks in karst research. Geophysical methods are often deployed to help locate voids by mapping variations of physical properties of the subsurface. Conduits can cause significant contrasts of some physical properties that can be detected; other subsurface features such as water-bearing fractures often yield similar contrasts, which are difficult to distinguish from the effects of the conduits. This study used electrical resistivity method to search for an unmapped karst conduit that recharges Royal Spring in the Inner Bluegrass karst region, Kentucky, USA. Three types of resistivity techniques (surface 2D survey, quasi-3D survey, and time-lapse survey) were used to map and characterize resistivity anomalies. Some of the major anomalies were selected as drilling targets to verify the existence of the conduits. Drilling near an anomaly identified by an electrical resistivity profile resulted in successful penetration of a major water-filled conduit. The drilling results also suggest that, in this study area, low resistivity anomalies in general are associated with water-bearing features. However, differences in the anomaly signals between the water-filled conduit and other water-bearing features such as water-filled fracture zones were undistinguishable. The electrical resistivity method is useful in conduit detection by providing potential drilling targets. Knowledge of geology and hydrogeology about the site and professional judgment also played important roles in locating the major conduit. ?? 2011 Elsevier B.V.

3D Bioprinting of Heterogeneous Aortic Valve Conduits with Alginate/Gelatin Hydrogels

Science.gov (United States)

Duan, Bin; Hockaday, Laura A.; Kang, Kevin H.; Butcher, Jonathan T.

2013-01-01

Heart valve disease is a serious and growing public health problem for which prosthetic replacement is most commonly indicated. Current prosthetic devices are inadequate for younger adults and growing children. Tissue engineered living aortic valve conduits have potential for remodeling, regeneration, and growth, but fabricating natural anatomical complexity with cellular heterogeneity remain challenging. In the current study, we implement 3D bioprinting to fabricate living alginate/gelatin hydrogel valve conduits with anatomical architecture and direct incorporation of dual cell types in a regionally constrained manner. Encapsulated aortic root sinus smooth muscle cells (SMC) and aortic valve leaflet interstitial cells (VIC) were viable within alginate/gelatin hydrogel discs over 7 days in culture. Acellular 3D printed hydrogels exhibited reduced modulus, ultimate strength, and peak strain reducing slightly over 7-day culture, while the tensile biomechanics of cell-laden hydrogels were maintained. Aortic valve conduits were successfully bioprinted with direct encapsulation of SMC in the valve root and VIC in the leaflets. Both cell types were viable (81.4±3.4% for SMC and 83.2±4.0% for VIC) within 3D printed tissues. Encapsulated SMC expressed elevated alpha-smooth muscle actin when printed in stiff matrix, while VIC expressed elevated vimentin in soft matrix. These results demonstrate that anatomically complex, heterogeneously encapsulated aortic valve hydrogel conduits can be fabricated with 3D bioprinting. PMID:23015540

Genipin-Cross-Linked Chitosan Nerve Conduits Containing TNF-α Inhibitors for Peripheral Nerve Repair.

Science.gov (United States)

Zhang, Li; Zhao, Weijia; Niu, Changmei; Zhou, Yujie; Shi, Haiyan; Wang, Yalin; Yang, Yumin; Tang, Xin

2018-07-01

Tissue engineered nerve grafts (TENGs) are considered a promising alternative to autologous nerve grafting, which is considered the "gold standard" clinical strategy for peripheral nerve repair. Here, we immobilized tumor necrosis factor-α (TNF-α) inhibitors onto a nerve conduit, which was introduced into a chitosan (CS) matrix scaffold utilizing genipin (GP) as the crosslinking agent, to fabricate CS-GP-TNF-α inhibitor nerve conduits. The in vitro release kinetics of TNF-α inhibitors from the CS-GP-TNF-α inhibitor nerve conduits were investigated using high-performance liquid chromatography. The in vivo continuous release profile of the TNF-α inhibitors released from the CS-GP-TNF-α inhibitor nerve conduits was measured using an enzyme-linked immunosorbent assay over 14 days. We found that the amount of TNF-α inhibitors released decreased with time after the bridging of the sciatic nerve defects in rats. Moreover, 4 and 12 weeks after surgery, histological analyses and functional evaluations were carried out to assess the influence of the TENG on regeneration. Immunochemistry performed 4 weeks after grafting to assess early regeneration outcomes revealed that the TENG strikingly promoted axonal outgrowth. Twelve weeks after grafting, the TENG accelerated myelin sheath formation, as well as functional restoration. In general, the regenerative outcomes following TENG more closely paralleled findings observed with autologous grafting than the use of the CS matrix scaffold. Collectively, our data indicate that the CS-GP-TNF-α inhibitor nerve conduits comprised an elaborate system for sustained release of TNF-α inhibitors in vitro, while studies in vivo demonstrated that the TENG could accelerate regenerating axonal outgrowth and functional restoration. The introduction of CS-GP-TNF-α-inhibitor nerve conduits into a scaffold may contribute to an efficient and adaptive immune microenvironment that can be used to facilitate peripheral nerve repair.

78 FR 61987 - Corbett Water District; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

Science.gov (United States)

2013-10-09

... District; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Corbett Hydroelectric...

Ileal-conduit following cystectomy, single-institution revision of indications and outcome

International Nuclear Information System (INIS)

Abol-Enein, Hassan A.; Abdul-Muhsin, Ausama S.; Alhallaq, Yousuf M.

2008-01-01

Objective was to revise indications, case fatality ratio, and postoperative early and late complications of ileal conduit as a method of urinary diversion. This is a retrospective study in which 200 patients underwent an ileal conduit from August 1994 to December 2000 in Mansoura Urology and Nephrology Center, Mansoura, Egypt. Preoperative criteria of patient selection, preoperative findings and postoperative follow-up data were reviewed. In 200 patients aged 29-75 years, with a mean age of 55.84-/+ 8.91 years, the ileal conduit was chosen as a method of urinary diversion, due to one of the following patient or surgical factors; 50 (25%) cardiopulmonary co-morbidities, 27(13.5%) liver cirrhosis, 20 (10%) impaired renal function, 18 (9%) poorly controlled diabetes mellitus and 3 (1.5%) morbid obesity. Frozen section pathological examination showed carcinoma invasion of the urethra in 26 (13%) and prostate stroma in 16 (8%) male patients. Severe adhesions and difficulty cystectomy were encountered in 25 (12.5%) patients. Tumor was found at or close to the bladder neck in 13 (6.5%) female patients and 2 (1%) patients were found to have short mesentery. The mean follow up period was 90.02 -/+ 22.63 months. Fatality rate was 2%. Twenty-three (11.5%) patients had early complications, while 36 (23.7%) patients had late complications. Ileal conduit is still the best urinary diversion method in many patients who have bladder cancer with associated chronic medical disease or certain surgical factors that render other urinary diversion methods more difficult carry more postoperative morbidity and mortality or both. (author)

Exploring Ultimate Water Capillary Evaporation in Nanoscale Conduits.

Science.gov (United States)

Li, Yinxiao; Alibakhshi, Mohammad Amin; Zhao, Yihong; Duan, Chuanhua

2017-08-09

Capillary evaporation in nanoscale conduits is an efficient heat/mass transfer strategy that has been widely utilized by both nature and mankind. Despite its broad impact, the ultimate transport limits of capillary evaporation in nanoscale conduits, governed by the evaporation/condensation kinetics at the liquid-vapor interface, have remained poorly understood. Here we report experimental study of the kinetic limits of water capillary evaporation in two dimensional nanochannels using a novel hybrid channel design. Our results show that the kinetic-limited evaporation fluxes break down the limits predicated by the classical Hertz-Knudsen equation by an order of magnitude, reaching values up to 37.5 mm/s with corresponding heat fluxes up to 8500 W/cm 2 . The measured evaporation flux increases with decreasing channel height and relative humidity but decreases as the channel temperature decreases. Our findings have implications for further understanding evaporation at the nanoscale and developing capillary evaporation-based technologies for both energy- and bio-related applications.

Scaffoldless tissue-engineered nerve conduit promotes peripheral nerve regeneration and functional recovery after tibial nerve injury in rats

Institute of Scientific and Technical Information of China (English)

Aaron M. Adams; Keith W. VanDusen; Tatiana Y. Kostrominova; Jacob P. Mertens; Lisa M. Larkin

2017-01-01

Damage to peripheral nerve tissue may cause loss of function in both the nerve and the targeted muscles it innervates. This study compared the repair capability of engineered nerve conduit (ENC), engineered fibroblast conduit (EFC), and autograft in a 10-mm tibial nerve gap. ENCs were fabricated utilizing primary fibroblasts and the nerve cells of rats on embryonic day 15 (E15). EFCs were fabricated utilizing primary fi-broblasts only. Following a 12-week recovery, nerve repair was assessed by measuring contractile properties in the medial gastrocnemius muscle, distal motor nerve conduction velocity in the lateral gastrocnemius, and histology of muscle and nerve. The autografts, ENCs and EFCs reestablished 96%, 87% and 84% of native distal motor nerve conduction velocity in the lateral gastrocnemius, 100%, 44% and 44% of native specific force of medical gastrocnemius, and 63%, 61% and 67% of native medial gastrocnemius mass, re-spectively. Histology of the repaired nerve revealed large axons in the autograft, larger but fewer axons in the ENC repair, and many smaller axons in the EFC repair. Muscle histology revealed similar muscle fiber cross-sectional areas among autograft, ENC and EFC repairs. In conclusion, both ENCs and EFCs promot-ed nerve regeneration in a 10-mm tibial nerve gap repair, suggesting that the E15 rat nerve cells may not be necessary for nerve regeneration, and EFC alone can suffice for peripheral nerve injury repair.

78 FR 63176 - Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting...

Science.gov (United States)

2013-10-23

... Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting Comments and Motions To... of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The...

MR and CT imaging of pulmonary valved conduits in children and adolescents: normal appearance and complications

Energy Technology Data Exchange (ETDEWEB)

Tenisch, Estelle V.; Alamo, Leonor T.; Gudinchet, Francois [Lausanne University Hospital, Department of Medical Imaging, Lausanne (Switzerland); Sekarski, Nicole [Lausanne University Hospital, Department of Pediatrics, Lausanne (Switzerland); Hurni, Michel [Lausanne University Hospital, Department of Cardiovascular Surgery, Lausanne (Switzerland)

2014-12-15

The Contegra registered is a conduit made from the bovine jugular vein and then interposed between the right ventricle and the pulmonary artery. It is used for cardiac malformations in the reconstruction of right ventricular outflow tract. To describe both normal and pathological appearances of the Contegra registered in radiological imaging, to describe imaging of complications and to define the role of CT and MRI in postoperative follow-up. Forty-three examinations of 24 patients (17 boys and 7 girls; mean age: 10.8 years old) with Contegra registered conduits were reviewed. Anatomical description and measurements of the conduits were performed. Pathological items examined included stenosis, dilatation, plicature or twist, thrombus or vegetations, calcifications and valvular regurgitation. Findings were correlated to the echographic gradient through the conduit when available. CT and MR work-up showed Contegra registered stenosis (n = 12), dilatation (n = 9) and plicature or twist (n = 7). CT displayed thrombus or vegetations in the Contegra registered in three clinically infected patients. Calcifications of the conduit were present at CT in 12 patients and valvular regurgitation in three patients. The comparison between CT and/or MR results showed a good correlation between the echographic gradient and the presence of stenosis in the Contegra registered. CT and MR bring additional information about permeability and postoperative anatomy especially when echocardiography is inconclusive. Both techniques depict the normal appearance of the conduit, and allow comparison and precise evaluation of changes in the postoperative follow-up. (orig.)

A Physicochemically Optimized and Neuroconductive Biphasic Nerve Guidance Conduit for Peripheral Nerve Repair.

Science.gov (United States)

Ryan, Alan J; Lackington, William A; Hibbitts, Alan J; Matheson, Austyn; Alekseeva, Tijna; Stejskalova, Anna; Roche, Phoebe; O'Brien, Fergal J

2017-12-01

Clinically available hollow nerve guidance conduits (NGCs) have had limited success in treating large peripheral nerve injuries. This study aims to develop a biphasic NGC combining a physicochemically optimized collagen outer conduit to bridge the transected nerve, and a neuroconductive hyaluronic acid-based luminal filler to support regeneration. The outer conduit is mechanically optimized by manipulating crosslinking and collagen density, allowing the engineering of a high wall permeability to mitigate the risk of neuroma formation, while also maintaining physiologically relevant stiffness and enzymatic degradation tuned to coincide with regeneration rates. Freeze-drying is used to seamlessly integrate the luminal filler into the conduit, creating a longitudinally aligned pore microarchitecture. The luminal stiffness is modulated to support Schwann cells, with laminin incorporation further enhancing bioactivity by improving cell attachment and metabolic activity. Additionally, this biphasic NGC is shown to support neurogenesis and gliogenesis of neural progenitor cells and axonal outgrowth from dorsal root ganglia. These findings highlight the paradigm that a successful NGC requires the concerted optimization of both a mechanical support phase capable of bridging a nerve defect and a neuroconductive phase with an architecture capable of supporting both Schwann cells and neurons in order to achieve functional regenerative outcome. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India.

Science.gov (United States)

Prinja, Shankar; Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

2016-01-01

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

Ureteric catheterization via an ileal conduit: technique and retrieval of a JJ stent.

Science.gov (United States)

Wah, T M; Kellett, M J

2004-11-01

Retrograde ureteric catheterization of a patient with an ileal conduit is difficult, because guide wires and catheters coil in the conduit. A modified loopogram, using a Foley catheter as a fulcrum through which catheters can be advanced to the ureteric anastomosis, is described. This technique was used to remove a JJ stent, which had been inserted previously across a stricture in one ureter, the stent crossing from one kidney to the other.

Primary Care Provider-Delivered Smoking Cessation Interventions and Smoking Cessation Among Participants in the National Lung Screening Trial.

Science.gov (United States)

Park, Elyse R; Gareen, Ilana F; Japuntich, Sandra; Lennes, Inga; Hyland, Kelly; DeMello, Sarah; Sicks, JoRean D; Rigotti, Nancy A

2015-09-01

The National Lung Screening Trial (NLST) found a reduction in lung cancer mortality among participants screened with low-dose computed tomography vs chest radiography. In February 2015, Medicare announced its decision to cover annual lung screening for patients with a significant smoking history. These guidelines promote smoking cessation treatment as an adjunct to screening, but the frequency and effectiveness of clinician-delivered smoking cessation interventions delivered after lung screening are unknown. To determine the association between the reported clinician-delivered 5As (ask, advise, assess, assist [talk about quitting or recommend stop-smoking medications or recommend counseling], and arrange follow-up) after lung screening and smoking behavior changes. A matched case-control study (cases were quitters and controls were continued smokers) of 3336 NLST participants who were smokers at enrollment examined participants' rates and patterns of 5A delivery after a lung screen and reported smoking cessation behaviors. Prevalence of the clinician-delivered 5As and associated smoking cessation after lung screening. Delivery of the 5As 1 year after screening were as follows: ask, 77.2%; advise, 75.6%; assess, 63.4%; assist, 56.4%; and arrange follow-up, 10.4%. Receipt of ask, advise, and assess was not significantly associated with quitting in multivariate models that adjusted for sociodemographic characteristics, medical history, screening results, nicotine dependence, and motivation to quit. Assist was associated with a 40% increase in the odds of quitting (odds ratio, 1.40; 95% CI, 1.21-1.63), and arrange was associated with a 46% increase in the odds of quitting (odds ratio, 1.46; 95% CI, 1.19-1.79). Assist and arrange follow-up delivered by primary care providers to smokers who were participating in the NLST were associated with increased quitting; less intensive interventions (ask, advise, and assess) were not. However, rates of assist and arrange

Continent catheterizable conduit for urinary diversion in children: Applicability and acceptability

Directory of Open Access Journals (Sweden)

Shailesh Solanki

2015-01-01

Full Text Available Background: Continent catheterizable conduit (CCC has made clean intermittent catheterization (CIC painless and easy. It is applicable in diverse clinical conditions. Nonetheless, convincing the parents for the need of conduit procedure is still difficult. Materials and Methods: A prospective study, included children who underwent CCC procedure from March 2008 to February 2013. The data were assessed for; diagnosis, type of conduit, number of preoperative counselling sessions before acceptance, role of "self-help group" in decision making, parental concern and satisfaction for the procedure. Results: Twenty-nine patients (males; 24, females; 5 underwent CCC procedure for various clinical conditions. The multiple preoperative counselling sessions and creation of "self-help groups" were helped them for decision making. The main concerns among parents were: (1 Impact of procedure on future fertility and sexual life. (2 Patency of native urethral channel. (3 Permanent urinary stoma over the abdomen. Conclusion: CCC procedures are applicable to a wide array of clinical situations with a good outcome. The acceptability of the CCC procedure improves with preoperative counselling of parent/child, initiation of preoperative per urethral CIC and creation of self-help groups.

Combined use of decellularized allogeneic artery conduits with autologous transdifferentiated adipose-derived stem cells for facial nerve regeneration in rats.

Science.gov (United States)

Sun, Fei; Zhou, Ke; Mi, Wen-juan; Qiu, Jian-hua

2011-11-01

Natural biological conduits containing seed cells have been widely used as an alternative strategy for nerve gap reconstruction to replace traditional nerve autograft techniques. The purpose of this study was to investigate the effects of a decellularized allogeneic artery conduit containing autologous transdifferentiated adipose-derived stem cells (dADSCs) on an 8-mm facial nerve branch lesion in a rat model. After 8 weeks, functional evaluation of vibrissae movements and electrophysiological assessment, retrograde labeling of facial motoneurons and morphological analysis of regenerated nerves were performed to assess nerve regeneration. The transected nerves reconstructed with dADSC-seeded artery conduits achieved satisfying regenerative outcomes associated with morphological and functional improvements which approached those achieved with Schwann cell (SC)-seeded artery conduits, and superior to those achieved with artery conduits alone or ADSC-seeded artery conduits, but inferior to those achieved with nerve autografts. Besides, numerous transplanted PKH26-labeled dADSCs maintained their acquired SC-phenotype and myelin sheath-forming capacity inside decellularized artery conduits and were involved in the process of axonal regeneration and remyelination. Collectively, our combined use of decellularized allogeneic artery conduits with autologous dADSCs certainly showed beneficial effects on nerve regeneration and functional restoration, and thus represents an alternative approach for the reconstruction of peripheral facial nerve defects. Copyright © 2011 Elsevier Ltd. All rights reserved.

Development and Implementation of a Segment/Junction Box Level Database for the ITS Fiber Optic Conduit Network

Science.gov (United States)

2012-03-01

This project initiated the development of a computerized database of ITS facilities, including conduits, junction : boxes, cameras, connections, etc. The current system consists of a database of conduit sections of various lengths. : Over the length ...

The Norwood procedure: in favor of the RV-PA conduit.

Science.gov (United States)

Barron, David J

2013-01-01

Evolution of the Norwood procedure has culminated in there currently being three treatment strategies available for initial management: the 'classical' Norwood (utilizing a Blalock-Taussig shunt), the Norwood with right-ventricle to pulmonary artery (RV-PA) conduit, and the 'hybrid' Norwood procedure utilizing bilateral pulmonary artery banding and ductal stenting. Each variant has its potential advantages and disadvantages, and this paper looks to examine the evidence in favor of each strategy, with emphasis on the supportive data for the RV-PA conduit. The 'classical' procedure has the benefit of the greatest accumulated surgical experience and avoids any incision into the ventricle. However, the diastolic run-off of the Blalock-Taussig shunt can cause hemodynamic instability and unpredictable coronary steal phenomenon. The RV-PA conduit has the advantage of maintaining diastolic pressure with a more stable postoperative course, but at the cost of a ventriculotomy that may have detrimental long-term sequelae. The 'hybrid' procedure has the advantage of avoiding cardiopulmonary bypass, but does not always secure coronary blood flow and has a high inter-stage morbidity and reintervention rate. The evidence shows that each technique may have its place in future management, and that treatment algorithms could emerge that direct the choice of procedure for specific patient groups. Copyright © 2013 Elsevier Inc. All rights reserved.

Parastomal hernias after radical cystectomy and ileal conduit diversion

Directory of Open Access Journals (Sweden)

Timothy F. Donahue

2016-07-01

Full Text Available Parastomal hernia, defined as an “incisional hernia related to an abdominal wall stoma”, is a frequent complication after conduit urinary diversion that can negatively impact quality of life and present a clinically significant problem for many patients. Parastomal hernia (PH rates may be as high as 65% and while many patients are asymptomatic, in some series up to 30% of patients require surgical intervention due to pain, leakage, ostomy appliance problems, urinary obstruction, and rarely bowel obstruction or strangulation. Local tissue repair, stoma relocation, and mesh repairs have been performed to correct PH, however, long-term results have been disappointing with recurrence rates of 30%–76% reported after these techniques. Due to high recurrence rates and the potential morbidity of PH repair, efforts have been made to prevent PH development at the time of the initial surgery. Randomized trials of circumstomal prophylactic mesh placement at the time of colostomy and ileostomy stoma formation have shown significant reductions in PH rates with acceptably low complication profiles. We have placed prophylactic mesh at the time of ileal conduit creation in patients at high risk for PH development and found it to be safe and effective in reducing the PH rates over the short-term. In this review, we describe the clinical and radiographic definitions of PH, the clinical impact and risk factors associated with its development, and the use of prophylactic mesh placement for patients undergoing ileal conduit urinary diversion with the intent of reducing PH rates.

78 FR 66355 - Pleasant Grove City, UT; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

Science.gov (United States)

2013-11-05

... City, UT; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and... Grove City, Utah (Pleasant Grove) filed a notice of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower...

78 FR 53752 - City of Sandpoint, Idaho; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

Science.gov (United States)

2013-08-30

... Sandpoint, Idaho; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and... intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Little...

78 FR 61985 - City of Astoria, Oregon; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

Science.gov (United States)

2013-10-09

..., Oregon; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The...

Evidence for Arbovirus Dissemination Conduits from the Mosquito (Diptera: Culicidae) Midgut

National Research Council Canada - National Science Library

Romoser, William

2004-01-01

.... Experiments using Venezuelan equine encephalitis viral replicon particles, which express the green fluorescent protein gene in cells, indicate the operation of tissue conduits, possibly involving...

AC losses and stability on large cable-in-conduit superconductors

Science.gov (United States)

Bruzzone, Pierluigi

1998-12-01

The cable-in-conduit superconductors are preferred for applications where the AC losses and stability are a major concern, e.g., fusion magnets and SMES. A review of coupling currents loss results for both NbTi and Nb 3Sn cable-in-conduit conductors (CICC) is presented and the AC loss relevant features are listed, with special emphasis for the role of the interstrand resistance and strand coating. The transient stability approach for CICCs is discussed and the analytical models are quoted as well as the relevant experimental database. The likely spectrum of transient disturbance in CICC is reviewed and the need to account for interstrand current sharing in the design is outlined. Eventually a practical criterion for the interstrand resistance is proposed to link the stability and AC loss design.

CIBLAGE D'INFLATION ET CONDUITE DE LA POLITIQUE ...

African Journals Online (AJOL)

Administrateur

de l'amendement de la loi relative à la monnaie et au crédit, l'Algérie a explicitement ... la Banque d'Algérie, très importante pour la conduite de la politique monétaire. ..... matière de contrainte budgétaire entre les secteurs public et privé. En.

Design and production of stopper made of concrete foam composite used for open channel conduit cover and parking bumper

Science.gov (United States)

Syam, Bustami; Sebayang, Alexander; Sebayang, Septian; Muttaqin, Maraghi; Darmadi, Harry; Basuki, WS; Sabri, M.; Abda, S.

2018-03-01

Open channel conduit is designed and produced with the aims to reduce excess water, whether from rain, seepage, or excess irrigation water in an area. It is also included in one of the important components of urban infrastructure in tackling the problem of flooding and waterlogging. On the roadway, e.g. housing complex the open channel conduits should function the same, however conduit covers are needed. The covers should be also designed to function as parking bumper. This paper discusses the design and production of the stoppers using our newly invented materials; the stoppers are structurally tested under static, dynamic, and bump test. Response of the conduit cover are found from structural analysis using finite element software ANSYS MECHANICAL version 17.5. Two types of stoppers are introduced: flat and curvy configuration. It was obtained that both types are suitable for open channel conduit cover and parking bumper.

78 FR 56872 - City of Barre, Vermont; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

Science.gov (United States)

2013-09-16

..., Vermont; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Nelson Street 17 kW...

Nitric oxide permits hypoxia-induced lymphatic perfusion by controlling arterial-lymphatic conduits in zebrafish and glass catfish

DEFF Research Database (Denmark)

Dahl Ejby Jensen, Lasse; Cao, Renhai; Hedlund, Eva-Maria

2009-01-01

and lymphatic perfusion. Here we show in the adult zebrafish and glass catfish (Kryptopterus bicirrhis) that blood-lymphatic conduits directly connect arterial vessels to the lymphatic system. Under hypoxic conditions, arterial-lymphatic conduits (ALCs) became highly dilated and linearized by NO...

The Use of Degradable Nerve Conduits for Human Nerve Repair: A Review of the Literature

Directory of Open Access Journals (Sweden)

M. F. Meek

2005-01-01

Full Text Available The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, has some disadvantages. Many alternative experimental techniques have thus been developed, such as degradable nerve conduits. Degradable nerve guides have been extensively studied in animal experimental studies. However, the repair of human nerves by degradable nerve conduits has been limited to only a few clinical studies. In this paper, an overview of the available international published literature on degradable nerve conduits for bridging human peripheral nerve defects is presented for literature available until 2004. Also, the philosophy on the use of nerve guides and nerve grafts is given.

Sciatic nerve regeneration in rats by a promising electrospun collagen/poly(ε-caprolactone nerve conduit with tailored degradation rate

Directory of Open Access Journals (Sweden)

Jiang Xinquan

2011-07-01

Full Text Available Abstract Background To cope with the limitations faced by autograft acquisitions particularly for multiple nerve injuries, artificial nerve conduit has been introduced by researchers as a substitute for autologous nerve graft for the easy specification and availability for mass production. In order to best mimic the structures and components of autologous nerve, great efforts have been made to improve the designation of nerve conduits either from materials or fabrication techniques. Electrospinning is an easy and versatile technique that has recently been used to fabricate fibrous tissue-engineered scaffolds which have great similarity to the extracellular matrix on fiber structure. Results In this study we fabricated a collagen/poly(ε-caprolactone (collagen/PCL fibrous scaffold by electrospinning and explored its application as nerve guide substrate or conduit in vitro and in vivo. Material characterizations showed this electrospun composite material which was made of submicron fibers possessed good hydrophilicity and flexibility. In vitro study indicated electrospun collagen/PCL fibrous meshes promoted Schwann cell adhesion, elongation and proliferation. In vivo test showed electrospun collagen/PCL porous nerve conduits successfully supported nerve regeneration through an 8 mm sciatic nerve gap in adult rats, achieving similar electrophysiological and muscle reinnervation results as autografts. Although regenerated nerve fibers were still in a pre-mature stage 4 months postoperatively, the implanted collagen/PCL nerve conduits facilitated more axons regenerating through the conduit lumen and gradually degraded which well matched the nerve regeneration rate. Conclusions All the results demonstrated this collagen/PCL nerve conduit with tailored degradation rate fabricated by electrospinning could be an efficient alternative to autograft for peripheral nerve regeneration research. Due to its advantage of high surface area for cell attachment, it

Long-Term Regeneration and Functional Recovery of a 15 mm Critical Nerve Gap Bridged by Tremella fuciformis Polysaccharide-Immobilized Polylactide Conduits

Directory of Open Access Journals (Sweden)

Shan-hui Hsu

2013-01-01

Full Text Available Novel peripheral nerve conduits containing the negatively charged Tremella fuciformis polysaccharide (TF were prepared, and their efficacy in bridging a critical nerve gap was evaluated. The conduits were made of poly(D,L-lactide (PLA with asymmetric microporous structure. TF was immobilized on the lumen surface of the nerve conduits after open air plasma activation. The TF-modified surface was characterized by the attenuated total reflection Fourier-transformed infrared spectroscopy and the scanning electron microscopy. TF modification was found to enhance the neurotrophic gene expression of C6 glioma cells in vitro. TF-modified PLA nerve conduits were tested for their ability to bridge a 15 mm gap of rat sciatic nerve. Nerve regeneration was monitored by the magnetic resonance imaging. Results showed that TF immobilization promoted the nerve connection in 6 weeks. The functional recovery in animals receiving TF-immobilized conduits was greater than in those receiving the bare conduits during an 8-month period. The degree of functional recovery reached ~90% after 8 months in the group of TF-immobilized conduits.

Analytical studies on hotspot temperature of cable-in-conduit conductors

International Nuclear Information System (INIS)

Yoshida, Kiyoshi; Takigami, Hiroyoshi; Kubo, Hiroatsu

2001-01-01

This paper describes an analytical study to review the hotspot temperature design criteria of the cable-in-conduit conductors for the ITER magnet system. The ITER magnet system uses three kinds of cable-in-conduit conductors for the Toroidal Field (TF) coils, the Central Solenoid (CS) and the Poloidal Field (PF) coils. The amount of copper in the superconducting cable has been defined by using the classical hotspot temperature design criteria that is based on the adiabatic condition. In the current design, ITER superconducting cables include a large amount of pure copper strands to satisfy the classical criteria. However, temperature and stress in the conduit and insulations after quench can be simulated with the quench simulation program and stress analysis program using the latest analysis tools. This analysis shows that the strand temperature is dominated by the conduction along strands and the heat capacity of other conductor materials and coolant. The hotspot temperature depends strongly on the delay time for quench detection. This analysis provides an estimation of delay times for quench detection. The thermal and stress analysis can provide the maximum allowable temperature after quench by determination of a failure or a functional disorder condition of the jacket material and turn insulation. In conclusion, it is found that the current density of the cable space can be increased, by reducing the extra copper strand, thereby, allowing a reduction of the coil radial build. (author)

Delivered volumes of enteral nutrition exceed prescribed volumes.

Science.gov (United States)

Walker, Renee Nichole; Utech, Anne; Velez, Maria Eugenia; Schwartz, Katie

2014-10-01

Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment. A supply of consecutively numbered ready-to-hang (RTH) EN product was delivered to the bedside of 26 inpatients with established EN tolerance at goal rates on various types of nursing units. The dietitian weighed the volume remaining in the infusing product and recorded the measurement time. On the following days, the dietitian continued to weigh the infusing RTH product and the empty RTH bottles saved by nursing. The primary outcome was the difference between the prescribed and delivered EN provisions, which was calculated with a paired t test. Patients received significantly more calories in the delivered enteral feeding (mean [SD], 1678 [385] kcal) than prescribed calories in the EN order (1489 [246 kcal]; t = 3.736, P = .001), adjusting for observed time. No significant differences were found between nursing units, product, and rate. EN delivered may actually exceed ordered amounts by 5%–21% (mean, 12%) with feeding pump inaccuracy as the primary contributing factor. This differs from what others have found. Our findings support using a volume-based ordering system vs a rate-based ordering system for more accurate EN delivery.

A rare case of prosthetic endocarditis and dehiscence in a mechanical valved conduit.

Science.gov (United States)

Kannan, Arun; Smith, Cristy; Subramanian, Sreekumar; Janardhanan, Rajesh

2014-02-07

A middle-aged adult patient with a history of aortic root replacement with a mechanical valved conduit and remote chest trauma was referred to our institution with prosthetic endocarditis. Transoesophageal echocardiogram at our institution confirmed a near-complete dehiscence of the prosthetic aortic valve from the conduit, with significant perivalvular flow forming a pseudoaneurysm. The patient underwent a high-risk re-operation, involving redo aortic root replacement with a homograft after extensive debridement of the infected tissue. The patient was discharged to an outside facility after an uncomplicated hospital course, and remains stable.

Thoracoscopic management of volvulus of the gastric conduit following minimally invasive Ivor-Lewis esophagectomy.

Science.gov (United States)

Linson, Jeremy; Latzko, Michael; Ahmed, Bestoun; Awad, Ziad

2016-07-01

We present a case of emergent thoracoscopic management of volvulus of the gastric conduit following minimally invasive Ivor-Lewis esophagectomy. The patient is a 69-year-old Caucasian male with a history of adenocarcinoma of the lower third of the esophagus. Initial presentation was dysphagia with solid foods, which progressed in severity until he was unable to swallow anything. EUS demonstrated a partially obstructing mass at 33 cm; biopsy revealed poorly differentiated adenocarcinoma, stage T3N2Mx. PET scan did not reveal any metastatic disease. Preoperative management included neo-adjuvant chemoradiation therapy (5-FU and cisplatin) and early placement of a jejunal feeding tube. Intra-operative leak test was performed as a matter of routine following completion of the esophagogastric anastomosis. A nasogastric tube was placed intra-operatively and removed on POD2 according to our standard pathway. Postoperatively, the patient progressed without difficulty to POD4, when we routinely obtain an upper GI swallow study. This demonstrated a lack of transit of contrast through the distal neo-esophagus. Follow-up endoscopy revealed volvulus of the gastric conduit with obliteration of the lumen. We immediately took the patient to the OR for thoracoscopic detorsion, which we accomplished successfully by entering the existing trochar sites and using blunt dissection.␣Upon entering the thoracic cavity, the staple line that had been oriented anteriorly was now posterior. Attachments were gently teased away from the chest wall and the conduit was detorsed and anchored to the chest wall in the correct orientation with silk suture. Intra-operative endoscopy demonstrated a patent conduit. Postoperative upper GI fluoroscopy now showed good transit of contrast. The patient continued to improve and was eventually advanced to mechanical soft diet and discharged on postoperative day 9. Early intervention is indicated in cases of volvulus of the gastric conduit following Ivor

Application of near real-time radial semblance to locate the shallow magmatic conduit at Kilauea Volcano, Hawaii

Science.gov (United States)

Dawson, P.; Whilldin, D.; Chouet, B.

2004-01-01

Radial Semblance is applied to broadband seismic network data to provide source locations of Very-Long-Period (VLP) seismic energy in near real time. With an efficient algorithm and adequate network coverage, accurate source locations of VLP energy are derived to quickly locate the shallow magmatic conduit system at Kilauea Volcano, Hawaii. During a restart in magma flow following a brief pause in the current eruption, the shallow magmatic conduit is pressurized, resulting in elastic radiation from various parts of the conduit system. A steeply dipping distribution of VLP hypocenters outlines a region extending from sea level to about 550 m elevation below and just east of the Halemaumau Pit Crater. The distinct hypocenters suggest the shallow plumbing system beneath Halemaumau consists of a complex plexus of sills and dikes. An unconstrained location for a section of the conduit is also observed beneath the region between Kilauea Caldera and Kilauea Iki Crater.

Numerical modeling and sensitivity analysis of seawater intrusion in a dual-permeability coastal karst aquifer with conduit networks

Directory of Open Access Journals (Sweden)

Z. Xu

2018-01-01

Full Text Available Long-distance seawater intrusion has been widely observed through the subsurface conduit system in coastal karst aquifers as a source of groundwater contaminant. In this study, seawater intrusion in a dual-permeability karst aquifer with conduit networks is studied by the two-dimensional density-dependent flow and transport SEAWAT model. Local and global sensitivity analyses are used to evaluate the impacts of boundary conditions and hydrological characteristics on modeling seawater intrusion in a karst aquifer, including hydraulic conductivity, effective porosity, specific storage, and dispersivity of the conduit network and of the porous medium. The local sensitivity analysis evaluates the parameters' sensitivities for modeling seawater intrusion, specifically in the Woodville Karst Plain (WKP. A more comprehensive interpretation of parameter sensitivities, including the nonlinear relationship between simulations and parameters, and/or parameter interactions, is addressed in the global sensitivity analysis. The conduit parameters and boundary conditions are important to the simulations in the porous medium because of the dynamical exchanges between the two systems. The sensitivity study indicates that salinity and head simulations in the karst features, such as the conduit system and submarine springs, are critical for understanding seawater intrusion in a coastal karst aquifer. The evaluation of hydraulic conductivity sensitivity in the continuum SEAWAT model may be biased since the conduit flow velocity is not accurately calculated by Darcy's equation as a function of head difference and hydraulic conductivity. In addition, dispersivity is no longer an important parameter in an advection-dominated karst aquifer with a conduit system, compared to the sensitivity results in a porous medium aquifer. In the end, the extents of seawater intrusion are quantitatively evaluated and measured under different scenarios with the variabilities of

Silicic magma differentiation in ascent conduits. Experimental constraints

Science.gov (United States)

Rodríguez, Carmen; Castro, Antonio

2017-02-01

Crystallization of water-bearing silicic magmas in a dynamic thermal boundary layer is reproduced experimentally by using the intrinsic thermal gradient of piston-cylinder assemblies. The standard AGV2 andesite under water-undersaturated conditions is set to crystallize in a dynamic thermal gradient of about 35 °C/mm in 10 mm length capsules. In the hotter area of the capsule, the temperature is initially set at 1200 °C and decreases by programmed cooling at two distinct rates of 0.6 and 9.6 °C/h. Experiments are conducted in horizontally arranged assemblies in a piston cylinder apparatus to avoid any effect of gravity settling and compaction of crystals in long duration runs. The results are conclusive about the effect of water-rich fluids that are expelled out the crystal-rich zone (mush), where water saturation is reached by second boiling in the interstitial liquid. Expelled fluids migrate to the magma ahead of the solidification front contributing to a progressive enrichment in the fluxed components SiO2, K2O and H2O. The composition of water-rich fluids is modelled by mass balance using the chemical composition of glasses (quenched melt). The results are the basis for a model of granite magma differentiation in thermally-zoned conduits with application of in-situ crystallization equations. The intriguing textural and compositional features of the typical autoliths, accompanying granodiorite-tonalite batholiths, can be explained following the results of this study, by critical phenomena leading to splitting of an initially homogeneous magma into two magma systems with sharp boundaries. Magma splitting in thermal boundary layers, formed at the margins of ascent conduits, may operate for several km distances during magma transport from deep sources at the lower crust or upper mantle. Accordingly, conduits may work as chromatographic columns contributing to increase the silica content of ascending magmas and, at the same time, leave behind residual mushes that

Selective reinnervation: a comparison of recovery following microsuture and conduit nerve repair.

Science.gov (United States)

Evans, P J; Bain, J R; Mackinnon, S E; Makino, A P; Hunter, D A

1991-09-20

Selective reinnervation was studied by comparing the regeneration across a conventional neurorraphy versus a conduit nerve repair. Lewis rats underwent right sciatic nerve transection followed by one of four different nerve repairs (n = 8/group). In groups I and II a conventional neurorraphy was performed and in groups III and IV the proximal and distal stumps were coapted by use of a silicone conduit with an interstump gap of 5 mm. The proximal and distal stumps in groups I and III were aligned anatomically correct and the proximal stump was rotated 180 degrees in groups II and IV (i.e. proximal peroneal nerve opposite the distal tibial nerve and the proximal tibial nerve opposite the distal peroneal nerve). By 14 weeks, there was an equivalent, but incomplete return in sciatic function index (SFI) in groups I, III, and IV as measured by walking track analysis. However, the SFI became unmeasurable by 6 weeks in all group II animals. At 14 weeks, the percent innervation of the tibialis anterior and medial gastronemius muscles by the peroneal and tibial nerves respectively was estimated by selective compound muscle action potential amplitude recordings. When fascicular alignment was reversed, there was greater tibial (P = 0.02) and lesser peroneal (P = 0.005) innervation of the gastrocnemius muscle in the conduit (group IV) versus the neurorraphy (group II) group. This suggests that the gastrocnemius muscle may be selectively reinnervated by the tibial nerve. However, there was no evidence of selective reinnervation of the tibialis anterior muscle. Despite these differences, the functional recovery in both conduit repair groups (III and IV) was equivalent to a correctly aligned microsuture repair (group I) and superior to that in the incorrectly aligned microsuture repair (group II).

Pericardial tissue valves and Gore-Tex conduits as an alternative for right ventricular outflow tract replacement in children.

Science.gov (United States)

Allen, Bradley S; El-Zein, Chawki; Cuneo, Betina; Cava, Joseph P; Barth, Mary Jane; Ilbawi, Michel N

2002-09-01

There is still no perfect conduit for reconstruction of the right ventricular outflow tract (RVOT) in children. Homografts are not always available in the appropriate size, and degenerate in a few years. This study evaluates the pericardial valve with Gore-Tex conduit as an alternative for RVOT construction. From January 1, 1993, to September 30, 1999, a pericardial tissue valve was inserted in all patients undergoing RVOT reconstruction or pulmonary valve replacement (PVR) who were large enough to accommodate a tissue valve. In patients without a native main pulmonary artery, a new technique was used to construct an RV-PA conduit out of a flat sheet of Gore-Tex, as Dacron frequently leads to stenosis. Data were collected by retrospective review, follow-up echocardiograms, and assessment by a single cardiologist. There were 48 patients, 22 undergoing a PVR alone and 26 a RV-PA valved Gore-Tex conduit. Diagnosis included tetralogy of Fallot (n = 25); truncus arteriosis (n = 9); ventricular septal defect with PA (n = 5); DORV (n = 4); D-TGA with PS (n = 2); and 1 each IAA with sub AS, VSD with PI, and PS s/p Ross procedure. Patient age ranged from 3 to 33 years and 98% were reoperations. The valve sizes ranged from 19 to 33 mm and the median hospital length of stay was 4 days. There were 2 (4.2%) perioperative and 1 (2.1%) late deaths, none related to the valve or Gore-Tex conduit. At a follow-up of 15 to 86 months (mean 43 +/- 16 months), all remaining 45 patients are New York Heart Association class I, all valves are functional, and no patient has required valve or conduit replacement or revision; more importantly, echocardiogram revealed no significant valve or conduit stenosis (mean gradient 16 +/- 8 mm Hg) and no evidence of regurgitation or structural degeneration. A pericardial tissue valve and Gore-Tex conduit provides a reliable alternative for RVOT reconstruction in pediatric patients. It is readily available, molds in the limited retrosternal space, and

Long distance seawater intrusion through a karst conduit network in the Woodville Karst Plain, Florida

OpenAIRE

Zexuan Xu; Seth Willis Bassett; Bill Hu; Scott Barrett Dyer

2016-01-01

Five periods of increased electrical conductivity have been found in the karst conduits supplying one of the largest first magnitude springs in Florida with water. Numerous well-developed conduit networks are distributed in the Woodville Karst Plain (WKP), Florida and connected to the Gulf of Mexico. A composite analysis of precipitation and electrical conductivity data provides strong evidence that the increases in conductivity are directly tied to seawater intrusion moving inland and travel...

Lorentz force effect on mixed convection micropolar flow in a vertical conduit

Science.gov (United States)

Abdel-wahed, Mohamed S.

2017-05-01

The present work provides a simulation of control and filtration process of hydromagnetic blood flow with Hall current under the effect of heat source or sink through a vertical conduit (pipe). This work meets other engineering applications, such as nuclear reactors cooled during emergency shutdown, geophysical transport in electrically conducting and heat exchangers at low velocity conditions. The problem is modeled by a system of partial differential equations taking the effect of viscous dissipation, and these equations are simplified and solved analytically as a series solution using the Differential Transformation Method (DTM). The velocities and temperature profiles of the flow are plotted and discussed. Moreover, the conduit wall shear stress and heat flux are deduced and explained.

Electromagnetic nondestructive testing at high lift-off using a magnetic image conduit

International Nuclear Information System (INIS)

Lee, Jin Yi; Jun, Jong Woo; Kim, Jung Min; Le, Min Hhuy

2013-01-01

To protect sensors from the extreme environments, such as, heat, moisture, pollution and radiation, cracks must be inspected for; this can be done by measuring the distribution of magnetic fields at high lift-off through nondestructive electro-magnetic testing. However, as the intensity of an electro-magnetic field is inversely proportional to the square of the lift-off, it becomes increasingly difficult to effective inspect a crack as the lift-off increases. In this paper, a magnetic image conduit to minimize the intensity loss of an electro-magnetic field at high lift-off is proposed, and the effectiveness of a conduit for magnetic imaging is verified by means of both theoretical and experimental approaches.

Using MODFLOW with CFP to understand conduit-matrix exchange in a karst aquifer during flooding

Science.gov (United States)

Spellman, P.; Screaton, E.; Martin, J. B.; Gulley, J.; Brown, A.

2011-12-01

Karst springs may reverse flow when allogenic runoff increases river stage faster than groundwater heads and may exchange of surface water with groundwater in the surrounding aquifer matrix. Recharged flood water is rich in nutrients, metals, and organic matter and is undersaturated with respect to calcite. Understanding the physical processes controlling this exchange of water is critical to understanding metal cycling, redox chemistry and dissolution in the subsurface. Ultimately the magnitude of conduit-matrix exchange should be governed by head gradients between the conduit and the aquifer which are affected by the hydraulic conductivity of the matrix, conduit properties and antecedent groundwater heads. These parameters are interrelated and it is unknown which ones exert the greatest control over the magnitude of exchange. This study uses MODFLOW-2005 coupled with the Conduit Flow Processes (CFP) package to determine how physical properties of conduits and aquifers influence the magnitude of surface water-groundwater exchange. We use hydraulic data collected during spring reversals in a mapped underwater cave that sources Madison Blue Spring in north-central Florida to explore which factors are most important in governing exchange. The simulation focused on a major flood in 2009, when river stage increased by about 10 meters over 9 days. In a series of simulations, we varied hydraulic conductivity, conduit diameter, roughness height and tortuosity in addition to antecedent groundwater heads to estimate the relative effects of each parameter on the magnitude of conduit-matrix exchange. Each parameter was varied across plausible ranges for karst aquifers. Antecedent groundwater heads were varied using well data recorded through wet and dry seasons throughout the spring shed. We found hydraulic conductivity was the most important factor governing exchange. The volume of exchange increased by about 61% from the lowest value (1.8x10-6 m/d) to the highest value (6 m

Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.

LENUS (Irish Health Repository)

Healy, David G

2012-02-03

We have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml\\/min (24), DDD-biventricular 52 ml\\/min (25), VVI-univentricular 47 ml\\/min (23), VVI-biventricular 50 ml\\/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.

Natural Occurring Silks and Their Analogues as Materials for Nerve Conduits

Directory of Open Access Journals (Sweden)

Christine Radtke

2016-10-01

Full Text Available Spider silk and its synthetic derivatives have a light weight in combination with good strength and elasticity. Their high cytocompatibility and low immunogenicity make them well suited for biomaterial products such as nerve conduits. Silk proteins slowly degrade enzymatically in vivo, thus allowing for an initial therapeutic effect such as in nerve scaffolding to facilitate endogenous repair processes, and then are removed. Silks are biopolymers naturally produced by many species of arthropods including spiders, caterpillars and mites. The silk fibers are secreted by the labial gland of the larvae of some orders of Holometabola (insects with pupa or the spinnerets of spiders. The majority of studies using silks for biomedical applications use materials from silkworms or spiders, mostly of the genus Nephila clavipes. Silk is one of the most promising biomaterials with effects not only in nerve regeneration, but in a number of regenerative applications. The development of silks for human biomedical applications is of high scientific and clinical interest. Biomaterials in use for biomedical applications have to meet a number of requirements such as biocompatibility and elicitation of no more than a minor inflammatory response, biodegradability in a reasonable time and specific structural properties. Here we present the current status in the field of silk-based conduit development for nerve repair and discuss current advances with regard to potential clinical transfer of an implantable nerve conduit for enhancement of nerve regeneration.

Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial.

Science.gov (United States)

Thirlwall, Kerstin; Cooper, Peter J; Karalus, Jessica; Voysey, Merryn; Willetts, Lucy; Creswell, Cathy

2013-12-01

Promising evidence has emerged of clinical gains using guided self-help cognitive-behavioural therapy (CBT) for child anxiety and by involving parents in treatment; however, the efficacy of guided parent-delivered CBT has not been systematically evaluated in UK primary and secondary settings. To evaluate the efficacy of low-intensity guided parent-delivered CBT treatments for children with anxiety disorders. A total of 194 children presenting with a current anxiety disorder, whose primary carer did not meet criteria for a current anxiety disorder, were randomly allocated to full guided parent-delivered CBT (four face-to-face and four telephone sessions) or brief guided parent-delivered CBT (two face-to-face and two telephone sessions), or a wait-list control group (trial registration: ISRCTN92977593). Presence and severity of child primary anxiety disorder (Anxiety Disorders Interview Schedule for DSM-IV, child/parent versions), improvement in child presentation of anxiety (Clinical Global Impression - Improvement scale), and change in child anxiety symptoms (Spence Children's Anxiety Scale, child/parent version and Child Anxiety Impact scale, parent version) were assessed at post-treatment and for those in the two active treatment groups, 6 months post-treatment. Full guided parent-delivered CBT produced superior diagnostic outcomes compared with wait-list at post-treatment, whereas brief guided parent-delivered CBT did not: at post-treatment, 25 (50%) of those in the full guided CBT group had recovered from their primary diagnosis, compared with 16 (25%) of those on the wait-list (relative risk (RR) 1.85, 95% CI 1.14-2.99); and in the brief guided CBT group, 18 participants (39%) had recovered from their primary diagnosis post-treatment (RR = 1.56, 95% CI 0.89-2.74). Level of therapist training and experience was unrelated to child outcome. Full guided parent-delivered CBT is an effective and inexpensive first-line treatment for child anxiety.

Lost and Found: Music Activities Delivered by Primary Classroom Generalists

Science.gov (United States)

King, Fiona

2015-01-01

Primary classroom teachers can play a vital role in the music education of primary school students, providing a basis for lifelong learning in music and the arts. Research shows that not all Victorian primary school students have equitable access to music education and that the role of the classroom teacher becomes valuable in supplying or…

Water exchange and pressure transfer between conduits and matrix and their influence on hydrodynamics of two karst aquifers with sinking streams

Science.gov (United States)

Bailly-Comte, Vincent; Martin, Jonathan B.; Jourde, Hervé; Screaton, Elizabeth J.; Pistre, Séverin; Langston, Abigail

2010-05-01

SummaryKarst aquifers are heterogeneous media where conduits usually drain water from lower permeability volumes (matrix and fractures). For more than a century, various approaches have used flood recession curves, which integrate all hydrodynamic processes in a karst aquifer, to infer physical properties of the movement and storage of groundwater. These investigations typically only consider flow to the conduits and thus have lacked quantitative observations of how pressure transfer and water exchange between matrix and conduit during flooding could influence recession curves. We present analyses of simultaneous discharge and water level time series of two distinctly different karst systems, one with low porosity and permeability matrix rocks in southern France, and one with high porosity and permeability matrix rocks in north-central Florida (USA). We apply simple mathematical models of flood recession using time series representations of recharge, storage, and discharge processes in the karst aquifer. We show that karst spring hydrographs can be interpreted according to pressure transfer between two distinct components of the aquifer, conduit and matrix porosity, which induce two distinct responses at the spring. Water exchange between conduits and matrix porosity successively control the flow regime at the spring. This exchange is governed by hydraulic head differences between conduits and matrix, head gradients within conduits, and the contrast of permeability between conduits and matrix. These observations have consequences for physical interpretations of recession curves and modeling of karst spring flows, particularly for the relative magnitudes of base flow and quick flow from karst springs. Finally, these results suggest that similar analyses of recession curves can be applied to karst aquifers with distinct physical characteristics utilizing well and spring hydrograph data, but information must be known about the hydrodynamics and physical properties of

A cluster randomised controlled trial of the efficacy of a brief walking intervention delivered in primary care: Study protocol

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Szczepura Ala

2011-06-01

Full Text Available Abstract Background The aim of the present research is to conduct a fully powered explanatory trial to evaluate the efficacy of a brief self-regulation intervention to increase walking. The intervention will be delivered in primary care by practice nurses (PNs and Healthcare Assistants (HCAs to patients for whom increasing physical activity is a particular priority. The intervention has previously demonstrated efficacy with a volunteer population, and subsequently went through an iterative process of refinement in primary care, to maximise acceptability to both providers and recipients. Methods/ Design This two arm cluster randomised controlled trial set in UK general practices will compare two strategies for increasing walking, assessed by pedometer, over six months. Patients attending practices randomised to the self-regulation intervention arm will receive an intervention consisting of behaviour change techniques designed to increase walking self-efficacy (confidence in ability to perform the behaviour, and to help people translate their "good" intentions into behaviour change by making plans. Patients attending practices randomised to the information provision arm will receive written materials promoting walking, and a short unstructured discussion about increasing their walking. The trial will recruit 20 PN/HCAs (10 per arm, who will be trained by the research team to deliver the self-regulation intervention or information provision control intervention, to 400 patients registered at their practices (20 patients per PN/HCA. This will provide 85% power to detect a mean difference of five minutes/day walking between the self-regulation intervention group and the information provision control group. Secondary outcomes include health services costs, and intervention effects in sub-groups defined by age, ethnicity, gender, socio-economic status, and clinical condition. A mediation analysis will investigate the extent to which changes in

Enhancement of Median Nerve Regeneration by Mesenchymal Stem Cells Engraftment in an Absorbable Conduit: Improvement of Peripheral Nerve Morphology with Enlargement of Somatosensory Cortical Representation.

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Julia Teixeira Oliveira

2014-10-01

Full Text Available We studied the morphology and the cortical representation of the median nerve (MN, 10 weeks after a transection immediately followed by treatment with tubulization using a polycaprolactone (PCL conduit with or without bone marrow-derived mesenchymal stem cell (MSC transplant. In order to characterize the cutaneous representation of MN inputs in primary somatosensory cortex (S1, electrophysiological cortical mapping of the somatosensory representation of the forepaw and adjacent body parts was performed after acute lesion of all brachial plexus nerves, except for the MN. This was performed in ten adult male Wistar rats randomly assigned in 3 groups: MN Intact (n=4, PCL-Only (n=3 and PCL+MSC (n=3. Ten weeks before mapping procedures in animals from PCL-Only and PCL+MSC groups, animal were subjected to MN transection with removal of a 4-mm-long segment, immediately followed by suturing a PCL conduit to the nerve stumps with (PCL+MSC group or without (PCL-Only group injection of MSC into the conduit. After mapping the representation of the MN in S1, animals had a segment of the regenerated nerve processed for light and transmission electron microscopy. For histomorphometric analysis of the nerve segment, sample size was increased to 5 animals per experimental group. The PCL+MSC group presented a higher number of myelinated fibers and a larger cortical representation of MN inputs in S1 (3,383±390 fibers; 2.3 mm2, respectively than the PCL-Only group (2,226±575 fibers; 1.6 mm2. In conclusion, MSC-based therapy associated with PCL conduits can improve MN regeneration. This treatment seems to rescue the nerve representation in S1, thus minimizing the stabilization of new representations of adjacent body parts in regions previously responsive to the MN.

Conduit dynamics in transitional rhyolitic activity recorded by tuffisite vein textures from the 2008-2009 Chaitén eruption

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Elodie eSaubin

2016-05-01

Full Text Available The mechanisms of hazardous silicic eruptions are controlled by complex, poorly-understood conduit processes. Observations of recent Chilean rhyolite eruptions have revealed the importance of hybrid activity, involving simultaneous explosive and effusive emissions from a common vent. Such behaviour hinges upon the ability of gas to decouple from magma in the shallow conduit. Tuffisite veins are increasingly suspected to be a key facilitator of outgassing, as they repeatedly provide a transient permeable escape route for volcanic gases. Intersection of foam domains by tuffisite veins appears critical to efficient outgassing. However, knowledge is currently lacking into textural heterogeneities within shallow conduits, their relationship with tuffisite vein propagation, and the implications for fragmentation and degassing processes. Similarly, the magmatic vesiculation response to upper conduit pressure perturbations, such as those related to the slip of dense magma plugs, remains largely undefined. Here we provide a detailed characterization of an exceptionally large tuffisite vein within a rhyolitic obsidian bomb ejected during transitional explosive-effusive activity at Chaitén, Chile in May 2008. Vein textures and chemistry provide a time-integrated record of the invasion of a dense upper conduit plug by deeper fragmented magma. Quantitative textural analysis reveals diverse vesiculation histories of various juvenile clast types.Using vesicle size distributions, bubble number densities, zones of diffusive water depletion, and glass H2O concentrations, we propose a multi-step degassing/fragmentation history, spanning deep degassing to explosive bomb ejection. Rapid decompression events of ~3-4 MPa are associated with fragmentation of foam and dense magma at ~200-350 metres depth in the conduit, permitting vertical gas and pyroclast mobility over hundreds of metres. Permeable pathway occlusion in the dense conduit plug by pyroclast accumulation

Comparative analysis of the pressure profilometry of vesicocutaneous continent catheterizable conduits between patients with and without rectus abdominis neosphincter (Yachia principle).

Science.gov (United States)

Rondon, Atila; Leslie, Bruno; Arcuri, Leonardo Javier; Ortiz, Valdemar; Macedo, Antonio

2015-09-01

To assess whether crossing rectus abdominis muscle strips, as proposed by Yachia, would change urinary catheterizable conduit's pressure profilometry, in static and dynamic conditions. Non-randomized selection of 20 continent patients that underwent Macedo's ileum-based reservoir, 10 including Yachia's technique (Study Group) and 10 without this mechanism of continence (Control Group). Demographics and cystometric data were assessed. Conduit's pressure profilometry was obtained by infusing saline through a multichannel catheter, at rest and during Valsalva maneuver. We assessed the pressure: (a) in the bladder; (b) in conduit's proximal segment; and (c) in conduit's distal segment, which is presumably the abdominal wall and crossed muscle strips site. Mean age at surgery was 6.1 years in the Control Group and 7.7 years in the Study Group. There was no statistically significant difference between groups regarding maximum cystometric bladder capacity and leakage point pressure. At rest, the pressure profilometry showed similar results between groups in all segments analyzed. During Valsalva maneuver, pressure profilometry showed similar results between groups in bladder and conduit's proximal segment pressure. In this condition, conduit's distal segment pressure in the Study Group (Mean = 72.9 and Peak = 128.7 cmH2 O) was significantly greater (P continence. © 2014 Wiley Periodicals, Inc.

A new venous conduit utilizing the recipient portal vein branches for segment V in adult partial liver transplantation.

Science.gov (United States)

Moon, I S; Kim, D G; Lee, M D; Hong, S K; Park, S C; Oh, D Y; Ahn, S T; Lee, Y J

2005-03-01

Right anterior-medial lobe congestion due to temporary clamping of segment V and/or VIII is common in the operative theater during adult donor right lobe liver transplantation, the most common procedure in our institute. We have used an autogenous saphenous vein conduit to recipient portal vein tributaries in 15 cases, as a "Y-to-I venoplasty" since January 2004. The recipient portal vein is transected 5 mm proximal to its bifurcation and extended to both sides with partial hepatic dissection. The "Y-to-I venoplasty" is made by suture closure of the portal vein transversely to form a tube. The average length is 7.5 cm with a 1.3 cm width. One end of "Y-to-I venoplasty" conduit is anastomosed to the donor segment V branch on the back table. And the other end is anastomosed directly to the IVC via a new window or the middle hepatic vein stump in recipient. The phase distension of the conduit with respiration is noted in the operative field. A 6/15 (40%) patency rate, was observed by CT angiography at the second postoperative week. All-patient conduits showed good flow on serial examinations at the 60th postoperative day. This new venous graft, made of recipient portal vein is a good conduit for segment V decongestion in adult right lobe partial liver transplantation.

Erosion of cohesive soil layers above underground conduits

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Luu, Li-Hua; Philippe, Pierre; Noury, Gildas; Perrin, Jérôme; Brivois, Olivier

2017-06-01

Using a recently developed 2D numerical modelling that combines Discrete Element (DEM) and Lattice Boltzmann methods (LBM), we simulate the destabilisation by an hydraulic gradient of a cohesive granular soil clogging the top of an underground conduit. We aim to perform a multi-scale study that relates the grain scale behavior to the macroscopic erosion process. In particular, we study the influence of the flow conditions and the inter-particle contact forces intensity on the erosion kinetic.

Documentation of a Conduit Flow Process (CFP) for MODFLOW-2005

Science.gov (United States)

Shoemaker, W. Barclay; Kuniansky, Eve L.; Birk, Steffen; Bauer, Sebastian; Swain, Eric D.

2007-01-01

This report documents the Conduit Flow Process (CFP) for the modular finite-difference ground-water flow model, MODFLOW-2005. The CFP has the ability to simulate turbulent ground-water flow conditions by: (1) coupling the traditional ground-water flow equation with formulations for a discrete network of cylindrical pipes (Mode 1), (2) inserting a high-conductivity flow layer that can switch between laminar and turbulent flow (Mode 2), or (3) simultaneously coupling a discrete pipe network while inserting a high-conductivity flow layer that can switch between laminar and turbulent flow (Mode 3). Conduit flow pipes (Mode 1) may represent dissolution or biological burrowing features in carbonate aquifers, voids in fractured rock, and (or) lava tubes in basaltic aquifers and can be fully or partially saturated under laminar or turbulent flow conditions. Preferential flow layers (Mode 2) may represent: (1) a porous media where turbulent flow is suspected to occur under the observed hydraulic gradients; (2) a single secondary porosity subsurface feature, such as a well-defined laterally extensive underground cave; or (3) a horizontal preferential flow layer consisting of many interconnected voids. In this second case, the input data are effective parameters, such as a very high hydraulic conductivity, representing multiple features. Data preparation is more complex for CFP Mode 1 (CFPM1) than for CFP Mode 2 (CFPM2). Specifically for CFPM1, conduit pipe locations, lengths, diameters, tortuosity, internal roughness, critical Reynolds numbers (NRe), and exchange conductances are required. CFPM1, however, solves the pipe network equations in a matrix that is independent of the porous media equation matrix, which may mitigate numerical instability associated with solution of dual flow components within the same matrix. CFPM2 requires less hydraulic information and knowledge about the specific location and hydraulic properties of conduits, and turbulent flow is approximated by

Convection in a volcanic conduit recorded by bubbles

Science.gov (United States)

Carey, Rebecca J.; Manga, Michael; Degruyter, Wim; Gonnermann, Helge M.; Swanson, Donald; Houghton, Bruce F.; Orr, Tim R.; Patrick, Matthew R.

2013-01-01

Microtextures of juvenile pyroclasts from Kīlauea’s (Hawai‘i) early A.D. 2008 explosive activity record the velocity and depth of convection within the basaltic magma-filled conduit. We use X-ray microtomography (μXRT) to document the spatial distribution of bubbles. We find small bubbles (radii from 5 μm to 70 μm) in a halo surrounding larger millimeter-size bubbles. This suggests that dissolved water was enriched around the larger bubbles—the opposite of what is expected if bubbles grow as water diffuses into the bubble. Such volatile enrichment implies that the volatiles within the large bubbles were redissolving into the melt as they descended into the conduit by the downward motion of convecting magma within the lava lake. The thickness of the small bubble halo is ∼100–150 μm, consistent with water diffusing into the melt on time scales on the order of 103 s. Eruptions, triggered by rockfall, rapidly exposed this magma to lower pressures, and the haloes of melt with re-dissolved water became sufficiently supersaturated to cause nucleation of the population of smaller bubbles. The required supersaturation pressures are consistent with a depth of a few hundred meters and convection velocities of the order of 0.1 m s−1, similar to the circulation velocity observed on the surface of the Halema‘uma‘u lava lake.

Systematic review of integrated models of health care delivered at the primary-secondary interface: how effective is it and what determines effectiveness?

Science.gov (United States)

Mitchell, Geoffrey K; Burridge, Letitia; Zhang, Jianzhen; Donald, Maria; Scott, Ian A; Dart, Jared; Jackson, Claire L

2015-01-01

Integrated multidisciplinary care is difficult to achieve between specialist clinical services and primary care practitioners, but should improve outcomes for patients with chronic and/or complex chronic physical diseases. This systematic review identifies outcomes of different models that integrate specialist and primary care practitioners, and characteristics of models that delivered favourable clinical outcomes. For quality appraisal, the Cochrane Risk of Bias tool was used. Data are presented as a narrative synthesis due to marked heterogeneity in study outcomes. Ten studies were included. Publication bias cannot be ruled out. Despite few improvements in clinical outcomes, significant improvements were reported in process outcomes regarding disease control and service delivery. No study reported negative effects compared with usual care. Economic outcomes showed modest increases in costs of integrated primary-secondary care. Six elements were identified that were common to these models of integrated primary-secondary care: (1) interdisciplinary teamwork; (2) communication/information exchange; (3) shared care guidelines or pathways; (4) training and education; (5) access and acceptability for patients; and (6) a viable funding model. Compared with usual care, integrated primary-secondary care can improve elements of disease control and service delivery at a modestly increased cost, although the impact on clinical outcomes is limited. Future trials of integrated care should incorporate design elements likely to maximise effectiveness.

Conduit for high temperature transfer of molten semiconductor crystalline material

Science.gov (United States)

Fiegl, George (Inventor); Torbet, Walter (Inventor)

1983-01-01

A conduit for high temperature transfer of molten semiconductor crystalline material consists of a composite structure incorporating a quartz transfer tube as the innermost member, with an outer thermally insulating layer designed to serve the dual purposes of minimizing heat losses from the quartz tube and maintaining mechanical strength and rigidity of the conduit at the elevated temperatures encountered. The composite structure ensures that the molten semiconductor material only comes in contact with a material (quartz) with which it is compatible, while the outer layer structure reinforces the quartz tube, which becomes somewhat soft at molten semiconductor temperatures. To further aid in preventing cooling of the molten semiconductor, a distributed, electric resistance heater is in contact with the surface of the quartz tube over most of its length. The quartz tube has short end portions which extend through the surface of the semiconductor melt and which are lef bare of the thermal insulation. The heater is designed to provide an increased heat input per unit area in the region adjacent these end portions.

Fabrication of bioactive conduits containing the fibroblast growth factor 1 and neural stem cells for peripheral nerve regeneration across a 15 mm critical gap

International Nuclear Information System (INIS)

Ni, Hsiao-Chiang; Tseng, Ting-Chen; Hsu, Shan-hui; Chen, Jeng-Rung; Chiu, Ing-Ming

2013-01-01

Nerve conduits are often used in combination with bioactive molecules and stem cells to enhance peripheral nerve regeneration. In this study, the acidic fibroblast growth factor 1 (FGF1) was immobilized onto the microporous/micropatterned poly (D, L-lactic acid) (PLA) nerve conduits after open air plasma treatment. PLA substrates grafted with chitosan in the presence of a small amount of gold nanoparticles (nano Au) showed a protective effect on the activity of the immobilized FGF1 in vitro. Different conduits were tested for their ability to bridge a 15 mm critical gap defect in a rat sciatic nerve injury model. Axon regeneration and functional recovery were evaluated by histology, walking track analysis and electrophysiology. Among different conduits, PLA conduits grafted with chitosan–nano Au and the FGF1 after plasma activation had the greatest regeneration capacity and functional recovery in the experimental animals. When the above conduit was seeded with aligned neural stem cells, the efficacy was further enhanced and it approached that of the autograft group. This work suggested that microporous/micropatterned nerve conduits containing bioactive growth factors may be successfully fabricated by micropatterning techniques, open plasma activation, and immobilization, which, combined with aligned stem cells, may synergistically contribute to the regeneration of the severely damaged peripheral nerve. (paper)

Erosion of cohesive soil layers above underground conduits

Directory of Open Access Journals (Sweden)

Luu Li-Hua

2017-01-01

Full Text Available Using a recently developed 2D numerical modelling that combines Discrete Element (DEM and Lattice Boltzmann methods (LBM, we simulate the destabilisation by an hydraulic gradient of a cohesive granular soil clogging the top of an underground conduit. We aim to perform a multi-scale study that relates the grain scale behavior to the macroscopic erosion process. In particular, we study the influence of the flow conditions and the inter-particle contact forces intensity on the erosion kinetic.

The Railway and the River: Conduits of Dickens’s Imaginary City

NARCIS (Netherlands)

Moore, B.; Murail, E.; Thornton, S.

2017-01-01

This chapter analyses the railway and the river as two key conduits of Dickens’ imaginary city, arguing that each simultaneously connects and fractures the modern urban world that he depicts. Focusing on Dombey and Son and Our Mutual Friend, the chapter explores how railway and river combine

Three-layer microfibrous peripheral nerve guide conduit composed of elastin-laminin mimetic artificial protein and poly(L-lactic acid

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Sachiro eKakinoki

2014-07-01

Full Text Available We developed a microfibrous poly(L-lactic acid (PLLA nerve conduit with a three-layered structure to simultaneously enhance nerve regeneration and prevent adhesion of surrounding tissue. The inner layer was composed of PLLA microfiber containing 25% elastin-laminin mimetic protein (AG73-(VPGIG30 that promotes neurite outgrowth. The thickest middle layer was constructed of pure PLLA microfibers that impart the large mechanical stremgth to the conduit. A 10% poly(ethylene glycol was added to the outer layer to prevent the adhesion with the surrounding tissue. The AG73-(VPGIG30 composisting of an elastin-like repetitive sequence (VPGIG30 and a laminin-derived sequence (RKRLQVQLSIRT: AG73 was biosynthesized using Escherichia coli. The PLLA microfibrous conduits were fabricated using an electrospinning procedure. AG73-(VPGIG30 was successfully mixed in the PLLA microfibers, and the PLLA/AG73-(VPGIG30 microfibers were stable under physiological conditions. The PLLA/AG73-(VPGIG30 microfibers enhanced adhesion and neurite outgrowth of PC12 cells. The electrospun microfibrous conduit with a three-layered structure was implanted for bridging a 2.0-cm gap in the tibial nerve of a rabbit. Two months after implantation, no adhesion of surrounding tissue was observed, and the action potential was slightly improved in the nerve conduit with the PLLA/AG73-(VPGIG30 inner layer.

Three-layer microfibrous peripheral nerve guide conduit composed of elastin-laminin mimetic artificial protein and poly(L-lactic acid)

Science.gov (United States)

Kakinoki, Sachiro; Nakayama, Midori; Moritan, Toshiyuki; Yamaoka, Tetsuji

2014-07-01

We developed a microfibrous poly(L-lactic acid) (PLLA) nerve conduit with a three-layered structure to simultaneously enhance nerve regeneration and prevent adhesion of surrounding tissue. The inner layer was composed of PLLA microfiber containing 25% elastin-laminin mimetic protein (AG73-(VPGIG)30) that promotes neurite outgrowth. The thickest middle layer was constructed of pure PLLA microfibers that impart the large mechanical stremgth to the conduit. A 10% poly(ethylene glycol) was added to the outer layer to prevent the adhesion with the surrounding tissue. The AG73-(VPGIG)30 composisting of an elastin-like repetitive sequence (VPGIG)30 and a laminin-derived sequence (RKRLQVQLSIRT: AG73) was biosynthesized using Escherichia coli. The PLLA microfibrous conduits were fabricated using an electrospinning procedure. AG73-(VPGIG)30 was successfully mixed in the PLLA microfibers, and the PLLA/AG73-(VPGIG)30 microfibers were stable under physiological conditions. The PLLA/AG73-(VPGIG)30 microfibers enhanced adhesion and neurite outgrowth of PC12 cells. The electrospun microfibrous conduit with a three-layered structure was implanted for bridging a 2.0-cm gap in the tibial nerve of a rabbit. Two months after implantation, no adhesion of surrounding tissue was observed, and the action potential was slightly improved in the nerve conduit with the PLLA/AG73-(VPGIG)30 inner layer.

FDG-PET identification of infected pulmonary artery conduit following tetralogy of fallot (TOF) repair

Energy Technology Data Exchange (ETDEWEB)

Zhang, Yu Yang; Williams, Hadyn; Pucar, Darko [Dept. of Radiology, Medical College of Georgia, Augusta (United States)

2017-03-15

Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease usually managed by serial surgical repairs. The repaired prosthetic valve or conduit is susceptible to life-threatening infection. FDG-PET is an effective alternative to evaluate the source of infection when other examinations are inconclusive. We report an unusual case of an infected pulmonary artery conduit after TOF repair although the echocardiogram was negative for vegetation, which was later confirmed by surgery and pathology. The case highlights the role of FDG-PET as a problem-solving tool for potential endocarditis and cardiac device infection cases after complex cardiac surgery.

FDG-PET identification of infected pulmonary artery conduit following tetralogy of fallot (TOF) repair

International Nuclear Information System (INIS)

Zhang, Yu Yang; Williams, Hadyn; Pucar, Darko

2017-01-01

Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease usually managed by serial surgical repairs. The repaired prosthetic valve or conduit is susceptible to life-threatening infection. FDG-PET is an effective alternative to evaluate the source of infection when other examinations are inconclusive. We report an unusual case of an infected pulmonary artery conduit after TOF repair although the echocardiogram was negative for vegetation, which was later confirmed by surgery and pathology. The case highlights the role of FDG-PET as a problem-solving tool for potential endocarditis and cardiac device infection cases after complex cardiac surgery

Long distance seawater intrusion through a karst conduit network in the Woodville Karst Plain, Florida

Science.gov (United States)

Xu, Zexuan; Bassett, Seth Willis; Hu, Bill; Dyer, Scott Barrett

2016-08-01

Five periods of increased electrical conductivity have been found in the karst conduits supplying one of the largest first magnitude springs in Florida with water. Numerous well-developed conduit networks are distributed in the Woodville Karst Plain (WKP), Florida and connected to the Gulf of Mexico. A composite analysis of precipitation and electrical conductivity data provides strong evidence that the increases in conductivity are directly tied to seawater intrusion moving inland and traveling 11 miles against the prevailing regional hydraulic gradient from from Spring Creek Spring Complex (SCSC), a group of submarine springs at the Gulf Coast. A geochemical analysis of samples from the spring vent rules out anthropogenic contamination and upwelling regional recharge from the deep aquifer as sources of the rising conductivity. The interpretation is supported by the conceptual model established by prior researchers working to characterize the study area. This paper documents the first and longest case of seawater intrusion in the WKP, and also indicates significant possibility of seawater contamination through subsurface conduit networks in a coastal karst aquifer.

Dual-Component Gelatinous Peptide/Reactive Oligomer Formulations as Conduit Material and Luminal Filler for Peripheral Nerve Regeneration.

Science.gov (United States)

Kohn-Polster, Caroline; Bhatnagar, Divya; Woloszyn, Derek J; Richtmyer, Matthew; Starke, Annett; Springwald, Alexandra H; Franz, Sandra; Schulz-Siegmund, Michaela; Kaplan, Hilton M; Kohn, Joachim; Hacker, Michael C

2017-05-21

Toward the next generation of nerve guidance conduits (NGCs), novel biomaterials and functionalization concepts are required to address clinical demands in peripheral nerve regeneration (PNR). As a biological polymer with bioactive motifs, gelatinous peptides are promising building blocks. In combination with an anhydride-containing oligomer, a dual-component hydrogel system (cGEL) was established. First, hollow cGEL tubes were fabricated by a continuous dosing and templating process. Conduits were characterized concerning their mechanical strength, in vitro and in vivo degradation and biocompatibility. Second, cGEL was reformulated as injectable shear thinning filler for established NGCs, here tyrosine-derived polycarbonate-based braided conduits. Thereby, the formulation contained the small molecule LM11A-31. The biofunctionalized cGEL filler was assessed regarding building block integration, mechanical properties, in vitro cytotoxicity, and growth permissive effects on human adipose tissue-derived stem cells. A positive in vitro evaluation motivated further application of the filler material in a sciatic nerve defect. Compared to the empty conduit and pristine cGEL, the functionalization performed superior, though the autologous nerve graft remains the gold standard. In conclusion, LM11A-31 functionalized cGEL filler with extracellular matrix (ECM)-like characteristics and specific biochemical cues holds great potential to support PNR.

An international cross-sectional survey on the Quality and Costs of Primary Care (QUALICO-PC): recruitment and data collection of places delivering primary care across Canada.

Science.gov (United States)

Wong, Sabrina T; Chau, Leena W; Hogg, William; Teare, Gary F; Miedema, Baukje; Breton, Mylaine; Aubrey-Bassler, Kris; Katz, Alan; Burge, Fred; Boivin, Antoine; Cooke, Tim; Francoeur, Danièle; Wodchis, Walter P

2015-02-18

Performance reporting in primary health care in Canada is challenging because of the dearth of concise and synthesized information. The paucity of information occurs, in part, because the majority of primary health care in Canada is delivered through a multitude of privately owned small businesses with no mechanism or incentives to provide information about their performance. The purpose of this paper is to report the methods used to recruit family physicians and their patients across 10 provinces to provide self-reported information about primary care and how this information could be used in recruitment and data collection for future large scale pan-Canadian and other cross-country studies. Canada participated in an international large scale study-the QUALICO-PC (Quality and Costs of Primary Care) study. A set of four surveys, designed to collect in-depth information regarding primary care activities was collected from: practices, providers, and patients (experiences and values). Invitations (telephone, electronic or mailed) were sent to family physicians. Eligible participants were sent a package of surveys. Provincial teams kept records on the number of: invitation emails/letters sent, physicians who registered, practices that were sent surveys, and practices returning completed surveys. Response and cooperation rates were calculated. Invitations to participate were sent to approximately 23,000 family physicians across Canada. A total of 792 physicians and 8,332 patients from 772 primary care practices completed the surveys, including 1,160 participants completing a Patient Values survey and 7,172 participants completing a Patient Experience survey. Overall, the response rate was very low ranging from 2% (British Columbia) to 21% (Nova Scotia). However, the participation rate was high, ranging from 72% (Ontario) to 100% (New Brunswick/Prince Edward Island and Newfoundland & Labrador). The difficulties obtaining acceptable response rates by family physicians for

Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

International Nuclear Information System (INIS)

Das, Neelan; Bratby, Mark J.; Shrivastava, Vivek; Cornall, Alison J.; Darby, Christopher R.; Boardman, Philip; Anthony, Susan; Uberoi, Raman

2011-01-01

Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa ® , Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4–270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

Sciatic nerve regeneration by transplantation of Schwann cells via erythropoietin controlled-releasing polylactic acid/multiwalled carbon nanotubes/gelatin nanofibrils neural guidance conduit.

Science.gov (United States)

Salehi, Majid; Naseri-Nosar, Mahdi; Ebrahimi-Barough, Somayeh; Nourani, Mohammdreza; Khojasteh, Arash; Hamidieh, Amir-Ali; Amani, Amir; Farzamfar, Saeed; Ai, Jafar

2018-05-01

The current study aimed to enhance the efficacy of peripheral nerve regeneration using an electrically conductive biodegradable porous neural guidance conduit for transplantation of allogeneic Schwann cells (SCs). The conduit was produced from polylactic acid (PLA), multiwalled carbon nanotubes (MWCNTs), and gelatin nanofibrils (GNFs) coated with the recombinant human erythropoietin-loaded chitosan nanoparticles (rhEpo-CNPs). The PLA/MWCNTs/GNFs/rhEpo-CNPs conduit had the porosity of 85.78 ± 0.70%, the contact angle of 77.65 ± 1.91° and the ultimate tensile strength and compressive modulus of 5.51 ± 0.13 MPa and 2.66 ± 0.34 MPa, respectively. The conduit showed the electrical conductivity of 0.32 S cm -1 and lost about 11% of its weight after 60 days in normal saline. The produced conduit was able to release the rhEpo for at least 2 weeks and exhibited favorable cytocompatibility towards SCs. For functional analysis, the conduit was seeded with 1.5 × 10 4 SCs and implanted into a 10 mm sciatic nerve defect of Wistar rat. After 14 weeks, the results of sciatic functional index, hot plate latency, compound muscle action potential amplitude, weight-loss percentage of wet gastrocnemius muscle and Histopathological examination using hematoxylin-eosin and Luxol fast blue staining demonstrated that the produced conduit had comparable nerve regeneration to the autograft, as the gold standard to bridge the nerve gaps. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1463-1476, 2018. © 2017 Wiley Periodicals, Inc.

Magma wagging and whirling in volcanic conduits

Science.gov (United States)

Liao, Yang; Bercovici, David; Jellinek, Mark

2018-02-01

Seismic tremor characterized by 0.5-7 Hz ground oscillations commonly occur before and during eruptions at silicic volcanoes with widely ranging vent geometries and edifice structures. The ubiquitous characteristics of this tremor imply that its causes are potentially common to silicic volcanoes. Here we revisit and extend to three dimensions the magma-wagging model for tremor (Jellinek and Bercovici, 2011; Bercovici et al., 2013), wherein a stiff magma column rising in a vertical conduit oscillates against a surrounding foamy annulus of bubbly magma, giving rise to tremor. While prior studies were restricted to two-dimensional lateral oscillations, here we explore three-dimensional motion and additional modes of oscillations. In the absence of viscous damping, the magma column undergoes 'whirling' motion: the center of each horizontal section of the column traces an elliptical trajectory. In the presence of viscous effect we identify new 'coiling' and 'uncoiling' column bending shapes with relatively higher and comparable rates of dissipation to the original two-dimensional magma wagging model. We also calculate the seismic P-wave response of the crustal material around the volcanic conduit to the new whirling motions and propose seismic diagnostics for different wagging patterns using the time-lag between seismic stations. We test our model by analyzing pre-eruptive seismic data from the 2009 eruption of Redoubt Volcano. In addition to suggesting that the occurrence of elliptical whirling motion more than 1 week before the eruption, our analysis of seismic time-lags also implies that the 2009 eruption was accompanied by qualitative changes in the magma wagging behavior including fluctuations in eccentricity and a reversal in the direction of elliptical whirling motion when the eruption was immediately impending.

Vulcanian explosions at Volcán de Colima, Mexico: modelling the conduit processes

Science.gov (United States)

Varley, N. R.; Stevenson, J.; Johnson, J.; Reyes, G.; Weber, K.; Sanderson, R.

2006-12-01

Activity at Volcán de Colima has increased over the past 8 years, and is possibly building towards a significant eruption. Monitoring its current activity is therefore critical, with recent expansion of the network providing new types of data which need to be understood. Recent activity has consisted of 3 effusive episodes lasting up to 22 months, separated by periods characterised by daily Vulcanian eruptions of small to moderate size; the largest producing pyroclastic flows reaching over 5 km, representing the most significant since the last Plinian event (1913). A model has been proposed to explain the mechanism of the Vulcanian explosions, derived through integrating different data including seismicity, SO2 flux and the ascent velocity and thermal emission of the eruption column. Infrasound measurements have helped to demonstrate the variability in the distribution of energy produced by the events. Swarms of low frequency seismic events were associated with the largest magnitude explosions and have been examined statistically with variations observed in the magnitude-frequency relationship of each swarm and their distribution. Seismic evidence of migration of the source has been identified, maybe explained by brittle fracturing associated with an increasing pressure differential within the conduit system. Volcán de Colima has a complex edifice structure with explosions switching between multiple vents and showing pulsing. Variation in remotely monitored fumarole temperatures has also been related to the explosive activity. It is clear that small variations of certain critical factors within the conduit system can lead to a transition between effusive and explosive activity. Frequent transitions at Volcán de Colima provide an ideal opportunity to analyse variations in the observable signals and deduce relationships with changes within the conduit that influence magma ascent and degassing, such as its volatile contents or ascent velocity. One goal of this

Inactive supply wells as conduits for flow and contaminant migration: conditions of occurrence and suggestions for management

Science.gov (United States)

Gailey, Robert M.

2017-11-01

Water supply wells can act as conduits for vertical flow and contaminant migration between water-bearing strata under common hydrogeologic and well construction conditions. While recognized by some for decades, there is little published data on the magnitude of flows and extent of resulting water quality impacts. Consequently, the issue may not be acknowledged widely enough and the need for better management persists. This is especially true for unconsolidated alluvial groundwater basins that are hydrologically stressed by agricultural activities. Theoretical and practical considerations indicate that significant water volumes can migrate vertically through wells. The flow is often downward, with shallow groundwater, usually poorer in quality, migrating through conduit wells to degrade deeper water quality. Field data from locations in California, USA, are presented in combination with modeling results to illustrate both the prevalence of conditions conducive to intraborehole flow and the resulting impacts to water quality. Suggestions for management of planned wells include better enforcement of current regulations and more detailed consideration of hydrogeologic conditions during design and installation. A potentially greater management challenge is presented by the large number of existing wells. Monitoring for evidence of conduit flow and solute transport in areas of high well density is recommended to identify wells that pose greater risks to water quality. Conduit wells that are discovered may be addressed through approaches that include structural modification and changes in operations.

Incorporation of cooling-induced crystallization into a 2-dimensional axisymmetric conduit heat flow model

Science.gov (United States)

Heptinstall, David; Bouvet de Maisonneuve, Caroline; Neuberg, Jurgen; Taisne, Benoit; Collinson, Amy

2016-04-01

Heat flow models can bring new insights into the thermal and rheological evolution of volcanic 3 systems. We shall investigate the thermal processes and timescales in a crystallizing, static 4 magma column, with a heat flow model of Soufriere Hills Volcano (SHV), Montserrat. The latent heat of crystallization is initially computed with MELTS, as a function of pressure and temperature for an andesitic melt (SHV groundmass starting composition). Three fractional crystallization simulations are performed; two with initial pressures of 34MPa (runs 1 & 2) and one of 25MPa (run 3). Decompression rate was varied between 0.1MPa/° C (runs 1 & 3) and 0.2MPa/° C (run 2). Natural and experimental matrix glass compositions are accurately reproduced by all MELTS runs. The cumulative latent heat released for runs 1, 2 and 3 differs by less than 9% (8.69E5 J/kg*K, 9.32E5 J/kg*K, and 9.49E5 J/kg*K respectively). The 2D axisymmetric conductive cooling simulations consider a 30m-diameter conduit that extends from the surface to a depth of 1500m (34MPa). The temporal evolution of temperature is closely tracked at depths of 10m, 750m and 1400m in the centre of the conduit, at the conduit walls, and 20m from the walls into the host rock. Following initial cooling by 7-15oC at 10m depth inside the conduit, the magma temperature rebounds through latent heat release by 32-35oC over 85-123 days to a maximum temperature of 1002-1005oC. At 10m depth, it takes 4.1-9.2 years for the magma column to cool by 108-131oC and crystallize to 75wt%, at which point it cannot be easily remobilized. It takes 11-31.5 years to reach the same crystallinity at 750-1400m depth. We find a wide range in cooling timescales, particularly at depths of 750m or greater, attributed to the initial run pressure and the dominant latent heat producing crystallizing phase, Albite-rich Plagioclase Feldspar. Run 1 is shown to cool fastest and run 3 cool the slowest, with surface emissivity having the strongest cooling

Characterization and Schwann Cell Seeding of up to 15.0 cm Long Spider Silk Nerve Conduits for Reconstruction of Peripheral Nerve Defects

Directory of Open Access Journals (Sweden)

Tim Kornfeld

2016-11-01

Full Text Available Nerve reconstruction of extended nerve defect injuries still remains challenging with respect to therapeutic options. The gold standard in nerve surgery is the autologous nerve graft. Due to the limitation of adequate donor nerves, surgical alternatives are needed. Nerve grafts made out of either natural or artificial materials represent this alternative. Several biomaterials are being explored and preclinical and clinical applications are ongoing. Unfortunately, nerve conduits with successful enhancement of axonal regeneration for nerve defects measuring over 4.0 cm are sparse and no conduits are available for nerve defects extending to 10.0 cm. In this study, spider silk nerve conduits seeded with Schwann cells were investigated for in vitro regeneration on defects measuring 4.0 cm, 10.0 cm and 15.0 cm in length. Schwann cells (SCs were isolated, cultured and purified. Cell purity was determined by immunofluorescence. Nerve grafts were constructed out of spider silk from Nephila edulis and decellularized ovine vessels. Finally, spider silk implants were seeded with purified Schwann cells. Cell attachment was observed within the first hour. After 7 and 21 days of culture, immunofluorescence for viability and determination of Schwann cell proliferation and migration throughout the conduits was performed. Analyses revealed that SCs maintained viable (>95% throughout the conduits independent of construct length. SC proliferation on the spider silk was determined from day 7 to day 21 with a proliferation index of 49.42% arithmetically averaged over all conduits. This indicates that spider silk nerve conduits represent a favorable environment for SC attachment, proliferation and distribution over a distance of least 15.0 cm in vitro. Thus spider silk nerve implants are a highly adequate biomaterial for nerve reconstruction.

Influence of conduit flow mechanics on magma rheology and the growth style of lava domes

Science.gov (United States)

Husain, Taha; Elsworth, Derek; Voight, Barry; Mattioli, Glen; Jansma, Pamela

2018-06-01

We develop a 2-D particle-mechanics model to explore different lava-dome growth styles. These range from endogenous lava dome growth comprising expansion of a ductile dome core to the exogenous extrusion of a degassed lava plug resulting in generation of a lava spine. We couple conduit flow dynamics with surface growth of the evolving lava dome, fuelled by an open-system magma chamber undergoing continuous replenishment. The conduit flow model accounts for the variation in rheology of ascending magma that results from degassing-induced crystallization. A period of reduced effusive flow rates promote enhanced degassing-induced crystallization. A degassed lava plug extrudes exogenously for magmas with crystal contents (ϕ) of 78 per cent, yield strength >1.62 MPa, and at flow rates of 3 m3 s-1) for magma with lower relative yield strengths (p = 3 MPa) at the conduit exit is forced out by the high discharge rate pulse (2 process, which has been observed at Mount St. Helens and other locations, largely reflects gravitational loading of dome with a viscous core, with retardation by yield strength and talus friction.

A 40 kA NbTi cable in conduit conductor for the large poloidal field coils of net

International Nuclear Information System (INIS)

Torossian, A.; Bessette, D.; Turck, B.; Kazimierzak, B.

1990-01-01

The main feature of this cable in conduit design is to separate the manufacture of the full length of the steel conduit (400 m) and of the cable in order to minimize the industrial risk and consequently the cost. A circular cross section for that cable seems to be the most suitable for that purpose: - axisymmetric cabling with full transposition of strands, - cable behaviour independent of the field orientation, - less deformation of subcables, - cross section remains circular when the cable is under tension and makes the slippage of the cable in the conduit easier, - butt welding of 8 m long tubes forming the conduit becomes simpler. The square external shape allows to minimize the amount of insulating material and consequently improves the overall current density of the coil. This conductor is aimed to large poloidal field coils for NET which do not require high field and in that case NbTi seems to be the best choice with regard to reliability and cost but Nb 3 Sn could be used as well. Stainless steel ribbons are inserted between subcables in order to reduce losses induced by the rapid field changes and also to improve the mechanical behaviour of the cable

NRC Information No. 90-23: Improper installation of Patel conduit seals

International Nuclear Information System (INIS)

Rossi, C.E.

1992-01-01

On November 6, 1989, the staff at the H.B. Robinson plant notified the NRC that they had discovered that some of the conduit seal grommets used to seal insulated wire conductors entering environmentally qualified instrument housings were oversized for the application. The seals are used to prevent moisture from entering safety-related electrical components following loss-of-coolant accidents. The problem was attributed to inadequate installation instructions that were used when the seals were installed in 1986 and 1987. These instructions listed the grommets by wire gauge size and gave maximum wire insulation diameters for each wire size. In accordance with these instructions, the seals were selected based on wire gauge alone. However, since the insulation thickness for a given wire gauge the correct grommet size would have been the minimum wire insulation diameter for which a particular grommet will achieve an effective seal. The selection of grommet size based only on wire gauge size resulted in the installation of some grommets that were too large to provide an effective seal. As a result, some of the seals failed pressure tests that were designed to simulate post-LOCA pressures. During the investigation of the grommet leakage problem, the Robinson staff also checked the torque on the conduit seal union nuts that are used to compress the seals. EGS Corporation recommends that the union nuts be torqued to 50 ft-lb. On approximately half of the 90 seals inspected, the union nut moved about 1/4 inch when this torque was applied. EGS Corporation reports that 1/4 inch of movement does not necessarily indicate a degraded seal but recommends that the correct torque be verified on a representative sample of installed conduit seals

Pseudotachylyte formation in volcanic conduits: Montserrat vs. Mount St. Helens

Science.gov (United States)

Kendrick, J. E.; Lavallee, Y.; Petrakova, L.; Ferk, A.; Di Toro, G.; Hess, K.; Ferri, F.; Dingwell, D. B.

2012-12-01

Seismogenic fracture and faulting may result in non-equilibrium frictional melting of rock, which upon cooling and recrystallisation forms pseudotachylyte. In volcanic environments, the transition from endogenous to exogenous growth can be attributed to a shift in magma rheology into the brittle regime, and thus the ascent of high-viscosity magma can form discrete shear zones, comparable to tectonic faults, along conduit margins. Pseudotachylytes have, until now, rarely been noted in exogenous volcanic materials and seldom in active volcanic environments. This is despite the simultaneous occurrence of high pressures and differential stresses, which make high-viscosity magmas ideal candidates for the occurrence of frictional melting. Here, we compare the chemical, thermal, magnetic and structural properties of two candidate volcanic pseudotachylytes; one from Soufriere Hills (Montserrat) and one from Mount St. Helens (USA). Additionally, we present data from a set of high-velocity rotary shear experiments on the host materials of these natural pseudotachylytes in which melting was induced after just 10's of centimeters of slip at realistic extrusion velocities (0.4 - 1.6 ms-1) and low normal stresses (0.5-2 MPa). After 1-2 meters of slip a continuous melt layer formed, at which point friction decreased and the fault zone displayed slip-weakening behaviour. For volcanic conduits, this would facilitate temporarily elevated slip rates, or an increase in extrusion rate, and could cause transitions in dome morphology and eruption style. This study demonstrates that shear fracturing in magma or sliding along conduit margins can readily result in frictional melting. The conspicuous absence of pseudotachylytes in active volcanic environments is likely the result of exceptionally high background temperatures which precipitate near-equilibrium melting, thereby obviating one of the characteristic signatures of pseudotachylyte - glassy protomelts formed by selective melting of

Right ventricular to pulmonary artery conduit instead of modified Blalock-Taussig shunt improves postoperative hemodynamics in newborns after the Norwood operation.

Science.gov (United States)

Mair, Rudolf; Tulzer, Gerald; Sames, Eva; Gitter, Roland; Lechner, Evelyn; Steiner, Jürgen; Hofer, Anna; Geiselseder, Gertraud; Gross, Christoph

2003-11-01

Perioperative mortality, prolonged postoperative recovery after the Norwood procedure, and mortality between stage I and stage II might be related to shunt physiology. A right ventricular to pulmonary artery conduit offers a banded physiology in contrast to a Blalock-Taussig shunt. The purpose of this study was to assess the hemodynamic differences and their consequences in the postoperative course between Norwood patients with a Blalock-Taussig shunt and those with a right ventricular to pulmonary artery conduit. From October 1999 until May 2002, 32 unselected consecutive patients underwent a Norwood procedure at the General Hospital Linz. The first 18 patients received a Blalock-Taussig shunt. In the remaining 14 patients we performed a right ventricular to pulmonary artery conduit. Both groups were compared. The diastolic blood pressure was significantly higher in the right ventricular to pulmonary artery conduit group (P <.001). Despite a higher FIO(2), PO(2) levels tended to be lower in the first 5 postoperative days. At the age of 3 months, catheterization laboratory data showed a lower Qp/Qs ratio in the same group (0.86 [0.78; 1] versus 1.55 [1.15; 1.6]; P =.005) and a higher dp/dt (955 [773; 1110] vs 776 [615; 907]; P =.018). (Descriptive data reflect medians and quartiles [in brackets].) Hospital survival was 72% in the Blalock-Taussig shunt group versus 93% in the right ventricular to pulmonary artery conduit group. Mortality between stage I and stage II was 23% in the Blalock-Taussig shunt group versus 0% in the right ventricular to pulmonary artery conduit group. A higher diastolic blood pressure and a lower Qp/Qs ratio were associated with a more stable and efficient circulation in patients with a right ventricular to pulmonary artery conduit. More intensive ventilatory support was necessary during the first postoperative days. We did not note any adverse effects of the ventriculotomy on ventricular performance.

Impact of bed rest on conduit artery remodeling: effect of exercise countermeasures.

NARCIS (Netherlands)

Duijnhoven, N.T.L. van; Green, D.J.; Felsenberg, D.; Belavy, D.L.; Hopman, M.T.E.; Thijssen, D.H.J.

2010-01-01

Physical inactivity is a potent stimulus for vascular remodeling, leading to a marked decrease in conduit artery diameter. However, little is known about the impact of physical inactivity on artery wall thickness or wall:lumen ratio or the potential of exercise countermeasures to modify artery wall

Conduits to care: call lights and patients’ perceptions of communication

Science.gov (United States)

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Background Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. PMID:29075125

Conduits to care: call lights and patients' perceptions of communication.

Science.gov (United States)

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

Permeability Measurements of Rock Samples from Conduit Drilling at Unzen Volcano, Japan

Science.gov (United States)

Watanabe, T.; Shimizu, Y.; Noguchi, S.; Nakada, S.

2006-12-01

The last eruption of Unzen Volcano (1990-1995) was effusive to form lava domes, though magmas at depths are estimated to have contained volatile materials enough to cause explosive eruptions [e.g., Sato et al., 1995]. Most of volatile materials should have escaped from ascending magmas. The escape of gas is controlled by permeability of magmas and country rocks. Unzen Scientific Drilling Project sampled both the latest conduit and its country rock (USDP-4). In order to understand degassing processes, we have measured the permeability of these rock samples. Four cube samples with edges of 25 mm were cut from USDP-4 cores C1, C12 (country rock), C13 and C14 (conduit). Sample C1 is considered as Old Unzen Lava, and Sample C12 volcanic breccia. The transient pulse method was employed to measure the permeability. It applies a step of the fluid pressure difference across a specimen, and measures the decay rate of the fluid pressure difference. This method can be applied to samples with very low permeability, since it determines the permeability without measuring the fluid flux. Nitrogen gas was used as a pore fluid. Our permeametry system is built in a pressure vessel, and the confining pressure and the pore fluid pressure can be controlled independently. The temperature of the measurement system is kept constant within 0.1 degree. The temperature control and the background leak rate limit the measurable permeability to be higher than 10^{-20} m2. Measurements were first conducted under the atmospheric pressure. The permeability in a rock sample varies with the direction by a factor less than 5. Sample C1 has the lowest permeability (10^{-19} m2), and Sample C12 the highest value (10^{-17 m2). The permeability of C13 and C14 is of the order of 10^{- 18} m2. Though only a trace of vesicles can be seen in conduit samples, the interconnection is still maintained. The pressure dependence of the permeability is now investigated up to 50 MPa. The permeability of C13 and C14

Terrestrial analogs to lunar sinuous rilles - Kauhako Crater and channel, Kalaupapa, Molokai, and other Hawaiian lava conduit systems

International Nuclear Information System (INIS)

Coombs, C.R.; Hawke, B.R.; Wilson, L.

1990-01-01

Two source vents, one explosive and one effusive erupted to form a cinder cone and low lava shield that together compose the Kalaupapa peninsula of Molokai, Hawaii, A 50-100-m-wide channel/tube system extends 2.3 km northward from kauhako crater in the center of the shield. Based on modeling, a volume of up to about 0.2 cu km of lava erupted at a rate of 260 cu m/sec to flow through the Kauhako conduit system in one of the last eruptive episodes on the peninsula. Channel downcutting by thermal erosion occurred at a rate of about 10 micron/sec to help form the 30-m-deep conduit. Two smaller, secondary tube systems formed east of the main lava channel/tube. Several other lava conduit systems on the islands of Oahu and Hawaii were also compared to the Kauhako and lunar sinuous rille systems. These other lava conduits include Whittington, Kupaianaha, and Mauna Ulu lava tubes. Morphologically, the Hawaiian tube systems studied are very similar to lunar sinuous rilles in that they have deep head craters, sinuous channels, and gentle slopes. Thermal erosion is postulated to be an important factor in the formation of these terrestrial channel systems and by analogy is inferred to be an important process involved in the formation of lunar sinuous rilles. 28 refs

FATIGUE PROPERTIES OF MODIFIED 316LN STAINLESS STEEL AT 4 K FOR HIGH FIELD CABLE-IN-CONDUIT APPLICATIONS

International Nuclear Information System (INIS)

Toplosky, V. J.; Walsh, R. P.; Han, K.

2010-01-01

Cable-In-Conduit-Conductor (CICC) alloys, exposed to Nb 3 Sn reaction heat-treatments, such as modified 316LN require a design specific database. A lack of fatigue life data (S-n curves) that could be applied in the design of the ITER CS and the NHMFL Series Connected Hybrid magnets is the impetus for the research presented here. The modified 316LN is distinguished by a lower carbon content and higher nitrogen content when compared to conventional 316LN. Because the interstitial alloying elements affect the mechanical properties significantly, it is necessary to characterize this alloy in a systematic way. In conjunction, to ensure magnet reliability and performance, several criteria and expectations must be met, including: high fatigue life at the operating stresses, optimal stress management at cryogenic temperatures and thin walled conduit to reduce coil mass. Tension-tension load control axial fatigue tests have good applicability to CICC solenoid magnet design, thus a series of 4 K strength versus fatigue life curves have been generated. In-situ samples of 316LN base metal, seam welded, butt welded and seam plus butt welded are removed directly from the conduit in order to address base and weld material fatigue life variability. The more than 30 fatigue tests show good grouping on the fatigue life curve and allow discretionary 4 K fatigue life predictions for conduit made with modified 316LN.

On magma fragmentation by conduit shear stress: Evidence from the Kos Plateau Tuff, Aegean Volcanic Arc

Science.gov (United States)

Palladino, Danilo M.; Simei, Silvia; Kyriakopoulos, Konstantinos

2008-12-01

Large silicic explosive eruptions are the most catastrophic volcanic events. Yet, the intratelluric mechanisms underlying are not fully understood. Here we report a field and laboratory study of the Kos Plateau Tuff (KPT, 161 ka, Aegean Volcanic Arc), which provides an excellent geological example of conduit processes that control magma vesiculation and fragmentation during intermediate- to large-scale caldera-forming eruptions. A prominent feature of the KPT is the occurrence of quite unusual platy-shaped tube pumice clasts in pyroclastic fall and current deposits from the early eruption phases preceding caldera collapse. On macroscopic and SEM observations, flat clast faces are elongated parallel to tube vesicles, while transverse surfaces often occur at ~ 45° to vesicle elongation. This peculiar pumice texture provides evidence of high shear stresses related to strong velocity gradients normal to conduit walls, which induced vesiculation and fragmentation of the ascending magma. Either an increasing mass discharge rate without adequate enlargement of a narrow central feeder conduit or a developing fissure-like feeder system related to incipient caldera collapse provided suitable conditions for the generation of plate tube pumice within magma volumes under high shear during the pre-climactic KPT eruption phases. This mechanism implies that the closer to the conduit walls (where the stronger are the velocity gradients) the larger was the proportion of plate vs. conventional (lensoid) juvenile fragments in the ascending gas-pyroclast mixture. Consequently, plate pumice clasts were mainly entrained in the outer portions of the jet and convecting regions of a sustained, Plinian-type, eruption column, as well as in occasional lateral blast currents generated at the vent. As a whole, plate pumice clasts in the peripheral portions of the column were transported at lower altitudes and deposited by fallout or partial collapse closer to the vent relative to lensoid ones

What goes up might come down: Backflow in the conduits of persistently degassing volcanoes and ramifications for melt-inclusion analysis

Science.gov (United States)

Suckale, J.; Qin, Z.; Picchi, D.; Keller, T.

2017-12-01

Many active volcanoes erupt significantly less magma than they degas, implying that large quantities of magma must descend back into the plumbing system after degassing. The resulting bidirectional flow field in the volcanic conduit is fundamentally unstable. These instabilities are important to understand, because they likely control the episodicity of eruptive behavior observed at persistently degassing volcanoes. Laboratory experiments have provided invaluable insights into the flow regimes that may arise in volcanic conduits, but are not straightforward to scale up to volcanic systems. The goal of this study is to use direct numerical simulations to virtually reproduce the analogue experiments by Stevenson and Blake, 1998, compare them to simple analytical models and gain insights into the different flow regimes and interface instabilities observed in actual volcanic conduits. Direct numerical simulations provide a compelling complement to analogue experiments, because they are not constrained by the scales or flow properties achievable in a laboratory setting. By linking virtual and analogue experiments, we show that the interface between ascending and descending fluid is not usually stationary in volcanic conduits (see fig). The intuition that buoyant, volatile-rich magma moves up while heavy, degassed magma moves down is hence not generally true in bidirectional conduit flow. Instead, our results show that a potentially significant portion of the volatile-rich magma flows downwards despite its positive buoyancy - a process commonly referred to as backflow. The existence of backflow in volcanic conduits has potentially important ramifications for understanding melt-inclusion trends, because it affects exsolved and dissolved volatile components differently. Our preliminary results suggest that carbon dioxide bubbles exsolved at depth tend to decouple from the backflow and escape into the upward moving portion of the fluid, while dissolved water is recycled

Comparison of Fiber Optic and Conduit Attenuated Total Reflection (ATR) Fourier Transform Infrared (FT-IR) Setup for In-Line Fermentation Monitoring.

Science.gov (United States)

Koch, Cosima; Posch, Andreas E; Herwig, Christoph; Lendl, Bernhard

2016-12-01

The performance of a fiber optic and an optical conduit in-line attenuated total reflection mid-infrared (IR) probe during in situ monitoring of Penicillium chrysogenum fermentation were compared. The fiber optic probe was connected to a sealed, portable, Fourier transform infrared (FT-IR) process spectrometer via a plug-and-play interface. The optical conduit, on the other hand, was connected to a FT-IR process spectrometer via a knuckled probe with mirrors that had to be adjusted prior to each fermentation, which were purged with dry air. Penicillin V (PenV) and its precursor phenoxyacetic acid (POX) concentrations were determined by online high-performance liquid chromatography and the obtained concentrations were used as reference to build partial least squares regression models. Cross-validated root-mean-square errors of prediction were found to be 0.2 g L -1 (POX) and 0.19 g L -1 (PenV) for the fiber optic setup and 0.17 g L -1 (both POX and PenV) for the conduit setup. Higher noise-levels and spectrum-to-spectrum variations of the fiber optic setup lead to higher noise of estimated (i.e., unknown) POX and PenV concentrations than was found for the conduit setup. It seems that trade-off has to be made between ease of handling (fiber optic setup) and measurement accuracy (optical conduit setup) when choosing one of these systems for bioprocess monitoring. © The Author(s) 2016.

Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.

Science.gov (United States)

Pawa, Jasmine; Robson, John; Hull, Sally

2017-11-01

Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale. © British Journal of General Practice 2017.

Cardiovascular effects of right ventricle-pulmonary artery valved conduit implantation in experimental pulmonic stenosis

International Nuclear Information System (INIS)

Saida, Y.; Tanaka, R.; Fukushima, R.; Hoshi, K.; Hira, S.; Soda, A.; Iizuka, T.; Ishikawa, T.; Nishimura, T.; Yamane, Y.

2009-01-01

Right ventricle (RV)-pulmonary artery (PA) valved conduit (RPVC) implantation decreases RV systolic pressure in pulmonic stenosis (PS) by forming a bypass route between the RV and the PA. The present study evaluates valved conduits derived from canine aortae in a canine model of PS produced by pulmonary artery banding (PAB). Pulmonary stenosis was elicited using PAB in 10 conditioned beagles aged 8 months. Twelve weeks after PAB, the dogs were assigned to one group that did not undergo surgical intervention and another that underwent RPVC using denacol-treated canine aortic valved grafts (PAB+RPVC). Twelve weeks later, the rate of change in the RV-PA systolic pressure gradient was significantly decreased in the PAB+RPVC, compared with the PAB group (60.5+-16.7% vs. 108.9+-22.9%; p0.01). In addition, the end-diastolic RV free wall thickness (RVFWd) was significantly reduced in the PAB+RPVC, compared with the PAB group (8.2+-0.2 vs. 9.4+-0.7 mm; p0.05). Thereafter, regurgitation was not evident beyond the conduit valve and the decrease in RV pressure overload induced by RPVC was confirmed. The present results indicate that RPVC can be performed under a beating heart without cardiopulmonary bypass and adapted to dogs with various types of PS, including 'supra valvular' PS or PS accompanied by dysplasia of the pulmonary valve. Therefore, we consider that this method is useful for treating PS in small animals

Sexual Function after Non-Nerve-Sparing Radical Cystoprostatectomy: A Comparison between Ileal Conduit Urinary Diversion and Orthotopic Ileal Neobladder Substitution

Directory of Open Access Journals (Sweden)

M.A Asgari

2013-07-01

Full Text Available Objective To compare the erectile function (EF and sexual desire (SD in men after radical cystoprostatectomy (RCP who had either an ileal conduit urinary diversion or orthotropic ileal neobladder substitution. Materials and Methods Eighty one sexually active men with bladder cancer were enrolled in this prospective study. After RCP according to patients' preferences they underwent either ileal conduit urinary diversion (n = 41 or orthotropic ileal neobladder substitution (n = 40. EF and SD were assessed using International Index of Erectile Function (IIEF questionnaire. Patients were assessed at 4-week before surgery and were followed up at 1, 6, and 12-month postoperatively using the same questionnaire. Results Postoperatively the EF and SD domains deteriorated significantly in both groups, but in a small proportion of the patients submitted to ileal neobladder they gradually improved with time (P = 0.006. At 12-month postoperative period, 4 (9.8% and 14 (35.0% patients in ileal conduit and ileal neobladder groups were able to achieve erections hard enough for vaginal penetration and maintained their erection to completion of intercourse, respectively (P = 0.006. Among patients in the ileal conduit and ileal neobladder groups, additional 4 (9.8% and 7 (17.1% patients were able to get some erection, but were unable to maintain their erection to completion of intercourse (P = 0.02. At 12-month follow up period 24.4% of the ileal conduit and 45.0% of the ileal neobladder patients rated their sexual desire very high or high (P = 0.01. Conclusion When performed properly, orthotopic ileal neobladder substitution after RCP offers better long-term results in terms of EF and SD.

Three-dimensional fluid mechanics of particulate two-phase flows in U-bend and helical conduits

Science.gov (United States)

Tiwari, Prashant; Antal, Steven P.; Podowski, Michael Z.

2006-04-01

The results of numerous studies performed to date have shown that the performance of various hydraulic systems can be significantly improved by using curved conduit geometries instead of straight tubes. In particular, the formation of Dean vortices, which enhance the development of centrifugal instabilities, has been identified as a factor behind reducing the near-wall concentration buildup in particulate flow devices (e.g., in membrane filtration modules). Still, several issues regarding the effect of conduit curvature on local multidimensional phenomena governing fluid flow still remain open. A related issue is concerned with the impact that conduit geometry makes on the concentration distribution of a dispersed phase in two-phase flows in general, and in particulate flows (solid/liquid or solid/gas suspensions) in particular. It turns out that only very limited efforts have been made in the past to understand the fluid mechanics of such flows via advanced computer simulations. The purpose of this paper is to present the results of full three-dimensional (3D) theoretical and numerical analyses of single- and two-phase dilute particle/liquid flows in U-bend and helical curved conduits. The numerical analysis is based on computational fluid dynamics (CFD) simulations performed using a state-of-the-art multiphase flow computer code, NPHASE. The major issues discussed in the first part of the paper are concerned with the effect of curved/coiled geometry on the evolution of flow field and the associated wall shear. It has been demonstrated that the primary curvature (a common factor for both the U-bend and helix geometries) may cause a substantial asymmetry in the radial distribution of the main flow velocity. This, in turn, leads to a significant, albeit highly nonuniform, increase in the wall shear stress. Specifically, the wall shear around the outer half of tube circumference may become twice the corresponding value for a straight tube, and gradually decrease to

76 FR 53678 - Calleguas Municipal Water District Notice of Surrender of Exemption (Conduit)

Science.gov (United States)

2011-08-29

... Municipal Water District Notice of Surrender of Exemption (Conduit) Pursuant to section 4.95(a) of the Commission's regulations,\\1\\ Calleguas Municipal Water District filed with the Commission a petition to... Municipal Water District, 87 FERC ] 62,256 (1999). \\3\\ See filing of July 11, 2011 by Calleguas Municipal...

Incorporation of cooling-induced crystallisation into a 2-dimensional axisymmetric conduit heat flow model

Science.gov (United States)

Heptinstall, D. A.; Neuberg, J. W.; Bouvet de Maisonneuve, C.; Collinson, A.; Taisne, B.; Morgan, D. J.

2015-12-01

Heat flow models can bring new insights into the thermal and rheological evolution of volcanic systems. We shall investigate the thermal processes and timescales in a crystallizing, static magma column, with a heat flow model of Soufriere Hills Volcano (SHV), Montserrat. The latent heat of crystallization is initially computed with MELTS, as a function of pressure and temperature for an andesitic melt (SHV groundmass starting composition). Three fractional crystallization simulations are performed; two with initial pressures of 34MPa (runs 1 & 2) and one of 25MPa (run 3). Decompression rate was varied between 0.1MPa/°C (runs 1 & 3) and 0.2MPa/°C (run 2). Natural and experimental matrix glass compositions are accurately reproduced by all MELTS runs. The cumulative latent heat released for runs 1, 2 and 3 differs by less than 9% (8.69e5 J/kg*K, 9.32e5 J/kg*K, and 9.49e5 J/kg*K respectively). The 2D axisymmetric conductive cooling simulations consider a 30m-diameter conduit that extends from the surface to a depth of 1500m (34MPa). The temporal evolution of temperature is closely tracked at depths of 10m, 750m and 1400m in the center of the conduit, at the conduit walls, and 20m from the walls into the host rock. Following initial cooling by 7-15oC at 10m depth inside the conduit, the magma temperature rebounds through latent heat release by 32-35oC over 85-123 days to a maximum temperature of 1002-1005oC. At 10 m depth, it takes 4.1-9.2 years for the magma column to cool over 108-130oC and crystallize to 75wt%, at which point it cannot be easily remobilized. It takes 11-31.5 years to reach the same crystallinity at 750-1400m depth. We find a wide range in cooling timescales, particularly at depths of 750m or greater, attributed to the initial run pressure and dominant latent heat producing crystallizing phases (Quartz), where run 1 cools fastest and run 3 cools slowest. Surface cooling by comparison has the strongest influence on the upper tens of meters in all

Construction of nerve guide conduits from cellulose/soy protein composite membranes combined with Schwann cells and pyrroloquinoline quinone for the repair of peripheral nerve defect

Energy Technology Data Exchange (ETDEWEB)

Luo, Lihua [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China); Center of Molecular Medicine, School of Medicine, Hubei University of Arts and Sciences, Xiangyang 441053 (China); Gan, Li; Liu, Yongming; Tian, Weiqun; Tong, Zan [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China); Wang, Xiong; Huselstein, Celine [Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), UMR 7365 CNRS – Université de Lorraine, Biopôle, 54500 Vandoeuvre-lès-Nancy (France); Chen, Yun, E-mail: yunchen@whu.edu.cn [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China)

2015-02-20

Regeneration and functional reconstruction of peripheral nerve defects remained a significant clinical challenge. Nerve guide conduits, with seed cells or neurotrophic factors (NTFs), had been widely used to improve the repair and regeneration of injured peripheral nerve. Pyrroloquinoline quinone (PQQ) was an antioxidant that can stimulate nerve growth factors (NGFs) synthesis and accelerate the Schwann cells (SCs) proliferation and growth. In present study, three kinds of nerve guide conduits were constructed: one from cellulose/SPI hollow tube (CSC), another from CSC combined with SCs (CSSC), and the third one from CSSC combined with PQQ (CSSPC), respectively. And then they were applied to bridge and repair the sciatic nerve defect in rats, using autograft as control. Effects of different nerve guide conduits on the nerve regeneration were comparatively evaluated by general analysis, sciatic function index (SFI) and histological analysis (HE and TEM). Newly-formed regenerative nerve fibers were observed and running through the transparent nerve guide conduits 12 weeks after surgery. SFI results indicated that the reconstruction of motor function in CSSPC group was better than that in CSSC and CSC groups. HE images from the cross-sections and longitudinal-sections of the harvested regenerative nerve indicated that regenerative nerve fibers had been formed and accompanied with new blood vessels and matrix materials in the conduits. TEM images also showed that lots of fresh myelinated and non-myelinated nerve fibers had been formed. Parts of vacuolar, swollen and abnormal axons occurred in CSC and CSSC groups, while the vacuolization and swell of axons was the least serious in CSSPC group. These results indicated that CSSPC group had the most ability to repair and reconstruct the nerve structure and functions due to the comprehensive contributions from hollow CSC tube, SCs and PQQ. As a result, the CSSPC may have the potential for the applications as nerve guide

How to quantify conduits in wood?

Science.gov (United States)

Scholz, Alexander; Klepsch, Matthias; Karimi, Zohreh; Jansen, Steven

2013-01-01

Vessels and tracheids represent the most important xylem cells with respect to long distance water transport in plants. Wood anatomical studies frequently provide several quantitative details of these cells, such as vessel diameter, vessel density, vessel element length, and tracheid length, while important information on the three dimensional structure of the hydraulic network is not considered. This paper aims to provide an overview of various techniques, although there is no standard protocol to quantify conduits due to high anatomical variation and a wide range of techniques available. Despite recent progress in image analysis programs and automated methods for measuring cell dimensions, density, and spatial distribution, various characters remain time-consuming and tedious. Quantification of vessels and tracheids is not only important to better understand functional adaptations of tracheary elements to environment parameters, but will also be essential for linking wood anatomy with other fields such as wood development, xylem physiology, palaeobotany, and dendrochronology.

Characterization of molecule and particle transport through nanoscale conduits

Science.gov (United States)

Alibakhshi, Mohammad Amin

Nanofluidic devices have been of great interest due to their applications in variety of fields, including energy conversion and storage, water desalination, biological and chemical separations, and lab-on-a-chip devices. Although these applications cross the boundaries of many different disciplines, they all share the demand for understanding transport in nanoscale conduits. In this thesis, different elusive aspects of molecule and particle transport through nanofluidic conduits are investigated, including liquid and ion transport in nanochannels, diffusion- and reaction-governed enzyme transport in nanofluidic channels, and finally translocation of nanobeads through nanopores. Liquid or solvent transport through nanoconfinements is an essential yet barely characterized component of any nanofluidic systems. In the first chapter, water transport through single hydrophilic nanochannels with heights down to 7 nm is experimentally investigated using a new measurement technique. This technique has been developed based on the capillary flow and a novel hybrid nanochannel design and is capable of characterizing flow in both single nanoconduits as well as nanoporous media. The presence of a 0.7 nm thick hydration layer on hydrophilic surfaces and its effect on increasing the hydraulic resistance of the nanochannels is verified. Next, ion transport in a new class of nanofluidic rectifiers is theoretically and experimentally investigated. These so called nanofluidic diodes are nanochannels with asymmetric geometries which preferentially allow ion transport in one direction. A nondimensional number as a function of electrolyte concentration, nanochannel dimensions, and surface charge is derived that summarizes the rectification behavior of this system. In the fourth chapter, diffusion- and reaction-governed enzyme transport in nanofluidic channels is studied and the theoretical background necessary for understanding enzymatic activity in nanofluidic channels is presented. A

Natural Occurring Silks and Their Analogues as Materials for Nerve Conduits

OpenAIRE

Christine Radtke

2016-01-01

Spider silk and its synthetic derivatives have a light weight in combination with good strength and elasticity. Their high cytocompatibility and low immunogenicity make them well suited for biomaterial products such as nerve conduits. Silk proteins slowly degrade enzymatically in vivo, thus allowing for an initial therapeutic effect such as in nerve scaffolding to facilitate endogenous repair processes, and then are removed. Silks are biopolymers naturally produced by many species of arthropo...

Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction.

Science.gov (United States)

Dias, Ricardo Ribeiro; Mejia, Omar Asdrubal Vilca; Fiorelli, Alfredo Inácio; Pomerantzeff, Pablo Maria Alberto; Dias, Altamiro Ribeiro; Mady, Charles; Stolf, Noedir Antonio Groppo

2010-01-01

Comparative analysis of early and late results of aortic root reconstruction with aortic valve sparing operations and the composite mechanical valve conduit replacement. From November 2002 to September 2009, 164 consecutive patients with mean age 54 ± 15 years, 115 male, underwent the aortic root reconstruction (125 mechanical valve conduit replacements and 39 valve sparing operations). Sixteen percent of patients had Marfan syndrome and 4.3% had bicuspid aortic valve. One hundred and forty-four patients (88%) were followed for a mean period of 41.1 ± 20.8 months. The hospital mortality was 4.9%, 5.6% in operations with valved conduits and 2.6% in the valve sparing procedures (P valve sparing operations, respectively (95% CI = 70% - 95%, P = 0.001), (95% CI = 82% - 95% P = 0.03) and (95% CI = 81% - 95%, P = 0.03). Multivariate analysis showed that creatinine greater than 1.4 mg/dl, Cabrol operation and renal dialysis were predictors of mortality, respectively, with occurrence chance of 6 (95% CI = 1.8 - 19.5, P = 0.003), 12 (95% CI = 3 - 49.7, P = 0.0004) and 16 (95% CI = 3.6 - 71.3, P = 0.0002). The aortic root reconstruction has a low early and late mortality, high survival free of complications and low need for reoperation. During the late follow-up, valve sparing aortic root reconstructions presented fewer incidences of bleeding, thromboembolic events and endocarditis.

Rapid prototyping of a double-layer polyurethane-collagen conduit for peripheral nerve regeneration.

Science.gov (United States)

Cui, Tongkui; Yan, Yongnian; Zhang, Renji; Liu, Li; Xu, Wei; Wang, Xiaohong

2009-03-01

A new technique for preparing double-layer polyurethane (PU)-collagen nerve conduits for peripheral nerve repair via a double-nozzle, low-temperature, deposition manufacturing (DLDM) system has been developed. The DLDM system is based on a digital prototyping approach, and uses a combination of thermally induced phase separation and freeze-drying. With this system, two kinds of biomaterials with different properties can be combined to produce scaffold structures with good biocompatibility in the inner layer and with the desired mechanical strength protruded by the outer. The forming precision is high, the wall thickness can be controlled, and a tight connection between the two layers can be achieved. The effects of changing the processing parameters and the material temperature on the structure of the scaffolds have been investigated. Additionally, the effect of material concentration on the mechanical strength and hydrophilic properties of the scaffolds has also been studied. Ideal peripheral nerve repair conduits, comprising an outer microporous layer of PU and internal oriented filaments of collagen, have been manufactured through optimizing the processing parameters and the biomaterial concentrations.

Numerical simulation of freshwater/seawater interaction in a dual-permeability karst system with conduits: the development of discrete-continuum VDFST-CFP model

Science.gov (United States)

Xu, Zexuan; Hu, Bill

2016-04-01

Dual-permeability karst aquifers of porous media and conduit networks with significant different hydrological characteristics are widely distributed in the world. Discrete-continuum numerical models, such as MODFLOW-CFP and CFPv2, have been verified as appropriate approaches to simulate groundwater flow and solute transport in numerical modeling of karst hydrogeology. On the other hand, seawater intrusion associated with fresh groundwater resources contamination has been observed and investigated in numbers of coastal aquifers, especially under conditions of sea level rise. Density-dependent numerical models including SEAWAT are able to quantitatively evaluate the seawater/freshwater interaction processes. A numerical model of variable-density flow and solute transport - conduit flow process (VDFST-CFP) is developed to provide a better description of seawater intrusion and submarine groundwater discharge in a coastal karst aquifer with conduits. The coupling discrete-continuum VDFST-CFP model applies Darcy-Weisbach equation to simulate non-laminar groundwater flow in the conduit system in which is conceptualized and discretized as pipes, while Darcy equation is still used in continuum porous media. Density-dependent groundwater flow and solute transport equations with appropriate density terms in both conduit and porous media systems are derived and numerically solved using standard finite difference method with an implicit iteration procedure. Synthetic horizontal and vertical benchmarks are created to validate the newly developed VDFST-CFP model by comparing with other numerical models such as variable density SEAWAT, couplings of constant density groundwater flow and solute transport MODFLOW/MT3DMS and discrete-continuum CFPv2/UMT3D models. VDFST-CFP model improves the simulation of density dependent seawater/freshwater mixing processes and exchanges between conduit and matrix. Continuum numerical models greatly overestimated the flow rate under turbulent flow

Aptitude visuelle à la conduite automobile: exemple des candidats au permis de conduire à Libreville

Science.gov (United States)

Souhail, Hassane; Assoumou, Prudence; Birinda, Hilda; Mengome, Emmanuel Mve

2015-01-01

L'objectif était d’évaluer l'aptitude visuelle à la conduite automobile des candidats au permis de conduire à Libreville. Il s'agissait d'une étude transversale, descriptive et analytique, qui s'est déroulée à Libreville pendant la période du 4 avril 2012 au 14 juillet 2012 (soit 4 mois et 10 jours). La population d’étude concernait les candidats soumis aux épreuves d'obtention du permis de conduire. Nous avons inclus dans notre travail, les candidats, ayant donné leur consentement par écrit et exclus ceux refusant d'adhérer à l'enquête. Les variables étudiées concernaient l’âge, le sexe, la population d’étude, l'activité professionnelle, l'acuité visuelle de loin et de près, la vision des couleurs, la catégorie du permis de conduire, et l'aptitude visuelle à la conduite automobile. La saisie et l'analyse des données ont été collectées au moyen d'une fiche d'enquête standardisée; après vérification et validation, elles ont été saisies sur le logiciel Excel Windows et analysées sur le logiciel Epi Info version 3.5.1. L’âge moyen des 406 candidats était de 29 ans ± 6,65 ans avec des extrêmes allant de 17 ans à 52 ans. Les hommes représentaient 283 (69,7%) et les femmes 123 (30,3%), soit un ratio de 2,3. Les fonctionnaires étaient retrouvés dans 39,4 % des cas, suivi des élèves-étudiants dans 33,5%. Dans notre population d’étude, 71 sur 406 candidats avaient une baisse de l'acuité visuelle de loin, soit 17,5%. Dans notre série, nous avons retrouvés 34 candidats âgés de 40 ans et plus, et seulement 14 candidats (41,2%) avaient une baisse de l'acuité visuelle de près. La quasi-totalité des patients avaient une vision de couleurs normale (99,5%), cependant 2 candidats avaient une vision de couleurs anormale, soit une prévalence de 0,5%. Dans notre échantillon, 403 (99,3%) sollicitaient un permis de conduire de catégorie léger (perms A, A1, B, F) et 3 (0,7%) sollicitaient un permis de conduire de type

Multiple-port valve

International Nuclear Information System (INIS)

Doody, T.J.

1978-01-01

A multiple-port valve assembly is designed to direct flow from a primary conduit into any one of a plurality of secondary conduits as well as to direct a reverse flow. The valve includes two mating hemispherical sockets that rotatably receive a spherical valve plug. The valve plug is attached to the primary conduit and includes diverging passageways from that conduit to a plurality of ports. Each of the ports is alignable with one or more of a plurality of secondary conduits fitting into one of the hemispherical sockets. The other hemispherical socket includes a slot for the primary conduit such that the conduit's motion along that slot with rotation of the spherical plug about various axes will position the valve-plug ports in respect to the secondary conduits

Percutaneous transthoracic computed tomography-guided AICD insertion in a patient with extracardiac Fontan conduit.

LENUS (Irish Health Repository)

Murphy, Darra T

2011-02-01

Percutaneous pulmonary venous atrial puncture was performed under computed tomography guidance to successfully place an automated implantable cardiac defibrillator into a 26-year-old patient with extracardiac Fontan conduit who had presented with two out-of-hospital cardiac arrests. The procedure avoided the need for lead placement at thoracotomy.

Visualized Evaluation of Blood Flow to the Gastric Conduit and Complications in Esophageal Reconstruction.

Science.gov (United States)

Noma, Kazuhiro; Shirakawa, Yasuhiro; Kanaya, Nobuhiko; Okada, Tsuyoshi; Maeda, Naoaki; Ninomiya, Takayuki; Tanabe, Shunsuke; Sakurama, Kazufumi; Fujiwara, Toshiyoshi

2018-03-01

Evaluation of the blood supply to gastric conduits is critically important to avoid complications after esophagectomy. We began visual evaluation of blood flow using indocyanine green (ICG) fluorescent imaging in July 2015, to reduce reconstructive complications. In this study, we aimed to statistically verify the efficacy of blood flow evaluation using our simplified ICG method. A total of 285 consecutive patients who underwent esophagectomy and gastric conduit reconstruction were reviewed and divided into 2 groups: before and after introduction of ICG evaluation. The entire cohort and 68 patient pairs after propensity score matching (PS-M) were evaluated for clinical outcomes and the effect of visualized evaluation on reducing the risk of complication. The leakage rate in the ICG group was significantly lower than in the non-ICG group for each severity grade, both in the entire cohort (285 subjects) and after PS-M; the rates of other major complications, including recurrent laryngeal nerve palsy and pneumonia, were not different. The duration of postoperative ICU stay was approximately 1 day shorter in the ICG group than in the non-ICG group in the entire cohort, and approximately 2 days shorter after PS-M. Visualized evaluation of blood flow with ICG methods significantly reduced the rate of anastomotic complications of all Clavien-Dindo (CD) grades. Odds ratios for ICG evaluation decreased with CD grade (0.3419 for CD ≥ 1; 0.241 for CD ≥ 2; and 0.2153 for CD ≥ 3). Objective evaluation of blood supply to the reconstructed conduit using ICG fluorescent imaging reduces the risk and degree of anastomotic complication. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Robotic Assisted Radical Cystoprostatectomy and Intracorporeal Ileal Conduit Urinary Diversion for a Kidney Transplant Recipient

Directory of Open Access Journals (Sweden)

Peter A. Caputo

Full Text Available ABSTRACT Introduction and Objectives: Robotic assisted radical cystectomy (RARC is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. Materials and Methods: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008. His hospital course at time of transplant was complicated by low-level BK virus viremia. Interestingly his trans-urethral bladder tumor resection specimen at time of bladder cancer diagnosis stained positive for SV40. His native kidneys were anuric so bilateral laparoscopic nephrectomy was performed in a staged fashion 2 weeks prior to RARC. Our surgical technique utilizes 6 trocars, of note a 12-mm assistant trocar is placed 1 cm superior to the pubic symphysis, and this trocar is solely used to pass a laparoscopic stapler to facilitate the excision of the ileal segment and the stapled enteric anastomosis. Surgical steps include: identification of native ureters bilaterally (removed en bloc with the bladder specimen; identification of the transplanted ureter at the right bladder dome; posterior bladder and prostate dissection along Denonvilliers’ fascia; development of the space of Retzius; ligation and transection of the bladder and prostate vascular bundles; apical prostate dissection and transection of urethra; left pelvic lymphadenectomy; ilium resection for creation of the ileal conduit; stapled enteric anastomosis; ureteroileal anastomosis; maturation of the ileal conduit stoma. Results: The surgery had no intraoperative complications. Operative time was 443 minutes (7.4 hours. Estimated blood loss was 250 cc. Length of hospital stay was 5 days. The patient

Engineering based assessment for a shape design of a pediatric ePTFE pulmonary conduit valve.

Science.gov (United States)

Tsuboko, Yusuke; Shiraishi, Yasuyuki; Yamada, Akihiro; Yambe, Tomoyuki; Miura, Hidekazu; Mura, Seitaro; Yamagishi, Masaaki

2016-08-01

The authors examined the hemodynamic characteristics of expanded polytetrafluoroethylene (ePTFE) pulmonary valved conduits quantitatively by our originally developed pediatric pulmonary mechanical circulatory system, in order to suggest the optimal shape design. The system consisted of pneumatically driven right atrium and ventricle model, a pulmonary valve chamber, and elastic pulmonary compliance model with peripheral vascular resistance units, a venous reservoir. We employed two different types of ePTFE valve and evaluated the relationship between the leaflets motion and hemodynamic characteristics by using a high-speed video camera. As a result, we successfully reproduced hemodynamic simulations in our pediatric pulmonary mock system. We confirmed that the presence of bulging sinuses in the pulmonary valved conduit reduced the transvalvular energy loss and increased the valve opening area during systolic period. Our engineering-based in vitro analysis could be useful for proposing a shape design optimization of sophisticated pediatric ePTFE pulmonary valve.

Towards a Tissue-Engineered Contractile Fontan-Conduit: The Fate of Cardiac Myocytes in the Subpulmonary Circulation.

Directory of Open Access Journals (Sweden)

Daniel Biermann

Full Text Available The long-term outcome of patients with single ventricles improved over time, but remains poor compared to other congenital heart lesions with biventricular circulation. Main cause for this unfavourable outcome is the unphysiological hemodynamic of the Fontan circulation, such as subnormal systemic cardiac output and increased systemic-venous pressure. To overcome this limitation, we are developing the concept of a contractile extracardiac Fontan-tunnel. In this study, we evaluated the survival and structural development of a tissue-engineered conduit under in vivo conditions. Engineered heart tissue was generated from ventricular heart cells of neonatal Wistar rats, fibrinogen and thrombin. Engineered heart tissues started beating around day 8 in vitro and remained contractile in vivo throughout the experiment. After culture for 14 days constructs were implanted around the right superior vena cava of Wistar rats (n = 12. Animals were euthanized after 7, 14, 28 and 56 days postoperatively. Hematoxylin and eosin staining showed cardiomyocytes arranged in thick bundles within the engineered heart tissue-conduit. Immunostaining of sarcomeric actin, alpha-actin and connexin 43 revealed a well -developed cardiac myocyte structure. Magnetic resonance imaging (d14, n = 3 revealed no constriction or stenosis of the superior vena cava by the constructs. Engineered heart tissues survive and contract for extended periods after implantation around the superior vena cava of rats. Generation of larger constructs is warranted to evaluate functional benefits of a contractile Fontan-conduit.

Ceramic fiber blanket wrap for fire protection of cable trays and conduits

International Nuclear Information System (INIS)

Chaille, C.E.; Reiman, R.J.

1980-01-01

In some areas of nuclear power plants, cables of redundant electrical systems, which are necessary for the safe shutdown of the reactor, are in close proximity. If a fire should occur in one of these areas, both electrical systems could be destroyed before the fire is extinguished and control of the reactor may be lost. A ceramic fiber blanket was evaluated as a fire protective wrap around cable trays and conduits. 2 refs

Adult Stem Cell Based Enhancement of Nerve Conduit for Peripheral Nerve Repair

Science.gov (United States)

2016-10-01

accompanied by injuries to peripheral nerves; if not repaired, the trauma can lead to significant dysfunction and disability . While nerves have the ability to...recovery, minimized disability , and increased quality of life for our wounded warriors. 2. KEYWORDS: Stem Cell, Nerve Conduit, Peripheral Nerve...would be a paradigm shift away from ordering X-rays at 10-12 weeks and only ordering a CT scan. It has the potential to change the standard of care

Age-related changes in biomechanical properties of transgenic porcine pulmonary and aortic conduits

International Nuclear Information System (INIS)

Wilczek, Piotr; Malota, Zbigniew; Lesiak, Anna; Niemiec-Cyganek, Aleksandra; Kubin, Barbara; Nozynski, Jerzy; Mzyk, Aldona; Gramatyka, Michalina; Slomski, Ryszard; Wilczek, Grazyna; Opiela, Jolanta

2014-01-01

The limitations associated with conventional valve prosthesis have led to a search for alternatives. One potential approach is tissue engineering. Most tissue engineering studies have described the biomechanical properties of heart valves derived from adult pigs. However, because one of the factors affecting the function of valve prosthesis after implantation is appropriate sizing for a given patient, it is important to evaluate the usefulness of a heart valve given the donor animal’s weight and age. The aim of this study was to evaluate how the age of a pig can influence the biomechanical and hemodynamical properties of porcine heart valve prosthesis after acellularization. Acellular porcine aortic and pulmonary valve conduits were used. Hearts were harvested from animals differing in weight and age. The biomechanical properties of the valves were then characterized using a uniaxial tensile test. Moreover, computer simulations based on the finite element method (FEM) were used to study the influence of biomechanical properties on the hemodynamic conditions. Studying biomechanical and morphological changes in porcine heart valve conduits according to the weight and age of the animals can be valuable for developing age-targeted therapy using tissue engineering techniques. (paper)

Field observations of extended seawater intrusion through subsurface karst conduit networks at Wakulla Spring in the Woodville Karst Plain, Florida

Science.gov (United States)

Xu, Z.; Bassett, S.; Hu, B. X.; Dyer, S.

2016-12-01

Five periods of increased electrical conductivity have been found in the karst conduits supplying one of the largest first magnitude springs in Florida with water. Numerous well-developed conduit networks are distributed in the Woodville Karst Plain (WKP), Florida and connected to the Gulf of Mexico. A composite analysis of precipitation and electric conductivity data provides strong evidence that the increases in conductivity are directly tied to seawater intrusion moving inland and traveling 14 miles against the prevailing regional hydraulic gradient from from Spring Creek Spring Complex (SCSC), a group of submarine springs at the Gulf Coast. A geochemical analysis of samples from the spring vent rules out anthropogenic contamination and upwelling regional recharge from the deep aquifer as sources of the rising conductivity. The interpretation is supported by the conceptual model established by prior researchers working to characterize the study area. This abstract documented the first and longest case of seawater intrusion in the WKP, and also indicates significant possibility of seawater contamination through subsurface conduit networks in a coastal karst aquifer.

Randomized Controlled Trial of Nurse-Delivered Cognitive Behavioral Therapy Versus Supportive Psychotherapy Telehealth Interventions for Chronic Back Pain.

Science.gov (United States)

Rutledge, Thomas; Atkinson, J Hampton; Holloway, Rachael; Chircop-Rollick, Tatiana; D'Andrea, John; Garfin, Steven R; Patel, Shetal; Penzien, Donald B; Wallace, Mark; Weickgenant, Anne L; Slater, Mark

2018-04-16

This study evaluated a nurse-delivered, telehealth intervention of cognitive behavioral therapy versus supportive psychotherapy for chronic back pain. Participants (N=61) had chronic back pain (pain "daily" ≥ 6 months at an intensity ≥4/10 scale) and were randomized to an 8-week, 12-session, Cognitive Behavioral Therapy (CBT) or to Supportive Care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ). Secondary outcomes included the Numerical Rating Scale (NRS) and the Patient Global Impressions Scale (CGI). CBT participants (n=30) showed significant improvements on the RMDQ (means=11.4[5.9] vs. 9.4[6.1] at baseline and post-treatment, respectively, p.10). The results suggest that telehealth, nurse-delivered CBT and SC treatments for chronic back pain can offer significant and relatively comparable benefits. ClinicalTrials.gov: NCT00608530. This article describes the benefits of training primary care nurses to deliver evidence-based behavioral therapies for low back pain. Due to the high prevalence of chronic pain and the growing emphasis on non-opioid therapies, training nurses to provide behavior therapies could be a cost-effective way to improve pain management. Copyright © 2018. Published by Elsevier Inc.

Faulting within the Mount St. Helens conduit and implications for volcanic earthquakes

Science.gov (United States)

Pallister, John S.; Cashman, Katharine V.; Hagstrum, Jonathan T.; Beeler, Nicholas M.; Moran, Seth C.; Denlinger, Roger P.

2013-01-01

The 2004–2008 eruption of Mount St. Helens produced seven dacite spines mantled by cataclastic fault rocks, comprising an outer fault core and an inner damage zone. These fault rocks provide remarkable insights into the mechanical processes that accompany extrusion of degassed magma, insights that are useful in forecasting dome-forming eruptions. The outermost part of the fault core consists of finely comminuted fault gouge that is host to 1- to 3-mm-thick layers of extremely fine-grained slickenside-bearing ultracataclasite. Interior to the fault core, there is an ∼2-m-thick damage zone composed of cataclastic breccia and sheared dacite, and interior to the damage zone, there is massive to flow-banded dacite lava of the spine interior. Structures and microtextures indicate entirely brittle deformation, including rock breakage, tensional dilation, shearing, grain flow, and microfaulting, as well as gas and fluid migration through intergranular pores and fractures in the damage zone. Slickenside lineations and consistent orientations of Riedel shears indicate upward shear of the extruding spines against adjacent conduit wall rocks.Paleomagnetic directions, demagnetization paths, oxide mineralogy, and petrology indicate that cataclasis took place within dacite in a solidified steeply dipping volcanic conduit at temperatures above 500 °C. Low water content of matrix glass is consistent with brittle behavior at these relatively high temperatures, and the presence of tridymite indicates solidification depths of <1 km. Cataclasis was coincident with the eruption’s seismogenic zone at <1.5 km.More than a million small and low-frequency “drumbeat” earthquakes with coda magnitudes (Md) <2.0 and frequencies <5 Hz occurred during the 2004–2008 eruption. Our field data provide a means with which to estimate slip-patch dimensions for shear planes and to compare these with estimates of slip patches based on seismic moments and shear moduli for dacite rock and

Numerical study of groundwater flow cycling controlled by seawater/freshwater interaction in a coastal karst aquifer through conduit network using CFPv2

Science.gov (United States)

Xu, Zexuan; Hu, Bill X.; Davis, Hal; Kish, Stephen

2015-11-01

In this study, a groundwater flow cycling in a karst springshed and an interaction between two springs, Spring Creek Springs and Wakulla Springs, through a subground conduit network are numerically simulated using CFPv2, the latest research version of MODFLOW-CFP (Conduit Flow Process). The Spring Creek Springs and Wakulla Springs, located in a marine estuary and 11 miles inland, respectively, are two major groundwater discharge spots in the Woodville Karst Plain (WKP), North Florida, USA. A three-phase conceptual model of groundwater flow cycling between the two springs and surface water recharge from a major surface creek (Lost Creek) was proposed in various rainfall conditions. A high permeable subground karst conduit network connecting the two springs was found by tracer tests and cave diving. Flow rate of discharge, salinity, sea level and tide height at Spring Creek Springs could significantly affect groundwater discharge and water stage at Wakulla Springs simultaneously. Based on the conceptual model, a numerical hybrid discrete-continuum groundwater flow model is developed using CFPv2 and calibrated by field measurements. Non-laminar flows in conduits and flow exchange between conduits and porous medium are implemented in the hybrid coupling numerical model. Time-variable salinity and equivalent freshwater head boundary conditions at the submarine spring as well as changing recharges have significant impacts on seawater/freshwater interaction and springs' discharges. The developed numerical model is used to simulate the dynamic hydrological process and quantitatively represent the three-phase conceptual model from June 2007 to June 2010. Simulated results of two springs' discharges match reasonably well to measurements with correlation coefficients 0.891 and 0.866 at Spring Creeks Springs and Wakulla Springs, respectively. The impacts of sea level rise on regional groundwater flow field and relationship between the inland springs and submarine springs are

A pilot muon radiography to image the shallow conduit of the Stromboli volcano: results and future prospects

Science.gov (United States)

Miyamoto, Seigo; Tioukov, Valeri; Sirignano, Chiara; Bozza, Cristiano; Morishima, Kunihiro

2017-04-01

The test result of imaging the shallow part of the Stromboli crater zone by using cosmic-ray muons in 2012 and possible performance of the future muon observation will be presented. It is well known that the behavior of volcanic eruptions strongly depends on the shape of the conduit. Stromboli is one of the most known and studied active volcanoes in the world, nevertheless the details of its internal structure are not well defined yet. Geophysical exploration method which use high energy cosmic-ray muons and makes the density image of the object like X-ray radiography for the human body is called "muon radiography " or "muography". A pilot muography was done for the shallow part of Stromboli in 2012. We succeeded to clarify that there is a less density part at the North-East cone in the crater zone. It is considered that the stack of volcanic ashes. On the other hand, we also confirmed that the contamination of the physical background particles and they makes the noisy density image especially about 50 meter below from the top of the crater. In another observation, Nishiyama et al (2014) revealed the contents of background particles and the way to remove them were presented. They showed that the main contents of the background particles is low kinetic energy charged particles and also showed that it is possible to remove them by using multi-layerd muon film detector. We can plan the future muography observation to see the deeper part of the conduit( at least until 100 meter from the top of crater) by their backgroundless method. Therefore we estimated possible performance of the future observation by multi-layer muon films. The result suggests that we might get the image of shallow conduit from the surface to the depth of e.g. 55 meter with 20 meter spatial resolution or 100 meter with 27 meter resolution in case the density in the conduit is 0.0 g/cm3 and with 71 percent statistical confidence level.

Modified conduit preparation creates a pseudosinus in an aortic valve-sparing procedure for aneurysm of the ascending aorta.

Science.gov (United States)

Cochran, R P; Kunzelman, K S; Eddy, A C; Hofer, B O; Verrier, E D

1995-06-01

Mechanical valved conduit replacement of the aortic root is a durable and appropriate procedure for many diseases of the ascending aorta, but may sacrifice an anatomically salvageable aortic valve. For young active patients and for patients with "systemic" arterial disease (atherosclerosis, Marfan's syndrome) who may require future operations, life-long anticoagulation with its attendant thromboembolic versus hemorrhagic risks is not ideal. Several techniques have been suggested as aortic valve-sparing options. Recently, a procedure was described that combines the freehand homograft techniques with the standard Bentall techniques (David procedure). This innovative technique replaces the ascending aorta with a Dacron cylinder, spares the aortic valve, and restores competence and thus offers an excellent alternative. The durability of this procedure that places the aortic valve inside a cylindrical conduit without sinuses of Valsalva is unknown. In selected patients, we have used this technique to spare the aortic valve. On the basis of experimental data and preliminary computer modeling, with the hope of improving the durability, we have modified the conduit to create a "pseudosinus" in our most recent nine patients. We have done the David procedure in 10 patients. The pseudosinus modification was done in the most recent nine patients. Patients' ages ranged from 37 to 71 years (mean 49.9 years). There were five female and five male patients. Five patients had Marfan's syndrome and five patients had annuloaortic ectasia. There has been no mortality and all patients have had both early and late follow-up echocardiography. Five patients have zero to trace aortic insufficiency, four patients have trace to mild aortic insufficiency, and one patient has mild or "1+" aortic insufficiency. Aortic insufficiency has not progressed in any patient during the 18 months of follow-up. The patient with 1+ aortic insufficiency has no activity limits, good ventricular function, and

Permeability and 3-D melt geometry in shear-induced high melt fraction conduits

Science.gov (United States)

Zhu, W.; Cordonnier, B.; Qi, C.; Kohlstedt, D. L.

2017-12-01

Observations of dunite channels in ophiolites and uranium-series disequilibria in mid-ocean ridge basalt suggest that melt transport in the upper mantle beneath mid-ocean ridges is strongly channelized. Formation of high melt fraction conduits could result from mechanical shear, pyroxene dissolution, and lithological partitioning. Deformation experiments (e.g. Holtzman et al., 2003) demonstrate that shear stress causes initially homogeneously distributed melt to segregate into an array of melt-rich bands, flanked by melt-depleted regions. At the same average melt fraction, the permeability of high melt fraction conduits could be orders of magnitude higher than that of their homogenous counterparts. However, it is difficult to determine the permeability of melt-rich bands. Using X-ray synchrotron microtomography, we obtained high-resolution images of 3-dimensional (3-D) melt distribution in a partially molten rock containing shear-induced high melt fraction conduits. Sample CQ0705, an olivine-alkali basalt aggregate with a nominal melt fraction of 4%, was deformed in torsion at a temperature of 1473 K and a confining pressure of 300 MPa to a shear strain of 13.3. A sub-volume of CQ0705 encompassing 3-4 melt-rich bands was imaged. Microtomography data were reduced to binary form so that solid olivine is distinguishable from basalt glass. At a spatial resolution of 160 nm, the 3-D images reveal the shape and connectedness of melt pockets in the melt-rich bands. Thin melt channels formed at grain edges are connected at large melt nodes at grain corners. Initial data analysis shows a clear preferred orientation of melt pockets alignment subparallel to the melt-rich band. We use the experimentally determined geometrical parameters of melt topology to create a digital rock with identical 3-D microstructures. Stokes flow simulations are conducted on the digital rock to obtain the permeability tensor. Using this digital rock physics approach, we determine how deformation

Extraterrestrial processing and manufacturing of large space systems. Volume 3: Executive summary

Science.gov (United States)

Miller, R. H.; Smith, D. B. S.

1979-01-01

Facilities and equipment are defined for refining processes to commercial grade of lunar material that is delivered to a 'space manufacturing facility' in beneficiated, primary processed quality. The manufacturing facilities and the equipment for producing elements of large space systems from these materials and providing programmatic assessments of the concepts are also defined. In-space production processes of solar cells (by vapor deposition) and arrays, structures and joints, conduits, waveguides, RF equipment radiators, wire cables, converters, and others are described.

Trends and quality of care in outpatient visits to generalist and specialist physicians delivering primary care in the United States, 1997-2010.

Science.gov (United States)

Edwards, Samuel T; Mafi, John N; Landon, Bruce E

2014-06-01

Although many specialists serve as primary care physicians (PCPs), the type of patients they serve, the range of services they provide, and the quality of care they deliver is uncertain. To describe trends in patient, physician, and visit characteristics, and compare visit-based quality for visits to generalists and specialists self-identified as PCPs. Cross-sectional study and time trend analysis. Nationally representative sample of visits to office-based physicians from the National Ambulatory Medical Care Survey, 1997-2010. Proportions of primary care visits to generalist and specialists, patient characteristics, principal diagnoses, and quality. Among 84,041 visits to self-identified PCPs representing an estimated 4.0 billion visits, 91.5 % were to generalists, 5.9 % were to medical specialists and 2.6 % were to obstetrician/gynecologists. The proportion of PCP visits to generalists increased from 88.4 % in 1997 to 92.4 % in 2010, but decreased for medical specialists from 8.0 % to 4.8 %, p = 0.04). The proportion of medical specialist visits in which the physician self-identified as the patient's PCP decreased from 30.6 % in 1997 to 9.8 % in 2010 (p specialist PCPs take care of older patients (mean age 61 years), and dedicate most of their visits to chronic disease management (51.0 %), while generalist PCPs see younger patients (mean age 55.4 years) most commonly for new problems (40.5 %). Obstetrician/gynecologists self-identified as PCPs see younger patients (mean age 38.3 p specialists. Medical specialists are less frequently serving as PCPs for their patients over time. Generalist, medical specialist, and obstetrician/gynecologist PCPs serve different primary care roles for different populations. Delivery redesign efforts must account for the evolving role of generalist and specialist PCPs in the delivery of primary care.

Treatment acceptability and preferences for managing severe health anxiety: Perceptions of internet-delivered cognitive behaviour therapy among primary care patients.

Science.gov (United States)

Soucy, Joelle N; Hadjistavropoulos, Heather D

2017-12-01

While cognitive behaviour therapy (CBT) is an established treatment for health anxiety, there are barriers to service access. Internet-delivered cognitive behaviour therapy (ICBT) has demonstrated effectiveness and has the potential to improve access to treatment. Nevertheless, it is unknown how patients perceive ICBT relative to other interventions for health anxiety and what factors predict ICBT acceptability. This study investigated these questions. Primary care patients (N = 116) who reported elevated levels of health anxiety were presented three treatment vignettes that each described a different protocol for health anxiety (i.e., medication, CBT, ICBT). Acceptability and credibility of the treatments were assessed following the presentation of each vignette. Participants then ranked the three treatments and provided a rational for their preferences. The treatments were similarly rated as moderately acceptable. Relative to medication and ICBT, CBT was perceived as the most credible treatment for health anxiety. The highest preference ranks were for CBT and medication. Regression analyses indicated that lower computer anxiety, past medication use, and lower ratings of negative cognitions about difficulty coping with an illness significantly predicted greater ICBT acceptability. Health anxiety was not assessed with a diagnostic interview. Primary care patients were recruited through a Qualtrics panel. Patients did not have direct experience with treatment but learned about treatment options through vignettes. Medication and CBT are preferred over ICBT. If ICBT is to increase treatment access, methods of improving perceptions of this treatment option are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Delivering primary care in prison: the need to improve health information

Directory of Open Access Journals (Sweden)

Sudy Anaraki

2003-12-01

Conclusions To provide 'equivalence of care' for prisoners, primary care trusts need to implement full electronic clinical records in prisons and ensure staff have access to resources on the internet.

Electromagnetic analysis of a superconducting transformer for high current characterization of cable in conduit conductors in background magnetic field

Science.gov (United States)

Wu, Xiangyang; Tan, Yunfei; Fang, Zhen; Jiang, Donghui; Chen, Zhiyou; Chen, Wenge; Kuang, Guangli

2017-10-01

A large cable-in-conduit-conductor (CICC) test facility has been designed and fabricated at the High Magnetic Field Laboratory of the Chinese Academy of Sciences (CHMFL) in order to meet the test requirement of the conductors which are applied to the future fusion reactor. The critical component of the test facility is an 80 kA superconducting transformer which consists of a multi-turn primary coil and a minor-turn secondary coil. As the current source of the conductor samples, the electromagnetic performance of the superconducting transformer determines the stability and safety of the test facility. In this paper, the key factors and parameters, which have much impact on the performance of the transformer, are analyzed in detail. The conceptual design and optimizing principles of the transformer are discussed. An Electromagnetic-Circuit coupled model built in ANSYS Multiphysics is successfully used to investigate the electromagnetic characterization of the transformer under the dynamic operation condition.

Hot upwelling conduit beneath the Atlas Mountains, Morocco

Science.gov (United States)

Sun, Daoyuan; Miller, Meghan S.; Holt, Adam F.; Becker, Thorsten W.

2014-11-01

The Atlas Mountains of Morocco display high topography, no deep crustal root, and regions of localized Cenozoic alkaline volcanism. Previous seismic imaging and geophysical studies have implied a hot mantle upwelling as the source of the volcanism and high elevation. However, the existence, shape, and physical properties of an associated mantle anomaly are debated. Here we use seismic waveform analysis from a broadband deployment and geodynamic modeling to define the physical properties and morphology of the anomaly. The imaged low-velocity structure extends to ~200 km beneath the Atlas and appears ~350 K hotter than the ambient mantle with possible partial melting. It includes a lateral conduit, which suggests that the Quaternary volcanism arises from the upper mantle. Moreover, the shape and temperature of the imaged anomaly indicate that the unusually high topography of the Atlas Mountains is due to active mantle support.

Thermal Expansivity Between 150 and 800°C of Hydrothermally Altered Conduit Dyke Samples from USDP-4 Drill Core (Mt Unzen, Shimabara, Japan)

Science.gov (United States)

Yilmaz, T. I.; Hess, K. U.; Vasseur, J.; Wadsworth, F. B.; Gilg, H. A.; Nakada, S.; Dingwell, D. B.

2017-12-01

When hot magma intrudes the crust, the surrounding rocks expand. Similarly, the cooling magma contracts. The expansion and contraction of these multiphase materials is not simple and often requires empirical constraint. Therefore, we constrained the thermal expansivity of Unzen dome and conduit samples using a NETZSCH® DIL 402C. Following experiments, those samples were scanned using a Phoenix v|tome|x m to observe the cracks that may have developed during the heating and cooling. The dome samples do not show petrological or chemical signs of alteration. However, the alteration of the conduit dykes is represented by the occurrence of the main secondary phases such as chlorite, sulfides, carbonates, R1 (Reichweite parameter) illite-smectite, and kaolinite. These alteration products indicate an (I) early weak to moderate argillic magmatic alteration, and a (II) second stage weak to moderate propylitic hydrothermal alteration. The linear thermal expansion coefficient aL of the dome material is K-1 between 150° and 800°C and shows a sharp peak of up to K-1 around the alpha-beta-quartz-transition ( 573°C). In contrast, aL of the hydrothermally altered conduit samples starts to increase around 180° and reaches K-1 at 400°C. We interpret this effect as being due to the water content of the kaolinite and the R1 illite-smectite, which induces larger expansions per degree temperature change. Furthermore, the altered conduit samples show a more pronounced increases of aL between 500 and 650°C of up to peaks at K-1, which is generated by the breakdown of chlorite, iron-rich dolomite solid solutions, calcite, and pyrite. We use a 1D conductive model of heat transfer to explore how the country rock around the Unzen conduit zone would heat up after intrusion. In turn, we convert these temperature profiles to thermal stress profiles, assuming the edifice is largely undeformable. We show that these high linear thermal expansion coefficients of the hydrothermally altered

Transforming primary healthcare by including the stakeholders involved in delivering care to people living in poverty: EQUIhealThY study protocol.

Science.gov (United States)

Loignon, Christine; Hudon, Catherine; Boudreault-Fournier, Alexandrine; Dupéré, Sophie; Macaulay, Ann C; Pluye, Pierre; Gaboury, Isabelle; Haggerty, Jeannie L; Fortin, Martin; Goulet, Émilie; Lambert, Mireille; Pelissier-Simard, Luce; Boyer, Sophie; de Laat, Marianne; Lemire, Francine; Champagne, Louise; Lemieux, Martin

2013-03-11

Ensuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the healthcare system in the development of research interventions. The aim of this project is to stimulate changes in healthcare organizations and practices by encouraging collaboration between care teams and people living in poverty. Our objectives are twofold: 1) to identify actions required to promote the adoption of professional practices oriented toward social competence in primary care teams; and 2) to examine factors that would encourage the inclusion of people living in poverty in the process of developing social competence in healthcare organizations. This study will use a participatory action research design applied in healthcare organizations. Participatory research is an increasingly recognized approach that is helpful for involving the people for whom the research results are intended. Our research team consists of 19 non-academic researchers, 11 academic researchers and six partners. A steering committee composed of academic researchers and stakeholders will have a decision-making role at each step, including knowledge dissemination and recommendations for new interventions. In this project we will adopt a multiphase approach and will use a variety of methods, including photovoice, group discussions and interviews. The proposed study will be one of only a few using participatory research in primary care to foster changes aimed at enhancing quality and access to care for people living in poverty. To our knowledge this will be the first study to use photovoice in healthcare organizations to promote new interventions. Our project includes partners who are targeted for practice changes and improvements in delivering primary care to persons living in poverty

Cable-in-conduit conductor optimization for fusion magnet applications

International Nuclear Information System (INIS)

Miller, J.R.; Kerns, J.A.

1987-01-01

Careful design of the toroidal-field (TF) and poloidal-field (PF) coils in a tokamak machine using cable-in-conduit conductors (CICC) can result in quite high overall winding-pack current densities - even with the high nuclear heat loads that may be imposed in operating a fusion reactor - and thereby help reduce the overall machine size. In our design process, we systematically examined the operational environment of a magnet, e.g., mechanical stresses, current, field, heat load, coolant temperature, and cooldown stresses, to determine the optimum amounts of copper, superconductor, helium, and sheath material for the CICC. This process is being used to design the superconducting magnet systems that comprise the Tokamak Ignition/Burn Experimental Reactor (TIBER II). 13 refs., 2 figs

Hawaiian fissure fountains: Quantifying vent and shallow conduit geometry, episode 1 of the 1969-1974 Mauna Ulu eruption: Chapter 17

Science.gov (United States)

Parcheta, Carolyn; Fagents, Sarah; Swanson, Donald A.; Houghton, Bruce F.; Ericksen, Todd; Carey, Rebecca; Cayol, Valérie; Poland, Michael P.; Weis, Dominique

2015-01-01

Geometries of shallow magmatic pathways feeding volcanic eruptions are poorly constrained, yet many key interpretations about eruption dynamics depend on knowledge of these geometries. Direct quantification is difficult because vents typically become blocked with lava at the end of eruptions. Indirect geophysical techniques have shed light on some volcanic conduit geometries, but the scales are too coarse to resolve narrow fissures (widths typically 1 m). Kīlauea's Mauna Ulu eruption, which started with 30 m. Direct measurements at the ground surface were augmented by tripod-mounted lidar measurements to quantify the shallow conduit geometry for three vents at a resolution eruptive behavior, especially if incorporated into computer models.

Construction of nerve guide conduits from cellulose/soy protein composite membranes combined with Schwann cells and pyrroloquinoline quinone for the repair of peripheral nerve defect.

Science.gov (United States)

Luo, Lihua; Gan, Li; Liu, Yongming; Tian, Weiqun; Tong, Zan; Wang, Xiong; Huselstein, Celine; Chen, Yun

2015-02-20

Regeneration and functional reconstruction of peripheral nerve defects remained a significant clinical challenge. Nerve guide conduits, with seed cells or neurotrophic factors (NTFs), had been widely used to improve the repair and regeneration of injured peripheral nerve. Pyrroloquinoline quinone (PQQ) was an antioxidant that can stimulate nerve growth factors (NGFs) synthesis and accelerate the Schwann cells (SCs) proliferation and growth. In present study, three kinds of nerve guide conduits were constructed: one from cellulose/SPI hollow tube (CSC), another from CSC combined with SCs (CSSC), and the third one from CSSC combined with PQQ (CSSPC), respectively. And then they were applied to bridge and repair the sciatic nerve defect in rats, using autograft as control. Effects of different nerve guide conduits on the nerve regeneration were comparatively evaluated by general analysis, sciatic function index (SFI) and histological analysis (HE and TEM). Newly-formed regenerative nerve fibers were observed and running through the transparent nerve guide conduits 12 weeks after surgery. SFI results indicated that the reconstruction of motor function in CSSPC group was better than that in CSSC and CSC groups. HE images from the cross-sections and longitudinal-sections of the harvested regenerative nerve indicated that regenerative nerve fibers had been formed and accompanied with new blood vessels and matrix materials in the conduits. TEM images also showed that lots of fresh myelinated and non-myelinated nerve fibers had been formed. Parts of vacuolar, swollen and abnormal axons occurred in CSC and CSSC groups, while the vacuolization and swell of axons was the least serious in CSSPC group. These results indicated that CSSPC group had the most ability to repair and reconstruct the nerve structure and functions due to the comprehensive contributions from hollow CSC tube, SCs and PQQ. As a result, the CSSPC may have the potential for the applications as nerve guide

Simulation of Microdamage and Evaluation of Remaining Life of Steam Conduit Components from New-Generation Refractory Steel 10Kh9MF-Sh

Science.gov (United States)

Gladshtein, V. I.

2018-03-01

The effects of microdamage on the remaining life of high-temperature components of steam conduits from high-chromium steel 10Kh9MF-Sh and low-alloy steel 12Kh1M1F are compared. To simulate the microdamage, specimens with a circular notch and different relative diameters are fabricated. Specimens with a notch simulating the highest degree of microdamage and smooth specimens are tested for long-term strength. The coefficient of the remaining life of a conduit is computed for the range of relative damage presenting practical interest.

Numerical study of groundwater flow cycling controlled by seawater/freshwater interaction in a coastal karst aquifer through conduit network using CFPv2.

Science.gov (United States)

Xu, Zexuan; Hu, Bill X; Davis, Hal; Kish, Stephen

2015-11-01

In this study, a groundwater flow cycling in a karst springshed and an interaction between two springs, Spring Creek Springs and Wakulla Springs, through a subground conduit network are numerically simulated using CFPv2, the latest research version of MODFLOW-CFP (Conduit Flow Process). The Spring Creek Springs and Wakulla Springs, located in a marine estuary and 11 miles inland, respectively, are two major groundwater discharge spots in the Woodville Karst Plain (WKP), North Florida, USA. A three-phase conceptual model of groundwater flow cycling between the two springs and surface water recharge from a major surface creek (Lost Creek) was proposed in various rainfall conditions. A high permeable subground karst conduit network connecting the two springs was found by tracer tests and cave diving. Flow rate of discharge, salinity, sea level and tide height at Spring Creek Springs could significantly affect groundwater discharge and water stage at Wakulla Springs simultaneously. Based on the conceptual model, a numerical hybrid discrete-continuum groundwater flow model is developed using CFPv2 and calibrated by field measurements. Non-laminar flows in conduits and flow exchange between conduits and porous medium are implemented in the hybrid coupling numerical model. Time-variable salinity and equivalent freshwater head boundary conditions at the submarine spring as well as changing recharges have significant impacts on seawater/freshwater interaction and springs' discharges. The developed numerical model is used to simulate the dynamic hydrological process and quantitatively represent the three-phase conceptual model from June 2007 to June 2010. Simulated results of two springs' discharges match reasonably well to measurements with correlation coefficients 0.891 and 0.866 at Spring Creeks Springs and Wakulla Springs, respectively. The impacts of sea level rise on regional groundwater flow field and relationship between the inland springs and submarine springs are

Functional and regenerative effects of local administration of autologous mononuclear bone marrow cells combined with silicone conduit on transected femoral nerve of rabbits.

Science.gov (United States)

Trindade, Anelise Bonilla; Schestatsky, Pedro; Torres, Vítor Félix; Gomes, Cristiano; Gianotti, Giordano Cabral; Paz, Ana Helena da Rosa; Terraciano, Paula Barros; Marques, Janete Maria Volpato; Guimarães, Karina Magano; Graça, Dominguita Lühers; Cirne-Lima, Elizabeth Obino; Contesini, Emerson Antonio

2015-10-01

The inoculation of cells into injury sites can accelerate and improve the quality of nerve regeneration. This study aimed to evaluate the functional and regenerative effects of mononuclear autologous bone marrow cells (MABMC) combined with silicon conduit grafting in rabbit femoral nerves. Twenty-eight animals were allocated to one of two groups: treatment group (TG) or control group (CG), divided according to the time of evaluation, at either 50 or 75 days. After neurotmesis of the femoral nerve, surgical repair was performed with nerve autografts in silicon conduits, leaving a 5mm gap in both groups. The TG received MABMC in silicon conduits, and CG received a sham saline inoculum. Histological, clinical and electrophysiological analyses detected no differences between groups, but analysis of leg diameter showed that TG diameters were larger. This cell therapy did not improve regeneration of the femoral nerve, but there was a tendency for better functional recovery. Copyright © 2015 Elsevier Ltd. All rights reserved.

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

Directory of Open Access Journals (Sweden)

Shi-Min Yuan

2012-01-01

congenital heart defects, especially as a conduit for the right ventricular outflow tract reconstruction. This article aims to make a comprehensive review on the clinical outcomes of Contegra. Reports of Contegra published since 2002 were comprehensively retrieved, collected and analyzed. There were 1718 Contegra, applied in 1705 patients. The sizes of the conduits were 8-22 mm. The patients aged from newborn to 74.5 years, prevailed by pediatrics. The primary diagnosis was congenital heart defects in all cases, with Tetralogy of Fallot, truncus arteriosus and pulmonary atresia being the first three diagnoses, representing 25.6%, 16.7%, and 13.1%, respectively. Contegra was used as a tube graft in the pulmonary position in 1635 (95.9% patients, as a monocuspid patch in 12 (0.7%, as a graft in the position of the pulmonary valve or a monocusps in 40 (2.3%, and as an inferior vena cava-pulmonary artery conduit in the Fontan procedure in 18 (1.1% patients, respectively. Conduit reimplantation was performed in 141 (8.3% patients 33.8 ± 37 (8.6-106.8 months after the initial conduit insertion. Conduit plasty was necessary in 6 (0.4%, and reintervention in 83 (4.9% patients. Indications for conduit reimplantation included severe stenosis of the distal anastomosis, pseudoaneurysm of the proximal anastomosis and severe conduit regurgitation. As for the good performance, availability and longevity, Contegra is a biomaterial suitable for the right ventricular outflow tract reconstruction and for patch repair for ventricular septal defect, but not apt for Fontan procedure.

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

Directory of Open Access Journals (Sweden)

Shi-Min Yuan

2012-12-01

congenital heart defects, especially as a conduit for the right ventricular outflow tract reconstruction. This article aims to make a comprehensive review on the clinical outcomes of Contegra. Reports of Contegra published since 2002 were comprehensively retrieved, collected and analyzed. There were 1718 Contegra, applied in 1705 patients. The sizes of the conduits were 8-22 mm. The patients aged from newborn to 74.5 years, prevailed by pediatrics. The primary diagnosis was congenital heart defects in all cases, with Tetralogy of Fallot, truncus arteriosus and pulmonary atresia being the first three diagnoses, representing 25.6%, 16.7%, and 13.1%, respectively. Contegra was used as a tube graft in the pulmonary position in 1635 (95.9% patients, as a monocuspid patch in 12 (0.7%, as a graft in the position of the pulmonary valve or a monocusps in 40 (2.3%, and as an inferior vena cava-pulmonary artery conduit in the Fontan procedure in 18 (1.1% patients, respectively. Conduit reimplantation was performed in 141 (8.3% patients 33.8 ± 37 (8.6-106.8 months after the initial conduit insertion. Conduit plasty was necessary in 6 (0.4%, and reintervention in 83 (4.9% patients. Indications for conduit reimplantation included severe stenosis of the distal anastomosis, pseudoaneurysm of the proximal anastomosis and severe conduit regurgitation. As for the good performance, availability and longevity, Contegra is a biomaterial suitable for the right ventricular outflow tract reconstruction and for patch repair for ventricular septal defect, but not apt for Fontan procedure.

Hydrothermal Alteration of the Mt Unzen Conduit (Shimabara/Japan)

Science.gov (United States)

Yilmaz, T. I.; Mayer, K.; Hess, K. U.; Janots, E.; Gilg, H. A.; Dingwell, D. B.

2016-12-01

Investigations were carried out on hydrothermally altered coherent dacitic dykes samples from (USDP-4) drill core at Mt Unzen stratovolcano (Shimabara/Japan). XRF, XRD, EMPA, and C-O-isotope analysis led to insights concerning chemistry, mineralogy, and intensity of alteration as well as the origin of carbonate-precipitating fluids. Additionally a textural characterization of the occurring replacement features in the magma conduit zone was performed. The occurrence of the main secondary phases such as chlorite, pyrite, carbonates, and R1 (Reichweite parameter) illite-smectite indicate a weak to moderate propylitic to phyllic hydrothermal alteration. The dacitic samples of the dykes show different hydrothermal alteration features: (i) carbonate pseudomorphs after hornblende as well as core and zonal textures due to replacement of plagioclase by R1 illite-smectite, (ii) colloform banded fracture fillings and fillings in dissolution vugs, and (iii) chlorite and R1 illite-smectite in the groundmass. Carbonates in fractures comprise iron-rich dolomite solid solutions ("ankerite") and calcite. Isotopic values of d13Cvpdb = -4.59 ± 0.6‰ and d18Ovpdb = -21.73 ± 0.5‰ indicate a hydrothermal-magmatic origin for the carbonate formation. The chlorite-carbonate-pyrite index (CCPI) and the Ishikawa alteration index (AI), applied to the investigated samples show significant differences (CCPI=52.7-57.8; AI=36.1-40.6) indicating their different degree of alteration. According to Nakada et al., 2005, the C13 to C16 dykes represent the feeder dyke from the latest eruption (1991-1995) whereas C8 represents an earlier dyke feeder dyke from an older eruption. Weakest conduit alteration, which was obtained in samples C16-1-5 and C13-2-5, correlates with the alteration degree of the pristine dome rocks. Highest CCPI value was determined for sample C14-1-5 and the highest AI value was determined for sample C15-2-6. The degrees of alteration do not indicate highest alteration of the

Magnetic losses and reactance change by the use of metallic conduit in electrical installations; Perdidas magneticas y cambio de reactancia por la tuberia metalica en instalaciones electricas

Energy Technology Data Exchange (ETDEWEB)

Campero Littlewood, Eduardo; Castaneda D, Miguel; Castulo A, Roberto; Bratu Serban, Neagu [Universidad Autonoma Metropolitana-Azcapotzalco, Mexico, D. F. (Mexico)

1996-12-31

In this paper are presented the results obtained in the measurement of magnetic losses in metallic conduits in electric installations. The losses for parasitic currents and by hysteresis were obtained in different conditions of magnetic density, caused by the net current resulting from the sum of all the currents of all the conductors that travel along the conduit. These currents are named differential currents, and the conditions in which they appear in the electric installations are described. The magnetic induction phenomenon that occurs in metallic conduit is briefly described and the basic concepts that describe it. A theoretical-experimental methodology is offered to quantify the energy losses by parasitic currents and by the metal magnetization in these metallic conduits. At the same time, the impact of these differential currents impact in the reactance of the electric installation is quantified. The obtained results for twelve conduits of different diameters and different wall thickness are shown. A comparison analysis is made with the reported results in a previous article, where the losses were estimated by means of the temperature rise measurement of the metallic wall. [Espanol] En este articulo se presentan los resultados obtenidos en la medicion de perdidas magneticas en tuberias conduit (metalicas) en instalaciones electricas. Las perdidas por corrientes parasitas y por histeresis se obtuvieron para diferentes condiciones de densidad magnetica, provocada por la corriente neta resultante de la suma de las corrientes de todos los conductores que viajan por la tuberia. A estas corrientes se les designa corrientes diferenciales y se describen las condiciones en las que estas aparecen en las instalaciones electricas. Se explica brevemente el fenomeno de induccion magnetica que se presenta en las tuberias metalicas y los conceptos basicos que la describen. Se plantea una metodologia teorico-experiemental para cuantificar las perdidas de energia, por

Magnetic losses and reactance change by the use of metallic conduit in electrical installations; Perdidas magneticas y cambio de reactancia por la tuberia metalica en instalaciones electricas

Energy Technology Data Exchange (ETDEWEB)

Campero Littlewood, Eduardo; Castaneda D, Miguel; Castulo A, Roberto; Bratu Serban, Neagu [Universidad Autonoma Metropolitana-Azcapotzalco, Mexico, D. F. (Mexico)

1997-12-31

In this paper are presented the results obtained in the measurement of magnetic losses in metallic conduits in electric installations. The losses for parasitic currents and by hysteresis were obtained in different conditions of magnetic density, caused by the net current resulting from the sum of all the currents of all the conductors that travel along the conduit. These currents are named differential currents, and the conditions in which they appear in the electric installations are described. The magnetic induction phenomenon that occurs in metallic conduit is briefly described and the basic concepts that describe it. A theoretical-experimental methodology is offered to quantify the energy losses by parasitic currents and by the metal magnetization in these metallic conduits. At the same time, the impact of these differential currents impact in the reactance of the electric installation is quantified. The obtained results for twelve conduits of different diameters and different wall thickness are shown. A comparison analysis is made with the reported results in a previous article, where the losses were estimated by means of the temperature rise measurement of the metallic wall. [Espanol] En este articulo se presentan los resultados obtenidos en la medicion de perdidas magneticas en tuberias conduit (metalicas) en instalaciones electricas. Las perdidas por corrientes parasitas y por histeresis se obtuvieron para diferentes condiciones de densidad magnetica, provocada por la corriente neta resultante de la suma de las corrientes de todos los conductores que viajan por la tuberia. A estas corrientes se les designa corrientes diferenciales y se describen las condiciones en las que estas aparecen en las instalaciones electricas. Se explica brevemente el fenomeno de induccion magnetica que se presenta en las tuberias metalicas y los conceptos basicos que la describen. Se plantea una metodologia teorico-experiemental para cuantificar las perdidas de energia, por

Injunctions against mere conduit of information protected by copyright

DEFF Research Database (Denmark)

Sandfeld Jakobsen, Søren; Petersen, Clement Salung

2011-01-01

This paper includes an in-depth analysis of EU law and Scandinavian law on injunctions against internet access providers (IAPs) performing as mere conduit of information protected by copyright. In recent Scandinavian case law, courts have granted preliminary injunctions which have caused IAPs...... to either shut down specific internet connections allegedly used to infringe copyright or to block access to internet content, which allegedly infringed applicable copyright rules. This paper considers some significant legal challenges, which are emerging in the wake of this case law, and which should...... requires rules, which take into due consideration the special aspects related to enforcement of copyright on the internet through IAPs. Secondly, it is shown that the termination of internet connections and the blocking of access to internet content may not support the public policies behind copyright law...

Studying the causes for corrosive destruction of water conduits

Energy Technology Data Exchange (ETDEWEB)

Azamatova, F I; Kulinichev, G P; Porubov, I S

1979-01-01

Pipes from different oil and gas production administrations were selected for X-ray and metallographic studies of the cause of corrosive destruction. The chemical composition and mechanical properties of the pipe material are presented in tables. The phase composition of the corrosion products was studied by X-rays. The complex structure of the layer made up of the corrosion products was taken into consideration. The studies were conducted in an X-ray diffraction chamber. The obtained results are presented in a table. The metallographic studies showed that a significant corrosive damage of the materials of water conduits occurs as a result of the development of local corrosion processes, caused by the substantive heterogeneity of the structure of the metal, related to the nonuniform distribution of the pearlite because of carbon liquidation.

NECL1 coated PLGA as favorable conduits for repair of injured peripheral nerve

International Nuclear Information System (INIS)

Xu, Fuben; Zhang, Kun; Lv, Peizhen; Lu, Rongbin; Zheng, Li; Zhao, Jinmin

2017-01-01

Restoration of normal neurological function of transected peripheral nerve challenged regenerative medicine and surgery. Previous studies showed that Nectin-like molecule 1 (NECL1) is one of the important adhesion molecules on the axons and Schwann cells is located along the internodes in direct apposition to NECL1. In this study, we fabricated PLGA membrane pre-coated with NECL1, mimicking the natural axons to enhance the adhesion of Schwann cells. Investigation of the cellular response in vitro was performed by detecting cytotoxicity, proliferation, morphology, viability, specific markers and Scanning Electron Microscopy (SEM) of Schwann cells cultured in PLGA. Further, the NECL1-coated PLGA conduits were used for peripheral nerve repair after sciatic nerve defect was constructed. Results showed that PLGA-coated NECL1 enhanced cell proliferation compared with PLGA, as evidenced by MTT analysis, cell viability assay and histological evaluation. RT-PCR results showed that GDNF (glial cell line-derived neurotrophic factor), BDNF (brain-derived neurotrophic factor), CNTF (ciliary neurotrophic factor) and neurotrophic factors of axonal regeneration were highly expressed in PLGA/NECL1 group. S100, which is Schwann cell marker, was also elevated in PLGA-NCEL1 in both mRNA and protein expression as demonstrated by PCR and immunohistochemical examination. Moreover, in vivo study showed that implantation of PLGA/NCEL1 tubes in bridging the nerve defect can significantly improve Schwann cell aggregation and attachment and greatly enhance the functional recovery of nerve regeneration as compared with control and PLGA groups. Therefore, the novel blend of PLGA/NECL1 conduits proved to be promising candidate for tissue engineering scaffold. - Highlights: • A fabricated PLGA tubes pre-coated with Nectin-like molecule 1 (NECL1) strategy for sciatic nerve regeneration is proposed. • The NECL1 coated PLGA can promote Schwann cells adhesion and growth meanwhile maintain the

The efficacy of a scaffold-free Bio 3D conduit developed from human fibroblasts on peripheral nerve regeneration in a rat sciatic nerve model.

Directory of Open Access Journals (Sweden)

Hirofumi Yurie

Full Text Available Although autologous nerve grafting is the gold standard treatment of peripheral nerve injuries, several alternative methods have been developed, including nerve conduits that use supportive cells. However, the seeding efficacy and viability of supportive cells injected in nerve grafts remain unclear. Here, we focused on a novel completely biological, tissue-engineered, scaffold-free conduit.We developed six scaffold-free conduits from human normal dermal fibroblasts using a Bio 3D Printer. Twelve adult male rats with immune deficiency underwent mid-thigh-level transection of the right sciatic nerve. The resulting 5-mm nerve gap was bridged using 8-mm Bio 3D conduits (Bio 3D group, n = 6 and silicone tube (silicone group, n = 6. Several assessments were conducted to examine nerve regeneration eight weeks post-surgery.Kinematic analysis revealed that the toe angle to the metatarsal bone at the final segment of the swing phase was significantly higher in the Bio 3D group than the silicone group (-35.78 ± 10.68 versus -62.48 ± 6.15, respectively; p < 0.01. Electrophysiological studies revealed significantly higher compound muscle action potential in the Bio 3D group than the silicone group (53.60 ± 26.36% versus 2.93 ± 1.84%; p < 0.01. Histological and morphological studies revealed neural cell expression in all regions of the regenerated nerves and the presence of many well-myelinated axons in the Bio 3D group. The wet muscle weight of the tibialis anterior muscle was significantly higher in the Bio 3D group than the silicone group (0.544 ± 0.063 versus 0.396 ± 0.031, respectively; p < 0.01.We confirmed that scaffold-free Bio 3D conduits composed entirely of fibroblast cells promote nerve regeneration in a rat sciatic nerve model.

Large-area irradiated low-level laser effect in a biodegradable nerve guide conduit on neural regeneration of peripheral nerve injury in rats.

Science.gov (United States)

Shen, Chiung-Chyi; Yang, Yi-Chin; Liu, Bai-Shuan

2011-08-01

This study used a biodegradable composite containing genipin-cross-linked gelatin annexed with β-tricalcium phosphate ceramic particles (genipin-gelatin-tricalcium phosphate, GGT), developed in a previous study, as a nerve guide conduit. The aim of this study was to analyse the influence of a large-area irradiated aluminium-gallium-indium phosphide (AlGaInP) diode laser (660 nm) on the neural regeneration of the transected sciatic nerve after bridging the GGT nerve guide conduit in rats. The animals were divided into two groups: group 1 comprised sham-irradiated controls and group 2 rats underwent low-level laser (LLL) therapy. A compact multi-cluster laser system with 20 AlGaInP laser diodes (output power, 50mW) was applied transcutaneously to the injured peripheral nerve immediately after closing the wound, which was repeated daily for 5 min for 21 consecutive days. Eight weeks after implantation, walking track analysis showed a significantly higher sciatic function index (SFI) score (Pguide conduit in rats. Copyright © 2011 Elsevier Ltd. All rights reserved.

Conduit degassing and thermal controls on eruption styles at Mount St. Helens

Science.gov (United States)

Schneider, Andrew; Rempel, Alan W.; Cashman, Katharine V.

2012-12-01

The explosivity of silicic eruptions depends on the interplay between magma rheology, exsolution kinetics, and degassing. Magma degassing is governed by the competing effects of vertical transport within the conduit and the lateral flux of gas out of the conduit (Diller et al., 2006; Jaupart and Allegre, 1991). We combine a simplified treatment of these degassing processes with thermodynamic modeling to examine the conditions present at Mount St. Helens during the spine extruding eruption from 2004 to 2008. We find that two parameters are primarily responsible for controlling the eruptive style: the magma chamber temperature, and a dimensionless parameter that gauges the efficiency of lateral degassing. Together, these parameters determine whether and where magma can solidify at depth to form a dense solid plug that is gradually extruded as a volcanic spine. We show that the small (50 oC) decrease in magma chamber temperature between eruptive activity in the 1980s and that of 2004-2008, combined with a modest increase in degassing efficiency associated with lower volumetric flux, can explain the observed change in erupted material from viscous lava flows to solidified spines. More generally, we suggest that similar threshold behavior may explain observed abrupt transitions in effusive eruptive styles at other intermediate composition volcanoes. Finally, we extrapolate our results to suggest that the increase in degassing efficiency accompanying decreasing magma supply rates may have caused the transition from explosive to effusive activity in late 1980.

Delivering Results for Peace and Development

International Nuclear Information System (INIS)

Pattison, Hazel

2013-01-01

The IAEA’s technical cooperation programme is the primary mechanism for delivering the IAEA’s capacity-building services to its Member States. The programme supports the safe and secure application of nuclear technology for sustainable socioeconomic development in Member States. The overall strategic framework of the TC programme is determined by pertinent provisions laid down in key documents of the IAEA. Strategic direction for the multi-annual TC programme is provided by the Agency’s Members States and, more specifically, by relevant advisory and governance entities. The programme concentrates on: improving human health; supporting agriculture, rural development and food security; advancing water resource management; addressing environmental challenges; helping sustainable energy development, including the use of nuclear power for electricity; and promoting safety and security

Conduits to care: call lights and patients’ perceptions of communication

Directory of Open Access Journals (Sweden)

Montie M

2017-09-01

Full Text Available Mary Montie,1 Clayton Shuman,1 Jose Galinato,1 Lance Patak,2 Christine A Anderson,1 Marita G Titler1 1Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, 2Department of Anesthesiology and Pain Medicine, Seattle Children’s Hospital, Seattle, WA, USA Background: Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods: Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated. Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results: Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”. Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion: Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. Keywords: nurse–patient communication, medical technology, quality of care, qualitative research

Flow-rate measurements in closed-conduits by tracer techniques

International Nuclear Information System (INIS)

Lund Plantat, C.

1982-01-01

This paper presents the study of the precision obtained measuring flow-rates in closed-conduits by tracer techniques. The flow-rates analyzed were in the range of 10 to 20 l/s and Reynolds numbers from 10 5 to 2 x 10 5 . Tracer used were fluoresceine and In-113 m; and the measurements were performed with the dilution method (punctual and continuous injection) and the Allen method. Precisions for the method of punctual and continuous injections were 6.25% and 9.45% for fluoresceine and 9.3% and 3% for In-113, respectively. For Allen method with In-113 m a precision of 5% was obtained; probably this value was affected by the short distance between detectors. In all cases the error corresponds with the expected value except in one measurement at a 68.3% confidence level. (I.V.)

Exploring weight loss services in primary care and staff views on using a web-based programme.

Science.gov (United States)

Ware, Lisa J; Williams, Sarah; Bradbury, Katherine; Brant, Catherine; Little, Paul; Hobbs, F D Richard; Yardley, Lucy

2012-01-01

Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of e-health into primary care may face challenges. To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery. Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36) involved in delivering weight loss services. Data were analysed using inductive thematic analysis. Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation. Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and 'ad hoc' services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Exploring weight loss services in primary care and staff views on using a web-based programme

Directory of Open Access Journals (Sweden)

Lisa J Ware

2013-09-01

Full Text Available Background Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of ehealth into primary care may face challenges.Objectives To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery.Methods Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36 involved in delivering weight loss services. Data were analysed using inductive thematic analysis.Results Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation.Conclusions Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and ‘ad hoc’ services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Power generation systems and methods

Science.gov (United States)

Jones, Jack A. (Inventor); Chao, Yi (Inventor)

2011-01-01

A power generation system includes a plurality of submerged mechanical devices. Each device includes a pump that can be powered, in operation, by mechanical energy to output a pressurized output liquid flow in a conduit. Main output conduits are connected with the device conduits to combine pressurized output flows output from the submerged mechanical devices into a lower number of pressurized flows. These flows are delivered to a location remote of the submerged mechanical devices for power generation.

Combining Technologies to Deliver Distance Education

Directory of Open Access Journals (Sweden)

Vicki Freeman

1999-01-01

Full Text Available In 1997 a Health Resources and Services Administration (HRSA grant was awarded to the Department of Clinical Laboratory Sciences (CLS at The University of Texas Medical Branch - Galveston (UTMB for support of the Laboratory Education and Advancement Project (LEAP. The project entailed three primary objectives, targeting laboratory practitioners in rural and medically underserved areas of Texas for delivering a bachelor's degree, laboratory-intensive course of study via distance education. Several delivery mechanisms were utilized and evaluated for their effectiveness and friendliness to both the faculty and students. The authors discuss and describe the mechanisms utilized for delivery of courses, the advantages and disadvantages encountered with each mechanism, and subjective evaluation of the effectiveness of the courses. Also discussed are the lessons learned and plans for future development.

Bronchovascular reconstruction with a bovine pericardial conduit and surgical reintervention due to thrombosis with revascularisation.

Science.gov (United States)

Peña, Emilio; Blanco, Montserrat; Otero, Teresa

2014-01-01

We present the case of a 57-year-old male with left hilar squamous cell carcinoma infiltrating the pulmonary artery and in whom a sleeve bronchoplasty and angioplasty were performed using a bovine pericardial conduit. Three days post-operatively, graft thrombosis was detected; thrombectomy and graft reconstruction were performed with revascularisation of the graft. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Exhaust gas recirculation system for an internal combustion engine

Science.gov (United States)

Wu, Ko-Jen

2013-05-21

An exhaust gas recirculation system for an internal combustion engine comprises an exhaust driven turbocharger having a low pressure turbine outlet in fluid communication with an exhaust gas conduit. The turbocharger also includes a low pressure compressor intake and a high pressure compressor outlet in communication with an intake air conduit. An exhaust gas recirculation conduit fluidly communicates with the exhaust gas conduit to divert a portion of exhaust gas to a low pressure exhaust gas recirculation branch extending between the exhaust gas recirculation conduit and an engine intake system for delivery of exhaust gas thereto. A high pressure exhaust gas recirculation branch extends between the exhaust gas recirculation conduit and the compressor intake and delivers exhaust gas to the compressor for mixing with a compressed intake charge for delivery to the intake system.

[Electrophysiological study on rat conduit pulmonary artery smooth muscle cells under normoxia and acute hypoxia].

Science.gov (United States)

Hu, Ying; Zou, Fei; Cai, Chun-Qing; Wu, Hang-Yu; Yun, Hai-Xia; Chen, Yun-Tian; Jin, Guo-En; Ge, Ri-Li

2006-10-25

The present study was designed to investigate the electrophysiological characteristics of rat conduit pulmonary artery smooth muscle cells (PASMCs) and the response to acute hypoxia. PASMCs of the 1st to 2nd order branches in the conduit pulmonary arteries were obtained by enzymatic isolation. The PASMCs were divided into acute hypoxia preconditioned group and normoxia group. Hypoxia solutions were achieved by bubbling with 5% CO2 plus 95% N2 for at least 30 min before cell perfusion. Potassium currents were compared between these two groups using whole-cell patch clamp technique. The total outward current of PASMCs was measured under normoxia condition when iBTX [specific blocking agent of large conductance Ca-activated K(+) (BK(Ca)) channel] and 4-AP [specific blocking agent of delayed rectifier K(+) (K(DR)) channel] were added consequently into bath solution. PASMCs were classified into three types according to their size, shape and electrophysiological characteristics. Type I cells are the smallest with spindle shape, smooth surface and discrete perinuclear bulge. Type II cells show the biggest size with banana-like appearance. Type III cells have the similar size with type I, and present intermediary shape between type I and type II. iBTX had little effect on the total outward current in type I cells, while 4-AP almost completely blocked it. Most of the total outward current in type II cells was inhibited by iBTX, and the remaining was sensitive to 4-AP. In type III cells, the total outward current was sensitive to both iBTX and 4-AP. Acute hypoxia reduced the current in all three types of cells: (1614.8+/-62.5) pA to (892.4+/-33.6) pA for type I cells (Ppotassium current and improves the E(m) in PASMCs. These effects may be involved in the modulation of constriction/relaxation of conduit artery under acute hypoxia. Different distribution of K(DR) and BK(Ca) channels in these three types of PASMCs might account for their different constriction

Le projet de recherche: définition, conduite et réalisation

OpenAIRE

Stockinger , Peter

2013-01-01

Master; Ce support de séminaire développe brièvement les quatre points suivants: 1) Définition d’un projet de recherche – présentation générale et recommandations. 2) La conduite d’un projet de recherche – présentation générale et recommandations. 3) La réalisation d’un projet de recherche sous forme d’un mémoire - présentation générale et recommandations. 4) Des ressources pour conduire un projet de recherche : ressources enligne et références bibliographiques.

Biodegradable chitin conduit tubulation combined with bone marrow mesenchymal stem cell transplantation for treatment of spinal cord injury by reducing glial scar and cavity formation

Directory of Open Access Journals (Sweden)

Feng Xue

2015-01-01

Full Text Available We examined the restorative effect of modified biodegradable chitin conduits in combination with bone marrow mesenchymal stem cell transplantation after right spinal cord hemisection injury. Immunohistochemical staining revealed that biological conduit sleeve bridging reduced glial scar formation and spinal muscular atrophy after spinal cord hemisection. Bone marrow mesenchymal stem cells survived and proliferated after transplantation in vivo, and differentiated into cells double-positive for S100 (Schwann cell marker and glial fibrillary acidic protein (glial cell marker at 8 weeks. Retrograde tracing showed that more nerve fibers had grown through the injured spinal cord at 14 weeks after combination therapy than either treatment alone. Our findings indicate that a biological conduit combined with bone marrow mesenchymal stem cell transplantation effectively prevented scar formation and provided a favorable local microenvironment for the proliferation, migration and differentiation of bone marrow mesenchymal stem cells in the spinal cord, thus promoting restoration following spinal cord hemisection injury.

Biodegradable chitin conduit tubulation combined with bone marrow mesenchymal stem cell transplantation for treatment of spinal cord injury by reducing glial scar and cavity formation

Science.gov (United States)

Xue, Feng; Wu, Er-jun; Zhang, Pei-xun; Li-ya, A; Kou, Yu-hui; Yin, Xiao-feng; Han, Na

2015-01-01

We examined the restorative effect of modified biodegradable chitin conduits in combination with bone marrow mesenchymal stem cell transplantation after right spinal cord hemisection injury. Immunohistochemical staining revealed that biological conduit sleeve bridging reduced glial scar formation and spinal muscular atrophy after spinal cord hemisection. Bone marrow mesenchymal stem cells survived and proliferated after transplantation in vivo, and differentiated into cells double-positive for S100 (Schwann cell marker) and glial fibrillary acidic protein (glial cell marker) at 8 weeks. Retrograde tracing showed that more nerve fibers had grown through the injured spinal cord at 14 weeks after combination therapy than either treatment alone. Our findings indicate that a biological conduit combined with bone marrow mesenchymal stem cell transplantation effectively prevented scar formation and provided a favorable local microenvironment for the proliferation, migration and differentiation of bone marrow mesenchymal stem cells in the spinal cord, thus promoting restoration following spinal cord hemisection injury. PMID:25788929

Experimental sintering of ash at conduit conditions and implications for the longevity of tuffisites

Science.gov (United States)

Gardner, James E.; Wadsworth, Fabian B.; Llewellin, Edward W.; Watkins, James M.; Coumans, Jason P.

2018-03-01

Escape of gas from magma in the conduit plays a crucial role in mitigating explosivity. Tuffisite veins—ash-filled cracks that form in and around volcanic conduits—represent important gas escape pathways. Sintering of the ash infill decreases its porosity, eventually forming dense glass that is impermeable to gas. We present an experimental investigation of surface tension-driven sintering and associated densification of rhyolitic ash under shallow conduit conditions. Suites of isothermal (700-800 °C) and isobaric H2O pressure (20 and 40 MPa) experiments were run for durations of 5-90 min. Obsidian powders with two different size distributions were used: 1-1600 μm (mean size = 89 μm), and 63-400 μm (mean size = 185 μm). All samples evolved similarly through four textural phases: phase 1—loose and cohesion-less particles; phase 2—particles sintered at contacts and surrounded by fully connected tortuous pore space of up to 40% porosity; phase 3—continuous matrix of partially coalesced particles that contain both isolated spherical vesicles and connected networks of larger, contorted vesicles; phase 4—dense glass with 2-5% fully isolated vesicles that are mainly spherical. Textures evolve faster at higher temperature and higher H2O pressure. Coarse samples sinter more slowly and contain fewer, larger vesicles when fully sintered. We quantify the sintering progress by measuring porosity as a function of experimental run-time, and find an excellent collapse of data when run-time is normalized by the sintering timescale {λ}_s=η \\overline{R}/σ , where η is melt viscosity, \\overline{R} is mean particle radius, and σ is melt-gas surface tension. Because timescales of diffusive H2O equilibration are generally fast compared to those of sintering, the relevant melt viscosity is calculated from the solubility H2O content at experimental temperature and pressure. We use our results to develop a framework for estimating ash sintering rates under shallow

The role of external drains and peritoneal conduits in the treatment of recurrent chronic subdural hematoma.

Science.gov (United States)

Santarius, Thomas; Qureshi, Hammad U; Sivakumaran, Ram; Kirkpatrick, Peter J; Kirollos, Ramez W; Hutchinson, Peter J

2010-06-01

A considerable body of evidence supporting the use of external drainage after evacuation of primary chronic subdural hematoma (CSDH) exists in the literature. However, no systematic study of the value of postoperative drainage in the treatment of recurrent CSDH has been published. The aim of the study was to investigate external drains and subdural-to-peritoneal conduit in the treatment of recurrent CSDH. A retrospective review of cases of CSDH treated in our institution between October 2002 and October 2006 was conducted. During the study period, 408 patients had burr hole evacuation. Sixty-four patients (15.9%) had treatment for recurrence. One patient had craniotomy, and the remaining 63 had another burr hole evacuation: 36 without placement of a drain (BHO), 14 with external drainage (SED), and 13 with placement of subdural-peritoneal catheter (SPC). Fifteen patients (24%) developed a secondary recurrence requiring a third drainage procedure. Postoperative drainage (SED or SPC) was associated with a significantly lower secondary recurrence rate when compared to BHO: 3/27 (11%) versus 12/36 (33%) (χ(2), P=.040). There was no significant difference in recurrence rates between SED and SPC. Postoperative complications included acute subdural hematoma (2), subdural empyema (2), brain edema (2), pneumonia (3), and in-hospital death (2). None of the complications was associated with the use of a specific technique. The results indicate that, as in the treatment of primary CSDHs, the use of drain (SED or SPC) with burr hole evacuation is safe and is associated with lower recurrence rate. Further investigation is needed to clarify the indications of currently available surgical techniques in the treatment of recurrent CSDH. Copyright © 2010 Elsevier Inc. All rights reserved.

Theory and modelling of quench in cable-in-conduit superconducting magnets

International Nuclear Information System (INIS)

Shajii, A.

1994-04-01

A new simple, self consistent theoretical model is presented that describes the phenomena of quench propagation in Cable-In-Conduit superconducting magnets. The model (Quencher) circumvents many of the difficulties associated with obtaining numerical solutions in more general existing models. Specifically, a factor of 30-50 is gained in CPU time over the general, explicit time dependent codes used to study typical quench events. The corresponding numerical implementation of the new model is described and the numerical results are shown to agree very well with those of the more general models, as well as with experimental data. Further, well justified approximations lead to the MacQuench model that is shown to be very accurate and considerably more efficient than the Quencher model. The MacQuench code is suitable for performing quench studies on a personal computer, requiring only several minutes of CPU time. In order to perform parametric studies on new conductor designs it is required to utilize a model such as MacQuench because of the high computational efficiency of this model. Finally, a set of analytic solutions for the problem of quench propagation in Cable-In-Conduit Conductors is presented. These analytic solutions represent the first such results that remain valid for the long time scales of interest during a quench process. The assumptions and the resulting simplifications that lead to the analytic solutions are discussed, and the regimes of validity of the various approximations are specified. The predictions of the analytic results are shown to be in very good agreement with numerical as well as experimental results. Important analytic scaling relations are verified by such comparisons, and the consequences of some of these scalings on currently designed superconducting magnets are discussed

Internet-delivered cognitive-behavioral treatment for adolescents with chronic pain and their parents: a randomized controlled multicenter trial.

Science.gov (United States)

Palermo, Tonya M; Law, Emily F; Fales, Jessica; Bromberg, Maggie H; Jessen-Fiddick, Tricia; Tai, Gabrielle

2016-01-01

Internet-delivered interventions are emerging as a strategy to address barriers to care for individuals with chronic pain. This is the first large multicenter randomized controlled trial of Internet-delivered cognitive-behavioral therapy (CBT) for pediatric chronic pain. Participants included were 273 adolescents (205 females and 68 males), aged 11 to 17 years with mixed chronic pain conditions and their parents, who were randomly assigned in a parallel-group design to Internet-delivered CBT (n = 138) or Internet-delivered Education (n = 135). Assessments were completed before treatment, immediately after treatment, and at 6-month follow-up. All data collection and procedures took place online. The primary analysis used linear growth models. Results demonstrated significantly greater reduction on the primary outcome of activity limitations from baseline to 6-month follow-up for Internet CBT compared with Internet education (b = -1.13, P = 0.03). On secondary outcomes, significant beneficial effects of Internet CBT were found on sleep quality (b = 0.14, P = 0.04), on reducing parent miscarried helping (b = -2.66, P = 0.007) and protective behaviors (b = -0.19, P = 0.001), and on treatment satisfaction (P values parent-perceived impact (ie, reductions in depression, anxiety, self-blame about their adolescent's pain, and improvement in parent behavioral responses to pain). In conclusion, our Internet-delivered CBT intervention produced a number of beneficial effects on adolescent and parent outcomes, and could ultimately lead to wide dissemination of evidence-based psychological pain treatment for youth and their families.

Tissue-engineered spiral nerve guidance conduit for peripheral nerve regeneration.

Science.gov (United States)

Chang, Wei; Shah, Munish B; Lee, Paul; Yu, Xiaojun

2018-06-01

Recently in peripheral nerve regeneration, preclinical studies have shown that the use of nerve guidance conduits (NGCs) with multiple longitudinally channels and intra-luminal topography enhance the functional outcomes when bridging a nerve gap caused by traumatic injury. These features not only provide guidance cues for regenerating nerve, but also become the essential approaches for developing a novel NGC. In this study, a novel spiral NGC with aligned nanofibers and wrapped with an outer nanofibrous tube was first developed and investigated. Using the common rat sciatic 10-mm nerve defect model, the in vivo study showed that a novel spiral NGC (with and without inner nanofibers) increased the successful rate of nerve regeneration after 6 weeks recovery. Substantial improvements in nerve regeneration were achieved by combining the spiral NGC with inner nanofibers and outer nanofibrous tube, based on the results of walking track analysis, electrophysiology, nerve histological assessment, and gastrocnemius muscle measurement. This demonstrated that the novel spiral NGC with inner aligned nanofibers and wrapped with an outer nanofibrous tube provided a better environment for peripheral nerve regeneration than standard tubular NGCs. Results from this study will benefit for future NGC design to optimize tissue-engineering strategies for peripheral nerve regeneration. We developed a novel spiral nerve guidance conduit (NGC) with coated aligned nanofibers. The spiral structure increases surface area by 4.5 fold relative to a tubular NGC. Furthermore, the aligned nanofibers was coated on the spiral walls, providing cues for guiding neurite extension. Finally, the outside of spiral NGC was wrapped with randomly nanofibers to enhance mechanical strength that can stabilize the spiral NGC. Our nerve histological data have shown that the spiral NGC had 50% more myelinated axons than a tubular structure for nerve regeneration across a 10 mm gap in a rat sciatic nerve

Investigating the influence of conduit residues on polyurethane plates

Directory of Open Access Journals (Sweden)

Rachel Faverzani Magnago

Full Text Available Abstract Converting waste into a product similar to the original one or into another useful product is to save energy, protect natural resources, and bring back to the production cycle what was discarded. In that direction, new polyurethane-based composites have been developed by incorporating 5%, 10%, 15%, and 20% PVC conduit discarded by the construction industry. The objective of this study was to investigate the interaction between the phases of waste incorporation and the effect upon the new material properties. The samples were produced by the polycondensation process. Microstructural analysis revealed a reduction in pore size across the polymer matrix. However, there were no changes in thermal insulation, water absorption, compressive strength, and burning rate tests and in the thermogravimetric analysis and differential scanning calorimetry. The results from this study showed that the replacement of raw material by waste did not affect its properties.

The effect on stability and thermal hydraulic quenchback of perforating the jacket of a cable-in-conduit conductor

International Nuclear Information System (INIS)

Dresner, L.

1994-01-01

This Paper continues earlier work on the reduction of the quench pressure in a doubler cable-in-conduit conductor achieved by perforating the inner jacket. The present study examines the effect of the perforations on the stability margin and on the ononset of thermal hydraulic quenchback

Fast evolving conduits in clay-bonded sandstone: Characterization, erosion processes and significance for the origin of sandstone landforms

Czech Academy of Sciences Publication Activity Database

Bruthans, J.; Svetlik, D.; Soukup, J.; Schweigstillová, Jana; Válek, Jan; Sedláčková, M.; Mayo, A.L.

2012-01-01

Roč. 177, December (2012), s. 178-193 ISSN 0169-555X R&D Projects: GA AV ČR IAA300130806 Institutional support: RVO:67985891 ; RVO:68378297 Keywords : sandstone * erosion * piping * tensile strength * conduit * landform Subject RIV: DA - Hydrology ; Limnology Impact factor: 2.552, year: 2012

Utilização de valvas homólogas e heterólogas em condutos extracardíacos The use of homograph and heterograph valves in extracardiac conduits

Directory of Open Access Journals (Sweden)

Rui Siqueira de Almeida

1988-08-01

Full Text Available O conceito do uso de um conduto extracardíaco para estabelecer uma via de saída, conectando o ventrículo direito com o tronco pulmonar, ou seus ramos, foi desenvolvido na década de 60. Entre 1971 e 1986, 335 pacientes receberam, no The Hospital for Sick Children, de Londres, condutos extracardíacos para o lado direito do coração; 176 destes foram homoenxertos aórticos, preservados em solução antibióticonutriente; 140 heteroenxertos (Hancock, Ross, Carpentier-Edwards, lonescu-Shiley e 19 tubos não valvulados. Estes condutos foram usados na correção de defeitos cardíacos complexos. A idade média foi de 6,34 anos e o peso médio, de 17,8 kg. O diâmetro interno dos condutos variou de 8 a 30 mm. A mortalidade hospitalar foi de 29,2% e o seguimento dos sobrevivente teve uma duração máxima de 14,3 anos, sendo que apenas 40% delas foram relacionadas ao conduto extracardíaco. A curva atuarial, livre de obstrução, dos condutos extracardíacos foi significativa, quando se analisaram os homoenxertos, face a cada grupo de heteroenxertos (p The concept of using extracardiac conduits, to establish an outflow tract between the right ventricle and the pulmonary artery was developed on the sixties. Between 1971 and 1986, 335 patients received extracardiac conduits for the right heart, at The Hospital for Sick Children, London; 176 were antibiotic preserved aortic homografts (Hancock, Ross, Carpentier-Edwards, lonescu-Shiley and 19 non-valved tubes. These conduits were used for the repair of complex congenital heart defects. The mean age of these groups was 6.34 ± 4.6 years and the mean weight 17.8 ± 10.8 kg. The internal diameter of the conduits varied from 8 to 30 mm. The hospital mortality was 29.2% and long-term follow-up of the survivals had a maximum period of 14,39 years. Sixty patients (17.9% were submited to 60 reoperations, being only 40% conduit related. The actuarial survival cun/e of freedom from obstruction was significant

Impact of asymmetric lamp positioning on the performance of a closed-conduit UV reactor

Directory of Open Access Journals (Sweden)

Tipu Sultan

2017-06-01

Full Text Available Computational fluid dynamics (CFD analyses for the performance improvement of a closed-conduit ultraviolet (UV reactor were performed by changing the lamp positions from symmetric to asymmetric. The asymmetric lamp positioning can be useful for UV reactor design and optimization. This goal was achieved by incorporating the two performance factors, namely reduction equivalent dose (RED and system dose performance. Four cases were carried out for asymmetric lamp positioning within the UV reactor chamber and each case consisted of four UV lamps that were simulated once symmetrically and four times asymmetrically. The results of the four asymmetric cases were compared with the symmetric one. Moreover, these results were evaluated by using CFD simulations of a closed-conduit UV reactor. The fluence rate model, UVCalc3D was employed to validate the simulations results. The simulation results provide detailed information about the dose distribution, pathogen track modeling and RED. The RED value was increased by approximately 15% by using UVCalc3D fluence rate model. Additionally, the asymmetric lamp positioning of the UV lamps had more than 50% of the pathogens received a better and a higher UV dose than in the symmetric case. Consequently, the system dose performance was improved by asymmetric lamp positioning. It was concluded that the performance parameters (higher RED and system dose performance were improved by using asymmetric lamp positioning.

Enhancing Peripheral Nerve Regeneration with a Novel Drug Delivering Nerve Conduit

Science.gov (United States)

2017-12-01

In Vitro NGF/GNDF release kinetics experiments .......................... (Gale, Agarwal) (11-18months) 2. ELISA detection of NGF/GDNF... ELISA for NGF/GDNF detection of day 30 animals ........... (Gale) (24-29 months) b. Walking Track...26-30months) a. ELISA for NGF/GDNF detection of day 30 animals ........... (Gale) (29-33 months) b. Walking Track

Development and fabrication of superconducting hybrid Cable-In-Conduit-Conductor (CICC) for indigenous fusion programme

International Nuclear Information System (INIS)

Singh, A.K.; Hussain, M.M.; Abdulla, K.K.; Singh, R.P.

2011-01-01

The Atomic Fuels Division has initiated development and fabrication of Cable-In-Conduit-Conductor (CICC) of various configurations, for superconducting fusion grade magnets required for their indigenous Fusion Programme. The process involves development of high grade superconducting multifilamentary wire, multi stage cabling of superconducting as well as copper wires and, finally, jacketing of the cables in SS316LN tubes. The overview of the development and fabrication of CICC is presented in this article. (author)

Internet-Delivered Exposure Therapy for Fibromyalgia: A Randomized Controlled Trial.

Science.gov (United States)

Hedman-Lagerlöf, Maria; Hedman-Lagerlöf, Erik; Axelsson, Erland; Ljótsson, Brjánn; Engelbrektsson, Johanna; Hultkrantz, Sofia; Lundbäck, Karolina; Björkander, Daniel; Wicksell, Rikard K; Flink, Ida; Andersson, Erik

2018-06-01

Fibromyalgia (FM) is a common and disabling chronic pain disorder, for which existing pharmacological and psychological treatments have yet yielded insufficient effects. Previous literature has shown that exposure therapy may be an effective treatment for chronic pain. This study constitutes the first randomized controlled trial evaluating exposure therapy for FM. A total of 140 participants with diagnosed FM were randomized to a 10-week Internet-delivered exposure treatment (iExp; n=70) or a waitlist control condition (WLC; n=70). Primary outcome measure were FM symptoms and impact, and secondary outcome measures were fatigue, disability, quality of life, pain-related distress and avoidance behaviors, insomnia, depression, and anxiety. Data retention was high (100% data completion at posttreatment for primary outcome, 96% at 6-month follow-up and 94% at 12-month follow-up). Results showed that participants in the iExp group made large and superior improvements compared with WLC on FM symptoms and impact (B, -1.93; z, -10.14; P<0.001, between-group Cohen d=0.90), as well as all secondary outcomes (between-group Cohen d ranging from 0.44 to 1.38) with sustained results. We conclude that iExp seems to be an efficacious treatment for FM compared with no treatment, and the results also highlight the potential increase of accessibility by using the Internet format to deliver psychological treatments for these patients. Future trials with active control conditions are warranted.

Distilling allometric and environmental information from time series of conduit size: the standardization issue and its relationship to tree hydraulic architecture.

Science.gov (United States)

Carrer, Marco; von Arx, Georg; Castagneri, Daniele; Petit, Giai

2015-01-01

Trees are among the best natural archives of past environmental information. Xylem anatomy preserves information related to tree allometry and ecophysiological performance, which is not available from the more customary ring-width or wood-density proxy parameters. Recent technological advances make tree-ring anatomy very attractive because time frames of many centuries can now be covered. This calls for the proper treatment of time series of xylem anatomical attributes. In this article, we synthesize current knowledge on the biophysical and physiological mechanisms influencing the short- to long-term variation in the most widely used wood-anatomical feature, namely conduit size. We also clarify the strong mechanistic link between conduit-lumen size, tree hydraulic architecture and height growth. Among the key consequences of these biophysical constraints is the pervasive, increasing trend of conduit size during ontogeny. Such knowledge is required to process time series of anatomical parameters correctly in order to obtain the information of interest. An appropriate standardization procedure is fundamental when analysing long tree-ring-related chronologies. When dealing with wood-anatomical parameters, this is even more critical. Only an interdisciplinary approach involving ecophysiology, wood anatomy and dendrochronology will help to distill the valuable information about tree height growth and past environmental variability correctly. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Attitudes and Learning through Practice Are Key to Delivering Brief Interventions for Heavy Drinking in Primary Health Care: Analyses from the ODHIN Five Country Cluster Randomized Factorial Trial

Directory of Open Access Journals (Sweden)

Peter Anderson

2017-01-01

Full Text Available In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years who screened positive and were given advice to reduce their alcohol consumption (intervention activity. We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers’ screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity.

Hydraulic analysis of harmonic pumping tests in frequency and time domains for identifying the conduits networks in a karstic aquifer

Science.gov (United States)

Fischer, P.; Jardani, A.; Cardiff, M.; Lecoq, N.; Jourde, H.

2018-04-01

In a karstic field, the flow paths are very complex as they globally follow the conduit network. The responses generated from an investigation in this type of aquifer can be spatially highly variable. Therefore, the aim of the investigation in this case is to define a degree of connectivity between points of the field, in order to understand these flow paths. Harmonic pumping tests represent a possible investigation method for characterizing the subsurface flow of groundwater. They have several advantages compared to a constant-rate pumping (more signal possibilities, ease of extracting the signal in the responses and possibility of closed loop investigation). We show in this work that interpreting the responses from a harmonic pumping test is very useful for delineating a degree of connectivity between measurement points. We have firstly studied the amplitude and phase offset of responses from a harmonic pumping test in a theoretical synthetic modeling case in order to define a qualitative interpretation method in the time and frequency domains. Three different type of responses have been separated: a conduit connectivity response, a matrix connectivity, and a dual connectivity (response of a point in the matrix, but close to a conduit). We have then applied this method to measured responses at a field research site. Our interpretation method permits a quick and easy reconstruction of the main flow paths, and the whole set of field responses appear to give a similar range of responses to those seen in the theoretical synthetic case.

An Open Trial of the Anxiety Action Plan (AxAP): A Brief Pediatrician-Delivered Intervention for Anxious Youth

Science.gov (United States)

Ginsburg, Golda S.; Drake, Kelly; Winegrad, Heather; Fothergill, Kate; Wissow, Larry

2016-01-01

Background Anxiety disorders in youth are among the most common psychiatric disorders, yet the majority of affected youth do not receive treatment. One approach to improving access to care is identification and intervention within the primary care setting. Objective This manuscript presents data from a single group pre-post open trial of the Anxiety Action Plan (AxAP), a brief pediatrician-delivered intervention to reduce anxiety in youth who present in the primary care setting. Methods Eleven pediatricians conducted the intervention with 25 youth (mean age 11.16 years; range 6-18 years) with elevated levels of anxiety in their primary care practice setting. Results Pediatricians’ ratings of the AxAP training were positive (mean overall satisfaction was 4.82 on 5 point scale). Pediatricians and parents also reported high levels of intervention satisfaction and acceptability. Parents (but not children) who completed the intervention reported significant reductions from pre- to post-intervention on measures of child anxiety severity, impairment, and caregiver burden (Cohen's d 1.06, .75, .60, respectively). Conclusions Findings suggest that a brief, pediatrician-delivered intervention in primary care settings appears feasible and beneficial to patients. Additional controlled evaluation of the intervention's efficacy is needed. PMID:27403041

Quench detection by fluid dynamic means in cable-in-conduit superconductors

International Nuclear Information System (INIS)

Dresner, L.

1988-01-01

The tight confinement of the helium in cable-in-conduit superconductors creates protection problems because of the pressure rise that can occur during a quench. But the same pressure rise offers the possibility of a non-electrical means of detecting incipient quenches by monitoring the outflow from the various hydraulic paths of the magnet. If the method is to work, the signal must be large enough to be detected unambiguously at an early time, and must not depend too strongly on the length, Joule power density, or rate of growth of the initial normal zone. This paper explores by calculation the degree to which these conditions can be met. The Westinghouse Large Coil Task coil is used as an example

Assessing lateral flows and solute transport during floods in a conduit-flow-dominated karst system using the inverse problem for the advection-diffusion equation

Science.gov (United States)

Cholet, Cybèle; Charlier, Jean-Baptiste; Moussa, Roger; Steinmann, Marc; Denimal, Sophie

2017-07-01

The aim of this study is to present a framework that provides new ways to characterize the spatio-temporal variability of lateral exchanges for water flow and solute transport in a karst conduit network during flood events, treating both the diffusive wave equation and the advection-diffusion equation with the same mathematical approach, assuming uniform lateral flow and solute transport. A solution to the inverse problem for the advection-diffusion equations is then applied to data from two successive gauging stations to simulate flows and solute exchange dynamics after recharge. The study site is the karst conduit network of the Fourbanne aquifer in the French Jura Mountains, which includes two reaches characterizing the network from sinkhole to cave stream to the spring. The model is applied, after separation of the base from the flood components, on discharge and total dissolved solids (TDSs) in order to assess lateral flows and solute concentrations and compare them to help identify water origin. The results showed various lateral contributions in space - between the two reaches located in the unsaturated zone (R1), and in the zone that is both unsaturated and saturated (R2) - as well as in time, according to hydrological conditions. Globally, the two reaches show a distinct response to flood routing, with important lateral inflows on R1 and large outflows on R2. By combining these results with solute exchanges and the analysis of flood routing parameters distribution, we showed that lateral inflows on R1 are the addition of diffuse infiltration (observed whatever the hydrological conditions) and localized infiltration in the secondary conduit network (tributaries) in the unsaturated zone, except in extreme dry periods. On R2, despite inflows on the base component, lateral outflows are observed during floods. This pattern was attributed to the concept of reversal flows of conduit-matrix exchanges, inducing a complex water mixing effect in the saturated zone

Delivering at the right price - the costs of primary maternity care at ...

African Journals Online (AJOL)

This paper reports on a study of the costs of primary maternity care services at the Diepkloof Conmmnity Health Centre (DK) in Soweto. DK, the Soweto connnunity health centre system as a whole and nmnerous other non-hospital settings provide a wide range of Illaternal health services to substantial numbers of women, ...

The primary protection system software

International Nuclear Information System (INIS)

Tooley, P.A.

1992-01-01

This paper continues the detailed description of the Primary Protection System for Sizewell-B by providing an overview of design and implementation of the software, including the features of the design process which ensure that quality is delivered by the contractor. The Nuclear Electric software assessment activities are also described. The argument for the excellence of the software is made on the basis of a quality product delivered by the equipment supplier's design process, and the confirmation of this provided by the Nuclear Electric assessment process, which is as searching and complete an examination as is reasonably practicable to achieve. (author)

Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

Science.gov (United States)

Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

2015-01-01

Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…

Measurement of nanosize etched pits in SiO2 optical fiber conduit using AFM

International Nuclear Information System (INIS)

Espinosa, G.; Golzarri, J.I.; Vazquez, C.; Fragoso, R.

2003-01-01

Fission fragment tracks from 252 Cf have been observed in SiO 2 optical fiber, using an atomic force microscope (AFM), after a very short chemical etching in hydrofluoric acid solution at normal temperature. The nuclear track starting and evolution process is followed by the AFM direct measurements on the material surface and beyond a fine layer of the surface material. The images of the scanned cones were determined observing the two predominant energies from 252 Cf fission fragments and the development of the tracks in the 150 μm diameter optical fiber conduit

Clinical experience with an alloplastic stoma prosthesis (Biocarbon) for urinary conduits and cutaneous ureterostomy.

Science.gov (United States)

Månsson, W; Harzmann, R

1988-01-01

An alloplastic stoma prosthesis, Biocarbon, composed of 99.9% pure carbon in vitreous form, was used in six patients with conduit urinary diversion and in seven with cutaneous ureterostomy. The patients were thereafter observed for 2-86 months. Complications were subcutaneous infection, urinary fistula and ureteral stenosis, which necessitated removal of the prosthesis in most cases. The permanent stoma, without need for adhesive collecting device, was appreciated by the patients. Problems relating to biocompatibility remain to be solved before the place of the stoma prosthesis in urinary diversion can be determined.

Seismic stress analysis of feeder lines to LOFT primary coolant pump motors

International Nuclear Information System (INIS)

Kuehster, C.J.

1978-01-01

The conduit system in the LOFT Support Building was analyzed for seismic loading. The conduit itself plus its various supports were subjected to both horizontal and vertical forces. The results show the system loads or stresses to be within allowables

Functional collagen conduits combined with human mesenchymal stem cells promote regeneration after sciatic nerve transection in dogs.

Science.gov (United States)

Cui, Yi; Yao, Yao; Zhao, Yannan; Xiao, Zhifeng; Cao, Zongfu; Han, Sufang; Li, Xing; Huan, Yong; Pan, Juli; Dai, Jianwu

2018-05-01

Numerous studies have focused on the development of novel and innovative approaches for the treatment of peripheral nerve injury using artificial nerve guide conduits. In this study, we attempted to bridge 3.5-cm defects of the sciatic nerve with a longitudinally oriented collagen conduit (LOCC) loaded with human umbilical cord mesenchymal stem cells (hUC-MSCs). The LOCC contains a bundle of longitudinally aligned collagenous fibres enclosed in a hollow collagen tube. Our previous studies showed that an LOCC combined with neurotrophic factors enhances peripheral nerve regeneration. However, it remained unknown whether an LOCC seeded with hUC-MSCs could also promote regeneration. In this study, using various histological and electrophysiological analyses, we found that an LOCC provides mechanical support to newly growing nerves and functions as a structural scaffold for cells, thereby stimulating sciatic nerve regeneration. The LOCC and hUC-MSCs synergistically promoted regeneration and improved the functional recovery in a dog model of sciatic nerve injury. Therefore, the combined use of an LOCC and hUC-MSCs might have therapeutic potential for the treatment of peripheral nerve injury. Copyright © 2018 John Wiley & Sons, Ltd.

Magma shearing and friction in the volcanic conduit: A crystal constraint

Science.gov (United States)

Wallace, P. A.; Kendrick, J. E.; Henton De Angelis, S.; Ashworth, J. D.; Coats, R.; Miwa, T.; Mariani, E.; Lavallée, Y.

2017-12-01

Magma shearing and friction processes in the shallow volcanic conduit are typical manifestations of strain localisation, which in turn can have an influential role on magma ascent dynamics. The thermal consequences of such events could drive the destabilisation of magma and thus dictate the style of activity at the surface. Shear heating and fault friction are prime candidates for the generation of significant quantities of heat. Here we use a combination of field and experimental evidence to investigate how crystals can act as sensitive recorders of both physical and chemical processes occurring in the shallow volcanic conduit. Spine extrusion during the closing of the 1991-95 eruption at Unzen volcano, Japan, provided the unique opportunity to investigate marginal shear zone formation, which preserves a relic of the deformation during magma ascent. Our results show that crystals can effectively act as a deformation marker during magma ascent through the viscous-brittle transition by accommodating strain in the form of crystal plasticity before fracturing (comminution). Electron backscatter diffraction (EBSD) reveals up to 40° lattice distortion of biotite phenocrysts in zones of high shear, with negligible plasticity further away. Plagioclase microlites display a systematic plastic response to an increase in shear intensity, as recorded by an increase in lattice distortion towards the spine margin of up to 9°. This localisation of strain within the shear zone is also accompanied by the destabilisation of hydrous mineral phases (i.e. amphibole), compaction of pores (23-13% Φ), glass devitrification and magnetic anomalies. The narrow zone of disequilibrium textures suggests the likely effect of a thermal input due to strain localisation being the contributing factor. These observations are complimented by high-temperature high-velocity rotary shear experiments which simulate the deformation evolution during shear. Hence, understanding these shallow volcanic

Norwood with right ventricle-to-pulmonary artery conduit is more effective than Norwood with Blalock-Taussig shunt for hypoplastic left heart syndrome: mathematic modeling of hemodynamics.

Science.gov (United States)

Mroczek, Tomasz; Małota, Zbigniew; Wójcik, Elżbieta; Nawrat, Zbigniew; Skalski, Janusz

2011-12-01

The introduction of right ventricle to pulmonary artery (RV-PA) conduit in the Norwood procedure for hypoplastic left heart syndrome resulted in a higher survival rate in many centers. A higher diastolic aortic pressure and a higher mean coronary perfusion pressure were suggested as the hemodynamic advantage of this source of pulmonary blood flow. The main objective of this study was the comparison of two models of Norwood physiology with different types of pulmonary blood flow sources and their hemodynamics. Based on anatomic details obtained from echocardiographic assessment and angiographic studies, two three-dimensional computer models of post-Norwood physiology were developed. The finite-element method was applied for computational hemodynamic simulations. Norwood physiology with RV-PA 5-mm conduit and Blalock-Taussig shunt (BTS) 3.5-mm shunt were compared. Right ventricle work, wall stress, flow velocity, shear rate stress, energy loss and turbulence eddy dissipation were analyzed in both models. The total work of the right ventricle after Norwood procedure with the 5-mm RV-PA conduit was lower in comparison to the 3.5-mm BTS while establishing an identical systemic blood flow. The Qp/Qs ratio was higher in the BTS group. Hemodynamic performance after Norwood with the RV-PA conduit is more effective than after Norwood with BTS. Computer simulations of complicated hemodynamics after the Norwood procedure could be helpful in establishing optimal post-Norwood physiology. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

In vitro efficacy of a gene-activated nerve guidance conduit incorporating non-viral PEI-pDNA nanoparticles carrying genes encoding for NGF, GDNF and c-Jun.

Science.gov (United States)

Lackington, William A; Raftery, Rosanne M; O'Brien, Fergal J

2018-06-07

Despite the success of tissue engineered nerve guidance conduits (NGCs) for the treatment of small peripheral nerve injuries, autografts remain the clinical gold standard for larger injuries. The delivery of neurotrophic factors from conduits might enhance repair for more effective treatment of larger injuries but the efficacy of such systems is dependent on a safe, effective platform for controlled and localised therapeutic delivery. Gene therapy might offer an innovative approach to control the timing, release and level of neurotrophic factor production by directing cells to transiently sustain therapeutic protein production in situ. In this study, a gene-activated NGC was developed by incorporating non-viral polyethyleneimine-plasmid DNA (PEI-pDNA) nanoparticles (N/P 7 ratio, 2μg dose) with the pDNA encoding for nerve growth factor (NGF), glial derived neurotrophic factor (GDNF) or the transcription factor c-Jun. The physicochemical properties of PEI-pDNA nanoparticles, morphology, size and charge, were shown to be suitable for gene delivery and demonstrated high Schwann cell transfection efficiency (60±13%) in vitro. While all three genes showed therapeutic potential in terms of enhancing neurotrophic cytokine production while promoting neurite outgrowth, delivery of the gene encoding for c-Jun showed the greatest capacity to enhance regenerative cellular processes in vitro. Ultimately, this gene-activated NGC construct was shown to be capable of transfecting both Schwann cells (S42 cells) and neuronal cells (PC12 and dorsal root ganglia) in vitro, demonstrating potential for future therapeutic applications in vivo. The basic requirements of biomaterial-based nerve guidance conduits have now been well established and include being able to bridge a nerve injury to support macroscopic guidance between nerve stumps, while being strong enough to withstand longitudinal tension and circumferential compression, in addition to being mechanically sound to facilitate

The role of undifferentiated adipose-derived stem cells in peripheral nerve repair.

Science.gov (United States)

Zhang, Rui; Rosen, Joseph M

2018-05-01

Peripheral nerve injuries impose significant health and economic consequences, yet no surgical repair can deliver a complete recovery of sensory or motor function. Traditional methods of repair are less than ideal: direct coaptation can only be performed when tension-free repair is possible, and transplantation of nerve autograft can cause donor-site morbidity and neuroma formation. Cell-based therapy delivered via nerve conduits has thus been explored as an alternative method of nerve repair in recent years. Stem cells are promising sources of the regenerative core material in a nerve conduit because stem cells are multipotent in function, abundant in supply, and more accessible than the myelinating Schwann cells. Among different types of stem cells, undifferentiated adipose-derived stem cell (uASC), which can be processed from adipose tissue in less than two hours, is a promising yet underexplored cell type. Studies of uASC have emerged in the past decade and have shown that autologous uASCs are non-immunogenic, easy to access, abundant in supply, and efficacious at promoting nerve regeneration. Two theories have been proposed as the primary regenerative mechanisms of uASC: in situ trans-differentiation towards Schwann cells, and secretion of trophic and anti-inflammatory factors. Future studies need to fully elucidate the mechanisms, side effects, and efficacy of uASC-based nerve regeneration so that uASCs can be utilized in clinical settings.

A new cable-in-conduit conductor magnet with insulated strands

International Nuclear Information System (INIS)

Yamaguchi, Satarou; Yamamoto, Junya; Motojima, Osamu.

1995-09-01

Many studies have used cable-in-conduit conductor (CICC) coils in trying to develop an AC superconducting magnet because of its enormous potential if AC losses were low and insulation voltage was high. The strands in the most recent CICC magnets are coated with chromium or another metal with high electrical resistance to order to induce current re-distribution among the strands and to avoid a quench caused by a current imbalance. Current re-distribution is highly complex and very difficult to analyze because the conditions of the strand surfaces and the contact areas vary greatly with the operation of the conductor. If, however, the cable currents were well-balanced, insulating the strands would be the best way to reduce AC losses. We propose a new CICC magnet structure featuring a current lead that balances the strand currents via its resistance. Having calculated current balances, we find that strand currents are well within the present parameters for nuclear fusion experiments and superconducting magnet energy storages. (author)

Myectomy and LA-to-LV Conduit for Severe Calcific Mitral Stenosis and Hypertrophic Cardiomyopathy.

Science.gov (United States)

Meghji, Zahara; Nguyen, Anita; Geske, Jeffrey B; Schaff, Hartzell V

2018-02-26

Severe calcific mitral valve stenosis can rarely occur concomitantly with obstructive hypertrophic cardiomyopathy. In these patients, surgical decalcification of the stenotic mitral valve followed by mitral valve replacement carries significant operative risk and may result in paravalvular leakage, atrioventricular groove disruption, and excessive bleeding. We report the first 2 cases of obstructive hypertrophic cardiomyopathy with severe calcific mitral valve stenosis successfully treated with concomitant transaortic septal myectomy and bypass of the stenotic mitral valve using a valved left atrium to left ventricular conduit. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Laparoscopic ischemic conditioning of the stomach increases neovascularization of the gastric conduit in patients undergoing esophagectomy for cancer.

Science.gov (United States)

Pham, Thai H; Melton, Shelby D; McLaren, Patrick J; Mokdad, Ali A; Huerta, Sergio; Wang, David H; Perry, Kyle A; Hardaker, Hope L; Dolan, James P

2017-09-01

Gastric ischemic preconditioning has been proposed to improve blood flow and reduce the incidence of anastomotic complications following esophagectomy with gastric pull-up. This study aimed to evaluate the effect of prolonged ischemic preconditioning on the degree of neovascularization in the distal gastric conduit at the time of esophagectomy. A retrospective review of a prospectively maintained database identified 30 patients who underwent esophagectomy. The patients were divided into three groups: control (no preconditioning, n = 9), partial (short gastric vessel ligation only, n = 8), and complete ischemic preconditioning (left and short gastric vessel ligation, n = 13). Microvessel counts were assessed, using immunohistologic analysis to determine the degree of neovascularization at the distal gastric margin. The groups did not differ in age, gender, BMI, pathologic stage, or cancer subtype. Ischemic preconditioning durations were 163 ± 156 days for partial ischemic preconditioning, compared to 95 ± 50 days for complete ischemic preconditioning (P = 0.2). Immunohistologic analysis demonstrated an increase in microvessel counts of 29% following partial ischemic preconditioning (P = 0.3) and 67% after complete ischemic preconditioning (P gastric conduit. © 2017 Wiley Periodicals, Inc.

Histological study of right ventricle-pulmonary artery valved conduit implantation (RPVC) in dogs with pulmonic stenosis.

Science.gov (United States)

Saida, Yuuto; Tanaka, Ryou; Fukushima, Ryuji; Hira, Satoshi; Hoshi, Katsuichiro; Soda, Aiko; Iizuka, Tomoya; Ishikawa, Taisuke; Nishimura, Taiki; Yamane, Yoshihisa

2009-04-01

We examined whether right ventricle-pulmonary artery valved conduit (RPVC) implantation can overcome the disadvantages of current procedures for pulmonic stenosis (PS). We histologically evaluated the feasibility of RPVC using a homograft in PS model dogs. Eight dogs underwent pulmonary artery banding (PAB) and then 12 weeks later were assigned to PAB (n=4) or PAB+RPVC (n=4) groups. Dogs in the PAB group received no treatment throughout the experimental period, whereas the PAB+RPVC group underwent RPVC. At 1 year after PAB, hearts and conduits were explanted from euthanized dogs and histologically evaluated. The ratios (%) of myocardial fibrosis on right ventricle (RV) epicardial, median and endocardial layers were significantly lower in the PAB+RPVC, than in the PAB group. The ratio of myocardial fibrosis on left ventricular (LV) epicardial and endocardial layers were significantly lower in the PAB+RPVC, than in the PAB group. Neo-intimal thickness in the anastomosis areas of the Denacol and PAB+RPVC groups was 42.77 +/- 30.19 and 88.30 +/- 27.24 microm, respectively, with no significant differences between the groups. Calcification and neo- intima hypertrophy were not obvious in the valve area. Immunohistological staining showed that the internal surface of the anastomosis and intermediate areas were positive for endothelial cells. We concluded that RPVC using a bioprosthetic graft can apparently overcome the disadvantages of current procedures for pulmonic stenosis.

HealtheSteps™ Study Protocol: a pragmatic randomized controlled trial promoting active living and healthy lifestyles in at-risk Canadian adults delivered in primary care and community-based clinics

Directory of Open Access Journals (Sweden)

Dawn P. Gill

2017-02-01

Full Text Available Abstract Background Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. HealtheSteps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits. HealtheSteps™ participants are provided with in-person lifestyle coaching and access to eHealth technologies delivered in community-based primary care clinics and health care organizations. Method/Design To determine the effectiveness of Healthesteps™, we will conduct a 6-month pragmatic randomized controlled trial with integrated process and economic evaluations of HealtheSteps™ in 5 clinic settings in Southwestern Ontario. 110 participants will be individually randomized (1:1; stratified by site to either the intervention (HealtheSteps™ program or comparator (Wait-list control. There are 3 phases of the HealtheSteps™ program, lasting 6 months each. The active phase consists of bi-monthly in-person coaching with access to a full suite of eHealth technology supports. During the maintenance phase I, the in-person coaching will be removed, but participants will still have access to the full suite of eHealth technology supports. In the final stage, maintenance phase II, access to the full suite of eHealth technology supports is removed and participants only have access to publicly available resources and tools. Discussion This trial aims to determine the effectiveness of the program in increasing physical activity levels and improving other health behaviours and indicators, the acceptability of the HealtheSteps™ program, and the direct cost for each person participating in the program as well as the costs associated with delivering the program

Impact of Age and Aerobic Exercise Training on Conduit Artery Wall Thickness: Role of the Shear Pattern.

Science.gov (United States)

Tanahashi, Koichiro; Kosaki, Keisei; Sawano, Yuriko; Yoshikawa, Toru; Tagawa, Kaname; Kumagai, Hiroshi; Akazawa, Nobuhiko; Maeda, Seiji

2017-01-01

Hemodynamic shear stress is the frictional force of blood on the arterial wall. The shear pattern in the conduit artery affects the endothelium and may participate in the development and progression of atherosclerosis. We investigated the role of the shear pattern in age- and aerobic exercise-induced changes in conduit artery wall thickness via cross-sectional and interventional studies. In a cross-sectional study, we found that brachial shear rate patterns and brachial artery intima-media thickness (IMT) correlated with age. Additionally, brachial artery shear rate patterns were associated with brachial artery IMT in 102 middle-aged and older individuals. In an interventional study, 39 middle-aged and older subjects were divided into 2 groups: control and exercise. The exercise group completed 12 weeks of aerobic exercise training. Aerobic exercise training significantly increased the antegrade shear rate and decreased the retrograde shear rate and brachial artery IMT. Moreover, changes in the brachial artery antegrade shear rate and the retrograde shear rate correlated with the change in brachial artery IMT. The results of the present study indicate that changes in brachial artery shear rate patterns may contribute to age- and aerobic exercise training-induced changes in brachial artery wall thickness. © 2017 S. Karger AG, Basel.

Radial Artery as a Coronary Artery Bypass Conduit: 20-Year Results.

Science.gov (United States)

Gaudino, Mario; Tondi, Paolo; Benedetto, Umberto; Milazzo, Valentina; Flore, Roberto; Glieca, Franco; Ponziani, Francesca Romana; Luciani, Nicola; Girardi, Leonard N; Crea, Filippo; Massetti, Massimo

2016-08-09

There is a lack of evidence for the choice of the second conduit in coronary surgery. The radial artery (RA) is a possible option, but few data on very-long-term outcomes exist. This study describes 20-year results of RA grafts used for coronary artery bypass grafting and the effects of RA removal on forearm circulation. We report the results of the prospective 20-year follow-up of the first 100 consecutive patients who received the RA as a coronary bypass conduit at our institution. Follow-up was 100% complete. There were 64 deaths, 23 (35.9%) from cardiovascular causes. Kaplan-Meier 20-year survival was 31%. Of the 36 survivors, 33 (91.6%) underwent RA graft control at a mean of 19.0 ± 2.5 years after surgery. The RA was found to be patent in 24 cases (84.8% patency). In the overall population, probability of graft failure at 20 years was 19.0 ± 0.2% for the left internal thoracic artery (ITA), 25.0 ± 0.2% for the RA, and 55.0 ± 0.2% for the saphenous vein (p = 0.002 for RA vs. saphenous vein, 0.11 for RA vs. ITA, and p 90%, but not location of distal anastomosis, significantly influenced long-term RA graft patency. No patients reported hand or forearm symptoms. The ulnar artery diameter was increased in the operated arm (2.44 ± 0.43 mm vs. 2.01 ± 0.47 mm; p 90% stenosis. RA harvesting does not lead to hand or forearm symptoms, even at a very-long-term follow-up. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Guided parent-delivered cognitive behavioral therapy for childhood anxiety: Predictors of treatment response

OpenAIRE

Thirlwall, Kerstin; Cooper, Peter; Creswell, Cathy

2017-01-01

Background: Guided Parent-delivered Cognitive Behaviour Therapy (GPD-CBT) is a brief, effective treatment for childhood anxiety disorders, however not all children respond favourably. \\ud Aims: To examine predictors of response to GPD-CBT.\\ud Methods: Parents of 125 children (7 – 12 years) with an anxiety disorder received GPD-CBT over 2.6 or 5.3 hours). Recovery was measured post treatment and six months later. \\ud Results: Younger children and those with primary Generalised Anxiety Disorder...

Neural network based inspection of voids and karst conduits in hydro-electric power station tunnels using GPR

Science.gov (United States)

Kilic, Gokhan; Eren, Levent

2018-04-01

This paper reports on the fundamental role played by Ground Penetrating Radar (GPR), alongside advanced processing and presentation methods, during the tunnel boring project at a Dam and Hydro-Electric Power Station. It identifies from collected GPR data such issues as incomplete grouting and the presence of karst conduits and voids and provides full details of the procedures adopted. In particular, the application of collected GPR data to the Neural Network (NN) method is discussed.

C3 toxin and poly-DL-lactide-ε-caprolactone conduits in the critically damaged peripheral nervous system: a combined therapeutic approach.

Science.gov (United States)

Leibig, Nico; Boyle, Veronika; Kraus, Daniel; Stark, Gerhard Bjoern; Penna, Vincenzo

2015-03-01

Peripheral nerve regeneration over longer distances through conduits is limited. In the presented study, critical size nerve gap bridging with a poly-DL-lactide-ε-caprolactone (PLC) conduit was combined with application of C3 toxin to facilitate axonal sprouting. The PLC filled with fibrin (n = 10) and fibrin gel loaded with 1-μg C3-C2I and 2-μg C2II (n = 10) were compared to autologous nerve grafts (n = 10) in a 15-mm sciatic nerve gap lesion model of the rat. Functional and electrophysiological analyses were performed before histological evaluation. Evaluation of motor function and nerve conduction velocity at 16 weeks revealed no differences between the groups. All histological parameters and muscle weight were significantly elevated in nerve graft group. No differences were observed in both PLC groups. The PLCs are permissive for nerve regeneration over a 15-mm defect in rats. Intraluminal application of C3 toxin did not lead to significant enhancement of nerve sprouting.

Advanced data processing of airborne electromagnetic data for imaging hidden conduit networks in the coastal karst plain of Tulum (Mexico)

International Nuclear Information System (INIS)

Schiller, A.; Schattauer, I.; Ottowitz, D.

2016-01-01

This study is part of a series of international research cooperations which commenced in 2007 and are still ongoing. The study area is located on the east coast of the Yucatan Peninsula, Mexico, and comprises the northern most part of the Sian Kaan biosphere reserve, a coastal wetland of international importance, as well as the city of Tulum in the state of Quintana Roo, and part of the second largest barrier reef in the world some 300 metres to one kilometre off shore. Two airborne surveys, conducted in 2007 and 2008 by the Geological Survey of Austria, covered an area of some 200 square kilometres, including the well-known Ox Bel Ha cave system, already mapped by exploration divers. In order to get additional ground truth data and input for the hydrological model, extended ground geophysical campaigns have been conducted an - nually. The first processing of the airborne electromagnetic (AEM) data revealed not only a clear signature from known caves but also the image of a vast, unexplored, hidden conduit network. However, lateral and depth resolution was limited due to measurement drift and noise as well the specific behaviour of the ap - plied inversion technique. Newly developed algorithms for processing AEM data and inversion results have improved the signal-to-noise ratio significantly and enabled the imaging of well defined structures in the underground. Therefore, the AEM method is now capable of quickly deliver crucial structural information of karst-water regimes in difficult accessible areas with unique depth information compared to previous studies. (Author)

The delivery of primary care services.

NARCIS (Netherlands)

Wilson, A.; Windak, A.; Oleszczyk, M.; Wilm, S.; Hasvold, T.; Kringos, D.

2015-01-01

This chapter will be devoted to the dimensions which have been grouped in the framework as “process” and that focus on essential features of service delivery in primary care. In addition to the breadth of services delivered, a comparative overview will be provided of variation in access to services,

Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis

Science.gov (United States)

Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N.; Conte, Marisa L.; Rogers, Mary A. M.

2016-01-01

Background Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. Objectives The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. Data Sources We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Methods Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. Results We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; pinternet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to

Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Michael Seyffert

Full Text Available Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia.The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings.We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials.Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis.We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001 with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017 compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004. The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013 in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post

Optimizing a Drone Network to Deliver Automated External Defibrillators.

Science.gov (United States)

Boutilier, Justin J; Brooks, Steven C; Janmohamed, Alyf; Byers, Adam; Buick, Jason E; Zhan, Cathy; Schoellig, Angela P; Cheskes, Sheldon; Morrison, Laurie J; Chan, Timothy C Y

2017-06-20

Public access defibrillation programs can improve survival after out-of-hospital cardiac arrest, but automated external defibrillators (AEDs) are rarely available for bystander use at the scene. Drones are an emerging technology that can deliver an AED to the scene of an out-of-hospital cardiac arrest for bystander use. We hypothesize that a drone network designed with the aid of a mathematical model combining both optimization and queuing can reduce the time to AED arrival. We applied our model to 53 702 out-of-hospital cardiac arrests that occurred in the 8 regions of the Toronto Regional RescuNET between January 1, 2006, and December 31, 2014. Our primary analysis quantified the drone network size required to deliver an AED 1, 2, or 3 minutes faster than historical median 911 response times for each region independently. A secondary analysis quantified the reduction in drone resources required if RescuNET was treated as a large coordinated region. The region-specific analysis determined that 81 bases and 100 drones would be required to deliver an AED ahead of median 911 response times by 3 minutes. In the most urban region, the 90th percentile of the AED arrival time was reduced by 6 minutes and 43 seconds relative to historical 911 response times in the region. In the most rural region, the 90th percentile was reduced by 10 minutes and 34 seconds. A single coordinated drone network across all regions required 39.5% fewer bases and 30.0% fewer drones to achieve similar AED delivery times. An optimized drone network designed with the aid of a novel mathematical model can substantially reduce the AED delivery time to an out-of-hospital cardiac arrest event. © 2017 American Heart Association, Inc.

Delivering care to oncology patients in the community: an innovative integrated approach.

LENUS (Irish Health Repository)

Hanan, Terry

2014-08-01

A community oncology nursing programme was developed in Ireland between the hospital and community health services for patients receiving systemic cancer therapy, in response to a service need. A robust evaluation of the pilot programme was undertaken, which found that defined clinical procedures traditionally undertaken in hospitals were safely undertaken in the patient\\'s home with no adverse effects. There was a dramatic decrease in hospital attendances for these defined clinical procedures, and hospital capacity was consequently freed up. Patients valued having aspects of their care delivered at home and reported that it improved their quality of life, including reduced hospital visits and travel time. Community nurses expanded their scope of practice and became partners with oncology day-ward nurses in caring for these patients. Community nurses developed the competence and confidence to safely deliver cancer care in the community. This initiative shows that defined elements of acute cancer care can be safely delivered in the community so long as the training and support are provided. The findings and recommendations of the evaluation resulted in university accreditation and approval for national roll-out of the programme. Integration of services between primary and secondary care is a key priority. This innovative programme is a good example of shared integrated care that benefits both patients and health-care providers.

Aerodynamic improvement of the assembly through which gas conduits are taken into a smoke stack by simulating gas flow on a computer

Science.gov (United States)

Prokhorov, V. B.; Fomenko, M. V.; Grigor'ev, I. V.

2012-06-01

Results from computer simulation of gas flow motion for gas conduits taken on one and two sides into the gas-removal shaft of a smoke stack with a constant cross section carried out using the SolidWorks and FlowVision application software packages are presented.

Medical Assistant-based care management for high risk patients in small primary care practices

DEFF Research Database (Denmark)

Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

2016-01-01

Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

Relaxation of microparticles exposed to hydrodynamic forces in microfluidic conduits.

Science.gov (United States)

Janča, Josef; Halabalová, Věra; Polášek, Vladimír; Vašina, Martin; Menshikova, Anastasia Yu

2011-02-01

The behavior of microparticles exposed to gravitational and lift forces and to the velocity gradient in flow velocity profile formed in microfluidic conduits is studied from the viewpoint of the transient period (the relaxation) between the moment at which a particle starts to be transported by the hydrodynamic flow and the time at which it reaches an equilibrium position, characterized by a balance of all active forces. The theoretical model allowing the calculation of the relaxation time is proposed. The numerical calculus based on the proposed model is compared with the experimental data obtained under different experimental conditions, namely, for different lengths of microfluidic channels, different average linear velocities of the carrier liquid, and different sizes and densities of the particles used in the study. The results are important for the optimization of microfluidic separation units such as microthermal field-flow fractionation channels in which the separation or manipulation of the microparticles of various origin, synthetic, natural, biological, etc., is performed under similar experimental conditions but by applying an additional thermodynamic force.

Delivering Online Examinations: A Case Study

Directory of Open Access Journals (Sweden)

John MESSING

2004-07-01

Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

Heat exchanger with oscillating flow

Science.gov (United States)

Scotti, Stephen J. (Inventor); Blosser, Max L. (Inventor); Camarda, Charles J. (Inventor)

1993-01-01

Various heat exchange apparatuses are described in which an oscillating flow of primary coolant is used to dissipate an incident heat flux. The oscillating flow may be imparted by a reciprocating piston, a double action twin reciprocating piston, fluidic oscillators or electromagnetic pumps. The oscillating fluid flows through at least one conduit in either an open loop or a closed loop. A secondary flow of coolant may be used to flow over the outer walls of at least one conduit to remove heat transferred from the primary coolant to the walls of the conduit.

Hypoglossal-Facial Nerve Reconstruction Using a Y-Tube-Conduit Reduces Aberrant Synkinetic Movements of the Orbicularis Oculi and Vibrissal Muscles in Rats

Directory of Open Access Journals (Sweden)

Yasemin Kaya

2014-01-01

Full Text Available The facial nerve is the most frequently damaged nerve in head and neck trauma. Patients undergoing facial nerve reconstruction often complain about disturbing abnormal synkinetic movements of the facial muscles (mass movements, synkinesis which are thought to result from misguided collateral branching of regenerating motor axons and reinnervation of inappropriate muscles. Here, we examined whether use of an aorta Y-tube conduit during reconstructive surgery after facial nerve injury reduces synkinesis of orbicularis oris (blink reflex and vibrissal (whisking musculature. The abdominal aorta plus its bifurcation was harvested (N = 12 for Y-tube conduits. Animal groups comprised intact animals (Group 1, those receiving hypoglossal-facial nerve end-to-end coaptation alone (HFA; Group 2, and those receiving hypoglossal-facial nerve reconstruction using a Y-tube (HFA-Y-tube, Group 3. Videotape motion analysis at 4 months showed that HFA-Y-tube group showed a reduced synkinesis of eyelid and whisker movements compared to HFA alone.

Hypoglossal-facial nerve reconstruction using a Y-tube-conduit reduces aberrant synkinetic movements of the orbicularis oculi and vibrissal muscles in rats.

Science.gov (United States)

Kaya, Yasemin; Ozsoy, Umut; Turhan, Murat; Angelov, Doychin N; Sarikcioglu, Levent

2014-01-01

The facial nerve is the most frequently damaged nerve in head and neck trauma. Patients undergoing facial nerve reconstruction often complain about disturbing abnormal synkinetic movements of the facial muscles (mass movements, synkinesis) which are thought to result from misguided collateral branching of regenerating motor axons and reinnervation of inappropriate muscles. Here, we examined whether use of an aorta Y-tube conduit during reconstructive surgery after facial nerve injury reduces synkinesis of orbicularis oris (blink reflex) and vibrissal (whisking) musculature. The abdominal aorta plus its bifurcation was harvested (N = 12) for Y-tube conduits. Animal groups comprised intact animals (Group 1), those receiving hypoglossal-facial nerve end-to-end coaptation alone (HFA; Group 2), and those receiving hypoglossal-facial nerve reconstruction using a Y-tube (HFA-Y-tube, Group 3). Videotape motion analysis at 4 months showed that HFA-Y-tube group showed a reduced synkinesis of eyelid and whisker movements compared to HFA alone.

Current distribution in Cable-In-Conduit Conductors

International Nuclear Information System (INIS)

Ferri, M.A.

1994-05-01

A numerical study of the current distribution in Cable-In-Conduit Conductors (CICC's) experiencing linearly ramping transport currents and transverse magnetic fields was conducted for both infinitely long, periodic cables and finite length cables terminated in low resistance joints. The goal of the study was to gain insight into the phenomenon known as Ramp Rate Limitation, an as yet unexplained correspondence between maximum attainable current and the ramp time taken to reach that current in CICC superconducting magnets. A discrete geometric model of a 27 strand multiply twisted CICC was developed to effectively represent the flux linkages, mutual inductances, and resistive contact points between the strands of an experimentally tested cable. The results of the numerical study showed that for fully periodic cables, the current imbalances due to ramping magnetic fields and ramping transport currents are negligible in the range of experimentally explored operating conditions. For finite length, joint terminated cables, however, significant imbalances can exist. Unfortunately, quantitative results are limited by a lack of knowledge of the transverse resistance between strands in the joints. Nonetheless, general results are presented showing the dependency of the imbalance on cable length, ramp time, and joint resistance for both ramping transverse magnet fields and ramping transport currents. At the conclusion of the study, it is suggested that calculated current imbalances in a finite length cable could cause certain strands to prematurely ''quench'' -- become non-superconducting --thus leading to an instability for the entire cable. This numerically predicted ''current imbalance instability'' is compared to the experimentally observed Ramp Rate Limitation for the 27 strand CICC sample

The Relationship Between Women's Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks: A Prospective Observational Study.

Science.gov (United States)

Orbach-Zinger, Sharon; Landau, Ruth; Harousch, Avi Ben; Ovad, Oren; Caspi, Liron; Kornilov, Evgeniya; Ioscovich, Alexander; Bracco, Danielle; Davis, Atara; Fireman, Shlomo; Hoshen, Moshe; Eidelman, Leonid A

2018-05-01

Postpartum depression (PPD) is associated with pain during and after delivery, with studies showing reduced rates among women delivering with labor epidural analgesia (LEA). We hypothesized that women who intend to deliver with LEA but do not receive it are at higher risk for PPD at 6 weeks due to the combined experience of untreated labor pain and unmatched expectations during labor, and evaluated the interaction between labor plans related to LEA, satisfaction with pain control when actually delivering with LEA, and PPD at 6 weeks after delivery. A total of 1497 women with a vaginal delivery were enrolled into this prospective longitudinal study. Women's initial intention to deliver with or without LEA, how they subsequently delivered, and satisfaction with pain relief were recorded on postpartum day 1. Primary aim was selected as PPD at 6 weeks among women intending to deliver with but subsequently delivering without LEA compared with the rest of the cohort. Primary outcome was PPD at 6 weeks using the Edinburgh Postnatal Depression Scale; PPD was defined with a score ≥10 (scale from 0 to 30). Demographic and obstetric data were recorded. Fisher exact test was used for comparisons between groups. The interaction between intention and actual delivery with regard to LEA and PPD was tested. Overall, 87 of 1326 women completing the study at 6 weeks had PPD (6.6%). For the primary aim, 439 (29.3%) delivered without LEA, of which 193 (12.9%) had intended to deliver with LEA; the PPD rate among these women was 8.1%, which was not statistically different from the rest of the cohort (6.3%; odds ratio [OR], 1.30; 95% confidence interval [CI], 0.72-2.38; P = .41). A total of 1058 women (70.7%) delivered with LEA and 439 (29.3%) delivered without; therefore, 1169 (78.1%) delivered as intended and 328 (21.9%) did not (unmatched expectations). Evaluating the interaction between effects, there was a strong negative additive interaction between intending to deliver without

Optimization of the primary collimator settings for fractionated IMRT stereotactic radiotherapy

International Nuclear Information System (INIS)

Tobler, Matt; Leavitt, Dennis D.; Watson, Gordon

2004-01-01

Advances in field-shaping techniques for stereotactic radiosurgery/radiotherapy have allowed dynamic adjustment of field shape with gantry rotation (dynamic conformal arc) in an effort to minimize dose to critical structures. Recent work evaluated the potential for increased sparing of dose to normal tissues when the primary collimator setting is optimized to only the size necessary to cover the largest shape of the dynamic micro multi leaf field. Intensity-modulated radiotherapy (IMRT) is now a treatment option for patients receiving stereotactic radiotherapy treatments. This multisegmentation of the dose delivered through multiple fixed treatment fields provides for delivery of uniform dose to the tumor volume while allowing sparing of critical structures, particularly for patients whose tumor volumes are less suited for rotational treatment. For these segmented fields, the total number of monitor units (MUs) delivered may be much greater than the number of MUs required if dose delivery occurred through an unmodulated treatment field. As a result, undesired dose delivered, as leakage through the leaves to tissues outside the area of interest, will be proportionally increased. This work will evaluate the role of optimization of the primary collimator setting for these IMRT treatment fields, and compare these results to treatment fields where the primary collimator settings have not been optimized

Intensity-Modulated Radiation Therapy for Primary Brain Tumors

Institute of Scientific and Technical Information of China (English)

Zhong-min Wang

2004-01-01

Radiation therapy has been used to treat primary brain tumors as standard primary and/or adjunctive therapies for decades. It is difficult for conventional radiotherapy to deliver a lethal dose of radiation to the tumors while sparing surrounding normal brain due to complicated structures and multifunction in human brain. With the understanding of radiation physics and computer technology, a number of novel and more precise radiotherapies have been developed in recent years. Intensity modulated radiotherapy (IMRT) is one of these strategies. The use of IMRT in the treatment of primary brain tumors is being increasing nowadays. It shows great promise for some of primary brain tumors and also presents some problems, This review highlights current IMRT in the treatment of mainly primary brain tumors.

Medicare Chronic Care Management Payments and Financial Returns to Primary Care Practices: A Modeling Study.

Science.gov (United States)

Basu, Sanjay; Phillips, Russell S; Bitton, Asaf; Song, Zirui; Landon, Bruce E

2015-10-20

Physicians have traditionally been reimbursed for face-to-face visits. A new non-visit-based payment for chronic care management (CCM) of Medicare patients took effect in January 2015. To estimate financial implications of CCM payment for primary care practices. Microsimulation model incorporating national data on primary care use, staffing, expenditures, and reimbursements. National Ambulatory Medical Care Survey and other published sources. Medicare patients. 10 years. Practice-level. Comparison of CCM delivery approaches by staff and physicians. Net revenue per full-time equivalent (FTE) physician; time spent delivering CCM services. If nonphysician staff were to deliver CCM services, net revenue to practices would increase despite opportunity and staffing costs. Practices could expect approximately $332 per enrolled patient per year (95% CI, $234 to $429) if CCM services were delivered by registered nurses (RNs), approximately $372 (CI, $276 to $468) if services were delivered by licensed practical nurses, and approximately $385 (CI, $286 to $485) if services were delivered by medical assistants. For a typical practice, this equates to more than $75 ,00 of net annual revenue per FTE physician and 12 hours of nursing service time per week if 50% of eligible patients enroll. At a minimum, 131 Medicare patients (CI, 115 to 140 patients) must enroll for practices to recoup the salary and overhead costs of hiring a full-time RN to provide CCM services. If physicians were to deliver all CCM services, approximately 25% of practices nationwide could expect net revenue losses due to opportunity costs of face-to-face visit time. The CCM program may alter long-term primary care use, which is difficult to predict. Practices that rely on nonphysician team members to deliver CCM services will probably experience substantial net revenue gains but must enroll a sufficient number of eligible patients to recoup costs. None.

Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N; Conte, Marisa L; Rogers, Mary A M

2016-01-01

Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; pcognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post-treatment assessment. There were no statistically

Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER)

NARCIS (Netherlands)

Manniën, J.; Klomp, T.; Wiegers, T.; Pereboom, M.T.R.; Brug, J.; de Jonge, J.; van der Meijde, M.; Hutton, E.K.; Schellevis, F.; Spelten, E.

2012-01-01

Background: In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes

Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER).

NARCIS (Netherlands)

Manniën, J.; Klomp, T.; Wiegers, T.; Pereboom, M.; Brug, J.; Jonge, A. de; Meijde, M. van der; Hutton, E.; Schellevis, F.; Spelten, E.

2012-01-01

Background: In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes

Assessing lateral flows and solute transport during floods in a conduit-flow-dominated karst system using the inverse problem for the advection–diffusion equation

Directory of Open Access Journals (Sweden)

C. Cholet

2017-07-01

Full Text Available The aim of this study is to present a framework that provides new ways to characterize the spatio-temporal variability of lateral exchanges for water flow and solute transport in a karst conduit network during flood events, treating both the diffusive wave equation and the advection–diffusion equation with the same mathematical approach, assuming uniform lateral flow and solute transport. A solution to the inverse problem for the advection–diffusion equations is then applied to data from two successive gauging stations to simulate flows and solute exchange dynamics after recharge. The study site is the karst conduit network of the Fourbanne aquifer in the French Jura Mountains, which includes two reaches characterizing the network from sinkhole to cave stream to the spring. The model is applied, after separation of the base from the flood components, on discharge and total dissolved solids (TDSs in order to assess lateral flows and solute concentrations and compare them to help identify water origin. The results showed various lateral contributions in space – between the two reaches located in the unsaturated zone (R1, and in the zone that is both unsaturated and saturated (R2 – as well as in time, according to hydrological conditions. Globally, the two reaches show a distinct response to flood routing, with important lateral inflows on R1 and large outflows on R2. By combining these results with solute exchanges and the analysis of flood routing parameters distribution, we showed that lateral inflows on R1 are the addition of diffuse infiltration (observed whatever the hydrological conditions and localized infiltration in the secondary conduit network (tributaries in the unsaturated zone, except in extreme dry periods. On R2, despite inflows on the base component, lateral outflows are observed during floods. This pattern was attributed to the concept of reversal flows of conduit–matrix exchanges, inducing a complex water mixing effect

Hydraulic tomography of discrete networks of conduits and fractures in a karstic aquifer by using a deterministic inversion algorithm

Science.gov (United States)

Fischer, P.; Jardani, A.; Lecoq, N.

2018-02-01

In this paper, we present a novel inverse modeling method called Discrete Network Deterministic Inversion (DNDI) for mapping the geometry and property of the discrete network of conduits and fractures in the karstified aquifers. The DNDI algorithm is based on a coupled discrete-continuum concept to simulate numerically water flows in a model and a deterministic optimization algorithm to invert a set of observed piezometric data recorded during multiple pumping tests. In this method, the model is partioned in subspaces piloted by a set of parameters (matrix transmissivity, and geometry and equivalent transmissivity of the conduits) that are considered as unknown. In this way, the deterministic optimization process can iteratively correct the geometry of the network and the values of the properties, until it converges to a global network geometry in a solution model able to reproduce the set of data. An uncertainty analysis of this result can be performed from the maps of posterior uncertainties on the network geometry or on the property values. This method has been successfully tested for three different theoretical and simplified study cases with hydraulic responses data generated from hypothetical karstic models with an increasing complexity of the network geometry, and of the matrix heterogeneity.

Diabetes care provision in UK primary care practices.

Directory of Open Access Journals (Sweden)

Gillian Hawthorne

Full Text Available Although most people with Type 2 diabetes receive their diabetes care in primary care, only a limited amount is known about the quality of diabetes care in this setting. We investigated the provision and receipt of diabetes care delivered in UK primary care.Postal surveys with all healthcare professionals and a random sample of 100 patients with Type 2 diabetes from 99 UK primary care practices.326/361 (90.3% doctors, 163/186 (87.6% nurses and 3591 patients (41.8% returned a questionnaire. Clinicians reported giving advice about lifestyle behaviours (e.g. 88% would routinely advise about calorie restriction; 99.6% about increasing exercise more often than patients reported having received it (43% and 42% and correlations between clinician and patient report were low. Patients' reported levels of confidence about managing their diabetes were moderately high; a median (range of 21% (3% to 39% of patients reporting being not confident about various areas of diabetes self-management.Primary care practices have organisational structures in place and are, as judged by routine quality indicators, delivering high quality care. There remain evidence-practice gaps in the care provided and in the self confidence that patients have for key aspects of self management and further research is needed to address these issues. Future research should use robust designs and appropriately designed studies to investigate how best to improve this situation.

Neural-differentiated mesenchymal stem cells incorporated into muscle stuffed vein scaffold forms a stable living nerve conduit.

Science.gov (United States)

Hassan, Nur Hidayah; Sulong, Ahmad Fadzli; Ng, Min-Hwei; Htwe, Ohnmar; Idrus, Ruszymah B H; Roohi, Sharifah; Naicker, Amaramalar S; Abdullah, Shalimar

2012-10-01

Autologous nerve grafts to bridge nerve gaps have donor site morbidity and possible neuroma formation resulting in development of various methods of bridging nerve gaps without using autologous nerve grafts. We have fabricated an acellular muscle stuffed vein seeded with differentiated mesenchymal stem cells (MSCs) as a substitute for nerve autografts. Human vein and muscle were both decellularized by liquid nitrogen immersion with subsequent hydrolysis in hydrochloric acid. Human MSCs were subjected to a series of treatments with a reducing agent, retinoic acid, and a combination of trophic factors. The differentiated MSCs were seeded on the surface of acellular muscle tissue and then stuffed into the vein. Our study showed that 35-75% of the cells expressed neural markers such as S100b, glial fibrillary acidic protein (GFAP), p75 NGF receptor, and Nestin after differentiation. Histological and ultra structural analyses of muscle stuffed veins showed attachment of cells onto the surface of the acellular muscle and penetration of the cells into the hydrolyzed fraction of muscle fibers. We implanted these muscle stuffed veins into athymic mice and at 8 weeks post-implantation, the acellular muscle tissue had fully degraded and replaced with new matrix produced by the seeded cells. The vein was still intact and no inflammatory reactions were observed proving the biocompatibility and biodegradability of the conduit. In conclusion, we have successfully formed a stable living nerve conduit which may serve as a substitute for autologous nerves. Copyright © 2012 Orthopaedic Research Society.

Delivering high performance BWR fuel reliably

International Nuclear Information System (INIS)

Schardt, J.F.

1998-01-01

Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

Primary energy consumption of the dwelling with solar hot water system and biomass boiler

International Nuclear Information System (INIS)

Berković-Šubić, Mihaela; Rauch, Martina; Dović, Damir; Andrassy, Mladen

2014-01-01

Highlights: • Methodology for determing delivered and primary energy is developed. • Conventional and solar hot water system are analyzed. • Influence of system components, heat losses and energy consumption is explored. • Savings when using solar system in delivered energy is 30% and in primary 75%. • Dwelling with higher Q H,nd has 60% shorter payback period. - Abstract: This paper presents a new methodology, based on the energy performance of buildings Directive related European norms. It is developed to overcome ambiguities and incompleteness of these standards in determining the delivered and primary energy. The available procedures from the present “Algorithm for determining the energy demands and efficiency of technical systems in buildings”, normally used for energy performance certification of buildings, also allow detailed analyzes of the influence of particular system components on the overall system energy efficiency. The calculation example is given for a Croatian reference dwelling, equipped with a solar hot water system, backed up with a biomass boiler for space heating and domestic hot water purposes as a part of the dwelling energy performance certification. Calculations were performed for two cases corresponding to different levels of the dwelling thermal insulation with an appropriate heating system capacity, in order to investigate the influence of the building heat losses on the system design and energy consumption. The results are compared against those obtained for the conventional system with a gas boiler in terms of the primary energy consumption as well as of investment and operating costs. These results indicate great reduction in both delivered and primary energy consumption when a solar system with biomass boiler is used instead of the conventional one. Higher savings are obtained in the case of the dwelling with higher energy need for space heating. Such dwellings also have a shorter payback period than the ones with

Operator models for delivering municipal solid waste management services in developing countries. Part A: The evidence base.

Science.gov (United States)

Wilson, David C; Kanjogera, Jennifer Bangirana; Soós, Reka; Briciu, Cosmin; Smith, Stephen R; Whiteman, Andrew D; Spies, Sandra; Oelz, Barbara

2017-08-01

This article presents the evidence base for 'operator models' - that is, how to deliver a sustainable service through the interaction of the 'client', 'revenue collector' and 'operator' functions - for municipal solid waste management in emerging and developing countries. The companion article addresses a selection of locally appropriate operator models. The evidence shows that no 'standard' operator model is effective in all developing countries and circumstances. Each city uses a mix of different operator models; 134 cases showed on average 2.5 models per city, each applying to different elements of municipal solid waste management - that is, street sweeping, primary collection, secondary collection, transfer, recycling, resource recovery and disposal or a combination. Operator models were analysed in detail for 28 case studies; the article summarises evidence across all elements and in more detail for waste collection. Operators fall into three main groups: The public sector, formal private sector, and micro-service providers including micro-, community-based and informal enterprises. Micro-service providers emerge as a common group; they are effective in expanding primary collection service coverage into poor- or peri-urban neighbourhoods and in delivering recycling. Both public and private sector operators can deliver effective services in the appropriate situation; what matters more is a strong client organisation responsible for municipal solid waste management within the municipality, with stable political and financial backing and capacity to manage service delivery. Revenue collection is also integral to operator models: Generally the municipality pays the operator from direct charges and/or indirect taxes, rather than the operator collecting fees directly from the service user.

Comparison of the air-Q intubating laryngeal airway and the cobra perilaryngeal airway as conduits for fiber optic-guided intubation in pediatric patients.

Science.gov (United States)

Girgis, Karim K; Youssef, Maha M I; ElZayyat, Nashwa S

2014-10-01

One of the methods proposed in cases of difficult airway management in children is using a supraglottic airway device as a conduit for tracheal intubation. The aim of this study was to compare the efficacy of the Air-Q Intubating Laryngeal Airway (Air-Q) and the Cobra Perilaryngeal Airway (CobraPLA) to function as a conduit for fiber optic-guided tracheal intubation in pediatric patients. A total of 60 children with ages ranging from 1 to 6 years, undergoing elective surgery, were randomized to have their airway managed with either an Air-Q or CobraPLA. Outcomes recorded were the success rate, time and number of attempts required for fiber optic-guided intubation and the time required for device removal after intubation. We also recorded airway leak pressure (ALP), fiber optic grade of glottic view and occurrence of complications. Both devices were successfully inserted in all patients. The intubation success rate was comparable with the Air-Q and the CobraPLA (96.7% vs. 90%), as was the first attempt success rate (90% vs. 80%). The intubation time was significantly longer with the CobraPLA (29.5 ± 10.9 s vs. 23.2 ± 9.8 s; P fiber optic grade of glottic view was comparable with the two devices. The CobraPLA was associated with a significantly higher incidence of blood staining of the device on removal and post-operative sore throat. Both the Air-Q and CobraPLA can be used effectively as a conduit for fiber optic-guided tracheal intubation in children. However, the Air-Q proved to be superior due to a shorter intubation time and less airway morbidity compared with the CobraPLA.

Delivering high performance BWR fuel reliably

Energy Technology Data Exchange (ETDEWEB)

Schardt, J.F. [GE Nuclear Energy, Wilmington, NC (United States)

1998-07-01

Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

Delivering a medical school elective with massive open online course (MOOC) technology.

Science.gov (United States)

Robinson, Robert

2016-01-01

The educational technology of massive open online courses (MOOCs) has been successfully applied in a wide variety of disciplines and are an intense focus of educational research at this time. Educators are now looking to MOOC technology as a means to improve professional medical education, but very little is known about how medical MOOCs compare with traditional content delivery. A retrospective analysis of the course evaluations for the Medicine as a Business elective by fourth-year medical students at Southern Illinois University School of Medicine (SIU-SOM) for the 2012-2015 academic years was conducted. This course was delivered by small group flipped classroom discussions for 2012-2014 and delivered via MOOC technology in 2015. Learner ratings were compared between the two course delivery methods using routinely collected course evaluations. Course enrollment has ranged from 6-19 students per year in the 2012-2015 academic years. Student evaluations of the course are favorable in the areas of effective teaching, accurate course objectives, meeting personal learning objectives, recommending the course to other students, and overall when rated on a 5-point Likert scale. The majority of all student ratings (76-95%) of this elective course are for the highest possible choice (Strongly agree or Excellent) for any criteria, regardless if the course was delivered via a traditional or MOOC format. Statistical analysis of these ratings suggests that the Effective Teacher and Overall Evaluations did not statistically differ between the two delivery formats. Student ratings of this elective course were highly similar when delivered in a flipped classroom format or by using MOOC technology. The primary advantage of this new course format is flexibility of time and place for learners, allowing them to complete the course objectives when convenient for them. The course evaluations suggest this is a change that is acceptable to the target audience. This study suggests that

Materials Delivered by Member States

International Nuclear Information System (INIS)

1966-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1965 in compliance with requests the Agency had made under Article IX. D. Part III contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1965-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1964 in compliance with requests the Agency had made under Article IX. D. Part II contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1968-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1968 in compliance with requests the Agency had made under Article IX,D. Part II contains information about materials which had not been delivered by 30 June 1968 but which had been allocated, in accordance with Article XI.F.I of the Statute, to approved Agency projects for which project arrangements were in force on that date

Frictional melting dynamics in the upper conduit: A chemical answer to a complex physical question

Science.gov (United States)

Henton De Angelis, S.; Lavallee, Y.; Kendrick, J. E.; Hornby, A.; von Aulock, F. W.; Clesham, S.; Hirose, T.; Perugini, D.

2013-12-01

During volcanic eruptions the generation of frictional heat along the walls of the shallow conduit leads to melting of the rocks along the slip interface. Frictional melting has previously been described as a process out of thermodynamic equilibrium, but upon slip and mingling of the melt batches, homogeneity can be achieved, and may have an h important rheological control on the dynamics of slip. To test melt homogenization in the frictional melt zones of volcanic conduits we performed constant-rate slip experiments under controlled stress conditions using a high-velocity rotary shear apparatus. Volcanic dome samples from three different volcanoes (Volcán De Colima, Soufrière Hills Volcano and Santiaguito Volcano) were investigated. Each sample was subjected to a stress of 1 MPa and slip rate of 1 m/s. For each sample set 5 experiments were conducted: 1) experiment stopped at the onset of melting; 2) experiment stopped on the formation of a full melt layer; 3) experiment stopped after 5m of slip at steady state conditions; 4) experiment stopped after 10m of slip at steady state conditions; 5) experiment stopped after 15m of slip at steady state conditions. We analyzed the resulting proto-melt zones using micron sized X-ray spectroscopy in the high-brightness synchrotron beamline I18 (at Diamond Light Source UK). Particular focus was given to the concentration variance analysis of Rare Earth Elements as their mobilities can be used to precisely quantify the degree and timescale of homogenisation involved during frictional melting. This study refines our understanding of the chemical process of melting and mixing which carry important consequences for the rheological control on the physical dynamics of slip.

Reverse saphenous conduit flap in small animals: Clinical applications and outcomes

Directory of Open Access Journals (Sweden)

Ross C. Elliott

2014-08-01

Full Text Available Due to the lack of skin elasticity defects of the distal hind limb can be a challenge to close. This article assesses a well-described, but completely under-used technique for closure of wounds on the distal tarsus. The technique was used with good success in six cases presenting to the Bryanston Veterinary Hospital with a wide range of underlying pathology ranging from trauma to neoplastic disease of the tarsus. All six cases were treated with a reverse saphenous conduit flap and two of them underwent radiation therapy with no adverse side effects. All cases showed excellent results with a very low degree of flap necrosis that never exceeded 15% of the total flap area. This skin flap provides an excellent treatment method that is reliable in closure of defects of the distal tarsus with few adverse effects. To the author’s knowledge there has been only one previously published report on the clinical use of this type of skin flap,even though the flap is well described in most texts.

Troubles des conduites alimentaires et tempérament cyclothymique: étude transversale à propos de 107 étudiants Tunisiens

Science.gov (United States)

Jaweher, Masmoudi; Sonda, Trabelsi; Uta, Ouali; Inès, Feki; Rim, Sallemi; Imene, Baati; Abdelaziz, Jaoua

2014-01-01

Introduction Les objectifs de notre étude ont été d'estimer la prévalence des troubles des conduites alimentaires (TCA) chez les jeunes tunisiens et étudier la relation entre le tempérament cyclothymique et les TCA. Méthodes Nous avons ainsi mené une étude transversale descriptive et analytique. Elle a concerné 107 étudiants de l'Institut de Presse et des Sciences de l'Information de la Manouba, Tunisie. Pour l’évaluation des TCA, nous avons procédé par la passation de l'auto questionnaire EAT 40, dans sa version validée en Tunisie. C'est l'outil le plus utilisé pour le dépistage des TCA dans le monde. Pour l’évaluation du tempérament cyclothymique, nous avons utilisé le TEMPS A dans sa version arabe validée. Une fiche épidémiologique associée a permis de recueillir quelques facteurs sociodémographiques et hygiéno-diététiques. Résultats La prévalence des troubles de conduites alimentaires a été de 24,3%. Le pourcentage des étudiants ayant un score de tempérament cyclothymique ≥14 a été de 37,4%. Une association a été trouvée entre les troubles de conduites alimentaires et le tempérament affectif cyclothymique que ce soit selon l'approche dimensionnelle (p=0,005) ou selon celle catégorielle (p=0,046). Le tempérament cyclothymique multiplie par deux le risque de développer un TCA chez les étudiants de sexe féminin (p=0,04). Conclusion Es TCA sont fréquents chez nos étudiants particulièrement de sexe féminin. De plus, la présence d'un tempérament cyclothymique associé permettrait de suspecter doublement une appartenance au spectre bipolaire et devrait conduire à une attention particulière de la part du clinicien pour définir au mieux les stratégies thérapeutiques. PMID:25404977

A physiotherapist-delivered integrated exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a randomised controlled trial protocol

Directory of Open Access Journals (Sweden)

Bennell Kim L

2012-07-01

Full Text Available Abstract Background Knee osteoarthritis (OA is a prevalent chronic musculoskeletal condition with no cure. Pain is the primary symptom and results from a complex interaction between structural changes, physical impairments and psychological factors. Much evidence supports the use of strengthening exercises to improve pain and physical function in this patient population. There is also a growing body of research examining the effects of psychologist-delivered pain coping skills training (PCST particularly in other chronic pain conditions. Though typically provided separately, there are symptom, resource and personnel advantages of exercise and PCST being delivered together by a single healthcare professional. Physiotherapists are a logical choice to be trained to deliver a PCST intervention as they already have expertise in administering exercise for knee OA and are cognisant of the need for a biopsychosocial approach to management. No studies to date have examined the effects of an integrated exercise and PCST program delivered solely by physiotherapists in this population. The primary aim of this multisite randomised controlled trial is to investigate whether an integrated 12-week PCST and exercise treatment program delivered by physiotherapists is more efficacious than either program alone in treating pain and physical function in individuals with knee OA. Methods/design This will be an assessor-blinded, 3-arm randomised controlled trial of a 12-week intervention involving 10 physiotherapy visits together with home practice. Participants with symptomatic and radiographic knee OA will be recruited from the community in two cities in Australia and randomized into one of three groups: exercise alone, PCST alone, or integrated PCST and exercise. Randomisation will be stratified by city (Melbourne or Brisbane and gender. Primary outcomes are overall average pain in the past week measured by a Visual Analogue Scale and physical function measured by

Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel

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Trucks Seattle Bakery Delivers With Biodiesel Trucks to someone by E-mail Share Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Facebook Tweet about Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Twitter Bookmark Alternative Fuels

Design and synthesis of elastin-like polypeptides for an ideal nerve conduit in peripheral nerve regeneration

International Nuclear Information System (INIS)

Hsueh, Yu-Sheng; Savitha, S.; Sadhasivam, S.; Lin, Feng-Huei; Shieh, Ming-Jium

2014-01-01

The study involves design and synthesis of three different elastin like polypeptide (ELP) gene monomers namely ELP1, ELP2 and ELP3 that encode for ELP proteins. The formed ELPs were assessed as an ideal nerve conduit for peripheral nerve regeneration. ELP1 was constructed with a small elongated pentapeptide carrying VPGVG sequence to mimic the natural polypeptide ELP. The ELP2 was designed by the incorporation of 4-penta peptide chains to improve the biocompatibility and mechanical strength. Thus, the third position in unique VPGVG was replaced with alanine to VPAVG and in a similar way modified to VPGKG, VPGEG and VPGIG with the substitution of lysine, glutamic acid and isoleucine. In ELP3, fibronectin C5 domain endowed with REDV sequence was introduced to improve the cell attachment. The ELP1, ELP2 and ELP3 proteins expressed by Escherichia coli were purified by inverse transition cycling (ITC). The purified ELPs were confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and western blotting. The Schwann cell (SC) morphology and cell adhesion were assessed by fabrication of ELP membrane cross-linked with glutaraledhyde. The Schwann cell proliferation was measured by WST-1 assay. Immunofluorostaining of Schwann cells was accomplished with SC specific phenotypic marker, S100. - Highlights: • Design and synthesis of three gene monomers of elastin like polypeptides (ELP1, 2 and 3) were reported. • Molecular weight of ITC purified ELP1, ELP2 and ELP3 was in the range of 37–38 kDa. • Schwann cell adhesion was found to be prominent in ELP3 and could be used as nerve conduit for peripheral nerve regeneration

Design and synthesis of elastin-like polypeptides for an ideal nerve conduit in peripheral nerve regeneration

Energy Technology Data Exchange (ETDEWEB)

Hsueh, Yu-Sheng [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China); Savitha, S. [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); Department of Biotechnology, Sree Sastha Institute of Engineering and Technology, Chennai (India); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China); Sadhasivam, S. [Division of Biomedical Engineering and Nanomedicine Research, National Health Research Institutes, Miaoli 350, Taiwan (China); Lin, Feng-Huei, E-mail: double@ntu.edu.tw [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); Division of Biomedical Engineering and Nanomedicine Research, National Health Research Institutes, Miaoli 350, Taiwan (China); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China); Shieh, Ming-Jium [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); College of Medicine, National Taiwan University Hospital, Taipei 100, Taiwan (China); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China)

2014-05-01

The study involves design and synthesis of three different elastin like polypeptide (ELP) gene monomers namely ELP1, ELP2 and ELP3 that encode for ELP proteins. The formed ELPs were assessed as an ideal nerve conduit for peripheral nerve regeneration. ELP1 was constructed with a small elongated pentapeptide carrying VPGVG sequence to mimic the natural polypeptide ELP. The ELP2 was designed by the incorporation of 4-penta peptide chains to improve the biocompatibility and mechanical strength. Thus, the third position in unique VPGVG was replaced with alanine to VPAVG and in a similar way modified to VPGKG, VPGEG and VPGIG with the substitution of lysine, glutamic acid and isoleucine. In ELP3, fibronectin C5 domain endowed with REDV sequence was introduced to improve the cell attachment. The ELP1, ELP2 and ELP3 proteins expressed by Escherichia coli were purified by inverse transition cycling (ITC). The purified ELPs were confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and western blotting. The Schwann cell (SC) morphology and cell adhesion were assessed by fabrication of ELP membrane cross-linked with glutaraledhyde. The Schwann cell proliferation was measured by WST-1 assay. Immunofluorostaining of Schwann cells was accomplished with SC specific phenotypic marker, S100. - Highlights: • Design and synthesis of three gene monomers of elastin like polypeptides (ELP1, 2 and 3) were reported. • Molecular weight of ITC purified ELP1, ELP2 and ELP3 was in the range of 37–38 kDa. • Schwann cell adhesion was found to be prominent in ELP3 and could be used as nerve conduit for peripheral nerve regeneration.

Controls on magma permeability in the volcanic conduit during the climactic phase of the Kos Plateau Tuff eruption (Aegean Arc)

Science.gov (United States)

Degruyter, W.; Bachmann, O.; Burgisser, A.

2010-01-01

X-ray computed microtomography (µCT) was applied to pumices from the largest Quaternary explosive eruption of the active South Aegean Arc (the Kos Plateau Tuff; KPT) in order to better understand magma permeability within volcanic conduits. Two different types of pumices (one with highly elongated bubbles, tube pumice; and the other with near spherical bubbles, frothy pumice) produced synchronously and with identical chemical composition were selected for µCT imaging to obtain porosity, tortuosity, bubble size and throat size distributions. Tortuosity drops on average from 2.2 in frothy pumice to 1.5 in tube pumice. Bubble size and throat size distributions provide estimates for mean bubble size (~93-98 μm) and mean throat size (~23-29 μm). Using a modified Kozeny-Carman equation, variations in porosity, tortuosity, and throat size observed in KPT pumices explain the spread found in laboratory measurements of the Darcian permeability. Measured difference in inertial permeability between tube and frothy pumices can also be partly explained by the same variables but require an additional parameter related to the internal roughness of the porous medium (friction factor f 0 ). Constitutive equations for both types of permeability allow the quantification of laminar and turbulent gas escape during ascent of rhyolitic magma in volcanic conduits.

Chilling of dormant buds hyperinduces FLOWERING LOCUS T and recruits GA-inducible 1,3-beta-glucanases to reopen signal conduits and release dormancy in Populus.

Science.gov (United States)

Rinne, Päivi L H; Welling, Annikki; Vahala, Jorma; Ripel, Linda; Ruonala, Raili; Kangasjärvi, Jaakko; van der Schoot, Christiaan

2011-01-01

In trees, production of intercellular signals and accessibility of signal conduits jointly govern dormancy cycling at the shoot apex. We identified 10 putative cell wall 1,3-β-glucanase genes (glucan hydrolase family 17 [GH17]) in Populus that could turn over 1,3-β-glucan (callose) at pores and plasmodesmata (PD) and investigated their regulation in relation to FT and CENL1 expression. The 10 genes encode orthologs of Arabidopsis thaliana BG_ppap, a PD-associated glycosylphosphatidylinositol (GPI) lipid-anchored protein, the Arabidopsis PD callose binding protein PDCB, and a birch (Betula pendula) putative lipid body (LB) protein. We found that these genes were differentially regulated by photoperiod, by chilling (5°C), and by feeding of gibberellins GA(3) and GA(4). GA(3) feeding upregulated all LB-associated GH17s, whereas GA(4) upregulated most GH17s with a GPI anchor and/or callose binding motif, but only GA(4) induced true bud burst. Chilling upregulated a number of GA biosynthesis and signaling genes as well as FT, but not CENL1, while the reverse was true for both GA(3) and GA(4). Collectively, the results suggest a model for dormancy release in which chilling induces FT and both GPI lipid-anchored and GA(3)-inducible GH17s to reopen signaling conduits in the embryonic shoot. When temperatures rise, the reopened conduits enable movement of FT and CENL1 to their targets, where they drive bud burst, shoot elongation, and morphogenesis.

Fabrication of nerve guidance conduit with luminal filler as scaffold for peripheral nerve repair

International Nuclear Information System (INIS)

Aranilla, Charito T.; Wach, Rodoslaw; Ulanski, Piotr

2015-01-01

Peripheral nerve injury is a serious health concern for society, affecting trauma patients, many of whom acquire life-long disability. The gold standard of treatment for peripheral nerve injury is the use of nerve grafts, wherein nerve autograft or allograft is used to bridge the gap in the damaged nerve. Nerve guidance conduits (NGCs) are an attractive alternative to nerve autografts for aiding in the regeneration of peripheral nerve tissue. NGCs are small cylinders or tubes composed of either natural or synthetic biomaterials that are used to axon regeneration. The ends of the damaged nerve are inserted into either end of the cylinder and the NGC acts both as a connecting bridge for the severed nerve ends as well as a protective shelter for the regenerating nerve. This study aims at fabricating nerve guidance conduits with luminal structure based on synthetic biodegradable and biocompatible polymers such as poly (trimethylene carbonate ) (PTMC), poly (lactic acid) (PLA) and poly (caprolactone) (PCL). Initial base materials for fabrication were PLA acid tubes compared to PCL tubes when prepared by spray and dip-coating methods. The morphology of the tubes where examined by SEM and results showed better porosity of PLA acid tubes compared to PCL tubes when prepared by spraying technique. Poly(lactic acid) was then blended with poly(trimethylene carbonate) at a ratio of 1:4 (5% total polymer content) for further fabrication. Electron beam radiation (25 and 50 kGy) was employed for sterilization and the changes in properties induced by irradiation in comprising polymers were evaluated. The wettability, mechanical thermal properties were not significantly changed by irradiation.In a separate experiment, synthesis of carboxymethyl chitosan hydrogel crosslinked by electron beam radiation was studied to create a luminal filler for PTMC-PLA tubes. Based on proper viscosity of solution before crosslinking, sufficient gel fraction and swelling, 10% w/v concentration of

Challenges in developing drugs for primary headaches

DEFF Research Database (Denmark)

Schytz, Henrik Winther; Hargreaves, Richard; Ashina, Messoud

2017-01-01

This review considers the history of drug development in primary headaches and discusses challenges to the discovery of innovative headache therapeutics. Advances in headache genetics have yet to translate to new classes of therapeutics and there are currently no clear predictive human biomarkers...... for any of the primary headaches that can guide preventative drug discovery and development. Primary headache disorder subtypes despite common phenotypic presentation are undoubtedly heterogeneous in their pathophysiology as judged by the variability of response to headache medicines. Sub......, despite having promising effects in basic pain models, have not delivered efficacy in the clinic. Future efforts may triage novel physiological mediators using human experimental models of headache pain to support drug discovery strategies that target active pathways pharmacologically....

Six elements of integrated primary healthcare.

Science.gov (United States)

Brown, Lynsey J; Oliver-Baxter, Jodie

2016-03-01

Integrated care has the potential to deliver efficiencies and improvements in patient experiences and health outcomes. Efforts towards integrated care, especially at the primary and community health levels, have increasingly been under focus, both nationally and internationally. In Australia, regional integration is a priority, and integration of care is a task for meso-level organisations such as Primary Health Networks (PHNs). This paper seeks to provide a list of elements and questions for consideration by organisations working across primary healthcare settings, looking to enact and improve the delivery of integrated care. Six elements that consistently emerged during the development of a series of rapid reviews on integrated primary healthcare in Australia are presented in this paper. The elements identified are context, governance and leadership, infrastructure, financing, engagement, and communication. They offer a starting point for reflection in the planning and practices of organisations in their drive for continuous improvements in integrated care.

Pelvic Radiotherapy for Cancer of the Cervix: Is What You Plan Actually What You Deliver?

International Nuclear Information System (INIS)

Lim, Karen; Kelly, Valerie; Stewart, James; Xie, Jason; Cho, Young-Bin; Moseley, Joanne B.; Brock, Kristy; Fyles, Anthony; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael

2009-01-01

Purpose: Whole pelvic intensity-modulated radiotherapy (IMRT) is increasingly being used to treat cervix cancer and other gynecologic tumors. However, tumor and normal organ movement during treatment can substantially detract from the benefits of this approach. This study explored the effect of internal anatomic changes on the dose delivered to the tumor and organs at risk using a strategy integrating deformable soft-tissue modeling with simulated dose accumulation. Methods and Materials: Twenty patients with cervix cancer underwent baseline and weekly pelvic magnetic resonance imaging during treatment. Interfraction organ motion and delivered (accumulated) dose was modeled for three treatment scenarios: four-field box, large-margin whole pelvic IMRT (20-mm planning target volume, but 10 mm inferiorly) and small-margin IMRT (5-mm planning target volume). Results: Individually, the planned dose was not the same as the simulated delivered dose; however, when taken as a group, this was not statistically significant for the four-field box and large-margin IMRT plans. The small-margin IMRT plans yielded adequate target coverage in most patients; however, significant target underdosing occurred in 1 patient who displayed excessive, unpredictable internal target movement. The delivered doses to the organs at risk were significantly reduced with the small-margin plan, although substantial variability was present among the patients. Conclusion: Simulated dose accumulation might provide a more accurate depiction of the target and organ at risk coverage during fractionated whole pelvic IMRT for cervical cancer. The adequacy of primary tumor coverage using 5-mm planning target volume margins is contingent on the use of daily image-guided setup.

Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

Directory of Open Access Journals (Sweden)

Rajmohan Panda

2013-03-01

Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

Experimental composite guidance conduits for peripheral nerve repair: An evaluation of ion release

Energy Technology Data Exchange (ETDEWEB)

Zhang, X.F. [Department of Biological Sciences and Medical Engineering Design and Innovation Centre, Cork Institute of Technology, Cork (Ireland); Coughlan, A. [Inamori School of Engineering, Alfred University, Alfred, NY. 14802 (United States); O' Shea, H. [Department of Biological Sciences and Medical Engineering Design and Innovation Centre, Cork Institute of Technology, Cork (Ireland); Towler, M.R. [Inamori School of Engineering, Alfred University, Alfred, NY. 14802 (United States); Kehoe, S., E-mail: sharonkehoe@dal.ca [Department of Applied Oral Sciences, Dalhousie University, Halifax, NS, B3H 4R2 (Canada); School of Biomedical Engineering, Dalhousie University, Halifax, NS, B3H 4R2 (Canada); Boyd, D., E-mail: d.boyd@dal.ca [Department of Applied Oral Sciences, Dalhousie University, Halifax, NS, B3H 4R2 (Canada); School of Biomedical Engineering, Dalhousie University, Halifax, NS, B3H 4R2 (Canada)

2012-08-01

Poly (lactide-co-glycolide) (PLGA) - Pluronic F127 - glass composites have demonstrated excellent potential, from the perspective of controlled mechanical properties and cytocompatibility, for peripheral nerve regeneration. In addition to controlling the mechanical properties and cytotoxicity for such composite devices, the glass component may mediate specific responses upon implantation via degradation in the physiological environment and release of constituent elements. However, research focused on quantifying the release levels of such therapeutic ions from these experimental medical devices has been limited. To redress the balance, this paper explores the ion release profiles for Si{sup 4+}, Ca{sup 2+}, Na{sup +}, Zn{sup 2+}, and Ce{sup 4+} from experimental composite nerve guidance conduits (CNGC) comprising PLGA (at 12.5, and 20 wt.%), F127 (at 0, 2.5 and 5 wt.%) and various loadings of Si-Ca-Na-Zn-Ce glass (at 20 and 40 wt.%) for incubation periods of up to 28 days. The concentration of each ion, at various time points, was determined using Inductively Coupled Plasma-Atomic Emission Spectrometry (Perkin Elmer Optima 3000). It was observed that the Si{sup 4+}, Na{sup +}, Ca{sup 2+}, Zn{sup 2+} release from CNGCs in this study ranged from 0.22 to 6.477 ppm, 2.307 to 3.277 ppm, 40 to 119 ppm, and 45 to 51 ppm, respectively. The Ce{sup 4+} concentrations were under the minimum detection limits for the ICP instrument utilized. The results indicate that the ion release levels may be appropriate to mediate therapeutic effects with respect to peripheral nerve regeneration. The data generated in this paper provides requisite evidence to optimize composition for pre-clinical evaluation of the experimental composite. - Graphical abstract: Highlights: Black-Right-Pointing-Pointer Time-dependent degradation studies of PLGA/glass composite nerve guidance conduits (NGCs). Black-Right-Pointing-Pointer Si{sup 4+}, Na{sup +}, Ca{sup 2+} and Zn{sup 2+} release levels for the

Telemedicine and primary health: The virtual doctor project Zambia

OpenAIRE

Mupela, Evans; Mustarde, Paul; Jones, Huw

2011-01-01

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach d...

Guided parent-delivered cognitive behavioral therapy for childhood anxiety: Predictors of treatment response.

Science.gov (United States)

Thirlwall, Kerstin; Cooper, Peter; Creswell, Cathy

2017-01-01

Guided Parent-delivered Cognitive Behaviour Therapy (GPD-CBT) is a brief, effective treatment for childhood anxiety disorders, however not all children respond favourably. To examine predictors of response to GPD-CBT. Parents of 125 children (7-12 years) with an anxiety disorder received GPD-CBT over 2.6 or 5.3h. Recovery was measured post treatment and six months later. Younger children and those with primary Generalised Anxiety Disorder (GAD) improved more post treatment, but older children and those without primary GAD had better outcomes at six month follow up. Fewer children allocated to 2.6h had recovered post treatment compared to those allocated to the 5.2h intervention, but did not differ significantly six months later. The identification of predictors of short and longer-term treatment outcomes can guide treatment decisions following this low-intensity approach. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Leaders, leadership and future primary care clinical research

Directory of Open Access Journals (Sweden)

Qureshi Nadeem

2008-09-01

Full Text Available Abstract Background A strong and self confident primary care workforce can deliver the highest quality care and outcomes equitably and cost effectively. To meet the increasing demands being made of it, primary care needs its own thriving research culture and knowledge base. Methods Review of recent developments supporting primary care clinical research. Results Primary care research has benefited from a small group of passionate leaders and significant investment in recent decades in some countries. Emerging from this has been innovation in research design and focus, although less is known of the effect on research output. Conclusion Primary care research is now well placed to lead a broad re-vitalisation of academic medicine, answering questions of relevance to practitioners, patients, communities and Government. Key areas for future primary care research leaders to focus on include exposing undergraduates early to primary care research, integrating this early exposure with doctoral and postdoctoral research career support, further expanding cross disciplinary approaches, and developing useful measures of output for future primary care research investment.

Experience de conduite, alcool et environnement monotone. In Sandrine Gaymard et Teodor Tiplica (Eds.) Sécurité routière : un défi à l'aube du XXIème siècle

OpenAIRE

BERTHELON, Catherine; GALY, Edith

2017-01-01

L'hypothèse est faite que la prise d'une faible dose d'alcool en début d'après-midi, au moment de la baisse physiologique du niveau de vigilance (creux post prandial), pourrait entraîner un assoupissement précoce, notamment chez les jeunes conducteurs novices, ayant des répercussions sur la performance. La baisse de performance devrait s'amplifier au fur et à mesure de la conduite, de par la monotonie et la longueur de la séance de conduite. Seize jeunes conducteurs de 18 ans venant d'obtenir...

Field Experience from Li-Ion BESS Delivering Primary Frequency Regulation in the Danish Energy Market

DEFF Research Database (Denmark)

Swierczynski, Maciej Jozef; Stroe, Daniel Ioan; Lærke, Rasmus

2014-01-01

In this paper it is presented the practical experience from operating a 1.6 MW/ 0.4 MWh lithium ion battery energy storage system, which is providing primary frequency regulation service on the Danish energy market. Aspects of the battery system requirements and the used control strategy...

Healthcare is primary

Directory of Open Access Journals (Sweden)

Raman Kumar

2015-01-01

Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

The effectiveness of telemedicine-delivered opioid agonist therapy in a supervised clinical setting.

Science.gov (United States)

Eibl, Joseph K; Gauthier, Graham; Pellegrini, David; Daiter, Jeffery; Varenbut, Michael; Hogenbirk, John C; Marsh, David C

2017-07-01

Opioid use disorder has been declared a public health crisis across North America and opioid agonist therapy (OAT) is the standard of care for these patients. Despite the increasing adoption of telemedicine as a delivery method for OAT, its effectiveness has not yet been evaluated against traditional in-person treatment. This study compared treatment outcomes for in-person versus telemedicine-delivered OAT. We conducted a non-randomized cohort comparison study using an administrative database for patients who commenced OAT between 2011 and 2012 across 58 clinic sites in the province of Ontario, Canada. Patients were stratified by primary treatment modality as being: in-person (telemedicine), mixed (25-75% by telemedicine), or via telemedicine (>75% appointments by telemedicine). The primary outcome was continuous retention in treatment as defined by one year of uninterrupted therapy, based on pharmacy dosing records. A total of 3733 OAT initiating patients were identified. Patients treated via telemedicine were more likely to be retained in therapy than patients treated in-person (n=1590; aOR=1.27; 95% CI 1.14-1.41; pTelemedicine patients demonstrated a retention rate of 50% at one year whereas in-person patients were retained at a rate of 39%. The mixed group also had higher likelihood of retention than the in-person group (n=418; aOR=1.26; 95% CI 1.08-1.47; p=0.001) and had a retention rate of 47% at one year. Telemedicine may be an effective alternative to delivering in person OAT, and it has the potential to expand access to care in rural, remote, and urban regions. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Pockets, conduits, channels, and plumes: links to volcanism and orogeny in the rollback dominated western Mediterranean

Science.gov (United States)

Miller, Meghan S.; Sun, Daoyuan; O'Driscoll, Leland; Becker, Thorsten W.; Holt, Adam; Diaz, Jordi; Thomas, Christine

2015-04-01

Detailed mantle and lithospheric structure from the Canary Islands to Iberia have been imaged with data from recent temporary deployments and select permanent stations from over 300 broadband seismometers. The stations extended across Morocco and Spain as part of the PICASSO, IberArray, and Morocco-Münster experiments. We present results from S receiver functions (SRF), shear wave splitting, waveform modeling, and geodynamic models that help constrain the tectonic evolution of the westernmost Mediterranean, including orogenesis of the Atlas Mountains and occurrence of localized alkaline volcanism. Our receiver function images, in agreement with previous geophysical modeling, show that the lithosphere is thin (~65 km) beneath the Atlas, but thickens (~100 km) over a very short length scale at the flanks of the mountains. We find that these dramatic changes in lithospheric thickness also correspond to dramatic decreases in delay times inferred from S and SKS splitting observations of seismic anisotropy. Pockets and conduits of low seismic velocity material below the lithosphere extend along much of the Atlas to Southern Spain and correlate with the locations of Pliocene-Quaternary magmatism. Waveform analysis from the USC linear seismic array across the Atlas Mountains constrains the position, shape, and physical characteristics of one localized, low velocity conduit that extends from the uppermost mantle (~200 km depth) up to the volcanoes in the Middle Atlas. The shape, position and temperature of these seismically imaged low velocity anomalies, topography of the base of the lithosphere, morphology of the subducted slab beneath the Alboran Sea, position of the West African Craton and correlation with mantle flow inferred from shear wave splitting suggest that the unusually high topography of the Atlas Mountains and isolated recent volcanics are due to active mantle support that may be from material channeled from the Canary Island plume.

Solid-cryogen-stabilized, cable-in-conduit (CIC) superconducting cables

Science.gov (United States)

Voccio, J. P.; Michael, P. C.; Bromberg, L.; Hahn, S.

2015-12-01

This paper considers the use of a solid cryogen as a means to stabilize, both mechanically and thermally, magnesium diboride (MgB2) superconducting strands within a dual-channel cable-in-conduit (CIC) cable for use in AC applications, such as a generator stator winding. The cable consists of two separate channels; the outer channel contains the superconducting strands and is filled with a fluid (liquid or gas) that becomes solid at the device operating temperature. Several options for fluid will be presented, such as liquid nitrogen, hydrocarbons and other chlorofluorocarbons (CFCs) that have a range of melting temperatures and volumetric expansions (from solid at operating temperature to fixed volume at room temperature). Implications for quench protection and conductor stability, enhanced through direct contact with the solid cryogen, which has high heat capacity and thermal conductivity (compared with helium gas), will be presented. Depending on the cryogen, the conductor will be filled initially either with liquid at atmospheric conditions or a gas at high pressure (∼100 atm). After cooldown, the cryogen in the stranded-channel will be solid, essentially locking the strands in place, preventing strand motion and degradation due to mechanical deformation while providing enhanced thermal capacity for stability and protection. The effect of cryogen porosity is also considered. The relatively high heat capacity of solid cryogens at these lower temperatures (compared to gaseous helium) enhances the thermal stability of the winding. During operation, coolant flow through the open inner channel will minimize pressure drop.

The Himalayas: barrier and conduit for gene flow.

Science.gov (United States)

Gayden, Tenzin; Perez, Annabel; Persad, Patrice J; Bukhari, Areej; Chennakrishnaiah, Shilpa; Simms, Tanya; Maloney, Trisha; Rodriguez, Kristina; Herrera, Rene J

2013-06-01

The Himalayan mountain range is strategically located at the crossroads of the major cultural centers in Asia, the Middle East and Europe. Although previous Y-chromosome studies indicate that the Himalayas served as a natural barrier for gene flow from the south to the Tibetan plateau, this region is believed to have played an important role as a corridor for human migrations between East and West Eurasia along the ancient Silk Road. To evaluate the effects of the Himalayan mountain range in shaping the maternal lineages of populations residing on either side of the cordillera, we analyzed mitochondrial DNA variation in 344 samples from three Nepalese collections (Newar, Kathmandu and Tamang) and a general population of Tibet. Our results revealed a predominantly East Asian-specific component in Tibet and Tamang, whereas Newar and Kathmandu are both characterized by a combination of East and South Central Asian lineages. Interestingly, Newar and Kathmandu harbor several deep-rooted Indian lineages, including M2, R5, and U2, whose coalescent times from this study (U2, >40 kya) and previous reports (M2 and R5, >50 kya) suggest that Nepal was inhabited during the initial peopling of South Central Asia. Comparisons with our previous Y-chromosome data indicate sex-biased migrations in Tamang and a founder effect and/or genetic drift in Tamang and Newar. Altogether, our results confirm that while the Himalayas acted as a geographic barrier for human movement from the Indian subcontinent to the Tibetan highland, it also served as a conduit for gene flow between Central and East Asia. Copyright © 2013 Wiley Periodicals, Inc.

Materials Delivered by Member States

International Nuclear Information System (INIS)

1962-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered up to 30 September 1962 by Member States in compliance with requests the Agency has made under Article IX. D. Part II contains information about materials which have not yet been delivered but which have been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project agreements were in force on 30 September 1962. Reports on subsequent deliveries of materials and revised information about allocated but undelivered materials will be issued from time to time

Delivering energy efficiency and carbon reduction schemes in England: Lessons from Green Deal Pioneer Places

International Nuclear Information System (INIS)

Marchand, Robert D.; Koh, S.C. Lenny; Morris, Jonathan C.

2015-01-01

Against a background of growing international and national carbon reduction legislation, the UK government introduced the “Green Deal” to deliver a significant increase in housing energy efficiency and reduction in carbon emissions. This paper reflects on one English local authority's experience delivering a programme intended to foster local interest in the Green Deal. Drawing on social surveys and pre and post Green Deal intervention interviews with five demonstrator homes (households that applied to receive a Green Deal package fully funded by the scheme, providing a test bed for the Green Deal recruitment and installation process), this paper shows that awareness and understanding of the Green Deal scheme is low. There is opposition to the cost of finance offered but a strong interest in improving household warmth and for funding improvements through payments added to the electricity bill. Demonstrator home residents perceived Green Deals had improved the warmth and quality of their home, but saving money was the primary motivator for their involvement, not increasing warmth. Whilst Green Deal has not delivered the level of success that was hoped, much can be learned from the scheme to improve future energy efficiency schemes that will be necessary to deliver emission reduction commitments. -- Highlights: •Resident awareness and understanding of the Green Deal is low. •Green Deal assessment costs and loan interest rates are biggest barriers to uptake. •Funding energy improvements via a charge on electricity bill welcomed by residents. •Saving money rather than increasing warmth main motivator for scheme involvement. •Insights from this work should be used to inform future emission reduction schemes

A phase III randomized three-arm trial of physical therapist delivered pain coping skills training for patients with total knee arthroplasty: the KASTPain protocol

Directory of Open Access Journals (Sweden)

Riddle Daniel L

2012-08-01

Full Text Available Abstract Background Approximately 20% of patients report persistent and disabling pain following total knee arthroplasty (TKA despite an apparently normally functioning prosthesis. One potential risk factor for unexplained persistent pain is high levels of pain catastrophizing. We designed a three-arm trial to determine if a pain coping skills training program, delivered prior to TKA, effectively reduces function-limiting pain following the procedure in patients with high levels of pain catastrophizing. Methods/design The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Discussion The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Trial Registration NCT

Moving effective treatment for posttraumatic stress disorder to primary care: A randomized controlled trial with active duty military.

Science.gov (United States)

Cigrang, Jeffrey A; Rauch, Sheila A; Mintz, Jim; Brundige, Antoinette R; Mitchell, Jennifer A; Najera, Elizabeth; Litz, Brett T; Young-McCaughan, Stacey; Roache, John D; Hembree, Elizabeth A; Goodie, Jeffrey L; Sonnek, Scott M; Peterson, Alan L

2017-12-01

Many military service members with PTSD do not receive evidence-based specialty behavioral health treatment because of perceived barriers and stigma. Behavioral health providers in primary care can deliver brief, effective treatments expanding access and reducing barriers and stigma. The purpose of this randomized clinical trial was to determine if a brief cognitive-behavior therapy delivered in primary care using the Primary Care Behavioral Health model would be effective at reducing PTSD and co-occurring symptoms. A total of 67 service members (50 men, 17 women) were randomized to receive a brief, trauma-focused intervention developed for the primary care setting called Prolonged Exposure for Primary Care (PE-PC) or a delayed treatment minimal contact control condition. Inclusion criteria were significant PTSD symptoms following military deployment, medication stability, and interest in receiving treatment for PTSD symptoms in primary care. Exclusion criteria were moderate or greater risk of suicide, severe brain injury, or alcohol/substance use at a level that required immediate treatment. Assessments were completed at baseline, posttreatment/postminimal contact control, and at 8-week and 6-month posttreatment follow-up points. Primary measures were the PTSD Symptom Scale-Interview and the PTSD Checklist-Stressor-Specific. PE-PC resulted in larger reduction in PTSD severity and general distress than the minimal contact control. Delayed treatment evidenced medium to large effects comparable to the immediate intervention group. Treatment benefits persisted through the 6-month follow-up of the study. PE-PC delivered in integrated primary care is effective for the treatment of PTSD and co-occurring symptoms and may help reduce barriers and stigma found in specialty care settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Chilling of Dormant Buds Hyperinduces FLOWERING LOCUS T and Recruits GA-Inducible 1,3-β-Glucanases to Reopen Signal Conduits and Release Dormancy in Populus[W][OA

Science.gov (United States)

Rinne, Päivi L.H.; Welling, Annikki; Vahala, Jorma; Ripel, Linda; Ruonala, Raili; Kangasjärvi, Jaakko; van der Schoot, Christiaan

2011-01-01

In trees, production of intercellular signals and accessibility of signal conduits jointly govern dormancy cycling at the shoot apex. We identified 10 putative cell wall 1,3-β-glucanase genes (glucan hydrolase family 17 [GH17]) in Populus that could turn over 1,3-β-glucan (callose) at pores and plasmodesmata (PD) and investigated their regulation in relation to FT and CENL1 expression. The 10 genes encode orthologs of Arabidopsis thaliana BG_ppap, a PD-associated glycosylphosphatidylinositol (GPI) lipid-anchored protein, the Arabidopsis PD callose binding protein PDCB, and a birch (Betula pendula) putative lipid body (LB) protein. We found that these genes were differentially regulated by photoperiod, by chilling (5°C), and by feeding of gibberellins GA3 and GA4. GA3 feeding upregulated all LB-associated GH17s, whereas GA4 upregulated most GH17s with a GPI anchor and/or callose binding motif, but only GA4 induced true bud burst. Chilling upregulated a number of GA biosynthesis and signaling genes as well as FT, but not CENL1, while the reverse was true for both GA3 and GA4. Collectively, the results suggest a model for dormancy release in which chilling induces FT and both GPI lipid-anchored and GA3-inducible GH17s to reopen signaling conduits in the embryonic shoot. When temperatures rise, the reopened conduits enable movement of FT and CENL1 to their targets, where they drive bud burst, shoot elongation, and morphogenesis. PMID:21282527

Primary tracheal adenocystic carcinoma and tracheal tumors during pregnancy

Directory of Open Access Journals (Sweden)

Cem Gundogdu

2011-07-01

Full Text Available Cancer complicates approximately 0.1% of all pregnancies. Primary tracheal carcinoma is one of very rarely seen tumors and the rate of its being seen makes up approximately % 0,2 of all tumors of respiratory tract. The patient, 28 years old, who has 28-weeks-pregnant, was diagnosed with primary tracheal adenocystic carcinoma. Patient was made operation as thoracotomy and tracheal tumor was removed at the 28th week of pregnancy. Patient was delivered with sectio abdominale at the 39th week of pregnancy. Primary tracheal adenocystic carcinoma is very rarely seen tumors and it is the first tracheal ACC with pregnancy case in literature to have been detected and surgically treated during pregnancy. We discussed primary tracheal adenocystic carcinoma and tracheal tumors during pregnancy with literature.

Making Physics Matter in Primary Schools

Science.gov (United States)

Flaherty, Jackie; Cox, Wendy; Poole, Amanda; Watson, Jenny; Greygoose, Kirstin

2016-04-01

"Efforts to broaden students' aspirations, particularly in relation to STEM, need to begin in primary school." Kings College London "Aspires" Research Project 2013 From my outreach activity I have learnt that primary teachers could feel under pressure when faced with delivering the science curriculum. The teachers could be lacking confidence in their subject knowledge, lacking the equipment needed to deliver practical science or lacking enthusiasm for the subject. In addition, English and Mathematics were the subjects that were externally tested and reported to the authorities and so some teachers felt that time for science was being marginalised to ensure the best results in the externally assessed subjects. In my work with The Ogden Trust Primary Science team I have been involved in developing a range of strategies to address some of the issues outlined above. • CPD (Teacher Training) Programme We have provided free training to improve teachers knowledge and understanding of key physics concepts to GCSE standard and a practical workshop consisting of ten investigations, extension and challenge tasks. The teachers each receive a book of lesson plans and a resource box containing a class set of the equipment required. The four year programme covers Forces Light and Sound Electricity Earth & Space • "Phiz Labs" Funding from The Ogden Trust has allowed us to set up science laboratories within primary schools. The pupils have lab coats, goggles and access to a range of equipment that allows them to participate in more practical science activity and open-ended investigative work. My Phiz Lab is in the secondary school where I teach physics and practical workshops for primary pupils and teachers are held there on a regular basis. • Enrichment In order to enthuse and challenge the primary pupils a variety of enrichment activities take place. These include "Physics of Go-Karts" and "Particle Physics for Primary" workshops, competitions and regional Science Fairs

Community nurses working in piloted primary care teams: Irish Republic.

LENUS (Irish Health Repository)

Burke, Triona

2010-08-01

Primary care health services in the Irish Republic have undergone fundamental transformation with the establishment of multidisciplinary primary care teams nationwide. Primary care teams provide a community-based health service delivered through a range of health professionals in an integrated way. As part of this initiative ten pilot teams were established in 2003. This research was undertaken in order to gain an understanding of nurse\\'s experiences of working in a piloted primary care team. The methodology used was a focus group approach. The findings from this study illustrated how community nurse\\'s roles and responsibilities have expanded within the team. The findings also highlighted the benefits and challenges of working as a team with various other community-based health-care disciplines.

Structure Of Conduits Of The Acidic Volcanism And Related Deposits In The Paraná-Etendeka Magmatic Province, São Marcos Region, South Brazil

Science.gov (United States)

Guimarães, L. F.; De Campos, C. P.; Lima, E. F. D.; Janasi, V. A.

2015-12-01

Voluminous acidic volcanics from the Paraná-Etendeka Magmatic Province crop out in the southern part of Brazil. The conduits responsible for the feeding of this intermediate/acid volcanism are preserved and well exposed in the São Marcos region (Lima et al. 2012; Geologia USP 12:49-64). Conduits are aligned along a NW-SE trend and have thicknesses up to 1 km. These structures are often characterized by mixing between dacitic and rhyodacitic magmas, with intercalation between two major zones: 1) reddish or grayish vitrophiricdacite/rhyodacite, sub-divided in massive or vesiculated; 2) reddish or grayish vitrophiric fragmented dacite/rhyodacite composed of bubble-rich angular to rounded blocks. Such fragments commonly deform coeval to the flow. A third zone dominated by filaments depicts a chaotic stretching-and-folding process from the mixture of the acid magmas. We used classical field measurements of flow structures and recognized main flow directions in these feeder-dikes. They follow two preferential directions: NW, ranging from N272° to N 355°, and NE, varying from N20° to N85°. These directions are indicative of a transtensive fissural system, which seems to be related to conjugated fractures. Evidence of an important fragmentation process in the conduits point towards the presence of related products in this region, thus rheomorphic deposits such as those observed elsewhere (e.g. Uruguay and Namibia) are expected to occur. Possible vestiges of these deposits could be represented by restricted outcrops of lens-shaped and banded hipohyaline, occasionally bubble-rich, dacites. The presence of continuous pseudotachylitic levels, tightly folded bands with horizontal axial planes together with local deformed bubble-rich pumice-like lens could be indicative of remelting and rheomorphism of previous vulcanoclastic material. Coulees and compound (lobed) dacitic lava flows, reaching up to 5-8 meters length, occur as the uppermost deposits and correspond to the

Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

Science.gov (United States)

2012-01-01

Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially

Nanotechnology versus stem cell engineering: in vitro comparison of neurite inductive potentials.

Science.gov (United States)

Morano, Michela; Wrobel, Sandra; Fregnan, Federica; Ziv-Polat, Ofra; Shahar, Abraham; Ratzka, Andreas; Grothe, Claudia; Geuna, Stefano; Haastert-Talini, Kirsten

2014-01-01

Innovative nerve conduits for peripheral nerve reconstruction are needed in order to specifically support peripheral nerve regeneration (PNR) whenever nerve autotransplantation is not an option. Specific support of PNR could be achieved by neurotrophic factor delivery within the nerve conduits via nanotechnology or stem cell engineering and transplantation. Here, we comparatively investigated the bioactivity of selected neurotrophic factors conjugated to iron oxide nanoparticles (np-NTFs) and of bone marrow-derived stem cells genetically engineered to overexpress those neurotrophic factors (NTF-BMSCs). The neurite outgrowth inductive activity was monitored in culture systems of adult and neonatal rat sensory dorsal root ganglion neurons as well as in the cell line from rat pheochromocytoma (PC-12) cell sympathetic culture model system. We demonstrate that np-NTFs reliably support numeric neurite outgrowth in all utilized culture models. In some aspects, especially with regard to their long-term bioactivity, np-NTFs are even superior to free NTFs. Engineered NTF-BMSCs proved to be less effective in induction of sensory neurite outgrowth but demonstrated an increased bioactivity in the PC-12 cell culture system. In contrast, primary nontransfected BMSCs were as effective as np-NTFs in sensory neurite induction and demonstrated an impairment of neuronal differentiation in the PC-12 cell system. Our results evidence that nanotechnology as used in our setup is superior over stem cell engineering when it comes to in vitro models for PNR. Furthermore, np-NTFs can easily be suspended in regenerative hydrogel matrix and could be delivered that way to nerve conduits for future in vivo studies and medical application.

Oral microflora in infants delivered vaginally and by caesarean section

DEFF Research Database (Denmark)

Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

2011-01-01

International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

Using Primary Language Support via Computer to Improve Reading Comprehension Skills of First-Grade English Language Learners

Science.gov (United States)

Rodriguez, Cathi Draper; Filler, John; Higgins, Kyle

2012-01-01

Through this exploratory study the authors investigated the effects of primary language support delivered via computer on the English reading comprehension skills of English language learners. Participants were 28 First-grade students identified as Limited English Proficient. The primary language of all participants was Spanish. Students were…

[Laparoscopic cystectomy and ileal conduit urinary diversion for neurogenic bladders and related conditions. Morbidity and better quality of life].

Science.gov (United States)

Sakhri, R; Seigle-Murandi, F; Jacqmin, D; Lang, H; Saussine, C

2015-05-01

To assess morbidity and functional consequences of laparoscopic cystectomy with ileal conduit urinary diversion: in neurologic patients. We reviewed the records of forty-two patients (ten men and thirty-two women) who underwent surgery between August 2007 and October 2013. The median age of the patient was 54 years old (range between 21-79 years). A laparoscopic cystectomy was performed followed by a short laparotomy to perform the ileal conduit urinary diversion. Records were reviewed to retrieve the indications and describe the postoperative and functional course. Patients and GPs were interviewed during phone calls to appreciate the quality of life by the PGII scale in order to assess the functional outcome. The operation was performed on 42 patients, of whom 18 had multiple sclerosis, nine a post-traumatic neurogenic bladder. Among the total population, 10 patients (23.81%) required a transfusion of at least one packed red blood cells (1-7). The overall rate of early complications was 35.71%. Belated complications were seen in 52.38% of the population. The median duration of hospital stay was 16 days (range between 9-70 days). The median follow up was 34 months (range between 1-76 months). For patients, the PGII scale rating had a median value of 6 (2-7). All referring physicians described a better functional status. The laparoscopic cystectomy can make postoperative course smoother for the neurological patients. However, the surgeon must weigh individually the benefit of performing the operation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Comparative costs of mobile and fixed-clinic primary health care ...

African Journals Online (AJOL)

The costs of different methods of delivering primary health care in a local authority through mobile and fixed-clinic services have been analysed and aspects of their costefficiency compared. The information gained from such an analysis can be used for management purposes to optimise both the use of resources and the ...

Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents.

Science.gov (United States)

Fisher, Emma; Law, Emily; Palermo, Tonya M; Eccleston, Christopher

2015-03-23

-to-face between therapist and patient from this review. Children and adolescents (0 to 18 years of age) with a primary chronic pain condition were the target of the interventions. Each comparator arm, at each extraction point had to include 10 or more participants. For the analyses, we combined all psychological therapies. We split pain conditions into headache and mixed (non-headache) pain and analysed them separately. Pain, disability, depression, anxiety, and adverse events were extracted as primary outcomes. We also extracted satisfaction with treatment as a secondary outcome. We considered outcomes at two time points: first immediately following the end of treatment (known as 'post-treatment'), and second, any follow-up time point post-treatment between 3 and 12 months (known as 'follow-up'). We assessed all included studies for risk of bias. Eight studies (N = 371) that delivered treatment remotely were identified from our search; five studies investigated children with headache conditions, one study was with children with juvenile idiopathic arthritis, and two studies included mixed samples of children with headache and mixed (i.e. recurrent abdominal pain, musculoskeletal pain) chronic pain conditions. The average age of children receiving treatment was 12.57 years.For headache pain conditions, we found one beneficial effect of remotely delivered psychological therapy. Headache severity was reduced post-treatment (risk ratio (RR) = 2.65, 95% confidence interval (CI) 1.56 to 4.50, z = 3.62,p psychological therapies reduced pain intensity post-treatment (standardised mean difference (SMD) = -0.61, 95% CI -0.96 to -0.25, z = 3.38, p psychological therapies delivered remotely for disability post-treatment and a lack of data at follow-up meant no analyses could be run. Only one analysis could be conducted for depression outcomes. We found no beneficial effect of psychological therapies in reducing depression post-treatment for headache conditions. Only one study presented data

Interventionist training and intervention fidelity monitoring and maintenance for CONNECT, a nurse-led primary palliative care in oncology trial.

Science.gov (United States)

Robbins-Welty, Gregg A; Mueser, Lisa; Mitchell, Chandler; Pope, Nicole; Arnold, Robert; Park, SeoYoung; White, Doug; Smith, Kenneth J; Reynolds, Charles; Rosenzweig, Margaret; Bakitas, Marie; Schenker, Yael

2018-06-01

Intervention fidelity is a critical component of behavioral research that has received inadequate attention in palliative care studies. With increasing focus on the need for palliative care models that can be widely disseminated and delivered by non-specialists, rigorous yet pragmatic strategies for training interventionists and maintaining intervention fidelity are needed. (1) Describe components of a plan for interventionist training and monitoring and maintaining intervention fidelity as part of a primary palliative care trial (CONNECT) and (2) present data about perceived training effectiveness and delivery of key intervention content. Post-training evaluations, visit checklists, and visit audio-recordings. Data were collected from June, 2016 through April, 2017. We include procedures for (1) identification, training and certification of oncology nurses as CONNECT interventionists; (2) monitoring intervention delivery; and (3) maintaining intervention quality. All nurses (N = 14) felt prepared to deliver key competencies after a 3-day in-person training. As assessed via visit checklists, interventionists delivered an average of 94% (SD 13%) of key content for first intervention visits and 85% (SD 14%) for subsequent visits. As assessed via audio-recordings, interventionists delivered an average of 85% (SD 8%) of key content for initial visits and 85% (SD 12%) for subsequent visits. We present a 3-part strategy for training interventionists and monitoring and maintaining intervention delivery in a primary palliative care trial. Training was effective in having nurses feel prepared to deliver primary palliative care skills. As assessed via nursing checklists and visit audio-recordings, intervention fidelity was high.

"Give Me a Lesson and I'll Deliver It": Teaching Assistants' Experiences of Leading Primary Mathematics Lessons in England

Science.gov (United States)

Houssart, Jenny

2013-01-01

Teaching Assistants (TAs) in primary schools in England have a growing pedagogic role. For some, this sometimes includes responsibility for the whole class instead of the teacher. This article draws on 24 interview transcripts to examine the practice in the context of primary mathematics lessons and from TAs' viewpoints. Emergency cover is often…

Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial.

Science.gov (United States)

Creswell, Cathy; Violato, Mara; Fairbanks, Hannah; White, Elizabeth; Parkinson, Monika; Abitabile, Gemma; Leidi, Alessandro; Cooper, Peter J

2017-07-01

Half of all lifetime anxiety disorders emerge before age 12 years; however, access to evidence-based psychological therapies for affected children is poor. We aimed to compare the clinical outcomes and cost-effectiveness of two brief psychological treatments for children with anxiety referred to routine child mental health settings. We hypothesised that brief guided parent-delivered cognitive behavioural therapy (CBT) would be associated with better clinical outcomes than solution-focused brief therapy and would be cost-effective. We did this randomised controlled trial at four National Health Service primary child and mental health services in Oxfordshire, UK. Children aged 5-12 years referred for anxiety difficulties were randomly allocated (1:1), via a secure online minimisation tool, to receive brief guided parent-delivered CBT or solution-focused brief therapy, with minimisation for age, sex, anxiety severity, and level of parental anxiety. The allocation sequence was not accessible to the researcher enrolling participants or to study assessors. Research staff who obtained outcome measurements were masked to group allocation and clinical staff who delivered the intervention did not measure outcomes. The primary outcome was recovery, on the basis of Clinical Global Impressions of Improvement (CGI-I). Parents recorded patient-level resource use. Quality-adjusted life-years (QALYs) for use in cost-utility analysis were derived from the Child Health Utility 9D. Assessments were done at baseline (before randomisation), after treatment (primary endpoint), and 6 months after treatment completion. We did analysis by intention to treat. This trial is registered with the ISCRTN registry, number ISRCTN07627865. Between March 23, 2012, and March 31, 2014, we randomly assigned 136 patients to receive brief guided parent-delivered CBT (n=68) or solution-focused brief therapy (n=68). At the primary endpoint assessment (June, 2012, to September, 2014), 40 (59%) children in

A novel approach to estimate the eruptive potential and probability in open conduit volcanoes.

Science.gov (United States)

De Gregorio, Sofia; Camarda, Marco

2016-07-26

In open conduit volcanoes, volatile-rich magma continuously enters into the feeding system nevertheless the eruptive activity occurs intermittently. From a practical perspective, the continuous steady input of magma in the feeding system is not able to produce eruptive events alone, but rather surplus of magma inputs are required to trigger the eruptive activity. The greater the amount of surplus of magma within the feeding system, the higher is the eruptive probability.Despite this observation, eruptive potential evaluations are commonly based on the regular magma supply, and in eruptive probability evaluations, generally any magma input has the same weight. Conversely, herein we present a novel approach based on the quantification of surplus of magma progressively intruded in the feeding system. To quantify the surplus of magma, we suggest to process temporal series of measurable parameters linked to the magma supply. We successfully performed a practical application on Mt Etna using the soil CO2 flux recorded over ten years.

Materials Delivered by Member States

International Nuclear Information System (INIS)

1969-01-01

In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1969 in compliance with requests the Agency had made under Article IX. D

Normal zone propagation and Thermal Hydraulic Quenchback in a cable-in-conduit superconductor

International Nuclear Information System (INIS)

Lue, J.W.; Dresner, L.

1993-01-01

When a local normal zone appears in a cable-in-conduit superconductor, a slug of hot helium is produced. The pressure rises and the hot helium expands. Thus the normal zone propagation in such a conductor can be governed by the hot helium expansion, rather than the heat conduction along the conductor. The expansion of the hot helium compresses the cold helium outside of the normal zone. This raises th at sign temperature of the cold helium. When the temperature rise reaches the current sharing limit, the superconductor in contact goes normal. Thus a rapid increase in normal zone propagation occur. This phenomenon is termed Thermal Hydraulic Quenchback (THQ). An experiment was performed to investigate this process. The existence of THQ was verified. Thresholds of THQ were also observed by varying the conductor current, the magnetic field, the temperature, and the initial normal zone length. When THQ occurred, normal zone propagation approaching the velocity of sound was observed. A better picture of THQ is obtained by a careful comparison of the data with analytical studies

Contention between supply of hydrothermal fluid and conduit obstruction: inferences from numerical simulations

Science.gov (United States)

Tanaka, Ryo; Hashimoto, Takeshi; Matsushima, Nobuo; Ishido, Tsuneo

2018-05-01

We investigate a volcanic hydrothermal system using numerical simulations, focusing on change in crater temperature. Both increases and decreases in crater temperature have been observed before phreatic eruptions. We follow the system's response for up to a decade after hydrothermal fluid flux from the deep part of the system is increased and permeability is reduced at a certain depth in a conduit. Our numerical simulations demonstrate that: (1) changes in crater temperature are controlled by the magnitude of the increase in hydrothermal fluid flux and the degree of permeability reduction; (2) significant increases in hydrothermal flux with decreases in permeability induce substantial pressure changes in shallow depths in the edifice and decreases in crater temperature; (3) the location of maximum pressure change differs between the mechanisms. The results of this study imply that it is difficult to predict eruptions by crater temperature change alone. One should be as wary of large eruptions when crater temperature decreases as when crater temperature increases. It is possible to clarify the implications of changes in crater temperature with simultaneous observation of ground deformation.

Contractor firm strategies in delivering green project: A review

Science.gov (United States)

Powmya, Ayisha; Abidin, Nazirah Zainul; Azizi, Nurul Sakina Mokhtar

2017-10-01

Building green requires effort from various parties, from those who plan, design, manage and construct the building. Contractors are responsible for converting the design on paper into a real building and their role at the construction site support environmental sustainability by implementing responsible construction practices. Inefficient or inexperienced contractor in green construction project may find that delivering this type of project is not an easy task due to added requirement in design, stringent practices at site and the use of green technology and materials. Adopting suitable strategies at firm level will assist in preparatory process and readiness of delivering the green project. This paper reviews the strategies at firm level to deliver green construction project. From extensive literature review, it was discovered that there are six strategies to be adopted by the contractor. Understanding these strategies is expected to promote more contractors to be proactive in delivering green projects.

Materials Delivered by Member States

International Nuclear Information System (INIS)

1975-01-01

In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 30 June 1975, in compliance with requests the Agency had made under Article IX. D

Materials Delivered by Member States

International Nuclear Information System (INIS)

1974-01-01

In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 31 March 1974, in compliance with requests the Agency had made under Article IX. D

Materials Delivered by Member States

International Nuclear Information System (INIS)

1971-01-01

In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1970, in compliance with requests the Agency had made under Article IX. D

Materials Delivered by Member States

International Nuclear Information System (INIS)

1973-01-01

In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1972, in compliance with requests the Agency had made under Article IX. D

Materials Delivered by Member States

International Nuclear Information System (INIS)

1972-01-01

In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1971, in compliance with requests the Agency had made under Article IX. D

Blueprint for an Undergraduate Primary Care Curriculum.

Science.gov (United States)

Fazio, Sara B; Demasi, Monica; Farren, Erin; Frankl, Susan; Gottlieb, Barbara; Hoy, Jessica; Johnson, Amanda; Kasper, Jill; Lee, Patrick; McCarthy, Claire; Miller, Kathe; Morris, Juliana; O'Hare, Kitty; Rosales, Rachael; Simmons, Leigh; Smith, Benjamin; Treadway, Katherine; Goodell, Kristen; Ogur, Barbara

2016-12-01

In light of the increasing demand for primary care services and the changing scope of health care, it is important to consider how the principles of primary care are taught in medical school. While the majority of schools have increased students' exposure to primary care, they have not developed a standardized primary care curriculum for undergraduate medical education. In 2013, the authors convened a group of educators from primary care internal medicine, pediatrics, family medicine, and medicine-pediatrics, as well as five medical students to create a blueprint for a primary care curriculum that could be integrated into a longitudinal primary care experience spanning undergraduate medical education and delivered to all students regardless of their eventual career choice.The authors organized this blueprint into three domains: care management, specific areas of content expertise, and understanding the role of primary care in the health care system. Within each domain, they described specific curriculum content, including longitudinality, generalism, central responsibility for managing care, therapeutic alliance/communication, approach to acute and chronic care, wellness and prevention, mental and behavioral health, systems improvement, interprofessional training, and population health, as well as competencies that all medical students should attain by graduation.The proposed curriculum incorporates important core features of doctoring, which are often affirmed by all disciplines but owned by none. The authors argue that primary care educators are natural stewards of this curriculum content and can ensure that it complements and strengthens all aspects of undergraduate medical education.

Transdiagnostic versus disorder-specific internet-delivered cognitive behaviour therapy for anxiety and depression in primary care.

Science.gov (United States)

Newby, Jill M; Mewton, Louise; Andrews, Gavin

2017-03-01

Disorder-specific and transdiagnostic internet cognitive behaviour therapy (iCBT) programs are effective for anxiety and depression, but no studies have compared their effectiveness in primary care. Patient characteristics, adherence and effectiveness of Transdiagnostic iCBT (n=1005) were compared to disorder-specific programs for generalized anxiety disorder (GAD) (n=738) and depression (n=366) in a naturalistic non-randomised comparison study. Patients completed their iCBT program in primary care. The PHQ-9 (depression), GAD-7 (generalized anxiety), K-10 (distress), and the WHODAS-II (disability) were measured at pre- and post-treatment. Patients in the Transdiagnostic program had higher comorbidity rates and baseline distress. All programs were associated with medium to large within-group effect sizes for improving anxiety, depression and distress between pre- and post-treatment (d's=0.64-1.39). Controlling for baseline group differences in severity, we found small effect sizes favoring the Transdiagnostic program over the GAD program in reducing PHQ-9 (d=0.44, 95%CI: 0.34-0.53), K-10 (d=0.21, 95%CI: 0.16-0.35) and WHODAS scores (d=0.20, 95%CI: 0.10-0.29), and small effect sizes favoring the Transdiagnostic program over the Depression program in reducing GAD-7 scores (d=0.48, 95%CI: 0.36-0.60). A smaller proportion of patients completed the Transdiagnostic program (44.9%) compared to the depression (51.6%) and GAD (49.2%) programs, which was attributable to baseline differences in age and symptom severity. Both Transdiagnostic iCBT and disorder-specific iCBT programs are effective in primary care, but there appears to be small effects favoring Transdiagnostic iCBT. Methods to increase adherence are needed to optimize the benefits to patients, and these findings await replication in a RCT. Copyright © 2016 Elsevier Ltd. All rights reserved.

Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

Science.gov (United States)

Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

2016-09-06

Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change

Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas

Science.gov (United States)

Trucks Golden Eagle Delivers Beer With Natural Gas Trucks to someone by E-mail Share Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas Trucks on Facebook Tweet about Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas Trucks on Twitter Bookmark

Exploration of funding models to support hybridisation of Australian primary health care organisations.

Science.gov (United States)

Reddy, Sandeep

2017-09-01

Primary Health Care (PHC) funding in Australia is complex and fragmented. The focus of PHC funding in Australia has been on volume rather than comprehensive primary care and continuous quality improvement. As PHC in Australia is increasingly delivered by hybrid style organisations, an appropriate funding model that matches this set-up while addressing current issues with PHC funding is required. This article discusses and proposes an appropriate funding model for hybrid PHC organisations.

An international multicenter study comparing arrhythmia prevalence between the intracardiac lateral tunnel and the extracardiac conduit type of Fontan operations.

Science.gov (United States)

Balaji, Seshadri; Daga, Ankana; Bradley, David J; Etheridge, Susan P; Law, Ian H; Batra, Anjan S; Sanatani, Shubayan; Singh, Anoop K; Gajewski, Kelly K; Tsao, Sabrina; Singh, Harinder R; Tisma-Dupanovic, Svjetlana; Tateno, Shigeru; Takamuro, Motoki; Nakajima, Hiromichi; Roos-Hesselink, Jolien W; Shah, Maully

2014-08-01

The study objective was to determine whether the extracardiac conduit Fontan confers an arrhythmia advantage over the intracardiac lateral tunnel Fontan. This multicenter study of 1271 patients compared bradyarrhythmia (defined as need for pacing) and tachyarrhythmia (defined as needing antiarrhythmic therapy) between 602 patients undergoing the intracardiac Fontan and 669 patients undergoing the extracardiac Fontan. The median age at the time of the Fontan procedure was 2.1 years (interquartile range, 1.6-3.2 years) for the intracardiac group and 3.0 years (interquartile range, 2.4-3.9) for the extracardiac group (P 30 days) bradyarrhythmia occurred in 105 patients (18%) in the intracardiac group and 63 patients (9%) in the extracardiac group (P 30 days) tachyarrhythmia occurred in 58 patients (10%) in the intracardiac group and 23 patients (3%) in the extracardiac group (P factoring time since surgery, more patients in the extracardiac group had early bradycardia (odds ratio, 2.9; 95% confidence interval, 1.8-4.6), with no difference in early tachycardia, late bradycardia, or late tachycardia. Overall arrhythmia burden is similar between the 2 groups, but the extracardiac Fontan group had a higher incidence of early bradyarrhythmias. There was no difference in the incidence of late tachyarrhythmias over time between the 2 operations. Therefore, the type of Fontan performed should be based on factors other than an anticipated reduction in arrhythmia burden from the extracardiac conduit. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Impact of peer delivered wellness coaching.

Science.gov (United States)

Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

2016-09-01

People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A randomised trial of a 5 week, manual based, self-management programme for hypertension delivered in a cardiac patient club in Shanghai

Directory of Open Access Journals (Sweden)

Lewin Robert J

2008-05-01

Full Text Available Abstract Background In Shanghai there are 1.2 million people with hypertension, many of whom have difficulty in affording medical treatment. Community based, anti-hypertensive clubs have been created to provide health education but education alone is often ineffective. Lifestyle change programmes have shown some potential for reducing blood pressure but in previous trials have required specialist staff and extensive contact. We have previously demonstrated that self-management programmes delivered by health professionals, such as a nurse who has had short training in self-management techniques can change health behaviour and reduce symptoms. This study was designed to evaluate the benefits of a simple, cognitive-behavioural, self-management programme for hypertension based around a hypertension manual and delivered in the setting of a community anti-hypertensive club in Shanghai. Method The method was a pragmatic randomised controlled trial with an intention-to-treat analysis. Adult patients with mild-to-moderate primary hypertension, waiting to join a neighbourhood anti-hypertension club, were randomised to the self-management programme or to an information only control procedure. They attended the group treatment sessions on 4 occasions over 5 weeks for education combined with goal setting for lifestyle change and an introduction to exercise. The main outcome measures were: changes in blood pressure; blood total cholesterol; diet; activity level and health related quality of life 1 month and 4 months after the end of treatment. Results A total of 140 adults with mild-to-moderate primary hypertension took part. All of the main outcomes showed beneficial changes. Four months after the end of treatment the mean blood pressure differences between groups were systolic 10.15 mm Hg (P Conclusion Patients with mild-to-moderate primary hypertension attending a 5 week, group and manual based, cognitive-behavioural self-management programme, delivered

How to design and deliver a local teaching program

OpenAIRE

Limb, Christopher; Whitehurst, Katharine; Gundogan, Buket; Koshy, Kiron; Agha, Riaz

2017-01-01

Teaching is an invaluable aspect of any medical or surgical career. Many trainees will find themselves delivering teaching at several stages in their career and in this “How to” article we explain how to design, set up, and deliver a successful teaching program, as well as how to evidence this in your portfolio.

Exploring the role of lipids in intercellular conduits: breakthroughs in the pipeline

Directory of Open Access Journals (Sweden)

Elise eDelage

2013-12-01

Full Text Available It has been known for more than a century that most of the plant cells are connected to their neighbors through membranous pores perforating the cell wall, namely plasmodesmata (PDs. The recent discovery of tunneling nanotubes (TNTs, thin membrane bridges established between distant mammalian cells, suggests that intercellular communication mediated through cytoplasmic continuity could be a conserved feature of eukaryotic organisms. Although TNTs differ from PDs in their formation and architecture, both are characterized by a continuity of the plasma membrane between two cells, delimiting a nanotubular channel supported by actin-based cytoskeleton. Due to this unusual membrane organization, lipids are likely to play critical roles in the formation and stability of intercellular conduits like TNTs and PDs, but also in regulating the transfer through these structures. While it is crucial for a better understanding of those fascinating communication highways, the study of TNT lipid composition and dynamics turned out to be extremely challenging. The present review aims to give an overview of the recent findings in this context. We will also discuss some of the promising imaging approaches, which might be the key for future breakthroughs in the field and could also benefit the research on PDs.

Harmonic scalpel versus electrocautery for harvest of radial artery conduits: Reduced risk of spasm and intimal injury on optical coherence tomography

Science.gov (United States)

Brazio, Philip S.; Laird, Patrick C.; Xu, Chenyang; Gu, Junyan; Burris, Nicholas S.; Brown, Emile N.; Kon, Zachary N.; Poston, Robert S.

2009-01-01

Objective Vasospasm is the primary obstacle to widespread adoption of the radial artery as a conduit in coronary artery bypass grafting. We used optical coherence tomography, a catheter-based intravascular imaging modality, to measure the degree of radial artery spasm induced by means of harvest with electrocautery or a harmonic scalpel in patients undergoing coronary artery bypass grafting. Methods Radial arteries were harvested from 44 consecutive patients with a harmonic scalpel (n = 15) or electrocautery (n = 29). Vessels were imaged before harvesting and after removal from the arm, with saphenous vein tracts serving as internal controls. Optical coherence tomographic findings for the degree of harvesting-induced injury were validated against histologic measures. Results Optical coherence tomographic measures of endovascular dimensions and injury correlated strongly with histologic findings. Mean luminal volume, a measure of vasospasm, decreased significantly less after harvesting with a harmonic scalpel (9% ± 7%) than with electrocautery (35% ± 6%, P = .015). Completely intact intima was present in 11 (73%) of 15 radial arteries harvested with a harmonic scalpel (73%) compared with 9 of 29 arteries harvested by means of electrocautery (31%, P = .011). Intraoperative flow measurements and patency rates at 5 days postoperatively were not significantly different among groups. Conclusions Optical coherence tomography provides a level of speed and accuracy for quantifying endothelial injury and vasospasm that has not been described for any other modality, suggesting potential as an intraoperative quality assurance tool. Our optical coherence tomographic findings suggest that the harmonic scalpel induces less spasm and intimal injury compared with electrocautery. PMID:19026820

Particle tracker system delivered to CERN

CERN Multimedia

Pitcher, Graham

2006-01-01

"The CCLRC Rutherford Appleton Laboratory (RAL) has delivered a system to CERN that will help to process the vast amounts of data generated by the silicon tracking detector within the Compact Muon Solenoid experiment." (1/2 page)

An evaluation of experiences and views of Scottish leadership training opportunities amongst primary care professionals.

Science.gov (United States)

Power, Ailsa; Allbutt, Helen; Munro, Lucy; MacLeod, Marion; Kennedy, Susan; Cameron, Donald; Scoular, Ken; Orr, Graham; Gillies, John

2017-05-01

To determine experiences of leadership training of six primary care professions in Scotland and consider future development. A questionnaire on previous leadership course attendance and future intentions was distributed to community pharmacists, general dental practitioners, general practitioners, practice nurses, practice managers and optometrists. Analysis comprised descriptive statistics for closed questions and management of textual data. Formal leadership training participation was fairly low except for practice managers. Leadership was perceived to facilitate development of staff, problem-solving and team working. Preference for future delivery was similar across the six professions with e-modules and small group learning being preferred. Time and financial pressures to undertake courses were common barriers for professionals. Leadership is key to improve quality, safety and efficiency of care and help deliver innovative services and transformative change. To date, leadership provision for primary care professionals has typically been patchy, uni-disciplinary in focus and undertaken outwith work environments. Future development must reflect needs of busy primary care professionals and the reality of team working to deliver integrated services at local level.

Nurse-delivered counselling intervention for parental HIV disclosure: results from a pilot randomized controlled trial in China.

Science.gov (United States)

Simoni, Jane M; Yang, Joyce P; Shiu, Cheng-Shi; Chen, Wei-Ti; Udell, Wadiya; Bao, Meijuan; Zhang, Lin; Lu, Hongzhou

2015-06-01

The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. The study occurred at an outpatient HIV primary care centre in Shanghai, China. Participants were 20 HIV-positive outpatients with at least one child (13-25 years old) who was unaware of the parent's HIV diagnosis. The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy, and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a 'large' effect size. Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy.

Teachers' Knowledge and Confidence for Promoting Positive Mental Health in Primary School Communities

Science.gov (United States)

Askell-Williams, Helen; Lawson, Michael J.

2013-01-01

This paper reports an investigation into Australian primary school teachers' knowledge and confidence for mental health promotion. Questionnaires were delivered to 1397 teachers. In-depth interviews were held with 37 teachers. Quantitative results showed that half to two thirds of teachers felt efficacious and knowledgeable about selected…

A dynamic allocation mechanism of delivering capacity in coupled networks

International Nuclear Information System (INIS)

Du, Wen-Bo; Zhou, Xing-Lian; Zhu, Yan-Bo; Zheng, Zheng

2015-01-01

Traffic process is ubiquitous in many critical infrastructures. In this paper, we introduce a mechanism to dynamically allocate the delivering capacity into the data-packet traffic model on the coupled Internet autonomous-system-level network of South Korea and Japan, and focus on its effect on the transport efficiency. In this mechanism, the total delivering capacity is constant and the lowest-load node will give one unit delivering capacity to the highest-load node at each time step. It is found that the delivering capacity of busy nodes and non-busy nodes can be well balanced and the effective betweenness of busy nodes with interconnections is significantly reduced. Consequently, the transport efficiency such as average traveling time and packet arrival rate is remarkably improved. Our work may shed some light on the traffic dynamics in coupled networks.

Delivering migrant workers' remittances

OpenAIRE

Ballard, Roger

2004-01-01

As globalization has led to ever higher levels of labour mobility, so the volume of funds remitted to their families by workers employed in countries far distant from their homes has increased by leaps and bounds. The total volume of such transfers currently amounts to over $100 billion per annum, the greater part of which flows from economically advanced regions in the West and North to developing countries in the East and South. Delivering those funds swiftly, reliably and cheaply to relati...

The side-to-side fashion for individual distal coronary anastomosis using venous conduit.

Science.gov (United States)

Kato, Takayoshi; Tsunekawa, Tomohiro; Motoji, Yusuke; Hirakawa, Akihiro; Okawa, Yasuhide; Tomita, Shinji

2017-04-01

Regarding to coronary artery bypass grafting (CABG), the end-to-side anastomosis (ESA) has been performed as a gold standard. Recently, the effectiveness of the distal side-to-side anastomosis (SSA) in CABG using internal mammary artery has been reported. The benefit of SSA comparing to ESA also has been disclosed by computing simulation. However, use of SSA by venous conduit for individual CABG has not been reported. In this study, we investigated feasibility of SSA. From January 2013 to October 2014, we conducted 114 CABGs. There were 92 venous distal anastomoses without sequential anastomotic site (61 SSA and 31 ESA). The anastomosis was evaluated before discharge and at 1 year after the procedure by angiography or multi-detector row computed tomographic coronary angiography. The median values for time to anastomosis were 13 min in the two group (p = 0.89). There was no revision of anastomosis in both groups. Additional stitches for hemostasis were required significantly less in SSA than ESA (18.0 vs 45.2 %, respectively, p fashion is easy to perform and maybe beneficial in blood flow pattern.

Work-Related Depression in Primary Care Teams in Brazil.

Science.gov (United States)

da Silva, Andréa Tenório Correia; Lopes, Claudia de Souza; Susser, Ezra; Menezes, Paulo Rossi

2016-11-01

To identify work-related factors associated with depressive symptoms and probable major depression in primary care teams. Cross-sectional study among primary care teams (community health workers, nursing assistants, nurses, and physicians) in the city of São Paulo, Brazil (2011-2012; n = 2940), to assess depressive symptoms and probable major depression and their associations with job strain and other work-related conditions. Community health workers presented higher prevalence of probable major depression (18%) than other primary care workers. Higher odds ratios for depressive symptoms or probable major depression were associated with longer duration of employment in primary care; having a passive, active, or high-strain job; lack of supervisor feedback regarding performance; and low social support from colleagues and supervisors. Observed levels of job-related depression can endanger the sustainability of primary care programs. Public Health implications. Strategies are needed to deliver care to primary care workers with depression, facilitating diagnosis and access to treatment, particularly in low- and middle-income countries. Preventive interventions can include training managers to provide feedback and creating strategies to increase job autonomy and social support at work.

Multicriteria Gain Tuning for Rotorcraft Flight Controls (also entitled The Development of the Conduit Advanced Control System Design and Evaluation Interface with a Case Study Application Fly by Wire Helicopter Design)

Science.gov (United States)

Biezad, Daniel

1997-01-01

Handling qualities analysis and control law design would seem to be naturally complimenting components of aircraft flight control system design, however these two closely coupled disciplines are often not well integrated in practice. Handling qualities engineers and control system engineers may work in separate groups within an aircraft company. Flight control system engineers and handling quality specialists may come from different backgrounds and schooling and are often not aware of the other group's research. Thus while the handling qualities specifications represent desired aircraft response characteristics, these are rarely incorporated directly in the control system design process. Instead modem control system design techniques are based on servo-loop robustness specifications, and simple representations of the desired control response. Comprehensive handling qualities analysis is often left until the end of the design cycle and performed as a check of the completed design for satisfactory performance. This can lead to costly redesign or less than satisfactory aircraft handling qualities when the flight testing phase is reached. The desire to integrate the fields of handling qualities and flight,control systems led to the development of the CONDUIT system. This tool facilitates control system designs that achieve desired handling quality requirements and servo-loop specifications in a single design process. With CONDUIT, the control system engineer is now able to directly design and control systems to meet the complete handling specifications. CONDUIT allows the designer to retain a preferred control law structure, but then tunes the system parameters to meet the handling quality requirements.

Ecoulements intermittents de gaz et de liquide en conduite verticale Intermittent Gas and Liquid Flows in a Vertical Pipe.

Directory of Open Access Journals (Sweden)

Line A.

2006-11-01

Full Text Available Le modèle présenté ici permet la pré-détermination du gradient de pression, du taux global de gaz, et de grandeurs caractéristiques de l'intermittence, dans un écoulement à poches et bouchons en conduite verticale. L'écriture des lois de conservation en moyenne phasique conditionnelle conduit à la définition d'une cellule moyenne équivalente. La fermeture du modèle est assurée par des lois de contrainte de cisaillement film-paroi, film-poche, bouchon-paroi, par une loi d'arrachage du gaz au culot de la poche, une loi de glissement du gaz dans les bouchons et par une loi de la vitesse moyenne de propagation des fronts de poches. Le calibrage et la qualification du modèle s'appuient sur deux banques de données, dont l'une a été obtenue avec des fluides pétroliers dans des conditions proches des situations industrielles (boucle diphasique de Boussens. The model described here can be used to predetermine the pressure gradient, the overall gas rate and the characteristic intermittence magnitudes in pocket and slug flow in a vertical pipe. The way governing equations in the conditional phase average are written defines an equivalent average cell. The model is closed by film/wall, film/pocket and slug/wall shear-stress laws, by a pulloff law for the gas at the bottom of the pocket, a slippage law for the gas in the slugs, and a mean propagation velocity law for the pocket fronts. The calibration and qualification of the model are based on two data banks, one of which contains data on petroleum fluids under conditions close to industrial situations (two-phase loop at Boussens.

Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care.

Science.gov (United States)

Berkowitz, Callie; Allen, Deborah H; Tenhover, Jennifer; Zullig, Leah L; Ragsdale, John; Fischer, Jonathan E; Pollak, Kathryn I; Koontz, Bridget F

2017-07-14

Long-term care for head and neck cancer (HNC) survivors is complex and requires coordination among multiple providers. Clinical practice guidelines highlight the role of primary care providers (PCPs) in screening for secondary cancer/recurrence, assessment of late/long-term side effects, and referrals for appropriate specialty management of toxicity. However, these responsibilities may be difficult to meet within the scope of primary care practice. We conducted this study to explore preferences, comfort, and knowledge of PCPs in the care of HNC survivors. We piloted a 40-item web-based survey developed with oncologist and PCP input targeted for family medicine and internal medicine providers. Responses were collected within a single university health system over 2 months. PCPs (n = 28; RR = 11.3%) were interested in learning about health promotion after cancer treatment (89%) and generally agree that their current practice patterns address healthy lifestyle behaviors (82%). However, only 32% of PCPs felt confident they could manage late/long-term side effects of chemotherapy, radiation, or surgery. Only 29% felt confident they could provide appropriate cancer screening. Looking at shared care responsibilities with oncology providers, PCPs perceived being responsible for 30% of care in the first year after treatment and 81% of care after 5 years. Seventy-one percent of PCPs agreed that oncologists provided them necessary information, yet 32% of PCPs found it difficult to coordinate with cancer providers. While these PCPs perceive increased care responsibility for long-term survivors, most are uncomfortable screening for recurrence and managing late/long-term side effects. Education and mutual coordination between PCPs and oncology providers may improve survivor care.

Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit

OpenAIRE

Ivbijaro, GO; Kolkiewicz, LA; McGee, LSF; Gikunoo, M

2008-01-01

Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF).

How natural capital delivers ecosystem services

NARCIS (Netherlands)

Smith, A.C.; Harrison, P.A.; Pérez Soba, M.; Archaux, F.; Blicharska, M.; Egoh, B.N.; Erős, T.; Fabrega Domenech, N.; György, I.; Haines-Young, R.; Li, S.; Lommelen, E.; Meiresonne, L.; Miguel Ayala, L.; Mononen, L.; Simpson, G.; Stange, E.; Turkelboom, F.; Uiterwijk, M.; Veerkamp, C.J.; Wyllie de Echeverria, V.

2017-01-01

There is no unified evidence base to help decision-makers understand how the multiple components of natural capital interact to deliver ecosystem services. We systematically reviewed 780 papers, recording how natural capital attributes (29 biotic attributes and 11 abiotic factors) affect the

Religion in Nigerian President Olusegun Obasanjo's Political ...

African Journals Online (AJOL)

Language on the other hand provides the conduit for performance and expression of religion and religiousness; as well as political ideologies. The data consists of Obasanjo's speeches delivered on 29th May 1999 and 2003. Working within the tenets of Critical Discourse Analysis, the paper interrogates the trajectory in ...

Long-term outcomes of a cell phone-delivered intervention for smokers living with HIV/AIDS.

Science.gov (United States)

Gritz, Ellen R; Danysh, Heather E; Fletcher, Faith E; Tami-Maury, Irene; Fingeret, Michelle Cororve; King, Rachel Marks; Arduino, Roberto C; Vidrine, Damon J

2013-08-01

People living with human immunodeficiency virus (HIV)/AIDS (PLWHA) have a substantially higher prevalence of cigarette smoking compared to the general population. In addition, PLWHA are particularly susceptible to the adverse health effects of smoking. Our primary objective was to design and test the efficacy over 12 months of a smoking cessation intervention targeting PLWHA. Participants were enrolled from an urban HIV clinic with a multiethnic and economically disadvantaged patient population. Participants received smoking cessation treatment either through usual care (UC) or counseling delivered by a cell phone intervention (CPI). The 7-day point prevalence abstinence was evaluated at 3, 6, and 12 months using logistic regression and generalized linear mixed models. We randomized 474 HIV-positive smokers to either the UC or CPI group. When evaluating the overall treatment effect (7-day abstinence outcomes from 3-, 6-, and 12-month follow-ups), participants in the CPI group were 2.41 times (P = .049) more likely to demonstrate abstinence compared to the UC group. The treatment effect was strongest at the 3-month follow-up (odds ratio = 4.3, P .05). Cell phone-delivered smoking cessation treatment has a positive impact on abstinence rates compared to a usual care approach. Future research should focus on strategies for sustaining the treatment effect in the long term.

An exploratory trial of the effectiveness of an enhanced consultative approach to delivering speech and language intervention in schools.

Science.gov (United States)

Mecrow, Carol; Beckwith, Jennie; Klee, Thomas

2010-01-01

Increased demand for access to specialist services for providing support to children with speech, language and communication needs prompted a local service review of how best to allocate limited resources. This study arose as a consequence of a wish to evaluate the effectiveness of an enhanced consultative approach to delivering speech and language intervention in local schools. The purpose was to evaluate an intensive speech and language intervention for children in mainstream schools delivered by specialist teaching assistants. A within-subjects, quasi-experimental exploratory trial was conducted, with each child serving as his or her own control with respect to the primary outcome measure. Thirty-five children between the ages of 4;2 and 6;10 (years; months) received speech and/or language intervention for an average of four 1-hour sessions per week over 10 weeks. The primary outcome measure consisted of change between pre- and post-intervention scores on probe tasks of treated and untreated behaviours summed across the group of children, and maintenance probes of treated behaviours. Secondary outcome measures included standardized tests (Clinical Evaluation of Language Fundamentals - Preschool(UK) (CELF-P(UK)); Diagnostic Evaluation of Articulation and Phonology (DEAP)) and questionnaires completed by parents/carers and school staff before and after the intervention period. The primary outcome measure showed improvement over the intervention period, with target behaviours showing a significantly larger increase than control behaviours. The gains made on the target behaviours as a result of intervention were sustained when reassessed 3-12 months later. These findings were replicated on a second set of targets and controls. Significant gains were also observed on CELF-Preschool(UK) receptive and expressive language standard scores from pre- to post-intervention. However, DEAP standard scores of speech ability did not increase over the intervention period

Boosting restraint norms: a community-delivered campaign to promote booster seat use.

Science.gov (United States)

Bryant-Stephens, Tyra; Garcia-Espana, J Felipe; Winston, Flaura K

2013-01-01

The objective of this study was to evaluate the effectiveness of a theoretically grounded community-delivered marketing campaign to promote belt-positioning booster seat (BPB) use among vulnerable populations when disseminated by community members. A prospective, nonrandomized community intervention trial was conducted to evaluate the "Boosting Restraint Norms" social marketing campaign delivered by community partners in Norristown, Pennsylvania (intervention community), between October 2008 and November 2008. York, Pennsylvania, served as the comparison community. In total, 800 vehicles with 822 children aged 4 to 7 years were observed for BPB use, the primary outcome of interest, at baseline (September 2008) and at 6 months after intervention (April 2009). During the study period, a 28 percent increase in the prevalence of BPB use at 6 months was observed in the intervention community with no change in the prevalence of BPB use in the comparison community. After adjustment for child age and gender, vehicle type, driver gender, and driver level, BPB use increased from 39 to 50 percent in the intervention community. The "Boosting Restraint Norms" social marketing campaign, distributed through community organizations combined with caregiver education and a one-time free distribution of BPBs, was effective in increasing BPB use. This study demonstrates the feasibility of utilizing community organizations with established audiences to spread the "No Regrets" messaging of the campaign in the community. This study also indicates that spreading evidence-based messages in this manner may effectively change behavior in populations that are often hard to reach. Future studies are needed in which this methodology is tested in additional communities and rural settings.

Determining the Performances of Pre-Service Primary School Teachers in Problem Posing Situations

Science.gov (United States)

Kilic, Cigdem

2013-01-01

This study examined the problem posing strategies of pre-service primary school teachers in different problem posing situations (PPSs) and analysed the issues they encounter while posing problems. A problem posing task consisting of six PPSs (two free, two structured, and two semi-structured situations) was delivered to 40 participants.…

Guided parent-delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3- to 5-year follow-up.

Science.gov (United States)

Brown, Alexandra; Creswell, Cathy; Barker, Chris; Butler, Stephen; Cooper, Peter; Hobbs, Catherine; Thirlwall, Kerstin

2017-06-01

Brief guided parent-delivered cognitive behaviour therapy (CBT) has been developed to meet the demand for non-intensive interventions for children with anxiety disorders, and initial trials have shown it to be effective for children with a range of anxiety disorders. This study examined outcomes 3-5 years post-treatment. A long-term follow-up (LTFU) cohort study. Families who (1) completed at least 50% of allocated treatment sessions of guided parent-delivered CBT for childhood anxiety as part of a randomized control trial (RCT), (2) provided consent to be recontacted, (3) had not received further mental health interventions, and (4) were contactable were invited to take part. Fifty-seven families (29% of the original sample) completed structured diagnostic interviews on average 50 months after treatment (39-61 months). At LTFU, 79% of the assessed children who had received the treatment no longer met criteria for their primary diagnosis, 63% did not meet criteria for any anxiety disorder, and 61% did not meet criteria for any DSM-IV disorder. Treatment gains were mostly maintained (60%), and some children went on to recover during the follow-up period without additional input from mental health services (19%). Few young people had relapsed since their last assessment (12%). Mean scores on standardized symptom questionnaires were within the normal range. Children who recovered from anxiety disorders following brief guided parent-delivered CBT typically maintained good outcomes and few relapsed. These findings suggest that this is a viable first-line, low-intensity treatment approach. This study only included a small subsample of those in the original RCT (29%), and more information is required about those who dropped out of treatment and those who required further intervention immediately after treatment. Treatment gains from brief guided parent-delivered cognitive behaviour therapy for children with anxiety are maintained for most children 3-5 years later. The

Characterisation of karst hydrogeology in Western Ireland using geophysical and hydraulic modelling techniques

Directory of Open Access Journals (Sweden)

T. McCormack

2017-04-01

New hydrological insights for the region: Results suggest two primary pathways of northwards groundwater flow in the catchment, a fault which discharges offshore, and a ∼2 m diameter karst conduit running underneath the catchment lowlands against the prevailing geological dip. This conduit, whose existence was suspected but never confirmed, links a large ephemeral lake to the coast where it discharges intertidally. Hydraulic modelling indicates that the conduit network is a complex mixture of constrictions with multiple inlets and outlets. Two ephemeral lakes are shown to be hydraulically discontinuous, either drained separately or linked by a low pressure channel.

Heat exchanger

International Nuclear Information System (INIS)

Drury, C.R.

1988-01-01

A heat exchanger having primary and secondary conduits in heat-exchanging relationship is described comprising: at least one serpentine tube having parallel sections connected by reverse bends, the serpentine tube constituting one of the conduits; a group of open-ended tubes disposed adjacent to the parallel sections, the open-ended tubes constituting the other of the conduits, and forming a continuous mass of contacting tubes extending between and surrounding the serpentine tube sections; and means securing the mass of tubes together to form a predetermined cross-section of the entirety of the mass of open-ended tubes and tube sections

Primary care in a new era: disillusion and dissolution?.

Science.gov (United States)

Sandy, Lewis G; Schroeder, Steven A

2003-02-04

The current dilemmas in primary care stem from 1) the unintended consequences of forces thought to promote primary care and 2) the "disruptive technologies of care" that attack the very function and concept of primary care itself. This paper suggests that these forces, in combination with "tiering" in the health insurance market, could lead to the dissolution of primary care as a single concept, to be replaced by alignment of clinicians by economic niche. Evidence already exists in the marketplace for both tiering of health insurance benefits and corresponding practice changes within primary care. In the future, primary care for the top tier will cater to the affluent as "full-service brokers" and will be delivered by a wide variety of clinicians. The middle tier will continue to grapple with tensions created by patient demand and bureaucratic systems but will remain most closely aligned to primary care as a concept. The lower tier will become increasingly concerned with community health and social justice. Each primary care specialty will adapt in a unique way to a tiered world, with general internal medicine facing the most challenges. Given this forecast for the future, those concerned about primary care should focus less on workforce issues and more on macro health care financing and organization issues (such as Medicare reform); appropriate training models; and the development of a conception of primary care that emphasizes values and ethos, not just function.

Effectiveness of transdiagnostic Internet cognitive behavioural treatment for mixed anxiety and depression in primary care

NARCIS (Netherlands)

Newby, Jill M; Mewton, Louise; Williams, Alishia D|info:eu-repo/dai/nl/413576493; Andrews, Gavin

BACKGROUND: Internet-delivered cognitive behavioural treatment (iCBT) has been shown to be effective for the combined treatment of depression and anxiety in randomised controlled trials. The degree to which these findings generalise to patients in primary care awaits further investigation. METHODS:

Inefficient charging for delivered gas by local gas distributors

Directory of Open Access Journals (Sweden)

Siniša Bikić

2005-10-01

Full Text Available In this region, especially in Serbia, common belief is that local distributors of gas used by households don’t charge for gas properly. It is suspected that there are two sources for improper ways of gas charging. Local distributors charge for delivered gas only, according to flow rat but not according to gas quality. It is usual that local distributors deliver gas of different quality than one signed in contract. In this work will be considered only one of aspects inefficient charging for delivered gas by local gas distributors, which is connected to variable atmospheric pressure. There is doubt, that local distributors make mistakes during accounting for delivered gas to costumers in regard atmospheric pressure. At the beginning of every investigation, problem has to be located and recognized. Authors are going to collect as much as possible available data, to elaborate and analyze data by scientific methods and to represent conclusions. So, the aim of this work is to diagnose current state and to approve or disapprove above mentioned suspicions. In our region this theme is very interesting, both because of energy efficiency and air pollution control. In this way both consumer and distributor will know, how mush energy they have really spent.

Effectiveness of psychological interventions delivered by non-psychologists on low back pain and disability: a qualitative systematic review.

Science.gov (United States)

Bostick, Geoff P

2017-11-01

Psychological treatments delivered by non-psychologists have been proposed as a way to increase access to care to address important psychological barriers to recovery in people with low back pain (LBP). This review aimed to synthesize randomized controlled trials (RCTs) that assess the effectiveness of psychological interventions delivered by non-psychologists in reducing pain intensity and disability in adults with LBP, compared with usual care. A systematic review without meta-analysis was carried out. Randomized controlled trials including adult patients with all types of musculoskeletal LBP were eligible. Interventions included those based on psychological principles and delivered by non-psychologists. The primary outcomes of interest were self-reported pain intensity and disability. Information sources included Medline, EMBASE, and the Cochrane Central Registrar for Controlled Trials. The Cochrane Collaboration's tool for assessing risk of bias was used for the evaluation of internal validity. There were 1,101 records identified, 159 were assessed for eligibility, 16 were critically appraised, and 11 studies were included. Mild to moderate risk of bias was present in the included studies, with personnel and patient blinding, treatment fidelity, and attrition being the most common sources of bias. Considerable heterogeneity existed for patient population, intervention components, and comparison groups. Although most studies demonstrated statistical and clinical improvements in pain and disability, few were statistically superior to the comparison group. Consistent with the broader psychological literature, psychological interventions delivered by non-psychologists have modest effects on low back pain and disability. Additional high quality research is needed to understand what patients are likely to respond to psychological interventions, the appropriate dose to achieve the desired outcome, the amount of training required to implement psychological

A Decaheme Cytochrome as a Molecular Electron Conduit in Dye-Sensitized Photoanodes

Science.gov (United States)

Hwang, Ee Taek; Sheikh, Khizar; Orchard, Katherine L; Hojo, Daisuke; Radu, Valentin; Lee, Chong-Yong; Ainsworth, Emma; Lockwood, Colin; Gross, Manuela A; Adschiri, Tadafumi; Reisner, Erwin; Butt, Julea N; Jeuken, Lars J C

2015-01-01

In nature, charge recombination in light-harvesting reaction centers is minimized by efficient charge separation. Here, it is aimed to mimic this by coupling dye-sensitized TiO2 nanocrystals to a decaheme protein, MtrC from Shewanella oneidensis MR-1, where the 10 hemes of MtrC form a ≈7-nm-long molecular wire between the TiO2 and the underlying electrode. The system is assembled by forming a densely packed MtrC film on an ultra-flat gold electrode, followed by the adsorption of approximately 7 nm TiO2 nanocrystals that are modified with a phosphonated bipyridine Ru(II) dye (RuP). The step-by-step construction of the MtrC/TiO2 system is monitored with (photo)electrochemistry, quartz-crystal microbalance with dissipation (QCM-D), and atomic force microscopy (AFM). Photocurrents are dependent on the redox state of the MtrC, confirming that electrons are transferred from the TiO2 nanocrystals to the surface via the MtrC conduit. In other words, in these TiO2/MtrC hybrid photodiodes, MtrC traps the conduction-band electrons from TiO2 before transferring them to the electrode, creating a photobioelectrochemical system in which a redox protein is used to mimic the efficient charge separation found in biological photosystems. PMID:26180522

Nurse-delivered counselling intervention for parental HIV disclosure: Results from a pilot randomized controlled trial in China

Science.gov (United States)

Simoni, Jane M.; Yang, Joyce P.; Shiu, Cheng-Shi; Chen, Wei-ti; Udell, Wadiya; Bao, Meijuan; Zhang, Lin; Lu, Hongzhou

2016-01-01

Objective The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. Design This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. Setting The study occurred at an outpatient HIV primary care centre in Shanghai, China. Participants Participants were 20 HIV-positive outpatients with at least one child (13–25 years old) who was unaware of the parent’s HIV diagnosis. Intervention The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. Main outcome measure(s) Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. Results In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a ‘large’ effect size. Conclusion Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy. PMID:26049544

Delivered Pricing, FOB Pricing, and Collusion in Spatial Markets

OpenAIRE

Maria Paz Espinosa

1992-01-01

This article examines price discrimination and collusion in spatial markets. The problem is analyzed in the context of a repeated duopoly game. I conclude that the prevailing pricing systems depend on the structural elements of the market. Delivered pricing systems emerge in equilibrium in highly monopolistic and highly competitive industries, while FOB is used in intermediate market structures. The fact driving this result is that delivered pricing policies allow spatial price discrimination...

Digital Media in Primary Schools: Literacy or Technology? Analyzing Government and Media Discourses

Science.gov (United States)

Pereira, Sara; Pereira, Luís

2015-01-01

This article examines the political and the media discourses concerning the Portuguese governmental program responsible for delivering a laptop named "Magalhães" to all primary school children. The analysis is based on the official documents related to the launch and development of the initiative as well as the press coverage of this…

Thermo-Hydraulic behaviour of dual-channel superconducting Cable-In-Conduit Conductors for ITER

International Nuclear Information System (INIS)

Renard, B.

2006-09-01

In an effort to optimise the cryogenics of large superconducting coils for fusion applications (ITER), dual channel Cable-In-Conduit Conductors (CICC) are designed with a central channel spiral to provide low hydraulic resistance and faster helium circulation. The qualitative and economic rationale of the conductor central channel is here justified to limit the superconductor temperature increase, but brings more complexity to the conductor cooling characteristics. The pressure drop of spirals is experimentally evaluated in nitrogen and water and an explicit hydraulic friction model is proposed. Temperatures in the cable must be quantified to guarantee superconductor margin during coil operation under heat disturbance and set adequate inlet temperature. Analytical one-dimensional thermal models, in steady state and in transient, allow to better understand the thermal coupling of CICC central and annular channels. The measurement of a heat transfer characteristic space and time constants provides cross-checking experimental estimations of the internal thermal homogenization. A simple explicit model of global inter-channel heat exchange coefficient is proposed. The risk of thermosyphon between the two channels is considered since vertical portions of fusion coils are subject to gravity. The new hydraulic model, heat exchange model and gravitational risk ratio allow the thermohydraulic improvement of CICC central spirals. (author)

Study on the dynamic behavior of a current in cable-in-conduit conductors by using self magnetic field measurements

Energy Technology Data Exchange (ETDEWEB)

Obana, Tetsuhiro, E-mail: obana.tetsuhiro@LHD.nifs.ac.jp [National Institute for Fusion Science, 322-6 Oroshi, Toki 509-5292, Gifu (Japan); Takahata, Kazuya; Hamaguchi, Shinji; Imagawa, Shinsaku; Mito, Toshiyuki [National Institute for Fusion Science, 322-6 Oroshi, Toki 509-5292, Gifu (Japan); Kizu, Kaname; Murakami, Haruyuki; Yoshida, Kiyoshi [Japan Atomic Energy Agency, Ibaraki (Japan)

2011-10-15

In order to understand the current behavior inside a cable-in-conduit conductor (CICC), self magnetic field measurements on the CICC were conducted. A prototype NbTi CICC, the configuration of which is a racket shape, for JT-60SA EF coil was used as a short conductor sample. By using Hall sensors arranged around the short conductor sample, the variation in the self magnetic field was measured. Taking into account the measurements, the current behavior inside the CICC was analyzed by using analytical models consisting of line currents. The analytical results indicate that the current distribution in the cross-section of the CICC would be non-uniform before a normal propagation, and the current distribution would be improved after the normal propagation.

Risk of second primary lung cancer in women after radiotherapy for breast cancer

International Nuclear Information System (INIS)

Grantzau, Trine; Thomsen, Mette Skovhus; Væth, Michael; Overgaard, Jens

2014-01-01

Background: Several epidemiological studies have reported increased risks of second lung cancers after breast cancer irradiation. In this study we assessed the effects of the delivered radiation dose to the lung and the risk of second primary lung cancer. Methods: We conducted a nested case–control study of second lung cancer in a population based cohort of 23,627 early breast cancer patients treated with post-operative radiotherapy from 1982 to 2007. The cohort included 151 cases diagnosed with second primary lung cancer and 443 controls. Individual dose-reconstructions were performed and the delivered dose to the center of the second lung tumor and the comparable location for the controls were estimated, based on the patient specific radiotherapy charts. Results: The median age at breast cancer diagnosis was 54 years (range 34–74). The median time from breast cancer treatment to second lung cancer diagnosis was 12 years (range 1–26 years). 91% of the cases were categorized as ever smokers vs. 40% among the controls. For patients diagnosed with a second primary lung cancer five or more years after breast cancer treatment the rate of lung cancer increased linearly with 8.5% per Gray (95% confidence interval = 3.1–23.3%; p < 0.001). This rate was enhanced for ever smokers with an excess rate of 17.3% per Gray (95% CI = 4.5–54%; p < 0.005). Conclusions: Second lung cancer after radiotherapy for early breast cancer is associated with the delivered dose to the lung. Although the absolute risk is relative low, the growing number of long-time survivors after breast cancer treatment highlights the need for advances in normal tissue sparing radiation techniques

Toward a strategy of patient-centered access to primary care.

Science.gov (United States)

Berry, Leonard L; Beckham, Dan; Dettman, Amy; Mead, Robert

2014-10-01

Patient-centered access (PCA) to primary care services is rapidly becoming an imperative for efficiently delivering high-quality health care to patients. To enhance their PCA-related efforts, some medical practices and health systems have begun to use various tactics, including team-based care, satellite clinics, same-day and group appointments, greater use of physician assistants and nurse practitioners, and remote access to health services. However, few organizations are addressing the PCA imperative comprehensively by integrating these various tactics to develop an overall PCA management strategy. Successful integration means taking into account the changing competitive and reimbursement landscape in primary care, conducting an evidence-based assessment of the barriers and benefits of PCA implementation, and attending to the particular needs of the institution engaged in this important effort. This article provides a blueprint for creating a multifaceted but coordinated PCA strategy-one aimed squarely at making patient access a centerpiece of how health care is delivered. The case of a Wisconsin-based health system is used as an illustrative example of how other institutions might begin to conceive their fledgling PCA strategies without proposing it as a one-size-fits-all model. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Literature Review: Double-Barrelled Wet Colostomy (One Stoma) versus Ileal Conduit with Colostomy (Two Stomas).

Science.gov (United States)

Gan, Jason; Hamid, Rizwan

2017-01-01

The aim of this literature review was to analyse the advantages and disadvantages of a traditional ileal conduit (IC) with separate colostomy technique compared to the outcomes of a double-barrelled wet colostomy (DBWC) technique. The former technique results in the formation of two stomas, and the latter results in the formation of one stoma. PubMed was searched electronically for articles on DBWC. Fifteen articles were retrieved and of them 13 were included in the literature review (350 patients). Of the articles, 3 directly compared DBWC to IC with colostomy. Review of 13 DBWC articles demonstrated perioperative mortality ranging between 0 and 11.1% and postoperative complications ranging from 0 to 100%. Three of the studies directly compared DBWC to IC with colostomy; median operating times and length of stay were shorter in DBWC patients (p colostomy technique, as it requires only one stoma. This literature review supports the use of the technically less challenging DBWC technique as a viable alternative to the traditional IC with colostomy technique. © 2016 S. Karger AG, Basel.

Mindfulness Training in Primary Schools Decreases Negative Affect and Increases Meta-Cognition in Children

Science.gov (United States)

Vickery, Charlotte E.; Dorjee, Dusana

2016-01-01

Studies investigating the feasibility and impact of mindfulness programs on emotional well-being when delivered by school teachers in pre-adolescence are scarce. This study reports the findings of a controlled feasibility pilot which assessed acceptability and emotional well-being outcomes of an 8-week mindfulness program (Paws b) for children aged 7–9 years. The program was delivered by school teachers within a regular school curriculum. Emotional well-being was measured using self-report questionnaires at baseline, post-training and 3 months follow-up, and informant reports were collected at baseline and follow-up. Seventy one participants aged 7–9 years were recruited from three primary schools in the UK (training group n = 33; control group n = 38). Acceptability of the program was high with 76% of children in the training group reporting ‘liking’ practicing mindfulness at school, with a strong link to wanting to continue practicing mindfulness at school (p mindfulness and emotion regulation scores from baseline to post-training (p = 0.038) and baseline to follow-up (p = 0.033). Findings from this study provide initial evidence that the Paws b program in children aged 7–9 years (a) can be feasibly delivered by primary school teachers as part of the regular curriculum, (b) is acceptable to the majority of children, and (c) may significantly decrease negative affect and improve meta-cognition. PMID:26793145

ProSeal laryngeal mask airway improves oxygenation when used as a conduit prior to laryngoscope guided intubation in bariatric patients

Directory of Open Access Journals (Sweden)

Aparna Sinha

2013-01-01

Full Text Available Background: The primary objective of this study was to compare the effect of ventilation using the ProSeal TM laryngeal mask airway (PLMA with facemask and oropharyngeal airway (FM, prior to laryngoscopy, on arterial oxygenation in morbidly obese patients undergoing bariatric surgery. Methods: Forty morbidly obese patients were randomly recruited to either PLMA or FM. After pre-oxygenation (FiO 2 1.0 in the ramp position with continuous positive airway pressure of 10 cm H 2 O for 5 min, anaesthesia was induced. Following loss of jaw thrust oropharyngeal airway, the FM and PLMA were inserted. On achieving paralysis, volume control ventilation with PEEP (5 cm H 2 O was initiated. The difficulty in mask ventilation (DMV in FM, number of attempts at PLMA and laryngoscopy were graded (Cormack and Lehane in all patients. Time from onset of laryngoscopy to endotracheal tube confirmation was recorded. Hypoxia was defined as mild (SpO 2 ≤95%, moderate (SpO 2 ≤90% and severe (SpO 2 ≤85%. Results: Significant rise in pO 2 was observed within both groups ( P=0.001, and this was significantly higher in the PLMA ( P=0.0001 when compared between the groups. SpO 2 ≥ 90% ( P=0.018 was seen in 19/20 (95% patients in PLMA and 13/20 (65% in FM at confirmation of tracheal tube. A strong association was found between DMV and Cormack Lehane in the FM group and with number of attempts in the PLMA group. No adverse events were observed. Conclusion: ProSeal TM laryngeal mask airway as conduit prior to laryngoscopy in morbidly obese patients seems effective in increasing oxygen reserves, and can be suggested as a routine airway management technique when managing the airway in the morbidly obese.

Glacier surge mechanism based on linked cavity configuration of the basal water conduit system

Science.gov (United States)

Kamb, Barclay

1987-08-01

Based on observations of the 1982-1983 surge of Variegated Glacier, Alaska, a model of the surge mechanism is developed in terms of a transition from the normal tunnel configuration of the basal water conduit system to a linked cavity configuration that tends to restrict the flow of water, resulting in increased basal water pressures that cause rapid basal sliding. The linked cavity system consists of basal cavities formed by ice-bedrock separation (cavitation), ˜1 m high and ˜10 m in horizontal dimensions, widely scattered over the glacier bed, and hydraulically linked by narrow connections where separation is minimal (separation gap ≲ 0.1 m). The narrow connections, called orifices, control the water flow through the conduit system; by throttling the flow through the large cavities, the orifices keep the water flux transmitted by the basal water system at normal levels even though the total cavity cross-sectional area (˜200 m2) is much larger than that of a tunnel system (˜10 m2). A physical model of the linked cavity system is formulated in terms of the dimensions of the "typical" cavity and orifice and the numbers of these across the glacier width. The model concentrates on the detailed configuration of the typical orifice and its response to basal water pressure and basal sliding, which determines the water flux carried by the system under given conditions. Configurations are worked out for two idealized orifice types, step orifices that form in the lee of downglacier-facing bedrock steps, and wave orifices that form on the lee slopes of quasisinusoidal bedrock waves and are similar to transverse "N channels." The orifice configurations are obtained from the results of solutions of the basal-sliding-with-separation problem for an ice mass constituting of linear half-space of linear rheology, with nonlinearity introduced by making the viscosity stress-dependent on an intuitive basis. Modification of the orifice shapes by melting of the ice roof due to

Primary Care Practice Transformation and the Rise of Consumerism.

Science.gov (United States)

Shrank, William H

2017-04-01

Americans are increasingly demanding the same level of service in healthcare that they receive in other services and products that they buy. This rise in consumerism poses challenges for primary care physicians as they attempt to transform their practices to succeed in a value-based reimbursement landscape, where they are rewarded for managing costs and improving the health of populations. In this paper, three examples of consumer-riven trends are described: retail healthcare, direct and concierge care, and home-based diagnostics and care. For each, the intersection of consumer-driven care and the goals of value-based primary care are explored. If the correct payment and connectivity enablers are in place, some examples of consumer-driven care are well-positioned to support primary care physicians in their mission to deliver high-quality, efficient care for the populations they serve. However, concerns about access and equity make other trends less consistent with that mission.

Delivering construction projects using innovative building technologies

CSIR Research Space (South Africa)

Ampofo-Anti, Naalamkai

2017-07-01

Full Text Available . Figure 1: IBT delivery flowchart Proceedings 11th Built Environment Conference 6 th August – 8 th August 2017 Delivering construction projects using innovative building technologies Durban, South Africa 5. REFERENCES Ampofo-Anti, N...

Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial.

Science.gov (United States)

Butler, Christopher C; Simpson, Sharon A; Hood, Kerenza; Cohen, David; Pickles, Tim; Spanou, Clio; McCambridge, Jim; Moore, Laurence; Randell, Elizabeth; Alam, M Fasihul; Kinnersley, Paul; Edwards, Adrian; Smith, Christine; Rollnick, Stephen

2013-03-19

To evaluate the effect of training primary care health professionals in behaviour change counselling on the proportion of patients self reporting change in four risk behaviours (smoking, alcohol use, exercise, and healthy eating). Cluster randomised trial with general practices as the unit of randomisation. General practices in Wales. 53 general practitioners and practice nurses from 27 general practices (one each at all but one practice) recruited 1827 patients who screened positive for at least one risky behaviour. Behaviour change counselling was developed from motivational interviewing to enable clinicians to enhance patients' motivation to change health related behaviour. Clinicians were trained using a blended learning programme called Talking Lifestyles. Proportion of patients who reported making beneficial changes in at least one of the four risky behaviours at three months. 1308 patients from 13 intervention and 1496 from 14 control practices were approached: 76% and 72% respectively agreed to participate, with 831 (84%) and 996 (92%) respectively screening eligible for an intervention. There was no effect on the primary outcome (beneficial change in behaviour) at three months (362 (44%) v 404 (41%), odds ratio 1.12 (95% CI 0.90 to 1.39)) or on biochemical or biometric measures at 12 months. More patients who had consulted with trained clinicians recalled consultation discussion about a health behaviour (724/795 (91%) v 531/966 (55%), odds ratio 12.44 (5.85 to 26.46)) and intended to change (599/831 (72%) v 491/996 (49%), odds ratio 2.88 (2.05 to 4.05)). More intervention practice patients reported making an attempt to change (328 (39%) v 317 (32%), odds ratio 1.40 (1.15 to 1.70)), a sustained behaviour change at three months (288 (35%) v 280 (28%), odds ratio 1.36 (1.11 to 1.65)), and reported slightly greater improvements in healthy eating at three and 12 months, plus improved activity at 12 months. Training cost £1597 per practice. Training primary

Long-term Outcomes of a Cell Phone–Delivered Intervention for Smokers Living With HIV/AIDS

Science.gov (United States)

Gritz, Ellen R.; Danysh, Heather E.; Fletcher, Faith E.; Tami-Maury, Irene; Fingeret, Michelle Cororve; King, Rachel Marks; Arduino, Roberto C.; Vidrine, Damon J.

2013-01-01

Background. People living with human immunodeficiency virus (HIV)/AIDS (PLWHA) have a substantially higher prevalence of cigarette smoking compared to the general population. In addition, PLWHA are particularly susceptible to the adverse health effects of smoking. Our primary objective was to design and test the efficacy over 12 months of a smoking cessation intervention targeting PLWHA. Methods. Participants were enrolled from an urban HIV clinic with a multiethnic and economically disadvantaged patient population. Participants received smoking cessation treatment either through usual care (UC) or counseling delivered by a cell phone intervention (CPI). The 7-day point prevalence abstinence was evaluated at 3, 6, and 12 months using logistic regression and generalized linear mixed models. Results. We randomized 474 HIV-positive smokers to either the UC or CPI group. When evaluating the overall treatment effect (7-day abstinence outcomes from 3-, 6-, and 12-month follow-ups), participants in the CPI group were 2.41 times (P = .049) more likely to demonstrate abstinence compared to the UC group. The treatment effect was strongest at the 3-month follow-up (odds ratio = 4.3, P .05). Conclusions. Cell phone–delivered smoking cessation treatment has a positive impact on abstinence rates compared to a usual care approach. Future research should focus on strategies for sustaining the treatment effect in the long term. PMID:23704120

Comportement comparé de conduites rigides et flexibles ensouillées au voisinage de sols gelés Comparative Behavior of Rigid and Flexible Pipes Buried in the Vicinity of Frozen Ground

Directory of Open Access Journals (Sweden)

Putot C.

2006-11-01

Full Text Available Au cours des dernières années, les activités pétrolières à terre comme en mer, tant en Alaska qu'au Canada, se sont maintenues à un niveau raisonnable. En octobre 1987, le premier champ pétrolier offshore a été mis en exploitation en mer de Beaufort (Endicott. Bien que l'industrie soit principalement dans une phase d'exploration, des besoins vont progressivement se manifester en matière de lignes de collecte et d'injection. La détermination du tracé de conduites en offshore arctique ainsi que leur dimensionnement nécessite la prise en compte de facteurs très spécifiques : le raclage des glaces dérivantes impose une profondeur minimum d'ensouillage, ce qui accroît, malgré l'isolation des conduites, la proportion de chaleur communiquée au pergélisol (ou permafrost en dégel : les tassements différentiels résultant de la variabilité de composition des sols peuvent provoquer des déformations, voire des instabilités des conduites tout à fait inacceptables. Il est assez intuitif de penser que les conduites flexibles accommoderont plus facilement les mouvements de sol que les rigides. L'objet de cet article est de proposer une méthode d'analyse assez souple permettant de jauger facilement cet avantage. In recent years, onshore and offshore petroleum activities, in both Alaska and Canada, have continued on a reasonable level. In October 1987 the first offshore oil field began production in the Beaufort Sea (Endicott. Although the industry is mainly in an exploration phase, needs will steadily appear with regard to gathering and injection line. . The determination to lay flowlines in offshore arctic areas as well as their sizing require that very specific factors be taken into consideration. Scouring by drifting ice requires a minimum depth of burial. Despite the insulation of pipes, this burial increases the proportion of heat communicated to melting permafrost. The differential compaction resulting from the variability of

Utah Delivers Opportunities for Career Exploration

Science.gov (United States)

Dobson, Kristine; Fischio, Shannon

2006-01-01

Providing information and resources to support career exploration is key to the mission of career and technical education (CTE) in Utah. Utah CTE has responded in a variety of ways to meet the career exploration needs of students of all ages. This article discusses how the career and technical education in Utah delivers opportunities for career…

What influences patients’ acceptance of a blood pressure telemonitoring service in primary care? A qualitative study

Directory of Open Access Journals (Sweden)

Abdullah A

2016-01-01

Full Text Available Adina Abdullah,1 Su May Liew,1 Nik Sherina Hanafi,1 Chirk Jenn Ng,1 Pauline Siew Mei Lai,1 Yook Chin Chia,1 Chu Kiong Loo2 1Department of Primary Care Medicine, Faculty of Medicine, University Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Artificial Intelligence, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia Background: Telemonitoring of home blood pressure (BP is found to have a positive effect on BP control. Delivering a BP telemonitoring service in primary care offers primary care physicians an innovative approach toward management of their patients with hypertension. However, little is known about patients’ acceptance of such service in routine clinical care.Objective: This study aimed to explore patients’ acceptance of a BP telemonitoring service delivered in primary care based on the technology acceptance model (TAM.Methods: A qualitative study design was used. Primary care patients with uncontrolled office BP who fulfilled the inclusion criteria were enrolled into a BP telemonitoring service offered between the period August 2012 and September 2012. This service was delivered at an urban primary care clinic in Kuala Lumpur, Malaysia. Twenty patients used the BP telemonitoring service. Of these, 17 patients consented to share their views and experiences through five in-depth interviews and two focus group discussions. An interview guide was developed based on the TAM. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for analysis.Results: Patients found the BP telemonitoring service easy to use but struggled with the perceived usefulness of doing so. They expressed confusion in making sense of the monitored home BP readings. They often thought about the implications of these readings to their hypertension management and overall health. Patients wanted more feedback from their doctors and

Evaluation of a Telephone-Delivered, Community-Based Collaborative Care Management Program for Caregivers of Older Adults with Dementia.

Science.gov (United States)

Mavandadi, Shahrzad; Wray, Laura O; DiFilippo, Suzanne; Streim, Joel; Oslin, David

2017-09-01

To evaluate whether a community-based, telephone-delivered, brief patient/caregiver-centered collaborative dementia care management intervention is associated with improved caregiver and care recipient (CR) outcomes. Longitudinal program evaluation of a clinical intervention; assessments at baseline and 3- and 6-month follow-up. General community. Caregivers (N = 440) of older, community-dwelling, low-income CRs prescribed a psychotropic medication by a primary care provider who met criteria for dementia and were enrolled in the SUpporting Seniors Receiving Treatment And INtervention (SUSTAIN) program for older adults. Dementia care management versus clinical evaluation only. Perceived caregiving burden and caregiver general health (primary outcomes); CR neuropsychiatric symptoms and caregiver distress in response to CRs' challenging dementia-related behaviors (secondary outcomes). Caregivers were, on average, 64.0 (SD: 11.8) years old and 62.6% provided care for the CR for 20 or more hours per week. The majority of the sample was female (73.2%), non-Hispanic White (90.2%), and spousal caregivers (72.5%). Adjusted longitudinal models of baseline and 3- and 6-month data suggest that compared with caregivers receiving clinical evaluation only, caregivers receiving care management reported greater reductions in burden over time. Subgroup analyses also showed statistically significant reductions in caregiver-reported frequency of CR dementia-related behaviors and caregiver distress in response to those symptoms at 3-month follow-up. A community-based, telephone-delivered care management program for caregivers of individuals with dementia is associated with favorable caregiver and CR-related outcomes. Findings support replication and further research in the impact of tailored, collaborative dementia care management programs that address barriers to access and engagement. Published by Elsevier Inc.

Influence of definitive radiation therapy for primary breast cancer on ability to deliver adjuvant chemotherapy

International Nuclear Information System (INIS)

Lippman, M.E.; Edwards, B.K.; Findlay, P.; Danforth, D.W. Jr.; MacDonald, H.; D'Angelo, T.; Gorrell, C.

1986-01-01

Primary radiotherapy as a means of managing stage I and II breast cancer is receiving increasing attention. In a prospectively randomized trial comparing modified radical mastectomy to lumpectomy followed by definitive radiotherapy, we evaluated whether radiotherapy has a deleterious effect on the ability to administer adjuvant doxorubicin and cyclophosphamide to patients with histologically positive axillary lymph nodes. All patients were treated with an identical regimen, and doses were escalated to the same degree until myelosuppression occurred. There were no significant differences in the amount of chemotherapy administered to either treatment group. Patients in both groups received approximately 100% of the predicted dose of doxorubicin and approximately 117% of the predicted dose of cyclophosphamide. At present, we have no evidence that there are differences in recurrence rates as a function of the quantity of drug received, although longer follow-up is required

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

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Strom Joni L

2010-03-01

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

Ecoulements diphasiques gaz-liquide à poches et à bouchons en conduites Two-Phase Gas-Liquid Slug Flow in Pipes

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Ferschneider G.

2006-11-01

Full Text Available Les écoulements diphasiques gaz-liquide ont été étudiés afin de contribuer à développer des modèles de calculs prédictifs des pertes de charge dans les conduites de production des bruts pétroliers. Les expériences nécessaires ont été réalisées sur la boucle diphasique de Boussens dans les conditions suivantes représentatives des conditions industrielles : diamètre 6 , longueur 120 m, disposition de la conduite horizontale ou faiblement ascendante, couple de fluide gaz naturel-huile légère. Le gradient de pression, le contenu global, et la distribution locale des phases ont été mesurés. Le traitement des équations de conservation phasique intégrées sur la section par différents types de moyennes a permis de développer un modèle cellulaire qui inclue un nombre limité d'équations constitutives nécessaires à sa fermeture. Ce modèle prédétermine convenablement le gradient de pression, le contenu gaz global et la longueur des poches et des bouchons. Two-phase gas-liquid flows were analyzed so as to develop models for prediction of pressure drops in crude-oil production lines. The experiments were performed on the two-phase loop at Boussens under the following representative industrial conditions: 6 diameter, 120 m length, horizontal or slightly rising pipe, couple of fluids natural gas and light oil. The pressure gradient, average content and local phase distribution were measured. Conservation phase equations integrated along the cross-section were processed by different time-averaged operators so as to develop a cellular model including a limited number of constitutive equations required for its closure. This model suitably predetermines the pressure gradient, the average gas content and the length of gas and liquid slug.

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

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Ørner Roderick

2009-01-01

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

Multimorbidity, service organization and clinical decision making in primary care: a qualitative study.

Science.gov (United States)

Bower, Peter; Macdonald, Wendy; Harkness, Elaine; Gask, Linda; Kendrick, Tony; Valderas, Jose M; Dickens, Chris; Blakeman, Tom; Sibbald, Bonnie

2011-10-01

Primary care professionals often manage patients with multiple long-term health conditions, but managing multimorbidity is challenging given time and resource constraints and interactions between conditions. To explore GP and nurse perceptions of multimorbidity and the influence on service organization and clinical decision making. A qualitative interview study with primary care professionals in practices in Greater Manchester, U.K. Interviews were conducted with 15 GPs and 10 practice nurses. Primary care professionals identified tensions between delivering care to meet quality targets and fulfilling the patient's agenda, tensions which are exacerbated in multimorbidity. They were aware of the inconvenience suffered by patients through attendance at multiple clinic appointments when care was structured around individual conditions. They reported difficulties managing patients with multimorbidity in limited consultation time, which led to adoption of an 'additive-sequential' decision-making model which dealt with problems in priority order until consultation resources were exhausted, when further management was deferred. Other challenges included the need for patients to co-ordinate their care, the difficulties of self-management support in multimorbidity and problems of making sense of the relationships between physical and mental health. Doctor and nurse accounts included limited consideration of multimorbidity in terms of the interactions between conditions or synergies between management of different conditions. Primary care professionals identify a number of challenges in care for multimorbidity and adopt a particular model of decision making to deliver care for multiple individual conditions. However, they did not describe specific decision making around managing multimorbidity per se.

An Examination of Peer-Delivered Parenting Skills Programs Across New York State.

Science.gov (United States)

Acri, Mary C; Craig, Nancy; Adler, Josh

2018-03-24

Peers are an important adjunct to the public mental health service system, and are being increasingly utilized across the country as a cost-effective solution to workforce shortages. Despite the tremendous growth of peer-delivered support over the past two decades, it has only been within the past few years that peer programs have been the subject of empirical inquiry. The purpose of this study was to examine the prevalence and characteristics of peer-delivered parenting programs across the New York State public mental health service system. We surveyed 46 family peer organizations across New York State regarding their delivery of structured peer-delivered parenting programs. Thirty-four (76%) completed the questionnaire, and of them, 18 (53%) delivered a parenting program. Subsequent interviews with seven of the 18 organizations revealed peer organizations had been delivering eight unique parenting programs for upwards of two decades. Additionally, organizations offered multiple supports to families to participate. Training, supervision, and issues around fidelity are discussed, as well as the implications of this study for states utilizing a peer workforce.

SU-E-J-21: Advantages of Ultra Fast Radiation Dose Delivering

International Nuclear Information System (INIS)

Feng, Y

2014-01-01

Purpose: For delivering conformed dose to a moving tumor and sparing normal tissue, we presented an innovation that was combined a linear accelerator and a storage ring to generate ultra high dose rate. This innovation allows delivering prescribed dose to a moving target in such a short time period, for an example 0.1 second, during which the displacement of the target could be ignored. Methods: The advantages of this approach were evaluated based on normal tissue sparing, feasibility, accuracy, and time saving in clinical treatment. The target volume reduction with this innovation approach was demonstrated by analyzing the values of GTVs, ITVs, and PTVs obtained from 15 patients who had been diagnosed with malignant neoplasm of lung and treated with SBRT. The processes of SBRT treatment were investigated and advantages of this innovation in improving SBRT lung treatment were evaluated. Results: With the ultra-high dose rate, the target volumes could be reduced by ∼30% to 50%. The innovation combining with IGRT technique could deliver prescribed dose to moving target accurately with simpler procedures than that of adaptive approach. This new approach could reduce the time of guiding treatment by many times. The new technique make a new strategy became feasible that was to deliver the dose to a target when it moved to a desirable location, such as away from critical organs. Conclusion: Combining with IGRT technique, this innovation could significantly improve the accuracy to deliver dose to moving targets with a shorter time than conventional techniques. The innovation opens a door for new strategies to deliver dose to moving targets

Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists.

Science.gov (United States)

Gold, Rinat; Gold, Azgad

2018-02-06

The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery. Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news. Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.

Future of Food : Shaping the Food System to Deliver Jobs

OpenAIRE

Townsend, Robert; Benfica, Rui Manuel; Prasann, Ashesh; Lee, Maria

2017-01-01

Shaping the Food System to Deliver Jobs is the fourth paper in a series on The Future of Food. This paper focuses on how the food system can deliver jobs. It provides a framework for understanding the factors determining the number and quality of jobs in the food system, including inclusion of women and youth. It highlights a set of actions that countries can adopt, adapt, and apply to the...

Palliative radiation in primary squamous cell carcinoma of thyroid: A rare case report

Directory of Open Access Journals (Sweden)

Sushmita Ghoshal

2013-01-01

Full Text Available Primary squamous cell carcinoma of the thyroid is an extremely rare neoplasm with aggressive behavior. Until date, only around 60 cases have been reported in the literature. Primary treatment of the patient is radical surgery. With optimum treatment survival is not more than 6 months in this aggressive malignancy. However in our patient surgery it was not possible because of unresectability of the mass due to encroachment of major vessels. Hence, we have delivered radiotherapy alone, with which effective palliation could be achieved and patient is leading a good quality-of-life for last 1 year.

Plasma hydrogenated cationic detonation nanodiamonds efficiently deliver to human cells in culture functional siRNA targeting the Ewing sarcoma junction oncogene.

Science.gov (United States)

Bertrand, Jean-Rémi; Pioche-Durieu, Catherine; Ayala, Juan; Petit, Tristan; Girard, Hugues A; Malvy, Claude P; Le Cam, Eric; Treussart, François; Arnault, Jean-Charles

2015-03-01

The expression of a defective gene can lead to major cell dysfunctions among which cell proliferation and tumor formation. One promising therapeutic strategy consists in silencing the defective gene using small interfering RNA (siRNA). In previous publications we showed that diamond nanocrystals (ND) of primary size 35 nm, rendered cationic by polyethyleneimine-coating, can efficiently deliver siRNA into cell, which further block the expression of EWS/FLI-1 oncogene in a Ewing sarcoma disease model. However, a therapeutic application of such nanodiamonds requires their elimination by the organism, particularly in urine, which is impossible for 35 nm particles. Here, we report that hydrogenated cationic nanodiamonds of primary size 7 nm (ND-H) have also a high affinity for siRNA and are capable of delivering them in cells. With siRNA/ND-H complexes, we measured a high inhibition efficacy of EWS/FLI-1 gene expression in Ewing sarcoma cell line. Electron microscopy investigations showed ND-H in endocytosis compartments, and especially in macropinosomes from which they can escape before siRNA degradation occurred. In addition, the association of EWS/FLI-1 silencing by the siRNA/ND-H complex with a vincristine treatment yielded a potentiation of the toxic effect of this chemotherapeutic drug. Therefore ND-H appears as a promising delivery agent in anti-tumoral gene therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Delivering service adaptation with 3G technology

NARCIS (Netherlands)

Liotta, A.; Yew, A.; Bohoris, C.; Pavlou, G.; Feridun, M.; Kropf, P.G.; Babin, G.

2002-01-01

Now that 3G technologies have reached their maturity, newly advanced services can be delivered to the mobile user. These include context- aware services, adaptable services and Virtual Home Environment (VHE)-like services. Important research issues relate, however, to managing such services through

The ELT in 2017: The Year of the Primary Mirror

Science.gov (United States)

Cirasuolo, M.; Tamai, R.; Cayrel, M.; Koehler, B.; Biancat Marchet, F..; González, J. C.; Dimmler, M.; Tuti, M.; ELT Team

2018-03-01

The Extremely Large Telescope (ELT) is at the core of ESO's vision to deliver the largest optical and infrared telescope in the world. With its unrivalled sensitivity and angular resolution the ELT will transform our view of the Universe: from exoplanets to resolved stellar populations, from galaxy evolution to cosmology and fundamental physics. This article focuses on one of the most challenging aspects of the entire programme, the 39-metre primary mirror (M1). 2017 was a particularly intense year for M1, the main highlight being the approval by ESO's Council to proceed with construction of the entire mirror. In addition, several contracts have been placed to ensure that the giant primary mirror will be operational at first light.

Churn-annular flow pattern transition in a vertical upward gas-liquid two-phase flow in various conduits

International Nuclear Information System (INIS)

Takenaka, Nobuyuki; Ueda, Tadanobu; Asano, Hitoshi

2008-01-01

Void fraction was measured by neutron radiography for a vertical upward gas-water two-phase flow in a concentric annular tube with and with out a spacer, 4x4 rod bundle with and without a spacer and a tight rod bundle with and without a wrapping wire for various gas and liquid flow rates. The flow patterns of these two-phase flows were determined by the Mishima-Ishii flow pattern map and void fraction was calculated by the Ishii's drift flux model. The predicted values were compared with the experimental results. The void fraction was well predicted by the Mishima-Ishii flow pattern map and the Ishii's drift flux model except the annular flow region with void fraction lower than 0.8 for conduits with small equivalent diameter. A new churn-annular flow pattern transition condition of the void fraction equal to 0.8 was added. The void fraction for the present experimental condition was successful predicted with the new transition model. (author)

Helium flow dynamics and heat transfer in a cable in conduit conductor of superconducting magnets: a review

International Nuclear Information System (INIS)

Vaghela, Hitensinh; Sarkar, Biswanath; Lakhera, Vikas

2016-01-01

Superconducting (SC) magnets with Cable in Conduit Conductor (CICC) winding, cooled by helium at 4 K temperature are employed for many applications which require high magnetic field and high current densities. The construction of CICC aims to maintain superconductivity state by optimization of various parameters, i.e., thermal stability, ratio of normal conductor to superconductor material, mechanical strength, low hydraulic impedance, current density, magnetic field, etc. The cryogenic thermal stability of the CICC is of prime importance for the safe, stable and reliable operation of SC magnets. The prediction of thermal and hydraulic behaviour of CICC in large SC magnets is difficult due to the complex geometry, variation of fluid properties, various heat in-flux incidences over the long length of CICC and a complex heat transport phenomenon. A systematic review of the thermal and hydraulic studies of CICC has been presented in the paper highlighting the challenges and opportunities for further improvement in its design and performance. (author)

Self-targeting of TNF-releasing cancer cells in preclinical models of primary and metastatic tumors.

Science.gov (United States)

Dondossola, Eleonora; Dobroff, Andrey S; Marchiò, Serena; Cardó-Vila, Marina; Hosoya, Hitomi; Libutti, Steven K; Corti, Angelo; Sidman, Richard L; Arap, Wadih; Pasqualini, Renata

2016-02-23

Circulating cancer cells can putatively colonize distant organs to form metastases or to reinfiltrate primary tumors themselves through a process termed "tumor self-seeding." Here we exploit this biological attribute to deliver tumor necrosis factor alpha (TNF), a potent antitumor cytokine, directly to primary and metastatic tumors in a mechanism that we have defined as "tumor self-targeting." For this purpose, we genetically engineered mouse mammary adenocarcinoma (TSA), melanoma (B16-F10), and Lewis lung carcinoma cells to produce and release murine TNF. In a series of intervention trials, systemic administration of TNF-expressing tumor cells was associated with reduced growth of both primary tumors and metastatic colonies in immunocompetent mice. We show that these malignant cells home to tumors, locally release TNF, damage neovascular endothelium, and induce massive cancer cell apoptosis. We also demonstrate that such tumor-cell-mediated delivery avoids or minimizes common side effects often associated with TNF-based therapy, such as acute inflammation and weight loss. Our study provides proof of concept that genetically modified circulating tumor cells may serve as targeted vectors to deliver anticancer agents. In a clinical context, this unique paradigm represents a personalized approach to be translated into applications potentially using patient-derived circulating tumor cells as self-targeted vectors for drug delivery.

Internet-delivered interpersonal psychotherapy versus internet-delivered cognitive behavioral therapy for adults with depressive symptoms: randomized controlled noninferiority trial.

Science.gov (United States)

Donker, Tara; Bennett, Kylie; Bennett, Anthony; Mackinnon, Andrew; van Straten, Annemieke; Cuijpers, Pim; Christensen, Helen; Griffiths, Kathleen M

2013-05-13

Face-to-face cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are both effective treatments for depressive disorders, but access is limited. Online CBT interventions have demonstrated efficacy in decreasing depressive symptoms and can facilitate the dissemination of therapies among the public. However, the efficacy of Internet-delivered IPT is as yet unknown. This study examines whether IPT is effective, noninferior to, and as feasible as CBT when delivered online to spontaneous visitors of an online therapy website. An automated, 3-arm, fully self-guided, online noninferiority trial compared 2 new treatments (IPT: n=620; CBT: n=610) to an active control treatment (MoodGYM: n=613) over a 4-week period in the general population. Outcomes were assessed using online self-report questionnaires, the Center for Epidemiological Studies Depression scale (CES-D) and the Client Satisfaction Questionnaire (CSQ-8) completed immediately following treatment (posttest) and at 6-month follow-up. Completers analyses showed a significant reduction in depressive symptoms at posttest and follow-up for both CBT and IPT, and were noninferior to MoodGYM. Within-group effect sizes were medium to large for all groups. There were no differences in clinical significant change between the programs. Reliable change was shown at posttest and follow-up for all programs, with consistently higher rates for CBT. Participants allocated to IPT showed significantly lower treatment satisfaction compared to CBT and MoodGYM. There was a dropout rate of 1294/1843 (70%) at posttest, highest for MoodGYM. Intention-to-treat analyses confirmed these findings. Despite a high dropout rate and lower satisfaction scores, this study suggests that Internet-delivered self-guided IPT is effective in reducing depressive symptoms, and may be noninferior to MoodGYM. The completion rates of IPT and CBT were higher than MoodGYM, indicating some progress in refining Internet-based self

20 CFR 669.330 - How are services delivered to the customer?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are services delivered to the customer... Farmworker Jobs Program Customers and Available Program Services § 669.330 How are services delivered to the customer? To ensure that all services are focused on the customer's needs, services are provided through a...

Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Jonathan Stokes

Full Text Available An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis.We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care. Six bibliographic databases were searched using terms for 'case management', 'primary care', and a methodology filter (Cochrane EPOC group. Effectiveness compared to usual care was measured across a number of relevant outcomes: Health--self-assessed health status, mortality; Cost--total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately, and; Satisfaction--patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14. A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36 and long-term (0.35, 0.04 to 0.66. Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial 'strength' of primary care.This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and

Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Stokes, Jonathan; Panagioti, Maria; Alam, Rahul; Checkland, Kath; Cheraghi-Sohi, Sudeh; Bower, Peter

2015-01-01

An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis. We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care. Six bibliographic databases were searched using terms for 'case management', 'primary care', and a methodology filter (Cochrane EPOC group). Effectiveness compared to usual care was measured across a number of relevant outcomes: Health--self-assessed health status, mortality; Cost--total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately), and; Satisfaction--patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14). A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36) and long-term (0.35, 0.04 to 0.66). Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial 'strength' of primary care. This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and considered also the

Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

Science.gov (United States)

Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

2016-04-01

Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

Kinking and Torsion Can Significantly Improve the Efficiency of Valveless Pumping in Periodically Compressed Tubular Conduits. Implications for Understanding of the Form-Function Relationship of Embryonic Heart Tubes

Directory of Open Access Journals (Sweden)

Florian Hiermeier

2017-11-01

Full Text Available Valveless pumping phenomena (peristalsis, Liebau-effect can generate unidirectional fluid flow in periodically compressed tubular conduits. Early embryonic hearts are tubular conduits acting as valveless pumps. It is unclear whether such hearts work as peristaltic or Liebau-effect pumps. During the initial phase of its pumping activity, the originally straight embryonic heart is subjected to deforming forces that produce bending, twisting, kinking, and coiling. This deformation process is called cardiac looping. Its function is traditionally seen as generating a configuration needed for establishment of correct alignments of pulmonary and systemic flow pathways in the mature heart of lung-breathing vertebrates. This idea conflicts with the fact that cardiac looping occurs in all vertebrates, including gill-breathing fishes. We speculate that looping morphogenesis may improve the efficiency of valveless pumping. To test the physical plausibility of this hypothesis, we analyzed the pumping performance of a Liebau-effect pump in straight and looped (kinked configurations. Compared to the straight configuration, the looped configuration significantly improved the pumping performance of our pump. This shows that looping can improve the efficiency of valveless pumping driven by the Liebau-effect. Further studies are needed to clarify whether this finding may have implications for understanding of the form-function relationship of embryonic hearts.

The 2006 Eruption of Raoul Volcano (Kermadecs): A Phreato-magmatic Event From a Hydrothermally-Sealed Volcanic Conduit System.

Science.gov (United States)

Christenson, B. W.; Reyes, A. G.; Werner, C. A.

2006-12-01

The March 17, 2006 eruption from Raoul volcano (Kermadec Islands, NZ), which tragically claimed the life of NZ Department of Conservation staff member Mark Kearney, is being interpreted as a magmatic-hydrothermal event triggered by shaking associated with regional earthquake swarm activity. Although the eruption released ca. 200 T of SO2, thus confirming its magmatic nature, it occurred without significant precursory volcanic seismicity, and without any of the precursory responses of the volcanic hydrothermal system which were observed prior to the last eruption in 1964. Raoul Island has a long and varied eruption history dating back > 1.4 ma, and has been hydrothermally active throughout historic time. Present day fumarolic and hotspring discharges within Raoul caldera point to the existence of a small but well established, mixed meteoric - seawater hydrothermal system within the volcano. Magmatic signatures are apparent in fumarolic gas discharges, but are heavily masked by their interaction with hydrothermal system fluids (eg. near complete scrubbing of sulphur and halogen gases from the boiling point fumarolic discharges). A diffuse degassing study conducted in 2004 revealed that ca. 80 T/d CO2 is passively discharged from the volcano, suggesting that ongoing (albeit low level) convective degassing of magma occurs at depth. Interestingly, vent locations from the 2006 eruption correspond to areas of relatively low CO2 discharge on the crater floor in 2004. This, in conjunction with the preliminary findings of abundant hydrothermal mineralisation (calcite, anhydrite, quartz) in eruption ejecta, suggests that the main volcanic conduits had become effectively sealed during the interval since the last eruption. Calcite-hosted fluid inclusions are CO2 clathrate-bearing, and have relatively low homogenisation temperatures (165-180 °C), suggesting that the seal environment was both gas-charged and shallowly seated (< 200 m). Shaking associated with the regional

1000th magnet delivered!

CERN Multimedia

2006-01-01

On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35 tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which finished its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. "The production is proceeding well and we expect to be complete in October as previously foreseen," said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have been delivered.

1000th magnet delivered!

CERN Multimedia

2006-01-01

On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35-tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which completed its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. 'The production is proceeding well and we expect to be complete in October as foreseen,' said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have already been delivered.

BEING DELIVERED: SPIRITUALITY IN SURVIVORS OF SEXUAL VIOLENCE

Science.gov (United States)

Knapik, Gregory P.; Martsolf, Donna S.; Draucker, Claire B.

2011-01-01

A theoretical framework explaining how survivors of sexual violence use spirituality to respond to or recover from sexual violence is presented. Data were drawn from open-ended interviews of 27 women and 23 men who participated in a larger, ongoing study of women’s and men’s responses to sexual violence. Grounded theory methodology was used to develop the core category of Being Delivered, reflecting the participants’ experiences of being rescued, saved, or set free from the effects of sexual violence by a spiritual being or power. The theoretical framework describing Being Delivered is composed of three dimensions: Spiritual Connection, Spiritual Journey, and Spiritual Transformation. The framework can be used by clinicians to guide discussions of spirituality and healing with survivors of sexual violence. PMID:18382913

Nosocomial infections of ocular conjunctiva in newborns delivered by cesarian section.

Science.gov (United States)

Bezirtzoglou, E; Romond, C

1991-01-01

Colonization of the ocular conjunctiva in newborns delivered by cesarian section occurs usually within the first day of life. We have studied the flora of the ocular conjunctiva at birth, from 19 newborns delivered by cesarian section, coming from two different maternity hospitals. Ocular conjunctiva cultures yielded the main predominant flora in both maternity hospitals considered. The most common genus of this flora are: Staphylococcus, Corynebacterium and Propionibacterium acnes. Peptostreptococcus productus, Neisseria, Eubacterium and Clostridium perfringens are isolated occasionally. In newborns delivered by cesarian section, this flora principally acquired may be the consequence of the presence of bacteria in the ambient air, as well as differences in care provided by the nosocomial personnel.

Minimizing coupling loss by selection of twist pitch lengths in multi-stage cable-in-conduit conductors

International Nuclear Information System (INIS)

Rolando, G; Nijhuis, A; Devred, A

2014-01-01

The numerical code JackPot-ACDC (van Lanen et al 2010 Cryogenics 50 139–48, van Lanen et al 2011 IEEE Trans. Appl. Supercond. 21 1926–9, van Lanen et al 2012 Supercond. Sci. Technol. 25 025012) allows fast parametric studies of the electro-magnetic performance of cable-in-conduit conductors (CICCs). In this paper the code is applied to the analysis of the relation between twist pitch length sequence and coupling loss in multi-stage ITER-type CICCs. The code shows that in the analysed conductors the coupling loss is at its minimum when the twist pitches of the successive cabling stages have a length ratio close to one. It is also predicted that by careful selection of the stage-to-stage twist pitch ratio, CICCs cabled according to long twist schemes in the initial stages can achieve lower coupling loss than conductors with shorter pitches. The result is validated by AC loss measurements performed on prototype conductors for the ITER Central Solenoid featuring different twist pitch sequences. (paper)

School Nurse-Delivered Adolescent Relationship Abuse Prevention

Science.gov (United States)

Raible, Claire A.; Dick, Rebecca; Gilkerson, Fern; Mattern, Cheryl S.; James, Lisa; Miller, Elizabeth

2017-01-01

Background: Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office…

Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis.

Science.gov (United States)

Luque-Martinez, Issis; Reis, Alessandra; Schroeder, Marcos; Muñoz, Miguel Angel; Loguercio, Alessandro D; Masterson, Danielle; Maia, Lucianne C

2016-09-01

The aim of the study was to compare the color change produced by tray-delivered carbamide peroxide [CP] versus hydrogen peroxide products [HP] for at-home bleaching through a systematic review and meta-analysis. MEDLINE via PubMeb, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), and Cochrane Library and Grey literature were searched without restrictions. The abstracts of the International Association for Dental Research (IADR) and unpublished and ongoing trial registries were also searched. Dissertations and theses were explored using the ProQuest Dissertations and Periodicos Capes Theses databases. We included randomized clinical trials that compared tray-delivered CP versus HP for at-home dental bleaching. The color change in shade guide units (SGU) and ΔE were the primary outcomes, and tooth sensitivity and gingival irritation were the secondary outcomes. The risk of bias tool of the Cochrane Collaboration was used for quality assessment. After duplicate removal, 1379 articles were identified. However, only eight studies were considered to be at "low" risk of bias in the key domains of the risk bias tool and they were included in the analysis. For ΔE, the standardized mean difference was -0.45 (95 % CI -0.69 to -0.21), which favored tray-delivered CP products (p whitening efficacy than HP-based products in terms of ΔE, but they were similar in terms of ΔSGU. Both whitening systems demonstrated equal level of gingival irritation and tooth sensitivity. Tray-delivered CP gels have a slightly better whitening efficacy than HP-based products in terms of ΔE. This should be interpreted with caution as the data of ΔSGU did not show statistical difference between the products.

Health care policy and community pharmacy: implications for the New Zealand primary health care sector.

Science.gov (United States)

Scahill, Shane; Harrison, Jeff; Carswell, Peter; Shaw, John

2010-06-25

The aim of our paper is to expose the challenges primary health care reform is exerting on community pharmacy and other groups. Our paper is underpinned by the notion that a broad understanding of the issues facing pharmacy will help facilitate engagement by pharmacy and stakeholders in primary care. New models of remuneration are required to deliver policy expectations. Equally important is redefining the place of community pharmacy, outlining the roles that are mooted and contributions that can be made by community pharmacy. Consistent with international policy shifts, New Zealand primary health care policy outlines broad directives which community pharmacy must respond to. Policymakers are calling for greater integration and collaboration, a shift from product to patient-centred care; a greater population health focus and the provision of enhanced cognitive services. To successfully implement policy, community pharmacists must change the way they think and act. Community pharmacy must improve relationships with other primary care providers, District Health Boards (DHBs) and Primary Health Organisations (PHOs). There is a requirement for DHBs to realign funding models which increase integration and remove the requirement to sell products in pharmacy in order to deliver services. There needs to be a willingness for pharmacy to adopt a user pays policy. General practitioners (GPs) and practice nurses (PNs) need to be aware of the training and skills that pharmacists have, and to understand what pharmacists can offer that benefits their patients and ultimately general practice. There is also a need for GPs and PNs to realise the fiscal and professional challenges community pharmacy is facing in its attempt to improve pharmacy services and in working more collaboratively within primary care. Meanwhile, community pharmacists need to embrace new approaches to practice and drive a clearly defined agenda of renewal in order to meet the needs of health funders, patients

Enhanced peripheral nerve regeneration through asymmetrically porous nerve guide conduit with nerve growth factor gradient.

Science.gov (United States)

Oh, Se Heang; Kang, Jun Goo; Kim, Tae Ho; Namgung, Uk; Song, Kyu Sang; Jeon, Byeong Hwa; Lee, Jin Ho

2018-01-01

In this study, we fabricated a nerve guide conduit (NGC) with nerve growth factor (NGF) gradient along the longitudinal direction by rolling a porous polycaprolactone membrane with NGF concentration gradient. The NGF immobilized on the membrane was continuously released for up to 35 days, and the released amount of the NGF from the membrane gradually increased from the proximal to distal NGF ends, which may allow a neurotrophic factor gradient in the tubular NGC for a sufficient period. From the in vitro cell culture experiment, it was observed that the PC12 cells sense the NGF concentration gradient on the membrane for the cell proliferation and differentiation. From the in vivo animal experiment using a long gap (20 mm) sciatic nerve defect model of rats, the NGC with NGF concentration gradient allowed more rapid nerve regeneration through the NGC than the NGC itself and NGC immobilized with uniformly distributed NGF. The NGC with NGF concentration gradient seems to be a promising strategy for the peripheral nerve regeneration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 52-64, 2018. © 2017 Wiley Periodicals, Inc.

Nursing leaders can deliver a new model of care.

Science.gov (United States)

Shalala, Donna E

2014-01-01

Millions more insured Americans. Increasing numbers of older patients. Higher rates of chronic illness. Fewer providers. How can our healthcare system not only manage these challenges but also improve performance and access to care while containing costs? The answer lies with our nurses. In some parts of the United States, nurses provide the full spectrum of primary and preventive care. They have successfully improved access and quality in rural areas. In other parts, nurses' hands are tied by antiquated laws and regulations that limit their ability to expand access to care. Our system cannot increase access when we have providers who are not allowed to perform to the top of their education, training, and capability. It is time to rethink how we deliver primary and preventive care and redefine the roles of doctors and nurses. This article examines the history of the Institute of Medicine's (IOM) Future of Nursing report (chaired by the author) and the resulting Future of Nursing Campaign for Action, which is working to institute the report's recommendations in all 50 states. The IOM report's recommendations are simple: 1. Remove outdated restrictions on nursing practice. 2. Promote nurse leadership on hospital boards and in all healthcare sectors. 3. Strengthen nurse education and training, and increase the number of nurses with advanced degrees. 4. Increase diversity in the nursing workforce to better reflect the patient population. 5. Improve data reporting and compilation to predict workforce needs. New York, Kentucky, and Minnesota are three recent states to remove barriers pre venting advanced practice registered nurses from practicing at the top of their license. Similar efforts in California, Florida, and Indiana failed initially but are expected to make progress in the near future. The article makes clear how and why the Center to Champion Nursing in America (an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation) is working to

Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial.

Science.gov (United States)

Carey, M E; Mandalia, P K; Daly, H; Gray, L J; Hale, R; Martin Stacey, L; Taub, N; Skinner, T C; Stone, M; Heller, S; Khunti, K; Davies, M J

2014-11-01

To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Narrative review of provider behavior in primary care behavioral health: How process data can inform quality improvement.

Science.gov (United States)

Beehler, Gregory P; Lilienthal, Kaitlin R; Possemato, Kyle; Johnson, Emily M; King, Paul R; Shepardson, Robyn L; Vair, Christina L; Reyner, Jacqueline; Funderburk, Jennifer S; Maisto, Stephen A; Wray, Laura O

2017-09-01

Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice. For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles. Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high. This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Is International Accounting Education Delivering Pedagogical Value?

Science.gov (United States)

Patel, Chris; Millanta, Brian; Tweedie, Dale

2016-01-01

This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

The KwaZulu-Natal Child Eye Care Programme: Delivering refractive error services to primary school learners

Directory of Open Access Journals (Sweden)

Y. I. Mahraj

2011-12-01

sion screeners screened 239 606 primary school children from February 2007 to May 2008. Seven percent (15 944 of the children failed the vision screening and were referred for optometric assessments. Of the 15 944 children that failed the vision screening, 10 707 children were examined by optometrists and 1083 were found to have a refractive error and were therefore supplied with spectacles. The study indicates that a short-term programme to address a backlog of services can reach many underserved children. This programme identified many challenges of implementing a vision screening programme such as poor uptake of refractive services by learners in the absence of an appropriate referral system and high attrition of trained vision screeners. (S Afr Optom 2011 70(2 61-68

Biophysical effects in off-resonant gold nanoparticle mediated (GNOME) laser transfection of cell lines, primary- and stem cells using fs laser pulses.

Science.gov (United States)

Schomaker, Markus; Killian, Doreen; Willenbrock, Saskia; Heinemann, Dag; Kalies, Stefan; Ngezahayo, Anaclet; Nolte, Ingo; Ripken, Tammo; Junghanß, Christian; Meyer, Heiko; Murua Escobar, Hugo; Heisterkamp, Alexander

2015-08-01

Gold nanoparticle mediated (GNOME) laser transfection is a powerful technique to deliver small biologically relevant molecules into cells. However, the transfection of larger and especially negatively charged DNA remains challenging. The efficiency for pDNA was 0.57% using parameter that does not influence the endo- and exogenous DNA. In order to gain a deeper understanding of the actual molecule uptake process, the uptake efficiency was determined using molecules of different sizes. It was evaluated that uncharged dextran molecules (2000 kDa) were delivered with an efficiency of 68%. The intracellular distribution of injected molecules was visualized and larger molecules were primary found in the cytoplasm. Patch clamp measurements suggested a permeabilization time up to 15 minutes. The uptake efficiency depended on the size and charge of the molecule to deliver as well as the cell size. A minor role for transfection plays the cell type since primary stem cells were successfully transfected. The perforation efficiency of semi-adherent and suspension cells is influenced by the cell and molecule size. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Vagus nerve stimulation delivered during motor rehabilitation improves recovery in a rat model of stroke.

Science.gov (United States)

Khodaparast, Navid; Hays, Seth A; Sloan, Andrew M; Fayyaz, Tabbassum; Hulsey, Daniel R; Rennaker, Robert L; Kilgard, Michael P

2014-09-01

Neural plasticity is widely believed to support functional recovery following brain damage. Vagus nerve stimulation paired with different forelimb movements causes long-lasting map plasticity in rat primary motor cortex that is specific to the paired movement. We tested the hypothesis that repeatedly pairing vagus nerve stimulation with upper forelimb movements would improve recovery of motor function in a rat model of stroke. Rats were separated into 3 groups: vagus nerve stimulation during rehabilitation (rehab), vagus nerve stimulation after rehab, and rehab alone. Animals underwent 4 training stages: shaping (motor skill learning), prelesion training, postlesion training, and therapeutic training. Rats were given a unilateral ischemic lesion within motor cortex and implanted with a left vagus nerve cuff. Animals were allowed 1 week of recovery before postlesion baseline training. During the therapeutic training stage, rats received vagus nerve stimulation paired with each successful trial. All 17 trained rats demonstrated significant contralateral forelimb impairment when performing a bradykinesia assessment task. Forelimb function was recovered completely to prelesion levels when vagus nerve stimulation was delivered during rehab training. Alternatively, intensive rehab training alone (without stimulation) failed to restore function to prelesion levels. Delivering the same amount of stimulation after rehab training did not yield improvements compared with rehab alone. These results demonstrate that vagus nerve stimulation repeatedly paired with successful forelimb movements can improve recovery after motor cortex ischemia and may be a viable option for stroke rehabilitation. © The Author(s) 2014.

Cognitive behavior therapy versus interpersonal psychotherapy for social anxiety disorder delivered via smartphone and computer: a randomized controlled trial.

Science.gov (United States)

Dagöö, Jesper; Asplund, Robert Persson; Bsenko, Helene Andersson; Hjerling, Sofia; Holmberg, Anna; Westh, Susanne; Öberg, Louise; Ljótsson, Brjánn; Carlbring, Per; Furmark, Tomas; Andersson, Gerhard

2014-05-01

In this study, a previously evaluated guided Internet-based cognitive behavior therapy for social anxiety disorder (SAD) was adapted for mobile phone administration (mCBT). The treatment was compared with a guided self-help treatment based on interpersonal psychotherapy (mIPT). The treatment platform could be accessed through smartphones, tablet computers, and standard computers. A total of 52 participants were diagnosed with SAD and randomized to either mCBT (n=27) or mIPT (n=25). Measures were collected at pre-treatment, during the treatment, post-treatment and 3-month follow-up. On the primary outcome measure, the Liebowitz Social Anxiety Scale - self-rated, both groups showed statistically significant improvements. However, mCBT performed significantly better than mIPT (between group Cohen's d=0.64 in favor of mCBT). A larger proportion of the mCBT group was classified as responders at post-treatment (55.6% versus 8.0% in the mIPT group). We conclude that CBT for SAD can be delivered using modern information technology. IPT delivered as a guided self-help treatment may be less effective in this format. Copyright © 2014 Elsevier Ltd. All rights reserved.

Experiences of non-adherence to Internet-delivered cognitive behavior therapy: A qualitative study

OpenAIRE

Johansson, Olof; Michel, Teresa; Andersson, Gerhard; Paxling, Björn

2015-01-01

Many trials on Internet-delivered psychological treatments have had problems with nonadherence, but not much is known about the subjective reasons for non-adhering. The aim of this study was to explore participants' experiences of non-adherence to Internet-delivered psychological treatment. Grounded theory was used to analyze data from seven in-depth interviews with persons who had non-adhered to a study on Internet-delivered cognitive behavioral therapy for generalized anxiety disorder. The ...

Training radiographers to deliver an intervention to promote early presentation of breast cancer

International Nuclear Information System (INIS)

Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

2012-01-01

Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

Time scales of foam stability in shallow conduits: Insights from analogue experiments

Science.gov (United States)

Spina, L.; Scheu, B.; Cimarelli, C.; Arciniega-Ceballos, A.; Dingwell, D. B.

2016-10-01

Volcanic systems can exhibit periodical trends in degassing activity, characterized by a wide range of time scales. Understanding the dynamics that control such periodic behavior can provide a picture of the processes occurring in the feeding system. Toward this end, we analyzed the periodicity of outgassing in a series of decompression experiments performed on analogue material (argon-saturated silicone oil plus glass beads/fibers) scaled to serve as models of basaltic magma. To define the effects of liquid viscosity and crystal content on the time scale of outgassing, we investigated both: (1) pure liquid systems, at differing viscosities (100 and 1000 Pa s), and (2) particle-bearing suspensions (diluted and semidiluted). The results indicate that under dynamic conditions (e.g., decompressive bubble growth and fluid ascent within the conduit), the periodicity of foam disruption may be up to several orders of magnitude less than estimates based on the analysis of static conditions. This difference in foam disruption time scale is inferred to result from the contribution of bubble shear and bubble growth to inter-bubble film thinning. The presence of particles in the semidiluted regime is further linked to shorter bubble bursting times, likely resulting from contributions of the presence of a solid network and coalescence processes to the relative increase in bubble breakup rates. Finally, it is argued that these experiments represent a good analogue of gas-piston activity (i.e., the periodical rise-and-fall of a basaltic lava lake surface), implying a dominant role for shallow foam accumulation as a source process for these phenomena.

Computational modeling of lava domes using particle dynamics to investigate the effect of conduit flow mechanics on flow patterns

Science.gov (United States)

Husain, Taha Murtuza

Large (1--4 x 106 m3) to major (> 4 x 106 m3) dome collapses for andesitic lava domes such as Soufriere Hills Volcano, Montserrat are observed for elevated magma discharge rates (6--13 m3/s). The gas rich magma pulses lead to pressure build up in the lava dome that result in structural failure of the over steepened canyon-like walls which may lead to rockfall or pyroclastic flow. This indicates that dome collapse intimately related to magma extrusion rate. Variation in magma extrusion rate for open-system magma chambers is observed to follow alternating periods of high and low activity. Periodic behavior of magma exhibits a rich diversity in the nature of its eruptive history due to variation in magma chamber size, total crystal content, linear crystal growth rate and magma replenishment rate. Distinguished patterns of growth were observed at different magma flow rates ranging from endogenous to exogenous dome growth for magma with varying strengths. Determining the key parameters that control the transition in flow pattern of the magma during its lava dome building eruption is the main focus. This dissertation examines the mechanical effects on the morphology of the evolving lava dome on the extrusion of magma from a central vent using a 2D particle dynamics model. The particle dynamics model is coupled with a conduit flow model that incorporates the kinetics of crystallization and rheological stiffening to investigate important mechanisms during lava dome building eruptions. Chapter I of this dissertation explores lava dome growth and failure mechanics using a two-dimensional particle-dynamics model. The model follows the evolution of fractured lava, with solidification driven by degassing induced crystallization of magma. The particle-dynamics model emulates the natural development of dome growth and rearrangement of the lava dome which is difficult in mesh-based analyses due to mesh entanglement effects. The deformable talus evolves naturally as a frictional

The myth of standardized workflow in primary care.

Science.gov (United States)

Holman, G Talley; Beasley, John W; Karsh, Ben-Tzion; Stone, Jamie A; Smith, Paul D; Wetterneck, Tosha B

2016-01-01

Primary care efficiency and quality are essential for the nation's health. The demands on primary care physicians (PCPs) are increasing as healthcare becomes more complex. A more complete understanding of PCP workflow variation is needed to guide future healthcare redesigns. This analysis evaluates workflow variation in terms of the sequence of tasks performed during patient visits. Two patient visits from 10 PCPs from 10 different United States Midwestern primary care clinics were analyzed to determine physician workflow. Tasks and the progressive sequence of those tasks were observed, documented, and coded by task category using a PCP task list. Variations in the sequence and prevalence of tasks at each stage of the primary care visit were assessed considering the physician, the patient, the visit's progression, and the presence of an electronic health record (EHR) at the clinic. PCP workflow during patient visits varies significantly, even for an individual physician, with no single or even common workflow pattern being present. The prevalence of specific tasks shifts significantly as primary care visits progress to their conclusion but, notably, PCPs collect patient information throughout the visit. PCP workflows were unpredictable during face-to-face patient visits. Workflow emerges as the result of a "dance" between physician and patient as their separate agendas are addressed, a side effect of patient-centered practice. Future healthcare redesigns should support a wide variety of task sequences to deliver high-quality primary care. The development of tools such as electronic health records must be based on the realities of primary care visits if they are to successfully support a PCP's mental and physical work, resulting in effective, safe, and efficient primary care. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Epilepsy in Ireland: towards the primary-tertiary care continuum.

Science.gov (United States)

Varley, Jarlath; Delanty, Norman; Normand, Charles; Coyne, Imelda; McQuaid, Louise; Collins, Claire; Boland, Michael; Grimson, Jane; Fitzsimons, Mary

2010-01-01

Epilepsy is a chronic neurological disease affecting people of every age, gender, race and socio-economic background. The diagnosis and optimal management relies on contribution from a number of healthcare disciplines in a variety of healthcare settings. To explore the interface between primary care and specialist epilepsy services in Ireland. Using appreciative inquiry, focus groups were held with healthcare professionals (n=33) from both primary and tertiary epilepsy specialist services in Ireland. There are significant challenges to delivering a consistent high standard of epilepsy care in Ireland. The barriers that were identified are: the stigma of epilepsy, unequal access to care services, insufficient human resources, unclear communication between primary-tertiary services and lack of knowledge. Improving the management of people with epilepsy requires reconfiguration of the primary-tertiary interface and establishing clearly defined roles and formalised clinical pathways. Such initiatives require resources in the form of further education and training and increased usage of information communication technology (ICT). Epilepsy services across the primary-tertiary interface can be significantly enhanced through the implementation of a shared model of care underpinned by an electronic patient record (EPR) system and information communication technology (ICT). Better chronic disease management has the potential to halt the progression of epilepsy with ensuing benefits for patients and the healthcare system. Copyright 2009 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Computer-Based Phonological Skills Training for Primary Students with Mild to Moderate Dyslexia--A Pilot Study

Science.gov (United States)

Blythe, John M.

2006-01-01

This pilot study investigated the efficacy of "Phonics Alive 2: The Sound Blender", a computer-based phonological skills training program, delivered with both at-home and at-school components over a 10-week period, as a potential treatment of phonological dyslexia. Participants were 20 dyslexic primary students with an average delay of…

Experimental and theoretical fracture mechanics applied to volcanic conduits and domes

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Sammonds, P.; Matthews, C.; Kilburn, C.; Smith, R.; Tuffen, H.; Meredith, P.

2008-12-01

We present an integrated modelling and experimental approach to magma deformation and fracture, which we attempt to validate against field observations of seismicity. The importance of fracture processes in magma ascent dynamics and lava dome growth and collapse are apparent from the associated seismicity. Our laboratory experiments have shown that brittle fracture of magma can occur at high temperature and stress conditions prevalent in the shallow volcanic system. Here, we use a fracture mechanics approach to model seismicity preceding volcanic eruptions. Starting with the fracture mechanics concept of a crack in an elastic body, we model crack growth around the volcanic conduit through the processes of crack interactions, leading either to the propagation and linkage of cracks, or crack avoidance and the inhibition of crack propagation. The nature of that interaction is governed by the temperature and plasticity of the magma. We find that fracture mechanics rules can account for the style of seismicity preceding eruptions. We have derived the changes in seismic b-value predicted by the model and interpret these in terms of the style of fracturing, fluid flow and heat transport. We compare our model with results from our laboratory experiments where we have deformed lava at high temperatures under triaxial stresses. These experiments were conducted in dry and water saturated conditions at effective pressures up to 10 MPa, temperatures up to 1000°C and strain rates from 10-4 s-1 to 10-6 s-1. The behaviour of these magmas was largely brittle under these conditions. We monitored the acoustic emission emitted and calculate the change in micro-seismic b-value with deformation. These we find are in accord with volcano seismicity and our fracture mechanics model.

Modeling patients' acceptance of provider-delivered e-health.

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Wilson, E Vance; Lankton, Nancy K

2004-01-01

Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

A better way to deliver bad news.

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Manzoni, Jean-François

2002-09-01

In an ideal world, a subordinate would accept critical feedback from a manager with an open mind. He or she would ask a few clarifying questions, promise to work on certain performance areas, and show signs of improvement over time. But things don't always turn out that way. Such conversations can be unpleasant. Emotions can run high; tempers can flare. Fearing that the employee will become angry and defensive, the boss all too often inadvertently sabotages the meeting by preparing for it in a way that stifles honest discussion. This unintentional--indeed, unconscious--stress-induced habit makes it difficult to deliver corrective feedback effectively. Insead professor Jean-François Manzoni says that by changing the mind-set with which they develop and deliver negative feedback, managers can increase their odds of having productive conversations without damaging relationships. Manzoni describes two behavioral phenomena that color the feedback process--the fundamental attribution error and the false consensus effect--and uses real-world examples to demonstrate how bosses' critiques can go astray. Managers tend to frame difficult situations and decisions in a way that is narrow (alternatives aren't considered) and binary (there are only two possible outcomes--win or lose). And during the feedback discussion, managers' framing of the issues often remains frozen, regardless of the direction the conversation takes. Manzoni advises managers not to just settle on the first acceptable explanation for a behavior or situation they've witnessed. Bosses also need to consider an employee's circumstances rather than just attributing weak performance to a person's disposition. In short, delivering more effective feedback requires an open-minded approach, one that will convince employees that the process is fair and that the boss is ready for an honest conversation.

Preparing the Workforce for Behavioral Health and Primary Care Integration.

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Hall, Jennifer; Cohen, Deborah J; Davis, Melinda; Gunn, Rose; Blount, Alexander; Pollack, David A; Miller, William L; Smith, Corey; Valentine, Nancy; Miller, Benjamin F

2015-01-01

To identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. Observational cross-case comparison study of 19 U.S. practices, 11 participating in Advancing Care Together, and 8 from the Integration Workforce Study. Practices varied in size, ownership, geographic location, and experience delivering integrated care. Multidisciplinary teams collected data (field notes from direct practice observations, semistructured interviews, and online diaries as reported by practice leaders) and then analyzed the data using a grounded theory approach. Organizations had difficulty finding clinicians possessing the skills and experience necessary for working in an integrated practice. Practices newer to integration underestimated the time and resources needed to train and organizationally socialize (onboard) new clinicians. Through trial and error, practices learned that clinicians needed relevant training to work effectively as integrated care teams. Training efforts exclusively targeting behavioral health clinicians (BHCs) and new employees were incomplete if primary care clinicians (PCCs) and others in the practice also lacked experience working with BHCs and delivering integrated care. Organizations' methods for addressing employees' need for additional preparation included hiring a consultant to provide training, sending employees to external training programs, hosting residency or practicum training programs, or creating their own internal training program. Onboarding new employees through the development of training manuals; extensive shadowing processes; and protecting time for ongoing education, mentoring, and support opportunities for new and established clinicians and staff were featured in these internal training programs. Insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration

Effect of Surface Pore Structure of Nerve Guide Conduit on Peripheral Nerve Regeneration

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Oh, Se Heang; Kim, Jin Rae; Kwon, Gu Birm; Namgung, Uk; Song, Kyu Sang

2013-01-01

Polycaprolactone (PCL)/Pluronic F127 nerve guide conduits (NGCs) with different surface pore structures (nano-porous inner surface vs. micro-porous inner surface) but similar physical and chemical properties were fabricated by rolling the opposite side of asymmetrically porous PCL/F127 membranes. The effect of the pore structure on peripheral nerve regeneration through the NGCs was investigated using a sciatic nerve defect model of rats. The nerve fibers and tissues were shown to have regenerated along the longitudinal direction through the NGC with a nano-porous inner surface (Nanopore NGC), while they grew toward the porous wall of the NGC with a micro-porous inner surface (Micropore NGC) and, thus, their growth was restricted when compared with the Nanopore NGC, as investigated by immunohistochemical evaluations (by fluorescence microscopy with anti-neurofilament staining and Hoechst staining for growth pattern of nerve fibers), histological evaluations (by light microscopy with Meyer's modified trichrome staining and Toluidine blue staining and transmission electron microscopy for the regeneration of axon and myelin sheath), and FluoroGold retrograde tracing (for reconnection between proximal and distal stumps). The effect of nerve growth factor (NGF) immobilized on the pore surfaces of the NGCs on nerve regeneration was not so significant when compared with NGCs not containing immobilized NGF. The NGC system with different surface pore structures but the same chemical/physical properties seems to be a good tool that is used for elucidating the surface pore effect of NGCs on nerve regeneration. PMID:22871377

Sustained effectiveness and cost-effectiveness of Counselling for Alcohol Problems, a brief psychological treatment for harmful drinking in men, delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial.

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Nadkarni, Abhijit; Weiss, Helen A; Weobong, Benedict; McDaid, David; Singla, Daisy R; Park, A-La; Bhat, Bhargav; Katti, Basavaraj; McCambridge, Jim; Murthy, Pratima; King, Michael; Wilson, G Terence; Kirkwood, Betty; Fairburn, Christopher G; Velleman, Richard; Patel, Vikram

2017-09-01

Counselling for Alcohol Problems (CAP), a brief intervention delivered by lay counsellors, enhanced remission and abstinence over 3 months among male primary care attendees with harmful drinking in a setting in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of CAP over 12 months, and the effects of the hypothesized mediator 'readiness to change' on clinical outcomes. Male primary care attendees aged 18-65 years screening with harmful drinking on the Alcohol Use Disorders Identification Test (AUDIT) were randomised to either CAP plus enhanced usual care (EUC) (n = 188) or EUC alone (n = 189), of whom 89% completed assessments at 3 months, and 84% at 12 months. Primary outcomes were remission and mean standard ethanol consumed in the past 14 days, and the proposed mediating variable was readiness to change at 3 months. CAP participants maintained the gains they showed at the end of treatment through the 12-month follow-up, with the proportion with remission (AUDIT score costs and better outcomes; uncertainty analysis showed a 99% chance of CAP being cost-effective per remission achieved from a health system perspective, using a willingness to pay threshold equivalent to 1 month's wages for an unskilled manual worker in Goa. Readiness to change level at 3 months mediated the effect of CAP on mean standard ethanol consumption at 12 months (indirect effect -6.014 [95% CI -13.99, -0.046]). Serious adverse events were infrequent, and prevalence was similar by arm. The methodological limitations of this trial are the susceptibility of self-reported drinking to social desirability bias, the modest participation rates of eligible patients, and the examination of mediation effects of only 1 mediator and in only half of our sample. CAP's superiority over EUC at the end of treatment was largely stable over time and was mediated by readiness to change. CAP provides better outcomes at lower costs from a societal

Evaluation of a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care: the role of Primary Care Mental Health Specialists.

Science.gov (United States)

Hamilton-West, Kate; Hotham, Sarah; Yang, Wei; Hedayioglu, Julie; Brigden, Charlotte

2017-07-01

Aim We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care. Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required. The two-year pilot, across six Clinical Commissioning Groups in South East England, began in March 2013. Interviews were conducted with all PCMHS employed in the pilot service (n=13) and a sample of service users (n=12). The views of professionals working alongside the service, including GPs, Psychiatrists and Mental Health Nurses, were captured using a brief online questionnaire (n=50). Time and Activity Recording Sheets were used to capture data required for economic analysis. Findings Our findings indicate that the service is working well from the perspective of patients; staff employed within the service and professionals working alongside the service. Patients described the service as a 'safety net' they could fall back on in case of difficulties, whereas staff used the analogy of a 'bridge' to describe the way the service improved communication and collaboration between the various professionals and organisations involved in the patient's care. Improvements in well-being were seen to result from increased support for those transitioning from secondary to primary care, a more pro-active approach to relapse prevention and increased engagement in daily activities. Each PCMHS covered 36 patients in a one-month period, with a unit cost of £73.01 per patient.

Gas-Generator Augmented Expander Cycle Rocket Engine

Science.gov (United States)

Greene, William D. (Inventor)

2011-01-01

An augmented expander cycle rocket engine includes first and second turbopumps for respectively pumping fuel and oxidizer. A gas-generator receives a first portion of fuel output from the first turbopump and a first portion of oxidizer output from the second turbopump to ignite and discharge heated gas. A heat exchanger close-coupled to the gas-generator receives in a first conduit the discharged heated gas, and transfers heat to an adjacent second conduit carrying fuel exiting the cooling passages of a primary combustion chamber. Heat is transferred to the fuel passing through the cooling passages. The heated fuel enters the second conduit of the heat exchanger to absorb more heat from the first conduit, and then flows to drive a turbine of one or both of the turbopumps. The arrangement prevents the turbopumps exposure to combusted gas that could freeze in the turbomachinery and cause catastrophic failure upon attempted engine restart.

Efficacy of an education course delivered to community health workers in diabetes control: A randomized clinical trial.

Science.gov (United States)

de Souza, Camila Furtado; Dalzochio, Mériane Boeira; Zucatti, Alessandra Teixeira Netto; De Nale, Rosana; de Almeida, Marília Tavares; Gross, Jorge Luiz; Leitão, Cristiane Bauermann

2017-08-01

Community health workers are community members who provide education and care for patients for a broad range of health issues, including diabetes mellitus. However, few community health workers are trained for diabetes education and little is known about the effectiveness of their interventions. The aim of this study is to evaluate the effect of a diabetes education program delivered to community health workers in improving the metabolic control of patients with type 2 diabetes mellitus. Eight community health workers, providing care for 118 patients, were randomized in two groups to receive a 1-month diabetes education program (intervention, patients n = 62) or an education course in other health issues (control, patients n = 56). Each community health worker was responsible for transmitting the acquired knowledge to patients. Primary outcome was changed in HbA1C 3 months after the intervention. PARTICIPANTS: Mean age was 61 ± 11 years, 35% were men and 62% were whites. HbA1c levels reduced in both groups (intervention: 9.1 ± 2.2 vs. 7.9 ± 1.9%; control: 9.1 ± 2.1 vs. 8.4 ± 2.5%, p patients' follow-up, but it was similar in intervention and control groups. The diabetes mellitus education course delivered to community health workers was able to improve patients' lipid profile.

Multi-lipofection efficiently transfected genes into astrocytes in primary culture.

Science.gov (United States)

Wu, B Y; Liu, R Y; So, K L; Yu, A C

2000-10-30

This study demonstrated that liposome-mediated transfection - lipofection - is suitable for delivering genes into astrocytes. By repeatedly lipofecting the same astrocyte cultures, a process we call multi-lipofection, the transfection efficiency of the beta-galactosidase (beta-gal) gene was improved from 2.6+/-0.6 to 17. 4+/-1.1%. This is the highest efficiency ever reported in gene-transfer with Lipofectin(R) in a primary culture of mouse cerebral cortical astrocytes. Furthermore, multi-lipofection did not cause observable disturbance to astrocytes as indicated by insignificant changes in the glial fibrillary acidic protein content in the cultures. In order to demonstrate that the transfected gene achieved a physiologically relevant expression level, a plasmid containing the pEF-hsp70 protein gene was lipofected into astrocytes. This produced colonies of astrocytes showing an increased resistance to heat-induced cell death. A similar experiment was performed with the glial-derived neurotrophic factor (GDNF) gene. Control astrocytes had no detectable GDNF. In the transfected astrocytes, the GDNF protein could be identified intracellularly by immunocytochemistry. Western blot analysis revealed, as compared to astrocytes with one lipofection, a 2.9-fold increase of GDNF with four lipofections. GDNF remained detectable in astrocytes 2 weeks after four lipofections. Thus, multi-lipofection provides a mild and efficient means of delivering foreign genes into astrocytes in a primary culture, making astrocytes good candidate vehicle cells for gene/cell therapy in the CNS.

Comparison of radiation delivered by current diagnostic procedures for herniated disc

International Nuclear Information System (INIS)

Gasquet, C.; Drouineau, J.; Goubault, F.; Hurmic, A.; Lavigne, B.; Vandermarcq, P.

1983-01-01

Three methods are currently employed for the diagnosis of sciatica due to disc lesions: radiculography, spinal phlebography, and computed tomography. Though their indications vary according to the author, it seemed worthwhile to compare radiation delivered by each of them, because of the often young age of the patients. Dosimetric studies using a Rando Phantom enabled calculation of doses to the skin, spinal cord, and gonads. Results indicated that low doses were delivered by the scanner, relatively high doses by spinal phlebography, and intermediate doses by radiculography. These findings suggest that the initial examination preoperatively in cases of simple sciatica due to herniated disc should be a CT scan whenever possible. Phlebography, on the contrary, and particularly in young women, should be used only exceptionally, as a result of the high doses delivered to the ovaries even during technically simple explorations [fr

Primary prevention of adolescent pregnancy.

Science.gov (United States)

Schinke, S P; Blythe, B J; Gilchrist, L D; Burt, G A

1981-01-01

Teenage pregnancy is associated with many health, emotional and socioeconomic problems including higher rates of anemia, labor complications, mortality, legal and social struggles and hhigher divorce rates. Professional social workers need strategies to help teenagers avoid early, unwanted pregnancy. This paper offers promising experential and research backing for a primary prevention group work strategy for all adolescents. Social and health programs overlook educational, cognitive anc interpersonal factors biasing youths' ability to comprehend and regulate contraception. Primary prevention to assist adolescents in thinking analytically about their sexual behavior must stress problem solving and decision-making as well as facts about human reproduction and birth control. To implement decisions, youths also need interpersonal communication skills. Small groups are ideal for delivering cognitive-behavioral primary prevention. This approach is based on the premise that youths become pregnant not because of a lack of relevant information, but because they lack cognitive and behavioral skills necessary to use information. Group work involving role-playing helps develop communication skills. Results from 2 field studies describe short-term and longitudinal benefits of the prevention strategy. Professionals can reach significant numbers of youth in this way. By treating sexual issues and the risk of pregnancy as normal in adolescence, social workers can introduce information and pertinent skills to all teenagers. No one is singled out as deviant and the group format enables young people to discuss taboo topics, discovering what the norms are and gradually learning how to deal with peers, family members, techers and others. Adolescents in primary prevention groups gained knowledge, cognitive skills and communication acumen. Improved attitudes toward family planning, increased regular contraception and less unsafe sex resulted from this cognitive-behavioral approach

Design and Methods for a Pilot Study of a Phone-Delivered, Mindfulness-Based Intervention in Patients with Implantable Cardioverter Defibrillators

Directory of Open Access Journals (Sweden)

Elena Salmoirago-Blotcher

2012-01-01

Full Text Available Background. Meditation practices are associated with a reduction in adrenergic activity that may benefit patients with severe cardiac arrhythmias. This paper describes the design and methods of a pilot study testing the feasibility of a phone-delivered mindfulness-based intervention (MBI for treatment of anxiety in patients with implantable cardioverter defibrillators (ICDs. Design and Methods. Consecutive, clinically stable outpatients (n=52 will be screened for study eligibility within a month of an ICD-related procedure or ICD shock and will be randomly assigned to MBI or to usual care. MBI patients will receive eight weekly individual phone sessions based on two mindfulness practices (awareness of breath and body scan plus home practice with a CD for 20 minutes daily. Patients assigned to usual care will be offered the standard care planned by the hospital. Assessments will occur at baseline and at the completion of the intervention (between 9 and 12 weeks after randomization. The primary study outcome is feasibility; secondary outcomes include anxiety, mindfulness, and number of administered shocks during the intervention period. Conclusions. If proven feasible and effective, phone-delivered mindfulness-based interventions could improve psychological distress in ICD outpatients with serious cardiovascular conditions.

The dynamics of slug trains in volcanic conduits: Evidence for expansion driven slug coalescence

Science.gov (United States)

Pering, T. D.; McGonigle, A. J. S.; James, M. R.; Capponi, A.; Lane, S. J.; Tamburello, G.; Aiuppa, A.

2017-12-01

Strombolian volcanism is a ubiquitous form of activity, driven by the ascent and bursting of bubbles of slug morphology. Whilst considerable attention has been devoted to understanding the behaviour of individual slugs in this regime, relatively little is known about how inter-slug interactions modify flow conditions. Recently, we reported on high temporal frequency strombolian activity on Etna, in which the larger erupted slug masses were followed by longer intervals before the following explosion than the smaller bursts (Pering et al., 2015). We hypothesised that this behaviour arose from the coalescence of ascending slugs causing a prolonged lag before arrival of the next distinct bubble. Here we consider the potential importance of inter-slug interactions for the dynamics of strombolian volcanism, by reporting on the first study into the behaviour of trains of ascending gas slugs, scaled to the expansion rates in volcanic conduits. This laboratory analogue study illustrates that slugs in trains rise faster than individual slugs, and can be associated with aspects of co-current flow. The work also highlights that coalescence and inter-slug interactions play an important role in modulating slug train behaviour. We also report, for the first time, on slug coalescence driven by vertical expansion of the trailing slug, a process which can occur, even where the leading slug base ascent velocity is greater than that of the trailing slug.