WorldWideScience

Sample records for provide additional control

  1. Low-dose gamma irradiation following hot water immersion of papaya (Carica papaya linn.) fruits provides additional control of postharvest fungal infection to extend shelf life

    International Nuclear Information System (INIS)

    Rashid, M.H.A.; Grout, B.W.W.; Continella, A.; Mahmud, T.M.M.

    2015-01-01

    Low-dose gamma irradiation (0.08 kGy over 10 min), a level significantly below that required to satisfy the majority of international quarantine regulations, has been employed to provide a significant reduction in visible fungal infection on papaya fruit surfaces. This is appropriate for local and national markets in producer countries where levels of commercial acceptability can be retained despite surface lesions due to fungal infection. Irradiation alone and in combination with hot-water immersion (50 °C for 10 min) has been applied to papaya (Carica papaya L.) fruits at both the mature green and 1/3 yellow stages of maturity. The incidence and severity of surface fungal infections, including anthracnose, were significantly reduced by the combined treatment compared to irradiation or hot water treatment alone, extending storage at 11 °C by 13 days and retaining commercial acceptability. The combined treatment had no significant, negative impact on ripening, with quality characteristics such as surface and internal colour change, firmness, soluble solids, acidity and vitamin C maintained at acceptable levels. - Highlights: • Storage of papaya extended to 28 days whilst retaining commercial quality. • Additive effect of low gamma irradiation (0.08 kGy over 10 min) and hot-water treatment. • Significant reduction in surface fungal lesions. • No significant impact on colour change or flesh quality during storage

  2. Does additional support provided through e-mail or SMS in a Web-based Social Marketing program improve children's food consumption? A Randomized Controlled Trial.

    Science.gov (United States)

    Rangelov, Natalie; Della Bella, Sara; Marques-Vidal, Pedro; Suggs, L Suzanne

    2018-02-16

    The FAN Social Marketing program was developed to improve dietary and physical activity habits of families with children in Ticino, Switzerland. The aim of this study was to examine if the effects of the program on children's food intake differed by intervention group. Effects of the FAN program were tested through a Randomized Controlled Trial. The program lasted 8 weeks, during which participants received tailored communication about nutrition and physical activity. Families were randomly allocated to one of three groups, where the parent received the intervention by the Web (G1), Web + e-mail (G2) or Web + SMS (G3). Children in all groups received tailored print letters by post. Children's food consumption was assessed at baseline and immediate post intervention using a 7-day food diary. Generalized linear mixed models with child as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects were used to test the impact of the intervention. Analyses were conducted with a sample of 608 children. After participating in FAN the marginal means of daily consumption of fruit changed from 0.95 to 1.12 in G1, from 0.82 to 0.94 in G2, and from 0.93 to 1.18 in G3. The margins of the daily consumption of sweets decreased in each group (1.67 to 1.56 in G1, 1.71 to 1.49 in G2, and 1.72 to 1.62 in G3). The change in vegetable consumption observed from pre to post intervention in G3 (from 1.13 to 1.21) was significantly different from that observed in G1 (from 1.21 to 1.17). A well-designed Web-based Social Marketing intervention complemented with print letters can help improve children's consumption of water, fruit, soft drinks, and sweets. The use of SMS to support greater behavior change, in addition to Web-based communication, resulted only in a small significant positive change for vegetables, while the use of e-mail in addition to Web did not result in any significant difference. The trial was retrospectively registered in the

  3. Low-dose gamma irradiation following hot Water immersion of Papaya (Carica Papaya linn.) fruits provides additional control of postharvest fungal infection to extend shelf life

    DEFF Research Database (Denmark)

    Rashid, M.H.A.; Grout, Brian William Wilson; Continella, A.

    2015-01-01

    Low-dose gamma irradiation (0.08 kGy over 10 min), a level significantly below that required to satisfy the majority of international quarantine regulations, has been employed to provide a significant reduction in visible fungal infection on papaya fruit surfaces. This is appropriate for local an....... The combined treatment had no significant, negative impact on ripening, with quality characteristics such as surface and internal colour change, firmness, soluble solids, acidity and vitamin C maintained at acceptable levels....... and national markets in producer countries where levels of commercial acceptability can be retained despite surface lesions due to fungal infection. Irradiation alone and in combination with hot-water immersion (50 °C for 10 min) has been applied to papaya (Carica papaya L.) fruits at both the mature green...... and 1/3 yellow stages of maturity. The incidence and severity of surface fungal infections, including anthracnose, were significantly reduced by the combined treatment compared to irradiation or hot water treatment alone, extending storage at 11 °C by 13 days and retaining commercial acceptability...

  4. Device provides controlled gas leaks

    Science.gov (United States)

    Kami, S. K.; King, H. J.

    1968-01-01

    Modified palladium leak device provides a controlled release /leak/ of very small quantities of gas at low or medium pressures. It has no moving parts, requires less than 5 watts to operate, and is capable of releasing the gas either continuously or in pulses at adjustable flow rates.

  5. Build platform that provides mechanical engagement with additive manufacturing prints

    Science.gov (United States)

    Elliott, Amelia M.

    2018-03-06

    A build platform and methods of fabricating an article with such a platform in an extrusion-type additive manufacturing machine are provided. A platform body 202 includes features 204 that extend outward from the body 202. The features 204 define protrusive areas 206 and recessive areas 208 that cooperate to mechanically engage the extruded material that forms the initial layers 220 of an article when the article is being fabricated by a nozzle 12 of the additive manufacturing machine 10.

  6. JNC's experience of complementary accesses provided by the additional protocol

    International Nuclear Information System (INIS)

    Miura, Yasushi

    2001-01-01

    JNC (Japan Nuclear Cycle Development Institute) examined problems on implementation of the Additional Protocol to Japan/IAEA Safeguards Agreement with the Government of Japan and International Atomic Energy Agency through trials performed at Oarai Engineering Center before it entered into force. On December 16th 1999, the Additional Protocol entered into force, and in last January JNC provided the first JNC site information to STA. Then our Government provided it of all Japan to IAEA in last June. Also in this January, we sent the additional information changed from old one to MEXT (Ministry of Education, Culture, Sports, Science and Technology). The first Complementary Access of not only JNC but also Japan was implemented on JNC Ningyo-Toge Environmental Engineering Center on the end of last November. Since then, we have had over 10 times experience of Complementary Accesses for about one year especially on Tokai works and Ningyo-Toge. JNC's experience of Complementary Accesses will be introduced. (author)

  7. Additive Feed Forward Control with Neural Networks

    DEFF Research Database (Denmark)

    Sørensen, O.

    1999-01-01

    This paper demonstrates a method to control a non-linear, multivariable, noisy process using trained neural networks. The basis for the method is a trained neural network controller acting as the inverse process model. A training method for obtaining such an inverse process model is applied....... A suitable 'shaped' (low-pass filtered) reference is used to overcome problems with excessive control action when using a controller acting as the inverse process model. The control concept is Additive Feed Forward Control, where the trained neural network controller, acting as the inverse process model......, is placed in a supplementary pure feed-forward path to an existing feedback controller. This concept benefits from the fact, that an existing, traditional designed, feedback controller can be retained without any modifications, and after training the connection of the neural network feed-forward controller...

  8. Providing Technical assistance on corruption control

    OpenAIRE

    Serge, Lortie

    2012-01-01

    The phenomenon referred to as corruption has now been generating a high degree of interest for over twenty years. It has in fact spawned not only an abundant literature but also a monitoring and advisory industry whose specific outlook heavily shapes the debate on integrity issues. This industry is widely supported by aid providers, be it the international financing institutions or national development agencies. At this juncture, it therefore seemed worthwhile to examine more critically an ar...

  9. Microcontroller based automatic liquid poison addition control system

    International Nuclear Information System (INIS)

    Kapatral, R.S.; Ananthakrishnan, T.S.; Pansare, M.G.

    1989-01-01

    Microcontrollers are finding increasing applications in instrumentation where complex digital circuits can be substituted by a compact and simple circuit, thus enhancing the reliability. In addition to this, intelligence and flexibility can be incorporated. For applications not requiring large amount of read/write memory (RAM), microcontrollers are ideally suited since they contain programmable memory (Eprom), parallel input/output lines, data memory, programmable timers and serial interface ports in one chip. This paper describes the design of automatic liquid poison addition control system (ALPAS) using intel's 8 bit microcontroller 8751, which is used to generate complex timing control sequence signals for liquid poison addition to the moderator in a nuclear reactor. ALPAS monitors digital inputs coming from protection system and regulating system of a nuclear reactor and provides control signals for liquid poison addition for long term safe shutdown of the reactor after reactor trip and helps the regulating system to reduce the power of the reactor during operation. Special hardware and software features have been incorporated to improve performance and fault detection. (author)

  10. Electronic circuit provides automatic level control for liquid nitrogen traps

    Science.gov (United States)

    Turvy, R. R.

    1968-01-01

    Electronic circuit, based on the principle of increased thermistor resistance corresponding to decreases in temperature provides an automatic level control for liquid nitrogen cold traps. The electronically controlled apparatus is practically service-free, requiring only occasional reliability checks.

  11. A study for providing additional storage spaces to ET-RR-1 spent fuel

    International Nuclear Information System (INIS)

    El-Kady, A.; Ashoub, N.; Saleh, H.G.

    1995-01-01

    The ET-RR-1 reactor spent fuel storage pool is a trapezoidal aluminum tank concrete shield and of capacity 10 m 3 . It can hold up to 60 fuel assemblies. The long operation history of the ET-RR-1 reactor resulted in a partially filled spent fuel storage with the remaining spaces not enough to host a complete load from the reactor. This work have been initiated to evaluate possible alternative solutions for providing additional storage spaces to host the available EK-10 fuel elements after irradiation and any foreseen fuel in case of reactor upgrading. Several alternate solutions have been reviewed and decision on the most suitable one is under study. These studies include criticality calculation of some suggested alternatives like reracking the present spent fuel storage pool and double tiering by the addition of a second level storage rack above the existing rack. The two levels may have different factor. Criticality calculation of the double tiering possible accident was also studied. (author)

  12. Expert panel on additional cross subsidisation. Considering arguments and providing expert opinion

    International Nuclear Information System (INIS)

    Faber, J.; Nelissen, D.; Lowe, S.; Mason, A.

    2007-10-01

    In the period end 2005 till September 2006 MVA London in cooperation with SEO Amsterdam was commissioned by the Dutch Ministry of Transport to perform an analysis of the economic and competition effects of the different proposals from the European Commission to include aviation in the European Emission Trading System (ETS). Roughly at the same time CE Delft was commissioned to study the overall impacts of this inclusion for the European Commission. Both studies considered the possibility that inclusion of aviation in the ETS could lead to the distortion of competition between airlines through cross-subsidisation. The studies concluded differently on additional possibilities for cross-subsidisation. As a result, both parties have different views on the possible distortion of the competitive market on routes where EU-based carriers compete directly with carriers based outside the EU. CE Delft concluded that 'none of the policy options considered in this study will significantly damage the competitive position of EU airlines relative to non-EU airlines'. In contrast, MVA and SEO (2006) concluded that 'effective cross-subsidisation by non-EU carriers in the Departing EU scope of the ETS appears to be more probable than cross-subsidisation by EU network carriers in the Intra-EU scope of the ETS'. In July 2007, the Dutch Ministry of Transport, DGTL commissioned CE Delft, MVA and SEO to study the causes for their different opinions and to see whether a further investigation could shed more light on the likelihood of additional cross-subsidisation. Formally, the aim of the work currently carried out is: (1) To determine whether it is possible to assess the impacts on the competitive market between EU based carriers and non-EU based carriers based on sound economic reasoning and analysis of empirical data; and, if so, (2) to determine whether the inclusion of aviation in ETS as proposed by the European Commission will offer non-EU airlines the opportunity to increase their

  13. Carvacrol, a food-additive, provides neuroprotection on focal cerebral ischemia/reperfusion injury in mice.

    Directory of Open Access Journals (Sweden)

    Hailong Yu

    Full Text Available Carvacrol (CAR, a naturally occurring monoterpenic phenol and food additive, has been shown to have antimicrobials, antitumor, and antidepressant-like activities. A previous study demonstrated that CAR has the ability to protect liver against ischemia/reperfusion injury in rats. In this study, we investigated the protective effects of CAR on cerebral ischemia/reperfusion injury in a middle cerebral artery occlusion mouse model. We found that CAR (50 mg/kg significantly reduced infarct volume and improved neurological deficits after 75 min of ischemia and 24 h of reperfusion. This neuroprotection was in a dose-dependent manner. Post-treatment with CAR still provided protection on infarct volume when it was administered intraperitoneally at 2 h after reperfusion; however, intracerebroventricular post-treatment reduced infarct volume even when the mice were treated with CAR at 6 h after reperfusion. These findings indicated that CAR has an extended therapeutic window, but delivery strategies may affect the protective effects of CAR. Further, we found that CAR significantly decreased the level of cleaved caspase-3, a marker of apoptosis, suggesting the anti-apoptotic activity of CAR. Finally, our data indicated that CAR treatment increased the level of phosphorylated Akt and the neuroprotection of CAR was reversed by a PI3K inhibitor LY-294002, demonstrating the involvement of the PI3K/Akt pathway in the anti-apoptotic mechanisms of CAR. Due to its safety and wide use in the food industry, CAR is a promising agent to be translated into clinical trials.

  14. Prey-predator dynamics with prey refuge providing additional food to predator

    International Nuclear Information System (INIS)

    Ghosh, Joydev; Sahoo, Banshidhar; Poria, Swarup

    2017-01-01

    Highlights: • The effects of interplay between prey refugia and additional food are reported. • Hopf bifurcation conditions are derived analytically. • Existence of unique limit cycle is shown analytically. • Predator extinction may be possible at very high prey refuge ecological systems. - Abstract: The impacts of additional food for predator on the dynamics of a prey-predator model with prey refuge are investigated. The equilibrium points and their stability behaviours are determined. Hopf bifurcation conditions are derived analytically. Most significantly, existence conditions for unique stable limit cycle in the phase plane are shown analytically. The analytical results are in well agreement with the numerical simulation results. Effects of variation of refuge level as well as the variation of quality and quantity of additional food on the dynamics are reported with the help of bifurcation diagrams. It is found that high quality and high quantity of additional food supports oscillatory coexistence of species. It is observed that predator extinction possibility in high prey refuge ecological systems may be removed by supplying additional food to predator population. The reported theoretical results may be useful to conservation biologist for species conservation in real world ecological systems.

  15. The Hofmeister effect on nanodiamonds: How addition of ions provides superior drug loading platforms

    KAUST Repository

    Guo, Yong; Li, Song; Li, Wengang; Moosa, Basem; Khashab, Niveen M.

    2014-01-01

    Colloidal nanodiamonds (NDs) have emerged as highly versatile platforms for the controlled delivery of therapeutics, proteins, DNA, and other assorted biological agents. The most common mechanism of drug loading onto the ND surface depends mainly

  16. Decision support system of e-book provider selection for library using Simple Additive Weighting

    Science.gov (United States)

    Ciptayani, P. I.; Dewi, K. C.

    2018-01-01

    Each library has its own criteria and differences in the importance of each criterion in choosing an e-book provider for them. The large number of providers and the different importance levels of each criterion make the problem of determining the e-book provider to be complex and take a considerable time in decision making. The aim of this study was to implement Decision support system (DSS) to assist the library in selecting the best e-book provider based on their preferences. The way of DSS works is by comparing the importance of each criterion and the condition of each alternative decision. SAW is one of DSS method that is quite simple, fast and widely used. This study used 9 criteria and 18 provider to demonstrate how SAW work in this study. With the DSS, then the decision-making time can be shortened and the calculation results can be more accurate than manual calculations.

  17. Additive, control, energy, medical and other hot topics

    NARCIS (Netherlands)

    Brouwer, Dannis Michel

    2014-01-01

    The 14th International Conference of the European Society for Precision Engineering and Nanotechnology (euspen) was held in Dubrovnik, Croatia, on 2-6 June 2014. Among the hot topics discussed were additive manufacturing (AM), motion control in precision systems, renewable energy technologies, and

  18. Biliary complications following orthotopic liver transplantation: May contrast-enhanced MR Cholangiography provide additional information?

    Directory of Open Access Journals (Sweden)

    Piero Boraschi

    2016-01-01

    Conclusions: Contrast-enhanced T1-weighted MR Cholangiography may improve the level of diagnostic confidence provided by conventional T2-weighted MR Cholangiography in the evaluation of biliary complications after orthotopic liver transplantation.

  19. Additive Manufacturing: Multi Material Processing and Part Quality Control

    DEFF Research Database (Denmark)

    Pedersen, David Bue

    This Ph.D dissertation,ffAdditive Manufacturing: Multi Material Processing and Part Quality Controlff, deal with Additive Manufacturing technologies which is a common name for a series of processes that are recognized by being computer controlled, highly automated, and manufacture objects...... by a layered deposition of material. Two areas of particular interest is addressed. They are rooted in two very different areas, yet is intended to fuel the same goal. To help Additive Manufacturing technologies one step closer to becoming the autonomous, digital manufacturing method of tomorrow. Vision...... systems A paradox exist in the field of Additive Manufacturing. The technologies allow for close-to unrestrained and integral geometrical freedom. Almost any geometry can be manufactured fast, e"ciently and cheap. Something that has been missing fundamental capability since the entering of the industrial...

  20. Differential activation of an identified motor neuron and neuromodulation provide Aplysia's retractor muscle an additional function.

    Science.gov (United States)

    McManus, Jeffrey M; Lu, Hui; Cullins, Miranda J; Chiel, Hillel J

    2014-08-15

    To survive, animals must use the same peripheral structures to perform a variety of tasks. How does a nervous system employ one muscle to perform multiple functions? We addressed this question through work on the I3 jaw muscle of the marine mollusk Aplysia californica's feeding system. This muscle mediates retraction of Aplysia's food grasper in multiple feeding responses and is innervated by a pool of identified neurons that activate different muscle regions. One I3 motor neuron, B38, is active in the protraction phase, rather than the retraction phase, suggesting the muscle has an additional function. We used intracellular, extracellular, and muscle force recordings in several in vitro preparations as well as recordings of nerve and muscle activity from intact, behaving animals to characterize B38's activation of the muscle and its activity in different behavior types. We show that B38 specifically activates the anterior region of I3 and is specifically recruited during one behavior, swallowing. The function of this protraction-phase jaw muscle contraction is to hold food; thus the I3 muscle has an additional function beyond mediating retraction. We additionally show that B38's typical activity during in vivo swallowing is insufficient to generate force in an unmodulated muscle and that intrinsic and extrinsic modulation shift the force-frequency relationship to allow contraction. Using methods that traverse levels from individual neuron to muscle to intact animal, we show how regional muscle activation, differential motor neuron recruitment, and neuromodulation are key components in Aplysia's generation of multifunctionality. Copyright © 2014 the American Physiological Society.

  1. Kinesthetic Imagery Provides Additive Benefits to Internal Visual Imagery on Slalom Task Performance.

    Science.gov (United States)

    Callow, Nichola; Jiang, Dan; Roberts, Ross; Edwards, Martin G

    2017-02-01

    Recent brain imaging research demonstrates that the use of internal visual imagery (IVI) or kinesthetic imagery (KIN) activates common and distinct brain areas. In this paper, we argue that combining the imagery modalities (IVI and KIN) will lead to a greater cognitive representation (with more brain areas activated), and this will cause a greater slalom-based motor performance compared with using IVI alone. To examine this assertion, we randomly allocated 56 participants to one of the three groups: IVI, IVI and KIN, or a math control group. Participants performed a slalom-based driving task in a driving simulator, with average lap time used as a measure of performance. Results revealed that the IVI and KIN group achieved significantly quicker lap times than the IVI and the control groups. The discussion includes a theoretical advancement on why the combination of imagery modalities might facilitate performance, with links made to the cognitive neuroscience literature and applied practice.

  2. 42 CFR 424.516 - Additional provider and supplier requirements for enrolling and maintaining active enrollment...

    Science.gov (United States)

    2010-10-01

    ... on the type of services or supplies the provider or supplier type will furnish and bill Medicare. (3... the HHS Common Rule at 45 CFR part 76. (b) Reporting requirements Independent Diagnostic Testing... documentation includes written and electronic documents (including the NPI of the physician who ordered the home...

  3. Translation Initiation from Conserved Non-AUG Codons Provides Additional Layers of Regulation and Coding Capacity

    Directory of Open Access Journals (Sweden)

    Ivaylo P. Ivanov

    2017-06-01

    Full Text Available Neurospora crassa cpc-1 and Saccharomyces cerevisiae GCN4 are homologs specifying transcription activators that drive the transcriptional response to amino acid limitation. The cpc-1 mRNA contains two upstream open reading frames (uORFs in its >700-nucleotide (nt 5′ leader, and its expression is controlled at the level of translation in response to amino acid starvation. We used N. crassa cell extracts and obtained data indicating that cpc-1 uORF1 and uORF2 are functionally analogous to GCN4 uORF1 and uORF4, respectively, in controlling translation. We also found that the 5′ region upstream of the main coding sequence of the cpc-1 mRNA extends for more than 700 nucleotides without any in-frame stop codon. For 100 cpc-1 homologs from Pezizomycotina and from selected Basidiomycota, 5′ conserved extensions of the CPC1 reading frame are also observed. Multiple non-AUG near-cognate codons (NCCs in the CPC1 reading frame upstream of uORF2, some deeply conserved, could potentially initiate translation. At least four NCCs initiated translation in vitro. In vivo data were consistent with initiation at NCCs to produce N-terminally extended N. crassa CPC1 isoforms. The pivotal role played by CPC1, combined with its translational regulation by uORFs and NCC utilization, underscores the emerging significance of noncanonical initiation events in controlling gene expression.

  4. A genomic island provides Acidithiobacillus ferrooxidans ATCC 53993 additional copper resistance: a possible competitive advantage.

    Science.gov (United States)

    Orellana, Luis H; Jerez, Carlos A

    2011-11-01

    There is great interest in understanding how extremophilic biomining bacteria adapt to exceptionally high copper concentrations in their environment. Acidithiobacillus ferrooxidans ATCC 53993 genome possesses the same copper resistance determinants as strain ATCC 23270. However, the former strain contains in its genome a 160-kb genomic island (GI), which is absent in ATCC 23270. This GI contains, amongst other genes, several genes coding for an additional putative copper ATPase and a Cus system. A. ferrooxidans ATCC 53993 showed a much higher resistance to CuSO(4) (>100 mM) than that of strain ATCC 23270 (<25 mM). When a similar number of bacteria from each strain were mixed and allowed to grow in the absence of copper, their respective final numbers remained approximately equal. However, in the presence of copper, there was a clear overgrowth of strain ATCC 53993 compared to ATCC 23270. This behavior is most likely explained by the presence of the additional copper-resistance genes in the GI of strain ATCC 53993. As determined by qRT-PCR, it was demonstrated that these genes are upregulated when A. ferrooxidans ATCC 53993 is grown in the presence of copper and were shown to be functional when expressed in copper-sensitive Escherichia coli mutants. Thus, the reason for resistance to copper of two strains of the same acidophilic microorganism could be determined by slight differences in their genomes, which may not only lead to changes in their capacities to adapt to their environment, but may also help to select the more fit microorganisms for industrial biomining operations. © Springer-Verlag 2011

  5. Computerized analysis of isometric tension studies provides important additional information about vasomotor activity

    Directory of Open Access Journals (Sweden)

    Vincent M.B.

    1997-01-01

    Full Text Available Concentration-response curves of isometric tension studies on isolated blood vessels are obtained traditionally. Although parameters such as Imax, EC50 and pA2 may be readily calculated, this method does not provide information on the temporal profile of the responses or the actual nature of the reaction curves. Computerized data acquisition systems can be used to obtain average data that represent a new source of otherwise inaccessible information, since early and late responses may be observed separately in detail

  6. 34 CFR 645.13 - What additional services do Upward Bound Math and Science Centers provide and how are they...

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What additional services do Upward Bound Math and... Program? § 645.13 What additional services do Upward Bound Math and Science Centers provide and how are... provided under § 645.11(b), an Upward Bound Math and Science Center must provide— (1) Intensive instruction...

  7. Grain Structure Control of Additively Manufactured Metallic Materials

    Directory of Open Access Journals (Sweden)

    Fuyao Yan

    2017-11-01

    Full Text Available Grain structure control is challenging for metal additive manufacturing (AM. Grain structure optimization requires the control of grain morphology with grain size refinement, which can improve the mechanical properties of additive manufactured components. This work summarizes methods to promote fine equiaxed grains in both the additive manufacturing process and subsequent heat treatment. Influences of temperature gradient, solidification velocity and alloy composition on grain morphology are discussed. Equiaxed solidification is greatly promoted by introducing a high density of heterogeneous nucleation sites via powder rate control in the direct energy deposition (DED technique or powder surface treatment for powder-bed techniques. Grain growth/coarsening during post-processing heat treatment can be restricted by presence of nano-scale oxide particles formed in-situ during AM. Grain refinement of martensitic steels can also be achieved by cyclic austenitizing in post-processing heat treatment. Evidently, new alloy powder design is another sustainable method enhancing the capability of AM for high-performance components with desirable microstructures.

  8. The Hofmeister effect on nanodiamonds: How addition of ions provides superior drug loading platforms

    KAUST Repository

    Guo, Yong

    2014-01-01

    Colloidal nanodiamonds (NDs) have emerged as highly versatile platforms for the controlled delivery of therapeutics, proteins, DNA, and other assorted biological agents. The most common mechanism of drug loading onto the ND surface depends mainly on electrostatic interactions. Although a few reports have been published on using NaCl salt to increase the drug loading onto NDs, no comprehensive mechanistic study with a wide range of anions and cations has been reported. In this work, the Hofmeister effect of inorganic salts and amino acids with different isoelectric points was employed to understand the mechanism of doxorubicin (DOXH+) loading onto NDs with different sizes. Inorganic salts including NaCl, NaNO3, Na2SO4, KCl, CaCl2, (NH4)2SO4 and amino acids with an isoelectric point above 7 (positively charged at neutral pH) increase the DOXH+ loading onto small size NDs (SNDs, 5-10 nm). On the other hand, amino acids with an isoelectric point below 7 (negatively charged at neutral pH) increase the DOXH+ loading onto large size NDs (LNDs, 80-100 nm). © 2014 The Royal Society of Chemistry.

  9. Do detour tasks provide accurate assays of inhibitory control?

    Science.gov (United States)

    Whiteside, Mark A.; Laker, Philippa R.; Beardsworth, Christine E.

    2018-01-01

    Transparent Cylinder and Barrier tasks are used to purportedly assess inhibitory control in a variety of animals. However, we suspect that performances on these detour tasks are influenced by non-cognitive traits, which may result in inaccurate assays of inhibitory control. We therefore reared pheasants under standardized conditions and presented each bird with two sets of similar tasks commonly used to measure inhibitory control. We recorded the number of times subjects incorrectly attempted to access a reward through transparent barriers, and their latencies to solve each task. Such measures are commonly used to infer the differential expression of inhibitory control. We found little evidence that their performances were consistent across the two different Putative Inhibitory Control Tasks (PICTs). Improvements in performance across trials showed that pheasants learned the affordances of each specific task. Critically, prior experience of transparent tasks, either Barrier or Cylinder, also improved subsequent inhibitory control performance on a novel task, suggesting that they also learned the general properties of transparent obstacles. Individual measures of persistence, assayed in a third task, were positively related to their frequency of incorrect attempts to solve the transparent inhibitory control tasks. Neophobia, Sex and Body Condition had no influence on individual performance. Contrary to previous studies of primates, pheasants with poor performance on PICTs had a wider dietary breadth assayed using a free-choice task. Our results demonstrate that in systems or taxa where prior experience and differences in development cannot be accounted for, individual differences in performance on commonly used detour-dependent PICTS may reveal more about an individual's prior experience of transparent objects, or their motivation to acquire food, than providing a reliable measure of their inhibitory control. PMID:29593115

  10. Network Physics - the only company to provide physics-based network management - secures additional funding and new executives

    CERN Multimedia

    2003-01-01

    "Network Physics, the only provider of physics-based network management products, today announced an additional venture round of $6 million in funding, as well as the addition of David Jones as president and CEO and Tom Dunn as vice president of sales and business development" (1 page).

  11. Additives for pH control in PWR secondary water

    International Nuclear Information System (INIS)

    Cobble, J.W.; Turner, P.J.

    1985-08-01

    The purpose of this project is the development of methods for identifying the most promising materials for use as pH control agents in steam generator and auxiliary hot water systems. The methods developed in the first project year to select new pH control agents have been explored in more detail in an effort to assess and improve their reliability. In addition, some new classes of compounds which were not treatable before have been examined on the basis of new experimental results. Predictions of pH and volatility to 300 0 C have now been made for a total of 79 organic bases. Some of the newer classes of compounds studied present properties which may make them of interest either as secondary additives or as principal agents in the event of change in the approach to water treatment. While there have been no substantial changes in number of compounds which meet all EPRI criteria, there are other species which may meet the EPRI criteria after further research. 19 refs., 31 tabs

  12. ManiWordle: providing flexible control over Wordle.

    Science.gov (United States)

    Koh, Kyle; Lee, Bongshin; Kim, Bohyoung; Seo, Jinwook

    2010-01-01

    Among the multifarious tag-clouding techniques, Wordle stands out to the community by providing an aesthetic layout, eliciting the emergence of the participatory culture and usage of tag-clouding in the artistic creations. In this paper, we introduce ManiWordle, a Wordle-based visualization tool that revamps interactions with the layout by supporting custom manipulations. ManiWordle allows people to manipulate typography, color, and composition not only for the layout as a whole, but also for the individual words, enabling them to have better control over the layout result. We first describe our design rationale along with the interaction techniques for tweaking the layout. We then present the results both from the preliminary usability study and from the comparative study between ManiWordle and Wordle. The results suggest that ManiWordle provides higher user satisfaction and an efficient method of creating the desired "art work," harnessing the power behind the ever-increasing popularity of Wordle.

  13. [Critical of the additive model of the randomized controlled trial].

    Science.gov (United States)

    Boussageon, Rémy; Gueyffier, François; Bejan-Angoulvant, Theodora; Felden-Dominiak, Géraldine

    2008-01-01

    Randomized, double-blind, placebo-controlled clinical trials are currently the best way to demonstrate the clinical effectiveness of drugs. Its methodology relies on the method of difference (John Stuart Mill), through which the observed difference between two groups (drug vs placebo) can be attributed to the pharmacological effect of the drug being tested. However, this additive model can be questioned in the event of statistical interactions between the pharmacological and the placebo effects. Evidence in different domains has shown that the placebo effect can influence the effect of the active principle. This article evaluates the methodological, clinical and epistemological consequences of this phenomenon. Topics treated include extrapolating results, accounting for heterogeneous results, demonstrating the existence of several factors in the placebo effect, the necessity to take these factors into account for given symptoms or pathologies, as well as the problem of the "specific" effect.

  14. Fluxional additives: a second generation control in enantioselective catalysis.

    Science.gov (United States)

    Sibi, Mukund P; Manyem, Shankar; Palencia, Hector

    2006-10-25

    The concept of "fluxional additives", additives that can adopt enantiomeric conformations depending on the chiral information in the ligand, is demonstrated in enantioselective Diels-Alder and nitrone cycloaddition reactions. The additive design is modular, and diverse structures are accessible in three steps. Chiral Lewis acids from main group and transition metals show enhancements in enantioselectivity in the presence of these additives.

  15. Rural providers' access to online resources: a randomized controlled trial

    Science.gov (United States)

    Hall, Laura J.; McElfresh, Karen R.; Warner, Teddy D.; Stromberg, Tiffany L.; Trost, Jaren; Jelinek, Devin A.

    2016-01-01

    Objective The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state. Methods In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen's d statistic to compare pre- and post-study effects sizes. Results Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen's d increase of +1.50 compared to AccessMedicine users' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen's d. Conclusion Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine. PMID:26807050

  16. Metal-mediated aminocatalysis provides mild conditions: Enantioselective Michael addition mediated by primary amino catalysts and alkali-metal ions

    Directory of Open Access Journals (Sweden)

    Matthias Leven

    2013-01-01

    Full Text Available Four catalysts based on new amides of chiral 1,2-diamines and 2-sulfobenzoic acid have been developed. The alkali-metal salts of these betaine-like amides are able to form imines with enones, which are activated by Lewis acid interaction for nucleophilic attack by 4-hydroxycoumarin. The addition of 4-hydroxycoumarin to enones gives ee’s up to 83% and almost quantitative yields in many cases. This novel type of catalysis provides an effective alternative to conventional primary amino catalysis were strong acid additives are essential components.

  17. Tailor-Made Additives for Morphology Control in Molecular Bulk-Heterojunction Photovoltaics

    KAUST Repository

    Graham, Kenneth R.

    2013-01-09

    Tailor-made additives, which are molecules that share the same molecular structure as a parent molecule with only slight structural variations, have previously been demonstrated as a useful means to control crystallization dynamics in solution. For example, tailor-made additives can be added to solutions of a crystallizing parent molecule to alter the crystal growth rate, size, and shape. We apply this strategy as a means to predictably control morphology in molecular bulk-heterojunction (BHJ) photovoltaic cells. Through the use of an asymmetric oligomer substituted with a bulky triisobutylsilyl end group, the morphology of BHJ blends can be controlled resulting in a near doubling (from 1.3 to 2.2%) in power conversion efficiency. The use of tailor-made additives provides promising opportunities for controlling crystallization dynamics, and thereby film morphologies, for many organic electronic devices such as photovoltaics and field-effect transistors. © 2012 American Chemical Society.

  18. Tailor-Made Additives for Morphology Control in Molecular Bulk-Heterojunction Photovoltaics

    KAUST Repository

    Graham, Kenneth R.; Stalder, Romain; Wieruszewski, Patrick M.; Patel, Dinesh G.; Salazar, Danielle H.; Reynolds, John R.

    2013-01-01

    Tailor-made additives, which are molecules that share the same molecular structure as a parent molecule with only slight structural variations, have previously been demonstrated as a useful means to control crystallization dynamics in solution. For example, tailor-made additives can be added to solutions of a crystallizing parent molecule to alter the crystal growth rate, size, and shape. We apply this strategy as a means to predictably control morphology in molecular bulk-heterojunction (BHJ) photovoltaic cells. Through the use of an asymmetric oligomer substituted with a bulky triisobutylsilyl end group, the morphology of BHJ blends can be controlled resulting in a near doubling (from 1.3 to 2.2%) in power conversion efficiency. The use of tailor-made additives provides promising opportunities for controlling crystallization dynamics, and thereby film morphologies, for many organic electronic devices such as photovoltaics and field-effect transistors. © 2012 American Chemical Society.

  19. An overview of zinc addition for BWR dose rate control

    Energy Technology Data Exchange (ETDEWEB)

    Marble, W.J. [GE Nuclear Energy, San Jose, CA (United States)

    1995-03-01

    This paper presents an overview of the BWRs employing feedwater zinc addition to reduce primary system dose rates. It identifies which BWRs are using zinc addition and reviews the mechanical injection and passive addition hardware currently being employed. The impact that zinc has on plant chemistry, including the factor of two to four reduction in reactor water Co-60 concentrations, is discussed. Dose rate results, showing the benefits of implementing zinc on either fresh piping surfaces or on pipes with existing films are reviewed. The advantages of using zinc that is isotopically enhanced by the depletion of the Zn-64 precursor to Zn-65 are identified.

  20. Centralised gaming models: providing optimal gambling behaviour controls

    OpenAIRE

    Griffiths, MD; Wood, RTA

    2009-01-01

    The expansion in the gaming industry and its widening attraction points to the need for ever more verifiable means of controlling problem gambling. Various strategies have been built into casino venue operations to address this, but recently, following a new focus on social responsibility, a group of experts considered the possibilities of a centralised gaming model as a more effective control mechanism for dealing with gambling behaviours.

  1. Additional considerations regarding the choice of measurement control check frequency

    International Nuclear Information System (INIS)

    Bruckner, L.A.

    1993-01-01

    In a previous paper, factors involved in the choice of frequency of instrument measurement control checks were presented. Unfortunately, some discussions were inadvertently omitted from the paper during the process of review, editing and printing. That material is presented here

  2. Estimation and Control for Linear Systems with Additive Cauchy Noise

    Science.gov (United States)

    2013-12-17

    man & Hall, New York, 1994. [11] J. L. Speyer and W. H. Chung, Stochastic Processes, Estimation, and Control, SIAM, 2008. [12] Nassim N. Taleb ...Gaussian control algorithms. 18 4 References [1] N. N. Taleb . The Black Swan: The Impact of the Highly Improbable...the multivariable system. The estimator was then evaluated numerically for a third-order example. REFERENCES [1] N. N. Taleb , The Black Swan: The

  3. Distributed Smart Grid Asset Control Strategies for Providing Ancillary Services

    Energy Technology Data Exchange (ETDEWEB)

    Kalsi, Karanjit [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhang, Wei [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lian, Jianming [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Marinovici, Laurentiu D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Moya, Christian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dagle, Jeffery E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-10-30

    With large-scale plans to integrate renewable generation driven mainly by state-level renewable portfolio requirements, more resources will be needed to compensate for the uncertainty and variability associated with intermittent generation resources. Distributed assets can be used to mitigate the concerns associated with renewable energy resources and to keep costs down. Under such conditions, performing primary frequency control using only supply-side resources becomes not only prohibitively expensive but also technically difficult. It is therefore important to explore how a sufficient proportion of the loads could assume a routine role in primary frequency control to maintain the stability of the system at an acceptable cost. The main objective of this project is to develop a novel hierarchical distributed framework for frequency based load control. The framework involves two decision layers. The top decision layer determines the optimal gain for aggregated loads for each load bus. The gains are computed using decentralized robust control methods, and will be broadcast to the corresponding participating loads every control period. The second layer consists of a large number of heterogeneous devices, which switch probabilistically during contingencies so that aggregated power change matches the desired amount according to the most recently received gains. The simulation results show great potential to enable systematic design of demand-side primary frequency control with stability guarantees on the overall power system. The proposed design systematically accounts for the interactions between the total load response and bulk power system frequency dynamics. It also guarantees frequency stability under a wide range of time varying operating conditions. The local device-level load response rules fully respect the device constraints (such as temperature setpoint, compressor time delays of HVACs, or arrival and departure of the deferrable loads), which are crucial for

  4. Antagonistic control of a dual-input mammalian gene switch by food additives.

    Science.gov (United States)

    Xie, Mingqi; Ye, Haifeng; Hamri, Ghislaine Charpin-El; Fussenegger, Martin

    2014-08-01

    Synthetic biology has significantly advanced the design of mammalian trigger-inducible transgene-control devices that are able to programme complex cellular behaviour. Fruit-based benzoate derivatives licensed as food additives, such as flavours (e.g. vanillate) and preservatives (e.g. benzoate), are a particularly attractive class of trigger compounds for orthogonal mammalian transgene control devices because of their innocuousness, physiological compatibility and simple oral administration. Capitalizing on the genetic componentry of the soil bacterium Comamonas testosteroni, which has evolved to catabolize a variety of aromatic compounds, we have designed different mammalian gene expression systems that could be induced and repressed by the food additives benzoate and vanillate. When implanting designer cells engineered for gene switch-driven expression of the human placental secreted alkaline phosphatase (SEAP) into mice, blood SEAP levels of treated animals directly correlated with a benzoate-enriched drinking programme. Additionally, the benzoate-/vanillate-responsive device was compatible with other transgene control systems and could be assembled into higher-order control networks providing expression dynamics reminiscent of a lap-timing stopwatch. Designer gene switches using licensed food additives as trigger compounds to achieve antagonistic dual-input expression profiles and provide novel control topologies and regulation dynamics may advance future gene- and cell-based therapies. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

  5. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2016-10-01

    implement and evaluate a cost effective, web based self-paced training program to provide skills- oriented continuing education for mental health...Product Aim(s) The purpose of this study is to design, implement and evaluate a web based training program providing skills- oriented continuing education ...Rates and Data Quality i. The team collaborated with the VHA NCPTSD to monitor the collection rates and data quality on a weekly basis . b. Create Interim

  6. Perfusion magnetic resonance imaging provides additional information as compared to anatomical imaging for decision-making in vestibular schwannoma

    International Nuclear Information System (INIS)

    Kleijwegt, M.C.; Mey, A.G.L. van der; Wiggers-deBruine, F.T.; Malessy, M.J.A; Osch, M.J.P. van

    2016-01-01

    •DSC/ASL-MRI can be acquired in growing VS with sufficient image quality.•In most patients DSC and ASL techniques provide similar qualitative scores.•These techniques can be of importance in future decision-making. DSC/ASL-MRI can be acquired in growing VS with sufficient image quality. In most patients DSC and ASL techniques provide similar qualitative scores. These techniques can be of importance in future decision-making. The added value of perfusion MRI for decision-making in vestibular schwannoma (VS) patients is unknown. MRI offers two perfusion methods: the first employing contrast agent (dynamic susceptibility contrast (DSC)-MRI) that provides information on cerebral blood volume (CBV) and cerebral blood flow (CBF), the second by magnetic labeling of blood (arterial spin labeling (ASL)-MRI), providing CBF-images. The goal of the current study is to investigate whether DSC and ASL perfusion MRI provides complimentary information to current anatomical imaging in treatment selection process of VS. Nine patients with growing VS with extrameatal diameter >9 mm were included (>2 mm/year and 20% volume expansion/year) and one patient with 23 mm extrameatal VS without growth. DSC and ASL perfusion MRI were obtained on 3 T MRI. Perfusion in VS was scored as hyperintense, hypointense or isointense compared to the contralateral region. Seven patients showed hyperintense signal on DSC and ASL sequences. Three patients showed iso- or hypointense signal on at least one perfusion map (1 patient hypointense on both DSC-MRI and ASL; 1 patient isointense on DSC-CBF; 1 patient isointense on ASL). All patients showed enhancement on post-contrast T1 anatomical scan. Perfusion MR provides additional information compared to anatomical imaging for decision-making in VS

  7. Moment based model predictive control for systems with additive uncertainty

    NARCIS (Netherlands)

    Saltik, M.B.; Ozkan, L.; Weiland, S.; Ludlage, J.H.A.

    2017-01-01

    In this paper, we present a model predictive control (MPC) strategy based on the moments of the state variables and the cost functional. The statistical properties of the state predictions are calculated through the open loop iteration of dynamics and used in the formulation of MPC cost function. We

  8. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2016-10-29

    clinician applicants occurred. b. SP baseline interviews with eligible clinicians occurred. c. Automated random assignment of participants with Completed SP...intervention without web-centered supervision and a wait-list control with regard to improvements in two CBT-based skill areas (behavioral task...Secondary Aim #1: To compare improvements in knowledge and attitudes following internet- based training with or without web-centered supervision and

  9. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2013-10-01

    behavioral therapy (CBT) interventions have been shown to be effective in alleviating symptoms of Post - Traumatic Stress Disorder ( PTSD ) and related... traumatic stress disorder treatment providers: design and methods for a randomized, prospective intervention study. Implement Sci, 7, 43. doi: 10.1186...Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder

  10. Porosity Measurements and Analysis for Metal Additive Manufacturing Process Control.

    Science.gov (United States)

    Slotwinski, John A; Garboczi, Edward J; Hebenstreit, Keith M

    2014-01-01

    Additive manufacturing techniques can produce complex, high-value metal parts, with potential applications as critical metal components such as those found in aerospace engines and as customized biomedical implants. Material porosity in these parts is undesirable for aerospace parts - since porosity could lead to premature failure - and desirable for some biomedical implants - since surface-breaking pores allows for better integration with biological tissue. Changes in a part's porosity during an additive manufacturing build may also be an indication of an undesired change in the build process. Here, we present efforts to develop an ultrasonic sensor for monitoring changes in the porosity in metal parts during fabrication on a metal powder bed fusion system. The development of well-characterized reference samples, measurements of the porosity of these samples with multiple techniques, and correlation of ultrasonic measurements with the degree of porosity are presented. A proposed sensor design, measurement strategy, and future experimental plans on a metal powder bed fusion system are also presented.

  11. Hepatitis B virus vaccination booster does not provide additional protection in adolescents: a cross-sectional school-based study.

    Science.gov (United States)

    Chang, Yung-Chieh; Wang, Jen-Hung; Chen, Yu-Sheng; Lin, Jun-Song; Cheng, Ching-Feng; Chu, Chia-Hsiang

    2014-09-23

    Current consensus does not support the use of a universal booster of hepatitis B virus (HBV) vaccine because there is an anamnestic response in almost all children 15 years after universal infant HBV vaccination. We aimed to provide a booster strategy among adolescents as a result of their changes in lifestyle and sexual activity. This study comprised a series of cross-sectional serological surveys of HBV markers in four age groups between 2004 and 2012. The seropositivity rates of hepatitis B surface antigen (HBsAg) and its reciprocal antibody (anti-HBs) for each age group were collected. There were two parts to this study; age-specific HBV seroepidemiology and subgroup analysis, including effects of different vaccine types, booster response for immunogenicity at 15 years of age, and longitudinal follow-up to identify possible additional protection by HBV booster. Within the study period, data on serum anti-HBs and HBsAg in a total of 6950 students from four age groups were collected. The overall anti-HBs and HBsAg seropositivity rates were 44.3% and 1.2%, respectively. The anti-HBs seropositivity rate in the plasma-derived subgroup was significantly higher in both 15- and 18-year age groups. Overall response rate in the double-seronegative recipients at 15 years of age was 92.5% at 6 weeks following one recombinant HBV booster dose. Among the 24 recipients showing anti-HBs seroconversion at 6 weeks after booster, seven subjects (29.2%) had lost their anti-HBs seropositivity again within 3 years. Increased seropositivity rates and titers of anti-HBs did not provide additional protective effects among subjects comprehensively vaccinated against HBV in infancy. HBV booster strategy at 15 years of age was the main contributor to the unique age-related phenomenon of anti-HBs seropositivity rate and titer. No increase in HBsAg seropositivity rates within different age groups was observed. Vaccination with plasma-derived HBV vaccines in infancy provided higher

  12. Enhancement of Engine Oil Wear and Friction Control Performance Through Titanium Additive Chemistry

    International Nuclear Information System (INIS)

    Guevremont, J.; Guinther, G.; Szemenyei, D.; Devlin, M.; Jao, T.; Jaye, C.; Woicik, J.; Fischer, D.

    2008-01-01

    Traditionally, wear protection and friction modification by engine oil is provided by zinc dithiophosphate (ZDDP) or other phosphorus compounds. These additives provide effective wear protection and friction control on engine parts through formation of a glassy polyphosphate antiwear film. However, the deposition of phosphorus species on automotive catalytic converters from lubricants has been known for some time to have a detrimental effect of poisoning the catalysts. To mitigate the situation, the industry has been making every effort to find ZDDP-replacement additives that are friendly to catalysts. Toward this goal we have investigated a titanium additive chemistry as a ZDDP replacement. Fully formulated engine oils incorporating this additive component have been found to be effective in reducing wear and controlling friction in a high-frequency reciprocating rig (HFRR), 4-ball bench wear, Sequence IIIG, and Sequence IVA engine tests. Surface analysis of the tested parts by Auger electron spectroscopy, secondary ion mass spectrometry (SIMS), and X-ray photoelectron spectroscopy (XPS) have shown that Ti species have been incorporated into the wear tracks and can only be found on the wear tracks. We used synchrotron based near edge X-ray absorption fine structure (NEXAFS) to investigate the chemical bonding mechanism of the Ti additive with the metal surface that affects the wear improvement mechanism. We postulate that Ti provides antiwear enhancement through inclusion in the metal/metal oxide structure of the ferrous surface by forming FeTiO3.

  13. Picture processing computer to control movement by computer provided vision

    Energy Technology Data Exchange (ETDEWEB)

    Graefe, V

    1983-01-01

    The author introduces a multiprocessor system which has been specially developed to enable mechanical devices to interpret pictures presented in real time. The separate processors within this system operate simultaneously and independently. By means of freely moveable windows the processors can concentrate on those parts of the picture that are relevant to the control problem. If a machine is to make a correct response to its observation of a picture of moving objects, it must be able to follow the picture sequence, step by step, in real time. As the usual serially operating processors are too slow for such a task, the author describes three models of a special picture processing computer which it has been necessary to develop. 3 references.

  14. A process for providing positive primary control power by wind turbines

    Science.gov (United States)

    Marschner, V.; Michael, J.; Liersch, J.

    2014-12-01

    Due to the increasing share of wind energy in electricity generation, wind turbines have to fulfil additional requirements in the context of grid integration. The paper examines to which extent wind turbines can provide positive control power following the related grid code. The additional power has to be obtained from the rotating flywheel mass of the wind turbine's rotor. A simple physical model is developed that allows to draw conclusions about appropriate concepts by means of a dynamic simulation of the variables rotational speed, torque, power output and rotor power. The paper discusses scenarios to provide control power. The supply of control power at partial load is examined in detail using simulations. Under partial load conditions control power can be fed into the grid for a short time. Thereby the rotational speed drops so that aerodynamic efficiency decreases and feed-in power is below the initial value after the control process. In this way an unfavourable situation for the grid control is produced, therefore the paper proposes a modified partial load condition with a higher rotational speed. By providing primary control power the rotor is delayed to the optimum rotational speed so that more rotational energy can be fed in and fed-in power can be increased persistently. However, as the rotor does not operate at optimum speed, a small amount of the energy yield is lost. Finally, the paper shows that a wind farm can combine these two concepts: A part of the wind turbines work under modified partial load conditions can compensate the decrease of power of the wind turbines working under partial load conditions. Therefore the requested control power is provided and afterwards the original value of power is maintained.

  15. H∞ Control for a Networked Control Model of Systems with Two Additive Time-Varying Delays

    Directory of Open Access Journals (Sweden)

    Hanyong Shao

    2014-01-01

    Full Text Available This paper is concerned with H∞ control for a networked control model of systems with two additive time-varying delays. A new Lyapunov functional is constructed to make full use of the information of the delays, and for the derivative of the Lyapunov functional a novel technique is employed to compute a tighter upper bound, which is dependent on the two time-varying delays instead of the upper bounds of them. Then the convex polyhedron method is proposed to check the upper bound of the derivative of the Lyapunov functional. The resulting stability criteria have fewer matrix variables but less conservatism than some existing ones. The stability criteria are applied to designing a state feedback controller, which guarantees that the closed-loop system is asymptotically stable with a prescribed H∞ disturbance attenuation level. Finally examples are given to show the advantages of the stability criteria and the effectiveness of the proposed control method.

  16. Additional Haptic Information Provided by Anchors Reduces Postural Sway in Young Adults Less Than Does Light Touch

    Directory of Open Access Journals (Sweden)

    Renato Moraes

    2018-06-01

    Full Text Available This study investigated the effect of adding haptic information to the control of posture, as well as comparing the effect of both the “light touch” (LT and “anchor system” (AS paradigms on postural sway. Additionally, it compared the effect of location and number of points of contact to the control of posture in young adults. The location consisted of using the anchors tied to the finger and held by the hands, and, for LT, the fingertip. For the number of points of contact, participants used two hands, and then separately the dominant hand, and the non-dominant hand, for both anchor and LT paradigms. Participants stood upright with feet-together and in tandem position while performing tasks that combined the use of anchors and LT, points of contact (hand grip and finger, and number of points of contact (two hands and one hand. In this study, the anchors consist of holding in each hand a flexible cable with the other end attached to the ground. The LT consists of slightly touching a rigid surface with the tip of the index finger. The results showed, first, that the anchors improved postural control less than did the LT. Second, they revealed that holding the anchors with the hands or with them tied to the fingertip resulted in a similar reduction in postural sway only in the tandem position. For the feet-together position, the anchors tied to the fingertip were ineffective. Similarly, the use of one or two hands did not affect the contribution of the anchors. However, using two hands in the LT condition was more effective than was one hand. Third, our results showed the presence of a temporal delay between force and center-of-pressure (COP for the anchors, only in the AP direction with feet-together. In conclusion, overall, the anchors were less effective in reducing postural sway than was the LT. The anchors attached to fingertips were as effective as the hand-held anchors in the tandem position, yet ineffective during foot

  17. Adiponectin provides additional information to conventional cardiovascular risk factors for assessing the risk of atherosclerosis in both genders.

    Directory of Open Access Journals (Sweden)

    Jin-Ha Yoon

    Full Text Available BACKGROUND: This study evaluated the relation between adiponectin and atherosclerosis in both genders, and investigated whether adiponectin provides useful additional information for assessing the risk of atherosclerosis. METHODS: We measured serum adiponectin levels and other cardiovascular risk factors in 1033 subjects (454 men, 579 women from the Korean Genomic Rural Cohort study. Carotid intima-media-thickness (CIMT was used as measure of atherosclerosis. Odds ratios (ORs with 95% confidence intervals (95% CI were calculated using multiple logistic regression, and receiver operating characteristic curves (ROC, the category-free net reclassification improvement (NRI and integrated discrimination improvement (IDI were calculated. RESULTS: After adjustment for conventional cardiovascular risk factors, such as age, waist circumference, smoking history, low-density and high-density lipoprotein cholesterol, triglycerides, systolic blood pressure and insulin resistance, the ORs (95%CI of the third tertile adiponectin group were 0.42 (0.25-0.72 in men and 0.47 (0.29-0.75 in women. The area under the curve (AUC on the ROC analysis increased significantly by 0.025 in men and 0.022 in women when adiponectin was added to the logistic model of conventional cardiovascular risk factors (AUC in men: 0.655 to 0.680, p = 0.038; AUC in women: 0.654 to 0.676, p = 0.041. The NRI was 0.32 (95%CI: 0.13-0.50, p<0.001, and the IDI was 0.03 (95%CI: 0.01-0.04, p<0.001 for men. For women, the category-free NRI was 0.18 (95%CI: 0.02-0.34, p = 0.031 and the IDI was 0.003 (95%CI: -0.002-0.008, p = 0.189. CONCLUSION: Adiponectin and atherosclerosis were significantly related in both genders, and these relationships were independent of conventional cardiovascular risk factors. Furthermore, adiponectin provided additional information to conventional cardiovascular risk factors regarding the risk of atherosclerosis.

  18. A Self-Oscillating Control Scheme for a Boost Converter Providing a Controlled Output Current

    DEFF Research Database (Denmark)

    Knott, Arnold; Pfaffinger, Gerhard R.; Andersen, Michael A. E.

    2011-01-01

    Most switched mode power supplies provide a regulated voltage at their output. However, there are applications requiring a controlled current. Among others are battery chargers, test equipment for converters driven by solar cells, and LED drivers. This paper describes a dc–dc power converter real...

  19. Dose Tc-99m MIBI scintimammography provide more information additive to contrast enhanced MRI in highly suspected breast cancer patients?

    International Nuclear Information System (INIS)

    Kim, Seong Jang; Kim, In Ju; Kim, Yong Ki; Bae, Young Tae

    2000-01-01

    The aim of this study was to investigate whether Tc-99m MIBI scintimammography (SMM) provide more information than contrast enhanced MRI in highly suspected breast cancer patients. This study included 32 breast lesions of 29 highly suspected patients having breast cancer. All patients were performed SMM and contrast enhanced MRI. The SMMs and contrast enhanced MRI were correlated with histopathologic results. Thirty breast lesions were diagnosed malignant diseases and 2 were diagnosed benign diseases. SMM showed 29 true positives (TP), 1 true negative (TN), 1 false positive (FP), and 1 false negative (FN). The sensitivity was 96.6%. Contrast enhanced MRI revealed 24 TP, 0 TN, 1 FP, 3 FN and 4 indeterminate cases. The sensitivity was 88.8%. In the assessment of axillary lymph node metastasis, SMM showed 9 TP, 10 TN, 0 FP, and 3 FN. The sensitivity and specificity were 75% and 100%. Contrast enhanced MRI revealed 6 TP, 9 TN, 1 FP, and 6 FN. The sensitivity and specificity were 50% and 90%. Among 4 indeterminate cases with MRI findings, SMM correctly diagnosed malignant breast diseases in 3 lesions. However, SMM showed false positive in 1 lesion. SMM could correctly diagnosed malignant breast diseases more 5 lesions than contrast enhanced MRI. SMM revealed higher sensitivity in detection of primary breast cancer and axillary LN metastasis than contrast enhanced MRI. SMMs could correctly diagnosed malignant breast diseases even if the MRI showed indeterminate findings. In highly suspected patients having breast cancer, SMM may provide additive information in detection of breast cancer if contrast enhanced MRI showed indeterminate findings but this is to be determined later by large population based study

  20. Example-based learning: comparing the effects of additionally providing three different integrative learning activities on physiotherapy intervention knowledge.

    Science.gov (United States)

    Dyer, Joseph-Omer; Hudon, Anne; Montpetit-Tourangeau, Katherine; Charlin, Bernard; Mamede, Sílvia; van Gog, Tamara

    2015-03-07

    Example-based learning using worked examples can foster clinical reasoning. Worked examples are instructional tools that learners can use to study the steps needed to solve a problem. Studying worked examples paired with completion examples promotes acquisition of problem-solving skills more than studying worked examples alone. Completion examples are worked examples in which some of the solution steps remain unsolved for learners to complete. Providing learners engaged in example-based learning with self-explanation prompts has been shown to foster increased meaningful learning compared to providing no self-explanation prompts. Concept mapping and concept map study are other instructional activities known to promote meaningful learning. This study compares the effects of self-explaining, completing a concept map and studying a concept map on conceptual knowledge and problem-solving skills among novice learners engaged in example-based learning. Ninety-one physiotherapy students were randomized into three conditions. They performed a pre-test and a post-test to evaluate their gains in conceptual knowledge and problem-solving skills (transfer performance) in intervention selection. They studied three pairs of worked/completion examples in a digital learning environment. Worked examples consisted of a written reasoning process for selecting an optimal physiotherapy intervention for a patient. The completion examples were partially worked out, with the last few problem-solving steps left blank for students to complete. The students then had to engage in additional self-explanation, concept map completion or model concept map study in order to synthesize and deepen their knowledge of the key concepts and problem-solving steps. Pre-test performance did not differ among conditions. Post-test conceptual knowledge was higher (P example and completion example strategies to foster intervention selection.

  1. Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation.

    Science.gov (United States)

    Fang, Michele; Linson, Eric; Suneja, Manish; Kuperman, Ethan F

    2017-02-22

    Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation. In Fiscal Year (FY) 2014 and 2015, an additional faculty member was added to the SCM rotation. In FY 2014, the faculty member was a staff physician, and in FY 2015, the faculty member was an APP.. Resident workload was assessed using billing data. We measured residents' perceptions of the rotation using an anonymous electronic survey tool. We compared FY2014-2015 data to the baseline FY2013. The number of patients seen per resident per day decreased from 8.0(SD 3.3) in FY2013 to 5.0(SD 1.9) in FY2014 (p value of the rotation (40.0%, 72.2%, 72.6% in FY2013, 2014, 2015 respectively, p perceived educational value and clinical experience of a medical consultation rotation.

  2. The drone as an additional risk factor due to conditions not provided for in radiological safety at major events

    International Nuclear Information System (INIS)

    Oliveira, Gilberto de Jesus

    2015-01-01

    Major international events are potential targets of terrorist actions, seeking instant publicity that events of this magnitude provide, with the intention of causing terror and disseminate its power to a large number of people worldwide. In this context, the critical analysis of additional risk factor linked to procedures and protocols adopted on radiation safety is important. The possibility of unforeseen situations of risk, especially those resulting from the current global technological development, is a fact. Radioactive material can be used in this type of terrorism in a wide range of devices and illicit trafficking of this material is a reality that worries the International Atomic Energy Agency. In the current technological development scenario of the world, the potential occurrence of terrorist acts using drones combined with radioactive material dispersal devices, is real. The recent history of drones incidents presents cases where, despite not having been necessarily terrorist motivation, their circumstances and characteristics favor the occurrence of malicious acts. This paper proposes to alert the need of updating the current security protocols, considering the potential association of this technology with radioactive dispersal devices. (author)

  3. When do anterior external or internal fixators provide additional stability in an unstable (Tile C) pelvic fracture? A biomechanical study.

    Science.gov (United States)

    Mcdonald, E; Theologis, A A; Horst, P; Kandemir, U; Pekmezci, M

    2015-12-01

    This study aimed at evaluating the additional stability that is provided by anterior external and internal fixators in an unstable pelvic fracture model (OTA 61-C). An unstable pelvic fracture (OTA 61-C) was created in 27 synthetic pelves by making a 5-mm gap through the sacral foramina (posterior injury) and an ipsilateral pubic rami fracture (anterior injury). The posterior injury was fixed with either a single iliosacral (IS) screw, a single trans-iliac, trans-sacral (TS) screw, or two iliosacral screws (S1S2). Two anterior fixation techniques were utilized: external fixation (Ex-Fix) and supra-acetabular external fixation and internal fixation (In-Fix); supra-acetabular pedicle screws connected with a single subcutaneous spinal rod. The specimens were tested using a nondestructive single-leg stance model. Peak-to-peak (P2P) displacement and rotation and conditioning displacement (CD) were calculated. The Ex-Fix group failed in 83.3 % of specimens with concomitant single-level posterior fixation (Total: 15/18-7 of 9 IS fixation, 8 of 9 TS fixation), and 0 % (0/9) of specimens with concomitant two-level (S1S2) posterior fixation. All specimens with the In-Fix survived testing except for two specimens treated with In-Fix combined with IS fixation. Trans-sacral fixation had higher pubic rotation and greater sacral and pubic displacement than S1S2 (p < 0.05). Rotation of the pubis and sacrum was not different between In-Fix constructs combined with single-level IS and TS fixation. In this model of an unstable pelvic fracture (OTA 61-C), anterior fixation with an In-Fix was biomechanically superior to an anterior Ex-Fix in the setting of single-level posterior fixation. There was no biomechanical difference between the In-Fix and Ex-Fix when each was combined with two levels of posterior sacral fixation.

  4. The perceptions of teachers and principals toward providing additional compensation to teachers in high-need subject areas

    Science.gov (United States)

    Longing, Jeffrey Lucian

    The purpose of this study was to determine possible differences in the perceptions of teachers teaching in high-need areas (i.e., math, science, special education, etc.) and teachers not teaching in high-need areas, (i.e., business education, physical education, etc.) as defined by the states of Arkansas and Louisiana, regarding higher compensation for high-need teachers. In addition, possible perception differences among principals and teachers were determined. The independent variables consisted of gender, position held, years of certified experience, and certification areas. The dependent variable was the perceptions of the participants on providing higher compensation for high-need teachers in order to attract and retain them. The data for all variables were collected using the Teacher Compensation Survey. The sample for this study was limited to teachers, grades 9 through 12, and principals of public high schools in south Arkansas and north Louisiana. Forty-four school districts in south Arkansas (Arkansas Department of Education, 2008a) and north Louisiana (Louisiana Department of Education, 2008a) met the criteria for this study. Twenty-two superintendents gave permission for their districts to participate in the research. A sample of 849 teachers and 38 principals were identified in these districts. Surveys were returned from 350 teachers, creating a 41% response rate. When the 31 principals that returned surveys were added to the total population, the response rate increased to 43% with 381 of the 887 surveyed responding. However, 42 of the teachers and two of the principals skipped some of the questions on the survey and were not included in the study. The researcher used a One-Way ANOVA and independent t-tests to determine the presence of statistical differences at the .05 level. The data showed that most math and science teachers agreed that high-need teachers should be compensated at a higher rate than teachers not teaching in high-need areas. The data

  5. 48 CFR 227.7009-4 - Additional clauses-contracts providing for payment of a running royalty.

    Science.gov (United States)

    2010-10-01

    ...-contracts providing for payment of a running royalty. 227.7009-4 Section 227.7009-4 Federal Acquisition... clauses—contracts providing for payment of a running royalty. The clauses set forth below are examples... desired to cover the subject matter thereof and the contract provides for payment of a running royalty. (a...

  6. Controlling photo-oxidation processes of a polyfluorene derivative: The effect of additives and mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, G.R. [Laboratory of Polymers and Electronic Properties of Materials – UFOP, Ouro Preto, MG (Brazil); Nowacki, B. [Paulo Scarpa Polymer Laboratory – UFPR, Curitiba, PR (Brazil); Magalhães, A. [Instituto de Química, Universidade Estadual de Campinas – UNICAMP, Campinas, SP (Brazil); Azevedo, E.R. de [Instituto de Física de São Carlos, Universidade de São Paulo – USP, São Carlos, SP (Brazil); Sá, E.L. de [Chemistry Department, Federal University of Parana, Curitiba, PR (Brazil); Akcelrud, L.C. [Paulo Scarpa Polymer Laboratory – UFPR, Curitiba, PR (Brazil); Bianchi, R.F., E-mail: bianchi@iceb.ufop.br [Laboratory of Polymers and Electronic Properties of Materials – UFOP, Ouro Preto, MG (Brazil)

    2014-08-01

    The control of the photo degradation of a fluorene–vinylene–phenylene based-polymer, poly(9,9-di-hexylfluorenediylvinylene-alt-1,4-phenylenevinylene) (LaPPS16) was achieved by addition of a radical scavenger (RS) (enhancing photo resistance) or a radical initiator (RI) (reducing photo resistance). Photoluminescence, UV–Vis absorption, {sup 1}H NMR spectroscopies and gel permeation chromatography (GPC) revealed that the incorporating small amounts of RS or RI is an efficient way to control the rates of the photo-oxidation reactions, and thus to obtain the conjugated polymer with foreseeable degradation rates for applications in blue-light sensitive detectors for neonatal phototherapy. - Highlights: • Photo degradation control of a fluorene–vinylene–phenylene based polymer was achieved. • A radical scavenger enhanced photo resistance and radical initiator decreased it. • Color change rate with irradiation dose provided a basis for dosimeter construction.

  7. Systems and methods for providing power to a load based upon a control strategy

    Science.gov (United States)

    Perisic, Milun; Kajouke, Lateef A; Ransom, Ray M

    2013-12-24

    Systems and methods are provided for an electrical system. The electrical system includes a load, an interface configured to receive a voltage from a voltage source, and a controller configured to receive the voltage from the voltage source through the interface and to provide a voltage and current to the load. Wherein, when the controller is in a constant voltage mode, the controller provides a constant voltage to the load, when the controller is in a constant current mode, the controller provides a constant current to the load, and when the controller is in a constant power mode, the controller provides a constant power to the load.

  8. Compliance and control characteristics of an additive manufactured-flexure stage

    International Nuclear Information System (INIS)

    Lee, ChaBum; Tarbutton, Joshua A.

    2015-01-01

    This paper presents a compliance and positioning control characteristics of additive manufactured-nanopositioning system consisted of the flexure mechanism and voice coil motor (VCM). The double compound notch type flexure stage was designed to utilize the elastic deformation of two symmetrical four-bar mechanisms to provide a millimeter-level working range. Additive manufacturing (AM) process, stereolithography, was used to fabricate the flexure stage. The AM stage was inspected by using 3D X-ray computerized tomography scanner: air-voids and shape irregularity. The compliance, open-loop resonance peak, and damping ratio of the AM stage were measured 0.317 mm/N, 80 Hz, and 0.19, respectively. The AM stage was proportional-integral-derivative positioning feedback-controlled and the capacitive type sensor was used to measure the displacement. As a result, the AM flexure mechanism was successfully 25 nm positioning controlled within 500 μm range. The resonance peak was found approximately at 280 Hz in closed-loop. This research showed that the AM flexure mechanism and the VCM can provide millimeter range with high precision and can be a good alternative to an expensive metal-based flexure mechanism and piezoelectric transducer

  9. Compliance and control characteristics of an additive manufactured-flexure stage

    Energy Technology Data Exchange (ETDEWEB)

    Lee, ChaBum; Tarbutton, Joshua A. [Department of Mechanical Engineering, University of South Carolina, 300 Main St., Columbia, South Carolina 29208 (United States)

    2015-04-15

    This paper presents a compliance and positioning control characteristics of additive manufactured-nanopositioning system consisted of the flexure mechanism and voice coil motor (VCM). The double compound notch type flexure stage was designed to utilize the elastic deformation of two symmetrical four-bar mechanisms to provide a millimeter-level working range. Additive manufacturing (AM) process, stereolithography, was used to fabricate the flexure stage. The AM stage was inspected by using 3D X-ray computerized tomography scanner: air-voids and shape irregularity. The compliance, open-loop resonance peak, and damping ratio of the AM stage were measured 0.317 mm/N, 80 Hz, and 0.19, respectively. The AM stage was proportional-integral-derivative positioning feedback-controlled and the capacitive type sensor was used to measure the displacement. As a result, the AM flexure mechanism was successfully 25 nm positioning controlled within 500 μm range. The resonance peak was found approximately at 280 Hz in closed-loop. This research showed that the AM flexure mechanism and the VCM can provide millimeter range with high precision and can be a good alternative to an expensive metal-based flexure mechanism and piezoelectric transducer.

  10. 76 FR 59614 - Facilitating the Use of Microwave for Wireless Backhaul and Other Uses and Providing Additional...

    Science.gov (United States)

    2011-09-27

    ... requires ``complex electronics to coordinate the transmissions, with the additional disadvantage of... Service operators to utilize 60 and 80 megahertz channels, it will simplify the electronics, lowers costs... accordance with the Commission's ex parte rules. Persons making ex parte presentations must file a copy of...

  11. Foliar Potassium Fertilizer Additives Affect Soybean Response and Weed Control with Glyphosate

    Directory of Open Access Journals (Sweden)

    Kelly A. Nelson

    2012-01-01

    Full Text Available Research in 2004 and 2005 determined the effects of foliar-applied K-fertilizer sources (0-0-62-0 (%N-%P2O5-%K2O-%S, 0-0-25-17, 3-18-18-0, and 5-0-20-13 and additive rates (2.2, 8.8, and 17.6 kg K ha−1 on glyphosate-resistant soybean response and weed control. Field experiments were conducted at Novelty and Portageville with high soil test K and weed populations and at Malden with low soil test K and weed populations. At Novelty, grain yield increased with fertilizer additives at 8.8 kg K ha−1 in a high-yield, weed-free environment in 2004, but fertilizer additives reduced yield up to 470 kg ha−1 in a low-yield year (2005 depending on the K source and rate. At Portageville, K-fertilizer additives increased grain yield from 700 to 1160 kg ha−1 compared to diammonium sulfate, depending on the K source and rate. At Malden, there was no yield response to K sources. Differences in leaf tissue K (P=0.03, S (P=0.03, B (P=0.0001, and Cu (P=0.008 concentrations among treatments were detected 14 d after treatment at Novelty and Malden. Tank mixtures of K-fertilizer additives with glyphosate may provide an option for foliar K applications.

  12. Infection control and quality assurance of health services provided in ICU: development of an ICU website.

    Science.gov (United States)

    Diomidous, Marianna; Ponirou, Paraskevi; Mpizopoulou, Zoi; Tzalera, Vaia; Mechili, Aggelos

    2013-01-01

    The aim of this study is to examine the infections control methods in ICU as well as the issue of quality in health services provided, as they constitute an important quality assurance indicator. Moreover, nowadays the causes of Nosocomial infections are known and so do the measures for their control. There is a need however for an information resource that will promote specialized and general guidelines. The measures include the appropriate use of gloves, cleaning and disinfection of the ICU environment and hand washing which is the most important of all. Therefore an effort was made to develop an easy to navigate webpage with practical and comprehensible clinical guidelines. Additionally, it gives to all visitors the opportunity for further information research with the use of the included links. For the development of the web side existing clinical guide lines were scrutinizes as well as studies that concern the effectiveness of the measures mentioned and for the identification of quality assurance criteria.

  13. runjags: An R Package Providing Interface Utilities, Model Templates, Parallel Computing Methods and Additional Distributions for MCMC Models in JAGS

    Directory of Open Access Journals (Sweden)

    Matthew J. Denwood

    2016-07-01

    Full Text Available The runjags package provides a set of interface functions to facilitate running Markov chain Monte Carlo models in JAGS from within R. Automated calculation of appropriate convergence and sample length diagnostics, user-friendly access to commonly used graphical outputs and summary statistics, and parallelized methods of running JAGS are provided. Template model specifications can be generated using a standard lme4-style formula interface to assist users less familiar with the BUGS syntax. Automated simulation study functions are implemented to facilitate model performance assessment, as well as drop-k type cross-validation studies, using high performance computing clusters such as those provided by parallel. A module extension for JAGS is also included within runjags, providing the Pareto family of distributions and a series of minimally-informative priors including the DuMouchel and half-Cauchy priors. This paper outlines the primary functions of this package, and gives an illustration of a simulation study to assess the sensitivity of two equivalent model formulations to different prior distributions.

  14. 40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.31 Section 81.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

  15. Method for mapping population-based case-control studies: an application using generalized additive models

    Directory of Open Access Journals (Sweden)

    Aschengrau Ann

    2006-06-01

    Full Text Available Abstract Background Mapping spatial distributions of disease occurrence and risk can serve as a useful tool for identifying exposures of public health concern. Disease registry data are often mapped by town or county of diagnosis and contain limited data on covariates. These maps often possess poor spatial resolution, the potential for spatial confounding, and the inability to consider latency. Population-based case-control studies can provide detailed information on residential history and covariates. Results Generalized additive models (GAMs provide a useful framework for mapping point-based epidemiologic data. Smoothing on location while controlling for covariates produces adjusted maps. We generate maps of odds ratios using the entire study area as a reference. We smooth using a locally weighted regression smoother (loess, a method that combines the advantages of nearest neighbor and kernel methods. We choose an optimal degree of smoothing by minimizing Akaike's Information Criterion. We use a deviance-based test to assess the overall importance of location in the model and pointwise permutation tests to locate regions of significantly increased or decreased risk. The method is illustrated with synthetic data and data from a population-based case-control study, using S-Plus and ArcView software. Conclusion Our goal is to develop practical methods for mapping population-based case-control and cohort studies. The method described here performs well for our synthetic data, reproducing important features of the data and adequately controlling the covariate. When applied to the population-based case-control data set, the method suggests spatial confounding and identifies statistically significant areas of increased and decreased odds ratios.

  16. Additional electrodes on the Quartet™ LV lead provide more programmable pacing options than bipolar and tripolar equivalents.

    Science.gov (United States)

    O'Donnell, David; Sperzel, Johannes; Thibault, Bernard; Rinaldi, Christopher A; Pappone, Carlo; Gutleben, Klaus-Jürgen; Leclercq, Christopher; Razavi, Hedi; Ryu, Kyungmoo; Mcspadden, Luke C; Fischer, Avi; Tomassoni, Gery

    2017-04-01

    The aim of this study was to evaluate any benefits to the number of viable pacing vectors and maximal spatial coverage with quadripolar left ventricular (LV) leads when compared with tripolar and bipolar equivalents in patients receiving cardiac resynchronization therapy (CRT). A meta-analysis of five previously published clinical trials involving the Quartet™ LV lead (St Jude Medical, St Paul, MN, USA) was performed to evaluate the number of viable pacing vectors defined as capture thresholds ≤2.5 V and no phrenic nerve stimulation and maximal spatial coverage of viable vectors in CRT patients at pre-discharge (n = 370) and first follow-up (n = 355). Bipolar and tripolar lead configurations were modelled by systematic elimination of two and one electrode(s), respectively, from the Quartet lead. The Quartet lead with its four pacing electrodes exhibited the greatest number of pacing vectors per patient when compared with the best bipolar and the best tripolar modelled equivalents. Similarly, the Quartet lead provided the highest spatial coverage in terms of the distance between two furthest viable pacing cathodes when compared with the best bipolar and the best tripolar configurations (P tripolar configurations, elimination of the second proximal electrode (M3) resulted in the highest number of viable pacing options per patient. There were no significant differences observed between pre-discharge and first follow-up analyses. The Quartet lead with its four electrodes and the capability to pace from four anatomical locations provided the highest number of viable pacing vectors at pre-discharge and first follow-up visits, providing more flexibility in device programming and enabling continuation of CRT in more patients when compared with bipolar and tripolar equivalents. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  17. Contrast-enhanced spectral mammography: Does mammography provide additional clinical benefits or can some radiation exposure be avoided?

    Science.gov (United States)

    Fallenberg, Eva Maria; Dromain, Clarisse; Diekmann, Felix; Renz, Diane M; Amer, Heba; Ingold-Heppner, Barbara; Neumann, Avidan U; Winzer, Klaus J; Bick, Ulrich; Hamm, Bernd; Engelken, Florian

    2014-07-01

    The purpose of this study was to compare contrast-enhanced spectral mammography (CESM) with mammography (MG) and combined CESM + MG in terms of detection and size estimation of histologically proven breast cancers in order to assess the potential to reduce radiation exposure. A total of 118 patients underwent MG and CESM and had final histological results. CESM was performed as a bilateral examination starting 2 min after injection of iodinated contrast medium. Three independent blinded radiologists read the CESM, MG, and CESM + MG images with an interval of at least 4 weeks to avoid case memorization. Sensitivity and size measurement correlation and differences were calculated, average glandular dose (AGD) levels were compared, and breast densities were reported. Fisher's exact and Wilcoxon tests were performed. A total of 107 imaging pairs were available for analysis. Densities were ACR1: 2, ACR2: 45, ACR3: 42, and ACR4: 18. Mean AGD was 1.89 mGy for CESM alone, 1.78 mGy for MG, and 3.67 mGy for the combination. In very dense breasts, AGD of CESM was significantly lower than MG. Sensitivity across readers was 77.9 % for MG alone, 94.7 % for CESM, and 95 % for CESM + MG. Average tumor size measurement error compared to postsurgical pathology was -0.6 mm for MG, +0.6 mm for CESM, and +4.5 mm for CESM + MG (p < 0.001 for CESM + MG vs. both modalities). CESM alone has the same sensitivity and better size assessment as CESM + MG and was significantly better than MG with only 6.2 % increase in AGD. The combination of CESM + MG led to systematic size overestimation. When a CESM examination is planned, additional MG can be avoided, with the possibility of saving up to 61 % of radiation dose, especially in patients with dense breasts.

  18. Effect of providing risk information on undergoing cervical cancer screening: a randomized controlled trial.

    Science.gov (United States)

    Fujiwara, Hiroyuki; Shimoda, Akihiro; Ishikawa, Yoshiki; Taneichi, Akiyo; Ohashi, Mai; Takahashi, Yoshifumi; Koyanagi, Takahiro; Morisawa, Hiroyuki; Takahashi, Suzuyo; Sato, Naoto; Machida, Shizuo; Takei, Yuji; Saga, Yasushi; Suzuki, Mitsuaki

    2015-01-01

    In Japan, the cervical cancer screening rate is extremely low. Towards improving the cervical cancer screening rate, encouraging eligible people to make an informed choice, which is a decision-making process that relies on beliefs informed by adequate information about the possible benefits and risks of screening, has attracted increased attention in the public health domain. However, there is concern that providing information on possible risks of screening might prevent deter from participating. In total, 1,912 women aged 20-39 years who had not participated in screening in the fiscal year were selected from a Japanese urban community setting. Participants were randomly divided into 3 groups. Group A received a printed reminder with information about the possible benefits of screening, group B received a printed reminder with information about possible benefits and risks, and group C received a printed reminder with simple information only (control group). Out of 1,912 participants, 169 (8.8%) participated in cervical cancer screening. In the intervention groups, 137 (10.9%) participated in cervical cancer screening, compared to only 32 (4.9%) of the control group (p < 0.001). In addition, logistic regression analysis revealed that there was no significant difference in screening rate between group A and group B (p = 0.372). Providing information on the possible risks of screening may not prevent people from taking part in cervical cancer screening among a Japanese non-adherent population.

  19. The food additive vanillic acid controls transgene expression in mammalian cells and mice.

    Science.gov (United States)

    Gitzinger, Marc; Kemmer, Christian; Fluri, David A; El-Baba, Marie Daoud; Weber, Wilfried; Fussenegger, Martin

    2012-03-01

    Trigger-inducible transcription-control devices that reversibly fine-tune transgene expression in response to molecular cues have significantly advanced the rational reprogramming of mammalian cells. When designed for use in future gene- and cell-based therapies the trigger molecules have to be carefully chosen in order to provide maximum specificity, minimal side-effects and optimal pharmacokinetics in a mammalian organism. Capitalizing on control components that enable Caulobacter crescentus to metabolize vanillic acid originating from lignin degradation that occurs in its oligotrophic freshwater habitat, we have designed synthetic devices that specifically adjust transgene expression in mammalian cells when exposed to vanillic acid. Even in mice transgene expression was robust, precise and tunable in response to vanillic acid. As a licensed food additive that is regularly consumed by humans via flavoured convenience food and specific fresh vegetable and fruits, vanillic acid can be considered as a safe trigger molecule that could be used for diet-controlled transgene expression in future gene- and cell-based therapies.

  20. EFFECT OF AN ADDITIONAL HYDROPHILIC VERSUS HYDROPHOBIC COAT ON THE QUALITY OF DENTINAL SEALING PROVIDED BY TWO-STEP ETCH-AND-RINSE ADHESIVES

    Science.gov (United States)

    Silva, Safira Marques de Andrade; Carrilho, Marcela Rocha de Oliveira; Marquezini, Luiz; Garcia, Fernanda Cristina Pimentel; Manso, Adriana Pigozzo; Alves, Marcelo Corrêa; de Carvalho, Ricardo Marins

    2009-01-01

    Objective: To test the hypothesis that the quality of the dentinal sealing provided by two-step etch-and-rinse adhesives cannot be altered by the addition of an extra layer of the respective adhesive or the application of a more hydrophobic, non-solvated resin. Material and Methods: full-crown preparations were acid-etched with phosphoric acid for 15 s and bonded with Adper Single Bond (3M ESPE), Excite DSC (Ivoclar/Vivadent) or Prime & Bond NT (Dentsply). The adhesives were used according to the manufacturers' instructions (control groups) or after application to dentin they were a) covered with an extra coat of each respective system or b) coated with a non-solvated bonding agent (Adper Scotchbond Multi-Purpose Adhesive, 3M ESPE). Fluid flow rate was measured before and after dentin surfaces were acid-etched and bonded with adhesives. Results: None of the adhesives or experimental treatments was capable to block completely the fluid transudation across the treated dentin. Application of an extra coat of the adhesive did not reduce the fluid flow rate of adhesive-bonded dentin (p>0.05). Conversely, the application of a more hydrophobic non-solvated resin resulted in significant reductions in the fluid flow rate (padhesives. Conclusions: The quality of the dentinal sealing provided by etch-and-rinse adhesives can be significantly improved by the application of a more hydrophobic, non-solvated bonding agent. PMID:19466248

  1. 14 CFR 61.419 - How do I obtain privileges to provide training in an additional category or class of light-sport...

    Science.gov (United States)

    2010-01-01

    ... training in an additional category or class of light-sport aircraft? 61.419 Section 61.419 Aeronautics and...: PILOTS, FLIGHT INSTRUCTORS, AND GROUND INSTRUCTORS Flight Instructors With a Sport Pilot Rating § 61.419 How do I obtain privileges to provide training in an additional category or class of light-sport...

  2. The chaos and control of a food chain model supplying additional food to top-predator

    International Nuclear Information System (INIS)

    Sahoo, Banshidhar; Poria, Swarup

    2014-01-01

    Highlights: • We propose a chaotic food chain model supplying additional food to top-predator. • Local and global stability conditions are derived in presence of additional food. • Chaos is controlled only by increasing quantity of additional food. • System enters into periodic region and depicts Hopf bifurcations supplying additional food. • This an application of non-chemical methods for controlling chaos. -- Abstract: The control and management of chaotic population is one of the main objectives for constructing mathematical model in ecology today. In this paper, we apply a technique of controlling chaotic predator–prey population dynamics by supplying additional food to top-predator. We formulate a three species predator–prey model supplying additional food to top-predator. Existence conditions and local stability criteria of equilibrium points are determined analytically. Persistence conditions for the system are derived. Global stability conditions of interior equilibrium point is calculated. Theoretical results are verified through numerical simulations. Phase diagram is presented for various quality and quantity of additional food. One parameter bifurcation analysis is done with respect to quality and quantity of additional food separately keeping one of them fixed. Using MATCONT package, we derive the bifurcation scenarios when both the parameters quality and quantity of additional food vary together. We predict the existence of Hopf point (H), limit point (LP) and branch point (BP) in the model for suitable supply of additional food. We have computed the regions of different dynamical behaviour in the quantity–quality parametric plane. From our study we conclude that chaotic population dynamics of predator prey system can be controlled to obtain regular population dynamics only by supplying additional food to top predator. This study is aimed to introduce a new non-chemical chaos control mechanism in a predator–prey system with the

  3. Providing Meteorological Information for Controlled Burns at the Savannah River Site

    International Nuclear Information System (INIS)

    Buckley, R.

    1999-01-01

    Regional and local weather information are important for a variety of applications at the Savannah River Site (SRS), a Department of Energy (DOE) facility covering approximately 800 square kilometers of southwest South Carolina east of the Savannah River. For example, meteorological observations and forecasts are used to assess the consequences of an accidental radiological or chemical release. Traditionally, hazards posed by SRS operations have been associated with nuclear reactors, chemical reprocessing plants, fuel fabrication, or waste-vitrification facilities. However, recent events have shown site-specific meteorology to be a valuable tool to the United States Forest Service (USFS) in mitigating potential hazards from controlled burns that are conducted at the SRS. Prescribed burns at the SRS are important for a variety of reasons. The removal of thick undergrowth allows wildlife to more easily feed and migrate, accelerates the growth of young pine stands, and controls certain diseases that affect local pine forests (e.g. Adams et al. 1973). In addition, the removal of twigs, pine needles, or leaves (a fuel source) reduces the chance of serious wildfire damage. However, the threat of smoke inhalation and reduced visibility requires careful planning on the part of the fire professionals. At the SRS, approximately 100 square kilometers of land per year are burned in a controlled manner, mainly in the spring.To reduce the potentially harmful effects to any onsite activity, it is important that USFS personnel understand current and predicted weather patterns within the area. This paper discusses two sources of meteorological information that are provided to SRS-USFS personnel for use in planning forest burns: (1) a meteorological tower system which provides current data from a series of onsite locations, and (2) an operational prognostic mesoscale model used to generate forecast information. The forecast data supplements the basic National Weather Service (NWS

  4. Analysis of time to event outcomes in randomized controlled trials by generalized additive models.

    Directory of Open Access Journals (Sweden)

    Christos Argyropoulos

    Full Text Available Randomized Controlled Trials almost invariably utilize the hazard ratio calculated with a Cox proportional hazard model as a treatment efficacy measure. Despite the widespread adoption of HRs, these provide a limited understanding of the treatment effect and may even provide a biased estimate when the assumption of proportional hazards in the Cox model is not verified by the trial data. Additional treatment effect measures on the survival probability or the time scale may be used to supplement HRs but a framework for the simultaneous generation of these measures is lacking.By splitting follow-up time at the nodes of a Gauss Lobatto numerical quadrature rule, techniques for Poisson Generalized Additive Models (PGAM can be adopted for flexible hazard modeling. Straightforward simulation post-estimation transforms PGAM estimates for the log hazard into estimates of the survival function. These in turn were used to calculate relative and absolute risks or even differences in restricted mean survival time between treatment arms. We illustrate our approach with extensive simulations and in two trials: IPASS (in which the proportionality of hazards was violated and HEMO a long duration study conducted under evolving standards of care on a heterogeneous patient population.PGAM can generate estimates of the survival function and the hazard ratio that are essentially identical to those obtained by Kaplan Meier curve analysis and the Cox model. PGAMs can simultaneously provide multiple measures of treatment efficacy after a single data pass. Furthermore, supported unadjusted (overall treatment effect but also subgroup and adjusted analyses, while incorporating multiple time scales and accounting for non-proportional hazards in survival data.By augmenting the HR conventionally reported, PGAMs have the potential to support the inferential goals of multiple stakeholders involved in the evaluation and appraisal of clinical trial results under proportional and

  5. Robust reconfigurable control for parametric and additive faults with FDI uncertainties

    DEFF Research Database (Denmark)

    Stoustrup, Jakob; Yang, Zhenyu

    2000-01-01

    From the system recoverable point of view, this paper discusses robust reconfigurable control synthesis for LTI systems and a class of nonlinear control systems with parametric and additive faults as well as derivations generated by FDI algorithms. By following the model-matching strategy......, an augmented optimal control problem is constructed based on the considered faulty and fictitious nominal systems, such that the robust control design techniques, such as H-infinity control and mu synthesis, can be employed for the reconfigurable control design....

  6. Active-Reactive Additional Damping Control of a Doubly-Fed Induction Generator Based on Active Disturbance Rejection Control

    Directory of Open Access Journals (Sweden)

    Yanfeng Ma

    2018-05-01

    Full Text Available Large-scale wind power interfacing to the power grid has an impact on the stability of the power system. However, with an additional damping controller of the wind generator, new ways for improving system damping and suppressing the low frequency oscillation (LFO of power systems can be put forward. In this paper, an active-reactive power additional damping controller based on active disturbance rejection control (ADRC is proposed. In order to improve the precision of the controller, the theory of data driven control is adopted, using the numerical algorithms for subspace state space system identification (N4SID to obtain the two order model of the ADRC controlled object. Based on the identification model, the ADRC additional damping controller is designed. Taking a 2-area 4-machine system containing the doubly fed induction generator (DFIG wind farm as an example, it is verified that the active-reactive additional damping controller designed in this paper performs well in suppressing negative-damping LFO and forced power oscillation. When the operation state of the power system changes, it can still restrain the LFO effectively, showing stronger robustness and better effectiveness compared to the traditional proportional–integral–derivative (PID additional damping controller.

  7. Additional operations in algebra of structural numbers for control algorithm development

    Directory of Open Access Journals (Sweden)

    Morhun A.V.

    2016-12-01

    Full Text Available The structural numbers and the algebra of the structural numbers due to the simplicity of representation, flexibility and current algebraic operations are the powerful tool for a wide range of applications. In autonomous power supply systems and systems with distributed generation (Micro Grid mathematical apparatus of structural numbers can be effectively used for the calculation of the parameters of the operating modes of consumption of electric energy. The purpose of the article is the representation of the additional algebra of structural numbers. The standard algebra was proposed to be extended by the additional operations and modification current in order to expand the scope of their use, namely to construct a flexible, adaptive algorithms of control systems. It is achieved due to the possibility to consider each individual component of the system with its parameters and provide easy management of entire system and each individual component. Thus, structural numbers and extended algebra are the perspective line of research and further studying is required.

  8. 75 FR 30410 - Disease, Disability, and Injury Prevention and Control Special Interest Project (SIP): Provider...

    Science.gov (United States)

    2010-06-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Interest Project (SIP): Provider and Public Health... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC...

  9. Controlling the microstructure and properties of wire arc additive manufactured Ti–6Al–4V with trace boron additions

    International Nuclear Information System (INIS)

    Bermingham, M.J.; Kent, D.; Zhan, H.; StJohn, D.H.; Dargusch, M.S.

    2015-01-01

    This study demonstrates that trace boron addition to Ti–6Al–4V coupons produced by additive layer manufacturing is an effective way to eliminate the deleterious anisotropic microstructures often encountered with this manufacturing technique. Trace boron additions (up to 0.13 wt.%) to this alloy eliminate grain boundary-α and colony-α, and instead produce a homogeneous α-microstructure consisting of fine equiaxed α-grains in both as-deposited and heat treated coupons. Prior-β grains remain columnar with boron addition but become narrower due to the wider solidification range and growth restricting effect of the boron solute. Compared to unmodified Ti–6Al–4V alloy, Ti–6Al–4V modified with trace boron additions showed up to 40% improvement in plasticity with no loss in strength under uniaxial compression at room temperature. Boron additions were found to inhibit twinning transmission that causes sudden large load drops during deformation of the unmodified Ti–6Al–4V alloy in the heat treated condition

  10. Control device for a nuclear reactor with a multitude of control rods, extending into the reactor core from above, with linear drive mechanisms and additional gripper devices

    International Nuclear Information System (INIS)

    Bevilacqua, F.

    1979-01-01

    The components of the additional gripper devices with magnetically operated finger-shaped latches are separated from the also magnetically operated latches of the linear drive mechanisms in order to avoid common-mode failures when fast shutdown is required. Only part of the safety rods are held by the additional gripping devices in the withdrawn position. There is provided for recording elements indicating positively which one of the safety locks is gearing with the control rods. At the upper end of each control rod there is a coupling head held by electromagnetically operated locking devices in the withdrawn position, if control power is available. (DG) [de

  11. Challenges to Providing a Successful Central Configuration Service to Support CERN’s New Controls Diagnostics and Monitoring System

    CERN Document Server

    Makonnen, Z; Zaharieva, Z

    2014-01-01

    The Controls Diagnostic and Monitoring service (DIAMON) provides monitoring and diagnostics tools to the operators in the CERN Control Centre. A recent reengineering presented the opportunity to restructure its data management and to integrate it with the central Controls Configuration Service (CCS). The CCS provides the Configuration Management for the Controls System for all accelerators at CERN. The new facility had to cater for the configuration management of all agents monitored by DIAMON, (>3000 computers of different types), provide deployment information, relations between metrics, and historical information. In addition, it had to be integrated into the operational CCS, while ensuring stability and data coherency. An important design decision was to largely reuse the existing infrastructure in the CCS and adapt the DIAMON data management to it e.g. by using the device/property model through a Virtual Devices framework to model the DIAMON agents. This article will show how these challenging requiremen...

  12. Macro-/Micro-Controlled 3D Lithium-Ion Batteries via Additive Manufacturing and Electric Field Processing.

    Science.gov (United States)

    Li, Jie; Liang, Xinhua; Liou, Frank; Park, Jonghyun

    2018-01-30

    This paper presents a new concept for making battery electrodes that can simultaneously control macro-/micro-structures and help address current energy storage technology gaps and future energy storage requirements. Modern batteries are fabricated in the form of laminated structures that are composed of randomly mixed constituent materials. This randomness in conventional methods can provide a possibility of developing new breakthrough processing techniques to build well-organized structures that can improve battery performance. In the proposed processing, an electric field (EF) controls the microstructures of manganese-based electrodes, while additive manufacturing controls macro-3D structures and the integration of both scales. The synergistic control of micro-/macro-structures is a novel concept in energy material processing that has considerable potential for providing unprecedented control of electrode structures, thereby enhancing performance. Electrochemical tests have shown that these new electrodes exhibit superior performance in their specific capacity, areal capacity, and life cycle.

  13. Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.

    Science.gov (United States)

    Gillette, Chris; Blalock, Susan J; Rao, Jaya K; Williams, Dennis; Loughlin, Ceila E; Sleath, Betsy

    2014-08-01

    The objectives of this study were to: (1) describe the extent to which general pediatric providers discuss risks associated with asthma control medications with families, and (2) examine factors that are associated with risk discussions. This study was a cross-sectional secondary analysis of audio taped medical visits involving 35 pediatric providers and 248 children with asthma with their caregivers. Transcripts of the visits were coded for discussions about asthma medication risks. Generalized estimating equations were used to analyze the data. Providers discussed asthma control medication risks during 23% of visits. Risks were more likely to be discussed when the visit was longer and when the provider prescribed a new asthma control medication. When providers discussed asthma control medication risks, they were most likely to ask the family general questions and make general statements. Across all of the visits, caregivers asked a total of 16 questions and made a total of 20 statements about risks associated with asthma medications; children asked a total of 3 questions and made two statements about risks associated with asthma control medications. Providers discussed risks associated with asthma control medications in less than one-quarter of medical visits. Providers should involve families in discussions about risks associated with medications during every visit to assess potential barriers to medication adherence. © 2013 Wiley Periodicals, Inc.

  14. Hispanic women's health care provider control expectations: the influence of fatalism and acculturation.

    Science.gov (United States)

    Roncancio, Angelica M; Ward, Kristy K; Berenson, Abbey B

    2011-05-01

    In order to understand how culture influences Hispanic women's views about their health care provider (HCP), we examined the relationship between acculturation and fatalism in the HCP control expectations of Hispanic women. (A HCP control expectation is the extent to which an individual believes that her HCP has control over her health.) We predicted that acculturation would be negatively associated with HCP control expectations, and fatalism would be positively associated with HCP control expectations. A group of 1,027 young Hispanic women (mean age 21.24 years; SD=2.46) who were University of Texas Medical Branch clinic patients completed a comprehensive survey. Structural equation modeling was employed and, as predicted, acculturation was negatively associated with HCP control expectations (pexpectations will help us understand this population's perceptions of their HCPs. This knowledge will assist HCPs in providing culturally competent care which will increase adherence to medical treatment and screening guidelines.

  15. Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.

    Science.gov (United States)

    Bartel, Billie J

    2014-08-01

    This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. © The Author(s) 2013.

  16. Maximization of DRAM yield by control of surface charge and particle addition during high dose implantation

    Science.gov (United States)

    Horvath, J.; Moffatt, S.

    1991-04-01

    Ion implantation processing exposes semiconductor devices to an energetic ion beam in order to deposit dopant ions in shallow layers. In addition to this primary process, foreign materials are deposited as particles and surface films. The deposition of particles is a major cause of IC yield loss and becomes even more significant as device dimensions are decreased. Control of particle addition in a high-volume production environment requires procedures to limit beamline and endstation sources, control of particle transport, cleaning procedures and a well grounded preventative maintenance philosophy. Control of surface charge by optimization of the ion beam and electron shower conditions and measurement with a real-time charge sensor has been effective in improving the yield of NMOS and CMOS DRAMs. Control of surface voltages to a range between 0 and -20 V was correlated with good implant yield with PI9200 implanters for p + and n + source-drain implants.

  17. Laboratory technical services provides business opportunities for supervisory control and data acquisition systems

    International Nuclear Information System (INIS)

    Ballard, W.

    1994-01-01

    The author presents some additional information about what he considers are some really great opportunities for the business community to participate in developing the greatest scientific project in the history of mankind. Facility Engineering Services is part of Laboratory Technical Services. As part of this group, it has the responsibility to direct the construction of interim facilities, scientific labs, production process, cooling towers, cooling ponds and the operation and control of SSC Laboratory conventional support systems. These operations and controls will be accomplished through the employment of a Supervisory Control and Data Acquisition system (SCADA)

  18. Sensing and controlling resin-layer thickness in additive manufacturing processes

    NARCIS (Netherlands)

    Kozhevnikov, A.

    2017-01-01

    This AM-TKI project in collaboration with TNO focusses on the sensing and control of resin-layer thickness in AM applications. Industrial Additive Manufacturing is considered to be a potential breakthrough production technology for many applications. A specific AM implementation is VAT photo

  19. The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia

    DEFF Research Database (Denmark)

    Pinder, Margeret; Conteh, Lesong; Jeffries, David

    2016-01-01

    ) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. Methods/design A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide...

  20. Human-Inspired Eigenmovement Concept Provides Coupling-Free Sensorimotor Control in Humanoid Robot.

    Science.gov (United States)

    Alexandrov, Alexei V; Lippi, Vittorio; Mergner, Thomas; Frolov, Alexander A; Hettich, Georg; Husek, Dusan

    2017-01-01

    Control of a multi-body system in both robots and humans may face the problem of destabilizing dynamic coupling effects arising between linked body segments. The state of the art solutions in robotics are full state feedback controllers. For human hip-ankle coordination, a more parsimonious and theoretically stable alternative to the robotics solution has been suggested in terms of the Eigenmovement (EM) control. Eigenmovements are kinematic synergies designed to describe the multi DoF system, and its control, with a set of independent, and hence coupling-free , scalar equations. This paper investigates whether the EM alternative shows "real-world robustness" against noisy and inaccurate sensors, mechanical non-linearities such as dead zones, and human-like feedback time delays when controlling hip-ankle movements of a balancing humanoid robot. The EM concept and the EM controller are introduced, the robot's dynamics are identified using a biomechanical approach, and robot tests are performed in a human posture control laboratory. The tests show that the EM controller provides stable control of the robot with proactive ("voluntary") movements and reactive balancing of stance during support surface tilts and translations. Although a preliminary robot-human comparison reveals similarities and differences, we conclude (i) the Eigenmovement concept is a valid candidate when different concepts of human sensorimotor control are considered, and (ii) that human-inspired robot experiments may help to decide in future the choice among the candidates and to improve the design of humanoid robots and robotic rehabilitation devices.

  1. Wind farms providing secondary frequency regulation: evaluating the performance of model-based receding horizon control

    Directory of Open Access Journals (Sweden)

    C. R. Shapiro

    2018-01-01

    Full Text Available This paper is an extended version of our paper presented at the 2016 TORQUE conference (Shapiro et al., 2016. We investigate the use of wind farms to provide secondary frequency regulation for a power grid using a model-based receding horizon control framework. In order to enable real-time implementation, the control actions are computed based on a time-varying one-dimensional wake model. This model describes wake advection and wake interactions, both of which play an important role in wind farm power production. In order to test the control strategy, it is implemented in a large-eddy simulation (LES model of an 84-turbine wind farm using the actuator disk turbine representation. Rotor-averaged velocity measurements at each turbine are used to provide feedback for error correction. The importance of including the dynamics of wake advection in the underlying wake model is tested by comparing the performance of this dynamic-model control approach to a comparable static-model control approach that relies on a modified Jensen model. We compare the performance of both control approaches using two types of regulation signals, RegA and RegD, which are used by PJM, an independent system operator in the eastern United States. The poor performance of the static-model control relative to the dynamic-model control demonstrates that modeling the dynamics of wake advection is key to providing the proposed type of model-based coordinated control of large wind farms. We further explore the performance of the dynamic-model control via composite performance scores used by PJM to qualify plants for regulation services or markets. Our results demonstrate that the dynamic-model-controlled wind farm consistently performs well, passing the qualification threshold for all fast-acting RegD signals. For the RegA signal, which changes over slower timescales, the dynamic-model control leads to average performance that surpasses the qualification threshold, but further

  2. Hierarchical tailoring of strut architecture to control permeability of additive manufactured titanium implants.

    Science.gov (United States)

    Zhang, Z; Jones, D; Yue, S; Lee, P D; Jones, J R; Sutcliffe, C J; Jones, E

    2013-10-01

    Porous titanium implants are a common choice for bone augmentation. Implants for spinal fusion and repair of non-union fractures must encourage blood flow after implantation so that there is sufficient cell migration, nutrient and growth factor transport to stimulate bone ingrowth. Additive manufacturing techniques allow a large number of pore network designs. This study investigates how the design factors offered by selective laser melting technique can be used to alter the implant architecture on multiple length scales to control and even tailor the flow. Permeability is a convenient parameter that characterises flow, correlating to structure openness (interconnectivity and pore window size), tortuosity and hence flow shear rates. Using experimentally validated computational simulations, we demonstrate how additive manufacturing can be used to tailor implant properties by controlling surface roughness at a microstructual level (microns), and by altering the strut ordering and density at a mesoscopic level (millimetre). Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial.

    LENUS (Irish Health Repository)

    Carney, John

    2010-10-01

    The transversus abdominis plane (TAP) block provides effective postoperative analgesia in adults undergoing major abdominal surgery. Its efficacy in children remains unclear, with no randomized clinical trials in this population. In this study, we evaluated its analgesic efficacy over the first 48 postoperative hours after appendectomy performed through an open abdominal incision, in a randomized, controlled, double-blind clinical trial.

  4. Randomized, Controlled Trial to Examine the Impact of Providing Yogurt to Women Enrolled in WIC

    Science.gov (United States)

    Fung, Ellen B.; Ritchie, Lorrene D.; Walker, Brent H.; Gildengorin, Ginny; Crawford, Patricia B.

    2010-01-01

    Objective: Examine the impact of providing yogurt to women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: Randomized, controlled intervention trial. Setting: Two California WIC local agency sites. Participants: 511 pregnant, breast-feeding, or postpartum women. Intervention: Substitution of…

  5. Nectar accessibility determines fitness, flower choice and abundance of hoverflies that provide natural pest control

    NARCIS (Netherlands)

    van Rijn, Paul C. J.; Wäckers, Felix L.

    2016-01-01

    In modern agricultural landscapes, many organisms providing ecosystem services such as pollination and natural pest control are likely constrained by shortage of nectar and/or pollen required for adult nutrition. More and more flower-rich field margin strips and other habitats are created to

  6. Nectar accessibility determines fitness, flower choice and abundance of hoverflies that provide natural pest control

    NARCIS (Netherlands)

    van Rijn, P.C.J.; Wäckers, F.L.

    2016-01-01

    1. In modern agricultural landscapes, many organisms providing ecosystem services such as pollination and natural pest control are likely constrained by shortage of nectar and/or pollen required for adult nutrition. More and more flower-rich field margin strips and other habitats are created to

  7. Adoption of electronic prescribing for controlled substances among providers and pharmacies.

    Science.gov (United States)

    Hufstader Gabriel, Meghan; Yang, Yi; Vaidya, Varun; Wilkins, Tricia Lee

    2014-11-01

    Electronic prescribing for Schedule II through V controlled substances was legalized in the United States by the Drug Enforcement Administration in June 2010. However, little information exists about adoption and use of the electronic prescribing of controlled substances (EPCS) at the national level. Therefore, the objective of this study is to present the first information about national trends surrounding the adoption and use of the newly allowed EPCS by providers and pharmacies in the United States. Trends of EPCS adoption and use were examined for the number of EPCS, number of pharmacies enabled to accept EPCS, and the number of providers prescribing controlled substances electronically. Using nationally representative transactional Surescripts data from July 2012 to December 2013, we examined EPCS trends. During the study period, the total number of EPCS increased from 1535 to 52,423, and the number and percentage of all pharmacies enabled for EPCS increased from 8768 (13%) to 20,498 pharmacies (30%). The proportion of all providers prescribing controlled substances electronically is currently 1%, but increasing steadily each month. There is a positive national growth for EPCS in pharmacy preparedness to accept EPCS, the number of EPCS prescriptions sent each month, and the number of providers with the ability to send EPCS.

  8. Wind farms providing secondary frequency regulation: Evaluating the performance of model-based receding horizon control

    International Nuclear Information System (INIS)

    Shapiro, Carl R.; Meneveau, Charles; Gayme, Dennice F.; Meyers, Johan

    2016-01-01

    We investigate the use of wind farms to provide secondary frequency regulation for a power grid. Our approach uses model-based receding horizon control of a wind farm that is tested using a large eddy simulation (LES) framework. In order to enable real-time implementation, the control actions are computed based on a time-varying one-dimensional wake model. This model describes wake advection and interactions, both of which play an important role in wind farm power production. This controller is implemented in an LES model of an 84-turbine wind farm represented by actuator disk turbine models. Differences between the velocities at each turbine predicted by the wake model and measured in LES are used for closed-loop feedback. The controller is tested on two types of regulation signals, “RegA” and “RegD”, obtained from PJM, an independent system operator in the eastern United States. Composite performance scores, which are used by PJM to qualify plants for regulation, are used to evaluate the performance of the controlled wind farm. Our results demonstrate that the controlled wind farm consistently performs well, passing the qualification threshold for all fastacting RegD signals. For the RegA signal, which changes over slower time scales, the controlled wind farm's average performance surpasses the threshold, but further work is needed to enable the controlled system to achieve qualifying performance all of the time. (paper)

  9. Development of SM-2 emulsion detector and its application to automatic control of deemulsifying agent addition

    International Nuclear Information System (INIS)

    Wu Hongpei.

    1985-01-01

    Emulsion phenomena had ever occurred in trifattyamine solvent extraction in some uranium mills owing to the presence of the colloidal polysilicic acid in feed solutions with the concentration even as high as >= 0.46 g/l (based on SiO 2 ). Polyether has been used as the deemulsifying agent to remove colloidal polysilicic acid in feed solution in question. In order to reduce the amount of polyether consumption, SM-2 emulsion detector was thus developed and used for automatic control of polyether addition into feed solution. The working principle and basic constitutional structure of SM-2 detector are described. When polyether solution is added into feed solution, certain turbidity occurs owing to the flocculated particles of polysilicic acid. It was found that a linear relationship existed between turbidity and photoelectric pressure difference in millivolts which can be detected by the SM-2 detector. Therefore, it is feasible that the minimum concentration of polysilicic acid, over which emulsion may occurs, can be found through experiments. To take advantage of this linear relationship, we can automatically control the addition of polyether solution in an appropriate amount without occurrence of emulsion phenomenon during solvent extraction. The scheme of automatic control of addition of polyether solution is presented too

  10. Human-Inspired Eigenmovement Concept Provides Coupling-Free Sensorimotor Control in Humanoid Robot

    Directory of Open Access Journals (Sweden)

    Thomas Mergner

    2017-04-01

    Full Text Available Control of a multi-body system in both robots and humans may face the problem of destabilizing dynamic coupling effects arising between linked body segments. The state of the art solutions in robotics are full state feedback controllers. For human hip-ankle coordination, a more parsimonious and theoretically stable alternative to the robotics solution has been suggested in terms of the Eigenmovement (EM control. Eigenmovements are kinematic synergies designed to describe the multi DoF system, and its control, with a set of independent, and hence coupling-free, scalar equations. This paper investigates whether the EM alternative shows “real-world robustness” against noisy and inaccurate sensors, mechanical non-linearities such as dead zones, and human-like feedback time delays when controlling hip-ankle movements of a balancing humanoid robot. The EM concept and the EM controller are introduced, the robot's dynamics are identified using a biomechanical approach, and robot tests are performed in a human posture control laboratory. The tests show that the EM controller provides stable control of the robot with proactive (“voluntary” movements and reactive balancing of stance during support surface tilts and translations. Although a preliminary robot-human comparison reveals similarities and differences, we conclude (i the Eigenmovement concept is a valid candidate when different concepts of human sensorimotor control are considered, and (ii that human-inspired robot experiments may help to decide in future the choice among the candidates and to improve the design of humanoid robots and robotic rehabilitation devices.

  11. Magnitude and Variability of Controllable Charge Capacity Provided by Grid Connected Plug-in Electric Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Scoffield, Don R [Idaho National Lab. (INL), Idaho Falls, ID (United States); Smart, John [Idaho National Lab. (INL), Idaho Falls, ID (United States); Salisbury, Shawn [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-03-01

    As market penetration of plug-in electric vehicles (PEV) increases over time, the number of PEVs charging on the electric grid will also increase. As the number of PEVs increases, their ability to collectively impact the grid increases. The idea of a large body of PEVs connected to the grid presents an intriguing possibility. If utilities can control PEV charging, it is possible that PEVs could act as a distributed resource to provide grid services. The technology required to control charging is available for modern PEVs. However, a system for wide-spread implementation of controllable charging, including robust communication between vehicles and utilities, is not currently present. Therefore, the value of controllable charging must be assessed and weighed against the cost of building and operating such as system. In order to grasp the value of PEV charge control to the utility, the following must be understood: 1. The amount of controllable energy and power capacity available to the utility 2. The variability of the controllable capacity from day to day and as the number of PEVs in the market increases.

  12. Control of abusive water addition to Octopus vulgaris with non-destructive methods.

    Science.gov (United States)

    Mendes, Rogério; Schimmer, Ove; Vieira, Helena; Pereira, João; Teixeira, Bárbara

    2018-01-01

    Abusive water addition to octopus has evidenced the need for quick non-destructive methods for product qualification in the industry and control of fresh commercial products in markets. Electric conductivity (EC)/pH and dielectric property measurements were selected to detect water uptake in octopus. A significant EC decrease was determined after soaking octopus in freshwater for 4 h. EC reflected the water uptake of octopus and the correspondent concentration decrease of available ions in the interstitial fluid. Significant correlations were determined between octopus water uptake, EC (R = -0.940) and moisture/protein (M/P) ratio (R = 0.923) changes. Seasonal and spatial variation in proximate composition did not introduce any uncertainty in EC discrimination of freshwater tampering. Immersion in 5 g L -1 sodium tripolyphosphate (STPP) increased EC to a value similar to control octopus. EC false negatives resulting from the use of additives (STPP and citric acid) were eliminated with the additional determination of pH. Octopus soaked in freshwater, STPP and citric acid can also be clearly discriminated from untreated samples (control) and also from frozen (thawed) ones using the dielectric properties. No significant differences in the dielectric property scores were found between octopus sizes or geographical locations. Simultaneous EC/pH or dielectric property measurements can be used in a handheld device for non-destructive water addition detection in octopus. M/P ratio can be used as a reference destructive method. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  13. Fundamentals of Using Battery Energy Storage Systems to Provide Primary Control Reserves in Germany

    Directory of Open Access Journals (Sweden)

    Alexander Zeh

    2016-09-01

    Full Text Available The application of stationary battery storage systems to German electrical grids can help with various storage services. This application requires controlling the charge and discharge power of such a system. For example, photovoltaic (PV home storage, uninterruptible power supply, and storage systems for providing ancillary services such as primary control reserves (PCRs represent battery applications with positive profitability. Because PCRs are essential for stabilizing grid frequency and maintaining a robust electrical grid, German transmission system operators (TSOs released strict regulations in August 2015 for providing PCRs with battery storage systems as part of regulating the International Grid Control Cooperation (IGCC region in Europe. These regulations focused on the permissible state of charge (SoC of the battery during nominal and extreme conditions. The concomitant increased capacity demand oversizing may result in a significant profitability reduction, which can be attenuated only by using an optimal parameterization of the control algorithm for energy management of the storage systems. In this paper, the sizing optimization is achieved and a recommendation for a control algorithm that includes the appropriate parameters for the requirements in the German market is given. Furthermore, the storage cost is estimated, including battery aging simulations for different aging parameter sets to allow for a realistic profitability calculation.

  14. Variations upon a theme: Australian lizards provide insights into the endocrine control of vertebrate reproductive cycles.

    Science.gov (United States)

    Jones, Susan M

    2017-04-01

    Australian lizards exhibit a broad array of different reproductive strategies and provide an extraordinary diversity and range of models with which to address fundamental problems in reproductive biology. Studies on lizards have frequently led to new insights into hormonal regulatory pathways or mechanisms of control, but we have detailed knowledge of the reproductive cycle in only a small percentage of known species. This review provides an overview and synthesis of current knowledge of the hormonal control of reproductive cycles in Australian lizards. Agamid lizards have provided useful models with which to test hypotheses about the hormonal regulation of the expression of reproductive behaviors, while research on viviparous skinks is providing insights into the evolution of the endocrine control of gestation. However, in order to better understand the potential risks that environmental factors such as climate change and endocrine disrupting chemicals pose to our fauna, better knowledge is required of the fundamental characteristics of the reproductive cycle in a broader range of lizard species. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Impact of providing fee data on laboratory test ordering: a controlled clinical trial.

    Science.gov (United States)

    Feldman, Leonard S; Shihab, Hasan M; Thiemann, David; Yeh, Hsin-Chieh; Ardolino, Margaret; Mandell, Steven; Brotman, Daniel J

    2013-05-27

    Inpatient care providers often order laboratory tests without any appreciation for the costs of the tests. To determine whether we could decrease the number of laboratory tests ordered by presenting providers with test fees at the time of order entry in a tertiary care hospital, without adding extra steps to the ordering process. Controlled clinical trial. Tertiary care hospital. All providers, including physicians and nonphysicians, who ordered laboratory tests through the computerized provider order entry system at The Johns Hopkins Hospital. We randomly assigned 61 diagnostic laboratory tests to an "active" arm (fee displayed) or to a control arm (fee not displayed). During a 6-month baseline period (November 10, 2008, through May 9, 2009), we did not display any fee data. During a 6-month intervention period 1 year later (November 10, 2009, through May 9, 2010), we displayed fees, based on the Medicare allowable fee, for active tests only. We examined changes in the total number of orders placed, the frequency of ordered tests (per patient-day), and total charges associated with the orders according to the time period (baseline vs intervention period) and by study group (active test vs control). For the active arm tests, rates of test ordering were reduced from 3.72 tests per patient-day in the baseline period to 3.40 tests per patient-day in the intervention period (8.59% decrease; 95% CI, -8.99% to -8.19%). For control arm tests, ordering increased from 1.15 to 1.22 tests per patient-day from the baseline period to the intervention period (5.64% increase; 95% CI, 4.90% to 6.39%) (P fee data to providers at the time of order entry resulted in a modest decrease in test ordering. Adoption of this intervention may reduce the number of inappropriately ordered diagnostic tests.

  16. PRECISE - pregabalin in addition to usual care for sciatica: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Mathieson, Stephanie; Maher, Christopher G; McLachlan, Andrew J; Latimer, Jane; Koes, Bart W; Hancock, Mark J; Harris, Ian; Day, Richard O; Pik, Justin; Jan, Stephen; Billot, Laurent; Lin, Chung-Wei Christine

    2013-07-11

    Sciatica is a type of neuropathic pain that is characterised by pain radiating into the leg. It is often accompanied by low back pain and neurological deficits in the lower limb. While this condition may cause significant suffering for the individual, the lack of evidence supporting effective treatments for sciatica makes clinical management difficult. Our objectives are to determine the efficacy of pregabalin on reducing leg pain intensity and its cost-effectiveness in patients with sciatica. PRECISE is a prospectively registered, double-blind, randomised placebo-controlled trial of pregabalin compared to placebo, in addition to usual care. Inclusion criteria include moderate to severe leg pain below the knee with evidence of nerve root/spinal nerve involvement. Participants will be randomised to receive either pregabalin with usual care (n = 102) or placebo with usual care (n = 102) for 8 weeks. The medicine dosage will be titrated up to the participant's optimal dose, to a maximum 600 mg per day. Follow up consultations will monitor individual progress, tolerability and adverse events. Usual care, if deemed appropriate by the study doctor, may include a referral for physical or manual therapy and/or prescription of analgesic medication. Participants, doctors and researchers collecting participant data will be blinded to treatment allocation. Participants will be assessed at baseline and at weeks 2, 4, 8, 12, 26 and 52. The primary outcome will determine the efficacy of pregabalin in reducing leg pain intensity. Secondary outcomes will include back pain intensity, disability and quality of life. Data analysis will be blinded and by intention-to-treat. A parallel economic evaluation will be conducted from health sector and societal perspectives. This study will establish the efficacy of pregabalin in reducing leg pain intensity in patients with sciatica and provide important information regarding the effect of pregabalin treatment on disability and quality of life

  17. Medical Care Provided Under California's Workers' Compensation Program: Effects of the Reforms and Additional Opportunities to Improve the Quality and Efficiency of Care.

    Science.gov (United States)

    Wynn, Barbara O; Timbie, Justin W; Sorbero, Melony E

    2011-01-01

    Since 2004, significant changes have been made to the California workers' compensation (WC) system. The Commission on Health and Safety and Workers' Compensation (CHSWC) asked the RAND Corporation to examine the impact that these changes have on the medical care provided to injured workers. This study synthesizes findings from interviews and available information regarding the implementation of the changes affecting WC medical care and identifies areas in which additional changes might increase the quality and efficiency of care delivered under the WC system. To improve incentives for efficiently providing medically appropriate care, California should revise its fee schedule allowances for services provided by hospitals to inpatients, freestanding ambulatory surgery centers, and physicians, create nonmonetary incentives for providing medically appropriate care in the medical provider network (MPN) context through more-selective contracting with providers and reducing medical review requirements for high-performing physicians; reduce incentives for inappropriate prescribing practices by curtailing in-office physician dispensing; and implement pharmacy benefit network regulations. To increase accountability for performance, California should revise the MPN certification process to place accountability for meeting MPN standards on the entity contracting with the physician network; strengthen Division of Workers' Compensation (DWC) authorities to provide intermediate sanctions for failure to comply with MPN requirements; and modify the Labor Code to remove payers and MPNs from the definition of individually identifiable data so that performance on key measures can be publicly available. To facilitate monitoring and oversight, California should provide DWC with more flexibility to add needed data elements to medical data reporting and provide penalties for a claim administrator failing to comply with the data-reporting requirements; require that medical cost

  18. Robust Tests for Additive Gene-Environment Interaction in Case-Control Studies Using Gene-Environment Independence

    DEFF Research Database (Denmark)

    Liu, Gang; Lee, Seunggeun; Lee, Alice W

    2018-01-01

    test with case-control data. Our simulation studies suggest that the EB approach uses the gene-environment independence assumption in a data-adaptive way and provides power gain compared to the standard logistic regression analysis and better control of Type I error when compared to the analysis......There have been recent proposals advocating the use of additive gene-environment interaction instead of the widely used multiplicative scale, as a more relevant public health measure. Using gene-environment independence enhances the power for testing multiplicative interaction in case......-control studies. However, under departure from this assumption, substantial bias in the estimates and inflated Type I error in the corresponding tests can occur. This paper extends the empirical Bayes (EB) approach previously developed for multiplicative interaction that trades off between bias and efficiency...

  19. Morphological control in polymer solar cells using low-boiling-point solvent additives

    Science.gov (United States)

    Mahadevapuram, Rakesh C.

    In the global search for clean, renewable energy sources, organic photovoltaics (OPVs) have recently been given much attention. Popular modern-day OPVs are made from solution-processible, carbon-based polymers (e.g. the model poly(3-hexylthiophene) that are intimately blended with fullerene derivatives (e.g. [6,6]-phenyl-C71-butyric acid methyl ester) to form what is known as the dispersed bulk-heterojunction (BHJ). This BHJ architecture has produced some of the most efficient OPVs to date, with reports closing in on 10% power conversion efficiency. To push efficiencies further into double digits, many groups have identified the BHJ nanomorphology---that is, the phase separations and grain sizes within the polymer: fullerene composite---as a key aspect in need of control and improvement. As a result, many methods, including thermal annealing, slow-drying (solvent) annealing, vapor annealing, and solvent additives, have been developed and studied to promote BHJ self-organization. Processing organic photovoltaic (OPV) blend solutions with high-boiling-point solvent additives has recently been used for morphological control in BHJ OPV cells. Here we show that even low-boiling-point solvents can be effective additives. When P3HT:PCBM OPV cells were processed with a low-boiling-point solvent tetrahydrafuran as an additive in parent solvent o-dichlorobenzene, charge extraction increased leading to fill factors as high as 69.5%, without low work-function cathodes, electrode buffer layers or thermal treatment. This was attributed to PCBM demixing from P3HT domains and better vertical phase separation, as indicated by photoluminescence lifetimes, hole mobilities, and shunt leakage currents. Dependence on solvent parameters and applicability beyond P3HT system was also investigated.

  20. Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study.

    Science.gov (United States)

    Cottrell, Michelle A; Hill, Anne J; O'Leary, Shaun P; Raymer, Maree E; Russell, Trevor G

    2017-12-01

    The Neurosurgical & Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service (N/OPSC&MDS) originated as a complementary, non-surgical pathway for patients referred to public neurosurgical and orthopaedic specialist services. Patient access to the N/OPSC&MDS could potentially be improved with the implementation of telerehabilitation as an additional method of service delivery. To evaluate service provider's views on (1) current barriers to patients' accessing N/OPSC & MD services, and (2) the implementation of telerehabilitation within the N/OPSC&MDS. Qualitative descriptive study design. Healthcare providers (n = 26) were recruited from six N/OPSC&MD services located throughout Queensland, Australia. Semi-structured interviews were conducted to explore service providers' views with respect to existing barriers to patients accessing the N/OPSC&MDS, and if telerehabilitation could be feasibly adopted to address current barriers. Template analysis resulted in six themes: (1) barriers to some patients' accessing current N/OPSC&MD services are complex & multifaceted; (2) telerehabilitation could improve patient access to appropriate management for their musculoskeletal condition; (3) telerehabilitation may have limitations when compared to face-to-face healthcare; (4) the delivery of telerehabilitation needs to be flexible; (5) perceived barriers, and (6) facilitators to the successful implementation of telerehabilitation within the N/OPSC&MDS. This study represents a critical step in determining the readiness of service providers for the implementation of telerehabilitation within the N/OPSC&MDS. Although cautious, service providers are overall accepting of the implementation of telerehabilitation, acknowledging that it could eliminate several current barriers, subsequently achieving more equitable access to the service. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  1. Weld metal grain refinement of aluminium alloy 5083 through controlled additions of Ti and B

    Energy Technology Data Exchange (ETDEWEB)

    Schempp, Philipp; Rethmeier, Michael [Federal Institute for Materials Research and Testing BAM, Berlin (Germany). Div. ' ' Safety of Joined Components' ' ; Fraunhofer Institute for Production Systems and Design Technology IPK, Berlin (Germany). Dept. ' ' Joining and Coating Technology' ' ; Schwenk, Christopher; Cross, Carl Edward [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany)

    2011-07-01

    The refinement of the weld metal grain structure may lead to a significant change in its mechanical properties and in the weldability of the base metal. One possibility to achieve weld metal grain refinement is the inoculation of the weld pool. In this study, it is shown how additions of titanium and boron influence the weld metal grain structure of GTA welds of the aluminium alloy 5083 (Al Mg4.5Mn0.7). For this purpose, inserts consisting of base metal and additions of the master alloy Al Ti5B1 have been cast, deposited in the base metal and fused in a GTA welding process. The increase of the Ti and B content led to a significant decrease of the weld metal mean grain size and to a change in grain shape. The results provide a basis for a more precise definition of the chemical composition of commercial filler wires and rods for aluminium arc welding. (orig.)

  2. A Randomized Controlled Trial of the Effects of Online Pain Management Education on Primary Care Providers.

    Science.gov (United States)

    Trudeau, Kimberlee J; Hildebrand, Cristina; Garg, Priyanka; Chiauzzi, Emil; Zacharoff, Kevin L

    2017-04-01

    To improve pain management practices, we developed an online interactive continuing education (CE) program for primary care providers (PCPs). This program follows the flow of clinical decision-making through simulated cases at critical pain treatment points along the pain treatment continuum. A randomized controlled trial was conducted to test the efficacy of this program. Participants were randomized to either the experimental condition or the control condition (online, text-based CE program). A total of 238 primary care providers were recruited through hospitals, professional newsletters, and pain conferences. Participants in both conditions reported significantly improved scores on knowledge (KNOW-PAIN 50), attitudes (CAOS), and pain practice behaviors (PPBS) scales over the four-month study. The experimental condition showed significantly greater change over time on the tamper-resistant formulations (TRFs) of opioids and dosing CAOS subscale compared with the control condition. Post hoc comparisons suggested that participants in the experimental condition were less likely to endorse use of opioid TRFs over time compared with the control condition. Exploratory analyses for potential moderators indicated a significant three-way interaction with time, condition, and discipline (i.e., physician vs other) for the impediments and concerns attitudes subscale and the early refill behaviors subscale. Post hoc comparisons indicated that physicians in the experimental condition exhibited the greatest change in attitudes and the nonphysicians exhibited the greatest change in reported behaviors in response to requests for early refills. Findings suggest online CE programs may positively impact PCPs' knowledge, attitudes, and pain practice behaviors but provide minimal evidence for the value of including interactivity. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  3. Operation and Management of Thermostatically Controlled Loads for Providing Regulation Services to Power Grids

    Science.gov (United States)

    Vanouni, Maziar

    The notion of demand-side participation in power systems operation and control is on the verge of realization because of the advancement in the required technologies an tools like communications, smart meters, sensor networks, large data management techniques, large scale optimization method, etc. Therefore, demand-response (DR) programs can be one of the prosperous solutions to accommodate part of the increasing demand for load balancing services which is brought about by the high penetration of intermittent renewable energies in power systems. This dissertation studies different aspects of the DR programs that utilized the thermostatically controlled loads (TCLs) to provide load balancing services. The importance of TCLs among the other loads lie on their flexibility in power consumption pattern while the customer/end-user comfort is not (or minimally) impacted. Chapter 2 discussed a previously presented direct load control (DLC) to control the power consumption of aggregated TCLs. The DLC method performs a power tracking control and based on central approach where a central controller broadcasts the control command to the dispersed TCLs to toggle them on/off. The central controller receives measurement feedback from the TCLs once per couple of minutes to run a successful forecast process. The performance evaluation criteria to evaluate the load balancing service provided by the TCLs are presented. The results are discussed under different scenarios and situation. The numerical results show the proper performance of the DLC method. This DLC method is used as the control method in all the studies in this dissertation. Chapter 3 presents performance improvements for the original method in Chapter 2 by communicating two more pieces of information called forecast parameters (FPs). Communicating improves the forecast process in the DLC and hence, both performance accuracy and the amount of tear-and-wear imposed on the TCLs. Chapter 4 formulates a stochastic

  4. Hierarchical tailoring of strut architecture to control permeability of additive manufactured titanium implants

    International Nuclear Information System (INIS)

    Zhang, Z.; Jones, D.; Yue, S.; Lee, P.D.; Jones, J.R.; Sutcliffe, C.J.; Jones, E.

    2013-01-01

    Porous titanium implants are a common choice for bone augmentation. Implants for spinal fusion and repair of non-union fractures must encourage blood flow after implantation so that there is sufficient cell migration, nutrient and growth factor transport to stimulate bone ingrowth. Additive manufacturing techniques allow a large number of pore network designs. This study investigates how the design factors offered by selective laser melting technique can be used to alter the implant architecture on multiple length scales to control and even tailor the flow. Permeability is a convenient parameter that characterises flow, correlating to structure openness (interconnectivity and pore window size), tortuosity and hence flow shear rates. Using experimentally validated computational simulations, we demonstrate how additive manufacturing can be used to tailor implant properties by controlling surface roughness at a microstructual level (microns), and by altering the strut ordering and density at a mesoscopic level (millimetre). Highlights: • Experimentally validated permeability prediction tools for hierarchical implants. • Randomised structures form preferential flow channels with stronger shear flows. • Hierarchical strut structures allow independent tailoring of flow and pore size

  5. Hierarchical tailoring of strut architecture to control permeability of additive manufactured titanium implants

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Z. [Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ (United Kingdom); Jones, D. [School of Engineering, University of Liverpool, Brownlow Hill, Liverpool, L69 3GH (United Kingdom); Yue, S. [Manchester X-ray Imaging Facility, School of Materials, The University of Manchester, Oxford Road, M13 9PL (United Kingdom); Lee, P.D., E-mail: peter.lee@manchester.ac.uk [Manchester X-ray Imaging Facility, School of Materials, The University of Manchester, Oxford Road, M13 9PL (United Kingdom); Jones, J.R. [Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ (United Kingdom); Sutcliffe, C.J. [School of Engineering, University of Liverpool, Brownlow Hill, Liverpool, L69 3GH (United Kingdom); Jones, E. [Department of Advanced Technology, Stryker Orthopaedics, Raheen Business Park, Limerick (Ireland)

    2013-10-15

    Porous titanium implants are a common choice for bone augmentation. Implants for spinal fusion and repair of non-union fractures must encourage blood flow after implantation so that there is sufficient cell migration, nutrient and growth factor transport to stimulate bone ingrowth. Additive manufacturing techniques allow a large number of pore network designs. This study investigates how the design factors offered by selective laser melting technique can be used to alter the implant architecture on multiple length scales to control and even tailor the flow. Permeability is a convenient parameter that characterises flow, correlating to structure openness (interconnectivity and pore window size), tortuosity and hence flow shear rates. Using experimentally validated computational simulations, we demonstrate how additive manufacturing can be used to tailor implant properties by controlling surface roughness at a microstructual level (microns), and by altering the strut ordering and density at a mesoscopic level (millimetre). Highlights: • Experimentally validated permeability prediction tools for hierarchical implants. • Randomised structures form preferential flow channels with stronger shear flows. • Hierarchical strut structures allow independent tailoring of flow and pore size.

  6. Effects of a Patient-Provider, Collaborative, Medication-Planning Tool: A Randomized, Controlled Trial

    Directory of Open Access Journals (Sweden)

    James F. Graumlich

    2016-01-01

    Full Text Available Among patients with various levels of health literacy, the effects of collaborative, patient-provider, medication-planning tools on outcomes relevant to self-management are uncertain. Objective. Among adult patients with type II diabetes mellitus, we tested the effectiveness of a medication-planning tool (Medtable™ implemented via an electronic medical record to improve patients’ medication knowledge, adherence, and glycemic control compared to usual care. Design. A multicenter, randomized controlled trial in outpatient primary care clinics. 674 patients received either the Medtable tool or usual care and were followed up for up to 12 months. Results. Patients who received Medtable had greater knowledge about indications for medications in their regimens and were more satisfied with the information about their medications. Patients’ knowledge of drug indication improved with Medtable regardless of their literacy status. However, Medtable did not improve patients’ demonstrated medication use, regimen adherence, or glycemic control (HbA1c. Conclusion. The Medtable tool supported provider/patient collaboration related to medication use, as reflected in patient satisfaction with communication, but had limited impact on patient medication knowledge, adherence, and HbA1c outcomes. This trial is registered with ClinicalTrials.gov NCT01296633.

  7. Margins of safety provided by COSHH Essentials and the ILO Chemical Control Toolkit.

    Science.gov (United States)

    Jones, Rachael M; Nicas, Mark

    2006-03-01

    COSHH Essentials, developed by the UK Health and Safety Executive, and the Chemical Control Toolkit (Toolkit) proposed by the International Labor Organization, are 'control banding' approaches to workplace risk management intended for use by proprietors of small and medium-sized businesses. Both systems group chemical substances into hazard bands based on toxicological endpoint and potency. COSSH Essentials uses the European Union's Risk-phrases (R-phrases), whereas the Toolkit uses R-phrases and the Globally Harmonized System (GHS) of Classification and Labeling of Chemicals. Each hazard band is associated with a range of airborne concentrations, termed exposure bands, which are to be attained by the implementation of recommended control technologies. Here we analyze the margin of safety afforded by the systems and, for each hazard band, define the minimal margin as the ratio of the minimum airborne concentration that produced the toxicological endpoint of interest in experimental animals to the maximum concentration in workplace air permitted by the exposure band. We found that the minimal margins were always occupational exposure limits, we argue that the minimal margins are better indicators of health protection. Further, given the small margins observed, we feel it is important that revisions of these systems provide the exposure bands to users, so as to permit evaluation of control technology capture efficiency.

  8. Controlling the extrudate swell in melt extrusion additive manufacturing of 3D scaffolds: a designed experiment.

    Science.gov (United States)

    Yousefi, Azizeh-Mitra; Smucker, Byran; Naber, Alex; Wyrick, Cara; Shaw, Charles; Bennett, Katelyn; Szekely, Sarah; Focke, Carlie; Wood, Katherine A

    2018-02-01

    Tissue engineering using three-dimensional porous scaffolds has shown promise for the restoration of normal function in injured and diseased tissues and organs. Rigorous control over scaffold architecture in melt extrusion additive manufacturing is highly restricted mainly due to pronounced variations in the deposited strand diameter upon any variations in process conditions and polymer viscoelasticity. We have designed an I-optimal, split-plot experiment to study the extrudate swell in melt extrusion additive manufacturing and to control the scaffold architecture. The designed experiment was used to generate data to relate three responses (swell, density, and modulus) to a set of controllable factors (plotting needle diameter, temperature, pressure, and the dispensing speed). The fitted regression relationships were used to optimize the three responses simultaneously. The swell response was constrained to be close to 1 while maximizing the modulus and minimizing the density. Constraining the extrudate swell to 1 generates design-driven scaffolds, with strand diameters equal to the plotting needle diameter, and allows a greater control over scaffold pore size. Hence, the modulus of the scaffolds can be fully controlled by adjusting the in-plane distance between the deposited strands. To the extent of the model's validity, we can eliminate the effect of extrudate swell in designing these scaffolds, while targeting a range of porosity and modulus appropriate for bone tissue engineering. The result of this optimization was a predicted modulus of 14 MPa and a predicted density of 0.29 g/cm 3 (porosity ≈ 75%) using polycaprolactone as scaffold material. These predicted responses corresponded to factor levels of 0.6 μm for the plotting needle diameter, plotting pressure of 2.5 bar, melt temperature of 113.5 °C, and dispensing speed of 2 mm/s. The validation scaffold enabled us to quantify the percentage difference for the predictions, which was 9.5% for the

  9. A tuneable switch for controlling environmental degradation of bioplastics: addition of isothiazolinone to polyhydroxyalkanoates.

    Directory of Open Access Journals (Sweden)

    Catherine Anne Woolnough

    Full Text Available Controlling the environmental degradation of polyhydroxybutyrate (PHB and polyhydroxyvalerate (P(HB-co-HV bioplastics would expand the range of their potential applications. Combining PHB and P(HB-co-HV films with the anti-fouling agent 4,5-dichloro-2-n-octyl-4-isothiazolin-3-one (DCOI, <10% w/w restricted microbial colonisation in soil, but did not significantly affect melting temperature or the tensile strength of films. DCOI films showed reduced biofouling and postponed the onset of weight loss by up to 100 days, a 10-fold increase compared to unmodified films where the microbial coverage was significant. In addition, the rate of PHA-DCOI weight loss, post-onset, reduced by about 150%; in contrast a recorded weight loss of only 0.05% per day for P(HB-co-HV with a 10% DCOI loading was observed. This is in stark contrast to the unmodified PHB film, where a recorded weight loss of only 0.75% per day was made. The 'switch' that initiates film weight loss, and its subsequent reduced rate, depended on the DCOI loading to control biofouling. The control of biofouling and environmental degradation for these DCOI modified bioplastics increases their potential use in biodegradable applications.

  10. Effect of providing free glasses on children's educational outcomes in China: cluster randomized controlled trial.

    Science.gov (United States)

    Ma, Xiaochen; Zhou, Zhongqiang; Yi, Hongmei; Pang, Xiaopeng; Shi, Yaojiang; Chen, Qianyun; Meltzer, Mirjam E; le Cessie, Saskia; He, Mingguang; Rozelle, Scott; Liu, Yizhi; Congdon, Nathan

    2014-09-23

    To assess the effect of provision of free glasses on academic performance in rural Chinese children with myopia. Cluster randomized, investigator masked, controlled trial. 252 primary schools in two prefectures in western China, 2012-13. 3177 of 19,934 children in fourth and fifth grades (mean age 10.5 years) with visual acuity 6/12 with glasses. 3052 (96.0%) completed the study. Children were randomized by school (84 schools per arm) to one of three interventions at the beginning of the school year: prescription for glasses only (control group), vouchers for free glasses at a local facility, or free glasses provided in class. Spectacle wear at endline examination and end of year score on a specially designed mathematics test, adjusted for baseline score and expressed in standard deviations. Among 3177 eligible children, 1036 (32.6%) were randomized to control, 988 (31.1%) to vouchers, and 1153 (36.3%) to free glasses in class. All eligible children would benefit from glasses, but only 15% wore them at baseline. At closeout glasses wear was 41% (observed) and 68% (self reported) in the free glasses group, and 26% (observed) and 37% (self reported) in the controls. Effect on test score was 0.11 SD (95% confidence interval 0.01 to 0.21) when the free glasses group was compared with the control group. The adjusted effect of providing free glasses (0.10, 0.002 to 0.19) was greater than parental education (0.03, -0.04 to 0.09) or family wealth (0.01, -0.06 to 0.08). This difference between groups was significant, but was smaller than the prespecified 0.20 SD difference that the study was powered to detect. The provision of free glasses to Chinese children with myopia improves children's performance on mathematics testing to a statistically significant degree, despite imperfect compliance, although the observed difference between groups was smaller than the study was originally designed to detect. Myopia is common and rarely corrected in this setting.Trial Registration

  11. Safeguards agreement and additional protocol - IAEA instruments for control of nuclear materials distribution and their application in Tajikistan

    International Nuclear Information System (INIS)

    Nasrulloev, Kh.; Mirsaidov, U.

    2010-01-01

    Full text: It is known that IAEA plays an important role in facilitation of nuclear non-proliferation as international authority which carries out nuclear inspections. Republic of Tajikistan in 1997 signed nuclear weapon non-proliferation treaty. Then in 2004 Safeguards agreement, additional protocol and small quantity protocol were signed. During 5 years Republic of Tajikistan submits information on its nuclear activity as declarations, foreseen in article 2.3 of Additional protocol to Safeguards agreement. Currently 66 declarations are submitted. Information required in accordance with Safeguards agreement and Additional Protocol is figured on that IAEA could compile more detailed and exact conception about nuclear activity in Tajikistan and it has the following purpose: information will lead to more transparency, and make it possible to IAEA to ensure with high extent of confidence that in the framework of declared program, any unstated nuclear activity is concealed; the more exact and comprehensive information, the rare is questions and discrepancies are originating; required information is the basis for effective planning and IAEA activity realization, related not only with safeguards implementation in regard to declared nuclear material but also ensuring of confidence in absence of undeclared nuclear activity in Tajikistan. IAEA inspection mission consisting of Messrs. N.Lazarev and F. Coillou visited Dushanbe in 2008 for verification of republic’s declarations on account for and control of nuclear materials under Additional protocol and Small quantity protocol, as well as consultations were provided on correct declaration completing and providing information on all nuclear materials. Besides, in 2006, the training course was conducted in Chkalovsk with participation of Commonwealth of Independent States countries on Safeguards agreement and Additional protocol. These visits and events will facilitate to strengthening of weapons of mass destruction non

  12. Formalin treatments pass new tests. Additional notes on the control of ecto-parasitic protozoa

    Science.gov (United States)

    1940-01-01

    After the completion of the eхреriments reported recently, in which the efficacy of formalin in controlling infections of Gostia mecatrix was demonstrated, the author was afforded an opportunity to test the value of formalin solutions in combatting established mixed infections of (Gyrodactylus, Tricbodina, Cyclochaeta) and a stalked protozoan on rainbow trout fingerlings. This opportunity was provided through the courtesy and cooperation of Clarence F. Pautzke, Chief Biologist for the Washington State Game Department, and Lee Walters, Superintendent of the Washington State Hatchery at Seward Park, Seattle.

  13. The effects of providing periodontal disease risk information on psychological outcomes - a randomized controlled trial.

    Science.gov (United States)

    Asimakopoulou, Koula; Newton, Jonathon Tim; Daly, Blánaid; Kutzer, Yvonne; Ide, Mark

    2015-04-01

    In a two arm randomized controlled trial this study compared the effects of a routine periodontal assessment consultation versus a routine consultation + individualized risk assessment communication intervention on patient thoughts and emotions about periodontal disease. Adults (N = 102) with moderate/advanced chronic periodontitis referred to a Periodontology Department of a large UK dental school, completed psychological measures before a periodontal assessment and again at the end of the visit. Intervention participants received an individualized calculation of their periodontal disease risk using PreViser Risk Calculator in addition to their routine assessment consultation. In routine care, patients' thoughts about periodontal disease seriousness (p periodontal disease. These effects were also seen in intervention participants. Additionally, the individualized risk communication intervention led to patients reporting i) periodontal disease treatment as more effective than they did pre-consultation (p periodontal management (p periodontal disease risk communication influences psychological variables that underpin adherence with periodontal instructions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Additive controlled synthesis of gold nanorods (GNRs) for two-photon luminescence imaging of cancer cells

    International Nuclear Information System (INIS)

    Zhu Jing; Roy, Indrajit; Hu Rui; Ding Hong; Zhao Lingling; He, Guang S; Prasad, Paras N; Yong, Ken-Tye; Swihart, Mark T; Cui Yiping

    2010-01-01

    Gold nanorods (GNRs) with a longitudinal surface plasmon resonance peak that is tunable from 600 to 1100 nm have been fabricated in a cetyl trimethylammoniumbromide (CTAB) micellar medium using hydrochloric acid and silver nitrate as additives to control their shape and size. By manipulating the concentrations of silver nitrate and hydrochloric acid, the aspect ratio of the GNRs was reliably and reproducibly tuned from 2.5 to 8. The GNRs were first coated with polyelectrolyte multilayers and then bioconjugated to transferrin (Tf) to target pancreatic cancer cells. Two-photon imaging excited from the bioconjugated GNRs demonstrated receptor-mediated uptake of the bioconjugates into Panc-1 cells, overexpressing the transferrin receptor (TfR). The bioconjugated GNR formulation exhibited very low toxicity, suggesting that it is biocompatible and potentially suitable for targeted two-photon bioimaging.

  15. Additive controlled synthesis of gold nanorods (GNRs) for two-photon luminescence imaging of cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Zhu Jing; Roy, Indrajit; Hu Rui; Ding Hong; Zhao Lingling; He, Guang S; Prasad, Paras N [Institute for Lasers, Photonics and Biophotonics, University at Buffalo, State University of New York, Buffalo, NY 14260-4200 (United States); Yong, Ken-Tye [School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore 639798 (Singapore); Swihart, Mark T [Department of Chemical and Biological Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260-4200 (United States); Cui Yiping, E-mail: ktyong@ntu.edu.sg, E-mail: cyp@seu.edu.cn, E-mail: pnprasad@buffalo.edu [Advanced Photonics Center, School of Electronic Science and Engineering, Southeast University, Nanjing 210096 (China)

    2010-07-16

    Gold nanorods (GNRs) with a longitudinal surface plasmon resonance peak that is tunable from 600 to 1100 nm have been fabricated in a cetyl trimethylammoniumbromide (CTAB) micellar medium using hydrochloric acid and silver nitrate as additives to control their shape and size. By manipulating the concentrations of silver nitrate and hydrochloric acid, the aspect ratio of the GNRs was reliably and reproducibly tuned from 2.5 to 8. The GNRs were first coated with polyelectrolyte multilayers and then bioconjugated to transferrin (Tf) to target pancreatic cancer cells. Two-photon imaging excited from the bioconjugated GNRs demonstrated receptor-mediated uptake of the bioconjugates into Panc-1 cells, overexpressing the transferrin receptor (TfR). The bioconjugated GNR formulation exhibited very low toxicity, suggesting that it is biocompatible and potentially suitable for targeted two-photon bioimaging.

  16. Additive controlled synthesis of gold nanorods (GNRs) for two-photon luminescence imaging of cancer cells

    Science.gov (United States)

    Zhu, Jing; Yong, Ken-Tye; Roy, Indrajit; Hu, Rui; Ding, Hong; Zhao, Lingling; Swihart, Mark T.; He, Guang S.; Cui, Yiping; Prasad, Paras N.

    2010-07-01

    Gold nanorods (GNRs) with a longitudinal surface plasmon resonance peak that is tunable from 600 to 1100 nm have been fabricated in a cetyl trimethylammoniumbromide (CTAB) micellar medium using hydrochloric acid and silver nitrate as additives to control their shape and size. By manipulating the concentrations of silver nitrate and hydrochloric acid, the aspect ratio of the GNRs was reliably and reproducibly tuned from 2.5 to 8. The GNRs were first coated with polyelectrolyte multilayers and then bioconjugated to transferrin (Tf) to target pancreatic cancer cells. Two-photon imaging excited from the bioconjugated GNRs demonstrated receptor-mediated uptake of the bioconjugates into Panc-1 cells, overexpressing the transferrin receptor (TfR). The bioconjugated GNR formulation exhibited very low toxicity, suggesting that it is biocompatible and potentially suitable for targeted two-photon bioimaging.

  17. Controllable Microdroplet Splitting via Additional Lateral Flow and its Application in Rapid Synthesis of Multi-scale Microspheres

    KAUST Repository

    Zhou, Bingpu; Wang, Cong; Xiao, Xiao; Hui, Yu Sanna; Cao, Yulin; Wen, Weijia

    2015-01-01

    In this paper, we demonstrate that controllable microdroplet splitting could be obtained via additional lateral flow with simplicity and high controllability. The volume ratio of the two splitting products can be flexibly regulated by adjusting

  18. Depression treatment for impoverished mothers by point-of-care providers: A randomized controlled trial.

    Science.gov (United States)

    Segre, Lisa S; Brock, Rebecca L; O'Hara, Michael W

    2015-04-01

    Depression in low-income, ethnic-minority women of childbearing age is prevalent and compromises infant and child development. Yet numerous barriers prevent treatment delivery. Listening Visits (LV), an empirically supported intervention developed for delivery by British home-visiting nurses, could address this unmet mental health need. This randomized controlled trial (RCT) evaluated the effectiveness of LV delivered at a woman's usual point-of-care, including home visits or an ob-gyn office. Listening Visits were delivered to depressed pregnant women or mothers of young children by their point-of-care provider (e.g., home visitor or physician's assistant), all of whom had low levels of prior counseling experience. Three quarters of the study's participants were low-income. Of those who reported ethnicity, all identified themselves as minorities. Participants from 4 study sites (N = 66) were randomized in a 2:1 ratio, to LV or a wait-list control group (WLC). Assessments, conducted at baseline and 8 weeks, evaluated depression, quality of life, and treatment satisfaction. Depressive severity, depressive symptoms, and quality of life significantly improved among LV recipients as compared with women receiving standard social/health services. Women valued LV as evidenced by their high attendance rates and treatment satisfaction ratings. In a stepped model of depression care, LV can provide an accessible, acceptable, and effective first-line treatment option for at-risk women who otherwise are unlikely to receive treatment. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  19. Retroviral vectors encoding ADA regulatory locus control region provide enhanced T-cell-specific transgene expression.

    Science.gov (United States)

    Trinh, Alice T; Ball, Bret G; Weber, Erin; Gallaher, Timothy K; Gluzman-Poltorak, Zoya; Anderson, French; Basile, Lena A

    2009-12-30

    Murine retroviral vectors have been used in several hundred gene therapy clinical trials, but have fallen out of favor for a number of reasons. One issue is that gene expression from viral or internal promoters is highly variable and essentially unregulated. Moreover, with retroviral vectors, gene expression is usually silenced over time. Mammalian genes, in contrast, are characterized by highly regulated, precise levels of expression in both a temporal and a cell-specific manner. To ascertain if recapitulation of endogenous adenosine deaminase (ADA) expression can be achieved in a vector construct we created a new series of Moloney murine leukemia virus (MuLV) based retroviral vector that carry human regulatory elements including combinations of the ADA promoter, the ADA locus control region (LCR), ADA introns and human polyadenylation sequences in a self-inactivating vector backbone. A MuLV-based retroviral vector with a self-inactivating (SIN) backbone, the phosphoglycerate kinase promoter (PGK) and the enhanced green fluorescent protein (eGFP), as a reporter gene, was generated. Subsequent vectors were constructed from this basic vector by deletion or addition of certain elements. The added elements that were assessed are the human ADA promoter, human ADA locus control region (LCR), introns 7, 8, and 11 from the human ADA gene, and human growth hormone polyadenylation signal. Retroviral vector particles were produced by transient three-plasmid transfection of 293T cells. Retroviral vectors encoding eGFP were titered by transducing 293A cells, and then the proportion of GFP-positive cells was determined using fluorescence-activated cell sorting (FACS). Non T-cell and T-cell lines were transduced at a multiplicity of infection (MOI) of 0.1 and the yield of eGFP transgene expression was evaluated by FACS analysis using mean fluorescent intensity (MFI) detection. Vectors that contained the ADA LCR were preferentially expressed in T-cell lines. Further improvements

  20. Retroviral vectors encoding ADA regulatory locus control region provide enhanced T-cell-specific transgene expression

    Science.gov (United States)

    2009-01-01

    Background Murine retroviral vectors have been used in several hundred gene therapy clinical trials, but have fallen out of favor for a number of reasons. One issue is that gene expression from viral or internal promoters is highly variable and essentially unregulated. Moreover, with retroviral vectors, gene expression is usually silenced over time. Mammalian genes, in contrast, are characterized by highly regulated, precise levels of expression in both a temporal and a cell-specific manner. To ascertain if recapitulation of endogenous adenosine deaminase (ADA) expression can be achieved in a vector construct we created a new series of Moloney murine leukemia virus (MuLV) based retroviral vector that carry human regulatory elements including combinations of the ADA promoter, the ADA locus control region (LCR), ADA introns and human polyadenylation sequences in a self-inactivating vector backbone. Methods A MuLV-based retroviral vector with a self-inactivating (SIN) backbone, the phosphoglycerate kinase promoter (PGK) and the enhanced green fluorescent protein (eGFP), as a reporter gene, was generated. Subsequent vectors were constructed from this basic vector by deletion or addition of certain elements. The added elements that were assessed are the human ADA promoter, human ADA locus control region (LCR), introns 7, 8, and 11 from the human ADA gene, and human growth hormone polyadenylation signal. Retroviral vector particles were produced by transient three-plasmid transfection of 293T cells. Retroviral vectors encoding eGFP were titered by transducing 293A cells, and then the proportion of GFP-positive cells was determined using fluorescence-activated cell sorting (FACS). Non T-cell and T-cell lines were transduced at a multiplicity of infection (MOI) of 0.1 and the yield of eGFP transgene expression was evaluated by FACS analysis using mean fluorescent intensity (MFI) detection. Results Vectors that contained the ADA LCR were preferentially expressed in T

  1. Effect of fibre additions to flatbread flour mixes on glucose kinetics: a randomised controlled trial.

    Science.gov (United States)

    Boers, Hanny M; van Dijk, Theo H; Hiemstra, Harry; Hoogenraad, Anne-Roos; Mela, David J; Peters, Harry P F; Vonk, Roel J; Priebe, Marion G

    2017-11-01

    We previously found that guar gum (GG) and chickpea flour (CPF) added to flatbread wheat flour lowered postprandial blood glucose (PPG) and insulin responses dose dependently. However, rates of glucose influx cannot be determined from PPG, which integrates rates of influx, tissue disposal and hepatic glucose production. The objective was to quantify rates of glucose influx and related fluxes as contributors to changes in PPG with GG and CPF additions to wheat-based flatbreads. In a randomised cross-over design, twelve healthy males consumed each of three different 13C-enriched meals: control flatbreads (C), or C incorporating 15 % CPF with either 2 % (GG2) or 4 % (GG4) GG. A dual isotope technique was used to determine the time to reach 50 % absorption of exogenous glucose (T 50 %abs, primary objective), rate of appearance of exogenous glucose (RaE), rate of appearance of total glucose (RaT), endogenous glucose production (EGP) and rate of disappearance of total glucose (RdT). Additional exploratory outcomes included PPG, insulin, glucose-dependent insulinotropic peptide and glucagon-like peptide 1, which were additionally measured over 4 h. Compared with C, GG2 and GG4 had no significant effect on T 50 %abs. However, GG4 significantly reduced 4-h AUC values for RaE, RaT, RdT and EGP, by 11, 14, 14 and 64 %, respectively, whereas GG2 showed minor effects. Effect sizes over 2 and 4 h were similar except for significantly greater reduction in EGP for GG4 at 2 h. In conclusion, a soluble fibre mix added to flatbreads only slightly reduced rates of glucose influx, but more substantially affected rates of postprandial disposal and hepatic glucose production.

  2. CORE STABILIZATION EXERCISES AFTER ACL RECONSTRUCTION SURGERY PROVIDES BETTER OUTCOMES: A RANDOMIZED CONTROLLED TRIAL

    Directory of Open Access Journals (Sweden)

    Dilpreet Kaur

    2015-12-01

    Full Text Available Background: Decreased core stability displaces center of gravity away from base of support reducing activity participation of athlete. Present study was conducted to study the effect of core stabilization exercises after reconstruction surgery of ACL on functional outcomes. Methods: 30 subjects following 5 months of ACL reconstruction were randomly assigned to either group that performed (study group or did not performed (control group additional core stabilization exercises in conjugation with standard rehabilitation protocol. Outcome measures were: activity level using Tegnar activity level scale and functional performance using triple hop test. Outcome measures were compared at day 1 and day 42 of the treatment. Result: Significant improvement was seen in the study group for Tegnar score with mean difference changing from 4.5 to 1.5 from day 1 to day 42 of treatment (p=0.039 while the control group showed improvement in mean difference changing from 3.8 to 1.4 (p=.045 from day 1 to day 42 of treatment. Highly significant improvement was seen in the study group for triple hop test with mean difference changing from 25 to 6.7 (p<.001 compared to the control group with mean difference changing from 15.2 to 9.7(p=.005 from day 1 to day 42 of treatment. Conclusions: Both the groups showed improvement for activity level and functional performance but highly significant improvement was seen in the study group for functional performance. Core stabilization exercises in conjugation with the standard ACL rehabilitation protocol results better improvement in the triple hop test.

  3. Obtaining a pozzolanic addition from the controlled calcination of paper mill sludge. Performance in cement matrices

    Directory of Open Access Journals (Sweden)

    San José, J. T.

    2006-09-01

    Full Text Available Mineralogically, the paper mill sludge consists essentially of calcite, kaolinite, talc and other philosilicates (illite, chlorite. When such sludge is subjected to controlled thermal treatment, its kaolinite component may be transformed into metakaolin, yielding a product with high pozzolanic reactivity. This study was designed to analyze a number of scientific questions around the production of pozzolanic additions via controlled thermal activation of paper mill sludge and to evaluate the performance of such additions when included in a cement matrix. The findings show that paper mill waste activation is optimal when the sludge is calcined for 2 hours at 700 ºC in the 700-800 ºC interval. A comparative study between the cement made with the new addition and a commercial cement (CEM I-42.5R used as a reference led to highlight the scientific and technical viability of this waste as a cementing secondary material.Los lodos de destintado del papel están constituidos,mineralógicamente, por calcita, caolinita, talco y otros filosilicatos (ilita, clorita. Cuando al lodo se le somete aun tratamiento térmico controlado, la caolinita puede transformarse en metacaolín, dando origen a un producto de alta reactividad puzolánica.El objeto de este trabajo es analizar diferentes aspectos científicos relativos al proceso de obtención de una adiciónpuzolánica a partir de la activación térmica controlada de lodos de destintado del papel, así como evaluar el comportamiento de la nueva adición cuando se incorpora en una matriz de cemento. Los resultados obtenidos ponen de manifiesto la recomendación de utilizar 700 ºC durante 2 horas de permanencia en el horno, como condiciones más óptimas para activar los residuos de lodos de papel en el intervalo 700-800 ºC. Del estudio comparativo del cemento elaborado con la nueva adición con respecto a un cemento comercial (CEM I-42,5R, se puede destacar la viabilidad científica y técnica de

  4. Ultrahigh sensitivity endoscopic camera using a new CMOS image sensor: providing with clear images under low illumination in addition to fluorescent images.

    Science.gov (United States)

    Aoki, Hisae; Yamashita, Hiromasa; Mori, Toshiyuki; Fukuyo, Tsuneo; Chiba, Toshio

    2014-11-01

    We developed a new ultrahigh-sensitive CMOS camera using a specific sensor that has a wide range of spectral sensitivity characteristics. The objective of this study is to present our updated endoscopic technology that has successfully integrated two innovative functions; ultrasensitive imaging as well as advanced fluorescent viewing. Two different experiments were conducted. One was carried out to evaluate the function of the ultrahigh-sensitive camera. The other was to test the availability of the newly developed sensor and its performance as a fluorescence endoscope. In both studies, the distance from the endoscopic tip to the target was varied and those endoscopic images in each setting were taken for further comparison. In the first experiment, the 3-CCD camera failed to display the clear images under low illumination, and the target was hardly seen. In contrast, the CMOS camera was able to display the targets regardless of the camera-target distance under low illumination. Under high illumination, imaging quality given by both cameras was quite alike. In the second experiment as a fluorescence endoscope, the CMOS camera was capable of clearly showing the fluorescent-activated organs. The ultrahigh sensitivity CMOS HD endoscopic camera is expected to provide us with clear images under low illumination in addition to the fluorescent images under high illumination in the field of laparoscopic surgery.

  5. A Statistical Method for Aggregated Wind Power Plants to Provide Secondary Frequency Control

    DEFF Research Database (Denmark)

    Hu, Junjie; Ziras, Charalampos; Bindner, Henrik W.

    2017-01-01

    curtailment for aggregated wind power plants providing secondary frequency control (SFC) to the power system. By using historical SFC signals and wind speed data, we calculate metrics for the reserve provision error as a function of the scheduled wind power. We show that wind curtailment can be significantly......The increasing penetration of wind power brings significant challenges to power system operators due to the wind’s inherent uncertainty and variability. Traditionally, power plants and more recently demand response have been used to balance the power system. However, the use of wind power...... as a balancing-power source has also been investigated, especially for wind power dominated power systems such as Denmark. The main drawback is that wind power must be curtailed by setting a lower operating point, in order to offer upward regulation. We propose a statistical approach to reduce wind power...

  6. Method for providing slip energy control in permanent magnet electrical machines

    Science.gov (United States)

    Hsu, John S.

    2006-11-14

    An electric machine (40) has a stator (43), a permanent magnet rotor (38) with permanent magnets (39) and a magnetic coupling uncluttered rotor (46) for inducing a slip energy current in secondary coils (47). A dc flux can be produced in the uncluttered rotor when the secondary coils are fed with dc currents. The magnetic coupling uncluttered rotor (46) has magnetic brushes (A, B, C, D) which couple flux in through the rotor (46) to the secondary coils (47c, 47d) without inducing a current in the rotor (46) and without coupling a stator rotational energy component to the secondary coils (47c, 47d). The machine can be operated as a motor or a generator in multi-phase or single-phase embodiments and is applicable to the hybrid electric vehicle. A method of providing a slip energy controller is also disclosed.

  7. A recovery principle provides insight into auxin pattern control in the Arabidopsis root

    Science.gov (United States)

    Moore, Simon; Liu, Junli; Zhang, Xiaoxian; Lindsey, Keith

    2017-01-01

    Regulated auxin patterning provides a key mechanism for controlling root growth and development. We have developed a data-driven mechanistic model using realistic root geometry and formulated a principle to theoretically investigate quantitative auxin pattern recovery following auxin transport perturbation. This principle reveals that auxin patterning is potentially controlled by multiple combinations of interlinked levels and localisation of influx and efflux carriers. We demonstrate that (1) when efflux carriers maintain polarity but change levels, maintaining the same auxin pattern requires non-uniform and polar distribution of influx carriers; (2) the emergence of the same auxin pattern, from different levels of influx carriers with the same nonpolar localisation, requires simultaneous modulation of efflux carrier level and polarity; and (3) multiple patterns of influx and efflux carriers for maintaining an auxin pattern do not have spatially proportional correlation. This reveals that auxin pattern formation requires coordination between influx and efflux carriers. We further show that the model makes various predictions that can be experimentally validated. PMID:28220889

  8. The effect of provider control of Blue Shield plans on health care markets.

    Science.gov (United States)

    Arnould, R J; DeBrock, L M

    1985-07-01

    Blue Shield plans often are granted regulatory advantages by the states in which they operate. Run efficiently, such not-for-profit firms should use these lower costs to eliminate their less advantaged rivals, the commercial insurers. However, these higher-cost commercial providers have been able to offer insurance coverage at prices competitive with the Blues, as evidenced by the fact that Blue plans have, on average, less than 50 percent market share. Similar prices with lower overall costs implies that economic rents are being earned, rents which a not-for-profit firm cannot distribute to owners. In this paper we argue that when there are competing goals among the groups controlling the Blue Shield plans, the different possible "uses" of the regulatory advantage become endogenously determined, necessitating the use of simultaneous equation estimation. Testing this model we find the major effect of doctor-control of Blue Shield plans is to raise doctors' fees while lowering the amount of rents captured by both consumers and administrators.

  9. Forced-Air Warming Provides Better Control of Body Temperature in Porcine Surgical Patients

    Directory of Open Access Journals (Sweden)

    Brian T. Dent

    2016-09-01

    Full Text Available Background: Maintaining normothermia during porcine surgery is critical in ensuring subject welfare and recovery, reducing the risk of immune system compromise and surgical-site infection that can result from hypothermia. In humans, various methods of patient heating have been demonstrated to be useful, but less evaluation has been performed in techniques to prevent hypothermia perioperatively in pigs. Methods: We compared body temperature regulation during surgery before and after modification of the ambient temperature of the operating laboratories. Three different methods of heating were then compared; a standard circulating water mattress, a resistive fabric blanket, and a forced hot air system. The primary measure was percentage of temperature readings outside a specification range of 36.7–40.0 °C. Results: Tighter control of the ambient temperature while using a circulating water mattress reduced the occurrence of out-of-specification body temperature readings from 20.8% to 5.0%, with most of these the result of hypothermia. Use of a resistive fabric blanket further reduced out-of-specification readings to 1.5%, with a slight increase in the occurrence of hyperthermia. Use of a forced air system reduced out-of-specification readings to less 0.1%. Conclusions: Maintenance of normothermia perioperatively in pig can be improved by tightly controlling ambient temperatures. Use of a resistive blanket or a forced air system can lead to better control than a circulating water mattress, with the forced air system providing a faster response to temperature variations and less chance of hyperthermia.

  10. Control and Regulation of Private Security Providers in Latin America and the Caribbean: A Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Francesca Caonero

    2014-05-01

    Full Text Available States and different international players have drafted legal frameworks to adequately regulate the phenomenon of privatization of security. Among these initiatives is the Project for a Possible Convention on Private Military and Security Companies, prepared with guidance from the United Nations Human Rights Council. The objective of this proposed convention is to provide a universal framework to regulate these companies.The United Nations Regional Center for Peace, Disarmament and Development in Latin America and the Caribbean (UNLIREC has studied this Proposed Convention and contrasted it with existing national regulations. The objective of this study is to identify whether and how States already comply with some of the provisions contained in this proposal.Based on the study of national private security law, UNLIREC has contrasted it with the Convention Proposal identifying the different items in this document that are referred to in the different national regulations from various countries in Latin America and the Caribbean.As a result of this legal contrast, it can be observed that laws in some States in the region include significant legal aspects put forth in the Proposed Convention, such as licenses, registry and training. Other States go beyond that, stipulating specific regulations that can be noted. Others, on the contrary, lack any provisions regarding control and regulation of private security providers.DOI: http://dx.doi.org/10.5377/rpsp.v1i1.1392

  11. Classical and additional antiphospholipid antibodies in blood samples of ischemic stroke patients and healthy controls.

    Science.gov (United States)

    Carmel-Neiderman, Narin-Nard; Tanne, David; Goren, Idan; Rotman-Pikielny, Pnina; Levy, Yair

    2017-04-01

    Classical antiphospholipid antibodies (aPLa) are found in 6-25% of blood samples from stroke patients. The frequency of novel aPLa antibodies in blood samples of CVA patients is not known. Enzyme-linked immunosorbent assays (ELISA) were performed on blood samples from 209 CVA patients (170 samples were obtained during the acute phase and 39 samples were from patients with complete carotid stenosis) and compared to 54 healthy controls. Subjects were tested for the presence of the classical aPL antibodies anticardiolipin (aCL) and anti-beta2-glycoprotein (aβ2gI), in addition to antiphosphatidylethanolamine (aPE), anti-phosphatidylserine (aPS), and Annexin V. All antibodies were tested for both IgM and IgG subclasses. Numeric analysis of the antibody titer levels (μ/ml) revealed a significantly higher subclinical titer by two standard deviations of many aPL autoantibodies among CVA patients (Pv < 0.05). However, according to the kit manufacturer's cutoff value, no positive antibodies were found except a trend toward higher percentage of positive aPS IgG titer in the CVA group compared to controls (6.2 vs. %0; P = 0.077). According to the manufacturer's cutoff, significantly higher levels of positive antibodies were not found among stroke patients. However, the absolute ELISA values of stroke patients were significantly higher. These results suggest that lower cutoff values than those used for APS diagnosis should be used for risk stratification of CVA among healthy individuals.

  12. Animated sulfonated or sulformethylated lignins as cement fluid loss control additives

    Energy Technology Data Exchange (ETDEWEB)

    Schilling, P.

    1991-05-07

    This patent describes a method of cementing a zone in a well penetrating a subterranean formation comprising injecting down the well and positioning in the zone to be cemented a hydraulic aqueous cement slurry composition. It comprises: a hydraulic cement, and the following expressed as parts by weight per 100 parts of the hydraulic cement, water from about 25 to 105 parts, and a fluid loss control additive comprising from about 0.5 to 2.5 parts of a compound selected from the group consisting of a sulfonated lignin and a sulfomethylated lignin, wherein the lignin has been aminated by reacting it with between about 2-5 moles of a polyamine and 2-5 moles of an aldehyde per 1,000g of the lignin, and 0.1 to 1.5 parts of a compound selected from the group consisting of sodium carbonate, sodium metasilicate, sodium phosphate, sodium sulfite and sodium naphthalene sulfonate and a combination thereof.

  13. Design Process Control for Improved Surface Finish of Metal Additive Manufactured Parts of Complex Build Geometry

    Directory of Open Access Journals (Sweden)

    Mikdam Jamal

    2017-12-01

    Full Text Available Metal additive manufacturing (AM is increasingly used to create complex 3D components at near net shape. However, the surface finish (SF of the metal AM part is uneven, with surface roughness being variable over the facets of the design. Standard post-processing methods such as grinding and linishing often meet with major challenges in finishing parts of complex shape. This paper reports on research that demonstrated that mass finishing (MF processes are able to deliver high-quality surface finishes (Ra and Sa on AM-generated parts of a relatively complex geometry (both internal features and external facets under select conditions. Four processes were studied in this work: stream finishing, high-energy (HE centrifuge, drag finishing and disc finishing. Optimisation of the drag finishing process was then studied using a structured design of experiments (DOE. The effects of a range of finishing parameters were evaluated and optimal parameters and conditions were determined. The study established that the proposed method can be successfully applied in drag finishing to optimise the surface roughness in an industrial application and that it is an economical way of obtaining the maximum amount of information in a short period of time with a small number of tests. The study has also provided an important step in helping understand the requirements of MF to deliver AM-generated parts to a target quality finish and cycle time.

  14. Control of Ectoparasitic Monogenean Infestation on GIFT Tilapia (Oreochromis sp. using Salt Addition

    Directory of Open Access Journals (Sweden)

    Yani Hadiroseyani

    2009-07-01

    Full Text Available Ectoparasitic monogenean infestation is one of fish diseases which may cause mass mortality, therefore controlling the parasites is one of the important factors to ensure the success of aquaculture activities. Salt addition is one of disease curative and controlling techniques which is cheap, easy and environmental friendly as well as effective to control ectoparasites in freshwater environment. The objectives of this study were to examine monogenean parasites species in GIFT (Genetically Improved Farmed Tilapia tilapia, their tolerance to salt concentration and the most effective salt concentration to control the parasites. Identification, intensity and prevalence of parasitic monogenean were carried out on the external parts (body surface, fins and gills of 31 fishes. Subsequently, two different experiments were carried out  to determine parasites and fish resistance on various salt concentration at a range of 0 - 24 g/l with an interval of 2 g/l. To confirm the results of previous experiment, parasites infected fish was immersed in salt water at various concentration based on previous experiments. Two genera of monogenean were identified in GIFT tilapia, i.e. Gyrodactylus sp. on body surface and fins, and Cichlidogyrus sp. on gills with the same prevalence (100%. The intensity of those parasites was different, namely 27.84 ind/fish for Gyrodactylus sp. and 6.06 ind/fish for Cichlidogyrus sp. The intensity of both parasites was found to be lower as salt concentration increase. Salt concentration of 24 g/l was the most effective concentration to reduce parasites infestation and could totally treat the infested fish within 6 days. Keyword : tilapia, Oreochromis, monogenea, parasite and salt     ABSTRAK Serangan monogenea ektoparasitik merupakan salah satu masalah penyakit ikan yang dapat menyebabkan kematian masal, sehingga pengendaliannya merupakan salah satu kunci keberhasilan dalam usaha budidaya. Garam merupakan agen penyembuh atau

  15. Telemedicine Provides Non-Inferior Research Informed Consent for Remote Study Enrollment: A Randomized Controlled Trial

    Science.gov (United States)

    Bobb, Morgan R.; Van Heukelom, Paul G.; Faine, Brett A.; Ahmed, Azeemuddin; Messerly, Jeffrey T.; Bell, Gregory; Harland, Karisa K.; Simon, Christian; Mohr, Nicholas M.

    2016-01-01

    Objective Telemedicine networks are beginning to provide an avenue for conducting emergency medicine research, but using telemedicine to recruit participants for clinical trials has not been validated. The goal of this consent study is to determine whether patient comprehension of telemedicine-enabled research informed consent is non-inferior to standard face-to-face research informed consent. Methods A prospective, open-label randomized controlled trial was performed in a 60,000-visit Midwestern academic Emergency Department (ED) to test whether telemedicine-enabled research informed consent provided non-inferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of oral chlorhexidine gluconate 0.12% in preventing hospital-acquired pneumonia among adult ED patients with expected hospital admission. Prior to being recruited into the study, potential participants were randomized in a 1:1 allocation ratio to consent by telemedicine versus standard face-to-face consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc., Hackensack, NJ) to an emergency physician located in another part of the ED. Comprehension of research consent (primary outcome) was measured using the modified Quality of Informed Consent (QuIC) instrument, a validated tool for measuring research informed consent comprehension. Parent trial accrual rate and qualitative survey data were secondary outcomes. Results One-hundred thirty-one patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to face-to-face consent (QuIC scores 74.4 ± 8.1 vs. 74.4 ± 6.9 on a 100-point scale, p = 0.999). Subjective understanding of consent (p=0.194) and parent trial study accrual rates (56% vs. 69%, p = 0.142) were similar. Conclusion Telemedicine is non-inferior to face

  16. Controlled, Constrained, or Flexible? How Self-Management Goals Are Shaped By Patient-Provider Interactions.

    Science.gov (United States)

    Franklin, Marika; Lewis, Sophie; Willis, Karen; Rogers, Anne; Venville, Annie; Smith, Lorraine

    2018-06-01

    A person-centered approach to goal-setting, involving collaboration between patients and health professionals, is advocated in policy to support self-management. However, this is difficult to achieve in practice, reducing the potential effectiveness of self-management support. Drawing on observations of consultations between patients and health professionals, we examined how goal-setting is shaped in patient-provider interactions. Analysis revealed three distinct interactional styles. In controlled interactions, health professionals determine patients' goals based on biomedical reference points and present these goals as something patients should do. In constrained interactions, patients are invited to present goals, yet health professionals' language and questions orientate goals toward biomedical issues. In flexible interactions, patients and professionals both contribute to goal-setting, as health professionals use less directive language, create openings, and allow patients to decide on their goals. Findings suggest that interactional style of health professionals could be the focus of interventions when aiming to increase the effectiveness of goal-setting.

  17. Adaptive Information Dissemination Control to Provide Diffdelay for the Internet of Things.

    Science.gov (United States)

    Liu, Xiao; Liu, Anfeng; Huang, Changqin

    2017-01-12

    Applications running on the Internet of Things, such as the Wireless Sensor and Actuator Networks (WSANs) platform, generally have different quality of service (QoS) requirements. For urgent events, it is crucial that information be reported to the actuator quickly, and the communication cost is the second factor. However, for interesting events, communication costs, network lifetime and time all become important factors. In most situations, these different requirements cannot be satisfied simultaneously. In this paper, an adaptive communication control based on a differentiated delay (ACCDS) scheme is proposed to resolve this conflict. In an ACCDS, source nodes of events adaptively send various searching actuators routings (SARs) based on the degree of sensitivity to delay while maintaining the network lifetime. For a delay-sensitive event, the source node sends a large number of SARs to actuators to identify and inform the actuators in an extremely short time; thus, action can be taken quickly but at higher communication costs. For delay-insensitive events, the source node sends fewer SARs to reduce communication costs and improve network lifetime. Therefore, an ACCDS can meet the QoS requirements of different events using a differentiated delay framework. Theoretical analysis simulation results indicate that an ACCDS provides delay and communication costs and differentiated services; an ACCDS scheme can reduce the network delay by 11.111%-53.684% for a delay-sensitive event and reduce the communication costs by 5%-22.308% for interesting events, and reduce the network lifetime by about 28.713%.

  18. Expert advice provided through telemedicine improves healing of chronic wounds: prospective cluster controlled study.

    Science.gov (United States)

    Zarchi, Kian; Haugaard, Vibeke B; Dufour, Deirdre N; Jemec, Gregor B E

    2015-03-01

    Telemedicine is widely considered as an efficient approach to manage the growing problem of chronic wounds. However, to date, there is no convincing evidence to support the clinical efficacy of telemedicine in wound management. In this prospective cluster controlled study, we tested the hypothesis that advice on wound management provided by a team of wound-care specialists through telemedicine would significantly improve the likelihood of wound healing compared with the best available conventional practice. A total of 90 chronic wound patients in home care met all study criteria and were included: 50 in the telemedicine group and 40 in the conventional group. Patients with pressure ulcers, surgical wounds, and cancer wounds were excluded. During the 1-year follow-up, complete wound healing was achieved in 35 patients (70%) in the telemedicine group compared with 18 patients (45%) in the conventional group. After adjusting for important covariates, offering advice on wound management through telemedicine was associated with significantly increased healing compared with the best available conventional practice (telemedicine vs. conventional practice: adjusted hazard ratio 2.19; 95% confidence interval: 1.15-4.17; P=0.017). This study strongly supports the use of telemedicine to connect home-care nurses to a team of wound experts in order to improve the management of chronic wounds.

  19. Examining Gender Differences in Received, Provided and Invisible Social Control: An Application of the Dual-Effects-Model

    OpenAIRE

    Lüscher Janina; Ochsner Sibylle; Knoll Nina; Stadler Gertraud; Hornung Rainer; Scholz Urte

    2014-01-01

    The dual effects model of social control assumes that social control leads to better health practices but also arouses psychological distress. However findings are inconsistent. The present study advances the current literature by examining social control from a dyadic perspective in the context of smoking. In addition the study examines whether control continuous smoking abstinence and affect are differentially related for men and women. Before and three weeks after a self set quit attempt w...

  20. Prescription painkillers and controlled substances: an appraisal of drug information provided by six US pharmacies

    Directory of Open Access Journals (Sweden)

    Gill PS

    2013-02-01

    Full Text Available Preetinder S GillCollege of Technology, Eastern Michigan University, Ypsilanti, MI, USABackground: Health literacy impacts health outcomes. Health literacy is a measure of a person's competence to find, access, contextualize, and understand the information needed to make health decisions. Low levels of health literacy have been associated with poor health status. Health literacy can be enhanced by improving the readability of health literature. Misuse and abuse of prescription medicines and controlled substances is rising. It could be argued that improving the readability of the drug-information documents associated with these medicines could serve to alleviate this situation in a small, albeit incremental, manner. This paper provides a readability assessment of 71 such documents.Methods: The readability of drug-information documents associated with 12 commonly misused and abused painkiller medicines and controlled substances published by the top six US pharmacies was assessed. The Flesch-Kincaid Grade Level, Flesch Reading Ease, and Simple Measure of Gobbledygook (SMOG indices were used to assess the readability of these drug-information documents. One-way analysis of variance (ANOVA was used to compare the readability of the documents.Results: The average Flesch-Kincaid Grade Level index score was found to be 11.16. The average Flesch Reading Ease index score was found to be 45.94. The average SMOG index score was found to be 13.60. Pharmacies C and E had the best average readability scores, whereas pharmacies A and B had the worst average readability scores.Conclusion: Access, contents, and formatting of the documents were qualitatively analyzed to make recommendations to improve readability. Pharmacies C and E were used as benchmarks to identify the seven best practices. Good drug-information documents should have: (1 clear purpose, (2 limited scope, (3 summary/brief review, (4 well-placed graphics, (5 informative illustrations, (6 clean

  1. Experiences in simulating and testing coordinated voltage control provided by multiple wind power plants

    Energy Technology Data Exchange (ETDEWEB)

    Arlaban, T.; Alonso, O.; Ortiz, D. [Acciona Windpower S.A. (Spain); Peiro, J.; Rivas, R. [Red Electrica de Espana SAU (Spain); Quinonez-Varela, G.; Lorenzo, P. [Acciona Energia S.A. (Spain)

    2011-07-01

    This document presents some field tests performed in a transmission system node in order to check the adequacy of voltage control performance by multiple wind power plants, with an overall capacity of 395 MW. It briefly explains the Spanish TSO motivation towards new voltage control requirements and the necessity of performing such tests in order to set the most convenient voltage control parameters and to verify the stable operation. It presents how different the voltage control capability between modern wind turbines (DFIG) and older ones (SCIG) specifically retrofitted for voltage control is. (orig.)

  2. Limits on normal cochlear 'third' windows provided by previous investigations of additional sound paths into and out of the cat inner ear.

    Science.gov (United States)

    Rosowski, John J; Bowers, Peter; Nakajima, Hideko H

    2018-03-01

    While most models of cochlear function assume the presence of only two windows into the mammalian cochlea (the oval and round windows), a position that is generally supported by several lines of data, there is evidence for additional sound paths into and out of the inner ear in normal mammals. In this report we review the existing evidence for and against the 'two-window' hypothesis. We then determine how existing data and inner-ear anatomy restrict transmission of sound through these additional sound pathways in cat by utilizing a well-tested model of the cat inner ear, together with anatomical descriptions of the cat cochlear and vestibular aqueducts (potential additional windows to the cochlea). We conclude: (1) The existing data place limits on the size of the cochlear and vestibular aqueducts in cat and are consistent with small volume-velocities through these ducts during ossicular stimulation of the cochlea, (2) the predicted volume velocities produced by aqueducts with diameters half the size of the bony diameters match the functional data within ±10 dB, and (3) these additional volume velocity paths contribute to the inner ear's response to non-acoustic stimulation and conductive pathology. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Adaptive Information Dissemination Control to Provide Diffdelay for the Internet of Things

    Directory of Open Access Journals (Sweden)

    Xiao Liu

    2017-01-01

    Full Text Available Applications running on the Internet of Things, such as the Wireless Sensor and Actuator Networks (WSANs platform, generally have different quality of service (QoS requirements. For urgent events, it is crucial that information be reported to the actuator quickly, and the communication cost is the second factor. However, for interesting events, communication costs, network lifetime and time all become important factors. In most situations, these different requirements cannot be satisfied simultaneously. In this paper, an adaptive communication control based on a differentiated delay (ACCDS scheme is proposed to resolve this conflict. In an ACCDS, source nodes of events adaptively send various searching actuators routings (SARs based on the degree of sensitivity to delay while maintaining the network lifetime. For a delay-sensitive event, the source node sends a large number of SARs to actuators to identify and inform the actuators in an extremely short time; thus, action can be taken quickly but at higher communication costs. For delay-insensitive events, the source node sends fewer SARs to reduce communication costs and improve network lifetime. Therefore, an ACCDS can meet the QoS requirements of different events using a differentiated delay framework. Theoretical analysis simulation results indicate that an ACCDS provides delay and communication costs and differentiated services; an ACCDS scheme can reduce the network delay by 11.111%–53.684% for a delay-sensitive event and reduce the communication costs by 5%–22.308% for interesting events, and reduce the network lifetime by about 28.713%.

  4. Reaching the unreachable: providing STI control services to female sex workers via mobile team outreach.

    Directory of Open Access Journals (Sweden)

    Pablo E Campos

    Full Text Available As part of a community-randomized trial of a multicomponent intervention to prevent sexually transmitted infections, we created Mobile Teams (MTs in ten intervention cities across Peru to improve outreach to female sex workers (FSW for strengthened STI prevention services.Throughout 20 two-month cycles, MTs provided counseling; condoms; screening and specific treatment for Neisseria gonorrhoeae (NG, Chlamydia trachomatis (CT, and vaginal Trichomonas vaginalis (TV infections; and periodic presumptive metronidazole treatment for vaginal infections.MTs had 48,207 separate encounters with 24,814 FSW; numbers of sex work venues and of FSW reached increased steadily over several cycles. Approximately 50% of FSW reached per cycle were new. Reported condom use with last client increased from 73% to 93%. Presumptive metronidazole treatment was accepted 83% of times offered. Over 38 months, CT prevalence declined from 15.4% to 8.2%, and TV prevalence from 7.3% to 2.6%. Among participants in ≥ 9 cycles, CT prevalence decreased from 12.9% to 6.0% (p <0.001; TV from 4.6% to 1.5% (p <0.001; and NG from 0.8% to 0.4% (p = 0.07.Mobile outreach to FSW reached many FSW not utilizing government clinics. Self-reported condom use substantially increased; CT and TV prevalences declined significantly. The community-randomized trial, reported separately, demonstrated significantly greater reductions in composite prevalence of CT, NG, TV, or high-titer syphilis serology in FSW in these ten intervention cities than in ten matched control cities.

  5. Species traits and their non-additive interactions control the water economy of bryophyte cushions.

    NARCIS (Netherlands)

    Michel, P.; Lee, W.G.; During, H.J.; Cornelissen, J.H.C.; van der Putten, W.H.

    2012-01-01

    1. Ecological processes in mixed-species assemblages are not always an additive function of those in monocultures. In areas with high ground cover of bryophytes, renowned for their considerable water retention capacity, non-additive interactions in mixed-species cushions could play a key role in the

  6. Control of bulking in a full scale plant by addition of talc (PE 8418)

    NARCIS (Netherlands)

    Eikelboom, D.H.; Grovenstein, J.

    1998-01-01

    A very severe bulking problem (Type 021N) in the water treatment plant of Bodegraven in The Netherlands was solved by the addition of a specially shaped talqueous powder, PE 8418. After addition of this mineral product, the SVI dropped almost instantaneously from 850 ml/g to 250 ml/g and over the

  7. Success of lime additives for controlling SO2 releases from fluidized bed combustion units

    International Nuclear Information System (INIS)

    Muezzinoglu, A.; Bayram, A.; Odabasi, M.

    1995-01-01

    Purpose of this work was to study the desulfurization efficiencies of dry additives on the fluidized bed reactors fired with low quality lignites. In these tests selected initial SO 2 levels were in the order of 1000 ppm or less in the flue gases. Lime addition for desulfurization may either be made by mixing with the fuel or by injection into the combustion reactor. In fluidized bed combustion systems both methods are physically possible. In the fluidized combustion systems a third method of addition is also possible this, is by mixing dry additives with fluidizer sand. In this third method additives create a fluidizer effect as well as reacting with the sulfur oxides being formed during the combustion of fuel

  8. Precise control of polymer coated nanopores by nanoparticle additives: Insights from computational modeling

    Energy Technology Data Exchange (ETDEWEB)

    Eskandari Nasrabad, Afshin; Coalson, Rob D. [Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania 15260 (United States); Jasnow, David [Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260 (United States); Zilman, Anton [Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7 (Canada)

    2016-08-14

    Polymer-nanoparticle composites are a promising new class of materials for creation of controllable nano-patterned surfaces and nanopores. We use coarse-grained molecular dynamics simulations augmented with analytical theory to study the structural transitions of surface grafted polymer layers (brushes) induced by infiltration of nanoparticles that are attracted to the polymers in the layer. We systematically compare two different polymer brush geometries: one where the polymer chains are grafted to a planar surface and the other where the chains are grafted to the inside of a cylindrical nanochannel. We perform a comprehensive study of the effects of the material parameters such as the polymer chain length, chain grafting density, nanoparticle size, strength of attraction between nanoparticles and polymer monomers, and, in the case of the cylindrically grafted brush, the radius of the cylinder. We find a very general behavioral motif for all geometries and parameter values: the height of the polymer brush is non-monotonic in the nanoparticle concentration in solution. As the nanoparticle concentration increases, the brush height first decreases and after passing through a minimum value begins to increase, resulting in the swelling of the nanoparticle infused brush. These morphological features may be useful for devising tunable “smart” nano-devices whose effective dimensions can be reversibly and precisely adjusted by changing the nanoparticle concentration in solution. The results of approximate Self-Consistent Field Theory (SCFT) calculations, applicable in the regime of strong brush stretching, are compared to the simulation results. The SCFT calculations are found to be qualitatively, even semi-quantitatively, accurate when applied within their intended regime of validity, and provide a useful and efficient tool for modeling such materials.

  9. To assess whether indoor residual spraying can provide additional protection against clinical malaria over current best practice of long-lasting insecticidal mosquito nets in The Gambia: study protocol for a two-armed cluster-randomised trial

    Directory of Open Access Journals (Sweden)

    Parker David

    2011-06-01

    Full Text Available Abstract Background Recently, there has been mounting interest in scaling-up vector control against malaria in Africa. It needs to be determined if indoor residual spraying (IRS with DDT will provide significant marginal protection against malaria over current best practice of long-lasting insecticidal nets (LLINs and prompt treatment in a controlled trial, given that DDT is currently the most persistent insecticide for IRS. Methods A 2 armed cluster-randomised controlled trial will be conducted to assess whether DDT IRS and LLINs combined provide better protection against clinical malaria in children than LLINs alone in rural Gambia. Each cluster will be a village, or a group of small adjacent villages; all clusters will receive LLINs and half will receive IRS in addition. Study children, aged 6 months to 13 years, will be enrolled from all clusters and followed for clinical malaria using passive case detection to estimate malaria incidence for 2 malaria transmission seasons in 2010 and 2011. This will be the primary endpoint. Exposure to malaria parasites will be assessed using light and exit traps followed by detection of Anopheles gambiae species and sporozoite infection. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection and the prevalence of anaemia. Discussion Practical issues concerning intervention implementation, as well as the potential benefits and risks of the study, are discussed. Trial Registration ISRCTN01738840 - Spraying And Nets Towards malaria Elimination (SANTE

  10. 36 CFR 1281.12 - What information must be provided to NARA for its report to Congress on a change or addition to a...

    Science.gov (United States)

    2010-07-01

    ... sent to the Office of Presidential Libraries (NL), Room 2200, 8601 Adelphi Rd., College Park, MD 20740... the report to Congress in accordance with 44 U.S.C. 2112(a)(5). The normal lead time for submitting... Reduction Act by the Office of Management and Budget with the control number 3095-0036. (b) Paragraph (a)(4...

  11. Human-Inspired Eigenmovement Concept Provides Coupling-Free Sensorimotor Control in Humanoid Robot

    Czech Academy of Sciences Publication Activity Database

    Alexandrov, A.V.; Lippi, V.; Mergner, T.; Frolov, A. A.; Hettich, G.; Húsek, Dušan

    2017-01-01

    Roč. 11, 25 April (2017), č. článku 22. ISSN 1662-5188 Institutional support: RVO:67985807 Keywords : human sensorimotor system * neuromechanics * biorobotics * motor control * eigenmovements Subject RIV: JD - Computer Applications, Robotics OBOR OECD: Robotics and automatic control Impact factor: 1.821, year: 2016

  12. Pomegranate extract and exercise provide additive benefits on improvement of immune function by inhibiting inflammation and oxidative stress in high-fat-diet-induced obesity in rats.

    Science.gov (United States)

    Zhao, Fei; Pang, Wentao; Zhang, Ziyi; Zhao, Jialong; Wang, Xin; Liu, Ye; Wang, Xun; Feng, Zhihui; Zhang, Yong; Sun, Wenyan; Liu, Jiankang

    2016-06-01

    Obesity is reported to be associated with immune dysfunction and a state of low-grade, chronic inflammation. Either pomegranate extract (PomE) or exercise (Ex) has been shown to have antiobesity, anti-inflammatory and antioxidant effects. Nevertheless, no study has addressed the additive benefits of PomE and Ex on the restoration of obesity-induced immune defects. The present work aims to study the effect of PomE and Ex as a combined intervention on immune function and the underlying mechanism involved in inflammation and oxidative stress in rats with high-fat-diet (HFD)-induced obesity. Our results demonstrate that the combination of PomE and Ex showed additive benefits on inhibition of HFD-induced body weight increase and improvement of HFD-induced immune dysfunction, including (a) attenuating the abnormality of histomorphology of the spleen, (b) increasing the ratio of the CD4+:CD8+ T cell subpopulations in splenocytes and peripheral blood mononuclear cells (PBMC), (c) inhibition of apoptosis in splenocytes and PBMC, (d) normalizing peritoneal macrophage phenotypes and (e) restoring immunomodulating factors in serum. We also find that immune dysfunction in HFD-fed rats was associated with increased inflammatory cytokine secretion and oxidative stress biomarkers, and that the combination of PomE and Ex effectively inhibited the inflammatory response and decreased oxidative damage. The effect of PomE and Ex as a combined intervention is greater than the effect of either PomE or Ex alone, showing that PomE and Ex may be additively effective in improving immune function in HFD-fed rats by inhibiting inflammation and decreasing oxidative stress. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. A randomised controlled trial of sensory awareness training and additional motor practice for learning scalpel skills in podiatry students.

    Science.gov (United States)

    Causby, Ryan S; McDonnell, Michelle N; Reed, Lloyd; Hillier, Susan L

    2016-12-05

    The process of using a scalpel, like all other motor activities, is dependent upon the successful integration of afferent (sensory), cognitive and efferent (motor) processes. During learning of these skills, even if motor practice is carefully monitored there is still an inherent risk involved. It is also possible that this strategy could reinforce high levels of anxiety experienced by the student and affect student self-efficacy, causing detrimental effects on motor learning. An alternative training strategy could be through targeting sensory rather than motor processes. Second year podiatry students who were about to commence learning scalpel skills were recruited. Participants were randomly allocated into sensory awareness training (Sensory), additional motor practice (Motor) or usual teaching only (Control) groups. Participants were then evaluated on psychological measures (Intrinsic Motivation Inventory) and dexterity measures (Purdue Pegboard, Grooved Pegboard Test and a grip-lift task). A total of 44 participants were included in the study. There were no baseline differences or significant differences between the three groups over time on the Perceived Competence, Effort/ Importance or Pressure/ Tension, psychological measures. All groups showed a significant increase in Perceived Competence over time (F 1,41  = 13.796, p = 0.001). Only one variable for the grip-lift task (Preload Duration for the non-dominant hand) showed a significant difference over time between the groups (F 2,41  = 3.280, p = 0.038), specifically, Motor and Control groups. The use of sensory awareness training, or additional motor practice did not provide a more effective alternative compared with usual teaching. Further research may be warranted using more engaged training, provision of supervision and greater participant numbers. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616001428459 . Registered 13 th October 2016. Registered Retrospectively.

  14. Randomised controlled feasibility trial of an evidence-informed behavioural intervention for obese adults with additional risk factors.

    Directory of Open Access Journals (Sweden)

    Falko F Sniehotta

    Full Text Available Interventions for dietary and physical activity changes in obese adults may be less effective for participants with additional obesity-related risk factors and co-morbidities than for otherwise healthy individuals. This study aimed to test the feasibility and acceptability of the recruitment, allocation, measurement, retention and intervention procedures of a randomised controlled trial of an intervention to improve physical activity and dietary practices amongst obese adults with additional obesity related risk factors.Pilot single centre open-labelled outcome assessor-blinded randomised controlled trial of obese (Body Mass Index (BMI≥30 kg/m2 adults (age≥18 y with obesity related co-morbidities such as type 2 diabetes, impaired glucose tolerance or hypertension. Participants were randomly allocated to a manual-based group intervention or a leaflet control condition in accordance to a 2∶1 allocation ratio. Primary outcome was acceptability and feasibility of trial procedures, secondary outcomes included measures of body composition, physical activity, food intake and psychological process measures.Out of 806 potentially eligible individuals identified through list searches in two primary care general medical practices N = 81 participants (63% female; mean-age = 56.56(11.44; mean-BMI = 36.73(6.06 with 2.35(1.47 co-morbidities were randomised. Scottish Index of Multiple Deprivation (SIMD was the only significant predictor of providing consent to take part in the study (higher chances of consent for invitees with lower levels of deprivation. Participant flowcharts, qualitative and quantitative feedback suggested good acceptance and feasibility of intervention procedures but 34.6% of randomised participants were lost to follow-up due to overly high measurement burden and sub-optimal retention procedures. Participants in the intervention group showed positive trends for most psychological, behavioural and body composition outcomes

  15. Controlled synthesis of monodisperse gold nanorods with different aspect ratios in the presence of aromatic additives

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yun; Wang, Feihu [Shanghai Jiao Tong University, School of Pharmacy (China); Guo, Yuan [University of Leeds, School of Chemistry and Astbury Centre for Structural Molecular Biology (United Kingdom); Chen, Rongjun, E-mail: rongjun.chen@imperial.ac.uk [Imperial College London, Department of Chemical Engineering (United Kingdom); Shen, Yuanyuan; Guo, Aijie; Liu, Jieying; Zhang, Xiao [Shanghai Jiao Tong University, School of Pharmacy (China); Zhou, Dejian, E-mail: d.zhou@leeds.ac.uk [University of Leeds, School of Chemistry and Astbury Centre for Structural Molecular Biology (United Kingdom); Guo, Shengrong, E-mail: srguo@sjtu.edu.cn [Shanghai Jiao Tong University, School of Pharmacy (China)

    2014-12-15

    This paper reports the synthesis of monodisperse gold nanorods (GNRs) via a simple seeded growth approach in the presence of different aromatic additives, such as 7-bromo-3-hydroxy-2-naphthoic acid (7-BrHNA), 3-hydroxy-2-naphthoic acid (HNA), 5-bromosalicylic acid (5-BrSA), salicylic acid (SA), or phenol (PhOH). Effects of the aromatic additives and hydrochloric acid (HCl) on the structure and optical properties of the synthesized GNRs were investigated. The longitudinal surface plasmon resonance (LSPR) peak wavelength of the resulting GNRs was found to be dependent on the aromatic additive in the following sequence: 5-BrSA (778 nm) > 7-BrHNA (706 nm) > SA (688 nm) > HNA (676 nm) > PhOH (638 nm) without the addition of HCl, but this was changed to 7-BrHNA (920 nm) > SA (890 nm) > HNA (872 nm) > PhOH (858 nm) > 5-BrSA (816 nm) or 7-BrHNA (1,005 nm) > PhOH (995 nm) > SA (990 nm) > HNA (980 nm) > 5-BrSA (815 nm) with the addition of HCl or HNO{sub 3}, respectively. The LSPR peak wavelength was increased with the increasing concentration of 7-BrHNA without HCl addition; however, there was a maximum LSPR peak wavelength when HCl was added. Interestingly, the LSPR peak wavelength was also increased with the amount of HCl added. The results presented here thus established a simple approach to synthesize monodisperse GNRs of different LSPR wavelengths.

  16. LONG-TERM DEMONSTRATION OF SORBENT ENHANCEMENT ADDITIVE TECHNOLOGY FOR MERCURY CONTROL

    Energy Technology Data Exchange (ETDEWEB)

    Jason D. Laumb; Dennis L. Laudal; Grant E. Dunham; John P. Kay; Christopher L. Martin; Jeffrey S. Thompson; Nicholas B. Lentz; Alexander Azenkeng; Kevin C. Galbreath; Lucinda L. Hamre

    2011-05-27

    Long-term demonstration tests of advanced sorbent enhancement additive (SEA) technologies have been completed at five coal-fired power plants. The targeted removal rate was 90% from baseline conditions at all five stations. The plants included Hawthorn Unit 5, Mill Creek Unit 4, San Miguel Unit 1, Centralia Unit 2, and Hoot Lake Unit 2. The materials tested included powdered activated carbon, treated carbon, scrubber additives, and SEAs. In only one case (San Miguel) was >90% removal not attainable. The reemission of mercury from the scrubber at this facility prevented >90% capture.

  17. Viability for controlling long-term leaching of radionuclides from HLW glass by amorphous silica additives

    International Nuclear Information System (INIS)

    Inagaki, Y.; Uehara, S.

    2004-01-01

    Dissolution and deterioration experiments in coexistence system of amorphous silica and vitrified wastes have been executed in order to evaluating the effects of amorphous silica addition to high level radioactive vitrified waste (HLW glass) on suppression of nuclide leaching. Geo-chemical reaction mechanism among the vitrified waste, the amorphous silica and water was also evaluated. Dissolution of the silica network was suppressed by addition of the amorphous silica. However, the leaching of soluble nuclides like B proceeded depending on the hydration deterioration reaction. (A. Hishinuma)

  18. Army Corps of Engineers: Additional Steps Needed for Review and Revision of Water Control Manuals

    Science.gov (United States)

    2016-07-01

    Techniques, GAO-14-741 (Washington, D.C.: Sept. 12, 2014). The Department of Defense agreed with our recommendation to evaluate the pros and cons of...Visa, check, or money order. Call for additional information. Connect with GAO on Facebook, Flickr, Twitter, and YouTube . Subscribe to our RSS

  19. Do wood-based panels made with agro-industrial residues provide environmentally benign alternatives? An LCA case study of sugarcane bagasse addition to particle board manufacturing

    DEFF Research Database (Denmark)

    Silva, Diogo Aparecido Lopes; Lahr, Francisco Antonio Rocco; Pavan, Ana Laura Raymundo

    2014-01-01

    environmental impacts? Could it substitute wood as raw material? Accordingly, this paper presents a life cycle assessment (LCA) study of particle board manufactured with sugarcane bagasse residues.The cradle-to-gate assessment of 1 m3 of particle board made with sugarcane bagasse (PSB) considered three main...... subsystem was 9.08 % (economic base). The potential environmental impact phase was assessed by applying the CML and USEtox methods. PSB was compared with the conventional particle board manufactured in Brazil by the categories of the CML and USETox, and including land use indicators. Finally, two scenarios......, it is suggested that the sugarcane bagasse be mixed up to 75 % during particle board manufacturing so that good quality properties and environmental performance of panels can be provided....

  20. The inhibitory microcircuit of the substantia nigra provides feedback gain control of the basal ganglia output.

    Science.gov (United States)

    Brown, Jennifer; Pan, Wei-Xing; Dudman, Joshua Tate

    2014-05-21

    Dysfunction of the basal ganglia produces severe deficits in the timing, initiation, and vigor of movement. These diverse impairments suggest a control system gone awry. In engineered systems, feedback is critical for control. By contrast, models of the basal ganglia highlight feedforward circuitry and ignore intrinsic feedback circuits. In this study, we show that feedback via axon collaterals of substantia nigra projection neurons control the gain of the basal ganglia output. Through a combination of physiology, optogenetics, anatomy, and circuit mapping, we elaborate a general circuit mechanism for gain control in a microcircuit lacking interneurons. Our data suggest that diverse tonic firing rates, weak unitary connections and a spatially diffuse collateral circuit with distinct topography and kinetics from feedforward input is sufficient to implement divisive feedback inhibition. The importance of feedback for engineered systems implies that the intranigral microcircuit, despite its absence from canonical models, could be essential to basal ganglia function. DOI: http://dx.doi.org/10.7554/eLife.02397.001. Copyright © 2014, Brown et al.

  1. The role of hosting providers in fighting command and control infrastructure of financial malware

    NARCIS (Netherlands)

    Tajalizadehkhoob, S.; Hernandez Ganan, C.; Noroozian, A.; van Eeten, M.J.G.

    2017-01-01

    A variety of botnets are used in attacks on financial services. Banks and security firms invest a lot of effort in detecting and combating malware-assisted takeover of customer accounts. A critical resource of these botnets is their command-and-control (C&C) infrastructure. Attackers rent or

  2. Solar-energy conversion system provides electrical power and thermal control for life-support systems

    Science.gov (United States)

    Davis, B. K.

    1974-01-01

    System utilizes Freon cycle and includes boiler turbogenerator with heat exchanger, regenerator and thermal-control heat exchangers, low-pressure and boiler-feed pumps, and condenser. Exchanger may be of interest to engineers and scientists investigating new energy sources.

  3. Enzyme-polyelectrolyte complexes in water-ethanol mixtures: negatively charged groups artificially introduced into alpha-chymotrypsin provide additional activation and stabilization effects.

    Science.gov (United States)

    Kudryashova, E V; Gladilin, A K; Vakurov, A V; Heitz, F; Levashov, A V; Mozhaev, V V

    1997-07-20

    Formation of noncovalent complexes between alpha-chymotrypsin (CT) and a polyelectrolyte, polybrene (PB), has been shown to produce two major effects on enzymatic reactions in binary mixtures of polar organic cosolvents with water. (i) At moderate concentrations of organic cosolvents (10% to 30% v/v), enzymatic activity of CT is higher than in aqueous solutions, and this activation effect is more significant for CT in complex with PB (5- to 7-fold) than for free enzyme (1.5- to 2.5-fold). (ii) The range of cosolvent concentrations that the enzyme tolerates without complete loss of catalytic activity is much broader. For enhancement of enzyme stability in the complex with the polycation, the number of negatively charged groups in the protein has been artificially increased by using chemical modification with pyromellitic and succinic anhydrides. Additional activation effect at moderate concentrations of ethanol and enhanced resistance of the enzyme toward inactivation at high concentrations of the organic solvent have been observed for the modified preparations of CT in the complex with PB as compared with an analogous complex of the native enzyme. Structural changes behind alterations in enzyme activity in water-ethanol mixtures have been studied by the method of circular dichroism (CD). Protein conformation of all CT preparations has not changed significantly up to 30% v/v of ethanol where activation effects in enzymatic catalysis were most pronounced. At higher concentrations of ethanol, structural changes in the protein have been observed for different forms of CT that were well correlated with a decrease in enzymatic activity. (c) 1997 John Wiley & Sons, Inc. Biotechnol Bioeng 55: 267-277, 1997.

  4. Integrating Modeling and Monitoring to Provide Long-Term Control of Contaminants

    International Nuclear Information System (INIS)

    Fogwell, Th.

    2009-01-01

    An introduction is presented of the types of problems that exist for long-term control of radionuclides at DOE sites. A breakdown of the distributions at specific sites is given, together with the associated difficulties. A paradigm for remediation showing the integration of monitoring with modeling is presented. It is based on a feedback system that allows for the monitoring to act as principal sensors in a control system. Currently the establishment of a very prescriptive monitoring program fails to have a mechanism for improving models and improving control of the contaminants. The resulting system can be optimized to improve performance. Optimizing monitoring automatically entails linking the monitoring with modeling. If monitoring designs were required to be more efficient, thus requiring optimization, then the monitoring automatically becomes linked to modeling. Records of decision could be written to accommodate revisions in monitoring as better modeling evolves. The technical pieces of the required paradigm are already available; they just need to be implemented and applied to solve the long-term control of the contaminants. An integration of the various parts of the system is presented. Each part is described, and examples are given. References are given to other projects which bring together similar elements in systems for the control of contaminants. Trends are given for the development of the technical features of a robust system. Examples of monitoring methods for specific sites are given. The examples are used to illustrate how such a system would work. Examples of technology needs are presented. Finally, other examples of integrated modeling-monitoring approaches are presented. (authors)

  5. Haptic control of a pneumatic muscle actuator to provide resistance for simulated isokinetic exercise; part II: control development and testing.

    Science.gov (United States)

    Hall, Kara L; Phillips, Chandler A; Reynolds, David B; Mohler, Stanley R; Rogers, Dana B; Neidhard-Doll, Amy T

    2015-01-01

    Pneumatic muscle actuators (PMAs) have a high power to weight ratio and possess unique characteristics which make them ideal actuators for applications involving human interaction. PMAs are difficult to control due to nonlinear dynamics, presenting challenges in system implementation. Despite these challenges, PMAs have great potential as a source of resistance for strength training and rehabilitation. The objective of this work was to control a PMA for use in isokinetic exercise, potentially benefiting anyone in need of optimal strength training through a joint's range of motion. The controller, based on an inverse three-element phenomenological model and adaptive nonlinear control, allows the system to operate as a type of haptic device. A human quadriceps dynamic simulator was developed (as described in Part I of this work) so that control effectiveness and accommodation could be tested prior to human implementation. Tracking error results indicate that the control system is effective at producing PMA displacement and resistance necessary for a scaled, simulated neuromuscular actuator to maintain low-velocity isokinetic movement during simulated concentric and eccentric knee extension.

  6. Theory of the thermodynamic influence of solution-phase additives in shape-controlled nanocrystal synthesis.

    Science.gov (United States)

    Qi, Xin; Fichthorn, Kristen A

    2017-10-19

    Though many experimental studies have documented that certain solution-phase additives can play a key role in the shape-selective synthesis of metal nanocrystals, the origins and mechanisms of this shape selectivity are still unclear. One possible role of such molecules is to thermodynamically induce the equilibrium shape of a nanocrystal by altering the interfacial free energies of the facets. Using a multi-scheme thermodynamic integration method that we recently developed [J. Chem. Phys., 2016, 145, 194108], we calculate the solid-liquid interfacial free energies γ sl and investigate the propensity to achieve equilibrium shapes in such syntheses. We first apply this method to Ag(100) and Ag(111) facets in ethylene glycol solution containing polyvinylpyrrolidone (PVP), to mimic the environment in polyol synthesis of Ag nanocrystals. We find that although PVP has a preferred binding to Ag(100), its selectivity is not sufficient to induce a thermodynamic preference for {100}-faceted nanocubes, as has been observed experimentally. This indicates that PVP promotes Ag nanocube formation kinetically rather than thermodynamically. We further quantify the thermodynamic influence of adsorbed solution-phase additives for generic molecules, by building a γ sl ratio/nanocrystal shape map as a function of zero-temperature binding energies. This map can be used to gauge the efficacy of candidate additive molecules for producing targeted thermodynamic nanocrystal shapes. The results indicate that only additives with a strong facet selectivity can impart significant thermodynamic-shape change. Therefore, many of the nanocrystals observed in experiments are likely kinetic products.

  7. Control of interfacial intermetallic compounds in Fe–Al joining by Zn addition

    Energy Technology Data Exchange (ETDEWEB)

    Yang, J. [Key Laboratory of Robot and Welding Automation of Jiangxi Province, School of Mechanical and Electrical Engineering, Nanchang University, Nanchang, Jiangxi 330031 (China); Center for Advanced Materials Joining, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1 (Canada); Li, Y.L., E-mail: liyulong1112ster@gmail.com [Key Laboratory of Robot and Welding Automation of Jiangxi Province, School of Mechanical and Electrical Engineering, Nanchang University, Nanchang, Jiangxi 330031 (China); Zhang, H. [Key Laboratory of Robot and Welding Automation of Jiangxi Province, School of Mechanical and Electrical Engineering, Nanchang University, Nanchang, Jiangxi 330031 (China); Guo, W. [Center for Advanced Materials Joining, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1 (Canada); School of Mechanical Engineering and Automation, Beijing University of Aeronautics and Astronautics, Beijing 100191 (China); Zhou, Y. [Center for Advanced Materials Joining, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1 (Canada)

    2015-10-01

    By Zn addition to the fusion zone, the interfacial intermetallic compounds (IMCs) of laser Al/steel joint changed from layered Fe{sub 2}Al{sub 5} and needle-like FeAl{sub 3} to layered Fe{sub 2}Al{sub 5−x}Zn{sub x} and dispersed FeZn{sub 10} with minor Al-rich amorphous phase. This resulted in an improvement in the joint strength and the change of failure mode.

  8. Metal vapor micro-jet controls material redistribution in laser powder bed fusion additive manufacturing

    OpenAIRE

    Ly, Sonny; Rubenchik, Alexander M.; Khairallah, Saad A.; Guss, Gabe; Matthews, Manyalibo J.

    2017-01-01

    The results of detailed experiments and finite element modeling of metal micro-droplet motion associated with metal additive manufacturing (AM) processes are presented. Ultra high speed imaging of melt pool dynamics reveals that the dominant mechanism leading to micro-droplet ejection in a laser powder bed fusion AM is not from laser induced recoil pressure as is widely believed and found in laser welding processes, but rather from vapor driven entrainment of micro-particles by an ambient gas...

  9. A case control study of possible additional risk factors for chronic alcoholic pancreatitis

    OpenAIRE

    Sri Vengadesh Gopal; Ashley Solomon; Jaahnavi Konidala

    2016-01-01

    Background: Chronic pancreatitis (CP) is characterised by irreversible damage to pancreas leading to endocrine and exocrine insufficiency with considerable morbidity. Etiopathogenesis is multifactorial with interplay between genetics and environmental toxins. Alcoholism is more commonly associated with chronic pancreatitis. But it is not very clear why only certain proportion of the alcoholics develop pancreatitis. So this study was conducted to find the possible additional risk factors inv...

  10. Additive manufacturing of scaffolds with dexamethasone controlled release for enhanced bone regeneration.

    Science.gov (United States)

    Costa, Pedro F; Puga, Ana M; Díaz-Gomez, Luis; Concheiro, Angel; Busch, Dirk H; Alvarez-Lorenzo, Carmen

    2015-12-30

    The adoption of additive manufacturing in tissue engineering and regenerative medicine (TERM) strategies greatly relies on the development of novel 3D printable materials with advanced properties. In this work we have developed a material for bone TERM applications with tunable bioerosion rate and dexamethasone release profile which can be further employed in fused deposition modelling (the most common and accessible 3D printing technology in the market). The developed material consisted of a blend of poly-ϵ-caprolactone (PCL) and poloxamine (Tetronic®) and was processed into a ready-to-use filament form by means of a simplified melt-based methodology, therefore eliminating the utilization of solvents. 3D scaffolds composed of various blend formulations were additively manufactured and analyzed revealing blend ratio-specific degradation rates and dexamethasone release profiles. Furthermore, in vitro culture studies revealed a similar blend ratio-specific trend concerning the osteoinductive activity of the fabricated scaffolds when these were seeded and cultured with human mesenchymal stem cells. The developed material enables to specifically address different regenerative requirements found in various tissue defects. The versatility of such strategy is further increased by the ability of additive manufacturing to accurately fabricate implants matching any given defect geometry. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Fungi and bacteria boost resistance to pests and diseases : endophytes a useful addition to pest control

    NARCIS (Netherlands)

    Messelink, G.

    2017-01-01

    More and more research is revealing that endophytes – microorganisms that live in the plant without harming it – can significantly boost a plant’s resistance to pests. These findings prompted researchers to investigate the potential of endophytes in pest control in greenhouse horticulture.

  12. A tuneable switch for controlling environmental degradation of bioplastics: addition of isothiazolinone to polyhydroxyalkanoates.

    Science.gov (United States)

    Woolnough, Catherine Anne; Yee, Lachlan Hartley; Charlton, Timothy Stuart; Foster, Leslie John Ray

    2013-01-01

    Controlling the environmental degradation of polyhydroxybutyrate (PHB) and polyhydroxyvalerate (P(HB-co-HV)) bioplastics would expand the range of their potential applications. Combining PHB and P(HB-co-HV) films with the anti-fouling agent 4,5-dichloro-2-n-octyl-4-isothiazolin-3-one (DCOI, bioplastics increases their potential use in biodegradable applications.

  13. External Carbon Source Addition as a Means to Control an Activated Sludge Nutrient Removal Process

    DEFF Research Database (Denmark)

    Isaacs, Steven Howard; Henze, Mogens; Søeberg, Henrik

    1994-01-01

    In alternating type activated sludge nutrient removal processes, the denitrification rate can be limited by the availability of readily-degradable carbon substrate. A control strategy is proposed by which an easily metabolizable COD source is added directly to that point in the process at which d...

  14. Controlled laboratory challenge demonstrates substantial additive genetic variation in resistance to Streptococcus iniae in Nile tilapia

    Science.gov (United States)

    Streptococcus iniae is an etiologic agent of streptococcal disease in tilapia and is one of several Streptococcus spp. that negatively impact worldwide tilapia production. Methods for the prevention and control of S. iniae include vaccines, management strategies, and antibiotics. An alternative and ...

  15. Measuring Critical Care Providers' Attitudes About Controlled Donation After Circulatory Death.

    Science.gov (United States)

    Rodrigue, James R; Luskin, Richard; Nelson, Helen; Glazier, Alexandra; Henderson, Galen V; Delmonico, Francis L

    2018-06-01

    Unfavorable attitudes and insufficient knowledge about donation after cardiac death among critical care providers can have important consequences for the appropriate identification of potential donors, consistent implementation of donation after cardiac death policies, and relative strength of support for this type of donation. The lack of reliable and valid assessment measures has hampered research to capture providers' attitudes. Design and Research Aims: Using stakeholder engagement and an iterative process, we developed a questionnaire to measure attitudes of donation after cardiac death in critical care providers (n = 112) and examined its psychometric properties. Exploratory factor analysis, internal consistency, and validity analyses were conducted to examine the measure. A 34-item questionnaire consisting of 4 factors (Personal Comfort, Process Satisfaction, Family Comfort, and System Trust) provided the most parsimonious fit. Internal consistency was acceptable for each of the subscales and the total questionnaire (Cronbach α > .70). A strong association between more favorable attitudes overall and knowledge ( r = .43, P donation after cardiac death ( P donation after cardiac death.

  16. Doping control, providing whereabouts and the importance of privacy for elite athletes

    NARCIS (Netherlands)

    Valkenburg, D.; de Hon, O.; van Hilvoorde, I.M.

    2014-01-01

    Background: To improve anti-doping efforts in sports, the World Anti-Doping Agency (WADA) introduced the World Anti-Doping Program, in which (among others) regulations for providing athletes' whereabouts are described. Because the effectiveness and efficiency of this system depends on the

  17. Integrating inventory control and capacity management at a maintenance service provider

    NARCIS (Netherlands)

    Buyukkaramikli, N.C.; Ooijen, van H.P.G.; Bertrand, J.W.M.

    2015-01-01

    In this paper, we study the capacity flexibility problem of a maintenance service provider, who is running a repair shop and is responsible for the availability of numerous specialized systems which contain a critical component that is prone to failure. Upon a critical component failure, the

  18. Combined parecoxib and I.V. paracetamol provides additional analgesic effect with better postoperative satisfaction in patients undergoing anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Zeinab Ahmed Elseify

    2011-01-01

    Full Text Available Background : Adequacy of postoperative analgesia is one of the most important factors that determine early hospital discharge and patients′ ability to resume their normal activities postoperatively. The optimal non-opioid analgesic technique for postoperative pain management would reduce pain and enhance patient satisfaction, and it also facilitates earlier mobilization and rehabilitation by reducing pain-related complications after surgery. The aim of this study was to evaluate the analgesic efficacy of intravenous paracetamol and parecoxib when used alone, or in combination. Methods : Sixty American Society of Anesthesiology (ASA physical status I and II adult patients who were scheduled for anterior cruciate ligament reconstruction were included in this study. Patients were allocated into three groups: group I patients received 1g intravenous paracetamol after induction and another 1 g 4 h later, group II received 40 mg parecoxib after induction, while group III received combination of both drugs (paracetamol 1 g and parecoxib 40 mg. Pain during rest and mobility was assessed in the immediate postoperative period, 2 h and 8 h successively using visual analog scale (VAS. Patient satisfaction was rated according to satisfaction score. Results : Total morphine requirements were lower in group III patients (6.9±2.7 mg in comparison to group I patients (12.6±3.6 mg or group II patients (9.8±2.8 mg. The least VAS scores were recorded during knee movement (3.8±1.1 in group III patients compared to group I (6.0±1.8 and group II patients (4.8±1.9. Eight hours postoperatively, group III patients were more satisfied regarding the postoperative pain management. Conclusion : Combination of intravenous paracetamol and parecoxib provided better analgesia and higher patient satisfaction than each drug when used separately.

  19. Evaluation and additional recommendations for preparing a whole blood control material

    Directory of Open Access Journals (Sweden)

    Nilda E. Fink

    1998-04-01

    Full Text Available OBJECTIVE: The assessment of an easy to prepare and low cost control material for Hematology, available for manual and automated methods. MATERIAL AND METHOD: Aliquots of stabilized whole blood were prepared by partial fixation with aldehydes; the stability at different temperatures (4. 20 and 37 °C during periods of up to 8-9 weeks and aliquot variability with both methods were controlled. RESULTS: Aliquot variability with automated methods at day 1, expressed as CV% (coefficient of variation was: white blood cells (WBC 2.7, red blood cells (RBC 0.7, hemoglobin (Hb 0.6, hematocrit (Hct 0.7, mean cell volume (MCV 0.3, mean cell hemoglobin (MCH 0.6, mean cell hemoglobin concentration (MCHC 0.7, and platelets (PLT 4.6. The CV (coefficient of variation percentages obtained with manual methods in one of the batches were: WBC 23, Hct 2.8, Hb 4.5, MCHC 5.9, PLT 41. Samples stored at 4ºC and 20ºC showed good stability, only a very low initial hemolysis being observed, whereas those stored at 37ºC deteriobed a rapidly (metahemoglobin formation, aggregation of WBC and platelets, as well as alteration of erythrocyte indexes. CONCLUSIONS: It was confirmed that, as long as there is no exposure to high temperatures during distribution, this material is stable, allowing assessment, both esternal and internal, for control purposes, with acceptable reproductivity, both for manual and auttomatic methods.

  20. Increased efficiency in the second-hand tire trade provides opportunity for dengue control.

    Science.gov (United States)

    Pliego Pliego, Emilene; Velázquez-Castro, Jorge; Eichhorn, Markus P; Fraguela Collar, Andrés

    2018-01-21

    Dengue fever is increasing in geographical range, spread by invasion of its vector mosquitoes. The trade in second-hand tires has been implicated as a factor in this process because they act as mobile reservoirs of mosquito eggs and larvae. Regional transportation of tires can create linkages between rural areas with dengue and disease-free urban areas, potentially giving rise to outbreaks even in areas with strong local control measures. In this work we sought to model the dynamics of mosquito transportation via the tire trade, in particular to predict its role in causing unexpected dengue outbreaks through vertical transmission of the virus across generations of mosquitoes. We also aimed to identify strategies for regulating the trade in second-hand tires, improving disease control. We created a mathematical model which captures the dynamics of dengue between rural and urban areas, taking into account the movement and storage time of tires, and mosquito diapause. We simulate a series of scenarios in which a mosquito population is introduced to a dengue-free area via movement of tires, either as single or multiple events, increasing the likelihood of a dengue outbreak. A persistent disease state can be induced regardless of whether urban conditions for an outbreak are met, and an existing endemic state can be enhanced by vector input. Finally we assess the potential for regulation of tire processing as a means of reducing the transmission of dengue fever using a specific case study from Puerto Rico. Our work demonstrates the importance of the second-hand tire trade in modulating the spread of dengue fever across regions, in particular its role in introducing dengue to disease-free areas. We propose that reduction of tire storage time and control of their movement can play a crucial role in containing dengue outbreaks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. A Keystone Ant Species Provides Robust Biological Control of the Coffee Berry Borer Under Varying Pest Densities.

    Science.gov (United States)

    Morris, Jonathan R; Vandermeer, John; Perfecto, Ivette

    2015-01-01

    Species' functional traits are an important part of the ecological complexity that determines the provisioning of ecosystem services. In biological pest control, predator response to pest density variation is a dynamic trait that impacts the provision of this service in agroecosystems. When pest populations fluctuate, farmers relying on biocontrol services need to know how natural enemies respond to these changes. Here we test the effect of variation in coffee berry borer (CBB) density on the biocontrol efficiency of a keystone ant species (Azteca sericeasur) in a coffee agroecosystem. We performed exclosure experiments to measure the infestation rate of CBB released on coffee branches in the presence and absence of ants at four different CBB density levels. We measured infestation rate as the number of CBB bored into fruits after 24 hours, quantified biocontrol efficiency (BCE) as the proportion of infesting CBB removed by ants, and estimated functional response from ant attack rates, measured as the difference in CBB infestation between branches. Infestation rates of CBB on branches with ants were significantly lower (71%-82%) than on those without ants across all density levels. Additionally, biocontrol efficiency was generally high and did not significantly vary across pest density treatments. Furthermore, ant attack rates increased linearly with increasing CBB density, suggesting a Type I functional response. These results demonstrate that ants can provide robust biological control of CBB, despite variation in pest density, and that the response of predators to pest density variation is an important factor in the provision of biocontrol services. Considering how natural enemies respond to changes in pest densities will allow for more accurate biocontrol predictions and better-informed management of this ecosystem service in agroecosystems.

  2. Modulating laser intensity profile ellipticity for microstructural control during metal additive manufacturing

    International Nuclear Information System (INIS)

    Roehling, Tien T.; Wu, Sheldon S.Q.; Khairallah, Saad A.; Roehling, John D.; Soezeri, S. Stefan; Crumb, Michael F.; Matthews, Manyalibo J.

    2017-01-01

    Additively manufactured (AM) metals are often highly textured, containing large columnar grains that initiate epitaxially under steep temperature gradients and rapid solidification conditions. These unique microstructures partially account for the massive property disparity existing between AM and conventionally processed alloys. Although equiaxed grains are desirable for isotropic mechanical behavior, the columnar-to-equiaxed transition remains difficult to predict for conventional solidification processes, and much more so for AM. In this study, the effects of laser intensity profile ellipticity on melt track macrostructures and microstructures were studied in 316L stainless steel. Experimental results were supported by temperature gradients and melt velocities simulated using the ALE3D multi-physics code. As a general trend, columnar grains preferentially formed with increasing laser power and scan speed for all beam profiles. However, when conduction mode laser heating occurs, scan parameters that result in coarse columnar microstructures using Gaussian profiles produce equiaxed or mixed equiaxed-columnar microstructures using elliptical profiles. By modulating spatial laser intensity profiles on the fly, site-specific microstructures and properties can be directly engineered into additively manufactured parts.

  3. Exploration and classification of chromatographic fingerprints as additional tool for identification and quality control of several Artemisia species.

    Science.gov (United States)

    Alaerts, Goedele; Pieters, Sigrid; Logie, Hans; Van Erps, Jürgen; Merino-Arévalo, Maria; Dejaegher, Bieke; Smeyers-Verbeke, Johanna; Vander Heyden, Yvan

    2014-07-01

    -analysis technique. Samples of different quality could be indicated on the score plots. No multi-component analysis was required to reach the goal. Furthermore, differences related to the origin of some of the not-certified samples were shown. The importance of the specific herbal part used for its identification was also presented. In addition, no differences were observed among fingerprints of lyophilised or conditioned-air dried samples. Finally, a classification technique, Soft Independent Modelling by Class Analogy (SIMCA), was successfully evaluated as identification technique for unknown samples. Six additional Artemisia species (29 herbal samples) were identified as not belonging to any of the four modelled classes. The developed chromatographic fingerprints and the evaluation of the entire profiles provide an added value to the distinction, identification and quality control of the simultaneously investigated Artemisia species. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. DIMENSIONAL VERIFICATION AND QUALITY CONTROL OF IMPLANTS PRODUCED BY ADDITIVE MANUFACTURING

    Directory of Open Access Journals (Sweden)

    Teodor Toth

    2015-07-01

    Full Text Available Purpose: Development of computer technology and alternative manufacturing methods in form of additive manufacturing leads to the manufacture of products with complex shapes. In the field of medicine they include, inter alia, custom-made implants manufactured for a particular patient, such as cranial implants, maxillofacial implants, etc. With regard to the fact that such implants are inserted into a patient’s body, it is necessary to perform the verification, including the shape and dimensional verification. The article deals with the application of the industrial computer tomography within the process of inspection and verification of selected custom-made implant types.Methodology/Approach: The Department of Biomedical Engineering and Measurement performs the verification of medicinal products manufactured by the additive manufacturing technologies from the Ti-6Al-4V (Grade 5 titanium alloy, using the coordinate measuring machine Carl Zeiss Contura G2 and the industrial computed tomography machine Carl Zeiss Metrotom 1500. These equipment fulfil the requirements for the identification and evaluation of dimensions of both, the external and the internal structures. Findings: The article presents the possibilities of the computed tomography utilisation in the inspection of individual implant manufacture using the additive manufacturing technologies. The results indicate that with the adjustment of appropriate input parameters (alignment, this technology is appropriate for the analysis of shape deviations, when compared with the CAD model.Research Limitation/implication: With the increasing distance of measured object from X-ray source, the machine’s resolution function decreases. Decreasing of resolution has a minor impact on the measured dimensions (relatively high tolerances, but has a significant impact on the evaluation of porosity and inclusions. Originality/Value of paper: Currently, the verification of a manufactured implant  can be

  5. Mental health problems in adolescents with cochlear implants: Peer problems persist after controlling for additional handicaps

    Directory of Open Access Journals (Sweden)

    Maria eHuber

    2015-07-01

    Full Text Available The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (CIs in comparison to normal hearing (NH peers and to investigate possible relations between the extent of mental health problems of young CI users and hearing variables, such as age at implantation, or functional gain of CI. The survey included 140 adolescents with CI (mean age = 14.7, SD = 1.5 years and 140 NH adolescents (mean age = 14.8, SD = 1.4 years, their parents and teachers. Participants were matched by age, gender and social background. Within the CI group, 35 adolescents were identified as risk cases due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ in the versions Self, Parent, and Teacher. The CI group showed significantly more Peer Problems than the NH group. When the CI group was split into a risk-group (35 risk cases and 11 non-classifiable persons and a non-risk group (n = 94, increased peer problems were perceived in both CI subgroups by adolescents themselves. However, no further differences between the CI non-risk group and the NH group were observed in any rater. The CI-risk group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the CI non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the CI-risk group compared to the CI non-risk group and the NH group. Adolescents with CI, who were able to understand speech in noise had significantly less difficulties compared to constricted CI users. Parents, teachers, and clinicians should be aware that CI users with additionally special needs may have mental health problems. However, peer problems were also experienced by CI adolescents without additional handicaps

  6. Identification of additional genes under the control of the transcription factor sigma F of Bacillus subtilis.

    OpenAIRE

    Decatur, A; Losick, R

    1996-01-01

    We describe the identification of five transcriptional units under the control of the sporulation transcription factor sigma F in Bacillus subtilis. These are csfA, csfB, csfC, csfD, and csfF, located at approximately 230 degrees, 2 degrees, 316 degrees, 205 degrees, and approximately 290 degrees, respectively, on the genetic map. Null mutations in csfA, csfB, csfC, or csfD, either alone or together, do not cause a noticeable defect in sporulation or germination.

  7. Addition of ketamine or dexmedetomidine to lignocaine in intravenous regional anesthesia: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2012-01-01

    Results: Shortened sensory and motor block onset times (69.17 min and 7.83 min respectively, P < 0.0001 and improved quality of anesthesia (satisfaction score = 3, P < 0.05 were found in ketamine group. Visual analog scale scores (3.21 ± 0.41 were comparable while time to first analgesic requirement (166.25 ± 25.89 min, P < 0.0001 was significantly longer in dexmedetomidine group after tourniquet release. Conclusion: We conclude that the addition of 1 mcg/kg of body weight dexmedetomidine or 0.5 mg/kg of body weight ketamine to lignocaine for IVRA improves quality of anesthesia and perioperative analgesia without causing side effects. We considered ketamine reduced the time for onset of block, delayed the onset of tourniquet pain, and reduced postoperative analgesic requirement and had a better patient satisfaction than placebo or dexmedetomidine.

  8. Aspects of Additional Psychiatric Disorders in Severe Depression/Melancholia: A Comparison between Suicides and Controls and General Pattern

    Directory of Open Access Journals (Sweden)

    Ulrika Heu

    2018-06-01

    Full Text Available Objective: Additional and comorbid diagnoses are common among suicide victims with major depressive disorder (MDD and have been shown to increase the suicide risk. The aim of the present study was first, to investigate whether patients with severe depression/melancholia who had died by suicide showed more additional psychiatric disorders than a matched control group. Second, general rates of comorbid and additional diagnoses in the total group of patients were estimated and compared with literature on MDD. Method: A blind record evaluation was performed on 100 suicide victims with severe depression/melancholia (MDD with melancholic and/or psychotic features: MDD-M/P and matched controls admitted to the Department of Psychiatry, Lund, Sweden between 1956 and 1969 and monitored to 2010. Diagnoses in addition to severe depression were noted. Results: Less than half of both the suicides and controls had just one psychiatric disorder (47% in the suicide and 46% in the control group. The average number of diagnoses was 1.80 and 1.82, respectively. Additional diagnoses were not related to an increased suicide risk. Anxiety was the most common diagnosis. Occurrence of suspected schizophrenia/schizotypal or additional obsessive-compulsive symptoms were more common than expected, but alcohol use disorders did not appear very frequent. Conclusions: The known increased risk of suicide in MDD with comorbid/additional diagnoses does not seem to apply to persons with MDD-M/P (major depressive disorder-depression/Melancholia. Some diagnoses, such as schizophrenia/schizotypal disorders, were more frequent than expected, which is discussed, and a genetic overlap with MDD-M/P is proposed.

  9. Providing reviews of evidence to COPD patients: controlled prospective 12-month trial.

    Science.gov (United States)

    Harris, M; Smith, B J; Veale, A J; Esterman, A; Frith, P A; Selim, P

    2009-01-01

    The aim of this study was to evaluate a novel patient-held manual designed to reduce the evidence-practice gap in chronic obstructive pulmonary disease (COPD). The intervention manual contained summaries of research evidence. It was developed using current best practice for patient information materials and designed to cause discussion of evidence between patient and doctor. A controlled before-and-after study was employed in two similar but geographically separate regions of metropolitan Adelaide, South Australia. Participants had moderate to severe COPD, with 249 included at baseline and 201 completing the study. Evidence-based COPD management was measured using an indicator with three components: rates of influenza vaccination, bone density testing, and pulmonary rehabilitation. A survey of behavioral steps leading to practice change was conducted with the trial. Analysis, by median split of socioeconomic disadvantage, showed significant difference between study arms for only one component of the indicator of evidence-based practice, enrollment in pulmonary rehabilitation and only for the most socioeconomically disadvantaged stratum. For both socioeconomic strata, more intervention participants than control participants reported remembering being given the information material, reading part or all, and finding it very or quite helpful. Other significant differences were restricted to the stratum of greatest socioeconomic disadvantage: reading all of the material, learning from it, referring back, and talking to a doctor about a topic from the material. Above 90% of all participants who received the manual reported reading from it, 42% reported discussing topics with a doctor, but only 10% reported treatment change attributable to the manual. We have found that people with COPD will read an evidence manual developed using current best practice. However, the study demonstrated improvement for only one of the three components of an indicator of evidence

  10. Summary of Previous Chamber or Controlled Anthrax Studies and Recommendations for Possible Additional Studies

    Energy Technology Data Exchange (ETDEWEB)

    Piepel, Gregory F.; Amidan, Brett G.; Morrow, Jayne B.

    2010-12-29

    This report and an associated Excel file(a) summarizes the investigations and results of previous chamber and controlled studies(b) to characterize the performance of methods for collecting, storing and/or transporting, extracting, and analyzing samples from surfaces contaminated by Bacillus anthracis (BA) or related simulants. This report and the Excel are the joint work of the Pacific Northwest National Laboratory (PNNL) and the National Institute of Standards and Technology (NIST) for the Department of Homeland Security, Science and Technology Directorate. The report was originally released as PNNL-SA-69338, Rev. 0 in November 2009 with limited distribution, but was subsequently cleared for release with unlimited distribution in this Rev. 1. Only minor changes were made to Rev. 0 to yield Rev. 1. A more substantial update (including summarizing data from other studies and more condensed summary tables of data) is underway

  11. Additive effects of heating and exercise on baroreflex control of heart rate in healthy males.

    Science.gov (United States)

    Peçanha, Tiago; Forjaz, Cláudia L M; Low, David A

    2017-12-01

    This study assessed the additive effects of passive heating and exercise on cardiac baroreflex sensitivity (cBRS) and heart rate variability (HRV). Twelve healthy young men (25 ± 1 yr, 23.8 ± 0.5 kg/m 2 ) randomly underwent two experimental sessions: heat stress (HS; whole body heat stress using a tube-lined suit to increase core temperature by ~1°C) and normothermia (NT). Each session was composed of a preintervention rest (REST1); HS or NT interventions; postintervention rest (REST2); and 14 min of cycling exercise [7 min at 40%HR reserve (EX1) and 7 min at 60%HR reserve (EX2)]. Heart rate and finger blood pressure were continuously recorded. cBRS was assessed using the sequence (cBRS SEQ ) and transfer function (cBRS TF ) methods. HRV was assessed using the indexes standard deviation of RR intervals (SDNN) and root mean square of successive RR intervals (RMSSD). cBRS and HRV were not different between sessions during EX1 and EX2 (i.e., matched heart rate conditions: EX1 = 116 ± 3 vs. 114 ± 3 and EX2 = 143 ± 4 vs. 142 ± 3 beats/min but different workloads: EX1 = 50 ± 9 vs. 114 ± 8 and EX2 = 106 ± 10 vs. 165 ± 8 W; for HS and NT, respectively; P heat stress to exercise does not affect cBRS and HRV. Alternatively, in workload-matched conditions, the addition of heat to exercise results in reduced cBRS and HRV compared with exercise in normothermia. NEW & NOTEWORTHY The present study assessed cardiac baroreflex sensitivity during the combination of heat and exercise stresses. This is the first study to show that prior whole body passive heating reduces cardiac baroreflex sensitivity and autonomic modulation of heart rate during exercise. These findings contribute to the better understanding of the role of thermoregulation on cardiovascular regulation during exercise.

  12. Polyethylene glycol intestinal lavage in addition to usual antibiotic treatment for severe Clostridium difficile colitis: a randomised controlled pilot study.

    Science.gov (United States)

    McCreery, Greig; Jones, Philip M; Kidane, Biniam; DeMelo, Vanessa; Mele, Tina

    2017-07-31

    Clostridium difficile infections (CDI) are common, costly and potentially life threatening. Most CDI will respond to antibiotic therapy, but 3%-10% of all patients with CDI will progress to a severe, life-threatening course. Complete removal of the large bowel is indicated for severe CDI. However, the 30-day mortality following surgical intervention for severe CDI ranges from 20% to 70%. A less invasive approach using surgical faecal diversion and direct colonic lavage with polyethylene glycol (PEG) and vancomycin has demonstrated a relative mortality reduction of approximately 50%. As an alternative to these operative approaches, we propose to treat patients with bedside intestinal lavage with PEG and vancomycin instillation via nasojejunal tube, in addition to usual antibiotic management. Preliminary data collected by our research group are encouraging. We will conduct a 1-year, single-centre, pilot randomised controlled trial to study this new treatment strategy for patients with severe CDI and additional risk factors for fulminant or complicated infection. After informed consent, patients with severe-complicated CDI without immediate indication for surgery will be randomised to either usual antibiotic treatment or usual antibiotic treatment with the addition of 8 L of PEG lavage via nasojejunal tube. This pilot trial will evaluate our eligibility and enrolment rate, protocol compliance and adverse event rates and provide further data to inform a more robust sample size calculation and protocol modifications for a definitive multicentre trial design. Based on historical data, we anticipate enrolling approximately 24 patients during the 1-year pilot study period.As a pilot study, data will be reported in aggregate. Between-group differences will be assessed in a blinded fashion for evidence of harm, and to further refine our sample size calculation. This study protocol has been reviewed and approved by our local institutional review board. Results of the pilot

  13. Microstructure control of Zr-Nb-Sn alloy with Mo addition for HWR pressure tube application

    International Nuclear Information System (INIS)

    Hwang, S. K.; Kim, M. H.; Kim, J. H.; Kwon, S. I.; Kim, Y. S.

    1997-01-01

    As a basic research to develop the material for heavy water reactor pressure tube application the effect of Mo addition to Zr-Nb-Sn alloy was studied for the purpose of minimizing the amount of cold working while maintaining a high strength. To select the target alloy system we first designed various alloy compositions and chose Zr-Nb-Sn and Zr-Nb-Mo through multi-regression analysis of the relationship between the basic properties and the compositions. Plasma arc melting was used to produce the alloys and the microstructure change introduced by the processing steps including hot forging, beta-heat treatment, hot rolling, cold rolling and recrystallization heat treatment was investigated. Recrystallization of Zr-Nb-Sn was retarded by adding Mo and this resulted in a fine grain structure in Zr-Nb-Sn-Mo alloy. Beside the retarding effect recrystallization, Mo increased the amount of residual beta phase and showed an indication of precipitation hardening, which added up to the possibility of applying the alloy for the desired usage. (author)

  14. Antivenom Therapy for Crotaline Snakebites: Has the Poison Control Center Provided Effective Guidelines?

    Directory of Open Access Journals (Sweden)

    Yen-Chia Chen

    2007-12-01

    Full Text Available Crotaline snakebites (Protobothrops mucrosquamatus and Trimeresurus stejnegeri are a common medical emergency in Taiwan that can be effectively treated by a bivalent F(ab'2 antivenom. We investigated the differences in the clinical outcomes of patients who received different therapeutic regimens of antivenom in a medical center where clinical toxicologists followed the poison control center (PCC guidelines (medical group and surgeons did not (surgical group. The medical records of inpatients with crotaline snakebites between 1991 and 2005 were reviewed and information on demographics, treatments, adverse effects of antivenom, and complications was abstracted and analyzed. A total of 179 patients (90 medical, 89 surgical were eligible for study. There was no significant intergroup difference in baseline characteristics except that the dose of antivenom and the probability of antibiotic use were both higher in the surgical group (5.9 ± 4.2 vials vs. 2.7 ± 1.6 vials; 93% vs. 60%. Multiple logistic regression adjusting for age, gender, calendar year of envenomation, severity of envenomation, and antibiotic use did not disclose evidence of any difference in various clinical outcomes between medical and surgical patients. The lower dose of antivenom recommended by the PCC may be as effective and safe as the higher dose used in the surgical group for the treatment of crotaline snakebites.

  15. Parallel factor ChIP provides essential internal control for quantitative differential ChIP-seq.

    Science.gov (United States)

    Guertin, Michael J; Cullen, Amy E; Markowetz, Florian; Holding, Andrew N

    2018-04-17

    A key challenge in quantitative ChIP combined with high-throughput sequencing (ChIP-seq) is the normalization of data in the presence of genome-wide changes in occupancy. Analysis-based normalization methods were developed for transcriptomic data and these are dependent on the underlying assumption that total transcription does not change between conditions. For genome-wide changes in transcription factor (TF) binding, these assumptions do not hold true. The challenges in normalization are confounded by experimental variability during sample preparation, processing and recovery. We present a novel normalization strategy utilizing an internal standard of unchanged peaks for reference. Our method can be readily applied to monitor genome-wide changes by ChIP-seq that are otherwise lost or misrepresented through analytical normalization. We compare our approach to normalization by total read depth and two alternative methods that utilize external experimental controls to study TF binding. We successfully resolve the key challenges in quantitative ChIP-seq analysis and demonstrate its application by monitoring the loss of Estrogen Receptor-alpha (ER) binding upon fulvestrant treatment, ER binding in response to estrodiol, ER mediated change in H4K12 acetylation and profiling ER binding in patient-derived xenographs. This is supported by an adaptable pipeline to normalize and quantify differential TF binding genome-wide and generate metrics for differential binding at individual sites.

  16. Analysis of methods of providing anonymity in facial photographs; a randomised controlled study.

    LENUS (Irish Health Repository)

    Clover, A J P

    2010-09-01

    Clinical images are invaluable in medical teaching and research publications. In the past efforts to conceal patient identity, if any, were limited to a black bar concealing the eyes. However, there is no consensus on this among major journals and publishing houses. This research analyses the effectiveness of blacking out the eyes in facial photographs and evaluates alternative techniques. 126 questionnaires were completed. The average numbers of correct responses out of 30 was 24.64 (82.13%) in the control group, 20.59 (68.63%) in the eyes, 20.42 (68.07%) in the eyes and nose group, and 17.53 (58.43%) in the T-shaped group (eyes, nose and mouth). The traditional method of covering the eyes does significantly decrease recognition, however it is only as effective as covering the nose and mouth. The more of the face that is covered the less likely it is that the person is recognised. However, there are people who remain identifiable no matter how much of the face is covered. This work highlights the importance of obtaining consent prior to publication as well as attempting to hide identity.

  17. Providing Home-Based HIV Testing and Counseling for Transgender Youth (Project Moxie): Protocol for a Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Stephenson, Rob; Metheny, Nicholas; Sharma, Akshay; Sullivan, Stephen; Riley, Erin

    2017-11-28

    Transgender and gender nonconforming people experience some of the highest human immunodeficiency virus (HIV) rates in the United States, and experience many structural and behavioral barriers that may limit their engagement in HIV testing, prevention, and care. Evidence suggests that transgender and gender nonconforming youth (TY) are especially vulnerable to acquiring HIV, yet there is little research on TY and few services are targeted towards HIV testing, prevention, and care for this population. Telehealth presents an opportunity to mitigate some structural barriers that TY experience in accessing HIV testing, allowing TY to engage in HIV testing and counseling in a safe and nonjudgmental space of their choosing. Project Moxie is an HIV prevention intervention that pairs the use of HIV self-testing with remote video-based counseling and support from a trained, gender-affirming counselor. This study aims to offer a more positive HIV testing and counseling experience, with the goal of improving HIV testing frequency. Project Moxie involves a pilot randomized controlled trial (RCT) of 200 TY aged 15-24 years, who are randomized on a 1:1 basis to control or intervention arms. The aim is to examine whether the addition of counseling provided via telehealth, coupled with home-based HIV testing, can create gains in routine HIV testing among TY over a six-month follow-up period. This study implements a prospective pilot RCT of 200 TY recruited online. Participants in the control arm will receive one HIV self-testing kit and will be asked to report their results via the study's website. Participants in the experimental arm will receive one HIV self-testing kit and will test with a remotely-located counselor during a prescheduled video-counseling session. Participants are assessed at baseline, and at three and six months posttesting. Project Moxie was launched in June 2017 and recruitment is ongoing. As of August 21, 2017, the study had enrolled 130 eligible

  18. Insights into controls on hexavalent chromium in groundwater provided by environmental tracers, Sacramento Valley, California, USA

    Science.gov (United States)

    Manning, Andrew H.; Mills, Christopher T.; Morrison, Jean M.; Ball, Lyndsay B.

    2015-01-01

    Environmental tracers are useful for determining groundwater age and recharge source, yet their application in studies of geogenic Cr(VI) in groundwater has been limited. Environmental tracer data from 166 wells located in the Sacramento Valley, northern California, were interpreted and compared to Cr concentrations to determine the origin and age of groundwater with elevated Cr(VI), and better understand where Cr(VI) becomes mobilized and how it evolves along flowpaths. In addition to major ion and trace element concentrations, the dataset includes δ18O, δ2H, 3H concentration, 14C activity (of dissolved inorganic C), δ13C, 3He/4He ratio, and noble gas concentrations (He, Ne, Ar, Kr, Xe). Noble gas recharge temperatures (NGTs) were computed, and age-related tracers were interpreted in combination to constrain the age distribution in samples and sort them into six different age categories spanning from 10,000 yr old. Nearly all measured Cr is in the form of Cr(IV). Concentrations range from 3 mg L−1), and commonly have δ18O values enriched relative to local precipitation. These samples likely contain irrigation water and are elevated due to accelerated mobilization of Cr(VI) in the unsaturated zone (UZ) in irrigated areas. Group 2 samples are from throughout the valley and typically contain water 1000–10,000 yr old, have δ18O values consistent with local precipitation, and have unexpectedly warm NGTs. Chromium(VI) concentrations in Group 2 samples may be elevated for multiple reasons, but the hypothesis most consistent with all available data (notably, the warm NGTs) is a relatively long UZ residence time due to recharge through a deep UZ near the margin of the basin. A possible explanation for why Cr(VI) may be primarily mobilized in the UZ rather than farther along flowpaths in the oxic portion of the saturated zone is more dynamic cycling of Mn in the UZ due to transient moisture and redox conditions.

  19. Effectiveness of Provider and Community Interventions to Improve Treatment of Uncomplicated Malaria in Nigeria: A Cluster Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Obinna Onwujekwe

    Full Text Available The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT. Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs with basic instruction (control; RDTs with provider training (provider arm; and RDTs with provider training plus a school-based community intervention (provider-school arm. The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93% of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36: stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26 in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19 in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47. Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines.ClinicalTrials.gov NCT01350752.

  20. Control of radiation fields in BWRs after noble metal chemical addition

    Energy Technology Data Exchange (ETDEWEB)

    Cowan, R.L.; Wood, C.J. [EPRI, Palo Alto, CA (United States)

    2002-07-01

    Hydrogen water chemistry (HWC) was developed to mitigate the intergranular stress corrosion cracking (IGSCC) that can occur in the welded piping and internal components of boiling water reactors (BWRs). HWC is practiced by adding hydrogen gas to the feedwater to reduce the electrochemical corrosion potential (ECP) of the component to be protected to below -0.230 V(SHE). Unfortunately, only a few BWR owners implemented HWC for internals component IGSCC protection because of the factor of 4 to 5 increase in operating dose rates that accompanies its use. Noble metal chemical addition (NMCA) was developed to address this shortcoming. NMCA is a process in which Pt and Rh chemicals are added to a shutdown Boiling Water Reactor while the reactor water temperature is maintained in the range of 120 C to 150 C for 48 hours. During that time, a target concentration of Pt and Rh is maintained in the reactor water. At the end of the 48 hour period the plant then either goes back to power or enters into a refueling outage. The end result of the NMCA process is a uniform deposit of Pt and Rh metal at very low concentrations, on the order of 0.5 to 1.0 mg/cm{sup 2}, on the reactor wetted surfaces. During subsequent operation, when a small amount of hydrogen is added to the feedwater (less than 0.4 ppm), very low ECPs will be developed on the wetted catalytic surfaces, on the order of -0.500 V(SHE), and intergranular stress corrosion cracking (IGSCC) of components will be mitigated. Since NMCA with hydrogen changes the surface chemistry and not the bulk chemistry, there is little or no increase in operating dose rate. See References 1 through 5 for a more complete discussion of HWC and NMCA fundamentals. To date, 26 BWRs worldwide have applied NMCA. As operating plants have completed their first full operating cycle after NMCA application, it has become apparent that NMCA can have a significant impact on shutdown dose rates, as can be seen in Table 1. (The shut down dose rates

  1. Single-Amino Acid Modifications Reveal Additional Controls on the Proton Pathway of [FeFe]-Hydrogenase

    Energy Technology Data Exchange (ETDEWEB)

    Cornish, Adam J.; Ginovska, Bojana; Thelen, Adam; da Silva, Julio C. S.; Soares, Thereza A.; Raugei, Simone; Dupuis, Michel; Shaw, Wendy J.; Hegg, Eric L.

    2016-06-07

    The proton pathway of [FeFe]-hydrogenase is essential for enzymatic H2 production and oxidation and is composed of four residues and a modeled water molecule. Recently, a computational analysis of this pathway revealed that the solvent-exposed residue of the pathway (Glu282) could form hydrogen bonds to two residues outside of the pathway (Arg286 and Ser320), implicating that these residues could function in regulating proton transfer. Substituting Arg286 with leucine eliminates hydrogen bonding with Glu282 and results in a 2.5-fold enhancement in H2 production activity, suggesting that Arg286 serves an important role in controlling the rate of proton delivery. In contrast, substitution of Ser320 with alanine reduces the rate approximately 5-fold, implying that it either acts as a member of the pathway or influences Glu282 to enable proton transfer. Interestingly, QM/MM and molecular dynamics calculations indicate that Ser320 does not play an electronic or structural role. QM calculations also estimate that including Ser320 in the pathway does not significantly change the barrier to proton movement, providing further support for its role as a member of the proton pathway. While further studies are needed to quantify the role of Ser320, collectively, these data provide evidence that the enzyme scaffold plays a significant role in modulating the activity of the enzyme, demonstrating that the rate of intraprotein proton transfer can be accelerated, particularly in a non-biological context. This work was supported by the DOE Great Lakes Bioenergy Research Center (DOE BER Office of Science, DE-FC02-07ER64494). In addition, support from the DOE Office of Science Early Career Research Program through the Office of Basic Energy Sciences (WJS, BGP, SR) is gratefully acknowledged. Computational resources were provided at W. R. Wiley Environmental Molecular Science Laboratory (EMSL), a national scientific user facility sponsored by the Department of Energy’s Office of

  2. Internal audit: the expert in providing comfort to the audit committee. The case of risk management and internal control

    OpenAIRE

    G. SARENS; I. DE BEELDE

    2006-01-01

    This study investigates to what extent audit committees feel uncomfortable about risk management and internal control, and focuses on how internal audit can be the expert in providing comfort in these areas, building upon the sociology of professions literature. Four case studies reveal that audit committees need comfort with respect to the control environment. Thanks to their internal position, their familiarity with the company, and their position close to people across the company, interna...

  3. Effect of food additives on hyperphosphatemia among patients with end-stage renal disease: a randomized controlled trial.

    Science.gov (United States)

    Sullivan, Catherine; Sayre, Srilekha S; Leon, Janeen B; Machekano, Rhoderick; Love, Thomas E; Porter, David; Marbury, Marquisha; Sehgal, Ashwini R

    2009-02-11

    High dietary phosphorus intake has deleterious consequences for renal patients and is possibly harmful for the general public as well. To prevent hyperphosphatemia, patients with end-stage renal disease limit their intake of foods that are naturally high in phosphorus. However, phosphorus-containing additives are increasingly being added to processed and fast foods. The effect of such additives on serum phosphorus levels is unclear. To determine the effect of limiting the intake of phosphorus-containing food additives on serum phosphorus levels among patients with end-stage renal disease. Cluster randomized controlled trial at 14 long-term hemodialysis facilities in northeast Ohio. Two hundred seventy-nine patients with elevated baseline serum phosphorus levels (>5.5 mg/dL) were recruited between May and October 2007. Two shifts at each of 12 large facilities and 1 shift at each of 2 small facilities were randomly assigned to an intervention or control group. Intervention participants (n=145) received education on avoiding foods with phosphorus additives when purchasing groceries or visiting fast food restaurants. Control participants (n=134) continued to receive usual care. Change in serum phosphorus level after 3 months. At baseline, there was no significant difference in serum phosphorus levels between the 2 groups. After 3 months, the decline in serum phosphorus levels was 0.6 mg/dL larger among intervention vs control participants (95% confidence interval, -1.0 to -0.1 mg/dL). Intervention participants also had statistically significant increases in reading ingredient lists (Pfood knowledge scores (P = .13). Educating end-stage renal disease patients to avoid phosphorus-containing food additives resulted in modest improvements in hyperphosphatemia. clinicaltrials.gov Identifier: NCT00583570.

  4. Analysis and Design of a Maglev Permanent Magnet Synchronous Linear Motor to Reduce Additional Torque in dq Current Control

    Directory of Open Access Journals (Sweden)

    Feng Xing

    2018-03-01

    Full Text Available The maglev linear motor has three degrees of motion freedom, which are respectively realized by the thrust force in the x-axis, the levitation force in the z-axis and the torque around the y-axis. Both the thrust force and levitation force can be seen as the sum of the forces on the three windings. The resultant thrust force and resultant levitation force are independently controlled by d-axis current and q-axis current respectively. Thus, the commonly used dq transformation control strategy is suitable for realizing the control of the resultant force, either thrust force and levitation force. However, the forces on the three windings also generate additional torque because they do not pass the mover mass center. To realize the maglev system high-precision control, a maglev linear motor with a new structure is proposed in this paper to decrease this torque. First, the electromagnetic model of the motor can be deduced through the Lorenz force formula. Second, the analytic method and finite element method are used to explore the reason of this additional torque and what factors affect its change trend. Furthermore, a maglev linear motor with a new structure is proposed, with two sets of 90 degrees shifted winding designed on the mover. Under such a structure, the mover position dependent periodic part of the additional torque can be offset. Finally, the theoretical analysis is validated by the simulation result that the additionally generated rotating torque can be offset with little fluctuation in the proposed new-structure maglev linear motor. Moreover, the control system is built in MATLAB/Simulink, which shows that it has small thrust ripple and high-precision performance.

  5. Detection of stanozolol O- and N-sulfate metabolites and their evaluation as additional markers in doping control.

    Science.gov (United States)

    Balcells, Georgina; Matabosch, Xavier; Ventura, Rosa

    2017-07-01

    Stanozolol (STAN) is one of the most frequently detected anabolic androgenic steroids in sports drug testing. STAN misuse is commonly detected by monitoring metabolites excreted conjugated with glucuronic acid after enzymatic hydrolysis or using direct detection by liquid chromatography-tandem mass spectrometry (LC-MS/MS). It is well known that some of the previously described metabolites are the result of the formation of sulfate conjugates in C17, which are converted to their 17-epimers in urine. Therefore, sulfation is an important phase II metabolic pathway of STAN that has not been comprehensively studied. The aim of this work was to evaluate the sulfate fraction of STAN metabolism by LC-MS/MS to establish potential long-term metabolites valuable for doping control purposes. STAN was administered to six healthy male volunteers involving oral or intramuscular administration and urine samples were collected up to 31 days after administration. Sulfation of the phase I metabolites commercially available as standards was performed in order to obtain MS data useful to develop analytical strategies (neutral loss scan, precursor ion scan and selected reaction monitoring acquisitions modes) to detect potential sulfate metabolites. Eleven sulfate metabolites (M-I to M-XI) were detected and characterized by LC-MS/MS. This paper provides valuable data on the ionization and fragmentation of O-sulfates and N-sulfates. For STAN, results showed that sulfates do not improve the retrospectivity of the detection compared to the previously described long-term metabolite (epistanozolol-N-glucuronide). However, sulfate metabolites could be additional markers for the detection of STAN misuse. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Pattern formation and control of spatiotemporal chaos in a reaction diffusion prey–predator system supplying additional food

    International Nuclear Information System (INIS)

    Ghorai, Santu; Poria, Swarup

    2016-01-01

    Spatiotemporal dynamics of a predator–prey system in presence of spatial diffusion is investigated in presence of additional food exists for predators. Conditions for stability of Hopf as well as Turing patterns in a spatial domain are determined by making use of the linear stability analysis. Impact of additional food is clear from these conditions. Numerical simulation results are presented in order to validate the analytical findings. Finally numerical simulations are carried out around the steady state under zero flux boundary conditions. With the help of numerical simulations, the different types of spatial patterns (including stationary spatial pattern, oscillatory pattern, and spatiotemporal chaos) are identified in this diffusive predator–prey system in presence of additional food, depending on the quantity, quality of the additional food and the spatial domain and other parameters of the model. The key observation is that spatiotemporal chaos can be controlled supplying suitable additional food to predator. These investigations may be useful to understand complex spatiotemporal dynamics of population dynamical models in presence of additional food.

  7. Evaluation of the Addition of Wood Ash to Control the pH of Substrates in Municipal Biowaste Composting

    Directory of Open Access Journals (Sweden)

    Oviedo-Ocaña Edgar Ricardo

    2014-07-01

    Full Text Available This study evaluates the addition of wood ashes (WA for controlling the pH of substrates in municipal biowaste (MBW composting. Three combinations in wet weight percent (w/w of MBW and WA were tested: i BC1: 2% WA and 98% MBW; ii BC2: 4% WA and 96% MBW; and iii BC3: 8% WA and 92% MBW. Each combination was compared with a control (100% MBW called B1, B2 and B3 respectively. The experiment was conducted to pilot scale, with piles of 510 kg. The results indicate that the addition of WA improved the pH level and nutrients for the composting process; however, it had not substantial benefit in the process (start of the thermophilic phase and the behavior of the substrate degradation rate. Furthermore, a higher presence of salts and phytotoxic compounds in the product was observed. This could limit the product use for agricultural activities.

  8. Controllable Microdroplet Splitting via Additional Lateral Flow and its Application in Rapid Synthesis of Multi-scale Microspheres

    KAUST Repository

    Zhou, Bingpu

    2015-01-01

    In this paper, we demonstrate that controllable microdroplet splitting could be obtained via additional lateral flow with simplicity and high controllability. The volume ratio of the two splitting products can be flexibly regulated by adjusting the flow rate ratio between the main and additional lateral flows. The splitting phenomena under different main flow rates were investigated. A volume ratio up to 200 : 1 of the two daughter droplets under a relatively higher main flow rate was experimentally achieved based on our approach. In this case, we have successfully achieved uniform daughter droplets with a smallest diameter of ∼19.5 ± 1.6 μm. With such a design, we have synthesized uniform PEGDA hydrogel microspheres with diameters ranging from ∼30 μm to over hundred of micrometers simultaneously.

  9. A power comparison of generalized additive models and the spatial scan statistic in a case-control setting

    Directory of Open Access Journals (Sweden)

    Ozonoff Al

    2010-07-01

    Full Text Available Abstract Background A common, important problem in spatial epidemiology is measuring and identifying variation in disease risk across a study region. In application of statistical methods, the problem has two parts. First, spatial variation in risk must be detected across the study region and, second, areas of increased or decreased risk must be correctly identified. The location of such areas may give clues to environmental sources of exposure and disease etiology. One statistical method applicable in spatial epidemiologic settings is a generalized additive model (GAM which can be applied with a bivariate LOESS smoother to account for geographic location as a possible predictor of disease status. A natural hypothesis when applying this method is whether residential location of subjects is associated with the outcome, i.e. is the smoothing term necessary? Permutation tests are a reasonable hypothesis testing method and provide adequate power under a simple alternative hypothesis. These tests have yet to be compared to other spatial statistics. Results This research uses simulated point data generated under three alternative hypotheses to evaluate the properties of the permutation methods and compare them to the popular spatial scan statistic in a case-control setting. Case 1 was a single circular cluster centered in a circular study region. The spatial scan statistic had the highest power though the GAM method estimates did not fall far behind. Case 2 was a single point source located at the center of a circular cluster and Case 3 was a line source at the center of the horizontal axis of a square study region. Each had linearly decreasing logodds with distance from the point. The GAM methods outperformed the scan statistic in Cases 2 and 3. Comparing sensitivity, measured as the proportion of the exposure source correctly identified as high or low risk, the GAM methods outperformed the scan statistic in all three Cases. Conclusions The GAM

  10. A power comparison of generalized additive models and the spatial scan statistic in a case-control setting.

    Science.gov (United States)

    Young, Robin L; Weinberg, Janice; Vieira, Verónica; Ozonoff, Al; Webster, Thomas F

    2010-07-19

    A common, important problem in spatial epidemiology is measuring and identifying variation in disease risk across a study region. In application of statistical methods, the problem has two parts. First, spatial variation in risk must be detected across the study region and, second, areas of increased or decreased risk must be correctly identified. The location of such areas may give clues to environmental sources of exposure and disease etiology. One statistical method applicable in spatial epidemiologic settings is a generalized additive model (GAM) which can be applied with a bivariate LOESS smoother to account for geographic location as a possible predictor of disease status. A natural hypothesis when applying this method is whether residential location of subjects is associated with the outcome, i.e. is the smoothing term necessary? Permutation tests are a reasonable hypothesis testing method and provide adequate power under a simple alternative hypothesis. These tests have yet to be compared to other spatial statistics. This research uses simulated point data generated under three alternative hypotheses to evaluate the properties of the permutation methods and compare them to the popular spatial scan statistic in a case-control setting. Case 1 was a single circular cluster centered in a circular study region. The spatial scan statistic had the highest power though the GAM method estimates did not fall far behind. Case 2 was a single point source located at the center of a circular cluster and Case 3 was a line source at the center of the horizontal axis of a square study region. Each had linearly decreasing logodds with distance from the point. The GAM methods outperformed the scan statistic in Cases 2 and 3. Comparing sensitivity, measured as the proportion of the exposure source correctly identified as high or low risk, the GAM methods outperformed the scan statistic in all three Cases. The GAM permutation testing methods provide a regression

  11. The effect of solvents and hydrophilic additive on stable coating and controllable sirolimus release system for drug-eluting stent.

    Science.gov (United States)

    Kim, Seong Min; Park, Sung-Bin; Bedair, Tarek M; Kim, Man-Ho; Park, Bang Ju; Joung, Yoon Ki; Han, Dong Keun

    2017-09-01

    Various drug-eluting stents (DESs) have been developed to prevent restenosis after stent implantation. However, DES still needs to improve the drug-in-polymer coating stability and control of drug release for effective clinical treatment. In this study, the cobalt-chromium (CoCr) alloy surface was coated with biodegradable poly(D,L-lactide) (PDLLA) and sirolimus (SRL) mixed with hydrophilic Pluronic F127 additive by using ultrasonic spray coating system in order to achieve a stable coating surface and control SRL release. The degradation of PDLLA/SRL coating was studied under physiological solution. It was found that adding F127 reduced the degradation of PDLLA and improved the coating stability during 60days. The effects of organic solvent such as chloroform and tetrahydrofuran (THF) on the coating uniformity were also examined. It was revealed that THF produced a very smooth and uniform coating compared to chloroform. The patterns of in vitro drug release according to the type of organic solvent and hydrophilic additive proposed the possibility of controllable drug release design in DES. It was found that using F127 the drug release was sustained regardless of the organic solvent used. In addition, THF was able to get faster and controlled release profile when compared to chloroform. The structure of SRL molecules in different organic solvents was investigated using ultra-small angle neutron scattering. Furthermore, the structure of SRL is concentration-dependent in chloroform with tight nature under high concentration, but concentration-independent in THF. These results strongly demonstrated that coating stability and drug release patterns can be changed by physicochemical properties of various parameters such as organic solvents, additive, and coating strategy. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Use of cation selective membrane and acid addition for PH control in two-dimensional electrokinetic remediation of copper

    Energy Technology Data Exchange (ETDEWEB)

    Chan, M.S.M.; Lynch, R.J. [Cambridge Univ., Engineering Dept. (United Kingdom); Ilett, D.J. [AEA Technology, Harwell, Oxfordshire (United Kingdom)

    2001-07-01

    The feasibility of using a combination of a cation selective membrane and acid addition for pH control in electrokinetic remediation to toxic and heavy metals from low-permeability soil has been investigated. The high pH generated during the remediation process, as a result of surplus OH{sup -} ions, may cause metal ions to precipitate as hydroxides at or near the cathodes. This region of high pH is known to be associated with high electrical resistance, which limits the remediation efficiency by inhibiting current flow through the soil. One way to control pH is by adding acid to neutralize the OH{sup -} ions. However, preliminary work showed that addition of acid to the cathodic region was not effective in preventing the spread of the alkaline zone from cathodes toward anodes. Precipitates were formed before metal ions reached the cathodic region. Therefore, another method of pH control was investigated, using a cation selective membrane to enhance the electrokinetic process. The membrane was placed in front of the cathodes to contain the OH{sup -} ions generated, and confine the precipitates of metal hydroxide to a small cathodic region. The clean-up of a contaminated site was modelled in a rectangular tank, using silt as the low permeability soul and copper to simulate the contamination. The objective was to redistribute the contaminant so as to concentrate it into a small area. Three experiments were performed with the following methods of pH control: (1) acid addition, (2) use of a cation selective membrane and (3) a combination of acid addition and a cation selective membrane. Using the combined approach, it was found that 75% of the target clean-up section (bounded by the cation selective membrane and the anodes) had more than 40% of the initial copper removed. The general efficiency of remediation increased in the following order. (orig.)

  13. Spatially Controlled Delivery of siRNAs to Stem Cells in Implants Generated by Multi-Component Additive Manufacturing

    DEFF Research Database (Denmark)

    Andersen, Morten Østergaard; Le, Dang Quang Svend; Chen, Muwan

    2013-01-01

    Additive manufacturing is a promising technique in tissue engineering, as it enables truly individualized implants to be made to fit a particular defect. As previously shown, a feasible strategy to produce complex multicellular tissues is to deposit different small interfering RNA (siRNA) in porous...... implants that are subsequently sutured together. In this study, an additive manufacturing strategy to deposit carbohydrate hydrogels containing different siRNAs is applied into an implant, in a spatially controlled manner. When the obtained structures are seeded with mesenchymal stem (stromal) cells......, the selected siRNAs are delivered to the cells and induces specific and localized gene silencing. Here, it is demonstrated how to replicate part of a patient's spinal cord from a computed tomography scan, using an additive manufacturing technique to produce an implant with compartmentalized si...

  14. Final Report of the National Black Health Providers Task Force on High Blood Pressure Education and Control.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD.

    This is the final report of National Black Health Providers Task Force (NBHPTF) on High Blood Pressure Education and Control. The first chapter of the report recounts the history of the NBHPTF and its objectives. In the second chapter epidemiological evidence is presented to demonstrate the need for a suggested 20 year plan aimed at controlling…

  15. Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial

    NARCIS (Netherlands)

    Vlemmix, Floortje; Rosman, Ageeth N.; Rijnders, Marlies E.; Beuckens, Antje; Opmeer, Brent C.; Mol, Ben W. J.; Kok, Marjolein; Fleuren, Margot A. H.

    2015-01-01

    To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Cluster randomized controlled trial. Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands. Singleton breech

  16. Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial

    NARCIS (Netherlands)

    Vlemmix, F.; Rosman, A.N.; Rijnders, M.E.; Beuckens, A.; Opmeer, B.C.; Mol, B.W.J.; Kok, M.; Fleuren, M.A.H.

    2015-01-01

    Onjective: To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Design: Cluster randomized controlled trial.Setting: Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the

  17. "Great Job Cleaning Your Plate Today!" Determinants of Child-Care Providers' Use of Controlling Feeding Practices: An Exploratory Examination.

    Science.gov (United States)

    Dev, Dipti A; McBride, Brent A; Speirs, Katherine E; Blitch, Kimberly A; Williams, Natalie A

    2016-11-01

    National early childhood obesity prevention policies recommend that child-care providers avoid controlling feeding practices (CFP) (eg, pressure-to-eat, food as reward, and praising children for cleaning their plates) with children to prevent unhealthy child eating behaviors and childhood obesity. However, evidence suggests that providers frequently use CFP during mealtimes. Using the Academy of Nutrition and Dietetics (2011) benchmarks for nutrition in child care as a framework, researchers assessed child-care providers' perspectives regarding their use of mealtime CFP with young children (aged 2 to 5 years). Using a qualitative design, individual, face-to-face, semi-structured interviews were conducted with providers until saturation was reached. Providers were selected using maximum variation purposive sampling from varying child-care contexts (Head Start, Child and Adult Care Food Program [CACFP]-funded centers, non-CACFP programs). All providers were employed full-time in Head Start or state-licensed center-based child-care programs, cared for children (aged 2 to 5 years), and were directly responsible for serving meals and snacks. Child-care providers' perspectives regarding CFP. Thematic analysis using NVivo (version 9, 2010, QSR International Pty Ltd) to derive themes. Providers' perspectives showed barriers, motivators, and facilitators regarding their use of mealtime CFP. Providers reported barriers to avoiding CFP such as CFP were effective for encouraging desired behaviors, misconceptions that providers were encouraging but not controlling children's eating, and fear of parents' negative reaction if their child did not eat. Providers who did not practice CFP were motivated to avoid CFP because they were unnecessary for encouraging children to eat, and they resulted in negative child outcomes and obesity. Facilitators as an alternative to CFP included practicing healthful feeding practices such as role modeling, peer modeling, and sensory exploration of

  18. Shape-control by microwave-assisted hydrothermal method for the synthesis of magnetite nanoparticles using organic additives

    Energy Technology Data Exchange (ETDEWEB)

    Rizzuti, Antonino [Politecnico di Bari, Dipartimento di Ingegneria Civile, Ambientale, del Territorio, Edile e di Chimica (Italy); Dassisti, Michele [Politecnico di Bari, Dipartimento di Meccanica, Management e Matematica (Italy); Mastrorilli, Piero, E-mail: p.mastrorilli@poliba.it [Politecnico di Bari, Dipartimento di Ingegneria Civile, Ambientale, del Territorio, Edile e di Chimica (Italy); Sportelli, Maria C.; Cioffi, Nicola; Picca, Rosaria A. [Università di Bari, Dipartimento di Chimica (Italy); Agostinelli, Elisabetta; Varvaro, Gaspare [Consiglio Nazionale delle Ricerche, Istituto di Struttura della Materia (Italy); Caliandro, Rocco [Consiglio Nazionale delle Ricerche, Istituto di Cristallografia (Italy)

    2015-10-15

    A simple and fast microwave-assisted hydrothermal method is proposed for the synthesis of magnetite nanoparticles. The addition of different surfactants (polyvinylpyrrolidone, oleic acid, or trisodium citrate) was studied to investigate the effect on size distribution, morphology, and functionalization of the magnetite nanoparticles. Microwave irradiation at 150 °C for 2 h of aqueous ferrous chloride and hydrazine without additives resulted in hexagonal magnetite nanoplatelets with a facet-to-facet distance of 116 nm and a thickness of 40 nm having a saturation magnetization of ∼65 Am{sup 2} kg{sup −1}. The use of polyvinylpyrrolidone led to hexagonal nanoparticles with a facet-to-facet distance of 120 nm and a thickness of 53 nm with a saturation magnetization of ∼54 Am{sup 2} kg{sup −1}. Additives such as oleic acid and trisodium citrate yielded quasi-spherical nanoparticles of 25 nm in size with a saturation magnetization of ∼70 Am{sup 2} kg{sup −1} and spheroidal nanoparticles of 60 nm in size with a saturation magnetization up to ∼82 Am{sup 2} kg{sup −1}, respectively. A kinetic control of the crystal growth is believed to be responsible for the hexagonal habit of the nanoparticles obtained without additive. Conversely, a thermodynamic control of the crystal growth, leading to spheroidal nanoparticles, seems to occur when additives which strongly interact with the nanoparticle surface are used. A thorough characterization of the materials was performed. Magnetic properties were investigated by Superconducting Quantum Interference Device and Vibrating Sample magnetometers. Based on the observed magnetic properties, the magnetite obtained using citrate appears to be a promising support for magnetically transportable catalysts.

  19. Funnel plot control limits to identify poorly performing healthcare providers when there is uncertainty in the value of the benchmark.

    Science.gov (United States)

    Manktelow, Bradley N; Seaton, Sarah E; Evans, T Alun

    2016-12-01

    There is an increasing use of statistical methods, such as funnel plots, to identify poorly performing healthcare providers. Funnel plots comprise the construction of control limits around a benchmark and providers with outcomes falling outside the limits are investigated as potential outliers. The benchmark is usually estimated from observed data but uncertainty in this estimate is usually ignored when constructing control limits. In this paper, the use of funnel plots in the presence of uncertainty in the value of the benchmark is reviewed for outcomes from a Binomial distribution. Two methods to derive the control limits are shown: (i) prediction intervals; (ii) tolerance intervals Tolerance intervals formally include the uncertainty in the value of the benchmark while prediction intervals do not. The probability properties of 95% control limits derived using each method were investigated through hypothesised scenarios. Neither prediction intervals nor tolerance intervals produce funnel plot control limits that satisfy the nominal probability characteristics when there is uncertainty in the value of the benchmark. This is not necessarily to say that funnel plots have no role to play in healthcare, but that without the development of intervals satisfying the nominal probability characteristics they must be interpreted with care. © The Author(s) 2014.

  20. Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial.

    Science.gov (United States)

    Amemori, Masamitsu; Korhonen, Tellervo; Kinnunen, Taru; Michie, Susan; Murtomaa, Heikki

    2011-02-14

    Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on

  1. Non-Model-Based Control of a Wheeled Vehicle Pulling Two Trailers to Provide Early Powered Mobility and Driving Experiences.

    Science.gov (United States)

    Sanders Td Vr, David A

    2018-01-01

    Non-model-based control of a wheeled vehicle pulling two trailers is proposed. It is a fun train for disabled children consisting of a locomotive and two carriages. The fun train has afforded opportunities for both disabled and able bodied young people to share an activity and has provided early driving experiences for disabled children; it has introduced them to assistive and powered mobility. The train is a nonlinear system and subject to nonholonomic kinematic constraints, so that position and state depend on the path taken to get there. The train is described, and then, a robust control algorithm using proportional-derivative filtered errors is proposed to control the locomotive. The controller was not dependent on an accurate model of the train, because the mass of the vehicle and two carriages changed depending on the number, size, and shape of children and wheelchair seats on the train. The controller was robust and stable in uncertainty. Results are presented to show the effectiveness of the approach, and the suggested control algorithm is shown to be acceptable without knowing the exact plant dynamics.

  2. The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial.

    Science.gov (United States)

    Moustafa, Ibrahim M; Diab, Aliaa A

    2015-07-01

    The aim of this study was to investigate the immediate and long-term effects of a one-year multimodal program, with the addition of upper cervical manipulative therapy, on fibromyalgia management outcomes in addition to three-dimensional (3D) postural measures. This randomized clinical trial with one-year follow-up was completed at the research laboratory of our university. A total of 120 (52 female) patients with fibromyalgia syndrome (FMS) and definite C1-2 joint dysfunction were randomly assigned to the control or an experimental group. Both groups received a multimodal program; additionally, the experimental group received upper cervical manipulative therapy. Primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), whereas secondary outcomes included Pain Catastrophizing Scale (PCS), algometric score, Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and 3D postural measures. Measures were assessed at three time intervals: baseline, 12 weeks, and 1 year after the 12-week follow-up. The general linear model with repeated measures indicated a significant group × time effect in favor of the experimental group on the measures of 3D postural parameters (P < .0005), FIQ (P < .0005), PCS (P < .0005), algometric score (F = P < .0005), PSQI (P < .0005), BAI (P < .0005), and BDI (P < .0005). The addition of the upper cervical manipulative therapy to a multimodal program is beneficial in treating patients with FMS.

  3. Research on Mechanisms and Controlling Methods of Macro Defects in TC4 Alloy Fabricated by Wire Additive Manufacturing.

    Science.gov (United States)

    Ji, Lei; Lu, Jiping; Tang, Shuiyuan; Wu, Qianru; Wang, Jiachen; Ma, Shuyuan; Fan, Hongli; Liu, Changmeng

    2018-06-28

    Wire feeding additive manufacturing (WFAM) has broad application prospects because of its advantages of low cost and high efficiency. However, with the mode of lateral wire feeding, including wire and laser additive manufacturing, gas tungsten arc additive manufacturing etc., it is easy to generate macro defects on the surface of the components because of the anisotropy of melted wire, which limits the promotion and application of WFAM. In this work, gas tungsten arc additive manufacturing with lateral wire feeding is proposed to investigate the mechanisms of macro defects. The results illustrate that the defect forms mainly include side spatters, collapse, poor flatness, and unmelted wire. It was found that the heat input, layer thickness, tool path, and wire curvature can have an impact on the macro defects. Side spatters are the most serious defects, mainly because the droplets cannot be transferred to the center of the molten pool in the lateral wire feeding mode. This research indicates that the macro defects can be controlled by optimizing the process parameters. Finally, block parts without macro defects were fabricated, which is meaningful for the further application of WFAM.

  4. Selection for increased desiccation resistance in Drosophila melanogaster: Additive genetic control and correlated responses for other stresses

    International Nuclear Information System (INIS)

    Hoffmann, A.A.; Parsons, P.A.

    1989-01-01

    Previously we found that Drosophila melanogaster lines selected for increased desiccation resistance have lowered metabolic rate and behavioral activity levels, and show correlated responses for resistance to starvation and a toxic ethanol level. These results were consistent with a prediction that increased resistance to many environmental stresses may be genetically correlated because of a reduction in metabolic energy expenditure. Here we present experiments on the genetic basis of the selection response and extend the study of correlated responses to other stresses. The response to selection was not sex-specific and involved X-linked and autosomal genes acting additively. Activity differences contributed little to differences in desiccation resistance between selected and control lines. Selected lines had lower metabolic rates than controls in darkness when activity was inhibited. Adults from selected lines showed increased resistance to a heat shock, 60 Co-gamma-radiation, and acute ethanol and acetic acid stress. The desiccation, ethanol and starvation resistance of isofemale lines set up from the F2s of a cross between one of the selected and one of the control lines were correlated. Selected and control lines did not differ in ether-extractable lipid content or in resistance to acetone, ether or a cold shock

  5. Chloride ion addition for controlling shapes and properties of silver nanorods capped by polyvinyl alcohol synthesized using polyol method

    Energy Technology Data Exchange (ETDEWEB)

    Junaidi, E-mail: junaidi.1982@fmipa.unila.ac.id [Department of Physics, Universitas Gadjah Mada, Yogyakarta, 55281 (Indonesia); Department of Physics, Lampung University, Bandar Lampung (Indonesia); Yunus, Muhammad, E-mail: muhammad.yunus@mail.ugm.ac.id [Department of Physics, Universitas Gadjah Mada, Yogyakarta, 55281 (Indonesia); Triyana, Kuwat, E-mail: triyana@ugm.ac.id; Harsojo,, E-mail: harsojougm@ugm.ac.id; Suharyadi, Edi, E-mail: esuharyadi@ugm.ac.id [Department of Physics, Universitas Gadjah Mada, Yogyakarta, 55281 (Indonesia); Nanomaterials Research Group, Universitas Gadjah Mada, Yogyakarta, 55281 (Indonesia)

    2016-04-19

    We report our investigation on the effect of chloride ions on controlling the shapes and properties of silver nanorods (AgNRs) synthesized using a polyol method. In this study, we used polyvinyl alcohol (PVA) as a capping agent and sodium chloride (NaCl) as a salt precursor and performed at the oil bath temperature of 140°C. The chloride ions originating from the NaCl serve to control the growth of the silver nanorods. Furthermore, the synthesized silver nanorods were characterized using SEM and XRD. The results showed that besides being able to control the growth of AgCl atoms, the chloride ions were also able to control the growth of multi-twinned-particles into the single crystalline of silver nanorods by micrometer-length. At an appropriate concentration of NaCl, the diameter of silver nanorods decreased significantly compared to that of without chloride ion addition. This technique may be useful since a particular diameter of silver nanorods affects a particular application in the future.

  6. Chloride ion addition for controlling shapes and properties of silver nanorods capped by polyvinyl alcohol synthesized using polyol method

    International Nuclear Information System (INIS)

    Junaidi; Yunus, Muhammad; Triyana, Kuwat; Harsojo,; Suharyadi, Edi

    2016-01-01

    We report our investigation on the effect of chloride ions on controlling the shapes and properties of silver nanorods (AgNRs) synthesized using a polyol method. In this study, we used polyvinyl alcohol (PVA) as a capping agent and sodium chloride (NaCl) as a salt precursor and performed at the oil bath temperature of 140°C. The chloride ions originating from the NaCl serve to control the growth of the silver nanorods. Furthermore, the synthesized silver nanorods were characterized using SEM and XRD. The results showed that besides being able to control the growth of AgCl atoms, the chloride ions were also able to control the growth of multi-twinned-particles into the single crystalline of silver nanorods by micrometer-length. At an appropriate concentration of NaCl, the diameter of silver nanorods decreased significantly compared to that of without chloride ion addition. This technique may be useful since a particular diameter of silver nanorods affects a particular application in the future.

  7. Lack of patient risk counselling and a broader provider training affect malaria control in remote Somalia Kenya border: Qualitative assessment.

    Science.gov (United States)

    Asgary, Ramin; Grigoryan, Zoya; Naderi, Ramesh; Allan, Richard

    2012-01-01

    Effectiveness of providing health education solely via mass media and the providers' targeted training in malaria control needs further exploration. During pre-epidemic season, we conducted a qualitative study of 40 providers and community leaders using focus groups, comprehensive semi-structured interviews and consultation observations. Interviews were transcribed, coded and analysed for major themes. Community leaders believe that they can acquire malaria from contaminated water, animal products, air or garbage. Consequently, they under-utilise bed nets and other protective measures due to perceived continued exposure to other potential malaria sources. Practitioners do not provide individualised health counselling and risk assessment to patients during sick visits, leading to a range of misconceptions about malaria based on limited knowledge from rumours and mass media, and a strong belief in the curative power of traditional medicine. Providers overdiagnose malaria clinically and underutilise available tests due to time constraints, and the lack of training and resources to correctly diagnose other illnesses. Subsequently, misdiagnoses lead them to question the efficacy of recommended treatments. Promoting counselling during clinical encounters to address patient misconception and change risky behaviour is warranted. Wider-ranging ongoing training could enable providers to properly diagnose and manage differential diagnoses to manage malaria better.

  8. Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques.

    Science.gov (United States)

    Chien, Tsair-Wei; Chou, Ming-Ting; Wang, Wen-Chung; Tsai, Li-Shu; Lin, Weir-Sen

    2012-05-15

    Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan's year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. ICCs were generated for Taiwan's year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. We recommend using the ICC to annually assess a nation's year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

  9. Designing a system for patients controlling providers' access to their electronic health records: organizational and technical challenges.

    Science.gov (United States)

    Leventhal, Jeremy C; Cummins, Jonathan A; Schwartz, Peter H; Martin, Douglas K; Tierney, William M

    2015-01-01

    Electronic health records (EHRs) are proliferating, and financial incentives encourage their use. Applying Fair Information Practice principles to EHRs necessitates balancing patients' rights to control their personal information with providers' data needs to deliver safe, high-quality care. We describe the technical and organizational challenges faced in capturing patients' preferences for patient-controlled EHR access and applying those preferences to an existing EHR. We established an online system for capturing patients' preferences for who could view their EHRs (listing all participating clinic providers individually and categorically-physicians, nurses, other staff) and what data to redact (none, all, or by specific categories of sensitive data or patient age). We then modified existing data-viewing software serving a state-wide health information exchange and a large urban health system and its primary care clinics to allow patients' preferences to guide data displays to providers. Patients could allow or restrict data displays to all clinicians and staff in a demonstration primary care clinic, categories of providers (physicians, nurses, others), or individual providers. They could also restrict access to all EHR data or any or all of five categories of sensitive data (mental and reproductive health, sexually transmitted diseases, HIV/AIDS, and substance abuse) and for specific patient ages. The EHR viewer displayed data via reports, data flowsheets, and coded and free text data displayed by Google-like searches. Unless patients recorded restrictions, by default all requested data were displayed to all providers. Data patients wanted restricted were not displayed, with no indication they were redacted. Technical barriers prevented redacting restricted information in free textnotes. The program allowed providers to hit a "Break the Glass" button to override patients' restrictions, recording the date, time, and next screen viewed. Establishing patient-control

  10. A randomized, controlled study evaluating effects of amlodipine addition to chelators to reduce iron loading in patients with thalassemia major.

    Science.gov (United States)

    Eghbali, Aziz; Kazemi, Hamideh; Taherahmadi, Hassan; Ghandi, Yazdan; Rafiei, Mohammad; Bagheri, Bahador

    2017-12-01

    Cardiomyopathy due to iron overload can be fatal in patients with thalassemia major. Calcium channel blockers seem to be effective to reduce iron loading. Our goal was to study effects of amlodipine addition to chelators on iron loading in patients with thalassemia major. This randomized, controlled, and single-center trial was performed on 56 patients with thalassemia major. Patients were randomized 1:1 to combined group (iron chelator plus amlodipine) or control group (iron chelator) for 1 year. Iron content was measured by magnetic resonance imaging; heart T2*, and liver T2*. Serum ferritin was also measured. After 12 months of treatment, myocardial T2* values had significant improvement in combined group (21.9 ± 8.0 ms to 24.5 ± 7.6 ms; P < .05); Difference between two groups was significant (P = .02). Combined treatment had no effect on hepatic T2* value (9.6 ± 2.8 ms to 9.5 ± 3.6 ms); difference between two groups was not significant (P = .2). In addition, a significant reduction was seen in serum ferritin levels in two groups. Mild gastrointestinal upset was the most common untoward effect. Addition of amlodipine to iron chelators has beneficial effects for reduction of iron loading in patients with thalassemia major. This combination therapy seems safe. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Chemical additive to enhance antimicrobial efficacy of chlorine and control cross-contamination during immersion chill of broiler carcasses.

    Science.gov (United States)

    Schambach, B T; Berrang, M E; Harrison, M A; Meinersmann, R J

    2014-09-01

    Immersion chilling of broiler carcasses can be a site for cross-contamination between the occasional highly contaminated carcass and those that are co-chilled. Chlorine is often used as an antimicrobial but can be overcome by organic material. A proprietary chlorine stabilizer (T-128) based on phosphoric acid-propylene glycol was tested as a chill tank additive in experiments simulating commercial broiler chilling. In bench-scale experiments, 0.5% T-128 was compared with plain water (control), 50 ppm of chlorine, and the combination of 0.5% T-128 with 50 ppm of chlorine to control transfer of Salmonella and Campylobacter from inoculated wing drummettes to co-chilled uninoculated drummettes. Both chlorine and T-128 lessened cross-contamination with Salmonella (P additional experiment demonstrated that the antimicrobial effect of T-128 was not due merely to a lower pH. In commercial broiler chilling, a pH close to 6.0 is preferred to maximize chlorine effectiveness, while maintaining water-holding capacity of the meat. In a set of pilot-scale experiments with T-128, a near-ideal pH of 6.3 was achieved by using tap water instead of the distilled water used in bench-scale experiments. Pilot-scale chill tanks were used to compare the combination of 0.5% T-128 and 50 ppm of chlorine with 50 ppm of plain chlorine for control of cross-contamination between whole carcasses inoculated with Salmonella and Campylobacter and co-chilled uninoculated carcasses. The T-128 treatment resulted in significantly less crosscontamination by either direct contact or water transfer with both organisms compared with plain chlorine treatment. T-128 may have use in commercial broiler processing to enhance the effectiveness of chlorine in processing water.

  12. MP-AzeFlu provides rapid and effective allergic rhinitis control: results of a non-interventional study in Romania.

    Science.gov (United States)

    Agache, I; Doros, I C; Leru, P M; Bucur, I; Poenaru, M; Sarafoleanu, C

    2018-03-01

    Allergic Rhinitis and its Impact on Asthma (ARIA) and the European Union (EU) recommend a shift to guide allergic rhinitis (AR) treatment decisions from symptom severity to disease control, using a simple visual analogue scale (VAS). Using this VAS we assessed, in a real-life study in Romania, the effectiveness of MP-AzeFlu nasal spray. In this multi-centre, prospective, non-interventional study, 253 patients (over 11 years old) with moderate-to-severe AR were prescribed MP-AzeFlu and assessed their symptoms on a VAS (0 (not at all bothersome) to 100 mm (very bothersome)) on Days 0, 1, 3, 7 and 14. The proportion of patients who achieved a defined VAS score cut-off for well-controlled (38 mm) AR were also calculated. Patients perception of disease control was assessed on Day 3. MP-AzeFlu use was associated with a mean (standard deviation) VAS score reduction from 78.4 (15.1) mm at baseline to 14.7 (15.1) mm on the last day. Effectiveness was consistent irrespective of disease severity, phenotype or patient age. 83.4% of patients achieved the smaller than 39 mm well-controlled VAS score cut-off by last day and 95.2% considered their symptoms to be well- or partly controlled at Day 3. MP-AzeFlu provided rapid, effective and sustained AR symptom control in a real-life setting in Romania, irrespective of severity, phenotype or patient age, aligning with ARIA and EU recommendations and supporting the position of MP-AzeFlu as the drug of choice for the treatment of moderate-to-severe AR.

  13. Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Michie Susan

    2011-02-01

    randomised controlled design, we aim to provide further evidence on intervention effects, as well as on the validity and feasibility of the theoretical-domain approach. The empirical data collected within this trial will be useful in testing whether this theoretical-domain approach can improve our understanding of the implementation of TUPAC guidelines among dental providers. Trial registration Current Controlled Trials ISRCTN15427433

  14. Chloride ion addition for controlling shapes and properties of silver nanorods capped by polyvinyl alcohol synthesized by polyol method

    International Nuclear Information System (INIS)

    Junaidi; Triyana, Kuwat; Harsojo,; Suharyadi, Edi

    2016-01-01

    We report our investigation on the effect of chloride ions oncontrolling the shapes and properties of silver nanorods(AgNRs) synthesized using a polyol method. In this study, we used polyvinyl alcohol (PVA) as a capping agent and sodium chloride (NaCl) as asalt precursor and performed at the oilbath temperature of 140 °C. The chloride ions originating from the NaCl serve to control the growth of the silver nanorods. Furthermore, the synthesized silver nanorodswere characterized using UV-VIS, XRD, SEM and TEM. The results showed that besides being able to control the growth of AgCl atoms, the chloride ions were also able to control the growth of multi-twinned-particles into the single crystalline silver nanorods by micrometer-length. At an appropriate concentration of NaCl, the diameter of silver nanorodsdecreased significantly compared to that of without chloride ion addition. This technique may be useful since a particular diameter of silver nanorods affects a particular application in the future.

  15. Multiple behaviour change intervention and outcomes in recently diagnosed type 2 diabetes: the ADDITION-Plus randomised controlled trial.

    Science.gov (United States)

    Griffin, Simon J; Simmons, Rebecca K; Prevost, A Toby; Williams, Kate M; Hardeman, Wendy; Sutton, Stephen; Brage, Søren; Ekelund, Ulf; Parker, Richard A; Wareham, Nicholas J; Kinmonth, Ann Louise

    2014-07-01

    The aim of this study was to assess whether or not a theory-based behaviour change intervention delivered by trained and quality-assured lifestyle facilitators can achieve and maintain improvements in physical activity, dietary change, medication adherence and smoking cessation in people with recently diagnosed type 2 diabetes. An explanatory randomised controlled trial was conducted in 34 general practices in Eastern England (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care-Plus [ADDITION-Plus]). In all, 478 patients meeting eligibility criteria (age 40 to 69 years with recently diagnosed screen or clinically detected diabetes) were individually randomised to receive either intensive treatment (n = 239) or intensive treatment plus a theory-based behaviour change intervention led by a facilitator external to the general practice team (n = 239). Randomisation was central and independent using a partial minimisation procedure to balance stratifiers between treatment arms. Facilitators taught patients skills to facilitate change in and maintenance of key health behaviours, including goal setting, self-monitoring and building habits. Primary outcomes included physical activity energy expenditure (individually calibrated heart rate monitoring and movement sensing), change in objectively measured fruit and vegetable intake (plasma vitamin C), medication adherence (plasma drug levels) and smoking status (plasma cotinine levels) at 1 year. Measurements, data entry and laboratory analysis were conducted with staff unaware of participants' study group allocation. Of 475 participants still alive, 444 (93%; intervention group 95%, comparison group 92%) attended 1-year follow-up. There were no significant differences between groups in physical activity (difference: +1.50 kJ kg(-1) day(-1); 95% CI -1.74, 4.74), plasma vitamin C (difference: -3.84 μmol/l; 95% CI -8.07, 0.38), smoking (OR 1.37; 95% CI 0.77, 2.43) and

  16. Plant lighting system with five wavelength-band light-emitting diodes providing photon flux density and mixing ratio control

    Directory of Open Access Journals (Sweden)

    Yano Akira

    2012-11-01

    Full Text Available Abstract Background Plant growth and development depend on the availability of light. Lighting systems therefore play crucial roles in plant studies. Recent advancements of light-emitting diode (LED technologies provide abundant opportunities to study various plant light responses. The LED merits include solidity, longevity, small element volume, radiant flux controllability, and monochromaticity. To apply these merits in plant light response studies, a lighting system must provide precisely controlled light spectra that are useful for inducing various plant responses. Results We have developed a plant lighting system that irradiated a 0.18 m2 area with a highly uniform distribution of photon flux density (PFD. The average photosynthetic PFD (PPFD in the irradiated area was 438 micro-mol m–2 s–1 (coefficient of variation 9.6%, which is appropriate for growing leafy vegetables. The irradiated light includes violet, blue, orange-red, red, and far-red wavelength bands created by LEDs of five types. The PFD and mixing ratio of the five wavelength-band lights are controllable using a computer and drive circuits. The phototropic response of oat coleoptiles was investigated to evaluate plant sensitivity to the light control quality of the lighting system. Oat coleoptiles irradiated for 23 h with a uniformly distributed spectral PFD (SPFD of 1 micro-mol m–2 s–1 nm–1 at every peak wavelength (405, 460, 630, 660, and 735 nm grew almost straight upwards. When they were irradiated with an SPFD gradient of blue light (460 nm peak wavelength, the coleoptiles showed a phototropic curvature in the direction of the greater SPFD of blue light. The greater SPFD gradient induced the greater curvature of coleoptiles. The relation between the phototropic curvature (deg and the blue-light SPFD gradient (micro-mol m–2 s–1 nm–1 m–1 was 2 deg per 1 micro-mol m–2 s–1 nm–1 m–1. Conclusions The plant lighting system, with a computer with a

  17. Additional grain refinement in recrystallization controlled rolling of Ti-microalloyed steels processed by near-net-shape casting technology

    International Nuclear Information System (INIS)

    Arribas, M.; Lopez, B.; Rodriguez-Ibabe, J.M.

    2008-01-01

    This paper analyzes the recrystallization kinetics in Ti-microalloyed steels processed using 'beam blank' casting technology. The faster solidification rates associated with this technology brings a finer precipitation of TiN particles which are very effective in controlling austenite grain growth during hot working. Furthermore, these small precipitates have been shown to delay static and dynamic recrystallization. The finer the precipitates the higher the delay in recrystallization. Nevertheless, beyond particle size and distribution, the level of delay is very dependent on microstructure (above all austenite grain size) and deformation conditions (strain and temperature). This paper studies the effects of this recrystallization delay on the microstructure evolution during hot rolling. Special attention was paid to the study of the occurrence of partial recrystallization during the final stages of rolling, which could lead to the presence of mixed microstructures before transformation. The possibility of achieving an additional austenite grain size refinement prior to transformation was evaluated

  18. Usefulness of food chain information provided by Dutch finishing pig producers to control antibiotic residues in pork.

    Science.gov (United States)

    van Wagenberg, Coen P A; Backus, Gé B C; van der Vorst, Jack G A J; Urlings, Bert A P

    2012-11-01

    The EU prescribes that food business operators must use food chain information to assist in food safety control. This study analyses usefulness of food chain information about antibiotic usage covering the 60-day period prior to delivery of pigs to slaughter in the control of antibiotic residues in pork. A dataset with 479 test results for antibiotic residues in tissue samples of finishing pigs delivered to a Dutch slaughter company was linked to information provided by pig producers about antibiotic usage in these finishing pigs. Results show that twice as many producers reported using antibiotics in the group of 82 producers with antibiotic residues (11.0%) compared to the group without antibiotic residues (5.5%) (p=0.0686). For 89% of consignments with a finishing pig with antibiotic residues, the producer reported 'did not use antibiotics'. Food chain information about antibiotic usage provided by Dutch pig producers was no guarantee for absence of antibiotic residues in delivered finishing pigs. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. A Multicenter, Prospective, Randomized Controlled Trial to Evaluate the Additional Benefit of a Multistrain Synbiotic (Prodefen® in the Clinical Management of Acute Viral Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    Emilia García-Menor MD

    2016-11-01

    Full Text Available This randomized, open-label study evaluated the additional benefits of the synbiotic Prodefen® in the clinical management of acute diarrhea of suspected viral origin in children between 6 months and 12 years of age. Study outcomes included the duration of diarrhea, the recovery from diarrhea, and the tolerability and acceptance of the treatment. The proportion of patients without diarrhea over the study period was greater in the synbiotic group than in the control group at all study time points, showing a statistically significant difference on the fifth day (95% vs 79%, p < 0.001. The duration of diarrhea (median and interquartile range was reduced by 1 day in the synbiotic-treated patients (3 [2-5] vs 4 [3-5], p = 0.377. The tolerability of the treatment regimen, as evaluated by the parents, was significantly better in those receiving the synbiotic than in the control group. Overall, 96% of the parents of children receiving the synbiotic reported being satisfied to very satisfied with the treatment regimen. The results of this study indicate that the addition of the synbiotic Prodefen® is a well-tolerated and well-accepted approach that provides an additional benefit to the standard supportive therapy in the management of acute viral diarrhea in children.

  20. Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial.

    Science.gov (United States)

    Vlemmix, Floortje; Rosman, Ageeth N; Rijnders, Marlies E; Beuckens, Antje; Opmeer, Brent C; Mol, Ben W J; Kok, Marjolein; Fleuren, Margot A H

    2015-05-01

    To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Cluster randomized controlled trial. Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands. Singleton breech presentation from 32 weeks of gestation onwards. We randomized clusters to a client strategy (written information leaflets and decision aid), a care-provider strategy (1-day counseling course focused on knowledge and counseling skills), a combined client and care-provider strategy and care-as-usual strategy. We performed an intention-to-treat analysis. Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt. The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8-95%. Neither the client strategy (OR 0.8, 95% CI 0.4-1.5) nor the care-provider strategy (OR 1.2, 95% CI 0.6-2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3-1.4 and OR 2.0, 95% CI 0.7-4.5). Neither a client nor a care-provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  1. Health care Providers Needs About Malaria Control Program in Puskesmas Kisam Tinggi, South Ogan Komering Ulu District

    Directory of Open Access Journals (Sweden)

    Maya Arisanti

    2015-11-01

    Full Text Available Background: Malaria is an infectious disease that is still a health problem in Indonesia, which can cause death, especially in high-risk groups such as infants, toddlers, pregnant women and can directly lead to anemia and decreased work productivity. South Ogan Komering Ulu District was one of the endemic areas in South Sumatera Province. In a previous study in the District South Ogan Komering Ulu County Superior Data AMI found that high and low knowledge society related to malaria and most of respondents have not received counseling. Objective:The purpose of this study was to determine the needs of health care providers in malaria control programs. Methods:Data collected through in-depth interviews. Informant interviews are two people responsible for malaria at the health department, the head of health centers and two people responsible for malaria in health centers. Results: The results showed that the needs required by the health care providers to improve health care services, especially malaria is a need for laboratory equipment (microscope, reagents, and rapid diagnostic test, the need for microscopic power, the need for malaria drugs that are still effective, procurement of mosquito nets, education malaria to the community, and training needs for existing microscopic officer. Conclusion: The need of health care providers is the fulfillment of the malaria supplies equipment, laboratory personnel and training that support the ability of health care providers. With the fulfillment of the provider of health services to the community are expected to be performing well. Recommendation:Budget is needed to support supplier equipment & training.

  2. Patient-Provider Interactions Affect Symptoms in Gastroesophageal Reflux Disease: A Pilot Randomized, Double-Blind, Placebo-Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Michelle L Dossett

    Full Text Available It is unclear whether the benefits that some patients derive from complementary and integrative medicine (CIM are related to the therapies recommended or to the consultation process as some CIM provider visits are more involved than conventional medical visits. Many patients with gastrointestinal conditions seek out CIM therapies, and prior work has demonstrated that the quality of the patient-provider interaction can improve health outcomes in irritable bowel syndrome, however, the impact of this interaction on gastroesophageal reflux disease (GERD is unknown. We aimed to assess the safety and feasibility of conducting a 2 x 2 factorial design study preliminarily exploring the impact of the patient-provider interaction, and the effect of an over-the-counter homeopathic product, Acidil, on symptoms and health-related quality of life in subjects with GERD.24 subjects with GERD-related symptoms were randomized in a 2 x 2 factorial design to receive 1 either a standard visit based on an empathic conventional primary care evaluation or an expanded visit with questions modeled after a CIM consultation and 2 either Acidil or placebo for two weeks. Subjects completed a daily GERD symptom diary and additional measures of symptom severity and health-related quality of life.There was no significant difference in GERD symptom severity between the Acidil and placebo groups from baseline to follow-up (p = 0.41, however, subjects who received the expanded visit were significantly more likely to report a 50% or greater improvement in symptom severity compared to subjects who received the standard visit (p = 0.01. Total consultation length, perceived empathy, and baseline beliefs in CIM were not associated with treatment outcomes.An expanded patient-provider visit resulted in greater GERD symptom improvement than a standard empathic medical visit. CIM consultations may have enhanced placebo effects, and further studies to assess the active components of this

  3. Additional cash incentive within a conditional cash transfer scheme: a 'controlled before and during' design evaluation study from India.

    Science.gov (United States)

    Lahariya, Chandrakant; Mishra, Ashok; Nandan, Deoki; Gautam, Praveen; Gupta, Sanjay

    2011-01-01

    Conditional Cash Transfer (CCT) schemes have shown largely favorable changes in the health seeking behavior. This evaluation study assesses the process and performance of an Additional Cash Incentive (ACI) scheme within an ongoing CCT scheme in India, and document lessons. A controlled before and during design study was conducted in Madhya Pradesh state of India, from August 2007 to March 2008, with increased in institutional deliveries as a primary outcome. In depth interviews, focus group discussions and household surveys were done for data collection. Lack of awareness about ACI scheme amongst general population and beneficiaries, cumbersome cash disbursement procedure, intricate eligibility criteria, extensive paper work, and insufficient focus on community involvement were the major implementation challenges. There were anecdotal reports of political interference and possible scope for corruption. At the end of implementation period, overall rate of institutional deliveries had increased in both target and control populations; however, the differences were not statistically significant. No cause and effect association could be proven by this study. Poor planning and coordination, and lack of public awareness about the scheme resulted in low utilization. Thus, proper IEC and training, detailed implementation plan, orientation training for implementer, sufficient budgetary allocation, and community participation should be an integral part for successful implementation of any such scheme. The lesson learned this evaluation study may be useful in any developing country setting and may be utilized for planning and implementation of any ACI scheme in future.

  4. Utility of optical heterodyne displacement sensing and laser ultrasonics as in situ process control diagnostic for additive manufacturing

    Science.gov (United States)

    Manzo, Anthony J.; Helvajian, Henry

    2018-04-01

    An in situ process control monitor is presented by way of experimental results and simulations, which utilizes a pulsed laser ultrasonic source as a probe and an optical heterodyne displacement meter as a sensor. The intent is for a process control system that operates in near real time, is nonintrusive, and in situ: A necessary requirement for a serial manufacturing technology such as additive manufacturing (AM). We show that the diagnostic approach has utility in characterizing the local temperature, the area of the heat-affected zone, and the surface roughness (Ra ˜ 0.4 μm). We further demonstrate that it can be used to identify solitary defects (i.e., holes) on the order of 10 to 20 μm in diameter. Moreover, the technique shows promise in measuring properties of materials with features that have a small radius of curvature. We present results for a thin wire of ˜650 μm in diameter. By applying multiple pairs of probe-sensor systems, the diagnostic could also measure the local cooling rate on the scale of 1 μs. Finally, while an obvious application is used in AM technology, then all optical diagnostics could be applied to other manufacturing technologies.

  5. Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Ben Mathews

    Full Text Available Early childhood care and education providers (CCPs work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control. Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93; large effect size 0.95, p < 0.001; the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22; negligible effect size 0.03, p = 0.684. Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05. Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior.US National Institutes of Health NCT02225301.

  6. Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial.

    Science.gov (United States)

    Mathews, Ben; Yang, Chengwu; Lehman, Erik B; Mincemoyer, Claudia; Verdiglione, Nicole; Levi, Benjamin H

    2017-01-01

    Early childhood care and education providers (CCPs) work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control). Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93); large effect size 0.95, p < 0.001); the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22); negligible effect size 0.03, p = 0.684). Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05). Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior. US National Institutes of Health NCT02225301.

  7. Novel Control Strategy for Multiple Run-of-the-River Hydro Power Plants to Provide Grid Ancillary Services

    Energy Technology Data Exchange (ETDEWEB)

    Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob; Muljadi, Eduard; Gevorgian, Vahan; Koritarov, Vladimir

    2017-05-01

    Electricity generated by Hydropower Plants (HPPs) contributes a considerable portion of bulk electricity generation and delivers it with a low carbon footprint. In fact, HPP electricity generation provides the largest share from renewable energy resources, which includes solar and wind energy. The increasing penetration of wind and solar penetration leads to a lowered inertia in the grid and hence poses stability challenges. In recent years, breakthrough in energy storage technologies have demonstrated the economic and technical feasibility of extensive deployments in power grids. Multiple ROR HPPs if integrated with scalable, multi time-step energy storage so that the total output can be controlled. Although, the size of a single energy storage is far smaller than that of a typical reservoir, cohesively managing multiple sets of energy storage distributed in different locations is proposed. The ratings of storages and multiple ROR HPPs approximately equals the rating of a large, conventional HPP. The challenges associated with the system architecture and operation are described. Energy storage technologies such as supercapacitors, flywheels, batteries etc. can function as a dispatchable synthetic reservoir with a scalable size of energy storage will be integrated. Supercapacitors, flywheels, and battery are chosen to provide fast, medium, and slow responses to support grid requirements. Various dynamic and transient power grid conditions are simulated and performances of integrated ROR HPPs with energy storage is provided. The end goal of this research is to investigate the inertial equivalence of a large, conventional HPP with a unique set of multiple ROR HPPs and optimally rated energy storage systems.

  8. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2012-07-01

    Full Text Available Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which could delay the introduction of injectable insulin or reduce the insulin dose needed. Commonly available as a nutraceutical, berberine is a potential candidate.Methods and results: Because its low oral bioavailability can be overcome by P-glycoprotein inhibitors like herbal polyphenols, we have tested the nutraceutical combination of Berberis aristata extract and Silybum marianum extract (Berberol® in type 2 diabetes in terms of its additive effect when combined with a conventional oral regimen for patients with suboptimal glycemic control. After 90 days of treatment, the nutraceutical association had a positive effect on glycemic and lipid parameters, significantly reducing glycosylated hemoglobin, basal insulin, homeostatic model assessment of insulin resistance, total and low-density lipoprotein cholesterol, and triglycerides. A relevant effect was also observed in terms of liver function by measuring aspartate transaminase and alanine transaminase. The product had a good safety profile, with distinctive gastrointestinal side effects likely due to its acarbose-like action.Conclusion: Although further studies should be carried out to confirm our data, Berberol could be considered a good candidate as an adjunctive treatment option in diabetes, especially in patients with suboptimal glycemic control.Keywords: berberine, silymarin, glycosylated hemoglobin, diabetes

  9. Modelling the role of intrinsic electric fields in microtubules as an additional control mechanism of bi-directional intracellular transport.

    Science.gov (United States)

    Sataric, M V; Budinski-Petkovic, L; Loncarevic, I; Tuszynski, J A

    2008-01-01

    Active transport is essential for cellular function, while impaired transport has been linked to diseases such as neuronal degeneration. Much long distance transport in cells uses opposite polarity molecular motors of the kinesin and dynein families to move cargos along microtubules. It is clear that many types of cargo are moved by both sets of motors, and frequently in a reverse direction. The general question of how the direction of transport is regulated is still open. The mechanism of the cell's differential control of diverse cargos within the same cytoplasmic background is still unclear as is the answer to the question how endosomes and mitochondria move to different locations within the same cell. To answer these questions we postulate the existence of a local signaling mechanism used by the cell to specifically control different cargos. In particular, we propose an additional physical mechanism that works through the use of constant and alternating intrinsic (endogenous) electric fields as a means of controlling the speed and direction of microtubule-based transport. A specific model is proposed and analyzed in this paper. The model involves the rotational degrees of freedom of the C-termini of tubulin, their interactions and the coupling between elastic and dielectric degrees of freedom. Viscosity of the solution is also included and the resultant equation of motion is found as a nonlinear elliptic equation with dissipation. A particular analytical solution of this equation is obtained in the form of a kink whose properties are analyzed. It is concluded that this solution can be modulated by the presence of electric fields and hence may correspond to the observed behavior of motor protein transport along microtubules.

  10. The addition of a protein-rich breakfast and its effects on acute appetite control and food intake in 'breakfast-skipping' adolescents.

    Science.gov (United States)

    Leidy, H J; Racki, E M

    2010-07-01

    Breakfast skipping (BS) is closely associated with overeating (in the evening), weight gain and obesity. It is unclear whether the addition of breakfast, with emphasis on dietary protein, leads to better appetite and energy intake regulation in adolescents. The purpose of the study was to examine the impact of addition of a normal-protein (PN) breakfast vs protein-rich (PR) breakfast on appetite and food intake in 'breakfast-skipping' adolescents. A total of 13 adolescents (age 14.3+/-0.3 years; body mass index percentile 79+/-4 percentile; skipped breakfast 5+/-1 x per week) randomly completed 3 testing days that included a PN (18+/-1 g protein), PR (48+/-2 g protein) or BS. Breakfast was 24% of estimated daily energy needs. Appetite, satiety and hormonal responses were collected over 5 h followed by an ad libitum lunch and 24-h food intake assessments. Perceived appetite was not different following PN vs BS; PR led to greater reductions vs BS (PLunch energy intake was not different following PN vs BS; PR led to fewer kcal consumed vs BS (PDaily food intake was not different among treatments. Breakfast led to increased satiety through increased fullness and PYY concentrations in 'breakfast skipping' adolescents. A breakfast rich in dietary protein provides additional benefits through reductions in appetite and energy intake. These findings suggest that the addition of a protein-rich breakfast might be an effective strategy to improve appetite control in young people.

  11. Additional oligofructose/inulin does not increase faecal bifidobacteria in critically ill patients receiving enteral nutrition: a randomised controlled trial.

    Science.gov (United States)

    Majid, Hazreen A; Cole, Jayne; Emery, Peter W; Whelan, Kevin

    2014-12-01

    Patients with diarrhoea during enteral nutrition (EN) have been shown to have low faecal bifidobacteria concentrations. Oligofructose/inulin selectively stimulate the growth of bifidobacteria in healthy humans. This study investigates the effect of additional oligofructose/inulin on the gastrointestinal microbiota, short-chain fatty acids (SCFA) and faecal output in patients receiving EN. Adult patients in the intensive care unit (ICU) who were starting EN with a formula containing fibre were randomised to receive 7 g/d of additional oligofructose/inulin or an identically packaged placebo (maltodextrin). A fresh faecal sample was collected at baseline and following at least 7 days of supplementation. Faecal microbiota were analysed using fluorescent in-situ hybridisation and faecal output was monitored daily. Twenty-two patients (mean age 71 years) completed at least 7 days of intervention (mean 12 days). At the end of the intervention, there were no significant differences in the concentrations of bifidobacteria between the groups, after adjusting for baseline values (oligofructose/inulin 6.9 + 1.4, placebo 7.8 + 1.3 log10 cells/g dry faeces, P > 0.05), but there were significantly lower concentrations of Faecalibacterium prausnitzii (7.0 + 1.0 vs. 8.4 + 1.3 log10 cells/g, P = 0.01) and Bacteroides-Prevotella (9.1 + 1.0 vs. 9.9 + 0.9 log10 cells/g, P = 0.05) in patients receiving additional oligofructose/inulin. There were no differences in faecal concentrations of any SCFA, secretory IgA, daily faecal score or incidence of diarrhoea between the two groups. Additional oligofructose/inulin did not increase faecal bifidobacteria in critically ill patients receiving EN, although it did result in lower concentrations of F. prausnitzii and Bacteroides-Prevotella. This trial is registered at http://controlled-trials.com. Identifier: ISRCTN06446184. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All

  12. Parent and child care provider partnerships: Protocol for the Healthy Me, Healthy We (HMHW) cluster randomized control trial.

    Science.gov (United States)

    Hennink-Kaminski, Heidi; Vaughn, Amber E; Hales, Derek; Moore, Reneé H; Luecking, Courtney T; Ward, Dianne S

    2018-01-01

    Formation of diet and physical activity habits begins during early childhood. However, many preschool-aged children in the United States do not achieve recommendations for a nutritious diet or active lifestyle. Two important spheres of influence, home and child care, could ensure that children receive consistent health messages. Innovative approaches that engage both parents and child care providers in a substantial way are needed. Social marketing, a promising approach for health promotion targeting children, uses principles that recognize the need to engage multiple stakeholders and to emphasize benefits and overcome barriers associated with behavior change. Yet, application of social marketing principles in interventions for preschool-age children is limited. Healthy Me, Healthy We (HMHW) is 2-arm, cluster randomized controlled trial to evaluate the effect of a 8-month social marketing campaign on the diet and physical activity behaviors of preschool children (3-4years old), their parents, and child care providers. The campaign is delivered by the child care center and includes branded classroom and at-home activities and materials. Primary outcomes are children's diet quality (assessed with Healthy Eating Index scores) and minutes of non-sedentary activity (measured via accelerometers). Secondary outcomes assess children's body mass index, nutrition and physical activity practices at the child care center and at home, and health behaviors of child care providers and parents. HMHW is an innovative approach to promoting healthy eating and physical activity in preschool children. The campaign targets children during a key developmental period and leverages a partnership between providers and parents to affect behavior change. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Case Study: A Bio-Inspired Control Algorithm for a Robotic Foot-Ankle Prosthesis Provides Adaptive Control of Level Walking and Stair Ascent

    Directory of Open Access Journals (Sweden)

    Uzma Tahir

    2018-04-01

    Full Text Available Powered ankle-foot prostheses assist users through plantarflexion during stance and dorsiflexion during swing. Provision of motor power permits faster preferred walking speeds than passive devices, but use of active motor power raises the issue of control. While several commercially available algorithms provide torque control for many intended activities and variations of terrain, control approaches typically exhibit no inherent adaptation. In contrast, muscles adapt instantaneously to changes in load without sensory feedback due to the intrinsic property that their stiffness changes with length and velocity. We previously developed a “winding filament” hypothesis (WFH for muscle contraction that accounts for intrinsic muscle properties by incorporating the giant titin protein. The goals of this study were to develop a WFH-based control algorithm for a powered prosthesis and to test its robustness during level walking and stair ascent in a case study of two subjects with 4–5 years of experience using a powered prosthesis. In the WFH algorithm, ankle moments produced by virtual muscles are calculated based on muscle length and activation. Net ankle moment determines the current applied to the motor. Using this algorithm implemented in a BiOM T2 prosthesis, we tested subjects during level walking and stair ascent. During level walking at variable speeds, the WFH algorithm produced plantarflexion angles (range = −8 to −19° and ankle moments (range = 1 to 1.5 Nm/kg similar to those produced by the BiOM T2 stock controller and to people with no amputation. During stair ascent, the WFH algorithm produced plantarflexion angles (range −15 to −19° that were similar to persons with no amputation and were ~5 times larger on average at 80 steps/min than those produced by the stock controller. This case study provides proof-of-concept that, by emulating muscle properties, the WFH algorithm provides robust, adaptive control of level walking at

  14. A proteomic approach provides new insights into the control of soil-borne plant pathogens by Bacillus species.

    Directory of Open Access Journals (Sweden)

    Omür Baysal

    Full Text Available Beneficial microorganisms (also known as biopesticides are considered to be one of the most promising methods for more rational and safe crop management practices. We used Bacillus strains EU07, QST713 and FZB24, and investigated their inhibitory effect on Fusarium. Bacterial cell cultures, cell-free supernatants and volatiles displayed varying degrees of suppressive effect. Proteomic analysis of secreted proteins from EU07 and FZB24 revealed the presence of lytic enzymes, cellulases, proteases, 1,4-β-glucanase and hydrolases, all of which contribute to degradation of the pathogen cell wall. Further proteomic investigations showed that proteins involved in metabolism, protein folding, protein degradation, translation, recognition and signal transduction cascade play an important role in the control of Fusarium oxysporum. Our findings provide new knowledge on the mechanism of action of Bacillus species and insight into biocontrol mechanisms.

  15. A Randomized Controlled Trial Examining the Effect of the Addition of the Mandibular Block to Cervical Plexus Block for Carotid Endarterectomy.

    Science.gov (United States)

    Kavrut Ozturk, Nilgun; Kavakli, Ali Sait; Sagdic, Kadir; Inanoglu, Kerem; Umot Ayoglu, Raif

    2018-04-01

    Although the cervical plexus block generally provides adequate analgesia for carotid endarterectomy, pain caused by metal retractors on the inferior surface of the mandible is not prevented by the cervical block. Different pain relief methods can be performed for patients who experience discomfort in these areas. In this study, the authors evaluated the effect of mandibular block in addition to cervical plexus block on pain scores in carotid endarterectomy. A prospective, randomized, controlled trial. Training and research hospital. Patients who underwent a carotid endarterectomy. Patients scheduled for carotid endarterectomy under cervical plexus block were randomized into 2 groups: group 1 (those who did not receive a mandibular block) and group 2 (those who received a mandibular block). The main purpose of the study was to evaluate the mandibular block in addition to cervical plexus block in terms of intraoperative pain scores. Intraoperative visual analog scale scores were significantly higher in group 1 (p = 0.001). The amounts of supplemental 1% lidocaine and intraoperative intravenous analgesic used were significantly higher in group 1 (p = 0.001 and p = 0.035, respectively). Patient satisfaction scores were significantly lower in group 1 (p = 0.044). The amount of postoperative analgesic used, time to first analgesic requirement, postoperative visual analog scale scores, and surgeon satisfaction scores were similar in both groups. There was no significant difference between the groups with respect to complications. No major neurologic deficits or perioperative mortality were observed. Mandibular block in addition to cervical plexus block provides better intraoperative pain control and greater patient satisfaction than cervical plexus block alone. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy.

    Science.gov (United States)

    Trambert, Renee; Kowalski, Mildred Ortu; Wu, Betty; Mehta, Nimisha; Friedman, Paul

    2017-10-01

    Aromatherapy has been used to reduce anxiety in a variety of settings, but usefulness associated with breast biopsies has not been documented. This study was conducted in women undergoing image-guided breast biopsy. We explored the use of two different aromatherapy scents, compared to placebo, aimed at reducing anxiety with the intent of generating new knowledge. This was a randomized, placebo-controlled study of two different types of external aromatherapy tabs (lavender-sandalwood and orange-peppermint) compared with a matched placebo-control delivery system. Anxiety was self-reported before and after undergoing a breast biopsy using the Spielberger State Anxiety Inventory Scale. Eighty-seven women participated in this study. There was a statistically significant reduction in self-reported anxiety with the use of the lavender-sandalwood aromatherapy tab compared with the placebo group (p = .032). Aromatherapy tabs reduced anxiety during image-guided breast biopsy. The completion of the biopsy provided some relief from anxiety in all groups. The use of aromatherapy tabs offers an evidence-based nursing intervention to improve adaptation and reduce anxiety for women undergoing breast biopsy. Lavender-sandalwood aromatherapy reduced anxiety and promoted adaptation more than orange-peppermint aromatherapy or placebo. © 2017 Sigma Theta Tau International.

  17. Does routine psychosocial screening improve referral to psychosocial care providers and patient-radiotherapist communication? A cluster randomized controlled trial.

    Science.gov (United States)

    Braeken, Anna P B M; Lechner, Lilian; Eekers, Daniëlle B P; Houben, Ruud M A; van Gils, Francis C J M; Ambergen, Ton; Kempen, Gertrudis I J M

    2013-11-01

    This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication. A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention. Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (Pcommunication. Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients. Psychosocial screening can be enhanced by effective radiotherapist-patient communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. A serious videogame as an additional therapy tool for training emotional regulation and impulsivity control in severe gambling disorder.

    Directory of Open Access Journals (Sweden)

    Salome eTarrega

    2015-11-01

    Full Text Available Background: Gambling disorder (GD is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address these underlying processes. Objectives: To assess the utility of the Playmancer platform, a serious video game, as an additional therapy tool in a CBT intervention for GD, and to estimate pre-post changes in measures of impulsivity, anger expression and psychopathological symptomatology. Method: The sample comprised a single group of 16 male treatment-seeking individuals with severe GD diagnosis. Therapy intervention consisted of 16 group weekly CBT sessions and, concurrently, 10 additional weekly sessions of a serious video game. Pre-post treatment scores on South Oaks Gambling Screen (SOGS, Barratt Impulsiveness Scale (BIS-11, I7 Impulsiveness Questionnaire (I7, State-Trait Anger Expression Inventory 2 (STAXI-2, Symptom Checklist-Revised (SCL-90-R, State-Trait Anxiety Inventory (STAI-S-T, and Novelty Seeking from the Temperament and Character Inventory-Revised (TCI-R were compared. Results: After the intervention, significant changes were observed in several measures of impulsivity, anger expression and other psychopathological symptoms. Dropout and relapse rates during treatment were similar to those described in the literature for CBT. Conclusion: Complementing CBT interventions for GD with a specific therapy approach like a serious video game might be helpful in addressing certain underlying factors which are usually difficult to change, including impulsivity and anger expression.

  19. Neural Correlates of Task Cost for Stance Control with an Additional Motor Task: Phase-Locked Electroencephalogram Responses

    Science.gov (United States)

    Hwang, Ing-Shiou; Huang, Cheng-Ya

    2016-01-01

    With appropriate reallocation of central resources, the ability to maintain an erect posture is not necessarily degraded by a concurrent motor task. This study investigated the neural control of a particular postural-suprapostural procedure involving brain mechanisms to solve crosstalk between posture and motor subtasks. Participants completed a single posture task and a dual-task while concurrently conducting force-matching and maintaining a tilted stabilometer stance at a target angle. Stabilometer movements and event-related potentials (ERPs) were recorded. The added force-matching task increased the irregularity of postural response rather than the size of postural response prior to force-matching. In addition, the added force-matching task during stabilometer stance led to marked topographic ERP modulation, with greater P2 positivity in the frontal and sensorimotor-parietal areas of the N1-P2 transitional phase and in the sensorimotor-parietal area of the late P2 phase. The time-frequency distribution of the ERP primary principal component revealed that the dual-task condition manifested more pronounced delta (1–4 Hz) and beta (13–35 Hz) synchronizations but suppressed theta activity (4–8 Hz) before force-matching. The dual-task condition also manifested coherent fronto-parietal delta activity in the P2 period. In addition to a decrease in postural regularity, this study reveals spatio-temporal and temporal-spectral reorganizations of ERPs in the fronto-sensorimotor-parietal network due to the added suprapostural motor task. For a particular set of postural-suprapostural task, the behavior and neural data suggest a facilitatory role of autonomous postural response and central resource expansion with increasing interregional interactions for task-shift and planning the motor-suprapostural task. PMID:27010634

  20. A Serious Videogame as an Additional Therapy Tool for Training Emotional Regulation and Impulsivity Control in Severe Gambling Disorder.

    Science.gov (United States)

    Tárrega, Salomé; Castro-Carreras, Laia; Fernández-Aranda, Fernando; Granero, Roser; Giner-Bartolomé, Cristina; Aymamí, Neus; Gómez-Peña, Mónica; Santamaría, Juan J; Forcano, Laura; Steward, Trevor; Menchón, José M; Jiménez-Murcia, Susana

    2015-01-01

    Gambling disorder (GD) is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address these underlying processes. To assess the utility of the Playmancer platform, a serious video game, as an additional therapy tool in a CBT intervention for GD, and to estimate pre-post changes in measures of impulsivity, anger expression and psychopathological symptomatology. The sample comprised a single group of 16 male treatment-seeking individuals with severe GD diagnosis. Therapy intervention consisted of 16 group weekly CBT sessions and, concurrently, 10 additional weekly sessions of a serious video game. Pre-post treatment scores on South Oaks Gambling Screen (SOGS), Barratt Impulsiveness Scale (BIS-11), I7 Impulsiveness Questionnaire (I7), State-Trait Anger Expression Inventory 2 (STAXI-2), Symptom Checklist-Revised (SCL-90-R), State-Trait Anxiety Inventory (STAI-S-T), and Novelty Seeking from the Temperament and Character Inventory-Revised (TCI-R) were compared. After the intervention, significant changes were observed in several measures of impulsivity, anger expression and other psychopathological symptoms. Dropout and relapse rates during treatment were similar to those described in the literature for CBT. Complementing CBT interventions for GD with a specific therapy approach like a serious video game might be helpful in addressing certain underlying factors which are usually difficult to change, including impulsivity and anger expression.

  1. A Serious Videogame as an Additional Therapy Tool for Training Emotional Regulation and Impulsivity Control in Severe Gambling Disorder

    Science.gov (United States)

    Tárrega, Salomé; Castro-Carreras, Laia; Fernández-Aranda, Fernando; Granero, Roser; Giner-Bartolomé, Cristina; Aymamí, Neus; Gómez-Peña, Mónica; Santamaría, Juan J.; Forcano, Laura; Steward, Trevor; Menchón, José M.; Jiménez-Murcia, Susana

    2015-01-01

    Background: Gambling disorder (GD) is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address these underlying processes. Objectives: To assess the utility of the Playmancer platform, a serious video game, as an additional therapy tool in a CBT intervention for GD, and to estimate pre-post changes in measures of impulsivity, anger expression and psychopathological symptomatology. Method: The sample comprised a single group of 16 male treatment-seeking individuals with severe GD diagnosis. Therapy intervention consisted of 16 group weekly CBT sessions and, concurrently, 10 additional weekly sessions of a serious video game. Pre-post treatment scores on South Oaks Gambling Screen (SOGS), Barratt Impulsiveness Scale (BIS-11), I7 Impulsiveness Questionnaire (I7), State-Trait Anger Expression Inventory 2 (STAXI-2), Symptom Checklist-Revised (SCL-90-R), State-Trait Anxiety Inventory (STAI-S-T), and Novelty Seeking from the Temperament and Character Inventory-Revised (TCI-R) were compared. Results: After the intervention, significant changes were observed in several measures of impulsivity, anger expression and other psychopathological symptoms. Dropout and relapse rates during treatment were similar to those described in the literature for CBT. Conclusion: Complementing CBT interventions for GD with a specific therapy approach like a serious video game might be helpful in addressing certain underlying factors which are usually difficult to change, including impulsivity and anger expression. PMID:26617550

  2. Enhancing organizational capacity to provide cancer control programs among Latino churches: design and baseline findings of the CRUZA Study.

    Science.gov (United States)

    Allen, Jennifer D; Torres, Maria Idali; Tom, Laura S; Rustan, Sarah; Leyva, Bryan; Negron, Rosalyn; Linnan, Laura A; Jandorf, Lina; Ospino, Hosffman

    2015-04-09

    Faith-based organizations (FBOs) have been successful in delivering health promotion programs for African Americans, though few studies have been conducted among Latinos. Even fewer have focused on organizational change, which is required to sustain community-based initiatives. We hypothesized that FBOs serving Latinos would be more likely to offer evidence-based strategies (EBS) for cancer control after receiving a capacity enhancement intervention to implement health programs, and designed the CRUZA trial to test this hypothesis. This paper describes the CRUZA design and baseline findings. We identified Catholic parishes in Massachusetts that provided Spanish-language mass (n = 65). A baseline survey assessed organizational characteristics relevant to adoption of health programs, including readiness for adoption, "fit" between innovation and organizational mission, implementation climate, and organizational culture. In the next study phase, parishes that completed the baseline assessment will be recruited to a randomized cluster trial, with the parish as the unit of analysis. Both groups will receive a Program Manual and Toolkit. Capacity Enhancement parishes will also be offered technical support, assistance forming health committees and building inter-institutional partnerships, and skills-based training. Of the 49 parishes surveyed at baseline (75%), one-third (33%) reported having provided at least one health program in the prior year. However, only two program offerings were cancer-specific. Nearly one-fifth (18%) had an active health ministry. There was a high level of organizational readiness to adopt cancer control programs, high congruence between parish missions and CRUZA objectives, moderately conducive implementation climates, and organizational cultures supportive of CRUZA programming. Having an existing health ministry was significantly associated with having offered health programs within the past year. Relationships between health program

  3. Improved creep and oxidation behavior of a martensitic 9Cr steel by the controlled addition of boron and nitrogen

    Energy Technology Data Exchange (ETDEWEB)

    Mayr, Peter [Massachusetts Institute of Technology, Cambridge, MA (United States). Dept. of Materials Science; Graz Univ. of Technology (Austria). Inst. of Material Science and Welding; Holzer, Ivan; Mendez-Martin, Francisca [Graz Univ. of Technology (Austria). Inst. of Material Science and Welding; Albu, Mihaela; Mitsche, Stefan [Graz Univ. of Technology (Austria). Inst. for Electron Microscopy; Gonzalez, Vanessa; Agueero, Alina [Instituto Nacional de Tecnica Aeroespacial, Torrejon de Ardoz (Spain)

    2010-07-01

    This manuscript gives an overview on recent developments of a martensitic steel grade based on 9Cr3W3CoVNb with controlled additions of boron and nitrogen. Alloy design by thermodynamic equilibrium calculations and calculation of boron-nitrogen solubility is discussed. Out of this alloy design process, two melts of a 9Cr3W3CoVNbBN steel were produced. The investigation focused on microstructural evolution during high temperature exposure, creep properties and oxidation resistance in steam at 650 C. Microstructural characterization of ''as-received'' and creep exposed material was carried out using conventional optical as well as advanced electron microscopic methods. Creep data at 650 was obtained at various stress levels. Longest-running specimens have reached more than 20,000 hours of testing time. In parallel, long-term oxidation resistance has been studied at 650 C in steam atmosphere up to 5,000 hours. Preliminary results of the extensive testing program on a 9Cr3W3CoVNbBN steel show significant improvement in respect to creep strength and oxidation resistance compared to the state-of-the-art 9 wt. % Cr martensitic steel grades. Up to current testing times, the creep strength is significantly beyond the +20% scatterband of standard grade P92 material. Despite the chromium content of 9 wt % the material exhibits excellent oxidation resistance. Steam exposed plain base material shows comparable oxidation behavior to coated material, and the corrosion rate of the boron-nitrogen controlled steel is much lower compared to standard 9 wt % Cr steel grades, P91 and P92. (orig.)

  4. The Addition of Platelet-Rich Plasma to Facial Lipofilling: A Double-Blind, Placebo-Controlled, Randomized Trial.

    Science.gov (United States)

    Willemsen, Joep C N; Van Dongen, Joris; Spiekman, Maroesjka; Vermeulen, Karin M; Harmsen, Martin C; van der Lei, Berend; Stevens, H P Jeroen

    2018-02-01

    Lipofilling is a treatment modality to restore tissue volume, but it may also rejuvenate the aging skin. Platelet-rich plasma has been reported to augment the efficacy of lipofilling, both on graft take and rejuvenation, by altering the adipose-derived stem cells. The authors hypothesized that addition of platelet-rich plasma would increase the rejuvenating effect and shorten recovery time. The study conducted was a single-center, double-blind, placebo-controlled, randomized trial (2012 to 2015). In total, a well-defined cohort of 32 healthy female patients enrolled in the study, with 25 completing the follow-up. All patients underwent aesthetic facial lipofilling with either saline or platelet-rich plasma added. Outcome was determined by changes in skin elasticity, volumetric changes of the nasolabial fold, recovery time, and patient satisfaction during follow-up (1 year). Platelet-rich plasma did not improve the outcome of facial lipofilling when looking at skin elasticity improvement, graft volume maintenance in the nasolabial fold. Reversal of the correlation between age and elasticity, however, might suggest a small effect size, and thus might not be significant with our small study population. This randomized, double-blind, placebo-controlled study clearly has shown that platelet-rich plasma significantly reduces postoperative recovery time but does not improve patient outcome when looking at skin elasticity, improvement of the nasolabial fold, or patient satisfaction. The reversal of the correlation between age and elasticity might indicate some effect on skin but requires more power in future studies. Therapeutic, II.

  5. Adaptation effects in static postural control by providing simultaneous visual feedback of center of pressure and center of gravity.

    Science.gov (United States)

    Takeda, Kenta; Mani, Hiroki; Hasegawa, Naoya; Sato, Yuki; Tanaka, Shintaro; Maejima, Hiroshi; Asaka, Tadayoshi

    2017-07-19

    The benefit of visual feedback of the center of pressure (COP) on quiet standing is still debatable. This study aimed to investigate the adaptation effects of visual feedback training using both the COP and center of gravity (COG) during quiet standing. Thirty-four healthy young adults were divided into three groups randomly (COP + COG, COP, and control groups). A force plate was used to calculate the coordinates of the COP in the anteroposterior (COP AP ) and mediolateral (COP ML ) directions. A motion analysis system was used to calculate the coordinates of the center of mass (COM) in both directions (COM AP and COM ML ). The coordinates of the COG in the AP direction (COG AP ) were obtained from the force plate signals. Augmented visual feedback was presented on a screen in the form of fluctuation circles in the vertical direction that moved upward as the COP AP and/or COG AP moved forward and vice versa. The COP + COG group received the real-time COP AP and COG AP feedback simultaneously, whereas the COP group received the real-time COP AP feedback only. The control group received no visual feedback. In the training session, the COP + COG group was required to maintain an even distance between the COP AP and COG AP and reduce the COG AP fluctuation, whereas the COP group was required to reduce the COP AP fluctuation while standing on a foam pad. In test sessions, participants were instructed to keep their standing posture as quiet as possible on the foam pad before (pre-session) and after (post-session) the training sessions. In the post-session, the velocity and root mean square of COM AP in the COP + COG group were lower than those in the control group. In addition, the absolute value of the sum of the COP - COM distances in the COP + COG group was lower than that in the COP group. Furthermore, positive correlations were found between the COM AP velocity and COP - COM parameters. The results suggest that the novel visual feedback

  6. Construction of Genetically Engineered Streptococcus gordonii Strains to Provide Control in QPCR Assays for Assessing Microbiological Quality in Recreational Water.

    Science.gov (United States)

    Quantitative PCR (QPCR) methods for beach monitoring by estimating abundance of Enterococcus spp. in recreational waters use internal, positive controls which address only the amplification of target DNA. In this study two internal, positive controls were developed to control for...

  7. Towards the synthesis of hydroxyapatite/protein scaffolds with controlled porosities: bulk and interfacial shear rheology of a hydroxyapatite suspension with protein additives.

    Science.gov (United States)

    Maas, Michael; Bodnar, Pedro Marcus; Hess, Ulrike; Treccani, Laura; Rezwan, Kurosch

    2013-10-01

    The synthesis of porous hydroxyapatite scaffolds is essential for biomedical applications such as bone tissue engineering and replacement. One way to induce macroporosity, which is needed to support bone in-growth, is to use protein additives as foaming agents. Another reason to use protein additives is the potential to introduce a specific biofunctionality to the synthesized scaffolds. In this work, we study the rheological properties of a hydroxyapatite suspension system with additions of the proteins bovine serum albumin (BSA), lysozyme (LSZ) and fibrinogen (FIB). Both the rheology of the bulk phase as well as the interfacial shear rheology are studied. The bulk rheological data provides important information on the setting behavior of the thixotropic suspension, which we find to be faster with the addition of FIB and LSZ and much slower with BSA. Foam bubble stabilization mechanisms can be rationalized via interfacial shear rheology and we show that it depends on the growth of interfacial films at the suspension/air interface. These interfacial films support the stabilization of bubbles within the ceramic matrix and thereby introduce macropores. Due to the weak interaction of the protein molecules with the hydroxyapatite particles of the suspension, we find that BSA forms the most stable interfacial films, followed by FIB. LSZ strongly interacts with the hydroxyapatite particles and thus only forms thin films with very low elastic moduli. In summary, our study provides fundamental rheological insights which are essential for tailoring hydroxyapatite/protein suspensions in order to synthesize scaffolds with controlled porosities. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Long-term follow-up of a randomized controlled trial on additional core stability exercises training for improving dynamic sitting balance and trunk control in stroke patients.

    Science.gov (United States)

    Cabanas-Valdés, Rosa; Bagur-Calafat, Caritat; Girabent-Farrés, Montserrat; Caballero-Gómez, Fernanda Mª; du Port de Pontcharra-Serra, Helena; German-Romero, Ana; Urrútia, Gerard

    2017-11-01

    Analyse the effect of core stability exercises in addition to conventional physiotherapy training three months after the intervention ended. A randomized controlled trial. Outpatient services. Seventy-nine stroke survivors. In the intervention period, both groups underwent conventional physiotherapy performed five days/week for five weeks, and in addition the experimental group performed core stability exercises for 15 minutes/day. Afterwards, during a three-month follow-up period, both groups underwent usual care that could eventually include conventional physiotherapy or physical exercise but not in a controlled condition. Primary outcome was trunk control and dynamic sitting balance assessed by the Spanish-Version of Trunk Impairment Scale 2.0 and Function in Sitting Test. Secondary outcomes were standing balance and gait evaluated by the Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Spanish-Version of Postural Assessment Scale for Stroke and activities of daily living using the Barthel Index. A total of 68 subjects out of 79 completed the three-month follow-up period. The mean difference (SD) between groups was 0.78 (1.51) points ( p = 0.003) for total score on the Spanish-Version of Trunk Impairment Scale 2.0, 2.52 (6.46) points ( p = 0.009) for Function in Sitting Test, dynamic standing balance was 3.30 (9.21) points ( p= 0.009) on the Berg Balance Scale, gait was 0.82 (1.88) points ( p = 0.002) by Brunel Balance Assessment (stepping), and 1.11 (2.94) points ( p = 0.044) by Tinetti Test (gait), all in favour of core stability exercises. Core stability exercises plus conventional physiotherapy have a positive long-term effect on improving dynamic sitting and standing balance and gait in post-stroke patients.

  9. Enhancement of hydrogen production during waste activated sludge anaerobic fermentation by carbohydrate substrate addition and pH control.

    Science.gov (United States)

    Chen, Yinguang; Xiao, Naidong; Zhao, Yuxiao; Mu, Hui

    2012-06-01

    The effects of carbohydrate/protein ratio (CH/Pr) and pH on hydrogen production from waste activated sludge (WAS) were investigated. Firstly, the optimal pH value for hydrogen production was influenced by the CH/Pr ratio, which was pH 10, 9, 8, 8, 8 and 6 at the CH/Pr ratio (COD based) of 0.2 (sole sludge), 1, 2.4, 3.8, 5 and 6.6, respectively. The maximal hydrogen production (100.6 mL/g-COD) was achieved at CH/Pr of 5 and pH 8, which was due to the synergistic effect of carbohydrate addition on hydrogen production, the enhancement of sludge protein degradation and protease and amylase activities, and the suitable fermentation pathway for hydrogen production. As hydrogen consumption was observed at pH 8, in order to further increase hydrogen production a two-step pH control strategy (pH 8+pH 10) was developed and the hydrogen production was further improved by 17.6%. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Is there still a role for additional linear ablation in addition to pulmonary vein isolation in patients with paroxysmal atrial fibrillation? An Updated Meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Hu, Xiaoliang; Jiang, Jingzhou; Ma, Yuedong; Tang, Anli

    2016-04-15

    The benefits and risks of additional left atrium (LA) linear ablation in patients with paroxysmal atrial fibrillation (AF) remain unclear. Randomized controlled trials were identified in the PubMed, Web of Science, Embase and Cochrane databases, and the relevant papers were examined. Pooled relative risks (RR) and 95% confidence interval (95% CI) were estimated using random effects models. The primary endpoint was the maintenance of sinus rhythm after a single ablation. Nine randomized controlled trials involving 1138 patients were included in this analysis. Additional LA linear ablation did not improve the maintenance of the sinus rhythm following a single procedure (RR, 1.03; 95% CI, 0.93-1.13; P=0.60). A subgroup analysis demonstrated that all methods of additional linear ablation failed to improve the outcome. Additional linear ablation significantly increased the mean procedural time (166.53±67.7 vs. 139.57±62.44min, Plinear ablation did not exhibit any benefits in terms of sinus rhythm maintenance for paroxysmal AF patients following a single procedure. Additional linear ablation significantly increased the mean procedural, fluoroscopy and RF application times. This additional ablation was not associated with a statistically significant increase in complication rates. This finding must be confirmed by further large, high-quality clinical trials. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. State system of accounting for and control of nuclear materials and Protocol Additional in the Slovak Republic

    International Nuclear Information System (INIS)

    Bencova, A.

    2001-01-01

    proposed procedures at the facility for nuclear materials accountancy and control with special reference to material balance areas and key measurement points, measurements of flow and procedures for physical inventory taking. This document is prepared by the IAEA using the Design Information Questionnaire supplied by the facility operator. The Nuclear Regulatory Authority of the Slovak Republic uses computerised system for SSAC - Code ZARUKY 3.00. This code should be able to communicate with the database of operators, which are allowed to handle nuclear material and it should reflect all limitations specified in theirs permissions. It is created on a system with fully satisfactory safety, strictly defined confidentiality and in a system, which allows the access of several users in parallel. As a new component of the code the system for reporting in accordance with the requirements of the Additional Protocol will be incorporated. Starting after political changes in the Central Europe in the beginning of nineties the Slovak Republic is facing a new type of crime illicit trafficking of nuclear and radioactive materials. Direct economical losses in this case are not comparable with the impact on proliferation and radiation safety risk. The government of the Slovak Republic is aware of the situation and has prepared some measures, which may help us to cope with this problem. These measures were mostly concentrated on detection on the state border as well as inside the state. However, the most important is a state system of measures how to prevent removal of material into illegal use. The Protocol Additional was signed by the government of the Slovak Republic in September 1999. However, The Protocol cannot be ratified, as the laws now in effect in the Slovak Republic do not make it possible to meet all requirements resulting from the Protocol. To enable the ratification of the Protocol Additional, first of all it is necessary to amend the Atomic Law and associated regulations

  12. The Additional Value of an E-Mail to Inform Healthcare Professionals of a Drug Safety Issue: A Randomized Controlled Trial in the Netherlands.

    Science.gov (United States)

    Piening, Sigrid; de Graeff, Pieter A; Straus, Sabine M J M; Haaijer-Ruskamp, Flora M; Mol, Peter G M

    2013-09-01

    The usefulness and the impact of Direct Healthcare Professional Communications (DHPCs, or 'Dear Doctor letters') in changing the clinical behaviour of physicians have been debated. Changes in the current risk communication methods should preferably be based on the preferences of the healthcare professionals, to optimize the uptake of the message. The aim of this study was to assess whether safety issues are communicated more effectively with an additional e-mail sent by the Dutch Medicines Evaluation Board (MEB) than with the DHPC only. A randomized controlled trial was conducted amongst ophthalmologists and hospital pharmacists in the Netherlands, who were the target group of a DHPC that was issued for pegaptanib, a drug that is administered intra-ocularly in patients with macular degeneration. The intervention group (N = 110) received the pegaptanib DHPC, as well as the MEB e-mail. The control group (N = 105) received the traditional paper-based DHPC only. Two weeks later, the study population received an invitation to fill out an online questionnaire. Questions were asked about the respondents' knowledge and attitude regarding the pegaptanib issue, and any action they had consequently taken. Additional questions were asked about their satisfaction with the DHPC and the e-mail, and their preferred source of such information. Forty respondents (18.6%) completed the questionnaire. Eighty-one percent of the respondents in the intervention group (N = 21) and 47% of the control group (N = 19) correctly indicated that a serious increase in intra-ocular pressure could be caused by pegaptanib injections (Fishers' exact test, p = 0.046). Nine respondents in the intervention group versus none of the control group respondents indicated that they had taken action in response to the pegaptanib safety issue (Fishers' exact test, p = 0.01). The majority of both the intervention group and the control group confirmed that they would like to receive an MEB e-mail with safety

  13. Genetic mapping of QTLs controlling fatty acids provided insights into the genetic control of fatty acid synthesis pathway in peanut (Arachis hypogaea L..

    Directory of Open Access Journals (Sweden)

    Ming Li Wang

    Full Text Available Peanut, a high-oil crop with about 50% oil content, is either crushed for oil or used as edible products. Fatty acid composition determines the oil quality which has high relevance to consumer health, flavor, and shelf life of commercial products. In addition to the major fatty acids, oleic acid (C18:1 and linoleic acid (C18:2 accounting for about 80% of peanut oil, the six other fatty acids namely palmitic acid (C16:0, stearic acid (C18:0, arachidic acid (C20:0, gadoleic acid (C20:1, behenic acid (C22:0, and lignoceric acid (C24:0 are accounted for the rest 20%. To determine the genetic basis and to improve further understanding on effect of FAD2 genes on these fatty acids, two recombinant inbred line (RIL populations namely S-population (high oleic line 'SunOleic 97R' × low oleic line 'NC94022' and T-population (normal oleic line 'Tifrunner' × low oleic line 'GT-C20' were developed. Genetic maps with 206 and 378 marker loci for the S- and the T-population, respectively were used for quantitative trait locus (QTL analysis. As a result, a total of 164 main-effect (M-QTLs and 27 epistatic (E-QTLs QTLs associated with the minor fatty acids were identified with 0.16% to 40.56% phenotypic variation explained (PVE. Thirty four major QTLs (>10% of PVE mapped on five linkage groups and 28 clusters containing more than three QTLs were also identified. These results suggest that the major QTLs with large additive effects would play an important role in controlling composition of these minor fatty acids in addition to the oleic and linoleic acids in peanut oil. The interrelationship among these fatty acids should be considered while breeding for improved peanut genotypes with good oil quality and desired fatty acid composition.

  14. Novel Control Strategy for Multiple Run-of-the-River Hydro Power Plants to Provide Grid Ancillary Services

    Energy Technology Data Exchange (ETDEWEB)

    Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob; Muljadi, Eduard; Gevorgian, Vahan; Koritarov, Vladimir

    2017-07-12

    Hydropower plant (HPP) generation comprises a considerable portion of bulk electricity generation and is delivered with a low-carbon footprint. In fact, HPP electricity generation provides the largest share from renewable energy resources, which include wind and solar. Increasing penetration levels of wind and solar lead to a lower inertia on the electric grid, which poses stability challenges. In recent years, breakthroughs in energy storage technologies have demonstrated the economic and technical feasibility of extensive deployments of renewable energy resources on electric grids. If integrated with scalable, multi-time-step energy storage so that the total output can be controlled, multiple run-of-the-river (ROR) HPPs can be deployed. Although the size of a single energy storage system is much smaller than that of a typical reservoir, the ratings of storages and multiple ROR HPPs approximately equal the rating of a large, conventional HPP. This paper proposes cohesively managing multiple sets of energy storage systems distributed in different locations. This paper also describes the challenges associated with ROR HPP system architecture and operation.

  15. Simulator with integrated HW and SW for prediction of thermal comfort to provide feedback to the climate control system

    Science.gov (United States)

    Pokorný, Jan; Kopečková, Barbora; Fišer, Jan; JÍcha, Miroslav

    2018-06-01

    The aim of the paper is to assemble a simulator for evaluation of thermal comfort in car cabins in order to give a feedback to the HVAC (heating, ventilation and air conditioning) system. The HW (hardware) part of simulator is formed by thermal manikin Newton and RH (relative humidity), velocity and temperature probes. The SW (software) part consists of the Thermal Comfort Analyser (using ISO 14505-2) and Virtual Testing Stand of Car Cabin defining the heat loads of car cabin. Simulator can provide recommendation for the climate control how to improve thermal comfort in cabin by distribution and directing of air flow, and also by amount of ventilation power to keep optimal temperature inside a cabin. The methods of evaluation of thermal comfort were verified by tests with 10 test subjects for summer (summer clothing, ambient air temperature 30 °C, HVAC setup: +24 °C auto) and winter conditions (winter clothing, ambient air temperature -5 °C, HVAC setup: +18 °C auto). The tests confirmed the validity of the thermal comfort evaluation using the thermal manikin and ISO 14505-2.

  16. Simulator with integrated HW and SW for prediction of thermal comfort to provide feedback to the climate control system

    Directory of Open Access Journals (Sweden)

    Pokorný Jan

    2018-01-01

    Full Text Available The aim of the paper is to assemble a simulator for evaluation of thermal comfort in car cabins in order to give a feedback to the HVAC (heating, ventilation and air conditioning system. The HW (hardware part of simulator is formed by thermal manikin Newton and RH (relative humidity, velocity and temperature probes. The SW (software part consists of the Thermal Comfort Analyser (using ISO 14505-2 and Virtual Testing Stand of Car Cabin defining the heat loads of car cabin. Simulator can provide recommendation for the climate control how to improve thermal comfort in cabin by distribution and directing of air flow, and also by amount of ventilation power to keep optimal temperature inside a cabin. The methods of evaluation of thermal comfort were verified by tests with 10 test subjects for summer (summer clothing, ambient air temperature 30 °C, HVAC setup: +24 °C auto and winter conditions (winter clothing, ambient air temperature -5 °C, HVAC setup: +18 °C auto. The tests confirmed the validity of the thermal comfort evaluation using the thermal manikin and ISO 14505-2.

  17. Spatial analysis of lung, colorectal, and breast cancer on Cape Cod: An application of generalized additive models to case-control data

    Directory of Open Access Journals (Sweden)

    Aschengrau Ann

    2005-06-01

    Full Text Available Abstract Background The availability of geographic information from cancer and birth defect registries has increased public demands for investigation of perceived disease clusters. Many neighborhood-level cluster investigations are methodologically problematic, while maps made from registry data often ignore latency and many known risk factors. Population-based case-control and cohort studies provide a stronger foundation for spatial epidemiology because potential confounders and disease latency can be addressed. Methods We investigated the association between residence and colorectal, lung, and breast cancer on upper Cape Cod, Massachusetts (USA using extensive data on covariates and residential history from two case-control studies for 1983–1993. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. The resulting continuous surface estimates disease rates relative to the whole study area. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. Results Maps of colorectal cancer were relatively flat. Assuming 15 years of latency, lung cancer was significantly elevated just northeast of the Massachusetts Military Reservation, although the result did not hold when we restricted to residences of longest duration. Earlier non-spatial epidemiology had found a weak association between lung cancer and proximity to gun and mortar positions on the reservation. Breast cancer hot spots tended to increase in magnitude as we increased latency and adjusted for covariates, indicating that confounders were partly hiding these areas. Significant breast cancer hot spots were located near known groundwater plumes and the Massachusetts Military Reservation. Discussion Spatial epidemiology of population-based case-control studies addresses many methodological criticisms of cluster studies and generates new exposure

  18. Patient Controlled Epidural Analgesia during Labour: Effect of Addition of Background Infusion on Quality of Analgesia & Maternal Satisfaction

    Directory of Open Access Journals (Sweden)

    Uma Srivastava

    2009-01-01

    Full Text Available Patient controlled epidural analgesia (PCEA is a well established technique for pain relief during labor. But the inclusion of continuous background infusion to PCEA is controversial. The aim of this study was to assess whether the use of continuous infusion along with PCEA was beneficial for laboring women with regards to quality of analgesia, maternal satisfaction and neonatal outcome in comparison to PCEA alone. Fifty five parturients received epidural bolus of 10ml solution containing 0.125% bupivacaine +2 ìg.ml-1 of fentanyl. For maintenance of analgesia the patients of Group PCEA self administered 8 ml bolus with lockout interval of 20 minutes of above solution on demand with no basal infusion. While the patients of Group PCEA + CI received continuous epidural infusion at the rate of 10 ml.hr-1 along with self administered boluses of 3 ml with lockout interval of 10 minutes of similar epidural solution. Patients of both groups were given rescue boluses by the anaesthetists for distressing pain. Verbal analogue pain scores, incidence of distressing pain, need of supplementary/rescue boluses, dose of bupivacaine consumed, maternal satisfaction and neonatal Apgar scores were recorded. No significant difference was observed between mean VAS pain scores during labor, maternal satisfaction, mode of delivery or neonatal Apgar scores. But more patients (n=8 required rescue boluses in PCEA group for distressing pain. The total volume consumed of bupivacaine and opioid was slightly more in PCEA + CI group. In both the techniques the highest sensory level, degree of motor block were comparable& prolongation of labor was not seen. It was concluded that both the techniques provided equivalent labor analgesia, maternal satisfaction and neonatal Apgar scores. PCEA along with continuous infusion at the rate of 10 ml/ hr resulted in lesser incidence of distressing pain and need for rescue analgesic. Although this group consumed higher dose of bupivacaine

  19. Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.

    Science.gov (United States)

    Tucker, David L; Rockett, Mark; Hasan, Mehedi; Poplar, Sarah; Rule, Simon A

    2015-06-01

    Bone marrow aspiration and trephine (BMAT) biopsies remain important tests in haematology. However, the procedures can be moderately to severely painful despite standard methods of pain relief. To test the efficacy of transcutaneous electrical nerve stimulation (TENS) in alleviating the pain from BMAT in addition to standard analgesia using a numerical pain rating scale (NRS). 70 patients requiring BMAT were randomised (1:1) in a double-blind, placebo-controlled trial. -35 patients received TENS impulses at a strong but comfortable amplitude (intervention group) and 35 patients received TENS impulses just above the sensory threshold (control group) (median pulse amplitude 20 and 7 mA, respectively). Patients and operators were blinded to group allocation. Pain assessments were made using a numerical pain scale completed after the procedure. No significant difference in NRS pain recalled after the procedure was detected (median pain score 5.7 (95% CI 4.8 to 6.6) in control vs 5.6 (95% CI 4.8 to 6.4) in the intervention group). However, 100% of patients who had previous experience of BMAT and >94% of participants overall felt they benefited from using TENS and would recommend it to others for this procedure. There were no side effects from the TENS device, and it was well tolerated. TENS is a safe, non-invasive adjunct to analgesia for reducing pain during bone marrow biopsy and provides a subjective benefit to most users; however, no objective difference in pain scores was detected when using TENS in this randomised controlled study. NCT02005354. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. The gas grid control room, provider of external and internal services; Die Gasnetzleitwarte. Ein Dienstleister nach innen und aussen?

    Energy Technology Data Exchange (ETDEWEB)

    Brychcy, Andreas [NBB Netzgesellschaft Berlin-Brandenburg mbH und Co. KG, Berlin (Germany)

    2010-05-15

    The main task of the control room is the maintenance and extension of competence in a dynamically developing market environment. Grid control rooms must be able to react flexibly to changes in the market and accompany them in an active manner. (orig.)

  1. Substitution or addition? How overweight and obese adults incorporate vegetables into their diet during a randomized controlled vegetable feeding trial

    Science.gov (United States)

    Objective: When attempting to eat healthier, individuals may add vegetables to their diet (addition) without changing other eating behaviors. Alternatively, individuals adding vegetables may decrease consumption of other foods (substitution). Distinguishing between the two means of incorporation of ...

  2. 75 FR 37742 - Addition of New Export Control Classification Number 6A981 Passive Infrasound Sensors to the...

    Science.gov (United States)

    2010-06-30

    ... Infrasound Sensors to the Commerce Control List of the Export Administration Regulations, and Related... control passive infrasound sensors because of their military and commercial utility. Items under this new... Thompson, Sensors and Aviation Division, Bureau of Industry and Security, Telephone: (202) 482-4252...

  3. Integrated Autopilot/Autothrottle Based on a Total Energy Control Concept: Design and Evaluation of Additional Autopilot Modes

    Science.gov (United States)

    Bruce, Kevin R.

    1988-01-01

    An integrated autopilot/autothrottle system was designed using a total energy control design philosophy. This design ensures that the system can differentiate between maneuvers requiring a change in thrust to accomplish a net energy change, and those maneuvers which only require elevator control to redistribute energy. The system design, the development of the system, and a summary of simulation results are defined.

  4. An Online Health Prevention Intervention for Youth with Addicted or Mentally Ill Parents: Experiences and Perspectives of Participants and Providers from a Randomized Controlled Trial.

    Science.gov (United States)

    Woolderink, Marla; Bindels, Jill A P M; Evers, Silvia M A A; Paulus, Aggie T G; van Asselt, Antoinette D I; van Schayck, Onno C P

    2015-12-02

    Mental illnesses affect many people around the world, either directly or indirectly. Families of persons suffering from mental illness or addiction suffer too, especially their children. In the Netherlands, 864,000 parents meet the diagnostic criteria for a mental illness or addiction. Evidence shows that offspring of mentally ill or addicted parents are at risk for developing mental disorders or illnesses themselves. The Kopstoring course is an online 8-week group course with supervision by 2 trained psychologists or social workers, aimed to prevent behavioral and psychological problems for children (aged 16 to 25 years) of parents with mental health problems or addictions. The course addresses themes such as roles in the family and mastery skills. An online randomized controlled trial (RCT) was conducted to assess the effectiveness of the Kopstoring course. The aim was to gain knowledge about expectations, experiences, and perspectives of participants and providers of the online Kopstoring course. A process evaluation was performed to evaluate the online delivery of Kopstoring and the experiences and perspectives of participants and providers of Kopstoring. Interviews were performed with members from both groups. Participants were drawn from a sample from the Kopstoring RCT. Thirteen participants and 4 providers were interviewed. Five main themes emerged from these interviews: background, the requirements for the intervention, experience with the intervention, technical aspects, and research aspects. Overall, participants and providers found the intervention to be valuable because it was online; therefore, protecting their anonymity was considered a key component. Most barriers existed in the technical sphere. Additional barriers existed with conducting the RCT, namely gathering informed consent and gathering parental consent in the case of minors. This study provides valuable insight into participants' and providers' experiences and expectations with the online

  5. Selection of population controls for a Salmonella case-control study in the UK using a market research panel and web-survey provides time and resource savings.

    Science.gov (United States)

    Mook, P; Kanagarajah, S; Maguire, H; Adak, G K; Dabrera, G; Waldram, A; Freeman, R; Charlett, A; Oliver, I

    2016-04-01

    Timely recruitment of population controls in infectious disease outbreak investigations is challenging. We evaluated the timeliness and cost of using a market research panel as a sampling frame for recruiting controls in a case-control study during an outbreak of Salmonella Mikawasima in the UK in 2013. We deployed a web-survey by email to targeted members of a market research panel (panel controls) in parallel to the outbreak control team interviewing randomly selected public health staff by telephone and completing paper-based questionnaires (staff controls). Recruitment and completion of exposure history web-surveys for panel controls (n = 123) took 14 h compared to 15 days for staff controls (n = 82). The average staff-time cost per questionnaire for staff controls was £13·13 compared to an invoiced cost of £3·60 per panel control. Differences in the distribution of some exposures existed between these control groups but case-control studies using each group found that illness was associated with consumption of chicken outside of the home and chicken from local butchers. Recruiting market research panel controls offers time and resource savings. More rapid investigations would enable more prompt implementation of control measures. We recommend that this method of recruiting controls is considered in future investigations and assessed further to better understand strengths and limitations.

  6. Dual Enantioselective Control using D-phenylglycine-L-proline-derived Catalysts for the Enantioselective Addition of Diethylzinc to Aldehyde

    International Nuclear Information System (INIS)

    Kang, Seock Yong; Park, Yong Sun

    2016-01-01

    Dipeptide-derived catalysts are of great interest in various asymmetric transformations because of their short and simple preparation and easy modification of their modular structure by using different α-amino acids. We recently reported the first example of dipeptide-catalyzed enantioselective addition of dialkylzinc to aldehydes. We have developed a novel D-Phg-L-Pro dipeptide-derived catalyst for the addition of diethylzinc to aromatic aldehydes. We also disclosed an effective chiral switching by simply modifying nonchiral part of D-Phg-L-Pro dipeptide.

  7. The drone as an additional risk factor due to conditions not provided for in radiological safety at major events; O drone como fator adicional de risco decorrente de condicoes nao previstas na seguranca radiologica em grandes eventos

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Gilberto de Jesus

    2015-07-01

    Major international events are potential targets of terrorist actions, seeking instant publicity that events of this magnitude provide, with the intention of causing terror and disseminate its power to a large number of people worldwide. In this context, the critical analysis of additional risk factor linked to procedures and protocols adopted on radiation safety is important. The possibility of unforeseen situations of risk, especially those resulting from the current global technological development, is a fact. Radioactive material can be used in this type of terrorism in a wide range of devices and illicit trafficking of this material is a reality that worries the International Atomic Energy Agency. In the current technological development scenario of the world, the potential occurrence of terrorist acts using drones combined with radioactive material dispersal devices, is real. The recent history of drones incidents presents cases where, despite not having been necessarily terrorist motivation, their circumstances and characteristics favor the occurrence of malicious acts. This paper proposes to alert the need of updating the current security protocols, considering the potential association of this technology with radioactive dispersal devices. (author)

  8. Adherence to a diabetic care plan provides better glycemic control in ambulatory patients with type 2 diabetes.

    Science.gov (United States)

    Chiu, Yi-Wen; Chang, Jer-Ming; Lin, Li-Ing; Chang, Pi-Yu; Lo, Wan-Ching; Wu, Ling-Chu; Chen, Tun-Chieh; Hwang, Shang-Jyh

    2009-04-01

    Tight control of blood sugar improves the outcomes for diabetic patients, but it can only be achieved by adhering to a well-organized care plan. To evaluate the effect of a diabetes care plan with reinforcement of glycemic control in diabetic patients, 98 ambulatory patients with type 2 diabetes who visited our diabetes clinic every 3-4 months and who completed four education courses given by certified diabetes educators within 3 months after the first visit, were defined as the Intervention group. A total of 82 patients fulfilling the inclusion criteria for the Intervention group but who missed at least half of the diabetes education sessions were selected as controls. Both groups had comparable mean hemoglobin A1c (HbA1c) levels at baseline, which decreased significantly at 3 months and were maintained at approximately constant levels at intervals for up to 1 year. The HbA1c decrement in the Intervention group was significantly greater than that in the Control group over the 1-year follow-up period (HbA1c change: -2.5 +/- 1.8% vs. -1.1 +/- 1.7%, p decrement occurred during the first 3 months, and accounted for 95.6% and 94.6% of the total HbA1c decrements in the Intervention and Control groups, respectively. In the multiple regression model, after adjustment for age, body mass index, and duration of diabetes, the Intervention group may still have a 12.6% improvement in HbA1c from their original value to the end of 1 year treatment compared with the Control group (p < 0.05). Diabetes care, with reinforcement from certified diabetes educators, significantly improved and maintained the effects on glycemic control in ambulatory patients with type 2 diabetes.

  9. Adherence to A Diabetic Care Plan Provides Better Glycemic Control in Ambulatory Patients With Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Yi-Wen Chiu

    2009-04-01

    Full Text Available Tight control of blood sugar improves the outcomes for diabetic patients, but it can only be achieved by adhering to a well-organized care plan. To evaluate the effect of a diabetes care plan with reinforcement of glycemic control in diabetic patients, 98 ambulatory patients with type 2 diabetes who visited our diabetes clinic every 3–4 months and who completed four education courses given by certified diabetes educators within 3 months after the first visit, were defined as the Intervention group. A total of 82 patients fulfilling the inclusion criteria for the Intervention group but who missed at least half of the diabetes education sessions were selected as controls. Both groups had comparable mean hemoglobin A1c (HbA1c levels at baseline, which decreased significantly at 3 months and were maintained at approximately constant levels at intervals for up to 1 year. The HbA1c decrement in the Intervention group was significantly greater than that in the Control group over the 1-year follow-up period (HbA1c change: −2.5 ± 1.8% vs. −1.1 ± 1.7%, p < 0.01. The maximal HbA1c decrement occurred during the first 3 months, and accounted for 95.6% and 94.6% of the total HbA1c decrements in the Intervention and Control groups, respectively. In the multiple regression model, after adjustment for age, body mass index, and duration of diabetes, the Intervention group may still have a 12.6% improvement in HbA1c from their original value to the end of 1 year treatment compared with the Control group (p < 0.05. Diabetes care, with reinforcement from certified diabetes educators, significantly improved and maintained the effects on glycemic control in ambulatory patients with type 2 diabetes.

  10. The ADDITION-Cambridge trial protocol: a cluster – randomised controlled trial of screening for type 2 diabetes and intensive treatment for screen-detected patients

    Directory of Open Access Journals (Sweden)

    Kinmonth Ann

    2009-05-01

    accessible through primary care. It addresses the feasibility of population-based screening for diabetes, as well as the benefits and costs of screening and intensive multifactorial treatment early in the disease trajectory. The intensive treatment algorithm is based on evidence from studies including individuals with clinically diagnosed diabetes and the education materials are informed by psychological theory. ADDITION-Cambridge will provide timely evidence concerning the benefits of early intensive treatment and will inform policy decisions concerning screening for type 2 diabetes. Trial registration Current Controlled trials ISRCTN86769081

  11. Efficacy of Continuing Education in Improving Pharmacists' Competencies for Providing Weight Management Service: Three-Arm Randomized Controlled Trial

    Science.gov (United States)

    Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah; Torkamandi, Hassan; Javadi, Mohammadreza

    2012-01-01

    Introduction: Weight management is a new public health role for community pharmacists in many countries. Lack of expertise is one of the key barriers to counseling obese patients. We evaluated the comparative efficacy of three alternative continuing education (CE) meetings on weight management. Methods: We designed a randomized controlled trial…

  12. Modification of the process dynamics in micro-EDM by means of an additional piezo-control system

    Science.gov (United States)

    Herzig, M.; Berger, T.; Schulze, H.-P.; Hackert-Oschätzchen, M.; Kröning, O.; Schubert, A.

    2017-10-01

    For the application of spark erosion in micro- and precision manufacturing, it is particularly important that small structures with small spark gaps can be machined in the range of a few micrometers. Due to the application of an additional high- dynamic piezo positioning system, smaller feed steps can be implemented which ensure a higher process stability. This additional feed system can be adapted to existing feed systems, whereby the process variable to be influenced is the spark gap. The primary feed system does not have to be directly influenced. The article shows how the structures of parallel regulation circuits for such operating piezo positioning systems are constructed and how they can improve the productivity, the machining accuracy and the surface quality. A selected example shows how the structural design of the highly dynamic system can be designed for different process parameters of industrial basic systems.

  13. Changing redox potential by controlling soil moisture and addition of inorganic oxidants to dissipate pentachlorophenol in different soils

    International Nuclear Information System (INIS)

    Lin Jiajiang; He Yan; Xu Jianming

    2012-01-01

    The potential for dissipation of pentachlorophenol (PCP) was investigated in soils from four different sites in China. These were an umbraqualf (Soil 1), a Plinthudult (Soil 2), a Haplustalf (Soil 3) and an Argiustoll (Soil 4) which were either flooded, to produce anaerobic conditions, or incubated aerobically at 60% water-holding capacity (WHC). The dissipation of PCP in Soil 1 at 60% WHC was higher than under flooded condition, while the opposite occurred in the other three soils. Under flooded conditions, the redox potential decreased significantly in Soil 1 and Soil 4, where sulphate reduction was occurred and the dissipation of PCP was statistically significant (about 96% and 98%, respectively) at the end of incubation. After addition of inorganic oxidants, dissipation of PCP was significantly inhibited by FeCl 3 , while Na 2 SO 4 and NaNO 3 had different effects, depending upon the soil type. - Highlights: ► The extent of the aerobic/anaerobic interface depends upon the soil properties. ► The dissipation of PCP was accelerated in some soils due to the soil-water interface. ► The addition of oxidants inhibited the decrease in soil redox potential. ► Most external oxidants added under flooded condition inhibited PCP dechlorination. - The addition of inorganic oxidants limited the decrease in redox potential and inhibited the reductive dechlorination of pentachlorophenol.

  14. 78 FR 14217 - Control of Alcohol and Drug Use: Addition of Post-Accident Toxicological Testing for Non...

    Science.gov (United States)

    2013-03-05

    ... accidents for alcohol and certain controlled substances (marijuana, cocaine, phencyclidine (PCP), and... alcohol and marijuana, cocaine, phencyclidine (PCP), and certain opiates, amphetamines, barbiturates, and... prescription-only semi-synthetic opioid that can cause dizziness, and sought comment on how it should handle...

  15. Abrupt onsets capture attention independent of top-down control settings 11: Additivity is no evidence for filtering

    NARCIS (Netherlands)

    Schreij, D.; Theeuwes, J.; Olivers, C.N.L.

    2010-01-01

    Is attentional capture contingent on top-down control settings or involuntarily driven by salient stimuli? Supporting the stimulus-driven attentional capture view, Schreij, Owens, and Theeuwes (2008) found that an onset distractor caused a response delay, in spite of participants' having adopted an

  16. The additional value of a night splint to eccentric exercises in chronic midportion Achilles tendinopathy: a randomised controlled trial

    NARCIS (Netherlands)

    de Vos, R. J.; Weir, A.; Visser, R. J. A.; de Winter, ThC; Tol, J. L.

    2007-01-01

    To assess whether the use of a night splint is of added benefit on functional outcome in treating chronic midportion Achilles tendinopathy. This was a single-blind, prospective, single centre, randomised controlled trial set in the Sports Medical Department, The Hague Medical Centre, The

  17. Controlled challenge experiment demonstrates substantial additive genetic variation in resistance of Nile tilapia (Oreochromis niloticus) to Streptococcus iniae

    Science.gov (United States)

    Streptococcus iniae is an etiologic agent of streptococcal disease in tilapia and is one of several Streptococcus spp. that negatively impact worldwide tilapia production. Methods for the prevention and control of S. iniae include vaccines, management strategies, and antibiotics. A complimentary pre...

  18. MRI in patients with chronic pubalgia: Is precise useful information provided to the surgeon? A case-control study.

    Science.gov (United States)

    Larbi, A; Pesquer, L; Reboul, G; Omoumi, P; Perozziello, A; Abadie, P; Loriaut, P; Copin, P; Ducouret, E; Dallaudière, B

    2016-10-01

    Recent studies described that MRI is a good examination to assess damage in chronic athletic pubalgia (AP). However, to our knowledge, no studies focus on systematic correlation of precise tendon or parietal lesion in MRI with surgery and histological assessment. Therefore, we performed a case-control study to determine if MRI can precisely assess Adductor longus (AL) tendinopathy and parietal lesion, compared with surgery and histology. MRI can determine if AP comes from pubis symphysis, musculotendinous or inguinal orifice structures. Eighteen consecutive patients were enrolled from November 2011 to April 2013 for chronic AP. To constitute a control group, we also enrolled 18 asymptomatic men. All MRI were reviewed in consensus by 2 skeletal radiologists for pubic symphysis, musculotendinous, abdominal wall assessment and compared to surgery and histology findings. Regarding pubis symphysis, we found 4 symmetric bone marrow oedema (14%), 2 secondary cleft (7%) and 2 superior ligaments lesions (7%). For AL tendon, we mainly found 13 asymmetric bone marrow oedema (46%), 15 hyperaemia (54%). Regarding abdominal wall, the deep inguinal orifice size in the group of symptomatic athletes and the control group was respectively 27.3±6.4mm and 23.8±6.3mm. The correlation between MRI and surgery/histology was low: 20% for the AL tendon and 9% for the abdominal wall. If we chose the criteria "affected versus unaffected", this correlation became higher: 100% for AL tendon and 73% for the abdominal wall. MRI chronic athletic pubalgia concerns preferentially AL tendinopathy and deep inguinal canal dehiscence with high correlation to surgery/histology when only considering the item "affected versus unaffected" despite low correlation when we try to precisely grade these lesions. III: case-control study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Can Plant Defence Mechanisms Provide New Approaches for the Sustainable Control of the Two-Spotted Spider Mite Tetranychus urticae?

    Directory of Open Access Journals (Sweden)

    Blas Agut

    2018-02-01

    Full Text Available Tetranychus urticae (T. urticae Koch is a cosmopolitan, polyphagous mite which causes economic losses in both agricultural and ornamental plants. Some traits of T. urticae hamper its management, including a short life cycle, arrhenotokous parthenogenesis, its haplodiploid sex determination system, and its extraordinary ability to adapt to different hosts and environmental conditions. Currently, the use of chemical and biological control are the major control methods used against this mite. In recent years, some studies have focused on plant defence mechanisms against herbivores. Various families of plant compounds (such as flavonoids, glucosinolates, or acyl sugars have been shown to behave as acaricides. Plants can be induced upon appropriate stimuli to increase their resistance against spider mites. This knowledge, together with the understanding of mechanisms by which T. urticae detoxifies and adapts to pesticides, may complement the control of this pest. Herein, we describe plant volatile compounds (VOCs with repellent activity, and new findings about defence priming against spider mites, which interfere with the T. urticae performance. The use of VOCs and defence priming can be integrated into current management practices and reduce the damage caused by T. urticae in the field by implementing new, more sustainable crop management tools.

  20. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

    OpenAIRE

    Di Pierro, Francesco; Villanova,Nicola; Agostini,Federica; Soverini,Valentina; Marchesini,Giulio; Marzocchi,Rebecca

    2012-01-01

    Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which coul...

  1. A Serious Videogame as an Additional Therapy Tool for Training Emotional Regulation and Impulsivity Control in Severe Gambling Disorder

    OpenAIRE

    T?rrega, Salom?; Castro-Carreras, Laia; Fern?ndez-Aranda, Fernando; Granero, Roser; Giner-Bartolom?, Cristina; Aymam?, Neus; G?mez-Pe?a, M?nica; Santamar?a, Juan J.; Forcano, Laura; Steward, Trevor; Mench?n, Jos? M.; Jim?nez-Murcia, Susana

    2015-01-01

    Background: Gambling disorder (GD) is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address the...

  2. 78 FR 74218 - Imposition of Additional Sanctions on Syria Under the Chemical and Biological Weapons Control and...

    Science.gov (United States)

    2013-12-10

    ... sanctions are hereby imposed, subject to partial waivers as noted below: 1. Bank Loans--The United States Government shall prohibit any United States bank from making any loan or providing any credit to the Government of Syria, except for loans or credits for the purpose of purchasing food or other agricultural...

  3. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  4. Addition of non-invasive ventilatory support to combined aerobic and resistance training improves dyspnea and quality of life in heart failure patients: a randomized controlled trial.

    Science.gov (United States)

    Bittencourt, Hugo Souza; Cruz, Cristiano Gonçalves; David, Bruno Costa; Rodrigues, Erenaldo; Abade, Camille Magalhães; Junior, Roque Aras; Carvalho, Vitor Oliveira; Dos Reis, Francisco Borges Faria; Gomes Neto, Mansueto

    2017-11-01

    To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. A randomized, single-blind, controlled study. Cardiac rehabilitation center. A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support ( n = 23) or combined aerobic and resistance training alone ( n = 23). Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire. Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change: 4.8 vs. 1.3, p = 0.004), and quality of life (mean change: 19.3 vs. 6.8, p = 0.017 ). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 vs. 44.1, p = 0.924), but without a statistically significant difference. Non-invasive ventilatory support combined with combined aerobic and resistance training provides additional benefits for dyspnea and quality of life in moderate heart failure patients. ClinicalTrials.gov identifier: NCT02384798. Registered 03 April 2015.

  5. Ketoprofen gel improves low back pain in addition to IV dexketoprofen: a randomized placebo-controlled trial.

    Science.gov (United States)

    Serinken, Mustafa; Eken, Cenker; Tunay, Kamil; Golcuk, Yalcin

    2016-08-01

    Oligoanalgesia is common in emergency departments (EDs), and pain management is of concern for ED physicians. The aim of this study was to reveal the effect of ketoprofen gel in patients presenting with mechanical low back pain to the ED. All the study patients received intravenous dexketoprofen additional to study drugs. After dexketoprofen, 2 g of 2.5% ketoprofen gel or placebo was administered to the site with pain and tenderness. Pain relief at 15 and 30 minutes was measured by visual analog scale scores. Rescue drug need and adverse effects were also recorded. A total of 140 patients were enrolled into the study. The mean age of the study patients was 35±12, and 56% (n=79) of them were male. The mean pain reduction at 30 minutes was 52±18 for ketoprofen gel and 37±17 for placebo, and ketoprofen gel was better than placebo at 30 minutes (mean difference, 16 mm; 95% confidence interval, 10-21). Ten patients (14%) in the placebo group and 2 patients (3%) in the ketoprofen gel group needed rescue drug (P=.35). Ketoprofen gel improves pain in patients presenting with mechanical low back pain to ED at 30 minutes in addition to intravenous dexketoprofen when compared to placebo. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Measures of 'exposure needed for one additional patient to be harmed' in population-based case-control studies

    DEFF Research Database (Denmark)

    Hallas, J.; Christensen, R. D.; Sturmer, T.

    2014-01-01

    Purpose The magnitude of risk for adverse drug reactions may be communicated by a measure of 'exposure needed for one additional patient to be harmed' (ENH). We present four ENH measures, based on four different counterfactual contrasts, as illustrated by the known effects of NSAID use on peptic ...... bleeding. The ultimate choice of ENH measure will depend on epidemiological or clinical considerations and on availability of data. Copyright (C) 2014 John Wiley & Sons, Ltd.......Purpose The magnitude of risk for adverse drug reactions may be communicated by a measure of 'exposure needed for one additional patient to be harmed' (ENH). We present four ENH measures, based on four different counterfactual contrasts, as illustrated by the known effects of NSAID use on peptic...... ulcer bleeding. Methods The four measures were basic ENH (estimating the excess risk when treating the entire source population versus treating no one), age-restricted ENH (the entire source population above, e. g. 50 years old treated versus no one above 50 years old treated), standardised ENH (a...

  7. Project of an information integrated system to provide support to the regulatory control of the radioactive waste inventory

    International Nuclear Information System (INIS)

    Christovao, Marilia Tavares

    2005-05-01

    Sources and radioactive waste deriving from industry activities, medical practice and other areas are collected, received, and stored as waste on Brazilian Nuclear Energy Commission (CNEN) Institutes, that also generate, treat and store their own radioactive waste. The object of this project is to present an Integrated Information System named SICORR, having as guidelines, the referred processes to the radioactive waste regulatory control, under the responsibility of the Radioactive Waste Division (DIREJ), the General Coordination of Licensing and Control (CGLC), the Directorate of Safety and Radiation Protection (DRS) and the CNEN. The main objective of the work was reached, once the project SICORR modeling considers the radioactive waste control inventory, enclosing the treatment and integration of the radioactive waste and the radionuclides data and processes; the installations that produce, use, transport or store radiation sources data; and, CNEN Institutes responsible for the radioactive waste management data. The SICORR functions or essential modules involve the data treatment, integration, standardization and consistency between the processes. The SICORR specification and the analysis results are registered in documents, Software Specification Proposal (PESw) and Software Requirements Specification (ERSw), and are presented in text, in diagrams and user interfaces. Use cases have been used in the SICORR context diagram. The user interfaces for each use case have been detailed, defining the graphical layout, the relationships description with other interfaces, the interface details properties and the commands and the product entrances and exits. For objects radioactive waste and radionuclides, states diagrams have been drawn. The activities diagram represents the business model process. The class diagram represents the static objects and relationships that exist between them, under the specification point of view. The class diagram have been determined

  8. A novel heart rate control model provides insights linking LF-HRV behavior to the open-loop gain.

    Science.gov (United States)

    Dvir, Hila; Bobrovsky, Ben Zion; Gabbay, Uri

    2013-09-20

    Low-frequency heart rate variability (LF-HRV) at rest has already been successfully modeled as self-sustained oscillations in a nonlinear control loop, but these models fail to simulate LF-HRV decreases either during aerobic exercise or in heart failure patients. Following control engineering practices, we assume the existence of a biological excitation (dither) within the heart rate control loop that softens the nonlinearity and studied LF-HRV behavior in a dither-embedded model. We adopted the Ottesen model with some revisions and induced a dither of high-frequency stochastic perturbations. We simulated scenarios of a healthy subject at rest and during aerobic exercise (by decreasing peripheral vascular resistance) and a heart failure patient (by decreasing stroke volume). The simulations resembled physiological LF-HRV behavior, i.e., LF-HRV decreased during aerobic exercise and in the heart failure patient. The simulations exhibited LF-HRV dependency on the open-loop gain, which is related to the product of the feedback gain and the feed forward gain. We are the first to demonstrate that LF-HRV may be dependent on the open-loop gain. Accordingly, reduced open-loop gain results in decreased LF-HRV, and vice versa. Our findings explain a well-known but unexplained observed phenomenon of reduced LF-HRV both in heart failure patients and in healthy subjects performing aerobic exercise. These findings have implications on how changes in LF-HRV can be interpreted physiologically, a necessary step towards the clinical utilization of LF-HRV. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Urinary metabolites of histamine and leukotrienes before and after placebo-controlled challenge with ASA and food additives in chronic urticaria patients.

    Science.gov (United States)

    Di Lorenzo, G; Pacor, M L; Vignola, A M; Profita, M; Esposito-Pellitteri, M; Biasi, D; Corrocher, R; Caruso, C

    2002-12-01

    The recovery of mediator metabolites from urine has the potential to provide a rapid, safe, and easily available index of release of mediators. We aimed to determine urinary metabolites of both histamine and leukotrienes (LTs) in patients affected by chronic urticaria (CU). Twenty patients with CU were studied. They were selected on the basis of double-blind placebo-controlled challenge (DBPC) with acetyl salicylic acid (ASA) and food additives. Ten patients (group B) were negative to both challenges. Ten patients (group C) presented urticaria and/or the appearance of angioedema during or 24 h after challenge, with reactions to ASA (five patients) or food additives (five patients). We recruited 15 healthy volunteers as controls (group A). During a second challenge, groups B and C were challenged double-blind with a single dose of ASA, or a specific food additive, or placebo. The healthy group was challenged only with a placebo (talc capsule). Patients in groups B and C were challenged twice: with placebo (as groups B1 and C1) and with ASA (groups B2 and C2) or food additives (C2). Four samples of urine were collected; one during the night before the specific or sham challenge (baseline), and three at 2, 6 and 24 h after the challenge. Urinary methylhistamine (N-MH) and LTE4 were analyzed and normalized for urinary creatinine. For urinary N-MH at baseline, there was a significant difference only between group A and groups B1, B2, C1 and C2 (A vs. B1, P < 0.0001; A vs. B2, P < 0.0001; A vs. C1, P < 0.0001; A vs. C2, P < 0.0001). We detected a significant variation in urinary methylhistamine excretion only in group C2 after 2 h, 6 h and 24 h (P < 0.0001). However, no variations were observed in N-MH excretion rate in the other groups (A, B1, C1) after challenge with placebo, and in B2 after challenge with ASA 20 mg. For urinary LTE4 at baseline no differences were found between the mean values for the different groups. After specific challenge, only C2 patients showed

  10. Additive manufacturing.

    Science.gov (United States)

    Mumith, A; Thomas, M; Shah, Z; Coathup, M; Blunn, G

    2018-04-01

    Increasing innovation in rapid prototyping (RP) and additive manufacturing (AM), also known as 3D printing, is bringing about major changes in translational surgical research. This review describes the current position in the use of additive manufacturing in orthopaedic surgery. Cite this article: Bone Joint J 2018;100-B:455-60.

  11. The Quest for Converting Biorenewable Bifunctional α-Methylene-γ-butyrolactone into Degradable and Recyclable Polyester: Controlling Vinyl-Addition/Ring-Opening/Cross-Linking Pathways

    KAUST Repository

    Tang, Xiaoyan

    2016-10-04

    α-Methylene-γ-butyrolactone (MBL), a naturally occurring and biomass-sourced bifunctional monomer, contains both a highly reactive exocyclic C═C bond and a highly stable five-membered γ-butyrolactone ring. Thus, all previous work led to exclusive vinyl-addition polymerization (VAP) product P(MBL)VAP. Now, this work reverses this conventional chemoselectivity to enable the first ring-opening polymerization (ROP) of MBL, thereby producing exclusively unsaturated polyester P(MBL)ROP with Mn up to 21.0 kg/mol. This elusive goal was achieved through uncovering the thermodynamic, catalytic, and processing conditions. A third reaction pathway has also been discovered, which is a crossover propagation between VAP and ROP processes, thus affording cross-linked polymer P(MBL)CLP. The formation of the three types of polymers, P(MBL)VAP, P(MBL)CLP, and P(MBL)ROP, can be readily controlled by adjusting the catalyst (La)/initiator (ROH) ratio, which is determined by the unique chemoselectivity of the La–X (X = OR, NR2, R) group. The resulting P(MBL)ROP is degradable and can be readily postfunctionalized into cross-linked or thiolated materials but, more remarkably, can also be fully recycled back to its monomer thermochemically. Computational studies provided the theoretical basis for, and a mechanistic understanding of, the three different polymerization processes and the origin of the chemoselectivity.

  12. The Quest for Converting Biorenewable Bifunctional α-Methylene-γ-butyrolactone into Degradable and Recyclable Polyester: Controlling Vinyl-Addition/Ring-Opening/Cross-Linking Pathways

    KAUST Repository

    Tang, Xiaoyan; Hong, Miao; Falivene, Laura; Caporaso, Lucia; Cavallo, Luigi; Chen, Eugene Y X

    2016-01-01

    α-Methylene-γ-butyrolactone (MBL), a naturally occurring and biomass-sourced bifunctional monomer, contains both a highly reactive exocyclic C═C bond and a highly stable five-membered γ-butyrolactone ring. Thus, all previous work led to exclusive vinyl-addition polymerization (VAP) product P(MBL)VAP. Now, this work reverses this conventional chemoselectivity to enable the first ring-opening polymerization (ROP) of MBL, thereby producing exclusively unsaturated polyester P(MBL)ROP with Mn up to 21.0 kg/mol. This elusive goal was achieved through uncovering the thermodynamic, catalytic, and processing conditions. A third reaction pathway has also been discovered, which is a crossover propagation between VAP and ROP processes, thus affording cross-linked polymer P(MBL)CLP. The formation of the three types of polymers, P(MBL)VAP, P(MBL)CLP, and P(MBL)ROP, can be readily controlled by adjusting the catalyst (La)/initiator (ROH) ratio, which is determined by the unique chemoselectivity of the La–X (X = OR, NR2, R) group. The resulting P(MBL)ROP is degradable and can be readily postfunctionalized into cross-linked or thiolated materials but, more remarkably, can also be fully recycled back to its monomer thermochemically. Computational studies provided the theoretical basis for, and a mechanistic understanding of, the three different polymerization processes and the origin of the chemoselectivity.

  13. Possibility of controlling the chemical pattern of He and Ar “guided streamers” by means of N{sub 2} or O{sub 2} additives

    Energy Technology Data Exchange (ETDEWEB)

    Gazeli, K. [IPREM, LCABIE, Plasmas et Applications, Université de Pau et des Pays de l' Adour, 64000 Pau (France); High Voltage Laboratory, Electrical and Computer Engineering Department, University of Patras, 26504 Rion-Patras (Greece); Svarnas, P., E-mail: svarnas@ece.upatras.gr, E-mail: franck.clement@univ-pau.fr [High Voltage Laboratory, Electrical and Computer Engineering Department, University of Patras, 26504 Rion-Patras (Greece); Held, B.; Clément, F., E-mail: svarnas@ece.upatras.gr, E-mail: franck.clement@univ-pau.fr [IPREM, LCABIE, Plasmas et Applications, Université de Pau et des Pays de l' Adour, 64000 Pau (France); Marlin, L. [Atelier de Physique Générale, Université de Pau et des Pays de l' Adour, 64000 Pau (France)

    2015-03-07

    Plasma chemistry at atmospheric pressure and low temperature has met an increased interest due to the effective production of reactive species (mainly reactive nitrogen species and reactive oxygen species) which are demanded in many applications like in biomedicine. Τhe generation of such emissive reactive species is herein studied. A single parameter, i.e., the gas composition, is tuned and abundant chemical species are obtained in a quite controllable manner. The system refers to a small dielectric barrier discharge based reactor fed with He–N{sub 2}/O{sub 2} or Ar–N{sub 2}/O{sub 2} gases, which provides plasma in the form of “guided streamers.” The plasma is sustained by positive high voltage pulses, and the emissive transitions versus the gas composition is determined by UV-VIS optical emission spectroscopy. The relative intensities of emissive species are recorded in the ambient air where the streamers propagate. The evolution of dominant species as a function of the gas composition is mapped, and optimal conditions in terms of species production are clearly revealed. The results show that additives do not necessarily enhance the density of all species, implying the need for plasma chemistry optimization in respect to every application. The study is extended inside the reactor, supporting the above statements. Finally, the rotational and vibrational distributions of critical probe molecules are recorded, testing the dependence of the gas temperature and energy transfer, respectively, on the gas composition.

  14. Internet-provided cognitive behaviour therapy of posttraumatic stress symptoms following childbirth-a randomized controlled trial.

    Science.gov (United States)

    Nieminen, Katri; Berg, Ida; Frankenstein, Katri; Viita, Lina; Larsson, Kamilla; Persson, Ulrika; Spånberger, Loviisa; Wretman, Anna; Silfvernagel, Kristin; Andersson, Gerhard; Wijma, Klaas

    2016-06-01

    The aim of this study was to analyse the effects of trauma-focused guided Internet-based cognitive behaviour therapy for relieving posttraumatic stress disorder (PTSD) symptoms following childbirth, a problem that about 3% women encounter postpartum. Following inclusion, 56 traumatized women were randomized to either treatment or to a waiting list control group. Primary outcome measures were the Traumatic Event Scale (TES) and Impact of Event Scale-Reversed (IES-R). Secondary measures were Beck depression inventory II, Patient Health Questionnaire (PHQ-9), Beck Anxiety Inventory, Quality Of Life Inventory and the EuroQol 5 Dimensions. The treatment was guided by a clinician and lasted eight weeks and comprised eight modules of written text. The between-group effect size (ES) was d = .82 (p post-treatment showed large within-group ESs for PTSD symptoms in the treatment group both on the TES (d = 1.42) and the IES-R (d = 1.30), but smaller ESs in the control group from inclusion to after deferred treatment (TES, d = .80; IES-R d = .45). In both groups, the treatment had positive effects on comorbid depression and anxiety, and in the treatment group also on quality of life. The results need to be verified in larger trials. Further studies are also needed to examine long-term effects.

  15. Qing-Xin-Jie-Yu Granules in addition to conventional treatment for patients with stable coronary artery disease (QUEST Trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Li, Shengyao; Guo, Ming; Mao, Huimin; Gao, Zhuye; Xu, Hao; Shi, Dazhuo

    2016-09-15

    Recurrent cardiovascular event remains high in stable coronary artery disease (SCAD), especially in patients with multiple risk factors, despite a high rate of use conventional treatment. Traditional Chinese Medicine (TCM) is a promising complementary and alternative medicine for treating SCAD, while evidence for its effect on long-term survival is limited. This study was designed to test if Chinese herbal medicine in addition to conventional treatment is more effective than conventional treatment alone in reducing major adverse cardiac event (MACE) for SCAD patients with multiple risk factors during a 1-year follow-up. This is a multicenter, placebo-controlled, double-blinded, randomized controlled clinical trial. A total of 1500 patients are randomized in a 1:1 ratio to receive the Qing-Xin-Jie-Yu Granules (QXJYG) or the placebo granules, twice daily for 6 months. The primary outcome is the combined outcomes including cardiac death, nonfatal myocardial infarction and revascularization. The secondary outcome is the combined outcomes including all-cause mortality, re-admission for acute coronary syndrome (ACS), heart failure, malignant supraventricular and ventricular arrhythmia influencing hemodynamics, ischemic stroke, and other thromboembolic events during 1-year follow-up. The assessment is performed at baseline (before randomization), 1, 3, 6, 9, and 12 months after randomization. This is the first multicenter trial sponsored by the national funding of China to evaluate TCM in combination with conventional treatment on 1-year survival in high-risk SCAD patients. If successful, it will provide an evidence-based complementary therapeutic approach for reducing MACE from SCAD. The trial was registered in the Chinese Clinical Trial Registry on December 28, 2013. The registration number is ChiCTR-TRC-13004370 .

  16. [Is surgical education associated with additional costs? A controlled economic study on the German DRG System for primary TKA].

    Science.gov (United States)

    Göbel, P; Piesche, K; Randau, T; Wimmer, M D; Wirtz, D C; Gravius, S

    2013-04-01

    Total knee arthroplasty (TKA) is one of the most common procedures in orthopaedic surgery, the cost of surgical training has as yet not been quantified. In a pilot study, we investigated the economic impact of surgical training under DRG system influences, analysing the cost-proceeds structure in surgical training for orthopaedic residents. Consecutive TKAs were performed by the most educated surgeon (Group A) having implanted ≥ 1000 TKAs, another attending (Group B) with ≥ 200 TKAs and a resident (Group C) having assisted in 25 TKAs (n = 30 patients per Group A-C). All patients were embedded in a standardised clinical pathway. By analysing the costs parameters such as numbers of blood transfusions, the operating time and the length of stay in the hospital we investigated the health care-related costs matched to the DRG-based financial refunding. Data were analysed after undergoing a analysis of variance followed by a post-hoc Scheffé procedure. On the one hand the resident generated additional costs of 1111,7 ± 97 € in comparison to the Group A surgeon and 1729,8 ± 152 € compared to the attending Group B (p > 0,05), these were generated by longer stay in hospital, longer operation time and higher need of resources. On the other hand there were significantly higher proceeds of the Group C in comparison to the attending Group B and also to Group A: 474,78 ± 82 € vs. A and 150,54 ± 52 € vs. Group B (p DRG. Overall the deficit per patient treated by the resident is 637 ± 77 € vs. Group A and 1579,3 ± 137 € vs. Group B (p > 0,05). The German DRG matrix results in higher profits accounted to the learning surgeon by increased PCCL relevant status and grouping the case to a more profitable DRG. Hereby, the additional costs are only partly redeemed. Surgical education of residents is associated with additional costs for the hospital. These costs have to be redeemed to allow good surgical training for hospitals having good teaching conditions. Georg

  17. Examining the effects of enhanced provider-patient communication on postoperative tonsillectomy pain: protocol of a randomised controlled trial performed by nurses in daily clinical care.

    Science.gov (United States)

    van Vliet, Liesbeth M; van Dulmen, Sandra; Thiel, Bram; van Deelen, Gerard W; Immerzeel, Stephanie; Godfried, Marc B; Bensing, Jozien M

    2017-11-03

    Placebo effects (true biopsychological effects not attributable to the active ingredients of medical technical interventions) can be attributed to several mechanisms, such as expectancy manipulation and empathy manipulation elicited by a provider's communication. So far, effects have primarily been shown in laboratory settings. The aim of this study is to determine the separate and combined effects of expectancy manipulation and empathy manipulation during preoperative and postoperative tonsillectomy analgesia care on clinical adult patients' outcomes. Using a two-by-two randomised controlled trial, 128 adult tonsillectomy patients will be randomly assigned to one out of four conditions differing in the level of expectancy manipulation (standard vs enhanced) and empathy manipulation (standard vs enhanced). Day care ward nurses are trained to deliver the intervention, while patients are treated via the standard analgesia protocol and hospital routines. The primary outcome, perceived pain, is measured via hospital routine by a Numeric Rating Scale, and additional prehospitalisation, perihospitalisation and posthospitalisation questionnaires are completed (until day 3, ie, 2 days after the operation). The manipulation is checked using audio recordings of nurse-patient interactions. Although communication is manipulated, the manipulations do not cross norms or values of acceptable behaviour. Standard medical care is provided. The ethical committee of the UMC Utrecht and the local OLVG hospital committee approved the study. Results will be published via (inter)national peer-reviewed journals and a lay publication. NTR5994; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: a pilot randomized controlled trial.

    Science.gov (United States)

    Viana, R T; Laurentino, G E C; Souza, R J P; Fonseca, J B; Silva Filho, E M; Dias, S N; Teixeira-Salmela, L F; Monte-Silva, K K

    2014-01-01

    Upper limb (UL) impairment is the most common disabling deficit following a stroke. Previous studies have suggested that transcranial direct current stimulation (tDCS) enhances the effect of conventional therapies. This pilot double-blind randomized control trial aimed to determine whether or not tDCS, combined with Wii virtual reality therapy (VRT), would be superior to Wii therapy alone in improving upper limb function and quality of life in chronic stroke individuals. Twenty participants were randomly assigned either to an experimental group that received VRT and tDCS, or a control group that received VRT and sham tDCS. The therapy was delivered over 15 sessions with 13 minutes of active or sham anodal tDCS, and one hour of virtual reality therapy. The outcomes included were determined using the Fugl-Meyer scale, the Wolf motor function test, the modified Ashworth scale (MAS), grip strength, and the stroke specific quality of life scale (SSQOL). Minimal clinically important differences (MCID) were observed when assessing outcome data. Both groups demonstrated gains in all evaluated areas, except for the SSQOL-UL domain. Differences between groups were only observed in wrist spasticity levels in the experimental group, where more than 50% of the participants achieved the MCID. These findings support that tDCS, combined with VRT therapy, should be investigated and clarified further.

  19. Extracts from Field Margin Weeds Provide Economically Viable and Environmentally Benign Pest Control Compared to Synthetic Pesticides.

    Directory of Open Access Journals (Sweden)

    Prisila Mkenda

    Full Text Available Plants with pesticidal properties have been investigated for decades as alternatives to synthetics, but most progress has been shown in the laboratory. Consequently, research on pesticidal plants is failing to address gaps in our knowledge that constrain their uptake. Some of these gaps are their evaluation of their efficacy under field conditions, their economic viability and impact on beneficial organisms. Extracts made from four abundant weed species found in northern Tanzania, Tithonia diversifolia, Tephrosia vogelii, Vernonia amygdalina and Lippia javanica offered effective control of key pest species on common bean plants (Phaseolus vulgaris that was comparable to the pyrethroid synthetic, Karate. The plant pesticide treatments had significantly lower effects on natural enemies (lady beetles and spiders. Plant pesticide treatments were more cost effective to use than the synthetic pesticide where the marginal rate of return for the synthetic was no different from the untreated control, around 4USD/ha, compared to a rate of return of around 5.50USD/ha for plant pesticide treatments. Chemical analysis confirmed the presence of known insecticidal compounds in water extracts of T. vogelii (the rotenoid deguelin and T. diversifolia (the sesquiterpene lactone tagitinin A. Sesquiterpene lactones and the saponin vernonioside C were also identified in organic extracts of V. amygdalina but only the saponin was recorded in water extracts which are similar to those used in the field trial. Pesticidal plants were better able to facilitate ecosystem services whilst effectively managing pests. The labour costs of collecting and processing abundant plants near farm land were less than the cost of purchasing synthetic pesticides.

  20. Ihh controls cartilage development by antagonizing Gli3, but requires additional effectors to regulate osteoblast and vascular development.

    Science.gov (United States)

    Hilton, Matthew J; Tu, Xiaolin; Cook, Julie; Hu, Hongliang; Long, Fanxin

    2005-10-01

    Indian hedgehog (Ihh) controls multiple aspects of endochondral skeletal development, including proliferation and maturation of chondrocytes, osteoblast development and cartilage vascularization. Although it is known that Gli transcription factors are key effectors of hedgehog signaling, it has not been established which Gli protein mediates Ihh activity in skeletal development. Here, we show that removal of Gli3 in Ihh-null mouse embryos restored normal proliferation and maturation of chondrocytes, but only partially rescued the defects in osteoblast development and cartilage vascularization. Remarkably, in both Ihh-/- and Ihh-/-; Gli3-/- embryos, vascularization promoted osteoblast development in perichondrial progenitor cells. Our results not only establish Gli3 as a critical effector for Ihh activity in the developing skeleton, but also identify an osteogenic role for a vasculature-derived signal, which integrates with Ihh and Wnt signals to determine the osteoblast versus chondrocyte fate in the mesenchymal progenitors.

  1. Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trial.

    Science.gov (United States)

    Simmons, Rebecca K; Echouffo-Tcheugui, Justin B; Sharp, Stephen J; Sargeant, Lincoln A; Williams, Kate M; Prevost, A Toby; Kinmonth, Ann Louise; Wareham, Nicholas J; Griffin, Simon J

    2012-11-17

    The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, uncertainty persists around the benefits of screening for type 2 diabetes. We assessed the effect of a population-based stepwise screening programme on mortality. In a pragmatic parallel group, cluster-randomised trial, 33 general practices in eastern England were randomly assigned by the method of minimisation in an unbalanced design to: screening followed by intensive multifactorial treatment for people diagnosed with diabetes (n=15); screening plus routine care of diabetes according to national guidelines (n=13); and a no-screening control group (n=5). The study population consisted of 20,184 individuals aged 40-69 years (mean 58 years), at high risk of prevalent undiagnosed diabetes, on the basis of a previously validated risk score. In screening practices, individuals were invited to a stepwise programme including random capillary blood glucose and glycated haemoglobin (HbA(1c)) tests, a fasting capillary blood glucose test, and a confirmatory oral glucose tolerance test. The primary outcome was all-cause mortality. All participants were flagged for mortality surveillance by the England and Wales Office of National Statistics. Analysis was by intention-to-screen and compared all-cause mortality rates between screening and control groups. This study is registered, number ISRCTN86769081. Of 16,047 high-risk individuals in screening practices, 15,089 (94%) were invited for screening during 2001-06, 11,737 (73%) attended, and 466 (3%) were diagnosed with diabetes. 4137 control individuals were followed up. During 184,057 person-years of follow up (median duration 9·6 years [IQR 8·9-9·9]), there were 1532 deaths in the screening practices and 377 in control practices (mortality hazard ratio [HR] 1·06, 95% CI 0·90-1·25). We noted no significant reduction in

  2. Food additives

    Science.gov (United States)

    ... GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Food additives URL of this page: //medlineplus.gov/ency/article/ ...

  3. Empowering Parents of Obese Children (EPOC): A randomized controlled trial on additional long-term weight effects of parent training.

    Science.gov (United States)

    Warschburger, Petra; Kroeller, Katja; Haerting, Johannes; Unverzagt, Susanne; van Egmond-Fröhlich, Andreas

    2016-08-01

    Although inpatient lifestyle treatment for obese children and adolescents can be highly effective in the short term, long-term results are unconvincing. One possible explanation might be that the treatment takes place far from parents' homes, limiting the possibility to incorporate the parents, who play a major role in establishing and maintaining a healthy lifestyle in childhood and adolescence. The main goal was to develop a brief behaviorally oriented parent training program that enhances 'obesity-specific' parenting skills in order to prevent relapse. We hypothesized that the inclusion of additional parent training would lead to an improved long-term weight course of obese children. Parents of obese children (n = 686; 7-13 years old) either participated in complementary cognitive-behavioral group sessions (n = 336) or received written information only (n = 350) during the inpatient stay. Children of both groups attended multidisciplinary inpatient rehabilitation. BMI-SDS as a primary outcome was evaluated at baseline, post-intervention and at 6- and 12-month follow-up. Intention-to-treat (ITT) as well as per-protocol analyses (PPA) were performed. A significant within-group decrease of 0.24 (95% CI 0.18 to 0.30) BMI-SDS points from the beginning of the inpatient stay through the first year was found, but no group difference at the one-year follow-up (mean difference 0.02; 95% CI -0.04 to 0.07). We also observed an increase in quality of life scores, intake of healthy food and exercise for both groups, without differences between groups (ITT and PPA). Thus, while the inpatient treatment proved highly effective, additional parent training did not lead to better results in long-term weight maintenance or to better psychosocial well-being compared to written psycho-educational material. Further research should focus on subgroups to answer the question of differential treatment effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. The use of CO 2 as an additive for ignition delay and pollutant control in CH 4 /air autoignition

    KAUST Repository

    Tingas, Efstathios Al.

    2017-10-05

    The effect of CO2 dilution on the adiabatic and isochoric autoignition of CH4/air mixtures is analyzed with Computational Singular Perturbation (CSP) algorithmic tools, with a particular emphasis on the determination of the features of the chemical dynamics that control ignition delay and emission formation. Increasing CO2 dilution causes longer ignition delays, lower final temperatures and decreased formation of NO and CO. These effects of CO2 dilution are shown to be entirely thermal, contrary to what happens with dilution with H2O, which also has chemical activity and can reduce ignition delay. For the same initial mole fraction of the diluent, the decrease in final temperature and in NO concentration is larger in the CO2 case whereas the decrease in CO is larger in the H2O case. The thermal effect of CO2 is entirely analogous with those of dilution with the chemically inert Ar, only stronger for the same percentage of initial dilution, because of the larger specific heat of CO2. The reactions that have the largest contribution to the characteristic explosive time scale of the system during ignition delay (H2O2(+M)→OH+OH(+M), CH3O2+CH2O→CH3O2H+HCO, CH4+CH3O2→CH3+CH3O2H, H+O2→O+OH, etc.) are not substantially affected by CO2 dilution, neither are the species that are pointed by CSP (CH3O2, H2O2, CH2O, etc.) as having the largest impact on the this timescale. The same holds for the modes that control CO and NO formation. The results point to the possibility of cold exhaust gas recirculation being used in order to produce mixtures with longer ignition delays and therefore substantial resistance to uncontrolled ignition.

  5. Optimization of microwave heating in an existing cubicle cavity by incorporating additional wave guide and control components

    International Nuclear Information System (INIS)

    Erle, R.R.; Eschen, V.G.; Sprenger, G.S.

    1995-04-01

    The use of microwave energy to thermally treat Low Level (LLW), Transuranic (TRU), and mixed waste has been under development at the Rocky Flats Environmental Technology Site (Site) since 1986. During that time, the technology has progressed from bench-scale tests, through pilot-scale tests, and finally to a full-scale demonstration unit. Experimental operations have been conducted on a variety of non-radioactive surrogates and actual radioactive waste forms. Through these studies and development efforts, the Microwave Vitrification Engineering Team (MVET) at Rocky Flats has successfully proven the application of microwave energy for waste treatment operations. In the microwave solidification process, microwave energy is used to heat a mixture of waste and glass frit to produce a vitrified product that meets all the current acceptance criteria at the final disposal sites. All of the development to date has utilized a multi-mode microwave system to provide the energy to treat the materials. Currently, evaluations are underway on modifications to the full-scale demonstration system that provide a single-mode operation as a possible method to optimize the system. This poster presentation describes the modifications made to allow the single-mode operation

  6. Addition of ferrocene controls polymorphism and enhances charge mobilities in poly(3-hexylthiophene) thin-film transistors

    Science.gov (United States)

    Smith, Brandon; Clark, Michael; Grieco, Christopher; Larsen, Alec; Asbury, John; Gomez, Enrique

    2015-03-01

    Crystalline organic molecules often exhibit the ability to form multiple crystal structures depending on the processing conditions. Exploiting this polymorphism to optimize molecular orbital overlap between adjacent molecules within the unit lattice of conjugated polymers is an approach to enhance charge transport within the material. We have demonstrated the formation of tighter π- π stacking poly(3-hexylthiophene-2,5-diyl) polymorphs in films spin coated from ferrocene-containing solutions using grazing incident X-ray diffraction. As a result, we found that the addition of ferrocene to casting solutions yields thin-film transistors which exhibit significantly higher source-drain current and charge mobilities than neat polymer devices. Insights gleaned from ferrocene/poly(3-hexylthiophene) mixtures can serve as a template for selection and optimization of next generation small molecule/polymer systems possessing greater baseline charge mobilities. Ultimately, the development of such techniques to enhance the characteristics of organic transistors without imparting high costs or loss of advantageous properties will be a critical factor determining the future of organic components within the electronics market.

  7. Effects of stocking density of freshwater prawn Macrobrachium rosenbergii and addition of different levels of tilapia Oreochromis niloticus on production in C/N controlled periphyton based system

    NARCIS (Netherlands)

    Asaduzzaman, M.; Wahab, M.A.; Verdegem, M.C.J.; Mondal, M.N.; Azim, M.E.

    2009-01-01

    An on-station trial was conducted to evaluate the effect of stocking density of freshwater prawn and addition of different levels of tilapia on production in carbon/nitrogen (C/N) controlled periphyton based system. The experiment had a 2 × 3 factorial design, in which two levels of prawn stocking

  8. Effects of addition of tilapia Oreochromis niloticus and substrates for periphyton developments on pond ecology and production in C/N-controlled freshwater prawn Macrobrachium rosenbergii farming systems

    NARCIS (Netherlands)

    Asaduzzaman, M.; Wahab, M.A.; Verdegem, M.C.J.; Benerjee, S.; Akter, T.; Hasan, M.M.; Azim, M.E.

    2009-01-01

    The present research investigated the effect of addition of tilapia and substrates for periphyton development on pond ecology, production and economic performances in C/N controlled freshwater prawn farming system. The absence and presence (0 and 0.5 individual m- 2) of tilapia were investigated in

  9. A Promising Material by Using Residue Waste from Bisphenol A Manufacturing to Prepare Fluid-Loss-Control Additive in Oil Well Drilling Fluid

    Directory of Open Access Journals (Sweden)

    Zhi-Lei Zhang

    2013-01-01

    Full Text Available The residues mixture from Bisphenol A manufacturing process was analyzed. Fourier transform infrared (FTIR spectroscopy, gas chromatography-mass spectrometry (GC-MS, and nuclear magnetic resonance (NMR were used to characterize the residues. The results indicated that the residues were complex mixture of several molecules. 3-(2-Hydroxyphenyl-1,1,3-trimethyl-2,3-dihydro-1H-inden-5-ol and phenol were the main components of the residues. The technical feasibility of using it as phenol replacement in fluid-loss-control additive production was also investigated. The fluid-loss-control capacity of the novel additive was systematically investigated. It was discovered that the well fluid-loss performance of the prepared additive can be achieved, especially at high temperature.

  10. Effect of Nb Addition to Ti-Bearing Super Martensitic Stainless Steel on Control of Austenite Grain Size and Strengthening

    Science.gov (United States)

    Ma, Xiaoping; Langelier, Brian; Gault, Baptiste; Subramanian, Sundaresa

    2017-05-01

    The role of Nb in normalized and tempered Ti-bearing 13Cr5Ni2Mo super martensitic stainless steel is investigated through in-depth characterization of the bimodal chemistry and size of Nb-rich precipitates/atomic clusters and Nb in solid solution. Transmission electron microscopy and atom probe tomography are used to analyze the samples and clarify precipitates/atom cluster interactions with dislocations and austenite grain boundaries. The effect of 0.1 wt pct Nb addition on the promotion of (Ti, Nb)N-Nb(C,N) composite precipitates, as well as the retention of Nb in solution after cooling to room temperature, are analyzed quantitatively. (Ti, Nb)N-Nb(C,N) composite precipitates with average diameters of approximately 24 ± 8 nm resulting from epitaxial growth of Nb(C,N) on pre-existing (Ti,Nb)N particles, with inter-particle spacing on the order of 205 ± 68 nm, are found to be associated with mean austenite grain size of 28 ± 10 µm in the sample normalized at 1323 K (1050 °C). The calculated Zener limiting austenite grain size of 38 ± 13 µm is in agreement with the experimentally observed austenite grain size distribution. 0.08 wt pct Nb is retained in the as-normalized condition, which is able to promote Nb(C, N) atomic clusters at dislocations during tempering at 873 K (600 °C) for 2 hours, and increases the yield strength by 160 MPa, which is predicted to be close to maximum increase in strengthening effect. Retention of solute Nb before tempering also leads to it preferentially combing with C and N to form Nb(C, N) atom clusters, which suppresses the occurrence of Cr- and Mo-rich carbides during tempering.

  11. Evaluation of some natural water-insoluble cellulosic material as lost circulation control additives in water-based drilling fluid

    Directory of Open Access Journals (Sweden)

    Ahmed Mohamed Alsabagh

    2015-12-01

    In this work, three natural water-insoluble cellulosic materials; peanut hulls, bagasse and sawdust were investigated as lost circulation control materials. One hundred and eight different LCM samples made of various materials were tested with mud. The experiments were conducted in a permeability plugging apparatus (PPA at a differential pressure of 100 psi and 300 psi, using 10, 60 and 90 ceramic discs. The performance of each LCM sample was determined based on the amount of spurt loss and total fluid loss of the mud according to the American Petroleum Institute (API standard. The obtained results showed that, the amount of the fluid loss depends on the LCM material, concentration and size distribution, testing results show that, the peanut gives the best results among the bagasse and sawdust, especially fine size which exhibited better results in the filtration characteristics due to the better filling properties of this size. Peanut hulls, bagasse and sawdust show a slight effect on the rheological properties of the mud. The results were discussed on light of particle size distribution.

  12. Fludarabine Melphalan reduced-intensity conditioning allotransplanation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients.

    Science.gov (United States)

    Bryant, A; Nivison-Smith, I; Pillai, E S; Kennedy, G; Kalff, A; Ritchie, D; George, B; Hertzberg, M; Patil, S; Spencer, A; Fay, K; Cannell, P; Berkahn, L; Doocey, R; Spearing, R; Moore, J

    2014-01-01

    This was an Australasian Bone Marrow Transplant Recipient Registry (ABMTRR)-based retrospective study assessing the outcome of Fludarabine Melphalan (FluMel) reduced-intensity conditioning between 1998 and 2008. Median follow-up was 3.4 years. There were 344 patients with a median age of 54 years (18-68). In all, 234 patients had myeloid malignancies, with AML (n=166) being the commonest indication. There were 110 lymphoid patients with non-hodgkins lymphoma (NHL) (n=64) the main indication. TRM at day 100 was 14% with no significant difference between the groups. OS and disease-free survival (DFS) were similar between myeloid and lymphoid patients (57 and 50% at 3 years, respectively). There was no difference in cumulative incidence of relapse or GVHD between groups. Multivariate analysis revealed four significant adverse risk factors for DFS: donor other than HLA-identical sibling donor, not in remission at transplant, previous autologous transplant and recipient CMV positive. Chronic GVHD was associated with improved DFS in multivariate analysis predominantly due to a marked reduction in relapse (HR:0.44, P=0.003). This study confirms that FluMel provides durable and equivalent remissions in both myeloid and lymphoid malignancies. Disease stage and chronic GVHD remain important determinants of outcome for FluMel allografting.

  13. Human rotavirus vaccine Rotarix™ provides protection against diverse circulating rotavirus strains in African infants: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Steele Andrew

    2012-09-01

    .0% and P[6] was 55.2% (95% CI: -6.5%; 81.3% Conclusions Rotarix™ vaccine demonstrated efficacy against severe gastroenteritis caused by diverse circulating rotavirus types. These data add to a growing body of evidence supporting heterotypic protection provided by Rotarix™. Trial registration number NCT00241644

  14. Human rotavirus vaccine Rotarix™ provides protection against diverse circulating rotavirus strains in African infants: a randomized controlled trial.

    Science.gov (United States)

    Steele, Andrew Duncan; Neuzil, Kathleen M; Cunliffe, Nigel A; Madhi, Shabir A; Bos, Pieter; Ngwira, Bagrey; Witte, Desiree; Todd, Stacy; Louw, Cheryl; Kirsten, Mari; Aspinall, Sanet; Van Doorn, Leen Jan; Bouckenooghe, Alain; Suryakiran, Pemmaraju V; Han, Htay Htay

    2012-09-13

    .5%; 81.3%) Rotarix™ vaccine demonstrated efficacy against severe gastroenteritis caused by diverse circulating rotavirus types. These data add to a growing body of evidence supporting heterotypic protection provided by Rotarix™. NCT00241644.

  15. Prescribed computer games in addition to occlusion versus standard occlusion treatment for childhood amblyopia: a pilot randomised controlled trial.

    Science.gov (United States)

    Tailor, Vijay K; Glaze, Selina; Khandelwal, Payal; Davis, Alison; Adams, Gillian G W; Xing, Wen; Bunce, Catey; Dahlmann-Noor, Annegret

    2015-01-01

    Amblyopia ("lazy eye") is the commonest vision deficit in children. If not fully corrected by glasses, amblyopia is treated by patching or blurring the better-seeing eye. Compliance with patching is often poor. Computer-based activities are increasingly topical, both as an adjunct to standard treatment and as a platform for novel treatments. Acceptability by families has not been explored, and feasibility of a randomised controlled trial (RCT) using computer games in terms of recruitment and treatment acceptability is uncertain. We carried out a pilot RCT to test whether computer-based activities are acceptable and accessible to families and to test trial methods such as recruitment and retention rates, randomisation, trial-specific data collection tools and analysis. The trial had three arms: standard near activity advice, Eye Five, a package developed for children with amblyopia, and an off-the-shelf handheld games console with pre-installed games. We enrolled 60 children age 3-8 years with moderate or severe amblyopia after completion of optical treatment. This trial was registered as UKCRN-ID 11074. Pre-screening of 3600 medical notes identified 189 potentially eligible children, of whom 60 remained eligible after optical treatment, and were enrolled between April 2012 and March 2013. One participant was randomised twice and withdrawn from the study. Of the 58 remaining, 37 were boys. The mean (SD) age was 4.6 (1.7) years. Thirty-seven had moderate and 21 severe amblyopia. Three participants were withdrawn at week 6, and in total, four were lost to follow-up at week 12. Most children and parents/carers found the study procedures, i.e. occlusion treatment, usage of the allocated near activity and completion of a study diary, easy. The prescribed cumulative dose of near activity was 84 h at 12 weeks. Reported near activity usage numbers were close to prescribed numbers in moderate amblyopes (94 % of prescribed) but markedly less in severe amblyopes (64

  16. Effect of Providing Ankle-Foot Orthoses in Patients with Acute and Subacute Stroke: a Randomized Controlled Trial : A randomized controlled trial

    NARCIS (Netherlands)

    Nikamp-Simons, Corien D.M.; Buurke, Jaap H.; Van Der Palen, Job; Hermens, Hermie J.; Rietman, Johan S.; Ibánez, Jaime; Azorín, José María; Akay, Metin; Pons, José Luis

    2017-01-01

    Despite frequent application of ankle-foot orthoses (AFOs), little scientific evidence is available to guide AFO-provision early after stroke. A randomized controlled trial was conducted to study the effects of AFO-provision in (sub-) acute stroke patients. Primary aim: to study effects of the

  17. An infrastructure with a unified control plane to integrate IP into optical metro networks to provide flexible and intelligent bandwidth on demand for cloud computing

    Science.gov (United States)

    Yang, Wei; Hall, Trevor

    2012-12-01

    The Internet is entering an era of cloud computing to provide more cost effective, eco-friendly and reliable services to consumer and business users and the nature of the Internet traffic will undertake a fundamental transformation. Consequently, the current Internet will no longer suffice for serving cloud traffic in metro areas. This work proposes an infrastructure with a unified control plane that integrates simple packet aggregation technology with optical express through the interoperation between IP routers and electrical traffic controllers in optical metro networks. The proposed infrastructure provides flexible, intelligent, and eco-friendly bandwidth on demand for cloud computing in metro areas.

  18. The Effect of Ethanol Addition to Gasoline on Low- and Intermediate-Temperature Heat Release under Boosted Conditions in Kinetically Controlled Engines

    Science.gov (United States)

    Vuilleumier, David Malcolm

    The detailed study of chemical kinetics in engines has become required to further advance engine efficiency while simultaneously lowering engine emissions. This push for higher efficiency engines is not caused by a lack of oil, but by efforts to reduce anthropogenic carbon dioxide emissions, that cause global warming. To operate in more efficient manners while reducing traditional pollutant emissions, modern internal combustion piston engines are forced to operate in regimes in which combustion is no longer fully transport limited, and instead is at least partially governed by chemical kinetics of combusting mixtures. Kinetically-controlled combustion allows the operation of piston engines at high compression ratios, with partially-premixed dilute charges; these operating conditions simultaneously provide high thermodynamic efficiency and low pollutant formation. The investigations presented in this dissertation study the effect of ethanol addition on the low-temperature chemistry of gasoline type fuels in engines. These investigations are carried out both in a simplified, fundamental engine experiment, named Homogeneous Charge Compression Ignition, as well as in more applied engine systems, named Gasoline Compression Ignition engines and Partial Fuel Stratification engines. These experimental investigations, and the accompanying modeling work, show that ethanol is an effective scavenger of radicals at low temperatures, and this inhibits the low temperature pathways of gasoline oxidation. Further, the investigations measure the sensitivity of gasoline auto-ignition to system pressure at conditions that are relevant to modern engines. It is shown that at pressures above 40 bar and temperatures below 850 Kelvin, gasoline begins to exhibit Low-Temperature Heat Release. However, the addition of 20% ethanol raises the pressure requirement to 60 bar, while the temperature requirement remains unchanged. These findings have major implications for a range of modern engines

  19. In the shadow of a new smoke free policy: A discourse analysis of health care providers' engagement in tobacco control in community mental health

    Directory of Open Access Journals (Sweden)

    Malchy Leslie A

    2010-07-01

    Full Text Available Abstract Background The prevalence of tobacco use among individuals with mental illness remains a serious public health concern. Tobacco control has received little attention in community mental health despite the fact that many individuals with mental illness are heavy smokers and experience undue tobacco-related health consequences. Methods This qualitative study used methods of discourse analysis to examine the perceptions of health care providers, both professionals and paraprofessionals, in relation to their roles in tobacco control in the community mental health system. Tobacco control is best conceptualised as a suite of policies and practices directed at supporting smoke free premises, smoking cessation counselling and limiting access to tobacco products. The study took place following the establishment of a new policy that restricted tobacco smoking inside all mental health facilities and on their grounds. Ninety one health care providers participated in open-ended interviews in which they described their role in tobacco control. The interview data were analyzed discursively by asking questions such as: what assumptions underlie what is being said about tobacco? Results Five separate yet overlapping discursive frames were identified in which providers described their roles. Managing a smoke free environment emphasised the need to police and monitor the smoke free environment. Tobacco is therapeutic was a discourse that underscored the putative value of smoking for clients. Tobacco use is an individual choice located the decision to smoke with individual clients thereby negating a role in tobacco control for providers. It's someone else's role was a discourse that placed responsibility for tobacco control with others. Finally, the discourse of tobacco control as health promotion located tobacco control in a range of activities that are used to support the health of clients. Conclusions This study provides insights into the complex

  20. Early hCG addition to rFSH for ovarian stimulation in IVF provides better results and the cDNA copies of the hCG receptor may be an indicator of successful stimulation

    Directory of Open Access Journals (Sweden)

    Paraskevis Dimitris

    2009-10-01

    Full Text Available Abstract A simple, safe and cost-effective treatment protocol in ovarian stimulation is of great importance in IVF practice, especially in the case of previous unsuccessful attempts. hCG has been used as a substitute of LH because of the degree of homology between the two hormones. The main aim of this prospective randomized study was to determine, for the first time, whether low dose hCG added to rFSH for ovarian stimulation could produce better results compared to the addition of rLH in women entering IVF-ET, especially in those women that had previous IVF failures. An additional aim was to find an indicator that would allow us to follow-up ovarian stimulation and, possibly, modify it in order to achieve a better IVF outcome; and that indicator may be the cDNA copies of the LH/hCG receptor. Group A patients (n = 58 were administered hCG and Group B rLH (n = 56 in addition to rFSH in the first days of ovarian stimulation. The number of follicles and oocytes and, most importantly, implantation and pregnancy rates were shown to be statistically significantly higher in the hCG group. This study has also determined, for the first time to our best knowledge, m-RNA for LH/hCG receptors in the lymphocytes of peripheral blood 40 h before ovum pick-up. cDNA levels of the hCG receptor after ovarian stimulation were significantly higher among women receiving hCG compared to those receiving LH. In addition, higher levels were encountered among women with pregnancy compared to those without, although this was not statistically significant due to the small number of pregnancies. It seems that hCG permits a highly effective and more stable occupancy of rLH/hCG receptors and gives more follicles and more oocytes. The determination of cDNA copies could be, in the future, a marker during ovulation induction protocols and of course a predictor for the outcome of ART in the special subgroup of patients with previous failures.

  1. Combination of antagonistic yeasts with two food additives for control of brown rot caused by Monilinia fructicola on sweet cherry fruit.

    Science.gov (United States)

    Qin, G Z; Tian, S P; Xu, Y; Chan, Z L; Li, B Q

    2006-03-01

    To evaluate beneficial effect of two food additives, ammonium molybdate (NH4-Mo) and sodium bicarbonate (NaBi), on antagonistic yeasts for control of brown rot caused by Monilinia fructicola in sweet cherry fruit under various storage conditions. The mechanisms of action by which food additives enhance the efficacy of antagonistic yeasts were also evaluated. Biocontrol activity of Pichia membranefaciens and Cryptococcus laurentii against brown rot in sweet cherry fruit was improved by addition of 5 mmol l(-1) NH4-Mo or 2% NaBi when stored in air at 20 and 0 degrees C, and in controlled atmosphere (CA) storage with 10% O2 + 10% CO2 at 0 degrees C. Population dynamics of P. membranefaciens in the wounds of fruit were inhibited by NH4-Mo at 20 degrees C after 1 day of incubation and growth of C. laurentii was inhibited by NH4-Mo at 0 degrees C in CA storage after 60 days. In contrast, NaBi did not significantly influence growth of the two yeasts in fruit wounds under various storage conditions except that the growth of P. membranefaciens was stimulated after storage for 45 days at 0 degrees C in CA storage. When used alone, the two additives showed effective control of brown rot in sweet cherry fruit and the efficacy was closely correlated with the concentrations used. The result of in vitro indicated that growth of M. fructicola was significantly inhibited by NH4-Mo and NaBi. Application of additives improved biocontrol of brown rot on sweet cherry fruit under various storage conditions. It is postulated that the enhancement of disease control is directly because of the inhibitory effects of additives on pathogen growth, and indirectly because of the relatively little influence of additives on the growth of antagonistic yeasts. The results obtained in this study suggest that an integration of NH4-Mo or NaBi with biocontrol agents has great potential in commercial management of postharvest diseases of fruit.

  2. Review and Response to the Final Report of the National Black Health Providers Task Force on High Blood Pressure Education and Control.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD.

    This report presents the National Heart, Lung, and Blood Institute's (NHLBI) review of and response to the final report of the National Black Health Providers Task Force on High Blood Pressure Education and Control. The response includes a statement of NHLBI's involvement in health research, and descriptions of what steps can be taken to solve the…

  3. A randomized controlled dose-response pilot study of addition of hCG to recombinant FSH during controlled ovarian stimulation for in vitro fertilization

    DEFF Research Database (Denmark)

    Loft, A; Egeberg, Anne Noes; Smitz, J

    2012-01-01

    Is it possible to define an optimal dose of hCG in combination with rFSH from the first day of stimulation in the GnRH agonist protocol applied to IVF? SUMMARY ANSWER: Supplementation with hCG from the first day of stimulation may increase the number of top-quality embryos per patient. Daily doses...... has been previously reported. We suggest a large clinical trial to be proceeded with a group given 100 IU hCG daily versus a control group. WHAT IS KNOWN AND WHAT THIS PAPER ADDS: Prospective multicentre studies have indicated increased live birth rates and increased number of top-quality embryos when...

  4. Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 1: state of the art.

    Science.gov (United States)

    Johansen, Monika Alise; Henriksen, Eva; Horsch, Alexander; Schuster, Tibor; Berntsen, Gro K Rosvold

    2012-10-03

    Over the last two decades, the number of studies on electronic symptom reporting has increased greatly. However, the field is very heterogeneous: the choices of patient groups, health service innovations, and research targets seem to involve a broad range of foci. To move the field forward, it is necessary to build on work that has been done and direct further research to the areas holding most promise. Therefore, we conducted a comprehensive review of randomized controlled trials (RCTs) focusing on electronic communication between patient and provider to improve health care service quality, presented in two parts. Part 2 investigates the methodological quality and effects of the RCTs, and demonstrates some promising benefits of electronic symptom reporting. To give a comprehensive overview of the most mature part of this emerging field regarding (1) patient groups, (2) health service innovations, and (3) research targets relevant to electronic symptom reporting. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles published from 1990 to November 2011. Inclusion criteria were RCTs of interventions where patients or parents reported health information electronically to the health care system for health care purposes and were given feedback. Of 642 records identified, we included 32 articles representing 29 studies. The included articles were published from 2002, with 24 published during the last 5 years. The following five patient groups were represented: respiratory and lung diseases (12 studies), cancer (6), psychiatry (6), cardiovascular (3), and diabetes (1). In addition to these, 1 study had a mix of three groups. All included studies, except 1, focused on long-term conditions. We identified four categories of health service innovations: consultation support (7 studies), monitoring with clinician support (12), self-management with clinician support (9

  5. Family Food Providers' Perceptions of the Causes of Obesity and Effectiveness of Weight Control Strategies in Five Countries in the Asia Pacific Region: A Cross-Sectional Survey.

    Science.gov (United States)

    Worsley, Anthony; Wang, Wei; Sarmugam, Rani; Pham, Quynh; Februhartanty, Judhiastuty; Ridley, Stacey

    2017-01-18

    The rise of the middle classes in developing countries and the associated epidemiological transition raises the importance of assessing this population group's awareness of the causes of obesity and effective weight control strategies in order to develop effective health promotion strategies. The study aimed to examine the perceptions of the causes of obesity and weight control strategies held by middle class household food providers in Melbourne, Singapore, Shanghai, Indonesia and Vietnam. An online survey was conducted in late 2013, early 2014 among 3945 respondents. Information about body weight concerns, perceived causes of obesity, effectiveness of weight control methods, demographics, self-reported height and weight, and personal values was elicited. Confirmatory factor analyses (CFA) derived nine reliable factors which were used in structural equation modelling (SEM). Two thirds of respondents were trying to change their body weight, of them, 71% were trying to lose weight. The CFA and SEM showed that demographics, region of residence, personal values and perceptions of the causes of obesity ( Unhealthy food behaviours , influences Beyond personal control and Environmental influences ) had direct and indirect associations with three weight control methods factors, named: Healthy habits, Eat less, sit less , and Dieting. Middle class food providers in the study regions share public health views of obesity causation and personal weight control. These findings could inform public health and food policies, and the design of public health interventions and communications. Further research is required among lower socio economic status (SES) populations.

  6. Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness.

    Science.gov (United States)

    Santer, Miriam; Ridd, Matthew J; Francis, Nick A; Stuart, Beth; Rumsby, Kate; Chorozoglou, Maria; Becque, Taeko; Roberts, Amanda; Liddiard, Lyn; Nollett, Claire; Hooper, Julie; Prude, Martina; Wood, Wendy; Thomas, Kim S; Thomas-Jones, Emma; Williams, Hywel C; Little, Paul

    2018-05-03

    To determine the clinical effectiveness and cost effectiveness of including emollient bath additives in the management of eczema in children. Pragmatic randomised open label superiority trial with two parallel groups. 96 general practices in Wales and western and southern England. 483 children aged 1 to 11 years, fulfilling UK diagnostic criteria for atopic dermatitis. Children with very mild eczema and children who bathed less than once weekly were excluded. Participants in the intervention group were prescribed emollient bath additives by their usual clinical team to be used regularly for 12 months. The control group were asked to use no bath additives for 12 months. Both groups continued with standard eczema management, including leave-on emollients, and caregivers were given standardised advice on how to wash participants. The primary outcome was eczema control measured by the patient oriented eczema measure (POEM, scores 0-7 mild, 8-16 moderate, 17-28 severe) weekly for 16 weeks. Secondary outcomes were eczema severity over one year (monthly POEM score from baseline to 52 weeks), number of eczema exacerbations resulting in primary healthcare consultation, disease specific quality of life (dermatitis family impact), generic quality of life (child health utility-9D), utilisation of resources, and type and quantity of topical corticosteroid or topical calcineurin inhibitors prescribed. 483 children were randomised and one child was withdrawn, leaving 482 children in the trial: 51% were girls (244/482), 84% were of white ethnicity (447/470), and the mean age was 5 years. 96% (461/482) of participants completed at least one post-baseline POEM, so were included in the analysis, and 77% (370/482) completed questionnaires for more than 80% of the time points for the primary outcome (12/16 weekly questionnaires to 16 weeks). The mean baseline POEM score was 9.5 (SD 5.7) in the bath additives group and 10.1 (SD 5.8) in the no bath additives group. The mean POEM score

  7. The Tulip GT® airway versus the facemask and Guedel airway: a randomised, controlled, cross-over study by Basic Life Support-trained airway providers in anaesthetised patients.

    Science.gov (United States)

    Shaikh, A; Robinson, P N; Hasan, M

    2016-03-01

    We performed a randomised, controlled, cross-over study of lung ventilation by Basic Life Support-trained providers using either the Tulip GT® airway or a facemask with a Guedel airway in 60 anaesthetised patients. Successful ventilation was achieved if the provider produced an end-tidal CO2 > 3.5 kPa and a tidal volume > 250 ml in two of the first three breaths, within 60 sec and within two attempts. Fifty-seven (95%) providers achieved successful ventilation using the Tulip GT compared with 35 (58%) using the facemask (p Basic Life Support-trained airway providers. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  8. Localized melt-scan strategy for site specific control of grain size and primary dendrite arm spacing in electron beam additive manufacturing

    International Nuclear Information System (INIS)

    Raghavan, Narendran; Simunovic, Srdjan; Dehoff, Ryan; Plotkowski, Alex; Turner, John; Kirka, Michael; Babu, Suresh

    2017-01-01

    In addition to design geometry, surface roughness, and solid-state phase transformation, solidification microstructure plays a crucial role in controlling the performance of additively manufactured components. Crystallographic texture, primary dendrite arm spacing (PDAS), and grain size are directly correlated to local solidification conditions. We have developed a new melt-scan strategy for inducing site specific, on-demand control of solidification microstructure. We were able to induce variations in grain size (30 μm–150 μm) and PDAS (4 μm - 10 μm) in Inconel 718 parts produced by the electron beam additive manufacturing system (Arcam ® ). A conventional raster melt-scan resulted in a grain size of about 600 μm. The observed variations in grain size with different melt-scan strategies are rationalized using a numerical thermal and solidification model which accounts for the transient curvature of the melt pool and associated thermal gradients and liquid-solid interface velocities. The refinement in grain size at high cooling rates (>10 4  K/s) is also attributed to the potential heterogeneous nucleation of grains ahead of the epitaxially growing solidification front. The variation in PDAS is rationalized using a coupled numerical-theoretical model as a function of local solidification conditions (thermal gradient and liquid-solid interface velocity) of the melt pool.

  9. Additive Manufacturing Infrared Inspection

    Science.gov (United States)

    Gaddy, Darrell; Nettles, Mindy

    2015-01-01

    The Additive Manufacturing Infrared Inspection Task started the development of a real-time dimensional inspection technique and digital quality record for the additive manufacturing process using infrared camera imaging and processing techniques. This project will benefit additive manufacturing by providing real-time inspection of internal geometry that is not currently possible and reduce the time and cost of additive manufactured parts with automated real-time dimensional inspections which deletes post-production inspections.

  10. An Economic Evaluation of TENS in Addition to Usual Primary Care Management for the Treatment of Tennis Elbow: Results from the TATE Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Martyn Lewis

    Full Text Available The TATE trial was a multicentre pragmatic randomized controlled trial of supplementing primary care management (PCM-consisting of a GP consultation followed by information and advice on exercises-with transcutaneous electrical nerve stimulation (TENS, to reduce pain intensity in patients with tennis elbow. This paper reports the health economic evaluation.Adults with new diagnosis of tennis elbow were recruited from 38 general practices in the UK, and randomly allocated to PCM (n = 120 or PCM plus TENS (n = 121. Outcomes included reduction in pain intensity and quality-adjusted-life-years (QALYs based on the EQ5D and SF6D. Two economic perspectives were evaluated: (i healthcare-inclusive of NHS and private health costs for the tennis elbow; (ii societal-healthcare costs plus productivity losses through work absenteeism. Mean outcome and cost differences between the groups were evaluated using a multiple imputed dataset as the base case evaluation, with uncertainty represented in cost-effectiveness planes and through probabilistic cost-effectiveness acceptability curves. Incremental healthcare cost was £33 (95%CI -40, 106 and societal cost £65 (95%CI -307, 176 for PCM plus TENS. Mean differences in outcome were: 0.11 (95%CI -0.13, 0.35 for change in pain (0-10 pain scale; -0.015 (95%CI -0.058, 0.029 for QALYEQ5D; 0.007 (95%CI -0.022, 0.035 for QALYSF6D (higher score differences denote greater benefit for PCM plus TENS. The ICER (incremental cost effectiveness ratio for the main evaluation of mean difference in societal cost (£ relative to mean difference in pain outcome was -582 (95%CI -8666, 8113. However, incremental ICERs show differences in cost-effectiveness of additional TENS, according to the outcome being evaluated.Our findings do not provide evidence for or against the cost-effectiveness of TENS as an adjunct to primary care management of tennis elbow.

  11. Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol

    Science.gov (United States)

    2012-01-01

    Background Knee osteoarthritis (OA) is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability. Many people with knee OA also experience co-morbidities that further add to the OA burden. Uptake of and adherence to physical activity recommendations is suboptimal in this patient population, leading to poorer OA outcomes and greater impact of associated co-morbidities. This pragmatic randomised controlled trial will investigate the clinical- and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA. Methods/Design 168 people with clinically diagnosed knee OA will be recruited from the community in metropolitan and regional areas and randomly allocated to physiotherapy only, or physiotherapy plus nurse-delivered telephone coaching. Physiotherapy involves five treatment sessions over 6 months, incorporating a home exercise program of 4–6 exercises (targeting knee extensor and hip abductor strength) and advice to increase daily physical activity. Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia (HCA) Model of Health Change to provide behaviour change support. The telephone coaching intervention aims to maximise adherence to the physiotherapy program, as well as facilitate increased levels of participation in general physical activity. The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months. Secondary outcomes include physical activity levels, quality-of-life, and potential moderators and mediators of outcomes including self-efficacy, pain coping and depression. Relative cost-effectiveness will be determined from health service usage and outcome data. Follow

  12. Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2012-12-01

    Full Text Available Abstract Background Knee osteoarthritis (OA is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability. Many people with knee OA also experience co-morbidities that further add to the OA burden. Uptake of and adherence to physical activity recommendations is suboptimal in this patient population, leading to poorer OA outcomes and greater impact of associated co-morbidities. This pragmatic randomised controlled trial will investigate the clinical- and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA. Methods/Design 168 people with clinically diagnosed knee OA will be recruited from the community in metropolitan and regional areas and randomly allocated to physiotherapy only, or physiotherapy plus nurse-delivered telephone coaching. Physiotherapy involves five treatment sessions over 6 months, incorporating a home exercise program of 4–6 exercises (targeting knee extensor and hip abductor strength and advice to increase daily physical activity. Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia (HCA Model of Health Change to provide behaviour change support. The telephone coaching intervention aims to maximise adherence to the physiotherapy program, as well as facilitate increased levels of participation in general physical activity. The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months. Secondary outcomes include physical activity levels, quality-of-life, and potential moderators and mediators of outcomes including self-efficacy, pain coping and depression. Relative cost-effectiveness will be determined from health service usage and outcome

  13. Wind Turbine Providing Grid Support

    DEFF Research Database (Denmark)

    2011-01-01

    changing the operation of the wind turbine to a more efficient working point.; When the rotational speed of the rotor reaches a minimum value, the wind turbine enters a recovery period to re-accelerate the rotor to the nominal rotational speed while further contributing to the stability of the electrical......A variable speed wind turbine is arranged to provide additional electrical power to counteract non-periodic disturbances in an electrical grid. A controller monitors events indicating a need to increase the electrical output power from the wind turbine to the electrical grid. The controller...... is arranged to control the wind turbine as follows: after an indicating event has been detected, the wind turbine enters an overproduction period in which the electrical output power is increased, wherein the additional electrical output power is taken from kinetic energy stored in the rotor and without...

  14. Collaborative Russian-US work in nuclear material protection, control and accounting at the Institute of Physics and Power Engineering. II. extension to additional facilities

    International Nuclear Information System (INIS)

    Kuzin, V.V.; Pshakin, G.M.; Belov, A.P.

    1996-01-01

    During 1995, collaborative Russian-US nuclear material protection, control and accounting (MPC ampersand A) tasks at the Institute of Physics and Power Engineering (IPPE) in Obninsk, Russia focused on improving the protection of nuclear materials at the BFS Fast Critical Facility. BFS has thousands of fuel disks containing highly enriched uranium and weapons-grade plutonium that are used to simulate the core configurations of experimental reactors in two critical assemblies. Completed tasks culminated in demonstrations of newly implemented equipment and methods that enhanced the MPC ampersand A at BFS through computerized accounting, nondestructive inventory verification measurements, personnel identification and assess control, physical inventory taking, physical protection, and video surveillance. The collaborative work is now being extended. The additional tasks encompass communications and tamper-indicating devices; new storage alternatives; and systemization of the MPC ampersand A elements that are being implemented

  15. Mud-Bath Therapy in Addition to Usual Care in Bilateral Knee Osteoarthritis: An Economic Evaluation Alongside a Randomized Controlled Trial.

    Science.gov (United States)

    Ciani, Oriana; Pascarelli, Nicola Antonio; Giannitti, Chiara; Galeazzi, Mauro; Meregaglia, Michela; Fattore, Giovanni; Fioravanti, Antonella

    2017-07-01

    To perform a cost-effectiveness analysis of mud-bath therapy (MBT) in addition to usual treatment compared to usual treatment alone in patients with bilateral knee osteoarthritis (OA). An economic evaluation alongside a randomized controlled trial was conducted. Patients were randomly assigned to receive either a 2-week cycle of MBT in addition to their usual treatment or to continue routine care alone. The EuroQol 5-domain questionnaire was administered at baseline, 2 weeks, and at 3, 6, 9, and 12 months. Direct health care resource consumption data up until 12 months were derived from a daily diary given to patients and returned at prescheduled followup visits. A total of 103 patients were included (n = 53 for MBT patients; n = 50 for controls). Overall, patients in the MBT group accrued mean ± SD 0.835 ± 0.10 quality-adjusted life years (QALYs) compared to 0.753 ± 0.11 in the control group (P < 0.001). Average direct costs per patient (€303 versus €975; P < 0.001) were higher in the control group, primarily because of hospitalization for total knee replacement and use of intraarticular hyaluronic acid. Bootstrapping replications of costs and QALY sample distributions consistently indicated that the MBT therapy combined with standard therapy represents a dominant strategy as compared with standard therapy alone. The probability of MBT being cost-effective at standard cost-effectiveness thresholds (e.g., €20,000/QALY) is 100%. The results of this cost-effectiveness analysis support the use of MBT as midterm complementary therapy in the management of knee OA. © 2016, American College of Rheumatology.

  16. Evaluation of a Web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial.

    Science.gov (United States)

    Yardley, Lucy; Joseph, Judith; Michie, Susan; Weal, Mark; Wills, Gary; Little, Paul

    2010-12-15

    There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions. This study was designed as an evaluation of the usage and effects of the "Internet Doctor" website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change. Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use. The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline

  17. Additive Effect of Qidan Dihuang Grain, a Traditional Chinese Medicine, and Angiotensin Receptor Blockers on Albuminuria Levels in Patients with Diabetic Nephropathy: A Randomized, Parallel-Controlled Trial

    Science.gov (United States)

    Xiang, Lei; Jiang, Pingping; Zhou, Lin; Sun, Xiaomin; Bi, Jianlu; Cui, Lijuan; Nie, Xiaoli; Luo, Ren; Liu, Yanyan

    2016-01-01

    Albuminuria is characteristic of early-stage diabetic nephropathy (DN). The conventional treatments with angiotensin receptor blockers (ARB) are unable to prevent the development of albuminuria in normotensive individuals with type 2 diabetes mellitus (T2DM). Purpose. The present study aimed to evaluate the effect of ARB combined with a Chinese formula Qidan Dihuang grain (QDDHG) in improving albuminuria and Traditional Chinese Medicine Symptom (TCMS) scores in normotensive individuals with T2DM. Methods. Eligible patients were randomized to the treatment group and the control group. Results. Compared with baseline (week 0), both treatment and control groups markedly improved the 24-hour albuminuria, total proteinuria (TPU), and urinary albumin to creatinine ratio (A/C) at 4, 8, and 12 weeks. Between treatment and the control group, the levels of albuminuria in the treatment group were significantly lower than in the control group at 8 and 12 weeks (p < 0.05). In addition, treatment group markedly decreased the scores of TCMS after treatment. Conclusion. This trial suggests that QDDHG combined with ARB administration decreases the levels of albuminuria and the scores for TCMS in normotensive individuals with T2DM. PMID:27375762

  18. Addition of Ceftriaxone and Amikacin to a Ciprofloxacin plus Metronidazole Regimen for Preventing Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Izadpanahi

    2017-01-01

    Full Text Available Background. The objective of this study was to evaluate the efficacy of adding single doses of ceftriaxone and amikacin to a ciprofloxacin plus metronidazole regimen on the reduction of infectious complications following transrectal ultrasound-guided prostate biopsy (TRUS Bx. Materials and Methods. Four hundred and fifty patients who were candidates for TRUS Bx were divided into two groups of 225 each. The control group received ciprofloxacin 500 mg orally every 12 hours together with metronidazole 500 mg orally every 8 hours from the day prior to the procedure until the fifth postoperative day. In the second group, single doses of ceftriaxone 1 g by intravenous infusion and amikacin 5 mg/kg intramuscularly were administered 30–60 minutes before TRUS Bx in addition to the oral antimicrobials described for group 1. The incidence of infection was compared between the groups. Results. The incidence of infectious complications in the intervention group was significantly lower than that in the control group (4.6% versus 0.9%, p=0.017. Conclusion. The addition of single doses of intramuscular amikacin and intravenously infused ceftriaxone to our prophylactic regimen of ciprofloxacin plus metronidazole resulted in a statistically significant reduction of infectious complications following TRUS Bx.

  19. Addition of atropine to submaximal exercise stress testing in patients evaluated for suspected ischaemia with SPECT imaging: a randomized, placebo-controlled trial

    International Nuclear Information System (INIS)

    Manganelli, Fiore; Sauro, Rosario; Di Lorenzo, Emilio; Rosato, Giuseppe; Spadafora, Marco; Varrella, Paola; Peluso, Giuseppina; Daniele, Stefania; Cuocolo, Alberto

    2011-01-01

    To evaluate the effects of the addition of atropine to exercise testing in patients who failed to achieve their target heart rate (HR) during stress myocardial perfusion imaging with single-photon emission computed tomography (SPECT). The study was a prospective, randomized, placebo-controlled design. Patients with suspected or known coronary artery disease who failed to achieve a target HR (≥85% of maximal predicted HR) during exercise SPECT imaging were randomized to receive intravenous atropine (n = 100) or placebo (n = 101). The two groups of patients did not differ with respect to demographic or clinical characteristics. A higher proportion of patients in the atropine group achieved the target HR compared to the placebo group (60% versus 3%, p < 0.0001). SPECT imaging was abnormal in a higher proportion of patients in the atropine group as compared to the placebo group (57% versus 42%, p < 0.05). Stress-induced myocardial ischaemia was present in more patients in the atropine group as compared to placebo (47% versus 29%, p < 0.01). In both groups of patients, no major side effects occurred. The addition of atropine at the end of exercise testing is more effective than placebo in raising HR to adequate levels, without additional risks of complications. The use of atropine in patients who initially failed to achieve their maximal predicted HR is associated with a higher probability of achieving a diagnostic myocardial perfusion study. (orig.)

  20. Sustained impact of a short small group course with systematic feedback in addition to regular clinical clerkship activities on musculoskeletal examination skills--a controlled study.

    Science.gov (United States)

    Perrig, Martin; Berendonk, Christoph; Rogausch, Anja; Beyeler, Christine

    2016-01-28

    The discrepancy between the extensive impact of musculoskeletal complaints and the common deficiencies in musculoskeletal examination skills lead to increased emphasis on structured teaching and assessment. However, studies of single interventions are scarce and little is known about the time-dependent effect of assisted learning in addition to a standard curriculum. We therefore evaluated the immediate and long-term impact of a small group course on musculoskeletal examination skills. All 48 Year 4 medical students of a 6 year curriculum, attending their 8 week clerkship of internal medicine at one University department in Berne, participated in this controlled study. Twenty-seven students were assigned to the intervention of a 6×1 h practical course (4-7 students, interactive hands-on examination of real patients; systematic, detailed feedback to each student by teacher, peers and patients). Twenty-one students took part in the regular clerkship activities only and served as controls. In all students clinical skills (CS, 9 items) were assessed in an Objective Structured Clinical Examination (OSCE) station, including specific musculoskeletal examination skills (MSES, 7 items) and interpersonal skills (IPS, 2 items). Two raters assessed the skills on a 4-point Likert scale at the beginning (T0), the end (T1) and 4-12 months after (T2) the clerkship. Statistical analyses included Friedman test, Wilcoxon rank sum test and Mann-Whitney U test. At T0 there were no significant differences between the intervention and control group. At T1 and T2 the control group showed no significant changes of CS, MSES and IPS compared to T0. In contrast, the intervention group significantly improved CS, MSES and IPS at T1 (p skills during regular clinical clerkship activities. However, an additional small group, interactive clinical skills course with feedback from various sources, improved these essential examination skills immediately after the teaching and several months later

  1. Freezing point osmometry of milk to determine the additional water content – an issue in general quality control and German food regulation

    Directory of Open Access Journals (Sweden)

    Holz Birger

    2008-03-01

    Full Text Available Abstract Background The determination of the osmolality of aqueous samples using a freezing point osmometer is a well-established, routine laboratory method. In addition to their use in clinical and pharmaceutical laboratories, freezing point osmometers are also employed in food testing laboratories. One application is the determination of the osmolality of milk. Although cow's milk is a natural product whose water content is approximately 87%, the osmolality of milk is a significant value when the milk is collected from a larger population of animals. This value is used in milk processing to control the water content, based on the German Food Control Regulations for Milk. Results Measurement of the freezing point and osmolality of milk samples was performed with a Knauer Semi-Micro Freezing Point Osmometer. Osmolality was measured for the untreated milk samples and following their dilution (by volume with 10% and 50% water. The measurements were made after 1, 4 and 7 days to evaluate changes over time. All measurement values for the undiluted milk were spread over a small interval with an average of 271 mOsmol/kg. After mixing the milk samples with 10% water, the average decreased to 242 mOsmol/kg, while mixing with 50% water resulted in an average osmolality of 129 mOsmol/kg. There was no significant change for the osmolality within the 7 days (measurements from days 1, 4 and 7. Conclusion The results observed demonstrate clearly that the additional water content of milk can be determined easily using a freezing point osmometer. Milk samples that contain additional water have a significantly decreased osmolality, corresponding to an increased freezing point. The effect on osmolality of ageing the milk samples could not be determined in this study's time-dependent measurements.

  2. Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: a randomized controlled study.

    Science.gov (United States)

    Taubman, Danielle; Titler, Nava; Edelstein, Hana; Elias, Mazen; Saliba, Walid

    2013-12-01

    The compliance of screening for latent tuberculosis (TB) with the tuberculin purified protein derivative (PPD) test is very low among healthcare workers (HCWs) in Israel. This randomized controlled study uses the Health Belief Model (HBM) as a conceptual framework to examine whether providing more information about latent TB and the PPD test increases the response rate for PPD screening among HCWs. All candidate HCWs for latent TB screening were randomly allocated to one of the following two invitations to perform the PPD test: regular letter (control group, n=97), and a letter with information about latent TB and the PPD test (intervention group, n=196). 293 HCWs were included (185 nurses, and 108 physicians). Overall, 36 (12.3%) HCWs were compliant with the PPD test screening. Compliance with PPD testing in the intervention group was not statistically different from the control group, RR 0.87 (95% CI, 0.46-1.65). Compliance for latent TB screening is low among HCWs in northeastern Israel. Providing detailed information about latent TB was not associated with increased test compliance. Understanding existing disparities in screening rates and potential barriers to latent TB screening among HCWs is important in order to move forward and successfully increase screening rates. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  3. Do prehospital discharge pacemaker checks provide any additional clinical benefit?

    Science.gov (United States)

    Wheelan, Kevin R; Legge, Darlene M; Sakowski, Brent C; Bruce, Susan S; Roberts, David C; Johnston, L Murphy; Moore, B Jane; Beveridge, Thomas P; Wells, Peter J; Vallabahn, Ravi; Donsky, Michael S; Franklin, Jay O

    2005-08-01

    We performed a retrospective analysis of 250 records of consecutive, newly implanted, pacemaker patients from a single center to determine the rate of postimplant complications and observations discovered before and during the prehospital discharge evaluation. No observations occurred in 246 of 250 patients (98.4%) (1-sided 95% confidence interval 96.4%). Of the 250 patients, 4 had observations that were discovered at the prehospital discharge check and required reprogramming to increase the sensitivity safety margin (3 atrial and 1 ventricular). We documented only 1 complication that was discovered before the predischarge evaluation through telemetry and resulted in an atrial lead revision.

  4. Symbol addition by monkeys provides evidence for normalized quantity coding

    Science.gov (United States)

    Livingstone, Margaret S.; Pettine, Warren W.; Srihasam, Krishna; Moore, Brandon; Morocz, Istvan A.; Lee, Daeyeol

    2014-01-01

    Weber’s law can be explained either by a compressive scaling of sensory response with stimulus magnitude or by a proportional scaling of response variability. These two mechanisms can be distinguished by asking how quantities are added or subtracted. We trained Rhesus monkeys to associate 26 distinct symbols with 0–25 drops of reward, and then tested how they combine, or add, symbolically represented reward magnitude. We found that they could combine symbolically represented magnitudes, and they transferred this ability to a novel symbol set, indicating that they were performing a calculation, not just memorizing the value of each combination. The way they combined pairs of symbols indicated neither a linear nor a compressed scale, but rather a dynamically shifting, relative scaling. PMID:24753600

  5. Studies on sintering additives for hydroxyapatite, and controlled porosity structures of calcium aluminates and polypropylene-tricalcium phosphate for bone graft applications

    Science.gov (United States)

    Kalita, Samar Jyoti

    Tissue engineering has made a significant contribution in developing new biomaterials that can restore the structural features and physiological functions of natural tissues. Various materials, such as metals, ceramics, polymers and composites have been developed for their use in hard tissue engineering applications. Part A of this thesis describes my research on HAp ceramics. HAp, a bioactive ceramic, is known for its osteoconductivity, but shows poor mechanical performance. This program aimed at improving mechanical performance of synthetic HAp by introducing small quantities of various sintering additives. A range of oxide-based sintering additives were selected and prepared. Dense compacts were prepared using a uniaxial press with an average green density of 1.6 g/cc. Results showed that some of these sintering additives improved densification, hardness and compression strength of synthetic HAp compared to the pure composition. A maximum bulk density of 3.06 g/cc was achieved for 2.5 wt% addition of MgO. A Microhardness of 4.9 GPa (505 HV) was measured for 2.5 wt% addition of BaO, and the highest compression strength (220MPa) was reported for 2.5 wt% addition of CaO. Cytotoxicity and cell proliferation studies with a modified human osteoblast (HOB) cell-line (OPC1) proved most of these materials non-toxic and biocompatible. Microscopic observation revealed that bone cells were attached and grew well on most of these ceramic matrices. Part B describes my work on development of controlled porosity polypropylene-tricalcium phosphate composite scaffolds via the fused deposition modeling (FDM) process. Hg-porosimetry was performed to determine pore size and their distribution. Uniaxial compression testing performed on samples with 36 vol% porosity and pore size of 160 mum showed the best compressive strength of 12.7 MPa. Part C includes my research on development of "3-D honeycomb" porous calcium aluminate structures via the indirect FDM process. Samples of 29% and

  6. Semimanufacture intended to be mounted on a vibrating wall or a vibrating panel for actively damping vibrations of the wall, wall or panel provided with such semimanufacture, system provided with a semimanufacture and a control unit, wall or panel provided with a control unit and method for damping audible vibrations of a wall or panel

    NARCIS (Netherlands)

    de Goeje, Marius; van Overbeek, Michiel Wilbert R.M.; van der Waal, Adri; Berkhoff, Arthur P.; Nederveen, Peter J.

    2005-01-01

    A semimanufacture intended to be mounted on a vibrating wall or a vibrating panel for actively damping the vibrations in the wall or the panel with frequencies which are at least partly audible, wherein the semimanufacture is provided with a plate wherein the plate is integrated with: at least one

  7. The Kidney Awareness Registry and Education (KARE) study: protocol of a randomized controlled trial to enhance provider and patient engagement with chronic kidney disease.

    Science.gov (United States)

    Tuot, Delphine S; Velasquez, Alexandra; McCulloch, Charles E; Banerjee, Tanushree; Zhu, Yunnuo; Hsu, Chi-yuan; Handley, Margaret; Schillinger, Dean; Powe, Neil R

    2015-10-22

    Chronic kidney disease (CKD) is common and is associated with excess mortality and morbidity. Better management could slow progression of disease, prevent metabolic complications, and reduce cardiovascular outcomes. Low patient awareness of CKD and ineffective patient-provider communication can impede such efforts. We developed provider and patient-directed interventions that harness health information technology to enhance provider recognition of CKD and delivery of guideline concordant care and augment patient understanding and engagement in CKD care. We report the design and protocol of the Kidney Awareness Registry and Education (KARE) Study, a 2x2 factorial randomized controlled trial that examines the impact of a multi-level intervention on health outcomes among low-income English, Spanish and Cantonese-speaking patients with CKD in a safety net system. The intervention includes: (1) implementation of a primary care electronic CKD registry that notifies practice teams of patients' CKD status and employs a patient profile and quarterly feedback to encourage provision of guideline-concordant care at point-of-care and via outreach; and (2) a language-concordant, culturally-sensitive self-management support program that consists of automated telephone modules, provision of low-literacy written patient-educational materials and telephone health coaching. The primary outcomes of the trial are changes in systolic blood pressure (BP) and the proportion of patients with BP control (≤ 140/90 mmHg) after one year. Secondary outcomes include patient understanding of CKD, participation in healthy behaviors, and practice team delivery of guideline-concordant CKD care. Results from the KARE study will provide data on the feasibility, effectiveness, and acceptability of technology-based interventions that support primary care efforts at improving health outcomes among vulnerable patients with CKD. ClinicalTrials.gov, number: NCT01530958.

  8. Does addition of `mud-pack and hot pool treatment' to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study

    Science.gov (United States)

    Bağdatlı, Ali Osman; Donmez, Arif; Eröksüz, Rıza; Bahadır, Güler; Turan, Mustafa; Erdoğan, Nergis

    2015-12-01

    The aim of this randomized controlled single-blind study is to explore whether addition of mud-pack and hot pool treatments to patient education make a significant difference in short and mild term outcomes of the patients with fibromyalgia. Seventy women with fibromyalgia syndrome were randomly assigned to either balneotherapy with mud-pack and hot pool treatments (35) or control (35) groups. After randomization, five patients from balneotherapy group and five patients from control group were dropped out from the study with different excuses. All patients had 6-h patient education programme about fibromyalgia syndrome and were given a home exercise programme. The patients in balneotherapy group had heated pool treatment at 38 °C for 20 min a day, and mud-pack treatment afterwards on back region at 45 °C. Balneotherapy was applied on weekdays for 2 weeks. All patients continued to take their medical treatment. An investigator who was blinded to the intervention assessed all the patients before and after the treatment, at the first and the third months of follow-up. Outcome measures were FIQ, BDI and both patient's and physician's global assessments. Balneotherapy group was significantly better than control group at after the treatment and at the end of the first month follow-up assessments in terms of patient's and physician's global assessment, total FIQ score, and pain intensity, fatigue, non-refreshed awaking, stiffness, anxiety and depression subscales of FIQ. No significant difference was found between the groups in terms of BDI scores. It is concluded that patient education combined with 2 weeks balneotherapy application has more beneficial effects in patients with fibromyalgia syndrome as compared to patient education alone.

  9. Does addition of 'mud-pack and hot pool treatment' to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study.

    Science.gov (United States)

    Bağdatlı, Ali Osman; Donmez, Arif; Eröksüz, Rıza; Bahadır, Güler; Turan, Mustafa; Erdoğan, Nergis

    2015-12-01

    The aim of this randomized controlled single-blind study is to explore whether addition of mud-pack and hot pool treatments to patient education make a significant difference in short and mild term outcomes of the patients with fibromyalgia. Seventy women with fibromyalgia syndrome were randomly assigned to either balneotherapy with mud-pack and hot pool treatments (35) or control (35) groups. After randomization, five patients from balneotherapy group and five patients from control group were dropped out from the study with different excuses. All patients had 6-h patient education programme about fibromyalgia syndrome and were given a home exercise programme. The patients in balneotherapy group had heated pool treatment at 38 °C for 20 min a day, and mud-pack treatment afterwards on back region at 45 °C. Balneotherapy was applied on weekdays for 2 weeks. All patients continued to take their medical treatment. An investigator who was blinded to the intervention assessed all the patients before and after the treatment, at the first and the third months of follow-up. Outcome measures were FIQ, BDI and both patient's and physician's global assessments. Balneotherapy group was significantly better than control group at after the treatment and at the end of the first month follow-up assessments in terms of patient's and physician's global assessment, total FIQ score, and pain intensity, fatigue, non-refreshed awaking, stiffness, anxiety and depression subscales of FIQ. No significant difference was found between the groups in terms of BDI scores. It is concluded that patient education combined with 2 weeks balneotherapy application has more beneficial effects in patients with fibromyalgia syndrome as compared to patient education alone.

  10. Home visits by neighborhood Mentor Mothers provide timely recovery from childhood malnutrition in South Africa: results from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mbewu Nokwanele

    2010-11-01

    Full Text Available Abstract Background Child and infant malnourishment is a significant and growing problem in the developing world. Malnourished children are at high risk for negative health outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve childhood nourishment. The objective of this study is to evaluate whether the Philani program can rehabilitate malnourished children in a timely manner. Methods Mentor Mothers were trained to conduct home visits. Mentor Mothers went from house to house in assigned neighborhoods, weighed children age 5 and younger, and recruited mother-child dyads where there was an underweight child. Participating dyads were assigned in a 2:1 random sequence to the Philani intervention condition (n = 536 or a control condition (n = 252. Mentor Mothers visited dyads in the intervention condition for one year, supporting mothers' problem-solving around nutrition. All children were weighed by Mentor Mothers at baseline and three, six, nine and twelve month follow-ups. Results By three months, children in the intervention condition were five times more likely to rehabilitate (reach a healthy weight for their ages than children in the control condition. Throughout the course of the study, 43% (n = 233 of 536 of children in the intervention condition were rehabilitated while 31% (n = 78 of 252 of children in the control condition were rehabilitated. Conclusions Paraprofessional Mentor Mothers are an effective strategy for delivering home visiting programs by providing the knowledge and support necessary to change the behavior of families at risk.

  11. High-speed assembly language (80386/80387) programming for laser spectra scan control and data acquisition providing improved resolution water vapor spectroscopy

    Science.gov (United States)

    Allen, Robert J.

    1988-01-01

    An assembly language program using the Intel 80386 CPU and 80387 math co-processor chips was written to increase the speed of data gathering and processing, and provide control of a scanning CW ring dye laser system. This laser system is used in high resolution (better than 0.001 cm-1) water vapor spectroscopy experiments. Laser beam power is sensed at the input and output of white cells and the output of a Fabry-Perot. The assembly language subroutine is called from Basic, acquires the data and performs various calculations at rates greater than 150 faster than could be performed by the higher level language. The width of output control pulses generated in assembly language are 3 to 4 microsecs as compared to 2 to 3.7 millisecs for those generated in Basic (about 500 to 1000 times faster). Included are a block diagram and brief description of the spectroscopy experiment, a flow diagram of the Basic and assembly language programs, listing of the programs, scope photographs of the computer generated 5-volt pulses used for control and timing analysis, and representative water spectrum curves obtained using these programs.

  12. A cost-effectiveness analysis of provider interventions to improve health worker practice in providing treatment for uncomplicated malaria in Cameroon: a study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Wiseman Virginia

    2012-01-01

    Full Text Available Abstract Background Governments and donors all over Africa are searching for sustainable, affordable and cost-effective ways to improve the quality of malaria case management. Widespread deficiencies have been reported in the prescribing and counselling practices of health care providers treating febrile patients in both public and private health facilities. Cameroon is no exception with low levels of adherence to national guidelines, the frequent selection of non-recommended antimalarials and the use of incorrect dosages. This study evaluates the effectiveness and cost-effectiveness of introducing two different provider training packages, alongside rapid diagnostic tests (RDTs, designed to equip providers with the knowledge and practical skills needed to effectively diagnose and treat febrile patients. The overall aim is to target antimalarial treatment better and to facilitate optimal use of malaria treatment guidelines. Methods/Design A 3-arm stratified, cluster randomized trial will be conducted to assess whether introducing RDTs with provider training (basic or enhanced is more cost-effective than current practice without RDTs, and whether there is a difference in the cost effectiveness of the provider training interventions. The primary outcome is the proportion of patients attending facilities that report a fever or suspected malaria and receive treatment according to malaria guidelines. This will be measured by surveying patients (or caregivers as they exit public and mission health facilities. Cost-effectiveness will be presented in terms of the primary outcome and a range of secondary outcomes, including changes in provider knowledge. Costs will be estimated from a societal and provider perspective using standard economic evaluation methodologies. Trial Registration ClinicalTrials.gov: NCT00981877

  13. Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis: An FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial.

    Science.gov (United States)

    Smith, Patrick A

    2016-04-01

    Platelet-rich plasma (PRP) injections have become an intriguing treatment option for osteoarthritis (OA), particularly OA of the knee. Despite the plethora of PRP-related citations, there is a paucity of high-level evidence that is comparable, cohort specific, dose controlled, injection protocol controlled, and double-blinded. To determine the safety and efficacy of leukocyte-poor PRP autologous conditioned plasma (ACP) for knee OA treatment through a feasibility trial regulated by the US Food and Drug Administration (FDA). Randomized controlled trial; Level of evidence, 1. In accordance with FDA protocol, patient selection was based on strict inclusion/exclusion criteria; 114 patients were screened, and 30 were ultimately included in the study. These patients were randomized to receive either ACP (n = 15) or saline placebo (n = 15) for a series of 3 weekly injections. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores served as the primary efficacy outcome measure. Patients were followed for 1 year. No adverse events were reported for ACP administration. Furthermore, the results demonstrated no statistically significant difference in baseline WOMAC scores between the 2 groups. However, in the ACP group, WOMAC scores at 1 week were significantly decreased compared with baseline scores, and the scores for this group remained significantly lower throughout the study duration. At the study conclusion (12 months), subjects in the ACP group had improved their overall WOMAC scores by 78% from their baseline score, compared with 7% for the placebo group. ACP is safe and provides quantifiable benefits for pain relief and functional improvement with regard to knee OA. No adverse events were reported for ACP administration. After 1 year, WOMAC scores for the ACP subjects had improved by 78% from their baseline score, whereas scores for the placebo control group had improved by only 7%. Other joints affected with OA may also benefit from this

  14. Working Together to Promote Diabetes Control: A Practical Guide for Diabetes Health Care Providers in Establishing a Working Alliance to Achieve Self-Management Support.

    Science.gov (United States)

    Jones, Allan; Vallis, Michael; Cooke, Debbie; Pouwer, François

    2016-01-01

    The quality of the "patient-carer" relationship is the foundation of self-management support and has been shown to influence treatment outcome in relation to psychological and somatic illness, including diabetes. It has long been accepted within applied psychology that the quality of the client-therapist relationship--termed the working alliance--is of central importance to treatment outcome and may account for a significant degree of the overall treatment effect. Diabetes healthcare providers have recently expressed a need for further training in communication techniques and in the psychological aspects of diabetes. Could we take a page from the psychological treatment manual on working alliance in therapy to guide the diabetes healthcare provider in their role of supporting the person with diabetes achieve and maintain better metabolic control? This paper examines the role of the working alliance in diabetes care and offers a practical guide to the diabetes healthcare provider in establishing a working alliance with the person with diabetes in managing diabetes.

  15. Additively Manufactured Macroporous Titanium with Silver-Releasing Micro-/Nanoporous Surface for Multipurpose Infection Control and Bone Repair - A Proof of Concept.

    Science.gov (United States)

    Jia, Zhaojun; Xiu, Peng; Xiong, Pan; Zhou, Wenhao; Cheng, Yan; Wei, Shicheng; Zheng, Yufeng; Xi, Tingfei; Cai, Hong; Liu, Zhongjun; Wang, Caimei; Zhang, Weiping; Li, Zhijiang

    2016-10-26

    Restoring large-scale bone defects, where osteogenesis is slow while infections lurk, with biomaterials represents a formidable challenge in orthopedic clinics. Here, we propose a scaffold-based multipurpose anti-infection and bone repairing strategy to meet such restorative needs. To do this, personalized multifunctional titanium meshes were produced through an advanced additive manufacturing process and dual "TiO 2 -poly(dopamine)/Ag (nano)" post modifications, yielding macroporous constructs with micro-/nanoporous walls and nanosilver bullets immobilized/embedded therein. Ultrahigh loading capacity and durable release of Ag + were accomplished. The scaffolds were active against planktonic/adherent bacteria (Gram-negative and positive) for up to 12 weeks. Additionally, they not only defended themselves from biofilm colonization but also helped destroy existing biofilms, especially in combination with antibiotics. Further, the osteoblasts/bacteria coculture study displayed that the engineered surfaces aided MG-63 cells to combat bacterial invasion. Meanwhile, the scaffolds elicited generally acceptable biocompatibility (cell adhesion, proliferation, and viability) and hastened osteoblast differentiation and maturation (alkaline phosphatase production, matrix secretion, and calcification), by synergy of micro-/nanoscale topological cues and bioactive catecholamine chemistry. Although done ex vivo, these studies reveal that our three-in-one strategy (infection prophylaxis, infection fighting, and bone repair) has great potential to simultaneously prevent/combat infections and bridge defected bone. This work provides new thoughts to the use of enabling technologies to design biomaterials that resolve unmet clinical needs.

  16. Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control.

    Science.gov (United States)

    Dell'Arciprete, Ana; Braunstein, José; Touris, Cecilia; Dinardi, Graciela; Llovet, Ignacio; Sosa-Estani, Sergio

    2014-01-29

    Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers. Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice. Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities. Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when

  17. Structure provided by parents in middle childhood predicts cortisol reactivity in adolescence among the offspring of parents with bipolar disorder and controls.

    Science.gov (United States)

    Ellenbogen, Mark A; Hodgins, Sheilagh

    2009-06-01

    Recent studies suggest that childhood exposure to adversity influences later functioning of the hypothalamic-pituitary-adrenal (HPA) axis. Parenting style in childhood, a putative moderator of adversity, may be important in determining HPA reactivity in adolescence. As part of a prospective, longitudinal study, saliva was collected at awakening and 30 and 60 min later over 2 days among 27 offspring of parents with bipolar disorder (high risk; 16.7+/-1.5 years) and 26 offspring of parents with no mental disorders (low risk; 16.2+/-1.7 years). In addition, 24 of the high risk and 22 of the low risk adolescents completed the "Trier Social Stress Test" (TSST). Parents had rated their parenting style when their offspring were 6-13 years of age. Low levels of structure (i.e. organization and consistency) provided by parents in middle childhood were predictive of an elevated cortisol response following awakening (beta=-0.36; padolescents' mood and behavior. The level of structure provided by parents in childhood predicted independent measures of cortisol reactivity in adolescence, suggesting that parenting style may regulate different aspects of HPA reactivity.

  18. Integrated real-time information to use in commercial, logistics and operational activities provide by the national control center operation of Transpetro

    Energy Technology Data Exchange (ETDEWEB)

    Aniceto, Hello A. R. [National Control Center Operation Transpetro, Rio de Janeiro, (Brazil)

    2010-07-01

    TRANSPETRO needed real time computational tools to manage its commercial, logistics and operational activities more efficiently. TRANSPETRO's National Control Center Operation developed an information site that provides information in real time on the process plans involved in each operation, using a Plant Information Management System (PIMS). SCADA systems were introduced during 2009 and 2010. This paper reports on the global introduction of the site and its basic architecture. Every screen displays the overall data in real time on movement in volume in pipeline operated by TRANSPETRO. The products transported are tracked for each infrastructure and are shown on dynamic geographic maps. Applications have been developed to improve the quality of information available to customers. It was found that the development of this site using PIMS technology brought gains in support to decision-making at the strategic and tactical levels for TRANSPETRO.

  19. A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5-6 year old children.

    Science.gov (United States)

    Davies, G M; Worthington, H V; Ellwood, R P; Bentley, E M; Blinkhorn, A S; Taylor, G O; Davies, R M

    2002-09-01

    To assess the impact of regularly supplying free fluoride toothpaste regularly to children, initially aged 12 months, and living in deprived areas of the north west of England on the level of caries in the deciduous dentition at 5-6 years of age. A further aim was to compare the effectiveness of a programme using a toothpaste containing 440 ppmF (Colgate 0-6 Gel) with one containing 1,450 ppmF (Colgate Great Regular Flavour) in reducing caries. Randomised controlled parallel group clinical trial. Clinical data were collected from test and control groups when the children were 5-6 years old. A programme of posting toothpaste with dental health messages to the homes of children initially aged 12 months. Clinical examinations took place in primary schools. 7,422 children born in 3-month birth cohorts living in high caries areas in nine health districts in north west England. Within each district children were randomly assigned to test or control groups. Toothpaste, containing either 440 ppmF or 1450 ppmF, and dental health literature posted at three monthly intervals to children in test groups until they were aged 5-6 years. The dmft index, missing teeth and the prevalence of caries experience. An analysis of 3,731 children who were examined and remained in the programme showed the mean dmft to be 2.15 for the group who had received 1,450 ppmF toothpaste and 2.49 for the 440 ppmF group. The mean dmft for the control group was 2.57. This 16% reduction between the 1,450 ppmF and control group was statistically significant (Pcontrol was not significant. Further analyses to estimate the population effect of the programme also confirmed this relationship. This study demonstrates that a programme distributing free toothpaste containing 1,450 ppmF provides a significant clinical benefit for high caries risk children living in deprived, non-fluoridated districts.

  20. A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomised controlled trial in South Africa.

    Science.gov (United States)

    Horwood, Christiane; Butler, Lisa; Barker, Pierre; Phakathi, Sifiso; Haskins, Lyn; Grant, Merridy; Mntambo, Ntokozo; Rollins, Nigel

    2017-06-13

    Community health workers (CHWs) play key roles in delivering health programmes in many countries worldwide. CHW programmes can improve coverage of maternal and child health services for the most disadvantaged and remote communities, leading to substantial benefits for mothers and children. However, there is limited evidence of effective mentoring and supervision approaches for CHWs. This is a cluster randomised controlled trial to investigate the effectiveness of a continuous quality improvement (CQI) intervention amongst CHWs providing home-based education and support to pregnant women and mothers. Thirty CHW supervisors were randomly allocated to intervention (n = 15) and control (n = 15) arms. Four CHWs were randomly selected from those routinely supported by each supervisor (n = 60 per arm). In the intervention arm, these four CHWs and their supervisor formed a quality improvement team. Intervention CHWs received a 2-week training in WHO Community Case Management followed by CQI mentoring for 12 months (preceded by 3 months lead-in to establish QI processes). Baseline and follow-up surveys were conducted with mothers of infants Improved training and CQI-based mentoring of CHWs can improve quantity and quality of CHW-mother interactions at household level, leading to improvements in mothers' knowledge and infant feeding practices. ClinicalTrials.Gov NCT01774136.

  1. Adductor canal block for post-operative analgesia after simultaneous bilateral total knee replacement: A randomised controlled trial to study the effect of addition of dexmedetomidine to ropivacaine

    Directory of Open Access Journals (Sweden)

    Rakhee Goyal

    2017-01-01

    Full Text Available Background and Aims: Knee replacement surgery causes tremendous post-operative pain and adductor canal block (ACB is used for post-operative analgesia. This is a randomised, controlled, three-arm parallel group study using different doses of dexmedetomidine added to ropiavcaine for ACB. Methods: A total of 150 patients aged 18–75 years, scheduled for simultaneous bilateral total knee replacement, received ultrasound-guided ACB. They were randomised into three groups -Group A received ACB with plain ropivacaine; Groups B and C received ACB with ropivacaine and addition of dexmedetomidine 0.25 μg/kg and 0.50 μg/kg, respectively, on each side of ACB. The primary outcome was the duration of analgesia. Total opioid consumption, success of early ambulation, and level of patient satisfaction were also assessed. Results: The patient characteristics and block success rates were comparable in all groups. Group C patients had longer duration of analgesia (Group C 18.4 h ± 7.4; Group B 14.6 ± 7.1; Group A 10.8 ± 7; P < 0.001; lesser tramadol consumption (Group C 43.8 mg ± 53.2; Group B 76.4 ± 49.6; Group A 93.9 mg ± 58.3; P < 0.001 and lesser pain on movement (P < 0.001. The patients in Group B and C walked more steps than in Group A (P < 0.002. The level of patient satisfaction was highest in Group C (P < 0.001. Conclusions: The addition of dexmedetomidine to ropivacaine resulted in longer duration of analgesia after adductor canal block for simultaneous bilateral total knee replacement surgery.

  2. Enhanced Hg{sup 2+} removal and Hg{sup 0} re-emission control from wet fuel gas desulfurization liquors with additives

    Energy Technology Data Exchange (ETDEWEB)

    Tingmei Tang; Jiang Xu; Rongjie Lu; Jingjing Wo; Xinhua Xu [Zhejiang University, Hangzhou (China). Department of Environmental Engineering

    2010-12-15

    Secondary atmospheric pollutions may result from wet flue gas desulfurization (FGD) systems caused by the reduction of Hg{sup 2+} to Hg{sup 0}. The present study employed three agents: Na{sub 2}S, 2,4,6-trimercaptotiazine, trisodium salt nonahydrate (TMT) and sodium dithiocarbamate (DTCR) to precipitate aqueous Hg{sup 2+} in simulated desulfurization solutions. The effects of the precipitator's dosing quantity, the initial pH value, the reaction temperature, the concentrations of Cl{sup -} and other metal ions (e.g. Cu{sup 2+} and Pb{sup 2+}) on Hg{sup 2+} removal were studied. A linear relationship was observed between Hg{sup 2+} removal efficiency and the increasing precipitator's doses along with initial pH. The addition of chloride and metal ions impaired the Hg{sup 2+} removal from solutions due to the complexation of Cl{sup -} and Hg{sup 2+} as well as the chelating competition between Hg{sup 2+} and other metal ions. Based on a comprehensive comparison of the treatment effects, DTCR was found to be the most effective precipitating agent. Moreover, all the precipitating agents were potent enough to inhibit Hg{sup 2+} reduction as well as Hg{sup 0} re-emission from FGD liquors. More than 90% Hg{sup 2+} was captured by precipitating agents while Hg{sup 2+} reduction efficiency decreased from 54% to just less than 3%. The additives could efficiently control the secondary Hg{sup 0} pollution from FGD liquors. 21 refs., 6 figs.

  3. Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Wu Xiaosan

    2013-01-01

    Full Text Available Abstract Background Atrial arrhythmia (AA is the most common complication after coronary artery bypass grafting (CABG. Only beta-blockers and amiodarone have been convincingly shown to decrease its incidence. The effectiveness of magnesium on this complication is still controversial. This meta-analysis was performed to evaluate the effect of magnesium as a sole or adjuvant agent in addition to beta-blocker on suppressing postoperative AA after CABG. Methods We searched the PubMed, Medline, ISI Web of Knowledge, Cochrane library databases and online clinical trial database up to May 2012. We used random effects model when there was significant heterogeneity between trials and fixed effects model when heterogeneity was negligible. Results Five randomized controlled trials were identified, enrolling a total of 1251 patients. The combination of magnesium and beta-blocker did not significantly decrease the incidence of postoperative AA after CABG versus beta-blocker alone (odds ratio (OR 1.12, 95% confidence interval (CI 0.86-1.47, P = 0.40. Magnesium in addition to beta-blocker did not significantly affect LOS (weighted mean difference −0.14 days of stay, 95% CI −0.58 to 0.29, P = 0.24 or the overall mortality (OR 0.59, 95% CI 0.08-4.56, P = 0.62. However the risk of postoperative adverse events was higher in the combination of magnesium and beta-blocker group than beta-blocker alone (OR 2.80, 95% CI 1.66-4.71, P = 0.0001. Conclusions This meta-analysis offers the more definitive evidence against the prophylactic administration of intravenous magnesium for prevention of AA after CABG when beta-blockers are routinely administered, and shows an association with more adverse events in those people who received magnesium.

  4. Placebo versus low-dose ketamine infusion in addition to remifentanil target-controlled infusion for conscious sedation during oocyte retrieval: A prospective, double-blinded, randomised controlled trial.

    Science.gov (United States)

    Morue, Hélène I; Raj-Lawrence, Shalini; Saxena, Sarah; Delbaere, Anne; Engelman, Edgard; Barvais, Luc A

    2018-04-30

    Currently, there is no gold standard for monitored anaesthesia care during oocyte retrieval. In our institution, the standard is a conscious sedation technique using a target-controlled infusion (TCI) of remifentanil, titrated to maintain a visual analogue pain score less than 30 mm. This protocol is well accepted by patients but is associated with frequent episodes of respiratory depression. The main objective of this study was to evaluate whether the addition of a continuous intravenous infusion of ketamine could reduce these episodes. Controlled, randomised, prospective, double-blinded study. The current study was conducted in a tertiary-level hospital in Brussels (Belgium) from December 2013 to June 2014. Of the 132 women undergoing oocyte retrieval included, 121 completed the study. After randomisation, patients received either a ketamine infusion (40 μg kg min over 5 min followed by 2.5 μg kg min) or a 0.9% saline infusion in addition to the variable remifentanil TCI. The primary outcome was the number of respiratory depression episodes. Effect site target remifentanil concentrations, side effects, pain score, patient satisfaction and incidence of pregnancy were also recorded. No significant difference in the incidence of respiratory events was noted (pulse oximetry oxygen saturation the ketamine group and 63% in the control group; P = 0.121). No patient required ventilatory support. In the ketamine group, visual analogue pain score and remifentanil concentrations were significantly reduced, but the latter remained above 2 ng ml. Postoperative nausea was less frequent in the ketamine group, 4 versus 15% (P = 0.038). The addition of ketamine did not influence length of stay nor patient satisfaction. The addition of low plasma levels of ketamine to a TCI remifentanil conscious sedation technique did not decrease the incidence nor the severity of respiratory depression. Continuous monitoring of capnography and oxygen saturation is

  5. Effectiveness of various formulations of local anesthetics and additives for topical anesthesia – a prospective, randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Weilbach C

    2017-05-01

    Full Text Available Christian Weilbach,1 Christian Hoppe,2 Matthias Karst,3 Michael Winterhalter,4 Konstantinos Raymondos,3 Arthur Schultz,3 Niels Rahe-Meyer2 1Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, St. Josefs-Hospital Cloppenburg, Cloppenburg, 2Clinic for Anesthesiology and Operational Intensive Care, Franziskus Hospital Bielefeld, Bielefeld, 3Clinic for Anesthesiology and Intensive Care, Medizinische Hochschule Hannover, Hannover, 4Clinic for Anesthesiology and Pain Therapy, Klinikum Bremen-Mitte, Bremen, Germany Background: Topical anesthesia is used to control pain associated with many procedures in medicine. Today, the product most commonly applied for topical anesthesia in Germany is EMLA® (lidocaine/prilocaine. However, since prilocaine is a methemoglobin-inducing agent, there are limitations to its use, especially in neonates and infants. The aim of this study was to evaluate the effect of prilocaine and lidocaine as well as propylene glycol, a penetration enhancer, and trometamol, a buffer substance, in anesthetic creams.Patients and methods: Twenty-nine healthy adults participated in this study. Standardized creams with eight different compositions were applied and left for 20, 40 or 60 min. After exposure to standardized painful stimuli (blunt/sharp with pressures of 0.2, 0.4 or 0.8 N, subjects rated the experimental pain using a visual analog scale.Results: Significant results were only found with an exposure time of 60 min and a stamp pressure of 0.8 N. At a concentration of 20%, lidocaine was more effective compared to placebo and equally effective compared to lidocaine/prilocaine in controlling pain. The analgesic effect of the cream containing lidocaine 10% and additional trometamol was significantly superior to that of placebo and non-inferior to that of lidocaine/prilocaine. In this study, the penetration enhancer propylene glycol did not accelerate the onset of the analgesic effect. In contrast

  6. Short-term additional enfuvirtide therapy is associated with a greater immunological recovery in HIV very late presenters: a controlled pilot study.

    Science.gov (United States)

    Bonora, S; Calcagno, A; Cometto, C; Fontana, S; Aguilar, D; D'Avolio, A; Gonzalez de Requena, D; Maiello, A; Dal Conte, I; Lucchini, A; Di Perri, G

    2012-02-01

    To evaluate whether the addition of enfuvirtide to standard highly active antiretroviral therapy (HAART) could confer immunovirological benefits in human immunodeficiency virus (HIV)-infected very late presenters. The current study is an open comparative therapeutic trial of standard protease inhibitor (PI)-based HAART ± additional enfuvirtide in treatment-naïve deeply immunologically impaired HIV-positive patients. Very late presenters (CD4 HIV RNA was intensively monitored in the first month, and, thereafter, monthly, as for CD4+ cell count and percentage, clinical data, and plasma drug concentrations. Of 22 enrolled patients (11 per arm), 19 completed the study (10 in the ENF arm). Baseline CD4+ cell counts and % were comparable, with 20 CD4+/mm(3) (12-37) and a percentage of 3.3 (1.7-7.1) in the ENF arm, and 16 CD4+/mm(3) (9-29) and a percentage of 3.1 (2.3-3.8) in the CO arm, respectively. The baseline viral load was also comparable between the two arms, with 5.77 log10 (5.42-6) and 5.39 log10 (5.06-6) in the ENF and CO arms, respectively. Enfuvirtide recipients had higher CD4+ percentage at week 8 (7.6 vs. 3.6%, p = 0.02) and at week 24 (10.7 vs. 5.9%, p = 0.02), and a greater CD4+ increase at week 24 (207 vs. 134 cells/mm(3), p = 0.04), with 70% of enfuvirtide intakers versus 12.5% of controls who achieved a CD4+ cell count >200/mm(3) (p = 0.01). At 48 weeks, patients in the ENF arm had CD4+ cell counts higher than controls (251 vs. 153cells/mm(3), p = 0.04) and were also found to be faster in reaching a CD4 cell count over 200/mm(3): 18 (8-24) versus 48 (36-108) weeks (p = 0.01). Viral load decay at week 4 was greater in the ENF arm (-3 vs. -2.2 log, p = 0.04), while the proportion of patients with viral load discovered HIV-positive patients with very low CD4+ cell counts. Induction strategies using an enfuvirtide-based approach in such subjects warrant further investigation.

  7. Effects of eye movement desensitization and reprocessing (EMDR) on non-specific chronic back pain: a randomized controlled trial with additional exploration of the underlying mechanisms.

    Science.gov (United States)

    Tesarz, Jonas; Gerhardt, Andreas; Leisner, Sabine; Janke, Susanne; Hartmann, Mechthild; Seidler, Günther H; Eich, Wolfgang

    2013-08-30

    Non-specific chronic back pain (CBP) is often accompanied by psychological trauma, but treatment for this associated condition is often insufficient.Nevertheless, despite the common co-occurrence of pain and psychological trauma, a specific trauma-focused approach for treating CBP has been neglected to date. Accordingly, eye movement desensitization and reprocessing (EMDR), originally developed as a treatment approach for posttraumatic stress disorders, is a promising approach for treating CBP in patients who have experienced psychological trauma.Thus, the aim of this study is to determine whether a standardized, short-term EMDR intervention added to treatment as usual (TAU) reduces pain intensity in CBP patients with psychological trauma vs. TAU alone. The study will recruit 40 non-specific CBP patients who have experienced psychological trauma. After a baseline assessment, the patients will be randomized to either an intervention group (n = 20) or a control group (n = 20). Individuals in the EMDR group will receive ten 90-minute sessions of EMDR fortnightly in addition to TAU. The control group will receive TAU alone. The post-treatment assessments will take place two weeks after the last EMDR session and six months later.The primary outcome will be the change in the intensity of CBP within the last four weeks (numeric rating scale 0-10) from the pre-treatment assessment to the post-treatment assessment two weeks after the completion of treatment.In addition, the patients will undergo a thorough assessment of the change in the experience of pain, disability, trauma-associated distress, mental co-morbidities, resilience, and quality of life to explore distinct treatment effects. To explore the mechanisms of action that are involved, changes in pain perception and pain processing (quantitative sensory testing, conditioned pain modulation) will also be assessed.The statistical analysis of the primary outcome will be performed on an intention-to-treat basis

  8. Study protocol for a randomised controlled trial to test the effectiveness of providing information on childbirth and postnatal period to partners of pregnant women.

    Science.gov (United States)

    Takehara, Kenji; Okamura, Makoto; Sugiura, Naomi; Suto, Maiko; Sasaki, Hatoko; Mori, Rintaro

    2016-07-27

    The objective of this study is to investigate the effect of the distribution of a booklet providing information to fathers during their partners' pregnancies on fathers' and mothers' postpartum mental health and quality of life (QOL), as well as on fathers' childcare participation and living situations. This randomised controlled trial will comprise 554 couples consisting of pregnant women due to give birth at an obstetric institution in Aichi Prefecture, Japan and their partners. Participants will be recruited during prenatal check-ups in the third trimester, and those who provide written consent will be allocated randomly to an intervention and a control group. The pregnant women's partners allocated to the intervention group will be given a booklet written for men containing information on childbirth and postnatal period. Its content will include matters such as what preparations the partner should make before birth and tips for housework and childcare as well as how to prevent unintentional injury to the baby. The control group will not receive any intervention. A baseline survey in the third trimester and follow-up surveys at 1 and 3 months post partum will be carried out using self-administered questionnaires. The primary outcome is the proportion of new mothers' partners at risk for paternal depression (Edinburgh Postnatal Depression Scale score ≥8). Secondary outcomes include the risk of postnatal depression in new mothers, QOL of new mothers and their partners, partners' knowledge of and engagement in housework and childcare, marital relations and parenting stress on the part of new mothers. This study has been approved by the Ethical Committee at the National Center for Child Health and Development, Tokyo, Japan. The results of the study will be widely disseminated as peer-reviewed papers and at international conferences, with the aim of improving public health services in Japan. UMIN000021475; Pre-results. Published by the BMJ Publishing Group

  9. A conceptual study on the formulation of a permeable reactive pavement with activated carbon additives for controlling the fate of non-point source environmental organic contaminants.

    Science.gov (United States)

    Huang, Shengyi; Liang, Chenju

    2018-02-01

    To take advantage of the road pavement network where non-point source (NPS) pollution such as benzene, toluene, ethyl-benzene, and xylene (BTEX) from vehicle traffic exhaust via wet and dry atmospheric deposition occurs, the asphalt pavement may be used as a media to control the NPS pollution. An experiment to prepare an adsorptive porous reactive pavement (PRP) was initiated to explore the potential to reduce environmental NPS vehicle pollution. The PRP was prepared and studied as follows: various activated carbons (AC) were initially screened to determine if they were suitable as an additive in the porous asphalt mixture; various mixtures of a selected AC were incorporated with the design of porous asphalt concrete (PAC) to produce PRP, and the PRP formulations were tested to ensure that they comply with the required specifications; qualified specimens were subsequently tested to determine their adsorption capacity for BTEX in aqueous solution, as compared to conventional PAC. The PRP08 and PRP16 samples, named for the design formulations of 0.8% and 1.6% of AC (by wt. in the formulation), exhibited low asphalt drain-down and low abrasion loss and also met all regulated specifications. The BTEX adsorption capacity measurements of PRP08 and PRP16 were 33-46%, 36-51%, 20-22%, and 6-8% respectively, higher than those obtained from PACs. Based on the test results, PRPs showed good physical performance and adsorption and may be considered as a potential method for controlling the transport of NPS vehicle pollutants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. A preliminary path analysis of expectancy and patient-provider encounter in an open-label randomized controlled trial of spinal manipulation for cervicogenic headache.

    Science.gov (United States)

    Haas, Mitchell; Aickin, Mikel; Vavrek, Darcy

    2010-01-01

    The purpose of this article was to present a preliminary model to identify the effects of expectancy of treatment success and the patient-provider encounter (PPE) on outcomes in an open-label randomized trial. Eighty participants with chronic cervicogenic headache (CGH) were randomized to 4 groups: 2 levels of treatment dose (8 or 16) and 2 levels of therapy from a chiropractor (spinal manipulation or light massage). Providers were instructed to have equal enthusiasm for all care. Structural equation modeling with standardized path coefficients (beta) was used in a path analysis to identify the effects of patient expectancy and the PPE on CGH pain. The model included monthly pain from baseline to 12 weeks. Expectancy and PPE were evaluated on Likert scales. The patient-provider encounter was measured as patient perception of chiropractor enthusiasm, confidence, and comfort with care. Baseline patient expectancy was balanced across groups. The PPE measures were balanced across groups and consistent over the 8-week treatment period. Treatment and baseline pain had the strongest effects on pain outcomes (|beta| = .46-.59). Expectations had little effect on pain (abs value(beta) value(beta)= .03-.27) and on subsequent confidence in treatment success (abs value(beta)= .09 and .12). Encouraging equipoise in the PPE and balancing expectancy across treatment groups may protect against some confounding related to the absence of blinding in a randomized controlled trial of pain. In this trial, their effects were found to be small relative to the effects of treatment and baseline values. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  11. L6E9 Myoblasts Are Deficient of Myostatin and Additional TGF- Members Are Candidates to Developmentally Control Their Fiber Formation

    Directory of Open Access Journals (Sweden)

    Stefania Rossi

    2010-01-01

    Full Text Available This work provides evidence that the robust myoblast differentiation observed in L6E9 cells is causally linked to deficiency of myostatin, which, conversely, has been found to be expressed in C2C12 cells. However, despite the absence of endogenous myostatin, L6E9 myoblasts expressed functional Activin receptors type II (ActRIIs and follistatin as well as the highly related TGF- members Activins and GDF11, suggesting that in this cell line the regulation of fiber size might be under the control of multiple regulators regardless of myostatin. In line with this hypothesis, delivery of a dominant-negative ActRIIb form or the increase of follistatin, as obtained via Trichostatin treatment or stable transfection of a short human follistatin form, enhanced the L6E9 cell differentiation and further increased the size of myotubes, suggesting that L6E9 myoblasts provide a spontaneous myostatin knock-out in vitro model to study TGF- ligands involved in developmental regulation of fiber size.

  12. Safety and efficacy of rasagiline in addition to levodopa for the treatment of idiopathic Parkinson's disease: a meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Cai, Jiang-Ping; Chen, Wan-Jin; Lin, Yu; Cai, Bin; Wang, Ning

    2015-01-01

    To assess the safety and efficacy of rasagiline for the treatment of Parkinson's disease (PD) among individuals currently receiving levodopa. A systematic literature search was conducted to identify randomised controlled trials (RCT) comparing rasagiline with placebo/no treatment in individuals with PD currently receiving levodopa. Outcome measures included improvement in motor functions; symptomatic improvement; improvement in quality of life; adverse effects. Random-effect meta-analytical techniques were conducted for the outcome measure and subgroup analyses. Three RCTs were included (n = 1002). The results showed significantly greater improvements in daily 'on' time without dyskinesia in levodopa-treated participants with idiopathic PD receiving 1 mg/day rasagiline compared to placebo (n = 712, 2 RCTs, MD 0.80, CI 0.45 to 1.15; p rasagiline (0.5 mg/day: n = 282, MD -2.91, CI -4.59 to -1.23; p = 0.0007; 1 mg/day: n = 712, 2 RCTs, MD -2.91, CI -4.02 to -1.80; p rasagiline in addition to levodopa is a safe and well-tolerated combination therapy for individuals with Parkinson's disease.

  13. Sodium-glucose co-transporter 2 inhibitors in addition to insulin therapy for management of type 2 diabetes mellitus: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Tang, Huilin; Cui, Wei; Li, Dandan; Wang, Tiansheng; Zhang, Jingjing; Zhai, Suodi; Song, Yiqing

    2017-01-01

    Given inconsistent trial results of sodium-glucose cotransporter 2 (SGLT2) inhibitors in addition to insulin therapy for treating type 2 diabetes mellitus (T2DM), a meta-analysis was performed to evaluate the efficacy and safety of this combination for T2DM by searching available randomized trials from PubMed, Embase, CENTRAL and ClinicalTrials.gov. Our meta-analysis included seven eligible placebo-controlled trials involving 4235 patients. Compared with placebo, SGLT2 inhibitor treatment was significantly associated with a mean reduction in HbA1c of -0.56%, fasting plasma glucose of -0.95 mmol/L, body weight of -2.63 kg and insulin dose of -8.79 IU, but an increased risk of drug-related adverse events by 36%, urinary tract infections by 29% and genital infections by 357%. No significant increase was observed in risk of overall adverse events [risk ratio (RR), 1.00], serious adverse events (RR, 0.90), adverse events leading to discontinuation (RR, 1.16), hypoglycaemia events (RR, 1.07) and severe hypoglycaemia events (RR, 1.24). No diabetic ketoacidosis events were reported. Further studies are needed to establish optimal combination type and dose. © 2016 John Wiley & Sons Ltd.

  14. Optimization of lime addition in a dry air pollution control device; Optimerad rening av HCl och SO{sub 2} med minskade kalktillsatser vid torr roeasrening

    Energy Technology Data Exchange (ETDEWEB)

    Wikstroem-Blomqvist, Evalena; Samuelsson, Jessica; Ohlsson, Anna

    2006-12-15

    The focus of this project is to optimize the absorption of hydrochloric acid (HCl) and sulphuric acid (SO{sub 2}) in a dry air pollution control device system connected to a waste combustor. A significant amount of absorbent are generally added into the processes to achieve an efficient cleaning of the flue gas. Reduced absorbent consumption has double benefits on the operative expenses due to decreased purchase and landfilling costs. The objective was to study the affect of flue gas temperature and moisture, (relative humidity, RH), on the efficiency of HCl and SO{sub 2} absorption on hydrated lime. Additionally, the efficiency of a pre-treated hydrated lime with larger specific surface and pore volume was investigated. The measuring campaign was conducted on the 20 MW fluidized bed waste incinerator own by Boraas Energi och Miljoe AB in Sweden. Results from 26 experimental days with normal hydrated lime showed a positive correlation between the efficiency of the lime and RH in the flue gas. Four levels of RH between 3.28% to 4.84% were tested. The levels were adjusted by lowering the flue gas temperature and/or by adding water to the waste fuel. The smallest effect where achieved by solely adding water to the waste fuel. RH increased solely to 3.62% and the amount of lime consumption was reduced with only 5% compare to normal condition. By lowering the flue gas temperature 10 deg C to 143 deg C, RH increased to 4.06% and the amount of lime added was reduced with 13%. The largest impact was found when both the flue gas temperature and the moisture content were changed. At those process conditions RH reach 4.84 % and the usage of lime were reduced with 26%. Additional 12 experimental days were conducted to evaluate the efficiency of a pretreated hydrated lime with larger specific surface and pore volume. The results showed that the surface enlarged absorbent was almost twice as effective as the normal hydrated lime. Moreover, the results indicated an equal

  15. Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 2: methodological quality and effects.

    Science.gov (United States)

    Johansen, Monika Alise; Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander

    2012-10-03

    We conducted in two parts a systematic review of randomized controlled trials (RCTs) on electronic symptom reporting between patients and providers to improve health care service quality. Part 1 reviewed the typology of patient groups, health service innovations, and research targets. Four innovation categories were identified: consultation support, monitoring with clinician support, self-management with clinician support, and therapy. To assess the methodological quality of the RCTs, and summarize effects and benefits from the methodologically best studies. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles between 1990 and November 2011. Risk of bias and feasibility were judged according to the Cochrane recommendation, and theoretical evidence and preclinical testing were evaluated according to the Framework for Design and Evaluation of Complex Interventions to Improve Health. Three authors assessed the risk of bias and two authors extracted the effect data independently. Disagreement regarding bias assessment, extraction, and interpretation of results were resolved by consensus discussions. Of 642 records identified, we included 32 articles representing 29 studies. No articles fulfilled all quality requirements. All interventions were feasible to implement in a real-life setting, and theoretical evidence was provided for almost all studies. However, preclinical testing was reported in only a third of the articles. We judged three-quarters of the articles to have low risk for random sequence allocation and approximately half of the articles to have low risk for the following biases: allocation concealment, incomplete outcome data, and selective reporting. Slightly more than one fifth of the articles were judged as low risk for blinding of outcome assessment. Only 1 article had low risk of bias for blinding of participants and personnel. We excluded 12

  16. Controlling solution-phase polymer aggregation with molecular weight and solvent additives to optimize polymer-fullerene bulk heterojunction solar cells

    KAUST Repository

    Bartelt, Jonathan A.; Douglas, Jessica D.; Mateker, William R.; El Labban, Abdulrahman; Tassone, Christopher J.; Toney, Michael F.; Fré chet, Jean Mj J; Beaujuge, Pierre; McGehee, Michael D.

    2014-01-01

    The bulk heterojunction (BHJ) solar cell performance of many polymers depends on the polymer molecular weight (M n) and the solvent additive(s) used for solution processing. However, the mechanism that causes these dependencies is not well

  17. Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial.

    Science.gov (United States)

    Brocki, Barbara Cristina; Andreasen, Jan Jesper; Langer, Daniel; Souza, Domingos Savio R; Westerdahl, Elisabeth

    2016-05-01

    The aim was to investigate whether 2 weeks of inspiratory muscle training (IMT) could preserve respiratory muscle strength in high-risk patients referred for pulmonary resection on the suspicion of or confirmed lung cancer. Secondarily, we investigated the effect of the intervention on the incidence of postoperative pulmonary complications. The study was a single-centre, parallel-group, randomized trial with assessor blinding and intention-to-treat analysis. The intervention group (IG, n = 34) underwent 2 weeks of postoperative IMT twice daily with 2 × 30 breaths on a target intensity of 30% of maximal inspiratory pressure, in addition to standard postoperative physiotherapy. Standard physiotherapy in the control group (CG, n = 34) consisted of breathing exercises, coughing techniques and early mobilization. We measured respiratory muscle strength (maximal inspiratory/expiratory pressure, MIP/MEP), functional performance (6-min walk test), spirometry and peripheral oxygen saturation (SpO2), assessed the day before surgery and again 3-5 days and 2 weeks postoperatively. Postoperative pulmonary complications were evaluated 2 weeks after surgery. The mean age was 70 ± 8 years and 57.5% were males. Thoracotomy was performed in 48.5% (n = 33) of cases. No effect of the intervention was found regarding MIP, MEP, lung volumes or functional performance at any time point. The overall incidence of pneumonia was 13% (n = 9), with no significant difference between groups [IG 6% (n = 2), CG 21% (n = 7), P = 0.14]. An improved SpO2 was found in the IG on the third and fourth postoperative days (Day 3: IG 93.8 ± 3.4 vs CG 91.9 ± 4.1%, P = 0.058; Day 4: IG 93.5 ± 3.5 vs CG 91 ± 3.9%, P = 0.02). We found no association between surgical procedure (thoracotomy versus thoracoscopy) and respiratory muscle strength, which was recovered in both groups 2 weeks after surgery. Two weeks of additional postoperative IMT, compared with standard physiotherapy alone, did not preserve

  18. Does the addition of deep breathing exercises to physiotherapy-directed early mobilisation alter patient outcomes following high-risk open upper abdominal surgery? Cluster randomised controlled trial.

    Science.gov (United States)

    Silva, Y R; Li, S K; Rickard, M J F X

    2013-09-01

    To investigate whether the inclusion of deep breathing exercises in physiotherapy-directed early mobilisation confers any additional benefit in reducing postoperative pulmonary complications (PPCs) when patients are treated once daily after elective open upper abdominal surgery. This study also compared postoperative outcomes following early and delayed mobilisation. Cluster randomised controlled trial. Single-centre study in a teaching hospital. Eighty-six high-risk patients undergoing elective open upper abdominal surgery. Three groups: early mobilisation (Group A), early mobilisation plus breathing exercises (Group B), and delayed mobilisation (mobilised from third postoperative day) plus breathing exercises (Group C). PPCs and postoperative outcomes [number of days until discharge from physiotherapy, physiotherapy input and length of stay (LOS)]. There was no significant difference in PPCs between Groups A and B. The LOS for Group A {mean 10.7 [standard deviation (SD) 5.0] days} was significantly shorter than the LOS for Groups B [mean 16.7 (SD 9.7) days] and C [mean 15.2 (SD 9.8) days; P=0.036]. The greatest difference was between Groups A and B (mean difference -5.93, 95% confidence interval -10.22 to -1.65; P=0.008). Group C had fewer smokers (26%) and patients with chronic obstructive pulmonary disease (0%) compared with Group B (53% and 14%, respectively). This may have led to fewer PPCs in Group C, but the difference was not significant. Despite Group C having fewer PPCs and less physiotherapy input, the number of days until discharge from physiotherapy and LOS were similar to Group B. The addition of deep breathing exercises to physiotherapy-directed early mobilisation did not further reduce PPCs compared with mobility alone. PPCs can be reduced with once-daily physiotherapy if the patients are mobilised to a moderate level of exertion. Delayed mobilisation tended to increase physiotherapy input and the number of days until discharge from physiotherapy

  19. Targeted deletion of the Nesp55 DMR defines another Gnas imprinting control region and provides a mouse model of autosomal dominant PHP-Ib.

    Science.gov (United States)

    Fröhlich, Leopold F; Mrakovcic, Maria; Steinborn, Ralf; Chung, Ung-Il; Bastepe, Murat; Jüppner, Harald

    2010-05-18

    Approximately 100 genes undergo genomic imprinting. Mutations in fewer than 10 imprinted genetic loci, including GNAS, are associated with complex human diseases that differ phenotypically based on the parent transmitting the mutation. Besides the ubiquitously expressed Gsalpha, which is of broad biological importance, GNAS gives rise to an antisense transcript and to several Gsalpha variants that are transcribed from the nonmethylated parental allele. We previously identified two almost identical GNAS microdeletions extending from exon NESP55 to antisense (AS) exon 3 (delNESP55/delAS3-4). When inherited maternally, both deletions are associated with erasure of all maternal GNAS methylation imprints and autosomal-dominant pseudohypoparathyroidism type Ib, a disorder characterized by parathyroid hormone-resistant hypocalcemia and hyperphosphatemia. As for other imprinting disorders, the mechanisms resulting in abnormal GNAS methylation are largely unknown, in part because of a paucity of suitable animal models. We now showed in mice that deletion of the region equivalent to delNESP55/delAS3-4 on the paternal allele (DeltaNesp55(p)) leads to healthy animals without Gnas methylation changes. In contrast, mice carrying the deletion on the maternal allele (DeltaNesp55(m)) showed loss of all maternal Gnas methylation imprints, leading in kidney to increased 1A transcription and decreased Gsalpha mRNA levels, and to associated hypocalcemia, hyperphosphatemia, and secondary hyperparathyroidism. Besides representing a murine autosomal-dominant pseudohypoparathyroidism type Ib model and one of only few animal models for imprinted human disorders, our findings suggest that the Nesp55 differentially methylated region is an additional principal imprinting control region, which directs Gnas methylation and thereby affects expression of all maternal Gnas-derived transcripts.

  20. Gene Expression Data from the Moon Jelly, Aurelia, Provide Insights into the Evolution of the Combinatorial Code Controlling Animal Sense Organ Development.

    Directory of Open Access Journals (Sweden)

    Nagayasu Nakanishi

    Full Text Available In Bilateria, Pax6, Six, Eya and Dach families of transcription factors underlie the development and evolution of morphologically and phyletically distinct eyes, including the compound eyes in Drosophila and the camera-type eyes in vertebrates, indicating that bilaterian eyes evolved under the strong influence of ancestral developmental gene regulation. However the conservation in eye developmental genetics deeper in the Eumetazoa, and the origin of the conserved gene regulatory apparatus controlling eye development remain unclear due to limited comparative developmental data from Cnidaria. Here we show in the eye-bearing scyphozoan cnidarian Aurelia that the ectodermal photosensory domain of the developing medusa sensory structure known as the rhopalium expresses sine oculis (so/six1/2 and eyes absent/eya, but not optix/six3/6 or pax (A&B. In addition, the so and eya co-expression domain encompasses the region of active cell proliferation, neurogenesis, and mechanoreceptor development in rhopalia. Consistent with the role of so and eya in rhopalial development, developmental transcriptome data across Aurelia life cycle stages show upregulation of so and eya, but not optix or pax (A&B, during medusa formation. Moreover, pax6 and dach are absent in the Aurelia genome, and thus are not required for eye development in Aurelia. Our data are consistent with so and eya, but not optix, pax or dach, having conserved functions in sensory structure specification across Eumetazoa. The lability of developmental components including Pax genes relative to so-eya is consistent with a model of sense organ development and evolution that involved the lineage specific modification of a combinatorial code that specifies animal sense organs.

  1. Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lee Bonsan B

    2009-03-01

    Full Text Available Abstract Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use or a control group (usual care. The primary outcome measure will be falls (measured with 13 monthly calendars. Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855.

  2. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study.

    Science.gov (United States)

    Kapil, Vikas; Khambata, Rayomand S; Robertson, Amy; Caulfield, Mark J; Ahluwalia, Amrita

    2015-02-01

    Single dose administration of dietary inorganic nitrate acutely reduces blood pressure (BP) in normotensive healthy volunteers, via bioconversion to the vasodilator nitric oxide. We assessed whether dietary nitrate might provide sustained BP lowering in patients with hypertension. We randomly assigned 68 patients with hypertension in a double-blind, placebo-controlled clinical trial to receive daily dietary supplementation for 4 weeks with either dietary nitrate (250 mL daily, as beetroot juice) or a placebo (250 mL daily, as nitrate-free beetroot juice) after a 2-week run-in period and followed by a 2-week washout. We performed stratified randomization of drug-naive (n=34) and treated (n=34) patients with hypertension aged 18 to 85 years. The primary end point was change in clinic, ambulatory, and home BP compared with placebo. Daily supplementation with dietary nitrate was associated with reduction in BP measured by 3 different methods. Mean (95% confidence interval) reduction in clinic BP was 7.7/2.4 mm Hg (3.6-11.8/0.0-4.9, Pnitrate consumption with no change after placebo. The intervention was well tolerated. This is the first evidence of durable BP reduction with dietary nitrate supplementation in a relevant patient group. These findings suggest a role for dietary nitrate as an affordable, readily-available, adjunctive treatment in the management of patients with hypertension (funded by The British Heart Foundation). http://www.clinicaltrials.gov. Unique identifier: NCT01405898. © 2014 American Heart Association, Inc.

  3. Efficacy of the addition of positive airway pressure to conventional chest physiotherapy in resolution of pleural effusion after drainage: protocol for a randomised controlled trial.

    Science.gov (United States)

    da Conceição Dos Santos, Elinaldo; Lunardi, Adriana Claudia

    2015-04-01

    Chest drainage for pleural effusion can cause pain and changes in respiratory function. It can also increase the risk of pulmonary complications and impair functional ability, which may increase length of hospital stay and the associated costs. For these reasons, surgical and clinical strategies have been adopted to reduce the duration of chest drainage. To evaluate the efficacy of the addition of intermittent positive airway pressure applied by the Muller reanimator via a rubber facial mask versus conventional physiotherapy on the duration of chest drainage (primary objective), and its effect on the recovery of respiratory function, length of hospital stay and incidence of pulmonary complications (secondary objectives). Randomised, controlled trial. Inpatients with pleural effusion, aged over 18 years, who have had chest drainage in situ for drain will be a transudate output ≤ 200ml over 24hours and full lung expansion on chest radiography, as assessed by a blinded physician. Duration of chest drainage, length of hospital stay, and any pulmonary complications diagnosed during hospitalisation will be recorded. Intention to treat using: survival analysis for duration of chest drainage, and length of hospital stay; analysis of variance for chest-tube output, lung function and peripheral oxygen saturation; and chi-square tests for comparing the incidence of pulmonary complications between groups. Conventional chest physiotherapy and intermittent positive airway pressure breathing are widely indicated for people with pleural effusion and chest drains; however, no studies have evaluated the real benefit of this type of treatment. Our hypothesis is that optimised lung expansion achieved through the application of intermittent positive airway pressure will accelerate the reabsorption of pleural effusion, decrease the duration of chest drainage and respiratory system impairment, reduce the length of hospital stay, and reduce the incidence of pulmonary complications

  4. Risk of adverse events with bevacizumab addition to therapy in advanced non-small-cell lung cancer: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Lai XX

    2016-04-01

    Full Text Available Xi-Xi Lai, Ren-Ai Xu, Yu-Ping Li, Han Yang Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China Background: Bevacizumab, a monoclonal antibody against vascular endothelial growth factor ligand, has shown survival benefits in the treatment of many types of malignant tumors, including non-small-cell lung cancer (NSCLC. We conducted this systematic review and meta-analysis to investigate the risk of the most clinically relevant adverse events related to bevacizumab in advanced NSCLC.Methods: Databases from PubMed, Web of Science, and Cochrane Library up to August 2015, were searched to identify relevant studies. We included prospective randomized controlled Phase II/III clinical trials that compared therapy with or without bevacizumab for advanced NSCLC. Summary relative risk (RR and 95% confidence intervals were calculated using random effects or fixed effects according to the heterogeneity among included trials.Results: A total of 3,745 patients from nine clinical trials were included in the meta-analysis. Summary RRs showed a statistically significant bevacizumab-associated increased risk in three of the adverse outcomes studied: proteinuria (RR =7.55, hypertension (RR =5.34, and hemorrhagic events (RR =2.61. No statistically significant differences were found for gastrointestinal perforation (P=0.60, arterial and venous thromboembolic events (P=0.35 and P=0.92, respectively, or fatal events (P=0.29.Conclusion: The addition of bevacizumab to therapy in advanced NSCLC did significantly increase the risk of proteinuria, hypertension, and hemorrhagic events but not arterial/venous thromboembolic events, gastrointestinal perforation, or fatal adverse events. Keywords: toxicities, angiogenesis inhibitors, non-small-cell lung carcinoma, meta-analysis, safety

  5. An Open-label Randomized Controlled Trial to Compare Weight Gain of Very Low Birth Weight Babies with or without Addition of Coconut Oil to Breast Milk.

    Science.gov (United States)

    Arun, Sumitha; Kumar, Manish; Paul, Thomas; Thomas, Nihal; Mathai, Sarah; Rebekah, Grace; Thomas, Niranjan

    2018-03-23

    Nutritional guidelines involving the feeding of very low birth weight babies (VLBW) recommend addition of Human Milk Fortifiers to breast milk. Owing to financial constraints, it is a practice in low- and middle-income countries (LMIC) to add coconut oil to aid better weight gain. There are inadequate data on improvement of growth parameters with oral coconut oil supplementation of breast milk. In this randomized controlled trial, we measured growth parameters and body composition of 60 babies who received either breast milk with coconut oil or breast milk alone. Randomization was stratified according to intrauterine growth appropriate for gestational age (n = 30) and small for gestational age (n = 30). There was no difference in weight gain between the two groups. The weight gain velocity was 15 ± 3.6 and 14.4 ± 3.4 g/kg/day (p value = 0.49) in the breast milk alone and in the breast milk with coconut oil group, respectively. There was no difference in increase in head circumference and length. Triceps skinfold thickness (n = 56) was similar in both groups, but subscapular skinfold thickness was significantly more in the coconut oil group. Total body fat percentage did not differ between the groups (25.2 ± 4.3 vs. 25.5 ± 4.3%, p = 0.79). Oral supplementation of coconut oil along with breast milk did not increase growth parameters or result in change in body composition in very low birth weight (VLBW) babies.

  6. Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trial testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669).

    Science.gov (United States)

    Bishop, Annette; Wynne-Jones, Gwenllian; Lawton, Sarah A; van der Windt, Danielle; Main, Chris; Sowden, Gail; Burton, A Kim; Lewis, Martyn; Jowett, Sue; Sanders, Tom; Hay, Elaine M; Foster, Nadine E

    2014-07-10

    Musculoskeletal pain is a major contributor to short and long term work absence. Patients seek care from their general practitioner (GP) and yet GPs often feel ill-equipped to deal with work issues. Providing a vocational case management service in primary care, to support patients with musculoskeletal problems to remain at or return to work, is one potential solution but requires robust evaluation to test clinical and cost-effectiveness. This protocol describes a cluster randomised controlled trial, with linked qualitative interviews, to investigate the effect of introducing a vocational advice service into general practice, to provide a structured approach to managing work related issues in primary care patients with musculoskeletal pain who are absent from work or struggling to remain in work. General practices (n = 6) will be randomised to offer best current care or best current care plus a vocational advice service. Adults of working age who are absent from or struggling to remain in work due to a musculoskeletal pain problem will be invited to participate and 330 participants will be recruited. Data collection will be through patient completed questionnaires at baseline, 4 and 12 months. The primary outcome is self-reported work absence at 4 months. Incremental cost-utility analysis will be undertaken to calculate the cost per additional QALY gained and incremental net benefits. A linked interview study will explore the experiences of the vocational advice service from the perspectives of GPs, nurse practitioners (NPs), patients and vocational advisors. This paper presents the rationale, design, and methods of the Study of Work And Pain (SWAP) trial. The results of this trial will provide evidence to inform primary care practice and guide the development of services to provide support for musculoskeletal pain patients with work-related issues. Current Controlled Trials ISRCTN52269669.

  7. 40 CFR 80.162 - Additive compositional data.

    Science.gov (United States)

    2010-07-01

    ... detergent production quality control. EPA will respond to such requests in writing; the additional... variability is required, and provide evidence that the production detergent will perform adequately throughout... (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Detergent Gasoline § 80.162 Additive compositional data...

  8. Integrated RNA- and protein profiling of fermentation and respiration in diploid budding yeast provides insight into nutrient control of cell growth and development.

    Science.gov (United States)

    Becker, Emmanuelle; Liu, Yuchen; Lardenois, Aurélie; Walther, Thomas; Horecka, Joe; Stuparevic, Igor; Law, Michael J; Lavigne, Régis; Evrard, Bertrand; Demougin, Philippe; Riffle, Michael; Strich, Randy; Davis, Ronald W; Pineau, Charles; Primig, Michael

    2015-04-24

    Diploid budding yeast undergoes rapid mitosis when it ferments glucose, and in the presence of a non-fermentable carbon source and the absence of a nitrogen source it triggers sporulation. Rich medium with acetate is a commonly used pre-sporulation medium, but our understanding of the molecular events underlying the acetate-driven transition from mitosis to meiosis is still incomplete. We identified 263 proteins for which mRNA and protein synthesis are linked or uncoupled in fermenting and respiring cells. Using motif predictions, interaction data and RNA profiling we find among them 28 likely targets for Ume6, a subunit of the conserved Rpd3/Sin3 histone deacetylase-complex regulating genes involved in metabolism, stress response and meiosis. Finally, we identify 14 genes for which both RNA and proteins are detected exclusively in respiring cells but not in fermenting cells in our sample set, including CSM4, SPR1, SPS4 and RIM4, which were thought to be meiosis-specific. Our work reveals intertwined transcriptional and post-transcriptional control mechanisms acting when a MATa/α strain responds to nutritional signals, and provides molecular clues how the carbon source primes yeast cells for entering meiosis. Our integrated genomics study provides insight into the interplay between the transcriptome and the proteome in diploid yeast cells undergoing vegetative growth in the presence of glucose (fermentation) or acetate (respiration). Furthermore, it reveals novel target genes involved in these processes for Ume6, the DNA binding subunit of the conserved histone deacetylase Rpd3 and the co-repressor Sin3. We have combined data from an RNA profiling experiment using tiling arrays that cover the entire yeast genome, and a large-scale protein detection analysis based on mass spectrometry in diploid MATa/α cells. This distinguishes our study from most others in the field-which investigate haploid yeast strains-because only diploid cells can undergo meiotic development

  9. Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

    Directory of Open Access Journals (Sweden)

    Esbensen Bente

    2011-06-01

    Full Text Available Abstract Background Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus a barrier for health care providers (HCPs to overcome in their attempts to involve both adolescents and parents in improvement of glycaemic control. Evidence-based interventions that involve all three parties (i.e., adolescents, parents and HCPs and are integrated into routine outpatient clinic visits are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic visits will reduce haemoglobin A1c (HbA1c concentrations and improve adolescents' life skills compared with a control group. Methods/Design Using a mixed methods design comprising a randomised controlled trial and a nested qualitative evaluation, we will recruit 68 adolescents age 13 - 18 years with type 1 diabetes (HbA1c > 8.0% and their parents from 2 Danish hospitals and randomise into GSD-Y or control groups. During an 8-12 month period, the GSD-Y group will complete 8 outpatient GSD-Y visits, and the control group will completes an equal number of standard visits. The primary outcome is HbA1c. Secondary outcomes include the following: number of self-monitored blood glucose values and levels of autonomous motivation, involvement and autonomy support from parents, autonomy support from HCPs, perceived competence in managing diabetes, well-being, and diabetes-related problems. Primary and secondary outcomes will be evaluated within and between groups by comparing data from baseline, after completion of the visits, and again after a 6-month follow-up. To

  10. Improving communication when seeking informed consent: a randomised controlled study of a computer-based method for providing information to prospective clinical trial participants.

    Science.gov (United States)

    Karunaratne, Asuntha S; Korenman, Stanley G; Thomas, Samantha L; Myles, Paul S; Komesaroff, Paul A

    2010-04-05

    To assess the efficacy, with respect to participant understanding of information, of a computer-based approach to communication about complex, technical issues that commonly arise when seeking informed consent for clinical research trials. An open, randomised controlled study of 60 patients with diabetes mellitus, aged 27-70 years, recruited between August 2006 and October 2007 from the Department of Diabetes and Endocrinology at the Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne. Participants were asked to read information about a mock study via a computer-based presentation (n = 30) or a conventional paper-based information statement (n = 30). The computer-based presentation contained visual aids, including diagrams, video, hyperlinks and quiz pages. Understanding of information as assessed by quantitative and qualitative means. Assessment scores used to measure level of understanding were significantly higher in the group that completed the computer-based task than the group that completed the paper-based task (82% v 73%; P = 0.005). More participants in the group that completed the computer-based task expressed interest in taking part in the mock study (23 v 17 participants; P = 0.01). Most participants from both groups preferred the idea of a computer-based presentation to the paper-based statement (21 in the computer-based task group, 18 in the paper-based task group). A computer-based method of providing information may help overcome existing deficiencies in communication about clinical research, and may reduce costs and improve efficiency in recruiting participants for clinical trials.

  11. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sandra Haider

    Full Text Available The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35 conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23 received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2 to 3.0 pg/l (min-max = 2.0-20.8, and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9 to 0.3 mg/dl (min-max = 0.1-3.0 after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45 were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  12. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Science.gov (United States)

    Haider, Sandra; Grabovac, Igor; Winzer, Eva; Kapan, Ali; Schindler, Karin Emmi; Lackinger, Christian; Titze, Sylvia; Dorner, Thomas Ernst

    2017-01-01

    The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2) to 3.0 pg/l (min-max = 2.0-20.8), and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9) to 0.3 mg/dl (min-max = 0.1-3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  13. Additive effects of nutritional supplementation, together with bisphosphonates, on bone mineral density after hip fracture: a 12-month randomized controlled study

    Directory of Open Access Journals (Sweden)

    Flodin L

    2014-07-01

    Full Text Available Lena Flodin,1,2 Maria Sääf,3 Tommy Cederholm,4 Amer N Al-Ani,2,5 Paul W Ackermann,5,6 Eva Samnegård,7 Nils Dalen,7 Margareta Hedström2,51Department of Geriatric Medicine, Karolinska University Hospital Stockholm, Sweden; 2Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden; 3Department of Endocrinology, Metabolism, and Diabetes, Karolinska University Hospital, Stockholm, Sweden; 4Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden; 5Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden; 6Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; 7Department of Clinical Science, Division of Orthopedics, Karolinska Institutet, Danderyd Hospital, Stockholm, SwedenBackground: After a hip fracture, a catabolic state develops, with increased bone loss during the first year. The aim of this study was to evaluate the effects of postoperative treatment with calcium, vitamin D, and bisphosphonates (alone or together with nutritional supplementation on total hip and total body bone mineral density (BMD.Methods: Seventy-nine patients (56 women, with a mean age of 79 years (range, 61–96 years and with a recent hip fracture, who were ambulatory before fracture and without severe cognitive impairment, were included. Patients were randomized to treatment with bisphosphonates (risedronate 35 mg weekly for 12 months (B; n=28, treatment with bisphosphonates along with nutritional supplementation (40 g protein, 600 kcal daily for the first 6 months (BN; n=26, or to controls (C; n=25. All participants received calcium (1,000 mg and vitamin D3 (800 IU daily. Total hip and total body BMD were assessed with dual-energy X-ray absorptiometry at baseline, 6, and 12 months. Marker of bone resorption C-terminal telopeptide of collagen I and 25-hydroxy vitamin D were analyzed in serum

  14. Optimising corticosteroid injection for lateral epicondylalgia with the addition of physiotherapy: A protocol for a randomised control trial with placebo comparison

    Directory of Open Access Journals (Sweden)

    Brooks Peter

    2009-06-01

    Full Text Available Abstract Background Corticosteroid injection and physiotherapy are two commonly prescribed interventions for management of lateral epicondylalgia. Corticosteroid injections are the most clinically efficacious in the short term but are associated with high recurrence rates and delayed recovery, while physiotherapy is similar to injections at 6 weeks but with significantly lower recurrence rates. Whilst practitioners frequently recommend combining physiotherapy and injection to overcome harmful effects and improve outcomes, study of the benefits of this combination of treatments is lacking. Clinicians are also faced with the paradox that the powerful anti-inflammatory corticosteroid injections work well, albeit in the short term, for a non-inflammatory condition like lateral epicondylalgia. Surprisingly, these injections have not been rigorously tested against placebo injections. This study primarily addresses both of these issues. Methods A randomised placebo-controlled clinical trial with a 2 × 2 factorial design will evaluate the clinical efficacy, cost-effectiveness and recurrence rates of adding physiotherapy to an injection. In addition, the clinical efficacy and adverse effects of corticosteroid injection beyond that of a placebo saline injection will be studied. 132 participants with a diagnosis of lateral epicondylalgia will be randomly assigned by concealed allocation to one of four treatment groups – corticosteroid injection, saline injection, corticosteroid injection with physiotherapy or saline injection with physiotherapy. Physiotherapy will comprise 8 sessions of elbow manipulation and exercise over an 8 week period. Blinded follow-up assessments will be conducted at baseline, 4, 8, 12, 26 and 52 weeks after randomisation. The primary outcome will be a participant rating of global improvement, from which measures of success and recurrence will be derived. Analyses will be conducted on an intention-to-treat basis using linear

  15. The dilemma of allergy to food additives.

    Science.gov (United States)

    Bahna, Sami L; Burkhardt, Joshua G

    2018-01-01

    To provide a brief summary on food additives and to outline a practical approach for evaluating subjects suspected of having reactions to food additives. Information was derived from selected reviews and original articles published in peer-reviewed journals, supplemented by the clinical experience of the authors. Priority was given to studies that used blinded, placebo controlled, oral challenges to confirm adverse reactions to food additives. In addition, selected, appropriately evaluated case reports were included. A large number of food additives are widely used in the food industry. Allergic reactions to additives seem to be rare but are very likely underdiagnosed, primarily due to a low index of suspicion. A wide variety of symptoms to food additives have been reported, but a cause-and-effect relationship has not been well documented in the majority of cases. Reactions to food additives should be suspected in patients who report symptoms related to multiple foods or to a certain food when commercially prepared but not when home made. It is also prudent to investigate food additives in subjects considered to have "idiopathic" reactions. Except for a limited number of natural additives, there is a small role for skin tests or in vitro testing. Oral challenge, in stages, with commonly used additives is the definitive procedure for detecting the offending agent. Once the specific additive is identified, management is strict avoidance, which can be difficult.

  16. Subacute effects of cervicothoracic spinal thrust/non-thrust in addition to shoulder manual therapy plus exercise intervention in individuals with subacromial impingement syndrome: a prospective, randomized controlled clinical trial pilot study.

    Science.gov (United States)

    Wright, Alexis A; Donaldson, Megan; Wassinger, Craig A; Emerson-Kavchak, Alicia J

    2017-09-01

    To determine the subacute effects of cervicothoracic spinal thrust/non-thrust in addition to shoulder non-thrust plus exercise in patients with subacromial pathology. This was a randomized, single blinded controlled trial pilot study. This trial was registered at ClinicalTrials.gov (NCT01753271) and reported according to Consolidated Standards of Reporting Trials requirements. Patients were randomly assigned to either shoulder treatment plus cervicothoracic spinal thrust/non-thrust or shoulder treatment-only group. Primary outcomes were average pain intensity (Numeric Pain Rating Scale) and physical function (Shoulder Pain and Disability Index) at 2 weeks, 4 weeks, and patient discharge. 18 patients, mean age 43.1(15.8) years satisfied the eligibility criteria and were analyzed for follow-up data. Both groups showed statistically significant improvements in both pain and function at 2 weeks, 4 weeks, and discharge. The between-group differences for changes in pain or physical function were not significant at any time point. The addition of cervicothoracic spinal thrust/non-thrust to the shoulder treatment-only group did not significantly alter improvement in pain or function in patients with subacromial pathology. Both approaches appeared to provide an equally notable benefit. Both groups improved on all outcomes and met the criteria for clinical relevance for both pain and function. 2b.

  17. Teardrop bladder: additional considerations

    International Nuclear Information System (INIS)

    Wechsler, R.J.; Brennan, R.E.

    1982-01-01

    Nine cases of teardrop bladder (TDB) seen at excretory urography are presented. In some of these patients, the iliopsoas muscles were at the upper limit of normal in size, and additional evaluation of the perivesical structures with computed tomography (CT) was necessary. CT demonstrated only hypertrophied muscles with or without perivesical fat. The psoas muscles and pelvic width were measured in 8 patients and compared with the measurements of a control group of males without TDB. Patients with TDB had large iliopsoas muscles and narrow pelves compared with the control group. The psoas muscle width/pelvic width ratio was significantly greater (p < 0.0005) in patients with TDB than in the control group, with values of 1.04 + 0.05 and 0.82 + 0.09, respectively. It is concluded that TDB is not an uncommon normal variant in black males. Both iliopsoas muscle hypertrophy and a narrow pelvis are factors that predispose a patient to TDB

  18. Heme Oxygenase-1 Gene Therapy Provides Cardioprotection Via Control of Post-Ischemic Inflammation: An Experimental Study in a Pre-Clinical Pig Model.

    Science.gov (United States)

    Hinkel, Rabea; Lange, Philipp; Petersen, Björn; Gottlieb, Elena; Ng, Judy King Man; Finger, Stefanie; Horstkotte, Jan; Lee, Seungmin; Thormann, Michael; Knorr, Maike; El-Aouni, Chiraz; Boekstegers, Peter; Reichart, Bruno; Wenzel, Philip; Niemann, Heiner; Kupatt, Christian

    2015-07-14

    Heme oxygenase-1 (HO-1) is an inducible stress-responsive enzyme converting heme to bilirubin, carbon monoxide, and free iron, which exerts anti-inflammatory and antiapoptotic effects. Although efficient cardioprotection after HO-1 overexpression has been reported in rodents, its role in attenuating post-ischemic inflammation is unclear. This study assessed the efficacy of recombinant adenoassociated virus (rAAV)-encoding human heme oxygenase-1 (hHO-1) in attenuating post-ischemic inflammation in a murine and a porcine ischemia/reperfusion model. Murine ischemia was induced by 45 min of left anterior descending occlusion, followed by 24 h of reperfusion and functional as well as fluorescent-activated cell sorting analysis. Porcine hearts were subjected to 60 min of ischemia and 24h of reperfusion before hemodynamic and histologic analyses were performed. Human microvascular endothelial cells transfected with hHO-1 displayed an attenuated interleukin-6 and intercellular adhesion molecule 1 expression, resulting in reduced monocytic THP-1 cell recruitment in vitro. In murine left anterior descending occlusion and reperfusion, the post-ischemic influx of CD45(+) leukocytes, Ly-6G(+) neutrophils, and Ly-6C(high) monocytes was further exacerbated in HO-1-deficient hearts and reversed by rAAV.hHO-1 treatment. Conversely, in our porcine model of ischemia, the post-ischemic influx of myeloperoxidase-positive neutrophils and CD14(+) monocytes was reduced by 49% and 87% after rAAV.hHO-1 transduction, similar to hHO-1 transgenic pigs. Functionally, rAAV.hHO-1 and hHO-1 transgenic left ventricles displayed a smaller loss of ejection fraction than control animals. Whereas HO-1 deficiency exacerbates post-ischemic cardiac inflammation in mice, hHO-1 gene therapy attenuates inflammation after ischemia and reperfusion in murine and porcine hearts. Regional hHO-1 gene therapy provides cardioprotection in a pre-clinical porcine ischemia/reperfusion model. Copyright © 2015 American

  19. Additive manufactured serialization

    Science.gov (United States)

    Bobbitt, III, John T.

    2017-04-18

    Methods for forming an identifying mark in a structure are described. The method is used in conjunction with an additive manufacturing method and includes the alteration of a process parameter during the manufacturing process. The method can form in a unique identifying mark within or on the surface of a structure that is virtually impossible to be replicated. Methods can provide a high level of confidence that the identifying mark will remain unaltered on the formed structure.

  20. SACRI: A measure of situation awareness for use in the evaluation of nuclear power plant control room systems providing information about the current process state

    International Nuclear Information System (INIS)

    Hogg, D.N.; Follesoe, K.; Volden, F.S.; Torralba, B.

    1994-01-01

    Control room operator support systems and their interface designs have as one goal the enhancement of the operators' situation awareness of the dynamically changing process state. This paper describes a technique for measuring situation awareness within the Human Factors evaluation of control room operator-system interfaces. The technique, referred to as SACRI, has been evaluated in four simulator studies and the main findings from these studies are summarized in this paper. It is concluded that SACRI can be a useful supplement to operator performance measures currently existing for use within control room interface evaluations. (author). 16 refs, 2 figs, 3 tabs

  1. Haptic control of a pneumatic muscle actuator to provide resistance for simulated isokinetic exercise: Part I--dynamic test station and human quadriceps dynamic simulator.

    Science.gov (United States)

    Hall, Kara L; Phillips, Chandler A; Reynolds, David B; Mohler, Stanley R; Rogers, Dana B; Neidhard-Doll, Amy T

    2014-01-01

    Pneumatic muscle actuators (PMAs) have a high power to weight ratio and possess unique characteristics which make them ideal actuators for applications involving human interaction. PMAs are difficult to control due to nonlinear dynamics, presenting challenges in system implementation. Despite these challenges, PMAs have great potential as a source of resistance for strength training and rehabilitation. The objective of this work was to control a PMA for use in isokinetic exercise, potentially benefiting anyone in need of optimal strength training through a joint's range of motion. A human quadriceps dynamic simulator (HQDS) was developed so that control effectiveness and accommodation could be tested prior to human implementation. The experimental set-up and HQDS are discussed in Part I of this work. The development of a PMA haptic controller and its interaction with the HQDS are discussed in Part II.

  2. Proposed Regulation of Fuels and Fuel Additives: Federal Volatility Control Program in the Denver-Boulder-Greeley-Ft. Collins-Loveland, Colorado, 1997 8-Hour Ozone Nonattainment Area

    Science.gov (United States)

    This notice proposes establishing an applicable standard of 7.8 pounds (psi) Reid vapor pressure under the federal volatility control program, in the Denver-Boulder-Greeley-Ft. Collins-Loveland, Colorado, 1997 8-hour ozone nonattainment area.

  3. Model Additional Protocol

    International Nuclear Information System (INIS)

    Rockwood, Laura

    2001-01-01

    Since the end of the cold war a series of events has changed the circumstances and requirements of the safeguards system. The discovery of a clandestine nuclear weapons program in Iraq, the continuing difficulty in verifying the initial report of Democratic People's Republic of Korea upon entry into force of their safeguards agreement, and the decision of the South African Government to give up its nuclear weapons program and join the Treaty on the Non-Proliferation of Nuclear Weapons have all played a role in an ambitious effort by IAEA Member States and the Secretariat to strengthen the safeguards system. A major milestone in this effort was reached in May 1997 when the IAEA Board of Governors approved a Model Protocol Additional to Safeguards Agreements. The Model Additional Protocol was negotiated over a period of less than a year by an open-ended committee of the Board involving some 70 Member States and two regional inspectorates. The IAEA is now in the process of negotiating additional protocols, State by State, and implementing them. These additional protocols will provide the IAEA with rights of access to information about all activities related to the use of nuclear material in States with comprehensive safeguards agreements and greatly expanded physical access for IAEA inspectors to confirm or verify this information. In conjunction with this, the IAEA is working on the integration of these measures with those provided for in comprehensive safeguards agreements, with a view to maximizing the effectiveness and efficiency, within available resources, the implementation of safeguards. Details concerning the Model Additional Protocol are given. (author)

  4. Clinical control and histopathologic outcome of asthma when using airway hyperresponsiveness as an additional guide to long-term treatment. The AMPUL Study Group

    NARCIS (Netherlands)

    Sont, J. K.; Willems, L. N.; Bel, E. H.; van Krieken, J. H.; Vandenbroucke, J. P.; Sterk, P. J.

    1999-01-01

    According to international guidelines, the level and adjustment of antiinflammatory treatment for asthma are based solely on symptoms and lung function. We investigated whether a treatment strategy aimed at reducing airway hyperresponsiveness (AHR strategy) in addition to the recommendations in the

  5. Characterization of morphology controlled polyethersulfone hollow fiber membranes by the addition of polyethylene glycol to the dope and bore liquid solution

    NARCIS (Netherlands)

    Koops, G.H.; Liu, Y.; Liu, Y.; Strathmann, H.

    2003-01-01

    The preparation of polyethersulfone (PES) hollow fiber membranes has been studied using N-methylpyrrolidone (NMP) as solvent, polyethylene glycol 400 (PEG 400) as weak nonsolvent and water as strong nonsolvent. When PEG 400 is used as polymeric additive to the spinning dope the viscosity of the PES

  6. What's New is What's Old: Use of Bode's Integral Theorem (circa 1945) to Provide Insight for 21st Century Spacecraft Attitude Control System Design Tuning

    Science.gov (United States)

    Ruth, Mike; Lebsock, Ken; Dennehy, Neil

    2010-01-01

    This paper revisits the Bode integral theorem, first described in 1945 for feedback amplifier design, in the context of modern satellite Attitude Control System (ACS) design tasks. Use of Bode's Integral clarifies in an elegant way the connection between open-loop stability margins and closed-loop bandwidth. More importantly it shows that there is a very strong tradeoff between disturbance rejection below the satellite controller design bandwidth, and disturbance amplification in the 'penalty region' just above the design bandwidth. This information has been successfully used to re-tune the control designs for several NASA science-mission satellites. The Appendix of this paper contains a complete summary of the relevant integral conservation theorems for stable, unstable, and non-minimum- phase plants.

  7. Examining the effects of enhanced provider-patient communication on postoperative tonsillectomy pain: protocol of a randomised controlled trial performed by nurses in daily clinical care

    NARCIS (Netherlands)

    Vliet, L.M. van; Dulmen, S. van; Thiel, B.; Deelen, G.W. van; Immerzeel, S.; Godfried, M.B.; Bensing, J.M.

    2017-01-01

    INTRODUCTION: Placebo effects (true biopsychological effects not attributable to the active ingredients of medical technical interventions) can be attributed to several mechanisms, such as expectancy manipulation and empathy manipulation elicited by a provider's communication. So far, effects have

  8. Using Arrays of Microelectrodes Implanted in Residual Peripheral Nerves to Provide Dexterous Control of, and Modulated Sensory Feedback from, a Hand Prosthesis

    Science.gov (United States)

    2016-10-01

    machine interface (Some figures may appear in colour only in the online journal) 1. Introduction The volitional control of movement involves a complex and...enrolment, volunteers underwent a psychosocial evaluation in order to determine if any underlying psychological conditions were present which would

  9. The reinforcing value of vegetables does not increase with repeated exposure during a randomized controlled provided vegetable intervention among overweight and obese adults

    Science.gov (United States)

    Objective: The primary aim of this randomized controlled trial is to determine whether the relative reinforcing value (RRV) of vegetables compared to a snack food can be increased through repeated exposure (incentive sensitization) to amounts of vegetables recommended by the Dietary Guidelines for A...

  10. Evaluation of calculated energy and macronutrient contents of diets provided in controlled dietary intervention trials by chemical analysis of duplicate portions

    NARCIS (Netherlands)

    Siebelink, E.; Vries, de J.H.M.; Trijsburg, L.E.; Hulshof, P.J.M.

    2015-01-01

    The purpose of this study was to investigate whether Dutch food composition databases (Dutch-FCDB) are accurate enough to plan experimental diets with specified amounts of energy and macronutrients. From 2003 to 2012, 10 controlled dietary intervention trials lasting from 2 to 13 weeks were

  11. Low Conductive Thermal Barrier Coatings Produced by Ion Beam Assisted EB-PVD with Controlled Porosity, Microstructure Refinement and Alloying Additions for High Temperature Applications

    Science.gov (United States)

    Wolfe, Douglas E.; Singh, Jogender

    2005-01-01

    Various advanced Hafnia-based thermal barrier coatings (TBC) were applied on nickel-based superalloy coupons by electron beam physical vapor deposition. In addition, microstructural modifications to the coating material were made in an effort to reduce the thermal conductivity of the coating materials. Various processing parameters and coating system modifications were made in order to deposit the alloyed TBC with the desired microstructure and thus coating performance, some of which include applying coatings at substrate temperatures of 1150 C on both PtAl and CoNiCrAlY bond coated samples, as well as using 8YSZ as a bond layer. In addition, various characterization techniques including thermal cyclic tests, scanning electron microscopy, x-ray diffraction, thermal conductivity, and reflectivity measurements were performed. Although the coating microstructure was never fully optimized due to funding being cut short, significant reductions in thermal conductivity were accomplished through both chemistry changes (composition) and microstructural modifications.

  12. Insulin monotherapy compared with the addition of oral glucose-lowering agents to insulin for people with type 2 diabetes already on insulin therapy and inadequate glycaemic control

    NARCIS (Netherlands)

    Vos, Rimke C; van Avendonk, Mariëlle JP; Jansen, Hanneke; Goudswaard, Alexander N; van den Donk, Maureen; Gorter, Kees; Kerssen, Anneloes; Rutten, Guy EHM

    2016-01-01

    BACKGROUND: It is unclear whether people with type 2 diabetes mellitus on insulin monotherapy who do not achieve adequate glycaemic control should continue insulin as monotherapy or can benefit from adding oral glucose-lowering agents to the insulin therapy. OBJECTIVES: To assess the effects of

  13. Efficacy and safety assessment of the addition of bevacizumab to adjuvant therapy agents in cancer patients: A systematic review and meta-analysis of randomized controlled trials

    NARCIS (Netherlands)

    Ahmadizar, Fariba; Onland-Moret, N. Charlotte; De Boer, Anthonius; Liu, Geoffrey; Maitland-Van Der Zee, Anke H.

    2015-01-01

    Aim: To evaluate the efficacy and safety of bevacizumab in the adjuvant cancer therapy setting within different subset of patients. Methods & Design/Results: PubMed, EMBASE, Cochrane and Clinical trials.gov databases were searched for English language studies of randomized controlled trials

  14. Submersible Aircraft Concept Design Study - Amendment 1. Additional Assessment of Design Risks & Sensitivities within the Original Study, and an Initial Assessment of Key Control Aspects

    Science.gov (United States)

    2011-02-01

    http://www.redhammer.se/tornado/index.html (3) Aircraft Design: A Conceptual Approach, Daniel P. Raymer , AIAA, 1992 (4) (5) Moran, J., Computational...Fluid Dynamics, Wiley & Sons, 1984. Notes on the Stability and Control of Tailless Airplanes, Robert T. Jones, NACA Technical Note No.837, December

  15. Controlling solution-phase polymer aggregation with molecular weight and solvent additives to optimize polymer-fullerene bulk heterojunction solar cells

    KAUST Repository

    Bartelt, Jonathan A.

    2014-03-20

    The bulk heterojunction (BHJ) solar cell performance of many polymers depends on the polymer molecular weight (M n) and the solvent additive(s) used for solution processing. However, the mechanism that causes these dependencies is not well understood. This work determines how M n and solvent additives affect the performance of BHJ solar cells made with the polymer poly(di(2-ethylhexyloxy)benzo[1,2-b:4,5-b\\']dithiophene-co- octylthieno[3,4-c]pyrrole-4,6-dione) (PBDTTPD). Low M n PBDTTPD devices have exceedingly large fullerene-rich domains, which cause extensive charge-carrier recombination. Increasing the M n of PBDTTPD decreases the size of these domains and significantly improves device performance. PBDTTPD aggregation in solution affects the size of the fullerene-rich domains and this effect is linked to the dependency of PBDTTPD solubility on M n. Due to its poor solubility high M n PBDTTPD quickly forms a fibrillar polymer network during spin-casting and this network acts as a template that prevents large-scale phase separation. Furthermore, processing low M n PBDTTPD devices with a solvent additive improves device performance by inducing polymer aggregation in solution and preventing large fullerene-rich domains from forming. These findings highlight that polymer aggregation in solution plays a significant role in determining the morphology and performance of BHJ solar cells. The performance of poly(di(2-ethylhexyloxy) benzo[1,2-b:4,5-b\\']dithiophene-co-octylthieno[3,4-c]pyrrole-4,6-dione) (PBDTTPD) bulk heterojunction solar cells strongly depends on the polymer molecular weight, and processing these bulk heterojunctions with a solvent additive preferentially improves the performance of low molecular weight devices. It is demonstrated that polymer aggregation in solution significantly impacts the thin-film bulk heterojunction morphology and is vital for high device performance. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Combining Modeling and Monitoring to Produce a New Paradigm of an Integrated Approach to Providing Long-Term Control of Contaminants

    Science.gov (United States)

    Fogwell, T. W.

    2009-12-01

    Sir David King, Chief Science Advisor to the British government and Cambridge University Professor, stated in October 2005, "The scientific community is considerably more capable than it has been in the past to assist governments to avoid and reduce risk to their own populations. Prime ministers and presidents ignore the advice from the science community at the peril of their own populations." Some of these greater capabilities can be found in better monitoring techniques applied to better modeling methods. These modeling methods can be combined with the information derived from monitoring data in order to decrease the risk of population exposure to dangerous substances and to promote efficient control or cleanup of the contaminants. An introduction is presented of the types of problems that exist for long-term control of radionuclides at DOE sites. A breakdown of the distributions at specific sites is given, together with the associated difficulties. A paradigm for remediation showing the integration of monitoring with modeling is presented. It is based on a feedback system that allows for the monitoring to act as principal sensors in a control system. The resulting system can be optimized to improve performance. Optimizing monitoring automatically entails linking the monitoring with modeling. If monitoring designs were required to be more efficient, thus requiring optimization, then the monitoring automatically becomes linked to modeling. Records of decision could be written to accommodate revisions in monitoring as better modeling evolves. Currently the establishment of a very prescriptive monitoring program fails to have a mechanism for improving models and improving control of the contaminants. The technical pieces of the required paradigm are already available; they just need to be implemented and applied to solve the long-term control of the contaminants. An integration of the various parts of the system is presented. Each part is described, and examples are

  17. Enforcement Alert: U.S. EPA Encourages Iron and Steel Minimills to Self Audits to Address Noncompliance with Environmental Requirements; Nucor Corp. agrees to Control Practices; Provides Model for Industry

    Science.gov (United States)

    This is the enforcement alert for U.S. EPA Encourages Iron and Steel Minimills to Self Audits to Address Noncompliance with Environmental Requirements; Nucor Corp. agrees to Control Practices; Provides Model for Industry

  18. Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Danielle Taubman

    2013-12-01

    Conclusions: Compliance for latent TB screening is low among HCWs in northeastern Israel. Providing detailed information about latent TB was not associated with increased test compliance. Understanding existing disparities in screening rates and potential barriers to latent TB screening among HCWs is important in order to move forward and successfully increase screening rates.

  19. BWR zinc addition Sourcebook

    International Nuclear Information System (INIS)

    Garcia, Susan E.; Giannelli, Joseph F.; Jarvis, Alfred J.

    2014-01-01

    Boiling Water Reactors (BWRs) have been injecting zinc into the primary coolant via the reactor feedwater system for over 25 years for the purpose of controlling primary system radiation fields. The BWR zinc injection process has evolved since the initial application at the Hope Creek Nuclear Station in 1986. Key transitions were from the original natural zinc oxide (NZO) to depleted zinc oxide (DZO), and from active zinc injection of a powdered zinc oxide slurry (pumped systems) to passive injection systems (zinc pellet beds). Zinc addition has continued through various chemistry regimes changes, from normal water chemistry (NWC) to hydrogen water chemistry (HWC) and HWC with noble metals (NobleChem™) for mitigation of intergranular stress corrosion cracking (IGSCC) of reactor internals and primary system piping. While past reports published by the Electric Power Research Institute (EPRI) document specific industry experience related to these topics, the Zinc Sourcebook was prepared to consolidate all of the experience gained over the past 25 years. The Zinc Sourcebook will benefit experienced BWR Chemistry, Operations, Radiation Protection and Engineering personnel as well as new people entering the nuclear power industry. While all North American BWRs implement feedwater zinc injection, a number of other BWRs do not inject zinc. This Sourcebook will also be a valuable resource to plants considering the benefits of zinc addition process implementation, and to gain insights on industry experience related to zinc process control and best practices. This paper presents some of the highlights from the Sourcebook. (author)

  20. Indoor residual spraying with a mixture of clothianidin (a neonicotinoid insecticide) and deltamethrin provides improved control and long residual activity against pyrethroid resistant Anopheles gambiae sl in Southern Benin.

    OpenAIRE

    Ngufor, C; Fongnikin, A; Rowland, M; N'Guessan, R

    2017-01-01

    There is an urgent need for new insecticides for indoor residual spraying (IRS) which can provide improved and prolonged control of malaria vectors that have developed resistance to existing insecticides. The neonicotinoid, clothianidin represents a class of chemistry new to public health. Clothianidin acts as an agonist on nicotinic acetyl choline receptors. IRS with a mixture of Clothianidin and another WHO approved insecticide such as deltamethrin could provide improved control of insectic...

  1. Superhydrophobic powder additives to enhance chemical agent resistant coating systems for military equipment for the U.S. Marine Corps (USMC) Corrosion Prevention and Control (CPAC) Program

    Energy Technology Data Exchange (ETDEWEB)

    Pawel, Steven J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Armstrong, Beth L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Haynes, James A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-07-01

    The primary goal of the CPAC program at ORNL was to explore the feasibility of introducing various silica-based superhydrophobic (SH) powder additives as a way to improve the corrosion resistance of US Department of Defense (DOD) military-grade chemical agent resistant coating (CARC) systems. ORNL had previously developed and patented several SH technologies of interest to the USMC, and one of the objectives of this program was to identify methods to incorporate these technologies into the USMC’s corrosion-resistance strategy. This report discusses findings of the CPAC and their application.

  2. Close or positive margins after surgical resection for the head and neck cancer patient: the addition of brachytherapy improves local control

    International Nuclear Information System (INIS)

    Beitler, Jonathan J.; Smith, Richard V.; Silver, Carl E.; Quish, Astrid; Deore, Shivaji M.; Mullokandov, Eduard; Fontenla, Doracy P.; Wadler, Scott; Hayes, Mary Katherine; Vikram, Bhadrasain

    1998-01-01

    Purpose: Microscopically positive or close margins after surgical resection results in an approximately 21-26% local failure rate despite excellent postoperative external radiation therapy. We sought to demonstrate improved local control in head and neck cancer patients who had a resection with curative intent, and had unexpected, microscopically positive or close surgical margins. Methods and Materials: Twenty-nine patients with microscopically close or positive margins after curative surgery were given definitive, adjuvant external radiation therapy and 125 I brachytherapy. All 29 patients had squamous cell cancer and tonsil was the most common subsite within the head and neck region. After external radiation therapy and thorough discussions with the attending surgeon and pathologists, the slides, gross specimens, and appropriate radiographs were reviewed and a target volume was determined. The target volume was the region of the margin in question and varied in size based on the surgery and pathologic results. Once the target volume was identified the patient was taken back to the operating room for insertion of 125 I seeds. Activity implanted (range 2.9-21.5 millicuries) was designed to administer a cumulative lifetime dose of 120-160 Gy. Results: Twenty-nine patients were followed for a median of 26 months (range 5-86 months). Two-year actuarial local control was 92%. Conclusion: 125 I, after external radiation therapy, is an excellent method to improve local control in the subset of patients with unexpectedly unsatisfactory margins

  3. Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial.

    Science.gov (United States)

    Cruz-Díaz, David; Martínez-Amat, Antonio; Osuna-Pérez, M C; De la Torre-Cruz, M J; Hita-Contreras, Fidel

    2016-01-01

    To determine the short- and long-term effectiveness of the application of Clinical Pilates in addition to physical therapy versus a physical therapy treatment alone in a population of postmenopausal women with chronic low back pain (CLBP). A single-blind randomized controlled trial with repeated measures and a follow-up period. One hundred and one patients were randomly allocated to a Pilates + physical therapy (PPT) group or to a physical therapy (PT) only group for six weeks. Pain and disability were measured by visual analog scale (VAS) and the Oswestry disability index respectively preintervention, after 6 weeks of treatment and after 1-year follow-up. There were significant differences between groups in pain and disability after 6 weeks of treatment, with better results in the PPT group with an effect size of d = 3.14 and d = 2.33 for pain and disability. After 1-year follow-up, only PPT group showed better results compared with baseline with an effect size of d = 2.49 and d = 4.98 for pain and disability. The results suggest that using Clinical Pilates in addition to physical therapy provides improved results on pain management and functional status for postmenopausal woman with CLBP and that its benefits still linger after one year. Chronic Low Back Pain could benefit from the Pilates practice in postmenopausal women. Improvement in pain and disability derived from CLBP seem to be maintained over time due to Pilates practice. Pilates constitutes a safe tool to be applied in older population with CLBP due to its ability to be adapted to every performance and physical level.

  4. Development and validation of a multi-analyte method for the regulatory control of carotenoids used as feed additives in fish and poultry feed.

    Science.gov (United States)

    Vincent, Ursula; Serano, Federica; von Holst, Christoph

    2017-08-01

    Carotenoids are used in animal nutrition mainly as sensory additives that favourably affect the colour of fish, birds and food of animal origin. Various analytical methods exist for their quantification in compound feed, reflecting the different physico-chemical characteristics of the carotenoid and the corresponding feed additives. They may be natural products or specific formulations containing the target carotenoids produced by chemical synthesis. In this study a multi-analyte method was developed that can be applied to the determination of all 10 carotenoids currently authorised within the European Union for compound feedingstuffs. The method functions regardless of whether the carotenoids have been added to the compound feed via natural products or specific formulations. It is comprised of three steps: (1) digestion of the feed sample with an enzyme; (2) pressurised liquid extraction; and (3) quantification of the analytes by reversed-phase HPLC coupled to a photodiode array detector in the visible range. The method was single-laboratory validated for poultry and fish feed covering a mass fraction range of the target analyte from 2.5 to 300 mg kg - 1 . The following method performance characteristics were obtained: the recovery rate varied from 82% to 129% and precision expressed as the relative standard deviation of intermediate precision varied from 1.6% to 15%. Based on the acceptable performance obtained in the validation study, the multi-analyte method is considered fit for the intended purpose.

  5. Patient- and provider-level risk factors associated with default from tuberculosis treatment, South Africa, 2002: a case-control study.

    Science.gov (United States)

    Finlay, Alyssa; Lancaster, Joey; Holtz, Timothy H; Weyer, Karin; Miranda, Abe; van der Walt, Martie

    2012-01-20

    Persons who default from tuberculosis treatment are at risk for clinical deterioration and complications including worsening drug resistance and death. Our objective was to identify risk factors associated with tuberculosis (TB) treatment default in South Africa. We conducted a national retrospective case control study to identify factors associated with treatment default using program data from 2002 and a standardized patient questionnaire. We defined default as interrupting TB treatment for two or more consecutive months during treatment. Cases were a sample of registered TB patients receiving treatment under DOTS that defaulted from treatment. Controls were those who began therapy and were cured, completed or failed treatment. Two respective multivariable models were constructed, stratified by history of TB treatment (new and re-treatment patients), to identify independent risk factors associated with default. The sample included 3165 TB patients from 8 provinces; 1164 were traceable and interviewed (232 cases and 932 controls). Significant risk factors associated with default among both groups included poor health care worker attitude (new: AOR 2.1, 95% CI 1.1-4.4; re-treatment: AOR 12, 95% CI 2.2-66.0) and changing residence during TB treatment (new: AOR 2.0, 95% CI 1.1-3.7; re-treatment: AOR 3.4, 95% CI 1.1-9.9). Among new patients, cases were more likely than controls to report having no formal education (AOR 2.3, 95% CI 1.2-4.2), feeling ashamed to have TB (AOR 2.0, 95% CI 1.3-3.0), not receiving adequate counseling about their treatment (AOR 1.9, 95% CI 1.2-2.8), drinking any alcohol during TB treatment (AOR 1.9, 95% CI 1.2-3.0), and seeing a traditional healer during TB treatment (AOR 1.9, 95% CI 1.1-3.4). Among re-treatment patients, risk factors included stopping TB treatment because they felt better (AOR 21, 95% CI 5.2-84), having a previous history of TB treatment default (AOR 6.4, 95% CI 2.9-14), and feeling that food provisions might have helped

  6. Sewage sludge additive

    Science.gov (United States)

    Kalvinskas, J. J.; Mueller, W. A.; Ingham, J. D. (Inventor)

    1980-01-01

    The additive is for a raw sewage treatment process of the type where settling tanks are used for the purpose of permitting the suspended matter in the raw sewage to be settled as well as to permit adsorption of the dissolved contaminants in the water of the sewage. The sludge, which settles down to the bottom of the settling tank is extracted, pyrolyzed and activated to form activated carbon and ash which is mixed with the sewage prior to its introduction into the settling tank. The sludge does not provide all of the activated carbon and ash required for adequate treatment of the raw sewage. It is necessary to add carbon to the process and instead of expensive commercial carbon, coal is used to provide the carbon supplement.

  7. Flurbiprofen Axetil Provides Effective Analgesia Without Changing the Pregnancy Rate in Ultrasound-Guided Transvaginal Oocyte Retrieval: A Double-Blind Randomized Controlled Trial.

    Science.gov (United States)

    Zhao, Hong; Feng, Yi; Jiang, Yan; Lu, Qun

    2017-10-01

    In this prospective double-blind randomized study, we evaluated the analgesic effect and potential effect on pregnancy rate of the nonsteroidal anti-inflammatory drug flurbiprofen axetil in patients undergoing ultrasound-guided transvaginal oocyte retrieval under propofol-remifentanil anesthesia. A total of 200 patients scheduled to undergo ultrasound-guided transvaginal oocyte retrieval were randomly allocated to receive 1.5 mg/kg of flurbiprofen axetil (FA group) or placebo (control group) 30 minutes before the procedure. Postoperative pain scores, embryo implantation rate, and pregnancy rate were recorded. Neuroendocrine biomarkers and prostaglandin E2 levels in follicular fluid were tested after oocyte retrieval. Patients in the FA group awakened earlier after surgery than patients in the control group (3.3 ± 2.6 vs 5.3 ± 3.4 minutes, P Flurbiprofen axetil given before ultrasound-guided transvaginal oocyte retrieval for patients under propofol-remifentanil general anesthesia relieves pain without any detrimental effect on clinical pregnancy rate.

  8. Randomized controlled trial to study the effect of dexamethasone as additive to ropivacaine on duration of ultrasound-guided transversus abdominis plane block in cesarean section

    Directory of Open Access Journals (Sweden)

    Jasleen Sachdeva

    2016-01-01

    Full Text Available Background: Transversus abdominis plane (TAP block is a regional anesthesia technique whose efficacy has been proven for postoperative pain relief after cesarean section (CS. Dexamethasone, a glucocorticoid, is now emerging as a new adjunct to local anesthetics for prolonging the duration of action and has been studied in different brachial plexus blocks. The primary outcome was to study the effect of dexamethasone as additive to ropivacaine on the duration of TAP block as assessed by time to first analgesic (TFA . The secondary outcome was total postoperative analgesic consumption, postoperative nausea and vomiting, and patient satisfaction. Method: This RCT was conducted on seventy American Society of Anesthesiology Grade I and II patients undergoing CS under subarachnoid block. Patients were randomly allocated to two groups comprising 35 patients each. Patients in Group I received ultrasound-guided bilateral TAP block at the end of surgery using 40 ml ropivacaine 0.2% and 2 ml saline, and patients in Group II received the block using 40 ml ropivacaine 0.2% and 2 ml (8 mg dexamethasone. Result: TFA was significantly longer in Group II (5.92 ± 1.02 vs. 3.11 ± 0.82 h, P = 0. Group II also had decreased tramadol requirement postoperatively (100.00 ± 0.00 vs. 140.00 ± 50.26 mg, P = 0.046. The incidence of nausea and vomiting was also lower (82.86% vs. 97.14%, P = 0.02318. The patient satisfaction with regard to pain relief was more (57.14% vs. 25.71%, P = 0.038. Conclusion: Addition of dexamethasone to ropivacaine in TAP block prolonged the duration of the block. There was no complication seen with TAP block in any of the patients.

  9. Intensive multifactorial treatment modifies the effect of family history of diabetes on glycaemic control in people with Type 2 diabetes: a post hoc analysis of the ADDITION-Denmark randomized controlled trial.

    Science.gov (United States)

    Eliraqi, G M; Vistisen, D; Lauritzen, T; Sandbaek, A; Jørgensen, M E; Faerch, K

    2015-08-01

    To investigate whether intensive multifactorial treatment can reverse the predisposed adverse phenotype of people with Type 2 diabetes who have a family history of diabetes. Data from the randomized controlled trial ADDITION-Denmark were used. A total of 1441 newly diagnosed patients with diabetes (598 with family history of diabetes) were randomized to intensive treatment or routine care. Family history of diabetes was defined as having one parent and/or sibling with diabetes. Linear mix