Mode of delivery has an independent impact on neonatal condition at birth.

PubMed

Prior, Tomas; Kumar, Sailesh

2014-10-01

Current intra-partum monitoring techniques are often criticized for their poor specificity, with their performance frequently evaluated using measures of the neonatal condition at birth as a surrogate marker for intra-partum fetal compromise. However, these measures may potentially be influenced by a multitude of other factors, including the mode of delivery itself. This study aimed to investigate the impact of mode of delivery on neonatal condition at birth. This prospective observational study, undertaken at a tertiary referral maternity unit in London, UK, included 604 'low risk' women recruited prior to delivery. Commonly assessed neonatal outcome variables (Apgar score at 1 and 5min, umbilical artery pH and base excess, neonatal unit admission, and a composite neonatal outcome score) were used to compare the condition at birth between babies born by different modes of delivery, using one-way ANOVA and chi-squared testing. Infants born by instrumental delivery for presumed fetal compromise had the poorest condition at birth (mean composite score=1.20), whereas those born by Cesarean section for presumed fetal compromise had a better condition at birth (mean composite score=0.64) (p=<0.001). No difference in composite neonatal outcome scores was observed between babies born by instrumental delivery for a prolonged second stage (no evidence of compromise), and those born by Cesarean delivery for presumed fetal compromise. Mode of delivery represents a potential confounding factor when using condition at birth as a surrogate marker of intra-partum fetal compromise. When evaluating the efficacy of intra-partum monitoring techniques, the isolated use of Apgar scores, umbilical artery acidosis and neonatal unit admission should be discouraged. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Simulation Evaluation of Controller-Managed Spacing Tools under Realistic Operational Conditions

NASA Technical Reports Server (NTRS)

Callantine, Todd J.; Hunt, Sarah M.; Prevot, Thomas

2014-01-01

Controller-Managed Spacing (CMS) tools have been developed to aid air traffic controllers in managing high volumes of arriving aircraft according to a schedule while enabling them to fly efficient descent profiles. The CMS tools are undergoing refinement in preparation for field demonstration as part of NASA's Air Traffic Management (ATM) Technology Demonstration-1 (ATD-1). System-level ATD-1 simulations have been conducted to quantify expected efficiency and capacity gains under realistic operational conditions. This paper presents simulation results with a focus on CMS-tool human factors. The results suggest experienced controllers new to the tools find them acceptable and can use them effectively in ATD-1 operations.

Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation protocol

PubMed Central

Vareilles, Gaëlle; Pommier, Jeanine; Kane, Sumit; Pictet, Gabriel; Marchal, Bruno

2015-01-01

Introduction The recruitment of community health volunteers to support the delivery of health programmes is a well-established approach in many countries, particularly where health services are not readily available. However, studies on management of volunteers are scarce and current research on human resource management of volunteers faces methodological challenges. This paper presents the protocol of a realist evaluation that aims at identifying the factors influencing the performance of community health volunteers involved in the delivery of a Red Cross immunisation programme in Kampala (Uganda) with a specific focus on motivation. Methods and analysis The realist evaluation cycle structures the protocol. To develop the theoretical basis for the evaluation, the authors conducted interviews and reviewed the literature on community health volunteers’ performance, management and organisational behaviour. This led to the formulation of the initial programme theory, which links the intervention inputs (capacity-building strategies) to the expected outcomes (positive work behaviour) with mechanisms that point in the direction of drivers of motivation. The contextual elements include components such as organisational culture, resource availability, etc. A case study design will be adopted. We define a case as a Red Cross branch, run by a programme manager, and will select two cases at the district level in Kampala. Mixed methods will be used in data collection, including individual interviews of volunteers, participant observation and document review. The thematic analysis will be based on the initial programme theory and will seek for context-mechanism-outcome configurations. Findings from the two cases will be compared. Discussion We discuss the scope for applying realist evaluation and the methodological challenges we encountered in developing this protocol. Ethics and dissemination The study was approved by the Ethical Committee at Rennes University Hospital

Realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals.

PubMed

Mogre, Victor; Scherpbier, Albert J J A; Stevens, Fred; Aryee, Paul; Cherry, Mary Gemma; Dornan, Tim

2016-10-21

To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients' health by helping health students

Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation

PubMed Central

Vareilles, Gaëlle; Marchal, Bruno; Kane, Sumit; Petrič, Taja; Pictet, Gabriel; Pommier, Jeanine

2015-01-01

Objectives This paper presents the results of a realist evaluation that aimed to understand how, why and under what circumstances a Red Cross (RC) capacity-building intervention influences the motivation and the performance of RC community health volunteers involved in the delivery of an immunisation programme in Kampala, Uganda. Method Given the complexity of the intervention, we adopted realist evaluation as our methodological approach and the case study as our study design. Data collection included document review, participant observation and interviews. The constant comparative method was used for the analysis. Two contrasted cases were selected within the five Kampala districts. Each case covers the management of the immunisation programme implemented at a RC branch. In each case, a programme manager and 15 RC volunteers were interviewed. The selection of the volunteers was purposive. Results We found that a capacity-building programme including supervision supportive of autonomy, skills and knowledge enhancement, and adapted to the different subgroups of volunteers, leads to satisfaction of the three key drivers of volunteer motivation: feelings of autonomy, competence and connectedness. This contributes to higher retention, and better task performance and well-being among the volunteers. Enabling contextual conditions include the responsiveness of the Uganda Red Cross Society (URCS) to community needs, and recognition of the work of the volunteers, from the URCS and the community. Conclusions A management approach that caters for the different motivational states and changing needs of the volunteers will lead to better performance. The findings will inform not only the management of community health volunteers, but also the management of all kinds of health workers. PMID:26525721

Dynamic Response of an Energy Harvesting Device Under Realistic Flow Conditions

NASA Astrophysics Data System (ADS)

O'Connor, Joseph; Revell, Alistair

2017-11-01

The need for reliable, cost-efficient, green energy alternatives has led to increased research in the area of energy harvesting. One approach to energy harvesting is to take advantage of self-sustaining flow-induced vibrations. Through the use of a piezoelectric flag, the mechanical strain from the flapping motion can be converted into electrical energy. While such devices show a lot of promise, the fluid-structure-electrical interactions are highly nonlinear and their response to off-design variations in flow conditions, such as those likely to be encountered upon deployment, is relatively unexplored. The purpose of the present work is to examine how a representative energy harvesting device performs in realistic atmospheric flow conditions involving wind gusts with spatial and temporal variations. A recently developed lattice-Boltzmann-immersed boundary-finite element model is used to perform fully-coupled 3D simulations of the fluid-structure system. For a range of unsteady flow conditions the resulting flow features and structural motion are examined and key behaviour modes are mapped out. The findings of this work will be particularly relevant for self-powered remote sensing networks, which often require deployment in unpredictable and varied environments.

Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation protocol.

PubMed

Vareilles, Gaëlle; Pommier, Jeanine; Kane, Sumit; Pictet, Gabriel; Marchal, Bruno

2015-01-28

The recruitment of community health volunteers to support the delivery of health programmes is a well-established approach in many countries, particularly where health services are not readily available. However, studies on management of volunteers are scarce and current research on human resource management of volunteers faces methodological challenges. This paper presents the protocol of a realist evaluation that aims at identifying the factors influencing the performance of community health volunteers involved in the delivery of a Red Cross immunisation programme in Kampala (Uganda) with a specific focus on motivation. The realist evaluation cycle structures the protocol. To develop the theoretical basis for the evaluation, the authors conducted interviews and reviewed the literature on community health volunteers' performance, management and organisational behaviour. This led to the formulation of the initial programme theory, which links the intervention inputs (capacity-building strategies) to the expected outcomes (positive work behaviour) with mechanisms that point in the direction of drivers of motivation. The contextual elements include components such as organisational culture, resource availability, etc. A case study design will be adopted. We define a case as a Red Cross branch, run by a programme manager, and will select two cases at the district level in Kampala. Mixed methods will be used in data collection, including individual interviews of volunteers, participant observation and document review. The thematic analysis will be based on the initial programme theory and will seek for context-mechanism-outcome configurations. Findings from the two cases will be compared. We discuss the scope for applying realist evaluation and the methodological challenges we encountered in developing this protocol. The study was approved by the Ethical Committee at Rennes University Hospital, France. Results will be published in scientific journals, and communicated

Deriving realistic source boundary conditions for a CFD simulation of concentrations in workroom air.

PubMed

Feigley, Charles E; Do, Thanh H; Khan, Jamil; Lee, Emily; Schnaufer, Nicholas D; Salzberg, Deborah C

2011-05-01

Computational fluid dynamics (CFD) is used increasingly to simulate the distribution of airborne contaminants in enclosed spaces for exposure assessment and control, but the importance of realistic boundary conditions is often not fully appreciated. In a workroom for manufacturing capacitors, full-shift samples for isoamyl acetate (IAA) were collected for 3 days at 16 locations, and velocities were measured at supply grills and at various points near the source. Then, velocity and concentration fields were simulated by 3-dimensional steady-state CFD using 295K tetrahedral cells, the k-ε turbulence model, standard wall function, and convergence criteria of 10(-6) for all scalars. Here, we demonstrate the need to represent boundary conditions accurately, especially emission characteristics at the contaminant source, and to obtain good agreement between observations and CFD results. Emission rates for each day were determined from six concentrations measured in the near field and one upwind using an IAA mass balance. The emission was initially represented as undiluted IAA vapor, but the concentrations estimated using CFD differed greatly from the measured concentrations. A second set of simulations was performed using the same IAA emission rates but a more realistic representation of the source. This yielded good agreement with measured values. Paying particular attention to the region with highest worker exposure potential-within 1.3 m of the source center-the air speed and IAA concentrations estimated by CFD were not significantly different from the measured values (P = 0.92 and P = 0.67, respectively). Thus, careful consideration of source boundary conditions greatly improved agreement with the measured values.

Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation.

PubMed

Vareilles, Gaëlle; Marchal, Bruno; Kane, Sumit; Petrič, Taja; Pictet, Gabriel; Pommier, Jeanine

2015-11-02

This paper presents the results of a realist evaluation that aimed to understand how, why and under what circumstances a Red Cross (RC) capacity-building intervention influences the motivation and the performance of RC community health volunteers involved in the delivery of an immunisation programme in Kampala, Uganda. Given the complexity of the intervention, we adopted realist evaluation as our methodological approach and the case study as our study design. Data collection included document review, participant observation and interviews. The constant comparative method was used for the analysis. Two contrasted cases were selected within the five Kampala districts. Each case covers the management of the immunisation programme implemented at a RC branch. In each case, a programme manager and 15 RC volunteers were interviewed. The selection of the volunteers was purposive. We found that a capacity-building programme including supervision supportive of autonomy, skills and knowledge enhancement, and adapted to the different subgroups of volunteers, leads to satisfaction of the three key drivers of volunteer motivation: feelings of autonomy, competence and connectedness. This contributes to higher retention, and better task performance and well-being among the volunteers. Enabling contextual conditions include the responsiveness of the Uganda Red Cross Society (URCS) to community needs, and recognition of the work of the volunteers, from the URCS and the community. A management approach that caters for the different motivational states and changing needs of the volunteers will lead to better performance. The findings will inform not only the management of community health volunteers, but also the management of all kinds of health workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Multimodal person authentication on a smartphone under realistic conditions

NASA Astrophysics Data System (ADS)

Morris, Andrew C.; Jassim, Sabah; Sellahewa, Harin; Allano, Lorene; Ehlers, Johan; Wu, Dalei; Koreman, Jacques; Garcia-Salicetti, Sonia; Ly-Van, Bao; Dorizzi, Bernadette

2006-05-01

Verification of a person's identity by the combination of more than one biometric trait strongly increases the robustness of person authentication in real applications. This is particularly the case in applications involving signals of degraded quality, as for person authentication on mobile platforms. The context of mobility generates degradations of input signals due to the variety of environments encountered (ambient noise, lighting variations, etc.), while the sensors' lower quality further contributes to decrease in system performance. Our aim in this work is to combine traits from the three biometric modalities of speech, face and handwritten signature in a concrete application, performing non intrusive biometric verification on a personal mobile device (smartphone/PDA). Most available biometric databases have been acquired in more or less controlled environments, which makes it difficult to predict performance in a real application. Our experiments are performed on a database acquired on a PDA as part of the SecurePhone project (IST-2002-506883 project "Secure Contracts Signed by Mobile Phone"). This database contains 60 virtual subjects balanced in gender and age. Virtual subjects are obtained by coupling audio-visual signals from real English speaking subjects with signatures from other subjects captured on the touch screen of the PDA. Video data for the PDA database was recorded in 2 recording sessions separated by at least one week. Each session comprises 4 acquisition conditions: 2 indoor and 2 outdoor recordings (with in each case, a good and a degraded quality recording). Handwritten signatures were captured in one session in realistic conditions. Different scenarios of matching between training and test conditions are tested to measure the resistance of various fusion systems to different types of variability and different amounts of enrolment data.

Protocol for a realist review of workplace learning in postgraduate medical education and training.

PubMed

Wiese, Anel; Kilty, Caroline; Bergin, Colm; Flood, Patrick; Fu, Na; Horgan, Mary; Higgins, Agnes; Maher, Bridget; O'Kane, Grainne; Prihodova, Lucia; Slattery, Dubhfeasa; Bennett, Deirdre

2017-01-19

Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities. Those tasked with the design and delivery of postgraduate medical education and training need to understand the relationship between the processes of medical workplace learning and these contextual elements in order to optimise conditions for learning. We propose to conduct a realist synthesis of the literature to address the overarching questions; how, why and in what circumstances do doctors learn in clinical environments? This review is part of a funded projected with the overall aim of producing guidelines and recommendations for the design of high quality clinical learning environments for postgraduate medical education and training. We have chosen realist synthesis as a methodology because of its suitability for researching complexity and producing answers useful to policymakers and practitioners. This realist synthesis will follow the steps and procedures outlined by Wong et al. in the RAMESES Publication Standards for Realist Synthesis and the Realist Synthesis RAMESES Training Materials. The core research team is a multi-disciplinary group of researchers, clinicians and health professions educators. The wider research group includes experts in organisational behaviour and human resources management as well as the key stakeholders; doctors in training, patient representatives and providers of PGMET. This study will draw from the published literature and programme, and substantive, theories of workplace learning, to describe context, mechanism and outcome configurations for

The Formation of Teacher Work Teams under Adverse Conditions: Towards a More Realistic Scenario for Schools in Distress

ERIC Educational Resources Information Center

Mintrop, Rick; Charles, Jessica

2017-01-01

Group formation studies are rare in the literature on teacher professional learning communities (PLCs). But they are needed to render realistic scenarios and design interventions for practitioners who work in schools where teachers encounter distress and social adversity. Under these conditions, we may need approaches to PLC development that are…

System-state and operating condition sensitive control method and apparatus for electric power delivery systems

NASA Technical Reports Server (NTRS)

Burns, III, William Wesley (Inventor); Wilson, Thomas George (Inventor)

1978-01-01

This invention provides a method and apparatus for determining a precise switching sequence for the power switching elements of electric power delivery systems of the on-off switching type and which enables extremely fast transient response, precise regulation and highly stable operation. The control utilizes the values of the power delivery system power handling network components, a desired output characteristic, a system timing parameter, and the externally imposed operating conditions to determine where steady state operations should be in order to yield desired output characteristics for the given system specifications. The actual state of the power delivery system is continuously monitored and compared to a state-space boundary which is derived from the desired equilibrium condition, and from the information obtained from this comparison, the system is moved to the desired equilibrium condition in one cycle of switching control. Since the controller continuously monitors the power delivery system's externally imposed operating conditions, a change in the conditions is immediately sensed and a new equilibrium condition is determined and achieved, again in a single cycle of switching control.

Demonstrating a Realistic IP Mission Prototype

NASA Technical Reports Server (NTRS)

Rash, James; Ferrer, Arturo B.; Goodman, Nancy; Ghazi-Tehrani, Samira; Polk, Joe; Johnson, Lorin; Menke, Greg; Miller, Bill; Criscuolo, Ed; Hogie, Keith

2003-01-01

Flight software and hardware and realistic space communications environments were elements of recent demonstrations of the Internet Protocol (IP) mission concept in the lab. The Operating Missions as Nodes on the Internet (OMNI) Project and the Flight Software Branch at NASA/GSFC collaborated to build the prototype of a representative space mission that employed unmodified off-the-shelf Internet protocols and technologies for end-to-end communications between the spacecraft/instruments and the ground system/users. The realistic elements used in the prototype included an RF communications link simulator and components of the TRIANA mission flight software and ground support system. A web-enabled camera connected to the spacecraft computer via an Ethernet LAN represented an on-board instrument creating image data. In addition to the protocols at the link layer (HDLC), transport layer (UDP, TCP), and network (IP) layer, a reliable file delivery protocol (MDP) at the application layer enabled reliable data delivery both to and from the spacecraft. The standard Network Time Protocol (NTP) performed on-board clock synchronization with a ground time standard. The demonstrations of the prototype mission illustrated some of the advantages of using Internet standards and technologies for space missions, but also helped identify issues that must be addressed. These issues include applicability to embedded real-time systems on flight-qualified hardware, range of applicability of TCP, and liability for and maintenance of commercial off-the-shelf (COTS) products. The NASA Earth Science Technology Office (ESTO) funded the collaboration to build and demonstrate the prototype IP mission.

Is realistic neuronal modeling realistic?

PubMed Central

Almog, Mara

2016-01-01

Scientific models are abstractions that aim to explain natural phenomena. A successful model shows how a complex phenomenon arises from relatively simple principles while preserving major physical or biological rules and predicting novel experiments. A model should not be a facsimile of reality; it is an aid for understanding it. Contrary to this basic premise, with the 21st century has come a surge in computational efforts to model biological processes in great detail. Here we discuss the oxymoronic, realistic modeling of single neurons. This rapidly advancing field is driven by the discovery that some neurons don't merely sum their inputs and fire if the sum exceeds some threshold. Thus researchers have asked what are the computational abilities of single neurons and attempted to give answers using realistic models. We briefly review the state of the art of compartmental modeling highlighting recent progress and intrinsic flaws. We then attempt to address two fundamental questions. Practically, can we realistically model single neurons? Philosophically, should we realistically model single neurons? We use layer 5 neocortical pyramidal neurons as a test case to examine these issues. We subject three publically available models of layer 5 pyramidal neurons to three simple computational challenges. Based on their performance and a partial survey of published models, we conclude that current compartmental models are ad hoc, unrealistic models functioning poorly once they are stretched beyond the specific problems for which they were designed. We then attempt to plot possible paths for generating realistic single neuron models. PMID:27535372

Low cost digester monitoring under realistic conditions: Rural use of biogas and digestate quality.

PubMed

Castro, L; Escalante, H; Jaimes-Estévez, J; Díaz, L J; Vecino, K; Rojas, G; Mantilla, L

2017-09-01

The purpose of this work was to assess the behaviour of anaerobic digestion of cattle manure in a rural digester under realistic conditions, and estimate the quality and properties of the digestate. The data obtained during monitoring indicated that the digester operation was stable without risk of inhibition. It produced an average of 0.85Nm 3 biogas/d at 65.6% methane, providing an energy savings of 76%. In addition, the digestate contained high nutrient concentrations, which is an important feature of fertilizers. However, this method requires post-treatment due to the presence of pathogens. Copyright © 2017 Elsevier Ltd. All rights reserved.

Synthetic Tumor Networks for Screening Drug Delivery Systems

PubMed Central

Prabhakarpandian, Balabhaskar; Shen, Ming-Che; Nichols, Joseph B.; Garson, Charles J.; Mills, Ivy R.; Matar, Majed M.; Fewell, Jason G.; Pant, Kapil

2015-01-01

Tumor drug delivery is a complex phenomenon affected by several elements in addition to drug or delivery vehicle’s physico-chemical properties. A key factor is tumor microvasculature with complex effects including convective transport, high interstitial pressure and enhanced vascular permeability due to the presence of “leaky vessels”. Current in vitro models of the tumor microenvironment for evaluating drug delivery are oversimplified and, as a result, show poor correlation with in vivo performance. In this study, we report on the development of a novel microfluidic platform that models the tumor microenvironment more accurately, with physiologically and morphologically realistic microvasculature including endothelial cell lined leaky capillary vessels along with 3D solid tumors. Endothelial cells and 3D spheroids of cervical tumor cells were co-cultured in the networks. Drug vehicle screening was demonstrated using GFP gene delivery by different formulations of nanopolymers. The synthetic tumor network was successful in predicting in vivo delivery efficiencies of the drug vehicles. The developed assay will have critical applications both in basic research, where it can be used to develop next generation delivery vehicles, and in drug discovery where it can be used to study drug transport and delivery efficacy in realistic tumor microenvironment, thereby enabling drug compound and/or delivery vehicle screening. PMID:25599856

The analytical solution for drug delivery system with nonhomogeneous moving boundary condition

NASA Astrophysics Data System (ADS)

Saudi, Muhamad Hakimi; Mahali, Shalela Mohd; Harun, Fatimah Noor

2017-08-01

This paper discusses the development and the analytical solution of a mathematical model based on drug release system from a swelling delivery device. The mathematical model is represented by a one-dimensional advection-diffusion equation with nonhomogeneous moving boundary condition. The solution procedures consist of three major steps. Firstly, the application of steady state solution method, which is used to transform the nonhomogeneous moving boundary condition to homogeneous boundary condition. Secondly, the application of the Landau transformation technique that gives a significant impact in removing the advection term in the system of equation and transforming the moving boundary condition to a fixed boundary condition. Thirdly, the used of separation of variables method to find the analytical solution for the resulted initial boundary value problem. The results show that the swelling rate of delivery device and drug release rate is influenced by value of growth factor r.

Optical filter highlighting spectral features part II: quantitative measurements of cosmetic foundation and assessment of their spatial distributions under realistic facial conditions.

PubMed

Nishino, Ken; Nakamura, Mutsuko; Matsumoto, Masayuki; Tanno, Osamu; Nakauchi, Shigeki

2011-03-28

We previously proposed a filter that could detect cosmetic foundations with high discrimination accuracy [Opt. Express 19, 6020 (2011)]. This study extends the filter's functionality to the quantification of the amount of foundation and applies the filter for the assessment of spatial distributions of foundation under realistic facial conditions. Human faces that are applied with quantitatively controlled amounts of cosmetic foundations were measured using the filter. A calibration curve between pixel values of the image and the amount of foundation was created. The optical filter was applied to visualize spatial foundation distributions under realistic facial conditions, which clearly indicated areas on the face where foundation remained even after cleansing. Results confirm that the proposed filter could visualize and nondestructively inspect the foundation distributions.

More Realistic Face Model Surface Improves Relevance of Pediatric In-Vitro Aerosol Studies.

PubMed

Amirav, Israel; Halamish, Asaf; Gorenberg, Miguel; Omar, Hamza; Newhouse, Michael T

2015-01-01

Various hard face models are commonly used to evaluate the efficiency of aerosol face masks. Softer more realistic "face" surface materials, like skin, deform upon mask application and should provide more relevant in-vitro tests. Studies that simultaneously take into consideration many of the factors characteristic of the in vivo face are lacking. These include airways, various application forces, comparison of various devices, comparison with a hard-surface model and use of a more representative model face based on large numbers of actual faces. To compare mask to "face" seal and aerosol delivery of two pediatric masks using a soft vs. a hard, appropriately representative, pediatric face model under various applied forces. Two identical face models and upper airways replicas were constructed, the only difference being the suppleness and compressibility of the surface layer of the "face." Integrity of the seal and aerosol delivery of two different masks [AeroChamber (AC) and SootherMask (SM)] were compared using a breath simulator, filter collection and realistic applied forces. The soft "face" significantly increased the delivery efficiency and the sealing characteristics of both masks. Aerosol delivery with the soft "face" was significantly greater for the SM compared to the AC (p< 0.01). No statistically significant difference between the two masks was observed with the hard "face." The material and pliability of the model "face" surface has a significant influence on both the seal and delivery efficiency of face masks. This finding should be taken into account during in-vitro aerosol studies.

Maternal, fetal, and placental conditions associated with medically indicated late preterm and early term delivery: a retrospective study.

PubMed

Brown, H K; Speechley, K N; Macnab, J; Natale, R; Campbell, M K

2016-04-01

Our objectives were: (1) to examine the association between maternal, fetal, and placental phenotypes of preterm delivery and medically indicated early delivery of singletons during the late preterm and early term periods; and (2) to identify the specific maternal, fetal, and placental conditions associated with these early deliveries. Retrospective study. City of London and Middlesex County, Ontario, Canada. Singleton live deliveries, at 34-41 weeks of gestation to women in London and Middlesex. We obtained data from a city-wide perinatal database (2002-2011; n = 25 699). We used multinomial logistic regression for multivariable analyses. The outcome was the occurrence of medically indicated late preterm (34-36 weeks of gestation) and early term (37-38 weeks of gestation) delivery, versus delivery at full term (39-41 weeks of gestation). After controlling for confounding factors, all phenotypes were associated with increased odds of medically indicated late preterm and early term delivery. Within the maternal phenotype, chronic maternal medical conditions were associated with increased odds of medically indicated early term delivery (e.g. for gastrointestinal disease, adjusted odds ratio, aOR 1.72, 95% CI 1.47-2.00; for anaemia, aOR 1.40, 95% CI 1.20-1.63), but not late preterm delivery. The aetiology of medically indicated early delivery close to full term is heterogeneous. Patterns of associations suggest slightly different conditions underlying the late preterm and early term phenotypes, with chronic maternal medical conditions being associated with early term delivery but not with late preterm delivery. These results have implications for the prevention of early delivery as well as the identification of high-risk groups among those born early. The aetiology of medically indicated late preterm and early term delivery is heterogeneous. © 2015 Royal College of Obstetricians and Gynaecologists.

More Realistic Face Model Surface Improves Relevance of Pediatric In-Vitro Aerosol Studies

PubMed Central

Amirav, Israel; Halamish, Asaf; Gorenberg, Miguel; Omar, Hamza; Newhouse, Michael T.

2015-01-01

Background Various hard face models are commonly used to evaluate the efficiency of aerosol face masks. Softer more realistic “face” surface materials, like skin, deform upon mask application and should provide more relevant in-vitro tests. Studies that simultaneously take into consideration many of the factors characteristic of the in vivo face are lacking. These include airways, various application forces, comparison of various devices, comparison with a hard-surface model and use of a more representative model face based on large numbers of actual faces. Aim To compare mask to “face” seal and aerosol delivery of two pediatric masks using a soft vs. a hard, appropriately representative, pediatric face model under various applied forces. Methods Two identical face models and upper airways replicas were constructed, the only difference being the suppleness and compressibility of the surface layer of the “face.” Integrity of the seal and aerosol delivery of two different masks [AeroChamber (AC) and SootherMask (SM)] were compared using a breath simulator, filter collection and realistic applied forces. Results The soft “face” significantly increased the delivery efficiency and the sealing characteristics of both masks. Aerosol delivery with the soft “face” was significantly greater for the SM compared to the AC (p< 0.01). No statistically significant difference between the two masks was observed with the hard “face.” Conclusions The material and pliability of the model “face” surface has a significant influence on both the seal and delivery efficiency of face masks. This finding should be taken into account during in-vitro aerosol studies. PMID:26090661

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations.

PubMed

Nyssen, Olga P; Taylor, Stephanie J C; Wong, Geoff; Steed, Elizabeth; Bourke, Liam; Lord, Joanne; Ross, Carol A; Hayman, Sheila; Field, Victoria; Higgins, Ailish; Greenhalgh, Trisha; Meads, Catherine

2016-04-01

Writing therapy to improve physical or mental health can take many forms. The most researched model of therapeutic writing (TW) is unfacilitated, individual expressive writing (written emotional disclosure). Facilitated writing activities are less widely researched. Databases, including MEDLINE, EMBASE, PsycINFO, Linguistics and Language Behaviour Abstracts, Allied and Complementary Medicine Database and Cumulative Index to Nursing and Allied Health Literature, were searched from inception to March 2013 (updated January 2015). Four TW practitioners provided expert advice. Study procedures were conducted by one reviewer and checked by a second. Randomised controlled trials (RCTs) and non-randomised comparative studies were included. Quality was appraised using the Cochrane risk-of-bias tool. Unfacilitated and facilitated TW studies were analysed separately under International Classification of Diseases, Tenth Revision chapter headings. Meta-analyses were performed where possible using RevMan version 5.2.6 (RevMan 2012, The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark). Costs were estimated from a UK NHS perspective and three cost-consequence case studies were prepared. Realist synthesis followed Realist and Meta-narrative Evidence Synthesis: Evolving Standards guidelines. To review the clinical effectiveness and cost-effectiveness of TW for people with long-term conditions (LTCs) compared with no writing, or other controls, reporting any relevant clinical outcomes. To conduct a realist synthesis to understand how TW might work, and for whom. From 14,658 unique citations, 284 full-text papers were reviewed and 64 studies (59 RCTs) were included in the final effectiveness reviews. Five studies examined facilitated TW; these were extremely heterogeneous with unclear or high risk of bias but suggested that facilitated TW interventions may be beneficial in individual LTCs. Unfacilitated expressive writing was examined in 59 studies of variable

Realist complex intervention science: Applying realist principles across all phases of the Medical Research Council framework for developing and evaluating complex interventions

PubMed Central

Fletcher, Adam; Jamal, Farah; Moore, Graham; Evans, Rhiannon E.; Murphy, Simon; Bonell, Chris

2016-01-01

The integration of realist evaluation principles within randomised controlled trials (‘realist RCTs’) enables evaluations of complex interventions to answer questions about what works, for whom and under what circumstances. This allows evaluators to better develop and refine mid-level programme theories. However, this is only one phase in the process of developing and evaluating complex interventions. We describe and exemplify how social scientists can integrate realist principles across all phases of the Medical Research Council framework. Intervention development, modelling, and feasibility and pilot studies need to theorise the contextual conditions necessary for intervention mechanisms to be activated. Where interventions are scaled up and translated into routine practice, realist principles also have much to offer in facilitating knowledge about longer-term sustainability, benefits and harms. Integrating a realist approach across all phases of complex intervention science is vital for considering the feasibility and likely effects of interventions for different localities and population subgroups. PMID:27478401

Quantum-continuum simulation of the electrochemical response of pseudocapacitor electrodes under realistic conditions

NASA Astrophysics Data System (ADS)

Keilbart, Nathan; Okada, Yasuaki; Feehan, Aion; Higai, Shin'ichi; Dabo, Ismaila

2017-03-01

Pseudocapacitors are energy-storage devices characterized by fast and reversible redox reactions that enable them to store large amounts of electrical energy at high rates. We simulate the response of pseudocapacitive electrodes under realistic conditions to identify the microscopic factors that determine their performance, focusing on ruthenia (RuO2) as a prototypical electrode material. Electronic-structure methods are used together with a self-consistent continuum solvation (SCCS) model to build a complete data set of free energies as the surface of the charged electrode is gradually covered with protons under applied voltage. The resulting data set is exploited to compute hydrogen-adsorption isotherms and charge-voltage responses by means of grand-canonical sampling, finding close agreement with experimental voltammetry. These simulations reveal that small changes on the order of 5 μ F /cm2 in the intrinsic double-layer capacitance of the electrode-electrolyte interface can induce variations of up to 40 μ F /cm2 in the overall pseudocapacitance.

50 CFR Table 3a to Part 680 - Crab Delivery Condition Codes

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Crab Delivery Condition Codes 3a Table 3a to Part 680 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) SHELLFISH FISHERIES OF THE EXCLUSIVE ECONOMIC...

43 CFR 418.28 - Conditions of delivery.

Code of Federal Regulations, 2011 CFR

2011-10-01

... deliveries. If water is delivered to ineligible land or in excess of the appropriate water duty then: (1) The... year to determine the amount of water required to enable the delivery of full entitlements at... will take prompt action to avoid such violations. The Bureau will exercise reasonable latitude from...

43 CFR 418.28 - Conditions of delivery.

Code of Federal Regulations, 2013 CFR

2013-10-01

... deliveries. If water is delivered to ineligible land or in excess of the appropriate water duty then: (1) The... year to determine the amount of water required to enable the delivery of full entitlements at... will take prompt action to avoid such violations. The Bureau will exercise reasonable latitude from...

43 CFR 418.28 - Conditions of delivery.

Code of Federal Regulations, 2012 CFR

2012-10-01

... deliveries. If water is delivered to ineligible land or in excess of the appropriate water duty then: (1) The... year to determine the amount of water required to enable the delivery of full entitlements at... will take prompt action to avoid such violations. The Bureau will exercise reasonable latitude from...

Assessment of Solder Joint Fatigue Life Under Realistic Service Conditions

NASA Astrophysics Data System (ADS)

Hamasha, Sa'd.; Jaradat, Younis; Qasaimeh, Awni; Obaidat, Mazin; Borgesen, Peter

2014-12-01

The behavior of lead-free solder alloys under complex loading scenarios is still not well understood. Common damage accumulation rules fail to account for strong effects of variations in cycling amplitude, and random vibration test results cannot be interpreted in terms of performance under realistic service conditions. This is a result of the effects of cycling parameters on materials properties. These effects are not yet fully understood or quantitatively predictable, preventing modeling based on parameters such as strain, work, or entropy. Depending on the actual spectrum of amplitudes, Miner's rule of linear damage accumulation has been shown to overestimate life by more than an order of magnitude, and greater errors are predicted for other combinations. Consequences may be particularly critical for so-called environmental stress screening. Damage accumulation has, however, been shown to scale with the inelastic work done, even if amplitudes vary. This and the observation of effects of loading history on subsequent work per cycle provide for a modified damage accumulation rule which allows for the prediction of life. Individual joints of four different Sn-Ag-Cu-based solder alloys (SAC305, SAC105, SAC-Ni, and SACXplus) were cycled in shear at room temperature, alternating between two different amplitudes while monitoring the evolution of the effective stiffness and work per cycle. This helped elucidate general trends and behaviors that are expected to occur in vibrations of microelectronics assemblies. Deviations from Miner's rule varied systematically with the combination of amplitudes, the sequences of cycles, and the strain rates in each. The severity of deviations also varied systematically with Ag content in the solder, but major effects were observed for all the alloys. A systematic analysis was conducted to assess whether scenarios might exist in which the more fatigue-resistant high-Ag alloys would fail sooner than the lower-Ag ones.

Balancing health care education and patient care in the UK workplace: a realist synthesis.

PubMed

Sholl, Sarah; Ajjawi, Rola; Allbutt, Helen; Butler, Jane; Jindal-Snape, Divya; Morrison, Jill; Rees, Charlotte

2017-08-01

Patient care activity has recently increased without a proportionate rise in workforce numbers, impacting negatively on health care workplace learning. Health care professionals are prepared in part by spending time in clinical practice, and for medical staff this constitutes a contribution to service. Although stakeholders have identified the balance between health care professional education and patient care as a key priority for medical education research, there have been very few reviews to date on this important topic. We conducted a realist synthesis of the UK literature from 1998 to answer two research questions. (1) What are the key workplace interventions designed to help achieve a balance between health care professional education and patient care delivery? (2) In what ways do interventions enable or inhibit this balance within the health care workplace, for whom and in what contexts? We followed Pawson's five stages of realist review: clarifying scope, searching for evidence, assessment of quality, data extraction and data synthesis. The most common interventions identified for balancing health care professional education and patient care delivery were ward round teaching, protected learning time and continuous professional development. The most common positive outcomes were simultaneous improvements in learning and patient care or improved learning or improved patient care. The most common contexts in which interventions were effective were primary care, postgraduate trainee, nurse and allied health professional contexts. By far the most common mechanisms through which interventions worked were organisational funding, workload management and support. Our novel findings extend existing literature in this emerging area of health care education research. We provide recommendations for the development of educational policy and practice at the individual, interpersonal and organisational levels and call for more research using realist approaches to evaluate

Effects of feed delivery frequency in different environmental conditions on time budget of lactating dairy cows.

PubMed

Mattachini, Gabriele; Bava, Luciana; Sandrucci, Anna; Tamburini, Alberto; Riva, Elisabetta; Provolo, Giorgio

2017-08-01

This study aimed to examine the influence of feed delivery frequency and environmental conditions on daily time budget of lactating dairy cows. The study was carried out in two commercial dairy farms with Holstein herds. Fifty lactating dairy cows milked in automatic milking units (AMS farm) and 96 primiparous lactating dairy cows milked in a conventional milking parlour (conventional farm) were exposed to different frequencies of feed delivery replicated in different periods of the year (warm and mild) that were characterized by different temperature-humidity indices (THI). On each farm, feeding treatments consisted of two different feed delivery frequencies (1× and 2× on the AMS farm; 2× and 3× on the conventional farm). All behaviours of the cows were monitored for the last 8 d of each treatment period using continuous video recording. The two data sets from different farm systems were considered separately for analysis. On both farms, environmental conditions expressed as THI affected time budgets and the pattern of the behavioural indices throughout the day. The variation in the frequency of feed delivery seems to affect the cow's time budget only in a limited way. Standing time of cows on the conventional farm and the time spent by cows in the milking waiting area on the AMS farm both increased in response to increased feeding frequency. Although feed delivery frequency showed limited influence on cow's time budget, the effect on standing time could be carefully considered, especially on farms equipped with AMS where the type of cow traffic system (e.g., milking first) might amplify the negative consequences of more frequent feed delivery. Further investigations are required to evaluate the effect of THI and feed delivery frequency on other aspects of behavioural activity.

Novel high-fidelity realistic explosion damage simulation for urban environments

NASA Astrophysics Data System (ADS)

Liu, Xiaoqing; Yadegar, Jacob; Zhu, Youding; Raju, Chaitanya; Bhagavathula, Jaya

2010-04-01

Realistic building damage simulation has a significant impact in modern modeling and simulation systems especially in diverse panoply of military and civil applications where these simulation systems are widely used for personnel training, critical mission planning, disaster management, etc. Realistic building damage simulation should incorporate accurate physics-based explosion models, rubble generation, rubble flyout, and interactions between flying rubble and their surrounding entities. However, none of the existing building damage simulation systems sufficiently faithfully realize the criteria of realism required for effective military applications. In this paper, we present a novel physics-based high-fidelity and runtime efficient explosion simulation system to realistically simulate destruction to buildings. In the proposed system, a family of novel blast models is applied to accurately and realistically simulate explosions based on static and/or dynamic detonation conditions. The system also takes account of rubble pile formation and applies a generic and scalable multi-component based object representation to describe scene entities and highly scalable agent-subsumption architecture and scheduler to schedule clusters of sequential and parallel events. The proposed system utilizes a highly efficient and scalable tetrahedral decomposition approach to realistically simulate rubble formation. Experimental results demonstrate that the proposed system has the capability to realistically simulate rubble generation, rubble flyout and their primary and secondary impacts on surrounding objects including buildings, constructions, vehicles and pedestrians in clusters of sequential and parallel damage events.

Gastrin levels in mothers and neonates at delivery in various perinatal conditions.

PubMed

Morán, C; Carranza-Lira, S; Ochoa, R; Martínez, J C; Herrera, M; Fonseca, E; Zárate, A

1996-08-01

This study was designed to assess the variations of gastrin (Ga) serum levels in mothers and newborns at birth in some perinatal disorders. Ga levels were measured by RIA in maternal serum, amniotic fluid and cord sera of newborns in 55 cases with the following conditions: normal pregnancy and eutocic vaginal delivery (n = 8), repeat cesarean section (n = 10), and cardiotogographic register suggestive of fetal compromise (n = 15), cephalopelvic disproportion (n = 8), preeclampsia (n = 7) and postdate pregnancy (n = 7). Statistical analysis was performed by Mann-Whitney U test. Ga levels in cord sera of newborn and amniotic fluid in normal pregnancy and eutocic delivery were significantly higher (p < 0.02 and p < 0.01, respectively) than those found in patients with repeat cesarean operation. Serum Ga concentrations in women with postterm pregnancy were significantly higher (p < 0.02) than in women with prior cesarean section. Ga levels in amniotic fluid samples in the presence of suspected fetal compromise and postdate pregnancy were significantly higher (p < 0.001) than those observed in women who had repeat cesarean operation. Vaginal delivery and perinatal pathology may induce hypergastrinemia in both mother and neonate at birth.

Children's Responses to Contrasting 'Realistic' Mathematics Problems: Just How Realistic Are Children Ready To Be?

ERIC Educational Resources Information Center

Cooper, Barry; Harries, Tony

2002-01-01

Analyzes 11-12-year-old English children's responses to two 'realistic' problems. Through a comparison of responses to two items, suggests that, given suitable 'realistic' problems, many children may be more willing and able to introduce realistic responses in a testing context than earlier research might lead one to expect. (Author/MM)

Simulation of realistic retinoscopic measurement

NASA Astrophysics Data System (ADS)

Tan, Bo; Chen, Ying-Ling; Baker, K.; Lewis, J. W.; Swartz, T.; Jiang, Y.; Wang, M.

2007-03-01

Realistic simulation of ophthalmic measurements on normal and diseased eyes is presented. We use clinical data of ametropic and keratoconus patients to construct anatomically accurate three-dimensional eye models and simulate the measurement of a streak retinoscope with all the optical elements. The results show the clinical observations including the anomalous motion in high myopia and the scissors reflex in keratoconus. The demonstrated technique can be applied to other ophthalmic instruments and to other and more extensively abnormal eye conditions. It provides promising features for medical training and for evaluating and developing ocular instruments.

A conformally flat realistic anisotropic model for a compact star

NASA Astrophysics Data System (ADS)

Ivanov, B. V.

2018-04-01

A physically realistic stellar model with a simple expression for the energy density and conformally flat interior is found. The relations between the different conditions are used without graphic proofs. It may represent a real pulsar.

Porous Inorganic Drug Delivery Systems-a Review.

PubMed

Sayed, E; Haj-Ahmad, R; Ruparelia, K; Arshad, M S; Chang, M-W; Ahmad, Z

2017-07-01

Innovative methods and materials have been developed to overcome limitations associated with current drug delivery systems. Significant developments have led to the use of a variety of materials (as excipients) such as inorganic and metallic structures, marking a transition from conventional polymers. Inorganic materials, especially those possessing significant porosity, are emerging as good candidates for the delivery of a range of drugs (antibiotics, anticancer and anti-inflammatories), providing several advantages in formulation and engineering (encapsulation of drug in amorphous form, controlled delivery and improved targeting). This review focuses on key selected developments in porous drug delivery systems. The review provides a short broad overview of porous polymeric materials for drug delivery before focusing on porous inorganic materials (e.g. Santa Barbara Amorphous (SBA) and Mobil Composition of Matter (MCM)) and their utilisation in drug dosage form development. Methods for their preparation and drug loading thereafter are detailed. Several examples of porous inorganic materials, drugs used and outcomes are discussed providing the reader with an understanding of advances in the field and realistic opportunities.

Kinetics of devolatilization and oxidation of a pulverized biomass in an entrained flow reactor under realistic combustion conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jimenez, Santiago; Remacha, Pilar; Ballester, Javier

2008-03-15

In this paper the results of a complete set of devolatilization and combustion experiments performed with pulverized ({proportional_to}500 {mu}m) biomass in an entrained flow reactor under realistic combustion conditions are presented. The data obtained are used to derive the kinetic parameters that best fit the observed behaviors, according to a simple model of particle combustion (one-step devolatilization, apparent oxidation kinetics, thermally thin particles). The model is found to adequately reproduce the experimental trends regarding both volatile release and char oxidation rates for the range of particle sizes and combustion conditions explored. The experimental and numerical procedures, similar to those recentlymore » proposed for the combustion of pulverized coal [J. Ballester, S. Jimenez, Combust. Flame 142 (2005) 210-222], have been designed to derive the parameters required for the analysis of biomass combustion in practical pulverized fuel configurations and allow a reliable characterization of any finely pulverized biomass. Additionally, the results of a limited study on the release rate of nitrogen from the biomass particle along combustion are shown. (author)« less

Realistic full wave modeling of focal plane array pixels

DOE PAGES

Campione, Salvatore; Warne, Larry K.; Jorgenson, Roy E.; ...

2017-11-01

Here, we investigate full-wave simulations of realistic implementations of multifunctional nanoantenna enabled detectors (NEDs). We focus on a 2x2 pixelated array structure that supports two wavelengths of operation. We design each resonating structure independently using full-wave simulations with periodic boundary conditions mimicking the whole infinite array. We then construct a supercell made of a 2x2 pixelated array with periodic boundary conditions mimicking the full NED; in this case, however, each pixel comprises 10-20 antennas per side. In this way, the cross-talk between contiguous pixels is accounted for in our simulations. We observe that, even though there are finite extent effects,more » the pixels work as designed, each responding at the respective wavelength of operation. This allows us to stress that realistic simulations of multifunctional NEDs need to be performed to verify the design functionality by taking into account finite extent and cross-talk effects.« less

A realist evaluation of social prescribing: an exploration into the context and mechanisms underpinning a pathway linking primary care with the voluntary sector.

PubMed

Bertotti, Marcello; Frostick, Caroline; Hutt, Patrick; Sohanpal, Ratna; Carnes, Dawn

2018-05-01

This article adopts a realist approach to evaluate a social prescribing pilot in the areas of Hackney and City in London (United Kingdom). It unpacks the contextual factors and mechanisms that influenced the development of this pilot for the benefits of GPs, commissioners and practitioners, and reflects on the realist approach to evaluation as a tool for the evaluation of health interventions. Primary care faces considerable challenges including the increase in long-term conditions, GP consultation rates, and widening health inequalities. With its emphasis on linking primary care to non-clinical community services via a social prescribing coordinator (SPC), some models of social prescribing could contribute to reduce the burden on primary care, tackle health inequalities and encourage people to make greater use of non-clinical forms of support. This realist analysis was based on qualitative interviews with users, commissioners, a GP survey, focus groups and learning events to explore stakeholders' experience. To enable a detailed analysis, we adapted the realist approach by subdividing the social prescribing pathway into stages, each with contextual factors, mechanisms and outcomes. SPCs were pivotal to the effective functioning of the social prescribing service and responsible for the activation and initial beneficial impact on users. Although social prescribing shows significant potential for the benefit of patients and primary care, several challenges need to be considered and overcome, including 'buy in' from some GPs, branding, and funding for the third sector in a context where social care cuts are severely affecting the delivery of health care. With its emphasis on context and mechanisms, the realist evaluation approach is useful in understanding how to identify and improve health interventions, and analyse in greater detail the contribution of different stakeholders. As the SPC is central to social prescribing, more needs to be done to understand their role

Realists, Radicals, and Rainbows. The Twenty-Eighth Amy Morris Homans Lecture 1994.

ERIC Educational Resources Information Center

Bennett, Roberta S.

1995-01-01

Challenges physical education professionals to be realists who name the conditions around them that divide according to group identity and thus perpetuate injustice; to be radicals who work to change conditions; and to build and follow a rainbow path to a future where social justice, human rights, and the human condition are first priorities. (JB)

Helping With All Your Heart: Realistic Heart Stimulus and Compliance With an Organ Donation Request.

PubMed

Jacob, Céline; Guéguen, Nicolas

2015-01-01

Pictures and images are important aspects in fundraising advertising and could generate more donations. In two experimental studies, we examined the effect of various pictures of hearts on compliance with a request for organ donations. The solicitor wore a white tee shirt where various forms of hearts were printed: symbolic versus realistic (first experiment), none versus symbolic versus realistic (second experiment). Results showed that more compliance was found in the realistic heart experimental condition whereas the symbolic heart form had no significant effect.

Keeping It Real: How Realistic Does Realistic Fiction for Children Need to Be?

ERIC Educational Resources Information Center

O'Connor, Barbara

2010-01-01

O'Connor, an author of realistic fiction for children, shares her attempts to strike a balance between carefree, uncensored, authentic, realistic writing and age-appropriate writing. Of course, complicating that balancing act is the fact that what seems age-appropriate to her might not seem so to everyone. O'Connor suggests that while it may be…

The effectiveness and cost-effectiveness of shared care: protocol for a realist review.

PubMed

Hardwick, Rebecca; Pearson, Mark; Byng, Richard; Anderson, Rob

2013-02-12

Shared care (an enhanced information exchange over and above routine outpatient letters) is commonly used to improve care coordination and communication between a specialist and primary care services for people with long-term conditions. Evidence of the effectiveness and cost-effectiveness of shared care is mixed. Informed decision-making for targeting shared care requires a greater understanding of how it works, for whom it works, in what contexts and why. This protocol outlines how realist review methods can be used to synthesise evidence on shared care for long-term conditions.A further aim of the review is to explore economic evaluations of shared care. Economic evaluations are difficult to synthesise due to problems in accounting for contextual differences that impact on resource use and opportunity costs. Realist review methods have been suggested as a way to overcome some of these issues, so this review will also assess whether realist review methods are amenable to synthesising economic evidence. Database and web searching will be carried out in order to find relevant evidence to develop and test programme theories about how shared care works. The review will have two phases. Phase 1 will concentrate on the contextual conditions and mechanisms that influence how shared care works, in order to develop programme theories, which partially explain how it works. Phase 2 will focus on testing these programme theories. A Project Reference Group made up of health service professionals and people with actual experience of long-term conditions will be used to ground the study in real-life experience. Review findings will be disseminated through local and sub-national networks for integrated care and long-term conditions. This realist review will explore why and for whom shared care works, in order to support decision-makers working to improve the effectiveness of care for people outside hospital. The development of realist review methods to take into account cost and

Connecting drug delivery reality to smart materials design.

PubMed

Grainger, David W

2013-09-15

Inflated claims to both design and mechanistic novelty in drug delivery and imaging systems, including most nanotechnologies, are not supported by the generally poor translation of these systems to clinical efficacy. The "form begets function" design paradigm is seductive but perhaps over-simplistic in translation to pharmaceutical efficacy. Most innovations show few clinically important distinctions in their therapeutic benefits in relevant preclinical disease and delivery models, despite frequent claims to the contrary. Long-standing challenges in drug delivery issues must enlist more realistic, back-to-basics approaches to address fundamental materials properties in complex biological systems, preclinical test beds, and analytical methods to more reliably determine fundamental pharmaceutical figures of merit, including drug carrier purity and batch-batch variability, agent biodistribution, therapeutic index (safety), and efficacy. Copyright © 2013 Elsevier B.V. All rights reserved.

Intradermal delivery of vaccines: potential benefits and current challenges

PubMed Central

Hickling, JK; Jones, KR; Friede, M; Chen, D; Kristensen, D

2011-01-01

Abstract Delivery of vaccine antigens to the dermis and/or epidermis of human skin (i.e. intradermal delivery) might be more efficient than injection into the muscle or subcutaneous tissue, thereby reducing the volumes of antigen. This is known as dose-sparing and has been demonstrated in clinical trials with some, but not all, vaccines. Dose-sparing could be beneficial to immunization programmes by potentially reducing the costs of purchase, distribution and storage of vaccines; increasing vaccine availability and effectiveness. The data obtained with intradermal delivery of some vaccines are encouraging and warrant further study and development; however significant gaps in knowledge and operational challenges such as reformulation, optimizing vaccine presentation and development of novel devices to aid intradermal vaccine delivery need to be addressed. Modelling of the costs and potential savings resulting from intradermal delivery should be done to provide realistic expectations of the potential benefits and to support cases for investment. Implementation and uptake of intradermal vaccine delivery requires further research and development, which depends upon collaboration between multiple stakeholders in the field of vaccination. PMID:21379418

A realistic chemical system presenting a self-organized critical behavior

NASA Astrophysics Data System (ADS)

Gaveau, Bernard; Latrémolière, Daniel; Moreau, Michel

2003-04-01

We consider a realistic example of chemical system which presents self-organized criticality. We can study the kinetic equations analytically, and show that the conditions for self-organized criticality are satisfied. We find power relaxation laws for certain variables near the critical state, confirming the self-organized critical behavior.

Evidence of collaboration, pooling of resources, learning and role blurring in interprofessional healthcare teams: a realist synthesis.

PubMed

Sims, Sarah; Hewitt, Gillian; Harris, Ruth

2015-01-01

Interprofessional teamwork has become an integral feature of healthcare delivery in a wide range of conditions and services in many countries. Many assumptions are made in healthcare literature and policy about how interprofessional teams function and about the outcomes of interprofessional teamwork. Realist synthesis is an approach to reviewing research evidence on complex interventions which seeks to explore these assumptions. It does this by unpacking the mechanisms of an intervention, exploring the contexts which trigger or deactivate them and connecting these contexts and mechanisms to their subsequent outcomes. This is the second in a series of four papers reporting a realist synthesis of interprofessional teamworking. The paper discusses four of the 13 mechanisms identified in the synthesis: collaboration and coordination; pooling of resources; individual learning; and role blurring. These mechanisms together capture the day-to-day functioning of teams and the dependence of that on members' understanding each others' skills and knowledge and learning from them. This synthesis found empirical evidence to support all four mechanisms, which tentatively suggests that collaboration, pooling, learning, and role blurring are all underlying processes of interprofessional teamwork. However, the supporting evidence for individual learning was relatively weak, therefore there may be assumptions made about learning within healthcare literature and policy that are not founded upon strong empirical evidence. There is a need for more robust research on individual learning to further understand its relationship with interprofessional teamworking in healthcare.

Improving stamping simulation accuracy by accounting for realistic friction and lubrication conditions: Application to the door-outer of the Mercedes-Benz C-class Coupé

NASA Astrophysics Data System (ADS)

Hol, J.; Wiebenga, J. H.; Stock, J.; Wied, J.; Wiegand, K.; Carleer, B.

2016-08-01

In the stamping of automotive parts, friction and lubrication play a key role in achieving high quality products. In the development process of new automotive parts, it is therefore crucial to accurately account for these effects in sheet metal forming simulations. Only then, one can obtain reliable and realistic simulation results that correspond to the actual try-out and mass production conditions. In this work, the TriboForm software is used to accurately account for tribology-, friction-, and lubrication conditions in stamping simulations. The enhanced stamping simulations are applied and validated for the door-outer of the Mercedes- Benz C-Class Coupe. The project results demonstrate the improved prediction accuracy of stamping simulations with respect to both part quality and actual stamping process conditions.

Hyper-realistic face masks: a new challenge in person identification.

PubMed

Sanders, Jet Gabrielle; Ueda, Yoshiyuki; Minemoto, Kazusa; Noyes, Eilidh; Yoshikawa, Sakiko; Jenkins, Rob

2017-01-01

We often identify people using face images. This is true in occupational settings such as passport control as well as in everyday social environments. Mapping between images and identities assumes that facial appearance is stable within certain bounds. For example, a person's apparent age, gender and ethnicity change slowly, if at all. It also assumes that deliberate changes beyond these bounds (i.e., disguises) would be easy to spot. Hyper-realistic face masks overturn these assumptions by allowing the wearer to look like an entirely different person. If unnoticed, these masks break the link between facial appearance and personal identity, with clear implications for applied face recognition. However, to date, no one has assessed the realism of these masks, or specified conditions under which they may be accepted as real faces. Herein, we examined incidental detection of unexpected but attended hyper-realistic masks in both photographic and live presentations. Experiment 1 (UK; n = 60) revealed no evidence for overt detection of hyper-realistic masks among real face photos, and little evidence of covert detection. Experiment 2 (Japan; n = 60) extended these findings to different masks, mask-wearers and participant pools. In Experiment 3 (UK and Japan; n = 407), passers-by failed to notice that a live confederate was wearing a hyper-realistic mask and showed limited evidence of covert detection, even at close viewing distance (5 vs. 20 m). Across all of these studies, viewers accepted hyper-realistic masks as real faces. Specific countermeasures will be required if detection rates are to be improved.

20 CFR 662.430 - Under what conditions may One-Stop operators designated to operate in a One-Stop delivery system...

Code of Federal Regulations, 2011 CFR

2011-04-01

... designated to operate in a One-Stop delivery system established prior to the enactment of WIA be designated... DESCRIPTION OF THE ONE-STOP SYSTEM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT One-Stop Operators § 662.430 Under what conditions may One-Stop operators designated to operate in a One-Stop delivery system...

20 CFR 662.430 - Under what conditions may One-Stop operators designated to operate in a One-Stop delivery system...

Code of Federal Regulations, 2010 CFR

2010-04-01

... designated to operate in a One-Stop delivery system established prior to the enactment of WIA be designated... DESCRIPTION OF THE ONE-STOP SYSTEM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT One-Stop Operators § 662.430 Under what conditions may One-Stop operators designated to operate in a One-Stop delivery system...

Effect of delivery condition on desorption rate of ZrCo metal hydride bed for fusion fuel cycle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, H.G.; Yun, S.H.; Chung, D.

2015-03-15

For the safety of fusion fuel cycle, hydrogen isotope gases including tritium are stored as metal hydride form. To satisfy fueling requirement of fusion machine, rapid delivery from metal hydride bed is one of major factors for the development of tritium storage and delivery system. Desorption from metal hydride depends on the operation scenario by pressure and temperature control of the bed. The effect of operation scenario and pump performance on desorption rate of metal hydride bed was experimentally investigated using ZrCo bed. The results showed that the condition of pre-heating scenario before actual delivery of gas affected the deliverymore » performance. Different pumps were connected to desorption line from bed and the effect of pump capacity on desorption rate were also found to be significant. (authors)« less

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes

PubMed Central

Goodman, Claire; Davies, Sue L; Dening, Tom; Gage, Heather; Meyer, Julienne; Schneider, Justine; Bell, Brian; Jordan, Jake; Martin, Finbarr C; Iliffe, Steve; Bowman, Clive; Gladman, John R F; Victor, Christina; Mayrhofer, Andrea; Handley, Melanie; Zubair, Maria

2018-01-01

Abstract Introduction care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. Methods a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. Results context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which ‘wraps around’ care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. Conclusion activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise. PMID:29315370

Protocol for an HTA report: Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic modelling.

PubMed

Meads, C; Nyssen, O P; Wong, G; Steed, L; Bourke, L; Ross, C A; Hayman, S; Field, V; Lord, J; Greenhalgh, T; Taylor, S J C

2014-02-18

Long-term medical conditions (LTCs) cause reduced health-related quality of life and considerable health service expenditure. Writing therapy has potential to improve physical and mental health in people with LTCs, but its effectiveness is not established. This project aims to establish the clinical and cost-effectiveness of therapeutic writing in LTCs by systematic review and economic evaluation, and to evaluate context and mechanisms by which it might work, through realist synthesis. Included are any comparative study of therapeutic writing compared with no writing, waiting list, attention control or placebo writing in patients with any diagnosed LTCs that report at least one of the following: relevant clinical outcomes; quality of life; health service use; psychological, behavioural or social functioning; adherence or adverse events. Searches will be conducted in the main medical databases including MEDLINE, EMBASE, PsycINFO, The Cochrane Library and Science Citation Index. For the realist review, further purposive and iterative searches through snowballing techniques will be undertaken. Inclusions, data extraction and quality assessment will be in duplicate with disagreements resolved through discussion. Quality assessment will include using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data synthesis will be narrative and tabular with meta-analysis where appropriate. De novo economic modelling will be attempted in one clinical area if sufficient evidence is available and performed according to the National Institute for Health and Care Excellence (NICE) reference case.

43 CFR 418.28 - Conditions of delivery.

Code of Federal Regulations, 2010 CFR

2010-10-01

... particulars including the known or estimated location and amounts; (3) The amount will not be included as a valid headgate delivery for purposes of computing the Project efficiency and resultant incentive credit... treated directly as a debit to Lahontan storage in the same manner as an efficiency debit. (b) District...

Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes in Hong Kong.

PubMed

Lam, Winsome; Dawson, Angela; Fowler, Cathrine

2015-04-01

To identify factors affecting the delivery of health promotion interventions to prevent early childhood human influenza at the household level. Yearly, influenza epidemics seriously affect all age groups, particularly those with weakened immune systems, including children. Influenza is transmitted easily from person to person through droplet and direct contact. Maintaining personal hygiene, avoiding close contact with the infected person and proper hand washing are recommended as the most effective means of preventing the transmission of influenza. However, it is not clear what programme-related mechanisms and contexts are crucial to the successful delivery of interventions in the home. This study systematically reviewed published research studies to identify factors influencing the effective delivery of health promotion programmes targeting influenza in a household. Realist review. A realist review methodology was selected to examine what interventions are effective in preventing and managing influenza at the household level and in what circumstances. A structured search of the peer-reviewed primary research literature was undertaken using a defined search protocol. Eight studies were retrieved for the analysis. Mechanisms impacting on intervention delivery were identified, including timing of implementation, programme reach, organisational and healthcare worker involvement, mode and place of delivery, contact with infected person, health practice compliance and sustainability at home. These findings suggest contextual factors that could be identified through ecological approaches to health promotion that are crucial for policymakers to consider when designing interventions. The active involvement of community nurses through an integrated household visiting programme may help to better deliver family-based health promotion interventions to prevent illnesses such as influenza in children. © 2014 John Wiley & Sons Ltd.

Simplified realistic human head model for simulating Tumor Treating Fields (TTFields).

PubMed

Wenger, Cornelia; Bomzon, Ze'ev; Salvador, Ricardo; Basser, Peter J; Miranda, Pedro C

2016-08-01

Tumor Treating Fields (TTFields) are alternating electric fields in the intermediate frequency range (100-300 kHz) of low-intensity (1-3 V/cm). TTFields are an anti-mitotic treatment against solid tumors, which are approved for Glioblastoma Multiforme (GBM) patients. These electric fields are induced non-invasively by transducer arrays placed directly on the patient's scalp. Cell culture experiments showed that treatment efficacy is dependent on the induced field intensity. In clinical practice, a software called NovoTalTM uses head measurements to estimate the optimal array placement to maximize the electric field delivery to the tumor. Computational studies predict an increase in the tumor's electric field strength when adapting transducer arrays to its location. Ideally, a personalized head model could be created for each patient, to calculate the electric field distribution for the specific situation. Thus, the optimal transducer layout could be inferred from field calculation rather than distance measurements. Nonetheless, creating realistic head models of patients is time-consuming and often needs user interaction, because automated image segmentation is prone to failure. This study presents a first approach to creating simplified head models consisting of convex hulls of the tissue layers. The model is able to account for anisotropic conductivity in the cortical tissues by using a tensor representation estimated from Diffusion Tensor Imaging. The induced electric field distribution is compared in the simplified and realistic head models. The average field intensities in the brain and tumor are generally slightly higher in the realistic head model, with a maximal ratio of 114% for a simplified model with reasonable layer thicknesses. Thus, the present pipeline is a fast and efficient means towards personalized head models with less complexity involved in characterizing tissue interfaces, while enabling accurate predictions of electric field distribution.

Protocol for an HTA report: Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic modelling

PubMed Central

Meads, C; Nyssen, O P; Wong, G; Steed, L; Bourke, L; Ross, C A; Hayman, S; Field, V; Lord, J; Greenhalgh, T; Taylor, S J C

2014-01-01

Introduction Long-term medical conditions (LTCs) cause reduced health-related quality of life and considerable health service expenditure. Writing therapy has potential to improve physical and mental health in people with LTCs, but its effectiveness is not established. This project aims to establish the clinical and cost-effectiveness of therapeutic writing in LTCs by systematic review and economic evaluation, and to evaluate context and mechanisms by which it might work, through realist synthesis. Methods Included are any comparative study of therapeutic writing compared with no writing, waiting list, attention control or placebo writing in patients with any diagnosed LTCs that report at least one of the following: relevant clinical outcomes; quality of life; health service use; psychological, behavioural or social functioning; adherence or adverse events. Searches will be conducted in the main medical databases including MEDLINE, EMBASE, PsycINFO, The Cochrane Library and Science Citation Index. For the realist review, further purposive and iterative searches through snowballing techniques will be undertaken. Inclusions, data extraction and quality assessment will be in duplicate with disagreements resolved through discussion. Quality assessment will include using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data synthesis will be narrative and tabular with meta-analysis where appropriate. De novo economic modelling will be attempted in one clinical area if sufficient evidence is available and performed according to the National Institute for Health and Care Excellence (NICE) reference case. PMID:24549165

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes.

PubMed

Gordon, Adam L; Goodman, Claire; Davies, Sue L; Dening, Tom; Gage, Heather; Meyer, Julienne; Schneider, Justine; Bell, Brian; Jordan, Jake; Martin, Finbarr C; Iliffe, Steve; Bowman, Clive; Gladman, John R F; Victor, Christina; Mayrhofer, Andrea; Handley, Melanie; Zubair, Maria

2018-01-05

care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society.

A realist evaluation of the management of a well- performing regional hospital in Ghana

PubMed Central

2010-01-01

Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development

A realist evaluation of the management of a well-performing regional hospital in Ghana.

PubMed

Marchal, Bruno; Dedzo, McDamien; Kegels, Guy

2010-01-25

Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well

Semi-Solid and Solid Dosage Forms for the Delivery of Phage Therapy to Epithelia.

PubMed

Brown, Teagan L; Petrovski, Steve; Chan, Hiu Tat; Angove, Michael J; Tucci, Joseph

2018-02-26

The delivery of phages to epithelial surfaces for therapeutic outcomes is a realistic proposal, and indeed one which is being currently tested in clinical trials. This paper reviews some of the known research on formulation of phages into semi-solid dosage forms such as creams, ointments and pastes, as well as solid dosage forms such as troches (or lozenges and pastilles) and suppositories/pessaries, for delivery to the epithelia. The efficacy and stability of these phage formulations is discussed, with a focus on selection of optimal semi-solid bases for phage delivery. Issues such as the need for standardisation of techniques for formulation as well as for assessment of efficacy are highlighted. These are important when trying to compare results from a range of experiments and across different delivery bases.

Semi-Solid and Solid Dosage Forms for the Delivery of Phage Therapy to Epithelia

PubMed Central

Petrovski, Steve; Chan, Hiu Tat; Angove, Michael J.; Tucci, Joseph

2018-01-01

The delivery of phages to epithelial surfaces for therapeutic outcomes is a realistic proposal, and indeed one which is being currently tested in clinical trials. This paper reviews some of the known research on formulation of phages into semi-solid dosage forms such as creams, ointments and pastes, as well as solid dosage forms such as troches (or lozenges and pastilles) and suppositories/pessaries, for delivery to the epithelia. The efficacy and stability of these phage formulations is discussed, with a focus on selection of optimal semi-solid bases for phage delivery. Issues such as the need for standardisation of techniques for formulation as well as for assessment of efficacy are highlighted. These are important when trying to compare results from a range of experiments and across different delivery bases. PMID:29495355

Downscaling Ocean Conditions: Initial Results using a Quasigeostrophic and Realistic Ocean Model

NASA Astrophysics Data System (ADS)

Katavouta, Anna; Thompson, Keith

2014-05-01

Previous theoretical work (Henshaw et al, 2003) has shown that the small-scale modes of variability of solutions of the unforced, incompressible Navier-Stokes equation, and Burgers' equation, can be reconstructed with surprisingly high accuracy from the time history of a few of the large-scale modes. Motivated by this theoretical work we first describe a straightforward method for assimilating information on the large scales in order to recover the small scale oceanic variability. The method is based on nudging in specific wavebands and frequencies and is similar to the so-called spectral nudging method that has been used successfully for atmospheric downscaling with limited area models (e.g. von Storch et al., 2000). The validity of the method is tested using a quasigestrophic model configured to simulate a double ocean gyre separated by an unstable mid-ocean jet. It is shown that important features of the ocean circulation including the position of the meandering mid-ocean jet and associated pinch-off eddies can indeed be recovered from the time history of a small number of large-scales modes. The benefit of assimilating additional time series of observations from a limited number of locations, that alone are too sparse to significantly improve the recovery of the small scales using traditional assimilation techniques, is also demonstrated using several twin experiments. The final part of the study outlines the application of the approach using a realistic high resolution (1/36 degree) model, based on the NEMO (Nucleus for European Modelling of the Ocean) modeling framework, configured for the Scotian Shelf of the east coast of Canada. The large scale conditions used in this application are obtained from the HYCOM (HYbrid Coordinate Ocean Model) + NCODA (Navy Coupled Ocean Data Assimilation) global 1/12 degree analysis product. Henshaw, W., Kreiss, H.-O., Ystrom, J., 2003. Numerical experiments on the interaction between the larger- and the small-scale motion of

A realistic evaluation: the case of protocol-based care

PubMed Central

2010-01-01

Background 'Protocol based care' was envisioned by policy makers as a mechanism for delivering on the service improvement agenda in England. Realistic evaluation is an increasingly popular approach, but few published examples exist, particularly in implementation research. To fill this gap, within this paper we describe the application of a realistic evaluation approach to the study of protocol-based care, whilst sharing findings of relevance about standardising care through the use of protocols, guidelines, and pathways. Methods Situated between positivism and relativism, realistic evaluation is concerned with the identification of underlying causal mechanisms, how they work, and under what conditions. Fundamentally it focuses attention on finding out what works, for whom, how, and in what circumstances. Results In this research, we were interested in understanding the relationships between the type and nature of particular approaches to protocol-based care (mechanisms), within different clinical settings (context), and what impacts this resulted in (outcomes). An evidence review using the principles of realist synthesis resulted in a number of propositions, i.e., context, mechanism, and outcome threads (CMOs). These propositions were then 'tested' through multiple case studies, using multiple methods including non-participant observation, interviews, and document analysis through an iterative analysis process. The initial propositions (conjectured CMOs) only partially corresponded to the findings that emerged during analysis. From the iterative analysis process of scrutinising mechanisms, context, and outcomes we were able to draw out some theoretically generalisable features about what works, for whom, how, and what circumstances in relation to the use of standardised care approaches (refined CMOs). Conclusions As one of the first studies to apply realistic evaluation in implementation research, it was a good fit, particularly given the growing emphasis on

Improvement in Simulation of Eurasian Winter Climate Variability with a Realistic Arctic Sea Ice Condition in an Atmospheric GCM

NASA Technical Reports Server (NTRS)

Lim, Young-Kwon; Ham, Yoo-Geun; Jeong, Jee-Hoon; Kug, Jong-Seong

2012-01-01

The present study investigates how much a realistic Arctic sea ice condition can contribute to improve simulation of the winter climate variation over the Eurasia region. Model experiments are set up using different sea ice boundary conditions over the past 24 years (i.e., 1988-2011). One is an atmospheric model inter-comparison (AMIP) type of run forced with observed sea-surface temperature (SST), sea ice, and greenhouse gases (referred to as Exp RSI), and the other is the same as Exp RSI except for the sea ice forcing, which is a repeating climatological annual cycle (referred to as Exp CSI). Results show that Exp RSI produces the observed dominant pattern of Eurasian winter temperatures and their interannual variation better than Exp CSI (correlation difference up to approx. 0.3). Exp RSI captures the observed strong relationship between the sea ice concentration near the Barents and Kara seas and the temperature anomaly across Eurasia, including northeastern Asia, which is not well captured in Exp CSI. Lagged atmospheric responses to sea ice retreat are examined using observations to understand atmospheric processes for the Eurasian cooling response including the Arctic temperature increase, sea-level pressure increase, upper-level jet weakening and cold air outbreak toward the mid-latitude. The reproducibility of these lagged responses by Exp RSI is also evaluated.

Realistic Clocks for a Universe Without Time

NASA Astrophysics Data System (ADS)

Bryan, K. L. H.; Medved, A. J. M.

2018-01-01

There are a number of problematic features within the current treatment of time in physical theories, including the "timelessness" of the Universe as encapsulated by the Wheeler-DeWitt equation. This paper considers one particular investigation into resolving this issue; a conditional probability interpretation that was first proposed by Page and Wooters. Those authors addressed the apparent timelessness by subdividing a faux Universe into two entangled parts, "the clock" and "the remainder of the Universe", and then synchronizing the effective dynamics of the two subsystems by way of conditional probabilities. The current treatment focuses on the possibility of using a (somewhat) realistic clock system; namely, a coherent-state description of a damped harmonic oscillator. This clock proves to be consistent with the conditional probability interpretation; in particular, a standard evolution operator is identified with the position of the clock playing the role of time for the rest of the Universe. Restrictions on the damping factor are determined and, perhaps contrary to expectations, the optimal choice of clock is not necessarily one of minimal damping.

Realistic Simulation for Body Area and Body-To-Body Networks.

PubMed

Alam, Muhammad Mahtab; Ben Hamida, Elyes; Ben Arbia, Dhafer; Maman, Mickael; Mani, Francesco; Denis, Benoit; D'Errico, Raffaele

2016-04-20

In this paper, we present an accurate and realistic simulation for body area networks (BAN) and body-to-body networks (BBN) using deterministic and semi-deterministic approaches. First, in the semi-deterministic approach, a real-time measurement campaign is performed, which is further characterized through statistical analysis. It is able to generate link-correlated and time-varying realistic traces (i.e., with consistent mobility patterns) for on-body and body-to-body shadowing and fading, including body orientations and rotations, by means of stochastic channel models. The full deterministic approach is particularly targeted to enhance IEEE 802.15.6 proposed channel models by introducing space and time variations (i.e., dynamic distances) through biomechanical modeling. In addition, it helps to accurately model the radio link by identifying the link types and corresponding path loss factors for line of sight (LOS) and non-line of sight (NLOS). This approach is particularly important for links that vary over time due to mobility. It is also important to add that the communication and protocol stack, including the physical (PHY), medium access control (MAC) and networking models, is developed for BAN and BBN, and the IEEE 802.15.6 compliance standard is provided as a benchmark for future research works of the community. Finally, the two approaches are compared in terms of the successful packet delivery ratio, packet delay and energy efficiency. The results show that the semi-deterministic approach is the best option; however, for the diversity of the mobility patterns and scenarios applicable, biomechanical modeling and the deterministic approach are better choices.

Realistic Simulation for Body Area and Body-To-Body Networks

PubMed Central

Alam, Muhammad Mahtab; Ben Hamida, Elyes; Ben Arbia, Dhafer; Maman, Mickael; Mani, Francesco; Denis, Benoit; D’Errico, Raffaele

2016-01-01

In this paper, we present an accurate and realistic simulation for body area networks (BAN) and body-to-body networks (BBN) using deterministic and semi-deterministic approaches. First, in the semi-deterministic approach, a real-time measurement campaign is performed, which is further characterized through statistical analysis. It is able to generate link-correlated and time-varying realistic traces (i.e., with consistent mobility patterns) for on-body and body-to-body shadowing and fading, including body orientations and rotations, by means of stochastic channel models. The full deterministic approach is particularly targeted to enhance IEEE 802.15.6 proposed channel models by introducing space and time variations (i.e., dynamic distances) through biomechanical modeling. In addition, it helps to accurately model the radio link by identifying the link types and corresponding path loss factors for line of sight (LOS) and non-line of sight (NLOS). This approach is particularly important for links that vary over time due to mobility. It is also important to add that the communication and protocol stack, including the physical (PHY), medium access control (MAC) and networking models, is developed for BAN and BBN, and the IEEE 802.15.6 compliance standard is provided as a benchmark for future research works of the community. Finally, the two approaches are compared in terms of the successful packet delivery ratio, packet delay and energy efficiency. The results show that the semi-deterministic approach is the best option; however, for the diversity of the mobility patterns and scenarios applicable, biomechanical modeling and the deterministic approach are better choices. PMID:27104537

Filled Prescriptions for Opioids After Vaginal Delivery.

PubMed

Jarlenski, Marian; Bodnar, Lisa M; Kim, Joo Yeon; Donohue, Julie; Krans, Elizabeth E; Bogen, Debra L

2017-03-01

To estimate the prevalence of filled opioid prescriptions after vaginal delivery. We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy. Outcomes included a binary measure of whether a woman had any opioid prescription fill 5 days or less after delivery and, among those women, a second opioid prescription fill 6-60 days after delivery. Among women with no coded pain-inducing conditions at delivery, we used multivariable logistic regression with standard errors clustered to account for within-hospital correlation to assess the association between patient characteristics and odds of a filled opioid prescription. Twelve percent of women (n=18,131) filled an outpatient opioid prescription 5 days or less after vaginal delivery; among those women, 14% (n=2,592, or 1.6% of the total) filled a second opioid prescription 6-60 days after delivery. Of the former, 5,110 (28.2%) had one or more pain-inducing conditions. Predictors of filled opioid prescriptions with no observed pain-inducing condition at delivery included tobacco use (adjusted odds ratio [OR] 1.3, 95% confidence interval [CI] 1.2-1.4) and a mental health condition (adjusted OR 1.3, 95% CI 1.2-1.4). Having a diagnosis of substance use disorder other than opioid use disorder was not associated with filling an opioid prescription 5 days or less after delivery, but was associated with having a second opioid prescription 6-60 days after delivery (adjusted OR 1.4, 95% CI 1.2-1.6). More than 1 in 10 Medicaid-enrolled women fill an outpatient opioid prescription after vaginal delivery. National opioid-prescribing recommendations for

Highly stable and degradable multifunctional microgel for self-regulated insulin delivery under physiological conditions

NASA Astrophysics Data System (ADS)

Zhang, Xinjie; Lü, Shaoyu; Gao, Chunmei; Chen, Chen; Zhang, Xuan; Liu, Mingzhu

2013-06-01

The response to glucose, pH and temperature, high drug loading capacity, self-regulated drug delivery and degradation in vivo are simultaneously probable by applying a multifunctional microgel under a rational design in a colloid chemistry method. Such multifunctional microgels are fabricated with N-isopropylacrylamide (NIPAAm), (2-dimethylamino)ethyl methacrylate (DMAEMA) and 3-acrylamidephenylboronic acid (AAPBA) through a precipitation emulsion method and cross-linked by reductive degradable N,N'-bis(arcyloyl)cystamine (BAC). This novel kind of microgel with a narrow size distribution (~250 nm) is suitable for diabetes because it can adapt to the surrounding medium of different glucose concentrations over a clinically relevant range (0-20 mM), control the release of preloaded insulin and is highly stable under physiological conditions (pH 7.4, 0.15 M NaCl, 37 °C). When synthesized multifunctional microgels regulate drug delivery, they gradually degrade as time passes and, as a result, show enhanced biocompatibility. This exhibits a new proof-of-concept for diabetes treatment that takes advantage of the properties of each building block from a multifunctional micro-object. These highly stable and versatile multifunctional microgels have the potential to be used for self-regulated therapy and monitoring of the response to treatment, or even simultaneous diagnosis as nanobiosensors.The response to glucose, pH and temperature, high drug loading capacity, self-regulated drug delivery and degradation in vivo are simultaneously probable by applying a multifunctional microgel under a rational design in a colloid chemistry method. Such multifunctional microgels are fabricated with N-isopropylacrylamide (NIPAAm), (2-dimethylamino)ethyl methacrylate (DMAEMA) and 3-acrylamidephenylboronic acid (AAPBA) through a precipitation emulsion method and cross-linked by reductive degradable N,N'-bis(arcyloyl)cystamine (BAC). This novel kind of microgel with a narrow size

Induction of transplantation tolerance by combining non-myeloablative conditioning with delivery of alloantigen by T cells

PubMed Central

Tian, Chaorui; Yuan, Xueli; Bagley, Jessamyn; Blazar, Bruce R.; Sayegh, Mohamed H.; Iacomini, John

2008-01-01

The observation that bone marrow derived hematopoietic cells are potent inducers of tolerance has generated interest in trying to establish transplantation tolerance by inducing a state of hematopoietic chimerism through allogeneic bone marrow transplantation. However, this approach is associated with serious complications that limit its utility for tolerance induction. Here we describe the development of a novel approach that allows for tolerance induction without the need for an allogeneic bone marrow transplant by combining non-myeloablative host conditioning with delivery of donor alloantigen by adoptively transferred T cells. CBA/Ca mice were administered 2.5Gy whole body irradiation (WBI). The following day the mice received Kb disparate T cells from MHC class I transgenic CBK donor mice, as well as rapamycin on days 0–13 and anti-CD40L monoclonal antibody on days 0–5, 8,11 and 14 relative to T cell transfer. Mice treated using this approach were rendered specifically tolerant to CBK skin allografts through a mechanism involving central and peripheral deletion of alloreactive T cells. These data suggest robust tolerance can be established without the need for bone marrow transplantation using clinically relevant non-myeloablative conditioning combined with antigen delivery by T cells. PMID:18280792

Delivery of therapeutics for deep-seated ocular conditions - status quo.

PubMed

Nguyen, Hubert; Eng, Shawn; Ngo, Thanh; Dass, Crispin R

2018-04-19

There is a need for research into designing effective pharmaceutical systems for delivering therapeutic drugs to the posterior of the eye for glaucoma-related pathology, macular degeneration, diabetic retinopathy, macular oedema, retinitis and choroiditis. Conventionally, eye drops have been extensively utilised for topical drug delivery to the anterior segment of the eye, but are less effective for delivery of therapeutics to the back of the eye due to significant barriers hampering drug penetration into the target intraocular tissue. This review explores some of the current and novel delivery systems employed to deliver therapeutics to the back of the eye such as those using liposomes, ocular implants, in situ gels, and nanoparticles, and how they can overcome some of these limitations. Issues such as blinking, precorneal fluid drainage, tear dilution and turnover, conjunctiva and nasal drug absorption, the corneal epithelium, vitreous drug clearance, and the blood-ocular barriers are reviewed and discussed. Further studies are needed to address their shortcomings such as drug compatibility and stability, economic viability and patient compliance. © 2018 Royal Pharmaceutical Society.

Postpositivist Realist Theory: Identity and Representation Revisited

ERIC Educational Resources Information Center

Gilpin, Lorraine S.

2006-01-01

In postpositivist realist theory, people like Paula Moya (2000) and Satya Mohanty (2000) make a space that at once reflects and informs my location as a Third-World woman of color and a Black-immigrant educator in the United States. In postpositivist realist theory, understanding emerges from one's past and present experiences and interactions as…

Active and realistic passive marijuana exposure tested by three immunoassays and GC/MS in urine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mule, S.J.; Lomax, P.; Gross, S.J.

Human urine samples obtained before and after active and passive exposure to marijuana were analyzed by immune kits (Roche, Amersham, and Syva) and gas chromatography/mass spectrometry (GC/MS). Seven of eight subjects were positive for the entire five-day test period with one immune kit. The latter correlated with GC/MS in 98% of the samples. Passive inhalation experiments under conditions likely to reflect realistic exposure resulted consistently in less than 10 ng/mL of cannabinoids. The 10-100-ng/mL cannabinoid concentration range essential for detection of occasional and moderate marijuana users is thus unaffected by realistic passive inhalation.

SiC-based neutron detector in quasi-realistic working conditions: efficiency and stability at room and high temperature under fast neutron irradiations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferone, Raffaello; Issa, Fatima; Ottaviani, Laurent

In the framework of the European I SMART project, we have designed and made new SiC-based nuclear radiation detectors able to operate in harsh environments and to detect both fast and thermal neutrons. In this paper, we report experimental results of fast neutron irradiation campaign at high temperature (106 deg. C) in quasi-realistic working conditions. Our device does not suffer from high temperature, and spectra do show strong stability, preserving features. These experiments, as well as others in progress, show the I SMART SiC-based device skills to operate in harsh environments, whereas other materials would strongly suffer from degradation. Workmore » is still demanded to test our device at higher temperatures and to enhance efficiency in order to make our device fully exploitable from an industrial point of view. (authors)« less

Learning effect of a conditional cash transfer programme on poor rural women's selection of delivery care in Mexico.

PubMed

Sosa-Rubí, Sandra G; Walker, Dilys; Serván, Edson; Bautista-Arredondo, Sergio

2011-11-01

BACKGROUND The Mexican programme Oportunidades/Progresa conditionally transfers money to beneficiary families. Over the past 10 years, poor rural women have been obliged to attend antenatal care (ANC) visits and reproductive health talks. We propose that the length of time in the programme influences women's preferences, thus increasing their use not only of services directly linked to the cash transfers, but also of other services, such as clinic-based delivery, whose utilization is not obligatory. OBJECTIVE To analyse the long-term effect of Oportunidades on women's use of antenatal and delivery care. METHODOLOGY 5051 women aged between 15 and 49 years old with at least one child aged less than 24 months living in rural localities were analysed. Multilevel probit and logit models were used to analyse ANC visits and physician/nurse attended delivery, respectively. Models were adjusted with individual and socio-economic variables and the locality's exposure time to Oportunidades. Findings On average women living in localities with longer exposure to Oportunidades report 2.1% more ANC visits than women living in localities with less exposure. Young women aged 15-19 and 20-24 years and living in localities with longer exposure to Oportunidades (since 1998) have 88% and 41% greater likelihood of choosing a physician/nurse vs. traditional midwife for childbirth, respectively. Women of indigenous origin are 68.9% less likely to choose a physician/nurse for delivery care than non-indigenous women. CONCLUSIONS An increase in the average number of ANC visits has been achieved among Oportunidades beneficiaries. An indirect effect is the increased selection of a physician/nurse for delivery care among young women living in localities with greater exposure time to Oportunidades. Disadvantaged women in Mexico (indigenous women) continue to have less access to skilled delivery care. Developing countries must develop strategies to increase access and use of skilled obstetric

Shipbuilding Docks as Experimental Systems for Realistic Assessments of Anthropogenic Stressors on Marine Organisms

PubMed Central

Harding, Harry R.; Bunce, Tom; Birch, Fiona; Lister, Jessica; Spiga, Ilaria; Benson, Tom; Rossington, Kate; Jones, Diane; Tyler, Charles R.; Simpson, Stephen D.

2017-01-01

Abstract Empirical investigations of the impacts of anthropogenic stressors on marine organisms are typically performed under controlled laboratory conditions, onshore mesocosms, or via offshore experiments with realistic (but uncontrolled) environmental variation. These approaches have merits, but onshore setups are generally small sized and fail to recreate natural stressor fields, whereas offshore studies are often compromised by confounding factors. We suggest the use of flooded shipbuilding docks to allow studying realistic exposure to stressors and their impacts on the intra- and interspecific responses of animals. Shipbuilding docks permit the careful study of groups of known animals, including the evaluation of their behavioral interactions, while enabling full control of the stressor and many environmental conditions. We propose that this approach could be used for assessing the impacts of prominent anthropogenic stressors, including chemicals, ocean warming, and sound. Results from shipbuilding-dock studies could allow improved parameterization of predictive models relating to the environmental risks and population consequences of anthropogenic stressors. PMID:29599545

Shipbuilding Docks as Experimental Systems for Realistic Assessments of Anthropogenic Stressors on Marine Organisms.

PubMed

Bruintjes, Rick; Harding, Harry R; Bunce, Tom; Birch, Fiona; Lister, Jessica; Spiga, Ilaria; Benson, Tom; Rossington, Kate; Jones, Diane; Tyler, Charles R; Radford, Andrew N; Simpson, Stephen D

2017-09-01

Empirical investigations of the impacts of anthropogenic stressors on marine organisms are typically performed under controlled laboratory conditions, onshore mesocosms, or via offshore experiments with realistic (but uncontrolled) environmental variation. These approaches have merits, but onshore setups are generally small sized and fail to recreate natural stressor fields, whereas offshore studies are often compromised by confounding factors. We suggest the use of flooded shipbuilding docks to allow studying realistic exposure to stressors and their impacts on the intra- and interspecific responses of animals. Shipbuilding docks permit the careful study of groups of known animals, including the evaluation of their behavioral interactions, while enabling full control of the stressor and many environmental conditions. We propose that this approach could be used for assessing the impacts of prominent anthropogenic stressors, including chemicals, ocean warming, and sound. Results from shipbuilding-dock studies could allow improved parameterization of predictive models relating to the environmental risks and population consequences of anthropogenic stressors.

MEMS: Enabled Drug Delivery Systems.

PubMed

Cobo, Angelica; Sheybani, Roya; Meng, Ellis

2015-05-01

Drug delivery systems play a crucial role in the treatment and management of medical conditions. Microelectromechanical systems (MEMS) technologies have allowed the development of advanced miniaturized devices for medical and biological applications. This Review presents the use of MEMS technologies to produce drug delivery devices detailing the delivery mechanisms, device formats employed, and various biomedical applications. The integration of dosing control systems, examples of commercially available microtechnology-enabled drug delivery devices, remaining challenges, and future outlook are also discussed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Adapting realist synthesis methodology: The case of workplace harassment interventions.

PubMed

Carr, Tracey; Quinlan, Elizabeth; Robertson, Susan; Gerrard, Angie

2017-12-01

Realist synthesis techniques can be used to assess complex interventions by extracting and synthesizing configurations of contexts, mechanisms, and outcomes found in the literature. Our novel and multi-pronged approach to the realist synthesis of workplace harassment interventions describes our pursuit of theory to link macro and program level theories. After discovering the limitations of a dogmatic approach to realist synthesis, we adapted our search strategy and focused our analysis on a subset of data. We tailored our realist synthesis to understand how, why, and under what circumstances workplace harassment interventions are effective. The result was a conceptual framework to test our theory-based interventions and provide the basis for subsequent realist evaluation. Our experience documented in this article contributes to an understanding of how, under what circumstances, and with what consequences realist synthesis principles can be customized. Copyright © 2017 John Wiley & Sons, Ltd.

Experimental analysis of the vorticity and turbulent flow dynamics of a pitching airfoil at realistic flight (helicopter) conditions

NASA Astrophysics Data System (ADS)

Sahoo, Dipankar

Improved basic understanding, predictability, and controllability of vortex-dominated and unsteady aerodynamic flows are important in enhancement of the performance of next generation helicopters. The primary objective of this research project was improved understanding of the fundamental vorticity and turbulent flow physics for a dynamically stalling airfoil at realistic helicopter flight conditions. An experimental program was performed on a large-scale (C = 0.45 m) dynamically pitching NACA 0012 wing operating in the Texas A&M University large-scale wind tunnel. High-resolution particle image velocimetry data were acquired on the first 10-15% of the wing. Six test cases were examined including the unsteady (k>0) and steady (k=0) conditions. The relevant mechanical, shear and turbulent time-scales were all of comparable magnitude, which indicated that the flow was in a state of mechanical non-equilibrium, and the expected flow separation and reattachment hystersis was observed. Analyses of the databases provided new insights into the leading-edge Reynolds stress structure and the turbulent transport processes. Both of which were previously uncharacterized. During the upstroke motion of the wing, a bubble structure formed in the leading-edge Reynolds shear stress. The size of the bubble increased with increasing angle-of-attack before being diffused into a shear layer at full separation. The turbulent transport analyses indicated that the axial stress production was positive, where the transverse production was negative. This implied that axial turbulent stresses were being produced from the axial component of the mean flow. A significant portion of the energy was transferred to the transverse stress through the pressure-strain redistribution, and then back to the transverse mean flow through the negative transverse production. An opposite trend was observed further downstream of this region.

Realistic Real-Time Outdoor Rendering in Augmented Reality

PubMed Central

Kolivand, Hoshang; Sunar, Mohd Shahrizal

2014-01-01

Realistic rendering techniques of outdoor Augmented Reality (AR) has been an attractive topic since the last two decades considering the sizeable amount of publications in computer graphics. Realistic virtual objects in outdoor rendering AR systems require sophisticated effects such as: shadows, daylight and interactions between sky colours and virtual as well as real objects. A few realistic rendering techniques have been designed to overcome this obstacle, most of which are related to non real-time rendering. However, the problem still remains, especially in outdoor rendering. This paper proposed a much newer, unique technique to achieve realistic real-time outdoor rendering, while taking into account the interaction between sky colours and objects in AR systems with respect to shadows in any specific location, date and time. This approach involves three main phases, which cover different outdoor AR rendering requirements. Firstly, sky colour was generated with respect to the position of the sun. Second step involves the shadow generation algorithm, Z-Partitioning: Gaussian and Fog Shadow Maps (Z-GaF Shadow Maps). Lastly, a technique to integrate sky colours and shadows through its effects on virtual objects in the AR system, is introduced. The experimental results reveal that the proposed technique has significantly improved the realism of real-time outdoor AR rendering, thus solving the problem of realistic AR systems. PMID:25268480

Realistic real-time outdoor rendering in augmented reality.

PubMed

Kolivand, Hoshang; Sunar, Mohd Shahrizal

2014-01-01

Realistic rendering techniques of outdoor Augmented Reality (AR) has been an attractive topic since the last two decades considering the sizeable amount of publications in computer graphics. Realistic virtual objects in outdoor rendering AR systems require sophisticated effects such as: shadows, daylight and interactions between sky colours and virtual as well as real objects. A few realistic rendering techniques have been designed to overcome this obstacle, most of which are related to non real-time rendering. However, the problem still remains, especially in outdoor rendering. This paper proposed a much newer, unique technique to achieve realistic real-time outdoor rendering, while taking into account the interaction between sky colours and objects in AR systems with respect to shadows in any specific location, date and time. This approach involves three main phases, which cover different outdoor AR rendering requirements. Firstly, sky colour was generated with respect to the position of the sun. Second step involves the shadow generation algorithm, Z-Partitioning: Gaussian and Fog Shadow Maps (Z-GaF Shadow Maps). Lastly, a technique to integrate sky colours and shadows through its effects on virtual objects in the AR system, is introduced. The experimental results reveal that the proposed technique has significantly improved the realism of real-time outdoor AR rendering, thus solving the problem of realistic AR systems.

Generating realistic images using Kray

NASA Astrophysics Data System (ADS)

Tanski, Grzegorz

2004-07-01

Kray is an application for creating realistic images. It is written in C++ programming language, has a text-based interface, solves global illumination problem using techniques such as radiosity, path tracing and photon mapping.

Plasminogen Activators and Ischemic Stroke: Conditions for Acute Delivery

PubMed Central

del Zoppo, Gregory J

2013-01-01

Appropriate acute treatment with plasminogen activators (PAs) can significantly increase the probability of minimal or no disability in selected ischemic stroke patients. There is a great deal of evidence showing that intravenous recombinant tissue PAs (rt-PA) infusion accomplishes this goal, recanalization with other PAs has also been demonstrated in the development of this treatment. Recanalization of symptomatic, documented carotid or vertebrobasilar arterial territory occlusions have also been achieved by local intra-arterial PA delivery, although only a single prospective double-blinded randomized placebo-controlled study has been reported. The increase in intracerebral hemorrhage with these agents by either delivery approach underscores the need for careful patient selection, dose-appropriate safety and efficacy, proper clinical trial design, and an understanding of the evolution of cerebral tissue injury due to focal ischemia. Principles underlying the evolution of focal ischemia have been expanded by experience with acute PA intervention. Several questions remain open that concern the manner in which PAs can be applied acutely in ischemic stroke and how injury development can be limited. PMID:23539414

Engineering and evaluating drug delivery particles in microfluidic devices.

PubMed

Björnmalm, Mattias; Yan, Yan; Caruso, Frank

2014-09-28

The development of new and improved particle-based drug delivery is underpinned by an enhanced ability to engineer particles with high fidelity and integrity, as well as increased knowledge of their biological performance. Microfluidics can facilitate these processes through the engineering of spatiotemporally highly controlled environments using designed microstructures in combination with physical phenomena present at the microscale. In this review, we discuss microfluidics in the context of addressing key challenges in particle-based drug delivery. We provide an overview of how microfluidic devices can: (i) be employed to engineer particles, by providing highly controlled interfaces, and (ii) be used to establish dynamic in vitro models that mimic in vivo environments for studying the biological behavior of engineered particles. Finally, we discuss how the flexible and modular nature of microfluidic devices provides opportunities to create increasingly realistic models of the in vivo milieu (including multi-cell, multi-tissue and even multi-organ devices), and how ongoing developments toward commercialization of microfluidic tools are opening up new opportunities for the engineering and evaluation of drug delivery particles. Copyright © 2014 Elsevier B.V. All rights reserved.

20 CFR 662.430 - Under what conditions may One-Stop operators designated to operate in a One-Stop delivery system...

Code of Federal Regulations, 2013 CFR

2013-04-01

... designated to operate in a One-Stop delivery system established prior to the enactment of WIA be designated... (CONTINUED) DESCRIPTION OF THE ONE-STOP SYSTEM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT One-Stop Operators § 662.430 Under what conditions may One-Stop operators designated to operate in a One-Stop...

20 CFR 662.430 - Under what conditions may One-Stop operators designated to operate in a One-Stop delivery system...

Code of Federal Regulations, 2014 CFR

2014-04-01

... designated to operate in a One-Stop delivery system established prior to the enactment of WIA be designated... (CONTINUED) DESCRIPTION OF THE ONE-STOP SYSTEM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT One-Stop Operators § 662.430 Under what conditions may One-Stop operators designated to operate in a One-Stop...

20 CFR 662.430 - Under what conditions may One-Stop operators designated to operate in a One-Stop delivery system...

Code of Federal Regulations, 2012 CFR

2012-04-01

... designated to operate in a One-Stop delivery system established prior to the enactment of WIA be designated... (CONTINUED) DESCRIPTION OF THE ONE-STOP SYSTEM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT One-Stop Operators § 662.430 Under what conditions may One-Stop operators designated to operate in a One-Stop...

Realistic modeling of neurons and networks: towards brain simulation.

PubMed

D'Angelo, Egidio; Solinas, Sergio; Garrido, Jesus; Casellato, Claudia; Pedrocchi, Alessandra; Mapelli, Jonathan; Gandolfi, Daniela; Prestori, Francesca

2013-01-01

Realistic modeling is a new advanced methodology for investigating brain functions. Realistic modeling is based on a detailed biophysical description of neurons and synapses, which can be integrated into microcircuits. The latter can, in turn, be further integrated to form large-scale brain networks and eventually to reconstruct complex brain systems. Here we provide a review of the realistic simulation strategy and use the cerebellar network as an example. This network has been carefully investigated at molecular and cellular level and has been the object of intense theoretical investigation. The cerebellum is thought to lie at the core of the forward controller operations of the brain and to implement timing and sensory prediction functions. The cerebellum is well described and provides a challenging field in which one of the most advanced realistic microcircuit models has been generated. We illustrate how these models can be elaborated and embedded into robotic control systems to gain insight into how the cellular properties of cerebellar neurons emerge in integrated behaviors. Realistic network modeling opens up new perspectives for the investigation of brain pathologies and for the neurorobotic field.

Realistic modeling of neurons and networks: towards brain simulation

PubMed Central

D’Angelo, Egidio; Solinas, Sergio; Garrido, Jesus; Casellato, Claudia; Pedrocchi, Alessandra; Mapelli, Jonathan; Gandolfi, Daniela; Prestori, Francesca

Summary Realistic modeling is a new advanced methodology for investigating brain functions. Realistic modeling is based on a detailed biophysical description of neurons and synapses, which can be integrated into microcircuits. The latter can, in turn, be further integrated to form large-scale brain networks and eventually to reconstruct complex brain systems. Here we provide a review of the realistic simulation strategy and use the cerebellar network as an example. This network has been carefully investigated at molecular and cellular level and has been the object of intense theoretical investigation. The cerebellum is thought to lie at the core of the forward controller operations of the brain and to implement timing and sensory prediction functions. The cerebellum is well described and provides a challenging field in which one of the most advanced realistic microcircuit models has been generated. We illustrate how these models can be elaborated and embedded into robotic control systems to gain insight into how the cellular properties of cerebellar neurons emerge in integrated behaviors. Realistic network modeling opens up new perspectives for the investigation of brain pathologies and for the neurorobotic field. PMID:24139652

Liposomal systems as viable drug delivery technology for skin cancer sites with an outlook on lipid-based delivery vehicles and diagnostic imaging inputs for skin conditions'.

PubMed

Akhtar, Naseem; Khan, Riaz A

2016-10-01

Skin cancer is among one of the most common human malignancies wide-spread world-over with mortality statistics rising continuously at an alarming rate. The increasing frequency of these malignancies has marked the need for adopting effective treatment plan coupled with better and site-specific delivery options for the desired therapeutic agent's availability at the affected site. The concurrent delivery approaches to cancerous tissues are under constant challenge and, as a result, are evolving and gaining advancements in terms of delivery modes, therapeutic agents and site-specificity of the therapeutics delivery. The lipid-based liposomal drug delivery is an attractive and emerging option, and which is meticulously shaping up beyond a threshold level to a promising, and viable route for the effective delivery of therapeutic agents and other required injuctions to the skin cancer. An update on liposomal delivery of chemotherapeutic agents, natural-origin compounds, photosensitizer, and DNA repair enzymes as well as other desirable and typical delivery modes employed in drug delivery and in the treatment of skin cancers is discussed in details. Moreover, liposomal delivery of nucleic acid-based therapeutics, i.e., small interfering RNA (siRNA), mRNA therapy, and RGD-linked liposomes are among the other promising novel technology under constant development. The current clinical applicability, viable clinical plans, future prospects including transport feasibility of delivery vesicles and imaging techniques in conjunction with the therapeutic agents is also discussed. The ongoing innovations in liposomal drug delivery technology for skin cancers hold promise for further development of the methodology for better, more effective and site-specific delivery as part of the better treatment plan by ensuring faster drug transport, better and full payload delivery with enough and required concentration of the dose. Copyright © 2016 Elsevier B.V. All rights reserved.

Case management in primary care among frequent users of healthcare services with chronic conditions: protocol of a realist synthesis.

PubMed

Hudon, Catherine; Chouinard, Maud-Christine; Aubrey-Bassler, Kris; Muhajarine, Nazeem; Burge, Fred; Pluye, Pierre; Bush, Paula L; Ramsden, Vivian R; Legare, France; Guenette, Line; Morin, Paul; Lambert, Mireille; Groulx, Antoine; Couture, Martine; Campbell, Cameron; Baker, Margaret; Edwards, Lynn; Sabourin, Véronique; Spence, Claude; Gauthier, Gilles; Warren, Mike; Godbout, Julie; Davis, Breanna; Rabbitskin, Norma

2017-09-03

A common reason for frequent use of healthcare services is the complex healthcare needs of individuals suffering from multiple chronic conditions, especially in combination with mental health comorbidities and/or social vulnerability. Frequent users (FUs) of healthcare services are more at risk for disability, loss of quality of life and mortality. Case management (CM) is a promising intervention to improve care integration for FU and to reduce healthcare costs. This review aims to develop a middle-range theory explaining how CM in primary care improves outcomes among FU with chronic conditions, for what types of FU and in what circumstances. A realist synthesis (RS) will be conducted between March 2017 and March 2018 to explore the causal mechanisms that underlie CM and how contextual factors influence the link between these causal mechanisms and outcomes. According to RS methodology, five steps will be followed: (1) focusing the scope of the RS; (2) searching for the evidence; (3) appraising the quality of evidence; (4) extracting the data; and (5) synthesising the evidence. Patterns in context-mechanism-outcomes (CMOs) configurations will be identified, within and across identified studies. Analysis of CMO configurations will help confirm, refute, modify or add to the components of our initial rough theory and ultimately produce a refined theory explaining how and why CM interventions in primary care works, in which contexts and for which FU with chronic conditions. Research ethics is not required for this review, but publication guidelines on RS will be followed. Based on the review findings, we will develop and disseminate messages tailored to various relevant stakeholder groups. These messages will allow the development of material that provides guidance on the design and the implementation of CM in health organisations. Prospero CRD42017057753. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

A Radiosity Approach to Realistic Image Synthesis

DTIC Science & Technology

1992-12-01

AD-A259 082 AFIT/GCE/ENG/92D-09 A RADIOSITY APPROACH TO REALISTIC IMAGE SYNTHESIS THESIS Richard L. Remington Captain, USAF fl ECTE AFIT/GCE/ENG/92D...09 SJANl 1993U 93-00134 Approved for public release; distribution unlimited 93& 1! A -A- AFIT/GCE/ENG/92D-09 A RADIOSITY APPROACH TO REALISTIC IMAGE...assistance in creating the input geometry file for the AWACS aircraft interior. Without his assistance, a good model for the diffuse radiosity implementation

Factors contributing to the effectiveness of physical activity counselling in primary care: a realist systematic review.

PubMed

Gagliardi, Anna R; Abdallah, Flavia; Faulkner, Guy; Ciliska, Donna; Hicks, Audrey

2015-04-01

Physical activity (PA) counselling in primary care increases PA but is not consistently practiced. This study examined factors that optimise the delivery and impact of PA counselling. A realist systematic review based on the PRECEDE-PROCEED model and RAMESES principles was conducted to identify essential components of PA counselling. MEDLINE, EMBASE, Cochrane Library, PsycINFO, and Physical Education Index were searched from 2000 to 2013 for studies that evaluated family practice PA counselling. Of 1546 articles identified, 10 were eligible for review (3 systematic reviews, 5 randomised controlled trials, 2 observational studies). Counselling provided by clinicians or counsellors alone that explored motivation increased self-reported PA at least 12 months following intervention. Multiple sessions may sustain increased PA beyond 12 months. Given the paucity of eligible studies and limited detail reported about interventions, further research is needed to establish the optimal design and delivery of PA counselling. Research and planning should consider predisposing, reinforcing and enabling design features identified in these studies. Since research shows that PA counselling promotes PA but is not widely practiced, primary care providers will require training and tools to operationalize PA counselling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Assessment of tbe Performance of Ablative Insulators Under Realistic Solid Rocket Motor Operating Conditions (a Doctoral Dissertation)

NASA Technical Reports Server (NTRS)

Martin, Heath Thomas

2013-01-01

Ablative insulators are used in the interior surfaces of solid rocket motors to prevent the mechanical structure of the rocket from failing due to intense heating by the high-temperature solid-propellant combustion products. The complexity of the ablation process underscores the need for ablative material response data procured from a realistic solid rocket motor environment, where all of the potential contributions to material degradation are present and in their appropriate proportions. For this purpose, the present study examines ablative material behavior in a laboratory-scale solid rocket motor. The test apparatus includes a planar, two-dimensional flow channel in which flat ablative material samples are installed downstream of an aluminized solid propellant grain and imaged via real-time X-ray radiography. In this way, the in-situ transient thermal response of an ablator to all of the thermal, chemical, and mechanical erosion mechanisms present in a solid rocket environment can be observed and recorded. The ablative material is instrumented with multiple micro-thermocouples, so that in-depth temperature histories are known. Both total heat flux and thermal radiation flux gauges have been designed, fabricated, and tested to characterize the thermal environment to which the ablative material samples are exposed. These tests not only allow different ablative materials to be compared in a realistic solid rocket motor environment but also improve the understanding of the mechanisms that influence the erosion behavior of a given ablative material.

A gastro-resistant ovalbumin bi-layered mini-tablet-in-tablet system for the delivery of Lactobacillus acidophilus probiotic to simulated human intestinal and colon conditions.

PubMed

Govender, Mershen; Choonara, Yahya Essop; van Vuuren, Sandy; Kumar, Pradeep; du Toit, Lisa Claire; Pillay, Viness

2015-07-01

The viability of probiotic bacteria during formulation processes and delivery is vital to ensure health benefits. This study focuses on the use of gastro-resistant denatured ovalbumin for the targeted delivery of probiotic Lactobacillus acidophilus to simulated human intestinal and colon conditions through a bi-layered mini-tablet-in-tablet system (BMTTS). The BMTTS consists of two gastro-resistant ovalbumin mini-tablets containing L. acidophilus suspended in lactose and eudragit S100 for targeted intestinal and colonic delivery respectively. Luminescence has been utilized to ensure probiotic viability during formulation processes in addition to determining all probiotic release profiles. The mechanism of probiotic release from the ovalbumin matrix was ascertained using mathematical modelling and molecular docking studies. Magnetic resonance imaging and differential scanning calorimetry are also included as part of the in-vitro characterization of the ovalbumin system. The BMTTS was effective in the delivery of L. acidophilus to simulated human intestinal and colon conditions. Formulation processes were furthermore determined to maintain probiotic viability. Statistical analysis of the release data noted a significant effect of pH denaturation on the release properties of ovalbumin. Magnetic resonance imaging results have indicated a decrease in ovalbumin matrix size upon exposure to simulated intestinal fluid. Molecular docking studies carried out depicted the interaction and binding positions inherent to the ovalbumin-pancreatic trypsin interaction complex indicating the possible enzymatic degradation of ovalbumin leading to the release of the probiotic from the protein matrix. The BMTTS has been determined to be effective in the protection and delivery of probiotic L. acidophilus to simulated human intestinal and colonic conditions. Molecular docking analysis has noted that pancreatin exerts a significant effect on probiotic release from the gastro

Special problems in aerosol delivery: neonatal and pediatric considerations.

PubMed

Cole, C H

2000-06-01

if we had a clear understanding of the efficiency and functional differences among the various drugs and devices. These are substantive issues with daily therapeutic impact that have received increasingly outspoken concern over the past decade by aerosol scientists and clinicians. These issues must be given due attention by drug and device manufacturers as well as by regulatory agencies. The medication, the device, and the conditions under which they are tested must be considered together and studied as thoroughly as the medications themselves with respect to total output and particle size distribution. As noted by Bisgaard, medication dose recommendations are useless unless the device and technique used are specified. Medication dose recommendation could be facilitated by setting equivalent standards for generic and brand-name medications and devices. In addition, standardization of in vitro models with better replicas of infants' and children's anatomy (oropharynx, upper airways), and better in vitro lung models, plus utilization of realistic breathing patterns of infants and children will improve in vitro prediction of the in vivo dose delivered to lower airways. This would greatly facilitate selection of delivery systems under specific circumstances for infants and children of various ages). Safety profile, therapeutic efficacy, and efficiency of aerosolized medications delivered to infants and children need to be rigorously studied. This is particularly true for medications with potentially great benefit but possible adverse effects, such as inhaled glucocorticoid therapy in extremely premature infants. Common sense, ethics, and due respect for the same high standard of approval requirements of adults and older children should motivate further research in understanding and improving aerosol delivery in infants and young children.

Interprofessional education in a student-led emergency department: A realist evaluation.

PubMed

Ericson, Anne; Löfgren, Susanne; Bolinder, Gunilla; Reeves, Scott; Kitto, Simon; Masiello, Italo

2017-03-01

This article reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations, and questionnaires to study what worked, for whom, and under what circumstances in this specific interprofessional setting. The study participants were medical, nursing, and physiotherapy students, their supervisors, and two members of the emergency department's management staff. The data analysis indicated that the emergency ward provided an excellent environment for interprofessional education (IPE), as attested by the students, supervisors, and the clinical managers. An essential prerequisite is that the students have obtained adequate skills to work independently. Exemplary conditions for IPE to work well in an emergency department demand the continuity of effective and encouraging supervision throughout the training period and supervisors who are knowledgeable about developing a team.

Steering Microbubbles in Physiologically Realistic Flows Using the Bjerknes Force

NASA Astrophysics Data System (ADS)

Clark, Alicia; Aliseda, Alberto

2017-11-01

Ultrasound contrast agents (UCAs) are lipid-coated microbubbles that are used to increase contrast in ultrasound imaging due to their ability to scatter sound. Additionally, UCAs can be used in conjunction with ultrasound in medical applications such as targeted drug delivery and thrombolysis. These applications utilize the Bjerknes force, an ultrasound-induced force caused by the phase difference between the incoming ultrasound pressure wave and the microbubble volume oscillations. The dynamics of microbubbles under ultrasound excitation have been studied thoroughly in stagnant fluid baths; however, understanding of the fundamental physics of microbubbles in physiologically realistic flows is lacking. An in vitroexperiment that reproduces the dynamics (Reynolds and Womersley numbers) of a medium-sized blood vessel was used to explore the behavior of microbubbles. Using Lagrangian tracking, the trajectory of each individual bubble was reconstructed using information obtained from high speed imaging. The balance of hydrodynamic forces (lift, drag, added mass, etc.) against the primary Bjerknes force was analyzed. The results show that an increase in ultrasound pulse repetition frequency leads to a linear increase in the Bjerknes force and the increase in the force is quadratic with the amplitude of the excitation.

Survey of Approaches to Generate Realistic Synthetic Graphs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lim, Seung-Hwan; Lee, Sangkeun; Powers, Sarah S

A graph is a flexible data structure that can represent relationships between entities. As with other data analysis tasks, the use of realistic graphs is critical to obtaining valid research results. Unfortunately, using the actual ("real-world") graphs for research and new algorithm development is difficult due to the presence of sensitive information in the data or due to the scale of data. This results in practitioners developing algorithms and systems that employ synthetic graphs instead of real-world graphs. Generating realistic synthetic graphs that provide reliable statistical confidence to algorithmic analysis and system evaluation involves addressing technical hurdles in a broadmore » set of areas. This report surveys the state of the art in approaches to generate realistic graphs that are derived from fitted graph models on real-world graphs.« less

Quality control procedures for dynamic treatment delivery techniques involving couch motion.

PubMed

Yu, Victoria Y; Fahimian, Benjamin P; Xing, Lei; Hristov, Dimitre H

2014-08-01

In this study, the authors introduce and demonstrate quality control procedures for evaluating the geometric and dosimetric fidelity of dynamic treatment delivery techniques involving treatment couch motion synchronous with gantry and multileaf collimator (MLC). Tests were designed to evaluate positional accuracy, velocity constancy and accuracy for dynamic couch motion under a realistic weight load. A test evaluating the geometric accuracy of the system in delivering treatments over complex dynamic trajectories was also devised. Custom XML scripts that control the Varian TrueBeam™ STx (Serial #3) axes in Developer Mode were written to implement the delivery sequences for the tests. Delivered dose patterns were captured with radiographic film or the electronic portal imaging device. The couch translational accuracy in dynamic treatment mode was 0.01 cm. Rotational accuracy was within 0.3°, with 0.04 cm displacement of the rotational axis. Dose intensity profiles capturing the velocity constancy and accuracy for translations and rotation exhibited standard deviation and maximum deviations below 3%. For complex delivery involving MLC and couch motions, the overall translational accuracy for reproducing programmed patterns was within 0.06 cm. The authors conclude that in Developer Mode, TrueBeam™ is capable of delivering dynamic treatment delivery techniques involving couch motion with good geometric and dosimetric fidelity.

Designing field-controllable graphene-dot-graphene single molecule switches: A quantum-theoretical proof-of-concept under realistic operating conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pejov, Ljupčo, E-mail: ljupcop@pmf.ukim.mk; Petreska, Irina; Kocarev, Ljupčo

2015-12-28

A theoretical proof of the concept that a particularly designed graphene-based moletronics device, constituted by two semi-infinite graphene subunits, acting as source and drain electrodes, and a central benzenoid ring rotator (a “quantum dot”), could act as a field-controllable molecular switch is outlined and analyzed with the density functional theory approach. Besides the ideal (0 K) case, we also consider the operation of such a device under realistic operating (i.e., finite-temperature) conditions. An in-depth insight into the physics behind device controllability by an external field was gained by thorough analyses of the torsional potential of the dot under various conditionsmore » (absence or presence of an external gating field with varying strength), computing the torsional correlation time and transition probabilities within the Bloembergen-Purcell-Pound formalism. Both classical and quantum mechanical tunneling contributions to the intramolecular rotation were considered in the model. The main idea that we put forward in the present study is that intramolecular rotors can be controlled by the gating field even in cases when these groups do not possess a permanent dipole moment (as in cases considered previously by us [I. Petreska et al., J. Chem. Phys. 134, 014708-1–014708-12 (2011)] and also by other groups [P. E. Kornilovitch et al., Phys. Rev. B 66, 245413-1–245413-7 (2002)]). Consequently, one can control the molecular switching properties by an external electrostatic field utilizing even nonpolar intramolecular rotors (i.e., in a more general case than those considered so far). Molecular admittance of the currently considered graphene-based molecular switch under various conditions is analyzed employing non-equilibrium Green’s function formalism, as well as by analysis of frontier molecular orbitals’ behavior.« less

Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

PubMed

Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

2017-11-01

Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents

A Low-cost System for Generating Near-realistic Virtual Actors

NASA Astrophysics Data System (ADS)

Afifi, Mahmoud; Hussain, Khaled F.; Ibrahim, Hosny M.; Omar, Nagwa M.

2015-06-01

Generating virtual actors is one of the most challenging fields in computer graphics. The reconstruction of a realistic virtual actor has been paid attention by the academic research and the film industry to generate human-like virtual actors. Many movies were acted by human-like virtual actors, where the audience cannot distinguish between real and virtual actors. The synthesis of realistic virtual actors is considered a complex process. Many techniques are used to generate a realistic virtual actor; however they usually require expensive hardware equipment. In this paper, a low-cost system that generates near-realistic virtual actors is presented. The facial features of the real actor are blended with a virtual head that is attached to the actor's body. Comparing with other techniques that generate virtual actors, the proposed system is considered a low-cost system that requires only one camera that records the scene without using any expensive hardware equipment. The results of our system show that the system generates good near-realistic virtual actors that can be used on many applications.

Problem Posing with Realistic Mathematics Education Approach in Geometry Learning

NASA Astrophysics Data System (ADS)

Mahendra, R.; Slamet, I.; Budiyono

2017-09-01

One of the difficulties of students in the learning of geometry is on the subject of plane that requires students to understand the abstract matter. The aim of this research is to determine the effect of Problem Posing learning model with Realistic Mathematics Education Approach in geometry learning. This quasi experimental research was conducted in one of the junior high schools in Karanganyar, Indonesia. The sample was taken using stratified cluster random sampling technique. The results of this research indicate that the model of Problem Posing learning with Realistic Mathematics Education Approach can improve students’ conceptual understanding significantly in geometry learning especially on plane topics. It is because students on the application of Problem Posing with Realistic Mathematics Education Approach are become to be active in constructing their knowledge, proposing, and problem solving in realistic, so it easier for students to understand concepts and solve the problems. Therefore, the model of Problem Posing learning with Realistic Mathematics Education Approach is appropriately applied in mathematics learning especially on geometry material. Furthermore, the impact can improve student achievement.

Impact of age-related macular degeneration on object searches in realistic panoramic scenes.

PubMed

Thibaut, Miguel; Tran, Thi-Ha-Chau; Szaffarczyk, Sebastien; Boucart, Muriel

2018-05-01

This study investigated whether realistic immersive conditions with dynamic indoor scenes presented on a large, hemispheric panoramic screen covering 180° of the visual field improved the visual search abilities of participants with age-related macular degeneration (AMD). Twenty-one participants with AMD, 16 age-matched controls and 16 young observers were included. Realistic indoor scenes were presented on a panoramic five metre diameter screen. Twelve different objects were used as targets. The participants were asked to search for a target object, shown on paper before each trial, within a room composed of various objects. A joystick was used for navigation within the scene views. A target object was present in 24 trials and absent in 24 trials. The percentage of correct detection of the target, the percentage of false alarms (that is, the detection of the target when it was absent), the number of scene views explored and the search time were measured. The search time was slower for participants with AMD than for the age-matched controls, who in turn were slower than the young participants. The participants with AMD were able to accomplish the task with a performance of 75 per cent correct detections. This was slightly lower than older controls (79.2 per cent) while young controls were at ceiling (91.7 per cent). Errors were mainly due to false alarms resulting from confusion between the target object and another object present in the scene in the target-absent trials. The outcomes of the present study indicate that, under realistic conditions, although slower than age-matched, normally sighted controls, participants with AMD were able to accomplish visual searches of objects with high accuracy. © 2017 Optometry Australia.

SMART-DS: Synthetic Models for Advanced, Realistic Testing: Distribution

Science.gov Websites

statistical summary of the U.S. distribution systems World-class, high spatial/temporal resolution of solar Systems and Scenarios | Grid Modernization | NREL SMART-DS: Synthetic Models for Advanced , Realistic Testing: Distribution Systems and Scenarios SMART-DS: Synthetic Models for Advanced, Realistic

A full potential flow analysis with realistic wake influence for helicopter rotor airload prediction

NASA Technical Reports Server (NTRS)

Egolf, T. Alan; Sparks, S. Patrick

1987-01-01

A 3-D, quasi-steady, full potential flow solver was adapted to include realistic wake influence for the aerodynamic analysis of helicopter rotors. The method is based on a finite difference solution of the full potential equation, using an inner and outer domain procedure for the blade flowfield to accommodate wake effects. The nonlinear flow is computed in the inner domain region using a finite difference solution method. The wake is modeled by a vortex lattice using prescribed geometry techniques to allow for the inclusion of realistic rotor wakes. The key feature of the analysis is that vortices contained within the finite difference mesh (inner domain) were treated with a vortex embedding technique while the influence of the remaining portion of the wake (in the outer domain) is impressed as a boundary condition on the outer surface of the finite difference mesh. The solution procedure couples the wake influence with the inner domain solution in a consistent and efficient solution process. The method has been applied to both hover and forward flight conditions. Correlation with subsonic and transonic hover airload data is shown which demonstrates the merits of the approach.

Protocol: developing a conceptual framework of patient mediated knowledge translation, systematic review using a realist approach.

PubMed

Gagliardi, Anna R; Légaré, France; Brouwers, Melissa C; Webster, Fiona; Wiljer, David; Badley, Elizabeth; Straus, Sharon

2011-03-22

Patient involvement in healthcare represents the means by which to achieve a healthcare system that is responsive to patient needs and values. Characterization and evaluation of strategies for involving patients in their healthcare may benefit from a knowledge translation (KT) approach. The purpose of this knowledge synthesis is to develop a conceptual framework for patient-mediated KT interventions. A preliminary conceptual framework for patient-mediated KT interventions was compiled to describe intended purpose, recipients, delivery context, intervention, and outcomes. A realist review will be conducted in consultation with stakeholders from the arthritis and cancer fields to explore how these interventions work, for whom, and in what contexts. To identify patient-mediated KT interventions in these fields, we will search MEDLINE, the Cochrane Library, and EMBASE from 1995 to 2010; scan references of all eligible studies; and examine five years of tables of contents for journals likely to publish quantitative or qualitative studies that focus on developing, implementing, or evaluating patient-mediated KT interventions. Screening and data collection will be performed independently by two individuals. The conceptual framework of patient-mediated KT options and outcomes could be used by healthcare providers, managers, educationalists, patient advocates, and policy makers to guide program planning, service delivery, and quality improvement and by us and other researchers to evaluate existing interventions or develop new interventions. By raising awareness of options for involving patients in improving their own care, outcomes based on using a KT approach may lead to greater patient-centred care delivery and improved healthcare outcomes.

Protocol: developing a conceptual framework of patient mediated knowledge translation, systematic review using a realist approach

PubMed Central

2011-01-01

Background Patient involvement in healthcare represents the means by which to achieve a healthcare system that is responsive to patient needs and values. Characterization and evaluation of strategies for involving patients in their healthcare may benefit from a knowledge translation (KT) approach. The purpose of this knowledge synthesis is to develop a conceptual framework for patient-mediated KT interventions. Methods A preliminary conceptual framework for patient-mediated KT interventions was compiled to describe intended purpose, recipients, delivery context, intervention, and outcomes. A realist review will be conducted in consultation with stakeholders from the arthritis and cancer fields to explore how these interventions work, for whom, and in what contexts. To identify patient-mediated KT interventions in these fields, we will search MEDLINE, the Cochrane Library, and EMBASE from 1995 to 2010; scan references of all eligible studies; and examine five years of tables of contents for journals likely to publish quantitative or qualitative studies that focus on developing, implementing, or evaluating patient-mediated KT interventions. Screening and data collection will be performed independently by two individuals. Conclusions The conceptual framework of patient-mediated KT options and outcomes could be used by healthcare providers, managers, educationalists, patient advocates, and policy makers to guide program planning, service delivery, and quality improvement and by us and other researchers to evaluate existing interventions or develop new interventions. By raising awareness of options for involving patients in improving their own care, outcomes based on using a KT approach may lead to greater patient-centred care delivery and improved healthcare outcomes. PMID:21426573

Predicting clinical image delivery time by monitoring PACS queue behavior.

PubMed

King, Nelson E; Documet, Jorge; Liu, Brent

2006-01-01

The expectation of rapid image retrieval from PACS users contributes to increased information technology (IT) infrastructure investments to increase performance as well as continuing demands upon PACS administrators to respond to "slow" system performance. The ability to provide predicted delivery times to a PACS user may curb user expectations for "fastest" response especially during peak hours. This, in turn, could result in a PACS infrastructure tailored to more realistic performance demands. A PACS with a stand-alone architecture under peak load typically holds study requests in a queue until the DICOM C-Move command can take place. We investigate the contents of a stand-alone architecture PACS RetrieveSend queue and identified parameters and behaviors that enable a more accurate prediction of delivery time. A prediction algorithm for studies delayed in a stand-alone PACS queue can be extendible to other potential bottlenecks such as long-term storage archives. Implications of a queue monitor in other PACS architectures are also discussed.

Time management: a realistic approach.

PubMed

Jackson, Valerie P

2009-06-01

Realistic time management and organization plans can improve productivity and the quality of life. However, these skills can be difficult to develop and maintain. The key elements of time management are goals, organization, delegation, and relaxation. The author addresses each of these components and provides suggestions for successful time management.

Mathematical modeling in realistic mathematics education

NASA Astrophysics Data System (ADS)

Riyanto, B.; Zulkardi; Putri, R. I. I.; Darmawijoyo

2017-12-01

The purpose of this paper is to produce Mathematical modelling in Realistics Mathematics Education of Junior High School. This study used development research consisting of 3 stages, namely analysis, design and evaluation. The success criteria of this study were obtained in the form of local instruction theory for school mathematical modelling learning which was valid and practical for students. The data were analyzed using descriptive analysis method as follows: (1) walk through, analysis based on the expert comments in the expert review to get Hypothetical Learning Trajectory for valid mathematical modelling learning; (2) analyzing the results of the review in one to one and small group to gain practicality. Based on the expert validation and students’ opinion and answers, the obtained mathematical modeling problem in Realistics Mathematics Education was valid and practical.

Toxicokinetics of perfluorooctane sulfonate in birds under environmentally realistic exposure conditions and development of a kinetic predictive model.

PubMed

Tarazona, J V; Rodríguez, C; Alonso, E; Sáez, M; González, F; San Andrés, M D; Jiménez, B; San Andrés, M I

2015-01-22

This article describes the toxicokinetics of perfluorooctane sulfonate (PFOS) in birds under low repeated dosing, equivalent to 0.085 μg/kg per day, representing environmentally realistic exposure conditions. The best fitting was provided by a simple pseudo monocompartmental first-order kinetics model, regulated by two rates, with a pseudo first-order dissipation half-life of 230 days, accounting for real elimination as well as binding of PFOS to non-exchangeable structures. The calculated assimilation efficiency was 0.66 with confidence intervals of 0.64 and 0.68. The model calculations confirmed that the measured maximum concentrations were still far from the steady state situation, which for this dose regime, was estimated at a value of about 65 μg PFOS/L serum achieved after a theoretical 210 weeks continuous exposure. The results confirm a very different kinetics than that observed in single-dose experiments confirming clear dose-related differences in apparent elimination rates in birds, as described for humans and monkeys; suggesting that a capacity-limited saturable process should also be considered in the kinetic behavior of PFOS in birds. Pseudo first-order kinetic models are highly convenient and frequently used for predicting bioaccumulation of chemicals in livestock and wildlife; the study suggests that previous bioaccumulation models using half-lives obtained at high doses are expected to underestimate the biomagnification potential of PFOS. The toxicokinetic parameters presented here can be used for higher-tier bioaccumulation estimations of PFOS in chickens and as surrogate values for modeling PFOS kinetics in wild bird species. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[The role of informal care in individualized care plan delivery: a conditional choice for dependent people].

PubMed

Del Pozo Rubio, Raúl; Escribano Sotos, Francisco; Moya Martínez, Pablo

2011-12-01

To analyze the relationship between sociodemographic and health variables (including informal care) and the healthcare service delivery assigned in the individualized care plan. An observational cross-sectional study was conducted in a representative sample of the dependent population in Cuenca (Spain) in February, 2009. Information was obtained on people with level II and III dependency. Four different logistic regression models were used to identify the factors associated with the care service delivery assigned in the individualized care plan. Independent variables consisted of age, gender, marital status, annual income, place of residence, health conditions, medical treatment, and perception of informal care. A total of 83.7% of the sample was assigned economic benefits and 15.3% were assigned services. Eighty percent of the sample received informal care in addition to dependency benefits. People who received informal care were 3239 times more likely to be assigned economic benefits than persons not receiving informal care. For the period analyzed (the first phase of the implementation of the Dependency Act), the variables associated with receiving economic benefits (versus services) were being married, having a high annual income, the place of residence (rural areas versus urban area), and receiving hygiene-dietary treatment and informal care. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Mechanical stabilization of the Levitron's realistic model

NASA Astrophysics Data System (ADS)

Olvera, Arturo; De la Rosa, Abraham; Giordano, Claudia M.

2016-11-01

The stability of the magnetic levitation showed by the Levitron was studied by M.V. Berry as a six degrees of freedom Hamiltonian system using an adiabatic approximation. Further, H.R. Dullin found critical spin rate bounds where the levitation persists and R.F. Gans et al. offered numerical results regarding the initial conditions' manifold where this occurs. In the line of this series of works, first, we extend the equations of motion to include dissipation for a more realistic model, and then introduce a mechanical forcing to inject energy into the system in order to prevent the Levitron from falling. A systematic study of the flying time as a function of the forcing parameters is carried out which yields detailed bifurcation diagrams showing an Arnold's tongues structure. The stability of these solutions were studied with the help of a novel method to compute the maximum Lyapunov exponent called MEGNO. The bifurcation diagrams for MEGNO reproduce the same Arnold's tongue structure.

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

PubMed

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2014-01-01

To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013

Disparity profiles in 3DV applications: overcoming the issue of heterogeneous viewing conditions in stereoscopic delivery

NASA Astrophysics Data System (ADS)

Boisson, Guillaume; Chamaret, Christel

2012-03-01

More and more numerous 3D movies are released each year. Thanks to the current spread of 3D-TV displays, these 3D Video (3DV) contents are about to enter massively the homes. Yet viewing conditions determine the stereoscopic features achievable for 3DV material. Because the conditions at home - screen size and distance to screen - differ significantly from a theater, 3D Cinema movies need to be repurposed before broadcast and replication on 3D Blu-ray Discs for being fully enjoyed at home. In that paper we tackle that particular issue of how to handle the variety of viewing conditions in stereoscopic contents delivery. To that extend we first investigate what is basically at stake for granting stereoscopic viewers' comfort, through the well-known - and sometimes dispraised - vergence-accommodation conflict. Thereby we define a set of basic rules that can serve as guidelines for 3DV creation. We propose disparity profiles as new requirements for 3DV production and repurposing. Meeting proposed background and foreground constraints prevents from visual fatigue, and occupying the whole depth budget available grants optimal 3D effects. We present an efficient algorithm for automatic disparity-based 3DV retargeting depending on the viewing conditions. Variants are proposed depending on the input format (stereoscopic binocular content or depth-based format) and the level of complexity achievable.

Convective aggregation in realistic convective-scale simulations

NASA Astrophysics Data System (ADS)

Holloway, Christopher E.

2017-06-01

To investigate the real-world relevance of idealized-model convective self-aggregation, five 15 day cases of real organized convection in the tropics are simulated. These include multiple simulations of each case to test sensitivities of the convective organization and mean states to interactive radiation, interactive surface fluxes, and evaporation of rain. These simulations are compared to self-aggregation seen in the same model configured to run in idealized radiative-convective equilibrium. Analysis of the budget of the spatial variance of column-integrated frozen moist static energy shows that control runs have significant positive contributions to organization from radiation and negative contributions from surface fluxes and transport, similar to idealized runs once they become aggregated. Despite identical lateral boundary conditions for all experiments in each case, systematic differences in mean column water vapor (CWV), CWV distribution shape, and CWV autocorrelation length scale are found between the different sensitivity runs, particularly for those without interactive radiation, showing that there are at least some similarities in sensitivities to these feedbacks in both idealized and realistic simulations (although the organization of precipitation shows less sensitivity to interactive radiation). The magnitudes and signs of these systematic differences are consistent with a rough equilibrium between (1) equalization due to advection from the lateral boundaries and (2) disaggregation due to the absence of interactive radiation, implying disaggregation rates comparable to those in idealized runs with aggregated initial conditions and noninteractive radiation. This points to a plausible similarity in the way that radiation feedbacks maintain aggregated convection in both idealized simulations and the real world.