Genetic Optimization and Simulation of a Piezoelectric Pipe-Crawling Inspection Robot

Using the DarwinZk development software, a genetic algorithm (GA) was used to design and optimize a pipe-crawling robot for parameters such as mass, power consumption, and joint extension to further the research of the Miniature Inspection Systems Technology (MIST) team. In an attempt to improve on existing designs, a new robot was developed, the piezo robot. The final proposed design uses piezoelectric expansion actuators to move the robot with a 'chimneying' method employed by mountain climbers and greatly improves on previous designs in load bearing ability, pipe traversing specifications, and field usability. This research shows the advantages of GA assisted design in the field of robotics

A New Model for Assessing Teaching Quality Improvement to Family Medicine Residents: Does It Work?

Objective: To develop and implement a formal didactics and experiential curriculum to train Family Medicine (FM) residents in Quality Improvement (QI) knowledge and skills. Method: 1) All FM faculty participated in seven workshops on QI theory and design. 2) All second year residents received a day-long workshop on knowledge and skills of QI and conducted QI projects for up to two years. Results: Knowledge and confidence scores significantly improved following training,

Does Structured Quality Improvement Training for Residents Increase QI in Practice?

East Tennessee State University implemented quality improvement (QI) training for second-year family medicine residents in 2009. Results in 2011 indicated training increased scores in QI skill assessments as well as self-efficacy in QI. With residents who completed the training now in practice, does the increase in knowledge and skill translate to increased QI in practice? A survey of graduates compares frequency of QI cycles and self-assessment of QI skills among graduating classes, those receiving QI training and those graduating before training began. Residents that completed the QI curriculum rated their training higher; however residents that did not receive training were more involved in QI in practice. We suggest that this is due to QI involvement increasing with practice. Results will guide curriculum improvements to strengthen future resident training

Integrated Care in Rural Health: Seeking Sustainability

The increased awareness of the financial impact associated with social determinants of health coincides with expectations of the Affordable Care Act (HR 3590) to improve care while reducing costs. The integration of behavioral health providers (BHPs) into primary care has demonstrated improved clinical outcomes. This study was designed with 2 aims, including the evaluation of the financial viability of an integrated care model in a rural setting and the demonstration of incorporating practice-based research into clinical work. Method: A rural health plan caring for 22,000 members funded a pilot project placing BHPs in 3 clinics to provide integrated care. Patient utilization of medical services for 6 months following BHP services was compared with baseline utilization. Results: The BHPs treated 256 unique patients, with a total of 459 consultations. The percentage of patients receiving BHP services varied between clinics (Clinic A = 1.4%, Clinic B = 2.7%, and Clinic C = 3.9%). A between-clinic analysis showed differences in medical claims data between baseline and post-BH services. The overall effect sizes for reduced medical utilization for patients at clinics B and C were very large, Hedge’s g=-2.31 and -4.79, respectively. Utilization of 4 of the services (emergency, lab, outpatient, and primary care) showed the large reductions in their costs. In contrast, the data for Clinic A showed no change. Discussion: Patients receiving behavioral health services within the integrated care model may decrease utilization of medical services following treatment, resulting in cost offset. Potential reasons for variability between clinics are discussed

Semantic Memory Functional MRI and Cognitive Function After Exercise Intervention in Mild Cognitive Impairment

Mild cognitive impairment (MCI) is associated with early memory loss, Alzheimer\u27s disease (AD) neuropathology, inefficient or ineffective neural processing, and increased risk for AD. Unfortunately, treatments aimed at improving clinical symptoms or markers of brain function generally have been of limited value. Physical exercise is often recommended for people diagnosed with MCI, primarily because of its widely reported cognitive benefits in healthy older adults. However, it is unknown if exercise actually benefits brain function during memory retrieval in MCI. Here, we examined the effects of exercise training on semantic memory activation during functional magnetic resonance imaging (fMRI). Seventeen MCI participants and 18 cognitively intact controls, similar in sex, age, education, genetic risk, and medication use, volunteered for a 12-week exercise intervention consisting of supervised treadmill walking at a moderate intensity. Both MCI and control participants significantly increased their cardiorespiratory fitness by approximately 10% on a treadmill exercise test. Before and after the exercise intervention, participants completed an fMRI famous name discrimination task and a neuropsychological battery, Performance on Trial 1 of a list-learning task significantly improved in the MCI participants. Eleven brain regions activated during the semantic memory task showed a significant decrease in activation intensity following the intervention that was similar between groups (p-values ranged 0.048 to 0.0001). These findings suggest exercise may improve neural efficiency during semantic memory retrieval in MCI and cognitively intact older adults, and may lead to improvement in cognitive function. Clinical trials are needed to determine if exercise is effective to delay conversion to AD

Biodegredation of chlorinated solvents in the sediment of Ashumet Pond, Cape Cod, MA

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 1998.Includes bibliographical references (leaves 46-50).by Jeri A. Champion.M.Eng

Gambaran Kadar Urea Nitrogen Darah Pada Vegetarian Lacto-ovo

: Protein is required to provide amino acids for nitrogen formation. Urea is the major disposal form of amino groups derived from amino acids. The nitrogen of urea is derived from amonia and aspartatedue to the action of five enzyme-catalyzed reactions of urea cycle. Concentration of urea in blood mainly describes the balance between formation of urea and protein catabolism as well as urea excretion by the kidneys. Vegetarian lacto-ovo is a type of vegetarians who does not consume animal proteins except for milk and eggs, and all plant proteins. This study aimed to obtain blood urea levels among lacto-ovo vegetarians. This was a descriptive study with a cross-sectional design. Respondents were obtained by using total sampling method. This study was coducted in Klabat University, Airmadidi. Twentyfive respondents were involved in the study. The results showed that 19 respondents (76.0%) had normal blood urea level and 6 respondents (20%) had low blood urea levels; no respondent (0%) had a high blood urea level. Conclusion: Blood urea levels of most lacto-ovo vegetarians were within normal level

Food Combination and Alzheimer Disease Risk: A Protective Diet

Objective: To assess the association between food combination and Alzheimer disease (AD) risk. Because foods are not consumed in isolation, dietary pattern (DP) analysis of food combination, taking into account the interactions among food components, may offer methodological advantages. Design: Prospective cohort study. Setting: Northern Manhattan, New York, New York. Patients or Other Participants: Two thousand one hundred forty-eight community-based elderly subjects (aged ≥65 years) without dementia in New York provided dietary information and were prospectively evaluated with the same standardized neurological and neuropsychological measures approximately every 1.5 years. Using reduced rank regression, we calculated DPs based on their ability to explain variation in 7 potentially AD-related nutrients: saturated fatty acids, monounsaturated fatty acids, ω-3 polyunsaturated fatty acids, ω-6 polyunsaturated fatty acids, vitamin E, vitamin B12, and folate. The associations of reduced rank regression–derived DPs with AD risk were then examined using a Cox proportional hazards model. Main Outcome Measure: Incident AD risk. Results: Two hundred fifty-three subjects developed AD during a follow-up of 3.9 years. We identified a DP strongly associated with lower AD risk: compared with subjects in the lowest tertile of adherence to this pattern, the AD hazard ratio (95% confidence interval) for subjects in the highest DP tertile was 0.62 (0.43-0.89) after multivariable adjustment (P for trend = .01). This DP was characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter. Conclusion: Simultaneous consideration of previous knowledge regarding potentially AD-related nutrients and multiple food groups can aid in identifying food combinations that are associated with AD risk

An investigation of leadership characteristics and backgrounds of prominent women educators in the greater Guilford area

The purpose of this study was to determine the effect family background and personal and career experiences may have had on the leadership development of five prominent women educators in the Greater Guilford area. The study was based on a series of interviews with each of the five subjects. The interviews centered on eight broad-based questions which encompassed such areas as early childhood and adolescent years, college training, the influence of mentors, and the perceptions of each subject regarding her psychological and philosophical development

Amelioration of Experimental Autoimmune Encephalomyelitis in C57BL/6 Mice by Photobiomodulation Induced by 670 nm Light

The approved immunomodulatory agents for the treatment of multiple sclerosis (MS) are only partially effective. It is thought that the combination of immunomodulatory and neuroprotective strategies is necessary to prevent or reverse disease progression. Irradiation with far red/near infrared light, termed photobiomodulation, is a therapeutic approach for inflammatory and neurodegenerative diseases. Data suggests that near-infrared light functions through neuroprotective and anti-inflammatory mechanisms. We sought to investigate the clinical effect of photobiomodulation in the Experimental Autoimmune Encephalomyelitis (EAE) model of multiple sclerosis.The clinical effect of photobiomodulation induced by 670 nm light was investigated in the C57BL/6 mouse model of EAE. Disease was induced with myelin oligodendrocyte glycoprotein (MOG) according to standard laboratory protocol. Mice received 670 nm light or no light treatment (sham) administered as suppression and treatment protocols. 670 nm light reduced disease severity with both protocols compared to sham treated mice. Disease amelioration was associated with down-regulation of proinflammatory cytokines (interferon-γ, tumor necrosis factor-α) and up-regulation of anti-inflammatory cytokines (IL-4, IL-10) in vitro and in vivo.These studies document the therapeutic potential of photobiomodulation with 670 nm light in the EAE model, in part through modulation of the immune response