Meaningful moments of interaction with people with profound intellectual disabilities:Reflections from direct support staff

Background High-quality, affective relationships are built on meaningful moments of interaction, which are challenging for support staff to establish with people with profound intellectual disabilities. Therefore, we explored what makes a moment of interaction meaningful to support staff and what circumstances facilitate meaningful moments of interaction taking place. Method Five direct support staff took part in unstructured, in-depth interviews. The interviews were analysed using interpretative phenomenological analysis (IPA). Member checks were also conducted. Results Support staff experienced moments of interaction as meaningful because they felt a connection with a person with profound intellectual disabilities and/or they had the feeling of being meaningful for this person. Staff-related and contextual circumstances facilitating meaningful moments of interaction to take place were described. Conclusions Meaningful moments of interaction are highly valued by support staff, who believe these moments are valued by persons with profound intellectual disabilities as well. Implications for daily practice are described

Polishing of optical media by dielectric barrier discharge inert gas plasma at atmospheric pressure

In this paper, surface smoothing of optical glasses, glass ceramic and sapphire using a low-power dielectric barrier discharge inert gas plasma at atmospheric pressure is presented. For this low temperature treatment method, no vacuum devices or chemicals are required. It is shown that by such plasma treatment the micro roughness and waviness of the investigated polished surfaces were significantly decreased, resulting in a decrease in surface scattering. Further, plasma polishing of lapped fused silica is introduced. Based on simulation results, a plasma physical process is suggested to be the underlying mechanism for initialising the observed smoothing effect

The propargyl rearrangement to functionalised allyl-boron and borocation compounds

A diverse range of Lewis acidic alkyl, vinyl and aryl boranes and borenium compounds that are capable of new carbon–carbon bond formation through selective migratory group transfer have been synthesised. Utilising a series of heteroleptic boranes [PhB(C6F5)2 (1), PhCH2CH2B(C6F5)2 (2), and E-B(C6F5)2(C6F5)C=C(I)R (R=Ph 3 a, nBu 3 b)] and borenium cations [phenylquinolatoborenium cation ([QOBPh][AlCl4], 4)], it has been shown that these boron-based compounds are capable of producing novel allyl- boron and boronium compounds through complex rearrangement reactions with various propargyl esters and carbamates. These reactions yield highly functionalised, synthetically useful boron substituted organic compounds with substantial molecular complexity in a one-pot reaction

Los Alamos Plutonium Facility Waste Management System

This paper describes the new computer-based transuranic (TRU) Waste Management System (WMS) being implemented at the Plutonium Facility at Los Alamos National Laboratory (LANL). The Waste Management System is a distributed computer processing system stored in a Sybase database and accessed by a graphical user interface (GUI) written in Omnis7. It resides on the local area network at the Plutonium Facility and is accessible by authorized TRU waste originators, count room personnel, radiation protection technicians (RPTs), quality assurance personnel, and waste management personnel for data input and verification. Future goals include bringing outside groups like the LANL Waste Management Facility on-line to participate in this streamlined system. The WMS is changing the TRU paper trail into a computer trail, saving time and eliminating errors and inconsistencies in the process

Long-Term Outcomes of External Dacryocystorhinostomy in the Age of Transcanalicular Microendoscopic Techniques

Purpose. This study aimed to evaluate long-term results of external dacryocystorhinostomy (DCR) at a tertiary eye care center specializing in lacrimal duct surgery in Germany. Methods. The medical records of 1010 patients with acquired nasolacrimal duct obstruction (NLDO), who had undergone lacrimal duct surgery at a tertiary eye care center, were reviewed. Only adult patients who had undergone external DCR were included. The evaluation included the following parameters: age, gender, duration of symptoms, patient satisfaction, previous dacryocystitis, complication rates, and surgical outcome. Results. 154 eyes of 146 patients (14.5%) could be included in the study. The average age was 64.1±29.7 years. 66.4% of patients were females and 33.6% were males. Acute or chronic dacryocystitis was found in 81 patients (55.5%). Overall, 82.8% of patients had full resolution of symptoms. The success rate of external DCR for patients with previous episodes of dacryocystitis was 82.7% compared to 83.4% for patients without dacryocystitis in their medical history. Conclusion. In cases in which transcanalicular microendoscopic techniques are contraindicated (e.g., after dacryocystitis) or in complex cases where microendoscopic procedures have failed (revision surgery), external DCR is still the surgical treatment of choice with very good postoperative success

3D Fluid Flow Estimation with Integrated Particle Reconstruction

The standard approach to densely reconstruct the motion in a volume of fluid is to inject high-contrast tracer particles and record their motion with multiple high-speed cameras. Almost all existing work processes the acquired multi-view video in two separate steps, utilizing either a pure Eulerian or pure Lagrangian approach. Eulerian methods perform a voxel-based reconstruction of particles per time step, followed by 3D motion estimation, with some form of dense matching between the precomputed voxel grids from different time steps. In this sequential procedure, the first step cannot use temporal consistency considerations to support the reconstruction, while the second step has no access to the original, high-resolution image data. Alternatively, Lagrangian methods reconstruct an explicit, sparse set of particles and track the individual particles over time. Physical constraints can only be incorporated in a post-processing step when interpolating the particle tracks to a dense motion field. We show, for the first time, how to jointly reconstruct both the individual tracer particles and a dense 3D fluid motion field from the image data, using an integrated energy minimization. Our hybrid Lagrangian/Eulerian model reconstructs individual particles, and at the same time recovers a dense 3D motion field in the entire domain. Making particles explicit greatly reduces the memory consumption and allows one to use the high-res input images for matching. Whereas the dense motion field makes it possible to include physical a-priori constraints and account for the incompressibility and viscosity of the fluid. The method exhibits greatly (~70%) improved results over our recently published baseline with two separate steps for 3D reconstruction and motion estimation. Our results with only two time steps are comparable to those of sota tracking-based methods that require much longer sequences.Comment: To appear in International Journal of Computer Vision (IJCV

Switch-maintenance gemcitabine after first-line chemotherapy in patients with malignant mesothelioma (NVALT19):an investigator-initiated, randomised, open-label, phase 2 trial

Background Almost all patients with malignant mesothelioma eventually have disease progression after first-line therapy. Previous studies have investigated maintenance therapy, but none has shown a great effect. We aimed to assess the efficacy and safety of switch-maintenance gemcitabine in patients with malignant mesothelioma without disease progression after first-line chemotherapy. Methods We did a randomised, open-label, phase 2 trial in 18 hospitals in the Netherlands (NVALT19). We recruited patients aged older than 18 years with unresectable malignant mesothelioma with no evidence of disease progression after at least four cycles of first-line chemotherapy (with platinum and pemetrexed), who had a WHO performance status of 0-2, adequate organ function, and measurable or evaluable disease. Exclusion criteria were active uncontrolled infection or severe cardiac dysfunction, serious disabling conditions, symptomatic CNS metastases, radiotherapy within 2 weeks before enrolment, and concomitant use of any other drugs under investigation. Patients were randomly assigned (1:1), using the minimisation method, to maintenance intravenous gemcitabine (1250 mg/m(2) on days 1 and 8, in cycles of 21 days) plus supportive care, or to best supportive care alone, until disease progression, unacceptable toxicity, serious intercurrent illness, patient request for discontinuation, or need for any other anticancer agent, except for palliative radiotherapy. A CT scan of the thorax or abdomen (or both) and pulmonary function tests were done at baseline and repeated every 6 weeks. The primary outcome was progression-free survival in the intention-to-treat population. Safety was analysed in all participants who received one or more doses of the study drug or had at least one visit for supportive care. Recruitment is now closed; treatment and follow-up are ongoing. This study is registered with the Netherlands Trial Registry, NTR4132/NL3847. Findings Between March 20, 2014, and Feb 27, 2019, 130 patients were enrolled and randomly assigned to gemcitabine plus supportive care (65 patients [50%]) or supportive care alone (65 patients [50%]). No patients were lost to follow-up; median follow-up was 36.5 months (95% CI 34.2 to not reached), and one patient in the supportive care group withdrew consent. Progression-free survival was significantly longer in the gemcitabine group (median 6.2 months [95% CI 4.6-8.7]) than in the supportive care group (3.2 months [2.8-4.1]; hazard ratio [HR] 0.48 [95% CI 0.33-0.71]; p=0.0002). The benefit was confirmed by masked independent central review (HR 0.49 [0.33-0.72]; p=0.0002). Grade 3-4 adverse events occurred in 33 ( 52%) of 64 patients in the gemcitabine group and in ten (16%) of 62 patients in the supportive care group. The most frequent adverse events were anaemia, neutropenia, fatigue or asthenia, pain, and infection in the gemcitabine group, and pain, infection, and cough or dyspnoea in the supportive care group. One patient (2%) in the gemcitabine group died, due to a treatment-related infection. Interpretation Switch-maintenance gemcitabine, after first-line chemotherapy, significantly prolonged progression-free survival compared with best supportive care alone, among patients with malignant mesothelioma. This study confirms the activity of gemcitabine in treating malignant mesothelioma

Examining the effects of adjuvant chemotherapy on cognition and the impact of any cognitive impairment on quality of life in colorectal cancer patients: study protocol

Background: Research suggests that chemotherapy can cause deficits in both patients’ objectively measured and self-reported cognitive abilities which can in turn affect their quality of life (QoL). The majority of research studies have used post-treatment retrospective designs or have not included a control group in prospective cohorts. This has limited the conclusions that can be drawn from the results. There have also been a disproportionate number of studies focussed on women with breast cancer, which has limited the generalisability of the results to other cancer populations. Aim: This study aims to identify the extent and impact of chemotherapy-induced cognitive decline in colorectal cancer patients. Possible associations with poorer QoL will also be explored. Design: This will be a longitudinal controlled cohort study. Questionnaires measuring subjective cognitive functioning, QoL, fatigue and mood, and neuropsychological assessments of objective cognitive function will be collected pre-, mid- and post- chemotherapy treatment from a consecutive sample of 78 colorectal cancer patients from five London NHS Trusts. A further 78 colorectal cancer surgery only patients will be assessed at equivalent time points; this will allow the researchers to compare the results of patients undergoing surgery, but not chemotherapy against those receiving both treatments. Pre- and post-chemotherapy difference scores will be calculated to detect subtle changes in cognitive function as measured by the objective neuropsychological assessments and the self-reported questionnaires. A standardised zscore will be computed for every patient on each neuropsychological test, and for each test at each time point. The post-chemotherapy score will then be subtracted from the pre-chemotherapy score to produce a relative difference score for each patient. ANCOVA will be used to compare mean difference z-scores between the chemotherapy and surgery-only groups while controlling for the effects of gender, age, depression, anxiety, fatigue and education. Discussion: The result from this study will indicate whether a decline in cognitive functioning can be attributed to chemotherapy or to disease, surgical or some other confounding factor. Identification of risk factors for cognitive deficits may be used to inform targeted interventions, in order to improve QoL and help patients’ cope

An application of tomographic PIV to investigate the spray-induced turbulence in a direct-injection engine

Fuel sprays produce high-velocity, jet-like flows that impart turbulence onto the ambient flow field. The spray-induced turbulence augments fuel-air mixing, which has a primary role in controlling pollutant formation and cyclic variability in engines. This paper presents tomographic particle image velocimetry (TPIV) measurements to analyse the 3D spray-induced turbulence during the intake stroke of a direct-injection engine. The spray produces a strong spray-induced jet in the far field, which travels through the cylinder and imparts turbulence onto the surrounding flow. Planar high-speed PIV measurements at 4.8 kHz are combined with TPIV at 3.3 Hz to evaluate spray particle distributions and validate TPIV measurements in the particle-laden flow. An uncertainty analysis is performed to assess the uncertainty associated with vorticity and strain rate components. TPIV analyses quantify the spatial domain of the turbulence in relation to the SIJ and describe how turbulent flow features such as turbulent kinetic energy, strain rate and vorticity evolve into the surrounding flow field. Access to the full tensors facilitate the evaluation of turbulence for individual spray events. TPIV images reveal the presence of strong shear layers (visualized by high S magnitudes) and pockets of elevated vorticity along the immediate boundary of the SIJ. Values are extracted from spatial domains extending in 1mm increments from the SIJ. Turbulence levels are greatest within the 0-1mm region from the SIJ boarder and dissipate with radial distance. Individual strain rate and vorticity components are analyzed in detail to describe the relationship between local strain rates and 3D vortical structures produced within strong shear layers of the SIJ. Analyses are intended to understand the flow features responsible for rapid fuel-air mixing and provide valuable data for the development of numerical models