1,819 research outputs found

    Effect of strain on the orbital and magnetic ordering of manganite thin films and their interface with an insulator

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    We study the effect of uniform uniaxial strain on the ground state electronic configuration of a thin film manganite. Our model Hamiltonian includes the double-exchange, the Jahn-Teller electron-lattice coupling, and the antiferromagnetic superexchange. The strain arises due to the lattice mismatch between an insulating substrate and a manganite which produces a tetragonal distortion. This is included in the model via a modification of the hopping amplitude and the introduction of an energy splitting between the Mn e_g levels. We analyze the bulk properties of half-doped manganites and the electronic reconstruction at the interface between a ferromagnetic and metallic manganite and the insulating substrate. The strain drives an orbital selection modifying the electronic properties and the magnetic ordering of manganites and their interfaces.Comment: 8 pages, 8 figure

    Human-robot visual interface for 3D steering of a flexible, bioinspired needle for neurosurgery

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    Robotic minimally invasive surgery has been a subject of intense research and development over the last three decades, due to the clinical advantages it holds for patients and doctors alike. Particularly for drug delivery mechanisms, higher precision and the ability to follow complex trajectories in three dimensions (3D), has led to interest in flexible, steerable needles such as the programmable bevel-tip needle (PBN). Steering in 3D, however, holds practical challenges for surgeons, as interfaces are traditionally designed for straight line paths. This work presents a pilot study undertaken to evaluate a novel human-machine visual interface for the steering of a robotic PBN, where both qualitative evaluation of the interface and quantitative evaluation of the performance of the subjects in following a 3D path are measured. A series of needle insertions are performed in phantom tissue (gelatin) by the experiment subjects. User could adequately use the system with little training and low workload, and reach the target point at the end of the path with millimeter range accuracy

    Systematic Review on the Efficacy of Fexofenadine in Seasonal Allergic Rhinitis: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials

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    Rationale: Evidence-based medicine represents the effort to highlight the best intervention for patients, clinicians, and policy makers, each from their respective viewpoint, to solve a particular health condition. According to a recently diffused grading system of evidence and recommendations for medical interventions, efficacy and safety represent 2 of the most important features to consider, and data from meta-analyses of randomized controlled clinical trials (RCTs) is the strongest supporting demonstration. Fexofenadine has been used for its efficacy and safety in the treatment of allergic rhinitis (AR) for many years although no meta-analyses supporting its use currently exist. The aim of this study is to assess for the first time the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analytic analysis of existing RCTs. Since specific evidence should be provided to address recommendations in a pediatric population, the quality of the estimates of this subgroup analysis is assessed. Methods: All double-blind, placebo-controlled randomized trials assessing the efficacy of fexofenadine in AR were searched for in OVID, Medline, and Embase databases up to December 2007. Outcomes were extracted from original articles; when this information was not available, the authors of each trial were contacted. Some graphics were digitalized. The RevMan 5 program was used to perform the analysis. GradePro 3.2.2 was used to assess the quality of the evidence for a pediatric population. Results: Of 2,152 identified articles, 20 were potentially relevant trials. Eight studies satisfied the inclusion criteria and were included in the meta-analysis. The main reasons for exclusion were: unnatural exposure, strong study limitations, an atypical outcome measurement, a design for other outcomes, and not being a placebo-controlled, single-blind study. Seven trials investigated a mixed population of adults and children, 1 trial investigated only children, and 1 trial only adults. In 1,833 patients receiving fexofenadine (1,699 placebo), a significant reduction of the daily reflective total symptom scores (TSS) (SMD –0.42; 95% CI –0.49 to –0.35, p < 0.00001) was found. Positive results were also found for morning instantaneous TSS and individual nasal symptom scores (sneezing, rhinorrhea, itching, and congestion). The safety analysis did not show a significant difference in reported adverse events (AE) between the active and placebo treatment groups (OR = 1.03; 95% CI 0.87–1.22, p = 0.75). A very low heterogeneity between the studies was detected, so a fixed-effects model was used. The mean quality level of the included trials was medium. Specific information for a pediatric population may be assumed with a moderate quality of evidence from only 1 study and with a low quality of evidence, mainly due to indirectness, from the others. Conclusions: This study has 5 major strengths: it represents the first attempt to evaluate the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analysis of RCTs; there was consistency between positive results in terms of efficacy in TSS and in individual symptoms; a large population was studied; there was an irrelevant interstudy heterogeneity, and the AE frequency was similar in both groups. All of these values encourage the recommendation of fexofenadine for AR. Further research focused on the benefits and disadvantages for a pediatric population is needed

    Politics of oil in Venezuela: A decision-making analysis of PDVSA's internationalisation policy.

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    The high degree of international vertical integration achieved by the Venezuelan state oil enterprise, Petroleos de Venezuela S.A. (PDVSA), has placed it among the most important oil multinationals (MNs). The policy of creating downstream outlets through the establishment of foreign direct investments (FDIs) in the form of refinery assets was given the term of 'internationalisation'. By analysing PDVSA's internationalisation policy, the thesis explores the difficulties encountered by a major state-owned enterprise (SOE) from a developing country in its efforts to grow beyond national borders. The study focuses on the impact of democratic bargaining on the process of oil policymaking in Venezuela, stressing the constraints posed by politics on PDVSA's efforts to expand its foreign operations. Specifically, the study examines the intricate policymaking process that shaped the origins and the development of PDVSA's internationalisation policy, underlying the events and factors that influenced each one of its three distinguishable phases: adoption, formulation, and implementation. The tensions between politics and corporate strategy are highlighted at the core of the policymaking process. The study also looks at the relationship between the oil industry and the other two key decision-making centres involved in the oil policymaking process: the executive and Congress. In exploring the ways in which each one of them sought to influence policy outcome, the study attempts to gain insight into the main factors that prompted the tensions among the policy actors involved. Three environments, or pressure-generating centres, constantly exert influence on the oil industry: the oil market, the political context and the government's financial situation. By seeking to determine the industry's response to their pervasive influence on policy formulation and implementation, this research ascertains the extent to which these variables influenced the decision-making process that characterised PDVSA's internationalisation policy. Being too powerful a company in a developing country context where the executive and the legislature find it increasingly difficult to exert their means of control over it had the effect of minimising some of PDVSA's characteristics as SOE: accountability to Congress and subordination to the executive. The thesis argues that as a result of its role as oil MN PDVSA has minimised some of its attributes as SOE. In turn, the more PDVSA has diminished its status as SOE, the more the government has increased its dependence over it. The successful accomplishment of PDVSA's internationalisation policy has stressed this equation, highlighting the contentious interaction between an excessively dependent govemment and a company struggling to reconcile its roles as both a SOE and a MN. By examining the policy process that brought about the international expansion of a large SOE from a developing country, the findings of the thesis contribute significantly to the political science and public administration literatures and suggests new paths for further research in the area of public policymaking processes. (Abstract shortened by UMI.)

    Cyclic motion control for programmable bevel-tip needles 3D steering: a simulation study

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    Flexible, steerable, soft needles are desirable in Minimally Invasive Surgery to achieve complex trajectories while maintaining the benefits of percutaneous intervention compared to open surgery. One such needle is the multi-segment Programmable Bevel-tip Needle (PBN), which is inspired by the mechanical design of the ovipositor of certain wasps. PBNs can steer in 3D whilst minimizing the force applied to the surrounding substrate, due to the cyclic motion of the segments. Taking inspiration also from the control strategy of the wasp to perform insertions and lay their eggs, this paper presents the design of a cyclic controller that can steer a PBN to produce a desired trajectory in 3D. The performance of the controller is demonstrated in simulation in comparison to that of a direct controller without cyclic motion. It is shown that, while the same steering curvatures can be attained by both controllers, the time taken to achieve the configuration is longer for the cyclic controller, leading to issues of potential under-steering and longer insertion times

    Olfactory Dysfunction in Patients with Chronic Rhinosinusitis

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    Objectives. To measure the prevalence of and identify the clinical characteristics associated with olfactory decline in patients with chronic rhinosinusitis. Methods and Materials. There is analytical, prospective, and observational study in adult patients with a diagnosis of chronic rhinosinusitis. The olfactory test used was the Connecticut Chemosensory Clinical Research Center (CCCRC). Results. They are 33 patients total. Within the group of patients aged 18 to 39, 9% had normosmia, 73% hyposmia, and 18% anosmia (P<0.001). Between 40 and 64 years old, there was no patient with normosmia, 63% hyposmia, and 37% anosmia (P<0.001). Of patients older than 65 years old, 33% showed mild hyposmia, 34% severe hyposmia, and 33% anosmia (P<0.001). 52% were females, and 48% were males. Conclusion. Nasal polyposis, asthma, septal deviation, turbinate hypertrophy, tobacco, and allergic rhinitis are predicting factors of olfactory dysfunction. Antecedents of previous endoscopic surgeries, age, and gender would not be associated with olfactory loss
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