Weight management : an evidence-based approach

The management of obesity includes an individualized assessment of the need for weight loss and the determination of appropriate weight goals. Treatment includes dietary, exercise, and behavioural interventions, with emphasis on a particular treatment modality being dependent on individual circumstances. In general, dietary recommendations include a moderate caloric restriction and modifications in meal pattern and selection of foods. Once a health care professional has identified the need for weight loss by assessing body mass index, waist circumference, and risk factors, he/she can translate nutrition and health information into dietary choices for the overweight individual. This paper discusses a strategy for the evaluation and treatment of overweight patients using a practical treatment algorithm.peer-reviewe

„OPEN FOR CONSERVATION”: LIVE EXPERIENCES

The need to show to the public issues related to conservation of cultural properties first became clear in the eighties during the great projects conducted in the Roman forum. Three major conservation innovations were introduced at that time: documentation became part of the contract specifications; consolidation was performed using slaked lime; the worksite scaffolding was opened to non-specialists. The way in which the documentation is realized is an indicator of the quality and professionalism of a program. This should incorporate a communication plan, to promote and raise awareness among the public about the instances related to the conservation of cultural heritage. This article addresses the communication principles applied to conservation interventions.The need to show to the public issues related to conservation of cultural properties first became clear in the eighties during the great projects conducted in the Roman forum. Three major conservation innovations were introduced at that time: documentation became part of the contract specifications; consolidation was performed using slaked lime; the worksite scaffolding was opened to non-specialists. The way in which the documentation is realized is an indicator of the quality and professionalism of a program. This should incorporate a communication plan, to promote and raise awareness among the public about the instances related to the conservation of cultural heritage. This article addresses the communication principles applied to conservation interventions

Towards a robust human rights & equality framework : scoping consultation

Questions posed: Do you think that human rights and equality are sufficiently protected and promoted in Malta? If not: Which human rights do you believe need further protection and promotion? How can Malta better protect and promote human rights and equality overall? Are there any models that you would propose that government should consider looking at in terms of legislation, institutional frameworks or both? If yes, what is especially good about such models? Due to the fact that question (b) is broader in scope and consequence than question (a), it shall be dealt with first. A brief look into specific rights, which should serve only as an example of the many rights that need further protection, will then follow with regard to question (a), whilst the answers to question (c) will be incorporated into the first section. An observation is made about question (a) of the consultation: While it was understandable and conceivable that it is asked if the protection of any specific right seems particularly lacking, the latter part of the question, ‘Which human rights do you believe need further promotion?’ seemed anomalous to the very notion of universal human rights as proclaimed by the Universal Declaration of Human Rights. It is the Programme’s belief that all human rights should be promoted with equal vigour. How can Malta better protect and promote human rights and equality overall? It is the Programme’s tenet that a more holistic approach should be taken in protecting and promoting human rights and equality. Doing so would allow for the development of a culture of human rights wherein it is understood that such rights are universal, indivisible and inalienable and would thereby bring Maltese human rights protection within the standards of the Universal Declaration of Human Rights of 1950. In this regard, while several positive measures aimed at providing individuals with access to their human rights have been adopted in recent years, it would be remiss not to acknowledge that the Maltese system of human rights protection is still lacking in a number of areas.peer-reviewe

As novas formas de exploração do trabalho no capitalismo contemporâneo e as políticas de combate às desigualdades

O mercado de trabalho sofreu profundas transformações desde o começo do capitalismo até o momento atual, sendo possível compará-lo a uma loteria, na qual os trabalhadores passaram a competir entre si por ascensão profissional. Os bilhetes dessa loteria são os investimentos em capital humano. Nela haverá, necessariamente, vencedores e perdedores, com os primeiros apropriando-se do trabalho dos últimos. Dessa realidade, surge uma nova forma de exploração do trabalho, cujo instrumento de legitimação é o capital humano, que reforça a tendência inerente do capitalismo à geração de desigualdade e coloca limitações à visão tradicional de combate à desigualdade baseada na democratização do capital humano. O crescimento também tem limitações, tendo em vista que a motivação microeconômica que gera o crescimento macroeconômico é justamente a busca pela desigualdade. O presente artigo busca analisar essas questões do ponto de vista da economia política das teorias econômicas e no receituário de políticas públicas de combate à desigualdade.Desigualdade, Exploração do Trabalho, Mercado de Trabalho, Políticas Públicas

Marine Robots for Underwater Surveillance

Abstract Purpose of Review The paper reviews the role of marine robots, in particular unmanned vehicles, in underwater surveillance, i.e. the control and monitoring of an area of competence aimed at identifying potential threats in support of homeland defence, antiterrorism, force protection and Explosive Ordnance Disposal (EOD). Recent Findings The paper explores separately robotic missions for identification and classification of threats lying on the seabed (e.g. EOD) and anti-intrusion robotic systems. The current main scientific challenge is identified in terms of enhancing autonomy and team/swarm mission capabilities by improving interoperability among robotic vehicles and providing communication networking capabilities, a non-trivial task, giving the severe limitations in bandwidth and latency of acoustic underwater messaging. Summary The work is intended to be a critical guide to the recent prolific bibliography on the topic, providing pointers to the main recent advancements in the field, and to give also a set of references in terms of mission and stakeholders' requirements (port authorities, coastal guards, navies)

Real-time virtual sonography in gynecology & obstetrics. literature's analysis and case series

Fusion Imaging is a latest generation diagnostic technique, designed to combine ultrasonography with a second-tier technique such as magnetic resonance imaging and computer tomography. It has been mainly used until now in urology and hepatology. Concerning gynecology and obstetrics, the studies mostly focus on the diagnosis of prenatal disease, benign pathology and cervical cancer. We provided a systematic review of the literature with the latest publications regarding the role of Fusion technology in gynecological and obstetrics fields and we also described a case series of six emblematic patients enrolled from Gynecology Department of Sant ‘Andrea Hospital, “la Sapienza”, Rome, evaluated with Esaote Virtual Navigator equipment. We consider that Fusion Imaging could add values at the diagnosis of various gynecological and obstetrics conditions, but further studies are needed to better define and improve the role of this fascinating diagnostic tool

Myoelectric Control Architectures to Drive Upper Limb Exoskeletons

Myoelectric interfaces are sensing devices based on electromyography (EMG) able to read the electrical activity of motoneurons and muscles. These interfaces can be used to infer movement volition and to control assistive devices. Currently, these interfaces are widely used to control robotic prostheses for amputees, but their use could be beneficial even for people suffering from motor disabilities where the peripheral nervous system is intact and the impairment is only due to the muscles, e.g. muscular dystrophy, myopathies, or ageing. In combination with recent robotic orthoses and exoskeletons, myoelectric interfaces could dramatically improve these patients’ quality of life. Unfortunately, despite a wide plethora of methodologies has been proposed so far, a natural, intuitive, and reliable interface able to follow impaired subjects’ volition is still missing. The first contribution of this work is to provide a review of existing approaches. In this work we found that existing EMG-based control interfaces can be viewed as specific cases of a generic myoelectric control architecture composed by three distinct functional modules: a decoder to extract the movement intention from EMG signals, a controller to accomplish the desired motion through an actual command given to the actuators, and an adapter to connect them. The latter is responsible for translating the signal from decoder’s output to controller’s input domain and for modulating the level of provided assistance. We used this concept to analyse the case of study of linear regression decoders and an elbow exoskeleton. This thesis has the scientific objective to determine how these modules affect performance of EMG-driven exoskeletons and wearer’s fatigue. To experimentally test and compare myoelectric interfaces this work proposes: (1) a procedure to automatically tune the decoder module in order to equally compare or to normalize the decoder output among different sessions and subjects; (2) a procedure to automatically tune gravity compensation even for subjects suffering from severe disabilities, allowing them to perform the experimental tests; (3) a methodology to guide the impaired patients through the experimental session; (4) an evaluation procedure and metrics allowing statistically significant and unbiased comparison of different myoelectric interfaces. A further contribution of this work is the design of an experimental test bed composed by an elbow exoskeleton and by a software framework able to collect EMG signals and make them available to the exoskeleton’s actuators with minimal latency. Using this test bed, we were able to test different myoelectric interfaces based on our architecture, with different modules choices and tunings. We used linear regression decoders calibrated to predict the muscular torque, low-level controllers having torque or velocity as reference, and adapters consisting of a properly dimensioned gain or simple dynamic systems, such as an integrator or a mass-damping system. The results we obtained allow to conclude that EMG-based control is a viable technology to assist muscular weakness patients. Moreover, all the components of the myoelectric control architecture – decoder, adapter, controller, and their tuning – significantly affect the task-based performance measures we collect. Further investigations should be devoted to a methodology to automatically tune all the components, not the decoders only, and to the quantitative study of the effect the adapter has on the regulation of the assistance level and of the tradeoff between speed and accuracy

Performance Analysis in Off-design Condition of Gas Turbine Air-bottoming Combined System☆

Abstract Nowadays, the gradual depletion of fossil fuels associated with constraints on emissions of greenhouse gases leads to valorize their wasted heat from power plant. One of the technologies adopted for improvement is the utilization of combined cycles. For this purpose, the steam cycle is used most frequently. These systems are highly efficient, but they are very complex and water is requested, moreover they are very heavy, so they cannot always be used. In this context, Air Bottoming Cycles (ABC) become attractive for potential use in future plants and repowering because they are light, compact and they have flexible-use and no water consumption. An application of an Air Bottoming Cycle (ABC) is composed of a gas turbine powered by natural gas, an air compressor and an air turbine coupled to the system by means of a heat exchanger, referred to as the AHX (Air Heat Exchanger). The aim of this paper is to study an Air Bottoming Cycle (ABC) that uses a medium power industrial gas turbine as topper cycle. A thermodynamic optimization is realized, determining the best pressure ratio and air mass flow rate of bottomer cycle. Then, an off-design analysis varying ambient temperature and FAR (Fuel Air Ratio) is shown, in fact, in this case, the exhaust gas conditions from topper gas turbine and inlet air of bottoming joule cycle change

A scoping review of novel spinal cord stimulation modes for complex regional pain syndrome

Background: Paresthesia-based spinal cord stimulation (PB-SCS) is used for the treatment of complex regional pain syndrome (CRPS), but many patients are refractory to PB-SCS or experience attenuation of analgesic effect over time due to tolerance. Novel SCS modes including high-frequency, BurstTM, and high-density (HDTM) stimulation were introduced recently and this systematic review was conducted to summarize the evidence on their role for CRPS. Materials and Methods: We searched MEDLINE and other databases (up to September 21, 2017) for studies including adults with refractory CRPS treated by paresthesia-free SCS (PF-SCS) modes compared to placebo, conventional medical treatment, or PB-SCS. We determined the posttreatment intensity of pain (up to 24 months after intervention), changes in CRPS-associated symptoms, and associated domains. Sustainability and adverse effects were also assessed. Results: We identified 13 studies (seven case series, five conference abstracts, one randomized controlled trial) including 62 patients with upper or lower limb CRPS. Eleven papers reported on outcomes of high-frequency stimulation at 10 kHz (HF-10) and other high frequencies, two papers were on Burst, and one paper was on HD. In 59 patients, pain intensity with novel SCS modes was reduced by 30% to 100% with a corresponding reduction in analgesic medications. Novel SCS modes also attenuated CRPS-associated symptoms and six papers reported significant improvement of quality of life. Conclusions: Novel SCS modes have the potential to provide analgesia in patients with CRPS. However, the low quality of available evidence necessitates definitive and prospective comparative effectiveness studies to establish the role of these modes in CRPS