Crystallization and morphology development in polyethylene-octakis(n-octadecyldimethylsiloxy)octasilsesquioxane nancomposite blends.

The dispersion, morphology and crystallization kinetics of low density polyethylene (LDPE) - octakis(n-octadecyldimethylsiloxy)octasilsesquioxane (POSS) nanocomposite blends was investigated. Novel octakis(dimethylsiloxy)octasilsesquioxane (Q8M8H) molecules were octafunctionalised with octadecyl alkyl-chains (Q8C18) and blended with 0.25-10 wt% loadings into a commercial LDPE. Time-resolved Small- and Wide-Angle X-Ray scattering (SAXS/WAXS), thermal and microscopy techniques were used to elucidate the POSS dispersal, crystalline morphology and crystallization kinetics of the host polymer. POSS particles dispersed well in the host polymer up to 5% wt loading and acted as nucleating agents without disrupting the crystal lattice of PE. Above 5% wt loading the POSS aggregated, reduced the bulk crystallinity and hindered the crystallization process. The aggregation of POSS is attributed to increased POSS-POSS interactions whereby the POSS molecules self-assemble in an interdigitated manner. The results were compared with an analogous LDPE-T8C18 POSS cage blend at 10%wt loading. In complete contrast, the T8 POSS particles disperse well in the host polymer being effective nucleating agents and increased the bulk crystallinity. This may have important implications in the processing of polyolefins where the T8 system acts to accelerate crystallization whereas the Q8 system retards it

Self-assembly of fluoride-encapsulated polyhedral oligomeric silsesquioxane (POSS) nanocrystals

The self-assembly and crystal packing of a unique series of nanocrystalline fluoride ion-encapsulated polyhedral oligomeric silsesquioxane compounds (F-POSS), with substituted electron-withdrawing group (EWG) perfluorinated alkyl chain arms of varying lengths was investigated. The fluorine-encapsulated T8[(CH2)n-EWG]8F--18-crown-6-ether-M+ and T8[(CH2)n-EWG]8F--tetrabutyl ammonium TBA+ compounds with fluorinated alkyl chain arms, were synthesized and subsequently analyzed using differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and simultaneous small- and wide-angle X-ray scattering SAXS/WAXS techniques. DSC and TGA of the compounds showed that the melting temperatures occurred below 100 °C and were thermally stable above their melting temperatures. SAXS/WAXS data probed the crystalline structure and self-assembly of the nanocrystalline compounds. At ambient temperatures, the crystalline structures of the compounds were seen to be complex with triclinic unit cells. On cooling from the melt, the self-assembly of the compounds with shorter fluorinated alkyl chain arms is dominated by the ionic attraction between the cages such that the arms form a disordered state that only reorder on standing. In contrast, the self-assembly of the compounds with longer fluorinated alkyl chain arms is dominated by the alignment of the arms into rod-like morphologies such that a fully ordered solid is formed from the melt. Electrical characterization has revealed that the POSS cages exhibited an insulating behavior. The POSS cages with or without fluoride ion encapsulation had similar AC conductivities but cages without fluoride ion encapsulation have the highest relative permittivity. The results show that due to the inorganic-organic-ionic nature the F-POSS ion encapsulated compounds and nanocrystalline self-assembly, they have great potential as interfacial compatibilizers enhancing miscibility of polymer composites and aiding interactions between polar and non-polar solvents as ionic liquids

An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: protocol for a cluster randomized controlled trial

Background: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification. Methods: Following a systematic development process, the intervention will be evaluated in a pragmatic cluster randomized controlled trial including 70 general practices for a median period of 18 months. The 35 general practices in the intervention group will work with a nominated partner pharmacy, whereas those in the control group will provide usual care without access to the intervention tools. The primary outcome is the proportion of patients at high CVD risk who were inadequately treated at baseline who achieve target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels at the study end. The outcomes will be analyzed using data from electronic medical records, utilizing a validated extraction tool. Detailed process and economic evaluations will also be performed. Discussion: The study intends to establish evidence about an intervention that combines technological innovation with team collaboration between patients, pharmacists, and general practitioners (GPs) for CVD prevention. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN1261600023342

Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

<p>Abstract</p> <p>Background</p> <p>We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH) in China where the disease is more common than in Western populations.</p> <p>Methods</p> <p>Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) study, a multi-centre, prospective, 62 hospital registry in China during 2006-07.</p> <p>Results</p> <p>Nearly all ICH patients (n = 1572) received an intravenous haemodiluting agent such as mannitol (96%) or a neuroprotectant (72%), and there was high use of intravenous traditional Chinese medicine (TCM) (42%). Neurosurgery was undertaken in 137 (9%) patients; being overweight, having a low Glasgow Coma Scale (GCS) score on admission, and Total Anterior Circulation Syndrome (TACS) clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p < 0.001). Continuation of antihypertensives in-hospital and at 3 and 12 months post-stroke was reported in 732/935 (78%), 775/935 (83%), and 752/935 (80%) living patients with hypertension, respectively.</p> <p>Conclusions</p> <p>The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.</p

Fracture toughness of rotationally moulded polyethylene and polypropylene.

In this work, the fracture toughness of rotationally moulded Polyethylene (PE) and Polypropylene (PP) was measured using J integral methods at static loading rates and at room temperature. Two different commercially available rotational moulding grades PE and PP were tested in this study which have been used in various rotationally moulded products such as small leisure craft, water storage tanks etc. Scanning Electron Microscope (SEM), Optical Microscope, Differential Scanning Calorimetry (DSC), Solid-state Nuclear Magnetic Resonance (solid-state NMR) and X-ray scattering were used to investigate the microstructure, fracture surfaces and compare toughness properties of these materials. In PE, higher molecular weight and broader molecular weight distribution, larger amorphous and crystal region thicknesses are found to be related to higher toughness values. High molecular weight favours higher number of entanglements that improve fracture energy and broader distribution increases long chain branching of higher molecular weight fractions which creates higher entanglements at the branch sites. Larger amorphous regions promote micro-voiding more easily compared to thinner amorphous regions, leading to greater plastic deformation and energy absorption. Higher crystal thickness also contributes to micro-voiding in the amorphous region. For PP, greater plastic deformation observed in the fracture surfaces is related to higher fracture toughness values

Patient-reported GP health assessments rather than individual cardiovascular risk burden are associated with the engagement in lifestyle changes: Population-based survey in South Australia

© 2019 The Author(s). Background: Little is known about whether a more comprehensive health assessment, performed by a general practitioner (GP) during a clinical encounter, could influence patients' lifestyle. We aimed to investigate whether health assessments, performed by GPs, are more important than the presence of cardiovascular disease (CVD) or cardiometabolic risk factors (obesity, diabetes, hypertension, dyslipidaemia) for engagement in lifestyle change. Methods: Cross-sectional, population-based survey conducted in South Australia (September-December 2017) using face-To-face interviews and self-reported data of 2977 individuals aged 15+ years. The main outcome was engagement in four lifestyle changes: 1) increasing fruit/vegetable intake, 2) increasing physical activity level, 3) reducing alcohol consumption, and 4) attempts to stop smoking. Health assessments performed by a GP in the last 12 months included clinical/laboratory investigations (weight/waist circumference, blood pressure, glucose levels, lipid levels) and questions about lifestyle/wellbeing (current diet, physical activity, smoking status, alcohol intake, mental health, sleeping problems). Results were restricted to individuals aged 35+ years because of the low prevalence of CVD or their risk factors among younger participants. Logistic regression was used in all associations, adjusted for sociodemographic, lifestyle, mental health, and clinical variables. Results: Of the 2384 investigated adults (mean age 57.3 ± 13.9 years; 51.9% females), 10.2% had CVD and 49.1% at least one cardiometabolic risk factor. Clinical/laboratory assessments performed by the GP were 2-3 times more frequent than assessments of lifestyle, mental health status, or sleeping problems, especially among those with CVD. Individuals with CVD or a cardiometabolic risk factor were no more likely to be increasing their fruit/vegetable consumption (33.6%), physical activity level (40.9%), reducing alcohol consumption (31.1%), or trying to quit smoking (34.0%) than 'healthy' participants. However, lifestyle changes were between 30 and 100% more likely when GPs performed three or more health assessments (either clinical/laboratory or questions about lifestyle/wellbeing) than when individuals did not visit the GP or when GPs performed no any assessment during these clinical encounters (p < 0.05 in all cases). Conclusion: More frequent and comprehensive CVD-related assessments by GPs were more important in promoting a healthier lifestyle than the presence of CVD or cardiometabolic risk factors by themselves

SMARTphone-based, early cardiac REHABilitation in patients with acute coronary syndromes [SMART-REHAB Trial]: A randomized controlled trial protocol

© 2016 The Author(s). Background: There are well-documented treatment gaps in secondary prevention of coronary heart disease and no clear guidelines to assist early physical activity after acute coronary syndromes (ACS). Smartphone technology may provide an innovative platform to close these gaps. This paper describes the study design of a randomized controlled trial assessing whether a smartphone-based secondary prevention program can facilitate early physical activity and improve cardiovascular health in patients with ACS. Methods: We have developed a multi-faceted, patient-centred smartphone-based secondary prevention program emphasizing early physical activity with a graduated walking program initiated on discharge from ACS admission. The program incorporates; physical activity tracking through the smartphone's accelerometer with interactive feedback and goal setting; a dynamic dashboard to review and optimize cardiovascular risk factors; educational messages delivered twice weekly; a photographic food diary; pharmacotherapy review; and support through a short message service. The primary endpoint of the trial is change in exercise capacity, as measured by the change in six-minute walk test distance at 8-weeks when compared to baseline. Secondary endpoints include improvements in cardiovascular risk factor status, psychological well-being and quality of life, medication adherence, uptake of cardiac rehabilitation and re-hospitalizations. Discussion: This randomized controlled trial will use a smartphone-phone based secondary prevention program to emphasize early physical activity post-ACS. It will provide evidence regarding the feasibility and utility of this innovative platform in closing the treatment gaps in secondary prevention. Trial registration: The trial was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) on April 4, 2016. The registration number is ACTRN12616000426482

The haptic perception of spatial orientations

This review examines the isotropy of the perception of spatial orientations in the haptic system. It shows the existence of an oblique effect (i.e., a better perception of vertical and horizontal orientations than oblique orientations) in a spatial plane intrinsic to the haptic system, determined by the gravitational cues and the cognitive resources and defined in a subjective frame of reference. Similar results are observed from infancy to adulthood. In 3D space, the haptic processing of orientations is also anisotropic and seems to use both egocentric and allocentric cues. Taken together, these results revealed that the haptic oblique effect occurs when the sensory motor traces associated with exploratory movement are represented more abstractly at a cognitive level

Rationale and design of the Kanyini guidelines adherence with the polypill (Kanyini-GAP) study: a randomised controlled trial of a polypill-based strategy amongst Indigenous and non Indigenous people at high cardiovascular risk

<p>Abstract</p> <p>Background</p> <p>The Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP) Study aims to examine whether a polypill-based strategy (using a single capsule containing aspirin, a statin and two blood pressure-lowering agents) amongst Indigenous and non-Indigenous people at high risk of experiencing a cardiovascular event will improve adherence to guideline-indicated therapies, and lower blood pressure and cholesterol levels.</p> <p>Methods/Design</p> <p>The study is an open, randomised, controlled, multi-centre trial involving 1000 participants at high risk of cardiovascular events recruited from mainstream general practices and Aboriginal Medical Services, followed for an average of 18 months. The participants will be randomised to one of two versions of the polypill, the version chosen by the treating health professional according to clinical features of the patient, or to usual care. The primary study outcomes will be changes, from baseline measures, in serum cholesterol and systolic blood pressure and self-reported current use of aspirin, a statin and at least two blood pressure lowering agents. Secondary study outcomes include cardiovascular events, renal outcomes, self-reported barriers to indicated therapy, prescription of indicated therapy, occurrence of serious adverse events and changes in quality-of-life. The trial will be supplemented by formal economic and process evaluations.</p> <p>Discussion</p> <p>The Kanyini-GAP trial will provide new evidence as to whether or not a polypill-based strategy improves adherence to effective cardiovascular medications amongst individuals in whom these treatments are indicated.</p> <p>Trial Registration</p> <p>This trial is registered with the Australian New Zealand Clinical Trial Registry ACTRN126080005833347.</p