Optimization and quality control of suspended particulate matter concentration measurement using turbidity measurements

The dry weight concentration of suspended particulate material, [SPM] (units: mg L?1), is measured by passing a known volume of seawater through a preweighed filter and reweighing the filter after drying. This is apparently a simple procedure, but accuracy and precision of [SPM] measurements vary widely depending on the measurement protocol and experience and skills of the person filtering. We show that measurements of turbidity, T (units: FNU), which are low cost, simple, and fast, can be used to optimally set the filtration volume, to detect problems with the mixing of the sample during subsampling, and to quality control [SPM]. A relationship between T and ?optimal filtration volume?, Vopt, is established where Vopt is the volume at which enough matter is retained by the filter for precise measurement, but not so much that the filter clogs. This relationship is based on an assessment of procedural uncertainties in the [SPM] measurement protocol, including salt retention, filter preparation, weighing, and handling, and on a value for minimum relative precision for replicates. The effect of filtration volume on the precision of [SPM] measurement is investigated by filtering volumes of seawater ranging between one fifth and twice Vopt. It is shown that filtrations at Vopt maximize precision and cost effectiveness of [SPM]. Finally, the 90% prediction bounds of the T versus [SPM] regression allow the quality control of [SPM] determinations. In conclusion it is recommended that existing [SPM] gravimetric measurements be refined to include measurement of turbidity to improve their precision and quality control

Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders

Introduction In Denmark, the magnitude and impact of work disability on the individual worker and society has prompted the development of a new "coordinated and tailored work rehabilitation" (CTWR) approach. The aim of this study was to compare the effects of CTWR with conventional case management (CCM) on return-to-work of workers on sick leave due to musculoskeletal disorders (MSDs). Methods The study was a randomized controlled trial with economic evaluation undertaken with workers on sick leave for 4-12 weeks due to MSDs. CTWR consists of a work disability screening by an interdisciplinary team followed by the collaborative development of a RTW plan. The primary outcome variable was registered cumulative sickness absence hours during 12 months follow-up. Secondary outcomes were work status as well as pain intensity and functional disability, measured at baseline, 3 and 12 months follow-up. The economic evaluation (intervention costs, productivity loss, and health care utilization costs) was based on administrative data derived from national registries. Results For the time intervals 0-6 months, 6-12 months, and the entire follow-up period, the number of sickness absence hours was significantly lower in the CTWR group as compared to the control group. The total costs saved in CTWR participants compared to controls were estimated at US $1,366 per person at 6 months follow-up and US$ 10,666 per person at 12 months follow-up. Conclusions Workers on sick leave for 4-12 weeks due to MSD who underwent "CTWR" by an interdisciplinary team had fewer sickness absence hours than controls. The economic evaluation showed that-in terms of productivity loss-CTWR seems to be cost saving for the society

An integrated care program to prevent work disability due to chronic low back pain: a process evaluation within a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>In the past decade, a considerable amount of research has been carried out to evaluate the effectiveness of innovative low back pain (LBP) interventions. Although some interventions proved to be effective, they are not always applied in daily practice. To successfully implement an innovative program it is important to identify barriers and facilitators in order to change practice routine. Because usual care is not directly aimed at return to work (RTW), we evaluated an integrated care program, combining a patient-directed and a workplace-directed intervention provided by a multidisciplinary team, including a clinical occupational physician to reduce occupational disability in chronic LBP patients. The aims of this study were to describe the feasibility of the implementation of the integrated care program, to assess the satisfaction and expectations of the involved stakeholders and to describe the needs for improvement of the program.</p> <p>Methods</p> <p>Eligible for this study were patients who had been on sick leave due to chronic LBP. Data were collected from the patients, their supervisors and the involved health care professionals, by means of questionnaires and structured charts, during 3-month follow-up. Implementation, satisfaction and expectations were investigated.</p> <p>Results</p> <p>Of the 40 patients who were eligible to participate in the integrated care program, 37 patients, their supervisors and the health care professionals actually participated in the intervention. Adherence to the integrated care program was in accordance with the protocol, and the patients, their supervisors and the health care professionals were (very) satisfied with the program. The role of the clinical occupational physician was of additional value in the RTW process. Time-investment was the only barrier for implementation reported by the multidisciplinary team.</p> <p>Conclusion</p> <p>The implementation of this program will not be influenced by any flaws in its application that are related to the program itself, or to the adherence of patients with chronic LBP and their health care professionals.</p> <p>This program is promising in terms of feasibility, satisfaction and compliance of the patients, their supervisors and the health care professionals. Before implementation on a wider scale, the communication and the information technology of the program should be improved.</p> <p>Trials Registration</p> <p>[ISRCTN28478651]</p

In Utero Diagnosis of Niemann-Pick Type C in the Absence of Family History

Niemann-Pick type C (NPC) disease is a recessive disorder that results in unesterified cholesterol accumulating in the lysosomal and late endosomal system. It is caused by mutations in NPC1 or NPC2 genes and leads to systemic and neurodegenerative symptoms. Few cases of prenatal presentation of NPC have been reported and only two cases in the absence of previous family history, indicating the diagnosis is particularly difficult in such a situation. We report a prenatal diagnosis of NPC in a couple without family history. An ultrasound screening at 22 weeks of gestation (WG) detected fetal ascites and hepatomegaly, which were still present at 25, 27, and 29 WG, and a splenomegaly progressively appeared. No placentomegaly or other signs of hydrops fetalis were observed. The diagnostic of NPC was prenatally confirmed by a filipin test and NPC1 sequencing and multiplex ligation-dependent probe amplification assay which revealed a maternal missense mutation (c.2608T&gt;C; p.Ser870Pro) and a paternal deletion of exons 5 to 25. This additional prenatal case of NPC suggests that even in the absence of family history, fetal ascites associated with splenomegaly but no hydrops should nonetheless arouse suspicion concerning this disease as a possible diagnosis

Iron and Nickel spectral opacity calculations in conditions relevant for pulsating stellar envelopes and experiments

Seismology of stars is strongly developing. To address this question we have formed an international collaboration OPAC to perform specific experimental measurements, compare opacity calculations and improve the opacity calculations in the stellar codes [1]. We consider the following opacity codes: SCO, CASSANDRA, STA, OPAS, LEDCOP, OP, SCO-RCG. Their comparison has shown large differences for Fe and Ni in equivalent conditions of envelopes of type II supernova precursors, temperatures between 15 and 40 eV and densities of a few mg/cm3 [2, 3, 4]. LEDCOP, OPAS, SCO-RCG structure codes and STA give similar results and differ from OP ones for the lower temperatures and for spectral interval values [3]. In this work we discuss the role of Configuration Interaction (CI) and the influence of the number of used configurations. We present and include in the opacity code comparisons new HULLAC-v9 calculations [5, 6] that include full CI. To illustrate the importance of this effect we compare different CI approximations (modes) available in HULLAC-v9 [7]. These results are compared to previous predictions and to experimental data. Differences with OP results are discussed.Comment: 4 pages, 3 figures, conference Inertial Fusion Sciences and Applications, Bordeaux, 12th to 16th September 2011; EPJ web of Conferences 201

Theoretical and experimental activities on opacities for a good interpretation of seismic stellar probes

Opacity calculations are basic ingredients of stellar modelling. They play a crucial role in the interpretation of acoustic modes detected by SoHO, COROT and KEPLER. In this review we present our activities on both theoretical and experimental sides. We show new calculations of opacity spectra and comparisons between eight groups who produce opacity spectra calculations in the domain where experiments are scheduled. Real differences are noticed with real astrophysical consequences when one extends helioseismology to cluster studies of different compositions. Two cases are considered presently: (1) the solar radiative zone and (2) the beta Cephei envelops. We describe how our experiments are performed and new preliminary results on nickel obtained in the campaign 2010 at LULI 2000 at Polytechnique.Comment: 6 pages, 4 figures, invited talk at SOHO2

The cost effectiveness of NHS physiotherapy support for occupational health (OH) services

Background: Musculoskeletal pain is detrimental to quality of life (QOL) and disruptive to activities of daily living. It also places a major economic burden on healthcare systems and wider society. In 2006, the Welsh Assembly Government (WAG) established a three tiered self-referral Occupational Health Physiotherapy Pilot Project (OHPPP) comprising: 1.) telephone advice and triage, 2.) face-to-face physiotherapy assessment and treatment if required, and 3.) workplace assessment and a return-to-work facilitation package as appropriate. This study aimed to evaluate the feasibility and cost-effectiveness of the pilot service. Methods: A pragmatic cohort study was undertaken, with all OHPPP service users between September 2008 and February 2009 being invited to participate. Participants were assessed on clinical status, yellow flags, sickness absence and work performance at baseline, after treatment and at 3 month follow up. Cost-effectiveness was evaluated from both top-down and bottom-up perspectives and cost per Quality Adjusted Life Year (cost/QALY) was calculated. The cost-effectiveness analysis assessed the increase in service cost that would be necessary before the cost-effectiveness of the service was compromised. Results A total of 515 patients completed questionnaires at baseline. Of these, 486 were referred for face to face assessment with a physiotherapist and were included in the analysis for the current study. 264 (54.3%) and 199 (40.9%) were retained at end of treatment and 3 month follow up respectively. An improvement was observed at follow up in all the clinical outcomes assessed, as well as a reduction in healthcare resource usage and sickness absence, and improvement in self-reported work performance. Multivariate regression indicated that baseline and current physical health were associated with work-related outcomes at follow up. The costs of the service were £194-£360 per service user depending on the method used, and the health gains contributed to a cost/QALY of £1386-£7760, which would represent value for money according to current UK thresholds. Sensitivity analyses demonstrated that the service would remain cost effective until the service costs were increased to 160% per user. Conclusions: This pragmatic evaluation of the OHPPP indicated that it was likely to be feasible in terms of service usage and could potentially be cost effective in terms of QALYs. Further, the study confirmed that improving physical health status for musculoskeletal pain patients is important in reducing problems with work capacity and related costs. This study suggests that this type of service could be potentially be useful in reducing the burden of pain and should be further investigated, ideally via randomised controlled trials assessing effectiveness and cost-effectiveness

The Force-Velocity Relation for Growing Biopolymers

The process of force generation by the growth of biopolymers is simulated via a Langevin-dynamics approach. The interaction forces are taken to have simple forms that favor the growth of straight fibers from solution. The force-velocity relation is obtained from the simulations for two versions of the monomer-monomer force field. It is found that the growth rate drops off more rapidly with applied force than expected from the simplest theories based on thermal motion of the obstacle. The discrepancies amount to a factor of three or more when the applied force exceeds 2.5kT/a, where a is the step size for the polymer growth. These results are explained on the basis of restricted diffusion of monomers near the fiber tip. It is also found that the mobility of the obstacle has little effect on the growth rate, over a broad range.Comment: Latex source, 9 postscript figures, uses psfig.st