1,125 research outputs found
Choosing the Best Direction of Printing for Additive Manufacturing Process in Medical Applications Using a New Geometric Complexity Model Based on Part CAD Data
Additive manufacturing processes is now experiencing significant growth and is at the origin of intense research activity (optimization of topology, biomedical applications, etc.). One of the characteristics of this method is that the geometric complexity is free. The complexity of a CAD model is also a field of research. The basic idea is that the complexity of a component has implications in design and especially in manufacturing. Indeed, industrial competitiveness in the mechanical field generated the need to produce increasingly complex systems and parts (in terms of geometry, topology ...). Part deposition orientation is also very important factor of additive manufacturing as it effects build time, support structure, dimensional accuracy, surface finish and cost of the part. A number of layered manufacturing process specific parameters and constraints have to be considered while deciding the part deposition orientation. Determination of an optimal part deposition orientation is a difficult and time consuming task as one has to trade-off among various contradicting objectives like part surface finish and build time. This paper describes and compares various attempts made to determine part deposition orientation of orthoses using geometric complexity model and part CAD information. (c) Springer Nature Switzerland AG 2019
Telecare motivational interviewing for diabetes patient education and support : a randomised controlled trial based in primary care comparing nurse and peer supporter delivery
Background: There is increasing interest in developing peer-led and 'expert patient'-type interventions, particularly to meet the support and informational needs of those with long term conditions, leading to improved clinical outcomes, and pressure relief on mainstream health services. There is also increasing interest in telephone support, due to its greater accessibility and potential availability than face to face provided support. The evidence base for peer telephone interventions is relatively weak, although such services are widely available as support lines provided by user groups and other charitable services.
Methods/Design: In a 3-arm RCT, participants are allocated to either an intervention group with Telecare service provided by a Diabetes Specialist Nurse (DSN), an intervention group with service provided by a peer supporter (also living with diabetes), or a control group receiving routine care only. All supporters underwent a 2-day training in motivational interviewing, empowerment and active listening skills to provide telephone support over a period of up to 6 months to adults with poorly controlled type 2 diabetes who had been recommended a change in diabetes management (i.e. medication and/or lifestyle
changes) by their general practitioner (GP). The primary outcome is self-efficacy; secondary outcomes include HbA1c, total and HDL cholesterol, blood pressure, body mass index, and adherence to treatment. 375 participants (125 in each arm) were sought from GP practices across West Midlands, to detect a difference in self-efficacy scores with an effect size of 0.35, 80% power, and 5% significance level. Adults
living with type 2 diabetes, with an HbA1c > 8% and not taking insulin were initially eligible. A protocol
change 10 months into the recruitment resulted in a change of eligibility by reducing HbA1c to > 7.4%. Several qualitative studies are being conducted alongside the main RCT to describe patient, telecare supporter and practice nurse experience of the trial.
Discussion and implications of the research: With its focus on self-management and telephone peer support, the intervention being trialled has the potential to support improved self-efficacy and patient experience, improved clinical outcomes and a reduction in diabetes-related complications
Value, but high costs in post-deposition data Curation
© The Author(s) 2016. Published by Oxford University Press. Discoverability of sequence data in primary data archives is proportional to the richness of contextual information associated with the data. Here, we describe an exercise in the improvement of contextual information surrounding sample records associated with metagenomics sequence reads available in the European Nucleotide Archive. We outline the annotation process and summarize findings of this effort aimed at increasing usability of publicly available environmental data. Furthermore, we emphasize the benefits of such an exercise and detail its costs. We conclude that such a third party annotation approach is expensive and has value as an element of curation, but should form only part of a more sustainable submitter-driven approach
Production of fructooligosaccharides and b-fructofuranosidase by batch and repeated batch fermentation with immobilized cells of Penicillium expansum
The production of fructooligosaccharides
(FOS) and b-fructofuranosidase (FFase) by immobilized
cells of Penicillium expansum was evaluated. In an initial
stage, different low-cost materials including synthetic fiber,
polyurethane foam, stainless steel sponge, loofah sponge,
and cork oak were tested as carrier for the fungus immobilization.
Additionally, the influence of the inoculum age
(1 or 3 weeks) on cells immobilization, FOS and FFase
production was also verified. Synthetic fiber and polyurethane
foam were the best materials for P. expansum
immobilization (2.21 and 1.98 g/g carrier, respectively)
and FOS production (120.3 and 104.8 g/l), and gave also
high results of FFase activity (23.01 and 32.42 U/ml).
Then, the production of FOS and FFase by repeated batch
fermentation with P. expansum immobilized on synthetic
fiber was studied, aiming to improve the batch fermentation
results. The results obtained in this stage were very
promising with FOS yields of 87, 72, and 44 %, in the 3
initial cycles (60 h), respectively; the FFase activity was
constant throughout the process (6 cycles, 96 h). Repeated
batch fermentation with immobilized cells of P. expansum
was found as being a technology with great potential for
FOS and FFase production on industrial scaleThe financial support from FCT, the Portuguese Foundation for Science and Technology (research grant SFRH/BPD/38212/2007) is gratefully acknowledged
Sequential analysis of surfactant, lung function and inflammation in cystic fibrosis patients
BACKGROUND: In a cross-sectional analysis of cystic fibrosis (CF) patients with mild lung disease, reduced surfactant activity was correlated to increased neutrophilic airway inflammation, but not to lung function. So far, longitudinal measurements of surfactant function in CF patients are lacking and it remains unclear how these alterations relate to the progression of airway inflammation as well as decline in pulmonary function over time. METHODS: As part of the BEAT trial, a longitudinal study to assess the course of airway inflammation in CF, we studied lung function, surfactant function and endobronchial inflammation using bronchoalveolar lavage fluid from 20 CF patients with normal pulmonary function (median FEV(1 )94% of predicted) at three times over a three year period. RESULTS: There was a progressive loss of surfactant function, assessed as minimal surface tension. The decline in surfactant function was negatively correlated to an increase in neutrophilic inflammation and a decrease in lung function, assessed by FEV(1), MEF(75/25%VC), and MEF(25%VC). The concentrations of the surfactant specific proteins A, C and D did not change, whereas SP-B increased during this time period. CONCLUSION: Our findings suggest a link between loss of surfactant function driven by progressive airway inflammation and loss of small airway function in CF patients with limited lung disease
An overview of the recent developments on fructooligosaccharide production and applications
Over the past years, many researchers have suggested
that deficiencies in the diet can lead to disease states
and that some diseases can be avoided through an adequate
intake of relevant dietary components. Recently, a great interest
in dietary modulation of the human gut has been registered.
Prebiotics, such as fructooligosaccharides (FOS), play a key
role in the improvement of gut microbiota balance and in
individual health. FOS are generally used as components of
functional foods, are generally regarded as safe (generally
recognized as safe statusâfrom the Food and Drug Administration,
USA), and worth about 150⏠per kilogram. Due to
their nutrition- and health-relevant properties, such as moderate
sweetness, low carcinogenicity, low calorimetric value,
and low glycemic index, FOS have been increasingly used
by the food industry. Conventionally, FOS are produced
through a two-stage process that requires an enzyme production
and purification step in order to proceed with the chemical
reaction itself. Several studies have been conducted on the
production of FOS, aiming its optimization toward the development
of more efficient production processes and their potential
as food ingredients. The improvement of FOS yield and
productivity can be achieved by the use of different fermentative
methods and different microbial sources of FOS producing
enzymes and the optimization of nutritional and
culture parameter; therefore, this review focuses on the latest
progresses in FOS research such as its production, functional
properties, and market data.Agencia de Inovacao (AdI)-Project BIOLIFE reference PRIME 03/347. Ana Dominguez acknowledges Fundacao para a Ciencia e a Tecnologia, Portugal, for her PhD grant reference SFRH/BD/23083/2005
National audit of post-operative management in spinal surgery
BACKGROUND: There is some evidence from a Cochrane review that rehabilitation following spinal surgery may be beneficial. METHODS: We conducted a survey of current post-operative practice amongst spinal surgeons in the United Kingdom in 2002 to determine whether such interventions are being included routinely in the post-operative management of spinal patients. The survey included all surgeons who were members of either the British Association of Spinal Surgeons (BASS) or the Society for Back Pain Research. Data on the characteristics of each surgeon and his or her current pattern of practice and post-operative care were collected via a reply-paid postal questionnaire. RESULTS: Usable responses were provided by 57% of the 89 surgeons included in the survey. Most surgeons (79%) had a routine post-operative management regime, but only 35% had a written set of instructions that they gave to their patients concerning this. Over half (55%) of surgeons do not send their patients for any physiotherapy after discharge, with an average of less than two sessions of treatment organised by those that refer for physiotherapy at all. Restrictions on lifting, sitting and driving showed considerable inconsistency both between surgeons and also within the recommendations given by individual surgeons. CONCLUSION: Demonstrable inconsistencies within and between spinal surgeons in their approaches to post-operative management can be interpreted as evidence of continuing and significant uncertainty across the sub-speciality as to what does constitute best care in these areas of practice. Conducting further large, rigorous, randomised controlled trials would be the best method for obtaining definitive answers to these questions
Molecular epidemiology, drug susceptibility and economic aspects of tuberculosis in mubende district, Uganda
<div><p>Background</p><p>Tuberculosis (TB) remains a global public health problem whose effects have major impact in developing countries like Uganda. This study aimed at investigating genotypic characteristics and drug resistance profiles of <i>Mycobacterium tuberculosis</i> isolated from suspected TB patients. Furthermore, risk factors and economic burdens that could affect the current control strategies were studied.</p><p>Methods</p><p>TB suspected patients were examined in a cross-sectional study at the Mubende regional referral hospital between February and July 2011. A questionnaire was administered to each patient to obtain information associated with TB prevalence. Isolates of <i>M. tuberculosis</i> recovered during sampling were examined for drug resistance to first line anti-TB drugs using the BACTEC-MGIT960<sup>TM</sup>system. All isolates were further characterized using deletion analysis, spoligotyping and MIRU-VNTR analysis. Data were analyzed using different software; MIRU-VNTR <i>plus</i>, SITVITWEB, BioNumerics and multivariable regression models.</p><p>Results</p><p><i>M. tuberculosis</i> was isolated from 74 out of 344 patients, 48 of these were co-infected with HIV. Results from the questionnaire showed that previously treated TB, co-infection with HIV, cigarette smoking, and overcrowding were risk factors associated with TB, while high medical related transport bills were identified as an economic burden. Out of the 67 isolates that gave interpretable results, 23 different spoligopatterns were detected, nine of which were novel patterns. T2 with the sub types Uganda-I and Uganda-II was the most predominant lineage detected. Antibiotic resistance was detected in 19% and multidrug resistance was detected in 3% of the isolates.</p><p>Conclusion</p><p>The study detected <i>M. tuberculosis</i> from 21% of examined TB patients, 62% of whom were also HIV positive. There is a heterogeneous pool of genotypes that circulate in this area, with the T2 lineage being the most predominant. High medical related transport bills and drug resistance could undermine the usefulness of the current TB strategic interventions.</p></div
Entry into primary care-based buprenorphine treatment is associated with identification and treatment of other chronic medical problems
Observation of associated near-side and away-side long-range correlations in âsNN=5.02ââTeV proton-lead collisions with the ATLAS detector
Two-particle correlations in relative azimuthal angle (ÎÏ) and pseudorapidity (Îη) are measured in âsNN=5.02ââTeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1ââÎŒb-1 of data as a function of transverse momentum (pT) and the transverse energy (ÎŁETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Îη|<5) ânear-sideâ (ÎÏâŒ0) correlation that grows rapidly with increasing ÎŁETPb. A long-range âaway-sideâ (ÎÏâŒÏ) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ÎŁETPb, is found to match the near-side correlation in magnitude, shape (in Îη and ÎÏ) and ÎŁETPb dependence. The resultant ÎÏ correlation is approximately symmetric about Ï/2, and is consistent with a dominant cosâĄ2ÎÏ modulation for all ÎŁETPb ranges and particle pT
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