Automated analysis of blood pressure measurements (Korotkov sound)

Automatic system for noninvasive measurements of arterial blood pressure is described. System uses Korotkov sound processor logic ratios to identify Korotkov sounds. Schematic diagram of system is provided to show components and method of operation

Apparatus and method for processing Korotkov sounds

A Korotkov sound processor, used in a noninvasive automatic blood measuring system where the brachial artery is occluded by an inflatable cuff, is disclosed. The Korotkoff sound associated with the systolic event is determined when the ratio of the absolute value of a voltage signal, representing Korotkov sounds in the range of 18 to 26 Hz to a maximum absolute peak value of the unfiltered signals, first equals or exceeds a value of 0.45. Korotkov sound associated with the diastolic event is determined when a ratio of the voltage signal of the Korotkov sounds in the range of 40 to 60 Hz to the absolute peak value of such signals within a single measurement cycle first falls below a value of 0.17. The processor signals the occurrence of the systolic and diastolic events and these signals can be used to control a recorder to record pressure values for these events

Precision laser range finder system design for Advanced Technology Laboratory applications

Preliminary system design of a pulsed precision ruby laser rangefinder system is presented which has a potential range resolution of 0.4 cm when atmospheric effects are negligible. The system being proposed for flight testing on the advanced technology laboratory (ATL) consists of a modelocked ruby laser transmitter, course and vernier rangefinder receivers, optical beacon retroreflector tracking system, and a network of ATL tracking retroreflectors. Performance calculations indicate that spacecraft to ground ranging accuracies of 1 to 2 cm are possible

Contourograph display system for monitoring electrocardiograms

Electrocardiogram is displayed as a contourogram on the cathode ray tube of a variable-persistence oscilloscope. Each cycle is stacked below its predecessors giving a three dimensional effect. A major change in the signal is apparent as a change in the contourogram pattern

A novel laser ranging system for measurement of ground-to-satellite distances

A technique was developed for improving the precision of laser ranging measurements of ground-to-satellite distances. The method employs a mode-locked laser transmitter and utilizes an image converter tube equipped with deflection plates in measuring the time of flight of the laser pulse to a distant retroreflector and back. Samples of the outgoing and returning light pulses are focussed on the photocathode of the image converter tube, whose deflection plates are driven by a high-voltage 120 MHz sine wave derived from a very stable oscillator. From the relative positions of the images produced at the output phosphor by the two light pulses, it is possible to make a precise determination of the fractional amount by which the time of flight exceeds some large integral multiple of the period of the deflection sinusoid

Precipitation of Secondary Phases from the Dissolution of Silicate Glasses

Basaltic and anorthositic glasses were subjected to aqueous weathering conditions in the laboratory where the variables were pH, temperature, glass composition, solution composition, and time. Leached layers formed at the surfaces of glasses followed by the precipitation of X-ray amorphous iron and titanium oxides in acidic and neutral solutions at 25 C over time. Glass under oxidative hydrothermal treatments at 150 C yielded a three-layered surface; which included an outer smectite layer, a Fe-Ti oxide layer and an innermost thin leached layer. The introduction of Mg into solutions facilitated the formation of phyllosilicates. Aqueous hydrothermal treatment of anorthositic glasses (high Ca, low Ti) at 200 C readily formed smectite, whereas, the basaltic glasses (high Ti) were more resistant to alteration and smectite was not observed. Alkaline hydrothermal treatment at 2000e produced zeolites and smectites; only smectites formed at 200 C in neutral solutions. These mineralogical changes, although observed under controlled conditions, have direct applications in interpreting planetary (e.g., meteorite parent bodies) and terrestrial aqueous alteration processes

The Duration of Chemical Weathering of Gusev Crater's Wishstone-Watchtower Sequence

Mineralogical abundance of primary minerals versus secondary minerals, chemical mixing relationships, and elemental ratios have been used to assess the degree of aqueous alteration at Gusev Crater and Meridiani Planum. However, limited work has used Ti-normalized mass-balance analysis chemical data to quantify gains and losses of elements from altered materials as well as estimate the duration of aqueous alteration on Mars. The Ti-normalized mass-balance approach accounts for volumetric changes associated with geochemical alteration. If volumetric changes are not considered, observed geochemical trends based on un-normalized data have the potential to be misleading. Assessing gains and losses from altered materials can indicate the geochemistry of fluids involved in the alteration. Furthermore, elemental losses can be combined with dissolution rates to estimate the duration of chemical weathering. Knowledge of the duration of aqueous alteration will provide insight into the climate history of Mars as well as indicate the potential for microbial habitability. The Wishstone-Watchtower materials in Gusev Crater are suitable candidates for Ti-normalized mass-balance analysis because mixing relationships of these two materials indicate that Watchtower materials may be derived from Wishstone-like materials. The objectives of this work are to (1) employ Ti-normalized mass-balance to assess gains and losses from the Wishstone-Watchtower sequence and (2) to combine losses with laboratory dissolution rates to estimate alteration times of the Watchtower material

Effective patient–clinician interaction to improve treatment outcomes for patients with psychosis: a mixed-methods design

BACKGROUND:At least 100,000 patients with schizophrenia receive care from community mental health teams (CMHTs) in England. These patients have regular meetings with clinicians, who assess them, engage them in treatment and co-ordinate care. As these routine meetings are not commonly guided by research evidence, a new intervention, DIALOG, was previously designed to structure consultations. Using a hand-held computer, clinicians asked patients to rate their satisfaction with eight life domains and three treatment aspects, and to indicate whether or not additional help was needed in each area, with responses being graphically displayed and compared with previous ratings. In a European multicentre trial, the intervention improved patients’ quality of life over a 1-year period. The current programme builds on this research by further developing DIALOG in the UK. RESEARCH QUESTIONS:(1) How can the practical procedure of the intervention be improved, including the software used and the design of the user interface? (2) How can elements of resource-oriented interventions be incorporated into a clinician manual and training programme for a new, more extensive ‘DIALOG+’ intervention? (3) How effective and cost-effective is the new DIALOG+ intervention in improving treatment outcomes for patients with schizophrenia or a related disorder? (4) What are the views of patients and clinicians regarding the new DIALOG+ intervention? METHODS:We produced new software on a tablet computer for CMHTs in the NHS, informed by analysis of videos of DIALOG sessions from the original trial and six focus groups with 18 patients with psychosis. We developed the new ‘DIALOG+’ intervention in consultation with experts, incorporating principles of solution-focused therapy when responding to patients’ ratings and specifying the procedure in a manual and training programme for clinicians. We conducted an exploratory cluster randomised controlled trial with 49 clinicians and 179 patients with psychosis in East London NHS Foundation Trust, comparing DIALOG+ with an active control. Clinicians working as care co-ordinators in CMHTs (along with their patients) were cluster randomised 1 : 1 to either DIALOG+ or treatment as usual plus an active control, to prevent contamination. Intervention and control were to be administered monthly for 6 months, with data collected at baseline and at 3, 6 and 12 months following randomisation. The primary outcome was subjective quality of life as measured on the Manchester Short Assessment of Quality of Life; secondary outcomes were also measured. We also established the cost-effectiveness of the DIALOG intervention using data from the Client Service Receipt Inventory, which records patients’ retrospective reports of using health- and social-care services, including hospital services, outpatient services and medication, in the 3 months prior to each time point. Data were supplemented by the clinical notes in patients’ medical records to improve accuracy. We conducted an exploratory thematic analysis of 16 video-recorded DIALOG+ sessions and measured adherence in these videos using a specially developed adherence scale. We conducted focus groups with patients (n = 19) and clinicians (n = 19) about their experiences of the intervention, and conducted thematic analyses. We disseminated the findings and made the application (app), manual and training freely available, as well as producing a protocol for a definitive trial. RESULTS:Patients receiving the new intervention showed more favourable quality of life in the DIALOG+ group after 3 months (effect size: Cohen’s d = 0.34), after 6 months (Cohen’s d = 0.29) and after 12 months (Cohen’s d = 0.34). An analysis of video-recorded DIALOG+ sessions showed inconsistent implementation, with adherence to the intervention being a little over half of the possible score. Patients and clinicians from the DIALOG+ arm of the trial reported many positive experiences with the intervention, including better self-expression and improved efficiency of meetings. Difficulties reported with the intervention were addressed by further refining the DIALOG+ manual and training. Cost-effectiveness analyses found a 72% likelihood that the intervention both improved outcomes and saved costs. LIMITATIONS:The research was conducted solely in urban east London, meaning that the results may not be broadly generalisable to other settings. CONCLUSIONS:(1) Although services might consider adopting DIALOG+ based on the existing evidence, a definitive trial appears warranted; (2) applying DIALOG+ to patient groups with other mental disorders may be considered, and to groups with physical health problems; (3) a more flexible use with variable intervals might help to make the intervention even more acceptable and effective; (4) more process evaluation is required to identify what mechanisms precisely are involved in the improvements seen in the intervention group in the trial; and (5) what appears to make DIALOG+ effective is that it is not a separate treatment and not a technology that is administered by a specialist; rather, it changes and utilises the existing therapeutic relationship between patients and clinicians in CMHTs to initiate positive change, helping the patients to improve their quality of life. FUTURE RESEARCH:Future studies should include a definitive trial on DIALOG+ and test the effectiveness of the intervention with other populations, such as people with depression. TRIAL REGISTRATION:Current Controlled Trials ISRCTN34757603. FUNDING:The National Institute for Health Research Programme Grants for Applied Research programme

Implications of the Optical Observations of Neutron Stars

We show that observations of pulsars with pulsed optical emission indicate that the peak flux scales according to the magnetic field strength at the light cylinder. The derived relationships indicate that the emission mechanism is common across all of the observed pulsars with periods ranging from 33ms to 385 ms and ages of 1000-300,000 years. It is noted that similar trends exist for $\gamma$ ray pulsars. Furthermore the model proposed by Pacini (1971) and developed by Pacini and Salvati (1983,1987) still has validity and gives an adequate explanation of the optical phenomena.Comment: 23 pages, 6 figures, accepted for publication in the Astrophysical Journa