Neutrino energy loss rates and positron capture rates on 55^{55}Co for presupernova and supernova physics

Proton-neutron quasi-particle random phase approximation (pn-QRPA) theory has recently being used for calculation of stellar weak interaction rates of $fp$-shell nuclide with success. Neutrino losses from proto-neutron stars play a pivotal role to decide if these stars would be crushed into black holes or explode as supernovae. The product of abundance and positron capture rates on $^{55}$Co is substantial and as such can play a role in fine tuning of input parameters of simulation codes specially in the presupernova evolution. Recently we introduced our calculation of capture rates on $^{55}$Co, in a luxurious model space of $7 \hbar \omega$, employing the pn-QRPA theory with a separable interaction. Simulators, however, may require these rates on a fine scale. Here we present for the first time an expanded calculation of the neutrino energy loss rates and positron capture rates on $^{55}$Co on an extensive temperature-density scale. These type of scale is appropriate for interpolation purposes and of greater utility for simulation codes. The pn-QRPA calculated neutrino energy loss rates are enhanced roughly up to two orders of magnitude compared with the large-scale shell model calculations and favor a lower entropy for the core of massive stars.Comment: 27 pages, 6 figures, 5 table

The forming of mild steel plates with a 2.5 kW high power diode laser

Bending of 07 M20 mild steel sheets to various degrees using a contemporary 2.5 kW high power diode laser (HPDL) has been successfully demonstrated for the first time. The experimental results revealed that the HPDL induced bending angle increased with an increasing number of irradiations and high laser powers, yet decreased as the traverse speed was increased. It was also apparent from the experimental results that the laser bending angle was only linearly proportional to the number of irradiations when the latter was small. It is believed that the absence of linearity observed when the number of irradiations was high is due to local material thickening along the bend edge. From graphical results and the employment of an analytical model, the laser line energy range in which accurate control of the HPDL bending of the 07 M20 mild steel sheets could be exercised was found to be between 138 J mm-1 and 260 J mm-1

Matching Adherence Interventions to Patient Determinants Using the Theoretical Domains Framework

Introduction: Despite much research, interventions to improve medication adherence report disappointing and inconsistent results. Tailored approaches that match interventions and patient determinants of non-adherence were seldom used in clinical trials. The presence of a multitude of theoretical frameworks and models to categorize interventions and patient determinants complicated the development of common categories shared by interventions and determinants. We retrieved potential interventions and patient determinants from published literature on medication adherence, matched them like locks and keys, and categorized them according to the Theoretical Domains Framework (TDF). Methods: We identified the most relevant literature reviews on interventions and determinants in a pragmatic literature search, extracted all interventions and determinants, grouped similar concepts to umbrella terms and assigned them to TDF categories. All steps were finalized in consensus discussion between the authors. Results: Sixteen articles (5 with determinants, 11 with interventions) were included for analysis. We extracted 103 interventions and 42 determinants that we divided in 26 modifiable and 16 unmodifiable determinants. All interventions and modifiable determinants were matched within 11 categories (Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Beliefs about consequences; Intentions; Memory, Attention and decision processes; Environmental context and resources; Social influences; Emotion; and Behavioral regulation). Conclusion: In published trials on medication adherence, the congruence between interventions and determinants can be assessed with matching interventions to determinants. To be successful, interventions in medication adherence should target current modifiable determinants and be tailored to the unmodifiable determinants. Modifiable and unmodifiable determinants need to be assessed at inclusion of intervention studies to identify the patients most in need of an adherence intervention. Our matched categories may be useful to develop interventions in trials that investigate the effectiveness of adherence interventions

Shoulder load during synchronous handcycling and handrim wheelchair propulsion in persons with paraplegia

Objective: To compare the shoulder load during handcycling and wheelchair propulsion under similar conditions of external power in persons with spinal cord injury. Design: Cross-sectional. Subjects: Eight men with spinal cord injury. Methods: Kinetics and kinematics were measured during handbike and wheelchair propulsion at 25, 35, 45 and 55 W on a treadmill. Shoulder load (glenohumeral contact forces, relative muscle forces) was calculated with the Delft Shoulder and Elbow Model. Results: At all power output levels, glenohumeral contact forces were significantly lower during handcycling compared with wheelchair propulsion (p < 0.001). At 55 W, the mean glenohumeral contact force was 345 N for handcycling, whereas it was 585 N for wheelchair propulsion. Also, relative muscle forces were lower during handcycling. The largest differences between handbike and wheelchair propulsion were found in the supraspinatus (4.5% vs. 20.7%), infraspinatus (3.7% vs. 16.5%) and biceps (5.0% vs. 17.7%). Conclusion: Due to continuous force application in handcycling, shoulder load was lower compared with wheelchair propulsion. Furthermore, muscles that are prone to overuse injuries were less stressed during handcycling. Therefore, handcycling may be a good alternative for outdoor mobility and may help prevent overuse injuries of the shoulder complex. © 2012 The Authors

Shoulder Pain Is Associated With Rate of Rise and Jerk of the Applied Forces During Wheelchair Propulsion in Individuals With Paraplegic Spinal Cord Injury

OBJECTIVE: To investigate the association between propulsion biomechanics, including variables that describe smoothness of the applied forces, and shoulder pain in persons with SCI. DESIGN: Cross-sectional, observational study. SETTING: Non-university research institution. PARTICIPANTS: 30 (age: 48.6±9.3 years, 83% males) community dwelling, wheelchair dependent participants with a chronic paraplegia between T2 and L1, with and without shoulder pain. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: Rate of rise and jerk of applied forces during wheelchair propulsion. Participants were stratified in low, moderate and high pain groups based on their Wheelchair User Shoulder Pain Index (WUSPI) score at the day of measurement. RESULTS: A mixed-effect multilevel analysis showed that wheelchair users in the high pain group propelled with significantly greater rate of rise and jerk - measures that describe smoothness of the applied forces - as compared to persons with less or no pain, when controlling for all co-variables. CONCLUSIONS: Persons with severe shoulder pain propelled with less smooth strokes as compared to persons with less or no pain. This supports a possible association between shoulder pain and rate of rise and jerk of the applied forces during wheelchair propulsion

MRI evaluation of shoulder pathologies in wheelchair users with spinal cord injury and the relation to shoulder pain

OBJECTIVE: To describe the number, specifics and co-occurrence of shoulder pathologies detected by MRI in manual wheelchair users with spinal cord injury and to evaluate the association between shoulder pathologies and presence of shoulder pain.DESIGN: Cross-sectional observation study.SETTING: Community.PARTICIPANTS: Fifty-one wheelchair-dependent persons with spinal cord injury (44 males, 7 females, median age 50 years (IQR 14), median time since injury 24 years (IQR 16)) were allocated to pain or no-pain group based on the Wheelchair User Shoulder Pain Index.INTERVENTIONS: Not applicable.OUTCOME MEASURES: All persons underwent shoulder MRI. Pathologies were scored blinded by two experienced radiologists. Participant characteristics, number and severity of shoulder pathologies were analyzed descriptively. Logistic regression was performed to evaluate the association between MRI findings and shoulder pain.RESULTS: The median number of co-occurring MRI findings per person ranged from 0 to 19 (out of 31 possible findings). The cluster of MRI findings occurring most often together were tendon tears of supraspinatus (present in 84%), subscapularis (69%) and biceps (67%) and osteoarthritis of acromioclavicular joint (80%). When correcting for age and time since injury, the logistic regression showed no statistically significant correlation between the individual pathologies and shoulder pain.CONCLUSION: MRI findings of shoulder pathology are very frequent in persons with and without shoulder pain. Therefore, when diagnosing the cause of shoulder pain and planning interventions, health care professionals should keep this finding in mind and MRI should not be interpreted without careful consideration of clinical history and functional testing.</p

Investigating the impact of extraneous distractions on consultations in general practice: Lessons learned

<p>Abstract</p> <p>Background</p> <p>Extraneous distractions may influence the flow of general practice consultations. This study piloted a methodology to examine the impact of interrupting general practitioners (GPs) while consulting actor-patients.</p> <p>Methods</p> <p>Six GPs were video recorded consulting six actor-patients each presenting a different clinical scenario in a simulated surgery. Five cases presented red flag cancer symptoms. Half the consultations were interrupted. Two independent assessors, blinded to the occurrence of interruptions, assessed consultation performance using the Leicester Assessment Package (LAP) for clinical competence.</p> <p>Results</p> <p>24 of 36 consultations were video recorded with sufficient audio-visual clarity to allow scoring. The association between LAP score and three variables could be studied: a variety of interruptions, different GPs and various scenarios. Agreement between assessors on GP performance was poor and showed an increased bias with increasing LAP score. Despite this, the interruption did not significantly impact on assessor LAP scores (Mean difference: 0.22, P = 0.83) even after controlling for assessor, different GPs and scenarios.</p> <p>Conclusion</p> <p>Extraneous distractions had no impact on GP performance in this underpowered pilot study, a conclusion which needs to be confirmed in a larger study. However several important lessons were learned. Recorded actor-patient clinical sessions are logistically challenging. GPs whose skills were not previously assessed were working in unfamiliar surroundings dealing with relatively straight forward diagnostic challenges and may have anticipated the interruptions. In a redesign of this experiment it may be possible to eliminate some of these limitations.</p