Wind tunnel results of the low-speed NLF(1)-0414F airfoil

The large performance gains predicted for the Natural Laminar Flow (NLF)(1)-0414F airfoil were demonstrated in two-dimensional airfoil tests and in wind tunnel tests conducted with a full scale modified Cessna 210. The performance gains result from maintaining extensive areas of natural laminar flow, and were verified by flight tests conducted with the modified Cessna. The lift, stability, and control characteristics of the Cessna were found to be essentially unchanged when boundary layer transition was fixed near the wing leading edge. These characteristics are very desirable from a safety and certification view where premature boundary layer transition (due to insect contamination, etc.) must be considered. The leading edge modifications were found to enhance the roll damping of the Cessna at the stall, and were therefore considered effective in improving the stall/departure resistance. Also, the modifications were found to be responsible for only minor performance penalties

Complex nanostructures in diamond

Meteoritic diamonds and synthesized diamond-related materials contain a wide variety of complex nanostructures. This Comment highlights and classifies this structural complexity by a systematic hierarchical approach, and discusses the perspectives on nanostructure and properties engineering of diamond-related materials

Untersuchungen zur Komplexierung von Cm(III) und Eu(III) mit partitioning-relevanten Liganden

In der vorliegenden Arbeit wird die Komplexbildung von Cm(III) und Eu(III) mit BTP- und BTBP-Liganden, welche als potentielle Extraktionsmittel zur technischen Umsetzung des SANEX-Prozesses im Rahmen der Partitioning & Transmutation-Strategie diskutiert werden, untersucht. Beide Ligandenklassen vermögen trivalente minore Actiniden selektiv in Gegenwart von Lanthaniden zu extrahieren, die Ursache ihrer Selektivität ist jedoch bisher weitgehend unverstanden. Ziel der Arbeit ist es, die Komplexbildung von BTP- und BTBP-Liganden mit trivalenten minoren Actiniden und Lanthaniden unter prozessrelevanten Bedingungen zu unter¬suchen und hieraus bedeutende Erkenntnisse über die Triebkraft der Selektivität auf molekularer Ebene zu erhalten. Die spektroskopische Quantifizierung der Komplexspezies in Lösung erfolgte mittels der zeitaufgelösten Laserfluoreszenzspektroskopie (TRLFS), welche für die verwendeten Metall¬ionen Cm(III) und Eu(III) eine hochempfindliche und selektive Speziationsmethode darstellt. Anhand von spektroskopischen Untersuchungen zur Komplexierung von n-Pr-BTP in 1 Octanol wurde gezeigt, dass die Stabilitätskonstanten der extraktionsrelevanten 1:3-Komplexe im Falle des Cm(III) fünf Größenordnungen höher sind als die der entsprechenden Eu(III)-Komplexe, worin sich die Selektivität der Liganden bezüglich der Extraktion widerspiegelt. Anhand von Untersuchungen zur Komplexbildung im Wasser-Methanol-Gemisch wurden die höheren Stabilitätskonstanten auf Unter¬schiede in der Reaktionsenthalpie (ΔH) zurückgeführt. Erstmalig wurde der Einfluss elektronischer Parameter SANEX-relevanter Liganden auf Extraktion und Komplex¬bildung gezielt untersucht. Hierzu wurde n-Pr-BTP mit einer Methoxy- beziehungsweise Chlorofunktion in 4-Position derivatisiert. Die Basizität der Liganden steigt hierbei mit der Elektronendichte im aromatischen System an. Es wurde gezeigt, dass die Erhöhung der Basizität sowohl mit der Erhöhung der Stabilitätskonstan¬ten der 1:3-Komplexe als auch mit höheren Verteilungsverhältnissen und Trennfaktoren bezüglich der Extraktion einhergeht. Im Falle der Komplexierung von Cm(III) und Eu(III) mit BTBP-Liganden in 1-Octanol weisen die Stabilitätskonstanten der extraktionsrelevanten 1:2 Komplexe im Falle des Cm(III) um eine Größenordnung höhere Stabilitätskonstanten als die entsprechenden Eu(III)-Komplexe auf, was die Ursache ihrer Selektivität bezüglich der Extraktion darstellt. Durch Untersuchungen im Wasser-Isopropanol-Gemisch wurden Unterschiede in ΔH als thermodynamische Triebkraft der Selektivität bestimmt. Die erhaltenen Daten korrelieren sehr gut mit experimentell bestimmten Trennfaktoren. Darüberhinaus wurden zwei neue Extraktionsliganden entwickelt, deren Strukturen sich von den BTP-Liganden (CA-BTP) und den BTBP-Liganden (Me-BBTBP) ableiten. CA-BTP stellt hierbei eine bedeutende Entwicklung im Hinblick auf die technische Umsetzung des SANEX-Prozesses dar. Es handelt sich um den ersten unter prozessrelevanten Konditionen hydrolysestabilen selektiven Liganden, dessen schnelle Massentransferkinetik den Einsatz in einem technischen Einsatz ermöglicht. Me-BBTBP stellt dagegen das erste Mitglied einer neuen Ligandenklasse dar, welche nun bezüglich ihrer Extraktions- und Komplexierungseigenschaften weiter untersucht werden. Im Rahmen dieser Arbeit konnten erstmals durch Untersuchungen zur bevorzugten Komplexbildung von trivalenten Actiniden im Vergleich zu Lanthaniden mit BTP- und BTBP-Liganden unter vergleichbaren, prozessrelevanten Bedingungen wichtige Informationen über die molekulare Ursache der Selektivität dieser Ligandensysteme erhalten werden, die eindeutig auf Unterschiede in der Reaktionsenthalpie zurückgeführt werden kann. Dies stellt einen bedeutenden Baustein zum Verständnis der Selektivität dieser Ligandenklassen dar und ist unverzichtbar für eine Optimierung der Extraktionsmittel im Hinblick auf die zukünftige technische Umsetzung des SANEX-Prozesses

The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer

The significance of the inter-relationship between tumour and host local/systemic inflammatory responses in primary operable invasive breast cancer is limited. The inter-relationship between the systemic inflammatory response (pre-operative white cell count, C-reactive protein and albumin concentrations), standard clinicopathological factors, tumour T-lymphocytic (CD4+ and CD8+) and macrophage (CD68+) infiltration, proliferative (Ki-67) index and microvessel density (CD34+) was examined using immunohistochemistry and slide-counting techniques, and their prognostic values were examined in 168 patients with potentially curative resection of early-stage invasive breast cancer. Increased tumour grade and proliferative activity were associated with greater tumour T-lymphocyte (P<0.05) and macrophage (P<0.05) infiltration and microvessel density (P<0.01). The median follow-up of survivors was 72 months. During this period, 31 patients died; 18 died of their cancer. On univariate analysis, increased lymph-node involvement (P<0.01), negative hormonal receptor (P<0.10), lower albumin concentrations (P<0.01), increased tumour proliferation (P<0.05), increased tumour microvessel density (P<0.05), the extent of locoregional control (P<0.0001) and limited systemic treatment (Pless than or equal to0.01) were associated with cancer-specific survival. On multivariate analysis of these significant covariates, albumin (HR 4.77, 95% CI 1.35–16.85, P=0.015), locoregional treatment (HR 3.64, 95% CI 1.04–12.72, P=0.043) and systemic treatment (HR 2.29, 95% CI 1.23–4.27, P=0.009) were significant independent predictors of cancer-specific survival. Among tumour-based inflammatory factors, only tumour microvessel density (P<0.05) was independently associated with poorer cancer-specific survival. The host inflammatory responses are closely associated with poor tumour differentiation, proliferation and malignant disease progression in breast cancer

Patient satisfaction with antiretroviral services at primary health-care facilities in the Free State, South Africa – a two-year study using four waves of cross-sectional data

<p>Abstract</p> <p>Background</p> <p>The study's first objective was to determine the levels of patient satisfaction with services at antiretroviral treatment (ART) assessment sites. Differences in patient satisfaction with several aspects of service over time and among health districts were measured. The second objective was to examine the association between human resource shortages and levels of patient satisfaction with services.</p> <p>Methods</p> <p>Four cross-sectional waves of data were collected from a random sample of 975 patients enrolled in the Free State's public-sector ART programme. One-way analysis of variance (ANOVA) with the Bonferroni adjustment for multiple comparisons was used to assess the differences in patient satisfaction among the Province's five districts and among the four waves of data. Correlation coefficient analysis using Pearson's <it>r </it>was used to assess the association between ART nurse vacancy rates and patient satisfaction with the services provided by nurses over time.</p> <p>Results</p> <p>With respect to both general services and the services provided by nurses, our results indicate high overall satisfaction among Free State patients receiving public-sector ART. However, our data present a less positive picture of patient satisfaction with waiting times. Patients in Fezile Dabi District were generally slightly dissatisfied with the waiting times at their assessment sites. In fact, waiting times at assessment sites were the most important predictor of discontent among ART patients. Significant geographical (<it>P </it>< 0.001) and temporal differences (<it>P </it>< 0.005) were observed in these three aspects of patient satisfaction. Patients were most satisfied in Thabo Mofutsanyana District and least satisfied in Motheo District. Patients in Fezile Dabi District were generally slightly dissatisfied with the waiting times at their assessment sites. Finally, our analysis revealed a strong negative association (<it>r </it>= -0.438, <it>P </it>< 0.001) between nurse vacancy rates and mean satisfaction levels with services performed by nurses at baseline. Patients attending facilities with high professional nurse vacancy rates reported significantly less satisfaction with nurses' services than did those attending facilities with fewer vacant nursing posts.</p> <p>Conclusion</p> <p>Collectively, our findings show high levels of patient satisfaction with ART-related services, but also confirm claims by other studies, which have identified human resource shortages as the most important obstacle to a successful South African AIDS strategy.</p

Food access and diet quality are associated with quality of life outcomes among HIV-infected individuals in Uganda.

BACKGROUND: Food insecurity is associated with poor nutritional and clinical outcomes among people living with HIV/AIDS. Few studies investigate the link between food insecurity, dietary diversity and health-related quality of life among people living with HIV/AIDS. OBJECTIVE: We investigated whether household food access and individual dietary diversity are associated with health-related quality of life among people living with HIV/AIDS in Uganda. METHODS: We surveyed 902 people living with HIV/AIDS and their households from two clinics in Northern Uganda. Health-related quality of life outcomes were assessed using the Medical Outcomes Study (MOS)-HIV Survey. We performed multivariate regressions to investigate the relationship between health-related quality of life, household food insecurity and individual dietary diversity. RESULTS: People living with HIV/AIDS from severe food insecurity households have mean mental health status scores that are 1.7 points lower (p<.001) and physical health status scores that are 1.5 points lower (p<.01). Individuals with high dietary diversity have mean mental health status scores that were 3.6 points higher (p<.001) and physical health status scores that were 2.8 points higher (p<.05). CONCLUSIONS: Food access and diet quality are associated with health-related quality of life and may be considered as part of comprehensive interventions designed to mitigate psychosocial consequences of HIV

Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice

Background: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost-effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs. Methods: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients’ non-adherence. Clinical event probability, treatment pathway, resource-use and costs were extracted from literature and costing tariffs. Incremental costs and outcomes associated with each disease were incorporated additively into a composite probabilistic model and combined with adherence rates and intervention costs from the trial. Costs per extra quality-adjusted-life-year(QALY) were calculated from the perspective of NHS England, using a lifetime horizon. Results: NMS generated a mean of 0.05 (95%CI: 0.00, 0.13) more QALYs per patient, at a mean reduced cost of -£144 (95%CI: -769, 73). The NMS dominates normal practice with probability of 0.78 (ICER: - £3166 per QALY). NMS has a 96.7% probability of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Sensitivity analysis demonstrated that targeting each disease with NMS has a probability over 0.90 of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Conclusions: Our study suggests that the New Medicine Service increased patient medicine adherence compared with normal practice, which translated into increased health gain at reduced overall cost

Gut Microbiota, Probiotics and Diabetes

Diabetes is a condition of multifactorial origin, involving several molecular mechanisms related to the intestinal microbiota for its development. In type 2 diabetes, receptor activation and recognition by microorganisms from the intestinal lumen may trigger inflammatory responses, inducing the phosphorylation of serine residues in insulin receptor substrate-1, reducing insulin sensitivity. In type 1 diabetes, the lowered expression of adhesion proteins within the intestinal epithelium favours a greater immune response that may result in destruction of pancreatic β cells by CD8+ T-lymphocytes, and increased expression of interleukin-17, related to autoimmunity. Research in animal models and humans has hypothesized whether the administration of probiotics may improve the prognosis of diabetes through modulation of gut microbiota. We have shown in this review that a large body of evidence suggests probiotics reduce the inflammatory response and oxidative stress, as well as increase the expression of adhesion proteins within the intestinal epithelium, reducing intestinal permeability. Such effects increase insulin sensitivity and reduce autoimmune response. However, further investigations are required to clarify whether the administration of probiotics can be efficiently used for the prevention and management of diabetes