A fast strong coupling algorithm for the partitioned fluid–structure interaction simulation of BMHVs

The numerical simulation of Bileaflet Mechanical Heart Valves (BMHVs) has gained strong interest in the last years, as a design and optimisation tool. In this paper, a strong coupling algorithm for the partitioned fluidstructure interaction simulation of a BMHV is presented. The convergence of the coupling iterations between the flow solver and the leaflet motion solver is accelerated by using the Jacobian with the derivatives of the pressure and viscous moments acting on the leaflets with respect to the leaflet accelerations. This Jacobian is numerically calculated from the coupling iterations. An error analysis is done to derive a criterion for the selection of useable coupling iterations. The algorithm is successfully tested for two 3D cases of a BMHV and a comparison is made with existing coupling schemes. It is observed that the developed coupling scheme outperforms these existing schemes in needed coupling iterations per time step and CPU time

m-Path:An easy-to-use and highly tailorable platform for ecological momentary assessment and intervention in behavioral research and clinical practice

In this paper, we present m-Path (www.m-Path.io), an online platform that provides an easy-to-use and highly tailorable framework for implementing smartphone-based ecological momentary assessment (EMA) and intervention (EMI) in both research and clinical practice in the context of blended care. Because real-time monitoring and intervention in people's everyday lives have unparalleled benefits compared to traditional data collection techniques (e.g., retrospective surveys or lab-based experiments), EMA and EMI have become popular in recent years. Although a surge in the use of these methods has led to a myriad of EMA and EMI applications, many existing platforms only focus on a single aspect of daily life data collection (e.g., assessment vs. intervention, active self-report vs. passive mobile sensing, research-dedicated vs. clinically-oriented tools). With m-Path, we aim to integrate all of these facets into a single platform, as it is exactly this all-in-one approach that fosters the clinical utility of accumulated scientific knowledge. To this end, we offer a comprehensive platform to set up complex and highly adjustable EMA and EMI designs with advanced functionalities, using an intuitive point-and click web interface that is accessible for researchers and clinicians with limited programming skills. We discuss the strengths of daily life data collection and intervention in general and m-Path in particular. We describe the regular workflow to set up an EMA or EMI design within the m-Path framework, and summarize both the basic functionalities and more advanced features of our software

Knowledge and practices of tour guides in Cuzco on the prevention and treatment of traveler's diarrhea

Objectives: To describe the knowledge and practices among tour guides in Cuzco, Peru regarding prevention and treatment of traveler's diarrhea. Methods: The main tour guide association in Cuzco organized a mandatory re-certification course for tour guides in February 2004. We invited tour guides attending this course to participate in the study. Those aged 18 to 50 who had worked as a tour guide for at least one year were asked to complete a brief anonymous questionnaire. Results: A total of 173 questionnaires were returned; 137 met the inclusion criteria and were included in the analysis. The median age was 31 years (interquartile range (IQR): 28-34 years), and 56.7% were male. The median number of foreign languages spoken by subjects included was 1, being English (91.9%) the most common, followed by French (17.9%) and Italian (16.8%). The median time working as a tour guide was 4 years (IQR: 2-8 years). Tour guidance was a full-time job for 47.1% of the subjects, and for 82.4% Inca Trail was the most commonly covered route. Traveler's diarrhea was considered a food-borne disease by 85.4%, but only 60.6% considered it a water-borne disease. The majority of subjects identified raw salads (84.4%), cold sauces (81.5%) and tap water (81.1%) as risky products whereas hot soups (77 8%) and bread (75.0%) were mainly considered as safe. Most of the tour guides considered bloody stools (84.8%) and fever (60.6%) as indications to seek medical attention. The medications most frequently recommended by tour guides were oral re-hydration solutions ( 85.1%), trimethoprim-sulphamethoxazole (26.1%) and loperamide (20.1%). Conclusions: Tour guides have a basic knowledge about traveler's diarrhea. However, more training is necessary to improve management while trekking outside of Cuzco The recommendation to seek pharmacists should be particularly addressed

Quality of life and functional status in patients with cancer of the oral cavity and oropharynx: pretreatment values of a prospective study

We assessed the pretreatment health-related quality of life (HRQOL) and functional status of patients with advanced oral and oropharyngeal cancer. Eighty patients were investigated. HRQOL was assessed by EORTC QLQ-C30/QLQ-H&N35 questionnaires. Functional status assessment comprised speech and oral function tests. The results revealed a wide range of HRQOL and functional deficits before treatment. HRQOL appeared to be related to some extent to tumor site (patients with oral tumors reported more pain compared to patients with oropharyngeal tumors) and tumor classification (patients with T3–T4 tumors reported more trouble opening the mouth and felt more ill compared to patients with T2 tumors). Comorbidity appeared to have a major impact. Patients with comorbidity had significantly worse scores on several scales/items on both the EORTC questionnaires. Functional deficits were related to tumor site, classification and comorbidity. Patients with oral cavity tumors (versus oropharyngeal tumors), patients with T3–T4 tumors (versus T2 tumors), and patients with comorbidity (versus without comorbidity) scored significantly worse on several speech and oral function tests. Impaired speech and oral function appeared to be clearly related to global quality of life (QLQ-C30) and self-reported speech (QLQ-H&N35). Many patients with advanced oral and oropharyngeal cancer have compromised HRQOL and functional status before the start of treatment. In addition to tumor site and tumor classification, comorbidity appears to have a major impact on HRQOL and functional status. Knowledge of pretreatment HRQOL and functional status levels is useful for better understanding the impact of treatment on these outcomes over time

Assessment of exposure determinants and exposure levels by using stationary concentration measurements and a probabilistic near-field/far-field exposure model

Background: The Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) regulation requires the establishment of Conditions of Use (CoU) for all exposure scenarios to ensure good communication of safe working practices. Setting CoU requires the risk assessment of all relevant Contributing Scenarios (CSs) in the exposure scenario. A new CS has to be created whenever an Operational Condition (OC) is changed, resulting in an excessive number of exposure assessments. An efficient solution is to quantify OC concentrations and to identify reasonable worst-case scenarios with probabilistic exposure modeling. Methods: Here, we appoint CoU for powder pouring during the industrial manufacturing of a paint batch by quantifying OC exposure levels and exposure determinants. The quantification was performed by using stationary measurements and a probabilistic Near-Field/Far-Field (NF/FF) exposure model. Work shift and OC concentration levels were quantified for pouring TiO 2 from big bags and small bags, pouring Micro Mica from small bags, and cleaning. The impact of exposure determinants on NF concentration level was quantified by (1) assessing exposure determinants correlation with the NF exposure level and (2) by performing simulations with different OCs. Results: Emission rate, air mixing between NF and FF and local ventilation were the most relevant exposure determinants affecting NF concentrations. Potentially risky OCs were identified by performing Reasonable Worst Case (RWC) simulations and by comparing the exposure 95 th percentile distribution with 10% of the occupational exposure limit value (OELV). The CS was shown safe except in RWC scenario (ventilation rate from 0.4 to 1.6 1/h, 100 m 3 room, no local ventilation, and NF ventilation of 1.6 m 3/min). Conclusions: The CoU assessment was considered to comply with European Chemicals Agency (ECHA) legislation and EN 689 exposure assessment strategy for testing compliance with OEL values. One RWC scenario would require measurements since the exposure level was 12.5% of the OELV

Erythrocyte and Porcine Intestinal Glycosphingolipids Recognized by F4 Fimbriae of Enterotoxigenic Escherichia coli

Enterotoxigenic F4-fimbriated Escherichia coli is associated with diarrheal disease in neonatal and postweaning pigs. The F4 fimbriae mediate attachment of the bacteria to the pig intestinal epithelium, enabling an efficient delivery of diarrhea-inducing enterotoxins to the target epithelial cells. There are three variants of F4 fimbriae designated F4ab, F4ac and F4ad, respectively, having different antigenic and adhesive properties. In the present study, the binding of isolated F4ab, F4ac and F4ad fimbriae, and F4ab/ac/ad-fimbriated E. coli, to glycosphingolipids from erythrocytes and from porcine small intestinal epithelium was examined, in order to get a comprehensive view of the F4-binding glycosphingolipids involved in F4-mediated hemagglutination and adhesion to the epithelial cells of porcine intestine. Specific interactions between the F4ab, F4ac and F4ad fimbriae and both acid and non-acid glycosphingolipids were obtained, and after isolation of binding-active glycosphingolipids and characterization by mass spectrometry and proton NMR, distinct carbohydrate binding patterns were defined for each fimbrial subtype. Two novel glycosphingolipids were isolated from chicken erythrocytes, and characterized as GalNAcα3GalNAcß3Galß4Glcß1Cer and GalNAcα3GalNAcß3Galß4GlcNAcß3Galß4Glcß1Cer. These two compounds, and lactosylceramide (Galß4Glcß1Cer) with phytosphingosine and hydroxy fatty acid, were recognized by all three variants of F4 fimbriae. No binding of the F4ad fimbriae or F4ad-fimbriated E. coli to the porcine intestinal glycosphingolipids occurred. However, for F4ab and F4ac two distinct binding patterns were observed. The F4ac fimbriae and the F4ac-expressing E. coli selectively bound to galactosylceramide (Galß1Cer) with sphingosine and hydroxy 24:0 fatty acid, while the porcine intestinal glycosphingolipids recognized by F4ab fimbriae and the F4ab-fimbriated bacteria were characterized as galactosylceramide, sulfatide (SO3-3Galß1Cer), sulf-lactosylceramide (SO3-3Galß4Glcß1Cer), and globotriaosylceramide (Galα4Galß4Glcß1Cer) with phytosphingosine and hydroxy 24:0 fatty acid. Finally, the F4ad fimbriae and the F4ad-fimbriated E. coli, but not the F4ab or F4ac subtypes, bound to reference gangliotriaosylceramide (GalNAcß4Galß4Glcß1Cer), gangliotetraosylceramide (Galß3GalNAcß4Galß4Glcß1Cer), isoglobotriaosylceramide (Galα3Galß4Glcß1Cer), and neolactotetraosylceramide (Galß4GlcNAcß3Galß4Glcß1Cer)