Comparing nonsynergy gamma models and interaction models to predict growth of emetic Bacillus cereus for combinations of pH and water activity values

This research aims to test the absence (gamma hypothesis) or occurrence of synergy between two growth-limiting factors, i.e., pH and water activity (aw), using a systematic approach for model selection. In this approach, preset criteria were used to evaluate the performance of models. Such a systematic approach is required to be confident in the correctness of the individual components of the combined (synergy) models. With Bacillus cereus F4810/72 as the test organism, estimated growth boundaries for the aw-lowering solutes NaCl, KCl, and glucose were 1.13 M, 1.13 M, and 1.68 M, respectively. The accompanying aw values were 0.954, 0.956, and 0.961, respectively, indicating that equal aw values result in similar effects on growth. Out of the 12 models evaluated using the preset criteria, the model of J. H. T. Luong (Biotechnol. Bioeng. 27:280–285, 1985) was the best model to describe the effect of aw on growth. This aw model and the previously selected pH model were combined into a gamma model and into two synergy models. None of the three models was able to describe the combined pH and aw conditions sufficiently well to satisfy the preset criteria. The best matches between predicted and experimental data were obtained with the gamma model, followed by the synergy model of Y. Le Marc et al. (Int. J. Food Microbiol. 73:219–237, 2002). No combination of models that was able to predict the impact of both individual and combined hurdles correctly could be found. Consequently, in this case we could not prove the existence of synergy nor falsify the gamma hypothesis

Haemophilia patients aged 0 - 18 years in the Western Cape

Objectives. To record the number of haemophiliacs aged 0- 18 years in the Western Cape (WC), what event led to the diagnosis, the level of clotting factor, treatment, functional status of their joints and impact of the disease on the family.Design. A prospective study of patients registered with the South African National Haemophilia Registry and new patients, utilising the patients' paediatricians, hospital records, patient and guardian interviews, physicalexamination and provincial nurse haemophilia co-ordinators.Setting. Haemophilia care centres at the three WC academic hospitals, regional hospitals and homes of patients. Two elective medical students, MHH and JJH, collected the information.Subjects. All boys with confirmed haemophilia A or B in the WC.Outcome measures. Events that led to diagnosis, degree of haemophilia, use of clotting factor, functional status, and effect on family.                                                                                                                                       Results. Of 78 patients (59 haemophilia A, 19 haemophilia B) identified, 49 could be studied. Forty-three per cent had severe, 29% moderate and 22% mild disease (6% unknown). Family history was present in 49%, but led to diagnosis in only 12%. The most common first symptoms were subcutaneous and mucosal bleeding. Delay in diagnosis varied from 0 to 9 months. Twenty-nine per cent of guardians were suspected of child abuse. RSA produced clotting factor was used 'on demand' in 73% of patients, for periodic prophylaxis in 20% and as continuous prophylaxis in 7%. Joints were functionally restricted in 43% of patients. The majority of guardians (59%) said the disease had a major impact on the family.Conclusions. The diagnosis of haemophilia in children with a positive family history was often delayed. Haemophilia causes significant morbidity in our patients and their families

Why Healthcare and Well-being Researchers should Become Developers: A Case Study Using Co-Creation Methodology

Wearable technologies increase the ability to track different parameters related to health and well-being. As the variety and amount of data sources grow, a better understanding of health-related data can be obtained through research on data fusion. Outcomes can either be validated by end users when results are finalized or throughout the design and development process of mobile health applications. This chapter addresses the co-creation methodology applied for the creation of a mobile health application, called Vire, and the backend, called Synergy, to serve personal data to the mobile health application. Synergy provides an interface for the research team to interact with participants and visualizes parameters relevant to the study. Modern frameworks and platforms, such as React Native and Meteor, are used to facilitate the adaptiveness and functionality required for the co-creation of Vire. The chapter concludes by addressing the findings from the study with 26 participants

Quality of life and behavioral functioning in Dutch pediatric patients with hereditary spherocytosis

The objective of this study was to evaluate health-related quality of life (HRQoL) and behavioral functioning in pediatric patients with hereditary spherocytosis (HS). A cross-sectional study was conducted in 132 Dutch children and adolescents with HS and aged 8-18 years of whom 48 underwent splenectomy prior to the study. HRQoL was assessed using the KIDSCREEN-27, and behavioral functioning was evaluated using the strength and difficulties questionnaire (SDQ). Scores of pediatric patients with HS were compared to a Dutch norm population. Additionally, the effects of three factors were assessed: fatigue, self-image, and parents' perceived vulnerability (measured with the checklist individual strength, the self-perception profile for children and adolescents, and the child vulnerability scale). Both unsplenectomised and splenectomised pediatric patients reported lower HRQoL on the domain physical well-being (KIDSCREEN-27) compared to Dutch peers. For behavioral functioning, parents of both groups reported more emotional problems (SDQ) compared to the norm population. Pediatric patients with lower scores on physical well-being experienced more fatigue. The patients' perceived social acceptance and parents' perceived vulnerability appeared as determinants of emotional problems. Conclusion: Pediatric patients in the current study generally report few complaints, and the results suggest that these patients overall have a strong ability to cope with HS. Despite these few complaints, fatigue and parents' perceived vulnerability seem to be important determinants for lower HRQoL and more emotional problems. Therefore, screening on these factors could serve as an addition to the treatment of HS, to help pediatric patients who are at risk for lower HRQoL or more emotional problems

Reliability and validity of a novel haemophilia-specific self-efficacy scale

Higher self-efficacy in chronic disease patients is associated with higher development of self-management skills and increased quality-of-life. Quantification and monitoring of self-efficacy is therefore of importance. Self-efficacy in haemophilia patients has received little attention due to lack of standardized scales. To validate the novel Haemophilia-specific Self-Efficacy Scale (HSES) in haemophilia patients on prophylactic home treatment, haemophilia patients aged 1-18 years on prophylactic treatment ≥1 year were included from three Dutch Haemophilia Treatment Centres. The HSES consists of 12 items, relating to perceptions of the ability to function on a day-to-day basis with regard to patient's disease. Retest was performed in a subsample. Validity was proven by the General Self-Efficacy Scale and by the health-related quality-of-life assessment tool Haemo-QoL. Data were analysed from 53 children (response 75%), with a mean age of 9.8 years (SD 4.0). Mean total scale score of HSES was 55.5 (SD 4.7; range 38-60), with a ceiling effect of 17%. The HSES showed adequate internal consistency (Cronbach's alpha 0.72) and good test-retest reliability (Intra-Class-Correlation coefficient 0.75; P < 0.01; n = 37). The convergent validity was adequate as haemophilia-specific self-efficacy correlated significantly with general self-efficacy (r = 0.38; P < 0.01). High HSES scores correlated significantly with quality-of-life as measured by the Haemo-QoL (r = -0.42; P ≤ 0.01). The novel HSES is a reliable and valid tool to assess self-efficacy in paediatric haemophilia patients on prophylactic home treatment. High self-efficacy correlated with higher quality-of-life, further underlining the importance to standardly assess, monitor and improve self-efficacy

A modification of the convective constraint release mechanism in the molecular stress function model giving enhanced vortex growth

The molecular stress function model with convective constraint release (MSF with CCR) constitutive model [J. Rheol. 45 (2001), 1387] is capable of fitting all viscometric data for IUPAC LDPE, with only two adjustable parameters (with difference found only on reported ¿steady-state¿ elongational viscosities). The full MSF with CCR model is implemented in a backwards particle-tracking implementation, using an adaptive method for the computation of relative stretch that reduces simulation time many-fold, with insignificant loss of accuracy. The model is shown to give improved results over earlier versions of the MSF (without CCR) when compared to well-known experimental data from White and Kondo [J. non-Newt. Fluid Mech., 3 (1977), 41]; but still to under-predict contraction flow opening angles. The discrepancy is traced to the interaction between the rotational dissipative function and the large stretch levels caused by the contraction flow. A modified combination of dissipative functions in the constraint release mechanism is proposed, which aims to reduce this interaction to allow greater strain hardening in a mixed flow. The modified constraint release mechanism is shown to fit viscometric rheological data equally well, but to give opening angles in the complex contraction flow that are much closer to the experimental data from White and Kondo. It is shown (we believe for the first time) that a constitutive model demonstrates an accurate fit to all planar elongational, uniaxial elongational and shear viscometric data, with a simultaneous agreement with this well-known experimental opening angle data. The sensitivity of results to inaccuracies caused by representing the components of the deformation gradient tensor to finite precision is examined; results are found to be insensitive to even large reductions in the precision used for the representation of components. It is shown that two models that give identical response in elongational flow, and a very similar fit to available shear data, give significantly different results in flows containing a mix of deformation modes. The implication for constitutive models is that evaluation against mixed deformation mode flow data is desirable in addition to evaluation against viscometric measurements

Finite Temperature Meson Correlation Functions in HTL Approximation

We calculate temporal correlators and their spectral functions with meson quantum numbers in the deconfined phase of QCD using the hard thermal loop (HTL) approximation for the quark propagator. Although this approach does not result in a complete next-to-leading order perturbative calculation it takes into account important medium effects such as thermal quark masses and Landau damping in the quark-gluon plasma. We show that both effects lead to competing modifications of the free mesonic correlation functions. We find that correlators in scalar channels are only moderately influenced by the HTL medium effects, while the HTL-vertex corrections lead to divergent vector correlators.Comment: 14 pages, LaTeX2e File, 8 EPS-files, minor changes in abstract and text, to appear in Phys. Lett.

Parallelization, Special Hardware and Post-Newtonian Dynamics in Direct N - Body Simulations

The formation and evolution of supermassive black hole (SMBH) binaries during and after galaxy mergers is an important ingredient for our understanding of galaxy formation and evolution in a cosmological context, e.g. for predictions of cosmic star formation histories or of SMBH demographics (to predict events that emit gravitational waves). If galaxies merge in the course of their evolution, there should be either many binary or even multiple black holes, or we have to find out what happens to black hole multiples in galactic nuclei, e.g. whether they come sufficiently close to merge resulting from emission of gravitational waves, or whether they eject each other in gravitational slingshot interactions

Self-infusion of prophylaxis: Evaluating the quality of its performance and time needed

Prophylactic replacement therapy is the cornerstone of treatment in severe haemophilia. Regular infusions with clotting factor concentrate have been proven effective to prevent bleeding, subsequent (joint) damage, and positively affect the impact of haemophilia on daily life [1]. Patients or parents of younger patients learn to infuse clotting factor concentrate in a peripheral vein (i.v.) or a central venous access device (CVAD) [2]