Effect of high resistive barrier on earthing system

Substation earthing provides a low impedance path and carries current into ground under normal and fault conditions without adversely affecting continuity of service. Under a fault condition, the ground voltage may rise to a level that may endanger the public outside the vicinity of the substation. In such a case a high resistive barrier can be inserted around the vicinity of the substation to reduce the surface potentials immediately beyond the barrier. In this paper the effect of barrier on the overall performance of the earthing system has been investigated experimentally and computationally based on an earthing system consisted of combined grid and rods in a water tank. The effect of the position and depth of the barrier to the resistance of the earthing system and surface potentials in and around the substation have been examined

Pretreatment health measures and complications after surgical management of elderly women with breast cancer

Elderly patients with breast cancer are less likely to be offered surgery, partly owing to co-morbidities and reduced functional ability. However, there is little consensus on how best to assess surgical risk in this patient group.The ability of pretreatment health measures to predict complications was investigated in a prospective cohort study of a consecutive series of women aged at least 70 years undergoing surgery for operable (stage I-IIIa) breast cancer at 22 English breast units between 2010 and 2013. Data on treatment, surgical complications, health measures and tumour characteristics were collected by case-note review and/or patient interview. Outcome measures were all complications and serious complications within 30 days of surgery.The study included 664 women. One or more complications were experienced by 41·0 per cent of the patients, predominantly seroma or primary/minor infections. Complications were serious in 6·5 per cent. More extensive surgery predicted a higher number of complications, but not serious complications. Older age did not predict complications. Several health measures were associated with complications in univariable analysis, and were included in multivariable analyses, adjusting for type/extent of surgery and tumour characteristics. In the final models, pain predicted a higher count of complications (incidence rate ratio 1·01, 95 per cent c.i. 1·00 to 1·01; P = 0·004). Fatigue (odds ratio (OR) 1·02, 95 per cent c.i. 1·01 to 1·03; P = 0·004), low platelet count (OR 4·19, 1·03 to 17·12: P = 0·046) and pulse rate (OR 0·96, 0·93 to 0·99; P = 0·010) predicted serious complications.The risk of serious complications from breast surgery is low for older patients. Surgical decisions should be based on patient fitness rather than age. Health measures that predict surgical risk were identified in multivariable models, but the effects were weak, with 95 per cent c.i. close to unity.This paper presents independent research funded by theBreast Cancer Campaign (2008NOVPR35), a NationalInstitute for Health Research (NIHR) Programme Grantfor Applied Research (RP-PG-0608-10168) and researcharising from a Post Doctoral Fellowship supported by theNIHR (PDF/01/2008/027). The views expressed in thispublication are those of the authors and not necessarilythose of the NHS, the NIHR or the Department of Health

The neural basis of hot and cold cognition in depressed patients, unaffected relatives, and low -risk healthy controls: An fMRI investigation

BACKGROUND: Modern cognitive neuropsychological models of depression posit that negatively biased emotional (“hot”) processing confers risk for depression, while preserved executive function (“cold”) cognition promotes resilience. METHODS: We compared neural responses during hot and cold cognitive tasks in 99 individuals: those at familial risk for depression (N = 30 unaffected first-degree relatives of depressed individuals) and those currently experiencing a major depressive episode (N = 39 unmedicated depressed patients) with low-risk healthy controls (N = 30). Primary analyses assessed neural activation on two functional magnetic resonance imaging tasks previously associated with depression: dorsolateral prefrontal cortex (DLPFC) responsivity during the n-back working memory task; and amygdala and subgenual anterior cingulate cortex (sgACC) responsivity during incidental emotional face processing. RESULTS: Depressed patients exhibited significantly attenuated working memory-related DLPFC activation, compared to low-risk controls and unaffected relatives; unaffected relatives did not differ from low-risk controls. We did not observe a complementary pattern during emotion processing. However, we found preliminary support that greater DLPFC activation was associated with lower amygdala response during emotion processing. LIMITATIONS: These findings require confirmation in a longitudinal study to observe each individual's risk of developing depression; without this, we cannot identify the true risk level of the first-degree relative or low-risk control group. CONCLUSIONS: These findings have implications for understanding the neural mechanisms of risk and resilience in depression: they are consistent with the suggestion that preserved executive function might confer resilience to developing depression in first-degree relatives of depressed patients

A comparison of 'pruning' during multi-step planning in depressed and healthy individuals

BACKGROUND: Real-life decisions are often complex because they involve making sequential choices that constrain future options. We have previously shown that to render such multi-step decisions manageable, people 'prune' (i.e. selectively disregard) branches of decision trees that contain negative outcomes. We have theorized that sub-optimal pruning contributes to depression by promoting an oversampling of branches that result in unsavoury outcomes, which results in a negatively-biased valuation of the world. However, no study has tested this theory in depressed individuals. METHODS: Thirty unmedicated depressed and 31 healthy participants were administered a sequential reinforcement-based decision-making task to determine pruning behaviours, and completed measures of depression and anxiety. Computational, Bayesian and frequentist analyses examined group differences in task performance and relationships between pruning and depressive symptoms. RESULTS: Consistent with prior findings, participants robustly pruned branches of decision trees that began with large losses, regardless of the potential utility of those branches. However, there was no group difference in pruning behaviours. Further, there was no relationship between pruning and levels of depression/anxiety. CONCLUSIONS: We found no evidence that sub-optimal pruning is evident in depression. Future research could determine whether maladaptive pruning behaviours are observable in specific sub-groups of depressed patients (e.g. in treatment-resistant individuals), or whether misuse of other heuristics may contribute to depression

The Global Health interactive Curricula Experience (iCE) Platform & App : Technology that Enables Inter-professional Innovation

Global Health Initiatives Committee (GHIC) Serves the Jefferson community as the premier point of engagement for students & faculty interested in medical and public health issues that transcend national boundaries Creates an institutional focus on preparing students for public service careers in population health and public policy at local, national, and global levels To enable all TJU faculty to: - Deliver global health education, in a friendly, interactive format - Does not require an expert to deliver - Can be used in very small or large pieces depending on your need

Building Interprofessional Global Health Infrastructure at a University and Health System: Navigating Challenges and Scaling Successes

Mission: Global Jefferson will create sustainable programs of global distinction through collaboration that position Jefferson as a local and international destination and resource for education, research, and clinical activities. Global Jefferson is supported by the Associate Provost for Global Affairs, part of the Office of the Provost. Global activity at Jefferson includes: Global Health Initiatives Committee (GHIC) Service Learning Global Research & Exchange between institutions Pre-clinical, translational, clinical, and applied research Poster presented at: 8th Annual Global Health Conference of the Consortium of Universities for Global Health (CUGH)https://jdc.jefferson.edu/globalhealthposters/1000/thumbnail.jp

Global Health Nursing Imperative: Using Competency-Based Analysis to Strengthen Accountability for Population Based Practice, Education and Research

Learning Objectives: Discuss the unique challenges of developing a collaborative global nursing workforce. Compare three sets of competencies for public health nursing. Analyze the results of the comparison of the three sets of competencies. Discuss how the analysis can be used to guide community/public health nursing education, practice and research to encompass local, national and global emphasis. Presentation presented at 2017 AHPA conference in Atlanta Georgia