Correcting for non-periodic behaviour in perturbative experiments: application to heat pulse propagation and modulated gas-puff experiments

This paper introduces a recent innovation in dealing with non-periodic behavior often referred to as transients. These transients can be the result from unforced response due to the initial condition and other drifts which are a source of error when performing and interpreting Fourier analysis on measurement data. Fourier analysis is particularly relevant in system identification used to build feedback controllers and the analysis of various pulsed experiments such as heat pulse propagation studies. The basic idea behind the methodology is that transients are continuous complex-valued smooth functions in the Fourier domain which can be estimated from the Fourier data. Then, these smooth functions can be approximately subtracted from the data such that only periodic components are retained. The merit of the approach is shown in two experimental examples, i.e., heat pulse propagation (core transport analysis) and radiation front movement due to gas puffing. The examples show that the quality of the data is significantly improved such that it allows new interpretation of the results even for non-ideal measurements.</p

Description and preliminary results from a structured specialist behavioural weight management group intervention:Specialist Lifestyle Management (SLiM) programme

Background -  Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods - The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results - Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions - The SLiM programme is an effective group intervention for the management of severe and complex obesity

Correcting for non-periodic behaviour in perturbative experiments: application to heat pulse propagation and modulated gas-puff experiments

This paper introduces a recent innovation in dealing with non-periodic behavior often referred to as transients in perturbative experiments. These transients can be the result from the unforced response due to the initial condition and other slow trends in the measurement data and are a source of error when performing and interpreting Fourier spectra. Fourier analysis is particularly relevant in system identification used to build feedback controllers and the analysis of various pulsed experiments such as heat pulse propagation studies. The basic idea behind the methodology is that transients are continuous complex-valued smooth functions in the Fourier domain which can be estimated from the Fourier data. Then, these smooth functions can be subtracted from the data such that only periodic components are retained. The merit of the approach is shown in two experimental examples, i.e. heat pulse propagation (core transport analysis) and radiation front movement due to gas puffing in the divertor. The examples show that the quality of the data is significantly improved such that it allows for new interpretation of the results even for non-ideal measurements

A retrospective cohort study on lifestyle habits of cardiovascular patients: how informative are medical records?

Contains fulltext : 79771.pdf (publisher's version ) (Open Access)BACKGROUND: To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of the university hospital of Nijmegen, The Netherlands, between June 2004 and June 2005. METHODS: For 209 patients information from medical records on lifestyle habits, physician feedback, and interventions in the past year was compared to data gathered in the last month by a self-report LSQ. RESULTS: Doctors register smoking habits most consistently (90.4%), followed by alcohol use (81.8%), physical activity (50.2%), and eating habits (27.3%). Compared to the LSQ, smoking, unhealthy alcohol use, physical activity, and unhealthy eating habits are underreported in medical records by 31, 83, 54 and 97%, respectively. Feedback, advice or referral was documented in 8% for smoking, 3% for alcohol use, 12% for physical activity, and 26% for eating habits. CONCLUSION: Lifestyle is insufficiently registered or recognized by doctors providing routine care in a cardiovascular outpatient setting. Of the unhealthy lifestyle habits that are registered, few are accompanied by notes on advice or intervention. A lifestyle questionnaire facilitates screening and interventions in target patients and should therefore be incorporated in the cardiovascular setting as a routine patient intake procedure

The effect of a comprehensive lifestyle intervention on cardiovascular risk factors in pharmacologically treated patients with stable cardiovascular disease compared to usual care: a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>The additional benefit of lifestyle interventions in patients receiving cardioprotective drug treatment to improve cardiovascular risk profile is not fully established.</p> <p>The objective was to evaluate the effectiveness of a target-driven multidisciplinary structured lifestyle intervention programme of 6 months duration aimed at maximum reduction of cardiovascular risk factors in patients with cardiovascular disease (CVD) compared with usual care.</p> <p>Methods</p> <p>A single centre, two arm, parallel group randomised controlled trial was performed. Patients with stable established CVD and at least one lifestyle-related risk factor were recruited from the vascular and cardiology outpatient departments of the university hospital. Blocked randomisation was used to allocate patients to the intervention (n = 71) or control group (n = 75) using an on-site computer system combined with allocations in computer-generated tables of random numbers kept in a locked computer file. The intervention group received the comprehensive lifestyle intervention offered in a specialised outpatient clinic in addition to usual care. The control group continued to receive usual care. Outcome measures were the lifestyle-related cardiovascular risk factors: smoking, physical activity, physical fitness, diet, blood pressure, plasma total/HDL/LDL cholesterol concentrations, BMI, waist circumference, and changes in medication.</p> <p>Results</p> <p>The intervention led to increased physical activity/fitness levels and an improved cardiovascular risk factor profile (reduced BMI and waist circumference). In this setting, cardiovascular risk management for blood pressure and lipid levels by prophylactic treatment for CVD in usual care was already close to optimal as reflected in baseline levels. There was no significant improvement in any other risk factor.</p> <p>Conclusions</p> <p>Even in CVD patients receiving good clinical care and using cardioprotective drug treatment, a comprehensive lifestyle intervention had a beneficial effect on some cardiovascular risk factors. In the present era of cardiovascular therapy and with the increasing numbers of overweight and physically inactive patients, this study confirms the importance of risk factor control through lifestyle modification as a supplement to more intensified drug treatment in patients with CVD.</p> <p>Trial registration</p> <p>ISRCTN69776211 at <url>http://www.controlled-trials.com</url></p

Greenhouse gas emissions from a Western Australian finfish supply chain

Greenhouse gas (GHG) emissions in the form of carbon dioxide equivalent (CO2 - eq) from two Western Australian finfish supply chains, from harvest to retail outlet, were measured using streamlined life cycle assessment methodology. The identification of interventions to potentially reduce the GHG emissions was determined from the results obtained. Electricity consumption contributed to the highest GHG emissions within the supply chains measured, followed by refrigeration gas leakage and disposal of unused fish portions. Potential cleaner production strategies (CPS) to reduce these impacts included installing solar panels, recycling the waste, good housekeeping in refrigeration equipment maintenance, and input substitution of refrigeration gas. The results show a combination of these strategies have the potential to reduce up to 35% of the total GHG emissions from fillet harvest, processing and retail

Registration and management of smoking behaviour in patients with coronary heart disease. The EUROASPIRE survey.

AIMS: To establish to what extent smoking status and its management is recorded in coronary patients' medical records, and to investigate their motivation to change smoking behaviour. METHODS: In EUROASPIRE, a survey on secondary prevention in 21 hospitals in the Czech Republic, Finland, France, Germany, Hungary, Italy, the Netherlands, Slovenia and Spain, data were collected from records of 4863 consecutive patients =<70 years of age, with previous (>6 months) admission for coronary bypass operation, angioplasty, myocardial infarction or ischaemia. Of these, 3569 patients were interviewed 1.6 years following their index hospitalization. RESULTS: Of the 82% of patients whose pre-hospitalization smoking behaviour was known, 34% were smokers. Documentation was significantly better in younger patients, in males and patients requiring angioplasty or bypass operation. In only 35% of 1364 smokers was the smoking habit recorded again after discharge from hospital At the time of the interview, 554 of the interviewed patients were still smoking. In over 90% of the smokers, advice to quit smoking was reported at interview. A positive relationship was found between receiving advice and seeking help to stop smoking, between receiving advice to stop smoking and attempting to stop, as well as between seeking help and attempting to stop. CONCLUSION: In almost 20% of coronary patients, smoking habits are not documented in medica

Heat flux reconstruction and effective diffusion estimation from perturbative experiments using advanced filtering and confidence analysis

The heat flux is one of the key parameter used to quantify and understand transport in fusion devices. In this paper, a new method is introduced to calculate the heat flux including its confidence with high accuracy based on perturbed measurements such as the electron temperature. The new method is based on ideal filtering to optimally reduce the noise contributions on the measurements and piece-wise polynomial approximations to calculate the time derivative. Both methods are necessary to arrive at a heat flux and effective diffusion coefficient with high accuracy. The new methodology is applied to a measurement example using electron cyclotron resonance heating block-wave modulation at the Large Helical Device showing the merit of the newly developed methodology