Meaningful moments of interaction with people with profound intellectual disabilities:Reflections from direct support staff

Background High-quality, affective relationships are built on meaningful moments of interaction, which are challenging for support staff to establish with people with profound intellectual disabilities. Therefore, we explored what makes a moment of interaction meaningful to support staff and what circumstances facilitate meaningful moments of interaction taking place. Method Five direct support staff took part in unstructured, in-depth interviews. The interviews were analysed using interpretative phenomenological analysis (IPA). Member checks were also conducted. Results Support staff experienced moments of interaction as meaningful because they felt a connection with a person with profound intellectual disabilities and/or they had the feeling of being meaningful for this person. Staff-related and contextual circumstances facilitating meaningful moments of interaction to take place were described. Conclusions Meaningful moments of interaction are highly valued by support staff, who believe these moments are valued by persons with profound intellectual disabilities as well. Implications for daily practice are described

Levo-α-acetylmethadol (LAAM) induced QTc-prolongation - results from a controlled clinical trial

<p>Abstract</p> <p>Background</p> <p>Due to potential proarrhythmic side-effects levo-α-Acetylmethadol (LAAM) is currently not available in EU countries as maintenance drug in the treatment of opiate addiction. However, recent studies and meta-analyses underline the clinical advantages of LAAM with respect to the reduction of heroin use. Thus a reappraisal of LAAM has been demanded. The aim of the present study was to evaluate the relative impact of LAAM on QTc-interval, as a measure of pro-arrhythmic risk, in comparison to methadone, the current standard in substitution therapy.</p> <p>Methods</p> <p>ECG recordings were analysed within a randomized, controlled clinical trial evaluating the efficacy and tolerability of maintenance treatment with LAAM compared with racemic methadone. Recordings were done at two points: 1) during a run-in period with all patients on methadone and 2) 24 weeks after randomisation into methadone or LAAM treatment group. These ECG recordings were analysed with respect to QTc-values and QTc-dispersion. Mean values as well as individual changes compared to baseline parameters were evaluated. QTc-intervals were classified according to CPMP-guidelines.</p> <p>Results</p> <p>Complete ECG data sets could be obtained in 53 patients (31 LAAM-group, 22 methadone-group). No clinical cardiac complications were observed in either group. After 24 weeks, patients receiving LAAM showed a significant increase in QTc-interval (0.409 s ± 0.022 s versus 0.418 s ± 0.028 s, p = 0.046), whereas no significant changes could be observed in patients remaining on methadone. There was no statistically significant change in QTc-dispersion in either group. More patients with borderline prolonged and prolonged QTc-intervals were observed in the LAAM than in the methadone treatment group (n = 7 vs. n = 1; p = 0.1).</p> <p>Conclusions</p> <p>In this controlled trial LAAM induced QTc-prolongation in a higher degree than methadone. Given reports of severe arrhythmic events, careful ECG-monitoring is recommended under LAAM medication.</p

Detection of bearing damage by statistic vibration analysis

The condition of bearings, which are essential components in mechanisms, is crucial to safety. The analysis of the bearing vibration signal, which is always contaminated by certain types of noise, is a very important standard for mechanical condition diagnosis of the bearing and mechanical failure phenomenon. In this paper the method of rolling bearing fault detection by statistical analysis of vibration is proposed to filter out Gaussian noise contained in a raw vibration signal. The results of experiments show that the vibration signal can be significantly enhanced by application of the proposed method. Besides, the proposed method is used to analyse real acoustic signals of a bearing with inner race and outer race faults, respectively. The values of attributes are determined according to the degree of the fault. The results confirm that the periods between the transients, which represent bearing fault characteristics, can be successfully detected

The impact of O/Si ratio and hydrogen content on ArF excimer laser ablation of fused silica

The impact of stoichiometry and hydrogen content on the ArF excimer laser ablation characteristics of fused silica is investigated. Nearsurface substoichiometic SiOx with x &lt; 2 diminishes the ablation threshold as a result of increased absorption. The ablation rate is raised by an elevated hydrogen content. As confirmed by mass spectrometric analysis, the laser-induced formation of substoichiometric near-surface layers within the ablation spot sustains absorption and ablation for consecutive laser pulses

Антицитрулінові антитіла в діагностиці артритів у дітей

Віходячи з проведеного дослідження, описаного в роботі, можна дійти висновку, що серед дітей із різними формами артритів тільки 4,8% пацієнтів були серопозитивними за РФ, та 23,8% дітей – за рівнем АЦЦП. Прогнастичне значення підвищеного рівня АЦЦП у дітей із РеА полягає в високій вірогідності розвитку ЮРА, що обумовлює більш ретельне їх спостереження із застосуванням індивідуальних схем профілактичного лікування. При цитуванні документа, використовуйте посилання http://essuir.sumdu.edu.ua/handle/123456789/1128

3D Fluid Flow Estimation with Integrated Particle Reconstruction

The standard approach to densely reconstruct the motion in a volume of fluid is to inject high-contrast tracer particles and record their motion with multiple high-speed cameras. Almost all existing work processes the acquired multi-view video in two separate steps, utilizing either a pure Eulerian or pure Lagrangian approach. Eulerian methods perform a voxel-based reconstruction of particles per time step, followed by 3D motion estimation, with some form of dense matching between the precomputed voxel grids from different time steps. In this sequential procedure, the first step cannot use temporal consistency considerations to support the reconstruction, while the second step has no access to the original, high-resolution image data. Alternatively, Lagrangian methods reconstruct an explicit, sparse set of particles and track the individual particles over time. Physical constraints can only be incorporated in a post-processing step when interpolating the particle tracks to a dense motion field. We show, for the first time, how to jointly reconstruct both the individual tracer particles and a dense 3D fluid motion field from the image data, using an integrated energy minimization. Our hybrid Lagrangian/Eulerian model reconstructs individual particles, and at the same time recovers a dense 3D motion field in the entire domain. Making particles explicit greatly reduces the memory consumption and allows one to use the high-res input images for matching. Whereas the dense motion field makes it possible to include physical a-priori constraints and account for the incompressibility and viscosity of the fluid. The method exhibits greatly (~70%) improved results over our recently published baseline with two separate steps for 3D reconstruction and motion estimation. Our results with only two time steps are comparable to those of sota tracking-based methods that require much longer sequences.Comment: To appear in International Journal of Computer Vision (IJCV

Switch-maintenance gemcitabine after first-line chemotherapy in patients with malignant mesothelioma (NVALT19):an investigator-initiated, randomised, open-label, phase 2 trial

Background Almost all patients with malignant mesothelioma eventually have disease progression after first-line therapy. Previous studies have investigated maintenance therapy, but none has shown a great effect. We aimed to assess the efficacy and safety of switch-maintenance gemcitabine in patients with malignant mesothelioma without disease progression after first-line chemotherapy. Methods We did a randomised, open-label, phase 2 trial in 18 hospitals in the Netherlands (NVALT19). We recruited patients aged older than 18 years with unresectable malignant mesothelioma with no evidence of disease progression after at least four cycles of first-line chemotherapy (with platinum and pemetrexed), who had a WHO performance status of 0-2, adequate organ function, and measurable or evaluable disease. Exclusion criteria were active uncontrolled infection or severe cardiac dysfunction, serious disabling conditions, symptomatic CNS metastases, radiotherapy within 2 weeks before enrolment, and concomitant use of any other drugs under investigation. Patients were randomly assigned (1:1), using the minimisation method, to maintenance intravenous gemcitabine (1250 mg/m(2) on days 1 and 8, in cycles of 21 days) plus supportive care, or to best supportive care alone, until disease progression, unacceptable toxicity, serious intercurrent illness, patient request for discontinuation, or need for any other anticancer agent, except for palliative radiotherapy. A CT scan of the thorax or abdomen (or both) and pulmonary function tests were done at baseline and repeated every 6 weeks. The primary outcome was progression-free survival in the intention-to-treat population. Safety was analysed in all participants who received one or more doses of the study drug or had at least one visit for supportive care. Recruitment is now closed; treatment and follow-up are ongoing. This study is registered with the Netherlands Trial Registry, NTR4132/NL3847. Findings Between March 20, 2014, and Feb 27, 2019, 130 patients were enrolled and randomly assigned to gemcitabine plus supportive care (65 patients [50%]) or supportive care alone (65 patients [50%]). No patients were lost to follow-up; median follow-up was 36.5 months (95% CI 34.2 to not reached), and one patient in the supportive care group withdrew consent. Progression-free survival was significantly longer in the gemcitabine group (median 6.2 months [95% CI 4.6-8.7]) than in the supportive care group (3.2 months [2.8-4.1]; hazard ratio [HR] 0.48 [95% CI 0.33-0.71]; p=0.0002). The benefit was confirmed by masked independent central review (HR 0.49 [0.33-0.72]; p=0.0002). Grade 3-4 adverse events occurred in 33 ( 52%) of 64 patients in the gemcitabine group and in ten (16%) of 62 patients in the supportive care group. The most frequent adverse events were anaemia, neutropenia, fatigue or asthenia, pain, and infection in the gemcitabine group, and pain, infection, and cough or dyspnoea in the supportive care group. One patient (2%) in the gemcitabine group died, due to a treatment-related infection. Interpretation Switch-maintenance gemcitabine, after first-line chemotherapy, significantly prolonged progression-free survival compared with best supportive care alone, among patients with malignant mesothelioma. This study confirms the activity of gemcitabine in treating malignant mesothelioma

Ação de fitoreguladores nos teores de macronutrientes em tomateiro (Lycopersicon esculentum Mill.)

This research deals with the effects of exogenous growth regulators on mineral nutrition of the tomato plant (Lycopersicon esculentum Mill, cv. 'Miguel Pereira'). To study the influence on mineral nutrition, (2-chloroethyl) trimethilammonium chloride (CCC), at concentration of 2,000 ppm, succinic acid-2,2-dimethylhydrazide (SADH) (4,000 ppm), gibberellic acid (GA) (100 ppm), (2-chloroethyl) phosphonic acid (CEPA) (200 ppm), indole-3-acetic acid (IAA) (100 ppm), and 6-furfurylamino purine (FAP) (500 ppm) were applied. Higher levels of nitrogen, calcium and magnesium occurred in the stem of plants sprayed with CCC. Treatments with FAP. SADH and CEPA demonstrated an increase in nitrogen levels in the stem. CEPA also increased calcium contents in stems. Growth regulators used did not alter the levels of macronutrients in leaves of tomatoes in relation to check plants.Verificaram-se os efeitos da aplicação de reguladores vegetais na nutrição mineral do tomateiro. Para isto aplicaram-se, em plantas com 4 folhas, cloreto de (2-cloroetil) trimetilamônio (CCC) 2.000 ppm, ácido succínico-2,2-dimetilhidrazida (SADH) 4.000 ppm, ácido giberélico (GA) 100 ppm, ácido (2-cloroetil) fosfônico (CEPA) 200 ppm, ácido 3-indolacético (IAA) 100 ppm e 6-furfurilaminopurina (FAP) na concentração de 500 ppm. Níveis mais elevados de nitrogênio, cálcio e magnésio foram determinados nas hastes de plantas pulverizadas com CCC. Tratamento com CEPA promoveu aumento nos teores de nitrogênio e cálcio nas hastes de tomateiro. Níveis mais elevados de nitrogênio foram determinados nas hastes de plantas tratadas com SADH e FAP. Os reguladores de crescimento utilizados não afetaram os níveis de macronutrientes nas folhas do tomateiro com relação às controle