1,308 research outputs found

    Associations between health-related quality of life, physical function and fear of falling in older fallers receiving home care

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    Falls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care

    Attention-dependent modulation of cortical taste circuits revealed by granger causality with signal-dependent noise

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    We show, for the first time, that in cortical areas, for example the insular, orbitofrontal, and lateral prefrontal cortex, there is signal-dependent noise in the fMRI blood-oxygen level dependent (BOLD) time series, with the variance of the noise increasing approximately linearly with the square of the signal. Classical Granger causal models are based on autoregressive models with time invariant covariance structure, and thus do not take this signal-dependent noise into account. To address this limitation, here we describe a Granger causal model with signal-dependent noise, and a novel, likelihood ratio test for causal inferences. We apply this approach to the data from an fMRI study to investigate the source of the top-down attentional control of taste intensity and taste pleasantness processing. The Granger causality with signal-dependent noise analysis reveals effects not identified by classical Granger causal analysis. In particular, there is a top-down effect from the posterior lateral prefrontal cortex to the insular taste cortex during attention to intensity but not to pleasantness, and there is a top-down effect from the anterior and posterior lateral prefrontal cortex to the orbitofrontal cortex during attention to pleasantness but not to intensity. In addition, there is stronger forward effective connectivity from the insular taste cortex to the orbitofrontal cortex during attention to pleasantness than during attention to intensity. These findings indicate the importance of explicitly modeling signal-dependent noise in functional neuroimaging, and reveal some of the processes involved in a biased activation theory of selective attention

    Heat transfer in solar absorber plates with micro-channels

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    Analytical, computational and experimental studies were carried out to investigate heat transfer and fluid flow in micro-channel absorber plates for compact (thin and light-weight) solar thermal collectors. The main objective of the work was to study different design and/or operating scenarios as well as study the significance of various micro-scaling effects. Analytical investigation showed that, under similar conditions, the proposed design yields a much higher fin efficiency, F and collector efficiency factor, F’ compared with the conventional solar collector design. An analytical model combining convective heat transfer in the collector fluid with axial conduction in the metal plate was developed. The predicted plate temperature profiles from the analytical model were in close agreement with the measured profiles. The model further showed that axial thermal conduction can significantly alter the plate temperature profile. Experiments were designed to represent real life operation of the proposed system. A CFD study, using the same design and operating parameters, produced results comparable with experiments. This numerical simulation also gave further insight into the heat transfer and fluid flow patterns in the micro-channel plate. The effect of channel cross section geometry was studied. The Nusselt number was observed to increase as the aspect ratio approached unity. Measured friction factors were similar in trend to the predictions for rectangular channels, although the overall rise in fluid temperature resulted in slightly lower friction factors. Thermal performance reduced slightly with increase in hydraulic diameter. The significance of various scaling effects was also investigated experimentally and numerically. Most of the typical scaling effects such as viscous dissipation and entrance effects were found to be insignificant however, conjugate heat transfer, surface boundary condition, surface finish and measurement uncertainties could be significant. The results showed a Reynolds number dependent Nusselt number which has been attributed to axial thermal conduction. It was also observed that only three walls were transferring heat; the walls of heat transfer had a uniform peripheral temperature while the heat flux varied peripherally. The closest simplified thermal boundary condition to represent heat transfer in these channels is the H1 with three (3) walls transferring heat. Increased surface roughness (obtained by using an etching technique to create the channels) was found to have a detrimental effect on heat transfer. The results showed that thermal improvement can be achieved by increasing the fluid velocity; however, pumping the thermal fluid above a pump power per plate area of 0.3 W/m2 resulted in marginal improvement. In practice, optimum microchannel geometry in plates should be sized based on fluid properties and operating conditions. The micro-channels should also have thin walls to minimise the effects of conjugate heat transfer. A Photovoltaic pump should be installed alongside the collector in order to provide pumping power required and minimise the overall fluid temperature rise. The results are beneficial for the design of micro-channel absorber plates for low heat flux operation up to 1000W/m2

    Protocol for a pilot randomised controlled clinical trial to compare the effectiveness of a graduated three layer straight tubular bandaging system when compared to a standard short stretch compression bandaging system in the management of people with venous ulceration: 3VSS2008

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    <p>Abstract</p> <p>Background</p> <p>The incidence of venous ulceration is rising with the increasing age of the general population. Venous ulceration represents the most prevalent form of difficult to heal wounds and these problematic wounds require a significant amount of health care resources for treatment. Based on current knowledge multi-layer high compression system is described as the gold standard for treating venous ulcers. However, to date, despite our advances in venous ulcer therapy, no convincing low cost compression therapy studies have been conducted and there are no clear differences in the effectiveness of different types of high compression.</p> <p>Methods/Design</p> <p>The trial is designed as a pilot multicentre open label parallel group randomised trial. Male and female participants aged greater than 18 years with a venous ulcer confirmed by clinical assessment will be randomised to either the intervention compression bandage which consists of graduated lengths of 3 layers of elastic tubular compression bandage or to the short stretch inelastic compression bandage (control). The primary objective is to assess the percentage wound reduction from baseline compared to week 12 following randomisation. Randomisation will be allocated via a web based central independent randomisation service (nQuery v7) and stratified by study centre and wound size ≤ 10 cm<sup>2 </sup>or >10 cm<sup>2</sup>. Neither participants nor study staff will be blinded to treatment. Outcome assessments will be undertaken by an assessor who is blinded to the randomisation process.</p> <p>Discussion</p> <p>The aim of this study is to evaluate the efficacy and safety of two compression bandages; graduated three layer straight tubular bandaging (3L) when compared to standard short stretch (SS) compression bandaging in healing venous ulcers in patients with chronic venous ulceration. The trial investigates the differences in clinical outcomes of two currently accepted ways of treating people with venous ulcers. This study will help answer the question whether the 3L compression system or the SS compression system is associated with better outcomes.</p> <p>Trial Registration</p> <p>ACTRN12608000599370</p

    Heart and systemic effects of statin pretreatment in a rat model of abdominal sepsis. Assessment by Tc99m-sestamibi biodistribition

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    PURPOSE: To evaluate the heart and the Tc-99m-sestamibi biodistribution after statin pretreatment in a rat model of abdominal sepsis. METHODS: Twenty-four Wistar rats were randomly distributed into four groups (n=6 per group): 1) sepsis with simvastatin treatment, 2) sepsis with vehicle, 3) sham control with simvastatin and 4) sham control with vehicle. 24 hours after cecal ligation and puncture rats received 1.0MBq of Tc-99m-sestamibi i.v. 30min after, animals were euthanized for ex-vivo tissue counting and myocardium histological analysis. RESULTS: Myocardial histologic alterations were not detected 24 hours post-sepsis. There was significantly increased cardiac Tc-99m-sestamibi activity in the sepsis group with simvastatin treatment (1.9±\pm0.3%ID/g, p<0.001) in comparison to the sepsis group+vehicle (1.0±\pm0.2% ID/g), control sham group+ simvastatin (1.2±\pm0.3% ID/g) and control sham group (1.3±\pm0.2% ID/g). Significant Tc-99m-sestamibi activity in liver, kidney and lungs was also detected in the sepsis group treated with simvastatinin comparison to the other groups. CONCLUSIONS: Statin treatment altered the biodistribution of Tc-99m-sestamibi with increased cardiac and solid organ activity in rats with abdominal sepsis, while no impact on controls. Increased myocardial tracer activity may be a result of a possible protection effect due to increased tissue perfusion mediated by statins

    Predictive model of pheochromocytoma based on the imaging features of the adrenal tumours

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    The purpose of our study was to develop a predictive model to rule out pheochromocytoma among adrenal tumours, based on unenhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) features. We performed a retrospective multicentre study of 1131 patients presenting with adrenal lesions including 163 subjects with histological confirmation of pheochromocytoma (PHEO), and 968 patients showing no clinical suspicion of pheochromocytoma in whom plasma and/or urinary metanephrines and/or catecholamines were within reference ranges (non-PHEO). We found that tumour size was significantly larger in PHEO than non-PHEO lesions (44.3 +/- 33.2 versus 20.6 +/- 9.2 mm respectively; P < 0.001). Mean unenhanced CT attenuation was higher in PHEO (52.4 +/- 43.1 versus 4.7 +/- 17.9HU; P < 0.001). High lipid content in CT was more frequent among non-PHEO (83.6% versus 3.8% respectively; P < 0.001); and this feature alone had 83.6% sensitivity and 96.2% specificity to rule out pheochromocytoma with an area under the receiver operating characteristics curve (AUC-ROC) of 0.899. The combination of high lipid content and tumour size improved the diagnostic accuracy (AUC-ROC 0.961, sensitivity 88.1% and specificity 92.3%). The probability of having a pheochromocytoma was 0.1% for adrenal lesions smaller than 20 mm showing high lipid content in CT. Ninety percent of non-PHEO presented loss of signal in the out of phase MRI sequence compared to 39.0% of PHEO (P < 0.001), but the specificity of this feature for the diagnosis of non-PHEO lesions low. In conclusion, our study suggests that sparing biochemical screening for pheochromocytoma might be reasonable in patients with adrenal lesions smaller than 20 mm showing high lipid content in the CT scan, if there are no typical signs and symptoms of pheochromocytoma
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