316 research outputs found

    Solid, 3-Mirror Fabry-Perot Etalon

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    We present modeling and performance of a solid, fused silica, 3-mirror Fabry-Perot-type etalon. We show the optical cavity design and construction of the new etalon and show >95% peak transmission, improved passband shape and 20 dB better out of band rejection than a similar 2-mirror etalon

    Computer-based clinical decision support for general practitioners.

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    A GP makes many decisions within every consultation. A computer-based clinical decision support system (CDSS) is software designed to support this decision making. It matches individual patient characteristics to a computerized clinical knowledge base and then provides patient-specific assessments or recommendations to the clinician to support a decision that can relate to diagnosis, investigation, prognosis or treatment. CDSSs offers the potential to translate the most up to date and robust evidence into practice. An example would include a GP being prompted to use a clinical prediction rule for pharyngitis (such as the Centor score) through a CDSS integrated into the electronic health record, after typing the word ‘sore throat’, with suggested management options then being delivered to the GP.</p

    Responses of Human Endothelial Cells to Pathogenic and Non-Pathogenic Leptospira Species

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    Leptospirosis is a widespread zoonotic infection that primarily affects residents of tropical regions, but causes infections in animals and humans in temperate regions as well. The agents of leptospirosis comprise several members of the genus Leptospira, which also includes non-pathogenic, saprophytic species. Leptospirosis can vary in severity from a mild, non-specific illness to severe disease that includes multi-organ failure and widespread endothelial damage and hemorrhage. To begin to investigate how pathogenic leptospires affect endothelial cells, we compared the responses of two endothelial cell lines to infection by pathogenic versus non-pathogenic leptospires. Microarray analyses suggested that pathogenic L. interrogans and non-pathogenic L. biflexa triggered changes in expression of genes whose products are involved in cellular architecture and interactions with the matrix, but that the changes were in opposite directions, with infection by L. biflexa primarily predicted to increase or maintain cell layer integrity, while L. interrogans lead primarily to changes predicted to disrupt cell layer integrity. Neither bacterial strain caused necrosis or apoptosis of the cells even after prolonged incubation. The pathogenic L. interrogans, however, did result in significant disruption of endothelial cell layers as assessed by microscopy and the ability of the bacteria to cross the cell layers. This disruption of endothelial layer integrity was abrogated by addition of the endothelial protective drug lisinopril at physiologically relevant concentrations. These results suggest that, through adhesion of L. interrogans to endothelial cells, the bacteria may disrupt endothelial barrier function, promoting dissemination of the bacteria and contributing to severe disease manifestations. In addition, supplementing antibiotic therapy with lisinopril or derivatives with endothelial protective activities may decrease the severity of leptospirosis

    Effects of Training Intensity on Locomotor Performance in Individuals With Chronic Spinal Cord Injury: A Randomized Crossover Study

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    Background. Many physical interventions can improve locomotor function in individuals with motor incomplete spinal cord injury (iSCI), although the training parameters that maximize recovery are not clear. Previous studies in individuals with other neurologic injuries suggest the intensity of locomotor training (LT) may positively influence walking outcomes. However, the effects of intensity during training of individuals with iSCI have not been tested. Objective. The purpose of this pilot, blinded-assessor randomized trial was to evaluate the effects of LT intensity on walking outcomes in individuals with iSCI. Methods. Using a crossover design, ambulatory participants with iSCI \u3e1 year duration performed either high- or low-intensity LT for ≤20 sessions over 4 to 6 weeks. Four weeks following completion, the training interventions were alternated. Targeted intensities focused on achieving specific ranges of heart rate (HR) or ratings of perceived exertion (RPE), with intensity manipulated by increasing speeds or applying loads. Results. Significantly greater increases in peak treadmill speeds (0.18 vs 0.02 m/s) and secondary measures of metabolic function and overground speed were observed following high- versus low-intensity training, with no effects of intervention order. Moderate to high correlations were observed between differences in walking speed or distances and differences in HRs or RPEs during high- versus low-intensity training. Conclusion. This pilot study provides the first evidence that the intensity of stepping practice may be an important determinant of LT outcomes in individuals with iSCI. Whether such training is feasible in larger patient populations and contributes to improved locomotor outcomes deserves further consideration

    Recirculating Etalon Spectrometer

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    Systems, methods, and devices may provide an optical scheme that achieves simultaneous wavelength channels and maintains the resolution and luminosity of an etalon. Various embodiments may provide a method to optically recirculate the light reflected from the etalon back through the same etalon at new angles. Various embodiments create an etalon spectrometer based on angular dispersion without moving parts and without losing the light that is not initially transmitted. Various embodiments may provide a spectrally-resolved receiver and/or transmitter. Various embodiments may provide a system including a retro-reflector, a detector or transmitter array, and an etalon disposed between the retro-reflector and the detector or transmitter array, wherein the retro-reflector is configured to redirect light reflected by the etalon back to the etalon at a different angle of incidence than an original angle of incidence on the etalon of the light reflected by the etalon

    Psychological Determinants of Medication Adherence in Stroke Survivors: a Systematic Review of Observational Studies

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    © 2017 The Author (s). This is an Open Access article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.BACKGROUND: Medications targeting stroke risk factors have shown good efficacy, yet adherence is suboptimal. To improve adherence, its determinants must be understood. To date, no systematic review has mapped identified determinants into the Theoretical Domains Framework (TDF) in order to establish a more complete understanding of medication adherence. PURPOSE: The aim of this study was to identify psychological determinants that most influence stroke survivors' medication adherence. METHODS: In line with the prospectively registered protocol (PROSPERO CRD42015016222), five electronic databases were searched (1953-2015). Hand searches of included full text references were undertaken. Two reviewers conducted screening, data extraction and quality assessment. Determinants were mapped into the TDF. RESULTS: Of 32,825 articles, 12 fulfilled selection criteria (N = 43,984 stroke survivors). Tested determinants mapped into 8/14 TDF domains. Studies were too heterogeneous for meta-analysis. Three TDF domains appeared most influential. Negative emotions ('Emotions' domain) such as anxiety and concerns about medications ('Beliefs about Consequences' domain) were associated with reduced adherence. Increased adherence was associated with better knowledge of medications ('Knowledge' domain) and stronger beliefs about medication necessity ('Beliefs about Consequences' domain). Study quality varied, often lacking information on sample size calculations. CONCLUSIONS: This review provides foundations for evidence-based intervention design by establishing psychological determinants most influential in stroke survivors' medication adherence. Six TDF domains do not appear to have been tested, possibly representing gaps in research design. Future research should standardise and clearly report determinant and medication adherence measurement to facilitate meta-analysis. The range of determinants explored should be broadened to enable more complete understanding of stroke survivors' medication adherence.Peer reviewedFinal Published versio

    Contrasting Development of Canopy Structure and Primary Production in Planted and Naturally Regenerated Red Pine Forests

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    Globally, planted forests are rapidly replacing naturally regenerated stands but the implications for canopy structure, carbon (C) storage, and the linkages between the two are unclear. We investigated the successional dynamics, interlinkages and mechanistic relationships between wood net primary production (NPPw) and canopy structure in planted and naturally regenerated red pine (Pinus resinosa Sol. ex Aiton) stands spanning ≥ 45 years of development. We focused our canopy structural analysis on leaf area index (LAI) and a spatially integrative, terrestrial LiDAR-based complexity measure, canopy rugosity, which is positively correlated with NPPw in several naturally regenerated forests, but which has not been investigated in planted stands. We estimated stand NPPw using a dendrochronological approach and examined whether canopy rugosity relates to light absorption and light–use efficiency. We found that canopy rugosity increased similarly with age in planted and naturally regenerated stands, despite differences in other structural features including LAI and stem density. However, the relationship between canopy rugosity and NPPw was negative in planted and not significant in naturally regenerated stands, indicating structural complexity is not a globally positive driver of NPPw. Underlying the negative NPPw-canopy rugosity relationship in planted stands was a corresponding decline in light-use efficiency, which peaked in the youngest, densely stocked stand with high LAI and low structural complexity. Even with significant differences in the developmental trajectories of canopy structure, NPPw, and light use, planted and naturally regenerated stands stored similar amounts of C in wood over a 45-year period. We conclude that widespread increases in planted forests are likely to affect age-related patterns in canopy structure and NPPw, but planted and naturally regenerated forests may function as comparable long-term C sinks via different structural and mechanistic pathways

    The promise and peril of intensive-site-based ecological research: insights from the Hubbard Brook ecosystem study

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    Abstract. Ecological research is increasingly concentrated at particular locations or sites. This trend reflects a variety of advantages of intensive, site-based research, but also raises important questions about the nature of such spatially delimited research: how well does site based research represent broader areas, and does it constrain scientific discovery?We provide an overview of these issues with a particular focus on one prominent intensive research site: the Hubbard Brook Experimental Forest (HBEF), New Hampshire, USA. Among the key features of intensive sites are: long-term, archived data sets that provide a context for new discoveries and the elucidation of ecological mechanisms; the capacity to constrain inputs and parameters, and to validate models of complex ecological processes; and the intellectual cross-fertilization among disciplines in ecological and environmental sciences. The feasibility of scaling up ecological observations from intensive sites depends upon both the phenomenon of interest and the characteristics of the site. An evaluation of deviation metrics for the HBEF illustrates that, in some respects, including sensitivity and recovery of streams and trees from acid deposition, this site is representative of the Northern Forest region, of which HBEF is a part. However, the mountainous terrain and lack of significant agricultural legacy make the HBEF among the least disturbed sites in the Northern Forest region. Its relatively cool, wet climate contributes to high stream flow compared to other sites. These similarities and differences between the HBEF and the region can profoundly influence ecological patterns and processes and potentially limit the generality of observations at this and other intensive sites. Indeed, the difficulty of scaling up may be greatest for ecological phenomena that are sensitive to historical disturbance and that exhibit the greatest spatiotemporal variation, such as denitrification in soils and the dynamics of bird communities. Our research shows that end member sites for some processes often provide important insights into the behavior of inherently heterogeneous ecological processes. In the current era of rapid environmental and biological change, key ecological responses at intensive sites will reflect both specific local drivers and regional trends

    Visual disorders and mal de debarquement syndrome : a potential comorbidity questionnaire-based study

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    Aim: Mal de debarquement syndrome (MdDS) is a neurological condition characterized by a constant sensation of self-motion; onset may be motion-triggered (MT) or non-motion-triggered/spontaneous (NMT/SO). People with MdDS experience similar symptoms to those with vertical heterophoria, a subset of binocular visual dysfunction. Hence, we aimed to explore potential visual symptom overlaps. Methods: MdDS patients (n=196) and controls (n=197) completed a visual health questionnaire. Results: Compared with controls, the MdDS group demonstrated higher visual disorder scores and visual complaints. NMT/SO participants reported unique visual symptoms and a higher prevalence of mild traumatic brain injury. Conclusion: Our findings suggest visual disorders may coexist with MdDS, particularly the NMT/SO subtype. The difference in visual dysfunction frequency and medical histories between subtypes, warrants further investigation into differing pathophysiological mechanisms. Plain language summary: MdDS is a condition where patients feel like they are always on a boat. It is typically triggered by passive motion-events (cruises, flights, etc.), but can develop after non-motion events. People with MdDS can experience symptoms like those with certain visual disorders, therefore we wanted to see if there were overlaps between these conditions. This study surveyed people with MdDS and individuals from the general population about visual health and found that the MdDS group reported a higher frequency of visual dysfunction symptoms. Compared with motion-triggered patients, non-motion patients reported unique visual symptoms. This demonstrates that visual disorders may coexist in MdDS. Tweetable abstract: Mal de debarquement syndrome #MdDS is a rare condition where patients feel like they are always on a boat. Given the overlap of symptoms between MdDS and a common visual disorder– these researchers turned their focus toward visual comorbidities and found some eye-raising results
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