672 research outputs found

    Coupled mixed layer-acoustic model.

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    A coupled ocean mixed layer-acoustic model is evaluated in two dimensions at a line of stations in the northeast Pacific Ocean. The Oceanic Boundary Layer Model (OBL) is initialized using bathythermograph data acquired during the 1980 Storm Transfer and Response Experiment (STREX). The OBL model was used to predict a new thermal profile after integrating in time for 20 days. This output was then compared with actual bathythermograph data taken 20 days later. Three cases were examined: initial, model, and final data as input to the RAYMODE acoustic model. The acoustic performance for the three cases was measured using median detection range (MDR) and convergence zone range (CZR). In the absence of strong horizontal advection, over a 20 day period the OBL can predict surface temperature to within an average of 0.5°C. Therefore the coupled . models can 4be used effectively to help predict MDR and CZR in a tactical situation.http://archive.org/details/coupledmixedlaye00mcmaCaptain, Canadian ForcesApproved for public release; distribution is unlimited

    Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review.

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    OBJECTIVE: To determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference. DESIGN: Systematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Bland-Altman analyses where individual patient data were available. Methodological quality appraised using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2) criteria. DATA SOURCES: MEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched. ELIGIBILITY CRITERIA: Cross-sectional, randomised and cohort studies of diagnostic test accuracy that compared any non-invasive BP tests (upper arm, forearm, wrist, finger) with an appropriate reference standard (invasive BP, correctly fitting upper arm cuff, ambulatory BP monitoring) in primary care were included. RESULTS: 4037 potentially relevant papers were identified. 20 studies involving 26 different comparisons met the inclusion criteria. Individual patient data were available from 4 studies. No studies satisfied all QUADAS2 criteria. Compared with the reference test of invasive BP, a correctly fitting upper arm BP cuff had a sensitivity of 0.87 (0.79 to 0.93) and a specificity of 0.85 (0.64 to 0.95); insufficient evidence was available for other comparisons to invasive BP. Compared with the reference test of a correctly fitting upper arm cuff, BP measurement at the wrist had a sensitivity of 0.92 (0.64 to 0.99) and a specificity of 0.92 (0.85 to 0.87). Measurement with an incorrectly fitting standard cuff had a sensitivity of 0.73 (0.67 to 0.78) and a specificity of 0.76 (0.69 to 0.82). Measurement at the forearm had a sensitivity of 0.84 (0.71 to 0.92) and a specificity 0.75 of (0.66 to 0.83). Bland-Altman analysis of individual patient data from 3 studies comparing wrist and upper arm BP showed a mean difference of 0.46 mm Hg for systolic BP measurement and 2.2 mm Hg for diastolic BP measurement. CONCLUSIONS: BP measurement with a correctly fitting upper arm cuff is sufficiently sensitive and specific to diagnose hypertension in patients with obesity with a large upper arm circumference. If a correctly fitting upper arm cuff cannot be applied, an incorrectly fitting standard size cuff should not be used and BP measurement at the wrist should be considered

    Retrieval of Infotainment System Artifacts from Vehicles Using iVe

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    The analysis of mobile devices and hard drives has been the focus of the digital forensics world for years, but there is another source of potential evidence not often considered: vehicles. Many of today’s “connected cars” have systems that function like computers, storing information they process including user data from devices synced to the system. There has been little to no research done regarding what types of user artifacts can be found on the system, how long these artifacts remain, whether or not the user can remove those artifacts, and whether certain systems provide more information than others. For this study, two different makes and models of vehicle infotainment systems were used for data acquisition: a Uconnect® system and a Toyota™ Extension Box. It was found that the Toyota™ system provided a significant amount of user information (contacts, call logs, media file information, and locations), while the Uconnect® system provided only locations. This indicates valuable user data can be obtained in this manner

    Clinical response to primary letrozole therapy in elderly patients with early breast cancer : possible role for p53 as a biomarker

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    Primary tamoxifen therapy has been widely used to treat elderly women with ER-positive breast cancer in the past. Aromatase inhibitors may be more beneficial than tamoxifen when used as primary endocrine therapy in elderly patients. We aimed to retrospectively evaluate a series of elderly women with ER-positive breast cancer treated with primary letrozole therapy as sole therapy with a minimum of 5 years follow up. To identify possible predictive biomarkers a pilot immunohistochemical analysis was performed to assess the expression of PR, HER2, EGFR, BCL2 and p53. A total of 45 women, aged more than 70 years with a diagnosis of ER-positive breast cancer that was treated with primary letrozole therapy were identified. A case note review was undertaken to obtain clinical information. Formalin fixed paraffin embedded tumour tissue from diagnostic core biopsies was available for all patients. Immunohistochemical analysis was performed to establish the protein expression status of p53, PR, HER2, EGFR and BCL2. The mean age of the 45 patients was 87 years (range 70–101). Clinical benefit was seen in 60% of the patients. Median progression free survival was 53 months (95% CI – 34–72) and the median time to progression was 43 months (95% CI – 22–64). BCL2 was expressed in 45/45 (100%); PR in 38/45 (84%); EGFR in 13/45 (28%); HER2 in 9/45 (20%) and p53 in 5/45 (11%) of tissue samples. Positive expression of p53 was associated with poor progression free survival (p = 0.03) in this pilot study. This study demonstrates that letrozole as sole treatment appears to be a suitable treatment option for elderly patients with ER-positive breast cancer who are not fit for, or decline, surgery. The analysis of p53 in a larger study is warranted in order to assess its role as a biomarker in this patient group

    Osterberg cell pile load test at Styx Mill overbridge

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    A bored pile constructed at the Styx Mill Bridge overpass, SH 1, in Christchurch, was load tested to determine axial compressive capacity. The testing technique involved using the Osterberg Load Cell, or O-cell. This im1ovative testing method is gaining widespread use worldwide because it provides a fast, effective, and economical means to conduct load tests on full-size deep foundations. The O-cell test at Styx Mill is the first in New Zealand and one of the objectives was to provide an opportunity for New Zealand engineers, contractors, owners, and other potential users of load test information to observe the test first-hand. The test was funded by Transit New Zealand and was conducted in conjunction with a workshop on bored pile design and construction organized by the authors at the University of Canterbury. Workshop attendees were on-site when the bored pile with the O-cell was installed, and were invited to attend the load test several days later. This rep01i describes the site conditions, provides a brief background on the Osterberg-cell concept, describes the test conditions, and summarizes the results. Comparisons are provided between pile capacities predicted by conventional methods and the O-cell test results

    Potential of Demand Side Management to Reduce Carbon Dioxide Emissions Associated with the Operation of Heat Pumps

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    This work considers the potential reduction in the carbon dioxide emissions associated with the operation of Air Source Heat Pump which could be achieved by using demand side management. In order to achieve significant reductions in carbon dioxide emissions, it is widely envisioned that electrification of the heating sector will need to be combined with decarbonisation of the electrical supply. By influencing the times at when electric heat pumps operate such that they coincide more with electricity generation which has a low marginal carbon emissions factor, it has been suggested that these emissions could be reduced further. In order to investigate this possibility, models of the UK electrical grid based on scenarios for 2020 to 2050 have been combined with a dynamic model of an air source heat pump unit and thermal models of a population of dwellings. The performance and carbon dioxide emissions associated with the heat pumps are compared both with and without demand side management interventions intended to give preference to operation when the marginal emissions factor of the electricity being generated is low. It is found that these interventions are unlikely to be effective at achieving further reductions in emissions. A reduction of around 3% was observed in scenarios based around 2035 but in other scenarios the reduction was insignificant. In the scenarios with high wind generation (2050), the DSM scheme considered here tends to improve thermal comfort (with minimal increases in emissions) rather than achieving a decrease in emissions. The reasons for this are discussed and further recommendations are made

    Study protocol for Smartphone Monitoring for Atrial fibrillation in Real-Time in India (SMART-India): a community-based screening and referral programme

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    INTRODUCTION: Atrial fibrillation (AF), the world\u27s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India, where AF epidemiology is undefined. AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF. This study aims to describe the epidemiology of AF in Anand District, Gujarat, India, characterise the clinical profile of individuals who are diagnosed with AF and determine the performance of two mobile technologies for community-based AF screening. METHODS: This observational study builds on findings from a previous feasibility study and leverages two novel technologies as well as an existing community health programme to perform door-to-door AF screening for 2000 people from 60 villages of Anand District, Gujarat, India using local health workers. A single-lead ECG and a pulse-based application is used to screen each individual for AF three times over a period of 5 days. Participants with suspected arrhythmias are followed up by study cardiologist who makes final diagnoses. Participants diagnosed with AF are initiated on treatment based on current anticoagulation guidelines and clinical reasoning. ANALYTICAL PLAN: Age-stratified and sex-stratified prevalence of AF in the Anand District will be calculated for sample and estimated for Anand distribution using survey design weights. Sociodemographic and clinical factors associated with AF will be evaluated using multivariable regression methods. Performance of each mobile technology in detecting AF will be evaluated using a 12-lead ECG interpretation as the gold standard. ETHICS AND DISSEMINATION: This protocol was approved separately by the Institutional Review Board of University of Massachusetts Medical School and the Human Research Ethics Committee at Charutar Arogya Mandal. The findings of this study will be disseminated through peer-reviewed journals and scientific conferences
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