Characteristics of muscle activation patterns at the ankle in stroke patients during walking.

Stroke causes impairment of the sensory and motor systems; this can lead to difficulties in walking and participation in society. For effective rehabilitation it is important to measure the essential characteristics of impairment and associate these with the nature of disability. Efficient gait requires a complex interplay of muscles. Surface electromyography(sEMG) can be used to measure muscle activity and to observe disruption to this interplay after stroke. Yet, classification of this disruption in stroke patients has not been achieved. It is hypothesised that features identified from the sEMG signal can be used to classify underlying impairments. A clinically viable gait analysis system has been developed, integrating an in-house wireless sEMG system synchronised with bilateral video and inertial orientation sensors. Signal processing techniques have been extended and implemented, appropriate for use with sEMG. These techniques have focussed on frequency domain features using wavelet analysis and muscle activation patterns using principal component analysis. The system has been used to measure gait from stroke patients and un-impaired subjects. Characteristic patterns of activity from the ankle musculature were defined using principal component analysis of the linear envelope. Patients with common patterns of tibialis anterior activity did not necessarily share common patterns of gastrocnemius or soleus activity. Patients with similar linear envelope patterns did not always present with the same kinematic profiles. The relationship between observable impairments, kinematics and sEMG is seen to be complex and there is therefore a need for a multidimensional view of gait data in relation to stroke impairment. The analysis of instantaneous mean frequency and time-frequency has revealed additional periods of activity not obvious in the linear or raw signal representation. Furthermore, characteristic calf activity was identified that may relate to abnormal reflex activity. This has provided additional information with which to group characteristic muscle activity. An evaluation of the co-activation of gastrocnemius and tibialis anterior muscles using a sub-band filtering technique revealed three groups; those with distinct co-activation, those with little co-activation and those with continuous activity in the antagonistic pair across the stride. Signal features have been identified in sEMG recordings from stroke patients whilst walking extending current signal processing techniques. Common features of the sEMG and movement have been grouped creating a decision matrix. These results have contributed to the field of clinical measurement and diagnosis because interpretation of this decision matrix is related to underlying impairment. This has provided a framework from which subsequent studies can classify characteristic patterns of impairment within the stroke population; and thus assist in the provision of rehabilitative interventions

Nursing Home Infection Control Program Characteristics, CMS Citations, and Implementation of Antibiotic Stewardship Policies: A National Study.

Recently, the Centers for Medicare & Medicaid Services (CMS) final rule required that nursing homes (NHs) develop an infection control program that includes an antibiotic stewardship component and employs a trained infection preventionist (IP). The objectives of this study were to provide a baseline assessment of (1) NH facility and infection control program characteristics associated with having an infection control deficiency citation and (2) associations between IP training and the presence of antibiotic stewardship policies, controlling for NH characteristics. A cross-sectional survey of 2514 randomly sampled US NHs was conducted to assess IP training, staff turnover, and infection control program characteristics (ie, frequency of infection control committee meetings and the presence of 7 antibiotic stewardship policies). Responses were linked to concurrent Certification and Survey Provider Enhanced Reporting data, which contain information about NH facility characteristics and citations. Descriptive statistics and multivariable regression analyses were conducted to account for NH characteristics. Surveys were received from 990 NHs; 922 had complete data. One-third of NHs in this sample received an infection control deficiency citation. The NHs that received deficiency citations were more likely to have committees that met weekly/monthly versus quarterly ( P \u3c .01). The IPs in 39% of facilities had received specialized training. Less than 3% of trained IPs were certified in infection control. The NHs with trained IPs were more likely to have 5 of the 7 components of antibiotic stewardship in place (all P \u3c .05). The IP training, although infrequent, was associated with the presence of antibiotic stewardship policies. Receiving an infection control citation was associated with more frequent infection control committee meetings. Training and support of IPs is needed to ensure infection control and antibiotic stewardship in NHs. As the CMS rule becomes implemented, more research is warranted. There is a need for increase in trained IPs in US NHs. These data can be used to evaluate the effectiveness of the CMS final rule on infection management processes in US NHs

Modelling of monopile-footing foundation system for offshore structures

While monopiles have proven to be an economically sound foundation solution for wind turbines, especially in relatively shallow water, their installation in deeper water and in hard ground may require a more complex foundation design in order to satisfy the loading conditions. One approach is that foundation systems are developed which combine several foundation elements to create a ‘hybrid’ system. In this way it is possible to develop a foundation system which is more efficient for the combination of vertical and lateral loads associated with wind turbines while maintaining the efficiency and simplicity of the design. Previous studies have reported the results of single gravity tests of the hybrid system where the benefits of adding the footing to the pile are illustrated. This paper presents experimental results on the performance of skirted and unskirted monopile-footings. A simplified design approach based on conventional lateral pile analysis is presented

Quantum Pumping in the Magnetic Field: Role of Discrete Symmetries

We consider an effect of the discrete spatial symmetries and magnetic field on the adiabatic charge pumping in mesoscopic systems. In general case, there is no symmetry of the pumped charge with respect to the inversion of magnetic field Q(B) \neq Q(-B). We find that the reflection symmetries give rise to relations Q(B)=Q(-B) or Q(B)=-Q(-B) depending on the orientation of the reflection axis. In presence of the center of inversion, Q(B) = 0. Additional symmetries may arise in the case of bilinear pumping.Comment: 4 page

Understanding infection prevention and control in nursing homes: A qualitative study.

Infections have been identified as a priority issue in nursing homes (NHs). We conducted a qualitative study purposively sampling 10 NHs across the country where 6-8 employees were recruited (N = 73). Semi-structured, open-ended guides were used to conduct in-depth interviews. Data were audiotaped, transcribed and a content analysis was performed. Five themes emerged: \u27Residents\u27 Needs\u27, \u27Roles and Training\u27 \u27Using Infection Data,\u27 \u27External Resources\u27 and \u27Focus on Hand Hygiene.\u27 Infection prevention was a priority in the NHs visited. While all sites had hand hygiene programs, other recommended areas were not a focus and many sites were not aware of available resources. Developing ways to ensure effective, efficient and standardized infection prevention and control in NHs continues to be a national priority

Universal Correlations of Coulomb Blockade Conductance Peaks and the Rotation Scaling in Quantum Dots

We show that the parametric correlations of the conductance peak amplitudes of a chaotic or weakly disordered quantum dot in the Coulomb blockade regime become universal upon an appropriate scaling of the parameter. We compute the universal forms of this correlator for both cases of conserved and broken time reversal symmetry. For a symmetric dot the correlator is independent of the details in each lead such as the number of channels and their correlation. We derive a new scaling, which we call the rotation scaling, that can be computed directly from the dot's eigenfunction rotation rate or alternatively from the conductance peak heights, and therefore does not require knowledge of the spectrum of the dot. The relation of the rotation scaling to the level velocity scaling is discussed. The exact analytic form of the conductance peak correlator is derived at short distances. We also calculate the universal distributions of the average level width velocity for various values of the scaled parameter. The universality is illustrated in an Anderson model of a disordered dot.Comment: 35 pages, RevTex, 6 Postscript figure

The discovery of ash dieback in the UK: the making of a focusing event

Why did the identification of ‘Ash Dieback’ (Chalara Fraxinea) in 2012 in the UK catch the national media, public and political zeitgeist, and lead to policy changes, in a way that no other contemporary tree pest or pathogen outbreak has?The identification of Ash Dieback in the UK is conceptualised as a successful ‘focusing event’ and the ways in which it was socially constructed by the media, stakeholders and the government are analysed. National newspaper coverage contributed to the way that the disease was understood and was significant in driving the political response. Ash Dieback’s focal power derived from the perceived scale and nature of its impact; the initial attribution of blame on government; the ‘war-like’ response from the government; and Ash’s status as a threatened ‘native’ tree. The Ash Dieback focusing event has increased the salience of plant health issues amongst policymakers, the public and conservation organisations in the UK

Interplanetary and Geomagnetic Consequences of Interacting CMEs of 13-14 June 2012

We report on the kinematics of two interacting CMEs observed on 13 and 14 June 2012. Both CMEs originated from the same active region NOAA 11504. After their launches which were separated by several hours, they were observed to interact at a distance of 100 Rs from the Sun. The interaction led to a moderate geomagnetic storm at the Earth with Dst index of approximately, -86 nT. The kinematics of the two CMEs is estimated using data from the Sun Earth Connection Coronal and Heliospheric Investigation (SECCHI) onboard the Solar Terrestrial Relations Observatory (STEREO). Assuming a head-on collision scenario, we find that the collision is inelastic in nature. Further, the signatures of their interaction are examined using the in situ observations obtained by Wind and the Advance Composition Explorer (ACE) spacecraft. It is also found that this interaction event led to the strongest sudden storm commencement (SSC) (approximately 150 nT) of the present Solar Cycle 24. The SSC was of long duration, approximately 20 hours. The role of interacting CMEs in enhancing the geoeffectiveness is examined.Comment: 17 pages, 5 figures, Accepted in Solar Physics Journa

Finite element simulation of three-dimensional free-surface flow problems

An adaptive finite element algorithm is described for the stable solution of three-dimensional free-surface-flow problems based primarily on the use of node movement. The algorithm also includes a discrete remeshing procedure which enhances its accuracy and robustness. The spatial discretisation allows an isoparametric piecewise-quadratic approximation of the domain geometry for accurate resolution of the curved free surface. The technique is illustrated through an implementation for surface-tension-dominated viscous flows modelled in terms of the Stokes equations with suitable boundary conditions on the deforming free surface. Two three-dimensional test problems are used to demonstrate the performance of the method: a liquid bridge problem and the formation of a fluid droplet

Resonance approximation and charge loading/unloading in adiabatic quantum pumping

Quantum pumping through mesoscopic quantum dots is known to be enhanced by resonant transmission. The pumped charge is close to an integer number of electrons when the pumping contour surrounds a resonance, but the transmission remains small on the contour. For non-interacting electrons, we give a quantitative account of the detailed exchange of electrons between the dot and the leads (to the electron reservoirs) during a pumping cycle. Near isolated distinct resonances, we use approximate Breit-Wigner expressions for the dot's Green function to discuss the loading/unloading picture of the pumping: the fractional charge exchanged between the dot and each lead through a single resonance point is related to the relative couplings of the dot and the leads at this resonance. If each resonance point along the pumping contour is dominated by the coupling to a single lead (which also implies a very small transmission), then the crossing of each such resonance results in a single electron exchange between the dot and that lead, ending up with a net quantized charge. When the resonance approximation is valid, the fractional charges can also be extracted from the peaks of the transmissions between the various leads.Comment: 10 pages, 4 figure