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The use of standardized tools for assessment and monitoring of a rehabilitation program is strongly recommended, though not so often accomplished in clinical practice.
To describe the development and feasibility of a computerised method of assessment of rehabilitation activities based on psychometrics.
The software “SVAROSKI” was implemented by means of a relational ER (Entity-Relationship) model with a user interface managed by MS-Access. The rehabilitation activities were: Physical therapy; Locomotion, Occupational Therapy and Reality-Orientation Therapy. Patients were administered at the beginning and at the end of admission the following tests: MMSE, MODA, Barthel Index, Tinetti.
The software enables processing of test data with those obtained from rating scales at each session.
For each patient, two graphical reports are made available:
Punctual performance of each item divided by subject areas;
Overall pace of the three scales assessing rehabilitation (physical therapy was maintained for an evaluation board, partly qualitative, for the sake of the physiotherapist of the structure).
The software allows:
1) the rapid storage of the scores obtained from patients during the course of rehabilitation activities,
2) the real-time consultation of the development of therapeutic and rehabilitation,
3) the comparison of the iteration of several rehabilitation interventions on the patient.
SVAROSKY is a useful tool for analysis and monitoring of developments in the rehabilitation of the patient as a valid tool for the development of a synthesis report of the rehabilitation process.
There is an increasing incidence of overweight/obesity and mental health disorders in young adults and the two conditions often coexist. We aimed to investigate the influence of antenatal and postnatal factors that may underlie this association with a focus on maternal prenatal smoking, socio-economic status and gender. Data from the Western Australian Pregnancy Cohort (Raine) Study (women enrolled 1989–1991) including 1056 offspring aged 20 years (cohort recalled 2010–2012) were analyzed (2015–2016) using multivariable models for associations between offspring depression scores (DASS-21 Depression-scale) and body mass index (BMI), adjusting for pregnancy and early life factors and offspring behaviours. There was a significant positive relationship between offspring depression-score and BMI independent of gender and other psychosocial covariates. There was a significant interaction between maternal prenatal smoking and depression-score (interaction coefficient=0.096; 95% CI: 0.006, 0.19, P=0.037), indicating the relationship between depression-score and BMI differed according to maternal prenatal smoking status. In offspring of maternal prenatal smokers, a positive association between BMI and depression-score (coefficient=0.133; 95% CI: 0.05, 0.21, P=0.001) equated to 1.1 kg/m2 increase in BMI for every 1standard deviation (8 units) increase in depression-score. Substituting low family income during pregnancy for maternal prenatal smoking in the interaction (interaction coefficient=0.091; 95% CI: 0.01, 0.17, P=0.027) showed a positive association between BMI and depression score only among offspring of mothers with a low family income during pregnancy (coefficient=0.118; 95% CI: 0.06, 0.18, P<0.001). There were no significant effects of gender on these associations. Whilst further studies are needed to determine whether these associations are supported in other populations, they suggest potentially important maternal behavioural and socio-economic factors that identify individuals vulnerable to the coexistence of obesity and depression in early adulthood.
We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.
We report detections of thermal X-ray line emission and proper motions in the supernova remnant (SNR) RX J1713.7-3946, the prototype of the small class of synchrotron dominated SNRs. Based on deep XMM-Newton observations, we find clear line features including Ne Lyα, Mg Heα, and Si Heα from the central portion of the remnant. The metal abundance ratios suggest that the thermal emission originates from core-collapse SN ejecta arising from a relatively low-mass (≲20 M⊙) progenitor. In addition, using XMM-Newton observations on a 13 yr time interval, we have measured expansion in the southeastern rim to be ~0.75″ yr−1 or ~3500 km s−1 at a distance of 1 kpc. Given this, we derive an upstream density to be ~0.01 cm−3, compatible with the lack of thermal X-rays from the shocked ambient medium. We also estimate the age of the remnant to be ~1200–1600 yr, roughly consistent with the idea that RX J1713.7-3946 is the remnant of SN 393.
It has been demonstrated that negatively distorted self-referential processing, in which individuals evaluate one's own self, is a pathogenic mechanism in subthreshold depression that has a considerable impact on the quality of life and carries an elevated risk of developing major depression. Behavioural activation (BA) is an effective intervention for depression, including subthreshold depression. However, brain mechanisms underlying BA are not fully understood. We sought to examine the effect of BA on neural activation during other perspective self-referential processing in subthreshold depression.
A total of 56 subjects underwent functional magnetic resonance imaging scans during a self-referential task with two viewpoints (self/other) and two emotional valences (positive/negative) on two occasions. Between scans, while the intervention group (n = 27) received BA therapy, the control group (n = 29) did not.
The intervention group showed improvement in depressive symptoms, increased activation in the dorsal medial prefrontal cortex (dmPFC), and increased reaction times during other perspective self-referential processing for positive words after the intervention. Also, there was a positive correlation between increased activation in the dmPFC and improvement of depressive symptoms. Additionally, there was a positive correlation between improvement of depressive symptoms and increased reaction times.
BA increased dmPFC activation during other perspective self-referential processing with improvement of depressive symptoms and increased reaction times which were associated with improvement of self-monitoring function. Our results suggest that BA improved depressive symptoms and objective monitoring function for subthreshold depression.
Enhancement of the quality of laser wake-field accelerated (LWFA) electron beams implies the improvement and controllability of the properties of the wake waves generated by ultra-short pulse lasers in underdense plasmas. In this work we present a compendium of useful formulas giving relations between the laser and plasma target parameters allowing one to obtain basic dependences, e.g. the energy scaling of the electrons accelerated by the wake field excited in inhomogeneous media including multi-stage LWFA accelerators. Consideration of the effects of using the chirped laser pulse driver allows us to find the regimes where the chirp enhances the wake field amplitude. We present an analysis of the three-dimensional effects on the electron beam loading and on the unlimited LWFA acceleration in inhomogeneous plasmas. Using the conditions of electron trapping to the wake-field acceleration phase we analyse the multi-equal stage and multiuneven stage LWFA configurations. In the first configuration the energy of fast electrons is a linear function of the number of stages, and in the second case, the accelerated electron energy grows exponentially with the number of stages. The results of the two-dimensional particle-in-cell simulations presented here show the high quality electron acceleration in the triple stage injection–acceleration configuration.
Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009–2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru.
The existence of Pt7Cu ordering phase (intermetallic compound) was investigated by ab initio calculations and high voltage electron microscopy (HVEM) focusing on irradiation-induced ordering. The Pt7Cu ordering phase (cF32, prototype Ca7Ge) was predicted at 0 K through density functional theory (DFT), and using cluster expansion (CE) method and grand canonical Monte Carlo (GCMC) simulation, the ordering temperature of fcc-based Pt7Cu ordering phase was estimated to be above room temperature. The formation of Pt7Cu ordering phase was confirmed by a short-time irradiation for 3.6×103 s at 600 K. MeV electron irradiation can reduce drastically the annealing time for the ordering in the Pt-Cu alloy system, indicating that the combination of the prediction by ab initio calculations and HVEM can offer the unique opportunity to investigate the existence of ordering phase in alloys.
Preparation of a sigma-CrFe single-phase specimen was achieved by arc melting of pure Fe and Cr, cold rolling, and subsequent annealing at 973 K or 1073 K in vacuum. Cold rolling before annealing is effective for the annealing-induced formation of sigma-CrFe from the bcc solid-solution phase. The phase stability and the structural change from sigma-CrFe to a bcc solid-solution phase under fast electron irradiation were investigated by in situ transmission electron microscope (TEM) observation in the temperature range between 22 K and 473 K by using an ultra-high voltage electron microscope (UHVEM). The phase transition of sigma-CrFe by fast electron irradiation was found to occur at a particular temperature.
An outbreak of leptospirosis occurred in the South of Belgium, during August 2012, in teenagers who participated in two consecutive adventure scout camps near the Semois river. Among the symptomatic patient population (ten scouts), clinical manifestations included headache (70%), myalgia (50%), fever (50%), bilateral conjunctival injection (50%), general malaise (30%), vomiting (20%), anorexia (20%) and cough (20%). Some of the cases presented elevated blood creatinine (40%), or proteinuria (30%). Three patients were confirmed by serology and one by polymerase chain reaction. Potential risk factors included direct contact with a muskrat and indirect contact with potentially contaminated environments including the river water. Prospective environmental investigation carried out near the river banks 2 weeks after the outbreak identified Ondatra zibethicus (muskrat) as one Leptospira sp. reservoir.
Evidence suggests that breastfeeding during infancy lowers the risk of metabolic syndrome (MS) and its attendant risk factors in adult life. To investigate the influence of feeding type on the risk factors of MS, we assessed insulin sensitivity and lipid and apolipoprotein metabolism in preterm infants. Blood samples were collected from preterm infants at the time of discharge. Infants were separated into two groups: a breast milk (BM) group receiving ⩾90% of their intake from BM, and a mixed-fed (MF) group receiving ⩾50% of their intake from formula. The following indices were then compared between the two groups. Blood glucose and serum insulin levels were used to calculate the quantitative insulin sensitivity check index (QUICKI). We also measured serum total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), apolipoprotein-A1 (apoA1) and apolipoprotein-B (apoB) levels, and the ratios of TC/HDLc, LDLc/HDLc and apoB/apoA1. The mean gestational age was 32.9 weeks at birth, and blood samples were collected at a mean corrected age of 37.4 weeks. There were 22 infants in the BM group and 19 in the MF group. QUICKI was significantly higher in the BM group. TC, HDLc and apoA1 were not significantly different between the groups, but LDLc and apoB levels were significantly higher in the BM group. The TC/HDLc, LDLc/HDLc and apoB/apoA1 ratios were significantly higher in the BM group. In preterm infants, the type of feeding exposure in the early postnatal period may influence glucose, lipid and apolipoprotein metabolism, and affect markers of MS.
Our nation discards more than 50% of the total input energy as waste heat in various industrial processes such as metal refining, heat engines, and cooling. If we could harness a small fraction of the waste heat through the use of thermoelectric (TE) devices while satisfying the economic demands of cost versus performance, then TE power generation could bring substantial positive impacts to our society in the forms of reduced carbon emissions and additional energy. To increase the unit-less figure of merit, ZT, single-crystal semiconductor nanowires have been extensively studied as a building block for advanced TE devices because of their predicted large reduction in thermal conductivity and large increase in power factor. In contrast, polycrystalline bulk semiconductors also indicate their potential in improving overall efficiency of thermal-to-electric conversion despite their large number of grain boundaries. To further our goal of developing practical and economical TE devices, we designed a material platform that combines nanowires and polycrystalline semiconductors which are integrated on a metallic surface. We will assess the potential of polycrystalline group III-V compound semiconductor nanowires grown on low-cost copper sheets that have ideal electrical/thermal properties for TE devices. We chose indium phosphide (InP) from group III-V compound semiconductors because of its inherent characteristics of having low surface states density in comparison to others, which is expected to be important for polycrystalline nanowires that contain numerous grain boundaries. Using metal organic chemical vapor deposition (MOCVD) polycrystalline InP nanowires were grown in three-dimensional networks in which electrical charges and heat travel under the influence of their characteristic scattering mechanisms over a distance much longer than the mean length of the constituent nanowires. We studied the growth mechanisms of polycrystalline InP nanowires on copper surfaces by analyzing their chemical, optical, and structural properties in comparison to those of single-crystal InP nanowires formed on single-crystal surfaces. We also assessed the potential of polycrystalline InP nanowires on copper surfaces as a TE material by modeling based on finite-element analysis to obtain physical insights of three-dimensional networks made of polycrystalline InP nanowires. Our discussion will focus on the synthesis of polycrystalline InP nanowires on copper surfaces and structural properties of the nanowires analyzed by transmission electron microscopy that provides insight into possible nucleation mechanisms, growth mechanisms, and the nature of grain boundaries of the nanowires.
Large electrocaloric (EC) effects in ferroelectric polymers and in ferroelectric ceramics have attracted great attention for new refrigeration development which is more environmental friendly and more efficient and thus could be an alternative to the existing vapor-compression refrigerators which consume large energy and release large amount of green house gas. However in the past, all EC effects investigations have been focused on solid state dielectrics. It is interesting to ask whether a large EC effect can also be realized in dielectric fluids. A dielectric fluid with large EC effect could lead to new design of cooling devices with simpler structures than these based on solid state EC materials, for example, they can be utilized as both the refrigerant and heat exchange fluid. Here we present that a large EC effect can be realized in the liquid crystal (LC) 5CB near it's nematic-isotropic (N-I) phase transition. The LC 5CB possesses a large dielectric anisotropy which can induce large polarization change from the isotropic phase to the nematic phase near the N-I transition. An isothermal entropy change of more than 23 Jkg-1K-1 was observed near 39 oC that is just above the N-I transition.
The present work investigates the fabrication, thermal conductivity (TC) and rheological properties of water based carbon nanotubes (CNTs) nanofluids (NFs) prepared using a two-step method. As-received (AR) CNTs heated and the effect of heat treatment was studied using X-ray diffraction and thermogravimetric analysis. The AR-CNTs and heat-treated CNTs (HT-CNTs) were dispersed with varying concentration of surface modifiers Gum Arabic (GA) and TritonX-100 (TX) respectively. It was found that heat treatment of CNTs effectively improved the TC and influenced rheological properties of NFs. Scanning electron microscopy analysis revealed TX modified NFs showed better dispersion ability compared to GA. Surface modification of the CNTs was confirmed by Fourier Transformation Infrared (FTIR) analysis. Zeta potential measurement showed the stability region for GA modified NFs in the pH range of 5-11, whereas pH was between 9.5-10 for TX NFs. The concentration of surface modifier plays an extensive role on both TC and rheological behavior of NFs. A maximum TC enhancement of 10% with increases in viscosity around 2% for TX based HT-CNTs NFs was measured. Finally comparison of experimental TC results with the predicted values obtained from a model demonstrated inadequacy of the predictive model for CNT NFs system.
The application of micro-fourier transform infrared (FTIR) mapping analysis to thermoelectric materials towards identification of doping inhomogeneities is described. Micro-FTIR, in conjunction with fitting, is used as analytical tool for probing carrier content gradients. The plasmon frequency ωP2 was studied as potential effective probe for carrier inhomogeneity and consequently doping differentiation based on its dependence of the carrier concentration. The method was applied to PbTe-, PbSe- and Mg2Si- based thermoelectric materials.
Latest nanotechnology concepts applied in thermoelectric (TE) research have opened many new avenues to improve the ZT value. Low dimensional structures can improve the ZT value as compared to bulk materials by substantial reduction in the lattice thermal conductivity, κL. However, the materials were not feasible for the industrial scale production of macroscopic devices because of complicated and costly manufacturing processes involved. Bulk nanostructured (NS) TEs are normally fabricated using a bulk process rather than a nano-fabrication process, which has the important advantage of producing in large quantities and in a form that is compatible with commercially available TE devices.
We developed fabrication strategies for bulk nanostructured skutterudite materials based on FexCo1-xSb3. The process is based on precipitation of a precursor material with the desired metal atom composition, which is then exposed to thermochemical processing of calcination followed by reduction. The resultant material thus formed maintains nanostructured particles which are then compacted using Spark Plasma Sintering (SPS) by utilizing previously optimized process parameters. Microstructure, crystallinity, phase composition, thermal stability and temperature dependent transport property evaluation has been performed for compacted NS FexCo1-xSb3. Evaluation results are presented in detail, suggesting the feasibility of devised strategy for bulk quantities of doped TE nanopowder fabrication.