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A developing application of laser-driven currents is the generation of magnetic fields of picosecond–nanosecond duration with magnitudes exceeding
. Single-loop and helical coil targets can direct laser-driven discharge currents along wires to generate spatially uniform, quasi-static magnetic fields on the millimetre scale. Here, we present proton deflectometry across two axes of a single-loop coil ranging from 1 to 2 mm in diameter. Comparison with proton tracking simulations shows that measured magnetic fields are the result of kiloampere currents in the coil and electric charges distributed around the coil target. Using this dual-axis platform for proton deflectometry, robust measurements can be made of the evolution of magnetic fields in a capacitor coil target.
The paper presents the design and experimental testing of the control system used in a new morphing wing application with a full-scaled portion of a real wing. The morphing actuation system uses four similar miniature brushless DC (BLDC) motors placed inside the wing, which execute a direct actuation of the flexible upper surface of the wing made from composite materials. The control system of each actuator uses three control loops (current, speed and position) characterised by five control gains. To tune the control gains, the Particle Swarm Optimisation (PSO) method is used. The application of the PSO method supposed the development of a MATLAB/Simulink® software model for the controlled actuator, which worked together with a software sub-routine implementing the PSO algorithm to find the best values for the five control gains that minimise the cost function. Once the best values of the control gains are established, the software model of the controlled actuator is numerically simulated in order to evaluate the quality of the obtained control system. Finally, the designed control system is experimentally validated in bench tests and wind-tunnel tests for all four miniature actuators integrated in the morphing wing experimental model. The wind-tunnel testing treats the system as a whole and includes, besides the evaluation of the controlled actuation system, the testing of the integrated morphing wing experimental model and the evaluation of the aerodynamic benefits brought by the morphing technology on this project. From this last perspective, the airflow on the morphing upper surface of the experimental model is monitored by using various techniques based on pressure data collection with Kulite pressure sensors or on infrared thermography camera visualisations.
An improved understanding of diagnostic and treatment practices for patients with rare primary mitochondrial disorders can support benchmarking against guidelines and establish priorities for evaluative research. We aimed to describe physician care for patients with mitochondrial diseases in Canada, including variation in care.
We conducted a cross-sectional survey of Canadian physicians involved in the diagnosis and/or ongoing care of patients with mitochondrial diseases. We used snowball sampling to identify potentially eligible participants, who were contacted by mail up to five times and invited to complete a questionnaire by mail or internet. The questionnaire addressed: personal experience in providing care for mitochondrial disorders; diagnostic and treatment practices; challenges in accessing tests or treatments; and views regarding research priorities.
We received 58 survey responses (52% response rate). Most respondents (83%) reported spending 20% or less of their clinical practice time caring for patients with mitochondrial disorders. We identified important variation in diagnostic care, although assessments frequently reported as diagnostically helpful (e.g., brain magnetic resonance imaging, MRI/MR spectroscopy) were also recommended in published guidelines. Approximately half (49%) of participants would recommend “mitochondrial cocktails” for all or most patients, but we identified variation in responses regarding specific vitamins and cofactors. A majority of physicians recommended studies on the development of effective therapies as the top research priority.
While Canadian physicians’ views about diagnostic care and disease management are aligned with published recommendations, important variations in care reflect persistent areas of uncertainty and a need for empirical evidence to support and update standard protocols.
The aim of this study was to examine the gender differential effects of eating habits and physical activity on overweight and obesity among school-aged adolescents in Bangladesh. Nationally representative data extracted from the 2014 Global School-based Student Health Survey (GSHS) were utilized. The survey collected information related to physical and mental health from 2989 school-aged adolescents in Bangladesh. An exploratory data analysis and multivariate logistic regression model were employed in this study. Female adolescents were at a lower risk of being overweight or obese (AOR=0.573) than males, with a prevalence of 7.4% (males: 9.9%). The results showed that high consumption of vegetables (both: AOR=0.454; males: AOR=0.504; females: AOR=0.432), high soft drink consumption (both: AOR=2.357; males: AOR=2.929; females: AOR=1.677), high fast food consumption (both: AOR=2.777; males: AOR=6.064; females: AOR=1.695), sleep disturbance (both: AOR=0.675; males: AOR=0.590; females: AOR=0.555) and regular walking or cycling to school (both: AOR=0.472; males: AOR=0.430; females: AOR=0.557) were vital influencing factors for being overweight or obese among adolescents for both sexes. Sedentary activities during leisure time were also identified as significant predictors of being overweight or obese for males. Regular fruit and vegetable consumption, the avoidance of soft drinks and fast food, an increase in vigorous physical activity, regular attendance at physical education classes and fewer sedentary leisure time activities could all help reduce the risk of being overweight or obese for both sexes.
New features of the twisted dusty plasma modes and associated instabilities are investigated in permeating plasmas. Using the Vlasov–Poisson model equations, a generalized dispersion relation is obtained for a Maxwellian distributed plasma to analyse the dust-acoustic and dust-ion-acoustic waves with finite orbital angular momentum (OAM) states. Existence conditions for damping/growth rates are discussed and showed significant modifications in twisted dusty modes as compared to straight propagating dusty modes. Numerically, the instability growth rate, which depends on particle streaming and twist effects in the wave potential, is significantly modified due to the Laguerre–Gaussian profiles. Relevance of the study to wave excitations due to penetration of solar wind into cometary clouds or interstellar dusty plasmas is discussed.
Although young people in South Africa are growing up in an era where their socioeconomic circumstances are seemingly better than those of their parents’ generation, they face greater risks in their trajectory to adulthood. This is mainly because the environment in which they are making sexual decisions is also rapidly evolving. Currently, South Africa has the highest prevalence of HIV and AIDS in the world among young people aged 15–24. This study examined the effect of sexual behaviours initiated in adolescence on enrolment in post-secondary education. The analysis was conducted using data from the longitudinal Cape Area Panel Study (CAPS, Waves 1–5) conducted in 2002–2009, which focused on young people’s sexual behaviours in Cape Town, South Africa. The sample was restricted to 3213 individuals who reported sexual debut during adolescence. Using logistic regression models fitted separately for males and females, the results revealed that several factors acted as either hindrances or protective factors to enrolment in post-secondary education. Early sexual debut (by age 17) was negatively associated with participation in tertiary education. Other variables that had a negative effect included not using contraception at first sex, parenthood, engaging in risky behaviours such as illegal substance use, cigarette smoking and drinking alcohol and neglect of school homework (doing less than an hour a day). Higher levels of parental education (except for paternal education in the female model), urban residence and higher aspirations and analogous behaviours (studying) acted as protective factors and were positively associated with post-secondary education initiation. The paper also points to the relationship between early sexual debut and persistent socioeconomic inequality and provides empirical evidence for re-thinking policy development and implementation around schooling and sex education.
The correlation coefficient (ρ) is an important metric for the evaluation of multiple-input–multiple-output (MIMO) antenna systems because it describes the relationship between the channels in a particular propagation environment. Highly correlated channels will degrade the MIMO system performance. Various methods to calculate ρ are analyzed in this work using three different types of antennas with different efficiencies and radiating properties. While the field-based method for finding ρ gives the most accurate results and should be used all the time. It is independent of antenna efficiency. The the S-parameter-based method might give reasonable results only when the antenna efficiency is very high and the patterns are separated in space, but in most cases, it underestimates ρ values and thus is not a reliable method and should be avoided. Incorporating the antenna efficiency can improve the ρ estimates using the S-parameters method under some specific conditions. The equivalent circuit method provides reasonable results for symmetric antenna structures only, and is the most complex in formulation. As part of the evaluation, two existing methods incorporating the radiation efficiency of the antennas are generalized to N-ports for the first time. Although less accurate than the field-based method, these extensions allow the evaluation of ρ for N-port antennas using only the radiation efficiency and the S-parameters of the antenna. The effect of the beam tilts on ρ estimation is investigated for the first time.
This article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital.
The service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts. We deemed the involvement of a liaison psychiatrist necessary in 241 (70.1%) referrals, with medication management as the most common reason.
A substantial amount of liaison ward work involves the treatment and management of severe and complex mental health problems. Our analysis suggests that in the majority of cases the input of a liaison psychiatrist is required.
Early sexual debut is of major concern because it is a correlate for health and economic shocks experienced in adulthood. In South Africa, this concern has provided impetus for research directed at the HIV and AIDS epidemic, teenage pregnancy and the effect of adolescent sexual behaviour on persistence in school. Of interest to the present study is high school completion, which is a well-established empirical barometer of adult socioeconomic opportunities. Using data from the five waves of the Cape Area Panel Study (CAPS), this paper examines the association between sexual behaviours initiated in pre- and early adolescence and high school completion rates. The CAPS study is a longitudinal survey that was designed to investigate young people’s (aged 14–22 years) educational attainment and sexual behaviours in Cape Town, South Africa. The sample was constituted from 3213 individuals who had initiated sex during their teenage years and the analysis was undertaken when the youngest cohort was aged 21, an age at which they should have completed high school if they were on time. Logistic regression models were fitted separately for males and females. Overall, the results reveal that early sexual debut is correlated with long-term negative educational outcomes. Individuals who experience early sexual debut are less likely to complete high school than their counterparts who make their sexual debut later on in life. This effect is worse for Africans, who also disproportionately have an earlier sexual debut than other race groups. Apart from race however, the findings also reinforce the effect of other demographic factors on high school completion, namely, place of residence and family socioeconomic status as measured by parental education and household income. Hence, early sexual debut adds another layer of inequality and worsens the plight of Africans, females, those living in rural areas and those who come from low-income families.
Oxleas NHS Foundation Trust has run a Court Diversion Service in South East London since 1991. It provides services for people within the earlier stages of the Criminal Justice System.
This evaluation aims to combine data from across the 25-year period since the introduction of the diversion scheme. It seeks to provide a longitudinal picture to elucidate the impact of service changes during this time.
The evaluation uses data obtained from a variety of sources for four points in time: 2015/2016, 2011, 1999 and 1991. Data across domains was collated to allow longitudinal analysis.
After the initial introduction of the scheme in 1991, the total mean time on remand was noted to drop from 67.1 days to 49.5 days (P < 0.001). There were 280 referrals over 18 months in 1991, 210 per year in 1999, 190 in 2011 and 174 between April 2015 and March 2016. Violent crimes increased from 29% in 1991 to 47% in 2011. The proportion with schizophrenia decreased from 31% in 1991 to 18% in 1999, before increasing again to 25% in 2011. The use of Section 37 hospital order disposal decreased from 15% in 1991 to just 4% in 2011.
The court diversion scheme has produced significant benefits since it was introduced in 1991, despite a rise in the proportion of violent alleged offences. Changes to the service have seen decreased use of hospital orders.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Graphene is a 2D carbon allotrope that has attracted significant attention because its properties have a wide range of applications. Graphene was deposited on the polycrystalline nickel substrate with a dimension of 0.10 mm × 10 mm × 10 mm via thermal chemical vapor deposition (TCVD). The natural carbon source was obtained from a commercial palm oil as a carbon precursor. The D, G, and 2D bands described the vibration of graphitic layer and overtone of the D band at 1352, 1594, and 2716 cm−1, respectively. The lowest G band full width at half maximum (FWHM) was 38.7 cm−1 at 900 °C deposition temperature. In the x-ray diffraction (XRD) pattern, the FWHM of Ni (200) peak was 0.38°. Raman spectroscopy, UV–vis spectrophotometry, atomic force microscopy, XRD, and field emission scanning electron microscopy characterized the synthesized graphene. Multilayer graphene was successfully synthesized from the palm oil via TCVD.
A serological and coprological survey of fasciolosis was conducted in bovine hosts from the Sargodha district, Pakistan using excretory–secretory (ES) antigens of Fasciola gigantica from cattle and buffaloes. Livers, faecal and blood samples of 146 cattle and 184 buffaloes were collected from slaughterhouses and examined for the presence of any Fasciola in bile ducts and ova in faeces. Serum was separated. ES antigens were prepared by incubating adult Fasciola in phosphate-buffered saline for 6–8 h and then filtering using a 0.22-μm syringe filter. Checkerboard titration was performed and optimum concentrations of antigen and serum were determined. Sero-prevalence was found to be 50.00 and 38.35% in buffalo and cattle, respectively. Using liver examination as the gold standard, enzyme-linked immunosorbent assay (ELISA) sensitivity was found to be 100% in both buffalo and cattle as compared with that of coprological examination in buffalo (61.79%) and cattle (54.54%). This indigenous ELISA was also highly specific, with values of 96.84 and 98.90% in buffalo and cattle, respectively. Positive predictive values were calculated as 96.74 and 98.21% in buffalo and cattle, respectively, while negative predictive values were 100%. For the validation of indigenous ELISA in field surveys, faecal and blood samples were collected from six sub-districts (tehsils) in the district of Sargodha. Sera were screened for the presence of anti-fasciola antibodies using both the indigenous and commercial ELISA kits. While both kits were equally sensitive, the indigenous ELISA was found to be more specific. The highest prevalence of fasciolosis was found in December, as ascertained using both serological and coprological examination. Significant differences were found in prevalences of fasciolosis in different sub-districts and age groups, together with feeding and watering systems.
The present paper is devoted to the investigation of steady MHD axi-symmetric flow between two infinite stretching disks with slip effects. Our attention lies in obtaining the similarity solutions of the governing partial differential equations. The transformed boundary value problem is solved analytically for a series solution using homotopy analysis method. The convergence of the obtained solution is established and fluid velocity and pressure are analyzed for various set of parameter values. The obtained results are valid for both moderate and large values of Reynolds number.
The purpose of the present paper is to examine the prevalence of metabolic syndrome (MetS) and its components using the harmonized definition in an interviewed sub-sample of diverse, low-income, adult South Asians (SA) of both sexes residing in Maryland. We also wanted to derive a BMI cut-off value that was highly correlated with the recommended waist circumference (WC) that we could apply to a larger sample of SA Americans for whom only BMI values were available from clinic files. We also examined differences in MetS prevalence among various Asian ethnic groups (defined by country of origin) and the clustering pattern of their MetS components.
Clinical data extraction on subjects (n 1002) and interviewees (n 401) were used in a cross-sectional study of SA Americans.
Two community health centres in Montgomery and Baltimore County, MD, USA.
SA adult males and females (n 1403) aged 20–68 years.
The prevalence of MetS using harmonized WC cut-offs (90 cm in men and 80 cm in women) was 47 % in men and 54 % in women. Using a BMI of 23·0 kg/m2 gave a similar prevalence of MetS for males (48 %) and females (47 %). Of the five MetS components, the prevalence pattern differed among the ethnic groups, particularly for SA Indians.
The prevalence of MetS in a diverse, low-income, SA American immigrant group using the harmonized definition was 51 %. Derived lowered BMI cut-off of 23·0 kg/m2 should be used by clinicians in studies on SA when WC values are not available for detecting metabolic risk. SA Indians had a higher prevalence of abnormal TAG and blood glucose values compared with other SA, and therefore results for SA Indians should not be generalized to all SA ethnic groups.
Cardiopulmonary bypass is associated with systemic inflammatory response. Steroids suppress this response, although the therapeutic evidence remains controversial. We hypothesised that intravenous steroids in children undergoing open-heart surgery would decrease inflammation leading to better early post-operative outcomes. We conducted a randomised controlled trial to evaluate the trends in the levels of immunomodulators and their effects on clinical parameters.
To assess the effects of intravenous steroids on early post-operative inflammatory markers and clinical parameters in children undergoing open-heart surgery.
Materials and methods
A randomised controlled trial involving 152 patients, from one month up to 18 years of age, who underwent open-heart surgery for congenital heart disease from April 2010–2012 was carried out. Patients were randomised and administered either three scheduled intravenous pulse doses of dexamethasone (1 mg/kg) or placebo. Blood samples were drawn at four time intervals and serum levels of inflammatory cytokines – Interleukin-6, 8, 10, 18, and tumour necrosis factor-alpha – were measured. Clinical parameters were also assessed.
Blood cytokine levels were compared between the dexamethasone (n=65) and placebo (n=64) groups. Interleukin-6 levels were lower at 6 and 24 hours post-operatively (p<0.001), and Interleukin-10 levels were higher 6 hours post-operatively (p<0.001) in the steroid group. Interleukin-8, 18, and tumour necrosis factor-alpha levels did not differ between the groups at any time intervals. The clinical parameters were similar in both the groups.
Dexamethasone caused quantitative suppression of Interleukin-6 and increased Interleukin-10 activation, contributing to reduced immunopathology, but it did not translate into clinical benefit in the short term.
Objectives: There have been multiple calls for explicit integration of ethical, legal, and social issues (ELSI) in health technology assessment (HTA) and addressing ELSI has been highlighted as key in optimizing benefits in the Omics/Personalized Medicine field. This study examines HTAs of an early clinical example of Personalized Medicine (gene expression profile tests [GEP] for breast cancer prognosis) aiming to: (i) identify ELSI; (ii) assess whether ELSIs are implicitly or explicitly addressed; and (iii) report methodology used for ELSI integration.
Methods: A systematic search for HTAs (January 2004 to September 2012), followed by descriptive and qualitative content analysis.
Results: Seventeen HTAs for GEP were retrieved. Only three (18%) explicitly presented ELSI, and only one reported methodology. However, all of the HTAs included implicit ELSI. Eight themes of implicit and explicit ELSI were identified. “Classical” ELSI including privacy, informed consent, and concerns about limited patient/clinician genetic literacy were always presented explicitly. Some ELSI, including the need to understand how individual patients’ risk tolerances affect clinical decision-making after reception of GEP results, were presented both explicitly and implicitly in HTAs. Others, such as concern about evidentiary deficiencies for clinical utility of GEP tests, occurred only implicitly.
Conclusions: Despite a wide variety of important ELSI raised, these were rarely explicitly addressed in HTAs. Explicit treatment would increase their accessibility to decision-makers, and may augment HTA efficiency maximizing their utility. This is particularly important where complex Personalized Medicine applications are rapidly expanding choices for patients, clinicians and healthcare systems.