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Master the art of vibration monitoring of induction motors with this unique guide to on-line condition assessment and fault diagnosis, building on the author's fifty years of investigative expertise.It includes:*Robust techniques for diagnosing of a wide range of common faults, including shaft misalignment and/or soft foot, rolling element bearing faults, sleeve bearing faults, magnetic and vibrational issues, resonance in vertical motor drives, and vibration and acoustic noise from inverters.*Detailed technical coverage of thirty real-world industrial case studies, from initial vibration spectrum analysis through to fault diagnosis and final strip-down. *An introduction to real-world vibration spectrum analysis for fault diagnosis, and practical guidelines to reduce bearing failure through effective grease management. This definitive book is essential reading for industrial end-users, engineers, and technicians working in motor design, manufacturing, and condition monitoring. It will also be of interest to researchers and graduate students working on condition monitoring.
The aim of this study was to describe the sensitivity of various C-reactive protein (CRP) cut-off values to identify patients requiring magnetic resonance imaging evaluation for pyogenic spinal infection among emergency department (ED) adults presenting with neck or back pain.
We prospectively enrolled a convenience series of adults presenting to a community ED with neck or back pain in whom ED providers had concern for pyogenic spinal infection in a derivation cohort from 2004 to 2010 and a validation cohort from 2010 to 2018. The validation cohort included only patients with pyogenic spinal infection. We analysed diagnostic test characteristics of various CRP cut-off values.
We enrolled 232 patients and analysed 201 patients. The median age was 55 years, 43.8% were male, 4.0% had history of intravenous drug use, and 20.9% had recent spinal surgery. In the derivation cohort, 38 (23.9%) of 159 patients had pyogenic spinal infection. Derivation sensitivity and specificity of CRP cut-off values were > 3.5 mg/L (100%, 24.8%), > 10 mg/L (100%, 41.3%), > 30 mg/L (100%, 61.2%), and > 50 mg/L (89.5%, 69.4%). Validation sensitivities of CRP cut-off values were > 3.5 mg/L (97.6%), > 10 mg/L (97.6%), > 30 mg/L (90.4%), and > 50 mg/L (85.7%).
CRP cut-offs beyond the upper limit of normal had high sensitivity for pyogenic spinal infection in this adult ED population. Elevated CRP cut-off values of 10 mg/L and 30 mg/L require validation in other settings.
The conopid fly Stylogaster neglecta Williston (Diptera: Conopidae) is a parasitoid with no known host. We report this species as the first recorded dipteran parasitoid of Oecanthus nigricornis Walker (Orthoptera: Gryllidae) (black-horned tree crickets). We reared field-collected O. nigricornis juveniles over several months in 2017 and found that larval S. neglecta emerged from them during late July into August. We estimated the incubation period for S. neglecta larvae to be around 30 days based on the length of time it took for them to emerge from the host and pupate (subsequently all hosts died). We documented several cases of multiple parasitism. In 2018, we dissected O. nigricornis sampled from four sites across southern Ontario, Canada and upstate New York, United States of America and found that the percentage of juvenile O. nigricornis parasitised ranged 2–39%. Further sampling will be necessary to determine whether this variation represents consistent population differences or between-year variation in parasitism.
In 2019, a 42-year-old African man who works as an Ebola virus disease (EVD) researcher traveled from the Democratic Republic of Congo (DRC), near an ongoing EVD epidemic, to Philadelphia and presented to the Hospital of the University of Pennsylvania Emergency Department with altered mental status, vomiting, diarrhea, and fever. He was classified as a “wet” person under investigation for EVD, and his arrival activated our hospital emergency management command center and bioresponse teams. He was found to be in septic shock with multisystem organ dysfunction, including circulatory dysfunction, encephalopathy, metabolic lactic acidosis, acute kidney injury, acute liver injury, and diffuse intravascular coagulation. Critical care was delivered within high-risk pathogen isolation in the ED and in our Special Treatment Unit until a diagnosis of severe cerebral malaria was confirmed and EVD was definitively excluded.
This report discusses our experience activating a longitudinal preparedness program designed for rare, resource-intensive events at hospitals physically remote from any active epidemic but serving a high-volume international air travel port-of-entry.
This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries.
Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models.
Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.
Bipartite networks represent pairwise relationships between nodes belonging to two distinct classes. While established methods exist for analyzing unipartite networks, those for bipartite network analysis are somewhat obscure and relatively less developed. Community detection in such instances is frequently approached by first projecting the network onto a unipartite network, a method where edges between node classes are encoded as edges within one class. Here we test seven different projection schemes by assessing the performance of community detection on both: (i) a real-world dataset from social media and (ii) an ensemble of artificial networks with prescribed community structure. A number of performance and accuracy issues become apparent from the experimental findings, especially in the case of long-tailed degree distributions. Of the methods tested, the “hyperbolic” projection scheme alleviates most of these difficulties and is thus the most robust scheme of those tested. We conclude that any interpretation of community detection algorithm performance on projected networks must be done with care as certain network configurations require strong community preference for the bipartite structure to be reflected in the unipartite communities. Our results have implications for the analysis of detected community structure in projected unipartite networks.
A growing body of evidence suggests that synaptic plasticity is involved in addictive behaviour and nicotine dependence (ND). Neurotrophic factors, such as neurotrophin 3 (NT3) play a key role in modulating neuronal plasticity. Therefore, an association between nicotine, smoking and neurotrophic factors has been suggested. However, the role of NT3 in ND has not been thoroughly investigated in humans so far.
We investigated the influence of chronic (long-term smoking) and acute nicotine administration on the plasma level of NT3. We measured plasma NT3 levels at baseline and then 15 and 45 minutes after nicotine or placebo administration using an enzyme-linked-immunoabsorbent-assay (ELISA). Smokers showed higher NT3 level than non-smokers at baseline. Interestingly, 15 minutes after acute nicotine injection, plasma level of NT3 in both smokers and non-smokers decreased significantly and went back to baseline levels after 30 minutes. We found that plasma nicotine and NT3 levels were positively correlated in smokers at baseline.
There is a direct interaction of nicotine with NT3, which is different in acute and chronic exposure. Interestingly, the concentration of NT3 is correlated and up-regulated in smokers. We propose that neuroplasticity, which plays a role in addictive behaviour such as smoking or nicotine dependence (ND) might be mediated by these interactions of nicotine and NT3. We speculate that these might even play a part in the so called “self-medicating” with cigarettes that is often seen in patients with certain mental disorders.
The functional Catechol-O-methyltransferase (COMT Val 108/158 Met) polymorphism has been shown to have an impact on tasks of executive function, memory and attention and recently, tasks with an affective component. As estrogen may downregulate COMT, we were interested in the effect of gender, COMT genotype and the interaction between these factors on brain activations during an affective processing task. We used functional MRI to record brain activations from 74 healthy subjects who engaged in a facial affect recognition task; subjects viewed and identified fearful faces compared to neutral faces. We found a significant effect of gender on brain activations in the left amygdala and right superior temporal gyrus, where females demonstrated increased activations over males. Within these regions, female val/val carriers showed greater activity compared to met/met carriers, while male participants with a met/met allele showed greater deactivations compared to val/val carriers. There was no main effect of the COMT polymorphism, gender or genotype by gender interaction on task performance. We propose that the observed effects of gender and COMT allele on brain activations arise from differences in dopamine levels in these groups and that the gender differences and gender genotype interaction may be due to the downregulation of COMT by estrogen.
Neurocognitive and functional neuroimaging studies point to frontal lobe abnormalities in schizophrenia. Molecular and behavioural genetic studies suggest that the frontal lobe is under significant genetic influence. We carried out structural magnetic resonance imaging (MRI) of the frontal lobe in monozygotic (MZ) twins concordant or discordant for schizophrenia and healthy MZ control twins.
The sample comprised 21 concordant pairs, 17 discordant affected and 18 discordant unaffected twins from 19 discordant pairs, and 27 control pairs. Groups were matched on sociodemographic variables. Patient groups (concordant, discordant affected) did not differ on clinical variables. Volumes of superior, middle, inferior and orbital frontal gyri were calculated using the Cavalieri principle on the basis of manual tracing of anatomic boundaries. Group differences were investigated covarying for whole-brain volume, gender and age.
Results for superior frontal gyrus showed that twins with schizophrenia (i.e. concordant twins and discordant affected twins) had reduced volume compared to twins without schizophrenia (i.e. discordant unaffected and control twins), indicating an effect of illness. For middle and orbital frontal gyrus, concordant (but not discordant affected) twins differed from non-schizophrenic twins. There were no group differences in inferior frontal gyrus volume.
These findings suggest that volume reductions in the superior frontal gyrus are associated with a diagnosis of schizophrenia (in the presence or absence of a co-twin with schizophrenia). On the other hand, volume reductions in middle and orbital frontal gyri are seen only in concordant pairs, perhaps reflecting the increased genetic vulnerability in this group.
Schizophrenia psychopathology clusters around several symptom domains. One of these domains is negative symptomatology. We have defined the deficit syndrome as a disease entity characterized by the presence of primary enduring negative symptoms. A focus on primary negative symptoms demonstrates that deficit and nondeficit schizophrenia subgroups differ on clinical features, associated neuroimaging findings, neuropsychological and neurological measures, pattern of risk factors, and pharmacological response profiles. In the present article we focus on the importance of the distinction between primary and secondary negative symptoms for pathophysiology research. The development and mechanistic understanding of anti-negative symptom drugs may be informative regarding pathophysiology of primary negative symptoms. Although new antipsychotics are effective for secondary negative symptoms they have shown no efficacy for the deficit syndrome and new mechanisms of drug action appear to be required to address this aspect of the disease syndrome. The loss of precious human experiences and the association with poor long-term functional outcome justifies a focused and dedicated effort to discover the causes and treatments of this distinctive aspect of schizophrenia.
Around a quarter of people suffering from psychotic conditions, like schizophrenia, continue to experience auditory hallucinations despite adequate drug treatment. In addition to medication, some help is also provided by psychological interventions, particularly cognitive behavioural therapy for psychosis (CBTp). AVATAR therapy is based on computer technology which enables each patient to create an avatar of the entity (human or non-human) that they believe is talking to them. The therapist promotes a dialogue between the patient and the avatar in which the avatar progressively comes under the patient's control. These sessions are audio recorded and provided to the patient on an MP3 player for continued use at home. In an initial pilot study, a maximum of 7 sessions lasting 30 minutes resulted in highly significant reductions in the patients’ hallucinations and the associated distress, enhancing the quality of their life (Leff et al., 2013). Our objective is to replicate the findings of this pilot study of the AVATAR therapy. We will carry out a randomised controlled evaluation of computer assisted voice therapy compared to supportive counselling to determine preliminary estimates of both effectiveness and cost-effectiveness. The study aims to recruit 142 people who have suffered from auditory hallucinations for at least 12 months despite taking medication regularly. Participants will complete a number of selfcompleted and interview based measures (on four assessment points: pre-treatment, post treatment, and then at 12 and 24 weeks follow-up) to assess the impact of interventions on outcomes and to explore potential mediators and modifiers of therapy.
Reconstructions of prehistoric vegetation composition help establish natural baselines, variability, and trajectories of forest dynamics before and during the emergence of intensive anthropogenic land use. Pollen–vegetation models (PVMs) enable such reconstructions from fossil pollen assemblages using process-based representations of taxon-specific pollen production and dispersal. However, several PVMs and variants now exist, and the sensitivity of vegetation inferences to PVM selection, variant, and calibration domain is poorly understood. Here, we compare the reconstructions, parameter estimates, and structure of a Bayesian hierarchical PVM, STEPPS, both to observations and to REVEALS, a widely used PVM, for the pre–Euro-American settlement-era vegetation in the northeastern United States (NEUS). We also compare NEUS-based STEPPS parameter estimates to those for the upper midwestern United States (UMW). Both PVMs predict the observed macroscale patterns of vegetation composition in the NEUS; however, reconstructions of minor taxa are less accurate and predictions for some taxa differ between PVMs. These differences can be attributed to intermodel differences in structure and parameter estimates. Estimates of pollen productivity from STEPPS broadly agree with estimates produced for use in REVEALS, while comparison between pollen dispersal parameter estimates shows no significant relationship. STEPPS parameter estimates are similar between the UMW and NEUS, suggesting that STEPPS parameter estimates are transferable between floristically similar regions and scales.
The available literature suggests that treatments and health services for psychosis are considered to be poorly organized and highly variable. Little is known, however, about how inpatient care is provided to individuals experiencing early psychosis. To facilitate quality improvement activities, we characterized the care this patient group receives in an inner city hospital.
We performed chart reviews of individuals admitted to psychiatric inpatient units at St. Paul's Hospital, Vancouver, British Columbia between 01/04/2014 and 31/03/2016. Those who were 17–25 years of age and hospitalized for psychotic symptoms at the time of admission were included. Demographic and health service use were summarized using descriptive characteristics.
We identified 73 inpatients (mean age = 22; males = 78%; Caucasian = 41%) that met study inclusion criteria, having a combined total of 102 care episodes and an average length of stay of 30.7 days (median = 18; min = 3; max = 268). Half of the care episodes were repeat admissions, with up to 30% of the patients readmitted within 28 days of discharge. Physical and mental status examinations (MSE) were performed in virtually all care episodes, although frequency is low (31.4% had daily physical examinations and 18.6% had MSE every nursing shift). In 49% and 50% of care episodes, patients were given oral antipsychotics and discharged on depot medications. Even when indicated, not all care episodes had follow-up appointments (60%) or referrals to income assistance (35%), community mental health teams (61%), and housing support (38%).
Specific programs are needed to address current gaps in inpatient care for patients with early psychosis.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Degradation of crop and grazing lands is a pervasive problem that negatively impacts agricultural productivity and livelihoods of crop-livestock farmers in the Blue Nile basin of Ethiopia. Area enclosure together with a cut and carry livestock feeding system is often advocated as an approach for the regeneration of degraded grazing lands. This paper reports the results of a two-year farmer participatory study conducted to assess the effects of infiltration trenches (ITs) and Chloris gayana Kunth (Rhodes grass; cultivar Masaba; tetraploid; C4 grass species) reseeding on restoration of degraded grazing lands. A split plot design was used with IT as the main plot and C. gayana reseeding as a sub-plot on 28 private grazing plots under enclosure. The results showed that IT alone increased soil moisture content and prolonged the growing period. IT and C. gayana reseeding together significantly (P ≤ 0.05) increased herbage dry matter yield and improved soil chemical properties. The highest mean herbage dry matter yield (21 Mg ha−1 per cut) was recorded for plots treated with IT and reseeded with C. gayana. The higher herbage dry matter yield was attributed to increased soil moisture and the resultant prolonged growing period induced by the trenches coupled with the ability of C. gayana to effectively utilize the retained water. The results suggest that an integrated land management approach involving enclosure, in-situ water conservation and C. gayana reseeding can rapidly increase biomass productivity on degraded grazing lands while also enhancing soil quality with concomitant livelihood benefits for farmers.
In the past decade, network analysis (NA) has been applied to psychopathology to quantify complex symptom relationships. This statistical technique has demonstrated much promise, as it provides researchers the ability to identify relationships across many symptoms in one model and can identify central symptoms that may predict important clinical outcomes. However, network models are highly influenced by node selection, which could limit the generalizability of findings. The current study (N = 6850) tests a comprehensive, cognitive–behavioral model of eating-disorder symptoms using items from two, widely used measures (Eating Disorder Examination Questionnaire and Eating Pathology Symptoms Inventory).
We used NA to identify central symptoms and compared networks across the duration of illness (DOI), as chronicity is one of the only known predictors of poor outcome in eating disorders (EDs).
Our results suggest that eating when not hungry and feeling fat were the most central symptoms across groups. There were no significant differences in network structure across DOI, meaning the connections between symptoms remained relatively consistent. However, differences emerged in central symptoms, such that cognitive symptoms related to overvaluation of weight/shape were central in individuals with shorter DOI, and behavioral central symptoms emerged more in medium and long DOI.
Our results have important implications for the treatment of individuals with enduring EDs, as they may have a different core, maintaining symptoms. Additionally, our findings highlight the importance of using comprehensive, theoretically- or empirically-derived models for NA.