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The objectives of this study were to obtain patient evaluations of the content, structure, and delivery modality of Meaning-Centered Pain Coping Skills Training (MCPC), a novel psychosocial intervention for patients with advanced cancer and pain. MCPC aims to help patients connect with valued sources of meaning in their lives (e.g., family relationships), while providing training in evidence-based cognitive and behavioral skills (e.g., guided imagery) to reduce pain.
Semi-structured interviews were conducted with 12 patients with stage IV solid tumor cancers and persistent pain. Transcripts were analyzed using methods from applied thematic analysis.
When evaluating MCPC's educational information and skills training descriptions, participants described ways in which this content resonated with their experience. Many coped with their pain and poor prognosis by relying on frameworks that provided them with a sense of meaning, often involving their personally held religious or spiritual beliefs. They also expressed a need for learning ways to cope with pain in addition to taking medication. A few participants offered helpful suggestions for refining MCPC's content, such as addressing common co-occurring symptoms of sleep disturbance and fatigue. Concerning MCPC's structure and delivery modality, most participants preferred that sessions include their family caregiver and described remote delivery (i.e., telephone or videoconference) as being more feasible than attending in-person sessions.
Significance of results
Participants were interested in an intervention that concurrently focuses on learning pain coping skills and enhancing a sense of meaning. Using remote delivery modalities may reduce access barriers (e.g., travel) that would otherwise prevent many patients from utilizing psychosocial services.
A novel low profile dual band patch antenna is presented. It consists of a composite right/left-handed transmission line (CRLH TL) unit cell gap coupled with the radiating edge of a rectangular patch antenna. The dual band behavior is achieved by coupling the zeroth order resonance mode of CRLH TL and TM10 mode of the patch antenna. It is shown that frequency ratio can be changed by varying the gap between the patch and CRLH TL unit cell. The proposed configuration enables frequency reconfigurability by changing the CRLH TL unit cell using a switch. A prototype of the antenna having frequency ratio f2/f1 = 1.08 is designed and fabricated. The proposed antenna shows measured S11 ≤ −10 dB bandwidth of 100 and 50 MHz at resonance frequencies of f1 = 4.84 and f2 = 5.22 GHz, respectively. A 2 × 2 dual band CRLH TL coupled patch array is also presented, showing more than 12.7 dBi gain at both resonance frequencies.
We computationally investigate coupling of a nonlinear rotational dissipative element to a sprung circular cylinder allowed to undergo transverse vortex-induced vibration (VIV) in an incompressible flow. The dissipative element is a ‘nonlinear energy sink’ (NES), consisting of a mass rotating at fixed radius about the cylinder axis and a linear viscous damper that dissipates energy from the motion of the rotating mass. We consider the Reynolds number range $20\leqslant Re\leqslant 120$, with $Re$ based on cylinder diameter and free-stream velocity, and the cylinder restricted to rectilinear motion transverse to the mean flow. Interaction of this NES with the flow is mediated by the cylinder, whose rectilinear motion is mechanically linked to rotational motion of the NES mass through nonlinear inertial coupling. The rotational NES provides significant ‘passive’ suppression of VIV. Beyond suppression however, the rotational NES gives rise to a range of qualitatively new behaviours not found in transverse VIV of a sprung cylinder without an NES, or one with a ‘rectilinear NES’, considered previously. Specifically, the NES can either stabilize or destabilize the steady, symmetric, motionless-cylinder solution and can induce conditions under which suppression of VIV (and concomitant reduction in lift and drag) is accompanied by a greatly elongated region of attached vorticity in the wake, as well as conditions in which the cylinder motion and flow are temporally chaotic at relatively low $Re$.
Psychotherapeutic interventions have been adopted effectively in the management of tinnitus for a long time. This study compared mindfulness meditation and relaxation therapy for management of tinnitus.
In this randomised controlled trial, patients were recruited for five sessions of mindfulness meditation or five sessions of relaxation therapy. Patients’ responses were evaluated using the Tinnitus Reaction Questionnaire as a primary outcome measure, and the Hospital Anxiety and Depression Scale, visual analogue scale and a health status indicator as secondary outcome measures.
A total of 86 patients were recruited. Thirty-four patients completed mindfulness meditation and 27 patients completed relaxation therapy. Statistically significant improvement was seen in all outcome measures except the health status indicator in both treatment groups. The change in treatment scores was greater in the mindfulness meditation group than in the relaxation therapy group.
This study suggests that although both mindfulness meditation and relaxation therapy are effective in the management of tinnitus, mindfulness meditation is superior to relaxation therapy.
We sought to determine whether the bacterial burden in the nares, as determined by the cycle threshold (CT) value from real-time MRSA PCR, is predictive of environmental contamination with MRSA.
Patients identified as MRSA nasal carriers per hospital protocol were enrolled within 72 hours of room admission. Patients were excluded if (1) nasal mupirocin or chlorhexidine body wash was used within the past month or (2) an active MRSA infection was suspected. Four environmental sites, 6 body sites and a wound, if present, were cultured with premoistened swabs. All nasal swabs were submitted for both a quantitative culture and real-time PCR (Roche Lightcycler, Indianapolis, IN).
At study enrollment, 82 patients had a positive MRSA-PCR. A negative correlation of moderate strength was observed between the CT value and the number of MRSA colonies in the nares (r=−0.61; P<0.01). Current antibiotic use was associated with lower levels of MRSA nasal colonization (CT value, 30.2 vs 27.7; P<0.01). Patients with concomitant environmental contamination had a higher median log MRSA nares count (3.9 vs 2.5, P=0.01) and lower CT values (28.0 vs 30.2; P<0.01). However, a ROC curve was unable to identify a threshold MRSA nares count that reliably excluded environmental contamination.
Patients with a higher burden of MRSA in their nares, based on the CT value, were more likely to contaminate their environment with MRSA. However, contamination of the environment cannot be predicted solely by the degree of MRSA nasal colonization.
Necrotic enteritis (NE) caused by Clostridium spp. is an economically significant bacterial disease of poultry worldwide. Traditionally the disease has been prevented through feed supplementation with antibiotics sub-therapeutically as antimicrobial growth promoters (AGPs). However this practice has led to the emergence of resistant pathogenic microbes and drug residues, potentially threatening animal and public health. Therefore the marketing and incorporation of AGPs into poultry feed has been banned in Europe which has exacerbated the incidence of NE, bringing about huge economic losses to poultry farmers. Poultry researchers, exporters and consumers have emphasised AGP-free poultry rearing and have been searching for non-antibiotic and cost effective alternatives to control NE. Strategies suggested include vaccination, coccidiosis control, probiotics, competitive exclusion products, prebiotics, egg yolk immunoglobulins, bacteriophages (or phage gene products), organic acids, feed enzymes, plants and plants extracts/essential oils and nutritional changes.
There are many predisposing as well as virulence factors for NE induction and pathogenesis and more are expected to be discovered in the future. The ambiguous pathogenesis trend of the disease is still hindering the development of a potent active vaccine against NE. The choice of a single and fully effective approach is difficult. However, probiotics and specific egg yolk immunoglobulins (IgYs) alone or in combination could serve as promising strategies for controlling NE in broilers in the absence of AGPs.
Model scale tests of modern ‘open rotor’ propulsor concepts that have potential for significant fuel burn reduction for aircraft applications were completed at NASA Glenn Research Center. The recent test campaign was a collaboration between NASA, FAA, and General Electric (GE). GE was the primary industrial partner, but other organisations were involved such as Boeing and Airbus who provided additional hardware for fuselage simulations. The open rotor is a modern version of the UnDucted Fan (UDF®) that was flight tested in the late 1980s through a partnership between NASA and GE. The UDF® was memorable for its scimitar shaped propeller blades and its unique noise signature. Design methods of the time were not able to optimise for both high aerodynamic efficiency and low noise simultaneously. Contemporary CFD/CAA based design methods can produce open rotor blade designs that maintain efficiency with acceptable acoustic signatures. Tests of two generations of new open rotor designs were conducted in the 9’ × 15’ Low Speed Wind Tunnel and the 8’ × 6’ Supersonic Wind Tunnel starting in late 2009 and completed in early 2012. Aerodynamic performance and acoustic data were obtained for take-off, approach and cruise conditions in isolated and semi-installed configurations. Additional detailed flow diagnostic measurements and acoustic measurements, including canonical shielding configurations, were obtained by NASA. NASA and GE conducted joint systems analysis to evaluate the performance of the new blade designs on a Boeing 737 class aircraft. The program demonstrated a 2-3% improvement in overall net efficiency relative to the best efficiency designs of the 1980s while nominally achieving 15-17 EPNdB noise margin to Chapter 4 (at a Technology Readiness Level of 5) for a notional aircraft system defined by NASA.
Metallic nanostructures can exhibit different optical properties compared to bulk materials mainly depending on their shape, size, and separation. We present the results of an optical modeling study on ordered arrays of aluminum (Al) nanorods with a hexagonal periodic geometry placed on an Al thin film. We used a finite-difference time-domain (FDTD) method to solve the Maxwell's equations and predict the reflectance of the nanorod arrays. The thickness of the base Al film was set to 100 nm, and diameter, height and nanorod center-to-center periodicity were varied. Incident light in the FDTD simulations was an EM-circular polarized plane wave and reflectance profiles were calculated in the wavelength range 200-1800 nm. In addition, we calculated spatial electric field intensity distributions around the nanorods for wavelengths 300, 500, and 700 nm. Our results show that average reflectance of Al nanorods can drop down to as low as ∼50%, which is significantly lower than the ∼90% reflectance of conventional flat Al film at similar wavelengths. In addition to the overall decrease in reflectance, Al nanorod arrays manifest multiple resonant modes (higher-order modes) indicated by several dips in their reflectance spectrums (i.e. multiple attenuation peaks in their absorption profiles). Positions of these dips in the reflectance spectrum and spatial EM field distribution vary with nanorod height and diameter. Multiple reflectance peaks are explained by cavity resonator effects. Spatial EM field distribution profiles indicate enhanced light trapping among the nanorods, which can be useful especially in optoelectronic and solar cell applications.
From wings of flies to plant leafs, hydrophobic surfaces are well-common in nature. Many of these surfaces have micro and nano hierarchical structures coated with low surface energy layer. In this work, we mimicked similar structure by fabricating Teflon coated periodic and well-ordered silver nanorod arrays and investigated the effect of nanorod separation on water contact angle (WCA). The silver nanorod arrays were deposited on patterned and flat silicon substrates using glancing angle deposition (GLAD) technique. Then a thin layer of Teflon was deposited on the silver nanorods by small angle deposition (SAD) technique. A systematic increase in water contact angle was observed with increasing nanorod separation which is attributed to the decreased area fraction of solid-liquid interface.
The 1,080 km2 Batang Gadis National Park in the North Sumatra province of Indonesia was established in December 2004 by the regional government of Mandailing Natal district. The Park has the potential to make an important contribution to tiger conservation but lacks scientific data on the occurrence of the species. This study aimed to assess the tiger population of the Park, using camera trapping conducted between December 2005 and July 2006. We recorded a mean tiger density of 1.8 tigers per 100 km2 (95% CI 1.8–6.4) and, based on this, estimated the tiger population in and adjacent to the Park to be 29–103 adults. We found that tiger presence was negatively correlated with altitude and positively correlated with distance from forest edge to the interior, and < 18% of the total suitable habitat occupied by tigers was of high quality. This study indicates that Batang Gadis National Park potentially serves as a natural corridor betwen the Angkola and Barumun-Rokan ecosystems, areas totalling c. 6,500 km2, and that this landscape could serve as a stronghold for tiger populations in northern Sumatra.
Control of residual stress in thin films is critical in obtaining high mechanical quality coatings without cracking, buckling, or delamination. In this work, we present a simple and effective method of residual stress reduction in sputter deposited thin films by stacking low and high material density layers of the same material. This multilayer density modulated film is formed by successively changing working gas pressure between high and low values, which results in columnar nanostructured and dense continuous layers, respectively. In order to investigate the evolution of residual stress in density modulated thin films, we deposited ruthenium (Ru) films using a DC magnetron sputtering system at alternating argon (Ar) pressures of 20 and 2 mTorr. Wafer’s radius of curvature was measured to calculate the intrinsic thin film stress of multilayer Ru coatings as a function of total film thickness by changing the number of high density and low density layers. By engineering the film density, we were able to reduce film stress more than one order of magnitude compared to the conventional dense films produced at low working gas pressures. Due to their low stress and enhanced mechanical stability, we were able to grow these density modulated films to much higher thicknesses without suffering from buckling. Morphology and crystal structure of the thin films were investigated by scanning electron microscopy (SEM), transmission electron microscopy (TEM), and X-ray diffraction (XRD). A previously proposed model for stress reduction by means of relatively rough and compliant sublayers was used to explain the unusually low stress in the specimens investigated.
Self-assembled InGaAs quantum dots (QD) grown by metal organic chemical vapor deposition (MOCVD) have a natural peak emission wavelength around 1150-1200-nm due to its specific composition, shapes, and sizes. In this work, a new method to engineer the emission wavelength capability of MOCVD-grown InGaAs QD on GaAs to ∼1000-nm by utilizing interdiffused InGaAsP QD has been demonstrated. Incorporation of phosphorus species from the GaAsP barriers into the MOCVD-grown self-assembled InGaAs QD is achieved by interdiffusion process. Reasonably low threshold characteristics of ∼ 200-280 A/cm2 have been obtained for interdiffused InGaAsP QD lasers emitting at 1040-nm, which corresponds to blue-shift of ∼ 85-90-nm in comparison to that of unannealed InGaAs QD laser.
In this paper we report the effect of low temperature annealing on the high field magnetotransport properties of epitaxial thin films of (Ga, Mn)As Dilute Magnetic Semiconductor (DMS) with low concentration (1.5 %) of Mn doping, which results in a ferromagnetic insulator. Annealing at an optimal temperature enhances the conductivity, carrier concentration, and ferromagnetic transition temperature. The field dependence of magnetoresistance is different below and above the ferromagnetic transition temperature. An attempt is made to analyze the data using a theoretical model proposed by Kaminski and Das Sarma .
Ensuring the delivery of comprehensive, high quality programs and services to seniors in Canada over the coming decades presents a significant challenge to policy makers and health care professionals. The goal of this study was to provide decision-makers with data on recent trends in the utilization of health services by seniors in Alberta. We compared recent trends in the utilization of acute hospital services (1992/93–1997/98), home care services (1994/95–1997/98), claims for physician consultations and procedures (1995/96–1997/98) and long-term facility care (1990–1996) for Albertans less than and over 65 years of age. We also assessed trends in the use of prescription drugs (1992/93–1997–98) by Albertans 65 years and older. Data for these analyses were obtained from Alberta Health and Wellness administrative databases and reports. Overall, the trends indicate fewer, though sicker, patients being cared for in institutions and more patients being cared for in the community. The receipt of prescription drugs obtained outside of facilities has also increased among seniors in recent years. The extent and appropriateness of substitution of community care for institutional care, the quality of that care, and whether health outcomes are better, worse, or unchanged, are important subjects for further study.
Choristoneura fumiferana nucleopolyhedrovirus(CfMNPV) is a baculovirus that infects the spruce budworm, Choristoneura fumiferana(Cf), and a few other related species. To study the infection process of this virus within the spruce budworm, we have constructed a recombinant virus (CfMNPV-GFP) expressing the green fluorescence protein(GFP) under the control of the polyhedrin promoter of Autographa californica nucleopolyhedrovirus. Each larva was fed 10,000 CfMNPV-GFP occlusion bodies(OB) applied to diet plugs and various tissues were dissected from the larvae at 24 hr intervals and examined for the presence of the OB and/or GFP using a fluorescence microscope. Larvae were also fixed and embedded for light and electron microscopy.
GFP-specific fluorescence was first detected as a few spots at the posterior end of the midgut at 72 hr post feeding(PF). By 96 hr PF, the fluorescence had expanded to include adjacent cells and some hemocytes.
A previously undescribed entomopoxvirus was isolated from larvae of Choristoneura conflictana Wlk. Samples of larvae taken from several points in Ontario indicated that the virus was widespread in the Province.
The morphology of the virus is described. The inclusion bodies are larger than those of another entomopoxvirus originally isolated from Choristoneura biennis Free. and propogated in Choristoneura fumiferana (Clem.). The virions are of the same order of size for both viruses. Microspindles are associated with these viruses and some of the spindles are occluded along with the virions within the oval inclusion bodies. The C. conflictana entomopoxvirus is also infectious to C. fumiferana.
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