47 resultados para low back problems


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In remanufacturing, the supply of used products and the demand for remanufactured products are usually mismatched because of the great uncertainties on both sides. In this paper, we propose a dynamic pricing policy to balance this uncertain supply and demand. Specifically, we study a remanufacturer’s problem of pricing a single class of cores with random price-dependent returns and random demand for the remanufactured products with backlogs. We model this pricing task as a continuous-time Markov decision process, which addresses both the finite and infinite horizon problems, and provide managerial insights by analyzing the structural properties of the optimal policy. We then use several computational examples to illustrate the impacts of particular system parameters on pricing policy.

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In a prospective cohort study of Finnish public sector employees, the authors examined the association between workplace social capital and depression. Data were obtained from 33,577 employees, who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000-2002. Their risk of depression was measured with two indicators: recorded purchases of antidepressants until December 31, 2005, and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004-2005. Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up. The odds for antidepressant treatment and physician-diagnosed depression were 20-50% higher for employees with low self-reported social capital than for those reporting high social capital. These associations were not accounted for by sex, age, marital status, socioeconomic position, place of work, smoking, alcohol use, physical activity, and body mass index. The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress (a proxy for undiagnosed mental health problems). Aggregate-level social capital was not associated with subsequent depression.

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This review examines the developments in optical biosensor technology, which uses the phenomenon of surface plasmon resonance, for the detection of paralytic shellfish poisoning (PSP) toxins. Optical biosensor technology measures the competitive biomolecular interaction of a specific biological recognition element or binder with a target toxin immobilised onto a sensor chip surface against toxin in a sample. Different binders such as receptors and antibodies previously employed in functional and immunological assays have been assessed. Highlighted are the difficulties in detecting this range of low molecular weight toxins, with analogues differing at four chemical substitution sites, using a single binder. The complications that arise with the toxicity factors of each toxin relative to the parent compound, saxitoxin, for the measurement of total toxicity relative to the mouse bioassay are also considered. For antibodies, the cross-reactivity profile does not always correlate to toxic potency, but rather to the toxin structure to which it was produced. Restrictions and availability of the toxins makes alternative chemical strategies for the synthesis of protein conjugate derivatives for antibody production a difficult task. However, when two antibodies with different cross-reactivity profiles are employed, with a toxin chip surface generic to both antibodies, it was demonstrated that the cross-reactivity profile of each could be combined into a single-assay format. Difficulties with receptors for optical biosensor analysis of low molecular weight compounds are discussed, as are the potential of alternative non-antibody-based binders for future assay development in this area.

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We present adaptive optics imaging of the core-collapse supernova (SN) 2009md, which we use together with archival Hubble Space Telescope data to identify a coincident progenitor candidate. We find the progenitor to have an absolute magnitude of V=-4.63+0.3-0.4 mag and a colour of V-I= 2.29+0.25-0.39 mag, corresponding to a progenitor luminosity of log L/L?similar to 4.54 +/- 0.19 dex. Using the stellar evolution code STARS, we find this to be consistent with a red supergiant progenitor with M= 8.5+6.5-1.5 M?. The photometric and spectroscopic evolution of SN 2009md is similar to that of the class of sub-luminous Type IIP SNe; in this paper we compare the evolution of SN 2009md primarily to that of the sub-luminous SN 2005cs. We estimate the mass of 56Ni ejected in the explosion to be (5.4 +/- 1.3) x 10-3 M? from the luminosity on the radioactive tail, which is in agreement with the low 56Ni masses estimated for other sub-luminous Type IIP SNe. From the light curve and spectra, we show the SN explosion had a lower energy and ejecta mass than the normal Type IIP SN 1999em. We discuss problems with stellar evolutionary models, and the discrepancy between low observed progenitor luminosities (log L/L?similar to 4.35 dex) and model luminosities after the second dredge-up for stars in this mass range, and consider an enhanced carbon burning rate as a possible solution. In conclusion, SN 2009md is a faint SN arising from the collapse of a progenitor close to the lower mass limit for core collapse. This is now the third discovery of a low-mass progenitor star producing a low-energy explosion and low 56Ni ejected mass, which indicates that such events arise from the lowest end of the mass range that produces a core-collapse SN (78 M?).

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Off-design performance is of key importance now in the design of automotive turbocharger turbines. Due to automotive drive cycles, a turbine that can extract more energy at high pressure ratios and lower rotational speeds is desirable. Typically a radial turbine provides peak efficiency at U/C values of 0.7, but at high pressure ratios and low rotational speeds, the U/C value will be low and the rotor will experience high values of positive incidence at the inlet. The positive incidence causes high blade loading resulting in additional tip leakage flow in the rotor as well as flow separation on the suction surface of the blade. An experimental assessment has been performed on a scaled automotive VGS (variable geometry system). Three different stator vane positions have been analyzed: minimum, 25%, and maximum flow position. The first tests were to establish whether positioning the endwall clearance on the hub or shroud side of the stator vanes produced a different impact on turbine efficiency. Following this, a back swept rotor was tested to establish the potential gains to be achieved during off-design operation. A single passage CFD model of the test rig was developed and used to provide information on the flow features affecting performance in both the stator vanes and turbine. It was seen that off-design performance was improved by implementing clearance on the hub side of the stator vanes rather than on the shroud side. Through CFD analysis and tests, it was seen that two leakage vortices form, one at the leading edge and one after the spindle of the stator vane. The vortices affect the flow angle at the inlet to the rotor, in the hub region. The flow angle is shifted to more negative values of incidence, which is beneficial at the off-design conditions but detrimental at the design point. The back swept rotor was tested with the hub side stator vane clearance configuration. The efficiency and MFR were increased at the minimum and 25% stator vane position. At the design point, the efficiency and MFR were decreased. The CFD investigation showed that the incidence angle was improved at the off-design conditions for the back swept rotor. This reduction in the positive incidence angle, along with the improvement caused by the stator vane tip leakage flow, reduced flow separation on the suction surface of the rotor. At the design point, both the tip leakage flow of the stator vanes and the back swept blade angle caused flow separation on the pressure surface of the rotor. This resulted in additional blockage at the throat of the rotor reducing MFR and efficiency.

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This article explores the literature concerning responses to pain of both premature and term-born newborn infants, the evidence for short-term and long-term effects of pain, and behavioral sequelae in individuals who have experienced repeated early pain in neonatal life as they mature. There is no doubt that pain causes stress in babies and this in turn may adversely affect long-term neurodevelopmental outcome. Although there are methods for assessing dimensions of acute reactivity to pain in an experimental setting, there are no very good measures available at the present time that can be used clinically. In the clinical setting repeated or chronic pain is more likely the norm rather than infrequent discrete noxious stimuli of the sort that can be readily studied. The wind-up phenomenon suggests that, exposed to a cascade of procedures as happens with clustering of care in the clinical setting in an attempt to provide periods of rest for stressed babies, an infant may in fact perceive procedures that are not normally viewed as noxious, as pain. Pain exposure during lifesaving intensive medical care of ELBW neonates may also affect subsequent reactivity to pain in the neonatal period, but behavioral differences are probably not likely to be clinically significant in the long term. Prolonged and repeated untreated pain in the newborn period, however, may produce a relatively permanent shift in basal autonomic arousal related to prior NICU pain experience, which may have long-term sequelae. In the long run, the most significant clinical effects of early pain exposure may be on neurodevelopment, contributing to later attention, learning, and behavior problems in these vulnerable children. Although there is considerable evidence to support a variety of adverse effects of early pain, there is less information about the long-term effects of opiates and benzodiazepines on the developing central nervous system. Current evidence reviewed suggests that judicious use of morphine for adjustment to mechanical ventilation may ameliorate the altered autonomic response. It may be very important, however, to distinguish stress from pain. Animal evidence suggests that the neonatal brain is affected differently when exposed to morphine administered in the absence of pain than in the presence of pain. Pain control may be important for many reasons but overuse of morphine or benzodiazepines may have undesirable long-term effects. This is a rapidly evolving area of knowledge of clear relevance to clinical management likely to affect long-term outcomes of high-risk children.

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The objective of this study was to describe the perceptions of Long Term Care (LTC) service providers in urban Canadian care facilities regarding the prevalence and nature of resident behavior problems and how staff manage these problems. Key informants from 15 LTC facilities housing 1,928 residents, participated in a cross sectional survey which employed semi-structured telephone interviews. Respondents estimated that on average 61% (n = 1,176) of residents had some type of mental health/behavioral problem, with facility estimates ranging from 20% to 90%. The most frequently reported problem behaviors included: general agitation and restlessness (36%); pacing and aimless wandering (28%); hoarding things (24%); hitting either self or others (23%); and verbal aggression (22%). Behaviors reported by respondents as "disruptive" or "very disruptive" were screaming (13%), sexual disinhibition (10%), and hitting either self or others (10%). The most common interventions used by staff were behavioral interventions followed by the use of medications. Low levels of staffing and educational training of staff were among the most common factors recognized as contributing to the difficulty in caring for residents with mental health needs.

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Realist evaluation is an innovative, multi-method approach to evaluating the effectiveness of complex health care interventions that is having an increasing impact on the research community. Drawing on their experience doing four realist evaluations in diverse areas of healthcare, the authors offer a comprehensive overview and critique of essential theory and practice. The first paper (Realist review and realist evaluation: an introduction) introduces the main components of the approach and shows how realist review can support realist evaluation. The second paper (Concepts and methodology for realist evaluation: help or hindrance?) provides further detail on the key concepts, shows how they can be operationalised, and discusses the advantages and difficulties of using these ideas. Following these two papers introducing and illustrating the major concepts, the third paper (Realist Evaluation: a critical realist critique) takes a step back to re-consider realist evaluation in relation to its critical realist roots, asking whether it leads to evaluators abandoning the attempt to understand (and if necessary challenge) the underlying values of health care interventions and contenting themselves merely with explicating the factors that help or hinder implementation. The fourth and final paper (Data analysis and theory development in realist evaluation) plunges back into the tangled undergrowth of multiple-method data collection and shows how disparate forms of data can be synthesised for theory development, and the results presented in a form that is useful to practitioners and policy-makers.

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The vegetation of Europe has undergone substantial changes during the course of the Holocene epoch, resulting from range expansion of plants following climate amelioration, competition between taxa and disturbance through anthropogenic activities. Much of the detail of this pattern is understood from
decades of pollen analytical work across Europe, and this understanding has been used to address questions relating to vegetation-climate feedback, biogeography and human impact. Recent advances in modelling the relationship between pollen and vegetation now make it possible to transform pollen
proportions into estimates of vegetation cover at both regional and local spatial scales, using the Landscape Reconstruction Algorithm (LRA), i.e. the REVEALS (Regional Estimates of VEgetation Abundance from Large Sites) and the LOVE (LOcal VEgetation) models. This paper presents the compilation and analysis of 73 pollen stratigraphies from the British Isles, to assess the application of the LRA and describe the pattern of landscape/woodland openness (i.e. the cover of low herb and bushy vegetation) through the Holocene. The results show that multiple small sites can be used as an effective replacement for a single large site for the reconstruction of regional vegetation cover. The REVEALS vegetation estimates imply that the British Isles had a greater degree of landscape/woodland openness at the regional scale than areas on the European mainland. There is considerable spatial bias in the British Isles dataset towards wetland areas and uplands, which may explain higher estimates of landscape openness compared with Europe. Where multiple estimates of regional vegetation are available from within the same region inter-regional differences are greater than intra-regional differences, supporting the use of the REVEALS model to the estimation of regional vegetation from pollen data.

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The demand for richer multimedia services, multifunctional portable devices and high data rates can only been visioned due to the improvement in semiconductor technology. Unfortunately, sub-90 nm process nodes uncover the nanometer Pandora-box exposing the barriers of technology scaling-parameter variations, that threaten the correct operation of circuits, and increased energy consumption, that limits the operational lifetime of today's systems. The contradictory design requirements for low-power and system robustness, is one of the most challenging design problems of today. The design efforts are further complicated due to the heterogeneous types of designs ( logic, memory, mixed-signal) that are included in today's complex systems and are characterized by different design requirements. This paper presents an overview of techniques at various levels of design abstraction that lead to low power and variation aware logic, memory and mixed-signal circuits and can potentially assist in meeting the strict power budgets and yield/quality requirements of future systems.

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Mixed flow turbines can offer improvements over typical radial turbines used in automotive turbochargers, with regards to transient performance and low velocity ratio efficiency. Turbine rotor mass dominates the rotating inertia of the turbocharger, and any reductions of mass in the outer radii of the wheel, including the rotor back-disk, can significantly reduce this inertia and improve the acceleration of the assembly. Off-design, low velocity ratio conditions are typified by highly tangential flow at the rotor inlet and a non-zero inlet blade angle is preferred for such operating conditions. This is achievable in a Mixed Flow Turbine without increasing bending stresses within the rotor blade, which is beneficial in high speed and high inlet temperature turbine design. A range of mixed flow turbine rotors was designed with varying cone angle and inlet blade angle and each was assessed at a number of operating points. These rotors were based on an existing radial flow turbine, and both the hub and shroud contours and exducer geometry were maintained. The inertia of each rotor was also considered. The results indicated that there was a trade-off between efficiency and inertia for the rotors and certain designs may be beneficial for the transient performance of downsized, turbocharged engines.

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Abstract. Mixed flow turbines can offer improvements over typical radial turbines used in automotive turbochargers, with respect to transient performance and low velocity ratio efficiency. Turbine rotor mass dominates the rotating inertia of the turbocharger’s rotating assembly, and any reductions of mass in the outer radii of the wheel, including the rotor back-disk, can significantly reduce this inertia and improve the acceleration of the assembly. Off-design, low velocity ratio conditions are typified by highly tangential flow at the rotor inlet and a non-zero inlet blade angle is desirable for such operating conditions. This is achievable in a Mixed Flow Turbine without increasing bending stresses within the rotor blade, which is beneficial in high speed and high inlet temperature turbine designs.
This study considers the meridional geometry of Mixed Flow Turbines using a multi-disciplinary study to assess both the structural and aerodynamic performance of each rotor, incorporating both CFD and FEA. Variations of rotor trailing edge were investigated at different operating conditions representing both on- and off-design operation within the constraints of existing hardware geometries. In all cases, the performance is benchmarked against an existing state-of-the-art radial turbocharger turbine with consideration of rotor inertia and its benefit for engine transient performance. The results indicate the influence of these parameters and this report details their benefits with respect to turbocharging a downsized, automotive engine.

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It has previously been shown that human body shadowing can have a considerable impact on body-to-body communications channels in low multipath environments. Signal degradation directly attributable to shadowing when one user's body obstructs the main line of sight can be as great as 40 dB. When both people's bodies obstruct the direct line of sight path, the communications link can be lost altogether even at very short distances of a few metres. In this paper, using front and back positioned antennas, we investigate the utility of a simple selection combination diversity combining scheme with the aim of mitigating human body shadowing in outdoor body-to-body communications channels at 2.45 GHz. Early results from this work are extremely promising, indicating substantial diversity gains, as great as 29 dB, may be achieved in a number of everyday scenarios likely to be encountered in body-to-body networking. © 2012 IEEE.

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Low-dose hyper-radiosensitivity (HRS) is the phenomenon whereby cells exposed to radiation doses of less than approximately 0.5 Gy exhibit increased cell killing relative to that predicted from back-extrapolating high-dose survival data using a linear-quadratic model. While the exact mechanism remains to be elucidated, the involvement of several molecular repair pathways has been documented. These processes in turn are also associated with the response of cells to O6-methylguanine (O6MeG) lesions. We propose a model in which the level of low-dose cell killing is determined by the efficiency of both pre-replicative repair by the DNA repair enzyme O6-methylguanine methyltransferase (MGMT) and post-replicative repair by the DNA mismatch repair (MMR) system. We therefore hypothesized that the response of cells to low doses of radiation is dependent on the expression status of MGMT and MMR proteins. MMR (MSH2, MSH6, MLH1, PMS1, PMS2) and MGMT protein expression signatures were determined in a panel of normal (PWR1E, RWPE1) and malignant (22RV1, DU145, PC3) prostate cell lines and correlated with clonogenic survival and cell cycle analysis. PC3 and RWPE1 cells (HRS positive) were associated with MGMT and MMR proficiency, whereas HRS negative cell lines lacked expression of at least one (MGMT or MMR) protein. MGMT inactivation had no significant effect on cell survival. These results indicate a possible role for MMR-dependent processing of damage produced by low doses of radiation.