Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: Randomised controlled trial

Objective: To evaluate the impact of a provider initiated primary care outreach intervention compared with usual care among older adults at risk of functional decline. Design: Randomised controlled trial. Setting: Patients enrolled with 35 family physicians in five primary care networks in Hamilton, Ontario, Canada. Participants Patients: were eligible if they were 75 years of age or older and were not receiving home care services. Of 3166 potentially eligible patients, 2662 (84%) completed the validated postal questionnaire used to determine risk of functional decline. Of 1724 patients who met the risk criteria, 769 (45%) agreed to participate and 719 were randomised. Intervention: The 12 month intervention, provided by experienced home care nurses in 2004-6, consisted of a comprehensive initial assessment using the resident assessment instrument for home care; collaborative care planning with patients, their families, and family physicians; health promotion; and referral to community health and social support services. Main outcome measures: Quality adjusted life years (QALYs), use and costs of health and social services, functional status, self rated health, and mortality. Results: The mean difference in QALYs between intervention and control patients during the study period was not statistically significant (0.017, 95% confidence interval -0.022 to 0.056; P=0.388). The mean difference in overall cost of prescription drugs and services between the intervention and control groups was not statistically significant, (-$C165 (£107; €118; $162), 95% confidence interval -$C16 545 to $C16 214; P=0.984). Changes over 12 months in functional status and self rated health were not significantly different between the intervention and control groups. Ten patients died in each group. Conclusions: The results of this study do not support adoption of this preventive primary care intervention for this target population of high risk older adults. Trial registration: Clinical trials NCT00134836.

Ultrafast low-loss 42-70 GHz differential SPDT switch in 0.35 μm SiGe technology

This paper presents an ultrafast wideband low-loss single-pole double-throw (SPDT) differential switch in 0.35 µ m SiGe bipolar technology. The proposed topology adopting current-steering technique results in a total measured switching time of 75 ps , which suggests a maximum switching rate of 13 Gb/s, the fastest ever reported at V-band. In addition, the switch exhibits an insertion loss lower than 1.25 dB and an isolation higher than 18 dB from 42 GHz to 70 GHz. © 2006 IEEE.

40-70 GHz 13 Gbps 1-dB loss SPST and SPDT differential switches in 0.35 μm SiGe technology

This paper presents the design and characterization of ultrafast wideband low-loss single-pole single-throw (SPST) and single-pole double-throw (SPDT) differential switches. The SPDT switch exhibits insertion loss of lower than 1.25 dB from 42 to 70 GHz and isolation of better than 20 dB from 40 to 65 GHz. Similar low-loss and broadband characteristics are also observed from the measured SPST switch. The proposed switch topologies adopting current-steering technique and implemented in 0.35 µm SiGe bipolar technology result in a switching time of only 75 ps. This suggests a maximum switching speed of 13 Gbps, the fastest ever reported at V-band.

Sub-luminous type Ia supernovae from the mergers of equal-mass white dwarfs with mass 0.9M

Type Ia supernovae are thought to result from thermonuclear explosions of carbong'oxygen white dwarf stars. Existing models generally explain the observed properties, with the exception of the sub-luminous 1991bg-like supernovae. It has long been suspected that the merger of two white dwarfs could give rise to a type Ia event, but hitherto simulations have failed to produce an explosion. Here we report a simulation of the merger of two equal-mass white dwarfs that leads to a sub-luminous explosion, although at the expense of requiring a single common-envelope phase, and component masses of 0.9M. The light curve is too broad, but the synthesized spectra, red colour and low expansion velocities are all close to what is observed for sub-luminous 1991bg-like events. Although the mass ratios can be slightly less than one and still produce a sub-luminous event, the masses have to be in the range 0.83M to 0.9M. © 2010 Macmillan Publishers Limited. All rights reserved.

The meaning and function of the middens on Monte Ingino and Monte Ansciano119-0

Malone, C.A.T. and S.K.F. Stoddart, in, C. Malone and S. Stoddart, Editors. 1994, Cambridge University Press: Cambridge. p. 119-127.

Structure and reactivity of the Ru(0 0 0 1) electrode towards fuel cell electrocatalysis

The reactivity of the Ru(0 0 0 1) electrode towards the adsorption and electrooxidation of CO and methanol has been studied by variable-temperature in situ FTIR spectroscopy in both perchloric acid and sodium hydroxide solution, and the results interpreted in terms of the surface chemistry of the Ru(0 0 0 1) electrode. Both linear (CO) and threefold hollow (CO) binding CO adsorbates (bands at 1970-2040 and 1770-1820 cm, respectively) were observed on the Ru(0 0 0 1) electrode in both 0.1 M HClO and 0.1 M NaOH solutions from the CO adsorption. In the acid solution, CO was detected as the main adsorbed species on Ru(0 0 0 1) surface over all the potential region studied. In contrast, in the alkaline solution, more CO than CO was detected at lower potentials, whilst increasing the potential resulted in the transformation of CO to CO. At higher potentials, the oxidation of the adsorbed CO took place via reaction with the active (1 × 1)-O oxide/hydroxide. It was found that no dissociative adsorption or electrooxidation of methanol took place at the Ru(0 0 0 1) at potentials below 900 mV vs Ag/AgCl in perchloric acid solution at both 20 and 55°C. However, in the alkaline solution, methanol did undergo dissociative adsorption, to form linearly adsorbed CO (CO) with little or no CO adsorbed at threefold hollow sites (CO) at both 20 and 55°C. Increasing the temperature from 20 to 55°C clearly facilitated the methanol dissociative adsorption to CO and also enhanced the electrooxidation of the CO. At the higher potentials, significant oxidation of methanol to CO and methyl formate in acid solution and to bicarbonate and formate in alkaline solution, was observed, which was attributed to the formation of an active RuO phase on the Ru(0 0 0 1) surface, in agreement with our previous studies. © 2003 Elsevier Ltd. All right reserved.

In situ FTIR spectroscopic studies of the oxidation of CO adsorbates on Ru(0 0 0 1) electrodes under open circuit conditions

This paper reports the first observation, using in situ FTIR spectroscopy, of the oxidation of CO adsorbates on the Ru(0001) electrode to CO under open circuit (oc) conditions in both perchloric acid and sulphuric acid solution at 20 and 55 °C. While the significant oc oxidation of the adsorbed CO on the Ru(0001) electrode was observed in perchloric acid solution, much less oc oxidation took place in sulfuric acid solution due to the specific adsorption of bisulfate at the Ru surface which inhibits the surface oxidation and reduces the reactivity of the surface towards the oxidation of CO . The oc oxidation of the CO depends strongly on the oxygen concentration in the solution and the temperature. The data so obtained are compared to those observed at the gas|solid interface, as well as to those obtained from the electro-oxidation of CO , and possible new catalytic oxidation reaction mechanisms are discussed. In addition, it is shown that the C-O frequency of the adsorbed CO may be used as an effective probe of the open circuit potential. © 2003 Elsevier B.V. All rights reserved.

Switching between molecular switch types by module rearrangement:Ca -enabled, H-driven 'off-on-off', H-driven YES and PASS 0 as well as H, Ca-driven AND logic operations

Several logic gates and switches can be accessed from two different combinations of a single set of fluorophore, receptor and spacer components.

TLM2.0 based timing accurate modeling method for complex NoC systems

Scalability and efficiency of on-chip communication of emerging Multiprocessor System-on-Chip (MPSoC) are critical design considerations. Conventional bus based interconnection schemes no longer fit for MPSoC with a large number of cores. Networks-on-Chip (NoC) is widely accepted as the next generation interconnection scheme for large scale MPSoC. The increase of MPSoC complexity requires fast and accurate system-level modeling techniques for rapid modeling and veri-fication of emerging MPSoCs. However, the existing modeling methods are limited in delivering the essentials of timing accuracy and simulation speed. This paper proposes a novel system-level Networks-on-Chip (NoC) modeling method, which is based on SystemC and TLM2.0 and capable of delivering timing accuracy close to cycle accurate modeling techniques at a significantly lower simulation cost. Experimental results are presented to demonstrate the proposed method. ©2010 IEEE.