An investigation of the pressaccidic spike potential

A large negative spike potential, which is closely related to the onset of saccadic eyemovements, can be recorded from electrodes adjacent to the orbits. This potential, thepresaccadic spike potential, has often been regarded as an artefact related to eyemovement recordings and little work has been performed to establish its normal waveformand parameters. A positive spike potential, exactly coincident with the frontal negativespike, has also been recorded from electrodes positioned over the posterior scalp andthere has been some debate regarding any possible relationship between the twopotentials. The frontal spike potential has been associated with motor unit activity in theextraocular muscles prior to the saccade. This thesis investigates both the large anteriorand smaller posterior spike potentials and relates these recordings to the saccadic eyemovements associated with them. The anterior spike potential has been recorded from normal subjects to ascertain its normallatency and amplitude parameters for both horizontal and vertical saccades. A relationshipbetween saccade size and spike potential amplitude is described, the spike potentialamplitude reducing with smaller saccades. The potential amplitude also reduces withadvancing age. Studying the topographical distribution of the spike potential across thescalp shows the posterior spike activity may arise from potential spread of the larger frontalspike potential. Spike potential recordings from subjects with anomalous eye movements further implicate the extraocular muscles and their innervation in the generation of the spike potential. These recordings indicate that the spike potential may have some use as a clinical recording from patients with disease conditions affecting either their extraocular muscles or the innervational pathways to these muscles. Further recordings of the potential are necessary, however, to determine the exact nature of the changes which may occur with such conditions.

A simulation of the surface EMG for analysis of muscle activity during whole body vibratory stimulation

Many studies have accounted for whole body vibration effects in the fields of exercise physiology, sport and rehabilitation medicine. Generally, surface EMG is utilized to assess muscular activity during the treatment; however, large motion artifacts appear superimposed to the raw signal, making sEMG recording not suitable before any artifact filtering. Sharp notch filters, centered at vibration frequency and at its superior harmonics, have been used in previous studies, to remove the artifacts. [6, 10] However, to get rid of those artifacts some true EMG signal is lost. The purpose of this study was to reproduce the effect of motor-unit synchronization on a simulated surface EMG during vibratory stimulation. In addition, authors mean to evaluate the EMG power percentage in those bands in which are also typically located motion artifact components. Model characteristics were defined to take into account two main aspect: the muscle MUs discharge behavior and the triggering effects that appear during local vibratory stimulation. [7] Inter-pulse-interval, was characterized by a polimodal distribution related to the MU discharge frequency (IPI 55-80ms, σ=12ms) and to the correlation with the vibration period within the range of ±2 ms due to vibration stimulus. [1, 7] The signals were simulated using different stimulation frequencies from 30 to 70 Hz. The percentage of the total simulated EMG power within narrow bands centered at the stimulation frequency and its superior harmonics (± 1 Hz) resulted on average about 8% (± 2.85) of the total EMG power. However, the artifact in those bands may contain more than 40% of the total power of the total signal. [6] Our preliminary results suggest that the analysis of the muscular activity of muscle based on raw sEMG recordings and RMS evaluation, if not processed during vibratory stimulation may lead to a serious overestimation of muscular response.

Simulation of surface EMG for the analysis of muscle activity during whole body vibratory stimulation

This study aims to reproduce the effect of motor-unit synchronization on surface EMG recordings during vibratory stimulation to highlight vibration evoked muscle activity. The authors intended to evaluate, through numerical simulations, the changes in surface EMG spectrum in muscles undergoing whole body vibration stimulation. In some specific bands, in fact, vibration induced motion artifacts are also typically present. In addition, authors meant to compare the simulated EMGs with respect to real recordings in order to discriminate the effect of synchronization of motor units discharges with vibration frequencies from motion artifacts. Computations were performed using a model derived from previous studies and modified to consider the effect of vibratory stimulus, the motor unit synchronization and the endplates-electrodes relative position on the EMG signal. Results revealed that, in particular conditions, synchronization of MUs' discharge generates visible peaks at stimulation frequency and its harmonics. However, only a part of the total power of surface EMGs might be enclosed within artifacts related bands (±1. Hz centered at the stimulation frequency and its superior harmonics) even in case of strong synchronization of motor units discharges with the vibratory stimulus. © 2013 Elsevier Ireland Ltd.

The exact sample complexity of PAC-learning problems with unit VC dimension

The Vapnik-Chervonenkis (VC) dimension is a combinatorial measure of a certain class of machine learning problems, which may be used to obtain upper and lower bounds on the number of training examples needed to learn to prescribed levels of accuracy. Most of the known bounds apply to the Probably Approximately Correct (PAC) framework, which is the framework within which we work in this paper. For a learning problem with some known VC dimension, much is known about the order of growth of the sample-size requirement of the problem, as a function of the PAC parameters. The exact value of sample-size requirement is however less well-known, and depends heavily on the particular learning algorithm being used. This is a major obstacle to the practical application of the VC dimension. Hence it is important to know exactly how the sample-size requirement depends on VC dimension, and with that in mind, we describe a general algorithm for learning problems having VC dimension 1. Its sample-size requirement is minimal (as a function of the PAC parameters), and turns out to be the same for all non-trivial learning problems having VC dimension 1. While the method used cannot be naively generalised to higher VC dimension, it suggests that optimal algorithm-dependent bounds may improve substantially on current upper bounds.

Work stressors, strains and hospital unit performance

Hospital employees who work in an environment with zero tolerance to error, face several stressors that may result in psychological, physiological, and behavioural strains, and subsequently, in suboptimal performance. This thesis includes two studies which investigate the stressor-to-strain-to-performance relationships in hospitals. The first study is a cross-sectional, multi-group investigation based on secondary data from 65,142 respondents in 172 acute/specialist UK NHS trusts. This model proposes that senior management leadership predicts social support and job design which, in turn, moderate stressors-to-strains across team structure. The results confirm the model's robustness. Regression analysis provides support for main effects and minimal support for moderation hypotheses. Therefore, based on its conclusions and inherent limitations, study one lays the framework for study two. The second study is a cross-sectional, multilevel investigation of the strain-reducing effects of social environment on externally-rated unit-level performance based on primary data from 1,137 employees in 136 units, in a hospital in Malta. The term "social environment" refers to the prediction of the moderator variables, which is to say, social support and decision latitude/control, by transformational leadership and team climate across hospital units. This study demonstrates that transformational leadership is positively associated with social support, whereas team climate is positively associated with both moderators. At the same time, it identifies a number of moderating effects which social support and decision latitude/control, both separately and together, had on specific stressor-to-strain relationships. The results show significant mediated stressor-to-strain-to-performance relationships. Furthermore, at the higher level, unit-level performance is positively associated with shared unit-level team climate and with unit-level vision, the latter being one of the five sub-dimension of transformational leadership. At the same time, performance is also positively related to both transformational leadership and team climate when the two constructs are tested together. Few studies have linked the buffering effects of the social environment in occupational stress with performance. Therefore, this research strives to make a significant contribution to the occupational stress and performance literature with a focus on hospital practice. Indeed, the study highlights the wide-ranging and far-reaching implications that these findings provide for theory, management, and practice.

Functional localisation of human sensory-motor cortex using magnetoencephalography

The 19 channel Neuromagnetometer system in the Clinical Neurophysiology Unit at Aston University is a multi-channel system, unique in the United Kingdom. A bite bar head localisation and MRI co-registration strategy which enabled accurate and reproducible localisation of MEG data into cortical space was developed. This afforded the opportunity to study magnetic fields of the human cortex generated by stimulation of peripheral nerve, by stimulation of visceral sensory receptors and by those evoked through voluntary finger movement. Initially, a study of sensory-motor evoked data was performed in a healthy control population. The techniques developed were then applied to patients who were to undergo neurosurgical intervention for the treatment of epilepsy and I or space occupying lesions. This enabled both validation of the effective accuracy of source localisation using MEG as well as to determine the clinical value of MEG in presurgical assessment of functional localisation in human cortex. The studies in this thesis have demonstrated that MEG can repeatedly and reliably locate sources contained within a single gyrus and thus potentially differentiate between disparate gyral activation. This ability is critical in the clinical application of any functional imaging technique; which is yet to be fully validated by any other 'non-invasive' functional imaging methodology. The technique was also applied to the study of visceral sensory representation in the cortex which yielded important data about the multiple cortical representation of visceral sensory function.

Electromagnetic interference from variable speed motor drives

A methodology is presented which can be used to produce the level of electromagnetic interference, in the form of conducted and radiated emissions, from variable speed drives, the drive that was modelled being a Eurotherm 583 drive. The conducted emissions are predicted using an accurate circuit model of the drive and its associated equipment. The circuit model was constructed from a number of different areas, these being: the power electronics of the drive, the line impedance stabilising network used during the experimental work to measure the conducted emissions, a model of an induction motor assuming near zero load, an accurate model of the shielded cable which connected the drive to the motor, and finally the parasitic capacitances that were present in the drive modelled. The conducted emissions were predicted with an error of +/-6dB over the frequency range 150kHz to 16MHz, which compares well with the limits set in the standards which specify a frequency range of 150kHz to 30MHz. The conducted emissions model was also used to predict the current and voltage sources which were used to predict the radiated emissions from the drive. Two methods for the prediction of the radiated emissions from the drive were investigated, the first being two-dimensional finite element analysis and the second three-dimensional transmission line matrix modelling. The finite element model took account of the features of the drive that were considered to produce the majority of the radiation, these features being the switching of the IGBT's in the inverter, the shielded cable which connected the drive to the motor as well as some of the cables that were present in the drive.The model also took account of the structure of the test rig used to measure the radiated emissions. It was found that the majority of the radiation produced came from the shielded cable and the common mode currents that were flowing in the shield, and that it was feasible to model the radiation from the drive by only modelling the shielded cable. The radiated emissions were correctly predicted in the frequency range 30MHz to 200MHz with an error of +10dB/-6dB. The transmission line matrix method modelled the shielded cable which connected the drive to the motor and also took account of the architecture of the test rig. Only limited simulations were performed using the transmission line matrix model as it was found to be a very slow method and not an ideal solution to the problem. However the limited results obtained were comparable, to within 5%, to the results obtained using the finite element model.

Costs and efficiency of higher education institutions in England:a DEA analysis

As student numbers in higher education in the UK have expanded during recent years, it has become increasingly important to understand its cost structure. This study applies Data Envelopment Analysis (DEA) to higher education institutions in England to assess their cost structure, efficiency and productivity. The paper complements an earlier study that used parametric methods to analyse the same panel data. Interestingly, DEA provides estimates of subject-specific unit costs that are in the same ballpark as those provided by the parametric methods. The paper then extends the previous analysis and finds that further student number increases of the order of 20–27% are feasible through exploiting operating and scale efficiency gains and also adjusting student mix. Finally the paper uses a Malmquist index approach to assess productivity change in the UK higher education. The results reveal that for a majority of institutions productivity has actually decreased during the study period.

Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit

The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.

Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust

This paper explores the potential for cost savings in the general Practice units of a Primary Care Trust (PCT) in the UK. We have used Data Envelopment Analysis (DEA) to identify benchmark Practices, which offer the lowest aggregate referral and drugs costs controlling for the number, age, gender, and deprivation level of the patients registered with each Practice. For the remaining, non-benchmark Practices, estimates of the potential for savings on referral and drug costs were obtained. Such savings could be delivered through a combination of the following actions: (i) reducing the levels of referrals and prescriptions without affecting their mix (£15.74 m savings were identified, representing 6.4% of total expenditure); (ii) switching between inpatient and outpatient referrals and/or drug treatment to exploit differences in their unit costs (£10.61 m savings were identified, representing 4.3% of total expenditure); (iii) seeking a different profile of referral and drug unit costs (£11.81 m savings were identified, representing 4.8% of total expenditure). © 2012 Elsevier B.V. All rights reserved.

Medication reconciliation by a pharmacy technician in a mental health assessment unit

Background: Medication discrepancies are common when patients cross organisational boundaries. However, little is known about the frequency of discrepancies within mental health and the efficacy of interventions to reduce discrepancies. Objective: To evaluate the impact of a pharmacy-led reconciliation service on medication discrepancies on admissions to a secondary care mental health trust. Setting: In-patient mental health services. Methods: Prospective evaluation of pharmacy technician led medication reconciliation for admissions to a UK Mental Health NHS Trust. From March to June 2012 information on any unintentional discrepancies (dose, frequency and name of medication); patient demographics; and type and cause of the discrepancy was collected. The potential for harm was assessed based on two scenarios; the discrepancy was continued into primary care, and the discrepancy was corrected during admission. Logistic regression identified factors associated with discrepancies. Main outcome measure: Mean number of discrepancies per admission corrected by the pharmacy technician. Results Unintentional medication discrepancies occurred in 212 of 377 admissions (56.2 %). Discrepancies involving 569 medicines (mean 1.5 medicines per admission) were corrected. The most common discrepancy was omission (n = 464). Severity was assessed for 114 discrepancies. If the discrepancy was corrected within 16 days the potential harm was minor in 71 (62.3 %) cases and moderate in 43 (37.7 %) cases whereas if the discrepancy was not corrected the potential harm was minor in 27 (23.7 %) cases and moderate in 87 (76.3 %) cases. Discrepancies were associated with both age and number of medications; the stronger association was age. Conclusions: Medication discrepancies are common within mental health services with potentially significant consequences for patients. Trained pharmacy technicians are able to reduce the frequency of discrepancies, improving safety. © 2013 Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie.

A small scale Multi-effect Distillation (MED) unit for rural micro enterprises:part I-design and fabrication

Removal of dissolved salts and toxic chemicals in water, especially at a few parts per million (ppm) levels is one of the most difficult problems. There are several methods used for water purification. The choice of the method depends mainly on the level of feed water salinity, source of energy and type of contaminants present. Distillation is an age old method which can remove all types of dissolved impurities from contaminated water. In multiple effect distillation (MED) latent heat of steam is recycled several times to produce many units of distilled water with one unit of primary steam input. This is already being used in large capacity plants for treating sea water. But the challenge lies in designing a system for small scale operations that can treat a few cubic meters of water per day, especially suitable for rural communities where the available water is brackish. A small scale MED unit with an extendable number of effects has been designed and analyzed for optimum yield in terms of total distillate produced. © 2010 Elsevier B.V.

Electromagnetic design and loss calculations of a 1.12-MW high-speed permanent-magnet motor for compressor applications

Electromagnetic design of a 1.12-MW, 18 000-r/min high-speed permanent-magnet motor (HSPMM) is carried out based on the analysis of pole number, stator slot number, rotor outer diameter, air-gap length, permanent magnet material, thickness, and pole arc. The no-load and full-load performance of the HSPMM is investigated in this paper by using 2-D finite element method (FEM). In addition, the power losses in the HSPMM including core loss, winding loss, rotor eddy current loss, and air friction loss are predicted. Based on the analysis, a prototype motor is manufactured and experimentally tested to verify the machine design.