Azithromycin efficacy in treatment of Chlamydia trachomatis

Adolescents 15 – 19 years of age have the highest prevalence of Chlamydia trachomatis out of any age group, reaching 28.3% among detained youth [1]. The 2010 Center for Disease Control guidelines recommend one dose of azithromycin for the treatment of uncomplicated chlamydia infections based on 97% cure rate with azithromycin. Recent studies found an 8% or higher failure rate of azithromycin treatment in adolescents [2-5]. We conducted a prospective study beginning May, 2012 in the Harris County Juvenile Justice Center (HCJJC) medical department. Study subjects were detainees with positive urine NAAT tests for chlamydia on intake. We provided treatment with Azithromycin, completed questionnaires assessing risk factors and performed a test of cure for chlamydia three weeks after successful treatment. Those with treatment failure (positive TOC) received doxycycline for seven days. The preliminary results summarized herein are based on data collected from May 2012 to January 2013. Of the 97 youth enrolled in the study to date, 4 (4.1%) experienced treatment failure after administration of Azithromycin. Of these four patients, all were male, African-American and asymptomatic at the time of initial diagnosis and treatment. Of note, 37 (38%) patients in the cohort complained of abdominal pain with administration of Azithromycin. Results to date suggest that the efficacy of Azithromycin in our study is higher than the recent reported studies indicating a possible upper bound of Azithromycin. These results are preliminary and recruitment will continue until a sample size of 127 youth is reached.^

The number and timing of time -dependent covariate measurements for the Cox regression model

The problem of analyzing data with updated measurements in the time-dependent proportional hazards model arises frequently in practice. One available option is to reduce the number of intervals (or updated measurements) to be included in the Cox regression model. We empirically investigated the bias of the estimator of the time-dependent covariate while varying the effect of failure rate, sample size, true values of the parameters and the number of intervals. We also evaluated how often a time-dependent covariate needs to be collected and assessed the effect of sample size and failure rate on the power of testing a time-dependent effect.^ A time-dependent proportional hazards model with two binary covariates was considered. The time axis was partitioned into k intervals. The baseline hazard was assumed to be 1 so that the failure times were exponentially distributed in the ith interval. A type II censoring model was adopted to characterize the failure rate. The factors of interest were sample size (500, 1000), type II censoring with failure rates of 0.05, 0.10, and 0.20, and three values for each of the non-time-dependent and time-dependent covariates (1/4,1/2,3/4).^ The mean of the bias of the estimator of the coefficient of the time-dependent covariate decreased as sample size and number of intervals increased whereas the mean of the bias increased as failure rate and true values of the covariates increased. The mean of the bias of the estimator of the coefficient was smallest when all of the updated measurements were used in the model compared with two models that used selected measurements of the time-dependent covariate. For the model that included all the measurements, the coverage rates of the estimator of the coefficient of the time-dependent covariate was in most cases 90% or more except when the failure rate was high (0.20). The power associated with testing a time-dependent effect was highest when all of the measurements of the time-dependent covariate were used. An example from the Systolic Hypertension in the Elderly Program Cooperative Research Group is presented. ^

Modelización de contactos termoelastohidrodinámicos

La mejora en la eficiencia energética y la reducción de la tasa de fallos en los contactos lubricados son aspectos que resultan de gran interés en numerosos sectores de la industria, y plantean en estos momentos nuevas dificultades operativas y retos para un futuro próximo. Los avances tecnológicos han incrementado las exigencias técnicas que se requieren a los aceites para cumplir su función al extender sus variables operativas a un mayor espectro de aplicaciones, tanto de condiciones de funcionamiento como a la gran variedad de nuevos materiales constitutivos de los engranajes en los que se tiene que utilizar. Por ello, actualmente se está incentivado el desarrollo de nuevos procedimientos que permitan comprender el comportamiento de este tipo de contactos lubricados, con el fin de lograr mejoras técnicas en su diseño y la correcta selección del aceite. En esta Tesis Doctoral se presenta una metodología de cálculo numérico que permite simular el comportamiento de contactos elastohidrodinámicos (EHD) puntuales, como puede ser el caso de un rodamiento. La resolución de este problema presenta diversas complejidades matemáticas y exige el desarrollo de un elaborado procedimiento de cálculo basado en técnicas multinivel. Para hacer del procedimiento una herramienta válida en un gran número de condiciones de funcionamiento y tipos de lubricantes, se ha tenido en cuenta en el cálculo la posible aparición de comportamientos no-Newtonianos del lubricante y fenómenos de generación y disipación de calor, provocados por el movimiento relativo del fluido y las superficies en contacto. Para la validación del procedimiento, se han contrastado los resultados numéricos obtenidos con nuestro método, con los resultados numéricos y experimentales publicados por otros autores y con valores experimentales propios medidos en un equipo de ensayo de contacto puntual tipo MTM. El desarrollo de este programa ha dotado a la División de Ingeniería de Máquinas de una herramienta que ha permitido, y sobre todo va permitir, evaluar la importancia de cada uno de los parámetros reológicos en los diferentes problemas que va a tener que abordar, evaluación que hasta el momento se realizaba con métodos aproximados que describen la fenomenología con mucha menos precisión. A la hora de emplear nuestro procedimiento numérico para simular situaciones reales, nos hemos encontrado con el obstáculo de que es muy complicado encontrar, en la bibliografía y bases de datos, los parámetros que caracterizan el comportamiento reológico del lubricante en las condiciones de presión, temperatura y grado de cizallamiento habituales en las que se trabaja en este tipo de contactos, y las pocas medidas que existen para estas condiciones de funcionamiento son poco fiables. Por ello como complemento al objetivo principal de esta Tesis hemos desarrollado una metodología para caracterizar los lubricantes en estas condiciones extremas. Dicha metodología está basada en la buena descripción que hace nuestro programa del coeficiente de fricción, lo que nos ha permitido obtener los parámetros reológicos del III lubricante a partir de las medidas experimentales del coeficiente de fricción generado en un equipo MTM lubricado con el lubricante que se desea caracterizar. Madrid, Octubre de 2012 IV Improving energy efficiency and reducing the failure rate in lubricated contacts are issues that are of great interest in many sectors of industry, and right now posed operational difficulties and new challenges for the near future. Technological advances have increased the technical demands required to oils to fulfil its role by extending its operational variables to a wider range of applications, both operating conditions and to the wide variety of new materials which constitute the gear in which must be used. For this reason, has being encouraged currently to develop new procedures to understand the behaviour of this type of lubricated contacts, in order to achieve improvements in design techniques and the correct oil selection. In this Thesis we present a numerical methodology to simulate the puntual elastohydrodynamic contact behaviour (EHD), such as a roller bearing. The resolution of this problem presents various mathematical complexities and requires the development of an elaborate calculation procedure based on multilevel techniques. To make the procedure a valid tool in a wide range of operating conditions and types of lubricants, has been taken into account in calculating the possible occurrence of non-Newtonian behaviour of the lubricant and phenomena of generation and dissipation of heat, caused by the fluid relative motion and contacting surfaces. For the validation of the method, we have compared the numerical results obtained with our method with numerical and experimental results published by other authors also with own experimental values measured on point-contact test equipment MTM. The development of this program has provided the Machines Engineering Division of a tool that has allowed, and especially will allow to evaluate the importance of each of the rheological parameters on the various problems that will have to be addressed, evaluation performed hitherto described methods that phenomenology approximated with much less accuracy. When using our numerical procedure to simulate real situations we have encountered the obstacle that is very difficult to find, in the literature and database, parameters characterizing the rheological behaviour of the lubricant in the usual conditions of pressure, temperature and shear rate in which you work in this type of contact, and the few measures that exist for these operating conditions are unreliable. Thus in addition to the main objective of this thesis, we have developed a methodology to characterize the lubricants in these extreme conditions. This methodology is based on the good description, which makes our program, of the coefficient of friction, that allowed us to obtain the lubricant rheological parameters from experimental measurements of the friction coefficient generated on lubricated MTM equipment with the lubricant to be characterized.

Modelling seed germination in forest tree species through survival analysis. The Pinus pinea L. case study

The direct application of existing models for seed germination may often be inadequate in the context of ecology and forestry germination experiments. This is because basic model assumptions are violated and variables available to forest managers are rarely used. In this paper, we present a method which addresses the aforementioned shortcomings. The approach is illustrated through a case study of Pinus pinea L. Our findings will also shed light on the role of germination in the general failure of natural regeneration in managed forests of this species. The presented technique consists of a mixed regression model based on survival analysis. Climate and stand covariates were tested. Data for fitting the model were gathered from a 5-year germination experiment in a mature, managed P. pinea stand in the Northern Plateau of Spain in which two different stand densities can be found. The model predictions proved to be unbiased and highly accurate when compared with the training data. Germination in P. pinea was controlled through thermal variables at stand level. At microsite level, low densities negatively affected the probability of germination. A time-lag in the response was also detected. Overall, the proposed technique provides a reliable alternative to germination modelling in ecology/forestry studies by using accessible/ suitable variables. The P. pinea case study highlights the importance of producing unbiased predictions. In this species, the occurrence and timing of germination suggest a very different regeneration strategy from that understood by forest managers until now, which may explain the high failure rate of natural regeneration in managed stands. In addition, these findings provide valuable information for the management of P. pinea under climate-change conditions.

Study about the Problem of Dropping of Subjects by Students During an Academinc Year at the University.

In university studies, it is not unusual for students to drop some of the subjects they have enrolled in for the academic year. They start by not attending lectures, sometimes due to neglect or carelessness, or because they find the subject too difficult, this means that they lose the continuity in the topics that the professor follows. If they try to attend again they discover that they hardly understand anything and become discouraged and so decide to give up attending lectures and study on their own. However some fail to turn up to do their final exams and the failure rate of those who actually do the exams is high. The problem is that this is not only the case with one specific subject, but it is often the same with many subjects. The result is that students arent’s productive enough, wasting time and also prolonging their years of study which entails a great cost for families. Degree courses structured to be conducted and completed in three academic courses, it may in fact take up to an average of six or more academic courses. In this paper, we have studied this problem, which apart from the waste of money and time, produces frustration in the student, who finds that he has not been able to achieve what he had proposed at the beginning of the course. It is quite common, to find students who do not even pass nor 50% of the subjects they had enrolled in for the academic year. If this happens repeatedly to a student, it can be the point when he considers dropping out altogether. This is also a concern for the universities, especially in the early courses. In our experience as professors, we have found that students, who attend lectures regularly and follow the explanations, approach the final exams with confidence and rarely fail the subject. In this proposal we present some techniques and methods carried out to solve in possible, the problem of lack of attendance to lectures. This involves "rewarding students for their assistance and participation in lectures". Rewarding assistance with a "prize" that counts for the final mark on the subject and involving more participation in the development of lectures. We believe that we have to teach students to use the lectures as part of their learning in a non-passive way. We consider the professor's work as fundamental in terms of how to convey the usefulness of these topics explained and the applications that they will have for their professional life in the future. In this way the student see for himself the use and importance of what he is learning. When his participation is required, he will feel more involved and confident participating in the educational system. Finally we present statistical results of studies carried out on different degrees and on different subjects over two consecutive years. In the first year we assessed only the final exams without considering the students attendance, or participation. In the second year, we have applied the techniques and methods proposed here. In addition we have compared the two ways of assessing subjects.

Evaluation of the reliability of commercial concentrator triple-junction solar cells by means of accelerated life tests (ALT)

A temperature accelerated life test on commercial concentrator lattice-matched GaInP/GaInAs/Ge triple-junction solar cells has been carried out. The solar cells have been tested at three different temperatures: 119, 126 and 164 °C and the nominal photo-current condition (820 X) has been emulated by injecting current in darkness. All the solar cells have presented catastrophic failures. The failure distributions at the three tested temperatures have been fitted to an Arrhenius-Weibull model. An Arrhenius activation energy of 1.58 eV was determined from the fit. The main reliability functions and parameters (reliability function, instantaneous failure rate, mean time to failure, warranty time) of these solar cells at the nominal working temperature (80 °C) have been obtained. The warranty time obtained for a failure population of 5 % has been 69 years. Thus, a long-term warranty could be offered for these particular solar cells working at 820 X, 8 hours per day at 80 °C.

Characterisation of the operation & maintenance phase in PV rural electrification programmes

Con 1.300 millones de personas en el mundo sin acceso a la electricidad (la mayoría en entornos rurales de países empobrecidos), la energía solar fotovoltaica constituye una solución viable técnica y económicamente para electrificar las zonas más remotas del planeta donde las redes eléctricas convencionales no llegan. Casi todos los países en el mundo han desarrollado algún tipo de programa de electrificación fotovoltaica rural durante los últimos 40 años, principalmente los países más pobres, donde a través de diferentes modelos de financiación, se han instalado millones de sistemas solares domiciliarios (pequeños sistemas fotovoltaicos para uso doméstico). Durante este largo período, se han ido superando muchas barreras, como la mejora de la calidad de los sistemas fotovoltaicos, la reducción de costes, la optimización del diseño y del dimensionado de los sistemas, la disponibilidad financiera para implantar programas de electrificación rural, etc. Gracias a esto, la electrificación rural descentralizada ha experimentado recientemente un salto de escala caracterizada por la implantación de grandes programas con miles de sistemas solares domiciliarios e integrando largos períodos de mantenimiento. Muchos de estos grandes programas se están llevando a cabo con limitado éxito, ya que generalmente parten de supuestos e hipótesis poco contrastadas con la realidad, comprometiendo así un retorno económico que permita el desarrollo de esta actividad a largo plazo. En este escenario surge un nuevo reto: el de cómo garantizar la sostenibilidad de los grandes programas de electrificación rural fotovoltaica. Se argumenta que la principal causa de esta falta de rentabilidad es el imprevisto alto coste de la fase de operación y mantenimiento. Cuestiones clave tales como la estructura de costes de operación y mantenimiento o la fiabilidad de los componentes del sistema fotovoltaico no están bien caracterizados hoy en día. Esta situación limita la capacidad de diseñar estructuras de mantenimiento capaces de asegurar la sostenibilidad y la rentabilidad del servicio de operación y mantenimiento en estos programas. Esta tesis doctoral tiene como objetivo responder a estas cuestiones. Se ha realizado varios estudios sobre la base de un gran programa de electrificación rural fotovoltaica real llevado a cabo en Marruecos con más de 13.000 sistemas solares domiciliarios instalados. Sobre la base de este programa se ha hecho una evaluación en profundidad de la fiabilidad de los sistemas solares a partir de los datos de mantenimiento recogidos durante 5 años con más de 80.000 inputs. Los resultados han permitido establecer las funciones de fiabilidad de los equipos tal y como se comportan en condiciones reales de operación, las tasas de fallos y los tiempos medios hasta el fallo para los principales componentes del sistema, siendo este el primer caso de divulgación de resultados de este tipo en el campo de la electrificación rural fotovoltaica. Los dos principales componentes del sistema solar domiciliario, la batería y el módulo fotovoltaico, han sido analizados en campo a través de una muestra de 41 sistemas trabajando en condiciones reales pertenecientes al programa solar marroquí. Por un lado se ha estudiado la degradación de la capacidad de las baterías y por otro la degradación de potencia de los módulos fotovoltaicos. En el caso de las baterías, los resultados nos han permitido caracterizar la curva de degradación en capacidad llegando a obtener una propuesta de nueva definición del umbral de vida útil de las baterías en electrificación rural. También sobre la base del programa solar de Marruecos se ha llevado a cabo un estudio de caracterización de los costes reales de operación y mantenimiento a partir de la base de datos de contabilidad del programa registrados durante 5 años. Los resultados del estudio han permitido definir cuáles son costes que más incidencia tienen en el coste global. Se han obtenido los costes unitarios por sistema instalado y se han calculado los montantes de las cuotas de mantenimiento de los usuarios para garantizar la rentabilidad de la operación y mantenimiento. Finalmente, se propone un modelo de optimización matemática para diseñar estructuras de mantenimiento basado en los resultados de los estudios anteriores. La herramienta, elaborada mediante programación lineal entera mixta, se ha aplicado al programa marroquí con el fin de validar el modelo propuesto. ABSTRACT With 1,300 million people worldwide deprived of access to electricity (mostly in rural environments), photovoltaic solar energy has proven to be a cost‐effective solution and the only hope for electrifying the most remote inhabitants of the planet, where conventional electric grids do not reach because they are unaffordable. Almost all countries in the world have had some kind of rural photovoltaic electrification programme during the past 40 years, mainly the poorer countries, where through different organizational models, millions of solar home systems (small photovoltaic systems for domestic use) have been installed. During this long period, many barriers have been overcome, such as quality enhancement, cost reduction, the optimization of designing and sizing, financial availability, etc. Thanks to this, decentralized rural electrification has recently experienced a change of scale characterized by new programmes with thousands of solar home systems and long maintenance periods. Many of these large programmes are being developed with limited success, as they have generally been based on assumptions that do not correspond to reality, compromising the economic return that allows long term activity. In this scenario a new challenge emerges, which approaches the sustainability of large programmes. It is argued that the main cause of unprofitability is the unexpected high cost of the operation and maintenance of the solar systems. In fact, the lack of a paradigm in decentralized rural services has led to many private companies to carry out decentralized electrification programmes blindly. Issues such as the operation and maintenance cost structure or the reliability of the solar home system components have still not been characterized. This situation does not allow optimized maintenance structure to be designed to assure the sustainability and profitability of the operation and maintenance service. This PhD thesis aims to respond to these needs. Several studies have been carried out based on a real and large photovoltaic rural electrification programme carried out in Morocco with more than 13,000 solar home systems. An in‐depth reliability assessment has been made from a 5‐year maintenance database with more than 80,000 maintenance inputs. The results have allowed us to establish the real reliability functions, the failure rate and the main time to failure of the main components of the system, reporting these findings for the first time in the field of rural electrification. Both in‐field experiments on the capacity degradation of batteries and power degradation of photovoltaic modules have been carried out. During the experiments both samples of batteries and modules were operating under real conditions integrated into the solar home systems of the Moroccan programme. In the case of the batteries, the results have enabled us to obtain a proposal of definition of death of batteries in rural electrification. A cost assessment of the Moroccan experience based on a 5‐year accounting database has been carried out to characterize the cost structure of the programme. The results have allowed the major costs of the photovoltaic electrification to be defined. The overall cost ratio per installed system has been calculated together with the necessary fees that users would have to pay to make the operation and maintenance affordable. Finally, a mathematical optimization model has been proposed to design maintenance structures based on the previous study results. The tool has been applied to the Moroccan programme with the aim of validating the model.

A friendly online C compiler to improve programming skills based on student self-assessment

This paper presents an online C compiler designed so that students can program their practical assignments in Programming courses. What is really innovative is the self-assessment of the exercises based on black-box tests and train students’ skill to test software. Moreover, this tool lets instructors, not only proposing and classifying practical exercises, but also evaluating automatically the efforts dedicated and the results obtained by the students. The system has been applied to the 1st-year students at the Industrial Engineering specialization at the Universidad Politecnica de Madrid. Results show that the students obtained better academic performance, reducing the failure rate in the practical exam considerably with respect to previous years, in addition that an anonymous survey proved that students are satisfied with the system because they get instant feedback about their programs.

Sistemática de transformação: desenvolvimento teórico para o alinhamento entre estratégia e cultura organizacional nos projetos de Lean

Desde o final do Século XX e início do Século XXI, estudos analisam a elevada taxa de insucesso ou insatisfação com os Programas de Lean. Esta taxa tem se demonstrado demasiadamente elevada, variando entre 66% e 90%. Como efeito deste insucesso, tem-se o desperdício de tempo, dinheiro, recursos e, talvez o pior, tem-se a propagação do medo nos agentes de mudança em empreitar novas iniciativas de mudança. Estudos apontam a falta de alinhamento de tais projetos com a Cultura Organizacional como uma das questões fundamentais deste insucesso. Partindo desta temática de pesquisa, este ensaio teórico pode ser caracterizado como uma abordagem qualitativa de análise do problema, de natureza básica de pesquisa buscando gerar conhecimentos novos e úteis às organizações, sem aplicação prática prevista neste primeiro estágio de pesquisa. A fonte de evidências para sustentar o modelo proposto foi revisão dos estudos de caso encontrados na literatura, sendo utilizadas tanto uma Revisão Bibliográfica Sistemática (RBS) quanto Exploratória, de tal maneira a buscar o \"estado da arte\" no campo de estudo. A Fundamentação Teórica do trabalho é baseada na literatura de quatro grandes campos de estudo: (i) Estratégia, (ii) Lean, (iii) Cultura Organizacional e (iv) Gestão de Mudanças. A RBS tem foco nas interseções destes grandes campos, agregando 190 trabalhos internacionais. Por sua vez, a Revisão Exploratória traz algumas das principais referências dos três campos de estudo, como: Edgar Schein, John Kotter, Kim Cameron, Robert Quinn, David Mann, dentre outros. Desta maneira, este trabalho estudou a influência da cultura organizacional nos projetos de transformação e, a partir da ruptura com a teoria atual, construiu e propôs uma sistemática teórica, intitulada de \"Sistemática de Transformação\" (ou simplesmente \"Sistemática T\"), a qual propõe o alinhamento entre três dimensões: Estratégia, Projeto de Transformação e Cultura Organizacional. Fazendo uso desta sistemática, é esperado que os agentes de mudança consigam ter um planejamento mais eficaz do processo de diagnóstico, avaliação e gestão da cultura organizacional alinhado à Estratégia e também ao Projeto de Transformação da organização, com ênfase nos Programas de Lean. A proposição e uso desta sistemática pode favorecer tanto a discussão acadêmica na área de Gestão de Operações sobre o tema, quanto fornecer subsídios para aplicações práticas mais eficazes.

Field experiences with floating breakwaters in the eastern United States /

In the past 10 years, the use of floating breakwaters as temporary coastal structures has become increasingly widespread in the United States as an inexpensive means for suppressing waves. However, as with any new technology, there have been many failures and a substantial number of imaginative, successful innovations. One of the chief problems contributing to the failure rate has been a lack of awareness by designers of reliable, up-to-date technical information. As part of a large research effort to remedy this problem, a survey was conducted on field experience with floating breakwaters in the Eastern United States. Results of the survey confirmed that state-of-the-art technical literature is not being properly disseminated. Structures built according to early design manuals were shown to have failed before the completion of their design life. Conversely, floating breakwaters built to the standards set by recent research have fared well and show promise of meeting their design golas. The weakest areas of the present technology are flotation and the anchoring systems. It is recommended that a concentrated research effort be directed toward these problem areas; it is also recommended that the monitoring of state-of-the-art projects continue. (Author).

Three horizontal muscle squint surgery for large angle infantile esotropia

Background: To report the long-term outcome of a series of 49 patients who underwent three horizontal muscle squint surgery for large angle infantile esotropia. Methods: The patient records were retrospectively reviewed of 49 (24 girls [49%], 25 boys) consecutive patients with infantile esotropia of angle greater than or equal to60 Delta, who had undergone three horizontal muscle surgery performed by one surgeon (author GG). Surgery consisted of bilateral medial rectus recession combined with graded unilateral lateral rectus resection. Surgeries were carried out over a 6-year period with a mean follow-up period of 32.9 months (3.7-71.8 months). Results: Using Kaplan-Meier life-table analysis, cumulative surgical success (orthotropia +/-10 Delta) was 93.9% at 1 week, 91.8% at 2 and 6 months, 87.7% at 12 and 18 months, 79.9% at 2 years, 77.1% at 3, 4 and 5 years, and 70.6% at 6 years. The mean preoperative deviation was 68.7 Delta. The mean age at surgery was 12.9 months. The failure rate was independent of preoperative deviation. Prevalence of residual esotropia (>10 Delta) varied from 2.0% at 1 week to 17.0% at 6 years. Similarly the prevalence of consecutive exotropia (>10 Delta) varied from 4.0% at 1 week to 12.4% at 6 years. Conclusion: Operating in a graded fashion on three horizontal muscles in children with large angle infantile esotropia has a high success rate, even over long-term follow up. Based on the study's results, amounts of surgery for a given angle of strabismus are proposed.

A clinical and echocardiographic score for assigning risk of major events after dobutamine echocardiograms

OBJECTIVES We sought to develop and validate a risk score combining both clinical and dobutamine echocardiographic (DbE) features in 4,890 patients who underwent DbE at three expert laboratories and were followed for death or myocardial infarction for up to five years. BACKGROUND In contrast to exercise scores, no score exists to combine clinical, stress, and echocardiographic findings with DbE. METHODS Dobutamine echocardiography was performed for evaluation of known or suspected coronary artery disease in 3,156 patients at two sites in the U.S. After exclusion of patients with incomplete follow-up, 1,456 DbEs were randomly selected to develop a multivariate model for prediction of events. After simplification of each model for clinical use, the models were internally validated in the remaining DbE patients in the same series and externally validated in 1,733 patients in an independent series. RESULTS The following score was derived from regression models in the modeling group (160 events): DbE risk = (age (.) 0.02) + (heart failure + rate-pressure product <15,000) (.) 0.4 + (ischemia + scar) (.) 0.6. The presence of each variable was scored as 1 and its absence scored as 0, except for age (continuous variable). Using cutoff values of 1.2 and 2.6, patients were classified into groups with five-year event-free survivals >95%, 75% to 95%, and <75%. Application of the score in the internal validation group (265 events) gave equivalent results, as did its application in the external validation group (494 events, C index = 0.72). CONCLUSIONS A risk score based on clinical and echocardiographic data may be used to quantify the risk of events in patients undergoing DbE. (C) 2004 by the American College of Cardiology Foundation.

Hip strategy for balance control in quiet standing is reduced in people with low back pain

Study Design. Quiet stance on supporting bases with different lengths and with different visual inputs were tested in 24 study participants with chronic low back pain (LBP) and 24 matched control subjects. Objectives. To evaluate postural adjustment strategies and visual dependence associated with LBP. Summary of Background Data. Various studies have identified balance impairments in patients with chronic LBP, with many possible causes suggested. Recent evidence indicates that study participants with LBP have impaired trunk muscle control, which may compromise the control of trunk and hip movement during postural adjustments ( e. g., hip strategy). As balance on a short base emphasizes the utilization of the hip strategy for balance control, we hypothesized that patients with LBP might have difficulties standing on short bases. Methods. Subjects stood on either flat surface or short base with different visual inputs. A task was counted as successful if balance was maintained for 70 seconds during bilateral stance and 30 seconds during unilateral stance. The number of successful tasks, horizontal shear force, and center-of-pressure motion were evaluated. Results. The hip strategy was reduced with increased visual dependence in study participants with LBP. The failure rate was more than 4 times that of the controls in the bilateral standing task on short base with eyes closed. Analysis of center-of-pressure motion also showed that they have inability to initiate and control a hip strategy. Conclusions. The inability to control a hip strategy indicates a deficit of postural control and is hypothesized to result from altered muscle control and proprioceptive impairment.

Effect of prolonged inactivity on skeletal motor nerve terminals during aestivation in the burrowing frog, Cyclorana alboguttata

This study examined the effect of prolonged inactivity, associated with aestivation, on neuromuscular transmission in the green-striped burrowing frog, Cyclorana alboguttata. We compared the structure and function of the neuromuscular junctions on the iliofibularis muscle from active C. alboguttata and from C. alboguttata that had been aestivating for 6 months. Despite the prolonged period of immobility, there was no significant difference in the shape of the terminals (primary, secondary or tertiary branches) or the length of primary terminal branches between aestivators and non-aestivators. Furthermore, there was no significant difference in the membrane potentials of muscle fibres or in miniature end plate potential (EPP) frequency and amplitude. However, there was a significant decrease in evoked transmitter release characterised by a 56% decrease in mean EPP amplitude, and a 29% increase in the failure rate of nerve terminal action potentials to evoke transmitter release. The impact of this suite of neuromuscular characteristics on the locomotor performance of emergent frogs is discussed.

Combining ERP systems with enterprise 2.0

The paper discusses both the complementary factors and contradictions of adoption ERP based systems with enterprise 2.0. ERP is well known as its' efficient business process management. Also the high failure rate the system implementation is famous as well. According to [1], ERP systems could achieve efficient business performance by enabling a standardized business process design, but at a cost of flexibility in operations. However, enterprise 2.0 supports flexible business process management, informal and less structured interactions [3],[4],[21]. Traditional researcher claimed efficiency and flexibility may seem incompatible in that they are different business objectives and may exist in different organizational environments. However, the paper will break traditional norms that combine ERP and enterprise 2.0 in a single enterprise to improve both efficient and flexible operations simultaneously. Based on the multiple cases studies, four cases presented different attitudes on usage ERP systems and enterprise social systems. Based on socio-technical theory, the paper presents in-depth analysis benefits of combination ERP with enterprise 2.0 for these firms.