The impact of psychosocial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers

Aims To identify self-care activities undertaken and determine relationships between self-efficacy, depression, quality of life, social support and adherence to compression therapy in a sample of patients with chronic venous insufficiency. Background Up to 70% of venous leg ulcers recur after healing. Compression hosiery is a primary strategy to prevent recurrence, however, problems with adherence to this strategy are well documented and an improved understanding of how psychosocial factors influence patients with chronic venous insufficiency will help guide effective preventive strategies. Design Cross-sectional survey and retrospective medical record review. Method All patients previously diagnosed with a venous leg ulcer which healed between 12–36 months prior to the study were invited to participate. Data on health, psychosocial variables and self-care activities were obtained from a self-report survey and data on medical and previous ulcer history were obtained from medical records. Multiple linear regression modelling was used to determine the independent influences of psychosocial factors on adherence to compression therapy. Results In a sample of 122 participants, the most frequently identified self-care activities were application of topical skin treatments, wearing compression hosiery and covering legs to prevent trauma. Compression hosiery was worn for a median of 4 days/week (range 0–7). After adjustment for all variables and potential confounders in a multivariable regression model, wearing compression hosiery was found to be significantly positively associated with participants’ knowledge of the cause of their condition (p=0.002), higher self-efficacy scores (p=0.026) and lower depression scores (p=0.009). Conclusion In this sample, depression, self-efficacy and knowledge were found to be significantly related to adherence to compression therapy. Relevance to clinical practice These findings support the need to screen for and treat depression in this population. In addition, strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy.

Deficits on self ordered tasks associated with hyperostosis frontalis interna

A 74 year old patient, EW, with dorsolateral frontal cortical compression due to hyperostosis frontalis interna, in the absence of the Morgagni or Stewart-Morel syndromes, is described. In addition to conventional neuropsychological measures EW was administered one nonspatial and two spatial self ordered working memory tasks, as well as a standard measure of fluid intelligence or g. She showed impaired performance on all three self ordered working memory tasks compared with a normal control group of 10 subjects matched for age, education, sex, and IQ. By contrast, her performance on the fluid intelligence test was comparable with that of the controls. It is concluded that the compression of dorsolateral frontal cortex accompanying hyperostosis frontalis interna may produce selective cognitive impairment.

Texture and Microstructural Evolution in Pearlitic Steel During Triaxial Compression

This article presents the deformation behavior of high-strength pearlitic steel deformed by triaxial compression to achieve ultra-fine ferrite grain size with fragmented cementite. The consequent evolution of microstructure and texture has been studied using scanning electron microscopy, electron back-scatter diffraction, and X-ray diffraction. The synergistic effect of diffusion and deformation leads to the uniform dissolution of cementite at higher temperature. At lower temperature, significant grain refinement of ferrite phase occurs by deformation and exhibits a characteristic deformation texture. In contrast, the high-temperature deformed sample shows a weaker texture with cube component for the ferrite phase, indicating the occurrence of recrystallization. The different mechanisms responsible for the refinement of ferrite as well as the fragmentation of cementite and their interaction with each other have been analyzed. Viscoplastic self-consistent simulation was employed to understand deformation texture in the ferrite phase during triaxial compression.

Laser wakefield and self-modulation of driving pulse

A self-consistent theory of plasma response to a single laser beam is proposed. The driving pump is not viewed as invariant during its interaction with the plasmas. Its modulation by the plasmas has an obvious influence on the strength of the wakefield behind the pulse. This suggests that the compression of the low-intensity pulse by the plasmas might be a possible way to excite largae-amplitude wakefield. (C) 2003 American Institute of Physics.

High-power extracavity pulse compression in solid materials

A novel technique for high-power extracavity pulse compression with a nonlinear solid material is demonstrated. Before spectral broadening by self-phase modulation in the solid material, a short filament generated in argon is used as a spatial filter, which works for a uniform spectrum broadening over the spatial profile. Compensated by chirped mirrors, a 15-fs pulse is generated from a 32-fs input laser pulse. A total transmission larger than 80% after the solid material is achieved.

Pulse compression by filamentation in argon with an acoustic optical programmable dispersive filter for predispersion compensation

We have experimentally demonstrated pulses 0.4 mJ in duration smaller than 12 fs; with an excellent spatial beam profile by self-guided propagation in argon. The original 52 fs pulses from the chirped pulsed amplification laser system are first precompressed to 32 fs by inserting an acoustic optical programmable dispersive filter instrument into the laser system for spectrum reshaping and dispersion compensation, and the pulse spectrum is subsequently broadened by filamentation in an argon cell. By using chirped mirrors for post-dispersion compensation, the pulses are successfully compressed to smaller than 12 fs.

Compensation for self-focusing by use of cascade quadratic nonlinearity

We demonstrate theoretically and experimentally compensation for positive Kerr phase shifts with negative phases generated by cascade quadratic processes. Experiments show correction of small-scale self-focusing and whole-beam self-focusing in the spatial domain and self-phase modulation in the temporal domain. (C) 2001 Optical Society of America.

Self-healing of fractured GaAs nanowires.

In-situ deformation experiments were carried out in a transmission electron microscope to investigate the structural response of single crystal GaAs nanowires (NWs) under compression. A repeatable self-healing process was discovered in which a partially fractured GaAs NW restored its original single crystal structure immediately after an external compressive force was removed. Possible mechanisms of the self-healing process are discussed.

Tuning the Exciton Binding Energies in Single Self-Assembled InGaAs/GaAs Quantum Dots by Piezoelectric-Induced Biaxial Stress

We study the effect of an external biaxial stress on the light emission of single InGaAs/GaAs(001) quantum dots placed onto piezoelectric actuators. With increasing compression, the emission blueshifts and the binding energies of the positive trion (X+) and biexciton (XX) relative to the neutral exciton (X) show a monotonic increase. This phenomenon is mainly ascribed to changes in electron and hole localization and it provides a robust method to achieve color coincidence in the emission of X and XX, which is a prerequisite for the possible generation of entangled photon pairs via the recently proposed "time reordering'' scheme.

Pulse Compression by Filamentation in Argon with an Acoustic Optical Programmable Dispersive Filter for Predispersion Compensation

We have experimentally demonstrated pulses 0.4 mJ in duration smaller than 12 fs with an excellent spatial beam profile by self-guided propagation in argon. The original 52 fs pulses from the chirped pulsed amplification laser system are first precompressed to 32 fs by inserting an acoustic optical programmable dispersive filter instrument into the laser system for spectrum reshaping and dispersion compensation, and the pulse spectrum is subsequently broadened by filamentation in an argon cell. By using chirped mirrors for post-dispersion compensation, the pulses are successfully compressed to smaller than 12 fs.

An implicit pole-assignment self-tuning regulator

A new self-tuning implicit pole-assignment algorithm is presented which, through the use of a pole compression factor and different RLS model and control structures, overcomes stability and convergence problems encountered in previously available algorithms. Computational requirements of the technique are much reduced when compared to explicit pole-assignment schemes, whereas the inherent robustness of the strategy is retained.

Compression of polyelectrolyte brushes in a salt-free theta solvent

This paper examines the normal force between two opposing polyelectrolyte brushes and the interpenetration of their chains that is responsible for sliding friction. It focuses on the special case of semi-dilute brushes in a salt-free theta solvent, for which Zhulina and Borisov [J. Chem. Phys., {\bf 107}, 5952, (1997)] have derived analytical predictions using the classical strong-stretching theory (SST) introduced by Semenov and developed by Milner, Witten and Cates. Interestingly, the SST predicts that the brushes contract maintaining a polymer-free gap as they are compressed together, which provides an explanation for the ultra-low frictional forces observed in experiment. We examine the degree to which the SST predictions are affected by chain fluctuations by employing self-consistent field theory (SCFT). While the normal force is relatively unaffected, fluctuations are found to have a strong impact on brush interpenetration. Even still, the contraction of the brushes does significantly prolong the onset of interpenetration, implying that a sizeable normal force can be achieved before the sliding friction becomes significant.

Effect of salt on the compression of polyelectrolyte brushes in a theta solvent

Classical strong-stretching theory (SST) predicts that, as opposing polyelectrolyte brushes are compressed together in a salt-free theta solvent, they contract so as to maintain a finite polymer-free gap, which offers a potential explanation for the ultra-low frictional forces observed in experiments even with the application of large normal forces. However, the SST ignores chain fluctuations, which would tend to close the gap resulting in physical contact and in turn significant friction. In a preceding study, we examined the effect of fluctuations using self-consistent field theory (SCFT) and illustrated that high normal forces can still be applied before the gap is destroyed. We now look at the effect of adding salt. It is found to reduce the long-range interaction between the brushes but has little effect on the short-range part, provided the concentration does not enter the salted-brush regime. Consequently, the maximum normal force between two planar brushes at the point of contact is remarkably unaffected by salt. For the crossed-cylinder geometry commonly used in experiments, however, there is a gradual reduction because in this case the long-range part of the interaction contributes to the maximum normal force.

Modeling and Experimental Aspects of Self-healing Bolted Joint through Shape Memory Alloy Actuators

Bolted joints are a form of mechanical coupling largely used in machinery due to their reliability and low cost. Failure of bolted joints can lead to catastrophic events, such as leaking, train derailments, aircraft crashes, etc. Most of these failures occur due to the reduction of the pre-load, induced by mechanical vibration or human errors in the assembly or maintenance process. This article investigates the application of shape memory alloy (SMA) washers as an actuator to increase the pre-load on loosened bolted joints. The application of SMA washer follows a structural health monitoring procedure to identify a damage (reduction in pre-load) occurrence. In this article, a thermo-mechanical model is presented to predict the final pre-load achieved using this kind of actuator, based on the heat input and SMA washer dimension. This model extends and improves on the previous model of Ghorashi and Inman [2004, "Shape Memory Alloy in Tension and Compression and its Application as Clamping Force Actuator in a Bolted Joint: Part 2 - Modeling," J. Intell. Mater. Syst. Struct., 15:589-600], by eliminating the pre-load term related to nut turning making the system more practical. This complete model is a powerful but complex tool to be used by designers. A novel modeling approach for self-healing bolted joints based on curve fitting of experimental data is presented. The article concludes with an experimental application that leads to a change in joint assembly to increase the system reliability, by removing the ceramic washer component. Further research topics are also suggested.

Real-life results of balloon kyphoplasty for vertebral compression fractures from the SWISSspine registry

BACKGROUND CONTEXT The Swiss Federal Office of Public Health mandated a nationwide health technology assessment-registry for balloon kyphoplasty (BKP) for decision making on reimbursement of these interventions. The early results of the registry led to a permanent coverage of BKP by basic health insurance. The documentation was continued for further evidence generation. PURPOSE This analysis reports on the 1 year results of patients after BKP treatment. STUDY DESIGN Prospective multicenter observational case series. PATIENT SAMPLE The data on 625 cases with 819 treated vertebrae were documented from March 2005 to May 2012. OUTCOME MEASURES Surgeon-administered outcome instruments were primary intervention form for BKP and the follow-up form; patient self-reported measures were EuroQol-5D questionnaire, North American Spine Society outcome instrument /Core Outcome Measures Index (including visual analog scale), and a comorbidity questionnaire. Outcome measures were back pain, medication, quality of life (QoL), cement extrusions, and new fractures within the first postoperative year. METHODS Data were recorded preoperatively and at 3 to 6-month and 1-year follow-ups. Wilcoxon signed-rank test was used for comparison of pre- with postoperative measurements. Multivariate logistic regression was used to identify factors with a significant influence on the outcome. RESULTS Seventy percent of patients were women with mean age of 71 years (range, 18-91 years); mean age of men was 65 years (range, 15-93 years). Significant and clinically relevant reduction of back pain, improvement of QoL, and reduction of pain killer consumption was seen within the first postoperative year. Preoperative back pain decreased from 69.3 to 29.0 at 3 to 6-month and remained unchanged at 1-year follow-ups. Consequently, QoL improved from 0.23 to 0.71 and 0.75 at the same follow-up intervals. The overall vertebra-based cement extrusion rates with and without extrusions into intervertebral discs were 22.1% and 15.3%, respectively. Symptomatic cement extrusions with radiculopathy were five (0.8%). A new vertebral fracture within a year from the BKP surgery was observed in 18.4% of the patients. CONCLUSIONS The results of the largest observational study for BKP so far are consistent with published randomized trials and systematic reviews. In this routine health care setting, BKP is safe and effective in reducing pain, improving QoL, and lowering pain_killer consumption and has an acceptable rate of cement extrusions. Postoperative outcome results show clear and significant clinical improvement at early follow-up that remain stable during the first postoperative year.