906 resultados para Medicine in literature


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Objectives This efficacy study assessed the added impact real time computer prompts had on a participatory approach to reduce occupational sedentary exposure and increase physical activity. Design Quasi-experimental. Methods 57 Australian office workers (mean [SD]; age = 47 [11] years; BMI = 28 [5] kg/m2; 46 men) generated a menu of 20 occupational ‘sit less and move more’ strategies through participatory workshops, and were then tasked with implementing strategies for five months (July–November 2014). During implementation, a sub-sample of workers (n = 24) used a chair sensor/software package (Sitting Pad) that gave real time prompts to interrupt desk sitting. Baseline and intervention sedentary behaviour and physical activity (GENEActiv accelerometer; mean work time percentages), and minutes spent sitting at desks (Sitting Pad; mean total time and longest bout) were compared between non-prompt and prompt workers using a two-way ANOVA. Results Workers spent close to three quarters of their work time sedentary, mostly sitting at desks (mean [SD]; total desk sitting time = 371 [71] min/day; longest bout spent desk sitting = 104 [43] min/day). Intervention effects were four times greater in workers who used real time computer prompts (8% decrease in work time sedentary behaviour and increase in light intensity physical activity; p < 0.01). Respective mean differences between baseline and intervention total time spent sitting at desks, and the longest bout spent desk sitting, were 23 and 32 min/day lower in prompt than in non-prompt workers (p < 0.01). Conclusions In this sample of office workers, real time computer prompts facilitated the impact of a participatory approach on reductions in occupational sedentary exposure, and increases in physical activity.

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Aim To describe glycaemia in both breastfeeding women and artificially feeding women with Type 1 diabetes, and the changes in glycaemia induced by suckling. Methods A blinded continuous glucose monitor was applied for up to 6 days in eight breastfeeding and eight artificially feeding women with Type 1 diabetes 2–4 months postpartum. Women recorded glucose levels, insulin dosages, oral intake and breastfeeding episodes. A standardized breakfast was consumed on 2 days. A third group (clinic controls) were identified from a historical database. Results Carbohydrate intake tended to be higher in breastfeeding than artificially feeding women (P = 0.09) despite similar insulin requirements. Compared with breastfeeding women, the high blood glucose index and standard deviation of glucose were higher in artificially feeding women (P = 0.02 and 0.06, respectively) and in the clinical control group (P = 0.02 and 0.05, respectively). The low blood glucose index and hypoglycaemia were similar. After suckling, the low blood glucose index increased compared with before (P < 0.01) and during (P < 0.01) suckling. Hypoglycaemia (blood glucose < 4.0 mmol/l) occurred within 3 h of suckling in 14% of suckling episodes, and was associated with time from last oral intake (P = 0.04) and last rapid-acting insulin (P = 0.03). After a standardized breakfast, the area under the glucose curve was positive. In breastfeeding women the area under the glucose curve was positive if suckling was avoided for 1 h after eating and negative if suckling occurred within 30 min of eating. Conclusions Breastfeeding women with Type 1 diabetes had similar hypoglycaemia but lower glucose variability than artificially feeding women. Suckling reduced maternal glucose levels but did not cause hypoglycaemia in most episodes.

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The well known features of crack face interpenetration/contact at the tip of an interface crack is re-examined using finite element analysis and assuming material nonlinear properties for the adherends. It was assumed in literature that the crack tips are fully open at all load levels in the presence of material nonlinearity of the adherends. Analysis for the case of remote tension shows that even in the presence of material nonlinearity, crack tip closes at small load levels and opens above a certain load level. Mixed-mode fracture parameters are evaluated for the situation when the crack tips are fully open. Due to the presence of nonlinearity, the mixed-mode fracture parameters are measured with the symmetric and anti-symmetric components of J-integral. The present analysis explains the sequence of events at the interface crack tip with progressively increasing remote tension load for the case of adherends with material nonlinear behaviour.

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The spread of multidrug-resistant (MDR) bacteria has reached a threatening level. Extended-spectrum betalactamase- producing enterobacteriaceae (ESBLE) are now endemic in many hospitals worldwide as well as in the community, while resistance rates continue to rise steadily in Acinetobacter baumannii and Pseudomonas aeruginosa [1]. Even more alarming is the dissemination of carbapenemase-producing enterobacteriaceae (CPE), causing therapeutic and organizational problems in hospitals facing outbreaks or endemicity. This context could elicit serious concerns for the coming two decades; nevertheless, effective measures exist to stop the amplification of the problem and several axes of prevention remain to be fully exploited, leaving room for realistic hopes, at least for many parts of the world...

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Introduction: Major Depressive Disorder (MDD) has high prevalence among adolescents and young adults. Evidence of any effective treatments is limited. Exercise as an effective treatment for adults has some support but studies in younger populations are lacking. Therefore the aim of this study was to investigate the feasibility and preliminary efficacy of brief motivational interviewing (MI) plus 12-weeks exercise training as a treatment for MDD in youth...

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By using the axisymmetric finite elements static limit analysis formulation, proposed recently by the authors, the stability numbers (gamma H/c(o)) for an unsupported vertical circular excavation in clays, whose cohesion increases with depth, have been determined under undrained condition; gamma = unit weight, H., height of the excavation and c(o) = cohesion along ground surface. The results are obtained for various values of H/b and m; where b = the radius of the excavation and m = a non-dimensional parameter which accounts for the rate of the increase of cohesion with depth. The values of the stability numbers increase continuously both with increases in H/b and m. The results obtained in this study compare well with those available in literature.(C) 2009 Elsevier Ltd. All rights reserved.

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The change in extension-twist Coupling due to delamination in antisymmetric laminates is experimentally measured. Experimental results are compared with the results from analytical expression existing in literature and finite element analysis. The application of the Macro-Fiber Composite (MFC) developed at the NASA Langley Research Center for sensing the delamination in the laminates is investigated. While many applications have been reported in the literature using the MFC as an actuator, here its use as a twist sensor has been studied. The real-life application envisaged is structural health monitoring of laminated composite flexbeams taking advantage of the symmetry in the structure. Apart from the defect detection under symmetric conditions, other methods of health monitoring for the same structure are reported for further validation. Results show that MFC works well as a sensor.

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Increasing antimicrobial resistance in bacteria has led to the need for better understanding of antimicrobial usage patterns. In 1999, the World Organisation for Animal Health (OIE) recommended that an international ad hoc group should be established to address human and animal health risks related to antimicrobial resistance and the contribution of antimicrobial usage in veterinary medicine. In European countries the need for continuous recording of the usage of veterinary antimicrobials as well as for animal species-specific and indication-based data on usage has been acknowledged. Finland has been among the first countries to develop prudent use guidelines in veterinary medicine, as the Ministry of Agriculture and Forestry issued the first animal species-specific indication-based recommendations for antimicrobial use in animals in 1996. These guidelines have been revised in 2003 and 2009. However, surveillance on the species-specific use of antimicrobials in animals has not been performed in Finland. This thesis provides animal species-specific information on indication-based antimicrobial usage. Different methods for data collection have been utilized. Information on antimicrobial usage in animals has been gathered in four studies (studies A-D). Material from studies A, B and C have been used in an overlapping manner in the original publications I-IV. Study A (original publications I & IV) presents a retrospective cross-sectional survey on prescriptions for small animals at the Veterinary Teaching Hospital of the University of Helsinki. Prescriptions for antimicrobial agents (n = 2281) were collected and usage patterns, such as the indication and length of treatment, were reviewed. Most of the prescriptions were for dogs (78%), and primarily for the treatment of skin and ear infections most of which were treated with cephalexin for a median period of 14 days. Prescriptions for cats (18%) were most often for the treatment of urinary tract infections with amoxicillin for a median length of 10 days. Study B (original publication II) was a retrospective cross-sectional survey where prescriptions for animals were collected from 17 University Pharmacies nationwide. Antimicrobial prescriptions (n = 1038) for mainly dogs (65%) and cats (19%) were investigated. In this study, cephalexin and amoxicillin were also the most frequently used drugs for dogs and cats, respectively. In study C (original publications III & IV), the indication-based usage of antimicrobials of practicing veterinarians was analyzed by using a prospective questionnaire. Randomly selected practicing veterinarians in Finland (n = 262) recorded all their antimicrobial usage during a 7-day study period. Cattle (46%) with mastitis were the most common patients receiving antimicrobial treatment, generally intramuscular penicillin G or intramammary treatment with ampicillin and cloxacillin. The median length of treatment was four days, regardless of the route of administration. Antimicrobial use in horses was evaluated in study D, the results of which are previously unpublished. Firstly, data collected with the prospective questionnaire from the practicing veterinarians showed that horses (n = 89) were frequently treated for skin or wound infections by using penicillin G or trimethoprim-sulfadiazine. The mean duration of treatment was five to seven days. Secondly, according to retrospective data collected from patient records, horses (n = 74) that underwent colic surgery at the Veterinary Teaching Hospital of the University of Helsinki were generally treated according to national and hospital recommendations; penicillin G and gentamicin was administered preoperatively and treatment was continued for a median of three days postoperatively. In conclusion, Finnish veterinarians followed well the national prudent use guidelines. Narrow-spectrum antimicrobials were preferred and, for instance, fluoroquinolones were used sparingly. Prescription studies seemed to give good information on antimicrobials usage, especially when combined with complementary information from patient records. A prospective questionnaire study provided a fair amount of valuable data on several animal species. Electronic surveys are worthwhile exploiting in the future.

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Data on pressure drop and heat transfer to aqueous solutions of glycerol flowing in different types of coiled pipes are presented for laminar flow in the range of NRe from 80 to 6000. An empirical correlation is set up which can account the present data as well as the data available in literature within ±10 per cent deviation. Conventional momentum and heat transfer analogy equation is used to analyse the present data.

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During active growth of Escherichia coli, majority of the transcriptional activity is carried out by the housekeeping sigma factor (Sigma 70), whose association with core RNAP is generally favoured because of its higher intracellular level and higher affinity to core RNAP. In order to facilitate transcription by alternative sigma factors during nutrient starvation, the bacterial cell uses multiple strategies by which the transcriptional ability of Sigma 70 is diminished in a reversible manner. The facilitators of shifting the balance in favour of alternative sigma factors happen to be as diverse as a small molecule (p)ppGpp (represents ppGpp or pppGpp), proteins (DksA, Rsd) and a species of RNA (6S RNA). Although 6S RNA and (p)ppGpp were known in literature for a long time, their role in transcriptional switching has been understood only in recent years. With themelucidation of function of DksA, a new dimension has been added to the phenomenon of stringent response. As the final outcome of actions of (p)ppGpp, DksA, 6S RNA and Rsd is similar, there is a need to analyse hese mechanisms in a collective manner. We review the recent trends in understanding the regulation of Sigma 70 by (p)ppGpp, DksA, Rsd and 6S RNA and present a case for evolving a unified model of RNAP redistribution during starvation by modulation of Sigma 70 activity in E. coli.

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A method for total risk analysis of embankment dams under earthquake conditions is discussed and applied to the selected embankment dams, i.e., Chang, Tapar, Rudramata, and Kaswati located in the Kachchh region of Gujarat, India, to obtain the seismic hazard rating of the dam site and the risk rating of the structures. Based on the results of the total risk analysis of the dams, coupled non-linear dynamic numerical analyses of the dam sections are performed using acceleration time history record of the Bhuj (India) earthquake as well as five other major earthquakes recorded worldwide. The objective of doing so is to perform the numerical analysis of the dams for the range of amplitude, frequency content and time duration of input motions. The deformations calculated from the numerical analyses are also compared with other approaches available in literature, viz, Makdisi and Seed (1978) approach, Jansen's approach (1990), Swaisgood's method (1995), Bureau's method (1997). Singh et al. approach (2007), and Saygili and Rathje approach (2008) and the results are utilized to foresee the stability of dams in future earthquake scenario. (C) 2010 Elsevier B.V. All rights reserved.

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For resonant column tests conducted in the flexure mode of excitation, a new methodology has been proposed to find the elastic modulus and associated axial strain of a cylindrical sample. The proposed method is an improvement over the existing one, and it does not require the assumption of either the mode shape or zero bending moment condition at the top of the sample. A stepwise procedure is given to perform the necessary calculations. From a number of resonant column experiments on aluminum bars and dry sand samples, it has been observed that the present method as compared with the one available in literature provides approximately (i) 5.9%-7.3% higher values of the elastic modulus and (ii) 6.5%-7.3% higher values of the associated axial strains.

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Existing models for dmax predict that, in the limit of μd → ∞, dmax increases with 3/4 power of μd. Further, at low values of interfacial tension, dmax becomes independent of σ even at moderate values of μd. However, experiments contradict both the predictions show that dmax dependence on μd is much weaker, and that, even at very low values of σ,dmax does not become independent of it. A model is proposed to explain these results. The model assumes that a drop circulates in a stirred vessel along with the bulk fluid and repeatedly passes through a deformation zone followed by a relaxation zone. In the deformation zone, the turbulent inertial stress tends to deform the drop, while the viscous stress generated in the drop and the interfacial stress resist deformation. The relaxation zone is characterized by absence of turbulent stress and hence the drop tends to relax back to undeformed state. It is shown that a circulating drop, starting with some initial deformation, either reaches a steady state or breaks in one or several cycles. dmax is defined as the maximum size of a drop which, starting with an undeformed initial state for the first cycle, passes through deformation zone infinite number of times without breaking. The model predictions reduce to that of Lagisetty. (1986) for moderate values of μd and σ. The model successfully predicts the reduced dependence of dmax on μd at high values of μd as well as the dependence of dmax on σ at low values of σ. The data available in literature on dmax could be predicted to a greater accuracy by the model in comparison with existing models and correlations.

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Existing models for dmax predict that, in the limit of μd → ∞, dmax increases with 3/4 power of μd. Further, at low values of interfacial tension, dmax becomes independent of σ even at moderate values of μd. However, experiments contradict both the predictions show that dmax dependence on μd is much weaker, and that, even at very low values of σ,dmax does not become independent of it. A model is proposed to explain these results. The model assumes that a drop circulates in a stirred vessel along with the bulk fluid and repeatedly passes through a deformation zone followed by a relaxation zone. In the deformation zone, the turbulent inertial stress tends to deform the drop, while the viscous stress generated in the drop and the interfacial stress resist deformation. The relaxation zone is characterized by absence of turbulent stress and hence the drop tends to relax back to undeformed state. It is shown that a circulating drop, starting with some initial deformation, either reaches a steady state or breaks in one or several cycles. dmax is defined as the maximum size of a drop which, starting with an undeformed initial state for the first cycle, passes through deformation zone infinite number of times without breaking. The model predictions reduce to that of Lagisetty. (1986) for moderate values of μd and σ. The model successfully predicts the reduced dependence of dmax on μd at high values of μd as well as the dependence of dmax on σ at low values of σ. The data available in literature on dmax could be predicted to a greater accuracy by the model in comparison with existing models and correlations.

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Gas-phase controlled absorption of ammonia in foams made of solutions of sulphuric acid has been studied experimentally. Effects of gas-phase concentration of ammonia and type of surfactant on the performance of the foam-bed reactor are investigated. Gas-phase controlled absorption from a spherical bubble is anaylzed using the asymptotic value of Sherwood number (Sh = 6.58), for both negligible as well as significant changes in the volume of the bubble. The experimental data are shown to be in good agreement with the single-stage model of the foam-bed reactor using these asymptotic sub-models, as well as the diffusion-in-sphere analysis available in literature. Influence of effective diffusivity on the time dependence of fractional gas absorption has been found to be unimportant for foam columns with large times of contact. The asymptotic sub-models have been compared and use of the rigid-sphere asymptotic sub-model is recommended for foam columns of practical relevence.