The past, present and future of renin-angiotensin aldosterone system inhibition.

The renin-angiotensin aldosterone system (RAAS) is central to the pathogenesis of cardiovascular disease. RAAS inhibition can reduce blood pressure, prevent target organ damage in hypertension and diabetes, and improve outcomes in patients with heart failure and/or myocardial infarction. This review presents the history of RAAS inhibition including a summary of key heart failure, myocardial infarction, hypertension and atrial fibrillation trials. Recent developments in RAAS inhibition are discussed including implementation and optimization of current drug therapies. Finally, ongoing clinical trials, opportunities for future trials and issues related to the barriers and approvability of novel RAAS inhibitors are highlighted.

Design Guide for Precast UHPC Waffle Deck Panel System, including Connections, June 2013

Abstract: As a part of an innovation project funded by the Federal Highway Administration (FHWA) Highways for LIFE program, a full-depth precast, ultra-high-performance concrete (UHPC) waffle deck panel and appropriate connections suitable for field implementation of waffle decks were developed. Following a successful full-scale validation test on a unit consisting of two panels with various types of connections under laboratory conditions, the waffle deck was installed successfully on a replacement bridge in Wapello County, Iowa. The subsequent load testing confirmed the desirable performance of the UHPC waffle deck bridge. Using the lessons from the completed project and outcomes from a series of simple and detailed finite element analyses of waffle decks, this report was developed to serve as a guide for broadening the design and installation of the UHPC waffle deck panel in new and existing bridges. Following an introduction to UHPC and waffle deck panels and a summary of completed work, this document presents information on waffle deck design, design of connections, redecking using waffle deck panels, and guidance on precast fabrication, construction, and installation of UHPC waffle deck panels.

Supporting interdisciplinary case studies: development and implementation of a joint learning environment for students in forensic science and criminal law

Scientific reporting and communication is a challenging topic for which traditional study programs do not offer structured learning activities on a regular basis. This paper reports on the development and implementation of a web application and associated learning activities that intend to raise the awareness of reporting and communication issues among students in forensic science and law. The project covers interdisciplinary case studies based on a library of written reports about forensic examinations. Special features of the web framework, in particular a report annotation tool, support the design of various individual and group learning activities that focus on the development of knowledge and competence in dealing with reporting and communication challenges in the students' future areas of professional activity.

A regional Industrial Symbiosis methodology and its implementation in Geneva, Switzerland

The Agenda 21 for the Geneva region is the results from a broad consultation process including all local actors. The article 12 stipulates that « the State facilitates possible synergies between economic activities in order to minimize their environmental impacts » thus opening the way for Industrial Ecology (IE) and Industrial Symbiosis (IS). An Advisory Board for Industrial Ecology and Industrial Symbiosis implementation was established in 2002 involving relevant government agencies. Regulatory and technical conditions for IS are studied in the Swiss context. Results reveal that the Swiss law on waste does not hinder by-product exchanges. Methodology and technical factors including geographic, qualitative, quantitative and economical aspects are detailed. The competition with waste operators in a highly developed recycling system is also tackled.The IS project develops an empirical and systematic method for detecting and implementing by-products synergies between industrial actors disseminated throughout the Geneva region. Database management tool for the treatment of input-output analysis data and GIS tools for detecting potentials industrial partners are constantly improved. Potential symbioses for 17 flows (including energy, water and material flows) are currently studied for implementation.

Challenges to the implementation of behavioural survellance for HIV/STI in Europe

Background: Well-conducted behavioural surveillance (BS) is essential for policy planning and evaluation. Data should be comparable across countries. In 2008, the European Centre for Disease Prevention and Control (ECDC) began a programme to support Member States in the implementation of BS for Second Generation Surveillance. Methods: Data from a mapping exercise on current BS activities in EU/EFTA countries led to recommendations for establishing national BS systems and international coordination, and the definition of a set of core and transversal (UNGASS-Dublin compatible) indicators for BS in the general and eight specific populations. A toolkit for establishing BS has been developed and a BS needs-assessment survey has been launched in 30 countries. Tools for BS self-assessment and planning are currently being tested during interactive workshops with country representatives. Results: The mapping exercise revealed extreme diversity between countries. Around half had established a BS system, but this did not always correspond to the epidemiological situation. Challenges to implementation and harmonisation at all levels emerged from survey findings and workshop feedback. These include: absence of synergy between biological and behavioural surveillance and of actors having an overall view of all system elements; lack of awareness of the relevance of BS and of coordination between agencies; insufficient use of available data; financial constraints; poor sustainability, data quality and access to certain key populations; unfavourable legislative environments. Conclusions: There is widespread need in the region not only for technical support but also for BS advocacy: BS remains the neglected partner of second generation surveillance and requires increased political support and capacity-building in order to become effective. Dissemination of validated tools for BS, developed in interaction with country experts, proves feasible and acceptable.

Time for change: a roadmap to guide the implementation of the World Anti-Doping Code 2015

A medical and scientific multidisciplinary consensus meeting was held from 29 to 30 November 2013 on Anti-Doping in Sport at the Home of FIFA in Zurich, Switzerland, to create a roadmap for the implementation of the 2015 World Anti-Doping Code. The consensus statement and accompanying papers set out the priorities for the antidoping community in research, science and medicine. The participants achieved consensus on a strategy for the implementation of the 2015 World Anti-Doping Code. Key components of this strategy include: (1) sport-specific risk assessment, (2) prevalence measurement, (3) sport-specific test distribution plans, (4) storage and reanalysis, (5) analytical challenges, (6) forensic intelligence, (7) psychological approach to optimise the most deterrent effect, (8) the Athlete Biological Passport (ABP) and confounding factors, (9) data management system (Anti-Doping Administration & Management System (ADAMS), (10) education, (11) research needs and necessary advances, (12) inadvertent doping and (13) management and ethics: biological data. True implementation of the 2015 World Anti-Doping Code will depend largely on the ability to align thinking around these core concepts and strategies. FIFA, jointly with all other engaged International Federations of sports (Ifs), the International Olympic Committee (IOC) and World Anti-Doping Agency (WADA), are ideally placed to lead transformational change with the unwavering support of the wider antidoping community. The outcome of the consensus meeting was the creation of the ad hoc Working Group charged with the responsibility of moving this agenda forward.

A Computer Based Information System for County Equipment Cost Records, Interim Report, HR-173, 1975

This report describes the work accomplished to date on research project HR-173, A Computer Based Information System for County Equipment Cost Records, and presents the initial design for this system. The specific topics discussed here are findings from the analysis of information needs, the system specifications developed from these findings, and the proposed system design based upon the system specifications. The initial system design will include tentative input designs for capturing input data, output designs to show the output formats and the items to be output for use in decision making, file design showing the organization of information to be kept on each piece of equipment in the computer data file, and general system design explaining how the entire system will operate. The Steering Committee appointed by Iowa Highway Research Board is asked to study this report, make appropriate suggestions, and give approval to the proposed design subject to any suggestions made. This approval will permit the designer to proceed promptly with the development of the computer program implementation phase of the design.

Electronic Construction Collaboration System – Final Phase, SPR RB02-008, 2014

This phase of the research project involved two major efforts: (1) Complete the implementation of AEC-Sync (formerly known as Attolist) on the Iowa Falls Arch Bridge project and (2) develop a web-based project management system (WPMS) for projects under $10 million. For the first major effort, AEC-Sync was provided for the Iowa Department of Transportation (DOT) in a software as a service agreement, allowing the Iowa DOT to rapidly implement the solution with modest effort. During the 2010 fiscal year, the research team was able to help with the implementation process for the solution. The research team also collected feedback from the Broadway Viaduct project team members before the start of the project and implementation of the solution. For the 2011 fiscal year, the research team collected the post-project surveys from the Broadway Viaduct project members and compared them to the pre-project survey results. The result of the AEC-Sync implementation in the Broadway Viaduct project was a positive one. The project members were satisfied with the performance of AEC-Sync and how it facilitated document management and transparency. In addition, the research team distributed, collected, and analyzed the pre-project surveys for the Iowa Falls Arch Bridge project. During the 2012 fiscal year, the research team analyzed the post-project surveys for the Iowa Falls Arch Bridge project AEC-Sync implementation and found a positive outcome when compared to the pre-project surveys. The second major effort for this project involved the identification and implementation of a WPMS solution for smaller bridge and highway projects. During the 2011 fiscal year, Microsoft SharePoint was selected to be implemented on these smaller highway projects. In this year, workflows for the shop/working drawings for the smaller highway projects specified in Section 1105 of the Iowa DOT Specifications were developed. These workflows will serve as the guide for the development of the SharePoint pages. In order to implement the Microsoft SharePoint pages, the effort of an integrated team proved to be vital because it brought together the expertise required from researchers, programmers, and webpage developers to develop the SharePoint pages.

Transportation Program Management System, HR-394, 2003

HR-394 was a software and database development project. Via funding provided by the Iowa Highway Research Board, the Iowa County Engineer's Association Service Bureau oversaw the planning and implementation of an Internet based application that supports two major local-government transportation project activities: Project programming and Development tracking. The goals were to reduce errors and inconsistencies, speed up the processes, link people to both project data and each other, and build a framework that could eventually support a 'paperless' work flow. The work started in 1999 and initial development was completed by the fall of 2002. Since going live, several 'piggy back' applications have been required to make the Programming side better fit actual work procedures. This part of the system has proven adequate but will be rewritten in 2004 to make it easier to use. The original development side module was rejected by the users and so had to be rewritten in 2003. The second version has proven much better, is heavily used, and is interconnected with Iowa DOT project data systems. Now that the system is in operation, it will be maintained and operated by the ICEA Service Bureau as an ongoing service function.

The use of the SeDeM diagram expert system for the formulation of Captopril SR matrix tablets by direct compression

The SeDeM Diagram Expert System has been used to study excipients, Captopril and designed formulations for their galenic characterization and to ascertain the critical points of the formula affecting product quality to obtain suitable formulations of Captopril Direct Compression SR Matrix Tablets. The application of the Sedem Diagram Expert System enables selecting excipients with in order to optimize the formula in the preformulation and formulation studies. The methodology is based on the implementation of ICH Q8, establishing the design space of the formula with the use of experiment design, using the parameters of the SeDeM Diagram Expert System as system responses.

Experimental Results and Evaluation of SmartBox Stimulation Device in a P2P E-learning System

In this paper, we present the experimental results and evaluation of the SmartBox stimulation device in P2P e-learning system which is based on JXTA-Overlay. We also show the design and implementation of the SmartBox environment that is used for stimulating the learners motivation to increase the learning efficiency. The SmartBox is integrated with our P2P system as a useful tool for monitoring and controlling learners¿ activity. We found by experimental results that the SmartBox is an effective way to increase the learner¿s concentration. We also investigated the relation between learner¿s body movement, concentration, and amount of study. From the experimental results, we conclude that the use of SmartBox is an effective way to stimulate the learners in order to continue studying while maintaining the concentration.

Exploring the implementation of a medication adherence programme by community pharmacists: a qualitative study

BACKGROUND: Medication adherence has been identified as an important factor for clinical success. Twenty-four Swiss community pharmacists participated in the implementation of an adherence support programme for patients with hypertension, diabetes mellitus and/or dyslipidemia. The programme combined tailored consultations with patients about medication taking (expected at an average of one intervention per month) and the delivery of each drug in an electronic monitoring system (MEMS6?). OBJECTIVE: To explore pharmacists' perceptions and experiences with implementation of the medication adherence programme and to clarify why only seven patients were enrolled in total. SETTING: Community pharmacies in French-speaking Switzerland. METHOD: Individual in-depth interviews were audio-recorded, with 20 of the pharmacists who participated in the adherence programme. These were transcribed verbatim, coded and thematically analysed. Process quality was ensured by using an audit trail detailing the development of codes and themes; furthermore, each step in the coding and analysis was verified by a second, experienced qualitative researcher. MAIN OUTCOME MEASURE: Community pharmacists' experiences and perceptions of the determining factors influencing the implementation of the adherence programme. RESULTS: Four major barriers were identified: (1) poor communication with patients resulting in insufficient promotion of the programme; (2) insufficient collaboration with physicians; (3) difficulty in integrating the programme into pharmacy organisation; and (4) insufficient pharmacist motivation. This was related to the remuneration perceived as insufficient and to the absence of clear strategic thinking about the pharmacist position in the health care system. One major facilitator of the programme's implementation was pre-existing collaboration with physicians. CONCLUSION: A wide range of barriers was identified. The implementation of medication adherence programmes in Swiss community pharmacies would benefit from an extended training aimed at developing communication and change management skills. Individualised onsite support addressing relevant barriers would also be necessary throughout the implementation process.

Synchronous Digital Hierarchy implementation to a Radio Transmission Node

Kiristyville markkinoille on aina tuotava jotain uutta tarjottavaa ja SDH-kortti on yksi sellainen tuote jonka Nokia Networks julkistaa osaksi uutta Nokia Flexihub Nodea. Tavoitteena on suunnitella VC-12kanavoitu STM-1 kortti yhdistämään ylemmän tason tietoliikenneverkko suuren kapasiteetin radioon. Ennen kuin markkinoilla on valmis tuote, on sen takana valtaisa määrä työtä. Erilaisia dokumentteja on pitänyt tuottaa ja sopimuksia tehdä. Esimerkiksi vaatimusmäärittelyt on oltava selvät, jotta tiedetään mitä tuotteelta halutaan. Tätä ennen on kuitenkin pitänyt ymmärtää miten SDHtoimii ja miten otsikkotavuja käsitellään. Myös erilaiset piirivalinnat aiheuttavat miettimistä, sillä markkinoilla on runsaasti valmiita piirejä SDH signaalinkäsittelyyn. Varma tiedonsiirto on tärkeää puhelinoperaattorille ja siksi joudutaan miettimään varmennuksia ja niiden toteuttamista. Myös synkronointi on tärkeä osa SDH järjestelmää ja sen toteuttaminen hyvin on tärkeää. Hälytykset on otettava huomioon ja mietittävä, miten niiden käsittely saadaan hoidettua järkevästi, ilman että mikään järjestelmän osa ruuhkautuu kohtuuttomasti. Tässä Diplomityössä on tutustuttu SDH-järjestelmään, otsikkotavujen käsittelyyn ja vaatimusmäärittelyihin.

Authentication and authorization in PeerHood System

The goal of this work is to design and implement authentication and authorization section to PeerHood system. PeerHood system is developedin Lappeenranta University of Technology. It provides functions of discovering devices compatible with PeerHood and listing services offered by those devices; based on wireless technologies: Wi-Fi, Bluetooth and GPRS. The thesis describes implementation of the security approach intomobile Ad-Hoc environment and includes both authentication and authorization processes.

Implementing theLean Manufacturing System

Tuottavuuden ja tehokkuuden parantaminen on keskeisimpiä menestystekijöitä glo-baaleilla markkinoilla. Yksi kehittämisen toimintamalli on lean manufacturing -ajattelutapa, joka perustuu imuohjaukseen. Sen lähtökohtana on asiakasarvo ja keskit-tyminen arvoa lisäävien toimintojen maksimointiin. Tutkimuksen tavoitteena oli parantaa Strömfors Electric Oy:n materiaalivirtauksia yhdellä tuotantolinjalla. Projektin oli tarkoitus olla pilotti lean-implementointiin koko tehtaalla. Projektissa otettiin käyttöön kanban-imuohjausjärjestelmä, jota varten teh-tiin analyysejä ja laskelmia arvovirtoihin, varastoihin ja ohjaukseen. Lean-ajattelutapaan ja -työkaluihin perustuvaa kirjallisuutta käytettiin pohjatietona pilotti-projektissa sekätulevien kehitysprojektien suunnittelussa. Pilottiprojektin tuloksena materiaalinohjaus tehostui ja keskeneräisen tuotannon va-rasto tasoittui käyttötarpeen mukaiseksi. Työntekijät ja työnjohtajat tutustuivat leanin perusteisiin osallistuessaan pilottiprojektiin. Pidemmän aikavälin suunnitelmissa ontoimitusvarmuuden ja laadun parantuminen ensin pilottiprojektia koskevalla linjalla ja myöhemmin koko tehtaalla imuohjauksen kokonaisvaltaisen käyttöönoton myötä.