Use of non-invasive ambulatory blood pressure monitoring to screen for high-risk hypertensive patients.

Blood pressures measured casually by a doctor often differ considerably from those recorded during everyday activities away from the medical environment. In the present study, we compared office and ambulatory recorded pressures in 475 consecutive untreated patients diagnosed hypertensive by physicians. Blood pressure monitored non-invasively during the day was, on average 15/7 mmHg lower than the corresponding office pressures. The difference between office and ambulatory recorded pressure tended to be greatest in those patients with the highest office blood pressure levels, although the relationship between the two types of measurement was too weak (r = 0.50 and 0.38 for systolic and diastolic pressure, respectively) to have any predictive value in the individual patient. Office blood pressures were at least 10 mmHg higher than ambulatory pressures in 62% of patients for systolic and 42% for diastolic pressure. Blood pressure levels recorded during ambulatory monitoring were higher than in the doctor's office for 18% of patients for systolic and 22% for diastolic pressure. Among patients with systolic pressures of between 161 and 180 mmHg or diastolic pressures between 96 and 105 mmHg when facing a doctor, 27 and 37% respectively, showed markedly lower systolic (less than 140 mmHg) or diastolic (less than 90 mmHg) ambulatory recorded pressures. These data therefore indicate that ambulatory blood pressure monitoring may help to identify those truly hypertensive patients who are most likely to benefit from antihypertensive therapy.

Systematic difference between blood pressure readings caused by cuff type.

In this study we determine whether blood pressure readings using a cuff of fixed size systematically differed from readings made with a triple-bladder cuff (Tricuff) that automatically adjusts bladder width to arm circumference and assessed subsequent clinical and epidemiological effects. Blood pressure was measured with a standard cuff or a Tricuff in 454 patients visiting an outpatient clinic in the Seychelles (Indian Ocean). Overall means of within-individual standard cuff-Tricuff differences in systolic and diastolic blood pressures were examined in relation to arm circumference and sex. The standard cuff-Tricuff difference in systolic and diastolic blood pressures increased monotonically with circumference (from 4.7 +/- 0.8/3.2 +/- 0.7 mm Hg for arm circumference of 30 to 31 cm to 10.0 +/- 1.1/8.0 +/- 0.9 mm Hg for arm circumference > or = 36 cm) and was larger in women than men. Multivariate linear regression indicated independent effects of arm circumference and sex. Forty percent of subjects with a diastolic blood pressure of > or = 95 mm Hg measured with a standard cuff had values less than 95 mm Hg measured with a Tricuff. Extrapolation to the entire population of the Seychelles decreased the prevalence of blood pressure greater than or equal to 160/95 mm Hg by 11.5% and 24.0% in men and women, respectively, aged 35 to 64 years. The age-adjusted effect of body mass index on systolic and diastolic blood pressures decreased twofold using blood pressure readings made with a Tricuff instead of a standard cuff.(ABSTRACT TRUNCATED AT 250 WORDS)

Evalution of Hot Mix Asphalt Moisture Sensitivity Using the Nottingham Asphalt Test Equipment, July 2005

Moisture sensitivity of Hot Mix Asphalt (HMA) mixtures, generally called stripping, is a major form of distress in asphalt concrete pavement. It is characterized by the loss of adhesive bond between the asphalt binder and the aggregate (a failure of the bonding of the binder to the aggregate) or by a softening of the cohesive bonds within the asphalt binder (a failure within the binder itself), both of which are due to the action of loading under traffic in the presence of moisture. The evaluation of HMA moisture sensitivity has been divided into two categories: visual inspection test and mechanical test. However, most of them have been developed in pre-Superpave mix design. This research was undertaken to develop a protocol for evaluating the moisture sensitivity potential of HMA mixtures using the Nottingham Asphalt Tester (NAT). The mechanisms of HMA moisture sensitivity were reviewed and the test protocols using the NAT were developed. Different types of blends as moisture-sensitive groups and non-moisture-sensitive groups were used to evaluate the potential of the proposed test. The test results were analyzed with three parameters based on performance character: the retained flow number depending on critical permanent deformation failure (RFNP), the retained flow number depending on cohesion failure (RFNC), and energy ratio (ER). Analysis based on energy ratio of elastic strain (EREE ) at flow number of cohesion failure (FNC) has higher potential to evaluate the HMA moisture sensitivity than other parameters. If the measurement error in data-acquisition process is removed, analyses based on RFNP and RFNC would also have high potential to evaluate the HMA moisture sensitivity. The vacuum pressure saturation used in AASHTO T 283 and proposed test has a risk to damage specimen before the load applying.

Spatial patterns of preconsolidation pressure and soil moisture along transects in two directions under coffee

Information on the spatial structure of soil physical and structural properties is needed to evaluate the soil quality. The purpose of this study was to investigate the spatial behavior of preconsolidation pressure and soil moisture in six transects, three selected along and three across coffee rows, at three different sites under different tillage management systems. The study was carried out on a farm, in Patrocinio, state of Minas Gerais, in the Southeast of Brazil (18 º 59 ' 15 '' S; 46 º 56 ' 47 '' W; 934 m asl). The soil type is a typic dystrophic Red Latosol (Acrustox) and consists of 780 g kg-1 clay; 110 g kg-1 silt and 110 g kg-1 sand, with an average slope of 3 %. Undisturbed soil cores were sampled at a depth of 0.10-0.13 m, at three different points within the coffee plantation: (a) from under the wheel track, where equipment used in farm operations passes; (b) in - between tracks and (c) under the coffee canopy. Six linear transects were established in the experimental area: three transects along and three across the coffee rows. This way, 161 samples were collected in the transect across the coffee rows, from the three locations, while 117 samples were collected in the direction along the row. The shortest sampling distance in the transect across the row was 4 m, and 0.5 m for the transect along the row. No clear patterns of the preconsolidation pressure values were observed in the 200 m transect. The results of the semivariograms for both variables indicated a high nugget value and short range for the studied parameters of all transects. A cyclic pattern of the parameters was observed for the across-rows transect. An inverse relationship between preconsolidation pressure and soil moisture was clearly observed in the samples from under the track, in both directions.

Evaluation of Hot Mix Asphalt Moisture Sensitivity Using the Nottingham Asphalt Test Equipment, July 2005

Moisture sensitivity of Hot Mix Asphalt (HMA) mixtures, generally called stripping, is a major form of distress in asphalt concrete pavement. It is characterized by the loss of adhesive bond between the asphalt binder and the aggregate (a failure of the bonding of the binder to the aggregate) or by a softening of the cohesive bonds within the asphalt binder (a failure within the binder itself), both of which are due to the action of loading under traffic in the presence of moisture. The evaluation of HMA moisture sensitivity has been divided into two categories: visual inspection test and mechanical test. However, most of them have been developed in pre-Superpave mix design. This research was undertaken to develop a protocol for evaluating the moisture sensitivity potential of HMA mixtures using the Nottingham Asphalt Tester (NAT). The mechanisms of HMA moisture sensitivity were reviewed and the test protocols using the NAT were developed. Different types of blends as moisture-sensitive groups and non-moisture-sensitive groups were used to evaluate the potential of the proposed test. The test results were analyzed with three parameters based on performance character: the retained flow number depending on critical permanent deformation failure (RFNP), the retained flow number depending on cohesion failure (RFNC), and energy ratio (ER). Analysis based on energy ratio of elastic strain (EREE ) at flow number of cohesion failure (FNC) has higher potential to evaluate the HMA moisture sensitivity than other parameters. If the measurement error in data-acquisition process is removed, analyses based on RFNP and RFNC would also have high potential to evaluate the HMA moisture sensitivity. The vacuum pressure saturation used in AASHTO T 283 and proposed test has a risk to damage specimen before the load applying.

Automated Traffic/Truck Weight Monitoring Equipment (Weigh-in-Motion), HR-282, 1988

This report documents work undertaken in the demonstration of a low-cost Automatic Weight and Classification System (AWACS). An AWACS procurement specification and details of the results of the project are also included. The intent of the project is to support and encourage transferring research knowledge to state and local agencies and manufacturers through field demonstrations. Presently available, Weigh-in-Motion and Classification Systems are typically too expensive to permit the wide deployment necessary to obtain representative vehicle data. Piezo electric technology has been used in the United Kingdom and Europe and is believed to be the basic element in a low-cost AWACS. Low-cost systems have been installed at two sites, one in Portland Cement Concrete (PCC) pavement in Iowa and the other in Asphaltic Cement Concrete (ACC) pavement in Minnesota to provide experience with both types of pavement. The systems provide axle weights, gross vehicle weight, axle spacing, vehicle classification, vehicle speed, vehicle count, and time of arrival. In addition, system self-calibration and a method to predict contact tire pressure is included in the system design. The study has shown that in the PCC pavement, the AWACS is capable of meeting the needs of state and federal highway agencies, producing accuracies comparable to many current commercial WIM devices. This is being achieved at a procurement cost of substantially less than currently available equipment. In the ACC pavement the accuracies were less than those observed in the PCC pavement which is concluded to result from a low pavement rigidity at this site. Further work is needed to assess the AWACS performance at a range of sites in ACC pavements.

Effects of Implements of Husbandry (Farm Equipment) on Pavement Performance, TR-563, 2012

The effects of farm equipment on the structural behavior of flexible and rigid pavements were investigated in this study. The project quantified the difference in pavement behavior caused by heavy farm equipment as compared to a typical 5-axle, 80 kip semi-truck. This research was conducted on full scale pavement test sections designed and constructed at the Minnesota Road Research facility (MnROAD). The testing was conducted in the spring and fall seasons to capture responses when the pavement is at its weakest state and when agricultural vehicles operate at a higher frequency, respectively. The flexible pavement sections were heavily instrumented with strain gauges and earth pressure cells to measure essential pavement responses under heavy agricultural vehicles, whereas the rigid pavement sections were instrumented with strain gauges and linear variable differential transducers (LVDTs). The full scale testing data collected in this study were used to validate and calibrate analytical models used to predict relative damage to pavements. The developed procedure uses various inputs (including axle weight, tire footprint, pavement structure, material characteristics, and climatic information) to determine the critical pavement responses (strains and deflections). An analysis was performed to determine the damage caused by various types of vehicles to the roadway when there is a need to move large amounts agricultural product.

Development of a Ceramic Membrane Filtration Equipment and Its Applicability for Different Wastewaters

In this thesis the membrane filtration equipment for plate type ceramic membranes was developed based on filtration results achieved with different kinds of wastewaters. The experiments were mainly made with pulp and board mill wastewaters, but some experiments were also made with a bore well water and a stone cutting mine wastewater. The ceramicmembranes used were alpha-alumina membranes with a pore size of 100 nm. Some ofthe membranes were coated with a gamma-alumina layer to reduce the membrane pore size to 10 nm, and some of them were modified with different metal oxides in order to change the surface properties of the membranes. The effects of operationparameters, such as cross-flow velocity, filtration pressure and backflushing on filtration performance were studied. The measured parameters were the permeateflux, the quality of the permeate, as well as the fouling tendency of the membrane. A dynamic membrane or a cake layer forming on top of the membrane was observed to decrease the flux and increase separa-tion of certain substances, especially at low cross-flow velocities. When the cross-flow velocities were increased the membrane properties became more important. Backflushing could also be used to decrease the thickness of the cake layer and thus it improved the permeate flux. However, backflushing can lead to a reduction of retentions in cases where the cake layer is improving them. The wastewater quality was important for the thickness of the dynamic membrane and the membrane pore size influenced the permeate flux. In general, the optimization of operation conditions is very important for the successful operation of a membrane filtration system. The filtration equipment with a reasonable range of operational conditions is necessary, especiallywhen different kinds of wastewaters are treated. This should be taken into account already in the development stage of a filtration equipment.

Influence of Equipment Operation and Performance Deterioration on Power Plant Economy.

Pysyäkseen kilpailukykyisenä vapautuneilla sähkömarkkinoilla on voimalaitoksen energiantuotantokustannusten oltava mahdollisimman matalia, tinkimättä kuitenkaan korkeasta käytettävyydestä. Polttoaineen energiasisällön mahdollisimman hyvä hyödyntäminen on ratkaisevan tärkeää voimalaitoksen kannattavuudelle. Polttoainekustannusten osuus on konvektiivisilla laitoksilla yleensä yli puolet koko elinjakson kustannuksista. Kun vielä päästörajat tiukkenevat koko ajan, korostuu polttoaineen korkea hyötykäyttö entisestään. Korkea energiantuotannon luotettavuus ja käytettävyys ovat myös elintärkeitä pyrittäessä kustannusten minimointiin. Tässä työssä on käyty läpi voimalaitoksen kustannuksiin vaikuttavia käsitteitä, kuten hyötysuhdetta, käytettävyyttä, polttoaineen hintoja, ylös- ja alasajoja ja tärkeimpiä häviöitä. Ajostrategiassa ja poikkeamien hallinnassa pyritään hyvään hyötysuhteeseen ja alhaisiin päästöihin joka käyttötilanteessa. Lisäksi on tarkasteltu tiettyjen suureiden, eli höyryn lämpötilan ja paineen, savukaasun hapen pitoisuuden, savukaasun loppulämpötilan, sekä lauhduttimen paineen poikkeamien vaikutusta ohjearvostaan energiantuotantokustannuksiin. Happi / hiilimonoksidi optimoinnissa on otettu huomioon myös pohjatuhkan palamattomat.

Does sealing endotracheal tube cuff pressure diminish the frequency of postoperative laryngotracheal complaints after nitrous oxide anesthesia?

Study Objectives: To study endotracheal tube (ETT) cuff pressures during nitrous oxide (N2O) anesthesia when the cuffs are inflated with air to achieve sealing pressure, and to evaluate the frequency of postoperative laryngotracheal complaints.Design: Prospective, randomized, blind study.Setting: Metropolitan teaching hospital.Patients: 50 ASA physical status I and II patients scheduled for elective abdominal surgery.Interventions: Patients received standard general anesthesia with 66% N2O in oxygen. In 25 patients, the ETT cuff was inflated with air to achieve a sealing pressure (P-seal group). In 25 patients, the ETT cuff was inflated with air to achieve a pressure of 25 cm H2O (P-25 group).Measurements and Main Results: ETT intracuff pressures were recorded before (control) and at 30, 60, 90, 120, and 150 minutes during N2O administration. We investigated the frequency and intensity of sore throat, hoarseness, and dysphagia in patients in the Post-Anesthesia Care Unit (PACU) and 24 hours following tracheal extubation. The cuff pressures in the P-seal group were significantly lower than in the P-25 group at all time points studied (p < 0.001), with a significant increase with time in both groups (p < 0.001). The cuff pressures exceeded the critical pressure of 30 cm H2O only after 90 minutes in the P-seal group and already by 30 minutes in the P-25 group. The frequency and intensity of sore throat, hoarseness, and dysphagia were similar in both groups in the PACU and 24 hours after tracheal extubation (p > 0.05).Conclusions: Minimum ETT sealing cuff pressure during N2O anesthesia did not prevent, but instead attenuated, the increase in cuff pressure and did not decrease postoperative laryngotracheal complaints. (C) 2004 by Elsevier B.V.

Development of a pressure nociceptive threshold testing device for evaluation of analgesics in cats

A pressure analgesiometric device was developed for unrestrained cats. Eleven cats were studied. Stimulation was via three rounded pins within a bracelet on the forearm. The pins were advanced by manual bladder inflation. Bladder pressure was measured using a strain gauge pressure transducer. The threshold was recorded at the behavioural end point. Thresholds were measured at 5 and 15 min intervals for 2-4 h, after removal/replacement of the cuff, for 120 min after SC butorphanol (0.4 mg/kg), and with mild skin inflammation at the testing site. Data were analysed using ANOVA. Pressure thresholds in untreated cats were around 150 mmHg. The minimum interval for testing was established as 15 min. Data were reproducible over 4 h and beyond 24 h. Thresholds in 5 cats increased (P < 0.05) above baseline for 45 min after butorphanol with a maximum increase of 270 +/- 182 mmHg at 10 min. Thresholds decreased with inflammation. The method appears suitable for feline analgesia investigations. (c) 2006 Elsevier Ltd. All rights reserved.

Calibration of therapeutic ultrasound equipment

Temporal and spatial acoustic intensity (SATA) of therapeutic ultrasound (US) equipment should be monitored periodically. In order to evaluate the conditions of US equipment in use in the city of Piracicaba-Sao Paulo, Brazil, 31 machines - representing all Brazilian manufacturers - were analysed under continuous and pulsed conditions at a frequency of 1 MHz. Data about temporal and spatial acoustic intensity were collected and the use of equipment was surveyed. Intensities of 0.1, 0.2, 0.5, 0.8, 1.0, 1.5, 2.0, 2.5 and 3.0 Wcm -2, indicated on the equipment panel were analysed using a previously calibrated digital radiation pressure scale, model UPM-DT-1 (Ohmic Instruments Co). The acoustic intensity (I) results were expressed as superior and inferior quartile ranges for transducers with metal surfaces of 9 cm 2 and an effective radiation area (ERA) Of 4 cm 2. The results under continuous conditions were: I 0.1 = -20.0% and -96%. I 0.2 = -3.1% and -83.7%. I 0.5 = -35.0% and -86.5%. I 0.8 = -37.5% and -71.0%. I 2.5 = -49.0% and -69.5%. I 3.0 = -58.1% and -77.6%. For pulsed conditions, intensities were: I 0.1 = -40.0% and -86.2%. I 1.0 = -50.0% and -86.5%. I 1.5 = -62.5% and -82.5%. I 2.0 = -62.5% and -81.6%. I 2.5 = -64.7% and -88.8%. I 3.0 = -87.1% and -94.8%. In reply to the questionnaire drawn up to check the conditions of use of equipment, all users reported the use of hydrosoluble gel as a coupling medium and none had carried out previous calibrations. Most users used intensities in the range of 0.4. to 1.0 Wcm -2 and used machines for 300 to 400 minutes per week. The majority of machines had been bought during the previous seven years and weekly use ranged from less than 100 minutes to 700 minutes (11 hours 40 minutes). Findings confirm previous observations of discrepancy between the intensity indicated on the equipment panel and that emitted by the transducer and highlight the necessity for periodic evaluations of US equipment.

Using a pressure mapping system to evaluate contact pressure on hands during use of axillary crutches

The aim of this study was to evaluate different handles used in axillary crutches with a Pressure Mapping System. The Grip Versatek system from Tekscan Inc. was used to measure the levels and the distribution of contact pressure in the hands during a simulated activity of ambulation with crutches. The sample included ten able-bodied subjects: five men and five women. The results show that the different models of handles appear to have influenced the pressure levels measured during the activity. Therefore, the measurement equipment provides parameters that allow the comparison among different designs and assess their contribution to the comprehension of the demands of ergonomic handles.

Correlates of blood pressure according to early, on time, and late maturation in adolescents

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Globalisation, E-learning and the Monetary Pressure on the Educational Field

Globalisation, this is my thesis, change first the trade of goods and services, produce a mercantilist pressure on different political fields and affect finally as a consequence effectively our normative comprehension of education. As states will be more and more under pressure to compete on an economic basis against each other they will rank decisions which generate jobs higher than any thing else. Also Education policy is changing its focus. E-learning is a driving force to bring together education, trade of ICT equipment, trade of educational used content and trade of study degrees and to merge the different objectives into effective distribution of knowledge and maximising profits.