Wearable soft robotic device for post-stroke shoulder rehabilitation: identifying misalignments

Stroke is the leading cause of long-term disability in the United States, affecting over 795,000 people annually. In order to regain motor function of the upper body, patients are usually treated by regular sessions with a dedicated physical therapist. A cost-effective wearable upper body orthotics system that can be used at home to empower both the patients and physical therapists is described. The system is composed of a thin, compliant, lightweight, cost-effective soft orthotic device with an integrated cable actuation system that is worn over the upper body, an embedded limb position sensing system, an electric actuator package and controller. The proposed device is robust to misalignments that may occur during actuation of the compliant brace or when putting on the system. Through simulations and experimental evaluation, it was demonstrated i) that the soft orthotic cable-driven shoulder brace can be successfully actuated without the production of off-axis torques in the presence of misalignments and ii) that the proposed model can identify linear and angular misalignments online.

Neural bruise prediction models for fruit handling and machinery evaluation.

Some neural bruise prediction models have been implemented in the laboratory, for the most traded fruit species and varieties, allowing the prediction of the acceptability or rejectability for damages, with respect to the EC Standards. Different models have been built for both quasi-static (compression) and dynamic (impact) loads covering the whole commercial ripening period of fruits. A simulation process has been developed gathering the information on laboratory bruise models and load sensor calibrations for different electronic devices (IS-100 and DEA-1, for impact and compression loads respectively). Some evaluation methodology has been designed gathering the information on the mechanical properties of fruits and the loading records of electronic devices. The evaluation system allows to determine the current stage of fruit handling process and machinery.

Shake-table tests of a reinforced concrete frame designed following modern codes: seismic performance and damage evaluation

This paper presents shake-table tests conducted on a two-fifths-scale reinforced concrete frame representing a conventional construction design under current building code provisions in the Mediterranean area. The structure was subjected to a sequence of dynamic tests including free vibrations and four seismic simulations in which a historical ground motion record was scaled to levels of increasing intensity until collapse. Each seismic simulation was associated with a different level of seismic hazard, representing very frequent, frequent, rare and very rare earthquakes. The structure remained basically undamaged and within the inter-story drift limits of the "immediate occupancy" performance level for the very frequent and frequent earthquakes. For the rare earthquake, the specimen sustained significant damage with chord rotations of up to 28% of its ultimate capacity and approached the upper bound limit of inter-story drift associated with "life safety". The specimen collapsed at the beginning of the "very rare" seismic simulation. Besides summarizing the experimental program, this paper evaluates the damage quantitatively at the global and local levels in terms of chord rotation and other damage indexes, together with the energy dissipation demands for each level of seismic hazard. Further, the ratios of column-to-beam moment capacity recommended by Eurocode 8 and ACI-318 to guarantee the formation of a strong column-weak beam mechanism are examined.

Seismic performance and damage evaluation of a reinforced concrete frame with hysteretic dampers through shake-table tests

Passive energy dissipation devices are increasingly implemented in frame structures to improve their performance under seismic loading. Most guidelines for designing this type of system retain the requirements applicable to frames without dampers, and this hinders taking full advantage of the benefits of implementing dampers. Further, assessing the extent of damage suffered by the frame and by the dampers for different levels of seismic hazard is of paramount importance in the framework of performance-based design. This paper presents an experimental investigation whose objectives are to provide empirical data on the response of reinforced concrete (RC) frames equipped with hysteretic dampers (dynamic response and damage) and to evaluate the need for the frame to form a strong column-weak beam mechanism and dissipate large amounts of plastic strain energy. To this end, shake-table tests were conducted on a 2/5-scale RC frame with hysteretic dampers. The frame was designed only for gravitational loads. The dampers provided lateral strength and stiffness, respectively, three and 12 times greater than those of the frame. The test structure was subjected to a sequence of seismic simulations that represented different levels of seismic hazard. The RC frame showed a performance level of "immediate occupancy", with maximum rotation demands below 20% of the ultimate capacity. The dampers dissipated most of the energy input by the earthquake. It is shown that combining hysteretic dampers with flexible reinforced concrete frames leads to structures with improved seismic performance and that requirements of conventional RC frames (without dampers) can be relieved.

Evaluación del rendimiento de jugadores y equipos de fútbol de nivel de élite en diferentes contextos situacionales = Evaluation on Match Performances of Professional Football Players and Teams under Different Situational Conditions = 不同情境条件下高水平足球运动员和运动队的比赛表现分析

El análisis del rendimiento en deportes juega un papel esencial en el fútbol profesional. Aunque el estudio del análisis del juego en fútbol se ha utilizado desde diferentes ámbitos y situaciones, todavía existen diferentes aspectos y componentes del juego que siguen sin estar estudiados. En este sentido existen diferentes aspectos que deben de superar los estudios previos centrados en el componente descriptivo tales como el uso de variables/ indicadores de rendimiento que no se han definido ni estudiado, la validez de los métodos observaciones que no han sido testados con los softwares específicos en fútbol, la aplicación y utilidad de los resultados, así como las limitaciones del estudio de las variables situacionales/contextuales. Con el objetivo de cubrir las citadas limitaciones se han diseñado 6 estudios independientes e inter-relacionados que tratan de estudiar los aspectos anteriormente referidos. El primer estudio evalua la fiabilidad inter-observadores de las estadísticas de juego de la empresa privada OPTA Sportsdata, estos datos son la muestra de estudio de la presente tesis doctoral. Dos grupos de observadores experimentados se requieren para analizar un partido de la liga española de manera independiente. Los resultados muestran que los eventos de equipos y porteros codificados por los inter-operadores alcanzan un acuerdo muy bueno (valores kappa entre 0.86 y 0.94). La validez inter-observadores de las acciones de juego y los datos de jugadores individuales se evaluó con elevados niveles de acuerdo (valores del coeficiente de correlación intraclase entre 0.88 hasta 1.00, el error típico estandarizado variaba entre 0.00 hasta 0.37). Los resultados sugieren que las estadísticas de juego registradas por los operadores de la empresa OPTA Sportsdata están bien entrenados y son fiables. El segundo, tercer y cuarto estudio se centran en resaltar la aplicabilidad del análisis de rendimiento en el fútbol así como para explicar en profundidad las influencias de las variables situacionales. Utilizando la técnica de los perfiles de rendimiento de jugadores y equipos de fútbol se puede evaluar y comparar de manera gráfica, fácil y visual. Así mismo, mediante esta técnica se puede controlar el efecto de las variables situacionales (localización del partido, nivel del equipo y del oponente, y el resultado final del partido). Los perfiles de rendimiento de porteros (n = 46 porteros, 744 observaciones) y jugadores de campo (n = 409 jugadores, 5288 observaciones) de la primera division professional de fútbol Española (La Liga, temporada 2012-13), los equipos (n = 496 partidos, 992 observaciones) de la UEFA Champions League (temporadas 2009-10 a 2012-13) fueron analizados registrando la media, desviación típica, mediana, cuartiles superior e inferior y el recuento de valores de cada indicador de rendimiento y evento, los cuales se presentaron en su forma tipificada y normalizada. Los valores medios de los porteros de los equipos de diferentes niveles de La Liga y de los equipos de diferente nivel de la UEFA Champions League cuando jugaban en diferentes contextos de juego y situaciones (variables situacionales) fueron comparados utilizando el ANOVA de un factor y la prueba t para muestras independientes (localización del partido, diferencias entre casa y fuera), y fueron establecidos en los perfiles de red después de unificar todos los registros en la misma escala derivada con valores estandarizados. Mientras que las diferencias de rendimiento entre los jugadores de los mejores equipos (Top3) y los peores (Bottom3) fueron comparados mediante el uso de diferencias en la magnitud del tamaño del efecto. El quinto y el sexto estudio analizaban el rendimiento del fútbol desde un punto de vista de predicción del rendimiento. El modelo linear general y el modelo lineal general mixto fue empleado para analizar la magnitud de las relaciones de los indicadores y estadísticas de juego con el resultado final del partido en función del tipo de partido (partidos ajustados o todos los partidos) en la fase de grupos de la Copa del Mundo 2014 de Brasil (n = 48 partidos, 38 partidos ajustados) y La Liga 2012-13 (n = 320 partidos ajustados). Las relaciones fueron evaluadas mediante las inferencias en la magnitud de las diferencias y se expresaron como partidos extra ganados o perdidos por cada 10 partidos mediante la variable calculada en 2 desviaciones típicas. Los resultados mostraron que, para los 48 partidos de la fase de grupos de la Copa del Mundo 2014, nueve variables tuvieron un efecto positive en la probabilidad de ganar (tiros, tiros a puerta, tiros de contraataque, tiros dentro del área, posesión de balón, pases en corto, media de secuencia de pases, duelos aéreos y entradas), cuatro tuvieron efectos negativos (tiros bloqueados, centros, regates y tarjetas amarillas), y otras 12 variables tenían efectos triviales o poco claros. Mientras que los 38 partidos ajustados, el efecto de duelos aéreos y tarjetas amarillas fueron triviales y claramente negativos respectivamente. En la La Liga, existió un efecto moderado positive para cada equipo para los tiros a puerta (3.4 victorias extras por cada 10 partidos; 99% IC ±1.0), y un efecto positivo reducido para tiros totales (1.7 victorias extrsa; ±1.0). Los efectos de la mayoría de los eventos se han relacionado con la posesión del balón, la cual obtuvo efectos negativos entre equipos (1.2 derrotas extras; ±1.0) pero un efecto positivo pequeño entra equipos (1.7 victorias extras; ±1.4). La localización del partido mostró un efecto positive reducido dentro de los equipos (1.9 victorias extras; ±0.9). Los resultados obtenidos en los perfiles y el modelado del rendimiento permiten ofrecer una información detallada y avanzada para el entrenamiento, la preparación previa a los partidos, el control de la competición y el análisis post-partido, así como la evaluación e identificación del talento de los jugadores. ABSTRACT Match performance analysis plays an important role in the modern professional football. Although the research in football match analysis is well-developed, there are still some issues and problems remaining in this field, which mainly include the lack of operational definitions of variables, reliability issues, applicability of the findings, the lack of contextual/situational variables, and focusing too much on descriptive and comparative analysis. In order to address these issues, six independent but related studies were conducted in the current thesis. The first study evaluated the inter-operator reliability of football match statistics from OPTA Sportsdata Company which is the data resourse of the thesis. Two groups of experienced operators were required to analyse a Spanish league match independently in the experiment. Results showed that team events and goalkeeper actions coded by independent operators reached a very good agreement (kappa values between 0.86 and 0.94). The inter-operator reliability of match actions and events of individual outfield players was also tested to be at a high level (intra-class correlation coefficients ranged from 0.88 to 1.00, standardised typical error varied from 0.00 to 0.37). These results suggest that the football match statistics collected by well-trained operators from OPTA Sportsdata Company are reliable. The second, third and fourth study aims to enhance the applicability of football match performance analysis and to explore deeply the influences of situational variables. By using a profiling technique, technical and tactical performances of football players and teams can be interpreted, evaluated and compared more easily and straightforwardly, meanwhile, influences and effects from situational variables (match location, strength of team and opposition, and match outcome) on the performances can be properly incorporated. Performance profiles of goalkeepers (n = 46 goalkeepers, 744 full match observations) and outfield players (n = 409 players, 5288 full match observations) from the Spanish First Division Professional Football League (La Liga, season 2012-13), teams (n = 496 matches, 992 observations) from UEFA Champions League (seasons 2009-10 to 2012-13) were set up by presenting the mean, standard deviation, median, lower and upper quartiles of the count values of each performance-related match action and event to represent their typical performances and spreads. Means of goalkeeper from different levels of team in La Liga and teams of different strength in UEFA Champions League when playing under different situational conditions were compared by using one-way ANOVA and independent sample t test (for match location, home and away differences), and were plotted into the same radar charts after unifying all the event counts by standardised score. While differences between the performances of outfield players from Top3 and from Bottom3 teams were compared by magnitude-based inferences. The fifth and sixth study aims to move from the descriptive and comparative football match analysis to a more predictive one. Generalised linear modelling and generalised mixed linear modelling were undertaken to quantify relationships of the performance-related match events, actions and variables with the match outcome in different types of games (close games and all games) in the group stage of 2014 Brazil FIFA World Cup (n = 48 games, 38 close games) and La Liga 2012-13 (n = 320 close games). Relationships were evaluated with magnitude-based inferences and were expressed as extra matches won or lost per 10 matches for an increase of two standard deviations of a variable. Results showed that, for all the 48 games in the group stage of 2014 FIFA World Cup, nine variables had clearly positive effects on the probability of winning (shot, shot on target, shot from counter attack, shot from inside area, ball possession, short pass, average pass streak, aerial advantage, and tackle), four had clearly negative effects (shot blocked, cross, dribble and red card), other 12 variabless had either trivial or unclear effects. While for the 38 close games, the effects of aerial advantage and yellow card turned to trivial and clearly negative, respectively. In the La Liga, there was a moderate positive within-team effect from shots on target (3.4 extra wins per 10 matches; 99% confidence limits ±1.0), and a small positive within-team effect from total shots (1.7 extra wins; ±1.0). Effects of most other match events were related to ball possession, which had a small negative within-team effect (1.2 extra losses; ±1.0) but a small positive between-team effect (1.7 extra wins; ±1.4). Game location showed a small positive within-team effect (1.9 extra wins; ±0.9). Results from the established performance profiles and modelling can provide detailed and straightforward information for training, pre-match preparations, in-match tactical approaches and post-match evaluations, as well as for player identification and development. 摘要 比赛表现分析在现代足球中起着举足轻重的作用。尽管如今对足球比赛表现分析的研究已经相对完善，但仍有很多不足之处。这些不足主要体现在：研究中缺乏对研究变量的清晰定义、数据信效度缺失、研究结果的实用性受限、比赛情境因素缺失以及过于集中在描述性和对比性分析等。针对这些问题，本论文通过六个独立而又相互联系的研究，进一步对足球比赛表现分析进行完善。 第一个研究对本论文的数据源--OPTA Sportsdata公司的足球比赛数据的信效度进行了实验检验。实验中，两组数据收集人员被要求对同一场西班牙足球甲级联赛的比赛进行分析。研究结果显示，两组收集人员记录下的球队比赛事件和守门员比赛行为具有高度的一致性(卡帕系数介于0.86和0.94)。收集人员输出的外场球员的比赛行为和比赛事件也具有很高的组间一致性(ICC相关系数介于0.88和1.00，标准化典型误差介于0.00和0.37)。实验结果证明了OPTA Sportsdata公司收集的足球比赛数据具有足够高的信效度。 第二、三、四个研究旨在提升足球比赛表现分析研究结果的实用性以及深度探讨比赛情境因素对足球比赛表现的影响。通过对足球运动员和运动队的比赛技战术表现进行档案创建，可以对运动员和运动队的比赛表现进行简直接而直观的呈现、评价和对比，同时，情境变量(比赛场地、球队和对手实力、比赛结果)对比赛表现的影响也可以被整合到表现档案中。本部分对2012-13赛季西班牙足球甲级联赛的参赛守门员(n = 46球员人次，744比赛场次)和外场球员(n = 409球员人次, 5288比赛场次)以及2009-10至2012-13赛季欧洲足球冠军联赛的参赛球队(n = 496比赛场次)的比赛技战术表现进行了档案创建。在表现档案中，各项比赛技战术指标的均值、标准差、中位数和大小四分位数被用来展现守门员、外场球员和球队的普遍表现和表现浮动性。方差分析(ANOVA)被用来对西甲不同水平球队的守门员、欧冠中不同水平球队在不同比赛情境下的普遍表现(各项指标的均值)进行对比，独立样本t检验被用来对比主客场比赛普遍表现的差异。数据量级推断(magnitude-based inferences)的方法则被用来对西甲前三名和最后三名球队外场球员的普遍表现进行对比分析。所有来自不同水平球队的运动员和不同水平运动队的各项比赛指标皆被转换成了标准分数，从而能把他们在各种不同比赛情境下的普遍表现(各项比赛指标的均值)投到相同的雷达图中进行直观的对比。 第五和第六个研究目的在于进行预测性足球比赛表现分析，从而跨越之前固有的描述性和对比性分析。广义线性模型和广义混合线性模型被用来对2014年巴西世界杯小组赛(n = 48 比赛场次，38小分差场次)和2012-13赛季西甲联赛(n = 320小分差场次)的比赛中各表现相关比赛事件、行为和变量与比赛结果(胜、平、负)的关系进行建模。模型中的关系通过数据量级推断(magnitude-based inferences)的方法来界定，具体表现为某个变量增加两个标准差对比赛结果的影响(每10场比赛中额外取胜或失利的场数)。研究结果显示，在2014年巴西世界杯小组赛的所有48场比赛中，9个变量(射门、射正、反击中射门、禁区内射门、控球、短传、连续传球平均次数、高空球争抢成功率和抢断)与赢球概率有清晰的正相关关系，4个变量(射门被封堵、传中、过人和红牌)与赢球概率有清晰的负相关关系，其他12个被分析的变量与赢球概率的相关关系微小或不清晰。而在38场小分差比赛中，高空球争抢成功率由正相关变为微小关系，黄牌则由微小关系变为清晰的负相关。在西甲联赛中，每一支球队增加两个标准差的“射正球门”可以给每10场比赛带来3.4场额外胜利(99%置信区间±1.0场)，而所有球队作为一个整体，每增加两个标准差的“射正球门”可以给每10场比赛带来1.7场额外胜利(99%置信区间±1.0场)。其他大多数比赛相关事件与比赛结果的相关关系与“控球”相关联。每一支球队增加两个标准差的“控球”将会给每10场比赛带来1.2场额外失利(99%置信区间±1.0场)，而所有球队作为一个整体，每增加两个标准差的“控球”可以给每10场比赛带来1.7场额外胜利(99%置信区间±1.4场)。与客场比赛相对，主场能给球队带来1.9 /10场额外胜利(99%置信区间±0.9场)。 比赛表现档案和模型中得出的研究结果可以为俱乐部、足球队、教练组、表现分析师和运动员提供详细而直接的参考信息。这些信息可用于训练指导、赛前备战、赛中技战术调整和赛后技战术表现分析，也可运用于足球运动员选材、培养和发展。

Loss of HMW1 and HMW3 in noncytadhering mutants of Mycoplasma pneumoniae occurs post-translationally

The genomic sequence of Mycoplasma pneumoniae establish this cell-wall-less prokaryote as among the smallest known microorganisms capable of self-replication. However, this genomic simplicity and corresponding biosynthetic austerity are sharply contrasted by the complex terminal structure found in this species. This tip structure (attachment organelle) directs colonization of the human respiratory mucosa, leading to bronchitis and atypical pneumonia. Furthermore, formation of a second tip structure appears to precede cell division, implying temporal regulation. However, the organization, regulation, and assembly of the attachment organelle in M. pneumoniae are poorly understood, and no counterparts have been identified among the walled bacteria. M. pneumoniae possesses a cytoskeleton-like structure required to localize adhesin proteins to the attachment organelle. The cytadherence-associated proteins HMW1, HMW2, and HMW3 are components of the mycoplasma cytoskeleton, with HMW1 localizing strictly along the filamentous extensions from the cell body and HMW3 being a key structural element of the terminal organelle. Disruptions in hmw2 result in the loss of HMW1 and HMW3. However, the hmw1 and hmw3 genes were transcribed and translated at wild-type levels in hmw2 mutants. HMW1 and HMW3 were relatively stable in the wild-type background over 8 h but disappeared in the mutants over this time period. Evaluation of recombinant HMW1 levels in mycoplasma mutants suggested a requirement for the C-terminal domain of HMW1 for turnover. Finally, an apparent defect in the processing of the precursor for the adhesin protein P1 was noted in the HMW− mutants.

Evaluation of hybrid and distance education learning environments in Spain

This article describes the adaptation and validation of the Distance Education Learning Environments Survey (DELES) for use in investigating the qualities found in distance and hybrid education psycho-social learning environments in Spain. As Europe moves toward post-secondary student mobility, equanimity in access to higher education, and more standardised degree programs across the European Higher Education Area (EHEA) the need for a high quality method for continually assessing the excellence of distance and hybrid learning environments has arisen. This study outlines how the English language DELES was adapted into the new Spanish-Distance Education Learning Environments Survey (S-DELES) for use with a Bachelor of Psychology and Criminology degree program offering both distance and hybrid education classes. We present the relationships between psycho-social learning environment perceptions and those of student affect. We also present the asynchronous aspects of the environment, scale means, and a comparison between the perceptions of distance education students and their hybrid education counterparts that inform the university about the baseline health of the information and communication technologies (ICT) environment within which the study was conducted.

Evaluation of the pathogenicity of multiple isolates of Beauveria bassiana (Hypocreales: Clavicipitaceae) on Rhynchophorus ferrugineus (Coleoptera: Dryophthoridae) for the assessment of a solid formulation under simulated field conditions

A solid state formulation of Beauveria bassiana (Balsamo) Vuillemin has been developed for biological control of the Red Palm Weevil (RPW), Rhynchophorus ferrugineus (Olivier, 1790). Two kinds of bioassays (dry conidia and dipping) using 10 isolates from several coleopterans in Mediterranean environments, identified 2 RPW derived isolates (193 and 203) as most pathogenic to RPW larvae and adults (zero survival within first 4–5 d for dry conidia, and 14 and 23 d for dipping bioassays). Isolate 203 (5.1 × 108 ± 1.9 × 108 conidia g-1) was formulated with fragmented date seed into solid granules and tested in palms infested with RPW under semi-field conditions in Feb, Apr/May and Jun of both 2007 and 2008. Beauveria bassiana significantly reduced RPW adult survival with respect to controls in May 2007 and in the Apr/Jun 2008 experiments. Total RPW adult mortality was achieved within 30 days for all B. bassiana treatments, and was associated with increasing numbers of insects with signs of mycosis in 2008 experiments. Beauveria bassiana formulation reduced RPW multiplication in artificially infested palms compared to controls, and a positive correlation between numbers of larvae and time post-infestation was recorded. The suppression of RPW adult populations by B. bassiana persisted for at least 3 months under semi-field conditions. The Beauveria bassiana solid formulation, which induces great adult mortality and persistence in the field, could be applied as a preventive as well as a curative treatment for the integrated management of RPW.

Post-mortem CT and MR brain imaging of putrefied corpses

INTRODUCTION Putrefaction of the brain is a challenge to a forensic pathologist because it may lead to considerable organ alterations and restrict documenting reliable autopsy findings. OBJECTIVES This study aims to present a new and systematic evaluation of possible benefits of post-mortem MR Neuroimaging (1.5 Tesla, sequences: T1w, T2w) in putrefied corpses in comparison to PMCT and autopsy. METHODS A post-mortem MRI brain examination was conducted on 35 adult, putrefied corpses after performing a whole body CT scan prior to a forensic autopsy. Imaging data and autopsy findings were compared with regard to brain symmetry, gray and white matter junction, ventricular system, basal ganglia, cerebellum, brain stem, and possible pathological findings. RESULTS At autopsy, a reliable assessment of the anatomical brain structures was often restricted. MR imaging offered an assessment of the anatomical brain structures, even at advanced stages of putrefaction. In two cases, MR imaging revealed pathological findings that were detectable neither by CT scans nor at autopsy. CONCLUSIONS Post-mortem MR imaging of putrefied brains offers the possibility to assess brain morphology, even if the brain is liquefied. Post-mortem MR imaging of the brain should be considered if the assessment of a putrefied brain is crucial to the evaluation of a forensic autopsy case.

Test and evaluation of the AMF, Inc. and Fairchild Industries experimental safety vehicles. Volume IV. ESV program summary. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Test and evaluation of the AMF, Inc. and Fairchild Industries experimental safety vehicles. Volume 1. ESV program summary. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Evaluation of the 2006 Thanksgiving Click It or Ticket Campaign in Illinois, November 6 - December 10, 2006 /

Evaluates the impact of the "Click It or Ticket" campaign (April 2007) by using statewide public opinion and observational surveys of licensed Illinois drivers.

Post-Operative Pain Scores and Level of Regional Anesthesia Expertise: Using Clinical Outcomes to Assess Procedural Proficiency

Background and Objectives: Peripheral nerve blockade requires regional anesthesia skills that trainees learn in several formats. Technical proficiency has shifted from a quota to comprehensive procedural evaluation. Successful nerve blockade is the clinical endpoint validating proficiency but patient, technical and procedural factors influence this result. The purpose of this study was to determine if procedural expertise for sciatic nerve blockade influenced postoperative pain scores and opioid requirements and if patient factors, technique and repetition influenced this outcome. Method: Sciatic nerve blockade by nerve stimulation and ultrasound guidance and training level of the resident performing the procedure were recorded. Patient obesity, trauma, chronic pain, opioid use and preoperative pain scores were compared to post-procedure pain scores and opioid analgesic requirements. Results: 102 patients received sciatic nerve blockade from 47 trainees over a 36 month interval. A significant relation between training level and improved pain scores was not demonstrated but transition from nerve stimulation to ultrasound guidance lowered scores in all groups. Nerve blockade failure was frequent with chronic opioid use and trauma. Conclusion: Analgesic outcomes should be an integral part of assessment of proficiency in regional anesthesia techniques. Evaluating outcomes of procedures throughout training will longitudinally assess technical expertise.

Evaluation of a Quality Improvement Intervention for Anesthetic Management of Acute Ischemic Stroke Patients Undergoing Endovascular Therapy

Thesis (Master's)--University of Washington, 2016-06

Prospective evaluation of a D-optimal designed population pharmacokinetic study

Recently, methods for computing D-optimal designs for population pharmacokinetic studies have become available. However there are few publications that have prospectively evaluated the benefits of D-optimality in population or single-subject settings. This study compared a population optimal design with an empirical design for estimating the base pharmacokinetic model for enoxaparin in a stratified randomized setting. The population pharmacokinetic D-optimal design for enoxaparin was estimated using the PFIM function (MATLAB version 6.0.0.88). The optimal design was based on a one-compartment model with lognormal between subject variability and proportional residual variability and consisted of a single design with three sampling windows (0-30 min, 1.5-5 hr and 11 - 12 hr post-dose) for all patients. The empirical design consisted of three sample time windows per patient from a total of nine windows that collectively represented the entire dose interval. Each patient was assigned to have one blood sample taken from three different windows. Windows for blood sampling times were also provided for the optimal design. Ninety six patients were recruited into the study who were currently receiving enoxaparin therapy. Patients were randomly assigned to either the optimal or empirical sampling design, stratified for body mass index. The exact times of blood samples and doses were recorded. Analysis was undertaken using NONMEM (version 5). The empirical design supported a one compartment linear model with additive residual error, while the optimal design supported a two compartment linear model with additive residual error as did the model derived from the full data set. A posterior predictive check was performed where the models arising from the empirical and optimal designs were used to predict into the full data set. This revealed the optimal'' design derived model was superior to the empirical design model in terms of precision and was similar to the model developed from the full dataset. This study suggests optimal design techniques may be useful, even when the optimized design was based on a model that was misspecified in terms of the structural and statistical models and when the implementation of the optimal designed study deviated from the nominal design.