Principles of fatigue in residency education: a qualitative study

Background: Proposals to implement fatigue-management strategies in residency education assume that medicine shares the view
of other risk-adverse industries that fatigue is hazardous. This view is an essential underpinning of fatigue-management strategies
that other industries have embedded as part of their workplace occupational health and safety programs. We sought to explore how
residents understand fatigue in the context of their training environment.

Methods: We interviewed 21 residents in 7 surgical and nonsurgical programs at Western University in 2014. All participants met the
inclusion criteria of routinely working 24-hour call shifts while enrolled in their training program. Data collection and analysis occurred iteratively in keeping with constructivist grounded theory methodology and informed theoretical sampling to sufficiency.

Results: Four predominant principles of fatigue captured how the social learning environment shaped residents’ perceptions of
fatigue. These included the conceptualization of fatigue as (a) inescapable and therefore accepted, (b) manageable through experience, (c) necessary for future practice and (d) surmountable when required.

Interpretation: This study elaborates our understanding of how principles of fatigue are constructed and reinforced by the training
environment. Whereas fatigue is seen as a collective hazard in other industries, our data showed that, in residency training, fatigue
may be seen as a personal challenge. Consequently, fatigue-management strategies that conceptualize fatigue as an occupational
threat may have a limited impact on resident behaviour and patient safety.

A randomized controlled trial on the effects of combined aerobic-resistance exercise on muscle strength and fatigue, glycemic control and health-related quality of life of type 2 diabetes patients

Aim: to evaluate the effects of a 12-weeks combined aerobic-resistance exercise therapy on fatigue and isokinetic muscle strength, glycemic control and health-related quality of life (HRQoL) in moderately affected type 2 diabetes (T2DM) patients. Methods: a randomized controlled trial design was employed. Forty-three T2DM patients were assigned to an exercise group (n = 22), performing 3 weekly sessions of 60 minutes of combined aerobic-resistance exercise for 12-weeks; or a no exercise control group (n = 21). Both groups were evaluated at a baseline and after 12-weeks of exercise therapy for: 1) muscle strength and fatigue by isokinetic dynamometry; 2) plasma glycated hemoglobin A1C (HbA1C); and 3) HRQoL utilizing the SF-36 questionnaire. Results: the exercise therapy led to improvements in muscle fatigue in knee extensors (-55%) and increased muscle strength in knee flexors and extensors (+15 to +30%), while HbA1C decreased (-18%). In addition, the exercising patients showed sizeable improvements in HRQoL: physical function (+53%), vitality (+21%) and mental health (+40%). Conclusion: 12-weeks of combined aerobic-resistance exercise was highly effective to improve muscle strength and fatigue, glycemic control and several aspects of HRQoL in T2DM patients. These data encourage the use of aerobic and resistance exercise in the good clinical care of T2DM.

The effect of carbohydrate mouth rinsing on fencing performance and cognitive function following a fatigue inducing simulated bout of fencing in national level foil fencers

Delivered at The Physiological Society's Biomedical Basis of Elite Performance conference, Nottingham, 6-8 March 2016

Power systems reliability calculation based on fuzzy data mining

This paper presents a methodology supported on the data base knowledge discovery process (KDD), in order to find out the failure probability of electrical equipments’, which belong to a real electrical high voltage network. Data Mining (DM) techniques are used to discover a set of outcome failure probability and, therefore, to extract knowledge concerning to the unavailability of the electrical equipments such us power transformers and high-voltages power lines. The framework includes several steps, following the analysis of the real data base, the pre-processing data, the application of DM algorithms, and finally, the interpretation of the discovered knowledge. To validate the proposed methodology, a case study which includes real databases is used. This data have a heavy uncertainty due to climate conditions for this reason it was used fuzzy logic to determine the set of the electrical components failure probabilities in order to reestablish the service. The results reflect an interesting potential of this approach and encourage further research on the topic.

Many-core approach to 2D-DCT calculation using an FPGA

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia de Electrónica e Telecomunicações

Calculation of fractional derivatives of noisy data with genetic algorithms

This paper addresses the calculation of derivatives of fractional order for non-smooth data. The noise is avoided by adopting an optimization formulation using genetic algorithms (GA). Given the flexibility of the evolutionary schemes, a hierarchical GA composed by a series of two GAs, each one with a distinct fitness function, is established.

Fatigue life assessment of exhaust systems for naval gas turbines

Dissertação para obtenção do Grau de Mestre em Engenharia Mecânica

Aquisição por Visão Artificial e Medição Automática de Micro Dureza Vickers

O ensaio de dureza, e mais concretamente o ensaio de micro dureza Vickers, é no universo dos ensaios mecânicos um dos mais utilizados quer seja na indústria, no ensino ou na investigação e desenvolvimento de produto no âmbito das ciências dos materiais. Na grande maioria dos casos, a utilização deste ensaio tem como principal aplicação a caracterização ou controlo da qualidade de fabrico de materiais metálicos. Sendo um ensaio de relativa simplicidade de execução, rapidez e com resultados comparáveis e relacionáveis a outras grandezas físicas das propriedades dos materiais. Contudo, e tratando-se de um método de ensaio cuja intervenção humana é importante, na medição da indentação gerada por penetração mecânica através de um sistema ótico, não deixa de exibir algumas debilidades que daí advêm, como sendo o treino dos técnicos e respetivas acuidades visuais, fenómenos de fadiga visual que afetam os resultados ao longo de um turno de trabalho; ora estes fenómenos afetam a repetibilidade e reprodutibilidade dos resultados obtidos no ensaio. O CINFU possui um micro durómetro Vickers, cuja realização dos ensaios depende de um técnico treinado para a execução do mesmo, apresentando todas as debilidades já mencionadas e que o tornou elegível para o estudo e aplicação de uma solução alternativa. Assim, esta dissertação apresenta o desenvolvimento de uma solução alternativa ao método ótico convencional na medição de micro dureza Vickers. Utilizando programação em LabVIEW da National Instruments, juntamente com as ferramentas de visão computacional (NI Vision), o programa começa por solicitar ao técnico a seleção da câmara para aquisição da imagem digital acoplada ao micro durómetro, seleção do método de ensaio (Força de ensaio); posteriormente o programa efetua o tratamento da imagem (aplicação de filtros para eliminação do ruído de fundo da imagem original), segue-se, por indicação do operador, a zona de interesse (ROI) e por sua vez são identificadas automaticamente os vértices da calote e respetivas distâncias das diagonais geradas concluindo, após aceitação das mesmas, com o respetivo cálculo de micro dureza resultante. Para validação dos resultados foram utilizados blocos-padrão de dureza certificada (CRM), cujos resultados foram satisfatórios, tendo-se obtido um elevado nível de exatidão nas medições efetuadas. Por fim, desenvolveu-se uma folha de cálculo em Excel com a determinação da incerteza associada às medições de micro dureza Vickers. Foram então comparados os resultados nas duas metodologias possíveis, pelo método ótico convencional e pela utilização das ferramentas de visão computacional, tendo-se obtido bons resultados com a solução proposta.

Fatigue life assessment of endodontic instruments subjected to multi planar curvature

This present study aimed to investigate the fatigue life of unused (new) endodontic instruments made of NiTi with control memory by Coltene™ and subjected to the multi curvature of a mandibular first molar root canal. Additionally, the instrument‟s structural behaviour was analysed through non-linear finite element analysis (FEA). The fatigue life of twelve Hyflex™ CM files was assessed while were forced to adopt a stance with multiple radius of curvature, similar to the ones usually found in a mandibular first molar root canal; nine of them were subjected to Pecking motion, a relative movement of axial type. To achieve this, it was designed an experimental setup with the aim of timing the instruments until fracture while worked inside a stainless steel mandibular first molar model with relative axial motion to simulate the pecking motion. Additionally, the model‟s root canal multi-curvature was confirmed by radiography. The non-linear finite element analysis was conducted using the computer aided design software package SolidWorks™ Simulation, in order to define the imposed displacement required by the FEA, it was necessary to model an endodontic instrument with simplified geometry using SolidWorks™ and subsequently analyse the geometry of the root canal CAD model. The experimental results shown that the instruments subjected to pecking motion displayed higher fatigue life values and higher lengths of fractured tips than those with only rotational relative movement. The finite element non-linear analyses shown, for identical conditions, maximum values for the first principal stress lower than the yield strength of the material and those were located in similar positions to the instrument‟s fracture location determined by the experimental testing results.

Vie professionnelle et vie familiale et sociale : une gestion du temps et de la fatigue

Sur la base d'une enquête de terrain, les auteures abordent la nécessité de repenser la division du travail tant sur le plan du travail professionnel, que domestique. Elles s'appuient sur l'expérience des TL (transports lausannois) qui ont mis en place une nouvelle gestion des horaires permettant aux conducteurs d'avoir une assez grande latitude sur leurs itinéraires des bus. Le taux d'absentéisme alarmant avait inquiété les dirigeants qui s'attachaient à faire le tour de solutions à même de réduire la fatigue des collaborateurs. Les effets indirects de cette innovation managériale a été de permettre une véritable conciliation vie privée-vie professionnelle avec, cependant, comme effet non voulu un clivage entre anciens et nouveaux - les anciens ayant priorité quant au choix d'itinéraire. Les femmes, minoritaires dans le métier, ont du mal à faire entendre leur voix pour un système qui va clairement dans le sens d'une double activité facilitée. [Auteurs]

Fatigue et réduction de la performance motrice chez le sportif, syndrome de surentraînement [Fatigue and reduction in motor performance in sportspeople or overtraining syndrome].

The main goal of training activities is to improve motor performance. After strenuous workouts, it is physiological to experience fatigue, which relieves within two weeks, and then induce an improvement in motor capacities. An overtraining syndrome is diagnosed when fatigue is postponed beyond two weeks, and affects mainly endurance athletes. It is a condition of chronic fatigue, underperformance and an increased vulnerability to infection leading to recurrent infections. The whole observed spectrum of symptoms is physiological, psychological, endocrinogical and immunological. All play a role in the failure to recover. Monitoring of athletes activities helps to prevent the syndrome with days with no sports. Rest, patience and empathy are the only ways of treatment options.

Cognition, mood and fatigue in patients in the early stage of multiple sclerosis.

QUESTION UNDER STUDY: Cognitive impairment occurs during multiple sclerosis (MS) and contributes to the burden of the disease, but its effect in the initial phase of MS still needs to be better understood. METHODS: We prospectively studied 127 early MS patients presenting with a clinically isolated syndrome (CIS) or definite MS, a mean disease duration of 2.6 years, and with minor disability (mean Expanded Disability Status Scale score 1.8). Patients were tested for long-term memory, executive functions, attention, fatigue, mood disorders, functional handicap and quality of life (QoL). Twenty-one CIS patients were excluded from study as the diagnosis of MS could not be confirmed. RESULTS: Over the 106 MS patients analysed, 31 (29.3%) were cognitively impaired (23.6% for memory, 10.4% for attention and 5.7% for executive functions). Cognitive deficits were already present in CIS patients in whom the diagnosis was not yet confirmed (20%). Impaired cognition was associated with anxiety (p = 0.05), depression(p = 0.004), fatigue (p = 0.03), handicap (p <0.001) and a lower QoL (p <0.001). After adjustment for QoL, handicap, depression, anxiety and fatigue were no longer associated with the presence of cognitive deficits. CONCLUSIONS: In this well-defined early MS group one third of the patients already exhibited cognitive deficits, which were usually apparent in an effortful learning situation and were generally mild. Mood disorders, fatigue, handicap and decreased QoL were all associated with the occurrence of cognitive deficits. QoL itself appeared to take all the other factors into account. Our results confirm the existence of an interplay between cognitive, affective and functional changes and fatigue in early MS.

High-Speed Solid-Rotor Induction Machine – Electromagnetic Calculation and Design

Within the latest decade high-speed motor technology has been increasingly commonly applied within the range of medium and large power. More particularly, applications like such involved with gas movement and compression seem to be the most important area in which high-speed machines are used. In manufacturing the induction motor rotor core of one single piece of steel it is possible to achieve an extremely rigid rotor construction for the high-speed motor. In a mechanical sense, the solid rotor may be the best possible rotor construction. Unfortunately, the electromagnetic properties of a solid rotor are poorer than the properties of the traditional laminated rotor of an induction motor. This thesis analyses methods for improving the electromagnetic properties of a solid-rotor induction machine. The slip of the solid rotor is reduced notably if the solid rotor is axially slitted. The slitting patterns of the solid rotor are examined. It is shown how the slitting parameters affect the produced torque. Methods for decreasing the harmonic eddy currents on the surface of the rotor are also examined. The motivation for this is to improve the efficiency of the motor to reach the efficiency standard of a laminated rotor induction motor. To carry out these research tasks the finite element analysis is used. An analytical calculation of solid rotors based on the multi-layer transfer-matrix method is developed especially for the calculation of axially slitted solid rotors equipped with wellconducting end rings. The calculation results are verified by using the finite element analysis and laboratory measurements. The prototype motors of 250 – 300 kW and 140 Hz were tested to verify the results. Utilization factor data are given for several other prototypes the largest of which delivers 1000 kW at 12000 min-1.

Dzov hoknadz : [la mer fatiguée] ; Antzir sev amb : [Passe le sombre nuage] / T. Babikian, T ; acc. piano et violon

[Traditions. Asie. Arménie]

Calculation of the magnetic field penetration depth for high-Tc cuprate superconductors based on the Interlayer Pair Tunneling model /

In this work, the magnetic field penetration depth for high-Tc cuprate superconductors is calculated using a recent Interlayer Pair Tunneling (ILPT) model proposed by Chakravarty, Sudb0, Anderson, and Strong [1] to explain high temperature superconductivity. This model involves a "hopping" of Cooper pairs between layers of the unit cell which acts to amplify the pairing mechanism within the planes themselves. Recent work has shown that this model can account reasonably well for the isotope effect and the dependence of Tc on nonmagnetic in-plane impurities [2] , as well as the Knight shift curves [3] and the presence of a magnetic peak in the neutron scattering intensity [4]. In the latter case, Yin et al. emphasize that the pair tunneling must be the dominant pairing mechanism in the high-Tc cuprates in order to capture the features found in experiments. The goal of this work is to determine whether or not the ILPT model can account for the experimental observations of the magnetic field penetration depth in YBa2Cu307_a7. Calculations are performed in the weak and strong coupling limits, and the efi"ects of both small and large strengths of interlayer pair tunneling are investigated. Furthermore, as a follow up to the penetration depth calculations, both the neutron scattering intensity and the Knight shift are calculated within the ILPT formalism. The aim is to determine if the ILPT model can yield results consistent with experiments performed for these properties. The results for all three thermodynamic properties considered are not consistent with the notion that the interlayer pair tunneling must be the dominate pairing mechanism in these high-Tc cuprate superconductors. Instead, it is found that reasonable agreement with experiments is obtained for small strengths of pair tunneling, and that large pair tunneling yields results which do not resemble those of the experiments.