Mobile Clinics & Bundled Healthcare: An Exploration of Patient Perceptions of the SughaVazhvu Approach to Chronic Care Management

As the burden of non-communicable diseases increases worldwide, it is imperative that health systems adopt delivery approaches that will enable them to provide accessible, high-quality, and low-cost care to patients that need consistent management of their lifelong conditions. This is especially true in low- and middle-income country settings, such as India, where the disease burden is high and the health sector resources to address it are limited. The subscription-based, managed care model that SughaVazhvu Healthcare—a non-profit social enterprise operating in rural Thanjavur, Tamil Nadu—has deployed demonstrates potential for ensuring continuity of care among chronic care patients in resource-strained areas. However, its effectiveness and sustainability will depend on its ability to positively impact patient health status and patient satisfaction with the care management they are receiving. Therefore, this study is not only a program appraisal to aid operational quality improvement of the SughaVazhvu Healthcare model, but also an attempt to identify the factors that affect patient satisfaction among individuals with chronic conditions actively availing services.

Francesco Grimaldi, un mercader-banquero genovés entre Granada, la corte e Inglaterra (siglos xv-xvi)

Los estudios sobre la comunidad genovesa del Reino de Granada suelen centrarse en las actividades desarrolladas en el territorio y rara vez en la reconstrucción de trayectorias individuales, circunstancia determinada por el recurso casi exclusivo a los protocolos notariales. El caso de Francesco Grimaldi es singular por muchas razones: su localización en fuentes de naturaleza muy variada –protocolos notariales de Granada y Málaga, Registro del Sello de Simancas y Granada, Chancillería de Valladolid, el epistolario del comendador Fuensalida y el archivo privado de la familia Grimaldo de Cáceres– ha permitido seguir su presencia y sus actividades en Granada, la Corte e Inglaterra –donde desempeñó un papel fundamental en el matrimonio entre Catalina de Aragón y Enrique VIII–. Así se conoce su interés por los préstamos y el negocio de la renta, las circunstancias de su matrimonio con Francisca de Cáceres y la adquisición de un importante patrimonio en el reino granadino.

Time-dependent Suppression of Oscillatory Power in Evolving Solar Magnetic Fields

Oscillation amplitudes are generally smaller within magnetically active regions like sunspots and plage when compared to their surroundings. Such magnetic features, when viewed in spatially resolved power maps, appear as regions of suppressed power due to reductions in the oscillation amplitudes. Employing high spatial- and temporal-resolution observations from the Dunn Solar Telescope (DST) in New Mexico, we study the power suppression in a region of evolving magnetic fields adjacent to a pore. By utilizing wavelet analysis, we study for the first time how the oscillatory properties in this region change as the magnetic field evolves with time. Image sequences taken in the blue continuum, G-band, Ca ii K, and Hα filters were used in this study. It is observed that the suppression found in the chromosphere occupies a relatively larger area, confirming previous findings. Also, the suppression is extended to structures directly connected to the magnetic region, and is found to get enhanced as the magnetic field strength increased with time. The dependence of the suppression on the magnetic field strength is greater at longer periods and higher formation heights. Furthermore, the dominant periodicity in the chromosphere was found to be anti-correlated with increases in the magnetic field strength.

The effects of transients on photospheric and chromospheric power distributions

We have observed a quiet Sun region with the Swedish 1-meter Solar Telescope (SST) equipped with CRISP Imaging SpectroPolarimeter. High-resolution, high-cadence, H-alpha line scanning images were taken to observe different layers of the solar atmosphere from the photosphere to upper chromosphere. We study the distribution of power in different period-bands at different heights. Power maps of the upper photosphere and the lower chromosphere show suppressed power surrounding the magnetic-network elements, known as "magnetic shadows". These also show enhanced power close to the photosphere, traditionally referred to as"power halos". The interaction between acoustic waves and inclined magnetic fields is generally believed to be responsible for these two effects. In this study we explore if small-scale transients can influence the distribution of power at different heights. We show that the presence of transients, like mottles, Rapid Blueshifted Excursions (RBEs) and Rapid Redshifted Excursions (RREs), can strongly influence the power-maps. The short and finite lifetime of these events strongly affects all powermaps, potentially influencing the observed power distribution. We show that Doppler-shifted transients like RBEs and RREs that occur ubiquitously, can have a dominant effect on the formation ofthe power halos in the quiet Sun. For magnetic shadows, transients like mottles do not seem to have a significant effect in the power suppression around 3 minutes and wave interaction may play a key role here. Our high cadence observations reveal that flows, waves and shocks manifest in presence of magnetic fields to form a non-linear magnetohydrodynamic system.

Alpheid shrimps (Crustacea: Decapoda: Alpheidae) of Vietnam

The present paper deals with a collection of alpheid shrimps from Vietnam received by Mr R. Serene, formerly Director the Institute of Oceanography, Nhatrang (Vietnam). Though small in size the material has proved to be fairly rich. It contains 23 species belonging to the genera Alpheopsis Coutiere, Synalpheus Bate and Alpheus Fabricius, the last named genus accounting for all but three species. Two new species, one each belonging to Alpheopsis and Alpheus, have been briefly described by the author (Tiwari, 1962) in an earlier paper. The remaining species are already known and some of them have an extensive distribution in the Indo-West-Pacific.

Desenvolvimento de uma Metodologia para a Seletividade cinética aplicada ao processo de hidroconversão do petróleo, ocorrendo em reator gás-líquido

Este trabalho tem como objetivo desenvolver uma metodologia de seletividade cinética, para os pseudocomponentes do petróleo em escoamento gás-liquido em colunas de bolhas usando a Fluidodinâmica Computacional (CFD). Uma geometria cilíndrica de 2,5m de altura e 0,162m de diâmetro foi usada tanto na validação fluidodinâmica com base em dados experimentais da literatura, como na análise cinética do reator operando em dois modos distintos em relação a fase líquida: batelada e contínuo. Todos os casos de estudo operam em regime heterogêneo de escoamento, com velocidade superficial do gás igual a 8 cm/s e diâmetro médio de bolhas de 6 mm. O modelo fluidodinâmico validado apresentou boa concordância com os dados experimentais, sendo empregado como base para a implementação do modelo cinético de rede de Krishna e Saxena (1989). A análise da hidroconversão foi realizada a 371ºC, e os resultados mostraram o comportamento esperado para o processo reativo estudado, definindo-se os tempos (batelada) e posições axiais (contínuo) de coleta ideal para os pseudocomponentes leves. Em síntese, ressaltase o uso da ferramenta CFD no entendimento, desenvolvimento e otimização de processos.

Kinematics and Local Motion Planning for Quasi-static Whole-body Mobile Manipulation

This thesis studies mobile robotic manipulators, where one or more robot manipulator arms are integrated with a mobile robotic base. The base could be a wheeled or tracked vehicle, or it might be a multi-limbed locomotor. As robots are increasingly deployed in complex and unstructured environments, the need for mobile manipulation increases. Mobile robotic assistants have the potential to revolutionize human lives in a large variety of settings including home, industrial and outdoor environments.

Mobile Manipulation is the use or study of such mobile robots as they interact with physical objects in their environment. As compared to fixed base manipulators, mobile manipulators can take advantage of the base mechanism’s added degrees of freedom in the task planning and execution process. But their use also poses new problems in the analysis and control of base system stability, and the planning of coordinated base and arm motions. For mobile manipulators to be successfully and efficiently used, a thorough understanding of their kinematics, stability, and capabilities is required. Moreover, because mobile manipulators typically possess a large number of actuators, new and efficient methods to coordinate their large numbers of degrees of freedom are needed to make them practically deployable. This thesis develops new kinematic and stability analyses of mobile manipulation, and new algorithms to efficiently plan their motions.

I first develop detailed and novel descriptions of the kinematics governing the operation of multi- limbed legged robots working in the presence of gravity, and whose limbs may also be simultaneously used for manipulation. The fundamental stance constraint that arises from simple assumptions about friction and the ground contact and feasible motions is derived. Thereafter, a local relationship between joint motions and motions of the robot abdomen and reaching limbs is developed. Baseeon these relationships, one can define and analyze local kinematic qualities including limberness, wrench resistance and local dexterity. While previous researchers have noted the similarity between multi- fingered grasping and quasi-static manipulation, this thesis makes explicit connections between these two problems.

The kinematic expressions form the basis for a local motion planning problem that that determines the joint motions to achieve several simultaneous objectives while maintaining stance stability in the presence of gravity. This problem is translated into a convex quadratic program entitled the balanced priority solution, whose existence and uniqueness properties are developed. This problem is related in spirit to the classical redundancy resoxlution and task-priority approaches. With some simple modifications, this local planning and optimization problem can be extended to handle a large variety of goals and constraints that arise in mobile-manipulation. This local planning problem applies readily to other mobile bases including wheeled and articulated bases. This thesis describes the use of the local planning techniques to generate global plans, as well as for use within a feedback loop. The work in this thesis is motivated in part by many practical tasks involving the Surrogate and RoboSimian robots at NASA/JPL, and a large number of examples involving the two robots, both real and simulated, are provided.

Finally, this thesis provides an analysis of simultaneous force and motion control for multi- limbed legged robots. Starting with a classical linear stiffness relationship, an analysis of this problem for multiple point contacts is described. The local velocity planning problem is extended to include generation of forces, as well as to maintain stability using force-feedback. This thesis also provides a concise, novel definition of static stability, and proves some conditions under which it is satisfied.

Mining information from atom probe data

Whilst atom probe tomography (APT) is a powerful technique with the capacity to gather information containing hundreds of millions of atoms from a single specimen, the ability to effectively use this information creates significant challenges. The main technological bottleneck lies in handling the extremely large amounts of data on spatial-chemical correlations, as well as developing new quantitative computational foundations for image reconstruction that target critical and transformative problems in materials science. The power to explore materials at the atomic scale with the extraordinary level of sensitivity of detection offered by atom probe tomography has not been not fully harnessed due to the challenges of dealing with missing, sparse and often noisy data. Hence there is a profound need to couple the analytical tools to deal with the data challenges with the experimental issues associated with this instrument. In this paper we provide a summary of some key issues associated with the challenges, and solutions to extract or "mine" fundamental materials science information from that data.

Divergent shifts in lipid mediator profile following supplementation with n-3 docosapentaenoic acid and eicosapentaenoic acid

In contrast to the well-characterized effects of specialized proresolving lipid mediators (SPMs) derived from eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), little is known about the metabolic fate of the intermediary long-chain (LC) n-3 polyunsaturated fatty acid (PUFA) docosapentaenoic acid (DPA). In this double blind crossover study, shifts in circulating levels of n-3 and n-6 PUFA-derived bioactive lipid mediators were quantified by an unbiased liquid chromatography-tandem mass spectrometry lipidomic approach. Plasma was obtained from human subjects before and after 7 d of supplementation with pure n-3 DPA, n-3 EPA or placebo (olive oil). DPA supplementation increased the SPM resolvin D5n-3DPA (RvD5n-3DPA) and maresin (MaR)-1, the DHA vicinal diol 19,20-dihydroxy-DPA and n-6 PUFA derived 15-keto-PG E2 (15-keto-PGE2). EPA supplementation had no effect on any plasma DPA or DHA derived mediators, but markedly elevated monohydroxy-eicosapentaenoic acids (HEPEs), including the e-series resolvin (RvE) precursor 18-HEPE; effects not observed with DPA supplementation. These data show that dietary n-3 DPA and EPA have highly divergent effects on human lipid mediator profile, with no overlap in PUFA metabolites formed. The recently uncovered biologic activity of n-3 DPA docosanoids and their marked modulation by dietary DPA intake reveals a unique and specific role of n-3 DPA in human physiology.-Markworth, J. F., Kaur, G., Miller, E. G., Larsen, A. E., Sinclair, A. J., Maddipati, K. R., Cameron-Smith, D. Divergent shifts in lipid mediator profile following supplementation with n-3 docosapentaenoic acid and eicosapentaenoic acid.

Effect of pH and temperature on the carbonate promoted dissolution of sodium meta-autunite

Release of uranium from Na-autunite, an artificial mineral created as a result of polyphosphate injection in the subsurface at the DOE Hanford Site, takes place during slow dissolution of the mineral structure. Stability information of the uranyl-phosphate phases is limited to conditions involving pH, temperature, and a few aqueous organic materials. The carbonate ion, which creates very strong complexes with uranium, is the predominant ion in the groundwater composition. The polyphosphate technology with the formation of autunite was identified as the most feasible remediation strategy to sequester uranium in contaminated groundwater and soil in situ. The objectives of the experimental work were (i) to quantify the effect of bicarbonate on the stability of synthetic sodium meta-autunite created as a result of uranium stabilization through polyphosphate injection, (ii) calculate the kinetic rate law parameters of the uranium release from Na-autunite during dissolution, and (iii) to compare the process parameters with those obtained for natural calcium meta-autunite. Experiments were conducted using SPTF apparatus, which consists of syringe pumps for controlling flow rate, Teflon reactors and a heating/cooling system. 0.25 grams of synthetic Na-autunite was placed in the reactor and buffer solutions with varying bicarbonate concentrations (0.0005 to 0.003 M) at different pH (6 - 11) were pumped through the reactors. Experiments were conducted at four different temperatures in the range of 5 - 60oC. It was concluded that the rate of release of uranium from synthetic Na-autunite is directly correlated to the bicarbonate concentration. The rate of release of uranium increased from 1.90 x 10-12 at pH 6 to 2.64 x 10-10 (mol m-2 s-1) at pH 11 at 23oC over the bicarbonate concentration range tested. The activation energy values were invariant with the change in the bicarbonate concentration; however, pH is shown to influence the activation energy values. Uranyl hydroxides and uranyl carbonates complexes helped accelerate the dissolution of autunite mineral.

Riesgo biomecánico y dolor lumbar en operarios y personal administrativo en una fábrica de jabón en Bogotá 2016

Introducción: El dolor lumbar y los desórdenes músculo esqueléticos comprometen la salud y la calidad de vida de los trabajadores, pueden poner en riesgo el futuro laboral de las personas. bjetivo: Estimar la prevalencia de dolor lumbar y los posibles factores biomecánicos asociados en el personal operativo y administrativo en una empresa manufacturera de jabón en Bogotá, en el año 2016 Metodología: Estudio de corte transversal donde se evaluó el riesgo biomecánico y la prevalencia del dolor lumbar en personal administrativo (138) y operativo (165); se utilizó como instrumento el ERGOPAR validado en España. Se revisó la asociación utilizando la prueba Chi Cuadrado de Pearson, con un nivel de significación α 0.05 Resultados: 303 trabajadores de una empresa manufacturera de jabón en Bogotá, donde predominó el género masculino (51,82%) y la población adulta media entre 30-39 años (57,42%). La prevalencia del dolor lumbar en la población fue de 61,39% (186). La edad no se asoció estadísticamente al dolor lumbar. Se encontró asociación estadística entre el síntoma dolor lumbar y extensión de cuello (p=0,05 OR1.95 IC 1.33-2.88), así como con agarrar o sujetar objetos (p= 0,036. OR 2.3 IC 1.59-3.51) y con las exigencias físicas laborales (p= 0.001 OR 1.99 IC 1.31-3.02). Conclusiones: La población estudiada presentó una alta prevalencia de dolor lumbar, con predominio en personal que realiza labores operativas, y del género femenino. La adopción de posturas de extensión del cuello y la sujeción o agarre de objetos son factores asociados directamente con la aparición de lumbalgia.