The strength and stiffness of slabs to column joints

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The move to servitization (from a product service system point of view)

Product Service Systems (PSSs) emphasize the substitution of products with services. The term “Servitisation” was introduced by Sandra Vendermerwe in the 80s to represent the addition of services to increase a company’s competitive edge. Key to PSS, and Servitisation more generally, is the “informated product”. The informated product enables health monitoring of the product in use and can be key to a workable PSS. This paper reviews the evolution of servitisation and the associated business benefit. It also then reviews the concept of informated product reconfiguration techniques and remote services that enables PSS to be delivered.

The Gilles de la Tourette Syndrome-Quality of Life Scale for children and adolescents (C&A-GTS-QOL):development and validation of the Italian version

BACKGROUND: Gilles de la Tourette syndrome (GTS) is a chronic childhood-onset neuropsychiatric disorder with a significant impact on patients' health-related quality of life (HR-QOL). Cavanna et al. (Neurology 2008; 71: 1410-1416) developed and validated the first disease-specific HR-QOL assessment tool for adults with GTS (Gilles de la Tourette Syndrome-Quality of Life Scale, GTS-QOL). This paper presents the translation, adaptation and validation of the GTS-QOL for young Italian patients with GTS. METHODS: A three-stage process involving 75 patients with GTS recruited through three Departments of Child and Adolescent Neuropsychiatry in Italy led to the development of a 27-item instrument (Gilles de la Tourette Syndrome-Quality of Life Scale in children and adolescents, C&A-GTS-QOL) for the assessment of HR-QOL through a clinician-rated interview for 6-12 year-olds and a self-report questionnaire for 13-18 year-olds. RESULTS: The C&A-GTS-QOL demonstrated satisfactory scaling assumptions and acceptability. Internal consistency reliability was high (Cronbach's alpha > 0.7) and validity was supported by interscale correlations (range 0.4-0.7), principal-component factor analysis and correlations with other rating scales and clinical variables. CONCLUSIONS: The present version of the C&A-GTS-QOL is the first disease-specific HR-QOL tool for Italian young patients with GTS, satisfying criteria for acceptability, reliability and validity. © 2013 - IOS Press and the authors. All rights reserved.

Study of the binding of gold to plasma proteins

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Characterisation of resistance to ß-lactam antibiotics in a population of Haemophilus influenzae

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When moving information online diminishes change:advisory services to SMEs

Improving the performance of private sector small and medium sized enterprises (SMEs) in a cost effective manner is a major concern for government. Governments have saved costs by moving information online rather than through more expensive face-to-face exchanges between advisers and clients. Building on previous work that distinguished between types of advice, this article evaluates whether these changes to delivery mechanisms affect the type of advice received. Using a multinomial logit model of 1334 cases of business advice to small firms collected in England, the study found that advice to improve capabilities was taken by smaller firms who were less likely to have limited liability or undertake business planning. SMEs sought word-of-mouth referrals before taking internal, capability-enhancing advice. This is also the case when that advice was part of a wider package of assistance involving both internal and external aspects. Only when firms took advice that used extant capabilities did they rely on the Internet. Therefore, when the Internet is privileged over face-to-face advice the changes made by each recipient of advice are likely to diminish causing less impact from advice within the economy. It implies that fewer firms will adopt the sorts of management practices that would improve their productivity. © 2014 Taylor & Francis.

Management of services differentiation and guarantee in IEEE 802.11e wireless LANs

In this paper, we study the management and control of service differentiation and guarantee based on enhanced distributed function coordination (EDCF) in IEEE 802.11e wireless LANs. Backoff-based priority schemes are the major mechanism for Quality of Service (QoS) provisioning in EDCF. However, control and management of the backoff-based priority scheme are still challenging problems. We have analysed the impacts of backoff and Inter-frame Space (IFS) parameters of EDCF on saturation throughput and service differentiation. A centralised QoS management and control scheme is proposed. The configuration of backoff parameters and admission control are studied in the management scheme. The special role of access point (AP) and the impact of traffic load are also considered in the scheme. The backoff parameters are adaptively re-configured to increase the levels of bandwidth guarantee and fairness on sharing bandwidth. The proposed management scheme is evaluated by OPNET. Simulation results show the effectiveness of the analytical model based admission control scheme. ©2005 IEEE.

The use of antidepressants to treat attention deficit hyperactivity disorder in adults

There is increasing evidence that children continue to experience attention deficit hyperactivity disorder (ADHD) symptoms into adult life. The two main treatments for ADHD are antidepressants and stimulants. Here, the effectiveness data relating to the use of antidepressants in adults with ADHD are reviewed. Four controlled and six open studies were identified. Although, there is only limited data currently available, antidepressants may offer an effective therapy for adult ADHD. Controlled trials have studied desipramine, atomoxetine and bupropion, with most evidence supporting the efficacy of desipramine. The initial data indicate that atomoxetine is less effective than desipramine. The efficacy of bupropion is unclear. Initial published open data suggest a response rate of 50-78% with venlafaxine. Controlled studies are required to confirm this efficacy. Most of the present data are short-term, therefore long-term effectiveness data are required.

Safety and use of sputum induction in children with cystic fibrosis

We assessed the safety and use of induced sputum (IS) in children with cystic fibrosis (CF). Forty-eight children (19 males) with CF, mean age 12.6 (range, 7.3-17.0) years and median forced expired volume in 1 sec (FEV1) 48% (range, 14-77%) predicted were recruited. Patients spontaneously expectorated sputum and then performed sputum induction by inhalation of nebulized 7% hypertonic saline. Samples were sent for bacteriological culture, and for measurement of the following inflammatory mediators: interleukin-8, myeloperoxidase, eosinophil cationic protein, and neutrophil elastase activity. FEV1 was performed before and after inhalation of hypertonic saline. There was no increase in mediator levels in IS compared to expectorated sputum (ES) samples. Only 3 patients demonstrated significant bronchoconstriction following inhalation of hypertonic saline, by the method used. From the ES samples, Pseudomonas aeruginosa was isolated in 13 patients, Staphylococcus aureus in 7 patients, Stenotrophomonas maltophilia in 1 patient, and both Pseudomonas aeruginosa and Staphylococcus aureus in 5 patients. All these organisms were found in the IS samples. However, in 2 patients whose ES grew no organisms, one patient's IS grew Pseudomonas aeruginosa, and the other patient's IS grew Staphylococcus aureus. In our study, sputum induction was safe, with no proinflammatory effect.

Dimensioning of Telecommunication Network Based on Quality of Services Demand and Detailed Behaviour of Users

The aim of this paper is to be determined the network capacity (number of necessary internal switching lines) based on detailed users’ behaviour and demanded quality of service parameters in an overall telecommunication system. We consider detailed conceptual and its corresponded analytical traffic model of telecommunication system with (virtual) circuit switching, in stationary state with generalized input flow, repeated calls, limited number of homogeneous terminals and losses due to abandoned and interrupted dialing, blocked and interrupted switching, not available intent terminal, blocked and abandoned ringing (absent called user) and abandoned conversation. We propose an analytical - numerical solution for finding the number of internal switching lines and values of the some basic traffic parameters as a function of telecommunication system state. These parameters are requisite for maintenance demand level of network quality of service (QoS). Dependencies, based on the numericalanalytical results are shown graphically. For proposed conceptual and its corresponding analytical model a network dimensioning task (NDT) is formulated, solvability of the NDT and the necessary conditions for analytical solution are researched as well. It is proposed a rule (algorithm) and computer program for calculation of the corresponded number of the internal switching lines, as well as corresponded values of traffic parameters, making the management of QoS easily.

The enantioselective population pharmacokinetics of intravenous ketorolac in children using a stereoselective assay suitable for microanalysis

Objective: To describe the effect of age and body size on enantiomer selective pharmacokinetic (PK) of intravenous ketorolac in children using a microanalytical assay. Methods: Blood samples were obtained at 0, 15 and 30 min and at 1, 2, 4, 6, 8 and 12 h after a weight-dependent dose of ketorolac. Enantiomer concentration was measured using a liquid chromatography tandem mass spectrometry method. Non-linear mixed-effect modelling was used to assess PK parameters. Key findings: Data from 11 children (1.7–15.6 years, weight 10.7–67.4 kg) were best described by a two-compartment model for R(+), S(−) and racemic ketorolac. Only weight (WT) significantly improved the goodness of fit. The final population models were CL = 1.5 × (WT/46)0.75, V1 = 8.2 × (WT/46), Q = 3.4 × (WT/46)0.75, V2 = 7.9 × (WT/46), CL = 2.98 × (WT/46), V1 = 13.2 × (WT/46), Q = 2.8 × (WT/46)0.75, V2 = 51.5 × (WT/46), and CL = 1.1 × (WT/46)0.75, V1 = 4.9 × (WT/46), Q = 1.7 × (WT/46)0.75 and V2 = 6.3 × (WT/46)for R(+), S(−) and racemic ketorolac. Conclusions: Only body weight influenced the PK parameters for R(+) and S(−) ketorolac. Using allometric size scaling significantly affected the clearances (CL, Q) and volumes of distribution (V1, V2).

Reductions of peak-to-average power ratio and optical beat interference in cost-effective OFDMA-PONs

The peak-to-average power ratio (PAPR) and optical beat interference (OBI) effects are examined thoroughly in orthogonal frequency-division multiplexing access (OFDMA)-passive optical networks (PONs) at a signal bit rate up to ∼ 20 Gb/s per channel using cost-effective intensity-modulation and direct-detection (IM/DD). Single-channel OOFDM and upstream multichannel OFDM-PONs are investigated for up to six users. A number of techniques for mitigating the PAPR and OBI effects are presented and evaluated including adaptive-loading algorithms such as bit/power-loading, clipping for PAPR reduction, and thermal detuning (TD) for the OBI suppression. It is shown that the bit-loading algorithm is a very efficient PAPR reduction technique by reducing it at about 1.2 dB over 100 Km of transmission. It is also revealed that the optimum method for suppressing the OBI is the TD + bit-loading. For a targeted BER of 1 × 10-3, the minimum allowed channel spacing is 11 GHz when employing six users. © 2013 Springer Science+Business Media New York.

A szolgáltatások ellátási láncának speciális menedzsmentjellemzői (Management specialties of supply chain of services)

Az elmúlt évtizedekben a gazdálkodástudomány kitüntetett figyelemmel kísért két – mind a makrogazdaság, mind az egyes vállalatok működésének sikere szempontjából meghatározó fontosságú – jelenséget, egyrészt a szolgáltatásoknak a hagyományos termeléssel szembeni egyre erőteljesebb térnyerését, másrészt a fogyasztói érték teremtése szempontjából növekvő jelentőségű ellátási láncoknak, illetve azok menedzsmentjének kérdéskörét. Ugyanakkor igen kevés elemzés, de kevés leíró jellegű munka is született a két jelenséget és menedzsmentproblémát összekapcsoló területről, azaz a szolgáltatások ellátási láncáról, ezen ellátási láncok kezelésének speciális problémáiról. A szerzők cikkükben a szolgáltatások ellátási láncának és menedzsmentjének jellegzetességeit, a klasszikus terméket előállító ellátási láncokhoz viszonyított sajátosságait foglalják össze a nemzetközi szakirodalom alapján. Ennek során bemutatják, hogy az ún. tiszta szolgáltatások széles körben ismert jellemzői hatással vannak a szolgáltatások előállítását és értékesítését végző ellátási láncok működésére is. Ezek a hatások és specialitások megjelennek az ellátásilánc-menedzsment irodalmában kiemelten tárgyalt mindhárom problémakörben, rányomják tehát bélyegüket mind az ellátási lánc felépítésére, mind az ellátási láncban együttműködő partnerek kapcsolatának kezelésére és végül, de nem utolsósorban az ellátásilánc-menedzsment folyamatok kezelésére. _________ In the last decades scholars have paid a lot of attention to both service operation and supply chain management. There is still limited research on the overlapping field of theses two management areas, on service supply chain specialties. This article gives a structured overview on the latest research results on this topic. Doing so the paper would like to draw attention of the Hungarian researchers to this field and facilitate these empirical researches. As described in the paper traditional service specialties (intangibility, perishability, inseparability, heterogeneity and the importance of human capital) create special management problems concerning (i) the structure of these supply chains, (ii) their relationship management and (iii) the management of supply chain processes.

Patterns of diagnostic comorbidity in children and adolescents with anxiety

Comorbidity is defined as the co-occurrence of two or more psychological disorders and has been identified as one of the most pressing issues facing child psychologists today. Unfortunately, research on comorbidity in anxious children is rare. The purpose of this research was to examine how specific comorbid patterns in children and adolescents referred with anxiety disorders affected clinical presentation. In addition, the effects of gender, age and total number of diagnoses were also examined.^ Three hundred fifty-five children and adolescents (145 girls and 210 boys, hereafter referred to as "children") aged 6 to 17 who presented to the Child Anxiety and Phobia Program during the years 1987 through 1996 were assessed through a structured clinical interview administered to both the children and their families. Based on information from both children and parents, children were assigned up to five DSM diagnoses. Global ratings of severity were also obtained. While children were interviewed, parents completed a number of questionnaires pertaining to their child's overall functioning, anxiety, thoughts and behaviors. Similarly, while parents were interviewed, children completed a number of self-report questionnaires concerning their own thoughts, feelings and behaviors.^ In general, children with only anxiety disorders were rated as severe as children who met criteria for both anxiety and externalizing disorders. Children with both anxiety and externalizing disorders were mostly young (i.e. age 6 through 11) and mostly male. These children tended to rate themselves (and be rated by their parents) equally as anxious as children with only anxiety disorders. Global ratings of severity tended to be associated with the type of comorbid pattern versus the number of diagnoses assigned to a child. The theoretical, development and clinical implications of these findings will be discussed. ^

The effects of a family-based educational intervention on the prevention of lead poisoning in children

The effects of lead exposure may endure through one's lifetime and can negatively effect educational performance. While the link between the cause and effects of lead poisoning has been identified, the application of lead health education as the mechanism of disease prevention has not. The purpose of this study was to examine whether caregiver participation in a family-based educational intervention can result in decreased lead exposure in low socioeconomic children. ^ Participants (n = 50) were caregivers of children 12 to 36 months of age. They were randomly selected from an urban clinic and randomly assigned to either a treatment or control group. The experimental design of this study involved two clinic visits. Parents in the treatment group were given the educational intervention during the first clinic visit while those in the control group were given the intervention during the second clinic visit. The intervention was reinforced with a lead education brochure coupled with a video on childhood lead poisoning. One instrument was used to test parental knowledge of lead poisoning both pre- and post-intervention. Blood lead levels in pediatric participants were tested using two blood lead screens approximately three to four months apart determined by well-child check-up schedules. ^ Findings from the analysis of variance showed the interaction between the change in blood lead level between the children's first and second clinic visits and the treatment level. This demonstrated a significant interaction between the differences of first and second clinic visits blood lead levels and the presence or absence of the educational intervention. ^ The findings from an analysis of covariance support that caregivers in the treatment group have significantly higher scores on the second clinic visit scores on the CLKT than the caregivers in the control group. These data suggest that the educational treatment is effective in increasing the knowledge of caregivers about the dangers of lead poisoning and the strategies for lead poisoning prevention. ^ Conclusions indicate that the education of adult caregivers can affect blood lead levels of children, the educational treatment increased the knowledge of caregivers, caregivers were able to carry out procedures taught, and caregivers retained knowledge over time. ^