DESIGN AND IMPLEMENTATION OF HOME USE PORTABLE SMART ELECTRONICS

The widespread of low cost embedded electronics makes it easier to implement the smart devices that can understand either the environment or the user behaviors. The main object of this project is to design and implement home use portable smart electronics, including the portable monitoring device for home and office security and the portable 3D mouse for convenient use. Both devices in this project use the MPU6050 which contains a 3 axis accelerometer and a 3 axis gyroscope to sense the inertial motion of the door or the human hands movement. For the portable monitoring device for home and office security, MPU6050 is used to sense the door (either home front door or cabinet door) movement through the gyroscope, and Raspberry Pi is then used to process the data it receives from MPU6050, if the data value exceeds the preset threshold, Raspberry Pi would control the USB Webcam to take a picture and then send out an alert email with the picture to the user. The advantage of this device is that it is a small size portable stand-alone device with its own power source, it is easy to implement, really cheap for residential use, and energy efficient with instantaneous alert. For the 3D mouse, the MPU6050 would use both the accelerometer and gyroscope to sense user hands movement, the data are processed by MSP430G2553 through a digital smooth filter and a complementary filter, and then the filtered data will pass to the personal computer through the serial COM port. By applying the cursor movement equation in the PC driver, this device can work great as a mouse with acceptable accuracy. Compared to the normal optical mouse we are using, this mouse does not need any working surface, with the use of the smooth and complementary filter, it has certain accuracy for normal use, and it is easy to be extended to a portable mouse as small as a finger ring.

Cold-Start Emissions testing of Snowmobiles Using Ethanol and Gasoline

Increasing prices for fuel with depletion and instability in foreign oil imports has driven the importance for using alternative and renewable fuels. The alternative fuels such as ethanol, methanol, butyl alcohol, and natural gas are of interest to be used to relieve some of the dependence on oil for transportation. The renewable fuel, ethanol which is made from the sugars of corn, has been used widely in fuel for vehicles in the United States because of its unique qualities. As with any renewable fuel, ethanol has many advantages but also has disadvantages. Cold startability of engines is one area of concern when using ethanol blended fuel. This research was focused on the cold startability of snowmobiles at ambient temperatures of 20 °F, 0 °F, and -20 °F. The tests were performed in a modified 48 foot refrigerated trailer which was retrofitted for the purpose of cold-start tests. Pure gasoline (E0) was used as a baseline test. A splash blended ethanol and gasoline mixture (E15, 15% ethanol and 85% gasoline by volume) was then tested and compared to the E0 fuel. Four different types of snowmobiles were used for the testing including a Yamaha FX Nytro RTX four-stroke, Ski-doo MX Z TNT 600 E-TEC direct injected two stroke, Polaris 800 Rush semi-direct injected two-stroke, and an Arctic Cat F570 carbureted two-stroke. All of the snowmobiles operate on open loop systems which means there was no compensation for the change in fuel properties. Emissions were sampled using a Sensors Inc. Semtech DS five gas emissions analyzer and engine data was recoded using AIM Racing Data Power EVO3 Pro and EVO4 systems. The recorded raw exhaust emissions included carbon monoxide (CO), carbon dioxide (CO2), total hydrocarbons (THC), and oxygen (O2). To help explain the trends in the emissions data, engine parameters were also recorded. The EVO equipment was installed on each vehicle to record the following parameters: engine speed, exhaust gas temperature, head temperature, coolant temperature, and test cell air temperature. At least three consistent tests to ensure repeatability were taken at each fuel and temperature combination so a total of 18 valid tests were taken on each snowmobile. The snowmobiles were run at operating temperature to clear any excess fuel in the engine crankcase before each cold-start test. The trends from switching from E0 to E15 were different for each snowmobile as they all employ different engine technologies. The Yamaha snowmobile (four-stroke EFI) achieved higher levels of CO2 with lower CO and THC emissions on E15. Engine speeds were fairly consistent between fuels but the average engine speeds were increased as the temperatures decreased. The average exhaust gas temperature increased from 1.3-1.8% for the E15 compared to E0 due to enleanment. For the Ski-doo snowmobile (direct injected two-stroke) only slight differences were noted when switching from E0 to E15. This could possibly be due to the lean of stoichiometric operation of the engine at idle. The CO2 emissions decreased slightly at 20 °F and 0 °F for E15 fuel with a small difference at -20 °F. Almost no change in CO or THC emissions was noted for all temperatures. The only significant difference in the engine data observed was the exhaust gas temperature which decreased with E15. The Polaris snowmobile (semi-direct injected two-stroke) had similar raw exhaust emissions for each of the two fuels. This was probably due to changing a resistor when using E15 which changed the fuel map for an ethanol mixture (E10 vs. E0). This snowmobile operates at a rich condition which caused the engine to emit higher values of CO than CO2 along with exceeding the THC analyzer range at idle. The engine parameters and emissions did not increase or decrease significantly with decreasing temperature. The average idle engine speed did increase as the ambient temperature decreased. The Arctic Cat snowmobile (carbureted two-stroke) was equipped with a choke lever to assist cold-starts. The choke was operated in the same manor for both fuels. Lower levels of CO emissions with E15 fuel were observed yet the THC emissions exceeded the analyzer range. The engine had a slightly lower speed with E15.

The effects of excluding patients from the analysis in randomised controlled trials: meta-epidemiological study

OBJECTIVE: To examine whether excluding patients from the analysis of randomised trials are associated with biased estimates of treatment effects and higher heterogeneity between trials. DESIGN: Meta-epidemiological study based on a collection of meta-analyses of randomised trials. DATA SOURCES: 14 meta-analyses including 167 trials that compared therapeutic interventions with placebo or non-intervention control in patients with osteoarthritis of the hip or knee and used patient reported pain as an outcome. METHODS: Effect sizes were calculated from differences in means of pain intensity between groups at the end of follow-up, divided by the pooled standard deviation. Trials were combined by using random effects meta-analysis. Estimates of treatment effects were compared between trials with and trials without exclusions from the analysis, and the impact of restricting meta-analyses to trials without exclusions was assessed. RESULTS: 39 trials (23%) had included all patients in the analysis. In 128 trials (77%) some patients were excluded from the analysis. Effect sizes from trials with exclusions tended to be more beneficial than those from trials without exclusions (difference -0.13, 95% confidence interval -0.29 to 0.04). However, estimates of bias between individual meta-analyses varied considerably (tau(2)=0.07). Tests of interaction between exclusions from the analysis and estimates of treatment effects were positive in five meta-analyses. Stratified analyses indicated that differences in effect sizes between trials with and trials without exclusions were more pronounced in meta-analyses with high between trial heterogeneity, in meta-analyses with large estimated treatment benefits, and in meta-analyses of complementary medicine. Restriction of meta-analyses to trials without exclusions resulted in smaller estimated treatment benefits, larger P values, and considerable decreases in between trial heterogeneity. CONCLUSION: Excluding patients from the analysis in randomised trials often results in biased estimates of treatment effects, but the extent and direction of bias is unpredictable. Results from intention to treat analyses should always be described in reports of randomised trials. In systematic reviews, the influence of exclusions from the analysis on estimated treatment effects should routinely be assessed.

The association between beliefs about low back pain and work presenteeism

OBJECTIVE: To examine the influence of beliefs about low back pain (LBP) on reduced productivity at work ("presenteeism") caused by LBP. METHODS: Two thousand five hundred seven individuals completed the Back Beliefs Questionnaire, the Fear Avoidance Beliefs questionnaire (FABQ), and questions about LBP-related work-absence, reduced work-productivity, pain, comorbidity, and demographics. RESULTS: Six hundred seventy (25%) individuals were of working age, employed and reported current LBP. Univariate models showed beliefs were more "negative" in individuals with work-absence and reduced productivity (P = 0.0001). In multivariable analysis, controlling for confounders, "FABQwork" was a unique predictor of both absenteeism and presenteeism (each, P = 0.0001), though with small effect sizes. CONCLUSIONS: Negative beliefs about LBP are associated with both work absence and reduced work-productivity. Further investigations should examine their potential as a target for educational interventions when considering initiatives to reduce the socioeconomic costs of LBP.

Personal experience with whole-body, low-dosage, digital X-ray scanning (LODOX-Statscan) in trauma

BACKGROUND: Lodox-Statscan is a whole-body, skeletal and soft-tissue, low-dose X-ray scanner Anterior-posterior and lateral thoraco-abdominal studies are obtained in 3-5 minutes with only about one-third of the radiation required for conventional radiography. Since its approval by the Food and Drug Administration (FDA) in the USA, several trauma centers have incorporated this technology into their Advanced Trauma Life Support protocols. This review provides a brief overview of the system, and describes the authors' own experience with the system. METHODS: We performed a PubMed search to retrieve all references with 'Lodox' and 'Stat-scan' used as search terms. We furthermore used the google search engine to identify existing alternatives. To the best of our knowledge, this is the only FDA-approved device of its kind currently used in trauma. RESULTS AND CONCLUSION: The intention of our review has been to sensitize the readership that such alternative devices exist. The key message is that low dosage full body radiography may be an alternative to conventional resuscitation room radiography which is usually a prelude to CT scanning (ATLS algorithm). The combination of both is radiation intensive and therefore we consider any reduction of radiation a success. But only the future will show whether LS will survive in the face of low-dose radiation CT scanners and magnetic resonance imaging devices that may eventually completely replace conventional radiography.

Intravaginal and intracervical application of seminal plasma in in vitro fertilization or intracytoplasmic sperm injection treatment cycles--a double-blind, placebo-controlled, randomized pilot study

OBJECTIVE: To evaluate whether intravaginal application of seminal plasma at the time of follicle aspiration in IVF or intracytoplasmic sperm injection treatment cycles has the potential to increase pregnancy rate. To calculate the number of patients needed to achieve significance in a multicenter trial. DESIGN: Double-blind, placebo-controlled randomized pilot study. SETTING: University department of gynecological endocrinology and reproductive medicine. PATIENT(S): One hundred sixty-eight patients undergoing IVF or intracytoplasmic sperm injection treatment. INTERVENTION(S): Cryopreserved seminal plasma from the patient's partner or sodium chloride (placebo) was injected into the cervix and the posterior fornix of the vagina just after follicle aspiration. MAIN OUTCOME MEASURE(S): Clinical-pregnancy rate. RESULT(S): One hundred sixty-eight patients agreed to participate in the study. Participation was limited to one treatment cycle. Thirty-one patients (18%) were excluded from the study, mainly as a result of canceled embryo transfers. Seventy patients received placebo, and 67 received seminal plasma. The clinical-pregnancy rate was 25.7% (18/70) in the placebo group. The clinical-pregnancy rate in the seminal plasma group reached 37.3% (25/67), corresponding to a relative increase of 45%. CONCLUSION(S): Even though significance was not reached in this pilot study, the data suggest that seminal plasma has the potential to improve pregnancy rate. It is estimated that around 450 patients need to be recruited to reach significance in a multicenter study.

Mutation screening of the medium-chain acyl-CoA dehydrogenase (MCAD) and the ornithine transcarbamylase (OTC) genes by multiplex PCR amplification and sequencing

BACKGROUND: Sequencing based mutation screening assays of genes encompassing large numbers of exons could be substantially optimized by multiplex PCR, which enables simultaneous amplification of many targets in one reaction. In the present study, a multiplex PCR protocol originally developed for fragment analysis was evaluated for sequencing based mutation screening of the ornithine transcarbamylase (OTC) and the medium-chain acyl-CoA dehydrogenase (MCAD) genes. METHODS: Single exon and multiplex PCR protocols were applied to generate PCR templates for subsequent DNA sequencing of all exons of the OTC and the MCAD genes. For each PCR protocol and using the same DNA samples, 66 OTC and 98 MCAD sequence reads were generated. The sequences derived from the two different PCR methods were compared at the level of individual signal-to-noise ratios of the four bases and the proportion of high-quality base-signals. RESULTS: The single exon and the multiplex PCR protocol gave qualitatively comparable results for the two genes. CONCLUSIONS: Many existing sequencing based mutation analysis protocols may be easily optimized with the proposed method, since the multiplex PCR protocol was successfully applied without any re-design of the PCR primers and other optimization steps for generating sequencing templates for the OTC and MCAD genes, respectively.

René Sand (1877-1953) and His Contribution to International Social Work, IASSW-President 1946 – 1953

The extraordinary significance of the life and work of René Sand lies in his central position as a mediator, promoter and coordinator of social work on an increasingly international level during the interwar-period and it can hardly be overestimated. To approach the achievements of Sand’s life and work you have to work archaeologically as he does not seem to have left any traces in the literature on social history. In Germany, even within the field of social work his name is hardly known. His biographical sketch and his importance for the development of the profession of social work have fallen into oblivion. The situation is a little different in the French-speaking countries where a biography has been published (compare Anciaux 1988a, b, c) which contains a detailed record of Sand’s writings. Altogether this lack of interest is regrettable because it doesn’t consider that René Sand is exemplary and in some parts fundamental to the emergence of professional social work in the 1920s in Belgium and Europe. Professional social work was established by a consequent international orientation and an emancipation from neighbouring fields such as social medicine and hygiene. Therefore it is a rewarding task to draw attention to this pioneer of social work and make the public appreciate his work. I want to emphasize explicitly that in this portrait Sand’s achievements concerning social work will be the main focus, even if this is an inevitable reduction of his accomplishments in the field of medicine and social medicine.

Effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections: observational study, systematic reviews and mathematical modelling

BACKGROUND Partner notification is essential to the comprehensive case management of sexually transmitted infections. Systematic reviews and mathematical modelling can be used to synthesise information about the effects of new interventions to enhance the outcomes of partner notification. OBJECTIVE To study the effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections (STIs). DESIGN Secondary data analysis of clinical audit data; systematic reviews of randomised controlled trials (MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials) published from 1 January 1966 to 31 August 2012 and of studies of health-related quality of life (HRQL) [MEDLINE, EMBASE, ISI Web of Knowledge, NHS Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA)] published from 1 January 1980 to 31 December 2011; static models of clinical effectiveness and cost-effectiveness; and dynamic modelling studies to improve parameter estimation and examine effectiveness. SETTING General population and genitourinary medicine clinic attenders. PARTICIPANTS Heterosexual women and men. INTERVENTIONS Traditional partner notification by patient or provider referral, and new partner notification by expedited partner therapy (EPT) or its UK equivalent, accelerated partner therapy (APT). MAIN OUTCOME MEASURES Population prevalence; index case reinfection; and partners treated per index case. RESULTS Enhanced partner therapy reduced reinfection in index cases with curable STIs more than simple patient referral [risk ratio (RR) 0.71; 95% confidence interval (CI) 0.56 to 0.89]. There are no randomised trials of APT. The median number of partners treated for chlamydia per index case in UK clinics was 0.60. The number of partners needed to treat to interrupt transmission of chlamydia was lower for casual than for regular partners. In dynamic model simulations, > 10% of partners are chlamydia positive with look-back periods of up to 18 months. In the presence of a chlamydia screening programme that reduces population prevalence, treatment of current partners achieves most of the additional reduction in prevalence attributable to partner notification. Dynamic model simulations show that cotesting and treatment for chlamydia and gonorrhoea reduce the prevalence of both STIs. APT has a limited additional effect on prevalence but reduces the rate of index case reinfection. Published quality-adjusted life-year (QALY) weights were of insufficient quality to be used in a cost-effectiveness study of partner notification in this project. Using an intermediate outcome of cost per infection diagnosed, doubling the efficacy of partner notification from 0.4 to 0.8 partners treated per index case was more cost-effective than increasing chlamydia screening coverage. CONCLUSIONS There is evidence to support the improved clinical effectiveness of EPT in reducing index case reinfection. In a general heterosexual population, partner notification identifies new infected cases but the impact on chlamydia prevalence is limited. Partner notification to notify casual partners might have a greater impact than for regular partners in genitourinary clinic populations. Recommendations for future research are (1) to conduct randomised controlled trials using biological outcomes of the effectiveness of APT and of methods to increase testing for human immunodeficiency virus (HIV) and STIs after APT; (2) collection of HRQL data should be a priority to determine QALYs associated with the sequelae of curable STIs; and (3) standardised parameter sets for curable STIs should be developed for mathematical models of STI transmission that are used for policy-making. FUNDING The National Institute for Health Research Health Technology Assessment programme.

In vitro and in vivo activities of dicationic diguanidino compounds against Echinococcus multilocularis metacestodes.

Alveolar echinococcosis (AE) is a disease predominantly affecting the liver, with metacestodes (larvae) of the tapeworm Echinococcus multilocularis proliferating and exhibiting tumor-like infiltrative growth. For many years, chemotherapeutical treatment against alveolar echinococcosis has relied on the benzimidazoles albendazole and mebendazole, which require long treatment durations and exhibit parasitostatic rather than parasiticidal efficacy. Although benzimidazoles have been and still are beneficial for the patients, there is clearly a demand for alternative and more efficient treatment options. Aromatic dications, more precisely a small panel of di-N-aryl-diguanidino compounds, were screened for efficacy against E. multilocularis metacestodes in vitro. Only those with a thiophene core group were active against metacestodes, while furans were not. The most active compound, DB1127, was further investigated in terms of in vivo efficacy in mice experimentally infected with E. multilocularis metacestodes. This diguanidino compound was effective against AE when administered intraperitoneally but not when applied orally. Thus, thiophene-diguanidino derivatives with improved bioavailability when administered orally could lead to treatment options against AE.

The Houston Academy of Medicine--Texas Medical Center Library management information system.

A management information system (MIS) provides a means for collecting, reporting, and analyzing data from all segments of an organization. Such systems are common in business but rare in libraries. The Houston Academy of Medicine-Texas Medical Center Library developed an MIS that operates on a system of networked IBM PCs and Paradox, a commercial database software package. The data collected in the system include monthly reports, client profile information, and data collected at the time of service requests. The MIS assists with enforcement of library policies, ensures that correct information is recorded, and provides reports for library managers. It also can be used to help answer a variety of ad hoc questions. Future plans call for the development of an MIS that could be adapted to other libraries' needs, and a decision-support interface that would facilitate access to the data contained in the MIS databases.

CHARACTERIZING, ASSESSING AND IMPROVING HEALTHCARE REFERRAL COMMUNICATION

Similar to other health care processes, referrals are susceptible to breakdowns. These breakdowns in the referral process can lead to poor continuity of care, slow diagnostic processes, delays and repetition of tests, patient and provider dissatisfaction, and can lead to a loss of confidence in providers. These facts and the necessity for a deeper understanding of referrals in healthcare served as the motivation to conduct a comprehensive study of referrals. The research began with the real problem and need to understand referral communication as a mean to improve patient care. Despite previous efforts to explain referrals and the dynamics and interrelations of the variables that influence referrals there is not a common, contemporary, and accepted definition of what a referral is in the health care context. The research agenda was guided by the need to explore referrals as an abstract concept by: 1) developing a conceptual definition of referrals, and 2) developing a model of referrals, to finally propose a 3) comprehensive research framework. This dissertation has resulted in a standard conceptual definition of referrals and a model of referrals. In addition a mixed-method framework to evaluate referrals was proposed, and finally a data driven model was developed to predict whether a referral would be approved or denied by a specialty service. The three manuscripts included in this dissertation present the basis for studying and assessing referrals using a common framework that should allow an easier comparative research agenda to improve referrals taking into account the context where referrals occur.

Towards a Hybrid Method to Categorize Interruptions and Activities in Healthcare

Objective Interruptions are known to have a negative impact on activity performance. Understanding how an interruption contributes to human error is limited because there is not a standard method for analyzing and classifying interruptions. Qualitative data are typically analyzed by either a deductive or an inductive method. Both methods have limitations. In this paper a hybrid method was developed that integrates deductive and inductive methods for the categorization of activities and interruptions recorded during an ethnographic study of physicians and registered nurses in a Level One Trauma Center. Understanding the effects of interruptions is important for designing and evaluating informatics tools in particular and for improving healthcare quality and patient safety in general. Method The hybrid method was developed using a deductive a priori classification framework with the provision of adding new categories discovered inductively in the data. The inductive process utilized line-by-line coding and constant comparison as stated in Grounded Theory. Results The categories of activities and interruptions were organized into a three-tiered hierarchy of activity. Validity and reliability of the categories were tested by categorizing a medical error case external to the study. No new categories of interruptions were identified during analysis of the medical error case. Conclusions Findings from this study provide evidence that the hybrid model of categorization is more complete than either a deductive or an inductive method alone. The hybrid method developed in this study provides the methodical support for understanding, analyzing, and managing interruptions and workflow.

New library buildings: the Houston Academy of Medicine--Texas Medical Center Library.

A historical account is given of the Houston Academy of Medicine--Texas Medical Center Library within its Texas Medical Center setting in Houston, Texas. Outlined are planning, financing, and construction of the new library, which consists in part of new building and in part of renovated interiors of an old building originally completed in 1954. A concise picture is given of the new library's interiors, showing its functional success for users and employees alike. An architectural summary is appended showing gross and net footages, source of funds, costs and capacities.