Psychological therapies for chronic pelvic pain:systematic review of randomized controlled trials

Chronic pelvic pain (CPP), a common cause of disability in women, is a condition best viewed in the biopsychosocial framework. Psychological interventions are frequently considered alongside medical and surgical treatments. Our objective was to evaluate the effectiveness of psychological therapies for the treatment of CPP. Electronic literature searches were conducted in Medline, Embase, PsycInfo and DARE databases from database inception to April 2010. Reference lists of selected articles were searched for further articles. The studies selected were randomized controlled trials of psychological therapies in patients with CPP compared with no treatment, standard gynecological treatment or another form of psychological therapy. Two reviewers independently selected articles without language restrictions and extracted data covering study characteristics, study quality and results. Reduction in pain, measured using visual analog scales or other measurements, was the main outcome measure. Of the 107 citations identified, four studies satisfied the inclusion criteria. Compared with no psychological intervention, therapy produced a standardized mean pain score of -3.27 [95% confidence interval (CI) -4.52 to -2.02] and 1.11 (95% CI -0.05 to 2.27) at 3 months and -3.95 (95% CI -5.35 to -2.55) and 0.54 (95% CI -0.78 to 1.86) at 6 months and greater, based on a visual analog scale score of 0-10. The current evidence does not allow us to conclude whether psychological interventions have an effect on self-reported pain scores in women with CPP.

The source, cost and prevention of central venous catheter-related infection

Central venous catheters have become an integral part of patient management however they are associated with many complications including infection. Despite efforts being made to reduce the incidence of such infect ions the problem continues to increase and has resource implications for the Health Service. Studies relating to the source of microorganisms causing CVC-associated infection, the cost of such infections and the efficacy of an antimicrobial catheter have been undertaken. Thirty patients who required a CVC as part of their medical management and underwent cardiac surgery had the distal tips of their catheters sampled whilst in situ. Sampling took place within 1 h of catheter placement. Bacteria were isolated from 16% of the catheter distal tips sampled in situ. The guidewires used to insert the devices were also contaminated (50%). When CVC were inserted via a protective sheath, avoiding contact with the skin. the incidence of microbial contamination was reduced. These findings suggest that despite rigorous skin disinfection and strict aseptic technique, viable microorganisms are impacted onto the distal tip of CVC during the insertion procedure. Needleless intravascular access devices have been introduced in order to reduce the incidence of need1estick injury. However, it was unclear whether such connectors would act as a portal of entry for microorganisms to CVC. The efficacy of these devices was investigated. Within the controlled laboratory environment it was demonstrated that needleless devices, when challenged with microorganisms, did not allow the passage of microbes when flu id was injected. This therefore suggested that the devices should not increase the risk of catheter colonisation. When used in clinical practice however microbial contamination of the needleless connectors was 55 % in comparison to the routinely used luer connectors (23%). The cost of infections associated with CVC was determined. Twenty patients catheterised with a CVC designed for long term use who were admitted to hospital with a presumptive diagnosis of catheter-related infection were studied. The treatment given specifically for this infection was costed. The mean cost of such an infection was £ 1781.81. Throughout the UK this may amount to £1.565.906 per annum. The cost of infections associated with CVC designed for short term use was estimated to be between 5 and 7 million pounds per annum in the UK. In an attempt to reduce both the incidence and cost of catheter- related infection antimicrobial CVC have been developed. The efficacy of a novel polyurethane CVC impregnated on both the internal and external catheter surface with the quaternary ammonium compound benzalkonium chloride was investigated. Eighty eight patients received an antimicrobial catheter and 78 patients a conventional polyurethane CVC. The anti-microbial CVC resulted in a reduction in microbial colonisation of the external and internal polymer surfaces as compared to the control device. The observed reduction in microbial colonisation with the anti-microbial CVC may decrease the likelihood of subsequent infection offering a useful approach to the prevention of catheter-related infections.

The prediction and control of transients in thyristor values

This thesis describes an investigation of methods by which both repetitive and non-repetitive electrical transients in an HVDC converter station may be controlled for minimum overall cost. Several methods of inrush control are proposed and studied. The preferred method, whose development is reported in this thesis, would utilize two magnetic materials, one of which is assumed to be lossless and the other has controlled eddy-current losses. Mathematical studies are performed to assess the optimum characteristics of these materials, such that inrush current is suitably controlled for a minimum saturation flux requirement. Subsequent evaluation of the cost of hardware and capitalized losses of the proposed inrush control, indicate that a cost reduction of approximately 50% is achieved, in comparison with the inrush control hardware for the Sellindge converter station. Further mathematical studies are carried out to prove the adequacy of the proposed inrush control characteristics for controlling voltage and current transients during both repetitive and non-repetitive operating conditions. The results of these proving studies indicate that no change in the proposed characteristics is required to ensure that integrity of the thyristors is maintained.

Trigger release liposome systems:local and remote controlled delivery?

Target-specific delivery has become an integral area of research in order to increase bioavailability and reduce the toxic effects of drugs. As a drug-delivery option, trigger-release liposomes offer sophisticated targeting and greater control-release capabilities. These are broadly divided into two categories; those that utilise the local environment of the target site where there may be an upregulation in certain enzymes or a change in pH and those liposomes that are triggered by an external physical stimulus such as heat, ultrasound or light. These release mechanisms offer a greater degree of control over when and where the drug is released; furthermore, targeting of diseased tissue is enhanced by incorporation of target-specific components such as antibodies. This review aims to show the development of such trigger release liposome systems and the current research in this field.

Current understanding of the mechanisms for clearance of apoptotic cells-a fine balance

Apoptosis is an important cell death mechanism by which multicellular organisms remove unwanted cells. It culminates in a rapid, controlled removal of cell corpses by neighboring or recruited viable cells. Whilst many of the molecular mechanisms that mediate corpse clearance are components of the innate immune system, clearance of apoptotic cells is an anti-inflammatory process. Control of cell death is dependent on competing pro-apoptotic and anti-apoptotic signals. Evidence now suggests a similar balance of competing signals is central to the effective removal of cells, through so called 'eat me' and 'don't eat me' signals. Competing signals are also important for the controlled recruitment of phagocytes to sites of cell death. Consequently recruitment of phagocytes to and from sites of cell death can underlie the resolution or inappropriate propagation of cell death and inflammation. This article highlights our understanding of mechanisms mediating clearance of dying cells and discusses those mechanisms controlling phagocyte migration and how inappropriate control may promote important pathologies. © the authors, publisher and licensee libertas academica limited.

Control of second-life hybrid battery energy storage system based on modular boost-multilevel buck converter

To fully utilize second-life batteries on the grid system, a hybrid battery scheme needs to be considered for several reasons: the uncertainty over using a single source supply chain for second-life batteries, the differences in evolving battery chemistry and battery configuration by different suppliers to strive for greater power levels, and the uncertainty of degradation within a second-life battery. Therefore, these hybrid battery systems could have widely different module voltage, capacity, and initial state of charge and state of health. In order to suitably integrate and control these widely different batteries, a suitable multimodular converter topology and an associated control structure are required. This paper addresses these issues proposing a modular boost-multilevel buck converter based topology to integrate these hybrid second-life batteries to a grid-tie inverter. Thereafter, a suitable module-based distributed control architecture is introduced to independently utilize each converter module according to its characteristics. The proposed converter and control architecture are found to be flexible enough to integrate widely different batteries to an inverter dc link. Modeling, analysis, and experimental validation are performed on a single-phase modular hybrid battery energy storage system prototype to understand the operation of the control strategy with different hybrid battery configurations.

Analysis and improvement of performance in LCL filter-based PWM rectifier/inverter application using hybrid damping approach

A hybrid passive-active damping solution with improved system stability margin and enhanced dynamic performance is proposed for high power grid interactive converters. In grid connected active rectifier/inverter application, line side LCL filter improves the high frequency attenuation and makes the converter compatible with the stringent grid power quality regulations. Passive damping though offers a simple and reliable solution but it reduces overall converter efficiency. Active damping solutions do not increase the system losses but can guarantee the stable operation up to a certain speed of dynamic response which is limited by the maximum bandwidth of the current controller. This paper examines this limit and introduces a concept of hybrid passive-active damping solution with improved stability margin and high dynamic performance for line side LCL filter based active rectifier/inverter applications. A detailed design, analysis of the hybrid approach and trade-off between system losses and dynamic performance in grid connected applications are reported. Simulation and experimental results from a 10 kVA prototype demonstrate the effectiveness of the proposed solution. An analytical study on system stability and dynamic response with the variations of various controller and passive filter parameters is presented.

Identification of key temperature measurement technologies for the enhancement of product and equipment integrity in the light controlled factory

Thermal effects in uncontrolled factory environments are often the largest source of uncertainty in large volume dimensional metrology. As the standard temperature for metrology of 20°C cannot be achieved practically or economically in many manufacturing facilities, the characterisation and modelling of temperature offers a solution for improving the uncertainty of dimensional measurement and quantifying thermal variability in large assemblies. Technologies that currently exist for temperature measurement in the range of 0-50°C have been presented alongside discussion of these temperature measurement technologies' usefulness for monitoring temperatures in a manufacturing context. Particular aspects of production where the technology could play a role are highlighted as well as practical considerations for deployment. Contact sensors such as platinum resistance thermometers can produce accuracy closest to the desired accuracy given the most challenging measurement conditions calculated to be ∼0.02°C. Non-contact solutions would be most practical in the light controlled factory (LCF) and semi-invasive appear least useful but all technologies can play some role during the initial development of thermal variability models.

Control of cascaded DC-DC converter based hybrid battery energy storage systems - Part II:Lyapunov approach

A cascaded DC-DC boost converter is one of the ways to integrate hybrid battery types within a grid-tie inverter. Due to the presence of different battery parameters within the system such as, state-of-charge and/or capacity, a module based distributed power sharing strategy may be used. To implement this sharing strategy, the desired control reference for each module voltage/current control loop needs to be dynamically varied according to these battery parameters. This can cause stability problem within the cascaded converters due to relative battery parameter variations when using the conventional PI control approach. This paper proposes a new control method based on Lyapunov Functions to eliminate this issue. The proposed solution provides a global asymptotic stability at a module level avoiding any instability issue due to parameter variations. A detailed analysis and design of the nonlinear control structure are presented under the distributed sharing control. At last thorough experimental investigations are shown to prove the effectiveness of the proposed control under grid-tie conditions.

Crowdsourcing, citizen science or volunteered geographic information? The current state of crowdsourced geographic information

Citizens are increasingly becoming an important source of geographic information, sometimes entering domains that had until recently been the exclusive realm of authoritative agencies. This activity has a very diverse character as it can, amongst other things, be active or passive, involve spatial or aspatial data and the data provided can be variable in terms of key attributes such as format, description and quality. Unsurprisingly, therefore, there are a variety of terms used to describe data arising from citizens. In this article, the expressions used to describe citizen sensing of geographic information are reviewed and their use over time explored, prior to categorizing them and highlighting key issues in the current state of the subject. The latter involved a review of 100 Internet sites with particular focus on their thematic topic, the nature of the data and issues such as incentives for contributors. This review suggests that most sites involve active rather than passive contribution, with citizens typically motivated by the desire to aid a worthy cause, often receiving little training. As such, this article provides a snapshot of the role of citizens in crowdsourcing geographic information and a guide to the current status of this rapidly emerging and evolving subject.

High frequency inverter topologies integrated with the coupled inductor bridge arm

A new topology of the high frequency alternating current (HFAC) inverter bridge arm is proposed which comprises a coupled inductor, a switching device and an active clamp circuit. Based on it, new single-phase and threephase inverters are proposed and their operating states are analysed along with the traditional H-bridge inverter. Multiphase and multi-level isolated inverters are also developed using the HFAC bridge arm. Furthermore, based on the proposed HFAC, a front-end DC-DC converter is also developed for photovoltaic systems to demonstrate the application of the proposed HFAC converter. Simulation and experimental results from prototype converters are carried out to validate the proposed topologies which can be utilised widely in high frequency power conversion applications such as induction heating and wireless power transfer.

Online sensorless position estimation for switched reluctance motors using one current sensor

This paper proposes an online sensorless rotor position estimation technique for switched reluctance motors (SRMs) using just one current sensor. It is achieved by first decoupling the excitation current from the bus current. Two phase-shifted pulse width modulation signals are injected into the relevant lower transistors in the asymmetrical half-bridge converter for short intervals during each current fundamental cycle. Analog-to-digital converters are triggered in the pause middles of the dual pulse to separate the bus current for excitation current recognition. Next, the rotor position is estimated from the excitation current, by a current-rise-time method in the current-chopping-control mode in a low-speed operation and a current-gradient method in the voltage-pulse-control mode in a high-speed operation. The proposed scheme requires only a bus current sensor and a minor change to the converter circuit, without a need for individual phase current sensors or additional detection devices, achieving a more compact and cost-effective drive. The performance of the sensorless SRM drive is fully investigated. The simulation and experiments on a 750-W three-phase 12/8-pole SRM are carried out to verify the effectiveness of the proposed scheme.

Online two-section PV array fault diagnosis with optimized voltage sensor locations

Photovoltaic (PV) stations have been widely built in the world to utilize solar energy directly. In order to reduce the capital and operational costs, early fault diagnosis is playing an increasingly important role by enabling the long effective operation of PV arrays. This paper analyzes the terminal characteristics of faulty PV strings and arrays, and it develops a PV array fault diagnosis technique. The terminal current-voltage curve of a faulty PV array is divided into two sections, i.e., high-voltage and low-voltage fault diagnosis sections. The corresponding working points of healthy string modules and of healthy and faulty modules in an unhealthy string are then analyzed for each section. By probing into different working points, a faulty PV module can be located. The fault information is of critical importance for the maximum power point tracking and the array dynamical reconfiguration. Furthermore, the string current sensors can be eliminated, and the number of voltage sensors can be reduced by optimizing voltage sensor locations. Typical fault scenarios including monostring, multistring, and a partial shadow for a 1.6-kW 3 $times$ 3 PV array are presented and experimentally tested to confirm the effectiveness of the proposed fault diagnosis method.

Winding-centre-tapped switched reluctance motor drive for multi-source charging in electric vehicle applications

Switched reluctance motors (SRMs) can provide an attractive traction drive for electric vehicle applications. To lower the investment in the off-board charging station facilities, a multi-functional switched reluctance motor topology is proposed on the basis of the traditional asymmetrical half-bridge converter. The SRM phase windings are employed as input filter inductors and centre-tapped windings are also developed to form symmetrical inductors for three-phase grid supply. Owing to the varying rotor position, phase inductors are unequal between one another. A hysteresis control scheme is therefore developed for grid-connection operation. In addition to AC supplies, the proposed topology can also supports the DC-source charging. A new current sharing strategy is employed to diminish the influence of the unequal winding inductances. The simulation and experimental tests are carried out to verify the proposed topology and control methods. Since this work eliminates the need for building charging station infrastructure, its potential economic impact on the automotive market can be significant.

Ionized cluster beam deposition: Modeling, cluster size measurement and applications

Clusters are aggregations of atoms or molecules, generally intermediate in size between individual atoms and aggregates that are large enough to be called bulk matter. Clusters can also be called nanoparticles, because their size is on the order of nanometers or tens of nanometers. A new field has begun to take shape called nanostructured materials which takes advantage of these atom clusters. The ultra-small size of building blocks leads to dramatically different properties and it is anticipated that such atomically engineered materials will be able to be tailored to perform as no previous material could.^ The idea of ionized cluster beam (ICB) thin film deposition technique was first proposed by Takagi in 1972. It was based upon using a supersonic jet source to produce, ionize and accelerate beams of atomic clusters onto substrates in a vacuum environment. Conditions for formation of cluster beams suitable for thin film deposition have only recently been established following twenty years of effort. Zinc clusters over 1,000 atoms in average size have been synthesized both in our lab and that of Gspann. More recently, other methods of synthesizing clusters and nanoparticles, using different types of cluster sources, have come under development.^ In this work, we studied different aspects of nanoparticle beams. The work includes refinement of a model of the cluster formation mechanism, development of a new real-time, in situ cluster size measurement method, and study of the use of ICB in the fabrication of semiconductor devices.^ The formation process of the vaporized-metal cluster beam was simulated and investigated using classical nucleation theory and one dimensional gas flow equations. Zinc cluster sizes predicted at the nozzle exit are in good quantitative agreement with experimental results in our laboratory.^ A novel in situ real-time mass, energy and velocity measurement apparatus has been designed, built and tested. This small size time-of-flight mass spectrometer is suitable to be used in our cluster deposition systems and does not suffer from problems related to other methods of cluster size measurement like: requirement for specialized ionizing lasers, inductive electrical or electromagnetic coupling, dependency on the assumption of homogeneous nucleation, limits on the size measurement and non real-time capability. Measured ion energies using the electrostatic energy analyzer are in good accordance with values obtained from computer simulation. The velocity (v) is measured by pulsing the cluster beam and measuring the time of delay between the pulse and analyzer output current. The mass of a particle is calculated from m = (2E/v$\sp2).$ The error in the measured value of background gas mass is on the order of 28% of the mass of one N$\sb2$ molecule which is negligible for the measurement of large size clusters. This resolution in cluster size measurement is very acceptable for our purposes.^ Selective area deposition onto conducting patterns overlying insulating substrates was demonstrated using intense, fully-ionized cluster beams. Parameters influencing the selectivity are ion energy, repelling voltage, the ratio of the conductor to insulator dimension, and substrate thickness. ^