999 resultados para Protocol controller


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While physical activity, energy restriction and weight loss are the cornerstone of type 2 diabetes management, less emphasis is placed on optimizing skeletal muscle mass. As muscle is the largest mass of insulin-sensitive tissue and the predominant reservoir for glucose disposal, there is a need to develop safe and effective evidence-based, lifestyle management strategies that optimize muscle mass as well as improve glycaemic control and cardiometabolic risk factors in people with this disease, particularly older adults who experience accelerated muscle loss.

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Health behaviours are important determinants of health and adoption of unhealthy behaviour is considered as one of the mechanisms through which immigrants' health changes over time in the host country. The change in health behaviours over time can contribute either to improving or worsening the overall health status of immigrants. Despite being the important mediators for the change in overall health status and chronic health conditions, no previous review (either general or systematic) has examined differences in key health behaviours simultaneously between immigrants and non-immigrants. This study aims to provide a systematic overview of the current global literature on differences in key health behaviours (that is, tobacco smoking, physical activity and alcohol drinking) between immigrant and non-immigrant groups.

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While current pharmacotherapies are efficacious, there remain a clear shortfall between symptom remission and functional recovery. With the explosion in our understanding of the biology of these disorders, the time is ripe for the investigation of novel therapies. Recently depression is conceptualized as an immune-inflammatory and nitro-oxidative stress related disorder. Minocycline is a tetracycline antibiotic that has anti-inflammatory, pro-oxidant, glutamatergic, neurotrophic and neuroprotective properties that make it a viable target to explore as a new therapy. This double blind, randomised, placebo controlled adjunctive trial will investigate the benefits of 200 mg/day of minocycline treatment, in addition to any usual treatment, as an adjunctive treatment for moderate-severe major depressive disorder. Sixty adults are being randomised to 12 weeks of treatment (with a 4 week follow-up post-discontinuation). The primary outcome measure for the study is mean change on the Montgomery-Asberg Depression Rating Scale (MADRS), with secondary outcomes including the Social and Occupational Functioning Assessment Scale (SOFAS), Clinical Global Impressions (CGI), Hamilton Rating Scale for Anxiety (HAM-A), Patient Global Impression (PGI), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and Range of Impaired Functioning Tool (LIFE-RIFT). Biomarker analyses will also be conducted at baseline and week 12. The study has the potential to provide new treatment targets, both by showing efficacy with a new class of 'antidepressant' but also through the analysis of biomarkers that may further inform our understanding of the pathophysiology of unipolar depression.

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Evidence of patients' experiences is fundamental to creating effective health policy and service responses, yet is missing from our knowledge of adverse events. This protocol describes explorative research redressing this significant deficit; investigating the experiences of a large cohort of recently hospitalised patients aged 45 years and above in hospitals in New South Wales (NSW), Australia.

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The aim of the Youth Depression Alleviation-Combined Treatment (YoDA-C) study is to determine whether antidepressant medication should be started as a first-line treatment for youth depression delivered concurrently with psychotherapy. Doubts about the use of medication have been raised by meta-analyses in which the efficacy and safety of antidepressants in young people have been questioned, and subsequent treatment guidelines for youth depression have provided only qualified support.

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 Background: The initiation of end of life care in an acute stroke context should be focused on those patients and families with greatest need. This requires clinicians to synthesise information on prognosis, patterns (trajectories) of dying and patient and family preferences. Within acute stroke, prognostic models are available to identify risks of dying, but variability in dying trajectories makes it difficult for clinicians to know when to commence palliative interventions. This study aims to investigate clinicians’ use of different types of evidence in decisions to initiate end of life care within trajectories typical of the acute stroke population.
Methods/design: This two-phase, mixed methods study comprises investigation of dying trajectories in acute stroke (Phase 1), and the use of clinical scenarios to investigate clinical decision-making in the initiation of palliative care (Phase 2). It will be conducted in four acute stroke services in North Wales and North West England. Patient and public involvement is integral to this research, with service users involved at each stage.
Discussion: This study will be the first to examine whether patterns of dying reported in other diagnostic groups are transferable to acute stroke care. The strengths and limitations of the study will be considered. This research will produce comprehensive understanding of the nature of clinical decision-making around end of life care in an acute stroke context, which in turn will inform the development of interventions to further build staff knowledge, skills and confidence in this challenging aspect of acute stroke care.

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Immobilization of catechol derivatives on GC electrode surfaces can be performed by in situ generation and reduction of nitrocatechol. We present the oxidative nitration of catechol in the presence of nitrous acid followed by electrochemically reduction of the generated nitro aromatic group to the corresponding amine group and its conversion to diazonium cation at the electrode surface to yield a surface covalently modified with catechol. In this manner, some derivatives of catechol can be immobilized on the electrode surface. Whole of the process is carried out in Triethylammonium acetate ionic liquid as an inert and neutral medium (pH∼7.0). Surface coverage can be easily controlled by the applied potential, time and concentration of catechol. After modification, the electrochemical features of modified surface have been studied. Also modified GC electrode exhibited remarkable catalytic activity in the oxidation of NADH. The catalytic currents were proportional to the concentration of NADH over the range 0.01-0.80 mM. This condition can be used for modification of GC surfaces by various aromatic molecules for different application such as design of sensors and biosensors. © 2014 Elsevier Ltd. All rights reserved.

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This paper presents a robust nonlinear distributed controller design for islanded operation of microgrids in order to maintain active and reactive power balance. In this paper, microgrids are considered as inverter-dominated networks integrated with renewable energy sources (RESs) and battery energy storage systems (BESSs), where solar photovoltaic generators act as RESs and plug-in hybrid electric vehicles as BESSs to supply power into the grid. The proposed controller is designed by using partial feedback linearization and the robustness of this control scheme is ensured by considering structured uncertainties within the RESs and BESSs. An approach for modeling the uncertainties through the satisfaction of matching conditions is also provided in this paper. The proposed distributed control scheme requires information from local and neighboring generators to communicate with each other and the communication among RESs, BESSs, and control centers is developed by using the concept of the graph theory. Finally, the performance of the proposed robust controller is demonstrated on a test microgrid and simulation results indicate the superiority of the proposed scheme under different operating conditions as compared to a linear-quadratic-regulator-based controller.

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Many maternity providers recommend that women with diabetes in pregnancy express and store breast milk in late pregnancy so breast milk is available after birth, given (1) infants of these women are at increased risk of hypoglycaemia in the first 24 h of life; and (2) the delay in lactogenesis II compared with women without diabetes that increases their infant's risk of receiving infant formula. The Diabetes and Antenatal Milk Expressing (DAME) trial will establish whether advising women with diabetes in pregnancy (pre-existing or gestational) to express breast milk from 36 weeks gestation increases the proportion of infants who require admission to special or neonatal intensive care units (SCN/NICU) compared with infants of women receiving standard care. Secondary outcomes include birth gestation, breastfeeding outcomes and economic impact.

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This paper presents a robust nonlinear controller design for a three-phase grid-connected photovoltaic (PV) system to control the current injected into the grid and the dc-link voltage for extracting maximum power from PV units. The controller is designed based on the partial feedback linearization approach, and the robustness of the proposed control scheme is ensured by considering structured uncertainties within the PV system model. An approach for modeling the uncertainties through the satisfaction of matching conditions is provided. The superiority of the proposed robust controller is demonstrated on a test system through simulation results under different system contingencies along with changes in atmospheric conditions. From the simulation results, it is evident that the robust controller provides excellent performance under various operating conditions. © 2014 IEEE.

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There is a need for psychosocial interventions for men with prostate cancer to promote adaptive coping with the challenges and distress associated with diagnosis, treatment and recovery. In addition, interventions are needed that help to overcome barriers to psychosocial treatment such as limited face-to-face psychosocial support services, a shortage of adequately trained professionals, geographical distance, perceived and personal stigma and a preference for consumer-centric and self-directed learning. My Road Ahead is an online cognitive behaviour therapy (CBT) intervention for prostate cancer. This protocol describes a randomised controlled trial (RCT) that will evaluate the efficacy of this online intervention alone, the intervention in combination with a moderated online forum, and the moderated online forum alone.

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This project will provide a comprehensive investigation into the prevalence of alcohol-related harms and community attitudes in the context of community-based interventions being implemented to reduce harm in two regional centres of Australia. While considerable experimentation and innovation to address these harms has occurred in both Geelong and Newcastle, only limited ad-hoc documentation and analysis has been conducted on changes in the prevalence of harm as a consequence, leaving a considerable gap in terms of a systematic, evidence-based analysis of changes in harm over time and the need for further intervention. Similarly, little evidence has been reported regarding the views of key stakeholder groups, industry, government agencies, patrons or community regarding the need for, and the acceptability of, interventions to reduce harms. This project will aim to provide evidence regarding the impact and acceptability of local initiatives aimed at reducing alcohol-related harms.

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Background: The implementation of healthy school canteen policies has been recommended as a strategy to help prevent unhealthy eating and excessive weight gain. Internationally, research suggests that schools often fail to implement practices consistent with healthy school canteen policies. Without a population wide implementation, the potential benefits of these policies will not be realised. The aim of this trial is to assess the effectiveness of an implementation intervention in increasing school canteen practices consistent with a healthy canteen policy of the New South Wales (NSW), Australia, government known as the 'Fresh Tastes @ School NSW Healthy School Canteen Strategy'.Methods/design: The parallel randomised trial will be conducted in 70 primary schools located in the Hunter region of New South Wales, Australia. Schools will be eligible to participate if they are not currently meeting key components of the healthy canteen policy. Schools will be randomly allocated after baseline data collection in a 1:1 ratio to either an intervention or control group using a computerised random number function in Microsoft Excel. Thirty-five schools will be selected to receive a multi-component intervention including implementation support from research staff, staff training, resources, recognition and incentives, consensus and leadership strategies, follow-up support and implementation feedback. The 35 schools allocated to the control group will not receive any intervention support as part of the research trial. The primary outcome measures will be i) the proportion of schools with a canteen menu that does not contain foods or beverages restricted from regular sale ('red' and 'banned' items) and ii) the proportion of schools where healthy canteen items ('green' items) represent the majority (>50%) of products listed on the menu. Outcome data will be collected via a comprehensive menu audit, conducted by dietitians blind to group allocation. Intervention effectiveness will be assessed using logistic regression models adjusting for baseline values.Discussion: The proposed trial will represent a novel contribution to the literature, being the first randomised trial internationally to examine the effectiveness of an intervention to facilitate implementation of a healthy canteen policy.

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Traffic signal controlling is one of the solutions to reduce the traffic congestion in cities. To set appropriate green times for traffic signal lights, we have applied Adaptive Neuro-Fuzzy Inference System (ANFIS) method in traffic signal controllers. ANFIS traffic signal controller is used for controlling traffic congestion of a single intersection with the purpose of minimizing travel delay time. The ANFIS traffic controller is an intelligent controller that learns to set an appropriate green time for each phase of traffic signal lights at the start of the phase and based on the traffic information. The controller uses genetic algorithm to tune ANFIS parameters during learning time. The results of the experiments show higher performance of the ANFIS traffic signal controller compared to three other traffic controllers that are developed as benchmarks. One of the benchmarks is GA-FLC (Araghi et al., 2014), next one is a fixed-FLC, and a fixed-time controller with three different values for green phase. Results show the higher performance of ANFIS controller.