Augmentation cystoplasty using pedicled and de-epithelialized gastric patches in the mini-pig model.

PURPOSE: The most common methods of bladder augmentation are gastrocystoplasty and enterocystoplasty. Gastrocystoplasty is advantageous due to minimal mucous secretion and a well developed muscular wall as well as good urodynamic properties of the patch. However, the permanent contact of urine with the gastric mucosa is not free of complications. We report the urodynamic, macroscopic and histological outcomes of a pedicled de-epithelialized gastric patch incorporated in the bladder. We compared the results to those of our previous study, which sought to analyze these techniques of patch coverage using sigmoid patches. MATERIALS AND METHODS: We performed 20 augmentation cystoplasties in the mini-pig model using a pedicled de-epithelialized gastric patch and 5 techniques of patch coverage. RESULTS: Three months after surgery all bladders had an increase in volume except those in which the auto-augmentation technique was used. However, all gastric patches were smaller compared to preoperative size. Many had irregular fibrosed inner surfaces and histological evaluation revealed a fibrosed newly formed submucosal layer with a complete urothelial coverage in every patch. No gastric mucosal remnant was found. CONCLUSIONS: De-epithelialized gastrocystoplasty is an attractive procedure that can increase bladder capacity as well as provide a complete urothelial lining without mucosal remnants. However, the success of this procedure seems to be limited by increased morbidity and fibrotic changes, and decreased surface of the patch.

A contingency model of job satisfaction

The present research study was designed to test a contingency model of job satisfaction based on participation in decision making as the antecedent variable and job involvement as the intervening variable. The instruments used to measure the variables were the participation in decision making scale developed by Siegel and Ruh (1973), the job involvement scale by Lodahl and Kejner (1965) and the job satisfaction construct derived from Hoppock (1935). The findings indicate that statistically significant correlations do exist for the 1995 educators surveyed in this study. Educators who reported high levels of participation in decision making consistently reported high levels of job involvement (p!: 0.001). Also, teachers reporting high levels of job involvement consistently scored high on their levels of job satis faction (p!: 0.001). All major hypotheses were sUPFOrted by the data. Through exploratory hypotheses, the study attempted to develop statements of relationships between criteria of job satisfaction and sex and marital status of employees in the system. The hypotheses received only minimal support, but the results did highlight the impracticability of attempting to develop any such relationships without using definite personality and situational variables as moderators. Differences between male and female socialization, sex discrimination and multiplicity of roles are briefly discussed as possible explanations for the reported findings.

Minimal Contact Intervention for Tobacco Dependence

This study was conducted to measure the degree of adherence by public health care providers to a policy that requires them to implement minimal contact intervention for tobacco cessation with their clients. This study also described what components of the intervention may have contributed to the adherence of the policy and how health care providers felt about adhering to the policy. The intervention consisted of a policy for implementation of minimal contact intervention, changes to documentation, a health care provider mentor trained, a training session for health care providers, and ongoing paper and people supports for implementation. Data for this study were collected through a health care provider questionnaire, focus group interviews, and a compliance protocol including a chart audit. The findings of this study showed a high degree of adherence to the policy, that health care providers thought minimal contact intervention was important to conduct with their clients, and that health care providers felt supported to implement the intervention. No statistically significant difference was found between new and experienced health care providers on 17 of the 18 questions on the health care provider questionnaire. However there was a statistically significant difference between new and experienced health care providers with respect to their perception that “clients often feel like they have to accept tobacco cessation information from me.” Changes could be made to the minimal contact intervention and to documentation of the intervention. Implications for future research include implementation within other programs within Hamilton Public Health Services and implementation of this model within other public health units and other types of health care providers within Ontario.

Evaluation of a novel transcortical pin-sleeve system in a calf model

Le desserrage des tiges est une complication fréquente des plâtres avec tiges transcorticales (TP) chez les grands animaux, nécessitant souvent leur retrait prématuré avant la guérison des fractures. Les charges excessives centrées sur le cortex à l’interface os-tige proximo-externe et disto-interne causent de l'ostéolyse. En utilisant un modèle de veau nouveau-né, ce projet a évalué un nouveau système de tige-manchon et anneau integré dans un plâtre (PS) optimisé pour réduire la contrainte péri-implant et le stress à l'interface os-implant. On a émis l'hypothèse que les PS se traduiraient par une ostéolyse péri-implant moindre par rapport aux TP. Dix veaux en bonne santé, de 3 semaines d'âge, ont été implantés avec les TP ou PS dans le métacarpe droit, à raison de 2 implants par veau. Les veaux ont été observés quotidiennement pour le confort et la boiterie et ont été euthanasiés à 28 jours. Les données recueillies comprenaient les radiographies à la chirurgie et à l'euthanasie et les mesures histomorphométriques de contact os-implant sur des échantillons non-décalcifiés avec les implants in situ. Les données ont été analysées en utilisant le test de Cochran-Mantel-Haenszel, une valeur de P <0,05 a été considérée comme significative. L'épaisseur corticale était plus importante pour les implants distaux que proximaux pour les deux groupes lors de la chirurgie (P = 0,03), mais était similaire entre les groupes (P > 0,3). Les veaux avec TP ont développé une boiterie plus tôt (au jour 21) que les veaux avec PS (P = 0,04). Histologiquement, il y avait plus de contact direct os-implant cortical pour les implants PS distaux que les implants TP (P = 0,04). La jonction métaphyso-diaphysaire osseuse où les implants proximaux étaient situés est impropre aux deux systèmes; chacun a un minimum de contact os-implant et de l'ostéolyse extensive. Le système PS n'ayant pas causé une ostéolyse importante lorsque implantés dans l'os diaphysaire et peut-être une alternative convenable aux TP pour des fractures comminutives des membres distaux.

Chronic catheterization using vascular-access-port in rats: blood sampling with minimal stress for plasma catecholamine determination

Chronic catheterization is illustrated using vascular-access-port model SLA where the port is surgically placed subcutaneously on the back of the rat. The catheter is tunnelled to the neck and inserted into the jugular vein . Within 24 h rats showed normal blood pressure and blood samples were collected at intervals with minimal stress to the animals . A comparison of the plasma catecholamine of blood collected from vascular-access-ports with that obtained from decapitation indicates that there was minimal stress to the rats when blood was drawn through the vascular-access-port.

Some theoretical and methodological considerations for the development of a critical competences model (CCM): an operant approach

This paper develops some theoretical and methodological considerations for the development of a critical competence model (CCM). The model is defined as a set of skills and knowledge functionally organized allowing measurable results with positive consequences for the strategic business objectives. The theoretical approaches of classical model of competences, the contemporary model of competencies and human competencies model were revised for the proposal development. implementation of the model includes 5 steps: 1) conducting a job analysis considering which dimensions or facets are subject to revision, 2) identify people with the opposite performance (the higher performance and lower performance); 3) identify critical incidents most relevant to the job position, 4) develop behavioral expectation scales (bes) and 5) validate BES obtained for experts in the field. As a final consideration, is determined that the competence models require accurate measurement. Approaches considering excessive theoreticism may cause the issue of competence become a fashion business with low or minimal impact, affecting its validity, reliability and deployment in organizations.

Numerical model of solid phase transformations governed by nucleation and growth: microstructure development during isothermal crystallization

A simple numerical model which calculates the kinetics of crystallization involving randomly distributed nucleation and isotropic growth is presented. The model can be applied to different thermal histories and no restrictions are imposed on the time and the temperature dependences of the nucleation and growth rates. We also develop an algorithm which evaluates the corresponding emerging grain-size distribution. The algorithm is easy to implement and particularly flexible, making it possible to simulate several experimental conditions. Its simplicity and minimal computer requirements allow high accuracy for two- and three-dimensional growth simulations. The algorithm is applied to explore the grain morphology development during isothermal treatments for several nucleation regimes. In particular, thermal nucleation, preexisting nuclei, and the combination of both nucleation mechanisms are analyzed. For the first two cases, the universal grain-size distribution is obtained. The high accuracy of the model is stated from its comparison to analytical predictions. Finally, the validity of the Kolmogorov-Johnson-Mehl-Avrami model SSSR, is verified for all the cases studied

A simple theoretical model for the intensification of tropical cyclones and polar lows

A simple theoretical model for the intensification of tropical cyclones and polar lows is developed using a minimal set of physical assumptions. These disturbances are assumed to be balanced systems intensifying through the WISHE (Wind-Induced Surface Heat Exchange) intensification mechanism, driven by surface fluxes of heat and moisture into an atmosphere which is neutral to moist convection. The equation set is linearized about a resting basic state and solved as an initial-value problem. A system is predicted to intensify with an exponential perturbation growth rate scaled by the radial gradient of an efficiency parameter which crudely represents the effects of unsaturated processes. The form of this efficiency parameter is assumed to be defined by initial conditions, dependent on the nature of a pre-existing vortex required to precondition the atmosphere to a state in which the vortex can intensify. Evaluation of the simple model using a primitive-equation, nonlinear numerical model provides support for the prediction of exponential perturbation growth. Good agreement is found between the simple and numerical models for the sensitivities of the measured growth rate to various parameters, including surface roughness, the rate of transfer of heat and moisture from the ocean surface, and the scale for the growing vortex.

Liposomes and skin: From drug delivery to model membranes

The early eighties saw the introduction of liposomes as skin drug delivery systems, initially promoted primarily for localised effects with minimal systemic delivery. Subsequently, a novel ultradeformable vesicular system (termed "Transfersomes" by the inventors) was reported for transdermal delivery with an efficiency similar to subcutaneous injection. Further research illustrated that the mechanisms of liposome action depended on the application regime and the vesicle composition and morphology. Ethical, health and supply problems with human skin have encouraged researchers to use skin models. 'IYaditional models involved polymer membranes and animal tissue, but whilst of value for release studies, such models are not always good mimics for the complex human skin barrier, particularly with respect to the stratum corneal intercellular lipid domains. These lipids have a multiply bilayered organization, a composition and organization somewhat similar to liposomes, Consequently researchers have used vesicles as skin model membranes. Early work first employed phospholipid liposomes and tested their interactions with skin penetration enhancers, typically using thermal analysis and spectroscopic analyses. Another approach probed how incorporation of compounds into liposomes led to the loss of entrapped markers, analogous to "fluidization" of stratum corneum lipids on treatment with a penetration enhancer. Subsequently scientists employed liposomes formulated with skin lipids in these types of studies. Following a brief description of the nature of the skin barrier to transdermal drug delivery and the use of liposomes in drug delivery through skin, this article critically reviews the relevance of using different types of vesicles as a model for human skin in permeation enhancement studies, concentrating primarily on liposomes after briefly surveying older models. The validity of different types of liposome is considered and traditional skin models are compared to vesicular model membranes for their precision and accuracy as skin membrane mimics. (c) 2008 Elsevier B.V. All rights reserved.

Simulating global properties of electroencephalograms with minimal random neural networks

The human electroencephalogram (EEG) is globally characterized by a 1/f power spectrum superimposed with certain peaks, whereby the "alpha peak" in a frequency range of 8-14 Hz is the most prominent one for relaxed states of wakefulness. We present simulations of a minimal dynamical network model of leaky integrator neurons attached to the nodes of an evolving directed and weighted random graph (an Erdos-Renyi graph). We derive a model of the dendritic field potential (DFP) for the neurons leading to a simulated EEG that describes the global activity of the network. Depending on the network size, we find an oscillatory transition of the simulated EEG when the network reaches a critical connectivity. This transition, indicated by a suitably defined order parameter, is reflected by a sudden change of the network's topology when super-cycles are formed from merging isolated loops. After the oscillatory transition, the power spectra of simulated EEG time series exhibit a 1/f continuum superimposed with certain peaks. (c) 2007 Elsevier B.V. All rights reserved.

A model for self-directed problem-based learning for renal therapeutics

Objective To introduce a new approach to problem-based learning (PBL) for self-directed learning in renal therapeutics. Design This 5-week course, designed for large student cohorts using minimal teaching resources, was based on a series of case studies and subsequent pharmaceutical care plans, followed by intensive and regular feedback from the instructor. Assessment Assessment of achievement of the learning outcomes was based on weekly-graded care plans and peer review assessment, allowing each student to judge the contributions of each group member and their own, along with a written case-study based examination. The pharmaceutical care plan template, designed using a “tick-box” system, significantly reduced staff time for feedback and scoring. Conclusion The proposed instructional model achieved the desired learning outcomes with appropriate student feedback, while promoting skills that are essential for the students' future careers as health care professionals.

Symmetry breaking, mixing, instability, and low frequency variability in a minimal Lorenz-like system

Starting from the classical Saltzman two-dimensional convection equations, we derive via a severe spectral truncation a minimal 10 ODE system which includes the thermal effect of viscous dissipation. Neglecting this process leads to a dynamical system which includes a decoupled generalized Lorenz system. The consideration of this process breaks an important symmetry and couples the dynamics of fast and slow variables, with the ensuing modifications to the structural properties of the attractor and of the spectral features. When the relevant nondimensional number (Eckert number Ec) is different from zero, an additional time scale of O(Ec−1) is introduced in the system, as shown with standard multiscale analysis and made clear by several numerical evidences. Moreover, the system is ergodic and hyperbolic, the slow variables feature long-term memory with 1/f3/2 power spectra, and the fast variables feature amplitude modulation. Increasing the strength of the thermal-viscous feedback has a stabilizing effect, as both the metric entropy and the Kaplan-Yorke attractor dimension decrease monotonically with Ec. The analyzed system features very rich dynamics: it overcomes some of the limitations of the Lorenz system and might have prototypical value in relevant processes in complex systems dynamics, such as the interaction between slow and fast variables, the presence of long-term memory, and the associated extreme value statistics. This analysis shows how neglecting the coupling of slow and fast variables only on the basis of scale analysis can be catastrophic. In fact, this leads to spurious invariances that affect essential dynamical properties (ergodicity, hyperbolicity) and that cause the model losing ability in describing intrinsically multiscale processes.

Development of a food-exchange model to replace saturated fat with MUFAS and n-6 PUFAS in adults at moderate cardiovascular risk

The recommendation to reduce saturated fatty acid (SFA) consumption to ≤10% of total energy (%TE) is a key public health target aimed at lowering cardiovascular disease (CVD) risk. Replacement of SFA with unsaturated fats may provide greater benefit than replacement with carbohydrates, yet the optimal type of fat is unclear. The aim was to develop a flexible food-exchange model to investigate the effects of substituting SFAs with monounsaturated fatty acids (MUFAs) or n-6 (ω-6) polyunsaturated fatty acids (PUFAs) on CVD risk factors. In this parallel study, UK adults aged 21-60 y with moderate CVD risk (50% greater than the population mean) were identified using a risk assessment tool (n = 195; 56% females). Three 16-wk isoenergetic diets of specific fatty acid (FA) composition (%TE SFA:%TE MUFA:%TE n-6 PUFA) were designed using spreads, oils, dairy products, and snacks as follows: 1) SFA-rich diet (17:11:4; n = 65); 2) MUFA-rich diet (9:19:4; n = 64); and 3) n-6 PUFA-rich diet (9:13:10; n = 66). Each diet provided 36%TE total fat. Dietary targets were broadly met for all intervention groups, reaching 17.6 ± 0.4%TE SFA, 18.5 ± 0.3%TE MUFA, and 10.4 ± 0.3%TE n-6 PUFA in the respective diets, with significant overall diet effects for the changes in SFA, MUFA, and n-6 PUFA between groups (P < 0.001). There were no differences in the changes of total fat, protein, carbohydrate, and alcohol intake or anthropometric measures between groups. Plasma phospholipid FA composition showed changes from baseline in the proportions of total SFA, MUFA, and n-6 PUFA for each diet group, with significant overall diet effects for total SFA and MUFA between groups (P < 0.001). In conclusion, successful implementation of the food-exchange model broadly achieved the dietary target intakes for the exchange of SFA with MUFA or n-6 PUFA with minimal disruption to the overall diet in a free-living population. This trial was registered at clinicaltrials.gov as NCT01478958.

Aircraft routing with minimal climate impact: the REACT4C climate cost function modelling approach (V1.0)

In addition to CO2, the climate impact of aviation is strongly influenced by non-CO2 emissions, such as nitrogen oxides, influencing ozone and methane, and water vapour, which can lead to the formation of persistent contrails in ice-supersaturated regions. Because these non-CO2 emission effects are characterised by a short lifetime, their climate impact largely depends on emission location and time; that is to say, emissions in certain locations (or times) can lead to a greater climate impact (even on the global average) than the same emission in other locations (or times). Avoiding these climate-sensitive regions might thus be beneficial to climate. Here, we describe a modelling chain for investigating this climate impact mitigation option. This modelling chain forms a multi-step modelling approach, starting with the simulation of the fate of emissions released at a certain location and time (time-region grid points). This is performed with the chemistry–climate model EMAC, extended via the two submodels AIRTRAC (V1.0) and CONTRAIL (V1.0), which describe the contribution of emissions to the composition of the atmosphere and to contrail formation, respectively. The impact of emissions from the large number of time-region grid points is efficiently calculated by applying a Lagrangian scheme. EMAC also includes the calculation of radiative impacts, which are, in a second step, the input to climate metric formulas describing the global climate impact of the emission at each time-region grid point. The result of the modelling chain comprises a four-dimensional data set in space and time, which we call climate cost functions and which describes the global climate impact of an emission at each grid point and each point in time. In a third step, these climate cost functions are used in an air traffic simulator (SAAM) coupled to an emission tool (AEM) to optimise aircraft trajectories for the North Atlantic region. Here, we describe the details of this new modelling approach and show some example results. A number of sensitivity analyses are performed to motivate the settings of individual parameters. A stepwise sanity check of the results of the modelling chain is undertaken to demonstrate the plausibility of the climate cost functions.

Uncertainty Characterization Of A Conceptual Rainfall-Runoff Model By Using Grey Numbers

A procedure for characterizing global uncertainty of a rainfall-runoff simulation model based on using grey numbers is presented. By using the grey numbers technique the uncertainty is characterized by an interval; once the parameters of the rainfall-runoff model have been properly defined as grey numbers, by using the grey mathematics and functions it is possible to obtain simulated discharges in the form of grey numbers whose envelope defines a band which represents the vagueness/uncertainty associated with the simulated variable. The grey numbers representing the model parameters are estimated in such a way that the band obtained from the envelope of simulated grey discharges includes an assigned percentage of observed discharge values and is at the same time as narrow as possible. The approach is applied to a real case study highlighting that a rigorous application of the procedure for direct simulation through the rainfall-runoff model with grey parameters involves long computational times. However, these times can be significantly reduced using a simplified computing procedure with minimal approximations in the quantification of the grey numbers representing the simulated discharges. Relying on this simplified procedure, the conceptual rainfall-runoff grey model is thus calibrated and the uncertainty bands obtained both downstream of the calibration process and downstream of the validation process are compared with those obtained by using a well-established approach, like the GLUE approach, for characterizing uncertainty. The results of the comparison show that the proposed approach may represent a valid tool for characterizing the global uncertainty associable with the output of a rainfall-runoff simulation model.