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Phosphate esters decompose on metal surfaces and form protective polyphosphate films. For many applications, such as in lubricants for electric vehicles and wind turbines, an understanding of the effect of electric fields on molecular decomposition is urgently required. Experimental investigations have yielded contradictory results, with some suggesting that electric fields improve tribological performance, while others have reported the opposite effect. Here, we use nonequilibrium molecular dynamics (NEMD) simulations to study the decomposition of tri-n-butyl phosphate (TNBP) molecules nanoconfined between ferrous surfaces (iron and iron oxide) under electrostatic fields. The reactive force field (ReaxFF) method is used to model the effects of chemical bonding and molecular dissociation. We show that the charge transfer with the polarization current equalization (QTPIE) method gives more realistic behavior compared to the standard charge equilibration (QEq) method under applied electrostatic fields. The rate of TNBP decomposition via carbon–oxygen bond dissociation is faster in the nanoconfined systems than that in the bulk due to the catalytic action of the surfaces. In all cases, the application of an electric field accelerates TNBP decomposition. When electric fields are applied to the confined systems, the phosphate anions are pulled toward the surface with high electric potential, while the alkyl cations are pulled to the surface with lower potential, leading to asymmetric film growth. Analysis of the temperature- and electric field strength-dependent dissociation rate constants using the Arrhenius equation suggests that, on reactive iron surfaces, the increased reactivity under an applied electric field is driven mostly by an increase in the pre-exponential factor, which is linked to the number of molecule–surface collisions. Conversely, the accelerated decomposition of TNBP on iron oxide surfaces can be attributed to a reduction in the activation energy with increasing electric field strength. Single-molecule nudged-elastic band (NEB) calculations also show a linear reduction in the energy barrier for carbon–oxygen bond breaking with electric field strength, due to stabilization of the charged transition state. The simulation results are consistent with experimental observations of enhanced and asymmetric tribofilm growth under electrostatic fields.

ABSTRACTWe analysed movement parameters of reach and return actions to cards with rectangle orientations referenced to the self or with either a close (mother) or distant (experimenter) other. Movement duration was faster overall for reaches to self- than other-referenced rectangles, and velocity was slowed for mother- than experimenter-referenced rectangles. Curvature of the trajectory of the reach movement was reduced for self- compared with mother-referenced rectangles, while the angle of the trajectory was smaller for self- compared with other-referenced rectangles. No changes were seen in the return movement parameters. These differences in timing and spatial parameters are consistent with dissociations in self and other processing evident in perception and recognition memory paradigms, and consistent with a bias towards forming associations for information referenced to the self vs. significant others, even when the information is virtual and arbitrary.

Retrons are prokaryotic genetic retroelements encoding a reverse transcriptase that produces multi-copy single-stranded DNA1(msDNA). Despite decades of research on the biosynthesis of msDNA2, the function and physiological roles of retrons have remained unknown. Here we show that Retron-Sen2 of Salmonella entericaserovar Typhimurium encodes an accessory toxin protein, STM14_4640, which we renamed as RcaT. RcaT is neutralized by the reverse transcriptase–msDNA antitoxin complex, and becomes active upon perturbation of msDNA biosynthesis. The reverse transcriptase is required for binding to RcaT, and the msDNA is required for the antitoxin activity. The highly prevalent RcaT-containing retron family constitutes a new type of tripartite DNA-containing toxin–antitoxin system. To understand the physiological roles of such toxin–antitoxin systems, we developed toxin activation–inhibition conjugation (TAC-TIC), a high-throughput reverse genetics approach that identifies the molecular triggers and blockers of toxin–antitoxin systems. By applying TAC-TIC to Retron-Sen2, we identified multiple trigger and blocker proteins of phage origin. We demonstrate that phage-related triggers directly modify the msDNA, thereby activating RcaT and inhibiting bacterial growth. By contrast, prophage proteins circumvent retrons by directly blocking RcaT. Consistently, retron toxin–antitoxin systems act as abortive infection anti-phage defence systems, in line with recent reports3,4. Thus, RcaT retrons are tripartite DNA-regulated toxin–antitoxin systems, which use the reverse transcriptase–msDNA complex both as an antitoxin and as a sensor of phage protein activities.

The data obtained from the Greek Telecommunications Organization is employed for determining the relative productivity and efficiency observed in the corporate real estate usage across the different decision-making units. A new framework for efficiently utilizing the real estate assets is also presented.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ijpe.2009.07.006 Byline: Manolis N. Kritikos, George Ioannou Keywords: Vehicle routing with time windows; Heuristics; Data envelopment analysis; Free disposal hull method Abstract: This paper addresses a variant of the vehicle routing problem with time windows (VRPTW) that targets the balancing of the load carried by each active vehicle (balanced cargo VRPTW or BCVRPTW). A new approach, based on the free disposal hull (FDH) method of data envelopment analysis, is proposed; it consists of an initial, feasible route generation procedure that employs an effective heuristic for the VRPTW, followed by an iterative method for selecting routes on the efficiency frontier, according to the criteria of the BCVRPTW and the notion of non-dominated solutions embedded within FDH. This new approach produces, according to our computational evaluation, very good results for the BCVRPTW, and can serve as the basis for solving real-life vehicle routing problems. Author Affiliation: Management Science Laboratory, Department of Management Science and Technology, Athens University of Economics and Business, Evelpidon 47A and Lefkados 33, 113-62 Athens, Greece Article History: Received 20 June 2007; Accepted 23 July 2009

Internal turning process is a very important and widely used process for enlarging and finishing holes. Especially for the components that work with external members, this operation needs to assure surface and geometric quality. In that case, the correct definition of working parameters will directly contribute to the quality of component. Aim of the current research was to analyse the form error and the roughness of workpieces submitted to internal turning process using boring bars in long overhangs with three different internal tools (steel, carbide and antivibrating tool). For the experiments, heat-treated DIN EN 1.2842 (ISO 90MnCrV8) steel with 58 HRC of hardness was submitted to boring process using CBN (cubic boron nitride) inserts, and a boring bar with the most possible rigid clamping system (Easy Fix). The workpiece roughness and circularity were measured using a profilometer and a form error measuring machine. The measurements provided the data to identify the boring bar levels of stability, and the workpiece micro and macro geometric errors. The experiments allowed to conclude that, for all toolbars, the evaluated errors kept constant with increasing L/D ratio during stable clamping conditions, without any vibration. On the other hand, higher values of overhangs, limited to L/D>4.25 for steel tool, can cause serious damages in the cutting system if the antivibration tools or the carbide will be not used.

This paper reviews the effects of iron-based powder on shape accuracy of injection moulded parts. Analysed specimens were produced on a micro injection moulding machine. At first, specimens of pure polypropylene (PP) were manufactured. Then specimens containing 1, 2 and 3 vol. % of iron powder additive were produced using the same process parameters. Subsequently, the samples were scanned using scanned using Zeiss METROTOM CT scanner. Results were analysed via CAE inspection tools. The main aim was to compare the shape and flatness of the scanned specimens to the nominal models. Results showed that iron-based additives of this vol.% had no significant effect on shape accuracy of produced parts. This paper is a partial result of the ongoing research focused on effect of iron and steel-based additives on material, magnetic and mechanical properties of polymers.

Background: Randomised controlled trials have shown that treatment with anti-tumour necrosis factor (anti-TNF) agents is effective in refractory rheumatoid arthritis (RA). Objective: To determine the effectiveness of anti-TNF in a [...]

ABSTRACT:Isolated chronic granulomatous meningitis remains a diagnostic challenge for the physician. Symptoms are often nonspecific and ancillary tests have low-sensitivity rates, which may delay targeted treatment and lead to increased morbidity and mortality. Here, we discuss the challenges in diagnosing and treating patients with chronic meningitis by reporting two cases of previously healthy patients who presented with granulomatous meningitis on brain biopsy.

This article has supplementary material on the web site: www.jdbp.org.

Experimental research on the process of cold tubes drawing was performed in order to obtain important information about the behaviour of the tube material in the drawing tool during the drawing to the required outer diameter of Ø12 mm. The DEFORM-3D simulation software was an important tool for verifying the plastic flow of material in the drawing tool (i.e. drawing die), as well as for optimizing the technological parameters of cold tubes drawing. In the finite element (FE) analysis, emphasis was placed on determining the influence of tool geometry, strain degree, drawing speed and friction on the size of the drawing force and the quality of production of drawn tubes. The paper points out the importance of simulation software for common comparison of results obtained from laboratory experiment and FE analysis of the process of tubes drawing. By comparing the results, the reliability of the used simulation software was proved, as the results were identical for all monitored technological parameters. Computer simulation brings valuable knowledge that is important for the correct design of the drawing tool as well as for the technology of production of tubes with precise dimensions.

Introduction: Correct inhaler technique is essential for the optimal delivery of inhaled medicines and the successfully management of respiratory conditions. The general practitioner (GP), the prescriber of inhaled medicines, plays a crucial role in educating patients on inhaler technique. However, in the real-world setting, there are barriers. For the GP, it is time and competence and for the patient, it is their ability to recognise inhaler technique as an issue and their ability to maintain correct inhaler technique over time. This study aimed to determine GPs’ experience, skills and priority placed on inhaler technique and to identify factor(s) associated with inhaler technique competence. Methods: This cross-sectional observational study design surveyed GPs’ perspectives on inhaler use and preferences for inhaler prescribing within their practice setting. GP inhaler technique was assessed. GPs were recruited through an established network of GP practices. Data collected include (i) practice demographics, (ii) inhaler technique opinions and experience, (iii) inhaler prescribing preferences and (iv) inhaler education history data. Data were analysed descriptively and multivariate logistic regression modelling was used to explore the relationship between outcomes and GPs’ ability to use devices correctly. Results: A total of 227 GPs completed the inhaler survey. Sixty-three percent of GPs reported receiving previous inhaler education and 73.3% educated or checked their patients’ inhaler technique; 64.5% felt they were somewhat competent in doing so. GPs who reported not demonstrating inhaler technique believed that a pharmacist or a practice nurse would do so. When prescribing new inhaler devices, GPs considered the disease being treated first and then patient’s experience with inhalers; they often already have an inhaler preference and this was related to familiarity and perceived ease of use. For GPs, inhaler competence was not associated with their previous inhaler education or the priority placed on inhaler technique. Conclusion: GPs do recognise the importance of inhaler technique in respiratory management but their technique can be better supported with regular educational updates to inform them about new inhalers and management practices and to support appropriate inhaler choices for their patients.

Project designer (PD) personality defines the way PDs cooperate with the project team, make decisions, and influence the project performance. The current research focused on identifying attributes associated with successful PDs as considered by male and female project engineers. In this context, a five-year questionnaire survey collected 423 responses from Greek engineers. The survey recorded data regarding the respondents and the scores assigned to the required PDs attributes. The methodological approach included an SPSS database, followed by descriptive statistics analysis, independent sample t-test, and correlation analysis. It became obvious that gender influences the assessment and selection of desired PD personality characteristics. Female engineers tend to assign the highest Likert scale-based scores, whereas male respondents tend to assign lower scores. The most highly ranked abilities included “responsibility,” “reliability,” and “obedience to rules.” The findings facilitate the implementation of multi-criteria decision-making tools for efficient project teams.

Background States are rapidly moving to reverse marijuana prohibition, most frequently through legalization of medical marijuana laws (MMLs), and there is concern that marijuana legalization may affect adolescent marijuana use.Methods This natural-experimental study used state Youth Risk Behavior Survey (YRBS) data collected from participants in grades 9–12 from 1991 to 2015 in 46 states (N= 1,091,723). Taking advantage of heterogeneity across states in MML status and MML dispensary design, difference-in-difference estimates compared states with enacted MMLs/dispensaries to non-MML/dispensaries states. Multivariable logistic regression modeling was used to adjust for state and year effects, and student demographics. The main outcome assessed was past 30-day adolescent marijuana use [“any” and “heavy” (≥20)].Results In the overall sample, the adjusted odds of adolescents reporting any past 30-day marijuana use was lower in states that enacted MMLs at any time during the study period (OR 0.94, 95% CI 0.89 to 0.99; p< .05), and in states with operational dispensaries in 2015 (OR 0.93, 95% CI 0.88 to 0.99; p< .05). Among grade cohorts, only 9th graders showed a significant effect, with lower odds of use with MML enactment. We found no effects on heavy marijuana use.Conclusions This study found no evidence between 1991 and 2015 of increases in adolescents reporting past 30-day marijuana use or heavy marijuana use associated with state MML enactment or operational MML dispensaries. In a constantly evolving marijuana policy landscape, continued monitoring of adolescent marijuana use is important for assessing policy effects.

Two poly(acrylic acid) (PAA)/graphene oxide nanocomposite systems, characterized by the same graphene oxide (GO) weight fraction (13.5 wt %) but with different sizes of nanoflakes, are studied by means of molecular dynamic (MD) simulations and the solid-to-liquid-glass (SLG) transition model. The MD density data were described well by the SLG equation of state (SLG-EoS), and the PAA thermal expansion coefficient was predicted to decrease with the size of GO nanosheets. A new equation for the description of the bulk modulus is introduced and used for the estimation of the effects of the size of GO flakes on the mechanical properties of the composites. The mechanical behavior of the composites was found to depend on the size of the GO filler. In the case of larger-sized GO flakes, the chains form longer sequentially adsorbed configurations (trains) as well as loops, while in the presence of smaller-sized GO nanoflakes, the train configurations are shorter and the polymer bridging is extensive. The slow mobility of the large GO flakes results in more retarded dynamics of the PAA chains, explaining the higher viscosity and the enhanced mechanical properties compared to the small GO system. Furthermore, using a generalized Arrhenius equation (SLG model), the dynamic behavior at high temperatures is extrapolated to the glass-transition region, providing thus a means to describe dynamics at lower temperatures. Analysis of the configuration-specific bound-layer polymer dynamics, in hydrogen-bond-forming systems, reveals that chain immobilization is restricted to a layer surrounding the nanofiller rather than propagating in a way that would promote the formation of “glassy bridges” between nanofillers.

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Introduction: Interventions aimed at optimizing parents’ ability to manage their children’s asthma could be strengthened by better understanding the networks that influence these parents’ choices when managing asthma. This study aimed to explore the asthma networks of parents of children with asthma—specifically to gain insights into whom parents select to be within their networks and why; how individuals within parents’ networks influence the way in which they manage their children’s asthma medications, and factors driving the development of these networks. Methods: A qualitative research methodology utilizing semi-structured interviews with parents of children with asthma was employed to fulfil the objectives of this study. Results: Twenty-six face-to-face interviews with parents of children with asthma were conducted, recorded, and transcribed. Transcriptions were independently coded for concepts and themes by the research team. Asthma medications was a dominant theme identified, and revealed that parents actively sought advice and support from a series of complex and multidimensional relationships with people and resources in their health network. These not only included health care professionals (HCPs) but also personal connections, lay individuals, and resources. The composition and development of these asthma networks occurred over time and were determined by several key factors: satisfaction with their HCP provider; need for information; convenience; trust and support; self-confidence in management; and parents’ perceptions of their children’s asthma severity. Conclusions: By exploring parents’ asthma network, this study uncovers the complex relationship between HCPs, family and friends of parents of children with asthma, and provides new insight into the intimate and parallel influence they have on parent’s decision-making.

ABSTRACTAccumulation of redox-active iron in human sporadic Creutzfeldt-Jakob disease (sCJD) brain tissue and scrapie-infected mouse brains has been demonstrated previously. Here, we explored whether upregulation of local hepcidin secreted within the brain is the underlying cause of iron accumulation and associated toxicity. Using scrapie-infected mouse brains, we demonstrate transcriptional upregulation of hepcidin relative to controls. As a result, ferroportin (Fpn), the downstream effector of hepcidin and the only known iron export protein was downregulated, and ferritin, an iron storage protein was upregulated, suggesting increased intracellular iron. A similar transcriptional and translational upregulation of hepcidin, and decreased expression of Fpn and an increase in ferritin expression was observed in sCJD brain tissue. Further evaluation in human neuroblastoma cells (M17) exposed to synthetic mini-hepcidin showed downregulation of Fpn, upregulation of ferritin, and an increase in reactive oxygen species (ROS), resulting in cytotoxicity in a dose-dependent manner. Similar effects were noted in primary neurons isolated from mouse brain. As in M17 cells, primary neurons accumulated ferritin and ROS, and showed toxicity at five times lower concentration of mini-hepcidin. These observations suggest that upregulation of brain hepcidin plays a significant role in iron accumulation and associated neurotoxicity in human and animal prion disorders.

A reactive Molecular Dynamics (MD) study of toluene oxidation at high temperatures under externally applied electrostatic fields has been performed. The impact of the modeling of local charge distribution has been investigated by comparing the widely used Charge Equilibration (QEq) method with the Charge Transfer with Polarization Current Equalization (QTPIE) method, which shields charge transfers up to atomic orbitals and introduces molecular polarization. Using the latter method, it is possible to improve the computation of the atomic charges, which are a critical aspect for the numerical study of electric fields, and to capture important effects of the electric field on rotational and vibrational energies of the toluene molecule. Results show that a more comprehensive treatment of inter- and intramolecular charge distribution achieved through the QTPIE method leads to substantially different applied forces and oxidation rates of toluene compared to the QEq method. Using the QTPIE method, no significant effects of the electrostatic field on the toluene oxidation rate were observed for the range of temperatures and pressures studied here, which is in disagreement with the results obtained with the QEq method where a clear impact of the electrostatic field on the average oxidation rate was found. Therefore, when studying electric field effects with MD simulations, the choice of the method used for the charge equilibration is a key modeling assumption whose impact should be carefully evaluated.

Introduction: Generic substitution of inhaler devices is a relatively new phenomenon. The best patient outcomes associated with generic substitution occur when prescribers obtain consent from their patients to prescribe a generic inhaler and also teach their patient how to correctly use the new device. To date, no prospective observational study has assessed the level of training required for general practitioners (GPs) to demonstrate correct inhaler technique using two dry powder inhaler devices delivering fixed-dose combination budesonide/formoterol therapy. This study aims to (1) determine the level of training required for GPs to master and maintain correct IT when using two different dry powder inhalers that are able to be substituted in clinical practice and (2) determine the number and types of errors made by GPs on each device and inhaler device preference at each training visit. Method: A randomized, parallel-group cross-over study design was used to compare the inhaler technique of participants with a Spiromax®placebo device and a Turbuhaler®placebo device. This study consisted of two visits with each participant over a period of 4?±?1 weeks (visit 1 and visit 2). A total of six levels of assessment and five levels of training were implemented as required. Level 1, no instruction; level 2, following use of written instruction; level 3, following viewing of instructional video; level 4, expert tuition from the researcher; level 5/level 6, repeats of expert tuition from the researcher when required. Participants progressed through each level and stopped at the point at which they demonstrated device mastery. At each level, trained researchers assessed the inhaler technique of the participants. Participants were also surveyed about their previous inhaler use and training. Results: In total, 228 GPs participated in this study by demonstrating their ability to use a Turbuhaler®and a Spiromax®device. There was no significant difference between the proportion of participants who demonstrated device mastery with the Turbuhaler®compared with the Spiromax®at level 1, (no instruction), (119/228 (52%) versus 131/228 (57%), respectively, n?=?228, p?=?0.323 (McNemar’s test of paired data). All but one participant had demonstrated correct inhaler technique for both devices by level 3(instructional video). There was a significant difference between the proportion of participants who demonstrated maintenance of device mastery with the Turbuhaler®compared with the Spiromax®at visit 2, level 1 (127/177 (72%) versus 151/177 (85%) respectively, p?=?0.003; McNemar’s test of paired data). All but two participants achieved device mastery by level 3, visit 2. More participants reported previous training with the Turbuhaler®than with Spiromax®. Discussion: This study demonstrates that GPs are able to equally demonstrate correct use of the Turbuhaler®and Spiromax®devices, even though most had not received training on a Spiromax®device prior to this study. The significance of being able to demonstrate correct technique on these two devices equally has ramifications on practice and supported generic substitution of inhaler devices at the point of prescribing, as the most impactful measure a GP can take to ensure effective use of inhaled medicine is the correct demonstration of inhaler technique.

The object of the study was to create a computer model that resembles the process of cold drawing seamless steel tubes, and evaluate the influence of selected process parameters on selected final dimensions and tolerances of STL models of the tubes obtained from DEFORM simulation software. The STL models of tubes generated from the simulations were evaluated, and the effects of the reduction angle and the friction coefficient on the inner/outer diameter, inner/outer roundness and concentricity were subsequently found. It was proven that the inner and outer diameters are not influenced by different values of the friction coefficient at the same reduction angle. On the other hand, increasing value of the reduction angle affects decrease of the outer and inner diamaters after drawing. Furthermore, this experimental investigation vindicates that friction coefficient and reduction angle have the minimal impact on the inner/outer roundness and outer concentricity.

Molecular dynamics simulations were employed to study the bound layer in polymer/graphene-based nanocomposites. We focused on the dynamic behavior of polar (poly(acrylic acid)) and nonpolar (polystyrene) linear chains, at the interface with graphene-based fillers, bearing different affinities with the polymers and different nanoroughness. Four temperatures were examined with a step of 50 K and the lowest one 100 K above the Tgof the corresponding bulk polymers. The dynamic response of the adsorbed layer exhibited an increased departure from that of the bulk, accompanied by a higher degree of dynamical heterogeneity, especially for the oxidized graphene systems. In the case of the nonoxidized analogues, an increased anisotropy of polymer diffusion parallel and perpendicular to the filler’s plane was observed. Dynamics within the adsorbed layer exhibited Arrhenius-like characteristics in all the examined systems, in agreement with recent experimental studies. The combination of the results associated with backbone torsional motion and the chain desorption process revealed a strong dynamic transition near both the examined nanosheets, almost 100 K above the bulk Tg. However, in the adjacent-to-the-adsorbed layer, polymer dynamic characteristics approached the bulk behavior. It is therefore implied that, depending on its average size, a polymer chain may experience different dynamic regimes across its length near the interface region.

The conformations and the dynamics of poly(butadiene) (PB) chains, of various molecular weights, in PB/silica nanocomposites are studied through long-time atomistic molecular dynamics simulations at T= 413 K, well above Tg. The effect of the stereochemistry of PB chains is addressed by simulation of cis-1,4-PB/silica and trans-1,4-PB/silica nanocomposites. The model systems contain 30 wt % (≈12 vol %) silica nanoparticles (NPs) of diameter ≈4 nm. The nanocomposites are characterized through analyzing (i) interfacial packing and the dimensions of the PB chains; (ii) statistics of the train, bridge, loop, and tail conformations of adsorbed chains and the coupling between segmental orientational dynamics and chain conformations; and (iii) the orientational and translational dynamics of the polymer chains and the desorption kinetics of chains and segments. The dimensions of PB chains, excluding a small fraction of chains that wrap around the NP, are not affected. The segmental and terminal dynamics of PB chains are slower in the nanocomposites than in the respective bulk melts. Moreover, the dynamics of PB chains in the nanocomposites is very heterogeneous, and a coupling between the dynamics and the conformation of PB chains is observed: the adsorbed segments (trains) and the chains that have a higher number of contacts to the NPs are more decelerated. Additionally, at long times, bridge segments exhibit a very slow orientational decorrelation. The self-diffusion coefficients, D, of PB chains in the nanocomposites are also reduced compared to the respective bulk systems. A clear crossover from the unentangled (Rouse-like) to the entangled (reptation-like) regime is observed based on the calculation of the segmental mean-square displacement and Das a function of the chain length. The effective tube diameter of entangled PB chains in the nanocomposites is estimated to be slightly smaller than in the pure melts. The deceleration of dynamics in the nanocomposites, in both Rouse and reptation-like regimes, is discussed in terms of a higher effective monomeric friction coefficient. Finally, the correlation times for the desorption of segments and chains are much larger than the segmental and end-to-end-vector correlation times, respectively.

ABSTRACTFamily stress theory explains how demands placed on the family system interact with capabilities to influence family adaptation. One capability that some military families may use naturalistically is that of benefit-finding, the recognition of value and benefit after a stressful or traumatic experience. In this mixed methods study, authors explore the perception of benefits associated with military service amongst 26 home-front mothers. Methods incorporate a self-report questionnaire adapted for this population and a qualitative interview aimed at understanding challenges and benefits associated with these women’s experiences as members of a military family. Results revealed that more women than not endorsed meaningful changes that they have experienced as a result of their family’s military service, despite a wide range of challenges and negative experiences. Four themes of benefits emerged from analyses: (a) financial, educational and career benefits; (b) cultivating strength; (c) friendships and community; and (d) pride. These findings illuminate the diverse ways in which women find meaning in their family’s military service and upon replication and elaboration of these results, have clinical implications for the development of future prevention and intervention work with military families.

Introduction: Asthma and allergic rhinitis (AR) are chronic respiratory diseases of a united airway. Poor AR control is a risk factor for uncontrolled asthma. We know that people with AR feel confident in making their own treatment choices with over-the-counter therapies, yet only 16% of purchases were the optimal selection. With the high level of poor asthma control and overuse of over-the-counter, short-acting beta-agonists, we must consider whether poor AR self-management behaviours are extended to asthma management in those with both diseases. This study aims to investigate asthma management from the perspective of the patient with asthma and AR and understand the influences behind their asthma management decisions. Methods: This study utilized a mixed methods approach based on the theoretical and analytical framework of social network theory, including mapping of the asthma network and exploring the roles and influence of those that appear within the network. Results: Twenty-two people with asthma and allergic rhinitis participated in this study. General practitioners (GPs), pharmacists and respiratory physicians were the most commonly reported influences behind participants’ asthma management decisions. Although non-healthcare professional (HCP) influences appear within the asthma network, they represented a smaller proportion. Conclusion: The asthma network of people with AR is dominated by HCP influences. This network is unique and different to other previously published asthma and AR networks. Further research on the impact of AR on asthma management patient behaviour is required.

Mepolizumab can induce an early response and clinical remission in people with severe eosinophilic asthma (SEA).

A reactive molecular dynamics (MD) study of iron nanoparticle oxidation under externally applied electrostatic fields is performed, with a focus on the role of charge transfers and electrically induced polarization. Two charge equilibration methods that either enable or shield long-range charge transfers and two ReaxFF parameter sets that predict different bonded and nonbonded interactions are used in the evaluation. The field-induced polarization modeled in MD simulations is in good agreement with analytical solutions and density functional theory (DFT) computations. Results show that oriented external electric fields affect the transition states of reactions involved in oxygen adsorption on the nanoparticle surface and oxygen diffusion inside the iron lattice. The oxygen diffusion inside the nanoparticle can be either aided or hindered by the external electric field depending on the direction of motion of oxygen compared to the direction of the external electric field. Simulations also demonstrate that long-range charge transfers increase the reactivity of the system compared to shielded interactions. Regarding ambient conditions, a density increase can accelerate the kinetics of the system, while temperature variations have a smaller effect on the oxidation rate for the systems investigated here. The external electrostatic field affects the kinetic energy, collision frequency, and reactivity of the system. When charge transfers are limited to close interactions, the system’s kinetics is accelerated only under strong external electric fields. On the contrary, if long-range charge transfers are enabled, an increase in the oxidation rate is observed for weak electric fields, whereas for stronger electric fields the oxidation rate decreases due to a more coherent movement of the charged particles under the Lorentz forces. In addition, external electric fields affect the chemical composition of iron and iron oxide nanoparticles. The diffusion of the negatively charged absorbed oxygen atoms toward one side of the nanoparticle causes an anisotropic thickness of the oxidation layer. The influence of the external electric field on the system’s kinetics depends on the choice of the ReaxFF parameter set, highlighting the importance of accurate training of the force field with a focus on charge transfers and their distribution under external fields. These findings provide insight into the fundamental effects of charge transfers and field-induced polarization on the oxidation process of a nanoparticle in the presence of an external electrostatic field and offer a comprehensive evaluation of the capability of the MD-ReaxFF framework to predict the underlying physical mechanisms at the atomistic scale.

ABSTRACTProactive HPV vaccination at age 9 better prevents infection and improves vaccine series completion. Because national organizations recommend starting the vaccine at different ages, we sought to understand the impact of these recommendation frames. In 2022, we surveyed 2,527 US clinical staff (45% physicians) who provide HPV vaccine for children. We randomized respondents to one of three frames based on HPV vaccine recommendations of national organizations or a no-recommendation control, and assessed willingness to recommend HPV vaccine for children ages 9–10. Respondents also reported perceived benefits of HPV vaccination at ages 9 or 12. Recommending HPV vaccination “at ages 11–12” led to lower willingness to vaccinate at ages 9–10 than control (37% vs. 54%, p < .05). Recommending vaccination “at ages 9–12” led to similar willingness as control. However, “starting at age 9” led to higher willingness than control (63% vs. 54%, p < .05). Results were similar across respondents’ training, specialty, or years in practice, or their clinic’s rurality or healthcare system membership. More common benefits of recommending at age 9 than 12 were avoiding the topic of sex (24% vs. 10%, OR = 2.78, 95%CI: 2.23, 3.48) and completing the vaccine series before age 13 (56% vs. 47%, OR = 1.44, 95%CI: 1.23, 1.68). Less common benefits for age 9 were having parents ready to talk about HPV vaccine and agreeing to vaccination (both p < .05). An effective way to encourage proactive HPV vaccination is to say that it starts at age 9. Aligning national recommendations to start at age 9 can promote timely vaccination.

The Allergic Rhinitis Clinical Management Pathway (AR-CMaP) was developed to overcome the challenge of implementing current AR guidelines in the Australian community pharmacy practice and support pharmacists in optimally managing patients' AR.

The paper is focused on the experiment where the effects of the cutting environment and feed of drilling on the bores roughness and cylindricity were evaluated. Dry drilling of aluminium alloys (without using cutting fluids) is an environmentally friendly machining process but also an extremely difficult task, which is due to the tendency of aluminium to adhere to the drills made of conventional materials such as high-speed steel; and therefore three cutting environments (namely two different emulsions and compressed air) were used in the experiment. The article demonstrates multicriterial optimization of input factors (cutting environment, feed) for two defined target functions: roughness and cylindricity). The measured values were subjected to mathematico–statistical Analysis of Variance (ANOVA). ANOVA was used for examining the effects of machining parameters and their contribution to the surface roughness and bores cylindricity. The optimal cutting parameters were evaluated for “Smaller-the-Better” quality characteristics of both output responses, as can be seen in our article published previously. Based on the ANOVA, we determined that cutting environment exhibited higher percentage of contribution on bores quality than feed of machining. The results show 77.37 % impact of cutting environment and 8.13 % impact of feed on quality of machined bores.

Measurement of industrial parts is very important for current production. There are many different methods (contact and non – contact) for part ́s control. Every of those methods have some advantages and disadvantages. The biggest problem was found in measurement of very small parts or complex parts which have some inaccessible places. The solution was implementation of X-ray technology into the measuring process. It is called computed tomography or metrotomography (connecting metrology and tomography). This technology finds application in many different fields, especially in the automotive industry. The result of the method is cloud of points or generated STL models which are suitable for use in other software for evaluation. However, there is still question of the method accuracy and accuracy of the generated STL models. This paper is dealing with scanning of plastic part with X-ray technology, generating of STL models by different methods and their accuracy evaluation.

Introduction Duplication of the vertebral artery (VA) is a rare vascular variant, with less than 50 reported cases in the literature.Case series We present four cases of VA duplication and discuss the imaging findings, which highlight the rarely seen VA duplication.Discussion VA duplication is generally considered to be an incidental finding. The VA is formed from the fusion of the longitudinal anastomoses that link the cervical intersegmental arteries, during the 32–40-day stage. The duplication of the VA is a clinically relevant finding for planning of head and neck surgery and neuro-interventional procedures.

AbstractThis study aims to measure the differences in technical efficiency of technical schools and general high schools that operate in the same neighbourhood in Athens city-centre. We choose ten pairs by nearby schools in distance or co-location including one technical school and one general high school per pair. The schools were divided into two groups; ten technical schools and ten high schools. Because of the heterogeneity across two groups of schools we used data envelopment metafrontier analysis. The results indicate that the group scores are high for high and technical school and the metafronier score of technical schools is very low. The results also indicate that the meta-technology ratio of high schools is higher than meta-technology ratio of technical schools proving the need for setting clear different objectives, processes and outcomes for the two types of schools of the Hellenic Educational System. The realized correlation analysis demonstrated the relation between the inputs and the metafrontier scores. Also, by defining the strong leading group (SLG) to be the the group of the general high schools have been developed some useful theoretical approaches on the performance evaluation of schools.

In this work, we elucidated the nanostructure and dynamics of Nafion-doped graphene-oxide (GO) systems from molecular dynamics simulations at varying hydration levels and temperature. It was found that the presence of GO resulted in the formation of Nafion layers along a direction normal to the GO surface. Chain conformations in the Nafion layers close to the GO interface were characterized by a backbone preferably oriented parallel to the GO plane, whereas the size of the formed nanochannels was found to be commensurate to the average dimensions of the Nafion side chains. The mechanism of water cluster growth was found to change drastically upon introduction of Nafion chains, although addition of GO in the membranes did not impart further measurable changes at the examined temperatures. Hydronium ions were found to adsorb partly onto the GO surface, whereas the pertinent adsorption/desorption rate increased significantly with hydration. Translational dynamics of water molecules was much slower close to the GO surface compared to that at distances far from GO. In the temperature range examined, the dynamics of the effectively confined water molecules was found to follow an Arrhenius-like dependence. Water retention at the Nafion/GO interface appears only at high hydration levels of Nafion.

Medication use has always played a highly significant role in the overall management of asthma, with appropriate use being linked to good asthma control. However, while patients with asthma enjoy the ‘luxury’ of having medications delivered directly to the lungs via inhaler devices, with that comes the additional challenge of ensuring that inhaler devices are used correctly. Research and practice provides evidence to the challenges associated with inhaler use and the particular steps that patients perform incorrectly. While this problem is well documented, acknowledged and reported, little has changed in 40 years, and the proportion of patients using inhaler devices remains unacceptably high. This review focuses on aspects specific to the errors that patient’s make, the significance of these errors, and the important considerations for health care practitioners in supporting patients in correctly using their inhalers. This review highlights the complexities associated with patient’s making inhaler technique errors and highlights the opportunities that lie in future technological developments of inhaler devices. Now more than ever, in the era of precision medicine, it is important that we address inhaler technique use once and for all.

AbstractThe paper introduces the decision-making through a system of inequalities for high-school students and first-year undergraduate students. The objective of this paper is to enable the students to understand the importance of mathematics in real business application problems. Moreover, we present a production problem and highlight the set of solutions for the problem. The set of solutions is defined by the system of inequalities resulting from available resources for production, storage, and consumption. Furthermore, we introduce the elimination method of Fourier-Motzkin. The method helps us to find the optimum solution for the production problem by solving systems of inequalities without using linear programming.

In this paper, we consider the problem of learning the genetic interaction map, i.e., the topology of a directed acyclic graph (DAG) of genetic interactions from noisy double-knockout (DK) data. Based on a set of well-established biological interaction models, we detect and classify the interactions between genes. We propose a novel linear integer optimization program called the Genetic-Interactions-Detector (GENIE) to identify the complex biological dependencies among genes and to compute the DAG topology that matches the DK measurements best. Furthermore, we extend the GENIE program by incorporating genetic interaction profile (GI-profile) data to further enhance the detection performance. In addition, we propose a sequential scalability technique for large sets of genes under study, in order to provide statistically significant results for real measurement data. Finally, we show via numeric simulations that the GENIE program and the GI-profile data extended GENIE (GI-GENIE) program clearly outperform the conventional techniques and present real data results for our proposed sequential scalability technique.

ABSTRACTThis article provides best and promising practices for recommending HPV vaccination at age 9 as a way to ensure high uptake. An effective method for recommending HPV vaccination is the Announcement Approach, which consists of 3 evidence-based steps. The first step, Announce, involves noting that the child is 9 years old, saying they are due for a vaccine that prevents 6 HPV cancers, and saying you’ll vaccinate today. This adapted version of the Announce step simplifies the bundled approach used at ages 11–12 that emphasizes the prevention of meningitis and whooping cough in addition to HPV cancers. For hesitant parents, the second step, Connect and Counsel, involves finding common ground with the parent and communicating the value of starting HPV vaccination at the first opportunity. Finally, for parents who decline, the third step is to Try Againat a later visit. Using the Announcement Approach at age 9 stands to increase HPV vaccine uptake, save time, and lead to high family and provider satisfaction.

Chronically re-experiencing the memory of a traumatic event might cause a glial response. This study examined whether glial activation would be associated with PTSD in a study of responders present after the 9/11 World Trade Center attacks without comorbid cerebrovascular disease.