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The introduction of Variable Speed Drives (VSD) motor driven systems in industry is driven by the desire to increase motor efficiencies in plant. The efficiency savings are usually determined by initial energy assessments which consider factors such as the motor load type and operating conditions where the motor actual load may also be measured. However, once the system is installed and in operation, the designed-in energy efficiency of these systems may remain unchecked throughout the lifetime of the installation. Efficiency reductions may be caused by mechanical or electrical degradation of equipment that could remain undetected by the drive or user whilst the equipment appears to operate as normal. On larger systems, the financial cost of reduced efficiency can be significant. The aim of this paper is to simulate minor deteriorations in the operating conditions of a standard motor controlled from a VSD and ascertain if the worsening condition can be detected at an early stage. The deterioration in motor condition will be small enough to remain undetected by the VSD and not cause a drive fault. This paper also reviews the effect of the introduced motor imbalance on motor efficiency and introduces power factor measurement methods which can be a useful indicator of increased operating costs for equipment. Test results from the two drive operating modes of Volts/Hertz (v/f) and Sensorless Vector (SV) are compared. This is to determine if there is any noticeable difference in the measurements obtained for efficiency and power factor between drive operating modes.

Nonexudative choroidal neovascularization (CNV) is a new phenomenon that has only recently been described in the literature with the advent of optical coherence tomography angiography (OCTA) imaging. The authors present a 1-year longitudinal follow-up of a nonexudative CNV lesion secondary to age-related macular degeneration. This report describes the appearance of the lesion on two commercially available spectral-domain OCTA devices and one prototype swept-source OCTA device. Management of these cases is still debatable. Watchful waiting with regular follow-up using serial OCTA to monitor disease progression has been valuable in this case., National Institutes of Health (U.S.) (Grant R01-EY011309), United States. Air Force Office of Scientific Research (Grant FA9550-15-1-0473), United States. Air Force Office of Scientific Research (Grant FA9550-12-1-0499)

Background Foreign-educated physical therapists are often viewed as one possible solution to the current shortage of physical therapists, yet there is very little research regarding these individuals. Objective The purpose of this study was to describe those physical therapists who are licensed in the United States but who were educated in another country. This description includes their country of education, their employment patterns, and the reasons they decided to emigrate and work as a physical therapist in the United States. Design A cross-sectional survey was conducted. Methods An electronic survey was sent to all physical therapists currently licensed in the United States who had been educated in another country. Those who had been licensed within the last 5 years are reported. Results The results of the survey indicated that the typical foreign-educated physical therapist is female, aged 32.2 years, and was born and trained in either the Philippines or India. A majority of foreign-educated physical therapists obtained their first license in New York, Michigan, Illinois, Texas, or Florida. The most common reasons cited as to why a particular jurisdiction was chosen for initial employment were “recruiter recommendation,” “family, spouse, partner, or friends,” “ease of the licensure process,” and “ability to secure a visa sponsor.” A majority of foreign-educated physical therapists in this study initially worked in a skilled nursing facility, a long-term care or extended care facility, or a home health setting. Limitations Only those foreign-educated physical therapists licensed within the last 5 years are reported. Conclusions This study is the first to report on foreign-educated physical therapists in the United States. The findings of this study will provide important and useful information to others dealing with physical therapy professional and workforce issues.

This article was originally published with the copyright: the author(s) 2018, CC-BY-NC. However, the license should be the author(s) 2018, CC-BY.

Purpose: Donated corneas are classified as tectonic if there are defects within any layers of the cornea which would prevent a satisfactory visual outcome after transplantation. This study aimed to evaluate whether some tectonic corneas have sufficient endothelial characteristics to allow their use in posterior lamellar keratoplasty, and explored their reclassification for use in this sight-improving procedure. Methods: A retrospective review of all corneal tissues preserved by the Sorocaba Eye Bank from January to April of 2014 was performed. All donated corneas classified as tectonic were included. Endothelial tissue was defined as healthy and viable for posterior lamellar keratoplasty if endothelial cell density was ≥2000 cells/mm2. Additional parameters analyzed included Descemet folds and stretch marks, loss of endothelial cells, corneal endothelial polymegathism/ pleomorphism, pseudo-guttata, and reflectivity. Results: During the study period, 2,847 corneas were preserved, of which 423 (14.85%) were classified as tectonic. Of these, 87 (20.56%) were reported as having endothelial viability and were included in the posterior lamellar keratoplasty group. Average corneal endothelial cell density of this group was 2,471 SD ± 256 cells/mm2 (range 2012-2967 cells/mm2). Conclusion: A significant number of corneas classified as tectonic showed endothelial viability and were included in the posterior lamellar keratoplasty group (20.56%). Despite stromal and/or epithelial alterations, these corneas could have been potentially distributed for posterior lamellar transplantation to improve vision, thus reducing the corneal transplantation waiting period. This study highlights how corneal tissue reclassification could increase the potential amount of corneal tissue available for optical transplantation. RESUMO Objetivo: Avaliar a vitalidade endotelial das córneas classificadas como tectônicas e discutir a viabilidade de seu uso na ceratoplastia lamelar posterior. Métodos: Realizou-se uma revisão retrospectiva de todos os tecidos corneanos preservados pelo Banco de Olhos Sorocaba de janeiro a abril de 2014. Todas as córneas doadas classificadas como tectônicas foram incluídas e avaliadas com ênfase na vitalidade endotelial. Os parâmetros de avaliação da lâmpada de fenda de cada córnea e densidade de células endoteliais medidos por microscópio especular foram registrados: córneas que apresentavam vitalidade endotelial apesar de alterações no estroma e/ou no epitélio foram selecionadas e incluídas em um grupo denominado grupo lamelar posterior. O tecido endotelial foi definido como saudável e viável para a ceratoplastia lamelar posterior, se houvesse uma densidade de células endoteliais ≥2.000 células/mm2. Outros parâmetros também foram analisados, incluindo; estrias ou pregas na Descemet, perda de células endoteliais, polimegatismo e pleomorfismo endotelial, pseudo-guttata e reflexividade endotelial. Resultados: Durante o período do estudo, foram preservadas 2.847 córneas, das quais 423 (14,85%) foram classificadas como tectônicas. Dessas, 87 (20,56%) apresentaram vitalidade endotelial e foram incluídos no grupo lamelar posterior. A densidade média das células endoteliais da córnea deste grupo era de 2.471 SD ± 256 células/mm2, variando de 2.012 a 2.967 células/mm2. Conclusão: Um número significativo de córneas classificadas como tectônicas apresentaram vitalidade endotelial e foram incluídas no grupo lamelar posterior (20,56%). Apesar de alterações estromais e/ou epiteliais, estas córneas poderiam ter sido potencialmente distribuídas para transplantes lamelares posteriores com finalidade ótica, otimizando a disponibilidade de tecidos, com impacto positivo na saúde pública.

Background: Activation of the ileal brake through the delivery of nutrients into the distal small intestine to promote satiety and suppress food intake provides a new target for weight loss. Evidence is limited, with support from naso-ileal lipid infusion studies.Objective: The objective of the study was to investigate whether glucose infused into the duodenum and ileum differentially alters appetite response, food intake, and secretion of satiety-related gastrointestinal peptides.Design: Fourteen healthy male participants were randomly assigned to a blinded 4-treatment crossover, with each treatment of single-day duration. On the day before the intervention (day 0), a 380-cm multilumen tube (1.75-mm diameter) with independent port access to the duodenum and ileum was inserted, and position was confirmed by X-ray. Subsequently (days 1-4), a standardized breakfast meal was followed midmorning by a 90-min infusion of isotonic glucose (15 g, 235 kJ) or saline to the duodenum or ileum. Appetite ratings were assessed with the use of visual analog scales (VASs), blood samples collected, and ad libitum energy intake (EI) measured at lunch, afternoon snack, and dinner.Results: Thirteen participants completed the 4 infusion days. There was a significant effect of nutrient infused and site (treatment × time, P < 0.05) such that glucose-to-ileum altered VAS-rated fullness, satisfaction, and thoughts of food compared with saline-to-ileum (Tukey's post hoc, P < 0.05); decreased ad libitum EI at lunch compared with glucose-to-duodenum [-22%, -988 ± 379 kJ (mean ± SEM), Tukey's post hoc, P < 0.05]; and increased glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) compared with all other treatments (Tukey's post hoc, P < 0.05).Conclusions: Macronutrient delivery to the proximal and distal small intestine elicits different outcomes. Glucose infusion to the ileum increased GLP-1 and PYY secretion, suppressed aspects of VAS-rated appetite, and decreased ad libitum EI at a subsequent meal. Although glucose to the duodenum also suppressed appetite ratings, eating behavior was not altered. This trial was registered at www.anzctr.org.au as ACTRN12612000429853.

The association between socioeconomic position and morbidity and mortality has long been recognized. We evaluate the evidence for an association between multiple aspects of deprivation and ocular health in a global context. This is a systematic review of studies that evaluated deprivation in the adult population in the context of the major acquired causes of visual loss such as cataract, diabetic eye disease, glaucoma, age-related macular degeneration, and ocular trauma. The search strategy identified relevant studies reported between 1946 and August 2016, with randomized control trials, case-control, cohort, and cross-sectional study designs being selected for inclusion. The studies identified in this review from across the world demonstrate the extent to which the common themes such as low educational attainment and low income may be associated with increased incidence of various sight-threatening conditions and may adversely affect access to specialist assessment and delivery of treatment. Health inequality may always persist, but an increased recognition of the importance of the various impacts of deprivation may empower policy makers to target limited resources to the most vulnerable groups in order to deliver the greatest benefit.

To describe the appearance of a scleral-derived feeder vessel in a highly myopic eye with secondary choroidal neovascularization (CNV) as visualized on both en face high-speed swept-source (SS) optical coherence tomography angiography (OCTA) prototype, and a commercially available spectral-domain (SD) OCTA, with the corresponding en face and cross-sectional structural OCT images. In this case report, a 60-year-old white male presented with high myopia and secondary CNV in the right eye, previously treated with anti-vascular endothelial growth factor, and was imaged on both SD-OCT and SS-OCT. The neovascular complex could be visualized on both devices. Structural en face SS-OCT images demonstrated a large choroidal-scleral feeder vessel that was not visualized with SD-OCT. The authors concluded that structural en face SS-OCT better visualizes scleral feeder vessel compared to SD-OCT due to the longer wavelength (∼1,050 nm) with increased choroidal penetration and decreased sensitivity roll-off in the SS-OCT system. [ Ophthalmic Surg Lasers Imaging Retina . 2016;47:960–964.]

Background To investigate the choroidal thickness in older patients with central serous chorioretinopathy (CSCR) compared to age-matched normal subjects. Methods Fifteen patients (30 eyes) with CSCR, all aged ≥60 years, and 21 age-matched normal subjects (21 eyes) underwent high-definition raster scanning using SD-OCT. Both eyes from CSCR patients were included in the analysis. The eyes in patients with CSCR were divided into two groups: active CSCR (17 eyes) if there was foveal-involving subretinal fluid and inactive contralateral eye group (13 eyes). Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroidal–scleral junction at 500 µm intervals up to 2500 µm temporal and nasal to the fovea (11 locations). Results The mean age of the patients with CSCR was 68.87 ± 6.83 years (mean ± standard deviation). Reliable measurements of choroidal thickness were obtainable in 70.6 % of eyes examined. The choroid was statistically significantly thicker in eyes with both active CSCR (P 0.05). Conclusion Choroid in older patients with active CSCR was thicker than the choroid in age-matched normal eyes. It is important to consider CSCR as a differential diagnosis of serous retinal detachment in elderly patients with thickened choroid and to consider SD-OCT as an imaging modality by which to evaluate the choroidal thickness.

As a primer driver, induction motors are the most electric energy consuming component in industry. The exposure of the motor to stator winding asymmetry, combined with broken rotor bar fault significantly increases the temperature and reduces the efficiency and life of the motor. Accurate and timely diagnosis of these faults will help to maintain motors operating under optimal statues and avoid excessive energy consumption and severe damage to systems. This paper examines the performance of diagnosing the effect of asymmetry stator winding on broken rotor bar faults under closed loop operation modes. It examines the effectiveness of conventional diagnosis features in both motor current and voltage signals using spectrum and modulation signal bispectrum analysis (MSBA). Evaluation results show that the combined faults cause an additional increase in the sideband amplitude and this increase in sideband can be observed in both the current and voltage signals under the sensorless control mode. MSB analysis has a good noise reduction capability and produces a more accurate and reliable diagnosis in that it gives more correct indication of the fault severity and location for all operating conditions.

Purpose: To investigate the appearance of choriocapillaris (CC) flow under drusen by comparing long-wavelength (1050 nm) swept-source optical coherence tomography (SS-OCT) angiography with shorter-wavelength (840 nm) spectral-domain (SD) OCT angiography. Methods: Patients with drusen imaged on both devices on the same day were selected and graded. Ambiguous OCT angiography (OCTA) signal loss was defined as low OCTA signal on the en face OCTA CC image that also had low OCT signal in the corresponding area on the en face OCT CC image and OCT B-scans. Unambiguous OCTA signal loss was defined as low OCTA signal on the en face OCTA CC image that did not have low OCT signal in the corresponding area on the en face OCT CC image and OCT B-scans. False-positive flow impairment on SS-OCTA was defined as ambiguous OCTA signal loss on SS-OCTA but no OCTA signal loss on SD-OCTA. False-positive flow impairment on SD-OCTA was defined as ambiguous OCTA signal loss on SD-OCTA but no OCTA signal loss on SS-OCTA. Results: Nine eyes from seven patients were enrolled, 23 drusen were analyzed. On 840-nm SD-OCTA, 17 drusen (73.9%) exhibited OCTA signal loss. Fourteen (82.4%) were classified as ambiguous, and three (17.6%) were classified as unambiguous; 10 (58.8%) were classified as having false-positive flow impairment. On 1050-nm SS-OCTA, seven drusen (30.4%) exhibited OCTA signal loss and were classified as unambiguous; none were classified as having false-positive flow impairment. Conclusions: Results showed that 1050-nm SS-OCTA appears less prone to producing areas of false-positive flow impairment under drusen., Macula Vision Research Foundation, National Institutes of Health (U.S.) (NIH R01-EY011289-30), National Institutes of Health (U.S.) (R44-EY022864-03), National Institutes of Health (U.S.) (R01-CA075289-19), United States. Air Force Office of Scientific Research (AFOSR FA9550-15-1-0473), United States. Air Force Office of Scientific Research (AFA9550-12-1-0499), Champalimaud Foundation, Massachusetts Lions Club, Birdshot Uveitis Society/Fight for Sight (24BU151), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil. Ministry of Education

Background The potassium channel I Ks , which is encoded by the KCNQ1 gene, is expressed in organ systems including the inner ear, kidneys, lungs, intestine, and stomach in addition to the heart. Increasing evidence indicates that I Ks in the stomach plays an essential role in enabling gastric acid production. It is not known whether gastric acid production is disordered in patients with long QT type 1. Serum gastrin levels become elevated in subjects with disordered gastric acid production. Objective The purpose of this study was to evaluate serum gastrin levels, as a surrogate for impaired gastric acid secretion, in patients with KCNQ1 mutations, and to see if gastrin levels correlate with severity of cardiac disease. Methods Fasting serum gastrin levels were measured using a standardized immunometric technique in an index case and 12 subjects with known KCNQ1 mutations. Results An adult female with Jervell and Lange-Nielsen syndrome (JLNS; with KCNQ1 nonsense mutations p.Arg518X and p.Arg190AlafsX95 ) presented with multiple gastric carcinoid tumors and grossly elevated serum gastrin levels (943–1,570 pmol/L; normal 6–55 pmol/L) and absent acid secretion. Gastrin levels in two girls with JLNS, unrelated to the index case (missense mutations p.Leu266Pro and Gly269Ser), also were high (305 and 229 pmol/L). Gastrin levels were normal in 10 KCNQ1 heterozygous single mutation carriers, even in those with severe long QT syndrome, including three heterozygous family members of the JLNS subjects. Conclusion JLNS may be associated with elevated gastrin levels, impaired acid secretion, and risk of gastric carcinoid tumors. Among KCNQ1 single mutation carriers, gastrin levels were normal and did not appear to be linked to the severity of clinical expression of long QT syndrome.

Population health is a concept that emerged from the desire of providers to care for patients in a manner that produces the best possible outcomes while minimizing cost. It may be defined as the study of medical data of large groups of people in order to recognize and investigate patterns. This information is then used to create disease management guidelines that streamline care and regulate practice patterns. Whereas population health looks to recognize commonalities in data, the concept of patient-centered care focuses on embracing individualization and increasing the involvement of each patient within their treatment planning. Combining both perspectives creates a challenge for providers and patients to strike the proper balance between adhering to standardized guidelines based on the treatment methods and outcomes recognized in populations and applying it clinically to individual patients. A significant contribution of population health studies is the identification of risk factors associated with increased rates of complications following total joint arthroplasty as well as preventative measures for conditions such as osteoarthritis. However, to employ these findings in a patient-centered manner orthopaedic surgeons must take this a step further and also evaluate a patient’s ability to adhere to the recommendations by exploring factors such as home environment and socioeconomic factors, thus proactively addressing issues that could hinder patient compliance. With focused collection methods of acquiring data, these two practices of care will hopefully begin to see less divergence when it comes to applying data derived from population health initiatives to individual patients in a patient-centered manner.

Purpose The aim of this study was to determine whether social deprivation is a risk factor for late presentation of patients with proliferative diabetic retinopathy and whether it affects their access to urgent laser treatment. Methods Using a 2:1 case: control design, 102 patients referred to a UK teaching hospital as part of the UK Diabetic Retinopathy National Screening Programme were identified for the period between 1 June 2010 to 1 June 2013. Social deprivation was scored using the Index of Multiple Deprivation 2010. Additional variables considered included age, duration of disease, ethnicity, and HbA1c at time of referral. Results The cases comprised 34 patients referred with proliferative (grade R3) retinopathy with a control group of 68 patients with lower retinopathy grades; two control patients were excluded due to incomplete data. On univariate analysis, R3 retinopathy was associated with higher social deprivation (P

Maintaining the efficiency of AC motors in site equipment is important, given the increasing cost of energy. Reduction of motor efficiency from baseline manufacturer data can go undetected until total failure of the equipment is experienced. This paper introduces motor current signature analysis methods used to detect the early onset of motor efficiency reduction in AC motors controlled by modern Sensorless-Vector Variable Speed Control inverters. A step increase in the resistance of one stator winding is simulated in stages. Off-line processing of motor current data signals using data analysis methods developed for the MATLAB platform is used to identify imbalances caused by subtle stator resistance increases. Initial results indicate that small increases in stator resistances can be observed in the motor current signals received after data processing techniques have been used on the measured signals. The test results are presented herein along with details on the research work to be continued.

Purpose Choroidal thickness increases linearly with intraocular pressure (IOP) lowering. We studied the relationship between the change in size of the choroidal vasculature and IOP lowering after glaucoma procedures. Methods Thirty eyes of twenty-nine patients were examined pre- and postoperatively for up to 6 months with standard clinical assessment, enhanced depth imaging spectral-domain optical coherence tomography (OCT), and axial length measurement. Each enhanced depth imaging spectral-domain OCT image was analyzed using three separate methods to determine the choroidal thickness, choroidal vessel thickness, choroidal interstitial thickness, large choroidal vessel layer thickness, medium choroidal vessel layer thickness, and light-dark ratio. Bivariate linear regression analysis was completed with largest change in IOP as the independent variable. The dependent variables included choroidal thickness, choroidal vessel thickness, and choroidal interstitial thickness, at the largest change in IOP. Multivariable regression analysis using a generalized estimating equation to account for multiple measurements per eye was also completed. Results Mean choroidal vessel thickness increases 1.5 μm for every 1 mm Hg decrease in IOP (P < 0.0001; 95% confidence interval [CI], 0.8, 2.1) and choroidal interstitial thickness increases 1.3 μm for every 1 mm Hg change in IOP (P < 0.0001; 95% CI, 0.8, 1.8). There was no significant association between change in IOP and change in large choroidal vessel layer temporally (P = 0.13), nasally (P = 0.20), or subfoveally (P = 0.18). There was also no association between IOP and the light-dark ratio (P = 0.16). Conclusions The increase in choroidal thickness at lower IOP is associated with approximately equal increases in its intravascular and extravascular compartments.

Importance Alterations in ocular blood flow play an important role in the pathogenesis and progression of diabetic retinopathy (DR). However, the measurement of retinal blood flow in clinical studies has been challenging. En face Doppler optical coherence tomography (OCT) provides an effective method for measuring total retinal blood flow (TRBF) in the clinic. Objective To investigate TRBF in eyes with DR of varying severity, with or without diabetic macular edema (DME), using en face Doppler OCT. Design, Setting, and Participants This was a cross-sectional study conducted from May 23, 2014, to January 11, 2016, which analyzed 41 eyes with DR from 31 diabetic patients, 20 eyes without DR from 11 diabetic patients, and 16 eyes from 12 healthy age-matched controls, all at the New England Eye Center in Boston, Massachusetts. Main Outcomes and Measures Participants were imaged with a high-speed, swept-source OCT prototype at 1050-nm wavelength using repeated en face Doppler OCT raster scans, comprising 600 × 80 axial scans and covering a 1.5 × 2-mm 2 area centered at the optic disc. The TRBF was automatically calculated using custom Matlab software. Results This study included 41 eyes with DR from 31 diabetic patients (mean [SD] age, 62.8 [13.4] years; 12 were female patients), 20 eyes without DR from 11 diabetic patients (mean [SD] age, 58.8 [10.1] years; 5 were female patients), and 16 eyes from 12 healthy age-matched controls (mean [SD] age, 57.9 [8.1] years; 8 were female participants). The mean (SD) TRBF was 28.0 (8.5) µL/min in the eyes with DME, 48.8 (13.4) µL/min in the eyes with DR but without DME, 40.1 (7.7) µL/min in the diabetic eyes without retinopathy, and 44.4 (8.3) µL/min in age-matched healthy eyes. A difference in TRBF between the eyes with DME that were treated and the eyes with DME that were not treated was not identified. The TRBF was consistently low in the eyes with DME regardless of DR severity. The eyes with moderate nonproliferative DR but without DME exhibited a wide range of TRBF from 31.1 to 75.0 µL/min, with the distribution being highly skewed. Conclusions and Relevance High-speed en face Doppler OCT can measure TRBF in healthy and diabetic eyes. Diabetic eyes with DME exhibited lower TRBF than healthy eyes ( P ≤ .001). Further longitudinal studies of TRBF in eyes with DR would be helpful to determine whether reduced TRBF is a risk factor for DME.

Background We report an interesting case of asymptomatic retinal involvement in an encephalopathic patient enabling early identification of Susac’s syndrome. Case presentation A 39-year-old Caucasian lady with hearing loss and encephalopathy was referred for ophthalmic assessment, including screening for branch retinal artery occlusions characteristic of Susac’s syndrome. Clinical features included severe headaches, right-sided hypoacusis, dysphasia and poor memory. Routine blood tests were normal. MRI brain showed numerous hyperintense lesions mainly in corpus callosum. Although she was visually asymptomatic, dilated funduscopy detected bilateral multiple peripheral branch retinal artery occlusions which were confirmed on fluorescein angiography. She was subsequently started on intravenous steroids and pulsed cyclophosphamide which improved her symptoms within 48 hours. Full recovery was made with no new arterial occlusions on four months follow-up. Conclusion The case further establishes the crucial role of a detailed ophthalmic examination supported by fluorescein angiography in the assessment of these patients, who are at risk of being misdiagnosed and undertreated.

This article was migrated. The article was marked as recommended. BackgroundIn the UK there is a 6% increase in the mortality of emergency patients in the week following 'Black Wednesday'. On this day, there is an abrupt change in the dynamic of medical teams; medical students become Foundation Year 1 doctors (FY1s) and existing junior doctors step up a grade in seniority. Attempts have been made to develop induction initiatives to better prepare FY1 doctors for their new role.Methods FY1 focus groups noted a lack of dedicated teaching in existing induction programmes from the unique perspective of a FY1. To address this, the SOS Guide was developed; a one day course, created and taught exclusively by FY1s for FY1s. The course has been delivered five times, in four hospitals, over two consecutive years to 175 FY1 doctors. Cascade teaching was employed to recruit and support tutor teams of FY1s to create their own hospital specific SOS Guide. All attendees completed pre/post-course questionnaires.ResultsQualitative questionnaire feedback demonstrated high satisfaction and a significant average increase of 26.8% (95% CI:2.25-3.11, p=

The gear faults are time-localized transient events so time-frequency analysis techniques (such as the Short-Time Fourier Transform, Wavelet Transform, motor current signature analysis) are widely used to deal with non-stationary and nonlinear signals. Newly developed signal processing techniques (such as empirical mode decomposition and Teager Kaiser Energy Operator) enabled the recognition of the vibration modes that coexist in the system, and to have a better understanding of the nature of the fault information contained in the vibration signal. However these methods require a lot of computational power so this paper presents a novel approach of gearbox fault detection using the inverter signals to monitor the load, rather than the motor current. The proposed technique could be used for continuous monitoring as well as on-line damage detection systems for gearbox maintenance.

Chapter 1 describes the purpose, goals, and context of the project. Further, the basis for the project is discussed, along with the project's definitions, limitations, and delimitations. Last, the research methodology for the Discipleship Mentoring Project is outlined. "Biblical and Theological Support for Discipling One Another" is the title of chapter 2. The chapter includes a discussion of modern obstacles to disciplemaking, key New Testament words that define discipleship mentoring, a study of the transformational training of the disciples, key concepts for disciplemaking, and the rationale for discipleship and biblical counseling. Chapter 3 reviews "Mentoring in the Twenty-first Century". Secular models from three different industries were reviewed and a number of Evangelical models of discipleship training were also examined. Practices from secular and Evangelical models were then compared to a biblical model of disciplemaking. The chapter concludes with a recap of useful ideas for a discipleship mentoring program. The Discipleship Mentoring project, as implemented from week one through fifteen, is the subject of chapter 4. It includes an overview of the process, project description, schedule of study topics, and a description of the program participants. Also included is a description of the homework used, changes made to the original plan, the experience of mentoring others, and the process for evaluation. Results of the project are interpreted and discussed in chapter 5. Sections include an analysis of an eighty-two statement pre-survey and post-survey, and an evaluation of project goals and methods, as well as theological and personal reflections, and insights gained. Eight appendices are also included. Appendix 1 is a comparison of the pre-project and post-project surveys. Appendix 2 includes the participants closing comments about the project Appendix 3 shows the Scripture memory verses used in the project and what week they were assigned. Appendix 4 consists of the complete outline of the Bible studies used in the project. Appendix 5 contains the suggested reading list for the project participants. Appendices 6 and 7 contain examples of weekly handouts and weekly homework, respectively. Appendix 8 includes an example of the commitment card participants signed at the beginning of the project.

The aim of this prospective study was to audit all endoscopic retrograde cholangiopancreatographic (ERCP) procedures performed between July 1999 and November 1999, in particular to determine the spectrum and rate of complications.An audit data sheet was designed with 100 variables on which the endoscopist recorded all the relevant details of the procedure, from patient demographics to overall success of the procedure. Data were collected at the time of ERCP and before discharge. Any complications within 30 days of ERCP were also recorded.Of 210 consecutive patients audited, successful diagnostic and therapeutic ERCP was performed in 93% with an overall complication rate of 9.5%. The incidence of pancreatitis was 4.76% and haemorrhage 2.38%. No severe complication or procedure-related mortality occurred.The most common complications of ERCP were pancreatitis and haemorrhage.

To audit the results of a nurse-led dyspepsia clinic.Referrals to the Gastroenterology Department at Auckland Hospital for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP.There were 173 patients; mean age 38 years; 73 had a positive UBT (42%). A positive UBT was significantly associated with place of birth (NZ 16%; other place of birth 60%; p = 0.001). If the dominant symptom was epigastric pain 54% had a positive UBT; if it was reflux or bloating 29% were positive, p = 0.005. Forty nine UBT-positive patients had follow-up data and of these 43 had successful eradication (88%). Of patients with successful eradication, 40% had an excellent response, 38% improved, and 22% were not improved. After a mean follow up of 3.3 years 42/173 (24%) patients had a gastroscopy. Of these, 30 were initially UBT negative and 12 were UBT positive (9 had been successfully eradicated). The endoscopic findings were normal in 27, reflux oesophagitis in 13, pyloric stenosis in one, and gastric ulcer (HP+ve) in one. Helicobacter pylori status by biopsy was consistent with the UBT result. One hundred and thirteen patients also had H. pylori serology (Cobas Core, Roche) performed. There were three false negatives (negative predictive value of 94% [51/54]) and seven false positives (positive predictive value of 88% [52/59]).The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive.

The aim of this study was to audit the efficacy of endoscopic injection therapy for non-variceal upper gastrointestinal (GI) bleeding at Auckland Hospital.The medical records of 183 patients who had undergone endoscopic injection of adrenaline for non-variceal upper GI bleeding at Auckland Hospital between November 1996 and May 1999 were reviewed.Primary haemostasis was achieved in 177 (96.7%) patients and six (3.3%) patients had early surgery due to failure of injection therapy. The overall rate of rebleeding was 18.6%. The rate of rebleeding according to the stigmata seen at the time of endoscopy was 36.8% for patients showing spurting vessel; 24% for active ooze; 18.2% for visible vessel; and 3.2% for adherent clot. Active spurting vessels seen on endoscopy were associated with higher risk of repeat injection (p0.01) and death (p0.001). Sixteen (9%) patients had repeat injection. Haemostasis was achieved in all, and no deaths or surgical interventions were observed in this subgroup.Endoscopic injection therapy is an effective, simple and cheap first-line therapy for non-variceal upper GI bleeding. The repeat injection also appears to be an effective treatment for patients rebleeding after the initial injection therapy.

A global definition of K-nice subgroup is formulated, which generalizes both the notion of a nice subgroup in the context of torsion groups and the notion of a K-nice submodule used in a recent study of p-local balanced projective groups. It is shown, analogous to Hill's treatment of totally projective p-groups, that the (global) balanced projective groups of Warfield are precisely those mixed abelian groups that satisfy the Third Axiom of Countability for K-nice subgroups. A variety of equivalent characterizations of balanced projectives are derived by methods independent of the uniqueness and existence theorems previously established for these groups.

By generalizing Hill's theorem giving a necessary and sufficient condition for an isotype subgroup of a totally projective p -group to be itself totally projective, we are able to give a condition which will determine the balanced-projective dimension of an arbitrary p -local abelian group when that dimension is finite. We rely on our recent third axiom of countability characterization for p -local balanced projectives and are able to carry over almost routinely the arguments given recently by Fuchs and Hill which were used to determine the balanced-projective dimension of an arbitrary abelian p -group. We are then able to prove that the balanced-projective dimension of any countable p -local abelian group and of any p -local Warfieid group is less than or equal to 1.

By giving necessary and sufficient conditions for two isotype submodules of a p p -local balanced projective group to be equivalent, we are able to introduce a general theory of isotype submodules of p p -local balanced projective groups (or I B IB modules). Numerous applications of the above result are available particularly for the special class of I B IB modules introduced by Wick (known as SKT modules). We first show that the class of SKT modules is closed under direct summands, and then we are able to show that if H H appears as an isotype submodule of the p p -local balanced projective group G G such that G / H G/H is the coproduct of countably generated torsion groups, then H H is an SKT module. Finally we show that I B IB modules satisfy general structural properties such as transitivity, full transitivity, and the equivalence of p α {p^\alpha } -high submodules.

The use of cryopreserved in vitro produced bovine embryos as nuclear transfer donors was assessed. Day 4 or 5 morulae were vitrified and warmed using the open pulled straw method and used as donors for nuclear transfer. Although the proportion of morulae and blastocysts that developed from nuclear transfer embryos derived from day 5 vitrified embryos did not differ from that derived from fresh embryos (16.7 and 24.3%, respectively), development to blastocysts was reduced when vitrified donor cells were used (8.3 and 19.1%, respectively). Likewise, development to morulae and blastocysts was not different between nuclear transfer embryos derived from day 4 vitrified embryos allowed to recover for 24 h, and day 5 vitrified embryos allowed to recover for 1-2 h (27.7 and 15.6%, respectively), but the development to blastocysts was reduced when day 5 vitrified donor cells were used (23.2 and 10.0%, respectively). However, in nuclear transfer embryos derived from either day 4 vitrified or day 5 fresh donors, no differences were observed in development rates to morulae and blastocysts (34.3 and 36.3%, respectively) or to blastocysts alone (20.2 and 18.1%, respectively). Nor were there differences in the development rates of fresh or day 4 or day 5 vitrified in vitro produced (non-nuclear transfer) embryos (47.9, 51.0 and 35.5% developing to blastocysts at day 7, respectively). In vitro produced embryos and nuclear transfer embryos derived from day 4 vitrified or day 5 fresh donors were transferred to recipients at morula or blastocyst stage at day 6 or 7. The pregnancy rates were similar in both groups of nuclear transfer embryos, but higher in the control group consisting of in vitro produced embryos (47, 42 and 67%, respectively). In conclusion, if vitrified donor embryos are allowed to recover for 24 h after warming, their use in nuclear transfer results in similar efficiencies to those achieved with fresh embryos.