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Silicon photomultipliers are regarded as a very promising technology for next-generation, cutting-edge detectors for low-background experiments in particle physics. This work presents systematic reflectivity studies of Silicon Photomultipliers (SiPM) and other samples in liquid xenon at vacuum ultraviolet (VUV) wavelengths. A dedicated setup at the University of M\"unster has been used that allows to acquire angle-resolved reflection measurements of various samples immersed in liquid xenon with 0.45{\deg} angular resolution. Four samples are investigated in this work: one Hamamatsu VUV4 SiPM, one FBK VUV-HD SiPM, one FBK wafer sample and one Large-Area Avalanche Photodiode (LA-APD) from EXO-200. The reflectivity is determined to be 25-36% at an angle of incidence of 20{\deg} for the four samples and increases to up to 65% at 70{\deg} for the LA-APD and the FBK samples. The Hamamatsu VUV4 SiPM shows a decline with increasing angle of incidence. The reflectivity results will be incorporated in upcoming light response simulations of the nEXO detector., Comment: 18 pages, 11 figures

Future space telescopes with coronagraph instruments will use a wavefront sensor (WFS) to measure and correct for phase errors and stabilize the stellar intensity in high-contrast images. The HabEx and LUVOIR mission concepts baseline a Zernike wavefront sensor (ZWFS), which uses Zernike's phase contrast method to convert phase in the pupil into intensity at the WFS detector. In preparation for these potential future missions, we experimentally demonstrate a ZWFS in a coronagraph instrument on the Decadal Survey Testbed in the High Contrast Imaging Testbed facility at NASA's Jet Propulsion Laboratory. We validate that the ZWFS can measure low- and mid-spatial frequency aberrations up to the control limit of the deformable mirror, with surface height sensitivity as small as 1 pm, using a configuration similar to the HabEx and LUVOIR concepts. Furthermore, we demonstrate closed-loop control, resolving an individual DM actuator, with residuals consistent with theoretical models. In addition, we predict the expected performance of a ZWFS on future space telescopes using natural starlight from a variety of spectral types. The most challenging scenarios require ~1 hr of integration time to achieve picometer sensitivity. This timescale may be drastically reduced by using internal or external laser sources for sensing purposes. The experimental results and theoretical predictions presented here advance the WFS technology in the context of the next generation of space telescopes with coronagraph instruments., Comment: Accepted for publication in JATIS

Background In today's health care context, nurse educators teach with limited clinical placement availability, competition for available spaces and increasingly complex clients. Setting As part of the baccalaureate of nursing program at the University of Calgary in Qatar, students are required to complete 208 h of maternal-child clinical. Unfortunately, due to social and cultural norms in this predominantly Muslim country, male nursing students are prohibited from practicing with mothers and babies in Qatar. In order to address this need, we developed a fully simulated clinical practice module for these male students. Objectives The aim of the current study was to better understand the learning experiences of the students undertaking this experience. Design The authors developed and implemented a fully simulated, campus-based, maternity clinical experience that used a variety of levels of fidelity, incorporated the tenets of Kolb's (1984) experiential learning theory, and Jeffries' (2005) simulation design framework. Post-simulation debriefing sessions were recorded and transcribed. Typed weekly reflections were provided. All data was blinded. Participants A convenience sample of ten adult, male participants was obtained. Methods Using an inductive qualitative approach, researchers analyzed transcripts of debriefing sessions and reflective journals. Results The main themes were knowledge application, clinical judgement, communication, and crossing cultural barriers. Conclusions Themes from this study can be used to support and/or change existing practices in a way that supports learner-centered, experiential teaching practices.

Characterization of the vacuum ultraviolet (VUV) reflectance of silicon photomultipliers (SiPMs) is important for large-scale SiPM-based photodetector systems. We report the angular dependence of the specular reflectance in a vacuum of SiPMs manufactured by Fondazionc Bruno Kessler (FBK) and Hamamatsu Photonics K.K. (HPK) over wavelengths ranging from 120 nm to 280 nm. Refractive index and extinction coefficient of the thin silicon-dioxide film deposited on the surface of the FBK SiPMs are derived from reflectance data of a FBK silicon wafer with the same deposited oxide film as SiPMs. The diffuse reflectance of SiPMs is also measured at 193 nm. We use the VUV spectral dependence of the optical constants to predict the reflectance of the FBK silicon wafer and FBK SiPMs in liquid xenon.

Understanding reflective properties of materials and photodetection efficiency (PDE) of photodetectors is important for optimizing energy resolution and sensitivity of the next generation neutrinoless double beta decay, direct detection dark matter, and neutrino oscillation experiments that will use noble liquid gases, such as nEXO, DARWIN, DarkSide-20k, and DUNE. Little information is currently available about reflectivity and PDE in liquid noble gases, because such measurements are difficult to conduct in a cryogenic environment and at short enough wavelengths. Here we report a measurement of specular reflectivity and relative PDE of Hamamatsu VUV4 silicon photomultipliers (SiPMs) with 50 micrometer micro-cells conducted with xenon scintillation light (~175 nm) in liquid xenon. The specular reflectivity at 15 deg. incidence of three samples of VUV4 SiPMs is found to be 30.4+/-1.4%, 28.6+/-1.3%, and 28.0+/-1.3%, respectively. The PDE at normal incidence differs by +/-8% (standard deviation) among the three devices. The angular dependence of the reflectivity and PDE was also measured for one of the SiPMs. Both the reflectivity and PDE decrease as the angle of incidence increases. This is the first measurement of an angular dependence of PDE and reflectivity of a SiPM in liquid xenon., Comment: 21 pages, 15 figures, 6 tables. As accepted by JINST

Future tonne-scale liquefied noble gas detectors depend on efficient light detection in the VUV range. In the past years Silicon Photomultipliers (SiPMs) have emerged as a valid alternative to standard photomultiplier tubes or large area avalanche photodiodes. The next generation double beta decay experiment, nEXO, with a 5 tonne liquid xenon time projection chamber, will use SiPMs for detecting the $178\,\text{nm}$ xenon scintillation light, in order to achieve an energy resolution of $\sigma / Q_{\beta\beta} = 1\, \%$. This paper presents recent measurements of the VUV-HD generation SiPMs from Fondazione Bruno Kessler in two complementary setups. It includes measurements of the photon detection efficiency with gaseous xenon scintillation light in a vacuum setup and dark measurements in a dry nitrogen gas setup. We report improved photon detection efficiency at $175\,\text{nm}$ compared to previous generation devices, that would meet the criteria of nEXO. Furthermore, we present the projected nEXO detector light collection and energy resolution that could be achieved by using these SiPMs., Comment: 11 pages, 13 figures, 2 tables

> We are now into the higher risk period of lungworm disease in cattle As we are now into the higher risk period of lungworm disease in cattle, we are writing to make colleagues aware of the diagnostic options, importance of correct treatment and the investigation of possible inefficacious treatments. Parasitic bronchitis, due to Dictyocaulus viviparus, can occur in grazing cattle of all ages. Clinical disease is characterised by coughing that may be accompanied by increased respiratory rate and effort, respiratory distress, milk drop and reduced weight gain/weight loss. Clinical signs are seen two to four weeks after the ingestion of infective larvae by non-immune cattle. Diagnostic testing for lungworm in live cattle is …

A new design for the anode of a time projection chamber, consisting of a charge-detecting "tile", is investigated for use in large scale liquid xenon detectors. The tile is produced by depositing 60 orthogonal metal charge-collecting strips, 3~mm wide, on a 10~\si{\cm} $\times$ 10~\si{\cm} fused-silica wafer. These charge tiles may be employed by large detectors, such as the proposed tonne-scale nEXO experiment to search for neutrinoless double-beta decay. Modular by design, an array of tiles can cover a sizable area. The width of each strip is small compared to the size of the tile, so a Frisch grid is not required. A grid-less, tiled anode design is beneficial for an experiment such as nEXO, where a wire tensioning support structure and Frisch grid might contribute radioactive backgrounds and would have to be designed to accommodate cycling to cryogenic temperatures. The segmented anode also reduces some degeneracies in signal reconstruction that arise in large-area crossed-wire time projection chambers. A prototype tile was tested in a cell containing liquid xenon. Very good agreement is achieved between the measured ionization spectrum of a $^{207}$Bi source and simulations that include the microphysics of recombination in xenon and a detailed modeling of the electrostatic field of the detector. An energy resolution $\sigma/E$=5.5\% is observed at 570~\si{keV}, comparable to the best intrinsic ionization-only resolution reported in literature for liquid xenon at 936~V/\si{cm}., Comment: 18 pages, 13 figures, as published

Purpose We previously reported on the feasibility of a Web-based system to capture patient-reported outcomes (PROs) in the immediate postoperative period. The purpose of this study was to update the experience of these patients and assess patient and provider satisfaction and feedback regarding the system. Methods This is a prospective cohort study of patients scheduled to undergo laparotomy for presumed gynecologic malignancy. Patients completed a Web-based Symptom Tracking and Reporting (STAR) questionnaire preoperatively and weekly during a 6-week postoperative period. Email alerts were sent to study nurses when concerning patient responses were entered. The patient and the nurse assessments of STAR's usefulness were measured via an exit survey. Results The study enrolled 96 eligible patients. Of these, 71 patients (74%) completed at least four of seven total sessions. Of the patients who completed the exit satisfaction survey, 98% found STAR easy to use; 84% found it useful; and 82% would recommend it to other patients. Despite positive feedback from patients, clinical personnel found that the STAR system increased their current workload without enhancing patient care. Conclusions Application of an electronic program for PROs in those recovering from major gynecologic cancer surgery is feasible, and acceptable to most patients. While most clinicians did not find STAR clinically helpful, the majority of patients reported a positive experience with the system and would recommend its use. The program helped many patients feel more empowered in their postoperative recovery.

The energy resolution of the EXO-200 detector is limited by electronics noise in the measurement of the scintillation response. Here we present a new technique to extract optimal scintillation energy measurements for signals split across multiple channels in the presence of correlated noise. The implementation of these techniques improves the energy resolution of the detector at the neutrinoless double beta decay Q-value from $\left[1.9641\pm 0.0039\right]\%$ to $\left[1.5820\pm 0.0044\right]\%$., Comment: 21 pages, 8 figures, 1 table

We report on the performance of silicon photomultiplier (SiPM) light sensors operating in electric field strength up to 30 kV/cm and at a temperature of 149K, relative to their performance in the absence of an external electric field. The SiPM devices used in this study show stable gain, photon detection efficiency, and rates of correlated pulses, when exposed to external fields, within the estimated uncertainties. No observable physical damage to the bulk or surface of the devices was caused by the exposure., Comment: 16 pages, 12 figures, 2 tables and two conferences (INPC2016 and TIPP2017)

Policymaking is a highly complex process that is often difficult to predict or influence. Most of the scholarship examining the role of research evidence in policymaking has focused narrowly on characteristics of the evidence and the interactions between scientists and government officials. The real-life context in which policymakers are situated and make decisions also is crucial to the development of evidence-informed policy.This qualitative study expands on other studies of research utilization at the state level through interviews with twenty-eight state legislators and administrators about their real-life experiences incorporating evidence into policymaking. The interviews were coded inductively into the following categories: (1) the important or controversial issue or problem being addressed, (2) the information that was used, (3) facilitators, and (4) hindrances.Hindrances to evidence-informed policymaking included institutional features; characteristics of the evidence supply, such as research quantity, quality, accessibility, and usability; and competing sources of influence, such as interest groups. The policymakers identified a number of facilitators to the use of evidence, including linking research to concrete impacts, costs, and benefits; reframing policy issues to fit the research; training to use evidence-based skills; and developing research venues and collaborative relationships in order to generate relevant evidence.Certain hindrances to the incorporation of research into policy, like limited budgets, are systemic and not readily altered. However, some of the barriers and facilitators of evidence-informed health policymaking are amenable to change. Policymakers could benefit from evidence-based skills training to help them identify and evaluate high-quality information. Researchers and policymakers thus could collaborate to develop networks for generating and sharing relevant evidence for policy.

Notice and comment provisions in agency rulemaking provide an important mechanism for the public to contribute to policy. Yet there is limited research on how interest groups participate in this process. California's passage of an ergonomics standard in 1997, the only current state statute in the country, provides a useful, high salience policy case for examining public commentary. Between an initially proposed comprehensive standard and the enactment of a much weaker regulation occurred the largest public response in California's state Occupational Safety and Health Administration history. Through a detailed content analysis of the notice and comment submissions we identify features of participation and claimsmaking that differ between business and nonbusiness submissions. Business groups were the large majority of participants and also presented a disproportionate amount of evidence, using an “abstract-technical” policy frame to assert the illegitimacy of the ergonomics standard. Labor, public health organizations and private citizens represented less than one-third of the participants and relied primarily on experiential information and a “concretized-moral” characterization of policy issues in support of the standard. The existence of these distinct “interpretive communities” that mobilize different resources raises questions about whether public commentary can fulfill its purported “democratic accountability” purpose as well as underline the limitations of appealing to scientific expertise for solving complex policy problems.

A 120-Gb/s optical link (12 channels at 10 Gb/s/ch for both a transmitter and a receiver) has been demonstrated. The link operated at a bit-error rate of less than 10/sup -12/ with all channels operating and with a total fiber length of 316 m, which comprises 300 m of next-generation (OM-3) multimode fiber (MMF) plus 16 m of standard-grade MMF. This is the first time that a parallel link with this bandwidth at this per-channel rate has ever been demonstrated. For the transmitter, an SiGe laser driver was combined with a GaAs vertical-cavity surface-emitting laser (VCSEL) array. For the receiver, the signal from a GaAs photodiode array was amplified by a 12-channel SiGe receiver integrated circuit. Key to the demonstration were several custom testing tools, most notably a 12-channel pattern generator. The package is very similar to the commercial parallel modules that are available today, but the per-channel bit rate is three times higher than that for the commercial modules. The new modules demonstrate the possibility of extending the parallel-optical module technology that is available today into a distance-bandwidth product regime that is unattainable for copper cables.

It was hypothesized that nutrient removal from wastewater could be achieved by using methane oxidizing bacteria (methanotrophs). Because methane is inexpensive, it can be used as an energy source to encourage bacterial growth to assimilate nitrogen and phosphorus and other trace elements. This initial feasibility study used synthetic nutrient mixtures and secondary sewage effluent as feed to a laboratory-scale methanotrophic attached-film expanded bed (MAFEB) reactor operated at 35°C and 20°C. The MAFEB system operated successfully at low nutrient concentrations under a variety of nutrientlimited conditions.

Methods are presented for kinetic analysis of anaerobic biomass reactors. In some cases, assumptions implicit in kinetic analysis techniques developed for conventional dilute digestion modes are not applicable to systems operating at high rates and/or high solids concentrations. As a result, modified definitions are presented for CST digester retention times and first order kinetic coefficients. Procedures are presented for converting biogas data to standard conditions. Two novel methods for quantifying mass removals, based on direct measurement of reactor mass losses and on biogas production, allow rapid determination of mass removal rates and detection of gas leakage. The use of a per unit mass basis for reporting concentrations and kinetics is recommended.

The popular dietary shift to fish and the limits on natural fish populations have caused rapid growth in fish farming and aquaculture. Optimized aquaculture systems are attempting to use as complete recycle as possible to obtain maximum control over the fish populations, and limit water and energy requirements. Closed systems aquaculture is severely limited by water quality since pollutants accumulate in the system. This study examined the possibility of simultaneous BOD5 reduction, SS removal, nitrification and denitrification with an expanded bed in complete recycle growth systems with Atlantic salmon and brook trout. The fish rearing tank volume was 10 m3 and the expanded bed volume was 2.6 m3. The total duration of the study was 180 days. The expanded bed developed a film capable of nitrification and denitrification within 40 days. After this time, the SS and BOD were maintained at less than 6 mg/l. Ammonia, nitrates, and nitrites were below detectable levels, thus confirming the simultaneous one-stage removal potentials. Maximum nitrogen removal rates of 40 mg per liter of AFEB per day are similar to the higher removal rates predicted for maximum removal efficiencies at bulk solution ammonia-nitrogen concentrations of 0.5 mg/l. Dissolved oxygen concentrations in the expanded bed appear to be the most sensitive control parameter for these simultaneous reactions. This one-stage pollution control process for complete recycle aquaculture would be useful in both freshwater and seawater applications. The system is easily modularized for fish rearing tank capacities of 1,000 to more than 10,000 kg. The treatment system volume would be less than half the rearing volumes at low fish densities and low ammonia concentrations (less than 0.5 mg/l of ammonia nitrogen).

The diagnosis of upper extremity pain can be a daunting task for the examining physician. The differential diagnosis for pain at each level in the upper extremity is often extensive and diverse. Quite frequently, the clinical signs and symptoms of multiple pathologic conditions are overlapping and nonspecific. The decision to treat conservatively or with surgery often depends on the magnetic resonance imaging (MRI) findings. MRI's ability to produce multiplanar images with excellent soft tissue contrast has made it an indispensable tool for diagnosis and treatment planning in patients with upper extremity pain. In most instances, MR imaging provides information that all other modalities cannot. This is all possible due to an incredible imaging device that creates magnificent images painlessly and with no known detrimental biological side effects. This article demonstrates only a small number of the possible causes of upper extremity pain that can be diagnosed with MR imaging. It is comforting to know that the vast majority of pathology causing pain in the upper extremity can be visualized with MRI scanning.

Swedish social assistance is a second example of a “needs-based” system, one that aspires to secure claimants a “reasonable standard of living,” while also assisting them to “live an independent life.” Like its German counterpart, it consists of a two-tiered system of support. A relatively rule-bound standardized grant is intended to cover most typical living expenses a household will incur. A second, more discretionary, area of support is available to cover a variety of exceptional needs, including longer-term and emergency expenses. Assessments are, in principle, individualized, and caseworkers have full authority over the decisions they make.

A 120 Gb/s optical link (12 channels at 10 Gb/s/ch) has been demonstrated. The link operated at a BER of less than 10/sup -12/ with all channels operating and with a total fiber length of 316 m, which comprises 300 m of next generation (OM-3) multimode fiber (MMF) plus 16 m of standard grade MMF. This is the first time that a parallel link with this bandwidth at this per-channel rate has ever been demonstrated. For the transmitter, a SiGe laser driver was combined with a GaAs VCSEL array. For the receiver, the signal from a GaAs photodiode array was amplified by a 12 channel SiGe receiver IC. Key to the demonstration is the use of several custom testing tools, most notably a 12-channel pattern generator. The package is very similar to the commercial parallel modules that are available today, but the per-channel bit rate is three times higher than for the commercial modules. The new modules demonstrate the possibility of extending the parallel optical module technology that is available today into a distance/spl times/ bandwidth regime that is unattainable for copper cables.

A 120 Gb/s, 12 channel parallel optical transmitter using 850 nm VCSELs over 300 m of fiber is described. All channels operate simultaneously, driven by a custom-built low cost 120 Gb/s test station. Error free operation with margin is confirmed.

The Animal Health and Veterinary Laboratories Agency (AHVLA), formerly Veterinary Laboratories Agency, has investigated on-farm potential food safety incidents on behalf of the Foods Standards Agency (FSA) since 2001. Lead intoxication accounts for the majority of on-farm potential food safety incidents and is associated with a variety of different sources of lead, including lead acid batteries, paint, geochemical lead and metallic lead. Several of the metallic lead incidents involve exposure to lead shot from clay pigeon shooting. This paper describes five such cases that have occurred since 2008, three in birds and two in cattle, with the intention of highlighting this hazard. Case 1 : Lead poisoning was confirmed in a flock of 2000 free range laying hens which were 42 weeks into lay. The hens' range was next to an active clay pigeon shoot. The flock had never reached its expected production potential and mortality had slowly increased. Postmortem examinations revealed egg peritonitis and lead shot was consistently present in the gizzards with one bird having 59.0 g (Figs 1 and 2). FIG 1: Lead shot in situ in the gizzard FIG 2: Lead shot removed and washed from gizzard content Subsequent whole egg analyses revealed raised lead concentrations of up to 2550 μg/kg lead. Eggs from hens which have not been exposed to lead should contain very low concentrations of lead. Trampel and others (2003) reported yolk lead concentrations of

The purposes of this study were to describe physical therapists' knowledge regarding battered women and to determine whether physical therapists recognize these patients in clinical settings.Two hundred questionnaires were distributed to outpatient physical therapists in northern California. One hundred fifty-one usable questionnaires (76%) were returned.Although 43% of the respondents reported treating a patient they identified or strongly suspected as having been battered, only two respondents (1%) reported they routinely asked patients about physical abuse. Less than 50% of the respondents correctly identified that battering injuries are more likely to occur in a central pattern (ie, head, neck, chest, abdomen).The results of this survey suggest that physical therapists have treated patients who are battered. Many physical therapists, however, may not be fully educated to detect the signs of abuse. This study is the first step in initiating physical therapy research in domestic violence identification and education.Domestic violence from a spouse or an intimate partner has become a public issue as well as criminal justice, since it was known to be a leading cause of death, in the US. Physical therapists (PTs) play a critical role in prevention, treatment, and rehabilitation in health care of a battered patient. This study describes the knowledge of PTs regarding battered women and determines whether PTs recognize these patients in clinical settings. 200 questionnaires were distributed to 25 outpatient PT facilities in northern California. 151 usable questionnaires were returned. Results showed that out of the 151 respondents (121 females, 30 males), 43% dealt with women whom they strongly suspected or identified as being physically battered; however, only 1% of the respondents routinely inquired about physical abuse. Furthermore, 42% correctly identified the neck, head, chest, and abdomen as the most common location of injuries, and having depression as a psychological symptom resulting from the abuse. The results of the survey suggest that the detection of battered patients by a PT was very low. This could be due to the PT's lack of domestic violence education; and reluctance to ask patients whether they were abused; or beliefs that domestic violence was an uncommon occurrence in their patients' lives.

The paper describes instrumentation which uses machine vision to inspect rolls of web textile fabric in real time. This involves detection of “message” signals arising from defects buried in noise caused by fabric structure. Analogy with the detection of targets in radar and sonar is exploited to provide effective signal processing. The hardware implementation achieves efficiency with economy by using standard devices wherever possible — such as a CCD linescan camera for sensing and a 486 PC as host processor. A special interface card is provided which compensates for deterministic noise and eliminates more than 99% of the redundant data gathered by the camera.

A method of securing a dressing on scalp wounds, using silastic foam, is described. This method has the advantage of leaving the rest of the scalp uncovered and is particularly effective in the unco-operative patient.

Objective monitoring of cough may be preferred to subjective reporting of the symptom in clinical and research settings. Therefore, a self-contained, ambulatory cough monitoring system is needed that is non-invasive, usable for children and adults of all ages, inexpensive, and highly accurate with easy to use analysis software. After development of a new device, 15 subjects with frequent coughing were recorded with the novel cough monitor and a simultaneous video recording in order to validate the monitor compared with a gold standard. Two investigators independently analyzed the recordings and counted the number of coughs during the study period from both the cough monitor and the video recording. When measuring agreement between the two investigators, the sample concordance correlation coefficient for audio counts was 0.998 (p < 0.001). In the comparison of video counts, the sample concordance correlation coefficient was 0.997 (p < 0.001). For the comparison of investigator 1's video counts to the corresponding audio counts, the sample concordance correlation coefficient was 0.968 (p = 0.026). For the comparison of investigator 2's video counts to the corresponding counts, the sample concordance correlation coefficient was 0.973 (p = 0.015). We have developed and piloted a new, valid, and reproducible method of objectively recording and analyzing cough. This device appears to be useful for subjects of any age and in clinical and research settings.

A 25 kW cogeneration unit was designed and operated for 2500 h on biogas produced from two anaerobic digesters using dairy manure as their feed. Performance studies detailed specifications for the spark system, thermodynamic performance of the unit, and other important operation parameters. Extended operation also provided insights on the effects of hydrogen sulfide within the biogas on the engine and potential procedures for controlling such problems as well as other long term operating considerations.

The effect of autoheated aerobic thermophilic digestion on the pathogen content of sewage sludges was studied and compared to that of conventional mesophilic anaerobic digestion. Both systems were full scale, continuously-fed facilities operated in parallel and utilized a feed sludge of thickened primary and waste-activated sludge. The relative populations of viruses, Salmonella sp., total and fecal coliforms, fecal streptococci and parasites found before and after digestion were compared. The full scale mesophilic anaerobic digesters were operated at relatively constant conditions, i.e. digester temperature constant at 35°C, and loading rates constant, etc., while the full scale autoheated aerobic digester was operated under a wide range of loading conditions. At all of the conditions studied, the autoheated digester temperature exceeded 45 C. Virus and Salmonella sp. concentrations in the effluent from the aerobic unit were below detectable limits in 10 of 11 samples and 6 of 6 samples, respectively, whereas the anaerobic digester effluent contained detectable numbers of viruses and Salmonella sp. Bacterial indicator counts and parasite concentrations were less in the autoheated digester effluent than in the effluent from the anaerobic digester. It was concluded that the simple autoheated aerobic digestion process could be used to produce a virtually pathogen-free sludge at a cost comparable to that of conventional, mesophilic anaerobic digestion.

OBJECTIVE--To assess whether an organised programme of prevention including the use of a health promotion nurse noticeably improved recording and follow up of cardiovascular risk factors and cervical smears in a general practice that had access to computerised cell and recall. DESIGN--Randomised controlled trial. SETTING--General practice in inner London. PATIENTS--All 3206 men and women aged 30-64 registered with the practice. INTERVENTION--The intervention group had their risk factors ascertained and followed up by the health promotion nurse and the general practitioner, whereas those in the control group were managed by the general practitioner alone. END POINT--Recording and follow up of blood pressure and cervical smears after three years. Recording of smoking, family history of ischaemic heart disease, and serum cholesterol concentrations were also examined. MEASUREMENTS and MAIN RESULTS--When the trial was stopped after two years the measurements of blood pressure in the preceding five years were 93% (1511/1620) v 73% (1160/1586) (95% confidence interval for difference 17.5 to 22.7%) for intervention and control groups respectively. For patients with hypertension the figures were 97% (104/107) v 69% (80/116) (18.2 to 38.2%). For women the proportion who had had a cervical smear in the preceding three years were 76% (606/799) v 49% (392/806) (22.5 to 31.9%). Recording of smoking, family history of ischaemic heart disease, and serum cholesterol concentrations was also higher in the intervention group compared with the control group. CONCLUSION--An organised programme, which includes a nurse with specific responsibility for adult prevention, is likely to make an important contribution to recording of risk factors and follow up of those patients with known risks.

The effect of approximation on the postural sway of healthy subjects wearing a weighted belt around their pelvis was measured. Twenty subjects between the ages of 23 and 30 years stood on a polyurethane foam platform that amplified their postural sway and were filmed from a lateral view. All subjects wore markers over their mandibles, hips, and knees and were filmed three times with the weighted belt worn on a randomly selected trial. Frames from a 10-second interval of film from each trial were studied, and the summed displacement at each bony landmark between each frame of film was calculated. A significant decrease in displacement at the mandible (p less than .02) was found when the weighted belt was worn. The decrease in displacement was not significant at the hip or knee. Approximation was shown to decrease the postural sway of healthy subjects. Further study is indicated to investigate the effect of approximation on patient populations.

In this study, we investigated the applicability of thermography as a technique for evaluating the painful postcerebrovascular accident (CVA) shoulder in hemiplegic patients. A thermographic series was taken of the upper extremities and upper trunk of 27 female subjects. The four groups we evaluated were nonhemiplegic subjects (n = 9), post-CVA subjects with recovered function (n = 6), hemiplegic subjects with upper extremity motor impairment (n = 6), and hemiplegic subjects with both motor impairment and ipsilateral shoulder pain (n = 6). The data revealed a normal thermographic series in 8 of the 9 nonhemiplegic subjects, but only in 1 of the 18 post-CVA subjects. The majority of the abnormal thermographic series of post-CVA subjects showed a 1 degree to 5 degree C coolness on the involved side. No consistent thermographic patterns emerged that could be related to the severity or location of pain. Further studies are needed to evaluate the efficacy of thermography as a means of determining the relationship between ipsilateral post-CVA coolness and hemiplegic shoulder pain.

The use of microscopic algae to store solar energy has long been an attractive possibility, both for wastewater purification, food production and fertilizer synthesis. The total potential energy available from these sources would appear to exceed 2 quads of energy annually on a renewable basis.

Earlier studies have shown that although large quantities of agricultural residues are generated on small farms, it was difficult to economically justify use of conventional anaerobic digestion technology, such as used for sewage sludge digestion. A simple, unmixed, earthen-supported structure appeared to be capable of producing significant quantities of biogas at a cost that would make it competitive with many existing fuels. The goal of this study was to define and demonstrate a methane fermentation technology that could be practical and economically feasible on small farms. This study provides the first long term, large scale (reactor volumes of 34 m/sup 3/) parallel testing of the major theory, design, construction, and operation of a low cost approach to animal manure fermentation as compared to the more costly and complex designs. The main objectives were to define the lower limits for successful fermentor operation in terms of mixing, insulation, temperature, feed rate, and management requirements in a cold climate with both pilot scale and full scale fermentors. Over a period of four years, innovative fermentation processes for animal manures were developed from theoretical concept to successful full scale demonstration. Reactors were sized for 50 to 65 dairy animals, or for the one-familymore » dairy size. The results show that a small farm biogas generation system that should be widely applicable and economically feasible was operated successfully for nearly two years. Although this low cost system out-performed the completely mixed unit throughout the study, perhaps the greatest advantage of this approach is its ease of modification, operation, and maintenance.« less

Tactile hypersensitivity is a common sequela of traumatic hand injury. Vibration is used clinically to reduce this hypersensitivity. The purpose of this study was to determine if vibration has an effect on tactile threshold and if so to determine the duration of that effect. Mean tactile thresholds were determined for 24 healthy adults by means of a pressure aesthesiometer. The experimental group (6 men, 6 women) received 10 minutes of vibration. Mean tactile thresholds were redetermined at the end of the 10-minute treatment period in the experimental group and after a 10-minute rest period in the control group (6 men, 6 women). Thresholds were also redetermined at 5-minute intervals for the next 20 minutes in all subjects. The experimental group showed a significant change in mean tactile threshold after 10 minutes of vibration (p less than .001). This difference remained at 5 (p less than .001) and 10 (p less than .05) minutes postvibration but not at 15 and 20 minutes. No significant change in mean tactile threshold was found in the control group. The results indicate that vibration does increase tactile threshold in "normal" hands and the effect lasts for at least 10 minutes. The application of this information to the clinical setting is discussed.

Needs and requirements for optical interconnects in next generation servers are outlined. Related results on equalizing and characterizing high speed multimode links, building and testing parallel 12 /spl times/ 10 Gbit/sec transceivers, and highly parallel silicon photodetectors are presented.