This paper presents the topology known as the isolated flying capacitor multilevel flyback converter (FCMFC). The topology uses isolated flying capacitors (FC) for high-gain, DC-DC power conversion ...while maintaining primary-secondary isolation and improving the efficiency and capability of a standard flyback transformer circuit. Three converters have been developed and tested, one flyback as a control, a 3 level FCMFC, and a 4 level FCMFC to prove the gain and efficiency benefits of this new topology. The FCMFC prototypes achieve higher gain and efficiencies relative to a flyback design utilizing the same off-the-shelf transformer. The stress of the input and output switches is reduced because of the fractioning of the output voltage across multiple output stages, allowing future iterations to utilize lower-rated components. The operating parameters are 5V to 40V boosting for a 10W load at 250kHz. Utilizing the same semiconductor components, the flyback converter control prototype achieves 78% efficiency while the proposed FCMFC converters reach 85% and 82% efficiency, even with the added isolated power, gate drive, and bootstrap circuitry. The FCMFCs have a multiplying effect on the gain of the traditional flyback which also increases near the 90% duty cycle flyback threshold. Additional testing was done at light load and at 100kHz, 250kHz, 452kHz, and 500kHz.
Developmental theorists have made strong claims about the fundamental prosocial or aggressive nature of the human infant. However, only rarely have prosocial behavior and aggression been studied ...together in the same sample. We charted the parallel development of both behaviors from infancy to childhood in a British community sample, using a two‐construct, multimethod longitudinal design.
Data were drawn from the Cardiff Child Development Study (CCDS), a prospective longitudinal study of a volunteer sample of parents and their firstborn children. A sample of 332 mothers was recruited from National Health Service (NHS) prenatal clinics and general practice clinics in Wales, UK, between Fall of 2005 and Summer of 2007. Potential participants represented the full range of sociodemographic classifications of neighborhoods. Participating families were divided about equally between middle‐ and working‐class families, were somewhat more likely to have sons than daughters, and the majority (90%) were in a stable partnership. In response to standard categories recommended for use in Wales at the time, the majority (93%) of mothers reported themselves as Welsh, Scottish, English, or Irish; most others named a European or South Asian nationality.
Of the 332 families agreeing to participate, 321 mothers (Mage = 28 years) and 285 partners (Mage = 31 years) were interviewed during the pregnancy and 321 of the families contributed data at least once after the child's birth. After an initial home visit at 6 months, data collection occurred in four additional waves of testing when children's mean ages were approximately 1, 1.5, 2.5, and 7 years. Data collection alternated between family homes and Cardiff University. Of those families seen after the child's birth, 89% were assessed at the final wave of testing. Data collection ended in 2015.
Methods included direct observation, experimental tasks, and collection of reports from mothers, fathers, other relatives or family friends, and classroom teachers. Interactions with a familiar peer were observed at 1.5 years. Interactions with unfamiliar peers took place during experimental birthday parties at 1 and 2.5 years. At 7 years, parents were interviewed, parents and teachers completed questionnaires, and the children engaged in cognitive and social decision‐making tasks.
Based on reports from parents and other informants who knew the children well, individual differences in both prosocial behavior and aggression were evident in children. Both types of behavior showed stability across the second and third years. The association between prosocial behavior and aggression changed over time: at 1.5 years, they were not significantly related (the association approached zero), but they became negatively correlated by 3 years.
Different patterns were seen when children played with familiar versus unfamiliar peers. At 1.5 years, when children were observed at home with a familiar peer, prosocial behavior and aggression were unrelated, thus showing a pattern of results like that seen in the analysis of informants' reports. However, a different pattern emerged during the experimental birthday parties with unfamiliar peers: prosocial behavior and aggression were positively correlated at both 1 and 2.5 years, contributing to a general sociability factor at both ages.
Gender differences in prosocial behavior were evident in informants' reports and were also evident at the 1‐year (though not the 2.5‐year) birthday parties. In contrast, gender differences in both prosocial behavior and aggression were evident by 7 years, both in children's aggressive decision‐making and in their parents' and teachers' reports of children's aggressive behavior at home and school.
By age 7, children's aggressive decision‐making and behavior were inversely associated with their verbal skills, working memory, and emotional understanding. Some children had developed aggressive behavioral problems and callous‐unemotional traits. A few (12%) met diagnostic criteria for conduct disorder or oppositional‐defiant disorders, which had been predicted by early angry aggressiveness and lack of empathy for other people.
Taken together, the findings revealed a gradual disaggregation of two ways in which children interact with other people. Individual differences in both prosocial behavior and aggression revealed continuity over time, with gender differences emerging first in prosocial behavior, then in aggression.
Restrictions in the participant sample and the catchment area (e.g., all were first‐time parents; all were drawn from a single region in the United Kingdom) mean that it is not possible to generalize findings broadly. It will be important to expand the study of prosocial behavior and aggression in other family and environmental contexts in future work. Learning more about early appearing individual differences in children's approaches to the social world may be useful for both educational and clinical practice.
To assess the outcome of surgical resection in patients with primary mediastinal nonseminomatous germ-cell tumors (PMNSGCT) with rising serum tumor markers (STM) following standard platinum-based ...chemotherapy.
A total of 158 consecutive patients with PMNSGCT who received platinum-based chemotherapy followed by complete surgical extirpation of residual disease at Indiana University from 1982 to 2007 were retrospectively reviewed. Thirty-five of these 158 patients had rising STM at time of resection.
Thirty-five patients (34 males and 1 female) comprise the basis of this report. Three patients had rising human chorionic gonadotropin, and the remaining 32 patients had rising alpha-fetoprotein at the time of thoracic surgery. Twenty-four of the 35 (69%) pathologically demonstrated viable germ-cell tumor, while 8 patients had teratoma and 3 patients had necrosis only at time of resection, despite the presence of rising STM. Twenty-seven patients normalized their tumor markers postoperatively. Twenty-one of 35 died, 5 were lost to follow-up, and 9 are alive. Of the nine patients alive, seven are continuously disease free with median follow-up of 64 months (range 25–220 months).
The presence of rising STM doesn’t preclude successful therapy with surgical resection, especially if carried out by experienced thoracic surgical oncologists.
MACDONALD SE, NEWBURN‐COOK CV, ALLEN M and REUTTER L. Nursing Inquiry 2013; 20: 30–41 Embracing the population health framework in nursing research
Individuals’ health outcomes are influenced not ...only by their knowledge and behavior, but also by complex social, political and economic forces. Attention to these multi‐level factors is necessary to accurately and comprehensively understand and intervene to improve human health. The population health framework is a valuable conceptual framework to guide nurse researchers in identifying and targeting the broad range of determinants of health. However, attention to the intermediate processes linking multi‐level factors and use of appropriate multi‐level theory and research methodology is critical to utilizing the framework effectively. Nurse researchers are well equipped to undertake such investigations but need to consider a number of political, societal, professional and organizational barriers to do so. By fully embracing the population health framework, nurse researchers have the opportunity to explore the multi‐level influences on health and to develop, implement and evaluate interventions that target immediate needs, more distal factors and the intermediate processes that connect them.
Bone remodeling is an essential, delicately balanced physiological process of coordinated activity of bone cells that remove and deposit new bone tissue in the adult skeleton. Due to the complex ...nature of this process, many mathematical models of bone remodeling have been developed. Each of these models has unique features, but they have underlying patterns. In this review, the authors highlight the important aspects frequently found in mathematical models for bone remodeling and discuss how and why these aspects are included when considering the physiology of the bone basic multicellular unit, which is the term used for the collection of cells responsible for bone remodeling. The review also emphasizes the view of bone remodeling from a systems biology perspective. Understanding the systemic mechanisms involved in remodeling will help provide information on bone pathology associated with aging, endocrine disorders, cancers, and inflammatory conditions and enhance systems pharmacology. Furthermore, some features of the bone remodeling cycle and interactions with other organ systems that have not yet been modeled mathematically are discussed as promising future directions in the field.
Study C was an open-label, non-inferiority, randomised controlled trial of fixed-dose combination (FDC) or separate drugs given during the intensive phase of treatment to 1585 patients with ...smear-positive pulmonary tuberculosis conducted at 11 sites in Africa, Asia and Latin America. Thirty months post-randomisation, the failure/relapse rates in the per protocol population were 7.4% of 591 patients on FDCs and 6.5% of 587 patients on separate drugs; the site-adjusted difference was 0.3% (90%CI -1.8 to 2.3). In the modified intention-to-treat analysis, the corresponding results were respectively 17.9% of 683 and 16.1% of 671; the site-adjusted difference was 2.0% (90%CI -1.2 to 5.2).
Delays in diagnosis of tuberculosis (TB) have been associated with previous use of antibiotics, and in particular fluoroquinolones (FQ), for suspected pulmonary infections.
We conducted a ...population-based cohort study with 2232 patients who had active TB between 1997 and 2006 (records obtained from the British Columbia Linked Health Databases). Patients with a record of an initial health care contact preceding the diagnosis of TB were identified for inclusion. Health care delay was defined as the time between initial health care contact and the initiation of anti-tuberculosis medication, and was compared between patients prescribed antibiotics and those not exposed to any antibiotics.
A total of 1544 patients were included. After adjusting for covariates, average health care delay for patients exposed to antibiotics was found to be significantly greater, by a factor of 2.10 (95%CI 1.80-2.44), with a median delay of 41 days in the antibiotic group compared to 14 days in the non-antibiotic group. Sex, age, foreign-born status and socio-economic status were non-significant factors. Health care delay increased with the number of antibiotic courses received, but not with the type of antibiotic.
Previous treatment with any antibiotic, and not only a FQ, is associated with a delay in TB diagnosis.
A group of pigmented, slowly growing mycobacteria identified by 16S rRNA gene sequencing as 'MCRO 33' (GenBank accession no. AF152559) have been isolated from several clinical specimens in various ...laboratories across Canada. Genotypically, the organism is most closely related to Mycobacterium simiae. However, it presents with a similar phenotypic profile to Mycobacterium scrofulaceum. Several reference strains obtained from ATCC and TMC culture collections, previously identified as M. scrofulaceum or M. simiae, have also been found to possess the MCRO 33 16S rRNA gene sequence. Biochemical testing, susceptibility testing, HPLC, hsp65 gene and 16S-23S spacer (ITS1) sequencing were performed on clinical and reference strains to characterize further this unique species. Of the clinical strains, one was isolated from a cervix biopsy whereas all other clinical isolates were obtained from respiratory samples. In one patient, symptoms, imaging and repeat clinical specimens positive on culture for this organism were suggestive of active clinical disease. The description of this species, for which the name Mycobacterium parascrofulaceum sp. nov. is proposed, follows the present trend of a large number of novel Mycobacterium species identified due in great part to sequence-based methods. The type strain is HSC68T (= ATCC BAA-614T = DSM 44648T).
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