Hear my voice: a community-based participatory study gathering the lived experiences of people with disabilities and older people in Tanzania

This is the final version of the article. Available from the publisher via the URL in this record.This study provides evidence on the specific nature and experiences of people with disabilities and older people from their own perspectives in rural and urban settings in Tanzania. Its aim was to better inform efforts to provide services for and improve the lives of people living in those regions. A community-based participatory approach was used, involving collaboration with the community. Peer researchers and research partners collected and analysed interviews with people with disabilities and older people, leading to policy and advocacy recommendations and early stage plans. Findings were framed in terms of experiences of participation and inclusion as impacted by physical, social and attitudinal factors, as well presented at individual, interpersonal and societal levels. They demonstrate how lack of access to healthcare and education, social limitations and powerful community attitudes were interwoven and exacerbated poverty in these contexts. Policy recommendations cover issues such as halting persecution and killings of people with albinism, support and guidance for families of children with disabilities, national policy on ageing legislation, and implementing and monitoring the UN Convention on the Rights of Persons with Disabilities

Perancangan Robot Pengikut Garis Berbasis Microcontroller

Currently the development of robot technology is growing rapidly. The technology is utilized and developed to assist people in doing their activities more easily and efficiently. One application of the robotic technology is the line follower robot that is widely used in transportation in industrial field. The purpose of this thesis was to determine the working principle and reliability of the line follower robot with its main components that are power supply, sensors, microcontrollers, and motor drivers. The methodology of the research is to design and to assamble a line follower robot and perform direct testing of the reliability on the on 6,5m “Ϩ” - shaped tracked. The results show that the stages of the assembling of the line follower robot consist of the installation of each circuit and the installation of the drive system in robot frame. The test results show that the line follower robot is able to pass through the track well with average speed of 0,22 m/sec

AN ANALYSIS OF THE COMMERCIALITY DETERMINATION FOR UNITED STATES SPACE FORCE SPACE LAUNCH SERVICES

The Orbital Service Program-4 (OSP-4) acquires launch missions as commercial items in accordance with FAR Part 12 to comply with 51 USC §50132, “Acquisition of commercial space transportation services,” which requires space transportation to be considered a commercial item under acquisition laws. As a result, acquisition professionals must opt for contract structures that only allow for Firm Fixed Price contract types and consequently are prohibited from utilizing cost reimbursement contract types. The National Security Space Launch program (NSSL) and the Orbital Service Program (as part of the Rocket Systems Launch Program) share a common commercial item determination and operated under the same Launch Enterprise Division of Space Systems Command until March 2022. As of March 2022, the two programs were realigned under different Deltas within Space Systems Command. This Capstone Applied Project analyzes the current policy for the acquisition of commercial space transportation services as it applies to both the NSSL and OSP-4 programs. Furthermore, the research seeks to address difficulties in determining fair and reasonable prices for space launch services due to the commercial contracts for space launch services containing noncommercial requirements.Civilian, DARPACivilian, Department of the Air ForceApproved for public release. Distribution is unlimited

GALA:an international multicentre randomised trial comparing general anaesthesia versus local anaesthesia for carotid surgery

BACKGROUND: Patients who have severe narrowing at or near the origin of the internal carotid artery as a result of atherosclerosis have a high risk of ischaemic stroke ipsilateral to the arterial lesion. Previous trials have shown that carotid endarterectomy improves long-term outcomes, particularly when performed soon after a prior transient ischaemic attack or mild ischaemic stroke. However, complications may occur during or soon after surgery, the most serious of which is stroke, which can be fatal. It has been suggested that performing the operation under local anaesthesia, rather than general anaesthesia, may be safer. Therefore, a prospective, randomised trial of local versus general anaesthesia for carotid endarterectomy was proposed to determine whether type of anaesthesia influences peri-operative morbidity and mortality, quality of life and longer term outcome in terms of stroke-free survival. METHODS/DESIGN: A two-arm, parallel group, multicentre randomised controlled trial with a recruitment target of 5000 patients. For entry into the study, in the opinion of the responsible clinician, the patient requiring an endarterectomy must be suitable for either local or general anaesthesia, and have no clear indication for either type. All patients with symptomatic or asymptomatic internal carotid stenosis for whom open surgery is advised are eligible. There is no upper age limit. Exclusion criteria are: no informed consent; definite preference for local or general anaesthetic by the clinician or patient; patient unlikely to be able to co-operate with awake testing during local anaesthesia; patient requiring simultaneous bilateral carotid endarterectomy; carotid endarterectomy combined with another operation such as coronary bypass surgery; and, the patient has been randomised into the trial previously. Patients are randomised to local or general anaesthesia by the central trial office. The primary outcome is the proportion of patients alive, stroke free (including retinal infarction) and without myocardial infarction 30 days post-surgery. Secondary outcomes include the proportion of patients alive and stroke free at one year; health related quality of life at 30 days; surgical adverse events, re-operation and re-admission rates; the relative cost of the two methods of anaesthesia; length of stay and intensive and high dependency bed occupancy. TRIAL REGISTRATION: Current Controlled Trials ISRCTN00525237

The RAPID-CTCA trial (Rapid Assessment of Potential Ischaemic Heart Disease with CTCA) - a multicentre parallel-group randomised trial to compare early computerised tomography coronary angiography versus standard care in patients presenting with suspected or confirmed acute coronary syndrome: study protocol for a randomised controlled trial.

BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk. METHODS/DESIGN: Participants will be recruited in about 35 tertiary and district general hospitals in the UK. Patients ≥18 years old with symptoms with suspected/confirmed ACS with at least one of the following will be included: (1) ECG abnormalities, e.g. ST-segment depression >0.5 mm; (2) history of ischaemic heart disease; (3) troponin elevation above the 99(th) centile of the normal reference range or increase in high-sensitivity troponin meeting European Society of Cardiology criteria for 'rule-in' of myocardial infarction (MI). The early use of ≥64-slice CTCA as part of routine assessment will be compared to standard care. The primary endpoint will be 1-year all-cause death or recurrent type 1 or type 4b MI at 1 year, measured as the time to such event. A number of secondary clinical, process and safety endpoints will be collected and analysed. Cost effectiveness will be estimated in terms of the lifetime incremental cost per quality-adjusted life year gained. We plan to recruit 2424 (2500 with ~3% drop-out) evaluable patients (1212 per arm) to have 90% power to detect a 20% versus 15% difference in 1-year death or recurrent type 1 MI or type 4b MI, two-sided p < 0.05. Analysis will be on an intention-to-treat basis. The relationship between intervention and the primary outcome will be analysed using Cox proportional hazard regression adjusted for study site (used to stratify the randomisation), age, baseline Global Registry of Acute Coronary Events score, previous CAD and baseline troponin level. The results will be expressed as a hazard ratio with the corresponding 95% confidence intervals and p value. DISCUSSION: The Rapid Assessment of Potential Ischaemic Heart Disease with CTCA (RAPID-CTCA) trial will recruit 2500 participants across about 35 hospital sites. It will be the first study to investigate the role of CTCA in the early assessment of patients with suspected or confirmed ACS who are at intermediate risk and including patients who have raised troponin measurements during initial assessment. TRIAL REGISTRATION: ISRCTN19102565 . Registered on 3 October 2014. ClinicalTrials.gov: NCT02284191

Fertilizante de liberação controlada na enxertia precoce de Araucaria angustifolia.

A enxertia precoce tem se mostrado uma alternativa promissora na formação de pomares para produção de pinhão. Assim, objetivou-se avaliar o efeito de fertilizante de liberação controlada (FLC) na sobrevivência inicial de enxertos de araucária. Os porta-enxertos foram produzidos por sementes, com substrato a base de casca de pinus (90%) e solo de floresta nativa de araucária (10%, v/v)

Improving the Segmentation of Scanning Probe Microscope Images using Convolutional Neural Networks

A wide range of techniques can be considered for segmentation of images of nanostructured surfaces. Manually segmenting these images is time-consuming and results in a user-dependent segmentation bias, while there is currently no consensus on the best automated segmentation methods for particular techniques, image classes, and samples. Any image segmentation approach must minimise the noise in the images to ensure accurate and meaningful statistical analysis can be carried out. Here we develop protocols for the segmentation of images of 2D assemblies of gold nanoparticles formed on silicon surfaces via deposition from an organic solvent. The evaporation of the solvent drives far-from-equilibrium self-organisation of the particles, producing a wide variety of nano- and micro-structured patterns. We show that a segmentation strategy using the U-Net convolutional neural network outperforms traditional automated approaches and has particular potential in the processing of images of nanostructured systems.Comment: 21 pages, 10 figure

Feasibility of comparing medical management and surgery (with neurosurgery or stereotactic radiosurgery) with medical management alone in people with symptomatic brain cavernoma - protocol for the Cavernomas:A Randomised Effectiveness (CARE) pilot trial

INTRODUCTION: The top research priority for cavernoma, identified by a James Lind Alliance Priority setting partnership was 'Does treatment (with neurosurgery or stereotactic radiosurgery) or no treatment improve outcome for people diagnosed with a cavernoma?' This pilot randomised controlled trial (RCT) aims to determine the feasibility of answering this question in a main phase RCT.METHODS AND ANALYSIS: We will perform a pilot phase, parallel group, pragmatic RCT involving approximately 60 children or adults with mental capacity, resident in the UK or Ireland, with an unresected symptomatic brain cavernoma. Participants will be randomised by web-based randomisation 1:1 to treatment with medical management and with surgery (neurosurgery or stereotactic radiosurgery) versus medical management alone, stratified by prerandomisation preference for type of surgery. In addition to 13 feasibility outcomes, the primary clinical outcome is symptomatic intracranial haemorrhage or new persistent/progressive focal neurological deficit measured at 6 monthly intervals. An integrated QuinteT Recruitment Intervention (QRI) evaluates screening logs, audio recordings of recruitment discussions, and interviews with recruiters and patients/parents/carers to identify and address barriers to participation. A Patient Advisory Group has codesigned the study and will oversee its progress.ETHICS AND DISSEMINATION: This study was approved by the Yorkshire and The Humber-Leeds East Research Ethics Committee (21/YH/0046). We will submit manuscripts to peer-reviewed journals, describing the findings of the QRI and the Cavernomas: A Randomised Evaluation (CARE) pilot trial. We will present at national specialty meetings. We will disseminate a plain English summary of the findings of the CARE pilot trial to participants and public audiences with input from, and acknowledgement of, the Patient Advisory Group.TRIAL REGISTRATION NUMBER: ISRCTN41647111.</p

Fertilizante de liberação controlada na produção de porta-enxertos de araucária.

Edição binacional Brasil-Argentina