Outstanding Compliance Research Articles

Self-healing and antistatic waterborne polyurethane hybrid coating resulting from hard but reversible Zr-O-Si networks

Robust, self-healing waterborne coatings have become the preferred choice in the field of flexible electronic devices owing to their outstanding compliance, restorability, and environmental friendliness. Nevertheless, most of the existing self-healing waterborne polymers exhibit viscoelasticity, irreversible fatigue damage, and the challenge of reconciling self-healing functions with mechanical properties, all stemming from inherent molecular structure contradictions between flexibility and rigidity. Here, we propose a novel strategy that utilizes a nanofiller with dynamic reversible bonds to overcome the self-healing limitations that theoretically demand flexible chain, for achieving both mechanical robustness and self-healing ability in the waterborne polyurethane (WPU) hybrid coating system. We modified tetrapropyl zirconate (TPOZ) with 3-aminopropyltriethoxysilane (APTES) to enhance compatibility between the matrix and inorganic particles, while the formation of dynamic reversible bonds through both condensation hydrolysis endows the self-healing abilities. The WPU hybrid coating was designed by covalently incorporating amino-modified TPOZ (A-ZrO2) into a glycinamide-functionalized WPU network, conferring excellent fracture energy (50.3 kJ/m2), elastic recovery, along with antistatic capability to the coating. Furthermore, the hybrid coating maintains a robust mechanical performance alongside 92.58 % of healing efficiency, exhibiting a potential for flexible electronics application. The hybridization strategy via incorporation of the nanofillers with hard but reversible covalent bond resolves the inherent robustness-healing trade-off, providing exciting thoughts to expand WPU applications.

Electrically Insulative Film Adhesive with Enhanced Thermal Performance to Assemble High Power Density Electronic Devices

Assembly adhesives play a critical role in microelectronic packaging and contribute significant value for circuit assembly interconnection, protection, and thermal management. Of particular interest with today’s more powerful systems is thermal management of high-power density electronic systems, including power modules, power amplifiers, communication systems, and directed energy systems. As requirements for performance and functionality increase, heat generated from these devices increases exponentially. For example, local heat flux can easily exceed 50 W/cm2 for IGBT power modules while it may reach several hundred Watts/cm2 at active areas for Gallium Nitride (GaN) power amplifiers. Simultaneously, many of these systems demand a higher level of electrical insulation to eliminate or minimize current leakage to ensure high reliability over a long service life. Effectively and safely dissipating the high heat and ensuring excellent electrical insulation has become an increasingly critical and challenging task in the microelectronics packaging technology for aerospace and defense systems. This paper presents integration of thermally conductive adhesives with an electrically insulative polyimide film into a carefully engineered laminate, which enables high thermal transfer and robust electrical insulation. This new film adhesive provides outstanding compliance and augmented tolerance to large topographical features and warpage (5-7 mils). This film adhesive is one of the potential solutions to addresses the evolving needs of the electronics assembly industry in the areas of management of high-power systems

Pediatric Anisometropia: Case Series and Review

Background: The etiology and natural course and history of pediatric anisometropia are incompletely understood. This article reviews the literature regarding pediatric anisometropia with much of the review integrated into a case series. The review and case reports are intended to elevate clinical understanding of pediatric anisometropia including and especially treatment outcomes. Case Reports: Case one is anisomyopia with amblyopia that resulted in a poor treatment outcome despite outstanding compliance with prescribed spectacles, vision therapy, and occlusion. Case two is anisometropia caused by organic vision loss from optic neuritis early in life. Case three is an infant with hyperopic anisometropia and esotropia. The esotropia did not respond to spectacles and home based vision therapy. Neonatal high bilateral hyperopia that converted to anisometropia because of early onset cosmetically invisible unilateral esotropia is speculated. Case four describes a boy diagnosed with hyperopic anisometropia at age 11 months coincident with a diagnosis of pseudoesotropia. His compliance with prescribed spectacles was spotty until age three years. An outstanding visual outcome was achieved by age five years with spectacles only (no occlusion therapy). Case five concerns a boy who acquired hyperopic anisometropia because one eye experienced increasing hyperopia during his toddler years. His response to treatment, spectacles and part time occlusion with home vision therapy, was outstanding. Case six is an infant diagnosed with 2.50 diopters of hyperopic anisometropia at age six months. Monocular home based vison developmental activities, not glasses, were prescribed. Her anisometropia vanished three months later. Conclusions: Pediatric anisometropia presents and responds to treatment in a variety of ways that challenge clinical care. Etiology and age of onset, which usually elude clinicians, can explain this variety. Additional research is required to improve clinical outcomes.

Ansätze und Herausforderungen der Implementierung von ESG-Kriterien in Wettbewerben und der unternehmerischen Nachhaltigkeitsbewertung

Zusammenfassung: Awards stellen im Rahmen eines Wettbewerbs aus dem Teilnehmerfeld den Besten heraus. Sie sind damit ein vereinfachtes, meist positives Signal, das die Transparenz verbessern, belohnen und Verbesserungs- und Nachahmeffekte erzielen möchte. Grundlage für die Vergabe eines Nachhaltigkeitsawards an Unternehmen ist deren herausragende Erfüllung von Leitlinien oder vorgegebenen ESG (Environmental, Social, Governance)-Kriterien. Mittels einer Befragung unter 15 Wettbewerben, die sich deutschlandweit an alle Unternehmensbranchen richten, wird in diesem Beitrag dargestellt, welche konkreten Kriterien in die unternehmerischen Nachhaltigkeitsbewertung von Wettbewerben eingehen und welche Herausforderungen damit verbunden sind. Soziale Aspekte, wie Arbeitssicherheit und Menschenrechte, stehen neben ökologischen Aspekten, insbesondere Emissionen und Klimawandel, an vorderer Stelle der Bewertungen. Insgesamt erreichen jedoch nur wenige Wettbewerbe ein gehoben-mittleres Qualitätsniveau mit der gewählten Nachhaltigkeitsbewertung. Die Vergabe bleibt oftmals vage. Vor allem die Transparenz ist sehr verbesserungswürdig. Ein einheitlicher Qualitätsstandard für Nachhaltigkeitswettbewerbe wird empfohlen, dessen Verbindlichkeit und anzulegende Mindestkriterien gilt es weiter auszuloten.

Kinematic analysis and navigation method of a cable-driven continuum robot used for minimally invasive surgery.

Due to the outstanding compliance and dexterity, continuum robot have great advantages in confined space applications, especially in minimally invasive surgery (MIS). However, the vascular environment is complicated and tortuous, it is necessary to preoperative motion planning and navigation for a continuum robot. A cable-driven continuum robot is proposed, and the mapping relationship among the driven space, joint space and task space, as well as the decoupling algorithm are analyzed based on piecewise constant curvature assumption. Moreover, a navigation method is presented to achieve semi-autonomous interventional surgery based on the vascular constraints by using the backbone cure method. Finally, by using the prototype, the interventional simulations and experiments for a simulated glass blood vessel are developed to validate the feasibility and maneuverability of the proposed model and navigation method. The established motion model and navigation method can be used as a motion control and navigation reference.

Kinematics optimization and static analysis of a modular continuum robot used for minimally invasive surgery.

For the outstanding compliance and dexterity of continuum robot, it is increasingly used in minimally invasive surgery. The wide workspace, high dexterity and strong payload capacity are essential to the continuum robot. In this article, we investigate the workspace of a cable-driven continuum robot that we proposed. The influence of section number on the workspace is discussed when robot is operated in narrow environment. Meanwhile, the structural parameters of this continuum robot are optimized to achieve better kinematic performance. Moreover, an indicator based on the dexterous solid angle for evaluating the dexterity of robot is introduced and the distal end dexterity is compared for the three-section continuum robot with different range of variables. Results imply that the wider range of variables achieve the better dexterity. Finally, the static model of robot based on the principle of virtual work is derived to analyze the relationship between the bending shape deformation and the driven force. The simulations and experiments for plane and spatial motions are conducted to validate the feasibility of model, respectively. Results of this article can contribute to the real-time control and movement and can be a design reference for cable-driven continuum robot.

VAMONOS (Veterans Affairs' Metabolism, Obstructed and Non-Obstructed Sleep) Study: Effects of CPAP Therapy on Glucose Metabolism in Patients with Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) and type 2 diabetes mellitus (T2DM) are prevalent disorders that pose increased risk of cardiovascular disease and death. The objective of this study was to clarify if continuous positive airway pressure (CPAP) therapy for OSA affects T2DM control and emergence. Point-of-care, comparative effectiveness study; cross-sectional and longitudinal analyses. Our cohort included 928 consecutive patients; 13% were women; 36% were Caucasians and 61% African-Americans. OSA was diagnosed in approximately 738 patients and CPAP was initiated in 718 patients; median duration of therapy was 5 mo (25% to 75% interquartile range [IQR] 3-14). Patients with OSA used CPAP therapy for a median duration of 4.8 h, 34.5% of the nights. Adherence to CPAP was prespecified as follows: good (≥ 70% nights and ≥ 4 h/night), excellent (≥ 80% nights and ≥ 6 h/night) or outstanding (≥ 90% of nights and 8 h/night). Based on objective data, good, excellent, and outstanding compliance were found in only 30%, 20%, and 6%, respectively. Three percent of subjects without CPAP follow-up and less than 4% of those nonadherent to CPAP therapy (based on the established criteria) developed incident T2DM. Incident T2DM developed in only 0.8% of those with good compliance and in none (0%) of those in the excellent and outstanding groups. During follow-up, median weight change was +0.3 kg (IQR -1.8 to 2.7). We found that an outstanding compliance to CPAP reduced fasting blood glucose in patients with OSA. Longitudinally, higher levels of therapeutic adherence may affect the rate of incident impaired fasting glucose, prediabetes, and T2DM, despite the observed weight gains. A commentary on this article appears in this issue on page 365.

Abstract LB-188: Isoflavone pharmacokinetics and metabolism after consumption of soy and soy-almond bread in men with asymptomatic prostate cancer.

Abstract Background: Soy phytochemicals, particularly isoflavones, are hypothesized to have anti-prostate cancer activity. Soy isoflavones are present predominantly as glucosides but when combined with β-glucosidase activity in almond meal, a greater conversion to aglycones has been observed. We hypothesized that soy bread will serve as an excellent source of soy polyphenols and that an aglycone-rich soy-almond bread (SAB) compared to a glycoside-rich soy bread (SB) will demonstrate greater bioavailability of soy isoflavones. Methods: SB and SAB were fed in a 20 week randomized phase II cross-over trial involving 32 men with asymptomatic metastatic prostate cancer and escalating prostate specific antigen (PSA). Isoflavones were quantitated by HPLC in soy breads and isoflavone metabolites in 24h urine. HPLC-tandem mass spectrometry evaluated isoflavone pharmacokinetics in plasma. Biomarkers were determined by chemiluminescence-based assays. Results: The aglycone composition in the SB and SAB was 18% and 78%, respectively. Compliance was 95±14%, toxicity rare and limited to grade I GI complaints (NIH_NCI criteria). Urinary isoflavone patterns over 24hours revealed that isoflavonoid metabolites were significantly greater with soy bread consumption. Plasma pharmacokinetics following a test meal showed that daidzein (p=0.028) and genistein (p=0.010) absorption was significantly faster from the aglycone-rich SAB. Interestingly, PSA doubling time was prolonged compared to pre-enrollment, in 60% of men (n=30) with soy intervention. Conclusions: Bread is an excellent vehicle for the delivery of soy phytochemicals with outstanding compliance. Modification of soy bread with a source of β-glucosidase may enhance the initial absorption rates of isoflavones. Food products, such as SAB, with consistent and stable composition of phytochemicals can be developed that are appropriate for long-term chemoprevention studies in humans or as an adjunct to therapy. Citation Format: Jennifer H. Ahn-Jarvis, Steven K. Clinton, Elizabeth M. Grainger, Kenneth M. Riedl, Steven J. Schwartz, Yael Vodovotz. Isoflavone pharmacokinetics and metabolism after consumption of soy and soy-almond bread in men with asymptomatic prostate cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr LB-188. doi:10.1158/1538-7445.AM2013-LB-188

Phase II trial of neoadjuvant docetaxel and cisplatin followed by intensity-modulated radiotherapy with concurrent cisplatin in locally advanced nasopharyngeal carcinoma

To evaluate the feasibility and efficacy of neoadjuvant chemotherapy involving docetaxel and cisplatin followed by intensity-modulated radiotherapy (IMRT) with concurrent cisplatin in patients with newly diagnosed stage III to IVB nasopharyngeal carcinoma (NPC). Docetaxel (75 mg/m(2) on day 1) and cisplatin (75 mg/m(2) on day 1) were administered on a 3-week cycle for 2 courses, followed by radical IMRT (72 Gy/33F/6.5-7 W) with concurrent cisplatin (75 mg/m(2), on day 1) every 3 weeks for 2 cycles. From June 2008 to October 2010, forty-six patients were recruited in this trial. Forty-five patients completed neoadjuvant setting, and all patients completed planned concurrent chemoradiotherapy (CCRT). The complete and partial response rates were 28.3 and 56.5 % after neoadjuvant chemotherapy, and 91.3, 8.7 % after CCRT, respectively. After median follow-up of 26 months (range 12-39 months), one patient experienced local recurrence and 4 patients developed distant metastasis. The 3-year overall survival and progression-free survival rate were 94.1 and 72.7 %, respectively. Neutropenia (37.0 %) and vomiting (28.3 %) were the most common Grade 3-4 adverse effects during neoadjuvant course, while mucositis (30.4 %), xerostomia (30.4 %) and radiodermatitis (21.7 %) were the most common Grades 3 acute toxicities during CCRT. Xerostomia (73.9 %), dysphagia (56.5 %), hear loss (30.4 %) and skin reaction (21.7 %) were the common Grade 1-2 late effects. There were no Grades 3-4 late toxicities. The protocol of neoadjuvant docetaxel and cisplatin followed by IMRT with concurrent cisplatin was well tolerated, with outstanding compliance and efficacy in locally advanced NPC, which deserved further follow-up.

Evaluation of treatment adherence in type 1 diabetes: a novel approach

Intensified insulin therapy requires outstanding compliance but no measure of therapy adherence has been agreed upon. The aim of the current study was to test the hypothesis that treatment adherence, as described by a novel multiple regression model, relates to glycosylated haemoglobin and hypoglycaemia frequency in type 1 diabetes. Furthermore, we sought to analyse the complex diurnal patterns of therapy adherence. Thirty type 1 diabetes patients (20 females and 10 males), treated with intensified insulin therapy, were studied in a retrospective manner. Patients were trained to follow treatment algorithms for adjusting regular insulin dosage which took into account the actual blood glucose, food intake and the time of the day. By means of multiple linear regression analysis, with regular insulin dosage as the dependent variable, blood glucose and food intake as the independent variables, the insulin treatment algorithms actually used by the individual patient were retrieved. The correlation between prescribed and implemented insulin therapy served as a measure of adherence. Metabolic control was assessed by glycosylated haemoglobin and hypoglycaemia frequency. Median glycosylated haemoglobin was 7.7% (range: 6.3-10.8); median monthly hypoglycaemia frequency was 3.8 (range: 0-9.8). Patients with good metabolic control (glycosylated haemoglobin < 7.7 and/or hypoglycaemia frequency < 3.8 per month) adhered to prescribed insulin dosing algorithms more frequently than those with poor metabolic control. In patients with type 1 diabetes on intensified therapy a positive relationship between adherence to the therapy prescribed and metabolic control exists.

The Establishment and Validation of the Mobile Immunization Team Concept at a Clinic Level

Faced with unacceptably low and declining overall immunization compliance, as well as specific flu immunization compliance, the Executive Committee of a 32-person Air National Guard clinic asked the nursing service to devise a method of correcting these deficiencies as rapidly as possible and maintaining immunization compliance at a rate of 90% or better of the total patient population of approximately 1,100 full-time and Guard personnel for whom the clinic was responsible. The concept of a mobile immunization team was devised and validated over a 2-year interval. In order to successfully develop and implement this concept, command emphasis and a high level of cooperation from both clinic personnel and the Unit Commanders involved was requested and received. The make-up of the team, risk management, the timing and place of team visits, and record keeping were among the problems addressed and resolved. The mobile immunization team concept was a success, achieving excellent overall immunization compliance and outstanding compliance with the flu immunization program over a 2-year period.

Soviet aims in europe

new arms control agreement to serve as the centerpiece of a second summit meeting in the latter half of 1986 or early 1987. The extent to which compliance has become a sore point in United States-Soviet relations and has raised doubts in the United States about the reliability of the USSR as a negotiating partner, indicates that the two countries will need to pursue settlement of the outstanding compliance problems as a first step toward a new arms accord. Agreement on the issues that have emerged from the compliance d i spu te -more precise limits on LPHARs, more airtight limits on encryption and on ICBM modernization, and many other possible measures to strengthen the existing arms control regime--would provide an appropriate and convenient series of successful accords for another Reagan-Gorbachev summit meeting. Formal United States and Soviet recommitment to the ABM treaty and other accords, together with agreement on updating and rendering much more precise the provisions that have come under pressure from the two countries' military programs, appear increasingly possible today because of Soviet incentives for a new arms control agreement. Such a set of agreed interpretations of past treaties could smooth the road toward new accords. In any case, it stretches the imagination to believe that the United States and the Soviet Union will be able to conclude the comprehensive agreements both are now proposing, reaching far beyond the terms of existing treaties, in the absence of the ability to even confirm their adherence to the more modest limitations of the past. []