Benzodiazepine dependence is a significant national problem. Although benzodiazepines — a class of drugs that includes drugs such as alprazolam, lorazepam, temazepam, clonazepam, and diazepam—have a wide range of uses including the treatment of insomnia, anxiety, and seizures; they are addictive. Individuals taking these drugs can quickly develop dangerous tolerances. Therefore, these drugs should not be selected as first choice nor used for more than short periods, yet a significant portion of the population uses benzodiazepines for long periods. This problem is significantly more pronounced in the elderly, a population that scholars have agreed should not use these drugs outside of extreme circumstances. Because benzodiazepines may be wrongfully perceived as an easy treatment for so many common afflictions, providers continue to prescribe them, and patients may be reluctant to discontinue use due to the symptoms associated with withdrawal (i.e., insomnia and anxiety). To avoid these symptoms, the standard discontinuation approach seen in an outpatient setting is a long-term taper that may take eight to 12 weeks of gradual reduction. However, in an inpatient setting, this long-term approach is unfeasible due to the short length of patient stays. The literature has given little consideration to this problem. Thus, it was necessary to review evidence and develop a guideline for benzodiazepine tapering in elderly patients receiving inpatient psychiatric care. The purpose of this project was to develop a guideline to taper benzodiazepines in the elderly using the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP). The guideline was validated by expert peer reviewers using the AGREE II instrument. The completed guidelines offer recommendations on the tapering of benzodiazepines in an inpatient geropsych unit and best practices for interventions to increase the success rate of discontinuation.

Les travaux de recherche présentés dans ce manuscrit ont pour but de concevoir, simuler, fabriquer et caractériser un convertisseur modal à base de canne microstructurée air-silice (CMAS). Cette fonction représente un élément clé pour les multiplexeurs modaux et les compensateurs de dispersion chromatique. Le composant proposé est basé sur une CMAS effilée dite « taper » qui constitue une transition entre les deux fibres différentes. La conversion se fait à travers l’excitation d’un mode particulier dans une fibre multimode à partir d’une fibre standard. Dans les structures à diamètre évolutif, la compréhension des différentes théories régissant le couplage entre les différents modes est nécessaire. Une étude approfondie est réalisée pour analyser le phénomène de couplage et étudier le critère d’adiabaticité. Ce composant est élaboré autour d’une technologie de fabrication existante à XLIM qui se base sur la technique fusion-étirage. Enfin, nous validons numériquement et expérimentalement ce principe. Nous réussissons à exciter le mode fondamental et d’autres modes d’ordre supérieur dans une fibre multimode. / These research works presented in this manuscript aim at designing, simulate, manufacture and characterizing the modal converter based microstructured air-silica cane. This function represents a key element for modal multiplexers and chromatic dispersion compensators. The proposed component is based on a tapered microstructured air-silica cane « taper » which constitutes a transition between the two different fibers. The conversion is done through the excitation of a particular mode in a multimode or few mode fibers from a standard fiber. In the tapered structures, the understanding of the different theories involving the coupling between the different modes was yet necessary. A thorough study is carried to analyze the phenomenon of coupling and study the adiabatic criterion. This component is developed around an existing manufacturing technology at XLIM which based in the technique « stack and draw». Finally, we validate numerically and experimentally that principle. We succeed to excite the fundamental mode and higher order modes in a multimode fiber.

Fiber tapers have attracted much attention and have been successfully employed in various applications, ranging from resonators, filters, interferometers to sensors. This thesis studies the properties of fiber tapers for the purpose of making tapered-based devices and sensors in aerospace related application where small size and light weight are critical. This thesis includes theoretical derivation and experimental verifications of distributed mode coupling in tapered single-mode fibers (SMFs) with high-resolution optical frequency-domain reflectometry (OFDR) technique. The studies are realized with OFDR through phase detection of a Mach-Zehnder interferometer (MZI), which measures local refractive index change relative to the reference arm. The wavelength shifts converted by the phase change give the group index differences between the fundamental mode and higher-order modes of fiber tapers. The energy re-distribution is observed in Rayleigh backscatter amplitude as a function of fiber length with a ~13µm resolution over the entire fiber taper, and group index difference between core and cladding modes is measured with a spatial resolution of ~2cm by using autocorrelation data processing. The thermal and mechanical properties of fiber tapers have also been characterized with OFDR. The cross-correlation wavelength shift is related to the refractive index change of the modes. It is shown that residual stress induced by the tapering process results in the inhomogeneous thermal property, which can be significantly reduced by an annealing treatment. A fiber taper with a waist diameter of ~6µm has a force sensitivity of ~620.83nm/N, ~500 times higher than that of SMF. Furthermore, polarization-preserving character of tapered polarization-maintaining fibers (PMFs) is evaluated by OFDR-based distributed birefringence along tapered PMFs. Three tapered-based micro-fiber devices have been used as effective mode selecting components to build narrow-linewidth tunable Erbium-doped fiber ring lasers. The fabrication is easy and at a low cost. 1) a tapered fiber tip forms multimode interference mechanism; 2) a two-taper MZI has been demonstrated by splitting/combining the fundamental mode and higher-order modes through fiber tapers and is tuned by bending one taper waist; 3) a novel tunable fiber Fabry-Perot filter, consisting of a hollow-core photonic bandgap fiber and a micro-fiber, is employed in the reflection mode.

A pluridade de características de espécies nativas, aliada a leis que limitam sua exploração, acarreta na necessidade de estabelecimento de novas espécies capazes de suprir a demanda madeireira brasileira. Os Eucalyptus spp. são altamente produtivos sob clima tropical, sendo extensamente plantados no país para diversas finalidades, em especial papel e celulose, energia, painéis e serraria, entretanto, pouca ênfase tem sido dada a esta última, devido ao horizonte longo de planejamento, dificuldades no processamento primário e defeitos na madeira apresentados pelas espécies mais produtivas do gênero. Visando traçar estratégias que minimizem essas dificuldades, analisamos o efeito de 2 formas de manipulação de copa - destopo e desrama -, sob diferentes regimes de luminosidade, em parâmetros da copa e do tronco em híbridos de Eucalyptus urophylla dos 11 aos 23 meses de idade. Tanto o destopo quanto a desrama afetaram negativamente o incremento diamétrico e volumétrico do híbrido, entretanto, árvores destopadas sob níveis maiores de luminosidade exibiram fatores de afilamento menores, quando comparadas ao tratamento Controle. Dentro do mesmo regime de luminosidade, árvores desramadas também apresentaram fatores de afilamento inferiores. Apesar de sua alta demanda por luz, o híbrido foi capaz de alterar sua estrutura foliar de acordo com o nível de luminosidade: árvores sob regimes de luminosidade reduzida adaptaram suas folhas à sombra (folhas de sombra), enquanto que àquelas sem limitação de luminosidade folhas adaptadas ao sol (folhas de sol). Brotações em resposta ao destopo se resumiram à brotações epicórmicas próximo à seção destopada. / The diversity of characteristics of native species, allied to laws that limit their exploration, reinforces the need of establishing news species to supply the national wood demand. The Eucalyptus spp. are highly productive under tropical whether, being extensively planted in the country to many finalities, especially paper, pulp, energy, panels and sawn wood, however, low attention is being given to the last due to the long term planning, difficulties in the primary processing and wood blemishes present in the most productive species of the gender. Aiming to trace strategies that minimize these hardships, we analyzed the effects of two forms of crown manipulation - topping and pruning -, under different light patterns, in parameters of crown and bole of Eucalytpus urophylla hybrids from 11 to 23 months of age. Both topping and pruning impacted negatively the diametric and volumetric increment, although topped trees showed smaller taper when compared to the Control treatment. Within the same light pattern pruned trees also presented smaller taper. Although the hybrid demands high amounts of light, it was capable of altering its foliage structure according to the light level: trees under reduced light adapted its leaves to shadow (\"shadow leaves\"), while those without light limitation leaves adapted to sun (\"sunleaves\"). Shoots in response to topping were resumed to epicormic shoots close to the topped section.

A pluridade de características de espécies nativas, aliada a leis que limitam sua exploração, acarreta na necessidade de estabelecimento de novas espécies capazes de suprir a demanda madeireira brasileira. Os Eucalyptus spp. são altamente produtivos sob clima tropical, sendo extensamente plantados no país para diversas finalidades, em especial papel e celulose, energia, painéis e serraria, entretanto, pouca ênfase tem sido dada a esta última, devido ao horizonte longo de planejamento, dificuldades no processamento primário e defeitos na madeira apresentados pelas espécies mais produtivas do gênero. Visando traçar estratégias que minimizem essas dificuldades, analisamos o efeito de 2 formas de manipulação de copa - destopo e desrama -, sob diferentes regimes de luminosidade, em parâmetros da copa e do tronco em híbridos de Eucalyptus urophylla dos 11 aos 23 meses de idade. Tanto o destopo quanto a desrama afetaram negativamente o incremento diamétrico e volumétrico do híbrido, entretanto, árvores destopadas sob níveis maiores de luminosidade exibiram fatores de afilamento menores, quando comparadas ao tratamento Controle. Dentro do mesmo regime de luminosidade, árvores desramadas também apresentaram fatores de afilamento inferiores. Apesar de sua alta demanda por luz, o híbrido foi capaz de alterar sua estrutura foliar de acordo com o nível de luminosidade: árvores sob regimes de luminosidade reduzida adaptaram suas folhas à sombra (folhas de sombra), enquanto que àquelas sem limitação de luminosidade folhas adaptadas ao sol (folhas de sol). Brotações em resposta ao destopo se resumiram à brotações epicórmicas próximo à seção destopada. / The diversity of characteristics of native species, allied to laws that limit their exploration, reinforces the need of establishing news species to supply the national wood demand. The Eucalyptus spp. are highly productive under tropical whether, being extensively planted in the country to many finalities, especially paper, pulp, energy, panels and sawn wood, however, low attention is being given to the last due to the long term planning, difficulties in the primary processing and wood blemishes present in the most productive species of the gender. Aiming to trace strategies that minimize these hardships, we analyzed the effects of two forms of crown manipulation - topping and pruning -, under different light patterns, in parameters of crown and bole of Eucalytpus urophylla hybrids from 11 to 23 months of age. Both topping and pruning impacted negatively the diametric and volumetric increment, although topped trees showed smaller taper when compared to the Control treatment. Within the same light pattern pruned trees also presented smaller taper. Although the hybrid demands high amounts of light, it was capable of altering its foliage structure according to the light level: trees under reduced light adapted its leaves to shadow (\"shadow leaves\"), while those without light limitation leaves adapted to sun (\"sunleaves\"). Shoots in response to topping were resumed to epicormic shoots close to the topped section.

Introduction: The aim of this in vitro study was two part. The first being to assess and compare the amount of dentin removed by an instrument with a taper of 0.04 versus an instrument with a taper of 0.06 using the Edge Evolve® file system at different increments within the canal system. Secondly, this study evaluated whether instrumentation with either taper resulted in a remaining dentin thickness (RDT) of less than 0.3mm. If this RDT was imposed upon, fracture resistance was compromised. Both pre and post instrumentation measurements were taken of samples instrumented with the 0.04 and 0.06 tapered files. Methods: Ten maxillary premolars exhibiting Weine class III canal systems and minimal to no root canal curvature were mounted in an acrylic resin filled K-cube. Each acrylic resin cube was sectioned horizontally at 3, 6, 9, and 12mm increments from the apex. The K-cube is a device which allows the investigator to disassemble and then reassemble root slices in their original orientation. Dentin thickness was measured at three positions on each canal using the Zeiss Discovery V20 stereomicroscope. The sections were then reassembled into the K-cube. The ten premolar roots were separated into two groups. In half of the teeth the buccal canals were instrumented with 0.04 tapered files and the lingual canals instrumented with 0.06 tapered files. In the other half of the teeth, instrumentation was reversed: the buccal canals were instrumented with 0.06 tapered files and the lingual canals were instrumented with 0.04 tapered files. Root sections were again separated, and the remaining dentin thickness was measured. A repeated-measures mixed-model ANCOVA was performed to analyze the effect of taper on RDT. Results: The amount of dentin removed was statistically different between the two tapers (P=0.02). Across all of the slices and positions, the 0.04 tapered instruments had an average pre-post difference of 0.1313mm. The 0.06 tapered instruments had an average pre-post difference of 0.1672mm. None of the instruments imposed upon the recommended 0.3mm RDT. Conclusion: The 0.04 tapered files instrument with greater conservancy than the 0.06 tapered files. The 0.06 tapered files had their greatest effect on the canal in the 9mm and 12mm sections. However, neither taper imposed upon the recommended RDT for optimal fracture resistance within the apical 12mm root portion observed in this study. Keywords: Instrumentation, Edge Evolve, Root canal preparation, Taper

Fiber tapers have attracted much attention and have been successfully employed in various applications, ranging from resonators, filters, interferometers to sensors. This thesis studies the properties of fiber tapers for the purpose of making tapered-based devices and sensors in aerospace related application where small size and light weight are critical. This thesis includes theoretical derivation and experimental verifications of distributed mode coupling in tapered single-mode fibers (SMFs) with high-resolution optical frequency-domain reflectometry (OFDR) technique. The studies are realized with OFDR through phase detection of a Mach-Zehnder interferometer (MZI), which measures local refractive index change relative to the reference arm. The wavelength shifts converted by the phase change give the group index differences between the fundamental mode and higher-order modes of fiber tapers. The energy re-distribution is observed in Rayleigh backscatter amplitude as a function of fiber length with a ~13µm resolution over the entire fiber taper, and group index difference between core and cladding modes is measured with a spatial resolution of ~2cm by using autocorrelation data processing. The thermal and mechanical properties of fiber tapers have also been characterized with OFDR. The cross-correlation wavelength shift is related to the refractive index change of the modes. It is shown that residual stress induced by the tapering process results in the inhomogeneous thermal property, which can be significantly reduced by an annealing treatment. A fiber taper with a waist diameter of ~6µm has a force sensitivity of ~620.83nm/N, ~500 times higher than that of SMF. Furthermore, polarization-preserving character of tapered polarization-maintaining fibers (PMFs) is evaluated by OFDR-based distributed birefringence along tapered PMFs. Three tapered-based micro-fiber devices have been used as effective mode selecting components to build narrow-linewidth tunable Erbium-doped fiber ring lasers. The fabrication is easy and at a low cost. 1) a tapered fiber tip forms multimode interference mechanism; 2) a two-taper MZI has been demonstrated by splitting/combining the fundamental mode and higher-order modes through fiber tapers and is tuned by bending one taper waist; 3) a novel tunable fiber Fabry-Perot filter, consisting of a hollow-core photonic bandgap fiber and a micro-fiber, is employed in the reflection mode.

Tapered I-section members have been employed widely for the design of long-span structures such as large clear-span buildings, stadiums, and bridges because of their structural efficiency. For optimized member design providing maximum strength and stiffness at minimum cost, general non-prismatic (tapered and/or stepped cross-sections) as well as singly-symmetric cross-sections have been commonly employed. Fabricators equipped to produce web-tapered members can create a wide range of optimized members from a minimal stock of different plates and coil. Linearly tapered web plates can be nested to minimize scrap. In many cases, the savings in material and manufacturing efficiencies lead to significant cost savings relative to the use of comparable rolled shapes. To employ Design Guide 25 (DG25) which provides guidance for the application of the provisions of the AISC Specification to the design of frames composed of general non-prismatic members, designers need a robust and general capability for determining the elastic buckling loads. Furthermore, robust tools are needed to facilitate the selection of optimum non-prismatic member designs based on minimum cost. This research addresses the calculation of the elastic buckling loads for general non-prismatic members subjected to general loadings and bracing conditions (typically involving multiple brace points along a given member). This research develops an elastic buckling analysis tool (SABRE2) that can be used to define general geometries, loadings and bracing conditions and obtain a rigorous calculation of the elastic buckling load levels. The three-dimensional finite element equations using open section thin-walled beam theory are derived and formulated using a co-rotational approach including load height effects of transverse loads, stepped flange dimensions, and bracing and support height effects. In addition, this research addresses an algorithmic means to obtain automatic optimized member and frame designs using the above types of members based on Genetic Algorithms (GA). These capabilities are implemented in the tool SABRE2D, which provides a graphical user interface for optimized member and frame design based on updated DG25 provisions and the elastic buckling load calculations from SABRE2.

Fiber tapers have attracted much attention and have been successfully employed in various applications, ranging from resonators, filters, interferometers to sensors. This thesis studies the properties of fiber tapers for the purpose of making tapered-based devices and sensors in aerospace related application where small size and light weight are critical. This thesis includes theoretical derivation and experimental verifications of distributed mode coupling in tapered single-mode fibers (SMFs) with high-resolution optical frequency-domain reflectometry (OFDR) technique. The studies are realized with OFDR through phase detection of a Mach-Zehnder interferometer (MZI), which measures local refractive index change relative to the reference arm. The wavelength shifts converted by the phase change give the group index differences between the fundamental mode and higher-order modes of fiber tapers. The energy re-distribution is observed in Rayleigh backscatter amplitude as a function of fiber length with a ~13µm resolution over the entire fiber taper, and group index difference between core and cladding modes is measured with a spatial resolution of ~2cm by using autocorrelation data processing. The thermal and mechanical properties of fiber tapers have also been characterized with OFDR. The cross-correlation wavelength shift is related to the refractive index change of the modes. It is shown that residual stress induced by the tapering process results in the inhomogeneous thermal property, which can be significantly reduced by an annealing treatment. A fiber taper with a waist diameter of ~6µm has a force sensitivity of ~620.83nm/N, ~500 times higher than that of SMF. Furthermore, polarization-preserving character of tapered polarization-maintaining fibers (PMFs) is evaluated by OFDR-based distributed birefringence along tapered PMFs. Three tapered-based micro-fiber devices have been used as effective mode selecting components to build narrow-linewidth tunable Erbium-doped fiber ring lasers. The fabrication is easy and at a low cost. 1) a tapered fiber tip forms multimode interference mechanism; 2) a two-taper MZI has been demonstrated by splitting/combining the fundamental mode and higher-order modes through fiber tapers and is tuned by bending one taper waist; 3) a novel tunable fiber Fabry-Perot filter, consisting of a hollow-core photonic bandgap fiber and a micro-fiber, is employed in the reflection mode.

Magister Chirurgiae Dentium (MChD) / Background: Lack of appropriate bone thickness is a common clinical limitation for tooth replacement, often requiring narrow implants, which have shown better results when combined with Morse taper connections. Little is known about the sealing of the abutment-implant interface of narrow implants with Morse taper connections against oral bacteria. Aims: To investigate the in vitro ability of four commercially available narrow diameter implant (< 3.5 mm) with Morse-taper type implant abutment connections to impede bacterial penetration of their implant abutment interface (IAI). Material and Methods: Four commercially available narrow implant systems with Morse taper connections were subjected to Streptococcus sanguinis cultures in vitro and evaluated for contamination and microgaps through Scanning Electron Microscopy (SEM). Results: Bacterial penetration of the IAI was observed in all systems (n=12), ranging from 65 to >300 CFU. There were no statistically significant differences in the average log CFU between the four implant groups (χ2= 5.244, P=0.155). Microgaps ranging from 5-10 μm were observed in all assemblies when analyzed under SEM, with no statistically significant differences between the different systems (P>0.05). Conclusions: Despite the advantages of Morse taper systems, the evaluated narrow diameter implants using this type of abutment geometry failed to provide bacterial sealing. The observed microgaps can form reservoirs and potentially lead to inflammation in the peri-implant tissues and micromovements.