Sample records for reduces prolonged frequency-adjusted

  1. Frequency adjustable MEMS vibration energy harvester

    NASA Astrophysics Data System (ADS)

    Podder, P.; Constantinou, P.; Amann, A.; Roy, S.

    2016-10-01

    Ambient mechanical vibrations offer an attractive solution for powering the wireless sensor nodes of the emerging “Internet-of-Things”. However, the wide-ranging variability of the ambient vibration frequencies pose a significant challenge to the efficient transduction of vibration into usable electrical energy. This work reports the development of a MEMS electromagnetic vibration energy harvester where the resonance frequency of the oscillator can be adjusted or tuned to adapt to the ambient vibrational frequency. Micro-fabricated silicon spring and double layer planar micro-coils along with sintered NdFeB micro-magnets are used to construct the electromagnetic transduction mechanism. Furthermore, another NdFeB magnet is adjustably assembled to induce variable magnetic interaction with the transducing magnet, leading to significant change in the spring stiffness and resonance frequency. Finite element analysis and numerical simulations exhibit substantial frequency tuning range (25% of natural resonance frequency) by appropriate adjustment of the repulsive magnetic interaction between the tuning and transducing magnet pair. This demonstrated method of frequency adjustment or tuning have potential applications in other MEMS vibration energy harvesters and micromechanical oscillators.

  2. Relay protection features of frequency-adjustable electric drive

    NASA Astrophysics Data System (ADS)

    Kuprienko, V. V.

    2018-03-01

    The features of relay protection of high-voltage electric motors in composition of the frequency-adjustable electric drive are considered in the article. The influence of frequency converters on the stability of the operation of various types of relay protection used on electric motors is noted. Variants of circuits for connecting relay protection devices are suggested. The need to develop special relay protection devices for a frequency-adjustable electric drive is substantiated.

  3. Frequency band adjustment match filtering based on variable frequency GPR antennas pairing scheme for shallow subsurface investigations

    NASA Astrophysics Data System (ADS)

    Shaikh, Shahid Ali; Tian, Gang; Shi, Zhanjie; Zhao, Wenke; Junejo, S. A.

    2018-02-01

    Ground penetrating Radar (GPR) is an efficient tool for subsurface geophysical investigations, particularly at shallow depths. The non-destructiveness, cost efficiency, and data reliability are the important factors that make it an ideal tool for the shallow subsurface investigations. Present study encompasses; variations in central frequency of transmitting and receiving GPR antennas (Tx-Rx) have been analyzed and frequency band adjustment match filters are fabricated and tested accordingly. Normally, the frequency of both the antennas remains similar to each other whereas in this study we have experimentally changed the frequencies of Tx-Rx and deduce the response. Instead of normally adopted three pairs, a total of nine Tx-Rx pairs were made from 50 MHz, 100 MHz, and 200 MHz antennas. The experimental data was acquired at the designated near surface geophysics test site of the Zhejiang University, Hangzhou, China. After the impulse response analysis of acquired data through conventional as well as varied Tx-Rx pairs, different swap effects were observed. The frequency band and exploration depth are influenced by transmitting frequencies rather than the receiving frequencies. The impact of receiving frequencies was noticed on the resolution; the more noises were observed using the combination of high frequency transmitting with respect to low frequency receiving. On the basis of above said variable results we have fabricated two frequency band adjustment match filters, the constant frequency transmitting (CFT) and the variable frequency transmitting (VFT) frequency band adjustment match filters. By the principle, the lower and higher frequency components were matched and then incorporated with intermediate one. Therefore, this study reveals that a Tx-Rx combination of low frequency transmitting with high frequency receiving is a better choice. Moreover, both the filters provide better radargram than raw one, the result of VFT frequency band adjustment filter is

  4. High frequency of pertussis in older children and adolescents with prolonged cough in Turkey.

    PubMed

    Aslan, Aslı; Kurugöl, Zafer; Aydemir, Şöhret; Gürsel, Derya; Koturoğlu, Güldane

    2016-01-01

    This study aimed to determine the frequency of B. pertussis infection among Turkish children with prolonged cough. Nasopharyngeal specimens were collected from 7-18 year old children, presenting with prolonged cough of two to four weeks' duration. Specimens were examined for B. pertussis by PCR. Of 101 children with prolonged cough, 20 (19.8%) had a positive PCR testing for B. pertussis. Children who were vaccinated ≥5 years previously had a 6.13-fold higher risk of PCR-confirmed pertussis than those who were vaccinated < 5 years before. The classic symptoms of pertussis (paroxysmal cough, whooping and post-tussive vomiting) were seen in 30%, 15% and 25% of the patients with positive PCR, respectively; 55% of them had only a prolonged cough without any classic symptoms. Pertussis is common among Turkish children with prolonged cough, even after implementation of a fifth dose of pertussis vaccination and despite high vaccination coverage.

  5. Branched-Chain Amino Acid Supplementation Reduces Oxidative Stress and Prolongs Survival in Rats with Advanced Liver Cirrhosis

    PubMed Central

    Mifuji-Moroka, Rumi; Hara, Nagisa; Miyachi, Hirohide; Sugimoto, Ryosuke; Tanaka, Hideaki; Fujita, Naoki; Gabazza, Esteban C.; Takei, Yoshiyuki

    2013-01-01

    Long-term supplementation with branched-chain amino acids (BCAA) is associated with prolonged survival and decreased frequency of development of hepatocellular carcinoma (HCC) in patients with liver cirrhosis. However, the pharmaceutical mechanism underlying this association is still unclear. We investigated whether continuous BCAA supplementation increases survival rate of rats exposed to a fibrogenic agent and influences the iron accumulation, oxidative stress, fibrosis, and gluconeogenesis in the liver. Further, the effects of BCAA on gluconeogenesis in cultured cells were also investigated. A significant improvement in cumulative survival was observed in BCAA-supplemented rats with advanced cirrhosis compared to untreated rats with cirrhosis (P<0.05). The prolonged survival due to BCAA supplementation was associated with reduction of iron contents, reactive oxygen species production and attenuated fibrosis in the liver. In addition, BCAA ameliorated glucose metabolism by forkhead box protein O1 pathway in the liver. BCAA prolongs survival in cirrhotic rats and this was likely the consequences of reduced iron accumulation, oxidative stress and fibrosis and improved glucose metabolism in the liver. PMID:23936183

  6. Capacitance-Based Frequency Adjustment of Micro Piezoelectric Vibration Generator

    PubMed Central

    Mao, Xinhua; He, Qing; Li, Hong; Chu, Dongliang

    2014-01-01

    Micro piezoelectric vibration generator has a wide application in the field of microelectronics. Its natural frequency is unchanged after being manufactured. However, resonance cannot occur when the natural frequencies of a piezoelectric generator and the source of vibration frequency are not consistent. Output voltage of the piezoelectric generator will sharply decline. It cannot normally supply power for electronic devices. In order to make the natural frequency of the generator approach the frequency of vibration source, the capacitance FM technology is adopted in this paper. Different capacitance FM schemes are designed by different locations of the adjustment layer. The corresponding capacitance FM models have been established. Characteristic and effect of the capacitance FM have been simulated by the FM model. Experimental results show that the natural frequency of the generator could vary from 46.5 Hz to 42.4 Hz when the bypass capacitance value increases from 0 nF to 30 nF. The natural frequency of a piezoelectric vibration generator could be continuously adjusted by this method. PMID:25133237

  7. Operational amplifier with adjustable frequency response.

    PubMed

    Gulisek, D; Hencek, M

    1978-01-01

    The authors describe an operational amplifier with an adjustable frequency response and its use in membrane physiology, using the voltage clamp and current clamp method. The amplifier eliminates feedback poles causing oscillation. It consists of a follower with a high input resistance in the form of a tube and of an actual amplifier with an adjustable frequency response allowing the abolition of clicks by one pole and of oscillation by two poles in the 500 Hz divided by infinity range. Further properties of the amplifier: a long-term voltage drift of 1 mv, a temperature voltage drift of 0.5 mv/degrees K, input resistance greater than 1 GOhm, amplification greater than 80 dB, output +/- 12 v, 25 ma, noise, measured from the width of the oscilloscope track in the presence of a ray of normal brightness, not exceeding 50 muv in the 0-250 kHz band, f1 = 1 MHz. A short report on the amplifier was published a few years ago (Gulísek and Hencek 1973).

  8. Use of Prolonged Travel to Improve Pediatric Risk-Adjustment Models

    PubMed Central

    Lorch, Scott A; Silber, Jeffrey H; Even-Shoshan, Orit; Millman, Andrea

    2009-01-01

    Objective To determine whether travel variables could explain previously reported differences in lengths of stay (LOS), readmission, or death at children's hospitals versus other hospital types. Data Source Hospital discharge data from Pennsylvania between 1996 and 1998. Study Design A population cohort of children aged 1–17 years with one of 19 common pediatric conditions was created (N=51,855). Regression models were constructed to determine difference for LOS, readmission, or death between children's hospitals and other types of hospitals after including five types of additional illness severity variables to a traditional risk-adjustment model. Principal Findings With the traditional risk-adjustment model, children traveling longer to children's or rural hospitals had longer adjusted LOS and higher readmission rates. Inclusion of either a geocoded travel time variable or a nongeocoded travel distance variable provided the largest reduction in adjusted LOS, adjusted readmission rates, and adjusted mortality rates for children's hospitals and rural hospitals compared with other types of hospitals. Conclusions Adding a travel variable to traditional severity adjustment models may improve the assessment of an individual hospital's pediatric care by reducing systematic differences between different types of hospitals. PMID:19207591

  9. Prolonged immunosuppression preserves nonsensitization status after kidney transplant failure.

    PubMed

    Casey, Michael J; Wen, Xuerong; Kayler, Liise K; Aiyer, Ravi; Scornik, Juan C; Meier-Kriesche, Herwig-Ulf

    2014-08-15

    When kidney transplants fail, transplant medications are discontinued to reduce immunosuppression-related risks. However, retransplant candidates are at risk for allosensitization which prolonging immunosuppression may minimize. We hypothesized that for these patients, a prolonged immunosuppression withdrawal after graft failure preserves nonsensitization status (PRA 0%) better than early immunosuppression withdrawal. We retrospectively examined subjects transplanted at a single center between July 1, 1999 and December 1, 2009 with a non-death-related graft loss. Subjects were stratified by timing of immunosuppression withdrawal after graft loss: early (≤3 months) or prolonged (>3 months). Retransplant candidates were eligible for the main study where the primary outcome was nonsensitization at retransplant evaluation. Non-retransplant candidates were included in the safety analysis only. We found 102 subjects with non-death-related graft loss of which 49 were eligible for the main study. Nonsensitization rates at retransplant evaluation were 30% and 66% for the early and prolonged immunosuppression withdrawal groups, respectively (P=0.01). After adjusting for cofactors such as blood transfusion and allograft nephrectomy, prolonged immunosuppression withdrawal remained significantly associated with nonsensitization (adjusted odds ratio=5.78, 95% CI [1.37-24.44]). No adverse safety signals were seen in the prolonged immunosuppression withdrawal group compared to the early immunosuppression withdrawal group. These results suggest that prolonged immunosuppression may be a safe strategy to minimize sensitization in retransplant candidates and provide the basis for larger or prospective studies for further verification.

  10. Heart Rate Variability Frequency Domain Alterations among Healthy Nurses Exposed to Prolonged Work Stress.

    PubMed

    Borchini, Rossana; Veronesi, Giovanni; Bonzini, Matteo; Gianfagna, Francesco; Dashi, Oriana; Ferrario, Marco Mario

    2018-01-11

    The deregulation of the autonomic nervous system assessed through the heart rate variability (HRV) analysis is a promising pathway linking work stress and cardiovascular diseases. We aim to investigate the associations between HRV High Frequency (HF) and Low Frequency (LF) powers and work stress in a sample of 36 healthy nurses. Perceived work stress was assessed twice one year apart, using the Job Content and Effort Reward Imbalance questionnaires. This allows to classify nurses in three exposure groups: "prolonged high stress" (PHS), "recent high stress" (RHS) and "stable low stress" (SLS). A 24-h ECG monitoring was later performed during a working day (WD) and a subsequent resting day (RD). Statistically significantly lower ( p < 0.02) HF and LF means were found in PHS and RHS nurses during the working periods. In the subsequent resting periods, HF means showed increases over time in the RHS (beta = +0.41, p < 0.05), but not in PHS nurses. LF means did not show any substantial increases in the resting periods, in the PHS group with geometric means lower when compared to SLS, in the non-working and resting periods. Our study evidences that both prolonged and recent perceived high work stress were associated with a reduction of HF and LF powers during work. In addition, prolonged stress was associated with a lack of recovery during not-working and resting periods.

  11. Competing for Consciousness: Prolonged Mask Exposure Reduces Object Substitution Masking

    ERIC Educational Resources Information Center

    Goodhew, Stephanie C.; Visser, Troy A. W.; Lipp, Ottmar V.; Dux, Paul E.

    2011-01-01

    In object substitution masking (OSM) a sparse, temporally trailing 4-dot mask impairs target identification, even though it has different contours from, and does not spatially overlap with the target. Here, we demonstrate a previously unknown characteristic of OSM: Observers show reduced masking at prolonged (e.g., 640 ms) relative to intermediate…

  12. Reactive oxygen species and fatigue-induced prolonged low-frequency force depression in skeletal muscle fibres of rats, mice and SOD2 overexpressing mice.

    PubMed

    Bruton, Joseph D; Place, Nicolas; Yamada, Takashi; Silva, José P; Andrade, Francisco H; Dahlstedt, Anders J; Zhang, Shi-Jin; Katz, Abram; Larsson, Nils-Göran; Westerblad, Håkan

    2008-01-01

    Skeletal muscle often shows a delayed force recovery after fatiguing stimulation, especially at low stimulation frequencies. In this study we focus on the role of reactive oxygen species (ROS) in this fatigue-induced prolonged low-frequency force depression. Intact, single muscle fibres were dissected from flexor digitorum brevis (FDB) muscles of rats and wild-type and superoxide dismutase 2 (SOD2) overexpressing mice. Force and myoplasmic free [Ca(2+)] ([Ca(2+)](i)) were measured. Fibres were stimulated at different frequencies before and 30 min after fatigue induced by repeated tetani. The results show a marked force decrease at low stimulation frequencies 30 min after fatiguing stimulation in all fibres. This decrease was associated with reduced tetanic [Ca(2+)](i) in wild-type mouse fibres, whereas rat fibres and mouse SOD2 overexpressing fibres instead displayed a decreased myofibrillar Ca(2+) sensitivity. The SOD activity was approximately 50% lower in wild-type mouse than in rat FDB muscles. Myoplasmic ROS increased during repeated tetanic stimulation in rat fibres but not in wild-type mouse fibres. The decreased Ca(2+) sensitivity in rat fibres could be partially reversed by application of the reducing agent dithiothreitol, whereas the decrease in tetanic [Ca(2+)](i) in wild-type mouse fibres was not affected by dithiothreitol or the antioxidant N-acetylcysteine. In conclusion, we describe two different causes of fatigue-induced prolonged low-frequency force depression, which correlate to differences in SOD activity and ROS metabolism. These findings may have clinical implications since ROS-mediated impairments in myofibrillar function can be counteracted by reductants and antioxidants, whereas changes in SR Ca(2+) handling appear more resistant to interventions.

  13. Associations between frequency of bullying involvement and adjustment in adolescence.

    PubMed

    Gower, Amy L; Borowsky, Iris W

    2013-01-01

    To examine whether infrequent bullying perpetration and victimization (once or twice a month) are associated with elevated levels of internalizing and externalizing problems and to assess evidence for a minimum frequency threshold for bullying involvement. The analytic sample included 128,681 6th, 9th, and 12th graders who completed the 2010 Minnesota Student Survey. Logistic regression and general linear models examined the association between bullying frequency and adjustment correlates including emotional distress, self-harm, physical fighting, and substance use while controlling for demographic characteristics. Gender and grade were included as moderators. Infrequent bullying perpetration and victimization were associated with increased levels of all adjustment problems relative to those who did not engage in bullying in the past 30 days. Grade moderated many of these findings, with perpetration frequency being more strongly related to substance use, self-harm, and suicidal ideation for 6th graders than 12th graders, whereas victimization frequency was associated with self-harm more strongly for 12th graders than 6th graders. Evidence for minimum thresholds for bullying involvement across all outcomes, grades, and bullying roles was inconsistent. Infrequent bullying involvement may pose risks to adolescent adjustment; thus, clinicians and school personnel should address even isolated instances of bullying behavior. Researchers should reexamine the use of cut points in bullying research in order to more fully understand the nature of bullying in adolescence. These data indicate the need for prevention and intervention programs that target diverse internalizing and externalizing problems for bullies and victims, regardless of bullying frequency. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  14. Prolonging the duration of masseter muscle reduction by adjusting the masticatory movements after the treatment of masseter muscle hypertrophy with botulinum toxin type a injection.

    PubMed

    Wei, Jiao; Xu, Hua; Dong, Jiasheng; Li, Qingfeng; Dai, Chuanchang

    2015-01-01

    Botulinum toxin type A (BTX-A) is widely used for the clinical treatment of masseteric hypertrophy. Until now, few reports have discussed how to prolong the duration of its effectiveness. This study evaluated that purposely adjusting the masticatory movements is possible of postponing the masseter muscle rehypertrophy. Ninety-eight patients were randomly and equally divided into 2 groups, and 35 U BTX-A per side was injected into the masseters. The thickness and volume of the masticatory muscles were measured by ultrasound and computerized tomography, respectively. Patients in Group 1 were instructed to strengthen their masticatory effort during the denervated atrophic stage of the masseter (the interval was evaluated by real-time ultrasound monitoring), whereas patients in Group 2 were not given this instruction. When the masseter muscle began to recover, patients in both groups were instructed to reduce their chewing. The duration of the masseter muscle rehypertrophy was significantly prolonged in Group 1 patients. The thickness and the volume of the other masticatory muscles were significantly increased in Group 1 but were either slightly decreased or insignificantly different in Group 2. Purposely strengthening masticatory muscle movement during the denervated atrophic stage of the masseter can prolong the duration of masseter rehypertrophy.

  15. Hypoxic ventilatory sensitivity in men is not reduced by prolonged hyperoxia (Predictive Studies V and VI)

    NASA Technical Reports Server (NTRS)

    Gelfand, R.; Lambertsen, C. J.; Clark, J. M.; Hopkin, E.

    1998-01-01

    Potential adverse effects on the O2-sensing function of the carotid body when its cells are exposed to toxic O2 pressures were assessed during investigations of human organ tolerance to prolonged continuous and intermittent hyperoxia (Predictive Studies V and VI). Isocapnic hypoxic ventilatory responses (HVR) were determined at 1.0 ATA before and after severe hyperoxic exposures: 1) continuous O2 breathing at 1.5, 2.0, and 2.5 ATA for 17.7, 9.0, and 5.7 h and 2) intermittent O2 breathing at 2.0 ATA (30 min O2-30 min normoxia) for 14.3 O2 h within 30-h total time. Postexposure curvature of HVR hyperbolas was not reduced compared with preexposure controls. The hyperbolas were temporarily elevated to higher ventilations than controls due to increments in respiratory frequency that were proportional to O2 exposure time, not O2 pressure. In humans, prolonged hyperoxia does not attenuate the hypoxia-sensing function of the peripheral chemoreceptors, even after exposures that approach limits of human pulmonary and central nervous system O2 tolerance. Current applications of hyperoxia in hyperbaric O2 therapy and in subsea- and aerospace-related operations are guided by and are well within these exposure limits.

  16. System and method for tuning adjusting the central frequency of a laser while maintaining frequency stabilization to an external reference

    NASA Technical Reports Server (NTRS)

    Livas, Jeffrey (Inventor); Thorpe, James I. (Inventor); Numata, Kenji (Inventor)

    2011-01-01

    A method and system for stabilizing a laser to a frequency reference with an adjustable offset. The method locks a sideband signal generated by passing an incoming laser beam through the phase modulator to a frequency reference, and adjusts a carrier frequency relative to the locked sideband signal by changing a phase modulation frequency input to the phase modulator. The sideband signal can be a single sideband (SSB), dual sideband (DSB), or an electronic sideband (ESB) signal. Two separate electro-optic modulators can produce the DSB signal. The two electro-optic modulators can be a broadband modulator and a resonant modulator. With a DSB signal, the method can introduce two sinusoidal phase modulations at the phase modulator. With ESB signals, the method can further drive the optical phase modulator with an electrical signal with nominal frequency OMEGA(sub 1) that is phase modulated at a frequency OMEGA(sub 2)

  17. Adjusting for background mutation frequency biases improves the identification of cancer driver genes.

    PubMed

    Evans, Perry; Avey, Stefan; Kong, Yong; Krauthammer, Michael

    2013-09-01

    A common goal of tumor sequencing projects is finding genes whose mutations are selected for during tumor development. This is accomplished by choosing genes that have more non-synonymous mutations than expected from an estimated background mutation frequency. While this background frequency is unknown, it can be estimated using both the observed synonymous mutation frequency and the non-synonymous to synonymous mutation ratio. The synonymous mutation frequency can be determined across all genes or in a gene-specific manner. This choice introduces an interesting trade-off. A gene-specific frequency adjusts for an underlying mutation bias, but is difficult to estimate given missing synonymous mutation counts. Using a genome-wide synonymous frequency is more robust, but is less suited for adjusting biases. Studying four evaluation criteria for identifying genes with high non-synonymous mutation burden (reflecting preferential selection of expressed genes, genes with mutations in conserved bases, genes with many protein interactions, and genes that show loss of heterozygosity), we find that the gene-specific synonymous frequency is superior in the gene expression and protein interaction tests. In conclusion, the use of the gene-specific synonymous mutation frequency is well suited for assessing a gene's non-synonymous mutation burden.

  18. Demonstration of the frequency offset errors introduced by an incorrect setting of the Zeeman/magnetic field adjustment on the cesium beam frequency standard

    NASA Technical Reports Server (NTRS)

    Kaufmann, D. C.

    1976-01-01

    The fine frequency setting of a cesium beam frequency standard is accomplished by adjusting the C field control with the appropriate Zeeman frequency applied to the harmonic generator. A novice operator in the field, even when using the correct Zeeman frequency input, may mistakenly set the C field to any one of seven major Beam I peaks (fingers) represented by the Ramsey curve. This can result in frequency offset errors of as much as 2.5 parts in ten to the tenth. The effects of maladjustment are demonstrated and suggestions are discussed on how to avoid the subtle traps associated with C field adjustments.

  19. Contribution of impaired myofibril and ryanodine receptor function to prolonged low-frequency force depression after in situ stimulation in rat skeletal muscle.

    PubMed

    Watanabe, Daiki; Kanzaki, Keita; Kuratani, Mai; Matsunaga, Satoshi; Yanaka, Noriyuki; Wada, Masanobu

    2015-06-01

    The aim of this study was to examine whether prolonged low-frequency force depression (PLFFD) that occurs in situ is the result of decreased myofibrillar Ca(2+) sensitivity and/or reduced sarcoplasmic reticulum (SR) Ca(2+) release. Intact rat gastrocnemius muscles were electrically stimulated via the sciatic nerve until force was reduced to ~50% of the initial and dissected 30 min following the cessation of stimulation. Skinned fibre and whole muscle analyses were performed in the superficial region composed exclusively of type IIB fibres. Fatiguing stimulation significantly reduced the ratio of force at low frequency to that at high frequency to 65% in skinned fibres (1 vs. 50 Hz) and 73% in whole muscles (20 vs. 100 Hz). In order to evaluate changes in myofibrillar Ca(2+) sensitivity and ryanodine receptor caffeine sensitivity, skinned fibres were activated in Ca(2+)- and caffeine-containing solutions, respectively. Skinned fibres from fatigued muscles displayed decreased caffeine sensitivity together with increased myofibrillar Ca(2+) sensitivity. Treatment with 2,2'-dithiodipyridine and reduced glutathione induced a smaller increase in myofibrillar Ca(2+)sensitivity in fatigued than in rested fibres. In fatigued muscles, S-glutathionylation of troponin I was increased and submaximal SR Ca(2+) release, induced by 4-chloro-m-cresol, was decreased. These findings suggest that in the early stage of PLFFD that occurs in fast-twitch muscles of exercising animals and humans, S-glutathionylation of troponin I may attenuate PLFFD by increasing myofibrillar Ca(2+) sensitivity and that under such a circumstance, PLFFD may be ascribable to failure of SR Ca(2+) release.

  20. Standing on a declining surface reduces transient prolonged standing induced low back pain development.

    PubMed

    Gallagher, Kaitlin M; Callaghan, Jack P

    2016-09-01

    While alternating standing position on a sloped surface has proven successful at reducing low back pain during standing, the purpose of this study was to evaluate standing solely on a declining surface to isolate the influence of the postural change. Seventeen participants performed two 75-min prolonged standing occupational simulations- level ground and declining surface. Fifty-three percent of participants (9/17) were categorized as pain developers during the level ground standing condition. For these same pain developers, their average maximum pain scores were 58% lower during sloped standing. All participants showed greater hip flexion, trunk-to-thigh angle flexion, and posterior translation of the trunk center of gravity when standing on the sloped surface. These postural changes could cause the muscles crossing the hip posteriorly to increase passive stiffness and assist with stabilizing the pelvis. This study stresses the importance of hip kinematics, not just lumbar spine posture, in reducing prolonged standing induced low back pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Auto Accidents: Reducing Frequency, Increasing Recovery.

    ERIC Educational Resources Information Center

    Comeaux, Linda Atkins

    1988-01-01

    Careful hiring, monitoring, training, discipline, and safety policies will reduce school automobile and bus accidents. Guidelines are offered for accident reporting, claim handling, and dealing with insurance adjusters. (MLF)

  2. Frequency adjustment and synchrony in networks of delayed pulse-coupled oscillators

    NASA Astrophysics Data System (ADS)

    Nishimura, Joel

    2015-01-01

    We introduce a system of pulse-coupled oscillators that can change both their phases and frequencies and prove that when there is a separation of time scales between phase and frequency adjustment the system converges to exact synchrony on strongly connected graphs with time delays. The analysis involves decomposing the network into a forest of tree-like structures that capture causality. These results provide a robust method of sensor net synchronization as well as demonstrate a new avenue of possible pulse-coupled oscillator research.

  3. Effect of fluid ingestion on neuromuscular function during prolonged cycling exercise.

    PubMed

    Vallier, J-M; Grego, F; Basset, F; Lepers, R; Bernard, T; Brisswalter, J

    2005-04-01

    To investigate the effects of fluid ingestion on neuromuscular function during prolonged cycling exercise. Eight well trained subjects exercised for 180 minutes in a moderate environment at a workload requiring approximately 60% maximal oxygen uptake. Two conditions, fluid (F) and no fluid (NF) ingestion, were investigated. During maximal voluntary isometric contraction (MVC), prolonged cycling exercise reduced (p<0.05) the maximal force generating capacity of quadriceps muscles (after three hours of cycling) and root mean square (RMS) values (after two hours of cycling) with no difference between the two conditions despite greater body weight loss (p<0.05) in NF. The mean power frequency (MPF) for vastus lateralis muscle was reduced (p<0.05) and the rate of force development (RFD) was increased (p<0.05) only during NF. During cycling exercise, integrated electromyographic activity and perceived exertion were increased in both conditions (p<0.05) with no significant effect of fluid ingestion. The results suggest that fluid ingestion did not prevent the previously reported decrease in maximal force with exercise duration, but seems to have a positive effect on some indicators of neuromuscular fatigue such as mean power frequency and rate of force development during maximal voluntary contraction. Further investigations are needed to assess the effect of change in hydration on neural mechanisms linked to the development of muscular fatigue during prolonged exercise.

  4. Biomechanical investigation of prolonged driving in an ergonomically designed truck seat prototype.

    PubMed

    Cardoso, Michelle; McKinnon, Colin; Viggiani, Dan; Johnson, Michel J; Callaghan, Jack P; Albert, Wayne J

    2018-03-01

    A postural evaluation during a prolonged driving task was conducted to determine the ergonomic validity of a new freely adjustable truck seat prototype. Twenty participants were recruited to perform two 2-h simulated driving sessions. Postures were assessed using motion capture, accelerometers and pressure pads. Subjective discomfort was also monitored in 15-min increments using ratings of perceived discomfort (RPD) and the Automotive Seating Discomfort Questionnaire. Participants had a more neutral spine posture during the first hour of the drive and reported lower RPDs while sitting in the prototype. Pairing the gluteal backrest panel with the adjustable seat pan helped reduce the average sitting pressure. The industry-standard truck seat may lead to the development of poor whole body posture, and the proposed ergonomic redesign of a new truck seat helped improve sitting posture and reduce perceived discomfort. Practitioner Summary: A new freely adjustable truck seat prototype was compared to an Industry standard seat to assess hypothesised improvements to sitting posture and discomfort for long haul driving. It was found that the adjustable panels in the prototype helped promote spine posture, reduce sitting pressure and improved discomfort ratings.

  5. Design, fabrication, and initial test of a fixture for reducing the natural frequency of the Mod-O wind turbine tower

    NASA Technical Reports Server (NTRS)

    Winemiller, J. R.; Sullivan, T. L.; Sizemore, R. L.; Yee, S. T.

    1979-01-01

    It was desired to observe the behavior of a two bladed wind turbine where the tower first bending natural frequency is less than twice the rotor speed. The system then passes through resonance when accelerating to operating speed. The frequency of the original Mod-O tower was reduced by placing it on a spring fixture. The fixture is adjustable to provide a range of tower bending frequencies. Fixture design details are given and behavior during initial operation is described.

  6. Paternal work stress and prolonged time to pregnancy.

    PubMed

    Lee, Mi-Sun; Paek, Domyung; Eum, Ki-Do; Siegrist, Johannes; Li, Jian; Lee, Hye-Eun; Cho, Sung-Il

    2009-01-01

    The aim of this study was to explore an association between psychosocial stress at work in married men and their spouses' prolonged time to pregnancy (TTP). All married male workers of a large Korean petrochemical enterprise and their wives fulfilling the selection criteria were included. Main selection criteria were lack of use of contraceptives and experienced pregnancy in recent past. Data were available from 322 couples. Psychosocial stress at work was measured by the effort-reward imbalance questionnaire. Prolonged TTP was measured by the "TTP questionnaire". After adjustment for confounding effects of demographic and life-style characteristics and benzene exposure, delayed TTP, defined by frequency of first-cycle pregnancy, was associated with one standard deviation (SD) increase of the effort-reward ratio in the chronically stressed group of married men (OR = 0.47; 95% CI = 0.22-0.99) in logistic regression analysis. A similar, but somewhat weaker effect, was found for the overall group (OR = 0.67; 95% CI = 0.47-0.94). Paternal stress at work, as measured by effort-reward imbalance, seemed to be associated with a decreased number of conceptions in the first menstrual cycle.

  7. Frequency of neck and shoulder pain and use of adjustable computer workstation among bankers

    PubMed Central

    Shabbir, Maryam; Rashid, Sajid; Umar, Bilal; Ahmad, Aqeel; Ehsan, Sarah

    2016-01-01

    Background & Objective: Neck and shoulder are the most susceptible areas for developing musculoskeletal symptoms among computer users. The modifiable risk factors for these work related musculoskeletal disorders include physical office environment and psychosocial work related factors. Computer workstation layout had been shown to be an important physical aspect of work environment that influences the upper quadrant symptoms. Our objective was to find the frequency of neck and shoulder pain and use of adjustable computer workstation among bankers of Islamabad/Rawalpindi/Multan Methods: A cross sectional study was conducted and 120 participants were questioned. Purposive sampling technique was used in this study. Maastricht Upper Extremity Questionnaire (MUEQ) was remodeled and important questions were extracted from its detailed version. The tool was then validated by taking expert opinion. Frequencies and percentages were calculated for categorical variables. Results: Pain in the neck during working hours was experienced by 71.67% of the respondents and 48.33% of the participants had experienced shoulder pain during working hours. Adjustable keyboards were used by 16.67% of respondents. Back care material was used by 40% bankers. Adjustable chairs were used by 95.83% of the participants. Only 3% of the bankers did not have chairs with adjustable heights. Chairs with adjustable armrests were used by 25% bankers. Conclusion: Neck and shoulder pain are common occurrences among bankers. Most of the components of workstations of bankers were adjustable but some of them still need attention. PMID:27182253

  8. Analysis of a piezoelectric power harvester with adjustable frequency by precise electric field method.

    PubMed

    Wang, Yujue; Lian, Ziyang; Yao, Mingge; Wang, Ji; Hu, Hongping

    2013-10-01

    A power harvester with adjustable frequency, which consists of a hinged-hinged piezoelectric bimorph and a concentrated mass, is studied by the precise electric field method (PEFM), taking into account a distribution of the electric field over the thickness. Usually, using the equivalent electric field method (EEFM), the electric field is approximated as a constant value in the piezoelectric layer. Charge on the upper electrode (UEC) of the bimorph is often assumed as output charge. However, different output charge can be obtained by integrating on electric displacement over the electrode with different thickness coordinates. Therefore, an average charge (AC) on thickness is often assumed as the output value. This method is denoted EEFM AC. The flexural vibration of the bimorph is calculated by the three methods and their results are compared. Numerical results illustrate that EEFM UEC overestimates resonant frequency, output power, and efficiency. EEFM AC can accurately calculate the output power and efficiency, but underestimates resonant frequency. The performance of the harvester, which depends on concentrated mass weight, position, and circuit load, is analyzed using PEFM. The resonant frequency can be modulated 924 Hz by moving the concentrated mass along the bimorph. This feature suggests that the natural frequency of the harvester can be adjusted conveniently to adapt to frequency fluctuation of the ambient vibration.

  9. Does Use of Low-Molecular-Weight Heparin during Pregnancy Influence the Risk of Prolonged Labor: A Population-Based Cohort Study

    PubMed Central

    Sandström, Anna; Cnattingius, Sven; Wikström, Anna-Karin

    2015-01-01

    Background The use of low-molecular-weight heparins (LMWHs) during pregnancy is increasing. In vitro studies and small clinical studies support the hypothesis that LMWH treatment during pregnancy may reduce duration of labor. The aim of this study was to investigate if use of LMWH is associated with a reduced risk of diagnosis of prolonged labor, after taking maternal, fetal and other delivery characteristics into account. Methods and Findings A population-based cohort study from the Swedish Medical Birth Register from April 2006 through December 2011. We identified 514 875 term (≥37 weeks) deliveries of live singleton infants in cephalic presentation with spontaneous or induced onsets of labor. The Birth Register was linked to the Prescribed Drug Register to retrieve information on dispensed LMWH during pregnancy and to the Patient Register for information on underlying diagnosis for use of LMWH. Diagnosis of prolonged labor in the Birth Register was retrieved from diagnosis at discharge from the delivery hospital. The risk of diagnosis of prolonged labor in relation to treatment with LMWH was assessed using logistic regression analysis to estimate unadjusted and adjusted odds ratios. A total of 5 275 (1.0%) of the pregnant women used LMWH. The absolute risk of diagnosis of prolonged labor for nulliparous women was 19.9% among women using LMWH in third trimester, and 21.2% in women without use of LMWH. For parous women the corresponding absolute risks were 4.3% and 4.7%, respectively. Compared to nulliparous women without use of LMWH, nulliparous women with LMWH during third trimester had an odds ratio (OR) of 0.92 (95% CI 0.81–1.05, p-value: 0.051) for diagnosis of prolonged labor in unadjusted analyses and after adjustments for maternal characteristics, gestational age and epidural analgesia the OR was 1.00 (95% CI 0.87–1.15, p-value: 0.673). Parous women treated with LMWH in third trimester presented the same pattern, unadjusted OR for diagnosis of

  10. Validation of the force and frequency characteristics of the activator adjusting instrument: effectiveness as a mechanical impedance measurement tool.

    PubMed

    Keller, T S; Colloca, C J; Fuhr, A W

    1999-02-01

    To determine the dynamic force-time and force-frequency characteristics of the Activator Adjusting Instrument and to validate its effectiveness as a mechanical impedance measurement device; in addition, to refine or optimize the force-frequency characteristics of the Activator Adjusting Instrument to provide enhanced dynamic structural measurement reliability and accuracy. An idealized test structure consisting of a rectangular steel beam with a static stiffness similar to that of the human thoracolumbar spine was used for validation of a method to determine the dynamic mechanical response of the spine. The Activator Adjusting Instrument equipped with a load cell and accelerometer was used to measure forces and accelerations during mechanical excitation of the steel beam. Driving point and transfer mechanical impedance and resonant frequency of the beam were determined by use of a frequency spectrum analysis for different force settings, stylus masses, and stylus tips. Results were compared with beam theory and transfer impedance measurements obtained by use of a commercial electronic PCB impact hammer. The Activator Adjusting Instrument imparted a very complex dynamic impact comprising an initial high force (116 to 140 N), short duration pulse (<0.1 ms) followed by several lower force (30 to 100 N), longer duration impulses (1 to 5 ms). The force profile was highly reproducible in terms of the peak impulse forces delivered to the beam structure (<8% variance). Spectrum analysis of the Activator Adjusting Instrument impulse indicated that the Activator Adjusting Instrument has a variable force spectrum and delivers its peak energy at a frequency of 20 Hz. Added masses and different durometer stylus tips had very little influence on the Activator Adjusting Instrument force spectrum. The resonant frequency of the beam was accurately predicted by both the Activator Adjusting Instrument and electronic PCB impact hammer, but variations in the magnitude of the driving

  11. Effects of sound-field frequency modulation amplification on reducing teachers' sound pressure level in the classroom.

    PubMed

    Sapienza, C M; Crandell, C C; Curtis, B

    1999-09-01

    Voice problems are a frequent difficulty that teachers experience. Common complaints by teachers include vocal fatigue and hoarseness. One possible explanation for these symptoms is prolonged elevations in vocal loudness within the classroom. This investigation examined the effectiveness of sound-field frequency modulation (FM) amplification on reducing the sound pressure level (SPL) of the teacher's voice during classroom instruction. Specifically, SPL was examined during speech produced in a classroom lecture by 10 teachers with and without the use of sound-field amplification. Results indicated a significant 2.42-dB decrease in SPL with the use of sound-field FM amplification. These data support the use of sound-field amplification in the vocal hygiene regimen recommended to teachers by speech-language pathologists.

  12. Low-frequency oscillation amplitude elevation of prefrontal cerebral hemodynamics with driving duration during prolonged driving test

    NASA Astrophysics Data System (ADS)

    Deng, Zishan; Gao, Yuan; Li, Ting

    2018-02-01

    It has been observed that there is a low-frequency oscillation (LFO) around 0.1 Hz in cerebral hemodynamics related to brain activity. Since functional near-infrared spectroscopy (fNIRS) is a novel technique to monitor hemodynamic responses noninvasively, we applied it to detect LFOs of cerebral hemodynamic parameters, such as oxyhemoglobin and deoxyhemoglobin, during prolonged driving. We performed an experiment lasting for 7 hours and an experimental test was done every hour and 8 times altogether. 7 subjects were recruited and the data of 3 of them were analyzed. By means of Fourier transformation, the amplitude of the three parameters during each test at 0.1 Hz in frequency domain was extracted. The results showed an increasing trend in the 0.1 Hz amplitudes of the three hemodynamic parameters during 7 hours' simulated driving test. Our findings indicated the potential of LFOs of prefrontal cerebral hemodynamics in brain research and brain function evaluation.

  13. [Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice].

    PubMed

    Chantry, A A; Monier, I; Marcellin, L

    2015-12-01

    The objectives were to on assess the frequency and the duration of breastfeeding in France. On the other hand, the objectives were to identify its benefits and drawbacks, and to study the factors influencing its initiation and its extension. Bibliographic research in Medline, Google Scholar and in the Cochrane Library. Breastfeeding concerns in France about 70% of children at birth (EL2). Its median duration is about 15 weeks and 3 weeks ½ for exclusive breastfeeding. At three months, only one third of children breastfed at birth are still being breastfed (EL2). Whether this is due to the composition of breast milk or the behavior of mothers with their children or their socio-cultural level, or even by all these components at once, breastfeeding is associated with better cognitive development children (EL2). This effect is even more reinforced that mothers breastfeed exclusively and prolonged (EL2). As part of the prevention of many diseases (ear infections, gastrointestinal infections, atopic diseases, obesity and cardiovascular diseases…), exclusive and prolonged breastfeeding (grade B) between 4 to 6 months is recommended (professional consensus). Breastfeeding is not a means of preventing postpartum depression (professional consensus). To reduce the incidence of breast cancer, prolonged breastfeeding is recommended (grade B). In order to increase the rate of initiation of breastfeeding as well as its duration, it is recommended that health professionals work closely with mothers in their project (grade A), the breastfeeding promotion messages include message to husbands (grade B), and to promote breastfeeding on demand without fixed interval between feedings (grade B). However, there is not enough data to recommend the use of a specific position during breastfeeding, or the use of one or two breast or to early start breastfeeding or not (professional consensus). Exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (professional

  14. The frequency of human, manual adjustments in balancing an inverted pendulum is constrained by intrinsic physiological factors

    PubMed Central

    Loram, Ian D; Gawthrop, Peter J; Lakie, Martin

    2006-01-01

    While standing naturally and when manually or pedally balancing an equivalent inverted pendulum, the load sways slowly (characteristic unidirectional duration ∼1 s) and the controller, calf muscles or hand, makes more frequent adjustments (characteristic unidirectional duration 400 ms). Here we test the hypothesis that these durations reflect load properties rather than some intrinsic property of the human neuromuscular system. Using a specialized set-up mechanically analogous to real standing, subjects manually balanced inverted pendulums with different moments of inertia through a compliant spring representing the Achilles tendon. The spring bias was controlled by a sensitive joystick via a servo motor and accurate visual feedback was provided on an oscilloscope. As moment of inertia decreased, inverted pendulum sway size increased and it became difficult to sustain successful balance. The mean duration of unidirectional balance adjustments did not change. Moreover, the mean duration of unidirectional inverted pendulum sway reduced only slightly, remaining around 1 s. The simplest explanation is that balance was maintained by a process of manual adjustments intrinsically limited to a mean frequency of two to three unidirectional adjustments per second corresponding to intermittent control observed in manual tracking experiments. Consequently the inverted pendulum sway duration, mechanically related to the bias duration, reflects an intrinsic constraint of the neuromuscular control system. Given the similar durations of sway and muscle adjustments observed in real standing, we postulate that the characteristic duration of unidirectional standing sway reflects intrinsic intermittent control rather than the inertial properties of the body. PMID:16973712

  15. Symptom Severity Predicts Prolonged Recovery after Sport-Related Concussion: Age and Amnesia Do Not

    PubMed Central

    Meehan, William P.; Mannix, Rebekah C.; Stracciolini, Andrea; Elbin, R.J.; Collins, Michael W.

    2013-01-01

    Objective To identify predictors of prolonged symptoms for athletes who sustain concussions. Study design We conducted a multi-center, prospective, cohort study of patients in 2 sport concussion clinics. Possible predictors of prolonged symptoms from concussion were compared between two groups: those whose symptoms resolved within 28 days and those whose symptoms persisted beyond 28 days. Candidate predictor variables were entered into a logistic regression model that was used to generate adjusted odds ratios. Results During the study period, 182 patients met inclusion criteria. The mean age was 15.2 years (SD 3.04 years). Over a third (N=65) of patients underwent computerized neurocognitive testing on their initial visit. In univariate analyses, Post Concussion Symptom Scale (PCSS) score and all composite scores on computerized neurocognitive testing appeared to be associated with prolonged symptom duration. Sex, age, loss of consciousness at time of injury and amnesia at time of injury were not associated with prolonged symptom duration. After adjusting for potential confounding, however, only total score on the PCSS score was associated with the odds of suffering prolonged symptoms. Conclusions After adjusting for other potential confounding variables, only total score on the PCSS was associated with the odds of suffering prolonged symptoms from sport-related concussions; age and amnesia were not. Further efforts to develop clinical tools for predicting which athletes will suffer prolonged recoveries after concussion should focus on initial symptom score. PMID:23628374

  16. Prevalence of QT interval prolongation in patients admitted to cardiac care units and frequency of subsequent administration of QT interval-prolonging drugs: a prospective, observational study in a large urban academic medical center in the US.

    PubMed

    Tisdale, James E; Wroblewski, Heather A; Overholser, Brian R; Kingery, Joanna R; Trujillo, Tate N; Kovacs, Richard J

    2012-06-01

    Cardiac arrest due to torsades de pointes (TdP) is a rare but catastrophic event in hospitals. Patients admitted to cardiac units are at higher risk of drug-induced QT interval prolongation and TdP, due to a preponderance of risk factors. Few data exist regarding the prevalence of QT interval prolongation in patients admitted to cardiac units or the frequency of administering QT interval-prolonging drugs to patients presenting with QT interval prolongation. The aim of this study was to determine the prevalence of Bazett's-corrected QT (QT(c)) interval prolongation upon admission to cardiac units and the proportion of patients presenting with QT(c) interval prolongation who are subsequently administered QT interval-prolonging drugs during hospitalization. This was a prospective, observational study conducted over a 1-year period (October 2008-October 2009) in 1159 consecutive patients admitted to two cardiac units in a large urban academic medical centre located in Indianapolis, IN, USA. Patients were enrolled into the study at the time of admission to the hospital and were followed daily during hospitalization. Exclusion criteria were age <18 years, ECG rhythm of complete ventricular pacing, and patient designation as 'outpatient' in a bed and/or duration of stay <24 hours. Data collected included demographic information, past medical history, daily progress notes, medication administration records, laboratory data, ECGs, telemetry monitoring strips and diagnostic reports. All patients underwent continuous cardiac telemetry monitoring and/or had a baseline 12-lead ECG obtained within 4 hours of admission. QT intervals were determined manually from lead II of 12-lead ECGs or from continuous lead II telemetry monitoring strips. QT(c) interval prolongation was defined as ≥470 ms for males and ≥480 ms for females. In both males and females, QT(c) interval >500 ms was considered abnormally high. A medication was classified as QT interval-prolonging if there

  17. Job adjustment as a means to reduce sickness absence during pregnancy.

    PubMed

    Strand, K; Wergeland, E; Bjerkedal, T

    1997-10-01

    This study examined the effect of job adjustment on sickness absence during pregnancy and also determined the conditions under which such adjustments are obtained. Data were derived from a nationally representative survey on work conditions during pregnancy in Norway in 1989. For employees (N = 2713) remaining in the same job throughout pregnancy, the percentage of women on sick leave immediately before delivery was determined according to the need for job adjustment and the obtainment of job adjustment. Those obtaining job adjustment were grouped according to workplace size, labor-market sector, co-worker gender, educational level, work schedules, weekly workhours, children under 16 years of age in the household, and age. All told, 1691 women (62.3%) needed job adjustment, among whom 936 (55.4%) obtained such adjustment. The proportions of those on sick leave before delivery were 45.2% for "no need", 67.9% for "need - adjustment obtained", and 79.2% for "need - adjustment not obtained". In the last category, the difference (versus "adjustment obtained") constituted 44.5% of the weeks lost because of sickness absence in the last half of pregnancy. The odds ratio (OR) for obtaining job adjustment was larger for workplaces with more than 50 employees (OR 1.4) and smaller for jobs with work schedules other than daytime or shift work (OR 0.5) and also for women living with children under 16 years of age (OR 0.8). Job adjustment is associated with reduced sickness absence during pregnancy. Further studies should explore workplace characteristics that make it difficult to obtain such adjustments, as required by law.

  18. Home-based detoxification for neonatal abstinence syndrome reduces length of hospital admission without prolonging treatment.

    PubMed

    Smirk, Cameron L; Bowman, Ellen; Doyle, Lex W; Kamlin, Omar

    2014-06-01

    Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome, secondary to in utero chemical exposure and characterised by tremor, irritability and feed intolerance. It often requires prolonged hospital treatment and separation of families. Outpatient therapy may reduce this burden, but current literature is sparse. This review aimed to evaluate the safety and efficacy of our home-based detoxification programme and compare it with standard inpatient care. Infants requiring treatment for NAS between January 2004 and December 2010 were reviewed. Data on demographics, drug exposure, length of stay and type of therapy were compared between infants selected for home-based therapy and those treated conventionally. Of the 118 infants who were admitted for treatment of NAS, 38 (32%) were managed at home. Infants receiving home-based detoxification had shorter hospital stays (mean 19 days vs. 39 days), with no increase in total duration of treatment (mean 36 days vs. 41 days), and were more likely to be breastfeeding on discharge from hospital care (45% vs. 22%). In selected infants, home-based detoxification is associated with reduced hospital stays and increased rates of breastfeeding, without prolonging therapy. Safety of the infants remains paramount, which precludes many from entering such a programme. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Is prolongation of corrected QT interval associated with seizures induced by electroconvulsive therapy reduced by atropine sulfate?

    PubMed

    Suzuki, Yoko; Miyajima, Miho; Ohta, Katsuya; Yoshida, Noriko; Omoya, Rie; Fujiwara, Mayo; Watanabe, Takafumi; Okumura, Masaki; Yamazaki, Hiroaki; Shintaku, Masayuki; Murata, Issei; Ozaki, Shigeru; Sasaki, Takeshi; Nakamura, Mitsuru; Suwa, Hiroshi; Sasano, Tetsuo; Kawara, Tokuhiro; Matsuura, Masato; Matsushima, Eisuke

    2017-11-01

    Electrocardiogram abnormalities have been reported during electroconvulsive therapy (ECT). A corrected QT interval (QTc) prolongation indicates delayed ventricular repolarization, which can trigger ventricular arrhythmias such as torsade de pointes (TdP). We examined the QTc changes during generalized tonic-clonic seizures induced by ECT, and the effects of atropine sulfate on these QTc changes. We analyzed heart rate, QT interval, and QTc in 32 patients with depression who underwent ECT (25 women, 67.4 ± 8.7 years of age). The QTc from -30 to 0 seconds prestimulation was used as baseline, which was compared with QTc at 20-30 seconds and 140-150 seconds poststimulus onset. QTc was significantly prolonged at 20-30 seconds poststimulus, then significantly decreased at 140-150 seconds poststimulus, compared with baseline. QTc prolongation induced by ECT was significantly decreased by atropine sulfate. These data suggest that the risk of TdP may be enhanced by ECT. Further, the risk of cardiac ventricular arrhythmias, including TdP, may be reduced by administration of atropine sulfate. © 2017 Wiley Periodicals, Inc.

  20. Pediatric optic neuritis: does a prolonged course of steroids reduce relapses? A preliminary study.

    PubMed

    Jayakody, Himali; Bonthius, Daniel J; Longmuir, Reid; Joshi, Charuta

    2014-11-01

    Optic neuritis is an important pediatric disorder causing visual impairment. Because of the absence of pediatric-specific studies, data extrapolated from the adult-based optic neuritis treatment trial are used to guide management of pediatric patients. Recent literature promotes a prolonged course of oral steroids to prevent relapses. However, there are no published data to support this view. Patients who were recently treated in our hospital received a longer course of steroids, relative to those treated several years ago. We hypothesized that a longer course of steroids results in fewer relapses and better final visual acuity. A retrospective analysis of 26 consecutive patients (age 4.5-19 years) treated for optic neuritis within the past 10 years was conducted. Patients received either a short course (2 weeks) or a prolonged course (more than 2 weeks) of steroids. Some patients were not treated. Mean follow-up was 70 weeks (3 weeks-10 years). Comparisons were made among the groups receiving 2 weeks of steroid treatment (16 of 26 patients) and greater than 2 weeks of steroid treatment (seven of 26 patients) to evaluate relapse rate, eventual visual acuity, and reported side effects. There were no significant differences in the relapse rates, reported side effects, and final visual acuity in the two treatment groups. In this cohort, a prolonged course of steroids was not associated with reduced relapse rate, increased side effects, or improved visual outcome. This cohort was small, but the results do not identify any reason to deviate from the common approach of optic neuritis treatment, which is 2 weeks of steroids. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Nanocantilevers with Adjustable Static Deflection and Significantly Tunable Spectrum Resonant Frequencies for Applications in Nanomechanical Mass Sensors

    PubMed Central

    Stachiv, Ivo; Sittner, Petr

    2018-01-01

    Nanocantilevers have become key components of nanomechanical sensors that exploit changes in their resonant frequencies or static deflection in response to the environment. It is necessary that they can operate at a given, but adjustable, resonant frequency and/or static deflection ranges. Here we propose a new class of nanocantilevers with a significantly tunable spectrum of the resonant frequencies and changeable static deflection utilizing the unique properties of a phase-transforming NiTi film sputtered on the usual nanotechnology cantilever materials. The reversible frequency tuning and the adjustable static deflection are obtained by intentionally changing the Young’s modulus and the interlayer stress of the NiTi film during its phase transformation, while the usual cantilever elastic materials guarantee a high frequency actuation (up to tens of MHz). By incorporating the NiTi phase transformation characteristic into the classical continuum mechanics theory we present theoretical models that account for the nanocantilever frequency shift and variation in static deflection caused by a phase transformation of NiTi film. Due to the practical importance in nanomechanical sensors, we carry out a complete theoretical analysis and evaluate the impact of NiTi film on the cantilever Young’s modulus, static deflection, and the resonant frequencies. Moreover, the importance of proposed NiTi nanocantilever is illustrated on the nanomechanical based mass sensors. Our findings will be of value in the development of advanced nanotechnology sensors with intentionally-changeable physical and mechanical properties. PMID:29462996

  2. Using temperature to reduce noise in quantum frequency conversion.

    PubMed

    Kuo, Paulina S; Pelc, Jason S; Langrock, Carsten; Fejer, M M

    2018-05-01

    Quantum frequency conversion is important in quantum networks to interface nodes operating at different wavelengths and to enable long-distance quantum communication using telecommunications wavelengths. Unfortunately, frequency conversion in actual devices is not a noise-free process. One main source of noise is spontaneous Raman scattering, which can be reduced by lowering the device operating temperature. We explore frequency conversion of 1554 nm photons to 837 nm using a 1813 nm pump in a periodically poled lithium niobate waveguide device. By reducing the temperature from 85°C to 40°C, we show a three-fold reduction in dark count rates, which is in good agreement with theory.

  3. Distinct effects of brief and prolonged adaptation on orientation tuning in primary visual cortex

    PubMed Central

    Patterson, Carlyn A.; Wissig, Stephanie C.; Kohn, Adam

    2013-01-01

    Recent stimulus history–adaptation–alters neuronal responses and perception. Previous electrophysiological and perceptual studies suggest that prolonged adaptation strengthens and makes more persistent the effects seen after briefer exposures. However, no systematic comparison has been made between the effects of adaptation lasting hundreds of milliseconds, which might arise during a single fixation, and the more prolonged adaptation typically used in imaging and perceptual studies. Here we determine how 0.4 s, 4 s, and 40 s of adaptation alters orientation tuning in primary visual cortex of anesthetized macaque monkeys, and how quickly responses recover after adapter offset. We measured responses to small (1.3 deg) and large (7.4 deg) gratings because previous work has shown that adaptation effects can depend on stimulus size. Adaptation with small gratings reduced responsivity and caused tuning to shift away from the adapter. These effects strengthened with more prolonged adaptation. For responses to large gratings, brief and prolonged adaptation produced indistinguishable effects on responsivity but caused opposite shifts in tuning preference. Recovery from adaptation was notably slower after prolonged adaptation, even when this did not induce stronger effects. We show that our results can be explained by an adaptation-induced weakening of surround suppression, the dynamics of this suppression, and differential effects of brief and prolonged adaptation across response epochs. Our findings show that effects do not simply scale with adaptation duration, and suggest that distinct strategies exist for adjusting to moment-to-moment fluctuations in input and to more persistent visual stimuli. PMID:23303933

  4. Safinamide reduces dyskinesias and prolongs L-DOPA antiparkinsonian effect in parkinsonian monkeys.

    PubMed

    Grégoire, Laurent; Jourdain, Vincent A; Townsend, Matthew; Roach, Arthur; Di Paolo, Thérèse

    2013-05-01

    Safinamide is a compound under investigation for use in the treatment of Parkinson's disease for combination with pharmacological therapy currently available. The objective of this study was to test the effects of safinamide in an animal model of l-DOPA-induced dyskinesias (LID), the MPTP lesioned dyskinetic macaque monkey, in comparison to and in combination with amantadine. LID and parkinsonian symptoms were measured in dyskinetic monkeys treated with l-DOPA with and without several dose levels of safinamide, amantadine, and the two in combination. Safinamide plasma levels were monitored during the experiments. Safinamide pre-treatment (3, 10, 20 and 30 mg/kg) dose-dependently reduced LID scores, in two acute and one semi-chronic experiment. Intensity and duration of LID were reduced and inversely correlated with safinamide blood levels. All doses of safinamide tested prolonged the duration of the beneficial antiparkinsonian effect of l-DOPA. Amantadine (5 and 20 mg/kg) reduced LID, but reduced duration of antiparkinsonian response to l-DOPA. When added to amantadine (5 mg/kg), safinamide showed no (3 mg/kg) or modest (20 mg/kg) additional beneficial effects on LID while the combined treatment prevented the reduction of the duration of the l-DOPA antiparkinsonian effect observed with amantadine only. Safinamide and amantadine reduced LID in this primate model while only safinamide increased the duration of the antiparkinsonian response of l-DOPA, suggesting that safinamide may have effects on LID that are pharmacologically distinct from amantadine, which is in current clinical use for control of LID. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Flake-shell capsules: adjustable inorganic structures.

    PubMed

    Ji, Qingmin; Guo, Chunyan; Yu, Xiaoyan; Ochs, Christopher J; Hill, Jonathan P; Caruso, Frank; Nakazawa, Hiromoto; Ariga, Katsuhiko

    2012-08-06

    Structure-adjustable capsules are fabricated from inorganic components by using a self-template dissolution-regrowth mechanism to give flake-shell silica microcapsules. The capsules shrink under thermal stimulus and their structures can be adjusted by treatment at different pH values. Tuning of shell pore diameters leads to tailored drug release over prolonged periods. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Prolonged hydrocephalus induced by intraventricular hemorrhage in rats is reduced by curcumin therapy.

    PubMed

    Qi, Zhihua; Zhang, Huiqin; Fu, Chuhua; Liu, Xiao; Chen, Bo; Dang, Yanwei; Chen, Huayun; Liu, Lijun

    2017-01-10

    Prolonged hydrocephalus is a major cause of severe disability and death of intraventricular hemorrhage (IVH) patients. However, the therapeutic options to minimize the detrimental effects of post-hemorrhagic hydrocephalus are limited. Curcumin has been reported to confer neuroprotective effects in numerous neurological diseases and injuries, but its role in IVH-induced hydrocephalus has not been determined. The aim of present study was to determine whether curcumin treatment ameliorates blood brain barrier (BBB) damage and reduces the incidence of post-hemorrhagic hydrocephalus in IVH rat model. Autologous blood intraventricular injection was used to establish the IVH model. Our results revealed that repeated intraperitoneal injection of curcumin ameliorated IVH-induced learning and memory deficits as determined by Morris water maze and reduced the incidence of post-hemorrhagic hydrocephalus in a dose-dependent manner at 28 d post-IVH induction. Further, the increased BBB permeability and brain edema induced by IVH were significantly reduced by curcumin administration. In summary, these findings highlighted the important role of curcumin in improving neurological function deficits and protecting against BBB disruption via promoting the neurovascular unit restoration, and thus it reduced the severity of post-hemorrhagic hydrocephalus in the long term. It is believed that curcumin might prove to be an effective therapeutic component in prevent the post-IVH hydrocephalus in the near future. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. System for adjusting frequency of electrical output pulses derived from an oscillator

    DOEpatents

    Bartholomew, David B.

    2006-11-14

    A system for setting and adjusting a frequency of electrical output pulses derived from an oscillator in a network is disclosed. The system comprises an accumulator module configured to receive pulses from an oscillator and to output an accumulated value. An adjustor module is configured to store an adjustor value used to correct local oscillator drift. A digital adder adds values from the accumulator module to values stored in the adjustor module and outputs their sums to the accumulator module, where they are stored. The digital adder also outputs an electrical pulse to a logic module. The logic module is in electrical communication with the adjustor module and the network. The logic module may change the value stored in the adjustor module to compensate for local oscillator drift or change the frequency of output pulses. The logic module may also keep time and calculate drift.

  8. [Maternal effects of prolonged expulsive efforts].

    PubMed

    Korb, D; Merazka, R; Théau, A; Goffinet, F; Le Ray, C

    2016-02-01

    Some studies found an association between duration of expulsive efforts (DEE) and risk of postpartum haemorrhage (PPH). But none demonstrated an association between DEE and severe perineal lacerations. Our aim was to evaluate the impact of prolonged expulsive efforts (EE) beyond 45min on the risk of maternal complication, especially risk of severe perineal laceration. We performed a retrospective study comparing 2 groups, 1: women with an instrumental vaginal delivery performed before 45min for non-fetal progression without FHR abnormalities (VBI for NP<45min) and 2: women with a DEE longer than 45min (DEE≥45min). We compared maternal issues (3rd and 4th degrees perineal lacerations and PPH), using uni- and multivariate analysis. We compared 85 women in group VBI for NP<45min with 124 women in group EE≥45min. In the group EE≥45min, 39% of women had an instrumental vaginal delivery versus 100% in the group VBI for NP<45min (P<0.001). The rate of severe perineal lacerations was significantly higher in the group VBI for NP<45min (8.2% versus 1.7%, P=0.027) and its risk remained significant after adjustment (adjusted OR=6.5 [1.1-40.1]). The rate of PPH was higher in the group EE≥45min (12.9% versus 3.5%, P=0.016), however this association was not significant after adjustment (adjusted OR=3.4 [0.9-12.4]). There was no difference about neonatal issues between the two studied groups. In comparison with a limitation of EE, to prolong EE beyond 45min allows a spontaneous vaginal delivery for more than half of women, if FHR is normal. Such strategy should also decrease the risk of severe perineal laceration. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Clinical impact of prolonged diagnosis to treatment interval (DTI) among patients with oropharyngeal squamous cell carcinoma.

    PubMed

    Sharma, Sonam; Bekelman, Justin; Lin, Alexander; Lukens, J Nicholas; Roman, Benjamin R; Mitra, Nandita; Swisher-McClure, Samuel

    2016-05-01

    We examined practice patterns using the National Cancer Data Base (NCDB) to determine risk factors for prolonged diagnosis to treatment interval (DTI) and survival outcomes in patients receiving chemoradiation for oropharyngeal squamous cell carcinoma (OPSCC). We identified 6606 NCDB patients with Stage III-IV OPSCC receiving chemoradiation from 2003 to 2006. We determined risk factors for prolonged DTI (>30days) using univariate and multivariable logistic regression models. We examined overall survival (OS) using Kaplan Meier and multivariable Cox proportional hazards models. 3586 (54.3%) patients had prolonged DTI. Race, IMRT, insurance status, and high volume facilities were significant risk factors for prolonged DTI. Patients with prolonged DTI had inferior OS compared to DTI⩽30days (Hazard Ratio (HR)=1.12, 95% CI 1.04-1.20, p=0.005). For every week increase in DTI there was a 2.2% (95% CI 1.1-3.3%, p<0.001) increase in risk of death. Patients receiving IMRT, treatment at academic, or high-volume facilities were more likely to experience prolonged DTI (High vs. Low volume: 61.5% vs. 51.8%, adjusted OR 1.38, 95% CI 1.21-1.58; Academic vs. Community: 59.5% vs. 50.6%, adjusted OR 1.26, 95% CI 1.13-1.42; non-IMRT vs. IMRT: 53.4% vs. 56.5%; adjusted OR 1.17, 95% CI 1.04-1.31). Our results suggest that prolonged DTI has a significant impact on survival outcomes. We observed disparities in DTI by socioeconomic factors. However, facility level factors such as academic affiliation, high volume, and IMRT also increased risk of DTI. These findings should be considered in developing efficient pathways to mitigate adverse effects of prolonged DTI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Low frequency noise fiber delay stabilized laser with reduced sensitivity to acceleration

    NASA Astrophysics Data System (ADS)

    Argence, B.; Clivati, C.; Dournaux, J.-L.; Holleville, D.; Faure, B.; Lemonde, P.; Santarelli, G.

    2017-11-01

    Lasers with sub-hertz line-width and fractional frequency instability around 1×10-15 for 0.1 s to 10 s averaging time are currently realized by locking onto an ultra-stable Fabry-Perot cavity using the Pound-Drever-Hall method. This powerful method requires tight alignment of free space optical components, precise polarization adjustment and spatial mode matching. To circumvent these issues, we use an all-fiber Michelson interferometer with a long fiber spool as a frequency reference and a heterodyne detection technique with a fibered acousto optical modulator (AOM)1. At low Fourier frequencies, the frequency noise of our system is mainly limited by mechanical vibrations, an issue that has already been explored in the field of optoelectronic oscillators.2,3,4

  11. An adjustable multi-scale single beam acoustic tweezers based on ultrahigh frequency ultrasonic transducer.

    PubMed

    Chen, Xiaoyang; Lam, Kwok Ho; Chen, Ruimin; Chen, Zeyu; Yu, Ping; Chen, Zhongping; Shung, K Kirk; Zhou, Qifa

    2017-11-01

    This paper reports the fabrication, characterization, and microparticle manipulation capability of an adjustable multi-scale single beam acoustic tweezers (SBAT) that is capable of flexibly changing the size of "tweezers" like ordinary metal tweezers with a single-element ultrahigh frequency (UHF) ultrasonic transducer. The measured resonant frequency of the developed transducer at 526 MHz is the highest frequency of piezoelectric single crystal based ultrasonic transducers ever reported. This focused UHF ultrasonic transducer exhibits a wide bandwidth (95.5% at -10 dB) due to high attenuation of high-frequency ultrasound wave, which allows the SBAT effectively excite with a wide range of excitation frequency from 150 to 400 MHz by using the "piezoelectric actuator" model. Through controlling the excitation frequency, the wavelength of ultrasound emitted from the SBAT can be changed to selectively manipulate a single microparticle of different sizes (3-100 μm) by using only one transducer. This concept of flexibly changing "tweezers" size is firstly introduced into the study of SBAT. At the same time, it was found that this incident ultrasound wavelength play an important role in lateral trapping and manipulation for microparticle of different sizes. Biotechnol. Bioeng. 2017;114: 2637-2647. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  12. Cellular-foam polypropylene ferroelectrets with increased film thickness and reduced resonance frequency

    NASA Astrophysics Data System (ADS)

    Sborikas, Martynas; Wegener, Michael

    2013-12-01

    Ferroelectrets are piezoelectric materials suitable for acoustic applications such as airborne ultrasonic transducers. Typical ferroelectrets exhibit resonance frequencies in the high kHz to low MHz range. In order to decrease the transducer resonance frequencies to the low kHz range, processes such as gas-diffusion expansion and electric charging were adjusted to cellular films which are initially twice as thick as in earlier studies. The demonstrated film expansion and electric charging lead to mechanically soft cellular structures which show high piezoelectric activities with coefficients up to 130 pC/N. Due to the simultaneously increased film thicknesses, the resonance frequencies are lowered down to about 233 kHz.

  13. Prolonged fermentation of whole wheat sourdough reduces phytate level and increases soluble magnesium.

    PubMed

    Lopez, H W; Krespine, V; Guy, C; Messager, A; Demigne, C; Remesy, C

    2001-05-01

    This work was designed to compare the effects of different leavens (yeast, sourdough, and a mixture of both) on phytic acid (PA) degradation and to assess the repercussions of PA breakdown on phosphorus and magnesium solubility during bread-making. Sourdough fermentation was more efficient than yeast fermentation in reducing the phytate content in whole wheat bread (-62 and -38%, respectively). Furthermore, lactic acid bacteria present in sourdough enhanced acidification, leading to increased magnesium and phosphorus solubility. To intensify phytate breakdown, bran was incubated with microorganisms (yeast or sourdough) before bread-making. Using this new method, the percentage of phytate breakdown was near 90%, whereas 40% of phytate remained in traditional French bread. In conclusion, a prolonged fermentation with sourdough still leads to improved Mg and P solubility by decreasing phytate content and through acidification.

  14. Reduced transpiration response to precipitation pulses precedes mortality in a piñon-juniper woodland subject to prolonged drought.

    PubMed

    Plaut, Jennifer A; Wadsworth, W Duncan; Pangle, Robert; Yepez, Enrico A; McDowell, Nate G; Pockman, William T

    2013-10-01

    Global climate change is predicted to alter the intensity and duration of droughts, but the effects of changing precipitation patterns on vegetation mortality are difficult to predict. Our objective was to determine whether prolonged drought or above-average precipitation altered the capacity to respond to the individual precipitation pulses that drive productivity and survival. We analyzed 5 yr of data from a rainfall manipulation experiment in piñon-juniper (Pinus edulis-Juniperus monosperma) woodland using mixed effects models of transpiration response to event size, antecedent soil moisture, and post-event vapor pressure deficit. Replicated treatments included irrigation, drought, ambient control and infrastructure control. Mortality was highest under drought, and the reduced post-pulse transpiration in the droughted trees that died was attributable to treatment effects beyond drier antecedent conditions and reduced event size. In particular, trees that died were nearly unresponsive to antecedent shallow soil moisture, suggesting reduced shallow absorbing root area. Irrigated trees showed an enhanced response to precipitation pulses. Prolonged drought initiates a downward spiral whereby trees are increasingly unable to utilize pulsed soil moisture. Thus, the additive effects of future, more frequent droughts may increase drought-related mortality. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

  15. Severe multiple sclerosis reactivation during prolonged lymphopenia after dimethyl fumarate discontinuation.

    PubMed

    Zecca, C; Antozzi, C G; Torri Clerici, V; Ferrazzini, M; Mantegazza, R E; Rossi, S; Gobbi, C

    2018-06-01

    Delayed-release dimethyl fumarate (DMF) treatment can be associated with reduced lymphocyte and leucocyte counts, which might persist after DMF discontinuation. We report the case of a patient with severe disease reactivation despite prolonged lymphopenia after DMF discontinuation. We describe the frequency and impact of prolonged lymphopenia after DMF discontinuation at two tertiary MS centres. A 36-year-old female patient with multiple sclerosis was switched to DMF after 14 years of treatment with interferon beta-1a. DMF was suspended after 4 months because of persistent lymphopenia for 3 months. Six months later, the patient had a severe relapse with multiple enhancing brain lesions at MRI although lymphopenia was still persistent. Haematological assessment excluded other causes of lymphopenia, which was evaluated as a probable iatrogenic complication of DMF. The patient was treated with i.v. methylprednisolone 1 gr daily for 3 days with clinical recovery. Prolonged lymphopenia after DMT discontinuation does not protect against disease reactivation. Starting a new immune therapy should be balanced against the option of a "wait and see." A different immunotherapeutic strategy such as an anti-B therapeutic approach could be considered. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Design and kinetic analysis of piezoelectric energy harvesters with self-adjusting resonant frequency

    NASA Astrophysics Data System (ADS)

    Yu-Jen, Wang; Tsung-Yi, Chuang; Jui-Hsin, Yu

    2017-09-01

    Vibration-based energy harvesters have been developed as power sources for wireless sensor networks. Because the vibration frequency of the environment is varied with surrounding conditions, how to design an adaptive energy harvester is a practical topic. This paper proposes a design for a piezoelectric energy harvester possessing the ability to self-adjust its resonant frequency in rotational environments. The effective length of a trapezoidal cantilever is extended by centrifugal force from a rotating wheel to vary its area moment of inertia. The analytical solution for the natural frequency of the piezoelectric energy harvester was derived from the parameter design process, which could specify a structure approaching resonance at any wheel rotating frequency. The kinetic equation and electrical damping induced by power generation were derived from a Lagrange method and a mechanical-electrical coupling model, respectively. An energy harvester with adequate parameters can generate power at a wide range of car speeds. The output power of an experimental prototype composed of piezoelectric thin films and connected to a 3.3 MΩ external resistor was approximately 70-140 μW at wheel speeds ranging from 200 to 700 RPM. These results demonstrate that the proposed piezoelectric energy harvester can be applied as a power source for the wireless tire pressure monitoring sensor.

  17. Pathological prolongation of action potential duration as a cause of the reduced alpha-adrenoceptor-mediated negative inotropy in streptozotocin-induced diabetic mice myocardium.

    PubMed

    Kanae, Haruna; Hamaguchi, Shogo; Wakasugi, Yumi; Kusakabe, Taichi; Kato, Keisuke; Namekata, Iyuki; Tanaka, Hikaru

    2017-11-01

    Effect of pathological prolongation of action potential duration on the α-adrenoceptor-mediated negative inotropy was studied in streptozotocin-induced diabetic mice myocardium. In streptozotocin-treated mouse ventricular myocardium, which had longer duration of action potential than that in control mice, the negative inotropic response induced by phenylephrine was smaller than that in control mice. 4-Aminopyridine prolonged the action potential duration and decreased the negative inotropy in control mice. Cromakalim shortened the action potential duration and increased the negative inotropy in streptozotocin-treated mice. These results suggest that the reduced α-adrenoceptor-mediated inotropy in the diabetic mouse myocardium is partly due to its prolonged action potential. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  18. Double-spin-echo diffusion weighting with a modified eddy current adjustment.

    PubMed

    Finsterbusch, Jürgen

    2010-04-01

    Magnetic field inhomogeneities like eddy current-related gradient fields cause geometric distortions in echo-planar imaging (EPI). This in particular affects diffusion-weighted imaging where these distortions vary with the direction of the diffusion weighting and hamper the accurate determination of diffusion parameters. The double-spin-echo preparation often used aims to reduce the cumulative eddy current effect by adjusting the diffusion-weighting gradient pulse durations to the time constant of the dominant eddy current contribution. However, eddy currents with a variety of time constants may be present and cause residual distortions. Here, a modification is proposed where the two bipolar gradient pairs of the preparation are adjusted independently to different time constants. At the expense of a slightly prolonged echo time, residual geometric distortions and correspondingly increased values of the diffusion anisotropy can be reduced as is demonstrated in phantoms and the human brain. Thus, it may help to improve the reliability of diffusion-weighted EPI. Copyright 2010 Elsevier Inc. All rights reserved.

  19. Risk-adjusted models for adverse obstetric outcomes and variation in risk-adjusted outcomes across hospitals.

    PubMed

    Bailit, Jennifer L; Grobman, William A; Rice, Madeline Murguia; Spong, Catherine Y; Wapner, Ronald J; Varner, Michael W; Thorp, John M; Leveno, Kenneth J; Caritis, Steve N; Shubert, Phillip J; Tita, Alan T; Saade, George; Sorokin, Yoram; Rouse, Dwight J; Blackwell, Sean C; Tolosa, Jorge E; Van Dorsten, J Peter

    2013-11-01

    Regulatory bodies and insurers evaluate hospital quality using obstetrical outcomes, however meaningful comparisons should take preexisting patient characteristics into account. Furthermore, if risk-adjusted outcomes are consistent within a hospital, fewer measures and resources would be needed to assess obstetrical quality. Our objective was to establish risk-adjusted models for 5 obstetric outcomes and assess hospital performance across these outcomes. We studied a cohort of 115,502 women and their neonates born in 25 hospitals in the United States from March 2008 through February 2011. Hospitals were ranked according to their unadjusted and risk-adjusted frequency of venous thromboembolism, postpartum hemorrhage, peripartum infection, severe perineal laceration, and a composite neonatal adverse outcome. Correlations between hospital risk-adjusted outcome frequencies were assessed. Venous thromboembolism occurred too infrequently (0.03%; 95% confidence interval [CI], 0.02-0.04%) for meaningful assessment. Other outcomes occurred frequently enough for assessment (postpartum hemorrhage, 2.29%; 95% CI, 2.20-2.38, peripartum infection, 5.06%; 95% CI, 4.93-5.19, severe perineal laceration at spontaneous vaginal delivery, 2.16%; 95% CI, 2.06-2.27, neonatal composite, 2.73%; 95% CI, 2.63-2.84). Although there was high concordance between unadjusted and adjusted hospital rankings, several individual hospitals had an adjusted rank that was substantially different (as much as 12 rank tiers) than their unadjusted rank. None of the correlations between hospital-adjusted outcome frequencies was significant. For example, the hospital with the lowest adjusted frequency of peripartum infection had the highest adjusted frequency of severe perineal laceration. Evaluations based on a single risk-adjusted outcome cannot be generalized to overall hospital obstetric performance. Copyright © 2013 Mosby, Inc. All rights reserved.

  20. Dual-frequency transducer with a wideband PVDF receiver for contrast-enhanced, adjustable harmonic imaging

    NASA Astrophysics Data System (ADS)

    Kim, Jinwook; Lindsey, Brooks D.; Li, Sibo; Dayton, Paul A.; Jiang, Xiaoning

    2017-04-01

    Acoustic angiography is a contrast-enhanced, superharmonic microvascular imaging method. It has shown the capability of high-resolution and high-contrast-to-tissue-ratio (CTR) imaging for vascular structure near tumor. Dual-frequency ultrasound transducers and arrays are usually used for this new imaging technique. Stacked-type dual-frequency transducers have been developed for this vascular imaging method by exciting injected microbubble contrast agent (MCA) in the vessels with low-frequency (1-5 MHz), moderate power ultrasound burst waves and receiving the superharmonic responses from MCA by a high-frequency receiver (>10 MHz). The main challenge of the conventional dual-frequency transducers is a limited penetration depth (<25 mm) due to the insufficient receiving sensitivity for highfrequency harmonic signal detection. A receiver with a high receiving sensitivity spanning a wide superharmonic frequency range (3rd to 6th) enables selectable bubble harmonic detection considering the required penetration depth. Here, we develop a new dual-frequency transducer composed of a 2 MHz 1-3 composite transmitter and a polyvinylidene fluoride (PVDF) receiver with a receiving frequency range of 4-12 MHz for adjustable harmonic imaging. The developed transducer was tested for harmonic responses from a microbubble-injected vessel-mimicking tube positioned 45 mm away. Despite the long imaging distance (45 mm), the prototype transducer detected clear harmonic response with the contrast-to-noise ratio of 6-20 dB and the -6 dB axial resolution of 200-350 μm for imaging a 200 um-diameter cellulose tube filled with microbubbles.

  1. Clinical outcome of Guillain-Barré syndrome after prolonged mechanical ventilation.

    PubMed

    van den Berg, Bianca; Storm, Eline F; Garssen, Marcel J P; Blomkwist-Markens, Patricia H; Jacobs, Bart C

    2018-04-07

    Patients with Guillain-Barré syndrome (GBS) may suffer from respiratory failure for months or longer. The aim of this study was to determine the frequency, clinical course and outcome of patients with GBS requiring prolonged mechanical ventilation (MV). Prospectively collected data from 526 patients with GBS participating in previous trials were analysed to determine the frequency and duration of prolonged MV (longer than 2 months). In addition, a cross-sectional study was conducted in patients with GBS requiring MV to determine the clinical course and long-term outcome with the ability to walk unaided as primary endpoint. In the cohort study, 145 of 526 patients with GBS (28%) required MV, including 33 (6%) patients with prolonged MV. Patients requiring prolonged MV had a lower Medical Research Council sum score and more frequent bulbar involvement and inexcitable nerves compared with shorter ventilated patients. At 6 months, 18% of patients with prolonged MV were able to walk unaided compared with 76% of patients requiring shorter MV (P<0.001). In the cross-sectional study, 63 patients requiring MV were included with a median follow-up of 11 years (range 2-44 years). Twenty-six (41%) of these patients needed prolonged MV (median 93 days, range 62-261). Fifteen (58%) of these patients were able to walk unaided at maximum follow-up and eight (31%) reached this endpoint more than 1 year after diagnosis. Prolonged ventilation in GBS is associated with poor prognosis, yet patients requiring prolonged ventilation may show slow but persistent recovery for years and even reach the ability to walk and live independently. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Length of Stay, Conditional Length of Stay, and Prolonged Stay in Pediatric Asthma

    PubMed Central

    Silber, Jeffrey H; Rosenbaum, Paul R; Even-Shoshan, Orit; Shabbout, Mayadah; Zhang, Xuemei; Bradlow, Eric T; Marsh, Roger R

    2003-01-01

    Objective To understand differences in length of stay for asthma patients between New York State and Pennsylvania across children's and general hospitals in order to better guide policy. Data Sources/Study Setting All pediatric admissions for asthma in the states of Pennsylvania and New York using claims data obtained from each state for the years 1996–1998, n=38,310. Study Design A retrospective cohort design to model length of stay (LOS), the probability of prolonged stay, conditional length of stay (CLOS or the LOS after stay is prolonged), and the probability of readmission, controlling for patient factors, state, location and hospital type. Analytic Methods Logit models were used to estimate the probability of prolonged stay and readmission. The LOS and the CLOS were estimated with Cox regression. Model variables included comorbidities, income, race, distance from hospital, and insurance type. Prolonged stay was based on a Hollander-Proschan “New-Worse-Than-Used” test, corresponding to a three-day stay. Principal Findings The LOS was longer in New York than Pennsylvania, and the probabilities of prolonged stay and readmission were much higher in New York than Pennsylvania. However, once an admission was prolonged, there were no differences in CLOS between states (when readmissions were not added to the LOS calculation). In both states, children's hospitals and general hospitals had similar adjusted LOS. Conclusions Management of asthma appears more efficient in Pennsylvania than New York: Less severe patients are discharged faster in Pennsylvania than New York; once discharged, patients are less likely to be readmitted in Pennsylvania than New York. However, once a stay is prolonged, there is little difference between New York and Pennsylvania, suggesting medical care for severely ill patients is similar across states. Differences between children's and general hospitals were small as compared to differences between states. We conclude that policy

  3. Low numeracy predicts reduced accuracy of retrospective reports of frequency of sexual behavior.

    PubMed

    McAuliffe, Timothy L; DiFranceisco, Wayne; Reed, Barbara R

    2010-12-01

    Assessment of the frequency of sexual behavior relies on participants' ability to arithmetically aggregate information over time and across partners. This study examines the effect of numeracy (arithmetic skills) on the accuracy of retrospective reports of sexual behavior. For 91 days, the participants completed daily reports about their sexual activity. Participants then completed a survey on sexual behavior over the same period. The discrepancies between the survey-based and the diary-based measures of frequency of vaginal and anal intercourse were evaluated. Multiple regression analysis showed that the discrepancy between retrospective and diary measurements of sexual intercourse increased with lower numeracy (P = 0.026), lower education (P = 0.001), aggregate question format compared to partner-by-partner format (P = 0.031) and higher frequency of intercourse occasions (P < 0.001). Lower numeracy led to a 1.5-fold increase (adjusted mean = 14.1-20.9) in the discrepancy for those using the aggregate question format and a 2.0-fold increase (adjusted mean = 3.7-7.6) for those using the partner-by-partner format.

  4. The Relationship between Frequency of Family Dinner and Adolescent Problem Behaviors after Adjusting for Other Family Characteristics

    ERIC Educational Resources Information Center

    Sen, Bisakha

    2010-01-01

    Objective: To examine the association between frequency of family dinners (FFD) and selected problem behaviors for adolescents after adjusting for family connectedness, parental awareness, other family activities, and other potentially confounding factors. Methods: Data are drawn from the National Longitudinal Survey of Youth, 1997. The primary…

  5. Does prolonged anti-inflammatory therapy reduce number of unnecessary repeat saturation prostate biopsy?

    PubMed

    Candiano, Giuseppe; Pepe, Pietro; Pietropaolo, Francesco; Aragona, Francesco

    2013-06-24

    The effect of a prolonged oral anti-inflammatory therapy on PSA values in patients with persistent abnormal PSA values after negative prostate biopsy (PBx) was evaluated. From September 2011 to September 2012, 70 patients (medi- an age 62 years), with persistent abnormal PSA values after negative extended PBx, were given an herbal extract with anti-inflammatory activity for 3 months (Lenidase®; 1 tablet daily constituted of baicalina, bromelina and escina). All patients were submitted to prostate biopsy for: abnormal DRE; PSA > 10 ng/mL, PSA values between 4.1-10 or 2.6-4 ng/mL with free/total PSA < 25% and < 20%, respectively. Three months after the end of anti-inflammato- ry therapy all patients were revaluated; indication for repeat saturation biopsy (SPBx) and detection rate for PCa were compared with those previously recorded in our Department using the same inclusions criteria for biopsy. Oral administration of Lenidase® was well tolerated and no side effects were observed; PSA values decreased in 54 (77.8%) out 70 patients with a median PSA reduction of 20.5% (from 8.8 to 7 ng/mL) and remained unchanged in 16 patients (22.2%); the repeat SPBx rate resulted significantly lower (22.8% vs 35.5%; p < 0.05) showing a superimposable detection rate for PCa (3 cases) in comparison with our previous data (18.7% vs 22%). In our preliminary data a prolonged oral anti-inflammatory therapy reduced PSA levels in patients with negative PBx and persistent suspicious for PCa decreasing the indication to perform repeat SPBx (about 30% of the cases).

  6. Systematic review: height-adjustable workstations to reduce sedentary behaviour in office-based workers.

    PubMed

    Tew, G A; Posso, M C; Arundel, C E; McDaid, C M

    2015-07-01

    Time spent sitting in the workplace is an important contributor to overall sedentary risk. Installation of height-adjustable workstations has been proposed as a feasible approach for reducing occupational sitting time in office workers. To provide an accurate overview of the controlled trials that have evaluated the effects of height-adjustable workstation interventions on workplace sitting time in office-based workers. A comprehensive search was conducted up until March 2014 in the following databases: Medline, PsychINFO, CENTRAL, EMBASE and PEDro. To identify unpublished studies and grey literature, the reference lists of relevant official or scientific web pages were also checked. Studies assessing the effectiveness of height-adjustable workstations using a randomized or non-randomized controlled design were included. The initial search yielded a total of 8497 citations. After a thorough selection process, five studies were included with 172 participants. A formal quality assessment indicated that risk of bias was high in all studies and heterogeneity in interventions and outcomes prevented meta-analysis. Nevertheless, all studies reported that height-adjustable workstation interventions reduced occupational sitting time in office workers. There was insufficient evidence to determine effects on other relevant health outcomes (e.g. body composition, musculoskeletal symptoms, mental health). There is insufficient evidence to make firm conclusions regarding the effects of installing height-adjustable workstations on sedentary behaviour and associated health outcomes in office workers. Larger and longer term controlled studies are needed, which include more representative populations. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. A microfluidic device for studying cell signaling with multiple inputs and adjustable amplitudes and frequencies

    NASA Astrophysics Data System (ADS)

    Ningsih, Zubaidah; Chon, James W. M.; Clayton, Andrew H. A.

    2013-12-01

    Cell function is largely controlled by an intricate web of macromolecular interactions called signaling networks. It is known that the type and the intensity (concentration) of stimulus affect cell behavior. However, the temporal aspect of the stimulus is not yet fully understood. Moreover, the process of distinguishing between two stimuli by a cell is still not clear. A microfluidic device enables the delivery of a precise and exact stimulus to the cell due to the laminar flow established inside its micro-channel. The slow stream delivers a constant stimulus which is adjustable according to the experiment set up. Moreover, with controllable inputs, microfluidic facilitates the stimuli delivery according to a certain pattern with adjustable amplitude, frequency and phase. Several designs of PDMS microfluidic device has been produced in this project via photolithography and soft lithography processes. To characterize the microfluidic performance, two experiments has been conducted. First, by comparing the fluorescence intensity and the lifetime of fluorescein in the present of KI, mixing extent between two inputs was observed using Frequency Lifetime Imaging Microscopy (FLIM). Furthermore, the input-output relationship of fluorescein concentration delivered was also drawn to characterize the amplitude, frequency and phase of the inputs. Second experiment involved the cell culturing inside microfluidic. Using NG108-15 cells, proliferation and differentiation were observed based on the cell number and cell physiological changes. Our results demonstrate that hurdle design gives 86% mixing of fluorescein and buffer. Relationship between inputoutput fluorescein concentrations delivered has also been demonstrated and cells were successfully cultured inside the microfluidic.

  8. Rifaximin treatment is associated with reduced risk of cirrhotic complications and prolonged overall survival in patients experiencing hepatic encephalopathy.

    PubMed

    Kang, S H; Lee, Y B; Lee, J-H; Nam, J Y; Chang, Y; Cho, H; Yoo, J-J; Cho, Y Y; Cho, E J; Yu, S J; Kim, M Y; Kim, Y J; Baik, S K; Yoon, J-H

    2017-11-01

    Rifaximin might decrease the risk of portal hypertension-related complications by controlling small intestinal bacterial overgrowth. To evaluate whether rifaximin was associated with the risk of death and cirrhotic complications. We conducted a retrospective study that included 1042 patients experiencing hepatic encephalopathy (HE): 421 patients without hepatocellular carcinoma (HCC; the non-HCC cohort) and 621 patients with HCC (the HCC cohort). The primary endpoint was overall survival and secondary endpoints were recurrence of HE and the development of spontaneous bacterial peritonitis (SBP), hepatorenal syndrome (HRS) and variceal bleeding. In the non-HCC cohort, 145 patients received rifaximin plus lactulose (the rifaximin group) and 276 patients received lactulose alone (the control group). The multivariate analysis revealed that rifaximin was significantly associated with lower risk of death (adjusted hazard ratio [aHR], 0.697; P = .024) and reduced the risk of recurrent HE (aHR, 0.452; P < .001), SBP (aHR, 0.210; P < .001) and variceal bleeding (aHR, 0.425; P = .011) but not HRS (aHR, 0.598; P = .08). In the HCC cohort, 173 patients received rifaximin plus lactulose and 448 patients received lactulose. Rifaximin was not associated with the risk of death (aHR, 1.177; P = .121). Rifaximin was associated with lower risk of SBP (aHR, 0.323; P < .001) but not with variceal bleeding (aHR, 0.660; P = .104) or recurrent HE (aHR, 0.689; P = .057). The risk of Clostridium difficile-associated diarrhoea was not different between the groups (aHR, 0.028; P = .338). In patients without HCC, rifaximin treatment was significantly associated with prolonged overall survival and reduced risks of spontaneous bacterial peritonitis, variceal bleeding and recurrent hepatic encephalopathy. © 2017 John Wiley & Sons Ltd.

  9. A population health approach to reducing observational intensity bias in health risk adjustment: cross sectional analysis of insurance claims

    PubMed Central

    Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J

    2014-01-01

    Objective To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Setting Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n=5 153 877). Main outcome measures The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services—Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare’s administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Results Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for

  10. A population health approach to reducing observational intensity bias in health risk adjustment: cross sectional analysis of insurance claims.

    PubMed

    Wennberg, David E; Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J; Wennberg, John E

    2014-04-10

    To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Cross sectional analysis. 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n = 5,153,877). The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services--Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare's administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for the standard HCC index, 0.21 for the population health index, 0.12 for the

  11. Effectiveness of an acoustical product in reducing high-frequency sound within unoccupied incubators.

    PubMed

    Kellam, Barbara; Bhatia, Jatinder

    2009-08-01

    Few noise measurement studies in the neonatal intensive care unit have reported sound frequencies within incubators. Sound frequencies within incubators are markedly different from sound frequencies within the gravid uterus. This article reports the results of sound spectral analysis (SSA) within unoccupied incubators under control and treatment conditions. SSA indicated that acoustical foam panels (treatment condition) markedly reduced sound frequencies > or =500 Hz when compared with the control condition. The main findings of this study (a) illustrate the need to monitor high-frequency sound within incubators and (b) indicate one method to reduce atypical sound exposure within incubators.

  12. Wavelength adjustability of frequency conversion light of Yb-doped fiber laser based on FBGs

    NASA Astrophysics Data System (ADS)

    Dobashi, Kazuma; Tomihari, Yasuhiro; Imai, Koichi; Hirohashi, Junji; Makio, Satoshi

    2018-02-01

    We focused on wavelength conversion of simple and compact CW Yb-Doped fiber laser based on FBGs with wavelength adjustable function. By controlling temperatures of FBGs in fiber laser, it was possible to tune oscillated wavelength from 1064.101 nm to 1064.414 nm with more than 20 W in CW operation mode. Based on this fundamental light, frequency converted light (SHG and THG) were generated by utilizing two PP:Mg-SLT devises. We obtained more than 3 W of SHG light with tuning range of 150 pm and more than 35 mW of THG with tuning range of 100 pm. By selecting FBG grating and QPM grating properly, we can realize adjustable wavelength laser with the same scheme from 1040 nm to 1090 nm and their SHG/THG. With this combination of FBG based fiber laser and QPM devices, it is possible to tune the wavelength just by temperature tuning without any changes of beam shape and beam pointing.

  13. Reducing Sweeping Frequencies in Microwave NDT Employing Machine Learning Feature Selection

    PubMed Central

    Moomen, Abdelniser; Ali, Abdulbaset; Ramahi, Omar M.

    2016-01-01

    Nondestructive Testing (NDT) assessment of materials’ health condition is useful for classifying healthy from unhealthy structures or detecting flaws in metallic or dielectric structures. Performing structural health testing for coated/uncoated metallic or dielectric materials with the same testing equipment requires a testing method that can work on metallics and dielectrics such as microwave testing. Reducing complexity and expenses associated with current diagnostic practices of microwave NDT of structural health requires an effective and intelligent approach based on feature selection and classification techniques of machine learning. Current microwave NDT methods in general based on measuring variation in the S-matrix over the entire operating frequency ranges of the sensors. For instance, assessing the health of metallic structures using a microwave sensor depends on the reflection or/and transmission coefficient measurements as a function of the sweeping frequencies of the operating band. The aim of this work is reducing sweeping frequencies using machine learning feature selection techniques. By treating sweeping frequencies as features, the number of top important features can be identified, then only the most influential features (frequencies) are considered when building the microwave NDT equipment. The proposed method of reducing sweeping frequencies was validated experimentally using a waveguide sensor and a metallic plate with different cracks. Among the investigated feature selection techniques are information gain, gain ratio, relief, chi-squared. The effectiveness of the selected features were validated through performance evaluations of various classification models; namely, Nearest Neighbor, Neural Networks, Random Forest, and Support Vector Machine. Results showed good crack classification accuracy rates after employing feature selection algorithms. PMID:27104533

  14. Nonlinear predictive control for adaptive adjustments of deep brain stimulation parameters in basal ganglia-thalamic network.

    PubMed

    Su, Fei; Wang, Jiang; Niu, Shuangxia; Li, Huiyan; Deng, Bin; Liu, Chen; Wei, Xile

    2018-02-01

    The efficacy of deep brain stimulation (DBS) for Parkinson's disease (PD) depends in part on the post-operative programming of stimulation parameters. Closed-loop stimulation is one method to realize the frequent adjustment of stimulation parameters. This paper introduced the nonlinear predictive control method into the online adjustment of DBS amplitude and frequency. This approach was tested in a computational model of basal ganglia-thalamic network. The autoregressive Volterra model was used to identify the process model based on physiological data. Simulation results illustrated the efficiency of closed-loop stimulation methods (amplitude adjustment and frequency adjustment) in improving the relay reliability of thalamic neurons compared with the PD state. Besides, compared with the 130Hz constant DBS the closed-loop stimulation methods can significantly reduce the energy consumption. Through the analysis of inter-spike-intervals (ISIs) distribution of basal ganglia neurons, the evoked network activity by the closed-loop frequency adjustment stimulation was closer to the normal state. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Stand by Me: Qualitative Insights into the Ease of Use of Adjustable Workstations

    PubMed Central

    Leavy, Justine; Jancey, Jonine

    2016-01-01

    Background Office workers sit for more than 80% of the work day making them an important target for work site health promotion interventions to break up prolonged sitting time. Adjustable workstations are one strategy used to reduce prolonged sitting time. This study provides both an employees' and employers' perspective into the advantages, disadvantages, practicality and convenience of adjustable workstations and how movement in the office can be further supported by organisations. Methods This qualitative study was part of the Uprising pilot study. Employees were from the intervention arm of a two group (intervention n = 18 and control n = 18) study. Employers were the immediate line-manager of the employee. Data were collected via employee focus groups (n = 17) and employer individual interviews (n = 12). The majority of participants were female (n = 18), had healthy weight, and had a post-graduate qualification. All focus group discussions and interviews were recorded, transcribed verbatim and the data coded according to the content. Qualitative content analysis was conducted. Results Employee data identified four concepts: enhanced general wellbeing; workability and practicality; disadvantages of the retro-fit; and triggers to stand. Most employees (n = 12) reported enhanced general well-being, workability and practicality included less email exchange and positive interaction (n = 5), while the instability of the keyboard a commonly cited disadvantage. Triggers to stand included time and task based prompts. Employer data concepts included: general health and wellbeing; work engagement; flexibility; employee morale; and injury prevention. Over half of the employers (n = 7) emphasised back care and occupational health considerations as important, as well as increased level of staff engagement and strategies to break up prolonged periods of sitting. Discussion The focus groups highlight the perceived general health benefits from this short intervention

  16. Stand by Me: Qualitative Insights into the Ease of Use of Adjustable Workstations.

    PubMed

    Leavy, Justine; Jancey, Jonine

    2016-01-01

    Office workers sit for more than 80% of the work day making them an important target for work site health promotion interventions to break up prolonged sitting time. Adjustable workstations are one strategy used to reduce prolonged sitting time. This study provides both an employees' and employers' perspective into the advantages, disadvantages, practicality and convenience of adjustable workstations and how movement in the office can be further supported by organisations. This qualitative study was part of the Uprising pilot study. Employees were from the intervention arm of a two group (intervention n = 18 and control n = 18) study. Employers were the immediate line-manager of the employee. Data were collected via employee focus groups (n = 17) and employer individual interviews (n = 12). The majority of participants were female (n = 18), had healthy weight, and had a post-graduate qualification. All focus group discussions and interviews were recorded, transcribed verbatim and the data coded according to the content. Qualitative content analysis was conducted. Employee data identified four concepts: enhanced general wellbeing; workability and practicality; disadvantages of the retro-fit; and triggers to stand. Most employees (n = 12) reported enhanced general well-being, workability and practicality included less email exchange and positive interaction (n = 5), while the instability of the keyboard a commonly cited disadvantage. Triggers to stand included time and task based prompts. Employer data concepts included: general health and wellbeing; work engagement; flexibility; employee morale; and injury prevention. Over half of the employers (n = 7) emphasised back care and occupational health considerations as important, as well as increased level of staff engagement and strategies to break up prolonged periods of sitting. The focus groups highlight the perceived general health benefits from this short intervention, including opportunity to sit less and interact

  17. Temporary persistence of conduction block after prolonged kilohertz frequency alternating current on rat sciatic nerve

    NASA Astrophysics Data System (ADS)

    Bhadra, Narendra; Foldes, Emily; Vrabec, Tina; Kilgore, Kevin; Bhadra, Niloy

    2018-02-01

    Objective. Application of kilohertz frequency alternating current (KHFAC) waveforms can result in nerve conduction block that is induced in less than a second. Conduction recovers within seconds when KHFAC is applied for about 5-10 min. This study investigated the effect of repeated and prolonged application of KHFAC on rat sciatic nerve with bipolar platinum electrodes. Approach. Varying durations of KHFAC at signal amplitudes for conduction block with intervals of no stimulus were studied. Nerve conduction was monitored by recording peak Gastrocnemius muscle force utilizing stimulation electrodes proximal (PS) and distal (DS) to a blocking electrode. The PS signal traveled through the block zone on the nerve, while the DS went directly to the motor end-plate junction. The PS/DS force ratio provided a measure of conduction patency of the nerve in the block zone. Main results. Conduction recovery times were found to be significantly affected by the cumulative duration of KHFAC application. Peak stimulated muscle force returned to pre-block levels immediately after cessation of KHFAC delivery when it was applied for less than about 15 min. They fell significantly but recovered to near pre-block levels for cumulative stimulus of 50  ±  20 min, for the tested On/Off times and frequencies. Conduction recovered in two phases, an initial fast one (60-80% recovery), followed by a slower phase. No permanent conduction block was seen at the end of the observation period during any experiment. Significance. This carry-over block effect may be exploited to provide continuous conduction block in peripheral nerves without continuous application of KHFAC.

  18. Reduced turning frequency and delayed poultry manure addition reduces N loss from sugarcane compost.

    PubMed

    Bryndum, S; Muschler, R; Nigussie, A; Magid, J; de Neergaard, A

    2017-07-01

    Composting is an effective method to recycle biodegradable waste as soil amendment in smallholder farming systems. Although all essential plant nutrients are found in compost, a substantial amount of nitrogen is lost during composting. This study therefore investigated the potential of reducing N losses by (i) delaying the addition of nitrogen-rich substrates (i.e. poultry manure), and (ii) reducing the turning frequency during composting. Furthermore, we tested the effect of compost application method on nitrogen mineralization. Sugarcane-waste was composted for 54days with addition of poultry manure at the beginning (i.e. early addition) or after 21days of composting (delayed addition). The compost pile was then turned either every three or nine days. Composts were subsequently applied to soil as (i) homogeneously mixed, or (ii) stratified, and incubated for 28days to test the effect of compost application on nitrogen mineralization. The results showed that delayed addition of poultry manure reduced total nitrogen loss by 33% and increased mineral nitrogen content by >200% compared with early addition. Similarly, less frequent turning reduced total N loss by 12% compared with frequent turning. Stratified placement of compost did not enhance N mineralization compared to a homogeneous mixing. Our results suggested that simple modifications of the composting process (i.e. delayed addition and/or turning frequency) could significantly reduce N losses and improve the plant-nutritional value of compost. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study.

    PubMed

    Ong, Mei-Sing; Magrabi, Farah; Coiera, Enrico

    2018-05-16

    Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS. A retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804). Generalized linear models were developed to examine the relationship between hospital LOS and cumulative clinician read time (CRT), defined as the time taken by clinicians to review laboratory test results performed during an inpatient stay after they were reported in the computerized test reporting system. The models were adjusted for patients' age, sex, and disease severity (measured by the Charlson Comorbidity index), the number of test panels performed, the number of unreviewed tests pre-discharge, and the cumulative laboratory turnaround time (LTAT) of tests performed during an inpatient stay. Cumulative CRT is significantly associated with prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of prolonged LOS by 13.2% (p < 0.0001). Restricting the analysis to tests with abnormal results strengthened the relationship between cumulative CRT and prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of delayed discharge by 33.6% (p < 0.0001). Increasing age, disease severity and total number of tests were also significantly associated with prolonged LOS. Increasing number of unreviewed tests was negatively associated with prolonged LOS. Reducing unnecessary hospital LOS has become a critical health policy goal as healthcare costs escalate. Preventing delay in reviewing test results represents an important opportunity to address potentially avoidable hospital stays and unnecessary resource utilization.

  20. Prolonged second stage of labor is associated with low Apgar score.

    PubMed

    Altman, Maria; Sandström, Anna; Petersson, Gunnar; Frisell, Thomas; Cnattingius, Sven; Stephansson, Olof

    2015-11-01

    There is no consensus on the effects of a prolonged second stage of labor on neonatal outcomes. In this large Swedish population-based cohort study, our objective was to investigate prolonged second stage and risk of low Apgar score at 5 min. All nulliparous women (n = 32,796) delivering a live born singleton infant in cephalic presentation at ≥37 completed weeks after spontaneous onset of labor between 2008 and 2012 in the counties of Stockholm and Gotland were included. Data were obtained from computerized records. Exposure was time from fully retracted cervix until delivery. Logistic regression analyses were used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Adjustments were made for maternal age, height, BMI, smoking, sex, gestational age, sex-specific birth weight for gestational age and head circumference. Epidural analgesia was included in a second model. The primary outcome measure was Apgar score at 5 min <7 and <4. We found that the overall rates of 5 min Apgar score <7 and <4 were 7.0 and 1.3 per 1000 births, respectively. Compared to women with <1 h from retracted cervix to birth, adjusted ORs of Apgar score <7 at 5 min generally increased with length of second stage of labor: 1 to <2 h: OR 1.78 (95% CI 1.19-2.66); 2 to <3 h: OR 1.66 (1.05-2.62); 3 to <4 h: OR 2.08 (1.29-3.35); and ≥4 h: OR 2.71 (1.67-4.40). We conclude that prolonged second stage of labor is associated with an increased risk of low 5 min Apgar score.

  1. Prolonged fasting reduces IGF-1/PKA to promote hematopoietic-stem-cell-based regeneration and reverse immunosuppression.

    PubMed

    Cheng, Chia-Wei; Adams, Gregor B; Perin, Laura; Wei, Min; Zhou, Xiaoying; Lam, Ben S; Da Sacco, Stefano; Mirisola, Mario; Quinn, David I; Dorff, Tanya B; Kopchick, John J; Longo, Valter D

    2014-06-05

    Immune system defects are at the center of aging and a range of diseases. Here, we show that prolonged fasting reduces circulating IGF-1 levels and PKA activity in various cell populations, leading to signal transduction changes in long-term hematopoietic stem cells (LT-HSCs) and niche cells that promote stress resistance, self-renewal, and lineage-balanced regeneration. Multiple cycles of fasting abated the immunosuppression and mortality caused by chemotherapy and reversed age-dependent myeloid-bias in mice, in agreement with preliminary data on the protection of lymphocytes from chemotoxicity in fasting patients. The proregenerative effects of fasting on stem cells were recapitulated by deficiencies in either IGF-1 or PKA and blunted by exogenous IGF-1. These findings link the reduced levels of IGF-1 caused by fasting to PKA signaling and establish their crucial role in regulating hematopoietic stem cell protection, self-renewal, and regeneration. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Factors on working conditions and prolonged fatigue among physicians in Japan.

    PubMed

    Wada, Koji; Arimatsu, Mayuri; Yoshikawa, Toru; Oda, Susumu; Taniguchi, Hatsumi; Higashi, Toshiaki; Aizawa, Yoshiharu

    2008-10-01

    Fatigue among physicians could affect patients' safety and physicians' health. Fatigue could be caused by unfavorable working conditions. However, there have been no studies on the working conditions and fatigue among physicians in Japan. The objective of this study was to determine the factors on working conditions associated with prolonged fatigue among physicians in Japan. A questionnaire was mailed to physicians who graduated from one of the medical schools in Japan and who have had more than 3 years of experience in clinical practice. They were asked to assess 10 different aspects of their working conditions using a 5-point Likert scale. Prolonged fatigue was measured using the checklist of individual strength questionnaire. Multiple regression analysis was used to examine the multivariate relationship between the variables and prolonged fatigue. Data from 377 men and 101 women were analyzed in this study. For both male and female physicians, a harder workload was positively associated and better career satisfaction was negatively associated with prolonged fatigue. Prolonged fatigue was negatively associated with better relationships with other physicians and staff for male physicians and less personal time for female physicians. The adjusted variance in prolonged fatigue related to exposure variables was 26 and 29% in men and in women, respectively. The result of this study suggested that it is desirable to take these factors into consideration in the management of prolonged fatigue among physicians in Japan.

  3. Patient adjustment to reduced olfactory function.

    PubMed

    Croy, Ilona; Landis, Basile N; Meusel, Thomas; Seo, Han-Seok; Krone, Franziska; Hummel, Thomas

    2011-04-01

    To compare the importance of olfaction in daily life between patients with olfactory disorders and healthy normosmic individuals. Quasiexperimental. A total of 470 individuals (235 anosmic or hyposmic patients and 235 normosmic control individuals). The Individual Importance of Olfaction Questionnaire (IO) and olfactory testing using the "Sniffin' Sticks" test kit. The IO scores were lower in people with smell disorders compared with normosmic subjects (P < .001) and lower in patients with anosmia compared with hyposmic patients (P < .001). These scores suggest adjustment processes in the daily use of the sense of smell by patients. Patients attach less importance to their current sense of smell in daily life than do normosmic individuals. This adjustment might be an example of regaining psychological health despite acquired and long-lasting impairments.

  4. Recovery from impaired muscle growth arises from prolonged postnatal accretion of myonuclei in Atrx mutant mice

    PubMed Central

    Yan, Keqin; Price-O’Dea, Tina

    2017-01-01

    Reduced muscle mass due to pathological development can occur through several mechanisms, including the loss or reduced proliferation of muscle stem cells. Muscle-specific ablation of the α-thalassemia mental retardation syndrome mutant protein, Atrx, in transgenic mice results in animals with a severely reduced muscle mass at three weeks of age; yet this muscle mass reduction resolves by adult age. Here, we explore the cellular mechanism underlying this effect. Analysis of Atrx mutant mice included testing for grip strength and rotorod performance. Muscle fiber length, fiber volume and numbers of myofiber-associated nuclei were determined from individual EDL or soleus myofibers isolated at three, five, or eight weeks. Myofibers from three week old Atrx mutant mice are smaller with fewer myofiber-associated nuclei and reduced volume compared to control animals, despite similar fiber numbers. Nonetheless, the grip strength of Atrx mutant mice was comparable to control mice when adjusted for body weight. Myofiber volume remained smaller at five weeks, becoming comparable to controls by 8 weeks of age. Concomitantly, increased numbers of myofiber-associated nuclei and Ki67+ myoblasts indicated that the recovery of muscle mass likely arises from the prolonged accretion of new myonuclei. This suggests that under disease conditions the muscle satellite stem cell niche can remain in a prolonged active state, allowing for the addition of a minimum number of myonuclei required to achieve a normal muscle size. PMID:29095838

  5. The potential of prolonged tissue culture to reduce stress generation and retraction in engineered heart valve tissues.

    PubMed

    van Vlimmeren, Marijke A A; Driessen-Mol, Anita; Oomens, Cees W J; Baaijens, Frank P T

    2013-03-01

    In tissue-engineered (TE) heart valves, cell-mediated processes cause tissue compaction during culture and leaflet retraction at time of implantation. We have quantified and correlated stress generation, compaction, retraction, and tissue quality during a prolonged culture period of 8 weeks. Polyglycolic acid/poly-4-hydroxybutyrate strips were seeded with vascular-derived cells and cultured for 4-8 weeks. Compaction in width, generated force, and stress was measured during culture. Retraction in length, generated force, and stress was measured after release of constraints at weeks 4, 6, and 8. Further, the amount of DNA, glycosaminoglycans (GAGs), collagen, and collagen cross-links was assessed. During culture, compaction and force generation increased to, respectively, 63.9% ± 0.8% and 43.7 ± 4.3 mN at week 4, after which they remained stable. Stress generation reached 27.7 ± 3.2 kPa at week 4, after which it decreased to ∼8.5 kPa. At release of constraints, tissue retraction was 44.0% ± 3.7% at week 4 and decreased to 29.2% ± 2.8% and 26.1% ± 2.2% at, respectively, 6 and 8 weeks. Generated force (8-16 mN) was lower at week 6 than at weeks 4 and 8. Generated stress decreased from 11.8 ± 0.9 kPa at week 4 to 1.4 ± 0.3 and 2.4 ± 0.4 kPa at, respectively, weeks 6 and 8. The amount of GAGs increased at weeks 6 and 8 compared to week 4 and correlated to the reduced stress and retraction. In summary, prolonged culture resulted in decreased stress generation and retraction, likely as a result of the increased amount of GAGs. These results demonstrate the potential of prolonged tissue culture in developing functional, nonretracting, TE heart valves.

  6. ASSOCIATIVE ADJUSTMENTS TO REDUCE ERRORS IN DOCUMENT SEARCHING.

    ERIC Educational Resources Information Center

    BRYANT, EDWARD C.; AND OTHERS

    ASSOCIATIVE ADJUSTMENTS TO A DOCUMENT FILE ARE CONSIDERED AS A MEANS FOR IMPROVING RETRIEVAL. A THEORETICAL INVESTIGATION OF THE STATISTICAL PROPERTIES OF A GENERALIZED MISMATCH MEASURE WAS CARRIED OUT AND IMPROVEMENTS IN RETRIEVAL RESULTING FROM PERFORMING ASSOCIATIVE REGRESSION ADJUSTMENTS ON DATA FILE WERE EXAMINED BOTH FROM THE THEORETICAL AND…

  7. Remote glucose monitoring in cAMP setting reduces the risk of prolonged nocturnal hypoglycemia.

    PubMed

    DeSalvo, Daniel J; Keith-Hynes, Patrick; Peyser, Thomas; Place, Jérôme; Caswell, Kim; Wilson, Darrell M; Harris, Breanne; Clinton, Paula; Kovatchev, Boris; Buckingham, Bruce A

    2014-01-01

    This study tested the feasibility and effectiveness of remote continuous glucose monitoring (CGM) in a diabetes camp setting. Twenty campers (7-21 years old) with type 1 diabetes were enrolled at each of three camp sessions lasting 5-6 days. On alternating nights, 10 campers were randomized to usual wear of a Dexcom (San Diego, CA) G4™ PLATINUM CGM system, and 10 were randomized to remote monitoring with the Dexcom G4 PLATINUM communicating with the Diabetes Assistant, a cell phone platform, to allow wireless transmission of CGM values. Up to 15 individual graphs and sensor values could be displayed on a single remote monitor or portable tablet. An alarm was triggered for values <70 mg/dL, and treatment was given for meter-confirmed hypoglycemia. The primary end point was to decrease the duration of hypoglycemic episodes <50 mg/dL. There were 320 nights of CGM data and 197 hypoglycemic events. Of the remote monitoring alarms, 79% were true (meter reading of <70 mg/dL). With remote monitoring, 100% of alarms were responded to, whereas without remote monitoring only 54% of alarms were responded to. The median duration of hypoglycemic events <70 mg/dL was 35 min without remote monitoring and 30 min with remote monitoring (P=0.078). Remote monitoring significantly decreased prolonged hypoglycemic events, eliminating all events <50 mg/dL lasting longer than 30 min as well as all events <70 mg/dL lasting more than 2 h. Remote monitoring is feasible at diabetes camps and effective in reducing the risk of prolonged nocturnal hypoglycemia. This technology will facilitate forthcoming studies to evaluate the efficacy of automated closed-loop systems in the camp setting.

  8. Supplementation of Ascorbic Acid in Weanling Horses Following Prolonged Transportation

    PubMed Central

    Ralston, Sarah; Stives, Michelle

    2012-01-01

    Simple Summary Horses normally synthesize adequate amounts of ascorbic acid (vitamin C) in their liver to meet their needs for the vitamin. However, prolonged stress results in low plasma concentrations and reduced immune function. Weanling horses were supplemented with ascorbic acid for 5 or 10 days or no ascorbic acid (4 per group) following 50+ hours of transportation. Supplementation caused increases in plasma concentrations but both supplemented groups had decreased plasma ascorbic acid for 1 to 3 weeks following cessation of supplementation, possibly due to suppressed synthesis. Supplementation of ascorbic acid following prolonged stress will increase plasma concentrations, but prolonged supplementation should be avoided. Abstract Though horses synthesize ascorbic acid in their liver in amounts that meet their needs under normal circumstances, prolonged stress results in low plasma concentrations due to enhanced utilization and renal excretion and can reduce immune function. It was hypothesized that plasma ascorbic acid could be maintained in weanling horses by oral supplementation following prolonged transportation. Weanlings were supplemented with no ascorbic acid (Tx 0: n = 4), 5 grams ascorbic acid twice daily for 5 days (Tx 1: n = 4) or for 10 days (Tx 2: n = 4) following >50 hours of transportation. Supplementation caused slight (P < 0.2) increases in plasma ascorbic acid concentrations. Both supplemented groups had decreased (P < 0.05) plasma concentrations for 1 to 3 weeks following cessation of supplementation, possibly due to increased renal excretion or suppressed hepatic synthesis. Supplementation of ascorbic acid following prolonged stress will increase plasma concentrations, but prolonged supplementation should be avoided. PMID:26486916

  9. Ventricular Cycle Length Characteristics Estimative of Prolonged RR Interval during Atrial Fibrillation

    PubMed Central

    CIACCIO, EDWARD J.; BIVIANO, ANGELO B.; GAMBHIR, ALOK; EINSTEIN, ANDREW J.; GARAN, HASAN

    2014-01-01

    Background When atrial fibrillation (AF) is incessant, imaging during a prolonged ventricular RR interval may improve image quality. It was hypothesized that long RR intervals could be predicted from preceding RR values. Methods From the PhysioNet database, electrocardiogram RR intervals were obtained from 74 persistent AF patients. An RR interval lengthened by at least 250 ms beyond the immediately preceding RR interval (termed T0 and T1, respectively) was considered prolonged. A two-parameter scatterplot was used to predict the occurrence of a prolonged interval T0. The scatterplot parameters were: (1) RR variability (RRv) estimated as the average second derivative from 10 previous pairs of RR differences, T13–T2, and (2) Tm–T1, the difference between Tm, the mean from T13 to T2, and T1. For each patient, scatterplots were constructed using preliminary data from the first hour. The ranges of parameters 1 and 2 were adjusted to maximize the proportion of prolonged RR intervals within range. These constraints were used for prediction of prolonged RR in test data collected during the second hour. Results The mean prolonged event was 1.0 seconds in duration. Actual prolonged events were identified with a mean positive predictive value (PPV) of 80% in the test set. PPV was >80% in 36 of 74 patients. An average of 10.8 prolonged RR intervals per 60 minutes was correctly identified. Conclusions A method was developed to predict prolonged RR intervals using two parameters and prior statistical sampling for each patient. This or similar methodology may help improve cardiac imaging in many longstanding persistent AF patients. PMID:23998759

  10. Psychotropic Pharmacotherapy Associated With QT Prolongation Among Veterans With Posttraumatic Stress Disorder.

    PubMed

    Stock, Eileen M; Zeber, John E; McNeal, Catherine J; Banchs, Javier E; Copeland, Laurel A

    2018-04-01

    In 2012, the Food and Drug Administration issued Drug Safety Communications on several drugs associated with QT prolongation and fatal ventricular arrhythmias. Among these was citalopram, a selective serotonin reuptake inhibitor (SSRI) approved for depression and commonly used for posttraumatic stress disorder (PTSD). Evaluation of the risk for QT prolongation among other psychotropic drugs for individuals with PTSD remains limited. Explore psychotropic drugs associated with QT prolongation among veterans with PTSD. Patients in the Veterans Health Administration in 2006-2009 with PTSD and QT prolongation (176 cases) were matched 1:4 on age, gender, visit date and setting, and physical comorbidity. Classification trees assessed QT prolongation risk among prescribed medications (n=880). Receipt of any drug with known risk of QT prolongation varied by group (23% QT cases vs 15% control, p<0.01). Psychotropic medications conferring significant risks included ziprasidone (3% vs 1%, p=0.02) and buspirone (6% vs 2%, p=0.01). Increased risk was not observed for the SSRIs, citalopram and fluoxetine. Classification trees found that sotalol and amitriptyline carried greater risk among cardiac patients and methadone, especially if prescribed with quetiapine, among noncardiac patients. Per adjusted survival model, patients with QT prolongation were at increased risk for death (hazard ratio=1.60; 95% CI=1.04-2.44). Decision models are particularly advantageous when exploring nonlinear relationships or nonadditive interactions. These findings may potentially affect clinical decision-making concerning treatment for PTSD. For patients at higher risk of QT prolongation, antidepressants other than amitriptyline should be considered. Medications for comorbid conditions should also be closely monitored for heightened QT prolongation risk.

  11. Frequency up-converted piezoelectric energy harvester for ultralow-frequency and ultrawide-frequency-range operation

    NASA Astrophysics Data System (ADS)

    Zhang, Xiyang; Gao, Shiqiao; Li, Dongguang; Jin, Lei; Wu, Qinghe; Liu, Feng

    2018-04-01

    At present, frequency up-converted piezoelectric energy harvesters are disadvantaged by their narrow range of operating frequencies and low efficiency at ultralow-frequency excitation. To address these shortcomings, we propose herein an impact-driven frequency up-converted piezoelectric energy harvester composed of two driving beams and a generating beam. We find experimentally that the proposed device offers efficient energy output over an ultrawide-frequency-range and performs very well in the ultralow-frequency excitation. A maximum peak power of 29.3 mW is achieved under 0.5g acceleration at the excitation frequency of 12.7 Hz. The performance of the energy harvester can be adjusted and optimized by adjusting the spacing between the driving and generating beams. The results show that the proposed harvester has the potential to power miniaturized portable devices and wireless sensor nodes.

  12. Do Prolonged Prophylactic Antibiotics Reduce the Incidence of Surgical-Site Infections in Immediate Prosthetic Breast Reconstruction?

    PubMed

    Wang, Frederick; Chin, Robin; Piper, Merisa; Esserman, Laura; Sbitany, Hani

    2016-12-01

    Approximately 50,000 women in the United States undergo mastectomy and immediate prosthetic breast reconstruction annually, and most receive postoperative prophylactic antibiotics. The effect of these antibiotics on the risk of surgical-site infections remains unclear. The authors searched the Medline, Embase, and Cochrane Library databases for studies that compared less than 24 hours and greater than 24 hours of antibiotics following immediate prosthetic breast reconstruction. Primary outcomes were surgical-site infections and implant loss. Conservative random effects models were used to obtain pooled relative risk estimates. The authors identified 927 studies, but only four cohort studies and one randomized controlled trial met their inclusion criteria. Unadjusted incidences of surgical-site infections were 14 percent with more than 24 hours of antibiotics, 19 percent with less than 24 hours of antibiotics, and 16 percent overall. Unadjusted incidences of implant loss were 8 percent with more than 24 hours of antibiotics, 10 percent with less than 24 hours of antibiotics, and 9 percent overall. The pooled relative risk of implant loss was 1.17 (95 percent CI, 0.39 to 3.6) with less than 24 hours of antibiotics, which was not statistically significant. Prolonged antibiotic use did not have a statistically significant effect on reducing surgical-site infections or implant loss. There was significant heterogeneity between studies, and prolonged antibiotics may have increased the risk of implant loss in the randomized controlled trial. Definitive evidence may only be obtained with data from more prospective randomized controlled trials.

  13. An e-health intervention designed to increase workday energy expenditure by reducing prolonged occupational sitting habits.

    PubMed

    Pedersen, Scott J; Cooley, Paul D; Mainsbridge, Casey

    2014-01-01

    Desk-based employees face multiple workplace health hazards such as insufficient physical activity and prolonged sitting. The objective of this study was to increase workday energy expenditure by interrupting prolonged occupational sitting time and introducing short-bursts of physical activity to employees' daily work habits. Over a 13-week period participants (n=17) in the intervention group were regularly exposed to a passive prompt delivered through their desktop computer that required them to stand up and engage in a short-burst of physical activity, while the control group (n=17) was not exposed to this intervention. Instead, the control group continued with their normal work routine. All participants completed a pre- and post- intervention survey to estimate workplace daily energy expenditure (calories). There was a significant 2 (Group) × 2 (Test) interaction, F (1, 32)=9.26, p < 0.05. The intervention group increased the calories expended during the workday from pre-test (M=866.29 ± 151.40) to post-test (M=1054.10 ± 393.24), whereas the control group decreased calories expended during the workday from pre-test (M=982.55 ± 315.66) to post-test (M=892.21 ± 255.36). An e-health intervention using a passive prompt was an effective mechanism for increasing employee work-related energy expenditure. Engaging employees in regular short-bursts of physical activity during the workday resulted in reduced sitting time, which may have long-term effects on the improvement of employee health.

  14. Hydrazinonicotinamide prolongs quantum dot circulation and reduces reticuloendothelial system clearance by suppressing opsonization and phagocyte engulfment

    NASA Astrophysics Data System (ADS)

    Jung, Kyung-Ho; Park, Jin Won; Paik, Jin-Young; Lee, Eun Jeong; Choe, Yearn Seong; Lee, Kyung-Han

    2012-12-01

    In this study, we investigated the effects of hydrazinonicotinamide (HYNIC)—a bifunctional crosslinker widely used to 99mTc radiolabel protein and nanoparticles for imaging studies—on quantum dot opsonization, macrophage engulfment and in vivo kinetics. In streptavidin-coated quantum dots (SA-QDots), conjugation with HYNIC increased the net negative charge without affecting the zeta potential. Confocal microscopy and fluorescence-activated cell sorting showed HYNIC attachment to suppress SA-QDot engulfment by macrophages. Furthermore, HYNIC conjugation suppressed surface opsonization by serum protein including IgG. When intravenously injected into mice, HYNIC conjugation significantly prolonged the circulation of SA-QDots and reduced their hepatosplenic uptake. Diminished reticuloendothelial system clearance of SA-QDots and aminoPEG-QDots by HYNIC conjugation was also demonstrated by in vivo and ex vivo optical imaging. The effects of HYNIC on the opsonization, phagocytosis and in vivo kinetics of quantum dots were reversed by removal of the hydrazine component from HYNIC. Thus, surface functionalization with HYNIC can improve the in vivo kinetics of quantum dots by reducing phagocytosis via suppression of surface opsonization.

  15. Prolonged hypothyroidism severely reduces ovarian follicular reserve in adult rats.

    PubMed

    Meng, Li; Rijntjes, Eddy; Swarts, Hans J M; Keijer, Jaap; Teerds, Katja J

    2017-03-16

    There is substantial evidence both in humans and in animals that a prolonged reduction in plasma thyroid hormone concentration leads to reproductive problems, including disturbed folliculogenesis, impaired ovulation and fertilization rates, miscarriage and pregnancy complications. The objective of the present study is to examine the consequences of chronic hypothyroidism, induced in adulthood, for the size of the ovarian follicle pool. In order to investigate this, adult female rats were provided either a control or an iodide deficient diet in combination with perchlorate supplementation to inhibit iodide uptake by the thyroid. Sixteen weeks later animals were sacrificed. Blood was collected for hormone analyses and ovaries were evaluated histologically. At the time of sacrifice, plasma thyroid-stimulating hormone concentrations were 20- to 40-fold increased, thyroxine concentrations were negligible while tri-iothyronin concentrations were decreased by 40% in the hypothyroid group, confirming that the animals were hypothyroid. Primordial, primary and preantral follicle numbers were significantly lower in the hypothyroid ovaries compared to the euthyroid controls, while a downward trend in antral follicle and corpora lutea numbers was observed. Surprisingly the percentage of atretic follicles was not significantly different between the two groups, suggesting that the reduced preantral and antral follicle numbers were presumably not the consequence of increased degeneration of these follicle types in the hypothyroid group. Plasma anti-Müllerian hormone (AMH) levels showed a significant correlation with the growing follicle population represented by the total ovarian number of primary, preantral and antral follicles, suggesting that also under hypothyroid conditions AMH can serve as a surrogate marker to assess the growing ovarian follicle population. The induction of a chronic hypothyroid condition in adult female rats negatively affects the ovarian follicular

  16. Daily corticosteroids reduce infection-associated relapses in frequently relapsing nephrotic syndrome: a randomized controlled trial.

    PubMed

    Gulati, Ashima; Sinha, Aditi; Sreenivas, Vishnubhatla; Math, Aparna; Hari, Pankaj; Bagga, Arvind

    2011-01-01

    Relapses of nephrotic syndrome often follow minor infections, commonly of the upper respiratory tract. Daily administration of maintenance prednisolone during intercurrent infections was examined to determine whether the treatment reduces relapse rates in children with frequently relapsing nephrotic syndrome. In a randomized controlled trial (nonblind, parallel group, tertiary-care hospital), 100 patients with idiopathic, frequently relapsing nephrotic syndrome eligible for therapy with prolonged low-dose, alternate-day prednisolone with or without levamisole were randomized to either receive their usual dose of alternate-day prednisolone daily for 7 days during intercurrent infections (intervention group) or continue alternate-day prednisolone (controls). Primary outcome was assessed by comparing the rates of infection-associated relapses at 12-month follow-up. Secondary outcomes were the frequency of infections and the cumulative amount of prednisolone received in both groups. Patients in the intervention group showed significantly lower infection-associated (rate difference, 0.7 episodes/patient per year; 95% confidence intervals [CI] 0.3, 1.1) and lower total relapse rates (0.9 episodes/patient per year, 95% CI 0.4, 1.4) without increase in steroid toxicity. Poisson regression, adjusted for occurrence of infections, showed that daily administration of prednisolone during infections independently resulted in 59% reduction in frequency of relapses (rate ratio, 0.41; 95% CI 0.3, 0.6). For every six patients receiving this intervention, one showed a reduction of relapse frequency to less than three per year. Daily administration of maintenance doses of prednisolone, during intercurrent infections, significantly reduces relapse rates and the proportion of children with frequently relapsing nephrotic syndrome.

  17. Prolonged corrected QT interval is predictive of future stroke events even in subjects without ECG-diagnosed left ventricular hypertrophy.

    PubMed

    Ishikawa, Joji; Ishikawa, Shizukiyo; Kario, Kazuomi

    2015-03-01

    We attempted to evaluate whether subjects who exhibit prolonged corrected QT (QTc) interval (≥440 ms in men and ≥460 ms in women) on ECG, with and without ECG-diagnosed left ventricular hypertrophy (ECG-LVH; Cornell product, ≥244 mV×ms), are at increased risk of stroke. Among the 10 643 subjects, there were a total of 375 stroke events during the follow-up period (128.7±28.1 months; 114 142 person-years). The subjects with prolonged QTc interval (hazard ratio, 2.13; 95% confidence interval, 1.22-3.73) had an increased risk of stroke even after adjustment for ECG-LVH (hazard ratio, 1.71; 95% confidence interval, 1.22-2.40). When we stratified the subjects into those with neither a prolonged QTc interval nor ECG-LVH, those with a prolonged QTc interval but without ECG-LVH, and those with ECG-LVH, multivariate-adjusted Cox proportional hazards analysis demonstrated that the subjects with prolonged QTc intervals but not ECG-LVH (1.2% of all subjects; incidence, 10.7%; hazard ratio, 2.70, 95% confidence interval, 1.48-4.94) and those with ECG-LVH (incidence, 7.9%; hazard ratio, 1.83; 95% confidence interval, 1.31-2.57) had an increased risk of stroke events, compared with those with neither a prolonged QTc interval nor ECG-LVH. In conclusion, prolonged QTc interval was associated with stroke risk even among patients without ECG-LVH in the general population. © 2014 American Heart Association, Inc.

  18. Association between prolonged breast-feeding and early childhood caries: a hierarchical approach.

    PubMed

    Nunes, Ana Margarida Melo; Alves, Claudia Maria Coelho; Borba de Araújo, Fernando; Ortiz, Tânia Mara Lopes; Ribeiro, Marizélia Rodrigues Costa; Silva, Antônio Augusto Moura da; Ribeiro, Cecília Claudia Costa

    2012-12-01

    This study was conducted to investigate the association between prolonged breastfeeding and early childhood caries(ECC) with adjustment for important confounders, using hieraschical approach. This retrospective cohort study involved 260 low-income children (18-42 months). The number of decayed teeth was used as a measure of caries. Following a theoretical framework, the hierarchical model was built in a forward fashion, by adding the following levels in succession: level 1: age; level 2: social variables; level 3: health variables; level 4: behavioral variables; level 5: oral hygiene-related variables; level 6: oral hygiene quality measured by visible plaque; and level 7: contamination by mutans streptococci. Sequential forward multiple Poisson regression analysis was employed. Breast-feeding was not a risk factor for ECC after adjustment for some confounders (incidence density ratio, 1.15; 95% confidence interval, 0.84-1.59, P = 0.363). Prolonged breast-feeding was not a risk factor for ECC while age, high sucrose comption between main meals and the quality of oral higiene were associated with disease in children. © 2012 John Wiley & Sons A/S.

  19. Strategies to reduce the risk of drug-induced QT interval prolongation: a pharmaceutical company perspective.

    PubMed

    Pollard, C E; Valentin, J-P; Hammond, T G

    2008-08-01

    Drug-induced prolongation of the QT interval is having a significant impact on the ability of the pharmaceutical industry to develop new drugs. The development implications for a compound causing a significant effect in the 'Thorough QT/QTc Study' -- as defined in the clinical regulatory guidance (ICH E14) -- are substantial. In view of this, and the fact that QT interval prolongation is linked to direct inhibition of the hERG channel, in the early stages of drug discovery the focus is on testing for and screening out hERG activity. This has led to understanding of how to produce low potency hERG blockers whilst retaining desirable properties. Despite this, a number of factors mean that when an integrated risk assessment is generated towards the end of the discovery phase (by conducting at least an in vivo QT assessment) a QT interval prolongation risk is still often apparent; inhibition of hERG channel trafficking and partitioning into cardiac tissue are just two confounding factors. However, emerging information suggests that hERG safety margins have high predictive value and that when hERG and in vivo non-clinical data are combined, their predictive value to man, whilst not perfect, is >80%. Although understanding the anomalies is important and is being addressed, of greater importance is developing a better understanding of TdP, with the aim of being able to predict TdP rather than using an imperfect surrogate marker (QT interval prolongation). Without an understanding of how to predict TdP risk, high-benefit drugs for serious indications may never be marketed.

  20. Adjusted peak-flow frequency estimates for selected streamflow-gaging stations in or near Montana based on data through water year 2011: Chapter D in Montana StreamStats

    USGS Publications Warehouse

    Sando, Steven K.; Sando, Roy; McCarthy, Peter M.; Dutton, DeAnn M.

    2016-04-05

    The climatic conditions of the specific time period during which peak-flow data were collected at a given streamflow-gaging station (hereinafter referred to as gaging station) can substantially affect how well the peak-flow frequency (hereinafter referred to as frequency) results represent long-term hydrologic conditions. Differences in the timing of the periods of record can result in substantial inconsistencies in frequency estimates for hydrologically similar gaging stations. Potential for inconsistency increases with decreasing peak-flow record length. The representativeness of the frequency estimates for a short-term gaging station can be adjusted by various methods including weighting the at-site results in association with frequency estimates from regional regression equations (RREs) by using the Weighted Independent Estimates (WIE) program. Also, for gaging stations that cannot be adjusted by using the WIE program because of regulation or drainage areas too large for application of RREs, frequency estimates might be improved by using record extension procedures, including a mixed-station analysis using the maintenance of variance type I (MOVE.1) procedure. The U.S. Geological Survey, in cooperation with the Montana Department of Transportation and the Montana Department of Natural Resources and Conservation, completed a study to provide adjusted frequency estimates for selected gaging stations through water year 2011.The purpose of Chapter D of this Scientific Investigations Report is to present adjusted frequency estimates for 504 selected streamflow-gaging stations in or near Montana based on data through water year 2011. Estimates of peak-flow magnitudes for the 66.7-, 50-, 42.9-, 20-, 10-, 4-, 2-, 1-, 0.5-, and 0.2-percent annual exceedance probabilities are reported. These annual exceedance probabilities correspond to the 1.5-, 2-, 2.33-, 5-, 10-, 25-, 50-, 100-, 200-, and 500-year recurrence intervals, respectively.The at-site frequency estimates were

  1. Some features of the bioelectric activity of the muscles with prolonged hypokinesia

    NASA Technical Reports Server (NTRS)

    Belaya, N. A.; Amirov, R. Z.; Shaposhnikov, Y. A.; Lebedeva, I. P.; Sologub, B. S.

    1978-01-01

    The effects of prolonged hypokinesia, brought on by confinement to bed and the attendant lack of motor activity, on the bioelectric activity of muscles are studied. Electromyographic measurements of amplitude and frequency indicators of muscular bioelectric activity were analyzed.

  2. Prolonged length of stay in hospitalized internal medicine patients.

    PubMed

    Barba, Raquel; Marco, Javier; Canora, Jesús; Plaza, Susana; Juncos, Sara Nistal; Hinojosa, Juan; Bailon, Manuel Mendez; Zapatero, Antonio

    2015-12-01

    Targeting patients with prolonged hospitalizations may represent an effective strategy for reducing average hospital length of stay (LOS). We sought to characterize predictors of prolonged hospitalization among internal medicine patients in an effort to guide future improvement efforts. We conducted a retrospective cohort study using administrative data of internal medicine patients from all hospitals of the Spanish Public Health Service between January 1st, 2005 and December 31st, 2013. Multivariable logistic regression was performed to assess the association between sociodemographic and clinical variables and prolonged LOS, defined as >30days. Of 5,275,139 discharges, 166,470 (3.2%) had a prolonged LOS. Prolonged hospitalizations accounted for 17.4% of total inpatient days and contributed 0.5days to an average LOS of 9.8days during the study period. Prolonged hospitalizations were associated with younger age (odds ratio [OR]: 0.97 per 10-year increase in age, 95% confidence interval [CI]: 0.96-0.98) and male gender (OR 0.88 IC95% 0.87-0.89). Compared to patients without prolonged LOS, prolonged LOS patients were more likely to require a palliative care consult (OR: 2.48, 95% CI: 2.39-2.58), surgery (OR: 6.9 95% CI: 6.8-7.0); and be discharged to a post-acute-care facility (OR: 2.91, 95% CI: 2.86-2.95). Prolonged hospitalizations in a small proportion of patients were an important contributor to overall LOS and particularly affected complex hospital stays who were not discharged home. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  3. Reduced In-Plane, Low Frequency Helicopter Noise of an Active Flap Rotor

    NASA Technical Reports Server (NTRS)

    Sim, Ben W.; Janakiram, Ram D.; Barbely, Natasha L.; Solis, Eduardo

    2009-01-01

    Results from a recent joint DARPA/Boeing/NASA/Army wind tunnel test demonstrated the ability to reduce in-plane, low frequency noise of the full-scale Boeing-SMART rotor using active flaps. Test data reported in this paper illustrated that acoustic energy in the first six blade-passing harmonics could be reduced by up to 6 decibels at a moderate airspeed, level flight condition corresponding to advance ratio of 0.30. Reduced noise levels were attributed to selective active flap schedules that modified in-plane blade airloads on the advancing side of the rotor, in a manner, which generated counteracting acoustic pulses that partially offset the negative pressure peaks associated with in-plane, steady thickness noise. These favorable reduced-noise operating states are a strong function of the active flap actuation amplitude, frequency and phase. The associated noise reductions resulted in reduced aural detection distance by up to 18%, but incurred significant vibratory load penalties due to increased hub shear forces. Small reductions in rotor lift-to-drag ratios, of no more than 3%, were also measured

  4. Coexistence of Ureaplasma and chorioamnionitis is associated with prolonged mechanical ventilation.

    PubMed

    Jung, Euiseok; Choi, Chang Won; Kim, Su Yeong; Sung, Tae-Jung; Kim, Haeryoung; Park, Kyoung Un; Kim, Han-Suk; Kim, Beyong Il; Choi, Jung-Hwan

    2017-01-01

    Both histologic chorioamnionitis (HCAM) and Ureaplasma infection are considered important contributors to perinatal lung injury. We tested the hypothesis that coexistence of maternal HCAM and perinatal Ureaplasma exposure increases the risk of prolonged mechanical ventilation in extremely low-birthweight (ELBW) infants. A retrospective cohort study was carried out of all ELBW infants born between January 2008 and December 2013 at a single academic center. Placental pathology and gastric fluid Ureaplasma data were available for all infants. Culture and polymerase chain reaction were used to detect Ureaplasma in gastric fluid. Prolonged mechanical ventilation was defined as mechanical ventilation that began within 28 days after birth and continued. Of 111 ELBW infants enrolled, 84 survived beyond 36 weeks of postmenstrual age (PMA) and were included in the analysis. Eighteen infants (21.4%) had both HCAM and Ureaplasma exposure. Seven infants (8.3%) required mechanical ventilation beyond 36 weeks of PMA. Coexistence of HCAM and Ureaplasma in gastric fluid was significantly associated with prolonged mechanical ventilation after adjustment for gestational age, sex, mode of delivery, and use of macrolide antibiotics (OR, 8.7; 95%CI: 1.1-67.2). Coexistence of maternal HCAM and perinatal Ureaplasma exposure significantly increases the risk of prolonged mechanical ventilation in ELBW infants. © 2016 Japan Pediatric Society.

  5. Evidence of Health Risks Associated with Prolonged Standing at Work and Intervention Effectiveness

    PubMed Central

    Waters, Thomas R.; Dick, Robert B.

    2015-01-01

    Purpose Prolonged standing at work has been shown to be associated with a number of potentially serious health outcomes, such as lower back and leg pain, cardiovascular problems, fatigue, discomfort, and pregnancy related health outcomes. Recent studies have been conducted examining the relationship between these health outcomes and the amount of time spent standing while on the job. The purpose of this article was to provide a review of the health risks and interventions for workers and employers that are involved in occupations requiring prolonged standing. A brief review of recommendations by governmental and professional organizations for hours of prolonged standing is also included. Findings Based on our review of the literature, there seems to be ample evidence showing that prolonged standing at work leads to adverse health outcomes. Review of the literature also supports the conclusion that certain interventions are effective in reducing the hazards associated with prolonged standing. Suggested interventions include the use of floor mats, sit-stand workstations/chairs, shoes, shoe inserts and hosiery or stockings. Studies could be improved by using more precise definitions of prolonged standing (e.g., duration, movement restrictions, and type of work), better measurement of the health outcomes and more rigorous study protocols. Conclusion and Clinical Relevance Use of interventions and following suggested guidelines on hours of standing from governmental and professional organizations should reduce the health risks from prolonged standing. PMID:25041875

  6. Lean Six Sigma to Reduce Intensive Care Unit Length of Stay and Costs in Prolonged Mechanical Ventilation.

    PubMed

    Trzeciak, Stephen; Mercincavage, Michael; Angelini, Cory; Cogliano, William; Damuth, Emily; Roberts, Brian W; Zanotti, Sergio; Mazzarelli, Anthony J

    Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. Before-and-after cohort study. Multidisciplinary intensive care unit (ICU) in an academic medical center. Adult patients admitted to the ICU and treated with PMV, as defined by diagnosis-related group (DRG). We implemented a clinical redesign intervention based on LSS principles. We identified eight distinct processes in preparing patients with PMV for post-acute care. Our clinical redesign included reengineering daily patient care rounds ("Lean ICU rounds") to reduce variation and waste in these processes. We compared hospital LOS and direct cost per case in patients with PMV before (2013) and after (2014) our LSS intervention. Among 259 patients with PMV (131 preintervention; 128 postintervention), median hospital LOS decreased by 24% during the intervention period (29 vs. 22 days, p < .001). Accordingly, median hospital direct cost per case decreased by 27% ($66,335 vs. $48,370, p < .001). We found that a LSS-based clinical redesign reduced hospital LOS and the costs of care for patients with PMV.

  7. Resilience and vulnerability: prolonged grief in the bereaved spouses of marital partners who died of AIDS.

    PubMed

    Yu, Nancy Xiaonan; Chan, Cecilia L W; Zhang, Jianxin; Stewart, Sunita M

    2016-01-01

    Spousal bereavement is closely linked to prolonged grief, that is, significant adjustment symptoms that last for more than six months after the loss. This article focused on potential risk and protective factors that may influence bereavement outcomes. Participants in this study were surviving spouses of individuals who died of acquired immune deficiency syndrome (AIDS). These participants were themselves living with human immunodeficiency syndrome. In this cross-sectional study, 120 bereaved participants completed measures of grief, quality of dying and death of the deceased, negative conceptions of death resulting from AIDS, death attitudes, and personal resilience. The results showed that one-third (35.0%) of the bereaved participants reported grief levels above the prolonged grief cut-off scores, and can be categorized as the "prolonged grief" group. Although quality of dying and death was not associated with the intensity of grief, negative conceptions of death from AIDS, fear of death and resilience independently predicted grief symptoms in the regression models. Our findings provide insight into the grief process for the surviving spouse of AIDS victims in rural China. Since resilience is malleable, developing resilience interventions to enhance adjustment to bereavement may be a promising direction in grief counselling and therapies.

  8. Work-family conflict and prolonged fatigue among Japanese married male physicians.

    PubMed

    Ohta, Hiroshi; Wada, Koji; Kawashima, Masatoshi; Arimatsu, Mayuri; Higashi, Toshiaki; Yoshikawa, Toru; Aizawa, Yoshiharu

    2011-12-01

    Fatigue experienced by physicians may not only endanger their own health but may also affect the safety of patients. Such fatigue may be associated with the work environment and personal factors such as work-family conflict (WFC). This study aimed to determine the association between WFC and prolonged fatigue among Japanese married male physicians. Physicians who graduated from a Japanese medical school answered a mailed anonymous self-report questionnaire. For assessment of WFC and prolonged fatigue, the Japanese versions of the WFC scale and the Checklist of Individual Strength questionnaire (CIS) were used. Prolonged fatigue was defined as the upper quartile of total CIS scores. The WFC scale comprises six dimensions. Total scores were divided into tertiles: low, intermediate, and high levels of WFC. A multiple logistic regression analysis was performed to examine the association between WFC and prolonged fatigue. A total of 540 male physicians answered the questionnaire, and the data of 444 married male physicians were analyzed. The data were then adjusted for age and work condition factors. Prolonged fatigue was significantly associated with high strain-based work interference with family (WIF; corrected odds ratio, 5.56; 95% confidence interval, 2.55-12.1), intermediate strain-based WIF (2.53, 1.25-5.10), high time-based family interference with work (FIW; 1.92, 1.08-3.40), and there was a weak association with high strain-based FIW (1.93, 0.98-3.83). Employers should take measures to improve working conditions in hospitals, and give physicians the opportunity to learn how to cope with WFC. These measures could ultimately help prevent prolonged fatigue.

  9. Neonatal and Maternal Outcomes With Prolonged Second Stage of Labor

    PubMed Central

    Laughon, S. Katherine; Berghella, Vincenzo; Reddy, Uma M.; Sundaram, Rajeshwari; Lu, Zhaohui; Hoffman, Matthew K

    2014-01-01

    Objective To assess neonatal and maternal outcomes when when the second stage of labor was prolonged according to American College of Obstetricians and Gynecologists guidelines. Methods Electronic medical record data from a retrospective cohort (2002–2008) from 12 U.S. clinical centers (19 hospitals), including 43,810 nulliparous and 59,605 multiparous singleton deliveries ≥ 36 weeks, vertex presentation, who reached 10 cm cervical dilation were analyzed. Prolonged second stage was defined as: nulliparous women with epidural > 3 hours, without > 2 hours; multiparous women with epidural > 2 hours, without > 1 hour. Maternal and neonatal outcomes were compared and adjusted odds ratios calculated controlling for maternal race, BMI, insurance, and region. Results Prolonged second stage occurred in 9.9% and 13.9% of nulliparous and 3.1% and 5.9% of multiparous women, with and without an epidural, respectively. Vaginal delivery rates with prolonged second stage compared to within guidelines were 79.9% versus 97.9% and 87.0% versus 99.4% for nulliparous women with and without epidural, respectively, and 88.7% versus 99.7% and 96.2% versus 99.9% for multiparous women with and without epidural, respectively (P<.001 for all comparisons). Prolonged second stage was associated with increased chorioamnionitis and third-degree or fourth-degree perineal lacerations. Neonatal morbidity with prolonged second stage included sepsis in nulliparous women [with epidural: 2.6% versus 1.2% (AOR 2.08; 95%CI 1.60–2.70); without epidural: 1.8% versus 1.1% (AOR 2.34; 95%CI 1.28–4.27)]; asphyxia in nulliparous women with epidural [0.3% versus 0.1%, AOR 2.39; 95% CI 1.22–4.66]; and perinatal mortality without epidural [0.18% versus 0.04% for nulliparous women (AOR 5.92; 95% CI 1.43–24.51)], and 0.21% versus 0.03% for multiparous women (AOR 6.34; 95%CI 1.32–30.34)]. However, among the offspring of women with epidurals whose second stage was prolonged (3,533 nulliparous and 1

  10. Analysis of Relationship between Levofloxacin and Corrected QT Prolongation Using a Clinical Data Warehouse

    PubMed Central

    Park, Man Young; Kim, Eun Yeob; Lee, Young Ho; Kim, Woojae; Kim, Ku Sang; Sheen, Seung Soo; Lim, Hong Seok

    2011-01-01

    Objective The aim of this study was to examine whether or not levofloxacin has any relationship with QT prolongation in a real clinical setting by analyzing a clinical data warehouse of data collected from different hospital information systems. Methods Electronic prescription data and medical charts from 3 different hospitals spanning the past 9 years were reviewed, and a clinical data warehouse was constructed. Patients who were both administrated levofloxacin and given electrocardiograms (ECG) were selected. The correlations between various patient characteristics, concomitant drugs, corrected QT (QTc) prolongation, and the interval difference in QTc before and after levofloxacin administration were analyzed. Results A total of 2,176 patients from 3 different hospitals were included in the study. QTc prolongation was found in 364 patients (16.7%). The study revealed that age (OR 1.026, p < 0.001), gender (OR 0.676, p = 0.007), body temperature (OR 1.267, p = 0.024), and cigarette smoking (OR 1.641, p = 0.022) were related with QTc prolongation. After adjusting for related factors, 12 drugs concomitant with levofloxacin were associated with QTc prolongation. For patients who took ECGs before and after administration of levofloxacin during their hospitalization (n = 112), there was no significant difference in QTc prolongation. Conclusions The age, gender, body temperature, cigarette smoking and various concomitant drugs might be related with QTc prolongation. However, there was no definite causal relationship or interaction between levofloxacin and QTc prolongation. Alternative surveillance methods utilizing the massive accumulation of electronic medical data seem to be essential to adverse drug reaction surveillance in future. PMID:21818458

  11. The effects of prolonged weightlessness and reduced gravity environments on human survival.

    PubMed

    Taylor, R L

    1993-03-01

    The manned exploration of the solar system and the surfaces of some of the smaller planets and larger satellites requires that we are able to keep the adverse human physiological response to long term exposure to near zero and greatly reduced gravity environments within acceptable limits consistent with metabolic function. This paper examines the physiological changes associated with microgravity conditions with particular reference to the weightless demineralizatoin of bone (WDB). It is suggested that many of these changes are the result of physical/mechanical processes and are not primarily a medical problem. There are thus two immediately obvious and workable, if relatively costly, solutions to the problem of weightlessness. The provision of a near 1 g field during prolonged space flights, and/or the development of rapid transit spacecraft capable of significant acceleration and short flight times. Although these developments could remove or greatly ameliorate the effects of weightlessness during long-distance space flights there remains a problem relating to the long term colonization of the surfaces of Mars, the Moon, and other small solar system bodies. It is not yet known whether or not there is a critical threshold value of 'g' below which viable human physiological function cannot be sustained. If such a threshold exists permanent colonization may only be possible if the threshold value of 'g' is less than that at the surface of the planet on which we wish to settle.

  12. Modelling the impact of new patient visits on risk adjusted access at 2 clinics.

    PubMed

    Kolber, Michael A; Rueda, Germán; Sory, John B

    2018-06-01

    To evaluate the effect new outpatient clinic visits has on the availability of follow-up visits for established patients when patient visit frequency is risk adjusted. Diagnosis codes for patients from 2 Internal Medicine Clinics were extracted through billing data. The HHS-HCC risk adjusted scores for each clinic were determined based upon the average of all clinic practitioners' profiles. These scores were then used to project encounter frequencies for established patients, and for new patients entering the clinic based on risk and time of entry into the clinics. A distinct mean risk frequency distribution for physicians in each clinic could be defined providing model parameters. Within the model, follow-up visit utilization at the highest risk adjusted visit frequencies would require more follow-up slots than currently available when new patient no-show rates and annual patient loss are included. Patients seen at an intermediate or lower visit risk adjusted frequency could be accommodated when new patient no-show rates and annual patient clinic loss are considered. Value-based care is driven by control of cost while maintaining quality of care. In order to control cost, there has been a drive to increase visit frequency in primary care for those patients at increased risk. Adding new patients to primary care clinics limits the availability of follow-up slots that accrue over time for those at highest risk, thereby limiting disease and, potentially, cost control. If frequency of established care visits can be reduced by improved disease control, closing the practice to new patients, hiring health care extenders, or providing non-face to face care models then quality and cost of care may be improved. © 2018 John Wiley & Sons, Ltd.

  13. Incidence and management of prolonged charge times in the Medtronic model 7219 implantable cardioverter defibrillator.

    PubMed

    Mann, D E; Gleason, S A; Kelly, P A; Easley, A R; Reiter, M J

    2001-06-01

    The Medtronic Jewel PCD model 7219, introduced in 1994, was the first downsized, pectoral implantable cardioverter defibrillator (ICD), and many of these units are approaching or have reached the elective replacement indicator (ERI). Unlike later Medtronic ICDs and most other ICDs, in which ERI is defined by battery voltage, the ERI in the model 7219 series is defined when either the capacitor charge time to full output is repeatedly> or =14.5 s or when battery voltage is< or =4.91 V. In this study we examined which of the two ERI criteria was met first in patients with this device model. We also assessed the effects of manual dumping and recharging and of increasing the automatic capacitor reformation frequency on prolonged charge times. In 16 patients with follow-up <2 years, 15 reached the charge time ERI before battery voltage ERI. Manual dumping and recharging led to spuriously low charge times due to residual charge at the start of recharging, and increasing the automatic capacitor reformation frequency to once a month did not decrease prolonged charge times. Because of persistently prolonged charge times, 15 patients had generator changes. None of these patients had reached battery voltage ERI (battery voltage at time of explantation 5.06+/-0.06 V). Thus in this early pectoral device, prolonged charge times occur commonly before battery voltage ERI is reached. Whether prolonged charge times will have an impact on device longevity in later model ICDs is unknown.

  14. Lupus nephritis: prolonged immunoadsorption (IAS) reduces proteinuria and stabilizes global disease activity.

    PubMed

    Stummvoll, Georg H; Schmaldienst, Sabine; Smolen, Josef S; Derfler, Kurt; Biesenbach, Peter

    2012-02-01

    Systemic lupus erythematosus (SLE) is characterized by pathogenic autoantibodies, which can be removed by extracorporeal procedures. While previous studies have shown short-term efficacy of immunoadsorption (IAS) in SLE, no information on long-term benefit and safety is available. IAS was offered to patients with highly active renal disease when conventional therapy had failed. Eleven patients entered the prolonged IAS programme and were followed for up to 10 years (mean 6.4 ± 3.5). Efficacy of IAS was determined by reduction in proteinuria (primary outcome), global disease activity [SLE Disease Activity Index (SLEDAI)] and anti-double-stranded DNA (anti-dsDNA) levels (secondary outcomes). Full/partial remission was defined as ≤ 0.5/≤ 1.0 g/day for proteinuria, ≤ 5/≤ 8 for SLEDAI and ≤ 25/≤ 50 IU/mL for anti-dsDNA levels. We further assessed flares, infections, malignancies and procedure-related adverse events. Short-term IAS (≤ 1 year) resulted in a significant reduction of proteinuria (9.2 ± 3.7 to 2.3 ± 2.4, P = 0.0001), disease activity (SLEDAI 19 ± 8 to 4 ± 2, P = 0.0004) and dsDNA levels (168 ± 205 to 45 ± 34, P = 0.001). In patients without remission after 1 year (n = 5), prolonged IAS decreased proteinuria from 4.3 ± 2.4 to 0.5 ± 0.4 g/day, P = 0.02. At the end of observation, complete remission in proteinuria was achieved in seven patients (64%) and partial remission in two (18%) additional patients. One patient flared and was discontinued; in all other patients, disease activity and anti-dsDNA stabilized at remission levels. Flares (0.28 ± 0.30) and infections (0.66 ± 0.70 per patient/year) were relatively uncommon; no malignancies, anaphylactic or orthostatic adverse events were observed. IAS is effective in short-term use but prolonged IAS can provide additional therapeutic benefit while showing an acceptable safety profile. The vast majority of initially therapy-refractory patients met the remission criteria at the end of

  15. Amplitude modulation reduces loudness adaptation to high-frequency tones.

    PubMed

    Wynne, Dwight P; George, Sahara E; Zeng, Fan-Gang

    2015-07-01

    Long-term loudness perception of a sound has been presumed to depend on the spatial distribution of activated auditory nerve fibers as well as their temporal firing pattern. The relative contributions of those two factors were investigated by measuring loudness adaptation to sinusoidally amplitude-modulated 12-kHz tones. The tones had a total duration of 180 s and were either unmodulated or 100%-modulated at one of three frequencies (4, 20, or 100 Hz), and additionally varied in modulation depth from 0% to 100% at the 4-Hz frequency only. Every 30 s, normal-hearing subjects estimated the loudness of one of the stimuli played at 15 dB above threshold in random order. Without any amplitude modulation, the loudness of the unmodulated tone after 180 s was only 20% of the loudness at the onset of the stimulus. Amplitude modulation systematically reduced the amount of loudness adaptation, with the 100%-modulated stimuli, regardless of modulation frequency, maintaining on average 55%-80% of the loudness at onset after 180 s. Because the present low-frequency amplitude modulation produced minimal changes in long-term spectral cues affecting the spatial distribution of excitation produced by a 12-kHz pure tone, the present result indicates that neural synchronization is critical to maintaining loudness perception over time.

  16. Impact of an 8-Month Trial Using Height-Adjustable Desks on Children’s Classroom Sitting Patterns and Markers of Cardio-Metabolic and Musculoskeletal Health

    PubMed Central

    Contardo Ayala, Ana María; Salmon, Jo; Timperio, Anna; Sudholz, Bronwyn; Ridgers, Nicola D.; Sethi, Parneet; Dunstan, David W.

    2016-01-01

    During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children’s cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children’s overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort. PMID:27973414

  17. Pharmacokinetics and effect of food after oral administration of prolonged-release tablets of ropinirole hydrochloride in Japanese patients with Parkinson's disease.

    PubMed

    Hattori, N; Hasegawa, K; Sakamoto, T

    2012-10-01

    analysis (LOCF) at the final endpoint up to week 16 demonstrated a mean (SD) change from baseline in the Japanese UPDRS III (motor) and II (ADL) scores of -11·3 (8·21) and -3·9 (3·22), respectively, and thereafter remained at similar levels until week 52. After administration of prolonged-release tablets of ropinirole hydrochloride in the absence of L-dopa preparations in Japanese patients with PD, the plasma pharmacokinetics of ropinirole and its metabolites was linear and not affected by food. Compared with the immediate-release (IR) tablet, the prolonged-release tablet can be administered to Japanese patients with PD at a reduced daily dose frequency and adjusted to the maintenance dose after fewer dose changes with a smaller diurnal variation in the plasma ropinirole concentration. © 2012 Blackwell Publishing Ltd.

  18. Prolonged post-inhibitory rebound firing in the cerebellar nuclei mediated by group I mGluR potentiation of L-type Ca currents

    PubMed Central

    Zheng, Nan; Raman, Indira M.

    2011-01-01

    Neurons in the cerebellar nuclei fire at accelerated rates for prolonged periods after trains of synaptic inhibition that interrupt spontaneous firing. Both in vitro and in vivo, however, this prolonged rebound firing is favored by strong stimulation of afferents, suggesting that neurotransmitters other than GABA may contribute to the increased firing rates. Here, we tested whether metabotropic glutamate receptors modulate excitability of nuclear cells in cerebellar slices from mouse. In current clamp, the prolonged rebound firing rate after high-frequency synaptic stimulation was reduced by a variety of group I mGluR antagonists, including CPCCOEt (7-(hydroxyimino)cyclopropa[b]chromen-1a-carboxylate ethyl ester), JNJ16259685 ((3,4-dihydro-2H-pyrano[2,3-b]quinolin-7-yl)-(cis-4-methoxycyclohexyl)-methanone)+MPEP, or 3-MATIDA (α-amino-5-carboxy-3-methyl-2-thiopheneacetic acid) +MPEP, as long as both mGluR1 and mGluR5 were blocked. This mGluR-dependent acceleration of firing was reduced but still evident when IPSPs were prevented by GABAA receptor antagonists. In voltage clamp, voltage ramps revealed a non-inactivating, low-voltage-activated, nimodipine-sensitive current that was enhanced by the selective group I mGluR agonist s-DHPG ((S)-3,5-dihydroxyphenylglycine). This putative L-type current also increased when mGluRs were activated by trains of evoked synaptic currents instead of direct application of agonist. In current clamp, blocking L-type Ca channels with the specific blocker nifedipine greatly reduced prolonged post-stimulus firing and occluded the effect of adding group I mGluR antagonists. Thus, potentiation of a low-voltage-activated L-type current by synaptically released glutamate accounted nearly fully for the mGluR-dependent acceleration of firing. Together, these data suggest that prolonged rebound firing in the cerebellar nuclei in vivo is most likely to occur when GABAA and mGluRs are simultaneously activated by concurrent excitation and

  19. Interrupting prolonged sitting with brief bouts of light walking or simple resistance activities reduces resting blood pressure and plasma noradrenaline in type 2 diabetes.

    PubMed

    Dempsey, Paddy C; Sacre, Julian W; Larsen, Robyn N; Straznicky, Nora E; Sethi, Parneet; Cohen, Neale D; Cerin, Ester; Lambert, Gavin W; Owen, Neville; Kingwell, Bronwyn A; Dunstan, David W

    2016-12-01

    Prolonged sitting is increasingly recognized as a ubiquitous cardiometabolic risk factor, possibly distinct from lack of physical exercise. We examined whether interrupting prolonged sitting with brief bouts of light-intensity activity reduced blood pressure (BP) and plasma noradrenaline in type 2 diabetes (T2D). In a randomized crossover trial, 24 inactive overweight/obese adults with T2D (14 men; mean ± SD; 62 ± 6 years) consumed standardized meals during 3 × 8 h conditions: uninterrupted sitting (SIT); sitting + half-hourly bouts of walking (3.2 km/h for 3-min) (light-intensity walking); and sitting + half-hourly bouts of simple resistance activities for 3 min (SRAs), each separated by 6-14 days washout. Resting seated BP was measured hourly (mean of three recordings, ≥20-min postactivity). Plasma noradrenaline was measured at 30-min intervals for the first hour after meals and hourly thereafter. Compared with SIT, mean resting SBP and DBP were significantly reduced (P < 0.001) for both light-intensity walking (mean ± SEM; -14 ± 1/-8 ± 1 mmHg) and SRA (-16 ± 1/-10 ± 1 mmHg), with a more pronounced effect for SRA (P < 0.05 versus light-intensity walking). Similarly, mean plasma noradrenaline was significantly reduced for both light-intensity walking (-0.3 ± 0.1 nmol/l) and SRA (-0.6 ± 0.1 nmol/l) versus SIT, with SRA lower than light-intensity walking (P < 0.05). Mean resting heart rate was lowered by light-intensity walking (-3 ± 1 bpm; P < 0.05), but not SRA (-1 ± 1 bpm). Interrupting prolonged sitting with brief bouts of light-intensity walking or SRA reduces resting BP and plasma noradrenaline in adults with T2D, with SRA being more effective. Given the ubiquity of sedentary behaviors and poor adherence to structured exercise, this approach may have important implications for BP management in patients with T2D.

  20. Predominant cause of prolonged low-frequency force depression changes during recovery after in situ fatiguing stimulation of rat fast-twitch muscle.

    PubMed

    Watanabe, Daiki; Wada, Masanobu

    2016-11-01

    To investigate time-dependent changes in sarcoplasmic reticulum (SR) Ca 2+ release and myofibrillar (my-) Ca 2+ sensitivity during recovery from prolonged low-frequency force depression (PLFFD), rat gastrocnemius muscles were electrically stimulated in situ. After 0 h (R0), 0.5 h (R0.5), 2 h (R2), 6 h (R6), or 12 h of recovery, the superficial gastrocnemius muscles were excised and used for biochemical and skinned fiber analyses. At R0, R0.5, R2, and R6, the ratio of force at 1 Hz to that at 50 Hz was decreased in the skinned fibers. The ratio of depolarization-induced force to the maximum Ca 2+ -activated force (depol/Ca 2+ force ratio) was utilized as an indicator of SR Ca 2+ release. At R0, both the depol/Ca 2+ force ratio and my-Ca 2+ sensitivity were decreased. At R0.5 and R2, my-Ca 2+ sensitivity was recovered, while the depol/Ca 2+ force ratio remained depressed. At R6, my-Ca 2+ sensitivity was decreased again, whereas the depol/Ca 2+ force ratio was nearly restored. Western blot analyses demonstrated that decreased my-Ca 2+ sensitivity at R6 and reduced depol/Ca 2+ force ratio at R0, R0.5, and R2 were accompanied by depressions in S-glutathionylated troponin I and increases in dephosphorylated ryanodine receptor 1, respectively. These results indicate that, in the early stage of recovery, reduced SR Ca 2+ release plays a primary role in the etiology of PLFFD, whereas decreased my-Ca 2+ sensitivity is involved in the late stage, and suggest that S-glutathionylation of troponin I and dephosphorylation of ryanodine receptor 1 contribute, at least partly, to fatiguing contraction-induced alterations in my-Ca 2+ sensitivity and SR Ca 2+ release, respectively. Copyright © 2016 the American Physiological Society.

  1. The School Adjustment of Post-Meningitic Children. Final Report.

    ERIC Educational Resources Information Center

    Pate, John E.

    To study the school adjustment of children known to have had prolonged high fevers, 25 elementary school students who had had acute bacterial meningitis were matched by age, sex, and socioeconomic levels with peers from their same classroom. The nature and extent of school problems and educational handicaps of the post-meningitic children examined…

  2. Real-time, high frequency QRS electrocardiograph with reduced amplitude zone detection

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T. (Inventor); DePalma, Jude L. (Inventor); Moradi, Saeed (Inventor)

    2009-01-01

    Real time cardiac electrical data are received from a patient, manipulated to determine various useful aspects of the ECG signal, and displayed in real time in a useful form on a computer screen or monitor. The monitor displays the high frequency data from the QRS complex in units of microvolts, juxtaposed with a display of conventional ECG data in units of millivolts or microvolts. The high frequency data are analyzed for their root mean square (RMS) voltage values and the discrete RMS values and related parameters are displayed in real time. The high frequency data from the QRS complex are analyzed with imbedded algorithms to determine the presence or absence of reduced amplitude zones, referred to herein as ''RAZs''. RAZs are displayed as ''go, no-go'' signals on the computer monitor. The RMS and related values of the high frequency components are displayed as time varying signals, and the presence or absence of RAZs may be similarly displayed over time.

  3. New School Blues: Helping Children Adjust After a Family Move.

    ERIC Educational Resources Information Center

    Anderson, Marilyn

    2001-01-01

    Presents suggestions for parents to help their children make the adjustment to a new school, focusing on: understanding how moving affects children, teens, and in-betweens; meeting the school counselor or psychologist; looking for warning signs (e.g., prolonged anxiety, depression, or interrupted sleeping); and providing reassurance. A sidebar…

  4. Impact of statistical adjustment for frequency of venue attendance in a venue-based survey of men who have sex with men.

    PubMed

    Gustafson, Paul; Gilbert, Mark; Xia, Michelle; Michelow, Warren; Robert, Wayne; Trussler, Terry; McGuire, Marissa; Paquette, Dana; Moore, David M; Gustafson, Reka

    2013-05-15

    Venue sampling is a common sampling method for populations of men who have sex with men (MSM); however, men who visit venues frequently are more likely to be recruited. While statistical adjustment methods are recommended, these have received scant attention in the literature. We developed a novel approach to adjust for frequency of venue attendance (FVA) and assess the impact of associated bias in the ManCount Study, a venue-based survey of MSM conducted in Vancouver, British Columbia, Canada, in 2008-2009 to measure the prevalence of human immunodeficiency virus and other infections and associated behaviors. Sampling weights were determined from an abbreviated list of questions on venue attendance and were used to adjust estimates of prevalence for health and behavioral indicators using a Bayesian, model-based approach. We found little effect of FVA adjustment on biological or sexual behavior indicators (primary outcomes); however, adjustment for FVA did result in differences in the prevalence of demographic indicators, testing behaviors, and a small number of additional variables. While these findings are reassuring and lend credence to unadjusted prevalence estimates from this venue-based survey, adjustment for FVA did shed important insights on MSM subpopulations that were not well represented in the sample.

  5. Autologous fibrin sealant reduces the incidence of prolonged air leak and duration of chest tube drainage after lung volume reduction surgery: a prospective randomized blinded study.

    PubMed

    Moser, C; Opitz, I; Zhai, W; Rousson, V; Russi, E W; Weder, W; Lardinois, D

    2008-10-01

    Prolonged air leak is reported in up to 50% of patients after lung volume reduction surgery. The effect of an autologous fibrin sealant on the intensity and duration of air leak and on the time to chest drain removal after lung volume reduction surgery was investigated in a randomized prospective clinical trial. Twenty-five patients underwent bilateral thoracoscopic lung volume reduction surgery. In each patient, an autologous fibrin sealant was applied along the staple lines on one side, whereas no additional measure was taken on the other side. Randomization of treatment was performed at the end of the resection on the first side. Air leak was assessed semiquantitatively by use of a severity score (0 = no leak; 4 = continuous severe leak) by two investigators blinded to the treatment. Mean value of the total severity scores for the first 48 hours postoperative was significantly lower in the treated group (4.7 +/- 7.7) than in the control group (16.0 +/- 10.1) (P < .001), independently of the length of the resection. Prolonged air leak and mean duration of drainage were also significantly reduced after application of the sealant (4.5% and 2.8 +/- 1.9 days versus 31.8% and 5.9 +/- 2.9 days) (P = .03 and P < .001). Autologous fibrin sealant for reinforcement of the staple lines after lung volume reduction surgery significantly reduces prolonged air leak and duration of chest tube drainage.

  6. Seasonally adjusted birth frequencies follow the Poisson distribution.

    PubMed

    Barra, Mathias; Lindstrøm, Jonas C; Adams, Samantha S; Augestad, Liv A

    2015-12-15

    Variations in birth frequencies have an impact on activity planning in maternity wards. Previous studies of this phenomenon have commonly included elective births. A Danish study of spontaneous births found that birth frequencies were well modelled by a Poisson process. Somewhat unexpectedly, there were also weekly variations in the frequency of spontaneous births. Another study claimed that birth frequencies follow the Benford distribution. Our objective was to test these results. We analysed 50,017 spontaneous births at Akershus University Hospital in the period 1999-2014. To investigate the Poisson distribution of these births, we plotted their variance over a sliding average. We specified various Poisson regression models, with the number of births on a given day as the outcome variable. The explanatory variables included various combinations of years, months, days of the week and the digit sum of the date. The relationship between the variance and the average fits well with an underlying Poisson process. A Benford distribution was disproved by a goodness-of-fit test (p < 0.01). The fundamental model with year and month as explanatory variables is significantly improved (p < 0.001) by adding day of the week as an explanatory variable. Altogether 7.5% more children are born on Tuesdays than on Sundays. The digit sum of the date is non-significant as an explanatory variable (p = 0.23), nor does it increase the explained variance. INERPRETATION: Spontaneous births are well modelled by a time-dependent Poisson process when monthly and day-of-the-week variation is included. The frequency is highest in summer towards June and July, Friday and Tuesday stand out as particularly busy days, and the activity level is at its lowest during weekends.

  7. A review of ropinirole prolonged release in Parkinson’s disease

    PubMed Central

    Nashatizadeh, Muhammad M; Lyons, Kelly E; Pahwa, Rajesh

    2009-01-01

    Ropinirole prolonged release is a once-daily, 24-hour formulation of ropinirole, a non-ergot dopamine agonist. It is approved as monotherapy and as an adjunct to levodopa in the treatment of Parkinson’s disease (PD). Several potential advantages of ropinirole prolonged release compared to the immediate release formulation include maintaining more consistent dopaminergic activity with steadier plasma levels, increased tolerability, greater compliance from a simpler once-daily dosing regimen and ease in dose titration. In a randomized, double-blind, non-inferiority, crossover study, ropinirole prolonged release was shown to have comparable efficacy and tolerability to immediate release ropinirole in early PD patients, with significantly greater compliance. Subjects were converted overnight between ropinirole formulations without loss of efficacy and with good tolerability. In a randomized, double-blind, placebo-controlled study in advanced PD, daily “off” time was reduced by an average of 2.1 hours with ropinirole prolonged release compared to 0.4 hours with placebo. Patients on ropinirole prolonged release were also more likely to require less daily levodopa. Ropinirole prolonged release is well tolerated with a similar adverse effect profile to other non-ergot dopamine agonists. The most common adverse effects include dyskinesia, nausea, dizziness, hallucinations, somnolence, abdominal pain or discomfort and orthostatic hypotension. Ropinirole prolonged release is a safe and effective treatment option for both early and advanced PD. This manuscript briefly reviews the current pharmacological treatment options for PD and provides a more detailed review of the currently available data regarding ropinirole prolonged release as a treatment option for PD. PMID:19503779

  8. Prolonged financial stress predicts subsequent obesity: results from a prospective study of an Australian national sample.

    PubMed

    Siahpush, Mohammad; Huang, Terry T-K; Sikora, Asia; Tibbits, Melissa; Shaikh, Raees A; Singh, Gopal K

    2014-02-01

    The aim of this research was to assess the association of prolonged financial stress (FS) with subsequent obesity. Data were from Waves 8 (2008), 9 (2009), and 10 (2010) of Household Income and Labor Dynamics in Australia (HILDA) survey. The outcome was obesity measured in 2010. Prolonged FS was defined as having experienced FS in both 2008 and 2009. FS was measured in each year using seven questionnaire items. Analyses adjusted for health, physical activity, income, education, baseline obesity, and other covariates. Prolonged FS was a strong predictor of subsequent obesity. The adjusted risk of being obese in 2010 were 20% higher (RR: 1.20; 95% CI: 1.10-1.30) among individuals who experienced FS in both 2008 and 2009 than those who did not experience FS in either year. The association of FS with obesity was independent of income and constant across income categories. Obesity prevention research should pay more attention to FS as an important dimension of economic deprivation, a concept that is distinct from common indicators of socioeconomic status such as income. Future research can examine the effect of financial education and counseling programs that help individuals with such skills as money management, budgeting, and saving on a reduction in FS and obesity. Copyright © 2013 The Obesity Society.

  9. The Association between Job-Related Psychosocial Factors and Prolonged Fatigue among Industrial Employees in Taiwan

    PubMed Central

    Tang, Feng-Cheng; Li, Ren-Hau; Huang, Shu-Ling

    2016-01-01

    Background and Objectives Prolonged fatigue is common among employees, but the relationship between prolonged fatigue and job-related psychosocial factors is seldom studied. This study aimed (1) to assess the individual relations of physical condition, psychological condition, and job-related psychosocial factors to prolonged fatigue among employees, and (2) to clarify the associations between job-related psychosocial factors and prolonged fatigue using hierarchical regression when demographic characteristics, physical condition, and psychological condition were controlled. Methods A cross-sectional study was employed. A questionnaire was used to obtain information pertaining to demographic characteristics, physical condition (perceived physical health and exercise routine), psychological condition (perceived mental health and psychological distress), job-related psychosocial factors (job demand, job control, and workplace social support), and prolonged fatigue. Results A total of 3,109 employees were recruited. Using multiple regression with controlled demographic characteristics, psychological condition explained 52.0% of the variance in prolonged fatigue. Physical condition and job-related psychosocial factors had an adjusted R2 of 0.370 and 0.251, respectively. Hierarchical multiple regression revealed that, among job-related psychosocial factors, job demand and job control showed significant associations with fatigue. Conclusion Our findings highlight the role of job demand and job control, in addition to the role of perceived physical health, perceived mental health, and psychological distress, in workers’ prolonged fatigue. However, more research is required to verify the causation among all the variables. PMID:26930064

  10. Bile Acids Reduce Prion Conversion, Reduce Neuronal Loss, and Prolong Male Survival in Models of Prion Disease

    PubMed Central

    Cortez, Leonardo M.; Campeau, Jody; Norman, Grant; Kalayil, Marian; Van der Merwe, Jacques; McKenzie, Debbie

    2015-01-01

    ABSTRACT Prion diseases are fatal neurodegenerative disorders associated with the conversion of cellular prion protein (PrPC) into its aberrant infectious form (PrPSc). There is no treatment available for these diseases. The bile acids tauroursodeoxycholic acid (TUDCA) and ursodeoxycholic acid (UDCA) have been recently shown to be neuroprotective in other protein misfolding disease models, including Parkinson's, Huntington's and Alzheimer's diseases, and also in humans with amyotrophic lateral sclerosis. Here, we studied the therapeutic efficacy of these compounds in prion disease. We demonstrated that TUDCA and UDCA substantially reduced PrP conversion in cell-free aggregation assays, as well as in chronically and acutely infected cell cultures. This effect was mediated through reduction of PrPSc seeding ability, rather than an effect on PrPC. We also demonstrated the ability of TUDCA and UDCA to reduce neuronal loss in prion-infected cerebellar slice cultures. UDCA treatment reduced astrocytosis and prolonged survival in RML prion-infected mice. Interestingly, these effects were limited to the males, implying a gender-specific difference in drug metabolism. Beyond effects on PrPSc, we found that levels of phosphorylated eIF2α were increased at early time points, with correlated reductions in postsynaptic density protein 95. As demonstrated for other neurodegenerative diseases, we now show that TUDCA and UDCA may have a therapeutic role in prion diseases, with effects on both prion conversion and neuroprotection. Our findings, together with the fact that these natural compounds are orally bioavailable, permeable to the blood-brain barrier, and U.S. Food and Drug Administration-approved for use in humans, make these compounds promising alternatives for the treatment of prion diseases. IMPORTANCE Prion diseases are fatal neurodegenerative diseases that are transmissible to humans and other mammals. There are no disease-modifying therapies available, despite decades

  11. Very low frequency radio events with a reduced intensity observed by the low-altitude DEMETER spacecraft

    NASA Astrophysics Data System (ADS)

    Záhlava, J.; Němec, F.; Santolík, O.; Kolmašová, I.; Parrot, M.; Rodger, C. J.

    2015-11-01

    We present results of a systematic study of unusual very low frequency (VLF) radio events with a reduced intensity observed in the frequency-time spectrograms measured by the low-orbiting Detection of Electro-Magnetic Emissions Transmitted from Earthquake Regions (DEMETER) spacecraft. They occur exclusively on the nightside. During these events, the intensity of fractional hop whistlers at specific frequencies is significantly reduced. These frequencies are usually above about 3.4 kHz (second Earth-ionosphere waveguide cutoff frequency), but about 20% of events extend down to about 1.7 kHz (first Earth-ionosphere waveguide cutoff frequency). The frequencies of a reduced intensity vary smoothly with time. We have inspected 6.5 years of DEMETER data, and we identified in total 1601 such events. We present a simple model of the event formation based on the wave propagation in the Earth-ionosphere waveguide. We apply the model to two selected events, and we demonstrate that the model is able to reproduce both the minimum frequencies of the events and their approximate frequency-time shapes. The overall geographic distribution of the events is shifted by about 3000 km westward and slightly southward with respect to the areas with high long-term average lightning activity. We demonstrate that this shift is related to the specific DEMETER orbit, and we suggest its qualitative explanation by the east-west asymmetry of the wave propagation in the Earth-ionosphere waveguide.

  12. Cervical sympathetic block prolongs the latency and reduces the amplitude of trigeminal somatosensory evoked potentials on the contralateral side.

    PubMed

    Kawaguchi, Jun; Matsuura, Nobuyuki; Kasahara, Masataka; Ichinohe, Tatsuya

    2015-02-01

    The purpose of this study was to investigate the latency and amplitude of trigeminal somatosensory evoked potentials to clarify how nerve function on the contralateral side is affected after cervical sympathetic block (CSB). Subjects comprised 16 volunteers. For CSB, the tip of a needle was contacted with the transverse process of the sixth cervical vertebra on the right side, and lidocaine was injected. Trigeminal somatosensory evoked potentials were recorded bilaterally from C5/C6 scalp positions. Pupil diameters were also measured. Electrical stimulations were applied to the left-side lower lip, and trigeminal somatosensory evoked potentials waveforms derived from both sides of the scalp were recorded. Then, electrical stimulations were applied to the right-side of the lower lip, and recording was again performed. Recordings were performed at 5, 15, and 30 minutes after CSB. On the CSB side, pupil diameter decreased at 5 and 15 minutes after CSB. Trigeminal somatosensory evoked potentials at contralateral stimulation showed a prolongation of the latency in both P20 and N25 components on bilateral recording sites 5 and 15 minutes after CSB. Trigeminal somatosensory evoked potentials' amplitude at contralateral stimulation was smaller than at ipsilateral stimulation 5 minutes after CSB. Cervical sympathetic block prolongs the latency and reduces the amplitude of trigeminal somatosensory evoked potentials on the contralateral side.

  13. [Bereavement and complicated grief: towards a definition of Prolonged Grief Disorder for DSM-5].

    PubMed

    Lombardo, Luigi; Lai, Carlo; Luciani, Massimiliano; Morelli, Emanuela; Buttinelli, Elena; Aceto, Paola; Lai, Silvia; D'Onofrio, Marianna; Galli, Federico; Bellizzi, Fernando; Penco, Italo

    2014-01-01

    Mourning is a natural response to a loss and a condition which most people experience several times during their lives. Most individuals adjust adequately to the loss of a relative, neverthless, a small but noteworthy proportion of bereaved individuals experience a syndrome of prolonged psychological distress in relation to bereavement. Prolonged distress and disability in connection with bereavement has been termed Complicated Grief (CG) or Prolonged Grief Disorder (PGD). The purpose of this paper is to analyze the literature on loss and mourning making a review of the main studies published between 1993 and 2013, identified through a search conducted on Medline/PubMed, in order to describe the epidemiological and clinical aspects of "normal" grief and "complicated" grief, pointing out the path of the clinical definition of PGD and proposed diagnostic criteria for inclusion in the next edition of the Diagnostic and Statistic Manual of Mental Disorders, Fifth edition (DSM-5). The two main diagnostic systems proposed by Horowitz and Prigerson are also compared.

  14. Effectiveness of SmartGuard Technology in the Prevention of Nocturnal Hypoglycemia After Prolonged Physical Activity.

    PubMed

    Petruzelkova, Lenka; Pickova, Klara; Sumnik, Zdenek; Soupal, Jan; Obermannova, Barbora

    2017-05-01

    The prevention of postexercise nocturnal hypoglycemia after prolonged physical activity using sensor-augmented pump (SAP) therapy with predictive low-glucose management (PLGM) has not been well studied. We conducted a study at a pediatric diabetes camp to determine whether a SAP with PLGM reduces the frequency of nocturnal hypoglycemia after prolonged physical activity more effectively than a SAP with a carbohydrate intake algorithm. During a 1-week sport camp, 20 children (aged 10-13 years) with type 1 diabetes (T1D) managed by SAP therapy either with (n = 7) or without PLGM (n = 13) were studied. The hypoglycemia management strategy and the continuous glucose monitoring (CGM)/PLGM settings were standardized. The incidence, severity, and duration of hypoglycemia and carbohydrate intake were documented and compared. The PLGM system was activated on 78% of all nights (once per night on average). No difference was found between the SAP and PLGM groups in the mean overnight glucose curve or mean morning glucose (7.8 ± 2 mmol/L vs. 7.4 ± 3 mmol/L). There was no difference in the frequency and severity of hypoglycemia. However, the SAP group consumed significantly more carbohydrates to prevent and treat hypoglycemia than those in the PLGM group; the values were 10 ± 2 and 1 ± 2 gS (P < 0.0001) in the SAP and PLGM groups, respectively. Moreover, the SAP group spent a significantly longer time in hypoglycemia (64 ± 2 min vs. 38 ± 2 min, P < 0.05). We observed a difference in the time distribution of nocturnal hypoglycemia (10 to 12 p.m. in the PLGM group and 3 to 7 a.m. in the SAP group, P < 0.05). With PLGM system, euglycemia after prolonged physical activity was largely maintained with a minimal carbohydrate intake.

  15. Effects of prolonged and exclusive breastfeeding on child behavior and maternal adjustment: evidence from a large, randomized trial.

    PubMed

    Kramer, Michael S; Fombonne, Eric; Igumnov, Sergei; Vanilovich, Irina; Matush, Lidia; Mironova, Elena; Bogdanovich, Natalia; Tremblay, Richard E; Chalmers, Beverley; Zhang, Xun; Platt, Robert W

    2008-03-01

    The objective of this study was to assess the long-term effects of breastfeeding on child behavior and maternal adjustment. We followed up children who were in the Promotion of Breastfeeding Intervention Trial, a cluster-randomized trial of a breastfeeding promotion intervention based on the World Health Organization/United Nations Children's Fund Baby-Friendly Hospital Initiative. A total of 17,046 healthy, breastfeeding mother-infant pairs were enrolled from 31 Belarussian maternity hospitals and affiliated polyclinics; 13,889 (81.5%) were followed up at 6.5 years. Mothers and teachers completed the Strengths and Difficulties Questionnaire and supplemental questions bearing on internalizing and externalizing behavioral problems. Mothers also responded to questions concerning their relationships to their partner and child and their breastfeeding of subsequently born children. The experimental intervention led to a large increase in exclusive breastfeeding at 3 months (43.3% vs 6.4%) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. No significant treatment effects were observed on either the mother or the teacher Strengths and Difficulties Questionnaire ratings of total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, or prosocial behavior or on the supplemental behavioral questions. We found no evidence of treatment effects on the parent's marriage or on the mother's satisfaction with her relationships with her partner or child, but the experimental intervention significantly increased the duration of any breastfeeding, and mothers in the experimental group were nearly twice as likely to breastfeed exclusively the next-born child for at least 3 months. On the basis of the largest randomized trial ever conducted in the area of human lactation, we found no evidence of risks or benefits of prolonged and exclusive breastfeeding for child and maternal behavior. Breastfeeding promotion

  16. Brain glycogen decreases during prolonged exercise

    PubMed Central

    Matsui, Takashi; Soya, Shingo; Okamoto, Masahiro; Ichitani, Yukio; Kawanaka, Kentaro; Soya, Hideaki

    2011-01-01

    Abstract Brain glycogen could be a critical energy source for brain activity when the glucose supply from the blood is inadequate (hypoglycaemia). Although untested, it is hypothesized that during prolonged exhaustive exercise that induces hypoglycaemia and muscular glycogen depletion, the resultant hypoglycaemia may cause a decrease in brain glycogen. Here, we tested this hypothesis and also investigated the possible involvement of brain monoamines with the reduced levels of brain glycogen. For this purpose, we exercised male Wistar rats on a treadmill for different durations (30–120 min) at moderate intensity (20 m min−1) and measured their brain glycogen levels using high-power microwave irradiation (10 kW). At the end of 30 and 60 min of running, the brain glycogen levels remained unchanged from resting levels, but liver and muscle glycogen decreased. After 120 min of running, the glycogen levels decreased significantly by ∼37–60% in five discrete brain loci (the cerebellum 60%, cortex 48%, hippocampus 43%, brainstem 37% and hypothalamus 34%) compared to those of the sedentary control. The brain glycogen levels in all five regions after running were positively correlated with the respective blood and brain glucose levels. Further, in the cortex, the levels of methoxyhydroxyphenylglycol (MHPG) and 5-hydroxyindoleacetic acid (5-HIAA), potential involved in degradation of the brain glycogen, increased during prolonged exercise and negatively correlated with the glycogen levels. These results support the hypothesis that brain glycogen could decrease with prolonged exhaustive exercise. Increased monoamines together with hypoglycaemia should be associated with the development of decreased brain glycogen, suggesting a new clue towards the understanding of central fatigue during prolonged exercise. PMID:21521757

  17. QT Prolongation, Torsades de Pointes, and Psychotropic Medications: A 5-Year Update.

    PubMed

    Beach, Scott R; Celano, Christopher M; Sugrue, Alan M; Adams, Caitlin; Ackerman, Michael J; Noseworthy, Peter A; Huffman, Jeff C

    Some psychotropic medications have been associated with prolongation of the QT interval and QT prolongation, especially in those with medical illness, and are linked to lethal ventricular arrhythmias, such as Torsades de Pointes (TdP). In 2013, we published a review of QT prolongation, TdP, and psychotropic medications. We provide an update over the past 5 years on the specific concerns most relevant to clinicians who see medically ill patients. In this nonsystematic review, we aimed to carefully and intensively identify new articles by utilizing a structured PubMed search from 2012-present. QT prolongation remains an imperfect, though well-established marker of risk for TdP. Among antidepressant medications, citalopram does appear to prolong the QT interval more than other selective serotonin reuptake inhibitors, though the clinical significance of this prolongation remains unclear. Escitalopram appears to prolong the QT interval to a lesser extent. Haloperidol carries a risk for QT prolongation, but the assertion that intravenous haloperidol is inherently riskier may be confounded by its primary use in medically ill populations. Among atypical antipsychotic agents, ziprasidone-and possibly iloperidone-is associated with the greatest QT prolongation, whereas aripiprazole appears safest from this standpoint. The evidence for clinically meaningful QT prolongation with most classes of psychiatric agents remains minimal. The most important risk-reducing intervention clinicians can make is undertaking a careful analysis of other QT risk factors when prescribing psychiatric medications. Copyright © 2017 Academy of Consultation-Liaison Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Observational intensity bias associated with illness adjustment: cross sectional analysis of insurance claims

    PubMed Central

    Staiger, Douglas O; Sharp, Sandra M; Gottlieb, Daniel J; Bevan, Gwyn; McPherson, Klim; Welch, H Gilbert

    2013-01-01

    Objective To determine the bias associated with frequency of visits by physicians in adjusting for illness, using diagnoses recorded in administrative databases. Setting Claims data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in the United States in 2007 (n=5 153 877). Main outcome measures The effect of illness adjustment on regional mortality and spending rates using standard and visit corrected illness methods for adjustment. The standard method adjusts using comorbidity measures based on diagnoses listed in administrative databases; the modified method corrects these measures for the frequency of visits by physicians. Three conventions for measuring comorbidity are used: the Charlson comorbidity index, Iezzoni chronic conditions, and hierarchical condition categories risk scores. Results The visit corrected Charlson comorbidity index explained more of the variation in age, sex, and race mortality across the 306 hospital referral regions than did the standard index (R2=0.21 v 0.11, P<0.001) and, compared with sex and race adjusted mortality, reduced regional variation, whereas adjustment using the standard Charlson comorbidity index increased it. Although visit corrected and age, sex, and race adjusted mortality rates were similar in hospital referral regions with the highest and lowest fifths of visits, adjustment using the standard index resulted in a rate that was 18% lower in the highest fifth (46.4 v 56.3 deaths per 1000, P<0.001). Age, sex, and race adjusted spending as well as visit corrected spending was more than 30% greater in the highest fifth of visits than in the lowest fifth, but only 12% greater after adjustment using the standard index. Similar results were obtained using the Iezzoni and the hierarchical condition categories conventions for measuring comorbidity. Conclusion The

  19. Do regional methods really help reduce uncertainties in flood frequency analyses?

    NASA Astrophysics Data System (ADS)

    Cong Nguyen, Chi; Payrastre, Olivier; Gaume, Eric

    2013-04-01

    Flood frequency analyses are often based on continuous measured series at gauge sites. However, the length of the available data sets is usually too short to provide reliable estimates of extreme design floods. To reduce the estimation uncertainties, the analyzed data sets have to be extended either in time, making use of historical and paleoflood data, or in space, merging data sets considered as statistically homogeneous to build large regional data samples. Nevertheless, the advantage of the regional analyses, the important increase of the size of the studied data sets, may be counterbalanced by the possible heterogeneities of the merged sets. The application and comparison of four different flood frequency analysis methods to two regions affected by flash floods in the south of France (Ardèche and Var) illustrates how this balance between the number of records and possible heterogeneities plays in real-world applications. The four tested methods are: (1) a local statistical analysis based on the existing series of measured discharges, (2) a local analysis valuating the existing information on historical floods, (3) a standard regional flood frequency analysis based on existing measured series at gauged sites and (4) a modified regional analysis including estimated extreme peak discharges at ungauged sites. Monte Carlo simulations are conducted to simulate a large number of discharge series with characteristics similar to the observed ones (type of statistical distributions, number of sites and records) to evaluate to which extent the results obtained on these case studies can be generalized. These two case studies indicate that even small statistical heterogeneities, which are not detected by the standard homogeneity tests implemented in regional flood frequency studies, may drastically limit the usefulness of such approaches. On the other hand, these result show that the valuation of information on extreme events, either historical flood events at gauged

  20. Does a 'tight' hamstring predict low back pain reporting during prolonged standing?

    PubMed

    Raftry, Sean M; Marshall, Paul W M

    2012-06-01

    The purpose of this study was to investigate the relationship between hamstring passive stiffness and extensibility in asymptomatic individuals with the reporting of low back pain during 2-h prolonged standing. Twenty healthy participants with no history of low back pain (mean±SD, age 22.6±2.7 years, height 1.74±0.09 m, weight 76.2±14.8 kg). Low back pain (VAS score; mm) was continuously monitored during 2-h prolonged standing. Hamstring extensibility, passive stiffness, and stretch tolerance were measured before and after prolonged standing using an instrumented straight leg raise (iSLR). Ten participants reported a clinically relevant increase (Δ VAS>10mm) in low back pain during prolonged standing. Hamstring extensiblity (leg°(max)), passive stiffness (Nm.°(-1)), and stretch tolerance (VAS; mm) were no different between pain developers and non-pain developers. No changes in hamstring measures were observed following 2-h prolonged standing. No relationship was observed in this study between measures of hamstring extensibility and the reporting of low back pain during prolonged standing. There is no evidence to recommend hamstring extensibility interventions (i.e. passive stretching) as a means of reducing pain reporting in occupations requiring prolonged standing. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Prolonged energy harvesting for ingestible devices.

    PubMed

    Nadeau, Phillip; El-Damak, Dina; Glettig, Dean; Kong, Yong Lin; Mo, Stacy; Cleveland, Cody; Booth, Lucas; Roxhed, Niclas; Langer, Robert; Chandrakasan, Anantha P; Traverso, Giovanni

    2017-01-01

    Ingestible electronics have revolutionized the standard of care for a variety of health conditions. Extending the capacity and safety of these devices, and reducing the costs of powering them, could enable broad deployment of prolonged monitoring systems for patients. Although prior biocompatible power harvesting systems for in vivo use have demonstrated short minute-long bursts of power from the stomach, not much is known about the capacity to power electronics in the longer term and throughout the gastrointestinal tract. Here, we report the design and operation of an energy-harvesting galvanic cell for continuous in vivo temperature sensing and wireless communication. The device delivered an average power of 0.23 μW per mm 2 of electrode area for an average of 6.1 days of temperature measurements in the gastrointestinal tract of pigs. This power-harvesting cell has the capacity to provide power for prolonged periods of time to the next generation of ingestible electronic devices located in the gastrointestinal tract.

  2. Reducing variable frequency vibrations in a powertrain system with an adaptive tuned vibration absorber group

    NASA Astrophysics Data System (ADS)

    Gao, Pu; Xiang, Changle; Liu, Hui; Zhou, Han

    2018-07-01

    Based on a multiple degrees of freedom dynamic model of a vehicle powertrain system, natural vibration analyses and sensitivity analyses of the eigenvalues are performed to determine the key inertia for each natural vibration of a powertrain system. Then, the results are used to optimize the installation position of each adaptive tuned vibration absorber. According to the relationship between the variable frequency torque excitation and the natural vibration of a powertrain system, the entire vibration frequency band is divided into segments, and the auxiliary vibration absorber and dominant vibration absorber are determined for each sensitive frequency band. The optimum parameters of the auxiliary vibration absorber are calculated based on the optimal frequency ratio and the optimal damping ratio of the passive vibration absorber. The instantaneous change state of the natural vibrations of a powertrain system with adaptive tuned vibration absorbers is studied, and the optimized start and stop tuning frequencies of the adaptive tuned vibration absorber are obtained. These frequencies can be translated into the optimum parameters of the dominant vibration absorber. Finally, the optimal tuning scheme for the adaptive tuned vibration absorber group, which can be used to reduce the variable frequency vibrations of a powertrain system, is proposed, and corresponding numerical simulations are performed. The simulation time history signals are transformed into three-dimensional information related to time, frequency and vibration energy via the Hilbert-Huang transform (HHT). A comprehensive time-frequency analysis is then conducted to verify that the optimal tuning scheme for the adaptive tuned vibration absorber group can significantly reduce the variable frequency vibrations of a powertrain system.

  3. Principles and frequency of self-adjustment of insulin dose in people with diabetes mellitus type 1 and correlation with markers of metabolic control.

    PubMed

    Kramer, Guido; Kuniss, Nadine; Kloos, Christof; Lehmann, Thomas; Müller, Nicolle; Wolf, Gunter; Lorkowski, Stefan; Müller, Ulrich A

    2016-06-01

    Insulin dose self-adjustment (ISA) to different blood glucose levels, carbohydrate intake, exercise or illness is a core element of structured education programmes for people with diabetes mellitus type 1 (DM1). The aim of this study was to register the patients' current principles and frequency of ISA and to check the ability for correct adjustments. 117 people with DM1 (mean HbA1c 7.1%, diabetes duration 24y) were interviewed in a tertiary care centre. The number of ISA was drawn from the last 28days of the patients' diary. The ability to find the correct insulin dose was assessed using five different calculation examples. All patients had participated in a structured education programme. Mean frequency of ISA was 72.1±29.4 per 28days. ISA by adjustment rules was used in 48% (56/117) and by personal experience or feeling in 44% (52/117). Patients adjusting by feeling were older, did less ISA and had lower social status. There were no differences in HbA1c (feeling 7.2±0.8 vs. rules 7.0±0.9, p=0.403), non severe hypoglycaemia (feeling 1.7±1.8 vs. rules 1.9±1.9, p=0.132) and comprehensibility of ISA between both groups. Overall, the participants answered on average 2.8±2.3 of the five calculation examples correctly. Although all people were trained to use a factor for correction for ISA in case of high premeal blood glucose levels, only half of the patients adjusted their insulin dosage using the complex rules from the treatment and education programme. Patients, who performed their ISA based upon feeling, did not show worse metabolic control. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. QTc prolongation after brain surgery.

    PubMed

    Capparelli, Federico J; Abello, Mauricio; Patricio Maskin, L; Arista, Eugenia; Hlavnicka, Alejandro; Diaz, Maria Fernanda; Varela, Daniel; Wainsztein, Nestor A

    2013-03-01

    Abnormalities observed in the electrocardiogram (ECG) after acute central nervous system (CNS) events have been reported. Our objective was to assess the incidence of heart rate-corrected QT interval (QTc) prolongation in patients admitted to the intensive care unit (ICU) after brain surgery. Admission standard 12-lead ECGs were analyzed blinded to patient data. The QT interval was measured and Bazzett's formula was used to obtain QTc. Prolonged QTc was defined as ≧450 ms. We included 114 patients in the study. The mean age was 49±17 years. Brain neoplasm was the surgical indication in 90% of the patients. The mean QTc was 470±42 ms. Prolonged QTc was found in 71% patients. The heart rate-corrected QT interval was between 450 ms and 500 ms in 52% and >500 ms in 19% of the patients. The heart rate and concentration of serum glucose were higher in the prolonged QTc group. Only 7·5% of all patients had hypokalemia (≤3 mEq/l). In the prolonged QTc group 9·2% had hypokalemia compared to 3·2% in normal QTc patients (P = 0·406). There were no significant associations between categories of QTc and the serum levels of creatinine, magnesium, calcium, sodium, or pH. Phenytoin and metoclopramide were not frequently used in patients with prolonged QTc. This study supports our hypothesis that prolonged QTc is frequently observed after a brain surgery. Hypokalemia, hypocalcaemia, and drugs such as metoclopramide or phenytoin could not explain the high incidence of prolonged QTc. Brain injury during a surgical procedure may be one of the primary causes of QTc prolongation after neurosurgery.

  5. Neuromuscular Fatigue during Prolonged Exercise in Hypoxia.

    PubMed

    Jubeau, Marc; Rupp, Thomas; Temesi, John; Perrey, Stéphane; Wuyam, Bernard; Millet, Guillaume Y; Verges, Samuel

    2017-03-01

    Prolonged cycling exercise performance in normoxia is limited because of both peripheral and central neuromuscular impairments. It has been reported that cerebral perturbations are greater during short-duration exercise in hypoxia compared with normoxia. The purpose of this study was to test the hypothesis that central deficits are accentuated in hypoxia compared with normoxia during prolonged (three bouts of 80 min separated by 25 min) whole-body exercise at the same relative intensity. Ten subjects performed two sessions consisting of three 80-min cycling bouts at 45% of their relative maximal aerobic power in normoxia and hypoxia (FiO2 = 0.12). Before exercise and after each bout, maximal voluntary force, voluntary activation assessed with nerve stimulation and transcranial magnetic stimulation, corticospinal excitability (motor evoked potential), intracortical inhibition (cortical silent period), and electrical (M-wave) and contractile (twitch and doublet peak forces) properties of the knee extensors were measured. Prefrontal and motor cortical oxygenation was also recorded during each cycling bout in both conditions. A significant but similar force reduction (≈-22%) was observed at the end of exercise in normoxia and hypoxia. The modifications of voluntary activation assessed with transcranial magnetic stimulation and nerve stimulation, motor evoked potential, cortical silent period, and M-wave were also similar in both conditions. However, cerebral oxygenation was reduced in hypoxia compared with normoxia. These findings show that when performed at the same relative low intensity, prolonged exercise does not induce greater supraspinal fatigue in hypoxia compared with normoxia. Despite lower absolute exercise intensities in hypoxia, reduced brain O2 availability might contribute to similar amounts of central fatigue compared with normoxia.

  6. Low-intensity electromagnetic irradiation of 70.6 and 73 GHz frequencies enhances the effects of disulfide bonds reducer on Escherichia coli growth and affects the bacterial surface oxidation-reduction state.

    PubMed

    Torgomyan, Heghine; Trchounian, Armen

    2011-10-14

    Low-intensity electromagnetic irradiation (EMI) of 70.6 and 73 GHz frequencies (flux capacity - 0.06 mW cm(-2)) had bactericidal effects on Escherichia coli. This EMI (1h) exposure suppressed the growth of E. coli K-12(λ). The pH value (6.0-8.0) did not significantly affect the growth. The lag-phase duration was prolonged, and the growth specific rate was inhibited, and these effects were more noticeable after 73 GHz irradiation. These effects were enhanced by the addition of DL-dithiothreitol (DTT), a strong reducer of disulfide bonds in surface membrane proteins, which in its turn also has bactericidal effect. Further, the number of accessible SH-groups in membrane vesicles was markedly decreased by EMI that was augmented by N,N'-dicyclohexycarbodiimide and DTT. These results indicate a change in the oxidation-reduction state of bacterial cell membrane proteins that could be the primary membranous mechanism in the bactericidal effects of low-intensity EMI of the 70.6 and 73 GHz frequencies. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. The relationship between frequency of family dinner and adolescent problem behaviors after adjusting for other family characteristics.

    PubMed

    Sen, Bisakha

    2010-02-01

    To examine the association between frequency of family dinners (FFD) and selected problem behaviors for adolescents after adjusting for family connectedness, parental awareness, other family activities, and other potentially confounding factors. Data are drawn from the National Longitudinal Survey of Youth, 1997. The primary variable of interest is self-reported FFD in a typical week. Problem behaviors studied are substance-use, physical violence, property-destruction, stealing, running away from home, andgang membership. Multivariate logistic models are estimated for each behaviors. Linear regression models are estimated for behavior-frequency for the sub-samples engaging in them. Analysis is done separately by gender. FFD is negatively associated with substance-use and running away for females; drinking, physical violence, property-destruction, stealing and running away for males. Family meals are negatively associated to certain problem behaviors for adolescents even after controlling rigorously for potentially confounding factors. Thus, programs that promote family meals are beneficial. Copyright (c) 2009 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  8. [Causation between occupational prolonged standing time during progestation and pregnancy related complications].

    PubMed

    Weng, Ting-ting; Xu, Ye-qing; Yan, Shuang-qin; Pan, Wei-jun; Tao, Fang-biao

    2013-06-01

    To describe the epidemiological characteristics of profession related long-standing behavior during preconception and progestation, and to probe the relationship between prolonged standing jobs and the common pregnancy related complications among pregnant women, in Ma' anshan city,Anhui province. In this cohort study, subjects who had their first antenatal examination at Ma' anshan Maternal and Child Care Centers were recruited under informed consent, from October 2008 to October 2010. All the information were collected through questionnaires in the first, second and third trimesters respectively. Three questionnaires were filled in by subjects under the guidance of healthcare takers. In the study, the 75(th) percentile of prolonged-standing times were 4.0 h/d and 3.0 h/d respectively in preconception and progestation. The characteristics of pregnant women with low social/economic status, prone to be involved in stand-long occupation. Results in logistic regression analysis, prolonged-standing jobs during preconception was the risk factor of pregnancy-induced hypertension and severe anemia. The adjusted odds ratios were 2.05 (95%CI:1.26-3.31) and 1.38(95%CI:1.03-1.85)respectively. Prolonged standing jobs appeared to be common occupational exposure to and risks of both pregnant woman and their fetus. Exposure to these kinds of jobs during preconception could increase the risk of pregnancy-induced hypertension and severe anemia. In order to promote maternal health programs, all the related occupational risk factors should be valued and avoided during preconception and pregnancy.

  9. A proposed adjustable RF cable connector

    NASA Technical Reports Server (NTRS)

    Stringer, E. J.; Doyle, J. D.

    1973-01-01

    In system that requires negligible loss, it may be necessary to adjust cable length to exact multiple of transmitted wavelength. Adjustable cable connector saves time and cost by eliminating need to add to or cut from cable. Device was especially designed for use with high frequencies. For particular application, connector of suitable dimensions should be used.

  10. Maximum Dynamic Lower-Limb Strength Was Maintained During 24-Week Reduced Training Frequency in Previously Sedentary Older Women.

    PubMed

    Walker, Simon; Serrano, Javier; Van Roie, Evelien

    2018-04-01

    Walker, S, Serrano, J, and Van Roie, E. Maximum dynamic lower-limb strength was maintained during 24-week reduced training frequency in previously sedentary older women. J Strength Cond Res 32(4): 1063-1071, 2018-There is little study into the effects of reducing strength training below the recommended twice weekly frequency, particularly in older women, despite the possibility that individuals will encounter periods of reduced training frequency. The purpose of the present study was to determine the effects of a period of reduced training frequency on maximum strength and muscle mass of the lower limbs in comparison with the recommended training frequency of twice per week. After an initial 12-week period, where all subjects trained twice per week, a reduced strength training group (RST) trained once per week, whereas another strength training group (ST) continued to train twice per week for 24 weeks. A nontraining age-matched control group (CON) was used for comparison. All subjects were tested for leg press 1-repetition maximum (1RM), electromyogram (EMG) amplitude of vastus lateralis and medialis, and quadriceps cross-sectional area (CSA) measured by panoramic ultrasound at weeks 0, 12, and 36. Both ST and RST continued to increase 1RM during the reduced training frequency period compared with control (∼8% and ∼5% vs. ∼-3%, respectively; p ≤ 0.05). Accompanying these changes were significant increases in EMG amplitude in both ST and RST (p ≤ 0.05). However, the initial gains in quadriceps CSA made from week 0 to week 12 in RST were lost when training once per week (RST ∼-5%). Therefore, reduced training frequency in this population does not adversely affect maximum strength or muscle activity but can negatively affect muscle mass, even reversing training-induced gains. Older individuals not training at least twice per week may compromise potential increases in muscle mass, important in counteracting effects of aging.

  11. Intraocular pressure and cerebral oxygenation during prolonged headward acceleration.

    PubMed

    Eiken, Ola; Keramidas, Michail E; Taylor, Nigel A S; Grönkvist, Mikael

    2017-01-01

    Supra-tolerance head-to-foot directed gravitoinertial load (+Gz) typically induces a sequence of symptoms/signs, including loss of: peripheral vision-central vision-consciousness. The risk of unconsciousness is greater when anti-G-garment failure occurs after prolonged rather than brief exposures, presumably because, in the former condition, mental signs are not consistently preceded by impaired vision. The aims were to investigate if prolonged exposure to moderately elevated +Gz reduces intraocular pressure (IOP; i.e., improves provisions for retinal perfusion), or the cerebral anoxia reserve. Subjects were exposed to 4-min +Gz plateaux either at 2 and 3 G (n = 10), or at 4 and 5 G (n = 12). Measurements included eye-level mean arterial pressure (MAP), oxygenation of the cerebral frontal cortex, and at 2 and 3 G, IOP. IOP was similar at 1 (14.1 ± 1.6 mmHg), 2 (14.0 ± 1.6 mmHg), and 3 G (14.0 ± 1.6 mmHg). During the G exposures, MAP exhibited an initial prompt drop followed by a partial recovery, end-exposure values being reduced by ≤30 mmHg. Cerebral oxygenation showed a similar initial drop, but without recovery, and was followed by either a plateau or a further slight decrement to a minimum of about -14 μM. Gz loading did not affect IOP. That cerebral oxygenation remained suppressed throughout these G exposures, despite a concomitant partial recovery of MAP, suggests that the increased risk of unconsciousness upon G-garment failure after prolonged +Gz exposure is due to reduced cerebral anoxia reserve.

  12. Ambient but not local lactate underlies neuronal tolerance to prolonged glucose deprivation

    PubMed Central

    Sobieski, Courtney; Shu, Hong-Jin

    2018-01-01

    Neurons require a nearly constant supply of ATP. Glucose is the predominant source of brain ATP, but the direct effects of prolonged glucose deprivation on neuronal viability and function remain unclear. In sparse rat hippocampal microcultures, neurons were surprisingly resilient to 16 h glucose removal in the absence of secondary excitotoxicity. Neuronal survival and synaptic transmission were unaffected by prolonged removal of exogenous glucose. Inhibition of lactate transport decreased microculture neuronal survival during concurrent glucose deprivation, suggesting that endogenously released lactate is important for tolerance to glucose deprivation. Tandem depolarization and glucose deprivation also reduced neuronal survival, and trace glucose concentrations afforded neuroprotection. Mass cultures, in contrast to microcultures, were insensitive to depolarizing glucose deprivation, a difference attributable to increased extracellular lactate levels. Removal of local astrocyte support did not reduce survival in response to glucose deprivation or alter evoked excitatory transmission, suggesting that on-demand, local lactate shuttling is not necessary for neuronal tolerance to prolonged glucose removal. Taken together, these data suggest that endogenously produced lactate available globally in the extracellular milieu sustains neurons in the absence of glucose. A better understanding of resilience mechanisms in reduced preparations could lead to therapeutic strategies aimed to bolster these mechanisms in vulnerable neuronal populations. PMID:29617444

  13. Interpersonal ambivalence, perceived relationship adjustment, and conjugal loss.

    PubMed

    Bonanno, G A; Notarius, C I; Gunzerath, L; Keltner, D; Horowitz, M J

    1998-12-01

    Ambivalence is widely assumed to prolong grief. To examine this hypothesis, the authors developed a measure of ambivalence based on an algorithmic combination of separate positive and negative evaluations of one's spouse. Preliminary construct validity was evidenced in relation to emotional difficulties and to facial expressions of emotion. Bereaved participants, relative to a nonbereaved comparison sample, recollected their relationships as better adjusted but were more ambivalent. Ambivalence about spouses was generally associated with increased distress and poorer perceived health but did not predict long-term grief outcome once initial outcome was controlled. In contrast, initial grief and distress predicted increased ambivalence and decreased Dyadic Adjustment Scale scores at 14 months postloss, regardless of initial scores on these measures. Limitations and implications of the findings are discussed.

  14. The role of nitric oxide synthase in reduced vasocontractile responsiveness induced by prolonged α1-adrenergic receptor stimulation in rat thoracic aorta

    PubMed Central

    Gürdal, Hakan; Can, Alp; Uğur, Mehmet

    2005-01-01

    Prolonged exposure (6–12 h) of rat aorta to alpha1-adrenergic receptor (α1AR) agonist phenylephrine (Phe) leads to a decrease in α1AR-mediated vasoconstriction. This reduced responsiveness to α1AR stimulation was strongly dependent on the intactness of the endothelium. We examined the effect of Phe on nitric oxide synthase (NOS) activity by measuring the conversion of [3H]L-arginine to [3H]L-citrulline in rat aorta or in endothelial cells isolated from rat aorta. Phe stimulation increased NOS activity in control aortas. This response was antagonized by prazosin. However, Phe increased neither the activity of NOS nor intracellular Ca2+ in the isolated endothelial cells from the control aortas, whereas acetylcholine (Ach) was able to stimulate both responses in these cells. This result suggests that Phe stimulates α1AR on vascular smooth muscle cells and has an indirect influence on endothelial cells to increase NOS activity. In Phe-exposed aortic rings, basal NOS activity was found to have increased compared to vehicle-exposed control rings. Stimulation with Phe or Ach caused a small increase over basal NOS activity in these preparations. Prolonged exposure to Phe also caused an enhancement of Ach-mediated vasorelaxation in rat aorta. Immunoblot and reverse transcription–polymerase chain reaction experiments showed that prolonged exposure of rat aorta to Phe resulted in an increased expression of eNOS, but not iNOS. This increase was antagonized by nonselective antagonist prazosin. Immunohistochemical staining experiments also showed that expression of eNOS increased in endothelial cells after Phe exposure of the aortas. These results, all together, showed that prolonged exposure of rat aorta to α1AR agonist Phe enhanced the expression of eNOS and basal NOS activity, which probably causes a decreased vasocontractile response to Phe or to other agonists such as 5HT (5-hydroxytryptamine) in rat aorta. This phenomenon can be considered more as a functional

  15. Tetrodotoxin-Bupivacaine-Epinephrine Combinations for Prolonged Local Anesthesia

    PubMed Central

    Berde, Charles B.; Athiraman, Umeshkumar; Yahalom, Barak; Zurakowski, David; Corfas, Gabriel; Bognet, Christina

    2011-01-01

    Currently available local anesthetics have analgesic durations in humans generally less than 12 hours. Prolonged-duration local anesthetics will be useful for postoperative analgesia. Previous studies showed that in rats, combinations of tetrodotoxin (TTX) with bupivacaine had supra-additive effects on sciatic block durations. In those studies, epinephrine combined with TTX prolonged blocks more than 10-fold, while reducing systemic toxicity. TTX, formulated as Tectin, is in phase III clinical trials as an injectable systemic analgesic for chronic cancer pain. Here, we examine dose-duration relationships and sciatic nerve histology following local nerve blocks with combinations of Tectin with bupivacaine 0.25% (2.5 mg/mL) solutions, with or without epinephrine 5 µg/mL (1:200,000) in rats. Percutaneous sciatic blockade was performed in Sprague-Dawley rats, and intensity and duration of sensory blockade was tested blindly with different Tectin-bupivacaine-epinephrine combinations. Between-group comparisons were analyzed using ANOVA and post-hoc Sidak tests. Nerves were examined blindly for signs of injury. Blocks containing bupivacaine 0.25% with Tectin 10 µM and epinephrine 5 µg/mL were prolonged by roughly 3-fold compared to blocks with bupivacaine 0.25% plain (P < 0.001) or bupivacaine 0.25% with epinephrine 5 µg/mL (P < 0.001). Nerve histology was benign for all groups. Combinations of Tectin in bupivacaine 0.25% with epinephrine 5 µg/mL appear promising for prolonged duration of local anesthesia. PMID:22363247

  16. Tetrodotoxin-bupivacaine-epinephrine combinations for prolonged local anesthesia.

    PubMed

    Berde, Charles B; Athiraman, Umeshkumar; Yahalom, Barak; Zurakowski, David; Corfas, Gabriel; Bognet, Christina

    2011-12-01

    Currently available local anesthetics have analgesic durations in humans generally less than 12 hours. Prolonged-duration local anesthetics will be useful for postoperative analgesia. Previous studies showed that in rats, combinations of tetrodotoxin (TTX) with bupivacaine had supra-additive effects on sciatic block durations. In those studies, epinephrine combined with TTX prolonged blocks more than 10-fold, while reducing systemic toxicity. TTX, formulated as Tectin, is in phase III clinical trials as an injectable systemic analgesic for chronic cancer pain. Here, we examine dose-duration relationships and sciatic nerve histology following local nerve blocks with combinations of Tectin with bupivacaine 0.25% (2.5 mg/mL) solutions, with or without epinephrine 5 µg/mL (1:200,000) in rats. Percutaneous sciatic blockade was performed in Sprague-Dawley rats, and intensity and duration of sensory blockade was tested blindly with different Tectin-bupivacaine-epinephrine combinations. Between-group comparisons were analyzed using ANOVA and post-hoc Sidak tests. Nerves were examined blindly for signs of injury. Blocks containing bupivacaine 0.25% with Tectin 10 µM and epinephrine 5 µg/mL were prolonged by roughly 3-fold compared to blocks with bupivacaine 0.25% plain (P < 0.001) or bupivacaine 0.25% with epinephrine 5 µg/mL (P < 0.001). Nerve histology was benign for all groups. Combinations of Tectin in bupivacaine 0.25% with epinephrine 5 µg/mL appear promising for prolonged duration of local anesthesia.

  17. Digital frequency-offset detector

    NASA Technical Reports Server (NTRS)

    Bogart, R. W.; Juengst, M. J.

    1977-01-01

    Simple, low-cost device with designer-selectable tolerances provides accurate frequency comparison with minimal circuitry and ease of adjustment. Warning alerts if frequencies being compared fall outside selected tolerance. Device can be applied to any electronic system where accurate timing or frequency control is important.

  18. Corneal targeted nanoparticles for sustained natamycin delivery and their PK/PD indices: an approach to reduce dose and dosing frequency.

    PubMed

    Chandasana, Hardik; Prasad, Yarra Durga; Chhonker, Yashpal S; Chaitanya, Telaprolu K; Mishra, Nripendra N; Mitra, Kalyan; Shukla, Praveen K; Bhatta, Rabi S

    2014-12-30

    Natamycin is the only approved medication for the treatment of mycotic keratitis. Current dosage regimen include one drop of natamycin suspension (5% w/v) instilled in the conjunctival sac at hourly or two hourly intervals for several days which has poor patient compliance. The purpose of the present study was to design a corneal targeted nanoformulation in order to reduce dose and dosing frequency of natamycin and evaluate its pharmacokinetic/pharmacodynamic indices in comparison with clinical marketed preparation. The nanoparticles prepared by nanoprecipitation method were in nanometer size range with high entrapment efficiency and positive surface charge. In-vitro release studies indicated prolonged release of natamycin up to 8h. In-vitro antifungal activity was comparable with marketed preparation. The performance of nanoformulations was evaluated in rabbit eyes. The concentration of natamycin in tear fluid was determined by using LC-MS/MS. The pharmacokinetic parameters such as area under the curve, t½ and mean residence time were significantly higher and clearance was significantly lower for nanoformulations with that of marketed preparation. The optimized dosing schedule to maintain natamycin concentration above tenfold of MIC90 was one instillation in every 5h. Moreover, 1/5th dose reduction of nanoformulation was also effective. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Active shielding to reduce low frequency disturbances in direct current near biomagnetic measurements

    NASA Astrophysics Data System (ADS)

    Platzek, D.; Nowak, H.; Giessler, F.; Röther, J.; Eiselt, M.

    1999-05-01

    Measurements of dc near biomagnetic fields are disturbed by low frequency noise that is not reduced sufficiently by most of the magnetically shielded rooms or gradiometers. For this reason an active shielding system has been developed at the Biomagnetic Center of the University of Jena. This work describes the principle of the active shielding system and demonstrates its properties concerning the attenuation of disturbing fields, frequency range, and some applications in biomedical measurements. We achieved a reduction of external low frequency magnetic fields by more than 50 dB and an attenuation of the field gradient by about 25 dB. This active shielding enables measurements of near dc biomagnetic fields in investigations of periinfarct depolarizations after ischemic stroke and spreading depression in migraine patients.

  20. Conservation of body calcium by increased dietary intake of potassium: A potential measure to reduce the osteoporosis process during prolonged exposure to microgravity

    NASA Technical Reports Server (NTRS)

    Nechay, Bohdan R.

    1989-01-01

    During the 1988 NASA Summer Faculty Fellowship Program, it was proposed that the loss of skeletal calcium upon prolonged exposure to microgravity could be explained, in part, by a renal maladjustment characterized by an increased urinary excretion of calcium. It was theorized that because the conservation of body fluids and electrolytes depends upon the energy of adenosine triphosphate and enzymes that control the use of its energy for renal ion transport, an induction of renal sodium and potassium-dependent adenosine triphosphatase (Na + K ATPase) by oral loading with potassium would increase the reabsorption of sodium directly and that of calcium indirectly, leading to improved hydration and to reduced calcium loss. Preliminary studies showed the following. Rats drinking water containing 0.2 M potassium chloride for six to 13 days excreted in urine 22 muEq of calcium and 135 muEq of sodium per 100 grams of body weight per day. The corresponding values for control rats drinking tap water were 43 muEq and 269 muEq respectively. Renal Na + K ATPase activity in potassium loaded rats was higher than in controls. Thus, oral potassium loading resulted in increased Na + K ATPase activity and diminished urinary excretion of calcium and of sodium as predicted by the hypothesis. An extension of these studies to humans has the potential of resulting in development of harmless, non-invasive, drug-free, convenient measures to reduce bone loss and other electrolyte and fluid problems in space travelers exposed to prolonged periods of microgravity.

  1. Digital slip frequency generator and method for determining the desired slip frequency

    DOEpatents

    Klein, Frederick F.

    1989-01-01

    The output frequency of an electric power generator is kept constant with variable rotor speed by automatic adjustment of the excitation slip frequency. The invention features a digital slip frequency generator which provides sine and cosine waveforms from a look-up table, which are combined with real and reactive power output of the power generator.

  2. School-Based Racial and Gender Discrimination among African American Adolescents: Exploring Gender Variation in Frequency and Implications for Adjustment.

    PubMed

    Cogburn, Courtney D; Chavous, Tabbye M; Griffin, Tiffany M

    2011-01-03

    The present study examined school-based racial and gender discrimination experiences among African American adolescents in Grade 8 (n = 204 girls; n = 209 boys). A primary goal was exploring gender variation in frequency of both types of discrimination and associations of discrimination with academic and psychological functioning among girls and boys. Girls and boys did not vary in reported racial discrimination frequency, but boys reported more gender discrimination experiences. Multiple regression analyses within gender groups indicated that among girls and boys, racial discrimination and gender discrimination predicted higher depressive symptoms and school importance and racial discrimination predicted self-esteem. Racial and gender discrimination were also negatively associated with grade point average among boys but were not significantly associated in girls' analyses. Significant gender discrimination X racial discrimination interactions resulted in the girls' models predicting psychological outcomes and in boys' models predicting academic achievement. Taken together, findings suggest the importance of considering gender- and race-related experiences in understanding academic and psychological adjustment among African American adolescents.

  3. Predictive Analytics for Identification of Patients at Risk for QT Interval Prolongation - A Systematic Review.

    PubMed

    Tomaselli Muensterman, Elena; Tisdale, James E

    2018-06-08

    Prolongation of the heart rate-corrected QT (QTc) interval increases the risk for torsades de pointes (TdP), a potentially fatal arrhythmia. The likelihood of TdP is higher in patients with risk factors, which include female sex, older age, heart failure with reduced ejection fraction, hypokalemia, hypomagnesemia, concomitant administration of ≥ 2 QTc interval-prolonging medications, among others. Assessment and quantification of risk factors may facilitate prediction of patients at highest risk for developing QTc interval prolongation and TdP. Investigators have utilized the field of predictive analytics, which generates predictions using techniques including data mining, modeling, machine learning, and others, to develop methods of risk quantification and prediction of QTc interval prolongation. Predictive analytics have also been incorporated into clinical decision support (CDS) tools to alert clinicians regarding patients at increased risk of developing QTc interval prolongation. The objectives of this paper are to assess the effectiveness of predictive analytics for identification of patients at risk of drug-induced QTc interval prolongation, and to discuss the efficacy of incorporation of predictive analytics into CDS tools in clinical practice. A systematic review of English language articles (human subjects only) was performed, yielding 57 articles, with an additional 4 articles identified from other sources; a total of 10 articles were included in this review. Risk scores for QTc interval prolongation have been developed in various patient populations including those in cardiac intensive care units (ICUs) and in broader populations of hospitalized or health system patients. One group developed a risk score that includes information regarding genetic polymorphisms; this score significantly predicted TdP. Development of QTc interval prolongation risk prediction models and incorporation of these models into CDS tools reduces the risk of QTc interval

  4. Huntington disease reduced penetrance alleles occur at high frequency in the general population

    PubMed Central

    Kay, Chris; Collins, Jennifer A.; Miedzybrodzka, Zosia; Madore, Steven J.; Gordon, Erynn S.; Gerry, Norman; Davidson, Mark; Slama, Ramy A.

    2016-01-01

    Objective: To directly estimate the frequency and penetrance of CAG repeat alleles associated with Huntington disease (HD) in the general population. Methods: CAG repeat length was evaluated in 7,315 individuals from 3 population-based cohorts from British Columbia, the United States, and Scotland. The frequency of ≥36 CAG alleles was assessed out of a total of 14,630 alleles. The general population frequency of reduced penetrance alleles (36–39 CAG) was compared to the prevalence of patients with HD with genetically confirmed 36–39 CAG from a multisource clinical ascertainment in British Columbia, Canada. The penetrance of 36–38 CAG repeat alleles for HD was estimated for individuals ≥65 years of age and compared against previously reported clinical penetrance estimates. Results: A total of 18 of 7,315 individuals had ≥36 CAG, revealing that approximately 1 in 400 individuals from the general population have an expanded CAG repeat associated with HD (0.246%). Individuals with CAG 36–37 genotypes are the most common (36, 0.096%; 37, 0.082%; 38, 0.027%; 39, 0.000%; ≥40, 0.041%). General population CAG 36–38 penetrance rates are lower than penetrance rates extrapolated from clinical cohorts. Conclusion: HD alleles with a CAG repeat length of 36–38 occur at high frequency in the general population. The infrequent diagnosis of HD at this CAG length is likely due to low penetrance. Another important contributing factor may be reduced ascertainment of HD in those of older age. PMID:27335115

  5. Cocktail of Superoxide Dismutase and Fasudil Encapsulated in Targeted Liposomes Slows PAH Progression at a Reduced Dosing Frequency.

    PubMed

    Gupta, Nilesh; Rashid, Jahidur; Nozik-Grayck, Eva; McMurtry, Ivan F; Stenmark, Kurt R; Ahsan, Fakhrul

    2017-03-06

    Currently, two or more pulmonary vasodilators are used to treat pulmonary arterial hypertension (PAH), but conventional vasodilators alone cannot reverse disease progression. In this study, we tested the hypothesis that a combination therapy comprising a vasodilator plus a therapeutic agent that slows pulmonary arterial remodeling and right heart hypertrophy is an efficacious alternative to current vasodilator-based PAH therapy. Thus, we encapsulated a cocktail of superoxide dismutase (SOD), a superoxide scavenger, and fasudil, a specific rho-kinase inhibitor, into a liposomal formulation equipped with a homing peptide, CAR. We evaluated the effect of the formulations on pulmonary hemodynamics in monocrotaline-induced PAH rats (MCT-induced PAH) and assessed the formulation's efficacy in slowing the disease progression in Sugen-5416/hypoxia-induced PAH rats (SU/hypoxia-induced PAH). For acute studies, we monitored both mean pulmonary and systemic arterial pressures (mPAP and mSAP) for 2 to 6 h after a single dose of the plain drugs or formulations. In chronic studies, PAH rats received plain drugs every 48 h and the formulations every 72 h for 21 days. In MCT-induced PAH rats, CAR-modified liposomes containing fasudil plus SOD elicited a more pronounced, prolonged, and selective reduction in mPAP than unmodified liposomes and plain drugs did. In SU/hypoxia-induced PAH rats, the formulation produced a >50% reduction in mPAP and slowed right ventricular hypertrophy. When compared with individual plain drugs or combination, CAR-modified-liposomes containing both drugs reduced the extent of collagen deposition, muscularization of arteries, increased SOD levels in the lungs, and decreased the expression of pSTAT-3 and p-MYPT1. Overall, CAR-modified-liposomes of SOD plus fasudil, given every 72 h, was as efficacious as plain drugs, given every 48 h, suggesting that the formulation can reduce the total drug intake, systemic exposures, and dosing frequency.

  6. Inhibition of the purinergic pathway prolongs mouse lung allograft survival.

    PubMed

    Liu, Kaifeng; Vergani, Andrea; Zhao, Picheng; Ben Nasr, Moufida; Wu, Xiao; Iken, Khadija; Jiang, Dawei; Su, Xiaofeng; Fotino, Carmen; Fiorina, Paolo; Visner, Gary A

    2014-08-01

    Lung transplantation has limited survival with current immunosuppression. ATP is released from activated T cells, which act as costimulatory molecules through binding to the purinergic receptor P2XR7. We investigated the role of blocking the ATP/purinergic pathway, primarily P2XR7, using its inhibitor oxidized ATP (oATP) in modulating rejection of mouse lung allografts. Mouse lung transplants were performed using mice with major histocompatibility complex mismatch, BALB/c to C57BL6. Recipients received suramin or oATP, and lung allografts were evaluated 15 to ≥ 60 days after transplantation. Recipients were also treated with oATP after the onset of moderate to severe rejection to determine its ability to rescue lung allografts. Outcomes measures included lung function, histology, thoracic imaging, and allo-immune responses. Blocking purinergic receptors with the nonselective inhibitor suramin or with the P2XR7-selective inhibitor oATP reduced acute rejection and prolonged lung allograft survival for ≥ 60 days with no progression in severity. There were fewer inflammatory cells within lung allografts, less rejection, and improved lung function, which was maintained over time. CD4 and CD8 T cells were reduced within lung allografts with impaired activation with prolonged impairment of CD8 responses. In vitro, oATP reduced CD8 activation of Th1 inflammatory cytokines IFN-γ and TNF-α and cytolytic machinery, granzyme B. Cotreatment with immunosuppressive agents, cyclosporine, rapamycin, or CTLA-4Ig resulted in no additive benefits, and oATP alone resulted in better outcomes than cyclosporine alone. This study illustrates a potential new pathway to target in hopes of prolonging survival of lung transplant recipients.

  7. The ability of exogenous growth hormone to maintain milk production during prolonged lactation in the mouse is more evident with reduced nursing frequency

    USDA-ARS?s Scientific Manuscript database

    Although growth hormone (GH) increases milk production in dairy animals, the milk production response of lactating rodents to this treatment has been variable. Milk removal frequency in the lactating mouse is about 10-fold higher than that of lactating dairy cows. The hypothesis tested in this study...

  8. An improved accrual: reducing medical malpractice year-end adjustments.

    PubMed

    Frese, Richard C

    2012-08-01

    Healthcare organizations can improve their year-end malpractice insurance accruals by taking the following steps: Maintain productive communication. Match accrual and accounting policies. Adjust amount of credit to own historical loss experience. Request more frequent analysis. Obtain a second opinion.

  9. Prolonged sedentary time and physical activity in workplace and non-work contexts: a cross-sectional study of office, customer service and call centre employees.

    PubMed

    Thorp, Alicia A; Healy, Genevieve N; Winkler, Elisabeth; Clark, Bronwyn K; Gardiner, Paul A; Owen, Neville; Dunstan, David W

    2012-10-26

    To examine sedentary time, prolonged sedentary bouts and physical activity in Australian employees from different workplace settings, within work and non-work contexts. A convenience sample of 193 employees working in offices (131), call centres (36) and customer service (26) was recruited. Actigraph GT1M accelerometers were used to derive percentages of time spent sedentary (<100 counts per minute; cpm), in prolonged sedentary bouts (≥20 minutes or ≥30 minutes), light-intensity activity (100-1951 cpm) and moderate-to-vigorous physical activity (MVPA; ≥1952 cpm). Using mixed models adjusted for confounders, these were compared for: work days versus non-work days; work hours versus non-work hours (work days only); and, across workplace settings. Working hours were mostly spent sedentary (77.0%, 95%CI: 76.3, 77.6), with approximately half of this time accumulated in prolonged bouts of 20 minutes or more. There were significant (p<0.05) differences in all outcomes between workdays and non-work days, and, on workdays, between work- versus non-work hours. Results consistently showed "work" was more sedentary and had less light-intensity activity, than "non-work". The period immediately after work appeared important for MVPA. There were significant (p<0.05) differences in all sedentary and activity outcomes occurring during work hours across the workplace settings. Call-centre workers were generally the most sedentary and least physically active at work; customer service workers were typically the least sedentary and the most active at work. The workplace is a key setting for prolonged sedentary time, especially for some occupational groups, and the potential health risk burden attached requires investigation. Future workplace regulations and health promotion initiatives for sedentary occupations to reduce prolonged sitting time should be considered.

  10. Prolonged sedentary time and physical activity in workplace and non-work contexts: a cross-sectional study of office, customer service and call centre employees

    PubMed Central

    2012-01-01

    Background To examine sedentary time, prolonged sedentary bouts and physical activity in Australian employees from different workplace settings, within work and non-work contexts. Methods A convenience sample of 193 employees working in offices (131), call centres (36) and customer service (26) was recruited. Actigraph GT1M accelerometers were used to derive percentages of time spent sedentary (<100 counts per minute; cpm), in prolonged sedentary bouts (≥20 minutes or ≥30 minutes), light-intensity activity (100–1951 cpm) and moderate-to-vigorous physical activity (MVPA; ≥1952 cpm). Using mixed models adjusted for confounders, these were compared for: work days versus non-work days; work hours versus non-work hours (work days only); and, across workplace settings. Results Working hours were mostly spent sedentary (77.0%, 95%CI: 76.3, 77.6), with approximately half of this time accumulated in prolonged bouts of 20 minutes or more. There were significant (p<0.05) differences in all outcomes between workdays and non-work days, and, on workdays, between work- versus non-work hours. Results consistently showed “work” was more sedentary and had less light-intensity activity, than “non-work”. The period immediately after work appeared important for MVPA. There were significant (p<0.05) differences in all sedentary and activity outcomes occurring during work hours across the workplace settings. Call-centre workers were generally the most sedentary and least physically active at work; customer service workers were typically the least sedentary and the most active at work. Conclusion The workplace is a key setting for prolonged sedentary time, especially for some occupational groups, and the potential health risk burden attached requires investigation. Future workplace regulations and health promotion initiatives for sedentary occupations to reduce prolonged sitting time should be considered. PMID:23101767

  11. Modulation of internal estimates of gravity during and after prolonged roll-tilts.

    PubMed

    Tarnutzer, Alexander A; Bertolini, Giovanni; Bockisch, Christopher J; Straumann, Dominik; Marti, Sarah

    2013-01-01

    Perceived direction of gravity, as assessed by the subjective visual vertical (SVV), shows roll-angle dependent errors that drift over time and a bias upon return to upright. According to Bayesian observer theory, the estimated direction of gravity is derived from the posterior probability distribution by combining sensory input and prior knowledge about earth-vertical in a statistically optimal fashion. Here we aimed to further characterize the stability of SVV during and after prolonged roll-tilts. Specifically we asked whether the post-tilt bias is related to the drift pattern while roll-tilted. Twenty-nine healthy human subjects (23-56 yo) repetitively adjusted a luminous arrow to the SVV over periods of 5 min while upright, roll-tilted (± 45°, ± 90°), and immediately after returning to upright. Significant (p<0.05) drifts (median absolute drift-amplitude: 10°/5 min) were found in 71% (± 45°) and 78% (± 90°) of runs. At ± 90° roll-tilt significant increases in absolute adjustment errors were more likely (76%), whereas significant increases (56%) and decreases (44%) were about equally frequent at ± 45°. When returning to upright, an initial bias towards the previous roll-position followed by significant exponential decay (median time-constant: 71 sec) was noted in 47% of all runs (all subjects pooled). No significant correlations were found between the drift pattern during and immediately after prolonged roll-tilt. We conclude that the SVV is not stable during and after prolonged roll-tilt and that the direction and magnitude of drift are individually distinct and roll-angle-dependent. Likely sensory and central adaptation and random-walk processes contribute to drift while roll-tilted. Lack of correlation between the drift and the post-tilt bias suggests that it is not the inaccuracy of the SVV estimate while tilted that determines post-tilt bias, but rather the previous head-roll orientation relative to gravity. We therefore favor central

  12. Combined expectancies: electrophysiological evidence for the adjustment of expectancy effects

    PubMed Central

    Mattler, Uwe; van der Lugt, Arie; Münte, Thomas F

    2006-01-01

    Background When subjects use cues to prepare for a likely stimulus or a likely response, reaction times are facilitated by valid cues but prolonged by invalid cues. In studies on combined expectancy effects, two cues can independently give information regarding two dimensions of the forthcoming task. In certain situations, cueing effects on one dimension are reduced when the cue on the other dimension is invalid. According to the Adjusted Expectancy Model, cues affect different processing levels and a mechanism is presumed which is sensitive to the validity of early level cues and leads to online adjustment of expectancy effects at later levels. To examine the predictions of this model cueing of stimulus modality was combined with response cueing. Results Behavioral measures showed the interaction of cueing effects. Electrophysiological measures of the lateralized readiness potential (LRP) and the N200 amplitude confirmed the predictions of the model. The LRP showed larger effects of response cues on response activation when modality cues were valid rather than invalid. N200 amplitude was largest with valid modality cues and invalid response cues, medium with invalid modality cues, and smallest with two valid cues. Conclusion Findings support the view that the validity of early level expectancies modulates the effects of late level expectancies, which included response activation and response conflict in the present study. PMID:16674805

  13. 20 CFR 404.412 - After my benefits are reduced for age when and how will adjustments to that reduction be made?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false After my benefits are reduced for age when and how will adjustments to that reduction be made? 404.412 Section 404.412 Employees' Benefits SOCIAL...; and Nonpayments of Benefits § 404.412 After my benefits are reduced for age when and how will...

  14. Damping element for reducing the vibration of an airfoil

    DOEpatents

    Campbell, Christian X; Marra, John J

    2013-11-12

    An airfoil (10) is provided with a tip (12) having an opening (14) to a center channel (24). A damping element (16) is inserted within the opening of the center channel, to reduce an induced vibration of the airfoil. The mass of the damping element, a spring constant of the damping element within the center channel, and/or a mounting location (58) of the damping element within the center channel may be adjustably varied, to shift a resonance frequency of the airfoil outside a natural operating frequency of the airfoil.

  15. Feasibility and acceptability of reducing workplace sitting time: a qualitative study with Australian office workers.

    PubMed

    Hadgraft, Nyssa T; Brakenridge, Charlotte L; LaMontagne, Anthony D; Fjeldsoe, Brianna S; Lynch, Brigid M; Dunstan, David W; Owen, Neville; Healy, Genevieve N; Lawler, Sheleigh P

    2016-09-05

    Office workers spend a large proportion of their working hours sitting. This may contribute to an increased risk of chronic disease and premature mortality. While there is growing interest in workplace interventions targeting prolonged sitting, few qualitative studies have explored workers' perceptions of reducing occupational sitting outside of an intervention context. This study explored barriers to reducing office workplace sitting, and the feasibility and acceptability of strategies targeting prolonged sitting in this context. Semi-structured interviews were conducted with a convenience sample of 20 office workers (50 % women), including employees and managers, in Melbourne, Australia. The three organisations (two large, and one small organisation) were from retail, health and IT industries and had not implemented any formalised approaches to sitting reduction. Questions covered barriers to reducing sitting, the feasibility of potential strategies aimed at reducing sitting, and perceived effects on productivity. Interviews were audiotaped and transcribed verbatim. Data were analysed using thematic analysis. Participants reported spending most (median: 7.2 h) of their working hours sitting. The nature of computer-based work and exposure to furniture designed for a seated posture were considered to be the main factors influencing sitting time. Low cost strategies, such as standing meetings and in-person communication, were identified as feasible ways to reduce sitting time and were also perceived to have potential productivity benefits. However, social norms around appropriate workplace behaviour and workload pressures were perceived to be barriers to uptake of these strategies. The cost implications of height-adjustable workstations influenced perceptions of feasibility. Managers noted the need for an evidence-based business case supporting action on prolonged sitting, particularly in the context of limited resources and competing workplace health priorities

  16. A Pilot Study of Increasing Nonpurposeful Movement Breaks at Work as a Means of Reducing Prolonged Sitting

    PubMed Central

    Cooley, Dean; Pedersen, Scott

    2013-01-01

    There is a plethora of workplace physical activity interventions designed to increase purposeful movement, yet few are designed to alleviate prolonged occupational sitting time. A pilot study was conducted to test the feasibility of a workplace e-health intervention based on a passive approach to increase nonpurposeful movement as a means of reducing sitting time. The study was trialled in a professional workplace with forty-six participants (33 females and 13 males) for a period of twenty-six weeks. Participants in the first thirteen weeks received a passive prompt every 45 minutes on their computer screen reminding them to stand and engage in nonpurposeful activity throughout their workday. After thirteen weeks, the prompt was disabled, and participants were then free to voluntary engage the software. Results demonstrated that when employees were exposed to a passive prompt, as opposed to an active prompt, they were five times more likely to fully adhere to completing a movement break every hour of the workday. Based on this pilot study, we suggest that the notion that people are willing to participate in a coercive workplace e-health intervention is promising, and there is a need for further investigation. PMID:23690798

  17. Renal Function in De Novo Liver Transplant Recipients Receiving Different Prolonged-Release Tacrolimus Regimens-The DIAMOND Study.

    PubMed

    TruneČka, P; Klempnauer, J; Bechstein, W O; Pirenne, J; Friman, S; Zhao, A; Isoniemi, H; Rostaing, L; Settmacher, U; Mönch, C; Brown, M; Undre, N; Tisone, G

    2015-07-01

    DIAMOND: multicenter, 24-week, randomized trial investigating the effect of different once-daily, prolonged-release tacrolimus dosing regimens on renal function after de novo liver transplantation. Arm 1: prolonged-release tacrolimus (initial dose 0.2mg/kg/day); Arm 2: prolonged-release tacrolimus (0.15-0.175mg/kg/day) plus basiliximab; Arm 3: prolonged-release tacrolimus (0.2mg/kg/day delayed until Day 5) plus basiliximab. All patients received MMF plus a bolus of corticosteroid (no maintenance steroids). eGFR (MDRD4) at Week 24. Secondary endpoints: composite efficacy failure, BCAR and AEs. Baseline characteristics were comparable. Tacrolimus trough levels were readily achieved posttransplant; initially lower in Arm 2 versus 1 with delayed initiation in Arm 3. eGFR (MDRD4) was higher in Arms 2 and 3 versus 1 (p = 0.001, p = 0.047). Kaplan-Meier estimates of composite efficacy failure-free survival were 72.0%, 77.6%, 73.9% in Arms 1-3. BCAR incidence was significantly lower in Arm 2 versus 1 and 3 (p = 0.016, p = 0.039). AEs were comparable. Prolonged-release tacrolimus (0.15-0.175mg/kg/day) immediately posttransplant plus basiliximab and MMF (without maintenance corticosteroids) was associated with lower tacrolimus exposure, and significantly reduced renal function impairment and BCAR incidence versus prolonged-release tacrolimus (0.2mg/kg/day) administered immediately posttransplant. Delayed higher-dose prolonged-release tacrolimus initiation significantly reduced renal function impairment compared with immediate posttransplant administration, but BCAR incidence was comparable. © 2015 The Authors. American Journal of Transplantation published by Wiley Periodicals Inc.

  18. Reducing the gradient artefact in simultaneous EEG-fMRI by adjusting the subject's axial position.

    PubMed

    Mullinger, Karen J; Yan, Winston X; Bowtell, Richard

    2011-02-01

    Large artefacts that compromise EEG data quality are generated when electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) are carried out concurrently. The gradient artefact produced by the time-varying magnetic field gradients is the largest of these artefacts. Although average artefact correction (AAS) and related techniques can remove the majority of this artefact, the need to avoid amplifier saturation necessitates the use of a large dynamic range and strong low-pass filtering in EEG recording. Any intrinsic reduction in the gradient artefact amplitude would allow data with a higher bandwidth to be acquired without amplifier saturation, thus increasing the frequency range of neuronal activity that can be investigated using combined EEG-fMRI. Furthermore, gradient artefact correction methods assume a constant artefact morphology over time, so their performance is compromised by subject movement. Since the resulting, residual gradient artefacts can easily swamp signals from brain activity, any reduction in their amplitude would be highly advantageous for simultaneous EEG-fMRI studies. The aim of this work was to investigate whether adjustment of the subject's axial position in the MRI scanner can reduce the amplitude of the induced gradient artefact, before and after artefact correction using AAS. The variation in gradient artefact amplitude as a function of the subject's axial position was first investigated in six subjects by applying gradient pulses along the three Cartesian axes. The results of this study showed that a significant reduction in the gradient artefact magnitude can be achieved by shifting the subject axially by 4 cm towards the feet relative to the standard subject position (nasion at iso-centre). In a further study, the 4-cm shift was shown to produce a 40% reduction in the RMS amplitude (and a 31% reduction in the range) of the gradient artefact generated during the execution of a standard multi-slice, EPI sequence. By

  19. 20 CFR 408.905 - Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred in a different period? 408.905 Section 408.905 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS...

  20. 20 CFR 408.905 - Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred in a different period? 408.905 Section 408.905 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS...

  1. 20 CFR 408.905 - Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred in a different period? 408.905 Section 408.905 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS...

  2. 20 CFR 408.905 - Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Will we withhold or adjust an underpayment to reduce an overpayment if that overpayment occurred in a different period? 408.905 Section 408.905 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS...

  3. Prolonged CT urography in duplex kidney.

    PubMed

    Gong, Honghan; Gao, Lei; Dai, Xi-Jian; Zhou, Fuqing; Zhang, Ning; Zeng, Xianjun; Jiang, Jian; He, Laichang

    2016-05-13

    Duplex kidney is a common anomaly that is frequently associated with multiple complications. Typical computed tomography urography (CTU) includes four phases (unenhanced, arterial, parenchymal and excretory) and has been suggested to considerably aid in the duplex kidney diagnosi. Unfortunately, regarding duplex kidney with prolonged dilatation, the affected parenchyma and tortuous ureters demonstrate a lack of or delayed excretory opacification. We used prolonged-delay CTU, which consists of another prolonged-delay phase (1- to 72-h delay; mean delay: 24 h) to opacify the duplicated ureters and affected parenchyma. Seventeen patients (9 males and 8 females; age range: 2.5-56 y; mean age: 40.4 y) with duplex kidney were included in this study. Unenhanced scans did not find typical characteristics of duplex kidney, except for irregular perirenal morphology. Duplex kidney could not be confirmed on typical four-phase CTU, whereas it could be easily diagnosed in axial and CT-3D reconstruction using prolonged CTU (prolonged-delay phase). Between January 2005 and October 2010, in this review board-approved study (with waived informed consent), 17 patients (9 males and 8 females; age range: 2.5 ~ 56 y; mean age: 40.4 y) with suspicious duplex kidney underwent prolonged CTU to opacify the duplicated ureters and confirm the diagnosis. Our results suggest the validity of prolonged CTU to aid in the evaluation of the function of the affected parenchyma and in the demonstration of urinary tract malformations.

  4. A size-adjustable radiofrequency coil for investigating plants in a Halbach magnet

    NASA Astrophysics Data System (ADS)

    Oligschläger, Dirk; Rehorn, Christian; Lehmkuhl, Sören; Adams, Michael; Adams, Alina; Blümich, Bernhard

    2017-05-01

    A radio-frequency coil with adjustable distance has been developed and tested for in-situ examination of growing plants. The Helmholtz-based coil design reduces laborious tuning and matching efforts encountered with solenoids wound around a growing stem or branch. Relaxation experiments were performed on tomato plants and winter wheat under controlled light irradiation. Changes in signal amplitude and in relaxation times T2 were recorded over day and night cycles. Peaks in distributions of relaxation times were attributed to different tissue components of two different plants.

  5. Micro Ring Grating Spectrometer with Adjustable Aperture

    NASA Technical Reports Server (NTRS)

    Park, Yeonjoon (Inventor); King, Glen C. (Inventor); Elliott, James R. (Inventor); Choi, Sang H. (Inventor)

    2012-01-01

    A spectrometer includes a micro-ring grating device having coaxially-aligned ring gratings for diffracting incident light onto a target focal point, a detection device for detecting light intensity, one or more actuators, and an adjustable aperture device defining a circular aperture. The aperture circumscribes a target focal point, and directs a light to the detection device. The aperture device is selectively adjustable using the actuators to select a portion of a frequency band for transmission to the detection device. A method of detecting intensity of a selected band of incident light includes directing incident light onto coaxially-aligned ring gratings of a micro-ring grating device, and diffracting the selected band onto a target focal point using the ring gratings. The method includes using an actuator to adjust an aperture device and pass a selected portion of the frequency band to a detection device for measuring the intensity of the selected portion.

  6. Reduced long-term overall mortality in heart failure patients with prolonged QRS treated with CRT combined with ICD vs. heart failure patients with narrow QRS treated with ICD only.

    PubMed

    Palmisano, Pietro; Accogli, Michele; Pisanò, Ennio Carmine Luigi; Zaccaria, Maria; De Blasi, Sergio; Ponzetta, Maria Antonietta; Valsecchi, Sergio; Milanese, Giovanni; Lauretti, Maurelio; Magliari, Francesco

    2016-09-01

    It is not known whether heart failure (HF) patients with prolonged QRS who undergo cardiac resynchronization therapy combined with a defibrillator (CRT-D) have a prognostic advantage over HF patients with narrow QRS (therefore without indication for CRT) treated with an implantable cardioverter defibrillator (ICD) only. The aim of this study was to compare the long-term mortality of a group of HF patients with prolonged QRS receiving CRT-D with that of a similar group of patients with narrow QRS receiving ICD only. A total of 312 patients (mean age 66 ± 13 years; 84% male, mean left ventricular ejection fraction 25 ± 4%, mean New York Heart Association class 2.6 ± 0.5) were included in the analysis. Of these, 138 with a QRS complex duration ≥120 ms received a CRT-D. During follow-up, the time and cause of death were assessed. During a median follow-up of 46 months, CRT-D patients showed significantly lower overall mortality (P = 0.038). Compared with patients receiving ICD only, CRT-D patients showed lower HF mortality (P = 0.003). Coronary mortality, non-cardiac mortality, and sudden mortality were similar in both groups (all P > 0.05). A positive response to CRT was an independent predictor of reduced mortality on multivariate analysis (hazard ratio: 0.27; P = 0.047). In HF patients treated with ICD, the subgroup of patients with prolonged QRS who receive CRT-D displays better long-term survival than narrow QRS ICD recipients, owing to their reduced HF mortality. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  7. Mercury Trapped Ion Frequency Standard for Ultra-Stable Reference Applications

    NASA Technical Reports Server (NTRS)

    Larsen, Kameron (Inventor); Burt, Eric A. (Inventor); Tjoelker, Robert L. (Inventor); Hamell, Robert L. (Inventor); Tucker, Blake C. (Inventor)

    2017-01-01

    An atomic clock including an ion trap assembly, a C-field coil positioned for generating a first magnetic field in the interrogation region of the ion trap assembly, a compensation coil positioned for generating a second magnetic field in the interrogation region, wherein the combination of the first and second magnetic fields produces an ion number-dependent second order Zeeman shift (Zeeman shift) in the resonance frequency that is opposite in sign to an ion number-dependent second order Doppler shift (Doppler shift) in the resonance frequency, the C-field coil has a radius selected using data indicating how changes in the radius affect an ion-number-dependent shift in the resonance frequency, such that a difference in magnitude between the Doppler shift and the Zeeman shift is controlled or reduced, and the resonance frequency, including the adjustment by the Zeeman shift, is used to obtain the frequency standard.

  8. School-Based Racial and Gender Discrimination among African American Adolescents: Exploring Gender Variation in Frequency and Implications for Adjustment

    PubMed Central

    Chavous, Tabbye M.; Griffin, Tiffany M.

    2012-01-01

    The present study examined school-based racial and gender discrimination experiences among African American adolescents in Grade 8 (n = 204 girls; n = 209 boys). A primary goal was exploring gender variation in frequency of both types of discrimination and associations of discrimination with academic and psychological functioning among girls and boys. Girls and boys did not vary in reported racial discrimination frequency, but boys reported more gender discrimination experiences. Multiple regression analyses within gender groups indicated that among girls and boys, racial discrimination and gender discrimination predicted higher depressive symptoms and school importance and racial discrimination predicted self-esteem. Racial and gender discrimination were also negatively associated with grade point average among boys but were not significantly associated in girls’ analyses. Significant gender discrimination X racial discrimination interactions resulted in the girls’ models predicting psychological outcomes and in boys’ models predicting academic achievement. Taken together, findings suggest the importance of considering gender- and race-related experiences in understanding academic and psychological adjustment among African American adolescents. PMID:22837794

  9. Word frequency and the attentional blink: the effects of target difficulty on retrieval and consolidation processes.

    PubMed

    Wierda, Stefan M; Taatgen, Niels A; van Rijn, Hedderik; Martens, Sander

    2013-01-01

    When a second target (T2) is presented in close succession of a first target (T1) within a stream of non-targets, people often fail to detect T2-a deficit known as the attentional blink (AB). Two types of theories can be distinguished that have tried to account for this phenomenon. Whereas attentional-control theories suggest that protection of consolidation processes induces the AB, limited-resource theories claim that the AB is caused by a lack of resources. According to the latter type of theories, increasing difficulty of one or both targets should increase the magnitude of the AB. Similarly, attentional-control theories predict that a difficult T1 increases the AB due to prolonged processing. However, the prediction for T2 is not as straightforward. Prolonged processing of T2 could cause conflicts and increase the AB. However, if consolidation of T2 is postponed without loss of identity, the AB might be attenuated. Participants performed an AB task that consisted of a stream of distractor non-words and two target words. Difficulty of T1 and T2 was manipulated by varying word-frequency. Overall performance for high-frequency words was better than for low-frequency words. When T1 was highly frequent, the AB was reduced. The opposite effect was found for T2. When T2 was highly frequent, performance during the AB period was relatively worse than for a low-frequency T2. A threaded-cognition model of the AB was presented that simulated the observed pattern of behavior by taking changes in the time-course of retrieval and consolidation processes into account. Our results were replicated in a subsequent ERP study. The finding that a difficult low-frequency T2 reduces the magnitude of the AB is at odds with limited-resource accounts of the AB. However, it was successfully accounted for by the threaded-cognition model, thus providing an explanation in terms of attentional control.

  10. Understanding heart rate alarm adjustment in the intensive care units through an analytical approach.

    PubMed

    Fidler, Richard L; Pelter, Michele M; Drew, Barbara J; Palacios, Jorge Arroyo; Bai, Yong; Stannard, Daphne; Aldrich, J Matt; Hu, Xiao

    2017-01-01

    Heart rate (HR) alarms are prevalent in ICU, and these parameters are configurable. Not much is known about nursing behavior associated with tailoring HR alarm parameters to individual patients to reduce clinical alarm fatigue. To understand the relationship between heart rate (HR) alarms and adjustments to reduce unnecessary heart rate alarms. Retrospective, quantitative analysis of an adjudicated database using analytical approaches to understand behaviors surrounding parameter HR alarm adjustments. Patients were sampled from five adult ICUs (77 beds) over one month at a quaternary care university medical center. A total of 337 of 461 ICU patients had HR alarms with 53.7% male, mean age 60.3 years, and 39% non-Caucasian. Default HR alarm parameters were 50 and 130 beats per minute (bpm). The occurrence of each alarm, vital signs, and physiologic waveforms was stored in a relational database (SQL server). There were 23,624 HR alarms for analysis, with 65.4% exceeding the upper heart rate limit. Only 51% of patients with HR alarms had parameters adjusted, with a median upper limit change of +5 bpm and -1 bpm lower limit. The median time to first HR parameter adjustment was 17.9 hours, without reduction in alarms occurrence (p = 0.57). HR alarms are prevalent in ICU, and half of HR alarm settings remain at default. There is a long delay between HR alarms and parameters changes, with insufficient changes to decrease HR alarms. Increasing frequency of HR alarms shortens the time to first adjustment. Best practice guidelines for HR alarm limits are needed to reduce alarm fatigue and improve monitoring precision.

  11. Understanding heart rate alarm adjustment in the intensive care units through an analytical approach

    PubMed Central

    Pelter, Michele M.; Drew, Barbara J.; Palacios, Jorge Arroyo; Bai, Yong; Stannard, Daphne; Aldrich, J. Matt; Hu, Xiao

    2017-01-01

    Background Heart rate (HR) alarms are prevalent in ICU, and these parameters are configurable. Not much is known about nursing behavior associated with tailoring HR alarm parameters to individual patients to reduce clinical alarm fatigue. Objectives To understand the relationship between heart rate (HR) alarms and adjustments to reduce unnecessary heart rate alarms. Methods Retrospective, quantitative analysis of an adjudicated database using analytical approaches to understand behaviors surrounding parameter HR alarm adjustments. Patients were sampled from five adult ICUs (77 beds) over one month at a quaternary care university medical center. A total of 337 of 461 ICU patients had HR alarms with 53.7% male, mean age 60.3 years, and 39% non-Caucasian. Default HR alarm parameters were 50 and 130 beats per minute (bpm). The occurrence of each alarm, vital signs, and physiologic waveforms was stored in a relational database (SQL server). Results There were 23,624 HR alarms for analysis, with 65.4% exceeding the upper heart rate limit. Only 51% of patients with HR alarms had parameters adjusted, with a median upper limit change of +5 bpm and -1 bpm lower limit. The median time to first HR parameter adjustment was 17.9 hours, without reduction in alarms occurrence (p = 0.57). Conclusions HR alarms are prevalent in ICU, and half of HR alarm settings remain at default. There is a long delay between HR alarms and parameters changes, with insufficient changes to decrease HR alarms. Increasing frequency of HR alarms shortens the time to first adjustment. Best practice guidelines for HR alarm limits are needed to reduce alarm fatigue and improve monitoring precision. PMID:29176776

  12. Prolonged cold storage of red blood cells by oxygen removal and additive usage

    DOEpatents

    Bitensky, M.W.; Yoshida, Tatsuro

    1998-08-04

    Prolonged cold storage of red blood cells by oxygen removal and additive usage. A cost-effective, 4 C storage procedure that preserves red cell quality and prolongs post-transfusion in vivo survival is described. The improved in vivo survival and the preservation of adenosine triphosphate levels, along with reduction in hemolysis and membrane vesicle production of red blood cells stored at 4 C for prolonged periods of time, is achieved by reducing the oxygen level therein at the time of storage; in particular, by flushing the cells with an inert gas, and storing them in an aqueous solution which includes adenine, dextrose, mannitol, citrate ion, and dihydrogen phosphate ion, but no sodium chloride, in an oxygen-permeable container which is located in an oxygen-free environment containing oxygen-scavenging materials. 8 figs.

  13. Prolonged cold storage of red blood cells by oxygen removal and additive usage

    DOEpatents

    Bitensky, Mark W.; Yoshida, Tatsuro

    1998-01-01

    Prolonged cold storage of red blood cells by oxygen removal and additive usage. A cost-effective, 4.degree. C. storage procedure that preserves red cell quality and prolongs post-transfusion in vivo survival is described. The improved in vivo survival and the preservation of adenosine triphosphate levels, along with reduction in hemolysis and membrane vesicle production of red blood cells stored at 4.degree. C. for prolonged periods of time, is achieved by reducing the oxygen level therein at the time of storage; in particular, by flushing the cells with an inert gas, and storing them in an aqueous solution which includes adenine, dextrose, mannitol, citrate ion, and dihydrogen phosphate ion, but no sodium chloride, in an oxygen-permeable container which is located in an oxygen-free environment containing oxygen-scavenging materials.

  14. Prolonged activity of a recombinant factor VIII-Fc fusion protein in hemophilia A mice and dogs

    PubMed Central

    Dumont, Jennifer A.; Liu, Tongyao; Low, Susan C.; Zhang, Xin; Kamphaus, George; Sakorafas, Paul; Fraley, Cara; Drager, Douglas; Reidy, Thomas; McCue, Justin; Franck, Helen W. G.; Merricks, Elizabeth P.; Nichols, Timothy C.; Bitonti, Alan J.; Pierce, Glenn F.

    2012-01-01

    Despite proven benefits, prophylactic treatment for hemophilia A is hampered by the short half-life of factor VIII. A recombinant factor VIII-Fc fusion protein (rFVIIIFc) was constructed to determine the potential for reduced frequency of dosing. rFVIIIFc has an ∼ 2-fold longer half-life than rFVIII in hemophilia A (HemA) mice and dogs. The extension of rFVIIIFc half-life requires interaction of Fc with the neonatal Fc receptor (FcRn). In FcRn knockout mice, the extension of rFVIIIFc half-life is abrogated, and is restored in human FcRn transgenic mice. The Fc fusion has no impact on FVIII-specific activity. rFVIIIFc has comparable acute efficacy as rFVIII in treating tail clip injury in HemA mice, and fully corrects whole blood clotting time (WBCT) in HemA dogs immediately after dosing. Furthermore, consistent with prolonged half-life, rFVIIIFc shows 2-fold longer prophylactic efficacy in protecting HemA mice from tail vein transection bleeding induced 24-48 hours after dosing. In HemA dogs, rFVIIIFc also sustains partial correction of WBCT 1.5- to 2-fold longer than rFVIII. rFVIIIFc was well tolerated in both species. Thus, the rescue of FVIII by Fc fusion to provide prolonged protection presents a novel pathway for FVIII catabolism, and warrants further investigation. PMID:22246033

  15. College student engaging in cyberbullying victimization: cognitive appraisals, coping strategies, and psychological adjustments.

    PubMed

    Na, Hyunjoo; Dancy, Barbara L; Park, Chang

    2015-06-01

    The study's purpose was to explore whether frequency of cyberbullying victimization, cognitive appraisals, and coping strategies were associated with psychological adjustments among college student cyberbullying victims. A convenience sample of 121 students completed questionnaires. Linear regression analyses found frequency of cyberbullying victimization, cognitive appraisals, and coping strategies respectively explained 30%, 30%, and 27% of the variance in depression, anxiety, and self-esteem. Frequency of cyberbullying victimization and approach and avoidance coping strategies were associated with psychological adjustments, with avoidance coping strategies being associated with all three psychological adjustments. Interventions should focus on teaching cyberbullying victims to not use avoidance coping strategies. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Phonological neighborhood and word frequency effects on the stuttered disfluencies of children who stutter: comments on Anderson (2007).

    PubMed

    Howell, Peter

    2010-10-01

    This letter comments on a study by Anderson (2007) that compared the effects of word frequency, neighborhood density, and phonological neighborhood frequency on part-word repetitions, prolongations, and single-syllable word repetitions produced by children who stutter. Anderson discussed her results with respect to 2 theories about stuttering: the covert repair hypothesis and execution planning (EXPLAN) theory. Her remarks about EXPLAN theory are examined. Anderson considered that EXPLAN does not predict the relationship between word and neighborhood frequency and stuttering for part-word repetitions and prolongations (she considered that EXPLAN predicts that stuttering occurs on simple words for children). The actual predictions that EXPLAN makes are upheld by her results. She also considered that EXPLAN cannot account for why stuttering is affected by the same variables that lead to speech errors, and it is shown that this is incorrect. The effects of word frequency, neighborhood density, and phonological neighborhood frequency on part-word repetitions, prolongations, and single-syllable word repetitions reported by Anderson (2007) are consistent with the predictions of the EXPLAN model.

  17. [Brain function recovery after prolonged posttraumatic coma].

    PubMed

    Klimash, A V; Zhanaidarov, Z S

    2016-01-01

    To explore the characteristics of brain function recovery in patients after prolonged posttraumatic coma and with long-unconscious states. Eighty-seven patients after prolonged posttraumatic coma were followed-up for two years. An analysis of a clinical/neurological picture after a prolonged episode of coma was based on the dynamics of vital functions, neurological status and patient's reactions to external stimuli. Based on the dynamics of the clinical/neurological picture that shows the recovery of functions of the certain brain areas, three stages of brain function recovery after a prolonged episode of coma were singled out: brain stem areas, diencephalic areas and telencephalic areas. These functional/anatomic areas of brain function recovery after prolonged coma were compared to the present classifications.

  18. Selective Impairment in Frequency Discrimination in a Mouse Model of Tinnitus

    PubMed Central

    Mwilambwe-Tshilobo, Laetitia; Davis, Andrew J. O.; Aizenberg, Mark; Geffen, Maria N.

    2015-01-01

    Tinnitus is an auditory disorder, which affects millions of Americans, including active duty service members and veterans. It is manifested by a phantom sound that is commonly restricted to a specific frequency range. Because tinnitus is associated with hearing deficits, understanding how tinnitus affects hearing perception is important for guiding therapies to improve the quality of life in this vast group of patients. In a rodent model of tinnitus, prolonged exposure to a tone leads to a selective decrease in gap detection in specific frequency bands. However, whether and how hearing acuity is affected for sounds within and outside those frequency bands is not well understood. We induced tinnitus in mice by prolonged exposure to a loud mid-range tone, and behaviorally assayed whether mice exhibited a change in frequency discrimination acuity for tones embedded within the mid-frequency range and high-frequency range at 1, 4, and 8 weeks post-exposure. A subset of tone-exposed mice exhibited tinnitus-like symptoms, as demonstrated by selective deficits in gap detection, which were restricted to the high frequency range. These mice exhibited impaired frequency discrimination both for tones in the mid-frequency range and high-frequency range. The remaining tone exposed mice, which did not demonstrate behavioral evidence of tinnitus, showed temporary deficits in frequency discrimination for tones in the mid-frequency range, while control mice remained unimpaired. Our findings reveal that the high frequency-specific deficits in gap detection, indicative of tinnitus, are associated with impairments in frequency discrimination at the frequency of the presumed tinnitus. PMID:26352864

  19. [Pathophysiology of prolonged hypokinesia].

    PubMed

    Kovalenko, E A

    1976-01-01

    Hypokinesia is an important problem in modern medicine. In the pathogenetic effect of prolonged hypokinesia the main etiological factor is diminished motor activity; of major importance are disorders in the energy and plastic metabolism which affect the muscle system; the contributing factors are cardiovascular deconditioning and orthostatic intolerance. This is attributed to a decreased oxygen supply and eliminated hydrostatic influences during a prolonged recumbency. Blood redistribution in the vascular bed is related to the Gauer-Henry reflex and subsequent changes in the fluid-electrolyte balance. Decreased load on the bone system induces changes in the protein-phosphate-calcium metabolism, diminished bone density and increased calcium content in the blood and urine. Changes in the calcium metabolism are systemic. The activity of the higher nervous system and reflex functions is lowered. Changes in the function of the autonomic nervous system which include a noticeable decline of its adaptive-trophic role as a result of the decrease of afferent and efferent impulsation are of great importance. Changes in the hormonal function involve a peculiar stress-reaction which develops at an early stage of hypokinesia as a response to an unusual situation. Prolonged hypokinesia may result in a disturbed function of the pituitary-adrenal system. It is assumed that prolonged hypokinesia may induce a specific disease of hypokinesia during which man cannot lead a normal mode of life and work.

  20. Prolonged jaundice in newborns is associated with low antioxidant capacity in breast milk.

    PubMed

    Uras, Nurdan; Tonbul, Alpaslan; Karadag, Ahmet; Dogan, Derya G; Erel, Ozcan; Tatli, Mustafa M

    2010-10-01

    In breastfeeding newborns who are otherwise healthy, the mechanism of prolonged jaundice remains unclear. The aim of this study was to investigate relations between prolonged jaundice and oxidative parameters in breast milk. Full-term, otherwise healthy newborns with jaundice lasting more than 2 weeks were enrolled prospectively in the study. As a control group, newborns in the same age group but without prolonged jaundice were selected. All newborns in the study were exclusively breastfed. In the newborns with prolonged jaundice, investigations of the etiology of the jaundice included complete blood count, peripheral blood smear, blood typing, direct Coombs test, measurement of serum levels of total and direct bilirubin, tests for liver and thyroid function (TSH, free T4, total T4), urine culture and measurement of urine reducing substances, and determination of glucose 6 phosphate dehydrogenase enzyme levels. Breast milk was collected from the mothers of the newborns in both groups. The antioxidant status of the breast milk was assessed via determination of total antioxidant capacity (TAC). Oxidative stress was also assessed in breast milk by measurement of total oxidation status (TOS) and calculation of the oxidative stress index (OSI). The prolonged jaundice group differed significantly from the control group in terms of mean TAC and OSI (p < 0.001), but not in terms of TOS. In conclusion, in the breast milk of mothers of newborns with prolonged jaundice, oxidative stress was found to be increased, and protective antioxidant capacity was found to be decreased.

  1. Automatic Locking of Laser Frequency to an Absorption Peak

    NASA Technical Reports Server (NTRS)

    Koch, Grady J.

    2006-01-01

    An electronic system adjusts the frequency of a tunable laser, eventually locking the frequency to a peak in the optical absorption spectrum of a gas (or of a Fabry-Perot cavity that has an absorption peak like that of a gas). This system was developed to enable precise locking of the frequency of a laser used in differential absorption LIDAR measurements of trace atmospheric gases. This system also has great commercial potential as a prototype of means for precise control of frequencies of lasers in future dense wavelength-division-multiplexing optical communications systems. The operation of this system is completely automatic: Unlike in the operation of some prior laser-frequency-locking systems, there is ordinarily no need for a human operator to adjust the frequency manually to an initial value close enough to the peak to enable automatic locking to take over. Instead, this system also automatically performs the initial adjustment. The system (see Figure 1) is based on a concept of (1) initially modulating the laser frequency to sweep it through a spectral range that includes the desired absorption peak, (2) determining the derivative of the absorption peak with respect to the laser frequency for use as an error signal, (3) identifying the desired frequency [at the very top (which is also the middle) of the peak] as the frequency where the derivative goes to zero, and (4) thereafter keeping the frequency within a locking range and adjusting the frequency as needed to keep the derivative (the error signal) as close as possible to zero. More specifically, the system utilizes the fact that in addition to a zero crossing at the top of the absorption peak, the error signal also closely approximates a straight line in the vicinity of the zero crossing (see Figure 2). This vicinity is the locking range because the linearity of the error signal in this range makes it useful as a source of feedback for a proportional + integral + derivative control scheme that

  2. Temporal and spatial scales of geomorphic adjustments to reduced competency following flow regulation in bedload-dominated systems

    NASA Astrophysics Data System (ADS)

    Curtis, Katherine E.; Renshaw, Carl E.; Magilligan, Francis J.; Dade, William B.

    2010-05-01

    Because of the combined effects of reduced sediment transport capacity and competency following flow regulation, morphological changes are expected to occur in channels downstream from dams and, specifically, at tributary junctions where local inputs of water and sediment occur. Using a combination of historical aerial photographs, mainstem- and tributary-channel pebble counts, and HEC-RAS flow modeling for two watersheds in south-central VT, one unregulated and the other regulated since 1961, we document the time series of post-regulation channel narrowing and associated bar growth due to the influx of tributary sediment. Channel adjustments at regulated tributary junctions have been significant in ca. 50 years following impoundment, with channels downstream of the confluences narrowing over 15% after an initial ca. 20-year lag before the onset of accelerated narrowing. Moreover, flow modeling suggests that downstream of regulated confluences, the modern median grain size ( d50) along the channel bed is immobile. No significant channel narrowing has occurred either above or below unregulated tributary junctions or on the mainstem upstream of regulated confluences. However, greater channel sediment fining is observed upstream of regulated confluences than above unregulated confluences. Thus, the primary mode of mainstem channel adjustment differs up- and downstream of regulated tributaries. These confluence effects have occurred where the tributary drainage area is only 0.2 times that of the mainstem, well below the threshold ratio of 0.6 required for significant geomorphic effects at unregulated confluences, highlighting the geomorphic scale shift of dams. Lastly, we evaluate the downstream length required for a river to recover from the impacts of impoundment and demonstrate that even distal locations are impacted by flow regulation. Unlike the impacts of flow regulation in the western US where channel incision and bar erosion predominate following impoundment

  3. Historical space weather monitoring of prolonged aurora activities in Japan and in China

    NASA Astrophysics Data System (ADS)

    Kataoka, Ryuho; Isobe, Hiroaki; Hayakawa, Hisashi; Tamazawa, Harufumi; Kawamura, Akito Davis; Miyahara, Hiroko; Iwahashi, Kiyomi; Yamamoto, Kazuaki; Takei, Masako; Terashima, Tsuneyo; Suzuki, Hidehiko; Fujiwara, Yasunori; Nakamura, Takuji

    2017-02-01

    Great magnetic storms are recorded as aurora sightings in historical documents. The earliest known example of "prolonged" aurora sightings, with aurora persistent for two or more nights within a 7 day interval at low latitudes, in Japan was documented on 21-23 February 1204 in Meigetsuki, when a big sunspot was also recorded in China. We have searched for prolonged events over the 600 year interval since 620 in Japan based on the catalogue of Kanda and over the 700 year interval since 581 in China based on the catalogues of Tamazawa et al. (2017) and Hayakawa et al. (2015). Before the Meigetsuki event, a significant fraction of the 200 possible aurora sightings in Sòng dynasty (960-1279) of China was detected at least twice within a 7 day interval and sometimes recurred with approximately the solar rotation period of 27 days. The majority of prolonged aurora activity events occurred around the maximum phase of solar cycles rather than around the minimum, as estimated from the 14C analysis of tree rings. They were not reported during the Oort Minimum (1010-1050). We hypothesize that the prolonged aurora sightings are associated with great magnetic storms resulting from multiple coronal mass ejections from the same active region. The historical documents therefore provide useful information to support estimation of great magnetic storm frequency, which are often associated with power outages and other societal concerns.

  4. New age- and sex-specific criteria for QT prolongation based on rate correction formulas that minimize bias at the upper normal limits.

    PubMed

    Rautaharju, Pentti M; Mason, Jay W; Akiyama, Toshio

    2014-07-01

    Existing formulas for rate-corrected QT (QTc) commonly fail to properly adjust the upper normal limits which are more critical than the mean QTc for evaluation of prolonged QT. Age- and sex-related differences in QTc are also often overlooked. Our goal was to establish criteria for prolonged QTc using formulas that minimize QTc bias at the upper normal limits. Strict criteria were used in selecting a study group of 57,595 persons aged 5 to 89 years (54% women) and to exclude electrocardiograms (ECG) with possible disease-associated changes. Two QT rate adjustment formulas were identified which both minimized rate-dependency in the 98 th percentile limits: QTcmod, based on an electrophysiological model (QTcMod = QTx(120 + HR)/180)), and QTcLogLin, a power function of the RR interval with exponents 0.37 for men and 0.38 for women. QTc shortened in men during adolescence and QTcMod became 13 ms shorter than in women at age 20-29 years. The sex difference was maintained through adulthood although decreasing with age. The criteria established for prolonged QTc were: Age < 40 years, men 430 ms, women 440 ms; Age 40 to 69, men 440 ms, women 450 ms; Age ≥ 70 years, men 455 ms, and women 460 ms. Sex difference in QTc originates from shortened QT in adolescent males. Upper normal limits for QTc vary substantially by age and sex, and it is essential to use age- and sex-specific criteria for evaluation of QT prolongation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. The effects of vibration-reducing gloves on finger vibration

    PubMed Central

    Welcome, Daniel E.; Dong, Ren G.; Xu, Xueyan S.; Warren, Christopher; McDowell, Thomas W.

    2015-01-01

    Vibration-reducing (VR) gloves have been used to reduce the hand-transmitted vibration exposures from machines and powered hand tools but their effectiveness remains unclear, especially for finger protection. The objectives of this study are to determine whether VR gloves can attenuate the vibration transmitted to the fingers and to enhance the understanding of the mechanisms of how these gloves work. Seven adult male subjects participated in the experiment. The fixed factors evaluated include hand force (four levels), glove condition (gel-filled, air bladder, no gloves), and location of the finger vibration measurement. A 3-D laser vibrometer was used to measure the vibrations on the fingers with and without wearing a glove on a 3-D hand-arm vibration test system. This study finds that the effect of VR gloves on the finger vibration depends on not only the gloves but also their influence on the distribution of the finger contact stiffness and the grip effort. As a result, the gloves increase the vibration in the fingertip area but marginally reduce the vibration in the proximal area at some frequencies below 100 Hz. On average, the gloves reduce the vibration of the entire fingers by less than 3% at frequencies below 80 Hz but increase at frequencies from 80 to 400 Hz. At higher frequencies, the gel-filled glove is more effective at reducing the finger vibration than the air bladder-filled glove. The implications of these findings are discussed. Relevance to industry Prolonged, intensive exposure to hand-transmitted vibration can cause hand-arm vibration syndrome. Vibration-reducing gloves have been used as an alternative approach to reduce the vibration exposure. However, their effectiveness for reducing finger-transmitted vibrations remains unclear. This study enhanced the understanding of the glove effects on finger vibration and provided useful information on the effectiveness of typical VR gloves at reducing the vibration transmitted to the fingers. The new

  6. Risk Factors for Prolonged Length of Stay or Complications During Pediatric Respiratory Hospitalizations.

    PubMed

    Kaiser, Sunitha V; Bakel, Leigh-Anne; Okumura, Megumi J; Auerbach, Andrew D; Rosenthal, Jennifer; Cabana, Michael D

    2015-09-01

    Respiratory illnesses are the leading cause of pediatric hospitalizations in the United States, and a major focus of efforts to improve quality of care. Understanding factors associated with poor outcomes will allow better targeting of interventions for improving care. The objective of this study was to identify patient and hospital factors associated with prolonged length of stay (LOS) or complications during pediatric hospitalizations for asthma or lower respiratory infection (LRI). Cross-sectional study of hospitalizations of patients <18 years with asthma or LRI (bronchiolitis, influenza, or pneumonia) by using the nationally representative 2012 Kids Inpatient Database. We used multivariable logistic regression models to identify factors associated with prolonged LOS (>90th percentile) or complications (noninvasive ventilation, mechanical ventilation, or death). For asthma hospitalizations(n = 85 320), risks for both prolonged LOS and complications were increased with each year of age (adjusted odds ratio [AOR] 1.06, 95% confidence interval [CI] 1.05-1.07; AOR 1.05, 95% CI 1.03-1.07, respectively for each outcome) and in children with chronic conditions (AOR 4.87, 95% CI 4.15-5.70; AOR 21.20, 95% CI 15.20-29.57, respectively). For LRI hospitalizations (n = 204 950), risks for prolonged LOS and complications were decreased with each year of age (AOR 0.98, 95% CI 0.97-0.98; AOR 0.95, 95% CI 0.94-0.96, respectively) and increased in children with chronic conditions (AOR 9.86, 95% CI 9.03-10.76; AOR 56.22, 95% CI 46.60-67.82, respectively). Risks for prolonged LOS for asthma were increased in large hospitals (AOR 1.67, 95% CI 1.32-2.11) and urban-teaching hospitals (AOR 1.62, 95% CI 1.33-1.97). Older children with asthma, younger children with LRI, children with chronic conditions, and those hospitalized in large urban-teaching hospitals are more vulnerable to prolonged LOS and complications. Future research and policy efforts should evaluate and support

  7. Do Brief Motivational Interventions Reduce Drinking Game Frequency in Mandated Students? An analysis of data from two randomized controlled trials

    PubMed Central

    Fernandez, Anne C.; Yurasek, Allison M.; Merrill, Jennifer E.; Miller, Mary Beth; Zamboanga, Byron L.; Carey, Kate B.; Borsari, Brian

    2016-01-01

    Purpose College students frequently engage in drinking games (DG) and experience a variety of consequences as a result. It is currently unknown whether brief motivational interventions (BMI) that provide feedback on DG participation can reduce this high risk behavior. This study examined outcome data from two randomized clinical trials to examine whether BMIs facilitate change in DG frequency and how these changes may occur. Methods Mandated college students (Trial 1, N = 198, 46% female; Trial 2, N = 412; 32% female) were randomized to BMI or comparison control conditions. Hierarchical linear modeling (HLM) was used to compare the BMI and comparison groups to determine whether the BMI reduced DG participation over time. Percent change talk (PCT) during the discussion of DG during the session was examined as a predictor of change in DG frequency, and gender was examined as a moderator of treatment effects. Results Controlling for regular drinking frequency, participants who received a BMI did not significantly reduce their DG frequency relative to the comparison group in either sample, and the BMI was equally ineffective at reducing DG behavior for men and women. DG-related PCT during the BMI was associated with lower DG frequency at the second follow-up in both Trials. In Trial 1, PCT during the BMI was associated with less steep increases in DG frequency across the course of all follow-ups. Effects of PCT on DG behavior were not moderated by gender. Conclusions Findings did not support hypothesized reductions in DG participation following a BMI. Future research should explore whether targeted DG-specific interventions could reduce DG participation and the role of in-session client language in facilitating such change. PMID:27936818

  8. Adjusting export tax rebates to reduce the environmental impacts of trade: Lessons from China.

    PubMed

    Song, Peng; Mao, Xianqiang; Corsetti, Gabriel

    2015-09-15

    Export tax rebates are an important policy instrument for stimulating exports, which many developing countries make use of. However, excessive export tax rebates and inappropriate structural arrangements can lead to over-production in highly polluting industries and cause the environment to deteriorate. This paper, taking China as the study case, tests and verifies the statistical significance of the causal relationship between export tax rebates and pollution emissions. With a computable general equilibrium modeling, the current study further analyzes the effectiveness of export tax rebate adjustments aimed at alleviating environmental pressure for different time periods. It is found that before 2003, export tax rebates primarily promoted exports and boosted foreign exchange reserves, and highly polluting sectors enjoyed above-average export tax rebates, which led to increased pollution emissions. Between 2003 and 2010, the export tax rebate system was reformed to reduce support for the highly polluting export sectors, which led to decreases in emissions. Canceling export tax rebates for highly polluting sectors is shown to be the most favorable policy choice for improving the environmental performance of China's international trade. This study can serve as reference for other developing countries which similarly rely on export tax rebates, so that they can adjust their policies so as to combine economic growth with pollution control. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Influence of modulation frequency in rubidium cell frequency standards

    NASA Technical Reports Server (NTRS)

    Audoin, C.; Viennet, J.; Cyr, N.; Vanier, J.

    1983-01-01

    The error signal which is used to control the frequency of the quartz crystal oscillator of a passive rubidium cell frequency standard is considered. The value of the slope of this signal, for an interrogation frequency close to the atomic transition frequency is calculated and measured for various phase (or frequency) modulation waveforms, and for several values of the modulation frequency. A theoretical analysis is made using a model which applies to a system in which the optical pumping rate, the relaxation rates and the RF field are homogeneous. Results are given for sine-wave phase modulation, square-wave frequency modulation and square-wave phase modulation. The influence of the modulation frequency on the slope of the error signal is specified. It is shown that the modulation frequency can be chosen as large as twice the non-saturated full-width at half-maximum without a drastic loss of the sensitivity to an offset of the interrogation frequency from center line, provided that the power saturation factor and the amplitude of modulation are properly adjusted.

  10. Digital frequency offset-locked He–Ne laser system with high beat frequency stability, narrow optical linewidth and optical fibre output

    NASA Astrophysics Data System (ADS)

    Sternkopf, Christian; Manske, Eberhard

    2018-06-01

    We report on the enhancement of a previously-presented heterodyne laser source on the basis of two phase-locked loop (PLL) frequency coupled internal-mirror He–Ne lasers. Our new system consists of two digitally controlled He–Ne lasers with slightly different wavelengths, and offers high-frequency stability and very narrow optical linewidth. The digitally controlled system has been realized by using a FPGA controller and transconductance amplifiers. The light of both lasers was coupled into separate fibres for heterodyne interferometer applications. To enhance the laser performance we observed the sensitivity of both laser tubes to electromagnetic noise from various laser power supplies and frequency control systems. Furthermore, we describe how the linewidth of a frequency-controlled He–Ne laser can be reduced during precise frequency stabilisation. The digitally controlled laser source reaches a standard beat frequency deviation of less than 20 Hz (with 1 s gate time) and a spectral full width at half maximum (FWHM) of the beat signal less than 3 kHz. The laser source has enough optical output power to serve a fibre-coupled multi axis heterodyne interferometer. The system can be adjusted to output beat frequencies in the range of 0.1 MHz–20 MHz.

  11. Development of novel fast-dissolving tacrolimus solid dispersion-loaded prolonged release tablet.

    PubMed

    Cho, Jung Hyun; Kim, Yong-Il; Kim, Dong-Wuk; Yousaf, Abid Mehmood; Kim, Jong Oh; Woo, Jong Soo; Yong, Chul Soon; Choi, Han-Gon

    2014-04-11

    The goal of this research was to develop a novel prolonged release tablet bioequivalent to the commercial sustained release capsule. A number of tacrolimus-loaded fast-dissolving solid dispersions containing various amounts of DOSS were prepared using the spray drying technique. Their solubility, dissolution and pharmacokinetics in rats were studied. DOSS increased drug solubility and dissolution in the solid dispersions. Compared with the drug powder, the solubility, dissolution and bioavailability of tacrolimus with the fast-dissolving solid dispersion containing tacrolimus/HP-β-CD/DOSS in the weight ratio of 5:40:4 were boosted by approximately 700-, 30- and 2-fold, respectively. Several tablet formulations were accomplished with this solid dispersion in combination with various ratios of HPMC/ethylcellulose. The release behaviour and pharmacokinetic studies in beagle dogs were assessed compared with the commercial prolonged release capsule. A decrease in HPMC/ethylcellulose ratios reduced the dissolution of tacrolimus from the tablets. Particularly, the tacrolimus-loaded prolonged release tablet consisting of fast-dissolving tacrolimus solid dispersion, HPMC, ethylcellulose and talc at the weight ratio of 20:66:112:2 exhibited a dissolution profile similar to that produced by the commercial prolonged release capsule. Furthermore, there were no significant differences in the AUC, Cmax, Tmax and MRT values between them in beagle dogs. Consequently, this tacrolimus-loaded prolonged release tablet might be bioequivalent to the tacrolimus-loaded commercial capsule. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Prospective analysis of principles and frequency of self-adjustment of insulin dose in people with diabetes type 1 before and after participation in a diabetes treatment and teaching programme.

    PubMed

    Kramer, Guido; Kuniss, Nadine; Jörgens, Viktor; Lehmann, Thomas; Müller, Nicolle; Lorkowski, Stefan; Wolf, Gunter; Müller, Ulrich A; Kloos, Christof

    2016-09-01

    Insulin dose self-adjustment is an essential part of intensified insulin therapy - nowadays the routine treatment of type 1 diabetes (DM1). The aim of this study was to evaluate principles and frequency of insulin dose self-adjustments in people with DM1 before and one year after participating in a structured diabetes treatment and teaching programme (DTTP) and to determine to which extent the patients followed the way they had been trained. 72 people with DM1 were interviewed before participation in our inpatient (32/72) or outpatient (40/72) DTTP. Sixty-six participants (91.7%) were followed up after one year. The number of adaptations of the insulin dose by the patients was recorded from 28days of the patients' diary. The ability to find the correct dose was tested using five different examples. Metabolic control improved significantly after one year (7.9±1.0 to 7.5±0.8%, p=0.004). The participants performed 86.0±37.1 insulin dosage adaptations per 28days before the DTTP. After one year the frequency increased significantly to 99.1±30.7 per 28days (p=0.011). Before the DTTP, 42 of 72 patients (58.3%) adjusted their insulin dose to correct high blood glucose levels by adjustment rules (factor for correction or correction scheme) and 20 of 72 people (27.8%) by personal experience/feeling. One year after the DTTP, 73% (48/66) used adjustment rules. After participating in an structured education programme, patients adjusted their insulin dosage more frequently. Metabolic control improved despite the fact that many patients did not strictly apply the rules they had been trained for. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Modulation of Internal Estimates of Gravity during and after Prolonged Roll-Tilts

    PubMed Central

    Tarnutzer, Alexander A.; Bertolini, Giovanni; Bockisch, Christopher J.; Straumann, Dominik; Marti, Sarah

    2013-01-01

    Perceived direction of gravity, as assessed by the subjective visual vertical (SVV), shows roll-angle dependent errors that drift over time and a bias upon return to upright. According to Bayesian observer theory, the estimated direction of gravity is derived from the posterior probability distribution by combining sensory input and prior knowledge about earth-vertical in a statistically optimal fashion. Here we aimed to further characterize the stability of SVV during and after prolonged roll-tilts. Specifically we asked whether the post-tilt bias is related to the drift pattern while roll-tilted. Twenty-nine healthy human subjects (23-56yo) repetitively adjusted a luminous arrow to the SVV over periods of 5min while upright, roll-tilted (±45°, ±90°), and immediately after returning to upright. Significant (p<0.05) drifts (median absolute drift-amplitude: 10°/5min) were found in 71% (±45°) and 78% (±90°) of runs. At ±90° roll-tilt significant increases in absolute adjustment errors were more likely (76%), whereas significant increases (56%) and decreases (44%) were about equally frequent at ±45°. When returning to upright, an initial bias towards the previous roll-position followed by significant exponential decay (median time-constant: 71sec) was noted in 47% of all runs (all subjects pooled). No significant correlations were found between the drift pattern during and immediately after prolonged roll-tilt. We conclude that the SVV is not stable during and after prolonged roll-tilt and that the direction and magnitude of drift are individually distinct and roll-angle-dependent. Likely sensory and central adaptation and random-walk processes contribute to drift while roll-tilted. Lack of correlation between the drift and the post-tilt bias suggests that it is not the inaccuracy of the SVV estimate while tilted that determines post-tilt bias, but rather the previous head-roll orientation relative to gravity. We therefore favor central adaptation, most

  14. Increased risk of QT prolongation associated with atherosclerotic diseases in arseniasis-endemic area in southwestern coast of Taiwan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang, C.-H.; Chen, C.-L.; Hsiao, C.K.

    2009-09-15

    Chronic arsenic exposure has been documented to be associated with various cardiovascular diseases. We aimed to investigate 1) the increased risk of QT prolongation in chronic arsenic exposure, and 2) the relationships of cardiac repolarization (QT interval duration) with ischemic heart disease and carotid atherosclerosis. We studied 280 men and 355 women living in the endemic area of arseniasis in southwestern Taiwan. QT intervals in electrocardiogram and carotid intima-media thickness (IMT) by ultrasonography were measured. Ischemic heart disease was diagnosed by history or abnormal electrocardiogram. Significant associations of the corrected QT interval (QTc) duration with ischemic heart disease and carotidmore » intima-medium thickness and plaque were observed after adjustment for various risk factors in the multiple linear regression analysis (all p values < 0.05). Three indices of chronic arsenic exposure were all significantly associated with the risk of QTc prolongation showing dose-response relationships (p < 0.001). Chronic arsenic exposure was dose-dependently associated with the risk of QTc prolongation. Ischemic heart disease and carotid atherosclerosis were significantly associated with QTc intervals in chronic arsenic exposure. QTc prolongation might be suggested as an early biomarker for ischemic heart disease or carotid atherosclerosis in population with previous exposure to arsenic.« less

  15. Reduction of the coupling vibration between the bending vibrators of the frequency-change-type two-axis acceleration sensor

    NASA Astrophysics Data System (ADS)

    Sugawara, Sumio; Sasaki, Yoshifumi; Kudo, Subaru

    2018-07-01

    The frequency-change-type two-axis acceleration sensor uses a cross-type vibrator consisting of four bending vibrators. When coupling vibration exists between these four bending vibrators, the resonance frequency of each vibrator cannot be adjusted independently. In this study, methods of reducing the coupling vibration were investigated by finite-element analysis. A method of adjusting the length of the short arm of each vibrator was proposed for reducing the vibration. When piezoelectric ceramics were bonded to the single-sided surface of the vibrator, the method was not sufficient. Thus, the ceramics with the same dimensions were bonded to double-sided surfaces. As a result, a marked reduction was obtained in this case. Also, the linearity of the sensor characteristics was significantly improved in a small acceleration range. Accordingly, it was clarified that considering the symmetry along the thickness direction of the vibrator is very important.

  16. A randomized controlled trial of intranasal ketamine in migraine with prolonged aura.

    PubMed

    Afridi, Shazia K; Giffin, Nicola J; Kaube, Holger; Goadsby, Peter J

    2013-02-12

    The aim of our study was to test the hypothesis that ketamine would affect aura in a randomized controlled double-blind trial, and thus to provide direct evidence for the role of glutamatergic transmission in human aura. We performed a double-blinded, randomized parallel-group controlled study investigating the effect of 25 mg intranasal ketamine on migraine with prolonged aura in 30 migraineurs using 2 mg intranasal midazolam as an active control. Each subject recorded data from 3 episodes of migraine. Eighteen subjects completed the study. Ketamine reduced the severity (p = 0.032) but not duration of aura in this group, whereas midazolam had no effect. These data provide translational evidence for the potential importance of glutamatergic mechanisms in migraine aura and offer a pharmacologic parallel between animal experimental work on cortical spreading depression and the clinical problem. This study provides class III evidence that intranasal ketamine is effective in reducing aura severity in patients with migraine with prolonged aura.

  17. Actively adjustable step-type ultrasonic horns in longitudinal vibration

    NASA Astrophysics Data System (ADS)

    Lin, Shuyu; Guo, Hao; Xu, Jie

    2018-04-01

    Actively adjustable longitudinal step-type ultrasonic horns are proposed and studied. The horn is composed of a traditional ultrasonic horn and piezoelectric material. In practical applications, this kind of step-type ultrasonic horn is mechanically excited by an ultrasonic transducer and the piezoelectric material is connected to an adjustable electric impedance. In this research, the effects of the electric impedance and of the location of the piezoelectric material on the performance of the horn are studied. It is shown that when the electric resistance is increased, the resonance frequency of the horn is increased; the displacement magnification is increased when the piezoelectric material is located in the large end and decreased when the piezoelectric material is located in the small end of the horn. The displacement magnification for the piezoelectric material in the large end is larger than that for the piezoelectric material in the small end of the horn. Some step-type ultrasonic horns are designed and manufactured; the resonance frequency and the displacement magnification are measured by means of POLYTEC Laser Scanning vibrometer. It is shown that the theoretical resonance frequency and the displacement magnification are in good agreement with the measured results. It is concluded that by means of the insertion of the piezoelectric material in the longitudinal horn, the horn performance can be adjusted by changing the electric impedance and the location of the piezoelectric material in the horn. It is expected that this kind of adjustable ultrasonic horns can be used in traditional and potential ultrasonic technologies where the vibrational performance adjustment is needed.

  18. Reducing microwave absorption with fast frequency modulation.

    PubMed

    Qin, Juehang; Hubler, A

    2017-05-01

    We study the response of a two-level quantum system to a chirp signal, using both numerical and analytical methods. The numerical method is based on numerical solutions of the Schrödinger solution of the two-level system, while the analytical method is based on an approximate solution of the same equations. We find that when two-level systems are perturbed by a chirp signal, the peak population of the initially unpopulated state exhibits a high sensitivity to frequency modulation rate. We also find that the aforementioned sensitivity depends on the strength of the forcing, and weaker forcings result in a higher sensitivity, where the frequency modulation rate required to produce the same reduction in peak population would be lower. We discuss potential applications of this result in the field of microwave power transmission, as it shows applying fast frequency modulation to transmitted microwaves used for power transmission could decrease unintended absorption of microwaves by organic tissue.

  19. Low-intensity electromagnetic irradiation of 70.6 and 73 GHz frequencies enhances the effects of disulfide bonds reducer on Escherichia coli growth and affects the bacterial surface oxidation-reduction state

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Torgomyan, Heghine; Trchounian, Armen, E-mail: Trchounian@ysu.am

    2011-10-14

    Highlights: {yields} Low intensity 70.6 and 73 GHz electromagnetic irradiation (EMI) strongly suppressed Escherichia coli growth at 73 GHz and pH 7.3. {yields} Reducer DL-dithiothreitol had bactericidal effect and disturbed the SH-groups number. {yields} EMI enhanced E. coli sensitivity toward dithiothreitol. {yields} EMI decreased the SH-groups number of membrane disturbed by ATP and N,N'-dicyclohexycarbodiimide. {yields} The changed membrane oxidation-reduction state could be the primary mechanisms in EMI effects. -- Abstract: Low-intensity electromagnetic irradiation (EMI) of 70.6 and 73 GHz frequencies (flux capacity - 0.06 mW cm{sup -2}) had bactericidal effects on Escherichia coli. This EMI (1 h) exposure suppressed themore » growth of E. coli K-12({lambda}). The pH value (6.0-8.0) did not significantly affect the growth. The lag-phase duration was prolonged, and the growth specific rate was inhibited, and these effects were more noticeable after 73 GHz irradiation. These effects were enhanced by the addition of DL-dithiothreitol (DTT), a strong reducer of disulfide bonds in surface membrane proteins, which in its turn also has bactericidal effect. Further, the number of accessible SH-groups in membrane vesicles was markedly decreased by EMI that was augmented by N,N'-dicyclohexycarbodiimide and DTT. These results indicate a change in the oxidation-reduction state of bacterial cell membrane proteins that could be the primary membranous mechanism in the bactericidal effects of low-intensity EMI of the 70.6 and 73 GHz frequencies.« less

  20. Rates and risk factors for prolonged opioid use after major surgery: population based cohort study

    PubMed Central

    Soneji, Neilesh; Ko, Dennis T; Yun, Lingsong; Wijeysundera, Duminda N

    2014-01-01

    Objective To describe rates and risk factors for prolonged postoperative use of opioids in patients who had not previously used opioids and undergoing major elective surgery. Design Population based retrospective cohort study. Setting Acute care hospitals in Ontario, Canada, between 1 April 2003 and 31 March 2010. Participants 39 140 opioid naïve patients aged 66 years or older who had major elective surgery, including cardiac, intrathoracic, intra-abdominal, and pelvic procedures. Main outcome measure Prolonged opioid use after discharge, as defined by ongoing outpatient prescriptions for opioids for more than 90 days after surgery. Results Of the 39 140 patients in the entire cohort, 49.2% (n=19 256) were discharged from hospital with an opioid prescription, and 3.1% (n=1229) continued to receive opioids for more than 90 days after surgery. Following risk adjustment with multivariable logistic regression modelling, patient related factors associated with significantly higher risks of prolonged opioid use included younger age, lower household income, specific comorbidities (diabetes, heart failure, pulmonary disease), and use of specific drugs preoperatively (benzodiazepines, selective serotonin reuptake inhibitors, angiotensin converting enzyme inhibitors). The type of surgical procedure was also highly associated with prolonged opioid use. Compared with open radical prostatectomies, both open and minimally invasive thoracic procedures were associated with significantly higher risks (odds ratio 2.58, 95% confidence interval 2.03 to 3.28 and 1.95 1.36 to 2.78, respectively). Conversely, open and minimally invasive major gynaecological procedures were associated with significantly lower risks (0.73, 0.55 to 0.98 and 0.45, 0.33 to 0.62, respectively). Conclusions Approximately 3% of previously opioid naïve patients continued to use opioids for more than 90 days after major elective surgery. Specific patient and surgical characteristics were associated with

  1. AUTOMATIC FREQUENCY CONTROL SYSTEM

    DOEpatents

    Hansen, C.F.; Salisbury, J.D.

    1961-01-10

    A control is described for automatically matching the frequency of a resonant cavity to that of a driving oscillator. The driving oscillator is disconnected from the cavity and a secondary oscillator is actuated in which the cavity is the frequency determining element. A low frequency is mixed with the output of the driving oscillator and the resultant lower and upper sidebands are separately derived. The frequencies of the sidebands are compared with the secondary oscillator frequency. deriving a servo control signal to adjust a tuning element in the cavity and matching the cavity frequency to that of the driving oscillator. The driving oscillator may then be connected to the cavity.

  2. Do brief motivational interventions reduce drinking game frequency in mandated students? An analysis of data from two randomized controlled trials.

    PubMed

    Fernandez, Anne C; Yurasek, Ali M; Merrill, Jennifer E; Miller, Mary Beth; Zamboanga, Byron L; Carey, Kate B; Borsari, Brian

    2017-02-01

    College students frequently engage in drinking games (DGs) and experience a variety of consequences as a result. It is currently unknown whether brief motivational interventions (BMIs) that provide feedback on DG participation can reduce this high risk behavior. This study examined outcome data from 2 randomized clinical trials to examine whether BMIs facilitate change in DG frequency and how these changes may occur. Mandated college students (Trial 1, N = 198, 46% female; Trial 2, N = 412; 32% female) were randomized to BMI or comparison control conditions. Hierarchical linear modeling (HLM) was used to compare the BMI and comparison groups to determine whether the BMI reduced DG participation over time. Percent change talk (PCT) during the discussion of DG during the session was examined as a predictor of change in DG frequency, and gender was examined as a moderator of treatment effects. Controlling for regular drinking frequency, participants who received a BMI did not significantly reduce their DG frequency relative to the comparison group in either sample, and the BMI was equally ineffective at reducing DG behavior for men and women. DG-related PCT during the BMI was associated with lower DG frequency at the second follow-up in both trials. In Trial 1, PCT during the BMI was associated with less steep increases in DG frequency across the course of all follow-ups. Effects of PCT on DG behavior were not moderated by gender. Findings did not support hypothesized reductions in DG participation following a BMI. Future research should explore whether targeted DG-specific interventions could reduce DG participation and the role of in-session client language in facilitating such change. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Frequency-Accommodating Manchester Decoder

    NASA Technical Reports Server (NTRS)

    Vasquez, Mario J.

    1988-01-01

    No adjustment necessary to cover a 10:1 frequency range. Decoding circuit converts biphase-level pulse-code modulation to nonreturn-to-zero (NRZ)-level pulse-code modulation plus clock signal. Circuit accommodates input data rate of 50 to 500 kb/s. Tracks gradual changes in rate automatically, eliminating need for extra circuits and manual switching to adjust to different rates.

  4. Glycemic control during consecutive days with prolonged walking exercise in individuals with type 1 diabetes mellitus.

    PubMed

    van Dijk, Jan-Willem; Eijsvogels, Thijs M; Nyakayiru, Jean; Schreuder, Tim H A; Hopman, Maria T; Thijssen, Dick H; van Loon, Luc J C

    2016-07-01

    Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to consecutive days with prolonged walking exercise (∼8h daily) in individuals with type 1 diabetes. Ten individuals with type 1 diabetes participating in the worlds' largest walking event were recruited for this observational study. Simultaneous measurements of 24-h glycemic control (continuous glucose monitoring), insulin administration and food intake were performed during a non-walking day (control) and during three subsequent days with prolonged walking exercise (daily distance 40 or 50km). Despite an increase in daily energy (31±18%; p<0.01) and carbohydrate (82±71g; p<0.01) intake during walking days, subjects lowered their insulin administration by 26±16% relative to the control day (p<0.01). Average 24-h blood glucose concentrations, the prevalence of hyperglycemia (blood glucose >10 mmol/L) and hypoglycemia (blood glucose <3.9mmol/L) did not differ between the control day and walking days (p>0.05 for all variables). The prolonged walking exercise was associated with a modest increase in glycemic variability compared with the control day (p<0.05). Prolonged walking exercise allows for profound reductions in daily insulin administration in persons with type 1 diabetes, despite large increments in energy and carbohydrate intake. When taking such adjustments into account, prolonged moderate-intensity exercise does not necessarily impair 24-h glycemic control. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Clinical dysphagia risk predictors after prolonged orotracheal intubation.

    PubMed

    Medeiros, Gisele Chagas de; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Zilberstein, Bruno; Andrade, Claudia Regina Furquim de

    2014-01-01

    To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation. The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance. Of the 148 patients included in the study, 91 were male and 57 were female (mean age, 53.64 years). The univariate analysis results indicated that specific variables, including extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking, and other signs, were possible significant high-risk indicators of dysphagia onset. The multivariate analysis results indicated that cervical auscultation and coughing were independent predictive variables for high dysphagia risk. Patients displaying extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking and other signs should benefit from early swallowing evaluations. Additionally, early post-extubation dysfunction recognition is paramount in reducing the morbidity rate in this high-risk population.

  6. OFO experimental techniques and preliminary conclusions - Is artificial gravity needed during prolonged weightlessness.

    NASA Technical Reports Server (NTRS)

    Gualtierotti, T.; Bracchi, F.

    1972-01-01

    The technique of single unit recording from body systems generating electrical pulses coherent with their basic function (CNS, muscles, sense organs) has been proved feasible during the OFO A orbital flight, an automatic physiological experiment. The results of recording 155 hours of orbital flight of pulses from the nerve fibres of four vestibular gravity sensors in two bull frogs indicate that the vestibular organ adjusts to zero g. As all the other biological changes observed during orbit are due to lack of exercise, it is concluded that artificial gravity might not be necessary during prolonged space missions or on low gravity celestial bodies.

  7. Management of children with prolonged diarrhea

    PubMed Central

    Giannattasio, Antonietta; Guarino, Alfredo; Lo Vecchio, Andrea

    2016-01-01

    Prolonged diarrhea is usually defined as acute-onset diarrhea lasting 7 days or more, but less than 14 days. Its trend has been declining in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. The pathogenesis of prolonged diarrhea is multifactorial and essentially based on persistent mucosal damage due to specific infections or sequential infections with different pathogens, host-related factors including micronutrient and/or vitamin deficiency, undernutrition and immunodeficiency, high mucosal permeability due to previous infectious processes and nutrient deficiency with consequential malabsorption, and microbiota disruption. Infections seem to play a major role in causing prolonged diarrhea in both developing and developed areas. However, single etiologic pathogens have not been identified, and the pattern of agents varies according to settings, host risk factors, and previous use of antibiotics and other drugs. The management of prolonged diarrhea is complex. Because of the wide etiologic spectrum, diagnostic algorithms should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Often, expensive laboratory evaluations are of little benefit in guiding therapy, and an empirical approach may be effective in the majority of cases. The presence or absence of weight loss is crucial for driving the initial management of prolonged diarrhea. If there is no weight loss, generally there is no need for further evaluation. If weight loss is present, empiric anti-infectious therapy or elimination diet may be considered once specific etiologies have been excluded. PMID:26962439

  8. Management of children with prolonged diarrhea.

    PubMed

    Giannattasio, Antonietta; Guarino, Alfredo; Lo Vecchio, Andrea

    2016-01-01

    Prolonged diarrhea is usually defined as acute-onset diarrhea lasting 7 days or more, but less than 14 days. Its trend has been declining in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. The pathogenesis of prolonged diarrhea is multifactorial and essentially based on persistent mucosal damage due to specific infections or sequential infections with different pathogens, host-related factors including micronutrient and/or vitamin deficiency, undernutrition and immunodeficiency, high mucosal permeability due to previous infectious processes and nutrient deficiency with consequential malabsorption, and microbiota disruption. Infections seem to play a major role in causing prolonged diarrhea in both developing and developed areas. However, single etiologic pathogens have not been identified, and the pattern of agents varies according to settings, host risk factors, and previous use of antibiotics and other drugs. The management of prolonged diarrhea is complex. Because of the wide etiologic spectrum, diagnostic algorithms should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Often, expensive laboratory evaluations are of little benefit in guiding therapy, and an empirical approach may be effective in the majority of cases. The presence or absence of weight loss is crucial for driving the initial management of prolonged diarrhea. If there is no weight loss, generally there is no need for further evaluation. If weight loss is present, empiric anti-infectious therapy or elimination diet may be considered once specific etiologies have been excluded.

  9. Voluntary reduction of force variability via modulation of low-frequency oscillations.

    PubMed

    Park, Seoung Hoon; Casamento-Moran, Agostina; Yacoubi, Basma; Christou, Evangelos A

    2017-09-01

    Visual feedback can influence the force output by changing the power in frequencies below 1 Hz. However, it remains unknown whether visual guidance can help an individual reduce force variability voluntarily. The purpose of this study, therefore, was to determine whether an individual can voluntarily reduce force variability during constant contractions with visual guidance, and whether this reduction is associated with a decrease in the power of low-frequency oscillations (0-1 Hz) in force and muscle activity. Twenty young adults (27.6 ± 3.4 years) matched a force target of 15% MVC (maximal voluntary contraction) with ankle dorsiflexion. Participants performed six visually unrestricted contractions, from which we selected the trial with the least variability. Following, participants performed six visually guided contractions and were encouraged to reduce their force variability within two guidelines (±1 SD of the least variable unrestricted trial). Participants decreased the SD of force by 45% (P < 0.001) during the guided condition, without changing mean force (P > 0.2). The decrease in force variability was associated with decreased low-frequency oscillations (0-1 Hz) in force (R 2  = 0.59), which was associated with decreased low-frequency oscillations in EMG bursts (R 2  = 0.35). The reduction in low-frequency oscillations in EMG burst was positively associated with power in the interference EMG from 35 to 60 Hz (R 2  = 0.47). In conclusion, voluntary reduction of force variability is associated with decreased low-frequency oscillations in EMG bursts and consequently force output. We provide novel evidence that visual guidance allows healthy young adults to reduce force variability voluntarily likely by adjusting the low-frequency oscillations in the neural drive.

  10. Behavioral Adjustments by a Small Neotropical Primate (Callithrix jacchus) in a Semiarid Caatinga Environment

    PubMed Central

    De la Fuente, María Fernanda Castellón; Souto, Antonio; Sampaio, Marilian Boachá; Schiel, Nicola

    2014-01-01

    We provide the first information on the behavior of a small primate (Callithrix jacchus) inhabiting a semiarid Caatinga environment in northeastern Brazil. We observed behavioral variations in response to temperature fluctuation throughout the day. Due to the high temperatures, low precipitation, and resource scarcity in the Caatinga, as well as the lack of physiological adaptations (e.g., a highly concentrated urine and a carotid rete to cool down the brain) of these primates, we expected that the common marmosets would exhibit behavioral adjustments, such as a prolonged resting period or the use of a large home range. During the six-month period, we collected 246 hours of behavioral data of two groups (10 individuals) of Callithrix jacchus. Most of the observed behavioral patterns were influenced by temperature fluctuation. Animals rested longer and reduced other activities, such as foraging, when temperatures were higher. Both study groups exploited home ranges of 2.21–3.26 ha, which is within the range described for common marmosets inhabiting the Atlantic Forest. Our findings confirm that common marmosets inhabiting the Caatinga adjust their behavioral patterns to cope with the high temperatures that characterize this environment and highlight their ability to survive across a wide range of different environmental conditions. PMID:25431785

  11. Behavioral adjustments by a small neotropical primate (Callithrix jacchus) in a semiarid Caatinga environment.

    PubMed

    De la Fuente, María Fernanda Castellón; Souto, Antonio; Sampaio, Marilian Boachá; Schiel, Nicola

    2014-01-01

    We provide the first information on the behavior of a small primate (Callithrix jacchus) inhabiting a semiarid Caatinga environment in northeastern Brazil. We observed behavioral variations in response to temperature fluctuation throughout the day. Due to the high temperatures, low precipitation, and resource scarcity in the Caatinga, as well as the lack of physiological adaptations (e.g., a highly concentrated urine and a carotid rete to cool down the brain) of these primates, we expected that the common marmosets would exhibit behavioral adjustments, such as a prolonged resting period or the use of a large home range. During the six-month period, we collected 246 hours of behavioral data of two groups (10 individuals) of Callithrix jacchus. Most of the observed behavioral patterns were influenced by temperature fluctuation. Animals rested longer and reduced other activities, such as foraging, when temperatures were higher. Both study groups exploited home ranges of 2.21-3.26 ha, which is within the range described for common marmosets inhabiting the Atlantic Forest. Our findings confirm that common marmosets inhabiting the Caatinga adjust their behavioral patterns to cope with the high temperatures that characterize this environment and highlight their ability to survive across a wide range of different environmental conditions.

  12. Depressed tetanic contactile function cannot be compensated by increasing stimulating frequency in unloaded soleus muscle

    NASA Astrophysics Data System (ADS)

    Gao, Fang; Yu, Zhi-Bin

    2005-08-01

    The weightlessness-induced muscle atrophy is associated with a reduced force and power and with an increased fatigability [1]. In prolonged manned space missions, these alterations in skeletal muscles could limit the crew's ability to work in space and to rapidly egress in an emergency on return to Earth. In order to elucidate the underlying mechanisms of the increased fatigability in the atrophic skeletal muscle, we isolated the typically fast and slow muscle, extensor digitorum longus (EDL) and soleus (SOL), to observe the changes in maximal contraction tension, optimal stimulating frequency, and recovery features after fatigue in the intermittent tetanic contraction.

  13. Racial and Ethnic Differences in Utilization of Labor Management Strategies Intended to Reduce Cesarean Delivery Rates.

    PubMed

    Yee, Lynn M; Costantine, Maged M; Rice, Madeline Murguia; Bailit, Jennifer; Reddy, Uma M; Wapner, Ronald J; Varner, Michael W; Thorp, John M; Caritis, Steve N; Prasad, Mona; Tita, Alan T N; Sorokin, Yoram; Rouse, Dwight J; Blackwell, Sean C; Tolosa, Jorge E

    2017-12-01

    To examine whether racial and ethnic differences exist in the frequency of and indications for cesarean delivery and to assess whether application of labor management strategies intended to reduce cesarean delivery rates is associated with patient's race and ethnicity. This is a secondary analysis of a multicenter observational obstetric cohort. Trained research personnel abstracted maternal and neonatal records of greater than 115,000 pregnant women from 25 hospitals (2008-2011). Women at term with singleton, nonanomalous, vertex, liveborn neonates were included in two cohorts: 1) nulliparous women (n=35,529); and 2) multiparous women with prior vaginal deliveries only (n=39,871). Women were grouped as non-Hispanic black, non-Hispanic white, Hispanic, and Asian. Multivariable logistic regression was used to evaluate the following outcomes: overall cesarean delivery frequency, indications for cesarean delivery, and utilization of labor management strategies intended to safely reduce cesarean delivery. A total of 75,400 women were eligible for inclusion, of whom 47% (n=35,529) were in the nulliparous cohort and 53% (n=39,871) were in the multiparous cohort. The frequencies of cesarean delivery were 25.8% among nulliparous women and 6.0% among multiparous women. For nulliparous women, the unadjusted cesarean delivery frequencies were 25.0%, 28.3%, 28.7%, and 24.0% for non-Hispanic white, non-Hispanic black, Asian, and Hispanic women, respectively. Among nulliparous women, the adjusted odds of cesarean delivery were higher in all racial and ethnic groups compared with non-Hispanic white women (non-Hispanic black adjusted odds ratio [OR] 1.47, 95% CI 1.36-1.59; Asian adjusted OR 1.26, 95% CI 1.14-1.40; Hispanic adjusted OR 1.17, 95% CI 1.07-1.27) as a result of greater odds of cesarean delivery both for nonreassuring fetal status and labor dystocia. Nonapplication of labor management strategies regarding failed induction, arrest of dilation, arrest of descent, or

  14. Correlates of household seismic hazard adjustment adoption.

    PubMed

    Lindell, M K; Whitney, D J

    2000-02-01

    This study examined the relationships of self-reported adoption of 12 seismic hazard adjustments (pre-impact actions to reduce danger to persons and property) with respondents' demographic characteristics, perceived risk, perceived hazard knowledge, perceived protection responsibility, and perceived attributes of the hazard adjustments. Consistent with theoretical predictions, perceived attributes of the hazard adjustments differentiated among the adjustments and had stronger correlations with adoption than any of the other predictors. These results identify the adjustments and attributes that emergency managers should address to have the greatest impact on improving household adjustment to earthquake hazard.

  15. Cardiac electrical conduction, autonomic activity and biomarker release during recovery from prolonged strenuous exercise in trained male cyclists.

    PubMed

    Stewart, Glenn M; Kavanagh, Justin J; Koerbin, Gus; Simmonds, Michael J; Sabapathy, Surendran

    2014-01-01

    Although markers of myocyte injury, electrolyte disturbances and an autonomic imbalance have been reported following exercise, the effect of prolonged strenuous activity on cardiac electrical conduction is not well understood. This study examined atrial and ventricular conduction dynamics during recovery from exercise. Electrocardiographic intervals were obtained from eight highly-trained males before, during recovery (15, 30, 45 and 60 min post-exercise) and 24 h after a prolonged bout of strenuous exercise. Time-domain, frequency-domain and non-linear analyses of the RR, PR and QT intervals were analysed to investigate the effect of exercise on autonomic modulation and cardiac electrical conduction. Serum electrolyte and high-sensitivity cardiac troponin T (hs-cTnT) concentrations were measured before exercise, and after 60 min and 24 h of recovery. The root mean square of the successive differences of RR, PR and QT intervals was significantly reduced during recovery (p < 0.05). Normalised low- and high-frequency power of RR intervals significantly increased and decreased, respectively, during recovery. Approximate entropy of PR and QT intervals, and the QT-variability index significantly increased during recovery. All measures except mean QT interval (pre 422 ± 10 ms vs 24 h post 442 ± 11 ms, p = 0.013) returned to pre-exercise values after 24 h. Serum hs-cTnT was significantly elevated 60 min after exercise (pre 5.2 ± 0.7 ng L(-1) vs 60 min post 27.4 ± 6.2 ng L(-1), p = 0.01) and correlated with exercising heart rate (R(2) = 0.89, p < 0.001). Serum electrolyte concentrations were unchanged (p > 0.05). The results suggest suppressed parasympathetic and/or sustained sympathetic modulation of heart rate during recovery, concomitant with perturbations in atrial and ventricular conduction dynamics. Exercise-induced hs-cTnT release was heart rate dependent.

  16. Longitudinal changes and predictors of prolonged grief for bereaved family caregivers over the first 2 years after the terminally ill cancer patient's death.

    PubMed

    Tsai, Wei-I; Prigerson, Holly G; Li, Chung-Yi; Chou, Wen-Chi; Kuo, Su-Ching; Tang, Siew Tzuh

    2016-05-01

    A significant minority of bereaved caregivers experience prolonged grief. However, few longitudinal studies have examined prolonged grief, especially in an Asian context. We explored longitudinal changes and factors predicting prolonged grief in bereaved caregivers of terminally ill Taiwanese cancer patients. Observational, prospective, and longitudinal. Prolonged grief symptoms were measured with the PG-13 at 6, 13, 18, and 24 months postloss. A convenience sample of 493 caregivers (83.3% participation rate) of terminally ill cancer patients was recruited from a medical center in Taiwan. The prevalence of prolonged grief decreased significantly over time from the patient's death (7.73%, 1.80%, 2.49%, and 1.85% at 6, 13, 18, and 24 months postloss, respectively, p < 0.05 at all times in reference to 6 months postloss). Caregivers' likelihood of prolonged grief was significantly higher if they had severe preloss depressive symptoms, negatively perceived their relative's dying situation, and were poorly prepared for the patient's death. However, the likelihood of prolonged grief decreased significantly with greater perceived concurrent social support and subjective caregiving burden right before the patient's death. Prolonged grief in bereavement diminished over time and was predicted by modifiable factors before, during, and after bereavement. To facilitate bereavement adjustment and avoid prolonged grief, healthcare professionals should develop and provide at-risk caregivers with effective interventions starting when patients are still alive to improve their dying experience, to facilitate preparedness for the patient's forthcoming death, to alleviate caregivers' preloss depressive symptoms, and to enhance their perceived postloss social support. © The Author(s) 2015.

  17. Prolonged methylprednisolone therapy after the pulse treatment for patients with moderate-to-severe paraquat poisoning: A retrospective analysis.

    PubMed

    Gao, Jie; Feng, ShunYi; Wang, Jian; Yang, SiYuan; Li, Yong

    2017-06-01

    This retrospective study aims to evaluate the effect of prolonged methylprednisolone (MP) therapy on the mortality of patients with moderate-to-severe paraquat (PQ) poisoning after the pulse treatment.We performed a retrospective analysis of patients with acute moderate-to-severe PQ poisoning that were admitted to the emergency department from May 2012 to August 2016. Out of 138 patients, 60 were treated with pulse treatment (15 mg kg day MP for 3 days) and 78 were treated with prolonged MP therapy after pulse treatment (15 mg kg day MP for 3 days; afterward, the dosage was reduced in half every 2 days, and the MP therapy was terminated until 0.47 mg kg day). Kaplan-Meier method was used to compare the mortality between the 2 groups. Cox proportional hazard models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI).The mortality of the prolonged MP therapy after pulse treatment group was lower than that of the pulse group (47.4% vs 63.3%; log-rank tests, P  =  .003). According to the multivariate Cox analysis, the prolonged MP therapy after pulse treatment was significantly associated with a lower mortality risk (HR: 0.31, 95% CI: 0.19-0.52, P < .001) compared with the pulse group. In addition, the prolonged MP therapy after pulse treatment caused more incidences of leucopenia than the pulse treatment alone (25.6% vs 11.7%, P  =  .04).The prolonged MP therapy after pulse treatment can reduce the mortality of moderate-to-severe PQ poisoning patients.

  18. Editor's Choice - Prolonged ICU Length of Stay after AAA Repair: Analysis of Time Trends and Long-term Outcome.

    PubMed

    Gavali, H; Mani, K; Tegler, G; Kawati, R; Covaciu, L; Wanhainen, A

    2017-08-01

    The aim of the study was to investigate the frequency and outcome of prolonged intensive care unit (ICU) length of stay (LOS) after abdominal aortic aneurysm (AAA) repair in the endovascular era. All patients operated on for AAA between 1999 and 2013 at Uppsala University hospital were identified. Data were retrieved from the Swedish Vascular registry, the Swedish Intensive Care registry, the National Population registry, and case records. Prolonged ICU LOS was defined as ≥ 48 h during the primary hospital stay. Patients surviving ≥ 48 h after AAA surgery were included in the analysis. A total of 725 patients were identified, of whom 707 (97.5%) survived ≥ 48 h; 563 (79.6%) underwent intact AAA repair and 144 (20.4%) ruptured AAA repair. A total of 548 patients (77.5%) required < 48 h of intensive care, 115 (16.3%) 2-6 days and 44 (6.2%) ≥ 7 days. The rate of prolonged ICU LOS declined considerably over time, from 41.4% of all AAA repairs in 1999 to 7.3% in 2013 (p < .001) whereas the use of endovascular aortic repair (EVAR) increased from 6.9% in 1999 to 78.0% in 2013 (p < .001). The 30 day survival rate was 98.2% for those with < 48 h ICU stay versus 93.0% for 2-6 days versus 81.8% for ≥ 7 days (p < .001); the corresponding 90 day survival was 97.1% versus 86.1% versus 63.6% (p < .001) respectively. For patients surviving 90 days after repair, there was no difference in long-term survival between the groups. During the period of progressively increasing use of EVAR, a simultaneous significant reduction in frequency of prolonged ICU LOS occurred. Although prolonged ICU LOS was associated with a high short-term mortality, long-term outcome among those surviving the initial 90 days was less affected. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  19. Analysis of adjusting effects of mounting force on frequency conversion of mounted nonlinear optics.

    PubMed

    Su, Ruifeng; Liu, Haitao; Liang, Yingchun; Lu, Lihua

    2014-01-10

    Motivated by the need to increase the second harmonic generation (SHG) efficiency of nonlinear optics with large apertures, a novel mounting configuration with active adjusting function on the SHG efficiency is proposed and mechanically and optically studied. The adjusting effects of the mounting force on the distortion and stress are analyzed by the finite element methods (FEM), as well as the contribution of the distortion and stress to the change in phase mismatch, and the SHG efficiency are theoretically stated. Further on, the SHG efficiency is calculated as a function of the mounting force. The changing trends of the distortion, stress, and the SHG efficiency with the varying mounting force are obtained, and the optimal ones are figured out. Moreover, the mechanism of the occurrence of the optimal values is studied and the adjusting strategy is put forward. Numerical results show the robust adjustment of the mounting force, as well as the effectiveness of the mounting configuration, in increasing the SHG efficiency.

  20. Hand rest and wrist support are effective in preventing fatigue during prolonged typing.

    PubMed

    Callegari, Bianca; de Resende, Marília Maniglia; da Silva Filho, Manoel

    Case series (longitudinal). Only few reports concerning the efficacy of commonly used strategies for preventing upper limb occupational disorders associated with prolonged typing exist. We aimed to investigate whether the duration of typing and the use of 2 strategies (hand rest and wrist support) changes muscle physiological response and therefore the electromyography records. We enrolled 25 volunteers, who were unfamiliar with the task and did not have musculoskeletal disorders. The subjects underwent 3 prolonged typing protocols to investigate the efficacy of the 2 adopted strategies in reducing the trapezius, biceps brachii, and extensor digitorum communis fatigue. Typing for 1 hour induced muscular fatigue (60%-67% of the subjects). The extensor digitorum communis muscle exhibited the highest percentage of fatigue (72%-84%) after 1 and 4 hours of typing (1 hour, P = .04; 4 hours, P = .02). Fatigue levels in this muscle were significantly reduced (24%) with the use of pause typing (4 hours, P = .045), whereas biceps brachii muscle fatigue was reduced (32%) only with the use of wrist supports (P = .02, after 4 hours). Trapezius muscle fatigue was unaffected by the tested occupational strategies (1 hour, P = .62; 4 hours, P = .85). Despite presenting an overall tendency for fatigue detected during the application of the protocols, the assessed muscles exhibited different behavior patterns, depending on both the preventive strategy applied and the muscle mechanical role during the task. Hand rest and wrist support can successfully reduce muscle fatigue in specific upper limb muscles during prolonged typing, leading to a muscle-selective reduction in the occurrence of fatigue and thus provide direct evidence that they may prevent work-related musculoskeletal disorders. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  1. Prolonged pain and disability are common after rib fractures.

    PubMed

    Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John

    2013-05-01

    The contribution of rib fractures to prolonged pain and disability may be underappreciated and undertreated. Clinicians are traditionally taught that the pain and disability of rib fractures resolves in 6 to 8 weeks. This study was a prospective observation of 203 patients with rib fractures at a level 1 trauma center. Chest wall pain was evaluated by the McGill Pain Questionnaire (MPQ) pain rating index (PRI) and present pain intensity (PPI). Prolonged pain was defined as a PRI of 8 or more at 2 months after injury. Prolonged disability was defined as a decrease in 1 or more levels of work or functional status at 2 months after injury. Predictors of prolonged pain and disability were determined by multivariate analysis. One hundred forty-five male patients and 58 female patients with a mean injury severity score (ISS) of 20 (range, 1 to 59) had a mean of 5.4 rib fractures (range, 1 to 29). Forty-four (22%) patients had bilateral fractures, 15 (7%) had flail chest, and 92 (45%) had associated injury. One hundred eighty-seven patients were followed 2 months or more. One hundred ten (59%) patients had prolonged chest wall pain and 142 (76%) had prolonged disability. Among 111 patients with isolated rib fractures, 67 (64%) had prolonged chest wall pain and 69 (66%) had prolonged disability. MPQ PPI was predictive of prolonged pain (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.4 to 2.5), and prolonged disability (OR, 2.2; 95% CI, 1.5 to 3.4). The presence of significant associated injuries was predictive of prolonged disability (OR, 5.9; 95% CI, 1.4 to 29). Prolonged chest wall pain is common, and the contribution of rib fractures to disability is greater than traditionally expected. Further investigation into more effective therapies that prevent prolonged pain and disability after rib fractures is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Risk factors of prolonged mechanical ventilation following open heart surgery: what has changed over the last decade?

    PubMed

    Siddiqui, Muhammad-Mujtaba Ali; Paras, Iftikhar; Jalal, Anjum

    2012-09-01

    To identify the risk factors for prolonged invasive mechanical ventilation after open heart surgery in Pakistan. This study is based on retrospective analysis of database. We conducted study of all patients who underwent open heart surgery at CPE Institute of Cardiology, Multan from March 2009 to May 2011. The data was retrieved from the database in the form of electronic spreadsheet which was then analyzed using SPSS software. The patients with incomplete data entries were removed from the analysis resulting in a set of 1,617 patients. The data of each patient consisted of 65 preoperative, operative and postoperative variables. The data was summarized as means, medians and standard deviations for numeric variables and frequencies and percentages or categoric variables. These risk factors were compared using Chi-sqaure test. Their ODDs ratios and 95% confidence intervals of ODD's Ratios and P values were calculated. Out of a total of 1,617 patients, 77 patients (4.76%) had prolonged ventilation for a cumulated duration of more than over 24 hours. Preoperative renal failure, emphysema, low EF (<30%), urgent operation, preoperative critical state, prolonged bypass time, prolonged cross clamp time, complex surgical procedures and peri-operative myocardial infarction were found to be risk factors for PIMV. Old age, female gender, advanced ASA class, advanced NYHA class, diabetes mellitus, smoking, history of COPD, redo surgery, left main stenosis, obesity and use of intra-aortic balloon pump were not found to have significant ODDs ratios for PIMV. The patients with prolonged ventilation had significantly high mortality i.e. 32.47% while the normal ventilation group had 0.32% overall mortality. Many of the previously considered risk factors for prolonged ventilation after open heart study are no more significant risk factors. However, prolonged ventilation continues to be associated with very high mortality.

  3. Prolonged Nightly Fasting and Breast Cancer Risk: Findings from NHANES (2009-2010).

    PubMed

    Marinac, Catherine R; Natarajan, Loki; Sears, Dorothy D; Gallo, Linda C; Hartman, Sheri J; Arredondo, Elva; Patterson, Ruth E

    2015-05-01

    A novel line of research has emerged, suggesting that daily feeding-fasting schedules that are synchronized with sleep-wake cycles have metabolic implications that are highly relevant to breast cancer. We examined associations of nighttime fasting duration with biomarkers of breast cancer risk among women in the 2009-2010 U.S. National Health and Nutrition Examination Survey. Dietary, anthropometric, and HbA1c data were available for 2,212 women, and 2-hour postprandial glucose concentrations were available for 1,066 women. Nighttime fasting duration was calculated using 24-hour food records. Separate linear regression models examined associations of nighttime fasting with HbA1c and 2-hour glucose concentrations. Logistic regression modeled associations of nighttime fasting with elevated HbA1c (HbA1c ≥ 39 mmol/mol or 5.7%) and elevated 2-hour glucose (glucose ≥ 140 mg/dL). All models adjusted for age, education, race/ethnicity, body mass index, total kcal intake, evening kcal intake, and the number of eating episodes per day. Each 3-hour increase in nighttime fasting (roughly 1 SD) was associated with a 4% lower 2-hour glucose measurement [β, 0.96; 95% confidence interval (CI), 0.93-1.00; P < 0.05], and a nonstatistically significant decrease in HbA1c. Logistic regression models indicate that each 3-hour increase in nighttime fasting duration was associated with roughly a 20% reduced odds of elevated HbA1c (OR, 0.81; 95% CI, 0.68-0.97; P < 0.05) and nonsignificantly reduced odds of elevated 2-hour glucose. A longer nighttime duration was significantly associated with improved glycemic regulation. Randomized trials are needed to confirm whether prolonged nighttime fasting could improve biomarkers of glucose control, thereby reducing breast cancer risk. ©2015 American Association for Cancer Research.

  4. Uncomplicated Caesarean section: is prolonged hospital stay necessary?

    PubMed

    Fasubaa, O B; Ogunniyi, S O; Dare, F O; Isawumi, A I; Ezechi, O C; Orji, E O

    2000-08-01

    Caesarean section among the Yoruba of western Nigerian is surrounded by a lot of fears, miseries, aversion, guilt and misconceptions for reasons varying from the desire by women to have a natural vaginal birth, fear of surgery, morbidity and deaths from the operation and prolonged hospital stay. To examine issues of reduced hospital stay following Caesarean section with a view of making the operation more acceptable and proffering solution to some of the problems faced by women when Caesarean section is indicated. A prospective case control study. Wesley Guild Hospital, Ilesha, Nigeria from 1st July, 1997 to 30th June, 1998. One hundred consecutive patients who had uncomplicated Caesarean section, randomised into two groups of short (three days) and prolonged (seven to eight days) hospital stay respectively. Observations of patients in both groups were made by an independent observer on day seven post-operation and the main outcomes measured included: wound infection rates, ability to maintain erect posture, mood changes, neonatal sepsis rate, immunisation rate of the neonates and average hospital bills. The findings revealed that wound infection rates of six per cent and ten per cent among the short and prolonged hospitalised patients respectively are not significantly different. Patients with short stay have better erect posture, lower incidence of depressive mood, lower neonatal sepsis rate, lower hospital bill and are more satisfied with early home discharge. Embracing the concept of early home discharge after Caesarean section in uncomplicated cases may remove some of the psychological upsets and economical impediments associated with the operation and make the operation more acceptable.

  5. Prolonged delirium misdiagnosed as a mood disorder.

    PubMed

    Cao, Fei; Salem, Haitham; Nagpal, Caesa; Teixeira, Antonio L

    2017-01-01

    Delirium can be conceptualized as an acute decline in cognitive function that typically lasts from hours to a few days. Prolonged delirium can also affect patients with multiple predisposing and/or precipitating factors. In clinical practice, prolonged delirium is often unrecognized, and can be misdiagnosed as other psychiatric disorders. We describe a case of a 59-year-old male presenting with behavioral and cognitive symptoms that was first misdiagnosed as a mood disorder in a general hospital setting. After prolonged delirium due to multiple factors was confirmed, the patient was treated accordingly with symptomatic management. He evolved with progressive improvement of his clinical status. Early diagnosis and management of prolonged delirium are important to improve patient prognosis and avoid iatrogenic measures.

  6. Sprint training shortens prolonged action potential duration in postinfarction rat myocyte: mechanisms.

    PubMed

    Zhang, X Q; Zhang, L Q; Palmer, B M; Ng, Y C; Musch, T I; Moore, R L; Cheung, J Y

    2001-05-01

    Two electrophysiological manifestations of myocardial infarction (MI)-induced myocyte hypertrophy are prolongation of action potential duration (APD) and reduction of transient outward current (I(to)) density. Because high-intensity sprint training (HIST) ameliorated myocyte hypertrophy and improved myocyte Ca(2+) homeostasis and contractility after MI, the present study evaluated whether 6-8 wk of HIST would shorten the prolonged APD and improve the depressed I(to) in post-MI myocytes. There were no differences in resting membrane potential and action potential amplitude (APA) measured in myocytes isolated from sham-sedentary (Sed), MI-Sed, and MI-HIST groups. Times required for repolarization to 50 and 90% APA were significantly (P < 0.001) prolonged in MI-Sed myocytes. HIST reduced times required for repolarization to 50 and 90% APA to values observed in Sham-Sed myocytes. The fast and slow components of I(to) were significantly (P < 0.0001) reduced in MI-Sed myocytes. HIST significantly (P < 0.001) enhanced the fast and slow components of I(to) in MI myocytes, although not to levels observed in Sham-Sed myocytes. There were no significant differences in steady-state I(to) inactivation and activation parameters among Sham-Sed, MI-Sed, and MI-HIST myocytes. Likewise, recovery from time-dependent inactivation was also similar among the three groups. We suggest that normalization of APD after MI by HIST may be mediated by restoration of I(to) toward normal levels.

  7. LASER APPLICATIONS AND OTHER TOPICS IN QUANTUM ELECTRONICS: Frequency modulation upon nonstationary heating of the p - n junction in high-sensitive diode laser spectroscopy

    NASA Astrophysics Data System (ADS)

    Andreev, Sergei N.; Nikolaev, I. V.; Ochkin, Vladimir N.; Savinov, Sergei Yu; Spiridonov, Maksim V.; Tskhai, Sergei N.

    2007-04-01

    A special type of modulation of the injection current of a diode laser is proposed at which the frequency modulation of radiation is not accompanied by the residual amplitude modulation. This method considerably reduces the influence of the diode laser radiation instability on the recorded absorption spectra. This allows a prolonged monitoring of small amounts of impurities in gas analysis by retaining a high sensitivity. Prolonged measurements of absorption spectra are performed at a relative absorption of 8×10-7. By using a 50-cm multipass cell with the optical length of 90 m, the absorption coefficient of 1.2×10-10 cm-1 was detected. As an example, the day evolution of the background concentrations of NO2 molecules was measured in the atmosphere.

  8. Clinical factors and incidence of prolonged fever in neurosurgical patients.

    PubMed

    Wang, Zhuo; Shen, Meifen; Qiao, Meizhen; Zhang, Haiyin; Tang, Zaixiang

    2017-02-01

    To describe the incidence of prolonged fever in patients admitted to the neurosurgery department, and the corresponding risk indicators. Prolonged fever was defined as a temperature higher than 38·3°C lasting more than five days. Prolonged fever is a common phenomenon and could lead to worsened outcomes in specific patient groups, especially for those with brain injury. However, the studies on prolonged fever in neurosurgical patients are limited and insufficient. A retrospective observational study. Retrospective data were collected from 1 January 2014 to 31 December 2014, at the neurosurgical department of a large teaching hospital. We performed univariate and multivariate analyses to identify independent indicators for prolonged fever vs. short-term fever. Among 2845 patients, prolonged fever occurred in 466 (16%). The older patients were associated with longer duration of mechanical ventilation and hospital stay. It predominantly occurred in patients with subarachnoid haemorrhage (SAH) and traumatic brain injury. Patients receiving antibiotic treatment tended to manifest prolonged fever more frequently. Multivariate analysis revealed that the use of antibiotics, central venous catheter and prolonged mechanical ventilation were independent risk predictors for prolonged fever. Patients diagnosed with brain tumour seemed to be not associated with prolonged fever. Prolonged fever is the common complication in neurosurgical patients. The risks of prolonged fever in patients are attributed to antibiotic therapy, use of central venous catheter and prolonged mechanical ventilation. Indicators of prolonged fever are helpful for better identification of high-risk patients and fever control. A better reveal on the epidemiology and predictable factors of prolonged fever in neurosurgical patients will provide a better understanding on those patients who are most at risk, and therefore contribute to fever control and better outcome. © 2016 John Wiley & Sons Ltd.

  9. Prolonged preconditioning with natural honey against myocardial infarction injuries.

    PubMed

    Eteraf-Oskouei, Tahereh; Shaseb, Elnaz; Ghaffary, Saba; Najafi, Moslem

    2013-07-01

    Potential protective effects of prolonged preconditioning with natural honey against myocardial infarction were investigated. Male Wistar rats were pre-treated with honey (1%, 2% and 4%) for 45 days then their hearts were isolated and mounted on a Langendorff apparatus and perfused with a modified Krebs-Henseleit solution during 30 min regional ischemia fallowed by 120 min reperfusion. Two important indexes of ischemia-induced damage (infarction size and arrhythmias) were determined by computerized planimetry and ECG analysis, respectively. Honey (1% and 2%) reduced infarct size from 23±3.1% (control) to 9.7±2.4 and 9.5±2.3%, respectively (P<0.001). At the ischemia, honey (1%) significantly reduced (P<0.05) the number and duration of ventricular tachycardia (VT). Honey (1% and 2%) also significantly decreased number of ventricular ectopic beats (VEBs). In addition, incidence and duration of reversible ventricular fibrillation (Rev VF) were lowered by honey 2% (P<0.05). During reperfusion, honey produced significant reduction in the incidences of VT, total and Rev VF, duration and number of VT. The results showed cardioprotective effects of prolonged pre-treatment of rats with honey following myocardial infarction. Maybe, the existence of antioxidants and energy sources (glucose and fructose) in honey composition and improvement of hemodynamic functions may involve in those protective effects.

  10. Hydrograph structure informed calibration in the frequency domain with time localization

    NASA Astrophysics Data System (ADS)

    Kumarasamy, K.; Belmont, P.

    2015-12-01

    Complex models with large number of parameters are commonly used to estimate sediment yields and predict changes in sediment loads as a result of changes in management or conservation practice at large watershed (>2000 km2) scales. As sediment yield is a strongly non-linear function that responds to channel (peak or mean) velocity or flow depth, it is critical to accurately represent flows. The process of calibration in such models (e.g., SWAT) generally involves the adjustment of several parameters to obtain better estimates of goodness of fit metrics such as Nash Sutcliff Efficiency (NSE). However, such indicators only provide a global view of model performance, potentially obscuring accuracy of the timing or magnitude of specific flows of interest. We describe an approach for streamflow calibration that will greatly reduce the black-box nature of calibration, when response from a parameter adjustment is not clearly known. Fourier Transform or the Short Term Fourier Transform could be used to characterize model performance in the frequency domain as well, however, the ambiguity of a Fourier transform with regards to time localization renders its implementation in a model calibration setting rather useless. Brief and sudden changes (e.g. stream flow peaks) in signals carry the most interesting information from parameter adjustments, which are completely lost in the transform without time localization. Wavelet transform captures the frequency component in the signal without compromising time and is applied to contrast changes in signal response to parameter adjustments. Here we employ the mother wavelet called the Mexican hat wavelet and apply a Continuous Wavelet Transform to understand the signal in the frequency domain. Further, with the use of the cross-wavelet spectrum we examine the relationship between the two signals (prior or post parameter adjustment) in the time-scale plane (e.g., lower scales correspond to higher frequencies). The non-stationarity of

  11. The hallucinogen DOI reduces low-frequency oscillations in rat prefrontal cortex: reversal by antipsychotic drugs.

    PubMed

    Celada, Pau; Puig, M Victoria; Díaz-Mataix, Llorenç; Artigas, Francesc

    2008-09-01

    Perceptual and psychic alterations and thought disorder are fundamental elements of schizophrenia symptoms, a pathology associated with an abnormal macro- and microcircuitry of several brain areas including the prefrontal cortex (PFC). Alterations in information processing in PFC may partly underlie schizophrenia symptoms. The 5-HT(2A/2C) agonist DOI and antipsychotic drugs were administered to anesthetized rats. Single unit and local field potential (LFP) extracellular recordings were made in medial PFC (mPFC). Electrolytic lesions were performed in the thalamic nuclei. DOI markedly disrupts cellular and network activity in rat PFC. DOI altered pyramidal discharge in mPFC (39% excited, 27% inhibited, 34% unaffected; n = 51). In all instances, DOI concurrently reduced low-frequency oscillations (.3-4 Hz; power spectrum: .25 +/- .02 and .14 +/- .01 microV(2) in basal conditions and after 50-300 microg/kg intravenous (i.v.) DOI, respectively; n = 51). Moreover, DOI disrupted the temporal association between the active phase of LFP and pyramidal discharge. Both effects were reversed by M100907 (5-HT(2A) receptor antagonist) and were not attenuated by thalamic lesions, supporting an intracortical origin of the effects of DOI. The reduction in low-frequency oscillations induced by DOI was significantly reversed by the antipsychotic drugs haloperidol (.1-.2 mg/kg i.v.) and clozapine (1 mg/kg i.v.). DOI disorganizes network activity in PFC, reducing low-frequency oscillations and desynchronizing pyramidal discharge from active phases of LFP. These effects may underlie DOI's psychotomimetic action. The reversal by clozapine and haloperidol indicates that antipsychotic drugs may reduce psychotic symptoms by normalizing an altered PFC function.

  12. QT interval prolongation associated with sibutramine treatment

    PubMed Central

    Harrison-Woolrych, Mira; Clark, David W J; Hill, Geraldine R; Rees, Mark I; Skinner, Jonathan R

    2006-01-01

    Aims To investigate a possible association of sibutramine with QT interval prolongation. Methods Post-marketing surveillance using prescription event monitoring in the New Zealand Intensive Medicines Monitoring Programme (IMMP) identified a case of QT prolongation and associated cardiac arrest in a patient taking sibutramine for 25 days. This patient was further investigated, including genotyping for long QT syndrome. Other IMMP case reports suggesting arrhythmias associated with sibutramine were assessed and further reports were obtained from the World Health Organisation (WHO) adverse drug reactions database. Results The index case displayed a novel mutation in a cardiac potassium channel subunit gene, KCNQ1, which is likely to prolong cardiac membrane depolarization and increase susceptibility to long QT intervals. Assessment of further IMMP reports identified five additional patients who experienced palpitations associated with syncope or presyncopal symptoms, one of whom had a QTc at the upper limit of normal. Assessment of reports from the WHO database identified three reports of QT prolongation and one fatal case of torsade de pointes in a patient also taking cisapride. Conclusions This case series suggests that sibutramine may be associated with QT prolongation and related dysrhythmias. Further studies are required, but in the meantime we would recommend that sibutramine should be avoided in patients with long QT syndrome and in patients taking other medicines that may prolong the QT interval. PMID:16542208

  13. Dolphins Adjust Species-Specific Frequency Parameters to Compensate for Increasing Background Noise

    PubMed Central

    Papale, Elena; Gamba, Marco; Perez-Gil, Monica; Martin, Vidal Martel; Giacoma, Cristina

    2015-01-01

    An increase in ocean noise levels could interfere with acoustic communication of marine mammals. In this study we explored the effects of anthropogenic and natural noise on the acoustic properties of a dolphin communication signal, the whistle. A towed array with four elements was used to record environmental background noise and whistles of short-beaked common-, Atlantic spotted- and striped-dolphins in the Canaries archipelago. Four frequency parameters were measured from each whistle, while Sound Pressure Levels (SPL) of the background noise were measured at the central frequencies of seven one-third octave bands, from 5 to 20 kHz. Results show that dolphins increase the whistles’ frequency parameters with lower variability in the presence of anthropogenic noise, and increase the end frequency of their whistles when confronted with increasing natural noise. This study provides the first evidence that the synergy among SPLs has a role in shaping the whistles' structure of these three species, with respect to both natural and anthropogenic noise. PMID:25853825

  14. 2.32 THz quantum cascade laser frequency-locked to the harmonic of a microwave synthesizer source.

    PubMed

    Danylov, Andriy A; Light, Alexander R; Waldman, Jerry; Erickson, Neal R; Qian, Xifeng; Goodhue, William D

    2012-12-03

    Frequency stabilization of a THz quantum cascade laser (QCL) to the harmonic of a microwave source has been accomplished using a Schottky diode waveguide mixer designed for harmonic mixing. The 2.32 THz, 1.0 milliwatt CW QCL is coupled into the signal port of the mixer and a 110 GHz signal, derived from a harmonic of a microwave synthesizer, is coupled into the IF port. The difference frequency between the 21st harmonic of 110 GHz and the QCL is used in a discriminator to adjust the QCL bias current to stabilize the frequency. The short-term frequency jitter is reduced from 550 kHz to 4.5 kHz (FWHM) and the long-term frequency drift is eliminated. This performance is compared to that of several other THz QCL frequency stabilization techniques.

  15. Prolonged CD4 T cell lymphopenia increases morbidity and mortality after renal transplantation.

    PubMed

    Ducloux, Didier; Courivaud, Cécile; Bamoulid, Jamal; Vivet, Bérengère; Chabroux, Aline; Deschamps, Marina; Rebibou, Jean-Michel; Ferrand, Christophe; Chalopin, Jean-Marc; Tiberghien, Pierre; Saas, Philippe

    2010-05-01

    Prolonged CD4 T cell lymphopenia after administration of polyclonal anti-thymocyte globulins increases the rate of posttransplantation morbidity, but whether impaired immune reconstitution affects survival is unknown. We studied the effect of CD4 T cell lymphopenia on survival in 302 consecutive prevalent renal transplant recipients and the role of thymic function in CD4 T cell reconstitution and posttransplantation outcomes in 100 consecutive incident renal transplant recipients. We followed the prevalent cohort for a mean duration of 92 months. Of these 302 patients, 81 (27%) had persistent CD4 T cell counts <300/mm3 and 36 (12%) died during follow-up. We observed a higher death rate in patients with CD4 T cell lymphopenia persisting for >1 year (24.1 versus 7.6%; P < 0.001). Furthermore, in Cox regression analysis, CD4 T cell lymphopenia associated with a nearly five-fold risk for death (adjusted hazard ratio [HR] 4.63; 95% confidence interval [CI] 1.91 to 10.65; P = 0.001). In the incident cohort, we estimated thymic function by T cell receptor excision circles (TRECs) per 150,000 CD3+ cells, which predicted efficient CD4 T cell reconstitution. Higher pretransplantation TREC values associated with lower risks for cancer (adjusted HR 0.39; 95% CI 0.15 to 0.97; P = 0.046) and infection (HR 0.29; 95% CI 0.11 to 0.78; P = 0.013). In summary, prolonged polyclonal anti-thymocyte globulin-induced CD4 T cell lymphopenia is an independent risk factor for death. Determination of pretransplantation thymic function may identify patients at higher risk for CD4 T cell lymphopenia and posttransplantation morbidity, including cancer and infections.

  16. What factors are associated with increased risk for prolonged postoperative opioid usage after colorectal surgery?

    PubMed

    Stafford, Caitlin; Francone, Todd; Roberts, Patricia L; Ricciardi, Rocco

    2018-02-06

    Opioid-related deaths have increased substantially over the last 10 years placing clinician's prescription practices under intense scrutiny. Given the substantial risk of opioid dependency after colorectal surgery, we sought to analyze risk of postoperative prolonged opioid use after colorectal resections. Between 2008 and 2014, patients undergoing abdominopelvic procedure with intestinal resection at a tertiary care facility were retrospectively identified. Patient's postoperative narcotic usage including their prescriptions on discharge and their total opioid medication use was recorded. Patient variables such as demographics, surgical characteristics, and prescription use were evaluated. Finally, we developed multivariate models to identify risk factors for prolonged opioid use (> 30 days after incident surgical procedure). We identified 9423 recorded procedures of which 2173 consisted of abdominopelvic procedures with intestinal resection and survived > 1 year. Of these, 91% (n = 1981) were discharged on opioids, and 98% (n = 1955) of those patients filled only one prescription. A total of 92 (4%) patients remained on opioids beyond 30 days, and from this group, 25% (n = 23 patients) remained at 90 days. We found no association between postoperative complications, stoma formation, and patient's sex with risk of prolonged opioid use. However, younger age and history of chronic pain were associated with an increased risk of prolonged opioid use. The use of minimally invasive techniques also attenuated the risk of prolonged opioid use (Table 2). A small but considerable proportion of patients remain on opioids beyond 30 days. Predictors of opioid use for greater than 30 days include a history of chronic pain and younger age. The use of minimally invasive techniques reduced the risk of prolonged opioid use. We identified several immutable risk factors that predicted prolonged postoperative opioid use; however, surgeons may be able to attenuate

  17. Prolonged daily light exposure increases body fat mass through attenuation of brown adipose tissue activity

    PubMed Central

    Kooijman, Sander; van den Berg, Rosa; Ramkisoensing, Ashna; Boon, Mariëtte R.; Kuipers, Eline N.; Loef, Marieke; Zonneveld, Tom C. M.; Lucassen, Eliane A.; Sips, Hetty C. M.; Chatzispyrou, Iliana A.; Houtkooper, Riekelt H.; Meijer, Johanna H.; Coomans, Claudia P.; Biermasz, Nienke R.; Rensen, Patrick C. N.

    2015-01-01

    Disruption of circadian rhythmicity is associated with obesity and related disorders, including type 2 diabetes and cardiovascular disease. Specifically, prolonged artificial light exposure associates with obesity in humans, although the underlying mechanism is unclear. Here, we report that increasing the daily hours of light exposure increases body adiposity through attenuation of brown adipose tissue (BAT) activity, a major contributor of energy expenditure. Mice exposed to a prolonged day length of 16- and 24-h light, compared with regular 12-h light, showed increased adiposity without affecting food intake or locomotor activity. Mechanistically, we demonstrated that prolonged day length decreases sympathetic input into BAT and reduces β3-adrenergic intracellular signaling. Concomitantly, prolonging day length decreased the uptake of fatty acids from triglyceride-rich lipoproteins, as well as of glucose from plasma selectively by BAT. We conclude that impaired BAT activity is an important mediator in the association between disturbed circadian rhythm and adiposity, and anticipate that activation of BAT may overcome the adverse metabolic consequences of disturbed circadian rhythmicity. PMID:25964318

  18. Prolonged Soil Frost Affects Hydraulics and Phenology of Apple Trees

    PubMed Central

    Beikircher, Barbara; Mittmann, Claudia; Mayr, Stefan

    2016-01-01

    Restoration of an adequate water supply in spring is a prerequisite for survival of angiosperm trees in temperate regions. Trees must re-establish access to soil water and recover xylem functionality. We thus hypothesized that prolonged soil frost impairs recovery and affects hydraulics and phenology of Malus domestica var. ‘Golden Delicious.’ To test this hypothesis, over two consecutive winters the soil around some trees was insulated to prolong soil frosting, From mid-winter to early summer, the level of native embolism, the water and starch contents of wood, bark and buds were quantified at regular intervals and findings correlated with various phenological parameters, xylogenesis and fine root growth. The findings confirm that prolonged soil frost affects tree hydraulics and phenology but the severity of the effect depends on the climatic conditions. In both study years, percentage loss of hydraulic conductivity (PLC) decreased from about 70% at the end of winter to about 10% in May. Thereby, xylem refilling strongly coincided with a decrease of starch in wood and bark. Also treated trees were able to restore their hydraulic system by May but, in the warm spring of 2012, xylem refilling, the increases in water content and starch depolymerization were delayed. In contrast, in the cold spring of 2013 only small differences between control and treated trees were observed. Prolongation of soil frost also led to a delay in phenology, xylogenesis, and fine root growth. We conclude that reduced water uptake from frozen or cold soils impairs refilling and thus negatively impacts tree hydraulics and growth of apple trees in spring. Under unfavorable circumstances, this may cause severe winter damage or even dieback. PMID:27379146

  19. Prolonged Soil Frost Affects Hydraulics and Phenology of Apple Trees.

    PubMed

    Beikircher, Barbara; Mittmann, Claudia; Mayr, Stefan

    2016-01-01

    Restoration of an adequate water supply in spring is a prerequisite for survival of angiosperm trees in temperate regions. Trees must re-establish access to soil water and recover xylem functionality. We thus hypothesized that prolonged soil frost impairs recovery and affects hydraulics and phenology of Malus domestica var. 'Golden Delicious.' To test this hypothesis, over two consecutive winters the soil around some trees was insulated to prolong soil frosting, From mid-winter to early summer, the level of native embolism, the water and starch contents of wood, bark and buds were quantified at regular intervals and findings correlated with various phenological parameters, xylogenesis and fine root growth. The findings confirm that prolonged soil frost affects tree hydraulics and phenology but the severity of the effect depends on the climatic conditions. In both study years, percentage loss of hydraulic conductivity (PLC) decreased from about 70% at the end of winter to about 10% in May. Thereby, xylem refilling strongly coincided with a decrease of starch in wood and bark. Also treated trees were able to restore their hydraulic system by May but, in the warm spring of 2012, xylem refilling, the increases in water content and starch depolymerization were delayed. In contrast, in the cold spring of 2013 only small differences between control and treated trees were observed. Prolongation of soil frost also led to a delay in phenology, xylogenesis, and fine root growth. We conclude that reduced water uptake from frozen or cold soils impairs refilling and thus negatively impacts tree hydraulics and growth of apple trees in spring. Under unfavorable circumstances, this may cause severe winter damage or even dieback.

  20. Prolonged intestinal transit and diarrhea in patients with an activating GUCY2C mutation

    PubMed Central

    Brønstad, Ingeborg; Gilja, Odd Helge; R. Tronstad, Rune; Sangnes, Dag Andre; Nortvedt, Ragnar; Hausken, Trygve; Dimcevski, Georg; Fiskerstrand, Torunn; Nylund, Kim

    2017-01-01

    Introduction Increased intestinal hydration by activation of the epithelial enzyme linked receptor guanylate cyclase C (GC-C) is a pharmacological principle for treating constipation. Activating mutations in the GUCY2C gene encoding GC-C cause Familial GUCY2C diarrhea syndrome (FGDS) which has been diagnosed with severe dysmotility. Aim To investigate gut motility and hormones before and after a meal in FGDS patients and compare with healthy controls (HC). Subjects and methods Bristol stool chart and stool frequency was assessed. Before and after a meal occlusive and non-occlusive contractions were obtained using ultrasound. A wireless motility capsule (WMC) recorded gut transit time, pH, contractions and pressure. Plasma levels of selected gut hormones were measured at different time points. Results The FGDS patients had 4 (range 1–10) loose stools/day and prolonged total gut transit time compared to HC, 55.5 h vs 28.5 h, respectively,with significantly increased colon transit time. In FGDS patients, pH in duodenum, small bowel and colon was increased and the number of contractions and the intraluminal pressure were significantly decreased, measured by WMC. Ultrasound showed in small bowel increased number of non-occlusive contractions in the FGDS patients. Serotonin (5-HT) plasma levels in the HC peaked 30 min after the meal, while the FGDS patients had no response. Conclusion Despite having diarrhea, the FGDS patients have prolonged transit time through the gut compared to HC, particularly in colon. The reduced number of intestinal contractions and lack of 5-HT release after a meal in FGDS patients surprisingly resemble colonic motility disturbances seen in patients with constipation. PMID:28957388

  1. Single Frequency Impedance Analysis on Reduced Graphene Oxide Screen-Printed Electrode for Biomolecular Detection.

    PubMed

    Rajesh; Singal, Shobhita; Kotnala, Ravinder K

    2017-10-01

    A biofunctionalized reduced graphene oxide (rGO)-modified screen-printed carbon electrode (SPCE) was constructed as an immunosensor for C-reactive protein (CRP) detection, a biomarker released in early stage acute myocardial infarction. A different approach of single frequency analysis (SFA) study was utilized for the biomolecular sensing, by monitoring the response in phase angle changes obtained at an optimized frequency resulting from antigen-antibody interactions. A set of measurements were carried out to optimize a frequency where a maximum change in phase angle was observed, and in this case, we found it at around 10 Hz. The bioelectrode was characterized by contact angle measurements, scanning electron microscopy, and electrochemical techniques. A concentration-dependent response of immunosensor to CRP with the change in phase angle, at a fixed frequency of 10 Hz, was found to be in the range of 10 ng mL -1 to 10 μg mL -1 in PBS and was fit quantitative well with the Hill-Langmuir equation. Based on the concentration-response data, the dissociation constant (K d ) was found to be 3.5 nM (with a Hill coefficient n = 0.57), which indicated a negative cooperativity with high anti-CRP (antibody)-CRP (antigen) binding at the electrode surface. A low-frequency analysis of sensing with an ease of measurement on a disposable electroactive rGO-modified electrode with high selectivity and sensitivity makes it a potential tool for biological sensors.

  2. Influence of sex on microvascular and macrovascular responses to prolonged sitting.

    PubMed

    Vranish, Jennifer R; Young, Benjamin E; Kaur, Jasdeep; Patik, Jordan C; Padilla, Jaume; Fadel, Paul J

    2017-04-01

    Increased daily sitting time is associated with greater cardiovascular risk, and, on average, women are more sedentary than men. Recent reports have demonstrated that prolonged sitting reduces lower leg microvascular (reactive hyperemia) and macrovascular [flow-mediated dilation (FMD)] vasodilator function. However, these studies have predominately included men, and the effects of sitting in young women are largely unexplored. This becomes important given known sex differences in vascular function. Thus, herein, we assessed popliteal artery reactive hyperemia and FMD before and after a 3-h sitting period in healthy young women ( n = 12) and men ( n = 8). In addition, resting popliteal artery hemodynamics (duplex Doppler ultrasound) and calf circumference were measured before, during, and after sitting. Resting popliteal artery shear rate was reduced to a similar extent in both groups during the sitting period (women: -48.5 ± 8.4 s -1 and men: -52.9 ± 12.3 s -1 , P = 0.45). This was accompanied by comparable increases in calf circumference in men and women ( P = 0.37). After the sitting period, popliteal artery FMD was significantly reduced in men (PreSit: 5.5 ± 0.9% and PostSit: 1.6 ± 0.4%, P < 0.001) but not women (PreSit: 4.4 ± 0.6% and PostSit: 3.6 ± 0.6%, P = 0.29). In contrast, both groups demonstrated similar reductions in hyperemic blood flow area under the curve (women: -28,860 ± 5,742 arbitrary units and men: -28,691 ± 9,685 arbitrary units, P = 0.99), indicating impaired microvascular reactivity after sitting. These findings indicate that despite comparable reductions in shear rate during 3 h of uninterrupted sitting, macrovascular function appears protected in some young women but the response was variable, whereas men exhibited more consistent reductions in FMD. In contrast, the leg microvasculature is susceptible to similar sitting-induced impairments in men and women. NEW & NOTEWORTHY We demonstrate that leg macrovascular function was

  3. Clinical dysphagia risk predictors after prolonged orotracheal intubation

    PubMed Central

    de Medeiros, Gisele Chagas; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Zilberstein, Bruno; de Andrade, Claudia Regina Furquim

    2014-01-01

    OBJECTIVES: To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation. METHODS: The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance. RESULTS: Of the 148 patients included in the study, 91 were male and 57 were female (mean age, 53.64 years). The univariate analysis results indicated that specific variables, including extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking, and other signs, were possible significant high-risk indicators of dysphagia onset. The multivariate analysis results indicated that cervical auscultation and coughing were independent predictive variables for high dysphagia risk. CONCLUSIONS: Patients displaying extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking and other signs should benefit from early swallowing evaluations. Additionally, early post-extubation dysfunction recognition is paramount in reducing the morbidity rate in this high-risk population. PMID:24473554

  4. Frequency-doubled microwave waveforms generation using a dual-polarization quadrature phase shift keying modulator driven by a single frequency radio frequency signal

    NASA Astrophysics Data System (ADS)

    Zhu, Zihang; Zhao, Shanghong; Li, Xuan; Qu, Kun; Lin, Tao

    2018-01-01

    A photonic approach to generate frequency-doubled microwave waveforms using an integrated dual-polarization quadrature phase shift keying (DP-QPSK) modulator driven by a sinusoidal radio frequency (RF) signal is proposed. By adjusting the dc bias points of the DP-QPSK modulator, the obtained second-order and six-order harmonics are in phase while the fourth-order harmonics are complementary when the orthogonal polarized outputs of the modulator are photodetected. After properly setting the modulation indices of the modulator, the amplitude of the second-order harmonic is 9 times of that of the six-order harmonic, indicating a frequency-doubled triangular waveform is generated. If a broadband 90° microwave phase shifter is attached after the photodetector (PD) to introduce a 90° phase shift, a frequency-doubled square waveform can be obtained after adjusting the amplitude of the second-order harmonic 3 times of that of the six-order harmonic. The proposal is first theoretically analyzed and then validated by simulation. Simulation results show that a 10 GHz triangular and square waveform sequences are successfully generated from a 5 GHz sinusoidal RF drive signal.

  5. Identifying Patients at Higher Risk of Prolonged Air Leak After Lung Resection.

    PubMed

    Gilbert, Sebastien; Maghera, Sonam; Seely, Andrew J; Maziak, Donna E; Shamji, Farid M; Sundaresan, Sudhir R; Villeneuve, Patrick J

    2016-11-01

    Predictive models of prolonged air leak have relied on information not always available preoperatively (eg, extent of resection, pleural adhesions). Our objective was to construct a model to identify patients at increased risk of prolonged air leak using preoperative factors exclusively. From 2012 to 2014, data on consecutive patients undergoing pulmonary resection were collected prospectively. Prolonged air leak was defined as lasting longer than 7 days and requiring hospitalization. Factors associated with the primary outcome (p < 0.2) were included in a multivariate model. Regression coefficients were used to develop a weighted risk score for prolonged air leak. Of 225 patients, 8% (18/225) experienced a prolonged air leak. Male gender (p = 0.08), smoking history (p = 0.03), body mass index (BMI) 25 or below (p < 0.01), Medical Research Council (MRC) dyspnea score above 1 (p = 0.06), and diffusion capacity for carbon monoxide below 80% (Dlco) (p = 0.01) were selected for inclusion in the final model. Weighted scores were male gender (1 point), BMI 25 or below (0.5 point), smoker (2 points), Dlco% below 80% (2 points), and MRC dyspnea score above 1 (1 point). The area under the receiver operating characteristic curve was 0.8 (95% confidence interval [CI] = 0.7 to 0.9]. An air leak score above 4 points offered the best combination of sensitivity (83% [95% CI = 58 to 96]) and specificity (65% [95% CI = 58 to 71]). A subgroup of lung resection patients at higher risk for a prolonged air leak can be effectively identified with the use of widely available, preoperative factors. The proposed scoring system is simple, is clinically relevant to the informed consent, and allows preoperative patient selection for interventions to reduce the risk of prolonged air leak. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Hard-rock GMPEs versus Vs30-Kappa Host-to-Target Adjustment Techniques : Why so Large Differences in High Frequency Hard-Rock Motion ?

    NASA Astrophysics Data System (ADS)

    Bard, P. Y.; Laurendeau, A.; Hollender, F.; Perron, V.; Hernandez, B.; Foundotos, L.

    2016-12-01

    Assessment of local seismic hazard on hard rock sites (1000 < VS30 < 3000 m/s) is needed either for installations built on such hard rock, or as a reference motion for site response computation. Empirical ground motion prediction equations (GMPEs) are the traditional basis for estimating ground motion, but most of them are poorly constrained for VS30 larger than 1000 m/s. The presently used approach for estimating hard rock hazard consists of "host-to-target" adjustment techniques (HTTA) based on VS30 and κ0 values. Recent studies have investigated alternative methods to estimate reference motions on very hard rock through an original processing of the Japanese KiK-net recordings from stiff sites (500 < VS30 < 1350 m/s). The pairs of recordings at surface and depth, together with the knowledge of the velocity profile, allowed to derive two sets of "virtual" outcropping, hard-rock motion data for sites having velocities in the range [1000 - 3000 m/s]. The corrections are based either on a transformation of deep, within-motion to outcropping motion, or on a deconvolution of surface recordings using the velocity profile and 1D simulation, which has been performed both in the response spectrum and Fourier domains. Each of these virtual "outcropping hard-rock motion" data sets has then been used to derive GMPEs with simple functional forms, using as site condition proxy the S-wave velocity at depth (VSDH), ranging from 1000 to 3000 m/s. Both sets provide very similar predictions, which are much smaller at high frequencies (f > 10 Hz) than those estimated with the traditional HTTA technique - by a factor up to 3-4,. These differences decrease for decreasing frequency, and become negligible at low frequency (f < 1 Hz). The main focus will be to discuss the possible reasons of such differences, in relation with the implicit or explicit assumptions of either approach. Our present interpretation is related to the existence of a significant, high-frequency amplification on

  7. Marginal donors: can older donor hearts tolerate prolonged cold ischemic storage?

    PubMed

    Korkmaz, Sevil; Bährle-Szabó, Susanne; Loganathan, Sivakkanan; Li, Shiliang; Karck, Matthias; Szabó, Gábor

    2013-10-01

    Both advanced donor age and prolonged ischemic time are significant risk factors for the 1-year mortality. However, its functional consequences have not been fully evaluated in the early-phase after transplantation; even early graft dysfunction is the main determinant of long-term outcome following transplantation. We evaluated in vivo left-ventricular (LV) cardiac and coronary vascular function of old-donor grafts after short and prolonged cold ischemic times in rats 1 h after heart transplantation. The hearts were excised from young donor (3-month-old) or old donor (18-month-old) rats, stored in cold preservation solution for either 1 or 8 h, and heterotopically transplanted. After 1 h of ischemic period, in the old-donor group, LV pressure, maximum pressure development (dP/dt max), time constant of LV pressure decay (τ), LV end-diastolic pressure and coronary blood flow did not differ compared with young donors. However, endothelium-dependent vasodilatation to acetylcholine resulted in a significantly lower response of coronary blood flow in the old-donor group (33 ± 4 vs. 51 ± 15 %, p < 0.05). After 8 h preservation, two of the old-donor hearts showed no mechanical activity upon reperfusion. LV pressure (55 ± 6 vs. 72 ± 5 mmHg, p < 0.05), dP/dt max (899 ± 221 vs. 1530 ± 217 mmHg/s, p < 0.05), coronary blood flow and response to acetylcholine were significantly reduced and τ was increased in the old-donor group in comparison to young controls. During the early-phase after transplantation, the ischemic tolerance of older-donor hearts is reduced after prolonged preservation time and the endothelium is more vulnerable to ischemia/reperfusion.

  8. A hip abduction exercise prior to prolonged standing increased movement while reducing cocontraction and low back pain perception in those initially reporting low back pain.

    PubMed

    Viggiani, Daniel; Callaghan, Jack P

    2016-12-01

    Persons who develop low back pain from prolonged standing exhibit increased muscle cocontraction, decreased movement and increased spine extension. However, it is unclear how these factors relate to pain development. The purpose of this study was to use hip abductor fatigue to manipulate muscle activity patterns and determine its effects on standing behaviours and pain development. Forty participants stood for two hours twice, once following a hip abductor fatigue exercise (fatigue), and once without exercise beforehand (control). Trunk and gluteal muscle activity were measured to determine cocontraction. Lumbo-pelvic angles and force plates were used to assess posture and movement strategies. Visual analog scales differentiated pain (PDs) and non-pain developers (NPDs). PDs reported less low back pain during the fatigue session, with females having earlier reductions of similar scale than males. The fatigue session reduced gluteal and trunk cocontraction and increased centre of pressure movement; male and female PDs had opposing spine posture compensations. Muscle fatigue prior to standing reduced cocontraction, increased movement during standing and reduced the low back pain developed by PDs; the timing of pain reductions depended on spine postures adopted during standing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Postural strategy and trunk muscle activation during prolonged standing in chronic low back pain patients.

    PubMed

    Ringheim, Inge; Austein, Helene; Indahl, Aage; Roeleveld, Karin

    2015-10-01

    Prolonged standing has been associated with development and aggravation of low back pain (LBP). However, the underlying mechanisms are not well known. The aim of the present study was to investigate postural control and muscle activation during and as a result of prolonged standing in chronic LBP (cLBP) patients compared to healthy controls (HCs). Body weight shifts and trunk and hip muscle activity was measured during 15 min standing. Prior and after the standing trial, strength, postural sway, reposition error (RE), flexion relaxation ratio (FRR), and pain were assessed and after the prolonged standing, ratings of perceived exertion. During prolonged standing, the cLBP patients performed significantly more body weight shifts (p<.01) with more activated back and abdominal muscles (p=.01) and similar temporal variability in muscle activation compared to HCs, while the cLBP patients reported more pain and perceived exertion at the end of prolonged standing. Moreover, both groups had a similar change in strength, postural sway, RE and FRR from before to after prolonged standing, where changes in HC were towards pre-standing values of cLBP patients. Thus, despite a more variable postural strategy, the cLBP patients did not have higher muscle activation variability, but a general increased muscle activation level. This may indicate a reduced ability to individually deactivate trunk muscles. Plausibly, due to the increased variable postural strategy, the cLBP patients could compensate for the relatively high muscle activation level, resulting in normal variation in muscle activation and normal reduction in strength, RE and FRR after prolonged standing. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Prolonged response without prolonged chemotherapy: a lesson from PCV chemotherapy in low-grade gliomas

    PubMed Central

    Peyre, Matthieu; Cartalat-Carel, Stéphanie; Meyronet, David; Ricard, Damien; Jouvet, Anne; Pallud, Johan; Mokhtari, Karima; Guyotat, Jacques; Jouanneau, Emmanuel; Sunyach, Marie-Pierre; Frappaz, Didier; Honnorat, Jérôme; Ducray, François

    2010-01-01

    Previous studies with temozolomide suggest that a prolonged duration of chemotherapy is important for treating low-grade gliomas (LGGs). PCV (procarbazine, CCNU, vincristine) chemotherapy has demonstrated efficacy in treating LGGs, but this therapy cannot be used for a prolonged period because of the cumulative toxicity. The aim of the present study was to evaluate the impact of first-line PCV chemotherapy on LGGs growth kinetics. The mean tumor diameter (MTD) of 21 LGGs was measured on serial magnetic resonance images before (n=13), during, and after PCV onset (n=21). During PCV treatment, a decrease in the MTD was observed in all patients. After PCV discontinuation, an ongoing decrease in MTD was observed in 20 of the 21 patients. Median duration of the MTD decrease was 3.4 years (range, 0.8–7.7) after PCV onset and 2.7 years (range, 0–7) after the end of PCV treatment with 60% of LGGs, demonstrating an ongoing and prolonged (>2 years) response despite chemotherapy no longer being administered. According to McDonald's criteria, the rates of partial and minor responses were 5% and 38% at the end of PCV but 38% and 42% at the time of maximal MTD decrease, which occurred after a median period of 3.4 years after PCV onset. These results challenge the idea that a prolonged duration of chemotherapy is necessary for treating LGGs and raise the issue of understanding the mechanisms involved in the persistent tumor volume decrease once chemotherapy is terminated. PMID:20488959

  11. Standard versus atrial fibrillation-specific management strategy (SAFETY) to reduce recurrent admission and prolong survival: pragmatic, multicentre, randomised controlled trial.

    PubMed

    Stewart, Simon; Ball, Jocasta; Horowitz, John D; Marwick, Thomas H; Mahadevan, Gnanadevan; Wong, Chiew; Abhayaratna, Walter P; Chan, Yih K; Esterman, Adrian; Thompson, David R; Scuffham, Paul A; Carrington, Melinda J

    2015-02-28

    Patients are increasingly being admitted with chronic atrial fibrillation, and disease-specific management might reduce recurrent admissions and prolong survival. However, evidence is scant to support the application of this therapeutic approach. We aimed to assess SAFETY--a management strategy that is specific to atrial fibrillation. We did a pragmatic, multicentre, randomised controlled trial in patients admitted with chronic, non-valvular atrial fibrillation (but not heart failure). Patients were recruited from three tertiary referral hospitals in Australia. 335 participants were randomly assigned by computer-generated schedule (stratified for rhythm or rate control) to either standard management (n=167) or the SAFETY intervention (n=168). Standard management consisted of routine primary care and hospital outpatient follow-up. The SAFETY intervention comprised a home visit and Holter monitoring 7-14 days after discharge by a cardiac nurse with prolonged follow-up and multidisciplinary support as needed. Clinical reviews were undertaken at 12 and 24 months (minimum follow-up). Coprimary outcomes were death or unplanned readmission (both all-cause), measured as event-free survival and the proportion of actual versus maximum days alive and out of hospital. Analyses were done on an intention-to-treat basis. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTRN 12610000221055). During median follow-up of 905 days (IQR 773-1050), 49 people died and 987 unplanned admissions were recorded (totalling 5530 days in hospital). 127 (76%) patients assigned to the SAFETY intervention died or had an unplanned readmission (median event-free survival 183 days [IQR 116-409]) and 137 (82%) people allocated standard management achieved a coprimary outcome (199 days [116-249]; hazard ratio 0·97, 95% CI 0·76-1·23; p=0·851). Patients assigned to the SAFETY intervention had 99·5% maximum event-free days (95% CI 99·3-99·7), equating to a median

  12. Impact of prolonged leucine supplementation on protein synthesis and lean growth in neonatal pigs

    USDA-ARS?s Scientific Manuscript database

    Most low-birth weight infants experience extrauterine growth failure due to reduced nutrient intake as a result of feeding intolerance. The objective of this study was to determine whether prolonged enteral leucine supplementation improves lean growth in neonatal pigs fed a restricted protein diet. ...

  13. Low Magnitude, High Frequency Signals Could Reduce Bone Loss During Spaceflight

    NASA Astrophysics Data System (ADS)

    Hawkey, A.

    The removal of gravitational loading results in a loss of homeostasis of the skeleton. This leads to significant losses of bone mass during long-duration missions in space. Conventional exercise countermeasures, such as running and resistance training, have only limited effectiveness in reducing the rate at which bone is demineralised in microgravity. Bone loss, therefore, remains a major concern and if not annulled could be so severe as to jeopardise an extended human presence in space. In addition, current exercise regimes occupy valuable crew time, and astronauts often find the equipment cumbersome and uncomfortable to use. Recent studies suggest that exposing the body to short periods (<20mins) of low magnitude (<1g), high frequency (15-35Hz) signals (vibration) everyday could reduce, even prevent, bone loss during conditions such as osteoporo- sis on earth. The new vibration therapy treatment could also have several advantages over existing exercise countermeasures used in spaceflight due to it being very simple to operate, relatively inexpensive, and requiring only short periods of time `training', unlike the complicated, expensive and time-consuming devices currently used. This review highlights the detrimen- tal effects that microgravity has on the strength and integrity of bone, how current countermeasures are ineffective at stemming this level of deterioration, and how new vibration techniques could significantly reduce space-induced bone loss.

  14. Learning to cope: vocal adjustment to urban noise is correlated with prior experience in black-capped chickadees

    PubMed Central

    LaZerte, Stefanie E.; Slabbekoorn, Hans; Otter, Ken A.

    2016-01-01

    Urban noise can interfere with avian communication through masking, but birds can reduce this interference by altering their vocalizations. Although several experimental studies indicate that birds can rapidly change their vocalizations in response to sudden increases in ambient noise, none have investigated whether this is a learned response that depends on previous exposure. Black-capped chickadees (Poecile atricapillus) change the frequency of their songs in response to both fluctuating traffic noise and experimental noise. We investigated whether these responses to fluctuating noise depend on familiarity with noise. We confirmed that males in noisy areas sang higher-frequency songs than those in quiet areas, but found that only males in already-noisy territories shifted songs upwards in immediate response to experimental noise. Unexpectedly, males in more quiet territories shifted songs downwards in response to experimental noise. These results suggest that chickadees may require prior experience with fluctuating noise to adjust vocalizations in such a way as to minimize masking. Thus, learning to cope may be an important part of adjusting to acoustic life in the city. PMID:27358372

  15. Learning to cope: vocal adjustment to urban noise is correlated with prior experience in black-capped chickadees.

    PubMed

    LaZerte, Stefanie E; Slabbekoorn, Hans; Otter, Ken A

    2016-06-29

    Urban noise can interfere with avian communication through masking, but birds can reduce this interference by altering their vocalizations. Although several experimental studies indicate that birds can rapidly change their vocalizations in response to sudden increases in ambient noise, none have investigated whether this is a learned response that depends on previous exposure. Black-capped chickadees (Poecile atricapillus) change the frequency of their songs in response to both fluctuating traffic noise and experimental noise. We investigated whether these responses to fluctuating noise depend on familiarity with noise. We confirmed that males in noisy areas sang higher-frequency songs than those in quiet areas, but found that only males in already-noisy territories shifted songs upwards in immediate response to experimental noise. Unexpectedly, males in more quiet territories shifted songs downwards in response to experimental noise. These results suggest that chickadees may require prior experience with fluctuating noise to adjust vocalizations in such a way as to minimize masking. Thus, learning to cope may be an important part of adjusting to acoustic life in the city. © 2016 The Author(s).

  16. Effect of renal sympathetic denervation on atrial substrate remodeling in ambulatory canines with prolonged atrial pacing.

    PubMed

    Wang, Xule; Zhao, Qingyan; Huang, He; Tang, Yanhong; Xiao, Jinping; Dai, Zixuan; Yu, Shengbo; Huang, Congxin

    2013-01-01

    We have previously demonstrated that catheter-based renal sympathetic denervation (RSD) could suppress atrial fibrillation (AF) in canines with short-time rapid right atrial pacing (RAP). However, the role of renal denervation on atrial remodeling is unclear. The aim of the present study was to explore the long-term effect of RSD on the atrial remodeling during prolonged RAP. Twenty mongrel dogs were implanted with a high-frequency cardiac pacemaker with a transvenous lead inserted into the right atrial appendage. The dogs were divided into three groups: a sham-operated group (n = 6), the chronic RAP (CRAP) group (n = 7), and the CRAP+RSD group (n = 7). In the CRAP+RSD group, a pacemaker was implanted 6 weeks after RSD was performed bilaterally for recovery. RAP was maintained for 5 weeks in CRAP group and CRAP+RSD group. The plasma levels of Angiotensin II and aldosterone were significantly increased in CRAP group compared with sham-operated group, but the increasing trend was inhibited in CRAP+RSD group compared with CRAP group (P<0.05). Similarly, RSD suppressed the increasing trend that prolonged RAP produced in the left atrial levels of ANP, TNF-α and IL-6. Compared with the sham-operated group, the CRAP group had significantly increased levels of caspase-3, bax and Cx40 whereas the level of Bcl-2 decreased (P<0.05). RSD markedly reduced the upregulation of caspase-3, bax and Cx40 and the downregulation of Bcl-2 expression compared with the CRAP group (P<0.05). Picric acid-sirius red staining study suggested that RSD could markedly alleviate the lesion degree of cardic fibrosis induced by CRAP (P<0.05). Immunohistochemistry results showed that the densities of TH- and GAP43- positive nerves were significantly elevated in the CRAP group compared with the sham-operated group, while RSD operation signicantly inhibited the these changes produced by CRAP. These findings suggest that renal denervation could suppress the atrial remodeling after prolonged

  17. Effect of Renal Sympathetic Denervation on Atrial Substrate Remodeling in Ambulatory Canines with Prolonged Atrial Pacing

    PubMed Central

    Wang, Xule; Zhao, Qingyan; Huang, He; Tang, Yanhong; Xiao, Jinping; Dai, Zixuan; Yu, Shengbo; Huang, Congxin

    2013-01-01

    We have previously demonstrated that catheter-based renal sympathetic denervation (RSD) could suppress atrial fibrillation (AF) in canines with short-time rapid right atrial pacing (RAP). However, the role of renal denervation on atrial remodeling is unclear. The aim of the present study was to explore the long-term effect of RSD on the atrial remodeling during prolonged RAP. Twenty mongrel dogs were implanted with a high-frequency cardiac pacemaker with a transvenous lead inserted into the right atrial appendage. The dogs were divided into three groups: a sham-operated group (n = 6), the chronic RAP (CRAP) group (n = 7), and the CRAP+RSD group (n = 7). In the CRAP+RSD group, a pacemaker was implanted 6 weeks after RSD was performed bilaterally for recovery. RAP was maintained for 5 weeks in CRAP group and CRAP+RSD group. The plasma levels of Angiotensin II and aldosterone were significantly increased in CRAP group compared with sham-operated group, but the increasing trend was inhibited in CRAP+RSD group compared with CRAP group (P<0.05). Similarly, RSD suppressed the increasing trend that prolonged RAP produced in the left atrial levels of ANP, TNF-α and IL-6. Compared with the sham-operated group, the CRAP group had significantly increased levels of caspase-3, bax and Cx40 whereas the level of Bcl-2 decreased (P<0.05). RSD markedly reduced the upregulation of caspase-3, bax and Cx40 and the downregulation of Bcl-2 expression compared with the CRAP group (P<0.05). Picric acid–sirius red staining study suggested that RSD could markedly alleviate the lesion degree of cardic fibrosis induced by CRAP (P<0.05). Immunohistochemistry results showed that the densities of TH- and GAP43- positive nerves were significantly elevated in the CRAP group compared with the sham-operated group, while RSD operation signicantly inhibited the these changes produced by CRAP. These findings suggest that renal denervation could suppress the atrial remodeling after

  18. Does UTI cause prolonged jaundice in otherwise well infants?

    PubMed

    Chowdhury, Tanzila; Kisat, Hamudi; Tullus, Kjell

    2015-07-01

    The symptoms of urinary tract infections in infants are very non-specific and have historically included prolonged hyperbilirubinaemia. We studied the results of routine urine samples in 319 infants with prolonged jaundice. Convincing findings of UTI was not found in any of these children even if one of them was treated with antibiotics after four consecutive urine cultures with different bacteria. A urine culture might thus not be an appropriate investigation in a child with prolonged jaundice without any other symptoms of UTI. • The symptoms of UTI in infancy are very non-specific. • Old studies suggest that prolonged hyperbilirubinaemia is one such symptom; more modern studies give more conflicting results. What is New: • Our study could not confirm that children with prolonged jaundice have an increased risk of UTI. • Routine urine testing is thus not needed in otherwise healthy infants with prolonged jaundice.

  19. Effects of prolonged exposure to space flight factors for 175 days on lettuce seeds

    NASA Astrophysics Data System (ADS)

    Nevzgodina, L. V.; Maximova, E. N.; Akatov, Yu. A.

    We have studied the effects of prolonged (up to 175 days) exposure of Lactuca sativa seeds to space flight factors, including primary cosmic radiation heavy ions. The data obtained evidence a significant fourfold increase ofs pontaneous mutagenesis in seeds both with regard to the total number of aberrant cells as well as the formation of single cells with multiple aberrations. Comparison of the present experiment with earlier works shows that the frequency of such aberrations increases with the duration of the flight.

  20. Effects of multiparity and prolonged breast-feeding on maternal bone mineral density: a community-based cross-sectional study

    PubMed Central

    Lenora, Janaka; Lekamwasam, Sarath; Karlsson, Magnus K

    2009-01-01

    Background Studies conducted in Western countries have shown that bone loss associated with pregnancy and breast-feeding is recovered after weaning. However, it is not clear whether recovery takes place after repeated pregnancies followed by prolonged periods of breast-feeding; especially in developing countries where nutritional intake is comparatively low. This study was designed to examine the effects of multiparity and prolonged breast-feeding on maternal bone mineral density (BMD) in a community-based sample of 210 Sri Lankan women, aged between 46 and 98 years. Methods BMD of the lumbar spine (L2–L4) and femoral neck were measured by dual-energy X-ray absorptiometry. Reproductive history was recorded by using a questionnaire. Women were, first, divided into groups according to parity (nulliparous, 1–2, 3–4, and 5 or more children), and BMDs in different groups were compared, initially unadjusted and then adjusted for age. Same subjects were subdivided, again, according to the total duration of breast-feeding (0, 1–48, 49–96, and 97 months or more) and similar analysis was carried out. Results Women who had 5 or more children and women who had breast-fed for 97 months or more were older than the other women (p < 0.01) but no differences in height, weight or BMI were observed among the groups. Age adjusted BMD at lumbar spine and femoral neck BMDs of women grouped according to parity were not significantly different. Neither was there any difference between lumbar spine or femoral neck BMD in groups based on duration of breast-feeding. Conclusion From this population-based study conducted in a developing country, we infer that history of multiparity or prolonged breast-feeding has no detrimental effects on maternal BMD in post-menopausal age. PMID:19570205

  1. Effects of multiparity and prolonged breast-feeding on maternal bone mineral density: a community-based cross-sectional study.

    PubMed

    Lenora, Janaka; Lekamwasam, Sarath; Karlsson, Magnus K

    2009-07-01

    Studies conducted in Western countries have shown that bone loss associated with pregnancy and breast-feeding is recovered after weaning. However, it is not clear whether recovery takes place after repeated pregnancies followed by prolonged periods of breast-feeding; especially in developing countries where nutritional intake is comparatively low.This study was designed to examine the effects of multiparity and prolonged breast-feeding on maternal bone mineral density (BMD) in a community-based sample of 210 Sri Lankan women, aged between 46 and 98 years. BMD of the lumbar spine (L2-L4) and femoral neck were measured by dual-energy X-ray absorptiometry. Reproductive history was recorded by using a questionnaire. Women were, first, divided into groups according to parity (nulliparous, 1-2, 3-4, and 5 or more children), and BMDs in different groups were compared, initially unadjusted and then adjusted for age. Same subjects were subdivided, again, according to the total duration of breast-feeding (0, 1-48, 49-96, and 97 months or more) and similar analysis was carried out. Women who had 5 or more children and women who had breast-fed for 97 months or more were older than the other women (p < 0.01) but no differences in height, weight or BMI were observed among the groups. Age adjusted BMD at lumbar spine and femoral neck BMDs of women grouped according to parity were not significantly different. Neither was there any difference between lumbar spine or femoral neck BMD in groups based on duration of breast-feeding. From this population-based study conducted in a developing country, we infer that history of multiparity or prolonged breast-feeding has no detrimental effects on maternal BMD in post-menopausal age.

  2. Impact of Azithromycin on Pregnancy Prolongation in Women at Risk of Preterm Labor: A Time-to-Event Analysis.

    PubMed

    Goyer, Isabelle; Ferland, Gabrielle; Ruo, Ni; Morin, Caroline; Brochet, Marie-Sophie; Morin, Lucie; Ferreira, Ema

    2016-09-13

    Since 2006, the empiric use of azithromycin in women at risk of premature birth has become prevalent in our institution without any evidence of its efficacy. Although antibiotics can prolong pregnancy in preterm prolonged rupture of membranes, no published data are available for women with intact membranes. To describe the purpose of adding azithromycin to the usual treatments (cerclage, tocolysis, rest, etc.) to prolong pregnancy in women with intact membranes who are at risk of or already in preterm labour. A retrospective observational cohort study was done at a Mother-Child University Hospital Centre. Patients admitted to obstetric ward who received azithromycin between January 1 st , 2006 and August 1 st , 2010 were included. A total of 127 exposed women were matched to 127 controls through medical records and pharmacy software. A time-to-event analysis was done to compare gestational age at the time of the recorded composite event (delivery, or rupture of membranes, or second intervention to prolong pregnancy). To compare proportions of composite event at different time points, χ 2 tests were used. Patients who received azithromycin had a more severe condition at presentation. Once adjusted for confounding factors, prolongation of pregnancy (HR =1.049; CI 95%: 0.774-1.421 [p=0.758]) and gestational age at the event (HR=1.200; CI 95%: 0.894-1.609 [p=0.225]) did not differ between the groups. The proportions of women with an event ≥7 days post-diagnosis or ≥37 gestational weeks were similar. Azithromycin was added to medical therapy in a more at-risk population and no clear benefit was measured.

  3. Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs.

    PubMed

    Rutt, Benjamin T; Oehlert, Mary E; Krieshok, Thomas S; Lichtenberg, James W

    2018-04-01

    Objective This study evaluated the effectiveness of cognitive processing therapy and prolonged exposure in conditions reflective of current clinical practice within the Veterans Health Administration. Method This study involved a retrospective review of 2030 charts. A total of 750 veterans from 10 U.S. states who received cognitive processing therapy or prolonged exposure in individual psychotherapy were included in the study (participants in cognitive processing therapy, N = 376; participants in prolonged exposure, N = 374). The main dependent variable was self-reported posttraumatic stress disorder symptoms as measured by total scores on the Posttraumatic Stress Disorder Checklist. The study used multilevel modeling to evaluate the absolute and relative effectiveness of both treatments and determine the relationship between patient-level variables and total Posttraumatic Stress Disorder Checklist scores during treatment. Results Cognitive processing therapy and prolonged exposure were equally effective at reducing total Posttraumatic Stress Disorder Checklist scores. Veterans who completed therapy reported significantly larger reductions in the Posttraumatic Stress Disorder Checklist than patients who did not complete therapy. There were no significant differences in the improvement of posttraumatic stress disorder symptoms with respect to age and three racial/ethnic groups (Caucasian, African American, and Hispanic). Conclusions Cognitive processing therapy and prolonged exposure were shown to be effective in conditions highly reflective of clinical practice and with a highly diverse sample of veterans. Challenges related to dropout from trauma focused therapy should continue to be researched.

  4. Assessing the outcomes of prolonged cessation-induction and aid-to-cessation trials: floating prolonged abstinence.

    PubMed

    Aveyard, Paul; Wang, Dechao; Connock, Martin; Fry-Smith, Anne; Barton, Pelham; Moore, David

    2009-05-01

    A Society for Research on Nicotine and Tobacco working group recommended outcome measures for cessation-induction trials and aid-to-cessation trials. Cessation-induction trials aim to motivate unwilling quitters to make a quit attempt. Aid-to-cessation trials give either medication or behavioral interventions to increase the rate at which willing quitters succeed in their attempts. Nicotine-assisted reduction programs combine features of both types of interventions by giving nicotine replacement to unwilling quitters. Treatment can be prolonged more than a year, quit attempts can occur and succeed early or late in the program, and renewed quit attempts are an inherent part of the program. Conventional outcome measures are tied to a fixed but arbitrary point in follow-up and cannot capture the true outcome: Prolonged cessation anchored to the point at which a person makes a successful quit attempt. We propose that the outcome should be counted from the successful quit attempt that began during the treatment period and continues for a defined period, ideally 6 months. In particular, if a trial compared a short reduction program with a long reduction program, it would not be possible to obtain an unbiased assessment of the outcome of such a trial using a measure tied to a fixed point in follow-up. Floating prolonged abstinence could provide such an assessment and is suitable for either prolonged cessation-induction trial or combined cessation-induction and aid-to-cessation trials.

  5. The role of cross-racial/ethnic friendships in social adjustment.

    PubMed

    Kawabata, Yoshito; Crick, Nicki R

    2008-07-01

    The purpose of this study was to examine the frequency and correlates of cross-racial/ethnic friendships. The sample consisted of 509 (188 African American, 135 European American, 106 Asian American, and 80 Latino) children in 4th grade from 39 classrooms in several public elementary schools. The authors hypothesized that (a) the frequency of cross-racial/ethnic friendships would be different across races/ethnicities and (b) these friendships would be uniquely associated with social adjustment (relational inclusion, leadership). Results showed that European American children displayed a higher frequency of cross-racial/ethnic friendships than African American children. Compared with the sample average, Latino children exhibited a lower frequency of these friendships. Further, findings revealed that children who formed cross-racial/ethnic friendships were more likely to be viewed as relationally inclusive and possessing leadership skills by teachers. Overall, the results showed that cross-racial/ethnic friendships were associated with positive developmental outcomes and that future studies that examine how these friendships are formed and maintained, and how these pathways are related to social adjustment, are warranted.

  6. Effect on HRV of archer athletes one day before competition after three different abdominal respiratory frequency.

    PubMed

    Zhang, Kai; Wei, Jun; Wang, Lin

    2017-12-01

    To study the effect on HRV of archer athletes one day before competition after three different abdominal respiratory frequencies. Eight elite archers performed three different respiratory frequency tests, HRV were recorded in pre-, during, and post-frequency control in frequency 16 (F16 group, n = 8), 8 (F8 group, n = 8), and 5 (F5 group, n = 8) times per minute, and hoped to find a respiratory adjust way to reduce stress. RMSSD, RR_triangular index, TP, VLF, LF, HF and LF/HF were analyzed to describe the effect of respiratory frequency. The average RR separate, RR_triangular index and HF showed no significant change in three respiratory frequency ( P  > 0.05); LF increased significantly in F16 group, but LP of F8 and F5 group increased first then reduced ( P  < .05); VLF rose in F8 and F5 group ( P  < .05, respectively), the LF/HF has the similar change as the LF in all the groups. The F16 group increased equilibrium of sympathetic and pneumogastric nerve system; F8 increase excitability of sympathetic nerve; mental fatigue remission in F5.

  7. Prolonged ictal aphasia: a diagnosis to consider.

    PubMed

    Herskovitz, Moshe; Schiller, Yitzhak

    2012-11-01

    Aphasia is a common symptom encountered by clinical neurologists. It is usually caused by strokes or lesions involving language regions of the brain, yet prolonged aphasia is rarely the sole manifestation of a simple partial status epilepticus. We report six patients, who suffered from prolonged ictal aphasia. All but one patient had a structural lesion in the left hemisphere, only three suffered from clinical seizures during or shortly prior to the aphasic episode. All patients had ictal patterns on the electroencephalogram (EEG), four of whom had periodic lateralized epileptiform discharges, and five showed frequent recurrent electrographic seizures during the aphasic state. The aphasia lasted several days in all patients, and it resolved after administration of antiepileptic drug treatment. In conclusion, prolonged ictal aphasia is a rare but important treatable cause of aphasia. Surface EEG recordings should be obtained in all patients with unexplained prolonged aphasia to diagnose this rare but treatable entity. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  8. Prolonged breastfeeding and delayed introduction of whole cow's milk into the diet are factors associated with egg sensitization: A matched case-control study.

    PubMed

    Bedolla-Barajas, M; Morales-Romero, J; Gaxiola-Arredondo, B Y; Alcalá-Padilla, G; Romero-Velarde, E

    2018-05-05

    Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy. To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization. This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization. The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR=0.16 (95% CI: 0.07-0.36, p<0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR=5.54 (95% CI: 2.41-12.7, p<0.0001). Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings. Copyright © 2018 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  9. Cold intermittent cardioplegia reduces the acidosis during prolonged cardiac surgery with cardiopulmonary bypass.

    PubMed

    Nollo, Giandomenico; Ferrari, Paolo; Graffigna, Angelo C

    2011-01-01

    The effect on acid-base balance efficacy of intermittent warm and cold blood cardioplegia (IWBC, ICBC) was assessed in 44 patients who underwent cardiac surgery with prolonged aortic cross clamping. With this purpose a customized multi sensor probe was inserted in the coronary sinus, and pH, PO(2), PCO(2) and temperature were continuously measured at 1 Hz sampling rate. The mean cross-clamping time was of 76 ± 26 min on 19 IWBC cases and of 80 ± 24 min on 14 ICBC cases. With IWBC perfusion, at the end of every ischemic period, the lowest pH and PO(2) progressively decreased and the maximal PCO(2) increased. During ICBC the minimum of pH and PO(2) and maximum of PCO2 at the end of different ischemic period during time were constant, also during long cross-clamping time. With IWBC, myocardial ischemia seemed not completely reversed by standardized reperfusions, as reflected by steady deterioration of PCO(2) and pH after each reperfusion.

  10. Causes of Death Associated With Prolonged TV Viewing

    PubMed Central

    Keadle, Sarah K.; Moore, Steven C.; Sampson, Joshua N.; Xiao, Qian; Albanes, Demetrius; Matthews, Charles E.

    2015-01-01

    Introduction TV viewing is the most prevalent sedentary behavior and is associated with increased risk of cardiovascular disease and cancer mortality, but the association with other leading causes of death is unknown. This study examined the association between TV viewing and leading causes of death in the U.S. Methods A prospective cohort of 221,426 individuals (57% male) aged 50–71 years who were free of chronic disease at baseline (1995–1996), 93% white, with an average BMI of 26.7 (SD=4.4) kg/m2 were included. Participants self-reported TV viewing at baseline and were followed until death or December 31, 2011. Hazard ratios (HRs) and 95% CIs for TV viewing and cause-specific mortality were estimated using Cox proportional hazards regression. Analyses were conducted in 2014–2015. Results After an average follow-up of 14.1 years, adjusted mortality risk for a 2-hour/day increase in TV viewing was significantly higher for the following causes of death (HR [95% CI]): cancer (1.07 [1.03, 1.11); heart disease (1.23 [1.17, 1.29]); chronic obstructive pulmonary disease (1.28 [1.14, 1.43]); diabetes (1.56 [1.33, 1.83]); influenza/pneumonia (1.24 [1.02, 1.50]); Parkinson disease (1.35 [1.11, 1.65]); liver disease (1.33 [1.05, 1.67]); and suicide (1.43 [1.10, 1.85]. Mortality associations persisted in stratified analyses with important potential confounders, reducing causation concerns. Conclusions This study shows the breadth of mortality outcomes associated with prolonged TV viewing, and identifies novel associations for several leading causes of death. TV viewing is a prevalent discretionary behavior that may be a more important target for public health intervention than previously recognized. Trial Registration ClinicalTrials.gov number, NCT00340015 PMID:26215832

  11. Plasma cell-free mitochondrial DNA declines in response to prolonged moderate aerobic exercise.

    PubMed

    Shockett, Penny E; Khanal, Januka; Sitaula, Alina; Oglesby, Christopher; Meachum, William A; Castracane, V Daniel; Kraemer, Robert R

    2016-01-01

    Increased plasma cell-free mitochondrial DNA (cf-mDNA), a damage-associated molecular pattern (DAMP) produced by cellular injury, contributes to neutrophil activation/inflammation in trauma patients and arises in cancer and autoimmunity. To further understand relationships between cf-mDNA released by tissue injury, inflammation, and health benefits of exercise, we examined cf-mDNA response to prolonged moderate aerobic exercise. Seven healthy moderately trained young men (age = 22.4 ± 1.2) completed a treadmill exercise trial for 90 min at 60% VO2 max and a resting control trial. Blood was sampled immediately prior to exercise (0 min = baseline), during (+18, +54 min), immediately after (+90 min), and after recovery (R40). Plasma was analyzed for cf-mDNA, IL-6, and lactate. A significant difference in cf-mDNA response was observed between exercise and control trials, with cf-mDNA levels reduced during exercise at +54 and +90 (with or without plasma volume shift correction). Declines in cf-mDNA were accompanied by increased lactate and followed by an increase in IL-6, suggesting a temporal association with muscle stress and inflammatory processes. Our novel finding of cf-mDNA decline with prolonged moderate treadmill exercise provides evidence for increased clearance from or reduced release of cf-mDNA into the blood with prolonged exercise. These studies contrast with previous investigations involving exhaustive short-term treadmill exercise, in which no change in cf-mDNA levels were reported, and contribute to our understanding of differences between exercise- and trauma-induced inflammation. We propose that transient declines in cf-mDNA may induce health benefits, by reducing systemic inflammation. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  12. Detecting drug-induced prolongation of the QRS complex: New insights for cardiac safety assessment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cros, C., E-mail: caroline.cros@hotmail.co.uk; Skinner, M., E-mail: Matthew.Skinner@astrazeneca.com; Moors, J.

    Background: Drugs slowing the conduction of the cardiac action potential and prolonging QRS complex duration by blocking the sodium current (I{sub Na}) may carry pro-arrhythmic risks. Due to the frequency-dependent block of I{sub Na}, this study assesses whether activity-related spontaneous increases in heart rate (HR) occurring during standard dog telemetry studies can be used to optimise the detection of class I antiarrhythmic-induced QRS prolongation. Methods: Telemetered dogs were orally dosed with quinidine (class Ia), mexiletine (class Ib) or flecainide (class Ic). QRS duration was determined standardly (5 beats averaged at rest) but also prior to and at the plateau ofmore » each acute increase in HR (3 beats averaged at steady state), and averaged over 1 h period from 1 h pre-dose to 5 h post-dose. Results: Compared to time-matched vehicle, at rest, only quinidine and flecainide induced increases in QRS duration (E{sub max} 13% and 20% respectively, P < 0.01–0.001) whereas mexiletine had no effect. Importantly, the increase in QRS duration was enhanced at peak HR with an additional effect of + 0.7 ± 0.5 ms (quinidine, NS), + 1.8 ± 0.8 ms (mexiletine, P < 0.05) and + 2.8 ± 0.8 ms (flecainide, P < 0.01) (calculated as QRS at basal HR-QRS at high HR). Conclusion: Electrocardiogram recordings during elevated HR, not considered during routine analysis optimised for detecting QT prolongation, can be used to sensitise the detection of QRS prolongation. This could prove useful when borderline QRS effects are detected. Analysing during acute increases in HR could also be useful for detecting drug-induced effects on other aspects of cardiac function. -- Highlights: ► We aimed to improve detection of drug-induced QRS prolongation in safety screening. ► We used telemetered dogs to test class I antiarrhythmics at low and high heart rate. ► At low heart rate only quinidine and flecainide induced an increase in QRS duration. ► At high heart rate the effects

  13. Inhibition of spontaneous recovery of fear by mGluR5 after prolonged extinction training.

    PubMed

    Mao, Sheng-Chun; Chang, Chih-Hua; Wu, Chia-Chen; Orejarena, M Juliana; Orejanera, Maria Juliana; Manzoni, Olivier J; Gean, Po-Wu

    2013-01-01

    Fear behavior is vital for survival and involves learning contingent associations of non-threatening cues with aversive stimuli. In contrast, excessive levels of fear can be maladaptive and lead to anxiety disorders. Generally, extensive sessions of extinction training correlates with reduced spontaneous recovery. The molecular mechanisms underlying the long-term inhibition of fear recovery following repeated extinction training are not fully understood. Here we show that in rats, prolonged extinction training causes greater reduction in both fear-potentiated startle and spontaneous recovery. This effect was specifically blocked by metabotropic glutamate receptor 5 (mGluR5), but not by mGluR1 antagonists and by a protein synthesis inhibitor. Similar inhibition of memory recovery following prolonged extinction training was also observed in mice. In agreement with the instrumental role of mGluR5 in the prolonged inhibition of fear recovery, we found that FMR1-/- mice which exhibit enhanced mGluR5-mediated signaling exhibit lower spontaneous recovery of fear after extinction training than wild-type littermates. At the molecular level, we discovered that prolonged extinction training reversed the fear conditioning-induced increase in surface expression of GluR1, AMPA/NMDA ratio, postsynaptic density-95 (PSD-95) and synapse-associated protein-97 (SAP97). Accordingly, delivery of Tat-GluR2(3Y), a synthetic peptide that blocks AMPA receptor endocytosis, inhibited prolonged extinction training-induced inhibition of fear recovery. Together, our results demonstrate that prolonged extinction training results in the mGluR5-dependent long-term inhibition of fear recovery. This effect may involve the degradation of original memory and may explain the beneficial effects of prolonged exposure therapy for the treatment of phobias.

  14. Prolonged CD4 T Cell Lymphopenia Increases Morbidity and Mortality after Renal Transplantation

    PubMed Central

    Courivaud, Cécile; Bamoulid, Jamal; Vivet, Bérengère; Chabroux, Aline; Deschamps, Marina; Rebibou, Jean-Michel; Ferrand, Christophe; Chalopin, Jean-Marc; Tiberghien, Pierre; Saas, Philippe

    2010-01-01

    Prolonged CD4 T cell lymphopenia after administration of polyclonal anti-thymocyte globulins increases the rate of posttransplantation morbidity, but whether impaired immune reconstitution affects survival is unknown. We studied the effect of CD4 T cell lymphopenia on survival in 302 consecutive prevalent renal transplant recipients and the role of thymic function in CD4 T cell reconstitution and posttransplantation outcomes in 100 consecutive incident renal transplant recipients. We followed the prevalent cohort for a mean duration of 92 months. Of these 302 patients, 81 (27%) had persistent CD4 T cell counts <300/mm3 and 36 (12%) died during follow-up. We observed a higher death rate in patients with CD4 T cell lymphopenia persisting for >1 year (24.1 versus 7.6%; P < 0.001). Furthermore, in Cox regression analysis, CD4 T cell lymphopenia associated with a nearly five-fold risk for death (adjusted hazard ratio [HR] 4.63; 95% confidence interval [CI] 1.91 to 10.65; P = 0.001). In the incident cohort, we estimated thymic function by T cell receptor excision circles (TRECs) per 150,000 CD3+ cells, which predicted efficient CD4 T cell reconstitution. Higher pretransplantation TREC values associated with lower risks for cancer (adjusted HR 0.39; 95% CI 0.15 to 0.97; P = 0.046) and infection (HR 0.29; 95% CI 0.11 to 0.78; P = 0.013). In summary, prolonged polyclonal anti-thymocyte globulin–induced CD4 T cell lymphopenia is an independent risk factor for death. Determination of pretransplantation thymic function may identify patients at higher risk for CD4 T cell lymphopenia and posttransplantation morbidity, including cancer and infections. PMID:20203160

  15. Xenon treatment attenuates early renal allograft injury associated with prolonged hypothermic storage in rats.

    PubMed

    Zhao, Hailin; Yoshida, Akira; Xiao, Wei; Ologunde, Rele; O'Dea, Kieran P; Takata, Masao; Tralau-Stewart, Catherine; George, Andrew J T; Ma, Daqing

    2013-10-01

    Prolonged hypothermic storage elicits severe ischemia-reperfusion injury (IRI) to renal grafts, contributing to delayed graft function (DGF) and episodes of acute immune rejection and shortened graft survival. Organoprotective strategies are therefore needed for improving long-term transplant outcome. The aim of this study is to investigate the renoprotective effect of xenon on early allograft injury associated with prolonged hypothermic storage. Xenon exposure enhanced the expression of heat-shock protein 70 (HSP-70) and heme oxygenase 1 (HO-1) and promoted cell survival after hypothermia-hypoxia insult in human proximal tubular (HK-2) cells, which was abolished by HSP-70 or HO-1 siRNA. In the brown Norway to Lewis rat renal transplantation, xenon administered to donor or recipient decreased the renal tubular cell death, inflammation, and MHC II expression, while delayed graft function (DGF) was therefore reduced. Pathological changes associated with acute rejection, including T-cell, macrophage, and fibroblast infiltration, were also decreased with xenon treatment. Donors or recipients treated with xenon in combination with cyclosporin A had prolonged renal allograft survival. Xenon protects allografts against delayed graft function, attenuates acute immune rejection, and enhances graft survival after prolonged hypothermic storage. Furthermore, xenon works additively with cyclosporin A to preserve post-transplant renal function.

  16. Effects of drought and prolonged winter on Townsend's ground squirrel demography in shrubsteppe habitats

    USGS Publications Warehouse

    Van Horne, Beatrice; Olson, Gail S.; Schooley, Robert L.; Corn, Janelle G.; Burnham, Kenneth P.

    1997-01-01

    During a mark–recapture study of Townsend's ground squirrels (Spermophilus townsendii) on 20 sites in the Snake River Birds of Prey National Conservation Area, Idaho, in 1991 through 1994, 4407 animals were marked in 17639 capture events. This study of differences in population dynamics of Townsend's ground squirrels among habitats spanned a drought near the extreme of the 130-yr record, followed by prolonged winter conditions.Townsend's ground squirrels have a short active season (≈4 mo) in which to reproduce and store fat for overwintering. Their food consists largely of succulent grasses and forbs in this dry shrubsteppe and grassland habitat. The drought in the latter half of the 1992 active season produced early drying of Sandberg's bluegrass (Poa secunda) and was associated with low adult and juvenile body masses prior to immergence into estivation/hibernation. The following prolonged winter was associated with late emergence of females in 1993. Early-season body masses of adults were low in 1993 relative to 1992, whereas percentage of body fat in males was relatively high. These weather patterns in spring 1992 and winter 1993 also resulted in reduced adult persistence through the ≈7-mo inactive period, especially for adult females, and near-zero persistence of >1200 juveniles. Consequently, densities of Townsend's ground squirrels across the 20 livetrap sites declined.The demographic effects of drought and prolonged winter lasted at least through the subsequent breeding season. Adult females that survived these weather extremes produced fewer emergent young per female than did adult females prior to the event. Prior to the drought/prolonged winter, yearling female body masses were higher than, or indistinguishable from, those of adults. Females produced in 1993 had lower body masses as yearlings than did adult females.Demographic response to the drought and prolonged winter varied with habitat; ground squirrels in sagebrush habitat showed less decline

  17. Partial white and grey matter protection with prolonged infusion of recombinant human erythropoietin after asphyxia in preterm fetal sheep.

    PubMed

    Wassink, Guido; Davidson, Joanne O; Dhillon, Simerdeep K; Fraser, Mhoyra; Galinsky, Robert; Bennet, Laura; Gunn, Alistair J

    2017-03-01

    Perinatal asphyxia in preterm infants remains a significant contributor to abnormal long-term neurodevelopmental outcomes. Recombinant human erythropoietin has potent non-haematopoietic neuroprotective properties, but there is limited evidence for protection in the preterm brain. Preterm (0.7 gestation) fetal sheep received sham asphyxia (sham occlusion) or asphyxia induced by umbilical cord occlusion for 25 min, followed by an intravenous infusion of vehicle (occlusion-vehicle) or recombinant human erythropoietin (occlusion-Epo, 5000 international units by slow push, then 832.5 IU/h), starting 30 min after asphyxia and continued until 72 h. Recombinant human erythropoietin reduced neuronal loss and numbers of caspase-3-positive cells in the striatal caudate nucleus, CA3 and dentate gyrus of the hippocampus, and thalamic medial nucleus ( P < 0.05 vs. occlusion-vehicle). In the white matter tracts, recombinant human erythropoietin increased total, but not immature/mature oligodendrocytes ( P < 0.05 vs. occlusion-vehicle), with increased cell proliferation and reduced induction of activated caspase-3, microglia and astrocytes ( P < 0.05). Finally, occlusion-Epo reduced seizure burden, with more rapid recovery of electroencephalogram power, spectral edge frequency, and carotid blood flow. In summary, prolonged infusion of recombinant human erythropoietin after severe asphyxia in preterm fetal sheep was partially neuroprotective and improved electrophysiological and cerebrovascular recovery, in association with reduced apoptosis and inflammation.

  18. Partial white and grey matter protection with prolonged infusion of recombinant human erythropoietin after asphyxia in preterm fetal sheep

    PubMed Central

    Wassink, Guido; Davidson, Joanne O; Dhillon, Simerdeep K; Fraser, Mhoyra; Galinsky, Robert; Bennet, Laura

    2016-01-01

    Perinatal asphyxia in preterm infants remains a significant contributor to abnormal long-term neurodevelopmental outcomes. Recombinant human erythropoietin has potent non-haematopoietic neuroprotective properties, but there is limited evidence for protection in the preterm brain. Preterm (0.7 gestation) fetal sheep received sham asphyxia (sham occlusion) or asphyxia induced by umbilical cord occlusion for 25 min, followed by an intravenous infusion of vehicle (occlusion-vehicle) or recombinant human erythropoietin (occlusion-Epo, 5000 international units by slow push, then 832.5 IU/h), starting 30 min after asphyxia and continued until 72 h. Recombinant human erythropoietin reduced neuronal loss and numbers of caspase-3-positive cells in the striatal caudate nucleus, CA3 and dentate gyrus of the hippocampus, and thalamic medial nucleus (P < 0.05 vs. occlusion-vehicle). In the white matter tracts, recombinant human erythropoietin increased total, but not immature/mature oligodendrocytes (P < 0.05 vs. occlusion-vehicle), with increased cell proliferation and reduced induction of activated caspase-3, microglia and astrocytes (P < 0.05). Finally, occlusion-Epo reduced seizure burden, with more rapid recovery of electroencephalogram power, spectral edge frequency, and carotid blood flow. In summary, prolonged infusion of recombinant human erythropoietin after severe asphyxia in preterm fetal sheep was partially neuroprotective and improved electrophysiological and cerebrovascular recovery, in association with reduced apoptosis and inflammation. PMID:27207167

  19. Prolonged QRS Widening After Aripiprazole Overdose.

    PubMed

    Mazer-Amirshahi, Maryann; Porter, Robert; Dewey, Kayla

    2018-05-05

    Aripiprazole is an atypical antipsychotic with a long half-life. Overdose can result in protracted somnolence and cardiac disturbances, particularly QT interval prolongation. This is a single case report of a 14-year-old boy who took an overdose of aripiprazole and developed QRS widening. A 14-year-old boy intentionally ingested 20 tablets of aripiprazole (5 mg). He was brought to the emergency department when his ingestion was discovered. The patient's vital signs were as follows: temperature, 37.7°C; heart rate, 108 beats/min; blood pressure, 138/98 mm Hg; and respirations, 16 breaths/min. Activated charcoal was administered within 90 minutes of ingestion. Initial electrocardiogram (EKG) showed sinus tachycardia, with a QRS of 138 ms and QT interval of 444 ms. QRS duration was 90 ms on an EKG performed 3 months earlier. A bolus of sodium bicarbonate was administered, and the patient was transferred to the pediatric intensive care unit. Repeat EKG demonstrated a QRS of 156 ms, and a sodium bicarbonate infusion was initiated. The patient continued to have QRS prolongation for the next 8 days, reaching a peak of 172 ms 3 days postingestion. Despite aggressive treatment with sodium bicarbonate, there was persistent QRS prolongation; however, the patient did not have any dysrhythmias and remained hemodynamically stable. The patient was discharged 9 days postingestion when the QRS duration normalized to 82 ms. Genetic testing revealed that the patient was a CYP2D6 poor metabolizer. This case suggests that aripiprazole toxicity may possibly be associated with QRS prolongation without associated dysrhythmias or cardiovascular compromise. In addition, toxicity may be prolonged in patients who are CYP2D6 poor metabolizers.

  20. Synbiotic approach restores intestinal homeostasis and prolongs survival in leukaemic mice with cachexia

    PubMed Central

    Bindels, Laure B; Neyrinck, Audrey M; Claus, Sandrine P; Le Roy, Caroline I; Grangette, Corinne; Pot, Bruno; Martinez, Inés; Walter, Jens; Cani, Patrice D; Delzenne, Nathalie M

    2016-01-01

    Cancer cachexia is a multifactorial syndrome that includes muscle wasting and inflammation. As gut microbes influence host immunity and metabolism, we investigated the role of the gut microbiota in the therapeutic management of cancer and associated cachexia. A community-wide analysis of the caecal microbiome in two mouse models of cancer cachexia (acute leukaemia or subcutaneous transplantation of colon cancer cells) identified common microbial signatures, including decreased Lactobacillus spp. and increased Enterobacteriaceae and Parabacteroides goldsteinii/ASF 519. Building on this information, we administered a synbiotic containing inulin-type fructans and live Lactobacillus reuteri 100-23 to leukaemic mice. This treatment restored the Lactobacillus population and reduced the Enterobacteriaceae levels. It also reduced hepatic cancer cell proliferation, muscle wasting and morbidity, and prolonged survival. Administration of the synbiotic was associated with restoration of the expression of antimicrobial proteins controlling intestinal barrier function and gut immunity markers, but did not impact the portal metabolomics imprinting of energy demand. In summary, this study provided evidence that the development of cancer outside the gut can impact intestinal homeostasis and the gut microbial ecosystem and that a synbiotic intervention, by targeting some alterations of the gut microbiota, confers benefits to the host, prolonging survival and reducing cancer proliferation and cachexia. PMID:26613342

  1. Synbiotic approach restores intestinal homeostasis and prolongs survival in leukaemic mice with cachexia.

    PubMed

    Bindels, Laure B; Neyrinck, Audrey M; Claus, Sandrine P; Le Roy, Caroline I; Grangette, Corinne; Pot, Bruno; Martinez, Inés; Walter, Jens; Cani, Patrice D; Delzenne, Nathalie M

    2016-06-01

    Cancer cachexia is a multifactorial syndrome that includes muscle wasting and inflammation. As gut microbes influence host immunity and metabolism, we investigated the role of the gut microbiota in the therapeutic management of cancer and associated cachexia. A community-wide analysis of the caecal microbiome in two mouse models of cancer cachexia (acute leukaemia or subcutaneous transplantation of colon cancer cells) identified common microbial signatures, including decreased Lactobacillus spp. and increased Enterobacteriaceae and Parabacteroides goldsteinii/ASF 519. Building on this information, we administered a synbiotic containing inulin-type fructans and live Lactobacillus reuteri 100-23 to leukaemic mice. This treatment restored the Lactobacillus population and reduced the Enterobacteriaceae levels. It also reduced hepatic cancer cell proliferation, muscle wasting and morbidity, and prolonged survival. Administration of the synbiotic was associated with restoration of the expression of antimicrobial proteins controlling intestinal barrier function and gut immunity markers, but did not impact the portal metabolomics imprinting of energy demand. In summary, this study provided evidence that the development of cancer outside the gut can impact intestinal homeostasis and the gut microbial ecosystem and that a synbiotic intervention, by targeting some alterations of the gut microbiota, confers benefits to the host, prolonging survival and reducing cancer proliferation and cachexia.

  2. Dyadic coping mediates the relationship between parents' grief and dyadic adjustment following the loss of a child.

    PubMed

    Albuquerque, Sara; Narciso, Isabel; Pereira, Marco

    2018-01-01

    This study aimed to examine forms of dyadic coping (DC) as mediators of the association between parents' grief response and dyadic adjustment and to determine whether these indirect effects were moderated by the child's type of death, timing of death, and age. The study design was cross-sectional. The sample consisted of 197 bereaved parents. Participants completed the Prolonged Grief Disorder Scale, Revised Dyadic Adjustment Scale, and Dyadic Coping Inventory. Significant indirect effects of parents' grief response on dyadic adjustment were found through stress communication by oneself and by the partner, positive and negative DC by the partner, and joint DC. The timing of death moderated the association between grief response and dyadic adjustment and between joint DC and dyadic adjustment. Grief response was negatively associated with dyadic adjustment only when the death occurred after birth. Grief response was negatively associated with joint DC, which, in turn, was positively associated with dyadic adjustment, when the death occurred both before and after birth. However, the association was stronger in the latter. Specific forms of DC might be mechanisms through which grief response is associated with dyadic adjustment and should be promoted in clinical practice.

  3. Motor torque compensation of an induction electric motor by adjusting a slip command during periods of supposed change in motor temperature

    DOEpatents

    Kelledes, William L.; St. John, Don K.

    1992-01-01

    The present invention maintains constant torque in an inverter driven AC induction motor during variations in rotor temperature. It is known that the torque output of a given AC induction motor is dependent upon rotor temperature. At rotor temperatures higher than the nominal operating condition the rotor impedance increases, reducing the rotor current and motor torque. In a similar fashion, the rotor impedance is reduced resulting in increased rotor current and motor torque when the rotor temperature is lower than the nominal operating condition. The present invention monitors the bus current from the DC supply to the inverter and adjusts the slip frequency of the inverter drive to maintain a constant motor torque. This adjustment is based upon whether predetermined conditions implying increased rotor temperature or decreased rotor temperature exist for longer that a predetermined interval of time.

  4. Predicting prolonged dose titration in patients starting warfarin.

    PubMed

    Finkelman, Brian S; French, Benjamin; Bershaw, Luanne; Brensinger, Colleen M; Streiff, Michael B; Epstein, Andrew E; Kimmel, Stephen E

    2016-11-01

    Patients initiating warfarin therapy generally experience a dose-titration period of weeks to months, during which time they are at higher risk of both thromboembolic and bleeding events. Accurate prediction of prolonged dose titration could help clinicians determine which patients might be better treated by alternative anticoagulants that, while more costly, do not require dose titration. A prediction model was derived in a prospective cohort of patients starting warfarin (n = 390), using Cox regression, and validated in an external cohort (n = 663) from a later time period. Prolonged dose titration was defined as a dose-titration period >12 weeks. Predictor variables were selected using a modified best subsets algorithm, using leave-one-out cross-validation to reduce overfitting. The final model had five variables: warfarin indication, insurance status, number of doctor's visits in the previous year, smoking status, and heart failure. The area under the ROC curve (AUC) in the derivation cohort was 0.66 (95%CI 0.60, 0.74) using leave-one-out cross-validation, but only 0.59 (95%CI 0.54, 0.64) in the external validation cohort, and varied across clinics. Including genetic factors in the model did not improve the area under the ROC curve (0.59; 95%CI 0.54, 0.65). Relative utility curves indicated that the model was unlikely to provide a clinically meaningful benefit compared with no prediction. Our results suggest that prolonged dose titration cannot be accurately predicted in warfarin patients using traditional clinical, social, and genetic predictors, and that accurate prediction will need to accommodate heterogeneities across clinical sites and over time. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  5. Thermal buffering of concrete by seaweeds during a prolonged summer heatwave

    NASA Astrophysics Data System (ADS)

    Naylor, Larissa; Coombes, Martin

    2014-05-01

    Hard coastal infrastructure is subject to aggressive environmental conditions, including a suite of weathering processes in the intertidal zone. These processes, along with waves, lead to costly deterioration of coastal structures. Existing methods (e.g. coatings, less porous concrete) to reduce the risk of concrete deterioration rapidly lose their effectiveness in the intertidal zone. Additionally, a changing climate will lead to increased frequency of storms, higher sea level and higher extreme temperatures - and therefore, pose an increased risk of deterioration. Might there be a biogenic solution? New research (Coombes et al. 2013) has shown that fucoid seaweeds reduce microclimatic extremes and variability under normal summer conditions. The results presented here supplement these findings in two ways. First, they demonstrate that fucoid seaweeds act as a thermal buffer during a prolonged summer heatwave in Britain (July 2013). Over 36 days of continuous monitoring at two sites in Cornwall, UK, 19 of which were during the official heatwave, there were statistically significant differences (p = 0.000) in the maximum temperatures between thick seaweed (7.5 - 9.5 cm thickness) and thin seaweed (2 - 2.5 cm thickness) plots. Maximum temperatures reached 22°C and 33°C, for thick seaweed and thin seaweed plots, respectively. Variations in maximum temperatures between the two sites appear to be related to aspect. Second, the significantly different maximum temperature results between plots also demonstrate that seaweed thickness is an important factor influencing thermal buffering capacity. These data clearly demonstrate that fucoid seaweeds buffer concrete seawalls against extreme temperature fluxes during a heatwave, probably limiting the efficiency of deteriorative processes such as thermal expansion and contraction and salt crystallisation.

  6. A variable passive low-frequency absorber

    NASA Astrophysics Data System (ADS)

    Larsen, Niels Werner; Thompson, Eric R.; Gade, Anders Christian

    2005-04-01

    Multi-purpose concert halls face a dilemma. They can host classical music concerts, rock concerts and spoken word performances in a matter of a short period. These different performance types require significantly different acoustic conditions in order to provide the best sound quality to both the performers and the audience. A recommended reverberation time for classical music may be in the range of 1.5-2 s for empty halls, where rock music sounds best with a reverberation time around 0.8-1 s. Modern rhythmic music often contains high levels of sound energy in the low frequency bands but still requires a high definition for good sound quality. Ideally, the absorption of the hall should be adjustable in all frequency bands in order to provide good sound quality for all types of performances. The mid and high frequency absorption is easily regulated, but adjusting the low-frequency absorption has typically been too expensive or requires too much space to be practical for multi-purpose halls. Measurements were made on a variable low-frequency absorber to develop a practical solution to the dilemma. The paper will present the results of the measurements as well as a possible design.

  7. Active laser ranging with frequency transfer using frequency comb

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhang, Hongyuan; Wei, Haoyun; Yang, Honglei

    2016-05-02

    A comb-based active laser ranging scheme is proposed for enhanced distance resolution and a common time standard for the entire system. Three frequency combs with different repetition rates are used as light sources at the two ends where the distance is measured. Pulse positions are determined through asynchronous optical sampling and type II second harmonic generation. Results show that the system achieves a maximum residual of 379.6 nm and a standard deviation of 92.9 nm with 2000 averages over 23.6 m. Moreover, as for the frequency transfer, an atom clock and an adjustable signal generator, synchronized to the atom clock, are used asmore » time standards for the two ends to appraise the frequency deviation introduced by the proposed system. The system achieves a residual fractional deviation of 1.3 × 10{sup −16} for 1 s, allowing precise frequency transfer between the two clocks at the two ends.« less

  8. Gene-environment interaction between SCN5A-1103Y and hypokalemia influences QT interval prolongation in African Americans: the Jackson Heart Study.

    PubMed

    Akylbekova, Ermeg L; Payne, John P; Newton-Cheh, Christopher; May, Warren L; Fox, Ervin R; Wilson, James G; Sarpong, Daniel F; Taylor, Herman A; Maher, Joseph F

    2014-01-01

    African-American ancestry, hypokalemia, and QT interval prolongation on the electrocardiogram are all risk factors for sudden cardiac death (SCD), but their interactions remain to be characterized. SCN5A-1103Y is a common missense variant, of African ancestry, of the cardiac sodium channel gene. SCN5A-1103Y is known to interact with QT-prolonging factors to promote ventricular arrhythmias in persons at high risk for SCD, but its clinical impact in the general African-American population has not been established. We genotyped SCN5A-S1103Y in 4,476 participants of the Jackson Heart Study, a population-based cohort of African Americans. We investigated the effect of SCN5A-1103Y, including interaction with hypokalemia, on QT interval prolongation, a widely-used indicator of prolonged myocardial repolarization and predisposition to SCD. We then evaluated the two sub-components of the QT interval: QRS duration and JT interval. The carrier frequency for SCN5A-1103Y was 15.4%. SCN5A-1103Y was associated with QT interval prolongation (2.7 milliseconds; P < .001) and potentiated the effect of hypokalemia on QT interval prolongation (14.6 milliseconds; P = .02). SCN5A-1103Y had opposing effects on the two sub-components of the QT interval, with shortening of QRS duration (-1.5 milliseconds; P = .001) and prolongation of the JT interval (3.4 milliseconds; P < .001). Hypokalemia was associated with diuretic use (78%; P < .001). SCN5A-1103Y potentiates the effect of hypokalemia on prolonging myocardial repolarization in the general African-American population. These findings have clinical implications for modification of QT prolonging factors, such as hypokalemia, in the 15% of African Americans who are carriers of SCN5A-1103Y. © 2014.

  9. Ketoconazole in paracoccidioidomycosis: efficacy of prolonged oral therapy.

    PubMed

    Restrepo, A; Stevens, D A; Leiderman, E; Fuentes, J; Arana, A; Angel, R; Mejía, G; Gómez, I

    1980-08-29

    Ketoconazole, a new oral imidazole derivative, was employed for the treatment of five patients with paracoccidioidomycosis. The response was excellent, with objective clinical improvement and healing of both mucocutaneous and pulmonary lesions. Mycological and serological tests, as well as delayed hypersensitivity, were assessed and found to correlate with clinical improvement. Therapy was conducted for 12 months with a dose of 200 mg day in 2 patients; in the remainder the dose was reduced (100 mg day) after the first 6 months and maintained as such for an equal period. No side-effects or toxicity were noted despite prolonged treatment. The advantages of the new therapeutic approach are discussed.

  10. Phonon vibrational frequencies of all single-wall carbon nanotubes at the lambda point: reduced matrix calculations.

    PubMed

    Wang, Yufang; Wu, Yanzhao; Feng, Min; Wang, Hui; Jin, Qinghua; Ding, Datong; Cao, Xuewei

    2008-12-01

    With a simple method-the reduced matrix method, we simplified the calculation of the phonon vibrational frequencies according to SWNTs structure and their phonon symmetric property and got the dispersion properties of all SWNTs at Gamma point in Brillouin zone, whose diameters lie between 0.6 and 2.5 nm. The calculating time is shrunk about 2-4 orders. A series of the dependent relationships between the diameters of SWNTs and the frequencies of Raman and IR active modes are given. Several fine structures including "glazed tile" structures in omega approximately d figures are found, which might predict a certain macro-quantum phenomenon of the phonons in SWNTs.

  11. Peak-flow frequency estimates based on data through water year 2001 for selected streamflow-gaging stations in South Dakota

    USGS Publications Warehouse

    Sando, Steven K.; Driscoll, Daniel G.; Parrett, Charles

    2008-01-01

    Numerous users, including the South Dakota Department of Transportation, have continuing needs for peak-flow information for the design of highway infrastructure and many other purposes. This report documents results from a cooperative study between the South Dakota Department of Transportation and the U.S. Geological Survey to provide an update of peak-flow frequency estimates for South Dakota. Estimates of peak-flow magnitudes for 2-, 5-, 10-, 25-, 50-, 100-, 200-, and 500-year recurrence intervals are reported for 272 streamflow-gaging stations, which include most gaging stations in South Dakota with 10 or more years of systematic peak-flow records through water year 2001. Recommended procedures described in Bulletin 17B were used as primary guidelines for developing peak-flow frequency estimates. The computer program PEAKFQ developed by the U.S. Geological Survey was used to run the frequency analyses. Flood frequencies for all stations were initially analyzed by using standard Bulletin 17B default procedures for fitting the log-Pearson III distribution. The resulting preliminary frequency curves were then plotted on a log-probability scale, and fits of the curves with systematic data were evaluated. In many cases, results of the default Bulletin 17B analyses were determined to be satisfactory. In other cases, however, the results could be improved by using various alternative procedures for frequency analysis. Alternative procedures for some stations included adjustments to skew coefficients or use of user-defined low-outlier criteria. Peak-flow records for many gaging stations are strongly influenced by low- or zero-flow values. This situation often results in a frequency curve that plots substantially above the systematic record data points at the upper end of the frequency curve. Adjustments to low-outlier criteria reduced the influence of very small peak flows and generally focused the analyses on the upper parts of the frequency curves (10- to 500-year

  12. Prolonged exposure therapy for the treatment of patients diagnosed with psychogenic non-epileptic seizures (PNES) and post-traumatic stress disorder (PTSD).

    PubMed

    Myers, Lorna; Vaidya-Mathur, Urmi; Lancman, Marcelo

    2017-01-01

    Although there is general consensus that psychogenic non-epileptic seizures (PNES) are treated with psychotherapy, the effectiveness of most psychotherapeutic modalities remains understudied. In this treatment series of 16 patients dually diagnosed with PNES and post-traumatic stress disorder (PTSD), we evaluated the effect of prolonged exposure therapy (PE) on reduction of PNES. Secondary measures included Beck Depression Inventory (BDI-II) and Post-Traumatic Disorder Diagnostic Scale (PDS). Subjects diagnosed with video EEG-confirmed PNES and PTSD confirmed through neuropsychological testing and clinical interview were treated with traditional PE psychotherapy with certain modifications for the PNES. Treatment was conducted over the course of 12-15 weekly sessions. Seizure frequency was noted in each session by examining the patients' seizure logs, and mood and PTSD symptomatology was assessed at baseline and on the final session. Eighteen subjects enrolled, and 16 (88.8%) completed the course of treatment. Thirteen of the 16 (81.25%) therapy completers reported no seizures by their final PE session, and the other three reported a decline in seizure frequency (Z=-3.233, p=0.001). Mean scores on scales of depression (M=-13.56, SD=12.27; t (15)=-4.420, p<0,001) and PTSD symptoms (M=-17.1875, SD=13.01; t (15)=-5.281, p<0.001) showed significant improvement from baseline to final session. Longitudinal seizure follow up in 14 patients revealed that gains made on the final session were maintained at follow-up (Z=-1.069 p=0.285). Prolonged exposure therapy for patients dually diagnosed with PNES and PTSD reduced the number of PNES and improved mood and post traumatic symptomatology. Follow-up revealed that gains made in seizure control on the last day of treatment were maintained over time. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study.

    PubMed

    Kertai, Miklos D; Ji, Yunqi; Li, Yi-Ju; Mathew, Joseph P; Daubert, James P; Podgoreanu, Mihai V

    2016-04-01

    We characterized cardiac surgery-induced dynamic changes of the corrected QT (QTc) interval and tested the hypothesis that genetic factors are associated with perioperative QTc prolongation independent of clinical and procedural factors. All study subjects were ascertained from a prospective study of patients who underwent elective cardiac surgery during August 1999 to April 2002. We defined a prolonged QTc interval as > 440 msec, measured from 24-hr pre- and postoperative 12-lead electrocardiograms. The association of 37 single nucleotide polymorphisms (SNPs) in 21 candidate genes -involved in modulating arrhythmia susceptibility pathways with postoperative QTc changes- was investigated in a two-stage design with a stage I cohort (n = 497) nested within a stage II cohort (n = 957). Empirical P values (Pemp) were obtained by permutation tests with 10,000 repeats. After adjusting for clinical and procedural risk factors, we selected four SNPs (P value range, 0.03-0.1) in stage I, which we then tested in the stage II cohort. Two functional SNPs in the pro-inflammatory cytokine interleukin-1β (IL1β), rs1143633 (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.53 to 0.95; Pemp = 0.02) and rs16944 (OR, 1.31; 95% CI, 1.01 to 1.70; Pemp = 0.04), remained independent predictors of postoperative QTc prolongation. The ability of a clinico-genetic model incorporating the two IL1B polymorphisms to classify patients at risk for developing prolonged postoperative QTc was superior to a clinical model alone, with a net reclassification improvement of 0.308 (P = 0.0003) and an integrated discrimination improvement of 0.02 (P = 0.000024). The results suggest a contribution of IL1β in modulating susceptibility to postoperative QTc prolongation after cardiac surgery.

  14. Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study

    PubMed Central

    Kertai, Miklos D.; Ji, Yunqi; Li, Yi-Ju; Mathew, Joseph P.; Daubert, James P.; Podgoreanu, Mihai V.

    2016-01-01

    Background We characterized cardiac surgery-induced dynamic changes of the corrected QT (QTc) interval and tested the hypothesis that genetic factors are associated with perioperative QTc prolongation independent of clinical and procedural factors. Methods All study subjects were ascertained from a prospective study of patients who underwent elective cardiac surgery during August 1999 to April 2002. We defined a prolonged QTc interval as >440 msec, measured from 24-hr pre- and postoperative 12-lead electrocardiograms. The association of 37 single nucleotide polymorphisms (SNPs) in 21 candidate genes – involved in modulating arrhythmia susceptibility pathways with postoperative QTc changes–was investigated in a two-stage design with a stage I cohort (n = 497) nested within a stage II cohort (n = 957). Empirical P values (Pemp) were obtained by permutation tests with 10,000 repeats. Results After adjusting for clinical and procedural risk factors, we selected four SNPs (P value range, 0.03-0.1) in stage I, which we then tested in the stage II cohort. Two functional SNPs in the pro-inflammatory cytokine interleukin-1β (IL1β), rs1143633 (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.53 to 0.95; Pemp = 0.02) and rs16944 (OR, 1.31; 95% CI, 1.01 to 1.70; Pemp = 0.04), remained independent predictors of postoperative QTc prolongation. The ability of a clinico-genetic model incorporating the two IL1B polymorphisms to classify patients at risk for developing prolonged postoperative QTc was superior to a clinical model alone, with a net reclassification improvement of 0.308 (P = 0.0003) and an integrated discrimination improvement of 0.02 (P = 0.000024). Conclusion The results suggest a contribution of IL1β in modulating susceptibility to postoperative QTc prolongation after cardiac surgery. PMID:26858093

  15. Carotid Baroreflex Function During Prolonged Exercise

    NASA Technical Reports Server (NTRS)

    Raven, P. B.

    1999-01-01

    Astronauts are often required to work (exercise) at moderate to high intensities for extended periods while performing extra-vehicular activities (EVA). Although the physiologic responses associated with prolonged exercise have been documented, the mechanisms involved in blood pressure regulation under these conditions have not yet been fully elucidated. An understanding of this issue is pertinent to the ability of humans to perform work in microgravity and complies with the emphasis of NASA's Space Physiology and Countermeasures Program. Prolonged exercise at a constant workload is know to result in a progressive decrease in mean arterial pressure (MAP) concomitant with a decrease in stroke volume and a compensatory increase in heart rate. The continuous decrease in MAP during the exercise, which is related to the thermoregulatory redistribution of circulating blood volume to the cutaneous circulation, raises the question as to whether there is a loss of baroreflex regulation of arterial blood pressure. We propose that with prolongation of the exercise to 60 minutes, progressive increases on central command reflect a progressive upward resetting of the carotid baroreflex (CBR) such that the operating point of the CBR is shifted to a pressure below the threshold of the reflex rendering it ineffectual in correcting the downward drift in MAP. In order to test this hypothesis, experiments have been designed to uncouple the global hemodynamic response to prolonged exercise from the central command mediated response via: (1) continuous maintenance of cardiac filling volume by intravenous infusion of a dextran solution; and (2) whole body surface cooling to counteract thermoregulatory cutaneous vasodialation. As the type of work (exercise) performed by astronauts is inherently arm and upper body dependent, we will also examine the physiologic responses to prolonged leg cycling and arm ergometry exercise in the supine positions with and without level lower body negative

  16. How noisy does a noisy miner have to be? Amplitude adjustments of alarm calls in an avian urban 'adapter'.

    PubMed

    Lowry, Hélène; Lill, Alan; Wong, Bob B M

    2012-01-01

    Urban environments generate constant loud noise, which creates a formidable challenge for many animals relying on acoustic communication. Some birds make vocal adjustments that reduce auditory masking by altering, for example, the frequency (kHz) or timing of vocalizations. Another adjustment, well documented for birds under laboratory and natural field conditions, is a noise level-dependent change in sound signal amplitude (the 'Lombard effect'). To date, however, field research on amplitude adjustments in urban environments has focused exclusively on bird song. We investigated amplitude regulation of alarm calls using, as our model, a successful urban 'adapter' species, the Noisy miner, Manorina melanocephala. We compared several different alarm calls under contrasting noise conditions. Individuals at noisier locations (arterial roads) alarm called significantly more loudly than those at quieter locations (residential streets). Other mechanisms known to improve sound signal transmission in 'noise', namely use of higher perches and in-flight calling, did not differ between site types. Intriguingly, the observed preferential use of different alarm calls by Noisy miners inhabiting arterial roads and residential streets was unlikely to have constituted a vocal modification made in response to sound-masking in the urban environment because the calls involved fell within the main frequency range of background anthropogenic noise. The results of our study suggest that a species, which has the ability to adjust the amplitude of its signals, might have a 'natural' advantage in noisy urban environments.

  17. Survival without sequelae after prolonged cardiopulmonary resuscitation after electric shock.

    PubMed

    Motawea, Mohamad; Al-Kenany, Al-Sayed; Hosny, Mostafa; Aglan, Omar; Samy, Mohamad; Al-Abd, Mohamed

    2016-03-01

    "Electrical shock is the physiological reaction or injury caused by electric current passing through the human body. It occurs upon contact of a human body part with any source of electricity that causes a sufficient current through the skin, muscles, or hair causing undesirable effects ranging from simple burns to death." Ventricular fibrillation is believed to be the most common cause of death after electrical shock. "The ideal duration of cardiac resuscitation is unknown. Typically prolonged cardiopulmonary resuscitation is associated with poor neurologic outcomes and reduced long term survival. No consensus statement has been made and traditionally efforts are usually terminated after 15-30 minutes." The case under discussion seems worthy of the somewhat detailed description given. It is for a young man who survived after 65 minutes after electrical shock (ES) after prolonged high-quality cardiopulmonary resuscitation (CPR), multiple defibrillations, and artificial ventilation without any sequelae. Early start of adequate chest compressions and close adherence to advanced cardiac life support protocols played a vital role in successful CPR.

  18. Benefits of rice seed priming are offset permanently by prolonged storage and the storage conditions

    PubMed Central

    Hussain, Saddam; Zheng, Manman; Khan, Fahad; Khaliq, Abdul; Fahad, Shah; Peng, Shaobing; Huang, Jianliang; Cui, Kehui; Nie, Lixiao

    2015-01-01

    Seed priming is a commercially successful practice, but reduced longevity of primed seeds during storage may limit its application. We established a series of experiments on rice to test: (1) whether prolonged storage of primed and non-primed rice seeds for 210 days at 25°C or −4°C would alter their viability, (2) how long primed rice seed would potentially remain viable at 25°C storage, and (3) whether or not post-storage treatments (re-priming or heating) would reinstate the viability of stored primed seeds. Two different rice cultivars and three priming agents were used in all experiments. Prolonged storage of primed seeds at 25°C significantly reduced the germination (>90%) and growth attributes (>80%) of rice compared with un-stored primed seeds. However, such negative effects were not observed in primed seeds stored at −4°C. Beneficial effects of seed priming were maintained only for 15 days of storage at 25°C, beyond which the performance of primed seeds was worse even than non-primed seeds. The deteriorative effects of 25°C storage were related with hampered starch metabolism in primed rice seeds. None of the post-storage treatments could reinstate the lost viability of primed seeds suggesting that seeds become unviable by prolonged post-priming storage at 25°C. PMID:25631923

  19. Children with autism spectrum disorder have reduced otoacoustic emissions at the 1 kHz mid-frequency region.

    PubMed

    Bennetto, Loisa; Keith, Jessica M; Allen, Paul D; Luebke, Anne E

    2017-02-01

    Autism spectrum disorder (ASD) is a behaviorally diagnosed disorder of early onset characterized by impairment in social communication and restricted and repetitive behaviors. Some of the earliest signs of ASD involve auditory processing, and a recent study found that hearing thresholds in children with ASD in the mid-range frequencies were significantly related to receptive and expressive language measures. In addition, otoacoustic emissions have been used to detect reduced cochlear function in the presence of normal audiometric thresholds. We were interested then to know if otoacoustic emissions in children with normal audiometric thresholds would also reveal differences between children with ASD and typical developing (TD) controls in mid-frequency regions. Our objective was to specifically measure baseline afferent otoacoustic emissions (distortion-product otoacoustic emissions [DPOAEs]), transient-evoked otoacoustic emissions (TrOAEs), and efferent suppression, in 35 children with high-functioning ASD compared with 42 aged-matched TD controls. All participants were males 6-17 years old, with normal audiometry, and rigorously characterized via Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. Children with ASD had greatly reduced DPOAE responses in the 1 kHz frequency range, yet had comparable DPOAE responses at 0.5 and 4-8 kHz regions. Furthermore, analysis of the spectral features of TrOAEs revealed significantly decreased emissions in ASD in similar frequencies. No significant differences were noted in DPOAE or TrOAE noise floors, middle ear muscle reflex activity, or efferent suppression between children with ASD and TD controls. In conclusion, attention to specific-frequency deficits using non-invasive measures of cochlear function may be important in auditory processing impairments found in ASD. Autism Res 2017, 10: 337-345. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International

  20. Reduced anticoagulation variability in patients on warfarin monitored with Fiix-prothrombin time associates with reduced thromboembolism: The Fiix-trial.

    PubMed

    Oskarsdóttir, Alma Rut; Gudmundsdottir, Brynja R; Indridason, Olafur S; Lund, Sigrun H; Arnar, David O; Bjornsson, Einar S; Magnusson, Magnus K; Jensdottir, Hulda M; Vidarsson, Brynjar; Francis, Charles W; Onundarson, Pall T

    2017-05-01

    Fiix-prothrombin time (Fiix-PT) differs from traditional PT in being affected by reduced factor (F) II or FX only. In the randomized controlled Fiix-trial, patients on warfarin monitored with Fiix-PT (Fiix-warfarin patients) had fewer thromboembolisms (TE), similar major bleeding (MB) and more stable anticoagulation than patients monitored with PT (PT-warfarin patients). In the current Fiix-trial report we analyzed how reduced anticoagulation variability during Fiix-PT monitoring was reflected in patients with TE or bleeding. Data from 1143 randomized patients was used. We analyzed the groups for anticoagulation intensity (time within target range; TTR), international normalized ratio (INR) variability (variance growth rate B 1 ; VGR) and dose adjustment frequency. We assessed how these parameters associated with clinically relevant vascular events (CRVE), ie TE or MB or clinically relevant non-MB. TTR was highest in Fiix-warfarin patients without CRVE (median 82%;IQR 72-91) and lowest in PT-warfarin patients with TE (62%;56-81). VGR was lowest in Fiix-warfarin patients without CRVE (median VGR B 1 0.17; 95% CI 0.08-0.38) and with TE (0.20;0.07-0.26) and highest in PT-warfarin patients with TE (0.50;0.27-0.90) or MB (0.59;0.07-1.36). The mean annual dose adjustment frequency was lowest in Fiix-warfarin patients with TE (mean 5.4;95% CI 3.9-7.3) and without CRVE (mean 6.0; 5.8-6.2) and highest in PT-warfarin patients with TE (14.2;12.2-16.3). Frequent dose changes predicted MB in both study arms. Compared to patients monitored with PT, high anticoagulation stability in Fiix-warfarin patients coincided with their low TE rate. Those with bleeding had high variability irrespective of monitoring method. Thus, although further improvements are needed to reduce bleeding, stabilization of anticoagulation by Fiix-PT monitoring associates with reduced TE.

  1. The influence of a seated break on prolonged standing induced low back pain development.

    PubMed

    Gallagher, Kaitlin M; Campbell, Troy; Callaghan, Jack P

    2014-01-01

    With the recent attention to 'sitting disease', health practitioners and scientists are promoting standing in the workplace to decrease sedentary time, despite a high prevalence of low back pain (LBP) development during prolonged standing. The purpose of this study was to assess how a seated break inserted between bouts of prolonged standing would influence LBP development, posture and movement. A total of 20 participants stood for 45 minutes, sat for 15 minutes and repeated this sequence while lumbar and thoracic angles were measured, and LBP visual analogue scale reports were taken. Of the sample, 55% participants reported LBP in standing. A stand to sit ratio of 3:1 did not provide lasting recovery of LBP from standing and pain developers utilised a limited range of their lumbar spine angle and increased thoracic extension, resulting in static postures that caused tissue aggravation that was not resolved after 15 minutes of sitting. Prolonged standing in the workplace has the potential to result in LBP for some workers and alternate ways to reduce sedentary time should be investigated.

  2. Adjustable Optical-Fiber Attenuator

    NASA Technical Reports Server (NTRS)

    Buzzetti, Mike F.

    1994-01-01

    Adjustable fiber-optic attenuator utilizes bending loss to reduce strength of light transmitted along it. Attenuator functions without introducing measurable back-reflection or insertion loss. Relatively insensitive to vibration and changes in temperature. Potential applications include cable television, telephone networks, other signal-distribution networks, and laboratory instrumentation.

  3. Why Do Blood Donors Lapse or Reduce Their Donation's Frequency?

    PubMed

    Charbonneau, Johanne; Cloutier, Marie-Soleil; Carrier, Élianne

    2016-01-01

    Finding effective ways to retain blood donors is crucial. This study seeks to compare, in a context of a voluntary and nonremunerated system, donor demographics and deterrents to blood donation among plasma/platelet donors (PPDs), regular whole blood donors (WBDs), and lapsed whole blood donors (LWBD). Among 1879 participants to a survey on motivations, time use, and blood donation, 207 WBDs (26%) and 148 PPDs (31%) said that they reduced their donation frequency over the last 5 years. Participants to this survey also included 609 LWBDs, who did not donate in the past 5 years. We asked about reasons why they reduce or cease to donate blood and demographic variables. χ(2) Tests were completed to determine which deterrents stand out across the 3 blood donor groups. The deterrent indicating the highest percentage was "time constraints related to work or studies" (43% for all respondents). Comparison of WBDs, LWBDs, and PPDs shows that results for 7 deterrents were statistically different between the 3 groups. Obstacles to donating blood also vary based on sex, age (life course), and level of education. Blood collection agencies should consider developing new retention strategies tailored to blood donors, taking into account the specific profiles of female/male donors, events that typically occur at various stages of life, and particular challenges associated with differences in levels of education. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Gastrografin may reduce time to oral diet in prolonged post-operative ileus: a pooled analysis of two randomized trials.

    PubMed

    Milne, Tony G E; Vather, Ryash; O'Grady, Gregory; Miquel, Jordi; Biondo, Sebastiano; Bissett, Ian

    2018-03-06

    Gastrografin has been suggested as a rescue therapy for prolonged post-operative ileus (PPOI) but trial data has been inconclusive. This study aimed to determine the benefit of gastrografin use in patients with PPOI by pooling the results of two recent randomized controlled trials assessing the efficacy of gastrografin compared to placebo given at time of PPOI diagnosis. Anonymized, individual patient data from patients undergoing elective bowel resection for any indication were included, stoma closure was excluded. The primary outcome was duration of PPOI. Secondary outcomes were time to tolerate oral diet, passage of flatus/stool, requirement and duration of nasogastric tube, length of post-operative stay and rate of post-operative complications. Individual patient data were pooled for analysis (53 gastrografin, 55 placebo). Gastrografin trended towards a reduction in PPOI duration compared to placebo, respectively, median 96 h (interquartile range, IQR, 78 h) versus median 120 h (IQR, 84 h), however, this result was non-significant (P = 0.11). In addition, no significant difference was detected between the two groups for time to passage of flatus/stool (P = 0.36) and overall length of stay (P = 0.35). Gastrografin conferred a significantly faster time to tolerate an oral diet compared to placebo (median 84 h versus median 107 h, P = 0.04). There was no difference in post-operative complications between the two interventions (P > 0.05). Gastrografin did not significantly reduce PPOI duration or length of stay after abdominal surgery, but did reduce time to tolerate a solid diet. Further studies are required to clarify the role of gastrografin in PPOI. © 2018 Royal Australasian College of Surgeons.

  5. Extending Prednisolone Treatment Does Not Reduce Relapses in Childhood Nephrotic Syndrome

    PubMed Central

    Kist-van Holthe, Joana E.; van Rijswijk, Nienske; de Mos, Nienke I.; Hop, Wim C.J.; Wetzels, Jack F.M.; van der Heijden, Albert J.; Nauta, Jeroen

    2012-01-01

    Prolonged prednisolone treatment for the initial episode of childhood nephrotic syndrome may reduce relapse rate, but whether this results from the increased duration of treatment or a higher cumulative dose remains unclear. We conducted a randomized, double-blind, placebo-controlled trial in 69 hospitals in The Netherlands. We randomly assigned 150 children (9 months to 17 years) presenting with nephrotic syndrome to either 3 months of prednisolone followed by 3 months of placebo (n=74) or 6 months of prednisolone (n=76), and median follow-up was 47 months. Both groups received equal cumulative doses of prednisolone (approximately 3360 mg/m2). Among the 126 children who started trial medication, relapses occurred in 48 (77%) of 62 patients who received 3 months of prednisolone and 51 (80%) of 64 patients who received 6 months of prednisolone. Frequent relapses, according to international criteria, occurred with similar frequency between groups as well (45% versus 50%). In addition, there were no statistically significant differences between groups with respect to the eventual initiation of prednisolone maintenance and/or other immunosuppressive therapy (50% versus 59%), steroid dependence, or adverse effects. In conclusion, in this trial, extending initial prednisolone treatment from 3 to 6 months without increasing cumulative dose did not benefit clinical outcome in children with nephrotic syndrome. Previous findings indicating that prolonged treatment regimens reduce relapses most likely resulted from increased cumulative dose rather than the treatment duration. PMID:23274956

  6. Effects of Peer Victimization on Psychological and Academic Adjustment in Early Adolescence

    ERIC Educational Resources Information Center

    Rueger, Sandra Yu; Jenkins, Lyndsay N.

    2014-01-01

    The purpose of the current study is to investigate the effects of frequency of peer victimization experiences on psychological and academic adjustment during early adolescence, with a focus on testing psychological adjustment as a mediator, as well as differences based on gender and type of victimization. The sample in this short-term longitudinal…

  7. Poincare oscillations and geostrophic adjustment in a rotating paraboloid

    NASA Astrophysics Data System (ADS)

    Kalashnik, M.; Kakhiani, V.; Patarashvili, K.; Tsakadze, S.

    2009-10-01

    Free liquid oscillations (Poincare oscillations) in a rotating paraboloid are investigated theoretically and experimentally. Within the framework of shallow-water theory, with account for the centrifugal force, expressions for the free oscillation frequencies are obtained and corrections to the frequencies related with the finiteness of the liquid depth are found. It is shown that in the rotating liquid, apart from the wave modes of free oscillations, a stationary vortex mode is also generated, that is, a process of geostrophic adjustment takes place. Solutions of the shallow-water equations which describe the wave dynamics of the adjustment process are presented. In the experiments performed the wave and vortex modes were excited by removing a previously immersed hemisphere from the central part of the paraboloid. Good agreement between theory and experiment was obtained. Address: alex_gaina@yahoo.com Database: phy

  8. A School-Based Intervention Designed To Reduce the Frequency of Tics in Children with Tourette's Syndrome.

    ERIC Educational Resources Information Center

    Clarke, Marlene A.; Bray, Melissa A.; Kehle, Thomas J.; Truscott, Stephen D.

    2001-01-01

    Examines the effects of a two-component treatment package composed of habit reversal and self-modeling to reduce the frequency of tics in 4 school-age students diagnosed with Tourette's Syndrome. Results reveal that 3 of the 4 students showed substantial decreases in their tics, which were maintained during a 5- to 10-week follow up. The fourth…

  9. Fatigue associated with prolonged graded running.

    PubMed

    Giandolini, Marlene; Vernillo, Gianluca; Samozino, Pierre; Horvais, Nicolas; Edwards, W Brent; Morin, Jean-Benoît; Millet, Guillaume Y

    2016-10-01

    Scientific experiments on running mainly consider level running. However, the magnitude and etiology of fatigue depend on the exercise under consideration, particularly the predominant type of contraction, which differs between level, uphill, and downhill running. The purpose of this review is to comprehensively summarize the neurophysiological and biomechanical changes due to fatigue in graded running. When comparing prolonged hilly running (i.e., a combination of uphill and downhill running) to level running, it is found that (1) the general shape of the neuromuscular fatigue-exercise duration curve as well as the etiology of fatigue in knee extensor and plantar flexor muscles are similar and (2) the biomechanical consequences are also relatively comparable, suggesting that duration rather than elevation changes affects neuromuscular function and running patterns. However, 'pure' uphill or downhill running has several fatigue-related intrinsic features compared with the level running. Downhill running induces severe lower limb tissue damage, indirectly evidenced by massive increases in plasma creatine kinase/myoglobin concentration or inflammatory markers. In addition, low-frequency fatigue (i.e., excitation-contraction coupling failure) is systematically observed after downhill running, although it has also been found in high-intensity uphill running for different reasons. Indeed, low-frequency fatigue in downhill running is attributed to mechanical stress at the interface sarcoplasmic reticulum/T-tubule, while the inorganic phosphate accumulation probably plays a central role in intense uphill running. Other fatigue-related specificities of graded running such as strategies to minimize the deleterious effects of downhill running on muscle function, the difference of energy cost versus heat storage or muscle activity changes in downhill, level, and uphill running are also discussed.

  10. Body weight status and cardiovascular risk factors in adults by frequency of candy consumption.

    PubMed

    Murphy, Mary M; Barraj, Leila M; Bi, Xiaoyu; Stettler, Nicolas

    2013-04-30

    Limited information is available regarding the impact of candy consumption on health. The purpose of this study was to investigate associations between typical frequency of candy consumption and body weight status and select cardiovascular risk factors among adults in the United States. Using data collected in the 2003-2006 National Health and Nutrition Examination Surveys (NHANES), adults were categorized as infrequent (≤ 3 eating occasions [EO]/month), moderate (> 3 EO/month and ≤ 3.5 EO/week), or frequent (> 3.5 EO/week) candy consumers based on the combined frequency of chocolate and other candy consumption over the previous 12 months. Weight and adiposity status were analyzed using logistic regression models, and blood pressure, lipids, and insulin sensitivity were analyzed using linear regression models. Models were adjusted for age, sex and race/ethnicity, and also for additional covariates with potential associations with the outcomes. Appropriate statistical weights were used to yield results generalizable to the US population. Frequency of candy consumption was not associated with the risk of obesity, overweight/obesity, elevated waist circumference, elevated skinfold thickness, blood pressure, low density lipoprotein (LDL) or high density lipoprotein (HDL) cholesterol, triglycerides, or insulin resistance. Increased frequency of candy consumption was associated with higher energy intakes and higher energy adjusted intakes of carbohydrates, total sugars and added sugars, total fat, saturated fatty acids and monounsaturated fatty acids (p < 0.05), and lower adjusted intakes of protein and cholesterol (p < 0.001). Increased frequency of candy consumption among adults in the United States was not associated with objective measures of adiposity or select cardiovascular risk factors, despite associated dietary differences. Given the cross-sectional study design, however, it cannot be concluded that candy consumption does not cause obesity or

  11. Prolonged partial cardiopulmonary bypass in rats.

    PubMed

    Alexander, B; Al Ani, H R

    1983-07-01

    Membrane oxygenators have been shown to be atraumatic during cardiopulmonary bypass. A novel design for a membrane tubing oxygenator originated in this laboratory was used for prolonged partial supportive cardiopulmonary bypass in lambs and displayed excellent biocompatability characteristics. This was miniaturized, to result in a prime volume of 12 ml, in order to investigate the feasibility of prolonged partial supportive cardiopulmonary bypass in rats. The performance of this miniaturized circuit over perfusion periods up to 6 hr is described, with particular reference to hematological changes.

  12. Slack length reduces the contractile phenotype of the Swine carotid artery.

    PubMed

    Rembold, Christopher M; Garvey, Sean M; Tejani, Ankit D

    2013-01-01

    Contraction is the primary function of adult arterial smooth muscle. However, in response to vessel injury or inflammation, arterial smooth muscle is able to phenotypically modulate from the contractile state to several 'synthetic' states characterized by proliferation, migration and/or increased cytokine secretion. We examined the effect of tissue length (L) on the phenotype of intact, isometrically held, initially contractile swine carotid artery tissues. Tissues were studied (1) without prolonged incubation at the optimal length for force generation (1.0 Lo, control), (2) with prolonged incubation for 17 h at 1.0 Lo, or (3) with prolonged incubation at slack length (0.6 Lo) for 16 h and then restoration to 1.0 Lo for 1 h. Prolonged incubation at 1.0 Lo minimally reduced the contractile force without substantially altering the mediators of contraction (crossbridge phosphorylation, shortening velocity or stimulated actin polymerization). Prolonged incubation of tissues at slack length (0.6 Lo), despite return of length to 1.0 Lo, substantially reduced contractile force, reduced crossbridge phosphorylation, nearly abolished crossbridge cycling (shortening velocity) and abolished stimulated actin polymerization. These data suggest that (1) slack length treatment significantly alters the contractile phenotype of arterial tissue, and (2) slack length treatment is a model to study acute phenotypic modulation of intact arterial smooth muscle. Copyright © 2013 S. Karger AG, Basel.

  13. Reduced frequency and severity of residential fires following delivery of fire prevention education by on-duty fire fighters: cluster randomized controlled study.

    PubMed

    Clare, Joseph; Garis, Len; Plecas, Darryl; Jennings, Charles

    2012-04-01

    In 2008, Surrey Fire Services, British Columbia, commenced a firefighter-delivered, door-to-door fire-prevention education and smoke alarm examination/installation initiative with the intention of reducing the frequency and severity of residential structure fires in the City of Surrey. High-risk zones within the city were identified and 18,473 home visits were undertaken across seven temporal delivery cohorts (13.8% of non-apartment dwellings in the city). The frequency and severity of fires pre- and post- the home visit intervention was examined in comparison to randomized high-risk cluster controls. Overall, the frequency of fires was found to have reduced in the city overall, however, the reduction in the intervention cohorts was significantly larger than for controls. Furthermore, when fires did occur within the intervention cohorts, smoke detectors were activated more frequently and the fires were confined to the object of origin more often post-home visits. No equivalent pattern was observed for the cluster control. On-duty fire fighters can reduce the frequency and severity of residential fires through targeted, door-to-door distribution of fire prevention education in high-risk areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Low-flow frequency curves for selected long-term stream gaging stations in eastern United States

    USGS Publications Warehouse

    Hardison, Clayton H.; Martin, Robert O.R.

    1963-01-01

    Curves showing the magnitude and frequency of annual low flow at 85 streamgaging stations located in 17 States east and 5 States west of the Mississippi River have been smoothed and adjusted to one of four long-term periods. They are presented to show the similarity and dissimilarity of curves even in the same State and to provide background information for studies of the statistical properties of low-flow frequency curves and for studies of the relation between hydrologic environment and low flow. The results are presented as greatly reduced graphs to facilitate comparison and are summarized in tables from which expanded graphs can be plotted.

  15. Inequalities in the frequency of free sugars intake among Syrian 1-year-old infants: a cross-sectional study.

    PubMed

    Joury, Easter; Khairallah, May; Sabbah, Wael; Elias, Kanaan; Bedi, Raman

    2016-09-08

    High frequency of free sugars intake, during the first year of life is probably the greatest risk factor for early childhood caries. The latter is a global public health challenge. Very little is known about the social determinants of infant's frequency of free sugars intake, particularly in low-income countries. Thus, the present study aimed to assess the association between the frequency of free sugars intake among 1-year-old Syrian infants and each of parents' socioeconomic position (SEP), maternal frequency of free sugars intake and knowledge of infant's oral health behaviour. Using a cross-sectional design, 323 1-year-old infants, attending vaccination clinics in 3 maternal and child health centres (MCHCs) in Damascus, Syria, were selected. A systematic random sampling was applied using the MCHCs' monthly vaccination registries. The 3 MCHCs were located in affluent, moderate and deprived areas. Infants' mothers completed a structured questionnaire on socio-demographics, infant's and mother's frequency of free sugars intake from cariogenic foods and beverages, and mother's knowledge about infant's oral health behaviour. Binary and multiple regression analyses were performed. The level of significance was set at 5 %. The response rate was 100 %. Overall, 42.7 % of infants had high frequency of free sugars intake (>4times a day). Infants whose fathers were not working were more likely to have high frequency of free sugars intake. Similarly, infants whose mothers had low level of knowledge about infant's oral health behaviour, or high frequency of free sugars intake were more likely to have high frequency of free sugars intake. The association between father's occupation and infant's frequency of free sugars intake attenuated after adjustment for mother's knowledge and frequency of free sugars intake (adjusted OR = 1.5, 1.8, 3.2; 95%CI = 0.5-4.8, 1.1-3, 1.4-7.4; respectively). There are socioeconomic inequalities in the frequency of free sugars intake

  16. Amisulpride overdose is frequently associated with QT prolongation and torsades de pointes.

    PubMed

    Isbister, Geoffrey K; Balit, Corrine R; Macleod, Dawson; Duffull, Stephen B

    2010-08-01

    This study aimed to describe the effects of the antipsychotic amisulpride in overdose, including the frequency of QT prolongation and torsades de pointes. Cases of amisulpride overdose (>1 g) were recruited from 2 state poison centers and a tertiary toxicology unit over 5 years. A 1-page clinical research form was used to collect clinical information. Copies of all electrocardiograms were obtained. Electrocardiogram parameters (QRS and QT intervals) were manually measured as previously described, and plots of QT-heart rate (HR) pairs were compared with the QT nomogram. There were 83 patients with amisulpride overdoses with a median age of 29 years (interquartile range [IQR], 23-40 years), and 42 (51%) were female. The median dose ingested was 6 g (IQR, 3-13 g, range, 1.2-120 g). The median HR was 66 beats/min (IQR, 60-81 beats/min). Bradycardia occurred in 20 cases (24%), and hypotension in 19 (23%). From 440 electrocardiograms (average of 5 per case; range, 1-15), an abnormal QT-HR pair occurred in 61 cases (73%). Torsades de pointes developed in 6 cases (7%), with doses of 4, 4.6, 18, 24, 32, and 80 g. The patient taking 32 g died after a cardiac arrest. Widened QRS did not occur except transient rate-dependent bundle-branch block in 3 cases. There were significant associations of bradycardia, hypokalemia, and hypocalcaemia, with QT prolongation and torsades de pointes. Central nervous system effects were uncommon with coma in 7 cases, seizures in 2, and dystonic reactions in 2. Amisulpride overdose commonly causes QT prolongation, bradycardia, and hypotension. Torsades de pointes occurred commonly enough to suggest that amisulpride is highly cardiotoxic in overdose.

  17. RADIO FREQUENCY ATTENUATOR

    DOEpatents

    Giordano, S.

    1963-11-12

    A high peak power level r-f attenuator that is readily and easily insertable along a coaxial cable having an inner conductor and an outer annular conductor without breaking the ends thereof is presented. Spaced first and second flares in the outer conductor face each other with a slidable cylindrical outer conductor portion therebetween. Dielectric means, such as water, contact the cable between the flares to attenuate the radio-frequency energy received thereby. The cylindrical outer conductor portion is slidable to adjust the voltage standing wave ratio to a low level, and one of the flares is slidable to adjust the attenuation level. An integral dielectric container is also provided. (AFC)

  18. Recurrence of CMV Infection and the Effect of Prolonged Antivirals in Organ Transplant Recipients.

    PubMed

    Natori, Yoichiro; Humar, Atul; Husain, Shahid; Rotstein, Coleman; Renner, Eberhard; Singer, Lianne; Kim, S Joseph; Kumar, Deepali

    2017-06-01

    Although initial therapy for cytomegalovirus (CMV) is usually successful, a significant subset of patients may have recurrent viremia. However, the epidemiology and risk factors for recurrence have not been fully defined, as well as the utility of prolonged antivirals after initial clearance. Solid organ transplant patients with first episode of CMV disease or asymptomatic viremia (≥1000 IU/mL) requiring treatment were identified by chart review. Clinical and virologic data were collected. The primary outcome was recurrence of CMV viremia or disease within 6 months of treatment discontinuation. The first episode of CMV viremia requiring antiviral therapy was assessed in 282 patients (147 CMV disease and 135 asymptomatic viremia). Cytomegalovirus occurred at 5.6 (0.63-27.7) months posttransplant. Recurrent CMV occurred in 30.5% patients at a median of 51 (0-160) days after discontinuation of therapy. Factors predictive of recurrence were treatment phase viral kinetics (P = 0.005), lung transplant (P = 0.002), CMV donor (D)+/recipient (R)- serostatus(P = 0.04) and recent acute rejection(P = 0.02). Prolonged antiviral therapy was given to 226 (80.1%) of 282 patients. Recurrence occurred in 73 (32.3%) of 226 patients that received prolonged antivirals versus 13 (23.2%) of 56 in those with no prolonged antivirals (P = 0.19). Recurrent CMV occurs in a significant percentage of patients after treatment of the first episode of CMV viremia/disease. CMV D+/R- serostatus, lung transplant, and treatment phase viral kinetics were significant predictors of recurrence. Continuation of prolonged antivirals beyond initial clearance was not associated with a reduced risk of recurrence.

  19. Frequency-velocity mismatch: a fundamental abnormality in parkinsonian gait.

    PubMed

    Cho, Catherine; Kunin, Mikhail; Kudo, Koji; Osaki, Yasuhiro; Olanow, C Warren; Cohen, Bernard; Raphan, Theodore

    2010-03-01

    Gait dysfunction and falling are major sources of disability for patients with advanced Parkinson's disease (PD). It is presently thought that the fundamental defect is an inability to generate normal stride length. Our data suggest, however, that the basic problem in PD gait is an impaired ability to match step frequency to walking velocity. In this study, foot movements of PD and normal subjects were monitored with an OPTOTRAK motion-detection system while they walked on a treadmill at different velocities. PD subjects were also paced with auditory stimuli at different frequencies. PD gait was characterized by step frequencies that were faster and stride lengths that were shorter than those of normal controls. At low walking velocities, PD stepping had a reduced or absent terminal toe lift, which truncated swing phases, producing shortened steps. Auditory pacing was not able to normalize step frequency at these lower velocities. Peak forward toe velocities increased with walking velocity and PD subjects could initiate appropriate foot dynamics during initial phases of the swing. They could not control the foot appropriately in terminal phases, however. Increased treadmill velocity, which matched the natural PD step frequency, generated a second toe lift, normalizing step size. Levodopa increased the bandwidth of step frequencies, but was not as effective as increases in walking velocity in normalizing gait. We postulate that the inability to control step frequency and adjust swing phase dynamics to slower walking velocities are major causes for the gait impairment in PD.

  20. Frequency-Velocity Mismatch: A Fundamental Abnormality in Parkinsonian Gait

    PubMed Central

    Kunin, Mikhail; Kudo, Koji; Osaki, Yasuhiro; Olanow, C. Warren; Cohen, Bernard; Raphan, Theodore

    2010-01-01

    Gait dysfunction and falling are major sources of disability for patients with advanced Parkinson's disease (PD). It is presently thought that the fundamental defect is an inability to generate normal stride length. Our data suggest, however, that the basic problem in PD gait is an impaired ability to match step frequency to walking velocity. In this study, foot movements of PD and normal subjects were monitored with an OPTOTRAK motion-detection system while they walked on a treadmill at different velocities. PD subjects were also paced with auditory stimuli at different frequencies. PD gait was characterized by step frequencies that were faster and stride lengths that were shorter than those of normal controls. At low walking velocities, PD stepping had a reduced or absent terminal toe lift, which truncated swing phases, producing shortened steps. Auditory pacing was not able to normalize step frequency at these lower velocities. Peak forward toe velocities increased with walking velocity and PD subjects could initiate appropriate foot dynamics during initial phases of the swing. They could not control the foot appropriately in terminal phases, however. Increased treadmill velocity, which matched the natural PD step frequency, generated a second toe lift, normalizing step size. Levodopa increased the bandwidth of step frequencies, but was not as effective as increases in walking velocity in normalizing gait. We postulate that the inability to control step frequency and adjust swing phase dynamics to slower walking velocities are major causes for the gait impairment in PD. PMID:20042701

  1. Skin surface cooling improves orthostatic tolerance following prolonged head-down bed rest

    PubMed Central

    Keller, David M.; Low, David A.; Davis, Scott L.; Hastings, Jeff

    2011-01-01

    Prolonged exposure to microgravity, as well as its ground-based analog, head-down bed rest (HDBR), reduces orthostatic tolerance in humans. While skin surface cooling improves orthostatic tolerance, it remains unknown whether this could be an effective countermeasure to preserve orthostatic tolerance following HDBR. We therefore tested the hypothesis that skin surface cooling improves orthostatic tolerance after prolonged HDBR. Eight subjects (six men and two women) participated in the investigation. Orthostatic tolerance was determined using a progressive lower-body negative pressure (LBNP) tolerance test before HDBR during normothermic conditions and on day 16 or day 18 of 6° HDBR during normothermic and skin surface cooling conditions (randomized order post-HDBR). The thermal conditions were achieved by perfusing water (normothermia ∼34°C and skin surface cooling ∼12–15°C) through a tube-lined suit worn by each subject. Tolerance tests were performed after ∼30 min of the respective thermal stimulus. A cumulative stress index (CSI; mmHg LBNP·min) was determined for each LBNP protocol by summing the product of the applied negative pressure and the duration of LBNP at each stage. HDBR reduced normothermic orthostatic tolerance as indexed by a reduction in the CSI from 1,037 ± 96 mmHg·min to 574 ± 63 mmHg·min (P < 0.05). After HDBR, skin surface cooling increased orthostatic tolerance (797 ± 77 mmHg·min) compared with normothermia (P < 0.05). While the reduction in orthostatic tolerance following prolonged HDBR was not completely reversed by acute skin surface cooling, the identified improvements may serve as an important and effective countermeasure for individuals exposed to microgravity, as well as immobilized and bed-stricken individuals. PMID:21454746

  2. How Noisy Does a Noisy Miner Have to Be? Amplitude Adjustments of Alarm Calls in an Avian Urban ‘Adapter’

    PubMed Central

    Lowry, Hélène; Lill, Alan; Wong, Bob B. M.

    2012-01-01

    Background Urban environments generate constant loud noise, which creates a formidable challenge for many animals relying on acoustic communication. Some birds make vocal adjustments that reduce auditory masking by altering, for example, the frequency (kHz) or timing of vocalizations. Another adjustment, well documented for birds under laboratory and natural field conditions, is a noise level-dependent change in sound signal amplitude (the ‘Lombard effect’). To date, however, field research on amplitude adjustments in urban environments has focused exclusively on bird song. Methods We investigated amplitude regulation of alarm calls using, as our model, a successful urban ‘adapter’ species, the Noisy miner, Manorina melanocephala. We compared several different alarm calls under contrasting noise conditions. Results Individuals at noisier locations (arterial roads) alarm called significantly more loudly than those at quieter locations (residential streets). Other mechanisms known to improve sound signal transmission in ‘noise’, namely use of higher perches and in-flight calling, did not differ between site types. Intriguingly, the observed preferential use of different alarm calls by Noisy miners inhabiting arterial roads and residential streets was unlikely to have constituted a vocal modification made in response to sound-masking in the urban environment because the calls involved fell within the main frequency range of background anthropogenic noise. Conclusions The results of our study suggest that a species, which has the ability to adjust the amplitude of its signals, might have a ‘natural’ advantage in noisy urban environments. PMID:22238684

  3. Frequency discriminator/phase detector

    NASA Technical Reports Server (NTRS)

    Crow, R. B.

    1974-01-01

    Circuit provides dual function of frequency discriminator/phase detector which reduces frequency acquisition time without adding to circuit complexity. Both frequency discriminators, in evaluated frequency discriminator/phase detector circuits, are effective two decades above and below center frequency.

  4. Prolongation structures of nonlinear evolution equations

    NASA Technical Reports Server (NTRS)

    Wahlquist, H. D.; Estabrook, F. B.

    1975-01-01

    A technique is developed for systematically deriving a 'prolongation structure' - a set of interrelated potentials and pseudopotentials - for nonlinear partial differential equations in two independent variables. When this is applied to the Korteweg-de Vries equation, a new infinite set of conserved quantities is obtained. Known solution techniques are shown to result from the discovery of such a structure: related partial differential equations for the potential functions, linear 'inverse scattering' equations for auxiliary functions, Backlund transformations. Generalizations of these techniques will result from the use of irreducible matrix representations of the prolongation structure.

  5. Oscillator or Amplifier With Wide Frequency Range

    NASA Technical Reports Server (NTRS)

    Kleinberg, L.; Sutton, J.

    1987-01-01

    Inductive and capacitive effects synthesized with feedback circuits. Oscillator/amplifier resistively tunable over wide frequency range. Feedback circuits containing operational amplifiers, resistors, and capacitors synthesize electrical effects of inductance and capacitance in parallel between input terminals. Synthetic inductance and capacitance, and, therefore, resonant frequency of input admittance, adjusted by changing potentiometer setting.

  6. Electroacoustic verification of frequency modulation systems in cochlear implant users.

    PubMed

    Fidêncio, Vanessa Luisa Destro; Jacob, Regina Tangerino de Souza; Tanamati, Liége Franzini; Bucuvic, Érika Cristina; Moret, Adriane Lima Mortari

    2017-12-26

    The frequency modulation system is a device that helps to improve speech perception in noise and is considered the most beneficial approach to improve speech recognition in noise in cochlear implant users. According to guidelines, there is a need to perform a check before fitting the frequency modulation system. Although there are recommendations regarding the behavioral tests that should be performed at the fitting of the frequency modulation system to cochlear implant users, there are no published recommendations regarding the electroacoustic test that should be performed. Perform and determine the validity of an electroacoustic verification test for frequency modulation systems coupled to different cochlear implant speech processors. The sample included 40 participants between 5 and 18 year's users of four different models of speech processors. For the electroacoustic evaluation, we used the Audioscan Verifit device with the HA-1 coupler and the listening check devices corresponding to each speech processor model. In cases where the transparency was not achieved, a modification was made in the frequency modulation gain adjustment and we used the Brazilian version of the "Phrases in Noise Test" to evaluate the speech perception in competitive noise. It was observed that there was transparency between the frequency modulation system and the cochlear implant in 85% of the participants evaluated. After adjusting the gain of the frequency modulation receiver in the other participants, the devices showed transparency when the electroacoustic verification test was repeated. It was also observed that patients demonstrated better performance in speech perception in noise after a new adjustment, that is, in these cases; the electroacoustic transparency caused behavioral transparency. The electroacoustic evaluation protocol suggested was effective in evaluation of transparency between the frequency modulation system and the cochlear implant. Performing the adjustment of

  7. Research on frequency control strategy of interconnected region based on fuzzy PID

    NASA Astrophysics Data System (ADS)

    Zhang, Yan; Li, Chunlan

    2018-05-01

    In order to improve the frequency control performance of the interconnected power grid, overcome the problems of poor robustness and slow adjustment of traditional regulation, the paper puts forward a frequency control method based on fuzzy PID. The method takes the frequency deviation and tie-line deviation of each area as the control objective, takes the regional frequency deviation and its deviation as input, and uses fuzzy mathematics theory, adjusts PID control parameters online. By establishing the regional frequency control model of water-fire complementary power generation in MATLAB, the regional frequency control strategy is given, and three control modes (TBC-FTC, FTC-FTC, FFC-FTC) are simulated and analyzed. The simulation and experimental results show that, this method has better control performance compared with the traditional regional frequency regulation.

  8. Hydraulic adjustments underlying drought resistance of Pinus halepensis.

    PubMed

    Klein, Tamir; Cohen, Shabtai; Yakir, Dan

    2011-06-01

    Drought-induced tree mortality has increased over the last decades in forests around the globe. Our objective was to investigate under controlled conditions the hydraulic adjustments underlying the observed ability of Pinus halepensis to survive seasonal drought under semi-arid conditions. One hundred 18-month saplings were exposed in the greenhouse to 10 different drought treatments, simulating combinations of intensities (fraction of water supply relative to control) and durations (period with no water supply) for 30 weeks. Stomata closed at a leaf water potential (Ψ(l)) of -2.8 MPa, suggesting isohydric stomatal regulation. In trees under extreme drought treatments, stomatal closure reduced CO(2) uptake to -1 µmol m(-2) s(-1), indicating the development of carbon starvation. A narrow hydraulic safety margin of 0.3 MPa (from stomatal closure to 50% loss of hydraulic conductivity) was observed, indicating a strategy of maximization of CO2 uptake in trees otherwise adapted to water stress. A differential effect of drought intensity and duration was observed, and was explained by a strong dependence of the water stress effect on the ratio of transpiration to evapotranspiration T/ET and the larger partitioning to transpiration associated with larger irrigation doses. Under intense or prolonged drought, the root system became the main target for biomass accumulation, taking up to 100% of the added biomass, while the stem tissue biomass decreased, associated with up to 60% reduction in xylem volume.

  9. The Effect of Frequency Altered Feedback on Stuttering Duration and Type

    ERIC Educational Resources Information Center

    Stuart, Andrew; Frazier, Carmen L.; Kalinowski, Joseph; Vos, Paul W.

    2008-01-01

    Purpose: The effect of frequency altered feedback (FAF) on stuttering type (i.e., prolongation, repetition, or silent block) and stuttering duration (i.e., average duration of stuttering event and total stuttering time) was examined. Method: Retrospective analyses of previously collected data from 12 adult persons who stutter who participated in…

  10. Impact of Prolonged Mechanical Ventilation in Very Low Birth Weight Infants: Results From a National Cohort Study.

    PubMed

    Choi, Young-Bin; Lee, Juyoung; Park, Jisun; Jun, Yong Hoon

    2018-03-01

    To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less. The individual mortality rate increased after 8 weeks, reaching 50% and 60% at 14 and 16 weeks of cumulative mechanical ventilation, respectively. After adjusting for potential confounders, the cumulative duration of mechanical ventilation was associated with a clinically significant increase in the odds of bronchopulmonary dysplasia and pulmonary hypertension. Mechanical ventilation exposure for longer than 2 weeks, compared with 7 days or less, was associated with retinopathy of prematurity requiring laser coagulation and periventricular leukomalacia. The odds of abnormal auditory screening test results were significantly increased in infants who needed mechanical ventilation for more than 4 weeks. A longer cumulative duration of mechanical ventilation was associated with increased lengths of hospitalization and parenteral nutrition and a higher probability of discharge with poor achievement of physical growth. Although mechanical ventilation is a life-saving intervention for premature infants, these results indicate that it is associated with negative consequences when applied for prolonged periods. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Prolonged Particulate Hexavalent Chromium Exposure Suppresses Homologous Recombination Repair in Human Lung Cells

    PubMed Central

    Browning, Cynthia L.; Qin, Qin; Kelly, Deborah F.; Prakash, Rohit; Vanoli, Fabio; Jasin, Maria

    2016-01-01

    Abstract Genomic instability is one of the primary models of carcinogenesis and a feature of almost all cancers. Homologous recombination (HR) repair protects against genomic instability by maintaining high genomic fidelity during the repair of DNA double strand breaks. The defining step of HR repair is the formation of the Rad51 nucleofilament, which facilitates the search for a homologous sequence and invasion of the template DNA strand. Particulate hexavalent chromium (Cr(VI)), a human lung carcinogen, induces DNA double strand breaks and chromosome instability. Since the loss of HR repair increases Cr(VI)-induced chromosome instability, we investigated the effect of extended Cr(VI) exposure on HR repair. We show acute (24 h) Cr(VI) exposure induces a normal HR repair response. In contrast, prolonged (120 h) exposure to particulate Cr(VI) inhibited HR repair and Rad51 nucleofilament formation. Prolonged Cr(VI) exposure had a profound effect on Rad51, evidenced by reduced protein levels and Rad51 mislocalization to the cytoplasm. The response of proteins involved in Rad51 nuclear import and nucleofilament formation displayed varying responses to prolonged Cr(VI) exposure. BRCA2 formed nuclear foci after prolonged Cr(VI) exposure, while Rad51C foci formation was suppressed. These results suggest that particulate Cr(VI), a major chemical carcinogen, inhibits HR repair by targeting Rad51, causing DNA double strand breaks to be repaired by a low fidelity, Rad51-independent repair pathway. These results further enhance our understanding of the underlying mechanism of Cr(VI)-induced chromosome instability and thus, carcinogenesis. PMID:27449664

  12. Prolonged Febrile Seizures in the Immature Rat Model Enhance Hippocampal Excitability Long Term

    PubMed Central

    Dube, Celine; Chen, Kang; Eghbal-Ahmadi, Mariam; Brunson, Kristen; Soltesz, Ivan; Baram, Tallie Z.

    2011-01-01

    Febrile seizures (FSs) constitute the most prevalent seizure type during childhood. Whether prolonged FSs alter limbic excitability, leading to spontaneous seizures (temporal lobe epilepsy) during adulthood, has been controversial. Recent data indicate that, in the immature rat model, prolonged FSs induce transient structural changes of some hippocampal pyramidal neurons and long-term functional changes of hippocampal circuitry. However, whether these neuroanatomical and electrophysiological changes promote hippocampal excitability and lead to epilepsy has remained unknown. By using in vivo and in vitro approaches, we determined that prolonged hyperthermia-induced seizures in immature rats caused long-term enhanced susceptibility to limbic convulsants that lasted to adulthood. Thus, extensive hippocampal electroencephalographic and behavioral monitoring failed to demonstrate spontaneous seizures in adult rats that had experienced hyperthermic seizures during infancy. However, 100% of animals developed hippocampal seizures after systemic administration of a low dose of kainate, and most progressed to status epilepticus. Conversely, a minority of normothermic and hyperthermic controls had (brief) seizures, none developing status epilepticus. In vitro, spontaneous epileptiform discharges were not observed in hippocampal-entorhinal cortex slices derived from either control or experimental groups. However, Schaeffer collateral stimulation induced prolonged, self-sustaining, status epilepticus-like discharges exclusively in slices from experimental rats. These data indicate that hyperthermic seizures in the immature rat model of FSs do not cause spontaneous limbic seizures during adulthood. However, they reduce thresholds to chemical convulsants in vivo and electrical stimulation in vitro, indicating persistent enhancement of limbic excitability that may facilitate the development of epilepsy. PMID:10716253

  13. Complex carbohydrates reduce the frequency of antagonistic interactions among bacteria degrading cellulose and xylan.

    PubMed

    Deng, Yi-Jie; Wang, Shiao Y

    2017-03-01

    Bacterial competition for resources is common in nature but positive interactions among bacteria are also evident. We speculate that the structural complexity of substrate might play a role in mediating bacterial interactions. We tested the hypothesis that the frequency of antagonistic interactions among lignocellulolytic bacteria is reduced when complex polysaccharide is the main carbon source compared to when a simple sugar such as glucose is available. Results using all possible pairwise interactions among 35 bacteria isolated from salt marsh detritus showed that the frequency of antagonistic interactions was significantly lower on carboxymethyl cellulose (CMC)-xylan medium (7.8%) than on glucose medium (15.5%). The two interaction networks were also different in their structures. Although 75 antagonistic interactions occurred on both media, there were 115 that occurred only on glucose and 20 only on CMC-xylan, indicating that some antagonistic interactions were substrate specific. We also found that the frequency of antagonism differed among phylogenetic groups. Gammaproteobacteria and Bacillus sp. were the most antagonistic and they tended to antagonize Bacteroidetes and Actinobacteria, the most susceptible groups. Results from the study suggest that substrate complexity affects how bacteria interact and that bacterial interactions in a community are dynamic as nutrient conditions change. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Prolonged dry apnoea: effects on brain activity and physiological functions in breath-hold divers and non-divers.

    PubMed

    Ratmanova, Patricia; Semenyuk, Roxana; Popov, Daniil; Kuznetsov, Sergey; Zelenkova, Irina; Napalkov, Dmitry; Vinogradova, Olga

    2016-07-01

    The aim of the study was to investigate the effects of voluntary breath-holding on brain activity and physiological functions. We hypothesised that prolonged apnoea would trigger cerebral hypoxia, resulting in a decrease of brain performance; and the apnoea's effects would be more pronounced in breath-hold divers. Trained breath-hold divers and non-divers performed maximal dry breath-holdings. Lung volume, alveolar partial pressures of O2 and CO2, attention and anxiety levels were estimated. Heart rate, blood pressure, arterial blood oxygenation, brain tissue oxygenation, EEG, and DC potential were monitored continuously during breath-holding. There were a few significant changes in electrical brain activity caused by prolonged apnoea. Brain tissue oxygenation index and DC potential were relatively stable up to the end of the apnoea in breath-hold divers and non-divers. We also did not observe any decrease of attention level or speed of processing immediately after breath-holding. Interestingly, trained breath-hold divers had some peculiarities in EEG activity at resting state (before any breath-holding): non-spindled, sharpened alpha rhythm; slowed-down alpha with the frequency nearer to the theta band; and untypical spatial pattern of alpha activity. Our findings contradicted the primary hypothesis. Apnoea up to 5 min does not lead to notable cerebral hypoxia or a decrease of brain performance in either breath-hold divers or non-divers. It seems to be the result of the compensatory mechanisms similar to the diving response aimed at centralising blood circulation and reducing peripheral O2 uptake. Adaptive changes during apnoea are much more prominent in trained breath-hold divers.

  15. Parent-Adolescent Conflicts, Conflict Resolution Types, and Adolescent Adjustment

    ERIC Educational Resources Information Center

    Branje, Susan J. T.; van Doorn, Muriel; van der Valk, Inge; Meeus, Wim

    2009-01-01

    The current study examined the moderating role of conflict resolution on the association between parent-adolescent conflicts and adolescent problematic adjustment. Participants were 1313 Dutch early and middle adolescents who completed measures on conflict frequency, conflict resolution with parents, and internalizing and externalizing adjustment…

  16. Different effects of prolonged exercise on the right and left ventricles.

    PubMed

    Douglas, P S; O'Toole, M L; Hiller, W D; Reichek, N

    1990-01-01

    To examine the functional consequences of the greater increase in right ventricular work with exercise, the effects of prolonged exercise on the right and left heart chambers were compared in 41 athletes before, at the finish (13 min) and after recovery (28 h) from the Hawaii Ironman Triathlon (3.9 km swim, 180.2 km bike ride, 42.2 km run). Two-dimensional and Doppler echocardiograms were analyzed for left and right atrial and ventricular areas at end-diastole and end-systole, right and left ventricular inflow velocities and mitral and tricuspid regurgitation. After exercise, left ventricular and left and right atrial sizes were reduced, whereas right ventricular size increased (diastole: 21.4 to 24.2 cm2; systole: 15.8 to 18.2 cm2; p less than 0.01). The emptying fraction of all chambers was unchanged. Left but not right ventricular inflow showed an increase in peak velocity of rapid filling, whereas both atrial systolic velocities increased (26 to 38 cm/s tricuspid; 38 to 54 cm/s mitral; both p less than 0.01). Overall, the right ventricular early to atrial velocity ratio was reduced after exercise (1.56 to 1.17; p less than 0.05) and the left ventricular pattern was unchanged. The prevalence of tricuspid regurgitation was statistically unchanged (86% to 52%), although that of mitral regurgitation was greatly reduced (76% to 0%). Changes in all variables returned toward prerace values during recovery. Thus, in highly trained athletes, prolonged exercise causes differing responses of the right and left ventricles. These differences may be due to changes in right ventricular function, shape or compliance.

  17. Cardiac remodeling in preterm infants with prolonged exposure to a patent ductus arteriosus.

    PubMed

    de Waal, Koert; Phad, Nilkant; Collins, Nick; Boyle, Andrew

    2017-05-01

    Sustained volume load due to a patent ductus arteriosus (PDA) leads to cardiac remodeling. Remodeling changes can become pathological and are associated with cardiovascular disease progression. Data on remodeling changes in preterm infants is not available. Clinical and echocardiography data were collected in preterm infants <30 weeks gestation on postnatal day 3 and then every 7-14 days until closure of the ductus arteriosus. Images were analyzed using conventional techniques and speckle tracking. Remodeling changes of infants with prolonged (>14 days) exposure to a PDA were compared to control infants without a PDA. Thirty out of 189 infants had prolonged exposure to a PDA. The left heart remodeled to a larger and more spherical shape and thus significantly increased in volume. Most changes occurred in the first 4 weeks, plateaued, and then returned to control values. Systolic function and estimates of filling pressure increased and effective arterial elastance reduced with a PDA, however contractility was unchanged. Wall thickness increased after 4 weeks of increased volume exposure. The preterm PDA induces early and significant remodeling of the left heart. A compensated cardiac physiology was seen with preserved systolic function, suggesting adaptive rather than pathological remodeling changes with prolonged exposure to a PDA. © 2017 Wiley Periodicals, Inc.

  18. Prolonged Non-metabolic Heart Rate Variability Reduction as a Physiological Marker of Psychological Stress in Daily Life.

    PubMed

    Verkuil, Bart; Brosschot, Jos F; Tollenaar, Marieke S; Lane, Richard D; Thayer, Julian F

    2016-10-01

    Prolonged cardiac activity that exceeds metabolic needs can be detrimental for somatic health. Psychological stress could result in such "additional cardiac activity." In this study, we examined whether prolonged additional reductions in heart rate variability (AddHRVr) can be measured in daily life with an algorithm that filters out changes in HRV that are purely due to metabolic demand, as indexed by movement, using a brief calibration procedure. We tested whether these AddHRVr periods were related to worry, stress, and negative emotions. Movement and the root of the mean square of successive differences (RMSSD) in heart rate were measured during a calibration phase and the subsequent 24 h in 32 participants. Worry, stress, explicit and implicit emotions were assessed hourly using smartphones. The Levels of Emotional Awareness Scale and resting HRV were used to account for individual differences. During calibration, person-specific relations between movement and RMSSD were determined. The 24-h data were used to detect prolonged periods (i.e., 7.5 min) of AddHRVr. AddHRVr periods were associated with worrying, with decreased explicit positive affect, and with increased tension, but not with the frequency of stressful events or implicit emotions. Only in people high in emotional awareness and high in resting HRV did changes in AddHRVr covary with changes in explicit emotions. The algorithm can be used to capture prolonged reductions in HRV that are not due to metabolic needs. This enables the real-time assessment of episodes of potentially detrimental cardiac activity and its psychological determinants in daily life.

  19. Analysis of disruptive events and precarious situations caused by interaction with neurosurgical microscope.

    PubMed

    Eivazi, Shahram; Afkari, Hoorieh; Bednarik, Roman; Leinonen, Ville; Tukiainen, Markku; Jääskeläinen, Juha E

    2015-07-01

    Developments in micro-neurosurgical microscopes have improved operating precision and ensured the quality of outcomes. Using the stereoscopic magnified view, however, necessitates frequent manual adjustments to the microscope during an operation. This article reports on an investigation of the interaction details concerning a state-of-the-art micro-neurosurgical microscope. The video data from detailed observations of neurosurgeons' interaction patterns with the microscope were analysed to examine disruptive events caused by adjusting the microscope. The primary findings show that interruptions caused by adjusting the microscope handgrips and mouth switch prolong the surgery time up to 10%. Surgeons, we observed, avoid interaction with the microscope's controls, settings, and configurations by working at the edge of the view, operating on a non-focused view, and assuming unergonomic body postures. The lack of an automatic method for adjusting the microscope is a major problem that causes interruptions during micro-neurosurgery. From this understanding of disruptive events, we discuss the opportunities and limitations of interactive technologies that aim to reduce the frequency or shorten the duration of interruptions caused by microscope adjustment.

  20. Simulation and Automation of Microwave Frequency Control in Dynamic Nuclear Polarization for Solid Polarized Targets

    NASA Astrophysics Data System (ADS)

    Perera, Gonaduwage; Johnson, Ian; Keller, Dustin

    2017-09-01

    Dynamic Nuclear Polarization (DNP) is used in most of the solid polarized target scattering experiments. Those target materials must be irradiated using microwaves at a frequency determined by the difference in the nuclear Larmor and electron paramagnetic resonance (EPR) frequencies. But the resonance frequency changes with time as a result of radiation damage. Hence the microwave frequency should be adjusted accordingly. Manually adjusting the frequency can be difficult, and improper adjustments negatively impact the polarization. In order to overcome these difficulties, two controllers were developed which automate the process of seeking and maintaining the optimal frequency: one being a standalone controller for a traditional DC motor and the other a LabVIEW VI for a stepper motor configuration. Further a Monte-Carlo simulation was developed which can accurately model the polarization over time as a function of microwave frequency. In this talk, analysis of the simulated data and recent improvements to the automated system will be presented. DOE.

  1. Organ toxicity and mortality in propofol-sedated rabbits under prolonged mechanical ventilation.

    PubMed

    Ypsilantis, Petros; Politou, Maria; Mikroulis, Dimitrios; Pitiakoudis, Michail; Lambropoulou, Maria; Tsigalou, Christina; Didilis, Vasilios; Bougioukas, Georgios; Papadopoulos, Nikolaos; Manolas, Constantinos; Simopoulos, Constantinos

    2007-07-01

    Prolonged administration of propofol at large doses has been implicated in propofol infusion syndrome in intensive care unit patients. In this study we investigated organ toxicity and mortality of propofol sedation at large doses in prolonged mechanically ventilated rabbits and determined the role of propofol's lipid vehicle. Eighteen healthy male rabbits were endotracheally intubated and sedated with propofol 2% (Group P), sevoflurane (Group S) or sevoflurane while receiving Intralipid 10% (Group SI). Sedation lasted 48 h or until death (Group P) or the maximum surviving period of Group P (Groups S and SI). The initial propofol infusion rate (20 mg x kg(-1) x h(-1)) or sevoflurane concentration (1.5%) was adjusted, if needed, to maintain a standard level of sedation. Blood biochemical analysis was performed in serial blood samples and histologic examination in the heart, lungs, liver, gallbladder, kidneys, urinary bladder, and quadriceps femoris muscle at autopsy. The mortality rate was 100% (surviving period, 26-38 h) for Group P, whereas 0% for Groups S and SI. The initial propofol infusion rate had to be increased up to 65.7 +/- 4.6 mg x kg(-1) x h(-1) and sevoflurane concentration up to 4%. Serum liver function indices, lipids and creatine kinase were significantly increased (P < 0.05) in Groups P and SI and lactate was increased only in Group P, whereas amylase was increased in all groups. In Group P, histologic examination revealed myocarditis, pulmonary edema with interstitial pneumonia, hepatitis, steatosis, and focal liver necrosis, cholangitis, gallbladder necrosis, acute tubular necrosis of the kidneys, focal loss of the urinary bladder epithelium, and rhabdomyolysis of skeletal muscles; in Group S, low-grade bronchitis and incipient inflammation of the liver and the kidneys; and in Group SI, low-grade bronchitis, liver steatosis and hepatitis, and incipient inflammation of the gallbladder, kidneys, and urinary bladder. Continuous infusion of 2

  2. Objective quantification of seizure frequency and treatment success via long-term outpatient video-EEG monitoring: a feasibility study.

    PubMed

    Stefan, H; Kreiselmeyer, G; Kasper, B; Graf, W; Pauli, E; Kurzbuch, K; Hopfengärtner, R

    2011-03-01

    A reliable method for the estimation of seizure frequency and severity is indispensable in assessing the efficacy of drug treatment in epilepsies. These quantities are usually deduced from subjective patient reports, which may cause considerable problems due to insufficient or false descriptions of seizures and their frequency. We present data from two difficult-to-treat patients with intractable epilepsy. Pat. 1 has had an unknown number of CP seizures. Here, a prolonged outpatient video-EEG monitoring over 160 h and 137 h (over an interval of three months) was performed with an automated seizure detection method. Pat. 2 suffered exclusively from nocturnal seizures originating from the frontal lobe. In this case, an objective quantification of the efficacy of drug treatment over a time period of 22 weeks was established. For the reliable quantification of seizures, a prolonged outpatient video/video-EEG monitoring was appended after a short-term inpatient monitoring period. Patient 1: The seizure detection algorithm was capable of detecting 10 out of 11 seizures. The number of false-positive events was <0.03/h. It was clearly demonstrated that the patient showed more seizures than originally reported. Patient 2: The add-on medication of lacosamide led to a significant reduction in seizure frequency and to a marked decrease in the mean duration of seizures. The severity of seizures was reduced from numerous hypermotoric seizures to few mild, head-turning seizures. Outpatient monitoring may be helpful to guide treatment for severe epilepsies and offers the possibility to more reliably quantify the efficacy of treatment in the long-term, even over several months. Copyright © 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. A thorough QT study to evaluate the QTc prolongation potential of two neuropsychiatric drugs, quetiapine and escitalopram, in healthy volunteers.

    PubMed

    Kim, Anhye; Lim, Kyoung Soo; Lee, Howard; Chung, Hyewon; Yoon, Seo Hyun; Yu, Kyung-Sang; Cho, Joo-Youn; Jang, In-Jin; Chung, Jae-Yong

    2016-07-01

    Prolongation of the QT interval on an ECG is a surrogate marker for predicting the proarrhythmic potential of a drug under development. The aim of this study was to evaluate the QTc prolongation potential of two neuropsychiatric drugs, quetiapine immediate release (IR) and escitalopram, in healthy individuals. This was a randomized, open-label, 4×4 Williams crossover study, with four single-dose treatments [placebo, 400 mg moxifloxacin (positive control), 20 mg escitalopram, and 100 mg quetiapine IR], conducted in 40 healthy volunteers. Serial blood samples for pharmacokinetics and ECG were collected. Individually, RR-corrected QTc intervals (QTcI) and placebo-adjusted changes from baseline values of QTcI (ΔΔQTcI) were evaluated. Lower-bound values of the one-sided 95% confidence interval for ΔΔQTcI of moxifloxacin with more than 5 ms confirmed the sensitivity of the assay. The maximum upper bound 95% confidence interval for the ΔΔQTcI of quetiapine IR and escitalopram was 13.7 and 10.5 ms, with mean estimates of 10.2 and 6.9 ms, respectively. Peak effects of moxifloxacin and quetiapine IR on ΔΔQTcI were observed at approximately time to maximum concentration (Tmax), whereas that of escitalopram was observed 3 h after Tmax. The concentration-ΔΔQTcI relationships of quetiapine IR and escitalopram were relatively flat, as compared with that of moxifloxacin. The results demonstrated the validity of trial methodology and that quetiapine IR and escitalopram caused QT prolongation in healthy individuals. In addition, hysteresis of escitalopram-induced QTc prolongation. These results indicate that higher doses of these drugs could lead to greater QT prolongation in a dose-response manner.

  4. Methods for automatic trigger threshold adjustment

    DOEpatents

    Welch, Benjamin J; Partridge, Michael E

    2014-03-18

    Methods are presented for adjusting trigger threshold values to compensate for drift in the quiescent level of a signal monitored for initiating a data recording event, thereby avoiding false triggering conditions. Initial threshold values are periodically adjusted by re-measuring the quiescent signal level, and adjusting the threshold values by an offset computation based upon the measured quiescent signal level drift. Re-computation of the trigger threshold values can be implemented on time based or counter based criteria. Additionally, a qualification width counter can be utilized to implement a requirement that a trigger threshold criterion be met a given number of times prior to initiating a data recording event, further reducing the possibility of a false triggering situation.

  5. Temporally Adjusted Complex Ambiguity Function Mapping Algorithm for Geolocating Radio Frequency Signals

    DTIC Science & Technology

    2014-12-01

    Introduction 1.1 Background In today’s world of high -tech warfare, we have developed the ability to deploy virtually any type of ordnance quickly and... ANSI Std. 239–18 i THIS PAGE INTENTIONALLY LEFT BLANK ii Approved for public release; distribution is unlimited TEMPORALLY ADJUSTED COMPLEX AMBIGUITY...this time due to time constraints and the high computational complexity involved in the current implementation of the Moss algorithm. Full maps, with

  6. Why are we prolonging QT interval monitoring?

    PubMed

    Barrett, Trina

    2015-01-01

    At present, monitoring of the QT interval (QTI) is not a standard practice in the medical intensive care unit setting, where many drugs that prolong the QTI are administered. This literature review looked at the current research for evidence-based standards to support QTI monitoring of patients with risk factors for QTI prolongation, which can result in life-threatening arrhythmias such as torsade de pointes. The objective of this article is to establish the existence of evidence-based standards for monitoring of the QTI and to raise awareness in the nursing profession of the need for such monitoring among patients who are at high risk for prolonged QTI. To determine whether published standards for QTI monitoring exist, a search was conducted of the bibliographic databases CINAHL, EBSCOhost, Medline, PubMed, Google Scholar, and the Cochrane Library for the years 2013 and 2014. Also, a survey was conducted to determine whether practice standards for QTI monitoring are being implemented at 4 major hospitals in the Memphis area, including a level 1 trauma center. The database search established the existence of published guidelines that support the need for QTI monitoring. Results of the hospital survey indicated that direct care nurses were not aware of the need to identify high-risk patients, drugs with the potential to prolong QTI that were being administered to their patients, or evidence-based standards for QTI monitoring. Review of the research literature underscored the need for QTI monitoring among high-risk patients, that is, those with genetic conditions that predispose them to QTI prolongation, those with existing cardiac conditions being treated with antiarrhythmic medications, or those who are prescribed any new medication classified as high risk on the basis of clinical research. This need is especially crucial in intensive care unit settings, where many antiarrhythmic medications are administered.

  7. Music exposure induced prolongation of cardiac allograft survival and generated regulatory CD4⁺ cells in mice.

    PubMed

    Uchiyama, M; Jin, X; Zhang, Q; Amano, A; Watanabe, T; Niimi, M

    2012-05-01

    In clinical practice, music has been used to decrease stress, heart rate, and blood pressure and to provide a distraction from disease symptoms. We investigated sound effects on alloimmune responses in murine heart transplantation. Naïve and eardrum-ruptured CBA/N (CBA, H2(K)) underwent transplantation of a C57BL/6 (B6, H2(b)) heart and were exposed to 1 of 3 types of music-opera (La Traviata), classical (Mozart), and New Age (Enya)-or 1 of 6 different single sound frequencies for 7 days. An adoptive transfer study was performed to determine whether regulatory cells were generated in allograft recipients. Cell-proliferation, cytokine, and flow cytometry assessments were also performed. CBA recipients of a B6 graft exposed to opera and classical music had significantly prolonged allograft survival (median survival times [MSTs], 26.5 and 20 days, respectively), whereas those exposed to 6 single sound frequencies and New Age did not (MSTs, 7, 8, 9, 8, 8, 8, and 11 days, respectively). Untreated and eardrum-ruptured CBA rejected B6 grafts acutely (MSTs, 7 and 8.5 days, respectively). Adoptive transfer of whole splenocytes, CD4(+) cells, and CD4(+)CD25(+) cells from opera-exposed primary recipients resulted in significantly prolonged allograft survival in naive secondary recipients (MSTs, 36, 68, and >50 days, respectively). Cell-proliferation, interleukin (IL)-2 and interferon-γ were suppressed in opera-exposed mice, whereas IL-4 and IL-10 from opera-exposed recipients were up-regulated. Flow cytometry studies showed an increased CD4(+)CD25(+)Foxp3(+) cell population in splenocytes from opera-exposed mice. In conclusion, exposure to some types of music may induce prolonged survival of fully allogeneic cardiac allografts and generate CD4(+)CD25(+)Foxp3(+) regulatory cells. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. 27 CFR 19.386 - Adjusting pH of denatured spirits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... will counteract or reduce the effect of the denaturants. A proprietor who adjusts the pH of denatured... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Adjusting pH of denatured... of Articles Rules for Denaturing Spirits and Testing Denaturants § 19.386 Adjusting pH of denatured...

  9. 27 CFR 19.386 - Adjusting pH of denatured spirits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... will counteract or reduce the effect of the denaturants. A proprietor who adjusts the pH of denatured... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Adjusting pH of denatured... of Articles Rules for Denaturing Spirits and Testing Denaturants § 19.386 Adjusting pH of denatured...

  10. 27 CFR 19.386 - Adjusting pH of denatured spirits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... will counteract or reduce the effect of the denaturants. A proprietor who adjusts the pH of denatured... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Adjusting pH of denatured... of Articles Rules for Denaturing Spirits and Testing Denaturants § 19.386 Adjusting pH of denatured...

  11. 27 CFR 19.386 - Adjusting pH of denatured spirits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... will counteract or reduce the effect of the denaturants. A proprietor who adjusts the pH of denatured... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Adjusting pH of denatured... of Articles Rules for Denaturing Spirits and Testing Denaturants § 19.386 Adjusting pH of denatured...

  12. An acid/alkaline stress and the addition of amino acids induce a prolonged viability of Lactobacillus plantarum loaded into alginate gel.

    PubMed

    Bevilacqua, Antonio; Sinigaglia, Milena; Corbo, Maria Rosaria

    2010-08-15

    This study reports on the investigation on the effects of the conditions used throughout the step of biomass production on the survival of Lactobacillus plantarum loaded into alginate gels. L. plantarum was grown under different conditions (MRS or a laboratory medium-LB(2)-at acidic or alkaline pHs, with NaCl, phenols, vitamins or amino acids) and immobilized in sodium alginate; cell number was evaluated throughout the storage and death (delta(stand)) and first-reduction times (delta) were calculated. The storage of alginate gels at 4 degrees C prolonged cell viability up to 60 days (ca. 20 days for cells produced in MRS and stored at 30 degrees C); however, a similar prolongation was achieved for cells produced in LB(2) adjusted to pH 5.0 and 9.0 or added with amino acids (death time>50-60 days). Copyright 2010 Elsevier B.V. All rights reserved.

  13. NAC-NOR mutations in tomato Penjar accessions attenuate multiple metabolic processes and prolong the fruit shelf life.

    PubMed

    Kumar, Rakesh; Tamboli, Vajir; Sharma, Rameshwar; Sreelakshmi, Yellamaraju

    2018-09-01

    Several Penjar accessions of tomato grown in the Mediterranean exhibit prolonged shelf life and harbor alcobaca mutation. To uncover the metabolic basis underlying shelf life, we compared four Penjar accessions to Ailsa Craig. Three accessions bore alcobaca mutation, whereas the fourth was a novel NAC-NOR allele. Cuticle composition of Penjars varied widely during fruit ripening. All Penjars exhibited delayed ripening, prolonged on-vine and off-vine shelf life, low ethylene emission, and carotenoid levels. Metabolic profiling revealed shifts in Krebs cycle intermediates, amino acids, and γ-aminobutyric acid levels indicating the attenuation of respiration in Penjars during post-harvest storage. Penjar fruits also showed concerted downregulation of several cell-wall modifying genes and related metabolites. The high ABA and sucrose levels at the onset of senescence in Penjar fruits likely contribute to reduced water loss. Our analyses reveal that the attenuation of various metabolic processes by NAC-NOR mutation likely prolongs the shelf life of Penjar fruits. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Channel Acquisition for Massive MIMO-OFDM With Adjustable Phase Shift Pilots

    NASA Astrophysics Data System (ADS)

    You, Li; Gao, Xiqi; Swindlehurst, A. Lee; Zhong, Wen

    2016-03-01

    We propose adjustable phase shift pilots (APSPs) for channel acquisition in wideband massive multiple-input multiple-output (MIMO) systems employing orthogonal frequency division multiplexing (OFDM) to reduce the pilot overhead. Based on a physically motivated channel model, we first establish a relationship between channel space-frequency correlations and the channel power angle-delay spectrum in the massive antenna array regime, which reveals the channel sparsity in massive MIMO-OFDM. With this channel model, we then investigate channel acquisition, including channel estimation and channel prediction, for massive MIMO-OFDM with APSPs. We show that channel acquisition performance in terms of sum mean square error can be minimized if the user terminals' channel power distributions in the angle-delay domain can be made non-overlapping with proper phase shift scheduling. A simplified pilot phase shift scheduling algorithm is developed based on this optimal channel acquisition condition. The performance of APSPs is investigated for both one symbol and multiple symbol data models. Simulations demonstrate that the proposed APSP approach can provide substantial performance gains in terms of achievable spectral efficiency over the conventional phase shift orthogonal pilot approach in typical mobility scenarios.

  15. Regression equations for estimation of annual peak-streamflow frequency for undeveloped watersheds in Texas using an L-moment-based, PRESS-minimized, residual-adjusted approach

    USGS Publications Warehouse

    Asquith, William H.; Roussel, Meghan C.

    2009-01-01

    Annual peak-streamflow frequency estimates are needed for flood-plain management; for objective assessment of flood risk; for cost-effective design of dams, levees, and other flood-control structures; and for design of roads, bridges, and culverts. Annual peak-streamflow frequency represents the peak streamflow for nine recurrence intervals of 2, 5, 10, 25, 50, 100, 200, 250, and 500 years. Common methods for estimation of peak-streamflow frequency for ungaged or unmonitored watersheds are regression equations for each recurrence interval developed for one or more regions; such regional equations are the subject of this report. The method is based on analysis of annual peak-streamflow data from U.S. Geological Survey streamflow-gaging stations (stations). Beginning in 2007, the U.S. Geological Survey, in cooperation with the Texas Department of Transportation and in partnership with Texas Tech University, began a 3-year investigation concerning the development of regional equations to estimate annual peak-streamflow frequency for undeveloped watersheds in Texas. The investigation focuses primarily on 638 stations with 8 or more years of data from undeveloped watersheds and other criteria. The general approach is explicitly limited to the use of L-moment statistics, which are used in conjunction with a technique of multi-linear regression referred to as PRESS minimization. The approach used to develop the regional equations, which was refined during the investigation, is referred to as the 'L-moment-based, PRESS-minimized, residual-adjusted approach'. For the approach, seven unique distributions are fit to the sample L-moments of the data for each of 638 stations and trimmed means of the seven results of the distributions for each recurrence interval are used to define the station specific, peak-streamflow frequency. As a first iteration of regression, nine weighted-least-squares, PRESS-minimized, multi-linear regression equations are computed using the watershed

  16. A comparative study of QT prolongation with serotonin reuptake inhibitors.

    PubMed

    Ojero-Senard, Ana; Benevent, Justine; Bondon-Guitton, Emmanuelle; Durrieu, Geneviève; Chebane, Leila; Araujo, Melanie; Montastruc, Francois; Montastruc, Jean-Louis

    2017-10-01

    QT interval prolongations were described with citalopram and escitalopram. However, the effects of the other serotonin reuptake inhibitors (SRIs) remained discussed. In order to identify a putative signal with other SRIs, the present study investigates the reports of QT interval prolongation with SRIs in two pharmacovigilance databases (PVDB). Two kinds of investigations were performed: (1) a comparative study in VigiBase®, the WHO PVDB, where notifications of QT prolongation with six SRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) were selected. Cases with overdose or pregnancy were excluded. The relationship between the "suspected" SRI and occurrence of QT prolongation was assessed by calculating reporting odds ratio (ROR) in a case/non-case design. (2) A descriptive study of QT prolongation reports with citalopram and escitalopram in the French FPVD. In VigiBase®, 855 notifications were identified (mean age 56.2 years, mainly women 73%). Among them, 172 (20.1%) were associated to escitalopram; 299 (35.0%), to citalopram; 186 (21.8%), to fluoxetine; 94 (11.0%), to sertraline; 66 (7.7%), to paroxetine; and 38 (4.4%) to fluvoxamine. A significant ROR value (higher than 1) was only found for citalopram (3.35 CI95% [2.90-3.87]) or escitalopram (2.50 [2.11-2.95]). In the FPVD, eight reports of QT prolongation were found with citalopram and 27 with escitalopram, mainly in women (77.1%) with a mean age of 73.2 years. In 23 cases (66%), SRIs were associated with other suspected drugs, mainly cardiotropic or psychotropic ones. Hypokalemia was associated in six patients. This study, performed in real conditions of life, shows a clear signal of QT prolongation with only two SRIs, citalopram and escitalopram, indicating that QT prolongation is not a SRI class effect.

  17. Frequency of soup intake and amount of dietary fiber intake are inversely associated with plasma leptin concentrations in Japanese adults.

    PubMed

    Kuroda, Motonaka; Ohta, Masanori; Okufuji, Tatsuya; Takigami, Chieko; Eguchi, Masafumi; Hayabuchi, Hitomi; Ikeda, Masaharu

    2010-06-01

    Previous studies have shown that the intake of soup negatively correlates with the body mass index (BMI), suggesting that soup intake reduces the risk of obesity. In this study, to clarify the association of the intake of soup and various nutrients with plasma leptin concentration, a cross-sectional study on 504 Japanese adults aged 20-76 years (103 men and 401 women) was performed. The intake of soup and various nutrients was investigated by food frequency questionnaires. Plasma leptin concentration was measured in fasting blood by radioimmunoassay. The correlation was analyzed by multiple regression analysis. The average frequency of soup intake was 7.6 times/week. The average plasma leptin concentration was 7.76 ng/ml. After adjusting the confounding factors, the frequency of soup intake has a significant inverse association with plasma leptin concentration. Among the macronutrients, only dietary fiber intake negatively correlated with plasma leptin concentration after the adjustment for potential confounding factors. These results suggest that the intakes of soup and dietary fiber were negatively correlated with plasma leptin concentration in Japanese adults. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Effects of dynamic-demand-control appliances on the power grid frequency.

    PubMed

    Tchuisseu, E B Tchawou; Gomila, D; Brunner, D; Colet, P

    2017-08-01

    Power grid frequency control is a demanding task requiring expensive idle power plants to adapt the supply to the fluctuating demand. An alternative approach is controlling the demand side in such a way that certain appliances modify their operation to adapt to the power availability. This is especially important to achieve a high penetration of renewable energy sources. A number of methods to manage the demand side have been proposed. In this work we focus on dynamic demand control (DDC), where smart appliances can delay their switchings depending on the frequency of the system. We introduce a simple model to study the effects of DDC on the frequency of the power grid. The model includes the power plant equations, a stochastic model for the demand that reproduces, adjusting a single parameter, the statistical properties of frequency fluctuations measured experimentally, and a generic DDC protocol. We find that DDC can reduce small and medium-size fluctuations but it can also increase the probability of observing large frequency peaks due to the necessity of recovering pending task. We also conclude that a deployment of DDC around 30-40% already allows a significant reduction of the fluctuations while keeping the number of pending tasks low.

  19. Effects of dynamic-demand-control appliances on the power grid frequency

    NASA Astrophysics Data System (ADS)

    Tchuisseu, E. B. Tchawou; Gomila, D.; Brunner, D.; Colet, P.

    2017-08-01

    Power grid frequency control is a demanding task requiring expensive idle power plants to adapt the supply to the fluctuating demand. An alternative approach is controlling the demand side in such a way that certain appliances modify their operation to adapt to the power availability. This is especially important to achieve a high penetration of renewable energy sources. A number of methods to manage the demand side have been proposed. In this work we focus on dynamic demand control (DDC), where smart appliances can delay their switchings depending on the frequency of the system. We introduce a simple model to study the effects of DDC on the frequency of the power grid. The model includes the power plant equations, a stochastic model for the demand that reproduces, adjusting a single parameter, the statistical properties of frequency fluctuations measured experimentally, and a generic DDC protocol. We find that DDC can reduce small and medium-size fluctuations but it can also increase the probability of observing large frequency peaks due to the necessity of recovering pending task. We also conclude that a deployment of DDC around 30-40% already allows a significant reduction of the fluctuations while keeping the number of pending tasks low.

  20. Brain Perfusion and Arterial Blood Flow Velocity During Prolonged Body Tilting.

    PubMed

    Montero, David; Rauber, Sven

    2016-08-01

    It remains unknown whether brain perfusion is preserved and mirrored by middle cerebral blood flow velocity (MCA BFV) during prolonged changes in body posture. Herein, we examined the impact of sustained (180 min) 30° head-up (HUT) and head-down (HDT) tilt on brain perfusion, as determined by MCA BFV and blood flow in the extracranial arteries. In 10 healthy male subjects, arterial diameters, BFVs, and blood flows were determined in the left internal carotid (ICA) and vertebral (VA) arteries using duplex Doppler ultrasound in supine rest, and 5, 20, 60, 120, and 180 min following 30° HUT and HDT. MCA BFV was recorded throughout with transcranial Doppler ultrasound. ICA as well as VA diameters and blood flows were unaltered during HUT. Likewise, brain blood flow and MCA BFV were preserved with HUT. In the HDT protocol, ICA and VA diameters were gradually increased, although ICA, VA, and brain blood flows were preserved. MCA BFV was progressively reduced during HDT. In addition, MCA BFV was positively associated with ICA BFV (β = 0.9) and negatively associated with ICA diameter (β = -125.5). MCA BFV was positively associated with brain blood flow during HUT (β = 0.2) but not HDT. Brain perfusion is preserved whereas MCA BFV is progressively decreased and associated with extracranial arterial BFV during sustained 30° HDT. Therefore, MCA BFV may not be a surrogate of brain perfusion in conditions including prolonged HDT. Montero D, Rauber S. Brain perfusion and arterial blood flow velocity during prolonged body tilting. Aerosp Med Hum Perform. 2016; 87(8):682-687.

  1. The Association Between Nutritional Adequacy and Long-Term Outcomes in Critically Ill Patients Requiring Prolonged Mechanical Ventilation: A Multicenter Cohort Study.

    PubMed

    Wei, Xuejiao; Day, Andrew G; Ouellette-Kuntz, Hélène; Heyland, Daren K

    2015-08-01

    To examine the association between short-term nutritional adequacy received while in the ICU and long-term outcomes including 6-month survival and health-related quality of life in critically ill patients requiring prolonged mechanical ventilation. Retrospective analysis of data prospectively collected in the context of a multicenter randomized controlled trial. An international sample of ICUs. Adult patients who were mechanically ventilated for more than 8 days in the ICU. None. Nutritional adequacy was obtained from the average proportion of prescribed calories received over the amount prescribed during the first 8 days. Survival status and health-related quality of life as assessed using the Short-Form 36 v2 were obtained at 3- and 6 months post ICU admission. Of the 1,223 patients enrolled in the randomized controlled trial, 475 met the inclusion criteria for this study. At 6-month follow-up, 302 of the 475 patients (64%) were alive. Survival time in those who received low nutritional adequacy was significantly shorter than those who received high nutritional adequacy while adjusting for important covariates (adjusted hazard ratio, 1.7; 95% CI, 1.1-2.6). At 3-month follow-up, a 25% increase in nutritional adequacy was associated with improvements in Physical Functioning and Role Physical of 7.3 (p = 0.02) and 8.3 (p = 0.004) points, respectively. At 6-month follow-up, adjusted increases in Physical Functioning and Role Physical scores for every 25% increase in nutrition adequacy became smaller and were no longer statistically significant (adjusted estimate for Physical Functioning = 4.2, p = 0.14; for Role Physical = 3.2, p = 0.25). Greater amounts of nutritional intake received during the first week in the ICU were associated with longer survival time and faster physical recovery to 3 months but not 6 months post ICU discharge in critically ill patients requiring prolonged mechanical ventilation. Current recommendations to underfeed critically ill patients may

  2. Impulsivity and temporal frame: Reducing frequency of snacking by highlighting immediate health benefits.

    PubMed

    Pavey, Louisa; Churchill, Sue

    2017-08-01

    The current study aimed to examine the effect of giving temporally framed health information regarding either the immediate or long-term health consequences of consuming high-calorie snacks, for people with high Negative Urgency (a dimension of impulsivity), and for those primed with impulsivity. We expected that for participants with high Negative Urgency, and those primed with impulsivity, information which detailed the immediate health benefits of avoiding snack consumption would be more effective than information which detailed long-term health benefits. Participants (N=110) completed a measure of Negative Urgency, reported their snacking frequency over the previous seven days, and completed either an impulsivity or neutral prime task. Following this, they read information detailing either the immediate or long-term health benefits of avoiding high-calorie snacks. High-calorie snack consumption was reported 7days later. The results showed a significant three-way interaction between Negative Urgency, prime task, and temporal frame. Participants who were primed with impulsivity and those high in Negative Urgency showed a greater reduction in snacking frequency after being given information about the immediate vs. long-term health benefits of snacking. The results suggest that the immediacy of health consequences should be considered when designing health information to reduce impulsive snacking behaviour. Copyright © 2017. Published by Elsevier Ltd.

  3. [The prevention and treatment of suppurative-inflammatory complications in the bronchopulmonary system during prolonged artificial ventilation].

    PubMed

    Mozhaev, G A; Tikhonovskiĭ, I Iu

    1992-01-01

    The use of physical methods, namely low frequency magnetic field in critically ill patients under respiratory therapy made it possible to prevent and in case of their development to effectively treat pyoinflammatory bronchopulmonary complications that accompany prolonged controlled lung ventilation. The results obtained were due to the elimination of an unfavourable effect of controlled lung ventilation on natural resistance and immune response of the respiratory tract because of normalization of physicochemical properties of the tracheobronchial tree secretion, enhanced functional capacities of phagocytes, repaired bonds between cellular and humoral local immunity in the lungs.

  4. Frequency of First-Year Student Interactions with Advisors

    ERIC Educational Resources Information Center

    Fosnacht, Kevin; McCormick, Alexander C.; Nailos, Jennifer N.; Ribera, Amy K.

    2017-01-01

    Although acknowledged that academic advising helps students adjust to and deal with the challenges of college, little is known about students' frequency of interactions with advisors. Using data from 52,546 full-time, first-year students at 209 diverse institutions, we examined the frequency with which students met with academic advisors and the…

  5. Vocal impact of a prolonged reading task in dysphonic versus normophonic female teachers.

    PubMed

    Remacle, Angélique; Morsomme, Dominique; Berrué, Elise; Finck, Camille

    2012-11-01

    This study evaluates the effect of a 2-hour reading task between 70 and 75 dB(A) in 16 normophonic and 16 dysphonic female teachers with vocal nodules. Objective measurements (acoustic analysis, voice range measurements, and aerodynamic measurements) and subjective self-ratings were collected before and every 30 minutes during the reading to determine the voice evolution in both groups. Fundamental frequency, lowest frequency, highest frequency (F-High), highest intensity, and intensity range increase through the reading, whereas shimmer decreases. Maximum phonation time decreases after 30 minutes. Estimated subglottal pressure (ESP) and sound pressure level increase during the first hour. Afterward, ESP decreases. Self-ratings worsen through time. When comparing the normophonic and the dysphonic teachers, self-ratings reveal more complaints in the dysphonic group. Few differences in objective measurements are found between both groups: normophonic teachers show lower ESP, higher F-High, and greater frequency range. Frequency modifications from acoustic analysis and voice range measurements suggest an increased laryngeal tension during vocal load, while subjects perceive a worsening of voice. Aerodynamic parameters depict first a deterioration of voice efficiency and then an adaptation to the prolonged reading. The comparison between both groups shows a discrepancy between objective measurements and self-ratings, suggesting that both approaches are necessary to have a complete view of vocal load effects. Surprisingly, both groups behave similarly through vocal load, without more or quicker deterioration of voice in the dysphonic group. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  6. Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual.

    PubMed

    Nacasch, Nitzah; Foa, Edna B; Huppert, Jonathan D; Tzur, Dana; Fostick, Leah; Dinstein, Yula; Polliack, Michael; Zohar, Joseph

    2011-09-01

    Empirically based studies have demonstrated that prolonged exposure therapy effectively reduces posttraumatic stress disorder (PTSD) symptoms in a vast range of traumas, yet reports of the efficacy of such therapies in combat- and terror-related PTSD are scarce. In this article, we examine the efficacy of prolonged exposure therapy in combat- and terror-related PTSD in comparison to treatment as usual (TAU). Between July 2002 and October 2005, 30 patients of a trauma unit within a psychiatric outpatient clinic were recruited and randomized into prolonged exposure versus TAU therapies. Patients were diagnosed with chronic PTSD (Mini-International Neuropsychiatric Interview criteria) related to combat- (n = 19) or terror-related (n = 11) trauma. Main outcome measures included symptoms of PTSD and depression, as measured by the PTSD Symptom Scale-Interview Version and the Beck Depression Inventory. Posttraumatic stress disorder symptom severity was significantly lower in patients who received prolonged exposure therapy in comparison to patients who received TAU (F(1,24) = 35.3, P < .001). Similar results have emerged in measures of depression and state and trait anxiety. In addition, a significant change from pretreatment to follow-up was found for the prolonged exposure group (F(1,14) = 80.5, P < .0001), but not for the TAU group (F(1,10.3) = 0.6, P = .44). Findings indicate that, similar to PTSD related to other types of trauma, prolonged exposure therapy is beneficial in the amelioration of combat- and terror-related PTSD symptoms. In addition, prolonged exposure was superior to TAU in the short- and long-term reduction of PTSD and depression symptoms. clinicaltrials.gov Identifier: NCT00229372. © Copyright 2011 Physicians Postgraduate Press, Inc.

  7. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... corresponding to changes in the interest rate index. (d) Frequency of interest rate changes. (1) The interest...) Interest-rate index. Changes in the interest rate charged on an adjustable rate mortgage must correspond either to changes in the one-year London Interbank Offered Rate (LIBOR) or to changes in the weekly...

  8. New technique to prevent prolonged air leak: use of 'Tachosuture' technique.

    PubMed

    Nishida, Tatsuya; Mikami, Iwao; Fujii, Yoshitaka

    2017-02-01

    Prolonged air leak (defined as air leak >7 days), caused by pulmonary resection or alveolar-pleural fistula, increases postoperative morbidity, prolongs hospital stay and increases healthcare costs. We describe a new technique ('Tachosuture' technique) to prevent prolonged air leak. The key point of this new technique is that air leak is classified into three types and an absorbable suture is added to a TachoSil ® patch in each type to prevent detachment from the lung parenchyma. Between August 2013 and March 2016, 40 patients underwent thoracoscopic surgery using 'Tachosuture' technique. Postoperative air leak always stopped within 3 days (95% confidence interval for the absence of prolonged air leak: 92.5-100%). It is considered that this simple technique is useful to prevent prolonged air leak.

  9. Psychosocial and Behavioral Interventions and Cancer Patient Survival Again: Hints of an Adjusted Meta-Analysis.

    PubMed

    Xia, Yi; Tong, Guixian; Feng, Rui; Chai, Jing; Cheng, Jing; Wang, Debin

    2014-07-01

    Although there is evidence that psychosocial and behavioral interventions (PBIs) increase well-being, improve coping and adjustment, and reduce distress among cancer patients, findings regarding PBIs as a means for prolonging survival were not convincing. Conflicting findings resulted in tremendous controversies over the efficacy of PBIs. This study aims at estimating the pooled effects of PBIs on survival of cancer patients. Randomized controlled trials (RCTs) testing the effects of any kind of PBIs on the survival of cancer patients included in MEDLINE, EMBASE, Cancer Lit, CINAHL, Cochrane Library, and reference lists of relevant articles were retrieved and reviewed by 2 independent researchers. Data items derived from the articles included time and duration of study, intervention types and doses, and numbers of patients dying and surviving 1, 2, 4, and 6 years after intervention. Estimation of the collective effects of the interventions used meta-analysis via Review Manager (version 5). A total of 15 RCTs met inclusion criteria, involving 2041 subjects (1118 in intervention and 923 in control groups). Inclusive total mean Mantel-Haenszel risk ratios (RRs) ranged from 0.83 to 0.99, and 3 of these effect sizes were statistically nonsignificant. Yet when the RCTs with less than 30 hours of PBIs were excluded, all the RRs decreased to some extent, with the RR for the first 2 years being decreased to 0.69 (95% CI, 0.55-0.87) and 0.82 (95% CI, 0.71-0.95), respectively. PBIs with adequate intervention doses prolong survival at least for some cancer patients in the first 2 years after intervention, although longer term effects need to be determined via more studies. © The Author(s) 2014.

  10. Preparation, characterization and in vivo evaluation of a combination delivery system based on hyaluronic acid/jeffamine hydrogel loaded with PHBV/PLGA blend nanoparticles for prolonged delivery of Teriparatide.

    PubMed

    Bahari Javan, Nika; Montazeri, Hamed; Rezaie Shirmard, Leila; Jafary Omid, Nersi; Barbari, Ghullam Reza; Amini, Mohsen; Ghahremani, Mohammad Hossein; Rafiee-Tehrani, Morteza; Abedin Dorkoosh, Farid

    2017-04-01

    In the current study, biodegradable PHBV/PLGA blend nanoparticles (NPs) containing Teriparatide were loaded in hyaluronic acid/jeffamine (HA-JEF ED-600) hydrogel to prepare a combination delivery system (CDS) for prolonged delivery of Teriparatide. The principal purpose of the present study was to formulate an effective and prolonged Teriparatide delivery system in order to reduce the frequency of injection and thus enhance patient's compliance. Morphological properties, swelling behaviour, crosslinking efficiency and rheological characterization of HA-JEF ED-600 hydrogel were evaluated. The CDS was acquired by adding PHBV/PLGA NPs to HA-JEF ED-600 hydrogel simultaneously with crosslinking reaction. The percentage of NPs incorporation within the hydrogel as well as the loading capacity and morphology of Teriparatide loaded CDS were examined. Intrinsic fluorescence and circular dichroism spectroscopy proved that Teriparatide remains stable after processing. The release profile represented 63% Teriparatide release from CDS within 50days with lower burst release compared to NPs and hydrogel. MTT assay was conducted by using NIH3T3 cell line and no sign of reduction in cell viability was observed. Based on Miller and Tainter method, LD 50 of Teriparatide loaded CDS was 131.8mg/kg. In vivo studies demonstrated that Teriparatide loaded CDS could effectively increase serum calcium level after subcutaneous injection in mice. Favourable results in the current study introduced CDS as a promising candidate for controlled delivery of Teriparatide and pave the way for future investigations in the field of designing prolonged delivery systems for other peptides and proteins. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Frequency and characteristics of infections caused by extended-spectrum beta-lactamase-producing organisms in neonates: a prospective cohort study.

    PubMed

    Vijayakanthi, Nandini; Bahl, Dheeraj; Kaur, Nirmaljit; Maria, Arti; Dubey, Nand Kishore

    2013-01-01

    This prospective cohort study was conducted to determine the frequency of infections caused by extended-spectrum beta-lactamase- (ESBL-) producing organisms, various bacteria producing ESBL, antibiotic susceptibility of these organisms, and the risk factors associated with these infections in a neonatal intensive care unit in a tertiary care hospital in North India. Of the 150 neonates enrolled in the study, 47 culture-positive neonates were included in the study cohort and were divided into two groups: ESBL-positive (8 neonates) and ESBL-negative (39 neonates) cohorts. Various organisms were isolated from 72 culture samples in these 47 neonates. Of these, 10 culture samples grew ESBL-positive organisms and 62 samples grew ESBL-negative organisms. The frequency of ESBL-producing organisms was found to be 5.3%. ESBL infection incidence densities were found to be 3.4 per 1000 patient-days. Klebsiella (60%) was the most common organism producing ESBL followed by Escherichia coli (30%) and Pseudomonas (10%). Eighty percent of the ESBL-producing organisms were sensitive to piperacillin-tazobactam. Risk factors found significant by univariate analysis (P < 0.05) were preterm, low birthweight, perinatal asphyxia, respiratory distress syndrome, anaemia, metabolic acidosis, prolonged mechanical ventilation (>7 days), length of hospitalization, length of level 3 stay, prior antibiotic use, central venous catheter duration, peripherally inserted central venous catheter duration, and total parenteral nutrition duration. Factors that retained significance in the logistic regression model were duration of hospital stay (adjusted OR: 0.958, CI: 0.920-0.997, and P value = 0.037) and gestational age (adjusted OR: 1.39, CI: 1.037-1.865, and P value = 0.028). There was no significant difference in the mortality between the two groups.

  12. Frequency control of wind turbine in power system

    NASA Astrophysics Data System (ADS)

    Xu, Huawei

    2018-06-01

    In order to improve the stability of the overall frequency of the power system, automatic power generation control and secondary frequency adjustment were applied. Automatic power generation control was introduced into power generation planning. A dual-fed wind generator power regulation model suitable for secondary frequency regulation was established. The results showed that this method satisfied the basic requirements of frequency regulation control of large-scale wind power access power systems and improved the stability and reliability of power system operation. Therefore, this system frequency control method and strategy is relatively simple. The effect is significant. The system frequency can quickly reach a steady state. It is worth applying and promoting.

  13. Frequency, predictors, and economic impact of upward dose adjustment of infliximab in managed care patients with rheumatoid arthritis.

    PubMed

    Ollendorf, Daniel A; Massarotti, Elena; Birbara, Charles; Burgess, Somali Misra

    2005-06-01

    To examine dosing patterns and costs among rheumatoid arthritis (RA) patients newly treated with infliximab in a large national health care claims database. Using data from a proprietary database of pharmacy and medical claims for 75 U.S. health plans, RA patients newly treated with infliximab between June 2000 and June 2002 were selected and assigned an .index date. based on the first infusion. A pretreatment period of 6 months was created; patients were also followed for a minimum of 6 months after the initial infusion. Follow-up was allowed to vary beyond this minimum 6 months in order to preserve all available patient data. A maintenance number of infliximab vials was determined as of the second infusion; patients with 1 subsequent increase in vials used or 2 intervals between infusions of <49 days were considered to have had an upward dose adjustment. Differences (i.e., between those with upward dose adjustment and those with no upward dose) in patient characteristics were examined using descriptive statistics. In addition, time to upward dose adjustment and factors influencing its likelihood were analyzed using Kaplan-Meier and Cox proportional hazards techniques. Finally, differences in RA-related and unrelated costs (medication, outpatient, inpatient, and total, expressed in 2003 dollars) were examined using Wilcoxon rank-sum tests and were also stratified by a number of patient characteristics found to differ between the 2 groups. A total of 1,236 patients met all study entry criteria and were included in these analyses. One or more upward dose adjustments were experienced by 61.7% (N=762) of patients during an average of 15 months of follow-up (median =13 months, range=6 to 31 months). The majority (63.3%) of upward dose adjustments were due to increases in the number of billed vials. Median time to upward dose adjustment was 254 days and declined steadily based on year of initiation (from 330 days in 2000 to 224 days in 2002). Factors significantly

  14. Prolonged forearm ischemia attenuates endothelium-dependent vasodilatation and plasma nitric oxide metabolites in overweight middle-aged men.

    PubMed

    Aboo Bakkar, Zainie; Fulford, Jonathan; Gates, Phillip E; Jackman, Sarah R; Jones, Andrew M; Bond, Bert; Bowtell, Joanna L

    2018-05-21

    Repeated cycles of endothelial ischemia-reperfusion injury and the resulting respiratory burst contribute to the irreversible pathophysiology of vascular diseases, and yet, the effects of ischemia reperfusion on vascular function, oxidative stress, and nitric oxide (NO) bioavailability have not been assessed simultaneously. Therefore, this study sought to examine the effects of prolonged forearm occlusion and subsequent reperfusion on NO-dependent brachial artery endothelial function. Flow-mediated dilatation was measured at baseline and 15, 30, and 45 min after 20-min forearm occlusion in 14 healthy, but physically inactive middle-aged men (53.7 ± 1.2 years, BMI: 28.1 ± 0.1 kg m -2 ). Venous blood samples collected from the occluded arm were analyzed for NO metabolites and markers of oxidative stress. FMD was significantly depressed after the prolonged occlusion compared to baseline, with a significant reduction 15-min post-occlusion (6.6 ± 0.7 to 2.9 ± 0.4%, p < 0.001); FMD remained depressed after 30 min (4.1 ± 0.6%, p = 0.001), but was not significantly different to baseline after 45-min recovery (5.4 ± 0.7%, p = 0.079). Plasma nitrate (main time effect: p = 0.015) and nitrite (main time effect: p = 0.034) concentrations were significantly reduced after prolonged occlusion. Plasma catalase activity was significantly elevated at 4- (p = 0.016) and 45-min (p = 0.001) post-occlusion, but plasma peroxiredoxin 2 and protein carbonyl content did not change. Prolonged forearm occlusion resulted in acute impairment of endothelium-dependent vasodilatation of the brachial artery for at least 30 min after reperfusion. We demonstrate that this vascular dysfunction is associated with oxidative stress and reduced NO bioavailability following reperfusion.

  15. Leg exoskeleton reduces the metabolic cost of human hopping.

    PubMed

    Grabowski, Alena M; Herr, Hugh M

    2009-09-01

    During bouncing gaits such as hopping and running, leg muscles generate force to enable elastic energy storage and return primarily from tendons and, thus, demand metabolic energy. In an effort to reduce metabolic demand, we designed two elastic leg exoskeletons that act in parallel with the wearer's legs; one exoskeleton consisted of a multiple leaf (MLE) and the other of a single leaf (SLE) set of fiberglass springs. We hypothesized that hoppers, hopping on both legs, would adjust their leg stiffness while wearing an exoskeleton so that the combination of the hopper and exoskeleton would behave as a linear spring-mass system with the same total stiffness as during normal hopping. We also hypothesized that decreased leg force generation while wearing an exoskeleton would reduce the metabolic power required for hopping. Nine subjects hopped in place at 2.0, 2.2, 2.4, and 2.6 Hz with and without an exoskeleton while we measured ground reaction forces, exoskeletal compression, and metabolic rates. While wearing an exoskeleton, hoppers adjusted their leg stiffness to maintain linear spring-mass mechanics and a total stiffness similar to normal hopping. Without accounting for the added weight of each exoskeleton, wearing the MLE reduced net metabolic power by an average of 6% and wearing the SLE reduced net metabolic power by an average of 24% compared with hopping normally at frequencies between 2.0 and 2.6 Hz. Thus, when hoppers used external parallel springs, they likely decreased the mechanical work performed by the legs and substantially reduced metabolic demand compared with hopping without wearing an exoskeleton.

  16. Reducing the frequency of acute otitis media by individualized care.

    PubMed

    Pichichero, Michael E; Casey, Janet R; Almudevar, Anthony

    2013-05-01

    We sought to determine if use of more stringent diagnostic criteria for acute otitis media (AOM) than currently advocated by the American Academy of Pediatrics, tympanocentesis and pathogen-specific antibiotic treatment (individualized care) would result in reducing the incidence of recurrent AOM and consequent tympanostomy tube surgery. A 5-year longitudinal, prospective study in Rochester, NY, was conducted from July 2006 to July 2011 involving 254 individualized care children. When this individualized care group developed symptoms of AOM, strict diagnostic criteria were applied and a tympanocentesis was performed. Pathogen resistance to empiric high-dose amoxicillin/clavulanate (80 mg/kg of amoxicillin component) caused a change in antibiotic to an optimized choice. Legacy controls (n = 208) were diagnosed with the same diagnostic criteria by the same physicians as the individualized care group and received the same empiric amoxicillin/clavulanate (80 mg/kg of amoxicillin component) but no tympanocentesis or change in antibiotic. Community control children (n = 1020) were diagnosed according to current American Academy of Pediatrics guidelines and treated with high-dose amoxicillin (80 mg/kg) without tympanocentesis as guideline recommended. 5.9% of children of the individualized care group compared with 14.4% of Legacy controls and 27.3% of community controls became otitis prone, defined as 3 episodes of AOM within a 6-month time span or 4 AOM episodes within a 12-month time span (P < 0.0001). 2.4% of the individualized care group compared with 6.3% of Legacy controls, and 14.8% of community controls received tympanostomy tubes (P < 0.0001). Individualized care of AOM significantly reduces the frequency of AOM and tympanostomy tube surgery. Use of strict diagnostic criteria for AOM and empiric antibiotic treatment using evidence-based knowledge of circulating otopathogens and their antimicrobial susceptibility profile also produces improved outcomes.

  17. Improved Conjugate Gradient Bundle Adjustment of Dunhuang Wall Painting Images

    NASA Astrophysics Data System (ADS)

    Hu, K.; Huang, X.; You, H.

    2017-09-01

    Bundle adjustment with additional parameters is identified as a critical step for precise orthoimage generation and 3D reconstruction of Dunhuang wall paintings. Due to the introduction of self-calibration parameters and quasi-planar constraints, the structure of coefficient matrix of the reduced normal equation is banded-bordered, making the solving process of bundle adjustment complex. In this paper, Conjugate Gradient Bundle Adjustment (CGBA) method is deduced by calculus of variations. A preconditioning method based on improved incomplete Cholesky factorization is adopt to reduce the condition number of coefficient matrix, as well as to accelerate the iteration rate of CGBA. Both theoretical analysis and experimental results comparison with conventional method indicate that, the proposed method can effectively conquer the ill-conditioned problem of normal equation and improve the calculation efficiency of bundle adjustment with additional parameters considerably, while maintaining the actual accuracy.

  18. The Impact of AUC-Based Monitoring on Pharmacist-Directed Vancomycin Dose Adjustments in Complicated Methicillin-Resistant Staphylococcus aureus Infection.

    PubMed

    Stoessel, Andrew M; Hale, Cory M; Seabury, Robert W; Miller, Christopher D; Steele, Jeffrey M

    2018-01-01

    This study aimed to assess the impact of area under the curve (AUC)-based vancomycin monitoring on pharmacist-initiated dose adjustments after transitioning from a trough-only to an AUC-based monitoring method at our institution. A retrospective cohort study of patients treated with vancomycin for complicated methicillin-resistant Staphylococcus aureus (MRSA) infection between November 2013 and December 2016 was conducted. The frequency of pharmacist-initiated dose adjustments was assessed for patients monitored via trough-only and AUC-based approaches for trough ranges: 10 to 14.9 mg/L and 15 to 20 mg/L. Fifty patients were included: 36 in the trough-based monitoring and 14 in the AUC-based-monitoring group. The vancomycin dose was increased in 71.4% of patients when troughs were 10 to 14.9 mg/L when a trough-only approach was used and in only 25% of patients when using AUC estimation ( P = .048). In the AUC group, the dose was increased only when AUC/minimum inhibitory concentration (MIC) <400; unchanged regimens had an estimated AUC/MIC ≥400. The AUC-based monitoring did not significantly increase the frequency of dose reductions when trough concentrations were 15 to 20 mg/L (AUC: 33.3% vs trough: 4.6%; P = .107). The AUC-based monitoring resulted in fewer patients with dose adjustments when trough levels were 10 to 14.9 mg/L. The AUC-based monitoring has the potential to reduce unnecessary vancomycin exposure and warrants further investigation.

  19. A Machine Learning Framework for Plan Payment Risk Adjustment.

    PubMed

    Rose, Sherri

    2016-12-01

    To introduce cross-validation and a nonparametric machine learning framework for plan payment risk adjustment and then assess whether they have the potential to improve risk adjustment. 2011-2012 Truven MarketScan database. We compare the performance of multiple statistical approaches within a broad machine learning framework for estimation of risk adjustment formulas. Total annual expenditure was predicted using age, sex, geography, inpatient diagnoses, and hierarchical condition category variables. The methods included regression, penalized regression, decision trees, neural networks, and an ensemble super learner, all in concert with screening algorithms that reduce the set of variables considered. The performance of these methods was compared based on cross-validated R 2 . Our results indicate that a simplified risk adjustment formula selected via this nonparametric framework maintains much of the efficiency of a traditional larger formula. The ensemble approach also outperformed classical regression and all other algorithms studied. The implementation of cross-validated machine learning techniques provides novel insight into risk adjustment estimation, possibly allowing for a simplified formula, thereby reducing incentives for increased coding intensity as well as the ability of insurers to "game" the system with aggressive diagnostic upcoding. © Health Research and Educational Trust.

  20. Neuromuscular adjustments of gait associated with unstable conditions

    PubMed Central

    Ivanenko, Y. P.; d'Avella, A.; Serrao, M.; Ranavolo, A.; Draicchio, F.; Cappellini, G.; Casali, C.; Lacquaniti, F.

    2015-01-01

    A compact description of coordinated muscle activity is provided by the factorization of electromyographic (EMG) signals. With the use of this approach, it has consistently been shown that multimuscle activity during human locomotion can be accounted for by four to five modules, each one comprised of a basic pattern timed at a different phase of gait cycle and the weighting coefficients of synergistic muscle activations. These modules are flexible, in so far as the timing of patterns and the amplitude of weightings can change as a function of gait speed and mode. Here we consider the adjustments of the locomotor modules related to unstable walking conditions. We compared three different conditions, i.e., locomotion of healthy subjects on slippery ground (SL) and on narrow beam (NB) and of cerebellar ataxic (CA) patients on normal ground. Motor modules were computed from the EMG signals of 12 muscles of the right lower limb using non-negative matrix factorization. The unstable gait of SL, NB, and CA showed significant changes compared with controls in the stride length, stride width, range of angular motion, and trunk oscillations. In most subjects of all three unstable conditions, >70% of the overall variation of EMG waveforms was accounted for by four modules that were characterized by a widening of muscle activity patterns. This suggests that the nervous system adopts the strategy of prolonging the duration of basic muscle activity patterns to cope with unstable conditions resulting from either slippery ground, reduced support surface, or pathology. PMID:26378199

  1. Radio frequency sustained ion energy

    DOEpatents

    Jassby, Daniel L.; Hooke, William M.

    1977-01-01

    Electromagnetic (E.M.) energy injection method and apparatus for producing and sustaining suprathermal ordered ions in a neutral, two-ion-species, toroidal, bulk equilibrium plasma. More particularly, the ions are produced and sustained in an ordered suprathermal state of existence above the average energy and velocity of the bulk equilibrium plasma by resonant rf energy injection in resonance with the natural frequency of one of the ion species. In one embodiment, the electromagnetic energy is injected to clamp the energy and velocity of one of the ion species so that the ion energy is increased, sustained, prolonged and continued in a suprathermal ordered state of existence containing appreciable stored energy that counteracts the slowing down effects of the bulk equilibrium plasma drag. Thus, selective deuteron absorption may be used for ion-tail creation by radio-frequency excitation alone. Also, the rf can be used to increase the fusion output of a two-component neutral injected plasma by selective heating of the injected deuterons.

  2. Evaluation of three different devices to reduce stasis edema in poorly mobile nursing home patients.

    PubMed

    Benigni, Jean-Patrick; Uhl, Jean-François; Balet, Florence; Filori, Pascal; Chahim, Maxime

    2018-03-08

    Prolonged immobility in the sitting position in the elderly is known to produce venous stasis with leg edema and possible skin changes. Compression stockings are often applied for this clinical problem. There are few experienced nursing staff available to supervise the difficult task of stocking application. The authors have researched other effective and simple devices that may be suitable alternatives. This article reports the results of three different devices to reduce leg edema, as measured by reduction in leg volume : an electro- stimulation device, an adjustable compression Velcro® wrap and a short stretch bandage, each tested over a two-hour period. In this randomized pilot study including 38 patients, the authors observed no difference in leg volume following electro-stimulation (Veinoplus®). They noted a significant reduction in leg volume following use of the other two devices, more with the adjustable Velcro® wrap compression (Circaid Juxtafit®) than with the short stretch bandage (Rosidal K®). Measurement of the interface pressures created by these two devices and also assessing the stiffness created by applying each device for two hours confirm that pressure is more important than stiffness in the reduction of edema in these particular patients. This pilot study is to be added to the results of previous published studies showing the efficacy in reducting leg edema of Velcro® adjustable compression wrap and its ease of use.

  3. Recovery of Breathing and Forelimb Function after Prolonged Exposure to Repetitive Acute Intermittent Hypoxia

    DTIC Science & Technology

    2017-03-01

    breathing capacity (Aim 1) and forelimb function (Aim 2), without systemic hypertension or hippocampal pathology (Aim 3). SPECIFIC AIMS Aim 1 (Florida...benefits. On the other hand, there was no evidence for pathology ( hypertension or hippocampal pathology). We were not able to perform time-series... hypertension or hippocampal (CA1) pathology. However, we did see striking (and surprising) preliminary evidence that prolonged rAIH: 1) reduced volume of the

  4. Measurement of Quality of Life VI. Quality-Adjusted Life Years (QALY) is an Unfortunate Use of the Quality-of-Life Concept

    PubMed Central

    Ventegodt, Soren; Merrick, Joav; Andersen, Niels Jorgen

    2003-01-01

    The QALY (quality-adjusted life years) attempts to incorporate the dimension of quality of life into the evaluation by adjusting life years by a quality factor. In practice, this is based on discussing with people the progression of a number of hypothetical illnesses and their ensuing side effects. From this information, the person assesses how each state of health described compares with a theoretical maximum state of health. For example, 1 day with a certain condition might the equivalent of living only 0.5 days in good health.We believe that QALY value only represents a superficial impression of a person's quality of life. In short, the QALY does not express what it means for a person to live a life at reduced quality. We believe that if the patients were optimally informed and allowed to decide for themselves, they would more often reject high-tech expensive biomedical treatments that only serve to prolong life and do not increase its quality. The problem of priorities may then turn out to be far more simple and also more ethical: the focus will be on the quality of life, not on QALY, and the question of the meaning of life and death will achieve greater openness and respect. PMID:14570991

  5. Very prolonged liposomal amphotericin B use leading to a lysosomal storage disease.

    PubMed

    Michot, J M; Gubavu, C; Fourn, E; Maigne, G; Teicher, E; Angoulvant, A; Blanche, S; Lortholary, O; Coilly, A; Duclos-Vallée, J C; Sebagh, M; Guettier, C; Aumont, C; Delfraissy, J F; Lambotte, O

    2014-06-01

    Amphotericin B is a powerful polyene antifungal drug used for treating systemic fungal infections and is usually administered for a short period. Side effects after prolonged use are unknown in humans. Here we report the case of a 28-year-old man suffering from chronic granulomatous disease (CGD), treated for invasive cerebral aspergillosis with liposomal amphotericin B (L-AmB) for a very long time (8 consecutive years). We describe the efficacy and safety of this treatment in the long term. Aspergillosis was kept under control as long as L-AmB therapy was maintained, but relapsed when the dose was reduced. No overt renal toxicity was noted. The patient gradually developed hepatosplenomegaly and pancytopenia. Abnormalities of bone marrow were similar to the sea-blue histiocyte syndrome. Liver biopsy showed images of nodular regenerative hyperplasia related to CGD as well as a histiocytic storage disease. We discuss the very prolonged use of L-AmB leading to the development of a lysosomal storage disease. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  6. Peak high-frequency HRV and peak alpha frequency higher in PTSD.

    PubMed

    Wahbeh, Helané; Oken, Barry S

    2013-03-01

    Posttraumatic stress disorder (PTSD) is difficult to treat and current PTSD treatments are not effective for all people. Despite limited evidence for its efficacy, some clinicians have implemented biofeedback for PTSD treatment. As a first step in constructing an effective biofeedback treatment program, we assessed respiration, electroencephalography (EEG) and heart rate variability (HRV) as potential biofeedback parameters for a future clinical trial. This cross-sectional study included 86 veterans; 59 with and 27 without PTSD. Data were collected on EEG measures, HRV, and respiration rate during an attentive resting state. Measures were analyzed to assess sensitivity to PTSD status and the relationship to PTSD symptoms. Peak alpha frequency was higher in the PTSD group (F(1,84) = 6.14, p = 0.01). Peak high-frequency HRV was lower in the PTSD group (F(2,78) = 26.5, p < 0.00005) when adjusting for respiration rate. All other EEG and HRV measures and respiration were not different between groups. Peak high-frequency HRV and peak alpha frequency are sensitive to PTSD status and may be potential biofeedback parameters for future PTSD clinical trials.

  7. Acceptability of an oral contraceptive that reduces the frequency of menstruation: the tri-cycle pill regimen.

    PubMed Central

    Loudon, N B; Foxwell, M; Potts, D M; Guild, A L; Short, R V

    1977-01-01

    The frequency of menstruation was reduced to once every three months in 196 women by the continuous administration of the oral contraceptive pill, Minilyn, for 84 days (tri-cycle regimen). No pregnancies occurred. One hundred and sixty-one women (82%) welcomed the reduction in the number of periods with the associated freedom from menstrual and premenstrual symptoms, and many found the tri-cycle regimen easier to follow. Weight gain of more than 2 kg, irregular cycle control, especially in the first three months, breast tenderness, and headaches were the main side effects. Menstrual loss was unchanged or reduced in all but seven women. The doctors and nurses on the clinic staff were less enthusiastic about this regimen than the volunteers themselves. PMID:890363

  8. The association of sibling relationship and abuse with later psychological adjustment.

    PubMed

    Mackey, Amber L; Fromuth, Mary Ellen; Kelly, David B

    2010-06-01

    This study of 59 undergraduate men and 85 undergraduate women explored how defining emotional and physical sibling abuse affected the frequency of reported sibling abuse. In addition, the current study examined how the emotional context of the sibling relationship (i.e., rivalry and conflict) moderated the relationship between sibling abuse and later psychological adjustment (i.e., depression and anxiety). Respondents completed self-report questionnaires of sibling abuse (CTS2-SP), self-labeling of sibling abuse, quality of sibling relationships (SRQ), depression (CES-D), and anxiety (ZAS). Results indicated differences in frequency of reported abuse depending on how sibling abuse was defined. Also, there were no statistically significant correlations between the CTS2-SP and measures of psychological adjustment. Although self-labeling as emotionally abused correlated with later anxiety, the emotional context of the sibling relationship did not moderate this relationship.

  9. CHANGES IN PHYSIOLOGICAL TREMOR RESULTING FROM SLEEP DEPRIVATION UNDER CONDITIONS OF INCREASING FATIGUE DURING PROLONGED MILITARY TRAINING

    PubMed Central

    Gajewski, J; Mazur–Różycka, J

    2014-01-01

    The aim of the study was to define the changes of the characteristics of physiological postural tremor under conditions of increasing fatigue and lack of sleep during prolonged military training (survival). The subjects of the study were 15 students of the Polish Air Force Academy in Dęblin. The average age was 19.9±1.3 years. During the 36-hour-long continuous military training (survival) the subjects were deprived of sleep. Four tremor measurements were carried out for each of the subjects: Day 1 – morning, after rest (measurement 0); Day 2 – morning, after overnight physical exercise (measurement 1); afternoon, after continuous sleep deprivation (measurement 2); Day 3 – morning, after a full night sleep (measurement 3). The accelerometric method using an acceleration measuring kit was applied to analyse tremor. A significant difference between mean values of the index evaluating tremor power in low frequencies L2-4 in measurement 0 and measurement 3 was observed (p<0.01). No significant differences were found in mean values of index L10-20. Mean frequencies F2-4 differed significantly from each other (F2,42=4.53; p<0.01). Their values were 2.94±0.11, 2.99±0.9, 2.93±0.07 and 2.91±0.07 for successive measurements. A gradual, significant decrease of F8-14 was observed (F2,42=5.143; p<0.01). Prolonged sleep deprivation combined with performing tasks demanding constant physical effort causes long-lasting (over 24 hours) changes of the amplitude of low-frequency tremor changes. This phenomenon may significantly influence psychomotor performance, deteriorating the ability to perform tasks requiring movement precision. PMID:25609888

  10. Prolonged Stimulation of a Brainstem Raphe Region Attenuates Experimental Autoimmune Encephalomyelitis

    PubMed Central

    Madsen, Pernille M.; Sloley, Stephanie S.; Vitores, Alberto A.; Carballosa-Gautam, Melissa M.; Brambilla, Roberta; Hentall, Ian D.

    2017-01-01

    Multiple sclerosis (MS), a neuroinflammatory disease, has few treatment options, none entirely adequate. We studied whether prolonged electrical stimulation of a hindbrain region (the nucleus raphe magnus) can attenuate experimental autoimmune encephalomyelitis, a murine model of MS induced by MOG35-55 injection. Eight days after symptoms emerged, a wireless electrical stimulator with a connectorless protruding microelectrode was implanted cranially, and daily intermittent stimulation of awake, unrestrained mice began immediately. The thoracic spinal cord was analyzed for changes in histology (on day 29) and gene expression (on day 37), with a focus on myelination and cytokine production. Controls, with inactive implants, showed a phase of disease exacerbation on days 19–25 that stimulation for >16 days eliminated. Prolonged stimulation also reduced infiltrating immune cells and increased numbers of myelinated axons. It additionally lowered gene expression for some pro-inflammatory cytokines (interferon gamma and tumor necrosis factor) and for platelet-derived growth factor receptor alpha, a marker of oligodendrocyte precursors, while raising it for myelin basic protein. Restorative treatments for MS might profitably consider ways to stimulate the raphe magnus, directly or via its inputs, or to emulate its serotonergic and peptidergic output. PMID:28147248

  11. Effects of prolonged agmatine treatment in aged male Sprague-Dawley rats.

    PubMed

    Rushaidhi, M; Zhang, H; Liu, P

    2013-03-27

    Increasing evidence suggests that altered arginine metabolism contributes to cognitive decline during ageing. Agmatine, decarboxylated arginine, has a variety of pharmacological effects, including the modulation of behavioural function. A recent study demonstrated the beneficial effects of short-term agmatine treatment in aged rats. The present study investigated how intraperitoneal administration of agmatine (40mg/kg, once daily) over 4-6weeks affected behavioural function and neurochemistry in aged Sprague-Dawley rats. Aged rats treated with saline displayed significantly reduced exploratory activity in the open field, impaired spatial learning and memory in the water maze and object recognition memory relative to young rats. Prolonged agmatine treatment improved animals' performance in the reversal test of the water maze and object recognition memory test, and significantly suppressed age-related elevation in nitric oxide synthase activity in the dentate gyrus of the hippocampus and prefrontal cortex. However, this prolonged supplementation was unable to improve exploratory activity and spatial reference learning and memory in aged rats. These findings further demonstrate that exogenous agmatine selectively improves behavioural function in aged rats. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

  12. Prolonged restricted sitting effects in UH-60 helicopters.

    PubMed

    Games, Kenneth E; Lakin, Joni M; Quindry, John C; Weimar, Wendi H; Sefton, JoEllen M

    2015-01-01

    Advances in flight technologies and the demand for long-range flight have increased mission lengths for U.S. Army Black Hawk UH-60 crewmembers. Prolonged mission times have increased reports of pilot discomfort and symptoms of paresthesia thought to be due to UH-60 seat design and areas of locally high pressure. Discomfort created by the seat-system decreases situational awareness, putting aviators and support crew at risk of injury. Therefore, the purpose of this study was to examine the effects of prolonged restricted sitting in a UH-60 on discomfort, sensory function, and vascular measures in the lower extremities. There were 15 healthy men (age = 23.4 ± 3.1 yr) meeting physical flight status requirements who sat in an unpadded, UH-60 pilot's seat for 4 h while completing a common cognitive task. During the session, subjective discomfort, sensory function, and vascular function were measured. Across 4 h of restricted sitting, subjective discomfort increased using the Category Partitioning Scale (30.27 point increase) and McGill Pain Questionnaire (8.53 point increase); lower extremity sensory function was diminished along the S1 dermatome; and skin temperature decreased on both the lateral (2.85°C decrease) and anterior (2.78°C decrease) aspects of the ankle. The results suggest that prolonged sitting in a UH-60 seat increases discomfort, potentially through a peripheral nervous or vascular system mechanism. Further research is needed to understand the etiology and onset of pain and paresthesia during prolonged sitting in UH-60 pilot seats. Games KE, Lakin JM, Quindry JC, Weimar WH, Sefton JM. Prolonged restricted sitting effects in UH-60 helicopters.

  13. Prolonged Particulate Hexavalent Chromium Exposure Suppresses Homologous Recombination Repair in Human Lung Cells.

    PubMed

    Browning, Cynthia L; Qin, Qin; Kelly, Deborah F; Prakash, Rohit; Vanoli, Fabio; Jasin, Maria; Wise, John Pierce

    2016-09-01

    Genomic instability is one of the primary models of carcinogenesis and a feature of almost all cancers. Homologous recombination (HR) repair protects against genomic instability by maintaining high genomic fidelity during the repair of DNA double strand breaks. The defining step of HR repair is the formation of the Rad51 nucleofilament, which facilitates the search for a homologous sequence and invasion of the template DNA strand. Particulate hexavalent chromium (Cr(VI)), a human lung carcinogen, induces DNA double strand breaks and chromosome instability. Since the loss of HR repair increases Cr(VI)-induced chromosome instability, we investigated the effect of extended Cr(VI) exposure on HR repair. We show acute (24 h) Cr(VI) exposure induces a normal HR repair response. In contrast, prolonged (120 h) exposure to particulate Cr(VI) inhibited HR repair and Rad51 nucleofilament formation. Prolonged Cr(VI) exposure had a profound effect on Rad51, evidenced by reduced protein levels and Rad51 mislocalization to the cytoplasm. The response of proteins involved in Rad51 nuclear import and nucleofilament formation displayed varying responses to prolonged Cr(VI) exposure. BRCA2 formed nuclear foci after prolonged Cr(VI) exposure, while Rad51C foci formation was suppressed. These results suggest that particulate Cr(VI), a major chemical carcinogen, inhibits HR repair by targeting Rad51, causing DNA double strand breaks to be repaired by a low fidelity, Rad51-independent repair pathway. These results further enhance our understanding of the underlying mechanism of Cr(VI)-induced chromosome instability and thus, carcinogenesis. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Fetal brain hypometabolism during prolonged hypoxaemia in the llama

    PubMed Central

    Ebensperger, Germán; Ebensperger, Renato; Herrera, Emilio A; Riquelme, Raquel A; Sanhueza, Emilia M; Lesage, Florian; Marengo, Juan J; Tejo, Rodrigo I; Llanos, Aníbal J; Reyes, Roberto V

    2005-01-01

    In this study we looked for additional evidence to support the hypothesis that fetal llama reacts to hypoxaemia with adaptive brain hypometabolism. We determined fetal llama brain temperature, Na+ and K+ channel density and Na+–K+-ATPase activity. Additionally, we looked to see whether there were signs of cell death in the brain cortex of llama fetuses submitted to prolonged hypoxaemia. Ten fetal llamas were instrumented under general anaesthesia to measure pH, arterial blood gases, mean arterial pressure, heart rate, and brain and core temperatures. Measurements were made 1 h before and every hour during 24 h of hypoxaemia (n = 5), which was imposed by reducing maternal inspired oxygen fraction to reach a fetal arterial partial pressure of oxygen (Pa,O2) of about 12 mmHg. A normoxaemic group was the control (n = 5). After 24 h of hypoxaemia, we determined brain cortex Na+–K+-ATPase activity, ouabain binding, and the expression of NaV1.1, NaV1.2, NaV1.3, NaV1.6, TREK1, TRAAK and KATP channels. The lack of brain cortex damage was assessed as poly ADP-ribose polymerase (PARP) proteolysis. We found a mean decrease of 0.56°C in brain cortex temperature during prolonged hypoxaemia, which was accompanied by a 51% decrease in brain cortex Na+–K+-ATPase activity, and by a 44% decrease in protein content of NaV1.1, a voltage-gated Na+ channel. These changes occurred in absence of changes in PARP protein degradation, suggesting that the cell death of the brain was not enhanced in the fetal llama during hypoxaemia. Taken together, these results provide further evidence to support the hypothesis that the fetal llama responds to prolonged hypoxaemia with adaptive brain hypometabolism, partly mediated by decreases in Na+–K+-ATPase activity and expression of NaV channels. PMID:16037083

  15. Effects of high frequency current in welding aluminum alloy 6061

    NASA Technical Reports Server (NTRS)

    Fish, R. E.

    1968-01-01

    Uncontrolled high frequency current causes cracking in the heat-affected zone of aluminum alloy 6061 weldments during tungsten inert gas ac welding. Cracking developed when an improperly adjusted superimposed high frequency current was agitating the semimolten metal in the areas of grain boundary.

  16. Relation between Severity of Chronic Illness and Adjustment in Children and Adolescents with Sickle Cell Disease.

    ERIC Educational Resources Information Center

    Hurtig, Anita Landau; And Others

    1989-01-01

    The study with 70 children and adolescents with sickle cell disease did not support the hypothesis that illness severity (measured by frequency of hospitalization) would affect adjustment (measured by IQ, self-esteem, social and personal adjustment, behavioral problems, school performance, and peer relations). (Author/DB)

  17. Reduced intrinsic heart rate is associated with reduced arrhythmic susceptibility in guinea-pig heart.

    PubMed

    Osadchii, Oleg E

    2014-12-01

    In the clinical setting, patients with slower resting heart rate are less prone to cardiovascular death compared with those with elevated heart rate. However, electrophysiological adaptations associated with reduced cardiac rhythm have not been thoroughly explored. In this study, relationships between intrinsic heart rate and arrhythmic susceptibility were examined by assessments of action potential duration (APD) rate adaptation and inducibility of repolarization alternans in sinoatrial node (SAN)-driven and atrioventricular (AV)-blocked guinea-pig hearts perfused with Langendorff apparatus. Electrocardiograms, epicardial monophasic action potentials, and effective refractory periods (ERP) were assessed in normokalemic and hypokalemic conditions. Slower basal heart rate in AV-blocked hearts was associated with prolonged ventricular repolarization during spontaneous beating, and with attenuated APD shortening at increased cardiac activation rates during dynamic pacing, when compared with SAN-driven hearts. During hypokalemic perfusion, the inducibility of repolarization alternans and tachyarrhythmia by rapid pacing was found to be lower in AV-blocked hearts. This difference was ascribed to prolonged ERP in the setting of reduced basal heart rate, which prevented ventricular capture at critically short pacing intervals required to induce arrhythmia. Reduced basal heart rate is associated with electrophysiological changes that prevent electrical instability upon an abrupt cardiac acceleration.

  18. Tunable single frequency fiber laser based on FP-LD injection locking.

    PubMed

    Zhang, Aiqin; Feng, Xinhuan; Wan, Minggui; Li, Zhaohui; Guan, Bai-ou

    2013-05-20

    We propose and demonstrate a tunable single frequency fiber laser based on Fabry Pérot laser diode (FP-LD) injection locking. The single frequency operation principle is based on the fact that the output from a FP-LD injection locked by a multi-longitudinal-mode (MLM) light can have fewer longitudinal-modes number and narrower linewidth. By inserting a FP-LD in a fiber ring laser cavity, single frequency operation can be possibly achieved when stable laser oscillation established after many roundtrips through the FP-LD. Wavelength switchable single frequency lasing can be achieved by adjusting the tunable optical filter (TOF) in the cavity to coincide with different mode of the FP-LD. By adjustment of the drive current of the FP-LD, the lasing modes would shift and wavelength tunable operation can be obtained. In experiment, a wavelength tunable range of 32.4 nm has been obtained by adjustment of the drive current of the FP-LD and a tunable filter in the ring cavity. Each wavelength has a side-mode suppression ratio (SMSR) of at least 41 dB and a linewidth of about 13 kHz.

  19. Reducing office workers’ sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial

    PubMed Central

    2013-01-01

    Background Excessive time spent in sedentary behaviours (sitting or lying with low energy expenditure) is associated with an increased risk for type 2 diabetes, cardiovascular disease and some cancers. Desk-based office workers typically accumulate high amounts of daily sitting time, often in prolonged unbroken bouts. The Stand Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting, particularly prolonged, unbroken sitting time, and results in improvements in cardio-metabolic biomarkers and work-related outcomes, compared to usual practice. Methods/Design A two-arm cluster-randomized controlled trial (RCT), with worksites as the unit of randomization, will be conducted in 16 worksites located in Victoria, Australia. Work units from one organisation (Department of Human Services, Australian Government) will be allocated to either the multi-component intervention (organisational, environmental [height-adjustable workstations], and individual behavioural strategies) or to a usual practice control group. The recruitment target is 160 participants (office-based workers aged 18–65 years and working at least 0.6 full time equivalent) per arm. At each assessment (0- [baseline], 3- [post intervention], and 12-months [follow-up]), objective measurement via the activPAL3 activity monitor will be used to assess workplace: sitting time (primary outcome); prolonged sitting time (sitting time accrued in bouts of ≥30 minutes); standing time; sit-to-stand transitions; and, moving time. Additional outcomes assessed will include: non-workplace activity; cardio-metabolic biomarkers and health indicators (including fasting glucose, lipids and insulin; anthropometric measures; blood pressure; and, musculoskeletal symptoms); and, work-related outcomes (presenteeism, absenteeism, productivity, work performance). Incremental cost-effectiveness and identification of both workplace and individual

  20. High frequency of fluoroquinolone- and macrolide-resistant streptococci among clinically isolated group B streptococci with reduced penicillin susceptibility.

    PubMed

    Kimura, Kouji; Nagano, Noriyuki; Nagano, Yukiko; Suzuki, Satowa; Wachino, Jun-ichi; Shibayama, Keigo; Arakawa, Yoshichika

    2013-03-01

    Recently several clinical isolates of Streptococcus agalactiae [also known as group B Streptococcus (GBS)] that have acquired reduced penicillin susceptibility (PRGBS) by amino acid substitutions in the penicillin-binding protein 2X have emerged. The frequency of fluoroquinolone (FQ)- and macrolide-resistant streptococci among PRGBS is not yet known. Fifty-seven GBS [19 PRGBS and 38 penicillin-susceptible GBS (PSGBS)], isolated from different medical institutions in Japan, were studied. For GBS, the MICs of penicillin G, levofloxacin and erythromycin were determined using the agar dilution method. Nineteen PRGBS were previously confirmed as genetically diverse streptococci by PFGE. Further, the mechanisms underlying penicillin, FQ and macrolide non-susceptibility/resistance were analysed. The frequency of non-susceptibility to FQs among PSGBS was 18.4% (7/38), whereas that among PRGBS was 100% (19/19). The frequency of resistance to erythromycin among PSGBS was 7.9% (3/38), while that among PRGBS was 47.4% (9/19). Statistical significance was determined using Fisher's exact test between reduced penicillin susceptibility and FQ non-susceptibility (P ≤ 0.0001) and macrolide resistance (P=0.0012). The resistance/non-susceptibility mechanisms among PRGBS were diverse, suggesting that the PRGBS examined were not clonal. PRGBS isolates tend to show resistance to FQs and/or macrolides. Because the drug choice for treating these multidrug-resistant GBS is more limited than that for usual GBS, these strains may present future public health challenges.

  1. Aldosterone-to-Renin Ratio Is Associated With Reduced 24-Hour Heart Rate Variability and QTc Prolongation in Hypertensive Patients

    PubMed Central

    Grübler, Martin R.; Kienreich, Katharina; Gaksch, Martin; Verheyen, Nicolas; Hartaigh, Bríain Ó.; Fahrleitner-Pammer, Astrid; März, Winfried; Schmid, Johannes; Oberreither, Eva-Maria; Wetzel, Julia; Catena, Cristiana; Sechi, Leonardo A.; Pieske, Burkert; Tomaschitz, Andreas; Pilz, Stefan

    2016-01-01

    Abstract Aldosterone is considered to exert direct effects on the myocardium and the sympathetic nervous system. Both QT time and heart rate (HR) variability (HRV) are considered to be markers of arrhythmic risk and autonomous dysregulation. In this study, we investigated the associations between aldosterone, QT time, and HRV in patients with arterial hypertension. We recruited 477 hypertensive patients (age: 60.2 ± 10.2 years; 52.3% females) with a mean systolic/diastolic 24-hour ambulatory blood pressure monitoring (ABPM) value of 128 ± 12.8/77.1 ± 9.2 mmHg and with a median of 2 (IQR: 1–3) antihypertensive agents. Patients were recruited from the outpatient clinic at the Department of Internal Medicine of the Medical University of Graz, Austria. Blood samples, 24-hour HRV derived from 24-hour blood pressure monitoring (ABPM) and ECG's were obtained. Plasma aldosterone and plasma renin concentrations were measured by means of a radioimmunoassay. Twenty-four-hour urine specimens were collected in parallel with ABPM. Mean QTc was 423.3 ± 42.0 milliseconds for males and 434.7 ± 38.3 milliseconds for females. Mean 24H-HR and 24H-HRV was 71.9 ± 9.8 and 10.0 ± 3.6 bpm, respectively. In linear regression analyses adjusted for age, sex, body mass index, ABPM, and current medication, aldosterone to active renin ratio (AARR) was significantly associated with the QTc interval, a marker for cardiac repolarization abnormalities (mean = 426 ± 42.4 milliseconds; β-coefficient = 0.121; P = 0.03) as well as with the 24-hour heart rate variability a surrogate for autonomic dysfunction (median = 9.67 [IQR = 7.38–12.22 bpm]; β-coefficient = −0.133; P = 0.01). In hypertensive patients, AARR is significantly related to QTc prolongation as well as HRV. Further studies investigating the effects of mineralocorticoid receptor blocker and aldosterone synthase inhibitors on QTc and HRV are warranted

  2. Multibeam single frequency synthetic aperture radar processor for imaging separate range swaths

    NASA Technical Reports Server (NTRS)

    Jain, A. (Inventor)

    1982-01-01

    A single-frequency multibeam synthetic aperture radar for large swath imaging is disclosed. Each beam illuminates a separate ""footprint'' (i.e., range and azimuth interval). The distinct azimuth intervals for the separate beams produce a distinct Doppler frequency spectrum for each beam. After range correlation of raw data, an optical processor develops image data for the different beams by spatially separating the beams to place each beam of different Doppler frequency spectrum in a different location in the frequency plane as well as the imaging plane of the optical processor. Selection of a beam for imaging may be made in the frequency plane by adjusting the position of an aperture, or in the image plane by adjusting the position of a slit. The raw data may also be processed in digital form in an analogous manner.

  3. Prolonged anticholinergic delirium following antihistamine overdose.

    PubMed

    Scott, James; Pache, David; Keane, Greg; Buckle, Helen; O'Brien, Natalie

    2007-06-01

    A case of anticholinergic delirium in a female adolescent is described, exploring the pharmacokinetic reasons for the prolonged time course and reviewing the management provided. A 14 year old female hospitalised for depression ingested large quantities of promethazine and cyproheptadine. A severe anticholinergic delirium ensued which resolved after six days, much longer than the expected duration. The likely cause of the prolonged delirium was the interaction of promethazine and fluvoxamine through the inhibition of the CYP2D6 enzyme. The patient's young age, the severity of the poisoning and the use of drugs with anticholinergic properties to manage the delirium may also have contributed. The delirium may have been reversed had a cholinesterase inhibitor been provided soon after the overdose.

  4. The Significance of Prolonged and Saddleback Fever in Hospitalised Adult Dengue

    PubMed Central

    Thein, Tun-Linn; Leo, Yee-Sin; Lye, David C.

    2016-01-01

    Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR) confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study. Sixty-nine percent of them were male with a median age of 34 years. Prolonged fever (fever > 7 days duration) was present in 572 (20.1%) of patients. Dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and severe dengue (SD) were significantly more likely to occur in patients with prolonged fever. Mucosal bleeding, anorexia, diarrhea, abdominal pain, nausea or vomiting, lethargy, rash, clinical fluid accumulation, hepatomegaly, nosocomial infection, leukopenia, higher neutrophil count, higher hematocrit, higher alanine transaminase (ALT) and aspartate transaminase (AST), higher creatinine, lower protein and prolonged activated partial thromboplastin time (APTT) were significantly associated with prolonged fever but not platelet count or prothrombin time (PT). Saddleback fever was present in 165 (5.8%). Although DHF and SD were more likely to occur in patients in those with saddleback fever, DSS was not. Compared with prolonged fever, saddleback fever did not show many significant associations except for diarrhea, abdominal pain, clinical fluid accumulation, hematocrit and platelet change, and lower systolic blood pressure. This study demonstrates that prolonged fever may be associated with various warning signs and more severe forms of dengue (SD, DSS, DHF), while saddleback fever showed associations with DHF and SD but not DSS. The presence of prolonged or saddleback fever in dengue patients should therefore prompt

  5. The Significance of Prolonged and Saddleback Fever in Hospitalised Adult Dengue.

    PubMed

    Ng, Deborah Hl; Wong, Joshua Gx; Thein, Tun-Linn; Leo, Yee-Sin; Lye, David C

    2016-01-01

    Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR) confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study. Sixty-nine percent of them were male with a median age of 34 years. Prolonged fever (fever > 7 days duration) was present in 572 (20.1%) of patients. Dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and severe dengue (SD) were significantly more likely to occur in patients with prolonged fever. Mucosal bleeding, anorexia, diarrhea, abdominal pain, nausea or vomiting, lethargy, rash, clinical fluid accumulation, hepatomegaly, nosocomial infection, leukopenia, higher neutrophil count, higher hematocrit, higher alanine transaminase (ALT) and aspartate transaminase (AST), higher creatinine, lower protein and prolonged activated partial thromboplastin time (APTT) were significantly associated with prolonged fever but not platelet count or prothrombin time (PT). Saddleback fever was present in 165 (5.8%). Although DHF and SD were more likely to occur in patients in those with saddleback fever, DSS was not. Compared with prolonged fever, saddleback fever did not show many significant associations except for diarrhea, abdominal pain, clinical fluid accumulation, hematocrit and platelet change, and lower systolic blood pressure. This study demonstrates that prolonged fever may be associated with various warning signs and more severe forms of dengue (SD, DSS, DHF), while saddleback fever showed associations with DHF and SD but not DSS. The presence of prolonged or saddleback fever in dengue patients should therefore prompt

  6. [Factors related to the QT prolongation in chronic renal failure].

    PubMed

    Kurosu, M; Ando, Y; Akimoto, T; Ono, S; Kusano, E; Asano, Y

    1999-04-01

    QT prolongation, a risk factor for arrhythmia and cardiac death, is observed in uremic patients. Though hypocalcemia, autonomic nerve dysfunction and cardiac hypertrophy are assumed to cause the uremic QT prolongation, the exact mechanism remains unspecified. We therefore examined factors related to the QT interval in chronic renal failure (CRF). Corrected QT interval (QTc) was significantly prolonged in CRF just before the induction of dialysis therapy (group A) compared with nephrotic syndrome with the intact or mildly impaired renal function (group B). QTc was also prolonged in acute renal failure (group C). Cardio-thoracic ratio, serum albumin and Ca correlated with QTc in group A, but not in B or C. A single HD session in group A failed to shorten QTc, despite a significant increase in serum Ca++. Autonomic dysfunction did not appear to be a major determinant of QT prolongation, since QTc was not different between diabetics and non-diabetics in group A and in chronic HD patients (group D). In group D, QTc did not correlate with SV1 + RV5 on ECG or left ventricular wall thickness (LVWT) on echocardiography. In another group of chronic HD patients (group E), there was no significant correlation between QTc and the parameters of left ventricular mass, plasma brain natriuretic peptide (BNP). However, in the patients subjected to repeated echocardiography in group D, QTc and LVWT changed in parallel. In a retrospective analysis of QTc in group D, QTc was maximally prolonged at the time of starting HD therapy, and gradually improved in the following 1-5 years in both diabetics and non-diabetics. In contrast, chronic CAPD patients (group F) revealed no improvement of QTc. Thus, uremic QT prolongation cannot be explained simply by any of the previously assumed factors, but appears to be affected by multiple factors, which are partially correctable by chronic HD therapy.

  7. Prolonged morphine treatment alters δ opioid receptor post-internalization trafficking

    PubMed Central

    Ong, E W; Xue, L; Olmstead, M C; Cahill, C M

    2015-01-01

    BACKGROUND AND PURPOSE The δ opioid receptor (DOP receptor) undergoes internalization both constitutively and in response to agonists. Previous work has shown that DOP receptors traffic from intracellular compartments to neuronal cell membranes following prolonged morphine treatment. Here, we examined the effects of prolonged morphine treatment on the post-internalization trafficking of DOP receptors. EXPERIMENTAL APPROACH Using primary cultures of dorsal root ganglia neurons, we measured the co-localization of endogenous DOP receptors with post-endocytic compartments following both prolonged and acute agonist treatments. KEY RESULTS A departure from the constitutive trafficking pathway was observed following acute DOP receptor agonist-induced internalization by deltorphin II. That is, the DOP receptor underwent distinct agonist-induced post-endocytic sorting. Following prolonged morphine treatment, constitutive DOP receptor trafficking was augmented. SNC80 following prolonged morphine treatment also caused non-constitutive DOP receptor agonist-induced post-endocytic sorting. The μ opioid receptor (MOP receptor) agonist DAMGO induced DOP receptor internalization and trafficking following prolonged morphine treatment. Finally, all of the alterations to DOP receptor trafficking induced by both DOP and MOP receptor agonists were inhibited or absent when those agonists were co-administered with a DOP receptor antagonist, SDM-25N. CONCLUSIONS AND IMPLICATIONS The results support the hypothesis that prolonged morphine treatment induces the formation of MOP–DOP receptor interactions and subsequent augmentation of the available cell surface DOP receptors, at least some of which are in the form of a MOP/DOP receptor species. The pharmacology and trafficking of this species appear to be unique compared to those of its individual constituents. LINKED ARTICLES This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other

  8. Prolonged morphine treatment alters δ opioid receptor post-internalization trafficking.

    PubMed

    Ong, E W; Xue, L; Olmstead, M C; Cahill, C M

    2015-01-01

    The δ opioid receptor (DOP receptor) undergoes internalization both constitutively and in response to agonists. Previous work has shown that DOP receptors traffic from intracellular compartments to neuronal cell membranes following prolonged morphine treatment. Here, we examined the effects of prolonged morphine treatment on the post-internalization trafficking of DOP receptors. Using primary cultures of dorsal root ganglia neurons, we measured the co-localization of endogenous DOP receptors with post-endocytic compartments following both prolonged and acute agonist treatments. A departure from the constitutive trafficking pathway was observed following acute DOP receptor agonist-induced internalization by deltorphin II. That is, the DOP receptor underwent distinct agonist-induced post-endocytic sorting. Following prolonged morphine treatment, constitutive DOP receptor trafficking was augmented. SNC80 following prolonged morphine treatment also caused non-constitutive DOP receptor agonist-induced post-endocytic sorting. The μ opioid receptor (MOP receptor) agonist DAMGO induced DOP receptor internalization and trafficking following prolonged morphine treatment. Finally, all of the alterations to DOP receptor trafficking induced by both DOP and MOP receptor agonists were inhibited or absent when those agonists were co-administered with a DOP receptor antagonist, SDM-25N. The results support the hypothesis that prolonged morphine treatment induces the formation of MOP-DOP receptor interactions and subsequent augmentation of the available cell surface DOP receptors, at least some of which are in the form of a MOP/DOP receptor species. The pharmacology and trafficking of this species appear to be unique compared to those of its individual constituents. This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2. © 2014 The Authors. British

  9. [Mechanism of neoglottic adjustment for voice variation in tracheoesophageal speech].

    PubMed

    Fujimoto, T; Kinishi, M; Mohri, M; Amatsu, M

    1994-06-01

    Over the past 17 years, we have been performing tracheoesophageal (TE) fistulization for voice restoration following total laryngectomy. The purpose of this technique is to divert the exhaled air through the TE fistula into the hypopharynx where the inferior constrictor muscle forms the retropharyngeal prominence on which the neoglottis is located. It is generally accepted that both pulmonary power and laryngeal adjustment control voice frequency and intensity change in laryngeal phonation. Regularity at various pitches and voice intensities was seen in TE phonation, despite laryngeal adjustment being lost. Regular voice production with various pitches and intensities requires a regulatory mechanism for both pulmonary power and the neoglottis. This study was designed to clarify the mechanism of neoglottic adjustment in TE phonation. Ten speakers with TE fistula were subjected to aerodynamic and electrophysiological investigations. Tracheal pressure, fundamental frequency, intensity, and airflow rate were measured for easy phonation, a high-pitched voice, and a loud voice. Resistance and efficiency of the neoglottis were calculated from the data obtained. Electromyograms of the inferior constrictor muscle and tracheal pressure were simultaneously recorded when the pitch or intensity of the voice increased. Six of the ten subjects examined were able to produce a high-pitched voice. Tracheal pressure increased in all six, the airflow rate in four, and neoglottal resistance in five, as compared with the data obtained during easy phonation. Nine of the ten subjects examined were able to produce a loud voice. In all nine, both tracheal pressure and the airflow rate increased as compared with the values measured during easy phonation. Neoglottal resistance had no definite pattern in relation to voice intensity changes. Electrophysiological study demonstrated that the activity of the inferior constrictor muscle increased as tracheal pressure increased so as to raise the

  10. Perceived social support and psychosocial adjustment in patients with coronary heart disease.

    PubMed

    Karataş, Tuğba; Bostanoğlu, Hatice

    2017-08-01

    This study was performed to assess perceived social support and psychosocial adjustment in patients with coronary heart disease. Participants were 250 patients referred to the cardiology outpatient clinic of a university hospital in Ankara, Turkey, between December 2013 and March 2014. Data were collected using a participant information form, the Multidimensional Scale of Perceived Social Support, and the Psychosocial Adjustment to Illness Scale-Self-Report. Data were analysed using frequencies, percentages, mean scores, and Pearson's correlation coefficient. Patients' mean perceived social support scores were relatively low and patients' mean scores for psychosocial adjustment considered to be poor. Subgroups in the psychosocial adjustment and social support scales were significantly associated. This study's results indicate that patients' social support is linked to their psychosocial adjustment to coronary heart disease. As psychosocial adjustment is inhibited in patients who lack sufficient social support, sources of social support of patients should be identified and facilitated. © 2017 John Wiley & Sons Australia, Ltd.

  11. Slumped glass foils as substrate for adjustable x-ray optics

    NASA Astrophysics Data System (ADS)

    Salmaso, Bianca; Basso, Stefano; Civitani, Marta; Ghigo, Mauro; Hołyszko, Joanna; Pelliciari, Carlo; Spiga, Daniele; Vecchi, Gabriele; Pareschi, Giovanni

    2016-09-01

    Thin glass modular mirrors are a viable solution to build future X-ray telescopes with high angular resolution and large collecting area. In our laboratories, we shape thin glass foils by hot slumping and we apply pressure to assist the replication of a cylindrical mould figure; this technology is coupled with an integration process able to damp low frequency errors and produces optics in the Wolter I configuration, typical for the X-ray telescopes. From the point of view of the hot slumping process, the efforts were focused in reducing low-, mid- and high- frequency errors of the formed Eagle glass foils. Some of our slumped glass foils were used for the development of active X-ray optics, where piezoelectric actuators are used to correct the slumped glass foil deviations from the ideal shape. In particular, they were used for the Adjustable X-raY optics for astrOnoMy project (AXYOM) developed in Italy, and the X-ray Surveyor mission, as developed at the Smithsonian Astrophysical Observatory / Center for Astrophysics (SAO/CfA) in USA. In this paper we describe the optimisation of the hot slumping process, comparing the results with the requirements of the considered active optics projects. Finally, since the present configuration of the Pennsylvania State University (PSU) coating equipment is limited to 100 x 100 mm2, the slumped glass foils used for the SAO project were cut from 200 x 200 mm2 to 100 x 100 mm2, and a low-frequency change was observed. A characterisation of the profile change upon cutting is presented.

  12. Impact of a resistant dextrin with a prolonged oxidation pattern on day-long ghrelin profile.

    PubMed

    Nazare, Julie-Anne; Sauvinet, Valérie; Normand, Sylvie; Guérin-Deremaux, Laetitia; Gabert, Laure; Désage, Michel; Wils, Daniel; Laville, Martine

    2011-02-01

    The effects of a new resistant dextrin ingested at breakfast on day-long metabolic parameters and ghrelin profile at subsequent lunch were investigated. In this randomized, single-blinded, crossover study, 12 healthy men ingested a standardized breakfast with 50 g of NUTRIOSE 10, a resistant dextrin (RD), or of maltodextrin (Malto) and a standardized lunch 5 hours later. Both products (RD and Malto) were derived from corn naturally rich in (13)C to follow their metabolic fate (by using stable isotope analysis). Oxidation and fermentation patterns were assessed by simultaneous (13)CO(2)/H(2) breath testing. The appearance of exogenous (13)C-glucose in plasma, glycemia, insulinemia, nonesterified fatty acids (NEFAs), and ghrelin concentrations were measured for 10 hours following breakfast ingestion. With RD, H(2) excretion (fermentation) was significantly enhanced compared with Malto, whereas the appearance of (13)CO(2) (oxidation) was significantly prolonged (p < 0.0001). Following breakfast, ghrelin secretion was significantly less inhibited and NEFA concentration was higher with RD (p < 0.05), but unexpectedly, both remained lower after lunch and up to T600 minutes. According to the reduced bioavailability of RD compared with Malto, the appearance of (13)C-glucose in plasma (p < 0.0001) and glycemic and insulinemic responses to breakfast (p < 0.05) were significantly reduced. Ingestion of this new resistant dextrin at breakfast decreased ghrelin concentrations in response to the subsequent lunch, even if the caloric load ingested at breakfast was lower. This effect may be linked to the prolonged fermentation/oxidation pattern seen in the late postprandial phase (up to 10 hours after ingestion at breakfast), and thus prolonged energy release with the resistant dextrin.

  13. Reduced dream-recall frequency in left-handed adolescents: a replication.

    PubMed

    Schredl, Michael; Beaton, Alan A; Henley-Einion, Josie; Blagrove, Mark

    2014-01-01

    The ability to recall a dream upon waking up in the morning has been linked to a broad variety of factors such as personality, creativity, sleep behaviour and cognitive function. There have been conflicting findings as to whether dream recall is related more to the right or to the left hemisphere, and conflicting findings regarding the relationship of dream-recall frequency to handedness. We have found previously that right- and mixed-handers report having more dreams than left-handers, a finding more pronounced among adolescents than adults. In the present sample of 3535 participants aged from 6 to 18 years, right-handedness and mixed/inconsistent handedness were associated with higher dream-recall frequency compared to that of left-handed persons, again especially in adolescents compared with children. Further research is required to uncover the reason for the lower frequency of dream recall by left-handers.

  14. Prolonged social withdrawal disorder: a hikikomori case in Spain.

    PubMed

    Ovejero, Santiago; Caro-Cañizares, Irene; de León-Martínez, Victoria; Baca-Garcia, Enrique

    2014-09-01

    The Japanese term hikikomori means literally 'to be confined'. Social withdrawal can be present in severe psychiatric disorders; however, in Japan, hikikomori is a defined nosologic entity. There have been only a few reported cases in occidental culture. We present a case report of a Spanish man with prolonged social withdrawal lasting for 4 years. This is a case of prolonged social withdrawal not bound to culture, as well as the second case of hikikomori reported in Spain. We propose prolonged social withdrawal disorder as a disorder not linked to culture, in contrast to hikikomori. Further documentation of this disorder is still needed to encompass all cases reported in Japan and around the world. © The Author(s) 2013.

  15. The low-frequency encoding disadvantage: Word frequency affects processing demands.

    PubMed

    Diana, Rachel A; Reder, Lynne M

    2006-07-01

    Low-frequency words produce more hits and fewer false alarms than high-frequency words in a recognition task. The low-frequency hit rate advantage has sometimes been attributed to processes that operate during the recognition test (e.g., L. M. Reder et al., 2000). When tasks other than recognition, such as recall, cued recall, or associative recognition, are used, the effects seem to contradict a low-frequency advantage in memory. Four experiments are presented to support the claim that in addition to the advantage of low-frequency words at retrieval, there is a low-frequency disadvantage during encoding. That is, low-frequency words require more processing resources to be encoded episodically than high-frequency words. Under encoding conditions in which processing resources are limited, low-frequency words show a larger decrement in recognition than high-frequency words. Also, studying items (pictures and words of varying frequencies) along with low-frequency words reduces performance for those stimuli. Copyright 2006 APA, all rights reserved.

  16. Influence of rate of change of frequency on the overall pitch of frequency-modulated tones.

    PubMed

    Gockel, H; Moore, B C; Carlyon, R P

    2001-02-01

    The mechanism(s) determining pitch may assign less weight to portions of a sound where the frequency is changing rapidly. The present experiments explored the possible effect of this on the overall pitch of frequency-modulated sounds. Pitch matches were obtained between an adjustable unmodulated sinusoid and a sinusoidal carrier that was frequency modulated using a highly asymmetric function with the form of a repeating U or inverted U shaped function. The amplitude was constant during the 400-ms presentation time of each stimulus, except for 10-ms raised-cosine onset and offset ramps. In experiment 1, the carrier level was 50 dB SPL and the geometric mean of the instantaneous frequency of the modulated carrier, fc, was either 0.5, 1, 2, or 8 kHz. The modulation rate (fm) was 5, 10, or 20 Hz. The overall depth (maximum to minimum) of the FM was 8% of fc. For all carrier frequencies, the matched frequency was shifted away from the mean carrier frequency, downwards for the U shaped function stimuli and upwards for the repeated inverted U shaped function stimuli. The shift was typically slightly greater than 1% of fc, and did not vary markedly with fc. The effect of fm was small, but there was a trend for the shifts to decrease with increasing fm for fc = 0.5 kHz and to increase with increasing fm for fc = 2 kHz. In experiment 2, the carrier level was reduced to 20 dB SL and matches were obtained only for fc = 2 kHz. Shifts in matched frequency of about 1% were still observed, but the trend for the shifts to increase with increasing fm no longer occurred. In experiment 3, matches were obtained for a 4-kHz carrier at 50 dB SPL. Shifts of about 1% again occurred, which did not vary markedly with fm. The shifts in matched frequency observed in all three experiments are not predicted by models based on the amplitude- or intensity-weighted average of instantaneous frequency (EWAIF or IWAIF). The shifts (and the pitch shifts observed earlier for two-tone complexes and for

  17. Defining futile life-prolonging treatments through Neo-Socratic Dialogue.

    PubMed

    Aizawa, Kuniko; Asai, Atsushi; Bito, Seiji

    2013-12-09

    In Japan, people are negative towards life-prolonging treatments. Laws that regulate withholding or discontinuing life-prolonging treatments and advance directives do not exist. Physicians, however, view discontinuing life-prolonging treatments negatively due to fears of police investigations. Although ministerial guidelines were announced regarding the decision process for end-of-life care in 2007, a consensus could not be reached on the definition of end-of-life and conditions for withholding treatment. We established a forum for extended discussions and consensus building on this topic. We used the Neo-Socratic Dialogue (NSD) method which promotes philosophical discussion based on a case-study to address a question and formulate a consensus and answer in a group. The question chosen for the dialogue was: "What is a life-prolonging treatment?" A series of dialogues took place over a period of one and a half days. It was carried out by three groups in 2010 and 2011. Seven participants with diverse backgrounds were recruited per group. We analyzed the content of the discussion. Based on three case studies concerning different opinions about treatment options for an older dementia patient, a patient demanding chemotherapy, and a severely ill neonate, conditions for futile life-prolonging treatment were elucidated through NSD. Such treatments are those carried out for the sole purpose of prolonging life and are detrimental to the patient, and should be decided based foremost on the patient's lack of desire for treatment, the consensus of those involved, and through social acceptance. These arguments are essentially consistent with ones on medical futility in the United States. By expressing the objective of healthcare and the requirement of social acceptance, participants were also able to elucidate issues related to the awareness of those involved and the medical environment. Compared to the end-of-life guidelines in Japan, the objective of treatment, its effects

  18. Defining futile life-prolonging treatments through Neo-Socratic Dialogue

    PubMed Central

    2013-01-01

    Background In Japan, people are negative towards life-prolonging treatments. Laws that regulate withholding or discontinuing life-prolonging treatments and advance directives do not exist. Physicians, however, view discontinuing life-prolonging treatments negatively due to fears of police investigations. Although ministerial guidelines were announced regarding the decision process for end-of-life care in 2007, a consensus could not be reached on the definition of end-of-life and conditions for withholding treatment. We established a forum for extended discussions and consensus building on this topic. Methods We used the Neo-Socratic Dialogue (NSD) method which promotes philosophical discussion based on a case-study to address a question and formulate a consensus and answer in a group. The question chosen for the dialogue was: “What is a life-prolonging treatment?” A series of dialogues took place over a period of one and a half days. It was carried out by three groups in 2010 and 2011. Seven participants with diverse backgrounds were recruited per group. We analyzed the content of the discussion. Results Based on three case studies concerning different opinions about treatment options for an older dementia patient, a patient demanding chemotherapy, and a severely ill neonate, conditions for futile life-prolonging treatment were elucidated through NSD. Such treatments are those carried out for the sole purpose of prolonging life and are detrimental to the patient, and should be decided based foremost on the patient’s lack of desire for treatment, the consensus of those involved, and through social acceptance. These arguments are essentially consistent with ones on medical futility in the United States. By expressing the objective of healthcare and the requirement of social acceptance, participants were also able to elucidate issues related to the awareness of those involved and the medical environment. Compared to the end-of-life guidelines in Japan, the

  19. Incorporating peer support during in vivo exposure to reverse dropout from prolonged exposure therapy for posttraumatic stress disorder: Clinical outcomes.

    PubMed

    Hernandez-Tejada, Melba A; Hamski, Stephanie; Sánchez-Carracedo, David

    2017-01-01

    Objective Prolonged exposure is characterized by reported dropout rates ranging from 25% to 40%. This premature attrition is also observed in other evidence-based treatments for posttraumatic stress disorder. While home-based telehealth delivery of prolonged exposure resolves logistical barriers to care such as travel time and cost, dropout appears unaffected. A previous study on dropouts from prolonged exposure delivered via telehealth found that Veterans, particularly those receiving care via telehealth, reported problems with in vivo exposure and that having a peer to offer support during in vivo exposure assignments might have prevented their attrition from treatment. Methods The present pilot study treatment was designed in a manner consistent with the aforementioned Veteran suggestions, specifically to involve peers offering verbal support and encouragement during in vivo exposure homework. Such a treatment modification might be particularly useful for those receiving care via telehealth, given increased difficulties with exposure reported when this treatment delivery modality is used. It was hypothesized that dropouts would agree to reengage in treatment with a peer and would subsequently evince improvement in posttraumatic stress disorder and depression scores as a result of this treatment reengagement. Results Of 82 dropouts from prolonged exposure, 29 reentered treatment when offered peer support during exposure (12 in telehealth and 17 in person). Conclusion Treatment reentry was effective insofar as indices of both posttraumatic stress disorder and depression were significantly reduced in both telehealth and in person groups, indicating that using peers in this way may be an effective means by which to return Veterans to care, and ultimately reduce symptomatology.

  20. A self-adjusting expandable GPS collar for male elk

    Treesearch

    Brian L. Dick; Scott L. Findholt; Bruce K. Johnson

    2013-01-01

    It is a challenge to use collars on male cervids because their neck size can increase substantially during the rut and also because of growth as the animal matures. We describe how to build a self-adjusting expandable collar for yearling or adult male Rocky Mountain elk (Cervus elaphus) to which very high frequency transmitters and global...

  1. The biological effect of prolonged radiation and ways of selecting new anti-radiation drugs effective in this kind of radiation injury

    NASA Technical Reports Server (NTRS)

    Rogozkin, V. D.; Chertkov, K. S.; Nikolov, I.

    1974-01-01

    The basic characteristics of prolonged radiation - increased tolerance of radiation injury - are attributed to cellular kinetics; as dose rate is reduced, the population rate is not disturbed, particularly that of stem cells which makes it possible for the organism to tolerate higher radiation loads. It is concluded that this effect makes approved radio protectors, whose effect contains an established cytostatic component, unsuitable for prolonged radiation. It is better to correct the stem pool formation process by either accelerating the proliferation of cells or limiting the effect of stimuli causing cells to lose colony forming properties.

  2. Safety and Efficacy of a Progressively Prolonged Maintenance Interval of Venom Immunotherapy.

    PubMed

    Kontou-Fili, Kalliopi; Pitsios, Constantinos; Kompoti, Evangelia; Giannakopoulos, Dionysios; Kouridakis, Spyros

    2018-01-01

    The long-term protection provided by venom immunotherapy (VIT) is related to the dose administered and to its long duration; the latter, however, becomes inconvenient for patients in countries like Greece, with many islanders or inhabitants of distant mountainous areas. Maintenance interval prolongation reduces the number of office visits - saving time and money - and as a consequence contributes to the patients' compliance. The aim of this prospective study was to evaluate the safety and efficacy of VIT on a progressively prolonged maintenance interval (PPMI). 450 venom-allergic patients were reviewed for participation in our study; all of them were initially treated with a modified rush or an ultrarush protocol using freshly reconstituted, pure venoms. Upon reaching the maintenance dose, the VIT interval was scheduled to be gradually prolonged - by 1 week each time - aiming at a maximal interval of 26 weeks. 267/450 patients consented to participate in our VIT PPMI protocol: 98 were treated with vespid(s) venom, 142 with honeybee venom, and 27 with both. The mean duration of patient follow-up was 9.1 ± 4.2 years. The majority of systemic reactions due to VIT injections occurred up to the 8-weeks PPMI; few additional reactions were documented in a small fraction (2.9%) of our patient population beyond 9 weeks and up to 16 weeks; all were caused by honeybee VIT. No reactions were observed during VIT administration at the 26-week interval. Ninety-six patients reported 204 field sting occurrences by the culprit insect. Ten systemic reactions (8 mild and 2 moderate in severity) were registered between the 9- and 18-week PPMI; the honeybee was the culprit insect in all cases. 108 field stings by the offending insect were sustained beyond the 20- and up to the 26-week PPMI; there were no reactions at all. Progressively prolonging the VIT maintenance interval up to 26 weeks appears to be safe and efficacious. © 2018 S. Karger AG, Basel.

  3. Prolongation of RBC survival in the hypophysectomized rat.

    NASA Technical Reports Server (NTRS)

    Landaw, S. A.; Bristol, S. K.

    1971-01-01

    Red blood cell (RBC) survival was prolonged in hypophysectomized rats. While the rate of random hemolysis was decreased in some hypophysectomized hosts, in all directly injected and cross-transfused hypophysectomized rat hosts, there was a significant prolongation of the phase of senescent death. In contrast, RBCs from hypophysectomized donors survived normally in normal hosts. These experiments are further evidence of a relationship between RBC aging and metabolic rate, and suggest an intimate involvement with the calorigenic hormones.

  4. Reduced nursing frequency during prolonged lactation in the mouse decreases milk production and increases mammary expression of tryptophan hydroxylase 1 (TPH1), but does not accelerate mammary gland remodeling

    USDA-ARS?s Scientific Manuscript database

    We have observed that lactating mouse dams nursed 4 times per day (4X) maintained lactation, but had lower milk yields by the weigh-suckle-weigh method, than dams nursed ad libitum (AL). Therefore, we hypothesized that decreased nursing frequency would also decrease lactation persistence, increase m...

  5. Women's experiences of becoming a mother after prolonged labour.

    PubMed

    Nystedt, Astrid; Högberg, Ulf; Lundman, Berit

    2008-08-01

    This paper is a report of a study to explore women's experiences of becoming a mother after prolonged labour. The negativity associated with a complicated labour such as prolonged labour can lead to a struggle to become a healthy mother and could restrict the process of becoming a mother. Interviews were conducted in 2004 with 10 mothers who had been through a prolonged labour with assisted vaginal or caesarean delivery 1-3 months previously. Thematic content analysis was used. Three themes were formulated, describing women's experiences as fumbling in the dark, struggling for motherhood and achieving confidence in being a mother. The difficulties and suffering involved in becoming a mother after a prolonged labour were interpreted to be like 'fumbling in the dark'. Women experienced bodily fatigue, accompanied by feelings of illness and detachment from the child. Having the child when in this condition entailed a struggle to become a mother. In spite of these experiences and the desire to achieve confidence in being a mother, the reassurance of these women regarding their capacity for motherhood was crucial: it was central to their happiness as mothers, encouraged interaction and relationship with the child, and contributed to their adaptation to motherhood. Women experiencing prolonged labour may be comparable with the experience of and recovery from illness, which could contribute to difficulties transitioning to motherhood and limit a woman's ability to be emotionally available for the child.

  6. Adjustable Nyquist-rate System for Single-Bit Sigma-Delta ADC with Alternative FIR Architecture

    NASA Astrophysics Data System (ADS)

    Frick, Vincent; Dadouche, Foudil; Berviller, Hervé

    2016-09-01

    This paper presents a new smart and compact system dedicated to control the output sampling frequency of an analogue-to-digital converters (ADC) based on single-bit sigma-delta (ΣΔ) modulator. This system dramatically improves the spectral analysis capabilities of power network analysers (power meters) by adjusting the ADC's sampling frequency to the input signal's fundamental frequency with a few parts per million accuracy. The trade-off between straightforwardness and performance that motivated the choice of the ADC's architecture are preliminary discussed. It particularly comes along with design considerations of an ultra-steep direct-form FIR that is optimised in terms of size and operating speed. Thanks to compact standard VHDL language description, the architecture of the proposed system is particularly suitable for application-specific integrated circuit (ASIC) implementation-oriented low-power and low-cost power meter applications. Field programmable gate array (FPGA) prototyping and experimental results validate the adjustable sampling frequency concept. They also show that the system can perform better in terms of implementation and power capabilities compared to dedicated IP resources.

  7. Symptoms of prolonged grief and posttraumatic stress following loss: A latent class analysis.

    PubMed

    Maccallum, Fiona; Bryant, Richard A

    2018-04-01

    Individuals vary in how they respond to bereavement. Those who experience poor bereavement outcomes often report symptoms from more than one diagnostic category. This study sought to identify groups of individuals who share similar patterns of prolonged grief disorder and posttraumatic stress disorder symptoms to determine whether these profiles are differentially related to negative appraisals thought to contribute to prolonged grief disorder and posttraumatic stress disorder symptomatology. Participants were 185 bereaved adults. Latent class analysis was used to identify subgroups of individuals who showed similar patterns of co-occurrence of prolonged grief disorder and posttraumatic stress disorder symptoms. Multinomial regression was used to examine the extent to which appraisal domains and sociodemographic and loss factors predicted class membership. Latent class analysis revealed three classes of participants: a low symptom group, a high prolonged grief disorder symptom group, and a high prolonged grief disorder and posttraumatic stress disorder symptom group. Membership of the prolonged grief disorder group and prolonged grief disorder and posttraumatic stress disorder group was predicted by higher mean negative self-related appraisals. Demographic and loss-related factors did not predict group membership. These findings have implications for understanding co-occurrence of prolonged grief disorder and posttraumatic stress disorder symptoms following bereavement. Findings are consistent with theoretical models highlighting the importance of negative self-related beliefs in prolonged grief disorder.

  8. Prolonged environmental exposure of arsenic through drinking water on the risk of hypertension and type 2 diabetes.

    PubMed

    Li, Xin; Li, Bing; Xi, Shuhua; Zheng, Quanmei; Lv, Xiuqiang; Sun, Guifan

    2013-11-01

    Prolonged exposure to inorganic arsenic has been a severe environmental public health issue worldwide in the recent decades. Increasing evidence has suggested a possible role of prolonged arsenic exposure through drinking water in the development of arsenic-induced chronic noncancer diseases, among which hypertension and type 2 diabetes (T2D) are the focus of concern. Although exposure to high levels of arsenic has been reported to be associated with excess risk of hypertension or T2D in a dose-dependent manner, the association has yet to be established, especially low-level exposure. This cross-sectional study was designed to evaluate the potential association between prolonged environmental arsenic exposure through drinking water and the prevalence of hypertension and T2D in Inner Mongolia, China, with emphasis on the assessment of low-level exposure. In this study (a total of 669 men and women), we found that the blood pressure levels were significantly correlated with cumulative arsenic exposure and that the systolic blood pressure of the subjects with arsenic exposure>50 μg/L was significantly higher than those of the subjects with <10 and 10-50 μg/L exposure. Significant prevalence of hypertension was found in the subjects of the >50 μg/L group both before and after adjustment for confounders. In addition, a significant negative relationship was found between urinary arsenic percentage of dimethylated arsenic (DMA%) and the prevalence of hypertension in the >50 μg/L group. However, low-level arsenic exposure (10-50 μg/L) was not statistically associated with hypertension. No significant difference of blood glucose was found among the groups with different arsenic exposure levels. No statistical association was found between arsenic exposure and T2D. Our findings suggested that prolonged arsenic exposure might play a role in the development of hypertension; however, only high-level arsenic was associated with the risk of hypertension. Our findings also

  9. Adaptive frequency-domain equalization in digital coherent optical receivers.

    PubMed

    Faruk, Md Saifuddin; Kikuchi, Kazuro

    2011-06-20

    We propose a novel frequency-domain adaptive equalizer in digital coherent optical receivers, which can reduce computational complexity of the conventional time-domain adaptive equalizer based on finite-impulse-response (FIR) filters. The proposed equalizer can operate on the input sequence sampled by free-running analog-to-digital converters (ADCs) at the rate of two samples per symbol; therefore, the arbitrary initial sampling phase of ADCs can be adjusted so that the best symbol-spaced sequence is produced. The equalizer can also be configured in the butterfly structure, which enables demultiplexing of polarization tributaries apart from equalization of linear transmission impairments. The performance of the proposed equalization scheme is verified by 40-Gbits/s dual-polarization quadrature phase-shift keying (QPSK) transmission experiments.

  10. Time and frequency domain characteristics of detrending-operation-based scaling analysis: Exact DFA and DMA frequency responses

    NASA Astrophysics Data System (ADS)

    Kiyono, Ken; Tsujimoto, Yutaka

    2016-07-01

    We develop a general framework to study the time and frequency domain characteristics of detrending-operation-based scaling analysis methods, such as detrended fluctuation analysis (DFA) and detrending moving average (DMA) analysis. In this framework, using either the time or frequency domain approach, the frequency responses of detrending operations are calculated analytically. Although the frequency domain approach based on conventional linear analysis techniques is only applicable to linear detrending operations, the time domain approach presented here is applicable to both linear and nonlinear detrending operations. Furthermore, using the relationship between the time and frequency domain representations of the frequency responses, the frequency domain characteristics of nonlinear detrending operations can be obtained. Based on the calculated frequency responses, it is possible to establish a direct connection between the root-mean-square deviation of the detrending-operation-based scaling analysis and the power spectrum for linear stochastic processes. Here, by applying our methods to DFA and DMA, including higher-order cases, exact frequency responses are calculated. In addition, we analytically investigate the cutoff frequencies of DFA and DMA detrending operations and show that these frequencies are not optimally adjusted to coincide with the corresponding time scale.

  11. Time and frequency domain characteristics of detrending-operation-based scaling analysis: Exact DFA and DMA frequency responses.

    PubMed

    Kiyono, Ken; Tsujimoto, Yutaka

    2016-07-01

    We develop a general framework to study the time and frequency domain characteristics of detrending-operation-based scaling analysis methods, such as detrended fluctuation analysis (DFA) and detrending moving average (DMA) analysis. In this framework, using either the time or frequency domain approach, the frequency responses of detrending operations are calculated analytically. Although the frequency domain approach based on conventional linear analysis techniques is only applicable to linear detrending operations, the time domain approach presented here is applicable to both linear and nonlinear detrending operations. Furthermore, using the relationship between the time and frequency domain representations of the frequency responses, the frequency domain characteristics of nonlinear detrending operations can be obtained. Based on the calculated frequency responses, it is possible to establish a direct connection between the root-mean-square deviation of the detrending-operation-based scaling analysis and the power spectrum for linear stochastic processes. Here, by applying our methods to DFA and DMA, including higher-order cases, exact frequency responses are calculated. In addition, we analytically investigate the cutoff frequencies of DFA and DMA detrending operations and show that these frequencies are not optimally adjusted to coincide with the corresponding time scale.

  12. Does Serum Homocysteine Explain the Connection Between Sexual Frequency and Cardiovascular Risk?

    PubMed

    Yang, Hui-Fang; Kao, Tung-Wei; Lin, Yuan-Yung; Shih, Mu-Tsun; Wu, Li-Wei; Liaw, Fang-Yih; Peng, Tao-Chun; Chen, Wei-Liang

    2017-07-01

    Sexual activity correlates with various health issues, and homocysteine is considered an independent risk factor for cardiovascular events and atherosclerosis. Research on the relation of sexual activity to sexual frequency and homocysteine is sparse. To examine the association between sexual frequency and homocysteine in the general population in the United States. In total, 2,267 eligible participants 20 to 59 years old who had serum homocysteine data and completed a sexual behavior questionnaire were enrolled from the National Health and Nutrition Examination Survey of 2005 to 2006. The correlation between sexual frequency and serum homocysteine levels was analyzed using a linear regression model and an extended-model approach was performed for covariate adjustment. Individuals, especially men, in the lower quartiles of sexual frequency had significantly higher serum homocysteine levels, and a sex difference was identified in subgroup analysis. In a model of quartile-based analysis after adjustment for age, sex, and race and ethnicity, the regression coefficient of the highest quartile of sexual frequency compared with the lowest quartile was -1.326 (P = .012). After further adjustment for multiple covariates, the inverse association between sexual frequency and serum homocysteine levels remained unchanged. Negative trends maintained statistical significance (P for trend < .05). In subgroup analysis by sex, a negative association between sexual frequency and serum homocysteine levels remained unchanged in men even after adjusting for multiple covariates, but not in women. Clinical physicians in primary care should support patients' sexual activity, and there are implications for health promotion programs. This is the first observational investigation stratified by sex to evaluate the correlation between sexual frequency and serum homocysteine levels. The study was a cross-sectional observational investigation and the causal relation should be evaluated in a

  13. Mechanistic insight into prolonged electromechanical delay in dyssynchronous heart failure: a computational study

    PubMed Central

    Constantino, Jason; Hu, Yuxuan; Lardo, Albert C.

    2013-01-01

    In addition to the left bundle branch block type of electrical activation, there are further remodeling aspects associated with dyssynchronous heart failure (HF) that affect the electromechanical behavior of the heart. Among the most important are altered ventricular structure (both geometry and fiber/sheet orientation), abnormal Ca2+ handling, slowed conduction, and reduced wall stiffness. In dyssynchronous HF, the electromechanical delay (EMD), the time interval between local myocyte depolarization and myofiber shortening onset, is prolonged. However, the contributions of the four major HF remodeling aspects in extending EMD in the dyssynchronous failing heart remain unknown. The goal of this study was to determine the individual and combined contributions of HF-induced remodeling aspects to EMD prolongation. We used MRI-based models of dyssynchronous nonfailing and HF canine electromechanics and constructed additional models in which varying combinations of the four remodeling aspects were represented. A left bundle branch block electrical activation sequence was simulated in all models. The simulation results revealed that deranged Ca2+ handling is the primary culprit in extending EMD in dyssynchronous HF, with the other aspects of remodeling contributing insignificantly. Mechanistically, we found that abnormal Ca2+ handling in dyssynchronous HF slows myofiber shortening velocity at the early-activated septum and depresses both myofiber shortening and stretch rate at the late-activated lateral wall. These changes in myofiber dynamics delay the onset of myofiber shortening, thus giving rise to prolonged EMD in dyssynchronous HF. PMID:23934857

  14. Sexual satisfaction, sexual compatibility, and relationship adjustment in couples: the role of sexual behaviors, orgasm, and men's discernment of women's intercourse orgasm.

    PubMed

    Klapilová, Kateřina; Brody, Stuart; Krejčová, Lucie; Husárová, Barbara; Binter, Jakub

    2015-03-01

    Research indicated that (i) vaginal orgasm consistency is associated with indices of psychological, intimate relationship, and physiological functioning, and (ii) masturbation is adversely associated with some such measures. The aim of this study was to examine the association of various dyadic and masturbation behavior frequencies and percentage of female orgasms during these activities with: (i) measures of dyadic adjustment; (ii) sexual satisfaction; and (iii) compatibility perceived by both partners. In a sample of 85 Czech long-term couples (aged 20-40; mean relationship length 5.4 years), both partners provided details of recent sexual behaviors and completed sexual satisfaction, Spanier dyadic adjustment, and Hurlbert sexual compatibility measures. Multiple regression analyses were used. The association of sexual behaviors with dyadic adjustment, sexual compatibility, and satisfaction was analyzed. In multivariate analyses, women's dyadic adjustment is independently predicted by greater vaginal orgasm consistency and lower frequency of women's masturbation. For both sexes, sexual compatibility was independently predicted by higher frequency of penile-vaginal intercourse and greater vaginal orgasm consistency. Women's sexual satisfaction score was significantly predicted by greater vaginal orgasm consistency, frequency of partner genital stimulation, and negatively with masturbation. Men's sexual satisfaction score was significantly predicted by greater intercourse frequency and any vaginal orgasm of their female partners. Concordance of partner vaginal orgasm consistency estimates was associated with greater dyadic adjustment. The findings suggest that specifically penile-vaginal intercourse frequency and vaginal orgasm consistency are associated with indices of greater intimate relationship adjustment, satisfaction, and compatibility of both partners, and that women's masturbation is independently inversely associated with measures of dyadic and personal

  15. The effect of estrogen on muscle damage biomarkers following prolonged aerobic exercise in eumenorrheic women.

    PubMed

    Williams, T; Walz, E; Lane, A R; Pebole, M; Hackney, A C

    2015-09-01

    This study assessed the influence of estrogen (E2) on muscle damage biomarkers [skeletal muscle - creatine kinase (CK); cardiac muscle - CK-MB] responses to prolonged aerobic exercise. Eumenorrheic women (n=10) who were physically active completed two 60-minute treadmill running sessions at ∼60-65% maximal intensity during low E2 (midfollicular menstrual phase) and high E2 (midluteal menstrual phase) hormonal conditions. Blood samples were collected prior to exercise (following supine rest), immediately post-, 30 min post-, and 24 hours post-exercise to determine changes in muscle biomarkers. Resting blood samples confirmed appropriate E2 hormonal levels Total CK concentrations increased following exercise and at 24 hours post-exercise were higher in the midfollicular low E2 phase (p<0.001). However, CK-MB concentrations were unaffected by E2 level or exercise (p=0.442) resulting in the ratio of CK-MB to total CK being consistently low in subject responses (i.e., indicative of skeletal muscle damage). Elevated E2 levels reduce the CK responses of skeletal muscle, but had no effect on CK-MB responses following prolonged aerobic exercise. These findings support earlier work showing elevated E2 is protective of skeletal muscle from exercise-induced damage associated with prolonged aerobic exercise.

  16. The effect of estrogen on muscle damage biomarkers following prolonged aerobic exercise in eumenorrheic women

    PubMed Central

    Walz, E; Lane, AR; Pebole, M; Hackney, AC

    2015-01-01

    This study assessed the influence of estrogen (E2) on muscle damage biomarkers [skeletal muscle - creatine kinase (CK); cardiac muscle - CK-MB] responses to prolonged aerobic exercise. Eumenorrheic women (n=10) who were physically active completed two 60-minute treadmill running sessions at ∼60-65% maximal intensity during low E2 (midfollicular menstrual phase) and high E2 (midluteal menstrual phase) hormonal conditions. Blood samples were collected prior to exercise (following supine rest), immediately post-, 30 min post-, and 24 hours post-exercise to determine changes in muscle biomarkers. Resting blood samples confirmed appropriate E2 hormonal levels Total CK concentrations increased following exercise and at 24 hours post-exercise were higher in the midfollicular low E2 phase (p<0.001). However, CK-MB concentrations were unaffected by E2 level or exercise (p=0.442) resulting in the ratio of CK-MB to total CK being consistently low in subject responses (i.e., indicative of skeletal muscle damage). Elevated E2 levels reduce the CK responses of skeletal muscle, but had no effect on CK-MB responses following prolonged aerobic exercise. These findings support earlier work showing elevated E2 is protective of skeletal muscle from exercise-induced damage associated with prolonged aerobic exercise. PMID:26424921

  17. The difficult coughing child: prolonged acute cough in children

    PubMed Central

    2013-01-01

    Cough is one of the most common symptoms that patients bring to the attention of primary care clinicians. Cough can be designated as acute (<3 weeks in duration), prolonged acute cough (3 to 8 weeks in duration) or chronic (> 8 weeks in duration). The use of the term ‘prolonged acute cough’ in a cough guideline allows a period of natural resolution to occur before further investigations are warranted. The common causes are in children with post viral or pertussis like illnesses causing the cough. Persistent bacterial bronchitis typically occurs when an initial dry acute cough due to a viral infection becomes a prolonged wet cough remaining long after the febrile illness has resolved. This cough responds to a completed course of appropriate antibiotics. PMID:23574624

  18. Correcting length-frequency distributions for imperfect detection

    USGS Publications Warehouse

    Breton, André R.; Hawkins, John A.; Winkelman, Dana L.

    2013-01-01

    Sampling gear selects for specific sizes of fish, which may bias length-frequency distributions that are commonly used to assess population size structure, recruitment patterns, growth, and survival. To properly correct for sampling biases caused by gear and other sources, length-frequency distributions need to be corrected for imperfect detection. We describe a method for adjusting length-frequency distributions when capture and recapture probabilities are a function of fish length, temporal variation, and capture history. The method is applied to a study involving the removal of Smallmouth Bass Micropterus dolomieu by boat electrofishing from a 38.6-km reach on the Yampa River, Colorado. Smallmouth Bass longer than 100 mm were marked and released alive from 2005 to 2010 on one or more electrofishing passes and removed on all other passes from the population. Using the Huggins mark–recapture model, we detected a significant effect of fish total length, previous capture history (behavior), year, pass, year×behavior, and year×pass on capture and recapture probabilities. We demonstrate how to partition the Huggins estimate of abundance into length frequencies to correct for these effects. Uncorrected length frequencies of fish removed from Little Yampa Canyon were negatively biased in every year by as much as 88% relative to mark–recapture estimates for the smallest length-class in our analysis (100–110 mm). Bias declined but remained high even for adult length-classes (≥200 mm). The pattern of bias across length-classes was variable across years. The percentage of unadjusted counts that were below the lower 95% confidence interval from our adjusted length-frequency estimates were 95, 89, 84, 78, 81, and 92% from 2005 to 2010, respectively. Length-frequency distributions are widely used in fisheries science and management. Our simple method for correcting length-frequency estimates for imperfect detection could be widely applied when mark–recapture data

  19. Physiological responses of mules on prolonged exposure to high altitude (3 650 m)

    NASA Astrophysics Data System (ADS)

    Riar, S. S.; Shankar Bhat, K.; Sen Gupta, J.

    1982-06-01

    Eight healthy male animals were inducted and kept for 2 1/2 years at 3 650 m altitude and subjected to normal work schedules. Physiological measurements viz. heart rate, blood pressure, minute ventilation, oxygen consumption, respiration rate, hemoglobin, packed cell haematocrit volume and eosinophil count were made on these animals at periodic intervals. On acute induction to an altitude of 3 650 m these animals demonstrated a sudden increase in tidal volume, a decrease in Rf and no change in VE, suggesting a decreased dead space/tidal volume ratio at altitude. However, all these changes stabilised within 3 weeks but on prolongation of stay, the physical state of these animals was adversely affected. The respiratory adjustments occurring on return to sea level appear to be a response to thermal stress. The initial increase in heart rate and blood pressure stabilised by the 2nd week.

  20. Prolonged partial epilepsy: a case report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wilson, M.A.

    1980-11-01

    The case study of a patient with prolonged partial epilepsy is presented. There was a discrepancy between the extent of the abnormality seen on the radionuclide angiogram and that seen on the static brain scan.

  1. Proliferation and differentiation of adipose tissue in prolonged lean and obese critically ill patients.

    PubMed

    Goossens, Chloë; Vander Perre, Sarah; Van den Berghe, Greet; Langouche, Lies

    2017-12-01

    In prolonged non-obese critically ill patients, preservation of adipose tissue is prioritized over that of the skeletal muscle and coincides with increased adipogenesis. However, we recently demonstrated that in obese critically ill mice, this priority was switched. In the obese, the use of abundantly available adipose tissue-derived energy substrates was preferred and counteracted muscle wasting. These observations suggest that different processes are ongoing in adipose tissue of lean vs. overweight/obese critically ill patients. We hypothesize that to preserve adipose tissue mass during critical illness, adipogenesis is increased in prolonged lean critically ill patients, but not in overweight/obese critically ill patients, who enter the ICU with excess adipose tissue. To test this, we studied markers of adipogenesis in subcutaneous and visceral biopsies of matched lean (n = 24) and overweight/obese (n = 24) prolonged critically ill patients. Secondly, to further unravel the underlying mechanism of critical illness-induced adipogenesis, local production of eicosanoid PPARγ agonists was explored, as well as the adipogenic potential of serum from matched lean (n = 20) and overweight/obese (n = 20) critically ill patients. The number of small adipocytes, PPARγ protein, and CEBPB expression were equally upregulated (p ≤ 0.05) in subcutaneous and visceral adipose tissue biopsies of lean and overweight/obese prolonged critically ill patients. Gene expression of key enzymes involved in eicosanoid production was reduced (COX1, HPGDS, LPGDS, ALOX15, all p ≤ 0.05) or unaltered (COX2, ALOX5) during critical illness, irrespective of obesity. Gene expression of PLA2G2A and ALOX15B was upregulated in lean and overweight/obese patients (p ≤ 0.05), whereas their end products, the PPARγ-activating metabolites 15s-HETE and 9-HODE, were not increased in the adipose tissue. In vitro, serum of lean and overweight/obese prolonged critically ill

  2. Effect of prophylactic fluconazole on the frequency of fungal infections, amphotericin B use, and health care costs in patients undergoing intensive chemotherapy for hematologic neoplasias.

    PubMed

    Schaffner, A; Schaffner, M

    1995-10-01

    Fungal infections are a major problem in patients with hematologic malignancy. Attempts to reduce their frequency with antifungal agents have not been successful. A double-blind, controlled, single-center trial was conducted with 96 consecutive patients undergoing 154 episodes of chemotherapy. Patients received 400 mg of fluconazole or placebo until bone marrow recovery or initiation of intravenous amphotericin B infusions. End points were amphotericin B use, fungal infection, stable neutrophil count > 0.5 x 10(9)/L, toxicity precluding further fluconazole use, and death. By Kaplan-Meier estimation, the time to initiation of amphotericin B therapy was shorter in 76 patients treated with placebo than in 75 treated with fluconazole (P = .003). Also, fluconazole reduced the number of febrile days by 20% (P = .002) and prevented oropharyngeal candidiasis (1/75 vs. 9/76, P = .018). The frequency of deep mycoses (8/76 vs. 8/75) and outcome were unaffected. Fluconazole did not have a favorable effect on infection-related health care costs and was associated with prolonged severe neutropenia (P = .01).

  3. Effects of peer victimization on psychological and academic adjustment in early adolescence.

    PubMed

    Rueger, Sandra Yu; Jenkins, Lyndsay N

    2014-03-01

    The purpose of the current study is to investigate the effects of frequency of peer victimization experiences on psychological and academic adjustment during early adolescence, with a focus on testing psychological adjustment as a mediator, as well as differences based on gender and type of victimization. The sample in this short-term longitudinal design study consists of 7th and 8th graders (n = 670, 50% male) from an ethnically and socioeconomically diverse middle school. Victimization was measured using 10 items that assessed frequency of verbal, physical, and relational victimization experiences, and outcomes were assessed with the Behavior Assessment System for Children (2nd ed.) and school records. There was support for gender differences in frequency of peer victimization experiences based on type of victimization. More specifically, boys reported higher levels of physical and verbal victimization, and girls reported higher levels of relational victimization. In addition, there were statistically significant differences between boys and girls on the relation between victimization and anxiety, attendance, and grades, with girls experiencing more maladjustment than boys in response to peer victimization. Finally, results demonstrated no gender differences in indirect effects of psychological adjustment on the relation between peer victimization and academic outcomes, whether victimization was physical, verbal, and relational. These findings highlight the importance of addressing social-emotional functioning as well as peer victimization in the schools for both boys and girls, as both affect students' academic functioning. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  4. Prolongation structures of nonlinear evolution equations. II

    NASA Technical Reports Server (NTRS)

    Estabrook, F. B.; Wahlquist, H. D.

    1976-01-01

    The prolongation structure of a closed ideal of exterior differential forms is further discussed, and its use illustrated by application to an ideal (in six dimensions) representing the cubically nonlinear Schroedinger equation. The prolongation structure in this case is explicitly given, and recurrence relations derived which support the conjecture that the structure is open - i.e., does not terminate as a set of structure relations of a finite-dimensional Lie group. We introduce the use of multiple pseudopotentials to generate multiple Baecklund transformation, and derive the double Baecklund transformation. This symmetric transformation concisely expresses the (usually conjectured) theorem of permutability, which must consequently apply to all solutions irrespective of asymptotic constraints.

  5. Peak High-Frequency HRV and Peak Alpha Frequency Higher in PTSD

    PubMed Central

    Oken, Barry S.

    2012-01-01

    Posttraumatic stress disorder (PTSD) is difficult to treat and current PTSD treatments are not effective for all people. Despite limited evidence for its efficacy, some clinicians have implemented biofeedback for PTSD treatment. As a first step in constructing an effective biofeedback treatment program, we assessed respiration, electroencephalography (EEG) and heart rate variability (HRV) as potential biofeedback parameters for a future clinical trial. This cross-sectional study included 86 veterans; 59 with and 27 without PTSD. Data were collected on EEG measures, HRV, and respiration rate during an attentive resting state. Measures were analyzed to assess sensitivity to PTSD status and the relationship to PTSD symptoms. Peak alpha frequency was higher in the PTSD group (F(1,84) = 6.14, p = 0.01). Peak high-frequency HRV was lower in the PTSD group (F(2,78) = 26.5, p<0.00005) when adjusting for respiration rate. All other EEG and HRV measures and respiration were not different between groups. Peak high-frequency HRV and peak alpha frequency are sensitive to PTSD status and may be potential biofeedback parameters for future PTSD clinical trials. PMID:23178990

  6. Effect of prolonged breast-feeding on risk of atopic dermatitis in early childhood.

    PubMed

    Hong, Soyoung; Choi, Won-Jun; Kwon, Ho-Jang; Cho, Yoon Hee; Yum, Hye Yung; Son, Dong Koog

    2014-01-01

    The effect of breast-feeding on the risk of developing atopic disease remains controversial. This study is an investigation of the effect of breast-feeding on current atopic dermatitis (AD) among Korean children. This cross-sectional study of children's histories of current AD and environmental factors was completed by the subjects' parents. The subjects included 10,383 children aged 0-13 years in Seoul, Korea, in 2008. The diagnostic criteria of the International Study of Asthma and Allergies in Childhood were applied in this study. Adjustments were performed for age, gender, maternal education, smoking in the household, relocation to a new house within 1 year of birth, and parental history of atopic disease. After adjustment for confounders, age and duration of maternal education were found to be inversely associated with the prevalence of AD. Among subjects aged ≤5 years, the prevalence of AD was positively associated with the duration of breast-feeding (p < 0.001). However, there was no significant association between AD and breast-feeding among children >5 years of age. Regardless of parental history of atopic diseases, breast-feeding >12 months was a significant risk factor for AD. The effect of breast-feeding differed by age group. Prolonged breast-feeding increased the risk of AD in children <5 years of age, regardless of parental history of atopic diseases.

  7. Testing a simple control law to reduce broadband frequency harmonic vibrations using semi-active tuned mass dampers

    NASA Astrophysics Data System (ADS)

    Moutinho, Carlos

    2015-05-01

    This paper is focused on the control problems related to semi-active tuned mass dampers (TMDs) used to reduce harmonic vibrations, specially involving civil structures. A simplified version of the phase control law is derived and its effectiveness is investigated and evaluated. The objective is to improve the functioning of control systems of this type by simplifying the measurement process and reducing the number of variables involved, making the control system more feasible and reliable. Because the control law is of ON/OFF type, combined with appropriate trigger conditions, the activity of the actuation system may be significantly reduced, which may be of few seconds a day in many practical cases, increasing the durability of the device and reducing its maintenance. Moreover, due to the ability of the control system to command the motion of the inertial mass, the semi-active TMD is relatively insensitive to its initial tuning, resulting in the capability of self-tuning and in the possibility of controlling several vibration modes of a structure over a significant broadband frequency.

  8. Fitting stress relaxation experiments with fractional Zener model to predict high frequency moduli of polymeric acoustic foams

    NASA Astrophysics Data System (ADS)

    Guo, Xinxin; Yan, Guqi; Benyahia, Lazhar; Sahraoui, Sohbi

    2016-11-01

    This paper presents a time domain method to determine viscoelastic properties of open-cell foams on a wide frequency range. This method is based on the adjustment of the stress-time relationship, obtained from relaxation tests on polymeric foams' samples under static compression, with the four fractional derivatives Zener model. The experimental relaxation function, well described by the Mittag-Leffler function, allows for straightforward prediction of the frequency-dependence of complex modulus of polyurethane foams. To show the feasibility of this approach, complex shear moduli of the same foams were measured in the frequency range between 0.1 and 16 Hz and at different temperatures between -20 °C and 20 °C. A curve was reconstructed on the reduced frequency range (0.1 Hz-1 MHz) using the time-temperature superposition principle. Very good agreement was obtained between experimental complex moduli values and the fractional Zener model predictions. The proposed time domain method may constitute an improved alternative to resonant and non-resonant techniques often used for dynamic characterization of polymers for the determination of viscoelastic moduli on a broad frequency range.

  9. Return period adjustment for runoff coefficients based on analysis in undeveloped Texas watersheds

    USGS Publications Warehouse

    Dhakal, Nirajan; Fang, Xing; Asquith, William H.; Cleveland, Theodore G.; Thompson, David B.

    2013-01-01

    The rational method for peak discharge (Qp) estimation was introduced in the 1880s. The runoff coefficient (C) is a key parameter for the rational method that has an implicit meaning of rate proportionality, and the C has been declared a function of the annual return period by various researchers. Rate-based runoff coefficients as a function of the return period, C(T), were determined for 36 undeveloped watersheds in Texas using peak discharge frequency from previously published regional regression equations and rainfall intensity frequency for return periods T of 2, 5, 10, 25, 50, and 100 years. The C(T) values and return period adjustments C(T)/C(T=10  year) determined in this study are most applicable to undeveloped watersheds. The return period adjustments determined for the Texas watersheds in this study and those extracted from prior studies of non-Texas data exceed values from well-known literature such as design manuals and textbooks. Most importantly, the return period adjustments exceed values currently recognized in Texas Department of Transportation design guidance when T>10  years.

  10. Relationships Between the Performance of Time/Frequency Standards and Navigation/Communication Systems

    NASA Technical Reports Server (NTRS)

    Hellwig, H.; Stein, S. R.; Walls, F. L.; Kahan, A.

    1978-01-01

    The relationship between system performance and clock or oscillator performance is discussed. Tradeoffs discussed include: short term stability versus bandwidth requirements; frequency accuracy versus signal acquisition time; flicker of frequency and drift versus resynchronization time; frequency precision versus communications traffic volume; spectral purity versus bit error rate, and frequency standard stability versus frequency selection and adjustability. The benefits and tradeoffs of using precise frequency and time signals are various levels of precision and accuracy are emphasized.

  11. Carry-over fluency induced by extreme prolongations: A new behavioral paradigm.

    PubMed

    Briley, P M; Barnes, M P; Kalinowski, J S

    2016-04-01

    Extreme prolongations, which can be generated via extreme delayed auditory feedback (DAF) (e.g., 250-500 ms) or mediated cognitively with timing applications (e.g., analog stopwatch) at 2 s per syllable, have long been behavioral techniques used to inhibit stuttering. Some therapies have used this rate solely to establish initial fluency, while others use extremely slowed speech to establish fluency and add other strategic techniques such as easy onsets and diaphragmatic breathing. Extreme prolongations generate effective, efficient, and immediate forward flowing fluent speech, removing the signature behaviors of discrete stuttering (i.e., syllable repetitions and audible and inaudible postural fixations). Prolonged use of extreme prolongations establishes carry-over fluency, which is spontaneous, effortless speech absent of most, if not all, overt and covert manifestations of stuttering. The creation of this immediate fluency and the immense potential of extreme prolongations to generate long periods of carry-over fluency have been overlooked by researchers and clinicians alike. Clinicians depart from these longer prolongation durations as they attempt to achieve the same fluent results at a near normal rate of speech. Clinicians assume they are re-teaching fluency and slow rates will give rise to more normal rates with less control, but without carry-over fluency, controls and cognitive mediation are always needed for the inherently unstable speech systems of persons who stutter to experience fluent speech. The assumption being that the speech system is untenable without some level of cognitive and motoric monitoring that is always necessary. The goal is omnipresent "near normal rate sounding fluency" with continuous mediation via cognitive and motoric processes. This pursuit of "normal sounding fluency" continues despite ever-present relapse. Relapse has become so common that acceptance of stuttering is the new therapy modality because relapse has come to be

  12. Chemical pleurodesis for prolonged postoperative air leak in primary spontaneous pneumothorax.

    PubMed

    How, Cheng-Hung; Tsai, Tung-Ming; Kuo, Shuenn-Wen; Huang, Pei-Ming; Hsu, Hsao-Hsun; Lee, Jang-Ming; Chen, Jin-Shing; Lai, Hong-Shiee

    2014-05-01

    Prolonged air leak is the most common complication after thoracoscopic operation for primary spontaneous pneumothorax (PSP), and the role of chemical pleurodesis in treating air leaks remains unclear. This study evaluated the safety and efficacy of chemical pleurodesis with a comparison between minocycline and OK-432. Between 1994 and 2011, 1083 PSP patients were treated by thoracoscopic operation. After the operation, patients with persistent air leak for 3 days or more were managed by minocycline or OK-432 pleurodesis. The demographic and outcome data for these patients were collected by retrospective chart review. Seventy-nine patients (7.3%) with prolonged air leak after thoracoscopy underwent minocycline pleurodesis (60 patients) or OK-432 pleurodesis (19 patients) as the primary treatment. The primary success rate was 63% (38/60) for minocycline pleurodesis and 95% (18/19) for OK-432 pleurodesis (p = 0.009). Postpleurodesis pain was common and comparable between the two groups. No major complications were noted after a total of 121 treatments. Patients undergoing primary OK-432 pleurodesis had shorter durations of postpleurodesis chest drainage (mean 8.5 vs. 2.3 days; p < 0.001) and postoperative hospital stay (mean 11.9 vs. 6.8 days; p < 0.001) than those undergoing primary minocycline pleurodesis. After a median follow-up of 16 months, recurrence was noted in one patient in the OK-432 group and none in the minocycline group. Long-term pulmonary function in the two groups was comparable. Chemical pleurodesis using OK-432 or minocycline is safe and convenient for prolonged air leak after thoracoscopic treatment for PSP. Our experience suggested that OK-432 may be more effective than minocycline in reducing air leak. Copyright © 2013. Published by Elsevier B.V.

  13. Burst-by-burst laser frequency monitor

    NASA Technical Reports Server (NTRS)

    Esproles, Carlos (Inventor)

    1994-01-01

    The invention is a system for real-time frequency monitoring and display of an RF burst where the burst frequency is analyzed and displayed on a burst-by-burst basis in order to allow for frequency control. Although the invention was made for monitoring the laser frequency of a LIDAR system, it has other applications where realtime monitoring is required. The novelty of the invention resides in the use of a counter that is reset at the beginning of each unit time of monitoring and then gated for a unit of time. The invention also has an LED bar graph for displaying the measure of frequency at the end of each unit time in either a bar length mode or a moving dot mode. In the latter mode, the operator makes necessary adjustments to maintain the dot at the center of the bar graph.

  14. IV crystalloid fluid for acute alcoholic intoxication prolongs ED length of stay.

    PubMed

    Homma, Yosuke; Shiga, Takashi; Hoshina, Yuiko; Numata, Kenji; Mizobe, Michiko; Nakashima, Yoshiyuki; Takahashi, Jin; Inoue, Tetsuya; Takahashi, Osamu; Funakoshi, Hiraku

    2018-04-01

    Acute alcohol intoxication is often treated in emergency departments by intravenous crystalloid fluid (IVF), but it is not clear that this shortens the time to achieving sobriety. The study aim was to investigate the association of IVF infusion and length of stay in the ED. This single-center retrospective cohort study was conducted in Japan and included patients aged ≥20years of age and treated for acute alcohol intoxication without or with IVF. The primary outcome was the length of the ED stay and the treatments were compared by time-to-event analysis. A total of 106 patients, 42 treated without IVF and 64 with IVF. The baseline characteristics of the two groups were similar. Kaplan-Meier analysis and the generalized Wilcoxon test found no significant difference between the two treatments in the time to ED discharge. The median time was 189 (IQR 160-230) minutes without IVF and 254.5 (203-267 minutes with IVF; p=0.052). A Cox proportional hazards regression model adjusted for potential confounding variables found that patients treated with IVF were less likely to be discharged earlier than those treated without IVF (HR 0.54, 95% CI: 0.35-0.84, p=0.006). IVF for treatment of acute alcoholic intoxication prolonged ED length of stay even after adjustment for potential confounders. Patients given IVF for acute alcohol intoxication should be selected with care. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Reflections on societal change, adjustments, and responses.

    PubMed

    Friedlander, D; Okun, B

    2009-04-01

    Building on Davis (1963) and subsequent work, we propose a conceptual framework that provides a guide for the organization of empirical demographic research. Our approach is based on the notion that changes in nuptiality, fertility, and migration are not objectives in and of themselves, but means for reducing welfare gaps - defined as the gaps between actual welfare and that which could be attained with altered demographic and/or other behavior. We clarify theoretical issues concerning three levels of analysis. At the highest level, societal change leads to welfare gaps for families and/or individuals. In turn, behavioral adjustments are made to reduce these gaps. Finally, demographic responses at the community level result when large numbers of families and/or individuals adjust behavior in a particular manner. We consider and exemplify relationships among demographic and other responses in historical, agricultural contexts.

  16. Diverse definitions of prolonged labour and its consequences with sometimes subsequent inappropriate treatment.

    PubMed

    Nystedt, Astrid; Hildingsson, Ingegerd

    2014-07-16

    Prolonged labour very often causes suffering from difficulties that may have lifelong implications. This study aimed to explore the prevalence and treatment of prolonged labour and to compare birth outcome and women's experiences of prolonged and normal labour. Women with spontaneous onset of labour, living in a Swedish county, were recruited two months after birth, to a cross-sectional study. Women (n = 829) completed a questionnaire that investigated socio-demographic and obstetric background, birth outcome and women's feelings and experiences of birth. The prevalence of prolonged labour, as defined by a documented ICD-code and inspection of partogram was calculated. Four groups were identified; women with prolonged labour as identified by documented ICD-codes or by partogram inspection but no ICD-code; women with normal labour augmented with oxytocin or not. Every fifth woman experienced a prolonged labour. The prevalence with the documented ICD-code was (13%) and without ICD-code but positive partogram was (8%). Seven percent of women with prolonged labour were not treated with oxytocin. Approximately one in three women (28%) received oxytocin augmentation despite having no evidence of prolonged labour. The length of labour differed between the four groups of women, from 7 to 23 hours.Women with a prolonged labour had a negative birth experience more often (13%) than did women who had a normal labour (3%) (P <0.00). The factors that contributed most strongly to a negative birth experience in women with prolonged labour were emergency Caesarean section (OR 9.0, 95% CI 1.2-3.0) and to strongly agree with the following statement 'My birth experience made me decide not to have any more children' (OR 41.3, 95% CI 4.9-349.6). The factors that contributed most strongly to a negative birth experience in women with normal labour were less agreement with the statement 'It was exiting to give birth' (OR 0.13, 95% CI 0.34-0.5). There is need for increased clinical skill in

  17. Identifying QT prolongation from ECG impressions using a general-purpose Natural Language Processor

    PubMed Central

    Denny, Joshua C.; Miller, Randolph A.; Waitman, Lemuel Russell; Arrieta, Mark; Peterson, Joshua F.

    2009-01-01

    Objective Typically detected via electrocardiograms (ECGs), QT interval prolongation is a known risk factor for sudden cardiac death. Since medications can promote or exacerbate the condition, detection of QT interval prolongation is important for clinical decision support. We investigated the accuracy of natural language processing (NLP) for identifying QT prolongation from cardiologist-generated, free-text ECG impressions compared to corrected QT (QTc) thresholds reported by ECG machines. Methods After integrating negation detection to a locally-developed natural language processor, the KnowledgeMap concept identifier, we evaluated NLP-based detection of QT prolongation compared to the calculated QTc on a set of 44,318 ECGs obtained from hospitalized patients. We also created a string query using regular expressions to identify QT prolongation. We calculated sensitivity and specificity of the methods using manual physician review of the cardiologist-generated reports as the gold standard. To investigate causes of “false positive” calculated QTc, we manually reviewed randomly selected ECGs with a long calculated QTc but no mention of QT prolongation. Separately, we validated the performance of the negation detection algorithm on 5,000 manually-categorized ECG phrases for any medical concept (not limited to QT prolongation) prior to developing the NLP query for QT prolongation. Results The NLP query for QT prolongation correctly identified 2,364 of 2,373 ECGs with QT prolongation with a sensitivity of 0.996 and a positive predictive value of 1.000. There were no false positives. The regular expression query had a sensitivity of 0.999 and positive predictive value of 0.982. In contrast, the positive predictive value of common QTc thresholds derived from ECG machines was 0.07–0.25 with corresponding sensitivities of 0.994–0.046. The negation detection algorithm had a recall of 0.973 and precision of 0.982 for 10,490 concepts found within ECG impressions

  18. Diverse definitions of prolonged labour and its consequences with sometimes subsequent inappropriate treatment

    PubMed Central

    2014-01-01

    Background Prolonged labour very often causes suffering from difficulties that may have lifelong implications. This study aimed to explore the prevalence and treatment of prolonged labour and to compare birth outcome and women’s experiences of prolonged and normal labour. Method Women with spontaneous onset of labour, living in a Swedish county, were recruited two months after birth, to a cross-sectional study. Women (n = 829) completed a questionnaire that investigated socio-demographic and obstetric background, birth outcome and women’s feelings and experiences of birth. The prevalence of prolonged labour, as defined by a documented ICD-code and inspection of partogram was calculated. Four groups were identified; women with prolonged labour as identified by documented ICD-codes or by partogram inspection but no ICD-code; women with normal labour augmented with oxytocin or not. Results Every fifth woman experienced a prolonged labour. The prevalence with the documented ICD-code was (13%) and without ICD-code but positive partogram was (8%). Seven percent of women with prolonged labour were not treated with oxytocin. Approximately one in three women (28%) received oxytocin augmentation despite having no evidence of prolonged labour. The length of labour differed between the four groups of women, from 7 to 23 hours. Women with a prolonged labour had a negative birth experience more often (13%) than did women who had a normal labour (3%) (P <0.00). The factors that contributed most strongly to a negative birth experience in women with prolonged labour were emergency Caesarean section (OR 9.0, 95% CI 1.2-3.0) and to strongly agree with the following statement ‘My birth experience made me decide not to have any more children’ (OR 41.3, 95% CI 4.9-349.6). The factors that contributed most strongly to a negative birth experience in women with normal labour were less agreement with the statement ‘It was exiting to give birth’ (OR 0.13, 95% CI 0

  19. Context-specific adjustment of cognitive control: Transfer of adaptive control sets.

    PubMed

    Surrey, Caroline; Dreisbach, Gesine; Fischer, Rico

    2017-11-01

    Cognitive control protects processing of relevant information from interference by irrelevant information. The level of this processing selectivity can be flexibly adjusted to different control demands (e.g., frequency of conflict) associated with a certain context, leading to the formation of specific context-control associations. In the present study we investigated the robustness and transferability of the acquired context-control demands to new situations. In three experiments, we used a version of the context-specific proportion congruence (CSPC) paradigm, in which each context (e.g., location) is associated with a specific conflict frequency, determining high and low control demands. In a learning phase, associations between context and control demands were established. In a subsequent transfer block, stimulus-response mappings, whole task sets, or context-control demands changed. Results showed an impressive robustness of context-control associations, as context-specific adjustments of control from the learning phase were virtually unaffected by new stimuli and tasks in the transfer block. Only a change of the context-control demand eliminated the context-specific adjustment of control. These findings suggest that context-control associations that have proven to be adaptive in the past are continuously applied despite major changes in the task structure as long as the context-control associations remain the same.

  20. Neurally adjusted ventilatory assist in patients with acute respiratory failure: study protocol for a randomized controlled trial.

    PubMed

    Villar, Jesús; Belda, Javier; Blanco, Jesús; Suarez-Sipmann, Fernando; Añón, José Manuel; Pérez-Méndez, Lina; Ferrando, Carlos; Parrilla, Dácil; Montiel, Raquel; Corpas, Ruth; González-Higueras, Elena; Pestaña, David; Martínez, Domingo; Fernández, Lorena; Soro, Marina; García-Bello, Miguel Angel; Fernández, Rosa Lidia; Kacmarek, Robert M

    2016-10-13

    Patient-ventilator asynchrony is a common problem in mechanically ventilated patients with acute respiratory failure. It is assumed that asynchronies worsen lung function and prolong the duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) is a novel approach to MV based on neural respiratory center output that is able to trigger, cycle, and regulate the ventilatory cycle. We hypothesized that the use of NAVA compared to conventional lung-protective MV will result in a reduction of the duration of MV. It is further hypothesized that NAVA compared to conventional lung-protective MV will result in a decrease in the length of ICU and hospital stay, and mortality. This is a prospective, multicenter, randomized controlled trial in 306 mechanically ventilated patients with acute respiratory failure from several etiologies. Only patients ventilated for less than 5 days, and who are expected to require prolonged MV for an additional 72 h or more and are able to breathe spontaneously, will be considered for enrollment. Eligible patients will be randomly allocated to two ventilatory arms: (1) conventional lung-protective MV (n = 153) and conventional lung-protective MV with NAVA (n = 153). Primary outcome is the number of ventilator-free days, defined as days alive and free from MV at day 28 after endotracheal intubation. Secondary outcomes are total length of MV, and ICU and hospital mortality. This is the first randomized clinical trial examining, on a multicenter scale, the beneficial effects of NAVA in reducing the dependency on MV of patients with acute respiratory failure. ClinicalTrials.gov website ( NCT01730794 ). Registered on 15 November 2012.

  1. Prolonged fasting activates Nrf2 in post-weaned elephant seals

    PubMed Central

    Vázquez-Medina, José Pablo; Soñanez-Organis, José G.; Rodriguez, Ruben; Viscarra, Jose A.; Nishiyama, Akira; Crocker, Daniel E.; Ortiz, Rudy M.

    2013-01-01

    SUMMARY Elephant seals naturally experience prolonged periods of absolute food and water deprivation (fasting). In humans, rats and mice, prolonged food deprivation activates the renin–angiotensin system (RAS) and increases oxidative damage. In elephant seals, prolonged fasting activates RAS without increasing oxidative damage likely due to an increase in antioxidant defenses. The mechanism leading to the upregulation of antioxidant defenses during prolonged fasting remains elusive. Therefore, we investigated whether prolonged fasting activates the redox-sensitive transcription factor Nrf2, which controls the expression of antioxidant genes, and if such activation is potentially mediated by systemic increases in RAS. Blood and skeletal muscle samples were collected from seals fasting for 1, 3, 5 and 7 weeks. Nrf2 activity and nuclear content increased by 76% and 167% at week 7. Plasma angiotensin II (Ang II) and transforming growth factor β (TGF-β) were 5000% and 250% higher at week 7 than at week 1. Phosphorylation of Smad2, an effector of Ang II and TGF signaling, increased by 120% at week 7 and by 84% in response to intravenously infused Ang II. NADPH oxidase 4 (Nox4) mRNA expression, which is controlled by smad proteins, increased 430% at week 7, while Nox4 protein expression, which can activate Nrf2, was 170% higher at week 7 than at week 1. These results demonstrate that prolonged fasting activates Nrf2 in elephant seals and that RAS stimulation can potentially result in increased Nox4 through Smad phosphorylation. The results also suggest that Nox4 is essential to sustain the hormetic adaptive response to oxidative stress in fasting seals. PMID:23619404

  2. Prolonged fasting activates Nrf2 in post-weaned elephant seals.

    PubMed

    Vázquez-Medina, José Pablo; Soñanez-Organis, José G; Rodriguez, Ruben; Viscarra, Jose A; Nishiyama, Akira; Crocker, Daniel E; Ortiz, Rudy M

    2013-08-01

    Elephant seals naturally experience prolonged periods of absolute food and water deprivation (fasting). In humans, rats and mice, prolonged food deprivation activates the renin-angiotensin system (RAS) and increases oxidative damage. In elephant seals, prolonged fasting activates RAS without increasing oxidative damage likely due to an increase in antioxidant defenses. The mechanism leading to the upregulation of antioxidant defenses during prolonged fasting remains elusive. Therefore, we investigated whether prolonged fasting activates the redox-sensitive transcription factor Nrf2, which controls the expression of antioxidant genes, and if such activation is potentially mediated by systemic increases in RAS. Blood and skeletal muscle samples were collected from seals fasting for 1, 3, 5 and 7 weeks. Nrf2 activity and nuclear content increased by 76% and 167% at week 7. Plasma angiotensin II (Ang II) and transforming growth factor β (TGF-β) were 5000% and 250% higher at week 7 than at week 1. Phosphorylation of Smad2, an effector of Ang II and TGF signaling, increased by 120% at week 7 and by 84% in response to intravenously infused Ang II. NADPH oxidase 4 (Nox4) mRNA expression, which is controlled by smad proteins, increased 430% at week 7, while Nox4 protein expression, which can activate Nrf2, was 170% higher at week 7 than at week 1. These results demonstrate that prolonged fasting activates Nrf2 in elephant seals and that RAS stimulation can potentially result in increased Nox4 through Smad phosphorylation. The results also suggest that Nox4 is essential to sustain the hormetic adaptive response to oxidative stress in fasting seals.

  3. Chronic Ketamine Reduces the Peak Frequency of Gamma Oscillations in Mouse Prefrontal Cortex Ex vivo.

    PubMed

    McNally, James M; McCarley, Robert W; Brown, Ritchie E

    2013-01-01

    Abnormalities in EEG gamma band oscillations (GBO, 30-80 Hz) serve as a prominent biomarker of schizophrenia (Sz), associated with positive, negative, and cognitive symptoms. Chronic, subanesthetic administration of antagonists of N-methyl-D-aspartate receptors (NMDAR), such as ketamine, elicits behavioral effects, and alterations in cortical interneurons similar to those observed in Sz. However, the chronic effects of ketamine on neocortical GBO are unknown. Thus, here we examine the effects of chronic (five daily i.p. injections) application of ketamine (5 and 30 mg/kg) and the more specific NMDAR antagonist, MK-801 (0.02, 0.5, and 2 mg/kg), on neocortical GBO ex vivo. Oscillations were generated by focal application of the glutamate receptor agonist, kainate (KA), in coronal brain slices containing the prelimbic cortex. This region constitutes the rodent analog of the human dorsolateral prefrontal cortex, a brain region strongly implicated in Sz-pathophysiology. Here we report the novel finding that chronic ketamine elicits a reduction in the peak oscillatory frequency of KA-elicited oscillations (from 47 to 40 Hz at 30 mg/kg). Moreover, the power of GBO in the 40-50 Hz band was reduced. These findings are reminiscent of both the reduced resonance frequency and power of cortical oscillations observed in Sz clinical studies. Surprisingly, MK-801 had no significant effect, suggesting care is needed when equating Sz-like behavioral effects elicited by different NMDAR antagonists to alterations in GBO activity. We conclude that chronic ketamine in the mouse mimics GBO abnormalities observed in Sz patients. Use of this ex vivo slice model may be useful in testing therapeutic compounds which rescue these GBO abnormalities.

  4. AORN Ergonomic Tool 4: Solutions for Prolonged Standing in Perioperative Settings.

    PubMed

    Hughes, Nancy L; Nelson, Audrey; Matz, Mary W; Lloyd, John

    2011-06-01

    Prolonged standing during surgical procedures poses a high risk of causing musculoskeletal disorders, including back, leg, and foot pain, which can be chronic or acute in nature. Ergonomic Tool 4: Solutions for Prolonged Standing in Perioperative Settings provides recommendations for relieving the strain of prolonged standing, including the use of antifatigue mats, supportive footwear, and sit/stand stools, that are based on well-accepted ergonomic safety concepts, current research, and access to new and emerging technology. Published by Elsevier Inc.

  5. Reducing Aggressive Behavior and Increasing Motivation in School: The Evolution of an Intervention to Strengthen School Adjustment

    ERIC Educational Resources Information Center

    Hudley, Cynthia; Graham, Sandra; Taylor, April

    2007-01-01

    The pervasive links between problem behaviors and school adjustment suggest that effective intervention programs to enhance school adjustment must focus both on decreasing the motivation to aggress and increasing the motivation to achieve. We describe a program of intervention research to improve social behavior and academic motivation in…

  6. Positive effects of Red Bull® Energy Drink on driving performance during prolonged driving.

    PubMed

    Mets, Monique A J; Ketzer, Sander; Blom, Camilla; van Gerven, Maartje H; van Willigenburg, Gitta M; Olivier, Berend; Verster, Joris C

    2011-04-01

    The purpose of this study was to examine if Red Bull® Energy Drink can counteract sleepiness and driving impairment during prolonged driving. Twenty-four healthy volunteers participated in this double-blind placebo-controlled crossover study. After 2 h of highway driving in the STISIM driving simulator, subjects had a 15-min break and consumed Red Bull® Energy Drink (250 ml) or placebo (Red Bull® Energy Drink without the functional ingredients: caffeine, taurine, glucuronolactone, B vitamins (niacin, pantothenic acid, B6, B12), and inositol) before driving for two additional hours. A third condition comprised 4 h of uninterrupted driving. Primary parameter was the standard deviation of lateral position (SDLP), i.e., the weaving of the car. Secondary parameters included SD speed, subjective driving quality, sleepiness, and mental effort to perform the test. No significant differences were observed during the first 2 h of driving. Red Bull® Energy Drink significantly improved driving relative to placebo: SDLP was significantly reduced during the 3rd (p < 0.046) and 4th hour of driving (p < 0.011). Red Bull® Energy Drink significantly reduced the standard deviation of speed (p < 0.004), improved subjective driving quality (p < 0.0001), and reduced mental effort to perform the test (p < 0.024) during the 3rd hour of driving. Subjective sleepiness was significantly decreased during both the 3rd and 4th hour of driving after Red Bull® Energy Drink (p < 0.001 and p < 0.009, respectively). Relative to uninterrupted driving, Red Bull® Energy Drink significantly improved each parameter. Red Bull® Energy Drink significantly improves driving performance and reduces driver sleepiness during prolonged highway driving.

  7. Effects of OPC-51803, a novel, nonpeptide vasopressin V2-receptor agonist, on micturition frequency in Brattleboro and aged rats.

    PubMed

    Nakamura, Shigeki; Hirano, Takahiro; Yamamura, Yoshitaka; Itoh, Shuji; Kondo, Kazumi; Mori, Toyoki; Kambe, Toshimi

    2003-12-01

    We assessed the effects of OPC-51803 ((5R)-2-[1-(2-chloro-4-(1-pyrrolidinyl)benzoyl)-2,3,4,5-tetrahydro-1H-1-benzazepin-5-yl]-N-isopropylacetamide), a nonpeptide vasopressin V(2)-receptor agonist, on micturition frequency in female homozygous Brattleboro rats (strain carries hereditary diabetes insipidus) and aged male Sprague-Dawley rats with polyuria. Female homozygous Brattleboro rats exhibited more diuresis and a larger micturition frequency over a 24-h period than did the heterozygous controls. In Brattleboro rats, an oral administration of OPC-51803 at 0.03 and 0.3 mg/kg significantly decreased urinary frequency and was accompanied by decreased urine volume. However, little effect was seen in the mean and maximal micturition volume. Aged male Sprague-Dawley rats (25-month-old) showed a significant increase in urine volume throughout a 0- to 24-h period compared with mature (6-month-old) rats. Orally administered OPC-51803 at 0.3 mg/kg decreased not only urine volume but also urinary frequency in aged rats. Furthermore, OPC-51803 prolonged the time prior to the first micturition. Therefore, OPC-51803 decreased micturition frequency in both rat species by reducing urine outflow. This suggests that the compound will be useful for treating micturition disorders that result in frequent micturition, such as that from polyuria, nocturnal polyuria, and some kinds of urinary incontinence.

  8. Randomized trial of a dual-hormone artificial pancreas with dosing adjustment during exercise compared with no adjustment and sensor-augmented pump therapy.

    PubMed

    Jacobs, P G; El Youssef, J; Reddy, R; Resalat, N; Branigan, D; Condon, J; Preiser, N; Ramsey, K; Jones, M; Edwards, C; Kuehl, K; Leitschuh, J; Rajhbeharrysingh, U; Castle, J R

    2016-11-01

    To test whether adjusting insulin and glucagon in response to exercise within a dual-hormone artificial pancreas (AP) reduces exercise-related hypoglycaemia. In random order, 21 adults with type 1 diabetes (T1D) underwent three 22-hour experimental sessions: AP with exercise dosing adjustment (APX); AP with no exercise dosing adjustment (APN); and sensor-augmented pump (SAP) therapy. After an overnight stay and 2 hours after breakfast, participants exercised for 45 minutes at 60% of their maximum heart rate, with no snack given before exercise. During APX, insulin was decreased and glucagon was increased at exercise onset, while during SAP therapy, subjects could adjust dosing before exercise. The two primary outcomes were percentage of time spent in hypoglycaemia (<3.9 mmol/L) and percentage of time spent in euglycaemia (3.9-10 mmol/L) from the start of exercise to the end of the study. The mean (95% confidence interval) times spent in hypoglycaemia (<3.9 mmol/L) after the start of exercise were 0.3% (-0.1, 0.7) for APX, 3.1% (0.8, 5.3) for APN, and 0.8% (0.1, 1.4) for SAP therapy. There was an absolute difference of 2.8% less time spent in hypoglycaemia for APX versus APN (p = .001) and 0.5% less time spent in hypoglycaemia for APX versus SAP therapy (p = .16). Mean time spent in euglycaemia was similar across the different sessions. Adjusting insulin and glucagon delivery at exercise onset within a dual-hormone AP significantly reduces hypoglycaemia compared with no adjustment and performs similarly to SAP therapy when insulin is adjusted before exercise. © 2016 John Wiley & Sons Ltd.

  9. Soup consumption is associated with a reduced risk of overweight and obesity but not metabolic syndrome in US adults: NHANES 2003-2006.

    PubMed

    Zhu, Yong; Hollis, James H

    2013-01-01

    A limited number of studies have found that soup consumption is related to a lower risk of overweight and obesity in Asian and European populations, however, these studies do not provide a consistent picture regarding the association between soup consumption and markers of metabolic syndrome. To date, no study examining the relationship between soup and body weight or metabolic syndrome have been conducted in the US population. The present study used a sample of 4158 adults aged 19-64 who participated in the National Health and Nutrition Examination Survey between 2003 and 2006. The frequency of soup consumption was determined using a food frequency questionnaire. The weighted prevalence of soup consumption was 94%, with a seasonal variation in the frequency of soup consumption being found. Non-consumers of soup were at a higher risk of being overweight or obese (adjusted odds ratio = 1.381, P = 0.013), with a higher adjusted prevalence of reduced HDL cholesterol (adjusted odds ratio = 1.280, P = 0.045), but there was no association between soup consumption and metabolic syndrome (P = 0.520). The frequency of soup consumption was inversely associated with covariate-adjusted body mass index and waist circumference (P<0.05), but not with biomarkers of metabolic syndrome, except for a lower fasting insulin level in frequent soup consumers (P = 0.022). Results from the present study suggest soup consumption is not associated with metabolic syndrome. However, there is an inverse relationship between soup consumption and body weight status in US adults, which support laboratory studies showing a potential benefit of soup consumption for body weight management.

  10. Reduced insulin-like growth factor-I serum levels in formerly obese women subjected to laparoscopic-adjustable gastric banding or diet-induced long-term caloric restriction.

    PubMed

    Mitterberger, Maria C; Mattesich, Monika; Klaver, Elise; Piza-Katzer, Hildegunde; Zwerschke, Werner

    2011-11-01

    Life-span extension in laboratory rodents induced by long-term caloric restriction correlates with decreased serum insulin-like growth factor-I (IGF-I) levels. Reduced activity of the growth hormone/IGF-I signaling system slows aging and increases longevity in mutant mouse models. In the present study, we show that long-term caloric restriction achieved by two different interventions for 4 years, either laparoscopic-adjustable gastric banding or reducing diet, leads to reduced IGF-I serum levels in formerly obese women relative to normal-weight women eating ad libitum. Moreover, we present evidence that the long-term caloric restriction interventions reduce fasting growth hormone serum levels. The present study indicates that the activity of the growth hormone/IGF-I axis is reduced in long-term calorically restricted formerly obese humans. Furthermore, our findings suggest that the duration and severity of the caloric restriction intervention are important for the outcome on the growth hormone/IGF-I axis in humans.

  11. Use of low frequency repetitive transcranial magnetic stimulation to reduce context-dependent learning in people with Parkinson's disease.

    PubMed

    Lee, Ya-Yun; Fisher, Beth E

    2017-05-22

    Compared with age-matched non-disabled adults, people with Parkinson's disease (PD) demonstrated greater context-dependent learning, a phenomenon in which an individual shows inferior motor performance when the testing environmental context is different from the original practice context. Additionally, enhanced context- dependency has been shown to be associated with an increased activation of the dorsolateral prefrontal cortex (DLPFC). This study aimed to determine whether context-dependent learning in people with PD could be reduced by decreasing DLPFC activation with low frequency repetitive transcranial magnetic stimulation (rTMS). Quasi-experimental pre-post test controlled study. University laboratory. Twenty-seven participants (18 individuals with PD and 9 age-matched non- disabled adults) were recruited into the PD, PD_rTMS (PD participants who received low frequency rTMS), and Control groups. All participants practiced a finger sequence task containing 3 sequences embedded within specific contexts (colored circles and spatial location on a computer screen) on the first day. On day 2, the participants were tested under the SWITCH and SAME conditions. In the SWITCH condition, the sequence-context association changed from that of practice; in the SAME condition, the sequence-context association remained the same as practice. The PD_rTMS group received 1 Hz rTMS applied over the left DLPFC on the second day before the testing conditions. Switch cost, the performance difference between the SWITCH and SAME conditions, was calculated to indicate context-dependency. All participants improved throughout practice on the first day. Analysis of the switch cost revealed a significant group main effect (p = 0.050). Post-hoc analysis revealed that the PD_rTMS group had significantly smaller switch cost than the PD group (p = 0.031) but not the Control group. Low frequency rTMS applied over DLPFC reduced context-dependency in people with PD. The findings provide a

  12. Principles of self-adjustment of insulin dose in people with diabetes type 2 and flexible insulin therapy.

    PubMed

    Kramer, G; Kuniss, N; Kloos, C; Lehmann, T; Müller, N; Sanow, B; Lorkowski, S; Wolf, G; Müller, U A

    2016-06-01

    Structured treatment and education programmes for people with type 2 diabetes mellitus (T2DM) and flexible insulin therapy provide rules for self-adjustment of insulin dose, that are extensively trained. The aim of this cohort study was to register current principles and the frequency of self-adjustment of insulin dose and their association with metabolic control in people with T2DM. Details of insulin dose adjustment were assessed by a structured interview in 149 people with T2DM on flexible insulin therapy (mean HbA1c 7.1%/53.8mmol/mol, age 65y, diabetes duration 19.0y, BMI 33.8kg/m(2)) in a tertiary care centre. The frequency of insulin dose adjustments was obtained from the last 28days of the patients' diaries. Insulin dose adjustment by adjustment rules was used by 33 people (22.1%) and by personal experience/feeling in 111 participants (74.5%). People adjusting by rules were younger (60.9±9.8 vs. 65.7±9.2, p=0.011) and did more insulin dose adjustments per 28days (50.0±31.0 vs. 33.4±23.5, p=0.016). HbA1c and incidence of hypoglycaemia were comparable. There were no differences in satisfaction of treatment, quality of life as well as current well-being between the groups. Only a fifth of the participants used the rule trained within the education programme to adjust their insulin dose. The majority adjusted their insulin dose by personal experience/feeling. However, people in both groups were able to adjust their insulin dose. Although people using adjustment rules adjust their insulin dose more frequently, HbA1c and the incidence of hypoglycaemia was similar compared to those using personal experience/feeling. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Physiology Of Prolonged Bed Rest

    NASA Technical Reports Server (NTRS)

    Greenleaf, John E.

    1991-01-01

    Report describes physiological effects of prolonged bed rest. Rest for periods of 24 hours or longer deconditions body to some extent; healing proceeds simultaneously with deconditioning. Report provides details on shifts in fluid electrolytes and loss of lean body mass, which comprises everything in body besides fat - that is, water, muscle, and bone. Based on published research.

  14. Prolonged antibiotics for non-cystic fibrosis bronchiectasis in children and adults.

    PubMed

    Hnin, Khin; Nguyen, Chau; Carson, Kristin V; Evans, David J; Greenstone, Michael; Smith, Brian J

    2015-08-13

    antibiotics with a moderate quality grade of supporting evidence (37 per 1000 in the intervention arm (95% CI 13 to 96) and 87 per 1000 in control (OR 0.40, 95% CI 0.14 to 1.11; P value = 0.08). Drug resistance developed in 36 of 220 participants taking antibiotics compared with 10 of 211 participants given placebo or standard therapy (OR 3.48, 95% CI 1.20 to 10.07; P value = 0.02), translating to natural frequencies of 155 per 1000 in the intervention arm (95% CI 59 to 346) and 50 per 1000 in the control arm. The intervention was well tolerated with no overall significant difference in withdrawal between treatment and placebo groups (OR 0.91, 95% CI 0.56 to 1.49). Diarrhoea was commonly reported as an adverse event, particularly with an oral intervention. Available evidence shows benefit associated with use of prolonged antibiotics in the treatment of patients with bronchiectasis, at least halving the odds of exacerbation (with 275 fewer exacerbations per every 1000 people treated in the antibiotic arm compared with the control arm) and hospitalisation (50 fewer hospitalisations per 1000 people in the antibiotic arm compared with the control arm). However, the risk of emerging drug resistance is increased more than threefold. This review is limited by diversity of trials and by evidence of moderate to low quality. Further randomised controlled trials with adequate power and standardised end points are required.

  15. A novel pulse compression algorithm for frequency modulated active thermography using band-pass filter

    NASA Astrophysics Data System (ADS)

    Chatterjee, Krishnendu; Roy, Deboshree; Tuli, Suneet

    2017-05-01

    This paper proposes a novel pulse compression algorithm, in the context of frequency modulated thermal wave imaging. The compression filter is derived from a predefined reference pixel in a recorded video, which contains direct measurement of the excitation signal alongside the thermal image of a test piece. The filter causes all the phases of the constituent frequencies to be adjusted to nearly zero value, so that on reconstruction a pulse is obtained. Further, due to band-limited nature of the excitation, signal-to-noise ratio is improved by suppressing out-of-band noise. The result is similar to that of a pulsed thermography experiment, although the peak power is drastically reduced. The algorithm is successfully demonstrated on mild steel and carbon fibre reference samples. Objective comparisons of the proposed pulse compression algorithm with the existing techniques are presented.

  16. Bronchopulmonary C-fibers' IL1RI contributes to the prolonged apneic response to intra-atrial injection of capsaicin by prenatal nicotinic exposure in rat pups

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhao, Lei; Zhuang, Jianguo; Xu, Fadi, E-mail: fxu@

    Prenatal nicotinic exposure (PNE) as a SIDS model reportedly sensitizes bronchopulmonary C-fibers (PCFs), contributing to the prolonged PCF-mediated apnea in rat pups, but the relevant mechanisms are not fully understood. Pulmonary IL-1β upregulated by cigarette smoke is known to stimulate or sensitize PCFs acting via IL-1 type I receptor (IL1RI) and inhibit inspiration frequency. Because of its upregulation observed in SIDS victims, we hypothesized that PNE increased pulmonary IL-1β release and IL1RI expression in pulmonary C-neurons via action on α7 nicotinic acetylcholine receptors (α7nAChR) to induce the prolonged PCF-mediated apnea. IL-1β in BALF and IL1RI in the nodose/jugular (N/J) ganglionmore » and vagal pulmonary C-neurons retrogradely-traced were compared between Ctrl (saline) and PNE pups and among the vehicle-treated Ctrl and PNE and methyllycaconitine (a selective α7nAChR antagonist)-treated PNE pups. The effect of IL-1RI blockade (IL-1Ra) on the PCF-mediated apnea was also compared between Ctrl and PNE pups. PNE significantly elevated IL-1β in BALF and upregulated IL1RI gene and protein expression in N/J ganglia and gene in vagal pulmonary C-neurons. All of these responses were eliminated by pretreatment with blockade of α7nAChR. In addition, the prolonged PCF-mediated apnea in PNE pups was significantly shortened by right atrial bolus injection of IL-1Ra. We conclude that PNE enhances pulmonary IL-1β release and PCF IL1RI expression acting via α7nAChR in contributing to sensitization of PCFs and prolongation of the PCF-mediated apneic response. - Highlights: • PNE increased pulmonary IL-1β release and IL1R1 expression in the N/J ganglia. • PNE elevated IL1R1 mRNA in vagal pulmonary C-neurons. • Blockage of peripheral IL1R1 reduced the PNE-induced PCF sensitization. • PNE induced the changes in IL-1β and IL1R1 dependent on action of α7nAChR.« less

  17. Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: A prospective cohort study.

    PubMed

    Allard, Johane P; Keller, Heather; Jeejeebhoy, Khursheed N; Laporte, Manon; Duerksen, Don R; Gramlich, Leah; Payette, Helene; Bernier, Paule; Davidson, Bridget; Teterina, Anastasia; Lou, Wendy

    2016-02-01

    Reducing length of stay (LOS) is a priority for hospitals but patients' decline in nutritional status may have a negative impact. The aims of the study were to assess the change in nutritional status during hospitalization and determine if its decline is associated with prolonged LOS. This is a prospective cohort study conducted in 18 Canadian hospitals. Subjective global assessment (SGA) and weight measurements were performed at admission and discharge. Patient information was collected at admission and extracted from the chart during hospitalization. Association between LOS and changes in SGA or weight loss ≥5% was tested using multivariate Cox PH approach. Results are expressed as hazard ratios (HR) and their 95% CI. 409 patients (53% male) with a LOS >7 days were analyzed. Patients' median (q1,q3) age was 68 years (58,79) and LOS was 11 days (8,17). At admission, 49% of patients were well nourished (SGA A), 37% were moderately malnourished (SGA B) and 14% were severely malnourished (SGA C). From admission to discharge, 34% remained well-nourished, 29% remained malnourished (SGA B or C), 20% deteriorated and 17% improved. Of the 409 patients, 373 had weight measurements at admission and discharge: 92 (25%) had ≥5% weight loss. Multivariate models showed that after adjusting for covariates, decline in nutritional status from SGA A to B/C or SGA B to C (HR: 0.62, CI: (0.44, 0.87); HR: 0.35, CI: (0.20, 0.62) respectively) and weight loss ≥5% (HR: 0.52; CI: 0.40, 0.69) were significantly associated with longer LOS. In-hospital decline in nutritional status as assessed by SGA or weight loss ≥5% is associated with prolonged LOS independently of factors reflecting demographics, living accommodations and disease severity. This suggests a role for nutrition care in reducing LOS. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Long-lived coherences: Improved dispersion in the frequency domain using continuous-wave and reduced-power windowed sustaining irradiation

    NASA Astrophysics Data System (ADS)

    Sadet, A.; Fernandes, L.; Kateb, F.; Balzan, R.; Vasos, P. R.

    2014-08-01

    Long-lived coherences (LLC's) are detectable magnetisation modes with favourable relaxation times that translate as sharp resonances upon Fourier transform. The frequency domain of LLC's was previously limited to the range of J-couplings within pairs of homonuclear spins. LLC evolution at high magnetic fields needs to be sustained by radio-frequency irradiation. We show that LLC-based spectral dispersion can be extended beyond the J-couplings domain using adapted carrier offsets and introduce a new reduced-power sustaining method to preserve LLC's within the required range of offsets. Spectral resolution is enhanced as the natively narrow lines of LLC's are further dispersed, making them potential probes for the study of biomolecules featuring strong resonance overlap and for media where NMR spectroscopy is commonly hindered by line broadening.

  19. Prolonging life: legal, ethical, and social dilemmas.

    PubMed

    Paulson, Steve; Comfort, Christopher P; Lee, Barbara Coombs; Shemie, Sam; Solomon, Mildred Z

    2014-11-01

    The ability of modern medicine to prolong life has raised a variety of difficult legal, ethical, and social issues on which reasonable minds can differ. Among these are the morality of euthanasia in cases of deep coma or irreversible injury, as well as the Dead Donor Rule with respect to organ harvesting and transplants. As science continues to refine and develop lifesaving technologies, questions remain as to how much medical effort and financial resources should be expended to prolong the lives of patients suspended between life and death. At what point should death be considered irreversible? What criteria should be used to determine when to withhold or withdraw life-prolonging treatments in cases of severe brain damage and terminal illness? To explore these complex dilemmas, Steve Paulson, executive producer and host of To the Best of Our Knowledge, moderated a discussion panel. Pediatrician Sam Shemie, hospice medical director Christopher P. Comfort, bioethicist Mildred Z. Solomon, and attorney Barbara Coombs Lee examined the underlying assumptions and considerations that ultimately shape individual and societal decisions surrounding these issues. The following is an edited transcript of the discussion that occurred November 12, 2013, 7:00-8:30 PM, at the New York Academy of Sciences in New York City. © 2014 New York Academy of Sciences.

  20. [Comparative study of the conventional scheme and prolonged treatment with steroids on primary steroid-sensitive nephrotic syndrome in children].

    PubMed

    Liern, Miguel; Codianni, Paola; Vallejo, Graciela

    In the steroid-sensitive nephrotic syndrome (SSNS) the prolonged treatment with steroids could decrease the frequency of relapses. We conducted a comparative study of prolonged steroid scheme and the usual treatment of primary SSNS to assess: the number of patients with relapses, mean time to treatment initiation, to remission and to first relapse, total number of relapses, total cumulative dose of steroids, and the steroid toxicity. Patients were divided into two groups: group A (27 patients) received 16-β-methylprednisolone for 12 weeks, reducing the steroid until week 24. Group B (29 patients) received 16-β-methylprednisolone for 12 weeks and placebo until week 24. Cumulative incidence rate of relapse (person/years) for group A was of 36/100 and 66/100 for group B (p=0.04). Average elapsed time to first relapse was of 114 days for group A and of 75 days to for group B (p=0.01). The difference in time for initial response to treatment and up to achieve remission between both groups was not significant. Total cumulative relapses were 9 for group A and 17 for group B (p=0.04). Total patients with relapses were 3 for group A and 7 for group B (p=0.17). Cumulative average dose per patient was 5,243mg/m 2 for group A and 4,306mg/m 2 for group B (p=0.3), and serum cortisol was 14μg/dl for group A and 16μg/dl for group B (p=0.4). There were no steroid toxicity differences between groups. The duration of the treatment had an impact on the number of relapses without increasing steroid toxicity. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.