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Sample records for 12-hour overnight fast

  1. Metabolic characteristics of human subcutaneous abdominal adipose tissueafter overnight fast

    PubMed Central

    Humphreys, Sandy M.

    2012-01-01

    Subcutaneous abdominal adipose tissue is one of the largest fat depots and contributes the major proportion of circulating nonesterified fatty acids (NEFA). Little is known about aspects of human adipose tissue metabolism in vivo other than lipolysis. Here we collated data from 331 experiments in 255 healthy volunteers over a 23-year period, in which subcutaneous abdominal adipose tissue metabolism was studied by measurements of arterio-venous differences after an overnight fast. NEFA and glycerol were released in a ratio of 2.7:1, different (P < 0.001) from the value of 3.0 that would indicate no fatty acid re-esterification. Fatty acid re-esterification was 10.2 ± 1.4%. Extraction of triacylglycerol (TG) (fractional extraction 5.7 ± 0.4%) indicated intravascular lipolysis by lipoprotein lipase, and this contributed 21 ± 3% of the glycerol released. Glucose uptake (fractional extraction 2.6 ± 0.3%) was partitioned around 20–25% for provision of glycerol 3-phosphate and 30% into lactate production. There was release of lactate and pyruvate, with extraction of the ketone bodies 3-hydroxybutyrate and acetoacetate, although these were small numerically compared with TG and glucose uptake. NEFA release (expressed per 100 g tissue) correlated inversely with measures of fat mass (e.g., with BMI, rs = −0.24, P < 0.001). We examined within-person variability. Systemic NEFA concentrations, NEFA release, fatty acid re-esterification, and adipose tissue blood flow were all more consistent within than between individuals. This picture of human adipose tissue metabolism in the fasted state should contribute to a greater understanding of adipose tissue physiology and pathophysiology. PMID:22167523

  2. Effects of overnight fasting on working memory-related brain network: an fMRI study.

    PubMed

    Chechko, Natalia; Vocke, Sebastian; Habel, Ute; Toygar, Timur; Kuckartz, Lisa; Berthold-Losleben, Mark; Laoutidis, Zacharias G; Orfanos, Stelios; Wassenberg, Annette; Karges, Wölfram; Schneider, Frank; Kohn, Nils

    2015-03-01

    Glucose metabolism serves as the central source of energy for the human brain. Little is known about the effects of blood glucose level (BGL) on higher-order cognitive functions within a physiological range (e.g., after overnight fasting). In this randomized, placebo-controlled, double blind study, we assessed the impact of overnight fasting (14 h) on brain activation during a working memory task. We sought to mimic BGLs that occur naturally in healthy humans after overnight fasting. After standardized periods of food restriction, 40 (20 male) healthy participants were randomly assigned to receive either glucagon to balance the BGL or placebo (NaCl). A parametric fMRI paradigm, including 2-back and 0-back tasks, was used. Subclinically low BGL following overnight fasting was found to be linked to reduced involvement of the bilateral dorsal midline thalamus and the bilateral basal ganglia, suggesting high sensitivity of those regions to minimal changes in BGLs. Our results indicate that overnight fasting leads to physiologically low levels of glucose, impacting brain activation during working memory tasks even when there are no differences in cognitive performance.

  3. Overnight Fasting Regulates Inhibitory Tone to Cholinergic Neurons of the Dorsomedial Nucleus of the Hypothalamus

    PubMed Central

    Groessl, Florian; Jeong, Jae Hoon; Talmage, David A.; Role, Lorna W.; Jo, Young-Hwan

    2013-01-01

    The dorsomedial nucleus of the hypothalamus (DMH) contributes to the regulation of overall energy homeostasis by modulating energy intake as well as energy expenditure. Despite the importance of the DMH in the control of energy balance, DMH-specific genetic markers or neuronal subtypes are poorly defined. Here we demonstrate the presence of cholinergic neurons in the DMH using genetically modified mice that express enhanced green florescent protein (eGFP) selectively in choline acetyltransferase (Chat)-neurons. Overnight food deprivation increases the activity of DMH cholinergic neurons, as shown by induction of fos protein and a significant shift in the baseline resting membrane potential. DMH cholinergic neurons receive both glutamatergic and GABAergic synaptic input, but the activation of these neurons by an overnight fast is due entirely to decreased inhibitory tone. The decreased inhibition is associated with decreased frequency and amplitude of GABAergic synaptic currents in the cholinergic DMH neurons, while glutamatergic synaptic transmission is not altered. As neither the frequency nor amplitude of miniature GABAergic or glutamatergic postsynaptic currents is affected by overnight food deprivation, the fasting-induced decrease in inhibitory tone to cholinergic neurons is dependent on superthreshold activity of GABAergic inputs. This study reveals that cholinergic neurons in the DMH readily sense the availability of nutrients and respond to overnight fasting via decreased GABAergic inhibitory tone. As such, altered synaptic as well as neuronal activity of DMH cholinergic neurons may play a critical role in the regulation of overall energy homeostasis. PMID:23585854

  4. Severe catabolic state after an overnight fast in patients with chronic renal failure.

    PubMed

    Nakaya, Yutaka; Shimohata, Takaaki; Haraguchi, Sayaka; Nakao, Toshiyuki; Minaguchi, Jun; Sumitani, Haruo; Harada, Nagakatsu; Sakaue, Hiroshi

    2011-03-01

    Starvation causes more rapid development of a catabolic state in patients with liver cirrhosis than in normal subjects. Because the kidneys have a gluconeogenic activity similar to that of the liver, we tested whether patients with chronic renal failure develop a catabolic state after an overnight fast. The effect of an overnight fast on diurnal changes in respiratory quotient (RQ) was studied in 12 normal subjects and 12 patients with stable chronic renal failure. Changes in RQ in the early morning after an overnight fast were also studied in 27 patients with chronic renal failure not on dialysis. We also examined the effect on RQ of consuming a light snack in the evening before the measurements. The RQ before breakfast, but not at other times, was significantly lower in patients with renal failure than in normal subjects (0.824 ± 0.051 versus 0.868 ± 0.038, P < 0.05). This indicated that patients with renal failure had higher fat use and developed a catabolic state early in the morning. The RQ before breakfast showed significant inverse correlations with creatinine levels (r = -0.604, P < 0.001). Supplementation with a carbohydrate-rich snack in the evening resulted in a significant increase of 0.07 ± 0.04 (P < 0.05) in mean RQ in the early morning. This suggested that a late evening snack is useful for improving the catabolic state of patients with renal failure. Starvation involving an overnight fast facilitates catabolism of visceral and muscle proteins in renal failure. This suggests that nutritional management of renal failure should focus not only on the contents of a meal, but also on the timing of the meal. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Effects of caloric restriction and overnight fasting on cycling endurance performance.

    PubMed

    Ferguson, Lisa M; Rossi, Kelly A; Ward, Emily; Jadwin, Emily; Miller, Todd A; Miller, Wayne C

    2009-03-01

    In addition to aerobic endurance and anaerobic capacity, high power-to-weight ratio (PWR) is important for cycling performance. Cyclists often try to lose weight before race season to improve body composition and optimize PWR. Research has demonstrated body fat-reducing benefits of exercise after fasting overnight. We hypothesized that fasted-state exercise in calorie-restricted trained cyclists would not result in performance decrements and that their PWR would improve significantly. We also hypothesized that substrate use during fasted-state submaximal endurance cycling would shift to greater reliance on fat. Ten trained, competitive cyclists completed a protocol consisting of baseline testing, 3 weeks of caloric restriction (CR), and post-CR testing. The testing sessions measured pre- and post-CR values for resting metabolic rate (RMR), body composition, VO2, PWR and power-to-lean weight ratio (PLWR), and power output, as well as 2-hour submaximal cycling performance, rating of perceived exertion (RPE), and respiratory exchange ratio (RER). There were no significant differences between baseline and post-CR for submaximal trial RER, power output, VO2, RMR, VO2max, or workload at VO2max. However, RPE was significantly lower, and PWR was significantly higher post-CR, whereas RER did not change. The cyclists' PWR and body composition improved significantly, and their overall weight, fat weight, and body fat percentage decreased. Lean mass was maintained. The cyclists' RPE decreased significantly during 2 hours of submaximal cycling post-CR, and there was no decrement in submaximal or maximal cycling performance after 3 weeks of CR combined with overnight fasting. Caloric restriction (up to 40% for 3 weeks) and exercising after fasting overnight can improve a cyclist's PWR without compromising endurance cycling performance.

  6. Diving response after a one-week diet and overnight fasting.

    PubMed

    Ghiani, Giovanna; Marongiu, Elisabetta; Olla, Sergio; Pinna, Marco; Pusceddu, Matteo; Palazzolo, Girolamo; Sanna, Irene; Roberto, Silvana; Crisafulli, Antonio; Tocco, Filippo

    2016-01-01

    We hypothesized that overnight fasting after a short dietary period, especially with carbohydrates, could allow performing breath-hold diving with no restraint for diaphragm excursion and blood shift and without any increase of metabolism, and in turn improve the diving response. During two separate sessions, 8 divers carried out two trials: (A) a 30-m depth dive, three hours after a normal breakfast and (B) a dive to the same depth, but after following a diet and fasting overnight. Each test consisted of 3 apnea phases: descent, static and ascent whose durations were measured by a standard chronometer. An impedance cardiograph, housed in an underwater torch, provided data on trans-thoracic fluid index (TFI), stroke volume (SV), heart rate (HR) and cardiac output (CO). Mean blood pressure (MBP), arterial O2 saturation (SaO2), blood glucose (Glu) and blood lactate (BLa) were also collected. In condition B, duration of the static phase of the dive was longer than A (37.8 ± 7.4 vs. 27.3 ± 8.4 s respectively, P < 0.05). In static phases, mean ∆ SV value (difference between basal and nadir values) during fasting was lower than breakfast one (-2.6 ± 5.1 vs. 5.7 ± 7.6 ml, P < 0.05). As a consequence, since mean ∆ HR values were equally decreased in both metabolic conditions, mean ∆ CO value during static after fasting was lower than the same phase after breakfast (-0.4 ± 0.5 vs. 0.4 ± 0.5 L · min(-1) respectively, P < 0.05). At emersion, despite the greater duration of dives during fasting, SaO2 was higher than A (92.0 ± 2.7 vs. 89.4 ± 2.9 % respectively, P < 0.05) and BLa was lower in the same comparison (4.2 ± 0.7 vs. 5.3 ± 1.1 mmol∙L(-1), P < 0.05). An adequate balance between metabolic and splancnic status may improve the diving response during a dive at a depth of 30 m, in safe conditions for the athlete's health.

  7. Whole-body fat oxidation increases more by prior exercise than overnight fasting in elite endurance athletes.

    PubMed

    Andersson Hall, Ulrika; Edin, Fredrik; Pedersen, Anders; Madsen, Klavs

    2016-04-01

    The purpose of this study was to compare whole-body fat oxidation kinetics after prior exercise with overnight fasting in elite endurance athletes. Thirteen highly trained athletes (9 men and 4 women; maximal oxygen uptake: 66 ± 1 mL·min(-1)·kg(-1)) performed 3 identical submaximal incremental tests on a cycle ergometer using a cross-over design. A control test (CON) was performed 3 h after a standardized breakfast, a fasting test (FAST) 12 h after a standardized evening meal, and a postexercise test (EXER) after standardized breakfast, endurance exercise, and 2 h fasting recovery. The test consisted of 3 min each at 30%, 40%, 50%, 60%, 70%, and 80% of maximal oxygen uptake and fat oxidation rates were measured through indirect calorimetry. During CON, maximal fat oxidation rate was 0.51 ± 0.04 g·min(-1) compared with 0.69 ± 0.04 g·min(-1) in FAST (P < 0.01), and 0.89 ± 0.05 g·min(-1) in EXER (P < 0.01). Across all intensities, EXER was significantly higher than FAST and FAST was higher than CON (P < 0.01). Blood insulin levels were lower and free fatty acid and cortisol levels were higher at the start of EXER compared with CON and FAST (P < 0.05). Plasma nuclear magnetic resonance-metabolomics showed similar changes in both EXER and FAST, including increased levels of fatty acids and succinate. In conclusion, prior exercise significantly increases whole-body fat oxidation during submaximal exercise compared with overnight fasting. Already high rates of maximal fat oxidation in elite endurance athletes were increased by approximately 75% after prior exercise and fasting recovery.

  8. Effect of a 12-hour/day shift on performance

    SciTech Connect

    Lewis, P.M.; Swaim, D.J.

    1988-06-01

    The operating crews at the Fast Flux Facility near Richland, Washington, changed their rotating shift schedule from an 8- to 12- hour/day work schedule. The primary reason for the change was to reduce the attrition of operators by increasing their job satisfaction. Eighty-four percent of the operators favored the change. Plant performance and safety were not adversely affected. A statistical analysis of 53 operator-related, off-normal events in 28 months concluded that there was no significant difference in either the number or the severity of off-normal events on the 12-hour shift. A statistical analysis of 200,000 log entries concluded that the error rate in completing logs actually declined by 25 percent on the 12-hour shift. Alertness, which was measured using computerized tests of mathematics and logical reasoning, reach a nadir on the first night shift for the 8- and 12-hour schedules alike, which indicates that the primary cause of fatigue was sleep disruption, not cumulative hours of work. All supervisors and 52 percent of the operators believe their crews work more effectively on the 12-hour shift; only 12 percent of the operators believe that their crews work less effectively. The evaluation indicated that the 12-hour shift scheduled is a reasonable alternative to an 8-hour schedule at this facility. 2 refs.

  9. Evaluation of a 12-hour/day shift schedule

    SciTech Connect

    Lewis, P.M.; Swaim, D.J.

    1986-06-01

    In April 1985, the operating crews at the Fast Flux Test Facility near Richland, Washington, changed their rotating shift schedule from an 8- to a 12-hour/day work schedule. The primary purpose of the change was to reduce the attrition of operators by increasing their job satisfaction. Eighty-four percent of the operators favored the change. A program was established to evaluate the effects on plant performance, operator alertness, attrition, sleep, health, job satisfaction, and off-the-job satisfaction. Preliminary results from that evaluation program indicate that the 12-hour shift schedule is a reasonable alternative to an 8-hour schedule at this facility.

  10. Metabolomic and transcriptomic changes induced by overnight (16 h) fasting in male and female Sprague-Dawley rats.

    PubMed

    Robertson, Donald G; Ruepp, Stefan U; Stryker, Steven A; Hnatyshyn, Serhiy Y; Shipkova, Petia A; Aranibar, Nelly; Mcnaney, Colleen A; Fiehn, Oliver; Reily, Michael D

    2011-04-18

    The overnight (16-h) fast is one of the most common experimental manipulations performed in rodent studies. Despite its ubiquitous employment, a comprehensive evaluation of metabolomic and transcriptomic sequelae of fasting in conjunction with routine clinical pathology evaluation has not been undertaken. This study assessed the impact of a 16-h fast on urine and serum metabolic profiles, transcript profiles of liver, psoas muscle, and jejunum as well as on routine laboratory clinical pathology parameters. Fasting rats had an approximate 12% relative weight decrease compared to ad libitum fed animals, and urine volume was significantly increased. Fasting had no effect on hematology parameters, though several changes were evident in serum and urine clinical chemistry data. In general, metabolic changes in biofluids were modest in magnitude but broad in extent, with a majority of measured urinary metabolites and from 1/3 to 1/2 of monitored serum metabolites significantly affected. Increases in fatty acids and bile acids dominated the upregulated metabolites. Downregulated serum metabolites were dominated by diet-derived and/or gut-microflora derived metabolites. Major transcriptional changes included genes with roles in fatty acid, carbohydrate, cholesterol, and bile acid metabolism indicating decreased activity in glycolytic pathways and a shift toward increased utilization of fatty acids. Typically, several genes within these metabolic pathways, including key rate limiting genes, changed simultaneously, and those changes were frequently correlative to changes in clinical pathology parameters or metabolomic data. Importantly, up- or down-regulation of a variety of cytochrome P450s, transporters, and transferases was evident. Taken together, these data indicate profound consequences of fasting on systemic biochemistry and raise the potential for unanticipated interactions, particularly when metabolomic or transcriptomic data are primary end points.

  11. Comparison of the effects of acute exercise after overnight fasting and breakfast on energy substrate and hormone levels in obese men.

    PubMed

    Kim, Tae Woon; Lee, Sang Hoon; Choi, Kyu Hwan; Kim, Dong Hyun; Han, Tae Kyung

    2015-06-01

    [Purpose] We compared the effects of acute aerobic exercise following overnight fasting and breakfast on energy substrate and hormone levels in obese male college students. [Subjects and Methods] This crossover study recruited 10 obese male college students with a body mass index >25 kg/m(2) or >20% body fat. One week post-recruitment, the subjects exercised in the morning after an overnight fast. At 2 weeks, they exercised post-breakfast. Energy substrate (glucose, free fatty acid) and metabolic hormone (insulin, growth hormone, and cortisol) levels were measured immediately before and after exercise and at 60 min post-exercise. [Results] We observed interaction effects between the measurement time and exercise treatment for glucose; significant differences between measurement times and between exercise treatments for free fatty acids; interaction effects between the measurement time and exercise treatment for insulin and significant differences in the measurement time; significance differences between measurement times and between exercise treatments for growth hormone; and significant differences between measurement times and between exercise treatments for cortisol. [Conclusion] Morning exercise following an overnight fast can be more effective in reducing body fat than post-prandial exercise. However, increased cortisol levels following exercise after overnight fasting may negatively affect long-term weight loss in obese men.

  12. What are 12-hour shifts good for?

    PubMed

    In the UK many hospitals use 12-hour shifts, believing it to be a cost-efficient means of providing 24-hour nursing care on wards. While healthcare organisations need to find ways to deliver nursing care around the clock and efficiency is a key consideration, nurse leaders have raised concerns about ' whether nurses can function effectively and safely when working long hours (Calkin, 2012; Rogers et al, 2004). In this Policy Plus, we focus specifically on what is known about the impact of shift length on patient safety, employee health and quality of care.

  13. Markers of glycemic control in the mouse: comparisons of 6-h- and overnight-fasted blood glucoses to Hb A1c.

    PubMed

    Han, Byoung Geun; Hao, Chuan-Ming; Tchekneva, Elena E; Wang, Ying-Ying; Lee, Chieh Allen; Ebrahim, Benyamin; Harris, Raymond C; Kern, Timothy S; Wasserman, David H; Breyer, Matthew D; Qi, Zhonghua

    2008-10-01

    The present studies examined the relationship between fasting blood glucose and Hb A(1c) in C57BL/6J, DBA/2J, and KK/HlJ mice with and without diabetes mellitus. Daily averaged blood glucose levels based on continuous glucose monitoring and effects of 6-h vs. overnight fasting on blood glucose were determined. Daily averaged blood glucose levels were highly correlated with Hb A(1c), as determined with a hand-held automated device using an immunodetection method. R(2) values were 0.90, 0.95, and 0.99 in KK/HIJ, C57BL/6J, and DBA/2J, respectively. Six-hour fasting blood glucose correlated more closely with the level of daily averaged blood glucose and with Hb A(1c) than did blood glucose following an overnight fast. To validate the immunoassay-determined Hb A(1c), we also measured total glycosylated hemoglobin using boronate HPLC. Hb A(1c) values correlated well with total glycosylated hemoglobin in all three strains but were relatively lower than total glycosylated hemoglobin in diabetic DBA/2J mice. These results show that 6-h fasting glucose provides a superior index of glycemic control and correlates more closely with Hb A(1c) than overnight-fasted blood glucose in these strains of mice.

  14. Randomized trial comparing overnight preoperative fasting period Vs oral administration of apple juice at 06:00-06:30 am in pediatric orthopedic surgical patients.

    PubMed

    Castillo-Zamora, Carlos; Castillo-Peralta, Luz A; Nava-Ocampo, Alejandro A

    2005-08-01

    We aimed to evaluate the efficacy of clear liquids orally administered at 06:00-06:30 am on the morning of surgery to reduce prolonged preoperative fasting periods. After obtaining informed parental consent, 100 children undergoing scheduled orthopedic surgical procedures, ASA I-II, were randomly allocated to two groups. In group 1, children underwent the typical overnight preoperative period and patients in group 2 received a commercial brand of apple juice (glucose 28 g in 250 ml) at 06:00-06:30 am on the day of surgery. Patients <3 years old received 15 ml.kg(-1) and older children 10 ml.kg(-1) to a maximum volume of 250 ml. All patients underwent overnight fasting for milk and solids. Fasting time was 4.8 +/- 2.1 h (ranging from 3 to 11 h) in the group receiving apple juice at 06:00-06:30 am and 13.2 +/- 3.3 h (ranging from 5 to 19 h) in the overnight-fasting group (P < 0.05; 95% CI: -9.6 to -7.4 h). More patients were irritable (odds ratio, OR 4.5; 95% CI: 1.9-10.8) and dehydrated (OR 21.6; 95% CI: 5.9-79.0) in the overnight-fasting group. Glucose levels <2.7 mmol.l(-1) (50 mg.dl(-1)) were not reported in any case. A 15 ml.kg(-1) of apple juice for patients of <3 years of age or 10 ml.kg(-1) for older children, at 06:00-06:30 am of the surgical morning is a simple procedure to prevent dehydration and to produce positive behavior in low-risk, pediatric surgical patients.

  15. Overnight Scentsation Rose Plant

    NASA Technical Reports Server (NTRS)

    1998-01-01

    International Flavors and Fragrances Inc., Dr. Braja Mookherjee with the Overnight Scentsation rose plant after its flight aboard NASA's shuttle mission STS-95 for experimentation on scent in microgravity.

  16. Is it time to pull the plug on 12-hour shifts? Part 3. harm reduction strategies if keeping 12-hour shifts.

    PubMed

    Geiger-Brown, Jeanne; Trinkoff, Alison M

    2010-09-01

    This article is part 3 of the series "Pulling the Plug on 12-Hour Shifts." In part 1 (March 2010), the authors provided an update on recent evidence that challenges the current scheduling paradigm and supports the lack of safety of long work hours. Part 2 (April 2010) described the barriers to change and challenges for the nurse executive in moving away from the practice of 12-hour shifts. This article presents strategies for mitigating the effects of 12-hour shifts for nurses who continue to work 12-hour shifts despite the potential risks to their health and to patient safety.

  17. The overnight effect of dietary energy balance on postprandial plasma free amino acid (PFAA) profiles in Japanese adult men.

    PubMed

    Nishioka, Manabu; Imaizumi, Akira; Ando, Toshihiko; Tochikubo, Osamu

    2013-01-01

    The plasma free amino acid (PFAA) profile is affected by various nutritional conditions, such as the dietary energy balance. Regarding the clinical use of PFAA profiling, it is of concern that differences in food ingestion patterns may generate systematic errors in a plasma amino acid profile and constitute a confounding factor in assessment. In this study, the overnight impact of the dietary energy balance on the postprandial plasma amino acid profile was investigated to elucidate in particular the effects of high protein meals typical in Japanese cuisine. We conducted diet-controlled, crossover trials in eleven healthy male volunteers aged 40-61 y. They consumed either a normal meal (meal N) or high protein meal (meal H) at dinner. Forearm venous blood was collected, and plasma amino acid concentrations were measured before dinner and the next morning. We found that a high protein meal in the evening that contained 40% energy would significantly increase the PFAA concentration the next morning, even more than 12 hours after the meal. Among amino acids, the most significant difference was observed in the branched-chain amino acids (BCAAs) and in some urea-cycle related compounds. If the subject consumed the high protein diet at dinner, the PFAA profile after overnight fasting might be still affected by the meal even 12 hours after the meal, suggesting that the PFAA profile does not reflect the subject's health condition, but rather the acute effect of high protein ingestion.

  18. The Overnight Effect of Dietary Energy Balance on Postprandial Plasma Free Amino Acid (PFAA) Profiles in Japanese Adult Men

    PubMed Central

    Nishioka, Manabu; Imaizumi, Akira; Ando, Toshihiko; Tochikubo, Osamu

    2013-01-01

    The plasma free amino acid (PFAA) profile is affected by various nutritional conditions, such as the dietary energy balance. Regarding the clinical use of PFAA profiling, it is of concern that differences in food ingestion patterns may generate systematic errors in a plasma amino acid profile and constitute a confounding factor in assessment. In this study, the overnight impact of the dietary energy balance on the postprandial plasma amino acid profile was investigated to elucidate in particular the effects of high protein meals typical in Japanese cuisine. We conducted diet-controlled, crossover trials in eleven healthy male volunteers aged 40–61 y. They consumed either a normal meal (meal N) or high protein meal (meal H) at dinner. Forearm venous blood was collected, and plasma amino acid concentrations were measured before dinner and the next morning. We found that a high protein meal in the evening that contained 40% energy would significantly increase the PFAA concentration the next morning, even more than 12 hours after the meal. Among amino acids, the most significant difference was observed in the branched-chain amino acids (BCAAs) and in some urea-cycle related compounds. If the subject consumed the high protein diet at dinner, the PFAA profile after overnight fasting might be still affected by the meal even 12 hours after the meal, suggesting that the PFAA profile does not reflect the subject's health condition, but rather the acute effect of high protein ingestion. PMID:23667542

  19. A study examining the impact of 12-hour shifts on critical care staff.

    PubMed

    Richardson, Annette; Turnock, Christopher; Harris, Liz; Finley, Alison; Carson, Sarah

    2007-11-01

    Twelve-hour shifts contribute to flexible patterns of work, but the effects on delivery of direct care and staff fatigue are important topics for deeper examination. To examine the impact and implications of 12-hour shifts on critical care staff. A staged dual approach using two focus groups (n = 16) and questionnaires (n = 147) with critical care staff from three critical care units. Positive effects were found with planning and prioritizing care, improved relationships with patients/relatives, good-quality time off work and ease of travelling to work. Less favourable effects were with caring for patients in isolation cubicles and the impact on staff motivation and tiredness. Acceptable patterns of work were suggested for 'numbers of consecutive shifts' and 'rest periods between shifts'. Most participants believed 12-hour shifts should continue. The challenge is to ensure existing systems and practices develop to improve on the less positive effects of working 12-hour shifts. This study provides nurse managers with important and relevant staff views on the impact of working 12-hour shifts. In particular to those working within a critical care environment and suggests the challenge is to ensure existing systems and practices develop to improve on the less encouraging effects of working 12-hour shifts. It adds an understanding of the senior nurse's view on the positive and negative effects of managing and organizing staff off duty to safely run a department with 12-hour shifts.

  20. Effect of carbohydrate restriction in the first meal after an overnight fast on glycemic control in people with type 2 diabetes: a randomized trial.

    PubMed

    Pedersen, Eva; Lange, Kylie; Clifton, Peter

    2016-11-01

    People with type 2 diabetes are advised to consume an even meal distribution of carbohydrate. Whether this distribution is optimal is unknown. Our objective was to show that omitting carbohydrate in the first meal after a fast would lead to an augmented lunch response. Two diets of 1-d duration that differed only in the breakfast-meal composition (carbohydrate or no carbohydrate) were consumed on sequential days in a randomized crossover study. The procedure was repeated in the alternate order 1 wk later. Blood glucose concentrations were tested with the use of continuous glucose monitoring. The primary endpoints were the percentage of time spent with a blood glucose concentration >10 mmol/L (%T >10) and peak blood glucose (Gmax). The following 45 adults with type 2 diabetes were recruited: subjects with glycated hemoglobin (HbA1c) ≤7% and subjects with HbA1c ≥8%. Twenty-eight adults completed the study. The daily Gmax was significantly lower after the no-carbohydrate breakfast than after the carbohydrate breakfast (11.0 ± 0.4 and 12.1 ± 0.4 mmol/L, respectively; P = 0.003) whereas the %T >10 throughout the day was a nonsignificant 22% less after the no-carbohydrate breakfast than after the carbohydrate breakfast (13% ± 10% compared with 10% ± 8%; P = 0.09). Gmax over 5 h after breakfast was significantly lower after the no-carbohydrate meal (by 1.9 ± 0.4 mmol/L; P < 0.001), and the %T >10 was lower after the no-carbohydrate meal than after the carbohydrate meal (11% ± 3% compared with 26% ± 4%, respectively; P < 0.001). The withholding of carbohydrate in the first meal results in significantly decreased Gmax after the meal, but the lunch response is not affected. Overall daily control is not significantly improved. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12609000331235. © 2016 American Society for Nutrition.

  1. The Energy Content and Composition of Meals Consumed after an Overnight Fast and Their Effects on Diet Induced Thermogenesis: A Systematic Review, Meta-Analyses and Meta-Regressions.

    PubMed

    Quatela, Angelica; Callister, Robin; Patterson, Amanda; MacDonald-Wicks, Lesley

    2016-10-25

    This systematic review investigated the effects of differing energy intakes, macronutrient compositions, and eating patterns of meals consumed after an overnight fast on Diet Induced Thermogenesis (DIT). The initial search identified 2482 records; 26 papers remained once duplicates were removed and inclusion criteria were applied. Studies (n = 27) in the analyses were randomized crossover designs comparing the effects of two or more eating events on DIT. Higher energy intake increased DIT; in a mixed model meta-regression, for every 100 kJ increase in energy intake, DIT increased by 1.1 kJ/h (p < 0.001). Meals with a high protein or carbohydrate content had a higher DIT than high fat, although this effect was not always significant. Meals with medium chain triglycerides had a significantly higher DIT than long chain triglycerides (meta-analysis, p = 0.002). Consuming the same meal as a single bolus eating event compared to multiple small meals or snacks was associated with a significantly higher DIT (meta-analysis, p = 0.02). Unclear or inconsistent findings were found by comparing the consumption of meals quickly or slowly, and palatability was not significantly associated with DIT. These findings indicate that the magnitude of the increase in DIT is influenced by the energy intake, macronutrient composition, and eating pattern of the meal.

  2. The Energy Content and Composition of Meals Consumed after an Overnight Fast and Their Effects on Diet Induced Thermogenesis: A Systematic Review, Meta-Analyses and Meta-Regressions

    PubMed Central

    Quatela, Angelica; Callister, Robin; Patterson, Amanda; MacDonald-Wicks, Lesley

    2016-01-01

    This systematic review investigated the effects of differing energy intakes, macronutrient compositions, and eating patterns of meals consumed after an overnight fast on Diet Induced Thermogenesis (DIT). The initial search identified 2482 records; 26 papers remained once duplicates were removed and inclusion criteria were applied. Studies (n = 27) in the analyses were randomized crossover designs comparing the effects of two or more eating events on DIT. Higher energy intake increased DIT; in a mixed model meta-regression, for every 100 kJ increase in energy intake, DIT increased by 1.1 kJ/h (p < 0.001). Meals with a high protein or carbohydrate content had a higher DIT than high fat, although this effect was not always significant. Meals with medium chain triglycerides had a significantly higher DIT than long chain triglycerides (meta-analysis, p = 0.002). Consuming the same meal as a single bolus eating event compared to multiple small meals or snacks was associated with a significantly higher DIT (meta-analysis, p = 0.02). Unclear or inconsistent findings were found by comparing the consumption of meals quickly or slowly, and palatability was not significantly associated with DIT. These findings indicate that the magnitude of the increase in DIT is influenced by the energy intake, macronutrient composition, and eating pattern of the meal. PMID:27792142

  3. Normal rates of whole-body fat oxidation and gluconeogenesis after overnight fasting and moderate-intensity exercise in patients with medium-chain acyl-CoA dehydrogenase deficiency.

    PubMed

    Huidekoper, Hidde H; Ackermans, Mariëtte T; Koopman, René; van Loon, Luc J C; Sauerwein, Hans P; Wijburg, Frits A

    2013-09-01

    Impairments in gluconeogenesis have been implicated in the pathophysiology of fasting hypoglycemia in medium-chain acyl-CoA dehydrogenase deficiency. However, whole body glucose and fat metabolism have never been studied in vivo. Stable isotope methodology was applied to compare fat and glucose metabolism between four adult patients with MCADD and four matched controls both at rest and during 1.5 h of moderate-intensity exercise. Additionally, intramyocellular lipid and glycogen content and intramyocellular acylcarnitines were assessed in muscle biopsies collected prior to and immediately after cessation of exercise. At rest, plasma FFA turnover was significantly higher in patients with MCADD, whereas the plasma FFA concentrations did not differ between patients and controls. Blood glucose kinetics did not differ between groups both at rest and during exercise. Palmitate and FFA turnover, total fat and carbohydrate oxidation rates, the use of muscle glycogen and muscle derived triglycerides during exercise did not differ between patients and controls. Plasma FFA oxidation rates were significantly lower in patients at the latter stages of exercise. Free carnitine levels in muscle were lower in patients, whereas no differences were detected in muscle acetylcarnitine levels. Whole-body or skeletal muscle glucose and fat metabolism were not impaired in adult patients with MCADD. This implies that MCADD is not rate limiting for energy production under the conditions studied. In addition, patients with MCADD have a higher FFA turnover rate after overnight fasting, which may stimulate ectopic lipid deposition and, as such, make them more susceptible for developing insulin resistance.

  4. A linear programming model for determining efficient combinations of 8-, 10-, and 12-hour shifts.

    PubMed

    Cooper, R B

    1981-11-01

    I have formulated a linear programming model to determine changes in efficiency and productivity that would result from scheduling personnel to work combinations of 8-, 10-, and 12-hour shifts in a section of our pulmonary medicine department. My objective was to minimize the number of staff hours worked each day, subject to the constraints imposed by the levels of staffing required during each hour of the day. I found that a combination of 8-, 10- and 12-hour shifts could increase productivity 8.1% and reduce personnel requirements by one full-time equivalent. Salary expenses would decrease 7.5% if overtime were not paid for the extended hours of the 10- and 12-hour shifts. Two considerations in implementing the proposed schedule are the willingness of staff to work extended hours and the necessity of developing a format for communication between therapists who work discontinuous shifts.

  5. Work shift duration: a review comparing eight hour and 12 hour shift systems

    PubMed Central

    Smith, L.; Folkard, S.; Tucker, P.; Macdonald, I.

    1998-01-01

    OBJECTIVES: Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. METHODS: Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. RESULTS: The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. CONCLUSIONS: There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.   PMID:9624275

  6. Impact of low level of high-density lipoprotein-cholesterol sampled in overnight fasting state on the clinical outcomes in patients with acute myocardial infarction (difference between ST-segment and non-ST-segment-elevation myocardial infarction).

    PubMed

    Ji, Mi Seon; Jeong, Myung Ho; Ahn, Young Keun; Kim, Young Jo; Chae, Shung Chull; Hong, Taek Jong; Seong, In Whan; Chae, Jei Keon; Kim, Chong Jin; Cho, Myeong Chan; Rha, Seung-Woon; Bae, Jang Ho; Seung, Ki Bae; Park, Seung Jung

    2015-01-01

    Despite good treatment, there are residual risks in acute myocardial infarction (AMI) patients, and low level of high-density lipoprotein-cholesterol (HDL) has drawn attention as a possible cause. However, the impact of low HDL on ST-segment-elevation myocardial infarction (STEMI) compared with non-ST-segment-elevation myocardial infarction (NSTEMI) is not clear. Our aim was to evaluate the impact of low HDL on clinical outcomes in patients with STEMI or NSTEMI. We included 9270 AMI patients undergoing successful percutaneous coronary intervention. They were grouped into STEMI and NSTEMI, and subdivided into two groups according to HDL level sampled in overnight fasting state. Primary end point was in-hospital death. Secondary end point was a composite of major adverse cardiac events (MACE) in hospital survivors during one-year follow-up. In the STEMI population, low HDL group showed significantly higher in-hospital death rate [4.6% vs. 1.4%, hazard ratio (HR): 2.380, 95% confidence interval (CI): 1.143-4.956, p=0.020] than normal HDL group. In NSTEMI population, there was no significant difference between two groups (1.8% vs. 0.9%, HR: 1.231, 95% CI: 0.649-2.335, p=0.525), but in subgroup analysis, very low HDL subgroup showed higher in-hospital mortality rate compared with normal HDL group (4.0% vs. 0.9%, respectively, p=0.009). In 12-month MACE rates, there was no significant difference between two groups in both populations. Low HDL was associated with significantly higher risk of in-hospital mortality in STEMI patients, but not in NSTEMI patients. Thus, more aggressive treatment should be considered in STEMI patients with low HDL. Copyright © 2014. Published by Elsevier Ltd.

  7. [Is It Time to Implement a 12-Hour Shift for Nurses in Taiwan?

    PubMed

    Lin, Yi-Fung; Chang, Shiow-Ru; Wang, Li-Ting

    2017-04-01

    The twelve-hour shift system, first introduced in the U.S. in 1967 to address a nursing shortage, is now the main system of shift rotation used in numerous countries. In recent years, several hospitals in Taiwan have implemented the 12-hour shift model as one initiative to improve the problems of overtime and high turnover rate among nursing staff. Under this model, nurses work only three to four days per week for 12-hour shifts per day. Despite the increase in numbers of days off, there is growing concern that long shift hours may harm both the safety of patients and the well being of the nurses. The aim of the present article is to explain the application of the 12-hour shift system and to review the potential impacts of this model. Benefits of the 12-hour shift system include improving quality of life for nursing staff, reducing the turnover rate, and increasing job satisfaction. Primary concerns regarding this system include patient safety, nurse fatigue, and the potential negative effects on the sleep quality of nurses. These findings may be referenced by policymakers considering the development / implementation of flexible work schedules in Taiwan. The government must set a ceiling on work hours allowed per week and impose limits on overtime in order to prevent burnout in nursing staff.

  8. Abbreviated (12-hour) versus traditional (24-hour) postpartum magnesium sulfate therapy in severe pre-eclampsia.

    PubMed

    Maia, Sabina B; Katz, Leila; Neto, Carlos Noronha; Caiado, Bárbara V R; Azevedo, Ana P R L; Amorim, Melania M R

    2014-09-01

    To compare the use of magnesium sulfate for 12 hours versus 24 hours in postpartum women with stable severe pre-eclampsia. In 2011, an open randomized clinical trial was conducted with 120 postpartum women with severe pre-eclampsia who gave birth at a tertiary hospital in Brazil; 60 women received magnesium sulfate for 24 hours and 60 for 12 hours. The analysis was by intention-to-treat and the intervention was not masked. Abbreviated (12-hour) magnesium sulfate therapy was associated with less exposure to the drug, and clinical outcomes were similar in both groups. No woman developed eclampsia and there was no need to re-initiate treatment after completing the scheduled magnesium sulfate therapy in either group. Magnesium sulfate therapy was extended in only three women in the 12-hour group. In addition, in this group, significant reductions were found in the duration of postpartum use of an indwelling bladder catheter, the time to ambulation, and the time to maternal contact with the newborn. Abbreviated postpartum magnesium sulfate therapy in patients with stable severe pre-eclampsia was associated with less drug exposure, similar outcomes, and benefits such as a reduction in the time to contact with the newborn. clinicaltrials.gov NCT1408979. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. [Seven hour shifts versus 12 hours in intensive nursing care: going against the tide].

    PubMed

    Moreno Arroyo, M C; Jerez González, J A; Cabrera Jaime, S; Estrada Masllorens, J M; López Martín, A

    2013-01-01

    Working in shifts has an impact on the well being of health care professionals, affecting their quality of life. The main objective of this study is to describe the consequences of 12hours work shifts versus 7hours for nursing professionals working in intensive care units. A cost-sectional, descriptive study was conducted in two tertiary hospitals of Barcelona, these being the Hospital Clínico and Hospital Vall d'Hebron (of 7hour and 12hour shifts, respectively). The data was collected through a questionnaire having 29 closed questions that was anonymous and self-administered. The questionnaire was based on two scales: Standard Shiftwork Index and Shiftwork. locus of control. Data was processed through SPSS V.18.0. The target population consisted of 85 people, for whom 52 surveys were valid: 22 in Hospital Clínico of Barcelona and 30 in Hospital Vall d'Hebron. Professionals working a 12-hour shift express higher levels of work and family conciliation, especially in the case of leisure time to enjoy (×2: 10.635 p=0.031) and family-friends time dedication as well as lower levels of perceived fatigue. No differences were found between type of shift and ease of development of professional work, even though the 12-hour shift has higher levels.

  10. The Overnight Scentsation Rose Plant

    NASA Technical Reports Server (NTRS)

    1998-01-01

    International Flavors and Fragrances Inc., is a company that creates and manufactures flavors, fragrances and aroma chemicals. The Overnight Scentsation rose plant will be housed aboard NASA's shuttle flight STS-95 in a specially-designed structure under ultraviolet lights. The flowering plant was brought to Cape Canaveral from its home at IFF's greenhouse in Union Beach, New Jersey.

  11. The Overnight Scentsation Rose Plant

    NASA Technical Reports Server (NTRS)

    1998-01-01

    International Flavors and Fragrances Inc., is a company that creates and manufactures flavors, fragrances and aroma chemicals. The Overnight Scentsation rose plant will be housed aboard NASA's shuttle flight STS-95 in a specially-designed structure under ultraviolet lights. The flowering plant was brought to Cape Canaveral from its home at IFF's greenhouse in Union Beach, New Jersey.

  12. Cognitive Performance During 12 Hours at 10,000 Ft Altitude During Night Conditions

    DTIC Science & Technology

    2008-03-01

    To) 03-2008 Abstract in Journal 2007 - 2008 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Cognitive Performance During 12 Hours at 10,000 Ft Altitude...Aviation Space and Environmental Medicine Journal. 1S. S UBJECT TERMS Cognitive performance, hypobaric exposures, night-operational ai rcraft...opiates, stimulants, barbiturates, benzodiazepines, non-steroidal anti-inflammatory drugs (NSAID), ana lgesics, antidepressants, and cannabis

  13. An evaluation of the deterrent impact of Ontario's 12-hour licence suspension law.

    PubMed

    Vingilis, E; Blefgen, H; Lei, H; Sykora, K; Mann, R

    1988-02-01

    The deterrent impact of Ontario's 12-hour licence suspension law, a law intended to mete out swift punishment is evaluated. A process model of deterrence is included. Time series analyses of the monthly log odds of number of positive B.A.C. fatalities over the number of negative B.A.C. fatalities indicated a small, short-term effect. The intermediate measures of four surveys of media coverage, Toronto residents, Ontario residents, and police forces supported these results, and affirmed the potential validity of the process model of deterrence. The results suggest that laws to increase the celerity and certainty of punishment will have little deterrent impact without enforcement and publicity of the new laws.

  14. 46 CFR 177.710 - Overnight accommodations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Overnight accommodations. 177.710 Section 177.710 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Crew Spaces § 177.710 Overnight accommodations....

  15. Unplanned overnight hospital admission after strabismus surgery.

    PubMed

    Elder, Mark; Steven, David; Beasley, Spencer; Wium, David

    2007-08-24

    To examine the reasons for unplanned overnight hospital admission in paediatric patients undergoing strabismus repair, to identify preventable causes (particularly postoperative nausea and vomiting), and to compare the rate of unplanned overnight stay with a group undergoing inguinal hernia repair. A retrospective review of consecutive patients under age 17 having strabismus surgery over a 5-year period between January 1995 and December 1999 was undertaken at Christchurch Hospital, New Zealand. A control group, from a similar period, of children having elective inguinal hernia repair was used to compare the rate of overnight stay. 375 patients had strabismus surgery, of which 51 stayed overnight; 19 of these were from remote locations and stayed for geographic reasons only, 9 stayed overnight preoperatively only, thus leaving an unplanned overnight stay rate of 6.4%. This compared to a rate of 1.1% in those having hernia surgery. The reasons for overnight stay were postoperative nausea and vomiting (50%), anaesthetic complications (18%), late afternoon surgery (14%), social factors (14%), and pain (5%). Significant associations were found between postoperative nausea and vomiting and the extent and duration of surgery. Possible associations not reaching significance included a higher rate of postoperative nausea and vomiting in those receiving nitrous oxide, and those with evidence of stimulation of the oculo-cardiac reflex. The provision of suitable accommodation and careful planning of the type and timing of surgery would be expected to reduce the overnight stay rate after strabismus surgery.

  16. Subzero 12-hour Nonfreezing Cryopreservation of Porcine Heart in a Variable Magnetic Field

    PubMed Central

    Seguchi, Ryuta; Watanabe, Go; Kato, Hiroki; Yamaguchi, Shojiro

    2015-01-01

    Background A novel subzero nonfreezing heart preservation method has been developed. It uses a refrigerating device that generates a variable magnetic field, allowing the whole organ to be cooled simultaneously to a supercooled state without the use of cryoprotectant. As a fundamental experiment for heart preservation, we verified whether this novel method is able to suppress anaerobic metabolism and reduce damage in the hearts of large animals. Methods Twelve porcine hearts were collected and preserved for 12 hours using a simple immersion method. The hearts were divided into 2 groups: 6 underwent nonfreezing preservation at −3°C in a variable magnetic field (subzero group), and 6 underwent conventional preservation at 4°C (conventional group). The quantity of anaerobic metabolism and the degree of ultrastructural change in the 2 groups were evaluated and compared. Results The concentration of adenosine triphosphate in the myocardial tissue was significantly greater in the subzero group than in the conventional group (21.06±5.87 μmol/g vs 5.96±3.41 μmol/g; P < 0.05). The accumulated lactate concentration was significantly lower in the subzero group than in the conventional group (6.58±2.28 μmol/g vs 11.15±3.74 μmol/g; P < 0.05). The Flameng score, an index of ultrastructural changes to the mitochondria, was significantly lower in the subzero group than in the conventional group (1.28±0.40 vs 2.73±0.30; P < 0.05). Conclusions Subzero nonfreezing preservation using a variable magnetic field resulted in a remarkable suppression of anaerobic metabolism and myocardial protection in porcine hearts. PMID:27500233

  17. Fluid-attenuated inversion recovery evolution within 12 hours from stroke onset: a reliable tissue clock?

    PubMed

    Ebinger, Martin; Galinovic, Ivana; Rozanski, Michal; Brunecker, Peter; Endres, Matthias; Fiebach, Jochen B

    2010-02-01

    It has recently been proposed that fluid-attenuated inversion recovery (FLAIR) imaging may serve as a surrogate marker for time of symptom onset after stroke. We assessed the hypothesis that FLAIR imaging could be used to decide if an MRI was performed within 4.5 hours from symptom onset or later. All consecutive patients with presumed stroke who underwent an MRI within 12 hours after known symptom onset were included regardless of stroke subtype and severity between May 2008 and May 2009. Blinded to time of symptom onset, 2 raters judged the visibility of lesions on FLAIR. Apparent diffusion coefficient values, lesion volume on diffusion-weighted imaging, and relative signal intensity of FLAIR lesions were determined. In 94 consecutive patients with stroke, we found that median time from symptom onset for FLAIR-positive patients (189 minutes; interquartile range, 110 to 369 minutes) was significantly longer compared with FLAIR-negative patients (103 minutes; interquartile range, 75 to 183 minutes; P=0.011). Negative FLAIR had a sensitivity of 46% and a specificity of 79% for allocating patients to a time window of less than 4.5 hours. FLAIR positivity increased with diffusion-weighted imaging lesion volume (P<0.001) but showed no correlation with apparent diffusion coefficient values (P=0.795). There was no significant correlation between relative signal intensity and time from symptom onset (Spearman correlation coefficient -0.152, P=0.128). Based on our findings, we cannot recommend the use of FLAIR visibility as an estimate of time from symptom onset within the first 4.5 hours.

  18. Long-Lasting Efficacy of an Experimental 1450 ppm Fluoride/Zinc-Based Dentifrice as Measured by Calcium Buildup Using an In Situ Intra-Oral Device After 12 Hours: A Randomized Clinical Trial.

    PubMed

    Richter, R; Jogun, S; Won, B; Zhang, Y P; Miller, S

    2015-01-01

    To assess the efficacy of an experimental 1450 ppm fluoride as sodium monofluorophosphate (SMFP)/zinc-based dentifrice (Test), a clinically proven 1450 ppm fluoride as SMFP/zinc-based dentifrice (Positive Control), and a 1000 ppm fluoride as SMFP and 450 ppm fluoride as sodium fluoride (NaF) dentifrice (Negative Control) in delivering 12-hour anti-tartar benefits as measured by calcium buildup after a single product brushing. Fourteen (14) adult subjects completed this single-center, double-blind, randomized, cross-over clinical study conducted in Piscataway, New Jersey. An intra-oral appliance was custom-made for each subject as a surface on which the anti-calculus agents' inhibition of early calculus formation could be analyzed. After brushing with their assigned toothpaste, each subject wore their respective appliance for 12 hours overnight. When the appliance was removed, it was washed, suspended in 0.1 MHCL to release Ca2+ from deposits, and analyzed by Inductively Coupled Plasma (ICP) for deposited calcium. There was a one-week washout period between each product use. Statistical analyses were performed on the mean level of calcium (μg). Comparisons of the treatment groups with respect to 12-hour post-brushing (overnight) calcium levels were performed via a two-way analysis of variance (ANOVA), with subjects and products as factors in the ANOVA model. Post-ANOVA pair-wise comparisons of the study treatments were performed using the Tukey's test for multiple comparisons. All statistical tests of hypothesis were two-sided, and employed a level of significance of α = 0.05. At the 12-hour post-brushing examination, the mean level of calcium buildup was 0.46 μg for subjects assigned to the experimental Test dentifrice, 0.41 μg for subjects assigned to the Positive Control dentifrice, and 2.47 μg for subjects assigned to the Negative Control dentifrice. After 12 hours post-brushing, subjects assigned to the experimental Test dentifrice and Positive Control

  19. Distribution of rest days in 12 hour shift systems: impacts on health, wellbeing, and on shift alertness

    PubMed Central

    Tucker, P.; Smith, L.; Macdonald, I.; Folkard, S.

    1999-01-01

    OBJECTIVES: To investigate of the effects of distribution of rest days in 12 hour shift systems. Although several studies have examined the effects of compressing work schedules by comparing 8 and 12 hour shift systems, there is little published research examining the various forms of 12 hour shift system. METHODS: An abridged version of the standard shiftwork index which included retrospective alertness ratings was completed by a large sample of industrial shiftworkers. The respondents worked 12 hour shift systems that either did or did not incorporate breaks of > 24 hours between the blocks of day and night shifts. For the purposes of the analysis, each of these two groups were further subdivided into those who started their morning shift at 0600 and those who started at 0700. RESULTS: Systems which incorporated rest days between the day and night shifts were associated with slightly higher levels of on shift alertness, slightly lower levels of chronic fatigue, along with longer sleep durations when working night shifts and between rest days. Early changeovers were associated with shorter night sleeps between successive day shifts, but longer and less disturbed day sleeps between night shifts. These effects of changeover time were broadly in agreement with previous research findings. CONCLUSIONS: The distribution of rest days in 12 hour shift systems had only limited effects on the outcome measures, although the few modest differences that were found favoured systems which incorporated rest days between the day and night shifts. It is conceded that the design of the study may have obscured some subtle differences between the shift systems. Nevertheless, it is concluded that the impact of distribution of rest days seems to be minor relative to previously found effects of other features of shift systems--for example, shift duration.   PMID:10448331

  20. Overnight and postcall errors in medication orders.

    PubMed

    Hendey, Gregory W; Barth, Bradley E; Soliz, Tricia

    2005-07-01

    To compare the error rates in medication orders by physicians who were off call, on overnight call, and postcall. This was a retrospective review of inpatient medication orders, pharmacy records, and resident physician work schedules in a university-affiliated community teaching hospital with residency programs in emergency medicine, family practice, internal medicine, obstetrics, pediatrics, and surgery. The authors calculated error rates, odds ratios (ORs), and 95% confidence intervals (95% CIs) for physicians during April 2000. In 8,195 medication orders, there were 177 errors (2.16% overall error rate). There was an increased error rate for overnight and postcall orders (2.71%, OR 1.44, 95% CI = 1.06 to 1.95) in comparison to orders written by off-call physicians (1.90%). Error rates were significantly higher on the medical/surgical wards during the overnight (3.91%, OR 1.89, 95% CI = 1.22 to 2.92) and postcall (3.41%, OR 1.64, 95% CI = 1.10 to 2.43) periods compared with the off-call (2.11%) period, and postgraduate year 1 (PGY1) physicians had a higher overnight error rate (4.23%, OR 2.28, 95% CI = 1.44 to 3.61). Error rates were also higher on the medical/surgical wards compared with critical care units (2.62% vs. 1.22%, OR 2.17, 95% CI = 1.48 to 3.18). The PGY1 physicians had error rates similar to those of the PGY2-5 physicians when off call, but were significantly higher on overnight call (4.23% vs. 0.52%, OR 8.47, 95% CI = 2.00 to 35.82). Medication-ordering error rates were higher for overnight and postcall physicians, particularly on the general medical/surgical wards, and in PGY1 physicians during the overnight period.

  1. Overnight Changes Recorded by Phoenix Conductivity Probe

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This graph presents simplified data from overnight measurements by the Thermal and Electrical Conductivity Probe on NASA's Phoenix Mars Lander from noon of the mission's 70th Martian day, or sol, to noon the following sol (Aug. 5 to Aug. 6, 2008).

    The graph shows that water disappeared from the atmosphere overnight, at the same time that electrical measurements detected changes consistent with addition of water to the soil.

    Water in soil appears to increase overnight, when water in the atmosphere disappears.

    The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  2. Overnight Changes Recorded by Phoenix Conductivity Probe

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This graph presents simplified data from overnight measurements by the Thermal and Electrical Conductivity Probe on NASA's Phoenix Mars Lander from noon of the mission's 70th Martian day, or sol, to noon the following sol (Aug. 5 to Aug. 6, 2008).

    The graph shows that water disappeared from the atmosphere overnight, at the same time that electrical measurements detected changes consistent with addition of water to the soil.

    Water in soil appears to increase overnight, when water in the atmosphere disappears.

    The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  3. A mechanical model of overnight hair curling.

    PubMed

    Xiao, Hang; Chen, Xi

    2015-09-01

    Based on the observation of overnight hair curling procedure, we establish a mechanical model to describe the temporary wave formation of straight hair (initial curvature is zero), which incorporates the contact between hair and hair roller. Systematic studies are carried out to explore the effects of radius ratio between hair and hair roller, hair's average axial strain, creep time, Poisson's ratio and gravity on the curl retention. The variation of curl retention with respect to time obtained from our numerical model is validated by a simple theoretical model and by overnight curling experiments on hair samples. The results of simulation show that overnight hair curling is suitable to create a wavy hairstyle within about 7 hours, while the combined usage with hair fixatives enables a wavy hairstyle with desired curvature that lasts for a day or more.

  4. Negative reinforcement impairs overnight memory consolidation.

    PubMed

    Stamm, Andrew W; Nguyen, Nam D; Seicol, Benjamin J; Fagan, Abigail; Oh, Angela; Drumm, Michael; Lundt, Maureen; Stickgold, Robert; Wamsley, Erin J

    2014-11-01

    Post-learning sleep is beneficial for human memory. However, it may be that not all memories benefit equally from sleep. Here, we manipulated a spatial learning task using monetary reward and performance feedback, asking whether enhancing the salience of the task would augment overnight memory consolidation and alter its incorporation into dreaming. Contrary to our hypothesis, we found that the addition of reward impaired overnight consolidation of spatial memory. Our findings seemingly contradict prior reports that enhancing the reward value of learned information augments sleep-dependent memory processing. Given that the reward followed a negative reinforcement paradigm, consolidation may have been impaired via a stress-related mechanism.

  5. Overnight Changes Recorded by Phoenix Conductivity Probe

    NASA Image and Video Library

    2008-12-15

    This graph presents simplified data from overnight measurements by the Thermal and Electrical Conductivity Probe on NASA Phoenix Mars Lander from noon of the mission 70th Martian day, or sol, to noon the following sol Aug. 5 to Aug. 6, 2008.

  6. Dysfunctional overnight memory consolidation in ecstasy users.

    PubMed

    Smithies, Vanessa; Broadbear, Jillian; Verdejo-Garcia, Antonio; Conduit, Russell

    2014-08-01

    Sleep plays an important role in the consolidation and integration of memory in a process called overnight memory consolidation. Previous studies indicate that ecstasy users have marked and persistent neurocognitive and sleep-related impairments. We extend past research by examining overnight memory consolidation among regular ecstasy users (n=12) and drug naïve healthy controls (n=26). Memory recall of word pairs was evaluated before and after a period of sleep, with and without interference prior to testing. In addition, we assessed neurocognitive performances across tasks of learning, memory and executive functioning. Ecstasy users demonstrated impaired overnight memory consolidation, a finding that was more pronounced following associative interference. Additionally, ecstasy users demonstrated impairments on tasks recruiting frontostriatal and hippocampal neural circuitry, in the domains of proactive interference memory, long-term memory, encoding, working memory and complex planning. We suggest that ecstasy-associated dysfunction in fronto-temporal circuitry may underlie overnight consolidation memory impairments in regular ecstasy users. © The Author(s) 2014.

  7. Negative Reinforcement Impairs Overnight Memory Consolidation

    ERIC Educational Resources Information Center

    Stamm, Andrew W.; Nguyen, Nam D.; Seicol, Benjamin J.; Fagan, Abigail; Oh, Angela; Drumm, Michael; Lundt, Maureen; Stickgold, Robert; Wamsley, Erin J.

    2014-01-01

    Post-learning sleep is beneficial for human memory. However, it may be that not all memories benefit equally from sleep. Here, we manipulated a spatial learning task using monetary reward and performance feedback, asking whether enhancing the salience of the task would augment overnight memory consolidation and alter its incorporation into…

  8. Negative Reinforcement Impairs Overnight Memory Consolidation

    ERIC Educational Resources Information Center

    Stamm, Andrew W.; Nguyen, Nam D.; Seicol, Benjamin J.; Fagan, Abigail; Oh, Angela; Drumm, Michael; Lundt, Maureen; Stickgold, Robert; Wamsley, Erin J.

    2014-01-01

    Post-learning sleep is beneficial for human memory. However, it may be that not all memories benefit equally from sleep. Here, we manipulated a spatial learning task using monetary reward and performance feedback, asking whether enhancing the salience of the task would augment overnight memory consolidation and alter its incorporation into…

  9. Increased error rates in preliminary reports issued by radiology residents working more than 10 consecutive hours overnight.

    PubMed

    Ruutiainen, Alexander T; Durand, Daniel J; Scanlon, Mary H; Itri, Jason N

    2013-03-01

    To determine if the rate of major discrepancies between resident preliminary reports and faculty final reports increases during the final hours of consecutive 12-hour overnight call shifts. Institutional review board exemption status was obtained for this study. All overnight radiology reports interpreted by residents on-call between January 2010 and June 2010 were reviewed by board-certified faculty and categorized as major discrepancies if they contained a change in interpretation with the potential to impact patient management or outcome. Initial determination of a major discrepancy was at the discretion of individual faculty radiologists based on this general definition. Studies categorized as major discrepancies were secondarily reviewed by the residency program director (M.H.S.) to ensure consistent application of the major discrepancy designation. Multiple variables associated with each report were collected and analyzed, including the time of preliminary interpretation, time into shift study was interpreted, volume of studies interpreted during each shift, day of the week, patient location (inpatient or emergency department), block of shift (2-hour blocks for 12-hour shifts), imaging modality, patient age and gender, resident identification, and faculty identification. Univariate risk factor analysis was performed to determine the optimal data format of each variable (ie, continuous versus categorical). A multivariate logistic regression model was then constructed to account for confounding between variables and identify independent risk factors for major discrepancies. We analyzed 8062 preliminary resident reports with 79 major discrepancies (1.0%). There was a statistically significant increase in major discrepancy rate during the final 2 hours of consecutive 12-hour call shifts. Multivariate analysis confirmed that interpretation during the last 2 hours of 12-hour call shifts (odds ratio (OR) 1.94, 95% confidence interval (CI) 1.18-3.21), cross

  10. Evaluation of the Military Acute Concussion Evaluation for use in combat operations more than 12 hours after injury.

    PubMed

    Coldren, Rodney L; Kelly, Mark P; Parish, Robert V; Dretsch, Michael; Russell, Michael L

    2010-07-01

    The diagnosis and management of concussion can be difficult in a combat environment, especially in the absence of loss of consciousness or post-traumatic amnesia. As no validated test exists to diagnose or grade neurocognitive impairment from a concussion, the military currently employs the Military Acute Concussion Evaluation (MACE) in Iraq. This is a two-part test, which incorporates the standardized assessment of concussion (SAC) as its objective score, although it has not been shown to be valid unless administered shortly after injury. A research team deployed to Iraq between January and April 2009 to examine the validity of several tests of neurocognitive function following a concussion, including the MACE. When administered more than 12 hours after the concussive injury, the MACE lacked sufficient sensitivity and specificity to be clinically useful.

  11. Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up

    PubMed Central

    Merkus, Suzanne L.; Holte, Kari Anne; Huysmans, Maaike A.; van de Ven, Peter M.; van Mechelen, Willem; van der Beek, Allard J.

    2015-01-01

    Background Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Methods Sixty-one male offshore employees—20 night workers, 16 swing shift workers, and 25 day workers—rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1–11) for 14 days after an offshore tour. After the two night-work schedules, differences on the 1st day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. Results After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05–1.89) and swing shift workers (1.42, 95% confidence interval 1.03–1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. Conclusion After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the 1st day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality. PMID:26929834

  12. Semantic and phonological schema influence spoken word learning and overnight consolidation.

    PubMed

    Havas, Viktória; Taylor, J S H; Vaquero, Lucía; de Diego-Balaguer, Ruth; Rodríguez-Fornells, Antoni; Davis, Matthew H

    2017-08-31

    We studied the initial acquisition and overnight consolidation of new spoken words that resemble words in the native language (L1) or in an unfamiliar, non-native language (L2). Spanish-speaking participants learned the spoken forms of novel words in their native language (Spanish) or in a different language (Hungarian), which were paired with pictures of familiar or unfamiliar objects, or no picture. We thereby assessed, in a factorial way, the impact of existing knowledge (schema) on word learning by manipulating both semantic (familiar vs. unfamiliar objects) and phonological (L1- vs. L2-like novel words) familiarity. Participants were trained and tested with a 12-hour intervening period that included overnight sleep or daytime awake. Our results showed; i) benefits of sleep to recognition memory that were greater for words with L2-like phonology; ii) that learned associations with familiar but not unfamiliar pictures enhanced recognition memory for novel words. Implications for complementary systems accounts of word learning are discussed.

  13. Insulin sensitivity measured by the minimal model: no associations with fasting respiratory exchange ratio in trained athletes.

    PubMed

    Goedecke, J H; Levitt, N S; St Clair Gibson, A; Grobler, L; Noakes, T D; Lambert, E V

    2001-11-01

    The aim of this study was to examine the role of fasting insulin concentrations and tissue insulin sensitivity on whole-body substrate oxidation in 61 well-trained subjects. Subjects underwent a frequently sampled intravenous glucose tolerance test (FSIVGT) after a 10- to 12-hour overnight fast. Minimal model analysis was used to determine insulin sensitivity (S(i)). A week later, fasting (10- to 12-hour) respiratory exchange ratio (RER) was measured at rest and during exercise at 25%, 50%, and 70% of peak power output (W(peak)). Prior to these measurements, training volume, dietary intake, and muscle fiber composition, substrate concentrations, and enzyme activities were determined. The average fasting plasma insulin concentration was 7.3 +/- 2.4 microU/mL (4.0 to 10.5 microU/mL), and the mean S(i) was 14.0 +/- 6.1 x (10(-4) min(-1) x microU(-1) x mL(-1)) (2.6 to 26.3 x 10(-4) min(-1) x microU(-1) x mL(-1)). There was no significant correlation between fasting plasma insulin concentration and S(i) (r = -.14, P =.336) or between these measurements and fasting RER, measured at rest and during exercise at 25%, 50%, and 70% W(peak). Only VO(2max) and the proportion of type 1 muscle fibers were significantly correlated with S(i) (r =.30, P =.045 and r =.34, P =.026, respectively), and waist-to-hip ratio (WHR) was significantly correlated with fasting plasma insulin concentration (r =.35, P =.006). In conclusion, S(i) and fasting plasma insulin concentration were not associated with fasting RER at rest and during exercise of increasing intensity in trained athletes who have high S(i).

  14. Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells 12-Hours Post-Exposure to 532 nm, 120 ps Pulsed Laser Light

    DTIC Science & Technology

    2004-04-01

    years or younger, either sex, with no mitigating ocular or retinal pathology such as glaucoma, diabetic retinopathy, retinitis pigmentosa , etc. Donor: The...USAFA TR 2004-01 Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells 12-hours Post-Exposure to 532 nm, 120 ps Pulsed...TR 2004-01 This article, "Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells 12-hours Post-Exposure to 532 nm, 120 ps

  15. Ramelteon Prior to a Short Evening Nap Impairs Neurobehavioral Performance for up to 12 Hours after Awakening

    PubMed Central

    Cohen, Daniel A.; Wang, Wei; Klerman, Elizabeth B.; Rajaratnam, Shantha M.W.

    2010-01-01

    Study Objectives: Planned naps can improve performance when the habitual or nocturnal sleep schedule is disrupted. It may be difficult, however, to achieve sleep during a nap, particularly during the circadian peak in alertness in the early evening. Prior studies with the melatonin agonist, ramelteon, reported that this hypnotic does not impair neurobehavioral performance. We tested whether ramelteon could improve nap efficiency in the early evening and subsequent performance during a simulated 8-h night shift. Methods: 10 healthy volunteers aged 19-31 years participated in an inpatient randomized, double-blind, placebo-controlled crossover study. Ramelteon 8 mg or placebo was administered 30 min prior to a 2-h nap opportunity commencing 13 h after each individual's habitual morning wake time. Results: Ramelteon did not significantly affect sleep efficiency during the nap prior to the night shift. Following the nap, ramelteon was associated with significantly worse neurobehavioral performance on assessments immediately following the nap and during the simulated night shift. Conclusions: Although ramelteon did not significantly affect sleep during the nap, it was associated with significant impairments in neurobehavioral performance for up to 12 h after administration. High homeostatic sleep pressure combined with the circadian performance nadir may increase the vulnerability to hypnotic-induced neurobehavioral impairments. The findings do not support the use of ramelteon prior to an evening prophylactic nap, as there may be residual effects that last for several hours. Furthermore, this study highlights the pitfalls of applying side-effect profiles obtained in one context to another. Citation: Cohen DA; Wang W; Klerman EB; Rajaratnam SMW. Ramelteon prior to a short evening nap impairs neurobehavioral performance for up to 12 hours after awakening. J Clin Sleep Med 2010;6(6):565-571. PMID:21206545

  16. Metabolic Characteristics of Human Hearts Preserved for 12 Hours by Static Storage, Antegrade Perfusion or Retrograde Coronary Sinus Perfusion

    PubMed Central

    Cobert, Michael L.; Merritt, Matthew E.; West, LaShondra M.; Ayers, Colby; Jessen, Michael E.; Peltz, Matthias

    2014-01-01

    Objective(s) Machine perfusion of donor hearts is a promising strategy to increase the donor pool. Antegrade perfusion is effective but can lead to aortic valve incompetence and non-nutrient flow. Experience with retrograde coronary sinus perfusion of donor hearts has been limited. We tested the hypothesis that retrograde perfusion could support myocardial metabolism over an extended donor ischemic interval. Methods Human hearts from donors rejected or not offered for transplantation were preserved for 12 hours in University of Wisconsin Machine Perfusion Solution by: 1. Static hypothermic storage 2. Hypothermic antegrade machine perfusion or 3. Hypothermic retrograde machine perfusion. Myocardial oxygen consumption (MVO2), and lactate accumulation were measured. Ventricular tissue was collected for proton (1H) and phosphorus-31 (31P) magnetic resonance spectroscopy (MRS) to evaluate the metabolic state of the myocardium. Myocardial water content was determined at end-experiment. Results Stable perfusion parameters were maintained throughout the perfusion period with both perfusion techniques. Lactate/alanine ratios were lower in perfused hearts compared to static hearts (p<.001). Lactate accumulation (Antegrade 2.0±.7, Retrograde 1.7±.1 mM) and MVO2 (Antegrade 0.25±.2, Retrograde 0.26±.3 mL O2/min/100g) were similar in machine perfused groups. High energy phosphates were better preserved in both perfused groups (p<.05). Left ventricular myocardial water content was increased in retrograde perfused (80.2±.8%) compared to both antegrade perfused (76.6±.8%, p=.02) and static storage hearts (76.7±1%, p=.02). Conclusions In conclusion, machine perfusion by either the antegrade or the retrograde technique can support myocardial metabolism over long intervals. Machine perfusion appears promising for long term preservation of human donor hearts. PMID:24642559

  17. Effects of a 12-hour shift on mood states and sleepiness of Neonatal Intensive Care Unit nurses.

    PubMed

    Ferreira, Tadeu Sartini; Moreira, Clarice Zinato; Guo, James; Noce, Franco

    2017-03-09

    To assess the effect of a 12-hour shift on mood states and sleepiness at the beginning and end of the shift. Quantitative, cross-sectional and descriptive study.It was conducted with 70 neonatal intensive care unit nurses. The Brunel Mood Scale (BRUMS), Karolinska Sleepiness Scale (KSS), and a socio-demographic profile questionnaire were administered. When the KSS and BRUMS scores were compared at the beginning of the shift associations were found with previous sleep quality (p ≤ 0.01), and quality of life (p ≤ 0.05). Statistical significant effects on BRUMS scores were also associated with previous sleep quality, quality of life, liquid ingestion, healthy diet, marital status, and shift work stress. When the beginning and end of the shift were compared, different KSS scores were seen in the group of all nurses and in the night shift one. Significant vigor and fatigue scores were observed within shift groups. A good night's sleep has positive effects on the individual`s mood states both at the beginning and the end of the shift. The self-perception of a good quality of life also positively influenced KSS and BRUMS scores at the beginning and end of the shift. Proper liquid ingestion led to better KSS and BRUMS scores. Evaluar el efecto de un turno de 12 horas en estados de ánimo y somnolencia al principio y al final del turno. Estudio cuantitativo, transversal y descriptivo.Se realizó con 70 enfermeras de unidades de cuidados intensivos neonatales. Se administró la Escala de Humor Brunel (BRUMS), la Escala de Somnolencia de Karolinska (KSS) y un cuestionario de perfil sociodemográfico. Cuando se compararon las puntuaciones de KSS y BRUMS al comienzo del turno se encontraron asociaciones con calidad de sueño previa (p ≤ 0,01) y calidad de vida (p ≤ 0,05). Los efectos estadísticos significativos en las puntuaciones de BRUMS también se asociaron con la calidad previa del sueño, la calidad de vida, la ingestión de líquidos, la dieta saludable, el

  18. The overnight effect on the Taiwan stock market

    NASA Astrophysics Data System (ADS)

    Tsai, Kuo-Ting; Lih, Jiann-Shing; Ko, Jing-Yuan

    2012-12-01

    This study examines statistical regularities among three components of stocks and indices: daytime (trading hour) return, overnight (off-hour session) return, and total (close-to-close) return. Owing to the fact that the Taiwan Stock Exchange (TWSE) has the longest non-trading periods among major markets, the TWSE is selected to explore the correlation among the three components and compare it with major markets such as the New York Stock Exchange (NYSE) and the National Association of Securities Dealers Automated Quotation (NASDAQ). Analysis results indicate a negative cross correlation between the sign of daytime return and the sign of overnight return; possibly explaining why most stocks feature a negative cross correlation between daytime return and overnight return [F. Wang, S.-J. Shieh, S. Havlin, H.E. Stanley, Statistical analysis of the overnight and daytime return, Phys. Rev. E 79 (2009) 056109]. Additionally, the cross correlation between the magnitude of returns is analyzed. According to those results, a larger magnitude of overnight return implies a higher probability that the sign of the following daytime return is the opposite of the sign of overnight return. Namely, the predictability of daytime return might be improved when a stock undergoes a large magnitude of overnight return. Furthermore, the cross correlations of 29 indices of worldwide markets are discussed.

  19. [The effects of overnight sleep deprivation on cardiovascular autonomic modulation].

    PubMed

    Zhong, Xu; Xiao, Yi; Huang, Rong; Huang, Xi-zhen

    2005-08-01

    This study aimed to delineate cardiovascular autonomic modulation associated with overnight total sleep deprivation (TSD) in humans. Cardiovascular autonomic modulation during overnight total sleep deprivation was assessed in 18 normal male subjects [age: (26.2 +/- 4.2) years, BMI (23.9 +/- 1.7) kg/m(2)]. ECG and continuous blood pressure from radial artery tonometry were obtained in seated position before TSD (baseline) and after overnight TSD. Spectral analysis of heart rate variability (HRV) and BP variability (BPV) were computed for cardiac parasympathetic modulation (high frequency power, HF); sympathetic modulation (low frequency power, LF), sympatho-vagal balance (LF/HF power of R-R variability, LF/HF) and BPV sympathetic modulation (low frequency power, BPV LF) in normalized (N) units [(total power of the components)/(total power-very low frequency power) x 100]. No significant changes were found in BP and heart rate. HRV LF was increased significantly from baseline (59.4 +/- 15.7)% to overnight SD (67.0 +/- 13.9)%. HRV LF/HF was increased significantly from baseline (2.7 +/- 1.7) to overnight SD (3.8 +/- 2.3), HRV HFN was decreased from baseline (29.0 +/- 11.6)% to overnight SD (22.8 +/- 10.4)%, BPV LF was significantly increased from baseline (63.2 +/- 16.5)% to overnight SD (72.4 +/- 13.2)%. Acute SD was associated with increased sympathetic and decreased parasympathetic cardiovascular modulation.

  20. Normobaric hypoxia overnight impairs cognitive reaction time.

    PubMed

    Pramsohler, Stephan; Wimmer, Stefan; Kopp, Martin; Gatterer, Hannes; Faulhaber, Martin; Burtscher, Martin; Netzer, Nikolaus Cristoph

    2017-05-15

    Impaired reaction time in patients suffering from hypoxia during sleep, caused by sleep breathing disorders, is a well-described phenomenon. High altitude sleep is known to induce periodic breathing with central apneas and oxygen desaturations, even in perfectly healthy subjects. However, deficits in reaction time in mountaineers or workers after just some nights of hypoxia exposure are not sufficiently explored. Therefore, we aimed to investigate the impact of sleep in a normobaric hypoxic environment on reaction time divided by its cognitive and motoric components. Eleven healthy non acclimatized students (5f, 6m, 21 ± 2.1 years) slept one night at a simulated altitude of 3500 m in a normobaric hypoxic room, followed by a night with polysomnography at simulated 5500 m. Preexisting sleep disorders were excluded via BERLIN questionnaire. All subjects performed a choice reaction test (SCHUHFRIED RT, S3) at 450 m and directly after the nights at simulated 3500 and 5500 m. We found a significant increase of cognitive reaction time with higher altitude (p = 0.026). No changes were detected in movement time (p = n.s.). Reaction time, the combined parameter of cognitive- and motoric reaction time, didn't change either (p = n.s.). Lower SpO2 surprisingly correlated significantly with shorter cognitive reaction time (r = 0.78, p = 0.004). Sleep stage distribution and arousals at 5500 m didn't correlate with reaction time, cognitive reaction time or movement time. Sleep in hypoxia does not seem to affect reaction time to simple tasks. The component of cognitive reaction time is increasingly delayed whereas motoric reaction time seems not to be affected. Low SpO2 and arousals are not related to increased cognitive reaction time therefore the causality remains unclear. The fact of increased cognitive reaction time after sleep in hypoxia, considering high altitude workers and mountaineering operations with overnight stays, should be further investigated.

  1. Positive net movements of amino acids in the hindlimb after overnight food deprivation contribute to sustaining the elevated anabolism of neonatal pigs.

    PubMed

    Thivierge, M Carole; Bush, Jill A; Suryawan, Agus; Nguyen, Hanh V; Orellana, Renan A; Burrin, Douglas G; Jahoor, Farook; Davis, Teresa A

    2008-12-01

    During the neonatal period, high protein breakdown rate is a metabolic process inherent to elevated rates of protein accretion in skeletal muscle. To determine the relationship between hindlimb net movements of essential and nonessential amino acids in the regulation of hindlimb protein breakdown during an overnight fasting-feeding cycle, we infused overnight-food-deprived 10- and 28-day-old piglets with [1-(13)C]phenylalanine and [ring-(2)H(4)]tyrosine over 7 h (during 3 h of fasting and then during 4 h of feeding). Extraction rates for aspartate and glutamate after an overnight fast were 15% and 51% in the 10-day-old compared with 6% and 25% in the 28-day-old (P < 0.05) piglets, suggesting an altered requirement for precursors of amino acids to shuttle nitrogen to the liver as early life progresses. This occurred simultaneously with marginal positive hindlimb net balance of essential amino acids after an overnight fast, with negative net release of many nonessential amino acids, such as alanine, asparagine, glutamine, glycine, and proline. This suggests that newborn muscle does not undergo significant protein mobilization after a short period of fasting in support of an elevated rate of protein accretion. Furthermore, tyrosine efflux from hindlimb breakdown between overnight fasting and feeding periods was not different in the 10-day-old piglets, for which tyrosine was limiting, but when tyrosine supply balanced requirements in the 28-day-old piglet, hindlimb efflux was increased (P = 0.01). The results of the present study indicate that proteolysis and net movements of amino acids are coordinated mechanisms that sustain the elevated rate of net protein accretion during overnight feeding-fasting cycles in the neonate.

  2. Reduced overnight consolidation of procedural learning in chronic medicated schizophrenia is related to specific sleep stages.

    PubMed

    Manoach, Dara S; Thakkar, Katharine N; Stroynowski, Eva; Ely, Alice; McKinley, Sophia K; Wamsley, Erin; Djonlagic, Ina; Vangel, Mark G; Goff, Donald C; Stickgold, Robert

    2010-01-01

    We previously reported that patients with schizophrenia failed to demonstrate normal sleep-dependent improvement in motor procedural learning. Here, we tested whether this failure was associated with the duration of Stage 2 sleep in the last quartile of the night (S2q4) and with spindle activity during this epoch. Fourteen patients with schizophrenia and 15 demographically matched controls performed a motor sequence task (MST) before and after a night of polysomnographically monitored sleep. Patients showed no significant overnight task improvement and significantly less than controls, who did show significant improvement. While there were no group differences in overall sleep architecture, patients showed significant reductions in fast sigma frequency power (45%) and in spindle density (43%) during S2q4 sleep at the electrode proximal to the motor cortex controlling the hand that performed the MST. Although spindle activity did not correlate with overnight improvement in either group, S2q4 sleep duration in patients significantly correlated with the plateau level of overnight improvement seen at the end of the morning testing session, and slow wave sleep (SWS) duration correlated with the delay in reaching this plateau. SWS and S2q4 sleep each predicted the initial level of overnight improvement in schizophrenia, and their product explained 77% of the variance, suggesting that both sleep stages are necessary for consolidation. These findings replicate our prior observation of reduced sleep-dependent consolidation of motor procedural learning in schizophrenia and link this deficit to specific sleep stages. They provide further evidence that sleep is an important contributor to cognitive deficits in schizophrenia.

  3. Contractile function of smooth muscle retained after overnight storage.

    PubMed

    Loong, B J; Tan, J H; Lim, K H; Mbaki, Y; Ting, K N

    2015-10-01

    The functional responses of different overnight-stored in vitro tissues are not clearly described in any animal model. The influence of overnight storage in an animal model may vary between tissue types. We employed Sprague-Dawley rat as our animal model and investigated the functional changes of rat aorta, trachea, bronchus and bladder that were used (i) immediately after surgical removal (denoted as fresh) and (ii) after storage in aerated (95% O2, 5% CO2) Krebs-Ringer bicarbonate solution at 4 °C for 24 h (denoted as stored). The aorta ring was pre-contracted with phenylephrine, and the functional response of the tissue was investigated using isoprenaline, forskolin and carbachol. Carbachol was also used to increase the tone in trachea, bronchus rings and bladder strips. A clear reduced function of endothelium, with a minor if any effect in the smooth muscle function in rat aorta was observed after overnight storage. The contractile response of overnight-stored rat airway (trachea and bronchus) and bladder smooth muscles remained unchanged. Among all tested tissues, only bronchus showed a reduced response rate (only 40% responded) after storage. In vitro rat tissues that are stored in Krebs solution at 4 °C for 24 h can still be used to investigate smooth muscle responses, however, not endothelium-mediated responses for aorta. The influence of overnight storage on different tissues from an animal model (Sprague-Dawley rat in our study) also provides an insight in maximising the use of sacrificed animals.

  4. Overnight Custody Arrangements, Attachment, and Adjustment Among Very Young Children

    PubMed Central

    Tornello, Samantha L.; Emery, Robert; Rowen, Jenna; Potter, Daniel; Ocker, Bailey; Xu, Yishan

    2014-01-01

    Large numbers of infants and toddlers have parents who live apart due to separation, divorce, or nonmarital/noncohabiting child-bearing, yet this important topic, especially the controversial issue of frequent overnights with nonresidential parents, is understudied. The authors analyzed data from the Fragile Families and Child Wellbeing Study, a longitudinal investigation of children born to primarily low-income, racial/ethnic minority parents that is representative of 20 U.S. cities with populations over 200,000. Among young children whose parents lived apart, 6.9% of infants (birth to age 1) and 5.3% of toddlers (ages 1 to 3) spent an average of at least 1 overnight per week with their nonresident parent. An additional 6.8% of toddlers spent 35% – 70% of overnights with nonresident parents. Frequent overnights were significantly associated with attachment insecurity among infants, but the relationship was less clear for toddlers. Attachment insecurity predicted adjustment problems at ages 3 and 5, but frequent overnights were not directly linked with adjustment problems at older ages. PMID:25635146

  5. Comparison of Celsior and Perfadex lung preservation solutions in rat lungs subjected to 6 and 12 hours of ischemia using an ex-vivo lung perfusion system.

    PubMed

    Menezes, Arteiro Queiroz; Pêgo-Fernandes, Paulo Manuel; Cardoso, Paulo Francisco Guerreiro; Braga, Karina Andrighetti de Oliveira; Nepomuceno, Natalia Aparecida; Pazetti, Rogerio; Correia, Aristides Tadeu; Canzian, Mauro; Santim, Jacqueline Klarosk; Jatene, Fabio Biscegli

    2012-11-01

    This study evaluated the performance of lungs that were preserved with different solutions (Celsior, Perfadex or saline) in an ex vivo rat lung perfusion system. Sixty Wistar rats were anesthetized, anticoagulated and randomized into three groups (n = 20). The rats were subjected to antegrade perfusion via the pulmonary artery with Perfadex, Celsior, or saline, followed by 6 or 12 hours of ischemia (4ºC, n = 10 in each group). Respiratory mechanics, gas exchange and hemodynamics were measured at 10-minute intervals during the reperfusion of heart-lung blocks in an ex vivo system (IL2-Isolated Perfused Rat or Guinea Pig Lung System, Harvard Apparatus, Holliston, Massachusetts, USA; Hugo Sachs Elektronik, Germany) for 60 minutes. The lungs were prepared for histopathology and evaluated for edema following reperfusion. Group comparisons were performed using ANOVA and the Kruskal-Wallis test with a 5% level of significance. Gas exchange was not significantly different between lungs perfused with either Perfadex or Celsior at the same ischemic times, but it was very low in lungs that were preserved with saline. Airway resistance was greater in the lungs that were preserved for 12 hours. Celsior lungs that were preserved for 6 and 12 hours exhibited lower airway resistance (p = 0.01) compared to Perfadex lungs. Pulmonary artery pressure was not different between the groups, and no significant differences in histopathology and apoptosis were observed between the groups. Lungs that were preserved with Celsior or Perfadex exhibited similar gas exchange and histopathological findings. Airway resistance was slightly lower in the Celsior-preserved lungs compared with the Perfadex-preserved lungs.

  6. Sensor Life and Overnight Closed Loop: A Randomized Clinical Trial.

    PubMed

    Tauschmann, Martin; Allen, Janet M; Wilinska, Malgorzata E; Ruan, Yue; Thabit, Hood; Acerini, Carlo L; Dunger, David B; Hovorka, Roman

    2017-05-01

    Closed-loop (CL) systems direct insulin delivery based on continuous glucose monitor (CGM) sensor values. CGM accuracy varies with sensor life, being least accurate on day 1 of sensor insertion. We evaluated the effect of sensor life (enhanced Enlite, Medtronic MiniMed, Northridge, CA) on overnight CL. In an open-label, randomized, 2-period, inpatient crossover pilot study, 12 adolescents on insulin pump (age 16.7 ± 1.9 years; HbA1c 66 ± 10 mmol/mol) attended a clinical research facility on 2 overnight occasions. In random order, participants received CL on day 1 or on day 3-4 after sensor insertion. During both periods, glucose was automatically controlled by a model predictive control algorithm informed by sensor glucose. Plasma glucose was measured every 30 to 60 min. During overnight CL (22:30 to 07:30), the proportion of time with plasma glucose readings in the target range (3.9-8.0 mmol/l, primary endpoint) when initiated on day 1 of sensor insertion vs day 3-4 were comparable (58 ± 32% day 1 vs 56 ± 36% day 3-4; P = .34), and there were no significant differences between interventions in terms of mean plasma glucose ( P = .26), percentage time above 8.0 mmol/l ( P = .49), and time spent below 3.9 mmol/l ( P = .93). Sensor accuracy varied with sensor life (mean absolute relative difference 19.8 ± 15.0% on day 1 and 13.7 ± 10.2% on day 3 to 4). Sensor glucose tended to under-read plasma glucose inflating benefits of CL on glucose control. In spite of differences in sensor accuracy, overnight CL glucose control informed by sensor glucose on day 1 or day 3-4 after sensor insertion was comparable. The model predictive controller appears to mitigate against sensor inaccuracies.

  7. Safety and efficacy of overnight orthokeratology in myopic children.

    PubMed

    Mika, Renée; Morgan, Bruce; Cron, Michael; Lotoczky, Josh; Pole, John

    2007-05-01

    This prospective case series was conducted to describe the safety and efficacy of orthokeratology with the Emerald Contact Lens for Overnight Orthokeratology (Oprifocon A; Euclid Systems Corporation, Herndon, Virginia) among young myopes. Twenty subjects (ages 10 to 16) were enrolled in the 6-month pilot study. Subjects were fit empirically with overnight orthokeratology lenses and evaluated at 1 day, 1 week, 1 month, 2 months, 3 months, and 6 months. Sixteen subjects completed the study. The mean baseline spherical equivalent refraction (SER) was -2.06 diopters (D) (+/-0.75). The mean SER at 6 months was -0.16 D (+/-0.38). The mean baseline uncorrected acuity was 0.78 (+/-0.28) logarithmic minimum angle of resolution (logMAR) equivalent (20/100 Snellen). The mean logMAR equivalent at 6 months was -0.03 +/- 0.12 (<20/20 Snellen). On average, 40% of eyes showed some type of corneal staining between the 1-week and 6-month visits. No serious adverse events occurred during the study. In contrast to previously published studies that reported maximum results at 2 weeks, subjects reached maximum reduction in myopia at the 1-week visit and, on average, obtained a 92.2% reduction in spherical equivalent refractive error at 6 months. This pilot study lends to a growing body of evidence that short-term correction of mild to moderate myopia with overnight orthokeratology is safe and efficacious in children and adolescents.

  8. Variations in physician interpretation of overnight pulse oximetry monitoring.

    PubMed

    Ramsey, Rory; Mehra, Reena; Strohl, Kingman P

    2007-09-01

    Overnight pulse oximetry is commonly used for hypoxemia evaluation in patients with COPD and sleep-disordered breathing. There is little information regarding its impact on physician decision making, and therefore an important measure of its clinical utility is untested and unknown. The aim of this study was to describe physician interpretation, use, and opinions regarding overnight pulse oximetry. Forty-one pulmonary physicians and fellows participated in structured interviews consisting of three oximetry record interpretations, oral responses to a standard question set, and a questionnaire. Qualitative data were analyzed using an open coding process. Quantitative data were assessed for distributions. Four measures were consistently used by the majority of physicians in record interpretation: background information, arterial oxygen saturation measured by pulse oximetry (Spo(2)) waveform and pattern, and time spent with Spo(2) < 90%. An additional 10 measures were consistently used by 5 to 46% of physicians. No interpretation generated a recommendation with > 60% consensus. There was a wide range of opinions on important matters related to this test, including test utility, indications, variables considered most important for interpretation, and criteria for nocturnal oxygen prescription. Forty-one physicians provided 35 different opinions on when nocturnal supplemental oxygen should be initiated. The variation in physician interpretation, use, and opinions regarding overnight pulse oximetry calls into question its clinical utility and underscores a need for standardization of presentation, training, and interpretation.

  9. Statistical analysis of the overnight and daytime return.

    PubMed

    Wang, Fengzhong; Shieh, Shwu-Jane; Havlin, Shlomo; Stanley, H Eugene

    2009-05-01

    We investigate the two components of the total daily return (close-to-close), the overnight return (close-to-open), and the daytime return (open-to-close), as well as the corresponding volatilities of the 2215 New York Stock Exchange stocks for the 20 year period from 1988 to 2007. The tail distribution of the volatility, the long-term memory in the sequence, and the cross correlation between different returns are analyzed. Our results suggest that (i) the two component returns and volatilities have features similar to that of the total return and volatility. The tail distribution follows a power law for all volatilities, and long-term correlations exist in the volatility sequences but not in the return sequences. (ii) The daytime return contributes more to the total return. Both the tail distribution and the long-term memory of the daytime volatility are more similar to that of the total volatility, compared to the overnight records. In addition, the cross correlation between the daytime return and the total return is also stronger. (iii) The two component returns tend to be anticorrelated. Moreover, we find that the cross correlations between the three different returns (total, overnight, and daytime) are quite stable over the entire 20 year period.

  10. Pregnancy outcomes of blastocysts cultured overnight after thawing.

    PubMed

    Fang, Cong; Yue, Chao-Min; Huang, Rui; Wei, Li-Na; Jia, Lei

    2016-06-01

    To compare embryo quality and outcomes of blastocysts thawed and transferred the same day with those thawed and cultured overnight before transfer. In this retrospective study, patients with infertility who underwent thawed embryo transfer (TET) the same day as thawing (0TET group) and those that received TET after embryos were thawed and cultured overnight before transfer (1TET group) were enrolled. Univariable and multivariable logistic regression were performed to detect the factors associated with the clinical pregnancy rate (CPR), implantation rate, miscarriage rate, and multiple pregnancy rate. A total of 489 patients (489 cycles) were included with 234 in the 0TET group and 255 in the 1TET group. There were no significant differences between the two groups with respect to age, body mass index (BMI), basal FSH and estradiol (E2) level, and causes of infertility (all, p > 0.05). There were no significant differences in the CPR, implantation rate, miscarriage rate, or multiple pregnancy rate between the two groups (all, p > 0.05), and this finding was irrespective of the endometrial preparation method. Pregnancy outcomes are the same for blastocysts thawed and cultured overnight 1 day before transfer and those thawed and transferred on the same day.

  11. Oscillatory theta activity during memory formation and its impact on overnight consolidation: a missing link?

    PubMed

    Heib, Dominik P J; Hoedlmoser, Kerstin; Anderer, Peter; Gruber, Georg; Zeitlhofer, Josef; Schabus, Manuel

    2015-08-01

    Sleep has been shown to promote memory consolidation driven by certain oscillatory patterns, such as sleep spindles. However, sleep does not consolidate all newly encoded information uniformly but rather "selects" certain memories for consolidation. It is assumed that such selection depends on salience tags attached to the new memories before sleep. However, little is known about the underlying neuronal processes reflecting presleep memory tagging. The current study sought to address the question of whether event-related changes in spectral theta power (theta ERSP) during presleep memory formation could reflect memory tagging that influences subsequent consolidation during sleep. Twenty-four participants memorized 160 word pairs before sleep; in a separate laboratory visit, they performed a nonlearning control task. Memory performance was tested twice, directly before and after 8 hr of sleep. Results indicate that participants who improved their memory performance overnight displayed stronger theta ERSP during the memory task in comparison with the control task. They also displayed stronger memory task-related increases in fast sleep spindle activity. Furthermore, presleep theta activity was directly linked to fast sleep spindle activity, indicating that processes during memory formation might indeed reflect memory tagging that influences subsequent consolidation during sleep. Interestingly, our results further indicate that the suggested relation between sleep spindles and overnight performance change is not as direct as once believed. Rather, it appears to be mediated by processes beginning during presleep memory formation. We conclude that theta ERSP during presleep memory formation reflects cortico-hippocampal interactions that lead to a better long-term accessibility by tagging memories for sleep spindle-related reprocessing.

  12. Practices and provisions for parents sleeping overnight with a hospitalized child.

    PubMed

    Stremler, Robyn; Wong, Lily; Parshuram, Christopher

    2008-04-01

    To describe practices affecting parents' overnight stays, provisions for parents sleeping overnight and parents' involvement in overnight care of their hospitalized child. A cross-sectional telephone survey of Canadian and American hospitals with more or equal to 50 acute pediatric beds and more or equal to two pediatric wards was conducted. Surveys were completed by 135 hospitals (77% response rate). All general pediatric units allowed parents to sleep at the bedside overnight; higher acuity units limited parental stays. The majority of hospitals limited overnight visitors at the bedside to one parent, and few hospitals routinely allowed siblings to sleep overnight. One hundred and thirty-three (99%) hospitals reported parental involvement in their child's care at night, with 52 (39%) stating this was an expectation. In general, parents are given the opportunity to stay at the bedside overnight, but barriers exist that limit opportunities for sleep during their child's hospitalization, and serve to separate families who have a hospitalized child.

  13. Comparison of seasonal variation in the fasting respiratory quotient of young Japanese, Polish and Thai women in relation to seasonal change in their percent body fat.

    PubMed

    Morinaka, Tomoko; Wozniewicz, Malgorzata; Jeszka, Jan; Bajerska, Joanna; Limtrakul, Porn-ngarm; Makonkawkeyoon, Luksana; Hirota, Naoko; Kumagai, Shoko; Sone, Yoshiaki

    2012-05-04

    From the viewpoint of human physiological adaptability, we previously investigated seasonal variation in the amount of unabsorbed dietary carbohydrates from the intestine after breakfast in Japanese, Polish and Thai participants. In this investigation we found that there were significant seasonal variations in the amount of unabsorbed dietary carbohydrates in Japanese and Polish participants, while we could not find significant seasonal variation in Thai participants. These facts prompted us to examine seasonal variations in the respiratory quotient after an overnight fast (an indicator of the ratio of carbohydrate and fat oxidized after the last meal) with female university students living in Osaka (Japan), Poznan (Poland) and Chiang Mai (Thailand). We enrolled 30, 33 and 32 paid participants in Japan, Poland and Thailand, respectively, and measurements were taken over the course of one full year. Fasting respiratory quotient was measured with the participants in their postabsorptive state (after 12 hours or more fasting before respiratory quotient measurement). Respiratory quotient measurements were carried out by means of indirect calorimetry using the mixing chamber method. The percent body fat was measured using an electric bioelectrical impedance analysis scale. Food intake of the participants in Osaka and Poznan were carried out by the Food Frequency Questionnaire method. There were different seasonal variations in the fasting respiratory quotient values in the three different populations; with a significant seasonal variation in the fasting respiratory quotient values in Japanese participants, while those in Polish and Thai participants were non-significant. We found that there were significant seasonal changes in the percent body fat in the three populations but we could not find any significant correlation between the fasting respiratory quotient values and the percent body fat. There were different seasonal variations in the fasting respiratory quotient

  14. Comparison of seasonal variation in the fasting respiratory quotient of young Japanese, Polish and Thai women in relation to seasonal change in their percent body fat

    PubMed Central

    2012-01-01

    Background From the viewpoint of human physiological adaptability, we previously investigated seasonal variation in the amount of unabsorbed dietary carbohydrates from the intestine after breakfast in Japanese, Polish and Thai participants. In this investigation we found that there were significant seasonal variations in the amount of unabsorbed dietary carbohydrates in Japanese and Polish participants, while we could not find significant seasonal variation in Thai participants. These facts prompted us to examine seasonal variations in the respiratory quotient after an overnight fast (an indicator of the ratio of carbohydrate and fat oxidized after the last meal) with female university students living in Osaka (Japan), Poznan (Poland) and Chiang Mai (Thailand). Methods We enrolled 30, 33 and 32 paid participants in Japan, Poland and Thailand, respectively, and measurements were taken over the course of one full year. Fasting respiratory quotient was measured with the participants in their postabsorptive state (after 12 hours or more fasting before respiratory quotient measurement). Respiratory quotient measurements were carried out by means of indirect calorimetry using the mixing chamber method. The percent body fat was measured using an electric bioelectrical impedance analysis scale. Food intake of the participants in Osaka and Poznan were carried out by the Food Frequency Questionnaire method. Results There were different seasonal variations in the fasting respiratory quotient values in the three different populations; with a significant seasonal variation in the fasting respiratory quotient values in Japanese participants, while those in Polish and Thai participants were non-significant. We found that there were significant seasonal changes in the percent body fat in the three populations but we could not find any significant correlation between the fasting respiratory quotient values and the percent body fat. Conclusions There were different seasonal

  15. Day-case versus overnight stay in laparoscopic cholecystectomy.

    PubMed

    Gurusamy, K S; Junnarkar, S; Farouk, M; Davidson, B R

    2008-01-23

    Although day-case elective laparoscopic cholecystectomy can save bed costs, its safety remains to be established. To assess the safety and benefits of day-case surgery compared to overnight stay in patients undergoing elective laparoscopic cholecystectomy. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until February 2007 for identifying randomised trials using search strategies. Only randomised clinical trials, irrespective of language, blinding, or publication status, comparing day-case and overnight stay in elective laparoscopic cholecystectomy were considered for the review. We collected the data on the characteristics of the trial, methodological quality of the trials, morbidity, prolonged hospitalisation, re-admissions, pain and quality of life from each trial. We analysed the data with both the fixed-effect and the random-effects models using RevMan Analysis. For each outcome we calculated the relative risk, weighted mean difference, or standardised mean difference with 95% confidence intervals (CI) based on available case-analysis. Five trials with 429 patients randomised to the day-case group (215) and overnight stay group (214) were included in the review. Four of the five trials were of low risk of bias regarding randomisation and follow up, but all lacked blinding. The trials recruited 49% of patients undergoing cholecystectomy. The selection criteria varied, but most included only patients without other diseases. The patients were living in easy reach of the hospital and with a responsible adult to take care of them. On the day of surgery, 81% of day-case patients were discharged. The drop-out rate after randomisation varied from 6.5% to 12.7%. There was no significant difference between day-case and overnight stay group as regards to morbidity, prolongation of hospital stay, re

  16. Parameters from preoperative overnight oximetry predict postoperative adverse events.

    PubMed

    Chung, F; Zhou, L; Liao, P

    2014-10-01

    Continuous home monitoring of oxygen saturation has become a reliable and feasible practice. The objective of this study was to investigate the role of preoperative overnight oximetry in predicting postoperative adverse events. Following research ethics board approval, consented patients underwent a preoperative overnight monitoring of oxygen saturation with a portable oximeter. Parameters from the oximetry data were extracted and their predictive performance for postoperative adverse events was evaluated. A total of 573 patients were studied with age: 60±12 years and 45% male. Oxygen desaturation index (ODI), cumulative time percentage with SpO2 <90% (CT90) and mean SpO2 were identified as significant predictors for postoperative adverse events. The privilege sensitivity, optimal predictive and privilege specificity cut-offs were: ODI: >3.0 events/h, >9.2 events/h and > 28.5 events/h; CT90: >0.1%, >1.1% and >7.2%; mean SpO2: <96.2%, <94.6% and <92.7%. The odds ratio for corresponding optimal cut-offs was: ODI 1.9 (95% CI: 1.4,2.7); CT90: 1.7 (95% CI: 1.2,2.4) and mean SpO2: 2.7 (95% CI: 1.9,3.8). The patients classified as high risk by ODI or CT90 or mean SpO2 had a significantly higher rate of postoperative adverse events. For ODI >28.5 vs. ODI ⋝28.5 events/h, the odds ratio adjusted with age, gender, body mass index and American Society of Anesthesiologists physical status was 2.2 (95% CI: 1.3-3.9). Patients with mean preoperative overnight SpO2 <92.7% or ODI >28.5 events/h or CT90 >7.2% are at higher risk for postoperative adverse events. Overnight oximetry could be a useful tool to stratify patients for the risk of postoperative adverse events.

  17. Overnight transfusions in New Zealand hospitals: potential risk to patients.

    PubMed

    Donegan, Rachel; Wright, Angela; Bobbitt, Louise; Charlewood, Richard; Blacklock, Hilary

    2016-03-11

    This audit aimed to assess how frequently overnight transfusions were taking place and compare it to the previous 2004 audit. All red cell units transfused between 20:00 and 08:00 hours in low acuity areas over 4 weeks in 2010 in 8 of New Zealand's largest public hospitals were identified prospectively, followed by review of clinical notes and laboratory results by the hospital Transfusion Nurse Specialist (TNS). 535 red cell units were transfused overnight, or 9% of the total units administered over the study period. Indications for transfusion were symptomatic anaemia, active bleeding or haemolysis (66%), but 16% of patients were asymptomatic. Of the non-urgent overnight transfusions (OTs), 42% were assessed as non-essential during the night. 49% of post-transfusion haemoglobin (Hb) levels were >100 g/L indicating a liberal transfusion practice. Although frequently cited as a reason for OT, only 16% of patients were discharged the following day. The median interval from pre-transfusion haemoglobin testing and starting the OT was approximately 9 hours, far exceeding the time needed to obtain routine full blood results. Adherence to recommended best transfusion practice was poor at night, with 12% of transfusions exceeding the 4 hour recommendation. End of transfusion observations fell to less than 80%, with the lowest compliance rate (69%) occurring at 06:00 hours. In addition to the 4 adverse reactions reported to the Haemovigilance programme, another 9 unreported reactions were identified by the auditors from the clinical notes. This audit has shown an improvement from 22% to 9% in the rate of OT compared to the 2004 audit. Nevertheless, 42% of transfusions were not considered appropriate based on current guidelines, and there is therefore room for improvement. A mean delay of 9 hours from haemoglobin sampling to transfusion suggests that reasons for this delay could be explored to help optimise transfusion start time. Some aspects of OT were worse than

  18. Day-surgery versus overnight stay surgery for laparoscopic cholecystectomy.

    PubMed

    Vaughan, Jessica; Gurusamy, Kurinchi Selvan; Davidson, Brian R

    2013-07-31

    Laparoscopic cholecystectomy is used to manage symptomatic gallstones. There is considerable controversy regarding whether it should be done as day-surgery or as an overnight stay surgery with regards to patient safety. To assess the impact of day-surgery versus overnight stay laparoscopic cholecystectomy on patient-oriented outcomes such as mortality, severe adverse events, and quality of life. We searched the Cochrane Hepato-Biliary Group Controlled Trials Register and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and mRCT until September 2012. We included randomised clinical trials comparing day-surgery versus overnight stay surgery for laparoscopic cholecystectomy, irrespective of language or publication status. Two authors independently assessed trials for inclusion and independently extracted the data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager 5 analysis. We calculated the risk ratio (RR), mean difference (MD), or standardised mean difference (SMD) with 95% confidence intervals (CI) based on intention-to-treat or available case analysis. We identified a total of six trials at high risk of bias involving 492 participants undergoing day-case laparoscopic cholecystectomy (n = 239) versus overnight stay laparoscopic cholecystectomy (n = 253) for symptomatic gallstones. The number of participants in each trial ranged from 28 to 150. The proportion of women in the trials varied between 74% and 84%. The mean or median age in the trials varied between 40 and 47 years.With regards to primary outcomes, only one trial reported short-term mortality. However, the trial stated that there were no deaths in either of the groups. We inferred from the other outcomes that there was no short-term mortality in the remaining trials. Long-term mortality was not reported in any of the trials. There was no significant difference in the

  19. Day-case versus overnight stay for laparoscopic cholecystectomy.

    PubMed

    Gurusamy, Kurinchi Selvan; Junnarkar, Sameer; Farouk, Marwan; Davidson, Brian R

    2008-07-16

    Although day-case elective laparoscopic cholecystectomy can save bed costs, its safety remains to be established. To assess the safety and benefits of day-case surgery compared to overnight stay in patients undergoing elective laparoscopic cholecystectomy. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until April 2008 for identifying randomised trials using search strategies. Only randomised clinical trials, irrespective of language, blinding, or publication status, comparing day-case and overnight stay in elective laparoscopic cholecystectomy were considered for the review. We collected the data on the characteristics of the trial, methodological quality of the trials, morbidity, prolonged hospitalisation, re-admissions, pain and quality of life from each trial. We analysed the data with both the fixed-effect and the random-effects models using RevMan Analysis. For each outcome we calculated the risk ratio, weighted mean difference, or standardised mean difference with 95% confidence intervals (CI) based on available case-analysis. Five trials with 429 patients randomised to the day-case group (215) and overnight stay group (214) were included in the review. All the trials were of high risk of bias. The trials recruited 49% of patients undergoing cholecystectomy. The selection criteria varied, but most included only patients without other diseases. The patients were living in easy reach of the hospital and with a responsible adult to take care of them. On the day of surgery, 81% of day-case patients were discharged. The drop-out rate after randomisation varied from 6.5% to 12.7%. There was no significant difference between day-case and overnight stay group as regards to morbidity, prolongation of hospital stay, re-admission rates, pain, quality of life, patient satisfaction and return to normal

  20. Overnight versus 24 hours of continuous subcutaneous insulin infusion as supplement to oral antidiabetic drugs in type 2 diabetes.

    PubMed

    Parkner, Tina; Laursen, Torben; Chen, Jian-Wen; Møller, Marianne K; Thomsen, Henrik F; Jørgensen, Christina; Smedegaard, Jørgen S; Lauritzen, Torsten; Christiansen, Jens S

    2007-09-01

    Basal continuous subcutaneous insulin infusion (CSII) therapy at a fixed rate may effectively improve glycemic control in patients with type 2 diabetes when oral antidiabetic treatment fails. Regimens of simple constant subcutaneous delivery of insulin may provide theoretical advantages in type 2 diabetes. Ten subjects with type 2 diabetes who obtained insufficient glycemic control on oral antidiabetic drugs were included. Following an initial control day, two periods of 3 days with CSII of a rapid-acting insulin analogue, 1.5 IU/h (dose obtained from a preceding study), for 8 hours overnight and for 24 hours, respectively, were carried out in random order. Profiles of serum insulin aspart, serum endogenous insulin, and plasma glucose were recorded. Compared to the control day, an 8-hour overnight insulin infusion during a 3-day period improved fasting plasma glucose (FPG) (mean differences +/- SEM; Delta59.0 +/- 10.1 mg/dl; p < 0.01) and 2-hour postprandial plasma glucose (PPPG) (Delta57.8 +/- 10.6 mg/dl; p < 0.01) after breakfast. Compared to an 8-hour overnight infusion, a 24-hour infusion further improved all three PPPG values after breakfast, lunch, and dinner (Delta28.8 +/- 8.1 mg/dl, Delta30.6 +/- 8.1 mg/dl, and Delta35.1 +/- 7.9 mg/dl; p < 0.01). During insulin infusion, only one hypoglycemic episode with PG <55.8 mg/dl and mild symptoms was recorded. Continuous subcutaneous insulin infusion with a rapid-acting insulin analogue at a fixed rate of 1.5 IU/h, either overnight or for 24 hours, improved glycemic control without safety concerns in patients with type 2 diabetes who had secondary failure to oral antidiabetic drugs. The effect on FPG was similar for both treatments, whereas the effect on PPPG was superior when insulin was infused during the entire 24 hours.

  1. Providing Housing, Food and Medical Support for 25,000 Katrina Evacuees with 12 Hours Notice: The Harris County Medical Support of the Superdome Evacuees

    NASA Technical Reports Server (NTRS)

    Hamilton, Douglas; Smart, Kieran; Gavagan, Tom

    2006-01-01

    Hurricane Katrina was responsible for trapping 25,000 people in the New Orleans Superdome and isolating many others throughout Louisiana and Mississippi. The transport of these evacuees to the Reliant Park (Houston, Texas) used 500 buses each containing about 55 people. Processing the arriving evacuees included addressing their health status and medical needs as follows: an initial triage at disembarkation, a secondary triage in the Reliant Astrodome and Center, and definitive clinical care in the Reliant Arena "Katrina" Clinic. Baylor College of Medicine (BCM) physicians boarded buses and identified the sickest for emergency transport to Harris County Hospital District (HCHD) hospitals. BCM departments represented included pediatrics, family and community medicine, internal medicine, radiology, obstetrics and gynecology, orthopedics, surgery, and psychiatry. Astrodome and Center triage was managed by BCM physicians and staffed by HCHD Nurses and volunteers from Texas and beyond. The Reliant Astrodome, Center and Arena reached peak headcounts of 15,000,4500, and 2500, respectively Most evacuees visiting the triage sites in the Astrodome and Center were treated using "over-the-counter" medications with the remaining being transported to the "Katrina" clinic. The clinic was equipped with a lab, pharmacy, digital X-ray, and ultrasound machines in addition to electronic patient records created using 80 computer terminals. The Katrina clinic saw more than 15,000 patients during 15 days of operations (2,000 on the first full day), administered 10,000 tetanus shots, and filled thousands of prescriptions. At the peak of operations, the clinic saw 150 patients/hour with 25 physicians scheduled for each 12-hour shift. Approximately 900 people were transported to hospital emergency rooms. Within 3 weeks of arriving at the Reliant Park facilities, more than 90% of the families found permanent housing, enrolled children in schools, and found work. Using data obtained from

  2. Diurnal variation in insulin-stimulated systemic glucose and amino acid utilization in pigs fed with identical meals at 12-hour intervals.

    PubMed

    Koopmans, S J; van der Meulen, J; Dekker, R; Corbijn, H; Mroz, Z

    2006-09-01

    The diurnal variation in insulin-stimulated systemic glucose and amino acid utilization was investigated in eleven pigs of approximately 40 kg. Pigs were fed isoenergetic/isoproteinic diets (366 kJ/kg BW (0.75) per meal) in two daily rations (06:00 and 18:00 h). After a 3-week habituation period, hyperinsulinemic euglycemic euaminoacidemic clamp studies (by intra-portal insulin, glucose and amino acids infusion and arterial blood sampling) were performed starting at 06:00 or 18:00 h (while skipping the meal), using a cross-over within-animal design. Basal (preclamp) plasma concentrations of insulin, glucose, lactate, individual amino acids and urea were similar in the morning compared to the evening. Insulin-stimulated ( approximately 4-fold increase over basal) systemic glucose utilization was similar (17.6+/-1.4 and 18.9+/-1.8 mg x kg (-1) x min (-1)) but amino acid utilization was 19% greater in the morning VS. the evening (2.37+/-0.21 VS. 1.99+/-0.15 mg x kg (-1) x min (-1), p<0.05), respectively. Insulin-stimulated plasma lactate concentrations remained constant in the morning (0.77+/-0.06 to 0.71+/-0.04 mmol x l (-1)) but declined in the evening (0.89+/-0.09 to 0.65+/-0.06 mmol x l (-1), p<0.05). By contrast, insulin-stimulated plasma urea concentrations declined in the morning (2.48+/-0.11 to 2.03+/-0.10 mmol x l (-1), p<0.005) but remained constant in the evening (2.18+/-0.14 to 2.12+/-0.12 mmol x l (-1)). In conclusion, pigs fed identical meals at 12-hour intervals follow a clear diurnal biorhythm in protein anabolism, with greater insulin-stimulated systemic amino acid utilization and lower plasma urea response in the morning compared to the evening.

  3. Evaluation of a 12-Hour Sustained-Release Acetaminophen (Paracetamol) Formulation: A Randomized, 3-Way Crossover Pharmacokinetic and Safety Study in Healthy Volunteers.

    PubMed

    Yue, Yong; Collaku, Agron; Liu, Dongzhou J

    2017-08-16

    Acetaminophen (paracetamol) is a first-line treatment for mild and moderate pain. A twice-daily sustained-release (SR) formulation may be more convenient for chronic users than standard immediate-release (IR) acetaminophen. This randomized, 3-way crossover study evaluated pharmacokinetics and safety of single-dose 1500- and 2000-mg SR acetaminophen formulations and 2 doses of IR acetaminophen 1000 mg given 6 hours apart in healthy adults (n = 14). Primary outcome was time that plasma acetaminophen concentration was ≥4 μg/mL (TC≥4μg/mL ). Key secondary outcomes were area under the plasma concentration-time curve (AUC) from time 0 to time t, when plasma acetaminophen was detectable (AUC0-t ), AUC from 0 to infinity (AUC0-inf ), and maximum plasma acetaminophen concentration (Cmax ). TC≥4μg/mL from 2000-mg SR acetaminophen was similar to that from 2 doses of IR acetaminophen, whereas TC≥4μg/mL for 1500-mg SR acetaminophen was significantly shorter than that for IR acetaminophen (P = .004). The extent of acetaminophen absorption from 2000-mg SR and 2 doses of the IR formulation was similar and within bioequivalence limits with regard to AUC0-12 , AUC0-t , and AUC0-inf . The extent of acetaminophen absorption from 1500-mg SR was significantly lower than that from IR acetaminophen. The 2000-mg SR represents a potential candidate formulation for 12-hour dosing with acetaminophen. © 2017, The American College of Clinical Pharmacology.

  4. Substantial overnight reaeration by convective cooling discovered in pond ecosystems

    NASA Astrophysics Data System (ADS)

    Holgerson, Meredith A.; Zappa, Christopher J.; Raymond, Peter A.

    2016-08-01

    Trends in freshwater dissolved oxygen (DO) reflect whole-ecosystem properties and influence organismal survival and behavior. Here we show that small ponds have unique oxygen dynamics that differ from larger lakes. We discovered that ponds undersaturated in DO experienced substantial increases in oxygen concentration overnight. Nighttime increases in DO occurred on 45% of the nights sampled and resulted in DO saturation increasing 12-fold (22% saturation) on average. Oxygen spikes were likely to occur when ponds became at least 1.8°C warmer than the air and later in the season when oxygen levels were low (<31% saturation) and the air was warm (≥5.8°C). We demonstrate that overnight increases in surface water DO resulted from atmospheric oxygen invasion as opposed to internal production. Convective cooling enhanced turbulence and air-water gas exchange, leading to intense bursts of oxygen invasion during nighttime hours. This mechanism has not been demonstrated before and has important implications for the biogeochemistry of these systems, as well as understanding how organisms survive in hypoxic small ponds.

  5. Overnight closed suction drainage after axillary lymphadenectomy for breast cancer.

    PubMed

    Liu, C D; McFadden, D W

    1997-10-01

    Axillary lymphadenectomy in breast conservation surgery is associated with substantial morbidity in either seroma formation or infection. Seroma formation in the axilla requiring aspiration occurs in up to 42 per cent of patients treated without drainage. Prolonged outpatient suction drainage reduces but does not eliminate the incidence of seroma formation, while increasing cost, discomfort, and possibly infection rates. We studied the efficacy of overnight closed suction drainage in patients undergoing breast conservation surgery. Fifty consecutive patients undergoing a standard axillary dissection for breast cancer were studied. The axilla was drained with a 7-French closed suction drain. All drains were removed within 23 hours of surgery and prior to discharge from the outpatient surgical center. Patients were examined by the operating surgeon 7 to 10 days after surgery. One patient (2%) experienced a seroma postoperatively. No infections were observed in all 50 patients, and the remaining 49 patients did not experience visible or symptomatic seromas. The number of lymph nodes removed ranged between 5 and 33 with a mean of 15.5 +/- 0.6. Nine out of 50 (18%) patients had metastatic breast cancer to the axillary lymph nodes. Patients undergoing breast conservation surgery benefit from overnight closed suction drainage of the axilla. This short-term method reduces the incidence and the inherent morbidity of axillary seroma formation.

  6. The risk of microbial keratitis with overnight corneal reshaping lenses.

    PubMed

    Bullimore, Mark A; Sinnott, Loraine T; Jones-Jordan, Lisa A

    2013-09-01

    To estimate the incidence of microbial keratitis (MK) associated with overnight corneal reshaping contact lenses and to compare rates in children and adults. A retrospective study of randomly selected practitioners, stratified by order volume and lens company, was conducted. Practitioners were invited to participate and those agreeing were asked to provide deidentified patient information for up to 50 lens orders and to complete a comprehensive event form for any of these patients who have attended an unscheduled visit for a painful red eye. Duration of contact lens wear was calculated from the original fitting date or January 2005 (whichever was later) to when the patient was last seen by the practitioner wearing the lenses on a regular basis. Cases of MK were classified by majority decision of a 5-member expert panel. For the 191 practitioners who could be contacted, 119 (62%) agreed to participate. Subsequently, 11 withdrew, 22 did not respond, and 86 (43%) returned completed forms corresponding to 2202 lens orders and 1494 patients. Limiting the sample to those patients with at least 3 months of documented contact lens wear since 2005 resulted in a sample of 1317 patients; 640 adults (49%) and 677 children (51%) representing 2599 patient-years of wear (adults = 1164; children = 1435). Eight events of corneal infiltrates associated with a painful red eye were reported (six in children and two in adults). Two were classified as MK. Both occurred in children but neither resulted in a loss of visual acuity. The overall estimated incidence of MK is 7.7 per 10,000 years of wear (95% confidence interval [CI] = 0.9 to 27.8). For children, the estimated incidence of MK is 13.9 per 10,000 patient-years (95% CI = 1.7 to 50.4). For adults, the estimated incidence of MK is 0 per 10,000 patient-years (95% CI = 0 to 31.7). The risk of MK with overnight corneal reshaping contact lenses is similar to that with other overnight modalities. The fact that the CIs for the rates

  7. Protein ingestion before sleep improves postexercise overnight recovery.

    PubMed

    Res, Peter T; Groen, Bart; Pennings, Bart; Beelen, Milou; Wallis, Gareth A; Gijsen, Annemie P; Senden, Joan M G; VAN Loon, Luc J C

    2012-08-01

    The role of nutrition in modulating postexercise overnight recovery remains to be elucidated. We assessed the effect of protein ingestion immediately before sleep on digestion and absorption kinetics and protein metabolism during overnight recovery from a single bout of resistance-type exercise. Sixteen healthy young males performed a single bout of resistance-type exercise in the evening (2000 h) after a full day of dietary standardization. All subjects were provided with appropriate recovery nutrition (20 g of protein, 60 g of CHO) immediately after exercise (2100 h). Thereafter, 30 min before sleep (2330 h), subjects ingested a beverage with (PRO) or without (PLA) 40 g of specifically produced intrinsically [1-C]phenylalanine-labeled casein protein. Continuous intravenous infusions with [ring-H5]phenylalanine and [ring-H2]tyrosine were applied with blood and muscle samples collected to assess protein digestion and absorption kinetics, whole-body protein balance and mixed muscle protein synthesis rates throughout the night (7.5 h). During sleep, casein protein was effectively digested and absorbed resulting in a rapid rise in circulating amino acid levels, which were sustained throughout the remainder of the night. Protein ingestion before sleep increased whole-body protein synthesis rates (311 ± 8 vs 246 ± 9 μmol·kg per 7.5 h) and improved net protein balance (61 ± 5 vs -11 ± 6 μmol·kg per 7.5 h) in the PRO vs the PLA experiment (P < 0.01). Mixed muscle protein synthesis rates were ∼22% higher in the PRO vs the PLA experiment, which reached borderline significance (0.059%·h ± 0.005%·h vs 0.048%·h ± 0.004%·h, P = 0.05). This is the first study to show that protein ingested immediately before sleep is effectively digested and absorbed, thereby stimulating muscle protein synthesis and improving whole-body protein balance during postexercise overnight recovery.

  8. The impact of silicone hydrogel materials on overnight corneal swelling.

    PubMed

    Steffen, Robert B; Schnider, Cristina M

    2007-05-01

    To identify the corneal swelling response associated with silicone hydrogel contact lens wear. Twenty-five subjects were recruited to participate in this single-center, controlled, single-masked, clinical trial. The corneal swelling response was evaluated by central corneal pachymetry after overnight wear of balafilcon A, etafilcon A, lotrafilcon A, senofilcon A, and no lens wear. More specifically, after 8 hours of closed-eye wear of each material, corneal thickness was measured immediately on eye opening, in addition to the first 4 hours of open-eye wear. Paired t tests were used to compare the swelling response from each condition to that associated with senofilcon A, and given the numerous statistical comparisons, a P value of overnight wear of the lenses.

  9. Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells 24-Hours Post-Exposure to 532 nm, 3.0 ns Pulsed Laser Light and 1064 nm, 170 ps Pulsed Laser Light 12-Hours Post-Exposure: Results Compendium

    DTIC Science & Technology

    2004-06-01

    Laser Light and 1064 nm, 170 ps Pulsed Laser Light 12-hours Post-Exposure: Results Compendium John W. Obringer Martin D. Johnson Laser and Optics...Explanted Human Retinal Pigment Epithelial Cells 12-hours Post-Exposure to 532 nm, 3.0 ns Pulsed Laser Light and 1064 nm, 170 ps Pulsed Laser Lightl2-hours...Explanted Human Retinal Pigment Epithelial USAFA F05611-02-P-0471 Cells 24-Hours Post-Exposure to 532 nm, 3.0 ns Pulsed Laser-Light and 1064nm, 170 ps Pulsed

  10. Estimating overnight weight loss of corralled yearling steers in semiarid rangeland

    USDA-ARS?s Scientific Manuscript database

    Free-ranging livestock grazing native vegetation on rangelands are frequently gathered and confined overnight in a corral (sensu drylot) prior to weighing to determine periodic weight gains for grazing studies. Quantification of this overnight percent shrink across the grazing season could provide t...

  11. Do environmental variables influence overnight weight loss of yearling steers in semiarid rangelands?

    USDA-ARS?s Scientific Manuscript database

    In order to measure the weight gains of free-ranging livestock, animals are frequently corralled and confined overnight prior to weighing. Animals may take several days to recover from this overnight loss in weight associated with dehydration and excretion of urine and feces. Quantitative estimates ...

  12. Hybrid optimal online-overnight charging coordination of plug-in electric vehicles in smart grid

    NASA Astrophysics Data System (ADS)

    Masoum, Mohammad A. S.; Nabavi, Seyed M. H.

    2016-10-01

    Optimal coordinated charging of plugged-in electric vehicles (PEVs) in smart grid (SG) can be beneficial for both consumers and utilities. This paper proposes a hybrid optimal online followed by overnight charging coordination of high and low priority PEVs using discrete particle swarm optimization (DPSO) that considers the benefits of both consumers and electric utilities. Objective functions are online minimization of total cost (associated with grid losses and energy generation) and overnight valley filling through minimization of the total load levels. The constraints include substation transformer loading, node voltage regulations and the requested final battery state of charge levels (SOCreq). The main challenge is optimal selection of the overnight starting time (toptimal-overnight,start) to guarantee charging of all vehicle batteries to the SOCreq levels before the requested plug-out times (treq) which is done by simultaneously solving the online and overnight objective functions. The online-overnight PEV coordination approach is implemented on a 449-node SG; results are compared for uncoordinated and coordinated battery charging as well as a modified strategy using cost minimizations for both online and overnight coordination. The impact of toptimal-overnight,start on performance of the proposed PEV coordination is investigated.

  13. A comparison of overnight and 24 hour collection to measure urinary catecholamines.

    PubMed

    White, I R; Brunner, E J; Barron, J L

    1995-02-01

    The period of urine collection used to measure excretion of catecholamines varies in epidemiological practice. We set out to compare overnight with 24 hour collection. Twenty-four subjects each collected urine for 24 hours, with the overnight urine being separately collected. The correlation of overnight and 24 hour catecholamines was highest when both measures were standardised for creatinine excretion and when creatinine excretion was adjusted for urine flow rate. The observed correlations were 0.74 for dopamine, 0.81 for noradrenaline and 0.54 for adrenaline. The use of overnight collections may therefore require a sample size up to 1.5 times as large (for noradrenaline) or 3.4 times as large (for adrenaline) to achieve the same power as with 24 hour collections. However, the figures given exaggerate the advantage of 24 hour collections if these incorporate measurement errors that are not present in overnight collections.

  14. Fasting and sport: an introduction.

    PubMed

    Maughan, R J

    2010-06-01

    Most humans observe an overnight fast on a daily basis, and the human body copes well with short duration fasting. Periodic fasting is widely practised for cultural, religious or health reasons. Fasting may take many different forms. Prolonged restriction of food and fluid is harmful to health and performance, and it is often automatically assumed that intermittent fasting will lead to decrements in exercise performance. Athletes who choose to fast during training or competitions may therefore be at a disadvantage. The available evidence does not entirely support this view, but there is little or no information on the effects on elite athletes competing in challenging environments. Prolonged periods of training in the fasted state may not allow optimum adaptation of muscles and other tissues. Further research on a wide range of athletes with special nutrition needs is urgently required. In events where performance might be affected, other strategies to eliminate or minimise any effects must be sought.

  15. Overnight prescription of oxygen in long term oxygen therapy: time to reconsider the guidelines?

    PubMed

    Nisbet, M; Eaton, T; Lewis, C; Fergusson, W; Kolbe, J

    2006-09-01

    Guidelines for long term oxygen therapy (LTOT) recommend increasing oxygen flow by 1 l/min overnight. A study was undertaken in patients with COPD on LTOT to determine the prevalence of overnight desaturation if the usual oxygen flow rate is not increased at night, whether resting oxygen saturation predicts overnight desaturation, and whether overnight desaturation correlates with health related quality of life (HRQL) and sleep quality. A cross sectional prospective study was performed on consecutive patients with COPD on LTOT attending our regional outpatient oxygen service. All patients fulfilled standard criteria for LTOT, had been established on LTOT at a flow to achieve resting oxygen saturations >90%, but had not been instructed to increase oxygen flow overnight. Overnight desaturation was defined as <90% for > or =30% of the night on either of two consecutive nights. HRQL was evaluated with the SF-36 Health Survey Questionnaire, Chronic Respiratory Questionnaire, and the Pittsburgh Sleep Quality Index. Thirty eight patients (63% men) of mean (SD) age 73.5 (8.04) years and mean (SD) forced expiratory volume in 1 second 0.77 (0.35) l were evaluated. Overnight desaturation occurred in six (16%; 95% CI 4 to 27). Desaturators had mean (SD) resting oxygen saturation on room air of 88 (4.2)% compared with 90 (4.1)% in non-desaturators (p = 0.15), and corrected saturations of 93 (2.0)% versus 94 (2.0)% (p = 0.18). HRQL and sleep quality were poor but did not differ between desaturators and non-desaturators. Most patients did not exhibit overnight desaturation despite not increasing their LTOT prescription overnight. These results challenge the recommendation of routinely increasing overnight oxygen flow in patients receiving LTOT.

  16. Overnight versus 24 Hours of Continuous Subcutaneous Insulin Infusion as Supplement to Oral Antidiabetic Drugs in Type 2 Diabetes

    PubMed Central

    Parkner, Tina; Laursen, Torben; Chen, Jian-Wen; Møller, Marianne K.; Thomsen, Henrik F.; Jørgensen, Christina; Smedegaard, Jørgen S.; Lauritzen, Torsten; Christiansen, Jens S.

    2007-01-01

    Background Basal continuous subcutaneous insulin infusion (CSII) therapy at a fixed rate may effectively improve glycemic control in patients with type 2 diabetes when oral antidiabetic treatment fails. Regimens of simple constant subcutaneous delivery of insulin may provide theoretical advantages in type 2 diabetes. Methods Ten subjects with type 2 diabetes who obtained insufficient glycemic control on oral antidiabetic drugs were included. Following an initial control day, two periods of 3 days with CSII of a rapid-acting insulin analogue, 1.5 IU/h (dose obtained from a preceding study), for 8 hours overnight and for 24 hours, respectively, were carried out in random order. Profiles of serum insulin aspart, serum endogenous insulin, and plasma glucose were recorded. Results Compared to the control day, an 8-hour overnight insulin infusion during a 3-day period improved fasting plasma glucose (FPG) (mean differences ± SEM; Δ59.0 ± 10.1 mg/dl; p < 0.01) and 2-hour postprandial plasma glucose (PPPG) (Δ57.8 ± 10.6 mg/dl; p < 0.01) after breakfast. Compared to an 8-hour overnight infusion, a 24-hour infusion further improved all three PPPG values after breakfast, lunch, and dinner (Δ28.8 ± 8.1 mg/dl, Δ30.6 ± 8.1 mg/dl, and Δ35.1 ± 7.9 mg/dl; p < 0.01). During insulin infusion, only one hypoglycemic episode with PG <55.8 mg/dl and mild symptoms was recorded. Conclusion Continuous subcutaneous insulin infusion with a rapid-acting insulin analogue at a fixed rate of 1.5 IU/h, either overnight or for 24 hours, improved glycemic control without safety concerns in patients with type 2 diabetes who had secondary failure to oral antidiabetic drugs. The effect on FPG was similar for both treatments, whereas the effect on PPPG was superior when insulin was infused during the entire 24 hours. PMID:19885138

  17. Is an overnight stay after percutaneous nephrolithotomy safe?

    PubMed

    Alyami, Fahad; Norman, Richard W

    2012-12-01

    To establish a clinical care pathway that plans for hospital discharge the day after percutaneous nephrolithotomy (PCNL), to evaluate the safety, effectiveness and feasibility of this pathway, and to identify factors associated with a postoperative length of hospital stay (LOS) of >1 day. PCNL is the treatment of choice for patients with large kidney stones and those in whom extracorporeal shockwave lithotripsy has failed, and the mean LOS is typically 2-5 days. We retrospectively reviewed the charts of 109 patients (mean age 57.4 years; 58 men, 53%) who had PCNL between 2006 and 2009. All had nephrostomy tubes placed after surgery. The patients' demographics, LOS, incidence of complications, clinical outcomes, stone-free rates, number of early postoperative emergency-room visits, need for subsequent admission and/or other procedures, were noted and analysed. The modified Clavien classification was used to describe the postoperative complications. Bivariate analyses were used to test for associations between LOS and other variables. The mean (range) stone size was 2.2 (0.9-5.9) cm, and the mean (SEM) LOS was 1.7 (0.13) days. Of the 109 patients, 20% had a LOS of >1 day for surgical, 3% for medical and 5% for social reasons. The stone-free rate was 89%. There was no difference in the number of subsequent hospital visits or ancillary procedures for patients discharged after one or more postoperative nights. No variables were associated with a longer LOS. An overnight hospital stay after PCNL is safe and represents an effective strategy for improved bed use in selected patients. A longer LOS was not affected by patient age or body mass index, stone size or operative time. We continue to use our clinical care pathway, as supported by these data.

  18. β-Cell lipotoxicity after an overnight intravenous lipid challenge and free fatty acid elevation in African American versus American white overweight/obese adolescents.

    PubMed

    Hughan, Kara S; Bonadonna, Riccardo C; Lee, SoJung; Michaliszyn, Sara F; Arslanian, Silva A

    2013-05-01

    Overweight/obese (OW/OB) African American (AA) adolescents have a more diabetogenic insulin secretion/sensitivity pattern compared with their American white (AW) peers. The present study investigated β-cell lipotoxicity to test whether increased free fatty acid (FFA) levels result in greater β-cell dysfunction in AA vs AW OW/OB adolescents. Glucose-stimulated insulin secretion was modeled, from glucose and C-peptide concentrations during a 2-hour hyperglycemic (225 mg/dL) clamp in 22 AA and 24 AW OW/OB adolescents, on 2 occasions after a 12-hour overnight infusion of either normal saline or intralipid (IL) in a random sequence. β-Cell function relative to insulin sensitivity, the disposition index (DI), was examined during normal saline and IL conditions. Substrate oxidation was evaluated with indirect calorimetry and body composition and abdominal adiposity with dual-energy X-ray absorptiometry and magnetic resonance imaging at L4-L5, respectively. Age, sex, body mass index, total and sc adiposity were similar between racial groups, but visceral adiposity was significantly lower in AAs. During IL infusion, FFAs and fat oxidation increased and insulin sensitivity decreased similarly in AAs and AWs. β-Cell glucose sensitivity of first- and second-phase insulin secretion did not change significantly during IL infusion in either group, but DI in each phase decreased significantly and similarly in AAs and AWs. Overweight/obese AA and AW adolescents respond to an overnight fat infusion with significant declines in insulin sensitivity, DI, and β-cell function relative to insulin sensitivity, suggestive of β-cell lipotoxicity. However, contrary to our hypothesis, there does not seem to be a race differential in β-cell lipotoxicity. Longer durations of FFA elevation may unravel such race-related contrasts.

  19. Lipid metabolism during fasting.

    PubMed

    Jensen, M D; Ekberg, K; Landau, B R

    2001-10-01

    These studies were conducted to understand the relationship between measures of systemic free fatty acid (FFA) reesterification and regional FFA, glycerol, and triglyceride metabolism during fasting. Indirect calorimetry was used to measure fatty acid oxidation in six men after a 60-h fast. Systemic and regional (splanchnic, renal, and leg) FFA ([(3)H]palmitate) and glycerol ([(3)H]glycerol) kinetics, as well as splanchnic triglyceride release, were measured. The rate of systemic FFA reesterification was 366 +/- 93 micromol/min, which was greater (P < 0.05) than splanchnic triglyceride fatty acid output (64 +/- 6 micromol/min), a measure of VLDL triglyceride fatty acid export. The majority of glycerol uptake occurred in the splanchnic and renal beds, although some leg glycerol uptake was detected. Systemic FFA release was approximately double that usually present in overnight postabsorptive men, yet the regional FFA release rates were of the same proportions previously observed in overnight postabsorptive men. In conclusion, FFA reesterification at rest during fasting far exceeds splanchnic triglyceride fatty acid output. This indicates that nonhepatic sites of FFA reesterification are important, and that peripheral reesterification of FFA exceeds the rate of simultaneous intracellular triglyceride fatty acid oxidation.

  20. Does overnight birth influence treatment or outcome in congenital diaphragmatic hernia?

    PubMed

    Mills, Jessica L A; Lin, Yi; MacNab, Ying C; Skarsgard, Erik D

    2010-01-01

    We examined the effect of overnight birth on treatment and outcome (including initial cardiorespiratory stabilization) in newborns with congenital diaphragmatic hernia (CDH). CDH births between May 2005 and May 2008 were abstracted from a national CDH database. Overnight birth was defined as occurring between 8 PM and 8 AM. Patient characteristics, treatment, and outcomes were compared between birth time groups, including the subset of infants in whom a prenatal diagnosis of CDH had been made. Of 132 cases evaluated, 106 (80%) survived. Forty-nine babies (37%) were born overnight. Eighty-five infants (64%) with a prenatal diagnosis were evenly distributed between the birth time cohorts. Survival to discharge, surgical management, duration of mechanical ventilation, and length of hospital stay were comparable between the risk-matched (SNAP-II score) birth time groups. Overnight birth did predict a lower rate of cesarean section deliveries (P = 0.03). Escalation of ventilator mode, inability to achieve/maintain blood gas targets, development of pneumothorax, and need for extracorporeal membrane oxygenation were all considered "stabilization failures." Overnight birth predicted a failure to maintain or improve pH to within target range (P = 0.008). Overnight birth did not adversely affect outcome in this birth time comparison of newborns with CDH. Thieme Medical Publishers.

  1. An Overnight Success?: Usage Patterns and Demographics of Academic Library Patrons during the Overnight Period from 11 p.m.-8 a.m.

    ERIC Educational Resources Information Center

    Sanders, Mark; Hodges, Chris

    2014-01-01

    During the Fall 2013 semester East Carolina University's main library piloted 24/5 hours of operation by opening on Sunday morning and not closing until Friday night. This article details the planning and execution of the pilot program, as well the findings from the data collected during the overnight period by people-counting cameras and a…

  2. An Overnight Success?: Usage Patterns and Demographics of Academic Library Patrons during the Overnight Period from 11 p.m.-8 a.m.

    ERIC Educational Resources Information Center

    Sanders, Mark; Hodges, Chris

    2014-01-01

    During the Fall 2013 semester East Carolina University's main library piloted 24/5 hours of operation by opening on Sunday morning and not closing until Friday night. This article details the planning and execution of the pilot program, as well the findings from the data collected during the overnight period by people-counting cameras and a…

  3. Feasibility of Overnight Closed-Loop Control Based on Hourly Blood Glucose Measurements

    PubMed Central

    Patte, Caroline; Pleus, Stefan; Galley, Paul; Weinert, Stefan; Haug, Cornelia; Freckmann, Guido

    2012-01-01

    Introduction Safe and effective closed-loop control (artificial pancreas) is the ultimate goal of insulin delivery. In this study, we examined the performance of a closed-loop control algorithm used for the overnight time period to safely achieve a narrow target range of blood glucose (BG) concentrations prior to breakfast. The primary goal was to compare the quality of algorithm control during repeated overnight experiments. Materials and Methods Twenty-three subjects with type 1 diabetes performed 2 overnight experiments on each of three visits at the study site, resulting in 138 overnight experiments. On the first evening, the subject’s insulin therapy was applied; on the second, the insulin was delivered by an algorithm based on subcutaneous continuous glucose measurements (including meal control) until midnight. Overnight closed-loop control was applied between midnight and 6 a.m. based on hourly venous BG measurements during the first and second nights. Results The number of BG values within the target range (90–150 mg/dl) increased from 52.9% (219 out of 414 measure-ments) during the first nights to 72.2% (299 out of 414 measurements) during the second nights (p < .001, χ2-test). The occurrence of hypoglycemia interventions was reduced from 14 oral glucose interventions, the latest occurring at 2:36 a.m. during the first nights, to 1 intervention occurring at 1:02 a.m. during the second nights (p < .001, χ2-test). Conclusions Overnight controller performance improved when optimized initial control was given; this was suggested by the better metabolic control during the second night. Adequate controller run-in time seems to be important for achieving good overnight control. In addition, the findings demonstrate that hourly BG data are sufficient for the closed-loop control algorithm tested to achieve appropriate glycemic control. PMID:22920817

  4. Night-to-night Variability in Obstructive Sleep Apnea Severity: Relationship to Overnight Rostral Fluid Shift

    PubMed Central

    White, Laura H.; Lyons, Owen D.; Yadollahi, Azadeh; Ryan, Clodagh M.; Bradley, T. Douglas

    2015-01-01

    Study Objectives: Overnight rostral fluid shift from the legs to the neck may narrow the pharynx and contribute to obstructive sleep apnea (OSA) pathogenesis. We hypothesized that night-to-night changes in the apneahypopnea index (AHI) would be associated with changes in overnight rostral fluid shift. Methods: Twenty-six patients with OSA (AHI ≥ 10) underwent two polysomnograms 14 days apart with measurement of neck and leg fluid volumes (LFV), neck circumference and upper-airway cross-sectional area before and after sleep. Results: Although mean AHI did not differ between polysomnograms, 35% of patients had a difference in AHI > 10, indicating significant intra-individual variability. There were direct correlations between change in non-rapid-eye movement (NREM), but not REM AHI and change in evening LFV between polysomnograms (r = 0.440, p = 0.036 and r = 0.005, p = 0.982, respectively) and between change in supine, but not non-supine AHI and change in evening LFV (r = 0.483, p = 0.020 and r = 0.269, p = 0.280, respectively). An increase in evening LFV between polysomnograms was associated with a greater overnight decrease in LFV (r = 0.560, p = 0.005) and a greater overnight increase in neck fluid volume (r = 0.498, p = 0.016). Additionally, a greater overnight increase in neck circumference was associated with a greater overnight increase in neck fluid volume between polysomnograms (r = 0.453, p = 0.020) and a greater overnight decrease in upper-airway cross-sectional area (r = −0.587, p = 0.005). Conclusion: Intra-individual variability in OSA severity may be partly explained by day-to-day changes in evening leg fluid volume and overnight rostral fluid shift, which may be most important in the pathogenesis of OSA during NREM and supine sleep. Citation: White LH, Lyons OD, Yadollahi A, Ryan CM, Bradley TD. Night-to-night variability in obstructive sleep apnea severity: relationship to overnight rostral fluid shift. J Clin Sleep Med 2015;11(2):149–156

  5. Frequency of Morning Ketosis After Overnight Insulin Suspension Using an Automated Nocturnal Predictive Low Glucose Suspend System

    PubMed Central

    Beck, Roy W.; Raghinaru, Dan; Wadwa, R. Paul; Chase, H. Peter; Maahs, David M.; Buckingham, Bruce A.

    2014-01-01

    OBJECTIVE To assess the effect of overnight insulin pump suspension in an automated predictive low glucose suspend system on morning blood glucose and ketone levels in an attempt to determine whether routine measurement of ketone levels is useful when a closed-loop system that suspends insulin delivery overnight is being used. RESEARCH DESIGN AND METHODS Data from an in-home randomized trial of 45 individuals with type 1 diabetes (age range 15–45 years) were analyzed, evaluating an automated predictive low glucose pump suspension system in which blood glucose, blood ketone, and urine ketone levels were measured on 1,954 mornings. RESULTS One or more pump suspensions occurred during 744 of the 977 intervention nights (76%). The morning blood ketone level was ≥0.6 mmol/L after 11 of the 744 nights (1.5%) during which a pump suspension occurred and 2 of the 233 nights (0.9%) during which there was no suspension compared with 11 of 977 control nights (1.1%). The morning blood ketone level was ≥0.6 mmol/L after only 2 of 159 nights (1.3%) with a pump suspension exceeding 2 h. Morning fasting blood glucose level was not a good predictor of the presence of blood ketones. CONCLUSIONS Routine measurement of blood or urine ketones during use of an automated pump suspension system using continuous glucose monitoring, whether threshold based or predictive, is not necessary. Recommendations for checking ketone levels should be no different when a patient is using a system with automated insulin suspension than it is for conventional diabetes self-management. PMID:24757229

  6. Overnight observation in stand-alone surgicenters: is the practice safe?

    PubMed

    Otterburn, David M; Paredes, Alfredo; Hester, Roderick T

    2009-05-01

    The safety of performing operations in surgery centers that require overnight stays has not been established. To determine whether this practice is safe we performed a retrospective chart review of all cases performed at Paces over a 12-year period. There were 12,072 total cases and 11,147 general anesthesia (GA) or monitored anesthesia care (MAC) cases. Four thousand eight hundred ten patients stayed overnight. The hospital admission rate for patients undergoing either GA or MAC was 0.12% and for local anesthesia it was 0%. Overnight stay patients had a rate of 0.15%, while same day discharge patients had a rate of 0.08%. Excluding local anesthesia cases, the rate increased to 0.10%. For the GA and MAC patients, there was no statistical difference in hospitalization rates between the same day and the overnight stay groups. All patients had good outcomes after hospitalization. Performing operations that require an overnight stay in a surgery center can be a safe practice.

  7. Hypoxia, overnight wear, and tear stagnation effects on the corneal epithelium: data and proposed model.

    PubMed

    Lin, Meng C; Polse, Kenneth A

    2007-11-01

    : To explore the possible mechanisms that may lead to overnight contact lens-associated corneal morbidity by examining data from several corneal epithelial permeability experiments obtained under different environmental and lens fitting paradigms. : Epithelial permeability was assessed by using fluorometry to determine the fluorescein penetration rate from the tear film into the corneal stroma. Changes in this rate provide an index of the corneal epithelial status; increased permeability leads to decreased barrier function. : Hypoxia and tear stagnation during overnight lens wear play a significant role in altering the corneal epithelial barrier function (P<0.05). However, eliminating lens-induced hypoxia alone does not ameliorate changes in epithelial status (P<0.05). : Based on data from these experiments, it is suggested that hypoxia and tear stagnation should be eliminated to minimize alteration of the corneal epithelium associated with overnight contact lens wear.

  8. Quality Sleep Is Associated With Overnight Metabolic Rate in Healthy Older Adults.

    PubMed

    Valenti, Giulio; Bonomi, Alberto G; Westerterp, Klaas R

    2017-04-01

    Increasing age is associated with an increase in overnight metabolic rate. To determine the relationship between quality sleep, sleep efficiency, and overnight metabolic rate as measured in a respiration chamber in older participants. The study design was cross sectional. Forty participants, aged 50 to 83 years (17 males, age 63±7 years, body mass index 25.7±2.3kg/m2) spent one night in a respiration chamber to measure sleep stages by polysomnography and overnight metabolic rate (OMR). Data were collected between 23:00 and 07:00. Subsequently basal metabolic rate (BMR) was measured under a ventilated hood. Quality sleep was calculated as time spent in rapid-eye movement (REM) sleep and slow wave sleep divided by total sleep time, and sleep efficiency was calculated as total sleep time divided by the sleep period time. Body movement was measured between 23:00 and 07:00 with an accelerometer on the wrist. Overnight metabolic rate was adjusted for body size by dividing by basal metabolic rate (OMR/BMR). OMR/BMR was positively associated with age (r = 0.48, p < .001), and quality sleep was negatively associated with age (r = -0.51, p < .001). The variance of OMR/BMR was significantly explained by quality sleep (r = -0.58, p < 0.001). Body movement was negatively related to sleep efficiency (r = -0.38, p<0.01) with no effect on OMR/BMR. When OMR/BMR was adjusted for quality sleep, the effect of age was non significant. Quality sleep is inversely associated with the age-related rise in overnight metabolic rate, suggesting that increased overnight metabolic rate is a biological sign of ageing as a consequence of diminished quality sleep.

  9. Learning and Overnight Retention in Declarative Memory in Specific Language Impairment

    PubMed Central

    Lukács, Ágnes; Kemény, Ferenc; Lum, Jarrad A. G.; Ullman, Michael T.

    2017-01-01

    We examined learning and retention in nonverbal and verbal declarative memory in Hungarian children with (n = 21) and without (n = 21) SLI. Recognition memory was tested both 10 minutes and one day after encoding. On nonverbal items, only the children with SLI improved overnight, with no resulting group differences in performance. In the verbal domain, the children with SLI consistently showed worse performance than the typically-developing children, but the two groups showed similar overnight changes. The findings suggest the possibility of spared or even enhanced declarative memory consolidation in SLI. PMID:28046095

  10. Asymmetry of cross-correlations between intra-day and overnight volatilities

    NASA Astrophysics Data System (ADS)

    Zadourian, Rubina; Grassberger, Peter

    2017-04-01

    We point out a stunning time asymmetry in the short-time cross-correlations between intra-day and overnight volatilities (absolute values of log-returns of stock prices). While overnight volatility is significantly (and positively) correlated with the intra-day volatility during the following day (allowing thus non-trivial predictions), it is much less correlated with the intra-day volatility during the preceding day. While the effect is not unexpected in view of previous observations, its robustness and extreme simplicity are remarkable.

  11. Learning and Overnight Retention in Declarative Memory in Specific Language Impairment.

    PubMed

    Lukács, Ágnes; Kemény, Ferenc; Lum, Jarrad A G; Ullman, Michael T

    2017-01-01

    We examined learning and retention in nonverbal and verbal declarative memory in Hungarian children with (n = 21) and without (n = 21) SLI. Recognition memory was tested both 10 minutes and one day after encoding. On nonverbal items, only the children with SLI improved overnight, with no resulting group differences in performance. In the verbal domain, the children with SLI consistently showed worse performance than the typically-developing children, but the two groups showed similar overnight changes. The findings suggest the possibility of spared or even enhanced declarative memory consolidation in SLI.

  12. Ocular microbiota and polymorphonuclear leucocyte recruitment during overnight contact lens wear.

    PubMed

    Stapleton, F; Willcox, M D; Sansey, N; Holden, B A

    1997-05-01

    Bacterial colonization of the ocular surface and contact lens (CL) and recruitment of polymorphonuclear leucocytes (PMN) during overnight CL wear was examined in 11 asymptomatic wearers. The ocular surface was more frequently colonized than the CL, with commensal bacteria (P < 0.05). Following sleep, more bacteria were recovered from the CL compared with daily use (P < 0.05), and fewer PMN were recruited compared to sleep without CL wear (P < 0.05). Overnight CL wear may inhibit physiological PMN recruitment to the cornea by preventing their access, by modifying the chemotactic signal or by altering the activation state of the recruited cells.

  13. Is Everything All Right at Night? Measuring User Response to Overnight Library Services

    ERIC Educational Resources Information Center

    Chrzastowski, Tina E.; Nutefall, Jennifer E.

    2016-01-01

    A multiple methods study was conducted over three academic terms during the 2015 fiscal year at Santa Clara University Library to assess the impact and value of overnight library hours. A survey was conducted after midnight during times the Library was open 24 hours, five days a week (24/5), the last two weeks of the quarter. The survey was…

  14. EVALUATION OF SPERM CHROMATIN STRUCTURE ASSAY (SCSA REGISTERED TRADEMARK) IN HUMAN SPERM AFTER SIMULATED OVERNIGHT SHIPMENT

    EPA Science Inventory

    Home semen collection kits allow men to collect a sample at their convenience and send it via overnight mail to the laboratory. Benefits of this approach include facilitated sample collection from different geographic locations, minimized variability through analysis by a central...

  15. Objective Sleep Assessments in Patients with Postural Tachycardia Syndrome using Overnight Polysomnograms

    PubMed Central

    Bagai, Kanika; Peltier, Amanda C.; Malow, Beth A.; Diedrich, André; Shibao, Cyndya A.; Black, Bonnie K.; Paranjape, Sachin Y.; Orozco, Carlos; Biaggioni, Italo; Robertson, David; Raj, Satish R.

    2016-01-01

    Study Objectives: Patients with postural tachycardia syndrome (POTS) commonly complain of fatigue, unrefreshing sleep, daytime sleepiness, and diminished quality of life. The study objective was to assess objective sleep quality in POTS patients using overnight polysomnography. Methods: We studied 16 patients with POTS and 15 healthy control subjects performing daytime autonomic functions tests and overnight polysomnography at the Vanderbilt Clinical Research Center. Results: There were no significant differences in the objective sleep parameters including sleep efficiency, sleep onset latency, wake time after sleep onset, REM latency, percentage of time spent in N1, N2, N3, and REM sleep, arousal index, apnea-hypopnea index, or periodic leg movement index in POTS patients as compared with healthy control subjects. There were significant negative correlations between sleep efficiency and the change in HR from supine to stand (rs = −0.527; p = 0.036) Conclusions: POTS patients do not have significant differences in objective sleep parameters as compared to control subjects based on overnight polysomnograms. Activation of the sympathetic nervous system may contribute significantly to the hyper arousal state and worsening of subjective estimates of sleep quality as previously reported in POTS patients. Citation: Bagai K, Peltier AC, Malow BA, Diedrich A, Shibao CA, Black BK, Paranjape SY, Orozco C, Biaggioni I, Robertson D, Raj SR. Objective sleep assessments in patients with postural tachycardia syndrome using overnight polysomnograms. J Clin Sleep Med 2016;12(5):727–733. PMID:26951415

  16. Effects of Model Performances on Music Skill Acquisition and Overnight Memory Consolidation

    ERIC Educational Resources Information Center

    Cash, Carla D.; Allen, Sarah E.; Simmons, Amy L.; Duke, Robert A.

    2014-01-01

    This study was designed to investigate the extent to which the presentation of an auditory model prior to learning a novel melody affects performance during active practice and the overnight consolidation of procedural memory. During evening training sessions, 32 nonpianist musicians practiced a 13-note keyboard melody with their left…

  17. Psychosocial outcomes of a summer overnight recreational experience for children with heart disease.

    PubMed

    Bultas, Margaret W; Steurer, Lisa M; Balakas, Karen; Brooks, Charlotte; Fields, Heidi

    2015-12-01

    Children with chronic heart disease (CHD) are often turned away from recreational summer overnight experiences because of complicated medical histories and medication regimens. The purpose of this qualitative study was to evaluate the psychosocial impact of a five-day overnight recreational experience for children with CHD and their parents. Thirty-six children with CHD between the age of 8 and 15 years and their parents participated in the study. Data were collected from the children using photovoice interviews. Parent data were collected using a post camp survey. Results included the following external outcome themes: inclusion in a peer group and the importance of friendship, fun, and safety. Internal or personal outcome themes included counselor as a role model, increased self-confidence, and the realization of life's possibilities. Parent themes included increased child independence, increased child confidence, and child feelings of normalcy related to belonging to a peer group. Findings from this study can be used to encourage families of children with CHD to allow participation in a well-supervised overnight recreational experience. Such an experience can foster the child's overall development, provide peer group support, and reduce parent anxiety about overnight separation from the child.

  18. EVALUATION OF CHROMOMYCIN A3 ASSAY IN HUMAN SPERM AFTER SIMULATED OVERNIGHT SHIPMENT

    EPA Science Inventory

    EVALUATION OF CHROMOMYCIN A3ASSAY IN HUMAN SPERM AFTER SIMULATED OVERNIGHT SHIPMENT.
    SC Jeffay1, R Morris Buus1, LF Strader1, AF Olshan2, DP Evenson3, SD Perreault1. 1US EPA/ORD, RTP, NC;2UNC-CH, Chapel Hill, NC;3SDSU, Brookings, SD.

    Semen collection kits that allow ...

  19. Is Everything All Right at Night? Measuring User Response to Overnight Library Services

    ERIC Educational Resources Information Center

    Chrzastowski, Tina E.; Nutefall, Jennifer E.

    2016-01-01

    A multiple methods study was conducted over three academic terms during the 2015 fiscal year at Santa Clara University Library to assess the impact and value of overnight library hours. A survey was conducted after midnight during times the Library was open 24 hours, five days a week (24/5), the last two weeks of the quarter. The survey was…

  20. Avian Influenza and Ban on Overnight Poultry Storage in Live Poultry Markets, Hong Kong

    PubMed Central

    Leung, Y.H. Connie; Lau, Eric H.Y.; Zhang, Li Juan; Guan, Yi; Cowling, Benjamin J.

    2012-01-01

    We analyzed ≈12 years of surveillance data on avian influenza in Hong Kong live poultry markets. A ban on keeping live poultry overnight in these markets reduced virus isolation rates by 84% in chickens (p = 0.006) and 100% (p = 0.01) in minor poultry. PMID:22840782

  1. EVALUATION OF SPERM CHROMATIN STRUCTURE ASSAY (SCSA REGISTERED TRADEMARK) IN HUMAN SPERM AFTER SIMULATED OVERNIGHT SHIPMENT

    EPA Science Inventory

    Home semen collection kits allow men to collect a sample at their convenience and send it via overnight mail to the laboratory. Benefits of this approach include facilitated sample collection from different geographic locations, minimized variability through analysis by a central...

  2. Overnight deep body temperature and urinary cortisol excretion in infants from economically deprived areas.

    PubMed

    Wailoo, M P; Westaway, J A; Joseph, D; Petersen, S A; Davies, T; Thompson, J R

    2003-11-01

    To assess the pattern of postnatal physiological maturation in economically deprived infants by measuring the age-related changes in deep body temperature during night-time sleep. Inner city Leicester, UK. Forty-eight infants aged 6-21 weeks from economically deprived areas and 87 control infants from more affluent areas. Average deep body temperature between 2 and 4 h after bedtime, overnight and early morning urinary cortisol excretion. Both groups showed a decline in overnight deep body temperature with age that averaged 0.030 degrees C per week (SE = 0.003). Over the age range studied, the average age-adjusted overnight temperature in the infants from deprived homes was 0.090 degrees C (SE = 0.028) higher than that for the affluent group (P = 0.001). Deprived infants had on average 51% higher overnight urinary cortisol and 80% higher morning cortisol. The differences remained when the effects of room temperature, clothing, smoking, birthweight and gestational age were taken into account. These indicators of postnatal physiological maturation suggest that infants from economically deprived homes mature less quickly. This might increase their vulnerability to illness.

  3. Effects of Model Performances on Music Skill Acquisition and Overnight Memory Consolidation

    ERIC Educational Resources Information Center

    Cash, Carla D.; Allen, Sarah E.; Simmons, Amy L.; Duke, Robert A.

    2014-01-01

    This study was designed to investigate the extent to which the presentation of an auditory model prior to learning a novel melody affects performance during active practice and the overnight consolidation of procedural memory. During evening training sessions, 32 nonpianist musicians practiced a 13-note keyboard melody with their left…

  4. Overnight urethral stenting after tubularized incised plate urethroplasty for distal hypospadias.

    PubMed

    Ritch, Chad R; Murphy, Alana M; Woldu, Solomon L; Reiley, Elizabeth A; Hensle, Terry W

    2010-06-01

    The duration of urethral stenting after tubularized incised plate (TIP) urethroplasty for hypospadias varies among surgeons. Typically the catheter is left for up to 7 days with the goal of minimizing post-operative complications. We describe our experience with overnight stenting for distal TIP hypospadias repair. A retrospective chart review was performed on patients who underwent TIP hypospadias repair from 2003 to 2008. Patients who had their urethral catheter overnight were included in this analysis. Outcomes analyzed were the rates of: urethrocutaneous fistula, meatal stenosis, urethral stricture and urinary tract infections. A total of 64 patients underwent outpatient TIP hypospadias repair. Forty-nine patients had overnight urethral stenting with at least 12 months follow-up and were included in the analysis. Five of the 49 patients (10.2%) developed urethrocutaneous fistula. Of these five patients, two had undergone re-do hypospadias repair. The fistula rate in primary repairs was 3/45 (6.7%). There were no incidences of meatal stenosis, urinary tract infections or urethral strictures. In our experience, overnight urethral stenting for TIP hypospadias repair does not significantly affect the rates of urethrocutaneous fistula, meatal stenosis and urinary tract infections. Patients who have had a primary TIP hypospadias repair may have their urethral catheter removed safely on post-operative day one.

  5. EVALUATION OF CHROMOMYCIN A3 ASSAY IN HUMAN SPERM AFTER SIMULATED OVERNIGHT SHIPMENT

    EPA Science Inventory

    EVALUATION OF CHROMOMYCIN A3ASSAY IN HUMAN SPERM AFTER SIMULATED OVERNIGHT SHIPMENT.
    SC Jeffay1, R Morris Buus1, LF Strader1, AF Olshan2, DP Evenson3, SD Perreault1. 1US EPA/ORD, RTP, NC;2UNC-CH, Chapel Hill, NC;3SDSU, Brookings, SD.

    Semen collection kits that allow ...

  6. Crew Factors in Flight Operations 7: Psychophysiological Responses to Overnight Cargo Operations

    NASA Technical Reports Server (NTRS)

    Gander, Philippa H.; Gregory, Kevin B.; Connell, Linda J.; Miller, Donna L.; Graeber, R. Curtis; Rosekind, Mark R.

    1996-01-01

    To document the psychophysiological effects of flying overnight cargo operations, 41 B-727 crew members (average age 38 yr) were monitored before, during, and after one of two typical 8-day trip patterns. During daytime layovers, the average sleep episode was 3 hr (41%) shorter than nighttime sleeps and was rated as lighter, less restorative, and poorer overall. Sleep was frequently split into several episodes and totaled 1.2 hr less per 24 hr than on pretrip days. Each trip pattern included a night off, which was an effective countermeasure against the accumulating sleep debt. The organization of sleep during daytime layovers reflected the interaction of duty timing with circadian physiology. The circadian temperature rhythm did not adapt completely to the inverted wake-rest schedule on duty days, being delayed by about 3 hr. Highest subjective fatigue and lowest activation occurred around the time of the temperature minimum. On duty days, reports of headaches increased by 400%, of congested nose by 200%, and of burning eyes by 900%. Crew members also reported eating more snacks. Compared with daytime short-haul air-transport operations, the overnight cargo trips included fewer duty and flight hours, and had longer layovers. Overnight cargo crews also averaged 5.4 yr younger than their daytime short-haul counterparts. On trips, both groups lost a comparable amount of sleep per 24 hr, but the overnight cargo crews had shorter individual sleep episodes and more broken sleep. These data clearly demonstrate that overnight cargo operations, like other night work, involve physiological disruption not found in comparable daytime operations.

  7. The effect of overnight storage of leukapheresis stem cell products on cell viability, recovery, and cost.

    PubMed

    Sugrue, M W; Hutcheson, C E; Fisk, D D; Roberts, C G; Mageed, A; Wingard, J R; Moreb, J S

    1998-10-01

    The cost of harvesting, processing, and freezing multiple peripheral blood stem cell (PBSC) products could easily exceed that of bone marrow harvest. To reduce costs while maintaining product viability, we examined the effect of overnight storage on PBSC products. Sixteen consecutive leukapheresis samples from 12 patients were examined prospectively. Each initial leukapheresis product was stored overnight on ice (median temperature 15 degrees C) after adding an equal amount of M199 culture medium containing heparin. After overnight storage, the product was combined with the next day PBSC harvest if required and processed/frozen per protocols. Parameters measured before and after storage include cell count and differential, viability, bacterial cultures, and colony-forming unit (CFU) assays. The results show that the median cell concentration during storage was 7.12 x 10(7)/ml and the median length of storage was 20 h. After storage, the median viability and nucleated cell recovery were 100% and 99.5%, respectively. In addition, 98% recovery of CFU-GM was achieved. No clotting or bacterial contamination was detected. All 12 patients studied engrafted promptly. In addition, 124 similarly treated patients were retrospectively analyzed. Of these, 48% required > or = 2 large-volume leukaphereses to achieve the target cell dose. As a result of overnight storage, 150 final products, instead of 224, were processed and cryopreserved. This difference is equivalent to 33% cost savings. Again, all patients were transplanted and engrafted successfully. In conclusion, overnight storage and pooling of two consecutive PBSC products are safe, reduce cost, and allow for optimum laboratory staffing.

  8. Socioeconomic determinants of overnight and weekend emergency department use for acute rhinosinusitis.

    PubMed

    Bergmark, Regan W; Ishman, Stacey L; Scangas, George A; Cunningham, Michael J; Sedaghat, Ahmad R

    2015-11-01

    Prior work has shown Medicaid and self-pay insurance status is associated with emergency department (ED), rather than outpatient clinic, presentation for uncomplicated acute rhinosinusitis (ARS). We investigate whether the disparate use of ED resources for this nonemergent condition by patients with Medicaid and self-pay insurance can be attributed to presentation overnight or on weekends. Cross-sectional survey of 990,849 patients from the 2009 and 2010 National Hospital Ambulatory Medical Care Survey presenting to EDs with uncomplicated ARS. Patients with orbital and intracranial complications of ARS were excluded. Univariate and multivariate associations identified demographic and socioeconomic characteristics, including insurance status, which were independently associated with overnight (between 5 pm and 7 am) or daytime weekend ED presentation for uncomplicated ARS. Medicaid or self-pay insurance status was associated with evening/overnight ED presentation (odds ratio=1.88, P=.018) in comparison to private or Medicare insurance. However, weekend daytime ED presentation was not associated with Medicaid or self-pay insurance statuses (P=.144). Income and education levels of patients' zip codes, taken as markers of socioeconomic status, were not associated with either evening/overnight or daytime weekend ED presentation for uncomplicated ARS (P>.05). ARS patients with Medicaid or self-pay status, previously shown to preferentially use EDs for uncomplicated ARS, were more likely to present for overnight ED care compared to patients with private insurance or Medicare. These findings suggest a potential lack of access to extended-hours primary care during evenings and nights for Medicaid patients. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Randomized clinical trial of day-care versus overnight-stay laparoscopic cholecystectomy.

    PubMed

    Johansson, M; Thune, A; Nelvin, L; Lundell, L

    2006-01-01

    Laparoscopic cholecystectomy has been performed as a day-care procedure for many years. Few studies have been conducted with primary focus on patient acceptance and preferences in terms of quality of life for this practice compared with overnight stay. Data from 100 patients with symptomatic gallstones randomized to laparoscopic cholecystectomy performed either as a day-care procedure or with overnight stay were analysed. Complications, admissions and readmissions, quality of life and health economic aspects were assessed. Two instruments were used to assess quality of life, the Hospital Anxiety and Depression Scale (HADS) and the Psychological General Well-Being Index (PGWB). Forty-eight (92 per cent) of 52 patients in day-care group were discharged 4-8 h after the operation. Forty-two (88 per cent) of 48 in the overnight group went home on the first day after surgery. The overall conversion rate was 2 per cent. Two patients had complications after surgery, both in the day-care group. No patient in either group was readmitted. There was no significant difference in total quality of life score between the two groups. The mean direct medical cost per patient in the day-care group (3085 Euros) was lower than that in the overnight group (3394 Euros). Laparoscopic cholecystectomy can be performed as a day-case procedure with a low rate of complications and admissions/readmissions. Patient acceptance in terms of quality of life variables is similar to that for cholecystectomy with an overnight stay. The day-care strategy is associated with a reduction in cost. Copyright 2005 British Journal of Surgery Society Ltd.

  10. Endocrine responses during overnight recovery from exercise: impact of nutrition and relationships with muscle protein synthesis.

    PubMed

    Betts, James A; Beelen, Milou; Stokes, Keith A; Saris W, H M; van Loon L, J C

    2011-10-01

    Nocturnal endocrine responses to exercise performed in the evening and the potential role of nutrition are poorly understood. To gain novel insight, 10 healthy men ingested carbohydrate with (C+P) and without (C) protein in a randomized order and double-blind manner during 2 hr of interval cycling followed by resistance-type exercise and into early postexercise recovery. Blood samples were obtained hourly throughout 9 hr of postexercise overnight recovery for analysis of key hormones. Muscle samples were taken from the vastus lateralis before and after exercise and then again the next morning (7 a.m.) to calculate mixed-muscle protein fractional synthetic rate (FSR). Overnight plasma hormone concentrations were converted into overall responses (expressed as area under the concentration curve) and did not differ between treatments for either growth hormone (1,464 ± 257 vs. 1,432 ± 164 pg/ml · 540 min) or total testosterone (18.3 ± 1.2 vs. 17.9 ± 1.2 nmol/L · 540 min, C and C+P, respectively). In contrast, the overnight cortisol response was higher with C+P (102 ± 11 nmol/L · 540 min) than with C (81 ± 8 nmol/L · 540 min; p = .02). Mixed-muscle FSR did not differ between C and C+P during overnight recovery (0.062% ± 0.006% and 0.062% ± 0.009%/hr, respectively) and correlated significantly with the plasma total testosterone response (r = .7, p < .01). No correlations with FSR were apparent for the response of growth hormone (r = -.2, p = .4), cortisol (r = .1, p = .6), or the ratio of testosterone to cortisol (r = .2, p = .5). In conclusion, protein ingestion during and shortly after exercise does not modulate the endocrine response or muscle protein synthesis during overnight recovery.

  11. Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

    PubMed

    Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

    2015-09-01

    Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p < 0.001. Admitting new patients, following their course and responding to emergencies were rated as important overnight tasks for both clerkship and sub-internship students. Overnight experiences offer students additional educational opportunities. Clerkship directors felt that the overnight experience for the sub-intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences

  12. Serum Phosphorus and Mortality in the Third National Health and Nutrition Examination Survey (NHANES III): Effect Modification by Fasting

    PubMed Central

    Chang, Alex R.; Grams, Morgan

    2014-01-01

    Background Serum phosphorus levels have been associated with mortality in some but not all studies. Since dietary intake prior to measurement can affect serum phosphorus levels, we hypothesized that the association between serum phosphorus and mortality is strongest in those who have fasted for longer duration. Study Design Prospective cohort study. Setting & Participants Nationally representative sample of 12,984 participants aged 20 years or older in the Third National Health and Nutrition Examination Survey (1988–1994). Factors Serum phosphorus, fasting duration (dichotomized as ≥12 or <12 hours) Outcomes All-cause and cardiovascular mortality determined by death certificate data from the National Death Index. Measurements Serum phosphorus measured in a central laboratory and fasting duration recorded as amount of time since food or drink other than water was consumed. Results Individuals fasting12 hours had lower serum phosphorus levels than those fasting < 12 hours (3.34 vs. 3.55 mg/dL; p<0.001) and higher correlation with repeated measurement (0.66 vs. 0.53; p=0.002). In multivariable-adjusted Cox regression models, the highest quartile of serum phosphorus was associated with increased mortality in participants fasting12 hours (adjusted HR, 1.74; 95% CI, 1.38–2.20; reference, lowest quartile) but not in participants fasting <12 hours (adjusted HR, 1.08; 95% CI, 0.89–1.32; p for interaction=0.002). Relationships were consistent using 8 hours as the fasting cutpoint or cardiovascular mortality as the outcome. Limitations Observational study, lack of fibroblast growth factor 23 or intact parathyroid hormone measurements. Conclusions Fasting but not non-fasting serum phosphorus levels were associated with increased mortality. Risk prognostication based on serum phosphorus may be improved using fasting levels. PMID:24935232

  13. Reproducibility and utility of an overnight 0.25 mg dexamethasone suppression test as a marker for glucocorticoid sensitivity in children with asthma.

    PubMed

    Willemsen, R H; van Leeuwen, L; Voorend-van Bergen, T A S; de Rijke, Y B; Pijnenburg, M W; van den Akker, E L T

    2016-01-01

    Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment in children. However, there is considerable inter-individual variation in glucocorticoid sensitivity, leading to over- as well as undertreatment. A simple and fast test to predict glucocorticoid sensitivity would enable more tailored therapy in children with asthma. To study reproducibility and utility of an overnight 0.25 mg dexamethasone suppression test (DST) with salivary cortisol levels as marker for glucocorticoid sensitivity in asthmatic children. 23 children with atopic asthma were recruited for two overnight 0.25 mg DST's, 1 month apart. Baseline cortisol levels correlated well between both tests. However, cortisol levels, change in cortisol levels or fractional suppression of cortisol levels after dexamethasone did not correlate between the two tests. Bland-Altman plots showed that the difference in salivary cortisol levels between test 1 and 2 of an individual patient could go up to 12 nmol/l, which is a clinically relevant difference. ICS dose did not correlate with baseline cortisol levels, height and BMI SDS. The low-dose salivary DST test in its current form is not suitable for use in clinical practice in children with asthma, due to low reproducibility. Therefore, studies using the 0.25 mg salivary DST should be interpreted cautiously.

  14. Overnight Science.

    ERIC Educational Resources Information Center

    Smith, Nancy N.; Stahl, Robert J.

    1981-01-01

    Outlines objectives for an elementary science camping program and summarizes general operational procedures. Campsite activities related to such topics as microorganisms, eye and sight, nature trails, bees, carpentry, and astronomy are described. (DS)

  15. Overnight Science.

    ERIC Educational Resources Information Center

    Smith, Nancy N.; Stahl, Robert J.

    1981-01-01

    Outlines objectives for an elementary science camping program and summarizes general operational procedures. Campsite activities related to such topics as microorganisms, eye and sight, nature trails, bees, carpentry, and astronomy are described. (DS)

  16. Hantavirus Infections among Overnight Visitors to Yosemite National Park, California, USA, 2012

    PubMed Central

    Núñez, Jonathan J.; Fritz, Curtis L.; Knust, Barbara; Buttke, Danielle; Enge, Barryett; Novak, Mark G.; Kramer, Vicki; Osadebe, Lynda; Messenger, Sharon; Albariño, César G.; Ströher, Ute; Niemela, Michael; Amman, Brian R.; Wong, David; Manning, Craig R.; Nichol, Stuart T.; Rollin, Pierre E.; Xia, Dongxiang; Watt, James P.

    2014-01-01

    In summer 2012, an outbreak of hantavirus infections occurred among overnight visitors to Yosemite National Park in California, USA. An investigation encompassing clinical, epidemiologic, laboratory, and environmental factors identified 10 cases among residents of 3 states. Eight case-patients experienced hantavirus pulmonary syndrome, of whom 5 required intensive care with ventilatory support and 3 died. Staying overnight in a signature tent cabin (9 case-patients) was significantly associated with becoming infected with hantavirus (p<0.001). Rodent nests and tunnels were observed in the foam insulation of the cabin walls. Rodent trapping in the implicated area resulted in high trap success rate (51%), and antibodies reactive to Sin Nombre virus were detected in 10 (14%) of 73 captured deer mice. All signature tent cabins were closed and subsequently dismantled. Continuous public awareness and rodent control and exclusion are key measures in minimizing the risk for hantavirus infection in areas inhabited by deer mice. PMID:24565589

  17. Overnight Enrichment is Essential for Reliable Salmonella PCR Testing from Fecal Samples.

    PubMed

    Wolff, Dietmar; Gerritzen, Andreas

    2017-03-01

    A rapid molecular test for identifying cases of infectious diarrhea might be beneficial for patients. We established a LightMix modular multiplex PCR assay for rapid detection of Campylobacter, Salmonella, Yersinia, and Shigella species from fecal samples. Unlike Campylobacter sp., direct detection of Salmonella from feces by multiplex PCR was significantly less sensitive than culture. Only 11 out of 21 (52%) Salmonella culture positive specimens were positive for Salmonella in the direct multiplex PCR assay (Campylobacter: 52/53 samples [98%]). In contrast, an overnight selenite enrichment step prior to multiplex PCR increased the Salmonella assay sensitivity significantly: 18 out of 18 Salmonella culture positive samples were then also detected by PCR. An overnight enrichment step is necessary for reliable PCR detection of Salmonella from fecal samples.

  18. Hantavirus infections among overnight visitors to Yosemite National Park, California, USA, 2012.

    PubMed

    Núñez, Jonathan J; Fritz, Curtis L; Knust, Barbara; Buttke, Danielle; Enge, Barryett; Novak, Mark G; Kramer, Vicki; Osadebe, Lynda; Messenger, Sharon; Albariño, César G; Ströher, Ute; Niemela, Michael; Amman, Brian R; Wong, David; Manning, Craig R; Nichol, Stuart T; Rollin, Pierre E; Xia, Dongxiang; Watt, James P; Vugia, Duc J

    2014-03-01

    In summer 2012, an outbreak of hantavirus infections occurred among overnight visitors to Yosemite National Park in California, USA. An investigation encompassing clinical, epidemiologic, laboratory, and environmental factors identified 10 cases among residents of 3 states. Eight case-patients experienced hantavirus pulmonary syndrome, of whom 5 required intensive care with ventilatory support and 3 died. Staying overnight in a signature tent cabin (9 case-patients) was significantly associated with becoming infected with hantavirus (p<0.001). Rodent nests and tunnels were observed in the foam insulation of the cabin walls. Rodent trapping in the implicated area resulted in high trap success rate (51%), and antibodies reactive to Sin Nombre virus were detected in 10 (14%) of 73 captured deer mice. All signature tent cabins were closed and subsequently dismantled. Continuous public awareness and rodent control and exclusion are key measures in minimizing the risk for hantavirus infection in areas inhabited by deer mice.

  19. Molecular characterization of Acanthamoeba isolated from amebic keratitis related to orthokeratology lens overnight wear

    PubMed Central

    Lee, Sun Joo; Jeong, Hae Jin; Lee, Ji Eun; Lee, Jong Soo; Xuan, Ying Hua; Kong, Hyun-Hee; Chung, Dong-Il; Ock, Mee-Sun

    2006-01-01

    In an effort to characterize, on the molecular scale, the Acanthamoeba initially isolated from the cornea of an amoebic keratitis patient associated with overnight-wear orthokeratology lens in Korea, we conducted mitochondrial DNA restriction fragment length polymorphism, 18S rDNA sequencing, and drug sensitivity analyses on the isolate (KA/PE1). The patient was treated with polyhexamethylene biguanide, chlorhexidine and oral itraconazole, which resulted in resolution of the patient's ocular inflammation. The majority of the molecular characteristics of the KA/PE1 were determined to be identical, or quite similar, to those of A. castellanii Ma strain, which had been isolated also from amoebic keratitis. The risk of Acanthamoeba keratitis as a potential complication of overnight orthokeratology is briefly discussed. PMID:17170573

  20. The effect of chronic propranolol treatment on overnight plasma levels of anterior pituitary and related hormones.

    PubMed Central

    Dart, A M; Lewis, M J; Groom, G V; Meek, E M; Henderson, A H

    1981-01-01

    1 Treatment of eight healthy males with propranolol (80 mg twice daily) for 6 weeks resulted in a significant reduction in overnight plasma levels of prolactin and LH. 2 Plasma testosterone levels were elevated whilst GH and cortisol were unchanged by such treatment. 3 Measurement of overnight hormone levels 48 h after discontinuing treatment showed no evidence of a 'rebound' phenomenon. 4 Cortisol, GH, prolactin, and testosterone plasma levels all showed time dependent changes: propranolol treatment significantly altered the time course of cortisol but not of the other hormones. 5 The effects of chronic propranolol treatment are discussed in terms of a probable direct central action of the drug. In addition the lowered plasma prolactin levels may directly contribute to the hypotensive action of propranolol. PMID:7340886

  1. Optimal Fasting Time before Measurement of Serum Triglyceride Levels in Healthy Volunteers.

    PubMed

    Pongsuthana, Surapun; Tivatunsakul, Naris

    2016-02-01

    Coronary heart disease is a major public health problem. Elevated triglyceride levels are a risk factor for atherosclerosis and coronary heart disease. Food intake interferes with the measurement of serum triglyceride levels, and in previous studies, fasting for 12 hours was recommended before blood sampling. In real-world practice, long fasting times cause patient discomfort and poor compliance, and the present study was, therefore, designed to determine the appropriate fasting time prior to measuring serum triglyceride levels. To determine the appropriate fasting time before measuring serum triglyceride levels. This was a pilot study performed using healthy volunteers aged between 20 and 30 years old from November 2013 to December 2013 at Rajavithi Hospital. The first blood sample was measured in the morning after fasting over 12 hours. The subjects then took their regular breakfast, after which they fasted for 8 hours. Blood samples were taken 6 and 8 hours later and sent to the laboratory for measurement of serum triglyceride levels. 40 volunteers, of whom 25 were female, were enrolled. Their mean age was 25.9 ± 2.81 years old, and their mean weight, height, and body mass index were 61.5 ± 12.5 kg, 167.2 ± 8.3 cm and 21.84 ± 3.1 kg/m2, respectively. Mean fasting serum triglyceride level at 12 hours was 80.23 ± 36.33 mg/dl, at 6 hours it was 110.65 ± 73.45 mg/dl, and at 8 hours it was 75.62 ± 46.81 mg/dl. The group fasting for 12 hours had significantly lower serum triglyceride levels than the group fasting for 6 hours (p-value = 0.003), but no significant difference was found between the group fasting for 12 hours and the one fasting for 8 hours (p-value = 0.493). The present study showed no significant difference in triglyceride levels in patients who had fasted or 8 hours and those who had done so for 12 hours. Fasting for only 8 hours before measurement of serum triglyceride may be sufficient.

  2. Overnight consolidation promotes generalization across talkers in the identification of nonnative speech sounds.

    PubMed

    Earle, F Sayako; Myers, Emily B

    2015-01-01

    This investigation explored the generalization of phonetic learning across talkers following training on a nonnative (Hindi dental and retroflex) contrast. Participants were trained in two groups, either in the morning or in the evening. Discrimination and identification performance was assessed in the trained talker and an untrained talker three times over 24 h following training. Results suggest that overnight consolidation promotes generalization across talkers in identification, but not necessarily discrimination, of nonnative speech sounds.

  3. Overnight S100B in Parkinson's Disease: A glimpse into sleep-related neuroinflammation.

    PubMed

    Carvalho, D Z; Schönwald, S V; Schumacher-Schuh, A F; Braga, C W; Souza, D O; Oses, J P; Donis, K C; Rieder, C R

    2015-11-03

    Calcium-binding protein B (S100B), a primary product of astrocytes, is a proposed marker of Parkinson's Disease (PD) pathophysiology, diagnosis and progression. However, it has also been implicated in sleep disruption, which is very common in PD. To explore the relationship between S100B, disease severity, sleep symptoms and polysomnography (PSG) findings, overnight changes in serum S100B levels were investigated for the first time in PD. 17 fully treated, non-demented, moderately advanced PD patients underwent PSG and clinical assessment of sleep symptoms. Serum S100B samples were collected immediately before and after the PSG. Results are shown as median [interquartile range]. Night and morning S100B levels were similar, but uncorrelated (rs=-0.277, p=0.28). Morning S100B levels, as opposed to night levels, positively correlated with the Unified Parkinson's Disease rating scale (UPDRS) subsections I and II (rs=0.547, p=0.023; rs=0.542, p=0.025). Compared to those with overnight S100B reduction, patients with overnight S100B elevation had higher H&Y scores (2.5 [0.87] vs. 2 [0.25], p=0.035) and worse total Pittsburgh Sleep Quality Index (PSQI) and Parkinson's Disease Sleep Scores (10 [3.2] vs. 8 [4.5], p=0.037; 92.9 [39] vs. 131.4 [28], p=0.034). Correlation between morning S100B levels and total UPDRS score was strengthened after controlling for total PSQI score (rs=0.531, p=0.034; partial rs=0.699, p=0.004, respectively). Overnight S100B variation and morning S100B were associated with PD severity and perceived sleep disruption. S100B is proposed as a putative biomarker for sleep-related neuroinflammation in PD. Noradrenergic-astrocytic dysfunction is hypothesized as a possible mechanism underlying these findings.

  4. Pegvisomant improves insulin sensitivity and reduces overnight free fatty acid concentrations in patients with acromegaly.

    PubMed

    Higham, C E; Rowles, S; Russell-Jones, D; Umpleby, A M; Trainer, P J

    2009-07-01

    Acromegaly is complicated by an increased incidence of diabetes mellitus caused by impaired insulin sensitivity and reduced beta-cell function. Pegvisomant blocks activity at GH receptors, normalizing IGF-I in over 90% of patients and improving insulin sensitivity. The mechanisms for this increase in insulin sensitivity are not fully determined. We used stable isotope techniques to investigate the effects of pegvisomant on glucose and lipid metabolism in acromegaly. Five patients (age, 43 yr +/- sd) with active acromegaly were studied on two occasions: before pegvisomant and after 4 wk of pegvisomant (20 mg daily sc). (2)H(5)-glycerol was infused overnight to measure overnight and early morning (basal) glycerol production rate (Ra). The next morning (2)H(2)-glucose was infused for 2 h before and throughout a hyperinsulinemic euglycemic (1.5 mU/kg x min insulin) clamp to measure basal glucose Ra and insulin-stimulated peripheral glucose disposal (Rd). Mean IGF-I was significantly reduced after pegvisomant treatment (mean, 539 +/- 176 vs. 198 +/- 168 microg/ml; P = 0.001). The insulin sensitivity of endogenous glucose production was significantly increased after pegvisomant [mean glucose Ra *insulin, 118.5 +/- 28 vs. 69.2 +/- 22 micromol/kg x min *(mU/liter); P = 0.04]. No differences in glucose Rd were seen after pegvisomant. All patients showed a reduction in glycerol Ra adjusted for insulin [mean, 18.12 +/- 1.75 vs. 14.4 +/- 4.75 micromol/kg x min *(mU/liter); P = 0.08] and overnight FFA concentrations (mean area under the curve, 278 +/- 84 vs. 203 +/- 71; P < 0.05) after pegvisomant. Short-term administration of pegvisomant leads to a reduction in overnight endogenous glucose production, and this may be related to reduced levels of FFA.

  5. Agreement between the frailty index and phenotype and their associations with falls and overnight hospitalizations.

    PubMed

    Zhu, Yinsheng; Liu, Zuyun; Wang, Yong; Wang, Zhengdong; Shi, Jianming; Xie, Xuejuan; Jin, Li; Chu, Xuefeng; Wang, Xiaofeng

    2016-01-01

    The objective of this study is to examine the agreement between two commonly used frailty measurements (frailty index and phenotype) and their associations with falls and overnight hospitalizations in a community-based population. Data was collected from 1663 elderly adults (aged 70-84 years) from the aging arm of the Rugao Longevity and Ageing study, a two-arm cohort conducted in Rugao, China. Items concerning the frailty index and phenotype, falls and overnight hospitalizations were collected. The Kappa agreement examining three levels of these two frailty measurements was 0.310 (95% CI: 0.277-0.343) according to the frailty index cut-off developed by Hoover et al. Both frailty measurements were significantly associated with falls and overnight hospitalizations. For instance, compared with the frailty index defined non-frail participants, their pre-frail and frail counterparts had significantly increased risks for falls, with odds ratios (ORs) of 1.69 (95% CI: 1.17-2.43) and 2.87 (95% CI: 1.93-4.28), respectively. When the two frailty measurements were simultaneously included in the models, significant associations were also observed. More importantly, a sub-analysis in participants who were categorized as robust by frailty phenotype revealed that frail participants (frailty index>0.21) still had increased risks for falls (OR=2.35, 95% CI: 1.24-4.46) and overnight hospitalizations (OR=2.56, 95% CI: 1.05-6.23) compared with their non-frail counterparts. Common characteristics and complementarity existed in the frailty index and phenotype in the elderly Chinese population. Additional consideration of the frailty index when applying frailty phenotype should be undertaken. The findings provide preliminary but crucial clues for future studies on frailty. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. A single bout of exercise activates skeletal muscle satellite cells during subsequent overnight recovery.

    PubMed

    Snijders, Tim; Verdijk, Lex B; Beelen, Milou; McKay, Bryon R; Parise, Gianni; Kadi, Fawzi; van Loon, Luc J C

    2012-06-01

    Skeletal muscle satellite cell (SC) content has been reported to increase following a single bout of exercise. Data on muscle fibre type-specific SC content and/or SC activation status are presently lacking. The objective of the study was to determine the impact of a single bout of exercise on muscle fibre type-specific SC content and activation status following subsequent overnight recovery. Eight healthy men (age, 20 ± 1 years) performed a single bout of combined endurance- and resistance-type exercise. Muscle biopsies were collected before and immediately after exercise, and following 9 h of postexercise, overnight recovery. Muscle fibre type-specific SC and myonuclear content and SC activation status were determined by immunohistochemical analyses. Satellite cell activation status was assessed by immunohistochemical staining for both Delta-like homologue 1 (DLK1) and Ki-67. Muscle fibre size and fibre area per nucleus were greater in type II compared with type I muscle fibres (P < 0.05). At baseline, no differences were observed in the percentage of SCs staining positive for DLK1 and/or Ki67 between fibre types. No significant changes were observed in SC content following 9 h of postexercise, overnight recovery; however, the percentage of DLK1-positive SCs increased significantly during overnight recovery, from 22 ± 5 to 41 ± 5% and from 24 ± 6 to 51 ± 9% in the type I and II muscle fibres, respectively. No changes were observed in the percentage of Ki-67-positive SCs. A single bout of exercise activates both type I and II skeletal muscle fibre SCs within a single night of postexercise recovery, preceding the subsequent increase in SC content.

  7. Overnight malodor effect with a 0.454% stabilized stannous fluoride sodium hexametaphosphate dentifrice.

    PubMed

    Farrell, Svetlana; Barker, Matthew L; Gerlach, Robert W

    2007-12-01

    Stannous fluoride (SnF2) is a broad-spectrum antimicrobial agent effective against caries, plaque, and gingivitis. Because oral malodor has a microbial etiology, the potential immediate effects of SnF2 on malodor were evaluated in 2 independent, randomized clinical trials. Both studies used a similar double-blind, crossover design, with subjects randomized to a treatment sequence with a 0.454% stabilized SnF2 sodium hexametaphosphate dentifrice or sodium fluoride dentifrice control. Overnight malodor was assessed at baseline in the morning before brushing and 24 hours later, after morning and evening brushing with the assigned product. In the first study, volatile sulfur compounds (VSC) were measured instrumentally via a portable sulfide monitor (Halimeter) with an electrochemical gas sensor. The second study used second-person malodor assessment on a 9-point hedonic scale. Treatments were compared at each time point using analysis of variance for crossover designs. Seventy-five subjects completed the evaluation (26 in the first and 49 in the second clinical trial). The use of the stabilized SnF2 dentifrice resulted in statistically significant reduction of overnight VSC (P <.03) and the overnight hedonic scores (P <.02) relative to the negative control after 1 day of product use. These 2 randomized, controlled clinical trials provide evidence of significant immediate malodor activity for a 0.454% stabilized SnF2 sodium hexametaphosphate dentifrice.

  8. Obstructive sleep apnea in children is associated with severity-dependent deterioration in overnight endothelial function.

    PubMed

    Kheirandish-Gozal, Leila; Etzioni, Tamar; Bhattacharjee, Rakesh; Tan, Hui-Leng; Samiei, Arash; Molero Ramirez, Helena; Abu Eta, Busool; Pillar, Giora

    2013-06-01

    Restorative sleep is expected to promote improved endothelial function (EF) in the morning compared to the evening. However, in adults with obstructive sleep apnea (OSA) EF is not only adversely affected, but it worsens during the night. Data in pediatric OSA are scarce, and overnight changes have not been explored. Therefore, we sought to examine potential associations between pediatric OSA and overnight changes in EF. 59 habitually snoring children with various degrees of sleep-disordered breathing (age range, 4-16 years) underwent EF assessment (reactive hyperemia test by EndoPAT, Itamar Medical, Israel) in the evening before and the morning after an overnight polysomnography (PSG). Two brachial occlusion periods (1 min and 5 min) also were tested. Potential associations between evening-to-morning changes in EF and polysomnographic parameters were explored. Evening-to-morning changes in children with OSA displayed severity-dependent deterioration of EF, and occlusions lasting 1 or 5 min during the reactive hyperemia test yielded similar findings. In children deterioration in EF during the night significantly correlated with the severity of OSA. Furthermore, the reactive hyperemia test can be reliably performed with only 60 seconds of arterial flow occlusion in children. These findings support our hypothesis that similarly to adults, sleep apnea in children results in endothelial dysfunction (ED). We speculate that pediatric OSA is less commonly associated with cardiovascular complications possibly due to the shorter duration of the syndrome. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Overnight caffeine abstinence and negative reinforcement of preference for caffeine-containing drinks.

    PubMed

    Rogers, P J; Richardson, N J; Elliman, N A

    1995-08-01

    It has been suggested that liking for the taste, flavour and aroma of, for example, coffee and tea is acquired through the process of classical conditioning, involving association of these orosensory cues with the psychopharmacological consequences of caffeine ingestion. Accordingly, this study investigated caffeine reinforcement by assessing changes in preference for a novel drink consumed with or without caffeine. Particular care was taken to use "ecologically valid" procedures; that is, overnight caffeine abstinence followed by a cup-of-coffee equivalent dose of caffeine (70 mg) at breakfast. Caffeine had no significant effects on drink preference or mood in subjects with habitually low intakes of caffeine. In contrast, moderate users of caffeine developed a relative dislike for the drink lacking caffeine and showed somewhat lowered mood following overnight caffeine abstinence (e.g., less lively, clearheaded and cheerful), which was significantly improved by caffeine. These together with other recent results strongly suggest that, in everyday life, caffeine reinforcement can occur as the result of the alleviation by caffeine of the adverse effects of overnight caffeine abstinence (negative reinforcement). They also demonstrate the utility of this flavour-conditioning procedure, which could be applied in the wider investigation of the reinforcing properties of drugs.

  10. Behavioral changes in female Asian elephants when given access to an outdoor yard overnight.

    PubMed

    Powell, David M; Vitale, Cathy

    2016-07-01

    A study was conducted at the Bronx Zoo to determine whether providing elephants with access to an outdoor corral at night had any significant effects on behavior, use of space, and use of a sand corral. Activity budgets for three female Asian elephants were compared when the subjects were housed indoors overnight and when they were given access to an outdoor yard overnight. Observations were recorded via infrared video cameras between the hours of 1900 and 0700 during the months of July-September. Two of the three elephants showed a significant preference for spending time outdoors, whereas, the third elephant spent most of her time indoors. Standing and play behavior increased when the elephants had outdoor access while lying down and feeding behavior decreased. Swaying behavior decreased significantly when the elephants had access to the outdoor yard. The elephants made very little use of a sand-floor stall regardless of whether or not they had access to outdoors. The results of this study, suggest that having access to alternate areas overnight can promote well-being by reducing repetitive behavior and allowing animals to express their preferences for different locations. The relative importance of choice alone vs. the behavioral opportunities provided by choice options for zoo animals is discussed. Zoo Biol. 35:298-303, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Pancreatic lipase activity in overnight effluent predicts high transport status in peritoneal dialysis patients.

    PubMed

    Idei, Mayumi; Tabe, Yoko; Hamada, Chieko; Miyake, Kazunori; Takemura, Hiroyuki; Io, Hiroaki; Wakita, Mitsuru; Horii, Takashi; Tomino, Yasuhiko; Ohsaka, Akimichi; Miida, Takashi

    2016-11-01

    Long-term peritoneal dialysis (PD) causes peritoneal morphological and functional changes, resulting in high transport status featuring increased peritoneal permeability. High transport status is diagnosed by peritoneal equilibration test (PET), a reliable but time-consuming method. We identifed a reliable biomarker in peritoneal effluent to predict high transport status in PD patients. We collected peritoneal effluent and serum from 33 PD patients and measured common laboratory test parameters. High transport status was determined by PET if the dialysate/plasma ratio of creatinine at 4h dwell (D/P Cr 4h) was ≥0.81. There were significant correlations between D/P Cr 4h and some laboratory parameters in overnight effluent (pancreatic lipase activity, r=0.65, p<0.001; β2-microglobulin concentration, r=0.59, p<0.001; IL-6 concentration, r=0.53, p<0.001; and CA125 concentration, r=0.29, p=0.027). In a multivariate logistic regression analysis, the pancreatic lipase activity in overnight effluent was identified as an independent predictor of high transport status even after adjusting for age, PD duration, and glomerular filtration rate [OR=1.43 (95% CI: 1.11-1.83), p=0.005]. The pancreatic lipase activity in overnight effluent is an independent predictor of high transport status in PD patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Faculty and resident perceptions regarding overnight student call during the third year OB/GYN clerkship.

    PubMed

    Hiraoka, Mark; Sung, Stephen; Davis, James; Kim, David

    2011-09-01

    The objective of this study is to identify university faculty, community physician, and resident perceptions of how a schedule that employs overnight call in addition to a traditional weekday schedule affects medical student education, well being, and patient care during the third year obstetrics and gynecology clerkship. In July 2007, a descriptive study was performed by distributing surveys to community teaching physicians, current residents, and faculty in the University of Hawai'i Department of Obstetrics and Gynecology. A total of 114 surveys were distributed to all current residents, clinical faculty and full-time faculty in the University of Hawai'i Department of Obstetrics and Gynecology. The survey included questions regarding the effect of the student call/work hour restrictions. A response rate of 45.6% was obtained (52/114). Results demonstrate that 84.6% (44/52) of residents, faculty, and community attendings agree that third year medical students should take call during their obstetrics and gynecology clerkship. Data was analyzed utilizing Spearman correlation and Cochran-Mantel-Haenszel statistics. No statistical difference was detected in terms of age or physician type (resident vs faculty vs community attending). Most physician-educators believe that medical students benefit from taking overnight call during their obstetrics and gynecology clerkship. Careful consideration should be given prior to elimination of overnight call in the obstetrics and gynecology clerkship.

  13. Impaired Overnight Counterregulatory Hormone Responses to Spontaneous Hypoglycemia in Children with Type 1 Diabetes

    PubMed Central

    2007-01-01

    To assess the changes in counterregulatory hormones overnight after an afternoon of structured exercise or sedentary activity in children with Type 1 Diabetes Mellitus (T1DM), the Diabetes Research in Children Network (DirecNet) studied 50 children (10-<18y) with T1DM in 5 clinical research centers on two separate days (with and without an afternoon exercise session) using a crossover design. Glucose, epinephrine, norepinephrine, cortisol, growth hormone (GH) and glucagon concentrations were measured hourly overnight. Nocturnal hypoglycemia (plasma glucose concentrations ≤70 mg/dL [3.9 mmol/L]) occurred more frequently on the nights following exercise (56% vs. 36%; p=0.008). Mean hourly concentrations of most hormones did not differ between sedentary or exercise nights or between nights with or without hypoglycemia. Spontaneous nocturnal hypoglycemia only stimulated small increases in plasma epinephrine and growth hormone concentrations and failed to cause a rise in norepinephrine, cortisol or glucagon levels in comparison to values during the hour before or after hypoglycemia or other times during those same nights. Counterregulatory hormone responses to spontaneous nocturnal hypoglycemia were markedly decreased regardless of whether there was antecedent afternoon exercise in children with T1DM. Sleep-induced impairments in counterregulatory hormone responses likely contribute to the increased risk of hypoglycemia during the entire overnight period in youth with T1DM. PMID:17659061

  14. Overnight Motor Skill Learning Outcomes in Obstructive Sleep Apnea: Effect of Continuous Positive Airway Pressure

    PubMed Central

    Landry, Shane; O'Driscoll, Denise M.; Hamilton, Garun S.; Conduit, Russell

    2016-01-01

    Study Objective: To determine the effectiveness of continuous positive airway pressure (CPAP) therapy in alleviating known impairments in the overnight consolidation of motor skill learning in patients with obstructive sleep apnea (OSA). Methods: Twenty-five patients with untreated moderate-severe OSA, 13 first-night CPAP users, 17 compliant CPAP users, and 14 healthy control patients were trained on a motor sequence learning task (Sequential Finger Tapping Task, SFTT) and were subsequently tested prior to and after polysomnographic recorded sleep. Measures of subjective sleepiness (Karolinska Sleepiness Scale) and sustained attention (Psychomotor Vigilance Task) were also completed before and after sleep. Results: Typical analyses of overnight improvement on the SFTT show significantly greater overnight gains in motor task speed in controls (+11.6 ± 4.7%, p = 0.007) and compliant CPAP users (+8.9 ± 4.3%, p = 0.008) compared to patients with OSA (−4.86 ± 4.5%). Additional analyses suggest that these improvements in motor performance occurred prior to the sleep episode, as all groups significantly improved (15% to 22%) over a 10-min presleep rest period. Thereafter, performance in all groups significantly deteriorated over sleep (6% to 16%) with trends toward patients with OSA showing greater losses in performance compared to control patients and compliant CPAP users. No between-group differences in subjective sleepiness and sustained attention were found presleep and postsleep. Conclusions: The current data suggest impairments in overnight motor learning in patients with OSA may be a combination of deficient stabilization of memory over a sleep episode as well as increased vulnerability to time on task fatigue effects. Compliant CPAP usage possibly offsets both of these impediments to learning outcomes by improving both sleep quality and subsequent daytime function. Citation: Landry S, O'Driscoll DM, Hamilton GS, Conduit R. Overnight motor skill learning

  15. Effects of long working hours and the night shift on severe sleepiness among workers with 12-hour shift systems for 5 to 7 consecutive days in the automobile factories of Korea.

    PubMed

    Son, Mia; Kong, Jeong-Ok; Koh, Sang-Baek; Kim, Jaeyoung; Härmä, Mikko

    2008-12-01

    We investigated the effects of 12-hour shift work for five to seven consecutive days and overtime on the prevalence of severe sleepiness in the automobile industry in Korea. [Correction added after online publication 28 Nov: Opening sentence of the summary has been rephrased for better clarity.] A total of 288 randomly selected male workers from two automobile factories were selected and investigated using questionnaires and sleep-wake diaries in South Korea. The prevalence of severe sleepiness at work [i.e. Karolinska Sleepiness Scale (KSS) score of 7 or higher] was modeled using marginal logistic regression and included theoretical risk factors related to working hours and potential confounding factors related to socio-economic status, work demands, and health behaviors. Factors related to working hours increased the risk for severe sleepiness at the end of the shift in the following order: the night shift [odds ratio (OR): 4.7; 95% confidence interval (CI): 3.6-6.0)], daily overtime (OR: 2.2; 95% CI: 1.7-2.9), weekly overtime (OR: 1.6; 95% CI: 1.0-2.6), and night overtime (OR: 1.6; 95% CI: 0.8-3.0). Long working hours and shift work had a significant interactive effect for severe sleepiness at work. Night shift workers who worked for 12 h or more a day were exposed to a risk of severe sleepiness that was 7.5 times greater than day shift workers who worked less than 11 h. Night shifts and long working hours were the main risk factors for severe sleepiness among automobile factory workers in Korea. Night shifts and long working hours have a high degree of interactive effects resulting in severe sleepiness at work, which highlight the need for immediate measures to address these characteristics among South Korean labor force patterns.

  16. Evaluation of a clinical tool to test and adjust the programmed overnight basal profiles for insulin pump therapy: a pilot study.

    PubMed

    Orszag, Andrej; Falappa, C Marcelo; Lovblom, Leif E; Partridge, Helen; Tschirhart, Holly; Boulet, Genevieve; Picton, Peter; Cafazzo, Joseph A; Perkins, Bruce A

    2015-10-01

    Clinical protocols for basal rate testing and adjustment are needed for effective insulin pump therapy. We evaluated the effects of a continuous glucose monitoring (CGM)-based semiautomated basal algorithm on glycemia. We developed and piloted a basal rate analyzer that interpreted CGM data from overnight fasts and recommended dose changes for subsequent nights. Subjects uploaded data online using sensor-augmented pumps for evaluation by the analyzer after each of 5 overnight fasts conducted over 2 to 8 weeks. It was designed to be conservative and iterative, making changes that did not exceed 10% at each iteration. The standard deviation and interquartile range of CGM values from midnight to 7 am (SD12-7am and IQR12-7am) over 3 baseline and 3 postintervention nights, hypoglycemia incidence (CGM values <4.0 mmol/L), and glycated hemoglobin (A1C) were compared. Twenty subjects with mean ages of 38±13 years and A1C 7.6%±0.8% (60±8.7 mmol/mol) underwent the 5 iterations of basal assessments over 5±3 weeks. SD12-7am and IQR12-7am did not change from baseline to postintervention (1.57±0.8 to 1.63±0.8 mmol/L; p=0.35; 3.66±2.07 to 3.47±2.26 mmol/L; p=0.90). However, mean glucose values were lower between 2 to 3 am at baseline compared to postintervention; 3-night hypoglycemia incidence declined from 1.6±1.8 to 0.5±0.7 episodes (p=0.01), and A1C improved from 7.6%±0.8% to 7.4%±0.9% (60%±8.7% to 57%±9.8% mmol/mol; p=0.03). The use of a basal rate analyzer was associated with reduced hypoglycemia and improved A1C. However, overnight glycemic stability was not improved. Further research into the efficacy of the CGM-based semiautomated algorithm is warranted. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  17. Morning Spot Urine Glucose-to-Creatinine Ratios Predict Overnight Urinary Glucose Excretion in Patients With Type 2 Diabetes

    PubMed Central

    Kim, So Ra; Lee, Yong-ho; Lee, Sang-Guk; Lee, Sun Hee; Kang, Eun Seok; Cha, Bong-Soo; Lee, Hyun Chul; Kim, Jeong-Ho

    2017-01-01

    Background With the advent of sodium glucose co-transporter 2 inhibitors to control glucose and treat diabetes, laboratory data aided by either timed or spot glucose levels in the urine could be used as an alternative marker of drug response. The aim of this study was to assess the agreement between overnight urinary glucose excretion (UGE) and morning spot urinary glucose-to-creatinine ratio (UGCR). Methods In this prospective cross-sectional study, we enrolled a total of 215 participants with either normal glucose tolerance (NGT), pre-diabetes, or type 2 diabetes mellitus (T2DM). To exclude external factors such as food intake and physical activity, urine samples collected overnight at an 8-hr interval and the first-voided morning spot urine were collected and compared. Results The median values of overnight 8-hr UGE in participants with NGT (N=14), pre-diabetes (N=41), and T2DM (N=160) were 35.0 mg, 35.6 mg, and 653.4 mg, respectively. In participants with T2DM, the median values of overnight 8-hr UGCR and first-voided morning spot UGCR (M-UGCR) were 1.37 mg/mg and 0.16 mg/mg, respectively. Quantitative analyses using an intraclass correlation coefficient (ICC) demonstrated a good reliability of measurement of the overnight 8-hr UGCR and M-UGCR (ICC=0.943, P<0.001). The M-UGCR was also significantly related to the overnight 8-hr UGE (r=0.828, P<0.001). Conclusions M-UGCR and overnight 8-hr UGCR showed good agreement, suggesting that M-UGCR be used as a simple index for estimating overnight amounts of UGE in patients with T2DM. PMID:27834060

  18. How Fast Is Fast?

    ERIC Educational Resources Information Center

    Korn, Abe

    1994-01-01

    Presents an activity that enables students to answer for themselves the question of how fast a body must travel before the nonrelativistic expression must be replaced with the correct relativistic expression by deciding on the accuracy required in describing the kinetic energy of a body. (ZWH)

  19. Overnight switch from ropinirole to transdermal rotigotine patch in patients with Parkinson disease

    PubMed Central

    2011-01-01

    Background A recent trial involving predominantly Caucasian subjects with Parkinson Disease (PD) showed switching overnight from an oral dopaminergic agonist to the rotigotine patch was well tolerated without loss of efficacy. However, no such data have been generated for Korean patients. Methods This open-label multicenter trial investigated PD patients whose symptoms were not satisfactorily controlled by ropinirole, at a total daily dose of 3 mg to 12 mg, taken as monotherapy or as an adjunct to levodopa. Switching treatment from oral ropinirole to transdermal rotigotine was carried out overnight, with a dosage ratio of 1.5:1. After a 28-day treatment period, the safety and tolerability of switching was evaluated. Due to the exploratory nature of this trial, the effects of rotigotine on motor and nonmotor symptoms of PD were analyzed in a descriptive manner. Results Of the 116 subjects who received at least one treatment, 99 (85%) completed the 28-day trial period. Dose adjustments were required for 11 subjects who completed the treatment period. A total of 76 treatment-emergent adverse events (AEs) occurred in 45 subjects. No subject experienced a serious AE. Thirteen subjects discontinued rotigotine prematurely due to AEs. Efficacy results suggested improvements in both motor and nonmotor symptoms and quality of life after switching. Fifty-two subjects (46%) agreed that they preferred using the patch over oral medications, while 31 (28%) disagreed. Conclusions Switching treatment overnight from oral ropinirole to transdermal rotigotine patch, using a dosage ratio of 1.5:1, was well tolerated in Korean patients with no loss of efficacy. Trial registration This trial is registered with the ClincalTrails.gov Registry (NCT00593606). PMID:21831297

  20. Effects of increased overnight supervision on resident education, decision-making, and autonomy.

    PubMed

    Haber, Lawrence A; Lau, Catherine Y; Sharpe, Bradley A; Arora, Vineet M; Farnan, Jeanne M; Ranji, Sumant R

    2012-10-01

    New supervisory regulations highlight the challenge of balancing housestaff supervision and autonomy. To better understand the impact of increased supervision on residency training, we investigated housestaff perceptions of education, autonomy, and clinical decision-making before and after implementation of an in-hospital, overnight attending physician (nocturnist). We established a nocturnist program in July 2010 at our academic, tertiary care medical center. We administered pre-surveys and post-surveys of internal medicine residents on night float rotation during the 2010-2011 academic year. We surveyed residents before and after experiencing the nocturnist program. Housestaff reported an increase in the clinical value of the night float rotation (3.95 vs 4.27, P = 0.01) and the adequacy of overnight supervision (3.65 vs 4.30, P < 0.0001) without a change in decision-making autonomy (4.35 vs 4.45, P = 0.44). Trainees agreed that nocturnist supervision positively impacted patient outcomes (3.79 vs 4.30, P = 0.002). Housestaff contacted attendings more frequently for transfers from outside facilities (2.00 vs 3.20, P = 0.006), during adverse events (2.51 vs 3.25, P = 0.04), prior to ordering invasive diagnostics (1.75 vs 2.76, P = 0.004), and prior to vasopressor use (1.52 vs 2.40, P = 0.004). Residents' fear of revealing knowledge gaps and desire to make decisions independently did not change. Increased overnight supervision enhanced the clinical value of the night float rotation, increased rates of attending contact during critical clinical decision-making, and improved perception of patient care. These changes occurred without a decrease in housestaff's perceived decision-making autonomy. Copyright © 2012 Society of Hospital Medicine.

  1. Relationship between overnight rostral fluid shift and obstructive sleep apnea in drug-resistant hypertension.

    PubMed

    Friedman, Oded; Bradley, T Douglas; Chan, Christopher T; Parkes, Robert; Logan, Alexander G

    2010-12-01

    Obstructive sleep apnea occurs frequently in patients with drug-resistant hypertension. The factors accounting for this observation, however, are unclear. Both conditions demonstrate clinical features suggestive of extracellular fluid volume overload. The aims of this study were to examine whether the spontaneous overnight fluid shift from the legs to the upper body is associated with obstructive sleep apnea in hypertensive subjects and whether its magnitude is greater in drug-resistant hypertension. Leg fluid volume and the circumference of the calf and neck were measured before and after sleep in drug-resistant hypertensive (n = 25) and controlled hypertensive (n=15) subjects undergoing overnight polysomnography. The severity of obstructive sleep apnea was greater in the drug-resistant hypertensive group than in the controlled hypertensive group (apnea-hypopnea index: 43.0 ± 5.4 versus 18.1 ± 4.2 events per hour of sleep; P = 0.02, case-mix adjusted). In both groups, the apnea-hypopnea index strongly related to the amount of leg fluid volume displaced (R² = 0.56; P < 0.0001), although the magnitude of change was greater in the drug-resistant hypertensive group (346.7 ± 24.1 versus 175.8 ± 31.3 mL; P = 0.01, propensity-score adjusted). The overnight reduction in calf circumference and increase in neck circumference were also greater in drug-resistant hypertension (both P ≤ 0.02). In hypertensive subjects, rostral fluid displacement strongly relates to the severity of obstructive sleep apnea with its magnitude being greater in drug-resistant hypertension. Our findings support the concept that fluid redistribution centrally during sleep accounts for the high prevalence of obstructive sleep apnea in drug-resistant hypertension.

  2. Safety of Outpatient Total Ankle Arthroplasty vs Traditional Inpatient Admission or Overnight Observation.

    PubMed

    Mulligan, Ryan P; Parekh, Selene G

    2017-08-01

    Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control. The medical records of patients who underwent TAA with 1 fellowship-trained orthopedic foot and ankle surgeon were reviewed. Outcome measures included operative complications, adverse medical events, readmission or emergency room visit for any reason, or reoperation within 90 days following surgery; surgeon's office contact before first postoperative visit regarding pain or other issues; visual analog scale pain score at the first postoperative visit; and need for narcotic refill. Outcomes were assessed by admission status: outpatient, overnight observation, or inpatient admission. Standard statistical analysis was used, and P < .05 was considered significant. Eighty-one patients underwent TAA who met inclusion criteria, and 8 had a complication (10%). A significant difference in complication rate was seen among groups ( P = .01) but not rate of readmission or reoperation. Of 16 patients, 5 (31%) who were admitted for 2 or more nights following surgery had a complication, as opposed to 3 of 65 (5%) who were outpatient or admitted overnight ( P = .01). There were no differences in frequency of postoperative phone calls, narcotic refills, or visual analog scale pain scores at the first postoperative visit. There were no adverse medical events. With proper instruction, TAA was performed safely in the outpatient setting. As health care policy continues to evolve in the United States, safe and efficient practices will remain a priority. Level III, retrospective comparative study.

  3. Transcranial direct current stimulation reduces negative affect but not cigarette craving in overnight abstinent smokers.

    PubMed

    Xu, Jiansong; Fregni, Felipe; Brody, Arthur L; Rahman, Ardeshir S

    2013-01-01

    Transcranial direct current stimulation (tDCS) can enhance cognitive control functions including attention and top-down regulation over negative affect and substance craving in both healthy and clinical populations, including early abstinent (∼1.5 h) smokers. The aim of this study was to assess whether tDCS modulates negative affect, cigarette craving, and attention of overnight abstinent tobacco dependent smokers. In this study, 24 smokers received a real and a sham session of tDCS after overnight abstinence from smoking on two different days. We applied anode to the left dorsolateral prefrontal cortex and cathode to the right supra-orbital area for 20 min with a current of 2.0 mA. We used self-report questionnaires Profile of Mood States (POMS) to assess negative affect and Urge to Smoke (UTS) Scale to assess craving for cigarette smoking, and a computerized visual target identification task to assess attention immediately before and after each tDCS. Smokers reported significantly greater reductions in POMS scores of total mood disturbance and scores of tension-anxiety, depression-dejection, and confusion-bewilderment subscales after real relative to sham tDCS. Furthermore, this reduction in negative affect positively correlated with the level of nicotine dependence as assessed by Fagerström scale. However, reductions in cigarette craving after real vs. sham tDCS did not differ, nor were there differences in reaction time or hit rate change on the visual task. Smokers did not report significant side effects of tDCS. This study demonstrates the safety of tDCS and its promising effect in ameliorating negative affect in overnight abstinent smokers. Its efficacy in treating tobacco dependence deserves further investigation.

  4. Outcomes of operations performed by attending surgeons after overnight trauma shifts.

    PubMed

    Sharpe, John P; Weinberg, Jordan A; Magnotti, Louis J; Nouer, Simonne S; Yoo, Wonsuk; Zarzaur, Ben L; Cullinan, Darren R; Hendrick, Leah E; Fabian, Timothy C; Croce, Martin A

    2013-04-01

    To date, work-hour restrictions have not been imposed on attending surgeons in the United States. The purpose of this study was to investigate the impact of working an overnight trauma shift on outcomes of general surgery operations performed the next day by the post-call attending physician. Consecutive patients over a 3.5-year period undergoing elective general surgical procedures were reviewed. Procedures were limited to hernia repairs (inguinal and ventral), cholecystectomies, and intestinal operations. Any operations that were performed the day after the attending surgeon had taken an overnight trauma shift were considered post-call (PC) cases; all other cases were considered nonpost-call (NP). Outcomes from the PC operations were compared with those from the NP operations. There were 869 patients identified; 132 operations were performed PC and 737 were NP. The majority of operations included hernia repairs (46%), followed by cholecystectomies (35%), and intestinal procedures (19%). Overall, the PC operations did not differ from the NP operations with respect to complication rate (13.7% vs 13.5%, p = 0.93) or readmission within 30 days (5% vs 6%, p = 0.84). Additionally, multivariable logistic regression failed to identify an association between PC operations and the development of adverse outcomes. Follow-up was obtained for an average of 3 months. Performance of general surgery operations the day after an overnight in-hospital trauma shift did not affect complication rates or readmission rates. At this time, there is no compelling evidence to mandate work-hour restrictions for attending general surgeons. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. The "Glucositter" overnight automated closed loop system for type 1 diabetes: a randomized crossover trial.

    PubMed

    Nimri, Revital; Danne, Thomas; Kordonouri, Olga; Atlas, Eran; Bratina, Natasa; Biester, Torban; Avbelj, Magdalena; Miller, Shahar; Muller, Ido; Phillip, Moshe; Battelino, Tadej

    2013-05-01

    Tight glucose control is needed to prevent long-term diabetes complications; this is hindered by the risk of hypoglycemia, especially at night. To assess the safety and efficacy of the closed-loop MD-Logic Artificial Pancreas (MDLAP), controlling nocturnal glucose levels in patients with type 1 diabetes mellitus (T1DM). This was a randomized, multicenter, multinational, crossover trial conducted in Slovenia, Germany, and Israel. Twelve patients with T1DM (age 23.8 ± 15.6 yr; duration of diabetes 13.5 ± 11.9 yr; A1c 8.1 ± 0.8%, mean ±  SD) were randomly assigned to participate in two sequential overnight sessions: one using continuous subcutaneous insulin infusion (CSII) and the other, closed-loop insulin delivery by MDLAP. The primary outcome was the number of hypoglycemic events below 63 mg/dL. Endpoints analyses were based on sensor glucose readings. Three events of nocturnal hypoglycemia occurred during CSII and none during the closed-loop control (p = 0.18). The percentage of time spent in the near normal range of 63-140 mg/dL was significantly higher in the overnight closed-loop sessions [76% (54-85)] than during CSII therapy [29% (11-44)] [p = 0.02, median (interquartile range)]. The mean overnight glucose level was reduced by 36 mg/dL with closed-loop insulin delivery (p = 0.02) with a significantly less glucose variability when compared with the CSII nights (p < 0.001). The results of this study demonstrate the ability of the MDLAP to safely improve overnight glucose control without increased risk of hypoglycemia in patients with T1DM at three different national, geographic, and clinical centers (ClinicalTrials.gov number, NCT 01238406). © 2013 John Wiley & Sons A/S.

  6. Overnight heart rate variability in patients with obstructive sleep apnoea: a time and frequency domain study.

    PubMed

    Zhu, Kaixian; Chemla, Denis; Roisman, Gabriel; Mao, Wenyuan; Bazizi, Samir; Lefevre, Amaury; Escourrou, Pierre

    2012-11-01

    Heightened sympathetic activity plays a role in the cardiovascular sequelae of obstructive sleep apnoea (OSA). Cardiac autonomic function may be assessed non-invasively by studying heart rate variability (HRV). The aim of the present study was to compare overnight HRV between a control group and a group of subjects with severe OSA. The potential confounding effects of age, sex, baseline autonomic status and sleep stage distribution were taken into account. Our prospective Holter study compared overnight (0030-0530 hours) HRV in 23 controls (apnoea hypopnoea index (AHI) = 5 ± 3 /h) and 23 subjects with severe OSA (AHI = 65 ± 23 /h), matched for age and sex and with a similar percentage of rapid eye movement sleep. The mean normal-to-normal RR interval (NN) was shorter in the OSA compared with control group (903 vs 1039 ms, respectively), whereas the other time-domain indices of HRV, as well as the classic frequency-domain indices, were similar. Essentially similar results were obtained hourly and when only subjects with high mean values of the standard deviation of all NN (≥ 90 ms) were evaluated. In the 0.01-0.06 Hz range corresponding to the typical OSA pattern of bradycardia-tachycardia termed cyclic variation of heart rate (CVHR), higher power was documented hourly in OSA, with a significant correlation between overnight power and both AHI and mean oxyhaemoglobin saturation. The percentage of NN > x ms different from the previous one (pNNx family) had no diagnostic value. The results of the present study suggest that NN may be the best index to quantify the overnight sympathovagal balance in OSA and that a spectral band overlapping the apnoea-related pattern of CVHR slightly improved the characterization of the apnoea-related HRV patterns. © 2012 The Authors Clinical and Experimental Pharmacology and Physiology © 2012 Wiley Publishing Asia Pty Ltd.

  7. Effect of intensified diuretic therapy on overnight rostral fluid shift and obstructive sleep apnoea in patients with uncontrolled hypertension.

    PubMed

    Kasai, Takatoshi; Bradley, T Douglas; Friedman, Oded; Logan, Alexander G

    2014-03-01

    Fluid displacement from the lower extremities to the upper body during sleep is strongly associated with obstructive sleep apnoea in hypertensive patients. The present pathophysiological study tests the hypothesis that intensified diuretic therapy will reduce the apnoea-hypopnoea index and blood pressure of uncontrolled hypertensive patients with obstructive sleep apnoea in proportion to the reduction in overnight change in leg fluid volume. Uncontrolled treated hypertensive patients underwent overnight polysomnography and measurement of overnight changes in leg fluid volume and neck circumference. Those with an apnoea-hypopnoea index at least 20 events per hour (n=16) received metolazone 2.5 mg and spironolactone 25 mg daily for 7 days after which the daily dose was doubled for 7 additional days. Baseline testing was again repeated. Intensified diuretic therapy reduced the apnoea-hypopnoea index from 57.7 ± 33.0 to 48.5 ± 28.2 events per hour (P=0.005), overnight change in leg fluid volume from -418.1 ± 177.5 to -307.5 ± 161.9 ml (P<0.001) and overnight change in neck circumference from 1.2 ± 0.6 to 0.7 ± 0.4 cm (P<0.001). There was an inverse correlation between the reduction in overnight change in leg fluid volume and decrease in apnoea-hypopnoea index (r=-0.734, P=0.001). The reduction in overnight change in leg fluid volume was also significantly correlated with the change in morning blood pressure (r=0.708, P=0.002 for SBP; r=0.512, P=0.043 for DBP). The findings provide further evidence that fluid redistribution from the legs to the neck during sleep contributes to the severity of obstructive sleep apnoea in hypertension and may be an important link between these two conditions.

  8. Comparison of 1 mg and 2 mg overnight dexamethasone suppression tests for the screening of Cushing's syndrome in obese patients.

    PubMed

    Sahin, Mustafa; Kebapcilar, Levent; Taslipinar, Abdullah; Azal, Omer; Ozgurtas, Taner; Corakci, Ahmet; Akgul, Emin Ozgur; Taslipinar, Mine Yavuz; Yazici, Mahmut; Kutlu, Mustafa

    2009-01-01

    Obesity is currently a major public health problem and one of the potential underlying causes of obesity in a minority of patients is Cushing's syndrome (CS). Traditionally, the gold standard screening test for CS is 1 mg dexamethasone overnight suppression test. However, it is known that obese subjects have high false positive results with this test. We have therefore compared the 1 mg and 2 mg overnight dexamethasone suppression tests in obese subjects. Patients whose serum cortisol after ODST was >50 nM underwent and a low-dose dexamethasone suppression test (LDDST); 24-hour urine cortisol was collected for basal urinary free cortisol (UFC). For positive results after overnight 1-mg dexamethasone suppression test we also performed the overnight 2-mg dexamethasone suppression test. We prospectively evaluated 100 patients (22 men and 78 women, ranging in age from 17 to 73 years with a body mass index (BMI) >30 kg/m2 who had been referred to our hospital-affiliated endocrine clinic because of simple obesity. Suppression of serum cortisol to <50 nM (1.8 microg/dL) after dexamethasone administration was chosen as the cut-off point for normal suppression. Thyroid function tests, lipid profiles, homocysteine, antithyroglobulin, anti-thyroid peroxidase antibody levels, vitamin B12, folate levels, insulin resistance [by homeostasis model assessment (HOMA)] and 1.0 mg postdexamethasone (postdex) suppression cortisol levels were measured. We found an 8% false-positive rate in 1 mg overnight test and 2% in 2 mg overnight test (p=0.001). There was no correlation between the cortisol levels after ODST and other parameters. Our results indicate that the 2 mg overnight dexamethasone suppression test (ODST) is more convenient and accurate than 1-mg ODST as a screening test for excluding CS in subjects with simple obesity.

  9. Corneal edema after overnight lid closure of rabbits wearing silicone rubber contact lenses.

    PubMed

    Koch, J M; Refojo, M F; Leong, F L

    1991-03-01

    Elastofilcon A silcone rubber contact lenses induce less corneal swelling than no lens wear during sleep, and increasing the central thickness and volume of the lens does not influence its overnight performance. We sought to elucidate whether a silicone rubber lens can promote the distribution of atmospheric O2 on the cornea through a small interpalpebral opening under closed-eye conditions. Three groups of rabbit eyes comprised 12 eyes wearing Silflex (Dk 79.8 barrer) lenses, 12 with elastofilcon A (Dk 340 barrer) lenses, and 12 without lenses. All eyes were surgically closed overnight; six eyes in each group had a complete lid closure and six eyes had a partial tarsorrhaphy that left a small, central gap approximately 3 mm in length. When the lids were opened the next morning, the partially closed elastofilcon A eyes showed less corneal swelling (6.2 +/- 1.4%) than the partially closed no-lens eyes did (9.6 +/- 1.3%) (p less than 0.01), whereas the partially closed Silflex eyes were significantly more swollen (12.8 +/- 2.1%) (p = 0.01) than the other two partially closed groups were. The completely closed eyes showed no significant difference in corneal swelling among the groups. These results indicate that small lid gaps during sleep may lead to less corneal swelling when elastofilcon A lenses are used than with no lenses.

  10. Heart rate variability, overnight urinary norepinephrine, and plasma cholesterol in apparently healthy human adults.

    PubMed

    Thayer, Julian F; Fischer, Joachim E

    2013-01-20

    The aim of this study was to assess the relationship between autonomic nervous system activity as indexed by measures of heart rate variability and overnight urinary norepinephrine, and plasma cholesterol levels in a large sample of working adults. The study population comprised 611 apparently healthy employees of an airplane manufacturing plant in Southern Germany. Heart rate variability was calculated as beat-to-beat intervals over the course of one 24-hour weekday measured with an ambulatory ECG recorder. Overnight urine collection and blood samples were also obtained. We found an inverse association between indices of vagally-mediated heart rate variability and plasma levels of total cholesterol, low density lipoprotein (LDL), and the ratio of LDL to high density lipoprotein (HDL) that remained significant in multivariate models after controlling for relevant covariates including norepinephrine. Urinary norepinephrine was not significantly related to any measure of cholesterol in multivariate models. We report here for the first time, in a large sample of healthy human adults, evidence supporting the hypothesis of a clinically relevant inverse relationship between measures of plasma cholesterol and vagally-mediated heart rate variability after controlling for sympathetic nervous system activity. This suggests an important role for the vagal control of plasma cholesterol levels in cardiovascular disease. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. An overnight chill induces a delayed inhibition of photosynthesis at midday in mango (Mangifera indica L.).

    PubMed

    Allen, D J; Ratner, K; Giller, Y E; Gussakovsky, E E; Shahak, Y; Ort, D R

    2000-11-01

    The effect of a cold night on photosynthesis in herbaceous chilling-sensitive crops, like tomato, has been extensively studied and is well characterized. This investigation examined the behaviour of the sub-tropical fruit tree, mango, to enable comparison with these well-studied systems. Unlike tomato, chilling between 5 degrees C and 7 degrees C overnight produced no significant inhibition of light-saturated CO(2) assimilation (A:) during the first hours following rewarming, measured either under controlled environment conditions or in the field. By midday, however, there was a substantial decline in A:, which could not be attributed to photoinhibition of PSII, but rather was associated with an increase in stomatal limitation of A: and lower Rubisco activity. Overnight chilling of tomato can cause severe disruption in the circadian regulation of key photosynthetic enzymes and is considered to be a major factor underlying the dysfunction of photosynthesis in chilling-sensitive herbaceous plants. Examination of the gas exchange of mango leaves maintained under constant conditions for 2 d, demonstrated that large depressions in A: during the subjective night were primarily the result of stomatal closure. Chilling did not disrupt the ability of mango leaves to produce a circadian rhythm in stomatal conductance. Rather, the midday increase in stomatal limitation of A: appeared to be the result of altered guard cell sensitivity to CO(2) following the dark chill.

  12. Diagnosis of PLMD from increased pulse rate variability on overnight oximetry.

    PubMed

    Krishnaswamy, Uma M; Higgins, Sean E; Kosky, Christopher A; Delacy, Simone; Williams, Adrian J

    2010-01-01

    This study was undertaken in a group of patients with periodic limb movement disorder (PLMD) to assess whether the presence of increased pulse rate variability (PRV) without desaturation on overnight oximetry was suggestive of the occurrence of periodic limb movements (PLMs). Seventy sleepy patients with a polysomnographic diagnosis of PLMD and 25 controls with obstructive sleep apnea were included in this retrospective study. All patients had undergone initial domiciliary oximetry and subsequent polysomnography (PSG). The oximetry tracings were independently interpreted by five sleep unit personnel for the presence of increased PRV. Further, the association between increased PRV and PLMs was evaluated in the summary graph of the PSG. Fifty seven (81.4%) patients had definite evidence of increased PRV without episodes of desaturation on initial oximetry, which was later confirmed to be due to PLMs on PSG. 13 (18.6%) patients had no PRV on oximetry and PSG but had PLMD. The inter-interpreter concurrence in suspecting a diagnosis of PLMD based on oximetry alone was more than 80% in 64 (91%) patients. The presence of isolated increased PRV on overnight oximetry is a valuable tool in suspecting nonsleep apnea disorders like PLMD.

  13. Diagnosis of PLMD from increased pulse rate variability on overnight oximetry

    PubMed Central

    Krishnaswamy, Uma M; Higgins, Sean E; Kosky, Christopher A; deLacy, Simone; Williams, Adrian J

    2010-01-01

    Study objective This study was undertaken in a group of patients with periodic limb movement disorder (PLMD) to assess whether the presence of increased pulse rate variability (PRV) without desaturation on overnight oximetry was suggestive of the occurrence of periodic limb movements (PLMs). Methods Seventy sleepy patients with a polysomnographic diagnosis of PLMD and 25 controls with obstructive sleep apnea were included in this retrospective study. All patients had undergone initial domiciliary oximetry and subsequent polysomnography (PSG). The oximetry tracings were independently interpreted by five sleep unit personnel for the presence of increased PRV. Further, the association between increased PRV and PLMs was evaluated in the summary graph of the PSG. Results Fifty seven (81.4%) patients had definite evidence of increased PRV without episodes of desaturation on initial oximetry, which was later confirmed to be due to PLMs on PSG. 13 (18.6%) patients had no PRV on oximetry and PSG but had PLMD. The inter-interpreter concurrence in suspecting a diagnosis of PLMD based on oximetry alone was more than 80% in 64 (91%) patients. Conclusion The presence of isolated increased PRV on overnight oximetry is a valuable tool in suspecting nonsleep apnea disorders like PLMD. PMID:23616703

  14. Day surgery versus overnight stay laparoscopic cholecystectomy: A systematic review and meta-analysis.

    PubMed

    Tang, Huairong; Dong, Aihua; Yan, Lunan

    2015-07-01

    Laparoscopic cholecystectomies are being increasingly performed as a day surgery procedure. To systematically assess the safety and efficacy of laparoscopic cholecystectomy as a day surgery procedure compared to overnight stay. Randomized controlled trials and clinical controlled trials involving day surgery laparoscopic cholecystectomy were included in a systematic literature search. Two authors independently assessed the studies for inclusion and extracted the data. A meta-analysis was conducted to estimate the safety and feasibility of day surgery compared to overnight stay laparoscopic cholecystectomy. Twelve studies were selected for our meta-analysis. The meta-analysis showed that there was no significant difference between the two groups on morbidity (P=0.65). The mean in-hospital admission and readmission rates were 13.1% and 2.4% in the day surgery group, respectively. The two groups had similar prolonged hospitalization (P=0.27), readmission rate (P=0.58) and consultation rate (P=0.73). In addition, there was no significant difference in the visual analogue scale score, postoperative nausea and vomiting scale, time to return to activity and work between the two groups (P>0.05). Currently available evidence demonstrates that laparoscopic cholecystectomy can be performed safely in selected patients as a day surgery procedure, though further studies are needed. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Laparoscopic sleeve gastrectomy as day-case surgery (without overnight hospitalization).

    PubMed

    Rebibo, Lionel; Dhahri, Abdennaceur; Badaoui, Rachid; Dupont, Hervé; Regimbeau, Jean-Marc

    2015-01-01

    Day-case surgery (DCS) has boomed over recent years, as has laparoscopic sleeve gastrectomy (SG) for the treatment of morbid obesity. The objective of this study was to evaluate the safety and feasibility of day-case SG. This was a prospective, nonrandomized study of 100 patients undergoing day-case SG from May 2011 to July 2013. All patients met the criteria for DCS and for the treatment of morbid obesity. Standard surgical, anesthetic, and analgesic protocols were used. The primary study endpoint was the unplanned overnight admission rate. Secondary endpoints were standard DCS criteria, frequency and type of complications, and satisfaction rate of performing day-case SG. The short-term postoperative course of patients undergoing day-case and conventional SG also were compared. A total of 416 patients were screened and 100 (24%) were included. There were 8 unplanned overnight admissions. Seven unexpected consultations, 7 hospital readmissions, and 5 major complications were recorded, including 3 cases of unexpected surgery for gastric leak. At follow-up, 96% of the patients were satisfied with day-case SG. The short-term postoperative course was similar among patients undergoing DCS and conventional management. In selected patients, day-case SG is feasible with acceptable complication and readmission rates. The postoperative course was similar to that observed for standard SG. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  16. Associations of acute stress and overnight heart rate with feed efficiency in beef heifers.

    PubMed

    Munro, J C; Schenkel, F S; Physick-Sheard, P W; Fontoura, A B P; Miller, S P; Tennessen, T; Montanholi, Y R

    2017-03-01

    Proxies have the potential to accelerate feed efficiency (residual feed intake (RFI); kg dry matter/day) improvement, assisting with the reduction of beef cattle feed costs and environmental impact. Heart rate (HR) (beats per minute (BPM)) is associated with feed efficiency and influenced by autonomic activity and peripheral metabolism, suggesting HR could be used as a proxy for feed efficiency. Objectives were to assess associations between overnight HR, lying patterns and RFI, and between acute stress HR and RFI. Heifer calves (n=107; 408±28 days of age, 341±42.2 kg) and yearling heifers (n=36; 604±92 days of age, 539±52.2 kg) were exposed to a performance test to determine productive performance. Overnight HR (electrode based) and lying patterns (accelerometer based) were monitored on a subgroup of heifer calves (n=40; 20 lowest RFI; 20 highest RFI). In the 10-min acute stress assessment, all heifers were individually exposed to the opening and closing of an umbrella and HR before (HRBEF), in response to (HRMAX), after (HRAFT) and change (HRCHG; HRAFT-HRBEF) as a result of exposure were determined. Using polynomial regression, rate of HR decrease pre-exposure (β 1) and rates of HR increase (β 2) and decrease (β 3, β 4) post-exposure were determined. Heifer calves in the overnight assessment were classified into equal RFI groups (low RFI; high RFI) and HR means were treated as repeated measures and compared using multiple regression. In the acute stress assessment, heifers were classified within cattle category into equal RFI groups (low RFI; high RFI) and means and polynomial regression parameters were compared using multiple regression. Low-RFI heifer calves had a lower overnight HR (69.2 v. 72.6 BPM), similar HR change from lying to standing intervals (8.9 v. 9.2 BPM) and similar time lying (61.1% v. 64.5%) compared with high-RFI heifer calves. Low-RFI heifer calves had a higher absolute HRMAX (162.9 v. 145.7 BPM) and β 2 (-0.34 v. -0.20) than high

  17. Ambulatory laparoscopic cholecystectomy: An audit of day case vs overnight surgery at a community hospital in Japan

    PubMed Central

    Sato, Atsushi; Terashita, Yukio; Mori, Yoichiro; Okubo, Tomotaka

    2012-01-01

    AIM: To evaluate the applicability and safety of ambulatory laparoscopic cholecystectomy (LC) and to compare day case and overnight stay LC. METHODS: Data were collected retrospectively and consecutively for day case and overnight stay LC patients from July 1, 2009 to April 30, 2011. Outcomes were analyzed for patient demographics, operation time, blood loss during operation and frequency and reasons for unexpected or prolonged hospitalization in each group. RESULTS: There was no hospital mortality and no patient was readmitted with serious morbidity after discharge. 50 patients received a day case LC and 19 had an overnight stay LC. There was a significant difference in age between both groups (P < 0.02). There were no significant differences between the day case LC performed (n = 41) and failed (n = 9) groups and between the day case LC performed and the one night stay LC (n = 12) groups. There was a significant difference in age between the one night stay and more nights stay LC groups (P < 0.05). Thus, elderly patients showed a tendency to like to stay in hospital rather than being a day case. The proportion of unexpected or prolonged hospitalization was not significantly different between the day case and overnight stay LC groups, when the patient’s request was excluded. CONCLUSION: Day case LC can be performed with a low rate of complications. In overnight stay patients, there are many who could be performed safely as a day case. Moreover, we need to take special care to treat elderly patients. PMID:23493831

  18. Ambulatory laparoscopic cholecystectomy: An audit of day case vs overnight surgery at a community hospital in Japan.

    PubMed

    Sato, Atsushi; Terashita, Yukio; Mori, Yoichiro; Okubo, Tomotaka

    2012-12-27

    To evaluate the applicability and safety of ambulatory laparoscopic cholecystectomy (LC) and to compare day case and overnight stay LC. Data were collected retrospectively and consecutively for day case and overnight stay LC patients from July 1, 2009 to April 30, 2011. Outcomes were analyzed for patient demographics, operation time, blood loss during operation and frequency and reasons for unexpected or prolonged hospitalization in each group. There was no hospital mortality and no patient was readmitted with serious morbidity after discharge. 50 patients received a day case LC and 19 had an overnight stay LC. There was a significant difference in age between both groups (P < 0.02). There were no significant differences between the day case LC performed (n = 41) and failed (n = 9) groups and between the day case LC performed and the one night stay LC (n = 12) groups. There was a significant difference in age between the one night stay and more nights stay LC groups (P < 0.05). Thus, elderly patients showed a tendency to like to stay in hospital rather than being a day case. The proportion of unexpected or prolonged hospitalization was not significantly different between the day case and overnight stay LC groups, when the patient's request was excluded. Day case LC can be performed with a low rate of complications. In overnight stay patients, there are many who could be performed safely as a day case. Moreover, we need to take special care to treat elderly patients.

  19. Intermittent fasting modulation of the diabetic syndrome in streptozotocin-injected rats.

    PubMed

    Belkacemi, Louiza; Selselet-Attou, Ghalem; Hupkens, Emeline; Nguidjoe, Evrard; Louchami, Karim; Sener, Abdullah; Malaisse, Willy J

    2012-01-01

    This study investigates the effects of intermittent overnight fasting in streptozotocin-induced diabetic rats (STZ rats). Over 30 days, groups of 5-6 control or STZ rats were allowed free food access, starved overnight, or exposed to a restricted food supply comparable to that ingested by the intermittently fasting animals. Intermittent fasting improved glucose tolerance, increased plasma insulin, and lowered Homeostatis Model Assessment index. Caloric restriction failed to cause such beneficial effects. The β-cell mass, as well as individual β-cell and islet area, was higher in intermittently fasting than in nonfasting STZ rats, whilst the percentage of apoptotic β-cells appeared lower in the former than latter STZ rats. In the calorie-restricted STZ rats, comparable findings were restricted to individual islet area and percentage of apoptotic cells. Hence, it is proposed that intermittent fasting could represent a possible approach to prevent or minimize disturbances of glucose homeostasis in human subjects.

  20. Obstructive Sleep Apnea Severity and Overnight Body Fluid Shift before and after Hemodialysis.

    PubMed

    Ogna, Adam; Forni Ogna, Valentina; Mihalache, Alexandra; Pruijm, Menno; Halabi, Georges; Phan, Olivier; Cornette, Françoise; Bassi, Isabelle; Haba Rubio, José; Burnier, Michel; Heinzer, Raphaël

    2015-06-05

    Obstructive sleep apnea is associated with significantly increased cardiovascular morbidity and mortality. Fluid overload may promote obstructive sleep apnea in patients with ESRD through an overnight fluid shift from the legs to the neck soft tissues. Body fluid shift and severity of obstructive sleep apnea before and after hemodialysis were compared in patients with ESRD. Seventeen patients with hemodialysis and moderate to severe obstructive sleep apnea were included. Polysomnographies were performed the night before and after hemodialysis to assess obstructive sleep apnea, and bioimpedance was used to measure fluid overload and leg fluid volume. The mean overnight rostral fluid shift was 1.27±0.41 L prehemodialysis; it correlated positively with fluid overload volume (r=0.39; P=0.02) and was significantly lower posthemodialysis (0.78±0.38 L; P<0.001). There was no significant difference in the mean obstructive apnea-hypopnea index before and after hemodialysis (46.8±22.0 versus 42.1±18.6 per hour; P=0.21), but obstructive apnea-hypopnea index was significantly lower posthemodialysis (-10.1±10.8 per hour) in the group of 12 patients, with a concomitant reduction of fluid overload compared with participants without change in fluid overload (obstructive apnea-hypopnea index +8.2±16.1 per hour; P<0.01). A lower fluid overload after hemodialysis was significantly correlated (r=0.49; P=0.04) with a lower obstructive apnea-hypopnea index. Fluid overload-assessed by bioimpedance-was the best predictor of the change in obstructive apnea-hypopnea index observed after hemodialysis (standardized r=-0.68; P=0.01) in multivariate regression analysis. Fluid overload influences overnight rostral fluid shift and obstructive sleep apnea severity in patients with ESRD undergoing intermittent hemodialysis. Although no benefit of hemodialysis on obstructive sleep apnea severity was observed in the whole group, the change in obstructive apnea-hypopnea index was significantly

  1. Obstructive Sleep Apnea Severity and Overnight Body Fluid Shift before and after Hemodialysis

    PubMed Central

    Forni Ogna, Valentina; Mihalache, Alexandra; Pruijm, Menno; Halabi, Georges; Phan, Olivier; Cornette, Françoise; Bassi, Isabelle; Haba Rubio, José; Burnier, Michel; Heinzer, Raphaël

    2015-01-01

    Background and objectives Obstructive sleep apnea is associated with significantly increased cardiovascular morbidity and mortality. Fluid overload may promote obstructive sleep apnea in patients with ESRD through an overnight fluid shift from the legs to the neck soft tissues. Body fluid shift and severity of obstructive sleep apnea before and after hemodialysis were compared in patients with ESRD. Design, setting, participants, & measurements Seventeen patients with hemodialysis and moderate to severe obstructive sleep apnea were included. Polysomnographies were performed the night before and after hemodialysis to assess obstructive sleep apnea, and bioimpedance was used to measure fluid overload and leg fluid volume. Results The mean overnight rostral fluid shift was 1.27±0.41 L prehemodialysis; it correlated positively with fluid overload volume (r=0.39; P=0.02) and was significantly lower posthemodialysis (0.78±0.38 L; P<0.001). There was no significant difference in the mean obstructive apnea-hypopnea index before and after hemodialysis (46.8±22.0 versus 42.1±18.6 per hour; P=0.21), but obstructive apnea-hypopnea index was significantly lower posthemodialysis (−10.1±10.8 per hour) in the group of 12 patients, with a concomitant reduction of fluid overload compared with participants without change in fluid overload (obstructive apnea-hypopnea index +8.2±16.1 per hour; P<0.01). A lower fluid overload after hemodialysis was significantly correlated (r=0.49; P=0.04) with a lower obstructive apnea-hypopnea index. Fluid overload—assessed by bioimpedance—was the best predictor of the change in obstructive apnea-hypopnea index observed after hemodialysis (standardized r=−0.68; P=0.01) in multivariate regression analysis. Conclusions Fluid overload influences overnight rostral fluid shift and obstructive sleep apnea severity in patients with ESRD undergoing intermittent hemodialysis. Although no benefit of hemodialysis on obstructive sleep apnea severity

  2. Automated overnight closed-loop glucose control in young children with type 1 diabetes.

    PubMed

    Elleri, Daniela; Allen, Janet M; Nodale, Marianna; Wilinska, Malgorzata E; Mangat, Jasdip S; Larsen, Anne Mette F; Acerini, Carlo L; Dunger, David B; Hovorka, Roman

    2011-04-01

    We evaluated the effectiveness of automated overnight closed-loop (AOCL) insulin delivery and the influence of timing of initiation on glucose control overnight in young children with type 1 diabetes (T1D). Eight children with T1D (four boys, four girls) (mean ± SD: 9.4 ± 2.7 years old; body mass index, 18.3 ± 2.3 kg/m(2); duration of diabetes, 3.9 ± 2.5 years; total daily insulin dose, 0.7 ± 0.1 U/kg/day; glycosylated hemoglobin, 7.9 ± 0.9%) were studied in a clinical research facility on two separate occasions. Subjects had a meal at 18:00 (77 ± 8 g of carbohydrate [CHO]) and snack at 21:00 (21 ± 6 g of CHO), both accompanied by a prandial insulin bolus. In random order, AOCL was started at 18:00 or 21:00 h and ran until 08:00 h the next day. Subcutaneous continuous glucose monitoring data were fed automatically into the model predictive control algorithm. Calculated subcutaneous insulin infusion rates were sent wirelessly to an insulin pump. Plasma glucose was measured to assess closed-loop performance. No rescue CHOs were administered. Time spent with plasma glucose in the target range from 3.9 to 8.0 mmol/L was 50.7% (29.0%, 72.2%), and it did not differ on the two occasions: median (interquartile range), 42% (18%, 64%) versus 58% (32%, 79%) (P = 0.161). Time when plasma glucose was above 8.0 mmol/L (42% [25%, 82%] vs. 29% [14%, 64%], P = 0.093), time below 3.9 mmol/L (0% [0%, 11%] vs. 8% [0%, 17%], P = 0.500), low blood glucose index (0.1 [0.0, 2.5] vs. 1.7 [0.4, 3.3], P = 0.380), plasma glucose at the start of AOCL (12.5 ± 2.7 vs. 11.6 ± 4.2 mmol/L, P = 0.562), and mean overnight plasma glucose (8.3 ± 2.1 vs. 7.5 ± 2.2 mmol/L, P = 0.246) were also similar. AOCL is feasible in young children with T1D. Comparable results were obtained when closed-loop was initiated at 18:00 or 21:00 h.

  3. A naturally occurring -263G/C variant of the human AA-NAT gene and overnight melatonin production.

    PubMed

    Ying, Grace Wang; Lee, Caroline Guat Lay; Lee, Edmund Jon Deoon

    2004-01-01

    Several lines of evidence show that the daily amount of melatonin produced differs greatly between individuals. Any polymorphism in the gene of arylalkylamine N-acetyltransferase (AA-NAT), a critical enzyme involved in melatonin biosynthesis, may contribute to the variability of melatonin production. The present study investigated the possible association between overnight melatonin excretion and a commonly occurring -263G/C polymorphism in the promoter region of the human AA-NAT gene. However, we found that -263G/C variant had no effect on the overnight 6-OHMS excretion. In this study, individual genotyping for -263G/C was determined by denaturing high performance liquid chromatography (DHPLC) and confirmed by sequencing. The overnight urinary 6-hydroxymelatonin sulfate (6-OHMS) excretion was quantified by enzyme-linked immunosorbent assay (ELISA).

  4. Silicone elastomer lens wear induces less overnight corneal edema than sleep without lens wear.

    PubMed

    Sweeney, D F; Holden, B A

    1987-12-01

    Corneal thickness was measured on awakening in both eyes of ten subjects who slept with a silicone elastomer lens in one eye only. The mean corneal edema level with the silicone lens after eight hours of sleep was 2.0 +/- 2.0% and was significantly lower (p less than 0.01) than the level in the eye that did not wear a lens (3.6 +/- 2.1%). This indicates that the oxygen level supplied to the anterior cornea during sleep with silicone elastomer lenses is higher than without a lens. We hypothesize that the lower overnight swelling with the silicone lenses is a result of reduced resistance to oxygen flow from the eyelid capillaries to the corneal epithelial cells possibly due to decreased tear film thickness. Other possible explanations include insulating the cornea from the hypo-osmotic shift that occurs with sleep.

  5. Evaluation of pharmacy resident alertness in an overnight on-call program.

    PubMed

    Knauss, Michael; Bonner, C Lea; Patka, John; Abraham, Prasad

    2015-07-15

    Results of a study to determine the impact of overnight on-call duty on pharmacy residents' alertness are presented. A prospective single-site observational study was conducted to evaluate sleep patterns and alertness levels among pharmacy residents serving 24-hour on-call duty assignments at a large hospital. The study participants (n = 10) wore a wrist actigraph to allow continuous tracking of rest-activity patterns; in addition, study participants completed a validated three-minute psychomotor vigilance test (PVT) during designated time periods around the beginning and the end of each duty shift and several hours after the shift ended. Study participants also documented sleep quality and quantity in a sleep log and self-rated their level of alertness using the Karolinska sleepiness scale (KSS). Assessments were conducted for a total of 31 on-call duty shifts over one month. Paired comparisons of PVT data obtained at the three assessment periods indicated that on-call duty was not associated with significant changes in PVT performance measures (mean response speed and number of attention lapses). On average, on-call residents rated the quality of sleep during duty assignments as 5 on a 10-point Likert scale. On-call residents slept for a mean of six hours during overnight duty shifts, with half of the residents reporting sleep interruptions (a mean of 1.73 per shift). PVT results and KSS values indicated no overall decline in resident alertness during the study period. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Differences in Overnight Polysomnography Scores Using the Adult and Pediatric Criteria for Respiratory Events in Adolescents

    PubMed Central

    Accardo, Jennifer A.; Shults, Justine; Leonard, Mary B.; Traylor, Joel; Marcus, Carole L.

    2010-01-01

    Study Objectives: There was no consensus in the 2007 American Academy of Sleep Medicine scoring manual on whether pediatric or adult respiratory criteria should be used in adolescents due to lack of data. Our objective was to compare pediatric and adult criteria in adolescents referred for obstructive sleep apnea (OSA). We hypothesized that pediatric criteria would capture more respiratory events than adult criteria. Design: Retrospective cross-sectional analysis. Setting: Clinical sleep laboratory. Participants: 101 subjects aged 13-18 years clinically referred for OSA. Interventions: Overnight polysomnogram. Data were scored using both adult and pediatric AASM criteria. For adult criteria, data were scored using both AASM hypopnea rule A, defined by ≥ 4% desaturation, and B, defined by ≥ 3% desaturation or arousal. Results: Median (range) apnea hypopnea index (AHI) by pediatric criteria was 1.7 events/hour (0–42.9). AHI using rule A was 0.4 (0–35.6); rule B, 1.4 (0–38.4). A higher pediatric AHI was associated with greater differences between pediatric and adult AHI using either rule A or B. There was no significant discordance in OSA classification comparing pediatric and adult criteria rule B (P = 0.3), but there was a significant rate of discordance classification comparing pediatric and adult criteria rule A (P < 0.001). Conclusions: Either pediatric or adult criteria rule B can be used in adolescents as few subjects change diagnostic category between these 2 criteria. Use of adult rule A results in fewer children meeting criteria for OSA. Further research into the clinical relevance of the scoring metric in adolescents is warranted. Citation: Accardo JA; Shults J; Leonard MB; Traylor J; Marcus CL. Differences in overnight polysomnography scores using the adult and pediatric criteria for respiratory events in adolescents. SLEEP 2010;33(10):1333-1339. PMID:21061855

  7. Overnight atmospheric transport and chemical processing of photochemically aged Houston urban and petrochemical industrial plume

    NASA Astrophysics Data System (ADS)

    Zaveri, Rahul A.; Voss, Paul B.; Berkowitz, Carl M.; Fortner, Edward; Zheng, Jun; Zhang, Renyi; Valente, Ralph J.; Tanner, Roger L.; Holcomb, Daniel; Hartley, Thomas P.; Baran, Leslie

    2010-12-01

    Overnight atmospheric transport and chemical evolution of photochemically aged Houston urban and petrochemical industrial plume were investigated in July 2005. We report here on the 26 July episode in which the aged plume was tagged 1.5 h before sunset with a pair of free-floating controlled meteorological balloons, which guided quasi-Lagrangian aircraft sampling in the plume as it was advected 300 km to the north over 8 h. The aged plume around sunset was well mixed within a 1600 m residual layer, and was characterized by enhanced levels of aerosol, O3, CO, olefins, acetaldehyde, total odd nitrogen compounds (NOy), and relatively small amounts (<1 ppbv) of NOx. The plume experienced appreciable shearing overnight due to the development of a low-altitude nocturnal jet between 300 and 500 m above mean sea level (MSL). However, the plume above 600 m MSL remained largely undiluted even after 8 h of transport due to lack of turbulent mixing above the jet. About 40-60% of the NOx present in the aged plume around sunset was found to be depleted over this 8 h period. A constrained plume modeling analysis of the quasi-Lagrangian aircraft observations suggested that by dawn this NOx was converted to nitric acid, organic nitrates, and peroxy acyl nitrates via reactions of NO3 radicals with enhanced levels of olefins and aldehydes in the plume. Sensitivity of NOx depletion to heterogeneous hydrolysis of N2O5 on aerosols was examined. These results have significant implications for the impacts of urban and industrial pollution on far downwind regions.

  8. Prolonged fasting impairs neural reactivity to visual stimulation.

    PubMed

    Kohn, N; Wassenberg, A; Toygar, T; Kellermann, T; Weidenfeld, C; Berthold-Losleben, M; Chechko, N; Orfanos, S; Vocke, S; Laoutidis, Z G; Schneider, F; Karges, W; Habel, U

    2016-01-01

    Previous literature has shown that hypoglycemia influences the intensity of the BOLD signal. A similar but smaller effect may also be elicited by low normal blood glucose levels in healthy individuals. This may not only confound the BOLD signal measured in fMRI, but also more generally interact with cognitive processing, and thus indirectly influence fMRI results. Here we show in a placebo-controlled, crossover, double-blind study on 40 healthy subjects, that overnight fasting and low normal levels of glucose contrasted to an activated, elevated glucose condition have an impact on brain activation during basal visual stimulation. Additionally, functional connectivity of the visual cortex shows a strengthened association with higher-order attention-related brain areas in an elevated blood glucose condition compared to the fasting condition. In a fasting state visual brain areas show stronger coupling to the inferior temporal gyrus. Results demonstrate that prolonged overnight fasting leads to a diminished BOLD signal in higher-order occipital processing areas when compared to an elevated blood glucose condition. Additionally, functional connectivity patterns underscore the modulatory influence of fasting on visual brain networks. Patterns of brain activation and functional connectivity associated with a broad range of attentional processes are affected by maturation and aging and associated with psychiatric disease and intoxication. Thus, we conclude that prolonged fasting may decrease fMRI design sensitivity in any task involving attentional processes when fasting status or blood glucose is not controlled.

  9. Should children with suspected obstructive sleep apnea syndrome and normal nap sleep studies have overnight sleep studies?

    PubMed

    Saeed, M M; Keens, T G; Stabile, M W; Bolokowicz, J; Davidson Ward, S L

    2000-08-01

    Overnight polysomnography (ONP) is the "gold standard" for the diagnosis of sleep-disordered breathing, but it is expensive and time-consuming. Thus, daytime nap studies have been used as screening tests. If the findings of a nap study are normal or mildly abnormal, should ONP be performed? Do specific abnormalities in nap studies predict abnormal findings in ONP? To answer these questions, we conducted this study. Retrospective chart review. Children's hospital. One hundred forty-three children with suspected obstructive sleep apnea syndrome secondary to isolated adenotonsillar hypertrophy, who had normal or mildly abnormal nap studies, and underwent ONP. We compared daytime nap and overnight polysomnograms in 143 children (52 girls; mean [+/- SD] age, 5.6 +/- 3.1 years). Total sleep time was 1 h in daytime nap, and 5.1 +/- 1.3 h in ONP. The interval between the two studies was 5.9 +/- 4.8 months. The findings of 59% of the nap studies were mildly abnormal, while 66% of overnight studies were abnormal. No individual nap study parameter (including short obstructive apneas, hypopneas, hypoxemia, hypoventilation, snoring, paradoxical breathing, gasping, retractions) had good sensitivity at predicting abnormal overnight polysomnograms, but most had good specificity and positive predictive value. We conclude that individual nap study parameters are not very sensitive in predicting abnormal ONP findings. However, when nap study parameters are abnormal, the chance of obstructive sleep apnea syndrome is high.

  10. A comparison of leisure constraints among three outdoor recreation activities: whitewater rafting, canoeing and overnight horseback riding

    Treesearch

    Gyan P. Nyaupane; Duarte B. Morais; Alan Graefe

    2003-01-01

    The purpose of this study was to compare leisure constraints across three outdoor recreation activities, whitewater rafting, canoeing, and overnight horseback riding, in the context of the three-dimensional leisure constraints model proposed by Crawford and Godbey (1987). The sample consisted of 650 outdoor enthusiasts from 14 U.S. states who showed an interest in...

  11. Sink or Night Float: University of British Columbia Radiology Residents' Experience With Overnight Call.

    PubMed

    Scali, Elena P; Strovski, Evgeny; Forster, Bruce B; Mar, Colin; Chang, Silvia D

    2015-05-01

    In July 2012, in response to residents' concerns regarding the impact of the traditional 24-hour call system on their personal well-being and educational experience, the University of British Columbia Radiology residency program adopted a 12-hour night float system. This shift takes place in the context of increasing concerns, both across Canada and internationally, about resident well-being and the impact of prolonged duty hours on patient care. An anonymous survey was distributed to all 25 postgraduate years 2-5 University of British Columbia radiology residents 12 months after the introduction of night float. This study sought to solicit residents' feedback about these changes and to identify potential future changes to optimize the call system. The response rate was 100%; 96% of residents were in favor of continuing with night float rather than the traditional call system; 72% of residents reported that their judgement was affected secondary to being on night float. Although most residents described varying degrees of impairment, the rate of acute discrepancies between resident preliminary and attending radiologist final reports decreased by more than half, from 2% to less than 1%. The vast majority of our residents were in favor of maintaining the night float call system. Night float had a beneficial effect on the resident educational experience: by eliminating the pre-call morning and post-call day off rotation, residents gained an additional 24 days per year on other clinical rotations. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  12. Overnight closed-loop insulin delivery in young people with type 1 diabetes: a free-living, randomized clinical trial.

    PubMed

    Hovorka, Roman; Elleri, Daniela; Thabit, Hood; Allen, Janet M; Leelarathna, Lalantha; El-Khairi, Ranna; Kumareswaran, Kavita; Caldwell, Karen; Calhoun, Peter; Kollman, Craig; Murphy, Helen R; Acerini, Carlo L; Wilinska, Malgorzata E; Nodale, Marianna; Dunger, David B

    2014-01-01

    To evaluate feasibility, safety, and efficacy of overnight closed-loop insulin delivery in free-living youth with type 1 diabetes. Overnight closed loop was evaluated at home by 16 pump-treated adolescents with type 1 diabetes aged 12-18 years. Over a 3-week period, overnight insulin delivery was directed by a closed-loop system, and on another 3-week period sensor-augmented therapy was applied. The order of interventions was random. The primary end point was time when adjusted sensor glucose was between 3.9 and 8.0 mmol/L from 2300 to 0700 h. Closed loop was constantly applied over at least 4 h on 269 nights (80%); sensor data were collected over at least 4 h on 282 control nights (84%). Closed loop increased time spent with glucose in target by a median 15% (interquartile range -9 to 43; P < 0.001). Mean overnight glucose was reduced by a mean 14 (SD 58) mg/dL (P < 0.001). Time when glucose was <70 mg/dL was low in both groups, but nights with glucose <63 mg/dL for at least 20 min were less frequent during closed loop (10 vs. 17%; P = 0.01). Despite lower total daily insulin doses by a median 2.3 (interquartile range -4.7 to 9.3) units (P = 0.009), overall 24-h glucose was reduced by a mean 9 (SD 41) mg/dL (P = 0.006) during closed loop. Unsupervised home use of overnight closed loop in adolescents with type 1 diabetes is safe and feasible. Glucose control was improved during the day and night with fewer episodes of nocturnal hypoglycemia.

  13. Treatment of persistent corneal epithelial defect with overnight wear of a prosthetic device for the ocular surface.

    PubMed

    Lim, Pauline; Ridges, Ryan; Jacobs, Deborah S; Rosenthal, Perry

    2013-12-01

    To report experience in the treatment of persistent corneal epithelial defect using overnight wear of a prosthetic device for the ocular surface. Retrospective interventional case series. A clinical database of patients who underwent prosthetic replacement of the ocular surface ecosystem (PROSE) treatment from March 2003 to August 2008 was searched to identify patients treated for persistent corneal epithelial defect. In early 2003, overnight wear of a PROSE device and addition of commercially available, nonpreserved, topical ophthalmic moxifloxacin to the saline in the device reservoir became standard practice at this center when treating persistent corneal epithelial defect. Medical records were abstracted to obtain underlying diagnoses, previous treatments, days to re-epithelialization, and complications for subsequent analysis. PROSE treatment incorporating overnight wear, with adjunctive use of moxifloxacin, was employed in 20 eyes of 19 patients for a total of 372 days. Re-epithelialization occurred in 17 of 20 eyes. Median duration of treatment incorporating overnight wear was 8.5 days (range = 2-76 days). Healing occurred in ≤7 days in 12 eyes, 8-14 days in 3 eyes, and >14 days in 2 eyes (range = 1-35 days). There were no cases of microbial keratitis. Overnight wear of a PROSE device is effective in promoting healing of persistent corneal epithelial defect. In comparison to an earlier series from this center, the rate of microbial keratitis as a complication of treatment has been reduced with the use of a nonpreserved topical fourth-generation fluoroquinolone in the device reservoir. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial

    PubMed Central

    Hovorka, Roman; Elleri, Daniela; Thabit, Hood; Allen, Janet M.; Leelarathna, Lalantha; El-Khairi, Ranna; Kumareswaran, Kavita; Caldwell, Karen; Calhoun, Peter; Kollman, Craig; Murphy, Helen R.; Acerini, Carlo L.; Wilinska, Malgorzata E.; Nodale, Marianna; Dunger, David B.

    2014-01-01

    OBJECTIVE To evaluate feasibility, safety, and efficacy of overnight closed-loop insulin delivery in free-living youth with type 1 diabetes. RESEARCH DESIGN AND METHODS Overnight closed loop was evaluated at home by 16 pump-treated adolescents with type 1 diabetes aged 12–18 years. Over a 3-week period, overnight insulin delivery was directed by a closed-loop system, and on another 3-week period sensor-augmented therapy was applied. The order of interventions was random. The primary end point was time when adjusted sensor glucose was between 3.9 and 8.0 mmol/L from 2300 to 0700 h. RESULTS Closed loop was constantly applied over at least 4 h on 269 nights (80%); sensor data were collected over at least 4 h on 282 control nights (84%). Closed loop increased time spent with glucose in target by a median 15% (interquartile range −9 to 43; P < 0.001). Mean overnight glucose was reduced by a mean 14 (SD 58) mg/dL (P < 0.001). Time when glucose was <70 mg/dL was low in both groups, but nights with glucose <63 mg/dL for at least 20 min were less frequent during closed loop (10 vs. 17%; P = 0.01). Despite lower total daily insulin doses by a median 2.3 (interquartile range −4.7 to 9.3) units (P = 0.009), overall 24-h glucose was reduced by a mean 9 (SD 41) mg/dL (P = 0.006) during closed loop. CONCLUSIONS Unsupervised home use of overnight closed loop in adolescents with type 1 diabetes is safe and feasible. Glucose control was improved during the day and night with fewer episodes of nocturnal hypoglycemia. PMID:24757227

  15. Positive Self-Perceptions of Aging and Lower Rate of Overnight Hospitalization in the US Population Over Age 50.

    PubMed

    Sun, Jennifer K; Kim, Eric S; Smith, Jacqui

    2017-01-01

    The aging of the baby boomer generation has led to an unprecedented rise in the number of US adults reaching old age, prompting an urgent call for innovative and cost-effective ways to address the increasing health care needs of the aging population. Studying the role of psychosocial factors on health care use could offer insight into how to minimize hospitalizations among older adults. We use prospective data from a subsample of 4735 participants (mean [standard deviation] age = 69 [8.79] years, 61% women) from the Health and Retirement Study, a nationally representative study of US adults over age 50, to examine the association between self-perceptions of aging (SPA) and self-reported overnight hospitalizations after adjusting for a comprehensive list of sociodemographic, health-related, and behavioral factors. Over the 4-year follow-up period, there were a total of 5196 overnight hospitalizations, and 44% of the sample reported being hospitalized overnight at least once. After adjusting for sociodemographic factors, each standard deviation increase in positive SPA was associated with a lower rate of overnight hospitalization (incidence rate ratio = 0.75; 95% confidence interval = 0.71-0.80, p < .001). After dividing respondents into quartiles of SPA, we observed a dose-response relationship with individuals in higher quartiles showing increasingly lower rates of overnight hospitalization. Positive self-perceptions of aging are associated with a lower rate of hospitalization among older adults over a 4-year period. Future research should examine the factors that contribute to older adults' SPA and explore the pathways through which attitudes toward aging influence the use of health care resources.

  16. Body composition changes associated with fasted versus non-fasted aerobic exercise.

    PubMed

    Schoenfeld, Brad Jon; Aragon, Alan Albert; Wilborn, Colin D; Krieger, James W; Sonmez, Gul T

    2014-01-01

    It has been hypothesized that performing aerobic exercise after an overnight fast accelerates the loss of body fat. The purpose of this study was to investigate changes in fat mass and fat-free mass following four weeks of volume-equated fasted versus fed aerobic exercise in young women adhering to a hypocaloric diet. Twenty healthy young female volunteers were randomly assigned to 1 of 2 experimental groups: a fasted training (FASTED) group that performed exercise after an overnight fast (n = 10) or a post-prandial training (FED) group that consumed a meal prior to exercise (n = 10). Training consisted of 1 hour of steady-state aerobic exercise performed 3 days per week. Subjects were provided with customized dietary plans designed to induce a caloric deficit. Nutritional counseling was provided throughout the study period to help ensure dietary adherence and self-reported food intake was monitored on a regular basis. A meal replacement shake was provided either immediately prior to exercise for the FED group or immediately following exercise for the FASTED group, with this nutritional provision carried out under the supervision of a research assistant. Both groups showed a significant loss of weight (P = 0.0005) and fat mass (P = 0.02) from baseline, but no significant between-group differences were noted in any outcome measure. These findings indicate that body composition changes associated with aerobic exercise in conjunction with a hypocaloric diet are similar regardless whether or not an individual is fasted prior to training.

  17. Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters.

    PubMed

    Sahadan, Dg Zuraini; Davey, Margot J; Horne, Rosemary S C; Nixon, Gillian M

    2015-12-01

    Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. Children having home overnight oximetry for suspected OSA were identified over 12 months, and those with a normal result who went on to have polysomnography (PSG) were included. Oximetry, including PR-SD and PRI (rises of 8, 10 and 15 beats/min per hour), was analyzed using commercially available software. PR parameters were compared between those with OSA (obstructive apnoea-hypopnoea index (OAHI) >1 event/h) and those without OSA. One hundred sixteen children had normal oximetry, of whom 93 (median age 4.5 years; 55 % M) had PSG. Fifty-seven of 93 (61 %) children had OSA (median OAHI 4.5 events/h, range 1.1-24). PR-SD was not different between the OSA and non-OSA groups (p = 0.87). PRI tended to be higher in those with OSA, but there was considerable overlap between the groups: PRI-8 (mean ± SD 58.5 ± 29.0/h in OSA group vs 48.6 ± 20.2/h in non-OSA group, p = 0.07), PRI-10 (45.1 ± 25.0 vs 36.2 ± 16.7, p = 0.06) and PRI-15 (24.4 ± 14.5 vs 18.9 ± 9.0, p = 0.04). A PRI-15 threshold of >35/h had specificity of 97 % for OSA. The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.

  18. Mutagenic activity of overnight urine from healthy non-smoking subjects.

    PubMed

    Pavanello, Sofia; Lupi, Silvia; Pulliero, Alessandra; Gregorio, Pasquale; Saia, Bruno Onofrio; Clonfero, Erminio

    2007-03-01

    Urinary mutagenicity was evaluated in relation to environmental mutagen exposure (i.e., diet, indoor/outdoor activities, residential area etc.) on the day prior to sample collection, and also considering factors that contribute to the variability of Salmonella mutagenicity assay results. Overnight urine samples from 283 healthy non-smoking residents of northeast Italy (46% males, 20-62 years) were analyzed for mutagenicity on sensitive Salmonella typhimurium strain YG1024 with S9 mix employing the preincubation version of the plate incorporation assay (i.e., the Salmonella reverse mutation test). Urinary mutagenicity varied between 0.02 and 9.84 rev/ equiv. ml, and 7% of samples were positive (i.e., sample elicited a two-fold increase in revertants). There was an evident increase in mutagenicity in subjects with increased intake of mutagen-rich meals (n = 80) (P < 0.01 and positive urine 13% vs. 5%, P = 0.025). Indoor-exposed subjects (n = 65) also showed a higher percentage of positive urine (14% vs. 5%, P = 0.015). In particular, those subjects exposed to cooking fumes the previous evening (n = 28) revealed higher urinary mutagenicity (P = 0.035, positive urine 25% vs. 5%, P < 0.001) than non-indoor exposed. The sources of variability of the mutagenicity assay, mainly the histidine content of the urine concentrate (z = 4.06, P < 0.0001), and to a lesser extent bacterial inoculum size (z = 2.33, P = 0.019), also significantly influenced urinary mutagenicity values. In a linear multiple regression analysis, their effects were still significant (i.e., histidine content P = 0.026 and inoculum size P = 0.021), but the effects of diet, indoor exposure, and other environmental exposures (i.e., traffic and heating system exhausts, residential area) were not. It is concluded that the previous day's exposure to mutagen-rich meals and cooking fumes may influence the presence of mutagenic activity in the overnight urine of non-smoking subjects. This mutagenic activity, which

  19. Flight Schedule and the Circadian Clock Influence on Sleep Loss During Overnight Cargo Operations

    NASA Technical Reports Server (NTRS)

    Gander, Philippa H.; Gregory, Kevin B.; Rosekind, Mark R.; Shafto, Michael G. (Technical Monitor)

    1995-01-01

    Thirty-four flight crew members were monitored before, during, and after two 8-day overnight cargo duty patterns which involved multiple flights at night crossing no more than one time zone per 24 h. Rectal temperature, heart rate, and wrist activity were recorded every 2 min. Sleep quantity and quality, and nap timing, were noted in a logbook. To reduce the masking effects of physical activity on temperature, 0.28 C was added to each subject's raw temperature data whenever he reported being asleep. For both masked and unmasked data, daily temperature minima were estimated from the multiple complex demodulated waveform. The temperature minima did not show a progressive adaptation to night duty, which was interrupted by a night off after 5 nights on one trip pattern and after 3 nights on the other. On duty days, the average temperature minimum delayed by about 3 h, occurring near the end of the duty period. Daytime sleep episodes averaged 2.9 h shorter than nighttime sleep episodes, and were rated as lighter, less restorative, and poorer overall. Fifty-three percent of subjects slept more than once per 24 h while they were on night duty, compared to 17% when able to sleep at night. The total sleep per 24 h on duty days averaged 1.2 h less than pretrip. Twenty-nine percent of subjects lost more than 2 h of sleep per 24 h across the 8-day duty patterns. After night duty, subjects awoke around 1400 local time, even when they had slept 2-3 h less than a normal nocturnal sleep episode. Consequently, the duration of morning sleep episodes was correlated with the off-duty time (multiple r(sup 2)=0.44, F=37.23, p less than 0.0001). Anecdotally, crew members complained of being unable to sleep longer and not feeling well-rested. These wakeups were clustered 6 h after the temperature minimum, which suggests that they may have been a response to the circadian wakeup signal. Daytime layovers in which crew members were able to sleep again in the evening ended later (0200

  20. Single- and Dual-Hormone Artificial Pancreas for Overnight Glucose Control in Type 1 Diabetes.

    PubMed

    Haidar, Ahmad; Rabasa-Lhoret, Rémi; Legault, Laurent; Lovblom, Leif E; Rakheja, Rohan; Messier, Virginie; D'Aoust, Émilie; Falappa, C Marcelo; Justice, Tara; Orszag, Andrej; Tschirhart, Holly; Dallaire, Maryse; Ladouceur, Martin; Perkins, Bruce A

    2016-01-01

    The added benefit of glucagon in artificial pancreas systems for overnight glucose control in type 1 diabetes has not been fully explored. The objective of the study was to compare the efficacy of dual-hormone (insulin and glucagon) artificial pancreas, single-hormone (insulin alone) artificial pancreas, and conventional insulin pump therapy. This study was a three-center, three-arm, open-label, randomized, crossover controlled trial involving three interventions, each applied over a night after a high carbohydrate/high fat meal and a second after exercise to mimic real-life glycemic excursions. The study was conducted in a home setting. Twenty-eight type 1 diabetes participants (21 adults and seven adolescents) participated in the study. Dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional pump therapy was activated from 9:00 PM to 7:00 AM. The main outcome was a proportion of time in target (4-8 mmol/L) by continuous glucose monitoring from 11:00 PM to 7:00 AM. Analysis was by intention to treat. The median (interquartile range) percentage of time-in-target glucose range was 47% (36%-71%) for conventional therapy, higher on both single-hormone (76% [65%-91%], P < .001) and dual-hormone artificial pancreas (81 [68%-93%], P < .001). The median (interquartile range) time spent below 4 mmol/L was 14% (4%-28%) for conventional therapy, lower on both single-hormone (5% [0%-13%], P = .004) and dual-hormone artificial pancreas (1% [0%-8%], P < .001). There were 14 hypoglycemic events on conventional therapy compared with six incidences on the single-hormone artificial pancreas (P = .059) and three incidences on the dual-hormone artificial pancreas (P = .017). None of these outcomes differed significantly between single- and dual-hormone configurations. Single- and dual-hormone artificial pancreas systems both provided better glucose control than conventional therapy. Although the dual-hormone configuration did not increase overnight time

  1. Fast Reactors

    NASA Astrophysics Data System (ADS)

    Esposito, S.; Pisanti, O.

    The following sections are included: * Elementary Considerations * The Integral Equation to the Neutron Distribution * The Critical Size for a Fast Reactor * Supercritical Reactors * Problems and Exercises

  2. Room air conditioning by means of overnight cooling of the concrete ceiling

    SciTech Connect

    Meierhans, R.A.

    1996-11-01

    Active control of the storage mass of an office building in Horgen, Switzerland, by means of a water-carrying pipe system installed in the core of the concrete ceilings has already proven successful over a period of three summers. Comfort measurements in practice and under load-simulated operating conditions have confirmed the suitability of the system for small and medium loads. During the day, only the supply air volume of the mechanical ventilation system is cooled to a temperature of 19 C (66.2 F); the heat stored in the concrete mass is discharged overnight. However, the proportion of cooling water generated in the free-cooling mode remained below expectations. This is attributable to the clearly lower inner thermal loads and the facade insulation, which is no longer up-to-date. Since the building already dispenses a part of its heat via the facade on cooler summer nights, the utilization efficiency of the free concrete core-cooling system diminishes somewhat in importance. The experience gained, however, is recommendation enough for the employment of the embedded pipework system, not only for the cooling but also for the heating of well-insulated buildings with small and medium cooling loads.

  3. Calcium Pre-Rinse Greatly Increases Overnight Salivary Fluoride after a 228 ppm Fluoride Rinse

    PubMed Central

    Vogel, G.L.; Chow, L.C.; Carey, C.M.

    2008-01-01

    Background Large increases in salivary fluoride were reported 1 h after a calcium pre-rinse/NaF rinse. Aims This study examined the persistence of these increases. Methods 12 subjects rinsed in the evening with water, with a 228 μg/g (ppm) F rinse or with 150 mmol/l calcium lactate followed by a 228 μg/g F rinse. In a second experiment these same patients rinsed with a 912 μg/g F rinse. Saliva samples were obtained the morning after rinsing, centrifuged and the supernatants analyzed. Results The Ca pre-rinse/228 μg/g F rinse induced an increase in overnight salivary F over the 912 μg/g F rinse (≈2.5 times) and a statistically significant increase over the 228 μg/g F rinse (≈5.5 times). Conclusions The results suggest that a Ca pretreatment may increase the cariostatic effect of topical F agents. PMID:18781069

  4. Infrequent dream recall associated with low performance but high overnight improvement on mirror-tracing.

    PubMed

    Dumel, Gaëlle; Carr, Michelle; Marquis, Louis-Philippe; Blanchette-Carrière, Cloé; Paquette, Tyna; Nielsen, Tore

    2015-08-01

    Although sleep facilitates learning and memory, the roles of dreaming and habitual levels of recalling dreams remain unknown. This study examined if performance and overnight improvement on a rapid eye movement sleep-sensitive visuomotor task is associated differentially with habitually high or low dream recall frequency. As a relation between dream production and visuospatial skills has been demonstrated previously, one possibility is that frequency of dream recall will be linked to performance on visuomotor tasks such as the Mirror Tracing Task. We expected that habitually low dream recallers would perform more poorly on the Mirror Tracing Task than would high recallers and would show less task improvement following a night of sleep. Fifteen low and 20 high dream recallers slept one night each in the laboratory and performed the Mirror Tracing Task before and after sleep. Low recallers had overall worse baseline performance but a greater evening-to-morning improvement than did high recallers. Greater improvements in completion time in low recallers were associated with Stage 2 rather than rapid eye movement sleep. Findings support the separate notions that dreaming is related to visuomotor processes and that different levels of visuomotor skill engage different sleep- and dream-related consolidation mechanisms. © 2015 European Sleep Research Society.

  5. Overnight stagnation of drinking water in household taps induces microbial growth and changes in community composition.

    PubMed

    Lautenschlager, Karin; Boon, Nico; Wang, Yingying; Egli, Thomas; Hammes, Frederik

    2010-09-01

    Drinking water quality is routinely monitored in the distribution network but not inside households at the point of consumption. Fluctuating temperatures, residence times (stagnation), pipe materials and decreasing pipe diameters can promote bacterial growth in buildings. To test the influence of stagnation in households on the bacterial cell concentrations and composition, water was sampled from 10 separate households after overnight stagnation and after flushing the taps. Cell concentrations, measured by flow cytometry, increased (2-3-fold) in all water samples after stagnation. This increase was also observed in adenosine tri-phosphate (ATP) concentrations (2-18-fold) and heterotrophic plate counts (4-580-fold). An observed increase in cell biovolume and ATP-per-cell concentrations furthermore suggests that the increase in cell concentrations was due to microbial growth. After 5 min flushing of the taps, cell concentrations and water temperature decreased to the level generally found in the drinking water network. Denaturing gradient gel electrophoresis also showed a change in the microbial composition after stagnation. This study showed that water stagnation in household pipes results in considerable microbial changes. While hygienic risk was not directly assessed, it emphasizes the need for the development of good material validation methods, recommendations and spot tests for in-house water installations. However, a simple mitigation strategy would be a short flushing of taps prior to use.

  6. Hot rocks or no hot rocks: overnight retreat availability and selection by a diurnal lizard.

    PubMed

    Sabo, John L

    2003-08-01

    I used radio telemetry to determine the effects of substrate size and composition on overnight retreat site selection by western fence lizards (Sceloporus occidentalis). In watersheds of northern California (USA), these lizards occupy two habitat types differing in substrate characteristics: rocky cobble bars found in the dry, active channels of rivers and grassy upland meadows. Rocky substrates, found almost exclusively on cobble bars, provided warmer potential retreat sites than all available retreat sites on meadows during the first 5 h of inactivity. Only cobble and sand substrates provided retreats with temperatures within the preferred daily active range (32-36 degrees C) during the inactive period for these lizards (1900-0900 hours). Females on a cobble bar used rocks as retreats on >90% of nights during the breeding season whereas females on a meadow used wood (>70% of nights) and burrows (>25% of nights). In contrast to females, cobble bar males used rocks significantly less frequently (<70%) and slept in the open air significantly more frequently (25% vs. <1%). Cobble bar females further, showed a significant preference for cobbles 15 cm thick, whereas the rocks used by males did not differ significantly in thickness from those measured in randomly placed transects. Rocks 15 cm thick were the warmest retreats commonly available on this habitat type. Thus, thermal microenvironments available to and chosen by gravid female lizards differ considerably between river and non-river habitats.

  7. Corneal deswelling following overnight wear of rigid and hydrogel contact lenses.

    PubMed

    Holden, B A; Sweeney, D F; La Hood, D; Kenyon, E

    1988-01-01

    The edema response over a 24-hour sleep/wake cycle of ten subjects wearing a rigid gas-permeable (RGP) lens in one eye and a hydrogel lens in the other was evaluated. Lenses that result in equivalent amounts of overnight edema were selected. There was no significant difference in the rates of deswelling during the initial hour. However, at three and five hours after eye opening, the amount of residual edema was greater in the eye wearing the hydrogel lens. We suggest that when an RGP lens provides the same closed-eye level of oxygen as a hydrogel lens, the greater tear exchange of the RGP lens will result in a greater open-eye oxygen supply, leading to less daytime edema. This suggests that the more complete deswelling we observed with RGP lenses can be attributed to a lower stimulus to open-eye swelling. Biomicroscopy, subjective vision, and patient comfort were also rated on waking and ten hours after eye opening. On eye opening there was significantly more back-surface debris (P = 0.01) with the RGP lenses. Patients wearing RGPs rated comfort as poorer and vision as better but only the latter attained statistical significance.

  8. Efficient lentiviral gene transfer to canine repopulating cells using an overnight transduction protocol.

    PubMed

    Horn, Peter A; Keyser, Kirsten A; Peterson, Laura J; Neff, Tobias; Thomasson, Bobbie M; Thompson, Jesse; Kiem, Hans-Peter

    2004-05-15

    The use of lentiviral vectors for the transduction of hematopoietic stem cells has evoked much interest owing to their ability to stably integrate into the genome of nondividing cells. However, published large animal studies have reported highly variable gene transfer rates of typically less than 1%. Here we report the use of lentiviral vectors for the transduction of canine CD34(+) hematopoietic repopulating cells using a very short, 18-hour transduction protocol. We compared lentiviral transduction of hematopoietic repopulating cells from either stem cell factor (SCF)- and granulocyte-colony stimulating factor (G-CSF)-primed marrow or mobilized peripheral blood in a competitive repopulation assay in 3 dogs. All dogs engrafted rapidly within 9 days. Transgene expression was detected in all lineages (B cells, T cells, granulocytes, and red blood cells as well as platelets) indicating multilineage engraftment of transduced cells, with overall long-term marking levels of up to 12%. Gene transfer levels in mobilized peripheral blood cells were slightly higher than in primed marrow cells. In conclusion, we show efficient lentiviral transduction of canine repopulating cells using an overnight transduction protocol. These results have important implications for the design of stem cell gene therapy protocols, especially for those diseases in which the maintenance of stem cells in culture is a major limitation.

  9. Overnight consolidation aids the transfer of statistical knowledge from the medial temporal lobe to the striatum.

    PubMed

    Durrant, Simon J; Cairney, Scott A; Lewis, Penelope A

    2013-10-01

    Sleep is important for abstraction of the underlying principles (or gist) which bind together conceptually related stimuli, but little is known about the neural correlates of this process. Here, we investigate this issue using overnight sleep monitoring and functional magnetic resonance imaging (fMRI). Participants were exposed to a statistically structured sequence of auditory tones then tested immediately for recognition of short sequences which conformed to the learned statistical pattern. Subsequently, after consolidation over either 30 min or 24h, they performed a delayed test session in which brain activity was monitored with fMRI. Behaviorally, there was greater improvement across 24h than across 30 min, and this was predicted by the amount of slow wave sleep (SWS) obtained. Functionally, we observed weaker parahippocampal responses and stronger striatal responses after sleep. Like the behavioral result, these differences in functional response were predicted by the amount of SWS obtained. Furthermore, connectivity between striatum and parahippocampus was weaker after sleep, whereas connectivity between putamen and planum temporale was stronger. Taken together, these findings suggest that abstraction is associated with a gradual shift from the hippocampal to the striatal memory system and that this may be mediated by SWS.

  10. Basal metabolic rate as a proxy for overnight energy expenditure: the effect of age.

    PubMed

    Wouters-Adriaens, Mirjam P E; Westerterp, Klaas R

    2006-06-01

    Recommendations for daily energy requirements use factorial calculations based on BMR. Expressing total energy requirements as a multiple of BMR is based on the assumption that BMR is equal to overnight metabolic rate (OMR). The objective of the present study was to determine if BMR is an appropriate proxy for OMR in children, young adults and elderly. Data are presented of thirty children (11 (SD 2) years), thirty young adults (25 (SD 5) years) and fifty-nine elderly (61 (SD 5) years). OMR was measured in a respiration chamber while sleep was not hindered and BMR was measured directly afterwards with a ventilated hood system under strictly controlled conditions. The mean ratio of OMR:BMR was 0.92 (SD 0.09) for children, which was significantly different from 1.00 (P<0.001), 1.00 (SD 0.07) for young adults and 1.06 (SD 0.09) for elderly which was also different from 1.00 (P<0.001). For adults, BMR is an appropriate measure of OMR. In children, the use of BMR to estimate OMR would introduce an overestimate and for elderly an underestimate.

  11. Wearable cuff-less PTT-based system for overnight blood pressure monitoring.

    PubMed

    Zheng, Yali; Yan, Bryan P; Zhang, Yuanting; Yu, C M; Poon, Carmen C Y

    2013-01-01

    A wearable cuff-less pulse transit time (PTT) based monitoring device is developed for ambulatory blood pressure (BP) monitoring. Ten healthy subjects (aged 27 ± 4 years old) underwent 24-hour ambulatory BP monitoring using 1) a standard brachial cuff-based oscillometric device as reference and 2) the proposed cuff-less PTT measuring system. Raw PTT and BP measurements were linearly interpolated and then smoothed by a low-pass filter to remove aliasing effect caused by the low sampling rate and synchronized. Resampled PTT and BP were assessed for correlation using correlation coefficients and Bland-Altman plots. Our study showed that PTT estimated systolic BP most accurately within 4.8 ± 4.3 mmHg on healthy young subjects during sleep time. We conclude from this study that the proposed cuff-less PTT-based BP monitoring system has potential to be a less intrusive alternative to standard oscillometric method for long-term overnight BP monitoring.

  12. Effect of short-term maternal fasting in the third trimester on uterine, umbilical, and fetal middle cerebral artery Doppler indices.

    PubMed

    Abd-El-Aal, Diaa-Eldeen M; Shahin, Ahmed Y; Hamed, Hossam O

    2009-10-01

    To assess the effect of short-term maternal fasting on uterine, umbilical, and middle cerebral artery Doppler indices, and on maternal serum glucose levels and fetal behavior. Maternal serum glucose levels, fetal biophysical profiles, and uterine, umbilical, and middle cerebral artery Doppler indices were assessed in 110 healthy women in the third trimester of pregnancy after fasting for 10-12 hours and 2 hours after a balanced meal. Maternal serum glucose levels, nonstress test results, fetal breathing movements, and biophysical profile improved after a meal compared with after fasting for 10-12 hours. Uterine, umbilical, and middle cerebral artery Doppler indices were not significantly different after fasting and after a meal. Short-term maternal fasting during the third trimester of pregnancy has no effect on uterine, umbilical, or fetal cerebral artery Doppler indices, and has a transient but significant effect on maternal serum glucose levels and fetal behavior.

  13. Overnight Closed Loop Control Improves Glycemic Control in a Multicenter Study of Adults with Type 1 Diabetes.

    PubMed

    Brown, Sue A; Breton, Marc D; Anderson, Stacey M; Kollar, Laura; Keith-Hynes, Patrick; Levy, Carol J; Lam, David W; Levister, Camilla; Baysal, Nihat; Kudva, Yogish C; Basu, Ananda; Dadlani, Vikash; Hinshaw, Ling; McCrady-Spitzer, Shelly; Bruttomesso, Daniela; Visentin, Roberto; Galasso, Silvia; Favero, Simone Del; Leal, Yenny; Boscari, Federico; Avogaro, Angelo; Cobelli, Claudio; Kovatchev, Boris P

    2017-06-28

    Closed-loop control (CLC) for the management of T1D is a novel method for optimizing glucose control and strategies for individualized implementation are being developed. Analyze glycemic control in an Overnight CLC system designed to "reset" the patient to near normal glycemic targets every morning. Randomized cross-over multicenter clinical trial. 44 subjects with T1D on insulin pump therapy. Sensor-augmented pump therapy (SAP) at home vs 5 nights of CLC (active from 23:00 to 07:00) in a supervised outpatient setting (research house or hotel) with a substudy of 5 nights of CLC subsequently at home. Percent time spent in target range (70-180 mg/dL measured by CGM). 40 subjects (age:45.5±9.5 years, HbA1c:7.4±0.8%) completed the study. Time in target range (70-180 mg/dL) significantly improved in CLC vs. SAP over 24 hours (78.3% vs. 71.4%, p=0.003) as well as overnight (85.7% vs. 67.6%, p<0.001). Time spent in a hypoglycemic range (<70 mg/dL) significantly decreased in CLC vs. SAP over 24 hours (2.5% vs. 4.3%, p=0.002) and overnight (0.9% vs. 3.2%, p<0.001). Mean glucose at 07:00 was lower with CLC vs. SAP (123.7 vs. 145.3 mg/dL, p<0.001). The substudy at home, involving 10 T1D subjects, showed similar trends with increased time in target (70-180 mg/dL) overnight (75.2% vs. 62.2%, p=0.07) and decreased time spent in hypoglycemic range (<70 mg/dL) overnight in CLC vs SAP (0.6% vs. 3.7%, p=0.03). Overnight-only CLC increased time in target range over 24 hours and decreased time in hypoglycemic range over 24 hours in a supervised outpatient setting. A pilot extension study at home showed a similar non-significant trend.

  14. Effect of Reduced Meal Frequency during Ramadan Fasting on Retinal and Choroidal Thickness.

    PubMed

    Ersan, Ismail; Tufan, Hasan Ali; Arikan, Sedat; Kara, Selcuk; Gencer, Baran; Hondur, Ahmet Murat

    2017-01-01

    To evaluate the effects of Ramadan fasting on central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) in healthy individuals using enhanced depth imaging optical coherence tomography (EDI-OCT). The EDI-OCT scans of 42 healthy individuals obtained after about 12 hours of fasting on at least the twenty-first consecutive day of fasting were compared to scans of the same patients taken one month after the last day they had fasted. CFT values were similar for both time periods (p > 0.05). The SFCT was significantly higher after consecutive fasting days towards the end of Ramadan, compared to the SFCT after one month of no fasting (one month after Ramadan ended) (p < 0.001). Ramadan fasting may lead to a significant increase in subfoveal choroidal thickness without affecting the central foveal thickness.

  15. Electroencephalogram (EEG) duration needed to detect abnormalities in angelman syndrome: is 1 hour of overnight recording sufficient?

    PubMed

    Robinson, Althea A; Goldman, Suzanne; Barnes, Gregory; Goodpaster, Luke; Malow, Beth A

    2015-01-01

    Approximately, 90% of patients with Angelman syndrome present with epileptic seizures. Obtaining an electroencephalogram (EEG) with sleep improves the chances of detecting ictal, interictal, and benign abnormal rhythms in Angelman syndrome. However, electroencephalograms, even when obtained during sleep, can be challenging in this population because of tactile sensitivities as well as anxiety related to a novel environment. We tested the hypothesis that 1 hour of sleep on an electroencephalogram would provide as much information as an entire night of electroencephalogram recording, yet more than a routine electroencephalogram conducted during the day. Overnight polysomnograms were collected in 14 children with Angelman syndrome seen at Vanderbilt University. All patients who obtained sleep within the first hour of the overnight electroencephalogram had interictal discharges recorded. Our results show that when sleep is obtained, a 1-hour electroencephalogram yields just as much information as recording an entire night.

  16. Detecting failures of the glucose sensor-insulin pump system: improved overnight safety monitoring for Type-1 diabetes.

    PubMed

    Facchinetti, Andrea; Del Favero, Simone; Sparacino, Giovanni; Cobelli, Claudio

    2011-01-01

    New sensors for real-time continuous glucose monitoring (CGM) and pumps for continuous subcutaneous insulin infusion (CSII), possibly mounted on the same device, opened new scenarios for Type-1 diabetes treatment. However, possible failures of either CGM or CSII can expose diabetic patients to risks that can be dangerous especially overnight. In this contribution we present a proof-of-concept method, developed in a state-space context and implemented through a Kalman estimator, to detect in real time possible overnight failures of the sensor-pump system by simultaneously using CGM and CSII data. The method is tested on two simulated and one real subject. Results show that the method is able to correctly generate alerts for sensor-pump failures and stimulates further investigation on its development.

  17. Overnight Changes in the Slope of Sleep Slow Waves during Infancy

    PubMed Central

    Fattinger, Sara; Jenni, Oskar G.; Schmitt, Bernhard; Achermann, Peter; Huber, Reto

    2014-01-01

    Study Objectives: Slow wave activity (SWA, 0.5-4.5 Hz) is a well-established marker for sleep pressure in adults. Recent studies have shown that increasing sleep pressure is reflected by an increased synchronized firing pattern of cortical neurons, which can be measured by the slope of sleep slow waves. Thus we aimed at investigating whether the slope of sleep slow waves might provide an alternative marker to study the homeostatic regulation of sleep during early human development. Design: All-night sleep electroencephalography (EEG) was recorded longitudinally at 2, 4, 6, and 9 months after birth. Setting: Home recording. Patients or Participants: 11 healthy full-term infants (5 male, 6 female). Interventions: None Measurements and Results: The slope of sleep slow waves increased with age. At all ages the slope decreased from the first to the last hour of non rapid-eye-movement (NREM) sleep, even when controlling for amplitude differences (P < 0.002). The decrease of the slope was also present in the cycle-by-cycle time course across the night (P < 0.001) at the age of 6 months when the alternating pattern of low-delta activity (0.75-1.75 Hz) is most prominent. Moreover, we found distinct topographical differences exhibiting the steepest slope over the occipital cortex. Conclusions: The results suggest an age-dependent increase in synchronization of cortical activity during infancy, which might be due to increasing synaptogenesis. Previous studies have shown that during early postnatal development synaptogenesis is most pronounced over the occipital cortex, which could explain why the steepest slope was found in the occipital derivation. Our results provide evidence that the homeostatic regulation of sleep develops early in human infants. Citation: Fattinger S; Jenni OG; Schmitt B; Achermann P; Huber R. Overnight changes in the slope of sleep slow waves during infancy. SLEEP 2014;37(2):245-253. PMID:24497653

  18. Overnight studies in severe chronic left heart failure: arrhythmias and oxygen desaturation.

    PubMed Central

    Davies, S W; John, L M; Wedzicha, J A; Lipkin, D P

    1991-01-01

    Overnight studies were performed in 10 patients with severe chronic left heart failure (New York Heart Association grades III and IV) without pulmonary disease and in eight controls. Transcutaneous oxygen (Po2) and carbon dioxide tensions (Pco2) and oxygen saturation were measured and the electro-cardiogram was recorded. During sleep mean oxygen saturation fell to 92.7% (minimum 86.1%) from 95.1% when awake. During the night oxygen saturation was below 95% for 62% of the time, below 90% for 6% of the time, and below 85% for 1% of the time. In four patients there were oxygen desaturation dips (a fall of greater than 4% in oxygen saturation from a stable baseline that lasted greater than 30 s) with concurrent increases in Pco2. Two patients had bradycardia during the dips: in one there was non-sustained ventricular tachycardia during the dips and in the other there was ST depression (greater than 0.1 mV at 80 ms after the J point) during a dip. In the controls the fall in mean oxygen saturation from 95.4% when they were awake to 94.4% when they were asleep was less than the fall in patients with heart failure and there were no desaturation dips or arrhythmias. Thus patients with severe heart failure had episodes of oxygen desaturation during sleep, some of which were associated with arrhythmia. Such episodes may be related to the increased risk of sudden death in chronic heart failure. PMID:1907836

  19. Overnight duty impairs behaviour, awake activity and sleep in medical doctors.

    PubMed

    Dru, Michel; Bruge, Philippe; Benoit, Odile; Mason, Nicholas P; Combes, Xavier; Margenet, Alain; Dhonneur, Gilles; Marty, Jean

    2007-08-01

    The impact of prolonged work cycles among senior doctors remains disputed. We evaluated the effects of overnight duty on awake activity and sleep quality in senior doctors in emergency medical specialties. Thirty-six healthy doctors were monitored during a 2-week period including three separate 84 h on-call cycles. An on-call cycle consisted of the night and the day before night duty; the night duty itself and the subsequent 2 days and nights after night duty. The first day after night duty could either be worked or not. Actigraphy was used to measure physical activity and to evaluate sleep duration and quality. A standardized questionnaire was used to assess daytime performance and night sleep quality. Night actigraphy demonstrated that on-call work induced a significant reduction in sleep duration that was not recovered during the subsequent two nights. Sleep during the night duty itself was fragmented and of poor quality. Awake activity was significantly impaired on the day after night duty. Although subjectively night sleep quality did not differ between the nights before and after night duty, all subjective daytime parameters were impaired the day after night duty, and mood, fatigue and concentration remained altered on the second day. Working the day after night duty impaired objective measurements of daytime activity and sleep quality during the subsequent two nights. On-call night work in acute specialties induces sleep debt associated with prolonged impairment of awake activity, sleep quality and performance. Not working the following day after an on-call night allows partial recovery of sleep quality to begin.

  20. Differences in overnight polysomnography scores using the adult and pediatric criteria for respiratory events in adolescents.

    PubMed

    Accardo, Jennifer A; Shults, Justine; Leonard, Mary B; Traylor, Joel; Marcus, Carole L

    2010-10-01

    There was no consensus in the 2007 American Academy of Sleep Medicine scoring manual on whether pediatric or adult respiratory criteria should be used in adolescents due to lack of data. Our objective was to compare pediatric and adult criteria in adolescents referred for obstructive sleep apnea (OSA). We hypothesized that pediatric criteria would capture more respiratory events than adult criteria. Retrospective cross-sectional analysis. Clinical sleep laboratory. 101 subjects aged 13-18 years clinically referred for OSA. Overnight polysomnogram. Data were scored using both adult and pediatric AASM criteria. For adult criteria, data were scored using both AASM hypopnea rule A, defined by > or = 4% desaturation, and B, defined by > or = 3% desaturation or arousal. Median (range) apnea hypopnea index (AHI) by pediatric criteria was 1.7 events/hour (0-42.9). AHI using rule A was 0.4 (0-35.6); rule B, 1.4 (0-38.4). A higher pediatric AHI was associated with greater differences between pediatric and adult AHI using either rule A or B. There was no significant discordance in OSA classification comparing pediatric and adult criteria rule B (P = 0.3), but there was a significant rate of discordance classification comparing pediatric and adult criteria rule A(P < 0.001). Either pediatric or adult criteria rule B can be used in adolescents as few subjects change diagnostic category between these 2 criteria. Use of adult rule A results in fewer children meeting criteria for OSA. Further research into the clinical relevance of the scoring metric in adolescents is warranted.

  1. Impact of successful treatment of acromegaly on overnight heart rate variability and sleep apnea.

    PubMed

    Chemla, Denis; Attal, Pierre; Maione, Luigi; Veyer, Anne-Sophie; Mroue, Ghassan; Baud, Dany; Salenave, Sylvie; Kamenicky, Peter; Bobin, Serge; Chanson, Philippe

    2014-08-01

    Successful treatment of acromegaly improves disease-related cardiovascular mortality and morbidity, but its effects on autonomic modulation of the heart rate are unknown. We documented treatment-induced changes in time-domain heart rate variability, taking into account the confounding effects of obstructive sleep apnea. Sixteen consecutive patients (12 males, aged 43 ± 12 y) with newly diagnosed acromegaly underwent overnight (12:00-7:00 am) cardiac Holter recordings coupled with polysomnography. Data were obtained before and 10 ± 6 months after successful treatment of acromegaly. IGF-1 levels fell from 807 ± 333 to 207 ± 69 μg/L and normalized in all patients. Seven patients (44%) had obstructive sleep apnea (apnea-hypopnea index 33 ± 21/h) at baseline. Treatment had no significant effect on polysomnographic indices. After treatment, increases were noted in the normal-to-normal heart period (NN), SD-NN, the percentage of NN differing from the previous NN by greater than 50 msec, and the root mean square of successive differences in NN (each P < .05). These heart rate variability results were not influenced by the type of treatment, and there was no relationship between changes in NN and changes in the apnea-hypopnea index (P = .58). Early after successful treatment of acromegaly, we observed increased parasympathetic modulation/decreased sympathetic modulation of the nighttime heart rate, an effect that seems unrelated to changes in sleep apnea status. Treatments aimed at normalizing IGF-1 may improve cardiovascular homeostasis through improved cardiac autonomic nervous system modulation.

  2. Intra-individual variability and adaptation of overnight- and sleeping metabolic rate.

    PubMed

    Schoffelen, Paul F M; Westerterp, Klaas R

    2008-05-23

    The largest component of daily energy expenditure is resting energy expenditure as reflected in overnight metabolic rate (OMR) and sleeping metabolic rate (SMR). Here, we determined the variation in OMR (24:00-6:00 h) and SMR values (3 h intervals) as affected by physical activity (PA) during the day and the night. Subjects were 32 females and 17 males, age 18-52 years. Energy expenditure (EE) was measured for 36 h in a whole room calorimeter (14 m3), starting in the evening, providing values before and after behavioral limitation. The mean intra-individual coefficient of variation was 1.8+/-1.4% for SMRmin (minimum EE), 2.8+/-2.0% for SMRact (minimum PA), 2.4+/-2.5% for SMRres (minimum residual EE, residual calculated from 24 h relationship between EE and PA) and 2.8+/-2.2% for OMR (n=49). Mean clock time for SMR ranged from 3:15 till 4:13 h. EE and PA increased in the hour before awakening. Surprisingly, OMR showed a significant 2.7% increase (P<0.05) during the second night of the 36 h measurement, but only for a second visit, and was related to increased physical activity during night period (R2=0.50, P<0.001). OMR measurements following unrestricted daily activity showed identical results for first and second (repeat) visits: 6.82+/-0.86 MJ/day and 6.79+/-0.93 MJ/day (n=49), respectively. It is advised to measure SMR based on minimum residual EE during nights following free-living conditions, and to exclude EE measures 1 h before awakening from SMR and OMR calculations to prevent influences of habitual wake-up time.

  3. The effect of daily lens replacement during overnight wear on ocular adverse events.

    PubMed

    Ozkan, Jerome; Willcox, Mark D P; de la Jara, Percy Lazon; Mandathara, Preeji S; Rathi, Varsha M; Thomas, Varghese; Holden, Brien A

    2012-12-01

    Compared with daily disposable wear schedule, continuous wear (CW) or extended wear of contact lenses has been associated with an increased risk of developing an ocular infection. Proof-of-principle studies were conducted to investigate the impact of daily replacement of lenses on the rate of contact lens-related ocular adverse events (AEs) during 30-night CW. A total of 215 subjects were dispensed with silicone hydrogel lenses on a 30-night CW schedule but replaced lenses daily either each night before sleeping (n = 178 eyes) or each morning after waking (n = 252 eyes). Scheduled clinic visits were conducted at 1 week and 1 month. Neophytes were required to complete 1 week of daily wear before commencing CW. A historical control (n = 191 eyes) using the same site, subject demographics, and visit schedule but monthly lens replacement was used for AE rates. Logistic regression analysis showed a significant reduction in mechanical AEs (0.8 vs 5.2%, p = 0.01) and overall AEs (inflammatory and mechanical events) (4.0 vs 8.9%, p = 0.04) when lenses were replaced each morning compared with being replaced monthly. Estimation of handling-related lens contamination of unworn lenses in a subgroup of subjects showed isolation of Staphylococcus aureus from the lenses of 35% of subjects, and 65% of subjects had more than 1000 colony-forming units per lens of gram-positive bacterial contamination. Morning lens replacement during CW reduced mechanical and overall ocular AEs. Replacing lenses at night had no beneficial effects perhaps because the benefit of a fresh lens at night might be partially negated by contamination of the contact lens caused by lens handling before overnight eye closure. Contact lens wearers on an extended wear or CW schedule should be advised to minimize lens handling before sleep to reduce the risk of complications.

  4. Urinary albumin excretion in healthy adults: a cross sectional study of 24-hour versus timed overnight samples and impact of GFR and other personal characteristics.

    PubMed

    Fagerstrom, Peter; Sallsten, Gerd; Akerstrom, Magnus; Haraldsson, Borje; Barregard, Lars

    2015-01-24

    Urinary albumin can be measured in 24 h or spot samples. The 24 h urinary albumin excretion rate is considered the gold standard, but is cumbersome to collect. Instead, often an overnight sample is collected, and adjusted for dilution. Proxies for 24 h excretion rate have been studied in diabetics, but seldom in healthy individuals. Our aims were to compare 24 h and overnight albumin excretion, to assess the impact of personal characteristics, and to examine correlations between the 24 h excretion rate and proxies such as the albumin to creatinine ratio (ACR). Separate 24 h and overnight urine samples were collected from 152 healthy kidney donors. Urinary creatinine, specific gravity, collection time, and sample volume determined. Differences between 24 h and overnight samples were examined, and the effects of age, sex, smoking, body mass, glomerular filtration rate, and urinary flow rate were assessed. The 24 h albumin excretion rate and ACR were both significantly higher than their overnight counterparts. Unadjusted albumin was unsurprisingly higher in the more concentrated overnight samples, while concentrations adjusted for specific gravity were similar. In multivariate analysis, the 24 h excretion rate and proxies were positively associated with glomerular filtration rate, as was ACR in overnight samples. There were positive associations between urinary albumin and body mass. Proxies for the 24 h albumin excretion rate showed relatively high correlations with this gold standard, but differences due to sampling period, adjustment method, and personal characteristics were large enough to be worth considering in studies of albumin excretion in healthy individuals.

  5. The development of attachment in separated and divorced families. Effects of overnight visitation, parent and couple variables.

    PubMed

    Solomon, J; George, C

    1999-04-01

    This study represents the first systematic investigation of the effects on infant attachment to mother and to father of the increasingly common practice of overnight visitation (time-sharing) with the father in separated and divorced families. There were 145 infants (ages 12 to 20 months) and their mothers (and 83 fathers) who participated in the study. Parents completed questionnaires, were interviewed about their relationship with the baby, and were observed with their infants in the Strange Situation. Infants in separated/divorced families who had regular overnight visits with father (n = 44) were significantly less likely to be classified as secure and more likely to be classified as disorganized or unclassifiable in their attachment to mother than infants in a married comparison group (n = 52). Attachment classification to father was unrelated to visiting (time-sharing) arrangements, but infants were significantly more likely to be classified disorganized/unclassifiable with father in the separated/divorced groups (n = 39) than in dual-parent families (n = 44). Disorganized attachment to mother in the Overnight group was associated with maternal reports of low parent communication and high parent conflict, and with low maternal psychological protection of the infant, assessed from maternal interviews. Consistent with Bowlby's and Rutter's context-sensitive views of the effects of separation, the results suggest that repeated overnight separations from the primary caregiver are associated with disruption in mother-infant attachment when the conditions of visitation are poor, i.e. when parents are unable to provide adequate psychological support to the child.

  6. Preoperative overnight parenteral nutrition (TPN) improves skeletal muscle protein metabolism indicated by microarray algorithm analyses in a randomized trial.

    PubMed

    Iresjö, Britt-Marie; Engström, Cecilia; Lundholm, Kent

    2016-06-01

    Loss of muscle mass is associated with increased risk of morbidity and mortality in hospitalized patients. Uncertainties of treatment efficiency by short-term artificial nutrition remain, specifically improvement of protein balance in skeletal muscles. In this study, algorithmic microarray analysis was applied to map cellular changes related to muscle protein metabolism in human skeletal muscle tissue during provision of overnight preoperative total parenteral nutrition (TPN). Twenty-two patients (11/group) scheduled for upper GI surgery due to malignant or benign disease received a continuous peripheral all-in-one TPN infusion (30 kcal/kg/day, 0.16 gN/kg/day) or saline infusion for 12 h prior operation. Biopsies from the rectus abdominis muscle were taken at the start of operation for isolation of muscle RNA RNA expression microarray analyses were performed with Agilent Sureprint G3, 8 × 60K arrays using one-color labeling. 447 mRNAs were differently expressed between study and control patients (P < 0.1). mRNAs related to ribosomal biogenesis, mRNA processing, and translation were upregulated during overnight nutrition; particularly anabolic signaling S6K1 (P < 0.01-0.1). Transcripts of genes associated with lysosomal degradation showed consistently lower expression during TPN while mRNAs for ubiquitin-mediated degradation of proteins as well as transcripts related to intracellular signaling pathways, PI3 kinase/MAPkinase, were either increased or decreased. In conclusion, muscle mRNA alterations during overnight standard TPN infusions at constant rate altered mRNAs associated with mTOR signaling; increased initiation of protein translation; and suppressed autophagy/lysosomal degradation of proteins. This indicates that overnight preoperative parenteral nutrition is effective to promote muscle protein metabolism. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The

  7. The Significance of Transcutaneous Continuous Overnight CO2 Monitoring in Determining Initial Mechanical Ventilator Application for Patients with Neuromuscular Disease

    PubMed Central

    Lee, Soon Kyu; Kim, Dong-hyun; Choi, Won Ah; Won, Yu Hui; Kim, Sun Mi

    2012-01-01

    Objective To reveal the significance of continuous transcutaneous carbon dioxide (CO2) level monitoring through reviewing cases which showed a discrepancy in CO2 levels between arterial blood gas analysis (ABGA) and continuous transcutaneous blood gas monitoring. Method Medical record review was conducted retrospectively of patients with neuromuscular diseases who had started home mechanical ventilation between June 2008 and May 2010. The 89 patients underwent ABGA at the 1st hospital day, and changes to their CO2 level were continuously monitored overnight with a transcutaneous blood gas analysis device. The number of patients who initially appeared to show normal PaCO2 through ABGA, yet displayed hypercapnea through overnight continuous monitoring, was counted. Results 36 patients (40.45%) presented inconsistent CO2 level results between ABGA and continuous overnight monitoring. The mean CO2 level of the 36 patients using ABGA was 37.23±5.11 mmHg. However, the maximum and mean CO2 levels from the continuous monitoring device were 52.25±6.87 mmHg and 46.16±6.08 mmHg, respectively. From the total monitoring period (357.28±150.12 minutes), CO2 retention over 45 mmHg was detected in 198.97 minutes (55.69%). Conclusion Although ABGA only reflects ventilatory status at the puncturing moment, ABGA results are commonly used to monitor ventilatory status in most clinical settings. In order to decide the starting point of home mechanical ventilation in neuromuscular patients, continuous overnight monitoring should be considered to assess latent CO2 retention. PMID:22506245

  8. Qualitative differences in offline improvement of procedural memory by daytime napping and overnight sleep: An fMRI study.

    PubMed

    Sugawara, Sho K; Koike, Takahiko; Kawamichi, Hiroaki; Makita, Kai; Hamano, Yuki H; Takahashi, Haruka K; Nakagawa, Eri; Sadato, Norihiro

    2017-09-20

    Daytime napping offers various benefits for healthy adults, including enhancement of motor skill learning. It remains controversial whether napping can provide the same enhancement as overnight sleep, and if so, whether the same neural underpinning is recruited. To investigate this issue, we conducted functional MRI during motor skill learning, before and after a short day-nap, in 13 participants, and compared them with a larger group (n=47) who were tested following regular overnight sleep. Training in a sequential finger-tapping task required participants to press a keyboard in the MRI scanner with their non-dominant left hand as quickly and accurately as possible. The nap group slept for 60min in the scanner after the training run, and the previously trained skill was subsequently re-tested. The whole-night sleep group went home after the training, and was tested the next day. Offline improvement of speed was observed in both groups, whereas accuracy was significantly improved only in the whole-night sleep group. Correspondingly, the offline increment in task-related activation was significant in the putamen of the whole-night group. This finding reveals a qualitative difference in the offline improvement effect between daytime napping and overnight sleep. Copyright © 2017. Published by Elsevier B.V.

  9. Same-day discharge or overnight stay after percutaneous coronary intervention: comparison of net adverse cardiovascular events.

    PubMed

    Nascimento, Francisco O; Pineda, Andres M; Benjo, Alexandre; Mas, Ildefonso; Podesta, Carlos; Heimowitz, Todd B; Kirtane, Ajay; Beohar, Nirat

    2014-05-01

    Same-day discharge after percutaneous coronary intervention (PCI), if achieved with acceptable safety, could result in greater patient satisfaction and potential cost savings. Comparative analyses reporting the safety outcomes of same-day discharge vs overnight stay after elective PCI are lacking. Data of same-day discharge and overnight-stay patients undergoing elective PCI in a high-volume center were compared. We specifically evaluated the incidence of net adverse cardiovascular events (NACE; i.e., death, myocardial infarction, stroke, target vessel revascularization, vascular complication, and major bleeding) within 48 hours post index procedure among both groups and at 30 days. A total of 188 cases were evaluated, with 93 discharged the same day and 95 after overnight stay following elective PCI. Baseline characteristics were similar, except for older age (73.0 ± 7 years vs. 64.0 ± 12 years; P<.001), more prior PCI (49.5% vs. 34.7%; P<.001), and prior coronary artery bypass graft surgery (16.1% vs. 11.6%; P=.01) in the same-day discharge group. Procedural characteristics were similar in both groups. No significant difference in the NACE rate was found between the groups at 48 hours (0 [0%] vs. 2 [2.1%]; P=.25) or at 30 days (3 [3.2%] vs. 6 [6.3%]; P=.26). In the population studied, same-day discharge after PCI is safe and feasible. Adequately powered randomized prospective studies are necessary to confirm these results.

  10. Timing matters: open-loop stimulation does not improve overnight consolidation of word pairs in humans.

    PubMed

    Weigenand, Arne; Mölle, Matthias; Werner, Friederike; Martinetz, Thomas; Marshall, Lisa

    2016-09-01

    The application of auditory clicks during non-rapid eye movement (NREM) sleep phase-locked to the up state of the slow oscillation (closed-loop stimulation) has previously been shown to enhance the consolidation of declarative memories. We designed and applied sequences of three clicks during deep NREM sleep to achieve a quasi-phase-dependent open-loop stimulation. This stimulation was successful in eliciting slow oscillation power in the stimulation period. Although fast and slow spindle power were markedly decreased during the stimulation period, memory consolidation did not differ from control. During putative up states fast spindle power remained, however, at control levels. We conclude that concurrence of slow oscillations and fast spindles suffices to maintain memory consolidation at control levels despite an overall decreased spindle activity.

  11. Rat psychomotor vigilance task with fast response times using a conditioned lick behavior

    PubMed Central

    Walker, Jennifer L.; Walker, Brendan M.; Fuentes, Fernanda Monjaraz; Rector, David M.

    2010-01-01

    Investigations into the physiological mechanisms of sleep control require an animal psychomotor vigilance task (PVT) with fast response times (<300ms). Rats provide a good PVT model since whisker stimulation produces a rapid and robust cortical evoked response, and animals can be trained to lick following stimulation. Our prior experiments used deprivation-based approaches to maximize motivation for operant conditioned responses. However, deprivation can influence physiological and neurobehavioral effects. In order to maintain motivation without water deprivation, we conditioned rats for immobilization and head restraint, then trained them to lick for a 10% sucrose solution in response to whisker stimulation. After approximately 8 training sessions, animals produced greater than 80% correct hits to the stimulus. Over the course of training, reaction times became faster and correct hits increased. Performance in the PVT was examined after 3, 6 and 12 hours of sleep deprivation achieved by gentle handling. A significant decrease in percent correct hits occurred following 6 and 12 hours of sleep deprivation and reaction times increased significantly following 12 hours of sleep deprivation. While behaviorally the animals appeared to be awake, we observed significant increases in EEG delta power prior to misses. The rat PVT with fast response times allows investigation of sleep deprivation effects, time on task and pharmacological agents. Fast response times also allow closer parallel studies to ongoing human protocols. PMID:20696188

  12. MD-Logic overnight type 1 diabetes control in home settings: A multicentre, multinational, single blind randomized trial.

    PubMed

    Nimri, Revital; Bratina, Natasa; Kordonouri, Olga; Avbelj Stefanija, Magdalena; Fath, Maryam; Biester, Torben; Muller, Ido; Atlas, Eran; Miller, Shahar; Fogel, Aviel; Phillip, Moshe; Danne, Thomas; Battelino, Tadej

    2017-04-01

    To evaluate the safety, efficacy and need for remote monitoring of the MD-Logic closed-loop system during short-term overnight use at home. Seventy-five patients (38 male; aged 10-54 years; average A1c, 7.8% ± 0.7%, 61.8 ± 7.2 mmol/mol) were enrolled from 3 clinical sites. Patients were randomly assigned to participate in 2 overnight crossover periods, each including 4 consecutive nights, 1 under closed-loop control and 1 under sensor-augmented pump (SAP) therapy in the patient's home. Both study arms were supervised using a remote-monitoring system in a blinded manner. Primary endpoints were time spent with glucose levels below 70 mg/dL and percentage of nights in which mean overnight glucose levels were within 90 to 140 mg/dL. The median [interquartile range] percentage of time spent in hypoglycaemia was significantly lower on nights when MD-Logic was used, compared to SAP therapy (2.07 [0, 4.78] and 2.6 [0, 10.34], respectively; P = .004) and the percentage of individual nights with a mean overnight glucose level in target was significantly greater (75 [42, 75] and 50 [25,75], respectively; P = .008). The time spent in target range was increased by a median of 28% (P = .001), with the same amount of insulin (10.69 [7.28, 13.94] and 10.41[6.9, 14.07], respectively; P = .087). The remote monitoring triggered calls for hypoglycaemia at twice the rate during SAP therapy compared to closed-loop control (62 and 29, respectively; P = .002). The MD-Logic system demonstrated a safe and efficient profile during overnight use by children, adolescents and adults with type 1 diabetes and, therefore, provides an effective means of mitigating the risk of nocturnal hypoglycaemia. © 2016 John Wiley & Sons Ltd.

  13. Arousal Responses during Overnight Polysomnography and their Reproducibility in Healthy Young Adults

    PubMed Central

    Azarbarzin, Ali; Ostrowski, Michele; Younes, Magdy; Keenan, Brendan T.; Pack, Allan I.; Staley, Bethany; Kuna, Samuel T.

    2015-01-01

    Study Objectives: Arousal intensity and heart rate (HR) response to arousal during polysomnography (PSG) vary considerably between patients with sleep disorders. Our objective was to determine the range of these arousal characteristics in healthy young adults and whether they are consistent on repeated testing. Design: Post hoc analysis of 56 preexisting PSG files recorded from 28 healthy adults on 2 consecutive nights. Setting: Academic medical center and Research and Development Laboratory (YRT Limited, Winnipeg, Manitoba, Canada). Participants: Twenty-eight healthy young adults. Interventions: None. Measurements and Results: Arousals were identified using an automatic system followed by manual editing. The intensity of arousals was scaled (between 0 and 9) using an automatic algorithm based on the change in the electroencephalography (EEG) signals' wavelet characteristics. 4,751 arousals in 28 pairs of PSGs (night 1 and night 2) were scaled. HR responses (ΔHR) to all arousals were determined and averaged at each arousal scale per file. Overall average arousal intensity ranged 3.0–7.1 in different subjects, and average ΔHR ranged 1.9–18.3 beats.min−1. Heart rate response at a given arousal intensity, expressed as ΔHR at a moderate arousal scale of 5.0 (ΔHR5), ranged 4.1–18.1 beats.min−1. There was a strong correlation between arousal intensity and ΔHR within each subject. More importantly, there were excellent intraclass correlations (ICC) between night 1 and night 2 results for all three variables (ICC = 0.72 for average intensity, 0.92 for average ΔHR4, and 0.91 for ΔHR5). Conclusions: Average arousal intensity and heart rate response to arousal are highly variable among healthy young adults and stable within individuals. Citation: Azarbarzin A, Ostrowski M, Younes M, Keenan BT, Pack AI, Staley B, Kuna ST. Arousal responses during overnight polysomnography and their reproducibility in healthy young adults. SLEEP 2015;38(8):1313–1321. PMID

  14. Platelet concentrates from fresh or overnight-stored blood, an international study.

    PubMed

    Dijkstra-Tiekstra, M J; van der Meer, P F; Cardigan, R; Devine, D; Prowse, C; Sandgren, P; de Wildt-Eggen, J

    2011-01-01

    Whole blood and also buffy coats (BCs) can be held for a few hours or overnight before processing into blood components or platelet concentrates (PCs). Individual studies have reported a range of outcomes regarding in vitro variables for PCs prepared from fresh and stored whole blood. In this multicenter study, effects of storage of whole blood or BCs on the in vitro quality of PCs were studied. The leukoreduced BC PCs were prepared from fresh BCs (2-8 hr after collection; fresh/fresh), from BCs at 20 to 24 hours after collection (fresh/stored), or from BCs prepared from whole blood stored for 20 to 24 hours (stored/fresh). PCs were stored on a flat-bed shaker at 20 to 24°C for 7 days. PCs were tested on Days 0 (only fresh/fresh), 1, 5, and 7 for in vitro quality. There were six participating centers that tested all three conditions with n = 6 per condition. In comparison to fresh/stored and stored/fresh PCs, fresh/fresh PCs exhibited a lower platelet (PLT) count (Day 1-220 × 10(9) ± 70 × 10(9) vs. 324 × 10(9) ± 50 × 10(9) and 368 × 10(9) ± 56 × 10(9) PLTs/PC), lactate, pCO(2), and hypotonic shock response (HSR; Days 5 and 7; Day 7-50 ± 13% vs. 57 ± 12 and 63 ± 11%) and a higher pH, glucose, pO(2), and CD62P expression (than stored/fresh PCs only; Day 7-33 ± 10% vs. 28 ± 12 and 24 ± 11%; p < 0.05). No differences were observed for volume, swirling effect, white blood cell count, annexin V binding, or aggregation between these conditions. Based on PLT count, HSR, and PLT activation, PCs are best prepared after 20 to 24 hours hold of the whole blood or BCs. © 2010 American Association of Blood Banks.

  15. Short-Term Effects of Overnight Orthokeratology on Corneal Epithelial Permeability and Biomechanical Properties

    PubMed Central

    Yeh, Thao N.; Green, Harry M.; Zhou, Yixiu; Pitts, Julie; Kitamata-Wong, Britney; Lee, Sophia; Wang, Shiyin L.; Lin, Meng C.

    2013-01-01

    Purpose. To investigate the effects of 30 nights of overnight orthokeratology (OOK) on corneal epithelial permeability (Pdc) and corneal biomechanical properties. Methods. BE Retainer and Paragon CRT lenses were used. Visits were scheduled approximately 4 hours after awakening at baseline and after 1, 5, 10, 14, and 30 days of treatment. Pdc was measured at baseline and at day 30, whereas corneal biomechanical properties and visual acuities (VAs) were measured at all visits. Results. Thirty-nine neophytes and soft contact lens wearers completed the study. There was no difference in Pdc between baseline (ln[Pdc] [95% confidence interval (CI)] = −2.65 [−2.80 to −2.50]) and day 30 (ln[Pdc][CI] = −2.68 [−2.85 to −2.50]) (P = 0.88). Corneal hysteresis (CH) and corneal resistance factor (CRF) reduced significantly from baseline (CH [CI] = 10.89 [10.59–11.19] mm Hg and CRF [CI] = 10.35 [9.99–10.72] mm Hg) to day 30 (CH [CI] = 10.59 [10.31–10.87] mm Hg and CRF [CI] = 9.58 [9.26–9.89] mm Hg) (P = 0.001 for CH and P < 0.001 for CRF). Posttreatment VA did not reach baseline targets, and the difference was worse with low-contrast letters. Asian individuals (n = 18) had significantly worse VA than non-Asian individuals (n = 21) under most conditions through day 5, and the difference extended through day 14 with low-contrast letters under mesopic conditions. The percentage of participants who achieved 20/20 uncorrected was 17% Asian and 40% non-Asian individuals after day 1 and reached 69% Asian and 83% non-Asian individuals at day 30. Conclusions. Thirty nights of OOK did not alter Pdc when measured 4 hours after awakening. OOK caused CH and CRF to decrease, but the changes were not clinically significant compared with diseased and postsurgical cases. Asian individuals, who had lower baseline CH in this study, responded slower to OOK based on early uncorrected VA and overrefraction measurements. PMID:23652492

  16. A single overnight stay is possible for most patients undergoing robotic partial nephrectomy.

    PubMed

    Abaza, Ronney; Shah, Ketul

    2013-02-01

    To evaluate establishment of overnight stay only as sufficient after robotic partial nephrectomy (RPN). Stated benefits of minimally invasive surgery include reduced hospitalization, but published hospital stays after laparoscopic or robotic partial nephrectomy are not significantly less than with open surgery. We developed a clinical pathway targeting discharge on postoperative day (POD) 1 after RPN of any complexity. We reviewed all RPNs by a single surgeon since instituting our clinical pathway, including ambulation and diet the night of surgery, avoidance of intravenous narcotics and drains, and catheter removal on POD 1 before discharge. Targeted discharge was not modified regardless of RPN complexity. A total of 150 consecutive patients underwent 160 RPNs with 35 hilar tumors and 26 with segmental, and 33 with no artery clamping. Three had solitary kidneys, and 8 underwent multiple (range, 2-4) RPNs. Mean patient age was 57 years (range, 22-89 years), and body mass index was 32 kg/m(2) (range, 18-54 kg/m(2)). Mean tumor size was 3.6 cm (range, 1.0-11.0; median, 3.2 cm), and the RENAL (radius, exophytic/endophytic, nearness to collecting system, anterior/posterior, and location) nephrometry score was 8 (range, 4-12; median, 8). Mean warm ischemia time was 12.1 minutes (range, 0-30.0 minutes). Mean preoperative and discharge creatinine were 0.9 mg/dL (range, 0.43-2.79 mg/dL) and 1.13 mg/dL (range, 0.56-2.93 mg/dL). All patients ambulated on POD 0. One patient required one dose of intravenous narcotic. Mean length of stay was 1.1 days, with 145 (97%) discharged on POD 1, of which only 4 (2.7%) were readmitted within 30 days. Discharge on POD 1 is feasible in most RPN patients regardless of complexity. Readmission rate was low, indicating that longer admissions may not prevent complications when patients meeting discharge criteria go home on POD 1. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Transition to 12-hour shifts - The process and the product

    SciTech Connect

    Suter, P. )

    1992-01-01

    This paper examines Yankee Atomic Electric Company's (YAEC's) transition to a 12-h shift schedule for the operations department staff. It presents the approach to implementation, reactions of both shift workers and management to the new schedule (including perceived benefits and shortcomings), and provides recommendations to others considering this change. Experience demonstrates the ease of any transition when the desire for change originates with the individuals directly affected. Close cooperation with any union representation is also vital to its success. When all parties are in apparent agreement (e.g., that a 12-h rotation should commence), this allows for a trial period (in this case of at least two shift cycles) in order to evaluate and refine the program, thus leaving the option open to revert back to the previous condition if things prove unsatisfactory. At all costs, mutual respect must be maintained for all parties.

  18. Fast valve

    SciTech Connect

    Van Dyke, William J.

    1992-01-01

    A fast valve is disclosed that can close on the order of 7 milliseconds. It is closed by the force of a compressed air spring with the moving parts of the valve designed to be of very light weight and the valve gate being of wedge shaped with O-ring sealed faces to provide sealing contact without metal to metal contact. The combination of the O-ring seal and an air cushion create a soft final movement of the valve closure to prevent the fast air acting valve from having a harsh closing.

  19. Fast valve

    DOEpatents

    Van Dyke, W.J.

    1992-04-07

    A fast valve is disclosed that can close on the order of 7 milliseconds. It is closed by the force of a compressed air spring with the moving parts of the valve designed to be of very light weight and the valve gate being of wedge shaped with O-ring sealed faces to provide sealing contact without metal to metal contact. The combination of the O-ring seal and an air cushion create a soft final movement of the valve closure to prevent the fast air acting valve from having a harsh closing. 4 figs.

  20. Overnight closed-loop insulin delivery with model predictive control: assessment of hypoglycemia and hyperglycemia risk using simulation studies.

    PubMed

    Wilinska, Malgorzata E; Budiman, Erwin S; Taub, Marc B; Elleri, Daniela; Allen, Janet M; Acerini, Carlo L; Dunger, David B; Hovorka, Roman

    2009-09-01

    Hypoglycemia and hyperglycemia during closed-loop insulin delivery based on subcutaneous (SC) glucose sensing may arise due to (1) overdosing and underdosing of insulin by control algorithm and (2) difference between plasma glucose (PG) and sensor glucose, which may be transient (kinetics origin and sensor artifacts) or persistent (calibration error [CE]). Using in silico testing, we assessed hypoglycemia and hyperglycemia incidence during over-night closed loop. Additionally, a comparison was made against incidence observed experimentally during open-loop single-night in-clinic studies in young people with type 1 diabetes mellitus (T1DM) treated by continuous SC insulin infusion. Simulation environment comprising 18 virtual subjects with T1DM was used to simulate overnight closed-loop study with a model predictive control (MPC) algorithm. A 15 h experiment started at 17:00 and ended at 08:00 the next day. Closed loop commenced at 21:00 and continued for 11 h. At 18:00, protocol included meal (50 g carbohydrates) accompanied by prandial insulin. The MPC algorithm advised on insulin infusion every 15 min. Sensor glucose was obtained by combining model-calculated noise-free interstitial glucose with experimentally derived transient and persistent sensor artifacts associated with FreeStyle Navigator (FSN). Transient artifacts were obtained from FSN sensor pairs worn by 58 subjects with T1DM over 194 nighttime periods. Persistent difference due to FSN CE was quantified from 585 FSN sensor insertions, yielding 1421 calibration sessions from 248 subjects with diabetes. Episodes of severe (PG < or = 36 mg/dl) and significant (PG < or = 45 mg/dl) hypoglycemia and significant hyperglycemia (PG > or = 300 mg/dl) were extracted from 18,000 simulated closed-loop nights. Severe hypoglycemia was not observed when FSN CE was less than 45%. Hypoglycemia and hyperglycemia incidence during open loop was assessed from 21 overnight studies in 17 young subjects with T1DM (8 males; 13

  1. Effect of a Protected Sleep Period on Hours Slept During Extended Overnight In-hospital Duty Hours Among Medical Interns

    PubMed Central

    Volpp, Kevin G.; Shea, Judy A.; Small, Dylan S.; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian; Novak, Cristina; Bellini, Lisa M.; Dine, C. Jessica; Mollicone, Daniel J.; Dinges, David F.

    2013-01-01

    Context A 2009 Institute of Medicine report recommended protected sleep periods for medicine trainees on extended overnight shifts, a position reinforced by new Accreditation Council for Graduate Medical Education requirements. Objective To evaluate the feasibility and consequences of protected sleep periods during extended duty. Design, Setting, and Participants Randomized controlled trial conducted at the Philadelphia VA Medical Center medical service and Oncology Unit of the Hospital of the University of Pennsylvania (2009–2010). Of the 106 interns and senior medical students who consented, 3 were not scheduled on any study rotations. Among the others, 44 worked at the VA center, 16 at the university hospital, and 43 at both. Intervention Twelve 4-week blocks were randomly assigned to either a standard intern schedule (extended duty overnight shifts of up to 30 hours; equivalent to 1200 overnight intern shifts at each site), or a protected sleep period (protected time from 12:30 AM to 5:30 AM with handover of work cell phone; equivalent to 1200 overnight intern shifts at each site). Participants were asked to wear wrist actigraphs and complete sleep diaries. Main Outcome Measures Primary outcome was hours slept during the protected period on extended duty overnight shifts. Secondary outcome measures included hours slept during a 24-hour period (noon to noon) by day of call cycle and Karolinska sleepiness scale. Results For 98.3% of on-call nights, cell phones were signed out as designed. At the VA center, participants with protected sleep had a mean 2.86 hours (95% CI, 2.57–3.10 hours) of sleep vs 1.98 hours (95% CI, 1.68–2.28 hours) among those who did not have protected hours of sleep (P < .001). At the university hospital, participants with protected sleep had a mean 3.04 hours (95% CI, 2.77–3.45 hours) of sleep vs 2.04 hours (95% CI, 1.79–2.24) among those who did not have protected sleep (P <.001). Participants with protected sleep were

  2. Overnight Closed-Loop Insulin Delivery with Model Predictive Control: Assessment of Hypoglycemia and Hyperglycemia Risk Using Simulation Studies

    PubMed Central

    Wilinska, Malgorzata E.; Budiman, Erwin S.; Taub, Marc B.; Elleri, Daniela; Allen, Janet M.; Acerini, Carlo L.; Dunger, David B.; Hovorka, Roman

    2009-01-01

    Background Hypoglycemia and hyperglycemia during closed-loop insulin delivery based on subcutaneous (SC) glucose sensing may arise due to (1) overdosing and underdosing of insulin by control algorithm and (2) difference between plasma glucose (PG) and sensor glucose, which may be transient (kinetics origin and sensor artifacts) or persistent (calibration error [CE]). Using in silico testing, we assessed hypoglycemia and hyperglycemia incidence during over-night closed loop. Additionally, a comparison was made against incidence observed experimentally during open-loop single-night in-clinic studies in young people with type 1 diabetes mellitus (T1DM) treated by continuous SC insulin infusion. Methods Simulation environment comprising 18 virtual subjects with T1DM was used to simulate overnight closed-loop study with a model predictive control (MPC) algorithm. A 15 h experiment started at 17:00 and ended at 08:00 the next day. Closed loop commenced at 21:00 and continued for 11 h. At 18:00, protocol included meal (50 g carbo-hydrates) accompanied by prandial insulin. The MPC algorithm advised on insulin infusion every 15 min. Sensor glucose was obtained by combining model-calculated noise-free interstitial glucose with experimentally derived tran-sient and persistent sensor artifacts associated with FreeStyle Navigator® (FSN). Transient artifacts were obtained from FSN sensor pairs worn by 58 subjects with T1DM over 194 nighttime periods. Persistent difference due to FSN CE was quantified from 585 FSN sensor insertions, yielding 1421 calibration sessions from 248 subjects with diabetes. Results Episodes of severe (PG ≤ 36 mg/dl) and significant (PG ≤ 45 mg/dl) hypoglycemia and significant hy-perglycemia (PG ≥ 300 mg/dl) were extracted from 18,000 simulated closed-loop nights. Severe hypoglycemia was not observed when FSN CE was less than 45%. Hypoglycemia and hyperglycemia incidence during open loop was assessed from 21 overnight studies in 17 young subjects

  3. Project FAST.

    ERIC Educational Resources Information Center

    Essexville-Hampton Public Schools, MI.

    Described are components of Project FAST (Functional Analysis Systems Training) a nationally validated project to provide more effective educational and support services to learning disordered children and their regular elementary classroom teachers. The program is seen to be based on a series of modules of delivery systems ranging from mainstream…

  4. Fast CRCs

    DTIC Science & Technology

    2009-10-01

    or any other computing topic, please visit our Digital Library at www.computer.org/publications/ dlib . NGUYEN: FAST CRCS 1331 Authorized licensed use... Library at http://doi.ieeecomputersociety.org/10.1109/ TC.2009.83. The notation ðk; l; dÞ denotes a systematic code with k ¼ the total bit length of

  5. Frailty Index and Its Relation to Falls and Overnight Hospitalizations in Elderly Chinese People: A Population-based Study.

    PubMed

    Liu, Z; Wang, Q; Zhi, T; Zhu, Y; Wang, Y; Wang, Z; Shi, J; Xie, X; Chu, X; Wang, X; Jiang, X

    2016-01-01

    To investigate current status of frailty index (FI) defined as deficit accumulation and its relations to falls and overnight hospitalizations in an elderly Chinese population. A cross-sectional cohort study. All of the 31 valiages in Jiang'an township, a typical medium-sized township in Rugao city, China. Overall 1773 participants aged 70-84 years were randomly recruited. A FI including symptoms, activities of daily living, co-morbidities, cognitive and psychological function was constructed using 45 health deficits. The mean of FI was 0.14 in men and 0.19 in women. According to a usual FI cut-point of 0.25, 8.2% of men and 23.2% of women were classified as frail. Literate participants had lower levels of FI than their illiterate counterpart. In men, the FI was positively related to age (r = 0.186, p<.001), with a mean rate of deficit accumulation of 0.032 (on a log scale) per year. Each increment of 0.01 on the FI was associated with significantly increased risks of falls and overnight hospitalizations, with odds ratios of 1.05 (95% CI: 1.03, 1.07) and 1.05 (95% CI: 1.03, 1.08). Similarly, the aforementioned associations were observed in women. Education level moderated the associations of FI with falls in men and women. Elderly Chinese women were more frail than men. The FI significantly increased with chronological age and was significantly associated with falls and overnight hospitalizations, and education level may play an important role. This study provides preliminary but crucial evidences for future researches on frailty in China.

  6. Overnight energy expenditure determined by whole-body indirect calorimetry does not differ during different sleep stages.

    PubMed

    Gonnissen, Hanne K J; Drummen, Mathijs; Rosique Esteban, Núria; Schoffelen, Paul F M; Westerterp-Plantenga, Margriet S

    2013-10-01

    Sleep has been associated with the regulation of energy balance, yet the relation between sleep stages and energy expenditure remains unclear. The objective was to investigate the relation between sleep stages and energy expenditure, with sleep stage and overnight energy expenditure patterns taken into account. Thirteen subjects aged (mean ± SD) 24.3 ± 2.5 y with a BMI (in kg/m(2)) of 23.6 ± 1.7 slept in a respiration chamber while sleep was polysomnographically recorded to determine wake after sleep onset (WASO), slow-wave sleep (SWS), and rapid eye movement (REM) sleep. Energy expenditure was calculated during each sleep stage for the whole night and separately for sleeping metabolic rate (SMR; ie, 3-h period during the night with the lowest mean energy expenditure) and non-SMR. Energy expenditure and sleep stages showed characteristic patterns during the night, independently of each other. Sleep stages exerted no effect on energy expenditure during the whole night, except for WASO compared with SWS (P < 0.05) and WASO compared with REM sleep (P < 0.05). During the SMR and non-SMR periods of the night, no overall effect of sleep stage on energy expenditure, except for WASO compared with SWS (P < 0.05) and WASO compared with REM sleep (P < 0.01) during the non-SMR period of the night, was found. Energy expenditure and activity counts during the night were positively correlated (r = 0.927, P < 0.001). Energy expenditure does not vary according to sleep stage overnight, except for higher energy expenditure during wake episodes than during SWS and REM sleep. Coincidence of the sleep stage pattern and the overnight energy expenditure pattern may have caused accidental relations in previous observations. This trial was registered at http://apps.who.int/trialsearch as NTR2926.

  7. Suspended insulin infusion during overnight closed-loop glucose control in children and adolescents with Type 1 diabetes.

    PubMed

    Elleri, D; Allen, J M; Nodale, M; Wilinska, M E; Acerini, C L; Dunger, D B; Hovorka, R

    2010-04-01

    We assessed an extended interruption of subcutaneous insulin delivery during overnight closed-loop glucose control in children and adolescents with Type 1 diabetes (T1D). In seven young subjects with T1D [age 14.2+/-2.1 years, diabetes duration 6.9+/-4.0 years, glycated haemoglobin (HbA1c) 8.0+/-1.5%, body mass index (BMI) 21.4+/-4.0 kg/m2, total daily insulin dose 0.9+/-0.2 units/kg/day; mean+/-sd) participating in overnight closed-loop glucose control studies, insulin delivery was interrupted for at least 90 min on the basis of predicted hypoglycaemia, low prevailing glucose levels or a too-steep decline in glucose levels. Insulin delivery was interrupted for 165 (105, 210) min [median, interquartile range (IQR)]. Plasma glucose was 6.2+/-3.2 mmol/l at the time of interruption and 5.5+/-2.0 mmol/l 105 min later (P=0.15, paired t-test). Plasma glucose declined during the first hour of the interruption at a rate of 0.02+/-0.03 mmol/l per min and reached a nadir of 5.2+/-2.7 mmol/l; 105 min after the interruption, plasma glucose was increasing at a rate of 0.01+/-0.03 mmol/l per min. When insulin delivery restarted, plasma glucose was 6.4+/-2.2 mmol/l and peaked at 7.9+/-2.1 mmol/l in 60 min (P=0.01). Physiological levels of plasma insulin were measured throughout with a nadir of 119+/-78 pmol/l. A prolonged interruption of insulin delivery during overnight closed-loop glucose control to prevent hypoglycaemia was not associated with an increased risk of hyperglycaemia in young people with T1D.

  8. Misoprostol 1 to 3 h preprocedure vs. overnight osmotic dilators prior to early second-trimester surgical abortion.

    PubMed

    Ramesh, Shanthi; Roston, Alicia; Zimmerman, Lindsay; Patel, Ashlesha; Lichtenberg, E Steve; Chor, Julie

    2015-09-01

    We sought to compare the effectiveness of at least 1 h of 400 mcg of buccal misoprostol to overnight osmotic dilators for early second-trimester surgical abortion cervical preparation. We conducted a retrospective cohort study, reviewing 145 consecutive charts to compare procedure duration for women who received 400 mcg of buccal misoprostol at least 1 h preprocedure vs. overnight osmotic dilators before dilation and evacuation between 14 weeks, 0 days and 15 weeks, 6 days' gestation. Primary outcome was procedure duration and secondary outcomes included maximum mechanical dilator size, estimated blood loss and side effects. Sixty-four women (44.1%) received buccal misoprostol (mean 1.6 h), and 81 women (55.9%) received overnight osmotic dilators. Groups did not differ regarding mean gestational age or gynecologic history. All procedures in both groups were completed. Procedure duration was not significantly different between the misoprostol and osmotic dilator groups (median 11.0 min vs. 10.0 min, p=.22), even after multivariable linear regression (p=.17). The mean total cervical preparation duration was 1.6 h for women in the misoprostol group compared to 20.3 h in the osmotic dilator group (p<.001). Secondary outcomes did not differ between groups. We found that at least 1 h of preprocedure misoprostol decreased the duration of cervical preparation for early second-trimester procedures performed by an experienced surgeon. In this small, retrospective review, at least 1 h of preprocedure buccal misoprostol decreased the duration from cervical preparation initiation to procedure completion in early second-trimester procedures performed by an experienced surgeon. These results should be considered as a pilot evaluation, and further prospective study is needed to further clarify whether this short interval could be applied in general practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Overnight Polysomnography versus Respiratory Polygraphy in the Diagnosis of Pediatric Obstructive Sleep Apnea

    PubMed Central

    Tan, Hui-Leng; Gozal, David; Ramirez, Helena Molero; Bandla, Hari P. R.; Kheirandish-Gozal, Leila

    2014-01-01

    ) when they should have received a trial of anti-inflammatory therapy or been referred for ear, nose, and throat (ENT) review. Sixty percent of patients in group C would have received either a trial of medical treatment to treat mild OSA or no treatment, instead of referral to ENT services or commencement of continuous positive airway pressure. Conclusion: Apnea-hypopnea index (AHI) is underestimated in respiratory polygraphy (RP), and the disparity in AHI-RP and AHI-polysomnography can significantly affect clinical management decisions, particularly in children with mild and moderate obstructive sleep apnea (1 < AHI < 10/h total sleep time). Citation: Tan HL; Gozal D; Ramirez HM; Bandla HPR; Kheirandish-Gozal L. Overnight polysomnography versus respiratory polygraphy in the diagnosis of pediatric obstructive sleep apnea. SLEEP 2014;37(2):255-260. PMID:24497654

  10. Protein Ingestion before Sleep Increases Overnight Muscle Protein Synthesis Rates in Healthy Older Men: A Randomized Controlled Trial.

    PubMed

    Kouw, Imre Wk; Holwerda, Andrew M; Trommelen, Jorn; Kramer, Irene Fleur; Bastiaanse, Jacqueline; Halson, Shona L; Wodzig, Will Kwh; Verdijk, Lex B; van Loon, Luc Jc

    2017-08-30

    Background: The loss of skeletal muscle mass with aging has been attributed to the blunted anabolic response to protein intake. Presleep protein ingestion has been suggested as an effective strategy to compensate for such anabolic resistance.Objective: We assessed the efficacy of presleep protein ingestion on dietary protein digestion and absorption kinetics and overnight muscle protein synthesis rates in older men.Methods: In a randomized, double-blind, parallel design, 48 older men (mean ± SEM age: 72 ± 1 y) ingested 40 g casein (PRO40), 20 g casein (PRO20), 20 g casein plus 1.5 g leucine (PRO20+LEU), or a placebo before sleep. Ingestion of intrinsically l-[1-(13)C]-phenylalanine- and l-[1-(13)C]-leucine-labeled protein was combined with intravenous l-[ring-(2)H5]-phenylalanine and l-[1-(13)C]-leucine infusions during sleep. Muscle and blood samples were collected throughout overnight sleep.Results: Exogenous phenylalanine appearance rates increased after protein ingestion, but to a greater extent in PRO40 than in PRO20 and PRO20+LEU (P < 0.05). Overnight myofibrillar protein synthesis rates (based on l-[ring-(2)H5]-phenylalanine) were 0.033% ± 0.002%/h, 0.037% ± 0.003%/h, 0.039% ± 0.002%/h, and 0.044% ± 0.003%/h in placebo, PRO20, PRO20+LEU, and PRO40, respectively, and were higher in PRO40 than in placebo (P = 0.02). Observations were similar based on l-[1-(13)C]-leucine tracer (placebo: 0.047% ± 0.004%/h and PRO40: 0.058% ± 0.003%/h, P = 0.08). More protein-derived amino acids (l-[1-(13)C]-phenylalanine) were incorporated into myofibrillar protein in PRO40 than in PRO20 (0.033 ± 0.002 and 0.019 ± 0.002 MPE, respectively, P < 0.001) and tended to be higher than in PRO20+LEU (0.025 ± 0.002 MPE, P = 0.06).Conclusions: Protein ingested before sleep is properly digested and absorbed throughout the night, providing precursors for myofibrillar protein synthesis during sleep in healthy older men. Ingestion of 40 g protein before sleep increases myofibrillar

  11. Pre-sleep dietary protein-derived amino acids are incorporated in myofibrillar protein during post-exercise overnight recovery.

    PubMed

    Trommelen, Jorn; Kouw, Imre W K; Holwerda, Andrew M; Snijders, Tim; Halson, Shona L; Rollo, Ian; Verdijk, Lex B; van Loon, Luc J C

    2017-05-23

    The purpose of this study was to determine the impact of ingesting 30 g casein protein with and without 2 g free leucine prior to sleep on myofibrillar protein synthesis rates during post-exercise overnight recovery. 36 healthy young males performed a single bout of resistance-type exercise in the evening (19:45 h) after a full day of dietary standardization. Thirty min prior to sleep (23:30 h), subjects ingested 30 g intrinsically L-[1-(13)C]-phenylalanine-labeled protein with (PRO+leu, n=12) or without (PRO, n=12) 2 g free leucine, or a noncaloric placebo (PLA, n=12). Continuous intravenous L-[ring-(2)H5]-phenylalanine, L-[1-(13)C]-leucine and L-[ring-(2)H2]-tyrosine infusions were applied. Blood and muscle tissue samples were collected to assess whole-body protein net balance, myofibrillar protein synthesis rates and overnight incorporation of dietary protein-derived amino acids into myofibrillar protein. Protein ingestion prior to sleep improved overnight whole-body protein net balance (P<0.001). Myofibrillar protein synthesis rates did not differ significantly between treatments as assessed by L-[ring-(2)H5]-phenylalanine (0.057±0.002, 0.055±0.002, and 0.055±0.004 %∙h(-1) for PLA, PRO, and PRO+leu, respectively; P=0.850) or L-[1-(13)C]-leucine (0.080±0.004, 0.073±0.004, and 0.083±0.006 %∙h-1, respectively; P=0.328). Myofibrillar L-[1-(13)C]-phenylalanine enrichments increased following protein ingestion, but did not differ between the PRO and PRO+leu treatments. In conclusion, protein ingestion prior to sleep improves whole-body protein net balance and provides amino acids that are incorporated into myofibrillar protein during sleep. However, the ingestion of 30 g casein protein with or without additional free leucine prior to sleep does not increase muscle protein synthesis rates during post-exercise overnight recovery. Copyright © 2016, American Journal of Physiology-Endocrinology and Metabolism.

  12. Effect of fasting on serum lithium levels: an experimental study in animal models.

    PubMed

    Ahmed, Zia; Subhan, Fazal; Shah, Muhammad Tahir; Farooq, Saeed

    2014-01-01

    Muslims throughout the world observe dawn to dusk fast in the month of Holy Ramadan. This study aims to investigate the effect of fasting on serum lithium levels in an animal model under typical conditions of Ramadan. Animals were categorized into oral and intraperitoneal groups. Each group was divided into fasting and non fasting groups along with their controls having six animals each. Mean serum lithium levels of non-fasting and fasting rats were assessed. Mean serum lithium levels of oral non-fasting rats was 0.23±0.004 mequiv/L, (n=6) compared to oral fasting rats 0.20+0.002 mequiv/L, (n=6) mean difference=0.003. The mean difference between mean serum lithium level of intraperitoneal non fasting (0.246±0.015 mequiv/L, n = 6) and intraperitoneal fasting rats (0.206±0.020 mequiv/L, n = 6) was 0.02. These differences were statistically non significant (P>0.05). The mean serum lithium is not grossly affected by fasting in rats under 25ºC and fasting for almost 12 hours which is consistent with a previous clinical study. Lithium can be used by fasting bipolar patients but, will require careful supervision.

  13. Characterization of blood components separated from donated whole blood after an overnight holding at room temperature with the buffy coat method.

    PubMed

    Lu, Fa Qiang; Kang, Wei; Peng, Yu; Wang, Wei Ming

    2011-10-01

    With buffy coat (BC) processing of whole blood (WB) donations, increase in WB storage time to facilitate overnight holding before the separation of blood components would be a logistically attractive development. This study undertakes a comparative in vitro characterization of blood components prepared from WB samples that were either processed within 8 hours or stored overnight at room temperature before processing by the BC method. The WB units (400 mL) collected were either processed within 8 hours (fresh blood) or stored overnight (overnight blood) at room temperature. WB units were separated into individual-component red blood cells (RBCs), BC, and plasma. The in vitro quality of these blood components (RBCs, pooled platelet concentrates [PCs], and plasma) was analyzed during storage. Levels of 2,3-diphosphoglycerate (2,3-DPG) were found to be significantly lower immediately after processing, compared with the fresh WB samples, in RBCs that had been separated from an overnight-hold sample. However, this difference was not apparent after 14 days of storage. In pooled PCs, measurements for glucose, lactate, PO(2), PCO(2), extent of shape change, and hypotonic shock response were similar. The platelet yield in PCs prepared from an overnight-hold WB sample was significantly higher, while CD62P expression and annexin V binding were lower (p < 0.05). For frozen plasma (FP), no significant differences were observed for the coagulation factors (F)II, FVII, FV, F IX, FX, and FXI; fibrinogen; and von Willebrand factor content between the 8- and 24-hour FP. The FVIII was the component that was most sensitive to the prolongation of production time and it only had 80% of the activity of the 8-hour FP. These data suggest that blood components (RBCs, pooled PCs, and FP) separated from WB that has been stored overnight at room temperature by the BC method are of acceptable quality. © 2011 American Association of Blood Banks.

  14. Randomized clinical trial of multimodal physiotherapy treatment compared to overnight lidocaine ointment in women with provoked vestibulodynia: Design and methods.

    PubMed

    Morin, Mélanie; Dumoulin, Chantale; Bergeron, Sophie; Mayrand, Marie-Hélène; Khalifé, Samir; Waddell, Guy; Dubois, Marie-France

    2016-01-01

    Provoked vestibulodynia (PVD) is a highly prevalent and debilitating condition yet its management relies mainly on non-empirically validated interventions. Among the many causes of PVD, there is growing evidence that pelvic floor muscle (PFM) dysfunctions play an important role in its pathophysiology. Multimodal physiotherapy, which addresses these dysfunctions, is judged by experts to be highly effective and is recommended as a first-line treatment. However, the effectiveness of this promising intervention has been evaluated through only two small uncontrolled trials. The proposed bi-center, single-blind, parallel group, randomized controlled trial (RCT) aims to evaluate the efficacy of multimodal physiotherapy and compare it to a frequently used first-line treatment, topical overnight application of lidocaine, in women with PVD. A total of 212 women diagnosed with PVD according to a standardized protocol were eligible for the study and were randomly assigned to either multimodal physiotherapy or lidocaine treatment for 10weeks. The primary outcome measure is pain during intercourse (assessed with a numerical rating scale). Secondary measures include sexual function, pain quality, psychological factors (including pain catastrophizing, anxiety, depression and fear of pain), PFM morphology and function, and patients' global impression of change. Assessments are made at baseline, post-treatment and at the 6-month follow-up. This manuscript presents and discusses the rationale, design and methodology of the first RCT investigating physiotherapy in comparison to a commonly prescribed first-line treatment, overnight topical lidocaine, for women with PVD.

  15. Replacing tracheostomy with overnight intubation to manage the airway in head and neck oncology patients: towards an improved recovery.

    PubMed

    Coyle, Margaret J; Tyrrell, Robert; Godden, Andrew; Hughes, Ceri W; Perkins, Charles; Thomas, Steve; Godden, Daryl

    2013-09-01

    In maxillofacial head and neck oncology, tracheostomy is often used to secure the airway, but not without risk. This study compared the existing practice of two units: one where tracheostomy was routinely done with one where overnight intubation was used. From both units we retrospectively analysed 50 consecutive patients who had intraoral resection, neck dissection, and microvascular reconstruction for head and neck cancer. When compared with tracheostomy, overnight intubation resulted in a shorter mean stay in the intensive therapy unit (ITU) (1.4 compared with 3.7 days), a shorter overall hospital stay (12.9 compared with 18.0 days), less time to first oral intake (8.9 compared with 12.8 days), and a lower rate of lower respiratory tract infection (LRTI) (10% compared with 38%). This study supports the discontinuation of routine tracheostomy and the adoption of a more selective practice to improve recovery. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Embolized Stems Recover Overnight in Zea mays: The Role of Soil Water, Root Pressure, and Nighttime Transpiration

    PubMed Central

    Gleason, Sean M.; Wiggans, Dustin R.; Bliss, Clayton A.; Young, Jason S.; Cooper, Mitchell; Willi, Katie R.; Comas, Louise H.

    2017-01-01

    It is not currently well-understood how much xylem conductance is lost in maize plants during the day, if conductance is recovered during the night, or what soil water conditions are required for recovery to take place. To answer these questions we designed a greenhouse experiment whereby two genetically dissimilar maize genotypes were subjected to a level of water stress commonly experienced in the field (Ψxylem ∼-2 MPa). We then measured the loss of stem-specific conductivity associated with this level of stress, as well as the overnight recovery following three re-watering treatments: Ψsoil ∼ 0 MPa, Ψsoil ∼-0.40 MPa, and Ψsoil ∼-1.70 MPa. Mid-day leaf water potentials of -1.98 MPa resulted in stem-specific conductivity (KS) values that were 31.5% of maximal (i.e., 68% loss). Returning soils to field capacity (Ψsoil ∼ 0 MPa) overnight allowed for the significant recovery of KS (76% of maximal), whereas partial watering (Ψsoil ∼-0.40 MPa) resulted KS values that were 51.7% of maximal values, whereas not watering resulted in no recovery (35.4% of maximal; Ψsoil ∼-1.7 MPa). Recovery of KS was facilitated by the generation of root pressure and low rates of nighttime transpiration. PMID:28503183

  17. A randomized controlled trial: the efficacy of eluoride rinse combined with calcium pre-rinse to increase overnight salivary fluoride.

    PubMed

    Chen, Margaret Sällberg; Strömberg, Elin; Vogel, Gerald Lee; Sandborgh-Englund, Gunilla

    2014-10-01

    Previous studies have shown that a calcium (Ca) pre-rinse given before a 228 ppm fluoride (F) rinse greatly increased salivary fluoride. Objectives. The aim of this randomized controlled trial is to examine if Ca pre-rinse could increase the fluoride concentration in the overnight unstimulated saliva after a 905 ppm F-rinse. Pre-rinses containing 150 mM, 75 mM or 0 mM Ca-lactate prepared by a validated pharmaceutical cGPM procedure were tested by nine subjects in a randomized order immediately followed by a 905 ppm F-rinse. The fluoride concentration was measured in unstimulated saliva collected 10 h later. The Ca pre-treatment significantly increased F level in overnight saliva following the 905 ppm fluoride rinse by 1.7× relative to the 905 ppm F-rinse alone; however, a significant effect was only observed with the highest (150 mM) Ca concentration as pre-rinse. Clinical relevance. High concentration F rinses (905 ppm) are commonly recommended for patients at high-risk of caries. A pre-treatment with high levels of Ca may further improve the cariostatic effect of this ion.

  18. Fasting breath hydrogen concentration: normal values and clinical application.

    PubMed

    Perman, J A; Modler, S; Barr, R G; Rosenthal, P

    1984-12-01

    Excretion of hydrogen in breath commonly persists despite an overnight fast. Although elevation of hydrogen concentration above the fasting value after administration of a test sugar is evidence of malabsorption, the significance of the fasting value itself is unknown. We determined the normal limits of fasting breath hydrogen in healthy children and adults, and in patients with chronic diarrhea or recurrent abdominal pain. Fasting breath hydrogen in 221 healthy children and 9 healthy adults averaged 7.1 +/- 5.0 parts per million (mean +/- SD), exceeding 30 parts per million in less than 1%. No value exceed 42 parts per million. In 73 patients with recurrent abdominal pain and 76 patients with chronic diarrhea, fasting breath hydrogen was less than 42 parts per million in 97% and 83%, respectively. History and laboratory data were reviewed in the 15 patients where fasting breath hydrogen exceeded 42 parts per million. Seven had documented small bowel bacterial overgrowth and an additional 3 patients had radiographic evidence of intestinal stasis. Using test dinner meals, we prospectively evaluated the effect of previously ingested foods containing complex carbohydrates on fasting breath hydrogen. Dinner meals consisting of rice, wheat, or beans influenced fasting breath hydrogen values, but did not result in elevated fasting breath hydrogen in healthy individuals. Rice bread resulted in uniformly low fasting breath hydrogen values in healthy subjects (2.0 +/- 2.5 parts per million), but fasting breath hydrogen remained elevated in patients with bacterial overgrowth. Our studies indicate that conditions for measurement of the fasting breath hydrogen value may be standardized to improve discrimination between normal and abnormal values.

  19. Fasting Decreases the Content of D-Chiroinositol in Human Skeletal Muscle

    PubMed Central

    Shashkin, Pavel N.; Huang, Laura C.; Larner, Joseph; Vandenhoff, George E.

    2002-01-01

    Two classes of inositol phosphoglycans have been implicated as second messengers of insulin, one that activates pyruvate dehydrogenase and contains D-chiroinositol, and one that inhibits cyclic AMP–dependent protein kinase and contains myoinositol. We examined the effects of a 3-day fast on muscle contents of inositols in healthy humans. An oral glucose tolerance test was performed and a biopsy was obtained from the quadriceps femoris muscle after an overnight fast and after a 72-hour fast. The 72-hour fast significantly increased plasma glucose (1.5- to 2-fold) and insulin (2- to 4-fold) after glucose ingestion versus the values after the overnight fast, indicating the manifestation of peripheral insulin resistance. The 72-hour fast resulted in an ∼20% decrease in the muscle content of D-chiroinositol (P < 0.02), but no change in the myoinositol content. These data demonstrate that fasting specifically decreases the muscle content of D-chiroinositol in human muscle and this may contribute to the finding that insulin-mediated activation of pyruvate dehydrogenase is attenuated after short-term starvation. PMID:12458657

  20. Effects of overnight sleep restriction on brain chemistry and mood in women with unipolar depression and healthy controls

    PubMed Central

    Bernier, Denise; Bartha, Robert; Devarajan, Sivakumaran; MacMaster, Frank P.; Schmidt, Matthias H.; Rusak, Benjamin

    2009-01-01

    Background Partial or total overnight sleep deprivation produces immediate mood improvement in about 50% of patients with depression, but not in healthy controls. Our objectives were to compare the neurochemical changes that accompanied partial overnight sleep deprivation in healthy and depressed participants, and to compare baseline neurochemical profiles and overnight neurochemical changes between those depressed participants who did and did not respond to sleep loss with mood improvement. Methods We studied 2 brain regions (left dorsal prefrontal area and pons) in 12 women with unipolar depression and in 15 healthy women using proton magnetic resonance spectroscopy acquired at 1.5 T. The scans took place at baseline and 24 hours later after a night with sleep restricted to a maximum of 2.5 hours (22:30–01:00). We assessed 3 neurochemical signals (referenced to internal water): N-acetylaspartate (NAA), choline compounds (Cho) and creatine-plus-phosphocreatine (tCr). Results In both groups combined, sleep restriction caused a 20.1% decrease in pontine tCr (F1–16 = 5.07, p = 0.039, Cohen’s d = 0.54) and an 11.3% increase in prefrontal Cho (F1–21 = 5.24, p = 0.033, Cohen’s d = 0.46). Follow-up tests revealed that prefrontal Cho increases were significant only among depressed participants (17.9% increase, t9 = −3.35, p = 0.008, Cohen’s d = 1.06). Five depressed patients showed at least 30% improvement in mood, whereas 6 showed no change or worsening in mood after sleep restriction. Baseline pontine Cho levels distinguished subsequent responders from nonresponders to sleep restriction among depressed participants (z = 2.61, p = 0.008). Limitations A limitation of this study is the relatively small sample size. Conclusion Sleep restriction altered levels of pontine tCr and prefrontal Cho in both groups combined, suggesting effects on phospholipid and creatine metabolism. Baseline levels of pontine Cho were linked to subsequent mood responses to sleep loss

  1. Critical re-appraisal of blood component quality after overnight hold of whole blood outside current room temperature limits.

    PubMed

    Bontekoe, I J; van der Meer, P F; de Korte, D

    2017-02-01

    According to European guidelines, the temperature of whole blood (WB) has to be maintained at 20-24°C until processing within 24 h, but in blood bank practice, WB is frequently held at temperatures between 18-25°C. We aimed to assess the impact of these small temperature deviations on the quality of the blood components. After rapid cooling, 7 WB units were held overnight at 18°C and 8 units at 25°C, reflecting worst case holding conditions, and separated into a red cell concentrate (RCC), plasma and buffy coat (BC). RCCs were filtered at test temperature and stored for 42 days at 2-6°C. BCs were processed to single-BC platelet concentrates (sPC) and stored up to Day 8 at 20-24°C. After overnight hold at 18°C, 2,3-DPG in WB decreased by 34 ± 9%, while at 25°C the decrease was 82 ± 6%. Accordingly, the 2,3-DPG levels in the RCCs in the 25°C group were significantly lower than in the 18°C group (2·2 ± 1·4 vs. 10·4 ± 2·9 μmol/g Hb). RCCs and sPCs in the 25°C group showed higher initial lactate levels and lower pH compared to the 18°C group, but these differences levelled off at the end of storage. RCCs showed small differences in ATP levels and haemolysis. Plasma in both groups showed comparable Factor VIII:C levels. The temperature of WB during overnight hold strongly affects initial 2,3-DPG levels of RCCs and supports the maintenance of temperature limits between 20 and 24°C. Other in vitro effects of the temperature deviations were small and of no practical relevance. © 2016 International Society of Blood Transfusion.

  2. Overnight resident interpretation of torso CT at a level 1 trauma center an analysis and review of the literature.

    PubMed

    Chung, Jonathan H; Strigel, Roberta M; Chew, Annemarie Relyea; Albrecht, Emily; Gunn, Martin L

    2009-09-01

    At the authors' level 1 trauma center, postgraduate year 3 and 4 radiology residents interpret urgent overnight imaging studies, which are reviewed by attending radiologists the next morning. The goals of this study were to determine the discrepancy rate for torso computed tomography between resident radiologists' preliminary interpretations and attending radiologists' final interpretations and to identify adverse patient events secondary to the delayed diagnoses. All torso computed tomographic studies interpreted by weekday night residents (8 pm to 8 am) from January 1, 2005, to March 13, 2007, were evaluated retrospectively. Major discrepancies between the residents' interpretations and the attending radiologists' interpretations were compiled. Exams with major discrepancies were additionally reviewed by two radiology residents and an attending emergency radiologist. The medical records of patients with major discrepant findings were also reviewed to identify adverse events that occurred because of the delays in final interpretation. A total of 4768 chest, abdominal, and/or pelvic computed tomographic studies were interpreted during the study period. A total of 112 major discrepancies were collected. In 17 cases (15%), two additional radiology residents and an attending emergency radiologist agreed with the initial residents' interpretations, decreasing the major discrepancy rate to 95 of 4768 (2.0%), consistent with data from the literature (0.4%-10%). Management was changed in 16 patients (0.3%) because of the major discrepancies: 13 patients underwent additional investigations, and 3 patients were recalled to the emergency room. No mortality or morbidity was directly attributed to the delays in diagnosis. At the authors' institution, there was a 2.0% discrepancy rate between residents' preliminary interpretations and attending radiologists' final interpretations of overnight torso computed tomography, with a small rate of additional intervention as a result of

  3. Prolonged fasting of children before anaesthesia is common in private practice.

    PubMed

    Buller, Y; Sims, C

    2016-01-01

    Fasting guidelines for children are well established. Despite these guidelines, previous studies have shown children are often fasted for prolonged periods before anaesthesia, potentially causing discomfort and distress. Moreover, recent publications indicate shorter fasting times for oral clear fluids in children may be safe. We audited fasting times of children having elective surgery at a local large private hospital that provides care for both adults and children. We gave feedback and education to our caregivers, then repeated the audit. Data were collected from 307 children (age 6.0 ± 4.1 years) in an initial eight-week audit, and from 153 children (age 6.7 ± 4.5 years) in a follow-up four-week audit. We found fasting durations were excessive in many children. Sixty-two percent of children in each audit fasted longer than four hours for clear fluids. Children on morning lists fasted longer than children on afternoon lists. Fasting from solids was also excessively long. In the initial audit, 30% fasted more than 12 hours for solids, including 18 who last ate more than 16 hours before surgery. Data from the follow-up audit were similar. We conclude that fasting of children at our hospital is excessive, despite our efforts to shorten the duration. We suspect that our hospital is not the only one with a high incidence of prolonged fasting for children and suggest possible solutions.

  4. How Protective Mechanisms Interact to Prevent Overnight Calcium Phosphate Precipitation - An Observational Study to Determine Factors Against Calcium Phosphate Lithogenesis in a Healthy Cohort.

    PubMed

    Shafiee, Mohammad A; Logan, Alexander G; Halperin, Mitchell L

    2016-01-01

    As restful, non-interrupted sleep is essential for normal mental and physical functioning, the urine flow rate (UFR) overnight remains low. Due to this reduced UFR, the kidneys produce a lower urine volume, which may lead to supersaturation of lithogens in the renal collecting system. The protective mechanisms that prevent the rise in the concentration of the lithogenic substances in urine, such as calcium phosphate, are explored. Urine samples were collected from 26 subjects every 2-3 h during daylight with one nocturnal collection; the UFR was calculated in the median time for each collection period. Urinary constituents for calcium phosphate precipitation including electrolytes, calcium, phosphate, citrate, and pH were measured. Comparisons within individuals were done by paired t test. The calcium excretion rate fell significantly overnight (from 2.4 ± 0.2 µmol/min during the daytime to 1.5 ± 0.3 µmol/min, p < 0.05), in parallel with sodium excretion (54 ± 16 µmol/min from its daytime 127 ± 12 µmol/min, p < 0.05), preventing nocturnal calcium concentration from increasing (3.0 ± 0.3 mmol/l daytime to 2.5 ± 0.5 mmol/l overnight), while citrate concentration did not change significantly. The total urine phosphate concentration rose significantly overnight (daytime 18.7 ± 1.4 µmol/min vs. nocturnal 20.9 ± 1.7 µmol/min), but the concentration of divalent phosphate did not increase in the overnight period. Although the UFR was lower overnight, there was no evidence that the risk of calcium phosphate precipitate formation in healthy subjects was increased. © 2016 S. Karger AG, Basel.

  5. Same-day synthetic osmotic dilators compared with overnight laminaria before abortion at 14-18 weeks of gestation: a randomized controlled trial.

    PubMed

    Newmann, Sara J; Sokoloff, Abby; Tharyil, Mithu; Illangasekare, Tushani; Steinauer, Jody E; Drey, Eleanor A

    2014-02-01

    To increase access to early second-trimester surgical abortion by determining noninferiority of same-day synthetic osmotic dilators compared with overnight Laminaria for cervical preparation before early second-trimester dilation and evacuation. We enrolled women between 14 and 18 weeks of gestation and randomized them to same-day synthetic osmotic dilators or overnight Laminaria. Study participants and clinicians were blinded to group assignment. The primary outcome was procedure duration. The trial was powered to assess noninferiority of synthetic osmotic dilators to exclude a mean difference of 5 minutes or longer. We enrolled 72 patients: 36 were randomized to same-day synthetic osmotic dilators and 36 to overnight Laminaria. Mean procedure duration was 8.1 and 5.9 minutes, respectively, with a mean difference of 2.1 minutes (97.5% confidence interval -0.3 to 4.5). Same-day synthetic osmotic dilators resulted in less initial cervical dilation than overnight Laminaria (mean circumference 48 compared with 60 mm Pratt, P<.001) and required more mechanical dilation (69% compared with 27%, P=.001). There was no difference in complications, all of which were minor, or in the median procedural difficulty score rated by physicians. Most patients in both groups would choose a same-day procedure if necessary in the future. Despite less initial cervical dilation and a greater need for mechanical dilation, same-day synthetic osmotic dilators are not inferior to overnight Laminaria with respect to procedure duration. Same-day osmotic dilation is preferred by patients and may be a reasonable alternative to overnight Laminaria for cervical preparation before early second-trimester dilation and evacuation. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00775983. I.

  6. Evaluation of the overnight hold of whole blood at room temperature, before component processing: platelets (PLTs) from PLT-rich plasma.

    PubMed

    van der Meer, Pieter F; Cancelas, Jose A; Vassallo, Ralph R; Rugg, Neeta; Einarson, Mindy; Hess, John R

    2011-01-01

    Whole blood (WB) must be refrigerated within 8 hours to optimize Factor VIII: C yield, but chilled platelets (PLTs) are rapidly removed from circulation and cannot be used clinically. It is logistically preferable to hold WB overnight at room temperature for next-day processing. We compared in vitro quality of PLT-rich plasma (PRP)-derived PLT concentrates (PCs) from fresh versus overnight-held WB. Four units of WB were pooled and split to prevent donor-dependent differences. One unit was processed immediately; three others were held at room temperature and processed after 24 to 26 hours. After soft-spin centrifugation, PRP was separated from the red blood cells. PRP was hard-spun to make PLT-poor plasma, and the PLTs were resuspended in approximately 60 mL of plasma and stored for 7 days (n = 8 paired experiments by two blood centers). After overnight hold, the PLT concentration was 1.37 × 10(9) ± 0.19 × 10(9) /mL versus 1.03 × 10(9) ± 0.32 × 10(9) /mL for freshly prepared PCs (p < 0.05). pH and glucose were significantly lower and lactate higher for overnight-held units on Day 1, but by Day 5, the differences had disappeared. Hypotonic shock response was initially better, 73 ± 14% for overnight-held versus 53 ± 12% for freshly processed (p < 0.001), but this difference also disappeared during storage. Activation marker CD62P was not different. In vitro storage conditions produce immediate differences after preparation, which disappear throughout storage. PCs from overnight-held WB have similar in vitro variables as from freshly processed WB. These findings warrant confirmation in clinical trials, but underscore the possibility of use of these PCs as being equivalent to those obtained from freshly processed WB. © 2010 American Association of Blood Banks.

  7. Feasibility study of automated overnight closed-loop glucose control under MD-logic artificial pancreas in patients with type 1 diabetes: the DREAM Project.

    PubMed

    Nimri, Revital; Atlas, Eran; Ajzensztejn, Michal; Miller, Shahar; Oron, Tal; Phillip, Moshe

    2012-08-01

    Artificial pancreas systems may offer a potential major impact on the normalization of metabolic control and preventing hypoglycemic events. This study aims to establish near-normal overnight glucose control and reduce the risk of nocturnal hypoglycemia using the MD-Logic Artificial Pancreas (MDLAP), an algorithm that was developed by our research group. This inpatient feasibility study is the first step towards implementing an overnight closed-loop MDLAP system at the patient's home. Seven patients with type 1 diabetes (three adolescents and four adults; mean±SD age, 20.6±4.7 years; duration of diabetes, 9.6±2.6 years; body mass index, 24.3±3.9 kg/m(2); and glycated hemoglobin, 7.8±0.8%) participated in a total of 14 closed-loop overnight sessions. Each participant underwent two closed-loop inpatient sessions starting at dinner alone and at dinner following exercise. The closed-loop inpatient sessions were compared with data derived from nights spent at home with an open-loop system in a similar scenario to the study protocol. The mean percentage of time spent in the near normal glucose range of 63-140 mg/dL was 83±16%, and the median (interquartile range) was 85% (78-92%) for the overnight closed-loop sessions compared with 34±31% and 27% (6-57%) in the homecare open-loop setting, respectively. During the overnight closed-loop sessions at dinner alone 92±9% of the sensor values ranged within target range, compared with 73±19% for the sessions following exercise (P=0.03). No hypoglycemic (<63 mg/dL) events occurred during the closed-loop sessions. Closed-loop insulin delivery under MDLAP is a feasible and safe solution to control overnight glycemia.

  8. Effects of early and late rest breaks during training on overnight memory consolidation of a keyboard melody.

    PubMed

    Duke, Robert A; Allen, Sarah E; Cash, Carla D; Simmons, Amy L

    2009-07-01

    In two experiments, we tested the extent to which overnight procedural memory consolidation is affected by extended rest breaks during training. In the first experiment, nonmusicians practiced a 5-element keypress sequence with their nondominant hand in 12 30-s practice intervals separated by 30-s pauses. In the second experiment, nonpianist musicians practiced a 13-note keyboard melody using the same procedures. In both experiments, approximately one-third of the subjects took a 5-min break after the first three blocks of practice; another third took a break after nine blocks of practice; the remaining participants did not take an extended break. All were trained in the evening and were retested the following morning. Participants in both experiments made dramatic improvements over the course of the training and retest sessions, and participants who took an extended rest break early in practice made the largest gains in performance between the end of training and the beginning of retest.

  9. The effect of microgravity on the fragrance of a miniature rose, ``Overnight Scentsation™'' on Space Shuttle (STS-95)

    NASA Astrophysics Data System (ADS)

    Mookherjee, Braja D.; Patel, Subha; Zhou, Weijia

    2000-01-01

    To evaluate the effects of microgravity on the production of aroma constituents, the OVERNIGHT SCENTSATION™ rose plant with both an unopened bud and a half bloom was sent into the space aboard NASA space shuttle STS-95 for 9 days, from October 29 through November 6, 1998. While the flower was blooming in space, it was analyzed over four consecutive days using IFF's proprietary Solid Phase Micro Extraction (SPME) method. After returning to Earth on November 6, the information collected in space was analyzed and compared with the data collected from the same type of rose plant on the ground. The comparative results of the space rose and the Earth rose showed a drastic difference in their fragrance molecules. .

  10. K-band Doppler radar for contact-less overnight sleep marker assessment: a pilot validation study.

    PubMed

    Vasireddy, Rakesh; Roth, Corinne; Mathis, Johannes; Goette, Josef; Jacomet, Marcel; Vogt, Andreas

    2017-09-11

    An estimated 45 million persons in Europe are annually subjected to sleep-wake disorders. State-of-the-art polysomnography provides sophisticated insights into sleep (patho)physiology. A drawback of the method, however, is the obtrusive setting dependent on a clinical-based sleep laboratory with high operational costs. A contact-less prototype was developed to monitor limb movements and vital signs during sleep. A dual channel K-band Doppler radar transceiver captured limb movements and periodic chest wall motion due to respiration and heart activity. A wavelet transform based multi-resolution analysis (MRA) approach isolated limb movements, respiration, and heart rate from the demodulated signal. A test bench setup characterized the prototype simulating near physiological chest wall motions caused by periodic respiration and heartbeats in humans. Single- and multi-tone test bench simulations showed extremely low relative percentage errors of the prototype for respiratory and heart rate within -2 and 1%. The performance of the prototype was validated in overnight comparative studies, involving two healthy volunteers, with polysomnography as the reference. The prototype has successfully classified limb movements, with a sensitivity and specificity of 88.9 and 76.8% respectively, and has achieved accurate respiratory and heart rate measurement performance with overall absolute errors of 1 breath per minute for respiration and 3 beats per minute for heart rate. This pilot study shows that K-band Doppler radar and wavelet transform MRA seem to be valid for overnight sleep marker assessment. The contact-less approach might offer a promising solution for home-based sleep monitoring and assessment.

  11. Impact of Protected Sleep Period for Internal Medicine Interns on Overnight Call on Depression, Burnout, and Empathy

    PubMed Central

    Shea, Judy A.; Bellini, Lisa M.; Dinges, David F.; Curtis, Meredith L.; Tao, Yuanyuan; Zhu, Jingsan; Small, Dylan S.; Basner, Mathias; Norton, Laurie; Novak, Cristina; Dine, C. Jessica; Rosen, Ilene M.; Volpp, Kevin G.

    2014-01-01

    Background Patient safety and sleep experts advocate a protected sleep period for residents. Objective We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments. Methods We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009–2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal Reactivity Index (IRI). Results A total of 106 interns participated. There were no significant differences between groups in end-of-rotation BDI-II, MBI-HSS, or IRI scores at either location (P > .05). Amount of sleep while on call significantly predicted lower MBI-Emotional Exhaustion (P < .003), MBI-Depersonalization (P < .003), and IRI-Personal Distress (P < .006) at PVAMC, and higher IRI-Perspective Taking (P < .008) at HUP. Conclusions A protected sleep period produced few consistent improvements in depression, burnout, or empathy, although depression was already low at baseline. Possibly the amount of protected time was too small to affect these emotional states or sleep may not be directly related to these scores. PMID:24949128

  12. Corticotropic axis drive of overnight cortisol secretion is suppressed in adolescents and young adults with type 1 diabetes mellitus.

    PubMed

    Sharma, Animesh N; Wigham, Jean; Veldhuis, Johannes D

    2014-09-01

    Type 1 diabetes mellitus (T1DM) is a pro-inflammatory stress state, which, with its attendant hyperglycemia, likely disrupts hypothalamo-pituitary-adrenal (HPA) control, further dysregulating glucose homeostasis. To test the hypothesis that endogenous adrenocorticotropic hormone (ACTH)-cortisol dose-responsive drive, estimated analytically, is significantly accentuated in adolescents and young adults with T1DM compared with healthy individuals. This was a pilot study of 11 volunteers with T1DM and 10 controls, ages 16-30 yr, at a medical center. Subjects underwent overnight frequent blood sampling (every 10 min for ACTH and cortisol and every 60 min for blood glucose) from 10 pm to 8 am. T1DM volunteers maintained their home insulin regimen. Deconvolution analysis and dose-response estimates were the key outcomes. Mean free cortisol, but not ACTH, concentrations were lower in the T1DM group compared with controls (p = 0.012). Non-invasive ACTH-cortisol dose-response estimates revealed that T1DM patients had reduced ACTH efficacy (maximal cortisol secretion, p = 0.009), reduced ACTH potency as quantified by greater EC50 (ACTH concentration driving half-maximal cortisol secretion, p = 0.04), and increased ACTH sensitivity (more positive ACTH-cortisol slope, p = 0.03). Post-hoc gender comparisons indicated that these differences were limited to females. Linear regression in women showed a strong correlation of both ACTH efficacy and EC50 with C-peptide levels (both p < 0.01). Compared with healthy individuals, T1DM patients manifest decreased overnight adrenal responsiveness to endogenous ACTH leading to lower free cortisol concentrations. These findings suggest impaired stress-related adaptations of the HPA axis in T1DM. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Overnight, room temperature hold of whole blood followed by 42-day storage of red blood cells in additive solution-7.

    PubMed

    Dumont, Larry J; Cancelas, Jose A; Maes, Lou Ann; Rugg, Neeta; Whitley, Pamela; Herschel, Louise; Siegal, Alan H; Szczepiorkowski, Zbigniew M; Hess, John R; Zia, Majid

    2015-03-01

    Overnight, room temperature hold (ONH) of whole blood before component processing offers several benefits. This study evaluated the storage and in vivo recovery characteristics of ONH red blood cells (RBCs) stored in additive solution-7 (AS-7). We conducted a three-center, three-arm evaluation of a new blood collection system with AS-7 compared to leukoreduced RBCs processed within 8 hours and stored in AS-1 (control). Whole blood (500 ± 50 mL) from healthy research subjects (n = 240) was held at room temperature 0 to 2 hours, 6 to 8 hours, or ONH (18-24 hr) before component processing and storage at 1 to 6 °C. RBCs were evaluated on Days 42 and 56 with a panel of in vitro assays. Subsets of the AS-7-stored RBCs were evaluated for (51) Cr 24-hour in vivo recovery and long-term survival. Adenosine triphosphate (ATP) levels in ONH RBCs were not different than AS-7 RBCs prepared within 8 hours. ATP was higher in the ONH group on Day 42 than control, and ATP was maintained in all AS-7 groups through Day 56. ONH units had 0.36 ± 0.14% on Day 42 hemolysis (60/60 < 0.8%), and 0.54 ± 0.22% on Day 56 (10/60 > 0.8%, 2/60 > 1%). In vivo recoveries of stored RBCs were not different between the AS-7 arms at 42 days (p = 0.16; 27/27 ONH units > 75%), but the Day 56 ONH was significantly less than ONH on Day 42 (p = 0.008; 7/28 < 75%). Overnight hold of whole blood at room temperature before component processing meets current regulatory requirements when RBCs are stored up to 42 days in AS-7. © 2014 AABB.

  14. Improvement of sleep-disordered breathing in children is associated with a reduction in overnight blood pressure.

    PubMed

    Vlahandonis, Anna; Nixon, Gillian M; Davey, Margot J; Walter, Lisa M; Horne, Rosemary S C

    2013-12-01

    Childhood sleep-disordered breathing (SDB) is associated with elevated blood pressure (BP); however, little is known about the long-term outcomes in this population. We aimed to assess long-term changes in overnight BP in children with SDB. Forty children with previously diagnosed SDB and 20 nonsnoring control participants underwent repeat overnight polysomnography (PSG) with continuous BP measurement 4years after the original diagnosis. At follow-up, children aged 11-16years were categorized into 2 groups of resolved (absence of snoring and obstructive apnea-hypopnea index [OAHI]⩽1) or unresolved (continued to snore or had an OAHI >1) SDB. There were no group differences in age, sex, or body mass index (BMI) z score. OAHI was lower at follow-up (P<.05) in both the resolved (n=18) and unresolved (n=22) groups. BP was elevated during wake and sleep in both SDB groups compared to the control group at baseline (P<.01 for all), but it decreased by 5-15mmHg at follow-up during sleep for both SDB groups (P<.05 for all). BP during wake was unchanged in the SDB groups at follow-up but increased in the control group (P<.05). At follow-up, BP did not differ between the control group and the SDB groups during wake or sleep. Improved oxygen saturation (SpO2) during sleep was a significant predictor of a reduction in BP. SDB improved over the 4-year follow-up and both resolved and unresolved groups exhibited a significant reduction in BP during sleep, with levels similar to the control group. Our study highlights the fact that even small improvements can improve the cardiovascular effects of SDB. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  15. The Impact of Averaging Window Length on the"Desaturation Indexes during Overnight Pulse Oximetry at High-Altitude".

    PubMed

    Cross, Troy J; Keller-Ross, Manda; Issa, Amine; Wentz, Robert; Taylor, Bryan; Johnson, Bruce

    2015-08-01

    To determine the impact of averaging window-length on the "desaturation" indexes (DIs) obtained via overnight pulse oximetry (SpO2) at high altitude. Overnight SpO2 data were collected during a 10-day sojourn at high altitude. SpO2 was obtained using a commercial wrist-worn finger oximeter whose firmware was modified to store unaveraged beat-to-beat data. Simple moving averages of window lengths spanning 2 to 20 cardiac beats were retrospectively applied to beat-to-beat SpO2 datasets. After SpO2 artifacts were removed, the following DIs were then calculated for each of the averaged datasets: oxygen desaturation index (ODI); total sleep time with SpO2 < 80% (TST < 80), and the lowest SpO2 observed during sleep (SpO2 low). South Base Camp, Mt. Everest (5,364 m elevation). Five healthy, adult males (35 ± 5 y; 180 ± 1 cm; 85 ± 4 kg). N/A. 49 datasets were obtained from the 5 participants, totalling 239 hours of data. For all window lengths ≥ 2 beats, ODI and TST < 80 were lower, and SpO2 low was higher than those values obtained from the beat-to-beat SpO2 time series data (P < 0.05). Our findings indicate that increasing oximeter averaging window length progressively underestimates the frequency and magnitude of sleep disordered breathing events at high altitude, as indirectly assessed via the desaturation indexes. © 2015 Associated Professional Sleep Societies, LLC.

  16. Impact of overnight oximetry findings on cardiac autonomic modulation in women during second trimester of uncomplicated pregnancy.

    PubMed

    Watanabe, Minako; Shinohara, Hitomi; Kodama, Hideya

    2015-05-01

    Although sleep-disordered breathing (SDB) might impose an underlying health threat upon some pregnant women, the influence of SDB on the health status of most pregnant women is not discernible. In order to find out which pregnant women should be evaluated for clinically meaningful SDB during the second trimester, the present study aimed to determine which overnight oximetry findings significantly affect maternal resting cardiac autonomic modulations. Overnight arterial oxygen saturation (SaO2 ) was monitored at home using pulse oximetry by 64 women with uncomplicated pregnancy between 24 and 28 weeks of gestation. We then determined the impact of the findings on maternal resting heart rate variability (HRV) using 5-min photoplethysmography. A relatively increased oxygen desaturation index (number of oxygen desaturation events where SaO2 fell >3% below the baseline saturation/h) of ≥3.0 in five women did not significantly impact HRV. On the other hand, events associated with profound oxygen desaturation (minimum SaO2  ≤ 90%) in three women were associated with decreased HRV, including high- and low-frequency powers. Parasympathetic activities of cardiac autonomic modulations might be attenuated in women who experience profound night-time oxygen desaturation, even if the incidence of significant events is quite low. The oximetry finding of minimum SaO2  ≤ 90% might be a valuable criterion for clinically meaningful sleep-disordered breathing among women with early uncomplicated pregnancy. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  17. Closing the loop overnight at home setting: psychosocial impact for adolescents with type 1 diabetes and their parents

    PubMed Central

    Barnard, Katharine D; Wysocki, Tim; Allen, Janet M; Elleri, Daniela; Thabit, Hood; Leelarathna, Lalantha; Gulati, Arti; Nodale, Marianna; Dunger, David B; Tinati, Tannaze; Hovorka, Roman

    2014-01-01

    Objective To explore the experiences of adolescents with type 1 diabetes mellitus (T1DM) and their parents taking part in an overnight closed loop study at home, using qualitative and quantitative research methods. Research design and methods Adolescents aged 12–18 years on insulin pump therapy were recruited to a pilot closed loop study in the home setting. Following training on the use of a study insulin pump and continuous glucose monitoring (CGM), participants were randomized to receive either real-time CGM combined with overnight closed loop or real-time CGM alone followed by the alternative treatment for an additional 21 days with a 2–3-week washout period in between study arms. Semistructured interviews were performed to explore participants’ perceptions of the impact of the closed loop technology. At study entry and again at the end of each 21-day crossover arm of the trial, participants completed the Diabetes Technology Questionnaire (DTQ) and Hypoglycemia Fear Survey (HFS; also completed by parents). Results 15 adolescents and 13 parents were interviewed. Key positive themes included reassurance/peace of mind, confidence, ‘time off’ from diabetes demands, safety, and improved diabetes control. Key negative themes included difficulties with calibration, alarms, and size of the devices. DTQ results reflected these findings. HFS scores were mixed. Conclusions Closed loop insulin delivery represents cutting-edge technology in the treatment of T1DM. Results indicate that the psychological and physical benefits of the closed loop system outweighed the practical challenges reported. Further research from longitudinal studies is required to determine the long-term psychosocial benefit of the closed loop technology. PMID:25452866

  18. Is staying overnight in a farming hut a risk factor for malaria infection in a setting with insecticide-treated bed nets in rural Laos?

    PubMed Central

    2010-01-01

    Background Overnight stays in farming huts are known to pose a risk of malaria infection. However, studies reporting the risk were conducted in the settings of poor net coverage. This study sought to assess whether an overnight stay in a farming hut is associated with an increased risk of malaria infection if insecticide-treated bed nets (ITNs) are properly used. Methods A pair of cross-sectional surveys was carried out in the Lamarm district of Sekong province, Laos, in March (dry season) and August (rainy season) in 2008. Questionnaire-based interviews and blood examinations were conducted with farmers and their household members from three randomly selected villages in March (127 households, 891 people) and August (128 households, 919 people). Logistic regression analysis, adjusted for potential confounding factors, was used to assess the association between malaria infection status and frequency of overnight stays for the two weeks prior to the study in both the seasons. Results In March, 13.7% of participants reported staying overnight in a farming hut at least once in the previous two weeks. The percentage increased to 74.6% in August. Not only adults but also young children stayed overnight as often as adults. The use of an ITN the preceding night was common both in farming huts (66.3% in March, 95.2% in August), and in main residences (85.8% in March, 92.5% in August). Logistic regression analysis showed no statistical association between malaria infection status and frequency of overnight stays in farming huts in either study period. However, people sharing one family type net with five people or more were significantly more likely to have malaria than those sharing a net with up to two people in the dry season. Conclusions This study showed that staying overnight in farming huts was not associated with an increased risk of malaria infection in the setting where ITNs were widely used in farming huts. It suggests that malaria infection during overnight

  19. The effects of repeated ingestion of high and low glucose-electrolyte solutions on gastric emptying and blood 2H2O concentration after an overnight fast.

    PubMed

    Evans, Gethin H; Shirreffs, Susan M; Maughan, Ronald J

    2011-12-01

    The addition of carbohydrate to drinks designed to have a role in rehydrating the body is commonplace. The gastric emptying and fluid uptake characteristics following repeated ingestion of drinks with high and low glucose concentrations were examined in eight subjects (three male and five female). Following a 13 h fluid restriction period, the subjects ingested a volume of test solution amounting to 3 % of the initial body mass over a period of 60 min. Test drinks were 2 and 10 % glucose-electrolyte solutions with osmolalities of 189 (SD 3) and 654 (SD 3) mOsm/kg, respectively. The initial bolus of each test solution contained 10 g of (2)H(2)O. Blood samples were collected throughout drinking and for 60 min afterwards. Gastric volumes were determined via gastric aspiration at 15 min intervals for 120 min. No difference between trials in total stomach volume was observed until 30 min after the ingestion of the first bolus of test drink, but blood (2)H concentration was increased during both trials 10 min after ingestion of the first bolus. Blood (2)H concentration was greater at this time point during the 2 % glucose trial than during the 10 % glucose trial and remained higher for the duration of the trial with the exception of one time point. Urine volume at the end of the trial was greater in the 2 % glucose trial than in the 10 % glucose trial. It is concluded that the reduced overall rate of fluid uptake following ingestion of the 10 % glucose solution was due largely to a relatively slow rate of gastric emptying.

  20. Relationship between gastrointestinal transit time and anesthetic fasting protocols in the captive chimpanzee, Pan troglodytes.

    PubMed

    Ardente, A; Chinnadurai, S; De Voe, R; Stringer, E; Webb, T; Ireland, J; Saker, K

    2011-06-01

    Lengthy social separation and prolonged fasting time contribute to increased risks associated with anesthesia in captive primates. This study is an initial attempt to identify a safe pre-anesthetic fasting procedure by identifying gastric emptying time (GET) and gastrointestinal transit time (GTT) of captive chimpanzees, Pan troglodytes. Seven adult chimpanzees at the North Carolina Zoo immobilized for annual physical examinations were fed barium-impregnated polyethylene spheres to measure GET. Eleven animals were individually fed a color dye marker and fecal passage was observed to determine GTT. Gastric emptying time (GET) was approximated to be >3 hours but <16 hours. The mean GTT was 16.5 hours. This study indicates that a fasting time of 3 hours would allow for complete gastric emptying and could potentially replace the current overnight fast (≥16 hour) to help minimize complications associated with pre-anesthetic fasting in captive primates. © 2011 John Wiley & Sons A/S.

  1. Relations of parenting quality, interparental conflict, and overnights with mental health problems of children in divorcing families with high legal conflict.

    PubMed

    Sandler, Irwin N; Wheeler, Lorey A; Braver, Sanford L

    2013-12-01

    The current study examined the associations between child mental health problems and the quality of maternal and paternal parenting, and how these associations were moderated by three contextual factors: quality of parenting by the other parent, interparental conflict, and the number of overnights parents had with the child. Data for the current study came from a sample of divorcing families who are in high legal conflict over developing or maintaining a parenting plan following divorce. Analyses revealed that the associations between child mental health problems and positive maternal and paternal parenting were moderated by the quality of parenting provided by the other parent and by the number of overnights children spent with parents, but not by the level of interparental conflict. When parenting by the other parent and number of overnights were considered together in the same model, only number of overnights moderated the relations between parenting and child-behavior problems. The results support the proposition that the well-being of children in high-conflict divorcing families is better when they spend adequate time with at least one parent who provides high-quality parenting.

  2. 46 CFR 116.730 - Crew accommodations on vessels of more than 19.8 meters (65 feet) in length with overnight...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Crew accommodations on vessels of more than 19.8 meters... ARRANGEMENT Crew Spaces § 116.730 Crew accommodations on vessels of more than 19.8 meters (65 feet) in length... more than 19.8 meters (65 feet) in length with overnight accommodations for more than 49...

  3. 46 CFR 116.730 - Crew accommodations on vessels of more than 19.8 meters (65 feet) in length with overnight...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Crew accommodations on vessels of more than 19.8 meters... ARRANGEMENT Crew Spaces § 116.730 Crew accommodations on vessels of more than 19.8 meters (65 feet) in length... more than 19.8 meters (65 feet) in length with overnight accommodations for more than 49...

  4. 46 CFR 116.730 - Crew accommodations on vessels of more than 19.8 meters (65 feet) in length with overnight...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Crew accommodations on vessels of more than 19.8 meters... ARRANGEMENT Crew Spaces § 116.730 Crew accommodations on vessels of more than 19.8 meters (65 feet) in length... more than 19.8 meters (65 feet) in length with overnight accommodations for more than 49...

  5. 46 CFR 116.730 - Crew accommodations on vessels of more than 19.8 meters (65 feet) in length with overnight...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Crew accommodations on vessels of more than 19.8 meters... ARRANGEMENT Crew Spaces § 116.730 Crew accommodations on vessels of more than 19.8 meters (65 feet) in length... more than 19.8 meters (65 feet) in length with overnight accommodations for more than 49...

  6. 46 CFR 116.730 - Crew accommodations on vessels of more than 19.8 meters (65 feet) in length with overnight...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Crew accommodations on vessels of more than 19.8 meters... ARRANGEMENT Crew Spaces § 116.730 Crew accommodations on vessels of more than 19.8 meters (65 feet) in length... more than 19.8 meters (65 feet) in length with overnight accommodations for more than 49...

  7. Relations of Parenting Quality, Interparental Conflict, and Overnights with Mental Health Problems of Children in Divorcing Families with High Legal Conflict

    PubMed Central

    Sandler, Irwin N.; Wheeler, Lorey A.; Braver, Sanford L.

    2013-01-01

    The current study examined the associations between child mental health problems and the quality of maternal and paternal parenting, and how these associations were moderated by three contextual factors, quality of parenting by the other parent, interparental conflict, and the number of overnights parents had with the child. Data for the current study come from a sample of divorcing families who are in high legal conflict over developing or maintaining a parenting plan following divorce. Analyses revealed that the associations between child mental health problems and positive maternal and paternal parenting were moderated by the quality of parenting provided by the other parent and by the number of overnights children spent with parents, but not by the level of interparental conflict. When both parenting by the other parent and number of overnights were considered in the same model, only number of overnights moderated the relations between parenting and child behavior problems. The results support the proposition that the well-being of children in high conflict divorcing families is better when they spend adequate time with at least one parent who provides high quality parenting. PMID:24098960

  8. Associations of excessive sleepiness on duty with sleeping hours and number of days of overnight work among medical residents in Japan.

    PubMed

    Wada, Koji; Sakata, Yumi; Theriault, Gilles; Narai, Rie; Yoshino, Yae; Tanaka, Katsutoshi; Aizawa, Yoshiharu

    2007-11-01

    Despite long-standing concerns regarding the effects of working hours on the performance and health of medical residents, and the patients' safety, prior studies have not shown an association of excessive sleepiness with the number of sleeping hours and days of overnight work among medical residents. In August 2005, a questionnaire was mailed to 227 eligible participants at 16 teaching hospitals. The total number of sleeping hours in the last 30 d was estimated from the average number of sleeping hours during regular days and during days with overnight work, and the number of days of overnight work. Multiple logistic regression analysis was used to adjust for potentially associated variables. A total of 149 men and 47 women participated in this study. The participation rate was 86.3%. Among the participants, 55 (28.1%) suffered from excessive sleepiness. Excessive sleepiness was associated with sleeping for less than 150 h in the last 30 d (corrected odds ratio [cOR]=1.57; 95% confidence interval [CI], 1.02-2.16). The number of days of overnight work in the last 30 d showed no association with excessive sleepiness. Excessive sleepiness was also associated with smoking (cOR, 1.65; 95%CI, 1.01-2.32). Medical residents who slept for less than 150 h in the last 30 d and smoked had a significantly higher risk of excessive sleepiness on duty.

  9. Home use of closed loop insulin delivery improves overnight glucose control in adults with type 1 diabetes: A four-week multicentre randomised crossover study

    PubMed Central

    Thabit, Hood; Lubina-Solomon, Alexandra; Stadler, Marietta; Leelarathna, Lalantha; Walkinshaw, Emma; Pernet, Andrew; Allen, Janet M.; Iqbal, Ahmed; Choudhary, Pratik; Kumareswaran, Kavita; Nodale, Marianna; Nisbet, Chloe; Wilinska, Malgorzata E.; Barnard, Katharine D.; Dunger, David B.; Heller, Simon R.; Amiel, Stephanie A.; Evans, Mark L.; Hovorka, Roman

    2014-01-01

    Summary Background We assessed whether overnight home use of automated closed loop insulin delivery (artificial pancreas) improves glucose control. Methods We studied 24 adults with type 1 diabetes in a multicentre crossover study design comparing four weeks of overnight closed loop using a model predictive control algorithm to direct insulin delivery, with four weeks of insulin pump therapy in which participants used real-time display of continuous glucose monitoring independent of their pumps as control. Primary outcome was time when glucose was in the target range of 3·9 and 8·0mmol/l between midnight to 07:00. Analyses were by intention to treat. Trial registration ClinicalTrials.gov NCT01440140. Findings Closed loop was utilised over median 8·3 (interquartile range 6·0, 9·6)hours on 555nights (86%). Proportion of time when overnight glucose was in target range was significantly higher during closed loop compared to control by 13·5% (95% CI, 7·3–19·7; p<0·001). Mean overnight glucose (8·2±0·9 vs. 9·0±1·3mmol/l; p=0·005) and time spent above target (44·3%±11·9 vs. 57·1%±15·6; p=0·001) were significantly lower during closed loop. Time spent below target was low and comparable [1·8%(0·6, 3·6) vs. 2·1%(0·7, 3·9); p=0·28]. Lower mean overnight glucose was brought about by increased overnight insulin delivery [6·4 (4·5, 8·1) vs. 4·9 (3·7, 6·3)units; p<0·001) without changing the total daily insulin amount [34·5 (29·3, 48·4) vs. 35·4 (29·7, 45·2)units; p=0·32]. No severe hypoglycaemia episodes occurred during control period and two during closed loop not related to algorithm instructions. Interpretation Unsupervised overnight closed loop at home is feasible and may improve glucose control in adults with type 1 diabetes. PMID:24943065

  10. Impact of Denture Cleaning Method and Overnight Storage Condition on Denture Biofilm Mass and Composition: A Cross-Over Randomized Clinical Trial

    PubMed Central

    Duyck, Joke; Vandamme, Katleen; Krausch-Hofmann, Stefanie; Boon, Lies; De Keersmaecker, Katrien; Jalon, Eline; Teughels, Wim

    2016-01-01

    Background Appropriate oral hygiene is required to maintain oral health in denture wearers. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures. Methods In a cross-over randomized controlled trial in 13 older people, 4 conditions with 2 different mechanical cleaning methods and 2 overnight storage conditions were considered: (i) brushing and immersion in water without a cleansing tablet, (ii) brushing and immersion in water with a cleansing tablet, (iii) ultrasonic cleaning and immersion in water without a cleansing tablet, and (iv) ultrasonic cleaning and immersion in water with a cleansing tablet. Each test condition was performed for 5 consecutive days, preceded by a 2-days wash-out period. Biofilm samples were taken at baseline (control) and at the end of each test period from a standardized region. Total and individual levels of selected oral bacteria (n = 20), and of Candida albicans were identified using the Polymerase Chain Reaction (PCR) technique. Denture biofilm coverage was scored using an analogue denture plaque score. Paired t-tests and Wilcoxon-signed rank tests were used to compare the test conditions. The level of significance was set at α< 5%. Results Overnight denture storage in water with a cleansing tablet significantly reduced the total bacterial count (p<0.01). The difference in total bacterial level between the two mechanical cleaning methods was not statistically significant. No significant effect was observed on the amount of Candida albicans nor on the analogue plaque scores. Conclusions The use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water. This effect was more pronounced when combined with ultrasonic cleaning compared to

  11. Storage of platelet concentrates from pooled buffy coats made of fresh and overnight-stored whole blood processed on the novel Atreus 2C+ system: in vitro study.

    PubMed

    Sandgren, Per; Callaert, Martine; Shanwell, Agneta; Gulliksson, Hans

    2008-04-01

    The Atreus 2C+ system (Gambro BCT) automatically separates whole blood (WB) into buffy coat (BC), red blood cells (RBC), and plasma and transfers the components into separate containers. After processing with the Atreus, 4 to 6 BC units can be pooled and processed into leukoreduced platelets (PLTs) by use of the automated OrbiSac BC system (Gambro BCT). The aim of our in vitro study was to investigate the effects of holding either WB or BC overnight before preparation of PLTs by use of the Atreus 2C+ system for BC preparation. A standard routine procedure involving conventional blood containers for the preparation of BC combined with the OrbiSac process (top-and-top system; Terumo) was used as a reference. WB was either processed within 8 hours after collection ("fresh blood") or stored overnight before processing. WB units were separated into BC, RBC, and plasma units and transferred into individual containers. Either the BC or the WB units rested overnight at 22 +/- 2 degrees C. Six ABO-identical BCs, obtained from either fresh or overnight-stored WB, were pooled and processed with the OrbiSac BC system to obtain leukoreduced PLTs. In total, 20 Atreus and 10 reference (leukoreduced PLTs) samples were analyzed for various in vitro variables during the 7-day storage period. No significant difference in glucose consumption, lactate production, mean PLT volume, LDH activity, bicarbonate, ATP, RANTES, and the expression of CD62p and CD42b between groups was detected. pH was maintained at greater than 7.0 (Day 7). Swirling remained at the highest levels (score, 2) for all units throughout storage. PLTs derived from BCs, obtained from either fresh or overnight-stored WB processed on the novel automated Atreus 2C+ system, were equivalent to control PLTs with regard to PLT in vitro characteristics during 7 days of storage. Stable recovery of PLTs and satisfactory PLT content according to current standards were also found.

  12. The quality of fresh-frozen plasma produced from whole blood stored at 4 degrees C overnight.

    PubMed

    Cardigan, Rebecca; Lawrie, Andrew S; Mackie, Ian J; Williamson, Lorna M

    2005-08-01

    The aim of this study was to assess whether the quality of FFP produced from whole blood stored at 4 degrees C overnight is adequate for its intended purpose. Fresh-frozen plasma (FFP) separated from whole blood (n = 60) leukodepleted (LD) after storage at 4 degrees C overnight (18-24 hr from donation, Day 1 FFP) was compared with that LD within 8 hours of donation (Day 0 FFP, the current standard method). In more than 95 percent of Day 1 FFP units, levels of factor (F) II, FV, FVII, FVIII, F IX, FX, FXI, and FXII were greater than 0.50 U per mL except for von Willebrand factor (VWF) antigen and FVIII, where 92 and 87 percent of units, respectively, contained greater than 0.50 IU per mL. Compared with historical data on FFP stored for 8 hours, fibrinogen, FV, FVIII, and FXI were reduced by 12, 15, 23, and 7 percent, respectively, but other factors were not significantly reduced. Levels of VWF-cleaving protease activity were not different between FFP prepared from paired units of blood (n = 3) held for 8 or 24 hours, but were below the reference range in an additional 2 of 6 units held for 24 hours. The activities of protein S, protein C, antithrombin III, and alpha(2)-antiplasmin were reduced by less than 10 percent in Day 1 FFP (n = 20), but with final levels above the lower limit of the normal range in greater than 95 percent of units. Activated FXII antigen was not significantly raised in plasma stored for 18 to 24 hours, but levels of prothrombin fragment 1 + 2 were slightly increased (0.88 ng/mL, 18-24 hr; 0.65 ng/mL, < 8 hr). These data suggest that there is good retention of relevant coagulation factor activity in plasma produced from whole blood stored at 4 degrees C for 18 to 24 hours and that this would be an acceptable product for most patients requiring FFP.

  13. Bone resorption is suppressed immediately after the third and fourth days of multiday cycling but persistently increased following overnight recovery.

    PubMed

    Oosthuyse, Tanja; Badenhorst, Margaret; Avidon, Ingrid

    2014-01-01

    Previous studies suggest that seasoned cyclists may incur a low bone mineral density. This study investigated the effect of multiday cycling on bone turnover. Ten male cyclists completed 4 consecutive days of cycling for 3 h·day(-1). Sweat calcium excretion during exercise and serum calcium, cortisol, bone formation marker (bone alkaline phosphotase (bone-ALP)), bone resorptive marker (C-terminal telopeptide of type I collagen (β-CTX)), and parathyroid hormone concentration were measured before and immediately postexercise each day. Serum β-CTX concentration increased from pre- to postcycling on days 1 and 2 (p = 0.01) (day 1: 0.31 ± 0.14 to 0.60 ± 0.4 ng·mL(-1); day 2: 0.58 ± 0.26 to 0.87 ± 0.42 ng·mL(-1)), while serum bone-ALP concentration remained unchanged. Conversely, on days 3 and 4 both serum β-CTX (day 3: 0.60 ± 0.26 to 0.43 ± 0.26 ng·mL(-1), p < 0.05; day 4: 0.63 ± 0.21 to 0.43 ± 0.22 ng·mL(-1), p < 0.001) and bone-ALP (p < 0.01) response to exercise was suppressed. Interestingly, calcium lost to sweat and postexercise serum cortisol concentration were also significantly lower on days 3 and 4 than on day 1 (p < 0.05). However, both serum β-CTX (102%-124%) and bone-ALP (25%-29%) remained persistently elevated after 21 h of overnight recovery on all successive days compared with day 1 pre-exercise, where the percentage increase was greater for β-CTX (p < 0.05). Bone resorption, immediately following prolonged cycling, is acutely reduced by the third and fourth consecutive days and is coincident to reduced sweat calcium excretion and cortisol concentration. However, multiday cycling imposes a persistent increase in bone resorption following overnight recovery.

  14. Color stability, surface roughness and flexural strength of an acrylic resin submitted to simulated overnight immersion in denture cleansers.

    PubMed

    Paranhos, Helena de Freitas Oliveira; Peracini, Amanda; Pisani, Marina Xavier; Oliveira, Viviane de Cássia; de Souza, Raphael Freitas; Silva-Lovato, Cláudia Helena

    2013-01-01

    This study evaluated color stability, surface roughness and flexural strength of acrylic resin specimens after immersion in alkaline peroxide and alkaline hypochlorite, simulating a period of one and a half year of use of overnight immersion. Sixty disc-shaped (16x4 mm) and 80 rectangular specimens (65x10x3.3 mm) were prepared from heat-polymerized acrylic resin (Lucitone 550) and distributed into 4 groups (n=20): C1: without immersion, C2: 8 h immersion in distilled water; AP: 8 h immersion in alkaline peroxide effervescent tablet; SH: 8 h immersion in 0.5% NaOCl solution. Properties were evaluated at baseline and after the immersion. Color data were also calculated according the National Bureau of Standards (NBS). Results were analyzed statistically by ANOVA and Tukey's HSD test (α=0.05). AP (2.34 ± 0.41) caused color alteration significantly higher than C2 (0.39 ± 0.30) and SH (1.73 ± 0.52). The mean ΔE values were classified as indicial for C2 (0.36 ± 0.29) and noticeable for AP (2.12 ± 0.39) and SH (1.59 ± 0.48). SH (0.0195 ± 0.0150) caused significantly higher ΔRa (p=0.000) than the C2 (0.0005 ± 0.0115) and PA (0.0005 ± 0.0157) groups. There was no statistically significant difference (p=0.063) among the solutions for flexural strength (C1: 105.43 ± 14.93, C2: 100.30 ± 12.43, PA: 97.61 ± 11.09, SH: 95.23 ± 10.18). In conclusion, overnight immersion in denture cleansing solutions simulating a year and a half of use did not alter the flexural strength of acrylic resin but caused noticeable color alterations, higher for alkaline peroxide. The 0.5% NaOCl solution caused increase in surface roughness.

  15. Improvement of IFNγ ELISPOT Performance Following Overnight Resting of Frozen PBMC Samples Confirmed Through Rigorous Statistical Analysis

    PubMed Central

    Santos, Radleigh; Buying, Alcinette; Sabri, Nazila; Yu, John; Gringeri, Anthony; Bender, James; Janetzki, Sylvia; Pinilla, Clemencia; Judkowski, Valeria A.

    2014-01-01

    Immune monitoring of functional responses is a fundamental parameter to establish correlates of protection in clinical trials evaluating vaccines and therapies to boost antigen-specific responses. The IFNγ ELISPOT assay is a well-standardized and validated method for the determination of functional IFNγ-producing T-cells in peripheral blood mononuclear cells (PBMC); however, its performance greatly depends on the quality and integrity of the cryopreserved PBMC. Here, we investigate the effect of overnight (ON) resting of the PBMC on the detection of CD8-restricted peptide-specific responses by IFNγ ELISPOT. The study used PBMC from healthy donors to evaluate the CD8 T-cell response to five pooled or individual HLA-A2 viral peptides. The results were analyzed using a modification of the existing distribution free resampling (DFR) recommended for the analysis of ELISPOT data to ensure the most rigorous possible standard of significance. The results of the study demonstrate that ON resting of PBMC samples prior to IFNγ ELISPOT increases both the magnitude and the statistical significance of the responses. In addition, a comparison of the results with a 13-day preculture of PBMC with the peptides before testing demonstrates that ON resting is sufficient for the efficient evaluation of immune functioning. PMID:25546016

  16. EEG Σ and slow-wave activity during NREM sleep correlate with overnight declarative and procedural memory consolidation.

    PubMed

    Holz, Johannes; Piosczyk, Hannah; Feige, Bernd; Spiegelhalder, Kai; Baglioni, Chiara; Riemann, Dieter; Nissen, Christoph

    2012-12-01

    Previous studies suggest that sleep-specific brain activity patterns such as sleep spindles and electroencephalographic slow-wave activity contribute to the consolidation of novel memories. The generation of both sleep spindles and slow-wave activity relies on synchronized oscillations in a thalamo-cortical network that might be implicated in synaptic strengthening (spindles) and downscaling (slow-wave activity) during sleep. This study further examined the association between electroencephalographic power during non-rapid eye movement sleep in the spindle (sigma, 12-16 Hz) and slow-wave frequency range (0.1-3.5 Hz) and overnight memory consolidation in 20 healthy subjects (10 men, 27.1 ± 4.6 years). We found that both electroencephalographic sigma power and slow-wave activity were positively correlated with the pre-post-sleep consolidation of declarative (word list) and procedural (mirror-tracing) memories. These results, although only correlative in nature, are consistent with the view that processes of synaptic strengthening (sleep spindles) and synaptic downscaling (slow-wave activity) might act in concert to promote synaptic plasticity and the consolidation of both declarative and procedural memories during sleep.

  17. Effects of overnight captivity on antioxidant capacity and clinical chemistry of wild southern hairy-nosed wombats (Lasiorhinus latifrons).

    PubMed

    Debrincat, Steven; Taggart, David; Rich, Brian; Beveridge, Ian; Boardman, Wayne; Dibben, Ron

    2014-09-01

    An animal's antioxidant capacity is measured by its ability to quench reactive oxygen species (ROS). During everyday metabolism, antioxidants and ROS are in equilibrium with one another. In times of stress, an animal produces more ROS and therefore uses its antioxidant capacity more readily in order to maintain this equilibrium. When the production of ROS exceeds the antioxidant capacity, an animal will experience extensive oxidative stress, which can ultimately affect that animal's health. During experimental study of wild animals, it is often necessary to capture them for a short period of time. In order to obtain a measurement of the effects of short-term captivity on oxidative capacity in wild animals, a population of southern hairy-nosed wombats (Lasiorhinus latifrons) in Swan Reach, South Australia (34.57 degrees S, 139.60 degrees E), was studied. To assess the variation in antioxidant capacity, two assays, the ferric reducing ability of plasma and the trolox equivalent antioxidant capacity, were performed. A third assay, thiobarbituric acid reactive substances, was used to measure the effects of ROS. Measurements of the specific antioxidants uric acid, ascorbic acid, retinol, alpha-tocopherol, and superoxide dismutase were also performed. The biochemical parameters albumin, total protein, cholinesterase, creatinine, and urea were measured as indicators for health. Results showed a significant reduction in antioxidant capacity during the overnight period of captivity.

  18. Significant deficiencies in the overnight use of a Standardised Early Warning Scoring system in a teaching hospital.

    PubMed

    Gordon, Claire F; Beckett, Daniel J

    2011-02-01

    National Institute for Health and Clinical Excellence guidelines recommend the use of 'Track and Trigger' systems to identify early clinical deterioration. The Standardised Early Warning Score (SEWS) is used in the Royal Infirmary of Edinburgh. Previous work, suggested that the frequency and accuracy of SEWS documentation varied throughout the hospital. A prospective study was performed over a 14-night period looking at SEWS documentation in patients causing clinical concern requiring medical review, or triggering a SEWS of 4 (the 'trigger' score). SEWS charts were examined the following morning. In the ward arc, SEWS documentation was correct in only 21% of cases. The most frequent errors were one or more observations omitted (64%), SEWS total not calculated (55%) or incorrectly calculated (21%). Up to five errors per chart were noted. The observations most frequently omitted were respiratory rate, temperature and neurological status. In contrast, SEWS documentation was correct in 68% of patients in the combined assessment unit (CAU). This study demonstrates significant deficiencies in the overnight use of SEWS, particularly on the ward arc. This is particularly concerning as this study was limited only to patients already causing clinical concern, and highlights that basic observations are often incomplete, and the SEWS chart poorly understood and acted upon. SEWS recording and documentation was significantly better in CAU (P < 0.001, FET), where there is a dedicated, ongoing SEWS education programme for nursing and medical staff. We recommend this is rolled out across the hospital. Alternative methods of improving the use of SEWS are considered.

  19. FAST: FAST Analysis of Sequences Toolbox

    PubMed Central

    Lawrence, Travis J.; Kauffman, Kyle T.; Amrine, Katherine C. H.; Carper, Dana L.; Lee, Raymond S.; Becich, Peter J.; Canales, Claudia J.; Ardell, David H.

    2015-01-01

    FAST (FAST Analysis of Sequences Toolbox) provides simple, powerful open source command-line tools to filter, transform, annotate and analyze biological sequence data. Modeled after the GNU (GNU's Not Unix) Textutils such as grep, cut, and tr, FAST tools such as fasgrep, fascut, and fastr make it easy to rapidly prototype expressive bioinformatic workflows in a compact and generic command vocabulary. Compact combinatorial encoding of data workflows with FAST commands can simplify the documentation and reproducibility of bioinformatic protocols, supporting better transparency in biological data science. Interface self-consistency and conformity with conventions of GNU, Matlab, Perl, BioPerl, R, and GenBank help make FAST easy and rewarding to learn. FAST automates numerical, taxonomic, and text-based sorting, selection and transformation of sequence records and alignment sites based on content, index ranges, descriptive tags, annotated features, and in-line calculated analytics, including composition and codon usage. Automated content- and feature-based extraction of sites and support for molecular population genetic statistics make FAST useful for molecular evolutionary analysis. FAST is portable, easy to install and secure thanks to the relative maturity of its Perl and BioPerl foundations, with stable releases posted to CPAN. Development as well as a publicly accessible Cookbook and Wiki are available on the FAST GitHub repository at https://github.com/tlawrence3/FAST. The default data exchange format in FAST is Multi-FastA (specifically, a restriction of BioPerl FastA format). Sanger and Illumina 1.8+ FastQ formatted files are also supported. FAST makes it easier for non-programmer biologists to interactively investigate and control biological data at the speed of thought. PMID:26042145

  20. Substrate Metabolism and Insulin Sensitivity During Fasting in Obese Human Subjects: Impact of GH Blockade.

    PubMed

    Pedersen, Morten Høgild; Svart, Mads Vandsted; Lebeck, Janne; Bidlingmaier, Martin; Stødkilde-Jørgensen, Hans; Pedersen, Steen Bønløkke; Møller, Niels; Jessen, Niels; Jørgensen, Jens O L

    2017-04-01

    Insulin resistance and metabolic inflexibility are features of obesity and are amplified by fasting. Growth hormone (GH) secretion increases during fasting and GH causes insulin resistance. To study the metabolic effects of GH blockade during fasting in obese subjects. Nine obese males were studied thrice in a randomized design: (1) after an overnight fast (control), (2) after 72 hour fasting (fasting), and (3) after 72 hour fasting with GH blockade (pegvisomant) [fasting plus GH antagonist (GHA)]. Each study day consisted of a 4-hour basal period followed by a 2-hour hyperinsulinemic, euglycemic clamp combined with indirect calorimetry, assessment of glucose and palmitate turnover, and muscle and fat biopsies. GH levels increased with fasting (P < 0.01), and the fasting-induced reduction of serum insulin-like growth factor I was enhanced by GHA (P < 0.05). Fasting increased lipolysis and lipid oxidation independent of GHA, but fasting plus GHA caused a more pronounced suppression of lipid intermediates in response to hyperinsulinemic, euglycemic clamp. Fasting-induced insulin resistance was abrogated by GHA (P < 0.01) primarily due to reduced endogenous glucose production (P = 0.003). Fasting plus GHA also caused elevated glycerol levels and reduced levels of counterregulatory hormones. Fasting significantly reduced the expression of antilipolytic signals in adipose tissue independent of GHA. Suppression of GH activity during fasting in obese subjects reverses insulin resistance and amplifies insulin-stimulated suppression of lipid intermediates, indicating that GH is an important regulator of substrate metabolism, insulin sensitivity, and metabolic flexibility also in obese subjects.

  1. The traditions and risks of fasting for lipid profiles in patients with diabetes.

    PubMed

    Aldasouqi, Saleh; Grunberger, George

    2014-11-01

    Fasting overnight has been traditionally recommended by clinicians when ordering laboratory tests for lipid profiles for the purposes of health screening or monitoring of the effects of lipid-lowering medications. Patients with diabetes are tested for lipid profiles at least annually. This deeply rooted tradition of fasting for lipid testing has recently been challenged. Several studies have shown little benefit obtained by testing lipids in fasting compared with postprandial states. Furthermore, recent studies have shown the importance of postprandial lipid spikes in the pathogenesis of cardiovascular disease. At the same time, recent reports have alerted the medical community to the risk of hypoglycemia in patients with diabetes on antidiabetic medications (particularly insulin and sulfonylureas) who are asked to fast for lab tests. This article reviews the literature on these emerging issues in lipid testing in patients with diabetes, and offers recommendations for lipid testing in these patients in view of these emerging discussions.

  2. The effects of fasting on metabolism and performance.

    PubMed

    Maughan, R J; Fallah, J; Coyle, E F

    2010-06-01

    An overnight fast of 8-10 h is normal for most people. Fasting is characterised by a coordinated set of metabolic changes designed to spare carbohydrate and increase reliance on fat as a substrate for energy supply. As well as sparing the limited endogenous carbohydrate, and increased rate of gluconeogenesis from amino acids, glycerol and ketone bodies help maintain the supply of carbohydrate. Many individuals undergo periodic fasts for health, religious or cultural reasons. Ramadan fasting, involving 1 month of abstention from food and fluid intake during daylight hours, is practised by a large part of the world population. This period involves a shift in the pattern of intake from daytime to the hours of darkness. There seems to be little effect on overall daily dietary intake and only small metabolic effects, but there may be implications for both physical and cognitive function. The limited evidence suggests that effects of Ramadan-style fasting on exercise performance are generally small. This needs to be balanced, however, against the observation that small differences in performance are critical in determining the outcomes of sporting events. Studies involving challenging sporting events (prolonged sustained or intermittent high-intensity events, hot and humid environments) are needed. Increases in subjective sensations of fatigue may be the result of loss of sleep or disruption of normal sleep patterns. Modifications to the competition timetable may minimise or even eliminate any effect on performance in sport, but there may be negative effects on performance in some events.

  3. Overnight Social Isolation in Pigs Decreases Salivary Cortisol but Does Not Impair Spatial Learning and Memory or Performance in a Decision-Making Task

    PubMed Central

    van der Staay, F. Josef; Schoonderwoerd, Annelieke J.; Stadhouders, Bo; Nordquist, Rebecca E.

    2016-01-01

    Pigs in modern farming practice may be exposed to a number of stressors, including social stressors such as mixing or isolation. This may potentially affect both cognitive abilities and stress physiology of the animals. We tested the hypothesis that overnight social isolation in pigs impairs performance in a cognitive holeboard (HB) task (Experiment 1) and the Pig Gambling Task (PGT) (Experiment 2), a decision-making task inspired by the Iowa Gambling Task. In addition, we tested the effect of overnight social isolation on salivary cortisol levels. A within-subjects approach was used in which performance in the two behavioral tasks and cortisol levels were first determined during normal social housing, followed by performance and cortisol levels after experiencing stress induced by overnight social isolation. A total of 19 female pigs with a birth weight closest to their respective litter average was selected from 10 different litters and placed in two pens after weaning. Following habituation, pigs were trained in the HB task, starting at 10 weeks of age. Then, the pigs were isolated overnight, five individuals per night, at 15, 16, and 17 weeks of age. Between these three isolations, social housing and training in the HB continued. Starting 6 weeks after the end of the HB experiment, at approximately 23 weeks of age, the pigs were trained in the PGT. The effects of overnight social isolation on performance in this task were assessed once, when the pigs were 25 weeks old. Salivary cortisol was measured from samples collected 15 min after the start of isolation and at the end of the isolation period and compared to baseline values collected before the start of social isolation. Our results did not confirm the hypothesis that isolation impaired HB performance and decision-making in the PGT. Unexpectedly, overnight social isolation decreased cortisol levels below baseline values, an effect that was not associated with changes in performance of the

  4. Evaluation of a portable ambulatory prototype for automated overnight closed-loop insulin delivery in young people with type 1 diabetes.

    PubMed

    Elleri, Daniela; Allen, Janet M; Biagioni, Martina; Kumareswaran, Kavita; Leelarathna, Lalantha; Caldwell, Karen; Nodale, Marianna; Wilinska, Malgorzata E; Acerini, Carlo L; Dunger, David B; Hovorka, Roman

    2012-09-01

    To evaluate an ambulatory, portable prototype, overnight automated closed-loop (CL) system and to explore optimal time of CL initiation. We performed a randomized crossover study and compared automated overnight glucose control started at the time of an evening-meal or at bedtime. Eight young people with type 1 diabetes (T1D) on insulin pump therapy [M = 4; age = 14.3 (1.7) yr; HbA1c = 8.2 (1.3)%; mean (SD)] were studied on two occasions at clinical research facility. A standardized self-selected evening meal [70 (11)g CHO] and snack [22 (4)g CHO] accompanied by prandial insulin boluses were given at 18:00 and 21:00 hours, respectively. In random order, automated CL was started at 18:00 or 21:00 hours and ran until 8:00 hours the next day. Basal insulin delivery was automatically adjusted by a model predictive control algorithm based on real-time continuous glucose monitor readings. Overnight plasma glucose levels (between 21:00 and 08:00 hours) were within the target range (71-145 mg/dL) for 82 (59, 98)% of time when CL started at 18:00 hours and 64 (48, 70)% when CL started at 21:00 hours [median (IQR), p = 0.036]. Time spent above 180 mg/dL [8 (0, 17) vs. 13 (3, 26)%, p = 0.310] or below 70 mg/dL [0 (0,7) vs. 0 (0, 8)%, p = 1.000] did not differ between the two occasions. Mean overnight glucose [121 (14) vs. 137 (13) mg/dL, p = 0.731) was also similar. Overnight insulin infusion rates were comparable [0.8 (0.5, 1.3) vs. 0.8 (0.6, 1.4) U/h, p = 0.263]. No interruptions to CL delivery were observed. Automated CL delivery can be applied reliably and safely to control glucose levels overnight in young people with T1D. Tighter glucose levels may be achieved with an earlier time of CL initiation. © 2012 John Wiley & Sons A/S.

  5. Actual preoperative fasting time in Brazilian hospitals: the BIGFAST multicenter study

    PubMed Central

    de Aguilar-Nascimento, José E; de Almeida Dias, Ana L; Dock-Nascimento, Diana B; Correia, Maria Isabel TD; Campos, Antonio CL; Portari-Filho, Pedro Eder; Oliveira, Sergio S

    2014-01-01

    Background Prolonged fasting increases organic response to trauma. This multicenter study investigated the gap between the prescribed and the actual preoperative fasting times in Brazilian hospitals and factors associated with this gap. Methods Patients (18–90-years-old) who underwent elective operations between August 2011 and September 2012 were included in the study. The actual and prescribed times for fasting were collected and correlated with sex, age, surgical disease (malignancies or benign disease), operation type, American Society of Anesthesiologists score, type of hospital (public or private), and nutritional status. Results A total of 3,715 patients (58.1% females) with a median age of 49 (18–94) years from 16 Brazilian hospitals entered the study. The median (range) preoperative fasting time was 12 (2–216) hours, and fasting time was longer (P<0.001) in hospitals using a traditional fasting protocol (13 [6–216] hours) than in others that had adopted new guidelines (8 [2–48] hours). Almost 80% (n=2,962) of the patients were operated on after 8 or more hours of fasting and 46.2% (n=1,718) after more than 12 hours. Prolonged fasting was not associated with physical score, age, sex, type of surgery, or type of hospital. Patients operated on due to a benign disease had an extended duration of preoperative fasting. Conclusion Actual preoperative fasting time is significantly longer than prescribed fasting time in Brazilian hospitals. Most of these hospitals still adopt traditional rather than modern fasting guidelines. All patients are at risk of long periods of fasting, especially those in hospitals that follow traditional practices. PMID:24627636

  6. Clinical comparison of Colgate Total Advanced Fresh vs a commercially available fluoride breath-freshening toothpaste in reducing breath odor overnight: a multiple-use study.

    PubMed

    Niles, Hollandra P; Hunter, Catherine M; Vazquez, Joe; Williams, Malcolm I; Cummins, Diane

    2003-09-01

    The objective of this randomized, crossover study was to compare the effectiveness of Colgate Total Advanced Fresh toothpaste to a commercially available breath-freshening dentifrice containing fluoride for its ability to reduce volatile sulfur compounds (VSC) responsible for breath odor overnight. The study followed a two-treatment, two-period crossover design. Subjects were given a test product, along with a soft-bristled toothbrush, and instructed to brush their teeth for 1 minute, twice daily (once in the morning and the evening) using the assigned dentifrice for 7 consecutive days. After their evening brushing on the seventh day, subjects reported to the testing facility without oral hygiene, eating, or drinking for the overnight evaluation. After a washout period, subjects repeated the same regimen, now using the other test product. The levels of breath VSC were evaluated instrumentally using a gas chromatograph equipped with a flame photometric detector.

  7. AS-7 improved in vitro quality of red blood cells prepared from whole blood held overnight at room temperature.

    PubMed

    Veale, Margaret F; Healey, Geraldine; Sran, Amrita; Payne, Katherine A; Zia, Majid; Sparrow, Rosemary L

    2015-01-01

    Extended room temperature (RT) hold of whole blood (WB) may affect the quality of red blood cell (RBC) components produced from these donations. The availability of better RBC additive solutions (ASs) may help reduce the effects. A new AS, AS-7 (SOLX, Haemonetics Corporation), was investigated for improved in vitro quality of RBCs prepared from WB held overnight at RT. Sixteen WB units were held for 21.4 hours ± 40 minutes at 22°C on cooling plates before processing. Each pair of ABO-matched WB units were pooled, divided into a WB filter pack containing saline-adenine-glucose-mannitol (control) and a LEUKOSEP WB-filter pack containing SOLX, and processed according to manufacturer's instructions. RBCs were stored at 2 to 6°C and sampled weekly until expiry. Glycophorin A (GPA+) and annexin V-binding microparticles (MPs) were quantitated using flow cytometry. Osmotic fragility, intracellular pH (pHi), adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG), and routine quality variables were measured. Adhesion of RBCs to human endothelial cells (ECs) was evaluated by flow perfusion under low shear stress (0.5 dyne/cm(2) ), similar to low blood flow in microvessels. ATP and 2,3-DPG levels were improved for SOLX-RBCs. SOLX-RBCs maintained higher pHi, increased resistance to hypotonic stress, and reduced numbers of GPA+ MPs. No significant difference was observed between annexin V binding to MPs or adhesion of RBCs to ECs under shear stress. SOLX-stored RBCs showed increased osmotic resistance, pHi, and reduced GPA+ MPs and together with higher ATP and 2,3-DPG levels demonstrated improved in vitro RBC quality measures during 42 days of storage. © 2014 AABB.

  8. Artificial pancreas using a personalized rule-based controller achieves overnight normoglycemia in patients with type 1 diabetes.

    PubMed

    Capel, Ismael; Rigla, Mercedes; García-Sáez, Gema; Rodríguez-Herrero, Agustín; Pons, Belén; Subías, David; García-García, Fernando; Gallach, Maria; Aguilar, Montserrat; Pérez-Gandía, Carmen; Gómez, Enrique J; Caixàs, Assumpta; Hernando, M Elena

    2014-03-01

    This study assessed the efficacy of a closed-loop (CL) system consisting of a predictive rule-based algorithm (pRBA) on achieving nocturnal and postprandial normoglycemia in patients with type 1 diabetes mellitus (T1DM). The algorithm is personalized for each patient's data using two different strategies to control nocturnal and postprandial periods. We performed a randomized crossover clinical study in which 10 T1DM patients treated with continuous subcutaneous insulin infusion (CSII) spent two nonconsecutive nights in the research facility: one with their usual CSII pattern (open-loop [OL]) and one controlled by the pRBA (CL). The CL period lasted from 10 p.m. to 10 a.m., including overnight control, and control of breakfast. Venous samples for blood glucose (BG) measurement were collected every 20 min. Time spent in normoglycemia (BG, 3.9-8.0 mmol/L) during the nocturnal period (12 a.m.-8 a.m.), expressed as median (interquartile range), increased from 66.6% (8.3-75%) with OL to 95.8% (73-100%) using the CL algorithm (P<0.05). Median time in hypoglycemia (BG, <3.9 mmol/L) was reduced from 4.2% (0-21%) in the OL night to 0.0% (0.0-0.0%) in the CL night (P<0.05). Nine hypoglycemic events (<3.9 mmol/L) were recorded with OL compared with one using CL. The postprandial glycemic excursion was not lower when the CL system was used in comparison with conventional preprandial bolus: time in target (3.9-10.0 mmol/L) 58.3% (29.1-87.5%) versus 50.0% (50-100%). A highly precise personalized pRBA obtains nocturnal normoglycemia, without significant hypoglycemia, in T1DM patients. There appears to be no clear benefit of CL over prandial bolus on the postprandial glycemia.

  9. Same-day discharge compared with overnight hospitalization after uncomplicated percutaneous coronary intervention: a systematic review and meta-analysis.

    PubMed

    Abdelaal, Eltigani; Rao, Sunil V; Gilchrist, Ian C; Bernat, Ivo; Shroff, Adhir; Caputo, Ronald; Costerousse, Olivier; Pancholy, Samir B; Bertrand, Olivier F

    2013-02-01

    This study sought to evaluate outcomes of same-day discharge (SDD) following percutaneous coronary intervention (PCI) versus overnight hospitalization (ON). Although there are data on the safety and feasibility of SDD after PCI, ON continues to be prevalent. The Cochrane search strategy was used to search the PubMed database, EMBASE, and the Cochrane Library for relevant literature. Thirteen studies (5 randomized and 8 observational) of SDD after uncomplicated PCI versus ON met inclusion criteria. Data were pooled using a random effects model, and reported as odds ratios (OR) with their 95% confidence intervals (CI). The primary outcomes were incidence of total complications, major adverse cardiovascular events (MACE), and rehospitalization within 30 days after PCI. A total of 13 studies, involving 111,830 patients were pooled. There was significant variation in the definition of outcomes across studies. For total complications, the strategy of SDD compared with ON after PCI had an estimated OR of 1.20 (95% CI: 0.82 to 1.74) in randomized and 0.67 (95% CI: 0.27 to 1.66) in observational studies. Similar results were found for MACE (randomized, OR: 0.99, 95% CI: 0.45 to 2.18; observational, OR: 0.59, 95% CI: 0.06 to 5.57) and rehospitalizations (randomized, OR: 1.10, 95% CI: 0.70 to 1.74; observational, OR: 0.62, 95% CI: 0.10 to 3.98) at 30 days post PCI. There is considerable heterogeneity across published studies comparing SDD with ON. This, coupled with the low event rate and wide corresponding CIs, suggest that an adequately powered multicenter randomized trial comparing SDD with ON would require a very large sample size (>17,000). Until such a trial is completed, SDD after uncomplicated PCI seems a reasonable approach in selected patients. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Sampling of urinary cadmium: differences between 24-h urine and overnight spot urine sampling, and impact of adjustment for dilution.

    PubMed

    Akerstrom, Magnus; Lundh, Thomas; Barregard, Lars; Sallsten, Gerd

    2012-02-01

    Urinary cadmium (U-Cd) sampling can be done either by 24-h urine or spot urine sampling, and adjustment for dilution is usually needed. The choice of sampling period and adjustment technique could, however, potentially induce bias. The aim of the study was to compare 24-h urine and spot urine sampling and two dilution adjustment techniques, when assessing U-Cd. Separate 24-h urine (U24) and timed overnight spot urine (UON) samples were collected from 152 healthy kidney donors. U-Cd, creatinine concentration (U-Crea) and specific gravity (SG) were analysed. Differences between U24 and UON samples were tested using paired t test, and the effect of urinary flow rate (UF) was assessed by linear regression. The cadmium excretion rate (U-Cd/h) was lower in the UON than in U24 samples (mean 0.017 μg/h vs. 0.021 μg/h; p < 0.001). This decrease was found also for the creatinine-adjusted U-Cd (U-CdCrea) (mean 0.36 μg/gC and 0.41 μg/gC; p < 0.001). For U-Cd adjusted for specific gravity (U-CdSG), the difference was reversed, but not statistically significant. The creatinine excretion rate (U-Crea/h) decreased at low UF, especially in the UON. Since U-Cd/h was lower in UON than in U24 samples, the former will underestimate the true Cd excretion. This was seen for U-CdCrea but not for U-CdSG. However, it may be an advantage that the U-CdSG is similar, irrespective of sampling strategy. At low UF, U-CdCrea will be biased upwards. Whether U24 or UON samples adjusted for U-Crea or SG best reflect kidney-Cd is still unknown.

  11. The effect of overnight sleep deprivation after competitive rugby league matches on postmatch physiological and perceptual recovery.

    PubMed

    Skein, Melissa; Duffield, Rob; Minett, Geoffrey M; Snape, Alanna; Murphy, Alistair

    2013-09-01

    This study examined the effects of overnight sleep deprivation on recovery after competitive rugby league matches. Eleven male amateur rugby league players played 2 competitive matches, followed by either a normal night's sleep (~8 h; CONT) or a sleep-deprived night (~0 h; SDEP) in a randomized fashion. Testing was conducted the morning of the match, immediately postmatch, 2 h postmatch, and the next morning (16 h postmatch). Measures included countermovement-jump (CMJ) distance, knee-extensor maximal voluntary contraction (MVC) and voluntary activation (VA), venous-blood creatine kinase (CK) and C-reactive protein (CRP), perceived muscle soreness, and a word-color recognition cognitive-function test. Percent change between postmatch and 16-h postmatch was reported to determine the effect of the intervention the next morning. Large effects indicated a greater postmatch to 16-h-postmatch percentage decline in CMJ distance after SDEP than in CONT (P = .10-.16, d = 0.95-1.05). Similarly, the percentage decline in incongruent word-color reaction times was increased in SDEP trials (P = .007, d = 1.75). Measures of MVC did not differ between conditions (P = .40-.75, d = 0.13-0.33), although trends for larger percentage decline in VA were detected in SDEP (P = .19, d = 0.84). Furthermore, large effects indicated higher CK and CRP responses 16 h postmatch in SDEP than in CONT (P = .11-.87, d = 0.80-0.88). Sleep deprivation negatively affected recovery after a rugby league match, specifically impairing CMJ distance and cognitive function. Practitioners should promote adequate postmatch sleep patterns or adjust training demands the next day to accommodate the altered physical and cognitive state after sleep deprivation.

  12. 46 CFR 122.282 - Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight accommodations...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Logbook for vessels of more than 19.8 meters (65 feet... Voyage Records § 122.282 Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight..., the owner, managing operator, or master of a vessel of more than 19.8 meters (65 feet) in length...

  13. 46 CFR 122.282 - Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight accommodations...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Logbook for vessels of more than 19.8 meters (65 feet... Voyage Records § 122.282 Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight..., the owner, managing operator, or master of a vessel of more than 19.8 meters (65 feet) in length...

  14. 46 CFR 122.282 - Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight accommodations...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Logbook for vessels of more than 19.8 meters (65 feet... Voyage Records § 122.282 Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight..., the owner, managing operator, or master of a vessel of more than 19.8 meters (65 feet) in length...

  15. 46 CFR 122.282 - Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight accommodations...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Logbook for vessels of more than 19.8 meters (65 feet... Voyage Records § 122.282 Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight..., the owner, managing operator, or master of a vessel of more than 19.8 meters (65 feet) in length...

  16. 46 CFR 122.282 - Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight accommodations...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Logbook for vessels of more than 19.8 meters (65 feet... Voyage Records § 122.282 Logbook for vessels of more than 19.8 meters (65 feet) in length with overnight..., the owner, managing operator, or master of a vessel of more than 19.8 meters (65 feet) in length...

  17. Evaluation of overnight hold of whole blood at room temperature before component processing: effect of red blood cell (RBC) additive solutions on in vitro RBC measures.

    PubMed

    van der Meer, Pieter F; Cancelas, Jose A; Cardigan, Rebecca; Devine, Dana V; Gulliksson, Hans; Sparrow, Rosemary L; Vassallo, Ralph R; de Wildt-Eggen, Janny; Baumann-Baretti, Bärbel; Hess, John R

    2011-01-01

    Whole blood (WB) can be held at room temperature (18-25°C) up to 8 hours after collection; thereafter the unit must be refrigerated, rendering it unsuitable for platelet (PLT) production. Overnight hold at room temperature before processing has logistic advantages, and we evaluated this process in an international multicenter study for both buffy coat (BC)- and PLT-rich plasma (PRP)-based blood components and compared three red blood cell (RBC) additive solutions (ASs) for their ability to offset effects of overnight hold. Nine centers participated; seven used the BC method, and two used the PRP method. Four WB units were pooled and split; 1 unit was processed less than 8 hours from collection (Group A), and the other three (Groups B, C, and D) were held at room temperature and processed after 24 to 26 hours. RBCs in Groups A and B were resuspended in saline-adenine-glucose-mannitol, Group C in phosphate-adenine-guanosine-glucose-saline-mannitol, and Group D in ErythroSol-4 RBCs were stored at 2 to 6°C for 49 days. RBCs from overnight-held WB had lower 2,3-diphosphoglycerate (2,3-DPG) and higher adenosine triphosphate (ATP). At the end of storage there were no differences between groups, apart from a slightly higher hemolysis in Group B. ErythroSol-4 showed a slightly higher initial ATP and 2,3-DPG content, but at the end of storage no differences were found. Overnight hold of WB before processing has no lasting deleterious effects on in vitro quality of subsequently prepared components. The use of different RBC ASs did not appear to offer significant advantages in terms of RBC quality at the end, regardless of the processing method. © 2010 American Association of Blood Banks.

  18. Cryopreservation of bull semen shipped overnight and its effect on post-thaw sperm motility, plasma membrane integrity, mitochondrial membrane potential and normal acrosomes.

    PubMed

    Anzar, M; Kroetsch, T; Boswall, L

    2011-06-01

    In the Canadian Animal Genetic Resource Program, bull semen is donated in frozen or fresh (diluted) states. This study was designed to assess the cryopreservation of diluted bull semen shipped at 4°C overnight, and to determine the post-thaw quality of shipped semen using different straw volumes and freezing rates. Semen was collected from four breeding bulls (three ejaculates per bull). Semen was diluted in Tris-citric acid-egg yolk-glycerol (TEYG) extender, cooled to 4°C and frozen as per routine (control semen). After cooling to 4°C, a part of semen was removed and shipped overnight to the research laboratory via express courier (shipped semen). Semen was packaged in 0.25 or 0.5 ml straws and frozen in a programmable freezer using three freezing rates, i.e., -10, -25 or -40°C/min. Control semen was also shipped to the research laboratory. Post-thaw sperm motility characteristics were assessed using CASA, and post-thaw sperm plasma membrane, mitochondrial membrane potential and normal acrosomes were assessed using flow cytometry. Post-thaw sperm quality was greater in shipped semen as compared to control (P<0.001). The shipped semen packaged in 0.25 ml straws had better post-thaw sperm quality than in 0.5 ml straws (P<0.001). Freezing rate had no effect on post-thaw sperm quality. In conclusion, bull semen can be shipped overnight for subsequent cryopreservation and gene banking. Overnight shipping of semen was found advantageous for bull semen cryopreservation. Semen packaging in 0.25 ml straws yielded better post-thaw quality than 0.5 ml straws.

  19. The Use of an Automated, Portable Glucose Control System for Overnight Glucose Control in Adolescents and Young Adults With Type 1 Diabetes

    PubMed Central

    O'Grady, Michael J.; Retterath, Adam J.; Keenan, D. Barry; Kurtz, Natalie; Cantwell, Martin; Spital, Glenn; Kremliovsky, Michael N.; Roy, Anirban; Davis, Elizabeth A.; Jones, Timothy W.; Ly, Trang T.

    2012-01-01

    OBJECTIVE A key milestone in progress towards providing an efficacious and safe closed-loop artificial pancreas system for outpatient use is the development of fully automated, portable devices with fault detection capabilities to ensure patient safety. The ability to remotely monitor the operation of the closed-loop system would facilitate future physician-supervised home studies. RESEARCH DESIGN AND METHODS This study was designed to investigate the efficacy and safety of a fully automated, portable, closed-loop system. The Medtronic Portable Glucose Control System (PGCS) consists of two subcutaneous glucose sensors, a control algorithm based on proportional-integral-derivative with insulin feedback operating from a BlackBerry Storm smartphone platform, Bluetooth radiofrequency translator, and an off-the-shelf Medtronic Paradigm Veo insulin pump. Participants with type 1 diabetes using insulin pump therapy underwent two consecutive nights of in-clinic, overnight, closed-loop control after a baseline open-loop assessment. RESULTS Eight participants attended for 16 overnight studies. The PGCS maintained mean overnight plasma glucose levels of 6.4 ± 1.7 mmol/L (115 ± 31 mg/dL). The proportion of time with venous plasma glucose <3.9, between 3.9 and 8 (70 and 144 mg/dL), and >8 mmol/L was 7, 78, and 15%, respectively. The proportion of time the sensor glucose values were maintained between 3.9 and 8 mmol/L was greater for closed-loop than open-loop (84.5 vs. 46.7%; P < 0.0001), and time spent <3.3 mmol/L was also reduced (0.9 vs. 3%; P < 0.0001). CONCLUSIONS These results suggest that the PGCS, an automated closed-loop device, is safe and effective in achieving overnight glucose control in patients with type 1 diabetes. PMID:22875230

  20. Fast hybridization solution for the detection of immobilized nucleic acids.

    PubMed

    Yang, T T; Kain, S R

    1995-03-01

    We have developed a fast hybridization solution, termed ExpressHyb, for the rapid and sensitive detection of nucleic acids immobilized on membrane supports. This solution reduces typical hybridization times of 12-24 h to as little as 1 h while simultaneously increasing the sensitivity of detection in many applications. Using ExpressHyb, human beta-actin mRNA was detected on a human multiple tissue Northern (MTN) blot following a 30-min hybridization, with optimal detection occurring with a 1-h hybridization interval. The moderately abundant human glyceraldehyde-3-phosphate dehydrogenase (G3PDH) mRNA was detected using similar hybridization conditions and yielded improved signal-to-background characteristics relative to overnight hybridizations in conventional solutions. ExpressHyb can be used with either 32P- or digoxigenin-labeled probes and works effectively with both cDNA and oligonucleotide probes. For non-isotopic detection in particular, ExpressHyb reduces the nonspecific background commonly encountered with this technique. In cDNA library screening, ExpressHyb was found to both reduce the time required for effective hybridizations and to increase the number of positive colonies obtained relative to conventional overnight procedures. Taken together, these results illustrate the broad capability of ExpressHyb Hybridization Solution to improve nucleic acid detection in a variety of important techniques.

  1. Contributions of gluconeogenesis to glucose production in the fasted state.

    PubMed Central

    Landau, B R; Wahren, J; Chandramouli, V; Schumann, W C; Ekberg, K; Kalhan, S C

    1996-01-01

    Healthy subjects ingested 2H2O and after 14, 22, and 42 h of fasting the enrichments of deuterium in the hydrogens bound to carbons 2, 5, and 6 of blood glucose and in body water were determined. The hydrogens bound to the carbons were isolated in formaldehyde which was converted to hexamethylenetetramine for assay. Enrichment of the deuterium bound to carbon 5 of glucose to that in water or to carbon 2 directly equals the fraction of glucose formed by gluconeogenesis. The contribution of gluconeogenesis to glucose production was 47 +/- 49% after 14 h, 67 +/- 41% after 22 h, and 93 +/- 2% after 42 h of fasting. Glycerol's conversion to glucose is included in estimates using the enrichment at carbon 5, but not carbon 6. Equilibrations with water of the hydrogens bound to carbon 3 of pyruvate that become those bound to carbon 6 of glucose and of the hydrogen at carbon 2 of glucose produced via glycogenolysis are estimated from the enrichments to be approximately 80% complete. Thus, rates of gluconeogenesis can be determined without corrections required in other tracer methodologies. After an overnight fast gluconeogenesis accounts for approximately 50% and after 42 h of fasting for almost all of glucose production in healthy subjects. PMID:8755648

  2. Unsupervised overnight closed loop insulin delivery during free living: analysis of randomised cross-over home studies in adults and adolescents with type 1 diabetes.

    PubMed

    Thabit, Hood; Elleri, Daniela; Leelarathna, Lalantha; Allen, Janet; Lubina-Solomon, Alexandra; Stadler, Marietta; Walkinshaw, Emma; Iqbal, Ahmed; Choudhary, Pratik; Wilinska, Malgorzata; Barnard, Katharine; Heller, Simon; Amiel, Stephanie; Evans, Mark; Dunger, David; Hovorka, Roman

    2015-02-26

    The closed-loop system (artificial pancreas) delivers insulin in a glucose-responsive manner by the use of a control algorithm that automatically directs insulin delivery, based on real-time sensor glucose concentrations. Results from hospital-based studies have shown improved overnight glucose control and reduced risk of hypoglycaemia in type 1 diabetes. We aimed to assess whether unsupervised closed-loop systems can provide a realistic treatment option in patients with type 1 diabetes. We combined data from two open-label, phase 2, randomised, cross-over, unsupervised home trials of people with type 1 diabetes, one in 24 adults (mean age 43 years [SD 12], HbA1c 8·0% [0·9]) and the other in 16 adolescents (15·6 [3·6], 8·1 [0·8]). In each trial, after training on study devices, participants were allocated to two periods of sensor-augmented pump therapy either with or without overnight closed loop that used a model predictive control algorithm to direct insulin delivery. Allocation sequence was done with a computer-generated random code. Each period lasted 4 weeks in adults and 3 weeks in adolescents. Primary outcome for both trials was time when sensor glucose was in the target range (3·9-8·0 mmol/L). Analysis was by intention to treat. Participants (or parents) gave written informed consent. The trials are registered with ClinicalTrials.gov, numbers NCT01440140 and NCT01221467. Closed loop was started by participants on their own volition on 866 (89%) of 978 nights. The proportion of time when sensor glucose was in the target range between 0000 h and 0800 h was increased by a mean of 18·4% (95% CI 13·5-23·4, p<0·0001) during closed loop compared with no closed loop. Closed loop significantly reduced mean overnight sensor glucose by 0·9 mmol/L (95% CI 0·4-1·3, p=0·0001), and reduced the proportion of time when sensor glucose values were suggestive of hyperglycaemia (>8·0 mmol/L) (15·9%, 10·7-21·0; p<0·0001) and hypoglycaemia (<3·9 mmol

  3. Artificial Pancreas Using a Personalized Rule-Based Controller Achieves Overnight Normoglycemia in Patients with Type 1 Diabetes

    PubMed Central

    Rigla, Mercedes; García-Sáez, Gema; Rodríguez-Herrero, Agustín; Pons, Belén; Subías, David; García-García, Fernando; Gallach, Maria; Aguilar, Montserrat; Pérez-Gandía, Carmen; Gómez, Enrique J.; Caixàs, Assumpta; Hernando, M. Elena

    2014-01-01

    Abstract Objective: This study assessed the efficacy of a closed-loop (CL) system consisting of a predictive rule-based algorithm (pRBA) on achieving nocturnal and postprandial normoglycemia in patients with type 1 diabetes mellitus (T1DM). The algorithm is personalized for each patient's data using two different strategies to control nocturnal and postprandial periods. Research Design and Methods: We performed a randomized crossover clinical study in which 10 T1DM patients treated with continuous subcutaneous insulin infusion (CSII) spent two nonconsecutive nights in the research facility: one with their usual CSII pattern (open-loop [OL]) and one controlled by the pRBA (CL). The CL period lasted from 10 p.m. to 10 a.m., including overnight control, and control of breakfast. Venous samples for blood glucose (BG) measurement were collected every 20 min. Results: Time spent in normoglycemia (BG, 3.9–8.0 mmol/L) during the nocturnal period (12 a.m.–8 a.m.), expressed as median (interquartile range), increased from 66.6% (8.3–75%) with OL to 95.8% (73–100%) using the CL algorithm (P<0.05). Median time in hypoglycemia (BG, <3.9 mmol/L) was reduced from 4.2% (0–21%) in the OL night to 0.0% (0.0–0.0%) in the CL night (P<0.05). Nine hypoglycemic events (<3.9 mmol/L) were recorded with OL compared with one using CL. The postprandial glycemic excursion was not lower when the CL system was used in comparison with conventional preprandial bolus: time in target (3.9–10.0 mmol/L) 58.3% (29.1–87.5%) versus 50.0% (50–100%). Conclusions: A highly precise personalized pRBA obtains nocturnal normoglycemia, without significant hypoglycemia, in T1DM patients. There appears to be no clear benefit of CL over prandial bolus on the postprandial glycemia. PMID:24152323

  4. Acid-fast stain

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003766.htm Acid-fast stain To use the sharing features on this page, please enable JavaScript. The acid-fast stain is a laboratory test that determines ...

  5. Fast food (image)

    MedlinePlus

    Fast foods are quick, reasonably priced, and readily available alternatives to home cooking. While convenient and economical for a busy lifestyle, fast foods are typically high in calories, fat, saturated ...

  6. Is fast food addictive?

    PubMed

    Garber, Andrea K; Lustig, Robert H

    2011-09-01

    Studies of food addiction have focused on highly palatable foods. While fast food falls squarely into that category, it has several other attributes that may increase its salience. This review examines whether the nutrients present in fast food, the characteristics of fast food consumers or the presentation and packaging of fast food may encourage substance dependence, as defined by the American Psychiatric Association. The majority of fast food meals are accompanied by a soda, which increases the sugar content 10-fold. Sugar addiction, including tolerance and withdrawal, has been demonstrated in rodents but not humans. Caffeine is a "model" substance of dependence; coffee drinks are driving the recent increase in fast food sales. Limited evidence suggests that the high fat and salt content of fast food may increase addictive potential. Fast food restaurants cluster in poorer neighborhoods and obese adults eat more fast food than those who are normal weight. Obesity is characterized by resistance to insulin, leptin and other hormonal signals that would normally control appetite and limit reward. Neuroimaging studies in obese subjects provide evidence of altered reward and tolerance. Once obese, many individuals meet criteria for psychological dependence. Stress and dieting may sensitize an individual to reward. Finally, fast food advertisements, restaurants and menus all provide environmental cues that may trigger addictive overeating. While the concept of fast food addiction remains to be proven, these findings support the role of fast food as a potentially addictive substance that is most likely to create dependence in vulnerable populations.

  7. Effect of a protected sleep period on hours slept during extended overnight in-hospital duty hours among medical interns: a randomized trial.

    PubMed

    Volpp, Kevin G; Shea, Judy A; Small, Dylan S; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian; Novak, Cristina; Bellini, Lisa M; Dine, C Jessica; Mollicone, Daniel J; Dinges, David F

    2012-12-05

    A 2009 Institute of Medicine report recommended protected sleep periods for medicine trainees on extended overnight shifts, a position reinforced by new Accreditation Council for Graduate Medical Education requirements. To evaluate the feasibility and consequences of protected sleep periods during extended duty. Randomized controlled trial conducted at the Philadelphia VA Medical Center medical service and Oncology Unit of the Hospital of the University of Pennsylvania (2009-2010). Of the 106 interns and senior medical students who consented, 3 were not scheduled on any study rotations. Among the others, 44 worked at the VA center, 16 at the university hospital, and 43 at both. Twelve 4-week blocks were randomly assigned to either a standard intern schedule (extended duty overnight shifts of up to 30 hours; equivalent to 1200 overnight intern shifts at each site), or a protected sleep period (protected time from 12:30 AM to 5:30 AM with handover of work cell phone; equivalent to 1200 overnight intern shifts at each site). Participants were asked to wear wrist actigraphs and complete sleep diaries. Primary outcome was hours slept during the protected period on extended duty overnight shifts. Secondary outcome measures included hours slept during a 24-hour period (noon to noon) by day of call cycle and Karolinska sleepiness scale. For 98.3% of on-call nights, cell phones were signed out as designed. At the VA center, participants with protected sleep had a mean 2.86 hours (95% CI, 2.57-3.10 hours) of sleep vs 1.98 hours (95% CI, 1.68-2.28 hours) among those who did not have protected hours of sleep (P < .001). At the university hospital, participants with protected sleep had a mean 3.04 hours (95% CI, 2.77-3.45 hours) of sleep vs 2.04 hours (95% CI, 1.79-2.24) among those who did not have protected sleep (P < .001). Participants with protected sleep were significantly less likely to have call nights with no sleep: 5.8% (95% CI, 3.0%-8.5%) vs 18.6% (95% CI, 13

  8. Success rate, efficacy, and safety/tolerability of overnight switching from immediate- to extended-release pramipexole in advanced Parkinson's disease.

    PubMed

    Schapira, A H V; Barone, P; Hauser, R A; Mizuno, Y; Rascol, O; Busse, M; Debieuvre, C; Fraessdorf, M; Poewe, W

    2013-01-01

    For Parkinson's disease (PD), an extended-release (ER) pramipexole formulation taken once daily, has shown efficacy, safety, and tolerability resembling those of immediate-release (IR) pramipexole taken three times daily. The present study assessed, in advanced PD, the success of an overnight switch from adjunctive IR to ER. Levodopa users experiencing motor fluctuations were randomized to adjunctive double-blind (DB) placebo, IR, or ER. Amongst completers of ≥18 weeks, ER recipients were kept on DB ER, whilst IR recipients were switched overnight to DB ER at unchanged daily dosage. After a DB week, switch success was assessed. During the next 5 weeks, all patients underwent ER titration to optimal open-label maintenance dosage. One week post-switch, 86.2% of 123 IR-to-ER and 83.8% of 105 ER-to-ER patients had ≤15% (or ≤3-point, for pre-switch scores ≤20) increase on UPDRS Parts II + III, and 77.9% (of 122) and 70.2% (of 104) had ≤1-h increase in daily OFF-time. At 32 weeks, the groups showed comparable improvements from DB baseline (pramipexole inception), including, on UPDRS II + III, adjusted mean (SE) changes of -14.8 (1.5) for IR-to-ER and -13.3 (1.6) for ER-to-ER. Rates of premature discontinuation owing to adverse events were 6.5% for IR-to-ER and 4.9% for ER-to-ER. By OFF-time and UPDRS criteria, majorities of patients with advanced PD were successfully switched overnight from pramipexole IR to ER at unchanged daily dosage. During subsequent maintenance, pramipexole showed sustained efficacy, safety, and tolerability, regardless of formulation (IR or ER) in the preceding DB trial. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

  9. The bioequivalence of frozen plasma prepared from whole blood held overnight at room temperature compared to fresh-frozen plasma prepared within eight hours of collection.

    PubMed

    Dumont, Larry J; Cancelas, Jose A; Maes, Lou Ann; Rugg, Neeta; Whitley, Pamela; Herschel, Louise; Siegel, Alan H; Szczepiorkowski, Zbigniew M; Hess, John R; Zia, Majid

    2015-03-01

    Overnight, room temperature hold of whole blood (WB) before leukoreduction and component processing offers significant logistic and cost advantages over WB processed within 8 hours. Plasma prepared from WB held at room temperature overnight (PF24RT24WB) may result in a degradation of plasma coagulation protein activities compared to plasma frozen within 8 hours of collection. In this study, we intended to evaluate the bioequivalence (BE) of PF24RT24WB prepared using a new WB collection, leukoreduction, and storage system compared to fresh-frozen plasma (FFP) after 12 months of frozen storage. We conducted a three-center, three-arm evaluation of the LEUKOSEP HWB-600-XL test system (Hemerus Medical LLC) compared to the RZ2000 control (Fenwal, Inc.). FFP was prepared from WB held at room temperature more than 6 hours and placed at less than -18 °C by 8 hours for control (n = 60) and test (n = 60) arms. PF24RT24WB (n = 60) was prepared with the test system from WB held at room temperature and then filtered and processed 20 to 24 hours postcollection. Frozen plasma was tested at 3, 6, and 12 months using a comprehensive panel of protein and coagulation factor assays. The test FFP was BE for all coagulation factors and tested proteins at 12 months. As expected, PF24RT24WB had a reduced Factor (F)VIII activity compared to control FFP (87.1%; 90% confidence interval, 79.4%-93.3%) with the lower confidence limit less than 80%. All other factors were within the BE region. Leukoreduced FFP and PF24RT24WB prepared using the LEUKOSEP HWB-600-XL system has been shown to be BE to control leukoreduced FFP with an expected decrease in FVIII activity after overnight hold. © 2014 AABB.

  10. Immediate postoperative morbidity in patients with indwelling double-J stent versus overnight-externalized ureteral catheter after tubeless percutaneous nephrolithotomy: a prospective, randomized study.

    PubMed

    Mercado, Alejandro; Fernández, Mario I; Recabal, Pedro; Fleck, Daniela; Ledezma, Rodrigo; Moya, Francisco; Sepúlveda, Francisco; Vilches, Roberto; Reyes, Diego; Marchant, Fernando

    2013-06-01

    The conventional technique for percutaneous nephrolithotomy (PNL) ends by placing a nephrostomy tube within the access tract. However, feasibility and safety of tubeless PNL have been widely demonstrated. In this modification, a ureteral stent is usually left in place instead of the nephrostomy tube. The aim of this study is to compare the use of a postoperative indwelling double-J stent versus an overnight-externalized ureteral catheter in patients undergoing tubeless PNL. Sixty-eight patients undergoing tubeless PNL were randomized either for a postoperative double-J stent (group 1) or for an overnight-externalized ureteral catheter (group 2). Outcomes evaluated included postoperative pain, hospital stay length, incidence of hemorrhagic complications, residual lithiasis and urinary leakage. Groups were similar according to age, sex, body mass index and stone burden. There were no significant differences in terms of postoperative pain, incidence of perirenal hematomas, residual lithiasis and urinary leakage. However, patients in group 1 presented longer hospital stays (3.7 ± 1.7 vs. 1.9 ± 0.3 days; p < 0.001) and greater hematocrit drops (4.9 ± 2.2 vs. 2.1 ± 1.8 %; p < 0.001). Our results confirm that among patients undergoing tubeless PNL, both alternatives (i.e. leaving a double-J stent or an overnight-externalized ureteral catheter) are reliable and safe. However, further considerations, like the need of double-J stent removal under cystoscopy, need to be taken into account when deciding which modality to use.

  11. Meta-analysis of overnight closed-loop randomized studies in children and adults with type 1 diabetes: the Cambridge cohort.

    PubMed

    Kumareswaran, Kavita; Elleri, Daniela; Allen, Janet M; Harris, Julie; Xing, Dongyuan; Kollman, Craig; Nodale, Marianna; Murphy, Helen R; Amiel, Stephanie A; Heller, Simon R; Wilinska, Malgorzata E; Acerini, Carlo L; Evans, Mark L; Dunger, David B; Hovorka, Roman

    2011-11-01

    We reviewed the safety and efficacy of overnight closed-loop insulin delivery compared with conventional continuous subcutaneous insulin infusion (CSII) in two distinct age groups with type 1 diabetes mellitus (T1DM), young people aged 5 to 18 years and adults, combining data of previously published randomized studies. We evaluated four randomized crossover studies in 17 children and adolescents [13.4 ± 3.6 years; mean ± standard deviation (SD)] and 24 adults (37.5 ± 9.1 years) on 45 closed-loop (intervention) and 45 CSII (control) visits. Each subject attended for two overnight study visits, using either closed-loop or conventional pump therapy, in random order. In each age group, studies were designed to mimic realistic likely scenarios. In the children and adolescent studies, closed loop was used following a standard evening meal and following 40 min of moderate-intensity exercise. In the adult studies, closed loop was commenced following a 60 g carbohydrate meal or a 100 g carbohydrate meal accompanied by alcohol. The primary outcome measure was time for which plasma glucose was within target range (3.91-8.0 mmol/liter). Overnight closed loop increased the time in target plasma glucose in both young (from 40% to 60%, p = .002) and adults (from 50% to 76%, p < .001) compared with conventional CSII. Combined analysis showed an increase from 43% to 71% with closed loop (p < .001). Additionally, closed loop reduced the time spent below 3.91 mmol/liter and above 8.0 mmol/liter, from 4.1% to 2.1% (p = .01) and 33% to 20% (p = .03), respectively. Glycemic variability, as measured by the SD of plasma glucose, was lower during closed loop compared with CSII (1.5 versus 2.1 mmol/liter, p = .007). Overnight closed loop may improve glycemic control and reduce nocturnal hypoglycemia in both young people and adults with T1DM. © 2011 Diabetes Technology Society.

  12. Home use of closed-loop insulin delivery for overnight glucose control in adults with type 1 diabetes: a 4-week, multicentre, randomised crossover study.

    PubMed

    Thabit, Hood; Lubina-Solomon, Alexandra; Stadler, Marietta; Leelarathna, Lalantha; Walkinshaw, Emma; Pernet, Andrew; Allen, Janet M; Iqbal, Ahmed; Choudhary, Pratik; Kumareswaran, Kavita; Nodale, Marianna; Nisbet, Chloe; Wilinska, Malgorzata E; Barnard, Katharine D; Dunger, David B; Heller, Simon R; Amiel, Stephanie A; Evans, Mark L; Hovorka, Roman

    2014-09-01

    Closed-loop insulin delivery is a promising option to improve glycaemic control and reduce the risk of hypoglycaemia. We aimed to assess whether overnight home use of automated closed-loop insulin delivery would improve glucose control. We did this open-label, multicentre, randomised controlled, crossover study between Dec 1, 2012, and Dec 23, 2014, recruiting patients from three centres in the UK. Patients aged 18 years or older with type 1 diabetes were randomly assigned to receive 4 weeks of overnight closed-loop insulin delivery (using a model-predictive control algorithm to direct insulin delivery), then 4 weeks of insulin pump therapy (in which participants used real-time display of continuous glucose monitoring independent of their pumps as control), or vice versa. Allocation to initial treatment group was by computer-generated permuted block randomisation. Each treatment period was separated by a 3-4 week washout period. The primary outcome was time spent in the target glucose range of 3·9-8·0 mmol/L between 0000 h and 0700 h. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01440140. We randomly assigned 25 participants to initial treatment in either the closed-loop group or the control group, patients were later crossed over into the other group; one patient from the closed-loop group withdrew consent after randomisation, and data for 24 patients were analysed. Closed loop was used over a median of 8·3 h (IQR 6·0-9·6) on 555 (86%) of 644 nights. The proportion of time when overnight glucose was in target range was significantly higher during the closed-loop period compared to during the control period (mean difference between groups 13·5%, 95% CI 7·3-19·7; p=0·0002). We noted no severe hypoglycaemic episodes during the control period compared with two episodes during the closed-loop period; these episodes were not related to closed-loop algorithm instructions. Unsupervised overnight closed

  13. Neuromuscular electrical stimulation prior to presleep protein feeding stimulates the use of protein-derived amino acids for overnight muscle protein synthesis.

    PubMed

    Dirks, Marlou L; Groen, Bart B L; Franssen, Rinske; van Kranenburg, Janneau; van Loon, Luc J C

    2017-01-01

    Short periods of muscle disuse result in substantial skeletal muscle atrophy. Recently, we showed that both neuromuscular electrical stimulation (NMES) as well as presleep dietary protein ingestion represent effective strategies to stimulate muscle protein synthesis rates. In this study, we test our hypothesis that NMES can augment the use of presleep protein-derived amino acids for overnight muscle protein synthesis in older men. Twenty healthy, older [69 ± 1 (SE) yr] men were subjected to 24 h of bed rest, starting at 8:00 AM. In the evening, volunteers were subjected to 70-min 1-legged NMES, while the other leg served as nonstimulated control (CON). Immediately following NMES, 40 g of intrinsically l-[1-(13)C]-phenylalanine labeled protein was ingested prior to sleep. Blood samples were taken throughout the night, and muscle biopsies were obtained from both legs in the evening and the following morning (8 h after protein ingestion) to assess dietary protein-derived l-[1-(13)C]-phenylalanine enrichments in myofibrillar protein. Plasma phenylalanine concentrations and plasma l-[1-(13)C]-phenylalanine enrichments increased significantly following protein ingestion and remained elevated for up to 6 h after protein ingestion (P < 0.05). During overnight sleep, myofibrillar protein-bound l-[1-(13)C]-phenylalanine enrichments (MPE) increased to a greater extent in the stimulated compared with the control leg (0.0344 ± 0.0019 vs. 0.0297 ± 0.0016 MPE, respectively; P < 0.01), representing 18 ± 6% greater incorporation of presleep protein-derived amino acids in the NMES compared with CON leg. In conclusion, application of NMES prior to presleep protein feeding stimulates the use of dietary protein-derived amino acids for overnight muscle protein synthesis in older men. Neuromuscular electrical stimulation (NMES) as well as presleep dietary protein ingestion represent effective strategies to stimulate muscle protein synthesis rates. Here we demonstrate that in older

  14. Meta-Analysis of Overnight Closed-Loop Randomized Studies in Children and Adults with Type 1 Diabetes: The Cambridge Cohort

    PubMed Central

    Kumareswaran, Kavita; Elleri, Daniela; Allen, Janet M; Harris, Julie; Xing, Dongyuan; Kollman, Craig; Nodale, Marianna; Murphy, Helen R; Amiel, Stephanie A; Heller, Simon R; Wilinska, Malgorzata E; Acerini, Carlo L; Evans, Mark L; Dunger, David B; Hovorka, Roman

    2011-01-01

    Aim We reviewed the safety and efficacy of overnight closed-loop insulin delivery compared with conventional continuous subcutaneous insulin infusion (CSII) in two distinct age groups with type 1 diabetes mellitus (T1DM), young people aged 5 to 18 years and adults, combining data of previously published randomized studies. Methods We evaluated four randomized crossover studies in 17 children and adolescents [13.4 ± 3.6 years; mean ± standard deviation (SD)] and 24 adults (37.5 ± 9.1 years) on 45 closed-loop (intervention) and 45 CSII (control) visits. Each subject attended for two overnight study visits, using either closed-loop or conventional pump therapy, in random order. In each age group, studies were designed to mimic realistic likely scenarios. In the children and adolescent studies, closed loop was used following a standard evening meal and following 40 min of moderate-intensity exercise. In the adult studies, closed loop was commenced following a 60 g carbohydrate meal or a 100 g carbohydrate meal accompanied by alcohol. The primary outcome measure was time for which plasma glucose was within target range (3.91–8.0 mmol/liter). Results Overnight closed loop increased the time in target plasma glucose in both young (from 40% to 60%, p = .002) and adults (from 50% to 76%, p < .001) compared with conventional CSII. Combined analysis showed an increase from 43% to 71% with closed loop (p < .001). Additionally, closed loop reduced the time spent below 3.91 mmol/liter and above 8.0 mmol/liter, from 4.1% to 2.1% (p = .01) and 33% to 20% (p = .03), respectively. Glycemic variability, as measured by the SD of plasma glucose, was lower during closed loop compared with CSII (1.5 versus 2.1 mmol/liter, p = .007). Conclusions Overnight closed loop may improve glycemic control and reduce nocturnal hypoglycemia in both young people and adults with T1DM. PMID:22226252

  15. Glucose turnover in 48-hour-fasted running rats

    SciTech Connect

    Sonne, B.; Mikines, K.J.; Galbo, H.

    1987-03-01

    In fed rats, hyperglycemia develops during exercise. This contrasts with the view based on studies of fasted human and dog that euglycemia is maintained in exercise and glucose production (R/sub a/) controlled by feedback mechanisms. Forty-eight-hour-fasted rats (F) were compared to fed rats (C) and overnight food-restricted (FR) rats. (3-/sup 3/H)- and (U-/sup 14/C)glucose were infused and blood and tissue sampled. During running (21 m/min, 0% grade) R/sub a/ increased most in C and least in F and only in F did R/sub a/ not significantly exceed glucose disappearance. Plasma glucose increased more in C (3.3 mmol/1) than in FR (1.6 mmol/l) and only modestly (0.6 mmol/l) and transiently in F. Resting liver glycogen and exercise glycogenolysis were highest in C and similar in FR and F. Resting muscle glycogen and exercise glycogenolysis were highest in C and lowest in F. During running, lactate production and gluconeogenesis were higher in FR than in F. At least in rats, responses of production and plasma concentration of glucose to exercise depend on size of liver and muscle glycogen stores; glucose production matches increase in clearance better in fasted than in fed states. Probably glucose production is stimulated by feedforward mechanisms and feedback mechanisms are added if plasma glucose decreases.

  16. Corticotropin-releasing factor-overexpressing mice exhibit reduced neuronal activation in the arcuate nucleus and food intake in response to fasting.

    PubMed

    Stengel, Andreas; Goebel, Miriam; Million, Mulugeta; Stenzel-Poore, Mary P; Kobelt, Peter; Mönnikes, Hubert; Taché, Yvette; Wang, Lixin

    2009-01-01

    Corticotropin-releasing factor (CRF) overexpressing (OE) mice are a genetic model that exhibits features of chronic stress. We investigated whether the adaptive feeding response to a hypocaloric challenge induced by food deprivation is impaired under conditions of chronic CRF overproduction. Food intake response to a 16-h overnight fast and ip injection of gut hormones regulating food intake were compared in CRF-OE and wild type (WT) littermate mice along with brain Fos expression, circulating ghrelin levels, and gastric emptying of a nonnutrient meal. CRF-OE mice injected ip with saline showed a 47 and 44% reduction of 30-min and 4-h cumulative food intake response to an overnight fast, respectively, compared with WT. However, the 30-min food intake decrease induced by ip cholecystokinin (3 microg/kg) and increase by ghrelin (300 microg/kg) were similar in CRF-OE and WT mice. Overnight fasting increased the plasma total ghrelin to similar levels in CRF-OE and WT mice, although CRF-OE mice had a 2-fold reduction of nonfasting ghrelin levels. The number of Fos-immunoreactive cells induced by fasting in the arcuate nucleus was reduced by 5.9-fold in CRF-OE compared with WT mice whereas no significant changes were observed in other hypothalamic nuclei. In contrast, fasted CRF-OE mice displayed a 5.6-fold increase in Fos-immunoreactive cell number in the dorsal motor nucleus of the vagus nerve and a 34% increase in 20-min gastric emptying. These findings indicate that sustained overproduction of hypothalamic CRF in mice interferes with fasting-induced activation of arcuate nucleus neurons and the related hyperphagic response.

  17. Six-month overnight intraperitoneal amino-acid infusion in continuous ambulatory peritoneal dialysis (CAPD) patients--no effect on nutritional status.

    PubMed

    Dombros, N V; Prutis, K; Tong, M; Anderson, G H; Harrison, J; Sombolos, K; Digenis, G; Pettit, J; Oreopoulos, D G

    1990-01-01

    The long-term effect of an AA solution based on Travasol, a solution for total parenteral nutrition, given intraperitoneally over a 6-month period was studied in 5 patients 22 to 75 years old, having been on continuous ambulatory peritoneal dialysis (CAPD) for 3 to 57 months. A low oral protein intake (less than 0.8 g/kg bw/day) and/or a low serum albumin (less than 35 g/L) were used as inclusion criteria. Two liters of 1% AA solution were infused overnight, while a glucose Dianeal was used for the other exchanges. During the study, BUN increased from 22.04 mM/L to 28.06 mM/L the first month and remained at these levels, indicating the increased protein intake. However, average oral total energy and protein intake, body weight (bw), serum creatinine, cholesterol, triglycerides, total proteins, albumin, transferrin, skinfold thickness, total body potassium, and plasma AA levels remained basically unchanged. The average total body nitrogen decreased from 1.746 to 1.554 Kg, but this decrease did not reach statistical significance (p greater than 0.05). We conclude that intraperitoneal overnight administration of 2 L of 1% AA based on Travasol over 6 months did not improve the nutritional status of CAPD patients. This ineffectiveness might be due to the AA composition of the solution, the timing of administration, or to a low caloric intake and/or that our patients were not severely malnourished.

  18. Phage cocktail to control the exponential growth of normal flora in processed sputum specimens grown overnight in liquid medium for rapid TB diagnosis.

    PubMed

    Kumar, Vanaja; Balaji, S; Gomathi, N S; Venkatesan, P; Sekar, Gomathi; Jayasankar, K; Narayanan, P R

    2007-03-01

    The mechanical pressure exerted during centrifugation and the chemical pressure experienced when sputum specimens are processed, leave the tubercle bacilli in the sputum unsuitable for rapid detection especially in phage based assays. Thus, growing Mycobacterium tuberculosis in broth, at least overnight, is mandatory for allowing the tubercle bacilli to recoup. During this time the surviving colonizing flora grow faster and overgrow tubercle bacilli interfering with TB diagnosis. In the present study normal flora surviving the action of 4% NaOH was isolated and characterized. Phages capable of killing 14 different species representing this normal flora were isolated from soil and sewage samples and characterized. A novel and bio-friendly approach to treat sputum samples with a cocktail of three phages capable of killing most of the 14 representative organisms and not infecting mycobacteria is explored to control the overgrowth of colonizing bacteria in broth culture. While 26 of the 100 sputum samples processed by modified Petroff's procedure showed growth of colonizing flora on blood agar, all of them when grown in broth overnight showed mixed, confluent growth. The addition of phagebiotics controlled them all, showing a significant reduction in colony forming units but resulting in few discrete colonies in 54 samples. Isolation of phages capable of controlling these surviving organisms and including them in the phagebiotics mixture should lead to the control of colonizing bacteria effectively.

  19. Efficacy of an Overnight Predictive Low-Glucose Suspend System in Relation to Hypoglycemia Risk Factors in Youth and Adults With Type 1 Diabetes.

    PubMed

    Calhoun, Peter M; Buckingham, Bruce A; Maahs, David M; Hramiak, Irene; Wilson, Darrell M; Aye, Tandy; Clinton, Paula; Chase, Peter; Messer, Laurel; Kollman, Craig; Beck, Roy W; Lum, John

    2016-11-01

    We developed a system to suspend insulin pump delivery overnight when the glucose trend predicts hypoglycemia. This predictive low-glucose suspend (PLGS) system substantially reduces nocturnal hypoglycemia without an increase in morning ketosis. Evaluation of hypoglycemia risk factors that could potentially influence the efficacy of the system remains critical for understanding possible problems with the system and identifying patients that may have the greatest benefit when using the system. The at-home randomized trial consisted of 127 study participants with hemoglobin A1c (A1C) of ≤8.5% (mmol/mol) for patients aged 4-14 years and ≤8.0% for patient aged 15-45 years. Factors assessed included age, gender, A1C, diabetes duration, daily percentage basal insulin, total daily dose of insulin (units/kg-day), bedtime BG, bedtime snack, insulin on board, continuous glucose monitor (CGM) rate of change (ROC), day of the week, time system activated, daytime exercise intensity, and daytime CGM-measured hypoglycemia. The PLGS system was effective in preventing hypoglycemia for each factor subgroup. There was no evidence that the PLGS system was more or less effective in preventing hypoglycemia in any one subgroup compared with the other subgroups based on that factor. In addition, the effect of the system on overnight hyperglycemia did not differ in subgroups. The PLGS system tested in this study effectively reduced hypoglycemia without a meaningful increase in hyperglycemia across a variety of factors. © 2016 Diabetes Technology Society.

  20. fast-matmul

    SciTech Connect

    Grey Ballard, Austin Benson

    2014-11-26

    This software provides implementations of fast matrix multiplication algorithms. These algorithms perform fewer floating point operations than the classical cubic algorithm. The software uses code generation to automatically implement the fast algorithms based on high-level descriptions. The code serves two general purposes. The first is to demonstrate that these fast algorithms can out-perform vendor matrix multiplication algorithms for modest problem sizes on a single machine. The second is to rapidly prototype many variations of fast matrix multiplication algorithms to encourage future research in this area. The implementations target sequential and shared memory parallel execution.

  1. Fast wave current drive

    SciTech Connect

    Goree, J.; Ono, M.; Colestock, P.; Horton, R.; McNeill, D.; Park, H.

    1985-07-01

    Fast wave current drive is demonstrated in the Princeton ACT-I toroidal device. The fast Alfven wave, in the range of high ion-cyclotron harmonics, produced 40 A of current from 1 kW of rf power coupled into the plasma by fast wave loop antenna. This wave excites a steady current by damping on the energetic tail of the electron distribution function in the same way as lower-hybrid current drive, except that fast wave current drive is appropriate for higher plasma densities.

  2. Integrative Physiology of Fasting.

    PubMed

    Secor, Stephen M; Carey, Hannah V

    2016-03-15

    Extended bouts of fasting are ingrained in the ecology of many organisms, characterizing aspects of reproduction, development, hibernation, estivation, migration, and infrequent feeding habits. The challenge of long fasting episodes is the need to maintain physiological homeostasis while relying solely on endogenous resources. To meet that challenge, animals utilize an integrated repertoire of behavioral, physiological, and biochemical responses that reduce metabolic rates, maintain tissue structure and function, and thus enhance survival. We have synthesized in this review the integrative physiological, morphological, and biochemical responses, and their stages, that characterize natural fasting bouts. Underlying the capacity to survive extended fasts are behaviors and mechanisms that reduce metabolic expenditure and shift the dependency to lipid utilization. Hormonal regulation and immune capacity are altered by fasting; hormones that trigger digestion, elevate metabolism, and support immune performance become depressed, whereas hormones that enhance the utilization of endogenous substrates are elevated. The negative energy budget that accompanies fasting leads to the loss of body mass as fat stores are depleted and tissues undergo atrophy (i.e., loss of mass). Absolute rates of body mass loss scale allometrically among vertebrates. Tissues and organs vary in the degree of atrophy and downregulation of function, depending on the degree to which they are used during the fast. Fasting affects the population dynamics and activities of the gut microbiota, an interplay that impacts the host's fasting biology. Fasting-induced gene expression programs underlie the broad spectrum of integrated physiological mechanisms responsible for an animal's ability to survive long episodes of natural fasting. Copyright © 2016 John Wiley & Sons, Inc.

  3. EFFECTS OF INTERMITENT FASTING AND CHRONIC SWIMMING EXERCISE ON BODY COMPOSITION AND LIPID METABOLISM.

    PubMed

    Moraes, Ruan Carlos Macêdo; Portari, Guilherme Vannucchi; Ferraz, Alex Soares Marreiros; Silva, Tiago Eugênio Oliveira; Marocolo, Moacir

    2017-08-21

    Intermittent fasting protocol (IFP), has been suggested as a strategy to change body metabolism and improve health. The effects of IFP seem to be similar to aerobic exercise, having a hormetic adaptation according to intensity and frequency. However, the effects of combining both interventions are still unknown. Therefore, the aim of the present study was to evaluate the effects of IFP with and without endurance exercise training on body composition, food behavior, and lipid metabolism. Twenty weeks old Wistar rats were kept under an inverted circadian cycle of 12 hours with water ad libitum and assigned to four different groups: control group (CON; ad libitum feeding and sedentary); exercise group (EX; ad libitum feeding and endurance training); intermittent fasting group (IF; intermittent fasting and sedentary); intermittent fasting and exercise group (IFEX; intermittent fasting and endurance training). After six weeks, the body weight of IF and IFEX animals decreased without changes in food consumption. Yet, the body composition between the two groups was different, with the IFEX animals containing higher total protein and lower total fat content than the IF animals. The IFEX group also showed increases in total HDL cholesterol and increased intramuscular lipid content. The amount of brown adipose tissue was higher in IF and IFEX groups; however, the IFEX group showed higher expression levels of UCP-1 in this tissue, indicating a greater thermogenesis. The IFP combined with endurance training is an efficient method for decreasing body mass and altering fat metabolism, without inflicting losses in protein content.

  4. Fast optical pyrometry

    NASA Technical Reports Server (NTRS)

    Cezairliyan, Ared

    1988-01-01

    Design and operation of accurate millisecond and microsecond resolution optical pyrometers developed at the National Bureau of Standards during the last two decades are described. Results of tests are presented and estimates of uncertainties in temperature measurements are given. Calibration methods are discussed and examples of applications of fast pyrometry are given. Ongoing research in developing fast multiwavelength and spatial scanning pyrometers are summarized.

  5. fastKDE

    SciTech Connect

    O'Brien, Travis A.; Kashinath, Karthik

    2015-05-22

    This software implements the fast, self-consistent probability density estimation described by O'Brien et al. (2014, doi: ). It uses a non-uniform fast Fourier transform technique to reduce the computational cost of an objective and self-consistent kernel density estimation method.

  6. Fast and effective?

    PubMed

    Trueland, Jennifer

    2013-12-18

    The 5.2 diet involves two days of fasting each week. It is being promoted as the key to sustained weight loss, as well as wider health benefits, despite the lack of evidence on the long-term effects. Nurses need to support patients who wish to try intermittent fasting.

  7. Fast protein folding kinetics.

    PubMed

    Gelman, Hannah; Gruebele, Martin

    2014-05-01

    Fast-folding proteins have been a major focus of computational and experimental study because they are accessible to both techniques: they are small and fast enough to be reasonably simulated with current computational power, but have dynamics slow enough to be observed with specially developed experimental techniques. This coupled study of fast-folding proteins has provided insight into the mechanisms, which allow some proteins to find their native conformation well <1 ms and has uncovered examples of theoretically predicted phenomena such as downhill folding. The study of fast folders also informs our understanding of even 'slow' folding processes: fast folders are small; relatively simple protein domains and the principles that govern their folding also govern the folding of more complex systems. This review summarizes the major theoretical and experimental techniques used to study fast-folding proteins and provides an overview of the major findings of fast-folding research. Finally, we examine the themes that have emerged from studying fast folders and briefly summarize their application to protein folding in general, as well as some work that is left to do.

  8. Fast protein folding kinetics

    PubMed Central

    Gelman, Hannah; Gruebele, Martin

    2014-01-01

    Fast folding proteins have been a major focus of computational and experimental study because they are accessible to both techniques: they are small and fast enough to be reasonably simulated with current computational power, but have dynamics slow enough to be observed with specially developed experimental techniques. This coupled study of fast folding proteins has provided insight into the mechanisms which allow some proteins to find their native conformation well less than 1 ms and has uncovered examples of theoretically predicted phenomena such as downhill folding. The study of fast folders also informs our understanding of even “slow” folding processes: fast folders are small, relatively simple protein domains and the principles that govern their folding also govern the folding of more complex systems. This review summarizes the major theoretical and experimental techniques used to study fast folding proteins and provides an overview of the major findings of fast folding research. Finally, we examine the themes that have emerged from studying fast folders and briefly summarize their application to protein folding in general as well as some work that is left to do. PMID:24641816

  9. Kidney triglyceride accumulation in the fasted mouse is dependent upon serum free fatty acids.

    PubMed

    Scerbo, Diego; Son, Ni-Huiping; Sirwi, Alaa; Zeng, Lixia; Sas, Kelli M; Cifarelli, Vincenza; Schoiswohl, Gabriele; Huggins, Lesley-Ann; Gumaste, Namrata; Hu, Yunying; Pennathur, Subramaniam; Abumrad, Nada A; Kershaw, Erin E; Hussain, M Mahmood; Susztak, Katalin; Goldberg, Ira J

    2017-04-12

    Lipid accumulation is a pathological feature of every type of kidney injury. Despite this striking histological feature, physiological accumulation of lipids in the kidney is poorly understood. We studied whether the accumulation of lipids in the fasted kidney are derived from lipoproteins or non-esterified fatty acids (NEFAs). With overnight fasting, kidneys accumulated triglyceride but had reduced levels of ceramide and glycosphingolipid species. Fasting led to a nearly 5-fold increase in kidney uptake of plasma [14C]oleic acid. Increasing circulating NEFAs using a beta adrenergic receptor agonist caused a 15-fold greater accumulation of lipid in the kidney, while mice with reduced NEFAs due to adipose tissue deficiency of adipose triglyceride lipase had reduced triglycerides. Cd36 mRNA increased 2-fold, and Angptl4, an LpL inhibitor, increased 10-fold. Fasting-induced kidney lipid accumulation was not affected by inhibition of LpL with poloxamer 407 or by use of mice with induced genetic LpL deletion. Despite the increase in CD36 expression with fasting, genetic loss of CD36 did not alter fatty acid uptake or triglyceride accumulation. Our data demonstrate that fasting-induced triglyceride accumulation in the kidney correlates with the plasma concentrations of NEFAs, but is not due to uptake of lipoprotein lipids and does not involve the fatty acid transporter CD36.

  10. Short-term fasting alters cytochrome P450-mediated drug metabolism in humans.

    PubMed

    Lammers, Laureen A; Achterbergh, Roos; de Vries, Emmely M; van Nierop, F Samuel; Klümpen, Heinz-Josef; Soeters, Maarten R; Boelen, Anita; Romijn, Johannes A; Mathôt, Ron A A

    2015-06-01

    Experimental studies indicate that short-term fasting alters drug metabolism. However, the effects of short-term fasting on drug metabolism in humans need further investigation. Therefore, the aim of this study was to evaluate the effects of short-term fasting (36 h) on P450-mediated drug metabolism. In a randomized crossover study design, nine healthy subjects ingested a cocktail consisting of five P450-specific probe drugs [caffeine (CYP1A2), S-warfarin (CYP2C9), omeprazole (CYP2C19), metoprolol (CYP2D6), and midazolam (CYP3A4)] on two occasions (control study after an overnight fast and after 36 h of fasting). Blood samples were drawn for pharmacokinetic analysis using nonlinear mixed effects modeling. In addition, we studied in Wistar rats the effects of short-term fasting on hepatic mRNA expression of P450 isoforms corresponding with the five studied P450 enzymes in humans. In the healthy subjects, short-term fasting increased oral caffeine clearance by 20% (P = 0.03) and decreased oral S-warfarin clearance by 25% (P < 0.001). In rats, short-term fasting increased mRNA expression of the orthologs of human CYP1A2, CYP2C19, CYP2D6, and CYP3A4 (P < 0.05), and decreased the mRNA expression of the ortholog of CYP2C9 (P < 0.001) compared with the postabsorptive state. These results demonstrate that short-term fasting alters cytochrome P450-mediated drug metabolism in a nonuniform pattern. Therefore, short-term fasting is another factor affecting cytochrome P450-mediated drug metabolism in humans.

  11. Molecular mechanisms underlying fasting modulated liver insulin sensitivity and metabolism in male lipodystrophic Bscl2/Seipin-deficient mice.

    PubMed

    Chen, Weiqin; Zhou, Hongyi; Saha, Pradip; Li, Luge; Chan, Lawrence

    2014-11-01

    Bscl2(-/-) mice recapitulate many of the major metabolic manifestations in Berardinelli-Seip congenital lipodystrophy type 2 (BSCL2) individuals, including lipodystrophy, hepatomegly, hepatic steatosis, and insulin resistance. The mechanisms that underlie hepatic steatosis and insulin resistance in Bscl2(-/-) mice are poorly understood. To address this issue, we performed hyperinsulinemic-euglycemic clamp on Bscl2(-/-) and wild-type mice after an overnight (16-h) fast, and found that Bscl2(-/-) actually displayed increased hepatic insulin sensitivity. Interestingly, liver in Bscl2(-/-) mice after a short term (4-h) fast had impaired acute insulin signaling, a defect that disappeared after a 16-hour fast. Notably, fasting-dependent hepatic insulin signaling in Bscl2(-/-) mice was not associated with liver diacylglyceride and ceramide contents, but could be attributable in part to the expression of hepatic insulin signaling receptor and substrates. Meanwhile, increased de novo lipogenesis and decreased β-oxidation led to severe hepatic steatosis in fed or short-fasted Bscl2(-/-) mice whereas liver lipid accumulation and metabolism in Bscl2(-/-) mice was markedly affected by prolonged fasting. Furthermore, mice with liver-specific inactivation of Bscl2 manifested no hepatic steatosis even under high-fat diet, suggesting Bscl2 does not play a cell autonomous role in regulating liver lipid homeostasis. Overall, our results offered new insights into the metabolic adaptations of liver in response to fasting and uncovered a novel fasting-dependent regulation of hepatic insulin signaling in a mouse model of human BSCL2.

  12. Clinical usefulness of a timed overnight (8 hours) Urine Albumin (microalbumin) excretion in monitor-ing treatment in benign essential hypertension.

    PubMed

    Oluwatowoju, I O; Ajuluchukwu, J N A; Afonja, O A

    2014-06-01

    This research aims to establish the usefulness of timed over- night (8 hours) Urine Albumin(microalbumin) Excretion (UAE), in monitoring therapy in Nigerian patients with benign essential hypertension. The study population comprised 40 normotensives/controls, (23 males and 17 females) aged between 20-70 years, with a mean blood pressure 116/75mmHg, 30 well-controlled hypertensive patients, diastolic BP <100mmHg or MAP (mean arterial pressure) = 110mmHg and 30 poorly controlled hypertensive patients, diastolic blood pressure > 100mmHg or MAP >110mmHg.Urine albumin(microalbumin) was determined on the 8 hours overnight urine samples by ELISA method using kit from Randox Laboratories Limited, N.Ireland Cat No. MA 1410. UAE was calculated from the urine albumin concentration, urine volume and collection time. The intra assay precision was determined by running 20 replicates of two kit controls in a single batch. The coefficient of variation was 6.6% at 10.70mg/L and 4.3% at 51.20mg/L. The average UAE in the three groups were as follows: 12:22 +/-4.65ug/ min, 21.50 +/- 10.5ug/min and 30.10 +/- 24.25 ug/min in the control, well controlled and poorly controlled groups respectively, 12.5% of normotensive subjects, 40% of well controlled and 56.7% of poorly controlled patients were found to have microalbuminuria.The UAE increased significantly with the severity of hypertension (r = 0.32, p<0.001 for control) r = 0.38, p<00.05 for controlled and r = 0.49 p<0.05 for poorly controlled. A timed overnight (8 hours) Urinary UAE is a preferred alternative to cumbersome 24 hours urine collection for monitoring response to treatment in Nigerian patients with benign essential hypertension.

  13. Effects of wheat bran extract rich in arabinoxylan oligosaccharides and resistant starch on overnight glucose tolerance and markers of gut fermentation in healthy young adults.

    PubMed

    Boll, Elin V Johansson; Ekström, Linda M N K; Courtin, Christophe M; Delcour, Jan A; Nilsson, Anne C; Björck, Inger M E; Östman, Elin M

    2016-06-01

    Specific combinations of dietary fiber (DF) have been observed to result in improved glucose tolerance at a subsequent standardized breakfast. Arabinoxylan oligosaccharides (AXOS) are considered as DF with prebiotic potential, but so far no studies have investigated their metabolic effects in humans. This randomized cross-over study evaluated the overnight impact of breads containing AXOS-rich wheat bran extract and resistant starch (RS, Hi-Maize), separately or combined, on glucose tolerance, related metabolic parameters and markers of gut fermentation in healthy subjects. Evening reference and test products were: (1) reference white wheat flour bread (WWB), WWB supplemented with (2) AXOS and RS (WWB + AXOS + RS), (3) an increased content of either AXOS (WWB + hiAXOS) or (4) RS (WWB + hiRS). At the subsequent standardized breakfast, blood was sampled for 3 h to monitor glucose, insulin, nonesterified fatty acids, glucagon-like peptide (GLP)-1 and GLP-2. Breath hydrogen (H2) and short chain fatty acids (SCFA) were measured as markers of gut fermentation, and subjective appetite was rated using visual analog scales. Dose-dependent decreases in glucose responses were observed with increased AXOS over the duration of 3 h. Insulin sensitivity index was improved in the morning after the WWB + hiAXOS evening meal. An increase in breath H2 concentration and circulating SCFA was observed in the morning after both evening meals containing AXOS. The present study indicates that AXOS have the potential of improving glucose tolerance in an overnight perspective and suggested mechanisms are improved insulin sensitivity and increased gut fermentation.

  14. An online failure detection method of the glucose sensor-insulin pump system: improved overnight safety of type-1 diabetic subjects.

    PubMed

    Facchinetti, Andrea; Del Favero, Simone; Sparacino, Giovanni; Cobelli, Claudio

    2013-02-01

    Sensors for real-time continuous glucose monitoring (CGM) and pumps for continuous subcutaneous insulin infusion (CSII) have opened new scenarios for Type-1 diabetes treatment. However, occasional failures of either CGM or CSII may expose diabetic patients to possibly severe risks, especially overnight (e.g., inappropriate insulin administration). In this contribution, we present a method to detect in real time such failures by simultaneously using CGM and CSII data streams and a black-box model of the glucose-insulin system. First, an individualized state-space model of the glucose-insulin system is identified offline from CGM and CSII data collected during a previous monitoring. Then, this model, CGM and CSII real-time data streams are used online to obtain predictions of future glucose concentrations together with their confidence intervals by exploiting a Kalman filtering approach. If glucose values measured by the CGM sensor are not consistent with the predictions, a failure alert is generated in order to mitigate the risks for patient safety. The method is tested on 100 virtual patients created by using the UVA/Padova Type-1 diabetic simulator. Three different types of failures have been simulated: spike in the CGM profile, loss of sensitivity of glucose sensor, and failure in the pump delivery of insulin. Results show that, in all cases, the method is able to correctly generate alerts, with a very limited number of false negatives and a number of false positives, on average, lower than 10%. The use of the method in three subjects supports the simulation results, demonstrating that the accuracy of the method in generating alerts in presence of failures of the CGM sensor-CSII pump system can significantly improve safety of Type-1 diabetic patients overnight.

  15. Mood and psychomotor performance effects of the first, but not of subsequent, cup-of-coffee equivalent doses of caffeine consumed after overnight caffeine abstinence.

    PubMed

    Robelin, M; Rogers, P J

    1998-11-01

    Moderate caffeine consumers (n = 64, mean caffeine intake 453 mg/day) were deprived of caffeine overnight and semi-randomly allocated to four treatment groups, designated PPP, CPP, CCP and CCC, where P is placebo and C is caffeine (1.2 mg/kg, giving an amount of caffeine similar to that consumed in a serving of ground coffee). Caffeine or placebo (i.e. no caffeine) were administered double-blind in novel fruit juice drinks at 10:15, 11:30 and 13:00 h on the test day. Before (baseline), and 45 min after each of these times the participants completed a mood questionnaire and begun psychomotor performance tests lasting 25 min (1-min tapping task, and a long-duration simple reaction time task (SRT). Caffeine significantly increased energetic mood and improved psychomotor performance relative to placebo. Caffeine had particularly marked effects on SRT performance, ameliorating the slowing of performance with time on task and removing the post-lunch dip in performance. However, the three caffeine treatments, CPP, CCP and CCC, were equally effective. That is, mood and performance were improved to the same extent by one, two and three spaced doses (totalling 86, 172 and 258 mg) of caffeine. This result is consistent with previous findings indicating a flat dose-response relationship for the psychoactive effects of caffeine; and because of the adverse effects (e.g. fatigue) associated with overnight caffeine deprivation, it suggests that there is little net benefit to be gained from frequent caffeine use. At the very least, it appears that the psychostimulant effects of caffeine cannot on their own account for the typical pattern of consumption of caffeine-containing drinks.

  16. Day Care vs Overnight Stay after Laparoscopic Cholecystectomy even with Co-morbidity and a Possible Second Surgery: A Patient’s Choice

    PubMed Central

    2016-01-01

    Introduction Laparoscopic Cholecystectomy (LC) has become the gold standard for symptomatic gall stone disease. It is being practiced as a day care procedure in healthy individuals in American Society of Anaesthesialogists (ASA) grade I and II. It is not yet established in presence of co-morbidity and when a second surgery is added. In most of the study, patient’s choice and the psycho-social factors were not considered in deciding the day care procedure. Aim To find the safety of LC and a second surgery as day care in presence of compensated co-morbidity. To study the choice of the patient whether to stay in hospital or go home after declaring them fit for day care. Materials and Methods All the patients of symptomatic cholelithiasis with co-morbidity and associations were evaluated and made uncompromising for elective surgery. All the LC were done at 8mmHg CO2 peumo-peritoneal pressure using harmonic scalpel as the energy source for dissection of gall bladder from the liver bed. Cases with conversion and placement of drain were excluded. Results A total of 1029 out of 1042 patients was included from Jan 2005 to Jan 2015. The age range was 38 to 91years (mean 44.65, SD 14.15). There were 634 females and 395 males. A total of 121(11.7%) of them had co-morbidity and associations. A total of 72(7%) had undergone a second surgery. Only 0.8% had real day care. A total of 95.7% had overnight stay even after fulfilling all the criteria. Only 0.2% needed re-admission in 30 days and one required intervention. Conclusion Patients like to stay over night in the hospital even if found fit for day care after LC. Overnight stay makes them happy, psycho-socially confident in developing nation and best suited for all patients including co-morbidity. PMID:27891393

  17. Effectiveness and safety of overnight orthokeratology with Boston XO2 high-permeability lens material: A 24 week follow-up study.

    PubMed

    Cheng, Huey-Chuan; Liang, Jy-Been; Lin, Wen-Pin; Wu, Richard

    2016-02-01

    To examine the effectiveness of overnight orthokeratology lenses made with Boston XO2, highly gas-permeable lens material for the temporary correction of myopia. Myopic individuals from 9 to 62 years of age were eligible. Participants ≤ 12 years of age were required to have myopia ≤-4.00 D and astigmatism ≤ 1.50 D, and for those 13-62 years of age myopia ≤-5.00 D and astigmatism ≤ 3.00 D. All participants were required to have normal healthy eyes and not be receiving any ocular medications or systemic medications likely to affect the results of visual acuity. Participants wore the lenses for a minimum of 7h during sleep, and were evaluated on day 1 and weeks 1, 2, 4, 12, and 24. Success was defined as LogMAR ≤ 0.1. A total of 126 participants (63.5% females) with a mean age of 20.4 ± 11.5 years were recruited. Baseline LogMAR, and vertical and horizontal corneal curvature were 0.8, 7.7 mm, and 7.9 mm, respectively, in both eyes. A consistent decrease in LogMAR was noted from day 1 to week 12. The success rate increased with length of time (from 33.9% to 100% for the right eye and from 35.5% to 100% for the left eye from day 1 to week 24). No severe complications were noted. Overnight orthokeratology with lenses made of Boston XO2 material are effective and safe for the temporary reduction of myopia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Utility of overnight pulse oximetry and heart rate variability analysis to screen for sleep-disordered breathing in chronic heart failure.

    PubMed

    Ward, Neil R; Cowie, Martin R; Rosen, Stuart D; Roldao, Vitor; De Villa, Manuel; McDonagh, Theresa A; Simonds, Anita; Morrell, Mary J

    2012-11-01

    Sleep-disordered breathing (SDB) is under diagnosed in chronic heart failure (CHF). Screening with simple monitors may increase detection of SDB in a cardiology setting. This study aimed to evaluate the accuracy of heart rate variability analysis and overnight pulse oximetry for diagnosis of SDB in patients with CHF. 180 patients with CHF underwent simultaneous polysomnography, ambulatory electrocardiography and wrist-worn overnight pulse oximetry. SDB was defined as an apnoea-hypopnoea index ≥15/h. To identify SDB from the screening tests, the per cent very low frequency increment (%VLFI) component of heart rate variability was measured with a pre-specified cutoff ≥2.23%, and the 3% oxygen desaturation index was measured with a pre-specified cutoff >7.5 desaturations/h. 173 patients with CHF had adequate sleep study data; SDB occurred in 77 (45%) patients. Heart rate variability was measurable in 78 (45%) patients with area under the %VLFI receiver operating characteristic curve of 0.50. At the ≥2.23% cutoff, %VLFI sensitivity was 58% and specificity was 48%. The 3% oxygen desaturation index was measurable in 171 (99%) patients with area under the curve of 0.92. At the pre-specified cutoff of >7.5 desaturations/h, the 3% oxygen desaturation index had a sensitivity of 97%, specificity of 32%, negative likelihood ratio of 0.08 and positive likelihood ratio of 1.42. Diagnostic accuracy was increased using a cutoff of 12.5 desaturations/h, with sensitivity of 93% and specificity of 73%. The high sensitivity and low negative likelihood ratio of the 3% oxygen desaturation index indicates that pulse oximetry would be of use as a simple screening test to rule out SDB in patients with CHF in a cardiology setting. The %VLFI component of heart rate variability is not suitable for detection of SDB in CHF.

  19. Automated Overnight Closed-Loop Control Using a Proportional-Integral-Derivative Algorithm with Insulin Feedback in Children and Adolescents with Type 1 Diabetes at Diabetes Camp.

    PubMed

    Ly, Trang T; Keenan, D Barry; Roy, Anirban; Han, Jino; Grosman, Benyamin; Cantwell, Martin; Kurtz, Natalie; von Eyben, Rie; Clinton, Paula; Wilson, Darrell M; Buckingham, Bruce A

    2016-06-01

    This study determined the feasibility and efficacy of an automated proportional-integral-derivative with insulin feedback (PID-IFB) controller in overnight closed-loop (OCL) control of children and adolescents with type 1 diabetes over multiple days in a diabetes camp setting. The Medtronic (Northridge, CA) Android™ (Google, Mountain View, CA)-based PID-IFB system consists of the Medtronic Minimed Revel™ 2.0 pump and Enlite™ sensor, a control algorithm residing on an Android phone, a translator, and remote monitoring capabilities. An inpatient study was completed for 16 participants to determine feasibility. For the camp study, subjects with type 1 diabetes were randomized to either OCL or sensor-augmented pump therapy (control conditions) per night for up to 6 nights at diabetes camp. During the camp study, 21 subjects completed 50 OCL nights and 52 control nights. Based on intention to treat, the median time spent in range, from 70 to 150 mg/dL, was greater during OCL at 66.4% (n = 55) versus 50.6% (n = 52) during the control period (P = 0.004). A per-protocol analysis allowed for assessment of algorithm performance with the median percentage time in range, 70-150 mg/dL, being 75.5% (n = 37) for OCL versus 47.6% (n = 32) for the control period (P < 0.001). There was less time spent in the hypoglycemic ranges <60 mg/dL and <70 mg/dL during OCL compared with the control period (P = 0.003 and P < 0.001, respectively). The PID-IFB controller is effective in improving time spent in range as well as reducing nocturnal hypoglycemia during the overnight period in children and adolescents with type 1 diabetes in a diabetes camp setting.

  20. FAST Construction Progress

    NASA Astrophysics Data System (ADS)

    Nan, R. D.; Zhang, H. Y.; Zhang, Y.; Yang, L.; Cai, W. J.; Liu, N.; Xie, J. T.; Zhang, S. X.

    2016-11-01

    The Five-hundred-meter Aperture Spherical radio Telescope (FAST) is a Chinese mega-science project to build the largest single dish radio telescope in the world. A unique karst depression in Guizhou province has been selected as the site to build an active reflector radio telescope with a diameter of 500 m and three outstanding aspects, which enables FAST to have a large sky coverage and the ability of observing astronomical targets with a high precision. Chinese Academy of Sciences and Guizhou province are in charge of FAST construction. The first light of the telescope was expected on September 25, 2016.

  1. Reusable fast opening switch

    DOEpatents

    Van Devender, J.P.; Emin, D.

    1983-12-21

    A reusable fast opening switch for transferring energy, in the form of a high power pulse, from an electromagnetic storage device such as an inductor into a load. The switch is efficient, compact, fast and reusable. The switch comprises a ferromagnetic semiconductor which undergoes a fast transition between conductive and metallic states at a critical temperature and which undergoes the transition without a phase change in its crystal structure. A semiconductor such as europium rich europhous oxide, which undergoes a conductor to insulator transition when it is joule heated from its conductor state, can be used to form the switch.

  2. Reusable fast opening switch

    DOEpatents

    Van Devender, John P.; Emin, David

    1986-01-01

    A reusable fast opening switch for transferring energy, in the form of a high power pulse, from an electromagnetic storage device such as an inductor into a load. The switch is efficient, compact, fast and reusable. The switch comprises a ferromagnetic semiconductor which undergoes a fast transition between conductive and insulating states at a critical temperature and which undergoes the transition without a phase change in its crystal structure. A semiconductor such as europium rich europhous oxide, which undergoes a conductor to insulator transition when it is joule heated from its conductor state, can be used to form the switch.

  3. Fasting and cognitive function.

    PubMed

    Pollitt, E; Lewis, N L; Garza, C; Shulman, R J

    The effects of short-term fasting (skipping breakfast) on the problem-solving performance of 9 to 11 yr old children were studied under the controlled conditions of a metabolic ward. The behavioral test battery included an assessment of IQ, the Matching Familiar Figure Test and Hagen Central Incidental Test. Glucose and insulin levels were measured in blood. All assessments were made under fasting and non-fasting conditions. Skipping breakfast was found to have adverse effects on the children's late morning problem-solving performance. These findings support observations that the timing and nutrient composition of meals have acute and demonstrable effects on behavior.

  4. Fast Breeder Reactor studies

    SciTech Connect

    Till, C.E.; Chang, Y.I.; Kittel, J.H.; Fauske, H.K.; Lineberry, M.J.; Stevenson, M.G.; Amundson, P.I.; Dance, K.D.

    1980-07-01

    This report is a compilation of Fast Breeder Reactor (FBR) resource documents prepared to provide the technical basis for the US contribution to the International Nuclear Fuel Cycle Evaluation. The eight separate parts deal with the alternative fast breeder reactor fuel cycles in terms of energy demand, resource base, technical potential and current status, safety, proliferation resistance, deployment, and nuclear safeguards. An Annex compares the cost of decommissioning light-water and fast breeder reactors. Separate abstracts are included for each of the parts.

  5. Ramadan fasting and the goals of sports nutrition around exercise.

    PubMed

    Burke, Louise M; King, Christine

    2012-01-01

    Ramadan fasting, involving abstinence from fluid and food from sunrise to sundown, results in prolonged periods without nutrient intake and inflexibility with the timing of eating and drinking over the day. Dietary choices may also change due to special eating rituals. Although nutrition guidelines are specific to the sport, to the periodized training and competition calendar, and to the individual, many promote the consumption of carbohydrate and fluid before and during exercise, and consumption of protein, carbohydrate, and fluids soon after the session is completed. Failing to meet overall nutritional needs, or to provide specific nutritional support to a session of exercise, is likely to impair acute performance and reduce the effectiveness of training or recovery. Muslim athletes who fast during Ramadan should use overnight opportunities to consume foods and drinks that can supply the nutrients needed to promote performance, adaptation, and recovery in their sports. Because of the benefits of being able to consume at least some of these nutrients before, during or after an exercise session, the schedule of exercise should be shifted where possible to the beginning or end of the day, or during the evening when some nutritional support can be provided.

  6. Pneumococcal Disease Fast Facts

    MedlinePlus

    ... Home About Pneumococcal Types of Infection Risk Factors & Transmission Symptoms & Complications Diagnosis & Treatment Prevention Photos Fast Facts Pneumococcal Vaccination For Clinicians Streptococcus pneumoniae Transmission Clinical Features Risk Factors Diagnosis & Management Prevention For ...

  7. FAST joins Breakthrough programme

    NASA Astrophysics Data System (ADS)

    Banks, Michael

    2016-11-01

    The 180m Five-hundred-meter Aperture Spherical radio Telescope (FAST) - the world's largest single-aperture radio receiver - has become part of the Breakthrough Listen programme, which launched in July 2015 to look for intelligent life beyond Earth.

  8. Discovery with FAST

    NASA Astrophysics Data System (ADS)

    Wilkinson, P.

    2016-02-01

    FAST offers "transformational" performance well-suited to finding new phenomena - one of which might be polarised spectral transients. But discoveries will only be made if "the system" provides its users with the necessary opportunities. In addition to designing in as much observational flexibility as possible, FAST should be operated with a philosophy which maximises its "human bandwidth". This band includes the astronomers of tomorrow - many of whom not have yet started school or even been born.

  9. FAST Maser Surveys

    NASA Astrophysics Data System (ADS)

    Zhang, J. S.

    2014-09-01

    FAST, the Five-hundred meter Aperture Spherical radio Telescope, will become the largest operating single-dish telescope in the coming years. It has many advantages: much better sensitivity for its largest collecting area; large sky coverage due to its innovative design of the active primary surface; extremely radio quiet from its unique location, etc. In this work, I will highlight the future capabilities of FAST to discover and observe both galactic and extragalactic masers.

  10. Effect of fasting versus feeding on the bone metabolic response to running.

    PubMed

    Scott, Jonathan P R; Sale, Craig; Greeves, Julie P; Casey, Anna; Dutton, John; Fraser, William D

    2012-12-01

    Individuals often perform exercise in the fasted state, but the effects on bone metabolism are not currently known. We compared the effect of an overnight fast with feeding a mixed meal on the bone metabolic response to treadmill running. Ten, physically-active males aged 28 ± 4y (mean ±SD) completed two, counterbalanced, 8d trials. After 3d on a standardised diet, participants performed 60 min of treadmill running at 65% VO(2max) on Day 4 following an overnight fast (FAST) or a standardised breakfast (FED). Blood samples were collected at baseline, before and during exercise, for 3h after exercise, and on four consecutive follow-up days (FU1-FU4). Plasma/serum were analysed for the c-terminal telopeptide region of collagen type 1 (β-CTX), n-terminal propeptides of procollagen type 1 (P1NP), osteocalcin (OC), bone alkaline phosphatase (bone ALP), parathyroid hormone (PTH), albumin-adjusted calcium, phosphate, osteoprotegerin (OPG), cortisol, leptin and ghrelin. Only the β-CTX response was significantly affected by feeding. Pre-exercise concentrations decreased more in FED compared with FAST (47% vs 26%, P<0.001) but increased during exercise in both groups and were not significantly different from baseline at 1h post-exercise. At 3h post-exercise, concentrations were decreased (33%, P<0.001) from baseline in FAST and significantly lower (P<0.001) than in FED. P1NP and PTH increased, and OC decreased during exercise. Bone markers were not significantly different from baseline on FU1-FU4. Fasting had only a minor effect on the bone metabolic response to subsequent acute, endurance exercise, reducing the duration of the increase in β-CTX during early recovery, but having no effect on changes in bone formation markers. The reduced duration of the β-CTX response with fasting was not fully explained by changes in PTH, OPG, leptin or ghrelin. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Prolonged preoperative fasting in elective surgical patients: why should we reduce it?

    PubMed

    Pimenta, Gunther Peres; de Aguilar-Nascimento, José Eduardo

    2014-02-01

    Despite the abundance of evidence to the contrary, 6-8 hours of total preoperative fasting is still considered essential by many surgeons and anesthesiologists, based on the strength of old concepts. Patients frequently end up fasting for 12 hours or more because of delays and changes in operating room schedules. The metabolic response to long fasting leads to intensification of the organic response occurring after trauma, which is mainly manifested as increased insulin resistance, an acute-phase response, and loss of lean body mass. In fact, there has not been any evidence indicating that a shorter fast of 2-3 hours, which includes oral clear or carbohydrate (CHO)-rich (12.5% carbohydrates, 50 kcal/100 mL) fluids, results in an increased risk of aspiration, regurgitation, or related morbidity compared with the standard policy of "nil by mouth after midnight." In addition, preoperative treatment with CHO-rich fluids may reduce postoperative discomfort and, for patients undergoing major abdominal surgery, may decrease the duration of postoperative hospitalization. New formulas for preoperative oral fluids containing amino acid or protein such as glutamine or whey protein are also potential candidates for early preoperative treatment and merit further study.

  12. The effects of dietary fasting on physical balance among healthy young women

    PubMed Central

    2010-01-01

    Background The study examined the effects of dietary fasting on physical balance among young healthy women. Methods This study undertaken involving 22 young healthy women (age = 22 ± 1.5) using a within subject counterbalanced 2-week crossover study design. Participants were asked to refrain from consuming any food or beverage for 12 hours prior to the fasting trial and to maintain their regular diet for the non-fasting trial. Measures included: a background questionnaire, 24-hour dietary recall, and functional reach and timed single-limb stances. Results Fasting resulted in significant declines in functional reach (p < 0.01), and ability to balance in a single limb stance with eyes open, on both the dominant and non-dominant legs (p < 0.01 and p < 0.01, respectively), and with eyes closed on the dominant leg (p < 0.01). Conclusions The findings have implications for athletic performance in younger individuals as well as emphasizing the need for health education for young women to avoid skipping meals. PMID:20388217

  13. The effects of dietary fasting on physical balance among healthy young women.

    PubMed

    Johnson, Shanthi; Leck, Krista

    2010-04-13

    The study examined the effects of dietary fasting on physical balance among young healthy women. This study undertaken involving 22 young healthy women (age = 22 +/- 1.5) using a within subject counterbalanced 2-week crossover study design. Participants were asked to refrain from consuming any food or beverage for 12 hours prior to the fasting trial and to maintain their regular diet for the non-fasting trial. Measures included: a background questionnaire, 24-hour dietary recall, and functional reach and timed single-limb stances. Fasting resulted in significant declines in functional reach (p < 0.01), and ability to balance in a single limb stance with eyes open, on both the dominant and non-dominant legs (p < 0.01 and p < 0.01, respectively), and with eyes closed on the dominant leg (p < 0.01). The findings have implications for athletic performance in younger individuals as well as emphasizing the need for health education for young women to avoid skipping meals.

  14. Impact of fasting and postprandial state on plasma carnitine concentrations during aerobic exercise in type 2 diabetes.

    PubMed

    Ferland, A; Broderick, T L; Nadeau, A; Simard, S; Martin, J; Poirier, P

    2007-09-01

    The effects of metabolic states of fasting and post-absorption on plasma concentrations of free carnitine (FC), acylcarnitine (AC) and total carnitine (TC) were compared during submaximal exercise in subjects with type 2 diabetes mellitus. Ten sedentary men (54+/-5 years) treated with oral hypoglycaemic agents were tested on two separate occasions: following an overnight fast and 2 h after a 395-kcal standardised breakfast. Exercise was performed at 60% of [Formula: see text]O(2peak) on a cycle ergometer for 60 min. Blood samples were drawn at rest for baseline values and following 60 min of exercise and 30 min of recovery. Our results show that: (1) baseline levels of TC, FC and AC were similar in fasted and postprandial groups, (2) TC and AC levels were increased during exercise in the fasted group only, (3) FC levels were decreased during exercise in both fasted and postprandial state and (4) the AC/FC ratio increased during exercise in the fasted group. Our results indicate that the metabolic state of the diabetic patient is associated with a different plasma carnitine status. These patterns may reflect differences in energy metabolism associated with fasting and postprandial hyperglycaemia.

  15. The loss of CD34+ cells in peripheral hematopoietic stem cell products cryopreserved by non-controlled rate freezing and stored at -80 °C after overnight storage.

    PubMed

    Donmez, Ayhan; Yilmaz, Fergun; Soyer, Nur; Cagirgan, Seckin; Arik, Bahar; Tombuloglu, Murat

    2014-10-01

    Although peripheral blood stem cell (PBSC) products cryopreserved by non-controlled rate freezing and stored at -80 °C after overnight storage are used frequently, data regarding the rate of loss of CD34+ cells in these products are limited. In this prospective study, CD34+ cells were counted at three (fresh, post-overnight and post-thaw) points in 83 PBSC products from 41 patients by flow cytometry. Compared to fresh products, the mean losses of post-overnight and post-thaw total CD34+ cells are 16.3% and 38.4% (p = 0.02), and the mean losses of post-overnight and post-thaw viable CD34+ cells are 16.5% and 48.5%, respectively (p < 0.001). The numbers of fresh viable, post-thaw total and post-thaw viable CD34+ cells were inversely correlated with the durations of neutrophil and platelet engraftment. Our results indicate that the mean loss of post-thaw total and viable CD34+ cells is approximately 20% higher than that observed in standard cryopreservation methods. In addition, fresh viable, post-thaw total and especially post-thaw viable CD34+ cell levels are valuable predictors of both neutrophil and platelet engraftments. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Fast wave current drive

    NASA Astrophysics Data System (ADS)

    Goree, J.; Ono, M.; Colestock, P.; Horton, R.; McNeill, D.; Park, H.

    1985-07-01

    Experiments on the fast wave in the range of high ion cyclotron harmonics in the ACT-1 device show that current drive is possible with the fast wave just as it is for the lower hybrid wave, except that it is suitable for higher plasma densities. A 140° loop antenna launched the high ion cyclotron harmonic fast wave [ω/Ω=O(10)] into a He+ plasma with ne≂4×1012 cm-3 and B=4.5 kG. Probe and magnetic loop diagnostics and FIR laser scattering confirmed the presence of the fast wave, and the Rogowski loop indicated that the circulating plasma current increased by up to 40A with 1 kW of coupled power, which is comparable to lower hybrid current drive in the same device with the same unidirectional fast electron beam used as the target for the rf. A phased antenna array would be used for FWCD in a tokamak without the E-beam.

  17. Unsupervised home use of an overnight closed-loop system over 3-4 weeks: a pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetes.

    PubMed

    Thabit, H; Elleri, D; Leelarathna, L; Allen, J M; Lubina-Solomon, A; Stadler, M; Walkinshaw, E; Iqbal, A; Choudhary, P; Wilinska, M E; Barnard, K D; Heller, S R; Amiel, S A; Evans, M L; Dunger, D B; Hovorka, R

    2015-05-01

    To compare overnight closed-loop and sensor-augmented pump therapy in patients with type 1 diabetes by combining data collected during free-living unsupervised randomized crossover home studies. A total of 40 participants with type 1 diabetes, of whom 24 were adults [mean ± standard deviation (s.d.) age 43 ± 12 years and glycated haemoglobin (HbA1c) 8.0 ± 0.9%] and 16 were adolescents (mean ± s.d. age 15.6 ± 3.6 years and HbA1c 8.1 ± 0.8%), underwent two periods of sensor-augmented pump therapy in the home setting, in combination with or without an overnight closed-loop insulin delivery system that uses a model predictive control algorithm to direct insulin delivery. The order of the two interventions was random; each period lasted 4 weeks in adults and 3 weeks in adolescents. The primary outcome was time during which sensor glucose readings were in the target range of 3.9-8.0 mmol/l. The proportion of time when sensor glucose was in the target range (3.9-8.0 mmol/l) overnight (between 24:00 and 08:00 hours) was 18.5% greater during closed-loop insulin delivery than during sensor-augmented therapy (p < 0.001). Closed-loop therapy significantly reduced mean overnight glucose levels by 0.9 mmol/l (p < 0.001), with no difference in glycaemic variability, as measured by the standard deviation of sensor glucose. Time spent above the target range was reduced (p = 0.001), as was time spent in hypoglycaemia (<3.9 mmol/l; p = 0.014) during closed-loop therapy. Lower mean overnight glucose levels during closed-loop therapy were brought about by increased overnight insulin delivery (p < 0.001) without changes to the total daily delivery (p = 0.84). Overnight closed-loop insulin therapy at home in adults and adolescents with type 1 diabetes is feasible, showing improvements in glucose control and reducing the risk of nocturnal hypoglycaemia. © 2014 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  18. Fasting improves static apnea performance in elite divers without enhanced risk of syncope.

    PubMed

    Schagatay, Erika; Lodin-Sundström, Angelica

    2014-01-01

    In competitive apnea divers, the nutritional demands may be essentially different from those of, for example, endurance athletes, where energy resources need to be maximised for successful performance. In competitive apnea, the goal is instead to limit metabolism, as the length of the sustainable apneic period will depend to a great extent on minimising oxygen consumption. Many but not all elite divers fast before performing static apnea in competition. This may increase oxygen consumption as mainly lipid stores are metabolised but could also have beneficial effects on apneic duration. Our aim was to determine the effect of over-night fasting on apnea performance. Six female and seven male divers performed a series of three apneas after eating and fasting, respectively. The series consisted of two 2-min apneas spaced by 3 min rest and, after 5 min rest, one maximal effort apnea. Apneas were performed at supine rest and preceded by normal respiration and maximal inspiration. Mean (± SD) time since eating was 13 h (± 2 h 43 min) for the fasting and 1 h 34 min (± 33 min) for the eating condition (P < 0.001). Mean blood glucose was 5.1 (± 0.4) mmol/L after fasting and 5.9 (± 0.7) mmol/L after eating (P<0.01). Lung volumes were similar in both conditions (NS). For the 2-min apneas, nadir SaO2 during fasting was 95 (± 1)% and 92 (± 2)% (P < 0.001) on eating and ETCO2 was lower in the fasting condition (P < 0.01) while heart rate (HR) during apnea was 74 (± 10) bpm for fasting and 80 (± 10) bpm for eating conditions (P < 0.01). Maximal apnea durations were 4 min 41 s (± 43 s) during fasting and 3 min 51 s (± 37 s) after eating (P < 0.001), and time without respiratory contractions was 31 s (25%) longer after fasting (P < 0.01). At maximal apnea termination, SaO2 and ETCO2 were similar in both conditions (NS) and apneic HR was 63 (± 9) bpm for fasting and 70 (± 10) bpm for eating (P < 0.01). The 22% longer apnea duration after fasting with analogous end apnea

  19. Influence of previously ingested wheat on fasting breath hydrogen in celiac patients.

    PubMed

    Rana, S V; Sharma, S; Sinha, S K; Kaur, J; Prasad, K K; Singh, K

    2009-06-01

    The excretion of hydrogen in breath commonly persists, despite an overnight fast. Although the elevation of hydrogen concentration above the fasting value after the administration of a test sugar is evidence of malabsorption, the level of the fasting value itself in untreated celiac patients is unknown. Therefore, we studied the fasting breath hydrogen (FBH(2)) concentration in 40 healthy controls, 35 subjects with functional bowel disorders, and 30 patients of untreated celiac disease with and without bread or wheat diet one day before the test. The fasting level of hydrogen concentration in untreated celiac patients (28.7 +/- 19.5 ppm) was significantly higher than those in healthy volunteers (9.5 +/- 3.4 ppm) and subjects with functional bowel disorders (10.6 +/- 4.5 ppm). The percentage of patients with elevated H(2) fasting levels in untreated celiac disease (82.5%) was significantly higher than that in healthy controls (10%) and subjects with functional bowel disorders (17.1%). In 30 celiac patients, studied with and without wheat-free diet one day before the test, the fasting hydrogen levels decreased from 28.7 +/- 19.5 ppm to 10.6 +/- 3.5 ppm, and becoming normal in all patients of celiac disease. Our results show that the patients of untreated celiac disease should be instructed not to eat things made up of wheat one day before hydrogen breath testing so that the normal fasting hydrogen concentration can be obtained and false-negative hydrogen breath test results can be avoided.

  20. Influence of diurnal variation and fasting on serum iron concentrations in a community-based population.

    PubMed

    Nguyen, Leonard T; Buse, Joshua D; Baskin, Leland; Sadrzadeh, S M Hossein; Naugler, Christopher

    2017-09-23

    Serum iron is an important clinical test to help identify cases of iron deficiency or overload. Fluctuations caused by diurnal variation and diet are thought to influence test results, which may affect clinical patient management. We examined the impact of these preanalytical factors on iron concentrations in a large community-based cohort. Serum iron concentration, blood collection time, fasting duration, patient age and sex were obtained for community-based clinical testing from the Laboratory Information Service at Calgary Laboratory Services for the period of January 2011 to December 2015. A total of 276,307 individual test results were obtained. Iron levels were relatively high over a long period from 8:00 to 15:00. Mean concentrations were highest at blood collection times of 11:00 for adult men and 12:00 for adult women and children, however iron levels peaked as late as 15:00 in teenagers. With regard to fasting, iron levels required approximately 5h post-prandial time to return to a baseline, except for children and teenage females where no significant variation was seen until after 11h fasting. After 10h fasting, iron concentrations in all patient groups gradually increased to higher levels compared to earlier fasting times. Serum iron concentrations remain reasonably stable during most daytime hours for testing purposes. In adults, blood collection after 5 to 9h fasting provides a representative estimate of a patient's iron levels. For patients who have fasted overnight, i.e. ≥12h fasting, clinicians should be aware that iron concentrations may be elevated beyond otherwise usual levels. Copyright © 2017. Published by Elsevier Inc.

  1. Quantitative comparison of pathways of hepatic glycogen repletion in fed and fasted humans

    SciTech Connect

    Shulman, G.I.; Cline, G.; Schumann, W.C.; Chandramouli, V.; Kumaran, K.; Landau, B.R. )

    1990-09-01

    The effect of fasting vs. refeeding on hepatic glycogen repletion by the direct pathway, i.e., glucose----glucose 6-phosphate (G-6-P)----glycogen, was determined. Acetaminophen was administered during an infusion of glucose labeled with (1-13C)- and (6-14C)glucose into four healthy volunteers after an overnight fast and into the same subjects 4 h after breakfast. 13C enrichments in C-1 and C-6 of glucose formed from urinary acetaminophen glucuronide compared with enrichments in C-1 and C-6 of plasma glucose provided an estimate of glycogen formation by the direct pathway. The specific activity of glucose from the glucuronide compared with the specific activity of the plasma glucose, along with the percentages of 14C in C-1 and C-6 of the glucose from the glucuronide, also provided an estimate of the amount of glycogen formed by the direct pathway. The estimates were similar. Those from (6-14C)glucose would have been higher than from (1-13C)glucose if the pentose cycle contribution to overall glucose utilization had been significant. After an overnight fast, during the last hour of infusion, 49 +/- 3% of the glycogen formed was formed via the direct pathway. After breakfast, at similar plasma glucose and insulin concentrations, the percentage increased to 69 +/- 7% (P less than 0.02). Thus the contributions of the pathways to hepatic glycogen formation depend on the dietary state of the individual. For a dietary regimen in which individuals consume multiple meals per day containing at least a moderate amount of carbohydrates most glycogen synthesis occurs by the direct pathway.

  2. Usefulness of overnight pulse oximeter as the sleep assessment tool to assess the 6-year risk of road traffic collision: evidence from the Taiwan Bus Driver Cohort Study.

    PubMed

    Wu, Wei-Te; Tsai, Su-Shan; Liao, Hui-Yi; Lin, Yu-Jen; Lin, Ming-Hsiu; Wu, Trong-Neng; Shih, Tung-Sheng; Liou, Saou-Hsing

    2017-02-01

    In order to support health service organizations in arranging a system for prevention of road traffic collisions (RTC), it is important to study the usefulness of sleep assessment tools. A cohort study was used to evaluate the effectiveness of subjective and objective sleep assessment tools to assess for the 6-year risk of both first RTC event only and recurrent RTC events. The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1650 professional drivers from a large bus company in Taiwan in 2005. The subjects were interviewed in person, completed the sleep assessment questionnaires and had an overnight pulse oximeter survey. Moreover, this cohort of drivers was linked to the National Traffic Accident Database (NTAD) and researchers found 139 new RTC events from 2005 to 2010. Primary outcomes were traffic collisions from NTAD, nocturnal oxygen desaturation index (ODI) from pulse oximeter, Pittsburg sleeping quality score, Epworth daytime sleepiness score, Snore Outcomes Survey score and working patterns from questionnaires. A Cox proportional hazards model and an extended Cox regression model for repeated events were performed to estimate the hazard ratio for RTC. The RTC drivers had increased ODI4 levels (5.77 ± 4.72 vs 4.99 ± 6.68 events/h; P  = 0.008) and ODI3 levels (8.68 ± 6.79 vs 7.42 ± 7.94 events/h; P  = 0.007) in comparison with non-RTC drivers. These results were consistent regardless of whether ODI was evaluated as a continuous or a categorical variable. ODI4 and ODI3 levels increased the 6-year RTC risks among professional drivers even after adjusting for age, education, history of cardiovascular disease, caffeine intake, sleeping pills used, bus driving experience and shift modes. Moreover, there was an increased trend for ODI between the stratification of the number of RTCs in comparison with the non-RTC group. In the extended Cox regression models for repeated RTC events with the Anderson and Gill intensity model and Prentice

  3. Overnight ACTH-cortisol dose responsiveness: comparison with 24-h data, metyrapone administration and insulin-tolerance test in healthy adults.

    PubMed

    Iranmanesh, Ali; Keenan, Daniel M; Aoun, Paul; Veldhuis, Johannes D

    2011-11-01

    To estimate the dose dependence of endogenous ACTH stimulation of adrenal cortisol secretion overnight. Ten-minute sampling for ACTH and cortisol over 8 and 24 h (n = 17), after metyrapone administration (n = 6), during an insulin-tolerance test (n = 7). Healthy adults. ACTH dose-responsive estimates. Twenty-four hour ACTH-cortisol concentration pairs yielded an estimated EC(50) (one-half maximally stimulatory ACTH concentration) of 5·1 (2·2-9·5) pmol/l [median (range)]. This did not differ from EC(50) s based on 8- or 6-h data [5·9 (3·5-11) and 7·5 (3·7-41) pmol/l] in the same individuals. ACTH efficacy (maximally stimulatable cortisol secretion rate) was 8·4 (3·1-20), 11 (5·9-24) and 15 (5·9-22) nmol/l/min, when calculated over 24, 8 and 6 h, respectively (P = NS). Adrenal sensitivity (slope term) was also consistent across sampling durations, viz. 14 (1·3-95), 18 (1·3-64) and 20 (1·3-64) slope units. Compared with placebo, metyrapone reduced ACTH efficacy from 11 (6·2-62) to 2·8 (1·5-4·5) nmol/l/min for cortisol (n = 9, P < 0·001), while increasing ACTH efficacy for 11-desoxycortisol from 2·3 (0·9-2·9) to 99 (70-218) nmol/l/min (n = 6, P < 0·01), thus affirming face validity. Combined ACTH and cortisol responses to hypoglycaemia allowed an estimate of ACTH efficacy of 28 (22-81) nmol/l/min, compared with the control value of 8·7 (5·6-26), suggesting enhanced adrenal responsiveness. The results suggest that endogenous ACTH-adrenal drive can be approximated from overnight 8-h sampling of paired ACTH and cortisol concentrations. This strategy may have merit in clinical research in childhood, pregnancy, anxiety states and frail elderly individuals, when ACTH injections are not desired. © 2011 Blackwell Publishing Ltd.

  4. Overnight ACTH-Cortisol Dose-Responsiveness: comparison with 24-hr data, metyrapone administration, and insulin-tolerance test in healthy adults

    PubMed Central

    Iranmanesh, Ali; Keenan, Daniel M.; Aoun, Paul; Veldhuis, Johannes D.

    2012-01-01

    Objective To estimate the dose-dependence of endogenous ACTH’s stimulation of adrenal cortisol secretion overnight. Design Ten-minute sampling for ACTH and cortisol over 8 and 24 hr (N=17), after metyrapone administration (N=6), during an insulin tolerance test (N=7). Subjects Healthy adults. Measurements ACTH dose-responsive estimates. Results Twenty-four hr ACTH-cortisol concentration pairs yielded an estimated EC50 (one-half maximally stimulatory ACTH concentration) of 5.1 (2.2–9.5) pmol/L [median (range)]. This did not differ from EC50’s based upon 8 or 6-hr data [5.9 (3.5–11) and 7.5 (3.7–41) pmol/L] in the same individuals. ACTH efficacy (maximally stimulatable cortisol secretion rate) was 8.4 (3.1–20), 11 (5.9–24) and 15 (5.9–22) nmol/L/min, when calculated over 24, 8 and 6 hr, respectively (P=NS). Adrenal sensitivity (slope term) was also consistent across sampling durations, viz., 14 (1.3–95), 18 (1.3–64) and 20 (1.3–64) slope units. Compared with placebo, metyrapone reduced ACTH efficacy from 11 (6.2–62) to 2.8 (1.5–4.5) nmol/L/min for cortisol (N=9, P<0.001), while increasing ACTH efficacy for 11-desoxycortisol from 2.3 (0.9–2.9) to 99 (70–218) nmol/L/min (N=6, P<0.01), thus affirming face validity. Combined ACTH and cortisol responses to hypoglycemia allowed an estimate of ACTH efficacy of 28 (22–81) nmol/L/min, compared with the control value of 8.7 (5.6–26), suggesting enhanced adrenal responsiveness. Conclusions The results suggest that endogenous ACTH-adrenal drive can be approximated from overnight 8-hr sampling of paired ACTH and cortisol concentrations. This strategy may have merit in clinical research in childhood, pregnancy, anxiety states, and frail elderly individuals, when ACTH injections are not desired. PMID:21609353

  5. Cervical Preparation Before Dilation and Evacuation Using Adjunctive Misoprostol or Mifepristone Compared With Overnight Osmotic Dilators Alone: A Randomized Controlled Trial.

    PubMed

    Goldberg, Alisa B; Fortin, Jennifer A; Drey, Eleanor A; Dean, Gillian; Lichtenberg, E Steve; Bednarek, Paula H; Chen, Beatrice A; Dutton, Caryn; McKetta, Sarah; Maurer, Rie; Winikoff, Beverly; Fitzmaurice, Garrett M

    2015-09-01

    To evaluate operative time after adjunctive misoprostol or mifepristone compared with overnight osmotic dilators alone for cervical preparation before dilation and evacuation at 16-23 6/7 weeks of gestation. This double-blind, three-arm, multicenter, randomized trial compared overnight osmotic dilators alone, dilators plus 400 micrograms buccal misoprostol 3 hours preoperatively, and dilators plus 200 mg oral mifepristone during dilator placement for dilation and evacuation. Our primary outcome was dilation and evacuation operative time within two cohorts: 16-18 6/7 weeks of gestation (N=150) and 19-23 6/7 weeks of gestation (N=150). Three hundred women were required for 80% power to detect a 2-minute difference in operative time. Secondary outcomes included initial cervical dilation, side effects, physician satisfaction by Likert scale, and complications. Between February 2013 and February 2014 we randomized 300 women evenly across treatment arms. Group demographics were similar. We found no difference in operative time in either gestational cohort (early cohort [minutes]: 5.11±3.0 dilators alone, 4.99±3.3 misoprostol, 4.33±2.0 mifepristone, P=.34; late cohort [minutes]: 7.50±3.7 dilators alone, 7.62±5.4 misoprostol, 6.74±3.2 mifepristone, P=.53). In the early cohort, initial dilation was greater with misoprostol than dilators alone (2.4 compared with 2.0 cm, P=.007). Patients given misoprostol had significantly more pain, fever, and chills. In the late cohort, dilation and evacuation procedures were less difficult after mifepristone (4.1%, 95% confidence interval [CI] 0.0-9.6) than misoprostol (18.8%, 95% CI 7.7-29.8) or dilators alone (18.8%, 95% CI 7.7-29.8; P=.04). We had inadequate power to infer differences in complications: dilators alone (10%, 95% CI 4.2-16.0) compared with misoprostol (2%, 95% CI 0-4.7) compared with mifepristone (2%, 95% CI 0-4.8). Despite no difference in operative time, adjunctive mifepristone facilitates later dilation and

  6. A Fast Hermite Transform.

    PubMed

    Leibon, Gregory; Rockmore, Daniel N; Park, Wooram; Taintor, Robert; Chirikjian, Gregory S

    2008-12-17

    We present algorithms for fast and stable approximation of the Hermite transform of a compactly supported function on the real line, attainable via an application of a fast algebraic algorithm for computing sums associated with a three-term relation. Trade-offs between approximation in bandlimit (in the Hermite sense) and size of the support region are addressed. Numerical experiments are presented that show the feasibility and utility of our approach. Generalizations to any family of orthogonal polynomials are outlined. Applications to various problems in tomographic reconstruction, including the determination of protein structure, are discussed.

  7. Fast Overcurrent Tripping Circuit

    NASA Technical Reports Server (NTRS)

    Sullender, Craig C.; Davies, Bryan L.; Osborn, Stephen H.

    1993-01-01

    Fast overcurrent tripping circuit designed for incorporation into power metal oxide/semiconductor field-effect transistor (MOSFET) switching circuit. Serves as fast electronic circuit breaker by sensing voltage across MOSFET's during conduction and switching MOSFET's off within 1 microsecond after voltage exceeds reference value corresponding to tripping current. Acts more quickly than Hall-effect current sensor and, in comparison with shunt current-measuring circuits, smaller and consumes less power. Also ignores initial transient overcurrents during first 5 microseconds of switching cycle.

  8. Integral Fast Reactor concept

    SciTech Connect

    Till, C.E.; Chang, Y.I.

    1986-01-01

    The Integral Fast Reactor (IFR) is an innovative LMR concept, being developed at Argonne National Laboratory, that fully exploits the inherent properties of liquid metal cooling and metallic fuel to achieve breakthroughs in economics and inherent safety. This paper describes key features and potential advantages of the IFR concept, technology development status, fuel cycle economics potential, and future development path.

  9. The Integral Fast Reactor

    SciTech Connect

    Till, C.E.; Chang, Y.I. ); Lineberry, M.J. )

    1990-01-01

    Argonne National Laboratory, since 1984, has been developing the Integral Fast Reactor (IFR). This paper will describe the way in which this new reactor concept came about; the technical, public acceptance, and environmental issues that are addressed by the IFR; the technical progress that has been made; and our expectations for this program in the near term. 5 refs., 3 figs.

  10. Fast ForWord.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    This paper provides an overview of Fast ForWord, a CD-ROM and Internet-based training program for children (pre-K to grade 8) with language and reading problems that helps children rapidly build oral language comprehension and other critical skills necessary for learning to read or becoming a better reader. With the help of computers, speech…

  11. Levels of factor VIII and factor IX in fresh-frozen plasma produced from whole blood stored at 4 °C overnight in Turkey

    PubMed Central

    Agus, Neval; Yilmaz, Nisel; Colak, Ayfer; Liv, Fatma

    2012-01-01

    Background The aim of this study was to assess whether the quantities of factor VIII and factor IX in fresh-frozen plasma produced from whole blood stored at 4 °C for 24 hours are adequate for their intended purpose. Materials and methods Fresh-frozen plasma separated from whole blood after storage at 4 °C overnight (24 hours from donation) was compared with plasma prepared 8 hours after donation using a standard method. The amounts of factor VIII and factor IX obtained with the two methods were compared. Results Compared to the levels of factor VIII and factor IX in plasma prepared within 8 hours of blood collection, the levels in plasma prepared after 24 hours of storage at 4 °C were 25% and 9% lower, respectively. Ninety percent of the factor VIII and 100% of the factor IX levels were above 0.5 IU/mL (standard haematology reference range) after 24 hours of storage. Discussion These data suggest that there is good retention of coagulation factor activity in plasma produced from whole blood stored at 4 ºC for 24 hours and that such plasma would be an acceptable product for most patients requiring fresh-frozen plasma. PMID:22153689

  12. Levels of factor VIII and factor IX in fresh-frozen plasma produced from whole blood stored at 4 °C overnight in Turkey.

    PubMed

    Agus, Neval; Yilmaz, Nisel; Colak, Ayfer; Liv, Fatma

    2012-04-01

    The aim of this study was to assess whether the quantities of factor VIII and factor IX in fresh-frozen plasma produced from whole blood stored at 4 °C for 24 hours are adequate for their intended purpose. Fresh-frozen plasma separated from whole blood after storage at 4 °C overnight (24 hours from donation) was compared with plasma prepared 8 hours after donation using a standard method. The amounts of factor VIII and factor IX obtained with the two methods were compared. Compared to the levels of factor VIII and factor IX in plasma prepared within 8 hours of blood collection, the levels in plasma prepared after 24 hours of storage at 4 °C were 25% and 9% lower, respectively. Ninety percent of the factor VIII and 100% of the factor IX levels were above 0.5 IU/mL (standard haematology reference range) after 24 hours of storage. These data suggest that there is good retention of coagulation factor activity in plasma produced from whole blood stored at 4 ºC for 24 hours and that such plasma would be an acceptable product for most patients requiring fresh-frozen plasma.

  13. Differences in Dry Eye Questionnaire Symptoms in Two Different Modalities of Contact Lens Wear: Silicone-Hydrogel in Daily Wear Basis and Overnight Orthokeratology

    PubMed Central

    Rico-del-Viejo, Laura; Martin-Gil, Alba

    2016-01-01

    Purpose. To compare the ocular surface symptoms and signs in an adult population of silicone-hydrogel (Si-Hy) contact lens (CL) wearers with another modality of CL wear, overnight orthokeratology (OK). Materials and Methods. This was a prospective and comparative study in which 31 myopic subjects were fitted with the same Si-Hy CL and 23 underwent OK treatment for 3 months. Dry eye questionnaire (DEQ) was filled in at the beginning of the study and then after 15 days, 1 month, and 3 months using each CL modality. The tear quality was evaluated with noninvasive tear break-up time. Tear production was measured with Schirmer test. Tear samples were collected with Schirmer strips being frozen to analyze the dinucleotide diadenosine tetraphosphate (Ap4A) concentration with High-Performance Liquid Chromatography (HPLC). Results. After refitting with ortho-k, a reduction in discomfort and dryness symptoms at the end of the day (p < 0.05, χ 2) was observed. No significant changes were observed in Ap4A concentration in any group. Bulbar redness, limbal redness, and conjunctival staining increased significantly in the Si-Hy group (p < 0.05, Kruskal–Wallis test). Conclusion. Discomfort and dryness symptoms at the end of the day are lower in the OK CL group than in the Si-Hy CL group. PMID:27689073

  14. Impact on patient care of discordance in radiology readings between external overnight radiology services and staff radiology readings at a level 1 trauma center.

    PubMed

    Cheng, Tutu; Dumire, Russell; Golden, Stanley; Gregory, James

    2013-03-01

    Overnight radiology services (ORSs) provide computed tomography (CT) scan readings that are automatically reviewed by staff radiologists (SRs) and the trauma service. Discordant readings and their clinical significance were investigated. ORS-read CT scans over 3 years were reviewed. A discordant reading was clinically significant if it resulted in a substantive change in patient care. All clinically significant findings were reviewed by a blinded radiologist. Five hundred thirty-four CT scans were identified: 191 (35.8%) head, 187 (35%) cervical, 66 (12.4%) chest, and 90 (16.9%) abdomen/pelvis scans. One hundred twenty-three scans (23%) were abnormal with a DR of 16%: 5 head, 2 cervical, 7 chest, and 6 abdomen/pelvis scans. Seven (6%) scans had clinically significant findings missed: 3 head and 4 abdomen/pelvis scans. ORSs missed 7, and SRs missed 3 clinically significant findings. A blinded radiologist confirmed the clinically significant findings. The discordant rate of readings for abnormal CT scans was 16% with 37% considered to be clinically significant. ORSs missed 100%, and 29% of the clinically significant findings were identified after SR/trauma service rounds. SR/trauma service review of ORS readings is supported. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Fasting levels of ghrelin covary with the brain response to food pictures.

    PubMed

    Kroemer, Nils B; Krebs, Lena; Kobiella, Andrea; Grimm, Oliver; Pilhatsch, Maximilian; Bidlingmaier, Martin; Zimmermann, Ulrich S; Smolka, Michael N

    2013-09-01

    Ghrelin figures prominently in the regulation of appetite in normal-weighed individuals. The apparent failure of this mechanism in eating disorders and the connection to addictive behavior in general demand a deeper understanding of the endogenous central-nervous processes related to ghrelin. Thus, we investigated processing of pictures showing palatable food after overnight fasting and following a standardized caloric intake (i.e. a 75-g oral glucose tolerance test) using functional magnetic resonance imaging and correlated it with blood plasma levels of ghrelin. Twenty-six healthy female and male volunteers viewed food and control pictures in a block design and rated their appetite after each block. Fasting levels of ghrelin correlated positively with food-cue reactivity in a bilateral network of visual processing-, reward- and taste-related regions, including limbic and paralimbic regions. Notably, among those regions were the hypothalamus and the midbrain where ghrelin receptors are densely concentrated. In addition, high fasting ghrelin levels were associated with stronger increases of subjective appetite during the food-cue-reactivity task. In conclusion, brain activation and subjective appetite ratings suggest that ghrelin elevates the hedonic effects of food pictures. Thereby, fasting ghrelin levels may generally enhance subjective craving when confronted with reward cues.

  16. Does Ramadan fasting affect sleep?

    PubMed

    Bahammam, A

    2006-12-01

    Experimental fasting has been shown to alter the sleep-wakefulness pattern in various species. As fasting during Ramadan is distinct from experimental fasting, the physiological and behavioural changes occurring during Ramadan fasting may differ from those occurring during experimental fasting. There has been increased interest in recent years in sleep changes and daytime sleepiness during Ramadan. Moreover, many of those who fast during Ramadan associate this fasting with increased daytime sleepiness and decreased performance. This raises the question of whether Ramadan fasting affects sleep. In this review, we discuss the findings of research conducted to assess changes in sleep pattern, chronobiology, circadian rhythms, daytime sleepiness and function and sleep architecture during the month of Ramadan. Where applicable, these findings are compared with those obtained during experimental fasting.

  17. An all sky study of fast X-ray transients. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Connors, Alanna

    1988-01-01

    In the HEAO 1 A-2 survey of fast X-ray transients, a search of 2 to 20 keV scanning data was made for brief increases in flux, greater than 4 millicrabs, on timescales approximately 1 to 10 to the 4th s above a 12-hour average. The search was divided into two regions, and all-sky survey of the Galaxy, and a survey of the Magellanic Clouds. In the latter, 37 events were found and identified with 4 of the 5 brighest sources in the LMC, plus 2 as flares from a foreground star. Np X-ray bursts, no gamma-ray bursts, and no events from the SMC were found. In the all-sky survey, after excluding well-known variable sources, out of the equivalent of approximately 104 days of data, 15 events were found which falling into 2 broad categories: flares from coronal sources, roughly isotropically distributed, with optically thin thermal spectra; and harder fast transients apparently distributed near the Galactic plane. The first were identified as flares from ubiquitous active cool dwarf stars. It was hypothesized that the second may have been from distant Be-neutron star binaries. However, at least two of the harder, more luminous events remained unidentified. Future research should examine the nature of these rare events, and how they may fit into a hierarchy of hard fast transients from gamma-ray bursts to outbursts from pulsar systems.

  18. Discordant signaling and autophagy response to fasting in hearts of obese mice: Implications for ischemia tolerance.

    PubMed

    Andres, Allen M; Kooren, Joel A; Parker, Sarah J; Tucker, Kyle C; Ravindran, Nandini; Ito, Bruce R; Huang, Chengqun; Venkatraman, Vidya; Van Eyk, Jennifer E; Gottlieb, Roberta A; Mentzer, Robert M

    2016-07-01

    Autophagy is regulated by nutrient and energy status and plays an adaptive role during nutrient deprivation and ischemic stress. Metabolic syndrome (MetS) is a hypernutritive state characterized by obesity, dyslipidemia, elevated fasting blood glucose levels, and insulin resistance. It has also been associated with impaired autophagic flux and larger-sized infarcts. We hypothesized that diet-induced obesity (DIO) affects nutrient sensing, explaining the observed cardiac impaired autophagy. We subjected male friend virus B NIH (FVBN) mice to a high-fat diet, which resulted in increased weight gain, fat deposition, hyperglycemia, insulin resistance, and larger infarcts after myocardial ischemia-reperfusion. Autophagic flux was impaired after 4 wk on a high-fat diet. To interrogate nutrient-sensing pathways, DIO mice were subjected to overnight fasting, and hearts were processed for biochemical and proteomic analysis. Obese mice failed to upregulate LC3-II or to clear p62/SQSTM1 after fasting, although mRNA for LC3B and p62/SQSTM1 were appropriately upregulated in both groups, demonstrating an intact transcriptional response to fasting. Energy- and nutrient-sensing signal transduction pathways [AMPK and mammalian target of rapamycin (mTOR)] also responded appropriately to fasting, although mTOR was more profoundly suppressed in obese mice. Proteomic quantitative analysis of the hearts under fed and fasted conditions revealed broad changes in protein networks involved in oxidative phosphorylation, autophagy, oxidative stress, protein homeostasis, and contractile machinery. In many instances, the fasting response was quite discordant between lean and DIO mice. Network analysis implicated the peroxisome proliferator-activated receptor and mTOR regulatory nodes. Hearts of obese mice exhibited impaired autophagy, altered proteome, and discordant response to nutrient deprivation. Copyright © 2016 the American Physiological Society.

  19. Discordant signaling and autophagy response to fasting in hearts of obese mice: Implications for ischemia tolerance

    PubMed Central

    Kooren, Joel A.; Parker, Sarah J.; Tucker, Kyle C.; Ravindran, Nandini; Ito, Bruce R.; Huang, Chengqun; Venkatraman, Vidya; Van Eyk, Jennifer E.; Gottlieb, Roberta A.; Mentzer, Robert M.

    2016-01-01

    Autophagy is regulated by nutrient and energy status and plays an adaptive role during nutrient deprivation and ischemic stress. Metabolic syndrome (MetS) is a hypernutritive state characterized by obesity, dyslipidemia, elevated fasting blood glucose levels, and insulin resistance. It has also been associated with impaired autophagic flux and larger-sized infarcts. We hypothesized that diet-induced obesity (DIO) affects nutrient sensing, explaining the observed cardiac impaired autophagy. We subjected male friend virus B NIH (FVBN) mice to a high-fat diet, which resulted in increased weight gain, fat deposition, hyperglycemia, insulin resistance, and larger infarcts after myocardial ischemia-reperfusion. Autophagic flux was impaired after 4 wk on a high-fat diet. To interrogate nutrient-sensing pathways, DIO mice were subjected to overnight fasting, and hearts were processed for biochemical and proteomic analysis. Obese mice failed to upregulate LC3-II or to clear p62/SQSTM1 after fasting, although mRNA for LC3B and p62/SQSTM1 were appropriately upregulated in both groups, demonstrating an intact transcriptional response to fasting. Energy- and nutrient-sensing signal transduction pathways [AMPK and mammalian target of rapamycin (mTOR)] also responded appropriately to fasting, although mTOR was more profoundly suppressed in obese mice. Proteomic quantitative analysis of the hearts under fed and fasted conditions revealed broad changes in protein networks involved in oxidative phosphorylation, autophagy, oxidative stress, protein homeostasis, and contractile machinery. In many instances, the fasting response was quite discordant between lean and DIO mice. Network analysis implicated the peroxisome proliferator-activated receptor and mTOR regulatory nodes. Hearts of obese mice exhibited impaired autophagy, altered proteome, and discordant response to nutrient deprivation. PMID:27199111

  20. Fast electrochemical actuator

    NASA Astrophysics Data System (ADS)

    Uvarov, I. V.; Postnikov, A. V.; Svetovoy, V. B.

    2016-03-01

    Lack of fast and strong microactuators is a well-recognized problem in MEMS community. Electrochemical actuators can develop high pressure but they are notoriously slow. Water electrolysis produced by short voltage pulses of alternating polarity can overcome the problem of slow gas termination. Here we demonstrate an actuation regime, for which the gas pressure is relaxed just for 10 μs or so. The actuator consists of a microchamber filled with the electrolyte and covered with a flexible membrane. The membrane bends outward when the pressure in the chamber increases. Fast termination of gas and high pressure developed in the chamber are related to a high density of nanobubbles in the chamber. The physical processes happening in the chamber are discussed so as problems that have to be resolved for practical applications of this actuation regime. The actuator can be used as a driving engine for microfluidics.

  1. A fast template periodogram

    NASA Astrophysics Data System (ADS)

    Hoffman, John; VanderPlas, Jake; Hartman, Joel; Bakos, Gáspár

    2017-09-01

    This proceedings contribution presents a novel, non-linear extension to the Lomb-Scargle periodogram that allows periodograms to be generated for arbitrary signal shapes. Such periodograms are already known as "template periodograms" or "periodic matched filters," but current implementations are computationally inefficient. The "fast template periodogram" presented here improves existing techniques by a factor of ˜a few for small test cases (O(10) observations), and over three orders of magnitude for lightcurves containing O(104) observations. The fast template periodogram scales asymptotically as O(HNf log HNf + H4Nf), where H denotes the number of harmonics required to adequately approximate the template and Nf is the number of trial frequencies. Existing implementations scale as O(NobsNf), where Nobs is the number of observations in the lightcurve. An open source Python implementation is available on GitHub.

  2. Calibration and Data Analysis for the KCIF Fast Magnetics System

    SciTech Connect

    Heeter, R. F.; Fasoli, A. F.; Ali-Arshad, A. S.; Moret, J, M.

    2000-03-01

    Alfven Eigenmodes (AEs) and other magnetohydrodynamic (MHD) phenomena have been studied at the Joint European Torus (JET) using a new 8-channel, 4 s, 1 MHz, 12-bit data acquisition system KC1F in conjunction with the JET fast Mirnov magnetic fluctuation pickup coils. The JET magnetic pickup coils were calibrated for the first time in the range 30-460 kHz using a new remote calibration technique which accounts for the presence of the first few LRC circuit resonances. A data-processing system has been developed within the MATLAB software environment to produce spectrograms of fluctuation amplitude and toroidal mode number versus frequency and time. The analysis software has been automated to allow routine overnight production of spectrogram web pages. Modes with amplitudes {delta}B/B {ge} 10{sup -8} and toroidal mode numbers |n| < 32 are now routinely detected. A pulse-characterization database has also been developed to select for the analysis of various useful subsets of the 4000+ JET discharges for which KC1F data is now available. Based on the work presented here and recent advances in data-acquisition technology, it should now be possible to obtain complete diagnostic data on the AEs.

  3. Fast tracking hospital construction.

    PubMed

    Quirk, Andrew

    2013-03-01

    Hospital leaders should consider four factors in determining whether to fast track a hospital construction project: Expectations of project length, quality, and cost. Whether decisions can be made quickly as issues arise. Their own time commitment to the project, as well as that of architects, engineers, construction managers, and others. The extent to which they are willing to share with the design and construction teams how and why decisions are being made.

  4. PHENIX Fast TOF

    SciTech Connect

    Soha, Aria; Chiu, Mickey; Mannel, Eric; Stoll, Sean; Lynch, Don; Boose, Steve; Northacker, Dave; Alfred, Marcus; Lindesay, James; Chujo, Tatsuya; Inaba, Motoi; Nonaka, Toshihiro; Sato, Wataru; Sakatani, Ikumi; Hirano, Masahiro; Choi, Ihnjea

    2014-01-15

    This is a technical scope of work (TSW) between the Fermi National Accelerator Laboratory (Fermilab) and the experimenters of PHENIX Fast TOF group who have committed to participate in beam tests to be carried out during the FY2014 Fermilab Test Beam Facility program. The goals for this test beam experiment are to verify the timing performance of the two types of time-of-flight detector prototypes.

  5. The Integral Fast Reactor

    SciTech Connect

    Chang, Y.I.

    1988-01-01

    The Integral Fast Reactor (IFR) is an innovative liquid metal reactor concept being developed at Argonne National Laboratory. It seeks to specifically exploit the inherent properties of liquid metal cooling and metallic fuel in a way that leads to substantial improvements in the characteristics of the complete reactor system. This paper describes the key features and potential advantages of the IFR concept, with emphasis on its safety characteristics. 3 refs., 4 figs., 1 tab.

  6. Fast Radio Bursts

    NASA Astrophysics Data System (ADS)

    Rane, Akshaya; Lorimer, Duncan

    2017-09-01

    We summarize our current state of knowledge of fast radio bursts (FRBs) which were first discovered a decade ago. Following an introduction to radio transients in general, including pulsars and rotating radio transients, we discuss the discovery of FRBs. We then discuss FRB follow-up observations in the context of repeat bursts before moving on to review propagation effects on FRB signals, FRB progenitor models and an outlook on FRBs as potential cosmological tools.

  7. Fast Ion Conductors

    NASA Astrophysics Data System (ADS)

    Chadwick, Alan V.

    Fast ion conductors, sometimes referred to as superionic conductors or solid electrolytes, are solids with ionic conductivities that are comparable to those found in molten salts and aqueous solutions of strong electrolytes, i.e., 10-2-10 S cm-1. Such materials have been known of for a very long time and some typical examples of the conductivity are shown in Fig. 1, along with sodium chloride as the archetypal normal ionic solid. Faraday [1] first noted the high conductivity of solid lead fluoride (PbF2) and silver sulphide (Ag2S) in the 1830s and silver iodide was known to be unusually high ionic conductor to the German physicists early in the 1900s. However, the materials were regarded as anomalous until the mid 1960s when they became the focus of intense interest to academics and technologists and they have remained at the forefront of materials research [2-4]. The academic aim is to understand the fundamental origin of fast ion behaviour and the technological goal is to utilize the properties in applications, particularly in energy applications such as the electrolyte membranes in solid-state batteries and fuel cells, and in electrochemical sensors. The last four decades has seen an expansion of the types of material that exhibit fast ion behaviour that now extends beyond simple binary ionic crystals to complex solids and even polymeric materials. Over this same period computer simulations of solids has also developed (in fact these methods and the interest in fast ion conductors were almost coincidental in their time of origin) and the techniques have played a key role in this area of research.

  8. "Fast" Capitalism and "Fast" Schools: New Realities and New Truths.

    ERIC Educational Resources Information Center

    Robertson, Susan L.

    This paper locates the phenomenon of self-managing schools within the framework of "fast capitalism" and identifies themes of organization central to fast capitalism, which are argued to also underpin the self-managing schools. "Fast capitalism" refers to the rapidly intensified integration of regionalized productive activities into the global…

  9. Effect of a carbohydrate mouth rinse on simulated cycling time-trial performance commenced in a fed or fasted state.

    PubMed

    Lane, Stephen C; Bird, Stephen R; Burke, Louise M; Hawley, John A

    2013-02-01

    It is presently unclear whether the reported ergogenic effect of a carbohydrate (CHO) mouth rinse on cycling time-trial performance is affected by the acute nutritional status of an individual. Hence, the aim of this study was to investigate the effect of a CHO mouth rinse on a 60-min simulated cycling time-trial performance commenced in a fed or fasted state. Twelve competitive male cyclists each completed 4 experimental trials using a double-blinded Latin square design. Two trials were commenced 2 h after a meal that contained 2.5 g·kg(-1) body mass of CHO (FED) and 2 after an overnight fast (FST). Prior to and after every 12.5% of total time during a performance ride, either a 10% maltodextrin (CHO) or a taste-matched placebo (PLB) solution was mouth rinsed for 10 s then immediately expectorated. There were significant main effects for both pre-ride nutritional status (FED vs. FST; p < 0.01) and CHO mouth rinse (CHO vs. PLB; p < 0.01) on power output with an interaction evident between the interventions (p < 0.05). The CHO mouth rinse improved mean power to a greater extent after an overnight fast (282 vs. 273 W, 3.4%; p < 0.01) compared with a fed state (286 vs. 281 W, 1.8%; p < 0.05). We concluded that a CHO mouth rinse improved performance to a greater extent in a fasted compared with a fed state; however, optimal performance was achieved in a fed state with the addition of a CHO mouth rinse.

  10. Fast Track Study

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The NASA Fast Track Study supports the efforts of a Special Study Group (SSG) made up of members of the Advanced Project Management Class number 23 (APM-23) that met at the Wallops Island Management Education Center from April 28 - May 8, 1996. Members of the Class expressed interest to Mr. Vem Weyers in having an input to the NASA Policy Document (NPD) 7120.4, that will replace NASA Management Institute (NMI) 7120.4, and the NASA Program/Project Management Guide. The APM-23 SSG was tasked with assisting in development of NASA policy on managing Fast Track Projects, defined as small projects under $150 million and completed within three years. 'Me approach of the APM-23 SSG was to gather data on successful projects working in a 'Better, Faster, Cheaper' environment, within and outside of NASA and develop the Fast Track Project section of the NASA Program/Project Management Guide. Fourteen interviews and four other data gathering efforts were conducted by the SSG, and 16 were conducted by Strategic Resources, Inc. (SRI), including five interviews at the Jet Propulsion Laboratory (JPL) and one at the Applied Physics Laboratory (APL). The interviews were compiled and analyzed for techniques and approaches commonly used to meet severe cost and schedule constraints.

  11. Fast ignitor coupling physics

    SciTech Connect

    Mason, R.J.; Tabak, M.

    1997-10-01

    The Fast Ignitor is an alternate approach to ICF in which short pulse lasers are used to initiate burn at the surface of the compressed DT fuel. The aim is to avoid the need for careful central focusing of final shocks, and possibly to lower substantially the energy requirements for ignition. Ultimately, both goals may prove crucial to Science Based Stockpile Stewardship (SBSS). This will be the case should either emerging energetic needs, or funding difficulties render the presently planned radiative fusion approach to ignition with the NIF impractical. Ignition is a first step towards the achievement of substantial energy and neutron outputs for such Stewardship. For success with the Fast Ignitor, the laser energy must be efficiently deposited into megavolt electrons (suprathermal), which must, in turn, couple to the background ions within an alpha particle range. To understand the electron fuel coupling, we have used ANTHEM plasma simulation code to model the transport of hot electrons generated by an intense short pulse laser into plasma targets over a broad range of densities. Our study will spell out the acceleration and transport mechanisms active in the Fast Ignitor environment.

  12. Fasting - the ultimate diet?

    PubMed

    Johnstone, A M

    2007-05-01

    Adult humans often undertake acute fasts for cosmetic, religious or medical reasons. For example, an estimated 14% of US adults have reported using fasting as a means to control body weight and this approach has long been advocated as an intermittent treatment for gross refractory obesity. There are unique historical data sets on extreme forms of food restriction that give insight into the consequences of starvation or semi-starvation in previously healthy, but usually non-obese subjects. These include documented medical reports on victims of hunger strike, famine and prisoners of war. Such data provide a detailed account on how the body adapts to prolonged starvation. It has previously been shown that fasting for the biblical period of 40 days and 40 nights is well within the overall physiological capabilities of a healthy adult. However, the specific effects on the human body and mind are less clearly documented, either in the short term (hours) or in the longer term (days). This review asks the following three questions, pertinent to any weight-loss therapy, (i) how effective is the regime in achieving weight loss, (ii) what impact does it have on psychology? and finally, (iii) does it work long-term?

  13. Fast Light Optical Gyroscopes

    NASA Technical Reports Server (NTRS)

    Smith, David D.

    2015-01-01

    Next-generation space missions are currently constrained by existing spacecraft navigation systems which are not fully autonomous. These systems suffer from accumulated dead-reckoning errors and must therefore rely on periodic corrections provided by supplementary technologies that depend on line-of-sight signals from Earth, satellites, or other celestial bodies for absolute attitude and position determination, which can be spoofed, incorrectly identified, occluded, obscured, attenuated, or insufficiently available. These dead-reckoning errors originate in the ring laser gyros themselves, which constitute inertial measurement units. Increasing the time for standalone spacecraft navigation therefore requires fundamental improvements in gyroscope technologies. One promising solution to enhance gyro sensitivity is to place an anomalous dispersion or fast light material inside the gyro cavity. The fast light essentially provides a positive feedback to the gyro response, resulting in a larger measured beat frequency for a given rotation rate as shown in figure 1. Game Changing Development has been investing in this idea through the Fast Light Optical Gyros (FLOG) project, a collaborative effort which began in FY 2013 between NASA Marshall Space Flight Center (MSFC), the U.S. Army Aviation and Missile Research, Development, and Engineering Center (AMRDEC), and Northwestern University. MSFC and AMRDEC are working on the development of a passive FLOG (PFLOG), while Northwestern is developing an active FLOG (AFLOG). The project has demonstrated new benchmarks in the state of the art for scale factor sensitivity enhancement. Recent results show cavity scale factor enhancements of approx.100 for passive cavities.

  14. Response of rat hindlimb muscles to 12 hours recovery from tail-cast suspension

    NASA Technical Reports Server (NTRS)

    Tischler, M. E.; Henriksen, E. J.; Jacob, S.; Cook, P.; Jaspers, S.

    1985-01-01

    Previous work has shown a number of biochemical changes which accompany atrophy or reduced muscle growth in hindlimb of tail-casted, suspended rats. These results clearly show that altered muscle growth was due to changes in protein turnover. Accordingly, the rise in soleus tyrosine following unloading reflects the more negative protein balance. Other major changes we found included slower synthesis of glutamine as indicated by lower ratios of glutamine/glutamate and reduced levels of aspartate which coincide with slower aspartate and ammonia metabolism in vitro. In conjunction with the study of SL-3 rats, which were subjected to 12 h of post-flight gravity, a study of the effects of 12 h eight bearing on metabolism of 6-day unloaded hindlimb muscles was carried out.

  15. Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses.

    PubMed

    Geiger-Brown, Jeanne; Rogers, Valerie E; Trinkoff, Alison M; Kane, Robert L; Bausell, R Barker; Scharf, Steven M

    2012-03-01

    Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score  > 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.

  16. Response of rat hindlimb muscles to 12 hours recovery from tail-cast suspension

    NASA Technical Reports Server (NTRS)

    Tischler, M. E.; Henriksen, E. J.; Jacob, S.; Jaspers, S. R.

    1985-01-01

    Previous work has shown a number of biochemical changes which accompany atrophy or reduced muscle growth in hindlimb of tail-casted, suspended rats. These results clearly show that altered muscle growth was due to changes in protein turnover. Accordingly, the rise in soleus tyrosine following unloading reflects the more negative protein balance. Other major changes we found included slower synthesis of glutamine as indicated by lower ratios of glutamine/glutamate and reduced levels of aspartate which coincide with slower aspartate and ammonia metabolism in vitro. In conjunction with the study of SL-3 rats, which were subjected to 12 h of post-flight gravity, a study of the effects of 12 h eight bearing on metabolism of 6-day unloaded hindlimb muscles was carried out.

  17. Detection of vancomycin resistances in enterococci within 3 1/2 hours

    NASA Astrophysics Data System (ADS)

    Schröder, U. -Ch.; Beleites, C.; Assmann, C.; Glaser, U.; Hübner, U.; Pfister, W.; Fritzsche, W.; Popp, J.; Neugebauer, U.

    2015-02-01

    Vancomycin resistant enterococci (VRE) constitute a challenging problem in health care institutions worldwide. Novel methods to rapidly identify resistances are highly required to ensure an early start of tailored therapy and to prevent further spread of the bacteria. Here, a spectroscopy-based rapid test is presented that reveals resistances of enterococci towards vancomycin within 3.5 hours. Without any specific knowledge on the strain, VRE can be recognized with high accuracy in two different enterococci species. By means of dielectrophoresis, bacteria are directly captured from dilute suspensions, making sample preparation very easy. Raman spectroscopic analysis of the trapped bacteria over a time span of two hours in absence and presence of antibiotics reveals characteristic differences in the molecular response of sensitive as well as resistant Enterococcus faecalis and Enterococcus faecium. Furthermore, the spectroscopic fingerprints provide an indication on the mechanisms of induced resistance in VRE.

  18. The disposition of lidocaine during a 12-hour intravenous infusion to postoperative horses.

    PubMed

    Milligan, M; Kukanich, B; Beard, W; Waxman, S

    2006-12-01

    Lidocaine is administered as an intravenous infusion to horses for a variety of reasons, but no study has assessed plasma lidocaine concentrations during a 12-h infusion to horses. The purpose of this study was to evaluate the plasma concentrations and pharmacokinetics of lidocaine during a 12-h infusion to postoperative horses. A second purpose of the study was to evaluate the in vitro plasma protein binding of lidocaine in equine plasma. Lidocaine hydrochloride was administered as a loading dose, 1.3 mg/kg over 15 min, then by a constant rate IV infusion, 50 microg/kg/min to six postoperative horses. Lidocaine plasma concentrations were measured by a validated high-pressure liquid chromatography method. One horse experienced tremors and collapsed 5.5 h into the study. The range of plasma concentrations during the infusion was 1.21-3.13 microg/mL. Lidocaine plasma concentrations were significantly increased at 0.5, 4, 6, 8, 10 and 12 h compared with 1, 2 and 3 h. The in vitro protein binding of lidocaine in equine plasma at 2 microg/mL was 53.06+/-10.28% and decreased to 27.33+/-9.72% and 29.52+/-6.44% when in combination with ceftiofur or the combination of ceftiofur and flunixin, respectively. In conclusion, a lower lidocaine infusion rate may need to be administered to horses on long-term lidocaine infusions. The in vitro protein binding of lidocaine is moderate in equine plasma, but highly protein bound drugs may displace lidocaine increasing unbound concentrations and the risk of lidocaine toxicity.

  19. Is health, measured by work ability index, affected by 12-hour rotating shift schedules?

    PubMed

    Yong, Mei; Nasterlack, Michael; Pluto, Rolf-Peter; Elmerich, Kathrin; Karl, Dorothee; Knauth, Peter

    2010-07-01

    Two forms of continuously forward rotating 12-h shift schedules exist at BASF's Ludwigshafen site. These shift schedules were compared with a daytime working system to investigate potential differential effects on employee's health status assessed with the Work Ability Index (WAI). In the 3 x 12 system, a 12-h day shift is followed 24 h later by a 12-h night shift, and after a day off the employee returns to the day shift. The 4 x 12 schedule follows the same pattern except that there are 2 days off between the night and next day shift. A total of 924 participants (278 3 x 12 and 321 4 x 12 shiftworkers and 325 day workers) were recruited. A self-administered questionnaire was used to obtain information about shiftwork schedule, demographic characteristics, and lifestyle and social factors, and the WAI was applied. The outcomes of interest were the WAI sum score and its seven dimensions. In examining the relationship with the WAI categories, a Proportional Odds Model (POM) was used to identify the potential determinants. Logistic regression models were used to estimate the impact of age on single dimensions of WAI after adjustment for potential confounding factors. Increasing age and obesity (BMI > or = 30) were the only significant determinants of poorer WAI. Although a positive association was found linking the second WAI dimension (work ability in relation to job demands) with age, an inverse association was demonstrated consistently between age and the third and fourth WAI dimensions, i.e., number of diagnosed diseases and estimated work impairment due to disease, after adjustment for potential confounders. The age-dependency was moderate overall, but seemed to be stronger among shift- than day workers, although this difference did not reach statistical significance. There was no significant differential impact of the working time systems on the WAI sum score or on the individual WAI dimensions. Thus, there is no indication of an excessive adverse health impact of these shift schedules compared to day work, to the extent that health can be measured by the WAI.

  20. Metabolic Effects of Intermittent Fasting.

    PubMed

    Patterson, Ruth E; Sears, Dorothy D

    2017-08-21

    The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved health outcomes. A MEDLINE search was performed using PubMed and the terms "intermittent fasting," "fasting," "time-restricted feeding," and "food timing." Modified fasting regimens appear to promote weight loss and may improve metabolic health. Several lines of evidence also support the hypothesis that eating patterns that reduce or eliminate nighttime eating and prolong nightly fasting intervals may result in sustained improvements in human health. Intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on (a) circadian biology, (b) the gut microbiome, and (c) modifiable lifestyle behaviors, such as sleep. If proven to be efficacious, these eating regimens offer promising nonpharmacological approaches to improving health at the population level, with multiple public health benefits.

  1. How To Eliminate Narcissism Overnight

    PubMed Central

    2011-01-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition appears likely to eliminate the diagnosis of narcissistic personality disorder. There are significant problems with the discriminant validity of the current narcissistic personality disorder critiera set; furthermore, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition's narrow focus on “grandiosity” probably contributes to the wide disparity between low narcissistic personality disorder prevalence rates in epidemiological studies and high rates of narcissistic personality disorder in clinical practice. Nevertheless, the best course of action may be to refine the narcissistic personality disorder criteria, followed by careful field testing and a search for biomarkers, rather than wholesale elimination of the narcissistic personality disorder category. The construct of “malignant narcissism” is also worthy of more intense empirical investigation. PMID:21468294

  2. Neighborhood fast food availability and fast food consumption.

    PubMed

    Oexle, Nathalie; Barnes, Timothy L; Blake, Christine E; Bell, Bethany A; Liese, Angela D

    2015-09-01

    Recent nutritional and public health research has focused on how the availability of various types of food in a person's immediate area or neighborhood influences his or her food choices and eating habits. It has been theorized that people living in areas with a wealth of unhealthy fast-food options may show higher levels of fast-food consumption, a factor that often coincides with being overweight or obese. However, measuring food availability in a particular area is difficult to achieve consistently: there may be differences in the strict physical locations of food options as compared to how individuals perceive their personal food availability, and various studies may use either one or both of these measures. The aim of this study was to evaluate the association between weekly fast-food consumption and both a person's perceived availability of fast-food and an objective measure of fast-food presence - Geographic Information Systems (GIS) - within that person's neighborhood. A randomly selected population-based sample of eight counties in South Carolina was used to conduct a cross-sectional telephone survey assessing self-report fast-food consumption and perceived availability of fast food. GIS was used to determine the actual number of fast-food outlets within each participant's neighborhood. Using multinomial logistic regression analyses, we found that neither perceived availability nor GIS-based presence of fast-food was significantly associated with weekly fast-food consumption. Our findings indicate that availability might not be the dominant factor influencing fast-food consumption. We recommend using subjective availability measures and considering individual characteristics that could influence both perceived availability of fast food and its impact on fast-food consumption. If replicated, our findings suggest that interventions aimed at reducing fast-food consumption by limiting neighborhood fast-food availability might not be completely effective.

  3. Neighborhood fast food availability and fast food consumption

    PubMed Central

    Oexle, Nathalie; Barnes, Timothy L; Blake, Christine E; Bell, Bethany A; Liese, Angela D

    2015-01-01

    Recent nutritional and public health research has focused on how the availability of various types of food in a person’s immediate area or neighborhood influences his or her food choices and eating habits. It has been theorized that people living in areas with a wealth of unhealthy fast-food options may show higher levels of fast-food consumption, a factor that often coincides with being overweight or obese. However, measuring food availability in a particular area is difficult to achieve consistently: there may be differences in the strict physical locations of food options as compared to how individuals perceive their personal food availability, and various studies may use either one or both of these measures. The aim of this study was to evaluate the association between weekly fast-food consumption and both a person’s perceived availability of fast-food and an objective measure of fast-food presence—Geographic Information Systems (GIS)—within that person’s neighborhood. A randomly selected population-based sample of eight counties in South Carolina was used to conduct a cross-sectional telephone survey assessing self-report fast-food consumption and perceived availability of fast food. GIS was used to determine the actual number of fast-food outlets within each participant’s neighborhood. Using multinomial logistic regression analyses, we found that neither perceived availability nor GIS-based presence of fast-food was significantly associated with weekly fast-food consumption. Our findings indicate that availability might not be the dominant factor influencing fast-food consumption. We recommend using subjective availability measures and considering individual characteristics that could influence both perceived availability of fast food and its impact on fast-food consumption. If replicated, our findings suggest that interventions aimed at reducing fast-food consumption by limiting neighborhood fast-food availability might not be completely

  4. New activity-based funding model for Australian private sector overnight rehabilitation cases: the rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model.

    PubMed

    Hanning, Brian; Predl, Nicolle

    2015-09-01

    Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the process of being rolled out more widely. This paper compares and contrasts RAM with traditional overnight rehabilitation payment models. It considers the advantages of RAM for hospitals and Australian Health Service Alliance. It also considers payment model changes in the context of maintaining industry consistency with Electronic Claims Lodgement and Information Processing System Environment (ECLIPSE) and health reform generally.

  5. Impact of overnight traffic noise on sleep quality, sleepiness, and vigilant attention in long-haul truck drivers: Results of a pilot study

    PubMed Central

    Popp, Roland FJ; Maier, Stefanie; Rothe, Siegfried; Zulley, Jürgen; Crönlein, Tatjana; Wetter, Thomas C; Rupprecht, Rainer; Hajak, Göran

    2015-01-01

    This study aimed to evaluate the impact of traffic noise along the motorway on sleep quality, sleepiness, and vigilant attention in long-haul truck drivers. This was a randomized, crossover, within-subject controlled study. Healthy long-haul truck drivers spent 6 consecutive nights in a real truck berth with full sleep laboratory equipment. During 3 nights, subjects were exposed to replayed traffic noise alongside motorways, whereas the other 3 nights were without traffic noise. Polysomnography was recorded during the nights and numerous sleepiness tests and vigilance examinations were performed during the following standardized working day. Outcome measures were compared between noisy and silent nights using the paired Wilcoxon test. Ten healthy long-haul truck drivers with a mean age of 36.3 ± 7.3 years completed the study as planned. On noisy nights, subjects had greater latencies to the rapid eye movement (REM) phase (90 ± 32 min vs 69 ± 16 min, P = 0.074) and higher percentages of sleep stage 1 (13.7 ± 5.5% vs 11.2 ± 4.4%; P = 0.059). Subjects also rated their sleep quality as having been better during nights without noise (28.1 ± 3.7 vs 30.3 ± 6.2, P = 0.092). The impact of these differences on daytime sleepiness and vigilance was rather low; however, mean Karolinska Sleepiness Scale (KSS) scores measured during the course of the following day were higher on six out of eight occasions after noisy nights. The effects of overnight traffic noise on sleep quality are detectable but unlikely to have any major impact on the vigilant attention and driving performance of long haul-truck drivers with low nocturnal noise sensitivity. This might not be true for subgroups prone to sleeping disorders. PMID:26572698

  6. Overnight improvements in two REM sleep-sensitive tasks are associated with both REM and NREM sleep changes, sleep spindle features, and awakenings for dream recall.

    PubMed

    Nielsen, T; O'Reilly, C; Carr, M; Dumel, G; Godin, I; Solomonova, E; Lara-Carrasco, J; Blanchette-Carrière, C; Paquette, T

    2015-07-01

    Memory consolidation is associated with sleep physiology but the contribution of specific sleep stages remains controversial. To clarify the contribution of REM sleep, participants were administered two REM sleep-sensitive tasks to determine if associated changes occurred only in REM sleep. Twenty-two participants (7 men) were administered the Corsi Block Tapping and Tower of Hanoi tasks prior to and again after a night of sleep. Task improvers and non-improvers were compared for sleep structure, sleep spindles, and dream recall. Control participants (N = 15) completed the tasks twice during the day without intervening sleep. Overnight Corsi Block improvement was associated with more REM sleep whereas Tower of Hanoi improvement was associated with more N2 sleep. Corsi Block improvement correlated positively with %REM sleep and Tower of Hanoi improvement with %N2 sleep. Post-hoc analyses suggest Tower of Hanoi effects-but not Corsi Block effects-are due to trait differences. Sleep spindle density was associated with Tower of Hanoi improvement whereas spindle amplitude correlated with Corsi Block improvement. Number of REM awakenings for dream reporting (but not dream recall per se) was associated with Corsi Block, but not Tower of Hanoi, improvement but was confounded with REM sleep time. This non-replication of one of 2 REM-sensitive task effects challenges both 'dual-process' and 'sequential' or 'sleep organization' models of sleep-dependent learning and points rather to capacity limitations on REM sleep. Experimental awakenings for sampling dream mentation may not perturb sleep-dependent learning effects; they may even enhance them.

  7. Overnight Polysomnographic Characteristics and Oxygen Saturation of Healthy Infants, 1 to 18 Months of Age, Born and Residing At High Altitude (2,640 Meters)

    PubMed Central

    Bazurto-Zapata, María A.; Gozal, David; González-García, Mauricio; Durán-Cantolla, Joaquín; Torres-Duque, Carlos A.

    2015-01-01

    BACKGROUND: Approximately 8% of the world population resides above 1,600 m, with about 10 million people living above 2,500 m in Colombia. However, reference values for polysomnography (PSG) and oxygen saturation (Spo2) of children < 2 years old residing at high altitude are currently unavailable. METHODS: Healthy infants aged 1 to 18 months born and residing at high altitude (Bogotá: 2,640 m) underwent overnight PSG. Four age groups were defined: group 1, < 45 days; group 2, 3 to 4 months; group 3, 6 to 7 months; and group 4, 10 to 18 months. Of 122 children enrolled, 50 had three consecutive PSG tests and were analyzed as a longitudinal subcohort. RESULTS: A total of 281 PSG tests were performed in 122 infants (56% girls): group 1, 106 PSG tests; group 2, 89 PSG tests; group 3, 61 PSG tests; and group 4, 25 PSG tests. Active sleep diminished and quiet sleep increased with maturation. Apnea-hypopnea indexes (total, central, and obstructive) were highest in group 1 (21.4, 12.4, and 6.8/h total sleep time, respectively) and diminished with age (P < .001). Mean Spo2 during waking and sleep increased with age (P < .001). Nadir Spo2 values during respiratory events were lower in younger infants. Longitudinal assessments of 50 infants confirmed the temporal trends described for the cross-sectional dataset. CONCLUSIONS: Healthy infants (≤ 18 months old) born and residing at high altitude show preserved sleep architecture but higher apnea-hypopnea indexes and more prominent desaturation with respiratory events than do those living at low altitude. The current study findings can be used as reference values for infants at high altitude. PMID:25811138

  8. The frequency of apneas in premature infants after inguinal hernia repair: do they need overnight monitoring in the intensive care unit?

    PubMed

    Murphy, James J; Swanson, Todd; Ansermino, Mark; Milner, Ruth

    2008-05-01

    Postoperative apneas are reported in up to 49% of premature infants undergoing anesthesia for inguinal hernia repair. Our current practice is to monitor all of these babies in the intensive care unit (ICU) overnight after surgery. In addition to the considerable expense to the health care system, these cases are cancelled if no ICU bed is available. A retrospective chart review of all premature infants undergoing inguinal hernia repairs over the past 5 years was undertaken. All postoperative apneas were identified. Potential risk factors were evaluated. Five (4.7%) of 126 premature infants had apneas after inguinal hernia repair. All of these babies had a previous history of apneas. They also had lower weights both at birth (1.08 vs 1.73 kg) and at the time of surgery (3.37 vs 4.4 kg) as well as lower gestational ages (29 vs 32.3 weeks). They were much more likely to have a complicated past medical history. Markers for this included intraventricular hemorrhage, patent ductus arteriosus, bronchopulmonary dysplasia, and requirement for mechanical ventilation and supplemental oxygen after birth. The use of sevoflurane was the only anesthetic factor which had significance. Postoperative apnea in premature infants after inguinal hernia repair using current anesthetic techniques is much less common than previously reported. Infants with prior history of apneas are at highest risk. Other risk factors appear to include gestational age, birth weight, weight at time of surgery, and a complicated neonatal course. Selective use of postoperative ICU monitoring for high-risk patients could result in significant resource and cost savings to the health care system.

  9. Short-Term Fasting Alters Pharmacokinetics of Cytochrome P450 Probe Drugs: Does Protein Binding Play a Role?

    PubMed

    Lammers, Laureen A; Achterbergh, Roos; Romijn, Johannes A; Mathôt, Ron A A

    2017-09-19

    Short-term fasting differentially alters cytochrome P450 (CYP) mediated drug metabolism. This has been established by using CYP-enzyme selective probe drugs. However, the observed effects of fasting on the pharmacokinetics of these probe drugs may also include the effects of altered plasma protein binding of these drugs. Therefore, we studied the effect of short-term fasting on protein binding of five commonly used probe drugs [caffeine (CYP1A2), metoprolol (CYP2D6), midazolam (CYP3A4), omeprazole (CYP2C19) and S-warfarin (CYP2C9)]. The free and total plasma concentrations of the five probe drugs were analyzed by LC-MS/MS in samples retrieved in a cross-over study in which nine healthy subjects received an intravenous administration of the cocktail after an overnight fast (control) and after 36 h of fasting. Short-term fasting increased plasma free fatty acid concentrations from 0.48 mmol/L (control) to 1.29 mmol/L (36 h fasting) (p = 0.012). Short-term fasting did not alter the free fractions of caffeine, metoprolol and omeprazole compared to the control intervention (p > 0.05). Power to detect a difference for midazolam and S-warfarin was low since the majority of free concentrations were below the limit of quantification. This study demonstrates that short-term fasting does not alter protein binding of the probe drugs caffeine, metoprolol and omeprazole.

  10. Fasting adaptation in idiopathic ketotic hypoglycemia: a mismatch between glucose production and demand.

    PubMed

    Huidekoper, Hidde H; Duran, Marinus; Turkenburg, Marjolein; Ackermans, Mariëtte T; Sauerwein, Hans P; Wijburg, Frits A

    2008-08-01

    In order to study the pathophysiology of hypoglycemia in idiopathic ketotic hypoglycemia (KH), glucose kinetics during fasting in patients with KH were determined. A fasting test was performed in 12 children with previously documented KH. Besides determination of glucoregulatory hormones, plasma ketones, FFA and alanine, the rates of endogenous glucose production (EGP), glucose uptake, gluconeogenesis (GNG) and glycogenolysis (GGL) were quantified using the [6,6-(2)H(2)] glucose isotope dilution method and the deuterated water method. The five youngest subjects (age 2.5-3.9 years) became hypoglycemic (glucose <3.0 mmol/l) during the test. Mean differences in glucose kinetics between overnight fasting and the end of the test in the hypoglycemic vs. the normoglycemic subjects were: EGP: -31.9% vs. -17.9% (p = 0.007), GGL: -66.2% vs. -50.8% (p = 0.465) and GNG 6.8% vs. 19.5% (p = 0.465). Plasma alanine levels were significantly lower (p = 0.028) at the end of the test in the hypoglycemic subjects. Plasma ketones and FFA levels were in the normal range for fasting duration in all subjects. We conclude that hypoglycemia in KH is caused by the inability to sustain an adequate EGP during fasting in view of the higher glucose requirement in young children. The decrease in GGL is not accompanied by a significant increase in GNG, possibly because of a limitation in the supply of alanine. Our results support the hypothesis that KH represents the lower tail of the Gaussian distribution of fasting tolerance in children.

  11. Fast Ignitor coupling physics

    SciTech Connect

    Mason, R.J.; Tabak, M.

    1997-10-01

    The Fast Ignitor is an alternate approach to ICF in which short pulse lasers are used to initiate burn at the surface of the compressed DT fuel. The aim is to avoid the need for careful central focusing of final shocks, and possibly to lower substantially the energy requirements for ignition. Ultimately, both goals may prove crucial to Science Based Stockpile Stewardship (SBSS). This will be the case should either emerging energetic needs, or finding difficulties render the presently planned radiative fusion approach to ignition with the NIF impractical. Ignition is a first step towards the achievement of substantial energy and neutron outputs for such Stewardship.

  12. Simplified fast neutron dosimeter

    DOEpatents

    Sohrabi, Mehdi

    1979-01-01

    Direct fast-neutron-induced recoil and alpha particle tracks in polycarbonate films may be enlarged for direct visual observation and automated counting procedures employing electrochemical etching techniques. Electrochemical etching is, for example, carried out in a 28% KOH solution at room temperature by applying a 2000 V peak-to-peak voltage at 1 kHz frequency. Such recoil particle amplification can be used for the detection of wide neutron dose ranges from 1 mrad. to 1000 rads. or higher, if desired.

  13. Fast neutron dosimetry

    SciTech Connect

    DeLuca, P.M. Jr.; Pearson, D.W.

    1992-01-01

    This progress report concentrates on two major areas of dosimetry research: measurement of fast neutron kerma factors for several elements for monochromatic and white spectrum neutron fields and determination of the response of thermoluminescent phosphors to various ultra-soft X-ray energies and beta-rays. Dr. Zhixin Zhou from the Shanghai Institute of Radiation Medicine, People's Republic of China brought with him special expertise in the fabrication and use of ultra-thin TLD materials. Such materials are not available in the USA. The rather unique properties of these materials were investigated during this grant period.

  14. FAST NEUTRONIC REACTOR

    DOEpatents

    Snell, A.H.

    1957-12-01

    This patent relates to a reactor and process for carrying out a controlled fast neutron chain reaction. A cubical reactive mass, weighing at least 920 metric tons, of uranium metal containing predominantly U/sup 238/ and having a U/sup 235/ content of at least 7.63% is assembled and the maximum neutron reproduction ratio is limited to not substantially over 1.01 by insertion and removal of a varying amount of boron, the reactive mass being substantially freed of moderator.

  15. Fast quench reactor method

    SciTech Connect

    Detering, B.A.; Donaldson, A.D.; Fincke, J.R.; Kong, P.C.; Berry, R.A.

    1999-08-10

    A fast quench reaction includes a reactor chamber having a high temperature heating means such as a plasma torch at its inlet and a means of rapidly expanding a reactant stream, such as a restrictive convergent-divergent nozzle at its outlet end. Metal halide reactants are injected into the reactor chamber. Reducing gas is added at different stages in the process to form a desired end product and prevent back reactions. The resulting heated gaseous stream is then rapidly cooled by expansion of the gaseous stream. 8 figs.

  16. The fast encryption package

    NASA Technical Reports Server (NTRS)

    Bishop, Matt

    1988-01-01

    The organization of some tools to help improve passwork security at a UNIX-based site is described along with how to install and use them. These tools and their associated library enable a site to force users to pick reasonably safe passwords (safe being site configurable) and to enable site management to try to crack existing passworks. The library contains various versions of a very fast implementation of the Data Encryption Standard and of the one-way encryption functions used to encryp the password.

  17. Fast neutron nuclear reactor

    SciTech Connect

    Cabrillat, M. Th.; Lions, N.

    1985-01-08

    The invention relates to a fast neutron nuclear reactor of the integrated type comprising a cylindrical inner vessel. The inner vessel comprises two concentric ferrules and the connection between the hot collector defined within this vessel and the inlet port of the exchangers is brought about by a hot structure forming a heat baffle and supported by the inner ferrule and by a cold structure surrounding the hot structure, supported by the outer ferrule and sealingly connected to the exchanger. Application to the generation of electric power in nuclear power stations.

  18. Fast quench reactor method

    DOEpatents

    Detering, B.A.; Donaldson, A.D.; Fincke, J.R.; Kong, P.C.; Berry, R.A.

    1999-08-10

    A fast quench reaction includes a reactor chamber having a high temperature heating means such as a plasma torch at its inlet and a means of rapidly expanding a reactant stream, such as a restrictive convergent-divergent nozzle at its outlet end. Metal halide reactants are injected into the reactor chamber. Reducing gas is added at different stages in the process to form a desired end product and prevent back reactions. The resulting heated gaseous stream is then rapidly cooled by expansion of the gaseous stream. 8 figs.

  19. Fast quench reactor method

    DOEpatents

    Detering, Brent A.; Donaldson, Alan D.; Fincke, James R.; Kong, Peter C.; Berry, Ray A.

    1999-01-01

    A fast quench reaction includes a reactor chamber having a high temperature heating means such as a plasma torch at its inlet and a means of rapidly expanding a reactant stream, such as a restrictive convergent-divergent nozzle at its outlet end. Metal halide reactants are injected into the reactor chamber. Reducing gas is added at different stages in the process to form a desired end product and prevent back reactions. The resulting heated gaseous stream is then rapidly cooled by expansion of the gaseous stream.

  20. Same Day Discharge versus Overnight Stay in the Hospital following Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Bundhun, Pravesh Kumar; Soogund, Mohammad Zafooruddin Sani; Huang, Wei-Qiang

    2017-01-01

    Background New research in interventional cardiology has shown the demand for percutaneous coronary interventions (PCI) to have increased tremendously. Effective treatment with a lower hospital cost has been the aim of several PCI capable centers. This study aimed to compare the adverse clinical outcomes associated with same day discharge versus overnight stay in the hospital following PCI in a population of randomized patients with stable coronary artery disease (CAD). Methods The National Library of Medicine (MEDLINE/PubMed), the Cochrane Registry of Randomized Controlled Trials and EMBASE databases were searched (from March to June 2016) for randomized trials comparing same-day discharge versus overnight stay in the hospital following PCI. Main endpoints in this analysis included adverse cardiovascular outcomes observed during a 30-day period. Statistical analysis was carried out by the RevMan 5.3 software whereby odds ratios (OR) and 95% confidence intervals (CIs) were calculated with respect to a fixed or a random effects model. Results Eight randomized trials with a total number of 3081 patients (1598 patients who were discharged on the same day and 1483 patients who stayed overnight in the hospital) were included. Results of this analysis showed that mortality, myocardial infarction (MI) and major adverse cardiac events (MACEs) were not significantly different between same day discharge versus overnight stay following PCI with OR: 0.22, 95% CI: 0.04–1.35; P = 0.10, OR: 0.68, 95% CI: 0.33–1.41; P = 0.30 and OR: 0.45, 95% CI: 0.20–1.02; P = 0.06 respectively. Blood transfusion and re-hospitalization were also not significantly different between these two groups with OR: 0.64, 95% CI: 0.13–3.21; P = 0.59 and OR: 1.53, 95% CI: 0.88–2.65; P = 0.13 respectively. Similarly, any adverse event, major bleeding and repeated revascularization were also not significantly different between these two groups of patients with stable CAD, with OR: 0.42, 95% CI: 0

  1. Fast ignitor coupling physics

    SciTech Connect

    Mason, R.J.; Tabak, M.

    1997-10-01

    The Fast Ignitor is an alternate approach to ICF in which short pulse lasers are used to initiate burn at the surface of the compressed DT fuel. The aim is to avoid the need for careful central focussing of final shocks, and possibly to lower substantially the energy requirements for ignition. Ultimately, both goals may prove crucial to Stockpile Stewardship. For success with the Fast Ignitor, the laser energy must be efficiently deposited into megavolt electrons, which must, in turn, couple to the background ions within an alpha particle range. To understand this coupling, we have used ANTHEM plasma simulation code to model the transport of hot electrons generated by an intense ({ge} 3 x 10{sup 18} W/cm{sup 2}) short pulse 1.06 {mu}m laser into plasma targets over a broad range of densities (0.35 to 10{sup 4} x n{sub crit}). Ponderomotive effects are included as a force on the cold background and hot emission electrons of the form, F{sub h,c} = -({omega}{sup 2}{sub Ph,c}/2{omega}{sup 2}){del}I, in which I is the laser intensity and {omega}{sub p}{sup 2} = 4{pi}e{sup 2}n/m{sub 0}{gamma} with m{sub 0} the electron rest mass.

  2. Fast-Acting Valve

    NASA Technical Reports Server (NTRS)

    Wojciechowski, Bogdan V. (Inventor); Pegg, Robert J. (Inventor)

    2003-01-01

    A fast-acting valve includes an annular valve seat that defines an annular valve orifice between the edges of the annular valve seat, an annular valve plug sized to cover the valve orifice when the valve is closed, and a valve-plug holder for moving the annular valve plug on and off the annular valve seat. The use of an annular orifice reduces the characteristic distance between the edges of the valve seat. Rather than this distance being equal to the diameter of the orifice, as it is for a conventional circular orifice, the characteristic distance equals the distance between the inner and outer radii (for a circular annulus). The reduced characteristic distance greatly reduces the gap required between the annular valve plug and the annular valve seat for the valve to be fully open, thereby greatly reducing the required stroke and corresponding speed and acceleration of the annular valve plug. The use of a valve-plug holder that is under independent control to move the annular valve plug between its open and closed positions is important for achieving controllable fast operation of the valve.

  3. Fast SCR Thyratron Driver

    SciTech Connect

    Nguyen, M.N.; /SLAC

    2007-06-18

    As part of an improvement project on the linear accelerator at SLAC, it was necessary to replace the original thyratron trigger generator, which consisted of two chassis, two vacuum tubes, and a small thyratron. All solid-state, fast rise, and high voltage thyratron drivers, therefore, have been developed and built for the 244 klystron modulators. The rack mounted, single chassis driver employs a unique way to control and generate pulses through the use of an asymmetric SCR, a PFN, a fast pulse transformer, and a saturable reactor. The resulting output pulse is 2 kV peak into 50 {Omega} load with pulse duration of 1.5 {mu}s FWHM at 180 Hz. The pulse risetime is less than 40 ns with less than 1 ns jitter. Various techniques are used to protect the SCR from being damaged by high voltage and current transients due to thyratron breakdowns. The end-of-line clipper (EOLC) detection circuit is also integrated into this chassis to interrupt the modulator triggering in the event a high percentage of line reflections occurred.

  4. Generalized fast multipole method

    NASA Astrophysics Data System (ADS)

    Létourneau, Pierre-David; Cecka, Cristopher; Darve, Eric

    2010-06-01

    The fast multipole method (FMM) is a technique allowing the fast calculation of long-range interactions between N points in O(N) or O(N ln N) steps with some prescribed error tolerance. The FMM has found many applications in the field of integral equations and boundary element methods, in particular by accelerating the solution of dense linear systems arising from such formulations. Original FMMs required analytical expansions of the kernel, for example using spherical harmonics or Taylor expansions. In recent years, the range of applicability and the ease of use of FMMs has been extended by the introduction of black box [1] or kernel independent techniques [2]. In these approaches, the user only provides a subroutine to numerically calculate the interaction kernel. This allows changing the definition of the kernel with minimal change to the computer program. In this talk we will present a novel kernel independent FMM, which leads to diagonal multipole-to-local operators. This results in a significant reduction in the computational cost [1], in particular when high accuracy is needed. The approach is based on Cauchy's integral formula and the Laplace transform. We will present a numerical analysis of the convergence, methods to choose the parameters in the FMM given some tolerance, and the steps required to build a multilevel scheme from the single level formulation. Numerical results are given for benchmark calculations to demonstrate the accuracy as a function of the number of multipole coefficients, and the computational cost of the different steps in the method.

  5. Fast Fourier transform telescope

    SciTech Connect

    Tegmark, Max; Zaldarriaga, Matias

    2009-04-15

    We propose an all-digital telescope for 21 cm tomography, which combines key advantages of both single dishes and interferometers. The electric field is digitized by antennas on a rectangular grid, after which a series of fast Fourier transforms recovers simultaneous multifrequency images of up to half the sky. Thanks to Moore's law, the bandwidth up to which this is feasible has now reached about 1 GHz, and will likely continue doubling every couple of years. The main advantages over a single dish telescope are cost and orders of magnitude larger field-of-view, translating into dramatically better sensitivity for large-area surveys. The key advantages over traditional interferometers are cost (the correlator computational cost for an N-element array scales as Nlog{sub 2}N rather than N{sup 2}) and a compact synthesized beam. We argue that 21 cm tomography could be an ideal first application of a very large fast Fourier transform telescope, which would provide both massive sensitivity improvements per dollar and mitigate the off-beam point source foreground problem with its clean beam. Another potentially interesting application is cosmic microwave background polarization.

  6. Fast Food Jobs. National Study of Fast Food Employment.

    ERIC Educational Resources Information Center

    Charner, Ivan; Fraser, Bryna Shore

    A study examined employment in the fast-food industry. The national survey collected data from employees at 279 fast-food restaurants from seven companies. Female employees outnumbered males by two to one. The ages of those fast-food employees in the survey sample ranged from 14 to 71, with fully 70 percent being in the 16- to 20-year-old age…

  7. Islamic fasting and multiple sclerosis

    PubMed Central

    2014-01-01

    Background Month-long daytime Ramadan fasting pose s major challenges to multiple sclerosis (MS) patients in Muslim countries. Physicians should have practical knowledge on the implications of fasting on MS. We present a summary of database searches (Cochrane Database of Systematic Reviews, PubMed) and a mini-symposium on Ramadan fasting and MS. In this symposium, we aimed to review the effect of fasting on MS and suggest practical guidelines on management. Discussion In general, fasting is possible for most stable patients. Appropriate amendment of drug regimens, careful monitoring of symptoms, as well as providing patients with available evidence on fasting and MS are important parts of management. Evidence from experimental studies suggests that calorie restriction before disease induction reduces inflammation and subsequent demyelination and attenuates disease severity. Fasting does not appear to have unfavorable effects on disease course in patients with mild disability (Expanded Disability Status Scale (EDSS) score ≤3). Most experts believed that during fasting (especially in summer), some MS symptoms (fatigue, fatigue perception, dizziness, spasticity, cognitive problems, weakness, vision, balance, gait) might worsen but return to normal levels during feasting. There was a general consensus that fasting is not safe for patients: on high doses of anti-convulsants, anti-spastics, and corticosteroids; with coagulopathy or active disease; during attacks; with EDSS score ≥7. Summary These data suggest that MS patients should have tailored care. Fasting in MS patients is a challenge that is directly associated with the spiritual belief of the patient. PMID:24655543

  8. Effects of an overnight intravenous lipid infusion on intramyocellular lipid content and insulin sensitivity in African-American versus Caucasian adolescents

    PubMed Central

    Lee, SoJung; Boesch, Chris; Kuk, Jennifer L.; Arslanian, Silva

    2012-01-01

    Objective To explain the predisposition for insulin resistance among African American (AA) adolescents, this study aimed to: 1) examine changes in intramyocellular lipid content (IMCL), and insulin sensitivity with intralipid (IL) infusion; and 2) determine whether the increase in IMCL is comparable between AA and Caucasian adolescents. Materials and Methods Thirteen AA and 15 Caucasian normal-weight adolescents (BMI <85th) underwent a 3-h hyperinsulinemic-euglycemic clamp, on two occasions in random order, after an overnight 12-hr infusion of: 1) 20% IL and 2) normal saline (NS). IMCL was quantified by 1H-magnetic resonance spectroscopy in tibialis anterior muscle before and after IL infusion. Results During IL infusion, plasma TG, glycerol, FFA and fat oxidation increased significantly, with no race differences. Hepatic insulin sensitivity decreased with IL infusion with no difference between the groups. IL infusion was associated with a significant increase in IMCL, which was comparable between AA (Δ 105%; NS: 1.9 ± 0.8 vs. IL: 3.9 ± 1.6 mmol/kg wet weight) and Caucasian (Δ 86%; NS: 2.8 ± 2.1 vs. IL: 5.2 ± 2.4 mmol/kg wet weight), with similar reductions (P<0.01) in insulin sensitivity between the groups (Δ −44%: NS: 9.1 ± 3.3 vs. IL: 5.1 ± 1.8 mg/kg/min per µU/ml in AA) and (Δ−39%: NS: 12.9 ± 6.0 vs. IL: 7.9 ± 3.8 mg/kg/min per µU/ml in Caucasian) adolescents. Conclusions In healthy adolescents, an acute elevation in plasma FFA with IL infusion is accompanied by significant increases in IMCL and reductions in insulin sensitivity with no race differential. Our findings suggest that AA normal-weight adolescents are not more susceptible than Caucasians to FFA-induced IMCL accumulation and insulin resistance. PMID:23122836

  9. Effects of three month nasal continuous positive airway pressure treatment on electrocardiographic, echocardiographic and overnight polysomnographic parameters in newly diagnosed moderate/severe obstructive sleep apnea patients.

    PubMed

    Cicek, Davran; Balcioğlu, Akif Serhat; Lakadamyali, Hüseyin; Müderrisoğlu, Haldun

    2015-01-01

    The objective of the study was to determine the effects of nasal continuous positive airway pressure (nCPAP) therapy on left ventricular (LV) function and electrocardiographic parameters in newly diagnosed moderate/severe obstructive sleep apnea (OSA) patients without cardiovascular comorbidities and medical treatments. We examined 44 patients who underwent overnight polysomnography together with 24-hour Holter electrocardiography, cardiopulmonary exercise testing including heart rate recovery at 1 minute (HRR-1), echocardiography, surface electrocardiography, and those who were diagnosed with moderate/severe OSA apnea--hypopnea index ≥ 15. After 3 months of nCPAP treatment, the above-mentioned examinations were repeated. Forty-four patients completed the treatment period. Twelve weeks on effective nCPAP induced a significant increase in the mitral E/A ratio (P = 0.001), as well as reductions in isovolumic relaxation time (P = 0.001) and mitral deceleration time (DT) (P = 0.002). There were no significant differences in LV ejection fraction, LV mass index, and pulsed wave Doppler parameters. Mean heart rate was 79.2 ± 12.5 pulses/minute, maximum P-wave duration 117.5 ± 8.6 msec, P-wave dispersion (PWd) 54.6 ± 10.2 msec, corrected QT interval (QTc) 436.5 ± 40.5 msec, and QT dispersion (QTd) 46.3 ± 7.1 msec, which significantly decreased to 70.4 ± 9.6 pulses/minute (P < 0.001), 111.5 ± 8.7 msec (P < 0.001), 51.6 ± 8.9 msec (P < 0.001), 418.4 ± 31.2 msec (P < 0.001), and 33.8 ± 3.4 msec (P < 0.001), respectively. Exercise capacity at baseline determined as 10.5 ± 2.2 metabolic equivalents (METS) and HRR-1 (20.6 ± 11.7 bpm) significantly increased (12.1 ± 1.5 METS and 27.4 ± 8.6 bpm). There was no significant difference in aortic root parameters. Three-month nCPAP therapy significantly increased LV shortening fraction, with no effect on systolic function or aortic root diameters and a positive effect on heart rate, PWd, HRR-1, QTc and QTd time following

  10. Fast approximate stochastic tractography.

    PubMed

    Iglesias, Juan Eugenio; Thompson, Paul M; Liu, Cheng-Yi; Tu, Zhuowen

    2012-01-01

    Many different probabilistic tractography methods have been proposed in the literature to overcome the limitations of classical deterministic tractography: (i) lack of quantitative connectivity information; and (ii) robustness to noise, partial volume effects and selection of seed region. However, these methods rely on Monte Carlo sampling techniques that are computationally very demanding. This study presents an approximate stochastic tractography algorithm (FAST) that can be used interactively, as opposed to having to wait several minutes to obtain the output after marking a seed region. In FAST, tractography is formulated as a Markov chain that relies on a transition tensor. The tensor is designed to mimic the features of a well-known probabilistic tractography method based on a random walk model and Monte-Carlo sampling, but can also accommodate other propagation rules. Compared to the baseline algorithm, our method circumvents the sampling process and provides a deterministic solution at the expense of partially sacrificing sub-voxel accuracy. Therefore, the method is strictly speaking not stochastic, but provides a probabilistic output in the spirit of stochastic tractography methods. FAST was compared with the random walk model using real data from 10 patients in two different ways: 1. the probability maps produced by the two methods on five well-known fiber tracts were directly compared using metrics from the image registration literature; and 2. the connectivity measurements between different regions of the brain given by the two methods were compared using the correlation coefficient ρ. The results show that the connectivity measures provided by the two algorithms are well-correlated (ρ = 0.83), and so are the probability maps (normalized cross correlation 0.818 ± 0.081). The maps are also qualitatively (i.e., visually) very similar. The proposed method achieves a 60x speed-up (7 s vs. 7 min) over the Monte Carlo sampling scheme, therefore

  11. Triglycerides produced in the livers of fasting rabbits are predominantly stored as opposed to secreted into the plasma

    PubMed Central

    Tuvdendorj, Demidmaa; Zhang, Xiao-jun; Chinkes, David L.; Wang, Lijian; Wu, Zhanpin; Rodriguez, Noe A.; Herndon, David N.; Wolfe, Robert R.

    2015-01-01

    Objective The liver plays a central role in regulating fat metabolism; however, it is not clear how the liver distributes the synthesized triglycerides (TGs) to storage and to the plasma. Materials and Methods We have measured the relative distribution of TGs produced in the liver to storage and the plasma by means of U-13C16-palmitate infusion in anesthetized rabbits after an overnight fast. Results The fractional synthesis rates of TGs stored in the liver and secreted into the plasma were not significantly different (Stored vs. Secreted: 31.9 ± 0.8 vs. 27.7 ± 2.6 %•h−1, p > 0.05. However, the absolute synthesis rates of hepatic stored and secreted TGs were 543 ± 158 and 27 ± 7 nmol·kg−1·min−1 respectively, indicating that in fasting rabbits the TGs produced in the liver were predominately stored (92±3%) rather than secreted (8±3%) into the plasma. This large difference was mainly due to the larger pool size of the hepatic TGs which was 21±9-fold that of plasma TGs. Plasma free fatty acids (FFAs) contributed 47±1% of the FA precursor for hepatic TG synthesis, and the remaining 53±1% was derived from hepatic lipid breakdown and possibly plasma TGs depending on the activity of hepatic lipase. Plasma palmitate concentration significantly correlated with hepatic palmitoyl-CoA and TG synthesis. Conclusion In rabbits, after an overnight fast, the absolute synthesis rate of hepatic stored TGs was significantly higher than that of secreted due to the larger pool size of hepatic TGs. The net synthesis rate of TG was approximately half the absolute rate. Plasma FFA is a major determinant of hepatic TG synthesis, and therefore hepatic TG storage. PMID:25682063

  12. FAST NEUTRON SPECTROMETER

    DOEpatents

    Davis, F.J.; Hurst, G.S.; Reinhardt, P.W.

    1959-08-18

    An improved proton recoil spectrometer for determining the energy spectrum of a fast neutron beam is described. Instead of discriminating against and thereby"throwing away" the many recoil protons other than those traveling parallel to the neutron beam axis as do conventional spectrometers, this device utilizes protons scattered over a very wide solid angle. An ovoidal gas-filled recoil chamber is coated on the inside with a scintillator. The ovoidal shape of the sensitive portion of the wall defining the chamber conforms to the envelope of the range of the proton recoils from the radiator disposed within the chamber. A photomultiplier monitors the output of the scintillator, and a counter counts the pulses caused by protons of energy just sufficient to reach the scintillator.

  13. FAST OPENING SWITCH

    DOEpatents

    Bender, M.; Bennett, F.K.; Kuckes, A.F.

    1963-09-17

    A fast-acting electric switch is described for rapidly opening a circuit carrying large amounts of electrical power. A thin, conducting foil bridges a gap in this circuit and means are provided for producing a magnetic field and eddy currents in the foil, whereby the foil is rapidly broken to open the circuit across the gap. Advantageously the foil has a hole forming two narrow portions in the foil and the means producing the magnetic field and eddy currents comprises an annular coil having its annulus coaxial with the hole in the foil and turns adjacent the narrow portions of the foil. An electrical current flows through the coil to produce the magnetic field and eddy currents in the foil. (AEC)

  14. Fast thyratron driver

    SciTech Connect

    Nguyen, M.N.; Cassel, R.L.

    1991-04-01

    A fast solid-state pulse generator used as a thyratron grid driver for kicker pulsers, has been developed and built with power MOSFETs and a transmission line transformer. The MOSFET, pulsed on and off by a pair of P-N channel HEXFETs, switches charged capacitors into the transformer connected in parallel on one end and in series on the other end to step up the voltage. The resulting output pulse parameters are 2 kilovolts peak (into 50 Ohms), 13 nanoseconds risetime (10--90%), 250 nanoseconds duration, and less than 50 picoseconds pulse-to-pulse jitter. Various methods are employed to protect the MOSFETs from thyratron arc back, including the use of TransZorbs and a magnetic diode. 3 refs., 3 figs.

  15. Fast Radio Bursts

    NASA Astrophysics Data System (ADS)

    Kaspi, Victoria M.

    2017-01-01

    Fast Radio Bursts (FRBs) are a recently discovered phenomenon consisting of short (few ms) bursts of radio waves that have dispersion measures that strongly suggest an extragalactic and possibly cosmological origin. Current best estimates for the rate of FRBs is several thousand per sky per day at radio frequencies near 1.4 GHz. Even with so high a rate, to date, fewer than 20 FRBs have been reported, with one source showing repeated bursts. In this talk I will describe known FRB properties including what is known about the lone repeating source, as well as models for the origin of these mysterious events. I will also describe the CHIME radio telescope, currently under construction in Canada. Thanks to its great sensitivity and unprecedented field-of-view, CHIME promises major progress on FRBs.

  16. FAST ACTING CURRENT SWITCH

    DOEpatents

    Batzer, T.H.; Cummings, D.B.; Ryan, J.F.

    1962-05-22

    A high-current, fast-acting switch is designed for utilization as a crowbar switch in a high-current circuit such as used to generate the magnetic confinement field of a plasma-confining and heat device, e.g., Pyrotron. The device particularly comprises a cylindrical housing containing two stationary, cylindrical contacts between which a movable contact is bridged to close the switch. The movable contact is actuated by a differential-pressure, airdriven piston assembly also within the housing. To absorb the acceleration (and the shock imparted to the device by the rapidly driven, movable contact), an adjustable air buffer assembly is provided, integrally connected to the movable contact and piston assembly. Various safety locks and circuit-synchronizing means are also provided to permit proper cooperation of the invention and the high-current circuit in which it is installed. (AEC)

  17. Severe catabolic state after prolonged fasting in cirrhotic patients: effect of oral branched-chain amino-acid-enriched nutrient mixture.

    PubMed

    Nakaya, Yutaka; Harada, Nagakatsu; Kakui, Sae; Okada, Kazuko; Takahashi, Akira; Inoi, Junnya; Ito, Susumu

    2002-01-01

    Cirrhotic patients frequently undergo various medical procedures, such as diagnostic gastrointestinal endoscopy, without taking breakfast. The aim of the present study was to clarify the effect of longer fasting (> 12 h) on energy metabolism, and to test whether supplementation of an oral branched-chain amino-acid-enriched nutrient mixture (BCAA mixture), which contains various nutrients in addition to BCAA, could improve the catabolic state. Metabolic measurement was performed in 30 cirrhotic patients and 13 normal subjects, using indirect calorimetry. Compared with that in the normal subjects, the respiratory quotient (RQ) was significantly lower after an overnight fast in the cirrhotic patients, indicating accelerated fat oxidation and a catabolic state. In addition, RQ in cirrhotic patients (n = 7) decreased rapidly with longer fasting, whereas that in the normal subjects (n = 5) showed relatively stable values. These results indicate that special care should be taken with medical procedures that are carried out in patients who have fasted. The effect of oral glucose, a carbohydrate-rich snack (rice ball), and the BCAA mixture (each, 210 kcal) on RQ was studied in 6 normal subjects and 6 patients with liver cirrhosis after an overnight fast. Supplementation of the carbohydrate-rich snack and the BCAA mixture (210 kcal each) elevated RQ and blood glucose levels to a similar degree in the cirrhotic patients. Oral administration of glucose (210 kcal) led to significantly greater elevation of blood glucose levels than the other snacks, which may be unfavorable for cirrhotic patients, who frequently have glucose intolerance. In the 30 cirrhotic patients, supplementation with the BCAA mixture in the late evening significantly improved RQ in the early morning. Carbohydrate-rich meals are used as a late evening snack in cirrhotic patients, but our study indicates that supplementation with a BCAA mixture can also be used to reduce fat oxidation in the early morning

  18. Ghrelin mimics fasting to enhance human hedonic, orbitofrontal cortex, and hippocampal responses to food.

    PubMed

    Goldstone, Anthony P; Prechtl, Christina G; Scholtz, Samantha; Miras, Alexander D; Chhina, Navpreet; Durighel, Giuliana; Deliran, Seyedeh S; Beckmann, Christian; Ghatei, Mohammad A; Ashby, Damien R; Waldman, Adam D; Gaylinn, Bruce D; Thorner, Michael O; Frost, Gary S; Bloom, Stephen R; Bell, Jimmy D

    2014-06-01

    Ghrelin, which is a stomach-derived hormone, increases with fasting and energy restriction and may influence eating behaviors through brain hedonic reward-cognitive systems. Therefore, changes in plasma ghrelin might mediate counter-regulatory responses to a negative energy balance through changes in food hedonics. We investigated whether ghrelin administration (exogenous hyperghrelinemia) mimics effects of fasting (endogenous hyperghrelinemia) on the hedonic response and activation of brain-reward systems to food. In a crossover design, 22 healthy, nonobese adults (17 men) underwent a functional magnetic resonance imaging (fMRI) food-picture evaluation task after a 16-h overnight fast (Fasted-Saline) or after eating breakfast 95 min before scanning (730 kcal, 14% protein, 31% fat, and 55% carbohydrate) and receiving a saline (Fed-Saline) or acyl ghrelin (Fed-Ghrelin) subcutaneous injection before scanning. One male subject was excluded from the fMRI analysis because of excess head motion, which left 21 subjects with brain-activation data. Compared with the Fed-Saline visit, both ghrelin administration to fed subjects (Fed-Ghrelin) and fasting (Fasted-Saline) significantly increased the appeal of high-energy foods and associated orbitofrontal cortex activation. Both fasting and ghrelin administration also increased hippocampus activation to high-energy- and low-energy-food pictures. These similar effects of endogenous and exogenous hyperghrelinemia were not explicable by consistent changes in glucose, insulin, peptide YY, and glucagon-like peptide-1. Neither ghrelin administration nor fasting had any significant effect on nucleus accumbens, caudate, anterior insula, or amygdala activation during the food-evaluation task or on auditory, motor, or visual cortex activation during a control task. Ghrelin administration and fasting have similar acute stimulatory effects on hedonic responses and the activation of corticolimbic reward-cognitive systems during food

  19. Fast word reading in pure alexia: "fast, yet serial".

    PubMed

    Bormann, Tobias; Wolfer, Sascha; Hachmann, Wibke; Neubauer, Claudia; Konieczny, Lars

    2015-01-01

    Pure alexia is a severe impairment of word reading in which individuals process letters serially with a pronounced length effect. Yet, there is considerable variation in the performance of alexic readers with generally very slow, but also occasionally fast responses, an observation addressed rarely in previous reports. It has been suggested that "fast" responses in pure alexia reflect residual parallel letter processing or that they may even be subserved by an independent reading system. Four experiments assessed fast and slow reading in a participant (DN) with pure alexia. Two behavioral experiments investigated frequency, neighborhood, and length effects in forced fast reading. Two further experiments measured eye movements when DN was forced to read quickly, or could respond faster because words were easier to process. Taken together, there was little support for the proposal that "qualitatively different" mechanisms or reading strategies underlie both types of responses in DN. Instead, fast responses are argued to be generated by the same serial-reading strategy.

  20. Fast pitch softball injuries.

    PubMed

    Meyers, M C; Brown, B R; Bloom, J A

    2001-01-01

    The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increase in the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and approximately 31% of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, unorthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision

  1. Differential expression of cholesteryl ester transfer protein in the liver and plasma of fasted and fed transgenic mice.

    PubMed

    MacLean, P S; Vadlamudi, S; Hao, E; Barakat, H A

    2000-06-01

    Because cholesteryl ester transfer protein (CETP) is considered a potential target in the treatment of atherosclerosis, several reports have focused on the regulation of this enzyme, and there is evidence that insulin may be a regulatory factor. The present study examines the differential expression of the human CETP gene between physiologic conditions that are accompanied by low (fasted) and high (fed) insulin levels. CETP expression was examined in plasma and tissues of transgenic mice expressing the human CETP minigene after 12 hours of fasting (n = 20) or ad libitum feeding (n = 20) with normal mouse chow. Plasma cholesteryl ester transfer activity (CETA) was 20% higher in fed than in fasted mice, reflecting higher levels of CETP (P < 0.05). This observation was accompanied by higher liver mRNA in fed mice (100%, P < 0.05), as determined by ribonuclease protection assays, as well as by higher CETA (23%, P < 0.05) and CETP mass (29%, P < 0.05) in the particulate fraction of liver homogenates. These parameters of liver CETP expression correlated well with each other, as well as with plasma CETA. CETP in the liver particulate fraction was found as a doublet (approximately 70 and 65 kDa), which resolved to a single band (approximately 60 kDa) upon deglycosylation. No differences in CETP expression were observed in pooled adipose tissue samples from fed and fasted mice. Insulin and glucose were not related to any plasma or tissue parameter of CETP expression. In summary, the concerted, differential expression of CETP in the liver of fed and fasted transgenic mice appears to contribute to higher plasma CETP levels in fed mice, but the precise role of insulin and glucose in regulating CETP expression under fasted and fed conditions needs to be defined.

  2. Fast foldable tent domes

    NASA Astrophysics Data System (ADS)

    Jägers, Aswin P. L.; Sliepen, Guus; Bettonvil, Felix C. M.; Hammerschlag, Robert H.

    2008-07-01

    In the near future ELTs (Extreme Large Telescopes) will be built. Preferably these telescopes should operate without obstructions in the near surrounding to reach optimal seeing conditions and avoid large turbulences with wind-gust accelerations around large obstacles. This applies also to future large solar telescopes. At present two foldable dome prototypes have been built on the Canary Islands: the Dutch Open Telescope (DOT, La Palma) and the GREGOR Telescope (Tenerife), having a diameter of 7 and 9 meter, respectively. The domes are usually fully retracted during observations. The research consists of measurements on the two domes. New camera systems are developed and placed inside the domes for precise dome deformation measurements within 0.1 mm over the whole dome size. Simultaneously, a variety of wind-speed and -direction sensors measure the wind field around the dome. In addition, fast sensitive air-pressure sensors placed on the supporting bows measure the wind pressure. The aim is to predict accurately the expected forces and deformations on up-scaled, fully retractable domes to make their construction more economically. The dimensions of 7 and 9 meter are large enough for realistic on-site tests in gusty wind and will give much more information than wind tunnel experiments.

  3. Fast dual tomography

    NASA Astrophysics Data System (ADS)

    Carrion, Philip M.

    1990-09-01

    This paper can be considered as a continuation of the work by Carrion and Carneiro (1989), where a generalized approach to linearized inversion of geophysical data was developed. Their method allows one to incorporate virtually any constraints in the inversion and reformulate the problem in the dual space of Langrangian multipliers (see also Carrion, 1989a). The constrained tomography makes traveltime inversion robust: it automatically rejects “bad data” which correspond to solutions beyond the chosen constraints and allows one to start inversion with an arbitrary chosen initial model.In this paper, I will derive basic formulas for constrained tomographic imaging that can be used in such areas of geophysics as global mapping of the earth interior, exploration geophysics, etc. The method is fast: an example that will be shown in the paper took only 6 min. of VAX CPU time. Had the conventional least-squares matrix inversion been used it would have taken more than 10 hours of the CPU time to solve the same problem.

  4. Parallel fast gauss transform

    SciTech Connect

    Sampath, Rahul S; Sundar, Hari; Veerapaneni, Shravan

    2010-01-01

    We present fast adaptive parallel algorithms to compute the sum of N Gaussians at N points. Direct sequential computation of this sum would take O(N{sup 2}) time. The parallel time complexity estimates for our algorithms are O(N/n{sub p}) for uniform point distributions and O( (N/n{sub p}) log (N/n{sub p}) + n{sub p}log n{sub p}) for non-uniform distributions using n{sub p} CPUs. We incorporate a plane-wave representation of the Gaussian kernel which permits 'diagonal translation'. We use parallel octrees and a new scheme for translating the plane-waves to efficiently handle non-uniform distributions. Computing the transform to six-digit accuracy at 120 billion points took approximately 140 seconds using 4096 cores on the Jaguar supercomputer. Our implementation is 'kernel-independent' and can handle other 'Gaussian-type' kernels even when explicit analytic expression for the kernel is not known. These algorithms form a new class of core computational machinery for solving parabolic PDEs on massively parallel architectures.

  5. Fast Fuzzy Arithmetic Operations

    NASA Technical Reports Server (NTRS)

    Hampton, Michael; Kosheleva, Olga

    1997-01-01

    In engineering applications of fuzzy logic, the main goal is not to simulate the way the experts really think, but to come up with a good engineering solution that would (ideally) be better than the expert's control, In such applications, it makes perfect sense to restrict ourselves to simplified approximate expressions for membership functions. If we need to perform arithmetic operations with the resulting fuzzy numbers, then we can use simple and fast algorithms that are known for operations with simple membership functions. In other applications, especially the ones that are related to humanities, simulating experts is one of the main goals. In such applications, we must use membership functions that capture every nuance of the expert's opinion; these functions are therefore complicated, and fuzzy arithmetic operations with the corresponding fuzzy numbers become a computational problem. In this paper, we design a new algorithm for performing such operations. This algorithm is applicable in the case when negative logarithms - log(u(x)) of membership functions u(x) are convex, and reduces computation time from O(n(exp 2))to O(n log(n)) (where n is the number of points x at which we know the membership functions u(x)).

  6. Glycemic management during Jain fasts

    PubMed Central

    Julka, Sandeep; Sachan, Alok; Bajaj, Sarita; Sahay, Rakesh; Chawla, Rajeev; Agrawal, Navneet; Saboo, Banshi; Unnikrishnan, A. G.; Baruah, Manash P.; Parmar, Girish; Kalra, Sanjay

    2017-01-01

    This review describes the various fasts observed by adherents of the Jain religion. It attempts to classify them according to their suitability for people with diabetes and suggests appropriate regime and dose modification for those observing these fasts. The review is an endeavor to encourage rational and evidence-based management in this field of diabetology. PMID:28217525

  7. Insulin resistance after a 72-h fast is associated with impaired AS160 phosphorylation and accumulation of lipid and glycogen in human skeletal muscle.

    PubMed

    Vendelbo, M H; Clasen, B F F; Treebak, J T; Møller, L; Krusenstjerna-Hafstrøm, T; Madsen, M; Nielsen, T S; Stødkilde-Jørgensen, H; Pedersen, S B; Jørgensen, J O L; Goodyear, L J; Wojtaszewski, J F P; Møller, N; Jessen, N

    2012-01-15

    During fasting, human skeletal muscle depends on lipid oxidation for its energy substrate metabolism. This is associated with the development of insulin resistance and a subsequent reduction of insulin-stimulated glucose uptake. The underlying mechanisms controlling insulin action on skeletal muscle under these conditions are unresolved. In a randomized design, we investigated eight healthy subjects after a 72-h fast compared with a 10-h overnight fast. Insulin action on skeletal muscle was assessed by a hyperinsulinemic euglycemic clamp and by determining insulin signaling to glucose transport. In addition, substrate oxidation, skeletal muscle lipid content, regulation of glycogen synthesis, and AMPK signaling were assessed. Skeletal muscle insulin sensitivity was reduced profoundly in response to a 72-h fast and substrate oxidation shifted to predominantly lipid oxidation. This was associated with accumulation of both lipid and glycogen in skeletal muscle. Intracellular insulin signaling to glucose transport was impaired by regulation of phosphorylation at specific sites on AS160 but not TBC1D1, both key regulators of glucose uptake. In contrast, fasting did not impact phosphorylation of AMPK or insulin regulation of Akt, both of which are established upstream kinases of AS160. These findings show that insulin resistance in muscles from healthy individuals is associated with suppression of site-specific phosphorylation of AS160, without Akt or AMPK being affected. This impairment of AS160 phosphorylation, in combination with glycogen accumulation and increased intramuscular lipid content, may provide the underlying mechanisms for resistance to insulin in skeletal muscle after a prolonged fast.

  8. Fast food: unfriendly and unhealthy.

    PubMed

    Stender, S; Dyerberg, J; Astrup, A

    2007-06-01

    Although nutrition experts might be able to navigate the menus of fast-food restaurant chains, and based on the nutritional information, compose apparently 'healthy' meals, there are still many reasons why frequent fast-food consumption at most chains is unhealthy and contributes to weight gain, obesity, type 2 diabetes and coronary artery disease. Fast food generally has a high-energy density, which, together with large portion sizes, induces over consumption of calories. In addition, we have found it to be a myth that the typical fast-food meal is the same worldwide. Chemical analyses of 74 samples of fast-food menus consisting of French fries and fried chicken (nuggets/hot wings) bought in McDonalds and KFC outlets in 35 countries in 2005-2006 showed that the total fat content of the same menu varies from 41 to 65 g at McDonalds and from 42 to 74 g at KFC. In addition, fast food from major chains in most countries still contains unacceptably high levels of industrially produced trans-fatty acids (IP-TFA). IP-TFA have powerful biological effects and may contribute to increased weight gain, abdominal obesity, type 2 diabetes and coronary artery disease. The food quality and portion size need to be improved before it is safe to eat frequently at most fast-food chains.

  9. FastID: Extremely Fast Forensic DNA Comparisons

    DTIC Science & Technology

    2017-05-19

    FastID: Extremely Fast Forensic DNA Comparisons Darrell O. Ricke, PhD Bioengineering Systems & Technologies Massachusetts Institute of...Technology Lincoln Laboratory Lexington, MA USA Darrell.Ricke@ll.mit.edu Abstract—Rapid analysis of DNA forensic samples can have a critical impact on...time sensitive investigations. Analysis of forensic DNA samples by massively parallel sequencing is creating the next gold standard for DNA

  10. [Fast food promotes weight gain].

    PubMed

    Stender, Steen; Dyerberg, Jørn; Astrup, Arne V

    2007-05-07

    The total amounts of fat in a fast food menu consisting of French fries and fried Chicken Nuggets from McDonald's and KFC, respectively, bought in 35 different countries vary from 41 to 71 gram. In most countries the menu contained unacceptably high amounts of industrially-produced trans fat which contributes to an increased risk of ischaemic heart disease, weight gain, abdominal fat accumulation and type 2 diabetes. The quality of the ingredients in fast food ought to be better and the size of the portions smaller and less energy-dense so that frequent