Science.gov

Sample records for 24-hour ambulatory systolic

  1. [Ambulatory 24-hour blood pressure monitoring in patients with resistant hypertension].

    PubMed

    Sznajderman, M; Popławska, W; Cybulska, I; Niegowska, J; Makowiecka-Cieśla, M; Baranowski, R

    1990-01-01

    The aim of the study was to assess the usefulness of 24-hour blood pressure (BP) and heart rate (HR) monitoring in patients with "resistant" hypertension. 30 patients (44.1 +/- 9.9 years) with diastolic BP 100 mm Hg or more in spite of treatment with three or more antihypertensive drugs were studied. Ambulatory recording of BP and HR was performed by means of Del Mar Avionics monitoring system 9000. Mean recording time was 21.5 hours and mean number of measurements during one recording--56.7. Mean ambulatory systolic and diastolic BP values were significantly lower than mean value of three casual measurements (146.0 +/- 24.6 vs 171.5 +/- 21.2 mm Hg for systolic and 97.2 +/- 11.3 vs 110.4 +/- 7.5 mm Hg for diastolic BP p less than 0.01) In 14 (46.6%) systolic BP and in 10 patients (33.3%) diastolic BP were normal. The patients with normal and abnormal ambulatory BP recordings did not differ in regard to age and mean clinic BP levels. However, patients with abnormal ambulatory BP recordings were more often overweight and showed a greater frequency of left ventricular hypertrophy and family history of hypertension and its complications. The results of the study show that ambulatory BP monitoring may be of value in assessing the response to antihypertensive treatment in patients with so called resistant hypertension as judged on the basis of clinic pressure. PMID:2074634

  2. Effect of overtime work on 24-hour ambulatory blood pressure.

    PubMed

    Hayashi, T; Kobayashi, Y; Yamaoka, K; Yano, E

    1996-10-01

    Recently, the adverse effects of long working hours on the cardiovascular systems of workers in Japan, including "Karoshi" (death from overwork), have been the focus of social concern. However, conventional methods of health checkups are often unable to detect the early signs of such adverse effects. To evaluate the influence of overtime work on the cardiovascular system, we compared 24-hour blood pressure measurements among several groups of male white-collar workers. As a result, for those with normal blood pressure and those with mild hypertension, the 24-hour average blood pressure of the overtime groups was higher than that of the control groups; for those who periodically did overtime work, the 24-hour average blood pressure and heart rate during the busy period increased. These results indicate that the burden on the cardiovascular system of white-collar workers increases with overtime work. PMID:8899576

  3. Depressive Symptoms and 24-Hour Ambulatory Blood Pressure in Africans: The SABPA Study

    PubMed Central

    Hamer, Mark; Frasure-Smith, Nancy; Lespérance, François; Harvey, Brian H.; Malan, Nico T.; Malan, Leoné

    2012-01-01

    Disturbances in circadian rhythm might play a central role in the neurobiology of depression. We examined the association between depressive symptoms and 24-hour ambulatory BP in a sample of 405 (197 black and 208 Caucasian) urbanized African teachers aged 25 to 60 yrs (mean 44.6 ± 9.6 yrs). Depressive symptoms were assessed using the self-administered 9-item Patient Health Questionnaire (PHQ-9). After adjusting for age, sex, and ethnicity, participants with severe depressive symptoms (PHQ-9 ≥ 15) had higher odds of hypertension defined from ambulatory BP and/or use of antihypertensive medication (odds ratio = 2.19, 95% CI, 1.00–4.90) in comparison to participants with no symptoms. Compared to Caucasians with no depressive symptoms, those with severe symptoms had blunted nocturnal systolic BP drop of 4.7 mmHg (95% CI, −0.5 to 10.0, P = 0.07). In summary, depressive symptoms were associated with the circadian BP profile in black and Caucasian Africans. PMID:22028954

  4. The impact of kidney transplantation on 24-hour ambulatory blood pressure in end-stage renal disease patients.

    PubMed

    Lee, Myung Hyun; Ko, Kyung Min; Ahn, Seung Won; Bae, Myoung Nam; Choi, Bum Soon; Park, Cheol Whee; Kim, Yong-Soo; Yang, Chul Woo; Chung, Byung Ha

    2015-06-01

    In this study, we prospectively investigated the impact of kidney transplantation (KT) on the status of hypertension, including circadian rhythm in end-stage renal disease (ESRD) patients. We performed 24-hour ambulatory blood pressure (BP) monitoring and office BP measurement in 48 patients before and 1 year after KT. According to the nocturnal reduction in systolic BP (ΔSBP), the patients were divided into dippers, non-dippers, and reverse dippers. After KT, the mean BP value in office BP and 24-hour ambulatory BP monitoring did not change, but the proportion of patients taking anti-hypertensive drugs and the pill number significantly decreased. In contrast, the mean ΔSBP significantly decreased, and the proportion of non-dippers and reverse dippers did not decrease. Decrease in ΔSBP after KT was associated with inferior allograft function during follow-up. Our study suggests that KT improved the overall BP level, but it did not affect abnormal circadian rhythm in ESRD patients. PMID:26051924

  5. Sleep in healthy elderly subjects: a 24-hour ambulatory polysomnographic study.

    PubMed

    Gigli, G L; Placidi, F; Diomedi, M; Maschio, M; Silvestri, G; Scalise, A; Marciani, M G

    1996-04-01

    It is still debated whether the deterioration of the sleep pattern, frequently reported by elderly subjects, is due only to aging per se. Other factors associated with aging or modifications of biological rhythms could also be involved. Elderly subjects frequently complain of daytime sleepiness, but it is not clear whether this actually represents a return to a polyphasic structure of sleep, or only a consequence of a disturbed night sleep. Ten healthy, independent and active elderly subjects (age > 72 years) were elevated by means of 24-hour ambulatory polysomnography. Findings of nocturnal sleep were compared with sleep of the same group in the 24-hour period and with sleep of young healthy controls. We observed a fragmentation of nocturnal sleep, but a fairly good representation of stages and a preservation of cyclicity. Except for three cases, with early or late times of sleep onset and wake-up, sleep disruption did not seem to be related to modification of circadian rhythms. Only three subjects presented undesired daytime naps, whereas the others either did not show daytime sleep at all, or were used to having their siesta after lunch since their young adulthood. In normal aging, daytime sleep does not constitute a social problem. Ambulatory polysomnography is a valid alternative to laboratory recordings in the identification of daytime sleep. PMID:8734563

  6. Continuous 24 hour ambulatory monitoring of intragastric pH in man.

    PubMed

    Kapur, B K; Howlett, P J; Kenyon, N G; Lunt, M J; Mills, J G; Smallwood, R H; Wilson, A J; Bardhan, K D

    1987-05-01

    A system has been developed which permits continuous 24 hour ambulatory recording of intragastric pH under near-physiological conditions. The system utilises a Cecar combination pH electrode connected through a pre-amplifier to an Oxford Medical Systems Medilog 4-24 cassette recorder, and the pH recorded continuously on to tape. The data is replayed at high speed, digitised and then analysed. Sources of error included system drift, system noise and the effect of changes in electrode environment due to saliva, food, loss of fluid contact, temperature variations and electrode time constant. These were found to be small. In contrast, the major changes in pH detected reflect real changes at the electrode tip. These changes can be recorded by the system. Developments in electronics and improvements in both the size and quality of pH electrodes, over the past few decades, has enabled intragastric pH recordings to be made with greater ease. However, a large number of investigators still assess gastric acidity by infrequent, intermittent sampling of gastric secretion through a naso-gastric tube. This new ambulatory system is a significant improvement and its versatility allows studies in acid secretion physiology, pharmacology and pathophysiology. PMID:3595080

  7. Ambulatory 24-hour cardiac oxygen consumption and blood pressure-heart rate variability: effects of nebivolol and valsartan alone and in combination.

    PubMed

    Izzo, Joseph L; Khan, Safi U; Saleem, Osman; Osmond, Peter J

    2015-07-01

    We compared an angiotensin receptor blocker (valsartan; VAL), a beta-blocker (nebivolol; NEB) and the combination of NEB/VAL with respect to 24-hour myocardial oxygen consumption (determined by 24-hour ambulatory heart rate-central systolic pressure product [ACRPP]) and its components. Subjects with hypertension (systolic blood pressure >140 or diastolic blood pressure >90; n = 26) were studied in a double-blinded, double-dummy, forced-titration, crossover design with 3 random-order experimental periods: VAL 320 mg, NEB 40 mg, and NEB/VAL 320/40 mg daily. After 4 weeks of each drug, ambulatory pulse wave analysis (MobilOGraph) was performed every 20 minutes for 24 hours. All three treatments resulted in nearly identical brachial and central systolic blood pressures. NEB alone or in combination with VAL resulted in lower ACRPP (by 11%-14%; P < .001 each) and heart rate (by 18%-20%; P < .001 each) compared with VAL, but stroke work (ACRPP per beat) was lower with VAL. Relative and adjusted variability (standard deviation and coefficient of variation) of heart rate were also lower with NEB and NEB/VAL than VAL. Results in African Americans, the majority subpopulation, were similar to those of the entire treatment group. We conclude that the rate-slowing effects of NEB cause ambulatory cardiac myocardial oxygen consumption to be lower with NEB monotherapy or NEB/VAL combination therapy than with VAL monotherapy. NEB/VAL is not superior to NEB alone in controlling heart rate, blood pressure, or ACRPP. Heart rate variability but not ACRPP variability is reduced by NEB or the combination NEB/VAL. There is no attenuation of beta-blocker-induced rate-slowing effects of in African Americans. PMID:26116459

  8. 24-hour ambulatory blood pressure and renal disease in young subjects with type I diabetes.

    PubMed

    Garg, S K; Chase, H P; Icaza, G; Rothman, R L; Osberg, I; Carmain, J A

    1997-01-01

    Twenty-four hour ambulatory blood pressure (ABP) was evaluated in 150 teenage and young adults with insulin-dependent diabetes mellitus (IDDM) to define high-risk subjects who are likely to develop early diabetic nephropathy. Their age range was 16-28 years with diabetes of 3.5-25.8 years duration. All subjects had office blood pressure (BP) measured, wore an ABP monitor for 24 h, and collected two or more timed urine samples for albumin excretion rates (AERs). Eighty-six subjects had no elevation of AER (< 7.6 micrograms/min), 29 subjects had borderline elevations (7.6-20 micrograms/min), 24 subjects had microalbuminuria (20.1-200 micrograms/min), and 11 had macroalbuminuria (> 200 micrograms/min). Age, gender, duration of diabetes, and single office BP readings were similar in the four groups (p > 0.05, logistic regression). All 24-h ABP parameters were significantly higher in subjects with diabetes having AER values greater than 7.6 micrograms/min when compared with healthy age- and gender-matched nondiabetic controls (p < 0.05, Dunnett's t test). The percent of nighttime systolic and diastolic ABP readings above the 90th percentile of normal for age, gender, and race and the percent of readings in the hypertensive range (> 140/90) were significantly related with AERs (p < 0.01; logistic regression). A higher percentage of ABP values above the 90th percentile for age, gender, and ethnic group or of ABP readings above hypertensive levels (> or = 140/90) are associated with diabetic renal disease. PMID:9334907

  9. 24-hour central aortic systolic pressure and 24-hour central pulse pressure are related to diabetic complications in type 1 diabetes – a cross-sectional study

    PubMed Central

    2013-01-01

    Background Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 h-CASP) and central pulse pressure (24 h-CPP) are now feasible. We evaluate the relationship between 24 h central blood pressure and diabetes-related complications in patients with type 1 diabetes. Methods The study was cross-sectional, including 715 subjects: 86 controls (C), 69 patients with short diabetes duration (< 10 years), normoalbuminuria (< 30 mg/24 h) without receiving antihypertensive treatment (SN), 211 with longstanding diabetes (≥ 10 years) and normoalbuminuria (LN), 163 with microalbuminuria (30-299 mg/24 h) (Mi) and 186 with macroalbuminuria (> 300 mg/24 h) (Ma). 24 h-CASP and 24 h-CPP was measured using a tonometric wrist-watch-like device (BPro, HealthStats, Singapore) and derived using N-point moving average. Results In C, SN, LN, Mi and Ma mean ± SD 24 h-CASP was: 114 ± 17, 115 ± 13, 121 ± 13, 119 ± 16 and 121 ± 13 mmHg (p < 0.001); and 24 h-CPP: 38 ± 8, 38 ± 7, 44 ± 10, 46 ± 11 and 46 ± 11 mmHg, (p < 0.001). Following rigorous adjustment (24 h mean arterial pressure and conventional risk factors), 24 h-CASP and 24 h-CPP increased with diabetes, albuminuria degree, previous cardiovascular disease (CVD), retinopathy and autonomic dysfunction (p ≤ 0.031). Odds ratios per 1 standard deviation increase in 24 h-CASP, 24 h-CPP and 24 h systolic blood pressure (24 h-SBP) were for CVD: 3.19 (1.68-6.05), 1.43 (1.01-2.02) and 2.39 (1.32-4.33), retinopathy: 4.41 (2.03-9.57), 1.77 (1.17-2.68) and 3.72 (1.85-7.47) and autonomic dysfunction: 3.25 (1.65-6.41), 1.64 (1.12-2.39) and 2.89 (1.54-5.42). Conclusions 24 h-CASP and 24 h-CPP was higher in patients vs. controls and increased with diabetic complications independently of covariates. Furthermore, 24 h-CASP was stronger associated to complications than 24 h-SBP. The prognostic significance of 24 h-CASP and 24 h-CPP needs to be determined in follow-up studies. Trial

  10. [Brief overview of the guidelines for the use of 24 hour ambulatory blood pressure monitoring (ABPM)].

    PubMed

    Shimada, Kazuyuki

    2014-08-01

    The guidelines for the use of ambulatory blood pressure monitoring published from Japanese Circulation Society in 2010 was briefly overviewed. The accuracy of devices now used in clinical practice in Japan is of sufficient grade. The thresholds for hypertension diagnosis based on ABPM have been determined with international concensus. The evaluation of ABPM data and the clinical indications for ABPM are suggested. Particularly, white-coat hypertension, masked hypertension, nocturnal hypertension, morning hypertension and diurnal blood pressure variation are conditions for which ABPM is very useful for the detection, treatment decision and follow-up. Hypertension treatment would be very much improved by the introduction of ABPM into clinical practice. PMID:25167736

  11. Normal 24-hour Ambulatory Esophageal pH Values in Koreans

    PubMed Central

    Moon, Won; Kim, Gyung Mi; Kim, Kyu Jong; Park, Seun Ja; Mun, Hyo Sung; Lee, Kang Dae

    2008-01-01

    Background/Aims Twenty-four-hour ambulatory esophageal pH monitoring is considered the gold standard for diagnosing gastroesophageal reflux disease. The aim of this study was to quantify normal distal esophageal acid parameters in healthy Koreans. Methods Thirty healthy adults who were not on medication and were free from gastrointestinal symptoms were analyzed. Ambulatory esophageal acid (pH <4) exposure parameters were recorded at 5 cm above the lower esophageal sphincter. Results The 95th percentiles for reflux parameters assessed in the distal esophagus were as follows: percentage of total time with pH <4, 5.10%; percentage of upright time with pH <4, 7.88%; percentage of supine time with pH <4, 4.00%; number of reflux episodes, 62.7; number of reflux episodes with pH <4 for >5 minutes, 5.3; and the longest single acid-exposure episode, 21.3 minutes. Conclusions Physiological gastroesophageal reflux occurs frequently in healthy Koreans. These data provide a reference range that could be utilized in studies involving Korean subjects. PMID:20485604

  12. An Analysis of 24-Hour Ambulatory Blood Pressure Monitoring Data using Orthonormal Polynomials in the Linear Mixed Model

    PubMed Central

    Edwards, Lloyd J.; Simpson, Sean L.

    2014-01-01

    Background The use of 24-hour ambulatory blood pressure monitoring (ABPM) in clinical practice and observational epidemiological studies has grown considerably in the past 25 years. ABPM is a very effective technique for assessing biological, environmental, and drug effects on blood pressure. Objectives In order to enhance the effectiveness of ABPM for clinical and observational research studies via analytical and graphical results, developing alternative data analysis approaches using modern statistical techniques are important. Methods The linear mixed model for the analysis of longitudinal data is particularly well-suited for the estimation of, inference about, and interpretation of both population (mean) and subject-specific trajectories for ABPM data. We propose using a linear mixed model with orthonormal polynomials across time in both the fixed and random effects to analyze ABPM data. Results We demonstrate the proposed analysis technique using data from the Dietary Approaches to Stop Hypertension (DASH) study, a multicenter, randomized, parallel arm feeding study that tested the effects of dietary patterns on blood pressure. Conclusions The linear mixed model is relatively easy to implement (given the complexity of the technique) using available software, allows for straight-forward testing of multiple hypotheses, and the results can be presented to research clinicians using both graphical and tabular displays. Using orthonormal polynomials provides the ability to model the nonlinear trajectories of each subject with the same complexity as the mean model (fixed effects). PMID:24667908

  13. A 24-HOUR AMBULATORY ECG MONITORING IN ASSESSMENT OF QT INTERVAL DURATION AND DISPERSION IN ROWERS WITH PHYSIOLOGICAL MYOCARDIAL HYPERTROPHY

    PubMed Central

    Kim, Z.F.; Bilalova, R.R.; Tsibulkin, N.A.; Almetova, R.R.; Mudarisova, R.R.; Ahmetov, I.I.

    2013-01-01

    Myocardial hypertrophy (MH) due to cardiac pathology is characterized by an increase in QT interval duration and dispersion, while the findings for exercise-induced myocardial hypertrophy are contradictory. The majority of published research findings have not explored this relationship, but there have only been a few conducted studies using 24-hour ECG monitoring. The aim of the study was to determine the QT interval duration and dispersion in short-term and 24-hour ECG in endurance athletes with myocardial hypertrophy and without it. Methods: A total of 26 well-trained rowers underwent a resting 12-lead ECG, 24-hour ECG monitoring and echocardiography. Results: Athletes with MH (n = 7) at rest did not show any increase in QTc interval duration and dispersion, or mean and maximal QTc duration in Holter monitoring compared to athletes without MH (n = 19). Left ventricular mass was not significantly correlated with any QTc characteristics. Furthermore, athletes with MH had significantly longer mean QT (P = 0.01) and maximal QT (P = 0.018) intervals in Holter monitoring and higher 24-hour heart rate variability indexes due to stronger vagal effects. Conclusions: The present study demonstrated that athlete's heart syndrome with myocardial hypertrophy as a benign phenomenon does not lead to an increase in QT interval duration, or increases in maximal and mean duration in a 24-hour ECG. An increase in QT interval duration in athletes may have an autonomic nature. PMID:24744494

  14. Longitudinal Study of Left Ventricular Mass Growth: Comparative Study of Clinic and Ambulatory Systolic Blood Pressure in Chronic Kidney Disease.

    PubMed

    Agarwal, Rajiv

    2016-04-01

    Left ventricular (LV) hypertrophy is an established cardiovascular risk factor, yet little is known about its trajectory in people with chronic kidney disease. The goal of this prospective research study was to describe the trajectory of LV mass index, its relationship with blood pressure (BP), and specifically to compare the relationship of BP measured in the clinic and 24-hour ambulatory BP monitoring with LV mass index. Among 274 veterans with chronic kidney disease followed for over ≤ 4 years, the rate of growth of log LV mass index was inversely related to baseline LV mass index; it was rapid in the first 2 years, and plateaued subsequently. Systolic BP also significantly increased, but linearly, 1.7 mm Hg/y by clinic measurements and 1.8 mm Hg/y by 24-hour ambulatory BP. Cross-sectional and longitudinal associations of both clinic BP and 24-hour ambulatory BP with LV mass index were similar; both BP recording methods were associated with LV mass index and its growth over time. Controlled hypertension, masked uncontrolled hypertension, and uncontrolled hypertension categories had increasing LV mass index when diagnosed by 24-hour ambulatory and awake BP (P<0.05 for linear trend) but not sleep BP. After accounting for clinic BP both at baseline and longitudinally, LV mass index among individuals was additionally predicted by the difference in sleep systolic BP and clinic systolic BP (P=0.032). In conclusion, among people with chronic kidney disease, the growth of LV mass index is rapid. Research-grade clinic BP is useful to assess LV mass index and its growth over time. PMID:26831191

  15. Negative affect and 24-hour ambulatory physiological recordings as predictors of spontaneous improvement of medically unexplained symptoms.

    PubMed

    Houtveen, Jan H; VAN Doornen, Lorenz J P

    2008-12-01

    The predictive value for spontaneous improvement in individuals suffering from medically unexplained symptoms (MUS) was explored of (1) anxiety and depression obtained from questionnaires, (2) negative affective states obtained from experience-sampling, and (3) ambulatory-assessed real-life physiological recordings. Sixty-seven individuals with MUS and 61 healthy controls were included. Twenty-four hour ambulatory recordings of cardiac autonomic activity, respiration, end-tidal CO(2) and saliva cortisol were combined with experience-sampling of somatic complaints and mood. Complaints were assessed again after one year. Although a reduction in symptoms (25%) was found, this could not be predicted from initial anxiety and depression. Improvement was somewhat related to relatively low diary reports of fatigue, especially in the late-afternoon and evening (3% variance explained). From the physiological measures only relatively high PetCO(2) values in the morning predicted improvement (5% explained). It was concluded that spontaneous recovery from MUS is hard to predict from self-reported distress and ambulatory physiological recordings. PMID:18771476

  16. Relative prognostic value of rest thallium-201 imaging, radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring after acute myocardial infarction

    SciTech Connect

    Hakki, A.H.; Nestico, P.F.; Heo, J.; Unwala, A.A.; Iskandrian, A.S.

    1987-07-01

    Rest thallium-201 scintigraphy, radionuclide ventriculography and 24 hour Holter monitoring are acceptable methods to assess myocardial necrosis, performance and electrical instability. This study examined the relative value of the three tests, when obtained a mean of 7 days after acute myocardial infarction, in predicting 1 year mortality in 93 patients. Planar thallium-201 images were obtained in three projections and were scored on a scale of 0 to 4 in 15 segments (normal score = 60). Patients were classified as having high risk test results as follows: thallium score less than or equal to 45 (33 patients), left ventricular ejection fraction less than or equal to 40% (51 patients) and complex ventricular arrhythmias on Holter monitoring (36 patients). During the follow-up of 6.4 +/- 3.4 months (mean +/- SD), 15 patients died of cardiac causes. All three tests were important predictors of survival by univariate Cox survival analysis; the thallium score, however, was the only important predictor by multivariate analysis. The predictive power of the thallium score was comparable with that of combined ejection fraction and Holter monitoring (chi-square = 21 versus chi-square = 22). Thus, rest thallium-201 imaging performed before hospital discharge provides important prognostic information in survivors of acute myocardial infarction which is comparable with that provided by left ventricular ejection fraction and Holter monitoring. Patients with a lower thallium score (large perfusion defects) are at high risk of cardiac death during the first year after infarction.

  17. Effects of ranitidine and cisapride on acid reflux and oesophageal motility in patients with reflux oesophagitis: a 24 hour ambulatory combined pH and manometry study.

    PubMed

    Inauen, W; Emde, C; Weber, B; Armstrong, D; Bettschen, H U; Huber, T; Scheurer, U; Blum, A L; Halter, F; Merki, H S

    1993-08-01

    The effect of ranitidine and cisapride on acid reflux and oesophageal motility was investigated in 18 patients with endoscopically verified erosive reflux oesophagitis. Each patient was treated with placebo, ranitidine (150 mg twice daily), and ranitidine (150 mg twice daily) plus cisapride (20 mg twice daily) in a double blind, double dummy, within subject, three way cross over design. Oesophageal acidity and motility were monitored under ambulatory conditions for 24 hours on the fourth day of treatment, after a wash out period of 10 days during which patients received only antacids for relief of symptoms. Acid reflux was monitored by a pH electrode located 5 cm above the lower oesophageal sphincter. Intraoesophageal pressure was simultaneously recorded from four transducers placed 20, 15, 10, and 5 cm above the lower oesophageal sphincter. Upright reflux was three times higher than supine reflux (median (range) 13.3 (3.7-35.0)% v 3.7 (0-37.6)% of the time with pH < 4.0, p < 0.01, n = 18). Compared with placebo, ranitidine decreased total reflux (from 10.0 (3.2-32.6)% to 6.4 (1.2-22.9)%, p < 0.01), upright reflux (p < 0.05), supine reflux (p < 0.001), and postprandial reflux (p < 0.01), but did not affect oesophageal motility. The combination of ranitidine with cisapride further diminished the acid reflux found with ranitidine--that is, cisapride led to an additional reduction of total reflux (from 6.4 (1.2-22.9)% to 3.7 (1.0-12.7)%, p < 0.01), supine reflux (p < 0.05), and postprandial reflux (p < 0.05). Cisapride also reduced both the number (p<0.01) and duration (p<0.05) of reflux episodes and significantly increased amplitude, duration, and propagation velocity of oesophageal contractions (p<0.05) but did not affect the number of contractions. The findings show that the 30% reduction of oesophageal acid exposure achieved by a conventional dose of ranitidine (150 mg twice daily) can be improved to more than 60% by combination with cisapride (20 mg twice daily

  18. Impact of Stress Reduction Interventions on Hostility and Ambulatory Systolic Blood Pressure in African American Adolescents

    ERIC Educational Resources Information Center

    Wright, Lynda Brown; Gregoski, Mathew J.; Tingen, Martha S.; Barnes, Vernon A.; Treiber, Frank A.

    2011-01-01

    This study examined the impact of breathing awareness meditation (BAM), life skills (LS) training, and health education (HE) interventions on self-reported hostility and 24-hour ambulatory blood pressure (ABP) in 121 African American (AA) ninth graders at increased risk for development of essential hypertension. They were randomly assigned to BAM,…

  19. Normal values of 24-hour ambulatory esophageal impedance-pH monitoring in a rural South African cohort of healthy participants.

    PubMed

    Ndebia, E J; Sammon, A M; Umapathy, E; Iputo, J E

    2016-05-01

    There are no data on 24-hour multichannel intraluminal impedance and pH monitoring in African populations. The purpose of this study was to provide the normal values of esophageal impedance and pH monitoring in a rural African populations. South African healthy rural participants were recruited and underwent 24 hours of esophageal impedance and pH monitoring. The median and the 95th percentiles of the total reflux episodes were 49 and 97, respectively, of which the corresponding number of acidic, weakly acidic, and weakly alkaline reflux were 15 and 55, 17 and 51, and 8 and 36, respectively. The compositions of the total reflux were 5 and 21 for liquid, 27 and 72 for mixed, and 10 and 39 for gas reflux, respectively. The median bolus clearance was 18 seconds and the median bolus exposure was 14 minutes/24 hours. The proximal extent was 6%. The 95th percent time of esophageal exposure to acid was 8.6 in 24 hours. Female and overweight participants were associated with an increased number of reflux events. There were more reflux episodes, and of which, more were weakly alkaline compared with previous similar studies. The findings provide reference values of gastroesophageal reflux for a South African rural population. PMID:25721534

  20. Novel description of the 24-hour circadian rhythms of brachial versus central aortic blood pressure and the impact of blood pressure treatment in a randomized controlled clinical trial: The Ambulatory Central Aortic Pressure (AmCAP) Study.

    PubMed

    Williams, Bryan; Lacy, Peter S; Baschiera, Fabio; Brunel, Patrick; Düsing, Rainer

    2013-06-01

    Elevated brachial blood pressure (BP) is associated with increased cardiovascular risk and predicts morbidity and mortality in humans. Recently, 24-hour ambulatory BP monitoring and assessment of central aortic BP have been introduced to improve BP phenotyping. The Ambulatory Central Aortic Pressure (AmCAP) study combines these approaches and describes, for the first time, the diurnal patterns of simultaneously measured 24-hour ambulatory brachial and central pressures in a prespecified substudy embedded within a clinical trial of BP lowering in patients with hypertension. Twenty-four-hour ambulatory brachial and central pressure measurements were acquired using a tonometer mounted into the articulating strap of a wristwatch-like device (BPro) in 171 participants with hypertension recruited into the ASSERTIVE (AliSkiren Study of profound antihypERtensive efficacy in hyperTensIVE patients) trial. Participants were randomly assigned to BP lowering with either aliskiren 300 mg QD or telmisartan 80 mg QD for 12 weeks. Ambulatory brachial and central BP was measured in all participants both at baseline and at study end. Brachial and central BP both demonstrated typical diurnal patterns with lower pressures at night. However, night time was associated with smaller reductions in central relative to brachial pressure and decreased pulse pressure amplification (P<0.0001 for both). These effects were not modulated after BP lowering and were maintained after adjustment for day and night-time BP and heart rate (P=0.02). This study demonstrates that brachial and central pressure show different diurnal patterns, which are not modulated by BP-lowering therapy, with relatively higher night-time central pressures. These novel data indicate that night-time central BP may provide prognostic importance and warrants further investigation. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00865020. PMID:23630950

  1. Vascular calcification is not associated with increased ambulatory central aortic systolic pressure in prevalent dialysis patients

    PubMed Central

    Freercks, Robert J; Swanepoel, Charles R; Turest-Swartz, Kristy L; Rayner, Brian L; Carrara, Henri RO; Moosa, Sulaiman EI; Lachman, Anthony S

    2014-01-01

    Summary Introduction Central aortic systolic pressure (CASP) strongly predicts cardiovascular outcomes. We undertook to measure ambulatory CASP in 74 prevalent dialysis patients using the BPro (HealthStats, Singapore) device. We also determined whether coronary or abdominal aortic calcification was associated with changes in CASP and whether interdialytic CASP predicted ambulatory measurement. Methods All patients underwent computed tomography for coronary calcium score, lateral abdominal radiography for aortic calcium score, echocardiography for left ventricular mass index and ambulatory blood pressure measurement using BPro calibrated to brachial blood pressure. HealthStats was able to convert standard BPro SOFT® data into ambulatory CASP. Results Ambulatory CASP was not different in those without and with coronary (137.6 vs 141.8 mmHg, respectively, p = 0.6) or aortic (136.6 vs 145.6 mmHg, respectively, p = 0.2) calcification. Furthermore, when expressed as a percentage of brachial systolic blood pressure to control for peripheral blood pressure, any difference in CASP was abolished: CASP: brachial systolic blood pressure ratio = 0.9 across all categories regardless of the presence of coronary or aortic calcification (p = 0.2 and 0.4, respectively). Supporting this finding, left ventricular mass index was also not different in those with or without vascular calcification (p = 0.7 and 0.8 for coronary and aortic calcification). Inter-dialytic office blood pressure and CASP correlated excellently with ambulatory measurements (r = 0.9 for both). Conclusion Vascular calcification was not associated with changes in ambulatory central aortic systolic pressure in this cohort of prevalent dialysis patients. Inter-dialytic blood pressure and CASP correlated very well with ambulatory measurement. PMID:24626513

  2. [Ambulatory recording of esophageal pH over a 24-hour period in a population of 27 control subjects: analysis of technical and methodological factors influencing results].

    PubMed

    Gignoux, C; Bonnet-Eymard, P O; Hostein, J; Fournet, J

    1987-01-01

    Twenty-four hour pH monitoring is used increasingly as a technique for diagnosis of gastro-esophageal reflux (GER). The Synectics recording apparatus (Stockholm, Sweden) was used in 27 ambulatory control subjects in order to: identify the variations of the data-dependent factors (electrodes, buffer solutions, calibration, placement of esophageal electrode). The consequences of these variations were evaluated by studying the measurement deflection after 24 h, baseline variations, and a comparative double pH esophageal recording with reference equipment for 3 h postprandial; to provide normal values for several parameters of GER measurement under the conditions of this study (total number of reflux, number of reflux episodes longer than 5 min, duration of the longest reflux, percentage of time during which pH was less than 4.0). Important interindividual variations were observed. When interpreting the results provided by this type of apparatus, one should take into account these large variations due, first, to the technique used and second, to the conditions of ambulatory recording. PMID:3556956

  3. Derivation of a measure of systolic blood pressure mutability: a novel information theory-based metric from ambulatory blood pressure tests.

    PubMed

    Contreras, Danitza J; Vogel, Eugenio E; Saravia, Gonzalo; Stockins, Benjamin

    2016-03-01

    We provide ambulatory blood pressure (BP) exams with tools based on information theory to quantify fluctuations thus increasing the capture of dynamic test components. Data from 515 ambulatory 24-hour BP exams were considered. Average age was 54 years, 54% were women, and 53% were under BP treatment. The average systolic pressure (SP) was 127 ± 8 mm Hg. A data compressor (wlzip) designed to recognize meaningful information is invoked to measure mutability which is a form of dynamical variability. For patients with the same average SP, different mutability values are obtained which reflects the differences in dynamical variability. In unadjusted linear regression models, mutability had low association with the mean systolic BP (R(2) = 0.056; P < .000001) but larger association with the SP deviation (R(2) = 0.761; P < .001). Wlzip allows detecting levels of variability in SP that could be hazardous. This new indicator can be easily added to the 24-hour BP monitors improving information toward diagnosis. PMID:26965751

  4. Proposal of RAS-diuretic vs. RAS-calcium antagonist strategies in high-risk hypertension: insight from the 24-hour ambulatory blood pressure profile and central pressure.

    PubMed

    Kario, Kazuomi

    2010-01-01

    I here propose an individualized renin angiotensin system (RAS) inhibitor-based combination therapy with calcium-channel blockers (CCBs) or with diuretics, based on the 24-hr ambulatory blood pressure (BP) profiles and central pressure in relation to the target organ damage in high-risk hypertensive patients. For high-risk patients with increased circulating volume, such as that caused by chronic kidney disease (CKD) or congestive heart failure (CHF), who are likely to exhibit a non-dipper/riser pattern of nocturnal BP fall, diuretics are recommended in combination with a RAS inhibitor to reduce nocturnal BP preferentially. For high-risk patients with arterial diseases such as cardiovascular disease and increased arterial stiffness, who are likely to exhibit exaggerated BP variability, such as morning BP surge and day-to-day BP variability, a CCB is recommended for use in combination with a RAS inhibitor to reduce BP variability and central BP. In particular, bedtime dosing of a RAS inhibitor targeting sleep-early morning activation of RAS may be particularly effective for cardiorenal protection. PMID:20728424

  5. [24-hour blood pressure measurement in normal pregnancy in hypertensive pregnant patients].

    PubMed

    Rath, W; Schrader, J; Guhlke, U; Buhr-Schinner, H; Haupt, A; Kramer, A; Kuhn, W

    1990-08-01

    Noninvasive 24-hour ambulatory blood pressure monitoring was performed in 17 normotensive and 19 preeclamptic pregnant women. The normotensive women showed a significant nightly decline in their systolic and diastolic blood pressure. In contrast, the preeclamptic women demonstrated either an attenuated circadian rhythm or no circadian rhythm at all. This result was even more pronounced in patients with severe hypertension, some of whom had a nocturnal increase in blood pressure in spite of being treated with antihypertensive drugs in an evening dose. The lack of nocturnal blood pressure decrease was also found 24 hours post partum. In summary, these results suggest that preeclamptic women are endangered by hypertensive emergencies mostly during the night. Therefore blood pressure controls should be extended into the night, and antihypertensive drugs should also be given in a sufficient evening dose. PMID:2214601

  6. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury.

    PubMed

    Koufman, J A

    1991-04-01

    Occult (silent) gastroesophageal reflux disease (GER, GERD) is believed to be an important etiologic factor in the development of many inflammatory and neoplastic disorders of the upper aerodigestive tract. In order ot test this hypothesis, a human study and an animal study were performed. The human study consisted primarily of applying a new diagnostic technique (double-probe pH monitoring) to a population of otolaryngology patients with GERD to determine the incidence of overt and occult GERD. The animal study consisted of experiments to evaluate the potential damaging effects of intermittent GER on the larynx. Two hundred twenty-five consecutive patients with otolaryngologic disorders having suspected GERD evaluated from 1985 through 1988 are reported. Ambulatory 24-hour intraesophageal pH monitoring was performed in 197; of those, 81% underwent double-probe pH monitoring, with the second pH probe being placed in the hypopharynx at the laryngeal inlet. Seventy percent of the patients also underwent barium esophagography with videofluoroscopy. The patient population was divided into seven diagnostic subgroups: carcinoma of the larynx (n = 31), laryngeal and tracheal stenosis (n = 33), reflux laryngitis (n = 61), globus pharyngeus (n = 27), dysphagia (n = 25), chronic cough (n = 30), and a group with miscellaneous disorders (n = 18). The most common symptoms were hoarseness (71%), cough (51%), globus (47%), and throat clearing (42%). Only 43% of the patients had gastrointestinal symptoms (heartburn or acid regurgitation). Thus, by traditional symptomatology, GER was occult or silent in the majority of the study population. Twenty-eight patients (12%) refused or could not tolerate pH monitoring. Of the patients undergoing diagnostic pH monitoring, 62% had abnormal esophageal pH studies, and 30% demonstrated reflux into the pharynx. The results of diagnostic pH monitoring for each of the subgroups were as follows (percentage with abnormal studies): carcinoma (71

  7. Physician-pharmacist co-management and 24-hour blood pressure control.

    PubMed

    Chen, Ziqian; Ernst, Michael E; Ardery, Gail; Xu, Yinghui; Carter, Barry L

    2013-05-01

    The objectives of this study were to compare indices of 24-hour blood pressure (BP) following a physician-pharmacist collaborative intervention and to describe the associated changes in antihypertensive medications. This was a secondary analysis of a prospective, cluster-randomized clinical trial conducted in 6 family medicine clinics randomized to co-managed (n=3 clinics, 176 patients) or control (n=3 clinics, 198 patients) groups. Mean ambulatory systolic BP (SBP) was significantly lower in the co-managed vs the control group: daytime BP 122.8 mm Hg vs 134.4 mm Hg (P<.001); nighttime SBP 114.8 mm Hg vs 123.7 mm Hg (P<.001); and 24-hour SBP 120.4 mm Hg vs 131.8 mm Hg (P<.001), respectively. Significantly more drug changes were made in the co-managed than in the control group (2.7 vs 1.1 changes per patient, P<.001), and there was greater diuretic use in co-managed patients (79.6% vs 62.6%, P<.001). Ambulatory BPs were significantly lower for the patients who had a diuretic added during the first month compared with those who never had a diuretic added (P<.01). Physician-pharmacist co-management significantly improved ambulatory BP compared with the control group. Antihypertensive drug therapy was intensified much more for patients in the co-managed group. PMID:23614849

  8. 24-Hour Academic Libraries: Adjusting to Change

    ERIC Educational Resources Information Center

    Bowman, Adam C.

    2013-01-01

    The purpose of this study was to explore the adaptive measures that academic libraries perform when implementing and operating a 24-hour schedule. Five in-depth interviews were conducted with current managerial-level librarians at 24-hour academic libraries. The exploratory interviews revealed similar measures for security, budgeting, employee…

  9. The 24-hour pulse wave velocity, aortic augmentation index, and central blood pressure in normotensive volunteers

    PubMed Central

    Kuznetsova, Tatyana Y; Korneva, Viktoria A; Bryantseva, Evgeniya N; Barkan, Vitaliy S; Orlov, Artemy V; Posokhov, Igor N; Rogoza, Anatoly N

    2014-01-01

    The purpose of this study was to examine the pulse wave velocity, aortic augmentation index corrected for heart rate 75 (AIx@75), and central systolic and diastolic blood pressure during 24-hour monitoring in normotensive volunteers. Overall, 467 subjects (206 men and 261 women) were recruited in this study. Participants were excluded from the study if they were less than 19 years of age, had blood test abnormalities, had a body mass index greater than 2 7.5 kg/m2, had impaired glucose tolerance, or had hypotension or hypertension. Ambulatory blood pressure monitoring (ABPM) with the BPLab® device was performed in each subject. ABPM waveforms were analyzed using the special automatic Vasotens® algorithm, which allows the calculation of pulse wave velocity, AIx@75, central systolic and diastolic blood pressure for “24-hour”, “awake”, and “asleep” periods. Circadian rhythms and sex differences in these indexes were identified. Pending further validation in prospective outcome-based studies, our data may be used as preliminary diagnostic values for the BPLab ABPM additional index in adult subjects. PMID:24812515

  10. Assessment of systolic and diastolic function in heart failure using ambulatory monitoring with acoustic cardiography.

    PubMed

    Dillier, Roger; Zuber, Michel; Arand, Patricia; Erne, Susanne; Erne, Paul

    2011-08-01

    INTRODUCTION. The circadian variation of heart function and heart sounds in patients with and without heart failure (HF) is poorly understood. We hypothesized HF patients would exhibit less circadian variation with worsened cardiac function and sleep apnea. METHODS. We studied 67 HF patients (age 67.4 ± 8.2 years; 42% acute HF) and 63 asymptomatic control subjects with no history of HF (age 61.6 ± 7.7 years). Subjects wore a heart sound/ECG/respiratory monitor. The data were analyzed for sleep apnea, diastolic heart sounds, and systolic time intervals. RESULTS. The HF group had significantly greater prevalence of the third heart sound and prolongation of electro-mechanical activation time, while the control group had an age-related increase in the prevalence of the fourth heart sound. The control group showed more circadian variation in cardiac function. The HF subjects had more sleep apnea and higher occurrence of heart rate non-dipping. CONCLUSIONS. The control subjects demonstrated an increasing incidence of diastolic dysfunction with age, while systolic function was mostly unchanged with aging. Parameters related to systolic function were significantly worse in the HF group with little diurnal variation, indicating a constant stimulation of sympathetic tone in HF and reduction of diurnal regulation. PMID:21361859

  11. The 24-Hour Mathematical Modeling Challenge

    ERIC Educational Resources Information Center

    Galluzzo, Benjamin J.; Wendt, Theodore J.

    2015-01-01

    Across the mathematics curriculum there is a renewed emphasis on applications of mathematics and on mathematical modeling. Providing students with modeling experiences beyond the ordinary classroom setting remains a challenge, however. In this article, we describe the 24-hour Mathematical Modeling Challenge, an extracurricular event that exposes…

  12. Aldosterone-to-Renin Ratio Is Associated With Reduced 24-Hour Heart Rate Variability and QTc Prolongation in Hypertensive Patients

    PubMed Central

    Grübler, Martin R.; Kienreich, Katharina; Gaksch, Martin; Verheyen, Nicolas; Hartaigh, Bríain Ó.; Fahrleitner-Pammer, Astrid; März, Winfried; Schmid, Johannes; Oberreither, Eva-Maria; Wetzel, Julia; Catena, Cristiana; Sechi, Leonardo A.; Pieske, Burkert; Tomaschitz, Andreas; Pilz, Stefan

    2016-01-01

    Abstract Aldosterone is considered to exert direct effects on the myocardium and the sympathetic nervous system. Both QT time and heart rate (HR) variability (HRV) are considered to be markers of arrhythmic risk and autonomous dysregulation. In this study, we investigated the associations between aldosterone, QT time, and HRV in patients with arterial hypertension. We recruited 477 hypertensive patients (age: 60.2 ± 10.2 years; 52.3% females) with a mean systolic/diastolic 24-hour ambulatory blood pressure monitoring (ABPM) value of 128 ± 12.8/77.1 ± 9.2 mmHg and with a median of 2 (IQR: 1–3) antihypertensive agents. Patients were recruited from the outpatient clinic at the Department of Internal Medicine of the Medical University of Graz, Austria. Blood samples, 24-hour HRV derived from 24-hour blood pressure monitoring (ABPM) and ECG's were obtained. Plasma aldosterone and plasma renin concentrations were measured by means of a radioimmunoassay. Twenty-four-hour urine specimens were collected in parallel with ABPM. Mean QTc was 423.3 ± 42.0 milliseconds for males and 434.7 ± 38.3 milliseconds for females. Mean 24H-HR and 24H-HRV was 71.9 ± 9.8 and 10.0 ± 3.6 bpm, respectively. In linear regression analyses adjusted for age, sex, body mass index, ABPM, and current medication, aldosterone to active renin ratio (AARR) was significantly associated with the QTc interval, a marker for cardiac repolarization abnormalities (mean = 426 ± 42.4 milliseconds; β-coefficient = 0.121; P = 0.03) as well as with the 24-hour heart rate variability a surrogate for autonomic dysfunction (median = 9.67 [IQR = 7.38–12.22 bpm]; β-coefficient = −0.133; P = 0.01). In hypertensive patients, AARR is significantly related to QTc prolongation as well as HRV. Further studies investigating the effects of mineralocorticoid receptor blocker and aldosterone synthase inhibitors on QTc and HRV are warranted

  13. Pulse wave velocity 24-hour monitoring with one-site measurements by oscillometry

    PubMed Central

    Posokhov, Igor N

    2013-01-01

    This review describes issues for the estimation of pulse wave velocity (PWV) under ambulatory conditions using oscillometric systems. The difference between the principles of measuring the PWV by the standard method and by oscillometry is shown, and information on device validation studies is summarized. It was concluded that currently oscillometry is a method that is very convenient to use in the 24-hour monitoring of the PWV, is relatively accurate, and is reasonably comfortable for the patient. Several indices with the same principles as those in the analysis of blood pressure in ambulatory monitoring of blood pressure, namely the assessment of load, variability, and circadian rhythm, are proposed. PMID:23549868

  14. The effects of the spleen tyrosine kinase inhibitor fostamatinib on ambulatory blood pressure in patients with active rheumatoid arthritis: results of the OSKIRA-ABPM (ambulatory blood pressure monitoring) randomized trial.

    PubMed

    Kitas, George D; Abreu, Gabriel; Jedrychowicz-Rosiak, Krystyna; Miller, Jeffrey L; Nakov, Roumen; Panfilov, Seva; Vencovsky, Jiri; Wang, Millie; Weinblatt, Michael E; White, William B

    2014-11-01

    Clinical trials of fostamatinib in patients with rheumatoid arthritis showed blood pressure (BP) elevation using clinic measurements. The OSKIRA-ambulatory BP monitoring trial assessed the effect of fostamatinib on 24-hour ambulatory systolic BP (SBP) in patients with active rheumatoid arthritis. One hundred thirty-five patients were randomized to fostamatinib 100 mg twice daily (bid; n = 68) or placebo bid (n = 67) for 28 days. Ambulatory, clinic, and home BPs were measured at baseline and after 28 days of therapy. Primary end point was change from baseline in 24-hour mean SBP. Fostamatinib increased 24-hour mean SBP by 2.9 mm Hg (P = .023) and diastolic BP (DBP) by 3.5 mm Hg (P < .001) versus placebo. Clinic/home-measured BPs were similar to those observed with ambulatory BP monitoring. After treatment discontinuation (1 week), clinic BP values returned to baseline levels. Fostamatinib induced elevations in 24-hour mean ambulatory SBP and DBP. BP elevations resolved with fostamatinib discontinuation. PMID:25455003

  15. Validation of the BPLab® 24-hour blood pressure monitoring system in a pediatric population according to the 1993 British Hypertension Society protocol

    PubMed Central

    Ledyaev, Mikhail Y; Stepanova, Olga V; Ledyaeva, Anastasia M

    2015-01-01

    Background Automatic 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is a basic procedure performed in adults with arterial hypertension, but ABPM monitors have become widely used in pediatric practice only recently. The main problem is the lack of common normative data sets for ABPM in children and the small number of appropriate monitors that can be used for analysis of the 24-hour BP profile in this age group. The aim of this study was to validate the BPLab® ABPM monitor according to the 1993 British Hypertension Society (BHS-93) protocol, as well as to work out solutions regarding the feasibility of this device in pediatric practice. Methods Our study included 30 children of both sexes and aged 5–15 years, ie, “older” children according to the BHS-93 protocol. Before starting the study, we obtained ethical approval from the regional scientific ethics committee. All participants and their parents signed their written consent for participation in the study. The data were simultaneously obtained by three experts, who had completed a noninvasive BP measurement training course. BP values were measured using the Korotkoff auscultatory method (Phase I for systolic BP and Phase V for diastolic BP). Discrepancies in the systolic and diastolic BP measurements (n=180; 90 for each expert) were analyzed according to the criteria specified in the BHS-93 protocol. Results The device was graded “A” for both systolic BP and diastolic BP according to the criteria of the BHS-93 protocol. Conclusion The BPLab ABPM device may be recommended for extensive pediatric use. PMID:25674018

  16. 24-hour central blood pressure and intermediate cardiovascular phenotypes in untreated subjects

    PubMed Central

    Bednarek, Agnieszka; Jankowski, Piotr; Olszanecka, Agnieszka; Windak, Adam; Kawecka-Jaszcz, Kalina; Czarnecka, Danuta

    2014-01-01

    Background: Recently, 24-hour monitoring of central systolic blood pressure (SBP) has become available. However, the relation between end-organ damage and the 24-hour central SBP profile and variability has not so far been analyzed. Therefore, the aim of this cross-sectional study was to evaluate the relation between 24-hour central SBP, 24-hour central SBP profile as well as central SBP short-term variability and parameters of cardiac and vascular intermediate phenotypes. Methods: The study group consisted of 50 patients with newly diagnosed, untreated hypertension (age 40.4 ± 11.5 years, 35 men) and 50 normotensive subjects (age 38.3 ± 12.0 years, 35 men). Applanation tonometry of the radial artery and the “n-point forward moving average” method were used to determine 24-hour central SBP. Each study participant underwent echocardiography and carotid ultrasonography. Results: 24-hour, daytime, and nighttime central SBP was related to left ventricle end-diastole diameter (p < 0.05), left ventricular mass index (p < 0.001), relative wall thickness (p < 0.05), E/E’ ratio (p < 0.01), and left atrium volume (p < 0.01). The nocturnal central SBP fall was not related to any of the mentioned parameters, whereas parameters of short-term variability were related to IMT in hypertensives only (p < 0.05). Conclusions: The present study showed that 24-hour central SBP is related to intermediate cardiac phenotypes as assessed by echocardiography whereas short-term central SBP variability is mainly related to vascular phenotype as determined by IMT. PMID:25628959

  17. Cognitive Function in Ambulatory Patients with Systolic Heart Failure: Insights from the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial

    PubMed Central

    Graham, Susan; Ye, Siqin; Qian, Min; Sanford, Alexandra R.; Di Tullio, Marco R.; Sacco, Ralph L.; Mann, Douglas L.; Levin, Bruce; Pullicino, Patrick M.; Freudenberger, Ronald S.; Teerlink, John R.; Mohr, J. P.; Labovitz, Arthur J.; Lip, Gregory Y. H.; Estol, Conrado J.; Lok, Dirk J.; Ponikowski, Piotr; Anker, Stefan D.; Thompson, John L. P.; Homma, Shunichi

    2014-01-01

    We sought to determine whether cognitive function in stable outpatients with heart failure (HF) is affected by HF severity. A retrospective, cross-sectional analysis was performed using data from 2, 043 outpatients with systolic HF and without prior stroke enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial. Multivariable regression analysis was used to assess the relationship between cognitive function measured using the Mini-Mental Status Exam (MMSE) and markers of HF severity (left ventricular ejection fraction [LVEF], New York Heart Association [NYHA] functional class, and 6-minute walk distance). The mean (SD) for the MMSE was 28.6 (2.0), with 64 (3.1%) of the 2,043 patients meeting the cut-off of MMSE <24 that indicates need for further evaluation of cognitive impairment. After adjustment for demographic and clinical covariates, 6-minute walk distance (β-coefficient 0.002, p<0.0001), but not LVEF or NYHA functional class, was independently associated with the MMSE as a continuous measure. Age, education, smoking status, body mass index, and hemoglobin level were also independently associated with the MMSE. In conclusion, six-minute walk distance, but not LVEF or NYHA functional class, was an important predictor of cognitive function in ambulatory patients with systolic heart failure. PMID:25426862

  18. Cognitive function in ambulatory patients with systolic heart failure: insights from the warfarin versus aspirin in reduced cardiac ejection fraction (WARCEF) trial.

    PubMed

    Graham, Susan; Ye, Siqin; Qian, Min; Sanford, Alexandra R; Di Tullio, Marco R; Sacco, Ralph L; Mann, Douglas L; Levin, Bruce; Pullicino, Patrick M; Freudenberger, Ronald S; Teerlink, John R; Mohr, J P; Labovitz, Arthur J; Lip, Gregory Y H; Estol, Conrado J; Lok, Dirk J; Ponikowski, Piotr; Anker, Stefan D; Thompson, John L P; Homma, Shunichi

    2014-01-01

    We sought to determine whether cognitive function in stable outpatients with heart failure (HF) is affected by HF severity. A retrospective, cross-sectional analysis was performed using data from 2, 043 outpatients with systolic HF and without prior stroke enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial. Multivariable regression analysis was used to assess the relationship between cognitive function measured using the Mini-Mental Status Exam (MMSE) and markers of HF severity (left ventricular ejection fraction [LVEF], New York Heart Association [NYHA] functional class, and 6-minute walk distance). The mean (SD) for the MMSE was 28.6 (2.0), with 64 (3.1%) of the 2,043 patients meeting the cut-off of MMSE <24 that indicates need for further evaluation of cognitive impairment. After adjustment for demographic and clinical covariates, 6-minute walk distance (β-coefficient 0.002, p<0.0001), but not LVEF or NYHA functional class, was independently associated with the MMSE as a continuous measure. Age, education, smoking status, body mass index, and hemoglobin level were also independently associated with the MMSE. In conclusion, six-minute walk distance, but not LVEF or NYHA functional class, was an important predictor of cognitive function in ambulatory patients with systolic heart failure. PMID:25426862

  19. Human prolactin - 24-hour pattern with increased release during sleep.

    NASA Technical Reports Server (NTRS)

    Sassin, J. F.; Weitzman, E. D.; Kapen, S.; Frantz, A. G.

    1972-01-01

    Human prolactin was measured in plasma by radioimmunoassay at 20-minute intervals for a 24-hour period in each of six normal adults, whose sleep-wake cycles were monitored polygraphically. A marked diurnal variation in plasma concentrations was demonstrated, with highest values during sleep. Periods of episodic release occurred throughout the 24 hours.

  20. HEART RATE VARIABILITY AND 24-HOUR MINIMUM HEART RATE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Heart rate variability (HRV) indices based on 24-hour electrocardiograph recordings have been used in clinical research studies to assess the aggregate activity of the autonomic nervous system. While 24-hour HRV is generally considered non-invasive, use in research protocols typically involves cons...

  1. Symmetric ambulatory arterial stiffness index in the young.

    PubMed

    Nguyen, Minh B; Singer, Pamela; Kaskel, Fredrick; Mahgerefteh, Joseph

    2016-06-01

    The ambulatory arterial stiffness index (AASI) and the symmetric ambulatory arterial stiffness index (s-AASI) have been shown to correlate to arterial stiffness in adults. This study assesses these indices with anthropometric and blood pressure (BP) measures in children. A total of 102 children at a pediatric hypertension clinic who had ambulatory blood pressure monitoring (ABPM) done from 2009 to 2013 were included (75% males, 7-22yo, 47% hypertensive, 24% prehypertensive, and 34% white-coat hypertensives). AASI is 1 minus the regression slope of diastolic BP values on systolic BP values from a 24-hour ambulatory blood pressure monitoring. s-AASI is the symmetric regression of AASI. Obese patients had a significantly higher AASI. s-AASI correlated with systolic BP variability. In multivariable regression, BP variability independently correlated with AASI and s-AASI. s-AASI is related to systolic dipping.AASI and s-AASI are highly dependent on BP variability in children. Further studies are necessary to assess their utility. PMID:27118486

  2. Relationship of -Blocker Dose with Outcomes in Ambulatory Heart Failure Patients with Systolic Dysfunction: Results from the HF-ACTION Trial

    PubMed Central

    Fiuzat, Mona; Wojdyla, Daniel; Kitzman, Dalane; Fleg, Jerome; Keteyian, Steven J.; Kraus, William E.; Piña, Ileana L.; Whellan, David; O’Connor, Christopher M.

    2012-01-01

    Objectives To examine the association between baseline beta-blocker (BB) dose and outcomes in the HF-ACTION trial. Background BBs reduce morbidity and mortality in chronic heart failure (HF) patients with reduced ejection fraction, but it is unclear whether titrating to higher BB doses improves outcomes in this setting. Methods HF-ACTION was a randomized, multicenter trial enrolling 2331 ambulatory HF patients with systolic dysfunction (New York Heart Association class II–IV, left ventricular ejection fraction <0.35) randomized to exercise training vs. usual care, with median follow-up of 2.5 years. BB dose at baseline was standardized using carvedilol equivalents and analyzed as a continuous variable and by discrete dose groups. The relationship between BB dose and the primary endpoint of all-cause mortality or all-cause hospitalization, and other cardiovascular secondary endpoints, was determined before and after adjustment for variables significantly associated with outcomes in the HF-ACTION cohort. Results 95% of patients were on a BB. There was a significant inverse relationship between BB dose and all-cause death or hospitalization but not other cardiovascular endpoints after adjustment for other predictors of outcome, with a linear benefit up to the 50 mg daily dose. There was a significant inverse association between BB dose and change in peak VO2 at 3 months. There was no increase in bradycardia with higher doses of BB. Conclusion There was a significant inverse relationship between BB dose and the endpoint of all-cause death or all-cause hospitalization in this well-treated HF cohort with systolic dysfunction, supporting recommendations that titrating doses up to 50 mg per day may confer a benefit in such patients. Clinical Trial Registration (HF-ACTION) ClinicalTrials.gov, identifier NCT00047437 PMID:22560018

  3. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes...

  4. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes...

  5. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes...

  6. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes...

  7. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes...

  8. Associations of ambulatory blood pressure with urinary caffeine and caffeine metabolite excretions.

    PubMed

    Guessous, Idris; Pruijm, Menno; Ponte, Belén; Ackermann, Daniel; Ehret, Georg; Ansermot, Nicolas; Vuistiner, Philippe; Staessen, Jan; Gu, Yumei; Paccaud, Fred; Mohaupt, Markus; Vogt, Bruno; Pechère-Bertschi, Antoinette; Pechère-Berstchi, Antoinette; Martin, Pierre-Yves; Burnier, Michel; Eap, Chin B; Bochud, Murielle

    2015-03-01

    Intake of caffeinated beverages might be associated with reduced cardiovascular mortality possibly via the lowering of blood pressure. We estimated the association of ambulatory blood pressure with urinary caffeine and caffeine metabolites in a population-based sample. Families were randomly selected from the general population of Swiss cities. Ambulatory blood pressure monitoring was conducted using validated devices. Urinary caffeine, paraxanthine, theophylline, and theobromine excretions were measured in 24 hours urine using ultrahigh performance liquid chromatography tandem mass spectrometry. We used mixed models to explore the associations of urinary excretions with blood pressure although adjusting for major confounders. The 836 participants (48.9% men) included in this analysis had mean age of 47.8 and mean 24-hour systolic and diastolic blood pressure of 120.1 and 78.0 mm Hg. For each doubling of caffeine excretion, 24-hour and night-time systolic blood pressure decreased by 0.642 and 1.107 mm Hg (both P values <0.040). Similar inverse associations were observed for paraxanthine and theophylline. Adjusted night-time systolic blood pressure in the first (lowest), second, third, and fourth (highest) quartile of paraxanthine urinary excretions were 110.3, 107.3, 107.3, and 105.1 mm Hg, respectively (P trend <0.05). No associations of urinary excretions with diastolic blood pressure were generally found, and theobromine excretion was not associated with blood pressure. Anti-hypertensive therapy, diabetes mellitus, and alcohol consumption modify the association of caffeine urinary excretion with systolic blood pressure. Ambulatory systolic blood pressure was inversely associated with urinary excretions of caffeine and other caffeine metabolites. Our results are compatible with a potential protective effect of caffeine on blood pressure. PMID:25489060

  9. Chapter 4: 24-hour recall and diet record methods

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The two methods described in this chapter, the 24-hour dietary recall (24hdr) and the food record (FR) method, are the currently preferred methods of dietary intake assessment, and are based on foods and amounts actually consumed by an individual on one or more specific days. This minimizes some sou...

  10. The 24 Hours before Hospitalization: Factors Related to Suicide Attempting.

    ERIC Educational Resources Information Center

    Chiles, John A.; And Others

    1986-01-01

    Psychiatric inpatients (N=59) were interviewd concerning psychological and environmental events that occurred in the 24 hours prior to their hospitalization. Suicide attempters were more likely to have used alcohol or marijuana and less likely to have contacted a health care professional than suicide ideators, even when past history of suicide…

  11. Seasonal changes of 24-hour intraocular pressure rhythm in healthy Shanghai population

    PubMed Central

    Cheng, Jingyi; Xiao, Ming; Xu, Huan; Fang, Shaobin; Chen, Xu; Kong, Xiangmei; Sun, Xinghuai

    2016-01-01

    Abstract The aim of the present study was to investigate and compare the 24-hour intraocular pressure (IOP) rhythms in winter and summer in the healthy population of Shanghai, China. This is a cross-sectional study in which 24-hour IOP measurements were taken for all eligible healthy volunteers in winter and summer, respectively, and the temperature, hours of sunlight (sunlight time), and circulatory parameters, including heart rate, systolic blood pressure, and diastolic blood pressure, were also recorded. The 24-hour IOP curves and IOP parameters (mean, peak, trough, and fluctuation of IOP together with the diurnal-to-nocturnal IOP change) in winter and summer were obtained and compared. The magnitude of IOP changes from summer to winter was also calculated. A total of 29 participants (58 eyes), 14 (48.28%) male and 15 (51.72%) female, aged 43.66 ± 12.20 (19–61) years, were considered eligible for this study. Generally, IOP decreased progressively before noon, increased notably in the nocturnal period, and peaked at 12:00 am in winter and at 2:00 am in summer. The pattern of 24-hour IOP in winter and summer was significantly different (P = 0.002). The average IOPs from 4:00 pm to 8:00 am, except for 6:00 am, were significantly higher in winter (P < 0.05). However, no significant differences were shown after adjusting for temperature and/or sunlight time. From summer to winter, the extent of IOP increase was mostly around 0 to 3 mm Hg, and the IOPs increased more significantly in the nocturnal period than in the diurnal period (P = 0.05). The 24-hour IOP rhythms were different in winter and summer, with higher IOP level in winter. Temperature and sunlight time, which are independent of heart rate and blood pressure, affected the 24-hour IOP rhythms in healthy people in Shanghai, China. Further investigations are expected for the rhythm of some endogenous substance secretion and the inner mechanism of regulation of IOP. PMID:27495076

  12. Seasonal changes of 24-hour intraocular pressure rhythm in healthy Shanghai population.

    PubMed

    Cheng, Jingyi; Xiao, Ming; Xu, Huan; Fang, Shaobin; Chen, Xu; Kong, Xiangmei; Sun, Xinghuai

    2016-08-01

    The aim of the present study was to investigate and compare the 24-hour intraocular pressure (IOP) rhythms in winter and summer in the healthy population of Shanghai, China.This is a cross-sectional study in which 24-hour IOP measurements were taken for all eligible healthy volunteers in winter and summer, respectively, and the temperature, hours of sunlight (sunlight time), and circulatory parameters, including heart rate, systolic blood pressure, and diastolic blood pressure, were also recorded. The 24-hour IOP curves and IOP parameters (mean, peak, trough, and fluctuation of IOP together with the diurnal-to-nocturnal IOP change) in winter and summer were obtained and compared. The magnitude of IOP changes from summer to winter was also calculated.A total of 29 participants (58 eyes), 14 (48.28%) male and 15 (51.72%) female, aged 43.66 ± 12.20 (19-61) years, were considered eligible for this study. Generally, IOP decreased progressively before noon, increased notably in the nocturnal period, and peaked at 12:00 AM in winter and at 2:00 AM in summer. The pattern of 24-hour IOP in winter and summer was significantly different (P = 0.002). The average IOPs from 4:00 PM to 8:00 AM, except for 6:00 AM, were significantly higher in winter (P < 0.05). However, no significant differences were shown after adjusting for temperature and/or sunlight time. From summer to winter, the extent of IOP increase was mostly around 0 to 3 mm Hg, and the IOPs increased more significantly in the nocturnal period than in the diurnal period (P = 0.05).The 24-hour IOP rhythms were different in winter and summer, with higher IOP level in winter. Temperature and sunlight time, which are independent of heart rate and blood pressure, affected the 24-hour IOP rhythms in healthy people in Shanghai, China. Further investigations are expected for the rhythm of some endogenous substance secretion and the inner mechanism of regulation of IOP. PMID:27495076

  13. Ambulatory monitoring derived blood pressure variability and cardiovascular risk factors in elderly hypertensive patients.

    PubMed

    Magdás, Annamária; Szilágyi, László; Belényi, Boglárka; Incze, Alexandru

    2014-01-01

    Hypertension in the elderly is characterized by isolated systolic hypertension and high variability, but its clinical significance is not yet fully understood. The goal of this paper was to assess circadian blood pressure variability (BPV) in elderly hypertensives, and to determine its relationship to cardiovascular risk factors. To achieve this goal, a number of 75 inefficiently treated hypertensive patients were studied, 45 elderly, aged over 60 years, 30 middle-aged, younger than 60 years. After 24-hour ambulatory blood pressure monitoring (ABPM), blood pressure (BP) values, pulse pressure (PP), morning surge were compared between the groups. BPV was calculated using average real variability (ARV). The relationships between BPV, pulse pressure, left ventricular mass index (LVMI), and cardiovascular risk factors were assessed in both groups. As a result, it was found that left ventricular mass (p=0.01), PP, morning surge, 24-hour systolic ARV were significantly higher in the elderly group (p<0.05). In both groups, higher 24-hour BPV was associated with an increase in LVMI. In the elderly population 24-hour BPV was positively correlated to increased PP, total cholesterol and triglyceride levels (p<0.05). Moreover, it was concluded that ABPM-derived BP variability index could be an early predictive marker of end-organ damage in hypertension. Its reduction might be an important objective of hypertension management in elderly. PMID:25226958

  14. 24-Hour Measurement of Gastric pH in Rural South Africa

    PubMed Central

    Sammon, Alastair M.; Ndebia, Eugene J.; Umapathy, Ekambaram; Iputo, Jehu E.

    2015-01-01

    Background. Previous studies have established norms of 24-hour gastric pH profiles for western countries. This study was designed to establish the pattern for a rural African population with a high incidence of oesophageal cancer. Methods. After lower oesophageal manometry a probe was placed 10 cm distal to the lower oesophageal sphincter. We carried out 24-hour ambulatory monitoring of gastric pH on 59 healthy subjects. This was satisfactorily completed on 26 female and 18 male (age 21–64, median 35) subjects in the Transkei region of South Africa. Results. The mean 24 hour gastric pH was 2.84 and the mean night-time pH was 3.7. 40 volunteers recorded a night-time pH reaching over 4. 33 volunteers recorded a night-time pH over 7. Night-time alkalinisation was present for 136.4 minutes (25th centile 22.8, 75th centile 208.1) at pH4 or over, and 79.3 (2.5, 122.7) minutes at pH7 or over. Episodes of rapid alkaline rise were 17 (10, 47). 21.1% of these occurred while supine. 35 of 36 tested subjects were positive for H. pylori IgG. Conclusion. Gastric alkalinisation is common in Transkei, at a higher pH than that reported in other studies, and is sustained longer. Nighttime alkalinisation is frequent. This suggests a high level of duodenogastric reflux. PMID:25861260

  15. Accuracy of commercial 24-hour electrocardiogram analyzers for quantitation of total and repetitive ventricular arrhythmias.

    PubMed

    Salerno, D M; Granrud, G; Hodges, M

    1987-12-01

    The accuracy of 2 commercial 24-hour electrocardiogram analyzers was tested for quantitation of ventricular premature complexes (VPCs). Scanner 1 was the Cardiodata Systems Mark III and scanner 2 was the Avionics Trendsetter DCG VII. Twenty-four-hour electrocardiographic recordings from 19 consecutive ambulatory patients with frequent VPCs were analyzed by each device. Results were compared with those from hand counts of complete printouts of each of the 19 recordings. For total VPCs, scanner 1 had an average error of 13% (range 0 to 58%) and scanner 2 had an average error of 24% (range (1 to 80%). Scanner 1 had an error of more than 10% for 9 of the 19 recordings and scanner 2 more than 10% for 11 of the 19 recordings. For paired VPCs, scanner 1 had a mean error of 23% (range 4 to 77%), and scanner 2 of 56% (range 34 to 79%). For nonsustained ventricular tachycardia, scanner 1 had an average error of 20% (range 8 to 41%) and scanner 2 had an error of 56% (range 34 to 78%). Thus, when recordings from consecutive ambulatory patients with frequent VPCs were analyzed, neither device was consistently accurate for quantitation of total VPCs. Both analyzers had an unacceptable error for quantitation of repetitive VPCs. All currently available devices may have comparably large errors. This possibility is confirmed by recalculation of the reported data from a third scanner. PMID:2446488

  16. Breast milk intake: 12 hour versus 24 hour assessment.

    PubMed

    De Carvalho, M; Pittard, W

    1982-11-01

    Letter to the editor commenting on "Clinical and field studies of human lactation: methodological considerations," by Brown et al. The point is made that in test-weighing infants to estimate breast milk intake, culture related breastfeeding practices must be studied before a 12 hour test period is used to estimate intake for a complete 24 hour period. In western cultures milk intake between 7 am and 7 pm was found to differ significantly from intake between 7 pm and 7 am, whereas in a Bangladesh study milk intake during the 2 12 hour periods was comparable. PMID:7137079

  17. Beetroot supplementation lowers daily systolic blood pressure in older, overweight subjects.

    PubMed

    Jajja, A; Sutyarjoko, A; Lara, J; Rennie, K; Brandt, K; Qadir, O; Siervo, M

    2014-10-01

    Although inorganic nitrate and beetroot juice supplementation are associated with decreased systolic blood pressure (BP), these results have primarily been obtained from short-term trials that focused on healthy young adults. Therefore, we hypothesized that oral supplementation of beetroot juice concentrate would decrease systolic BP in overweight older participants but that the decline in BP would not be sustained after a 1-week interruption of the beetroot juice supplementation. For 3 weeks, 24 participants were randomized to either the beetroot juice concentrate or blackcurrant juice group, with a 1-week postsupplementation phase (week 4). Changes in systolic and diastolic BP were assessed during the supplementation and postsupplementation phases. Blood pressure was measured using 3 different methods: (1) resting clinic BP, (2) 24-hour ambulatory BP monitoring, and (3) home monitoring of daily resting BP. The first 2 methods were applied at baseline and after weeks 3 and 4. Daily measurements were conducted throughout the study, with 21 subjects completing the study (beetroot/blackcurrant = 10/11; male/female = 12/9; age = 62.0 ± 1.4 years; body mass index = 30.1 ± 1.2 kg/m(2)). After 3 weeks, beetroot juice supplementation was not associated with significant changes in resting clinic BP or 24-hour ABPM. Conversely, beetroot juice concentrate reduced daily systolic BP after 3 weeks (-7.3 ± 5.9 mm Hg, P = .02); however, the effect was not maintained after the interruption of the supplementation (week 4, 2.8 ± 6.1 mm Hg, P = .09). In overweight older subjects, beetroot juice concentrate supplementation was associated with beneficial effects on daily systolic BP, although the effects were not significant when measured by 24-hour ABPM or resting clinic BP. PMID:25294299

  18. [Isolation of Mycobacterium avium complex from the "24-hour bath"].

    PubMed

    Saito, H; Murakami, K; Ishii, N; Kwon, H H

    2000-01-01

    The "24-HOUR BATH" is an apparatus which circulates the bath water, keeps it clean and warm, and makes it possible to take a bath at any time during the day or night. It consists of apparatus for cleaning (sponge or mesh filter and filter material), heating (ceramic heater), and sterilizing (UV lamp). Recently, three cases of skin disease due to M. avium infection in private homes, in which "24-HOUR BATH" water was suspected to be the source of infection, have been reported. We attempted to isolate M. avium complex from the water (32 specimens), sponge filter (29 specimens), and filter material (32 specimens) of the "24-HOUR BATH". One hundred-ml samples of bath water, and 50-ml samples of rinse from a sponge filter or filter material were centrifuged at 3000 rpm for 20 min. Sediment was suspended in distilled water and a smear was prepared, and then digested and decontaminated with 2% sodium hydroxide. The processed specimens were cultured on 2% Ogawa medium containing ofloxacin (1 microgram/ml) and ethambutol (2.5 micrograms/ml) for 8 weeks at 37 degrees C. Positive smears were 3 (9.4%), 25 (86.2%) and 25 (78.1%) specimens from the water, sponge and filter material, respectively. A few bacterial clumps were observed, especially in the sponge specimens. The number of positive culture was 5 (15.6%), 24 (82.8%) and 25 (78.1%) from the water, sponge and filter material, respectively. Among them the number of Runyon's Group III-positive cultures was 5 (100%), 22 (91.7%) and 20 (80%) in the water, sponge, and filter material specimens, respectively. In most cases, cultures were positive for both the sponge and filter material specimens. All of the Group III mycobacteria were smooth, grew at 28, 37, 42, and 45 degrees C, negative for niacin, nitrate reductase, semiquantitative catalase, urease and Tween80 hydrolysis, and positive for 68 degrees C catalase. All of the strains reacted with M. avium complex AccuProbe and M. avium AccuProbe, but none of the strains reacted

  19. Physical and Mental Health of Patients Immediately After Discharge From Intensive Care Unit and 24 Hours Later

    PubMed Central

    Momennasab, Marzieh; Ghahramani, Tahereh; Yektatalab, Shahrzad; Zand, Farid

    2016-01-01

    Background: Monitoring the health status of patients discharged from intensive care units is a crucial method of service evaluation. Objectives: This study aimed to assess the physical and mental health status of patients immediately after discharge from the ICU and 24 hours later. Patients and Methods: This descriptive comparative study was conducted on 104 patients discharged from the ICUs of a referral trauma center in Shiraz, Southwest Iran. Physical parameters, including respiratory rate, need for supplemental oxygen, heart rate, blood pressure, and need for cardiac monitoring, were assessed. Hospital anxiety and depression scale (HADS) was used for mental health evaluation. The mental and physical status of patients were assessed before ICU discharge and 24 hours later; data were recorded in information forms and were analyzed using SPSS statistical software version 17. Results: At the time of discharge, the respiratory rate of 28% of the participants was more than 24 minutes, and 95.2% received supplemental oxygen. However, after 24 hours these values decreased to 10% and 21.6%, respectively. The mean heart rate and systolic blood pressure were within the normal range at both time points. Additionally, 63% of the patients had anxiety scores above 11 at both time points, reflecting high anxiety. The number of patients who reported depression increased from 58.7% at ICU discharge to 69.6% after 24 hours. Conclusions: Despite the considerable improvement in most of the patients’ physical condition in the first 24 hours after discharge from ICU, a significant number of them remain at risk for the development of adverse effects from this transition. The high prevalence of mental health disorders in these patients reveals the necessity to conduct follow-up consultations. PMID:27218059

  20. Ambulatory blood pressure reduction following high-intensity interval exercise performed in water or dryland condition.

    PubMed

    Sosner, Philippe; Gayda, Mathieu; Dupuy, Olivier; Garzon, Mauricio; Lemasson, Christopher; Gremeaux, Vincent; Lalongé, Julie; Gonzales, Mariel; Hayami, Douglas; Juneau, Martin; Nigam, Anil; Bosquet, Laurent

    2016-05-01

    We aimed to compare blood pressure (BP) responses following moderate-intensity continuous exercise (MICE), high-intensity interval exercise (HIIE) in dry land or HIIE in immersed condition, using 24-hour ambulatory BP monitoring. Forty-two individuals (65 ± 7 years, 52% men) with a baseline BP ≥ 130/85 mm Hg (systolic/diastolic blood pressures [SBP/DBP]) were randomly assigned to perform one of the three following exercises on a stationary cycle: MICE (24 minutes at 50% peak power output) or HIIE in dry land (two sets of 10 minutes with phases of 15 seconds 100% peak power output interspersed by 15 seconds of passive recovery) or HIIE in up-to-the-chest immersed condition. While MICE modified none of the 24-hour average hemodynamic variables, dryland HIIE induced a 24-hour BP decrease (SBP: -3.6 ± 5.7/DBP: -2.8 ± 3.0 mm Hg, P < .05) and, to a much greater extent, immersed HIIE (SBP: -6.8 ± 9.5/DBP: -3.0 ± 4.5 mm Hg, P < .05). The one condition that modified 24-hour pulse-wave velocity was immersed HIIE (-0.21 ± 0.30 m/s, P < .05). PMID:27026570

  1. Managing sleep and wakefulness in a 24-hour world

    PubMed Central

    Coveney, Catherine M

    2014-01-01

    This article contributes to literature on the sociology of sleep by exploring the sleeping practices and subjective sleep experiences of two social groups: shift workers and students. It draws on data, collected in the UK from 25 semi-structured interviews, to discuss the complex ways in which working patterns and social activities impact upon experiences and expectations of sleep in our wired awake world. The data show that, typically, sleep is valued and considered to be important for health, general wellbeing, appearance and physical and cognitive functioning. However, sleep time is often cut back on in favour of work demands and social activities. While shift workers described their efforts to fit in an adequate amount of sleep per 24-hour period, for students, the adoption of a flexible sleep routine was thought to be favourable for maintaining a work–social life balance. Collectively, respondents reported using a wide range of strategies, techniques, technologies and practices to encourage, overcome or delay sleep(iness) and boost, promote or enhance wakefulness/alertness at socially desirable times. The analysis demonstrates how social context impacts not only on how we come to think about sleep and understand it, but also how we manage or self-regulate our sleeping patterns. PMID:23957268

  2. [Necessity of a 24-hour system of blood transfusion testing].

    PubMed

    Kishimoto, Yuji

    2003-01-01

    The preventive effects of a 24-hour system of blood transfusion testing on mistyping of transfused blood was examined. Blood transfusion tests have been performed by blood transfusion technologists during working hours and by physicians at other times. In March 2000, we introduced a system in which technologists perform blood transfusion tests after working hours. Technologists of the Blood Transfusion Unit and Central Clinical Laboratory perform the test jointly, and column agglutination technology was introduced as the test method. A computer system setup exclusively for the testing was also introduced to perform computer cross-matching. Since transfusion error is likely to occur during emergency blood transfusion, a manual was established to prioritize safety. After introduction of the system, mistyping that may have been caused by inaccurate blood test results markedly decreased, confirming the usefulness of this system for prevention of mistyping. In addition, transfusion errors also decreased in wards and the improved system increased the safety of the entire medical care system. The frequency of mistyping was about 1% when physicians performed blood typing, showing the importance of clinical technologists for blood transfusion tests. PMID:12652691

  3. Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation

    PubMed Central

    Hartley, Geoffrey L.; Zaharieva, Dessi; Basset, Fabien A.; Hynes, Zach

    2016-01-01

    Survivor of a ship ground in polar regions may have to wait more than five days before being rescued. Therefore, the purpose of this study was to explore cognitive performance during prolonged cold exposure. Core temperature (Tc) and cognitive test battery (CTB) performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature). Participants (recruited from those who have regular occupational exposure to cold) were instructed that they could freely engage in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test conditions were sufficient to significantly decrease Tc after exposure and to eliminate the typical 0.5–1.0°C circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance regardless of exposure time. Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the benefit of maintaining metabolic heat production, improve motivation, and act as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance. PMID:27478839

  4. Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation.

    PubMed

    Taber, Michael J; Hartley, Geoffrey L; McGarr, Gregory W; Zaharieva, Dessi; Basset, Fabien A; Hynes, Zach; Haman, Francois; Pinet, Bernard M; DuCharme, Michel B; Cheung, Stephen S

    2016-01-01

    Survivor of a ship ground in polar regions may have to wait more than five days before being rescued. Therefore, the purpose of this study was to explore cognitive performance during prolonged cold exposure. Core temperature (T c) and cognitive test battery (CTB) performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature). Participants (recruited from those who have regular occupational exposure to cold) were instructed that they could freely engage in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test conditions were sufficient to significantly decrease T c after exposure and to eliminate the typical 0.5-1.0°C circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance regardless of exposure time. Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the benefit of maintaining metabolic heat production, improve motivation, and act as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance. PMID:27478839

  5. Arrhythmias Seen in Baseline 24-Hour Holter ECG Recordings in Healthy Normal Volunteers During Phase 1 Clinical Trials.

    PubMed

    Hingorani, Pooja; Karnad, Dilip R; Rohekar, Prashant; Kerkar, Vaibhav; Lokhandwala, Yash Y; Kothari, Snehal

    2016-07-01

    Regulatory agencies encourage sponsors to submit 24-hour ambulatory ECG data for assessing cardiac safety of new drugs, and some arrhythmias, hitherto considered rare, have been observed in some early-phase studies. Interpretation of these observations is difficult given the dearth of published data on the prevalence of cardiac arrhythmias seen during 24-hour continuous ECG monitoring in healthy volunteers (HV) from clinical trials. We analyzed drug-free ambulatory ECG recordings from 1273 HV (1000 males, 273 females; age 18-65 years) from 22 phase 1 studies that were analyzed in a core ECG laboratory; all subjects had normal screening ECGs. Supraventricular arrhythmias such as supraventricular premature complexes were observed in 60.8% of healthy volunteers, supraventricular tachycardia in 2.2%, and atrial fibrillation in 0.1%. Ventricular arrhythmias included premature ventricular complexes (PVCs) in 43.4%, >200 PVCs per 24 hours in 3.3%, multifocal PVCs in 5.3%, nonsustained ventricular tachycardia in 0.7%, and accelerated idioventricular rhythm in 0.3%. Bradyarrhythmias included sinus pause >3 seconds in 0.3%, and second-degree AV block in 2.4%. Complete heart block and torsades de pointes were not seen in any subject. Based on the observed incidence, we estimated the maximum number of healthy subjects in whom these arrhythmias may be seen as a matter of chance in studies with smaller sample sizes if the study drug has no arrhythmogenic effect. Our results and these estimates could help interpret whether cardiac arrhythmias observed in early-phase studies are due to chance or possibly are a drug effect. PMID:26626443

  6. Efficacy of combination therapy for systolic blood pressure in patients with severe systolic hypertension: the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study.

    PubMed

    Neutel, Joel M; Smith, David H G; Weber, Michael A; Schofield, Lesley; Purkayastha, Das; Gatlin, Marjorie

    2005-11-01

    Systolic hypertension is predominant among patients over 50 years of age, is a more important cardiovascular risk factor than diastolic blood pressure, and is more difficult to control than diastolic blood pressure. Consequently, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends combination therapy as first-line treatment for patients with stage 2 hypertension. In the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study, 24-hour ambulatory blood pressure monitoring was used to identify patients with systolic hypertension and to determine the impact of 8 weeks of treatment with either amlodipine besylate/benazepril HCl 5/20 mg combination therapy (n=149), amlodipine besylate 5 mg (n=146), or benazepril HCl 20 mg (n=148). Combination therapy was significantly more effective in reducing systolic blood pressure and pulse pressure than either monotherapy (p<0.0001). Significantly greater percentages of patients in the combination group compared with either monotherapy achieved blood pressure control (p<0.0001). Adverse events were low in all three treatment arms, with less peripheral edema in the combination group than in the amlodipine-treated group. The combination of amlodipine besylate/benazepril HCl given to patients with stage 2 systolic hypertension resulted in significantly greater reductions in blood pressure and pulse pressure than those seen with monotherapy and was at least as well tolerated as the separate components. This data supports the recommendation of the JNC 7 for the use of combination therapy in patients with stage 2 hypertension. PMID:16278521

  7. Electrodes for 24 hours pH monitoring--a comparative study.

    PubMed

    McLauchlan, G; Rawlings, J M; Lucas, M L; McCloy, R F; Crean, G P; McColl, K E

    1987-08-01

    Three pH electrodes in clinical use were examined--(1) antimony electrode with remote reference electrode (Synectics 0011), (2) glass electrode with remote reference electrode (Microelectrodes Inc. MI 506) and (3) combined glass electrode with integral reference electrode (Radiometer GK2801C). In vitro studies showed that both glass electrodes were similar and superior to the antimony electrode with respect to response time, drift, and sensitivity. The effect of the siting of the reference electrode on the recorded pH was examined in five human volunteers. The pH reading using a remote skin reference electrode was higher by a mean of 0.3 pH units (range 0.0-0.6) in the stomach, lower by 0.65 pH units (0.5-0.8) in the duodenum and lower by 0.3 pH units (0.0-0.6) in the oesophagus than that simultaneously obtained with an intraluminal reference electrode. Buccal reference electrodes gave similar readings to skin. Combined reference and glass pH electrodes are recommended for 24-hour ambulatory pH monitoring. PMID:3666560

  8. Preparation and results of a 24-hour orbital flight.

    PubMed

    Titov, G S

    1963-01-01

    The space age presents man with unprecedented opportunities for discovery and for cooperative endeavors to benefit all mankind. My flight of August 6-7, 1961 was conducted for the purpose of determining whether man can stay and work effectively and whether all systems of the spaceship can operate successfully during a period of 24 hours in space. The flight of Vostok II represents an experimental step in a logical sequence which included the first earth orbiting flight of USSR citizen Yuri A. Gagarin. Preparation for the flight included the study of theoretical and applied subjects, testing in various kinds of apparatus which provide acceleration, heat and isolation experience, brief airborne weightless flights and parachute landings, in addition to extensive training in a real spacecraft having simulators for normal and emergency contingencies of space flight. The actual flight was therefore carried out with a sense of confidence and familiarity and with continuous close radio contact with ground centers from whom my fellow cosmonauts served as spokesmen. Sequential boosters totaling 600 000 kg thrust placed the 4731 kg spaceship into a perfect orbit varying in altitude from 178-246 km in a plane 64 degrees 58' inclined to the equator. The spaceship made 17 orbits around the earth landing 25 hours, 18 minutes after take-off. The cabin had full atmospheric pressure and a comfortable habitability which could be extended for 10 days. I was able to maneuver the spaceship and perform many other control functions, make observations and take pictures of the earth and its cloud cover, eat meals and sleep all with good efficiency. I experienced mild symptoms suggestive of seasickness which were aggravated by head turning, ameliorated by sleep and entirely relieved by resumption of g-loading during descent. Altogether analyses of the physical and structural performance of the spaceship and the continuously monitored physiological responses of the pilot indicate that all

  9. Rapid Buildup of Brain White Matter Hyperintensities Over 4 Years Linked to Ambulatory Blood Pressure, Mobility, Cognition, and Depression in Old Persons

    PubMed Central

    2013-01-01

    Background. Brain white matter hyperintensities (WMH) are associated with functional decline in older people. We performed a 4-year cohort study examining progression of WMH, its effects on mobility, cognition, and depression with the role of clinic and 24-hour ambulatory systolic blood pressure as a predisposing factor. Methods. Ninety-nine subjects, 75–89 years were stratified by age and mobility, with the 67 completing 4-years comprising the cohort. Mobility, cognition, depressive symptoms, and ambulatory blood pressure were assessed, and WMH volumes were determined by quantitative analysis of magnetic resonance images. Results. WMH increased from 0.99±0.98% of intracranial cavity volume at baseline to 1.47±1.2% at 2 years and 1.74±1.30% after 4 years. Baseline WMH was associated with 4-year WMH (p < .0001), explaining 83% of variability. Small, but consistent mobility decrements and some evidence of cognitive decline were noted over 4 years. Regression analyses using baseline and 4-year WMHs were associated with three of five mobility measures, two of four cognitive measures and the depression scale, all performed at 4 years. Increases in ambulatory systolic blood pressure but not clinic systolic blood pressure during the initial 2 years were associated with greater WMH accrual during those years, while ambulatory systolic blood pressure was related to WMH at 4 years. Conclusion. Declines in mobility, cognition, and depressive symptoms were related to WMH accrual over 4 years, and WMH was related to out-of-office blood pressure. This suggests that prevention of microvascular disease, even in asymptomatic older persons, is fundamental for preserving function. There may be value in tighter 24-hour blood pressure control in older persons although this requires further investigation. PMID:23766429

  10. [Exercise tolerance in angina patients 3 and 24 hours after administration of a new delayed-action preparation of metoprolol].

    PubMed

    Giusti, C; Verdecchia, P; Pentimone, F; Regoli, F; Cordoni, M; Bongini, A M

    1981-01-01

    To assess the duration of improved exercise tolerance by metoprolol given in a new sustained-release formulation, 40 in-patients affected by stable exercise-induced angina pectoris received single-blind placebo in day 1 and thereafter, in double-blind cross-over once daily administration, metoprolol RETARD 100 mg and 200 mg in days 3 and 5. Symptom-limited cycloergometric exercise tests were performed at 3 and 24 hours after placebo and after each of the two doses of metoprolol RETARD. Duration of exercise, maximal workload and total work performed did significantly increase at 3 and 24 hours after metoprolol RETARD 100 mg (P less than 0.01) and 200 mg (P less than 0.01), without any significant difference between the two doses. Peak systolic arterial pressure and heart rate were lowered by metoprolol RETARD 200 mg at 3 (P less than 0.01) and 24 (P less than 0.01) hours, whereas only the peak heart rate at 3 hours was lowered (P less than 0.05) by the 100 mg dose. It is concluded that in patients with stable exercise-induced angina pectoris, metoprolol RETARD 200 mg appears to be able to increase exercise tolerance and to reduce exercise-induced myocardial oxygen consumption throughout 24 hours period. This may justify a once daily dosing schedule of the 200 mg dose, aimed at improving patient compliance. PMID:7343379

  11. Sleep-Disordered Breathing and 24-Hour Blood Pressure Pattern Among Older Adults

    PubMed Central

    White, William B.; Kutner, Michael; Ouslander, Joseph G.; Bliwise, Donald L.

    2009-01-01

    Background To examine the association between sleep-disordered breathing (SDB) and 24-hour blood pressure (BP) pattern among community-dwelling older adults. Methods A convenience sample of 70 community-dwelling older adults, recruited from senior housing, community centers, and learning centers, were admitted to General Clinical Research Center, Emory University Hospital, Atlanta, Ga. Information regarding demographic and clinical history was obtained using questionnaires. Twenty-four–hour BP monitoring in supine position was performed using Spacelabs model 20207. Breathing during sleep was monitored with the use of a modified sleep recording system (Embletta, PDS), which monitors nasal and oral airflow, chest and abdominal movements, and pulse oximetry. Night time–daytime (night-day) BP ratio (average night-time BP divided by daytime BP) was calculated both for systolic and diastolic BPs. Results Sixty-nine participants, mean age 74.9 ± 6.4 years (41 [57%] women), completed the study. The mean apnea-hypopnea index (AHI) was 13 ± 13 per hour of sleep, and 20 participants (29%) had AHI ≥15 per hour of sleep, indicating moderate to severe SDB. Moderate to severe SDB (AHI ≥15 per hour of sleep) was significantly associated with nocturnal hypertension, whereas there was no statistically significant difference in wake-time BP between those with and without moderate to severe SDB. Stepwise multiple regressions showed that AHI independently predicted increased night-day systolic and night-day diastolic BP ratio, even after controlling for nocturia frequency. Conclusions The results indicate increased BP load associated with increased AHI in this group of older adults. This increased BP load may contribute to increased hypertension-related morbidity and disease burden. PMID:19196901

  12. Short and Long-Term Effect of Carotid Artery Stenting on Arterial Blood Pressure Measured through Ambulatory Blood Pressure Monitoring

    PubMed Central

    Köklü, Erkan; Yüksel, İsa Öner; Arslan, Şakir; Bayar, Nermin; Köklü, Fatma; Çay, Serkan; Çağırcı, Göksel; Küçükseymen, Selçuk; Kuş, Görkem

    2016-01-01

    Background The aim of this study was to assess the short and long-term effects of carotid artery stenting (CAS) procedure on blood pressure (BP) through ambulatory BP monitoring. Methods One hundred fifty three patients who underwent CAS for primary or secondary protection from December 2010 to September 2013 were enrolled to our study. The BP levels of total of 123 patients were monitored for 1 year. Thereafter, the pre-procedure levels of BP were compared with BP levels at the 24-hour and the first year intervals after the procedure. Results Systolic and diastolic BP levels at the 24-hour and the first year intervals after CAS were significantly lower than the pre-procedure BP levels. The mean 24-hour systolic BP was 113 ± 13 mmHg and diastolic BP was 63 ± 8 mmHg, both of which were significantly lower (p < 0.001 and p < 0.001 respectively), while the pre-procedure mean systolic BP was 133 ± 10 mmHg and the mean diastolic BP was 75 ± 9 mmHg. Moreover, the mean first-year systolic BP was 125 ± 10 mmHg with a decline of 8 ± 8 mmHg and mean diastolic BP was 71 ± 8 mmHg with a decline of 4 ± 7 mmHg, both of which were again significantly lower compared to the pre-procedure levels (p < 0.001 and p < 0.001 respectively). Conclusions The results of our study suggested that systolic and diastolic BP levels diminished after CAS. Additionally, BP reduction continued even 1 year after the CAS. PMID:27274176

  13. Systolic arrays

    SciTech Connect

    Moore, W.R.; McCabe, A.P.H.; Vrquhart, R.B.

    1987-01-01

    Selected Contents of this book are: Efficient Systolic Arrays for the Solution of Toeplitz Systems, The Derivation and Utilization of Bit Level Systolic Array Architectures, an Efficient Systolic Array for Distance Computation Required in a Video-Codec Based Motion-Detection, On Realizations of Least-Squares Estimation and Kalman Filtering by Systolic Arrays, and Comparison of Systolic and SIMD Architectures for Computer Vision Computations.

  14. [A validation of the data obtained with the simultaneous recording of blood pressure and the 24-hour electrocardiogram].

    PubMed

    Germanò, G; Caparra, A; Valentino, S; Coia, F; Federico, L; Santucci, A

    1993-06-01

    Aim of this study was to evaluate the blood pressure (BP) measurement reliability of a light weight ambulatory BP and ECG recorder. Micro AM is a new 300 g portable apparatus that combines in one device both the ambulatory BP and solid state ECG recording. The dimensions of the Micro AM are 75 x 140 x 29 mm. The monitor measures BP using Korotkoff phase 1 for systolic and phase 5 for diastolic BP, and concurrently measures oscillometric BP, one method validating the other. In addition, the manual and programmed BP measurement modes can be supplemented by an "intelligent" mode in which the ECG triggers an ambulatory BP reading during an abnormal ST segment change. A standard mercury manometer was connected with the cuff of the Micro AM with a Y-shaped part, and 12 BP measurements were simultaneously taken at 5 min intervals by the automatic device in auscultatory mode and by a trained technician in 86 normotensive volunteers (aged from 18 to 44 years, 37 males and 49 females). The algebraic differences, the frequency distribution and the difference distribution of systolic and diastolic data between the 2 methods were calculated. The results show that the automatic method gives values for systolic BP that are lower than conventional ones (average differences -0.643 mmHg), whereas for diastolic BP, the values are higher (average differences +0.229 mmHg). Then, Student's paired t-test was used to evaluate statistically significant differences. The test relative to systolic BP was significant to the critical level of 0.1%, but the differences being 3 times smaller than the instrumental tolerance. On the contrary, diastolic BP differences were non significant. In conclusion, we found a good agreement between BP recorded automatically and by sphygmomanometer. PMID:8402748

  15. Ambulatory monitoring detects sorafenib-induced blood pressure elevations on the first day of treatment

    PubMed Central

    Maitland, Michael L.; Kasza, Kristen E.; Karrison, Theodore; Moshier, Kristin; Sit, Laura; Black, Henry R.; Undevia, Samir D.; Stadler, Walter M.; Elliott, William J.; Ratain, Mark J.

    2009-01-01

    Purpose Hypertension is a mechanism-based toxicity of sorafenib and other cancer therapeutics that inhibit the vascular endothelial growth factor (VEGF) signaling pathway (VSP). This prospective, single center, cohort study characterized ambulatory blood pressure (BP) monitoring (ABPM) as an early pharmacodynamic biomarker of VSP inhibition by sorafenib. Experimental Design Fifty-four normotensive advanced cancer patients underwent 24-hour ABPM prior to and between days 6 and 10 of sorafenib therapy. After BP changes were detected among the first cohort within 10 days, ABPM was performed during the first 24 hours of treatment for the second cohort. Results For the entire patient population the BP increase (mean systolic +10.8 mmHg [95% CI, 8.6 to 13.0], range −5.2 to +28.7 mmHg; mean diastolic +8.0 mmHg [95% CI, 6.3 to 9.7], range −4.4 to +27.1mmHg) was detected between days 6 and 10 (P <0.0001 for both) and plateaued thereafter. Variability in BP change did not associate with: age, body size, sex, self-reported race, baseline BP, or steady state sorafenib plasma concentrations. In the second cohort the BP elevation was detected during the first 24 hours (mean systolic +8.2 mmHg [95% CI, 5.0 to 11.3]; mean diastolic +6.5 mmHg [95% CI, 4.7 to 8.3] P <0.0001 for both). Conclusions ABPM detects the BP response to VSP inhibition by sorafenib during the first 24 hours of treatment. The magnitude of BP elevation is highly variable and unpredictable, but could be important in optimizing the therapeutic index of VSP inhibitor therapy. PMID:19773379

  16. Blood Pressure Measurements Taken by Patients are Similar to Home and Ambulatory Blood Pressure Measurements

    PubMed Central

    Pierin, Angela M. G.; Ignez, Edna C.; Filho, Wilson Jacob; Barbato, Alfonso Júlio Guedes; Mion, Décio

    2008-01-01

    OBJECTIVE To compare blood pressure measurements taken at home by physicians, nurses, and patients with office blood pressure measurement , ambulatory blood pressure monitoring and home blood pressure measurement. METHODS A total of 44 patients seen by a home care program were studied. Protocol 1 a) blood pressure was measured by the patient, a physician and a nurse during a regular home visit (Home1); b) home blood pressure measurement was measured for 4 days (HBPM1); c) office blood pressure measurement was measured by a physician, a nurse, and the patient; and by 24-hour ambulatory blood pressure monitoring. Protocol 2 blood pressure was measured by the patient, a physician, and a nurse during a special home visit in the presence of a physician and a nurse only (Home2); and b) home blood pressure measurement was taken for the second time (HBPM2). Echocardiography, guided by a two-dimensional echocardiograph, was performed. RESULTS Protocol 1: a) office blood pressure measurement and Home1 were significantly higher than ambulatory blood pressure monitoring, except for systolic and diastolic office blood pressure measurement taken by the patient or a family member, systolic blood pressure taken by a nurse, and diastolic blood pressure taken by a physician. b) ambulatory blood pressure monitoring and HBPM1 were similar. Protocol 2: a) HBPM2 and Home2 were similar. b) Home2 was significantly lower than Home1, except for diastolic blood pressure taken by a nurse or the patient. There were significant relationships between: a) diastolic blood pressure measured by the patient and the thickness of the interventricular septum, posterior wall, and left ventricular mass; and b) ambulatory and HBPM2 diastolic and systolic blood pressure taken by a physician (home2) and left ventricular mass. Therefore, the data indicate that home blood pressure measurement and ambulatory blood pressure monitoring had good prognostic values relative to “office measurement.” CONCLUSION

  17. INtensive versus Standard Ambulatory Blood Pressure Lowering to Prevent Functional DeclINe In The ElderlY (INFINITY)

    PubMed Central

    White, William B.; Marfatia, Ravi; Schmidt, Julia; Wakefield, Dorothy B.; Kaplan, Richard F.; Bohannon, Richard W.; Hall, Charles B.; Guttmann, Charles R.; Moscufo, Nicola; Fellows, Douglas; Wolfson, Leslie

    2012-01-01

    Reductions in mobility and cognitive function linked to accrual of brain microvascular disease related white-matter hyperintensities(WMH) on magnetic resonance imaging (MRI) canoccur in older hypertensive patients in as little as 2 years. We have designed a trial evaluating two levels of ambulatory BP control in individuals with normal or mildly impaired mobility and cognition who have detectable cerebrovascular disease (>0.5% WMH fraction of intracranial volume) on functional outcomes. The study is a prospective randomized, open-label trial with blinded endpoints, inpatients ages 75 and older with elevated 24-h systolic BP (≥145 mmHg in the untreated state) who do not have unstable cardiovascular disease, heart failure or stroke. The primary and key secondary outcomes in the trial are: change from baseline in mobility and cognitive function and damage to brain white matter as demonstrated by accrual of WMH volume and changes indiffusion tensor imaging.Approximately 300 patients will be enrolled and 200 randomized to one of two levels of ambulatory BP control (intensive to achieve a goal 24-hour systolic BP of ≤ 130 mmHg or standard to achieve a goal 24-hour systolic BP of ≤ 145 mmHg) for a total of 36 months using similar antihypertensive regimens. The analytical approach provides 85% power to show a clinically meaningful effect in differences in mobility accompanied by quantitative differences in WMH between treatment groups. The INFINITY trial is the first to guide antihypertensive therapy using ambulatory BP monitoring rather than clinic BP to reduce cerebrovascular disease. PMID:23453090

  18. A comparison between 24-hour and 2-hour urine collection for the determination of proteinuria.

    PubMed

    Somanathan, N; Farrell, T; Galimberti, A

    2003-07-01

    Proteinuria is one of the fundamental criteria for the diagnosis of pre-eclampsia with quantitative assessment based on the 24-hour urine protein estimation as the gold standard. This study was undertaken to determine whether a 2-hour protein estimation correlated with that of a formal 24-hour collection. Thirty women with proteinuric hypertension were recruited. There was significant correlation between the 2-hour and 24-hour urine protein levels (Pearson's correlation coefficient 0.76 (P 0.000). A positive 2-hour test was associated more closely with significant levels of 24-hour proteinuria than dipstick analysis alone. We conclude from this study that a random 2-hour sample could be used for the initial assessment of proteinuria and so avoid the delay associated with 24-hour quantification of urinary protein. PMID:12881076

  19. Recruiting Strategy and 24-Hour Biomonitoring of Paraquat in Agricultural Workers

    PubMed Central

    Park, Eun-Kee; Tagles, Hector Duarte; Gee, Shirley J.; Hammock, Bruce D.; Lee, Kiyoung; Schenker, Marc B.

    2010-01-01

    The objectives of this study were to recruit agricultural workers in Costa Rica to participate in a 24-hour urine collection for paraquat exposure assessment and to compare the 24-hour sampling to end-of-shift sampling. The authors recruited 187 handlers and 54 nonhandlers from coffee, banana, and palm oil plantations. The completeness of 24-hour urine samples collected (a total of 393 samples) was confirmed by questionnaire and urinary creatinine level. For a subset of 12 samples, the absorbed paraquat level was determined in 24-hours and end-of-shift spot urine samples. The participation rate for handlers was ~90%. The completeness of 24-hour urine collections was verified as the overall average of creatinine levels from 393 urines (1.11 ± 0.50 g/L). A total of 92.4% to 96.7% of urine samples were considered within the acceptable range of urinary creatinine, whereas 94.7% of the samples were described as “complete” from the questionnaire. Measured creatinine correlated well to predicted values (r = .327, p = .0024, 95% CI .12–.51). Detected paraquat levels in spot urine samples had a sensitivity of 96.9% at the high specificity of 100% compared to 24-hour urine samples as the gold standard. There was a significant (p < .0001) correlation between spot and 24-hour urine paraquat levels (r = .7825, 95% CI .61–.88). The recruiting strategy was successful in getting 24-hour urine samples from a farm worker population. Comparison between the paraquat levels in spot and 24-hour urine samples demonstrated that for this compound, end-of-shift spot urine samples would be an appropriate substitute for 24-hour collections. PMID:19064412

  20. Enhanced carotid-cardiac baroreflex response and elimination of orthostatic hypotension 24 hours after acute exercise in paraplegics

    NASA Technical Reports Server (NTRS)

    Engelke, K. A.; Shea, J. D.; Doerr, D. F.; Convertino, V. A.

    1992-01-01

    To test the hypothesis that an acute bout of maximal exercise can ameliorate orthostatic hypotension consequent to prolonged wheelchair confinement, we evaluated heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure responses during 15 minutes of 70 degrees head-up tilt (HUT) in 10 paraplegic subjects 24 hours after arm crank exercise designed to elicit maximal effort, and during a control (no exercise) conditions. Additionally, the carotid baroreceptor stimulus-cardiac response relationship was determined by measurement of R-R interval during external application of graded pressures to the carotid sinuses. One week separated the treatment conditions. The maximum slope of the carotid-cardiac baroreflex response was increased (p = 0.049) by exercise (6.2 +/- 1.7 msec/mmHg) compared to control (3.3 +/- 0.6). During control HUT, HR increased from 61 +/- 1 to 90 +/- 7 bpm (p = 0.001) while SBP decreased from 118 +/- 5 to 106 +/- 9 mmHg (p = 0.025). During HUT 24 hours after exercise, HR increased from 60 +/- 2 to 90 +/- 4 bpm (p = 0.001), but the reduction in SBP was essentially eliminated (116 +/- 5 to 113 +/- 5 mmHg).

  1. Systolic flow

    SciTech Connect

    Tsay, J.C.; Yuan, S. )

    1990-03-01

    This paper presents a formal algebraic notation to express the global data interacting activities of a systolic array. The notation we use is the generating function. Using generating functions, we can describe the velocity and the moving path of a data stream at any time. Several generating functions can be grouped together to form a systolic flow which can aid the specification, design, and verification of a systolic array.

  2. Effect of Intensive Salt-Restriction Education on Clinic, Home, and Ambulatory Blood Pressure Levels in Treated Hypertensive Patients During a 3-Month Education Period.

    PubMed

    Nakano, Masahiro; Eguchi, Kazuo; Sato, Toshiko; Onoguchi, Atsuko; Hoshide, Satoshi; Kario, Kazuomi

    2016-05-01

    The authors tested the hypothesis that low-salt diet education by nutritionists would lower blood pressure (BP) levels in treated hypertensive patients. The amount of urinary salt excretion and clinic, home, and ambulatory BP values at baseline and at 3 months were measured in 95 patients with hypertension. After randomization to a nutritional education group (E group, n=51) or a control group (C group, n=44), the C group received conventional salt-restriction education and the E group received intensive nutritional education aimed at salt restriction to 6 g/d by nutritionists. From baseline to the end of the study, 24-hour urinary sodium excretion was significantly lowered in the E group compared with the C group (6.8±2.9 g/24 h vs 8.6±3.4 g/24 h, P<.01). Morning home systolic BP tended to be lowered in the E group (P=.051), and ambulatory 24-hour systolic BP was significantly lowered in the E group (-4.5±1.3 mm Hg) compared with the C group (2.8±1.3 mm Hg, P<.001). Intensive nutritional education by nutritionists was shown to be effective in lowering BP in treated hypertensive patients. PMID:26732187

  3. Renal Nerve Stimulation-Induced Blood Pressure Changes Predict Ambulatory Blood Pressure Response After Renal Denervation.

    PubMed

    de Jong, Mark R; Adiyaman, Ahmet; Gal, Pim; Smit, Jaap Jan J; Delnoy, Peter Paul H M; Heeg, Jan-Evert; van Hasselt, Boudewijn A A M; Lau, Elizabeth O Y; Persu, Alexandre; Staessen, Jan A; Ramdat Misier, Anand R; Steinberg, Jonathan S; Elvan, Arif

    2016-09-01

    Blood pressure (BP) response to renal denervation (RDN) is highly variable and its effectiveness debated. A procedural end point for RDN may improve consistency of response. The objective of the current analysis was to look for the association between renal nerve stimulation (RNS)-induced BP increase before and after RDN and changes in ambulatory BP monitoring (ABPM) after RDN. Fourteen patients with drug-resistant hypertension referred for RDN were included. RNS was performed under general anesthesia at 4 sites in the right and left renal arteries, both before and immediately after RDN. RNS-induced BP changes were monitored and correlated to changes in ambulatory BP at a follow-up of 3 to 6 months after RDN. RNS resulted in a systolic BP increase of 50±27 mm Hg before RDN and systolic BP increase of 13±16 mm Hg after RDN (P<0.001). Average systolic ABPM was 153±11 mm Hg before RDN and decreased to 137±10 mm Hg at 3- to 6-month follow-up (P=0.003). Changes in RNS-induced BP increase before versus immediately after RDN and changes in ABPM before versus 3 to 6 months after RDN were correlated, both for systolic BP (R=0.77, P=0.001) and diastolic BP (R=0.79, P=0.001). RNS-induced maximum BP increase before RDN had a correlation of R=0.61 (P=0.020) for systolic and R=0.71 (P=0.004) for diastolic ABPM changes. RNS-induced BP changes before versus after RDN were correlated with changes in 24-hour ABPM 3 to 6 months after RDN. RNS should be tested as an acute end point to assess the efficacy of RDN and predict BP response to RDN. PMID:27432864

  4. Nighttime Systolic Blood-Pressure Load Is Correlated with Target-Organ Damage Independent of Ambulatory Blood-Pressure Level in Patients with Non-Diabetic Chronic Kidney Disease

    PubMed Central

    Deng, Wenjie; Gong, Wenyu; Liu, Xun; Ye, Zengchun; Peng, Hui; Lou, Tanqi

    2015-01-01

    Background The impacts of blood pressure (BP) load on target-organ damage in patients with chronic kidney disease (CKD) are largely unclear. We examined whether BP load is correlated with target-organ damage (TOD) in Chinese CKD patients independent of BP level. Methods We recruited 1219 CKD patients admitted to our hospital division in this cross-sectional study. The TOD were measured by estimated glomerular filtration rate (eGFR), proteinuria, left ventricular mass index (LVMI) and carotid intima-media thickness (cIMT) in this study. Univariate and multivariate linear analyses were used to evaluate the relationship between systolic blood pressure (SBP) load, diastolic blood pressure (DBP) load and these renal, cardiovascular parameters. Results In multivariable-adjusted models, BP load and ambulatory BP levels both independently correlated with LVMI, eGFR and proteinuria in all groups of CKD patients (p<0.05), 24-h SBP correlated with cIMT only in non-diabetic CKD patients without hypertension (p<0.05), while nighttime SBP load was associated with cIMT only in non-diabetic CKD patients (p<0.05). Furthermore, nighttime SBP load additionally increased coefficient of determination (R2) and correlated with LVMI, proteinuria in non-diabetic CKD patients without hypertension (R2 = 0.034, P<0.001 and R2 = 0.012, P = 0.006 respectively) and LVMI, cIMT, eGFR in non-diabetic CKD patients with hypertension (R2>0.008, P<0.05) in multivariable-adjusted model which already including the 24-h BP. BP load did not refine this correlation based on the 24-h BP level in diabetic CKD patients. Conclusion Night-time SBP load was correlated with TOD in patients with non-diabetic chronic kidney disease independent of BP level. PMID:26186336

  5. Ocean tide loading effects on 24 hour GPS height estimates and resulting time series

    NASA Astrophysics Data System (ADS)

    Penna, N. T.; Stewart, M. P.

    2003-04-01

    GPS data from continuously operating GPS receivers are usually made available on a daily basis in 24 hour data files, so it is convenient for the user to adopt 24 hour data processing sessions. Time series are often then formed from the discrete 24 hour solutions, used for such applications as crustal deformation monitoring or high quality coordinate determination. When heights are estimated, ocean tide loading is a systematic error source that must be considered. Since the principal ocean tide loading effects have periods close to 12 and 24 hours respectively, it has been suggested from previous works that if models for ocean tide loading are not applied when processing GPS data as 24 hour sessions, at worst a small increase in the variance of the height time series will result. This paper further investigates the effects of ocean tide loading on 24 hour GPS height estimates and resulting time series, by considering a year of both simulated and real data from sites in Australia, at which the ocean tide loading effects differ substantially. The effect of each of the individual constituents is also considered. The role of the tropospheric delay mitigation strategy is addressed, regarding the effect on the height estimates when ocean tide loading effects are modelled or ignored.

  6. Mean 24-hours sympathetic nervous system activity decreases during head-down tilted bed rest but not during microgravity

    NASA Astrophysics Data System (ADS)

    Christensen, Nj; Heer, M.; Ivanova, K.; Norsk, P.

    Sympathetic nervous system activity is closely related to gravitational stress in ground based experiments. Thus a high activity is present in the standing-up position and a very low activity is observed during acute head-out water immersion. Adjustments in sympathetic activity are necessary to maintain a constant blood pressure during variations in venous return. Head-down tilted bed rest is applied as a model to simulate changes observed during microgravity. The aim of the present study was to test the hypothesis that mean 24-hours sympathetic activity was low and similar during space flight and in ground based observation obtained during long-term head-down tilted bed rest. Forearm venous plasma noradrenaline was measured by a radioenzymatic technique as an index of muscle sympathetic activity and thrombocyte noradrenaline and adrenaline were measured as indices of mean 24-hours sympathoadrenal activity. Previous results have indicated that thrombocyte noradrenaline level has a half-time of 2 days. Thus to reflect sympathetic activity during a specific experiment the study period must last for at least 6 days and a sample must be obtained within 12 hours after the experiment has ended. Ten normal healthy subjects were studied before and during a 14 days head-down tilted bed rest as well as during an ambulatory study period of a similar length. The whole experiment was repeated while the subjects were on a low calorie diet. Thrombocyte noradrenaline levels were studied in 4 cosmonauts before and within 12 hours after landing after more than 7 days in flight. Thrombocyte noradrenaline decreased markedly during the head-down tilted bed rest (p<0.001), whereas there were no significant changes in the ambulatory study. Plasma noradrenaline decreased in the adaptation period but not during the intervention. During microgravity thrombocyte noradrenaline increased in four cosmonauts and the percentage changes were significantly different in cosmonauts and in subjects

  7. [THE INFLUENCE OF CYTOFLAVIN AND CARDIOXIPIN ON THE PARAMETERS OF 24-HOUR ARTERIAL PRESSURE MONITORING IN PATIENTS WITH CHRONIC CEREBRAL CIRCULATION INSUFFICIENCY, ARTERIAL HYPERTENSION AND HYPERCHOLESTEROLEMIA].

    PubMed

    Vodop'ianova, O A; Moiseeva, I Ia; Rodina, O P; Kustikova, I N; Antropova, N V

    2015-01-01

    This comparative study of the influence of cytoflavin and cardioxipin on the parameters of 24-hour arterial pressure monitoring in 56 patients with chronic cerebral circulation insufficiency, arterial hypertension and hypercholesterolemia included 32 women and 24 men aged 42-72 years divided into 3 groups matchedfor the stage of diseases, age, sex, severity of AH, total cholesterol level, and antihypertensive therapy. Patients of group 1 were treated without cytoflavin and cardioxipin. Those in group 2 received daily i/v droplet infusion of 10 mg/kg cardioxipin (20-30 droplets/min). Patients of group 3 were given daily i/v droplet infusion of 10 ml cytoflavin in 200 ml 0.9% sodium chloride solution for 10 days. 24-hour arterial pressure monitoring was used to estimate the influence of the two drugs on systolic and diastolic pressure, its daily rhythm, AP variability and frequency of elevation. The study showed that both therapeutic modalities improved daily AP rhythm as manifested in a significant increase of the number of patients with the dipper rhythm and a decrease in the number of systolic/diastolic non-dipper patients. Moreover cytoflavin significantly decreased the number of systolic over-dippers compared with control group. PMID:26117922

  8. Insights about serum sodium behavior after 24 hours of continuous renal replacement therapy

    PubMed Central

    Romano, Thiago Gomes; Martins, Cassia Pimenta Barufi; Mendes, Pedro Vitale; Besen, Bruno Adler Maccagnan Pinheiro; Zampieri, Fernando Godinho; Park, Marcelo

    2016-01-01

    Objective The aim of this study was to investigate the clinical and laboratorial factors associated with serum sodium variation during continuous renal replacement therapy and to assess whether the perfect admixture formula could predict 24-hour sodium variation. Methods Thirty-six continuous renal replacement therapy sessions of 33 patients, in which the affluent prescription was unchanged during the first 24 hours, were retrieved from a prospective collected database and then analyzed. A mixed linear model was performed to investigate the factors associated with large serum sodium variations (≥ 8mEq/L), and a Bland-Altman plot was generated to assess the agreement between the predicted and observed variations. Results In continuous renal replacement therapy 24-hour sessions, SAPS 3 (p = 0.022) and baseline hypernatremia (p = 0.023) were statistically significant predictors of serum sodium variations ≥ 8mEq/L in univariate analysis, but only hypernatremia demonstrated an independent association (β = 0.429, p < 0.001). The perfect admixture formula for sodium prediction at 24 hours demonstrated poor agreement with the observed values. Conclusions Hypernatremia at the time of continuous renal replacement therapy initiation is an important factor associated with clinically significant serum sodium variation. The use of 4% citrate or acid citrate dextrose - formula A 2.2% as anticoagulants was not associated with higher serum sodium variations. A mathematical prediction for the serum sodium concentration after 24 hours was not feasible. PMID:27410407

  9. Diurnal 24-hour rhythm in ambulatory heart rate variability during the day shift in rotating shift workers.

    PubMed

    Yoshizaki, Takahiro; Kawano, Yukari; Tada, Yuki; Hida, Azumi; Midorikawa, Toru; Hasegawa, Kohe; Mitani, Takeshi; Komatsu, Taiki; Togo, Fumiharu

    2013-06-01

    Circadian variation in cardiac autonomic nervous system activity and behavior during the day shifts of shift workers has not hitherto been clarified. This study examined diurnal 24-h variation in heart rate variability (HRV), sleep-wake cycle, physical activity, and food intake during the day shift in rotating shift workers. The subjects were female nurses and caregivers working at a health care facility (14 day workers and 13 rotating shift workers). Each subject was asked to undergo 24-h electrocardiograph and step count recordings. Coarse graining spectral analysis was used for approximately 10-min segments of HRV (600 beats) to derive the total power (TOT: >0.04 Hz), integrated power in the low-frequency (LF: 0.04-0.15 Hz) and high-frequency (HF: >0.15 Hz) ranges, the ratio of HF power to TOT (HF nu), and the ratio of LF power to HF power (LF/HF). Double cosinor analysis was used to obtain 24-h and 12-h period variations in variables of HRV and physical activity. While no difference was found in the acrophases of either period for step counts or in the 12-h period of HRV variables between the groups, the acrophases of the 24-h period for HRV variables were delayed by 1.3 to 5.5 h in rotating shift workers, and their differences in HF power, HF nu, and LF/HF reached a significant level (p < 0.05). On the days of the experiment, retiring time, waking up time, total time in bed, sleep efficiency, and mealtimes and energy intake for each diet did not differ between the groups. These results suggest that there is a possibility of an abnormal phase angle between circadian variation in cardiac autonomic nervous system activity and the sleep-wake cycle during the day shift in shift workers. PMID:23735502

  10. The Road Ahead to Continuous 24-Hour Intraocular Pressure Monitoring in Glaucoma

    PubMed Central

    Mansouri, Kaweh

    2014-01-01

    Intraocular pressure (IOP) is the only treatable risk factor for glaucoma. Yet, current glaucoma management usually relies on single IOP measurements during clinic hours despite the fact that IOP is a dynamic parameter with individual rhythms. Single IOP measurements underpin all major clinical guidelines on treatment of glaucoma. Other potentially informative parameters, such as IOP fluctuations and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. The search for continuous 24-hour IOP monitoring started over 50 years ago, but only recent technological advances have provided clinician-researchers with devices for continuous IOP monitoring. Herein, we discuss innovative approaches with permanent and temporary devices for 24-hour IOP monitoring, such as a contact lens sensor. Despite being in their infancy, these devices may soon enable clinicians to use 24-hour IOP data to improve glaucoma management and reduce the glaucoma-related burden of disease. PMID:25279129

  11. Microtensile bond strength of resin-resin interfaces after 24-hour and 2-month soaking.

    PubMed

    Leavitt, Curry; Boberick, Kenneth G; Winkler, Sheldon

    2007-01-01

    Evaluate the bond strengths of denture base-repair materials to minimize recurrent failure rate. Use microtensile bond strength (muTBS) testing to evaluate the interfacial bonding strength of 6 commercial denture repair materials after 24-hour and 12-month soaking. Blocks of poly(methyl metacrylate) (PMMA) and Triad were fabricated, fractured, and repaired. Twenty bars (1 x 1 x 30 mm) per group were sectioned from each block parallel to the long axis and approximately 90 degrees to the resin-resin repair interface and stored before muTBS testing in a servo-hydraulic tensile-testing machine. Intact PMMA and Triad bars that had been soaked for 24 hours and 12 months were tested for reference. The 24-hour repair strengths for PMMA ranged from 52% to 84% of original strength. Soaking for 12 months resulted in a 20% decrease in strength for the PMMA control. The 12-month repair strengths for PMMA ranged from 43% to 74% of the 12-month soaked material strength. Triad repair tested 35% of original strength after soaking for 24 hours. Permabond (cyanoacrylate) to PMMA tested 47% of original strength after 24 hours of soaking and 26% of the 12-month soaked material strength. Permabond to Triad tested 30% of original strength after 24 hours of soaking. Permabond and Triad showed a 100% adhesive mode of failure. All other materials tested exhibited either an adhesive mode of failure at the denture base-repair-material interface or a complex cohesive failure within the repair-material interface. The muTBS approach can be used to analyze the resin-resin interface of repaired acrylics. The relatively small standard deviations make the muTBS approach attractive. In this study, muTBS was used to evaluate the repair strength of 6 denture repair materials enabling clinicians to make clinical judgments regarding the strongest repair bond available. PMID:17987865

  12. The Three-Continent, 24-Hour Help Desk: An Academic First?

    ERIC Educational Resources Information Center

    Sykes, Jean

    2002-01-01

    Describes Follow the Sun, a computer help-desk service that takes advantage of time differences around the world to permit four universities (University of Colorado Boulder, Australia's Macquarie and Newcastle universities, and the London School of Economics) to share services and provide 24-hour support to users. (EV)

  13. Oropharyngeal 24-Hour pH Monitoring in Children With Airway-Related Problems

    PubMed Central

    Mesallam, Tamer A.

    2016-01-01

    Objectives Diagnosis and clinical presentation of pediatric laryngopharyngeal reflux (LPR) is still controversial. The aims of this work were to study the possibility of performing 24-hour oropharyngeal pH monitoring for children in the outpatient clinic setup and to explore the results of this test in correlation to airway-related problems. Methods In this descriptive qualitative study, 26 children suffering from airway-related problems were included. Oropharyngeal 24-hour pH monitoring was performed for all subjects in the outpatient clinic setting. The distribution of airway diagnoses among the study group was studied versus the results of the pH monitoring. Results There were 16 males and 10 females participated in the study with a mean age of 6.88 (SD, ±5.77) years. Thirty-five percent of the patients were under the age of 3 years (range, 11 months to 3 years). Eight-five percent of the patients tolerated the pH probe insertion and completed 24-hour of pH recording. Laryngomalacia and subglottic stenosis (SGS) were more frequently reported in the positive LPR patients (77%). Conclusion Oropharyngeal 24-hour pH monitoring can be conducted for children in the outpatient setup even in young age children below 3 years old. Among the positive LPR group, SGS and laryngomalacia were the most commonly reported airway findings. PMID:27090271

  14. Assessing dietary intake in childhood cancer survivors: Food frequency questionnaire versus 24-hour diet recalls

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cancer diagnosis and treatment may influence dietary intake. The validity of using self-reported methods to quantify dietary intake has not been evaluated in childhood cancer survivors. We validated total energy intake (EI) reported from Food Frequency Questionnaire (FFQ) and repeated 24-hour diet r...

  15. 24-Hour Access: Responding to Students' Need for Late Library Hours at the University of Denver

    ERIC Educational Resources Information Center

    Sewell, Bethany B.

    2013-01-01

    The University of Denver's Penrose Library saw a substantial increase in use as a result of several new and enhanced services over a six-year period. In turn, longer operating hours and increased staffing for a 24-hours-a-day, five-days-a-week (24 x 5) operating schedule was funded. This case study analyzes student need for longer library hours…

  16. Mood-Dependent Cognitive Change in a Man with Bipolar Disorder Who Cycles Every 24 Hours

    ERIC Educational Resources Information Center

    Lam, Dominic; Mansell, Warren

    2008-01-01

    A case study of a bipolar patient whose mood changes every 24 hours is described to illustrate the changes in cognitive processing and content during different phases of bipolar disorder. The participant completed a battery of questionnaires and tasks on 4 separate occasions: twice when depressed and twice when manic. Depression tended to be…

  17. Urinary electrolyte excretion in 24 hours and blood pressure in the INTERSALT Study. I. Estimates of reliability. The INTERSALT Cooperative Research Group.

    PubMed

    Dyer, A R; Shipley, M; Elliott, P

    1994-05-01

    This is the first of two reports dealing with the reliability of measurements of 24-hour urinary electrolyte excretion and blood pressure and estimates of electrolyte-blood pressure associations in INTERSALT, an international study of the relations of electrolyte excretion and other factors to blood pressure, involving more than 10,000 persons from 52 centers in 32 countries. This first report describes methods for estimating reliability, taking into account age and sex, and provides estimates for several urinary variables, blood pressure, and pulse rate. The second report (Am J Epidemiol 1994; 139:940-51) uses these estimates of reliability and multivariate procedures to correct multiple regression coefficients from regressions of blood pressure on 24-hour urinary sodium and potassium excretion, body mass index, and alcohol intake for "regression dilution bias." Age- and sex-adjusted estimates of reliability were computed from data on 805 INTERSALT participants with repeat measurements. These estimates ranged from 0.37 to 0.40 for 24-hour urinary sodium, from 0.47 to 0.52 for potassium, from 0.32 to 0.36 for the sodium:potassium ratio, from 0.64 to 0.69 for calcium, from 0.59 to 0.65 for creatinine, from 0.49 to 0.57 for urinary volume, from 0.49 to 0.51 for magnesium, from 0.58 to 0.62 for pulse, from 0.69 to 0.74 for systolic blood pressure, and from 0.63 to 0.67 for diastolic blood pressure. In addition, estimates of within- and between-person covariances among electrolytes indicated that about half of the observed covariance for sodium and potassium excretion in a single 24-hour urine collection was due to within-person covariation in excretion. PMID:8166143

  18. [Identification of paroxysmal, transient arrhythmias: Intermittent registration more efficient than the 24-hour Holter monitoring].

    PubMed

    Hendrikx, Tijn; Rosenqvist, Mårten; Sandström, Herbert; Persson, Mats; Hörnsten, Rolf

    2015-01-01

    Many patients suffer from palpitations or dizziness/presyncope. These patients are often referred for Holter ECG (24 hour), although the sensitivity for detecting arrhythmias is low. A new method, short intermittent regular and symptomatic ECG registrations at home, might be a convenient and more sensitive alternative also suitable for primary health care. In this case report we present a patient who had contacted health care several times during a seven year period for paroxysmal palpitations. Routine examination with 24 hour Holter ECG and event recorder did not result in a diagnosis. Using intermittent handheld ECG registration at home, a paroxysmal supraventricular arrhythmia was diagnosed. Further investigation revealed that the patient had a concealed Wolff-Parkinson-White (WPW) syndrome. PMID:25584602

  19. The association of resting state heart rate variability and 24-hour blood pressure variability in spinal cord injury.

    PubMed

    Thayer, Julian F; Sollers, John J; Clamor, Annika; Koenig, Julian; Hagglund, Kristofer J

    2016-02-15

    Patients with high cervical complete spinal cord injuries (tetraplegia) sustain damage to the autonomic neural pathways that influence cardiovascular functioning and produce variability in the heart rate (HR) and blood pressure (BP). In non-injured individuals, an inverse relationship exists between resting autonomic control of the heart (as evidenced by HR variability (HRV)) and BP variability (BPV). This study examined the relationship between HRV, BP and BPV in individuals with tetraplegic (n=10) and paraplegic (n=10) spinal cord injuries, and a group of healthy controls (n=14). Resting HRV at baseline and 24-hour ambulatory BP measurements were collected from electrocardiogram measures of each participant. HRV was quantified using time- and frequency-domain measures. The standard deviation of the BP measurements was used as an index of BPV. Multivariate analyses of variance were performed to examine group differences for laboratory-based and 24-h dependent variables. The MANOVAs for HRV parameters (λ(14,50)=.352, p=.010, η(2)=.407) and for BP indices and HR (λ(16,48)=.318, p=.013, η(2)=.436) were significant. Furthermore, in line with existing evidence, we found that vagally mediated HRV was inversely related to BPV in healthy controls. However, this relationship did not hold for the tetraplegia group (ρ<|.42|), and mixed results were found for the paraplegia group (e.g., ρ<|.29| for time domain HRV, ρ>|.65| for low-frequency power). These results support the conclusion that the damage to the spinal sympathetic pathways to the heart found in people with tetraplegia causes a significant disruption in baroreflex control of BP. PMID:26810517

  20. Circadian Polymorphisms in Night Owls, in Bipolars, and in Non-24-Hour Sleep Cycles

    PubMed Central

    Klimecki, Walter T.; Nievergelt, Caroline M.; Rex, Katharine M.; Murray, Sarah S.; Shekhtman, Tatyana; Tranah, Gregory J.; Loving, Richard T.; Lee, Heon-Jeong; Rhee, Min Kyu; Shadan, Farhad F.; Poceta, J. Steven; Jamil, Shazia M.; Kline, Lawrence E.; Kelsoe, John R.

    2014-01-01

    People called night owls habitually have late bedtimes and late times of arising, sometimes suffering a heritable circadian disturbance called delayed sleep phase syndrome (DSPS). Those with DSPS, those with more severe progressively-late non-24-hour sleep-wake cycles, and those with bipolar disorder may share genetic tendencies for slowed or delayed circadian cycles. We searched for polymorphisms associated with DSPS in a case-control study of DSPS research participants and a separate study of Sleep Center patients undergoing polysomnography. In 45 participants, we resequenced portions of 15 circadian genes to identify unknown polymorphisms that might be associated with DSPS, non-24-hour rhythms, or bipolar comorbidities. We then genotyped single nucleotide polymorphisms (SNPs) in both larger samples, using Illumina Golden Gate assays. Associations of SNPs with the DSPS phenotype and with the morningness-eveningness parametric phenotype were computed for both samples, then combined for meta-analyses. Delayed sleep and "eveningness" were inversely associated with loci in circadian genes NFIL3 (rs2482705) and RORC (rs3828057). A group of haplotypes overlapping BHLHE40 was associated with non-24-hour sleep-wake cycles, and less robustly, with delayed sleep and bipolar disorder (e.g., rs34883305, rs34870629, rs74439275, and rs3750275 were associated with n=37, p=4.58E-09, Bonferroni p=2.95E-06). Bright light and melatonin can palliate circadian disorders, and genetics may clarify the underlying circadian photoperiodic mechanisms. After further replication and identification of the causal polymorphisms, these findings may point to future treatments for DSPS, non-24-hour rhythms, and possibly bipolar disorder or depression. PMID:25395965

  1. Recovery of amplitude integrated electroencephalographic background patterns within 24 hours of perinatal asphyxia

    PubMed Central

    van Rooij, L G M; Toet, M; Osredkar, D; van Huffelen, A C; Groenendaal, F; de Vries, L S

    2005-01-01

    Objective: To assess the time course of recovery of severely abnormal initial amplitude integrated electroencephalographic (aEEG) patterns (flat trace (FT), continuous low voltage (CLV), or burst suppression (BS)) in full term asphyxiated neonates, in relation to other neurophysiological and neuroimaging findings and neurodevelopmental outcome. Methods: A total of 190 aEEGs of full term infants were reviewed. The neonates were admitted within 6 hours of birth to the neonatal intensive care unit because of perinatal asphyxia, and aEEG recording was started immediately. In all, 160 infants were included; 65 of these had an initial FT or CLV pattern and 25 an initial BS pattern. Neurodevelopmental outcome was assessed using a full neurological examination and the Griffiths' mental developmental scale. Results: In the FT/CLV group, the background pattern recovered to continuous normal voltage within 24 hours in six of the 65 infants (9%). All six infants survived the neonatal period; one had a severe disability, and five were normal at follow up. In the BS group, the background pattern improved to normal voltage in 12 of the 25 infants (48%) within 24 hours. Of these infants, one died, five survived with moderate to severe disability, two with mild disability, and four were normal. The patients who did not recover within 24 hours either died in the neonatal period or survived with a severe disability. Conclusion: In this study there was a small group of infants who presented with a severely abnormal aEEG background pattern within six hours of birth, but who achieved recovery to a continuous normal background pattern within the first 24 hours. Sixty one percent of these infants survived without, or with a mild, disability. PMID:15846017

  2. Patients in 24-hour home care striving for control and safety

    PubMed Central

    2012-01-01

    Background This article concerns Swedish patients receiving 24-hour home care from health care assistants (HC assistants) employed by the municipality. Home care is a complex interactive process involving the patient, family, HC assistants as well as professional care providers. Previous studies exploring patient perspectives on home care have been based mainly on patient interviews. In contrast, the present study took a broad perspective on patients’ experiences and thoughts by combining field observations on care situations with patient and HC assistant interviews. The aim of the study presented in this article was to promote a new and broadened understanding of patients receiving 24-hour home care by constructing a theoretical model to illuminate their main concern. Methods Field observations and semi-structured interviews were conducted with four patients receiving 24-hour home care and their HC assistants. Grounded theory methodology was used. Results The core process identified was Grasping the lifeline, which describes compensatory processes through which patients strived for control and safe care when experiencing a number of exposed states due to inadequate home care. Patients tried to take control by selecting their own HC assistants and sought safe hands by instructing untrained HC assistants in care procedures. When navigating the care system, the patients maintained contacts with professional care providers and coordinated their own care. When necessary, a devoted HC assistant could take over the navigating role. The results are illuminated in a theoretical model. Conclusions The results accentuate the importance to patients of participating in their own care, especially in the selection of HC assistants. The model illustrates some challenging areas for improvement within the organisation of 24-hour home care, such as personnel continuity and competence, collaboration, and routines for acute care. Furthermore, it may be used as a basis for reflection

  3. Mechanical properties of direct and indirect composites after storage for 24 hours and 10 months

    PubMed Central

    Alves, Paula Barbosa; Brandt, William Cunha; Neves, Ana Christina Claro; Cunha, Leonardo Gonçalves; Silva-Concilio, Lais Regiane

    2013-01-01

    Objective: The objective of this study was to evaluate the diametral tensile strength (DTS) and Knoop hardness (KH) of direct (Filtek Z350-3M/ESPE and Charisma-Heraeus Kulzer) and indirect composites (Sinfony-3M/ESPE and Signum-Heraeus Kulzer) kept in storage for two periods of time, 24 hours and 10 months, in distilled water. Methods: Twenty-five specimens of each material were prepared. DTS (n=10) was tested using a universal testing machine (Versat, model 2000) at a crosshead speed of 1.0 mm/min. KH (n=5) was measured using Knoop micro-hardness (HMV-2000; 50 gf for 15 s). All tests were performed 24 hours after polymerization and after 10 months of storage in distilled water at 37°C. The data were statistically analyzed using Kolmogorov-Smirnov, ANOVA and t-Student (P=.05). Results: Filtek Z350, Sinfony, and Signum showed higher DTS values than Charisma after 24 hours. After storage, Sinfony and Signum showed higher DTS values because the storage did not influence the DTS values of the indirect composites. Filtek Z350 showed higher KH values after 24 hours and after storage than other composites; the storage influenced the KH of all composites except Sinfony. Conclusion: Storage for 10 months did not influence the properties of the indirect composite Sinfony. In general, the indirect composites showed higher DTS values than direct composites, especially after 10 months storage. The direct composite Filtek Z350 obtained the highest KH values regardless of storage. PMID:23407869

  4. Analogue step-by-step DC component eliminator for 24-hour PPG signal monitoring.

    PubMed

    Pilt, Kristjan; Meigas, Kalju; Lass, Jaanus; Rosmann, Mart; Kaik, Jüri

    2007-01-01

    For applications where PPG signal AC component needs to be measured without disturbances in its shape and recorded digitally with high digitalization accuracy, the step-by-step DC component eliminator is developed. This paper describes step-by-step DC component eliminator, which is utilized with analogue comparator and operational amplifier. It allows to record PPG signal without disturbances in its shape in 24-hours PPG signal monitoring system. The experiments with PPG signal have been carried out. PMID:18002130

  5. 24-hour-restraint stress induces long-term depressive-like phenotypes in mice.

    PubMed

    Chu, Xixia; Zhou, Ying; Hu, Zhiqiang; Lou, Jingyu; Song, Wei; Li, Jing; Liang, Xiao; Chen, Chen; Wang, Shuai; Yang, Beimeng; Chen, Lei; Zhang, Xu; Song, Jinjing; Dong, Yujie; Chen, Shiqing; He, Lin; Xie, Qingguo; Chen, Xiaoping; Li, Weidong

    2016-01-01

    There is an increasing risk of mental disorders, such as acute stress disorder (ASD), post-traumatic stress disorder (PTSD) and depression among survivors who were trapped in rubble during earthquake. Such long-term impaction of a single acute restraint stress has not been extensively explored. In this study, we subjected mice to 24-hour-restraint to simulate the trapping episode, and investigated the acute (2 days after the restraint) and long-term (35 days after the restraint) impacts. Surprisingly, we found that the mice displayed depression-like behaviors, decreased glucose uptake in brain and reduced adult hippocampal neurogenesis 35 days after the restraint. Differential expression profiling based on microarrays suggested that genes and pathways related to depression and other mental disorders were differentially expressed in both PFC and hippocampus. Furthermore, the depression-like phenotypes induced by 24-hour-restraint could be reversed by fluoxetine, a type of antidepressant drug. These findings demonstrated that a single severe stressful event could produce long-term depressive-like phenotypes. Moreover, the 24-hour-restraint stress mice could also be used for further studies on mood disorders. PMID:27609090

  6. 24-hour-restraint stress induces long-term depressive-like phenotypes in mice

    PubMed Central

    Zhou, Ying; Hu, Zhiqiang; Lou, Jingyu; Song, Wei; Li, Jing; Liang, Xiao; Chen, Chen; Wang, Shuai; Yang, Beimeng; Chen, Lei; Zhang, Xu; Song, Jinjing; Dong, Yujie; Chen, Shiqing; He, Lin; Xie, Qingguo; Chen, Xiaoping; Li, Weidong

    2016-01-01

    There is an increasing risk of mental disorders, such as acute stress disorder (ASD), post-traumatic stress disorder (PTSD) and depression among survivors who were trapped in rubble during earthquake. Such long-term impaction of a single acute restraint stress has not been extensively explored. In this study, we subjected mice to 24-hour-restraint to simulate the trapping episode, and investigated the acute (2 days after the restraint) and long-term (35 days after the restraint) impacts. Surprisingly, we found that the mice displayed depression-like behaviors, decreased glucose uptake in brain and reduced adult hippocampal neurogenesis 35 days after the restraint. Differential expression profiling based on microarrays suggested that genes and pathways related to depression and other mental disorders were differentially expressed in both PFC and hippocampus. Furthermore, the depression-like phenotypes induced by 24-hour-restraint could be reversed by fluoxetine, a type of antidepressant drug. These findings demonstrated that a single severe stressful event could produce long-term depressive-like phenotypes. Moreover, the 24-hour-restraint stress mice could also be used for further studies on mood disorders. PMID:27609090

  7. A New Method to Make 24-Hour Urine Collection More Convenient: A Validity Study

    PubMed Central

    2014-01-01

    Background and Objectives. This study proposes a novel urine collection device that can divide each urine collection into 20 parts and store and cool just one part. The aim of the current study is to compare measured biomarkers from the proposed urine collection device to those of conventional 24-hour sampling method. We also hypothesized that the new method would significantly increase patients' adherence to the timed urine collection. Methods. Two 24-hour urine samples with the conventional method and with the new automated urine collection device that uses just one-twentieth of each void were obtained from 40 healthy volunteers. Urine parameters including volume, creatinine, and protein levels were compared between the two methods and the agreement of two measurements for each subject was reported through Bland-Altman plots. Results. Our results confirmed that for all three variables, there is a positive correlation (P < 0.001) between the two measurements and high degree of agreement could be seen in Bland-Altman plots. Moreover, more subjects reported the new method as “more convenient” for 24-hour urine collection. Conclusions. Our results clearly indicate that a fixed proportion of each void may significantly reduce the urine volume in timed collections and this, in turn, may increase subjects' adherence to this difficult sampling. PMID:24963405

  8. Phase II trial of cyclophosphamide, leucovorin, 5-fluorouracil 24-hour infusion and tamoxifen in pancreatic cancer.

    PubMed

    Eckel, F; Lersch, C; Lippl, F; Assmann, G; Schulte-Frohlinde, E

    2000-09-01

    Leucovorin modulates the cytotoxic effects of 5-fluorouracil (5-FU) in the treatment of cancer. 24-hour infusion of 5-FU has been shown to enhance antitumor activity in colorectal cancer compared to bolus infusion. According to experimental data cyclophosphamide and tamoxifen may enhance the effectiveness of leucovorin and 5-FU. A phase II trial was initiated to evaluate the effect of a combination of low-dose cyclophosphamide (C), leucovorin (L), 5-FU (F) and tamoxifen (T) (CLFT) in advanced pancreatic cancer. Fifty patients were treated monthly with 300 mg/m2 cyclophosphamide and weekly with 500 mg/m2 leucovorin followed by a 24-hour infusion of 2000 mg/m2 5-FU and tamoxifen 20 mg bid. Three patients had a partial response (6%), two a minor response (4%) and 32 (64%) no change of disease. The median survival time was 8.5 months for all patients, the median time to progression of disease was 4.6 months and the 1-year survival rate was 28%. CLFT was fairly well tolerated. These data suggest that biochemical modulation of 24-hour infusional 5-FU with leucovorin together with cyclophosphamide and tamoxifen has some positive effects in the treatment of pancreatic cancer. PMID:11144522

  9. [Formula creatinine clearance as a substitute for 24-hour creatine clearance in children with kidney transplantation].

    PubMed

    Aufricht, C; Balbisi, A; Gerdov, C; Müller, T; Lothaller, M A; Balzar, E

    1995-01-01

    Despite many theoretical advantages, formula-creatininclearance (Schwartz et al, Journal of Pediatrics 1976) has not found broad clinical acceptance in everyday pediatric patient care. In this study we report our results of long term observations (11.7 +/- 6.8 (1.7-24.8) months) of measured and computed creatininclearance in 27 children after renal transplantation (15 boys, 12 girls, mean age 14.5 +/- 4.2 (5.5-20) years) at the Kinderdialyse of the Universitäts-Kinderklinik of Vienna. We found a wide scattered correlation between the measured and computed creatininclearance values with a 90% confidence interval between -30% to +60% of the 24 hour creatininclearance. Formula creatininclearance (SD 17.8%) was markedly better reproducable than the 24 hour creatininclearancethe (SD 37.8%), the intraindividuell collecting error (36.1%) was almost twice the interindividuell "coefficient" error (20.27%). We therefore conclude that the 24 hour creatininclearance is by far not as accurate as the complexity of the procedure pretends and support broad clinical acceptance for the formula creatininclearance. PMID:7752601

  10. Impact of diet on 24-hour intragastric pH profile in healthy horses.

    PubMed

    Damkel, Cornelia; Snyder, Alice; Uhlig, Albrecht; Coenen, Manfred; Schusser, Gerald Fritz

    2015-01-01

    An electrode incorporated into a polyethylene hose was introduced under endoscopic control into the stomach of six fasting adult horses for long-lasting pH measurements. The intragastric pH was recorded every four seconds for a period of 24 hours. The Warmblood horses were assigned randomly to receive hay ad libitum (H group); 1.5 kg hay/100 kg BW/day and 1 kg concentrate/100 kg BW/ day (C group) or protocol C plus 75 g pectin-lecithin supplement/100 kg BW/day (P group). The horses were adapted to each diet for 14 days. The 24-hour median pH value for protocol H (2.69) was significantly lower compared to protocol C (3.35) and P (3.44) (p < 0.05). The horses in protocol P had a significant higher percentage (40.1 %) of 24-hour intragastric pH values ≥ 4 than in protocol C (36.2 %) or in protocol H (25.3 %) (p < 0.05). PMID:26591378

  11. Factors Associated With High Sodium Intake Based on Estimated 24-Hour Urinary Sodium Excretion

    PubMed Central

    Hong, Jae Won; Noh, Jung Hyun; Kim, Dong-Jun

    2016-01-01

    Abstract Although reducing dietary salt consumption is the most cost-effective strategy for preventing progression of cardiovascular and renal disease, policy-based approaches to monitor sodium intake accurately and the understanding factors associated with excessive sodium intake for the improvement of public health are lacking. We investigated factors associated with high sodium intake based on the estimated 24-hour urinary sodium excretion, using data from the 2009 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Among 21,199 adults (≥19 years of age) who participated in the 2009 to 2011 KNHANES, 18,000 participants (weighted n = 33,969,783) who completed urinary sodium and creatinine evaluations were analyzed in this study. The 24-hour urinary sodium excretion was estimated using Tanaka equation. The mean estimated 24-hour urinary sodium excretion level was 4349 (4286–4413) mg per day. Only 18.5% (weighted n = 6,298,481/3,396,973, unweighted n = 2898/18,000) of the study participants consumed less the 2000 mg sodium per day. Female gender (P < 0.001), older age (P < 0.001), total energy intake ≥50 percentile (P < 0.005), and obesity (P < 0.001) were associated with high sodium intake, even after adjusting for potential confounders. Senior high school/college graduation in education and managers/professionals in occupation were associated with lower sodium intake (P < 0.001). According to hypertension management status, those who had hypertension without medication consumed more sodium than those who were normotensive. However, those who receiving treatment for hypertension consumed less sodium than those who were normotensive (P < 0.001). The number of family members, household income, and alcohol drinking did not affect 24-hour urinary sodium excretion. The logistic regression analysis for the highest estimated 24-hour urinary sodium excretion quartile (>6033 mg/day) using the

  12. Comparison of Office, Ambulatory, and Home Blood Pressure Antihypertensive Response to Atenolol and Hydrochlorthiazide

    PubMed Central

    Beitelshees, Amber L.; Gong, Yan; Bailey, Kent R.; Turner, Stephen T.; Chapman, Arlene B.; Schwartz, Gary L.; Gums, John G.; Boerwinkle, Eric; Johnson, Julie A.

    2010-01-01

    Office, home, and ambulatory blood pressure (BP) demonstrate variable associations with outcomes. The authors sought to compare office BP (OBP), home BP (HBP), and ambulatory BP (ABP) for measuring responses to hydrochlorothiazide (HCTZ), atenolol, and their combination. After completing washout, eligible patients were randomized to atenolol 50 mg or HCTZ 12.5 mg daily. Doses were doubled after 3 weeks and the alternate drug was added after 6 weeks if BP was >120/70 mm Hg (chosen to allow maximum opportunity to assess genetic associations with dual BP therapy in the parent study). OBP (in triplicate), HBP (twice daily for 5 days), and 24-hour ABP were measured at baseline, after monotherapy, and after combination therapy. BP responses were compared between OBP, HBP, and ABP for each monotherapy and combination therapy. In 418 patients, OBP overestimated BP response compared with HBP, with an average 4.6 mm Hg greater reduction in systolic BP (P<.0001) and 2.1 mm Hg greater reduction in diastolic BP (P<.0001) across all therapies. Results were similar for atenolol and HCTZ monotherapy. ABP response was more highly correlated with HBP response (r=0.58) than with OBP response (r=0.47; P=.04). In the context of a randomized clinical trial, the authors have identified significant differences in HBP, OBP, and ABP methods of measuring BP response to atenolol and HCTZ monotherapy. PMID:20047624

  13. 77 FR 65310 - Additional Air Quality Designations for the 2006 24-Hour Fine Particle National Ambient Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... the 2006 24-hour Fine Particle (PM 2.5 ) National Ambient Air Quality Standards,'' 74 FR 58688... Federal Regulations DC District of Columbia EO Executive Order EPA Environmental Protection Agency FR... EPA finalized designations for the 2006 24-hour PM 2.5 NAAQS (74 FR 58688, November 13, 2009), the...

  14. 40 CFR 52.1990 - Interstate Transport for the 2006 24-hour PM2.5 NAAQS.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Interstate Transport for the 2006 24-hour PM2.5 NAAQS. 52.1990 Section 52.1990 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1990 Interstate Transport for the 2006 24-hour PM2.5 NAAQS. (a) EPA approves the portion of...

  15. 40 CFR 52.1990 - Interstate Transport for the 2006 24-hour PM2.5 NAAQS.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 4 2013-07-01 2013-07-01 false Interstate Transport for the 2006 24-hour PM2.5 NAAQS. 52.1990 Section 52.1990 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1990 Interstate Transport for the 2006 24-hour PM2.5 NAAQS. (a) EPA approves the portion of...

  16. 40 CFR 52.1990 - Interstate Transport for the 2006 24-hour PM2.5 NAAQS.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 4 2012-07-01 2012-07-01 false Interstate Transport for the 2006 24-hour PM2.5 NAAQS. 52.1990 Section 52.1990 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1990 Interstate Transport for the 2006 24-hour PM2.5 NAAQS. (a) EPA approves the portion of...

  17. Tasimelteon for the treatment of non-24-hour sleep-wake disorder.

    PubMed

    Neubauer, D N

    2015-01-01

    Tasimelteon (Hetlioz®), a melatonin receptor agonist, is the first, and, at the time of the publication, the only drug to be approved by the U.S. Food and Drug Administration (FDA) for the treatment of non-24-hour sleep-wake disorder (non-24). This circadian rhythm disorder occurs most commonly in blind individuals without light perception, and it results from their inability to entrain to the 24-hour photoperiod, although the indication does not specify a particular patient population. Non-24 is characterized by a persistent cycle of nighttime insomnia and daytime sleepiness, alternating with asymptomatic periods depending on an individual's degree of circadian rhythm synchronization with the photoperiod at any particular time. Phase II clinical trials in healthy individuals confirmed the circadian phase-shifting potential of tasimelteon. Phase III trials in totally blind subjects diagnosed with non-24 demonstrated the efficacy of tasimelteon in reducing both nighttime wakefulness and daytime napping. Physiologic monitoring revealed that tasimelteon resulted in a higher proportion of individuals becoming entrained to the 24-hour cycle compared with placebo. Safety assessments indicated that tasimelteon is well tolerated, with the most common adverse events being headache, alanine aminotransferase elevation, nightmares or unusual dreams, and upper respiratory or urinary tract infections. Tasimelteon is available as a capsule in a single 20-mg dose and it must be obtained through Vanda Pharmaceutical's HetliozSolutions program with dispensing through a specialty pharmacy. Safety studies in blind individuals diagnosed with non-24 are ongoing and a future clinical trial with Smith-Magenis syndrome patients is planned. PMID:25685859

  18. Bioenergetical and Cardiac Adaptations of Pilots to a 24-Hour Team Kart Race.

    PubMed

    Durand, Sylvain; Ripamonti, Michael; Rahmani, Abderrahmane; Beaune, Bruno

    2015-11-01

    This study aimed to evaluate energy expenditure (EE) and heart rate (HR) response in kart pilots to successive driving bouts during a 24-hour team race. Eight adult male pilots (22.8 ± 4.1 years) participated to a team 24-hour speedway kart race in Le Mans (France). They alternatively piloted a 390 cm kart. Each relay was 45 minutes long and each pilot performed 4 relays. For each pilot, mean speeds were calculated from lap-to-lap duration recordings using a telemetric infrared timing device. Heart rate values were recorded continuously on 5-second intervals using a portable cardiometric device. Total energy expenditure (EET) and physical activity ratio (PAR) were determined by accelerometry. To pilot a kart during 45 minutes at a mean speed around 62 km·h induces a 300-kcal EET, corresponding to a 5.6-Mets PAR. This effort is responsive for a 73 b·min increase in HR, from 84.1 ± 7.6 to 157.4 ± 11.0 b·min (82% maximal heart rate intensity). However, during this relay period, HR values seemed independent to mean speed performance and bioenergetical values. Thus, in the context of the 24-hour team race, the variability in effort made during each relay and relay succession did not alter bioenergetical adaptation of pilots to kart driving. The high EE and HR values would be better explained by both emotional stress and environmental constraints such as speedway configuration and vibrations. The way how these factors specifically influence bioenergetical demand, and their relative importance, has to be specified to optimize training procedure and recommendations. PMID:25029011

  19. Evaluation of Intradermal and Subcutaneous Infusion Set Performance Under 24-Hour Basal and Bolus Conditions

    PubMed Central

    McVey, Elaine; Keith, Steven; Herr, Joshua K.; Sutter, Diane; Pettis, Ronald J.

    2015-01-01

    Background: This study sought to assess the function and delivery reliability of intradermal (ID) infusion sets used with commercial insulin pumps. Method: Healthy subjects (n = 43) were randomized to either ID or subcutaneous (SC) arms, and received basal/bolus placebo delivery for 24 hours. Subjects received 4 of 8 infusion set combinations (ID: microneedle design A or B, with 2 pump brands [Animas or MiniMed]; SC: Teflon Quickset or steel Rapid-D, Animas pump only, with or without overtaping) and were evaluated for pump occlusion alarms, fluid leakage, pain, and tissue tolerability. A novel algorithm was developed to determine flow consistency based on fluid pressure, and the duration and occurrence rate for periods of unalarmed but interrupted flow (“silent occlusions’”) were compared. Results: ID delivery was successfully maintained over the 24-hour infusion period. The number of silent occlusions was lower for ID microneedle cannula design B than A (P < .01) and lower for Rapid-D SC device compared to Quick-set (P = .03). There was no significant difference in the number of occlusion alarms between the ID and SC devices with the Animas pump. However, the pumps tested with ID devices had significantly different alarm rates (MiniMed 29.5%, Animas 0%, P < .001). Leakage and tissue tolerability were comparable across devices. Conclusion: The ID infusion set reliably delivered diluent for an extended 24-hour period in healthy subjects and was well tolerated. Silent occlusion flow interruptions could be detected in both ID and SC infusion sets using a proprietary algorithm. This algorithm is a promising method for quantitatively evaluating infusion set flow performance. PMID:26319228

  20. Implementation of a 24-Hour Pharmacy Service with Prospective Medication Review in the Emergency Department

    PubMed Central

    Yee, Linda; Claudio-Saez, Maria; Halim, Qazi; Marshall, Lewis; Hayes-Quinn, Mary

    2015-01-01

    Background: It is reported that more than 128 million patients are seen in emergency departments (EDs) annually. Patient overcrowding had been associated with an increased occurrence of medication errors. Purpose: Due to increased patient volume and the need for improved patient safety, a 24-hour pharmacy service was established for our institution’s ED. The purpose of the study is to quantify and demonstrate the impact of a 24-hour pharmacy service in an urban ED. Methods: This was a retrospective descriptive study conducted at a regional level 1 trauma center. The study period occurred between December 2012 and July 2013. The following variables were quantified and analyzed: number of medication orders reviewed, number of intravenous medications compounded, and number of clinical interventions that were recommended by the ED pharmacy team (EDPT) and accepted by ED clinicians. Results: A total of 3,779 medication orders were reviewed by the EDPT. Of these orders, 3,482 (92%) were prospectively reviewed. A total of 3,068 (81.2%) and 711 (18.8%) orders were reviewed for the adult and pediatric ED, respectively. During the study period, the EDPT procured 549 intravenous admixtures and conducted 642 clinical interventions. Most of the interventions involved providing drug information for physicians and nurses (45.9%), adjusting drug dosages (21.1%), and recommending antimicrobial therapy (15.1%). Conclusion: The implementation of a 24-hour pharmacy service at our institution was an innovative practice that increased the role of pharmacists in the ED. The EDPT conducted prospective medication review, procured intravenous admixtures from a sterile environment, and provided therapeutic recommendations for the ED interdisciplinary team. PMID:25717209

  1. Treating allergic conjunctivitis: A once-daily medication that provides 24-hour symptom relief

    PubMed Central

    Schaeffer, Jack; Donnenfeld, Eric

    2016-01-01

    Background: Allergic conjunctivitis (AC) is a common ocular inflammatory manifestation of allergen exposure in sensitized individuals. Signs and symptoms of AC can decrease quality of life, interfere with productivity, and lead to considerable economic burden. Consistent suppression of conjunctival inflammation is necessary for managing AC, but currently available medications require frequent administration and exhibit limited duration of action. Methods: In this review, we summarized AC pathogenesis, diagnosis, and current treatment options as well as their limitations. Findings from the literature were discussed in the context of the unmet need for a once-daily medication with sustained 24-hour effectiveness. Results: Topical pharmacologic treatments are the most common approach for managing extant AC; however, most available medications require multiple daily instillations. Dual-acting antihistamine-mast cell stabilizing agents are currently considered first-line therapeutics for AC because they provide acute relief of signs and symptoms and block persistent inflammation to promote regression of AC. Recent studies of a newly-developed, higher-concentration formulation of a dual-acting antihistamine-mast cell stabilizer have demonstrated that this formulation provides a 24-hour duration of action with once-daily dosing. Conclusions: Dual-acting AC medications exhibit a high degree of overall effectiveness and are well tolerated for chronic use. A newly available once-daily medication that manages signs and symptoms of AC for a full 24 hours may be considered a treatment of choice for patients experiencing seasonal or perennial AC. ClinicalTrials.gov NCT01743027 and NCT01479374 PMID:27466061

  2. Comparison of observation level versus 24-hour average atmospheric loading corrections in VLBI analysis

    NASA Astrophysics Data System (ADS)

    MacMillan, D. S.; van Dam, T. M.

    2009-04-01

    Variations in the horizontal distribution of atmospheric mass induce displacements of the Earth's surface. Theoretical estimates of the amplitude of the surface displacement indicate that the predicted surface displacement is often large enough to be detected by current geodetic techniques. In fact, the effects of atmospheric pressure loading have been detected in Global Positioning System (GPS) coordinate time series [van Dam et al., 1994; Dong et al., 2002; Scherneck et al., 2003; Zerbini et al., 2004] and very long baseline interferometery (VLBI) coordinates [Rabble and Schuh, 1986; Manabe et al., 1991; van Dam and Herring, 1994; Schuh et al., 2003; MacMillan and Gipson, 1994; and Petrov and Boy, 2004]. Some of these studies applied the atmospheric displacement at the observation level and in other studies, the predicted atmospheric and observed geodetic surface displacements have been averaged over 24 hours. A direct comparison of observation level and 24 hour corrections has not been carried out for VLBI to determine if one or the other approach is superior. In this presentation, we address the following questions: 1) Is it better to correct geodetic data at the observation level rather than applying corrections averaged over 24 hours to estimated geodetic coordinates a posteriori? 2) At the sub-daily periods, the atmospheric mass signal is composed of two components: a tidal component and a non-tidal component. If observation level corrections reduce the scatter of VLBI data more than a posteriori correction, is it sufficient to only model the atmospheric tides or must the entire atmospheric load signal be incorporated into the corrections? 3) When solutions from different geodetic techniques (or analysis centers within a technique) are combined (e.g., for ITRF2008), not all solutions may have applied atmospheric loading corrections. Are any systematic effects on the estimated TRF introduced when atmospheric loading is applied?

  3. [Program for early detection of illness level in foals during the first 24 hours of life].

    PubMed

    Bostedt, H; Hospes, R; Herfen, K

    1997-11-01

    Basing on exact investigations of normal behaviour and abnormalities in newborn and up to 24 hours old foals a program for evaluation, comprehending exogeniously judgable criteria, was developed. It aims at a quick recognition of aberrations in behaviour. The program includes a score, which allows early diagnosis of even subtile abnormalities. As a result, a veterinary surgeon should be consulted if the score exposes a critical situation, so that therapy can be started in time. Furthermore informations about investigations on blood-glucose- and immunoglobulin-G-concentration in relation to neonatal foal diseases are given. PMID:9451764

  4. Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias

    PubMed Central

    2014-01-01

    Background Many patients report symptoms of palpitations or dizziness/presyncope. These patients are often referred for 24-hour Holter ECG, although the sensitivity for detecting relevant arrhythmias is comparatively low. Intermittent short ECG recording over a longer time period might be a convenient and more sensitive alternative. The objective of this study is to compare the efficacy of 24-hour Holter ECG with intermittent short ECG recording over four weeks to detect relevant arrhythmias in patients with palpitations or dizziness/presyncope. Methods Design: prospective, observational, cross-sectional study. Setting: Clinical Physiology, University Hospital. Patients: 108 consecutive patients referred for ambiguous palpitations or dizziness/presyncope. Interventions: All individuals underwent a 24-hour Holter ECG and additionally registered 30-second handheld ECG (Zenicor EKG® thumb) recordings at home, twice daily and when having cardiac symptoms, during 28 days. Main outcome measures: Significant arrhythmias: atrial fibrillation (AF), paroxysmal supraventricular tachycardia (PSVT), atrioventricular (AV) block II–III, sinus arrest (SA), wide complex tachycardia (WCT). Results 95 patients, 42 men and 53 women with a mean age of 54.1 years, completed registrations. Analysis of Holter registrations showed atrial fibrillation (AF) in two patients and atrioventricular (AV) block II in one patient (= 3.2% relevant arrhythmias [95% CI 1.1–8.9]). Intermittent handheld ECG detected nine patients with AF, three with paroxysmal supraventricular tachycardia (PSVT) and one with AV-block-II (= 13.7% relevant arrhythmias [95% CI 8.2–22.0]). There was a significant difference between the two methods in favour of intermittent ECG with regard to the ability to detect relevant arrhythmias (P = 0.0094). With Holter ECG, no symptoms were registered during any of the detected arrhythmias. With intermittent ECG, symptoms were registered during half of the arrhythmia

  5. Assessing Dietary Intake in Childhood Cancer Survivors: Food Frequency Questionnaire Versus 24-Hour Diet Recalls.

    PubMed

    Zhang, Fang Fang; Roberts, Susan B; Must, Aviva; Wong, William W; Gilhooly, Cheryl H; Kelly, Michael J; Parsons, Susan K; Saltzman, Edward

    2015-10-01

    Cancer diagnosis and treatment may influence dietary intake. The validity of using self-reported methods to quantify dietary intake has not been evaluated in childhood cancer survivors. We validated total energy intake (EI) reported from Food Frequency Questionnaire (FFQ) and repeated 24-hour diet recalls (24HRs) against total energy expenditure (TEE) measured using the doubly labeled water method in 16 childhood cancer survivors. Dietary underreporting, assessed by (EI-TEE)/TEE × 100%, was 22% for FFQ and 1% for repeated 24HRs. FFQ significantly underestimates dietary intake and should not be used to assess the absolute intake of foods and nutrients in childhood cancer survivors. PMID:25883059

  6. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns

    PubMed Central

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  7. Comparison of 3 different anesthetic techniques on 24-hour recovery after otologic surgical procedures.

    PubMed

    Jellish, W S; Leonetti, J P; Fahey, K; Fury, P

    1999-03-01

    Intravenous propofol anesthesia is better than inhalational anesthesia for otologic surgery, but cost and intraoperative movement make this technique prohibitive. This study compares a propofol sandwich anesthetic with a total propofol or inhalational anesthetic for otologic surgery to determine which produces the best perioperative conditions and least expense. One hundred twenty patients undergoing ear surgery were randomly chosen to receive an anesthetic with either isoflurane (INHAL), total propofol (TPROP), or propofol used in conjunction with isoflurane (PSAND). Postoperative wakeup and the incidence and severity of nausea, vomiting, and pain were compared among groups. Antiemetic administration and discharge times from recovery and the hospital were also compared. The groups were similar, but anesthesia times were longer in the INHAL group. Emergence from anesthesia after PSAND or TPROP was more rapid than after INHAL. Recovery during the next 24 hours was associated with less nausea and vomiting with PSAND than with INHAL. The cost of the PSAND anesthetic was similar to that of INHAL, and both were less than TPROP. PSAND anesthesia may be similar to TPROP and better than INHAL for otologic procedures. PSAND was less expensive than TPROP and produced a similar recovery profile and antiemetic effect in the 24-hour period after surgery. PMID:10064647

  8. Regional Neurodegeneration and Gliosis Are Amplified by Mild Traumatic Brain Injury Repeated at 24-Hour Intervals

    PubMed Central

    Bolton, Amanda Nicholle; Saatman, Kathryn Eileen

    2014-01-01

    Most traumatic brain injuries (TBIs) that occur every year are classified as ‘mild’. Individuals involved in high-risk activities may sustain multiple mild TBIs. We evaluated the acute physiological and histopathological consequences of mild TBI in a mouse model, comparing sham injury, single impact, or 5 impacts at a 24- or 48-hour inter-injury interval. A single closed skull impact resulted in bilateral gliosis in the hippocampus and entorhinal cortex that was proportional to impact depth. Midline impact, at a depth just above the threshold to induce transient unconsciousness, produced occasional axonal injury and degenerating neurons accompanied by astrogliosis in the entorhinal cortex and cerebellum. Mild TBI repeated every 24 hours resulted in bilateral hemorrhagic lesions in the entorhinal cortex along with significantly increased neurodegeneration and microglial activation despite diminished durations of apnea and unconsciousness with subsequent impacts. Astrogliosis and diffusely distributed axonal injury were also observed bilaterally in the cerebellum and the brainstem. When the interval between mild TBIs was increased to 48 hours, the pathological consequences were comparable to a single TBI. Together, these data suggest that in mice the brain remains at increased risk for damage for 24 hours after mild TBI despite reduced acute physiological responses to subsequent mild impacts. PMID:25232942

  9. Deviation of innate circadian period from 24 hours reduces longevity in mice

    PubMed Central

    Libert, Sergiy; Bonkowski, Michael S.; Pointer, Kelli; Pletcher, Scott D.; Guarente, Leonard

    2012-01-01

    Summary The variation of individual lifespans, even in highly inbred cohorts of animals and under strictly controlled environmental conditions, is substantial and not well understood. This variation in part could be due to epigenetic variation, which later affects the animal’s physiology and ultimately longevity. Identification of the physiological properties that impact health and lifespan is crucial for longevity research and the development of anti-aging therapies. Here we measured individual circadian and metabolic characteristics in a cohort of inbred F1 hybrid mice and correlated these parameters to their lifespans. We found that mice with innate circadian periods close to 24 hours (revealed during 30 days of housing in total darkness) enjoyed nearly 20% longer lifespans than their littermates, which had shorter or longer innate circadian periods. These findings show that maintenance of a 24 hour intrinsic circadian period is a positive predictor of longevity. Our data suggest that circadian period may be used to predict individual longevity and that processes that control innate circadian period affect aging. PMID:22702406

  10. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns.

    PubMed

    Xu, Sarah C; Gauthier, Angela C; Liu, Ji

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  11. A Compute Perspective: Delivering Decision Support Products in 24 Hours from the Airborne Snow Observatory

    NASA Astrophysics Data System (ADS)

    Ramirez, P.; Mattmann, C. A.; Painter, T. H.; Seidel, F. C.; Trangsrud, A.; Hart, A. F.; Goodale, C. E.; Boardman, J. W.; Heneghan, C.; Verma, R.; Khudikyan, S.; Boustani, M.; Zimdars, P. A.; Horn, J.; Neely, S.

    2013-12-01

    The JPL Airborne Snow Observatory (ASO) must process 100s of GB of raw data to 100s of Terabytes of derived data in 24 hour Near Real Time (NRT) latency in a geographically distributed mobile compute and data-intensive processing setting. ASO provides meaningful information to water resource managers in the Western US letting them know how much water to maintain; or release, and what the prospectus of the current snow season is in the Sierra Nevadas. Providing decision support products processed from airborne data in a 24 hour timeframe is an emergent field and required the team to develop a novel solution as this process is typically done over months. We've constructed a system that combines Apache OODT; with Apache Tika; with the Interactive Data Analysis (IDL)/ENVI programming environment to rapidly and unobtrusively generate, distribute and archive ASO data as soon as the plane lands near Mammoth Lakes, CA. Our system is flexible, underwent several redeployments and reconfigurations, and delivered this critical information to stakeholders during the recent "Snow On" campaign March 2013 - June 2013. This talk will take you through a day in the life of the compute team from data acquisition, delivery, processing, and dissemination. Within this context, we will discuss the architecture of ASO; the open source software we used; the data we stored; and how it was delivered to its users. Moreover we will discuss the logistics, system engineering, and staffing that went into the developing, deployment, and operation of the mobile compute system.

  12. The effect of low-sodium dialysate on ambulatory blood pressure measurement parameters in patients undergoing hemodialysis

    PubMed Central

    Akdag, Serkan; Akyol, Aytac; Cakmak, Huseyin Altug; Tosu, Aydin Rodi; Asker, Muntecep; Yaman, Mehmet; Babat, Naci; Soyoral, Yasemin; Cegin, Muhammed Bilal; Gur, Ali Kemal; Gumrukcuoglu, Hasan Ali

    2015-01-01

    Background End stage renal disease is related to increased cardiovascular mortality and morbidity. Hypertension is an important risk factor for cardiovascular disorder among hemodialysis (HD) patients. The aim of this study was to investigate the effect of low-sodium dialysate on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels detected by ambulatory BP monitoring (ABPM) and interdialytic weight gain (IDWG) in patients undergoing sustained HD treatment. Patients and methods The study included 46 patients who had creatinine clearance levels less than 10 mL/min/1.73 m2 and had been on chronic HD treatment for at least 1 year. After the enrollment stage, the patients were allocated low-sodium dialysate or standard sodium dialysate for 6 months via computer-generated randomization. Results Twenty-four hour SBP, daytime SBP, nighttime SBP, and nighttime DBP were significantly decreased in the low-sodium dialysate group (P<0.05). No significant reduction was observed in both groups in terms of 24-hour DBP and daytime DBP (P=NS). No difference was found in the standard sodium dialysate group in terms of ABPM. Furthermore, IDWG was found to be significantly decreased in the low-sodium dialysate group after 6 months (P<0.001). Conclusion The study revealed that low-sodium dialysate leads to a decrease in ABPM parameters including 24-hour SBP, daytime SBP, nighttime SBP, and nighttime DBP and it also reduces the number of antihypertensive drugs used and IDWG. PMID:26715849

  13. Acute respiratory distress induced by repeated saline lavage provides stable experimental conditions for 24 hours in pigs.

    PubMed

    Muellenbach, Ralf M; Kredel, Markus; Zollhoefer, Bernd; Bernd, Zollhoefer; Johannes, Amelie; Kuestermann, Julian; Schuster, Frank; Schwemmer, Ulrich; Wurmb, Thomas; Wunder, Christian; Roewer, Norbert; Brederlau, Jörg

    2009-04-01

    Surfactant depletion is most often used to study acute respiratory failure in animal models. Because model stability is often criticized, the authors tested the following hypotheses: Repeated pulmonary lavage with normal saline provides stable experimental conditions for 24 hours with a PaO2/FiO2 ratio < 300 mm Hg. Lung injury was induced by bilateral pulmonary lavages in 8 female pigs (51.5 +/- 4.8 kg). The animals were ventilated for 24 hours (PEEP: 5 cm H2O; tidal volume: 6 mL/kg; respiratory rate: 30/min). After 24 hours the animals were euthanized. For histopathology slides from all pulmonary lobes were obtained. Supernatant of the bronchoalveolar fluid collected before induction of acute respiratory distress syndrome (ARDS) and after 24 hours was analyzed. A total of 19 +/- 6 lavages were needed to induce ARDS. PaO2/FiO2 ratio and pulmonary shunt fraction remained significantly deteriorated compared to baseline values after 24 hours (P < .01). Slight to moderate histopathologic changes were detected. Significant increases of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6 were observed after 24 hours (P < .01). The presented surfactant depletion-based lung injury model was associated with increased pulmonary inflammation and fulfilled the criteria of acute ling injury (ALI) for 24 hours. PMID:19337905

  14. Association between Sleep Duration and 24-Hour Urine Free Cortisol in the MrOS Sleep Study

    PubMed Central

    Rao, Madhu N.; Blackwell, Terri; Redline, Susan; Punjabi, Naresh M.; Barrett-Connor, Elizabeth; Neylan, Thomas C.; Stone, Katie L.

    2013-01-01

    Context Short sleep duration is associated with adverse health outcomes, but the mechanisms involved are unknown. It has been postulated that short sleep duration may elevate cortisol levels, but studies have had conflicting results. It is unclear whether these differing findings may be due to methodological issues, such as assessment of sleep duration. Specifically, objective versus subjective methods of measuring habitual sleep duration may account for the conflicting results found in epidemiological studies. Objective Our goal was to determine whether habitual sleep duration, measured objectively (by actigraphy) and subjectively (by self-report), was associated with 24-hour urine free cortisol (UFC), a measure of integrated cortisol secretion. Our secondary goal was to determine whether slow wave sleep (SWS, determined by polysomnography) was associated with 24-hour UFC. Design/Setting Cross sectional study of community dwelling older men. Patients/Participants 325 men (mean age = 76.6 years, SD = 5.5) from the Portland site of the MrOS Sleep Study, who underwent 24-hour urine collection, polysomnography, actigraphy and sleep questionnaire. Primary Outcome 24-hour UFC. Results In this study of community dwelling older men, self-reported sleep duration was inversely related to 24-hour UFC levels. Participants reporting <5 hours of habitual sleep had an adjusted mean 24-hour UFC of 29.8 ug, compared to 28.0 ug in participants reporting >5 to <8 hours of sleep 25.5 ug in those reporting >8 hours of habitual sleep. However, sleep duration determined by actigraphy was not associated with 24-hour UFC in either univariable or multivariable regression models. SWS was not associated with 24-hour UFC. Conclusion Objectively measured (i.e., actigraphic) sleep duration is not associated with 24-hour UFC in these community dwelling older men. This finding, together with prior studies, suggests that elevated levels of integrated cortisol secretion is not the

  15. Pattern of 24 hour intragastric acidity in active duodenal ulcer disease and in healthy controls.

    PubMed Central

    Merki, H S; Fimmel, C J; Walt, R P; Harre, K; Röhmel, J; Witzel, L

    1988-01-01

    Twenty four hour intragastric acidity was measured by continuous recording using intragastric combined glass electrodes in 46 duodenal ulcer patients within 48 hours of endoscopic confirmation of active ulceration. Acidity during predefined time periods was compared with that measured in 40 healthy controls without gastrointestinal disease: it was significantly higher in duodenal ulcer patients at all times, but 25% of ulcer patients had median 24 hour acidity within the interquartile range of the normal group. During the evening (18,00 to 22,00 h) ulcer patients had considerable acidity with a median of 39.8 (63.1-31.6) mmol/l (interquartile range) compared with 5.6 (22.3-0.4) mmol/l of controls. It is suggested that antisecretory treatment be directed to decrease this period of unbuffered acidity, as well as during the night, which is presently considered of prime importance. PMID:3209116

  16. The Effects of 24-hour Sleep Deprivation on the Exploration-Exploitation Trade-off

    PubMed Central

    Glass, Brian D.; Maddox, W. Todd; Bowen, Christopher; Savarie, Zachary R.; Matthews, Michael D.; Markman, Arthur B.; Schnyer, David M.

    2010-01-01

    Sleep deprivation has a complex set of neurological effects that go beyond a mere slowing of mental processes. While cognitive and perceptual impairments in sleep deprived individuals are widespread, some abilities remain intact. In an effort to characterize these effects, some have suggested an impairment of complex decision making ability despite intact ability to follow simple rules. To examine this trade-off, 24-hour total sleep deprived individuals performed two versions of a resource acquisition foraging task, one in which exploration is optimal (to succeed, abandon low value, high saliency options) and another in which exploitation is optimal (to succeed, refrain from switching between options). Sleep deprived subjects exhibited decreased performance on the exploitation task compared to non-sleep deprived controls, yet both groups exhibited increased performance on the exploratory task. These results speak to previous neuropsychological work on cognitive control. PMID:21686036

  17. After 24-hour scrub, another tower rollback for the Boeing Delta II rocket carrying Stardust

    NASA Technical Reports Server (NTRS)

    1999-01-01

    As tower rollback begins, the Boeing Delta II rocket carrying the Stardust spacecraft waits on Launch Pad 17-A, Cape Canaveral Air Station, for the second launch attempt at 4:04 p.m. EST. The original launch was scrubbed on Feb. 6 for 24 hours. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  18. Tasimelteon: A Review in Non-24-Hour Sleep-Wake Disorder in Totally Blind Individuals.

    PubMed

    Keating, Gillian M

    2016-05-01

    Tasimelteon (Hetlioz(®)) is a dual melatonin receptor agonist indicated for the treatment of Non-24-Hour Sleep-Wake Disorder (Non-24) (free-running disorder). In two randomized, double-masked, multicentre, phase III trials, totally blind individuals with Non-24 who received oral tasimelteon 20 mg once nightly were significantly more likely than those receiving placebo to entrain the circadian pacemaker (the SET trial) and maintain entrainment (the RESET trial). Sleep/wake parameters and functioning were also improved with tasimelteon. Oral tasimelteon was generally well tolerated in totally blind patients with Non-24. In conclusion, tasimelteon is a useful drug for the treatment of Non-24 in totally blind individuals. PMID:27003694

  19. Setting Spacecraft Maximum Allowable Concentrations for 1 hour or 24 hour contingency exposures to airborne chemicals

    NASA Technical Reports Server (NTRS)

    Garcia, Hector D.; Limero, Thomas F.; James, John T.

    1992-01-01

    Since the early years of the manned space program, NASA has developed and used exposure limits called Spacecraft Maximum Allowable Concentrations (SMACs) to help protect astronauts from airborne toxicants. Most of these SMACS are based on an exposure duration of 7 days, since this is the duration of a 'typical' mission. A set of 'contingency SMACs' is also being developed for scenarios involving brief (1-hour or 24- hour) exposures to relatively high levels of airborne toxicants from event-related 'contingency' releases of contaminants. The emergency nature of contingency exposures dictates the use of different criteria for setting exposure limits. The NASA JSC Toxicology Group recently began a program to document the rationales used to set new SMACs and plans to review the older, 7-day SMACs. In cooperation with the National Research Council's Committee on Toxicology, a standard procedure has been developed for researching, setting, and documenting SMAC values.

  20. The association of knowledge, attitudes and behaviours related to salt with 24-hour urinary sodium excretion

    PubMed Central

    2014-01-01

    Aim Salt reduction efforts usually have a strong focus on consumer education. Understanding the association between salt consumption levels and knowledge, attitudes and behaviours towards salt should provide insight into the likely effectiveness of education-based programs. Methods A single 24-hour urine sample and a questionnaire describing knowledge, attitudes and behaviours was obtained from 306 randomly selected participants and 113 volunteers from a regional town in Australia. Results Mean age of all participants was 55 years (range 20–88), 55% were women and mean 24-hour urinary salt excretion was 8.8(3.6) g/d. There was no difference in salt excretion between the randomly selected and volunteer sample. Virtually all participants (95%) identified that a diet high in salt can cause serious health problems with the majority of participants (81%) linking a high salt diet to raised blood pressure. There was no difference in salt excretion between those who did 8.7(2.1) g/d and did not 7.5(3.3) g/d identify that a diet high in salt causes high blood pressure (p = 0.1). Nor was there a difference between individuals who believed they consumed “too much” 8.9(3.3) g/d “just the right amount” 8.4(2.6) g/d or “too little salt” 9.1(3.7) g/d (p = 0.2). Likewise, individuals who indicated that lowering their salt intake was important 8.5(2.9) g/d vs. not important 8.8(2.4) g/d did not have different consumption levels (p = 0.4). Conclusion The absence of a clear association between knowledge, attitudes and behaviours towards salt and actual salt consumption suggests that interventions focused on knowledge, attitudes and behaviours alone may be of limited efficacy. PMID:24708561

  1. Fasting for 24 Hours Heightens Reward from Food and Food-Related Cues

    PubMed Central

    Cameron, Jameason D.; Goldfield, Gary S.; Finlayson, Graham; Blundell, John E.; Doucet, Éric

    2014-01-01

    Introduction We examined the impact of a 24 hour complete fast (vs. fed state) on two measures of food reward: 1) ‘wanting’, as measured by response to food images and by the relative-reinforcing value of food (RRV), and 2) ‘liking’, as measured by response to food images and the hedonic evaluation of foods consumed. Methods Utilizing a randomized crossover design, 15 subjects (9 male; 6 female) aged 28.6±4.5 yrs with body mass index 25.3±1.4 kg/m2 were randomized and counterbalanced to normal feeding (FED) and 24-hour fast (FASTED) conditions. Trait characteristics were measured with the Three Factor Eating Questionnaire. Two computer tasks measured food reward: 1) RRV progressive ratio task, 2) explicit ‘liking’ and ‘wanting’ (Leeds Food Preference Questionnaire, LFPQ). Also measured were ad libitum energy intake (EI; buffet) and food ‘liking’ (visual analogue scale) of personalized stimuli. Results There were no significant anthropometric changes between conditions. Appetite scores, hedonic ratings of ‘liking’, and ad libitum EI all significantly increased under the FASTED condition (p<0.05). Under the FASTED condition there were significant increases in the RRV of snack foods; similarly, explicit ‘wanting’ and ‘liking’ significantly increased for all food categories. ‘Liking’ of sweet foods remained high across-meals under FASTED, but savory foods decreased in hedonic saliency. Conclusion Relative to a fed state, we observed an increase in hedonic ratings of food, the rewarding value of food, and food intake after a 24 hr fast. Alliesthesia to food and food cues is suggested by heightened hedonic ratings under the FASTED condition relative to FED. PMID:24454949

  2. A 24-Hour Study of the Hypothalamo-Pituitary Axes in Huntington’s Disease

    PubMed Central

    Nambron, Rajasree; Costelloe, Seán J.; Martin, Nicholas G.; Hill, Nathan R.; Frost, Chris; Watt, Hilary C.; Hindmarsh, Peter; Björkqvist, Maria; Warner, Thomas T.

    2015-01-01

    Background Huntington’s disease is an inherited neurodegenerative disorder characterised by motor, cognitive and psychiatric disturbances. Patients exhibit other symptoms including sleep and mood disturbances, muscle atrophy and weight loss which may be linked to hypothalamic pathology and dysfunction of hypothalamo-pituitary axes. Methods We studied neuroendocrine profiles of corticotropic, somatotropic and gonadotropic hypothalamo-pituitary axes hormones over a 24-hour period in controlled environment in 15 healthy controls, 14 premanifest and 13 stage II/III Huntington’s disease subjects. We also quantified fasting levels of vasopressin, oestradiol, testosterone, dehydroepiandrosterone sulphate, thyroid stimulating hormone, free triiodothyronine, free total thyroxine, prolactin, adrenaline and noradrenaline. Somatotropic axis hormones, growth hormone releasing hormone, insulin-like growth factor-1 and insulin-like factor binding protein-3 were quantified at 06:00 (fasting), 15:00 and 23:00. A battery of clinical tests, including neurological rating and function scales were performed. Results 24-hour concentrations of adrenocorticotropic hormone, cortisol, luteinizing hormone and follicle-stimulating hormone did not differ significantly between the Huntington’s disease group and controls. Daytime growth hormone secretion was similar in control and Huntington’s disease subjects. Stage II/III Huntington’s disease subjects had lower concentration of post-sleep growth hormone pulse and higher insulin-like growth factor-1:growth hormone ratio which did not reach significance. In Huntington’s disease subjects, baseline levels of hypothalamo-pituitary axis hormones measured did not significantly differ from those of healthy controls. Conclusions The relatively small subject group means that the study may not detect subtle perturbations in hormone concentrations. A targeted study of the somatotropic axis in larger cohorts may be warranted. However, the lack

  3. The effect of Operation 24 Hours on reducing collision in the City of Edmonton.

    PubMed

    Halim, Siana; Jiang, Heming

    2013-09-01

    In the City of Edmonton, in order to reduce the prevalence of collisions, the Operation 24 Hours program (OPS24) was developed by using existing police and transportation services resources. The program uses traditional manned police speed enforcement method, which are supplemented by traffic safety messages displayed on permanent and mobile dynamic messaging signs (DMS). In this paper, collision data analysis was performed by looking at the daily number of collisions from 2008 to 2011 that covers 28 Operation 24 Hours (OPS24) events. The objective of the collision data analysis is to analyze if there is a reduction in collision frequencies after OPS24 was held and examined how long the collision reduction effect last. Weather factors such as temperature, thickness of snow, and wind gust have been considered by many as a great influence on collision occurrences, especially in a city with long and cold winter such as Edmonton. Therefore, collision modeling was performed by considering these external weather factors. To analyze the linear and periodic trend of different collision types (injury, fatal, and property damage only (PDO)) and examine the influence of weather factors on collisions, negative binomial time series model that accounts for seasonality and weather factors was used to model daily collision data. The modeling also considered collision proportion to account for missing traffic volume data; the Gaussian time series model that accounts for seasonality and weather factors was used to model collision proportion. To estimate the collision trend and test for changes in collision levels before/after OPS24, interrupted time series model with segmented regression was used. While for estimating how long the effect of the OPS24 last, change point method was applied. PMID:23727551

  4. Heart rate variability and arrhythmic patterns of 24-hour Holter electrocardiography among Nigerians with cardiovascular diseases

    PubMed Central

    Adebayo, Rasaaq Ayodele; Ikwu, Amanze Nkemjika; Balogun, Michael Olabode; Akintomide, Anthony Olubunmi; Ajayi, Olufemi Eyitayo; Adeyeye, Victor Oladeji; Mene-Afejuku, Tuoyo Omasan; Bamikole, Olaniyi James; Ogunyemi, Suraj Adefabi; Ajibare, Adeola Olubunmi; Oketona, Omolola Abiodun

    2015-01-01

    Background Facilities for Holter electrocardiography (ECG) monitoring in many Nigerian hospitals are limited. There are few published works in Nigeria on the use of 24-hour Holter ECG in cardiac arrhythmic evaluation of patients with cardiovascular diseases. Objective To study the clinical indications, arrhythmic pattern, and heart rate variability (HRV) among subjects referred for 24-hour Holter ECG at our Cardiac Care Unit. Methods Three-hundred and ten patients (134 males and 176 females) were studied consecutively over a 48-month period using Schiller type (MT-101) Holter ECG machine. Results Out of the 310 patients reviewed, 134 were males (43.2%) and 176 were females (56.8%). The commonest indication for Holter ECG was palpitation followed by syncope in 71 (23%) and 49 (15.8%) of subjects, respectively. Premature ventricular complex and premature atrial complex were the commonest types of arrhythmia in 51.5% and 15% subjects, respectively. Ventricular arrhythmia was more prevalent in dilated cardiomyopathy patients (85.7%). The HRV of subjects with palpitation, stroke, and diabetes mellitus with autonomic neuropathy, using standard deviation of normal to normal intervals average (milliseconds), were 107.32±49.61, 79.15±49.15, and 66.50±15.54, respectively. The HRV, using standard deviation of averages of normal to normal intervals average (milliseconds), of patients with palpitation, stroke, and diabetes mellitus with autonomic neuropathy were 77.39±62.34, 57.82±37.05, and 55.50±12.71, respectively. Conclusion Palpitation and syncope were the commonest indications for Holter ECG among our subjects. The commonest arrhythmic patterns were premature ventricular complex and premature atrial complex, with ventricular arrhythmia being more prevalent in dilated cardiomyopathy. There was a reduction in HRV in patients with stroke and diabetic autonomic neuropathy. PMID:26170685

  5. Effects of exenatide and liraglutide on 24-hour glucose fluctuations in type 2 diabetes.

    PubMed

    Nagakura, Jo; Yamakawa, Tadashi; Taguri, Masataka; Tsuchiya, Hirohisa; Shigematsu, Erina; Suzuki, Jun; Morita, Satoshi; Kadonosono, Kazuaki; Terauchi, Yasuo

    2016-03-31

    We evaluated the influence of short-term treatment with exenatide twice daily or liraglutide once daily on daily blood glucose fluctuations in 40 patients with type 2 diabetes inadequately controlled by sulfonylureas. The patients in a multicenter, open-label trial were randomly assigned to receive add-on exenatide (10 μg/day, n = 21) or add-on liraglutide (0.3-0.9 mg/day, n = 19), and underwent 24-hour continuous subcutaneous glucose monitoring. There was no significant between-group difference in glucose fluctuations during the day, as assessed by calculating mean amplitude of glycemic excursion (MAGE) and standard deviation (SD). However, the mean blood glucose levels at 3 hours after breakfast and dinner were significantly lower in the exenatide group than the liraglutide group (breakfast: 127.3 ± 24.1 vs. 153.4 ± 28.7 mg/dL; p = 0.006, dinner: 108.7 ± 17.3 vs. 141.9 ± 24.2 mg/dL; p < 0.001). In contrast, mean blood glucose levels and their SD were significantly lower between 0000 h and 0600 h in the liraglutide group than the exenatide group (average glucose: 126.9 ± 27.1 vs. 107.1 ± 24.0 mg/dL; p = 0.029, SD: 15.2 ± 10.5 vs. 8.7 ± 3.8; p = 0.020). Both groups had similar glucose fluctuations despite differences in 24-hour blood glucose profiles. Therefore, each of these agents may have advantages or disadvantages and should be selected according to the blood glucose profile of the patient. PMID:26743240

  6. Personal Black Carbon Exposure Influences Ambulatory Blood Pressure: Air Pollution and Cardio-metabolic Disease (AIRCMD-China) Study

    PubMed Central

    Zhao, Xiaoyi; Sun, Zhichao; Ruan, Yanping; Yan, Jianhua; Mukherjee, Bhramar; Yang, Fumo; Duan, Fengkui; Sun, Lixian; Liang, Ruijuan; Lian, Hui; Zhang, Shuyang; Fang, Quan; Gu, Dongfeng; Brook, Jeffrey R.; Sun, Qinghua; Brook, Robert D.; Rajagopalan, Sanjay; Fan, Zhongjie

    2015-01-01

    Few prospective studies have assessed the blood pressure impact of extremely high air pollution encountered in Asia’s megacities. The objective of this study was to evaluate the association between combustion-related air pollution with ambulatory blood pressure and autonomic function. During February to July 2012, personal black carbon was determined for 5 consecutive days using microaethelometers in patients with metabolic syndrome in Beijing, China. Simultaneous ambient fine particulate matter concentration was obtained from the Beijing Municipal Environmental Monitoring Center and the U.S. Embassy. 24-hour ambulatory blood pressure and heart rate variability were measured from Day 4. Arterial stiffness and endothelial function were obtained at the end of Day 5. For statistical analysis, we used generalized additive mixed models for repeated outcomes and generalized linear models for single/summary outcomes. Mean (standard deviation) of personal black carbon and fine particulate matter over 24-hour was 4.66 (2.89) and 64.2 (36.9) μg/m3. Exposure to high levels of black carbon in the preceding hours was significantly associated with adverse cardiovascular responses. A unit increase in personal black carbon over the previous 10 hours was associated with an increase in systolic blood pressure of 0.53 mmHg and diastolic blood pressure of 0.37 mmHg (95% confidence interval, 0.17-0.89 and 0.10-0.65 mmHg, respectively), a percent change in low frequency to high frequency ratio of 5.11 and mean inter-beat interval of −0.06 (95% confidence interval, 0.62 to 9.60 and −0.11 to −0.01, respectively). These findings highlight the public health impact of air pollution and the importance of reducing air pollution. PMID:24420543

  7. Consumption of a Polyphenol-Rich Grape-Wine Extract Lowers Ambulatory Blood Pressure in Mildly Hypertensive Subjects

    PubMed Central

    Draijer, Richard; de Graaf, Young; Slettenaar, Marieke; de Groot, Eric; Wright, Chris I.

    2015-01-01

    Polyphenols in grape and wine have been suggested to contribute to the cardiovascular health benefits of the Mediterranean lifestyle. The reported effects of grape products on blood pressure (BP) remain, however, equivocal. In a double-blind placebo controlled crossover study, the effect of two grape extracts on BP and vascular function was assessed in 60 untreated, mildly hypertensive subjects after four weeks intervention. Both extracts (grape-red wine and grape alone) had high concentrations of anthocyanins and flavonols, but the grape alone was relatively poor in catechins and procyanidins. Parameters measured included ambulatory and office BP, flow-mediated vasodilation, arterial distensibility, platelet function and plasma lipoproteins. Results showed that 24-hour ambulatory systolic/diastolic BPs were significantly lower in the grape-wine extract intervention (135.9 ± 1.3/84.7 ± 0.8 mmHg; mean ± SEM) compared to placebo (138.9 ± 1.3/86.6 ± 1.2 mmHg), predominantly during daytime. Plasma concentrations of the vasoconstrictor endothelin-1 decreased by 10%, but other measures of vascular function were not affected. Grape juice extract alone had no effect on BP or any measures of vascular function. Polyphenol-rich food products, and may be specifically catechins and procyanidins, may thus help sustain a healthy BP and contribute to the healthy Mediterranean lifestyle. PMID:25942487

  8. Time-Based Measurement of Personal Mite Allergen Bioaerosol Exposure over 24 Hour Periods.

    PubMed

    Tovey, Euan R; Liu-Brennan, Damien; Garden, Frances L; Oliver, Brian G; Perzanowski, Matthew S; Marks, Guy B

    2016-01-01

    Allergic diseases such as asthma and rhinitis are common in many countries. Globally the most common allergen associated with symptoms is produced by house dust mites. Although the bed has often been cited as the main site of exposure to mite allergens, surprisingly this has not yet been directly established by measurement due to a lack of suitable methods. Here we report on the development of novel methods to determine the pattern of personal exposure to mite allergen bioaerosols over 24-hour periods and applied this in a small field study using 10 normal adults. Air was sampled using a miniature time-based air-sampler of in-house design located close to the breathing zone of the participants, co-located with a miniature time-lapse camera. Airborne particles, drawn into the sampler at 2L/min via a narrow slot, were impacted onto the peripheral surface of a disk mounted on the hour-hand of either a 12 or 24 hour clock motor. The impaction surface was either an electret cloth, or an adhesive film; both novel for these purposes. Following a review of the time-lapse images, disks were post-hoc cut into subsamples corresponding to eight predetermined categories of indoor or outdoor location, extracted and analysed for mite allergen Der p 1 by an amplified ELISA. Allergen was detected in 57.2% of the total of 353 subsamples collected during 20 days of sampling. Exposure patterns varied over time. Higher concentrations of airborne mite allergen were typically measured in samples collected from domestic locations in the day and evening. Indoor domestic Der p 1 exposures accounted for 59.5% of total exposure, whereas total in-bed-asleep exposure, which varied 80 fold between individuals, accounted overall for 9.85% of total exposure, suggesting beds are not often the main site of exposure. This study establishes the feasibility of novel methods for determining the time-geography of personal exposure to many bioaerosols and identifies new areas for future technical

  9. Time-Based Measurement of Personal Mite Allergen Bioaerosol Exposure over 24 Hour Periods

    PubMed Central

    Tovey, Euan R.; Liu-Brennan, Damien; Garden, Frances L.; Oliver, Brian G.; Perzanowski, Matthew S.; Marks, Guy B.

    2016-01-01

    Allergic diseases such as asthma and rhinitis are common in many countries. Globally the most common allergen associated with symptoms is produced by house dust mites. Although the bed has often been cited as the main site of exposure to mite allergens, surprisingly this has not yet been directly established by measurement due to a lack of suitable methods. Here we report on the development of novel methods to determine the pattern of personal exposure to mite allergen bioaerosols over 24-hour periods and applied this in a small field study using 10 normal adults. Air was sampled using a miniature time-based air-sampler of in-house design located close to the breathing zone of the participants, co-located with a miniature time-lapse camera. Airborne particles, drawn into the sampler at 2L/min via a narrow slot, were impacted onto the peripheral surface of a disk mounted on the hour-hand of either a 12 or 24 hour clock motor. The impaction surface was either an electret cloth, or an adhesive film; both novel for these purposes. Following a review of the time-lapse images, disks were post-hoc cut into subsamples corresponding to eight predetermined categories of indoor or outdoor location, extracted and analysed for mite allergen Der p 1 by an amplified ELISA. Allergen was detected in 57.2% of the total of 353 subsamples collected during 20 days of sampling. Exposure patterns varied over time. Higher concentrations of airborne mite allergen were typically measured in samples collected from domestic locations in the day and evening. Indoor domestic Der p 1 exposures accounted for 59.5% of total exposure, whereas total in-bed-asleep exposure, which varied 80 fold between individuals, accounted overall for 9.85% of total exposure, suggesting beds are not often the main site of exposure. This study establishes the feasibility of novel methods for determining the time-geography of personal exposure to many bioaerosols and identifies new areas for future technical

  10. Non-24-Hour Sleep-Wake Disorder Revisited – A Case Study

    PubMed Central

    Garbazza, Corrado; Bromundt, Vivien; Eckert, Anne; Brunner, Daniel P.; Meier, Fides; Hackethal, Sandra; Cajochen, Christian

    2016-01-01

    The human sleep-wake cycle is governed by two major factors: a homeostatic hourglass process (process S), which rises linearly during the day, and a circadian process C, which determines the timing of sleep in a ~24-h rhythm in accordance to the external light–dark (LD) cycle. While both individual processes are fairly well characterized, the exact nature of their interaction remains unclear. The circadian rhythm is generated by the suprachiasmatic nucleus (“master clock”) of the anterior hypothalamus, through cell-autonomous feedback loops of DNA transcription and translation. While the phase length (tau) of the cycle is relatively stable and genetically determined, the phase of the clock is reset by external stimuli (“zeitgebers”), the most important being the LD cycle. Misalignments of the internal rhythm with the LD cycle can lead to various somatic complaints and to the development of circadian rhythm sleep disorders (CRSD). Non-24-hour sleep-wake disorders (N24HSWD) is a CRSD affecting up to 50% of totally blind patients and characterized by the inability to maintain a stable entrainment of the typically long circadian rhythm (tau > 24.5 h) to the LD cycle. The disease is rare in sighted individuals and the pathophysiology less well understood. Here, we present the case of a 40-year-old sighted male, who developed a misalignment of the internal clock with the external LD cycle following the treatment for Hodgkin’s lymphoma (ABVD regimen, four cycles and AVD regimen, four cycles). A thorough clinical assessment, including actigraphy, melatonin profiles and polysomnography led to the diagnosis of non-24-hour sleep-wake disorders (N24HSWD) with a free-running rhythm of tau = 25.27 h. A therapeutic intervention with bright light therapy (30 min, 10,000 lux) in the morning and melatonin administration (0.5–0.75 mg) in the evening failed to entrain the free-running rhythm, although a longer treatment duration and more intense therapy

  11. Non-24-Hour Sleep-Wake Disorder Revisited - A Case Study.

    PubMed

    Garbazza, Corrado; Bromundt, Vivien; Eckert, Anne; Brunner, Daniel P; Meier, Fides; Hackethal, Sandra; Cajochen, Christian

    2016-01-01

    The human sleep-wake cycle is governed by two major factors: a homeostatic hourglass process (process S), which rises linearly during the day, and a circadian process C, which determines the timing of sleep in a ~24-h rhythm in accordance to the external light-dark (LD) cycle. While both individual processes are fairly well characterized, the exact nature of their interaction remains unclear. The circadian rhythm is generated by the suprachiasmatic nucleus ("master clock") of the anterior hypothalamus, through cell-autonomous feedback loops of DNA transcription and translation. While the phase length (tau) of the cycle is relatively stable and genetically determined, the phase of the clock is reset by external stimuli ("zeitgebers"), the most important being the LD cycle. Misalignments of the internal rhythm with the LD cycle can lead to various somatic complaints and to the development of circadian rhythm sleep disorders (CRSD). Non-24-hour sleep-wake disorders (N24HSWD) is a CRSD affecting up to 50% of totally blind patients and characterized by the inability to maintain a stable entrainment of the typically long circadian rhythm (tau > 24.5 h) to the LD cycle. The disease is rare in sighted individuals and the pathophysiology less well understood. Here, we present the case of a 40-year-old sighted male, who developed a misalignment of the internal clock with the external LD cycle following the treatment for Hodgkin's lymphoma (ABVD regimen, four cycles and AVD regimen, four cycles). A thorough clinical assessment, including actigraphy, melatonin profiles and polysomnography led to the diagnosis of non-24-hour sleep-wake disorders (N24HSWD) with a free-running rhythm of tau = 25.27 h. A therapeutic intervention with bright light therapy (30 min, 10,000 lux) in the morning and melatonin administration (0.5-0.75 mg) in the evening failed to entrain the free-running rhythm, although a longer treatment duration and more intense therapy might have

  12. Personal best marathon time and longest training run, not anthropometry, predict performance in recreational 24-hour ultrarunners.

    PubMed

    Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

    2011-08-01

    In recent studies, a relationship between both low body fat and low thicknesses of selected skinfolds has been demonstrated for running performance of distances from 100 m to the marathon but not in ultramarathon. We investigated the association of anthropometric and training characteristics with race performance in 63 male recreational ultrarunners in a 24-hour run using bi and multivariate analysis. The athletes achieved an average distance of 146.1 (43.1) km. In the bivariate analysis, body mass (r = -0.25), the sum of 9 skinfolds (r = -0.32), the sum of upper body skinfolds (r = -0.34), body fat percentage (r = -0.32), weekly kilometers ran (r = 0.31), longest training session before the 24-hour run (r = 0.56), and personal best marathon time (r = -0.58) were related to race performance. Stepwise multiple regression showed that both the longest training session before the 24-hour run (p = 0.0013) and the personal best marathon time (p = 0.0015) had the best correlation with race performance. Performance in these 24-hour runners may be predicted (r2 = 0.46) by the following equation: Performance in a 24-hour run, km) = 234.7 + 0.481 (longest training session before the 24-hour run, km) - 0.594 (personal best marathon time, minutes). For practical applications, training variables such as volume and intensity were associated with performance but not anthropometric variables. To achieve maximum kilometers in a 24-hour run, recreational ultrarunners should have a personal best marathon time of ∼3 hours 20 minutes and complete a long training run of ∼60 km before the race, whereas anthropometric characteristics such as low body fat or low skinfold thicknesses showed no association with performance. PMID:21642857

  13. The Canadian 24-Hour Movement Guidelines for Children and Youth: Implications for practitioners, professionals, and organizations.

    PubMed

    Latimer-Cheung, Amy E; Copeland, Jennifer L; Fowles, Jonathon; Zehr, Lori; Duggan, Mary; Tremblay, Mark S

    2016-06-01

    The new Canadian 24-Hour Movement Guidelines for Children and Youth emphasize the integration of all movement behaviours that occur over a whole day (i.e., light, moderate, and vigorous physical activity, sedentary behaviour, and sleep). These guidelines shift the paradigm away from considering each behaviour in isolation. This concept of the "whole day matters" not only calls for a change in thinking about movement but also for redevelopment of dissemination and implementation practice. Past guideline launch activities largely have aimed to create awareness through passive dissemination strategies (e.g., Website posts, distribution of print resources). For the integrated guidelines to have public health impact, we must move beyond dissemination and raising of awareness to implementation and behaviour change. Shifting this focus requires new, innovative approaches to intervention, including interdisciplinary collaboration, policy change, and refocused service provision. The purpose of this paper is to identify practitioners, professionals, and organizations with potential to disseminate and/or implement the guidelines, discuss possible implementation strategies for each of these groups, and describe the few resources being developed and those needed to support dissemination and implementation efforts. This discussion makes readily apparent the need for a well-funded, comprehensive, long-term dissemination, implementation, and evaluation plan to ensure uptake and activation of the guidelines. PMID:27306438

  14. [The diagnostic impact and limitations of 24 hour pH monitoring with multichannel intraluminal impedance].

    PubMed

    Korszun, Karolina; Dyrla, Przemysław; Wojtuń, Stanisław; Gil, Jerzy

    2014-08-01

    Gastroesophageal reflux disease (GERD) is a result of reflux of gastric contents into the esophagus. Gastroscopy is often the first examination performed in GERD diagnosis. Some patients have macroscopic lesions, namely erosions, in the esophagus above the cardia of stomach. It enables to diagnose gastroesophageal reflux disease. However, many patients have no macroscopic lesions of the esophageal mucosa in endoscopy. That is why 24-hour pH monitoring with multichannel intraluminal impedance is the gold standard in diagnosis establishing of GERD and make feasible to distinguish acid, weakly acid and nonacid reflux and its correlation with reported symptoms. Impedance-pH is used to establish diagnosis of GERD, in patient qualification to anti-reflux surgery, to find the cause of not efficient reflux disease treatment as well as the cause of extra-esophageal symptoms of reflux disease. During impedance-pH test catheter connected with the recorder is placed in patient's esophagus. Recorded data is analyzed with the computer program. The examination is safe, the only complication that can occur is nasal bleeding, which can be a result of mucosa damage caused while catheter implementation. Nowadays disposable catheters are used, that excludes the risk of catheter related infection. On the basis of pH-impedance results it is possible to divide patients into 3 groups: patients with functional heartburn, patients with esophageal hypersensitivity and abnormal esophageal acid exposure. This classification is very helpful in the choice of treatment - antireflux surgery, proton pump inhibitor or prokinetic therapy. PMID:25252438

  15. Evaluation study of the California Expanded Food and Nutrition Education Program: 24-hour food recall data.

    PubMed

    Del Tredici, A M; Joy, A B; Omelich, C L; Laughlin, S G

    1988-02-01

    The California Expanded Food and Nutrition Education program (EFNEP) Evaluation Study evaluated the effectiveness of the California program. The eating habits of 683 persons were studied in a group receiving EFNEP instruction (355 participants) and a control group (328 participants) that received no instruction. The 24-hour food recall was used to assess eating habits using the Synectics method. At the beginning of the study, there were no differences in food recall scores between the EFNEP and the control groups. After 6 months of instruction in the EFNEP group, there was a significant increase in food recall score for that group and no change in the control group. The improvements observed in the EFNEP group resulted from increased intakes from the milk, protein, and fruit and vegetable food groups. The program characteristics that led to those changes were determined to be in the length of the EFNEP visit, the number of EFNEP visits, and the EFNEP instruction topics. These results show that the California EFNEP is effective in producing significant changes in the eating habits of the low-income individuals it serves. PMID:3339205

  16. After 24-hour scrub, the Boeing Delta II rocket carrying Stardust launches on time

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Flames sear the pristine blue sky behind the Boeing Delta II rocket carrying the Stardust spacecraft after the 4:04:15 p.m. launch from Launch Pad 17-A, Cape Canaveral Air Station. A 24- hour scrub postponed the launch from the originally scheduled date of Feb. 6. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  17. After 24-hour scrub, the Boeing Delta II rocket carrying Stardust waits for launch

    NASA Technical Reports Server (NTRS)

    1999-01-01

    In the late morning light at Launch Pad 17-A, Cape Cananveral Air Station, the fixed utility tower (right) casts a long shadow across the base of the Boeing Delta II rocket (left) waiting to launch the Stardust spacecraft. After a 24-hour scrub, the new targeted launch time is 4:04 p.m. EST. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  18. After 24-hour scrub, the Boeing Delta II rocket carrying Stardust waits for launch

    NASA Technical Reports Server (NTRS)

    1999-01-01

    After a 24-hour postponement, the Boeing Delta II rocket carrying the Stardust spacecraft waits on Launch Pad 17-A, Cape Canaveral Air Station, for its scheduled launch at 4:04 p.m. EST. Umbilical lines (at top) still attached to the fixed utility tower (at right) feed electricity, air conditioning and coolants for the Stardust spacecraft inside the fairing (enclosing the upper stage) before launch. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  19. Age and individual sleep characteristics affect cognitive performance in anesthesiology residents after a 24-hour shift.

    PubMed

    Tadinac, Meri; Sekulić, Ante; Hromatko, Ivana; Mazul-Sunko, Branka; Ivancić, Romina

    2014-03-01

    Previous research has shown that both shift work and sleep deprivation have an adverse influence on various aspects of human cognitive performance. The aim of this study was to explore changes in cognitive functioning and subjective sleepiness of anesthesiology residents after a 24-hour shift. Twenty-six anesthesiology residents completed a set of psychological instruments at the beginning and at the end of the shift, as well as a questionnaire regarding information about the shift, Stanford Sleepiness Scale, and Circadian Type Questionnaire. There was a significant decline in cognitive performance measured by the Auditory Verbal Learning Test after the shift. The effect was stronger in older participants and in those with high scores on rigidity of sleep scale and low scores on the ability to overcome sleepiness scale. There were no differences in the digits forward test (a measure of concentration), while digits backward test (a measure of working memory) even showed an improved performance after the shift. Although participants reported being significantly sleepier after the shift, the subjective sleepiness did not correlate with any of the objective measures of cognitive performance. In conclusion, the performance in short tasks involving concentration and working memory was not impaired, while performance in long-term and monotone tasks declined after sleep deprivation, and the magnitude of this decline depended on the specific individual characteristics of sleep and on age Surprisingly, age seemed to have an important impact on cognitive functions after shift work even in the relatively age-homogeneous population of young anesthesiology residents. PMID:24974663

  20. Importance of all movement behaviors in a 24 hour period for overall health.

    PubMed

    Chaput, Jean-Philippe; Carson, Valerie; Gray, Casey E; Tremblay, Mark S

    2014-12-01

    Physical inactivity and childhood obesity are well-recognized public health concerns that are associated with a range of adverse health outcomes. Historically, the benefits of physical activity (e.g., moderate-to-vigorous physical activity-MVPA) to overall health have dominated discussions and emerging evidence indicates that a broader, more integrated approach is needed to better understand and address current public health crises. Existing guidelines for children and youth around the world only focus on MVPA, and recently sedentary behavior, despite an accumulating body of evidence showing that light-intensity physical activity (LPA) such as walking can provide important health benefits. Furthermore, there is accumulating support for the importance of adequate sleep and that these behaviors moderate the health impact of each other. Ignoring the other components of the movement continuum (i.e., sleep, sedentary time, LPA) while focusing efforts exclusively on MVPA (accounting for <5% of the time in a 24 h period) limits the potential to optimize the health benefits of movement behaviors. In order to address this limitation, experts in Canada are currently developing the world's first Integrated 24 Hour Movement Behaviour Guidelines for Children and Youth to help advance an integrated healthy active living agenda that has the potential to significantly improve the overall health and well-being of children and youth. PMID:25485978

  1. Obtaining liver tridimensional scaffold through the decellularization of rabbit whole liver in 24 hours

    NASA Astrophysics Data System (ADS)

    Federico, Schliamser; Ayelen, Rinaldi; Romina, Comin; Alba Nelly, Borchert; Adrian, Nari Gustavo; Alicia, Salvatierra Nancy; Mariana Paula, Cid

    2016-04-01

    In the present work, we development a new protocol for liver decellularization in which the hole decellularization was reached over 24 h. Introduction: the availability of transplantable livers is not sufficient to fulfill the current demand for grafts, with the search for therapeutic alternatives having generated different lines of research, one of which is the use of decellularized three-dimensional biological matrices and subsequent cell seeding to obtain a functional organ. Objective: to produce a decellularization protocol from rabbit liver to generate a three-dimensional matrixin which the time period involved didn't pass 24 h. Methods: The decellularization is obtained through the use of water and SDS (0,1-0,3 %), after freezing at -80 degrees, is the best alternative of different physical and/or chemical mechanisms to break down organ cells and leave only the extracellular matriz. After 24 h of retrograde perfusion, a decellularized translucent matrix was generated. To evaluate if the decellularization protocol was successful, with the extracellular matrix being preserved, we carried out histological (light microscopy) and biochemical (DNA quantification) studies. Results: the decellularization process was verified by macroscopic observation of the organ using microscopic observation corroborated the macroscopic results, with the hematoxylin-eosin and Masson staining showing no cells or nuclear material. In addition, the DNA quantification was less than 10% in the decellularized liver compared to control. Finally,the time taken to develop the decellularization protocol was less than 24 hours.

  2. Association between Diurnal Variation of Ozone Concentration and Stroke Occurrence: 24-Hour Time Series Study

    PubMed Central

    Han, Myung-Hoon; Yi, Hyeong-Joong; Kim, Young-Seo; Ko, Yong; Kim, Young-Soo

    2016-01-01

    Background and Purpose Increasing ozone concentrations have been known to damage human health and ecosystems. Although ozone tends to display diurnal variation, most studies have reported only on the association between daily ozone concentrations and ischemic stroke occurrence on the same day, or with a 1-day lag. We investigated the effect of the diurnal variation of ozone on ischemic stroke occurrence during the same day. Methods We included a consecutive series of 1,734 patients from January 1, 2008, to December 31, 2014, at a single tertiary hospital in Seoul, South Korea. We evaluated differences between temperature and pollutants at the time of stroke onset for each time interval and averaged those parameters across the 7-year study period. Results During the interval from 13:00 to 16:59, we found a positive association between ischemic stroke occurrence and ozone concentration relative to other time periods. Upper median ozone levels from 13:00 to 16:59 were positively correlated with ischemic stroke (odds ratio, 1.550; 95% confidence intervals, 1.220 to 1.970; P = <0.001) when compared with lower median levels. Conclusions The results show diurnal patterns of ischemic stroke occurrence based on upper and lower median ozone levels for a 24-hour period, which extends understanding of the association between stroke occurrence and environmental influences. PMID:27015421

  3. Deep venous thrombophlebitis: detection with 4-hour versus 24-hour platelet scintigraphy

    SciTech Connect

    Seabold, J.E.; Conrad, G.R.; Ponto, J.A.; Kimball, D.A.; Frey, E.E.; Ahmed, F.; Coughlan, J.D.; Jensen, K.C.

    1987-11-01

    Thirty-one nonheparinized patients with suspected deep venous thrombophlebitis (DVT) underwent contrast venography and indium-111 platelet scintigraphy (In-111 PS). Venography permitted identification of acute DVT in 12 of 31 cases (39%). One additional patient was considered to have acute DVT despite nonconclusive venography results. In-111 PS results were positive at 4 hours in nine of 13 cases (69%) and at 24 hours in 12 of 13 cases (92%). Two of four patients with false-negative 4-hour In-111 PS studies had received warfarin. Thus, the sensitivity of 4-hour In-111 PS in patients not receiving anticoagulants was 82%. Venography results were negative for acute DVT in 18 cases, and 4-hour In-111 PS studies were negative or equivocal in each. In-111 PS is an alternative to contrast venography for detecting acute DVT. If 4-hour In-111 PS results are positive, anticoagulation can be initiated. Delayed images are necessary if the 4-hour images are negative or equivocal.

  4. Severe community-acquired pneumonia: timely management measures in the first 24 hours.

    PubMed

    Phua, Jason; Dean, Nathan C; Guo, Qi; Kuan, Win Sen; Lim, Hui Fang; Lim, Tow Keang

    2016-01-01

    Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools. The bundles include early guideline-concordant antibiotics including macrolides, early haemodynamic support (lactate measurement, intravenous fluids, and vasopressors), and early respiratory support (high-flow nasal cannulae, lung-protective ventilation, prone positioning, and neuromuscular blockade for acute respiratory distress syndrome).While the proposed interventions appear straightforward, multiple barriers to their implementation exist. To successfully decrease mortality for severe CAP, early and close collaboration between emergency medicine and respiratory and critical care medicine teams is required. We propose a workflow incorporating these interventions. PMID:27567896

  5. Ambulatory Blood Pressure Monitoring in Individuals with HIV: A Systematic Review and Meta-Analysis

    PubMed Central

    Kent, Shia T.; Bromfield, Samantha G.; Burkholder, Greer A.; Falzon, Louise; Oparil, Suzanne; Overton, Edgar T.; Mugavero, Michael J.; Schwartz, Joseph E.; Shimbo, Daichi; Muntner, Paul

    2016-01-01

    Introduction Abnormal diurnal blood pressure (BP) rhythms may contribute to the high cardiovascular disease risk in HIV-positive (HIV+) individuals. To synthesize the current literature on ambulatory BP monitoring (ABPM) in HIV+ individuals, a systematic literature review and meta-analysis were performed. Methods Medical databases were searched through November 11, 2015 for studies that reported ABPM results in HIV+ individuals. Data were extracted by 2 reviewers and pooled differences between HIV+ and HIV-negative (HIV-) individuals in clinic BP and ABPM measures were calculated using random-effects inverse variance weighted models. Results Of 597 abstracts reviewed, 8 studies with HIV+ cohorts met the inclusion criteria. The 420 HIV+ and 714 HIV- individuals in 7 studies with HIV- comparison groups were pooled for analyses. The pooled absolute nocturnal systolic and diastolic BP declines were 3.16% (95% confidence interval [CI]: 1.13%, 5.20%) and 2.92% (95% CI: 1.64%, 4.19%) less, respectively, in HIV+ versus HIV- individuals. The pooled odds ratio for non-dipping systolic BP (nocturnal systolic BP decline <10%) in HIV+ versus HIV- individuals was 2.72 (95% CI: 1.92, 3.85). Differences in mean clinic, 24-hour, daytime, or nighttime BP were not statistically significant. I2 and heterogeneity chi-squared statistics indicated the presence of high heterogeneity for all outcomes except percent DBP dipping and non-dipping SBP pattern. Conclusions An abnormal diurnal BP pattern may be more common among HIV+ versus HIV- individuals. However, results were heterogeneous for most BP measures, suggesting more research in this area is needed. PMID:26882469

  6. Gender differences in the relationship between resting heart rate variability and 24-hour blood pressure variability.

    PubMed

    Thayer, Julian F; Sollers, John J; Friedman, Bruce H; Koenig, Julian

    2016-02-01

    The study explored the relationship between time- and frequency-domain indices of cardiac autonomic control and 24 h blood pressure variability (BPV) in a sample of healthy men and women. Vagally mediated cardiac control was inversely related to 24 h BPV, and measures of cardiac autonomic control were better predictors of systolic BPV in men and better predictors of diastolic BPV in women. These findings may help researchers to understand the disparity in cardiovascular disease morbidity and mortality between men and women. PMID:26415550

  7. Usability of a smartphone food picture app for assisting 24-hour dietary recall: a pilot study

    PubMed Central

    Pope, Benjamin T.; Bilgiç, Pelin; Orr, Barron J.; Suzuki, Asuka; Kim, Angela Sarah; Merchant, Nirav C.; Roe, Denise J.

    2015-01-01

    BACKGROUND/OBJECTIVES The Recaller app was developed to help individuals record their food intakes. This pilot study evaluated the usability of this new food picture application (app), which operates on a smartphone with an embedded camera and Internet capability. SUBJECTS/METHODS Adults aged 19 to 28 years (23 males and 22 females) were assigned to use the Recaller app on six designated, nonconsecutive days in order to capture an image of each meal and snack before and after eating. The images were automatically time-stamped and uploaded by the app to the Recaller website. A trained nutritionist administered a 24-hour dietary recall interview 1 day after food images were taken. Participants' opinions of the Recaller app and its usability were determined by a follow-up survey. As an evaluation indicator of usability, the number of images taken was analyzed and multivariate Poisson regression used to model the factors determining the number of images sent. RESULTS A total of 3,315 food images were uploaded throughout the study period. The median number of images taken per day was nine for males and 13 for females. The survey showed that the Recaller app was easy to use, and 50% of the participants would consider using the app daily. Predictors of a higher number of images were as follows: greater interval (hours) between the first and last food images sent, weekend, and female. CONCLUSIONS The results of this pilot study provide valuable information for understanding the usability of the Recaller smartphone food picture app as well as other similarly designed apps. This study provides a model for assisting nutrition educators in their collection of food intake information by using tools available on smartphones. This innovative approach has the potential to improve recall of foods eaten and monitoring of dietary intake in nutritional studies. PMID:25861429

  8. Difference in 24-Hour Urine Composition between Diabetic and Non-Diabetic Adults without Nephrolithiasis

    PubMed Central

    Qin, Jing; Duan, Xiaolu; Liu, Yang; Zhao, Zhijian; Yuan, Jian; Wan, Shaw P.; Zeng, Guohua

    2016-01-01

    Background Diabetic patients are more likely to develop kidney stones than the general population. The underlying mechanisms for this disparity remain to be elucidated. Little is known about the relationship between urine composition and diabetes mellitus in non-stone-forming individuals. We sought to examine the differences in the 24-hour (24-h) urine composition between diabetic and non-diabetic adults who were not stone formers. Methods A convenience sample of 538 individuals without a history of nephrolithiasis, gout, hyperparathyroidism, or gastroenteric diseases participated in this study. The 24-h urine profiles of 115 diabetic adults were compared with those of 423 non-diabetic adults. Diabetes was defined by self-reported physician diagnosis or medication use. All participants were non-stone formers confirmed by urinary tract ultrasonography. Participants provided a fasting blood sample and a single 24-h urine collection for stone risk analysis. Student’s t-test was used to compare mean urinary values. Linear regression models were adjusted for age, gender, body mass index, hypertension, fasting serum glucose, serum total cholesterol, estimated creatinine clearance rate and urinary factors. Results Univariable analysis showed that the diabetic participants had significantly higher 24-h urine volumes and lower urine calcium and magnesium excretions than non-diabetic participants (all P < 0.05). After multivariate adjustment, no significant differences in 24-h urine composition were observed between diabetic and non-diabetic participants except for a slightly increased 24-h urine volume in diabetic participants (all P > 0.05). The main limitation of this study is that the convenience samples and self-reported data may have been sources of bias. Conclusion Our data showed that there were no differences in 24-h urine composition between diabetic and non-diabetic adults who are not stone formers. The reason for it might be the improved glycemic control in

  9. A randomized controlled trial comparing the effects of yoga to an active control on ambulatory blood pressure in individuals with Pre- and Stage 1 Hypertension

    PubMed Central

    Hagins, Marshall; Rundle, Andrew; Consedine, Nathan S.; Khalsa, Sat Bir S.

    2013-01-01

    The purpose of this study was to compare the effects of yoga to an active control (non-aerobic exercise) in individuals with pre- and Stage 1 hypertension. A randomized clinical trial was performed using two arms: 1) yoga and 2) active control. Primary outcomes were 24-hour, day and night ambulatory systolic and diastolic blood pressures. Within-group and between-group analyses were performed using paired t-tests and repeated measures ANOVAs (time x group), respectively. Eighty-four participants enrolled with 68 participants completing the trial. Within-group analyses found 24-hour diastolic, night diastolic, and mean arterial pressure all significantly reduced in the yoga group (−3.93, −4.7, −4.23 mmHg, respectively) but no significant within-group changes in the active control group. Direct comparisons of the yoga intervention to the control group found a single blood pressure variable (diastolic night) to be significantly different (p =.038). This study has demonstrated that a yoga intervention can lower blood pressure in patients with mild hypertension. Although this study was not adequately powered to show between-group differences, the size of the yoga-induced blood pressure reduction we observed appears to justify performing a definitive trial of this intervention to test whether it can provide meaningful therapeutic value for the management of hypertension. PMID:24387700

  10. A randomized controlled trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension.

    PubMed

    Hagins, Marshall; Rundle, Andrew; Consedine, Nathan S; Khalsa, Sat Bir S

    2014-01-01

    The purpose of this study was to compare the effects of yoga with an active control (nonaerobic exercise) in individuals with prehypertension and stage 1 hypertension. A randomized clinical trial was performed using two arms: (1) yoga and (2) active control. Primary outcomes were 24-hour day and night ambulatory systolic and diastolic blood pressures. Within-group and between-group analyses were performed using paired t tests and repeated-measures analysis of variance (time × group), respectively. Eighty-four participants enrolled, with 68 participants completing the trial. Within-group analyses found 24-hour diastolic, night diastolic, and mean arterial pressure all significantly reduced in the yoga group (-3.93, -4.7, -4.23 mm Hg, respectively) but no significant within-group changes in the active control group. Direct comparisons of the yoga intervention with the control group found a single blood pressure variable (diastolic night) to be significantly different (P=.038). This study has demonstrated that a yoga intervention can lower blood pressure in patients with mild hypertension. Although this study was not adequately powered to show between-group differences, the size of the yoga-induced blood pressure reduction appears to justify performing a definitive trial of this intervention to test whether it can provide meaningful therapeutic value for the management of hypertension. PMID:24387700

  11. To Compare the Microleakage Among Experimental Adhesives Containing Nanoclay Fillers after the Storages of 24 Hours and 6 Months

    PubMed Central

    Mousavinasab, Seyed Mostafa; Atai, Mohammad; Alavi, Bagher

    2011-01-01

    Objectives: To compare the microleakage among experimental adhesives containing nanoclay fillers after the storages of 24 hours and 6 months. Materials and Methods: Class V cavities were prepared on extracted human molars with the occlusal margins located in enamel and the cervical margins in cementum. Phosphoric acid was applied to the enamel and dentin margins.Subsequently, the cavities were treated using four groups of experimental adhesive systems and restored with a resin composite. Adper Single Bond® was used as control group. After 24- hour and 6- month storages, the samples were subjected to thermocycling shocks and then immersed in silver nitrate as well as developer solution and finally evaluated for leakage. The data were analyzed using SPSS software. Results: Based on Kruskal –Wallis test, significant differences were found between groups regarding microleakage. The Mann- Whitney test showed that Leakage was significantly lower in Adper Single Bond® compared to the other groups in dentinal margins after 24 hours and 6 months and in enamel margins after 6 months. The Wilcoxon Signed Ranks test showed that the enamel leakage in experimental adhesives was significantly lower than dentinal leakage after 24 hours as well as enamel leakage in Adper Single Bond and adhesive with 0.5% PMAA-g-nanoclay was significantly lower than dentinal margins after storage period of 6 months. Conclusion: All the experimental adhesives were effective in reducing enamel leakage after 24 hours, but were not effective in reducing dentinal leakage after 24 hours as well as in enamel and dentinal leakage after a 6-month storage. No improvement was observed in the microleakage in dentin in both short (24 hrs) and long times (6 months). The high microleakage in the adhesives is probably attributed to the high concentration of HEMA in the recipe of the bonding agent. PMID:21566692

  12. Executive Functions are not Affected by 24 Hours of Sleep Deprivation: A Color-Word Stroop Task Study

    PubMed Central

    Dixit, Abhinav; Mittal, Tushar

    2015-01-01

    Background: Sleep is an important factor affecting cognitive performance. Sleep deprivation results in fatigue, lack of concentration, confusion and sleepiness along with anxiety, depression and irritability. Sleep deprivation can have serious consequences in professions like armed forces and medicine where quick decisions and actions need to be taken. Color-Word Stroop task is one of the reliable tests to assess attention and it analyzes the processing of information in two dimensions i.e., reading of words and naming of colour. The evidence regarding the effect of sleep deprivation on Stroop interference is conflicting. The present study evaluated the effect of 24 hours of sleep deprivation on reaction time and interference in Stroop task. Materials and Methods: The present study was done on 30 healthy male medical student volunteers in the age group of 18-25 years after taking their consent and clearance from Institute Ethics Committee. Recordings of Stroop task were at three times: baseline (between 7-9 am), after 12 hours (7-9 pm) and after 24 hours (7-9 am, next day). The subjects were allowed to perform normal daily activities. Results: The study revealed a significant increase in reaction time after 24 hours of sleep deprivation in comparison to baseline and after 12 hours of sleep deprivation. There was no significant change in interference and facilitation after sleep deprivation in comparison to baseline. The number of errors also did not show any significant change after sleep deprivation. Conclusion: The study indicated that there was slowing of responses without change in executive functions after 24 hours of sleep deprivation. It is probable that 24 hours of sleep deprivation does not bring about change in areas of brain affecting executive functions in healthy individuals who have normal sleep cycle. The present study indicated that in professions like armed forces and medicine working 24 hours at a stretch can lead to decrease in motor responses

  13. Society for Ambulatory Anesthesia

    MedlinePlus

    ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ... 6620 | E-mail: info@sambahq.org Copyright | 2016 Society for Ambulatory Anesthesia Home | Search | Terms | Privacy Policy | ...

  14. Tasimelteon (Hetlioz™): A New Melatonin Receptor Agonist for the Treatment of Non-24-Hour Sleep-Wake Disorder.

    PubMed

    Bonacci, Janene M; Venci, Jineane V; Gandhi, Mona A

    2015-10-01

    In January 2014, the US Food and Drug Administration approved tasimelteon (Hetlioz™), a melatonin-receptor agonist for the treatment of non-24-hour sleep-wake disorder. This article provides an overview of the mechanism of action, pharmacokinetic properties, as well as the clinical efficacy, safety, and tolerability of tasimelteon. Relevant information was identified through a comprehensive literature search of several databases using the key words tasimelteon, Non-24-hour Sleep-Wake disorder, Non-24, and melatonin. Further information was obtained from the tasimelteon package insert, fda.gov, clinicaltrials.gov, briefing materials provided by Vanda Pharmaceuticals, and posters from scientific meetings. PMID:25092604

  15. Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study

    PubMed Central

    2013-01-01

    Introduction Many intensive care patients experience sleep disruption potentially related to noise, light and treatment interventions. The purpose of this study was to characterise, in terms of quantity and quality, the sleep of intensive care patients, taking into account the impact of environmental factors. Methods This observational study was conducted in the adult ICU of a tertiary referral hospital in Australia, enrolling 57 patients. Polysomnography (PSG) was performed over a 24-hour period to assess the quantity (total sleep time: hh:mm) and quality (percentage per stage, duration of sleep episode) of patients' sleep while in ICU. Rechtschaffen and Kales criteria were used to categorise sleep. Interrater checks were performed. Sound pressure and illuminance levels and care events were simultaneously recorded. Patients reported on their sleep quality in ICU using the Richards Campbell Sleep Questionnaire and the Sleep in Intensive Care Questionnaire. Data were summarised using frequencies and proportions or measures of central tendency and dispersion as appropriate and Cohen's Kappa statistic was used for interrater reliability of the sleep data analysis. Results Patients' median total sleep time was 05:00 (IQR: 02:52 to 07:14). The majority of sleep was stage 1 and 2 (medians: 19 and 73%) with scant slow wave and REM sleep. The median duration of sleep without waking was 00:03. Sound levels were high (mean Leq 53.95 dB(A) during the day and 50.20 dB(A) at night) and illuminance levels were appropriate at night (median <2 lux) but low during the day (median: 74.20 lux). There was a median 1.7 care events/h. Patients' mean self-reported sleep quality was poor. Interrater reliability of sleep staging was highest for slow wave sleep and lowest for stage 1 sleep. Conclusions The quantity and quality of sleep in intensive care patients are poor and may be related to noise, critical illness itself and treatment events that disturb sleep. The study highlights the

  16. Self-Renewal and Differentiation Capacity of Urine-Derived Stem Cells after Urine Preservation for 24 Hours

    PubMed Central

    Shi, Yingai; Bharadwaj, Shantaram; Leng, Xiaoyan; Zhou, Xiaobo; Liu, Hong; Atala, Anthony; Zhang, Yuanyuan

    2013-01-01

    Despite successful approaches to preserve organs, tissues, and isolated cells, the maintenance of stem cell viability and function in body fluids during storage for cell distribution and transportation remains unexplored. The aim of this study was to characterize urine-derived stem cells (USCs) after optimal preservation of urine specimens for up to 24 hours. A total of 415 urine specimens were collected from 12 healthy men (age range 20–54 years old). About 6×104 cells shed off from the urinary tract system in 24 hours. At least 100 USC clones were obtained from the stored urine specimens after 24 hours and maintained similar biological features to fresh USCs. The stored USCs had a “rice grain” shape in primary culture, and expressed mesenchymal stem cell surface markers, high telomerase activity, and normal karyotypes. Importantly, the preserved cells retained bipotent differentiation capacity. Differentiated USCs expressed myogenic specific proteins and contractile function when exposed to myogenic differentiation medium, and they expressed urothelial cell-specific markers and barrier function when exposed to urothelial differentiation medium. These data demonstrated that up to 75% of fresh USCs can be safely persevered in urine for 24 hours and that these cells stored in urine retain their original stem cell properties, indicating that preserved USCs could be available for potential use in cell-based therapy or clinical diagnosis. PMID:23349776

  17. Accuracy and Usefulness of Select Methods for Assessing Complete Collection of 24-Hour Urine: A Systematic Review.

    PubMed

    John, Katherine A; Cogswell, Mary E; Campbell, Norm R; Nowson, Caryl A; Legetic, Branka; Hennis, Anselm J M; Patel, Sheena M

    2016-05-01

    Twenty-four-hour urine collection is the recommended method for estimating sodium intake. To investigate the strengths and limitations of methods used to assess completion of 24-hour urine collection, the authors systematically reviewed the literature on the accuracy and usefulness of methods vs para-aminobenzoic acid (PABA) recovery (referent). The percentage of incomplete collections, based on PABA, was 6% to 47% (n=8 studies). The sensitivity and specificity for identifying incomplete collection using creatinine criteria (n=4 studies) was 6% to 63% and 57% to 99.7%, respectively. The most sensitive method for removing incomplete collections was a creatinine index <0.7. In pooled analysis (≥2 studies), mean urine creatinine excretion and volume were higher among participants with complete collection (P<.05); whereas, self-reported collection time did not differ by completion status. Compared with participants with incomplete collection, mean 24-hour sodium excretion was 19.6 mmol higher (n=1781 specimens, 5 studies) in patients with complete collection. Sodium excretion may be underestimated by inclusion of incomplete 24-hour urine collections. None of the current approaches reliably assess completion of 24-hour urine collection. PMID:26726000

  18. Population Pharmacokinetic Model Characterizing 24-Hour Variation in the Pharmacokinetics of Oral and Intravenous Midazolam in Healthy Volunteers

    PubMed Central

    van Rongen, A; Kervezee, L; Brill, MJE; van Meir, H; den Hartigh, J; Guchelaar, H-J; Meijer, JH; Burggraaf, J; van Oosterhout, F

    2015-01-01

    Daily rhythms in physiology may affect the pharmacokinetics of a drug. The aim of this study was to evaluate 24-hour variation in the pharmacokinetics of the CYP3A substrate midazolam. Oral (2 mg) and intravenous (1 mg) midazolam was administered at six timepoints throughout the 24-hour period in 12 healthy volunteers. Oral bioavailability (population mean value [RSE%] of 0.28 (7.1%)) showed 24-hour variation that was best parameterized as a cosine function with an amplitude of 0.04 (17.3%) and a peak at 12:14 in the afternoon. The absorption rate constant was 1.41 (4.7%) times increased after drug administration at 14:00. Clearance (0.38 L/min (4.8%)) showed a minor 24-hour variation with an amplitude of 0.03 (14.8%) L/min and a peak at 18:50. Simulations show that dosing time minimally affects the concentration time profiles after intravenous administration, while concentrations are higher during the day compared to the night after oral dosing, reflecting considerable variation in intestinal processes. PMID:26380154

  19. Population Pharmacokinetic Model Characterizing 24-Hour Variation in the Pharmacokinetics of Oral and Intravenous Midazolam in Healthy Volunteers.

    PubMed

    van Rongen, A; Kervezee, L; Brill, Mje; van Meir, H; den Hartigh, J; Guchelaar, H-J; Meijer, J H; Burggraaf, J; van Oosterhout, F

    2015-08-01

    Daily rhythms in physiology may affect the pharmacokinetics of a drug. The aim of this study was to evaluate 24-hour variation in the pharmacokinetics of the CYP3A substrate midazolam. Oral (2 mg) and intravenous (1 mg) midazolam was administered at six timepoints throughout the 24-hour period in 12 healthy volunteers. Oral bioavailability (population mean value [RSE%] of 0.28 (7.1%)) showed 24-hour variation that was best parameterized as a cosine function with an amplitude of 0.04 (17.3%) and a peak at 12:14 in the afternoon. The absorption rate constant was 1.41 (4.7%) times increased after drug administration at 14:00. Clearance (0.38 L/min (4.8%)) showed a minor 24-hour variation with an amplitude of 0.03 (14.8%) L/min and a peak at 18:50. Simulations show that dosing time minimally affects the concentration time profiles after intravenous administration, while concentrations are higher during the day compared to the night after oral dosing, reflecting considerable variation in intestinal processes. PMID:26380154

  20. Value of 24-hour Delayed Film of Barium Enema for Evaluation of Colon Transit Function in Young Children with Constipation

    PubMed Central

    Yoo, Ha Yeong; Son, Jae Sung; Park, Hye Won; Kwak, Byung Ok; Kim, Hyeong Su; Bae, Sun Hwan

    2016-01-01

    Background/Aims A colon transit time test using radio-opaque markers (CTTRM) is considered the gold standard for evaluating colon transit function. A 24-hour delayed film of barium enema (BE) has been used as a supplementary method in structural evaluations. The aim of this study was to evaluate the utility of a 24-hour delayed BE film for assessing colon transit function in young children with constipation. Methods In total, 93 children with constipation who performed both single-contrast BE and CTTRM were enrolled in this study. Of these, the data from 70 children were analyzed (males 33, females 37; mean age [range], 5.63 ± 2.94 [2–14] years). The basic principle of the study is “velocity = distance/time”. Time values were identified in both studies, and the colon length and distance of barium movement were measured on the 24-hour delayed BE film. Thus, colon transit velocity values could be calculated using both methods. The correlation between colon transit velocity using a 24-hour delayed BE film versus CTTRM was analyzed statistically. Results Median value (interquartile range) of colon transit velocity using CTTRM was 1.57 (1.07–2.89) cm/hr, and that using BE of that was 1.58 (0.94–2.07) cm/hr. The Spearman correlation coefficient was 0.438 (P < 0.001) for the overall group. The correlation was strongest in children younger than 4 years (r = 0.537, P = 0.032). Conclusions Although the correlation between BE and CTTRM was not very strong, the 24-hour delayed BE film could provide broad information about colon transit function in young children, especially those under 4 years who usually cannot undergo CTTRM. PMID:26979249

  1. Microleakage of Two Self-Adhesive Cements in the Enamel and Dentin After 24 Hours and Two Months

    PubMed Central

    Jaberi Ansari, Zahra; Kalantar Motamedi, Mojdeh

    2014-01-01

    Objective: Microleakage is a main cause of restorative treatment failure. In this study, we compared occlusal and cervical microleakage of two self-adhesive cements after 24 hours and two months. Materials and Methods: In this in-vitro experimental study, class II inlay cavities were prepared on 60 sound human third molars. Composite inlays were fabricated with Z100 composite resin. The teeth were randomly assigned to six groups. RelyX-Arc (control), RelyX-Unicem and Maxcem were used for the first three groups and specimens were stored in distilled water at 37°C for 24 hours. The same cements were used for the remaining three groups, but the specimens were stored for 2 months. The teeth were subjected to 500 thermal cycles (5°C and 55°C) and immersed in 0.5% basic fuchsin for 24 hours and then sectioned mesiodistally and dye penetration was evaluated in a class II cavity with occlusal and cervical margins using X20 magnification stereomicroscope. Data were analyzed using Kruskal Wallis and Mann-Whitney U tests. Results: After 24 hours, cements had significant differences only in cervical margin microleakage (P=0.0001) and microleakage of RelyX-Unicem and Maxcem was significantly more than that of RelyX-Arc (both P=0.0001). Cervical microleakage in RelyX-Unicem and Maxcem was greater than occlusal (P=0.0001 and P=0.001, respectively). Microleakage was not significantly different between the occlusal and cervical margins after 2 months. Conclusion: Cervical microleakage was greater than occlusal in RelyX-Unicem and Maxcem after 24h. The greatest microleakage was reported for the cervical margin of RelyX-Unicem after 24 hours. PMID:25584053

  2. Changes in platelet morphology and function during 24 hours of storage.

    PubMed

    Braune, S; Walter, M; Schulze, F; Lendlein, A; Jung, F

    2014-01-01

    aggregates could be visualized microscopically. After four hours, first debris and very small aggregates occurred. After 24 hours, platelet aggregates and also debris progressively increased. In accordance to this, the CASY system revealed an increase of platelet aggregates (up to 90 μm diameter) with increasing storage time. The percentage of CD62P positive platelets and PF4 increased significantly with storage time in resting PRP. When soluble ADP was added to stored PRP samples, the number of activatable platelets decreased significantly over storage time. The present study reveals the importance of a consequent standardization in the preparation of WB and PRP. Platelet morphology and function, particularly platelet reactivity to adherent or soluble agonists in their surrounding milieu, changed rapidly outside the vascular system. This knowledge is of crucial interest, particularly in the field of biomaterial development for cardiovascular applications, and may help to define common standards in the in vitro hemocompatibility testing of biomaterials. PMID:25227196

  3. Irregular 24-hour Activity Rhythms and the Metabolic Syndrome in Older Adults

    PubMed Central

    Sohail, Shahmir; Yu, Lei; Bennett, David A.; Buchman, Aron S.; Lim, Andrew S.P.

    2015-01-01

    Circadian rhythms – near 24-hour intrinsic biological rhythms – modulate many aspects of human physiology and hence disruption of circadian rhythms may have an important impact on human health. Experimental work supports a potential link between irregular circadian rhythms and several key risk factors for cardiovascular disease including hypertension, obesity, diabetes, and dyslipidemia, collectively termed the metabolic syndrome. While several epidemiological studies have demonstrated an association between shift-work and the components of the metabolic syndrome in working-age adults, there is a relative paucity of data concerning the impact of non-occupational circadian irregularity in older women and men. To address this question, we studied 7 days of actigraphic data from 1137 older woman and men participating in the Rush Memory and Aging Project, a community-based cohort study of the chronic conditions of aging. The regularity of activity rhythms was quantified using the nonparametric interdaily stability metric, and was related to the metabolic syndrome and its components obesity, hypertension, diabetes, and dyslipidemia. More regular activity rhythms were associated with a lower odds of having the metabolic syndrome (OR=0.69, 95%CI=0.60–0.80, p=5.8×10−7), being obese (OR=0.73, 95%CI=0.63–0.85, p=2.5×10−5), diabetic (OR=0.76, 95%CI=0.65–0.90, p=9.3×10−4), hypertensive (OR=0.78, 95%CI=0.66–0.91, p=2.0×10−3), or dyslipidemic (OR=0.82, 95%CI=0.72–0.92, p=1.2×10−3). These associations were independent of differences in objectively measured total daily physical activity or rest, and were not accounted for by prevalent coronary artery disease, stroke, or peripheral artery disease. Moreover, more regular activity rhythms were associated with lower odds of having cardiovascular disease (OR=0.83; 95%CI=0.73–0.95, p=5.7×10−3), an effect that was statistically mediated by the metabolic syndrome. We conclude that irregular activity

  4. Resistance training decreases 24-hour blood pressure in women with metabolic syndrome

    PubMed Central

    2013-01-01

    Background The purpose of this study was to verify the effects of eight weeks of resistance training (RT) on 24 hour blood pressure (BP) in patients with and without metabolic syndrome (MetS). Methods Seventeen women volunteered to participate in this study, 9 with MetS (37.0 ± 8.7 yrs; body mass 77.3 ± 9.7 kg; body mass index 30.3 ± 4.2 kg · m-2) and 8 without MetS (35.1 ± 7.2 yrs; body mass 61.3 ± 8.1 kg; body mass index 24.2 ± 2.5 kg · m-2). Individuals were subjected to eight weeks (3 times/week) of whole body RT comprised of one exercise for each main muscle group with three sets of 8–12 repetitions of each subject’s maximal load . A rest interval of one minute was allowed between sets and exercises. Twenty-four hour BP was measured by ambulatory blood pressure monitoring. Results Mean and diastolic night-time BP decreased (−3.9 mmHg, p = 0.04; -5.5 mmHg, p = 0.03, respectively) after eight weeks of training in MetS patients. This decrease was observed at 11:00 pm, 02:00 am (only diastolic), 07:00 am, and 6:00 pm. There was no training effect on BP in women without MetS. Conclusions Considering the elevation of BP as a contributor to the pathogenesis of MetS, and also to the increase of cardiovascular risk, this study supports RT as a non-pharmacological therapy in the management of BP control for MetS. PMID:23711286

  5. Preventing Misdiagnosis of Ambulatory Hypertension: Algorithm Using Office and Home Blood Pressures

    PubMed Central

    Shimbo, Daichi; Kuruvilla, Sujith; Haas, Donald; Pickering, Thomas G.; Schwartz, Joseph E.; Gerin, William

    2009-01-01

    Objectives An algorithm for making a differential diagnosis between sustained and white coat hypertension (SH and WCH) has been proposed–patients with office hypertension undergo home blood pressure monitoring (HBPM) and those with normal HBP levels undergo ambulatory blood pressure monitoring (ABPM). We tested whether incorporating an upper office blood pressure (OBP) cutoff in the algorithm, higher than the traditional 140/90 mmHg, reduces the need for HBPM and ABPM. Methods 229 normotensive and untreated mildly hypertensive participants (mean age 52.5 ± 14.6, 54% female) underwent OBP measurements, HBPM, and 24-hour ABPM. Using the algorithm, sensitivity (SN), specificity (SP), and positive and negative predictive values (PPV, NPV) for SH and WCH were assessed. We then modified the algorithm utilizing a systolic and diastolic OBP cutoff at a SP of 95% for ambulatory hypertension –those with office hypertension but OBP levels below the upper cutoff undergo HBPM and subsequent ABPM if appropriate. Results Using the original algorithm, SN and PPV for SH were 100% and 93.8%. Despite a SP of 44.4%, NPV was 100%. These values correspond to SP, NPV, SN, and PPV for WCH respectively. Using the modified algorithm, the diagnostic accuracy for SH and WCH did not change. However, far fewer participants needed HBPM (29 vs. 84) and ABPM (8 vs. 15). Conclusions In this sample, the original and modified algorithms are excellent at diagnosing SH and WCH. However, the latter requires far fewer subjects to undergo HBPM and ABPM. These findings have important implications for the cost-effective diagnosis of SH and WCH. PMID:19491703

  6. Effects of aroma massage on home blood pressure, ambulatory blood pressure, and sleep quality in middle-aged women with hypertension.

    PubMed

    Ju, Myeong-Sook; Lee, Sahng; Bae, Ikyul; Hur, Myung-Haeng; Seong, Kayeon; Lee, Myeong Soo

    2013-01-01

    The purpose of this study was to evaluate the effects of aroma massage applied to middle-aged women with hypertension. The research study had a nonequivalent control group, nonsynchronized design to investigate the effect on home blood pressure (BP), ambulatory BP, and sleep. The hypertensive patients were allocated into the aroma massage group (n = 28), the placebo group (n = 28), and the no-treatment control group (n = 27). To evaluate the effects of aroma massage, the experimental group received a massage with essential oils prescribed by an aromatherapist once a week and body cream once a day. The placebo group received a massage using artificial fragrance oil once a week and body cream once a day. BP, pulse rate, sleep conditions, and 24-hour ambulatory BP were monitored before and after the experiment. There was a significant difference in home systolic blood pressure (SBP) (F = 6.71, P = 0.002) between groups after intervention. There was also a significant difference in SBP (F = 13.34, P = 0.001) and diastolic blood pressure (DBP) (F = 8.46, P = 0.005) in the laboratory between aroma massage and placebo groups. In sleep quality, there was a significant difference between groups (F = 6.75, P = 0.002). In conclusion, aroma massage may help improve patient quality of life and maintain health as a nursing intervention in daily life. PMID:23431338

  7. Effects of Aroma Massage on Home Blood Pressure, Ambulatory Blood Pressure, and Sleep Quality in Middle-Aged Women with Hypertension

    PubMed Central

    Ju, Myeong-Sook; Lee, Sahng; Bae, Ikyul; Hur, Myung-Haeng; Seong, Kayeon; Lee, Myeong Soo

    2013-01-01

    The purpose of this study was to evaluate the effects of aroma massage applied to middle-aged women with hypertension. The research study had a nonequivalent control group, nonsynchronized design to investigate the effect on home blood pressure (BP), ambulatory BP, and sleep. The hypertensive patients were allocated into the aroma massage group (n = 28), the placebo group (n = 28), and the no-treatment control group (n = 27). To evaluate the effects of aroma massage, the experimental group received a massage with essential oils prescribed by an aromatherapist once a week and body cream once a day. The placebo group received a massage using artificial fragrance oil once a week and body cream once a day. BP, pulse rate, sleep conditions, and 24-hour ambulatory BP were monitored before and after the experiment. There was a significant difference in home systolic blood pressure (SBP) (F = 6.71, P = 0.002) between groups after intervention. There was also a significant difference in SBP (F = 13.34, P = 0.001) and diastolic blood pressure (DBP) (F = 8.46, P = 0.005) in the laboratory between aroma massage and placebo groups. In sleep quality, there was a significant difference between groups (F = 6.75, P = 0.002). In conclusion, aroma massage may help improve patient quality of life and maintain health as a nursing intervention in daily life. PMID:23431338

  8. Ambulatory Assessment

    PubMed Central

    Trull, Timothy J.; Ebner-Priemer, Ulrich

    2014-01-01

    Ambulatory assessment (AA) covers a wide range of assessment methods to study people in their natural environment, including self-report, observational, and biological/physiological/behavioral. AA methods minimize retrospective biases while gathering ecologically valid data from patients’ everyday life in real time or near real time. Here, we report on the major characteristics of AA, and we provide examples of applications of AA in clinical psychology (a) to investigate mechanisms and dynamics of symptoms, (b) to predict the future recurrence or onset of symptoms, (c) to monitor treatment effects, (d) to predict treatment success, (e) to prevent relapse, and (f) as interventions. In addition, we present and discuss the most pressing and compelling future AA applications: technological developments (the smartphone), improved ecological validity of laboratory results by combined lab-field studies, and investigating gene-environment interactions. We conclude with a discussion of acceptability, compliance, privacy, and ethical issues. PMID:23157450

  9. Changes in foot volume, body composition, and hydration status in male and female 24-hour ultra-mountain bikers

    PubMed Central

    2014-01-01

    Background The effects of running and cycling on changes in hydration status and body composition during a 24-hour race have been described previously, but data for 24-hour ultra-mountain bikers are missing. The present study investigated changes in foot volume, body composition, and hydration status in male and female 24-hour ultra-mountain bikers. Methods We compared in 49 (37 men and 12 women) 24-hour ultra-mountain bikers (ultra-MTBers) changes (Δ) in body mass (BM). Fat mass (FM), percent body fat (%BF) and skeletal muscle mass (SM) were estimated using anthropometric methods. Changes in total body water (TBW), extracellular fluid (ECF) and intracellular fluid (ICF) were determined using bioelectrical impedance and changes in foot volume using plethysmography. Haematocrit, plasma [Na+], plasma urea, plasma osmolality, urine urea, urine specific gravity and urine osmolality were measured in a subgroup of 25 ultra-MTBers (16 men and 9 women). Results In male 24-hour ultra-MTBers, BM (P < 0.001), FM (P < 0.001), %BF (P < 0.001) and ECF (P < 0.05) decreased whereas SM and TBW did not change (P > 0.05). A significant correlation was found between post-race BM and post-race FM (r = 0.63, P < 0.001). In female ultra-MTBers, BM (P < 0.05), %BF (P < 0.05) and FM (P < 0.001) decreased, whereas SM, ECF and TBW remained stable (P > 0.05). Absolute ranking in the race was related to Δ%BM (P < 0.001) and Δ%FM in men (P < 0.001) and to Δ%BM (P < 0.05) in women. In male ultra-MTBers, increased post-race plasma urea (P < 0.001) was negatively related to absolute ranking in the race, Δ%BM, post-race FM and Δ%ECF (P < 0.05). Foot volume remained stable in both sexes (P > 0.05). Conclusions Male and female 24-hour ultra-MTBers experienced a significant loss in BM and FM, whereas SM remained stable. Body weight changes and increases in plasma urea do not reflect a change in body hydration status. No oedema

  10. Reasoning about systolic algorithms

    SciTech Connect

    Purushothaman, S.

    1986-01-01

    Systolic algorithms are a class of parallel algorithms, with small grain concurrency, well suited for implementation in VLSI. They are intended to be implemented as high-performance, computation-bound back-end processors and are characterized by a tesselating interconnection of identical processing elements. This dissertation investigates the problem of providing correctness of systolic algorithms. The following are reported in this dissertation: (1) a methodology for verifying correctness of systolic algorithms based on solving the representation of an algorithm as recurrence equations. The methodology is demonstrated by proving the correctness of a systolic architecture for optimal parenthesization. (2) The implementation of mechanical proofs of correctness of two systolic algorithms, a convolution algorithm and an optimal parenthesization algorithm, using the Boyer-Moore theorem prover. (3) An induction principle for proving correctness of systolic arrays which are modular. Two attendant inference rules, weak equivalence and shift transformation, which capture equivalent behavior of systolic arrays, are also presented.

  11. Food Intake Recording Software System, version 4 (FIRSSt4): A Self-Completed 24 Hour Dietary Recall for Children

    PubMed Central

    Baranowski, Tom; Islam, Noemi; Douglass, Deirdre; Dadabhoy, Hafza; Beltran, Alicia; Baranowski, Janice; Thompson, Debbe; Cullen, Karen W.; Subar, Amy F.

    2012-01-01

    The Food Intake Recording Software System, version 4(FIRSSt4), is a web-based 24 hour dietary recall (24hdr) self-administered by children based on the Automated Self-Administered 24-hour recall (ASA24) (a self-administered 24hdr for adults). The food choices in FIRSST4 are abbreviated to include only those reported by children in U.S. national surveys; and detailed food probe questions are simplified to exclude those that children could not be expected to answer (for example questions regarding food preparation and added fats). ASA24 and FIRSSt4 incorporate 10,000+ food images with up to eight images per food to assist in portion size estimation. This paper reviews the formative research conducted during the development of FIRSSt4. When completed, FIRSSt4 will be hosted and maintained for investigator use on the National Cancer Institute’s ASA24 website. PMID:22616645

  12. Dipstick Spot urine pH does not accurately represent 24 hour urine PH measured by an electrode

    PubMed Central

    Omar, Mohamed; Sarkissian, Carl; Jianbo, Li; Calle, Juan; Monga, Manoj

    2016-01-01

    ABSTRACT Objectives To determine whether spot urine pH measured by dipstick is an accurate representation of 24 hours urine pH measured by an electrode. Materials and Methods We retrospectively reviewed urine pH results of patients who presented to the urology stone clinic. For each patient we recorded the most recent pH result measured by dipstick from a spot urine sample that preceded the result of a 24-hour urine pH measured by the use of a pH electrode. Patients were excluded if there was a change in medications or dietary recommendations or if the two samples were more than 4 months apart. A difference of more than 0.5 pH was considered an inaccurate result. Results A total 600 patients were retrospectively reviewed for the pH results. The mean difference in pH between spot urine value and the 24 hours collection values was 0.52±0.45 pH. Higher pH was associated with lower accuracy (p<0.001). The accuracy of spot urine samples to predict 24-hour pH values of <5.5 was 68.9%, 68.2% for 5.5 to 6.5 and 35% for >6.5. Samples taken more than 75 days apart had only 49% the accuracy of more recent samples (p<0.002). The overall accuracy is lower than 80% (p<0.001). Influence of diurnal variation was not significant (p=0.588). Conclusions Spot urine pH by dipstick is not an accurate method for evaluation of the patients with urolithiasis. Patients with alkaline urine are more prone to error with reliance on spot urine pH. PMID:27286119

  13. 24-hour evaluation of dental plaque bacteria and halitosis after consumption of a single placebo or dental treat by dogs.

    PubMed

    Jeusette, Isabelle C; Román, Aurora Mateo; Torre, Celina; Crusafont, Josep; Sánchez, Nuria; Sánchez, Maria C; Pérez-Salcedo, Leire; Herrera, David

    2016-06-01

    OBJECTIVE To determine whether consumption of a single dental treat with specific mechanical properties and active ingredients would provide a 24-hour effect on dental plaque bacteria and halitosis in dogs. ANIMALS 10 dogs of various breeds from a privately owned colony that had received routine dental scaling and polishing 4 weeks before the study began. PROCEDURES Dogs were randomly assigned to receive 1 placebo or dental treat first. A 4-week washout period was provided, and then dogs received the opposite treatment. Oral plaque and breath samples were collected before and 0.5, 3, 12, and 24 hours after treat consumption. Volatile sulfur compounds (VSCs) concentration was measured in breath samples. Total aerobic, total anaerobic, Porphyromonas gulae, Prevotella intermedia-like, Tannerella forsythia, and Fusobacterium nucleatum bacterial counts (measured via bacterial culture) and total live bacterial counts, total live and dead bacterial counts, and bacterial vitality (measured via quantitative real-time PCR assay) were assessed in plaque samples. RESULTS Compared with placebo treat consumption, dental treat consumption resulted in a significant decrease in breath VSCs concentration and all plaque bacterial counts, without an effect on bacterial vitality. Effects of the dental treat versus the placebo treat persisted for 12 hours for several bacterial counts and for 24 hours for breath VSCs concentration. CONCLUSIONS AND CLINICAL RELEVANCE Although clinical benefits should be investigated in larger scale, longer-term studies, results of this study suggested that feeding the evaluated dental treat may help to decrease oral bacterial growth in dogs for 12 hours and oral malodor for 24 hours. A feeding interval of 12 hours is therefore recommended. PMID:27227499

  14. Reliability and Predictive Validity of Caloric Intake Measures from the 24-Hour Dietary Recalls of Homebound Older Adults

    PubMed Central

    Sun, Yanhui; Roth, David L.; Ritchie, Christine S.; Burgio, Kathryn L.; Locher, Julie L.

    2010-01-01

    24-hour dietary recalls are used frequently to study homebound older adults’ eating behaviors. However, the reliability and predictive validity of this method have not been established in this population. The purpose of this study is to examine whether homebound older adults provide reliable and valid measures of total caloric intake in 24-hour dietary recalls. 230 homebound older adults were interviewed in their homes using a questionnaire to assess eating behaviors and factors that could affect those behaviors. Participants completed three 24-hour dietary recalls at baseline and again at 6-month follow-up. Two sub-samples were identified for analyses. For participants who were not hospitalized during the 6-month interval and had their weight measured at both assessments (n = 52), sufficient test-retest reliability of caloric intake was observed (r = 0.59); but caloric intake deficiencies relative to estimated energy requirements did not predict actual weight loss (r = 0.08). When this sample was supplemented with 91 participants who experienced any adverse event (weight loss of 2.5% or more, hospitalization, institutionalization, or mortality) in the 6-month period (n = 143), adverse events were more likely to occur for those with insufficient caloric intake (odds ratio = 3.49, p = .009), and in White participants compared to African American participants (odds ratio = 3.13, p=0.016). Adequate test-retest reliability of the 24-hour dietary recall was demonstrated, but additional research with larger samples and longer follow-up intervals are needed to better evaluate the predictive validity of caloric intake measures for this population. PMID:20430140

  15. HOW RELIABLE IS 24 HOUR SERUM LITHIUM LEVEL AFTER A TEST DOSE OF LITHIUM IN PREDICTING OPTIMAL LITHIUM DOSE?

    PubMed Central

    Kuruvilla, K.; Shaji, K.S.

    1989-01-01

    SUMMARY 57% of a group of 35 patients treated with Lithium Carbonate at dosages predicted by the nomogram suggested by Cooper et al (1973) failed to reach therapeutic levels of serum lithium. This finding casts serious doubts on the usefulness of the claim by Cooper et al (1973 & 1976) that 24 hour serum lithium level after a test dose of 600 mg. lithium can predict the daily lithium dose. PMID:21927360

  16. Comparing food intake using the Dietary Risk Assessment with multiple 24-hour dietary recalls and the 7-Day Dietary Recall.

    PubMed

    Olendzki, B; Hurley, T G; Hebert, J R; Ellis, S; Merriam, P A; Luippold, R; Rider, L; Ockene, I S

    1999-11-01

    The Dietary Risk Assessment (DRA) is a brief dietary assessment tool used to identify dietary behaviors associated with cardiovascular disease. Intended for use by physicians and other nondietitians, the DRA identifies healthful and problematic dietary behaviors and alerts the physician to patients who require further nutrition counseling. To determine the relative validity of this tool, we compared it to the 7-Day Dietary Recall (an instrument developed to assess intake of dietary fat) and to the average of 7 telephone-administered 24-hour dietary recalls. Forty-two free-living subjects were recruited into the study. The 7-Day Dietary Recall and DRA were administered to each subject twice, at the beginning and the end of the study period, and the 24-hour recalls were conducted during the intervening time period. Correlation coefficients were computed to compare the food scores derived from the 3 assessment methods. Correlations between the DRA and 7-Day Dietary Recall data were moderate (r = .47, on average, for postmeasures); correlations between the DRA and 24-hour recalls were lower. The ability of the DRA to assess dietary fat consumption and ease of administration make it a clinically useful screening instrument for the physician when counseling patients about dietary fat reduction. PMID:10570682

  17. Flow cytometric comparison of platelets from a whole blood and finger-prick sample: impact of 24 hours storage.

    PubMed

    Swanepoel, Albe C; Stander, Andre; Pretorius, Etheresia

    2013-03-01

    In this study, we investigate the validity and laboratory utility of flow cytometry when analyzing platelet activation by studying CD41, CD42b, CD62P and CD63. We compare flow cytometry results from citrated whole-blood and finger-prick samples directly after collection and also after storing both a finger-prick and whole-blood sample for 24 hours. Citrated whole-blood and finger-prick samples were taken from three healthy individuals on two occasions, and a total of 60,000 cells were analyzed for each of the four phycoerythrin-labeled monoclonal antibodies. Half of each sample was analyzed immediately after sampling while the other half was kept in the fridge at 6 °C for 24 hours before analysis. No significant difference was found between the sampling methods or the period of time before analysis. Results therefore suggest that an appropriately prepared finger-prick sample can be used for platelet function analysis, and samples can be stored for 24 hours in the fridge at 6 °C before analysis. PMID:23320994

  18. Assessment of 24-hours Aldosterone Administration on Protein Abundances in Fluorescence-Sorted Mouse Distal Renal Tubules by Mass Spectrometry

    PubMed Central

    Jensen, Thomas B; Pisitkun, Trairak; Hoffert, Jason D; Jensen, Uffe B; Fenton, Robert A; Praetorius, Helle A; Knepper, Mark A; Praetorius, Jeppe

    2013-01-01

    Background/Aims Aldosterone exerts multiple long-term effects in the distal renal tubules. The aim of this study was to establish a method for identifying proteins in these tubules that change in abundance by only 24-hours aldosterone administration. Methods Mice endogenously expressing green fluorescent protein (eGFP) in the connecting tubule and cortical collecting ducts were treated with a subcutaneous injection of 2.0 mg/kg aldosterone or vehicle (n=5), and sacrificed 24 hours later. Suspensions of single cells were obtained enzymatically, and eGFP positive cells were isolated by fluorescence activated cell sorting (FACS). Samples of 100 μg proteins were digested with trypsin and labeled with 8-plex iTRAQ reagents and processed for liquid chromatography tandem mass spectrometry (LC-MS/MS). Results FACS yielded 1.4 million cells per mouse. The LC-MS/MS spectra were matched to peptides by the SEQUEST search algorithm, which identified 3002 peptides corresponding to 506 unique proteins of which 20 significantly changed abundance 24-hours after aldosterone injection. Conclusion We find the method suitable and useful for studying hormonal effects on protein abundance in distal tubular segments. PMID:23428628

  19. Self-esteem and the acute effect of anxiety on ambulatory blood pressure

    PubMed Central

    Edmondson, Donald; Arndt, Jamie; Alcántara, Carmela; Chaplin, William; Schwartz, Joseph E

    2015-01-01

    Objective Recent research suggests that self-esteem may be associated with improved parasympathetic nervous system functioning. This study tested whether high self-esteem is associated with decreased ambulatory systolic blood pressure (ASBP) reactivity to anxiety in healthy adults during the waking hours of a normal day. Methods Each of 858 participants completed a short version of the Rosenberg Self-Esteem Scale and then wore an ABP monitor which took two blood pressure readings per hour for 24 hours. Immediately after each blood pressure reading, participants completed an electronic diary report that included an anxiety rating on a 100-point visual analog scale (VAS). Using multilevel models, we assessed the association of momentary anxiety, high trait self-esteem, and their interaction on momentary ASBP, with adjustment for age, sex, race, ethnicity, and body mass index. Sensitivity analyses were conducted examining psychological factors associated with self-esteem: sense of mastery, optimism, social support, and depressive symptoms. Results On average, a 1-point increase in cube root-transformed anxiety was associated with a 0.80 mmHg (SE=0.09, p<0.001) increase in ASBP, and the interaction of high self-esteem and momentary anxiety was significant, such that this effect was 0.48 (SE=0.20, p=0.015) less in individuals with high self-esteem compared to all others. Results for self-esteem remained significant when adjusting for sex and psychological factors. Conclusions Momentary increases in anxiety are associated with acute increases in ASBP, and high self-esteem buffers the effect of momentary anxiety on blood pressure. Thus, high self-esteem may confer cardiovascular benefit by reducing the acute effects of anxiety on systolic blood pressure. PMID:26230481

  20. Associations between Diurnal 24-Hour Rhythm in Ambulatory Heart Rate Variability and the Timing and Amount of Meals during the Day Shift in Rotating Shift Workers

    PubMed Central

    Yoshizaki, Takahiro; Midorikawa, Toru; Hasegawa, Kohe; Mitani, Takeshi; Komatsu, Taiki; Togo, Fumiharu

    2014-01-01

    It has not hitherto been clarified whether there is an association between dietary behavior and circadian variation in autonomic nervous system activity among shift workers. This study examines diurnal 24-h rhythm in heart rate variability (HRV) and dietary behavior among rotating shift workers, while taking into account the sleep-wake cycle and physical activity. The subjects were 11 female and 2 male nurses or caregivers working in a rotating 2-shift system at a health care facility. All the subjects were asked to undergo 24-h electrocardiograph and step count recordings, and to record the time of each meal and the amounts of each food and beverage consumed. Coarse graining spectral analysis was used for approximately 10-min segments of HRV to derive the total power (TOT: >0.04 Hz) of the periodic components and the integrated power of periodic components in the low-frequency (LF: 0.04–0.15 Hz) and high-frequency (HF: >0.15 Hz) ranges. Then the ratio of HF power to TOT (HF nu) and the ratio of LF power to HF power (LF/HF) were calculated to assess cardiac vagal tone and cardiac sympathovagal balance, respectively. Single cosinor analysis was used to obtain 24-h period variations in both variables of HRV. Acrophases of HF nu and LF/HF expressed in time since awakening were significantly (p<0.05) delayed for subjects having breakfast at a later time after awakening. Multivariable regression analysis indicated that the timing of breakfast, the ratio of energy intake at dinner to total energy intake, and total energy intake were correlated to the acrophases of HF nu and/or LF/HF. These results suggest that the phase angle between circadian variation in cardiac autonomic nervous system activity and the sleep-wake cycle may be associated with dietary behavior in shift workers. PMID:25211024

  1. Ambulatory blood pressure monitoring in hypertensive adolescents.

    PubMed

    Fixler, D E; Wallace, J M; Thornton, W E; Dimmitt, P

    1990-04-01

    The purpose of this study was to determine the ability of ambulatory blood pressure monitoring to identify youths with chronic blood pressure elevation. Nineteen adolescent boys were studied, ten had 5-year average systolic or diastolic pressures above the 95th percentile, nine had normal pressure. A Del Mar Avionics Pressurometer III system recorded an average of 121 readings on each subject. The coefficients of variation for pressure were similar for hypertensive and normotensive individuals. During classes, eight of the ten hypertensive youths had elevated pressures in over half of the measurements. Also during these classes eight of ten hypertensive boys had average systolic or diastolic pressure above the 95th percentile, whereas only one of nine normotensive boys had average pressures above this level. We suggest that schooltime ambulatory pressures may be most useful in classifying the blood pressure trend in a youth. PMID:2346634

  2. Reasoning about systolic algorithms

    SciTech Connect

    Purushothaman, S.; Subrahmanyam, P.A.

    1988-12-01

    The authors present a methodology for verifying correctness of systolic algorithms. The methodology is based on solving a set of Uniform Recurrence Equations obtained from a description of systolic algorithms as a set of recursive equations. They present an approach to mechanically verify correctness of systolic algorithms, using the Boyer-Moore theorem proven. A mechanical correctness proof of an example from the literature is also presented.

  3. The quest for better validation: a critical comparison of the AAMI and BHS validation protocols for ambulatory blood pressure measurement systems.

    PubMed

    O'Brien, E; Mee, F; Atkins, N; O'Malley, K

    1992-01-01

    Two validation procedures are currently available for the evaluation of ambulatory blood pressure measurement systems--the standard of the Association for the Advancement of Medical Instrumentation (AAMI) and the protocol of the British Hypertension Society (BHS). Both are in the process of revision. Four systems for measuring 24-hour ambulatory blood pressure--SpaceLabs 90207, Novacor DIASYS 200, Del Mar Avionics Pressurometer IV, and Takeda TM-2420--were evaluated according to the BHS protocol, which incorporates many of the features of the AAMI standard, under similar conditions by the same personnel and in the same subjects, so as to examine the relative merits of the two evaluation procedures. Three recorders of each model were subjected to a before-use inter-device variability test, followed by an in-use phase and an after-use inter-device variability test. The main validation test was carried out in 86 subjects with a wide range of pressures, the results being analyzed according to the BHS grading system and the AAMI validation criteria. The SpaceLabs 90207 and the DIASYS 200 achieved B and C grades, respectively, according to the BHS protocol and also satisfied the AAMI criteria for accuracy. The Pressurometer IV achieved a Grade C rating for systolic pressure and a Grade D rating for diastolic pressure and the Takeda TM-2420 achieved Grade D ratings for both systolic pressure and diastolic pressure. Both these devices failed to fulfil the AAMI criteria for accuracy and both failed to function in the main validation test and had to be replaced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1393208

  4. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2012 version, for youth aged 9 to 11 Years: A validation study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to validate the 2012 version of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids-2012), a self-administered web-based 24-hour dietary recall (24hDR) instrument, among children aged 9 to 11 years, in two sites using a quasiexperimental design. In one s...

  5. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CLEANING: 24 HOUR FOOD DIARY (HAND ENTRY) (UA-D-40.0)

    EPA Science Inventory

    The purpose of the SOP is to define the particular steps involved in cleaning the electronic data generated from data entry of the 24 Hour Food Diary. The procedure was developed to use during the Arizona NHEXAS project and the "Border" study. Keywords: data; cleaning; 24 hour ...

  6. Developing a Method to Test the Validity of 24 Hour Time Use Diaries Using Wearable Cameras: A Feasibility Pilot

    PubMed Central

    Kelly, Paul; Thomas, Emma; Doherty, Aiden; Harms, Teresa; Burke, Órlaith; Gershuny, Jonathan; Foster, Charlie

    2015-01-01

    Self-report time use diaries collect a continuous sequenced record of daily activities but the validity of the data they produce is uncertain. This study tests the feasibility of using wearable cameras to generate, through image prompted interview, reconstructed 'near-objective' data to assess their validity. 16 volunteers completed the Harmonised European Time Use Survey (HETUS) diary and used an Autographer wearable camera (recording images at approximately 15 second intervals) for the waking hours of the same 24-hour period. Participants then completed an interview in which visual images were used as prompts to reconstruct a record of activities for comparison with the diary record. 14 participants complied with the full collection protocol. We compared time use and number of discrete activities from the diary and camera records (using 10 classifications of activity). In terms of aggregate totals of daily time use we found no significant difference between the diary and camera data. In terms of number of discrete activities, participants reported a mean of 19.2 activities per day in the diaries, while image prompted interviews revealed 41.1 activities per day. The visualisations of the individual activity sequences reveal some potentially important differences between the two record types, which will be explored at the next project stage. This study demonstrates the feasibility of using wearable cameras to reconstruct time use through image prompted interview in order to test the concurrent validity of 24-hour activity time-use budgets. In future we need a suitably powered study to assess the validity and reliability of 24-hour time use diaries. PMID:26633807

  7. Axial Diffusivity of the Corona Radiata at 24 Hours Post-Stroke: A New Biomarker for Motor and Global Outcome.

    PubMed

    Moulton, Eric; Amor-Sahli, Mélika; Perlbarg, Vincent; Pires, Christine; Crozier, Sophie; Galanaud, Damien; Valabregue, Romain; Yger, Marion; Baronnet-Chauvet, Flore; Samson, Yves; Dormont, Didier; Rosso, Charlotte

    2015-01-01

    Fractional anisotropy (FA) is an effective marker of motor outcome at the chronic stage of stroke yet proves to be less efficient at early time points. This study aims to determine which diffusion metric in which location is the best marker of long-term stroke outcome after thrombolysis with diffusion tensor imaging (DTI) at 24 hours post-stroke. Twenty-eight thrombolyzed patients underwent DTI at 24 hours post-stroke onset. Ipsilesional and contralesional FA, mean (MD), axial (AD), and radial (RD) diffusivities values were calculated in different Regions-of-Interest (ROIs): (1) the white matter underlying the precentral gyrus (M1), (2) the corona radiata (CoRad), (3) the posterior limb of the internal capsule (PLIC) and (4) the cerebral peduncles (CP). NIHSS scores were acquired at admission, day 1, and day 7; modified Rankin Scores (mRS) at 3 months. Significant decreases were found in FA, MD, and AD of the ipsilesional CoRad and M1. MD and AD were also significantly lower in the PLIC. The ratio of ipsi and contralesional AD of the CoRad (CoRad-rAD) was the strongest diffusion parameter correlated with motor NIHSS scores on day 7 and with the mRS at 3 months. A Receiver-Operator Curve analysis yielded a model for the CoRad-rAD to predict good outcome based on upper limb NIHSS motor scores and mRS with high specificity and sensitivity. FA values were not correlated with clinical outcome. In conclusion, axial diffusivity of the CoRad from clinical DTI at 24 hours post-stroke is the most appropriate diffusion metric for quantifying stroke damage to predict outcome, suggesting the importance of early axonal damage. PMID:26562509

  8. Caffeine does not entrain the circadian clock but improves daytime alertness in blind patients with non-24-hour rhythms

    PubMed Central

    St. Hilaire, Melissa A.; Lockley, Steven W.

    2015-01-01

    Objective/Background Totally blind individuals are highly likely to suffer from Non-24-Hour Sleep-Wake Disorder due to a failure of light to reset the circadian pacemaker in the suprachiasmatic nuclei. In this outpatient case series, we investigated whether daily caffeine administration could entrain the circadian pacemaker in non-entrained blind patients to alleviate symptoms of non-24-hour sleep–wake disorder. Patients/Methods Three totally blind males (63.0 ± 7.5 years old) were studied at home over ~4 months. Urinary 6-sulphatoxymelatonin (aMT6s) rhythms were measured for 48 h every 1–2 weeks. Participants completed daily sleep–wake logs, and rated their alertness and mood using nine-point scales every ~2–4 h while awake on urine sampling days. Caffeine capsules (150 mg per os) were self-administered daily at 10 a.m. for approximately one circadian beat cycle based on each participant's endogenous circadian period τ and compared to placebo (n = 2) or no treatment (n = 1) in a single-masked manner. Results Non-24-h aMT6s rhythms were confirmed in all three participants (τ range = 24.32–24.57 h). Daily administration of 150 mg caffeine did not entrain the circadian clock. Caffeine treatment significantly improved daytime alertness at adverse circadian phases (p < 0.0001) but did not decrease the occurrence of daytime naps compared with placebo. Conclusions Although caffeine was able to improve daytime alertness acutely and may therefore provide temporary symptomatic relief, the inability of caffeine to correct the underlying circadian disorder means that an entraining agent is required to treat Non-24-Hour Sleep–Wake Disorder in the blind appropriately. PMID:25891543

  9. The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use: Results from an Observational Study (ASSESS).

    PubMed

    Miravitlles, Marc; Worth, Heinrich; Soler-Cataluña, Juan José; Price, David; De Benedetto, Fernando; Roche, Nicolas; Godtfredsen, Nina S; van der Molen, Thys; Löfdahl, Claes-Göran; Padullés, Laura; Ribera, Anna

    2016-10-01

    This observational study assessed the relationship between nighttime, early-morning and daytime chronic obstructive pulmonary disease (COPD) symptoms and exacerbations and healthcare resource use. COPD symptoms were assessed at baseline in patients with stable COPD using a standardised questionnaire during routine clinical visits. Information was recorded on exacerbations and healthcare resource use during the year before baseline and during a 6-month follow-up period. The main objective of the analysis was to determine the predictive nature of current symptoms for future exacerbations and healthcare resource use. 727 patients were eligible (65.8% male, mean age: 67.2 years, % predicted forced expiratory volume in 1 second: 52.8%); 698 patients (96.0%) provided information after 6 months. Symptoms in any part of the day were associated with a prior history of exacerbations (all p < 0.05) and nighttime and early-morning symptoms were associated with the frequency of primary care visits in the year before baseline (both p < 0.01). During follow-up, patients with baseline symptoms during any part of the 24-hour day had more exacerbations than patients with no symptoms in each period (all p < 0.05); there was also an association between 24-hour symptoms and the frequency of primary care visits (all p ≤ 0.01). Although there was a significant association between early-morning and daytime symptoms and exacerbations during follow-up (both p < 0.01), significance was not maintained when adjusted for potential confounders. Prior exacerbations were most strongly associated with future risk of exacerbation. The results suggest 24-hour COPD symptoms do not independently predict future exacerbation risk. PMID:26983349

  10. Axial Diffusivity of the Corona Radiata at 24 Hours Post-Stroke: A New Biomarker for Motor and Global Outcome

    PubMed Central

    Moulton, Eric; Amor-Sahli, Mélika; Perlbarg, Vincent; Pires, Christine; Crozier, Sophie; Galanaud, Damien; Valabregue, Romain; Yger, Marion; Baronnet-Chauvet, Flore; Samson, Yves; Dormont, Didier; Rosso, Charlotte

    2015-01-01

    Fractional anisotropy (FA) is an effective marker of motor outcome at the chronic stage of stroke yet proves to be less efficient at early time points. This study aims to determine which diffusion metric in which location is the best marker of long-term stroke outcome after thrombolysis with diffusion tensor imaging (DTI) at 24 hours post-stroke. Twenty-eight thrombolyzed patients underwent DTI at 24 hours post-stroke onset. Ipsilesional and contralesional FA, mean (MD), axial (AD), and radial (RD) diffusivities values were calculated in different Regions-of-Interest (ROIs): (1) the white matter underlying the precentral gyrus (M1), (2) the corona radiata (CoRad), (3) the posterior limb of the internal capsule (PLIC) and (4) the cerebral peduncles (CP). NIHSS scores were acquired at admission, day 1, and day 7; modified Rankin Scores (mRS) at 3 months. Significant decreases were found in FA, MD, and AD of the ipsilesional CoRad and M1. MD and AD were also significantly lower in the PLIC. The ratio of ipsi and contralesional AD of the CoRad (CoRad-rAD) was the strongest diffusion parameter correlated with motor NIHSS scores on day 7 and with the mRS at 3 months. A Receiver-Operator Curve analysis yielded a model for the CoRad-rAD to predict good outcome based on upper limb NIHSS motor scores and mRS with high specificity and sensitivity. FA values were not correlated with clinical outcome. In conclusion, axial diffusivity of the CoRad from clinical DTI at 24 hours post-stroke is the most appropriate diffusion metric for quantifying stroke damage to predict outcome, suggesting the importance of early axonal damage. PMID:26562509

  11. The relationship between serum albumin levels and 24-h ambulatory blood pressure monitoring recordings in non-diabetic essential hypertensive patients

    PubMed Central

    Ahbap, Elbis; Sakaci, Tamer; Kara, Ekrem; Sahutoglu, Tuncay; Koc, Yener; Basturk, Taner; Sevinc, Mustafa; Akgol, Cuneyt; Kayalar, Arzu O.; Ucar, Zuhal A.; Bayraktar, Feyza; Unsal, Abdulkadir

    2016-01-01

    OBJECTIVES: The goal of this study was to evaluate the relationship between serum albumin levels and 24-hour ambulatory blood pressure monitoring (24-h ABPM) recordings in non-diabetic essential hypertensive patients. METHODS: A total of 354 patients (mean [SD] age: 55.5 [14.3] years, 50% females) with essential hypertension and 24-h ABPM recordings were included. Patient 24-h nighttime and daytime ABPM values, systolic and diastolic dipping status and average nocturnal dipping were recorded. The correlations between serum albumin levels and nocturnal systolic and diastolic dipping were evaluated, and correlates of average nocturnal systolic dipping were determined via a linear regression model. RESULTS: Overall, 73.2% of patients were determined to be non-dippers. The mean (SD) levels of serum albumin (4.2 [0.3] g/dL vs. 4.4 [0.4] g/dL, p<0.001) and the average nocturnal systolic (15.2 [4.8] mmHg vs. 0.3 [6.6] mmHg, p<0.001) and diastolic dipping (4.2 [8.6] mmHgvs. 18.9 [7.0] mmHg, p<0.001) were significantly lower in non-dippers than in dippers. A significant positive correlation was noted between serum albumin levels and both systolic (r=0.297, p<0.001) and diastolic dipping (r=0.265, p<0.001). The linear regression analysis revealed that for each one-unit increase in serum albumin, the average nocturnal dip in systolic BP increased by 0.17 mmHg (p=0.033). CONCLUSION: Our findings indicate an association between serum albumin levels and the deterioration of circadian BP rhythm among essential hypertensive patients along with the identification of a non-dipper pattern in more than two-thirds of patients. Our findings emphasize the importance of serum albumin levels, rather than urinary albumin excretion, as an independent predictor of nocturnal systolic dipping, at least in non-diabetic essential hypertensive patients with moderate proteinuria. PMID:27276394

  12. Comparison of Interviewer-Administered and Automated Self-Administered 24-Hour Dietary Recalls in 3 Diverse Integrated Health Systems.

    PubMed

    Thompson, Frances E; Dixit-Joshi, Sujata; Potischman, Nancy; Dodd, Kevin W; Kirkpatrick, Sharon I; Kushi, Lawrence H; Alexander, Gwen L; Coleman, Laura A; Zimmerman, Thea P; Sundaram, Maria E; Clancy, Heather A; Groesbeck, Michelle; Douglass, Deirdre; George, Stephanie M; Schap, TusaRebecca E; Subar, Amy F

    2015-06-15

    Twenty-four-hour dietary recalls provide high-quality intake data but have been prohibitively expensive for large epidemiologic studies. This study's goal was to assess whether the web-based Automated Self-Administered 24-Hour Recall (ASA24) performs similarly enough to the standard interviewer-administered, Automated Multiple-Pass Method (AMPM) 24-hour dietary recall to be considered a viable alternative. In 2010-2011, 1,081 adults from 3 integrated health systems in Detroit, Michigan; Marshfield, Wisconsin; and Kaiser-Permanente Northern California participated in a field trial. A quota design ensured a diverse sample by sex, age, and race/ethnicity. Each participant was asked to complete 2 recalls and was randomly assigned to 1 of 4 protocols differing by type of recall and administration order. For energy, the mean intakes were 2,425 versus 2,374 kcal for men and 1,876 versus 1,906 kcal for women by AMPM and ASA24, respectively. Of 20 nutrients/food groups analyzed and controlling for false discovery rate, 87% were judged equivalent at the 20% bound. ASA24 was preferred over AMPM by 70% of the respondents. Attrition was lower in the ASA24/AMPM study group than in the AMPM/ASA24 group, and it was lower in the ASA24/ASA24 group than in the AMPM/AMPM group. ASA24 offers the potential to collect high-quality dietary intake information at low cost with less attrition. PMID:25964261

  13. Modeling of 24-hour glucose and insulin profiles in patients with type 2 diabetes mellitus treated with biphasic insulin aspart.

    PubMed

    Røge, Rikke M; Klim, Søren; Kristensen, Niels R; Ingwersen, Steen H; Kjellsson, Maria C

    2014-07-01

    Insulin therapy for diabetes patients is designed to mimic the endogenous insulin response of healthy subjects and thereby generate normal blood glucose levels. In order to control the blood glucose in insulin-treated diabetes patients, it is important to be able to predict the effect of exogenous insulin on blood glucose. A pharmacokinetic/pharmacodynamic model for glucose homoeostasis describing the effect of exogenous insulin would facilitate such prediction. Thus the aim of this work was to extend the previously developed integrated glucose-insulin (IGI) model to predict 24-hour glucose profiles for patients with Type 2 diabetes following exogenous insulin administration. Clinical data from two trials were included in the analysis. In both trials, 24-hour meal tolerance tests were used as the experimental setup, where exogenous insulin (biphasic insulin aspart) was administered in relation to meals. The IGI model was successfully extended to include the effect of exogenous insulin. Circadian variations in glucose homeostasis were assessed on relevant parameters, and a significant improvement was achieved by including a circadian rhythm on the endogenous glucose production in the model. The extended model is a useful tool for clinical trial simulation and for elucidating the effect profile of new insulin products. PMID:24446385

  14. QTc interval prolongation in HIV-infected patients: a case–control study by 24-hour Holter ECG recording

    PubMed Central

    2012-01-01

    Background Aim of the study was to assess QTc interval by a 24-hour ECG recording in a group of HIV-infected individuals with a basal prolonged QTc. The risk factors associated with QTc prolongation and the indices of cardiovascular autonomic control were also evaluated. Methods A case–control study was performed using as cases 32 HIV-infected patients with prolonged (>440 msec) QTc interval as assessed by Holter ECG, and as controls 64 HIV-infected subjects with normal QTc interval. Autonomic function was evaluated by heart rate variability analysis during 24-hour recording. Results Duration of HIV disease was significantly longer among cases than among controls (p=0.04). Waist/hip ratio was also higher among cases than among controls (p=0.05). Frequency domain analysis showed the absence of physiologic decrease of low frequency (LF) in the night period in both cases and controls. The LF night in cases showed a statistically significant reduction when compared with controls (p=0.007). Conclusions In our study group, QTc interval prolongation was associated with a longer duration of HIV infection and with a greater waist/hip ratio. HIV patients with QTc interval prolongation and with a longer duration of HIV infection were more likely to have an impairment of parasympathetic and sympathetic cardiac component. PMID:23259665

  15. Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension

    PubMed Central

    2012-01-01

    Executive Summary Objective The objective of this health technology assessment was to determine the clinical effectiveness and cost-effectiveness of 24-hour ambulatory blood pressure monitoring (ABPM) for hypertension. Clinical Need: Condition and Target Population Hypertension occurs when either systolic blood pressure, the pressure in the artery when the heart contracts, or diastolic blood pressure, the pressure in the artery when the heart relaxes between beats, are consistently high. Blood pressure (BP) that is consistently more than 140/90 mmHg (systolic/diastolic) is considered high. A lower threshold, greater than 130/80 mmHg (systolic/diastolic), is set for individuals with diabetes or chronic kidney disease. In 2006 and 2007, the age-standardized incidence rate of diagnosed hypertension in Canada was 25.8 per 1,000 (450,000 individuals were newly diagnosed). During the same time period, 22.7% of adult Canadians were living with diagnosed hypertension. A smaller proportion of Canadians are unaware they have hypertension; therefore, the estimated number of Canadians affected by this disease may be higher. Diagnosis and management of hypertension are important, since elevated BP levels are related to the risk of cardiovascular disease, including stroke. In Canada in 2003, the costs to the health care system related to the diagnosis, treatment, and management of hypertension were over $2.3 billion (Cdn). Technology The 24-hour ABPM device consists of a standard inflatable cuff attached to a small computer weighing about 500 grams, which is worn over the shoulder or on a belt. The technology is noninvasive and fully automated. The device takes BP measurements every 15 to 30 minutes over a 24-to 28-hour time period, thus providing extended, continuous BP recordings even during a patient’s normal daily activities. Information on the multiple BP measurements can be downloaded to a computer. The main detection methods used by the device are auscultation and

  16. Designing linear systolic arrays

    SciTech Connect

    Kumar, V.K.P.; Tsai, Y.C. . Dept. of Electrical Engineering)

    1989-12-01

    The authors develop a simple mapping technique to design linear systolic arrays. The basic idea of the technique is to map the computations of a certain class of two-dimensional systolic arrays onto one-dimensional arrays. Using this technique, systolic algorithms are derived for problems such as matrix multiplication and transitive closure on linearly connected arrays of PEs with constant I/O bandwidth. Compared to known designs in the literature, the technique leads to modular systolic arrays with constant hardware in each PE, few control lines, lexicographic data input/output, and improved delay time. The unidirectional flow of control and data in this design assures implementation of the linear array in the known fault models of wafer scale integration.

  17. 24-hour urine protein

    MedlinePlus

    ... of fluid (dehydration) Any type of x-ray exam with dye (contrast material) within 3 days before the urine test Fluid from the vagina that gets into the urine Severe emotional stress Strenuous exercise Urinary tract infection

  18. Urine 24-hour volume

    MedlinePlus

    ... test results: Dehydration Any type of x-ray exam with dye (contrast material) within 3 days before the urine test Fluid from the vagina that gets into the urine Emotional stress Heavy exercise Urinary tract infection

  19. 24-hour care programs.

    PubMed

    Hergenrader, R

    1996-06-01

    Twenty-four-hour care programs, which combine group health programs with workers' compensation and disability benefits, hold considerable potential for cost savings and greater efficiency. This article explains these programs and uses a care history to show the savings they can achieve. PMID:10157798

  20. Urine 24-hour volume

    MedlinePlus

    ... in a day, such as: Creatinine Sodium Potassium Nitrogen Protein This test may also be done if ... disease Potassium urine test Sodium urine test Urea nitrogen urine test Urination - excessive amount Urine output - decreased ...

  1. 24-hour urine protein

    MedlinePlus

    ... a blockage of blood vessels, or other causes Multiple myeloma Healthy people may have higher than normal urine ... Distal Hemolytic anemia Macroglobulinemia of Waldenstrom Microalbuminuria test Multiple myeloma Nephrotic syndrome Proximal Wilson disease Update Date 11/ ...

  2. Ambulatory blood pressure measurement in the diagnosis and management of hypertension.

    PubMed

    O'Brien, E; O'Malley, K; Mee, F; Atkins, N; Cox, J

    1991-12-01

    Before the diagnostic potential of 24-hour non-invasive BP measurement can be assessed, the accuracy of ambulatory recorders must be established, and normal reference values determined. The accuracy criteria of four ambulatory BP measuring systems (the SpaceLabs 90207, the Novecor DIASYS 200, the Takeda TM-2420 and the Del Mar Avionics Pressurometer IV) have been assessed according to the British Hypertension Society (BHS) protocol, and the Medilog, Suntech Accutracker II and the SpaceLabs 90202 according to the standard of the Association for the Advancement of Medical Instrumentation (AAMI). The SpaceLabs 90202 and 90207, the DIASYS 200 and the Medilog fulfilled the AAMI criteria. The best devices with the BHS grading system are the SpaceLabs 90207 and the DIASYS 200. Normal reference values for daytime, night-time and 24-hour ambulatory BP have been provided by the Allied Irish Bank study of 815 healthy individuals, which showed clear age and sex differences. The mean 24-hour ambulatory pressure for the entire group was 118/72 mm Hg. 24-hour ambulatory BP measurement possesses clear advantages over conventional clinic measurement in evaluating drug efficacy, as it provides many more readings, allowing for the possibility of reducing the number of patients in antihypertensive drug studies and eliminating the need for a placebo-controlled crossover design. It allows assessment of night-time BP, which is important in view of the fact that excessive BP reduction may put patients at risk of myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1791615

  3. A 24-hour Approach to the Study of Health Behaviors: Temporal Relationships between Waking Health Behaviors and Sleep

    PubMed Central

    Irish, Leah A.; Kline, Christopher E.; Rothenberger, Scott D.; Krafty, Robert T.; Buysse, Daniel J.; Kravitz, Howard M.; Bromberger, Joyce T.; Zheng, Huiyong; Hall, Martica H.

    2013-01-01

    Background Although sleep is often associated with waking health behaviors (WHB) such as alcohol consumption, caffeine use, smoking, and exercise, the causal direction of these relationships is unclear. Purpose The present study used time-series data to examine the temporal dynamics of WHB and sleep characteristics in participants of the SWAN Sleep Study. Methods 303 women completed daily assessments of WHB and wore wrist actigraphs to measure sleep characteristics for the duration of the study (Mean=29.42 days, SD=6.71). Results Vector autoregressive modeling revealed that weekly patterns of sleep and WHB best predicted subsequent sleep and WHB, suggesting that the associations between WHB and sleep persist beyond their immediate influence. Some WHB predicted some subsequent sleep characteristics, but sleep did not predict subsequent WHB. Conclusions These novel findings provide insight into the temporal dynamics of 24-hour behaviors and encourage consideration of both sleep and WHB in health promotion and behavior change efforts. PMID:24043549

  4. Ultra-Rapid dUT1 Measurements on Japan-Fennoscandian Baselines - Application to 24-hour Sessions

    NASA Technical Reports Server (NTRS)

    Matsuzaka, Shigeru; Kurihara, Shinobu; Sekido, Mamoru; Hobiger, Thomas; Haas, Rudiger; Ritakari, Jouko; Wagner, Jan

    2010-01-01

    GSI, NICT, OSO, and MRO have been engaged in Ultra-rapid dUT1 experiments since 2007 aiming at the technological possibility of real-time dUT1 results using the e-VLBI technique. We have already successfully determined dUT1 in less than four minutes after the end of an experimental Intensive session in 2008, and at present we routinely get the results within 30 minutes for regular Intensives. In 2009 we applied the technique to 24-hour sessions and continuously obtained dUT1 values by processing and analyzing Tsukuba Onsala data in near real-time. It showed a detailed behavior of UT1 variations, which could be very valuable for scientific study as well as for precise prediction of UT1-UTC.

  5. Tolvaptan Prolongs Blockage of the Vasopressin Type II Receptor Over 24 Hours in Responders With Stage D Heart Failure.

    PubMed

    Imamura, Teruhiko; Kinugawa, Koichiro; Komuro, Issei

    2016-01-01

    The urine aquaporin-2 (U-AQP2) level relative to the plasma arginine vasopressin (P-AVP) level is a novel predictor of the responsiveness to the vasopressin type 2 receptor (V2R) antagonist tolvaptan (TLV). However, little has been reported about the concentration-time profile of U-AQP2 after TLV treatment. We evaluated 24 patients with decompensated stage D heart failure (HF) who had received 3.75 mg/day of TLV on a de novo basis for > 7 days to treat congestion refractory to conventional diuretics. Seventeen patients were TLV-responders, whose 24-hour urine volume (UV) increased after TLV initiation; the other 7 patients were TLV-non-responders. The U-AQP2 of the TLV-responders, corrected for the urine creatinine concentration, decreased significantly at 4 hours after TLV administration without returning to the day-1 morning level on the morning of day-7. The TLV-non-responder U-AQP2 levels remained low even before the TLV treatment. On the morning of day-7, the TLV-responder U-AQP2/P-AVP ratio was comparable to that of the TLV-non-responders. Among 18 patients (11 responders and 7 non-responders), the day-7 TLV trough concentration was 64 ± 62 ng/mL and was negatively correlated with the estimated glomerular filtration rate (eGFR). TLV has antagonistic effects on the V2R over 24 hours in TLV-responders with advanced heart failure and chronic kidney disease, probably due to persistently elevated blood TLV concentration. The unresponsiveness to TLV in the TLV-non-responders is not attributable to malabsorption. PMID:26742881

  6. Prognostic Value of the 24-Hour Neurological Examination in Anterior Circulation Ischemic Stroke: A post hoc Analysis of Two Randomized Controlled Stroke Trials

    PubMed Central

    Rangaraju, Srikant; Frankel, Michael; Jovin, Tudor G.

    2016-01-01

    Background Early prognostication of long-term outcomes following ischemic stroke can facilitate medical decision-making. We hypothesized that the 24-hour National Institute of Health Stroke Scale (NIHSS) predicts 3-month clinical outcomes in anterior circulation stroke. Methods Secondary analyses of the Interventional Management of Stroke 3 (IMS3) and intravenous tissue plasminogen activator (IV tPA) for acute ischemic stroke [National Institute of Neurological Diseases and Stroke (NINDS) IV tPA] trials were performed. In participants with documented 24-hour NIHSS and 3-month Modified Rankin Scale (mRS), the predictive power of the 24-hour NIHSS and 24-hour NIHSS improvement for 3-month outcomes [mRS 0-2 and Barthel Index (BI) ≥95] was assessed. Percentages of good outcome (mRS 0-2 or BI ≥95) at 3, 6, and 12 months and mean quality of life (EQ5D™) index at 3 months across 24-hour NIHSS quartiles were compared. Results The majority of the study participants were included (IMS3 n = 587/656, NINDS IV tPA n = 619/624). The 24-hour NIHSS was correlated with 3-month mRS (R = 0.73) with excellent predictive power for mRS 0-2 [area under the curve (AUC) = 0.91] and BI ≥95 (AUC = 0.9) in both cohorts. A model with the 24-hour NIHSS alone correctly classified 82-84% of patients in both cohorts. The percentages of good outcomes at 3-12 months across 24-hour NIHSS quartiles were similar in both cohorts. mRS 0-2 was achieved by 75.6-77.7% of patients with 24-hour NIHSS ≤11 but by only 1.4-3.6% with 24-hour NIHSS ≥20. The EQ5D index at 3 months varied among NIHSS 0-4 (mean 0.86 ± 0.16), 5-11 (0.77 ± 0.18), and 12-19 (0.59 ± 0.26) quartiles. Conclusions The 24-hour NIHSS strongly predicts long-term stroke outcomes and is associated with quality of life. Its easy availability, reliability, and validity support its use as an early prognostic marker and surrogate of clinical outcome in ischemic stroke. PMID:27051408

  7. The prevalence of exercise-associated hyponatremia in 24-hour ultra-mountain bikers, 24-hour ultra-runners and multi-stage ultra-mountain bikers in the Czech Republic

    PubMed Central

    2014-01-01

    Background To assess the prevalence of exercise-associated hyponatremia (EAH) in two 24-hour mountain bike (MTB) (R1,R2), one 24-hour running (R3) and one multi-stage MTB (R4) races held in the Czech Republic in a cluster of four cross-sectional studies. Methods In 27 ultra-mountain bikers (ultra-MTBers), 12 ultra-runners, and 14 multi-stage MTBers, fluid intake, changes (Δ) in body mass, hematocrit, plasma volume, plasma [Na+], plasma [K+], plasma osmolality, urine [Na+], urine [K+], urine specific gravity, urine osmolality, K+/Na+ ratio in urine, transtubular potassium gradient and glomerular filtration rate were measured and calculated. The use of non-steroidal anti-inflammatory drugs and symptoms of EAH were recorded using post-race questionnaires. Results Of the 53 finishers, three (5.7%) developed post-race EAH, thereof one (3.7%) ultra-MTBer, one (8.3%) ultra-runner and one (7.1%) multi-stage MTBer. Plasma [Na+] decreased significantly (p < 0.001) only in R4. Urine osmolality (R1, R3, R4 p < 0.001; R2 p < 0.05) and glomerular filtration rate (p < 0.001) increased, and body mass decreased in all races (p < 0.05). Δ body mass was inversely related to the number of kilometers achieved (p < 0.001) in R2 where better ultra-MTBers tended to lose more weight. Δ body mass (p < 0.001) and %Δ body mass (p = 0.05) were positively related to lower post-race plasma [Na+] in R3 that was associated with increased loss in body mass. Fluid intake was positively related to race performance in R1 and R2 (R1: p = 0.04; R2: p = 0.01) where ultra-MTBers in R1 and R2 who drank more finished ahead of those who drank less. Post-race plasma [Na+] was negatively associated with race performance in ultra-MTBers in R2 (p < 0.05), similarly ultra-runners in R3 (p < 0.05) where finishers with more kilometres had lower post-race plasma [Na+]. Conclusions The prevalence of EAH in the Czech Republic was no higher compared to existing reports on ultra-endurance athletes in other countries

  8. Amino-Terminal Pro-B-Type Natriuretic Peptide Improves Discrimination for Incident Atherosclerotic Cardiovascular Disease Beyond Ambulatory Blood Pressure in Elderly Men.

    PubMed

    Skoglund, Per H; Höijer, Jonas; Ärnlöv, Johan; Zethelius, Björn; Svensson, Per

    2015-09-01

    Improvement of risk prediction for atherosclerotic cardiovascular disease (ASCVD) is needed. Both ambulatory blood pressure (ABP) and biomarkers amino-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein and cystatin C improve risk prediction but they have not been evaluated in relation to each other. We analyzed whether NT-proBNP, high-sensitivity C-reactive protein, or cystatin C improved risk prediction beyond traditional ASCVD risk factors combined with 24-hour systolic BP (SBP). Secondary aim was to evaluate whether ABP improved risk prediction when compared with models with the biomarkers. We followed up 907 70-year-old men, free of baseline disease, for incident ASCVD defined as fatal or nonfatal myocardial infarction or fatal or nonfatal stroke for a median of 10 years. Cox regression was used to estimate the association between variables in the models and incident ASCVD. Biomarkers were added to a model containing both traditional risk factors and ABP and the models were compared on C-statistics and net reclassification improvement. Twenty-four hour SBP improved discrimination for incident ASCVD when compared with office SBP in a traditional risk factor model (area under the receiver-operating characteristic curve, +2.4%). NT-proBNP further improved reclassification (+18.7%-19.9%; P<0.01) when added to ABP models, whereas high-sensitivity C-reactive protein and cystatin C did not. Twenty-four hour SBP significantly improved net reclassification when added to a traditional risk factor model that included NT-proBNP. The combination of 24-hour SBP and NT-proBNP improved discrimination and net reclassification for incident ASCVD when compared with office SBP in elderly men. NT-proBNP, but not high-sensitivity C-reactive protein or cystatin C, improved risk prediction and discrimination when added to a model that included ABP. PMID:26150437

  9. Does home blood pressure monitoring improve patient outcomes? A systematic review comparing home and ambulatory blood pressure monitoring on blood pressure control and patient outcomes

    PubMed Central

    Breaux-Shropshire, Tonya L; Judd, Eric; Vucovich, Lee A; Shropshire, Toneyell S; Singh, Sonal

    2015-01-01

    Objective Our objective was to compare the clinical effectiveness of home blood pressure monitoring (HBPM) and 24-hour ambulatory blood pressure monitoring (ABPM) on blood pressure (BP) control and patient outcomes. Design A systematic review was conducted. We also appraised the methodological quality of studies. Data sources PubMed, Scopus, CINAHL, and the Cochrane Central Register of Control Trials (CENTRAL). Inclusion criteria Randomized control trials, prospective and retrospective cohort studies, observational studies, and case-control studies published in English from any year to present that describe HBPM and 24-hour ABPM and report on systolic and/or diastolic BP and/or heart attack, stroke, kidney failure and/or all-cause mortality for adult patients. Due to the nature of the question, studies with only untreated patients were not considered. Results Of 1,742 titles and abstractions independently reviewed by two reviewers, 137 studies met predetermined criteria for evaluation. Nineteen studies were identified as relevant and included in the paper. The common themes were that HBPM and ABPM correlated with cardiovascular events and mortality, and targeting HBPM or ABPM resulted in similar outcomes. Associations between BP measurement type and mortality differed by study population. Both the low sensitivity of office blood pressure monitoring (OBPM) to detect optimal BP control by ABPM and the added association of HBPM with cardiovascular mortality supported the routine use of HBPM in clinical practice. There was insufficient data to determine the benefit of using HBPM as a measurement standard for BP control. Conclusion HBPM encourages patient-centered care and improves BP control and patient outcomes. Given the limited number of studies with both HBPM and ABPM, these measurement types should be incorporated into the design of randomized clinical trials within hypertensive populations. PMID:26170715

  10. Synchronizing large systolic arrays

    SciTech Connect

    Fisher, A.L.; Kung, H.T.

    1982-04-01

    Parallel computing structures consist of many processors operating simultaneously. If a concurrent structure is regular, as in the case of systolic array, it may be convenient to think of all processors as operating in lock step. Totally synchronized systems controlled by central clocks are difficult to implement because of the inevitable problem of clock skews and delays. An alternate means of enforcing necessary synchronization is the use of self-timed, asynchronous schemes, at the cost of increased design complexity and hardware cost. Realizing that different circumstances call for different synchronization methods, this paper provides a spectrum of synchronization models; based on the assumptions made for each model, theoretical lower bounds on clock skew are derived, and appropriate or best-possible synchronization schemes for systolic arrays are proposed. This paper represents a first step towards a systematic study of synchronization problems for large systolic arrays.

  11. Reproducibility of ambulatory blood pressure load.

    PubMed

    Zachariah, P K; Sheps, S G; Bailey, K R; Wiltgen, C M; Moore, A G

    1990-12-01

    Twenty-two hypertensive patients were monitored during two separate drug-free occasions with a Del Mar Avionics ambulatory device. Blood pressure loads (percentage of systolic and diastolic readings more than 140 and 90 mmHg, respectively) and mean BP were measured both to determine their reproducibility and to examine how they correlate with each other. The systolic and diastolic mean awake BPs for day 1 and day 2 were 140/93 mmHg and 140/91 mmHg, respectively, and BP loads were 45%/55% and 43%/54%. Moreover, mean BP loads correlated highly (r = 0.93) with mean BP values taken on the same day. Both ambulatory mean SBP and BP load were highly reproducible (r = 0.87 and 0.80, respectively, during the awake hours), and mean DBP and load were fairly reproducible (r = 0.59 and 0.39, respectively, during the awake hours). Clinically, however, both were consistent from day 1 to day 2. Mean and individual standard deviations also were reproducible for both systolic and diastolic pressures and loads. PMID:2096203

  12. Systolic and semisystolic design

    SciTech Connect

    Leiserson, C.E.

    1983-01-01

    Architectural transformation techniques which can be used to help produce efficient systolic and semisystolic architectures for signal processing, image processing, numerical computation and raster graphics are identified. The transformations include: retiming, slowdown, broadcast and census elimination, coalescing, interlacing, code motion, resetting, register elimination and parallel/serial compromises. All the transformations are at the architectural or algorithmic level, as distinct from the electrical circuit level, and provide high-level tools for a designer. In addition, they provide a step toward automatic compilation of systolic and semisystolic systems. 12 references.

  13. Dietary quality varies according to data collection instrument: a comparison between a food frequency questionnaire and 24-hour recall.

    PubMed

    Rodrigues, Paulo Rogério Melo; de Souza, Rita Adriana Gomes; De Cnop, Mara Lima; Monteiro, Luana Silva; Coura, Camila Pinheiro; Brito, Alessandra Page; Pereira, Rosangela Alves

    2016-02-01

    The objective of this study was to assess the agreement between the Brazilian Healthy Eating Index - Revised (BHEI-R), estimated by a food frequency questionnaire (FFQ) and multiple 24-hour recalls (24h-R). The Wilcoxon paired test, partial correlations (PC), intraclass correlation coefficient (ICC), and Bland-Altman method were used. The total BHEI-R scores and its components ("total fruits", "whole fruits", "total vegetables", "integral cereals", "saturated fat", "sodium", and "energy intake derived from solid fat, added sugar, and alcoholic beverages") were statistically different, with the ICC and PC indicating poor concordance and correlation. The mean concordance estimated for the total BHEI-R and its components varied from 68% for "integral cereals" to 147% for "whole fruits". The suitable concordance limits were violated for most of the components of the BHEI-R. Poor concordance was observed between the BHEI-R estimated by the FFQ and by multiple 24h-R, which indicated a strong reliability of the BHEI-R on the instrument used to collect information on food consumption. PMID:26910251

  14. Extracorporeal membrane oxygenation improves survival in a novel 24-hour pig model of severe acute respiratory distress syndrome.

    PubMed

    Araos, Joaquín; Alegría, Leyla; García, Patricio; Damiani, Felipe; Tapia, Pablo; Soto, Dagoberto; Salomon, Tatiana; Rodriguez, Felipe; Amthauer, Macarena; Erranz, Benjamín; Castro, Gabriel; Carreño, Pamela; Medina, Tania; Retamal, Jaime; Cruces, Pablo; Bugedo, Guillermo; Bruhn, Alejandro

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) is increasingly being used to treat severe acute respiratory distress syndrome (ARDS). However, there is limited clinical evidence about how to optimize the technique. Experimental research can provide an alternative to fill the actual knowledge gap. The purpose of the present study was to develop and validate an animal model of acute lung injury (ALI) which resembled severe ARDS, and which could be successfully supported with ECMO. Eighteen pigs were randomly allocated into three groups: sham, ALI, and ALI + ECMO. ALI was induced by a double-hit consisting in repeated saline lavage followed by a 2-hour period of injurious ventilation. All animals were followed up to 24 hours while being ventilated with conventional ventilation (tidal volume 10 ml/kg). The lung injury model resulted in severe hypoxemia, increased airway pressures, pulmonary hypertension, and altered alveolar membrane barrier function, as indicated by an increased protein concentration in bronchoalveolar fluid, and increased wet/dry lung weight ratio. Histologic examination revealed severe diffuse alveolar damage, characteristic of ARDS. Veno-venous ECMO was started at the end of lung injury induction with a flow > 60 ml/kg/min resulting in rapid reversal of hypoxemia and pulmonary hypertension. Mortality was 0, 66.6 and 16.6% in the SHAM, ALI and ALI + ECMO groups, respectively (p < 0.05). This is a novel clinically relevant animal model that can be used to optimize the approach to ECMO and foster translational research in extracorporeal lung support. PMID:27398166

  15. Extracorporeal membrane oxygenation improves survival in a novel 24-hour pig model of severe acute respiratory distress syndrome

    PubMed Central

    Araos, Joaquín; Alegría, Leyla; García, Patricio; Damiani, Felipe; Tapia, Pablo; Soto, Dagoberto; Salomon, Tatiana; Rodriguez, Felipe; Amthauer, Macarena; Erranz, Benjamín; Castro, Gabriel; Carreño, Pamela; Medina, Tania; Retamal, Jaime; Cruces, Pablo; Bugedo, Guillermo; Bruhn, Alejandro

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) is increasingly being used to treat severe acute respiratory distress syndrome (ARDS). However, there is limited clinical evidence about how to optimize the technique. Experimental research can provide an alternative to fill the actual knowledge gap. The purpose of the present study was to develop and validate an animal model of acute lung injury (ALI) which resembled severe ARDS, and which could be successfully supported with ECMO. Eighteen pigs were randomly allocated into three groups: sham, ALI, and ALI + ECMO. ALI was induced by a double-hit consisting in repeated saline lavage followed by a 2-hour period of injurious ventilation. All animals were followed up to 24 hours while being ventilated with conventional ventilation (tidal volume 10 ml/kg). The lung injury model resulted in severe hypoxemia, increased airway pressures, pulmonary hypertension, and altered alveolar membrane barrier function, as indicated by an increased protein concentration in bronchoalveolar fluid, and increased wet/dry lung weight ratio. Histologic examination revealed severe diffuse alveolar damage, characteristic of ARDS. Veno-venous ECMO was started at the end of lung injury induction with a flow > 60 ml/kg/min resulting in rapid reversal of hypoxemia and pulmonary hypertension. Mortality was 0, 66.6 and 16.6% in the SHAM, ALI and ALI + ECMO groups, respectively (p < 0.05). This is a novel clinically relevant animal model that can be used to optimize the approach to ECMO and foster translational research in extracorporeal lung support. PMID:27398166

  16. Under-reporting of Energy Intake from 24-hour Dietary Recalls in the Korean National Health and Nutrition Examination Survey

    PubMed Central

    Kye, Seunghee; Kwon, Sung-Ok; Lee, Soon-Young; Lee, Jiyoon; Kim, Bok Hee; Suh, Hee-Jae; Moon, Hyun-Kyung

    2014-01-01

    Objectives Chronic degenerative diseases are closely related to daily eating habits, nutritional status, and, in particular, energy intake. In clarifying these relationships it is very important for dietary surveys to report accurate information about energy intake. This study attempted to identify the prevalence of the under-reporting of energy intake and its related characteristics based on the Korean National Health and Nutrition Examination Survey conducted in the years 2007–2009. Methods The present study analyzed dietary intake data from 15,133 adults aged ≥19 years using 24-hour dietary recalls. Basal metabolic rates were calculated from the age- and gender-specific equations of Schofield and under-reporting was defined as an energy intake <0.9, represented by the ratio of energy intake to estimated basal metabolic rate. Results Under-reporters (URs) accounted for 14.4% of men and 23.0% of women and the under-reporting rate was higher in the age group 30–49 years for both men and women. The results from an analysis of the age-specific socioeconomic characteristics of participants classified as URs showed that under-reporting was high in women living alone and in women with only elementary school education or no education. The results from an analysis of the health-specific characteristics of URs showed that a large proportion of URs had poor self-rated health or were obese, or both, compared with non-URs. The proportion of participants who consumed less than the estimated average requirements for nutrients was significantly higher in URs compared with non-URs. Conclusion The under-reporting of energy intake was associated with age, gender, education level, income level, household status (single-person or multi-person), self-rated health, physical activity, and obesity. PMID:24955317

  17. Variants in the LEPR gene are nominally associated with higher BMI and lower 24 hour energy expenditure in Pima Indians

    PubMed Central

    Traurig, Michael; Perez, Jessica; Ma, Lijun; Bian, Li; Kobes, Sayuko; Hanson, Robert L.; Knowler, William C.; Krakoff, Jonathan; Bogardus, Clifton; Baier, Leslie J.

    2012-01-01

    Genome-wide association studies (GWASs) have been used to search for susceptibility genes for type 2 diabetes and obesity in the Pima Indians, a population with high a prevalence of both diseases. In these studies, a variant (rs2025804) in the LEPR gene was nominally associated with BMI in 1082 subjects (P=0.03 adjusted for age, sex, birth year, and family membership). Therefore the LEPR and leptin overlapping transcript (LEPROT) genes were selected for further sequencing and genotyping in larger population-based samples for association analyses with obesity-related phenotypes. Selected variants (n=80) spanning these genes were genotyped in a sample of full-heritage Pima Indians (n=2842) and several common variants including rs2025804 were nominally associated with BMI (P=0.05-0.003 adjusted for age, sex, birth year, and family membership). Four common tag variants associated with BMI in the full-heritage Pima Indian sample were genotyped in a second sample of mixed-heritage Native Americans (n=2969) and 3 of the variants showed nominal replication (P=0.03-0.006 adjusted as above and additionally for Indian heritage). Combining both samples provided the strongest evidence for association (adjusted P=0.0003-0.0001). A subset of these individuals (n=403) had been metabolically characterized for predictors of obesity and the BMI risk alleles for the variants tagged by rs2025804 were also associated with lower 24 hour energy expenditure as assessed in a human respiratory chamber (P=0.0007 adjusted for age, sex, fat mass, fat free mass, activity, and family membership). We conclude that common non-coding variation in the LEPR gene is associated with higher BMI and lower energy expenditure in Native Americans. PMID:22810975

  18. 24-hour human urine and serum profiles of bisphenol A: Evidence against sublingual absorption following ingestion in soup.

    PubMed

    Teeguarden, Justin G; Twaddle, Nathan C; Churchwell, Mona I; Yang, Xiaoxia; Fisher, Jeffrey W; Seryak, Liesel M; Doerge, Daniel R

    2015-10-15

    Extensive first-pass metabolism of ingested bisphenol A (BPA) in the gastro-intestinal tract and liver restricts blood concentrations of bioactive BPA to <1% of total BPA in humans and non-human primates. Absorption of ingested BPA through non-metabolizing tissues of the oral cavity, recently demonstrated in dogs, could lead to the higher serum BPA concentrations reported in some human biomonitoring studies. We hypothesized that the extensive interaction with the oral mucosa by a liquid matrix, like soup, relative to solid food or capsules, might enhance absorption through non-metabolizing oral cavity tissues in humans, producing higher bioavailability and higher serum BPA concentrations. Concurrent serum and urine concentrations of d6-BPA, and its glucuronide and sulfate conjugates, were measured over a 24hour period in 10 adult male volunteers following ingestion of 30μg d6-BPA/kg body weight in soup. Absorption of d6-BPA was rapid (t1/2=0.45h) and elimination of the administered dose was complete 24h post-ingestion, evidence against any tissue depot for BPA. The maximum serum d6-BPA concentration was 0.43nM at 1.6h after administration and represented <0.3% of total d6-BPA. Pharmacokinetic parameters, pharmacokinetic model simulations, and the significantly faster appearance half-life of d6-BPA-glucuronide compared to d6-BPA (0.29h vs 0.45h) were evidence against meaningful absorption of BPA in humans through any non-metabolizing tissue (<1%). This study confirms that typical exposure to BPA in food produces picomolar to subpicomolar serum BPA concentrations in humans, not nM concentrations reported in some biomonitoring studies. PMID:25620055

  19. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep.

    PubMed

    Tremblay, Mark S; Carson, Valerie; Chaput, Jean-Philippe; Connor Gorber, Sarah; Dinh, Thy; Duggan, Mary; Faulkner, Guy; Gray, Casey E; Gruber, Reut; Janson, Katherine; Janssen, Ian; Katzmarzyk, Peter T; Kho, Michelle E; Latimer-Cheung, Amy E; LeBlanc, Claire; Okely, Anthony D; Olds, Timothy; Pate, Russell R; Phillips, Andrea; Poitras, Veronica J; Rodenburg, Sophie; Sampson, Margaret; Saunders, Travis J; Stone, James A; Stratton, Gareth; Weiss, Shelly K; Zehr, Lori

    2016-06-01

    Leaders from the Canadian Society for Exercise Physiology convened representatives of national organizations, content experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children and youth aged 5-17 years respect the natural and intuitive integration of movement behaviours across the whole day (24-h period). The development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument and systematic reviews of evidence informing the guidelines were assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Four systematic reviews (physical activity, sedentary behaviour, sleep, integrated behaviours) examining the relationships between and among movement behaviours and several health indicators were completed and interpreted by expert consensus. Complementary compositional analyses were performed using Canadian Health Measures Survey data to examine the relationships between movement behaviours and health indicators. A stakeholder survey was employed (n = 590) and 28 focus groups/stakeholder interviews (n = 104) were completed to gather feedback on draft guidelines. Following an introductory preamble, the guidelines provide evidence-informed recommendations for a healthy day (24 h), comprising a combination of sleep, sedentary behaviours, light-, moderate-, and vigorous-intensity physical activity. Proactive dissemination, promotion, implementation, and evaluation plans have been prepared in an effort to optimize uptake and activation of the new guidelines. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed. PMID:27306437

  20. Ambulatory Blood Pressure Monitoring in Clinical Practice: A Review

    PubMed Central

    Viera, Anthony J.; Shimbo, Daichi

    2016-01-01

    Ambulatory blood pressure monitoring offers the ability to collect blood pressure readings several times an hour across a 24-hour period. Ambulatory blood pressure monitoring facilitates the identification of white-coat hypertension, the phenomenon whereby certain individuals who are not on antihypertensive medication show elevated blood pressure in a clinical setting but show non-elevated blood pressure averages when assessed by ambulatory blood pressure monitoring. Additionally, readings can be segmented into time windows of particular interest, e.g., mean daytime and nighttime values. During sleep, blood pressure typically decreases, or dips, such that mean sleep blood pressure is lower than mean awake blood pressure. A non-dipping pattern and nocturnal hypertension are strongly associated with increased cardiovascular morbidity and mortality. Approximately 70% of individuals dip ≥10% at night, while 30% have non-dipping patterns, when blood pressure remains similar to daytime average, or occasionally rises above daytime average. The various blood pressure categorizations afforded by ambulatory blood pressure monitoring are valuable for clinical management of high blood pressure since they increase accuracy for diagnosis and the prediction of cardiovascular risk. PMID:25107387

  1. Jack Healy Remembers - Anecdotal Evidence for the Origin of the Approximate 24-hour Urine Sampling Protocol Used for Worker Bioassay Monitoring

    SciTech Connect

    Carbaugh, Eugene H.

    2008-10-01

    The origin of the approximate 24-hour urine sampling protocol used at Hanford for routine bioassay is attributed to an informal study done in the mid-1940s. While the actual data were never published and have been lost, anecdotal recollections by staff involved in the initial bioassay program design and administration suggest that the sampling protocol had a solid scientific basis. Numerous alternate methods for normalizing partial day samples to represent a total 24-hour collection have since been proposed and used, but no one method is obviously preferred.

  2. Design of robust systolic algorithms

    SciTech Connect

    Varman, P.J.; Fussell, D.S.

    1983-01-01

    A primary reason for the susceptibility of systolic algorithms to faults is their strong dependence on the interconnection between the processors in a systolic array. A technique to transform any linear systolic algorithm into an equivalent pipelined algorithm that executes on arbitrary trees is presented. 5 references.

  3. Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

    PubMed Central

    Pieńkowska, Joanna; Gwoździewicz, Katarzyna; Skrobisz-Balandowska, Katarzyna; Marek, Iwona; Kostro, Justyna; Szurowska, Edyta; Studniarek, Michał

    2016-01-01

    Purpose Severe acute pancreatitis (AP) is still a significant clinical problem which is associated with a highly mortality. The aim of this study was the evaluation of prognostic value of CT regional perfusion measurement performed on the first day of onset of symptoms of AP, in assessing the risk of developing severe form of acute pancreatitis. Material and Methods 79 patients with clinical symptoms and biochemical criteria indicative of acute pancreatitis (acute upper abdominal pain, elevated levels of serum amylase and lipase) underwent perfusion CT within 24 hours after onset of symptoms. The follow-up examinations were performed after 4–6 days to detect progression of the disease. Perfusion parameters were compared in 41 people who developed severe form of AP (pancreatic and/or peripancreatic tissue necrosis) with parameters in 38 consecutive patients in whom course of AP was mild. Blood flow, blood volume, mean transit time and permeability surface area product were calculated in the three anatomic pancreatic subdivisions (head, body and tail). At the same time the patient's clinical status was assessed by APACHE II score and laboratory parameters such as CRP, serum lipase and amylase, AST, ALT, GGT, ALP and bilirubin were compared. Results Statistical differences in the perfusion parameters between the group of patients with mild and severe AP were shown. Blood flow, blood volume and mean transit time were significantly lower and permeability surface area product was significantly higher in patients who develop severe acute pancreatitis and presence of pancreatic and/or peripancreatic necrosis due to pancreatic ischemia. There were no statistically significant differences between the two groups in terms of evaluated on admission severity of pancreatitis assessed using APACHE II score and laboratory tests. Conclusions CT perfusion is a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who are at risk of

  4. Systolic processor for signal processing

    SciTech Connect

    Frank, G.A.; Greenawalt, E.M.; Kulkarni, A.V.

    1982-01-01

    A systolic array is a natural architecture for a high-performance signal processor, in part because of the extensive use of inner-product operations in signal processing. The modularity and simple interconnection of systolic arrays promise to simplify the development of cost-effective, high-performance, special-purpose processors. ESL incorporated has built a proof of concept model of a systolic processor. It is flexible enough to permit experimentation with a variety of algorithms and applications. ESL is exploring the application of systolic processors to image- and signal-processing problems. This paper describes this experimental system and some of its applications to signal processing. ESL is also pursuing new types of systolic architectures, including the VLSI implementation of systolic cells for solving systems of linear equations. These new systolic architectures allow the real-time design of adaptive filters. 14 references.

  5. Characterization of pulmonary protein profiles in response to zinc oxide nanoparticles in mice: a 24-hour and 28-day follow-up study

    PubMed Central

    Pan, Chih-Hong; Chuang, Kai-Jen; Chen, Jen-Kun; Hsiao, Ta-Chih; Lai, Ching-Huang; Jones, Tim P; BéruBé, Kelly A; Hong, Gui-Bing; Ho, Kin-Fai; Chuang, Hsiao-Chi

    2015-01-01

    Although zinc oxide nanoparticles (ZnONPs) are recognized to cause systemic disorders, little is known about the mechanisms that underlie the time-dependent differences that occur after exposure. The objective of this study was to investigate the mechanistic differences at 24 hours and 28 days after the exposure of BALB/c mice to ZnONPs via intratracheal instillation. An isobaric tag for the relative and absolute quantitation coupled with liquid chromatography/tandem mass spectrometry was used to identify the differential protein expression, biological processes, molecular functions, and pathways. A total of 18 and 14 proteins displayed significant changes in the lung tissues at 24 hours and 28 days after exposure, respectively, with the most striking changes being observed for S100-A9 protein. Metabolic processes and catalytic activity were the main biological processes and molecular functions, respectively, in the responses at the 24-hour and 28-day follow-up times. The glycolysis/gluconeogenesis pathway was continuously downregulated from 24 hours to 28 days, whereas detoxification pathways were activated at the 28-day time-point after exposure. A comprehensive understanding of the potential time-dependent effects of exposure to ZnONPs was provided, which highlights the metabolic mechanisms that may be important in the responses to ZnONP. PMID:26251593

  6. VALIDATION OF THREE FOOD FREQUENCY QUESTIONNAIRES AND 24-HOUR RECALLS WITH SERUM CAROTENOID LEVELS IN A SAMPLE OF AFRICAN-AMERICAN ADULTS.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The validity of self-reported fruit and vegetable intake in minority populations has not been adequately established. In this study, the authors examined the association of three food frequency questionnaires (FFQs) and 24-hour dietary recalls with serum carotenoid levels. Approximately 1,000 Africa...

  7. Validation of the automated self-administered 24-hour dietary recall for children (ASA24-Kids) among 9- to 11-year-old youth

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our purpose was to validate ASA24-Kids-2012, a self-administered web-based 24-hour dietary recall (24hDR) among 9- to 11-year-old children. Sixty-nine children in two sites participated in the study. In one site, trained staff observed and recorded types and portions of foods and drinks consumed by ...

  8. Identifying nutrients that are under-reported by an automated 24-hour dietary recall method in overweight and obese women after weight loss

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Underreporting of energy intake by 15-50% is a common problem in dietary assessment. Evidence suggests overweight/obese respondents are more likely to under-report than normal weight. This study compared Automated Self-Administered 24-hour recall (ASA24)-reported dietary intake to true intake in ove...

  9. 24-HOUR DIFFUSIVE SAMPLING OF 1,3-BUTADIENE IN AIR ONTO CARBONPAK X SOLID ADSORBENT WITH THEMAL DESORPTION/GC/MS ANALYSIS - FEASIBILITY STUDIES

    EPA Science Inventory

    Diffusive sampling of 1,3-butadiene for 24 hours onto the graphitic adsorbent Carbopack X contained in a stainless steel tube badge (6.3 mm OD, 5 mm ID, and 90 mm in length) with analysis by thermal desorption/GC/MS has been evaluated in controlled tests. A test matrix of 42 tr...

  10. Characterization of pulmonary protein profiles in response to zinc oxide nanoparticles in mice: a 24-hour and 28-day follow-up study.

    PubMed

    Pan, Chih-Hong; Chuang, Kai-Jen; Chen, Jen-Kun; Hsiao, Ta-Chih; Lai, Ching-Huang; Jones, Tim P; BéruBé, Kelly A; Hong, Gui-Bing; Ho, Kin-Fai; Chuang, Hsiao-Chi

    2015-01-01

    Although zinc oxide nanoparticles (ZnONPs) are recognized to cause systemic disorders, little is known about the mechanisms that underlie the time-dependent differences that occur after exposure. The objective of this study was to investigate the mechanistic differences at 24 hours and 28 days after the exposure of BALB/c mice to ZnONPs via intratracheal instillation. An isobaric tag for the relative and absolute quantitation coupled with liquid chromatography/tandem mass spectrometry was used to identify the differential protein expression, biological processes, molecular functions, and pathways. A total of 18 and 14 proteins displayed significant changes in the lung tissues at 24 hours and 28 days after exposure, respectively, with the most striking changes being observed for S100-A9 protein. Metabolic processes and catalytic activity were the main biological processes and molecular functions, respectively, in the responses at the 24-hour and 28-day follow-up times. The glycolysis/gluconeogenesis pathway was continuously downregulated from 24 hours to 28 days, whereas detoxification pathways were activated at the 28-day time-point after exposure. A comprehensive understanding of the potential time-dependent effects of exposure to ZnONPs was provided, which highlights the metabolic mechanisms that may be important in the responses to ZnONP. PMID:26251593

  11. 49 CFR 375.607 - What must I do if I am able to tender a shipment for final delivery more than 24 hours before a...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 5 2013-10-01 2013-10-01 false What must I do if I am able to tender a shipment... INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Transportation of Shipments § 375.607 What must I do if I am able to tender a shipment for final delivery more than 24 hours before a specified date?...

  12. The effect of low level radiofrequency electromagnetic radiation on the excretion rates of stress hormones in operators during 24-hour shifts.

    PubMed

    Vangelova, K; Israel, M; Mihaylov, S

    2002-06-01

    The aim of the study was to investigate the effect of long term exposure to low level radiofrequency (RF) electromagnetic (EM) radiation on the excretion rates of stress hormones in satellite station operators during 24-hour shifts. Twelve male operators at a satellite station for TV communications and space research were studied during 24-hour shifts. Dosimetric evaluation of the exposure was carried out and showed low level exposure with specific absorption of 0.1127 J.kg-1. A control group of 12 unexposed male operators with similar job task and the same shift system were studied, too. The 11-oxycorticosteroids (11-OCS), adrenaline and noradrenaline were followed by spectrofluorimetric methods on 3-hour intervals during the 24-hour shifts. The data were analyzed by tests for interindividual analysis, Cosinor analysis and analysis of variance (ANOVA). Significant increase in the 24-hour excretion of 11-OCS and disorders in its circadian rhythm, manifested by increase in the mesor, decrease in the amplitude and shift in the acrophase were found in the exposed operators. The changes in the excretion rates of the catecholamines were significant and showed greater variability of both variables. The long term effect of the exposure to low-level RF EM radiation evoked pronounced stress reaction with changes in the circadian rhythm of 11-OCS and increased variability of catecholamines secretion. The possible health hazards associated with observed alteration in the stress system need to be clarified by identification of their significance and prognostic relevance. PMID:12096679

  13. The Automated Self-Administered 24-hour dietary recall (ASA24): A resource for researchers, clinicians, and educators from the National Cancer Institute

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Extensive evidence has demonstrated that 24-hour dietary recalls (24HDRs) provide high-quality dietary intake data with minimal bias, making them the preferred tool for monitoring the diets of populations and, increasingly, for studying diet and disease associations. Traditional 24HDRs, however, are...

  14. Screening for proteinuria in a rheumatology clinic: comparison of dipstick testing, 24 hour urine quantitative protein, and protein/creatinine ratio in random urine samples.

    PubMed

    Ralston, S H; Caine, N; Richards, I; O'Reilly, D; Sturrock, R D; Capell, H A

    1988-09-01

    Measurements of protein/creatinine ratio in 'spot' urine samples were compared with measurements of 24 hour quantitative proteinuria and side room 'dipstick' testing in 104 samples from 90 patients presenting consecutively to a rheumatology unit. Linear regression analysis showed a highly significant correlation between the random urinary protein/creatinine ratio and total protein excretion in 24 hour urine samples (r = 0.92, p less than 0.001, y = 6.55x + 0.04). Although an approximation of 24 hour urinary protein excretion could have been made from the regression line: 24 hour urine protein = 6.55 x protein/creatinine ratio + 0.04 (g/l), there was a wide scatter of values, particularly in patients with greater than 1 g/24 h urinary protein excretion. Nevertheless, significant proteinuria (greater than 300 mg/24 h) could have been confirmed or excluded with a sensitivity and specificity of 97% by adopting random protein/creatinine values of less than 0.04 as 'normal'. Specificity and sensitivity could have been increased to 100%, however, by excluding patients with values lying between 0.01 and 0.10 as all the false negatives (n = 3) and false positives (n = 3) lay within this range. In comparison, dipstick testing, although 100% sensitive, had a poor specificity due to the high false positive rate (40/83 (48%] in patients with 1+ to 3+ readings. Assessment of random urinary protein/creatinine ratio may obviate the need for 24 hour urine collections in the initial assessment of suspected proteinuria. A wider application of this technique seems indicated in view of the obvious advantages in terms of cost, time, and patient convenience. PMID:3263087

  15. Systolic systems: algorithms and complexity

    SciTech Connect

    Chang, J.H.

    1986-01-01

    This thesis has two main contributions. The first is the design of efficient systolic algorithms for solving recurrence equations, dynamic programming problems, scheduling problems, as well as new systolic implementation of data structures such as stacks, queues, priority queues, and dictionary machines. The second major contribution is the investigation of the computational power of systolic arrays in comparison to sequential models and other models of parallel computation.

  16. Bit-level systolic arrays

    SciTech Connect

    De Groot, A.J.

    1989-01-01

    In this dissertation the author considered the design of bit - level systolic arrays where the basic computational unit consists of a simple one - bit logic unit, so that the systolic process is carried out at the level of individual bits. In order to pursue the foregoing research, several areas have been studied. First, the concept of systolic processing has been investigated. Several important algorithms were investigated and put into systolic form using graph-theoretic methods. The bit-level, word-level and block-level systolic arrays which have been designed for these algorithms exhibit linear speedup with respect to the number of processors and exhibit efficiency close to 100%, even with low interprocessor communication bandwidth. Block-level systolic arrays deal with blocks of data with block-level operations and communications. Block-level systolic arrays improve cell efficiency and are more efficient than their word-level counterparts. A comparison of bit-level, word-level and block-level systolic arrays was performed. In order to verify the foregoing theory and analysis a systolic processor called the SPRINT was developed to provide and environment where bit-level, word-level and block-level systolic algorithms could be confirmed by direct implementation rather than by computer simulation. The SPRINT is a supercomputer class, 64-element multiprocessor with a reconfigurable interconnection network. The theory has been confirmed by the execution on the SPRINT of the bit-level, word-level, and block-level systolic algorithms presented in the dissertation.

  17. Ambulatory monitoring of oesophageal pH in reflux oesophagitis using a portable radiotelemetry system.

    PubMed Central

    Branicki, F J; Evans, D F; Ogilvie, A L; Atkinson, M; Hardcastle, J D

    1982-01-01

    Gastro-oesophageal reflux has been assessed in 10 symptomatic patients and 10 asymptomatic normal subjects during a study period of 24 hours at work and in the home using a newly developed pH sensitive radiotelemetry capsule and a portable receiving system. Oesophageal pH was continuously monitored by the tethered radiotelemetry capsule and recorded with a portable receiver and a 24-hour cassette recorder, allowing the patient complete freedom of movement so that ambulatory studies could be undertaken during a normal working day. The number and duration of reflux episodes was greater in symptomatic patients than normal subjects during 24-hour studies at home (p less than 0.002). In both groups, reflux occurred more during the day than at night (p less than 0.01). Patients refluxed significantly more at home than when they were in hospital (p less than 0.01). Ambulatory outpatient oesophageal pH monitoring may be useful in the management of patients with atypical symptoms and may demonstrate significant reflux when inpatient investigations and endoscopy findings show minimal abnormality. PMID:7129208

  18. A systolic array parallelizing compiler

    SciTech Connect

    Tseng, P.S. )

    1990-01-01

    This book presents a completely new approach to the problem of systolic array parallelizing compiler. It describes the AL parallelizing compiler for the Warp systolic array, the first working systolic array parallelizing compiler which can generate efficient parallel code for complete LINPACK routines. This book begins by analyzing the architectural strength of the Warp systolic array. It proposes a model for mapping programs onto the machine and introduces the notion of data relations for optimizing the program mapping. Also presented are successful applications of the AL compiler in matrix computation and image processing. A complete listing of the source program and compiler-generated parallel code are given to clarify the overall picture of the compiler. The book concludes that systolic array parallelizing compiler can produce efficient parallel code, almost identical to what the user would have written by hand.

  19. A systolic radiation monitoring system

    SciTech Connect

    Shpancer, I.; Kinsner, W.

    1982-12-01

    This paper describes a data acquisition system for radiation monitoring which significantly improves performance over conventional systems by providing higher throughput, elimination of data skew, easier and inexpensive isolation, improved system accuracy, and compact implementation. The novel systolic data acquisition system, including systolic converter, processor and networking was developed to alleviate drawbacks of various conventional data acquisition systems used in radiation monitoring. The system is based on a systolic conversion, processing and networking method amenable to highly integrated vector architecture. The method employs systolic rules which can be developed for a selected problem. The rules for the radiation monitoring problem have been developed so as to apply not only locally but also globally to the systolic network. A form of the network has been implemented and is operational in a nuclear reactor site. Other forms are being implemented and tested for other data skew sensitive problems.

  20. Factors Associated With High Sodium Intake Based on Estimated 24-Hour Urinary Sodium Excretion: The 2009-2011 Korea National Health and Nutrition Examination Survey.

    PubMed

    Hong, Jae Won; Noh, Jung Hyun; Kim, Dong-Jun

    2016-03-01

    Although reducing dietary salt consumption is the most cost-effective strategy for preventing progression of cardiovascular and renal disease, policy-based approaches to monitor sodium intake accurately and the understanding factors associated with excessive sodium intake for the improvement of public health are lacking. We investigated factors associated with high sodium intake based on the estimated 24-hour urinary sodium excretion, using data from the 2009 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Among 21,199 adults (≥19 years of age) who participated in the 2009 to 2011 KNHANES, 18,000 participants (weighted n = 33,969,783) who completed urinary sodium and creatinine evaluations were analyzed in this study. The 24-hour urinary sodium excretion was estimated using Tanaka equation. The mean estimated 24-hour urinary sodium excretion level was 4349 (4286-4413) mg per day. Only 18.5% (weighted n = 6,298,481/3,396,973, unweighted n = 2898/18,000) of the study participants consumed less the 2000 mg sodium per day. Female gender (P < 0.001), older age (P < 0.001), total energy intake ≥50 percentile (P < 0.005), and obesity (P < 0.001) were associated with high sodium intake, even after adjusting for potential confounders. Senior high school/college graduation in education and managers/professionals in occupation were associated with lower sodium intake (P < 0.001). According to hypertension management status, those who had hypertension without medication consumed more sodium than those who were normotensive. However, those who receiving treatment for hypertension consumed less sodium than those who were normotensive (P < 0.001). The number of family members, household income, and alcohol drinking did not affect 24-hour urinary sodium excretion. The logistic regression analysis for the highest estimated 24-hour urinary sodium excretion quartile (>6033 mg/day) using the abovementioned variables

  1. Systolic architecture for heirarchical clustering

    SciTech Connect

    Ku, L.C.

    1984-01-01

    Several hierarchical clustering methods (including single-linkage complete-linkage, centroid, and absolute overlap methods) are reviewed. The absolute overlap clustering method is selected for the design of systolic architecture mainly due to its simplicity. Two versions of systolic architectures for the absolute overlap hierarchical clustering algorithm are proposed: one-dimensional version that leads to the development of a two dimensional version which fully takes advantage of the underlying data structure of the problems. The two dimensional systolic architecture can achieve a time complexity of O(m + n) in comparison with the conventional computer implementation of a time complexity of O(m/sup 2*/n).

  2. Systolic algorithms and their implementation

    SciTech Connect

    Kung, H.T.

    1984-01-01

    Very high performance computer systems must rely heavily on parallelism since there are severe physical and technological limits on the ultimate speed of any single processor. The systolic array concept developed in the last several years allows effective use of a very large number of processors in parallel. This article illustrates the basic ideas by reviewing a systolic array design for matrix triangularization and describing its use in the on-the-fly updating of Cholesky decomposition of covariance matrices-a crucial computation in adaptive signal processing. Following this are discussions on issues related to the hardware implementation of systolic algorithms in general, and some guidelines for designing systolic algorithms that will be convenient for implementation. 33 references.

  3. Ambulatory Feedback System

    NASA Technical Reports Server (NTRS)

    Finger, Herbert; Weeks, Bill

    1985-01-01

    This presentation discusses instrumentation that will be used for a specific event, which we hope will carry on to future events within the Space Shuttle program. The experiment is the Autogenic Feedback Training Experiment (AFTE) scheduled for Spacelab 3, currently scheduled to be launched in November, 1984. The objectives of the AFTE are to determine the effectiveness of autogenic feedback in preventing or reducing space adaptation syndrome (SAS), to monitor and record in-flight data from the crew, to determine if prediction criteria for SAS can be established, and, finally, to develop an ambulatory instrument package to mount the crew throughout the mission. The purpose of the Ambulatory Feedback System (AFS) is to record the responses of the subject during a provocative event in space and provide a real-time feedback display to reinforce the training.

  4. Development and validity of a 3-day smartphone-assisted 24-hour recall to assess beverage consumption in a Chinese population: a randomized cross-over study

    PubMed Central

    Smith, Lindsey P.; Hua, Jenna; Seto, Edmund; Du, Shufa; Zang, Jiajie; Zou, Shurong; Popkin, Barry M.; Mendez, Michelle A.

    2014-01-01

    This paper addresses the need for diet assessment methods that capture the rapidly changing beverage consumption patterns in China. The objective of this study was to develop a 3-day smartphone-assisted 24-hour recall to improve the quantification of beverage intake amongst young Chinese adults (n=110) and validate, in a small subset (n=34), the extent to which the written record and smartphone-assisted recalls adequately estimated total fluid intake, using 24-hour urine samples. The smartphone-assisted method showed improved validity compared to the written-assisted method, when comparing reported total fluid intake to total urine volume. However, participants reported consuming fewer beverages on the smartphone-assisted method compared to the written-assisted method, primarily due to decreased consumption of traditional zero-energy beverages (i.e. water, tea) in the smartphone-assisted method. It is unclear why participants reported fewer beverages in the smartphone-assisted method than the written-assisted method. One possibility is that participants found the smartphone method too cumbersome, and responded by decreasing beverage intake. These results suggest that smartphone-assisted 24-hour recalls perform comparably but do not appear to substantially improve beverage quantification compared to the current written record based approach. In addition, we piloted a beverage screener to identify consumers of episodically consumed SSBs. As expected, a substantially higher proportion of consumers reported consuming SSBs on the beverage screener compared to either recall type, suggesting that a beverage screener may be useful in characterizing consumption of episodically consumed beverages in China’s dynamic food and beverage landscape. PMID:25516327

  5. Decreased striatal dopamine release underlies increased expression of long-term synaptic potentiation at corticostriatal synapses 24 hours after 3-nitropropionic acid induced chemical hypoxia

    PubMed Central

    Akopian, Garnik; Crawford, Cynthia; Beal, M. Flint; Cappelletti, Maurand; Jakowec, Michael W.; Petzinger, Giselle M.; Zheng, Ling; Gheorghe, Stacey L.; Reichel, Carmela M.; Chow, Robert; Walsh, John P

    2008-01-01

    The striatum is particularly sensitive to the irreversible inhibitor of succinate dehyrdrogenase 3-nitropropionic acid (3-NP). In the present study we examined early changes in behavior and dopamine and glutamate synaptic physiology created by a single systemic injection of 3-NP in Fischer 344 rats. Hind limb dystonia was seen 2 hours after 3-NP injections and rats performed poorly on balance beam and rota-rod motor tests 24 hours later. Systemic 3-NP increased NMDA receptor-dependent long-term potentiation (LTP) at corticostriatal synapses over the same time period. The 3-NP induced corticostriatal LTP was not due to increased NMDA receptor number or function, since 3-NP did not change MK-801 binding or NMDA/AMPA receptor current ratios. The LTP seen 24 hours after 3-NP was D1 receptor-dependent and reversed by exogenous addition of dopamine or a D2 receptor agonist to brain slices. High performance liquid chromatography and fast scan cyclic voltammetry revealed a decrease in dopamine content and release in rats injected 24 hours earlier with 3-NP, and much like the enhanced LTP, dopamine changes were reversed by 48 hours. Tyrosine hydroxylase expression was not changed and there was no evidence of striatal cell loss at 24–48 hours after 3-NP exposure. Sprague-Dawley rats showed similar physiological responses to systemic 3-NP, albeit with reduced sensitivity. Thus, 3-NP causes significant changes in motor behavior marked by parallel changes in striatal dopamine release and corticostriatal synaptic plasticity. PMID:18799690

  6. Broadcast normalization in systolic design

    SciTech Connect

    Lin, F.C. ); Wu, I.C. )

    1988-11-01

    When a sequential algorithm is directly mapped into an array of processing elements, quite likely data broadcasts are required and their source places vary during the computation. The authors introduce a normalization method to fix the positions of the broadcast sources so that the derived design can be further transformed by retimings into a systolic array. The authors' method is fully illustrated in designing systolic arrays for enumeration sort, solving simultaneous linear equations, and computing transitive closure.

  7. Dynamically Reconfigurable Systolic Array Accelorators

    NASA Technical Reports Server (NTRS)

    Dasu, Aravind (Inventor); Barnes, Robert C. (Inventor)

    2014-01-01

    A polymorphic systolic array framework that works in conjunction with an embedded microprocessor on an FPGA, that allows for dynamic and complimentary scaling of acceleration levels of two algorithms active concurrently on the FPGA. Use is made of systolic arrays and hardware-software co-design to obtain an efficient multi-application acceleration system. The flexible and simple framework allows hosting of a broader range of algorithms and extendable to more complex applications in the area of aerospace embedded systems.

  8. Ambulatory cardiovascular monitoring of healthy adults in Rochester, Minnesota: chronobiologic assessment.

    PubMed

    Zachariah, P K; Cornélissen, G; Halberg, F

    1990-01-01

    To serve as a tentative reference group for clinical health, 107 adults measured their systolic (S) and diastolic (D) blood pressure (BP) with an ambulatory Del Mar Avionics monitor (Irvine, California). Data were collected over approximately 24 hours at 7.5-minute intervals during waking and at 15-minute intervals during sleep. An echocardiogram served to determine the left ventricular mass (LVM), septal wall thickness (SWT), posterior wall thickness (PWT), ejection fraction (EjFr), and left atrial size (LAS). Each data series was analyzed by single cosinor. A statistically significant circadian rhythm (P less than 0.05) was found in 96 subjects (89.7 percent) for SBP and in 86 subjects (80.4 percent) for DBP. A population-mean cosinor reveals a highly significant circadian rhythm (P less than 0.001) for both variables in men (n = 44) as well as in women (n = 63), with an acrophase around 14:15. The double circadian amplitude, a measure of the total predictable change within a day, averages 10 (women) and 11 (men) mm Hg for DBP and 14 (women) and 17 (men) mm Hg for SBP. The midline-estimating statistic of rhythm (MESOR) of SBP is found to be higher for men (125 mm Hg) than for women (120 mm Hg), P = 0.018, whereas no difference in MESOR is found for DBP (71 mm Hg). A statistically significant correlation with age is found for the MESOR of SBP in both men (r = 0.352; P = 0.018) and women (r = 0.336; P = 0.007). The MESOR of SBP is also found to correlate with LVM in men (r = 0.300; P = 0.046), but not in women (r = 0.181; P = 0.153), whereas the MESOR of DBP correlates with LVM in women (R = 0.316; P = 0.011) but not in men (r = 0.117; P = 0.543). A positive correlation is also found between the MESOR of SBP and SWT as well as with EjFr, which is more prominent in women; between the MESOR of DBP and LAS, which is more prominent in men; and a negative correlation is found for women but not men between the circadian amplitude of both SBP and DBP and EjFr. Blood

  9. Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form

    PubMed Central

    2012-01-01

    Residents in training, medical students and other staff in surgical sector, emergency room (ER) and intensive care unit (ICU) or Burn Unit face a multitude of questions regarding burn care. Treatment of burns is not always straightforward. Furthermore, National and International guidelines differ from one region to another. On one hand, it is important to understand pathophysiology, classification of burns, surgical treatment, and the latest updates in burn science. On the other hand, the clinical situation for treating these cases needs clear guidelines to cover every single aspect during the treatment procedure. Thus, 10 questions have been organised and discussed in a step-by-step form in order to achieve the excellence of education and the optimal treatment of burn injuries in the first 24 hours. These 10 questions will clearly discuss referral criteria to the burn unit, primary and secondary survey, estimation of the total burned surface area (%TBSA) and the degree of burns as well as resuscitation process, routine interventions, laboratory tests, indications of Bronchoscopy and special considerations for Inhalation trauma, immediate consultations and referrals, emergency surgery and admission orders. Understanding and answering the 10 questions will not only cover the management process of Burns during the first 24 hours but also seems to be an interactive clear guide for education purpose. PMID:22583548

  10. Effect of current and lifetime posttraumatic stress disorder on 24-hour urinary catecholamines and cortisol: results from the Mind Your Heart Study

    PubMed Central

    Wingenfeld, Katja; Whooley, Mary A.; Neylan, Thomas C.; Otte, Christian; Cohen, Beth E.

    2014-01-01

    Summary Posttraumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular disease and several other chronic illnesses. Alterations in the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis in PTSD might contribute to these associations but findings regarding SNS and HPA activity in PTSD are heterogeneous. We measured 24-hour urinary catecholamines and cortisol in a large cohort of adult outpatients recruited from 2 Veterans Affairs medical centers. 24-hour urinary norepinephrine, epinephrine, dopamine and cortisol were measured by tandem mass spectrometry. Lifetime and current PTSD were assessed with the Clinician Administered PTSD Scale using DSM-IV-TR criteria. Out of 613 participants, 199 (32.5%) had current PTSD, 100 (16.3%) had lifetime but not current PTSD, and 314 (51.2%) never had PTSD. Patients with current PTSD had significantly higher norepinephrine secretion compared to those without PTSD. Patients in the lifetime PTSD group exhibited lower cortisol values compared to those without PTSD. Participants who never had PTSD showed the lowest norepinephrine and the highest cortisol values. All results remained stable when controlling for potentially confounding variables. This study provides evidence for increased norepinephrine secretion and decreased cortisol in PTSD. Future longitudinal studies are needed to determine whether these changes contribute to adverse health outcomes in patients with PTSD. PMID:25459895

  11. Estimation of 24-hour thyroid uptake of I-131 sodium iodide using a 5-minute uptake of technetium-99m pertechnetate

    SciTech Connect

    Smith, J.J.; Croft, B.Y.; Brookeman, V.A.; Teates, C.D. )

    1990-02-01

    The authors have developed a method to estimate the 24-hour sodium iodide thyroid uptake based on a 5-minute Tc-99m pertechnetate thyroid uptake using the equation: Estimated Iodide Uptake = 17.72*In(Pertechnetate Uptake) + 30.40. This estimation has a correlation coefficient of 0.90. It is based on a data pool of 44 patients who underwent I-131 and Tc-99m studies within 2 weeks of each other from 1978-1988, with established diagnoses as follows: 12 euthyroid, 6 hyperthyroid with multinodular goiters, 15 hyperthyroid with diffuse goiters, 4 with subacute thyroiditis, and 7 unknown. The population consisted of 30 women and 14 men with a mean age of 52.0 +/- 17.5 years; this sample was screened for use of thyroid hormone, propylthiouracil, and radiographic contrast. The authors believe this estimation method is of value whenever a 24-hour iodide uptake is desired, and where speed and minimizing radiation dose are factors. This method is strongly recommended for thyroid uptake evaluation before I-131 therapy.

  12. Estimate of the time zero lung burden of depleted uranium in Persian Gulf War veterans by the 24-hour urinary excretion and exponential decay analysis.

    PubMed

    Durakovic, Asaf; Horan, Patricia; Dietz, Leonard A; Zimmerman, Isaac

    2003-08-01

    The aim of this study was to estimate the amount of depleted uranium (DU) in the respiratory system of Allied Forces Gulf War Veterans. Mass spectrometry (thermal ionization mass spectrometry) analysis of 24-hour urinary excretion of DU isotopes in five positive (238U/235U > 191.00) and six negative (238U/235U > 138.25) veterans was utilized in the mathematical estimation of the pulmonary burden at the time of exposure. A minimum value for the biological half-life of ceramic DU oxide in the lungs was derived from the Battelle report of the minimum dissolution half-time in simulated interstitial lung fluid corresponding to 3.85 years. The average DU concentration was 3.27 x 10(-5) mg per 24 hours in DU-positive veterans and 1.46 x 10(-8) mg in DU-negative veterans. The estimated lung burden was 0.34 mg in the DU-positive and 0.00015 mg in the DU-negative veterans. Our results provide evidence that the pulmonary concentration of DU at time zero can be quantitated as late as 9 years after inhalational exposure. PMID:12943033

  13. Prognostic factors for death and survival with or without complications in cardiac arrest patients receiving CPR within 24 hours of anesthesia for emergency surgery

    PubMed Central

    Siriphuwanun, Visith; Punjasawadwong, Yodying; Lapisatepun, Worawut; Charuluxananan, Somrat; Uerpairojkit, Ketchada

    2014-01-01

    Purpose To determine prognostic factors for death and survival with or without complications in cardiac arrest patients who received cardiopulmonary resuscitation (CPR) within 24 hours of receiving anesthesia for emergency surgery. Patients and methods A retrospective cohort study approved by the Maharaj Nakorn Chiang Mai University Hospital Ethical Committee. Data used were taken from records of 751 cardiac arrest patients who received their first CPR within 24 hours of anesthesia for emergency surgery between January 1, 2003 and October 31, 2011. The reviewed data included patient characteristics, surgical procedures, American Society of Anesthesiologist (ASA) physical status classification, anesthesia information, the timing of cardiac arrest, CPR details, and outcomes at 24 hours after CPR. Univariate and polytomous logistic regression analyses were used to determine prognostic factors associated with the outcome variable. P-values of less than 0.05 were considered statistically significant. Results The outcomes at 24 hours were death (638/751, 85.0%), survival with complications (73/751, 9.7%), and survival without complications (40/751, 5.3%). The prognostic factors associated with death were: age between 13–34 years (OR =3.08, 95% CI =1.03–9.19); ASA physical status three and higher (OR =6.60, 95% CI =2.17–20.13); precardiopulmonary comorbidity (OR =3.28, 95% CI =1.09–9.90); the condition of patients who were on mechanical ventilation prior to receiving anesthesia (OR =4.11, 95% CI =1.17–14.38); surgery in the upper abdominal site (OR =14.64, 95% CI =2.83–75.82); shock prior to cardiac arrest (OR =6.24, 95% CI =2.53–15.36); nonshockable electrocardiography (EKG) rhythm (OR =5.67, 95% CI =1.93–16.62); cardiac arrest occurring in postoperative period (OR =7.35, 95% CI =2.89–18.74); and duration of CPR more than 30 minutes (OR =4.32, 95% CI =1.39–13.45). The prognostic factors associated with survival with complications were being greater

  14. Dynamically Reconfigurable Systolic Array Accelerator

    NASA Technical Reports Server (NTRS)

    Dasu, Aravind; Barnes, Robert

    2012-01-01

    A polymorphic systolic array framework has been developed that works in conjunction with an embedded microprocessor on a field-programmable gate array (FPGA), which allows for dynamic and complimentary scaling of acceleration levels of two algorithms active concurrently on the FPGA. Use is made of systolic arrays and a hardware-software co-design to obtain an efficient multi-application acceleration system. The flexible and simple framework allows hosting of a broader range of algorithms, and is extendable to more complex applications in the area of aerospace embedded systems. FPGA chips can be responsive to realtime demands for changing applications needs, but only if the electronic fabric can respond fast enough. This systolic array framework allows for rapid partial and dynamic reconfiguration of the chip in response to the real-time needs of scalability, and adaptability of executables.

  15. Systoles in discrete dynamical systems

    NASA Astrophysics Data System (ADS)

    Fernandes, Sara; Grácio, Clara; Ramos, Carlos Correia

    2013-01-01

    The fruitful relationship between Geometry and Graph Theory has been explored by several authors benefiting also the Theory of discrete dynamical systems seen as Markov chains in graphs. In this work we will further explore the relation between these areas, giving a geometrical interpretation of notions from dynamical systems. In particular, we relate the topological entropy with the systole, here defined in the context of discrete dynamical systems. We show that for continuous interval maps the systole is trivial; however, for the class of interval maps with one discontinuity point the systole acquires relevance from the point of view of the dynamical behavior. Moreover, we define the geodesic length spectrum associated to a Markov interval map and we compute the referred spectrum in several examples.

  16. New Advantage 24 contraceptive gel claims 24-hour effectiveness. But proposed FDA rule could put N-9 products to the test.

    PubMed

    1995-04-01

    Advantage 24 is a new contraceptive gel that makes use of bioadhesive technology to offer 24 hours of protection relying on the spermicide nonoxynol-9 (N-9) in lower concentrations. If a proposed US Food and Drug Administration (FDA) rule is enforced N-9 may be examined closely. The manufacturer, Whitehall-Robins Healthcare in New Jersey, stopped production of the Today contraceptive sponge because of the costs of complying with FDA standards. The Advantage 24 gel costs twice as much as the sponge. It is made in Switzerland and distributed by an Illinois company. Any vaginal contraceptive containing N-9 would be approved by the FDA as long as it complied with guidelines laid down in an FDA monograph. However, the registration of the gel could not be confirmed. The product uses a bioadhesive technology concept that natural substances adhere to epithelial and mucosal tissues in the body. Polycarbofil is mixed with water, N-9, and mineral oil to create an emulsion that allows for a time-release mechanism, but at any given time only 2 mg of N-9 is available to kill sperm. The final formula for Advantage 24 is 52.5 mg per dose. Too much N-9 can be toxic, as demonstrated by the Today sponge, which contained 1000 mg of N-9. In Kenya prostitutes using it frequently experienced 3 times as many genital lesions as those using a placebo. A study of Advantage 24 by a Miami laboratory involved 250 women, 22-45 years old, who had had prior tubal ligations. When the gel was applied 15-30 minutes before intercourse the efficacy rate was 98%; it was 91% for those applying it 12 hours before; and it was 86% when the gel was applied 24 hours ahead of time. FDA compliance officers are intrigued about the claim that the gel lasts 24 hours. However, if the claim is held up by research data, women will have an easily available, portable, efficient, aesthetic, and highly effective contraceptive. PMID:12347026

  17. Blood Pressure Measurement: Clinic, Home, Ambulatory, and Beyond

    PubMed Central

    Drawz, Paul E.; Abdalla, Mohamed; Rahman, Mahboob

    2014-01-01

    Blood pressure has traditionally been measured in the clinic setting using the auscultory method and a mercury sphygmomanometer. Technological advances have led to improvements in measuring clinic blood pressure and allowed for measuring blood pressures outside the clinic. This review outlines various methods for evaluating blood pressure and the clinical utility of each type of measurement. Home blood pressures and 24 hour ambulatory blood pressures have improved our ability to evaluate risk for target organ damage and hypertension related morbidity and mortality. Measuring home blood pressures may lead to more active participation in health care by patients and has the potential to improve blood pressure control. Ambulatory blood pressure monitoring enables the measuring nighttime blood pressures and diurnal changes, which may be the most accurate predictors of risk associated with elevated blood pressure. Additionally, reducing nighttime blood pressure is feasible and may be an important component of effective antihypertensive therapy. Finally, estimating central aortic pressures and pulse wave velocity are two of the newer methods for assessing blood pressure and hypertension related target organ damage. PMID:22521624

  18. Psychophysiological ambulatory assessment of affective dysregulation in borderline personality disorder.

    PubMed

    Ebner-Priemer, Ulrich W; Welch, Stacy S; Grossman, Paul; Reisch, Thomas; Linehan, Marsha M; Bohus, Martin

    2007-04-15

    Many experts now believe that pervasive problems in affect regulation constitute the central area of dysfunction in borderline personality disorder (BPD). However, data is sparse and inconclusive. We hypothesized that patients with BPD, in contrast to healthy gender and nationality-matched controls, show a higher frequency and intensity of self-reported emotions, altered physiological indices of emotions, more complex emotions and greater problems in identifying specific emotions. We took a 24-hour psychophysiological ambulatory monitoring approach to investigate affect regulation during everyday life in 50 patients with BPD and in 50 healthy controls. To provide a typical and unmanipulated sample, we included only patients who were currently in treatment and did not alter their medication schedule. BPD patients reported more negative emotions, fewer positive emotions, and a greater intensity of negative emotions. A subgroup of non-medicated BPD patients manifested higher values of additional heart rate. Additional heart rate is that part of a heart rate increase that does not directly result from metabolic activity, and is used as an indicator of emotional reactivity. Borderline participants were more likely to report the concurrent presence of more than one emotion, and those patients who just started treatment in particular had greater problems in identifying specific emotions. Our findings during naturalistic ambulatory assessment support emotional dysregulation in BPD as defined by the biosocial theory of [Linehan, M.M., 1993. Cognitive-Behavioral Treatment of Borderline Personality Disorder. The Guildford Press, New York.] and suggest the potential utility for evaluating treatment outcome. PMID:17321599

  19. Electronic Dietary Intake Assessment (e-DIA): Comparison of a Mobile Phone Digital Entry App for Dietary Data Collection With 24-Hour Dietary Recalls

    PubMed Central

    O'Connor, Sarah; Giannelli, Valentina; Yap, Megan LH; Tang, Lie Ming; Roy, Rajshri; Louie, Jimmy Chun Yu; Hebden, Lana; Kay, Judy; Allman-Farinelli, Margaret

    2015-01-01

    Background The electronic Dietary Intake Assessment (e-DIA), a digital entry food record mobile phone app, was developed to measure energy and nutrient intake prospectively. This can be used in monitoring population intakes or intervention studies in young adults. Objective The objective was to assess the relative validity of e-DIA as a dietary assessment tool for energy and nutrient intakes using the 24-hour dietary recall as a reference method. Methods University students aged 19 to 24 years recorded their food and drink intake on the e-DIA for five days consecutively and completed 24-hour dietary recalls on three random days during this 5-day study period. Mean differences in energy, macro-, and micronutrient intakes were evaluated between the methods using paired t tests or Wilcoxon signed-rank tests, and correlation coefficients were calculated on unadjusted, energy-adjusted, and deattenuated values. Bland-Altman plots and cross-classification into quartiles were used to assess agreement between the two methods. Results Eighty participants completed the study (38% male). No significant differences were found between the two methods for mean intakes of energy or nutrients. Deattenuated correlation coefficients ranged from 0.55 to 0.79 (mean 0.68). Bland-Altman plots showed wide limits of agreement between the methods but without obvious bias. Cross-classification into same or adjacent quartiles ranged from 75% to 93% (mean 85%). Conclusions The e-DIA shows potential as a dietary intake assessment tool at a group level with good ranking agreement for energy and all nutrients. PMID:26508282

  20. Demand and characteristics of a psychiatric 24-hour emergency service performed by mandatory rotation of licensed psychiatrists in Swiss primary care

    PubMed Central

    Chmiel, Corinne; Rosemann, Thomas; Senn, Oliver

    2014-01-01

    Background To investigate characteristics of and satisfaction with psychiatric 24-hour emergency primary care performed by mandatory rotation of licensed psychiatrists as a viable baseline for possible reorganizational measures. Methods This was a questionnaire-based cross-sectional study (November 2010–April 2011). The number of patient–psychiatrist encounters, modes of contact, and patient and psychiatrist characteristics were assessed. Diagnoses were coded with ICD-10 (International Classification of Diseases, version 10). Results From 167 duty episodes, 74 (44%) were recorded. Of the psychiatrists (n=44), 52% were female, and mean age (standard deviation) was 49.9 (5.2) years. The median number of encounters per episode was 4 (interquartile range 0–8), mainly in the evenings. Demand for “face-to-face” (direct) patient visits was significantly more common (64.0%) than practice (1.3%) or telephone consultations (34.7%). In 83.8%, psychiatrists judged the encounter as adequate at the patient’s location. A total of 43 different diagnoses were recorded: mainly schizophrenic disorders (23.9%), suicidal behavior (15.2%), and acute stress reactions (10.3%). Psychiatrists felt burdened by services (62.5%): in 39.2%, they felt threatened; and in 6.8%, violence occurred. In 32.4%, bills were not paid for. If services were optional, 45.2% would participate. Conclusion Our findings indicate justified demand for direct mobile patient visits, suggesting that emergency care should be multifaceted, and sole provision of psychiatric care at stationed emergency facilities may not always be appropriate. Reorganization of 24-hour emergency services should carefully evaluate patient and provider’s needs before changing established structures. PMID:24707172

  1. Correlation of Occupational Stress Index with 24-hour Urine Cortisol and Serum DHEA Sulfate among City Bus Drivers: A Cross-sectional Study

    PubMed Central

    Lin, Mia Chihya; Lu, Luo; Tai, John Jen

    2011-01-01

    Objectives The questionnaire of occupational stress index (OSI) has been popular in the workplace, and it has been tailored for bus drivers in Taiwan. Nevertheless, its outcomes for participants are based on self-evaluations, thus validation by their physiological stress biomarker is warranted and this is the main goal of this study. Methods A cross-sectional study of sixty-three city bus drivers and fifty-four supporting staffs for comparison was conducted. Questionnaire surveys, 24-hour urine cortisol testing, and blood draws for dehydroepiandrosterone-sulfate (DHEA-S) testing were performed. The measured concentrations of these biological measures were logarithmically transformed before the statistical analysis where various scores of stressor factors, moderators, and stress effects of each OSI domain were analyzed by applying multiple linear regression models. Results For drivers, the elevated 24-hour urine cortisol level was associated with a worker's relationship with their supervisor and any life change events in the most recent 3 months. The DHEA-S level was higher in drivers of younger age as well as drivers with more concerns relating to their salary and bonuses. Non-drivers showed no association between any stressor or satisfaction and urine cortisol and blood DHEA-S levels. Conclusion Measurements of biomarkers may offer additional stress evaluations with OSI questionnaires for bus drivers. Increased DHEA-S and cortisol levels may result from stressors like income security. Prevention efforts towards occupational stress and life events and health promotional efforts for aged driver were important anti-stress remedies. PMID:22953199

  2. Noninvasive ambulatory blood pressure control in normotensive pregnant women.

    PubMed

    Margulies, M; Zin, C; Margulies, N D; Voto, L S

    1989-12-01

    Twenty-four hour noninvasive, automatic and ambulatory control of blood pressure (BP) was carried out on 11 normotensive pregnant women in the third trimester of pregnancy with a Del Mar Avionics Model 1978 Pressurometer III System at 7.5 min intervals during 24 h. The patients kept a detailed record of their activities during those 24 h. BP increased from 9 AM to a peak between 7 and 10 PM. Mean (+/- SD) waking and sleeping values were 110.56 +/- 6.68 mm Hg and 96.5 +/- 10.01 mm Hg, respectively, for systolic BP, and 71.41 +/- 5.35 mm Hg and 62.82 +/- 5.47 mm Hg, respectively, for diastolic BP. There was a significant difference in systolic and diastolic BP between sleeping hours and waking hours. We believe that 24-h control of BP behavior in normotensive pregnant women allows us to adequately diagnose hypertensive disease in pregnancy. PMID:2610998

  3. Ambulatory pressure monitoring in the assessment of antihypertensive therapy.

    PubMed

    Coats, A J; Conway, J; Somers, V K; Isea, J E; Sleight, P

    1989-06-01

    A low-cost, ambulatory blood-pressure monitor has been calibrated and validated against a random zero sphygmomanometer. The repeatability of ambulatory pressure recordings after a placebo month in 44 mild to moderate untreated hypertensives was assessed. Systolic blood pressure showed a mean difference over 1 month of 2.0 mmHg, with a standard deviation of differences of 9.3 mmHg. The diastolic blood pressure mean difference was 0.1 mmHg (SD = 6.3 mmHg). This variability was much less than for clinic readings (SD = 17.3 mmHg) or for single home pressure readings (SD = 19.7 mmHg). Using ambulatory monitoring to detect a drop in pressure of 8/5 mmHg with a power of 0.9, the number of subjects needed in a parallel group trial is reduced from 360 to 68, and in a crossover study from 88 to 16 subjects. The usefulness of ambulatory pressure monitoring is demonstrated in a placebo-controlled comparison of atenolol, nifedipine retard, or their combination in random order. Eleven subjects, 21-60 years, with initial average blood pressures of 166.5/104.7 mmHg, showed a reduction in pressure with atenolol 50 mg a day of 15.1/10.0 mmHg, with nifedipine retard 20 mg b.i.d. of 21.0/11.6 mmHg, and with atenolol 50 mg and nifedipine retard 20 mg once a day of 26.2/16.8 mmHg. Ambulatory monitoring of pressure improved the accuracy of the trial and demonstrated a reduction in the alerting response with atenolol. PMID:2487802

  4. Ambulatory Blood Pressure Monitoring: Five Decades of More Light and Less Shadows

    PubMed Central

    Nobre, Fernando; Mion Junior, Décio

    2016-01-01

    Casual blood pressure measurements have been extensively questioned over the last five decades. A significant percentage of patients have different blood pressure readings when examined in the office or outside it. For this reason, a change in the paradigm of the best manner to assess blood pressure has been observed. The method that has been most widely used is the Ambulatory Blood Pressure Monitoring - ABPM. The method allows recording blood pressure measures in 24 hours and evaluating various parameters such as mean BP, pressure loads, areas under the curve, variations between daytime and nighttime, pulse pressure variability etc. Blood pressure measurements obtained by ABPM are better correlated, for example, with the risks of hypertension. The main indications for ABPM are: suspected white coat hypertension and masked hypertension, evaluation of the efficacy of the antihypertensive therapy in 24 hours, and evaluation of symptoms. There is increasing evidence that the use of ABPM has contributed to the assessment of blood pressure behaviors, establishment of diagnoses, prognosis and the efficacy of antihypertensive therapy. There is no doubt that the study of 24-hour blood pressure behavior and its variations by ABPM has brought more light and less darkness to the field, which justifies the title of this review. PMID:27168473

  5. Ambulatory Blood Pressure Monitoring: Five Decades of More Light and Less Shadows.

    PubMed

    Nobre, Fernando; Mion Junior, Décio

    2016-06-01

    Casual blood pressure measurements have been extensively questioned over the last five decades. A significant percentage of patients have different blood pressure readings when examined in the office or outside it. For this reason, a change in the paradigm of the best manner to assess blood pressure has been observed. The method that has been most widely used is the Ambulatory Blood Pressure Monitoring - ABPM. The method allows recording blood pressure measures in 24 hours and evaluating various parameters such as mean BP, pressure loads, areas under the curve, variations between daytime and nighttime, pulse pressure variability etc. Blood pressure measurements obtained by ABPM are better correlated, for example, with the risks of hypertension. The main indications for ABPM are: suspected white coat hypertension and masked hypertension, evaluation of the efficacy of the antihypertensive therapy in 24 hours, and evaluation of symptoms. There is increasing evidence that the use of ABPM has contributed to the assessment of blood pressure behaviors, establishment of diagnoses, prognosis and the efficacy of antihypertensive therapy. There is no doubt that the study of 24-hour blood pressure behavior and its variations by ABPM has brought more light and less darkness to the field, which justifies the title of this review. PMID:27168473

  6. Ambulatory Blood Pressure Monitoring-Derived Short-Term Blood Pressure Variability in Primary Aldosteronism.

    PubMed

    Grillo, Andrea; Bernardi, Stella; Rebellato, Andrea; Fabris, Bruno; Bardelli, Moreno; Burrello, Jacopo; Rabbia, Franco; Veglio, Franco; Fallo, Francesco; Carretta, Renzo

    2015-08-01

    The aim of this study was to investigate the short-term blood pressure (BP) variability (BPV) derived from ambulatory blood pressure monitoring (ABPM) in patients with primary aldosteronism (PA), either idiopathic hyperaldosteronism (IHA) or aldosterone-producing adenoma (APA), in comparison with patients with essential hypertension (EH) and normotensive (NT) controls. Thirty patients with PA (16 with IHA and 14 with APA), 30 patients with EH, and 30 NT controls, matched for sex, age, body mass index, and antihypertensive therapy, were studied. The standard deviation (SD) of 24-hour, daytime, and nighttime BP; 24-hour weighted SD of BP; and 24-hour BP average real variability were not different between patients with PA and those with EH (P=not significant). All BPV indices were higher in patients with PA, either IHA or APA subtypes, and patients with EH, compared with NT controls (P<.001 to P<.05). ABPM-derived short-term BPV is increased in patients with PA, and it may represent an additional cardiovascular risk factor in this disease. The role of aldosterone excess in BPV has to be clarified. PMID:25880017

  7. Design of optimal systolic arrays

    SciTech Connect

    Li, G.J.; Wah, B.W.

    1985-01-01

    Conventional design of systolic arrays is based on the mapping of an algorithm onto an interconnection of processing elements in a VLSI chip. This mapping is done in an ad hoc manner, and the resulting configuration usually represents a feasible but suboptimal design. In this paper, systolic arrays are characterized by three classes of parameters: the velocities of data flows, the spatial distributions of data, and the periods of computation. By relating these parameters in constraint equations that govern the correctness of the design, the design is formulated into an optimization problem. The size of the search space is a polynomial of the problem size, and a methodology to systematically search and reduce this space and to obtain the optimal design is proposed. Some examples of applying the method, including matrix multiplication, finite impulse response filtering, deconvolution, and triangular-matrix inversion, are given. 30 references.

  8. Prediction of Appropriate Shocks Using 24-Hour Holter Variables and T-Wave Alternans After First Implantable Cardioverter-Defibrillator Implantation in Patients With Ischemic or Nonischemic Cardiomyopathy.

    PubMed

    Seegers, Joachim; Bergau, Leonard; Expósito, Pascal Muñoz; Bauer, Axel; Fischer, Thomas H; Lüthje, Lars; Hasenfuß, Gerd; Friede, Tim; Zabel, Markus

    2016-07-01

    In patients treated with implantable cardioverter defibrillator (ICD), prediction of both overall survival and occurrence of shocks is important if improved patient selection is desired. We prospectively studied the predictive value of biomarkers and indexes of cardiac and renal function and spectral microvolt T-wave alternans testing and 24-hour Holter variables in a population who underwent first ICD implantation. Consecutive patients in sinus rhythm with ischemic or dilated cardiomyopathy scheduled for primary or secondary prophylactic ICD implantation were enrolled. Exercise microvolt T-wave alternans and 24-hour Holter for number of ventricular premature contractions (VPCs), deceleration capacity, heart rate variability, and heart rate turbulence were done. Death of any cause and first appropriate ICD shock were defined as end points. Over 33 ± 15 months of follow-up, 36 of 253 patients (14%) received appropriate shocks and 39 of 253 patients (15%) died. Only 3 of 253 patients (1%) died after receiving at least 1 appropriate shock. In univariate analyses, New York Heart Association class, ejection fraction, N-terminal pro brain-type natriuretic peptide (NT-proBNP), renal function, ICD indication, deceleration capacity, heart rate variability, and heart rate turbulence were predictive of all-cause mortality and VPC number and deceleration capacity predicted first appropriate shock. NT-proBNP (≥1,600 pg/ml) was identified as the only independent predictor of all-cause mortality (hazard ratio 3.0, confidence interval 1.3 to 7.3, p = 0.014). In contrast, VPC number predicted appropriate shocks (hazard ratio 2.3, confidence interval 1.0 to 5.5, p = 0.047) as the only independent risk marker. In conclusion, NT-proBNP is a strong independent predictor of mortality in a typical prospective cohort of newly implanted patients with ICD, among many electrocardiographic and clinical variables studied. Number of VPCs was identified as a predictor of appropriate shocks

  9. Metabolic Engineering of Light and Dark Biochemical Pathways in Wild-Type and Mutant Strains of Synechocystis PCC 6803 for Maximal, 24-Hour Production of Hydrogen Gas

    SciTech Connect

    Ely, Roger L.; Chaplen, Frank W.R.

    2014-03-11

    This project used the cyanobacterial species Synechocystis PCC 6803 to pursue two lines of inquiry, with each line addressing one of the two main factors affecting hydrogen (H2) production in Synechocystis PCC 6803: NADPH availability and O2 sensitivity. H2 production in Synechocystis PCC 6803 requires a very high NADPH:NADP+ ratio, that is, the NADP pool must be highly reduced, which can be problematic because several metabolic pathways potentially can act to raise or lower NADPH levels. Also, though the [NiFe]-hydrogenase in PCC 6803 is constitutively expressed, it is reversibly inactivated at very low O2 concentrations. Largely because of this O2 sensitivity and the requirement for high NADPH levels, a major portion of overall H2 production occurs under anoxic conditions in the dark, supported by breakdown of glycogen or other organic substrates accumulated during photosynthesis. Also, other factors, such as N or S limitation, pH changes, presence of other substances, or deletion of particular respiratory components, can affect light or dark H2 production. Therefore, in the first line of inquiry, under a number of culture conditions with wild type (WT) Synechocystis PCC 6803 cells and a mutant with impaired type I NADPH-dehydrogenase (NDH-1) function, we used H2 production profiling and metabolic flux analysis, with and without specific inhibitors, to examine systematically the pathways involved in light and dark H2 production. Results from this work provided rational bases for metabolic engineering to maximize photobiological H2 production on a 24-hour basis. In the second line of inquiry, we used site-directed mutagenesis to create mutants with hydrogenase enzymes exhibiting greater O2 tolerance. The research addressed the following four tasks: 1. Evaluate the effects of various culture conditions (N, S, or P limitation; light/dark; pH; exogenous organic carbon) on H2 production profiles of WT cells and an NDH-1 mutant; 2. Conduct metabolic flux analyses for

  10. Shortening the retention interval of 24-hour dietary recalls increases fourth-grade children’s accuracy for reporting energy and macronutrient intake at school meals

    PubMed Central

    Guinn, Caroline H.; Royer, Julie A.; Hardin, James W.; Mackelprang, Alyssa J.; Smith, Albert F.

    2010-01-01

    Background Accurate information about children’s intake is crucial for national nutrition policy and for research and clinical activities. To analyze accuracy for reporting energy and nutrients, most validation studies utilize the conventional approach which was not designed to capture errors of reported foods and amounts. The reporting-error-sensitive approach captures errors of reported foods and amounts. Objective To extend results to energy and macronutrients for a validation study concerning retention interval (elapsed time between to-be-reported meals and the interview) and accuracy for reporting school-meal intake, the conventional and reporting-error-sensitive approaches were compared. Design and participants/setting Fourth-grade children (n=374) were observed eating two school meals, and interviewed to obtain a 24-hour recall using one of six interview conditions from crossing two target periods (prior-24-hours; previous-day) with three interview times (morning; afternoon; evening). Data were collected in one district during three school years (2004–2005; 2005–2006; 2006–2007). Main outcome measures Report rates (reported/observed), correspondence rates (correctly reported/observed), and inflation ratios (intruded/observed) were calculated for energy and macronutrients. Statistical analyses performed For each outcome measure, mixed-model analysis of variance was conducted with target period, interview time, their interaction, and sex in the model; results were adjusted for school year and interviewer. Results Conventional approach — Report rates for energy and macronutrients did not differ by target period, interview time, their interaction, or sex. Reporting-error-sensitive approach — Correspondence rates for energy and macronutrients differed by target period (four P-values<0.0001) and the target-period by interview-time interaction (four P-values<0.0001); inflation ratios for energy and macronutrients differed by target period (four P

  11. Comparison of an in-pharmacy automated blood pressure kiosk to daytime ambulatory blood pressure in hypertensive subjects.

    PubMed

    Padwal, Raj S; Townsend, Raymond R; Trudeau, Luc; Hamilton, Peter G; Gelfer, Mark

    2015-02-01

    The objective of this study was to compare serial readings from an in-pharmacy automated blood pressure (BP) kiosk to mean daytime ambulatory BP. A total of 100 community-dwelling adults with hypertension underwent (1) three baseline automated office readings; (2) three in-pharmacy readings on each of four visits (12 total) using the PharmaSmart PS-2000 kiosk; and (3) 24-hour ambulatory BP monitoring between in-pharmacy visits two and three. Paired t-tests, Bland-Altman plots, and Pearson correlation coefficients were used for analysis. Mean BPs were 137.8 ± 13.7/81.9 ± 12.2 mm Hg for in-pharmacy and 135.5 ± 11.7/79.7 ± 10.0 mm Hg for daytime ambulatory (difference of 2.3 ± 9.5/2.2 ± 6.9 mm Hg [P ≤ .05]). Bland-Altman plots depicted a high degree of BP variability but did not show clinically important systematic BP differences. With ambulatory BP as the reference standard, in-pharmacy device results were similar to automated office results. The PharmaSmart PS-2000 closely approximated mean daytime ambulatory BP, supporting the use of serial readings from this device in the assessment of BP. PMID:25600420

  12. Control of bleeding by silk ligation and diathermy coagulation during tonsillectomy: A comparison of efficacy of the two techniques in the first 24 hours after surgery

    PubMed Central

    Anwar, Khurshid; Ahmad, Rafiq; Khan, Muneeb

    2015-01-01

    Objective: To assess and compare the relative efficacy of silk ligation and diathermy coagulation techniques in controlling bleeding during tonsillectomy in the first 24 hours. Methods: This prospective study was conducted at the Department of ENT, Khalifa Gul Nawaz Teaching Hospital, Bannu and this department related consultants’ private clinics from January 1, 2012 to December 31, 2014. The study included 180 cases. All patients included were having history of recurrent, acute tonsillitis, with more than 6–7 episodes in one year, five episodes per year for two years, or three episodes per year for three years. All the surgeries were performed by dissection method. Haemostasis during the procedure was secured by either ligation with silk 1 or using diathermy. The results were analyzed using SPSS 16.0 for windows. Results: A total of180 cases were included in the study. The ages of the patients ranged from 5 to 40 years with the mean age of 15.56 years and a std.deviation of +/- 8.24. The male to female ratio was 1.25:1. The number of hemorrhages occurring was greater in the ‘diathermy coagulation’ group as compared to the ‘silk ligation’ group. However, the observed difference was statistically insignificant (p >.05). Conclusion: Primary haemorrhage occurring during tonsillectomy is a serious threat and control of bleeding during the procedure should therefore be meticulous. Both suture ligation and coagulation diathermy for control of bleeders during the procedure by dissection method are equally effective. PMID:26430438

  13. A Day in the Life of Millisecond Pulsar J1713+0747: Limits on Timing Precision Over 24 Hours and Implications for Gravitational Wave Detection

    NASA Astrophysics Data System (ADS)

    Dolch, Timothy; Bailes, M.; Bassa, C.; Bhat, R.; Bhattacharyya, B.; Champion, D.; Chatterjee, S.; Cognard, I.; Cordes, J. M.; Crowter, K.; Demorest, P.; Finn, L. S.; Fonseca, E.; Hessels, J.; Hobbs, G.; Janssen, G.; Jones, G.; Jordan, C.; Karuppusamy, R.; Keith, M.; Kramer, M.; Kraus, A.; Lam, M. T.; Lazarus, P.; Lazio, J.; Lee, K.; Levin, L.; Liu, K.; Lorimer, D.; Manchester, R. N.; McLaughlin, M.; Palliyaguru, N.; Perrodin, D.; Petroff, E.; Rajwade, K.; Rankin, J. M.; Ransom, S. M.; Rosenblum, J.; Roy, J.; Shannon, R.; Stappers, B.; Stinebring, D.; Stovall, K.; Teixeira, M.; van Leeuwen, J.; van Straten, W.; Verbiest, J.; Zhu, W.

    2014-01-01

    A 24-hour global observation of millisecond radio pulsar J1713+0747 was undertaken by the International Pulsar Timing Array (IPTA) collaboration as an effort to better quantify sources of noise in this object, which is regularly timed for the purpose of detecting gravitational waves (GWs). Given an 8-year timing RMS of 30ns, it is regarded as one of the best precision clocks in the PTA. However, sources of timing noise visible on timescales longer than the usual 20-30min biweekly observation may nonetheless be present. Data from the campaign were taken contiguously with the Parkes, Arecibo, Green Bank, GMRT, LOFAR, Effelsberg, WSRT, Lovell, and Nancay radio telescopes. The combined pulse times-of-arrival provide an estimate of the absolute noise floor, in other words, what unaccounted sources of timing noise impede an otherwise simple sqrt(N) improvement in timing precision, where N is the number of pulses in a single observing session. We present first results of specific phenomena probed on the unusual timescale of tens of hours, in particular interstellar scattering (ISS), and discuss the degree to which ISS affects precision timing. Finally, we examine single pulse information during selected portions of the observation and determine the degree to which the pulse jitter of J1713+0747 varies throughout the course of the day-long dataset.

  14. Canadian 24-Hour Movement Guidelines for Children and Youth: Exploring the perceptions of stakeholders regarding their acceptability, barriers to uptake, and dissemination.

    PubMed

    Faulkner, Guy; White, Lauren; Riazi, Negin; Latimer-Cheung, Amy E; Tremblay, Mark S

    2016-06-01

    Engaging stakeholders in the development of guidelines and plans for implementation is vital. The purpose of this study was to examine stakeholders' (parents, teachers, exercise professionals, paediatricians, and youth) perceptions of the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth ("Movement Guidelines"). Stakeholders (n = 104) engaged in semi-structured focus groups or interviews to discuss the perceived acceptability of the guidelines, potential barriers to implementation, and preferred methods and messengers of dissemination. A thematic analysis was conducted. Overall, there was consistent support across all stakeholder groups, with the exception of youth participants, for the Movement Guidelines. Stakeholders identified a range of barriers to the uptake of the guidelines including concerns with accurately defining key terms such as "recreational" screen time; everyday challenges such as financial and time constraints; and the possibility of the Movement Guidelines becoming just another source of stress and guilt for already busy and overwhelmed parents. Participants identified a range of recommended methods and messengers for future dissemination. School and medical settings were the most commonly recommended settings through which dissemination efforts should be delivered. Overall, participants representing a range of stakeholder groups were receptive to the new Movement Guidelines and endorsed their value. In complementing the Movement Guidelines, messaging and resources will need to be developed that address common concerns participants had regarding their dissemination and implementation. PMID:27306436

  15. Tele-ECG and 24-hour physician support over telephone for rural doctors can help early treatment of acute myocardial infarction in rural areas.

    PubMed

    Vivek, Chauhan; Vikrant, Kanwar

    2016-04-01

    We observed that many patients of acute myocardial infarction (AMI) were reaching our hospital out of the 12 hour window period for thrombolysis. This led to poor patient outcomes. There were multiple reasons for the delay, prominent among them was lack of diagnostic facilities in the rural health care centers. We therefore planned a Tele-Electrocardiography (Tele-ECG) based pilot project in Kangra District of Himachal Pradesh in India, which was funded by the Indian Council of Medical Research. The intention was to reduce the pre-hospital delay in AMI by enabling the rural doctors of Kangra using Tele-ECG facility and a 24-hour physician support to manage patients of AMI. We did a baseline knowledge, attitude, and practice (KAP) assessment study of the doctors in our intervention centers to understand their needs. The data obtained through the KAP study was an eye opener for us and justifies the need for a Tele-ECG facility for rural doctors in India. PMID:26187625

  16. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group.

    PubMed Central

    1988-01-01

    The relations between 24 hour urinary electrolyte excretion and blood pressure were studied in 10,079 men and women aged 20-59 sampled from 52 centres around the world based on a highly standardised protocol with central training of observers, a central laboratory, and extensive quality control. Relations between electrolyte excretion and blood pressure were studied in individual subjects within each centre and the results of these regression analyses pooled for all 52 centres. Relations between population median electrolyte values and population blood pressure values were also analysed across the 52 centres. Sodium excretion ranged from 0.2 mmol/24 h (Yanomamo Indians, Brazil) to 242 mmol/24 h (north China). In individual subjects (within centres) it was significantly related to blood pressure. Four centres found very low sodium excretion, low blood pressure, and little or no upward slope of blood pressure with age. Across the other 48 centres sodium was significantly related to the slope of blood pressure with age but not to median blood pressure or prevalence of high blood pressure. Potassium excretion was negatively correlated with blood pressure in individual subjects after adjustment for confounding variables. Across centres there was no consistent association. The relation of sodium to potassium ratio to blood pressure followed a pattern similar to that of sodium. Body mass index and heavy alcohol intake had strong, significant independent relations with blood pressure in individual subjects. PMID:3416162

  17. Computer simulation of the effect of dDAVP with saline loading on fluid balance after 24-hour head-down tilt

    NASA Technical Reports Server (NTRS)

    Srinivasan, R. S.; Simanonok, K. E.; Charles, J. B.

    1994-01-01

    Fluid loading (FL) before Shuttle reentry is a countermeasure currently in use by NASA to improve the orthostatic tolerance of astronauts during reentry and postflight. The fluid load consists of water and salt tablets equivalent to 32 oz (946 ml) of isotonic saline. However, the effectiveness of this countermeasure has been observed to decrease with the duration of spaceflight. The countermeasure's effectiveness may be improved by enhancing fluid retention using analogs of vasopressin such as lypressin (LVP) and desmopressin (dDAVP). In a computer simulation study reported previously, we attempted to assess the improvement in fluid retention obtained by the use of LVP administered before FL. The present study is concerned with the use of dDAVP. In a recent 24-hour, 6 degree head-down tilt (HDT) study involving seven men, dDAVP was found to improve orthostatic tolerance as assessed by both lower body negative pressure (LBNP) and stand tests. The treatment restored Luft's cumulative stress index (cumulative product of magnitude and duration of LBNP) to nearly pre-bedrest level. The heart rate was lower and stroke volume was marginally higher at the same LBNP levels with administration of dDAVP compared to placebo. Lower heart rates were also observed with dDAVP during stand test, despite the lower level of cardiovascular stress. These improvements were seen with only a small but significant increase in plasma volume of approximately 3 percent. This paper presents a computer simulation analysis of some of the results of this HDT study.

  18. Ambulatory blood pressure and heart rate during shuttle flight, entry and landing

    NASA Technical Reports Server (NTRS)

    Thornton, W.; Moore, T. P.; Uri, J.

    1993-01-01

    Ambulatory blood pressures (BP) and heart rates (HR) were recorded on a series of early Shuttle flights during preflight and pre-entry, entry, landing and egress. There were no significant differences between flight and preflight values during routine activity. Systolic blood pressure was slightly elevated in the deorbit period and systolic and diastolic blood pressure and heart rates were all elevated with onset of gravitoinertial loads and remained so through egress. Two of seven subjects had orthostatic problems in egress but their data did not show significant differences from others except in heart rate. Comparison of this data to that from recent studies show even larger increase in HR/BP values during current deorbit and entry phases which is consistent with increased heat and weight loads imposed by added survival gear. Both value and limitations of ambulatory heart rate/blood pressure data in this situation are demonstrated.

  19. Analysis of systolic and systolic-type arrays

    SciTech Connect

    Jover, J.M.

    1986-01-01

    Synchronous, multiprocessor systems interconnected by fixed links are studied. These special-purpose systems, called systolic-type arrays, perform specific algorithms at a higher throughput rate than the sequential architecture of van Neumann. The main contributions of this thesis are the analysis of systolic-type arrays, and the design of one such complex system. In the analysis problem the topology of the network, the function performed by each processor (including timing information), and the input data streams are given. I/O algorithm performed by the array, and the iteration interval (i.e., the time between two consecutive input samples) are to be determined. Solution to the analysis problem turns out to be based on the simple, at least in retrospect, observation that analysis is the reverse of synthesis (design). In design, the start is with a mathematical algorithm and a representation of it as a signal flow graph (SFG) in which the computations (function evaluations) are presented by delay-free (instantaneous) blocks and the index shifts in the sequences processed by the algorithm are all lumped into so-called z/sup -1/ blocks. In the analysis problem, start is also with a physical implementation described by its computational blocks, their associated processing times, and their interconnections. Also presented is parallel architecture for the measurement update step of the Kalman filter, which estimates a vector parameter.

  20. Holter triage ambulatory ECG analysis. Accuracy and time efficiency.

    PubMed

    Cooper, D H; Kennedy, H L; Lyyski, D S; Sprague, M K

    1996-01-01

    Triage ambulatory electrocardiographic (ECG) analysis permits relatively unskilled office workers to submit 24-hour ambulatory ECG Holter tapes to an automatic instrument (model 563, Del Mar Avionics, Irvine, CA) for interpretation. The instrument system "triages" what it is capable of automatically interpreting and rejects those tapes (with high ventricular arrhythmia density) requiring thorough analysis. Nevertheless, a trained cardiovascular technician ultimately edits what is accepted for analysis. This study examined the clinical validity of one manufacturer's triage instrumentation with regard to accuracy and time efficiency for interpreting ventricular arrhythmia. A database of 50 Holter tapes stratified for frequency of ventricular ectopic beats (VEBs) was examined by triage, conventional, and full-disclosure hand-count Holter analysis. Half of the tapes were found to be automatically analyzable by the triage method. Comparison of the VEB accuracy of triage versus conventional analysis using the full-disclosure hand count as the standard showed that triage analysis overall appeared as accurate as conventional Holter analysis but had limitations in detecting ventricular tachycardia (VT) runs. Overall sensitivity, positive predictive accuracy, and false positive rate for the triage ambulatory ECG analysis were 96, 99, and 0.9%, respectively, for isolated VEBs, 92, 93, and 7%, respectively, for ventricular couplets, and 48, 93, and 7%, respectively, for VT. Error in VT detection by triage analysis occurred on a single tape. Of the remaining 11 tapes containing VT runs, accuracy was significantly increased, with a sensitivity of 86%, positive predictive accuracy of 90%, and false positive rate of 10%. Stopwatch-recorded time efficiency was carefully logged during both triage and conventional ambulatory ECG analysis and divided into five time phases: secretarial, machine, analysis, editing, and total time. Triage analysis was significantly (P < .05) more time

  1. Systolic VLSI for Kalman filters

    NASA Technical Reports Server (NTRS)

    Yeh, H.-G.; Chang, J. J.

    1986-01-01

    A novel two-dimensional parallel computing method for real-time Kalman filtering is presented. The mathematical formulation of a Kalman filter algorithm is rearranged to be the type of Faddeev algorithm for generalizing signal processing. The data flow mapping from the Faddeev algorithm to a two-dimensional concurrent computing structure is developed. The architecture of the resulting processor cells is regular, simple, expandable, and therefore naturally suitable for VLSI chip implementation. The computing methodology and the two-dimensional systolic arrays are useful for Kalman filter applications as well as other matrix/vector based algebraic computations.

  2. "2001: A Space Odyssey" Revisited: The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners. Revised

    NASA Technical Reports Server (NTRS)

    Borowski, Stanley K.; Dudzinski, Leonard A.

    2001-01-01

    The prospects for "24 hour" commuter flights to the Moon. similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale. are examined using two near term. "high leverage" technologies-liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and "lunar-derived" oxygen (LUNOX) production. Iron-rich volcanic glass. or "orange soil," discovered during the Apollo 17 mission to Taurus-Littrow. has produced a 4% oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way. LANTR utilizes the large divergent section of its nozzle as an "afterburner" into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging from the engine's choked sonic throat-essentially "scramjet propulsion in reverse." By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that "big engine" performance can be obtained using smaller. more affordable. easier to test NTR engines. The use of high-density LOX in place of low-density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or "in-line" Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an "expendable mode" initially, to maximize delivered surface payload on each mission. The increased

  3. "2001: A Space Odyssey" Revisited--The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners

    NASA Technical Reports Server (NTRS)

    Borowski, Stanley K.; Dudzinski, Leonard A.

    1998-01-01

    The prospects for "24 hour" commuter flights to the Moon, similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale, are examined using two near term, "high leverage" technologies--liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and "lunar-derived" oxygen (LUNOX) production. Ironrich volcanic glass, or "orange soil," discovered during the Apollo 17 mission to Taurus-Littrow, has produced a 4% oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way, LANTR utilizes the large divergent section of its nozzle as an "afterburner" into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging front the engine's choked sonic throat--essentially "scramjet propulsion in reverse." By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that "big engine" performance can be obtained using smaller, more affordable, easier to test NTR engines. The use of high-density LOX in place of low-density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or "in-line" Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an "expendable mode" initially, to maximize delivered surface payload on each mission. The increased

  4. 2001: A Space Odyssey Revisited: The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners. Revised

    NASA Technical Reports Server (NTRS)

    Borowski, Stanley; Dudzinski, Leonard A.

    2003-01-01

    The prospects for 24 hour commuter flights to the Moon, similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale, are examined using two near term, high leverage technologies: liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and lunar-derived oxygen (LUNOX) production. Iron-rich volcanic glass, or orange soil, discovered during the Apollo 17 mission to Taurus-Littrow, has produced a 4 percent oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way. LANTR utilizes the large divergent section of its nozzle as an afterburner into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging from the engine's choked sonic throat, essentially scramjet propulsion in reverse. By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that big engine performance can be obtained using smaller, more affordable, easier to test NTR engines. The use of high-density LOX in place of low density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or in-line Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an expendable mode initially, to maximize delivered surface payload on each mission. The increased payload is

  5. External Beam Radiotherapy Plus 24-Hour Continuous Infusion of Gemcitabine in Unresectable Pancreatic Carcinoma: Long-Term Results of a Phase II Study

    SciTech Connect

    Mattiucci, Gian C.; Morganti, Alessio G.; Valentini, Vincenzo; Ippolito, Edy; Alfieri, Sergio; Antinori, Armando; Crucitti, Antonio; D'Agostino, Giuseppe R.; Di Lullo, Liberato; Luzi, Stefano; Mantini, Giovanna; Smaniotto, Daniela; Doglietto, Gian B.; Cellini, Numa

    2010-03-01

    Purpose: To evaluate the efficacy of gemcitabine-based chemoradiation (CT-RT) in treating patients (pts) affected by locally advanced pancreatic cancers (LAPC). Methods and Materials: Weekly gemcitabine (100 mg/m{sup 2}) was given as a 24-hour infusion during the course of three-dimensional radiotherapy (50.4 Gy to the tumor, 39.6 Gy to the nodes). After CT-RT, pts received five cycles of sequential chemotherapy with gemcitabine (1000 mg/m{sup 2}; 1, 8, q21). Response rate was assessed according to World Health Organization criteria 6 weeks after the end of CT-RT. Local control (LC), time to progression (TTP), metastases-free survival (MFS), and overall survival (OS) were analyzed by the Kaplan Meier method. Results: Forty pts (male/female 22/18; median age 62 years, range, 36-76) were treated from 2000 to 2005. The majority had T4 tumour (n = 34, 85%), six pts (15%) had T3 tumour. Sixteen pts (40%) were node positive at diagnosis. Grade 3-4 acute toxicity was observed in 21 pts (52.5%). Thirty pts (75%) completed the treatment schedule. A clinical response was achieved in 12 pts (30%). With a median follow-up of 76 months (range, 32-98), 2-year LC was 39.6% (median, 12 months), 2-year TTP was 18.4% (median, 10 months), and 2-year MFS was 29.7% (median, 10 months). Two-year OS (25%; median, 15.5 months) compared with our previous study on 5-fluorouracil-based CT-RT (2.8%) was significantly improved (p <0.001). Conclusions: Gemcitabine CT-RT seems correlated with improved outcomes. Healthier patients who are likely to complete the treatment schedule may benefit most from this therapy.

  6. Biomedical Wireless Ambulatory Crew Monitor

    NASA Technical Reports Server (NTRS)

    Chmiel, Alan; Humphreys, Brad

    2009-01-01

    A compact, ambulatory biometric data acquisition system has been developed for space and commercial terrestrial use. BioWATCH (Bio medical Wireless and Ambulatory Telemetry for Crew Health) acquires signals from biomedical sensors using acquisition modules attached to a common data and power bus. Several slots allow the user to configure the unit by inserting sensor-specific modules. The data are then sent real-time from the unit over any commercially implemented wireless network including 802.11b/g, WCDMA, 3G. This system has a distributed computing hierarchy and has a common data controller on each sensor module. This allows for the modularity of the device along with the tailored ability to control the cards using a relatively small master processor. The distributed nature of this system affords the modularity, size, and power consumption that betters the current state of the art in medical ambulatory data acquisition. A new company was created to market this technology.

  7. Relaxation therapy and continuous ambulatory blood pressure in mild hypertension: a controlled study.

    PubMed Central

    van Montfrans, G A; Karemaker, J M; Wieling, W; Dunning, A J

    1990-01-01

    OBJECTIVE--To determine the long term effects of relaxation therapy on 24 hour ambulatory intra-arterial blood pressure in patients with mild untreated and uncomplicated hypertension. DESIGN--Four week screening period followed by randomisation to receive either relaxation therapy or non-specific counselling for one year. Ambulatory intra-arterial blood pressure was measured before and after treatment. SETTING--Outpatient clinic in Amsterdam's university hospital. SUBJECTS--35 Subjects aged 20-60 who were being treated by general practitioners for hypertension but were referred to take part in the study. At three consecutive screening visits all subjects had a diastolic blood pressure without treatment of 95-110 mm Hg. Subjects were excluded if they had damaged target organs, secondary hypertension, diabetes mellitus, a cholesterol concentration greater than 8 mmol/l, or a history of malignant hypertension. INTERVENTIONS--The group allocated to relaxation therapy was trained for eight weeks (one hour a week) in muscle relaxation, yoga exercises, and stress management and continued exercising twice daily for one year with monthly visits to the clinic. The control group had the same attendance schedule but had no training and were requested just to sit and relax twice a day. All subjects were asked not to change their diet or physical activity. MAIN OUTCOME MEASURE--Changes in ambulatory intra-arterial blood pressure after one year of relaxation therapy or non-specific counselling. RESULTS--Mean urinary sodium excretion, serum concentration of cholesterol, and body weight did not change in either group. Diastolic pressures measured by sphygmomanometry were 2 and 3 mm Hg lower in subjects in the relaxation group and control group respectively at the one year follow up compared with initial readings. The mean diastolic ambulatory intra-arterial pressure during the daytime had not changed after one year in either group, but small treatment effects could not be excluded

  8. NATIONAL SURVEY FOR AMBULATORY SURGERY (NSAS)

    EPA Science Inventory

    The National Survey of Ambulatory Surgery (NSAS), which was initiated by the National Center for Health Statistics in 1994, is a national survey designed to meet the need for information about the use of ambulatory surgery services in the United States. For NSAS, ambulatory surge...

  9. Knowing your partner is not enough: spousal importance moderates the link between attitude familiarity and ambulatory blood pressure.

    PubMed

    Uchino, Bert N; Sanbonmatsu, David M; Birmingham, Wendy

    2013-12-01

    Close relationships have been linked to cardiovascular morbidity and mortality. More research is needed, however, on the social and biological processes responsible for such links. In this study, we examined the role of relationship-based attitudinal processes (i.e., attitude familiarity and partner importance) on ambulatory blood pressure during daily life. Forty-seven married couples completed a questionnaire regarding their own attitudes, perceptions of their partner's attitudes, and perceptions of partner importance. They also underwent a 1-day ambulatory assessments of daily spousal interactions and blood pressure. Partner importance was related to better interpersonal functioning (e.g., partner responsiveness) and lower ambulatory systolic blood pressure. More interestingly, partner importance moderated the links between attitude familiarity and both ambulatory systolic and diastolic blood pressure. This statistical interaction revealed that simply knowing a partner's attitudes was not enough as partner knowledge was primarily related to lower ambulatory blood pressure when they were also viewed as more important. These data are discussed in light of how attitude familiarity and spousal importance may jointly influence health outcomes and the social-cognitive mechanisms potentially responsible for such links. PMID:22714654

  10. Sex and age-related differences in performance in a 24-hour ultra-cycling draft-legal event – a cross-sectional data analysis

    PubMed Central

    2014-01-01

    Background The purpose of this study was to examine the sex and age-related differences in performance in a draft-legal ultra-cycling event. Methods Age-related changes in performance across years were investigated in the 24-hour draft-legal cycling event held in Schötz, Switzerland, between 2000 and 2011 using multi-level regression analyses including age, repeated participation and environmental temperatures as co-variables. Results For all finishers, the age of peak cycling performance decreased significantly (β = −0.273, p = 0.036) from 38 ± 10 to 35 ± 6 years in females but remained unchanged (β = −0.035, p = 0.906) at 41.0 ± 10.3 years in males. For the annual fastest females and males, the age of peak cycling performance remained unchanged at 37.3 ± 8.5 and 38.3 ± 5.4 years, respectively. For all female and male finishers, males improved significantly (β = 7.010, p = 0.006) the cycling distance from 497.8 ± 219.6 km to 546.7 ± 205.0 km whereas females (β = −0.085, p = 0.987) showed an unchanged performance of 593.7 ± 132.3 km. The mean cycling distance achieved by the male winners of 960.5 ± 51.9 km was significantly (p < 0.001) greater than the distance covered by the female winners with 769.7 ± 65.7 km but was not different between the sexes (p > 0.05). The sex difference in performance for the annual winners of 19.7 ± 7.8% remained unchanged across years (p > 0.05). The achieved cycling distance decreased in a curvilinear manner with advancing age. There was a significant age effect (F = 28.4, p < 0.0001) for cycling performance where the fastest cyclists were in age group 35–39 years. Conclusion In this 24-h cycling draft-legal event, performance in females remained unchanged while their age of peak cycling performance decreased and performance in males improved while their age of peak cycling performance remained unchanged. The annual fastest females and males were 37.3 ± 8.5 and 38.3 ± 5.4 years old, respectively. The sex

  11. Introduction to systolic algorithms and architectures

    SciTech Connect

    Bentley, J.L.; Kung, H.T.

    1983-01-01

    The authors survey the class of systolic special-purpose computer architectures and algorithms, which are particularly well-suited for implementation in very large scale integrated circuitry (VLSI). They give a brief introduction to systolic arrays for a reader with a broad technical background and some experience in using a computer, but who is not necessarily a computer scientist. In addition they briefly survey the technological advances in VLSI that led to the development of systolic algorithms and architectures. 38 references.

  12. Vascular Health Assessment of The Hypertensive Patients (VASOTENS) Registry: Study Protocol of an International, Web-Based Telemonitoring Registry for Ambulatory Blood Pressure and Arterial Stiffness

    PubMed Central

    Parati, Gianfranco; Avolio, Alberto; Rogoza, Anatoly N; Kotovskaya, Yulia V; Mulè, Giuseppe; Muiesan, Maria Lorenza; Orlova, Iana A; Grigoricheva, Elena A; Cardona Muñoz, Ernesto; Zelveian, Parounak H; Pereira, Telmo; Peixoto Maldonado, João Manuel

    2016-01-01

    Background Hypertension guidelines recommend ambulatory blood pressure (ABP), central aortic pressure (CAP), and pulse wave velocity (PWV) as parameters for estimating blood pressure (BP) control and vascular impairment. Recent advances in technology have enabled devices to combine non-invasive estimation of these parameters over the 24-hour ABP monitoring. However, currently there is limited evidence on the usefulness of such an approach for routine hypertension management. Objective We recently launched an investigator-initiated, international, multicenter, observational, prospective study, the Vascular health Assessment Of The Hypertensive patients (VASOTENS) Registry, aimed at (1) evaluating non-invasive 24-hour ABP and arterial stiffness estimates (through 24-hour pulse wave analysis, PWA) in hypertensive subjects undergoing ambulatory blood pressure monitoring (ABPM) for clinical reasons; (2) assessing the changes in estimates following treatment; (3) weighing the impact of 24-hour PWA on target organ damage and cardiovascular prognosis; (4) assessing the relationship between arterial stiffness, BP absolute mean level and variability, and prognosis; and (5) validating the use of a 24-hour PWA electronic health (e-health) solution for hypertension screening. Methods Approximately 2000 subjects, referred to 20 hypertension clinics for routine diagnostic evaluation and follow-up of hypertension of any severity or stage, will be recruited. Data collection will include ABPM, performed with a device allowing simultaneous non-invasive assessment of 24-hour CAP and arterial stiffness (BPLab), and clinical data (including cardiovascular outcomes). As recommended by current guidelines, each patient will be followed-up with visits occurring at regular intervals (ideally every 6 months, and not less than once a year depending on disease severity). A Web-based telemedicine platform (THOLOMEUS) will be used for data collection. The use of the telemedicine system will allow

  13. Educational Strategies in Ambulatory Care

    ERIC Educational Resources Information Center

    Barker, Lee R.

    1978-01-01

    In 1974 an ambulatory practice was developed for the house staff in the Department of Medicine at Baltimore City Hospital and integrated into the traditional residency program, which is based upon block rotations in inpatient services, emergency service, and subspeciality electives. The goals and strategies of this program are described. (LB H)

  14. Relationships Between Blood Pressure and 24-Hour Urinary Excretion of Sodium and Potassium by Body Mass Index Status in Chinese Adults.

    PubMed

    Yan, Liuxia; Bi, Zhenqiang; Tang, Junli; Wang, Linhong; Yang, Quanhe; Guo, Xiaolei; Cogswell, Mary E; Zhang, Xiaofei; Hong, Yuling; Engelgau, Michael; Zhang, Jiyu; Elliott, Paul; Angell, Sonia Y; Ma, Jixiang

    2015-12-01

    This study examined the impact of overweight/obesity on sodium, potassium, and blood pressure associations using the Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH) project baseline survey data. Twenty-four-hour urine samples were collected in 1948 Chinese adults aged 18 to 69 years. The observed associations of sodium, potassium, sodium-potassium ratio, and systolic blood pressure (SBP) were stronger in the overweight/obese population than among those of normal weight. Among overweight/obese respondents, each additional standard deviation (SD) higher of urinary sodium excretion (SD=85 mmol) and potassium excretion (SD=19 mmol) was associated with a 1.31 mm Hg (95% confidence interval, 0.37-2.26) and -1.43 mm Hg (95% confidence interval, -2.23 to -0.63) difference in SBP, and each higher unit in sodium-potassium ratio was associated with a 0.54 mm Hg (95% confidence interval, 0.34-0.75) increase in SBP. The association between sodium, potassium, sodium-potassium ratio, and prevalence of hypertension among overweight/obese patients was similar to that of SBP. Our study indicated that the relationships between BP and both urinary sodium and potassium might be modified by BMI status in Chinese adults. PMID:26332433

  15. Accuracy of ambulatory blood pressure determination: a comparative study.

    PubMed

    Barthélémy, J C; Geyssant, A; Auboyer, C; Antoniadis, A; Berruyer, J; Lacour, J R

    1991-09-01

    This study was designed to discriminate, according to their accuracy, between three ambulatory pressurometers (Diasys 200R, Novacor; P IV, Del Mar Avionics; SpaceLab 90202, SpaceLab). The evaluation was performed against invasive arterial reference measurements. Accuracy was assessed by calculating the error on pressure (EOP) as the difference between invasive and non-invasive measurement of arterial blood pressure. For the systolic values, accuracy (mean of EOP differences) and uncertainty (SD of these differences) were -0.9 +/- 9.7, -4.3 +/- 10.1 and -16.7 +/- 10.1 mmHg for, respectively, Diasys, PIV and SpaceLab. For diastolic values, they were, respectively, 5.9 +/- 6.7, 6.8 +/- 8.5 and 9.1 +/- 6.6 mmHg. EOP was then separated in two different types of errors: (i) the error of dispersion appreciated by the index of homogeneity calculated by a Lehmann analysis and leading to a statistical classification (ii) the error due to the drift of EOP with the reference value, this last error being easier to correct. Two different behaviours were observed for the EOP: (i) the drift of EOP of systolic values was significantly larger for the oscillometric (SpaceLab) than for the auscultatory (Diasys and P IV) method, with no difference between Diasys and P IV (ii) the homogeneity index was not statistically different among these three devices. These data suggest that, in case the correction of the drift of EOP is carried out, there is no statistical significant difference in accuracy between these three pressurometers. However, in our experimental conditions, the two ambulatory pressurometers recording the Korotkoff sounds have a better accuracy than the one using the oscillometric approach. PMID:1947731

  16. Autonomic Nerve Activity and Blood Pressure in Ambulatory Dogs

    PubMed Central

    Hellyer, Jessica; Akingba, A. George; Rhee, Kyoung-Suk; Tan, Alex Y.; Lane, Kathleen A.; Shen, Changyu; Patel, Jheel; Fishbein, Michael C; Chen, Peng-Sheng

    2014-01-01

    Background The relationship between cardiac autonomic nerve activity and blood pressure (BP) changes in ambulatory dogs is unclear. Objective To test the hypotheses that simultaneous termination of stellate ganglion nerve activity (SGNA) and vagal nerve activity (VNA) predisposes to spontaneous orthostatic hypotension and that specific β2 adrenoceptor blockade prevents the hypotensive episodes. Methods We used a radiotransmitter to record SGNA, VNA and blood pressure (BP) in 8 ambulatory dogs. Video imaging was used to document postural changes. Results Out of these 8 dogs, 5 showed simultaneous sympathovagal discharges in which the minute by minute integrated SGNA correlated with integrated VNA in a linear pattern (“Group 1”). In these dogs abrupt termination of simultaneous SGNA-VNA at the time of postural changes (as documented by video imaging) was followed by abrupt (>20 mmHg over 4 beats) drops in BP. Dogs without simultaneous on/off firing (“Group 2”) did not have drastic drops in pressure. ICI 118,551 (ICI, a specific β2-blocker) infused at 3.1 µg/kg/hr for 7 days significantly increased BP from 126 (95% confidence interval, CI: 118 to 133) mmHg to 133 (95% CI 125 to141) mmHg (p=0.0001). The duration of hypotension (mean systolic BP < 100 mmHg) during baseline accounted for 7.1% of the recording. The percentage was reduced by ICI to 1.3% (p = 0.01). Conclusions Abrupt simultaneous termination of SGNA-VNA was observed at the time of orthostatic hypotension in ambulatory dogs. Selective β2 adrenoceptor blockade increased BP and reduced the duration of hypotension in this model. PMID:24275433

  17. SLAPP: A systolic linear algebra parallel processor

    SciTech Connect

    Drake, B.L.; Luk, F.T.; Speiser, J.M.; Symanski, J.J.

    1987-07-01

    Systolic array computer architectures provide a means for fast computation of the linear algebra algorithms that form the building blocks of many signal-processing algorithms, facilitating their real-time computation. For applications to signal processing, the systolic array operates on matrices, an inherently parallel view of the data, using numerical linear algebra algorithms that have been suitably parallelized to efficiently utilize the available hardware. This article describes work currently underway at the Naval Ocean Systems Center, San Diego, California, to build a two-dimensional systolic array, SLAPP, demonstrating efficient and modular parallelization of key matric computations for real-time signal- and image-processing problems.

  18. Matrix computations on systolic-type meshes

    SciTech Connect

    Moreno, J.H.; Lang, T. )

    1990-04-01

    This article focuses on the execution of matrix computations on systolic-type arrays in an application-specific environment. The authors first present an extension to the concept of a systolic cell by incorporating a small, fixed amount of storage inside the cells, and they discuss the trade-offs this storage gives rise to. Then they review different approaches to decomposing (partitioning) large problems, highlighting their bandwidth requirements and their capabilities for using the storage in the cells. Finally, the authors discuss the basic characteristics of methods for the design of systolic-type arrays, describe the multimesh graph (MMG) design method, and illustrate its application to the transitive closure algorithm.

  19. Continuous ambulatory pulmonary artery pressure monitoring. A new method using a transducer tipped catheter and a simple recording system.

    PubMed

    Levy, R D; Cunningham, D; Shapiro, L M; Wright, C; Mockus, L; Fox, K M

    1986-04-01

    A transducer tipped catheter and simple recording system were used for the continuous measurement of ambulatory pulmonary artery pressure. The pulmonary artery pressure was recorded on a miniaturised tape recorder and replayed via an optical writer. Pulmonary arterial systolic and diastolic pressures can be analysed on a beat to beat basis. Continuous ambulatory monitoring was performed for a total 288 hours in 13 patients who were undergoing routine investigation for coronary artery disease. There was less than 1% zero drift and 0.25% linearity error per full scale pressure. The frequency response of the entire system was flat to 8 Hz with a linear phase delay. The transducer tipped catheter and a conventional fluid-filled system were used to measure left ventricular and pulmonary artery end diastolic pressures in eight patients. The correlation between the results obtained by the two methods was excellent. This method could be used at any centre equipped for ambulatory electrocardiographic monitoring. PMID:3964499

  20. Systolic temporal arithmetic: A new formalism for specification, verification, and synthesis of systolic arrays

    SciTech Connect

    Ling, N.

    1989-01-01

    A novel formalism, termed Systolic Temporal Arithmetic (STA), is introduced. It provides necessary constructs to describe arithmetic operations in dynamic environments. The motivation behind the development of STA is to use it for systolic array design at the array architecture level. It is particularly useful for formally specifying systolic array designs, and for formally verifying their correctness with respect to the algorithm specifications. Besides providing value and operation abstractions from the lower level, the formalism exploits unique systolic features such as synchrony, regularity, repeatability, modularity, pipelinability, parallel processing ability, as well as spatial and temporal locality, to provide constructs and verification techniques for simple, efficient, and effective systolic array specification verification. STA overcomes many limitations of current specification and verification techniques. It can be used with lower level formalism for multilevel reasoning of systolic arrays. Application examples are given to show how STA can be applied to specify and verify several different systolic arrays. To present a more unified design environment, STA is also extended to describe systolic array synthesis process. A synthesis procedure for systolic arrays is presented which also includes an algorithm transformation technique developed that can improve the computation time of resulting arrays for suitable algorithms, without much increase in area requirement. Several systolic array synthesis examples are also provided in this dissertation.

  1. Comparisons of home and daytime ambulatory blood pressure measurements

    PubMed Central

    2014-01-01

    Background Home (HBPM) and ambulatory (ABPM) blood pressure measurements have their advantages and disadvantages in diagnosing and managing hypertension. We studied HBPMs and ABPMs in volunteers taking part in a survey. Methods Of 366 respondents, 270 provided a total of 5997 triplicate HBPMs ( Part 1 ); 175 also provided data on ABPMs, of which the measurements obtained between 6 am and 10 pm were used in this study (Part 2 ). Results Part 1 , When all 5997 triplicate HPPMs were considered, 1st readings tended to be significantly higher than those of the 2nd and 3rd for both, systolic and diastolic pressures, but when the consideration was restricted to the very first triplicate of each of the 270 subjects, this was true only for systolic HBPM. Part 2 , The ABPMs tended to have a wider range than the corresponding HBPMs, and to be distributed towards higher values. Of the non-parametric indices of (ABPM - corresponding HBPM), (First Quartile, Median, Third Quartile and Maximim) all but the minima had positive values. Conclusions In triplicate HBPMs, the first measurement is usually but not always the highest. Increasing the number of triplicates provided by each subject increases the chance of discriminating between measurements in the triplicates. ABPMs tended to be higher than the corresponding HBPMs. PMID:25084732

  2. Some results concerning linear iterative (systolic) arrays

    SciTech Connect

    Ibarra, O.H.; Palis, M.A.; Kim, S.M.

    1985-05-01

    The authors have shown some new interesting results concerning the properties, power, and limitations of various types of linear iterative (systolic) arrays. The method they employed consisted of finding sequential machine characterizations of these array models, and then using the characterizations to prove the results. Because of the absence of any concurrency and synchronization problems, the authors obtained simple proofs to results which when proved directly on the arrays would seem very difficult. The characterizations, therefore, provide a novel and promising method which can be used to analyze other systolic systems. In the future they hope to extend this methodology to the study of two-dimensional and multidimensional systolic arrays, and other systolic systems with different interconnection networks.

  3. Systolic arrays - From concept to implementation

    SciTech Connect

    Fortes, J.A.B.; Wah, B.W.

    1987-07-01

    Systolic arrays are the result of advances in semiconductor technology and of applications that require extensive throughput. Their realization requires human ingenuity combined with techniques and tools for algorithm development, architecture design, and hardware implementation. Invariably, the first reaction of people who are exposed to the systolic-array concept is one of admiration for the concept's elegance and for its potential for high performance. However, those who next attempt to implement a systolic array for a specific application soon realize that a wealth of subsumed concepts and engineering solutions must be mastered and understood. This special issue attempts to provide insights into the implementation process and to illustrate the different techniques and theories that contribute to the design of systolic arrays.

  4. Implementation and use of systolic array processes

    SciTech Connect

    Kung, H.T.

    1983-01-01

    Major effort are now underway to use systolic array processors in large, real-life applications. The author examines various implementation issues and alternatives, the latter from the viewpoints of flexibility and interconnection topologies. He then identifies some work that is essential to the eventual wide use of systolic array processors, such as the development of building blocks, system support and suitable algorithms. 24 references.

  5. Restructuring for fault-tolerant systolic arrays

    SciTech Connect

    Li, H.F.; Jayakumar, R.; Lam, C.

    1989-02-01

    The problem of restructuring systolic arrays with faulty cells is considered. An approach to derive the required data flow paths and computational sites is proposed. The data skewing requirement, which must be satisfied to find an input schedule, is also discussed. Algorithms to restructure systolic arrays for three different architecture of the processing elements are presented. A systematic method to retime the restructure array using additional programmable delays so that the retimed array satisfies the data skewing requirement is developed.

  6. Systolic acousto-optic binary convolver

    SciTech Connect

    Guilfoyle, P.S.

    1984-01-01

    A novel high speed array processing optical architecture is described. A multichannel acousto-optic binary convolver is architecturally configured as a systolic array processor. The architecture provides a high speed means of matrix/vector multiplications using the digital multiplication via an analog convolution algorithm. This algorithm and a systolic acousto-optic implementation permit the speed of optics to be combined with the accuracy of digital computation. 15 references.

  7. Big Data and Ambulatory Care

    PubMed Central

    Thorpe, Jane Hyatt; Gray, Elizabeth Alexandra

    2015-01-01

    Big data is heralded as having the potential to revolutionize health care by making large amounts of data available to support care delivery, population health, and patient engagement. Critics argue that big data's transformative potential is inhibited by privacy requirements that restrict health information exchange. However, there are a variety of permissible activities involving use and disclosure of patient information that support care delivery and management. This article presents an overview of the legal framework governing health information, dispels misconceptions about privacy regulations, and highlights how ambulatory care providers in particular can maximize the utility of big data to improve care. PMID:25401945

  8. Helping You Choose Quality Ambulatory Care

    MedlinePlus

    Helping you choose: Quality ambulatory care When you need ambulatory care, you should find out some information to help you choose the best ... the center follows rules for patient safety and quality. Go to Quality Check ® at www. qualitycheck. org ...

  9. The use of ambulatory blood pressure measurement.

    PubMed

    Hodgkinson, James A; Tucker, Katherine L; Martin, Una; Beesley, Louise; McManus, Richard J

    2015-11-01

    Measurement of ambulatory blood pressure is recommended by the National Institute for Health and Care Excellence guidelines to confirm the diagnosis of hypertension in the UK. This article describes the use of ambulatory devices, and discusses the benefits and disadvantages of their use in clinical practice. PMID:26551492

  10. Insurance incentives for ambulatory surgery.

    PubMed Central

    Pauly, M V; Erder, M H

    1993-01-01

    This study is an attempt to address both the extent to which surgical procedures on an outpatient basis substitute cost-effectively for inpatient procedures, and whether or not an insurance policy's financial incentives increase the volume of outpatient surgical procedures. In particular, given an insurance product of a given composition: What is the probability that the insured will have surgery? and if a surgery does take place, what is the probability that it will occur in an outpatient setting? Finally, the article assesses the implication of such products on the total cost of care by quantifying the insurance plans along two parameters, the relative user price for outpatient versus inpatient surgery and the absolute price for the inpatient surgery. The results indicate that insurance policies that offer relatively lower out-of-pocket payments for ambulatory surgery do not increase the probability that surgery will be done in the ambulatory setting. However, higher out-of-pocket payments for surgery, regardless of site, do reduce the surgery rate. There are other patient and market characteristics, especially the availability of freestanding surgery firms, that do influence the location of surgery. PMID:8428814

  11. Very high central aortic systolic pressures in a young hypertensive patient on telmisartan: Is central aortic systolic pressure associated with white coat hypertension?

    PubMed

    Sule, Ashish Anil; Hwang, Teong Hui; Chin, Tay Jam

    2010-01-01

    Central aortic systolic pressure (CASP) is a very well-recognized tool to assess the end organ damage in patients with hypertension. It is known that angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and calcium channel blockers reduce CASP more than some antihypertensives such as beta-blockers. White coat hypertension with CASP has not been described and validated. The present report describes a very anxious 24-year-old patient on telmisartan (an angiotensin receptor blocker), with a very high CASP compared with his peripheral blood pressure (BP). He had a strong family history of hypertension, and was fairly well controlled on 80 mg/day telmisartan, with his BP ranging from 125/80 mmHg to 130/85 mmHg (home BP monitoring). In May 2009, he underwent routine CASP at Tan Tock Seng Hospital (Singapore), and ambulatory BP measurements using a BPro watch (HealthSTATS, Singapore). The patient had a CASP of 132 mmHg at the hospital, but his calculated CASP by ambulatory BP measurement at 1 pm was 120 mmHg. His ambulatory BPs were 137/94 mmHg; thus, hydrochlorothiazide was added for further control. He was advised to repeat CASP measurements on follow-up in six weeks. He followed up on June 18, 2009, and July 30, 2009, and his CASPs were 139 mmHg and 137 mmHg, respectively. He underwent a magnetic resonance aortogram to exclude any obstructive cause for very high CASPs. His magnetic resonance aortogram revealed no evidence of coarctation of the aorta. CASP may have significant variations due to white coat phenomenon. Further 24 h CASP studies are needed to observe whether CASP is subject to white coat phenomenon. PMID:22479144

  12. A comparison of two ambulatory blood pressure monitors, the Del Mar Avionics Pressurometer IV and the Spacelabs 90202.

    PubMed

    Santucci, S; Cates, E M; James, G D; Schussel, Y R; Steiner, D; Pickering, T G

    1989-10-01

    The purpose of this study was to evaluate the accuracy of two noninvasive ambulatory blood pressure (BP) monitors, the new Del Mar Avionics Pressurometer IV (PIV) and the second generation Spacelabs 90202. Two sets of comparisons were made between two trained observers and the monitors on 17 normotensive and 28 hypertensive subjects. The result of the first comparison showed that the average difference between observers and the PIV was 1.2/-2.2 mm Hg for systolic and diastolic BP. Comparisons of both monitors to the observers showed differences of 0.9/1.0 mm Hg for the PIV and 0.3/0.8 mm Hg for the 90202 (systolic/diastolic). Correlations between the average observer reading and the monitors over both sets of comparisons ranged from 0.90 (diastolic 90202 vs observer) to 0.98 (systolic PIV vs observer). The percentage of readings within 5 mm Hg between observer and monitor over all comparisons ranged from a low of 68% (90202, systolic and diastolic) to a high of 83% (PIV, diastolic). In general, both devices are satisfactory and reliable machines for ambulatory BP monitoring, but each has a slightly different bias compared to auscultatory readings. PMID:2803673

  13. Design and descriptive tools for systolic architectures

    SciTech Connect

    Lewis, P.S.

    1984-01-01

    Automated design and descriptive tools are essential for the practical application of highly parallel special-purpose hardware such as systolic arrays. The use of special-purpose hardware can greatly increase the capabilities of signal processing systems. However, the more limited applications base makes design costs a critical factor in determining technical and economic viability. Systolic systems can be described at several levels of abstraction, each of which has unique descriptive requirements. This paper focuses on the descriptive issues involved at the system architectural level. Tools at this level must bridge the gap between logic- and circuit-oriented computer-aided design tools and algorithmic descriptions of systolic architectures. Traditionally, hardware description languages (HDLs) have been used at this level to describe conventional computer architectures. Systolic architectures, however, have different requirements. This paper examines these requirements and develops a set of criteria for evaluating HDLs. Four popular HDLs are evaluated and their strengths and weaknesses noted. The final section of the paper summarizes ongoing efforts at Los Alamos to develop a systolic array HDL based on the CONLAN family of languages.

  14. Design and descriptive tools for systolic architectures

    SciTech Connect

    Lewis, P.S.

    1984-01-01

    Automated design and descriptive tools are essential for the practical application of highly parallel special-purpose hardware such as systolic arrays. The use of special-purpose hardware can greatly increase the capabilities of signal processing systems. However, the more limited applications base makes design costs a critical factor in determining technical and economic viability. Systolic systems can be described at several levels of abstraction, each of which has unique descriptive requirements. This paper focuses on the descriptive issues involved at the system architectural level. Tools at this level must bridge the gap between logic- and circuit-oriented computer-aided design tools and algorithmic descriptions of systolic architectures. Traditionally, hardware description languages (HDLs) have been used at this level to describe conventional computer architectures. Systolic architectures, however, have different requirements. This paper examines these requirements and develops a set of criteria for evaluating HDLs. Four popular DHLs are evaluated and their strengths and weaknesses noted. The final section of the paper summarizes ongoing efforts at Los Alamos to develop a systolic array HDL based on the CONLAN family of languages. 14 references.

  15. Programming environments for systolic arrays. Technical report

    SciTech Connect

    Snyder, L.

    1986-02-01

    Although a systolic array is often thought of as a hard-wired device, there are many reasons to want to program systolic algorithms. In this paper the problem of providing an efficacious programming environment is addressed. The difficulties of programming complex parallel algorithms are shown to be reduced by using a new concept of a parallel program which maximizes the use of graphical abstractions and minimizes the need for symbolic text. This concept is illustrated by the Poker Parallel Programming Environment which, although designed for a broader class of algorithms, illustrates the main features that a programming environment specialized to systolic computation should have. In the event that the programming environment is for systolic arrays, the programs are parallel and thus impose additional demands on the system such as data formatting, management of multiple process sets, and the specification of data routings. Providing all of these facilities in a single integrated system requires a new concept of parallel program, which, although it is quite different from FORTRAN and PASCAL, is nevertheless easier to use for a systolic array than a conventional programming language. The key to achieving this simplicity is to use graphics so extensively that the resulting programs appear to be dynamic versions of the diagrams presented in textbooks.

  16. Systolic temporal arithmetic; A new formalism for specification and verification of systolic arrays

    SciTech Connect

    Ling, N. ); Bayoumi, M.A. )

    1990-08-01

    This paper introduces a novel formalism named systolic temporal arithmetic (STA) suitable for describing arithmetic operations in dynamic environments. The motivation behind the development of STA is to use it for formal specifications and verifications of systolic arrays at the array architecture level. Besides providing value and operation abstraction from the lower level, it also exploits several features of systolic arrays such as synchrony, regularity, repeatability, modularity, pipelinability, parallel processing ability, as well as spatial and temporal locality. STA provides constructs and verification techniques for simple, efficient, and effective systolic array specification and verification. Verification techniques such as mathematical induction are suggested to exploit these systolic array features so as to speedup the process.

  17. On mapping systolic algorithms onto the hypercube

    SciTech Connect

    Ibarra, O.H.; Sohn, S.M. )

    1990-01-01

    Much effort has been devoted toward developing efficient algorithms for systolic arrays. Here the authors consider the problem of mapping these algorithms into efficient algorithms for a fixed-size hypercube architecture. They describe in detail several optimal implementations of algorithms given for one-way one and two-dimensional systolic arrays. Since interprocessor communication is many times slower than local computation in parallel computers built to date, the problem of efficient communication is specifically addressed for these mappings. In order to experimentally validate the technique, five systolic algorithms were mapped in various ways onto a 64-node NCUBE/7 MMD hypercube machine. The algorithms are for the following problems: the shuffle scheduling problem, finite impulse response filtering, linear context-free language recognition, matrix multiplication, and computing the Boolean transitive closure. Experimental evidence indicates that good performance is obtained for the mappings.

  18. Algorithms for systolic-array synthesis

    SciTech Connect

    Wong, Yiwan.

    1989-01-01

    This dissertation presents efficient algorithms for solving some crucial transformation/optimization problems in the automatic synthesis of systolic arrays from algorithm specifications. The synthesis process consists of two steps. First, the given algorithm specification is transformed into a functionally equivalent form more amenable to systolic array implementation. Then, the computations defined by the equivalent form are assigned for execution on the processors (processor allocation) at different time steps (scheduling), with the objective that the time and space costs of the implementation be minimized. Many computation intensive algorithms, when expressed in their natural form, are unsuitable for systolic array implementations because they contain many-to-one data dependences (data sharing) which cannot be directly realized on processors with bounded fan-out and localized interconnections. A data routing scheme, called data propagation, is proposed which can be implemented as pipelining on a systolic array. It is shown that any data sharing can be transformed into data propagation and that the increase in I/O bandwidth requirement due to such transformation is bounded. Polynomial time procedures are devised for determining the necessary transformations. The time cost of a systolic array implementation of an algorithm is given by the product of two related quantities: the total number of systolic cycles required and the maximum duration of a cycle. It is shown that the scheduling which minimizes the time cost can be determined from solving a discrete optimization problem. Furthermore, the optimization problem is shown to have a bounded solution space, an efficient branch-and-bound method is proposed for determining the optimal solution. The space cost, on the other hand, is defined as the number of processors required for constructing the array.

  19. Ambulatory and central haemodynamics during progressive ascent to high-altitude and associated hypoxia.

    PubMed

    Schultz, M G; Climie, R E D; Sharman, J E

    2014-12-01

    High-altitude hypoxia causes major cardiovascular changes, which may result in raised resting brachial blood pressure (BP). However, the effect of high-altitude hypoxia on more sensitive measures of BP control (such as 24 h ambulatory BP and resting central BP) is largely unknown. This study aimed to assess this and compare high-altitude responses to resting brachial BP, as well as determine the haemodynamic correlates of acute mountain sickness (AMS) during a progressive trekking ascent to high-altitude. Measures of oxygen saturation (pulse oximetry), 24 h ambulatory BP, resting brachial and central BP (Pulsecor) were recorded in 10 adults (aged 27±4, 30% male) during a 9-day trek to Mount Everest base camp, Nepal. Data were recorded at sea level (stage 1; <450 m above sea level (ASL)) and at progressive ascension to 3440 m ASL (stage 2), 4350 m ASL (stage 3) and 5164 m ASL (stage 4). The Lake Louise score (LLS) was used to quantify AMS symptoms. Total LLS increased stepwise from sea level to stage 4 (0.3±0.7 vs 4.4±2.0, P=0.012), whereas oxygen saturation decreased to 77±9% (P=0.001). The highest recordings of 24 h ambulatory, daytime, night time, brachial and central systolic BP and diastolic BP were achieved at stage 3, which were significantly greater than at sea level (P<0.005 for all). Twenty-four-hour ambulatory heart rate (HR) and night HR correlated with oxygen saturation (r=-0.741 and -0.608, both P<0.001) and total LLS (r=0.648 and r=0.493, both P<0.001). We conclude that 24 h ambulatory BP, central BP and HR are elevated during high-altitude hypoxia, but AMS symptoms are only related to tachycardia. PMID:24621622

  20. Making nursing-sensitive quality indicators real in ambulatory care.

    PubMed

    Swan, Beth Ann

    2008-01-01

    Pay-for-performance initiatives are changing the quality landscape. Gaps exist in quantifying and linking ambulatory care quality indicators to care provided by nurses in ambulatory care. Ambulatory care quality indicators that are sensitive to nursing care, standardized, and tested need to be identified and adopted by ambulatory care nurses, ambulatory care provider organizations, professional organizations, and endorsed by a consensus organization. PMID:18616060

  1. Investigation of cattle methane production and emission over a 24-hour period using measurements of δ13C and δD of emitted CH4 and rumen water

    NASA Astrophysics Data System (ADS)

    Bilek, R. S.; Tyler, S. C.; Kurihara, M.; Yagi, K.

    2001-07-01

    We have conducted a series of experiments to determine the effects different diets, including the addition of unsaturated fatty acids, had on isotopic signatures of CH4 emissions from dairy cattle. Measurements of emitted δ13CH4, δ13CO2, and δD-CH4 were made on gases collected over a 24-hour period from animal chambers containing individual Holstein cows. Some measurements of δD-H2O from samples collected directly from the rumen were also made. We observed variation in δ13CH4 values with time after feeding and a correlation in δ13C between emitted gases and diet. The average δ13CH4 value, which includes all samples of emitted gases, was -70.6±4.9‰ (n = 57). Measurements of δD-CH4 over the 24-hour sampling period had an average value of -357.8±15.0‰ (n = 56). These δD measurements are among the lightest reported for CH4 produced by cattle. Our cattle data indicate that hydrogen incorporated into the CH4 produced by CO2 reduction in high H2 concentration environments is fractionated to a greater degree than that incorporated in systems with relatively low H2 conditions, such as wetlands. Our results support bacterial studies that have demonstrated large hydrogen fractionation in high H2 concentration systems during methanogenesis.

  2. Synthesis, verification, and optimization of systolic arrays

    SciTech Connect

    Rajopadhye, S.V.

    1986-01-01

    This dissertation addresses the issue of providing a sound theoretical basis for three important issues relating to systolic arrays, namely synthesis, verification, and optimization. Former research has concentrated on analysis of the dependency structure of the computation, and there have been numerous approaches to map this dependency structure onto a locally interconnected network. This study pursues a similar approach, but with a major generalization of the class of problems analyzed. In earlier research, it was essential that the dependencies were expressible as constant vectors (from a point in the domain to the points that it depended on); here they are permitted to be arbitrary linear functions of the point. Theory for synthesizing systolic architectures from such generalized specifications is developed. Also a systematic (mechanizable) approach to the synthesis of systolic architectures that have control signals is presented. In the areas of verification and optimization, a rigorous mathematical framework is presented that permits reasoning about the behavior of systolic arrays as functions on streams of data. Using this approach, the verification of such architectures reduces to the problem of verification of functional program.s

  3. A unified systolic array for adaptive beamforming

    SciTech Connect

    Bojanczyk, A.W.; Luk, F.T. )

    1990-04-01

    The authors present a new algorithm and systolic array for adaptive beamforming. The authors algorithm uses only orthogonal transformations and thus should have better numerical properties. The algorithm can be implemented on one single p {times} p triangular array of programmable processors that offers a throughput of one residual element per cycle.

  4. Setting up of ambulatory hysteroscopy service.

    PubMed

    Kolhe, Shilpa

    2015-10-01

    There is an obvious trend towards developing ambulatory procedures in gynaecology with ambulatory hysteroscopy as its mainstay. In the recent years, the fast pace of modern technological advances in gynaecologic endoscopy, and particularly in the field of hysteroscopy, have been both thrilling and spectacular. Despite this, the uptake of operative hysteroscopy in ambulatory settings has been relatively slow. There is some apprehension amongst gynaecologists to embark on therapeutic outpatient hysteroscopy, and an organisational change is required to alter the mindset. Although there are best practice guidelines for outpatient hysteroscopy, there are unresolved issues around adequate training and accreditation of future hysteroscopists. Virtual-reality simulation training for operative hysteroscopy has shown promising preliminary results, and it is being aggressively evaluated and validated. This review article is an attempt to provide a useful practical guide to all those who wish to implement ambulatory hysteroscopy services in their outpatient departments. PMID:25979350

  5. Ambulatory Spine Surgery: A Survey Study

    PubMed Central

    Baird, Evan O.; Brietzke, Sasha C.; Weinberg, Alan D.; McAnany, Steven J.; Qureshi, Sheeraz A.; Cho, Samuel K.; Hecht, Andrew C.

    2014-01-01

    Study Design Cross-sectional study. Objective To assess the current practices of spine surgeons performing ambulatory surgery in the United States. Methods An electronic survey was distributed to members of the International Society for the Advancement of Spine Surgery. Data were initially examined in a univariate manner; variables with a p value < 0.25 were entered into a multiple logistic regression model. All statistical analyses were performed using the SAS System software Version 9.2 (SAS Institute, Inc., Cary, North Carolina, United States). Results Overall, 84.2% of respondents performed some manner of ambulatory spine surgery, and 49.1% were investors in an ambulatory surgery center. Surgeon investors in ambulatory surgery centers were more likely to perform procedures of increased complexity than noninvestors, though limited data precluded a statistical correlation. Surgeons in private practice were more likely to perform ambulatory surgery (94.3%; p = 0.0176), and nonacademic surgeons were both more likely to invest in ambulatory surgery centers (p = 0.0024) and perform surgery at least part of the time in a surgery center (p = 0.0039). Conclusions Though the numbers were too few to calculate statistical significance, there was a trend toward the performance of high-risk procedures on an ambulatory basis being undertaken by those with investment status in an ambulatory center. It is possible that this plays a role in the decision to perform these procedures in this setting versus that of a hospital, where a patient may have better access to care should a complication arise requiring emergent assessment and treatment by a physician. This decision should divest itself of financial incentives and focus entirely on patient safety. PMID:25083356

  6. Ambulatory spine surgery: a survey study.

    PubMed

    Baird, Evan O; Brietzke, Sasha C; Weinberg, Alan D; McAnany, Steven J; Qureshi, Sheeraz A; Cho, Samuel K; Hecht, Andrew C

    2014-08-01

    Study Design Cross-sectional study. Objective To assess the current practices of spine surgeons performing ambulatory surgery in the United States. Methods An electronic survey was distributed to members of the International Society for the Advancement of Spine Surgery. Data were initially examined in a univariate manner; variables with a p value < 0.25 were entered into a multiple logistic regression model. All statistical analyses were performed using the SAS System software Version 9.2 (SAS Institute, Inc., Cary, North Carolina, United States). Results Overall, 84.2% of respondents performed some manner of ambulatory spine surgery, and 49.1% were investors in an ambulatory surgery center. Surgeon investors in ambulatory surgery centers were more likely to perform procedures of increased complexity than noninvestors, though limited data precluded a statistical correlation. Surgeons in private practice were more likely to perform ambulatory surgery (94.3%; p = 0.0176), and nonacademic surgeons were both more likely to invest in ambulatory surgery centers (p = 0.0024) and perform surgery at least part of the time in a surgery center (p = 0.0039). Conclusions Though the numbers were too few to calculate statistical significance, there was a trend toward the performance of high-risk procedures on an ambulatory basis being undertaken by those with investment status in an ambulatory center. It is possible that this plays a role in the decision to perform these procedures in this setting versus that of a hospital, where a patient may have better access to care should a complication arise requiring emergent assessment and treatment by a physician. This decision should divest itself of financial incentives and focus entirely on patient safety. PMID:25083356

  7. Virtual ambulatory care. Computer simulation applications.

    PubMed

    Zilm, Frank; Culp, Kristyna; Dorney, Beverley

    2003-01-01

    Computer simulation modeling has evolved during the past twenty years into an effective tool for analyzing and planning ambulatory care facilities. This article explains the use of this tool in three case-study, ambulatory care settings--a GI lab, holding beds for a cardiac catheterization laboratory, and in emergency services. These examples also illustrate the use of three software packages currently available: MedModel, Simul8, and WITNESS. PMID:12545512

  8. Ambulatory cleft lip surgery: A value analysis

    PubMed Central

    Arneja, Jugpal S; Mitton, Craig

    2013-01-01

    BACKGROUND: Socialized health systems face fiscal constraints due to a limited supply of resources and few reliable ways to control patient demand. Some form of prioritization must occur as to what services to offer and which programs to fund. A data-driven approach to decision making that incorporates outcomes, including safety and quality, in the setting of fiscal prudence is required. A value model championed by Michael Porter encompasses these parameters, in which value is defined as outcomes divided by cost. OBJECTIVES: To assess ambulatory cleft lip surgery from a quality and safety perspective, and to assess the costs associated with ambulatory cleft lip surgery in North America. Conclusions will be drawn as to how the overall value of cleft lip surgery may be enhanced. METHODS: A value analysis of published articles related to ambulatory cleft lip repair over the past 30 years was performed to determine what percentage of patients would be candidates for ambulatory cleft lip repair from a quality and safety perspective. An economic model was constructed based on costs associated with the inpatient stay related to cleft lip repair. RESULTS: On analysis of the published reports in the literature, a minority (28%) of patients are currently discharged in an ambulatory fashion following cleft lip repair. Further analysis suggests that 88.9% of patients would be safe candidates for same-day discharge. From an economic perspective, the mean cost per patient for the overnight admission component of ambulatory cleft surgery to the health care system in the United States was USD$2,390 and $1,800 in Canada. CONCLUSIONS: The present analysis reviewed germane publications over a 30-year period, ultimately suggesting that ambulatory cleft lip surgery results in preservation of quality and safety metrics for most patients. The financial model illustrates a potential cost saving through the adoption of such a practice change. For appropriately selected patients, ambulatory

  9. Automated measurement of office, home and ambulatory blood pressure in atrial fibrillation.

    PubMed

    Kollias, Anastasios; Stergiou, George S

    2014-01-01

    1. Hypertension and atrial fibrillation (AF) often coexist and are strong risk factors for stroke. Current guidelines for blood pressure (BP) measurement in AF recommend repeated measurements using the auscultatory method, whereas the accuracy of the automated devices is regarded as questionable. This review presents the current evidence on the feasibility and accuracy of automated BP measurement in the presence of AF and the potential for automated detection of undiagnosed AF during such measurements. 2. Studies evaluating the use of automated BP monitors in AF are limited and have significant heterogeneity in methodology and protocols. Overall, the oscillometric method is feasible for static (office or home) and ambulatory use and appears to be more accurate for systolic than diastolic BP measurement. 3. Given that systolic hypertension is particularly common and important in the elderly, the automated BP measurement method may be acceptable for self-home and ambulatory monitoring, but not for professional office or clinic measurement. 4. An embedded algorithm for the detection of asymptomatic AF during routine automated BP measurement with high diagnostic accuracy has been developed and appears to be a useful screening tool for elderly hypertensives. PMID:23647092

  10. Trends and initiatives in hospital ambulatory care.

    PubMed

    Burns, L A

    1982-05-01

    Changes in the financing and delivery of hospital ambulatory care are discussed. Ambulatory care encompasses a wide spectrum of clinical services provided to patients who are not confined overnight to an institutional bed as inpatients. There are a large and growing number of ways hospitals and physicians cooperate to provide ambulatory-care services. Technological advancements, which have spurred changes in other sectors of medicine, have also changed patterns of medical practice in ambulatory care. Some of the reasons why hospitals develop and expand ambulatory-care programs relate to the changing demand for health services, the shifting preferences of third-party payers and regulators, competitive influences, diversification of risk, and use of such programs as feeders for inpatient services and as teaching and research settings. Although outpatient revenues are a small portion of total hospital revenues, they are growing more rapidly than inpatient revenues. Changes in the health industry that offer opportunities to hospitals are described, such as the increasing physician supply and the formation of group practices, the climate of cost consciousness and price competition, and the trend toward new corporate structures for hospitals. These changes portend changes for hospital pharmacists and give them the opportunity to increase their clinical roles in providing ambulatory care. PMID:7081250

  11. 24-hour urinary aldosterone excretion rate

    MedlinePlus

    ... RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier Saunders; ... by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University ...

  12. Toys Remain Viral Playground for 24 Hours

    MedlinePlus

    ... a toy's surface at typical indoor temperatures and humidity levels. Specifically, they tested the ability of so- ... East Respiratory Syndrome (MERS). At 60 percent relative humidity, 1 percent of the virus remained infectious on ...

  13. Cross-Sectional Study of 24-Hour Urinary Electrolyte Excretion and Associated Health Outcomes in a Convenience Sample of Australian Primary Schoolchildren: The Salt and Other Nutrients in Children (SONIC) Study Protocol

    PubMed Central

    Baxter, Janet R; Campbell, Karen J; Riddell, Lynn J; Rigo, Manuela; Liem, Djin Gie; Keast, Russell S; He, Feng J; Nowson, Caryl A

    2015-01-01

    Background Dietary sodium and potassium are involved in the pathogenesis of cardiovascular disease. Data exploring the cardiovascular outcomes associated with these electrolytes within Australian children is sparse. Furthermore, an objective measure of sodium and potassium intake within this group is lacking. Objective The primary aim of the Salt and Other Nutrient Intakes in Children (“SONIC”) study was to measure sodium and potassium intakes in a sample of primary schoolchildren located in Victoria, Australia, using 24-hour urine collections. Secondary aims were to identify the dietary sources of sodium and potassium, examine the association between these electrolytes and cardiovascular risk factors, and assess children’s taste preferences and saltiness perception of manufactured foods. Methods A cross-sectional study was conducted in a convenience sample of schoolchildren attending primary schools in Victoria, Australia. Participants completed one 24-hour urine collection, which was analyzed for sodium, potassium, and creatinine. Completeness of collections was assessed using collection time, total volume, and urinary creatinine. One 24-hour dietary recall was completed to assess dietary intake. Other data collected included blood pressure, body weight, height, waist and hip circumference. Children were also presented with high and low sodium variants of food products and asked to discriminate salt level and choose their preferred variant. Parents provided demographic information and information on use of discretionary salt. Descriptive statistics will be used to describe sodium and potassium intakes. Linear and logistic regression models with clustered robust standard errors will be used to assess the association between electrolyte intake and health outcomes (blood pressure and body mass index/BMI z-score and waist circumference) and to assess differences in taste preference and discrimination between high and low sodium foods, and correlations between

  14. Bidiagonalization and symmetric tridiagonalization by systolic arrays

    NASA Technical Reports Server (NTRS)

    Schreiber, Robert

    1988-01-01

    A systolic algorithm and an array for bidiagonalization of an nxn matrix in O(nlog(2)n) time, using O(n to the 2nd power) cells are given. Bandedness of the input matrix may be effectively exploited. If the matrix is banded, with p nonzero subdiagonals and q nonzero superdiagonals, then 4nln(p + q) + O(n) clocks and 2n(p + q) + O((p + q) to the 2nd power + n) cells are needed. This is faster than the best previously reported result by the factor log(2)e = 1.44.... Moreover, in contrast to earlier systolic designs, which require the matrix to be preloaded into the array and the result matrix extracted after bidiagonalization, the present arrays are pipelined.

  15. Methodological Considerations in Ambulatory Skin Conductance Monitoring

    PubMed Central

    Doberenz, Sigrun; Roth, Walton T.; Maslowski, Nina I.; Wollburg, Eileen; Kim, Sunyoung

    2011-01-01

    Little is known how much skin conductance (SC) recordings from the fingers are affected by factors such as electrode site deterioration, ambient temperature (TMP), or physical activity (ACT), or by age, sex, race, or body mass index. We recorded SC, TMP, and ACT in 48 healthy control subjects for a 24-hour period, and calculated SC level (SCL), its standard deviation, the coefficient of SC variation, and frequency and amplitude of non-specific SC fluctuations. One method of assessing electrode site deterioration showed an average decline of 20 %, while a second method found no significant change. All SC measures were higher during waking than sleep. Other factors influenced different measures in different ways. Thus, 24-hour SC recording outside the laboratory is feasible, but some measures need to be corrected for the influence of confounding variables. PMID:21320551

  16. Hardware description languages for systolic architectures

    SciTech Connect

    Lewis, P.S.

    1984-10-01

    Systolic principles can be used to construct special purpose computer systems that achieve high throughput by exploiting algorithmic properties. These principles of regularity, localized communications, and parallel/pipelined execution nicely match the capabilities of integrated circuit technology. Hence, systolic arrays are an attractive method for building high-speed special-purpose hardware to rapidly solve sophisticated problems. However, the use of special-purpose hardware limits the applications base, making fixed costs such as those associated with system design much more critical. Although design costs are in part reduced by the very nature of systolic systems, further reduction can result from the use of automated design and descriptive tools. The design process stretches from the conception of the algorithm and its mapping onto an architecture down to the electronic implementation. In general, a good set of design tools allows the designer to describe, test, and trade off only those factors that are important at that particular point in the design process. A principle requirement in automating the design process is a formal notational mechanism that is capable of providing complete and unambiguous descriptions of the concepts being explored. This notational mechanism then provides a common basis for comparisons between alternate methods and an input mechanism to automated design tools. This thesis identifies the notational features that are necessary for the description of highly parallel, regular architectures such as systolic arrays. A set of language criteria is developed. A number of the more popular HDLs are evaluated using these criteria and their shortcomings noted. 65 references.

  17. Optical systolic array processor using residue arithmetic

    NASA Technical Reports Server (NTRS)

    Jackson, J.; Casasent, D.

    1983-01-01

    The use of residue arithmetic to increase the accuracy and reduce the dynamic range requirements of optical matrix-vector processors is evaluated. It is determined that matrix-vector operations and iterative algorithms can be performed totally in residue notation. A new parallel residue quantizer circuit is developed which significantly improves the performance of the systolic array feedback processor. Results are presented of a computer simulation of this system used to solve a set of three simultaneous equations.

  18. Systolic Time Intervals and New Measurement Methods.

    PubMed

    Tavakolian, Kouhyar

    2016-06-01

    Systolic time intervals have been used to detect and quantify the directional changes of left ventricular function. New methods of recording these cardiac timings, which are less cumbersome, have been recently developed and this has created a renewed interest and novel applications for these cardiac timings. This manuscript reviews these new methods and addresses the potential for the application of these cardiac timings for the diagnosis and prognosis of different cardiac diseases. PMID:27048269

  19. Ambulatory methods for recording cough.

    PubMed

    Smith, Jaclyn

    2007-01-01

    Recording cough sounds to objectively quantify coughing was first performed using large reel-to-reel tape recorders more than 40 years ago. Coughs were counted manually, which is an extremely laborious and time-consuming process. Current technologies including digital recording techniques, data compression and improvements in digital storage capacity should make the process of recording and counting coughs suitable for automation; however, to date no accurate, objective cough monitoring device is available. Cough sounds are easily distinguishable from other vocalizations by the human ear and hence it is reasonable to assume that coughs sounds should have characteristic, identifying acoustic properties. However, the acoustic features of spontaneously occurring cough sounds are extremely variable. Furthermore, in even the worst cases of cough, the time spent speaking is an order of magnitude greater than the time spent coughing. It follows that even an algorithm that mistakes only a very small proportion of speech as cough will still have an unacceptable false positive rate. There is a clear need for an objective measure of cough for use in clinical practice, clinical research and trials of novel treatments. In the near future automated ambulatory systems with sufficient accuracy to be of clinical use should be available. PMID:17161969

  20. Ambulatory purchasing: harnessing supply costs.

    PubMed

    Jager, P A

    1997-04-01

    The healthcare system remains in a dynamic state of flux. We have all heard the story: the changing healthcare market brings reduced reimbursement for services, increased competition, and steadily increasing supply, maintenance, and equipment costs. Ambulatory surgery centers (ASCs) must keep in sync with this change or fail to survive the current market forces. However, because they represent a small contract to various vendors, many ASCs pay premium prices for inventory while receiving less from Managed Care Plans (MCPs) and Health Maintenance Organizations (HMOs). This dilemma makes control of supply costs a top priority for ASCs. In reality, purchasing is becoming more strategically connected to the ASC balance sheet than ever before. Apart from personnel costs, supply and pharmaceutical purchasing represents the greatest expense category on our financial statement. Harnessing these costs directly relates to bottom line profitability. In addition, while performing cost savings magic, ASCs must maintain patient and surgeon satisfaction with the superior outcomes and state-of-the-art technology their reputations are based upon. Sound impossible? This article details how Surgery Center Plus, Inc. (SCP) implemented a cost containment project. PMID:10167012

  1. Tomographic image reconstruction using systolic array algorithms

    SciTech Connect

    Azevedo, S.G.; DeGroot, A.J.; Schneberk, D.J.; Brase, J.M.; Martz, H.E.; Jain, A.K.; Current, K.W.; Hurst, P.J.

    1988-12-22

    Image reconstruction for Computed Tomography (CT) is a time consuming operation on current uniprocessor computers and even on array processors. This is particularly true for three-dimensional data sets or for limited-data reconstructions requiring iterative procedures. In these cases, the projection operation (Radon transform) and its inverse (filtered back-projection) are major computational tasks that are performed many times. Multiprocessor computers, especially in systolic array configurations, can provide dramatic improvements in reconstruction times at reasonable costs. An in-house systolic processor, called SPRINT, has been programmed to demonstrate these improved speeds while achieving near 100% efficiency of all processor elements. We report on these results in this paper. In addition, two proposed hardware implementations of a new architecture are shown to have even greater speedup possibilities. One, using standard DSP chips, has been simulated to give a factor of three improvement over SPRINT, while the other, using custom VLSI that is now in the early stages of design, could potentially perform 512/sup 2/ reconstructions at video rates (100 times further speedup). These processors are also interconnected in a systolic array configuration. Experimental and projected results, with future plans, are also reported in this paper. 11 refs., 5 figs., 1 tab.

  2. Systolic blood pressure and systolic hypertension in adolescence of atomic bomb survivors exposed in utero.

    PubMed

    Nakashima, Eiji; Akahoshi, Masazumi; Neriishi, Kazuo; Fujiwara, Saeko

    2007-11-01

    Annual medical examinations were conducted during adolescence for the in utero clinical study sample subjects exposed prenatally to the atomic bombs in Hiroshima and Nagasaki. Systolic blood pressure and several anthropometric measurements were recorded during these examinations. For 1014 persons exposed in utero, two types of longitudinal analyses were performed, for a total of 7029 observations (6.93 observations per subject) of systolic blood pressure (continuous data) and systolic hypertension (binary data) for persons aged 9 to 19 years. Body mass index (BMI) and/or body weight were considered in the analyses as potential confounders. For the measurements of systolic blood pressure, the common dose effect was 2.09 mmHg per Gy and was significant (P = 0.017). The dose by trimester interaction was suggestive (P = 0.060). A significant radiation dose effect was found in the second trimester (P = 0.001), with an estimated 4.17 mmHg per Gy, but in the first and third trimesters, radiation dose effects were not significant (P > 0.50). For prevalence of systolic hypertension, the radiation dose effect was significant (P = 0.009); the odds ratio at 1 Gy was 2.23 [95% confidence interval (CI): 1.23, 4.04], and the dose by trimester interaction was not significant (P = 0.778). The dose response of systolic hypertension had no dose threshold, with a threshold point estimate of 0 Gy (95% CI: <0.0, 1.1 Gy). The dose response for systolic blood pressure was most pronounced in the second trimester, the most active organogenesis period for the organs relevant to blood pressure. PMID:17973553

  3. Effects of Concord grape juice on ambulatory blood pressure in prehypertension and stage 1 hypertension123

    PubMed Central

    Dohadwala, Mustali M; Hamburg, Naomi M; Holbrook, Monika; Kim, Brian H; Duess, Mai-Ann; Levit, Aaron; Titas, Megan; Chung, William B; Vincent, Felix B; Caiano, Tara L; Frame, Alissa A; Keaney, John F

    2010-01-01

    Background: Consumption of flavonoid-containing foods may be useful for the management of hypertension. Objective: We investigated whether 100% Concord grape juice lowers blood pressure in patients with prehypertension and stage 1 hypertension. Design: We conducted a double-blind crossover study to compare the effects of grape juice (7 mL · kg−1 · d−1) and matched placebo beverage on 24-h ambulatory blood pressure, stress-induced changes in blood pressure, and biochemical profile. Participants consumed each beverage for 8 wk with a 4-wk rest period between beverages. They ceased consumption of grapes and other flavonoid-containing beverages throughout the study. Results: We enrolled 64 otherwise healthy patients taking no antihypertensive medications (31% women, 42% black, age 43 ± 12 y). Baseline mean (±SD) cuff blood pressure was 138 ± 7 (systolic)/82 ± 7 (diastolic) mm Hg. No effects on the primary endpoint of 24-h mean systolic blood pressure, diastolic blood pressure, or stress-induced changes in blood pressure were observed. A secondary endpoint was nocturnal dip in systolic pressure. At baseline, nocturnal pressure was 8.3 ± 7.1% lower at night than during daytime. The mean nocturnal dip increased 1.4 percentage points after grape juice and decreased 2.3 percentage points after placebo (P = 0.005). Fasting blood glucose was 91 ± 10 mg/dL at baseline for the entire cohort. Glucose decreased 2 mg/dL after consumption of grape juice and increased 1 mg/dL after consuming the placebo (P = 0.03). Conclusions: We observed no effect of grape juice on ambulatory blood pressure in this cohort of relatively healthy individuals with modestly elevated blood pressure. Secondary analyses suggested favorable effects on nocturnal dip and glucose homeostasis that may merit further investigation. This trial was registered at clinicaltrials.gov as NCT00302809. PMID:20844075

  4. Association of left ventricular diastolic dysfunction with 24-h aortic ambulatory blood pressure: the SAFAR study.

    PubMed

    Zhang, Y; Kollias, G; Argyris, A A; Papaioannou, T G; Tountas, C; Konstantonis, G D; Achimastos, A; Blacher, J; Safar, M E; Sfikakis, P P; Protogerou, A D

    2015-07-01

    Aortic blood pressure (BP) and 24-h ambulatory BP are both better associated with target organ damage than office brachial BP. However, it remains unclear whether a combination of these two techniques would be the optimal methodology to evaluate patients' BP in terms of left ventricular diastolic dysfunction (LVDD) prevention. In 230 participants, office brachial and aortic BPs were measured by a validated BP monitor and a tonometry-based device, respectively. 24-h ambulatory brachial and aortic BPs were measured by a validated ambulatory BP monitor (Mobil-O-Graph, Germany). Systematic assessment of patients' LVDD was performed. After adjustment for age, gender, hypertension and antihypertensive treatment, septum and lateral E/Ea were significantly associated with office aortic systolic BP (SBP) and pulse pressure (PP) and 24-h brachial and aortic SBP and PP (P ⩽ 0.04), but not with office brachial BP (P ⩾ 0.09). Similarly, 1 standard deviation in SBP was significantly associated with 97.8 ± 20.9, 86.4 ± 22.9, 74.1 ± 23.3 and 51.3 ± 22.6 in septum E/Ea and 68.6 ± 2 0.1, 54.2 ± 21.9, 37.9 ± 22.4 and 23.1 ± 21.4 in lateral E/Ea, for office and 24-h aortic and brachial SBP, respectively. In qualitative analysis, except for office brachial BP, office aortic and 24-h brachial and aortic BPs were all significantly associated with LVDD (P ⩽ 0.03), with the highest odds ratio in 24-h aortic SBP. Furthermore, aortic BP, no matter in the office or 24-h ambulatory setting, showed the largest area under receiver operating characteristic curves (P ⩽ 0.02). In conclusion, 24-h aortic BP is superior to other BPs in the association with LVDD. PMID:25391758

  5. [Major ambulatory surgery: organizational models].

    PubMed

    Baldi, R; Lazzarato, M; Masiero, A; Mandini, A

    1992-09-01

    In this essay, the authors provide a definition for those medical care facilities representing a consolidated alternative to traditional hospitalization. These facilities can be basically ascribed to the following patterns: day case surgery; day-hospital activity; home-care. Day case surgery is a complex and, in most cases, interdisciplinary procedure; this type of activity necessitates a pre-hospitalization period and often also a "protected discharge" or even a home-care service. Some specific criteria regarding day surgery activity have been defined as follows: the main criteria have a clinical nature, but they interact with others belonging to a social and structural-organizational order. The Royal College of Surgeons of United Kingdom has officially recognized in 1985 this medical care typology as one of the constituents of surgical care, and has evaluated that at least 1/3 of the overall operations could be carried out as day care surgery. In the United States, besides hospital and ambulatory surgery activity, a new pattern known as "free-standing center" has been promoted; in 1993, 35% of the operations is expected to be carried out in day case surgery centers. As far as Italy is concerned, in 1988 only day-hospital practice has been adequately recognized as an alternative medical care facility to traditional hospitalization. The Emilia Romagna region, in order to increase day case surgery activity, has issued in 1991 a list of 53 DRGs, in which day bed units treatment was possible. Up to now, however, only a small part of these diseases is treated on a day case surgery basis. PMID:1306168

  6. Peritoneal clearance of leptin in continuous ambulatory peritoneal dialysis.

    PubMed

    Arkouche, W; Juillard, L; Delawari, E; Lasne, Y; Combarnous, F; Sibaï-Galland, R; Traeger, J; Laville, M; Fouque, D

    1999-11-01

    Leptin is a 16-kd protein that increases energy expenditure and limits food intake. Serum leptin (S-leptin) is elevated in dialysis patients, and little data have been reported on leptin clearance (Cl) during dialysis. We analyzed the peritoneal dialysis (PD) Cl of leptin in 15 continuous ambulatory peritoneal dialysis (CAPD) patients and compared the results to beta(2)-microglobulin (beta(2)-m), urea, and creatinine PD Cl. S-leptin was significantly elevated (Kruskal-Wallis, P < 0.005) in CAPD women (58.4 +/- 42.4 [SE] microg/L, n = 5) as compared with CAPD men (13.9 +/- 7.1, n = 10) and with healthy women (11.0 +/- 1.4, n = 13) and men (5.1 +/- 0. 9, n = 14). Correlations were found between percent of fat mass and S-leptin (P < 0.05); between S-leptin and the 24-hour PD leptin (P < 0.05); and between dialysate-to-plasma (D/P) beta(2)-m and D/P leptin (P < 0.01). PD leptin Cl (1.80 +/- 0.43 mL/min/1.73 m(2)) was higher than beta(2)-m Cl (1.22 +/- 0.31) (P < 0.01), but reduced as compared with urea Cl (8.84 +/- 1.20) (P < 0.005) and creatinine Cl (7.71 +/- 0.99) (P < 0.005). These results indicate that leptin is eliminated through the peritoneum membrane. However, peritoneal leptin clearance, as beta(2)-m, appears to be clearly restricted as compared with peritoneal transport of smaller molecules. Hence, leptin could use the same diffusion transport pathway as beta(2)-m. In addition, leptin, which has a higher molecular weight than beta(2)-m, was significantly more eliminated into the peritoneal dialysate. More studies are necessary to clarify whether this is an active leptin elimination process by peritoneal secretion or by a different restriction coefficient of diffusion through the peritoneum membrane. PMID:10561139

  7. Adaptive identification by systolic arrays. Master's thesis

    SciTech Connect

    Willis, P.A.

    1987-12-01

    This thesis is concerned with the implementation of an adaptive-identification algorithm using parallel processing and systolic arrays. In particular, discrete samples of input and output data of a system with uncertain characteristics are used to determine the parameters of its model. The identification algorithm is based on recursive least squares, QR decomposition, and block-processing techniques with covariance resetting. Along similar lines as previous approaches, the identification process is based on the use of Givens rotations. This approach uses the Cordic algorithm for improved numerical efficiency in performing the rotations. Additionally, floating-point and fixed-point arithmetic implementations are compared.

  8. Systolic hypertension: an increasing clinical challenge in Asia

    PubMed Central

    Park, Jeong Bae; Kario, Kazuomi; Wang, Ji-Guang

    2015-01-01

    Systolic hypertension, the predominant form of hypertension in patients aged over 50–60 years, is a growing health issue as the Asian population ages. Elevated systolic blood pressure is mainly caused by arterial stiffening, resulting from age-related vascular changes. Elevated systolic pressure increases the risk of cardiovascular disease, mortality and renal function decline, and this risk may increase at lower systolic pressure levels in Asian than Western subjects. Hence, effective systolic pressure lowering is particularly important in Asians yet blood pressure control remains inadequate despite the availability of numerous antihypertensive medications. Reasons for poor blood pressure control include low awareness of hypertension among health-care professionals and patients, under-treatment, and tolerability problems with antihypertensive drugs. Current antihypertensive treatments also lack effects on the underlying vascular pathology of systolic hypertension, so novel drugs that address the pathophysiology of arterial stiffening are needed for optimal management of systolic hypertension and its cardiovascular complications. PMID:25503845

  9. Diagnostic Errors in Ambulatory Care: Dimensions and Preventive Strategies

    ERIC Educational Resources Information Center

    Singh, Hardeep; Weingart, Saul N.

    2009-01-01

    Despite an increasing focus on patient safety in ambulatory care, progress in understanding and reducing diagnostic errors in this setting lag behind many other safety concerns such as medication errors. To explore the extent and nature of diagnostic errors in ambulatory care, we identified five dimensions of ambulatory care from which errors may…

  10. The Relationship of the Increase in the 'Time of the Earth Day,' from 18 Hours to 24 Hours, to the Increase in the Size of the Earth, Using the Laws of the Conservation of Momentum

    NASA Astrophysics Data System (ADS)

    Cimorelli, S. A.; Samuels, C.

    2010-12-01

    There are three articles, by others, which discuss the increase in the Earth's day, from 18 hours to 24 hours, over a period of time of about a billion years. One article refers to Striations in the Substructure of Coral, C.T. Scrutton, et al, 1965. Another article refers to the Laws of the Conservation of Momentum, as related to the relationship of the Earth and the Moon, the lunar tides, the reduction of the Earth year from 481 days to our present 365.25 days, and an increase in the lunar orbit time from 20 days to 28 days. The third article is based on the dates of tidal sediment deposits, tidalites, C. P. Sonett, et al, in the late 1980's. In this paper, we explain how the Earth's Day could have increased from 18 hours to 24 hours, as related to the Laws of Conservation of Momentum (L). Wherein we use the simple formulation from the Law of the Conservation of Angular Momentum, L=Iω, in which I=Moment of Inertia and ω=Angular Velocity; for which we assume the earth to be a perfect sphere, for which I=0.4MR2, where M and R are the Mass and radius of the earth, respectively. We evaluate the radius of the earth over a time period of several billion years, during which time the earth's angular momentum, L=Iω, is conserved. In this formulation, we show a growth in the size of the earth; and present a curve, using just three points in time, which indicates that the rate of growth is increasing over time. The first point is from about 4.5 billion years ago, the second point is from about 1 billion years ago, and the third point represents present day, with an average growth of about 1mm per year. Although evidence has been presented, by others, showing circumferential growth at the Red Sea and in the Atlantic Ocean, at about 1.5cm per year, total. However, no proof of reduction in the size of the Earth has been shown to occur in the Pacific, or anywhere else, including in references to subduction. Some might say that the subduction is occurring at the rim of the

  11. The Preoperative Patient With a Systolic Murmur

    PubMed Central

    Cowie, Brian

    2015-01-01

    Context: Patients with undifferentiated systolic murmurs present commonly during the perioperative period. Traditional bedside assessment and auscultation has not changed significantly in almost 200 years and relies on interpreting indirect acoustic events as a means of evaluating underlying cardiac pathology. This is notoriously inaccurate, even in expert cardiology hands, since many different valvular and cardiac diseases present with a similar auditory signal. Evidence Acquisition: The data on systolic murmurs, physical examination, perioperative valvular disease in the setting of non-cardiac surgery is reviewed. Results: Significant valvular heart disease increases perioperative risk in major non-cardiac surgery and increases long term patient morbidity and mortality. We propose a more modern approach to physical examination that incorporates the use of focused echocardiography to allow direct visualization of cardiac structure and function. This improves the diagnostic accuracy of clinical assessment, allows rational planning of surgery and anaesthesia technique, risk stratification, postoperative monitoring and appropriate referral to physicians and cardiologists. Conclusions: With a thorough preoperative assessment incorporating focused echocardiography, anaesthetists are in the unique position to enhance their role as perioperative physicians and influence short and long term outcomes of their patients. PMID:26705529

  12. Ambulatory blood pressure after acute exercise in older men with essential hypertension.

    PubMed

    Taylor-Tolbert, N S; Dengel, D R; Brown, M D; McCole, S D; Pratley, R E; Ferrell, R E; Hagberg, J M

    2000-01-01

    We sought to determine whether reductions in blood pressure in hypertensives after acute exercise persist for more than the 2 to 3 h found in controlled laboratory settings. Subjects (n = 11) were obese (32 +/- 4% body fat), sedentary (VO2max 27 +/- 4 mL/kg/min) 60 +/- 6-year-old men with stage 1 or 2 essential hypertension. Ambulatory blood pressure was recorded on 1 day preceded by 45 min of 70% VO2max treadmill exercise and on another day not preceded by exercise. Systolic blood pressure was lower by 6 to 13 mm Hg for the first 16 h after exercise (P < .05) compared to the day without prior exercise. Twenty-four-hour, day, and night average systolic blood pressures were significantly lower on the day after exercise. There was a trend for peak systolic blood pressure to be lower during the entire 24 h and the day portion of the recording; peak systolic blood pressure was significantly lower during the night portion of the recording after exercise. Systolic blood pressure load (percent of systolic blood pressure readings >140 mm Hg) was reduced during the entire 24 h and the day portion of the recording after exercise. Diastolic blood pressure was lower for 12 of the first 16 h after acute exercise (hours 0 to 4, 5 to 8, 13 to 16) (P < .05) compared to the day without prior exercise. Twenty-four-hour, day, and night average diastolic blood pressure was also significantly lower on the recording after exercise. Peak diastolic blood pressure was lower over the entire 24-h period. Diastolic blood pressure load (percent of diastolic blood pressure readings >90 mm Hg) was lower during the entire 24 h and the day portion of the day after exercise. Preliminary data also suggest that common genetic polymorphisms at the angiotensinogen, lipoprotein lipase, and angiotensin converting enzyme loci may affect the blood pressure-lowering response after acute exercise. Thus, in sedentary, obese hypertensive men a single aerobic exercise session reduced blood pressure enough to

  13. Correlations of plasma renin activity and aldosterone concentration with ambulatory blood pressure responses to nebivolol and valsartan, alone and in combination, in hypertension.

    PubMed

    Giles, Thomas D; Bakris, George; Oparil, Suzanne; Weber, Michael A; Li, Huiling; Mallick, Madhuja; Bharucha, David B; Chen, ChunLin; Ferguson, William G

    2015-11-01

    After demonstration of the antihypertensive efficacy of the combination of the beta-blocker nebivolol and the angiotensin receptor blocker valsartan in an 8-week, randomized, placebo-controlled trial (N = 4161), we now report the effects of this treatment on the renin-angiotensin-aldosterone system in a substudy (n = 805). Plasma renin activity increased with valsartan (54%-73%) and decreased with nebivolol (51%-65%) and the combination treatment (17%-39%). Plasma aldosterone decreased with individual treatments (valsartan, 11%-22%; nebivolol, 20%-26%), with the largest reduction (35%) observed with maximum combination dose (20 mg nebivolol/320 mg valsartan). Baseline ln(plasma renin activity) correlated with the 8-week reductions in 24-hour systolic and diastolic BP following treatments with the combination (all doses combined, P = .003 and P < .001) and nebivolol (both, P < .001), but not with valsartan. Baseline ln(aldosterone) correlated with 24-hour systolic and diastolic BP reductions following combination treatment only (P < .001 and P = .005). The implications of the renin-angiotensin-aldosterone system effects of this beta blocker-angiotensin receptor blocker combination should be explored further. PMID:26362831

  14. Initial emergency department systolic blood pressure predicts left ventricular systolic function in acute decompensated heart failure.

    PubMed

    Styron, Joseph F; Jois-Bilowich, Preeti; Starling, Randall; Hobbs, Robert E; Kontos, Michael C; Pang, Peter S; Peacock, W Frank

    2009-01-01

    Ejection fraction (EF) is often unknown in patients who present with acute decompensated heart failure (ADHF). The objective of this study was to determine whether a patient's systolic blood pressure is associated with their left ventricular EF. This study was a retrospective chart review of all patients admitted to an emergency department (ED) observation unit from January 2002 to December 2004. A low EF was defined as <40%. Among 475 patients, the median age was 72 years, 53% were men, 40% were white, 59% were black, and 59% had a low EF. Patients with low EFs were more likely male ( P<.0001), with prior congestive heart disease ( P<.0001), longer QRS duration ( P<.0001), left bundle branch block ( P<.0001), and higher B-type natriuretic peptide ( P<.0001). The low EF group was less likely to have diabetes ( P<.0001). Adjusted odds ratios for an EF >or=40% were significant at all systolic blood pressure readings >120 mm Hg. Having an ED systolic BP >120 mm Hg is associated with significantly higher rates of preserved left ventricular systolic function in patients with ADHF. PMID:19187401

  15. Effective cross-over to granisetron after failure to ondansetron, a randomized double blind study in patients failing ondansetron plus dexamethasone during the first 24 hours following highly emetogenic chemotherapy

    PubMed Central

    de Wit, R; de Boer, A C; vd Linden, G H M; Stoter, G; Sparreboom, A; Verweij, J

    2001-01-01

    In view of the similarity in chemical structure of the available 5HT3-receptor antagonists it is assumed, whilst these agents all act at the same receptor, that failure to one agent would predict subsequent failure to all 5HT3-receptor antagonists. We conducted a randomized double blind trial of granisetron 3 mg plus dexamethasone 10 mg versus continued treatment with ondansetron 8 mg plus dexamethasone 10 mg in patients with protection failure on ondansetron 8 mg plus dexamethasone 10 mg during the first 24 hours following highly emetogenic chemotherapy. Of 40 eligible patients, 21 received ondansetron + dexamethasone and 19 received granisetron + dexamethasone. We found a significant benefit from crossing-over to granisetron after failure on ondansetron. Of the 19 patients who crossed over to granisetron, 9 patients obtained complete protection, whereas this was observed in 1 of the 21 patients continuing ondansetron, P = 0.005. These results indicate that there is no complete cross-resistance between 5HT3-receptor antagonists, and that patients who have acute protection failure on one 5HT3-receptor antagonist should be offered cross-over to another 5HT3-receptor antagonist. © 2001 Cancer Research Campaign  http://www.bjcancer.com PMID:11710819

  16. Faculty Development for Ambulatory Care Education.

    ERIC Educational Resources Information Center

    Anderson, William A.; Carline, Jan D.; Ambrozy, Donna M.; Irby, David M.

    1997-01-01

    A study documented the practices of 14 peer-nominated medical educators who conduct faculty development programs in ambulatory care settings. Results indicate the programs were delivered almost exclusively in workshop format, with great similarities in topics and strategies. Evaluation was generally limited to satisfaction ratings. Makes…

  17. Clinical Assessment Applications of Ambulatory Biosensors

    ERIC Educational Resources Information Center

    Haynes, Stephen N.; Yoshioka, Dawn T.

    2007-01-01

    Ambulatory biosensor assessment includes a diverse set of rapidly developing and increasingly technologically sophisticated strategies to acquire minimally disruptive measures of physiological and motor variables of persons in their natural environments. Numerous studies have measured cardiovascular variables, physical activity, and biochemicals…

  18. Memo to: Ambulatory Health Care Planners.

    ERIC Educational Resources Information Center

    Educational Facilities Labs., Inc., New York, NY.

    Planning for changing types of health professions and a changing clientele necessitates designing flexible facilities. Findings from a recently completed analysis of ambulatory care facilities are directed to planners in the form of 16 memos. Approaches to planning and design considerations are made that attempt to humanize these facilities.…

  19. Management of Patients With Recovered Systolic Function.

    PubMed

    Basuray, Anupam; Fang, James C

    2016-01-01

    Advancements in the treatment of heart failure (HF) with systolic dysfunction have given rise to a new population of patients with improved ejection fraction (EF). The management of this distinct population is not well described due to a lack of consensus on the definition of myocardial recovery, a scarcity of data on the natural history of these patients, and the absence of focused clinical trials. Moreover, an improvement in EF may have different prognostic and management implications depending on the underlying etiology of cardiomyopathy. This can be challenging for the clinician who is approached by a patient inquiring about a reduction of medical therapy after apparent EF recovery. This review explores management strategies for HF patients with recovered EF in a disease-specific format. PMID:26796969

  20. Optical systolic solutions of linear algebraic equations

    NASA Technical Reports Server (NTRS)

    Neuman, C. P.; Casasent, D.

    1984-01-01

    The philosophy and data encoding possible in systolic array optical processor (SAOP) were reviewed. The multitude of linear algebraic operations achievable on this architecture is examined. These operations include such linear algebraic algorithms as: matrix-decomposition, direct and indirect solutions, implicit and explicit methods for partial differential equations, eigenvalue and eigenvector calculations, and singular value decomposition. This architecture can be utilized to realize general techniques for solving matrix linear and nonlinear algebraic equations, least mean square error solutions, FIR filters, and nested-loop algorithms for control engineering applications. The data flow and pipelining of operations, design of parallel algorithms and flexible architectures, application of these architectures to computationally intensive physical problems, error source modeling of optical processors, and matching of the computational needs of practical engineering problems to the capabilities of optical processors are emphasized.

  1. Singular value decomposition with systolic arrays

    NASA Technical Reports Server (NTRS)

    Ipsen, I. C. F.

    1984-01-01

    Systolic arrays for determining the singular value decomposition of a mxn, m n, matrix A of bandwidth w are presented. After A has been reduced to bidiagonal form B by means of Givens plane rotations, the singular values of B are computed by the Golub-Reinsch iteration. The products of plane rotations form the matrices of left and right singular vectors. Assuming each processor can compute or supply a plane rotation, O(wn) processors accomplish the reduction to bidiagonal form in O(np) steps, where p is the number of superdiagonals. A constant number of processors then determines each singular value in about 6n steps. The singular vectors are computed by rerouting the rotations through the arrays used for the reduction to bidiagonal form, or else along the way by employing another rectangular array of O(wm) processors.

  2. Using redundancy for testable and repairable systolic arrays

    SciTech Connect

    Shombert, L.A.

    1985-01-01

    This thesis presents a method of using spares to enhance the reliability and testability of systolic arrays. The method, called roving spares, provides fault detection and fault isolation without interrupting array operation, essentially providing a self testing array. Systolic arrays are defined, and the design space of systolic arrays is identified. The methodology for roving spares on the simplest, but still very powerful, type of systolic array is then derived. Several detailed designs are generated to provide sample data points for analysis. The analysis shows that reliability is increased by factors of two to ten, over a nonredundant array, and that this improvement is achieved at low cost. The testing capability of roving spares does not significantly decrease the reliability benefits of spares. A brief analysis of a more complex systolic array indicates that the benefits achievable for the simple array can be expected for all types of systolic arrays.

  3. Disrupting the EMMPRIN-Cyclophilin A interaction reduces infarct size and preserves systolic function after myocardial ischemia and reperfusion

    PubMed Central

    Seizer, Peter; Ochmann, Carmen; Schönberger, Tanja; Zach, Sebastian; Rose, Melanie; Borst, Oliver; Klingel, Karin; Kandolf, Reinhard; MacDonald, H. Robson; Nowak, Romana A.; Engelhardt, Stefan; Lang, Florian; Gawaz, Meinrad; May, Andreas E.

    2011-01-01

    Introduction Inflammation and proteolysis crucially contribute to myocardial ischemia and reperfusion injury. The Extracellular Matrix Metalloproteinase Inducer (EMMPRIN, CD147) and its ligand Cyclophilin A (CyPA) may be involved in both processes. The aim of the study was to characterize the role of the CD147 and CyPA interplay in myocardial ischemia/reperfusion (I/R) injury. Methods and results Immunohistochemistry showed enhanced expression of CD147 and CyPA in myocardial sections from human autopsies of patients who had died from acute myocardial infarction and from mice at 24 hours after I/R. At 24 hours and 7 days after I/R, the infarct size was reduced in CD147+/− mice versus CD147+/+ mice (C57Bl/6), in mice (C57Bl/6) treated with mAb anti-CD147 vs. control mAb, and in CyPA−/− mice vs. CyPA+/+ mice (129S6/SvEv), all of which being associated with reduced monocyte and neutrophil recruitment at 24h and with a preserved systolic function at 7 days. Combination of CyPA−/− mice with anti-CD147 treatment did not yield further protection in comparison to either inhibition strategy alone. In vitro, treatment with CyPA induced monocyte chemotaxis in a CD147- and PI3-kinase dependent manner and induced monocyte rolling and adhesion to endothelium (HUVEC) under flow in a CD147-dependent manner. Conclusion CD147 and its ligand CyPA are inflammatory mediators after myocardial ischemia and reperfusion and represent potential targets to prevent myocardial I/R injury. PMID:21441138

  4. Recursive least squares estimation and Kalman filtering by systolic arrays

    NASA Technical Reports Server (NTRS)

    Chen, M. J.; Yao, K.

    1988-01-01

    One of the most promising new directions for high-throughput-rate problems is that based on systolic arrays. In this paper, using the matrix-decomposition approach, a systolic Kalman filter is formulated as a modified square-root information filter consisting of a whitening filter followed by a simple least-squares operation based on the systolic QR algorithm. By proper skewing of the input data, a fully pipelined time and measurement update systolic Kalman filter can be achieved with O(n squared) processing cells, resulting in a system throughput rate of O (n).

  5. Job Strain and Ambulatory Blood Pressure: A Meta-Analysis and Systematic Review

    PubMed Central

    Dobson, Marnie; Koutsouras, George; Schnall, Peter

    2013-01-01

    We reviewed evidence of the relationship between job strain and ambulatory blood pressure (ABP) in 29 studies (1985–2012). We conducted a quantitative meta-analysis on 22 cross-sectional studies of a single exposure to job strain. We systematically reviewed 1 case–control study, 3 studies of cumulative exposure to job strain, and 3 longitudinal studies. Single exposure to job strain in cross-sectional studies was associated with higher work systolic and diastolic ABP. Associations were stronger in men than women and in studies of broad-based populations than those with limited occupational variance. Biases toward the null were common, suggesting that our summary results underestimated the true association. Job strain is a risk factor for blood pressure elevation. Workplace surveillance programs are needed to assess the prevalence of job strain and high ABP and to facilitate workplace cardiovascular risk reduction interventions. PMID:23327240

  6. Comparison of validity of food group intake by food frequency questionnaire between pre- and post- adjustment estimates derived from 2-day 24-hour recalls in combination with the probability of consumption.

    PubMed

    Kim, Dong Woo; Oh, Se-Young; Kwon, Sung-Ok; Kim, Jeongseon

    2012-01-01

    Validation of a food frequency questionnaire (FFQ) utilising a short-term measurement method is challenging when the reference method does not accurately reflect the usual food intake. In addition, food group intake that is not consumed on daily basis is more critical when episodically consumed foods are related and compared. To overcome these challenges, several statistical approaches have been developed to determine usual food intake distributions. The Multiple Source Method (MSM) can calculate the usual food intake by combining the frequency questions of an FFQ with the short-term food intake amount data. In this study, we applied the MSM to estimate the usual food group intake and evaluate the validity of an FFQ with a group of 333 Korean children (aged 3-6 y) who completed two 24-hour recalls (24HR) and one FFQ in 2010. After adjusting the data using the MSM procedure, the true rate of non-consumption for all food groups was less than 1% except for the beans group. The median Spearman correlation coefficients against FFQ of the mean of 2-d 24HRs data and the MSM-adjusted data were 0.20 (range: 0.11 to 0.40) and 0.35 (range: 0.14 to 0.60), respectively. The weighted kappa values against FFQ ranged from 0.08 to 0.25 for the mean of 2-d 24HRs data and from 0.10 to 0.41 for the MSM-adjusted data. For most food groups, the MSM-adjusted data showed relatively stronger correlations against FFQ than raw 2-d 24HRs data, from 0.03 (beverages) to 0.34 (mushrooms). The results of this study indicated that the application of the MSM, which was a better estimate of the usual intake, could be worth considering in FFQ validation studies among Korean children. PMID:22938437

  7. Conventional and Ambulatory Blood Pressure as Predictors of Retinal Arteriolar Narrowing.

    PubMed

    Wei, Fang-Fei; Zhang, Zhen-Yu; Thijs, Lutgarde; Yang, Wen-Yi; Jacobs, Lotte; Cauwenberghs, Nicholas; Gu, Yu-Mei; Kuznetsova, Tatiana; Allegaert, Karel; Verhamme, Peter; Li, Yan; Struijker-Boudier, Harry A J; Staessen, Jan A

    2016-08-01

    At variance with the long established paradigm that retinal arteriolar narrowing trails hypertension, several longitudinal studies, all based on conventional blood pressure (CBP) measurement, proposed that retinal arteriolar narrowing indicates heightened microvascular resistance and precedes hypertension. In 783 randomly recruited Flemish (mean age, 38.2 years; 51.3% women), we investigated to what extent CBP and daytime (10 am to 8 pm) ambulatory blood pressure (ABP) measured at baseline (1989-2008) predicted the central retinal arteriolar equivalent (CRAE) in retinal photographs obtained at follow-up (2008-2015). Systolic/diastolic hypertension thresholds were 140/90 mm Hg for CBP and 135/85 mm Hg for ABP. In multivariable-adjusted models including both baseline CBP and ABP, CRAE after 10.3 years (median) of follow-up was unrelated to CBP (P≥0.14), whereas ABP predicted CRAE narrowing (P≤0.011). Per 1-SD increment in systolic/diastolic blood pressure, the association sizes were -0.95 µm (95% confidence interval, -2.20 to 0.30)/-0.75 µm (-1.93 to 0.42) for CBP and -1.76 µm (-2.95 to -0.58)/-1.48 µm (-2.61 to -0.34) for ABP. Patients with ambulatory hypertension at baseline (17.0%) had smaller CRAE (146.5 versus 152.6 µm; P<0.001) at follow-up. CRAE was not different (P≥0.31) between true normotension (normal CBP and ABP; prevalence, 77.6%) and white-coat hypertension (elevated CBP and normal ABP, 5.4%) and between masked hypertension (normal CBP and elevated ABP, 10.2%) and hypertension (elevated CBP and ABP, 6.8%). In conclusion, the paradigm that retinal arteriolar narrowing precedes hypertension can be explained by the limitations of CBP measurement, including nonidentification of masked and white-coat hypertension. PMID:27324224

  8. Equine ambulatory practice: challenges and opportunities.

    PubMed

    Ramey, David W

    2012-04-01

    Current economic conditions make the practice of equine medicine challenging, to say the least. The downward trend in the US economy has had a huge impact on horse owners and equine veterinarians alike. Horses are expensive to keep; as such, economics are the driving factor in the problem of the unwanted horse. Under these conditions, efficient equine ambulatory practices are well-suited to weather the economic storm. As contributors to this issue of Veterinary Clinics of North America note, one can practice high-quality medicine and surgery without the overhead and expense of a large clinic. Ambulatory practitioners certainly face formidable challenges, but they also have opportunities to establish and secure a good future. PMID:22640575

  9. Advances in ambulatory monitoring: regulatory considerations.

    PubMed

    Buckles, David; Aguel, Felipe; Brockman, Randall; Cheng, James; Demian, Cindy; Ho, Charles; Jensen, Donald; Mallis, Elias

    2004-01-01

    Conventional ambulatory electrocardiogram (ECG) (Holter) monitoring involves 2 or 3 surface leads recorded with electrode positions and signal characteristics that are different from diagnostic quality 12-lead ECGs due to the limitations imposed by technology on the ambulatory recorders. The rapid pace of technological development for medical devices, particularly electrocardiography, has now enabled the recording of diagnostic quality 12-lead ECG waveforms for extended time periods. This capability allows Holter recording to become another source for diagnostic 12-lead ECG records on a par with other modalities such as resting ECG and exercise stress testing. Additionally, other diagnostic techniques such as S-T segment analysis and Q-T interval analysis that rely on diagnostic quality waveforms can now be applied. All of these enhancements to the traditional Holter modality have altered the regulatory perspective of these devices, since the enhancements may represent a new intended use for the device. PMID:15534803

  10. Bio-telemetric device for measurement of left ventricular pressure-volume loops using the admittance technique in conscious, ambulatory rats

    PubMed Central

    Raghavan, Karthik; Feldman, Marc D; Porterfield, John E; Larson, Erik R; Jenkins, J Travis; Escobedo, Daniel; Pearce, John A

    2011-01-01

    This paper presents the design, construction and testing of a device to measure pressure volume loops in the left ventricle of conscious, ambulatory rats. Pressure is measured with a standard sensor, but volume is derived from data collected from a tetrapolar electrode catheter using a novel admittance technique. There are two main advantages of the admittance technique to measure volume. First, the contribution from the adjacent muscle can be instantaneously removed. Second, the admittance technique incorporates the nonlinear relationship between the electric field generated by the catheter and the blood volume. A low power instrument weighing 27 g was designed, which takes pressure-volume loops every 2 minutes and runs for 24 hours. Pressure-volume data are transmitted wirelessly to a base station. The device was first validated in thirteen rats with an acute preparation with 2-D echocardiography used to measure true volume. From an accuracy standpoint, the admittance technique is superior to both the conductance technique calibrated with hypertonic saline injections, and calibrated with cuvettes. The device was then tested in six rats with a 24-hour chronic preparation. Stability of the animal preparation and careful calibration are important factors affecting the success of the device. PMID:21606560

  11. Design of easily testable and reconfigurable systolic arrays

    SciTech Connect

    Kim, J.H.

    1987-01-01

    Systolic arrays are considered to be preferred architectures for executing linear algebraic operations. In this thesis, easily testable and reconfigurable (ETAR) systolic arrays are studied to achieve the yield enhancement. New 2-D systolic arrays that lend themselves to easy reconfiguration as well as efficient implementations of algorithms are proposed. The 2-D bidirectional and unidirectional systolic arrays proposed are often better architectures than the rectangular and hexagonal systolic arrays proposed earlier, if one considers area, time and reconfigurability. Methods to design linear and 2-D ETAR systolic arrays are proposed. Procedures to design linear and 2-D unidirectional and bidirectional systolic arrays are given. The main feature of the proposed designs is that the COMUs of the PEs in the linear array can all be tested simultaneously. Another feature is that the throughputs of the reconfigured linear unidirectional as well as bidirectional arrays can remain to be equal to those of the fault-free linear arrays. A reconfiguration algorithm for 2-D systolic arrays is also proposed.

  12. Systoles on Heisenberg groups with Carnot-Caratheodory metrics

    SciTech Connect

    Dontsov, V V

    2001-04-30

    The systolic properties of the nilmanifolds N{sup 2n+1} associated with the higher Heisenberg groups H{sub 2n+1} are studied. Effective estimates of the systolic constants {sigma}(N{sup 2n+1}) in the Carnot-Caratheodory geometry, as functions of the parameters defining a uniform lattice on H{sub 2n+1}, are obtained.

  13. The evolution of ambulatory ECG monitoring.

    PubMed

    Kennedy, Harold L

    2013-01-01

    Ambulatory Holter electrocardiographic (ECG) monitoring has undergone continuous technological evolution since its invention and development in the 1950s era. With commercial introduction in 1963, there has been an evolution of Holter recorders from 1 channel to 12 channel recorders with increasingly smaller storage media, and there has evolved Holter analysis systems employing increasingly technologically advanced electronics providing a myriad of data displays. This evolution of smaller physical instruments with increasing technological capacity has characterized the development of electronics over the past 50 years. Currently the technology has been focused upon the conventional continuous 24 to 48 hour ambulatory ECG examination, and conventional extended ambulatory monitoring strategies for infrequent to rare arrhythmic events. However, the emergence of the Internet, Wi-Fi, cellular networks, and broad-band transmission has positioned these modalities at the doorway of the digital world. This has led to an adoption of more cost-effective strategies to these conventional methods of performing the examination. As a result, the emergence of the mobile smartphone coupled with this digital capacity is leading to the recent development of Holter smartphone applications. The potential of point-of-care applications utilizing the Holter smartphone and a vast array of new non-invasive sensors is evident in the not too distant future. The Holter smartphone is anticipated to contribute significantly in the future to the field of global health. PMID:24215744

  14. Effect of oral nitrates on pulse pressure and arterial elasticity in patients aged over 65 years with refractory isolated systolic hypertension: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Isolated systolic hypertension is a highly prevalent disease among the elderly. The little available evidence on the efficacy of nitrates for treating the disease is based on small experimental studies. Methods/design We performed a multicenter, randomized, double-blind, phase III, placebo-controlled trial in 154 patients aged over 65 years with refractory isolated systolic hypertension. Patients were randomized to placebo or 40 mg/day of extended-release isosorbide mononitrate added to standard therapy and titrated to 60 mg/day at week 6 if blood pressure exceeded 140/90 mmHg. The primary objective was to assess the effect on clinical pulse pressure of extended-release isosorbide mononitrate added to standard therapy in patients aged over 65 years with refractory isolated systolic hypertension after 3 months of treatment. The secondary objectives were as follows: to quantify the effect of adding the study drug on central blood pressure and vascular compliance using the augmentation index and pulse wave velocity; to evaluate the safety profile by recording adverse effects (frequency, type, severity) and the percentage of patients who had to withdraw from the trial because of adverse events; to quantify the percentage of patients who reach a clinical systolic blood pressure <140 mmHg or <130 mmHg measured by ambulatory blood pressure monitoring; and to quantify the change in pulse pressure measured by ambulatory blood pressure monitoring. Discussion Few clinical trials have been carried out to test the effect of oral nitrates on isolated systolic hypertension, even though these agents seem to be effective. Treatment with extended-release isosorbide mononitrate could improve control of systolic blood pressure without severe side effects, thus helping to reduce the morbidity and mortality of the disease. Trial registration EUDRACT Number: 2012-002988-10 PMID:24228894

  15. 76 FR 66929 - Medicare and Medicaid Programs; The American Association for Accreditation of Ambulatory Surgery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... Association for Accreditation of Ambulatory Surgery Facilities for Approval of Deeming Authority for Rural... American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) for recognition as a... of Ambulatory Surgery Facilities (AAAASF's) request for deeming authority for RHCs. This notice...

  16. Systolic array IC for genetic computation

    NASA Technical Reports Server (NTRS)

    Anderson, D.

    1991-01-01

    Measuring similarities between large sequences of genetic information is a formidable task requiring enormous amounts of computer time. Geneticists claim that nearly two months of CRAY-2 time are required to run a single comparison of the known database against the new bases that will be found this year, and more than a CRAY-2 year for next year's genetic discoveries, and so on. The DNA IC, designed at HP-ICBD in cooperation with the California Institute of Technology and the Jet Propulsion Laboratory, is being implemented in order to move the task of genetic comparison onto workstations and personal computers, while vastly improving performance. The chip is a systolic (pumped) array comprised of 16 processors, control logic, and global RAM, totaling 400,000 FETS. At 12 MHz, each chip performs 2.7 billion 16 bit operations per second. Using 35 of these chips in series on one PC board (performing nearly 100 billion operations per second), a sequence of 560 bases can be compared against the eventual total genome of 3 billion bases, in minutes--on a personal computer. While the designed purpose of the DNA chip is for genetic research, other disciplines requiring similarity measurements between strings of 7 bit encoded data could make use of this chip as well. Cryptography and speech recognition are two examples. A mix of full custom design and standard cells, in CMOS34, were used to achieve these goals. Innovative test methods were developed to enhance controllability and observability in the array. This paper describes these techniques as well as the chip's functionality. This chip was designed in the 1989-90 timeframe.

  17. [Value of long-term ambulatory pH-metry in the assessment of patients with reflux esophagitis].

    PubMed

    Tomás-Ridocci, M; Molina, R; Monforte, A; Peña, A; Mora, F; Benages, A; Bernal, J C

    1993-12-01

    The aim of this study is to analyze different reflux-patterns by 24-hour ambulatory pH-metry and to correlate them with clinical symptoms and intensity of esophagitis. 115 patients (50 males/65 females) with a median age of 47 +/- 16 years, typical reflux symptoms have been studied and classified attending to the grade of esophagitis microscopically only 17 cases and endoscopically (grade I = 29, grade II = 44 and grade III/IV = 25 patients). Demeester's score has been used for clinical evaluation. Ambulatory pH-metry has been done with a Holter Synectics Digitrapper MK II, which registered intraesophageal pH-variations every 4 seconds during 24 hours. 28 normal subjects (13 males/15 females) with a median age of 51 +/- 16 years are referred as the control group. Clinical symptoms became more intensified when pH-metric alterations resulted more evident. Thoracic pain was noted in 12 from 115 patients, increasing its frequency in parallel fashion to that of the degree of esophagitis (6% in grade 0, 9% in grades I/II and 20% in grades II/IV). With increasing grades of esophagitis all parameters departed from normality, with significant differences between median values of the different parameters (to the exception of reflux episodes) when comparing patients with low-grade esophagitis (O/I) and high-grade esophagitis (II/III/IV). There is an excellent correlation between severity of esophagitis and % of time to acid exposure (Spearman's correlation coefficient). Only 5% of the patients with esophagitis presented normal pH-metry values and corresponded to esophagitis grade O/I. No patient had only a night reflux pattern, but 10% of our patients had only a day reflux pattern, the mixed pattern being the most frequent one (85%). The fact that 82% of our patients with microscopical esophagitis had a pathological pH-metry recommends the use this method in patients with clinical reflux symptoms and with normal endoscopy. PMID:8129988

  18. New methodology for systematic construction of systolic arrays

    SciTech Connect

    Faroughi, N.

    1987-01-01

    Transforming an algorithm, represented by mathematical expressions with uniform and bounded index spaces, into a systolic-array architecture is discussed. Systolic arrays are highly structured architectures tailored to a specific application. They have specific architectural properties such as simple processing elements (cells), simple and regular data and control communication, and local-cell interconnections. The new design method is based on an understanding of the relationship between two highly structured representations of the algorithms: the mathematical expressions and their systolic solutions. The method consists of three major steps: algorithm representation, algorithm model, and architecture specification. The algorithm representation involves the translation of mathematical expressions into a set of equivalent simple computations which are grouped into subsets based on the required set of operations and same type operands. In the algorithm model, the properties of systolic arrays are represented in terms of feature interrelationships. A sub-systolic array is designed separately for each subset of the simple computations. The final array is constructed by joining the sub-systolic arrays. Other architecture specifications, such as data movement and cell count ratio, are determined early in a design process and thus can be used to select systolic solutions that require fewest cells and lowest I/O bandwidth.

  19. Chronobiologically Interpreted Ambulatory Blood Pressure Monitoring in Health and Disease.

    PubMed

    Halberg, Franz; Mult, Hc; Cornélissen, Germaine; Hillman, Dewayne; Beaty, Larry A; Hong, Shiyu; Schwartzkopff, Othild; Watanabe, Yoshihiko; Otsuka, Kuniaki; Siegelova, Jarmila

    2012-05-01

    To detect vascular variability anomalies (VVAs), a blood pressure and heart rate profile around the clock for at least 7 days is a start. As a minimum, measurement every 60 or preferably 30 minutes for a week is needed, to be continued if abnormality is found, to assess the about 24-hour (circadian) variability that exists in all individuals. As a first dividend, one then also obtains a glimpse of 2 of the very many longer-than-circadian periodicities, the biological half-week and week. Certainly if we can have sensors and computer chips in our cars that continuously monitor the pressure over a tire's life, we should be able to do the same job for ourselves for diagnostic and therapeutic decisions. Healthcare today emphasizes wellness with recommendations for exercise and a proper diet, yet these evaluations may not be adequate. BP may be measured at a visit to the doctor or before an exercise session, along with measuring body weight and performing a physical exam. The seeds of disease are planted long before they are visible, and what appears to be normal from a conventional point of view may in fact actually be abnormal. Hidden alterations of physiological function, masked by the body's remarkable adaptive capabilities, may become visible through a new diagnostic and therapeutic realm-chronobiology-that reveals hitherto unseen abnormalities. The tools of chronobiology may yield additional dividends, such as the detection of physiological "loads" related to stress and stress relief and the undesirable effcts of space weather upon personal events such as sudden cardiac death, societal events like terrorism and war, and natural disasters. Chronobiologi cally interpreted automatic ambulatory BP and heart rate (HR) monitoring (C-ABPM) may detect the antecedents of these types of events. C-ABPM is of interest in preventive cardiology, since it reveals new diagnoses as vascular variability anomalies (VVAs) and renders previous conventional diagnoses more reliable, such

  20. Chronobiologically Interpreted Ambulatory Blood Pressure Monitoring in Health and Disease

    PubMed Central

    Cornélissen, Germaine; Hillman, Dewayne; Beaty, Larry A.; Hong, Shiyu; Schwartzkopff, Othild; Watanabe, Yoshihiko; Otsuka, Kuniaki; Siegelova, Jarmila

    2012-01-01

    To detect vascular variability anomalies (VVAs), a blood pressure and heart rate profile around the clock for at least 7 days is a start. As a minimum, measurement every 60 or preferably 30 minutes for a week is needed, to be continued if abnormality is found, to assess the about 24-hour (circadian) variability that exists in all individuals. As a first dividend, one then also obtains a glimpse of 2 of the very many longer-than-circadian periodicities, the biological half-week and week. Certainly if we can have sensors and computer chips in our cars that continuously monitor the pressure over a tire's life, we should be able to do the same job for ourselves for diagnostic and therapeutic decisions. Healthcare today emphasizes wellness with recommendations for exercise and a proper diet, yet these evaluations may not be adequate. BP may be measured at a visit to the doctor or before an exercise session, along with measuring body weight and performing a physical exam. The seeds of disease are planted long before they are visible, and what appears to be normal from a conventional point of view may in fact be abnormal. Hidden alterations of physiological function, masked by the body's remarkable adaptive capabilities, may become visible through a new diagnostic and therapeutic realm—chronobiology—that reveals hitherto unseen abnormalities. The tools of chronobiology may yield additional dividends, such as the detection of physiological “loads” related to stress and stress relief and the undesirable effects of space weather upon personal events such as sudden cardiac death, societal events like terrorism and war, and natural disasters. Chronobiologically interpreted automatic ambulatory BP and heart rate (HR) monitoring (C-ABPM) may detect the antecedents of these types of events. C-ABPM is of interest in preventive cardiology, since it reveals new diagnoses as vascular variability anomalies (VVAs) and renders previous conventional diagnoses more reliable, such

  1. Ambulatory Pediatric Oncology CLABSIs: Epidemiology and Risk Factors

    PubMed Central

    Rinke, Michael L.; Milstone, Aaron M.; Chen, Allen R.; Mirski, Kara; Bundy, David G.; Colantuoni, Elizabeth; Pehar, Miriana; Herpst, Cynthia; Miller, Marlene R.

    2015-01-01

    Background To compare the burden of central line-associated bloodstream infections (CLABSIs) in ambulatory versus inpatient pediatric oncology patients, and identify the epidemiology of and risk factors associated with ambulatory CLABSIs. Procedure We prospectively identified infections and retrospectively identified central line days and characteristics associated with CLABSIs from January 2009 to October 2010. A nested case–control design was used to identify characteristics associated with ambulatory CLABSIs. Results We identified 319 patients with central lines. There were 55 ambulatory CLABSIs during 84,705 ambulatory central line days (0.65 CLABSIs per 1,000 central line days (95% CI 0.49, 0.85)), and 19 inpatient CLABSIs during 8,682 inpatient central line days (2.2 CLABSIs per 1,000 central lines days (95% CI 1.3, 3.4)). In patients with ambulatory CLABSIs, 13% were admitted to an intensive care unit and 44% had their central lines removed due to the CLABSI. A secondary analysis with a sub-cohort, suggested children with tunneled, externalized catheters had a greater risk of ambulatory CLABSI than those with totally implantable devices (IRR 20.6, P < 0.001). Other characteristics independently associated with ambulatory CLABSIs included bone marrow transplantation within 100 days (OR 16, 95% CI 1.1, 264), previous bacteremia in any central line (OR 10, 95% CI 2.5, 43) and less than 1 month from central line insertion (OR 4.2, 95% CI 1.0, 17). Conclusions In pediatric oncology patients, three times more CLABSIs occur in the ambulatory than inpatient setting. Ambulatory CLABSIs carry appreciable morbidity and have identifiable, associated factors that should be addressed in future ambulatory CLABSI prevention efforts. Pediatr Blood Cancer 2013;60:1882–1889. PMID:23881643

  2. On the Importance of Knowing Your Partner’s Views: Attitude Familiarity is Associated with Better Interpersonal Functioning and Lower Ambulatory Blood Pressure in Daily Life

    PubMed Central

    Birmingham, Wendy

    2011-01-01

    Background Relationships have been linked to significant physical health outcomes. However, little is known about the more specific processes that might be responsible for such links. Purpose The main aim of this study was to examine a previously unexplored and potentially important form of partner knowledge (i.e., attitude familiarity) on relationship processes and cardiovascular function. Methods In this study, 47 married couples completed an attitude familiarity questionnaire and ambulatory assessments of daily spousal interactions and blood pressure. Results Attitude familiarity was associated with better interpersonal functioning between spouses in daily life (e.g., greater partner responsiveness). Importantly, attitude familiarity was also related to lower overall ambulatory systolic blood pressure and diastolic blood pressure. Conclusions These data suggest that familiarity with a spouse’s attitudes may be an important factor linking relationships to better interpersonal and physical health outcomes. PMID:20878291

  3. Accuracy of the SpaceLabs 90207 ambulatory blood pressure monitor in children and adolescents.

    PubMed

    Belsha; Wells; Bowe Rice H; Neaville; Berry

    1996-04-01

    OBJECTIVE: To determine the accuracy of the SpaceLabs 90207 ambulatory blood pressure monitor for measurement of systolic and Korotkoff phases IV and V diastolic blood pressures in children aged 6-18 years. DESIGN: Monitor evaluation was performed using the 1990 British Hypertension Society (BHS) protocol, adapted for use in children. METHODS: Three SpaceLabs 90207 monitors were evaluated according to the five phases of the 1990 BHS protocol: observer training and assessment; before-use interdevice variability assessment; in-use (field) assessment; after-use interdevice variability assessment; and device validation. Outcome was classified according to the criteria from the BHS (1990) and Association for the Advancement of Medical Instrumentation (AAMI) protocols. RESULTS: During in-use assessment, the monitor failed to achieve the required 70% valid readings on four of 25 recording days. On three of four failed days, kinked tubing errors were noted, possibly caused by excess tubing length. After adjustment of tubing length to body size, criteria were satisfied on 24 additional recording days. During validation, the monitor achieved BHS grade C for systolic blood pressure and satisfied AAMI criteria with a mean difference of 5.0+/- 6.4 mmHg. The monitor received grade D for Korotkoff phase IV and V diastolic blood pressure and failed to satisfy AAMI criteria with a mean difference of -7.2+/- 11.0 mmHg for Korotkoff phase IV and 0.8+/-11.1 mmHg for Korotkoff phase V. CONCLUSION: The SpaceLabs 90207 monitor satisfied the minimum accuracy criteria for measurement of systolic, but not diastolic, blood pressure in children aged 6-18 years. PMID:10226214

  4. The application of systolic arrays to radar signal processing

    NASA Astrophysics Data System (ADS)

    Spearman, R.; Spracklen, C. T.; Miles, J. H.

    The design of a systolic array processor radar system is examined, and its performance is compared to that of a conventional radar processor. It is shown how systolic arrays can be used to replace the boards of high speed logic normally associated with a high performance radar and to implement all of the normal processing functions associated with such a system. Multifunctional systolic arrays are presented that have the flexibility associated with a general purpose digital processor but the speed associated with fixed function logic arrays.

  5. An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes

    PubMed Central

    Kengne, Andre Pascal; Libend, Christelle Nong; Dzudie, Anastase; Menanga, Alain; Dehayem, Mesmin Yefou; Kingue, Samuel; Sobngwi, Eugene

    2014-01-01

    Introduction Ambulatory blood pressure (BP) measurements (ABPM) predict health outcomes better than office BP, and are recommended for assessing BP control, particularly in high-risk patients. We assessed the performance of office BP in predicting optimal ambulatory BP control in sub-Saharan Africans with type 2 diabetes (T2DM). Methods Participants were a random sample of 51 T2DM patients (25 men) drug-treated for hypertension, receiving care in a referral diabetes clinic in Yaounde, Cameroon. A quality control group included 46 non-diabetic individuals with hypertension. Targets for BP control were systolic (and diastolic) BP. Results Mean age of diabetic participants was 60 years (standard deviation: 10) and median duration of diabetes was 6 years (min-max: 0-29). Correlation coefficients between each office-based variable and the 24-h ABPM equivalent (diabetic vs. non-diabetic participants) were 0.571 and 0.601 for systolic (SBP), 0.520 and 0.539 for diastolic (DBP), 0.631 and 0.549 for pulse pressure (PP), and 0.522 and 0.583 for mean arterial pressure (MAP). The c-statistic for the prediction of optimal ambulatory control from office-BP in diabetic participants was 0.717 for SBP, 0.494 for DBP, 0.712 for PP, 0.582 for MAP, and 0.721 for either SBP + DBP or PP + MAP. Equivalents in diabetes-free participants were 0.805, 0.763, 0.695, 0.801 and 0.813. Conclusion Office DBP was ineffective in discriminating optimal ambulatory BP control in diabetic patients, and did not improve predictions based on office SBP alone. Targeting ABPM to those T2DM patients who are already at optimal office-based SBP would likely be more cost effective in this setting. PMID:25838859

  6. Degree of Ambulatory Disability: Effects on Rural Siblings' Social Development.

    ERIC Educational Resources Information Center

    Chamberlain, Theresa Nowak; Ross-Reynolds, Jane

    1993-01-01

    Interviews with 22 mothers of children with ambulatory disability and 33 nondisabled siblings showed no differences in sibling's child care responsibilities, general home responsibilities, or independence related to severity of the ambulatory disability. A difference in the amount of social activity, reported by mothers, was not confirmed by…

  7. An Agenda for Residency Training in Ambulatory Care.

    ERIC Educational Resources Information Center

    Link, Kurt; Buchsbaum, David

    1984-01-01

    Some of the differences between in-hospital and ambulatory medicine and their implications for the teaching and practice of ambulatory care are explored. The availability of time, the role of patient cooperation, and the decision-making process differ in the two settings. (MLW)

  8. Randomised trial of ambulatory oxygen in oxygen-dependent COPD.

    PubMed

    Lacasse, Y; Lecours, R; Pelletier, C; Bégin, R; Maltais, F

    2005-06-01

    Long-term oxygen therapy may limit a patient's ability to remain active and may be detrimental to the rehabilitation process. This study aimed to determine the effect of ambulatory oxygen on quality of life and exercise capacity in patients with chronic obstructive pulmonary disease fulfilling the usual criteria of long-term oxygen therapy. In a 1-yr, randomised, three-period, crossover trial, 24 patients (mean age 68 yrs; mean arterial partial pressure of oxygen at rest 7.1 kPa (53 mmHg)) were allocated to one of the six possible sequences generated by three interventions: 1) standard therapy (home oxygen therapy with an oxygen concentrator only); 2) standard therapy plus as-needed ambulatory oxygen; and 3) standard therapy plus ambulatory compressed air. The comparison of ambulatory oxygen versus ambulatory compressed air was double blind. The main outcomes were quality of life (Chronic Respiratory Questionnaire), exercise tolerance (6-min walk test) and daily duration of exposure to oxygen therapy. The trial was stopped prematurely after an interim analysis. On average, the patients used few ambulatory cylinders (7.5 oxygen cylinders versus 7.4 compressed air cylinders over a 3-month study period). Ambulatory oxygen had no effect on any of the outcomes. In conclusion, the current results do not support the widespread provision of ambulatory oxygen to patients with oxygen-dependent chronic obstructive pulmonary disease. PMID:15929958

  9. [The influence of citoflavin on molecular mechanisms of hypertensive encephalopathy development in patients with systolic arterial hypertension].

    PubMed

    Kartashova, E A; Romantsov, M G; Sarvilina, I V

    2014-01-01

    The molecular pharmacological effects of cytoflavin in patients with hypertensive encephalopathy (HE) and isolated systolic arterial hypertension (ISAH) have been investigated using the following methods: assessment of complaints, 24-hour arterial pressure monitoring, ultrasound diagnostics including echocardiography, measurement of lipid profiles and coagulograms, and molecular phenotyping by MALDI-TOF/TOF-MS. A combination of cytoflavin administration with standard therapy of HE and ISAH led to the most expressed return development of clinical symptoms, restoration of the hemodynamic, structural, and geometrical parameters of cardiovascular system, and normalization of the indices of lipid profiles and coagulograms in comparison to patients with HE and ISAH, which accepted only standard therapy. Molecular mechanisms of cytoflavin action have been revealed, which include control of the activity of cellular signaling pathways by means of intermolecular interactions. The optimized therapy of HE and ISAH is recommended for clinical application, which assumes a combined use of standard therapy and cytoflavin and provides a geroprotective action upon the cardiovascular system. PMID:25102730

  10. Proceedings of the international conference on systolic arrays

    SciTech Connect

    Not Available

    1988-01-01

    The proceedings of this conference are grouped under the following headings: signal processing algorithms; applications; matrix algorithms; applications; architecture; algorithms; mapping methodology; design methodologies and tools; fault-tolerance and testing; hardware implementation; implementation; bit-level systolic systems.

  11. Systematic designs of buffers in macropipelines of systolic arrays

    SciTech Connect

    Wah, B.W.; Aboelaze, M.; Shang, W.

    1988-02-01

    In a macropipeline of systolic arrays, outputs of one systolic array in a given format have to be fed as inputs to another systolic array in a possibly different format. A common memory becomes a bottleneck and limits the number of systolic arrays that can be connected together. In this paper, they study designs of buffers to convert data from one format to another. The minimum number of buffers is determined by a dynamic-programming algorithm with THETA(n/sup 2/) computational complexity, where n is the problem size. A general-purpose converter to convert data from any distribution to any other in a subset of the possible data distribution is also proposed. Last, buffer designs for a macropipeline to perform feature extraction and pattern classification are used to exemplify the design process.

  12. A class of SIMD machines simulated by systolic arrays

    SciTech Connect

    Umeo, H.

    1985-11-01

    In this paper the authors introduce a new subclass of single instruction steam/multiple data stream (SIMD) machines, referred to as a simple SIMD, then consider an implementation of a class of simple SIMD parallel algorithms onto systolic arrays, which have been considered as one candidate for VLSI-based cellular computers. The class of simple SIMD algorithms is so large that it includes many conventional SIMD algorithms, such as sorting, image processing, and graph algorithms. We develop several time-efficient algorithms for the simulations of simple SIMD machines, which have global data communications, by systolic arrays with only local data communications. The systolic simulation theorems enable us to use many conventional SIMD algorithms on the systolic arrays with little loss of time efficiency.

  13. Loewner's conjecture, the Besicovitch barrel, and relative systolic geometry

    SciTech Connect

    Babenko, I K

    2002-04-30

    The paper is devoted to relative systolic geometry on a compact manifold with boundary. Sufficient conditions ensuring the intersystolic rigidity or intersystolic softness of such manifolds are analyzed. Several open questions are formulated.

  14. Late systolic click in non-obstructive cardiomyopathy

    PubMed Central

    Mercer, Edward N.; Frye, Robert L.; Giuliani, Emilio R.

    1970-01-01

    Two patients with seriously impaired left ventricular function, abnormal left ventricular conduction on the electrocardiogram, mitral regurgitation, and a very late systolic click are reported. Idiopathic non-obstructive cardiomyopathy seemed to be the cause of the left ventricular dysfunction in both cases. The mitral valve was anatomically normal at the time of operation in one patient, except for dilatation of the annulus, and the mitral regurgitation appeared to be secondary to left ventricular failure. The very late timing of the mitral systolic clicks in these two patients may be related to a large left ventricular end-diastolic volume and impaired left ventricular function, or to an abnormal sequence of excitation of the left ventricle. The timing of the late systolic click in these patients is in contrast to that in patients with mid systolic clicks, hearts of normal size, and little cardiac disability. Images PMID:5470052

  15. Home and ambulatory blood pressure monitoring: when? who?

    PubMed Central

    Kantarci, Gülçin

    2013-01-01

    Blood pressure measurement in the diagnosis and management of hypertension, including the technique required for ambulatory blood pressure monitoring and home blood pressure monitoring, will be reviewed in this article. Home and ambulatory measurements are widely used, both to confirm the diagnosis and to improve adherence to therapy. The major advantage of out-of-office blood pressure monitoring is that it provides a large number of blood pressure measurements away from the medical environment, which represents a more reliable assessment of actual blood pressure than office blood pressure. The advantage of ambulatory blood pressure monitoring is its unique ability to measure nocturnal blood pressure. Although not fully validated in large-scale clinical trials, ambulatory blood pressure monitoring appears to correlate best with prognosis. Ambulatory blood pressure monitoring and home blood pressure monitoring provide somewhat different information on the subject's blood pressure status, and the two methods should thus be regarded as complementary, rather than competitive or alternative. PMID:25019016

  16. Systolic s/sup 2/-way merge sort is optimal

    SciTech Connect

    Schmeck, H.; Schroder, H.; Starke, C.

    1989-07-01

    The time complexity of Thompson and Kun's s/sup 2/-way merge sort is analyzed and shown to be asymptotically optimal with respect to the recently improved lower bound on sorting on a mesh-connected n x n array. Furthermore, new lower bounds for systolic sorting are derived. A systolic version of s/sup 2/-way merge sort is systematically constructed and shown to be asymptotically optimal as well.

  17. A virtual zero-time, monolithic systolic sorting array

    SciTech Connect

    Britton, C.L.; Ericson, M.N.; Bouldin, D.W.

    1989-01-01

    A virtual zero-time monolithic sorting chip is described. The chip has a systolic array architecture and implements the ''sinking sort'' algorithm. The basic functional module of the systolic array is detailed and development techniques employed as well as functional simulation and results are presented. Lessons learned and educational significance of the development of this chip at a university are discussed. 3 refs., 4 figs.

  18. Minimum complexity FIR filters and sparse systolic arrays

    SciTech Connect

    Ferrari, L.A.; Sankar, P.V.

    1988-06-01

    The properties of BETA-spline approximation and the integral/derivative properties of convolution lead to efficient algorithms for the implementation of multidimensional FIR filters. The implementations are of minimum time complexity under the Nyquist criterion. The algorithm can easily be implemented using a sparse systolic array architecture. The resulting BETA-spline convolvers have much lower circuit complexity than systolic architectures based on conventional convolution algorithms. A two-dimensional hardware implementation based on simplifications of current architectures is presented.

  19. A virtual zero-time, monolithic systolic sorting array

    SciTech Connect

    Britton, C.L. Jr.; Ericson, M.N.; Bouldin, D.W.; Tennessee Univ., Knoxville, TN )

    1990-01-01

    A virtual zero-time monolithic sorting chip is described. The chip has a systolic array architecture and implements the sinking sort'' algorithm. The basic functional module of the systolic array is detailed and development techniques employed as well as functional simulation and results are presented. Lessons learned and educational significance of the development of this chip at a university are discussed. 3 refs., 4 figs.

  20. Gastrointestinal transit and prolonged ambulatory colonic motility in health and faecal incontinence

    PubMed Central

    Herbst, F; Kamm, M; Morris, G; Britton, K; Woloszko, J; Nicholls, R

    1997-01-01

    Background—Colonic motor function has not been studied in the ambulatory setting over a prolonged period in the unprepared state. Furthermore, the disturbance of this function in patients with faecal incontinence is unknown. 
Aim—To study colonic function over two to three days in the ambulatory, unprepared state in health and in patients with idiopathic faecal incontinence. 
Methods—Six healthy women and six women with faecal incontinence and a structurally intact anal sphincter ingested a dual radioisotope meal, and had a six sensor, solid state manometric probe colonoscopically inserted into the left colon. Scanning was performed until radioisotope left the gut and pressure was recorded for a median of 44hours. 
Results—Three of six patients showed abnormal gastric emptying. Patients showed no disturbance of colonic radioisotope transit. Controls had a median of 12, whereas patients had a median of 16, high amplitude propagated waves per 24 hours. In three patients urge incontinence was associated with high amplitude (up to 500 cm water) propagated waves which often reached the rectum. These high pressure waves were identical to those occuring in healthy subjects, the only difference being the lack of adequate sphincter response. Passive incontinence was not associated with colonic motor activity. Defaecation in all subjects was associated with identical propagated waves, and distal movement of 13% (median) of right colonic content and excretion of 32% from the left colon and rectum. The urge to defaecate was associated with either propagated waves (45%) or non-propagated contractions (55%). Rectal motor complexes were recorded in both groups of subjects, but similar rhythmic activity was also recorded in the sigmoid and descending colon. 
Conclusions—Normal colonic function consists of frequent high pressure propagated waves. Rhythmic activity occurs both proximal to and in the rectum. Defaecation is characterised by high pressure propagated

  1. Vibration white finger and digital systolic pressure during cooling.

    PubMed Central

    Ekenvall, L; Lindblad, L E

    1986-01-01

    A cold provocation test (measurement of finger systolic pressure during combined body and local finger cooling) was performed on 111 male patients exposed to vibration and with a typical history of cold induced white finger. A new method of calculating the test result is described--namely, digital systolic blood pressure in the cooled test finger as a percentage of the systolic pressure in the arm (DP%). The conventional way of calculating the result, the systolic pressure in the cooled test finger as a percentage of the systolic pressure in the test finger when heated to 30 degrees C, corrected for changes in systemic pressure by the use of a reference finger (FSP%), requires the measurement of the systolic pressure in a reference finger. The two ways of calculating the test results give a similar sensitivity (74% for FSP%, 79% for DP% if all histories are regarded as true) but the new method does not require pressure measurements in a reference finger. This makes the test easier to perform and the result easier to understand. PMID:3964577

  2. 76 FR 6572 - Non-Ambulatory Disabled Veal Calves and Other Non-Ambulatory Disabled Livestock at Slaughter...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-07

    ...The Food Safety and Inspection Service (FSIS) is requesting comments on two petitions for rulemaking submitted to the Agency that raise issues associated with the disposition of non-ambulatory disabled veal calves and other non-ambulatory disabled livestock at slaughter. The first petition, submitted by the Humane Society of the United States (HSUS), requests that FSIS repeal a provision in......

  3. Internet patient care applications in ambulatory care.

    PubMed

    Anderson, D G; Stenzel, C

    2001-10-01

    Over the next decade, the Internet and related technologies will revolutionize the administrative and clinical practices of ambulatory care, enhancing the ability of physicians to provide quality care, enabling "virtual care teams" to help patients deal effectively with acute episodes and chronic conditions, and reducing the cost of care. Like any major paradigm shift, this change will not happen overnight. Nor will it be without cost. The explosion of venture capital and meteoric rise of the Nasdaq in 1999 reflected the promise of the Internet to revolutionize many aspects of American business. The Nasdaq's equally rapid descent in 2000 reflected a growing realization that this change will not be free--that "creative destruction," to use Schumpeter's term, will inevitably require significant investment and produce substantial losses. This article takes a longer term view than the ups and downs in the stock market. We believe the forces unleashed by the Internet are inexorable and that 10 years from now we will look back at the millennium's first decade as a period when the practice of ambulatory medicine was transformed by communication technology. PMID:11680237

  4. Agreement between different frequencies of measurements in ambulatory blood pressure monitoring.

    PubMed

    Lede, R L; Voto, L S; Orti, J; Margulies, M

    1997-06-01

    The purpose of this study was to determine the degree of agreement among different frequencies of blood pressure measurements (FoM) in 24-hour ambulatory blood pressure monitoring (ABPM) in their ability to obtain useful clinical information. ABPM records were obtained with a Del Mar IV Avionics device from 49 hospitalised preeclamptic women with a FoM of 7 per hour (high-FoM). With these records, we simulated two sets of data as if measurements had been recorded at a rate of 1 measurement per hour (low-FoM) and of 2 per hour (medium-FoM). Diastolic blood pressure > 89 mmHg defined hypertension and > 109 mmHg, severe hypertension The median and 25th and 75th centiles for the differences in hypertensive rate detected (expressed as percentage points) between lowFoM vs. high-FoM was 0.00 (- 3.4-3.00) and between medium-FoM vs. high-FoM,- 1.04 (- 3.7-1.5). The agreement in the detection of severely affected patients was 85% (CI 95%: 74-96) between low-FoM and high-FoM and 87% (CI 95%: 77-98), between medium-FoM and high-FoM. Average blood pressure was similar in the three FoMs studied at day-time and night-time. We did not find any strong argument to perform ABPM at a high-FoM. Lower FoM are more comfortable for the patient and could reduce equipment deterioration, while providing equivalent information to that supplied by high-FoM. PMID:15511877

  5. Arrhythmias on ambulatory electrocardiographic monitoring in women without apparent heart disease.

    PubMed

    Romhilt, D W; Chaffin, C; Choi, S C; Irby, E C

    1984-09-01

    Cardiac arrhythmias were evaluated in apparently normal women by randomly selecting within the age decades of 20 to 60, 200 of the 788 women employees of a company. After exclusions for cardiac and medical reasons and refusals to participate, 101 subjects underwent 24-hour ambulatory electrocardiographic monitoring. The mean heart rate was 82 beats/min, but was higher in smokers (p less than 0.05). Premature supraventricular contractions were present in 28 of 101 subjects (28%); the prevalence increased with age (p less than 0.001), but the frequency was less than 1 per hour in 24 of 28. PVCs occurred in 34 of 101 subjects (34%); the frequency was less than 1 per hour in 25 of 34. The PVCs were complex (Lown grade 3 or higher) in 10 (10%) and multifocal in 9 of 10; there was 1 couplet each in 3 and 1 run of 4 PVCs in 1 subject. PVCs were present in 20 of 42 subjects (48%) taking any medication (primarily oral contraceptives, estrogenic hormones and maintenance thyroid), compared with 14 of 59 subjects (24%) not taking medication (p less than 0.01). In women younger than 40 years, PVCs were present in 8 of 15 women (53%) taking contraceptives, compared with 4 of 33 (12%) not taking contraceptives (p less than 0.001). PVCs occurred in 7 of 12 subjects (58%) taking thyroid medication, compared with 27 of 89 (30%) not taking thyroid medication (p less than 0.03). In the 59 subjects not taking medication only 1 subject averaged more than 1 PVC/hour and 1 had 1 couplet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6475777

  6. Ambulatory blood pressure monitoring: a useful tool to diagnose hypertension and supervise it's treatment.

    PubMed

    Shrestha, B; Dhungel, S; Pahari, S K

    2008-06-01

    Automatic ambulatory blood pressure monitoring (ABPM) for the diagnosis and treatment ofhypertension(HTN) is not common in Nepal. The purpose of this study is to evaluate various characteristics of hypertensive patients undergoing ABPM before starting antihypertensive treatment and evaluate the adequacy of the blood pressure (BP) control during antihypertensive treatment. ABPM was performed in 108 consecutive patients attending the hypertension clinic of Nepal Medical College Teaching Hospital from 1st March 2005 to 30th April 2007 with DynaPulse 5000A (version 3.20q ) for approximately 24 hours. Male female ratio was 59:49 and age (mean +/- SD) was 47.8 +/- 16.4 years. The maximum use of ABPM (25.9%) was noted in the age group of 40-49 years. Body mass index was 25.7 +/- 3.8. Diabetes was noted in 13% patients. Maximum use of ABPM was observed in Newar ethnic group (56.5%). ABPM was used for the diagnosis of HTN in 62.0% patients and for follow up in 38.0% patients. Severe HTN was seen in approximately half (47.2%) of the hypertensive patients. Majority of the patients (88.0%) had dipper type of HTN. Beta-blocker (35.6%), ACE inhibitor/Losartan (31.1%) and calcium channel antagonist (26.7%) were the usual antihypertensive agents used. Single antihypertensive agent was used in the majority of patients (64.1%). In a small number of patients (42, 38.9%) undergoing ABPM during antihypertensive therapy, the adequacy of control of HTN was very poor. PMID:18828435

  7. Predictors of exercise participation in ambulatory and non-ambulatory older people with multiple sclerosis.

    PubMed

    Ploughman, Michelle; Harris, Chelsea; Wallack, Elizabeth M; Drodge, Olivia; Beaulieu, Serge; Mayo, Nancy

    2015-01-01

    Background. Exercise at moderate intensity may confer neuroprotective benefits in multiple sclerosis (MS), however it has been reported that people with MS (PwMS) exercise less than national guideline recommendations. We aimed to determine predictors of moderate to vigorous exercise among a sample of older Canadians with MS who were divided into ambulatory (less disabled) and non-ambulatory (more disabled) groups. Methods. We analysed data collected as part of a national survey of health, lifestyle and aging with MS. Participants (n = 743) were Canadians over 55 years of age with MS for 20 or more years. We identified 'a priori' variables (demographic, personal, socioeconomic, physical health, exercise history and health care support) that may predict exercise at moderate to vigorous intensity (>6.75 metabolic equivalent hours/week). Predictive variables were entered into stepwise logistic regression until best fit was achieved. Results. There was no difference in explanatory models between ambulatory and non-ambulatory groups. The model predicting exercise included the ability to walk independently (OR 1.90, 95% CI [1.24-2.91]); low disability (OR 1.50, 95% CI [1.34-1.68] for each 10 point difference in Barthel Index score), perseverance (OR 1.17, 95% CI [1.08-1.26] for each additional point on the scale of 0-14), less fatigue (OR 2.01, 95% CI [1.32-3.07] for those in the lowest quartile), fewer years since MS diagnosis (OR 1.58, 95% CI [1.11-2.23] below the median of 23 years) and fewer cardiovascular comorbidities (OR 1.55 95% CI [1.02-2.35] one or no comorbidities). It was also notable that the factors, age, gender, social support, health care support and financial status were not predictive of exercise. Conclusions. This is the first examination of exercise and exercise predictors among older, more disabled PwMS. Disability is a major predictor of exercise participation (at moderate to vigorous levels) in both ambulatory and non-ambulatory groups suggesting

  8. Predictors of exercise participation in ambulatory and non-ambulatory older people with multiple sclerosis

    PubMed Central

    Harris, Chelsea; Wallack, Elizabeth M.; Drodge, Olivia; Beaulieu, Serge; Mayo, Nancy

    2015-01-01

    Background. Exercise at moderate intensity may confer neuroprotective benefits in multiple sclerosis (MS), however it has been reported that people with MS (PwMS) exercise less than national guideline recommendations. We aimed to determine predictors of moderate to vigorous exercise among a sample of older Canadians with MS who were divided into ambulatory (less disabled) and non-ambulatory (more disabled) groups. Methods. We analysed data collected as part of a national survey of health, lifestyle and aging with MS. Participants (n = 743) were Canadians over 55 years of age with MS for 20 or more years. We identified ‘a priori’ variables (demographic, personal, socioeconomic, physical health, exercise history and health care support) that may predict exercise at moderate to vigorous intensity (>6.75 metabolic equivalent hours/week). Predictive variables were entered into stepwise logistic regression until best fit was achieved. Results. There was no difference in explanatory models between ambulatory and non-ambulatory groups. The model predicting exercise included the ability to walk independently (OR 1.90, 95% CI [1.24–2.91]); low disability (OR 1.50, 95% CI [1.34–1.68] for each 10 point difference in Barthel Index score), perseverance (OR 1.17, 95% CI [1.08–1.26] for each additional point on the scale of 0–14), less fatigue (OR 2.01, 95% CI [1.32–3.07] for those in the lowest quartile), fewer years since MS diagnosis (OR 1.58, 95% CI [1.11–2.23] below the median of 23 years) and fewer cardiovascular comorbidities (OR 1.55 95% CI [1.02–2.35] one or no comorbidities). It was also notable that the factors, age, gender, social support, health care support and financial status were not predictive of exercise. Conclusions. This is the first examination of exercise and exercise predictors among older, more disabled PwMS. Disability is a major predictor of exercise participation (at moderate to vigorous levels) in both ambulatory and non-ambulatory

  9. Short-term exposure to noise, fine particulate matter and nitrogen oxides on ambulatory blood pressure: A repeated-measure study.

    PubMed

    Chang, Li-Te; Chuang, Kai-Jen; Yang, Wei-Ting; Wang, Ven-Shing; Chuang, Hsiao-Chi; Bao, Bo-Ying; Liu, Chiu-Shong; Chang, Ta-Yuan

    2015-07-01

    Exposure to road traffic noise, fine particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) and nitrogen oxides (NOx) has been associated with transient changes in blood pressure, but whether an interaction exists remains unclear. This panel study investigated whether noise, PM2.5 and NOx exposure were independently associated with changes in 24-h ambulatory blood pressure. We recruited 33 males and 33 females aged 18-32 years as study subjects. Personal noise exposure and ambulatory blood pressure were monitored simultaneously in 2007. During the data collection periods, 24-h data on PM2.5 and NOx from five air-quality monitors within 6 km of participants' home addresses were used to estimate their individual exposures. Linear mixed-effects regression models were used to estimate single and combined effects on ambulatory blood pressure. Exposure to both noise and PM2.5 was significantly associated with increased systolic blood pressure (SBP) and diastolic blood pressure (DBP) over 24h; NOx exposure was only significantly related to elevated DBP. Twenty-four-hour ambulatory blood pressure increased with the current noise exposure of 5 A-weighted decibels (dBA) (SBP 1.44 [95% confidence interval: 1.16, 1.71] mmHg and DBP 1.40 [1.18, 1.61] mmHg) and PM2.5 exposure of 10-µg/m(3) (SBP 0.81 [0.19, 1.43] mmHg and DBP 0.63 [0.17, 1.10] mmHg), as well as the current NOx exposure of 10-ppb (DBP 0.54 [0.12, 0.97] mmHg) after simultaneous adjustment. These findings suggest that exposure to noise and air pollutants may independently increase ambulatory blood pressure and the risk of cardiovascular diseases. PMID:26073201

  10. 77 FR 37680 - Medicare and Medicaid Programs; Application From the Accreditation Association for Ambulatory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-22

    ... the Accreditation Association for Ambulatory Health Care for Continued Approval of Its Ambulatory... Association for Ambulatory Health Care for continued recognition as a national accrediting organization for... 6 years or as determined by CMS. The Accreditation Association for Ambulatory Health Care...

  11. Arterial Wave Reflection and Subclinical Left Ventricular Systolic Dysfunction

    PubMed Central

    Russo, Cesare; Jin, Zhezhen; Takei, Yasuyoshi; Hasegawa, Takuya; Koshaka, Shun; Palmieri, Vittorio; Elkind, Mitchell S.V.; Homma, Shunichi; Sacco, Ralph L.; Di Tullio, Marco R.

    2011-01-01

    Objectives Increased arterial wave reflection is a predictor of cardiovascular events and has been hypothesized to be a cofactor in the pathophysiology of heart failure. Whether increased wave reflection is inversely associated with left ventricular (LV) systolic function in subjects without heart failure is not clear. Methods Arterial wave reflection and LV systolic function were assessed in 301 participants from the Cardiovascular Abnormalities and Brain Lesions (CABL) study using 2-dimensional echocardiography and applanation tonometry of the radial artery to derive central arterial waveform by a validated transfer function. Aortic augmentation index (AIx) and wasted energy index (WEi) were used as indices of wave reflection. LV systolic function was measured by ejection fraction (LVEF) and tissue Doppler imaging (TDI). Mitral annulus peak systolic velocity (Sm), peak longitudinal strain and strain rate were measured. Participants with history of coronary artery disease, atrial fibrillation, LVEF <50% or wall motion abnormalities were excluded. Results Mean age of the study population was 68.3±10.2 years (64.1% women, 65% hypertensive). LV systolic function by TDI was lower with increasing wave reflection, whereas LVEF was not. In multivariate analysis, TDI parameters of LV longitudinal systolic function were significantly and inversely correlated to AIx and WEi (p values from 0.05 to 0.002). Conclusions In a community cohort without heart failure and with normal LVEF, an increased arterial wave reflection was associated with subclinical reduction in LV systolic function assessed by novel TDI techniques. Further studies are needed to investigate the prognostic implications of this relationship. PMID:21169863

  12. Growing ambulatory care nurse leaders in a multigenerational workforce.

    PubMed

    Moye, Janet P; Swan, Beth Ann

    2009-01-01

    Ambulatory care faces challenges in sustaining a nursing workforce in the future as newly licensed nurses are heavily recruited to inpatient settings and retirements will impact ambulatory care sooner than other areas. Building a diverse team by recruiting nurses of different ages (generations) and skills may result in a more successful and robust organization. Knowledge about generational characteristics and preferences will aid nurse leaders and recruiters in attracting high-quality, talented nurses. Nurses of Generations X and Y can increase their likelihood of success in ambulatory care by better understanding intergenerational issues. PMID:20050492

  13. [Ambulatory surgery. Patients and patient education].

    PubMed

    Bredland, T; Duesund, R

    1996-02-20

    This article reviews the concept of day surgery and shows how the treatment can be organized pre-, per- and post-operatively. It can be established in a hospital-integrated unit, a unit separate from the hospital, but connected with it, or a satellite ambulatory facility. Because the patient spends only a short time in hospital it is necessary to have structured preparations before admission, for the benefit of both patient and staff. It should be easy to identify patients suitable for day surgery from the waiting lists, and preparations should be directed at treatment by day surgery right from the start. Rules must be worked out for selecting patients, as well as guidelines for information to patients. It is also necessary to plan the operation programme, and to agree how nurses and doctors should take care of the patient during the different steps of treatment. PMID:8658453

  14. [2012 literature findings in ambulatory internal medicine].

    PubMed

    Vu, F; Ceppi, M; Fasel, E; Dory, E; Amstutz, V; Monney, C; Nanchen, D; Willi, C Clair; Pasche, O; Vauthey, L; Bodenmann, P

    2013-01-23

    In 2012 several articles reported interesting findings for the ambulatory practice in internal general medicine. A negative rapid test for influenza does not rule out that diagnosis. A test assessing the walking speed in the elderly can help determining who would benefit from antihypertensive therapy. Antibiotic treatment has no benefit for acute uncomplicated rhinosinusitis and diverticulitis. Probiotics can reduce the risk of post-antibiotic diarrhea. Daily coffee intake could reduce mortality. Oral supplementation of calcium can be harmful to the cardiovascular system. Subclinical hyperthyroidism should be treated to prevent cardiovascular complications. Aspirin can prevent recurrences in case of a primary thromboembolic event. Local injection of corticosteroids under ultrasonographic guidance for plantar fasciitis can be a safe treatment. Ibuprofen can prevent acute mountain sickness. PMID:23413648

  15. [Redesigning Swiss ambulatory health care system].

    PubMed

    Bays, J-M; Ninane, F; Morin, D; Héritier, F; Cassis, I; Cornuz, J

    2012-11-28

    Primary care medicine is first in line to meet the necessary changes in our health care system. Innovations in this field pursue three types of objectives: accessibility, quality and continuity of care. The Department of ambulatory care and community medicine of the University of Lausanne (Policlinique médicale universitaire) is committed to this path, emphasizing interprofessional collaboration. The doctor, nurse and medical assistant coordinate their activities to contribute efficiently to meet the needs of patients today and tomorrow. This paper also addresses how our department, as a public and academic institution, might play a major role as a health care network actor. A master degree dissertation in health management has started to identify the critical success factors and the strategic core competencies needed to achieve this development. PMID:23240239

  16. Management competencies required in ambulatory care settings.

    PubMed

    Brooke, P P; Hudak, R P; Finstuen, K; Trounson, J

    1998-01-01

    A study was conducted to identify the most important competencies physician executives in medical groups and other ambulatory settings will need to have in the next five years. The specific job skills, knowledge, and abilities (SKA) that physician executives will need to acquire these competencies were also explored. The Delphi techniques were used to analyze responses from two surveys from members of the American College of Medical Practice Executives. The most important competencies were grouped into 13 management domains, each with specific SKAs. "Managing health care resources to create quality and value" and "fundamentals of business and finance" were rated as the most important competencies. The most frequently rated SKA was the "ability to build and maintain credibility and trust." PMID:10185642

  17. [Ambulatory treatment of deep venous thrombosis].

    PubMed

    Metz, D; Hezard, N; Brasselet, C

    2001-11-01

    Conventional treatment of deep venous thrombosis (DVT) has been based, until recently, on non-fractionated heparin by continuous intravenous infusion in hospital until effective anticoagulation could be obtained by oral anticoagulants introduced early. Low molecular weight heparin (LMWH) seems to be as effective and has a better bio-availability, which means that there are fewer adverse effects. This usage has logically led to the increase in the possibilities of treatment of DVT at home. However, certain precautions are necessary, especially the evaluation of the individual patient's risk with this strategy. This requires multidisciplinary collaboration and the respect of strict rules (precise diagnostic objective, hospital admission at the slightest doubt of pulmonary embolism) to demonstrate the value of ambulatory LMWH therapy which would improve patient comfort and allow early mobilisation. PMID:11794978

  18. Mapping nested loop algorithms into multidimensional systolic arrays

    SciTech Connect

    Lee, P.Z. ); Kedem, Z.M. )

    1990-01-01

    This paper is concerned with transforming depth p-nested for loop algorithms into q-dimensional systolic VLSI arrays where 1 {le} q {le} p {minus} 1. Previously there existed complete characterizations of correct transformations only for the cases when q = p {minus} 1 or q = 1. The authors fill in this gap by giving formal necessary and sufficient conditions for correct transformation of a p-nested loop algorithm into a q-dimensional systolic array for any q, 1 {le} q {le} p {minus} 1. They also provide practical methods to derive optimal or suboptimal systolic array implementations. They apply the techniques developed by us to the automatic design of special purpose and programmable systolic arrays. The author's results also contribute towards automatic compilation onto more general purpose programmable arrays. Synthesis of linear and planar systolic array implementations for a three-dimensional cube-graph algorithm and a reindexed Warshall-Floyd pathfinding algorithm is used to illustrate our method.

  19. Renal sympathetic denervation: effect on ambulatory blood pressure and blood pressure variability in patients with treatment-resistant hypertension. The ReShape CV-risk study.

    PubMed

    Miroslawska, A; Solbu, M; Skjølsvik, E; Toft, I; Steigen, T K

    2016-03-01

    Renal sympathetic denervation (RDN) represents a potential treatment option for highly selected patients with resistant arterial hypertension. In this open label study, we aimed to investigate the response of blood pressure (BP) and short-term BP variability (BPV) to RDN 6 months after procedure. We defined treatment-resistant hypertension as office systolic BP>140 mm Hg, despite maximum tolerated doses of ⩾4 antihypertensive drugs, including a diuretic. In addition, daytime systolic ambulatory blood pressure (ABPM) >135 mm Hg was required after witnessed intake of antihypertensive drugs. Bilateral RDN was performed with the Symplicity Catheter System (n=23). The mean systolic office BP and ABPM fell from 162±20 mm Hg to 139±19 mm Hg (P<0.001) and from 154±20 mm Hg to 144±16 mm Hg (P<0.038), respectively. In addition, we observed a significant reduction in diastolic office BP and ABPM. The current study also demonstrated a significant decrease of both systolic and diastolic average real variability, weighted standard deviation (s.d.) as well as conventional s.d. of mean and daytime BP, but not of s.d. of nighttime BP. RDN after witnessed intake of ⩾4 antihypertensive drugs reduced both office BP and ABPM at 6 months in patients with truly resistant hypertension. Also BPV improved, possibly reflecting an additional effect from intervening on the sympathetic nerve system. PMID:26134621

  20. Invasively Measured Aortic Systolic Blood Pressure and Office Systolic Blood Pressure in Cardiovascular Risk Assessment: A Prospective Cohort Study.

    PubMed

    Laugesen, Esben; Knudsen, Søren T; Hansen, Klavs W; Rossen, Niklas B; Jensen, Lisette Okkels; Hansen, Michael G; Munkholm, Henrik; Thomsen, Kristian K; Søndergaard, Hanne; Bøttcher, Morten; Raungaard, Bent; Madsen, Morten; Hulman, Adam; Witte, Daniel; Bøtker, Hans Erik; Poulsen, Per L

    2016-09-01

    Aortic systolic blood pressure (BP) represents the hemodynamic cardiac and cerebral burden more directly than office systolic BP. Whether invasively measured aortic systolic BP confers additional prognostic value beyond office BP remains debated. In this study, office systolic BP and invasively measured aortic systolic BP were recorded in 21 908 patients (mean age: 63 years; 58% men; 14% with diabetes mellitus) with stable angina pectoris undergoing elective coronary angiography during January 2001 to December 2012. Multivariate Cox models were used to assess the association with incident myocardial infarction, stroke, and death. Discrimination and reclassification were assessed using Harrell's C and the Continuous Net Reclassification Index. Data were analyzed with and without stratification by diabetes mellitus status. During a median follow-up period of 3.7 years (range: 0.1-10.8 years), 422 strokes, 511 myocardial infarctions, and 1530 deaths occurred. Both office and aortic systolic BP were associated with stroke in patients with diabetes mellitus (hazard ratio per 10 mm Hg, 1.18 [95% confidence interval, 1.07-1.30] and 1.14 [95% confidence interval, 1.05-1.24], respectively) and with myocardial infarction in patients without diabetes mellitus (hazard ratio, 1.07 [95% confidence interval, 1.02-1.12] and 1.05 [95% confidence interval, 1.01-1.10], respectively). In models including both BP measurements, aortic BP lost statistical significance and aortic BP did not confer improvement in either C-statistics or net reclassification analysis. In conclusion, invasively measured aortic systolic BP does not add prognostic information about cardiovascular outcomes and all-cause mortality compared with office BP in patients with stable angina pectoris, either with or without diabetes mellitus. PMID:27402917

  1. Ambulatory Blood Pressure Monitoring (ABPM) as the reference standard for diagnosis of hypertension and assessment of vascular risk in adults.

    PubMed

    Hermida, Ramón C; Smolensky, Michael H; Ayala, Diana E; Portaluppi, Francesco

    2015-01-01

    New information has become available since the ISC, AAMCC, and SECAC released their first extensive guidedelines to improve the diagnosis and treatment of adult arterial hypertension. A critical assessment of evidence and a comparison of what international guidelines now propose are the basis for the following statements, which update the recommendations first issued in 2013. Office blood pressure (BP) measurements should no longer be considered to be the "gold standard" for the diagnosis of hypertension and assessment of cardiovascular risk. Relying on office BP, even when supplemented with at-home wake-time self-measurements, to identify high-risk individuals, disregarding circadian BP patterning and asleep BP level, leads to potential misclassification of 50% of all evaluated persons. Accordingly, ambulatory BP monitoring is the recommended reference standard for the diagnosis of true hypertension and accurate assessment of cardiovascular risk in all adults ≥18 yrs of age, regardless of whether office BP is normal or elevated. Asleep systolic BP mean is the most significant independent predictor of cardiovascular events. The sleep-time relative SBP decline adds prognostic value to the statistical model that already includes the asleep systolic BP mean and corrected for relevant confounding variables. Accordingly, the asleep systolic BP mean is the recommended protocol to diagnose hypertension, assess cardiovascular risk, and predict cardiovascular event-free interval. In men, and in the absence of compelling clinical conditions, reference thresholds for diagnosing hypertension are 120/70 mmHg for the asleep systolic/diastolic BP means derived from ambulatory BP monitoring. However, in women, in the absence of complicating co-morbidities, the same thresholds are lower by 10/5 mmHg, i.e., 110/65 mmHg for the asleep means. In high-risk patients, including those diagnosed with diabetes or chronic kidney disease, and/or those having experienced past

  2. The use of ambulatory patient groups for regulation of hospital ambulatory surgery revenue in Maryland.

    PubMed

    Atkinson, Graham; Murray, Robert

    2008-01-01

    The Maryland Health Services Cost Review Commission (HSCRC or the commission) is a government agency with the authority to establish rates for both inpatient and outpatient services for all general acute care hospitals in the state. By law and consistent with the state's unique Medicare waiver, all payers (including Medicare and Medicaid) must pay hospitals on the basis of these rates. The HSCRC has used diagnosis related groups to set case-mix-adjusted limits on the revenue per discharge for inpatient services (similar to Medicare inpatient prospective payment nationally) yet, the Maryland rate-setting system for outpatient services has not embodied incentives to control utilization of services. Beginning in the state's fiscal year 2008, the HSCRC is implementing regulation of ambulatory surgery services using ambulatory patient groups to provide better incentives to control utilization, and to facilitate comparisons of the case-mix-adjusted charges per ambulatory surgery case across hospitals. Maryland has been an innovator in the design and successful implementation of payment systems and other incentive mechanisms to constrain hospital cost, maintain payment equity, and ensure access to needed hospital care. The HSCRC's adoption of all patient refined diagnosis related groups and the hospital-specific relative value method for establishing diagnosis related group weights in 2005 was relevant to the Centers for Medicare and Medicaid Services' decision to move to Medicare severity diagnosis related groups beginning in federal fiscal year 2008, and to consider the use of hospital-specific relative value weights. The HSCRC's decision to use ambulatory patient groups for ambulatory surgery is an attempt to apply the most effective features of inpatient payment systems, prospective payment, including incentives to control service volumes. As such, it represents a radical departure from prevailing payment arrangements in that it seeks to remove the traditional

  3. A new bit-serial systolic multiplier over GF(2/sup m/)

    SciTech Connect

    Zhou, B.B.

    1988-06-01

    A new bit-serial systolic array is developed to compute multiplications over GF(2/sup m/). In contrast to another systolic multiplier, this new systolic algorithm allows the input elements to enter a linear systolic array in the same order and the system only requires one control signal.

  4. A Josephson systolic array processor for multiplication/addition operations

    SciTech Connect

    Morisue, M.; Li, F.Q.; Tobita, M.; Kaneko, S. )

    1991-03-01

    A novel Josephson systolic array processor to perform multiplication/addition operations is proposed. The systolic array processor proposed here consists of a set of three kinds of interconnected cells of which main circuits are made by using SQUID gates. A multiplication of 2 bits by 2 bits is performed in the single cell at a time and an addition of three data with two bits is simultaneously performed in an another type of cell. Furthermore, information in this system flows between cells in a pipeline fashion so that a high performance can be achieved. In this paper the principle of Josephson systolic array processor is described in detail and the simulation results are illustrated for the multiplication/addition of (4 bits {times} 4 bits + 8 bits). The results show that these operations can be executed in 330ps.

  5. Design of the PSC: a programmable systolic chip

    SciTech Connect

    Fisher, A.L.; Kung, H.T.; Monier, L.M.; Walker, H.; Dohi, Y.

    1983-01-01

    The programmable systolic chip (PSC) is a high performance special-purpose single-chip microprocessor intended to be used in groups of tens or hundreds for the efficient implementation of a broad variety of systolic arrays. For implementing these systolic arrays, the psc is expected to be at least an order of magnitude more efficient than conventional microprocessors. The development of the psc design, from initial concept to a silicon layout, took slightly less than a year. This project represents an integration of many disciplines including applications, algorithms, architecture, microprocessor design, and chip layout. The author describes the goals of the project, the design process, major design features and current status. 22 references.

  6. Systolic array for fast computation of moment invariants

    NASA Astrophysics Data System (ADS)

    Liu, Jianguo; Chan, Francis H. Y.; Li, H. F.; Lam, F. K.

    1998-09-01

    Moment invariants, by virtue of invariance properties under translation, scaling and rotation, have played an important role in pattern recognition and computer vision. In the present paper, extending the systolic array for computing moments, a global systolic structure for fast computation of moment invariants has been proposed. This structure fully exploits parallelism of the network architecture and reduces computational time complexity from O(n2) in the case of direct computation to O(n) (n denotes image size). The systolic structure nearly consists of adders with area complexity O(n) and are highly regular and structurally very simple, resulting in simple hardware implementation. The method is suitable for both binary images and gray level images and is also suitable for image sequence moments.

  7. Systolic multipliers for finite fields GF(2 exp m)

    NASA Technical Reports Server (NTRS)

    Yeh, C.-S.; Reed, I. S.; Truong, T. K.

    1984-01-01

    Two systolic architectures are developed for performing the product-sum computation AB + C in the finite field GF(2 exp m) of 2 exp m elements, where A, B, and C are arbitrary elements of GF(2 exp m). The first multiplier is a serial-in, serial-out one-dimensional systolic array, while the second multiplier is a parallel-in, parallel-out two-dimensional systolic array. The first multiplier requires a smaller number of basic cells than the second multiplier. The second multiplier needs less average time per computation than the first multiplier, if a number of computations are performed consecutively. To perform single computations both multipliers require the same computational time. In both cases the architectures are simple and regular and possess the properties of concurrency and modularity. As a consequence, they are well suited for use in VLSI systems.

  8. FFT Computation with Systolic Arrays, A New Architecture

    NASA Technical Reports Server (NTRS)

    Boriakoff, Valentin

    1994-01-01

    The use of the Cooley-Tukey algorithm for computing the l-d FFT lends itself to a particular matrix factorization which suggests direct implementation by linearly-connected systolic arrays. Here we present a new systolic architecture that embodies this algorithm. This implementation requires a smaller number of processors and a smaller number of memory cells than other recent implementations, as well as having all the advantages of systolic arrays. For the implementation of the decimation-in-frequency case, word-serial data input allows continuous real-time operation without the need of a serial-to-parallel conversion device. No control or data stream switching is necessary. Computer simulation of this architecture was done in the context of a 1024 point DFT with a fixed point processor, and CMOS processor implementation has started.

  9. [Improving the ambulatory surgical services on the basis of the work experience of the Center of Ambulatory Surgery].

    PubMed

    Polozhentsev, S D; Malkin, D M; Marushkin, A V; Lisitsyn, A S; Vinnik, L F; Goncharov, V P; Shanin, S S

    1990-06-01

    Centers of ambulatory surgery made on the basis of large city polyclinics and regional medical formations are considered to be a perspective and economically effective form of perestroika of the ambulatory surgical aid to people. Specificity of the operative procedures performed at the Center and specific features of postoperative management of the patients should be taken into consideration, and the staff of such units must consist of highly trained surgeons of wide type. The ambulatory surgery Center must occupy its place in the system of dispensary examinations of the population. PMID:2175517

  10. Design and programming of systolic array cells for signal processing

    SciTech Connect

    Smith, R.A.W.

    1989-01-01

    This thesis presents a new methodology for the design, simulation, and programming of systolic arrays in which the algorithms and architecture are simultaneously optimized. The algorithms determine the initial architecture, and simulation is used to optimize the architecture. The simulator provides a register-transfer level model of a complete systolic array computation. To establish the validity of this design methodology two novel programmable systolic array cells were designed and programmed. The cells were targeted for applications in high-speed signal processing and associated matrix computations. A two-chip programmable systolic array cell using a 16-bit multiplier-accumulator chip and a semi-custom VLSI controller chip was designed and fabricated. A low chip count allows large arrays to be constructed, but the cell is flexible enough to be a building-block for either one- or two-dimensional systolic arrays. Another more flexible and powerful cell using a 32-bit floating-point processor and a second VLSI controller chip was also designed. It contains several architectural features that are unique in a systolic array cell: (1) each instruction is 32 bits, yet all resources can be updated every cycle, (2) two on-chip interchangeable memories are used, and (3) one input port can be used as either a global or local port. The key issues involved in programming the cells are analyzed in detail. A set of modules is developed which can be used to construct large programs in an effective manner. The utility of this programming approach is demonstrated with several important examples.

  11. Arrhythmias and Electrocardiographic Changes in Systolic Heart Failure

    PubMed Central

    Devkota, Ashok; Bakhit, Ahmed; Dufresne, Alix; Oo, Aung Naing; Parajuli, Premraj; Manhas, Saveena

    2016-01-01

    Background: Heart failure is a common condition that that leads to hospitalization. It is associated with various atrial and ventricular arrhythmias. Aim: The aim of this study is to find common arrhythmias and electrocardiographic changes in hospitalized patients who have systolic heart failure. Materials and Methods: This is a retrospective study of medical records, and electrocardiograms (EKGs) of 157 patients admitted to our hospital who had systolic heart failure with ejection fraction (EF) <50% on echocardiogram. Based on EF, the patients were divided into two groups; one with EF ≤ 35% and the other with EF > 35%. Twelve-lead EKG of these patients was studied to identify common arrhythmia and demographic variables; laboratory results were compared to identify the differences. Results: A total of 157 patients with systolic heart failure, 63.7% had an EF ≤ 35%. Hypertension 82.8%, diabetes 49%, coronary artery disease 40.8%, chronic obstructive pulmonary disease or bronchial asthma 22.3%, and stroke 12.1% were common associated co-morbidities. On analysis of EKG, 28.6% had tachycardia, 21.9% had prolonged PR > 200 ms, 16.3% had wide QRS > 120 ms, 70.7% had prolonged corrected QT (QTc), and 42.2% had left axis deviation. The most common arrhythmias were sinus tachycardia and atrial fibrillation/flutter which were found in 14.6% and 13.4%, respectively. The left ventricular hypertrophy was a common abnormality found in 22.4% followed by ventricular premature contractions 18.4%, atrial premature contractions 9.5%, and left bundle branch block 6.1%. Patients with severe systolic heart failure had prolonged QRS (P = 0.02) and prolonged QTc (P = 0.01) as compared to the other group. Conclusions: Sinus tachycardia and atrial fibrillation/flutter were common arrhythmias in patients with systolic heart failure. Patients with severe systolic heart failure had statistically significant prolongation of the QRS duration and QTc interval. PMID:27213140

  12. Conventional and Ambulatory Blood Pressure as Predictors of Retinal Arteriolar Narrowing

    PubMed Central

    Wei, Fang-Fei; Zhang, Zhen-Yu; Thijs, Lutgarde; Yang, Wen-Yi; Jacobs, Lotte; Cauwenberghs, Nicholas; Gu, Yu-Mei; Kuznetsova, Tatiana; Allegaert, Karel; Verhamme, Peter; Li, Yan; Struijker-Boudier, Harry A.J.

    2016-01-01

    At variance with the long established paradigm that retinal arteriolar narrowing trails hypertension, several longitudinal studies, all based on conventional blood pressure (CBP) measurement, proposed that retinal arteriolar narrowing indicates heightened microvascular resistance and precedes hypertension. In 783 randomly recruited Flemish (mean age, 38.2 years; 51.3% women), we investigated to what extent CBP and daytime (10 am to 8 pm) ambulatory blood pressure (ABP) measured at baseline (1989–2008) predicted the central retinal arteriolar equivalent (CRAE) in retinal photographs obtained at follow-up (2008–2015). Systolic/diastolic hypertension thresholds were 140/90 mm Hg for CBP and 135/85 mm Hg for ABP. In multivariable-adjusted models including both baseline CBP and ABP, CRAE after 10.3 years (median) of follow-up was unrelated to CBP (P≥0.14), whereas ABP predicted CRAE narrowing (P≤0.011). Per 1-SD increment in systolic/diastolic blood pressure, the association sizes were −0.95 µm (95% confidence interval, −2.20 to 0.30)/−0.75 µm (−1.93 to 0.42) for CBP and −1.76 µm (−2.95 to −0.58)/−1.48 µm (−2.61 to −0.34) for ABP. Patients with ambulatory hypertension at baseline (17.0%) had smaller CRAE (146.5 versus 152.6 µm; P<0.001) at follow-up. CRAE was not different (P≥0.31) between true normotension (normal CBP and ABP; prevalence, 77.6%) and white-coat hypertension (elevated CBP and normal ABP, 5.4%) and between masked hypertension (normal CBP and elevated ABP, 10.2%) and hypertension (elevated CBP and ABP, 6.8%). In conclusion, the paradigm that retinal arteriolar narrowing precedes hypertension can be explained by the limitations of CBP measurement, including nonidentification of masked and white-coat hypertension. PMID:27324224

  13. [Ambulatory procedures to replace inpatient care. Background and applications].

    PubMed

    Hensen, P; Bunzemeier, H; Fürstenberg, T; Luger, T A; Rochell, B; Roeder, N

    2004-07-01

    Since January 2004, German hospitals and specialists in private practice have equal rights to provide and to charge for ambulatory surgeries according to paragraph 115b, 5th Code of Social Law. The current agreement between the German self-governing bodies replaces the existing contracts from 1993. In contrast to the previous version, the revised catalogue contains additional non-operative procedures. Some procedures may be provided either in an ambulatory or inpatient setting. However, for the hospitals it is of particular importance that some specified procedures should be performed on an ambulatory basis. If these particular services are delivered in an inpatient setting at least one stipulated criteria of exception has to be fulfilled. From the perspective of dermatology, not only opportunities but also obligations for ambulatory care arise from the new conditions. The critical facts and aspects with special relevance to dermatology are reviewed in detail. PMID:15168028

  14. Content addressable systolic array for sparse matrix computation

    SciTech Connect

    Wing, O.

    1983-01-01

    A systolic array is proposed which is specifically designed to solve a system of sparse linear equations. The array consists of a number of processing elements connected in a ring. Each processing element has its own content addressable memory where the nonzero elements of the sparse matrix are stored. Matrix elements to which elementary operations are applied are extracted from the memory by content addressing. The system of equations is solved in a systolic fashion and the solution is obtained in nz+5n-2 steps where nz is the number of nonzero elements along and below the diagonal and n is the number of equations. 13 references.

  15. Systolic array for fast computation of discrete cosine transform

    NASA Astrophysics Data System (ADS)

    Liu, Jianguo; Li, H. F.; Chan, Francis H. Y.; Lam, F. K.

    1998-09-01

    Discrete cosine transform (DCT) is widely used in signal processing. This paper presents a novel approach to perform DCT. DCT is expressed in terms of discrete moments and a systolic array for computing DCT with only a few multiplications and without any cosine evaluations has been proposed. The execution time of the systolic array is only O(Nlog2N/log2log2N) in computing 1D DCT. The approach is also applicable to multiple dimensional DCT and DCT inverses.

  16. Low Power Systolic Array Based Digital Filter for DSP Applications.

    PubMed

    Karthick, S; Valarmathy, S; Prabhu, E

    2015-01-01

    Main concepts in DSP include filtering, averaging, modulating, and correlating the signals in digital form to estimate characteristic parameter of a signal into a desirable form. This paper presents a brief concept of low power datapath impact for Digital Signal Processing (DSP) based biomedical application. Systolic array based digital filter used in signal processing of electrocardiogram analysis is presented with datapath architectural innovations in low power consumption perspective. Implementation was done with ASIC design methodology using TSMC 65 nm technological library node. The proposed systolic array filter has reduced leakage power up to 8.5% than the existing filter architectures. PMID:25922854

  17. Systolic time interval data acquisition system. Specialized cardiovascular studies

    NASA Technical Reports Server (NTRS)

    Baker, J. T.

    1976-01-01

    The development of a data acquisition system for noninvasive measurement of systolic time intervals is described. R-R interval from the ECG determines instantaneous heart rate prior to the beat to be measured. Total electromechanical systole (Q-S2) is measured from the onset of the ECG Q-wave to the onset of the second heart sound (S2). Ejection time (ET or LVET) is measured from the onset of carotid upstroke to the incisure. Pre-ejection period (PEP) is computed by subtracting ET from Q-S2. PEP/ET ratio is computed directly.

  18. Prognostic significance of hyponatremia among ambulatory patients with heart failure and preserved and reduced ejection fractions.

    PubMed

    Bavishi, Chirag; Ather, Sameer; Bambhroliya, Arvind; Jneid, Hani; Virani, Salim S; Bozkurt, Biykem; Deswal, Anita

    2014-06-01

    Hyponatremia in heart failure (HF) is an established predictor of adverse outcomes in hospitalized patients with reduced ejection fraction (EF). However, there is a paucity of data in ambulatory patients with HF with preserved ejection fraction (HFpEF). We examined the prevalence, risk factors, and long-term outcomes of hyponatremia (serum sodium ≤135 mEq/L) in ambulatory HFpEF and HF with reduced EF (HFrEF) in a national cohort of 8,862 veterans treated in Veterans Affairs clinics. Multivariable logistic regression models were used to identify factors associated with hyponatremia, and multivariable Cox proportional hazard models were used for analysis of outcomes. The cohort consisted of 6,185 patients with HFrEF and 2,704 patients with HFpEF with a 2-year follow-up. Hyponatremia was present in 13.8% and 12.9% patients in HFrEF and HFpEF, respectively. Hyponatremia was independently associated with younger age, diabetes, lower systolic blood pressure, anemia, body mass index <30 kg/m(2), and spironolactone use, whereas African-American race and statins were inversely associated. In multivariate analysis, hyponatremia remained a significant predictor of all-cause mortality in both HFrEF (hazards ratio [HR] 1.26, 95% confidence interval [CI] 1.11 to 1.44, p <0.001) and HFpEF (HR 1.40, 95% CI 1.12 to 1.75, p = 0.004) and a significant predictor of all-cause hospitalization in patients with HFrEF (HR 1.18, 95% CI 1.07 to 1.31, p = 0.001) but not in HFpEF (HR 1.08, 95% CI 0.92 to 1.27, p = 0.33). In conclusion, hyponatremia is prevalent at a similar frequency of over 10% in ambulatory patients with HFpEF and HFrEF. Hyponatremia is an independent prognostic marker of mortality across the spectrum of patients with HFpEF and HFrEF. In contrast, it is an independent predictor for hospitalization in patients with HFrEF but not in patients with HFpEF. PMID:24837261

  19. Pros and cons of the ambulatory surgery center joint venture.

    PubMed

    Giannini, Deborah

    2008-01-01

    If a physician group has determined that it has a realistic patient base to establish an ambulatory surgery center, it may be beneficial to consider a partner to share the costs and risks of this new joint venture. Joint ventures can be a benefit or liability in the establishment of an ambulatory surgery center. This article discusses the advantages and disadvantages of a hospital physician-group joint venture. PMID:18061764

  20. Systolic Blood Pressure Intervention Trial (SPRINT) and Target Systolic Blood Pressure in Future Hypertension Guidelines.

    PubMed

    Egan, Brent M; Li, Jiexiang; Wagner, C Shaun

    2016-08-01

    The Systolic Blood Pressure (SBP, mm Hg) Intervention Trial (SPRINT) showed that targeting SBP <120 mm Hg (intensive treatment, mean SBP: 121.5 mm Hg) versus <140 (standard treatment, mean SBP: 134.6 mm Hg) reduced cardiovascular events 25%. SPRINT has 2 implicit assumptions that could impact future US hypertension guidelines: (1) standard therapy controlled SBP similarly to that in adults with treated hypertension and (2) intensive therapy produced a lower mean SBP than in adults with treated hypertension and SBP <140 mm Hg. To examine these assumptions, US National Health and Nutrition Examination Survey 2009 to 2012 data were analyzed on 3 groups of adults with treated hypertension: group 1 consisted of SPRINT-like participants aged ≥50 years; group 2 consisted of participants all aged ≥18 years; and group 3 consisted of participants aged ≥18 years excluding group 1 but otherwise similar to SPRINT-like participants except high cardiovascular risk. Mean SBPs in groups 1, 2, and 3 were 133.0, 130.1, and 124.6, with 66.2%, 72.2%, and 81.9%, respectively, controlled to SBP <140; 68.3%, 74.8%, and 83.4% of the controlled subset had SBP <130. Mean SBPs in those controlled to <140 were 123.3, 120.9, and 118.9, respectively. Among US adults with treated hypertension, (1) the SPRINT-like group had higher mean SBP than comparison groups, yet lower than SPRINT standard treatment group and (2) among groups 1 to 3 with SBP <140, SBP values were within <3 mm Hg of SPRINT intensive treatment. SPRINT results suggest that treatment should be continued and not reduced when treated SBP is <130, especially for the SPRINT-like subset. Furthermore, increasing the percentage of treated adults with SBP <140 could approximate SPRINT intensive treatment SBP without lowering treatment goals. PMID:27354422

  1. Specific dimensions of perceived support and ambulatory blood pressure: which support functions appear most beneficial and for whom?

    PubMed

    Bowen, Kimberly S; Birmingham, Wendy; Uchino, Bert N; Carlisle, McKenzie; Smith, Timothy W; Light, Kathleen C

    2013-06-01

    Perceived support has been related to lower cardiovascular morbidity and mortality. However, little is known about the specific functional components of support responsible for such links. We tested if emotional, informational, tangible, and belonging support predicted ambulatory blood pressure (ABP) and interpersonal interactions (e.g., responsiveness), and if such links were moderated by gender. In this study, 94 married couples underwent 12 h of ABP monitoring during daily life which included a night at home with their spouse. They completed a short-form of the interpersonal support evaluation list that provides information on total (global) support, as well as specific dimensions of support. Results revealed that global support scores did not predict ABP during daily life. However, separating out distinct support components revealed that emotional support was a significant predictor of lower ambulatory systolic and diastolic blood pressure, primarily for women. Finally, emotional support predicted greater partner responsiveness and self-disclosure, along with less perceived partner negativity although these results were not moderated by gender. These data are discussed in terms of the importance of considering specific support components and the contextual processes that might influence such links. PMID:22465206

  2. Association of ambulatory heart rate and atherosclerosis risk factors with blood pressure in young non-hypertensive adults

    PubMed Central

    Cheng, Cynthia; Daskalakis, Constantine

    2016-01-01

    Objective The study objective was to assess the association between 24 h ambulatory heart rate (HR), atherosclerosis risk factors and blood pressure (BP) in young non-hypertensive patients. Methods We recruited 186 participants aged 18–45 years from a large urban academic Family Medicine outpatient practice, serving 40 000 individuals for this observational study. The main analyses were based on multiple linear regression, with mean 24 h BP (systolic BP (SBP) or diastolic BP (DBP)) as the outcomes, mean 24 h HR as the main predictor of interest, and controlling for age, gender, race, insulin sensitivity/resistance and endothelial function measured by strain gauge venous occlusion plethysmography. Results HR was independently associated with mean 24 h SBP and DBP (SBP and DBP: p=0.042 and 0.001, respectively). In our analyses, associations were markedly stronger for ambulatory compared with office BP measurements. Endothelial dysfunction was associated with higher SBP (p=0.013); plasminogen activator inhibitor-1 was significantly associated with both SBP and DBP (p=0.041 and 0.015, respectively), while insulin resistance was not associated with either SBP or DBP. Insulin resistance and C reactive protein were significant predictors of HR (p=0.013 and 0.007, respectively). Conclusions These findings suggest that HR may be a potential marker of elevated cardiovascular risk in young asymptomatic individuals, prior to the development of clinical hypertension or cardiovascular disease. PMID:26925242

  3. Variations in 7-day/24-h circadian pattern of ambulatory blood pressure and heart rate of type 2 diabetes patients

    PubMed Central

    Bhardwaj, Shipra; Verma, Narsingh; Anjum, Baby; Bhardwaj, Kshitij

    2014-01-01

    Aims/Introduction Diabetes has profound consequences on the cardiovascular system leading to cardiovascular morbidity and mortality in diabetic patients. Blood pressure (BP) has a characteristic and reproducible circadian pattern, with high values during the day and low values at night. A 7-day timed analysis of BP through ambulatory blood pressure monitoring has been used not only to diagnose day and night dipping patterns of blood pressure, but also to measure day-to-day variability and the circadian hyper-amplitude-tension, a condition in which excessive circadian BP amplitude precedes the chronic established hypertension. Our objective was to assess the 7-day/24-h circadian pattern of BP and heart rate in diabetic patients, as it could be helpful in the diagnosis and prevention of cardiovascular morbidity. Materials and Methods A total of 50 diabetic patients with type 2 diabetes and 50 non-diabetic participants were recruited for the study. General health records were individually maintained, and 7-day/24-h ambulatory blood pressure monitoring using an ambulatory blood pressure monitor was carried out. Results The rhythmic parameters of systolic and diastolic BP, heart rate, double amplitude, acrophase and 3-h fractionated hyperbaric index were found to be significantly high in diabetic patients. A total of 12 participants were diagnosed with circadian hyper-amplitude-tension. These data suggest that diabetic patients have certain variations in the circadian pattern of blood pressure and heart rate, which can result in disturbed vascular events, and thus are at greater risk of cardiovascular morbidity. Conclusion Seven-day/24-h monitoring might be useful as an early predictive tool in assessing future cardiovascular risk, guiding treatment and management of these patients. PMID:25422775

  4. Higher Blood Pressure Variability in White Coat Hypertension; from the Korean Ambulatory Blood Pressure Monitoring Registry

    PubMed Central

    Kang, In Sook; Shin, Jinho; Ihm, Sang-Hyun; Kim, Ju Han; Park, Sungha; Kim, Kwang-Il; Kim, Woo-Shik; Kim, Soon Gil; Shin, Gil Ja

    2016-01-01

    Background and Objectives Blood pressure variability (BPV) was recently shown to be a risk factor of stroke. White coat hypertension (WCH) used to be regarded as innocuous, but one long-term follow-up study reported that WCH increased stroke rate compared to normotension (NT). In this study, we aimed to evaluate the relationship between WCH and BPV. Subjects and Methods We analyzed 1398 subjects from the Korean Ambulatory Blood Pressure Registry, who were divided into NT (n=364), masked hypertension (n=122), white coat hypertension (n=254), and sustained hypertension (n=658) groups. Results Baseline characteristics were similar among groups. The average real variability (ARV), a highly sensitive BPV parameter, was highest in the WCH group, followed by the sustained hypertension, masked hypertension, and NT groups. The results persisted after being adjusted for covariates. The WCH vs. sustained hypertension results (adjusted mean±standard error) were as follows: 24-h systolic ARV, 22.9±0.8 vs. 19.4±0.6; 24-h diastolic ARV, 16.8±0.6 vs. 14.3±0.5; daytime systolic ARV, 21.8±0.8 vs. 16.8±0.6; and daytime diastolic ARV, 16.2±0.6 vs. 13.4±0.5 (p<0.001 for all comparisons). Conclusion From the registry data, we found that subjects with WCH or masked hypertension had higher BPV than NT. However, long-term follow-up data assessing the clinical influences of WCH on stroke are needed.

  5. Algorithmic study on systolic array structures. Master's thesis

    SciTech Connect

    Souza, L.J.

    1985-06-01

    Computation bound problems impose a severe burden on the CPU. In order to speed up computation, specific problems that are identified as the main burden can be done using parallel processing. In this way, the time consuming tasks can be executed on specially tailored hardware. This hardware is designed to implement an algorithm-oriented parallel-processing structure that works more efficiently than the CPU for these specific tasks. This thesis is a study of the mapping of the algorithms onto a kind of structure called systolic array. The development and utilization of a software tool designed to assist on such analysis is presented here. This tool, named Systolic Array Graphics Simulator (SYSGRAS), has the capability to represent any type of systolic array, no matter how complex the cells and structure are. Because of the capability of SYSGRAS, an interactive computer program simulator, the study of systolic arrays is simplified. The complexity of the time-space relationships is analyzed with the help of some color-graphics techniques. The visualization of the data interaction is thus enhanced and the user is alleviated from the burden of keeping track of partial results and can dedicate attention to the processing algorithm.

  6. Guidelines for efficient use of optical systolic array processors

    SciTech Connect

    Casasent, D.

    1983-01-01

    The design, error analysis, component accuracy required, computational capacity, data flow and pipelining, plus the algorithm and application all seriously impact the use of optical systolic array processors. The author provides initial remarks, results, examples and solutions for each of these issues. 20 references.

  7. Clinical Decision Support Systems for Ambulatory Care

    PubMed Central

    Lloyd, Stephen C.

    1984-01-01

    This conference serves to further the state of the art in the application of computers to medical care via a forum for the intercommunication of ideas. Papers discuss the experiences of diverse research projects. It is the purpose of this article to review the major developments in ambulatory care decision support. From this vantage point, the major impediments to broad applicability of information systems are discussed. The DUCHESS Medical Information Management System is then described as a step towards overcoming these obstacles. Two distinct but often overlapping issues are the representation of the data and its subsequent manipulation: records vs. knowledge. The complexity of the medical record requires state-of-the-art computer science. Clinical decision support requires flexible means for representing medical knowledge and the ability to input “rules.” Artificial intelligence has provided tools for simulating the decision making processes. A sample of the major systems are contrasted and compared. In the realm of medical records COSTAR, TMR, SCAMP, HELP, and STOR are considered. In clinical decision support CADEUCUS, REGENSTRIEF, PKC, and DUCHESS are reviewed.

  8. Ambulatory blood pressure monitoring (ABPM) in nonagenarians.

    PubMed

    Formiga, Francesc; Ferrer, Assumpta; Sobrino, Javier; Coca, Antonio; Riera, Antoni; Pujol, Ramón

    2009-01-01

    The objective of the study is to investigate ambulatory blood pressure monitoring (ABPM) in a sample of Spanish nonagenarians. We also analyzed the misdiagnosis of hypertension and investigated blood pressure (BP) control in treated hypertensive nonagenarians. Twenty-four-hour ABPM was undertaken in a group of 42 nonagenarians. The 24-h mean, daytime BP, nighttime BP and heart rate (HR) were extracted from the ABPM. Sociodemographic data, the ability to perform basic daily activities, measured by the Barthel index (BI) or instrumental activities revealed by the Lawton and Brody index (LI), cognition, and comorbidity were evaluated. Thirty-one subjects were receiving antihypertensive drug treatment. Twenty-four hour, daytime and sleeping pressures averaged 130/65, 131/68 and 128/63mmHg, respectively. Seventeen (40.5%) of the 42 patients had a daytime BP of 135/85 or higher. In terms of the BP pattern, 8 (19%) subjects were dippers, 19 (45%) non-dippers, and 15 (36%) were risers. Five (45.46%) out of 11 patients with no evidence of hypertension (normotensive patients) had a daytime BP of 135/85 or higher. The mean daytime BP was 135/85 or higher in 12 (38.7%) out of 31 nonagenarians who had previously received therapy for hypertension. In, conclusion a high prevalence of hypertension, misdiagnosis and inadequate BP control was found in nonagenarians treated for hypertension. PMID:18423650

  9. Ambulatory device for surface EMG recordings.

    PubMed

    Airaksinen, O; Airaksinen, K

    1998-01-01

    The principles of electromyographic (EMG) analysis can be divided into the following groups: signal or motor unit shape analysis, amplitude analysis, multi-channel or successive time difference analysis, signal frequency composition analysis, change of frequency time based analysis based on simultaneous amplitude or frequency based analysis or concentric and excentric work based shape and amplitude ratio analysis. The aim of this paper is to present an ambulatory portable device for surface EMG analysing both for integrated EMG and for spectral analysis. The reliability of surface EMG recordings have established. The recent new technology gets a possibility to measure by reliable way surface EMG on-line during exercise, rehabilitation or occupational conditions. Portable EMG measurement unit and analysing program seems to be suitable for documentation of the response of rehabilitation programs, effects of physiotherapy, analysing the muscle balance and activity of sportsman and for documentation of occupational health problems. Automatic interpretation and wide data base for patient data makes the system useful in daily practice. PMID:9607100

  10. The accuracy and performance of the A&D TM 2421, a new ambulatory blood pressure monitoring device based on the cuff-oscillometric method and the Korotkoff sound technique.

    PubMed

    Imai, Y; Sasaki, S; Minami, N; Munakata, M; Hashimoto, J; Sakuma, H; Sakuma, M; Watanabe, N; Imai, K; Sekino, H

    1992-10-01

    The accuracy and performance of the A&D TM 2421, a new ambulatory blood pressure (BP) monitoring device using both the cuff-oscillometric method (O) and the Korotkoff sound method (K) were evaluated. The device was tested for accuracy under static and dynamic conditions by simultaneous comparison with two observers using a standard mercury column sphygmomanometer (standard method) and by the objective recording method (ORM). The performance of the device was also evaluated under ordinary ambulatory conditions. The mean differences in BP of standard method from K-method were -1.2 +/- 4.7 mm Hg systole and 1.3 +/- 4.7 mm Hg diastole (n = 323, mean +/- SD) and those of standard method from O-method were -0.4 +/- 5.3 mm Hg systole and 1.4 +/- 5.1 mm Hg diastole (n = 323). The agreement between each of the two methods of the device and the standard method was within 10 mm Hg for more than 90% of both systolic and diastolic readings. During bicycle exercise, the mean differences in BP of standard method from K-method were -3.4 +/- 4.8 mm Hg systole and 1.8 +/- 5.2 mm Hg diastole (n = 71) and those of standard method from O-method were -1.1 +/- 7.3 mm Hg systole and 1.7 +/- 7.8 mm Hg diastole (n = 67). There was a greater scatter in the individual comparisons of the device and the standard method during exercise, especially in diastolic BP. The relation between the device and ORM was almost similar to that between the device and the standard method.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1418835

  11. Surgical Site Infections Following Pediatric Ambulatory Surgery: An Epidemiologic Analysis.

    PubMed

    Rinke, Michael L; Jan, Dominique; Nassim, Janelle; Choi, Jaeun; Choi, Steven J

    2016-08-01

    OBJECTIVE To identify surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes. DESIGN Retrospective chart review of pediatric ambulatory surgeries with International Classification of Disease, Ninth Revision (ICD-9) codes for SSI, and a systematic random sampling of 5% of surgeries without SSI ICD-9 codes, all adjudicated for SSI on the basis of an ambulatory-adapted National Healthcare Safety Network definition. SETTING Urban pediatric tertiary care center April 1, 2009-March 31, 2014. METHODS SSI rates and sensitivity and specificity of ICD-9 codes were estimated using sampling design, and risk factors were analyzed in case-rest of cohort, and case-control, designs. RESULTS In 15,448 pediatric ambulatory surgeries, 34 patients had ICD-9 codes for SSI and 25 met the adapted National Healthcare Safety Network criteria. One additional SSI was identified with systematic random sampling. The SSI rate following pediatric ambulatory surgery was 2.9 per 1,000 surgeries (95% CI, 1.2-6.9). Otolaryngology surgeries demonstrated significantly lower SSI rates compared with endocrine (P=.001), integumentary (P=.001), male genital (P<.0001), and respiratory (P=.01) surgeries. Almost half of patients with an SSI were admitted, 88% received antibiotics, and 15% returned to the operating room. No risk factors were associated with SSI. The sensitivity of ICD-9 codes for SSI following ambulatory surgery was 55.31% (95% CI, 12.69%-91.33%) and specificity was 99.94% (99.89%-99.97%). CONCLUSIONS SSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children. Infect Control Hosp Epidemiol 2016;37:931-938. PMID:27121727

  12. Artificial Gravity with Ergometric Exercise Training Improves Cardiovascular Function in Ambulatory Men

    NASA Astrophysics Data System (ADS)

    Sun, Xi-Qing; Zhu, Chao; Shang, Shu; Yao, Yong-Jie

    2008-06-01

    The necessity of preventing physiological deconditioning in astronauts exposed to long-term space flights is well known. Artificial gravity training via short-arm centrifugation as a countermeasure to microgravity has been considered for many years. However, an optimal duration, level and rate of exposure to artificial gravity have not yet been determined. The purpose of the present study was to investigate the cardiovascular effects of three weeks of intermittent artificial gravity with ergometric exercise training on normal ambulatory men. During 3 weeks experiment, eight healthy male subjects received alternate +1 to +2 Gz (at the foot) short-arm centrifuge training with 30 W ergometric exercise for 30 min per day. Cardiac function, heart rate variability, heart rate and blood pressure were measured before and after training. Stroke volume and total peripheral resistance increased significantly after 3 weeks training, compared with the pre-training baseline. Left ventricular ejection time (LVET) and ejection fraction increased significantly after 3 weeks training, while heart rate, the ratio of pre-ejection period to LVET, and the ratio of low frequency to high frequency power decreased significantly after 3 weeks training. These results suggest that three weeks short-arm centrifuge training with ergometric exercise could improve human cardiac systolic and pumping functions, and increase cardiac vagal modulation.

  13. A comparison of systolic blood pressure measurement obtained using a pulse oximeter, and direct systolic pressure measurement in anesthetized sows.

    PubMed Central

    Caulkett, N A; Duke, T; Bailey, J V

    1994-01-01

    Systolic blood pressure measurement obtained with a pulse oximeter has been compared to values obtained by other indirect methods in man. Direct pressure measurement is subject to less error than indirect techniques. This study was designed to compare systolic pressure values obtained using a pulse oximeter, with values obtained by direct arterial pressure measurement. The pulse oximeter waveform was used as an indication of perfusion. A blood pressure cuff was applied proximal to the pulse oximeter probe. The cuff was inflated until the oximeter waveform disappeared, this value was recorded as the systolic pressure at the disappearance of the waveform (SPD). The cuff was inflated to a pressure > 200 mmHg, then gradually deflated until the waveform reappeared, this value was recorded as the systolic pressure at reappearance of the waveform (SPR). The average of the two values, SPD and SPR, was calculated and recorded as SPA. The study was performed in sows (n = 21) undergoing cesarean section under epidural anesthesia and IV sedation. A total of 280 measurements were made of SPD, SPR and SPA. Regression analysis of SPA and direct measurement revealed a correlation coefficient (r) of 0.81. Calculation of mean difference (bias) and standard deviation of the bias (precision) for direct pressure--SPA revealed a value of 1.3 +/- 12.1. When compared with direct measurement, the correlation of this technique was similar to that recorded for other indirect techniques used in small animals. This indicates that this technique would be useful for following systolic pressure trends.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8004540

  14. Transitioning the RN to Ambulatory Care: An Investment in Orientation.

    PubMed

    Allen, Juliet Walshe

    2016-01-01

    Registered nurses (RNs) struggle when transitioning from the inpatient setting to the outpatient clinical environment because it results in a diverse skill-set shift. The RN, considered an outpatient revenue source, experiences a decrease in peer-to-peer relationships, changes in leadership responsibilities, and changes in workgroup dynamics (supervision of unlicensed clinical personnel who function under the direction of the physician, not the RN). Ambulatory organizations find themselves implementing clinical orientation programs that may not delineate the attributes of the RN. This diminishes their value while emphasizing the unlicensed technical skill set. Creating a core RN orientation program template is paramount for the transition of the RN to the ambulatory setting. The literature reveals several areas where improving the value of the RN will ultimately enhance recruitment and retention, patient care outcomes, and leverage the RN role within any organization. Eleven 30-minute in-depth telephone interviews were conducted in addition to 4 nurse observations to explore the lived experience of the RN in ambulatory care. The findings disclosed an overarching theme of nurse isolation and offered insightful underpinnings for the nurse leader as ambulatory growth continues and nurse leaders further endorse the RN presence in the ambulatory setting. PMID:26938183

  15. Left Ventricular Systolic and Diastolic Function in Patients With Apical Ballooning Syndrome Compared With Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction: A Functional Paradox

    PubMed Central

    Park, Seong-Mi; Prasad, Abhiram; Rihal, Charanjit; Bell, Malcolm R.; Oh, Jae K.

    2009-01-01

    OBJECTIVE: To compare left ventricular (LV) systolic and diastolic function in patients with apical ballooning syndrome (ABS) and those with acute myocardial infarction (AMI) using 2-dimensional Doppler echocardiography and strain rate imaging (SRI). PATIENTS AND METHODS: We prospectively enrolled patients with newly diagnosed AMI and ABS who had akinetic apical walls. Both 2-dimensional Doppler echocardiography and SRI were performed on hospital day 1 or within 24 hours of primary percutaneous coronary intervention. RESULTS: Twenty-four patients with AMI and 13 patients with ABS (mean ± SD age, 63±15 vs 73±12 years; P=.03) were prospectively enrolled in the study from October 3, 2005 through July 12, 2006. The mean ± SD LV end-diastolic volume was larger (58.1±9.1 vs 45.2±10.6 mL/m2; P<.001) and the mean ± SD LV ejection fraction was lower (35%±6% vs 43%±9%; P=.006) in patients with ABS compared with patients with AMI. The early diastolic mitral annular velocity was similar (0.06±0.02 vs 0.06±0.02 m/s; P=.85) in both groups, but the ratio of early diastolic mitral valve inflow velocity to early diastolic mitral annulus velocity was higher in patients with AMI than in patients with ABS (16.3±6.9 vs 12.2±3.2; P=.05). The systolic strain rate was decreased at the apex in both groups (P=.98). Both the early diastolic strain rate of the apex (0.64±0.24 vs 0.48±0.30 s-1; P=.04) and the postsystolic shortening index of the apex (61%±15% vs 45%±23%; P=.006) were higher in the patients with ABS than in those with AMI. However, early diastolic SR was higher in the akinetic apical walls of patients with AMI with recovery than those with no recovery (0.64±0.35 vs 0.43±0.25 s-1; P=.04) and was similar between akinetic apical walls of patients with AMI with recovery and the akinetic apical walls of ABS. CONCLUSION: Compared with patients with AMI, those with ABS showed the functional paradox of worse initial LV systolic function with larger LV size but better

  16. Ambulatory laparoscopic cholecystectomy: A single center experience

    PubMed Central

    Tiryaki, Cagri; Bayhan, Zülfü; Kargi, Ertugrul; Alponat, Ahmet

    2016-01-01

    AIM: To evaluate the demographic and clinical parameters affecting the outcomes of ambulatory laparoscopic cholecystectomy (ALC) in terms of pain, nausea, anxiety level, and satisfaction of patients in a tertiary health center. MATERIALS AND METHODS: ALC was offered to 60 patients who met the inclusion criteria. Follow-up (questioning for postoperative pain or discomfort, nausea or vomiting, overall satisfaction) was done by telephone contact on the same day at 22:00 p.m. and the first day after surgery at 8: 00 a.m. and by clinical examination one week after operation. STAI I and II data were used for proceeding to the level of anxiety of patients before and/or after the operation. RESULTS: Sixty consecutive patients, with a mean age of 40.6 ± 8.1 years underwent ALC. Fifty-five (92%) patients could be sent to their homes on the same day but five patients could not be sent due to anxiety, pain, or social indications. Nausea was reported in four (6.7%) cases and not associated with any demographic or clinical features of patients. On the other hand, pain has been reported in 28 (46.7%) cases, and obesity and shorter duration of gallbladder disease were associated with the increased pain perception (P = 0.009 and 0.004, respectively). Preopereative anxiety level was significantly higher among patients who could not complete the ALC procedure (P = 0.018). CONCLUSION: Correct management of these possible adverse effects results in the increased satisfaction of patients and may encourage this more cost-effective and safe method of laparoscopic cholecystectomy. PMID:26917919

  17. Adaptive compression of the ambulatory electrocardiogram.

    PubMed

    Hamilton, P S

    1993-01-01

    Previous use of the MIT/BIH arrhythmia database, on analog tape, to investigate compression of ambulatory ECG data by average beat subtraction, residual differencing, and Huffman coding of the residuals had shown that with a quantization level of 35 mu V and a sample rate of 100 samples per second, it was possible to store ECG data with average data rates of 174 bits per second (bps), but because of the variation in ECG signals, data rates for different records ranged from 144 bps to 230 bps. In a practical storage system, it is desirable to fix the maximum data rate and store data with a minimum of distortion. For this study the previous compression algorithm was modified to adapt its quantization level to different ECG signal conditions. Two adaptation strategies were investigated. Both adapt the quantization-step size according to the number of bytes required for storing the coded signal, beat arrival times, and beat classifications. The new compression algorithm was tested with data from the MIT/BIH database on CD ROM. With the more successful of the two strategies, the adaptive compression algorithm stored MIT/BIH records with a difference of only 0.8 bps between the record with the highest data rate and the record with the lowest data rate. The average data rate for the entire database was 193.3 bps. Signal-to-compression noise ratios varied from record to record and varied over time for a given record. Average signal to compression noise ratios varied from 26.82 to 532.83. PMID:8418967

  18. [Ambulatory invasive and noninvasive blood pressure monitoring].

    PubMed

    Bachmann, K; Wortmann, A; Engels, G

    1989-08-01

    Indirect arterial blood pressure measurement has not changed substantially since its introduction by Riva-Rocci in 1986, Korotkoff in 1905 and Recklinghausen in 1906. Random measurements in the clinic or practice reflect only incompletely the dynamic nature of the blood pressure. Blood pressure recordings by patients themselves have provided more information through better temporal resolution, however, exact characterization of the pressure response throughout the entire day and, in particular, during physical exertion are not enabled; the latter are especially important with regard to diagnosis and treatment of hypertension. In 1966, therefore, radiotelemetric transmission of direct, continuously-measured arterial blood pressure was developed which enabled beat-to-beat registration of blood pressure, outside the laboratory, during normal daily life and sport activities. The initial results showed a marked variability of the blood pressure during the course of the day (Figure 1). Excessive blood pressure increases were observed during exposure to cold, static and dynamic exercise and to a lesser degree during automobile driving and exposure to heat (Figure 3). Recording of the pressure curves via transmission by radiotelemetry shows a high degree of accuracy and temporal resolution, spatial and situational freedom but is invasive and costly in terms of personnel. The same holds true for direct continuous blood pressure registration and storage on a portable tape recorder. Portable, automatic blood pressure measuring units for ambulatory monitoring employ indirect auscultatory or oscillometric recording with a cuff. As compared with the radiotelemetric direct continuous blood pressure measuring method, the indirect method has subordinate temporal resolution, that is, the measurements are only intermittent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2676813

  19. Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations.

    PubMed

    Hansen, T W; Thijs, L; Li, Y; Boggia, J; Liu, Y; Asayama, K; Kikuya, M; Björklund-Bodegård, K; Ohkubo, T; Jeppesen, J; Torp-Pedersen, C; Dolan, E; Kuznetsova, T; Stolarz-Skrzypek, K; Tikhonoff, V; Malyutina, S; Casiglia, E; Nikitin, Y; Lind, L; Sandoya, E; Kawecka-Jaszcz, K; Filipovský, J; Imai, Y; Wang, J; O'Brien, E; Staessen, J A

    2014-09-01

    Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (<20.7 kg m(-2)) predicted death (hazard ratio (HR) vs average risk, 1.52; P<0.0001) and high BMI (> or = 30.9 kg m(-2)) predicted the cardiovascular end point (HR, 1.27; P=0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P<0.001) and 0.98 (P=0.91), respectively. Across quartiles of the BMI distribution, 24-h and nighttime systolic BP predicted every end point (1.13 < or = standardized HR < or = 1.67; 0.046 < or = P<0.0001). The interaction between systolic BP and BMI was nonsignificant (P > or = .22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI. PMID:24430701

  20. 24-h ambulatory blood pressure monitoring in healthy young adult Anglo, Hispanic, and African-American subjects.

    PubMed

    Chase, H P; Garg, S K; Icaza, G; Carmain, J A; Walravens, C F; Marshall, G

    1997-01-01

    The purpose of this study was to compare office and 24-h ambulatory blood pressure (ABP) values for adolescent and young adult males and females of Anglo, Hispanic, and African-American descent. One hundred and eighteen healthy subjects (62 females, 56 males) participated, with an ethnic distribution of 50 Anglo, 32 Hispanic, and 36 African-American subjects. All subjects came to the clinic for height, weight, sitting blood pressure (BP), and to begin 24-h ABP monitoring using the SpaceLabs model 90207 automatic noninvasive monitor. The monitor recorded readings every 0.5 h from 06:00 to 22:00 and every hour at night from 22:00 to 06:00. Office systolic and diastolic BP values were higher for all males compared to all females. Mean 24-h, nighttime, and daytime systolic ABP values were also significantly higher for males compared to females. The 24-h mean and daytime systolic ABP values were significantly different by ethnic groups. The African-American subjects always had the highest readings. Mean 24-h diastolic ABP was also significantly different by ethnic groups, with the African-American subjects being higher than the Anglos or the Hispanics. Diastolic ABP (24-h mean, daytime, and nighttime) values (for all subjects combined) increased gradually and varied significantly with age. This study provides preliminary normative data about ABP in an understudied population (ie, teenagers and young adults of different ethnic backgrounds). It also shows that higher blood pressures are present among males and among subjects of African-American descent in the teenage and young adult population. PMID:9008244

  1. Systolic multiplier for finite fields gf(2/sup m/)

    SciTech Connect

    Yeh, C.S.; Reed, I.S.

    1983-01-01

    A systolic architecture is developed for performing the product-sum computation, ab+c, in the finite field gf(2/sup m/) of 2/sup m/ elements, where a, b and c are arbitrary elements of gf(2/sup m/). The multiplier is a serial-in, serial-out, one-dimensional systolic array. This multiplier for gf(2/sup m/) requires m basic cells. The average time per computation of the multiplier is m time units if a number of computations are computed consecutively. To perform an isolated computation the multiplier requires 3m time units. The architecture is simple and regular and possesses the desirable properties of concurrency and modularity and is well suited for use. 10 references.

  2. Systolic emulator experimentation. Report for April 1987-April 1990

    SciTech Connect

    Smith, R.N.; Fenton, M.W.

    1990-07-01

    Adaptive spatial filtering or adaptive antenna nulling techniques have been used to remove or eliminate directional electromagnetic interferences or unwanted signals from getting into radio receivers. This signal processing technique has been studied for many years. Many systems have been proposed, some have built and a few have been fielded. High speed parallel processors are beginning to show promise in providing real-time solutions for meeting the processing requirements needed for space applications. One type of high speed parallel processor architecture is called systolic. The name arises from the way the data pulses through the cell-like structure of the processor in a prescribed pipelined manner. Effective implementation of adaptive signal processing techniques using systolic array processors, especially, required careful matching between the algorithm to be performed and the processor architecture. This process of matching algorithm and architecture can be facilitated by computer emulation.

  3. [Arterial hypertension in special situations: mild, systolic and in pregnancy].

    PubMed

    Luque Otero, M; Fernández Pinilla, C

    1990-01-01

    Mild hypertension is very common, 50% of hypertensives being with their diastolic BP between 90 and 104 mmHg. Many large studies, especially HDFP, had shown not only the deleterious cardiovascular effects of mild hypertension but also the benefits obtained with the therapy. The non-pharmacological approach should be the first step in the treatment of mild hypertension. Isolated systolic hypertension have a high prevalence in the elderly, increasing the cardiovascular morbidity and mortality. Sodium restriction and, if necessary, vasodilators increasing the arterial compliance seem to be the logical approach to treat isolated systolic hypertension. Finally, eclampsia is the most serious complication of pregnancy - induced hypertension. The treatment with bed rest and either betablockers or methyldopa is beneficial. If eclampsia occurs hydralazine, magnesium sulphate or nifedipine should be used. PMID:2186454

  4. LU and Cholesky decomposition on an optical systolic array processor

    NASA Technical Reports Server (NTRS)

    Casasent, D.; Ghosh, A.

    1983-01-01

    Direct solutions of matrix-vector equations on an optical systolic array processor are considered. The solutions are discussed and a parallel algorithm for LU matrix decomposition that is very attractive for an optical realization is formulated. It is noted that when direct techniques are used, it is preferable to realize the matrix decomposition on an optical system and to utilize a digital processor for the solution of the simplified resultant matrix-vector problem. One method of realizing LU matrix decomposition on a new frequency-multiplexed optical systolic array matrix-matrix processor is described. A simple method for extending the process of LU decomposition to Cholesky decomposition on the optical processor is discussed.

  5. Fabrication of fault-tolerant systolic array processors

    SciTech Connect

    Golovko, V.A.

    1995-05-01

    Methods for designing fault-tolerant systolic array processors are discussed. Several ways of bypassing faulty elements in configurations, which depend on an input-data flow organization, are suggested. An analysis of the additional hardware costs of providing fault tolerance by various techniques and for various levels of redundancy is presented. Hadamard fault-tolerant processor design was used to illustrate the efficiency of the techniques suggested.

  6. Two-Dimensional Systolic Array For Kalman-Filter Computing

    NASA Technical Reports Server (NTRS)

    Chang, Jaw John; Yeh, Hen-Geul

    1988-01-01

    Two-dimensional, systolic-array, parallel data processor performs Kalman filtering in real time. Algorithm rearranged to be Faddeev algorithm for generalized signal processing. Algorithm mapped onto very-large-scale integrated-circuit (VLSI) chip in two-dimensional, regular, simple, expandable array of concurrent processing cells. Processor does matrix/vector-based algebraic computations. Applications include adaptive control of robots, remote manipulators and flexible structures and processing radar signals to track targets.

  7. Preserved Left Ventricular, Systolic Function in Clinical Congestive Heart Failure

    PubMed Central

    Lee, Bang Hun; Kim, Jeong Hyun; Lim, Heon Kil; Lee, Chung Kyun

    1987-01-01

    Although clinical congestive heart failure (CHF) is associated with significant left ventricular (LV) systolic dysfunction, recently it has been recognized that LV diastolic dysfunction also may occur in the absence of abnormal systolic performance. A retrospective study evaluated 23 patients with myocardial infarction and CHF who had undergone multigated blood pool scintigraphy and were found to have normal LV ejection fraction (≥ 50%). Average rapid filling velocity (RFV) and slow filling velocity (SFV) were both significantly reduced in CHF patients (5.1 ± 1.3 unit/s, 2.2 ± 1.4 unit/s respectively) compared with normal control group (3.9 ± 1.2 unit/s, 1.3 ± 0.8 unit/s respectively). Rapid filling time and total diastolic time were also significantly prolonged in CHF patients (p<0.01, p<0.05 respectively). There were no significant changes in heart rate and blood pressure between two groups. Thus, normal systolic LV function is encountered in patients with CHF and it appears to be prudent to evaluate diastolic performance as well for optimal therapeutic strategies for CHF patients. PMID:3154818

  8. Systolic array architecture for real-time Gabor decomposition

    NASA Astrophysics Data System (ADS)

    Iyengar, Giridharan; Panchanathan, Sethuraman

    1992-11-01

    In this paper, we propose a combined systolic array--content addressable memory architecture for image compression using Gabor decomposition. Gabor decomposition is attractive for image compression since the basis functions match the human visual profiles. Gabor functions also achieve the lowest bound on the joint entropy of data. However these functions are not orthogonal and hence an analytic solution for the decomposition does not exist. Recently it has been shown that Gabor decomposition can be computed as a multiplication between a transform matrix and a vector of image data. Systolic arrays are attractive for matrix multiplication problems and content addressable memories (CAM) offer fast means of data access. For an n X n image, the proposed architecture for Gabor decomposition consists of a linear systolic array of n processing elements each with a local CAM. Simulations and complexity studies show that this architecture can achieve real-time performance with current technology. This architecture is modular and regular and hence it can be implemented in VLSI as a codec.

  9. Ambulatory Monitoring in the Genetics of Psychosomatic Medicine

    PubMed Central

    Finan, Patrick H.; Tennen, Howard; Thoemmes, Felix; Zautra, Alex J.; Davis, Mary C.

    2015-01-01

    Psychosomatic disorders are comprised of an array of psychological, biological, and environmental features. The existing evidence points to a role for genetic factors in explaining individual differences in the development and maintenance of a variety of disorders, but studies to date have not shown consistent and replicable effects. As such, the attempt to uncover individual differences in the expression of psychosomatic disorders as a function of genetic architecture requires careful attention to their phenotypic architecture, or the various intermediate phenotypes that make up a heterogeneous disorder. Ambulatory monitoring offers a novel approach to measuring time-variant and situation-dependent intermediate phenotypes. Recent examples of the use of ambulatory monitoring in genetic studies of stress reactivity, chronic pain, alcohol use disorders, and psychosocial resilience are reviewed in an effort to highlight the benefits of ambulatory monitoring for genetic study designs. PMID:22582332

  10. Comparing ambulatory preceptors' and students' perceptions of educational planning.

    PubMed

    Qualters, D M; Regan, M B; O'Brien, M C; Stone, S L

    1999-03-01

    To compare ambulatory preceptors' and students' perceptions of the use of educational planning (setting goals, assessing needs, formulating objectives, choosing methods, and providing feedback and evaluation) in the office setting, we mailed a survey, which was returned by 127 longitudinal ambulatory preceptors and 168 first-year and second-year medical students. Faculty perceptions did not match student perceptions of what occurred in the longitudinal preceptor program teaching sessions in educational planning areas. Students perceived these activities were occurring with much less frequency than faculty perceived. Medical education needs to move beyond the usual faculty development workshop paradigm to a more comprehensive educational development model that includes training both faculty and students in core educational skills. This will enable the ambulatory setting to reach its full educational potential in training future physicians. PMID:10203628

  11. A Twelve-Year Experience in Ambulatory Surgery within Urology

    PubMed Central

    Navalón, Pedro; Pallás, Yoni; Navalón, Victor; Ordoño, Felipe; Monllor, Elisa

    2012-01-01

    Purpose. The aim of this study is to show you the results we obtained through the integration of the Urology Department into the Ambulatory Surgery Unit for the very first twelve years. Scope. We will explain both the criteria we followed for patients to join in and the surgical and anesthetic procedures we used with those 1544 patients who were ambulatory subjected to urological diseases. After those patients were treated, they reached up to 95% of reasonable results. Conclusions. Most of urological patients liable to have surgical treatment are bound to be included in an ambulatory surgery program, which implies neither a worse healthcare service standard nor a worse satisfaction in patients. PMID:22530152

  12. Designing appointment scheduling systems for ambulatory care services.

    PubMed

    Cayirli, Tugba; Veral, Emre; Rosen, Harry

    2006-02-01

    The current climate in the health care industry demands efficiency and patient satisfaction in medical care delivery. These two demands intersect in scheduling of ambulatory care visits. This paper uses patient and doctor-related measures to assess ambulatory care performance and investigates the interactions among appointment system elements and patient panel characteristics. Analysis methodology involves simulation modeling of clinic sessions where empirical data forms the basis of model design and assumptions. Results indicate that patient sequencing has a greater effect on ambulatory care performance than the choice of an appointment rule, and that panel characteristics such as walk-ins, no-shows, punctuality and overall session volume, influence the effectiveness of appointment systems. PMID:16613016

  13. Systolic array architecture for convolutional decoding algorithms: Viterbi algorithm and stack algorithm

    SciTech Connect

    Chang, C.Y.

    1986-01-01

    New results on efficient forms of decoding convolutional codes based on Viterbi and stack algorithms using systolic array architecture are presented. Some theoretical aspects of systolic arrays are also investigated. First, systolic array implementation of Viterbi algorithm is considered, and various properties of convolutional codes are derived. A technique called strongly connected trellis decoding is introduced to increase the efficient utilization of all the systolic array processors. The issues dealing with the composite branch metric generation, survivor updating, overall system architecture, throughput rate, and computations overhead ratio are also investigated. Second, the existing stack algorithm is modified and restated in a more concise version so that it can be efficiently implemented by a special type of systolic array called systolic priority queue. Three general schemes of systolic priority queue based on random access memory, shift register, and ripple register are proposed. Finally, a systematic approach is presented to design systolic arrays for certain general classes of recursively formulated algorithms.

  14. Association of Smoking, Sleep Apnea, and Plasma Alkalosis With Nocturnal Ventricular Arrhythmias in Men With Systolic Heart Failure

    PubMed Central

    Shukla, Rakesh; Wexler, Laura

    2012-01-01

    Background: Excess sudden death due to ventricular tachyarrhythmias remains a major mode of mortality in patients with systolic heart failure. The aim of this study was to determine the association of nocturnal ventricular arrhythmias in patients with low ejection fraction heart failure. We incorporated a large number of known pathophysiologic triggers to identify potential targets for therapy to reduce the persistently high incidence of sudden death in this population despite contemporary treatment. Methods: Eighty-six ambulatory male patients with stable low (≤ 45%) ejection fraction heart failure underwent full-night attendant polysomnography and simultaneous Holter recordings. Patients were divided into groups according to the presence or absence of couplets (paired premature ventricular excitations) and ventricular tachycardia (VT) (at least three consecutive premature ventricular excitations) during sleep. Results: In multiple regression analysis, four variables (current smoking status, increased number of arousals, plasma alkalinity, and old age) were associated with VT and two variables (apnea-hypopnea index and low right ventricular ejection fraction) were associated with couplets during sleep. Conclusions: We speculate that cessation of smoking, effective treatment of sleep apnea, and plasma alkalosis could collectively decrease the incidence of nocturnal ventricular tachyarrhythmias and the consequent risk of sudden death, which remains high despite the use of β blockades. PMID:22172636

  15. The role of ambulatory blood pressure monitoring in clinical practice.

    PubMed

    Zanchetti, A

    1997-09-01

    The introduction of noninvasive techniques for the repetitive measurement of blood pressure in ambulant subjects has permitted improved precision in the assessment of hypertension during normal daily life. The traditional clinic (or "office") method of blood pressure measurement has the advantages of simplicity and low cost, and forms the basis of the current operational definitions of hypertension, but it is limited by the normal variability of blood pressure and the "white coat effect." By contrast, ambulatory blood pressure provides information on circadian variations in blood pressure and alterations due to changes in behavior, and may, therefore, be more appropriate for diagnosing hypertension. However, it is important to note that the values used to define normotension and hypertension for clinic blood pressure are not appropriate for ambulatory blood pressure. Recent population studies have proposed that the upper limit for 24-h ambulatory pressure should be 119 to 126/75 to 80 mm Hg, and failure to recognize this may account for at least some cases of "white-coat hypertension." There is increasing evidence that ambulatory blood pressure is more effective than clinic blood pressure in predicting the organ damage associated with hypertension, whereas data from intervention studies indicate that a reduction in ambulatory pressure is correlated with a reduction in left ventricular (LV) mass. Finally, ambulatory blood pressure measurements may provide a number of advantages in the development of antihypertensive therapies: by permitting better identification of trough and peak effects, by confirming that the efficacy of formulations for once-daily dosing is maintained throughout the 24-h period, and by minimizing the placebo effect. PMID:9324116

  16. [Hospital Costs of Ambulatory Care-Sensitive Conditions in Germany].

    PubMed

    Fischbach, D

    2016-03-01

    Ambulatory care-sensitive conditions (ACSC) are defined as conditions that lead to a hospital admission of which the onset could have been prevented through a more easily accessible ambulatory sector or one that provides better quality care. They are used by health-care systems as a quality indicator for the ambulatory sector. The definition for ACSC varies internationally. Sets of conditions have been defined and evaluated already in various countries, e. g., USA, England, New Zealand and Canada, but not yet for Germany. Therefore this study aims to evaluate the hospital costs of ACSC in Germany using the National Health Service's set of ACSC. In order to calculate these costs a model has been set up for the time period between 2003 and 2010. It is based on G-DRG browsers issued by the German Institute for the Hospital Remuneration System as required by German law. Within these browsers all relevant DRG-ICD combinations have been extracted. The number of cases per combination was then multiplied by their corresponding cost weights and the average effective base rates. The results were then aggregated into their corresponding ICD groups and then into their respective conditions which lead to the costs per condition and the total costs. The total number of cases and total costs were then compared to another second source. These calculations resulted in 11.7 million cases, of which 10.7% were defined as ambulatory care-sensitive. Within the analysed time period the number of ambulatory care-sensitive cases increased by 6% in total and had a 0.9% CAGR. The corresponding costs amounted to a total of EUR 37.6B and to EUR 3.3B for ACSC. 60% of the costs were caused by three of the 19 ACSC. These results validate that it is worthwhile to further investigate this quality indicator for the ambulatory sector. PMID:25918929

  17. 77 FR 70783 - Medicare and Medicaid Programs; Approval of the Accreditation Association for Ambulatory Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... Accreditation Association for Ambulatory Health Care (AAAHC) Application for Continuing CMS Approval of Its... Association for Ambulatory Health Care (AAAHC) for continued recognition as a national accrediting... by CMS. The Ambulatory Health Care's (AAAHC) current term of approval for their ASC...

  18. [Ambulatory surgery in France: practical and medicolegal considerations].

    PubMed

    Wodey, E; de la Brière, F

    2013-12-01

    In France, ambulatory anaesthesia and surgery seem to be well codified. Many recommendations have been published by the Health Authority and the professional associations: they are summarized in this review. However, numerous practical problems persist: for example, two situations specific to paediatric practice are problematic parental comprehension and application of the information provided and poor access to strong analgesics outside the hospital. Despite this, the paediatric population is an ideal target for ambulatory care because of its usual good health and quicker recovery after minor injury as proven by the small percentage of failure and readmission. PMID:24209990

  19. Teaching interdisciplinary geriatrics ambulatory care: a case study.

    PubMed

    Williams, Brent C; Remington, Tami L; Foulk, Mariko A; Whall, Ann L

    2006-01-01

    Interdisciplinary health care training is advocated by numerous government and philanthropic organizations. Educators in the health professions are increasingly offering training in interdisciplinary health care in a variety of contexts, including ambulatory settings. This paper describes a three-year program to teach skills in interdisciplinary care to learners from internal medicine, social work, pharmacy, and nursing in a geriatrics clinic at a major academic institution in the United States. Framed in a critical review of existing evidence for the effectiveness of interdisciplinary training and health care and expert recommendations, specific recommendations are made to educators interested in interdisciplinary training in ambulatory settings. PMID:16446270

  20. Ambulatory surgery centers--current business and legal issues.

    PubMed

    Becker, S; Biala, M

    2000-01-01

    This article explores a handful of critical trends that have broad implications for ambulatory surgery centers and health care entities as a whole. As of the year 2000, the health care delivery system is experiencing broad changes and reconstruction in a variety of manners. One of the largest changes revolves around the accelerating movement of patient care from inpatient models to outpatient models, and the commensurate investment and development in outpatient systems and outpatient bricks and mortar. This metamorphosis is particularly evident as it relates to freestanding ambulatory surgery centers. This change in health care delivery will prove to have severe economic impacts on many of the nation's hospital systems. PMID:11140547