Sample records for conduction delay ivcd

  1. ECG parameters predict left ventricular conduction delay in patients with left ventricular dysfunction.

    PubMed

    Pastore, Gianni; Maines, Massimiliano; Marcantoni, Lina; Zanon, Francesco; Noventa, Franco; Corbucci, Giorgio; Baracca, Enrico; Aggio, Silvio; Picariello, Claudio; Lanza, Daniela; Rigatelli, Gianluca; Carraro, Mauro; Roncon, Loris; Barold, S Serge

    2016-12-01

    Estimating left ventricular electrical delay (Q-LV) from a 12-lead ECG may be important in evaluating cardiac resynchronization therapy (CRT). The purpose of this study was to assess the impact of Q-LV interval on ECG configuration. One hundred ninety-two consecutive patients undergoing CRT implantation were divided electrocardiographically into 3 groups: left bundle branch block (LBBB), right bundle branch block (RBBB), and nonspecific intraventricular conduction delay (IVCD). The IVCD group was further subdivided into 81 patients with left (L)-IVCD and 15 patients with right (R)-IVCD (resembling RBBB, but without S wave in leads I and aVL). The Q-LV interval in the different groups and the relationship between ECG parameters and the maximum Q-LV interval were analyzed. Patients with LBBB presented a long Q-LV interval (147.7 ± 14.6 ms, all exceeding cutoff value of 110 ms), whereas RBBB patients presented a very short Q-LV interval (75.2 ± 16.3 ms, all <110 ms). Patients with an IVCD displayed a wide range of Q-LV intervals. In L-IVCD, mid-QRS notching/slurring showed the strongest correlation with a longer Q-LV interval, followed, in decreasing order, by QRS duration >150 ms and intrinsicoid deflection >60 ms. Isolated mid-QRS notching/slurring predicted Q-LV interval >110 ms in 68% of patients. The R-IVCD group presented an unexpectedly longer Q-LV interval (127.0 ± 12.5 ms; 13/15 patients had Q-LV >110 ms). Patients with LBBB have a very prolonged Q-LV interval. Mid-QRS notching in lateral leads strongly predicts a longer Q-LV interval in L-IVCD patients. Patients with R-IVCD constitute a subgroup of patients with a long Q-LV interval. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  2. Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure.

    PubMed

    Cinca, Juan; Mendez, Ana; Puig, Teresa; Ferrero, Andreu; Roig, Eulalia; Vazquez, Rafael; Gonzalez-Juanatey, Jose R; Alonso-Pulpon, Luis; Delgado, Juan; Brugada, Josep; Pascual-Figal, Domingo

    2013-08-01

    Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted.

  3. Involvement of DPP IV/CD26 in cutaneous wound healing process in mice.

    PubMed

    Baticic Pucar, Lara; Pernjak Pugel, Ester; Detel, Dijana; Varljen, Jadranka

    2017-01-01

    Dipeptidyl peptidase IV (DPP IV/CD26) is a widely distributed multifunctional protein that plays a significant role in different physiological as well as pathological processes having a broad spectrum of bioactive substrates and immunomodulative properties. It has potential influence on different processes crucial for wound healing, including cell adhesion, migration, apoptosis, and extracellular matrix degradation. However, despite its known enzymatic and immunomodulative functions, limited data characterize the role of DPP IV/CD26 in cutaneous wound healing mechanisms. The aim of this study was to investigate the process of wound healing in conditions of CD26 deficiency in order to obtain better insights on the role of DPP IV/CD26 in cutaneous regeneration. Experimental wounds were made on the dorsal part of CD26 deficient (CD26 -/- ) and wild-type mice (C57BL/6). The process of cutaneous wound healing was monitored on defined time schedule postwounding by macroscopic, microscopic, and biochemical analyses. Obtained results revealed a better rate of wound closure, revascularization and cell proliferation in CD26 -/- mice, with enhanced local expression of hypoxia-inducible factor 1α and vascular endothelial growth factor. CD26 deficiency induced prompt macrophage recruitment at the site of skin damage but did not influence mobilization of T-cells in comparison with wild-type mice. CD26 -/- mice have significantly higher values of IP-10 in serum and control skins compared with wild-type mice but values in wounds did not differ significantly on days 2, 4, and 7 of wound healing. DPP IV/CD26 activity was found to be decreased 4 days postwounding in serum and 2, 4, and 7 days postwounding in wounds of wild-type animals compared with control skins. These findings contribute to better understanding of wound healing mechanisms and could give a support in finding new therapeutic approaches for wound healing and tissue regeneration. © 2016 by the Wound Healing Society.

  4. Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children.

    PubMed

    Kwon, Hyuksool; Jung, Jae Yun; Lee, Jin Hee; Kwak, Young Ho; Kim, Do Kyun; Jung, Jin Hee; Chang, Ik Wan; Kim, Kyuseok

    2016-09-01

    Current studies have not found sufficient evidence to encourage the use of ultrasound for assessing dehydration in children. We introduce a new sonographic parameter, the "aorta/inferior vena cava (IVC) cross-sectional area index" (Ao/IVCA) measured just inferior to the xiphoid process, for the effective evaluation of dehydration in children. This is a prospective, observational study. We enrolled children who presented to the pediatric emergency department (PED) between May 2014 and January 2015. We measured the maximum diameter of the aorta from inner wall to inner wall, and the long and short axis diameters of IVC using a convex array transducer. Ao/IVCA was calculated and compared with aorta/IVC maximal diameter index (Ao/IVCD) and the clinical dehydration scale (CDS). A total of 34 children were enrolled. We found a statistically significant correlation between Ao/IVCA and CDS (R(2) = 0.30; P <.001). Ao/IVCD did not correlate significantly with CDS (R(2) = 0.08; P =.11). The ability of Ao/IVCA and Ao/IVCD to predict CDS ≥1 was assessed using the receiver operating characteristic analysis. The area under the receiver operating characteristic curve for Ao/IVCA was larger than that for Ao/IVCD (0.87 vs 0.75, P= .04). The cut-off value of Ao/IVCA that yielded the maximum value of Youden index was 1.81 (sensitivity: 72%, specificity: 89%). Ao/IVCA might be a promising index for the assessment of dehydration. The diagnostic performance of Ao/IVCA for dehydration might be higher than that of the method that uses the maximum diameter of IVC and the aorta. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Are classic predictors of voltage valid in cardiac amyloidosis? A contemporary analysis of electrocardiographic findings.

    PubMed

    Sperry, Brett W; Vranian, Michael N; Hachamovitch, Rory; Joshi, Hariom; McCarthy, Meghann; Ikram, Asad; Hanna, Mazen

    2016-07-01

    Low voltage electrocardiography (ECG) coupled with increased ventricular wall thickness is the hallmark of cardiac amyloidosis. However, patient characteristics influencing voltage in the general population, including bundle branch block, have not been evaluated in amyloid heart disease. A retrospective analysis was performed of patients with newly diagnosed cardiac amyloidosis from 2002 to 2014. ECG voltage was calculated using limb (sum of QRS complex in leads I, II and III) and precordial (Sokolow: S in V1 plus R in V5-V6) criteria. The associations between voltage and clinical variables were tested using multivariable linear regression. A Cox model assessed the association of voltage with mortality. In 389 subjects (transthyretin ATTR 186, light chain AL 203), 30% had conduction delay (QRS >120ms). In those with narrow QRS, 68% met low limb, 72% low Sokolow and 57% both criteria, with lower voltages found in AL vs ATTR. LV mass index as well as other typical factors that impact voltage (age, sex, race, hypertension, BSA, and smoking) in the general population were not associated with voltage in this cardiac amyloidosis cohort. Patients with LBBB and IVCD had similar voltages when compared to those with narrow QRS. Voltage was significantly associated with mortality (p<0.001 for both criteria) after multivariable adjustment. Classic predictors of ECG voltage in the general population are not valid in cardiac amyloidosis. In this cohort, the prevalence estimates of ventricular conduction delay and low voltage are higher than previously reported. Voltage predicts mortality after multivariable adjustment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Mass psychogenic illness: psychological predisposition and iatrogenic pseudo-vocal cord dysfunction and pseudo-reactive airways disease syndrome.

    PubMed

    Staudenmayer, Herman; Christopher, Kent L; Repsher, Lawrence; Hill, Ronald H

    2011-06-01

    A multidisciplinary team assessed five patients who alleged chronic medically unexplained multiorgan system symptoms described by idiopathic environmental intolerance allegedly triggered by exposure to solvents used in membrane roofing repair work on an office building. The event precipitated an incident of mass psychogenic illness (MPI). Treating physicians diagnosed irritant-associated vocal cord dysfunction (IVCD) and reactive airways disease syndrome (RADS) resulting from exposure. The authors conducted medical, psychological, and industrial hygiene evaluations. Air monitoring data for total volatile organic compounds obtained during the 2-day exposure period, measurements of emissions during membrane roofing repair at a similar site, mathematical modeling of air contaminant concentrations, and injection of tracer gas into the incident building revealed exposure levels well below those doses anticipated to cause clinical symptoms. There was no objective medical evidence validating symptoms. Review of the medical records indicated that the video laryngoscopy data, pulmonary function tests, and medical examinations relied upon by the treating physicians were inconsistent with published criteria for IVCD and RADS. Psychological evaluation identified defensiveness and self-serving misrepresentations of exaggerated health concerns associated with somatization and malingering. Each case had personality traits associated with at least one personality disorder. Social histories identified premorbid life events and stressors associated with distress. This is the first study to assess psychological predisposition, social interaction among the plaintiffs, and iatrogenic reinforcement of beliefs by diagnoses of pseudo-disorders associated with patient misrepresentation of exaggerated health concerns in an incident of MPI.

  7. Maternal bradycardia occurring prior to onset of HELLP syndrome in a woman with pre-eclampsia.

    PubMed

    Hosokawa, Ami; Umazume, Takeshi; Yamada, Takahiro; Minakami, Hisanori

    2017-05-13

    A 36-year-old nulliparous woman developed pre-eclampsia at gestational week (GW) 28 -6/7 Cardiac status was checked regularly. Heart rate of 93 beats per minute (bpm) with left atrial diameter (LAD) of 35 mm, left ventricular hypertrophy and inferior vena cava diameter (IVCD) of 8 mm at GW 32 -0/7 decreased to 48 bpm with an expanded IVCD to 25 mm, dilated left atrium (LAD to 39 mm), increased pulmonary arterial pressure, increased systemic vascular resistance (approximate 3000  dyn s/cm 5 ) and biphasic intrarenal venous flow pattern 3.5 hours prior to childbirth at GW 32 -3/7 Epigastralgia, tachycardia (160 bpm) and marked hypertension (201/111 mm Hg) occurring 2 hours after echocardiography necessitated caesarean section, with subsequent development of HELLP syndrome. Acute fluid shift from the splanchnic vasculature to central vasculature may have occurred causing HELLP syndrome as a result from vasospasm associated with sympathetic hyperactivity. The cause of bradycardia prior to tachycardia remains unclear. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Kinetic study of the processing by dipeptidyl-peptidase IV/CD26 of neuropeptides involved in pancreatic insulin secretion.

    PubMed

    Lambeir, A M; Durinx, C; Proost, P; Van Damme, J; Scharpé, S; De Meester, I

    2001-11-02

    Dipeptidyl-peptidase IV (DPPIV/CD26) metabolizes neuropeptides regulating insulin secretion. We studied the in vitro steady-state kinetics of DPPIV/CD26-mediated truncation of vasoactive intestinal peptide (VIP), pituitary adenylyl cyclase-activating peptide (PACAP27 and PACAP38), gastrin-releasing peptide (GRP) and neuropeptide Y (NPY). DPPIV/CD26 sequentially cleaves off two dipeptides of VIP, PACAP27, PACAP38 and GRP. GRP situates between the best DPPIV/CD26 substrates reported, comparable to NPY. Surprisingly, the C-terminal extension of PACAP38, distant from the scissile bond, improves both PACAP38 binding and turnover. Therefore, residues remote from the scissile bond can modulate DPPIV/CD26 substrate selectivity as well as residues flanking it.

  9. Evidence for an interaction between leptin, T cell costimulatory antigens CD28, CTLA-4 and CD26 (dipeptidyl peptidase IV) in BCG-induced immune responses of leptin- and leptin receptor-deficient mice.

    PubMed

    Rüter, Jens; Hoffmann, Torsten; Demuth, Hans-Ulrich; Moschansky, Petra; Klapp, Burghard F; Hildebrandt, Martin

    2004-06-01

    We assessed changes of the enzyme dipeptidyl peptidase IV (DPP IV, CD26) in the context of leptin or leptin receptor deficiency. C57BL/6 mice, Leptin-deficient mice (ob/ob mice, B6.V-Lep) and Leptin-receptor-deficient mice (db/db mice, B6.Cg-m+/+Lepr) were infected with B. Calmette-Guerin (BCG) and sacrificed three days later. DPP IV activity in serum was higher in ob/ob mice and in db/db mice than in wild-type mice. The expression of DPP IV/CD26 on splenocytes was higher in ob/ob mice than in wild-type animals, and lower in db/db mice, and decreased upon stimulation with BCG in ob/ob mice only. Several T cell antigens including CTLA-4 were expressed aberrantly in ob/ob and in db/db mice. Our observations provide evidence for a relationship between DPP IV and leptin.

  10. Atrial electromechanical conduction delay in patients with neurocardiogenic syncope.

    PubMed

    Sucu, Murat; Ercan, Suleyman; Uku, Okkes; Davutoglu, Vedat; Altunbas, Gokhan

    2014-05-01

    We aimed to investigate the presence of atrial electromechanical conduction delay in patients with neurocardiogenic syncope, which was diagnosed with head-up tilt table test (HUTT). A total of 29 patients (mean age: 30.6 ± 15.9 years) with vasovagal syncope, as diagnosed by HUTT, and 23 healthy control subjects (mean age: 34.7 ± 16.3 years) with a negative HUTT were enrolled to the study. Atrial electromechanical conduction delay was defined as the time elapsed from the beginning of the P wave in the electrogardiogram to the beginning of the Am wave in tissue Doppler. There was no statistically significant difference between the groups in terms of interatrial conduction delay, whereas the difference was significant with regard to the right intraatrial electromechanical conduction delay (P < 0.01) and the left intraatrial electromechanical conduction delay (P < 0.0001). There was a negative correlation between the left intraatrial electromechanical conduction delay and the right intraatrial electromechanical conduction delay (r = -0.486, P = 0.001), whereas a positive correlation was present with the interatrial electromechanical conduction delay (r = 0.507, P = 0.001). In this study, the tissue Doppler method revealed that there is left and right intraatrial electromechanical conduction delay in patients with vasovagal syncope. The impact and role of atrial conduction delay as a pathophysiological determinant should be confirmed in further studies. ©2013 Wiley Periodicals, Inc.

  11. Functional roles of cell surface peptidases in reproductive organs

    PubMed Central

    2004-01-01

    A number of biologically active peptides have been proposed to regulate function and differentiation of reproductive organs in an autocrine and/or paracrine fashion. Regulation of the local concentrations of these peptides is one of the important factors influencing their physiological effects on target cells. Membrane‐bound cell surface peptidases can activate or inactivate biologically active peptides before peptide factors access their receptors on the cell surface. Aminopeptidase A (EC 3.4.11.7), placental leucine aminopeptidase (EC 3.4.11.3), aminopeptidase‐N/CD13 (EC 3.4.11.2), dipeptidyl peptidases IV/CD26 (EC.3.4.14.5), carboxypeptidase‐M (EC 3.4.17.12), neutral endopeptidase/CD10 (EC 3.4.24.11) and endothelin converting enzyme‐1 (EC 3.4.23) are differentially expressed on the ovary, endometrium and placenta. The inhibition of enzyme activity affects steroid hormone production by granulosa and thecal cells, decidualization of endometrium and migration of extravillous trophoblasts. These findings suggest that membrane‐bound cell surface peptidases are local regulators for cellular growth and differentiation in reproductive organs by controlling extracellular concentration of peptide factors. (Reprod Med Biol 2004; 3: 165 –176) PMID:29662383

  12. Pacemaker mediated tachycardia as a complication of the autointrinsic conduction search function.

    PubMed

    Dennis, Malcolm J; Sparks, Paul B

    2004-06-01

    The autointrinsic conduction search (AICS) option, featured on some DDD pacemakers, performs periodic assessments of atrioventricular (AV) conduction capability during a single beat AV delay extension. Demonstration of ventricular conduction during the prolonged AV delay, permits ongoing AV delay extension if the patient's intrinsic conduction is preferred to ventricular pacing. A case is presented where the wide separation of atrial and ventricular pacing during the conduction search permitted retrograde ventriculoatrial conduction, precipitating pacemaker mediated tachycardia (PMT) on seven occasions in one patient. Two onset patterns are reported, both attributable to the AICS option. Recommendations for prevention strategies are made.

  13. Enhancement of delayed-rectifier potassium conductance by low concentrations of local anaesthetics in spinal sensory neurones

    PubMed Central

    Olschewski, Andrea; Wolff, Matthias; Bräu, Michael E; Hempelmann, Gunter; Vogel, Werner; Safronov, Boris V

    2002-01-01

    Combining the patch-clamp recordings in slice preparation with the ‘entire soma isolation' method we studied action of several local anaesthetics on delayed-rectifier K+ currents in spinal dorsal horn neurones.Bupivacaine, lidocaine and mepivacaine at low concentrations (1–100 μM) enhanced delayed-rectifier K+ current in intact neurones within the spinal cord slice, while exhibiting a partial blocking effect at higher concentrations (>100 μM). In isolated somata 0.1–10 μM bupivacaine enhanced delayed-rectifier K+ current by shifting its steady-state activation characteristic and the voltage-dependence of the activation time constant to more negative potentials by 10–20 mV.Detailed analysis has revealed that bupivacaine also increased the maximum delayed-rectifier K+ conductance by changing the open probability, rather than the unitary conductance, of the channel.It is concluded that local anaesthetics show a dual effect on delayed-rectifier K+ currents by potentiating them at low concentrations and partially suppressing at high concentrations. The phenomenon observed demonstrated the complex action of local anaesthetics during spinal and epidural anaesthesia, which is not restricted to a suppression of Na+ conductance only. PMID:12055132

  14. Maps of interaural delay in the owl's nucleus laminaris

    PubMed Central

    Shah, Sahil; McColgan, Thomas; Ashida, Go; Kuokkanen, Paula T.; Brill, Sandra; Kempter, Richard; Wagner, Hermann

    2015-01-01

    Axons from the nucleus magnocellularis form a presynaptic map of interaural time differences (ITDs) in the nucleus laminaris (NL). These inputs generate a field potential that varies systematically with recording position and can be used to measure the map of ITDs. In the barn owl, the representation of best ITD shifts with mediolateral position in NL, so as to form continuous, smoothly overlapping maps of ITD with iso-ITD contours that are not parallel to the NL border. Frontal space (0°) is, however, represented throughout and thus overrepresented with respect to the periphery. Measurements of presynaptic conduction delay, combined with a model of delay line conduction velocity, reveal that conduction delays can account for the mediolateral shifts in the map of ITD. PMID:26224776

  15. Evaluation of atrial electromechanical conduction delay in case of hemodynamically insignificant rheumatic heart disease: A tissue Doppler study.

    PubMed

    Cagdas, Metin; Velibey, Yalcin; Guvenc, Tolga Sinan; Gungor, Baris; Guzelburc, Ozge; Calik, Nazmi; Ugur, Murat; Tekkesin, Ahmet Ilker; Gurkan, Kadir; Eren, Mehmet

    2015-01-01

    Atrial electromechanical delay (AEMD) that reflects delayed conduction may show us the clinical reflection of pathological changes in the atria. The main objective of the present study is to investigate AEMD in patients who had previous rheumatic carditis but without hemodynamically significant valvular disease. A total of 40 patients, previously diagnosed as rheumatic carditis but without significant valvular stenosis/regurgitation and atrial enlargement; and 39 age- and-sex matched controls were enrolled for the present study. Parameters of AEMD (lateral mitral annulus electromechanical delay, septal mitral annulus electromechanical delay and lateral tricuspid annulus electromechanical delay) were measured with tissue Doppler echocardiography and left intra-atrial and inter-atrial conduction times were calculated accordingly. A 24h ambulatory Holter monitoring was used in both groups to detect atrial fibrillation episodes and quantify atrial extrasystoles. Parameters of AEMD, including left intra-atrial and inter-atrial conduction times of subjects in the study group were longer compared to the control group (23.7 ± 7.0 vs. 18.3 ± 6.2). Increased AEMD is observed in patients with previous rheumatic carditis and no significant valvular stenosis/regurgitation and atrial enlargement, which may partly explain the increased incidence of atrial fibrillation observed in these patients.

  16. Contingency Tracking during Unsignaled Delayed Reinforcement

    ERIC Educational Resources Information Center

    Keely, Josue; Feola, Tyler; Lattal, Kennon A.

    2007-01-01

    Three experiments were conducted with rats in which responses on one lever (labeled the functional lever) produced reinforcers after an unsignaled delay period that reset with each response during the delay. Responses on a second, nonfunctional, lever did not initiate delays, but, in the first and third experiments, such responses during the last…

  17. Advanced Transport Delay Compensation Algorithms: Results of Delay Measurement and Piloted Performance Tests

    NASA Technical Reports Server (NTRS)

    Guo, Liwen; Cardullo, Frank M.; Kelly, Lon C.

    2007-01-01

    This report summarizes the results of delay measurement and piloted performance tests that were conducted to assess the effectiveness of the adaptive compensator and the state space compensator for alleviating the phase distortion of transport delay in the visual system in the VMS at the NASA Langley Research Center. Piloted simulation tests were conducted to assess the effectiveness of two novel compensators in comparison to the McFarland predictor and the baseline system with no compensation. Thirteen pilots with heterogeneous flight experience executed straight-in and offset approaches, at various delay configurations, on a flight simulator where different predictors were applied to compensate for transport delay. The glideslope and touchdown errors, power spectral density of the pilot control inputs, NASA Task Load Index, and Cooper-Harper rating of the handling qualities were employed for the analyses. The overall analyses show that the adaptive predictor results in slightly poorer compensation for short added delay (up to 48 ms) and better compensation for long added delay (up to 192 ms) than the McFarland compensator. The analyses also show that the state space predictor is fairly superior for short delay and significantly superior for long delay than the McFarland compensator.

  18. Oscillation, Conduction Delays, and Learning Cooperate to Establish Neural Competition in Recurrent Networks

    PubMed Central

    Kato, Hideyuki; Ikeguchi, Tohru

    2016-01-01

    Specific memory might be stored in a subnetwork consisting of a small population of neurons. To select neurons involved in memory formation, neural competition might be essential. In this paper, we show that excitable neurons are competitive and organize into two assemblies in a recurrent network with spike timing-dependent synaptic plasticity (STDP) and axonal conduction delays. Neural competition is established by the cooperation of spontaneously induced neural oscillation, axonal conduction delays, and STDP. We also suggest that the competition mechanism in this paper is one of the basic functions required to organize memory-storing subnetworks into fine-scale cortical networks. PMID:26840529

  19. Test Report Emission Test Program EPA Information Collection Request for Delayed Coking Units 736 Coker Unit

    EPA Pesticide Factsheets

    ARI Environmental, Inc. (ARI) was retained by Houston Refining LP (HRO) to conduct an emission test program at their refinery located in Houston, Texas. The testing was conducted on on the 736 Delayed Coking Unit (DCU) in response to EPA's ICR.

  20. Electrophysiologic studies in atrial fibrillation. Slow conduction of premature impulses: a possible manifestation of the background for reentry.

    PubMed

    Cosio, F G; Palacios, J; Vidal, J M; Cocina, E G; Gómez-Sánchez, M A; Tamargo, L

    1983-01-01

    Extrastimulus-induced intraatrial conduction delays were measured in 12 patients with documented episodes of atrial fibrillation (AF) by recording atrial electrograms at the high right atrium, His bundle region, and coronary sinus. Seventeen patients with and without heart disease, but without atrial arrhythmias served as the control group. During baseline-paced atrial rhythms, a conduction delay zone could be delineated, near the atrial effective refractory period, during which all extrastimuli produced conduction delays. When compared at the same paced cycle lengths (500 to 650 ms), the patients with AF had shorter atrial effective refractory periods (mean +/- standard deviation 206 +/- 24.1 versus 233 +/- 28.2 in control patients, p less than 0.02), wider conduction delay zones (79 +/- 21.7 ms versus 52 +/- 21 in control patients, p less than 0.01), and longer conduction delays both to the His bundle region (64 +/- 18.3 ms versus 35 +/- 21.7 in control patients, p less than 0.005) and the coronary sinus (76 +/- 18.9 ms versus 35 +/- 16.1 in control patients, p less than 0.001). Repetitive atrial responses were recorded in 6 patients with AF and in 9 control subjects. Sinus nodal function abnormalities were detected in 6 of the patients with fibrillation. Patients with AF had a higher tendency than control subjects to develop slow intraatrial conduction, as well as shorter effective refractory periods. Since both features would favor reentry, they may be the electrophysiologic manifestations of the abnormalities making these patients prone to atrial reentrant arrhythmias. Repetitive atrial responses were of no predictive value. Sinus nodal dysfunction was frequently found, but was not essential for the occurrence of AF.

  1. Molecular Basis of Cardiac Delayed Rectifier Potassium Channel Function and Pharmacology.

    PubMed

    Wu, Wei; Sanguinetti, Michael C

    2016-06-01

    Human cardiomyocytes express 3 distinct types of delayed rectifier potassium channels. Human ether-a-go-go-related gene (hERG) channels conduct the rapidly activating current IKr; KCNQ1/KCNE1 channels conduct the slowly activating current IKs; and Kv1.5 channels conduct an ultrarapid activating current IKur. Here the authors provide a general overview of the mechanistic and structural basis of ion selectivity, gating, and pharmacology of the 3 types of cardiac delayed rectifier potassium ion channels. Most blockers bind to S6 residues that line the central cavity of the channel, whereas activators interact with the channel at 4 symmetric binding sites outside the cavity. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Conduction Delay Learning Model for Unsupervised and Supervised Classification of Spatio-Temporal Spike Patterns

    PubMed Central

    Matsubara, Takashi

    2017-01-01

    Precise spike timing is considered to play a fundamental role in communications and signal processing in biological neural networks. Understanding the mechanism of spike timing adjustment would deepen our understanding of biological systems and enable advanced engineering applications such as efficient computational architectures. However, the biological mechanisms that adjust and maintain spike timing remain unclear. Existing algorithms adopt a supervised approach, which adjusts the axonal conduction delay and synaptic efficacy until the spike timings approximate the desired timings. This study proposes a spike timing-dependent learning model that adjusts the axonal conduction delay and synaptic efficacy in both unsupervised and supervised manners. The proposed learning algorithm approximates the Expectation-Maximization algorithm, and classifies the input data encoded into spatio-temporal spike patterns. Even in the supervised classification, the algorithm requires no external spikes indicating the desired spike timings unlike existing algorithms. Furthermore, because the algorithm is consistent with biological models and hypotheses found in existing biological studies, it could capture the mechanism underlying biological delay learning. PMID:29209191

  3. Conduction Delay Learning Model for Unsupervised and Supervised Classification of Spatio-Temporal Spike Patterns.

    PubMed

    Matsubara, Takashi

    2017-01-01

    Precise spike timing is considered to play a fundamental role in communications and signal processing in biological neural networks. Understanding the mechanism of spike timing adjustment would deepen our understanding of biological systems and enable advanced engineering applications such as efficient computational architectures. However, the biological mechanisms that adjust and maintain spike timing remain unclear. Existing algorithms adopt a supervised approach, which adjusts the axonal conduction delay and synaptic efficacy until the spike timings approximate the desired timings. This study proposes a spike timing-dependent learning model that adjusts the axonal conduction delay and synaptic efficacy in both unsupervised and supervised manners. The proposed learning algorithm approximates the Expectation-Maximization algorithm, and classifies the input data encoded into spatio-temporal spike patterns. Even in the supervised classification, the algorithm requires no external spikes indicating the desired spike timings unlike existing algorithms. Furthermore, because the algorithm is consistent with biological models and hypotheses found in existing biological studies, it could capture the mechanism underlying biological delay learning.

  4. Evaluation of electrical propagation delay with cardiomyocytes by photosensitization reaction in vitro

    NASA Astrophysics Data System (ADS)

    Doi, Marika; Ogawa, Emiyu; Arai, Tsunenori

    2017-02-01

    In order to study cardiomyocyte electrical conduction damage by a photosensitization reaction (PR) mostly comes from outside of the cells in a few minutes after the PR, we studied propagation delay of contact action potential with cardiomyocyte by the PR. To determine appropriate PR condition for tachyarrhythmia ablation, a precise electrophysiological experiment in vitro has been preferable. We measured the contact action potential using a microelectrode array system of which information may be correct than conventional Ca2+ measurement. We investigated the propagation delays of an evoked potential to evaluate the electrical conduction damage by the PR. Rat cardiomyocytes were cultivated for 5-7 days on a dish with which 64 electrodes were patterned, in an incubator controlled to 37°C, 5% CO2. The following conditions were used for the PR: 40 μg/ml talapordfin sodium and 290 mW/cm2, 40-78 J/cm2 for an irradiation. A 2D map was obtained to visualize the propagation delays of the evoked potential. The propagation speed, which was calculated based on the measured propagation delays, was decreased by about 30-50% on average of all electrodes after the PR. Therefore, we think 2D propagation delays measurement of the evoked potential with contact action potential measuring system might be available to evaluate the acute electrical conduction damage of cardiomyocyte by the PR.

  5. 77 FR 47705 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and... Processing Delays Project Committee will be held Tuesday, September 04, 2012, at 9:30 a.m. Pacific Time via...

  6. 77 FR 2611 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION... Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and... Processing Delays Project Committee will be held Tuesday, February 7, 2012, at 9:30 a.m. Pacific Time via...

  7. Familial diagnostic experiences in paediatric oncology.

    PubMed

    Evans, N T; Wakefield, C E; McLoone, J K; Cohn, R J

    2015-01-06

    Diagnostic delays may not have significant prognostic implications in paediatric oncology, but psychological impacts remain understudied. Interviews exploring diagnostic experiences were conducted with childhood cancer survivors (n=19), parents (n=78) and siblings (n=15). Median diagnostic time was 3 weeks. Participants described a mixture of rapid diagnoses (28.9%), plus delayed appraisal intervals (that is, parent- or patient-associated diagnostic delays; 40.0%) and diagnostic intervals (that is, healthcare-associated delays; 46.7%). Families experiencing delays described guilt and anger and deleterious impacts on the family-clinician relationship. Some believed delays impacted on treatment and prognosis. The effect of the diagnostic experience can be considerable.

  8. Using Time Delay to Teach Literacy to Students with Severe Developmental Disabilities

    ERIC Educational Resources Information Center

    Browder, Diane; Ahlgrim-Delzell, Lynn; Spooner, Fred; Mims, Pamela J.; Baker, Joshua N.

    2009-01-01

    A review of the literature was conducted for articles published between 1975 and 2007 on the application of time delay as an instructional procedure to teach word and picture recognition to students with severe developmental disabilities in an effort to evaluate time delay as an evidence-based practice. A total of 30 experiments were analyzed…

  9. COGNITIVE FUNCTIONING AND TOLERANCE FOR DELAY OF GRATIFICATION.

    ERIC Educational Resources Information Center

    ZIMILES, HERBERT

    TWO EXPERIMENTS WERE CONDUCTED TO STUDY THE RELATIONSHIP BETWEEN A CHILD'S TOLERANCE FOR DELAY OF GRATIFICATION AND HIS ABILITY TO CONSERVE NUMBER AND PICTURES. OTHER MEASURES OF COGNITION ALSO WERE USED. TOLERANCE FOR DELAY OF GRATIFICATION WAS MEASURED BY THE CHILD'S DECISION TO RECEIVE A PACK OF CANDY AND A TOY ON THE DAY OF TESTING OR TO…

  10. Timing and delay in children vaccination; evaluation of expanded program of immunization in outskirt of Iranian cities.

    PubMed

    Rejali, Mehri; Mohammadbeigi, Abolfazl; Mokhtari, Mohsen; Zahraei, Seyed Mohsen; Eshrati, Babak

    2015-01-01

    Most studies evaluated the vaccine coverage, but the time of vaccination is important as coverage. This study was conducted to evaluate the Expanded Program of Immunization (EPI) in outskirt of Iranian cities regarding to incidence of delay vaccination among children less than 4 years. This cross sectional descriptive study was conducted among children 24-47 months old, living in the suburbs of five metropolises of Iran. Totally, 3610 eligible children selected with proportioned cluster sampling method and data of vaccination card extracted after interview with child parents. Delayed incidence rate reported and predictive factors assessed by Chi square test and Multivariate logistic regression. Overall, 56.6% to 93.2% vaccines were administered out of time. Delayed vaccination incidence with more than one-week delay varies from 5.5% to 74.9% for polio at birth and MMR2 at 18 month, respectively. Mother's educational level and birth order were the most important predictors of delayed vaccination. Incidence of delayed vaccination was enlarged by increasing birth order and decreased in lower educated mothers. Incidence rate of delayed vaccination is more than expectation. Regarding to high coverage vaccines in Iran, heath officers and health policy makers should attempt for on-time vaccination beside of high immunization coverage especially in slum areas with more concentrated immigrants due to low literature and crowded families.

  11. Local conduction during acute myocardial infarction in rats: Interplay between central sympathetic activation and endothelin.

    PubMed

    Kolettis, Theofilos M; Kontonika, Marianthi; La Rocca, Vassilios; Vlahos, Antonios P; Baltogiannis, Giannis G; Kyriakides, Zenon S

    2017-04-01

    We investigated the effects of autonomic dysfunction and endothelin on local conduction and arrhythmogenesis during myocardial infarction. We recorded ventricular tachyarrhythmias, monophasic action potentials, and activation sequences in wild-type and ET B -deficient rats displaying high endothelin levels. Central sympathetic inputs were examined after clonidine administration. Clonidine mitigated early and delayed arrhythmogenesis in ET B -deficient and wild-type rats, respectively. The right ventricular activation delay increased in clonidine-treated ET B -deficient rats and slightly decreased in wild-type rats. The left ventricular voltage rise decreased in all groups, whereas the activation delay increased mainly in clonidine-treated ET B -deficient rats. Central sympathetic activation and endothelin modulate ischemia-induced arrhythmogenesis. Ischemia alters excitability, whereas endothelin impairs local conduction, an action partly counterbalanced by central sympathetic activity.

  12. Feedback and feedforward adaptation to visuomotor delay during reaching and slicing movements.

    PubMed

    Botzer, Lior; Karniel, Amir

    2013-07-01

    It has been suggested that the brain and in particular the cerebellum and motor cortex adapt to represent the environment during reaching movements under various visuomotor perturbations. It is well known that significant delay is present in neural conductance and processing; however, the possible representation of delay and adaptation to delayed visual feedback has been largely overlooked. Here we investigated the control of reaching movements in human subjects during an imposed visuomotor delay in a virtual reality environment. In the first experiment, when visual feedback was unexpectedly delayed, the hand movement overshot the end-point target, indicating a vision-based feedback control. Over the ensuing trials, movements gradually adapted and became accurate. When the delay was removed unexpectedly, movements systematically undershot the target, demonstrating that adaptation occurred within the vision-based feedback control mechanism. In a second experiment designed to broaden our understanding of the underlying mechanisms, we revealed similar after-effects for rhythmic reversal (out-and-back) movements. We present a computational model accounting for these results based on two adapted forward models, each tuned for a specific modality delay (proprioception or vision), and a third feedforward controller. The computational model, along with the experimental results, refutes delay representation in a pure forward vision-based predictor and suggests that adaptation occurred in the forward vision-based predictor, and concurrently in the state-based feedforward controller. Understanding how the brain compensates for conductance and processing delays is essential for understanding certain impairments concerning these neural delays as well as for the development of brain-machine interfaces. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  13. Monophasic action potentials of right atrium and electrophysiological properties of AV conducting system in patients with hypothyroidism.

    PubMed Central

    Gavrilescu, S; Luca, C; Streian, C; Lungu, G; Deutsch, G

    1976-01-01

    In 12 patients with manifest hypothyroidism right atrial monophasic action potentials showed a significant prolongation in comparison with data from normal or euthyroid patients. Atrial effective refractory periods were also significantly prolonged. After thyroid treatment the monophasic action potential duration and the effective refractory period of the right atrium were within normal ranges. In 6 hypothyroid patients studies of AV conduction with the aid of His bundle electrography and atrial pacing showed a supraHisian conduction delay which was manifest in one case and latent in another two. InfraHisian conduction delay was encountered in 2 cases. PMID:1008978

  14. Time-Resolved IR-Absorption Spectroscopy of Hot-Electron Dynamics in Satellite and Upper Conduction Bands in GaP

    NASA Technical Reports Server (NTRS)

    Cavicchia, M. A.; Alfano, R. R.

    1995-01-01

    The relaxation dynamics of hot electrons in the X6 and X7 satellite and upper conduction bands in GaP was directly measured by femtosecond UV-pump-IR-probe absorption spectroscopy. From a fit to the induced IR-absorption spectra the dominant scattering mechanism giving rise to the absorption at early delay times was determined to be intervalley scattering of electrons out of the X7 upper conduction-band valley. For long delay times the dominant scattering mechanism is electron-hole scattering. Electron transport dynamics of the upper conduction band of GaP has been time resolved.

  15. Barriers to help-seeking in men diagnosed with benign colorectal diseases.

    PubMed

    Oberoi, Devesh V; Jiwa, Moyez; McManus, Alexandra; Hodder, Rupert

    2015-01-01

    To explore the help-seeking pathway for lower bowel symptoms in men diagnosed with benign bowel diseases. Semi-structured interviews were conducted. The data were analyzed thematically using Andersen's Model of Patient Delay as the theoretical framework. The major delaying factors were attribution of symptoms to self-limiting conditions, failure to make time to visit a GP, low expectation of help from the GP, fear of cancer diagnosis and embarrassment. The major causes of delay in help-seeking were related to the participants, whereas factors associated with treatment delay were less prominent in diagnostic delay.

  16. Gender and Geographic Differences in Developmental Delays among Young Children: Analysis of the Data from the National Registry in Taiwan

    ERIC Educational Resources Information Center

    Lai, Der-Chung; Tseng, Yen-Cheng; Guo, How-Ran

    2011-01-01

    Although developmental delays are not uncommon in children, the incidence is seldom assessed, and the reported prevalence varies widely. In Taiwan, the government mandates the reporting of suspected cases. Using the national registry data, we conducted a study to estimate the incidence and prevalence of developmental delays in young children in…

  17. Relations between Self Regulation, Future Time Perspective and the Delay of Gratification in University Students

    ERIC Educational Resources Information Center

    Avci, Suleyman

    2013-01-01

    The present study was conducted on 508 (331 female, 144 male) first grade university students in order to investigate the relations between self regulation, the future time perspectives, and the delay of gratification in the academic field. A future time perspective scale, an academic delay of gratification scale and a motivational strategies for…

  18. Structural and Functional Aspects of Social Support for Mothers of Children with and without Cognitive Delays in Vietnam

    ERIC Educational Resources Information Center

    Park, So-Youn; Glidden, Laraine M.; Shin, Jin Y.

    2010-01-01

    Background: This study reports development of a social support scale appropriate to the Vietnamese culture and the impact of social support on mothers of children with cognitive delays by using the developing scale. Method: Interview surveys were conducted with 225 mothers of children with and without cognitive delays in Vietnam. The structural…

  19. [Diagnosis delay of pleural and pulmonary tuberculosis].

    PubMed

    Cherif, J; Mjid, M; Ladhar, A; Toujani, S; Mokadem, S; Louzir, B; Mehiri, N; Béji, M

    2014-08-01

    Tuberculosis (TB) is still being endemic in our country. Time until management determines both evolution and prognosis of this condition. The aim of this work is to evaluate the delay in diagnosis of TB in a respiratory unit from a university hospital series. The authors conducted a cross-sectional study including patients with pulmonary TBC and/or pleural. An evaluation of time management was conducted from the beginning of symptoms and various consultations with reference to the date of hospitalization and treatment set up. One hundred patients were included (pulmonary TB: 68 cases, pleural TB 23 cases, miliary pulmonary TB: 4 cases, pulmonary TB associated with other extrathoracic locations: 5 cases). The mean time of patient delay and total delay institution were respectively 43.6, 25.7 and 69.3 days. Variables responsible for long delays were: number of consultations more than 3 before hospitalization, empirical antibiotic therapy, of a regional hospital first consultation and the presence of extra-respiratory impairment. The patient delay was considered long. A reorganization of the TB control program, in particular by partial decentralization of care and health education is imperative in order to improve the quality of tuberculosis management in our country. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Which echocardiographic parameter is a better marker of volume status in hemodialysis patients?

    PubMed

    Sabaghian, Tahereh; Hajibaratali, Bahareh; Samavat, Shiva

    2016-11-01

    Bio-impedance analysis (BIA) is a preferred method for estimating the volume status. However, it cannot be utilized in daily practice. Since the assessment of the volume status is important and challenging for hemodialysis (HD) patients, the aim of study was to determine the volume status in chronic HD patients using echocardiographic parameters and assess its correlation with BIA. In this cross-sectional analysis, echocardiography and BIA were performed on 30 chronic HD patients 30 min before and 30 min after dialysis. All the cases of dialysis were performed in the middle of the week. This study also assessed the correlation between echocardiographic parameters and BIA parameters. There were significant differences between ECW, TBW, and TBW% (TBW/W) before and after HD. Significant differences were observed between echocardiographic parameters of IVCD, IVCDi min , IVCDi max before and after the HD. LVEDD, LVESD, LA area, mitral valve inflow, E/E', and IVRT, were improved after dialysis, too. There was a significant correlation between IVCDi min as an index of volume status, ECW% and TBW% before HD and IVCDi min change after dialysis had a significant correlation with %ECW change after dialysis. Comparison between hypertensive and non-hypertensive groups indicated IVCDi min was significantly lower in non-hypertensive group after dialysis. Our results showed a correlation between IVCDi min and BIA parameters before HD. So, it seems that IVCDi min can be a good parameter for determining the volume status of HD patients. However, further studies, with larger sample size and with a prospective study design, are required to confirm these results.

  1. Bilingualism as a strategy to delay the onset of Alzheimer’s disease

    PubMed Central

    Klimova, Blanka; Valis, Martin; Kuca, Kamil

    2017-01-01

    The purpose of this study is to explore original studies which provide evidence about the effects of bilingualism on the delay of the onset of dementia, specifically Alzheimer’s disease (AD). A literature review was conducted in the world’s acknowledged databases: Web of Science, Scopus, and MEDLINE. Altogether, 14 original studies focusing on the research topic were detected. These included six prospective cohort studies and eight retrospective studies. Both types of studies suggest different conclusions. The findings from the prospective cohort studies state that there is no association between bilingualism and the delay of the onset of AD, while the retrospective studies claim the opposite. Despite the negative results of the prospective cohort studies, more research should be conducted on bilingualism and its impact on the delay of the onset of AD, since the brain studies have brought positive findings as far as the enhancement of cognitive reserve is concerned. PMID:29089747

  2. Bilingualism as a strategy to delay the onset of Alzheimer's disease.

    PubMed

    Klimova, Blanka; Valis, Martin; Kuca, Kamil

    2017-01-01

    The purpose of this study is to explore original studies which provide evidence about the effects of bilingualism on the delay of the onset of dementia, specifically Alzheimer's disease (AD). A literature review was conducted in the world's acknowledged databases: Web of Science, Scopus, and MEDLINE. Altogether, 14 original studies focusing on the research topic were detected. These included six prospective cohort studies and eight retrospective studies. Both types of studies suggest different conclusions. The findings from the prospective cohort studies state that there is no association between bilingualism and the delay of the onset of AD, while the retrospective studies claim the opposite. Despite the negative results of the prospective cohort studies, more research should be conducted on bilingualism and its impact on the delay of the onset of AD, since the brain studies have brought positive findings as far as the enhancement of cognitive reserve is concerned.

  3. Barriers to emergency obstetric care services: accounts of survivors of life threatening obstetric complications in Malindi District, Kenya.

    PubMed

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique; Kombe, Yeri; Nyandieka, Lillian; Byskov, Jens

    2014-01-01

    Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced obstetric "near miss" at the only public hospital with capacity to provide comprehensive EmOC services in the district. Findings indicate that pregnant women experienced delays in making decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay was influenced by long distance and inconvenient transport to hospital. These two delays resulted in some women arriving at the hospital too late to save the life of the unborn baby. Delays in making the decision to seek care when obstetric complications occur, combined with delays in reaching the hospital, contribute to ineffective treatment upon arrival at the hospital. Interventions to reduce maternal mortality and morbidity must adequately consider the pre-hospital challenges faced by pregnant women in order to influence decision making towards addressing the three delays.

  4. A simulation study of the effects of communication delay on air traffic control

    DOT National Transportation Integrated Search

    1990-09-01

    This study was conducted to examine the impacts of voice communications delays : characteristic of Voice Switching and Control System (VSCS) and satellite : communications systems on air traffic system performance, controller stress : and workload, a...

  5. Delays affecting ITS projects : summary of findings

    DOT National Transportation Integrated Search

    2003-11-01

    This report documents the findings of a program review conducted from October 2002 to September 2003 that investigated what delays continue to affect ITS projects. The program review also identified what actions staffs at state DOTs are taking to add...

  6. The Results of a Simulator Study to Determine the Effects on Pilot Performance of Two Different Motion Cueing Algorithms and Various Delays, Compensated and Uncompensated

    NASA Technical Reports Server (NTRS)

    Guo, Li-Wen; Cardullo, Frank M.; Telban, Robert J.; Houck, Jacob A.; Kelly, Lon C.

    2003-01-01

    A study was conducted employing the Visual Motion Simulator (VMS) at the NASA Langley Research Center, Hampton, Virginia. This study compared two motion cueing algorithms, the NASA adaptive algorithm and a new optimal control based algorithm. Also, the study included the effects of transport delays and the compensation thereof. The delay compensation algorithm employed is one developed by Richard McFarland at NASA Ames Research Center. This paper reports on the analyses of the results of analyzing the experimental data collected from preliminary simulation tests. This series of tests was conducted to evaluate the protocols and the methodology of data analysis in preparation for more comprehensive tests which will be conducted during the spring of 2003. Therefore only three pilots were used. Nevertheless some useful results were obtained. The experimental conditions involved three maneuvers; a straight-in approach with a rotating wind vector, an offset approach with turbulence and gust, and a takeoff with and without an engine failure shortly after liftoff. For each of the maneuvers the two motion conditions were combined with four delay conditions (0, 50, 100 & 200ms), with and without compensation.

  7. A TDR-Based Soil Moisture Monitoring System with Simultaneous Measurement of Soil Temperature and Electrical Conductivity

    PubMed Central

    Skierucha, Wojciech; Wilczek, Andrzej; Szypłowska, Agnieszka; Sławiński, Cezary; Lamorski, Krzysztof

    2012-01-01

    Elements of design and a field application of a TDR-based soil moisture and electrical conductivity monitoring system are described with detailed presentation of the time delay units with a resolution of 10 ps. Other issues discussed include the temperature correction of the applied time delay units, battery supply characteristics and the measurement results from one of the installed ground measurement stations in the Polesie National Park in Poland. PMID:23202009

  8. Quantification of the Arrhythmogenic Effects of Spontaneous Atrial Extrasystole Using High-Resolution Epicardial Mapping.

    PubMed

    Teuwen, Christophe P; Kik, Charles; van der Does, Lisette J M E; Lanters, Eva A H; Knops, Paul; Mouws, Elisabeth M J P; Bogers, Ad J J C; de Groot, Natasja M S

    2018-01-01

    Atrial extrasystoles (AES) can initiate atrial fibrillation. However, the impact of spontaneous AES on intra-atrial conduction is unknown. The aims of this study were to examine conduction disorders provoked by AES and to correlate these conduction differences with patient characteristics, mapping locations, and type of AES. High-resolution epicardial mapping (electrodes N=128 or N=192; interelectrode distance, 2 mm) of the entire atrial surface was performed in patients (N=164; 69.5% male; age 67.2±10.5 years) undergoing open-chest cardiac surgery. AES were classified as premature, aberrant, or prematurely aberrant. Conduction delay and conduction block were quantified during sinus rhythm and AES and subsequently compared. Median incidence of conduction delay and conduction block during sinus rhythm was 1.2% (interquartile, 0%-2.3%) and 0.4% (interquartile, 0%-2.1%). In comparison, the median incidence of conduction delay and conduction block during 339 AES was respectively 2.8% (interquartile, 1.3%-4.6%) and 2.2% (interquartile, 0.3%-5.1%) and differed between the types of AES (prematurely aberrant>aberrant>premature). The degree of prematurity was not associated with a higher incidence of conduction disorders ( P >0.05). In contrast, a higher degree of aberrancy was associated with a higher incidence of conduction disorders; AES emerging as epicardial breakthrough provoked most conduction disorders ( P ≥0.002). AES caused most conduction disorders in patients with diabetes mellitus and left atrial dilatation ( P <0.05). Intraoperative high-resolution epicardial mapping showed that conduction disorders are mainly provoked by prematurely aberrant AES, particularly in patients with left atrial dilation and diabetes mellitus or emerging as epicardial breakthrough. © 2017 American Heart Association, Inc.

  9. Signal functions in delayed reinforcement

    PubMed Central

    Lattal, Kennon A.

    1984-01-01

    Three experiments were conducted with pigeons to examine the role of the signal in delay-of-reinforcement procedures. In the first, a blackout accompanying a period of nonreinforcement increased key-peck response rates maintained by immediate reinforcement. The effects of dissociating the blackout from the delay interval were examined in the second experiment. In three conditions, blackouts and unsignaled delays were negatively correlated or occurred randomly with respect to one another. A signaled delay and an unsignaled delay that omitted the blackouts were studied in two other conditions. All delay-of-reinforcement conditions generally produced response rates lower than those produced by immediate reinforcement. Signaled delays maintained higher response rates than did any of the various unsignaled-delay conditions, with or without dissociated blackouts. The effects of these latter conditions did not differ systematically from one another. The final experiment showed that response rates varied as a function of the frequency with which a blackout accompanied delay intervals. By eliminating a number of methodological difficulties present in previous delay-of-reinforcement experiments, these results suggest the importance of the signal in maintaining responding during delay-of-reinforcement procedures and, conversely, the importance of the delay interval in decreasing responding. PMID:16812387

  10. Sources of delayed provision of neurosurgical care in a rural kenyan setting

    PubMed Central

    Mansouri, Alireza; Chan, Vivien; Njaramba, Veronica; Cadotte, David W.; Albright, A. Leland; Bernstein, Mark

    2015-01-01

    Background: Delay to neurosurgical care can result in significant morbidity and mortality. In this study, we aim to identify and quantify the sources of delay to neurosurgical consultation and care at a rural setting in Kenya. Methods: A mixed-methods, cross-sectional analysis of all patients admitted to the neurosurgical department at Kijabe Hospital (KH) was conducted: A retrospective analysis of admissions from October 1 to December 31, 2013 and a prospective analysis from June 2 to June 20, 2014. Sources of delay were categorized and quantified. The Kruskal–Wallis test was used to identify an overall significant difference among diagnoses. The Mann–Whitney U test was used for pairwise comparisons within groups; the Bonferroni correction was applied to the alpha level of significance (0.05) according to the number of comparisons conducted. IBM SPSS version 22.0 (SPSS, Chicago, IL) was used for statistical analyses. Results: A total of 332 admissions were reviewed (237 retrospective, 95 prospective). The majority was pediatric admissions (median age: 3 months). Hydrocephalus (35%) and neural tube defects (NTDs; 27%) were most common. At least one source of delay was identified in 192 cases (58%); 39 (12%) were affected by multiple sources. Delay in primary care (PCPs), in isolation or combined with other sources, comprised 137 of total (71%); misdiagnosis or incorrect management comprised 46 (34%) of these. Finances contributed to delays in 25 of 95 prospective cases. At a median delay of 49 and 200.5 days, the diagnoses of hydrocephalus and tumors were associated with a significantly longer delay compared with NTDs (P < 0.001). Conclusion: A substantial proportion of patients experienced delays in procuring pediatric neurosurgical care. Improvement in PCP knowledge base, implementation of a triage and referral process, and development of community-based funding strategies can potentially reduce these delays. PMID:25745587

  11. Reasons for delay in decision making and reaching health facility among obstetric fistula and pelvic organ prolapse patients in Gondar University hospital, Northwest Ethiopia.

    PubMed

    Adefris, Mulat; Abebe, Solomon Mekonnen; Terefe, Kiros; Gelagay, Abebaw Addis; Adigo, Azmeraw; Amare, Selamawit; Lazaro, Dorothy; Berhe, Aster; Baye, Chernet

    2017-08-22

    Obstetric fistula and pelvic organ prolapse remain highly prevalent in sub-Saharan Africa, where women have poor access to modern health care. Women having these problems tend to stay at home for years before getting treatment. However, information regarding the reasons contributing to late presentation to treatment is scarce, especially at the study area. The objective of this study was to assess the reasons whywomen with obstetric fistula and pelvic organ prolapse at Gondar University Hospital delay treatment. A hospital based cross-sectional study was conducted among 384 women. Delay was evaluated by calculating symptom onset and time of arrival to get treatment at Gondar University Hospital. Regression analysis was conducted to elicit predictors of delay for treatment. Of the total 384 participants, 311 (80.9%) had pelvic organ prolapse and 73(19.1%) obstetric fistula. The proportion of women who delayed treatment of pelvic organ prolapse was 82.9% and that of obstetric fistula 60.9%. Fear of disclosing illness due to social stigma (AOR = 2; 1.03, 3.9) and lack of money (AOR = 1.97; 1.01, 3.86) were associated with the delay of treatment for pelvic organ prolapse,while increasing age (AOR =1.12; 1.01, 1.24) and divorce (AOR = 16.9; 1.75, 165.5) were were responsible for delaying treatment forobstetric fistula. A large numberof women with pelvic organ prolapse and obstetric fistula delayed treatment. Fear of disclosure due to social stigma and lack of moneywere the major factors that contributed to thedelay to seek treatment for pelvic organ prolapse,while increasing age and divorce were the predictors for delaying treatment for obstetric fistula.

  12. Mechanisms of Firing Patterns in Fast-Spiking Cortical Interneurons

    PubMed Central

    Golomb, David; Donner, Karnit; Shacham, Liron; Shlosberg, Dan; Amitai, Yael; Hansel, David

    2007-01-01

    Cortical fast-spiking (FS) interneurons display highly variable electrophysiological properties. Their spike responses to step currents occur almost immediately following the step onset or after a substantial delay, during which subthreshold oscillations are frequently observed. Their firing patterns include high-frequency tonic firing and rhythmic or irregular bursting (stuttering). What is the origin of this variability? In the present paper, we hypothesize that it emerges naturally if one assumes a continuous distribution of properties in a small set of active channels. To test this hypothesis, we construct a minimal, single-compartment conductance-based model of FS cells that includes transient Na+, delayed-rectifier K+, and slowly inactivating d-type K+ conductances. The model is analyzed using nonlinear dynamical system theory. For small Na+ window current, the neuron exhibits high-frequency tonic firing. At current threshold, the spike response is almost instantaneous for small d-current conductance, g d, and it is delayed for larger g d. As g d further increases, the neuron stutters. Noise substantially reduces the delay duration and induces subthreshold oscillations. In contrast, when the Na+ window current is large, the neuron always fires tonically. Near threshold, the firing rates are low, and the delay to firing is only weakly sensitive to noise; subthreshold oscillations are not observed. We propose that the variability in the response of cortical FS neurons is a consequence of heterogeneities in their g d and in the strength of their Na+ window current. We predict the existence of two types of firing patterns in FS neurons, differing in the sensitivity of the delay duration to noise, in the minimal firing rate of the tonic discharge, and in the existence of subthreshold oscillations. We report experimental results from intracellular recordings supporting this prediction. PMID:17696606

  13. Mechanisms of firing patterns in fast-spiking cortical interneurons.

    PubMed

    Golomb, David; Donner, Karnit; Shacham, Liron; Shlosberg, Dan; Amitai, Yael; Hansel, David

    2007-08-01

    Cortical fast-spiking (FS) interneurons display highly variable electrophysiological properties. Their spike responses to step currents occur almost immediately following the step onset or after a substantial delay, during which subthreshold oscillations are frequently observed. Their firing patterns include high-frequency tonic firing and rhythmic or irregular bursting (stuttering). What is the origin of this variability? In the present paper, we hypothesize that it emerges naturally if one assumes a continuous distribution of properties in a small set of active channels. To test this hypothesis, we construct a minimal, single-compartment conductance-based model of FS cells that includes transient Na(+), delayed-rectifier K(+), and slowly inactivating d-type K(+) conductances. The model is analyzed using nonlinear dynamical system theory. For small Na(+) window current, the neuron exhibits high-frequency tonic firing. At current threshold, the spike response is almost instantaneous for small d-current conductance, gd, and it is delayed for larger gd. As gd further increases, the neuron stutters. Noise substantially reduces the delay duration and induces subthreshold oscillations. In contrast, when the Na(+) window current is large, the neuron always fires tonically. Near threshold, the firing rates are low, and the delay to firing is only weakly sensitive to noise; subthreshold oscillations are not observed. We propose that the variability in the response of cortical FS neurons is a consequence of heterogeneities in their gd and in the strength of their Na(+) window current. We predict the existence of two types of firing patterns in FS neurons, differing in the sensitivity of the delay duration to noise, in the minimal firing rate of the tonic discharge, and in the existence of subthreshold oscillations. We report experimental results from intracellular recordings supporting this prediction.

  14. Effects of time delay and pitch control sensitivity in the flared landing

    NASA Technical Reports Server (NTRS)

    Berthe, C. J.; Chalk, C. R.; Wingarten, N. C.; Grantham, W.

    1986-01-01

    Between December 1985 and January 1986, a flared landing program was conducted, using the USAF Total In-Flight simulator airplane, to examine time delay effects in a formal manner. Results show that as pitch sensitivity is increased, tolerance to time delay decreases. With the proper selection of pitch sensitivity, Level I performance was maintained with time delays ranging from 150 milliseconds to greater than 300 milliseconds. With higher sensitivity, configurations with Level I performance at 150 milliseconds degraded to level 2 at 200 milliseconds. When metrics of time delay and pitch sensitivity effects are applied to enhance previously developed predictive criteria, the result is an improved prediction technique which accounts for significant closed loop items.

  15. Assessment of atrial conduction time in patients with polycystic ovary syndrome.

    PubMed

    Zehir, Regayip; Karabay, Can Yucel; Kocabay, Gonenc; Kalayci, Arzu; Kaymaz, Ozge; Aykan, Ahmet Cagrı; Karabay, Emre; Kirma, Cevat

    2014-11-01

    Polycystic ovary syndrome (PCOS) is closely related to increased cardiovascular risk in women of reproductive age. Atrial conduction abnormalities in these patients have not been investigated in terms of atrial electromechanical delay measured by tissue Doppler imaging (TDI) as an early predictor of atrial fibrillation development. The aim of this study was to evaluate whether TDI-derived atrial conduction time is prolonged in PCOS. The study included 51 patients with PCOS and 48 age-matched healthy controls. P-wave dispersion (PWD) was calculated on the 12-lead surface electrocardiogram. Systolic and diastolic left ventricular (LV) functions, atrial electromechanical coupling, intraatrial and interatrial electromechanical delays were measured with conventional echocardiography and TDI. PWD was higher in PCOS women (50.45 ± 3.7 vs 34.73 ± 6.7 ms, p = 0.008). Interatrial and intraatrial electromechanical delay were found longer in patients with PCOS compared to controls (41.9 ± 9.0 vs 22.2 ± 6.6 ms, p < 0.001; 22.6 ± 5.8 vs 5.9 ± 4.7 ms, p < 0.001, respectively). Left atrial (LA) volume index and LV diastolic parameters were significantly different between the groups. PWD was correlated with interatrial electromechanical delay (r = 0.54, p < 0.01). Interatrial electromechanical delay was strongly correlated with homeostatic model assessment insulin resistance index and high-sensitivity C-reactive protein levels (r = 0.68, p < 0.001; r = 0.53, p < 0.001, respectively). Interatrial electromechanical delay was positively correlated with LA volume index and deceleration time (r = 0.31, p = 0.04; r = 0.37, p = 0.021, respectively) and negatively correlated with flow propagation velocity (r = -0.38, p = 0.014). This study shows that atrial electromechanical delay is prolonged in PCOS patients. Atrial electromechanical delay prolongation is related to low-grade inflammation, insulin resistance, and LV diastolic dysfunction in PCOS.

  16. The influence of ground conductivity on the structure of RF radiation from return strokes

    NASA Technical Reports Server (NTRS)

    Levine, D. M.; Gesell, L.

    1984-01-01

    The combination of the finite conductivity of the Earth plus the propagation of the return stroke current up the channel which results in an apparent time delay between the fast field changes and RF radiation for distant observers is shown. The time delay predicted from model return strokes is on the order of 20 micro and the received signal has the characteristics of the data observed in Virginia and Florida. A piecewise linear model for the return stroke channel and a transmission line model for current propagation on each segment was used. Radiation from each segment is calculated over a flat Earth with finite conductivity using asymptotics approximations for the Sommerfeld integrals. The radiation at the observer is processed by a model AM radio receiver. The output voltage was calculated for several frequencies between HF-UHF assuming a system bandwidth (300 kHz) characteristic of the system used to collect data in Florida and Virginia. Comparison with the theoretical fast field changes indicates a time delay of 20 microns.

  17. Do executive deficits and delay aversion make independent contributions to preschool attention-deficit/hyperactivity disorder symptoms?

    PubMed

    Sonuga-Barke, Edmund J S; Dalen, Lindy; Remington, Bob

    2003-11-01

    To test whether deficits in executive function and delay aversion make independent contributions to levels of attention-deficit/hyperactivity disorder (ADHD) symptoms exhibited by preschool children. One hundred fifty-six children between 3 and 5.5 years old (78 girls and 78 boys) selected from the community completed an age-appropriate battery of tests measuring working memory, set shifting, planning, delay of gratification, and preference for delayed rewards. Parents completed a clinical interview about their children's ADHD symptoms. Analysis of test performance revealed two factors: executive dysfunction and delay aversion. Multivariate analysis demonstrated that when other factors (i.e., age, IQ, and conduct problems) were controlled, executive dysfunction and delay aversion each made significant independent contributions to predictions of ADHD symptoms. Preschool ADHD symptoms are psychologically heterogeneous. Executive dysfunction and delay aversion may represent two distinct and early appearing neurodevelopmental bases for ADHD symptoms.

  18. On the delay factors of the private construction projects in Medan city

    NASA Astrophysics Data System (ADS)

    Perwira Mulia Tarigan, A.; Subroto

    2018-03-01

    The delay in construction projects undertaken by contractors is impeding the economic growth of a region. Medan city which is one of the big cities in Indonesia is suffering from it. This study aims to identify the dominant factors causing delays in construction projects conducted by private contractors. The interview method with questionnaires is used to involve 20 contractors, 10 consultants, and 10 owner representatives in the study. From the 45 identified factors causing delays, the highest ranking is the change of work demand by the project owners with 71.84% importance index.

  19. Achievement motivation and memory: achievement goals differentially influence immediate and delayed remember-know recognition memory.

    PubMed

    Murayama, Kou; Elliot, Andrew J

    2011-10-01

    Little research has been conducted on achievement motivation and memory and, more specifically, on achievement goals and memory. In the present research, the authors conducted two experiments designed to examine the influence of mastery-approach and performance-approach goals on immediate and delayed remember-know recognition memory. The experiments revealed differential effects for achievement goals over time: Performance-approach goals showed higher correct remember responding on an immediate recognition test, whereas mastery-approach goals showed higher correct remember responding on a delayed recognition test. Achievement goals had no influence on overall recognition memory and no consistent influence on know responding across experiments. These findings indicate that it is important to consider quality, not just quantity, in both motivation and memory, when studying relations between these constructs.

  20. Tuberculosis related stigma and its effect on the delay for sputum examination under the Revised National Tuberculosis Control Program in India.

    PubMed

    Chakrabartty, Arupkumar; Basu, Pampa; Ali, Kazi Monjur; Sarkar, Aditi Kishore; Ghosh, Debidas

    2018-04-01

    One major barrier to achieve goal of tuberculosis (TB) control program globally, is the stigma attached to the disease. Perceived stigma can delay sputum test in time. Delay will lead to spread of infection in the community. There is no scientific information available in India exactly looking into the association between delay in sputum examination and stigma. We conducted a study in rural West Bengal among persons with cough for 2 weeks or more to assess their level of stigma, its influence on delay for sputum test and identify factors those shape the level of stigma. A community based cross sectional survey was conducted from February to June 2015 in West Bengal, India. We interviewed 135 persons of 15-60 years. Data were collected using a pretested structured questionnaire. Chi-square and logistic regression analysis were done using SPSS 23.0 statistical software. Among the 'lower stigma' group (score 4-24), 'delay' (14-25 days) is found among 46.2% respondents and 'much delay' (26-120 days) among 53.8%. Among the 'higher stigma' (score 25-36) group, 'delay' is found among 20.5% respondents and 'much delay' among 79.5%. Persons with lower stigma are 0.17 times likely to delay than persons with higher stigma [adjusted odds ratio (AOR): 0.17 (0.044-0.668), p=0.011)]. Important influencers of stigma are caste [AOR: 5.90 (1.66-20.90), p=0.006], number of family members [AOR: 3.46 (1.08-11.06), p=0.009] and residence in urban or rural [AOR: 3.97 (1.03-15.27), p=0.045]. Revised National Tuberculosis Control Program in India should de-stigmatize the community giving priorities to lower castes, big families and rural areas. Copyright © 2017 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  1. Delay in seeking medical help following Transient Ischemic Attack (TIA) or "mini-stroke": a qualitative study.

    PubMed

    Mc Sharry, Jennifer; Baxter, Alison; Wallace, Louise M; Kenton, Anthony; Turner, Andrew; French, David P

    2014-01-01

    Prompt treatment following Transient Ischemic Attack (TIA) can reduce the risk of subsequent stroke and disability. However, many patients delay in making contact with medical services. This study aimed to explore TIA patients' accounts of delay between symptom onset and contacting medical services including how decisions to contact services were made and the factors discussed in relation to delay. Twenty interviews were conducted with TIA patients in England. Using a previous systematic review as an initial framework, interview data were organised into categories of symptom recognition, presence of others and type of care sought. A thematic analysis was then conducted to explore descriptions of care-seeking relevant to each category. Delay in contacting medical services varied from less than an hour to eight days. Awareness of typical stroke symptoms could lead to urgent action when more severe TIA symptoms were present but could lead to delay when experienced symptoms were less severe. The role of friends and family varied widely from deciding on and enacting care-seeking decisions to simply providing transport to the GP practice. When family or friends played a greater role, and both made and enacted care-seeking decisions, delays were often shorter, even when patients themselves failed to identify symptoms. Healthcare professionals also impacted on patients' care-seeking with greater delays in seeking further care for the same episode described when patients perceived a lack of urgency during initial healthcare interactions. This study provides new information on patients' decisions to contact medical services following TIA and identifies overlapping factors that can lead to delay in receiving appropriate treatment. While recognition of symptoms may contribute to delay in contacting medical services, additional factors, including full responsibility being taken by others and initial healthcare interactions, can over-ride or undermine the importance of patients' own identification of TIA.

  2. Delay in Seeking Medical Help following Transient Ischemic Attack (TIA) or “Mini-Stroke”: A Qualitative Study

    PubMed Central

    Mc Sharry, Jennifer; Baxter, Alison; Wallace, Louise M.; Kenton, Anthony; Turner, Andrew; French, David P.

    2014-01-01

    Background Prompt treatment following Transient Ischemic Attack (TIA) can reduce the risk of subsequent stroke and disability. However, many patients delay in making contact with medical services. This study aimed to explore TIA patients' accounts of delay between symptom onset and contacting medical services including how decisions to contact services were made and the factors discussed in relation to delay. Methods Twenty interviews were conducted with TIA patients in England. Using a previous systematic review as an initial framework, interview data were organised into categories of symptom recognition, presence of others and type of care sought. A thematic analysis was then conducted to explore descriptions of care-seeking relevant to each category. Results Delay in contacting medical services varied from less than an hour to eight days. Awareness of typical stroke symptoms could lead to urgent action when more severe TIA symptoms were present but could lead to delay when experienced symptoms were less severe. The role of friends and family varied widely from deciding on and enacting care-seeking decisions to simply providing transport to the GP practice. When family or friends played a greater role, and both made and enacted care-seeking decisions, delays were often shorter, even when patients themselves failed to identify symptoms. Healthcare professionals also impacted on patients' care-seeking with greater delays in seeking further care for the same episode described when patients perceived a lack of urgency during initial healthcare interactions. Conclusions This study provides new information on patients' decisions to contact medical services following TIA and identifies overlapping factors that can lead to delay in receiving appropriate treatment. While recognition of symptoms may contribute to delay in contacting medical services, additional factors, including full responsibility being taken by others and initial healthcare interactions, can over-ride or undermine the importance of patients' own identification of TIA. PMID:25137185

  3. Evaluation of Empirical Tropospheric Models Using Satellite-Tracking Tropospheric Wet Delays with Water Vapor Radiometer at Tongji, China

    PubMed Central

    Wang, Miaomiao; Li, Bofeng

    2016-01-01

    An empirical tropospheric delay model, together with a mapping function, is commonly used to correct the tropospheric errors in global navigation satellite system (GNSS) processing. As is well-known, the accuracy of tropospheric delay models relies mainly on the correction efficiency for tropospheric wet delays. In this paper, we evaluate the accuracy of three tropospheric delay models, together with five mapping functions in wet delays calculation. The evaluations are conducted by comparing their slant wet delays with those measured by water vapor radiometer based on its satellite-tracking function (collected data with large liquid water path is removed). For all 15 combinations of three tropospheric models and five mapping functions, their accuracies as a function of elevation are statistically analyzed by using nine-day data in two scenarios, with and without meteorological data. The results show that (1) no matter with or without meteorological data, there is no practical difference between mapping functions, i.e., Chao, Ifadis, Vienna Mapping Function 1 (VMF1), Niell Mapping Function (NMF), and MTT Mapping Function (MTT); (2) without meteorological data, the UNB3 is much better than Saastamoinen and Hopfield models, while the Saastamoinen model performed slightly better than the Hopfield model; (3) with meteorological data, the accuracies of all three tropospheric delay models are improved to be comparable, especially for lower elevations. In addition, the kinematic precise point positioning where no parameter is set up for tropospheric delay modification is conducted to further evaluate the performance of tropospheric delay models in positioning accuracy. It is shown that the UNB3 model is best and can achieve about 10 cm accuracy for the N and E coordinate component while 20 cm accuracy for the U coordinate component no matter the meteorological data is available or not. This accuracy can be obtained by the Saastamoinen model only when meteorological data is available, and degraded to 46 cm for the U component if the meteorological data is not available. PMID:26848662

  4. Singer's preferred acoustic condition in performance in an opera house and self-perception of the singer's voice

    NASA Astrophysics Data System (ADS)

    Noson, Dennis; Kato, Kosuke; Ando, Yoichi

    2004-05-01

    Solo singers have been shown to over estimate the relative sound pressure level of a delayed, external reproduction of their own voice, singing single syllables, which, in turn, appears to influence the preferred delay of simulated stage reflections [Noson, Ph.D. thesis, Kobe University, 2003]. Bone conduction is thought to be one factor separating singer versus instrumental performer judgments of stage acoustics. Using a parameter derived from the vocal signal autocorrelation function (ACF envelope), the changes in singer preference for delayed reflections is primarily explained by the ACF parameter, rather than internal bone conduction. An auditory model of a singer's preferred reflection delay is proposed, combining the effects of acoustical environment (reflection amplitude), bone conduction, and performer vocal overestimate, which may be applied to the acoustic design of reflecting elements in both upstage and forestage environments of opera stages. For example, soloists who characteristically underestimate external voice levels (or overestimate their own voice) should be provided shorter distances to reflective panels-irrespective of their singing style. Adjustable elements can be deployed to adapt opera houses intended for bel canto style performances to other styles. Additional examples will also be discussed. a)Now at Kumamoto Univ., Kumamoto, Japan. b)Now at: 1-10-27 Yamano Kami, Kumamoto, Japan.

  5. Effects of stomatal development on stomatal conductance and on stomatal limitation of photosynthesis in Syringa oblata and Euonymus japonicus Thunb.

    PubMed

    Wu, Bing-Jie; Chow, Wah Soon; Liu, Yu-Jun; Shi, Lei; Jiang, Chuang-Dao

    2014-12-01

    During leaf development, the increase in stomatal conductance cannot meet photosynthetic demand for CO2, thus leading to stomatal limitation of photosynthesis (Ls). Considering the crucial influences of stomatal development on stomatal conductance, we speculated whether stomatal development limits photosynthesis to some extent. To test this hypothesis, stomatal development, stomatal conductance and photosynthesis were carefully studied in both Syringa oblata (normal greening species) and Euonymus japonicus Thunb (delayed greening species). Our results show that the size of stomata increased gradually with leaf expansion, resulting in increased stomatal conductance up to the time of full leaf expansion. During this process, photosynthesis also increased steadily. Compared to that in S. oblata, the development of chloroplasts in E. japonicus Thunb was obviously delayed, leading to a delay in the improvement of photosynthetic capacity. Further analysis revealed that before full leaf expansion, stomatal limitation increased rapidly in both S. oblata and E. japonicus Thunb; after full leaf expansion, stomatal limitation continually increased in E. japonicus Thunb. Accordingly, we suggested that the enhancement of photosynthetic capacity is the main factor leading to stomatal limitation during leaf development but that stomatal development can alleviate stomatal limitation with the increase of photosynthesis by controlling gas exchange. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Prevalence of conduction delay of the right atrium in patients with SSS: implications for pacing site selection.

    PubMed

    Verlato, Roberto; Zanon, Francesco; Bertaglia, Emanuele; Turrini, Pietro; Baccillieri, Maria Stella; Baracca, Enrico; Bongiorni, Maria Grazia; Zampiero, Aldo; Zonzin, Pietro; Pascotto, Pietro; Venturini, Diego; Corbucci, Giorgio

    2007-09-01

    To evaluate the prevalence of severe right atrial conduction delay in patients with sinus node dysfunction (SND) and atrial fibrillation (AF) and the effects of pacing in the right atrial appendage (RAA) and in the inter-atrial septum (IAS). Forty-two patients (15 male, 72 +/- 7 years) underwent electrophysiologic study to measure the difference between the conduction time from RAA to coronary sinus ostium during stimulation at 600 ms and after extrastimulus (DeltaCTos). Patients were classified as group A if DeltaCTos > 60 ms and group B if < 60 ms. Each Group was randomized to RAA/IAS pacing and algorithms ON/OFF. Fifteen patients (36%, group A) had DeltaCTos = 76 +/- 11 ms and 27 patients (64%, group B) had DeltaCTos = 36 +/- 20 ms. Twenty-two patients were paced at the RAA and 20 at the IAS. During the study, no AF recurrences were reported in 11 of 42 (26%) patients, independently of RAA or IAS pacing. Patients from group A and RAA pacing had 0.79 +/- 0.81 episodes of AF/day during DDD, which increased to 1.52 +/- 1.41 episodes of AF/day during DDDR + Alg (P = 0.046). Those with IAS pacing had 0.5 +/- 0.24 episodes of AF/day during DDD, which decreased to 0.06 +/- 0.08 episodes of AF/day during DDDR + Alg (P = 0.06). In group B, no differences were reported between pacing sites and pacing modes. Severe right atrial conduction delay is present in one-third of patients with SND and AF: continuous pacing at the IAS is superior to RAA for AF recurrences. In patients without severe conduction delay, no differences between pacing site or mode were observed.

  7. Evaluation of P-Wave Dispersion, Diastolic Function, and Atrial Electromechanical Conduction in Pediatric Patients with Subclinical Hypothyroidism.

    PubMed

    Irdem, Ahmet; Aydın Sahin, Derya; Kervancioglu, Mehmet; Baspinar, Osman; Sucu, Murat; Keskin, Mehmet; Kilinc, Metin

    2016-09-01

    This study aimed to evaluate ventricular diastolic dysfunction, inter- and intraatrial conduction delay, and P-wave dispersion in pediatric patients with subclinical hypothyroidism. The study comprised a total of 30 pediatric patients with subclinical hypothyroidism (SH) (mean age 7.8 ± 3.2 years) and 30 healthy children (mean age 8.4 ± 3.6 years) as the control group. A SH diagnosis was made in the event of increased serum thyroid-stimulating hormone (TSH) and decreased serum free triiodothyronine (T3 ) and free thyroxine (T4 ) concentrations. Conventional Doppler imaging (TDI) showed low mitral early diastolic E-wave velocity and E/A ratio (P < 0.001) and significantly higher mitral late diastolic A-wave velocity (P = 0.001) in hypothyroidism patients. Moreover, patients with hypothyroidism had significantly lower left ventricular (LV) septal Em velocity and Em /Am ratios compared with the control group (P < 0.001), whereas Am velocity was higher in hypothyroidism patients (P = 0.018). LV lateral Em velocity and Em /Am ratio were significantly lower in patients with hypothyroidism compared with the control group (P < 0.001). With regard to atrial electromechanical conduction, atrial electromechanical delay (PA) lateral, PA septum, PA tricuspid, and each of interatrial and intraatrial conduction delay were significantly prolonged in hypothyroidism patients as compared with the control group (P < 0.001, P < 0.001, P = 0.023, P = 0.002, and P = 0.003, respectively). P-wave dispersion was significantly different in the pediatric patients with hypothyroidism (P < 0.001). This study demonstrated atrial electromechanical conduction delay, abnormal P-wave dispersion, and ventricle diastolic dysfunction in pediatric patients with hypothyroidism. © 2016, Wiley Periodicals, Inc.

  8. Cognitive Function in Individuals with Atypical Pubertal Development.

    ERIC Educational Resources Information Center

    Rovet, Joanne F.; And Others

    A study of 55 growth-disturbed children, aged 8-17, was conducted to assess how rate of physical maturation and pubertal development influences cognitive and neuropsychological functioning. The sample included 27 boys with short stature and delayed pubertal development (SSB), 15 girls with delayed puberty (DPG), and 13 girls with precocious…

  9. Parenting Stress and Depression in Children with Mental Retardation and Developmental Disabilities.

    ERIC Educational Resources Information Center

    Kobe, Frank H.

    1994-01-01

    This study of 29 children with developmental delays found that parent ratings of children's depression were significantly associated with maternal depression, negative self-image, anxiety, and conduct problems. Data suggest that children with developmental delays exhibit a similar pattern of symptoms and associated characteristics to those found…

  10. Rosetting of Plasmodium falciparum-infected red blood cells with uninfected red blood cells enhances microvascular obstruction under flow conditions.

    PubMed

    Kaul, D K; Roth, E F; Nagel, R L; Howard, R J; Handunnetti, S M

    1991-08-01

    The occurrence of rosetting of Plasmodium falciparum-infected human red blood cells (IRBC) with uninfected red blood cells (RBC) and its potential pathophysiologic consequences were investigated under flow conditions using the perfused rat mesocecum vasculature. Perfusion experiments were performed using two knobby (K+) lines of P falciparum, ie, rosetting positive (K+R+) and rosetting negative (K+R-). The infusion of K+R+ IRBC resulted in higher peripheral resistance (PRU) than K+R- IRBC (P less than .0012). Video microscopy showed that under conditions of flow, in addition to cytoadherence of K+R+ IRBC to the venular endothelium, rosette formation was also restricted to venules, especially in the areas of slow flow. Rosettes were absent in arterioles and were presumably dissociated by higher wall shear rates. The presence of rosettes in the venules must therefore reflect their rapid reformation after disruption. Cytoadherence of K+R+ IRBC was characterized by formation of focal clusters along the venular wall. In addition, large aggregates of RBC were frequently observed at venular junctions, probably as a result of interaction between flowing rosettes, free IRBC, and uninfected RBC. In contrast, the infusion of K+R+ IRBC resulted in diffuse cytoadherence of these cells exclusively to the venular endothelium but not in rosetting or large aggregate formation. The cytoadherence of K+R+ IRBC showed strong inverse correlation with the venular diameter (r = -.856, P less than .00001). Incubation of K+R+ IRBC with heparin and with monoclonal antibodies to glycoprotein IV/CD36 abolished the rosette formation and resulted in decreased PRU and microvascular blockage. These findings demonstrate that rosetting of K+R+ IRBC with uninfected RBC enhances vasocclusion, suggesting an important in vivo role for rosetting in the microvascular sequestration of P falciparum-infected RBC.

  11. Mitigating Communication Delays in Remotely Connected Hardware-in-the-loop Experiments

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

    Cale, James; Johnson, Brian; Dall'Anese, Emiliano

    Here, this paper introduces a potential approach for mitigating the effects of communication delays between multiple, closed-loop hardware-in-the-loop experiments which are virtually connected, yet physically separated. The method consists of an analytical method for the compensation of communication delays, along with the supporting computational and communication infrastructure. The control design leverages tools for the design of observers for the compensation of measurement errors in systems with time-varying delays. The proposed methodology is validated through computer simulation and hardware experimentation connecting hardware-in-the-loop experiments conducted between laboratories separated by a distance of over 100 km.

  12. Mitigating Communication Delays in Remotely Connected Hardware-in-the-loop Experiments

    DOE PAGES

    Cale, James; Johnson, Brian; Dall'Anese, Emiliano; ...

    2018-03-30

    Here, this paper introduces a potential approach for mitigating the effects of communication delays between multiple, closed-loop hardware-in-the-loop experiments which are virtually connected, yet physically separated. The method consists of an analytical method for the compensation of communication delays, along with the supporting computational and communication infrastructure. The control design leverages tools for the design of observers for the compensation of measurement errors in systems with time-varying delays. The proposed methodology is validated through computer simulation and hardware experimentation connecting hardware-in-the-loop experiments conducted between laboratories separated by a distance of over 100 km.

  13. Cardiac Delayed Rectifier Potassium Channels in Health and Disease.

    PubMed

    Chen, Lei; Sampson, Kevin J; Kass, Robert S

    2016-06-01

    Cardiac delayed rectifier potassium channels conduct outward potassium currents during the plateau phase of action potentials and play pivotal roles in cardiac repolarization. These include IKs, IKr and the atrial specific IKur channels. In this article, we will review their molecular identities and biophysical properties. Mutations in the genes encoding delayed rectifiers lead to loss- or gain-of-function phenotypes, disrupt normal cardiac repolarization and result in various cardiac rhythm disorders, including congenital Long QT Syndrome, Short QT Syndrome and familial atrial fibrillation. We will also discuss the prospect of using delayed rectifier channels as therapeutic targets to manage cardiac arrhythmia. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Cardiac Delayed Rectifier Potassium Channels in Health and Disease

    PubMed Central

    Chen, Lei; Sampson, Kevin J.; Kass, Robert S.

    2016-01-01

    Cardiac delayed rectifier potassium channels conduct outward potassium currents during the plateau phase of action potentials and play pivotal roles in cardiac repolarization. These include IKs, IKr and the atrial specific IKur channels. In this chapter, we will review the molecular identities and biophysical properties of these channels. Mutations in the genes encoding delayed rectifiers lead to loss- or gain-of-function phenotypes, disrupt normal cardiac repolarization and result in various cardiac rhythm disorders, including congenital Long QT Syndrome, Short QT Syndrome and familial atrial fibrillation. We will also discuss the possibility and prospect of using delayed rectifier channels as therapeutic targets to manage cardiac arrhythmia. PMID:27261823

  15. Behaviour of fractional loop delay zero crossing digital phase locked loop (FR-ZCDPLL)

    NASA Astrophysics Data System (ADS)

    Nasir, Qassim

    2018-01-01

    This article analyses the performance of the first-order zero crossing digital phase locked loops (FR-ZCDPLL) when fractional loop delay is added to loop. The non-linear dynamics of the loop is presented, analysed and examined through bifurcation behaviour. Numerical simulation of the loop is conducted to proof the mathematical analysis of the loop operation. The results of the loop simulation show that the proposed FR-ZCDPLL has enhanced the performance compared to the conventional zero crossing DPLL in terms of wider lock range, captured range and stable operation region. In addition, extensive experimental simulation was conducted to find the optimum loop parameters for different loop environmental conditions. The addition of the fractional loop delay network in the conventional loop also reduces the phase jitter and its variance especially when the signal-to-noise ratio is low.

  16. Manipulation of peripheral neural feedback loops alters human corticomuscular coherence

    PubMed Central

    Riddle, C Nicholas; Baker, Stuart N

    2005-01-01

    Sensorimotor EEG shows ∼20 Hz coherence with contralateral EMG. This could involve efferent and/or afferent components of the sensorimotor loop. We investigated the pathways responsible for coherence genesis by manipulating nervous conduction delays using cooling. Coherence between left sensorimotor EEG and right EMG from three hand and two forearm muscles was assessed in healthy subjects during the hold phase of a precision grip task. The right arm was then cooled to 10°C for ∼90 min, increasing peripheral motor conduction time (PMCT) by ∼35% (assessed by F-wave latency). EEG and EMG recordings were repeated, and coherence recalculated. Control recordings revealed a heterogeneous subject population. In 6/15 subjects (Group A), the corticomuscular coherence phase increased linearly with frequency, as expected if oscillations were propagated along efferent pathways from cortex to muscle. The mean corticomuscular conduction delay for intrinsic hand muscles calculated from the phase–frequency regression slope was 10.4 ms; this is smaller than the delay expected for conduction over fast corticospinal pathways. In 8/15 subjects (Group B), the phase showed no dependence with frequency. One subject showed both Group A and Group B patterns over different frequency ranges. Following cooling, averaged corticomuscular coherence was decreased in Group A subjects, but unchanged for Group B, even though both groups showed comparable slowing of nervous conduction. The delay calculated from the slope of the phase–frequency regression was increased following cooling. However, the size of this increase was around twice the rise in PMCT measured using the F-wave (regression slope 2.33, 95% confidence limits 1.30–3.36). Both afferent and efferent peripheral nerves will be slowed by similar amounts following cooling. The change in delay calculated from the coherence phase therefore better matches the rise in total sensorimotor feedback loop time caused by cooling, rather than just the change in the efferent limb. A model of corticomuscular coherence which assumes that only efferent pathways contribute cannot be reconciled to these results. The data rather suggest that afferent feedback pathways may also play a role in the genesis of corticomuscular coherence. PMID:15919711

  17. Reduction of Weather-Related Terminal Area Delays in the Free-Flight Era

    NASA Technical Reports Server (NTRS)

    Johnson, Sally C.; Chin, David K.; Rovinsky, Robert B.; Kostiuk, Peter F.; Lee, David A.; Hemm, Robert V.; Wingrove, Earl R., III

    1996-01-01

    While much of the emphasis of the free-flight movement has been concentrated on reducing en-route delays, airport capacity is a major bottleneck in the current airspace system, particularly during bad weather. According to the Air Transport Association (ATA) Air Carrier Delay Reports, ground delays (gate-hold, taxi-in, and taxi-out) comprise 75 percent of total delays. It is likely that the projected steady growth in traffic will only exacerbate these losses. Preliminary analyses show that implementation of the terminal area technologies and procedures under development in NASA s Terminal Area Productivity program can potentially save the airlines at least $350M annually in weather-related delays by the year 2005 at Boston Logan and Detroit airports alone. This paper briefly describes the Terminal Area Productivity program, outlines the costhenefit analyses that are being conducted in support of the program, and presents some preliminary analysis results.

  18. Delays in using chromatic and luminance information to correct rapid reaches.

    PubMed

    Kane, Adam; Wade, Alex; Ma-Wyatt, Anna

    2011-09-07

    People can use feedback to make online corrections to movements but only if there is sufficient time to integrate the new information and make the correction. A key variable in this process is therefore the speed at which the new information about the target location is coded. Conduction velocities for chromatic signals are lower than for achromatic signals so it may take longer to correct reaches to chromatic stimuli. In addition to this delay, the sensorimotor system may prefer achromatic information over the chromatic information as delayed information may be less valuable when movements are made under time pressure. A down-weighting of chromatic information may result in additional latencies for chromatically directed reaches. In our study, participants made online corrections to reaches to achromatic, (L-M)-cone, and S-cone stimuli. Our chromatic stimuli were carefully adjusted to minimize stimulation of achromatic pathways, and we equated stimuli both in terms of detection thresholds and also by their estimated neural responses. Similar stimuli were used throughout the subjective adjustments and final reaching experiment. Using this paradigm, we found that responses to achromatic stimuli were only slightly faster than responses to (L-M)-cone and S-cone stimuli. We conclude that the sensorimotor system treats chromatic and achromatic information similarly and that the delayed chromatic responses primarily reflect early conduction delays.

  19. 76 FR 77891 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and... Project Committee will be held Tuesday, January 03, 2012, at 9:30 a.m. Pacific Time via telephone...

  20. 77 FR 40409 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and... Project Committee will be held Tuesday, August 7, 2012, at 9:30 a.m. Pacific Time via telephone conference...

  1. 77 FR 55525 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ... Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and... Project Committee will be held Tuesday, October 2, 2012, at 9:30 a.m. Pacific Time via telephone...

  2. 77 FR 37103 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and... Project Committee will be held Tuesday, July 03, 2012, at 9:30 a.m. Pacific Time via telephone conference... Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  3. Maternal Obesity: Risks for Developmental Delays in Early Childhood.

    PubMed

    Duffany, Kathleen O'Connor; McVeigh, Katharine H; Kershaw, Trace S; Lipkind, Heather S; Ickovics, Jeannette R

    2016-02-01

    To assess the risk for neurodevelopmental delays for children of mothers who were obese (≥200 pounds) prior to pregnancy, and to characterize delays associated with maternal obesity among children referred to and found eligible to receive Early Intervention Program services. We conducted a retrospective cohort study (N = 541,816) using a population-based New York City data warehouse with linked birth and Early Intervention data. Risks for children suspected of a delay and 'significantly delayed', with two moderate or one severe delay, were calculated. Among the group of children eligible by delay for Early Intervention, analyses assessed risk for being identified with a moderate-to-severe delay across each of five functional domains as well as risks for multiple delays. Children of mothers who were obese were more likely to be suspected of a delay (adjusted RR 1.19 [CI 1.15-1.22]) and borderline association for 'significantly delayed' (adjusted RR 1.01 [CI 1.00-1.02). Among children eligible by delay, children of mothers who were obese evidenced an increased risk for moderate-to-severe cognitive (adjusted RR 1.04 [CI 1.02-1.07]) and physical (adjusted RR 1.04 [CI 1.01-1.08]) delays and for global developmental delay (adjusted RR 1.05 [CI 1.01-1.08]). Maternal obesity is associated with increased risk of developmental delay in offspring. Among children with moderate or severe delays, maternal obesity is associated with increased risk of cognitive and physical delays as well as with increased risk for global developmental delay. While causation remains uncertain, this adds to the growing body of research reporting an association between maternal obesity and neurodevelopmental delays in offspring.

  4. Autoignition study of binary blends of n- dodecane/1-methylnaphthalene and iso- cetane/1-methylnaphthalene

    DOE PAGES

    Kukkadapu, Goutham; Sung, Chih-Jen

    2017-11-24

    An experimental study on autoignition of two binary blends, n-dodecane/1-methylnaphthalene and iso-cetane/1-methylnaphthalene, has been conducted using a rapid compression machine. Specifically, the ignition delays of the stoichiometric blend+air mixtures were measured at elevated pressures of P C = 15 bar and 30 bar, compressed temperatures of T C = 626–944 K, and varying blending ratios of the constituents. For a given set of P C and T C, a nonlinear response of the blend reactivity with respect to the relative amount of the constituents was observed. Since a comprehensive chemical kinetic model for the blends investigated here is under development,more » the current ignition delay datasets serve as the needed targets for model validation. For selected conditions, ignition delay simulations were conducted to highlight and discuss the deficiencies of the literature models and the potential areas for model improvements, especially at low temperatures. In conclusion, further chemical kinetic analyses were conducted to gain understanding of the blending behavior predicted by the available model.« less

  5. Autoignition study of binary blends of n- dodecane/1-methylnaphthalene and iso- cetane/1-methylnaphthalene

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

    Kukkadapu, Goutham; Sung, Chih-Jen

    An experimental study on autoignition of two binary blends, n-dodecane/1-methylnaphthalene and iso-cetane/1-methylnaphthalene, has been conducted using a rapid compression machine. Specifically, the ignition delays of the stoichiometric blend+air mixtures were measured at elevated pressures of P C = 15 bar and 30 bar, compressed temperatures of T C = 626–944 K, and varying blending ratios of the constituents. For a given set of P C and T C, a nonlinear response of the blend reactivity with respect to the relative amount of the constituents was observed. Since a comprehensive chemical kinetic model for the blends investigated here is under development,more » the current ignition delay datasets serve as the needed targets for model validation. For selected conditions, ignition delay simulations were conducted to highlight and discuss the deficiencies of the literature models and the potential areas for model improvements, especially at low temperatures. In conclusion, further chemical kinetic analyses were conducted to gain understanding of the blending behavior predicted by the available model.« less

  6. The effect of antithyroid treatment on atrial conduction times in patients with subclinical hyperthyroidism.

    PubMed

    Nacar, Alper Buğra; Acar, Gürkan; Yorgun, Hikmet; Akçay, Ahmet; Özkaya, Mesut; Canpolat, Uğur; Akkoyun, Murat; Tuncer, Cemal

    2012-09-01

    Prolonged atrial conduction time measured by tissue Doppler imaging (TDI) has been associated with increased risk of atrial fibrillation. We aimed to evaluate the effect of subclinical hyperthyroidism (SH) and antithyroid treatment on atrial conduction time. A total of 30 patients with SH (26 females; mean age 34.8 ± 8.5 years) and 30 age- and gender-matched controls were included. Using TDI, atrial conduction time was measured from the lateral mitral annulus, septal mitral annulus, and lateral tricuspid annulus. Intra- and interatrial conduction delay were calculated. TDI and thyroid hormone levels were studied at the time of enrollment and after achievement of euthyroid state with propylthiouracil treatment. Patients were followed for 14 ± 3 weeks. Atrial conduction time at the lateral and septal mitral annulus were significantly higher in patients with SH compared to controls. Both inter-, right, and left intraatrial electromechanical delay were prolonged in patients with SH compared to control subjects (21.3 ± 6.1 vs. 13.9 ± 4.3, P < 0.001 and 4.2 ± 3.5 vs. 2.3 ± 1.9, P = 0.014 and 17.1 ± 6.0 vs. 11.6 ± 3.8, P < 0.001, respectively). After achievement of euthyroid state, inter- and left intraatrial electromechanical delay were significantly decreased compared to baseline values and approximated to the values of the control group (P < 0.001). SH is associated with prolonged atrial conduction time. After achievement of euthyroid state, decrement in atrial conduction time may reveal how the antithyroid treatment may prevent the development of atrial fibrillation in these patients. © 2012, Wiley Periodicals, Inc.

  7. High frequency modulation circuits based on photoconductive wide bandgap switches

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

    Sampayan, Stephen

    Methods, systems, and devices for high voltage and/or high frequency modulation. In one aspect, an optoelectronic modulation system includes an array of two or more photoconductive switch units each including a wide bandgap photoconductive material coupled between a first electrode and a second electrode, a light source optically coupled to the WBGP material of each photoconductive switch unit via a light path, in which the light path splits into multiple light paths to optically interface with each WBGP material, such that a time delay of emitted light exists along each subsequent split light path, and in which the WBGP materialmore » conducts an electrical signal when a light signal is transmitted to the WBGP material, and an output to transmit the electrical signal conducted by each photoconductive switch unit. The time delay of the photons emitted through the light path is substantially equivalent to the time delay of the electrical signal.« less

  8. Minimization of Delay Costs in the Realization of Production Orders in Two-Machine System

    NASA Astrophysics Data System (ADS)

    Dylewski, Robert; Jardzioch, Andrzej; Dworak, Oliver

    2018-03-01

    The article presents a new algorithm that enables the allocation of the optimal scheduling of the production orders in the two-machine system based on the minimum cost of order delays. The formulated algorithm uses the method of branch and bounds and it is a particular generalisation of the algorithm enabling for the determination of the sequence of the production orders with the minimal sum of the delays. In order to illustrate the proposed algorithm in the best way, the article contains examples accompanied by the graphical trees of solutions. The research analysing the utility of the said algorithm was conducted. The achieved results proved the usefulness of the proposed algorithm when applied to scheduling of orders. The formulated algorithm was implemented in the Matlab programme. In addition, the studies for different sets of production orders were conducted.

  9. Young pigs exhibit differential exploratory behavior during novelty preference tasks in response to age, sex, and delay.

    PubMed

    Fleming, Stephen A; Dilger, Ryan N

    2017-03-15

    Novelty preference paradigms have been widely used to study recognition memory and its neural substrates. The piglet model continues to advance the study of neurodevelopment, and as such, tasks that use novelty preference will serve especially useful due to their translatable nature to humans. However, there has been little use of this behavioral paradigm in the pig, and previous studies using the novel object recognition paradigm in piglets have yielded inconsistent results. The current study was conducted to determine if piglets were capable of displaying a novelty preference. Herein a series of experiments were conducted using novel object recognition or location in 3- and 4-week-old piglets. In the novel object recognition task, piglets were able to discriminate between novel and sample objects after delays of 2min, 1h, 1 day, and 2 days (all P<0.039) at both ages. Performance was sex-dependent, as females could perform both 1- and 2-day delays (P<0.036) and males could perform the 2-day delay (P=0.008) but not the 1-day delay (P=0.347). Furthermore, 4-week-old piglets and females tended to exhibit greater exploratory behavior compared with males. Such performance did not extend to novel location recognition tasks, as piglets were only able to discriminate between novel and sample locations after a short delay (P>0.046). In conclusion, this study determined that piglets are able to perform the novel object and location recognition tasks at 3-to-4 weeks of age, however performance was dependent on sex, age, and delay. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Motivational Climate, Motor-Skill Development, and Perceived Competence: Two Studies of Developmentally Delayed Kindergarten Children

    ERIC Educational Resources Information Center

    Valentini, Nadia; Rudisill, Mary E.

    2004-01-01

    Two studies were conducted to examine the effects of motivational climate on motor-skill development and perceived physical competence in kindergarten children with developmental delays. In Experiment 1, two intervention groups were exposed to environments with either high (mastery climate) or low autonomy for 12 weeks. Results showed that the…

  11. Effects of delayed wrapping and moisture content on intake and digestibility of ryegrass silage by growing lambs

    USDA-ARS?s Scientific Manuscript database

    Baling silage provides an alternative method for preserving forage quality in areas where hay production can be compromised because of the risk of rain exposure and humidity. This study was conducted to examine the effects of moisture content at baling and delayed wrapping intervals on the intake an...

  12. Spontaneous ignition characteristics of gaseous hydrocarbon-air mixtures

    NASA Technical Reports Server (NTRS)

    Freeman, G.; Lefebvre, A. H.

    1984-01-01

    Experiments are conducted to determine the spontaneous ignition delay times of gaseous propane, kerosine vapor, and n-heptane vapor in mixtures with air, and oxygen-enriched air, at atmospheric pressure. Over a range of equivalence ratios from 0.2 to 0.8 it is found that ignition delay times are sensibly independent of fuel concentration. However, the results indicate a strong dependence of delay times on oxygen concentration. The experimental data for kerosine and propane demonstrate very close agreement with the results obtained previously by Mullins and Lezberg respectively.

  13. The effect of response-delay on estimating reachability.

    PubMed

    Gabbard, Carl; Ammar, Diala

    2008-11-01

    The experiment was conducted to compare visual imagery (VI) and motor imagery (MI) reaching tasks in a response-delay paradigm designed to explore the hypothesized dissociation between vision for perception and vision for action. Although the visual systems work cooperatively in motor control, theory suggests that they operate under different temporal constraints. From this perspective, we expected that delay would affect MI but not VI because MI operates in real time and VI is postulated to be memory-driven. Following measurement of actual reach, right-handers were presented seven (imagery) targets at midline in eight conditions: MI and VI with 0-, 1-, 2-, and 4-s delays. Results indicted that delay affected the ability to estimate reachability with MI but not with VI. These results are supportive of a general distinction between vision for perception and vision for action.

  14. Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal.

    PubMed

    LeBrun, Drake G; Talwar, Divya; Pham, Tuyetnhi A; Banskota, Bibek; Spiegel, David A

    2017-12-01

    Healthcare seeking behaviors among children with musculoskeletal disorders are poorly understood. We sought to analyze healthcare seeking delays among children with chronic musculoskeletal conditions in Nepal and identify predictors of clinically significant delays. A cross-sectional study was conducted at a large pediatric musculoskeletal rehabilitation center in Nepal. Baseline sociodemographic data and healthcare seeking behaviors were assessed via interviews with 75 randomly selected caregivers. Delays of at least 3 months between disease recognition and presentation to a health worker were considered clinically significant. Predictors of significant delay were assessed via multivariable logistic regression. Clubfoot was the most common condition seen in the study sample (N = 33; 37%). Mean and median presentation delays were 33 months and 14 months, respectively. Sixty-seven percent of children were delayed at least 3 months and 40% were delayed at least 2 years. Caregiver occupation in agriculture or unskilled labor was associated with an increased risk of delayed presentation (adjusted OR = 4.05; 95% CI: 1.36-12.09). Children with chronic musculoskeletal disorders in Nepal face significant delays in accessing healthcare. This poses a major clinical problem as the delayed diagnosis and treatment of childhood musculoskeletal disorders can complicate management options and decrease long-term quality of life. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  15. Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan.

    PubMed

    Abu-Helalah, Ahmad Munir; Alshraideh, Hussam Ahmad; Al-Hanaqtah, Mo'tasem; Da'na, Moh'd; Al-Omari, Asim; Mubaidin, Rasmi

    2016-01-01

    Breast cancer is the most common cancer, and one of the leading causes of death for females in Jordan and many countries in the world. Studies have shown that delay in symptoms presentation, diagnosis or treatment would result in poor prognosis. There has been no published study from Jordan on delays in patient presentation, delays in diagnosis, or delays in treatment. Therefore, we conducted this study to assess these important quality indicators aiming to improve prognosis for breast cancer patients in Jordan. This project was a cross-sectional study on female breast cancer patients in Jordan. The total number of participants was 327. The proportion of patients with presentation delay, diagnosis delay, and treatment delay was 32.2%, 49.1%, or 32.4%, respectively. The main reported reasons for delay in presentation were ignorance of the nature of the problem (65.6%), limited/lack of knowledge that symptoms were suggestive of cancer diagnosis (16.7%), and misdiagnosis (16.7%). Predictors of delay and mean time for presentation, diagnosis, and treatment were identified. Our results reveal that breast cancer patients in Jordan are experiencing delays in presentation, diagnosis, and treatment. This could justify the advanced stages at diagnosis and poor outcomes for breast cancer patients in Jordan. We recommend revising the current early detection and down-staging programs in Jordan. © 2015 Wiley Periodicals, Inc.

  16. Estimates of delays in diagnosis of cervical cancer in Nepal

    PubMed Central

    2014-01-01

    Background Cervical cancer is the leading cause of cancer related deaths among women in Nepal. The long symptom to diagnosis interval means that women have advanced disease at presentation. The aim of this study was to identify, estimate and describe the extent of different delays in diagnosis of cervical cancer in Nepal. Methods A cross-sectional descriptive study was conducted in two tertiary cancer hospitals of Nepal. Face to face interview and medical records review were carried out among 110 cervical cancer patients. Total diagnostic delay was categorized into component delays: patient delay, health care providers delay, referral delay and diagnostic waiting time. Results Total 110 patients recruited in the study represented 40 districts from all three ecological regions of the country. Median total diagnostic delay was 157 days with more than three fourth (77.3%) of the patients having longer total diagnostic delay of >90 days. Out of the total diagnostic delay, median patient delay, median health care provider delay, median referral delay and median diagnostic waiting time were 68.5 days, 40 days, 5 days and 9 days respectively. Majority of the patients had experienced longer delay of each type except referral delay. Fifty seven percent of the patients had experienced longer patient delay of >60 days, 90% had suffered longer health care provider delay of >1 week, 31.8% had longer referral delay of >1 week and 66.2% had waited >1 week at diagnostic center for final diagnosis. Variation in each type of delay was observed among women with different attributes and in context of health care service delivery. Conclusions Longer delays were observed in all the diagnostic pathways except for referral delay and diagnostic waiting time. Among the delays, patient delay is of crucial importance because of its longer span, although health care provider delay is equally important. In the context of limited screening services in Nepal, the efforts should be to reduce the diagnostic delay especially patient and health care provider delay for early detection and reduction of mortality rate of cervical cancer. PMID:24533670

  17. "Why doesn't she seek help for partner abuse?" An exploratory study with South Asian immigrant women.

    PubMed

    Ahmad, Farah; Driver, Natasha; McNally, Mary Jane; Stewart, Donna E

    2009-08-01

    This study explores why South Asian immigrant women with experiences of partner abuse delay seeking help from professionals. Three focus groups were conducted in Hindi language with South Asian immigrant women in Toronto. Twenty-two women participated with a mean age of 46 years (range 29-68 years). Thematic analysis was conducted on the transcribed data using constant comparison techniques within and across the groups. We found that three major themes emerged from the discussions: reasons for delayed help-seeking, turning points and talking to professionals. Women expressed delaying help-seeking to the point when "Pani sar se guzar jata he" (water crosses over your head). Their dominant reasons for delayed help-seeking were social stigma, rigid gender roles, marriage obligations, expected silence, loss of social support after migration and limited knowledge about available resources and myths about partner abuse. Women usually turned for help only after experiencing pronounced mental and physical health problems. The findings are interpreted in light of participants' immigration context and the socio-cultural norms of patriarchy, collectivism and familism. Prevention approaches to address partner abuse and delayed help-seeking among South Asian immigrant women should include tailored community education, social services to reduce vulnerability, and cultural competency of professionals. Further research and program evaluation is needed to advance the field.

  18. Organization of Anti-Phase Synchronization Pattern in Neural Networks: What are the Key Factors?

    PubMed Central

    Li, Dong; Zhou, Changsong

    2011-01-01

    Anti-phase oscillation has been widely observed in cortical neural network. Elucidating the mechanism underlying the organization of anti-phase pattern is of significance for better understanding more complicated pattern formations in brain networks. In dynamical systems theory, the organization of anti-phase oscillation pattern has usually been considered to relate to time delay in coupling. This is consistent to conduction delays in real neural networks in the brain due to finite propagation velocity of action potentials. However, other structural factors in cortical neural network, such as modular organization (connection density) and the coupling types (excitatory or inhibitory), could also play an important role. In this work, we investigate the anti-phase oscillation pattern organized on a two-module network of either neuronal cell model or neural mass model, and analyze the impact of the conduction delay times, the connection densities, and coupling types. Our results show that delay times and coupling types can play key roles in this organization. The connection densities may have an influence on the stability if an anti-phase pattern exists due to the other factors. Furthermore, we show that anti-phase synchronization of slow oscillations can be achieved with small delay times if there is interaction between slow and fast oscillations. These results are significant for further understanding more realistic spatiotemporal dynamics of cortico-cortical communications. PMID:22232576

  19. Delayed healing of lower limb fractures with bisphosphonate therapy.

    PubMed

    Yue, B; Ng, A; Tang, H; Joseph, S; Richardson, M

    2015-07-01

    Bisphosphonate therapy (BT) is used commonly in the management of osteoporosis. A systematic review was conducted investigating delayed union of lower limb, long bone fractures in patients on BT. We specifically assessed whether BT increases the risk of delayed union or non-union in lower limb, long bone fractures. A literature search was conducted in the PubMed and Embase™ on 4 November 2014. Articles that investigated lower limb fractures, history of BT and fracture union were included in the review. A total of 9,809 papers were retrieved and 14 were deemed suitable for this review. The mean time to union in patients on BT was 8.5 months. A longer time to union was reported in a study investigating BT users versus controls (6.5 vs 4.8 months respectively). The mean rate of delayed or non-union for BT associated atypical fractures was 20% per fracture. Specifically in one study, delayed union was more common in the cohort with more than three years of BT (67%) than in the group with less than three years of BT (26%). Surgical fixation was associated with improved outcomes compared with non-operative management. BT has been described to be associated with multiple adverse outcomes related to atypical fractures. Current evidence recommends operative management for this patient group. Further investigation is required to evaluate the exact effects of BT on lower limb fractures, in particular typical femoral fractures.

  20. Churg-Strauss syndrome associated with rapid deterioration of left ventricular diastolic dysfunction and conduction disturbance.

    PubMed

    Chin, Jung Yeon; Yi, Jeong Eun; Youn, Ho-Joong

    2013-10-01

    Cardiac involvement in Churg-Strauss syndrome (CSS) is a major cause of mortality. Here we report a case of a 75-year-old woman with eosinophilic endomyocarditis due to CSS. An electrocardiogram showed intraventricular conduction delay, and echocardiography showed an impaired relaxation pattern and biventricular apical thickening. Magnetic resonance imaging revealed subendocardial delayed enhancement with biventricular apical thrombi. Endomyocardial biopsy showed perivascular eosinophilic infiltration. Despite resolution of the hypereosinophilia after steroid therapy, her left ventricular (LV) diastolic function worsened into a restrictive pattern and she died with a ventricular escape rhythm on her 14th day in the hospital. This case is unusual in that there was rapid progression of the LV diastolic dysfunction and conduction disturbance due to CSS. © 2013, Wiley Periodicals, Inc.

  1. Impact of Morphometry, Myelinization and Synaptic Current Strength on Spike Conduction in Human and Cat Spiral Ganglion Neurons

    PubMed Central

    Rattay, Frank; Potrusil, Thomas; Wenger, Cornelia; Wise, Andrew K.; Glueckert, Rudolf; Schrott-Fischer, Anneliese

    2013-01-01

    Background Our knowledge about the neural code in the auditory nerve is based to a large extent on experiments on cats. Several anatomical differences between auditory neurons in human and cat are expected to lead to functional differences in speed and safety of spike conduction. Methodology/Principal Findings Confocal microscopy was used to systematically evaluate peripheral and central process diameters, commonness of myelination and morphology of spiral ganglion neurons (SGNs) along the cochlea of three human and three cats. Based on these morphometric data, model analysis reveales that spike conduction in SGNs is characterized by four phases: a postsynaptic delay, constant velocity in the peripheral process, a presomatic delay and constant velocity in the central process. The majority of SGNs are type I, connecting the inner hair cells with the brainstem. In contrast to those of humans, type I neurons of the cat are entirely myelinated. Biophysical model evaluation showed delayed and weak spikes in the human soma region as a consequence of a lack of myelin. The simulated spike conduction times are in accordance with normal interwave latencies from auditory brainstem response recordings from man and cat. Simulated 400 pA postsynaptic currents from inner hair cell ribbon synapses were 15 times above threshold. They enforced quick and synchronous spiking. Both of these properties were not present in type II cells as they receive fewer and much weaker (∼26 pA) synaptic stimuli. Conclusions/Significance Wasting synaptic energy boosts spike initiation, which guarantees the rapid transmission of temporal fine structure of auditory signals. However, a lack of myelin in the soma regions of human type I neurons causes a large delay in spike conduction in comparison with cat neurons. The absent myelin, in combination with a longer peripheral process, causes quantitative differences of temporal parameters in the electrically stimulated human cochlea compared to the cat cochlea. PMID:24260179

  2. System for sensing droplet formation time delay in a flow cytometer

    DOEpatents

    Van den Engh, Ger; Esposito, Richard J.

    1997-01-01

    A droplet flow cytometer system which includes a system to optimize the droplet formation time delay based on conditions actually experienced includes an automatic droplet sampler which rapidly moves a plurality of containers stepwise through the droplet stream while simultaneously adjusting the droplet time delay. Through the system sampling of an actual substance to be processed can be used to minimize the effect of the substances variations or the determination of which time delay is optimal. Analysis such as cell counting and the like may be conducted manually or automatically and input to a time delay adjustment which may then act with analysis equipment to revise the time delay estimate actually applied during processing. The automatic sampler can be controlled through a microprocessor and appropriate programming to bracket an initial droplet formation time delay estimate. When maximization counts through volume, weight, or other types of analysis exists in the containers, the increment may then be reduced for a more accurate ultimate setting. This may be accomplished while actually processing the sample without interruption.

  3. Influence of age on delayed surgical treatment of proximal femoral fractures

    PubMed Central

    Gomes, Lisiane Pinto; do Nascimento, Leandra Delfim; Campos, Tulio Vinicius de Oliveira; Paiva, Edson Barreto; de Andrade, Marco Antonio Percope; Guimarães, Henrique Cerqueira

    2015-01-01

    ABSTRACT OBJECTIVE : To investigate the influence of patients' age on the delay between diagnosis and surgical treatment of proximal femoral fractures METHODS : This is a retrospective study, con-ducted at a tertiary university hospital, including all patients admitted with proximal femoral fractures between March 2013 and March 2014. The participants were categorized into four groups according to age levels. The groups were compared according to demographics, comorbidities, fracture type, trau-ma circumstances, and time between diagnosis and surgical procedure RESULTS : One hundred and sixty one patients were included, 37 adults and 124 elderly. Among adults, the mean delay between diagnosis and surgical procedure was 6.4±5.3 days; among elderly the delay was 9.5±7.6 days. There was a progressive increase in the delay from the young-adults group through the elderly individuals (Kruskal-Wallis: 13.7; p=0.003) CONCLUSION : In spite of being the patients most susceptible to complications due to surgical delay, the elderly individuals pre-sented the longest delays from admission to surgical treatment. Level of Evidence III, Retrospective Study. PMID:27057145

  4. Working Towards Safe Motherhood: Delays and Barriers to Prenatal Care for Women in Rural and Peri-Urban Areas of Georgia.

    PubMed

    Meyer, Erika; Hennink, Monique; Rochat, Roger; Julian, Zoë; Pinto, Meredith; Zertuche, Adrienne D; Spelke, Bridget; Dott, Andrew; Cota, Pat

    2016-07-01

    Objectives Georgia has the highest rate of maternal mortality in the United States, and ranks 40th for infant mortality. The Georgia Maternal and Infant Health Research Group was formed to investigate and address the shortage of obstetric care providers outside the Atlanta area. Because access to prenatal care (PNC) can improve maternal and infant health outcomes, we used qualitative methods to identify the access barriers experienced by women who live in rural and peri-urban areas of the state. Methods We conducted semi-structured, in-depth interviews with 24 mothers who gave birth between July and August 2013, and who live in either shortage or non-shortage obstetric care service areas. We also conducted key informant interviews with four perinatal case managers, and analyzed all data using applied thematic analysis. We then utilized Thaddeus and Maine's "Three Delays to Care" theoretical framework structure to describe the recognized barriers to care. Results We identified delays in a woman's decision to seek PNC (such as awareness of pregnancy and stigma); delays in accessing an appropriate healthcare facility (such as choosing a doctor and receiving insurance coverage); and delays in receiving adequate and appropriate care (such as continuity of care and communication). Moreover, many participants perceived low self-worth and believed this influenced their PNC exchanges. Conclusion As a means of supporting Georgia's pregnant women who face barriers and delays to PNC, these data provide a rationale for developing contextually relevant solutions to both mothers and their providers.

  5. Stigma is Associated with Delays in Seeking Care Among HIV-Infected People in India

    PubMed Central

    Steward, Wayne T.; Bharat, Shalini; Ramakrishna, Jayashree; Heylen, Elsa; Ekstrand, Maria L.

    2012-01-01

    Background Stigma shapes the lives of people living with HIV and may affect their willingness to seek medical care. But treatment delays can compromise health and increase the risk of transmission to others. Purpose To examine whether four stigma manifestations—enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma’s prevalence) and internalized (personal endorsement of stigma beliefs)—were linked with delays in seeking care among HIV-infected people in India. Methods A cross-sectional survey was conducted with 961 HIV-positive men and women in Mumbai and Bengaluru. Results Enacted and internalized stigmas were correlated with delays in seeking care after testing HIV-positive. Depression symptoms mediated the associations of enacted and internalized stigmas with care seeking delays, whereas efforts to avoiding disclosing HIV status mediated only the association between internalized stigma and care seeking delays. Conclusions It is vital to develop stigma reduction interventions to ensure timely receipt of care. PMID:22282878

  6. Causes of shortage and delay in material supply: a preliminary study

    NASA Astrophysics Data System (ADS)

    Rahman, M. M.; Yap, Y. H.; Ramli, N. R.; Dullah, M. A.; Shamsuddin, M. S. W.

    2017-11-01

    Shortage and delay in materials supply is argued to be one of the most important factors that lead to delay in construction project delivery globally. However, the relevant underlying reasons vary from country to country. As such, this paper summarises the outcomes of a study that targeted identifying causes of shortage and delay in materials supply in Brunei Darussalam. The study was conducted through fifteen semi-structured interviews of contractors and materials suppliers in Brunei. The study identified six causes of shortageof materials and nine causes of delay in materials supply in Brunei. The most importantcausefor shortage of materials relates to the origin or availability of construction materials. On the other hand, the most influential cause of delay in material supply was found to be poor materials procurement and inventory management system, which has other underlying reasons such as late identification of the type of materials needed. The observations are expected to help in formulating or reviewing relevant policies, in order to ensure on-time project delivery.

  7. Factors Associated with Delayed Childbearing: From the Voices of Expectant Latina Adults and Teens in California

    ERIC Educational Resources Information Center

    Biggs, M. Antonia; Ralph, Lauren; Minnis, Alexandra M.; Arons, Abigail; Marchi, Kristen S.; Lehrer, Jocelyn A.; Braveman, Paula A.; Brindis, Claire D.

    2010-01-01

    There has been limited research on the protective factors that help Latinas delay childbearing until adulthood. In-depth interviews were conducted with 65 pregnant Latina teenage and adult women in California who were about to have their first child. Lack of or inconsistent birth control use as teens was attributed to wanting or ambivalence toward…

  8. Contextual-Specificity of Short-Delay Extinction in Humans: Renewal of Fear-Potentiated Startle in a Virtual Environment

    ERIC Educational Resources Information Center

    Alvarez, Ruben P.; Johnson, Linda; Grillon, Christian

    2007-01-01

    A recent fear-potentiated startle study in rodents suggested that extinction was not context dependent when extinction was conducted after a short delay following acquisition, suggesting that extinction can lead to erasure of fear learning in some circumstances. The main objective of this study was to attempt to replicate these findings in humans…

  9. A Microdata Model of Delayed Entry Program (DEP) Behavior. Technical Report 666.

    ERIC Educational Resources Information Center

    Phillips, Chester E.; Schmitz, Edward J.

    High personnel loss rates among recruits who have signed up for the Army's Delayed Entry Program (DEP) are becoming an increasing problem for DEP program managers. Therefore, a research project was conducted to examine DEP loss as a function of sociodemography and policy variables at the microdata level. Two DEP loss models were created. The first…

  10. The Effects of Imitation Instruction Using a Mirror on the Emergence of Duplicative Responses by Preschool Students Diagnosed with Developmental Delays

    ERIC Educational Resources Information Center

    Moreno, Jalene Donica

    2012-01-01

    Using pre-and post-intervention non-concurrent multiple probe designs across participants, I conducted 2 experiments that tested the effects of imitation instruction using a mirror on the emergence of both basic and advanced forms of generalized imitation (GI) involving physical actions with preschool students diagnosed with developmental delays.…

  11. The Effects of Social Skills Groups for Young Children with Social Delays

    ERIC Educational Resources Information Center

    Koyama, Takanori

    2011-01-01

    This study was conducted as a program evaluation of an existing social skills program. A review of literature identified a limited number of empirical studies on group-based social skills training for young children with social delays. The purpose of this study was to examine the effects of social skills groups as well as the effects of homework…

  12. Teaching Generalized Reading of Product Warning Labels to Young Adults with Autism Using the Constant Time Delay Procedure

    ERIC Educational Resources Information Center

    Dogoe, Maud S.; Banda, Devender R.; Lock, Robin H.; Feinstein, Rita

    2011-01-01

    This study examined the effectiveness of the constant timed delay procedure for teaching two young adults with autism to read, define, and state the contextual meaning of keywords on product warning labels of common household products. Training sessions were conducted in the dyad format using flash cards. Results indicated that both participants…

  13. Effects of simulator motion and visual characteristics on rotorcraft handling qualities evaluations

    NASA Technical Reports Server (NTRS)

    Mitchell, David G.; Hart, Daniel C.

    1993-01-01

    The pilot's perceptions of aircraft handling qualities are influenced by a combination of the aircraft dynamics, the task, and the environment under which the evaluation is performed. When the evaluation is performed in a groundbased simulator, the characteristics of the simulation facility also come into play. Two studies were conducted on NASA Ames Research Center's Vertical Motion Simulator to determine the effects of simulator characteristics on perceived handling qualities. Most evaluations were conducted with a baseline set of rotorcraft dynamics, using a simple transfer-function model of an uncoupled helicopter, under different conditions of visual time delays and motion command washout filters. Differences in pilot opinion were found as the visual and motion parameters were changed, reflecting a change in the pilots' perceptions of handling qualities, rather than changes in the aircraft model itself. The results indicate a need for tailoring the motion washout dynamics to suit the task. Visual-delay data are inconclusive but suggest that it may be better to allow some time delay in the visual path to minimize the mismatch between visual and motion, rather than eliminate the visual delay entirely through lead compensation.

  14. The effects of delay duration on visual working memory for orientation.

    PubMed

    Shin, Hongsup; Zou, Qijia; Ma, Wei Ji

    2017-12-01

    We used a delayed-estimation paradigm to characterize the joint effects of set size (one, two, four, or six) and delay duration (1, 2, 3, or 6 s) on visual working memory for orientation. We conducted two experiments: one with delay durations blocked, another with delay durations interleaved. As dependent variables, we examined four model-free metrics of dispersion as well as precision estimates in four simple models. We tested for effects of delay time using analyses of variance, linear regressions, and nested model comparisons. We found significant effects of set size and delay duration on both model-free and model-based measures of dispersion. However, the effect of delay duration was much weaker than that of set size, dependent on the analysis method, and apparent in only a minority of subjects. The highest forgetting slope found in either experiment at any set size was a modest 1.14°/s. As secondary results, we found a low rate of nontarget reports, and significant estimation biases towards oblique orientations (but no dependence of their magnitude on either set size or delay duration). Relative stability of working memory even at higher set sizes is consistent with earlier results for motion direction and spatial frequency. We compare with a recent study that performed a very similar experiment.

  15. Predictors of the Persistence of Conduct Difficulties in Children with Cognitive Delay

    ERIC Educational Resources Information Center

    Emerson, Eric; Einfeld, Stewart; Stancliffe, Roger J.

    2011-01-01

    Background: High rates of conduct difficulties have been reported among children with borderline intellectual disabilities or intellectual disabilities. Little is known about predictors of the persistence of conduct difficulties in the pre-adolescent period in this high-risk group. Methods: Secondary analysis of data from the first three waves of…

  16. Robust stability for stochastic bidirectional associative memory neural networks with time delays

    NASA Astrophysics Data System (ADS)

    Shu, H. S.; Lv, Z. W.; Wei, G. L.

    2008-02-01

    In this paper, the asymptotic stability is considered for a class of uncertain stochastic bidirectional associative memory neural networks with time delays and parameter uncertainties. The delays are time-invariant and the uncertainties are norm-bounded that enter into all network parameters. The aim of this paper is to establish easily verifiable conditions under which the delayed neural network is robustly asymptotically stable in the mean square for all admissible parameter uncertainties. By employing a Lyapunov-Krasovskii functional and conducting the stochastic analysis, a linear matrix inequality matrix inequality (LMI) approach is developed to derive the stability criteria. The proposed criteria can be easily checked by the Matlab LMI toolbox. A numerical example is given to demonstrate the usefulness of the proposed criteria.

  17. Radiation from lightning return strokes over a finitely conducting earth

    NASA Technical Reports Server (NTRS)

    Le Vine, D. M.; Gesell, L.; Kao, Michael

    1986-01-01

    The effects of the conductivity of the earth on radiation from lightning return strokes are examined theoretically using a piecewise linear transmission line model for the return stroke. First, calculations are made of the electric field radiated during the return stroke, and then this electric field is used to compute the response of conventional AM radio receivers and electric field change systems during the return stroke. The calculations apply to the entire transient waveform (they are not restricted to the initial portions of the return stroke) and yield fast field changes and RF radiation in agreement with measurements made during real lightning. This research was motivated by measurements indicating that a time delay exists between the time of arrival of the fast electric field change and the RF radiation from first return strokes. The time delay is on the order of 20 microsec for frequencies in the HF-UHF range for lightning in Florida. The time delay is obtained theoretically in this paper. It occurs when both the effects of attenuation due to conductivity of the earth, and the finite velocity of propagation of the current pulse up the return stroke channel, are taken into account in the model.

  18. Altering impulsive decision making with an acceptance-based procedure.

    PubMed

    Morrison, Kate L; Madden, Gregory J; Odum, Amy L; Friedel, Jonathan E; Twohig, Michael P

    2014-09-01

    Delay discounting is one facet of impulsive decision making and involves subjectively devaluing a delayed outcome. Steeply discounting delayed rewards is correlated with substance abuse and other problematic behaviors. To the extent that steep delay discounting underlies these clinical disorders, it would be advantageous to find psychosocial avenues for reducing delay discounting. Acceptance-based interventions may prove useful as they may help to decrease the distress that arises while waiting for a delayed outcome. The current study was conducted to determine if a 60-90 minute acceptance-based training would change delay discounting rates among 30 undergraduate university students in comparison to a waitlist control. Measures given at pre- and posttraining included a hypothetical monetary delay discounting task, the Acceptance and Action Questionnaire-II (AAQ-II), and the Distress Tolerance Scale. Those assigned to the treatment group decreased their discounting of delayed money, but not distress intolerance or psychological inflexibility when compared to the waitlist control group. After the waiting period, the control group received the intervention. Combining all participants' pre- to posttreatment data, the acceptance-based treatment significantly decreased discounting of monetary rewards and increased distress tolerance. The difference in AAQ-II approached significance. Acceptance-based treatments may be a worthwhile option for decreasing delay discounting rates and, consequently, affecting the choices that underlie addiction and other problematic behaviors. Copyright © 2014. Published by Elsevier Ltd.

  19. Piloted simulator study of allowable time delay in pitch flight control system of a transport airplane with negative static stability

    NASA Technical Reports Server (NTRS)

    Grantham, William D.; Smith, Paul M.; Person, Lee H., Jr.; Meyer, Robert T.; Tingas, Stephen A.

    1987-01-01

    A piloted simulation study was conducted to determine the permissible time delay in the flight control system of a 10-percent statically unstable transport airplane during cruise flight conditions. The math model used for the simulation was a derivative Lockheed L-1011 wide-body jet transport. Data were collected and analyzed from a total of 137 cruising flights in both calm- and turbulent-air conditions. Results of this piloted simulation study verify previous findings that show present military specifications for allowable control-system time delay may be too stringent when applied to transport-size airplanes. Also, the degree of handling-qualities degradation due to time delay is shown to be strongly dependent on the source of the time delay in an advanced flight control system. Maximum allowable time delay for each source of time delay in the control system, in addition to a less stringent overall maximum level of time delay, should be considered for large aircraft. Preliminary results also suggest that adverse effects of control-system time delay may be at least partially offset by variations in control gearing. It is recommended that the data base include different airplane baselines, control systems, and piloting tasks with many pilots participating, so that a reasonable set of limits for control-system time delay can be established to replace the military specification limits currently being used.

  20. Escaping the impulse to immediate gratification: the prospect concept promotes a future-oriented mindset, prompting an inclination towards delayed gratification.

    PubMed

    Cheng, Ying-Yao; Shein, Paichi Pat; Chiou, Wen-Bin

    2012-02-01

    People's willingness to postpone receiving an immediate reward in order to gain additional benefits in the future, that is, a tendency to shallow delay discounting, is closely related to one's health, wealth, and happiness. We conducted two experiments investigating how the prospect concept can induce a future-oriented mindset and induce people to behave accordingly. We found that engaging in prospective imagery led the participants to focus on delayed utility over immediate utility in financial decisions (Experiment 1). Participants who received the prospect prime via a scrambled-sentence task decreased their desire to pursue hedonic activities for instant gratification (Experiment 2). Moreover, a state of future orientation mediated the effect of the prospect prime on measures of delayed gratification (Experiments 1 and 2). Thus, reminders of prospect may activate a mindset for future orientation by which delayed gratification is strengthened. ©2011 The British Psychological Society.

  1. The slant path atmospheric refraction calibrator - An instrument to measure the microwave propagation delays induced by atmospheric water vapor

    NASA Technical Reports Server (NTRS)

    Walter, Steven J.; Bender, Peter L.

    1992-01-01

    The water vapor-induced propagation delay experienced by a radio signal traversing the atmosphere is characterized by the Slant Path Atmospheric Refraction Calibrator (SPARC), which measures the difference in the travel times between an optical and a microwave signal propagating along the same atmospheric path with an accuracy of 15 picosec or better. Attention is given to the theoretical and experimental issues involved in measuring the delay induced by water vapor; SPARC measurements conducted along a 13.35-km ground-based path are presented, illustrating the instrument's stability, precision, and accuracy.

  2. Perceived Discrimination and Reported Delay of Pharmacy Prescriptions and Medical Tests

    PubMed Central

    Van Houtven, Courtney Harold; Voils, Corrine I; Oddone, Eugene Z; Weinfurt, Kevin P; Friedman, Joëlle Y; Schulman, Kevin A; Bosworth, Hayden B

    2005-01-01

    BACKGROUND Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for economic constraints, self-reported health, depression, and demographics. DESIGN Cross-sectional, observational study. PARTICIPANTS A randomly selected community sample of 181 blacks, 148 Latinos, and 193 whites in Durham County, NC. MEASUREMENTS A phone survey conducted in 2002 to assess discrimination, trust in medical care, quality of care, and access to care. Treatment delays were measured by whether or not a person reported delaying or forgoing filling a prescription and delaying or forgoing having a medical test/treatment in the past 12 months. Perceived discrimination was measured as unfair treatment in health care and as racism in local health care institutions. RESULTS The odds of delaying filling prescriptions were significantly higher (odds ratio (OR)=2.02) for persons who perceived unfair treatment, whereas the odds of delaying tests or treatments were significantly higher (OR=2.42) for persons who thought racism was a problem in health care locally. People with self-reported depression and people who reported not working had greater odds of delaying both types of care. CONCLUSIONS A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment delays, would help us better understand the relationship between perceived discrimination and treatment delays. PMID:16050850

  3. Axonal Conduction Delays, Brain State, and Corticogeniculate Communication

    PubMed Central

    2017-01-01

    Thalamocortical conduction times are short, but layer 6 corticothalamic axons display an enormous range of conduction times, some exceeding 40–50 ms. Here, we investigate (1) how axonal conduction times of corticogeniculate (CG) neurons are related to the visual information conveyed to the thalamus, and (2) how alert versus nonalert awake brain states affect visual processing across the spectrum of CG conduction times. In awake female Dutch-Belted rabbits, we found 58% of CG neurons to be visually responsive, and 42% to be unresponsive. All responsive CG neurons had simple, orientation-selective receptive fields, and generated sustained responses to stationary stimuli. CG axonal conduction times were strongly related to modulated firing rates (F1 values) generated by drifting grating stimuli, and their associated interspike interval distributions, suggesting a continuum of visual responsiveness spanning the spectrum of axonal conduction times. CG conduction times were also significantly related to visual response latency, contrast sensitivity (C-50 values), directional selectivity, and optimal stimulus velocity. Increasing alertness did not cause visually unresponsive CG neurons to become responsive and did not change the response linearity (F1/F0 ratios) of visually responsive CG neurons. However, for visually responsive CG neurons, increased alertness nearly doubled the modulated response amplitude to optimal visual stimulation (F1 values), significantly shortened response latency, and dramatically increased response reliability. These effects of alertness were uniform across the broad spectrum of CG axonal conduction times. SIGNIFICANCE STATEMENT Corticothalamic neurons of layer 6 send a dense feedback projection to thalamic nuclei that provide input to sensory neocortex. While sensory information reaches the cortex after brief thalamocortical axonal delays, corticothalamic axons can exhibit conduction delays of <2 ms to 40–50 ms. Here, in the corticogeniculate visual system of awake rabbits, we investigate the functional significance of this axonal diversity, and the effects of shifting alert/nonalert brain states on corticogeniculate processing. We show that axonal conduction times are strongly related to multiple visual response properties, suggesting a continuum of visual responsiveness spanning the spectrum of corticogeniculate axonal conduction times. We also show that transitions between awake brain states powerfully affect corticogeniculate processing, in some ways more strongly than in layer 4. PMID:28559382

  4. Effects of iron on the lattice thermal conductivity of Earth's deep mantle and implications for mantle dynamics

    NASA Astrophysics Data System (ADS)

    Hsieh, Wen-Pin; Deschamps, Frédéric; Okuchi, Takuo; Lin, Jung-Fu

    2018-04-01

    Iron may critically influence the physical properties and thermochemical structures of Earth's lower mantle. Its effects on thermal conductivity, with possible consequences on heat transfer and mantle dynamics, however, remain largely unknown. We measured the lattice thermal conductivity of lower-mantle ferropericlase to 120 GPa using the ultrafast optical pump-probe technique in a diamond anvil cell. The thermal conductivity of ferropericlase with 56% iron significantly drops by a factor of 1.8 across the spin transition around 53 GPa, while that with 8–10% iron increases monotonically with pressure, causing an enhanced iron substitution effect in the low-spin state. Combined with bridgmanite data, modeling of our results provides a self-consistent radial profile of lower-mantle thermal conductivity, which is dominated by pressure, temperature, and iron effects, and shows a twofold increase from top to bottom of the lower mantle. Such increase in thermal conductivity may delay the cooling of the core, while its decrease with iron content may enhance the dynamics of large low shear-wave velocity provinces. Our findings further show that, if hot and strongly enriched in iron, the seismic ultralow velocity zones have exceptionally low conductivity, thus delaying their cooling.

  5. Effects of iron on the lattice thermal conductivity of Earth's deep mantle and implications for mantle dynamics.

    PubMed

    Hsieh, Wen-Pin; Deschamps, Frédéric; Okuchi, Takuo; Lin, Jung-Fu

    2018-04-17

    Iron may critically influence the physical properties and thermochemical structures of Earth's lower mantle. Its effects on thermal conductivity, with possible consequences on heat transfer and mantle dynamics, however, remain largely unknown. We measured the lattice thermal conductivity of lower-mantle ferropericlase to 120 GPa using the ultrafast optical pump-probe technique in a diamond anvil cell. The thermal conductivity of ferropericlase with 56% iron significantly drops by a factor of 1.8 across the spin transition around 53 GPa, while that with 8-10% iron increases monotonically with pressure, causing an enhanced iron substitution effect in the low-spin state. Combined with bridgmanite data, modeling of our results provides a self-consistent radial profile of lower-mantle thermal conductivity, which is dominated by pressure, temperature, and iron effects, and shows a twofold increase from top to bottom of the lower mantle. Such increase in thermal conductivity may delay the cooling of the core, while its decrease with iron content may enhance the dynamics of large low shear-wave velocity provinces. Our findings further show that, if hot and strongly enriched in iron, the seismic ultralow velocity zones have exceptionally low conductivity, thus delaying their cooling.

  6. The Effects of Constant Time Delay Embedded into Teaching Activities for Teaching the Names of Clothes for Preschool Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    Odluyurt, Serhat

    2011-01-01

    The general purpose of this study was to examine the effectiveness of constant time delay embedded in activities for teaching clothes name for preschool children with developmental disabilities. This study included four participants having Down syndrome with an age range of 43-46 months. All experimental sessions were conducted in one to one…

  7. A Tutorial on the Use of Excel 2010 and Excel for Mac 2011 for Conducting Delay-Discounting Analyses

    ERIC Educational Resources Information Center

    Reed, Derek D.; Kaplan, Brent A.; Brewer, Adam T.

    2012-01-01

    In recent years, researchers and practitioners in the behavioral sciences have profited from a growing literature on delay discounting. The purpose of this article is to provide readers with a brief tutorial on how to use Microsoft Office Excel 2010 and Excel for Mac 2011 to analyze discounting data to yield parameters for both the hyperbolic…

  8. Improving Early Reading Skills in Young Children through an iPad App: Small-Group Instruction and Observational Learning

    ERIC Educational Resources Information Center

    Chai, Zhen

    2017-01-01

    This study evaluated the effectiveness of using a researcher-developed iPad app with a 0- to 5-s constant time delay procedure to improve phonological awareness skills of young children with mild developmental delays in a small-group arrangement in a rural public elementary school in Southwest United States. The study was conducted using a…

  9. The acoustic sensor for rapid analysis of bacterial cells in the conductive suspensions.

    PubMed

    Borodina, I A; Zaitsev, B D; Guliy, O; Teplykh, A A; Shikhabudinov, A M

    2017-11-01

    The possibility of using the acoustic sensor on the basis of a two-channel delay line for rapid analysis of bacterial cells in the conductive suspensions was investigated. The dependencies of change in phase and insertion loss of output signal of the sensor on conductivity of buffer solution with various concentrations of cells due to a specific interaction "bacterial cells - mini-antibodies" for electrically open and electrically shorted channels of delay line were measured. It has been found that these changes have the most values for the electrically open channel. It has been also shown that the sensor rapidly responds to the specific interaction and the time stabilization of the phase and insertion loss of output signal is less than 10min. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Regulation of Aedes aegypti Population Dynamics in Field Systems: Quantifying Direct and Delayed Density Dependence

    PubMed Central

    Walsh, Rachael K.; Aguilar, Cristobal L.; Facchinelli, Luca; Valerio, Laura; Ramsey, Janine M.; Scott, Thomas W.; Lloyd, Alun L.; Gould, Fred

    2013-01-01

    Transgenic strains of Aedes aegypti have been engineered to help control transmission of dengue virus. Although resources have been invested in developing the strains, we lack data on the ecology of mosquitoes that could impact the success of this approach. Although studies of intra-specific competition have been conducted using Ae. aegypti larvae, none of these studies examine mixed age cohorts at densities that occur in the field, with natural nutrient levels. Experiments were conducted in Mexico to determine the impact of direct and delayed density dependence on Ae. aegypti populations. Natural water, food, and larval densities were used to estimate the impacts of density dependence on larval survival, development, and adult body size. Direct and delayed density-dependent factors had a significant impact on larval survival, larval development, and adult body size. These results indicate that control methods attempting to reduce mosquito populations may be counteracted by density-dependent population regulation. PMID:23669230

  11. Diagnostic Delay among Adults with Pulmonary Tuberculosis in a High Gross Domestic Product Per Capita Country: Reasons and Magnitude of the Problem.

    PubMed

    Ibrahim, Wanis H; Alousi, Faraj H; Al-Khal, Abdulatif; Bener, Abdulbari; AlSalman, Ahmed; Aamer, Aaiza; Khaled, Ahmed; Raza, Tasleem

    2016-01-01

    To determine the mean and median delays in pulmonary tuberculosis (PTB) diagnosis among adults in one of the world's highest gross domestic product per capita countries and identify patient and health system-related reasons for these delays. This is a cross-sectional, face-to-face, prospective study of 100 subjects with confirmed PTB, conducted at main tuberculosis (TB) admitting facilities in Qatar. The mean and median diagnostic delays were measured. The Chi-square test with two-sided P < 0.05 was considered to determine the association between factors and diagnostic delay. The mean and median total diagnostic delays of PTB were 53 (95% confidence interval [CI] 42.61-63.59) and 30 (interquartile range; Q1-Q3, 15-60) days, respectively. The mean patient factor delay was 45.7 (95% CI 28.1-63.4) days, and the median was 30 (interquartile range; Q1-Q3, 15-60) days. The mean health system factor delay was 46.3 (95% CI 35.46-57.06) days, and the median was 30 (interquartile range; Q1-Q3, 18-60) days. The most common cause of patient factor delay was neglect of TB symptoms by patients (in 39% of cases), and for health-care system factor delay was a failure (mostly at general and private care levels) to suspect PTB by doctors (in 57% of cases). There were no significant associations between the presence of language barrier, patient occupation or nationality, and diagnostic delay. Despite a favorable comparison to other countries, there is a substantial delay in the diagnosis of PTB in Qatar. Relevant actions including health education on TB are required to minimize this delay.

  12. Diagnostic delay among pulmonary tuberculosis patients in Sarawak, Malaysia: a cross-sectional study.

    PubMed

    Chang, Ching Thon; Esterman, Adrain

    2007-01-01

    Delayed diagnosis of tuberculosis (TB) can lead to an increased period of infectivity in the community, a delay in treatment and a severe form of the disease. The objective of this study was to determine the length of delay, and factors linking the delay from the onset of symptoms of pulmonary tuberculosis (PTB) until the commencement of treatment in Sarawak, Malaysia. An institution based cross-sectional study was conducted in 10 TB clinics in randomly selected divisions in Sarawak from June 2003 to May 2004. Delay was analyzed from two perspectives: (1) period between the onset of TB symptoms to any first medical consultation (patients' delay); and (2) period between the first medical consultation to the diagnosis of TB (diagnosis delay). Patients were interviewed on diagnosis or within the admission period using a semi-structured questionnaire. A total of 316 new smear-positive PTB patients participated in the study. The median patient interval was 30 days. Gender was found to be significantly associated with patient delay. The median diagnosis interval was 22 days. Respondents' incomes, health-care professional first consulted and actions taken by the health-care providers during the first consultation were significantly associated with diagnosis delay. The medium treatment interval was 0 days. Both patients and health providers played a role in delaying TB diagnosis. Females appeared to have longer delay. Respondents living above the poverty line had diagnosis delay as they made more visits to GPs or different government clinics without proper investigations for TB. A mechanism is needed to increase all health-care providers' suspicion of TB so that proper investigations can be done during first consultation.

  13. Semiclassical relation between open trajectories and periodic orbits for the Wigner time delay.

    PubMed

    Kuipers, Jack; Sieber, Martin

    2008-04-01

    The Wigner time delay of a classically chaotic quantum system can be expressed semiclassically either in terms of pairs of scattering trajectories that enter and leave the system or in terms of the periodic orbits trapped inside the system. We show how these two pictures are related on the semiclassical level. We start from the semiclassical formula with the scattering trajectories and derive from it all terms in the periodic orbit formula for the time delay. The main ingredient in this calculation are correlations between scattering trajectories which are due to trajectories that approach the trapped periodic orbits closely. The equivalence between the two pictures is also demonstrated by considering correlation functions of the time delay. A corresponding calculation for the conductance gives no periodic orbit contributions in leading order.

  14. Compounding diagnostic delays: a qualitative study of point-of-care testing in South Africa.

    PubMed

    Engel, Nora; Davids, Malika; Blankvoort, Nadine; Pai, Nitika Pant; Dheda, Keertan; Pai, Madhukar

    2015-04-01

    Successful point-of-care (POC) testing (completion of test-and-treat cycle in one patient encounter) has immense potential to reduce diagnostic and treatment delays, and improve patient and public health outcomes. We explored what tests are done and how in public/private, rural/urban hospitals and clinics in South Africa and whether they can ensure successful POC testing. This qualitative research study examined POC testing across major diseases in Cape Town, Durban and Eastern Cape. We conducted 101 semi-structured interviews and seven focus group discussions with doctors, nurses, community health workers, patients, laboratory technicians, policymakers, hospital managers and diagnostic manufacturers. In South Africa, diagnostics are characterised by a centralised system. Most tests conducted on the spot can be made to work successfully as POC tests. The majority of public/private clinics and smaller hospitals send samples via couriers to centralised laboratories and retrieve results the same way, via internet, fax or phone. The main challenge to POC testing lies in transporting samples and results, while delays risk patient loss from diagnostic/treatment pathways. Strategies to deal with associated delays create new problems, such as artificially prolonged turnaround times, strains on human resources and quality of testing, compounding additional diagnostic and treatment delays. For POC testing to succeed, particular characteristics of diagnostic ecosystems and adaptations of professional practices to overcome associated challenges must be taken into account. © 2014 John Wiley & Sons Ltd.

  15. A dual-loop adaptive control for minimizing time response delay in real-time structural vibration control with magnetorheological (MR) devices

    NASA Astrophysics Data System (ADS)

    Chen, Xi; Li, Yancheng; Li, Jianchun; Gu, Xiaoyu

    2018-01-01

    Time delay is a challenge issue faced by the real-time control application of the magnetorheological (MR) devices. Not to deal with it properly may jeopardize the effectiveness of the control, even lead to instability of the control system or catastrophic failure. This paper proposes a dual-loop adaptive control to address the response time delay associated with MR devices. In the proposed dual-loop control, the inner loop is designed to compensate the time delay of MR device induced by the PWM current driver. While the outer loop control can be any structural control algorithm with aims to reducing structural responses of a building during extreme loadings. Here an adaptive control strategy is adopted. To verify the proposed dual-loop control, a smart base isolation system employing magnetorheological elastomer base isolators is used as an example to illustrate the control effect. Numerical study is then conducted using a 5 -storey shear building model equipped with smart base isolation system. The result shows that with the implementation of the inner loop, the control current can instantly follow the control command which reduce the possibility of instability caused by the time delay. Comparative studies are conducted between three control strategies, i.e. dual-loop control, Lyapunov’s direct method based control and optimal passive base isolation control. The results of the study have demonstrated that the proposed dual-loop control strategy can achieve much better performance than the other two control strategies.

  16. Delayed healing of lower limb fractures with bisphosphonate therapy

    PubMed Central

    Ng, A; Tang, H; Joseph, S; Richardson, M

    2015-01-01

    Introduction Bisphosphonate therapy (BT) is used commonly in the management of osteoporosis. A systematic review was conducted investigating delayed union of lower limb, long bone fractures in patients on BT. We specifically assessed whether BT increases the risk of delayed union or non-union in lower limb, long bone fractures. Methods A literature search was conducted in the PubMed and Embase™ on 4 November 2014. Articles that investigated lower limb fractures, history of BT and fracture union were included in the review. Results A total of 9,809 papers were retrieved and 14 were deemed suitable for this review. The mean time to union in patients on BT was 8.5 months. A longer time to union was reported in a study investigating BT users versus controls (6.5 vs 4.8 months respectively). The mean rate of delayed or non-union for BT associated atypical fractures was 20% per fracture. Specifically in one study, delayed union was more common in the cohort with more than three years of BT (67%) than in the group with less than three years of BT (26%). Surgical fixation was associated with improved outcomes compared with non-operative management. Conclusions BT has been described to be associated with multiple adverse outcomes related to atypical fractures. Current evidence recommends operative management for this patient group. Further investigation is required to evaluate the exact effects of BT on lower limb fractures, in particular typical femoral fractures. PMID:26264082

  17. A comparison of control modes for time-delayed remote manipulation

    NASA Technical Reports Server (NTRS)

    Starr, G. P.

    1982-01-01

    Transmission time delay in the communication channel of a manual control system is investigated. A time delay can exist in remote manipulation systems, caused by long communication distances or bandwidth limitations. Ferrell 1 conducted the first research in time-delayed manipulation using a two degree-of-freedom manipulator. His subjects, working at time delays of 1.0, 2.1, and 3.2 s, could accomplish tasks even requiring great accuracy. The subjects spontaneously adopted a pattern of moving cautiously, then waiting to see the results of their actions. In experiments with a six degree-of-freedom master-slave manipulator system and time delays of 1.0 to 6 s, Black 2 saw that subjects tried to use the move-and-wait strategy; but there were often difficulties. The subjects seemed to have a problem in holding the master arm stationary while waiting for feedback. Any undesired drifting of the master arm introduced a discrepancy between the positions of the master and slave. This discrepancy was not perceived because of the time delay. The subject would then begin his next move with an inherent error. The difficulty of effectively using the move-and-wait strategy with a master-slave manipulator suggested that rate control might be a more effective control mode with time delay.

  18. [Factors linked to delayed diagnosis of tuberculosis in Conakry (Guinea)].

    PubMed

    Camara, A; Diallo, A; Camara, L M; Fielding, K; Sow, O Y; Chaperon, J

    2006-03-01

    Untreated smear-positive pulmonary tuberculosis constitutes a reservoir of infection which is highly contagious. The present study was conducted in Conakry, Guinea, to determine the different options which are available when seeking treatment or care, and to ascertain the average delay in diagnosis of pulmonary tuberculosis and the main factors linked to the delay in diagnosis after the initial onset of symptoms. Through a cross-sectional study, 113 consecutive patients with smear-positive pulmonary tuberculosis were interviewed through the use of a questionnaire. The median total delay from the onset of symptoms of pulmonary tuberculosis until the diagnosis was 11 weeks. This delay period exceeded 4 weeks for 90 of the patients (80%). The average delay linked to the conventional health care system was double that of the one at the fault of the patient (6 weeks versus 3 weeks, respectively). 54% of the patients had initially resorted to non-conventional care. To shorten this mean delay period, it is necessary to both strengthen the professional abilities and skills which train for one to better to detect tuberculosis and to sensitize the population to the subject matter and information on the illness and its symptoms.

  19. Hydrogen-Induced Delayed Cracking in TRIP-Aided Lean-Alloyed Ferritic-Austenitic Stainless Steels.

    PubMed

    Papula, Suvi; Sarikka, Teemu; Anttila, Severi; Talonen, Juho; Virkkunen, Iikka; Hänninen, Hannu

    2017-06-03

    Susceptibility of three lean-alloyed ferritic-austenitic stainless steels to hydrogen-induced delayed cracking was examined, concentrating on internal hydrogen contained in the materials after production operations. The aim was to study the role of strain-induced austenite to martensite transformation in the delayed cracking susceptibility. According to the conducted deep drawing tests and constant load tensile testing, the studied materials seem not to be particularly susceptible to delayed cracking. Delayed cracks were only occasionally initiated in two of the materials at high local stress levels. However, if a delayed crack initiated in a highly stressed location, strain-induced martensite transformation decreased the crack arrest tendency of the austenite phase in a duplex microstructure. According to electron microscopy examination and electron backscattering diffraction analysis, the fracture mode was predominantly cleavage, and cracks propagated along the body-centered cubic (BCC) phases ferrite and α'-martensite. The BCC crystal structure enables fast diffusion of hydrogen to the crack tip area. No delayed cracking was observed in the stainless steel that had high austenite stability. Thus, it can be concluded that the presence of α'-martensite increases the hydrogen-induced cracking susceptibility.

  20. Hydrogen-Induced Delayed Cracking in TRIP-Aided Lean-Alloyed Ferritic-Austenitic Stainless Steels

    PubMed Central

    Papula, Suvi; Sarikka, Teemu; Anttila, Severi; Talonen, Juho; Virkkunen, Iikka; Hänninen, Hannu

    2017-01-01

    Susceptibility of three lean-alloyed ferritic-austenitic stainless steels to hydrogen-induced delayed cracking was examined, concentrating on internal hydrogen contained in the materials after production operations. The aim was to study the role of strain-induced austenite to martensite transformation in the delayed cracking susceptibility. According to the conducted deep drawing tests and constant load tensile testing, the studied materials seem not to be particularly susceptible to delayed cracking. Delayed cracks were only occasionally initiated in two of the materials at high local stress levels. However, if a delayed crack initiated in a highly stressed location, strain-induced martensite transformation decreased the crack arrest tendency of the austenite phase in a duplex microstructure. According to electron microscopy examination and electron backscattering diffraction analysis, the fracture mode was predominantly cleavage, and cracks propagated along the body-centered cubic (BCC) phases ferrite and α’-martensite. The BCC crystal structure enables fast diffusion of hydrogen to the crack tip area. No delayed cracking was observed in the stainless steel that had high austenite stability. Thus, it can be concluded that the presence of α’-martensite increases the hydrogen-induced cracking susceptibility. PMID:28772975

  1. Delaying first birth: an analysis of household survey data from rural Southern Tanzania.

    PubMed

    Sedekia, Yovitha; Nathan, Rose; Church, Kathryn; Temu, Silas; Hanson, Claudia; Schellenberg, Joanna; Marchant, Tanya

    2017-01-31

    Currently, family planning metrics derived from nationally-representative household surveys such as the Demographic and Health Surveys (DHS) categorise women into those desiring to space or limit (permanently stop) births, or according to their age in the case of young women. This conceptualisation potentially ignores a large and growing group of young women who desire to delay a first birth. This study uses household survey data to investigate the characteristics and needs for family planning of women who want to delay their first birth. The research was conducted in two rural districts in southern Tanzania (Tandahimba and Newala), and nested within the Expanded Quality Management Using Information Power (EQUIP) study. Data were collected as part of a repeated cross sectional household survey conducted between September 2013 and April 2014. The socio-demographic characteristics, including parity, contraceptive practices and fertility intentions of 2128 women aged 13-49 were analysed. The association between women's life stages of reproduction (delayers of first birth, spacers of subsequent pregnancies and limiters of future birth) and selected contraceptive outcomes (current use, unmet need and demand for modern contraceptives) was assessed using the point estimates and 95% confidence intervals for each indicator, adjusted for the survey design. Overall, four percent of women surveyed were categorised as 'delayers of first birth', i.e. sexually active but not started childbearing. Among this group, the majority were younger than 20 years old (82%) and unmarried (88%). Fifty-nine percent were currently using a modern method of contraception and injectables dominated their contraceptive use. Unmet need for contraception was higher among delayers (41%; 95% CI 32-51) and limiters (41%; 95% CI 35-47) compared to spacers (19%; 95% CI 17-22). Delayers of first birth have very high unmet needs for modern contraceptives and they should be routinely and separately categorised and measured within nationally-representative surveys such as Demographic and Health Survey and Multiple Indicator Cluster surveys. Acknowledging their unique needs could help catalyse a programmatic response.

  2. Assessment of atrial electromechanical delay in children with acute rheumatic fever.

    PubMed

    Ciftel, Murat; Turan, Ozlem; Simşek, Ayşe; Kardelen, Fırat; Akçurin, Gayaz; Ertuğ, Halil

    2014-02-01

    There may be an increase in the risk of atrial arrhythmia due to left atrial enlargement and the influence on conduction system in acute rheumatic fever. The aim of this study is to investigate atrial electromechanical delay and P-wave dispersion in patients with acute rheumatic fever. A total of 48 patients diagnosed with acute rheumatic fever and 40 volunteers of similar age, sex, and body mass index were included in the study. The study groups were compared for M-mode echocardiographic parameters, interatrial electromechanical delay, intra-atrial electromechanical delay, and P-wave dispersion. Maximum P-wave duration, P-wave dispersion, and interatrial electromechanical delay were significantly higher in patients with acute rheumatic fever compared with the control group (p < 0.001). However, there was no difference in terms of intra-atrial electromechanical delay (p > 0.05). For patients with acute rheumatic fever, a positive correlation was identified between the left atrium diameter and the P-wave dispersion and interatrial electromechanical delay (r = 0.524 and p < 0.001, and r = 0.351 and p = 0.014, respectively). Furthermore, an important correlation was also identified between the P-wave dispersion and the interatrial electromechanical delay (r = 0.494 and p < 0.001). This study shows the prolongation of P-wave dispersion and interatrial electromechanical delay in acute rheumatic fever. Left atrial enlargement can be one of the underlying reasons for the increase in P-wave dispersion and interatrial electromechanical delay.

  3. A money management-based substance use treatment increases valuation of future rewards.

    PubMed

    Black, Anne C; Rosen, Marc I

    2011-01-01

    A positive association between delay discounting and substance use has been documented; substance users tend to discount future rewards more than non-users. However, studies detailing the responsiveness of delay discounting to interventions are lacking, and few have examined how any behavioral intervention affects delay discounting and whether these effects moderate changes in substance abuse. This study assesses the effectiveness of a money management intervention, Advisor-Teller Money Manager (ATM), in reducing delay discounting over time and the relationship of these effects to changes in cocaine use. Ninety psychiatric patients with histories of cocaine and/or alcohol use were randomly assigned to 36-weeks of ATM treatment or to a minimal-attention control condition. Delay discounting and cocaine use were measured throughout the intervention with a 52-week follow up measure of cocaine use. Analyses were conducted of (a) the effect of ATM on slopes of delay discounting and cocaine abstinence and (b) the relationship between change in delay discounting and change in cocaine abstinence. The ATM intervention was associated with significantly less delay discounting and less cocaine use over time relative to controls. Increases in delay discounting were associated with decreased abstinence from cocaine. ATM treatment decreased delay discounting rates and these effects extended to cocaine use. Concrete conceptualizations of future events, as occur in financial planning, with higher perceived probability may account for higher valuation of future rewards in counseled patients. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Early and late components of EEG delay activity correlate differently with scene working memory performance

    PubMed Central

    Ng, Kenneth; Reichert, Chelsea P.

    2017-01-01

    Sustained and elevated activity during the working memory delay period has long been considered the primary neural correlate for maintaining information over short time intervals. This idea has recently been reinterpreted in light of findings generated from multiple neural recording modalities and levels of analysis. To further investigate the sustained or transient nature of activity, the temporal-spectral evolution (TSE) of delay period activity was examined in humans with high density EEG during performance of a Sternberg working memory paradigm with a relatively long six second delay and with novel scenes as stimuli. Multiple analyses were conducted using different trial window durations and different baseline periods for TSE computation. Sensor level analyses revealed transient rather than sustained activity during delay periods. Specifically, the consistent finding among the analyses was that high amplitude activity encompassing the theta range was found early in the first three seconds of the delay period. These increases in activity early in the delay period correlated positively with subsequent ability to distinguish new from old probe scenes. Source level signal estimation implicated a right parietal region of transient early delay activity that correlated positively with working memory ability. This pattern of results adds to recent evidence that transient rather than sustained delay period activity supports visual working memory performance. The findings are discussed in relation to synchronous and desynchronous intra- and inter-regional neural transmission, and choosing an optimal baseline for expressing temporal-spectral delay activity change. PMID:29016657

  5. Effect of delay in hospital presentation on clinical and imaging findings in acute pulmonary thromboembolism.

    PubMed

    Jenab, Yaser; Alemzadeh-Ansari, Mohammad Javad; Fehri, Seyedeh Arezoo; Ghaffari-Marandi, Neda; Jalali, Arash

    2014-04-01

    There is limited information on the extent and clinical importance of the delay in hospital presentation of acute pulmonary thromboembolism (PTE). The aim of this study was to investigate the delay in hospital presentation of PTE and its association with clinical and imaging findings in PTE. This prospective study was conducted on patients admitted to our hospital with a diagnosis of acute PTE between September 2007 and September 2011. Relationships between delay in hospital presentation and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. Of the 195 patients enrolled, 84 (43.1%) patients presented 3 days after the onset of symptoms. Patients with chest pain, history of immobility for more than 3 days, recent surgery, and estrogen use had significantly less delayed presentation. Right ventricular dysfunction was significantly more frequent in patients with delayed presentation (odds ratio [OR] = 2.38; 95% confidence interval [CI] 1.27-4.44; p = 0.006); however, no relationship was found between delay in presentation and pulmonary computed tomographic angiography or color Doppler sonography findings. Patients with delayed presentation were at higher risk of in-hospital mortality (OR = 4.32; 95% CI 1.12-16.49; p = 0.021). Our study showed that a significant portion of patients with acute PTE had delayed presentation. Also, patients with delayed presentation had worse echocardiographic findings and higher in-hospital mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Early Changes in Atrial Electromechanical Coupling in Patients with Hypertension: Assessment by Tissue Doppler Imaging.

    PubMed

    Avci, Burcak Kilickiran; Gulmez, Oyku; Donmez, Guclu; Pehlivanoglu, Seckin

    2016-06-05

    Hypertension (HT) is associated with atrial electrophysiological abnormalities. Echocardiographic pulsed wave tissue Doppler imaging (TDI) is one of the noninvasive methods for evaluation of atrial electromechanical properties. The aims of our study were to investigate the early changes in atrial electromechanical conduction in patients with HT and to assess the parameters that affect atrial electromechanical conduction. Seventy-six patients with HT (41 males, mean age 52.6 ± 9.0 years) and 41 controls (22 males, mean age 49.8 ± 7.9 years) were included in the study. Atrial electromechanical coupling at the right (PRA), left (PLA), interatrial septum (PIS) were measured with TDI. Intra- (right: PIS-PRA, left: PLA-PIS) and inter-atrial (PLA-PRA) electromechanical delays were calculated. Maximum P-wave duration (Pmax) was calculated from 12-lead electrocardiogram. Atrial electromechanical coupling at PLA (76.6 ± 14.1 ms vs. 82.9 ± 15.8 ms, P = 0.036), left intra-atrial (10.9 ± 5.0 ms vs. 14.0 ± 9.7 ms, P = 0.023), right intra-atrial (10.6 ± 7.8 ms vs. 14.5 ± 10.1 ms, P = 0.035), and interatrial electromechanical (21.4 ± 9.8 ms vs. 28.3 ± 12.7 ms, P = 0.003) delays were significantly longer in patients with HT. The linear regression analysis showed that left ventricular (LV) mass index and Pmax were significantly associated with PLA (P = 0.001 and P = 0.002, respectively), and the LV mass index was the only related factor for interatrial delay (P = 0.001). Intra- and interatrial electromechanical delay, PLA were significantly prolonged in hypertensive patients. LV mass index and Pmax were significantly associated with PLA, and the LV mass index was the only related factor for interatrial delay. The atrial TDI can be a valuable method to assess the early changes of atrial electromechanical conduction properties in those patients.

  7. Early Changes in Atrial Electromechanical Coupling in Patients with Hypertension: Assessment by Tissue Doppler Imaging

    PubMed Central

    Avci, Burcak Kilickiran; Gulmez, Oyku; Donmez, Guclu; Pehlivanoglu, Seckin

    2016-01-01

    Background: Hypertension (HT) is associated with atrial electrophysiological abnormalities. Echocardiographic pulsed wave tissue Doppler imaging (TDI) is one of the noninvasive methods for evaluation of atrial electromechanical properties. The aims of our study were to investigate the early changes in atrial electromechanical conduction in patients with HT and to assess the parameters that affect atrial electromechanical conduction. Methods: Seventy-six patients with HT (41 males, mean age 52.6 ± 9.0 years) and 41 controls (22 males, mean age 49.8 ± 7.9 years) were included in the study. Atrial electromechanical coupling at the right (PRA), left (PLA), interatrial septum (PIS) were measured with TDI. Intra- (right: PIS-PRA, left: PLA-PIS) and inter-atrial (PLA-PRA) electromechanical delays were calculated. Maximum P-wave duration (Pmax) was calculated from 12-lead electrocardiogram. Results: Atrial electromechanical coupling at PLA (76.6 ± 14.1 ms vs. 82.9 ± 15.8 ms, P = 0.036), left intra-atrial (10.9 ± 5.0 ms vs. 14.0 ± 9.7 ms, P = 0.023), right intra-atrial (10.6 ± 7.8 ms vs. 14.5 ± 10.1 ms, P = 0.035), and interatrial electromechanical (21.4 ± 9.8 ms vs. 28.3 ± 12.7 ms, P = 0.003) delays were significantly longer in patients with HT. The linear regression analysis showed that left ventricular (LV) mass index and Pmax were significantly associated with PLA (P = 0.001 and P = 0.002, respectively), and the LV mass index was the only related factor for interatrial delay (P = 0.001). Conclusions: Intra- and interatrial electromechanical delay, PLA were significantly prolonged in hypertensive patients. LV mass index and Pmax were significantly associated with PLA, and the LV mass index was the only related factor for interatrial delay. The atrial TDI can be a valuable method to assess the early changes of atrial electromechanical conduction properties in those patients. PMID:27231168

  8. Pigeons' Memory for Number of Events: Effects of Intertrial Interval and Delay Interval Illumination

    ERIC Educational Resources Information Center

    Hope, Chris; Santi, Angelo

    2004-01-01

    In Experiment 1, pigeons were trained at a 0-s baseline delay to discriminate sequences of light flashes (illumination of the feeder) that varied in number but not time (2f/4s and 8f/4s). During training, the intertrial interval was illuminated by the houselight for Group Light, but it was dark for Group Dark. Testing conducted with dark delay…

  9. MyoR Modulates Cardiac Conduction by Repressing Gata4

    PubMed Central

    Harris, John P.; Bhakta, Minoti; Bezprozvannaya, Svetlana; Wang, Lin; Lubczyk, Christina; Olson, Eric N.

    2014-01-01

    The cardiac conduction system coordinates electrical activation through a series of interconnected structures, including the atrioventricular node (AVN), the central connection point that delays impulse propagation to optimize cardiac performance. Although recent studies have uncovered important molecular details of AVN formation, relatively little is known about the transcriptional mechanisms that regulate AV delay, the primary function of the mature AVN. We identify here MyoR as a novel transcription factor expressed in Cx30.2+ cells of the AVN. We show that MyoR specifically inhibits a Cx30.2 enhancer required for AVN-specific gene expression. Furthermore, we demonstrate that MyoR interacts directly with Gata4 to mediate transcriptional repression. Our studies reveal that MyoR contains two nonequivalent repression domains. While the MyoR C-terminal repression domain inhibits transcription in a context-dependent manner, the N-terminal repression domain can function in a heterologous context to convert the Hand2 activator into a repressor. In addition, we show that genetic deletion of MyoR in mice increases Cx30.2 expression by 50% and prolongs AV delay by 13%. Taken together, we conclude that MyoR modulates a Gata4-dependent regulatory circuit that establishes proper AV delay, and these findings may have wider implications for the variability of cardiac rhythm observed in the general population. PMID:25487574

  10. Latitude-dependent delay in the responses of the equatorial electrojet and Sq currents to X-class solar flares

    NASA Astrophysics Data System (ADS)

    Nogueira, Paulo A. B.; Abdu, Mangalathayil A.; Souza, Jonas R.; Denardini, Clezio M.; Barbosa Neto, Paulo F.; Serra de Souza da Costa, João P.; Silva, Ana P. M.

    2018-01-01

    We have analyzed low-latitude ionospheric current responses to two intense (X-class) solar flares that occurred on 13 May 2013 and 11 March 2015. Sudden intensifications, in response to solar flare radiation impulses, in the Sq and equatorial electrojet (EEJ) currents, as detected by magnetometers over equatorial and low-latitude sites in South America, are studied. In particular we show for the first time that a 5 to 8 min time delay is present in the peak effect in the EEJ, with respect that of Sq current outside the magnetic equator, in response to the flare radiation enhancement. The Sq current intensification peaks close to the flare X-ray peak, while the EEJ peak occurs 5 to 8 min later. We have used the Sheffield University Plasmasphere-Ionosphere Model at National Institute for Space Research (SUPIM-INPE) to simulate the E-region conductivity enhancement as caused by the flare enhanced solar extreme ultraviolet (EUV) and soft X-rays flux. We propose that the flare-induced enhancement in neutral wind occurring with a time delay (with respect to the flare radiation) could be responsible for a delayed zonal electric field disturbance driving the EEJ, in which the Cowling conductivity offers enhanced sensitivity to the driving zonal electric field.

  11. Defining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis

    PubMed Central

    Losina, Elena; Dervan, Elizabeth E.; Paltiel, A. David; Dong, Yan; Wright, R. John; Spindler, Kurt P.; Mandl, Lisa A.; Jones, Morgan H.; Marx, Robert G.; Safran-Norton, Clare E.; Katz, Jeffrey N.

    2015-01-01

    Background Arthroscopic partial meniscectomy (APM) is extensively used to relieve pain in patients with symptomatic meniscal tear (MT) and knee osteoarthritis (OA). Recent studies have failed to show the superiority of APM compared to other treatments. We aim to examine whether existing evidence is sufficient to reject use of APM as a cost-effective treatment for MT+OA. Methods We built a patient-level microsimulation using Monte Carlo methods and evaluated three strategies: Physical therapy (‘PT’) alone; PT followed by APM if subjects continued to experience pain (‘Delayed APM’); and ‘Immediate APM’. Our subject population was US adults with symptomatic MT and knee OA over a 10 year time horizon. We assessed treatment outcomes using societal costs, quality-adjusted life years (QALYs), and calculated incremental cost-effectiveness ratios (ICERs), incorporating productivity costs as a sensitivity analysis. We also conducted a value-of-information analysis using probabilistic sensitivity analyses. Results Calculated ICERs were estimated to be $12,900/QALY for Delayed APM as compared to PT and $103,200/QALY for Immediate APM as compared to Delayed APM. In sensitivity analyses, inclusion of time costs made Delayed APM cost-saving as compared to PT. Improving efficacy of Delayed APM led to higher incremental costs and lower incremental effectiveness of Immediate APM in comparison to Delayed APM. Probabilistic sensitivity analyses indicated that PT had 3.0% probability of being cost-effective at a willingness-to-pay (WTP) threshold of $50,000/QALY. Delayed APM was cost effective 57.7% of the time at WTP = $50,000/QALY and 50.2% at WTP = $100,000/QALY. The probability of Immediate APM being cost-effective did not exceed 50% unless WTP exceeded $103,000/QALY. Conclusions We conclude that current cost-effectiveness evidence does not support unqualified rejection of either Immediate or Delayed APM for the treatment of MT+OA. The amount to which society would be willing to pay for additional information on treatment outcomes greatly exceeds the cost of conducting another randomized controlled trial on APM. PMID:26086246

  12. Understanding the delayed prescribing of antibiotics for respiratory tract infection in primary care: a qualitative analysis.

    PubMed

    Ryves, R; Eyles, C; Moore, M; McDermott, L; Little, P; Leydon, G M

    2016-11-18

    To identify general practitioner (GP) views and understanding on the use of delayed prescribing in primary care. Qualitative semistructured telephone interview study. Primary care general practices in England. 32 GPs from identified high-prescribing and low-prescribing general practices in England. Semistructured telephone interviews were conducted with GPs identified from practices within clinical commissioning groups with the highest and lowest prescribing rates in England. A thematic analysis of the data was conducted to generate themes. All GPs had a good understanding of respiratory tract infection (RTI) management and how the delayed prescribing approach could be used in primary care. However, GPs highlighted factors that were influential as to whether delayed prescribing was successfully carried out during the consultation. These included the increase in evidence of antimicrobial resistance, and GPs' prior experiences of using delayed prescribing during the consultation. The patient-practitioner relationship could also influence treatment outcomes for RTI, and a lack of an agreed prescribing strategy within and between practices was considered to be of significance to GPs. Participants expressed that a lack of feedback on prescribing data at an individual and practice level made it difficult to know if delayed prescribing strategies were successful in reducing unnecessary consumption. GPs agreed that coherent and uniform training and guidelines would be of some benefit to ensure consistent prescribing throughout the UK. Delayed prescribing is encouraged in primary care, but is not always implemented successfully. Greater uniformity within and between practices in the UK is needed to operationalise delayed prescribing, as well as providing feedback on the uptake of antibiotics. Finally, GPs may need further guidance on how to answer the concerns of patients without interpreting these questions as a demand for antibiotics, as well as educating the patient about antimicrobial resistance and supporting a good patient-practitioner relationship. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Delayed Hospital Discharges of Older Patients: A Systematic Review on Prevalence and Costs.

    PubMed

    Landeiro, Filipa; Roberts, Kenny; Gray, Alastair Mcintosh; Leal, José

    2017-05-23

    To determine the prevalence of delayed discharges of elderly inpatients and associated costs. We searched Medline, Embase, Global Health, CAB Abstracts, Econlit, Web of Knowledge, EBSCO - CINAHL, The Cochrane Library, Health Management Information Consortium, and SCIE - Social Care Online for evidence published between 1990 and 2015 on number of days or proportion of delayed discharges for elderly inpatients in acute hospitals. Descriptive and regression analyses were conducted. Data on proportions of delayed discharges were pooled using a random effects logistic model and the association of relevant factors was assessed. Mean costs of delayed discharge were calculated in USD adjusted for Purchasing Power Parity (PPP). Of 64 studies included, 52 (81.3%) reported delayed discharges as proportions of total hospital stay and 9 (14.1%) estimated the respective costs for these delays. Proportions of delayed discharges varied widely, from 1.6% to 91.3% with a weighted mean of 22.8%. This variation was also seen in studies from the same country, for example, in the United Kingdom, they ranged between 1.6% and 60.0%. No factor was found to be significantly associated with delays. The mean costs of delayed discharge also varied widely (between 142 and 31,935 USD PPP adjusted), reflecting the variability in mean days of delay per patient. Delayed discharges occur in most countries and the associated costs are significant. However, the variability in prevalence of delayed discharges and available data on costs limit our knowledge of the full impact of delayed discharges. A standardization of methods is necessary to allow comparisons to be made, and additional studies are required-preferably by disease area-to determine the postdischarge needs of specific patient groups and the estimated costs of delays. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Study of Relationship Between Illness Perception and Delay in Seeking Help for Breast Cancer Patients Based on Leventhal's Self-Regulation Model.

    PubMed

    Attari, Seyedeh Maryam; Ozgoli, Giti; Solhi, Mahnaz; Alavi Majd, Hamid

    2016-01-01

    One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was 47.3±10.2. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ≥3 months. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.

  15. Socio-economic, gender and health services factors affecting diagnostic delay for tuberculosis patients in urban Zambia.

    PubMed

    Needham, D M; Foster, S D; Tomlinson, G; Godfrey-Faussett, P

    2001-04-01

    In-depth interviews regarding health seeking behaviour were conducted with 202 adults registered with pulmonary tuberculosis at the centralized Chest Clinic in Lusaka, Zambia. The median (mean) diagnostic delay was 8.6 (9) weeks, and was significantly associated with the following factors: female sex, lower education, more than six instances of health-seeking encounters, outpatient diagnosis of tuberculosis, and visiting a private doctor or traditional healer. More effective tuberculosis control interventions require novel methods of accessing women and less educated people. Decentralization of public tuberculosis care and improved integration with private sector health providers may also reduce diagnostic delay.

  16. The conduction block produced by oxcarbazepine in the isolated rat sciatic nerve: a comparison with lamotrigine.

    PubMed

    Guven, Mustafa; Kahraman, Ibrahim; Koc, Filiz; Bozdemir, Hacer; Sarica, Yakup; Gunay, Ismail

    2011-01-01

    Oxcarbazepine is an antiepileptic drug widely used for the treatment of neuropathic pain. In the present study, the effects of oxcarbazepine and lamotrigine on conduction properties in the rat sciatic nerves were examined. The experiments were conducted with in vitro sucrose-gap technique on the isolated wistar rat sciatic nerves. The compound action potentials were obtained by tonic (single) and phasic (10, 40, and 100 Hz) stimulation. Oxcarbazepine produced a significant concentration- and frequency-dependent reduction in the compound action potential amplitude. When the two drugs were applied at concentrations that produced equal levels of tonic (i.e., non-frequency-dependent) conduction block, oxcarbazepine produced the greatest phasic (i.e., frequency-dependent) conduction block, followed by lamotrigine. Oxcarbazepine and lamotrigine reduced the 4-aminopyridine-induced amplitude of delayed depolarization; however, oxcarbazepine had a significantly greater effect than lamotrigine. These results suggest that oxcarbazepine produces more potent frequency-dependent conduction block than lamotrigine, and suppresses the delayed depolarization which contributes to sensory signaling and may play a role in neuropathic pain. The findings provide insight into the mechanisms of action of oxcarbazepine and lamotrigine and may help in the development of novel therapies for neuropathic pain.

  17. A 2:1 AV rhythm: an adverse effect of a long AV delay during DDI pacing and its prevention by the ventricular intrinsic preference algorithm in DDD mode.

    PubMed

    Minamiguchi, Hitoshi; Oginosawa, Yasushi; Kohno, Ritsuko; Tamura, Masahito; Takeuchi, Masaaki; Otsuji, Yutaka; Abe, Haruhiko

    2012-07-01

    A 91-year-old woman received a dual-chamber pacemaker for sick sinus syndrome and intermittently abnormal atrioventricular (AV) conduction. The pacemaker was set in DDI mode with a 350-ms AV delay to preserve intrinsic ventricular activity. She complained of palpitation during AV sequential pacing. The electrocardiogram showed a 2:1 AV rhythm from 1:1 ventriculoatrial (VA) conduction during ventricular pacing in DDI mode with a long AV interval. After reprogramming of the pacemaker in DDD mode with a 250-ms AV interval and additional 100-ms prolongation of the AV interval by the ventricular intrinsic preference function, VA conduction disappeared and the patient's symptom were alleviated without increasing unnecessary right ventricular pacing. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.

  18. Interpretation of symptoms as a cause of delays in patients with acute myocardial infarction, Istanbul, Turkey.

    PubMed

    Koc, Sema; Durna, Zehra; Akin, Semiha

    2017-06-14

    This cross-sectional study aimed to assess interpretation of symptoms as a cause of delays in patients with acute myocardial infarction (AMI). It was conducted at a university hospital in Istanbul, Turkey. The sample included 93 patients: 73 male, mean age 57.89 (12.13) years. Prehospital delay time ranged from 15 minutes to 10 days, with a median of 2 hours (interquartile range: 9.50). Patients waited for pain to go away (48.4%) and tried to calm down (39.8%). Most patients attributed AMI-related symptoms to a reason other than heart disease. In a multivariate logistic regression analysis, the type of AMI was classified based on electrocardiography findings (odds ratio 5.18, 95% confidence interval: 1.69-15.91, P=0.004) and was independently associated with a long prehospital delay time, indicating that patients with ST segment elevation MI would seek early medical care. Misinterpretation of symptoms and misconceptions about emergency treatment during AMI cause delays in admission and may affect treatment.

  19. Advanced techniques for mitigating the effects of temporal distortions in human in the loop control systems

    NASA Astrophysics Data System (ADS)

    Guo, Liwen

    The desire to create more complex visual scenes in modern flight simulators outpaces recent increases in processor speed. As a result, the simulation transport delay remains a problem. Because of the limitations shown in the three prominent existing delay compensators---the lead/lag filter, the McFarland compensator and the Sobiski/Cardullo predictor---new approaches of compensating the transport delay in a flight simulator have been developed. The first novel compensator is the adaptive predictor making use of the Kalman filter algorithm in a unique manner so that the predictor can provide accurately the desired amount of prediction, significantly reducing the large spikes caused by the McFarland predictor. Among several simplified online adaptive predictors it illustrates mathematically why the stochastic approximation algorithm achieves the best compensation results. A second novel approach employed a reference aircraft dynamics model to implement a state space predictor on a flight simulator. The practical implementation formed the filter state vector from the operator's control input and the aircraft states. The relationship between the reference model and the compensator performance was investigated in great detail, and the best performing reference model was selected for implementation in the final tests. Piloted simulation tests were conducted for assessing the effectiveness of the two novel compensators in comparison to the McFarland predictor and no compensation. Thirteen pilots with heterogeneous flight experience executed straight-in and offset approaches, at various delay configurations, on a flight simulator where different predictors were applied to compensate for transport delay. Four metrics---the glide slope and touchdown errors, power spectral density of the pilot control inputs, NASA Task Load Index, and Cooper-Harper rating on the handling qualities---were employed for the analyses. The overall analyses show that while the adaptive predictor results in slightly poorer compensation for short added delay (up to 48 ms) and better compensation for long added delay (up to 192 ms) than the McFarland compensator, the state space predictor is fairly superior for short delay and significantly superior for long delay to the McFarland compensator. The state space predictor also achieves better compensation than the adaptive predictor. The results of the evaluation on the effectiveness of these predictors in the piloted tests agree with those in the theoretical offline tests conducted with the recorded simulation aircraft states.

  20. Determinants of delay in malaria care-seeking behaviour for children 15 years and under in Bata district, Equatorial Guinea.

    PubMed

    Romay-Barja, Maria; Cano, Jorge; Ncogo, Policarpo; Nseng, Gloria; Santana-Morales, Maria A; Valladares, Basilio; Riloha, Matilde; Benito, Agustin

    2016-03-31

    Malaria remains a major cause of morbidity and mortality in children under 5 years of age in Equatorial Guinea. Early appropriate treatment can reduce progression of the illness to severe stages, thus reducing of mortality, morbidity and onward transmission. The factors that contribute to malaria treatment delay have not been studied previously in Equatorial Guinea. The objective of this study was to assess the determinants of delay in seeking malaria treatment for children in the Bata district, in mainland Equatorial Guinea. A cross-sectional study was conducted in Bata district, in 2013, which involved 428 houses in 18 rural villages and 26 urban neighbourhoods. Household caregivers were identified in each house and asked about their knowledge of malaria and about the management of the last reported malaria episode in a child 15 years and younger under their care. Bivariate and multivariate statistical analyses were conducted to determine the relevance of socio-economic, geographical and behavioural factors on delays in care-seeking behaviour. Nearly half of the children sought treatment at least 24 h after the onset of the symptoms. The median delay in seeking care was 2.8 days. Children from households with the highest socio-economic status were less likely to be delayed in seeking care than those from households with the lowest socio-economic status (OR 0.37, 95% CI 0.19-0.72). Children that first received treatment at home, mainly paracetamol, were more than twice more likely to be delayed for seeking care, than children who did not first receive treatment at home (OR 2.36, 95% CI 1.45-3.83). Children living in a distance >3 km from the nearest health facility were almost two times more likely to be delayed in seeking care than those living closer to a facility but with non significant association once adjusted for other variables (OR 1.75, 95% CI 0.88-3.47). To decrease malaria morbidity and mortality in Bata district, efforts should be addressed to reduce household delays in seeking care. It is necessary to provide free access to effective malaria diagnosis and treatment, to reinforce malaria management at community level through community health workers and drug sellers and to increase awareness on the severity of malaria, the importance of early diagnosis and appropriate treatment.

  1. Slowing light down by low magnetic fields: pulse delay by transient spectral hole-burning in ruby.

    PubMed

    Riesen, Hans; Rebane, Aleksander K; Szabo, Alex; Carceller, Ivana

    2012-08-13

    We report on the observation of slow light induced by transient spectral hole-burning in a solid, that is based on excited-state population storage. Experiments were conducted in the R1-line (2E←4A2 transition) of a 2.3 mm thick pink ruby (Al2O3:Cr(III) 130 ppm). Importantly, the pulse delay can be controlled by the application of a low external magnetic field B||c≤9 mT and delays of up to 11 ns with minimal pulse distortion are observed for ~55 ns Gaussian pulses. The delay corresponds to a group velocity value of ~c/1400. The experiment is very well modelled by linear spectral filter theory and the results indicate the possibility of using transient hole-burning based slow light experiments as a spectroscopic technique.

  2. Longitudinal Models of Socio-Economic Status: Impact on Positive Parenting Behaviors

    ERIC Educational Resources Information Center

    Azad, Gazi; Blacher, Jan; Marcoulides, George

    2014-01-01

    Parenting research is frequently conducted without a thorough examination of socio-economic characteristics. In this study, longitudinal observations of positive parenting were conducted across six time points. Participants were 219 mothers of children with and without developmental delays. Mothers' positive parenting increased during early and…

  3. 12 CFR 19.5 - Authority of the administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... powers necessary to conduct a proceeding in a fair and impartial manner and to avoid unnecessary delay. (b) Powers. The administrative law judge shall have all powers necessary to conduct the proceeding in accordance with paragraph (a) of this section, including the following powers: (1) To administer oaths and...

  4. Distinguishing fissions of 232Th, 237Np and 238U with beta-delayed gamma rays

    DOE PAGES

    Iyengar, A.; Norman, E. B.; Howard, C.; ...

    2013-04-08

    Measurements of beta-delayed gamma-ray spectra following 14-MeV neutron-induced fissions of 232Th, 238U, and 237Np were conducted at Lawrence Berkeley National Laboratory’s 88-Inch Cyclotron. Spectra were collected for times ranging from 1 minute to 14 hours after irradiation. Lastly, intensity ratios of gamma-ray lines were extracted from the data that allow identification of the fissioning isotope.

  5. Bilingualism delays age at onset of dementia, independent of education and immigration status.

    PubMed

    Mortimer, James A

    2014-05-27

    Editors' Note: Mortimer argues that important confounding variables may have biased the conclusion by Alladi et al. on the role of bilingualism in delaying the onset of dementia. Following Mortimer’s comments, Alladi et al. conducted additional analysis of their data to support their conclusion. The attitude of "close enough" is not appropriate when determining brain death. Stadlan comments and supports Frank’s call for action regarding this sensitive issue.

  6. Human-in-the-Loop Operations over Time Delay: NASA Analog Missions Lessons Learned

    NASA Technical Reports Server (NTRS)

    Rader, Steven N.; Reagan, Marcum L.; Janoiko, Barbara; Johnson, James E.

    2013-01-01

    Teams at NASA have conducted studies of time-delayed communications as it effects human exploration. In October 2012, the Advanced Exploration Systems (AES) Analog Missions project conducted a Technical Interchange Meeting (TIM) with the primary stakeholders to share information and experiences of studying time delay, to build a coherent picture of how studies are covering the problem domain, and to determine possible forward plans (including how to best communicate study results and lessons learned, how to inform future studies and mission plans, and how to drive potential development efforts). This initial meeting s participants included personnel from multiple NASA centers (HQ, JSC, KSC, ARC, and JPL), academia, and ESA. It included all of the known studies, analog missions, and tests of time delayed communications dating back to the Apollo missions including NASA Extreme Environment Mission Operations (NEEMO), Desert Research and Technology Studies (DRATS/RATS), International Space Station Test-bed for Analog Research (ISTAR), Pavilion Lake Research Project (PLRP), Mars 520, JPL Mars Orbiters/Rovers, Advanced Mission Operations (AMO), Devon Island analog missions, and Apollo experiences. Additionally, the meeting attempted to capture all of the various functional perspectives via presentations by disciplines including mission operations (flight director and mission planning), communications, crew, Capcom, Extra-Vehicular Activity (EVA), Behavioral Health and Performance (BHP), Medical/Surgeon, Science, Education and Public Outreach (EPO), and data management. The paper summarizes the descriptions and results from each of the activities discussed at the TIM and includes several recommendations captured in the meeting for dealing with time delay in human exploration along with recommendations for future development and studies to address this issue.

  7. Impact of health care system delay in patients with ST-elevation myocardial infarction on return to labor market and work retirement.

    PubMed

    Laut, Kristina Grønborg; Hjort, Jacob; Engstrøm, Thomas; Jensen, Lisette Okkels; Tilsted Hansen, Hans-Henrik; Jensen, Jan Skov; Pedersen, Frants; Jørgensen, Erik; Holmvang, Lene; Pedersen, Alma Becic; Christensen, Erika Frischknecht; Lippert, Freddy; Lang-Jensen, Torsten; Jans, Henning; Hansen, Poul Anders; Trautner, Sven; Kristensen, Steen Dalby; Lassen, Jens Flensted; Lash, Timothy L; Clemmensen, Peter; Terkelsen, Christian Juhl

    2014-12-15

    System delay (delay from emergency medical service call to reperfusion with primary percutaneous coronary intervention [PPCI]) is acknowledged as a performance measure in ST-elevation myocardial infarction (STEMI), as shorter system delay is associated with lower mortality. It is unknown whether system delay also impacts ability to stay in the labor market. Therefore, the aim of the study was to evaluate whether system delay is associated with duration of absence from work or time to retirement from work among patients with STEMI treated with PPCI. We conducted a population-based cohort study including patients ≤67 years of age who were admitted with STEMI from January 1, 1999, to December 1, 2011 and treated with PPCI. Data were derived from Danish population-based registries. Only patients who were full- or part-time employed before their STEMI admission were included. Association between system delay and time to return to the labor market was analyzed using a competing-risk regression analysis. Association between system delay and time to retirement from work was analyzed using a Cox regression model. A total of 4,061 patients were included. Ninety-three percent returned to the labor market during 4 years of follow-up, and 41% retired during 8 years of follow-up. After adjustment, system delay >120 minutes was associated with reduced resumption of work (subhazard ratio 0.86, 95% confidence interval 0.81 to 0.92) and earlier retirement from work (hazard ratio 1.21, 95% confidence interval 1.08 to 1.36). In conclusion, system delay was associated with reduced work resumption and earlier retirement. This highlights the value of system delay as a performance measure in treating patients with STEMI. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Prognosis and delay of diagnosis among Kaposi’s sarcoma patients in Uganda: a cross-sectional study

    PubMed Central

    2014-01-01

    Background In low- and middle-income countries, the association between delay to treatment and prognosis for Kaposi’s sarcoma (KS) patients is yet to be studied. Methods This is a prospective study of HIV-infected adults with histologically-confirmed KS treated at the Uganda Cancer Institute (UCI). Standardized interviews were conducted in English or Luganda. Medical records were abstracted for KS stage at admission to UCI. Multivariable logistic regression assessed relationships between diagnostic delay and stage at diagnosis. Results Of 161 patients (90% response rate), 69% were men, and the mean age was 34.0 years (SD 7.7). 26% had been seen in an HIV clinic within 3 months, 72% were on antiretroviral therapy, and 26% had visited a traditional healer prior to diagnosis. 45% delayed seeking care at UCI for ≥3 months from symptom onset. Among those who delayed, 36% waited 6 months, and 25% waited 12 months. Common reasons for delay were lack of pain (48%), no money (32%), and distance to UCI (8%). In adjusted analysis patients who experienced diagnostic delay were more likely than those who did not delay to have poor-risk KS stage (OR 3.41, p = 0.002, 95% CI: 1.46-7.45). In adjusted analyses visiting a traditional healer was the only variable associated with greater likelihood of delay (OR 2.69, p = 0.020, 95% CI: 1.17-6.17). Conclusions Diagnostic delay was associated with poor-risk stage at diagnosis, and visiting a traditional healer was associated with higher odds of delay. The relationship between traditional and Western medicine presents a critical intervention point to improve KS-related outcomes in Uganda. PMID:24904686

  9. Delays during the administration of acetylcysteine for the treatment of paracetamol overdose

    PubMed Central

    Bailey, George P.; Najafi, Javad; Elamin, Muhammad E. M. O.; Waring, W. Stephen; Thomas, Simon H. L.; Archer, John R. H.; Wood, David M.

    2016-01-01

    Background The licensed intravenous acetylcysteine regimen for treating paracetamol overdose in most countries uses three separate infusions over 21 h. This complex regimen, requiring different infusion concentrations and rates, has been associated with administration errors. The aim of the present study was to assess the extent of administration delays occurring during this acetylcysteine regimen. Method A 6‐month retrospective observational study was conducted at three English teaching hospitals with clinical toxicology services from October 2014. Patients aged 16 years and over, treated with intravenous acetylcysteine for paracetamol overdose, were included. The start times for infusions were recorded and the delays compared with the prescribed infusion times were calculated. Anaphylactoid reactions, intravenous cannula problems, overdose intent and smoking status were recorded to assess their contribution to delays. Results From 263 cases identified, 198 met the study inclusion criteria. The median time between the start of infusions 1 and 3 was delayed from the intended 5 h by a median (interquartile range) of 90 (50–163) min, with 135 (68%) cases delayed by more than 1 h. Significantly longer delays were observed in patients with anaphylactoid reactions [median delay 267 (217–413) min, n = 8] and accidental/supratherapeutic overdose [median delay 170 (95–260) min, n = 29]. There were no significant differences between smokers and nonsmokers, or for patients with intravenous cannula problems. Conclusion Long delays were identified during the three‐infusion acetylcysteine regimen for the treatment of paracetamol overdose. These were of clinical significance and could lead to periods of subtherapeutic plasma acetylcysteine concentrations and potentially avoidable hepatotoxicity, as well as delaying hospital discharge. PMID:27412926

  10. Delays during the administration of acetylcysteine for the treatment of paracetamol overdose.

    PubMed

    Bailey, George P; Najafi, Javad; Elamin, Muhammad E M O; Waring, W Stephen; Thomas, Simon H L; Archer, John R H; Wood, David M; Dargan, Paul I

    2016-11-01

    The licensed intravenous acetylcysteine regimen for treating paracetamol overdose in most countries uses three separate infusions over 21 h. This complex regimen, requiring different infusion concentrations and rates, has been associated with administration errors. The aim of the present study was to assess the extent of administration delays occurring during this acetylcysteine regimen. A 6-month retrospective observational study was conducted at three English teaching hospitals with clinical toxicology services from October 2014. Patients aged 16 years and over, treated with intravenous acetylcysteine for paracetamol overdose, were included. The start times for infusions were recorded and the delays compared with the prescribed infusion times were calculated. Anaphylactoid reactions, intravenous cannula problems, overdose intent and smoking status were recorded to assess their contribution to delays. From 263 cases identified, 198 met the study inclusion criteria. The median time between the start of infusions 1 and 3 was delayed from the intended 5 h by a median (interquartile range) of 90 (50-163) min, with 135 (68%) cases delayed by more than 1 h. Significantly longer delays were observed in patients with anaphylactoid reactions [median delay 267 (217-413) min, n = 8] and accidental/supratherapeutic overdose [median delay 170 (95-260) min, n = 29]. There were no significant differences between smokers and nonsmokers, or for patients with intravenous cannula problems. Long delays were identified during the three-infusion acetylcysteine regimen for the treatment of paracetamol overdose. These were of clinical significance and could lead to periods of subtherapeutic plasma acetylcysteine concentrations and potentially avoidable hepatotoxicity, as well as delaying hospital discharge. © 2016 The British Pharmacological Society.

  11. Effect of metrology time delay on overlay APC

    NASA Astrophysics Data System (ADS)

    Carlson, Alan; DiBiase, Debra

    2002-07-01

    The run-to-run control strategy of lithography APC is primarily composed of a feedback loop as shown in the diagram below. It is known that the insertion of a time delay in a feedback loop can cause degradation in control performance and could even cause a stable system to become unstable, if the time delay becomes sufficiently large. Many proponents of integrated metrology methods have cited the damage caused by metrology time delays as the primary justification for moving from a stand-alone to integrated metrology. While there is little dispute over the qualitative form of this argument, there has been very light published about the quantitative effects under real fab conditions - precisely how much control is lost due to these time delays. Another issue regarding time delays is that the length of these delays is not typically fixed - they vary from lot to lot and in some cases this variance can be large - from one hour on the short side to over 32 hours on the long side. Concern has been expressed that the variability in metrology time delays can cause undesirable dynamics in feedback loops that make it difficult to optimize feedback filters and gains and at worst could drive a system unstable. By using data from numerous fabs, spanning many sizes and styles of operation, we have conducted a quantitative study of the time delay effect on overlay run- to-run control. Our analysis resulted in the following conclusions: (1) There is a significant and material relationship between metrology time delay and overlay control under a variety of real world production conditions. (2) The run-to-run controller can be configured to minimize sensitivity to time delay variations. (3) The value of moving to integrated metrology can be quantified.

  12. On the estimation of the reproduction number based on misreported epidemic data.

    PubMed

    Azmon, Amin; Faes, Christel; Hens, Niel

    2014-03-30

    Epidemic data often suffer from underreporting and delay in reporting. In this paper, we investigated the impact of delays and underreporting on estimates of reproduction number. We used a thinned version of the epidemic renewal equation to describe the epidemic process while accounting for the underlying reporting system. Assuming a constant reporting parameter, we used different delay patterns to represent the delay structure in our model. Instead of assuming a fixed delay distribution, we estimated the delay parameters while assuming a smooth function for the reproduction number over time. In order to estimate the parameters, we used a Bayesian semiparametric approach with penalized splines, allowing both flexibility and exact inference provided by MCMC. To show the performance of our method, we performed different simulation studies. We conducted sensitivity analyses to investigate the impact of misspecification of the delay pattern and the impact of assuming nonconstant reporting parameters on the estimates of the reproduction numbers. We showed that, whenever available, additional information about time-dependent underreporting can be taken into account. As an application of our method, we analyzed confirmed daily A(H1N1) v2009 cases made publicly available by the World Health Organization for Mexico and the USA. Copyright © 2013 John Wiley & Sons, Ltd.

  13. The biological acoustic sensor to record the interactions of the microbial cells with the phage antibodies in conducting suspensions.

    PubMed

    Guliy, О I; Zaitsev, B D; Borodina, I A; Shikhabudinov, А М; Teplykh, A A; Staroverov, S A; Fomin, A S

    2018-02-01

    The acoustic biological sensor for the analysis of the bacterial cells in conducting suspension was developed. The sensor represented the two channel delay line based on the piezoelectric plate of Y-X lithium niobate thick of 0.2mm. Two pairs of the interdigital transducers (IDT) for the excitation and reception of shear horizontal acoustic wave of zero order (SH 0 ) in each channel were deposited by the method of photolithography. One channel of the delay line was electrically shorted by the deposition of thin aluminum film between IDTs. The second channel remained as electrically open. The liquid container with the volume of 5ml was fixed on the plate surface between IDTs by the glue, which did not cause the additional insertion loss. For the first time the influence of the conductivity of the cell suspension on the registration of the specific and nonspecific interactions of the bacterial cells with phage-antibodies (phage-Abs) was studied by means of the developed sensor. The dependencies of the change in insertion loss and phase of the output signal on the conductivity of the buffer solution at specific/nonspecific interactions for the electrically open and shorted channels of the delay line were obtained. It was shown that the sensor successfully registered the interactions of microbial cells with phage-Abs in the range of the conductivity of 2-20 μS/cm on the model samples A. brasilense Sp245 - specific phage-Abs. The sensor in the time regime of the operation fast reacted on the specific/nonspecific interaction and the time of the stabilization of the output parameters did not exceed 10min. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Axonal Conduction Delays, Brain State, and Corticogeniculate Communication.

    PubMed

    Stoelzel, Carl R; Bereshpolova, Yulia; Alonso, Jose-Manuel; Swadlow, Harvey A

    2017-06-28

    Thalamocortical conduction times are short, but layer 6 corticothalamic axons display an enormous range of conduction times, some exceeding 40-50 ms. Here, we investigate (1) how axonal conduction times of corticogeniculate (CG) neurons are related to the visual information conveyed to the thalamus, and (2) how alert versus nonalert awake brain states affect visual processing across the spectrum of CG conduction times. In awake female Dutch-Belted rabbits, we found 58% of CG neurons to be visually responsive, and 42% to be unresponsive. All responsive CG neurons had simple, orientation-selective receptive fields, and generated sustained responses to stationary stimuli. CG axonal conduction times were strongly related to modulated firing rates (F1 values) generated by drifting grating stimuli, and their associated interspike interval distributions, suggesting a continuum of visual responsiveness spanning the spectrum of axonal conduction times. CG conduction times were also significantly related to visual response latency, contrast sensitivity (C-50 values), directional selectivity, and optimal stimulus velocity. Increasing alertness did not cause visually unresponsive CG neurons to become responsive and did not change the response linearity (F1/F0 ratios) of visually responsive CG neurons. However, for visually responsive CG neurons, increased alertness nearly doubled the modulated response amplitude to optimal visual stimulation (F1 values), significantly shortened response latency, and dramatically increased response reliability. These effects of alertness were uniform across the broad spectrum of CG axonal conduction times. SIGNIFICANCE STATEMENT Corticothalamic neurons of layer 6 send a dense feedback projection to thalamic nuclei that provide input to sensory neocortex. While sensory information reaches the cortex after brief thalamocortical axonal delays, corticothalamic axons can exhibit conduction delays of <2 ms to 40-50 ms. Here, in the corticogeniculate visual system of awake rabbits, we investigate the functional significance of this axonal diversity, and the effects of shifting alert/nonalert brain states on corticogeniculate processing. We show that axonal conduction times are strongly related to multiple visual response properties, suggesting a continuum of visual responsiveness spanning the spectrum of corticogeniculate axonal conduction times. We also show that transitions between awake brain states powerfully affect corticogeniculate processing, in some ways more strongly than in layer 4. Copyright © 2017 the authors 0270-6474/17/376342-17$15.00/0.

  15. The effects of computer-assisted cognitive rehabilitation on Alzheimer's dementia patients memories.

    PubMed

    Hwang, Jung-Ha; Cha, Hyun-Gyu; Cho, Young-Seok; Kim, Tae-Sue; Cho, Hyuk-Shin

    2015-09-01

    [Purpose] The purpose of the present study was to conduct Computer-Assisted Cognitive Rehabilitation (COMCOG) to examine the effects of COMCOG on Alzheimer's dementia patients' memories. [Subjects] Thirty-five patients diagnosed with Alzheimer's dementia received COMCOG for 30 minutes per day, five days per week for four weeks. [Methods] Before and after the COMCOG intervention, subjects' cognitive functions were evaluated using the Cognitive Assessment Reference Diagnosis System (CARDS) and Mini-Mental State Examination-Korea (MMSE-K) test. [Results] According to the results of the evaluation, among the CARDS scores of the subjects who received COMCOG, the scores of the delayed 10-word list, delayed 10-object list, recognition 10-object, and recent memory significantly increased while the scores of recognition 10-word significantly decreased after intervention compared to before intervention. In addition, among the MMSE-K items, the orientation, registration, and recall showed significant increases. [Conclusion] Based on these results, delay in the progress of memory deterioration can be expected when COMCOG is conducted for Alzheimer's dementia patients who show declines in cognitive functions.

  16. Real life is different: a qualitative study of why women delay abortion until the second trimester in Vietnam.

    PubMed

    Gallo, Maria F; Nghia, Nguyen C

    2007-05-01

    Although legal and safe-induced abortion services are available on request in Vietnam, second-trimester abortion still occurs. Given the increased risks and higher costs associated with later-term abortions, we conducted a qualitative study to understand the determinants of delaying abortion until the second trimester. We used purposive sampling to conduct semi-structured face-to-face interviews with 60 women aged 14-47 receiving an abortion at 13-24 weeks of gestation in 5 health facilities in 3 provinces in Vietnam. We also interviewed 6 providers from the study facilities. Three broad categories for factors influencing delays in obtaining abortions emerged: most women failed to recognize their pregnancy during the first trimester; women described structural barriers to accessing services earlier; and some women either needed time to make a decision or only decided to abort after other events had transpired. A richer understanding of the factors that prevent women from obtaining an abortion during the first trimester could be useful for informing interventions that support women in receiving care earlier during their pregnancies.

  17. [Are antioxidant supplements effective in reducing delayed onset muscle soreness? A systematic review].

    PubMed

    Candia-Luján, Ramón; De Paz Fernández, José Antonio; Costa Moreira, Osvaldo

    2014-10-05

    In recent years, antioxidant supplements have become popular to counter the effects of free radicals and muscle damage symptoms, including delayed onset muscle soreness (DOMS). To conduct a systematic review in different databases to determine the effects of antioxidant supplements on DOMS. We conducted a search in databases; Cochrane, Pubmed, Scopus and SportDiscus and Web of Science (WOS). The words and acronyms used were; Delayed onset muscle soreness, exercise induced muscle damage, DOMS, EIMD, antioxidant and oxidative stress. 54 articles were identified of which 48 were retreived, all in English, 17 related to vitamin C and E, supplements polyphenolic correspond to fourteen, eleven other antioxidant supplements and six to commercial supplements, all of them used to diminish the DOMS and other variables. Both vitamins and commercial supplements have low effectiveness in reducing DOMS, while polyphenols and other antioxidant supplements show moderate to good effectiveness in combating DOMS. However, most of the studies have effectiveness in reducing other symptoms of muscle damage besides helping in the post-exercise recovery. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  18. Impact of media and antifoam selection on monoclonal antibody production and quality using a high throughput micro‐bioreactor system

    PubMed Central

    Velugula‐Yellela, Sai Rashmika; Williams, Abasha; Trunfio, Nicholas; Hsu, Chih‐Jung; Chavez, Brittany; Yoon, Seongkyu

    2017-01-01

    Monoclonal antibody production in commercial scale cell culture bioprocessing requires a thorough understanding of the engineering process and components used throughout manufacturing. It is important to identify high impact components early on during the lifecycle of a biotechnology‐derived product. While cell culture media selection is of obvious importance to the health and productivity of mammalian bioreactor operations, other components such as antifoam selection can also play an important role in bioreactor cell culture. Silicone polymer‐based antifoams were known to have negative impacts on cell health, production, and downstream filtration and purification operations. High throughput screening in micro‐scale bioreactors provides an efficient strategy to identify initial operating parameters. Here, we utilized a micro‐scale parallel bioreactor system to study an IgG1 producing CHO cell line, to screen Dynamis, ProCHO5, PowerCHO2, EX‐Cell Advanced, and OptiCHO media, and 204, C, EX‐Cell, SE‐15, and Y‐30 antifoams and their impacts on IgG1 production, cell growth, aggregation, and process control. This study found ProCHO5, EX‐Cell Advanced, and PowerCHO2 media supported strong cellular growth profiles, with an IVCD of 25‐35 × 106 cells‐d/mL, while maintaining specific antibody production (Qp > 2 pg/cell‐d) for our model cell line and a monomer percentage above 94%. Antifoams C, EX‐Cell, and SE‐15 were capable of providing adequate control of foaming while antifoam 204 and Y‐30 noticeably stunted cellular growth. This work highlights the utility of high throughput micro bioreactors and the importance of identifying both positive and negative impacts of media and antifoam selection on a model IgG1 producing CHO cell line. © 2017 The Authors Biotechnology Progress published by Wiley Periodicals, Inc. on behalf of American Institute of Chemical Engineers Biotechnol. Prog., 34:262–270, 2018 PMID:29086492

  19. The Diagnostic Yield of Array Comparative Genomic Hybridization Is High Regardless of Severity of Intellectual Disability/Developmental Delay in Children.

    PubMed

    D'Arrigo, Stefano; Gavazzi, Francesco; Alfei, Enrico; Zuffardi, Orsetta; Montomoli, Cristina; Corso, Barbara; Buzzi, Erika; Sciacca, Francesca L; Bulgheroni, Sara; Riva, Daria; Pantaleoni, Chiara

    2016-05-01

    Microarray-based comparative genomic hybridization is a method of molecular analysis that identifies chromosomal anomalies (or copy number variants) that correlate with clinical phenotypes. The aim of the present study was to apply a clinical score previously designated by de Vries to 329 patients with intellectual disability/developmental disorder (intellectual disability/developmental delay) referred to our tertiary center and to see whether the clinical factors are associated with a positive outcome of aCGH analyses. Another goal was to test the association between a positive microarray-based comparative genomic hybridization result and the severity of intellectual disability/developmental delay. Microarray-based comparative genomic hybridization identified structural chromosomal alterations responsible for the intellectual disability/developmental delay phenotype in 16% of our sample. Our study showed that causative copy number variants are frequently found even in cases of mild intellectual disability (30.77%). We want to emphasize the need to conduct microarray-based comparative genomic hybridization on all individuals with intellectual disability/developmental delay, regardless of the severity, because the degree of intellectual disability/developmental delay does not predict the diagnostic yield of microarray-based comparative genomic hybridization. © The Author(s) 2015.

  20. Delay and reward choice in ADHD: an experimental test of the role of delay aversion.

    PubMed

    Marco, Rafaela; Miranda, Ana; Schlotz, Wolff; Melia, Amanda; Mulligan, Aisling; Müller, Ueli; Andreou, Penny; Butler, Louise; Christiansen, Hanna; Gabriels, Isabel; Medad, Sheera; Albrecht, Bjorn; Uebel, Henrik; Asherson, Phillip; Banaschewski, Tobias; Gill, Michael; Kuntsi, Jonna; Mulas, Fernando; Oades, Robert; Roeyers, Herbert; Steinhausen, Hans-Christoph; Rothenberger, Aribert; Faraone, Stephen V; Sonuga-Barke, Edmund J S

    2009-05-01

    Children with attention deficit/hyperactivity disorder (ADHD) choose smaller sooner (SS) over larger later (LL) rewards more than controls. Here we assess the contributions of impulsive drive for immediate rewards (IDIR) and delay aversion (DAv) to this pattern. We also explore the characteristics of, and the degree of familiality in, ADHD SS responders. We had 360 ADHD probands; 349 siblings and 112 controls (aged between 6 to 17 years) chose between SS (1 point after 2 s) and LL reward (2 points after 30 s) outcomes on the Maudsley Index of Delay Aversion (Kuntsi, Oosterlaan, & Stevenson, 2001): Under one condition SS choice led to less overall trial delay under another it did not. ADHD participants chose SS more than controls under both conditions. This effect was larger when SS choice reduced trial delay. ADHD SS responders were younger, had lower IQ, more conduct disorder and had siblings who were more likely to be SS responders themselves. The results support a dual component model in which both IDIR and DAv contribute to SS choice in ADHD. SS choice may be a marker of an ADHD motivational subtype.

  1. The first signs of prospective memory.

    PubMed

    Ślusarczyk, Elżbieta; Niedźwieńska, Agnieszka; Białecka-Pikul, Marta

    2018-06-05

    We conducted a study to examine the impact of motivation and length of delay on performance on prospective memory (PM) tasks in 2-year of children. A total of 158 children aged exactly 24 months were asked to perform a naturalistic PM task. Length of delay (10 min; 35 min) and motivation (high; very high) were between-subjects factors. Two thirds of children had to be excluded from the analysis because of poor retrospective memory for the PM task instructions which were no longer remembered at the end of the session. For the children who did remember the instructions, both motivation and delay had significant effects on PM. Also, their PM performance was reliably above zero, even after the long delay. The findings indicate that when children as young as 24 months are able to remember the PM task instructions they can reliably succeed in PM tasks that are intrinsically motivating for them.

  2. Separation attenuation in swept shock wave-boundary-layer interactions using different microvortex generator geometries

    NASA Astrophysics Data System (ADS)

    Martis, R. R.; Misra, A.

    2017-09-01

    A numerical study is conducted to determine the effectiveness of six different microvortex generator geometries in controlling swept shock wave/boundary-layer interactions. The geometries considered are base ramp, base ramp with declining angle of 45°, blunt ramp, split ramp, thick vanes, and ramped vanes. Microvortex generators with a gap were found to be better suited for delaying the separation. Thick vanes showed the largest delay in separation among the devices studied.

  3. Investigation of the effects of bandwidth and time delay on helicopter roll-axis handling qualities

    NASA Technical Reports Server (NTRS)

    Pausder, Heinz-Juergen; Blanken, Chris L.

    1992-01-01

    Several years of cooperative research conducted under the U.S./German Memorandum of Understanding (MOU) in helicopter flight control has recently resulted in a successful handling qualities study. The focus of this cooperative research has been the effects on handling qualities due to time delays in combination with a high bandwidth vehicle. The jointly performed study included the use of U.S. ground-based simulation and German in-flight simulation facilities. The NASA-Ames Vertical Motion Simulator (VMS) was used to develop a high bandwidth slalom tracking task which took into consideration the constraints of the facilities. The VMS was also used to define a range of the test parameters and to perform initial handling qualities evaluations. The flight tests were conducted using DLR's variable-stability BO 105 S3 Advanced Technology Testing Helicopter System (ATTHeS). Configurations included a rate command and an attitude command response system with added time delays up to 160 milliseconds over the baseline and bandwidth values between 1.5 and 4.5 rad/sec. Sixty-six evaluations were performed in about 25 hr of flight time during 10 days of testing. The results indicate a need to more tightly constrain the allowable roll axis phase delay for the Level 1 and Level 2 requirements in the U.S. Army's specification for helicopter handling qualities, ADS-33C.

  4. Investigation of the effects of bandwidth and time delay on helicopter roll-axis handling qualities

    NASA Technical Reports Server (NTRS)

    Blanken, Chris L.; Pausder, Heinz-Jurgen

    1994-01-01

    Several years of cooperative research conducted under the U.S./German Memorandum of Understanding (MOU) in helicopter aeromechanics have recently resulted in a successful handling qualities study. The focus of this cooperative research has been the effect of time delays in a high bandwidth vehicle on handling qualities. The jointly performed study included the use of U.S. ground-based simulation and German in-flight simulation facilities. The NASA-Ames Vertical Motion Simulator (VMS) was used to develop a high bandwidth slalom tracking task which took into consideration the constraints of the facilities. The VMS was used to define a range of the test parameters and to perform initial handling qualities evaluations. The flight tests were conducted using DLR's variable-stability BO 105 S3 Advanced Technology Testing Helicopter System (ATTHeS). Configurations included a rate command and an attitude command response system with added time delays of up to 160 milliseconds over the baseline and band width values between 1.5 and 4.5 rad/sec. Sixty-six evaluations were performed in about 25 hours of flight time during ten days of testing. The results indicate a need to more tightly constrain the allowable roll axis phase delay for the Level 1 and Level 2 requirements in the U.S. Army's specification for helicopter handling qualities Aeronautical Design Standard (ADS)-33C.

  5. Investigation of the effects of bandwidth and time delay on helicopter roll-axis handling qualities

    NASA Technical Reports Server (NTRS)

    Pausder, Heinz-Juergen; Blanken, Chris L.

    1993-01-01

    Several years of cooperative research conducted under the U.S./German Memorandum of Understanding (MOU) in helicopter flight control has recently resulted in a successful handling qualities study. The focus of this cooperative research has been the effects on handling qualities due to time delays in combination with a high bandwidth vehicle. The jointly performed study included the use of U.S. ground-based simulation and German in-flight simulation facilities. The NASA-Ames Vertical Motion Simulator (VMS) was used to develop a high bandwidth slalom tracking task which took into consideration the constraints of the facilities. The VMS was also used to define a range of the test parameters and to perform initial handling qualities evaluations. The flight tests were conducted using DLR's variable-stability BO 105 S3 Advanced Technology Testing Helicopter System (ATTHeS). Configurations included a rate command and an attitude command response system with added time delays up to 160 milliseconds over the baseline and bandwidth values between 1.5 and 4.5 rad/sec. Sixty-six evaluations were performed in about 25 hours of flight time during ten days of testing. The results indicate a need to more tightly constrain the allowable roll axis phase delay for the Level 1 and Level 2 requirements in the U.S. Army's specification for helicopter handling qualities, ADS-33C.

  6. Adult language use and infant comprehension of English: associations with encoding and generalization across cues at 20 months.

    PubMed

    Phung, Janice N; Milojevich, Helen M; Lukowski, Angela F

    2014-11-01

    Adult-provided language shapes event memory in children who are preverbal and in those who are able to discuss the past using language. The research conducted to date, however, has not yet established whether infant language comprehension abilities moderate the extent to which preverbal infants benefit from adult-provided supportive language. The present study was conducted to address this question by examining immediate imitation and 1-week delayed generalization across cues in 20-month-old infants as a function of (a) variability in adult-provided linguistic support at encoding and test, (b) infant language comprehension abilities, and (c) their interaction. The provision of supportive adult language at encoding and test was associated with delayed generalization across cues although supportive adult language at encoding did not influence performance at immediate imitation. Infant language comprehension abilities were associated with performance at immediate imitation and delayed generalization across cues. In addition, infant language comprehension abilities moderated the extent to which infants benefited from adult-provided supportive language at encoding and test. The findings contribute to the literature by demonstrating that adult language use and infant language comprehension are independently and differentially associated with immediate imitation and 1-week delayed generalization across cues but also serve to jointly structure event memory in the second year of life. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. [Hugo von Ziemssen poster award 2015].

    PubMed

    2015-12-01

    Prize winner: Herr Dr. Stefano Bordignon, for the poster presentation "The SCAR-AF study: electroanatomial scar distribution and left atrial conduction delay in patients undergoing pulmonary vein isolation".

  8. Reward: commentary. Temporal discounting in conduct disorder: toward an experience-adaptation hypothesis of the role of psychosocial insecurity.

    PubMed

    Sonuga-Barke, Edmund J S

    2014-02-01

    Young people with conduct disorder often experience histories of psychosocial adversity and socioeconomic insecurity. For these individuals, real-world future outcomes are not only delayed in their delivery but also highly uncertain. Under such circumstances, accentuated time preference (extreme favoring of the present over the future) is a rational response to the everyday reality of social and economic transactions. Building on this observation, the author sets out the hypothesis that the exaggerated temporal discounting displayed by individuals with conduct disorder reported by White et al. (2014) is an adaptation to chronic exposure to psychosocial insecurity during development. The author postulates that this adaptation leads to (a) a decision-making bias whereby delay and uncertainty are coded as inseparable characteristics of choice outcomes and/or (b) reprogramming of the brain networks regulating intertemporal decision making. Future research could explore the putative role of environmental exposures to adversity in the development of exaggerated temporal discounting in conduct disorder as well as the mediating role of putative cognitive and neurobiological adaptations.

  9. Methods for analysis of passenger trip performance in a complex networked transportation system

    NASA Astrophysics Data System (ADS)

    Wang, Danyi

    2007-12-01

    The purpose of the Air Transportation System (ATS) is to provide safe and efficient transportation service of passengers and cargo. The on-time performance of a passenger's trip is a critical performance measurement of the Quality of Service (QOS) provided by any Air Transportation System. QOS has been correlated with airline profitability, productivity, customer loyalty and customer satisfaction (Heskett et al. 1994). Btatu and Barnhart have shown that official government and airline on-time performance metrics (i.e. flight-centric measures of air transportation) fail to accurately reflect the passenger experience (Btatu and Barnhart, 2005). Flight-based metrics do not include the trip delays accrued by passengers who were re-booked due to cancelled flights or missed connections. Also, flight-based metrics do not quantify the magnitude of the delay (only the likelihood) and thus fails to provide the consumer with a useful assessment of the impact of a delay. Passenger-centric metrics have not been developed because of the unavailability of airline proprietary data, which is also protected by anti-trust collusion concerns and civil liberty privacy restrictions. Moveover, the growth of the ATS is trending out of the historical range. The objectives of this research were to (1) estimate ATS-wide passenger trip delay using publicly accessible flight data, and (2) investigate passenger trip dynamics out of the range of historical data by building a passenger flow simulation model to predict impact on passenger trip time given anticipated changes in the future. The first objective enables researchers to conduct historical analysis on passenger on-time performance without proprietary itinerary data, and the second objective enables researchers to conduct experiments outside the range of historic data. The estimated passenger trip delay was for 1,030 routes between the 35 busiest airports in the United States in 2006. The major findings of this research are listed as follows: 1. High passenger trip delays are disproportionately generated by cancelled flights and missed connections. Passengers scheduled on cancelled flights or missed connections represent 3 percent of total enplanements, but generated 45 percent of total passenger trip delay. On average, passengers scheduled on cancelled flights experienced 607 minutes delay, and passengers who missed the connections experienced 341 minutes delay in 2006. The heavily skewed distribution of passenger trip delay reveals the fact that a small proportion of passengers experience heavy delays, which can not be reflected by flight-based performance metrics. 2. Trend analysis for passenger trip delays from 2000 to 2006 shows the increase in flight operations slowed down and leveled off in 2006, while enplanements kept increasing. This is due to the continuous increase in load factor. Load factor has increased from 69% in 2003 to 80% in 2006. Passenger performance is very sensitive to changes in flight operations: annual total passenger trip delay was increased by 17% and 7% from 2004 to 2005, and from 2005 to 2006, while flight operations barely increased (0.5% from 2004 to 2005, and no increase from 2005 to 2006) during the same time period. 3. Passenger trip delay is shown to have an asymmetric performance of passenger trip delay in terms of routes. Seventeen percent of the 1030 routes generated 50 percent of total passenger trip delays. An interesting observation is that routes between the New York metropolitan area and the Washington D.C. metropolitan area have the highest average passenger trip delays in the system. 4. In terms of airports, there is also an asymmetric performance of passenger trip delay. Nine of the 35 busiest airports generated 50 percent of total passenger trip delays. Some airports, especially major hubs, impact the passenger trip delays significantly more than others. Recognition of this asymmetric performance can help reduce the total passenger trip delay propagation in the air transportation network by making changes primarily in major airports, such as Atlanta, GA (ATL), Chicago O'Hare (ORD) and Newark (EWR) airports. 5. Congestion Flight Delay, Load Factor, Flight Cancellation Time, and Airline Cooperation Policy are the most significant factors affecting total passenger trip delay in the system.

  10. Contextual-specificity of short-delay extinction in humans: Renewal of fear-potentiated startle in a virtual environment

    PubMed Central

    Alvarez, Ruben P.; Johnson, Linda; Grillon, Christian

    2007-01-01

    A recent fear-potentiated startle study in rodents suggested that extinction was not context dependent when extinction was conducted after a short delay following acquisition, suggesting that extinction can lead to erasure of fear learning in some circumstances. The main objective of this study was to attempt to replicate these findings in humans by examining the context specificity of short-delay extinction in an ABA renewal procedure using virtual reality environments. A second objective was to examine whether renewal, if any, would be influenced by context conditioning. Subjects underwent differential aversive conditioning in virtual context A, which was immediately followed by extinction in virtual context B. Extinction was followed by tests of renewal in context A and B, with the order counterbalanced across subjects. Results showed that extinction was context dependent. Evidence for renewal was established using fear-potentiated startle as well as skin conductance and fear ratings. In addition, although contextual anxiety was greater in the acquisition context than in the extinction context during renewal, as assessed with startle, context conditioning did not influence the renewal effect. These data do not support the view that extinction conducted shortly after acquisition is context independent. Hence, they do not provide evidence that extinction can lead to erasure of a fear memory established via Pavlovian conditioning. PMID:17412963

  11. Semantic effects in sentence recall: the contribution of immediate vs delayed recall in language assessment.

    PubMed

    Polišenská, Kamila; Chiat, Shula; Comer, Amanda; McKenzie, Kirsty

    2014-01-01

    Sentence recall is increasingly used to assess language. It is widely debated what the task is actually testing, but one rarely explored aspect is the contribution of semantics to sentence recall. The few studies that have examined the role of semantics in sentence recall have employed an 'intrusion paradigm', following Potter and Lombardi (1990), and their paradigm relies on interference errors with conclusions based on an analysis of error patterns. We have instead manipulated the semantic plausibility of whole sentences to investigate the effects of semantics on immediate and delayed sentence recall. In Study 1, adults recalled semantically plausible and implausible sentences either immediately or after distracter tasks varying in lexical retrieval demands (backward counting and picture naming). Results revealed significant effects of plausibility, delay, and a significant interaction indicating increasing reliance on semantics as the demands of the distracter tasks increased. Study 2, conducted with 6-year-old children, employed delay conditions that were modified to avoid floor effects (delay with silence and forward counting) and a similar pattern of results emerged. This novel methodology provided robust evidence showing the effectiveness of delayed recall in the assessment of semantics and the effectiveness of immediate recall in the assessment of morphosyntax. The findings from our study clarify the linguistic mechanisms involved in immediate and delayed sentence recall, with implications for the use of recall tasks in language assessment. The reader will be able to: (i) define the difference between immediate and delayed sentence recall and different types of distractors, (ii) explain the utility of immediate and delayed recall sentence recall in language assessment, (iii) discuss suitability of delayed recall for the assessment of semantics. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Genetic architecture of delayed senescence, biomass, and grain yield under drought stress in cowpea.

    PubMed

    Muchero, Wellington; Roberts, Philip A; Diop, Ndeye N; Drabo, Issa; Cisse, Ndiaga; Close, Timothy J; Muranaka, Satoru; Boukar, Ousmane; Ehlers, Jeffrey D

    2013-01-01

    The stay-green phenomenon is a key plant trait with wide usage in managing crop production under limited water conditions. This trait enhances delayed senescence, biomass, and grain yield under drought stress. In this study we sought to identify QTLs in cowpea (Vigna unguiculata) consistent across experiments conducted in Burkina Faso, Nigeria, Senegal, and the United States of America under limited water conditions. A panel of 383 diverse cowpea accessions and a recombinant inbred line population (RIL) were SNP genotyped using an Illumina 1536 GoldenGate assay. Phenotypic data from thirteen experiments conducted across the four countries were used to identify SNP-trait associations based on linkage disequilibrium association mapping, with bi-parental QTL mapping as a complementary strategy. We identified seven loci, five of which exhibited evidence suggesting pleiotropic effects (stay-green) between delayed senescence, biomass, and grain yield. Further, we provide evidence suggesting the existence of positive pleiotropy in cowpea based on positively correlated mean phenotypic values (0.34< r <0.87) and allele effects (0.07< r <0.86) for delayed senescence and grain yield across three African environments. Three of the five putative stay-green QTLs, Dro-1, 3, and 7 were identified in both RILs and diverse germplasm with resolutions of 3.2 cM or less for each of the three loci, suggesting that these may be valuable targets for marker-assisted breeding in cowpea. Also, the co-location of early vegetative delayed senescence with biomass and grain yield QTLs suggests the possibility of using delayed senescence at the seedling stage as a rapid screening tool for post-flowering drought tolerance in cowpea breeding. BLAST analysis using EST sequences harboring SNPs with the highest associations provided a genomic context for loci identified in this study in closely related common bean (Phaseolus vulgaris) and soybean (Glycine max) reference genomes.

  13. Correlation Between Mothers' Depression and Developmental Delay in Infants Aged 6-18 Months.

    PubMed

    Vameghi, Roshanak; Amir Ali Akbari, Sedigheh; Sajjadi, Homeira; Sajedi, Firoozeh; Alavimajd, Hamid

    2015-08-23

    Regarding the importance of children's developmental status and various factors that delay their development, this study was conducted to examine the correlation between mothers' depression levels and the developmental delay in infants. This descriptive study was performed on 1053 mothers and their infants' age 6 to18 month-old in medical centers affiliated with Shahid Beheshti University of Medical Sciences, Iran, in 2014-2015. The participants were selected through multi-stage random sampling. The following instruments were used in this study: A demographic and obstetric specification questionnaire, infant specification questionnaire, the Beck Depression Inventory, and the Ages and Stages Questionnaire to determine the status of the children's development. The data were analyzed using SPSS19 software, Mann-Whitney; independent T-test and logistic-Regression tests were used. The results showed that 491 mothers (46.7%) suffered mild to extremely severe depression. The delay in infant development was 11.8%. The Mann-Whitney test showed a correlation between mothers' depression levels and developmental delay in infants (P=0.001). Moreover, there was a significant correlation between mothers' depression and developmental delays in gross-motor and problem-solving skills (P<0/05). In logistic model age of infants showed significant correlation with developmental delay (P=0.004 OR=1.07), but unwanted pregnancy, gender of infants, type of delivery and socioeconomic status had no correlation with developmental delay. Given the correlation between mothers' depression and infant development, it is recommended to screen mothers for depression in order to perform early interventions in developmental delay.

  14. [Time perception in depressed and manic patients].

    PubMed

    Zhao, Qi-yuan; Ji, Yi-fu; Wang, Kai; Zhang, Lei; Liu, Ping; Jiang, Yu-bao

    2010-02-02

    To investigate the time perception in affective disorders by using neuropsychological tests and to try to elucidate its neurobiochemical mechanism. Using a time reproduction task, a comparative study was conducted for 28 depressive patients, 22 manic patients, and 26 age and education level matched healthy persons as healthy controls. Both depressive patients and manic patients are abnormal (P < 0.001), depressive patients over-reproduced the time interval than healthy controls (600 ms/delay 1 s: 1.6 +/- 0.6, P < 0.001; 600 ms/delay 5 s: 1.7 +/- 0.6, P < 0.001; 3 s/delay 1 s: 3.9 +/- 0.9, P < 0.001; 3 s/delay 5 s: 3.9 +/- 0.7, P < 0.001; 5 s/delay 1 s: 5.9 +/- 1.3, P < 0.001; 5 s/delay 5 s: 6.1 +/- 1.3, P < 0.001), yet manic patients under-reproduced the time interval (600 ms/delay 1 s: 0.7 +/- 0.2, P < 0.01; 600 ms/delay 5 s: 0.6 +/- 0.3, P < 0.001; 3 s/delay 1 s: 1.7 +/- 0.5, P < 0.001; 3 s/delay 5 s: 1.8 +/- 0.6, P < 0.001; 5 s/delay 1 s: 2.9 +/- 0.7, P < 0.001; 5 s/delay 5 s: 3.0 +/- 0.8, P < 0.001). The results of time reproduction task in patients were not related to age, education, duration of illness, number of admission (P > 0.05), but had some relation to severity of illness.And the results were positively correlated with the score of HAMD in depressive patients (six times: r = 0.44, 0.46, 0.73, 0.61, 0.55, 0.50, P < 0.05), but negatively with the score of BRMS in manic patients (six times: r = -0.57, -0.54, -0.71, -0.69, -0.80, -0.71, P < 0.05). Emotion will affect one's time perception. And the neurotransmitter in brain may participate in the processes of time perception.

  15. CAN LARGE TIME DELAYS OBSERVED IN LIGHT CURVES OF CORONAL LOOPS BE EXPLAINED IN IMPULSIVE HEATING?

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

    Lionello, Roberto; Linker, Jon A.; Mikić, Zoran

    The light curves of solar coronal loops often peak first in channels associated with higher temperatures and then in those associated with lower temperatures. The delay times between the different narrowband EUV channels have been measured for many individual loops and recently for every pixel of an active region observation. The time delays between channels for an active region exhibit a wide range of values. The maximum time delay in each channel pair can be quite large, i.e., >5000 s. These large time delays make-up 3%–26% (depending on the channel pair) of the pixels where a trustworthy, positive time delaymore » is measured. It has been suggested that these time delays can be explained by simple impulsive heating, i.e., a short burst of energy that heats the plasma to a high temperature, after which the plasma is allowed to cool through radiation and conduction back to its original state. In this paper, we investigate whether the largest observed time delays can be explained by this hypothesis by simulating a series of coronal loops with different heating rates, loop lengths, abundances, and geometries to determine the range of expected time delays between a set of four EUV channels. We find that impulsive heating cannot address the largest time delays observed in two of the channel pairs and that the majority of the large time delays can only be explained by long, expanding loops with photospheric abundances. Additional observations may rule out these simulations as an explanation for the long time delays. We suggest that either the time delays found in this manner may not be representative of real loop evolution, or that the impulsive heating and cooling scenario may be too simple to explain the observations, and other potential heating scenarios must be explored.« less

  16. Factors associated with delay in trauma team activation and impact on patient outcomes.

    PubMed

    Connolly, Rory; Woo, Michael Y; Lampron, Jacinthe; Perry, Jeffrey J

    2017-09-05

    Trauma code activation is initiated by emergency physicians using physiological and anatomical criteria, mechanism of injury, and patient demographic factors. Our objective was to identify factors associated with delayed trauma team activation. We assessed consecutive cases from a regional trauma database from January 2008 to March 2014. We defined a delay in trauma code activation as a time greater than 30 minutes from the time of arrival. We conducted univariate analysis for factors potentially influencing trauma team activation, and we subsequently used multiple logistic regression analysis models for delayed activation in relation to mortality, length of stay, and time to operative management. Patients totalling 846 were included for our analysis; 4.1% (35/846) of trauma codes were activated after 30 minutes. Mean age was 40.8 years in the early group versus 49.2 in the delayed group (p=0.01). Patients were over age 70 years in 7.6% in the early activation group versus 17.1% in the delayed group (p=0.04). There was no significant difference in sex, type of injury, injury severity, or time from injury between the two groups. There was no significant difference in mortality, median length of stay, or median time to operative management. Delayed activation is linked with increasing age with no clear link to increased mortality. Given the severe injuries in the delayed cohort that required activation of the trauma team, further emphasis on the older trauma patient and interventions to recognize this vulnerable population should be made.

  17. The difference of delay time in monitoring system of facial acupressure learning media using bluetooth, wireless and ethernet

    NASA Astrophysics Data System (ADS)

    Agustin, Eny Widhia; Hangga, Arimaz; Fahrian, Muhammad Iqbal; Azhari, Anis Fikri

    2018-03-01

    The implementation of monitoring system in the facial acupressure learning media could increase the students' proficiency. However the common learning media still has not implemented a monitoring system in their learning process. This research was conducted to implement monitoring system in the mannequin head prototype as a learning media of facial acupressure using Bluetooth, wireless and Ethernet. The results of the implementation of monitoring system in the prototype showed that there were differences in the delay time between Bluetooth and wireless or Ethernet. The results data showed no difference in the average delay time between the use of Bluetooth with wireless and the use of Bluetooth with Ethernet in monitoring system of facial acupressure learning media. From all the facial acupressure points, the forehead facial acupressure point has the longest delay time of 11.93 seconds. The average delay time in all 3 class rooms was 1.96 seconds therefore the use of Bluetooth, wireless and Ethernet is highly recommended in the monitoring system of facial acupressure.

  18. Timing matters: negative emotion elicited 5 min but not 30 min or 45 min after learning enhances consolidation of internal-monitoring source memory.

    PubMed

    Wang, Bo; Bukuan, Sun

    2015-05-01

    Two experiments examined the time-dependent effects of negative emotion on consolidation of item and internal-monitoring source memory. In Experiment 1, participants (n=121) learned a list of words. They were asked to read aloud half of the words and to think about the remaining half. They were instructed to memorize each word and its associative cognitive operation ("reading" versus "thinking"). Immediately following learning they conducted free recall and then watched a 3-min either neutral or negative video clip when 5 min, 30 min or 45 min had elapsed after learning. Twenty-four hours later they returned to take surprise tests for item and source memory. Experiment 2 was similar to Experiment 1 except that participants, without conducting an immediate test of free recall, took tests of source memory for all encoded words both immediately and 24 h after learning. Experiment 1 showed that negative emotion enhanced consolidation of item memory (as measured by retention ratio of free recall) regardless of delay of emotion elicitation and that negative emotion enhanced consolidation of source memory when it was elicited at a 5 min delay but reduced consolidation of source memory when it was elicited at a 30 min delay; when elicited at a 45 min delay, negative emotion had little effect. Furthermore, Experiment 2 replicated the enhancement effect on source memory in the 5 min delay even when participants were tested on all the encoded words. The current study partially replicated prior studies on item memory and extends the literature by providing evidence for a time-dependent effect of negative emotion on consolidation of source memory based on internal monitoring. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Health care strategies to promote earlier presentation of symptomatic breast cancer: perspectives of women and family physicians

    PubMed Central

    Heisey, R.; Clemons, M.; Granek, L.; Fergus, K.; Hum, S.; Lord, B.; McCready, D.R.; Fitzgerald, B.

    2011-01-01

    Background Many women with symptoms suggestive of a breast cancer diagnosis delay presentation to their family physician. Although factors associated with delay have been well described, there is a paucity of data on strategies to mitigate delay. Objectives We conducted a qualitative research project to examine factors related to delay and to identify health care system changes that might encourage earlier presentation. Methods Individual semi-structured interviews were conducted with women who sought care 12 weeks or more after self-detection of breast cancer symptoms and with family physicians whose practices included patients meeting that criterion. Results The women and physicians both suggested a need for clearer screening mammography guidelines for women 40–49 years of age and for better messaging concerning breast awareness. The use of additional hopeful testimonials from breast cancer survivors were suggested to help dispel the notion of cancer as a “death sentence.” Educational initiatives were proposed, aimed at both increasing awareness of “non-lump” breast cancer symptoms and advising women that a previous benign diagnosis does not ensure that future symptoms are not cancer. Women wanted empathic nonjudgmental access to care. Improved methods to track compliance with screening mammography and with periodic health exams and access to a rapid diagnostic process were suggested. Conclusions A list of “at-risk situations for delay” in diagnosis of breast cancer was developed for physicians to assist in identifying women who might delay. Health care system changes actionable both at the health policy level and in the family physician’s office were identified to encourage earlier presentation of women with symptomatic breast cancer. PMID:21980254

  20. Surface acoustic wave devices as passive buried sensors

    NASA Astrophysics Data System (ADS)

    Friedt, J.-M.; Rétornaz, T.; Alzuaga, S.; Baron, T.; Martin, G.; Laroche, T.; Ballandras, S.; Griselin, M.; Simonnet, J.-P.

    2011-02-01

    Surface acoustic wave (SAW) devices are currently used as passive remote-controlled sensors for measuring various physical quantities through a wireless link. Among the two main classes of designs—resonator and delay line—the former has the advantage of providing narrow-band spectrum informations and hence appears compatible with an interrogation strategy complying with Industry-Scientific-Medical regulations in radio-frequency (rf) bands centered around 434, 866, or 915 MHz. Delay-line based sensors require larger bandwidths as they consists of a few interdigitated electrodes excited by short rf pulses with large instantaneous energy and short response delays but is compatible with existing equipment such as ground penetrating radar (GPR). We here demonstrate the measurement of temperature using the two configurations, particularly for long term monitoring using sensors buried in soil. Although we have demonstrated long term stability and robustness of packaged resonators and signal to noise ratio compatible with the expected application, the interrogation range (maximum 80 cm) is insufficient for most geology or geophysical purposes. We then focus on the use of delay lines, as the corresponding interrogation method is similar to the one used by GPR which allows for rf penetration distances ranging from a few meters to tens of meters and which operates in the lower rf range, depending on soil water content, permittivity, and conductivity. Assuming propagation losses in a pure dielectric medium with negligible conductivity (snow or ice), an interrogation distance of about 40 m is predicted, which overcomes the observed limits met when using interrogation methods specifically developed for wireless SAW sensors, and could partly comply with the above-mentioned applications. Although quite optimistic, this estimate is consistent with the signal to noise ratio observed during an experimental demonstration of the interrogation of a delay line buried at a depth of 5 m in snow.

  1. The Efficacy of Parent Counseling and Support Groups on the Stress Levels, Self-Esteem and Degree of Coping of Parents of Developmentally Delayed or Handicapped Children Who Are Involved in an Infant Intervention Program.

    ERIC Educational Resources Information Center

    La Fountain, Rebecca; Geoffroy, Kevin

    This study was conducted to investigate the effect that a parent support group and a counseling group had on the stress levels, self-esteem, and degree of coping of parents (N=48) of developmentally delayed or handicapped infants enrolled in an infant intervention program. It was hypothesized that, compared to parents in the control group, parents…

  2. Analysis and correction of ground reflection effects in measured narrowband sound spectra using cepstral techniques

    NASA Technical Reports Server (NTRS)

    Miles, J. H.; Stevens, G. H.; Leininger, G. G.

    1975-01-01

    Ground reflections generate undesirable effects on acoustic measurements such as those conducted outdoors for jet noise research, aircraft certification, and motor vehicle regulation. Cepstral techniques developed in speech processing are adapted to identify echo delay time and to correct for ground reflection effects. A sample result is presented using an actual narrowband sound pressure level spectrum. The technique can readily be adapted to existing fast Fourier transform type spectrum measurement instrumentation to provide field measurements/of echo time delays.

  3. Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study.

    PubMed

    Ozaki, Akihiko; Nomura, Shuhei; Leppold, Claire; Tsubokura, Masaharu; Tanimoto, Tetsuya; Yokota, Takeru; Saji, Shigehira; Sawano, Toyoaki; Tsukada, Manabu; Morita, Tomohiro; Ochi, Sae; Kato, Shigeaki; Kami, Masahiro; Nemoto, Tsuyoshi; Kanazawa, Yukio; Ohira, Hiromichi

    2017-06-19

    Little information is available concerning how patient delay may be affected by mass disasters. The main objectives of the present study are to identify whether there was a post-disaster increase in the risk of experiencing patient delay among breast cancer patients in an area affected by the 2011 triple disaster in Fukushima, Japan, and to elucidate factors associated with post-disaster patient delay. Sociodemographic factors (age, employment status, cohabitant status and evacuation status), health characteristics, and health access- and disaster-related factors were specifically considered. Records of symptomatic breast cancer patients diagnosed from 2005 to 2016 were retrospectively reviewed to calculate risk ratios (RRs) for patient delay in every year post-disaster compared with the pre-disaster baseline. Total and excessive patient delays were respectively defined as three months or more and twelve months or more from symptom recognition to first medical consultation. Logistic regression analysis was conducted for pre- and post-disaster patient delay in order to reveal any factors potentially associated with patient delay, and changes after the disaster. Two hundred nineteen breast cancer patients (122 pre-disaster and 97 post-disaster) were included. After adjustments for age, significant post-disaster increases in RRs of experiencing both total (RR: 1.66, 95% Confidence Interval (CI): 1.02-2.70, p < 0.05) and excessive patient delay (RR: 4.49, 95% CI: 1.73-11.65, p < 0.01) were observed. The RRs for total patient delay peaked in the fourth year post-disaster, and significant increases in the risk of excessive patient delay were observed in the second, fourth, and fifth years post-disaster, with more than five times the risk observed pre-disaster. A family history of any cancer was the only factor significantly associated with total patient delay post-disaster (odds ratio: 0.38, 95% CI: 0.15-0.95, p < 0.05), while there were no variables associated with delay pre-disaster. The triple disaster in Fukushima appears to have led to an increased risk of patient delay among breast cancer patients, and this trend has continued for five years following the disaster.

  4. The Role of Influenza in the Delay between Low Temperature and Ischemic Heart Disease: Evidence from Simulation and Mortality Data from Japan

    PubMed Central

    Imai, Chisato; Barnett, Adrian G.; Hashizume, Masahiro; Honda, Yasushi

    2016-01-01

    Many studies have found that cardiovascular deaths mostly occur within a few days of exposure to heat, whereas cold-related deaths can occur up to 30 days after exposure. We investigated whether influenza infection could explain the delayed cold effects on ischemic heart diseases (IHD) as they can trigger IHD. We hypothesized two pathways between cold exposure and IHD: a direct pathway and an indirect pathway through influenza infection. We created a multi-state model of the pathways and simulated incidence data to examine the observed delayed patterns in cases. We conducted cross-correlation and time series analysis with Japanese daily pneumonia and influenza (P&I) mortality data to help validate our model. Simulations showed the IHD incidence through the direct pathway occurred mostly within 10 days, while IHD through influenza infection peaked at 4–6 days, followed by delayed incidences of up to 20–30 days. In the mortality data from Japan, P&I lagged IHD in cross-correlations. Time series analysis showed strong delayed cold effects in the older population. There was also a strong delay on intense days of influenza which was more noticeable in the older population. Influenza can therefore be a plausible explanation for the delayed association between cold exposure and cardiovascular mortality. PMID:27136571

  5. Timeliness and completeness of vaccination and risk factors for low and late vaccine uptake in young children living in rural southern Tanzania.

    PubMed

    Le Polain de Waroux, Olivier; Schellenberg, Joanna R Armstrong; Manzi, Fatuma; Mrisho, Mwifadhi; Shirima, Kizito; Mshinda, Hassan; Alonso, Pedro; Tanner, Marcel; Schellenberg, David M

    2013-06-01

    We studied coverage and timeliness of vaccination and risk factors for low and delayed vaccine uptake in children aged <2 years in rural Tanzania. We used data from a cluster survey conducted in 2004, which included 1403 children. Risk factors were analysed by log-binomial regression adjusted for the clustering. The analysis was restricted to BCG, first and third dose of Diphtheria-Tetanus-Pertussis vaccines (DTP-1 and DTP-3) and first dose of measles-containing vaccine (MCV-1). Coverage for BCG, DTP-1, DTP-3 and MCV-1 was 94%, 96%, 90% and 86%, respectively. Delayed vaccination (>1 month after the recommended age) occurred in 398/1205 (33%) children for BCG, 404/1189 (34%) for DTP-1, 683/990 (69%) for DTP-3 and 296/643 (46%) for MCV-1. Coverage was lower for all vaccines except DTP-1 in children living ≥5 km from a healthcare facility. Delayed uptake was associated with poverty. Low and delayed MCV-1 vaccination was associated with low maternal education. Delayed BCG vaccination was associated with ethnicity and rainy season. Despite reasonably high vaccination coverage, we observed substantial vaccination delays, particularly for DTP-3 and MCV-1. We found specific factors associated with low and/or delayed vaccine uptake. These findings can help to improve strategies to reach children who remain inadequately protected.

  6. Autonomous Mission Operations

    NASA Technical Reports Server (NTRS)

    Frank, Jeremy; Spirkovska, Lilijana; McCann, Rob; Wang, Lui; Pohlkamp, Kara; Morin, Lee

    2012-01-01

    NASA's Advanced Exploration Systems Autonomous Mission Operations (AMO) project conducted an empirical investigation of the impact of time-delay on todays mission operations, and of the effect of processes and mission support tools designed to mitigate time-delay related impacts. Mission operation scenarios were designed for NASA's Deep Space Habitat (DSH), an analog spacecraft habitat, covering a range of activities including nominal objectives, DSH system failures, and crew medical emergencies. The scenarios were simulated at time-delay values representative of Lunar (1.2-5 sec), Near Earth Object (NEO) (50 sec) and Mars (300 sec) missions. Each combination of operational scenario and time-delay was tested in a Baseline configuration, designed to reflect present-day operations of the International Space Station, and a Mitigation configuration in which a variety of software tools, information displays, and crew-ground communications protocols were employed to assist both crews and Flight Control Team (FCT) members with the long-delay conditions. Preliminary findings indicate: 1) Workload of both crew members and FCT members generally increased along with increasing time delay. 2) Advanced procedure execution viewers, caution and warning tools, and communications protocols such as text messaging decreased the workload of both flight controllers and crew, and decreased the difficulty of coordinating activities. 3) Whereas crew workload ratings increased between 50 sec and 300 sec of time-delay in the Baseline configuration, workload ratings decreased (or remained flat) in the Mitigation configuration.

  7. A Study of Commuters’ Decision-Making When Delaying Departure for Work-Home Trips

    NASA Astrophysics Data System (ADS)

    Que, Fangjie; Wang, Wei

    2017-12-01

    Studies on the travel behaviors and patterns of residents are important to the arrangement of urban layouts and urban traffic planning. However, research on the characteristics of the decision-making behavior regarding departure time is not fully expanded yet. In this paper, the research focuses on commuters’ decision-making behavior regarding departure delay. According to the 2013 travel survey data of Suzhou City, a nested logit (NL) model was built to represent the probabilities of individual choices. Parameter calibration was conducted, so that the significant factors influencing the departure delay were obtained. Ultimately, the results of the NL model indicated that it performed better and with higher precision, compared to the traditional multinomial logit (MNL) model.

  8. Second-Degree Interatrial Block in Hemodialysis Patients

    PubMed Central

    Enriquez, Andres; D'Amato, Anna; de Luna, Antoni Bayes; Baranchuk, Adrian

    2015-01-01

    Interatrial conduction delays manifest as a prolonged P-wave duration on surface ECG and the term interatrial block (IAB) has been coined. They are usually fixed, but cases of intermittent IAB have been described, suggesting functional conduction block at the Bachmann bundle region. We report 2 cases of patients on chronic hemodialysis therapy presenting with intermittent IAB. PMID:25755895

  9. The Long-Term Effects of Functional Communication Training Conducted in Young Children's Home Settings

    ERIC Educational Resources Information Center

    Wacker, David P.; Schieltz, Kelly M.; Berg, Wendy K.; Harding, Jay W.; Padilla Dalmau, Yaniz C.; Lee, John F.

    2017-01-01

    This article describes the results of a series of studies that involved functional communication training (FCT) conducted in children's homes by their parents. The 103 children who participated were six years old or younger, had developmental delays, and engaged in destructive behaviors such as self-injury. The core procedures used in each study…

  10. [Evaluation of the effect of varicella outbreak control measures through a discrete time delay SEIR model].

    PubMed

    Pan, Jin-ren; Huang, Zheng-qiang; Chen, Kun

    2012-04-01

    forecast the epidemic trend and to evaluate the effect of outbreak control measures by investigation of a varicella outbreak event with a discrete time delay SEIR model. A discrete time delay model was formulated by discretization method based on a continuous SEIR model with the consideration of the time delay effect on latent period and communicable period. The epidemic trend forecast was carried out based on the number of expected cases. The theoretical effect evaluation was assessed by comparing the results from different emergency control measures. Without any control measures, the theoretical attack rate was 30.16% (504/1671). The course of the epidemic lasted for 4 months and the peak epidemic time was 78 days after the onset of the first case. 'Generation' phenomenon had been observed in the course of the epidemic with the interval of two weeks. The actual number of cases was decreased by 89.48% (451/504) compared with the number of expected cases under no control measure scenario. With the rigorous quarantine measure for all cases on their onset day, when the measure was conducted on 0, 14, 28, 42 days after the onset of the first case, the total numbers of expected cases were 22, 59, 127 and 220 respectively. With the quarantine measure conducted on 14 days after the onset of the first case, when the proportion of quarantine was 30%, 50%, 70%, 90%, the total number of expected cases were 485, 457, 386 and 169, respectively. With the emergent vaccination for all persons, when the measure was conducted on 0, 14, 28, 42 days after the onset of the first case, the total numbers of expected cases were 7, 26, 81 and 202 respectively. With the emergent vaccination conducted on 14 days after the onset of the first case, when the immunization coverage rate was 30%, 50%, 70%, 90%, the total numbers of expected cases were 354, 246, 127 and 40, respectively. The number of expected cases can be regarded as the reference to evaluate the effect of control measures. The simulation results suggest that it will get more benefits to conduct control measures earlier in varicella outbreak events, and the effect of emergent vaccination is better than that of quarantine measure under the same conditions.

  11. Reward type and behavioural patterns predict dogs’ success in a delay of gratification paradigm

    PubMed Central

    Brucks, Désirée; Soliani, Matteo; Range, Friederike; Marshall-Pescini, Sarah

    2017-01-01

    Inhibiting an immediate behaviour in favour of an alternative but more advantageous behaviour has been linked to individual success in life, especially in humans. Dogs, which have been living in the human environment for thousands of years, are exposed to daily situations that require inhibition different in context from other non-domesticated species. One task regularly used to study inhibitory control is the delay of gratification task, which requires individuals to choose between an immediate option of lower value and a delayed option of higher value. We tested sixteen dogs in a non-social delay of gratification task, conducting two different conditions: a quality and a quantity condition. While the majority of dogs failed to wait for more than 10 s, some dogs tolerated delays of up to 140 s, while one dog waited for 15 minutes. Moreover, dogs had more difficulties to wait if the reward increased in terms of quantity than quality. Interestingly, dogs were able to anticipate the delay duration and some dogs developed behavioural patterns that predicted waiting, which seems similar in some respects to ‘coping-strategies’ found in children, chimpanzees and parrots. Our results indicate that strategies to cope with impulsivity seem to be consistent and present across animal taxa. PMID:28272409

  12. Mitigating delay and non-payment in the Malaysian construction industry

    NASA Astrophysics Data System (ADS)

    Mohamad, N.; Suman, A. S.; Harun, H.; Hashim, H.

    2018-02-01

    Construction industry is one of the industries that have contributed towards the rapid growth of development and economics in Malaysia. However, the industry is inundated with delay and non-payment issues between the two parties in contract that is the clients and contractors Even though there are contractual and administrative provisions in the standard forms of contract in Malaysia regarding payments, delay and non-payment issues still occur between them. The aim of the study is to develop measures to mitigate delay and non-payment issues between contractors and clients in the Malaysian construction industry. Questionnaire survey was conducted with clients and contractors in Klang Valley. Results from data analysis identified significant measures to mitigate delay and non-payment issues between contractors and clients which include contractors should submit their progress work invoicing with adequate documents; contractors should follow up constantly with client regarding payment; proper understanding of requirements with regards to payment; mutual discussion of problems with client to address problems in a timely manner and proper use of payment provisions in the standard form of contract. This study is significant to contractors and clients and to other construction players in order to reduce and minimise delay and non-payment issues for the growth of economy in the Malaysian construction industry.

  13. Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel.

    PubMed

    Sargent, Lucy; McCullough, Amanda; Del Mar, Chris; Lowe, John

    2017-02-13

    Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners' (GPs') use of delayed prescribing and to gain pharmacists' and the public's views about delayed prescribing in Australia. This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs. The interviews revealed nine key domains that influence GPs' use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics. Using a theory-driven approach, we identified nine key domains that influence GPs' willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.

  14. Effects of overweight and obesity on motor and mental development in infants and toddlers.

    PubMed

    Cataldo, R; Huang, J; Calixte, R; Wong, A T; Bianchi-Hayes, J; Pati, S

    2016-10-01

    A consequence of childhood obesity may be poor developmental outcomes. This study aimed to examine the relationship between weight and developmental delays in young children. We conducted a secondary analysis of the Early Childhood Longitudinal Study Birth Cohort data. Logistic regression models quantified the association between different weight statuses (normal weight <85th, overweight ≥90th, obese ≥95th percentile for weight) and delays in motor and mental development. Children classified as overweight in both waves had higher percentages of delays in wave 2 (motor [7.5 vs. 6.2-6.4%], mental [8.6 vs. 5.9-6.7%]), as well as wave 1 and/or wave 2 (motor [14.8 vs. 10.9-13.0%], mental [11.9 vs. 9.0-10.1%]), compared with other children. This association was also found in children who were obese at both time points in wave 2 (motor delay [8.9 vs. 4.9-7.3%], mental delay [10.3 vs. 6.0-7.2%]), as well as wave 1 and/or wave 2 (motor delay [14.5 vs. 10.9-12.9%], mental delay [14.1 vs. 9.4-10.1%]). In the adjusted models, children classified as always obese were more likely to have a mental delay in wave 2 (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI]: 1.21-2.95) as well as wave 1 and/or wave 2 (aOR 1.56, 95% CI: 1.08-2.26). These children were also more likely to have motor delay (aOR 1.47, 95% CI: 1.02-2.13) in wave 1 and/or wave 2. Overweight children are more likely than their normal-weight peers to have motor and mental developmental delays. Preventing obesity during infancy may facilitate reducing developmental delays in young children. © 2015 World Obesity.

  15. Why the Wait? Delayed HIV Diagnosis among Men Who Have Sex with Men

    PubMed Central

    Thiede, Hanne; Hawes, Stephen E.; Golden, Matthew R.; Hutcheson, Rebecca; Carey, James W.; Kurth, Ann; Jenkins, Richard A.

    2010-01-01

    We sought to identify factors associated with delayed diagnosis of human immunodeficiency virus (HIV; testing HIV-seropositive 6 months or more after HIV seroconversion), by comparing delayed testers to non-delayed testers (persons who were diagnosed within 6 months of HIV seroconversion), in King County, Washington among men who have sex with men (MSM). Participants were recruited from HIV testing sites in the Seattle area. Delayed testing status was determined by the Serologic Testing Algorithm for Recent HIV Seroconversion or a self-reported previous HIV-negative test. Quantitative data on sociodemographic characteristics, health history, and drug-use and sexual behaviors were collected via computer-assisted self-interviews. Qualitative semi-structured interviews regarding testing and risk behaviors were also conducted. Multivariate analysis was used to identify factors associated with delayed diagnosis. Content analysis was used to establish themes in the qualitative data. Out of the 77 HIV-seropositive MSM in this sample, 39 (51%) had evidence of delayed diagnosis. Factors associated with delayed testing included being African-American, homeless, “out” to 50% or less people about male-male sex, and having only one sex partner in the past 6 months. Delayed testers often cited HIV-related sickness as their reason for testing and fear and wanting to be in denial of their HIV status as reasons for not testing. Delayed testers frequently did not identify as part of the MSM community, did not recognize that they were at risk for HIV acquisition, and did not feel a responsibility to themselves or others to disclose their HIV status. This study illustrates the need to further explore circumstances around delayed diagnosis in MSM and develop outreach methods and prevention messages targeted specifically to this potentially highly marginalized population in order to detect HIV infections earlier, provide HIV care, and prevent new infections. PMID:20186493

  16. [Determinants of patient and health system delays for women with breast cancer in Morocco, 2013].

    PubMed

    Benbakhta, B; Tazi, M; Benjaafar, N; Khattabi, A; Maaroufi, A

    2015-06-01

    In Morocco, breast cancer is the first most common cancer in women. It is diagnosed in most cases at an advanced stage. Delay in diagnosis and access to treatment for breast cancer increases morbidity and mortality. The objective of this study was to determine the consultation delay (patient delay), diagnosis delay and access to treatment delay (health system delays) of women with breast cancer admitted at the National Institute of Oncology in Rabat. Factors associated with these delays were analyzed. We conducted a cross-sectional study from December 2012 to May 2013 at the National Institute of Oncology in Rabat. Two hundred eligible and consenting women were interviewed using a structured and pre-tested questionnaire. Stages I and II were identified as "early stages" and III and IV as "advanced stages". In our population, 54% were diagnosed at an early stage of breast cancer and 46% at an advanced stage. The median total delay was 120 days (interquartile interval [IIQ]=81-202 days). The patient delay (median=65 days, IIQ=31-121) was longer than the health system delay (median=50 days, IIQ=29-77). High risk for a long total delay (more than 4 months) was observed for women who were aged over 65 years (OR=1.30, 95% CI 1.10-4.20), illiterate (OR=4.50, 95% CI 2.10-6.20), rural residents (OR=3.40, 95% CI 1.23-8.13), in a lower socioeconomic category (OR=4.75, 95% CI 1.45-15.60), without knowledge about breast self-examination (OR=5.67, 95% CI 2.65-12.15) and seen more than 2 times before diagnosis (OR=7.70, 95% CI 2.88-20.50). A long total delay increased the risk of being diagnosed at an advanced stage (OR=5.62, 95% CI 3.03-10.45). Efforts should be directed to providing good information to the population at risk, better access to screening and continuing medical training to enable diagnosis and early treatment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. AdVEGF-All6A+ Preconditioning of Murine Ischemic Skin Flaps Is Comparable to Surgical Delay.

    PubMed

    Gersch, Robert P; Fourman, Mitchell S; Phillips, Brett T; Nasser, Ahmed; McClain, Steve A; Khan, Sami U; Dagum, Alexander B; Bui, Duc T

    2015-08-01

    Surgical flap delay is commonly used in preconditioning reconstructive flaps to prevent necrosis. However, staged procedures are not ideal. Pharmacologic up-regulation of angiogenic and arteriogenic factors before flap elevation poses a nonsurgical approach to improve flap survival. Male Sprague Dawley rats were divided into control (n = 16), surgical delay (Delay), AdNull, AdEgr-1, and AdVEGF (n ≥ 9/group) groups. Delay rats had a 9 cm × 3 cm cranial based pedicle skin flap incised 10 days prior to elevation. Adenoviral groups received 28 intradermal injections (10(9) pu/animal total) throughout the distal two thirds of the flap 1 week prior to elevation. At postoperative day (POD) 0 flaps were elevated and silicone sheeting was placed between flap and wound bed. Perfusion analysis in arbitrary perfusion units of the ischemic middle third of the flap using laser Doppler imaging was conducted preoperatively and on POD 0, 3, and 7. Clinical and histopathologic assessments of the skin flaps were performed on POD 7. AdVEGF (50.8 ± 10.9 APU) and AdEgr-1 (39.3 ± 10.6 APU) perfusion levels were significantly higher than controls (16.5 ± 4.2 APU) on POD 7. Delay models were equivalent to controls (25.9 ± 6.8 APU). AdVEGF and Delay animals showed significantly more viable surface area on POD 7 (14.4 ± 1.3 cm(2), P < 0.01 and 12.4 ± 1.2 cm(2), P < 0.05, respectively) compared with Controls (8.7 ± 0.7 cm(2)). AdVEGF preconditioning resulted in flap survival comparable to surgical delay. Adenoviral preconditioning maintained perfusion levels postoperatively while surgical delay did not.

  18. AdVEGF-All6A+ Preconditioning of Murine Ischemic Skin Flaps Is Comparable to Surgical Delay

    PubMed Central

    Gersch, Robert P.; Fourman, Mitchell S.; Phillips, Brett T.; Nasser, Ahmed; McClain, Steve A.; Khan, Sami U.; Dagum, Alexander B.

    2015-01-01

    Background: Surgical flap delay is commonly used in preconditioning reconstructive flaps to prevent necrosis. However, staged procedures are not ideal. Pharmacologic up-regulation of angiogenic and arteriogenic factors before flap elevation poses a nonsurgical approach to improve flap survival. Methods: Male Sprague Dawley rats were divided into control (n = 16), surgical delay (Delay), AdNull, AdEgr-1, and AdVEGF (n ≥ 9/group) groups. Delay rats had a 9 cm × 3 cm cranial based pedicle skin flap incised 10 days prior to elevation. Adenoviral groups received 28 intradermal injections (109 pu/animal total) throughout the distal two thirds of the flap 1 week prior to elevation. At postoperative day (POD) 0 flaps were elevated and silicone sheeting was placed between flap and wound bed. Perfusion analysis in arbitrary perfusion units of the ischemic middle third of the flap using laser Doppler imaging was conducted preoperatively and on POD 0, 3, and 7. Clinical and histopathologic assessments of the skin flaps were performed on POD 7. Results: AdVEGF (50.8 ± 10.9 APU) and AdEgr-1 (39.3 ± 10.6 APU) perfusion levels were significantly higher than controls (16.5 ± 4.2 APU) on POD 7. Delay models were equivalent to controls (25.9 ± 6.8 APU). AdVEGF and Delay animals showed significantly more viable surface area on POD 7 (14.4 ± 1.3 cm2, P < 0.01 and 12.4 ± 1.2 cm2, P < 0.05, respectively) compared with Controls (8.7 ± 0.7 cm2). Conclusions: AdVEGF preconditioning resulted in flap survival comparable to surgical delay. Adenoviral preconditioning maintained perfusion levels postoperatively while surgical delay did not. PMID:26495207

  19. Early Compared With Delayed Physician Rounds on Patient Satisfaction of Postpartum Women: A Randomized Controlled Trial.

    PubMed

    Roberts, Robyn P; Blackwell, Sean C; Brown, Kelly M; Pedroza, Claudia; Sibai, Baha M; Tyson, Jon E

    2016-08-01

    To investigate whether delayed timing of physician rounds improves patient satisfaction for postpartum women. Women were randomized to early (5-7 AM) or delayed (8-10 AM) physician rounding. Women with stillbirth, high-risk pregnancy, or complications precluding delayed rounding were excluded. At discharge, women completed a modified Hospital Consumer Assessment of Healthcare Providers and Systems survey. The primary outcome was rating of the hospital. Secondary outcomes included patient assessment of patient-physician communication, various hospital experiences, and timing of maternal and neonatal discharge. We estimated that 74 women were needed to detect a 20% difference in rating of the hospital (0-10 score) between groups (assumption P=.05, power 90%). Given limited information on primary outcome, an a priori plan was in place to conduct the study for 2 months. One hundred fifty-two women were randomized (n=76 early rounding; n=76 delayed rounding). More women had a cesarean delivery in the early compared with the delayed rounding group (47.4% compared with 22.4%). Median rating of the hospital was higher in the delayed as compared with the early rounding group (9.0 [7.0-9.0] compared with 7.0 [6.0-8.0]; P<.01). Median scores regarding physician communication and perception of hospital experiences were higher in the delayed compared with the early group (8.0 [7.0-9.0] compared with 6.0 [5.0-7.0]; P<.001). Adjustment for delivery mode did not alter results (P<.01). No differences in timing of maternal (P=.47) or neonatal hospital discharge (P=.35) were observed. Postpartum women receiving delayed physician rounding were more satisfied with their hospital experience and patient-physician communication without prolonging maternal or neonatal discharge. ClinicalTrials.gov, https://clinicaltrials.gov, NCT02432573.

  20. Prevalence and reasons for delaying and foregoing necessary care by the presence and type of disability among working-age adults.

    PubMed

    Reichard, Amanda; Stransky, Michelle; Phillips, Kimberly; McClain, Monica; Drum, Charles

    2017-01-01

    While it is commonly accepted that disparities in unmet need for care vary by age, race/ethnicity, income, education, and access to care, literature documenting unmet needs experienced by adults with different types of disabilities is developing. The main objective was to determine whether subgroups of people with disabilities are more likely than people without disabilities to delay/forgo necessary care, in general and among the insured. We used pooled Medical Expenditure Panel Survey data (2004-2010) to examine delaying or forgoing medical, dental, and pharmacy care among five disability subgroups (physical, cognitive, visual, hearing, multiple) and the non-disabled population. Logistic regression was conducted to examine delayed/forgone care, controlling for sociodemographic, health, and health care factors. Over 13% of all working-age adults delayed/forwent necessary care; lack of insurance was the strongest predictor of unmet needs. Among the insured, disability subgroups were greater than two times more likely to report delayed/forgone care than adults without disabilities. Insured working-age adults with multiple chronic conditions and those with ADL/IADL assistance needs had higher odds of delayed or forgone care than their peers without these characteristics. Reasons related to affordability were most often listed as leading to unmet needs, regardless of disability. Although insurance status most strongly predicted unmet needs for care, many people with insurance delayed/forewent necessary care. Even among the insured, all disability subgroups had significantly greater likelihood of having to delay/forgo care than those without disabilities. Differences also existed between the disability subgroups. Cost was most frequently cited reason for unmet needs. Published by Elsevier Inc.

  1. Predictors of avoiding medical care and reasons for avoidance behavior.

    PubMed

    Kannan, Viji Diane; Veazie, Peter J

    2014-04-01

    Delayed medical care has negative health and economic consequences; interventions have focused on appraising symptoms, with limited success in reducing delay. To identify predictors of care avoidance and reasons for avoiding care. Using the Health Information National Trends Survey (2007), we conducted logistic regressions to identify predictors of avoiding medical visits deemed necessary by the respondents; and, we then conducted similar analyses on reasons given for avoidance behavior. Independent variables included geographic, demographic, socioeconomic, personal health, health behavior, health care system, and cognitive characteristics. Approximately one third of adults avoided doctor visits they had deemed necessary. Although unadjusted associations existed, avoiding needed care was not independently associated with geographic, demographic, and socioeconomic characteristics. Avoidance behavior is characterized by low health self-efficacy, less experience with both quality care and getting help with uncertainty about health, having your feelings attended to by your provider, no usual source of care, negative affect, smoking daily, and fatalistic attitude toward cancer. Reasons elicited for avoidance include preference for self-care or alternative care, dislike or distrust of doctors, fear or dislike of medical treatments, time, and money; respondents also endorsed discomfort with body examinations, fear of having a serious illness, and thoughts of dying. Distinct predictors distinguish each of these reasons. Interventions to reduce patient delay could be improved by addressing the health-related behavioral, belief, experiential, and emotional traits associated with delay. Attention should also be directed toward the interpersonal communications between patients and providers.

  2. Testing the performance of superhydrophobic aluminum surfaces.

    PubMed

    Ruiz-Cabello, F Javier Montes; Ibáñez-Ibáñez, Pablo F; Gómez-Lopera, J Francisco; Martínez-Aroza, José; Cabrerizo-Vílchez, Miguel; Rodríguez-Valverde, Miguel A

    2017-12-15

    The analysis of wetting properties of superhydrophobic surfaces may be a difficult task due to the restless behavior of drops on this type of surfaces and the limitations of goniometry for high contact angles. A method to validate the performance of superhydrophobic surfaces, rather than standard goniometry, is required. In this work, we used bouncing drop dynamics as a useful tool to predict the water repellency of different superhydrophobic surfaces. From bouncing drop experiments conducted over a wide range of superhydrophobic surfaces, we found that those surfaces with a proper roughness degree and homogeneous chemical composition showed higher water-repellency. We also conducted a drop condensation study at saturating conditions aimed to determine whether there is direct correlation between water repellency and condensation delay. We found that the drop condensation process is strongly related to the surface topography, as well as the intrinsic wettability. The condensation is promoted on rough surfaces but it is delayed on intrinsically hydrophobic surfaces. However, the differences found in condensation delay between the superhydrophobic surfaces explored in this study cannot be justified by their chemical homogeneity nor their efficiency as water repellent surfaces, separately. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Active feedforward noise control and signal tracking of headsets: Electroacoustic analysis and system implementation.

    PubMed

    Bai, Mingsian R; Pan, Weichi; Chen, Hungyu

    2018-03-01

    Active noise control (ANC) of headsets is revisited in this paper. An in-depth electroacoustic analysis of the combined loudspeaker-cavity headset system is conducted on the basis of electro-mechano-acoustical analogous circuits. Model matching of the primary path and the secondary path leads to a feedforward control architecture. The ideal controller sheds some light on the key parameters that affect the noise reduction performance. Filtered-X least-mean-squares algorithm is employed to implement the feedforward controller on a digital signal processor. Since the relative delay of the primary path and the secondary path is crucial to the noise reduction performance, multirate signal processing with polyphase implementation is utilized to minimize the effective analog-digital conversion delay in the secondary path. Ad hoc decimation and interpolation filters are designed in order not to introduce excessive phase delays at the cutoff. Real-time experiments are undertaken to validate the implemented ANC system. Listening tests are also conducted to compare the fixed controller and the adaptive controller in terms of noise reduction and signal tracking performance for three noise types. The results have demonstrated that the fixed feedforward controller achieved satisfactory noise reduction performance and signal tracking quality.

  4. Acidosis slows electrical conduction through the atrio-ventricular node

    PubMed Central

    Nisbet, Ashley M.; Burton, Francis L.; Walker, Nicola L.; Craig, Margaret A.; Cheng, Hongwei; Hancox, Jules C.; Orchard, Clive H.; Smith, Godfrey L.

    2014-01-01

    Acidosis affects the mechanical and electrical activity of mammalian hearts but comparatively little is known about its effects on the function of the atrio-ventricular node (AVN). In this study, the electrical activity of the epicardial surface of the left ventricle of isolated Langendorff-perfused rabbit hearts was examined using optical methods. Perfusion with hypercapnic Tyrode's solution (20% CO2, pH 6.7) increased the time of earliest activation (Tact) from 100.5 ± 7.9 to 166.1 ± 7.2 ms (n = 8) at a pacing cycle length (PCL) of 300 ms (37°C). Tact increased at shorter PCL, and the hypercapnic solution prolonged Tact further: at 150 ms PCL, Tact was prolonged from 131.0 ± 5.2 to 174.9 ± 16.3 ms. 2:1 AVN block was common at shorter cycle lengths. Atrial and ventricular conduction times were not significantly affected by the hypercapnic solution suggesting that the increased delay originated in the AVN. Isolated right atrial preparations were superfused with Tyrode's solutions at pH 7.4 (control), 6.8 and 6.3. Low pH prolonged the atrial-Hisian (AH) interval, the AVN effective and functional refractory periods and Wenckebach cycle length significantly. Complete AVN block occurred in 6 out of 9 preparations. Optical imaging of conduction at the AV junction revealed increased conduction delay in the region of the AVN, with less marked effects in atrial and ventricular tissue. Thus acidosis can dramatically prolong the AVN delay, and in combination with short cycle lengths, this can cause partial or complete AVN block and is therefore implicated in the development of brady-arrhythmias in conditions of local or systemic acidosis. PMID:25009505

  5. Acidosis slows electrical conduction through the atrio-ventricular node.

    PubMed

    Nisbet, Ashley M; Burton, Francis L; Walker, Nicola L; Craig, Margaret A; Cheng, Hongwei; Hancox, Jules C; Orchard, Clive H; Smith, Godfrey L

    2014-01-01

    Acidosis affects the mechanical and electrical activity of mammalian hearts but comparatively little is known about its effects on the function of the atrio-ventricular node (AVN). In this study, the electrical activity of the epicardial surface of the left ventricle of isolated Langendorff-perfused rabbit hearts was examined using optical methods. Perfusion with hypercapnic Tyrode's solution (20% CO2, pH 6.7) increased the time of earliest activation (Tact) from 100.5 ± 7.9 to 166.1 ± 7.2 ms (n = 8) at a pacing cycle length (PCL) of 300 ms (37°C). Tact increased at shorter PCL, and the hypercapnic solution prolonged Tact further: at 150 ms PCL, Tact was prolonged from 131.0 ± 5.2 to 174.9 ± 16.3 ms. 2:1 AVN block was common at shorter cycle lengths. Atrial and ventricular conduction times were not significantly affected by the hypercapnic solution suggesting that the increased delay originated in the AVN. Isolated right atrial preparations were superfused with Tyrode's solutions at pH 7.4 (control), 6.8 and 6.3. Low pH prolonged the atrial-Hisian (AH) interval, the AVN effective and functional refractory periods and Wenckebach cycle length significantly. Complete AVN block occurred in 6 out of 9 preparations. Optical imaging of conduction at the AV junction revealed increased conduction delay in the region of the AVN, with less marked effects in atrial and ventricular tissue. Thus acidosis can dramatically prolong the AVN delay, and in combination with short cycle lengths, this can cause partial or complete AVN block and is therefore implicated in the development of brady-arrhythmias in conditions of local or systemic acidosis.

  6. Defective sensorimotor integration in preparation for reaction time tasks in patients with multiple sclerosis.

    PubMed

    Cabib, Christopher; Llufriu, Sara; Casanova-Molla, Jordi; Saiz, Albert; Valls-Solé, Josep

    2015-03-01

    Slowness of voluntary movements in patients with multiple sclerosis (MS) may be due to various factors, including attentional and cognitive deficits, delays in motor conduction time, and impairment of specific central nervous system circuits. In 13 healthy volunteers and 20 mildly disabled, relapsing-remitting MS patients, we examined simple reaction time (SRT) tasks requiring sensorimotor integration in circuits involving the corpus callosum and the brain stem. A somatosensory stimulus was used as the imperative signal (IS), and subjects were requested to react with either the ipsilateral or the contralateral hand (uncrossed vs. crossed SRT). In 33% of trials, a startling auditory stimulus was presented together with the IS, and the percentage reaction time change with respect to baseline SRT trials was measured (StartReact effect). The difference between crossed and uncrossed SRT, which requires interhemispheric conduction, was significantly larger in patients than in healthy subjects (P = 0.021). The StartReact effect, which involves activation of brain stem motor pathways, was reduced significantly in patients with respect to healthy subjects (uncrossed trials: P = 0.015; crossed trials: P = 0.005). In patients, a barely significant correlation was found between SRT delay and conduction abnormalities in motor and sensory pathways (P = 0.02 and P = 0.04, respectively). The abnormalities found specifically in trials reflecting interhemispheric transfer of information, as well as the evidence for reduced subcortical motor preparation, indicate that a delay in reaction time execution in MS patients cannot be explained solely by conduction slowing in motor and sensory pathways but suggest, instead, defective sensorimotor integration mechanisms in at least the two circuits examined. Copyright © 2015 The American Physiological Society.

  7. Effect of Pressure on Piloted Ignition Delay of PMMA

    NASA Technical Reports Server (NTRS)

    McAllister, Sara; Lai, Janice; Scott, Sarah; Ramirez-Correa, Amelia; Fernandez-Pello, Carlos; Urban, David; Ruff, Gary

    2008-01-01

    In order to reduce the risk of decompression sickness associated with spacewalks, NASA is considering designing the next generation of exploration vehicles and habitats with a different cabin environment than used previously. The proposed environment uses a total cabin pressure of 52.7 to 58.6 kPa with an oxygen concentration of 30 to 34% by volume and was chosen with material flammability in mind. Because materials may burn differently under these conditions and there is little information on how this new environment affects the flammability of the materials onboard, it is important to conduct material flammability experiments at the intended exploration atmosphere. One method to evaluate material flammability is by its ease of ignition. To this end, piloted ignition delay tests were conducted in the Forced Ignition and Spread Test (FIST) apparatus subject to this new environment. In these tests, polymethylmethacylate (PMMA) was exposed to a range of oxidizer flow velocities and externally applied heat fluxes. The ultimate goal is to determine the individual effect of pressure and the combined effect of pressure and oxygen concentration on the ignition delay. Tests were conducted for a baseline case of normal pressure and oxygen concentration, low pressure (58.6 kPa) with normal oxygen (21%). Future work will focus on low pressure with 32% oxygen concentration (space exploration atmosphere - SEA) conditions. It was found that reducing the pressure while keeping the oxygen concentration at 21% reduced the ignition time by 17% on average. It was also noted that the critical heat flux for ignition decreases in low-pressure conditions. Because tests conducted in standard atmospheric conditions will underpredict the flammability of materials intended for use on spacecraft, fire safety onboard at exploration atmospheres may be compromised.

  8. Piloted Ignition Delay of PMMA in Space Exploration Atmospheres

    NASA Technical Reports Server (NTRS)

    McAllister, Sara; Fernandez-Pello, Carlos; Urban, David; Ruff, Gary

    2007-01-01

    In order to reduce the risk of decompression sickness associated with extravehicular activity (EVA), NASA is designing the next generation of exploration vehicles and habitats with a different cabin environment than used previously. The proposed environment uses a total cabin pressure of 52.7 to 58.6 kPa with an oxygen concentration of 30 to 34% by volume and was chosen with material flammability in mind. Because materials may burn differently under these conditions and there is little information on how this new environment affects the flammability of the materials onboard, it is important to conduct material flammability experiments at the intended exploration atmosphere. One method to evaluate material flammability is by its ease of ignition. To this end, piloted ignition delay tests were conducted in the Forced Ignition and Spread Test (FIST) apparatus subject to this new environment. In these tests, polymethylmethacylate (PMMA) was exposed to a range of oxidizer flow velocities and externally applied heat fluxes. Tests were conducted for a baseline case of normal pressure and oxygen concentration, low pressure (58.6 kPa) with normal oxygen (21%), and low pressure with 32% oxygen concentration conditions to determine the individual effect of pressure and the combined effect of pressure and oxygen concentration on the ignition delay. It was found that reducing the pressure while keeping the oxygen concentration at 21% reduced the ignition time by 17% on average. Increasing the oxygen concentration at low pressures reduced the ignition time by an additional 10%. It was also noted that the critical heat flux for ignition decreases at exploration atmospheres. These results show that tests conducted in standard atmospheric conditions will underpredict the ignition of materials intended for use on spacecraft and that, at these conditions, materials are more susceptible to ignition than at current spacecraft atmospheres.

  9. Delayed onset of lactogenesis among first-time mothers is related to maternal obesity and factors associated with ineffective breastfeeding.

    PubMed

    Nommsen-Rivers, Laurie A; Chantry, Caroline J; Peerson, Janet M; Cohen, Roberta J; Dewey, Kathryn G

    2010-09-01

    Delayed onset of lactogenesis (OL) is most common in primiparas and increases the risk of excess neonatal weight loss, formula supplementation, and early weaning. We examined variables associated with delayed OL among first-time mothers who delivered at term and initiated breastfeeding (n = 431). We conducted in-person interviews during pregnancy and at days 0, 3, and 7 postpartum and extracted obstetric and newborn information from medical records. We defined OL as delayed if it occurred after 72 h and used chi-square analysis to examine its association with potential risk factors across 6 dimensions: 1) prenatal characteristics, 2) maternal anthropometric characteristics, 3) labor and delivery experience, 4) newborn characteristics, 5) maternal postpartum factors, and 6) infant feeding variables. We examined independent associations by using multivariable logistic regression analysis. Median OL was 68.9 h postpartum; 44% of mothers experienced delayed OL. We observed significant bivariate associations between delayed OL and variables in all 6 dimensions (P < 0.05). In a multivariate model adjusted for prenatal feeding intentions, independent risk factors for delayed OL were maternal age > or =30 y, body mass index in the overweight or obese range, birth weight >3600 g, absence of nipple discomfort between 0-3 d postpartum, and infant failing to "breastfeed well" > or =2 times in the first 24 h. Postpartum edema was significant in an alternate model excluding body mass index (P < 0.05). The risk factors for delayed OL are multidimensional. Public health and obstetric and maternity care interventions are needed to address what has become an alarmingly common problem among primiparas.

  10. Effect of Interocular Delay on Disparity-Selective V1 Neurons: Relationship to Stereoacuity and the Pulfrich Effect

    PubMed Central

    Read, Jenny C. A.; Cumming, Bruce G.

    2006-01-01

    The temporal properties of disparity-sensitive neurons place important temporal constraints on stereo matching. We examined these constraints by measuring the responses of disparity-selective neurons in striate cortex of awake behaving monkeys to random-dot stereograms that contained interocular delays. Disparity selectivity was gradually abolished by increasing interocular delay (when the delay exceeds the integration time, the inputs from the 2 eyes become uncorrelated). The amplitude of the disparity-selective response was a Gaussian function of interocular delay, with a mean of 16 ms (±5 ms, SD). Psychophysical measures of stereoacuity, in both monkey and human observers, showed a closely similar dependency on time, suggesting that temporal integration in V1 neurons is what determines psychophysical matching constraints over time. There was a slight but consistent asymmetry in the neuronal responses, as if the optimum stimulus is one in which the right stimulus leads by about 4 ms. Because all recordings were made in the left hemisphere, this probably reflects nasotemporal differences in conduction times; psychophysical data are compatible with this interpretation. In only a few neurons (5/72), interocular delay caused a change in the preferred disparity. Such tilted disparity/delay profiles have been invoked previously to explain depth perception in the stroboscopic version of the Pulfrich effect (and other variants). However, the great majority of the neurons did not show tilted disparity/delay profiles. This suggests that either the activity of these neurons is ignored when viewing Pulfrich stimuli, or that current theories relating neuronal properties to perception in the Pulfrich effect need to be reevaluated. PMID:15788521

  11. Performance of 2-year-old children after early surgery for congenital heart disease on the Bayley Scales of Infant and Toddler Development, Third Edition.

    PubMed

    Long, Suzanne H; Galea, Mary P; Eldridge, Beverley J; Harris, Susan R

    2012-08-01

    Previous research on developmental outcomes of infants with congenital heart disease (CHD) has shown delays in both cognitive and motor skills. To describe outcomes on the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) for infants with CHD and to compare those findings to published results for similar samples of infants assessed on the 2nd edition of the Bayley Scales (BSID-II). Prospective cohort. Of 50 infants with CHD who participated in this longitudinal study (2006-2008) at the Royal Children's Hospital in Melbourne, Australia, 47 were assessed on the Bayley-III (median age=24.5 months), administered by a psychologist or neonatologist. Although neither assessor was blind to the CHD diagnosis, they were unaware of results of previous developmental assessments conducted in this longitudinal study. For the Bayley-III cognitive composite score, 17.0% of infants showed mild delays (1-2 SD below the mean), 2.1% had moderate delays (2-3 SD below the mean), and none had severe delays (greater than 3 SD below the mean). Motor composite scores showed mild delays in 10.9% of infants and moderate delays in 2.2%; none had severe motor delays. These findings differ from study results using the BSID-II in similar infants. The Bayley-III may underestimate developmental delay in 2-year-old children with CHD when compared to results of similar children tested at 12-36 months of age on the BSID-II. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Polypyrrole-chitosan conductive biomaterial synchronizes cardiomyocyte contraction and improves myocardial electrical impulse propagation.

    PubMed

    Cui, Zhi; Ni, Nathan C; Wu, Jun; Du, Guo-Qing; He, Sheng; Yau, Terrence M; Weisel, Richard D; Sung, Hsing-Wen; Li, Ren-Ke

    2018-01-01

    Background: The post-myocardial infarction (MI) scar interrupts electrical impulse propagation and delays regional contraction, which contributes to ventricular dysfunction. We investigated the potential of an injectable conductive biomaterial to restore scar tissue conductivity and re-establish synchronous ventricular contraction. Methods: A conductive biomaterial was generated by conjugating conductive polypyrrole (PPY) onto chitosan (CHI) backbones. Trypan blue staining of neonatal rat cardiomyocytes (CMs) cultured on biomaterials was used to evaluate the biocompatibility of the conductive biomaterials. Ca 2+ imaging was used to visualize beating CMs. A cryoablation injury rat model was used to investigate the ability of PPY:CHI to improve cardiac electrical propagation in the injured heart in vivo . Electromyography was used to evaluate conductivity of scar tissue ex vivo . Results: Cell survival and morphology were similar between cells cultured on biomaterials-coated and uncoated-control dishes. PPY:CHI established synchronous contraction of two distinct clusters of spontaneously-beating CMs. Intramyocardial PPY:CHI injection into the cryoablation-induced injured region improved electrical impulse propagation across the scarred tissue and decreased the QRS interval, whereas saline- or CHI-injected hearts continued to have delayed propagation patterns and significantly reduced conduction velocity compared to healthy controls. Ex vivo evaluation found that scar tissue from PPY:CHI-treated rat hearts had higher signal amplitude compared to those from saline- or CHI-treated rat heart tissue. Conclusions: The PPY:CHI biomaterial is electrically conductive, biocompatible and injectable. It improved synchronous contraction between physically separated beating CM clusters in vitro . Intra-myocardial injection of PPY:CHI following cardiac injury improved electrical impulse propagation of scar tissue in vivo .

  13. Effective utility accommodation : final report.

    DOT National Transportation Integrated Search

    2009-12-08

    The report presents research regarding methods to improve project delivery times and minimize construction delays due to utility coordination by conducting a study of the current best practices used by six (6) similar state transportation departments...

  14. Brief Report: Methods for Acquiring Structural MRI Data in Very Young Children with Autism Without the Use of Sedation

    PubMed Central

    Simon, Tony J.; Zierhut, Cynthia; Solomon, Marjorie; Rogers, Sally J.; Amaral, David G.

    2016-01-01

    We describe a protocol with which we achieved a 93% success rate in acquiring high quality MRI scans without the use of sedation in 2.5–4.5 year old children with autism, developmental delays, and typical development. Our main strategy was to conduct MRIs during natural nocturnal sleep in the evenings after the child's normal bedtime. Alternatively, with some older and higher functioning children, the MRI was conducted while the child was awake and watching a video. Both strategies relied heavily on the creation of a child and family friendly MRI environment and the involvement of parents as collaborators in the project. Scanning very young children with autism, typical development, and developmental delays without the use of sedation or anesthesia was possible in the majority of cases. PMID:18157624

  15. Segregation of the Brain into Gray and White Matter: A Design Minimizing Conduction Delays

    PubMed Central

    Wen, Quan; Chklovskii, Dmitri B

    2005-01-01

    A ubiquitous feature of the vertebrate anatomy is the segregation of the brain into white and gray matter. Assuming that evolution maximized brain functionality, what is the reason for such segregation? To answer this question, we posit that brain functionality requires high interconnectivity and short conduction delays. Based on this assumption we searched for the optimal brain architecture by comparing different candidate designs. We found that the optimal design depends on the number of neurons, interneuronal connectivity, and axon diameter. In particular, the requirement to connect neurons with many fast axons drives the segregation of the brain into white and gray matter. These results provide a possible explanation for the structure of various regions of the vertebrate brain, such as the mammalian neocortex and neostriatum, the avian telencephalon, and the spinal cord. PMID:16389299

  16. Teenage driver licensing in relation to state laws.

    PubMed

    Williams, A F; Lund, A K; Preusser, D F

    1985-04-01

    Previous studies have shown that delaying licensure reduces motor vehicle injuries. This study examined the relationship between licensing laws and the timing of obtaining drivers licenses. The states studied have various laws, including minimum licensing ages of 15, 16 and 17; minimum learners permit ages of 15 and 16; and teenage night driving curfews. A questionnaire survey of 52,304 students was conducted in 75 high schools during the spring of 1983. The schools were selected from Orange County, California; rural Colorado; and most or all of Louisiana, Michigan, Mississippi, New Jersey and New York. The results indicated that the minimum age of licensure has obvious strong effects in delaying licensure. Setting the learners permit age later also apparently delays licensure. The night driving curfew in New York State (9 p.m.-5 a.m.) is seen by students as a factor in their decisions to delay obtaining licenses; Louisiana's 11 p.m.-5 a.m. curfew has a much smaller effect, if any.

  17. Early-Onset LMNA-Associated Muscular Dystrophy with Later Involvement of Contracture.

    PubMed

    Lee, Younggun; Lee, Jung Hwan; Park, Hyung Jun; Choi, Young Chul

    2017-10-01

    The early diagnosis of LMNA-associated muscular dystrophy is important for preventing sudden arrest related to cardiac conduction block. However, diagnosing early-onset Emery-Dreifuss muscular dystrophy (EDMD) with later involvement of contracture and limb-girdle muscular dystrophy type 1B is often delayed due to heterogeneous clinical presentations. We aimed to determine the clinical features that contribute to a delayed diagnosis. We reviewed four patients who were recently diagnosed with LMNA-associated muscular dystrophy by targeted exome sequencing and who were initially diagnosed with nonspecific or other types of muscular dystrophy. Certain clinical features such as delayed contracture involvement and calf hypertrophy were found to contribute to a delayed diagnosis. Muscle biopsies were not informative for the diagnosis in these patients. Genetic testing of single or multiple genes is useful for confirming a diagnosis of LMNA-associated muscular dystrophy. Even EDMD patients could experience the later involvement of contracture, so clinicians should consider early genetic testing for patients with undiagnosed muscular dystrophy or laminopathy. Copyright © 2017 Korean Neurological Association

  18. Direct simulation of phase delay effects on induced-charge electro-osmosis under large ac electric fields

    NASA Astrophysics Data System (ADS)

    Sugioka, Hideyuki

    2016-08-01

    The standard theory of induced-charge electro-osmosis (ICEO) often overpredicts experimental values of ICEO velocities. Using a nonsteady direct multiphysics simulation technique based on the coupled Poisson-Nernst-Planck and Stokes equations for an electrolyte around a conductive cylinder subject to an ac electric field, we find that a phase delay effect concerning an ion response provides a fundamental mechanism for electrokinetic suppression. A surprising aspect of our findings is that the phase delay effect occurs even at much lower frequencies (e.g., 50 Hz) than the generally believed charging frequency of an electric double layer (typically, 1 kHz) and it can decrease the electrokinetic velocities in one to several orders. In addition, we find that the phase delay effect may also cause a change in the electrokinetic flow directions (i.e., flow reversal) depending on the geometrical conditions. We believe that our findings move toward a more complete understanding of complex experimental nonlinear electrokinetic phenomena.

  19. Delayed system response times affect immediate physiology and the dynamics of subsequent button press behavior.

    PubMed

    Kohrs, Christin; Hrabal, David; Angenstein, Nicole; Brechmann, André

    2014-11-01

    System response time research is an important issue in human-computer interactions. Experience with technical devices and general rules of human-human interactions determine the user's expectation, and any delay in system response time may lead to immediate physiological, emotional, and behavioral consequences. We investigated such effects on a trial-by-trial basis during a human-computer interaction by measuring changes in skin conductance (SC), heart rate (HR), and the dynamics of button press responses. We found an increase in SC and a deceleration of HR for all three delayed system response times (0.5, 1, 2 s). Moreover, the data on button press dynamics was highly informative since subjects repeated a button press with more force in response to delayed system response times. Furthermore, the button press dynamics could distinguish between correct and incorrect decisions and may thus even be used to infer the uncertainty of a user's decision. Copyright © 2014 Society for Psychophysiological Research.

  20. Delayed norovirus epidemic in the 2009-2010 season in Japan: potential relationship with intensive hand sanitizer use for pandemic influenza.

    PubMed

    Inaida, S; Shobugawa, Y; Matsuno, S; Saito, R; Suzuki, H

    2016-09-01

    Norovirus (NoV) epidemics normally peak in December in Japan; however, the peak in the 2009-2010 season was delayed until the fourth week of January 2010. We suspected intensive hand hygiene that was conducted for a previous pandemic influenza in 2009 as the cause of this delay. We analysed the NoV epidemic trend, based on national surveillance data, and its associations with monthly output data for hand hygiene products, including alcohol-based skin antiseptics and hand soap. The delayed peak in the NoV incidence in the 2009-2010 season had the lowest number of recorded cases of the five seasons studied (2006-2007 to 2010-2011). GII.4 was the most commonly occurring genotype. The monthly relative risk of NoV and monthly output of both alcohol-based skin antiseptics and hand soap were significantly and negatively correlated. Our findings suggest an association between hand hygiene using these products and prevention of NoV transmission.

  1. Identification of Mobile Phone and Analysis of Original Version of Videos through a Delay Time Analysis of Sound Signals from Mobile Phone Videos.

    PubMed

    Hwang, Min Gu; Har, Dong Hwan

    2017-11-01

    This study designs a method of identifying the camera model used to take videos that are distributed through mobile phones and determines the original version of the mobile phone video for use as legal evidence. For this analysis, an experiment was conducted to find the unique characteristics of each mobile phone. The videos recorded by mobile phones were analyzed to establish the delay time of sound signals, and the differences between the delay times of sound signals for different mobile phones were traced by classifying their characteristics. Furthermore, the sound input signals for mobile phone videos used as legal evidence were analyzed to ascertain whether they have the unique characteristics of the original version. The objective of this study was to find a method for validating the use of mobile phone videos as legal evidence using mobile phones through differences in the delay times of sound input signals. © 2017 American Academy of Forensic Sciences.

  2. A Nonlinearity Mitigation Method for a Broadband RF Front-End in a Sensor Based on Best Delay Searching

    PubMed Central

    Zhao, Wen; Ma, Hong; Zhang, Hua; Jin, Jiang; Dai, Gang; Hu, Lin

    2017-01-01

    The cognitive radio wireless sensor network (CR-WSN) is experiencing more and more attention for its capacity to automatically extract broadband instantaneous radio environment information. Obtaining sufficient linearity and spurious-free dynamic range (SFDR) is a significant premise of guaranteeing sensing performance which, however, usually suffers from the nonlinear distortion coming from the broadband radio frequency (RF) front-end in the sensor node. Moreover, unlike other existing methods, the joint effect of non-constant group delay distortion and nonlinear distortion is discussed, and its corresponding solution is provided in this paper. After that, the nonlinearity mitigation architecture based on best delay searching is proposed. Finally, verification experiments, both on simulation signals and signals from real-world measurement, are conducted and discussed. The achieved results demonstrate that with best delay searching, nonlinear distortion can be alleviated significantly and, in this way, spectrum sensing performance is more reliable and accurate. PMID:28956860

  3. A Fuel-Efficient Conflict Resolution Maneuver for Separation Assurance

    NASA Technical Reports Server (NTRS)

    Bowe, Aisha Ruth; Santiago, Confesor

    2012-01-01

    Automated separation assurance algorithms are envisioned to play an integral role in accommodating the forecasted increase in demand of the National Airspace System. Developing a robust, reliable, air traffic management system involves safely increasing efficiency and throughput while considering the potential impact on users. This experiment seeks to evaluate the benefit of augmenting a conflict detection and resolution algorithm to consider a fuel efficient, Zero-Delay Direct-To maneuver, when resolving a given conflict based on either minimum fuel burn or minimum delay. A total of twelve conditions were tested in a fast-time simulation conducted in three airspace regions with mixed aircraft types and light weather. Results show that inclusion of this maneuver has no appreciable effect on the ability of the algorithm to safely detect and resolve conflicts. The results further suggest that enabling the Zero-Delay Direct-To maneuver significantly increases the cumulative fuel burn savings when choosing resolution based on minimum fuel burn while marginally increasing the average delay per resolution.

  4. The impact of social isolation on delayed hospital discharges of older hip fracture patients and associated costs.

    PubMed

    Landeiro, F; Leal, J; Gray, A M

    2016-02-01

    Delayed discharges represent an inefficient use of acute hospital beds. Social isolation and referral to a public-funded rehabilitation unit were significant predictors of delayed discharges while admission from an institution was a protective factor for older hip fracture patients. Preventing delays could save between 11.2 and 30.7 % of total hospital costs for this patient group. Delayed discharges of older patients from acute care hospitals are a major challenge for administrative, humanitarian, and economic reasons. At the same time, older people are particularly vulnerable to social isolation which has a detrimental effect on their health and well-being with cost implications for health and social care services. The purpose of the present study was to determine the impact and costs of social isolation on delayed hospital discharge. A prospective study of 278 consecutive patients aged 75 or older with hip fracture admitted, as an emergency, to the Orthopaedics Department of Hospital Universitário de Santa Maria, Portugal, was conducted. A logistic regression model was used to examine the impact of relevant covariates on delayed discharges, and a negative binomial regression model was used to examine the main drivers of days of delayed discharges. Costs of delayed discharges were estimated using unit costs from national databases. Mean age at admission was 85.5 years and mean length of stay was 13.1 days per patient. Sixty-two (22.3 %) patients had delayed discharges, resulting in 419 bed days lost (11.5 % of the total length of stay). Being isolated or at a high risk of social isolation, measured with the Lubben social network scale, was significantly associated with delayed discharges (odds ratio (OR) 3.5) as was being referred to a public-funded rehabilitation unit (OR 7.6). These two variables also increased the number of days of delayed discharges (2.6 and 4.9 extra days, respectively, holding all else constant). Patients who were admitted from an institution were less likely to have delayed discharges (OR 0.2) with 5.5 fewer days of delay. Total costs of delayed discharges were between 11.2 and 30.7 % of total costs (€2352 and €9317 per patient with delayed discharge) conditional on whether waiting costs for placement in public-funded rehabilitation unit were included. High risk of social isolation, social isolation and referral to public-funded rehabilitation units increase delays in patients' discharges from acute care hospitals.

  5. Short-Term Anticoagulant Therapy and Thrombus Location Are Independent Risk Factors for Delayed Recanalization of Deep Vein Thrombosis.

    PubMed

    Zhang, Chuanlin; Fu, Qining; Zhao, Yu; Mu, Shaoyu; Liu, Liping

    2016-01-21

    Prompt recanalization of the vein containing the thrombus is an important goal during the initial treatment of DVT, and risk factors for delayed recanalization in patients with deep vein thrombosis (DVT) in the lower extremities need to be determined. A total of 174 patients with DVT in lower extremities were recruited from June 2014 to March 2015 at our hospital. Duplex ultrasound scanning was conducted for all patients at 1 and 6 months after baseline evaluation. We divided the patients into recanalization and non-recanalization groups and analyzed risk factors for delayed recanalization. The univariate analysis revealed that an oral anticoagulant time of less than 3 months and venous thrombus location were risk factors for delayed recanalization (P<0.01). However, age, gender, hypertension, diabetes, pulmonary embolism, incidence factors, the use of catheter-directed thrombolytic (CDT) drugs, and inferior vena cava filter (IVCF) implantation had no influence on the incidence of delayed recanalization in patients with DVT (P>0.05). The multivariate analysis showed that patients with an anticoagulant time of less than 3 months had a lower incidence of recanalization than those with an anticoagulant time of more than 3 months (OR=2.358, P<0.05). The risk of delayed recanalization in patients with proximal DVT was 7 times higher than that in patients with distal DVT. Duration of anticoagulant treatment of less than 3 months and venous thrombus location are independent risk factors for delayed recanalization of DVT in the lower extremities.

  6. Acute Cellular Rejection in ABO-Incompatible Renal Transplant Recipients Receiving Rituximab Is Associated with Delayed-Onset Neutropenia.

    PubMed

    Uchida, Junji; Iwai, Tomoaki; Nishide, Shunji; Kabei, Kazuya; Kuwabara, Nobuyuki; Yamasaki, Takeshi; Naganuma, Toshihide; Kumada, Norihiko; Takemoto, Yoshiaki; Nakatani, Tatsuya

    2017-07-25

    BACKGROUND Rituximab induces long-lasting B cell depletion in the peripheral blood and increases the levels of proinflammatory cytokines associated with regulatory B cell depletion. Previous reports showed that B cell-related cytokine release after administration of rituximab may induce acute cellular rejection (ACR) and delayed-onset neutropenia. The present study was conducted to investigate the correlation between acute rejection and delayed-onset neutropenia in ABO-incompatible renal transplant recipients who underwent administration of rituximab for 1 year after transplantation. MATERIAL AND METHODS From June 2006 to July 2015, 47 patients with chronic renal failure received ABO-incompatible renal transplant with rituximab induction at Osaka City University Hospital. All 47 patients underwent plasmapheresis due to removal of anti-A/B antibodies and administration of rituximab, and their transplants were carried out successfully. We investigated the correlation between ACR and delayed-onset neutropenia in ABO-incompatible renal transplant recipients who underwent administration of rituximab for 1 year after transplantation. RESULTS Fourteen patients (29.8%) experienced ACR (group A), and 33 recipients did not develop ACR (group B). The frequency of delayed-onset neutropenia was higher in group A than in group B (p=0.0503). Multivariate logistic regression analysis revealed that the frequency of ACR correlated significantly with the prevalence of delayed-onset neutropenia. CONCLUSIONS Our results indicated that ACR in ABO-incompatible renal transplant recipients receiving rituximab was associated with delayed-onset neutropenia.

  7. Neuropsychological tests for predicting cognitive decline in older adults

    PubMed Central

    Baerresen, Kimberly M; Miller, Karen J; Hanson, Eric R; Miller, Justin S; Dye, Richelin V; Hartman, Richard E; Vermeersch, David; Small, Gary W

    2015-01-01

    Summary Aim To determine neuropsychological tests likely to predict cognitive decline. Methods A sample of nonconverters (n = 106) was compared with those who declined in cognitive status (n = 24). Significant univariate logistic regression prediction models were used to create multivariate logistic regression models to predict decline based on initial neuropsychological testing. Results Rey–Osterrieth Complex Figure Test (RCFT) Retention predicted conversion to mild cognitive impairment (MCI) while baseline Buschke Delay predicted conversion to Alzheimer’s disease (AD). Due to group sample size differences, additional analyses were conducted using a subsample of demographically matched nonconverters. Analyses indicated RCFT Retention predicted conversion to MCI and AD, and Buschke Delay predicted conversion to AD. Conclusion Results suggest RCFT Retention and Buschke Delay may be useful in predicting cognitive decline. PMID:26107318

  8. Singer Responses to Sound Fields with a Simulated Reflection

    NASA Astrophysics Data System (ADS)

    NOSON, D.; SATO, S.; SAKAI, H.; ANDO, Y.

    2000-04-01

    While numerous recent studies have reported results concerning improvements to stage acoustics for orchestral performers, the preferred acoustical conditions on performing stages for singers has received limited attention in the past 20 years. A series of acoustical modifications have been proposed for a Seattle church to improve the acoustics for both the listeners and the performing choir. An on-site preliminary study was made to determine what acoustical changes might be important to singers. During solo fast-tempo singing and duet singing, singer preference increased with simulated short-delay reflections. The results suggest a potential for new reflectors to produce noticeable improvement in the choir acoustics. Subsequently, a solo singer study was conducted to establish preferred range of time delays for a single-simulated reflection. When singing faster-tempo music, the consensus of preference is statistically significant and the preferred delay averages 20 ms, while with a slow-tempo piece, the singers were not consistent in their judgment of preference and a strong individual variability predominated in the pair-comparison tests. The results point the way for an examination of a wider range of time delays and music motifs to acquire a clearer picture of consensus and individual preference for time-delayed reflections.

  9. Factors Associated with Delayed Enrollment in HIV Medical Care among HIV-Positive Individuals in Odessa Region, Ukraine.

    PubMed

    Neduzhko, Oleksandr; Postnov, Oleksandr; Perehinets, Ihor; DeHovitz, Jack; Joseph, Michael; Odegaard, David; Kaplan, Robert; Kiriazova, Tetiana

    In Ukraine, about one-third of identified HIV-positive individuals are not connected to care. We conducted a cross-sectional survey (n = 200) among patients registered at Odessa AIDS centers in October to December 2011. Factors associated with delayed enrollment in HIV care (>3 months since positive HIV test) were evaluated using logistic regression. Among study participants (mean age 35 ± 8.2 years, 47.5% female, 42.5% reported history of injecting drugs), 55% delayed HIV care enrollment. Odds of delayed enrollment were higher for those with lower educational attainment (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [CI]: 1.04-6.76), not feeling ill (aOR: 2.98, 95% CI: 1.50-5.93), or not having time to go to the AIDS center (aOR: 3.89, 95% CI: 1.39-10.89); injection drug use was not associated with delayed enrollment. Programs linking HIV-positive individuals to specialized care should address enrollment barriers and include education on HIV care benefits and case management for direct linkage to care. HIV testing and treatment should be coupled to ensure a continuum of care.

  10. Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors

    PubMed Central

    Bradford, Andrea; Kunik, Mark E.; Schulz, Paul; Williams, Susan P.; Singh, Hardeep

    2009-01-01

    Dementia is a growing public health problem for which early detection may be beneficial. Currently, the diagnosis of dementia in primary care is dependent mostly on clinical suspicion based on patient symptomsor caregivers’ concerns and is prone to be missed or delayed. We conducted a systematic review of the literature to ascertain the prevalence and contributing factors for missed and delayed dementia diagnoses in primary care. Prevalence of missed and delayed diagnosis was estimated by abstracting quantitative data from studies of diagnostic sensitivity among primary care providers. Possible predictors and contributory factors were determined from the text of quantitative and qualitative studies of patient-, caregiver-, provider-, and system-related barriers. Overall estimates of diagnostic sensitivity varied among studies and appeared to be in part a function of dementia severity, degree of patient impairment, dementia subtype, and frequency of patient-provider contact. Major contributory factors included problems with attitudes and patient-provider communication, educational deficits, and system resource constraints. The true prevalence of missed and delayed diagnoses of dementia is unknown but appears to be high. Until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis. PMID:19568149

  11. The effects of time delays on a telepathology user interface.

    PubMed Central

    Carr, D.; Hasegawa, H.; Lemmon, D.; Plaisant, C.

    1992-01-01

    Telepathology enables a pathologist to examine physically distant tissue samples by microscope operation over a communication link. Communication links can impose time delays which cause difficulties in controlling the remote device. Such difficulties were found in a microscope teleoperation system. Since the user interface is critical to pathologist's acceptance of telepathology, we redesigned the user interface for this system, built two different versions (a keypad whose movement commands operated by specifying a start command followed by a stop command and a trackball interface whose movement commands were incremental and directly proportional to the rotation of the trackball). We then conducted a pilot study to determine the effect of time delays on the new user interfaces. In our experiment, the keypad was the faster interface when the time delay is short. There was no evidence to favor either the keypad or trackball when the time delay was longer. Inexperienced participants benefitted by allowing them to move long distances over the microscope slide by dragging the field-of-view indicator on the touchscreen control panel. The experiment suggests that changes could be made to the trackball interface which would improve its performance. PMID:1482878

  12. A Delay-Aware and Reliable Data Aggregation for Cyber-Physical Sensing

    PubMed Central

    Zhang, Jinhuan; Long, Jun; Zhang, Chengyuan; Zhao, Guihu

    2017-01-01

    Physical information sensed by various sensors in a cyber-physical system should be collected for further operation. In many applications, data aggregation should take reliability and delay into consideration. To address these problems, a novel Tiered Structure Routing-based Delay-Aware and Reliable Data Aggregation scheme named TSR-DARDA for spherical physical objects is proposed. By dividing the spherical network constructed by dispersed sensor nodes into circular tiers with specifically designed widths and cells, TSTR-DARDA tries to enable as many nodes as possible to transmit data simultaneously. In order to ensure transmission reliability, lost packets are retransmitted. Moreover, to minimize the latency while maintaining reliability for data collection, in-network aggregation and broadcast techniques are adopted to deal with the transmission between data collecting nodes in the outer layer and their parent data collecting nodes in the inner layer. Thus, the optimization problem is transformed to minimize the delay under reliability constraints by controlling the system parameters. To demonstrate the effectiveness of the proposed scheme, we have conducted extensive theoretical analysis and comparisons to evaluate the performance of TSR-DARDA. The analysis and simulations show that TSR-DARDA leads to lower delay with reliability satisfaction. PMID:28218668

  13. Parenting Practices and Associations with Development Delays among Young Children in Dominican Republic.

    PubMed

    Uwemedimo, Omolara Thomas; Howlader, Afrin; Pierret, Giselina

    According to the World Health Organization, >200 million children in low- and middle-income countries experience developmental delays. However, household structure and parenting practices have been minimally explored as potential correlates of developmental delay in low- and middle-income countries, despite potential as areas for intervention. The objective of the study was to examine associations of developmental delays with use of World Health Organization-recommended parenting practices among a clinic-based cohort of children aged 6-60 months attending in La Romana, Dominican Republic. This study was conducted among 74 caregiver-child pairs attending the growth-monitoring clinic at Hospital Francisco Gonzalvo in June 2015. The Malawi Developmental Assessment Tool was adapted and performed on each child to assess socioadaptive, fine motor, gross motor, and language development. The IMCI Household Level Survey Questionnaire was used to assess parenting practices. Fisher's exact test was used to determine associations significant at P < .05. Significant variables were then entered into a multivariable logistic regression. Almost two-thirds of children had a delay in at least 1 developmental domain. Most caregivers used scolding (43.2%) or spanking (44%) for child discipline. Children who were disciplined by spanking and scolding were more likely to have language delay (P = .007) and socioadaptive delay (P = .077), respectively. On regression analysis, children with younger primary caregivers had 7 times higher odds of language delay (adjusted odds ratio [AOR]: 7.35, 95% confidence interval [CI]: 1.52-35.61) and 4 times greater odds of any delay (AOR: 4.72, 95% CI: 1.01-22.22). In addition, children punished by spanking had 5 times higher odds of having language delay (AOR: 5.04, 95% CI: 1.13-22.39). Parenting practices such as harsh punishment and lack of positive parental reinforcement were found to have strong associations with language and socioadaptive delays. Likewise, delays were also more common among children with younger caregivers. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  14. Application of a Modified Time Delay Spectrometry Technique in Modeling of Underwater Acoustic Propagation.

    DTIC Science & Technology

    1987-03-01

    W.B. Anderson) 1 Keyport, Washington 98345 7. Director, David W. Taylor Naval Ships 1 and Development Center Detachment Puget Sound Attn: George...Monterey, California 93943-5000 Sa IIAME ’) F NDN1G, SPONSOQ;NG 8ab OF ,CE SvM9OL 9 PROCUJREMENT ,NSTR MET *DEN’ CATiON .,.M4[R ORCA ’.:ZAr ON j Iapplecaboe...analysis of sound propagating by multiple paths in an ocean at short ranges has been conducted using a Modified Time Delay Spectrometry (TDS) technique

  15. Factors influencing diagnosis delay of advanced breast cancer in Moroccan women.

    PubMed

    Maghous, A; Rais, F; Ahid, S; Benhmidou, N; Bellahamou, K; Loughlimi, H; Marnouche, E; Elmajjaoui, S; Elkacemi, H; Kebdani, T; Benjaafar, N

    2016-06-07

    Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p < 0.001). Also, a significantly higher risk of more than 6 months delay was found among rural women (P = 0.035) and women who live far away from specialized care center (P = 0.001). Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by promoting early detection.

  16. [Diagnostic evaluation of the developmental level in children identified at risk of delay through the Child Development Evaluation Test].

    PubMed

    Rizzoli-Córdoba, Antonio; Campos-Maldonado, Martha Carmen; Vélez-Andrade, Víctor Hugo; Delgado-Ginebra, Ismael; Baqueiro-Hernández, César Iván; Villasís-Keever, Miguel Ángel; Reyes-Morales, Hortensia; Ojeda-Lara, Lucía; Davis-Martínez, Erika Berenice; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Sidonio-Aguayo, Beatriz; Palma-Tavera, Josuha Alexander; Muñoz-Hernández, Onofre

    The Child Development Evaluation (or CDE Test) was developed in Mexico as a screening tool for child developmental problems. It yields three possible results: normal, slow development or risk of delay. The modified version was elaborated using the information obtained during the validation study but its properties according to the base population are not known. The objective of this work was to establish diagnostic confirmation of developmental delay in children 16- to 59-months of age previously identified as having risk of delay through the CDE Test in primary care facilities. A population-based cross-sectional study was conducted in one Mexican state. CDE test was administered to 11,455 children 16- to 59-months of age from December/2013 to March/2014. The eligible population represented the 6.2% of the children (n=714) who were identified at risk of delay through the CDE Test. For inclusion in the study, a block randomization stratified by sex and age group was performed. Each participant included in the study had a diagnostic evaluation using the Battelle Development Inventory, 2 nd edition. From the 355 participants included with risk of delay, 65.9% were male and 80.2% were from rural areas; 6.5% were false positives (Total Development Quotient ˃90) and 6.8% did not have any domain with delay (Domain Developmental Quotient <80). The proportion of delay for each domain was as follows: communication 82.5%; cognitive 80.8%; social-personal 33.8%; motor 55.5%; and adaptive 41.7%. There were significant differences in the percentages of delay both by age and by domain/subdomain evaluated. In 93.2% of the participants, developmental delay was corroborated in at least one domain evaluated. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  17. Project Amistad (Friendship), a Joint Venture between DHS and Family Outreach. Final Report: Innovations in Protective Services.

    ERIC Educational Resources Information Center

    Dennis-Small, Lucretia

    Conducted by the Texas Department of Human Services (DHS), Project Amistad (Friendship) originally set out to recruit and train Black and Hispanic volunteers to conduct lay therapy sessions with Black and Hispanic families in which abuse and neglect of children had occurred. Start-up was significantly delayed due to personnel changes; as a result,…

  18. Piloting Changes to Changing Aircraft Dynamics: What Do Pilots Need to Know?

    NASA Technical Reports Server (NTRS)

    Trujillo, Anna C.; Gregory, Irene M.

    2011-01-01

    An experiment was conducted to quantify the effects of changing dynamics on a subject s ability to track a signal in order to eventually model a pilot adapting to changing aircraft dynamics. The data will be used to identify primary aircraft dynamics variables that influence changes in pilot s response and produce a simplified pilot model that incorporates this relationship. Each run incorporated a different set of second-order aircraft dynamics representing short period transfer function pitch attitude response: damping ratio, frequency, gain, zero location, and time delay. The subject s ability to conduct the tracking task was the greatest source of root mean square error tracking variability. As for the aircraft dynamics, the factors that affected the subjects ability to conduct the tracking were the time delay, frequency, and zero location. In addition to creating a simplified pilot model, the results of the experiment can be utilized in an advisory capacity. A situation awareness/prediction aid based on the pilot behavior and aircraft dynamics may help tailor pilot s inputs more quickly so that PIO or an upset condition can be avoided.

  19. Application of Time-Delay Absorber to Suppress Vibration of a Dynamical System to Tuned Excitation.

    PubMed

    El-Ganaini, W A A; El-Gohary, H A

    2014-08-01

    In this work, we present a comprehensive investigation of the time delay absorber effects on the control of a dynamical system represented by a cantilever beam subjected to tuned excitation forces. Cantilever beam is one of the most widely used system in too many engineering applications, such as mechanical and civil engineering. The main aim of this work is to control the vibration of the beam at simultaneous internal and combined resonance condition, as it is the worst resonance case. Control is conducted via time delay absorber to suppress chaotic vibrations. Time delays often appear in many control systems in the state, in the control input, or in the measurements. Time delay commonly exists in various engineering, biological, and economical systems because of the finite speed of the information processing. It is a source of performance degradation and instability. Multiple time scale perturbation method is applied to obtain a first order approximation for the nonlinear differential equations describing the system behavior. The different resonance cases are reported and studied numerically. The stability of the steady-state solution at the selected worst resonance case is investigated applying Runge-Kutta fourth order method and frequency response equations via Matlab 7.0 and Maple11. Time delay absorber is effective, but within a specified range of time delay. It is the critical factor in selecting such absorber. Time delay absorber is better than the ordinary one as from the effectiveness point of view. The effects of the different absorber parameters on the system behavior and stability are studied numerically. A comparison with the available published work showed a close agreement with some previously published work.

  20. Parents who refuse or delay HPV vaccine: Differences in vaccination behavior, beliefs, and clinical communication preferences

    PubMed Central

    Gilkey, Melissa B.; Calo, William A.; Marciniak, Macary W.

    2017-01-01

    ABSTRACT Background: We sought to estimate the national prevalence of HPV vaccine refusal and delay in a nationally-representative sample of parents of adolescents. We also compared parents who refused versus delayed HPV vaccine in terms of their vaccination beliefs and clinical communication preferences. Methods: In 2014 to 2015, we conducted an online survey of 1,484 US parents who reported on an 11- to 17-year-old child in their household. We used weighted multinomial logistic regression to assess correlates of HPV vaccine refusal and delay. Results: Overall, 28% of parents reported that they had ever “refused or decided not to get” HPV vaccine for their child, and an additional 8% of parents reported that they had “delayed or put off getting” HPV vaccine. Compared to no refusal/delay, refusal was associated with lower confidence in adolescent vaccination (relative risk ratio [RRR] = 0.66, 95% confidence interval [CI], 0.48–0.91), lower perceived HPV vaccine effectiveness (RRR = 0.68, 95% CI, 0.50–0.91), and higher perceived harms (RRR = 3.49, 95% CI, 2.65–4.60). In contrast, delay was associated with needing more information (RRR = 1.76, 95% CI, 1.08–2.85). Most parents rated physicians and information sheets as helpful for making decisions about HPV vaccination, although parents who reported refusal endorsed these resources less often. Conclusions: Our findings suggest that HPV vaccine refusal is common among parents of adolescents and may have increased relative to previous estimates. Because the vaccination beliefs and communication preferences of parents who refuse appear to differ from those who delay, targeted communication strategies may be needed to effectively address HPV vaccine hesitancy. PMID:27763818

  1. Maternal deaths in eastern Indonesia: 20 years and still walking: an ethnographic study

    PubMed Central

    2014-01-01

    Background The delays in receiving adequate emergency maternal care described by Thaddeus and Maine twenty years ago are still occurring, as exemplified in this study of cases of maternal deaths in a subdistrict in rural eastern Indonesia. Methods An ethnographic design was conducted, recruiting eleven families who reported on cases of maternal deaths in one sub-district of Indonesia, as well as assessing the geographical and cultural context of the villages. Traditional birth attendants and village leaders provided information to the research team which was thematically and contextually analysed. Results Two stages to the first and second delays have been differentiated in this study. First, delays in the decision to seek care comprised time taken to recognise (if at all) that an emergency situation existed, followed by time taken to reach a decision to request care. The decision to request care resided variously with the family or cadre. Second, delays in reaching care comprised time taken to deliver the request for help and then time for help to arrive. A phone was not available to request care in many cases and so the request was delivered by walking or motorbike. In two cases where the decision to seek care and the delivery of the request happened in a timely way, help was delayed because the midwife and ambulance respectively were unavailable. Conclusions This study, although a small sample, confirmed that either a single delay or a sequence of delays can prove fatal. Delays were determined by both social and geographic factors, any of which alone could be limiting. Initiatives to improve maternal health outcomes need to address multiple factors: increased awareness of equitable access to maternal health care, village preparedness for emergency response, improved access to telecommunications and geographic access. PMID:24447873

  2. Correlations between radiation-induced double strand breaks, cell division delay, and cyclin-dependent signaling in x-irradiated NIH3T3 fibroblasts

    NASA Astrophysics Data System (ADS)

    Cariveau, Mickael J.

    2005-07-01

    Molecular responses to radiation-induced DNA double strand breaks (DSB) are mediated by the phosphorylation of the histone variant H2AX which forms identifiable gamma-H2AX foci at the site of the DSB. This event is thought to be linked with the down-regulation of signaling proteins contributing to the checkpoints regulating cell cycle progression and, vis-a-vis , the induction of cell division delay. However, it is unclear whether this division delay is directly related to the number of DSB (gamma-H2AX foci) sustained by an irradiated cell and, if so, whether this number drives cells into cell cycle delay or apoptosis. For this reason, studies were conducted in the immortalized NIH/3T3 fibroblast cell in order to establish correlations between the temporal appearance of the gamma-H2AX foci (a DSB) and the expression of the cell cycle regulatory proteins, cyclin E, A, B1, and their cyclin kinase inhibitor, p21. Cell cycle kinetics and flow cytometry were used to establish radiation-induced division delay over a dose range of 1--6 Gy where a mitotic delay of 2.65 min/cGy was established. Correlations between the expression of cyclin E, A, B1, p21, and the generation of DSB were established in NIH/3T3 cells exposed to 2 or 4 Gy x-irradiation. The data suggest that the G1/S and S phase delay (cyclin E and cyclin A protein levels) are dependent on the dose of radiation while the G2/M (cyclin B1 protein levels) delay is dependent on the quantity of DSB sustained by the irradiated cell.

  3. Delayed Breast Reconstruction on Patients With Upper Extremity Lymphedema: A Systematic Review of the Literature and Pooled Analysis.

    PubMed

    Siotos, Charalampos; Hassanein, Aladdin H; Bello, Ricardo J; Sebai, Mohamad E; Seal, Stella M; Manahan, Michele A; Cooney, Damon S; Cooney, Carisa M; Rosson, Gedge D

    2018-06-26

    Breast cancer-related lymphedema (BCRL) is a debilitating condition with morbidity, hindered quality of life, and increased health-related costs. Experimental studies support the use of musculocutaneous flaps for managing animal models with lymphedema. Although vascularized lymph node transfer (VLNT) and lymphovenous anastomosis are used to surgically treat patients with lymphedema, it is not known whether musculocutaneous or adipocutaneous flaps (eg, delayed autologous breast reconstruction) are effective for treating refractory upper extremity BCRL. We conducted a systematic review and pooled analysis to assess the impact of delayed breast reconstruction on developed BCRL. Following PRISMA guidelines, we systematically searched PubMed, Scopus, EMBASE, and Google Scholar databases for relevant studies published through November 11, 2016. We screened 934 unique articles. Of these, we conducted full-text and reference screening on 37 articles. We then performed a pooled and sensitivity analysis using random effects. Eight studies met our inclusion criteria. One study was a case report; 7 studies were case series with sample sizes ranging from 3 to 38 patients. According to our pooled analysis 58% of patients reported improvement after breast reconstruction with or without VLNT. Sensitivity analysis revealed that 84% (95% confidence interval, 0.74-0.95) of patients who underwent breast reconstruction and VLNT reported improvement, whereas only 22% (95% confidence interval, 0.12-0.32) of those who had breast reconstruction alone reported improvement. Our review summarizes the current evidence regarding the effect of delayed breast reconstruction on established lymphedema. The VLNT component of the autologous breast reconstruction procedures may be the largest contributing factor leading to lymphedema improvement.

  4. RSR' pattern and the risk of mortality in men and women free of cardiovascular disease.

    PubMed

    O'Neal, Wesley T; Qureshi, Waqas; Li, Yabing; Soliman, Elsayed Z

    2015-01-01

    This study included 6,398 participants (mean age 55 ± 0.34 years; 54% female; 49% white; 22% black; 24% Mexican; 4.3% other) free of clinical cardiovascular disease (CVD) and major ECG abnormalities. Cox regression was used to examine the association between the RSR' (incomplete right bundle branch block (RBBB) or right ventricular conduction delay) pattern and CVD and all-cause mortalities. The RSR' pattern was not associated with an increased risk of CVD (HR=1.10; 95%CI=0.63, 1.91) mortality or all-cause (HR=0.95; 95%CI=0.66, 1.35) mortality. The results were similar when the RSR' pattern was further separated into incomplete RBBB and right ventricular conduction delay. In conclusion, the RSR' pattern is a benign finding in older adults free of clinical CVD. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Patient and health service delay in pulmonary tuberculosis patients attending a referral hospital: a cross-sectional study.

    PubMed

    Kiwuwa, Mpungu S; Charles, Karamagi; Harriet, Mayanja Kizza

    2005-11-24

    Delays in diagnosis and initiation of effective treatment increase morbidity and mortality from tuberculosis as well as the risk of transmission in the community. The aim of this study was to determine the time taken for patients later confirmed as having TB to present with symptoms to the first health provider (patient delay) and the time taken between the first health care visit and initiation of tuberculosis treatment (health service delay). Factors relating to these 'delays' were analyzed. A cross-sectional survey, of 231 newly diagnosed smear-positive tuberculosis patients was conducted in Mulago National referral Hospital Kampala, from January to May 2002. Socio-demographic, lifestyle and health seeking factors were evaluated for their association with patient delay (> 2 weeks) and health service delay (> 4 weeks), using odds ratios with 95% confidence intervals (CI) including multivariate logistic regression. The median total delay to treatment initiation was 12 weeks. Patients often presented to drug shops or pharmacies (39.4%) and private clinics (36.8%) more commonly than government health units (14%) as initial contacts. Several independent predictors of 'patient delay' were identified: being hospitalized (odds ratio [0R] = 0.32; 95% CI: 0.12-0.80), daily alcohol consumption (OR = 3.7; CI: 1.57-9.76), subsistence farming (OR = 4.70; CI: 1.67-13.22), and perception of smoking as a cause of TB (OR = 5.54; CI: 2.26-13.58). Independent predictors of 'health service delay' were: > 2 health seeking encounters per month (OR = 2.74; CI: 1.10-6.83), and medical expenditure on TB related symptoms > 29 US dollars (OR = 3.88; CI: 1.19-12.62). Perceived TB stigma and education status was not associated with either form of delay. Delay in diagnosis of TB is prolonged at the referral centre with a significant proportion of Health service delay. More specific and effective health education of the general public on tuberculosis and seeking of appropriate medical consultation is likely to improve case detection. Certain specific groups require further attention. Alcoholics and subsistence farmers should be targeted to improve accessibility to TB treatment. Continuing medical education about TB management procedures for health providers and improvement in the capacity of TB control services should be undertaken.

  6. Reversible acute axonal polyneuropathy associated with Wernicke-Korsakoff syndrome: impaired physiological nerve conduction due to thiamine deficiency?

    PubMed

    Ishibashi, S; Yokota, T; Shiojiri, T; Matunaga, T; Tanaka, H; Nishina, K; Hirota, H; Inaba, A; Yamada, M; Kanda, T; Mizusawa, H

    2003-05-01

    Acute axonal polyneuropathy and Wernicke-Korsakoff encephalopathy developed simultaneously in three patients. Nerve conduction studies (NCS) detected markedly decreased compound muscle action potentials (CMAPs) and sensory nerve action potentials (SNAPs) with minimal conduction slowing; sympathetic skin responses (SSRs) were also notably decreased. Sural nerve biopsies showed only mild axonal degeneration with scattered myelin ovoid formation. The symptoms of neuropathy lessened within two weeks after an intravenous thiamine infusion. CMAPs, SNAPs, and SSRs also increased considerably. We suggest that this is a new type of peripheral nerve impairment: physiological conduction failure with minimal conduction delay due to thiamine deficiency.

  7. Phase delaying the human circadian clock with a single light pulse and moderate delay of the sleep/dark episode: no influence of iris color.

    PubMed

    Canton, Jillian L; Smith, Mark R; Choi, Ho-Sun; Eastman, Charmane I

    2009-07-17

    Light exposure in the late evening and nighttime and a delay of the sleep/dark episode can phase delay the circadian clock. This study assessed the size of the phase delay produced by a single light pulse combined with a moderate delay of the sleep/dark episode for one day. Because iris color or race has been reported to influence light-induced melatonin suppression, and we have recently reported racial differences in free-running circadian period and circadian phase shifting in response to light pulses, we also tested for differences in the magnitude of the phase delay in subjects with blue and brown irises. Subjects (blue-eyed n = 7; brown eyed n = 6) maintained a regular sleep schedule for 1 week before coming to the laboratory for a baseline phase assessment, during which saliva was collected every 30 minutes to determine the time of the dim light melatonin onset (DLMO). Immediately following the baseline phase assessment, which ended 2 hours after baseline bedtime, subjects received a 2-hour bright light pulse (~4,000 lux). An 8-hour sleep episode followed the light pulse (i.e. was delayed 4 hours from baseline). A final phase assessment was conducted the subsequent night to determine the phase shift of the DLMO from the baseline to final phase assessment.Phase delays of the DLMO were compared in subjects with blue and brown irises. Iris color was also quantified from photographs using the three dimensions of red-green-blue color axes, as well as a lightness scale. These variables were correlated with phase shift of the DLMO, with the hypothesis that subjects with lighter irises would have larger phase delays. The average phase delay of the DLMO was -1.3 +/- 0.6 h, with a maximum delay of ~2 hours, and was similar for subjects with blue and brown irises. There were no significant correlations between any of the iris color variables and the magnitude of the phase delay. A single 2-hour bright light pulse combined with a moderate delay of the sleep/dark episode delayed the circadian clock an average of ~1.5 hours. There was no evidence that iris color influenced the magnitude of the phase shift. Future studies are needed to replicate our findings that iris color does not impact the magnitude of light-induced circadian phase shifts, and that the previously reported differences may be due to race.

  8. Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis.

    PubMed

    Li, Ying; Ehiri, John; Tang, Shenglan; Li, Daikun; Bian, Yongqiao; Lin, Hui; Marshall, Caitlin; Cao, Jia

    2013-07-02

    Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country. This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure). We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers.Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)). Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population-based interventions that seek to reduce TB stigma and raise awareness about the benefits of early diagnosis and prompt treatment are needed. Policies that remove patients' financial barriers in access to TB care, and integration of the informal care sector into TB control in urban and rural settings are central factors in TB control.

  9. Relation of polymorphism of arsenic metabolism genes to arsenic methylation capacity and developmental delay in preschool children in Taiwan

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

    Hsieh, Ru-Lan

    Inefficient arsenic methylation capacity has been associated with developmental delay in children. The present study was designed to explore whether polymorphisms and haplotypes of arsenic methyltransferase (AS3MT), glutathione-S-transferase omegas (GSTOs), and purine nucleoside phosphorylase (PNP) affect arsenic methylation capacity and developmental delay. A case-control study was conducted from August 2010 to March 2014. All participants were recruited from the Shin Kong Wu Ho-Su Memorial Teaching Hospital. In total, 179 children with developmental delay and 88 children without delay were recruited. Urinary arsenic species, including arsenite (As{sup III}), arsenate (As{sup V}), monomethylarsonic acid (MMA{sup V}), and dimethylarsinic acid (DMA{sup V}) weremore » measured using a high-performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. The polymorphisms of AS3MT, GSTO, and PNP were performed using the Sequenom MassARRAY platform with iPLEX Gold chemistry. Polymorphisms of AS3MT genes were found to affect susceptibility to developmental delay in children, but GSTO and PNP polymorphisms were not. Participants with AS3MT rs3740392 A/G + G/G genotype, compared with AS3MT rs3740392 A/A genotype, had a significantly lower secondary methylation index. This may result in an increased OR for developmental delay. Participants with the AS3MT high-risk haplotype had a significantly higher OR than those with AS3MT low-risk haplotypes [OR and 95% CI, 1.59 (1.08–2.34)]. This is the first study to show a joint dose-response effect of this AS3MT high-risk haplotype and inefficient arsenic methylation capacity on developmental delay. Our data provide evidence that AS3MT genes are related to developmental delay and may partially influence arsenic methylation capacity. - Highlights: • AS3MT genotypes were found to affect susceptibility to developmental delay. • AS3MT rs3740392 A/G and G/G genotype had a significantly low SMI (DMA/MMA) index. • AS3MT high-risk haplotype was significantly associated with developmental delay.« less

  10. Summary of the effects of engine throttle response on airplane formation-flying qualities

    NASA Technical Reports Server (NTRS)

    Walsh, Kevin R.

    1992-01-01

    A flight evaluation as conducted to determine the effect of engine throttle response characteristics on precision formation-flying qualities. A variable electronic throttle control system was developed and flight-tested on a TF-104G airplane with a J79-11B engine at the NASA Dryden Flight Research Facility. Ten research flights were flown to evaluate the effects of throttle gain, time delay, and fuel control rate limiting on engine handling qualities during a demanding precision wing formation task. Handling quality effects of lag filters and lead compensation time delays were also evaluated. Data from pilot ratings and comments indicate that throttle control system time delays and rate limits cause significant degradations in handling qualities. Threshold values for satisfactory (level 1) and adequate (level 2) handling qualities of these key variables are presented.

  11. Interventions for preventing, delaying the onset, or decreasing the burden of frailty: an overview of systematic reviews.

    PubMed

    Wilson, Michael G; Béland, François; Julien, Dominic; Gauvin, Lise; Guindon, G Emmanuel; Roy, Denis; Campbell, Kaitryn; Comeau, Donna G; Davidson, Heather; Raina, Parminder; Sattler, Deborah; Vrkljan, Brenda

    2015-09-25

    Many systematic reviews have evaluated the effectiveness of interventions to prevent, delay, or decrease frailty symptoms, but no effort has been made to identify, map, and synthesize the findings from reviews across the full spectrum of interventions. Our objectives are to (1) synthesize findings from all existing systematic reviews evaluating interventions for preventing, delaying the onset, or decreasing the burden of frailty symptoms; (2) examine different conceptualizations of frailty that have been used in the development and implementation of interventions; and (3) inform policy by convening a stakeholder dialogue with Canadian health-system leaders. We will conduct an overview of systematic reviews to identify and synthesize all of the systematic reviews addressing interventions to preventing, delaying the onset, or decreasing the burden of frailty symptoms. To identify relevant systematic reviews, we will conduct database searches for published and grey literature as well as contact key experts and search reference lists of included reviews. Two reviewers will independently review all search results for inclusion and then conceptually map, extract key findings (including the conceptualization/definition of frailty used) and assess the methodological quality of all included reviews. We will then synthesize the findings by producing a 'gap map' (i.e. mapping reviews in a matrix according to the interventions and outcomes assessed), and narratively synthesize the key messages across reviews related to type of interventions. Following the completion of the synthesis, we will use the findings to develop an evidence brief that mobilizes the best available evidence about the problem related to preventing, delaying the onset, or decreasing the burden of frailty symptoms in older adults, policy and programmatic options to address the problem and implementation considerations. The evidence brief will then be used as the input into a stakeholder dialogue, which will engage 18-22 Canadian health-system leaders (including policymakers, health providers, researchers, and other stakeholders) in 'off-the-record' deliberations to inform future actions and policymaking. PROSPERO CRD42015022082.

  12. Effects of iso-octane/ethanol blend ratios on the observance of negative temperature coefficient behavior within the Ignition Quality Tester

    DOE PAGES

    Bogin, Jr., Gregory E.; Luecke, Jon; Ratcliff, Matthew A.; ...

    2016-08-21

    Here, an ignition delay study investigating the reduction in low temperature heat release (LTHR) and negative temperature coefficient (NTC) region with increasing ethanol concentration in binary blends of ethanol/isooctane was conducted in the Ignition Quality Tester (IQT). The IQT is advantageous for studying multi-component fuels such as iso-octane/ethanol which are difficult to study at lower temperatures covering the NTC region in traditional systems (e.g., shock tubes, rapid compression machines, etc.). The high octane numbers and concomitant long ignition delay times of ethanol and iso-octane are ideal for study in the IQT allowing the system to reach a quasi-homogeneous mixture; allowingmore » the effect of fuel chemistry on ignition delay to be investigated with minimal impact from the fuel spray due to the relatively long ignition times. NTC behavior from iso-octane/ethanol blends was observed for the first time using an IQT. Temperature sweeps of iso-octane/ethanol volumetric blends (100/0, 90/10, 80/20, 50/50, and 0/100) were conducted from 623 to 993 K at 0.5, 1.0 and 1.5 MPa and global equivalence ratios ranging from 0.7 to 1.0. Ignition of the iso-octane/ethanol blends in the IQT was also modeled using a 0-D homogeneous batch reactor model. Significant observations include: (1) NTC behavior was observed for ethanol/ iso-octane fuel blends up to 20% ethanol. (2) Ethanol produced shorter ignition delay times than iso-octane in the high temperature region. (3) The initial increase in ethanol from 0% to 10% had a lesser impact on ignition delay than increasing ethanol from 10% to 20%. (4) The 0-D model predicts that at 0.5 and 1.0 MPa ethanol produces the shortest ignition time in the high-temperature regime, as seen experimentally.« less

  13. Once-daily MMX(®) mesalamine for endoscopic maintenance of remission of ulcerative colitis.

    PubMed

    D'Haens, Geert; Sandborn, William J; Barrett, Karen; Hodgson, Ian; Streck, Paul

    2012-07-01

    Treatment with mesalamine to maintain endoscopic remission (mucosal healing) of ulcerative colitis (UC) has been shown to reduce the risk of relapse and is the recommended first-line maintenance therapy. To improve treatment adherence, a mesalamine formulation that can be administered once-daily, MMX(®) mesalamine (Lialda; Shire Pharmaceuticals LLC, Wayne, PA), was developed. This study was conducted to determine the efficacy and safety of once-daily MMX mesalamine compared with twice-daily delayed-release mesalamine (Asacol; Warner Chilcott, Dublin, Ireland) for maintaining endoscopic remission in patients with UC. A multicenter, randomized, double-blind, 6-month, active-control trial was conducted to assess the non-inferiority of once-daily MMX mesalamine 2.4 g/day compared with twice-daily delayed-release mesalamine at a total daily dose of 1.6 g/day in patients with UC in endoscopic remission. The primary end point was maintenance of endoscopic remission at month 6 in the per-protocol (PP) population. Overall, 826 patients were randomized and dosed. The primary objective (non-inferiority) was met. At month 6, 83.7 and 77.8% of patients receiving MMX mesalamine in the PP and intent-to-treat (ITT) populations, respectively, had maintained endoscopic remission compared with 81.5% (PP) and 76.9% (ITT) of patients receiving delayed-release mesalamine (95% confidence interval for difference: -3.9%, 8.1% (PP); -5.0%, 6.9% (ITT)). Time to relapse was not significantly different between the two treatment groups (log-rank test, P=0.5116 (PP); P=0.5455 (ITT)). The proportion of patients with adverse events was 37.1 and 36.0% in patients receiving MMX mesalamine and delayed-release mesalamine, respectively. Once-daily dosing of MMX mesalamine 2.4 g/day was shown to be well tolerated and non-inferior to twice-daily dosing with delayed-release mesalamine 1.6 g/day for maintenance of endoscopic remission in patients with UC.

  14. Effects of iso-octane/ethanol blend ratios on the observance of negative temperature coefficient behavior within the Ignition Quality Tester

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

    Bogin, Jr., Gregory E.; Luecke, Jon; Ratcliff, Matthew A.

    Here, an ignition delay study investigating the reduction in low temperature heat release (LTHR) and negative temperature coefficient (NTC) region with increasing ethanol concentration in binary blends of ethanol/isooctane was conducted in the Ignition Quality Tester (IQT). The IQT is advantageous for studying multi-component fuels such as iso-octane/ethanol which are difficult to study at lower temperatures covering the NTC region in traditional systems (e.g., shock tubes, rapid compression machines, etc.). The high octane numbers and concomitant long ignition delay times of ethanol and iso-octane are ideal for study in the IQT allowing the system to reach a quasi-homogeneous mixture; allowingmore » the effect of fuel chemistry on ignition delay to be investigated with minimal impact from the fuel spray due to the relatively long ignition times. NTC behavior from iso-octane/ethanol blends was observed for the first time using an IQT. Temperature sweeps of iso-octane/ethanol volumetric blends (100/0, 90/10, 80/20, 50/50, and 0/100) were conducted from 623 to 993 K at 0.5, 1.0 and 1.5 MPa and global equivalence ratios ranging from 0.7 to 1.0. Ignition of the iso-octane/ethanol blends in the IQT was also modeled using a 0-D homogeneous batch reactor model. Significant observations include: (1) NTC behavior was observed for ethanol/ iso-octane fuel blends up to 20% ethanol. (2) Ethanol produced shorter ignition delay times than iso-octane in the high temperature region. (3) The initial increase in ethanol from 0% to 10% had a lesser impact on ignition delay than increasing ethanol from 10% to 20%. (4) The 0-D model predicts that at 0.5 and 1.0 MPa ethanol produces the shortest ignition time in the high-temperature regime, as seen experimentally.« less

  15. The delayed rectifier, IKI, is the major conductance in type I vestibular hair cells across vestibular end organs

    NASA Technical Reports Server (NTRS)

    Ricci, A. J.; Rennie, K. J.; Correia, M. J.

    1996-01-01

    Hair cells were dissociated from the semicircular canal, utricle, lagena and saccule of white king pigeons. Type I hair cells were identified morphologically based on the ratios of neck width to cuticular plate width (NPR < 0.72) as well as neck width to cell body width (NBR < 0.64). The perforated patch variant of the whole-cell recording technique was used to measure electrical properties from type I hair cells. In voltage-clamp, the membrane properties of all identified type I cells were dominated by a predominantly outward potassium current, previously characterized in semicircular canal as IKI. Zero-current potential, activation, deactivation, slope conductance, pharmacologic and steady-state properties of the complex currents were not statistically different between type I hair cells of different vestibular end organs. The voltage dependence causes a significant proportion of this conductance to be active about the cell's zero-current potential. The first report of the whole-cell activation kinetics of the conductance is presented, showing a voltage dependence that could be best fit by an equation for a single exponential. Results presented here are the first data from pigeon dissociated type I hair cells from utricle, saccule and lagena suggesting that the basolateral conductances of a morphologically identified population of type I hair cells are conserved between functionally different vestibular end organs; the major conductance being a delayed rectifier characterized previously in semicircular canal hair cells as IKI.

  16. A test of water vapor radiometer-based troposphere calibration using VLBI observations on a 21-kilometer baseline

    NASA Technical Reports Server (NTRS)

    Linfield, R. P.; Teitelbaum, L. P.; Skjerve, L. J.; Keihm, S. J.; Walter, S. J.; Mahoney, M. J.; Treuhaft, R. N.

    1995-01-01

    Simultaneous very long baseline interferometry (VLBI) and water vapor radiometer (WVR) measurements on a 21 km baseline showed that calibration by WVRs removed a significant fraction of the effect of tropospheric delay fluctuations for these experiments. From comparison of the residual delay variations within scans and between scans, the total tropospheric contribution t the delay residuals for each of the three 5 to 20 hour sessions was estimated as 1, 17, and 10%, with the first value being uncertain. The observed improvement in rms residual delay from WVR calibration during these three sessions was 4, 16, and 2%, respectively. The improvement is consistent with the estimated 2 to 3 mm path delay precision of current WVRs. The VLBI measurements, of natural radio sources, were conducted in April and May 1993 at Goldstone, California. Dual-frequency (2.3 and 8.4 GHz) observations were employed to remove the effects of charged particles from the data. Measurements with co-pointed WVRs, located within 50 m of the axis of each antenna, were performed to test the ability of the WVRs to calibrate line-of-sight path delays. Factors that made WVR performance assessment difficult included (1) the fact that the level of tropospheric fluctuations was smaller than is typical for Goldstone during these experiments and (2) VLBI delay variations on longer time scales (i.e., over multiple scans) contained uncalibrated instrumental effects (probably a result of slow temperature variations in the VLBI hardware) that were larger than the tropospheric effects.

  17. Ignition Delay of Combustible Materials in Normoxic Equivalent Environments

    NASA Technical Reports Server (NTRS)

    McAllister, Sara; Fernandez-Pello, Carlos; Ruff, Gary; Urban, David

    2009-01-01

    Material flammability is an important factor in determining the pressure and composition (fraction of oxygen and nitrogen) of the atmosphere in the habitable volume of exploration vehicles and habitats. The method chosen in this work to quantify the flammability of a material is by its ease of ignition. The ignition delay time was defined as the time it takes a combustible material to ignite after it has been exposed to an external heat flux. Previous work in the Forced Ignition and Spread Test (FIST) apparatus has shown that the ignition delay in the currently proposed space exploration atmosphere (approximately 58.6 kPa and32% oxygen concentration) is reduced by 27% compared to the standard atmosphere used in the Space Shuttle and Space Station. In order to determine whether there is a safer environment in terms of material flammability, a series of piloted ignition delay tests using polymethylmethacrylate (PMMA) was conducted in the FIST apparatus to extend the work over a range of possible exploration atmospheres. The exploration atmospheres considered were the normoxic equivalents, i.e. reduced pressure conditions with a constant partial pressure of oxygen. The ignition delay time was seen to decrease as the pressure was reduced along the normoxic curve. The minimum ignition delay observed in the normoxic equivalent environments was nearly 30% lower than in standard atmospheric conditions. The ignition delay in the proposed exploration atmosphere is only slightly larger than this minimum. Interms of material flammability, normoxic environments with a higher pressure relative to the proposed pressure would be desired.

  18. Short-Term Anticoagulant Therapy and Thrombus Location Are Independent Risk Factors for Delayed Recanalization of Deep Vein Thrombosis

    PubMed Central

    Zhang, Chuanlin; Fu, Qining; Zhao, Yu; Mu, Shaoyu; Liu, Liping

    2016-01-01

    Background Prompt recanalization of the vein containing the thrombus is an important goal during the initial treatment of DVT, and risk factors for delayed recanalization in patients with deep vein thrombosis (DVT) in the lower extremities need to be determined. Material/Methods A total of 174 patients with DVT in lower extremities were recruited from June 2014 to March 2015 at our hospital. Duplex ultrasound scanning was conducted for all patients at 1 and 6 months after baseline evaluation. We divided the patients into recanalization and non-recanalization groups and analyzed risk factors for delayed recanalization. Results The univariate analysis revealed that an oral anticoagulant time of less than 3 months and venous thrombus location were risk factors for delayed recanalization (P<0.01). However, age, gender, hypertension, diabetes, pulmonary embolism, incidence factors, the use of catheter-directed thrombolytic (CDT) drugs, and inferior vena cava filter (IVCF) implantation had no influence on the incidence of delayed recanalization in patients with DVT (P>0.05). The multivariate analysis showed that patients with an anticoagulant time of less than 3 months had a lower incidence of recanalization than those with an anticoagulant time of more than 3 months (OR=2.358, P<0.05). The risk of delayed recanalization in patients with proximal DVT was 7 times higher than that in patients with distal DVT. Conclusions Duration of anticoagulant treatment of less than 3 months and venous thrombus location are independent risk factors for delayed recanalization of DVT in the lower extremities. PMID:26790571

  19. Location in the right hemi-colon is an independent risk factor for delayed post-polypectomy hemorrhage: a multi-center case-control study.

    PubMed

    Buddingh, K Tim; Herngreen, Thomas; Haringsma, Jelle; van der Zwet, Wil C; Vleggaar, Frank P; Breumelhof, Ronald; Ter Borg, Frank

    2011-06-01

    Delayed hemorrhage is an infrequent, but serious complication of colonoscopic polypectomy. Large size is the only polyp-related factor that has been unequivocally proven to increase the risk of delayed bleeding. It has been suggested that location in the right hemi-colon is also a risk factor. The objective of this study was to determine whether polyp location is an independent risk factor for delayed post-polypectomy hemorrhage. A retrospective case-control study was conducted in two university hospitals and two community hospitals. Thirty-nine cases and 117 controls were identified. In multivariate analysis, size and location were found to be independent polyp-related risk factors for delayed type hemorrhage. The risk increased by 13% for every 1 mm increase in polyp diameter (odds ratio (OR) 1.13, 95% confidence interval (CI) 1.05-1.20, P<0.001). Polyps located in the right hemi-colon had an OR of 4.67 (1.88-11.61, P=0.001) for delayed hemorrhage. Polyps in the cecum seemed to be especially at high risk in univariate analysis (OR 13.82, 95% CI 2.66-71.73), but this could not be assessed in multivariate analysis as the number of cases was too small. Polyp type (sessile or pedunculated) was not a risk factor. Polyp location in the right hemi-colon seems to be an independent and substantial risk factor for delayed post-polypectomy hemorrhage. A low threshold for preventive hemostatic measures is advised when removing polyps from this region.

  20. Relationship between time management in construction industry and project management performance

    NASA Astrophysics Data System (ADS)

    Nasir, Najuwa; Nawi, Mohd Nasrun Mohd; Radzuan, Kamaruddin

    2016-08-01

    Nowadays, construction industry particularly in Malaysia struggle in achieving status of eminent time management for construction project. Project managers have a great responsibility to keep the project success under time of project completion. However, studies shows that delays especially in Malaysian construction industry still unresolved due to weakness in managing the project. In addition, quality of time management on construction projects is generally poor. Due to the progressively extended delays issue, time performance becomes an important subject to be explored to investigate delay factors. The method of this study is review of literature towards issues in construction industry which affecting time performance of project in general by focusing towards process involved for project management. Based on study, it was found that knowledge, commitment, cooperation are the main criteria as an overall to manage the project into a smooth process during project execution until completion. It can be concluded that, the strength between project manager and team members in these main criteria while conducting the project towards good time performance is highly needed. However, there is lack of establishment towards factors of poor time performance which strongly related with project management. Hence, this study has been conducted to establish factors of poor time performance and its relations with project management.

  1. Path integration of head direction: updating a packet of neural activity at the correct speed using axonal conduction delays.

    PubMed

    Walters, Daniel; Stringer, Simon; Rolls, Edmund

    2013-01-01

    The head direction cell system is capable of accurately updating its current representation of head direction in the absence of visual input. This is known as the path integration of head direction. An important question is how the head direction cell system learns to perform accurate path integration of head direction. In this paper we propose a model of velocity path integration of head direction in which the natural time delay of axonal transmission between a linked continuous attractor network and competitive network acts as a timing mechanism to facilitate the correct speed of path integration. The model effectively learns a "look-up" table for the correct speed of path integration. In simulation, we show that the model is able to successfully learn two different speeds of path integration across two different axonal conduction delays, and without the need to alter any other model parameters. An implication of this model is that, by learning look-up tables for each speed of path integration, the model should exhibit a degree of robustness to damage. In simulations, we show that the speed of path integration is not significantly affected by degrading the network through removing a proportion of the cells that signal rotational velocity.

  2. Path Integration of Head Direction: Updating a Packet of Neural Activity at the Correct Speed Using Axonal Conduction Delays

    PubMed Central

    Walters, Daniel; Stringer, Simon; Rolls, Edmund

    2013-01-01

    The head direction cell system is capable of accurately updating its current representation of head direction in the absence of visual input. This is known as the path integration of head direction. An important question is how the head direction cell system learns to perform accurate path integration of head direction. In this paper we propose a model of velocity path integration of head direction in which the natural time delay of axonal transmission between a linked continuous attractor network and competitive network acts as a timing mechanism to facilitate the correct speed of path integration. The model effectively learns a “look-up” table for the correct speed of path integration. In simulation, we show that the model is able to successfully learn two different speeds of path integration across two different axonal conduction delays, and without the need to alter any other model parameters. An implication of this model is that, by learning look-up tables for each speed of path integration, the model should exhibit a degree of robustness to damage. In simulations, we show that the speed of path integration is not significantly affected by degrading the network through removing a proportion of the cells that signal rotational velocity. PMID:23526976

  3. Risk assessment of underpass infrastructure project based on IS0 31000 and ISO 21500 using fishbone diagram and RFMEA (project risk failure mode and effects analysis) method

    NASA Astrophysics Data System (ADS)

    Purwanggono, Bambang; Margarette, Anastasia

    2017-12-01

    Completion time of highway construction is very meaningful for smooth transportation, moreover expected number of ownership motor vehicle will increase each year. Therefore, this study was conducted with to analyze the constraints that contained in an infrastructure development project. This research was conducted on Jatingaleh Underpass Project, Semarang. This research was carried out while the project is running, on the implementation, this project is experiencing delays. This research is done to find out what are the constraints that occur in execution of a road infrastructure project, in particular that causes delays. The method that used to find the root cause is fishbone diagram to obtain a possible means of mitigation. Coupled with the RFMEA method used to determine the critical risks that must be addressed immediately on road infrastructure project. The result of data tabulation in this study indicates that the most possible mitigation tool to make a Standard Operating Procedure (SOP) recommendations to disrupt utilities that interfere project implementation. Process of risk assessment has been carried out systematically based on ISO 31000:2009 on risk management and for determination of delayed variables, the requirements of process groups according to ISO 21500:2013 on project management were used.

  4. Methodological issues and evidence of malfeasance in research purporting to show thimerosal in vaccines is safe.

    PubMed

    Hooker, Brian; Kern, Janet; Geier, David; Haley, Boyd; Sykes, Lisa; King, Paul; Geier, Mark

    2014-01-01

    There are over 165 studies that have focused on Thimerosal, an organic-mercury (Hg) based compound, used as a preservative in many childhood vaccines, and found it to be harmful. Of these, 16 were conducted to specifically examine the effects of Thimerosal on human infants or children with reported outcomes of death; acrodynia; poisoning; allergic reaction; malformations; auto-immune reaction; Well's syndrome; developmental delay; and neurodevelopmental disorders, including tics, speech delay, language delay, attention deficit disorder, and autism. In contrast, the United States Centers for Disease Control and Prevention states that Thimerosal is safe and there is "no relationship between [T]himerosal[-]containing vaccines and autism rates in children." This is puzzling because, in a study conducted directly by CDC epidemiologists, a 7.6-fold increased risk of autism from exposure to Thimerosal during infancy was found. The CDC's current stance that Thimerosal is safe and that there is no relationship between Thimerosal and autism is based on six specific published epidemiological studies coauthored and sponsored by the CDC. The purpose of this review is to examine these six publications and analyze possible reasons why their published outcomes are so different from the results of investigations by multiple independent research groups over the past 75+ years.

  5. Methodological Issues and Evidence of Malfeasance in Research Purporting to Show Thimerosal in Vaccines Is Safe

    PubMed Central

    Kern, Janet; Geier, David; Haley, Boyd; King, Paul; Geier, Mark

    2014-01-01

    There are over 165 studies that have focused on Thimerosal, an organic-mercury (Hg) based compound, used as a preservative in many childhood vaccines, and found it to be harmful. Of these, 16 were conducted to specifically examine the effects of Thimerosal on human infants or children with reported outcomes of death; acrodynia; poisoning; allergic reaction; malformations; auto-immune reaction; Well's syndrome; developmental delay; and neurodevelopmental disorders, including tics, speech delay, language delay, attention deficit disorder, and autism. In contrast, the United States Centers for Disease Control and Prevention states that Thimerosal is safe and there is “no relationship between [T]himerosal[-]containing vaccines and autism rates in children.” This is puzzling because, in a study conducted directly by CDC epidemiologists, a 7.6-fold increased risk of autism from exposure to Thimerosal during infancy was found. The CDC's current stance that Thimerosal is safe and that there is no relationship between Thimerosal and autism is based on six specific published epidemiological studies coauthored and sponsored by the CDC. The purpose of this review is to examine these six publications and analyze possible reasons why their published outcomes are so different from the results of investigations by multiple independent research groups over the past 75+ years. PMID:24995277

  6. Effect of silane concentration on the supersonic combustion of a silane/methane mixture

    NASA Technical Reports Server (NTRS)

    Northam, G. B.; Mclain, A. G.; Pellett, G. L.; Diskin, G. S.

    1986-01-01

    A series of direct connect combustor tests was conducted to determine the effect of silane concentration on the supersonic combustion characteristics of silane/methane mixtures. Shock tube ignition delay data indicated more than an order of magnitude reduction in ignition delay times for both 10 and 20 percent silane/methane mixtures as compared to methane. The ignition delay time of the 10 percent mixture was only a factor of 2.3 greater than that of the 20 percent mixture. Supersonic combustion tests were conducted with the fuel injected into a model scramjet combustor. The combustor was mounted at the exit of a Mach 2 nozzle and a hydrogen fired heater was used to provide a variation in test gas total temperature. Tests using the 20 percent silane/methane mixture indicated considerable combustion enhancement when compared to methane alone. This mixture had an autoignition total temperature of 1650 R. This autoignition temperature can be contrasted with 2330 R for hydrogen and 1350 R for a 20 percent silane/hydrogen mixture in similar hardware. Methane without the silane additive did not autoignite in this configuration at total temperatures as high as 3900 R, the maximum temperature at which tests were conducted. Supersonic combustion tests with the silane concentration reduced to 10 percent indicated little improvement in combustion performance over pure methane. The addition of 20 percent silane to methane resulted in a pyrophoric fuel with good supersonic combustion performance. Reducing the silane concentration below this level, however, yielded a less pyrophoric fuel that exhibited poor supersonic combustion performance.

  7. Connected commercial vehicles-integrated truck project : vehicle build test report.

    DOT National Transportation Integrated Search

    2000-12-01

    This paper examines the ways ITS is changing the way federal and state motor carrier agencies conduct business with the motor carrier industry. New technologies are streamlining credentialing operations, reducing delays for safe carriers, and improvi...

  8. Electromechanical delay of the knee flexor muscles is impaired after harvesting hamstring tendons for anterior cruciate ligament reconstruction.

    PubMed

    Ristanis, Stavros; Tsepis, Elias; Giotis, Dimitrios; Stergiou, Nicholas; Cerulli, Guiliano; Georgoulis, Anastasios D

    2009-11-01

    Changes in electromechanical delay during muscle activation are expected when there are substantial alterations in the structural properties of the musculotendinous tissue. In anterior cruciate ligament reconstruction, specific tendons are being harvested for grafts. Thus, there is an associated scar tissue development at the tendon that may affect the corresponding electromechanical delay. This study was conducted to investigate whether harvesting of semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction will affect the electromechanical delay of the knee flexors. Case-control study; Level of evidence, 3. The authors evaluated 12 patients with anterior cruciate ligament reconstruction with a semitendinosus and gracilis autograft, 2 years after the reconstruction, and 12 healthy controls. Each participant performed 4 maximally explosive isometric contractions with a 1-minute break between contractions. The surface electromyographic activity of the biceps femoris and the semitendinosus was recorded from both legs during the contractions. The statistical comparisons revealed significant increases of the electromechanical delay of the anterior cruciate ligament-reconstructed knee for both investigated muscles. Specifically, the electromechanical delay values were increased for both the biceps femoris (P = .029) and the semitendinosus (P = .005) of the reconstructed knee when compared with the intact knee. Comparing the anterior cruciate ligament-reconstructed knee against healthy controls revealed similar significant differences for both muscles (semitendinosus, P = .011; biceps femoris, P = .024). The results showed that harvesting the semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction significantly increased the electromechanical delay of the knee flexors. Increased hamstring electromechanical delay might impair knee safety and performance by modifying the transfer time of muscle tension to the tibia and therefore affecting muscle response during sudden movements in athletic activities. However, further investigation is required to identify whether the increased electromechanical delay of the hamstrings can actually influence optimal sports performance and increase the risk for knee injury in athletes with anterior cruciate ligament reconstructions.

  9. Relation of polymorphism of arsenic metabolism genes to arsenic methylation capacity and developmental delay in preschool children in Taiwan.

    PubMed

    Hsieh, Ru-Lan; Su, Chien-Tien; Shiue, Horng-Sheng; Chen, Wei-Jen; Huang, Shiau-Rung; Lin, Ying-Chin; Lin, Ming-I; Mu, Shu-Chi; Chen, Ray-Jade; Hsueh, Yu-Mei

    2017-04-15

    Inefficient arsenic methylation capacity has been associated with developmental delay in children. The present study was designed to explore whether polymorphisms and haplotypes of arsenic methyltransferase (AS3MT), glutathione-S-transferase omegas (GSTOs), and purine nucleoside phosphorylase (PNP) affect arsenic methylation capacity and developmental delay. A case-control study was conducted from August 2010 to March 2014. All participants were recruited from the Shin Kong Wu Ho-Su Memorial Teaching Hospital. In total, 179 children with developmental delay and 88 children without delay were recruited. Urinary arsenic species, including arsenite (As III ), arsenate (As V ), monomethylarsonic acid (MMA V ), and dimethylarsinic acid (DMA V ) were measured using a high-performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. The polymorphisms of AS3MT, GSTO, and PNP were performed using the Sequenom MassARRAY platform with iPLEX Gold chemistry. Polymorphisms of AS3MT genes were found to affect susceptibility to developmental delay in children, but GSTO and PNP polymorphisms were not. Participants with AS3MT rs3740392 A/G+G/G genotype, compared with AS3MT rs3740392 A/A genotype, had a significantly lower secondary methylation index. This may result in an increased OR for developmental delay. Participants with the AS3MT high-risk haplotype had a significantly higher OR than those with AS3MT low-risk haplotypes [OR and 95% CI, 1.59 (1.08-2.34)]. This is the first study to show a joint dose-response effect of this AS3MT high-risk haplotype and inefficient arsenic methylation capacity on developmental delay. Our data provide evidence that AS3MT genes are related to developmental delay and may partially influence arsenic methylation capacity. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. A CCD Monolithic LMS Adaptive Analog Signal Processor Integrated Circuit.

    DTIC Science & Technology

    1980-03-01

    adaptive filter with electrically- reprogrammable MOS analog conductance weights. I The analog and digital peripheral MOS on-chip circuits are provided with...electrically reprogrammable analog weights at tap positions along a CCD analog delay line in order to form a basic linear combiner for adaptive filtering...electrically reprogrammable analog conductance weights was introduced with the use of non-volatile MNOS memory 6-7 transistors biased in their triode

  11. Effect of cochlear implantation on middle ear function: A three-month prospective study.

    PubMed

    Wasson, Joseph D; Campbell, Luke; Chambers, Scott; Hampson, Amy; Briggs, Robert J S; O'Leary, Stephen J

    2018-05-01

    To determine if cochlear implantation has a delayed effect on the middle ear conductive hearing mechanism by measuring laser Doppler vibrometry (LDV) of the tympanic membrane (TM) in both implanted and contralateral control ears preoperatively and 3 months postoperatively, and then comparing the relative change in LDV outcome measures between implanted and control ears. Prospective cohort study. Eleven preoperative adult unilateral cochlear implant recipients in previously unoperated ears with normal anatomy and aerated temporal bones were included in this study. The magnitude and phase angle of umbo velocity transfer function in response to air- conduction (AC) stimulus, and the magnitude of umbo velocity in response to bone- conduction (BC) stimulus were measured in the implant ear and the contralateral control ear preoperatively and 3 months postoperatively and compared. No significant changes in the magnitude or phase angle of TM velocity in response to either AC or BC stimulus were observed in the implanted ear relative to the contralateral control ear 3 months following cochlear implantation. From the results of LDV measurements, it can be said that cochlear implantation has no significant delayed effect on the middle ear conductive mechanism. 4. Laryngoscope, 128:1207-1212, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. A tutorial on the use of Excel 2010 and Excel for Mac 2011 for conducting delay-discounting analyses.

    PubMed

    Reed, Derek D; Kaplan, Brent A; Brewer, Adam T

    2012-01-01

    In recent years, researchers and practitioners in the behavioral sciences have profited from a growing literature on delay discounting. The purpose of this article is to provide readers with a brief tutorial on how to use Microsoft Office Excel 2010 and Excel for Mac 2011 to analyze discounting data to yield parameters for both the hyperbolic discounting model and area under the curve. This tutorial is intended to encourage the quantitative analysis of behavior in both research and applied settings by readers with relatively little formal training in nonlinear regression.

  13. A TUTORIAL ON THE USE OF EXCEL 2010 AND EXCEL FOR MAC 2011 FOR CONDUCTING DELAY-DISCOUNTING ANALYSES

    PubMed Central

    Reed, Derek D; Kaplan, Brent A; Brewer, Adam T

    2012-01-01

    In recent years, researchers and practitioners in the behavioral sciences have profited from a growing literature on delay discounting. The purpose of this article is to provide readers with a brief tutorial on how to use Microsoft Office Excel 2010 and Excel for Mac 2011 to analyze discounting data to yield parameters for both the hyperbolic discounting model and area under the curve. This tutorial is intended to encourage the quantitative analysis of behavior in both research and applied settings by readers with relatively little formal training in nonlinear regression. PMID:22844143

  14. Comparison of dual-k spacer and single-k spacer for single NWFET and 3-stack NWFET

    NASA Astrophysics Data System (ADS)

    Ko, Hyungwoo; Kim, Jongsu; Kim, Minsoo; Kang, Myounggon; Shin, Hyungcheol

    2018-02-01

    The investigation of the Dual-k spacer through comparative analysis of single nanowire-FET(NWFET)/3-stack NWFET and underlap/overlap channel is conducted. It is known that the dug 3-stack NWFET has better delay characteristics than single NWFET with the use of high permittivity material of Cin in Dual-k spacer structure. In addition, there is no difference of delay between overlap and underlap channel when it used Dual-k spacer structure but underlap channel of Dual-k 3-stack NWFET shows better short channel immunity.

  15. Longitudinal and reciprocal relations between delay discounting and crime

    PubMed Central

    Lee, Christine A.; Derefinko, Karen J.; Milich, Richard; Lynam, Donald R.; DeWall, C. Nathan

    2017-01-01

    Theorists argue that self-control failure is the underlying cause of criminal behavior, with previous research linking poor self-control to delinquency and drug use. The path from self-control to crime is well-established, but less is known about whether criminal behavior contributes to self-control deficits over time. We investigated bi-directional relations between self-control assessed via a delay discounting task and self-reported crime over a three-year period. During their first, second (73.38% retention rate), and third (63.12% retention rate) years of college, 526 undergraduates completed a delay discounting task and reported on their criminal behavior. In order to maximize variability, participants with conduct problems were overrecruited, comprising 23.1% of the final sample. As expected, more discounting of hypothetical monetary rewards significantly predicted future property crime across a one and two-year period, even when controlling for initial levels of both. This study also demonstrated evidence of a bi-directional relationship; violent crime predicted higher rates of delay discounting one year later. These results suggest that bi-directional relations exist between self-control and types of crime. PMID:28970645

  16. On delay adjustment for dynamic load balancing in distributed virtual environments.

    PubMed

    Deng, Yunhua; Lau, Rynson W H

    2012-04-01

    Distributed virtual environments (DVEs) are becoming very popular in recent years, due to the rapid growing of applications, such as massive multiplayer online games (MMOGs). As the number of concurrent users increases, scalability becomes one of the major challenges in designing an interactive DVE system. One solution to address this scalability problem is to adopt a multi-server architecture. While some methods focus on the quality of partitioning the load among the servers, others focus on the efficiency of the partitioning process itself. However, all these methods neglect the effect of network delay among the servers on the accuracy of the load balancing solutions. As we show in this paper, the change in the load of the servers due to network delay would affect the performance of the load balancing algorithm. In this work, we conduct a formal analysis of this problem and discuss two efficient delay adjustment schemes to address the problem. Our experimental results show that our proposed schemes can significantly improve the performance of the load balancing algorithm with neglectable computation overhead.

  17. Air pollution is associated with brainstem auditory nuclei pathology and delayed brainstem auditory evoked potentials

    PubMed Central

    Calderón-Garcidueñas, Lilian; D’Angiulli, Amedeo; Kulesza, Randy J; Torres-Jardón, Ricardo; Osnaya, Norma; Romero, Lina; Keefe, Sheyla; Herritt, Lou; Brooks, Diane M; Avila-Ramirez, Jose; Delgado-Chávez, Ricardo; Medina-Cortina, Humberto; González-González, Luis Oscar

    2011-01-01

    We assessed brainstem inflammation in children exposed to air pollutants by comparing brainstem auditory evoked potentials (BAEPs) and blood inflammatory markers in children age 96.3± 8.5 months from highly polluted (n=34) versus a low polluted city (n=17). The brainstems of nine children with accidental deaths were also examined. Children from the highly polluted environment had significant delays in wave III (t(50)=17.038; p<0.0001) and wave V (t(50)=19.730; p<0.0001) but no delay in wave I (p=0.548). They also had significantly longer latencies than controls for interwave intervals I–III, III–V, and I–V (all t(50)> 7.501; p<0.0001), consisting with delayed central conduction time of brainstem neural transmission. Highly exposed children showed significant evidence of inflammatory markers and their auditory and vestibular nuclei accumulated α synuclein and/or β amyloid 1–42. Medial superior olive neurons, critically involved in BAEPs, displayed significant pathology. Children’s exposure to urban air pollution increases their risk for auditory and vestibular impairment. PMID:21458557

  18. [Medical audit of neonatal deaths with the "three delay" model in a pediatric hospital in Ouagadougou].

    PubMed

    Kouéta, Fla; Ouédraogo Yugbaré, Solange Odile; Dao, Lassina; Dao, Fousséni; Yé, Diarra; Kam, Kobena Ludovic

    2011-01-01

    To determine the causes of neonatal deaths and their contributing factors. We used the "three-delay model" to conduct an audit of the neonatal deaths that occurred between January 2006 and December 2010 at the Charles de Gaulle University Pediatric Hospital, in Ouagadougou. The neonatal mortality rate was 12.3%. The main direct causes were infections (70%), cerebral distress (10%), respiratory distress (7%), congenital malformations (5.5%), prematurity (4.5%) and hemorrhagic syndromes (3%). All three delays were found: in decision making in 64.4% of cases, in access to health services in 77%, and in receiving appropriate care in 66.9%; they multiplied the risk of death by a factor of 4, 3 and 5, respectively. To reduce deaths of newborn babies, it is necessary to overcome the three delays that contribute to it, pending the improvement of socioeconomic conditions of populations. This combat requires optimizing the implementation of the subsidies for obstetric and neonatal emergency care and strengthening the involvement of all stakeholders, specifically, policy makers, the community and health professionals.

  19. Arrival Metering Precision Study

    NASA Technical Reports Server (NTRS)

    Prevot, Thomas; Mercer, Joey; Homola, Jeffrey; Hunt, Sarah; Gomez, Ashley; Bienert, Nancy; Omar, Faisal; Kraut, Joshua; Brasil, Connie; Wu, Minghong, G.

    2015-01-01

    This paper describes the background, method and results of the Arrival Metering Precision Study (AMPS) conducted in the Airspace Operations Laboratory at NASA Ames Research Center in May 2014. The simulation study measured delivery accuracy, flight efficiency, controller workload, and acceptability of time-based metering operations to a meter fix at the terminal area boundary for different resolution levels of metering delay times displayed to the air traffic controllers and different levels of airspeed information made available to the Time-Based Flow Management (TBFM) system computing the delay. The results show that the resolution of the delay countdown timer (DCT) on the controllers display has a significant impact on the delivery accuracy at the meter fix. Using the 10 seconds rounded and 1 minute rounded DCT resolutions resulted in more accurate delivery than 1 minute truncated and were preferred by the controllers. Using the speeds the controllers entered into the fourth line of the data tag to update the delay computation in TBFM in high and low altitude sectors increased air traffic control efficiency and reduced fuel burn for arriving aircraft during time based metering.

  20. The continuing problem of missed test results in an integrated health system with an advanced electronic medical record.

    PubMed

    Wahls, Terry; Haugen, Thomas; Cram, Peter

    2007-08-01

    Missed results can cause needless treatment delays. However, there is little data about the magnitude of this problem and the systems that clinics use to manage test results. Surveys about potential problems related to test results management were developed and administered to clinical staff in a regional Veterans Administration (VA) health care network. The provider survey, conducted four times between May 2005 and October 2006, sampling VA staff physicians, physician assistants, nurse practitioners, and internal medicine trainees, asked questions about the frequency of missed results and diagnosis or treatment delays seen in the antecedent two weeks in their clinics, or if a trainee, the antecedent month. Clinical staff survey response rate was 39% (143 of 370), with 40% using standard operating procedures to manage test results. Forty-four percent routinely reported all results to patients. The provider survey response rate was 50% (441 of 884) overall, with responses often (37% overall; range 29% to 46%) indicating they had seen patients with diagnosis or treatment delays attributed to a missed result; 15% reported two or more such encounters. Even in an integrated health system with an advanced electronic medical record, missed test results and associated diagnosis or treatment delays are common. Additional study and measures of missed results and associated treatment delays are needed.

  1. The measurement of atmospheric water vapor - Radiometer comparison and spatial variations

    NASA Technical Reports Server (NTRS)

    Rocken, C.; Johnson, J. M.; Ware, R. H.; Neilan, R. E.; Cerezo, M.; Jordan, J. R.; Falls, M. J..; Nelson, L. D.; Hayes, M.

    1991-01-01

    Two water vapor radiometer (WVR) experiments were conducted to evaluate whether such instruments are both suitable and necessary to correct for propagation effects that are induced by precipitable water vapor (PWV) on signals from GPS and VLBI. WVRs are suitable for these corrections if they provide wet path delays to better than 0.5 cm. They are needed if spatial variations of PWV result in complicated, direction-dependent propagation effects that are too complex to be parametrized in the GPS or VLBI geodetic solution. The suitability of radiometers was first addressed by comparing six airport WVRs for two weeks. While two WVRs showed an average wet path delay bias of only 0.1 cm, others were biased by 1-3 cm relative to each other and relative to radiosondes. The second experiment addressed the question whether radiometers are needed for the detection of inhomogeneities in the wet delay. Three JPL D-series radiometers were operated at three sites 50 km apart. The WVRs simultaneously sampled PWV at different azimuths and elevations in search of spatial variations of PWV. On one day of this second experiment evidence was found for spatial variations of the wet path delay as high as 20 percent of the total wet path delay.

  2. Method and Apparatus for Monitoring the Integrity of a Geomembrane Liner using time Domain Reflectometry

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

    Morris, John L.

    1998-11-09

    Leaks are detected in a multi-layered geomembrane liner by a two-dimensional time domain reflectometry (TDR) technique. The TDR geomembrane liner is constructed with an electrically conductive detection layer positioned between two electrically non-conductive dielectric layers, which are each positioned between the detection layer and an electrically conductive reference layer. The integrity of the TDR geomembrane liner is determined by generating electrical pulses within the detection layer and measuring the time delay for any reflected electrical energy caused by absorption of moisture by a dielectric layer.

  3. Method and apparatus for monitoring the integrity of a geomembrane liner using time domain reflectometry

    DOEpatents

    Morrison, John L [Idaho Falls, ID

    2001-04-24

    Leaks are detected in a multi-layered geomembrane liner by a two-dimensional time domain reflectometry (TDR) technique. The TDR geomembrane liner is constructed with an electrically conductive detection layer positioned between two electrically non-conductive dielectric layers, which are each positioned between the detection layer and an electrically conductive reference layer. The integrity of the TDR geomembrane liner is determined by generating electrical pulses within the detection layer and measuring the time delay for any reflected electrical energy caused by absorption of moisture by a dielectric layer.

  4. Cognitive and emotional factors affecting avoidable decision-making delay in acute myocardial infarction male adults.

    PubMed

    Vidotto, Giulio; Bertolotti, Giorgio; Zotti, AnnaMaria; Marchi, Stefano; Tavazzi, Luigi

    2013-01-01

    To study the potentially avoidable decision-making delay in acute myocardial infarction (AMI) adults male with different psychological characteristics a nationwide multicentre study was conducted in Italy by the 118 Coronary Care Units (CCUs). 929 AMI patients consecutively presented to the CCU in a conscious condition less than two hours, 2-6 hours, 6-12 hours, and more than 12 hours after symptom onset and completing the Disease Distress Questionnaire (DDQ) were enrolled in a multicentre case-control study. The DDQ collects information regarding the decision time to seek help, and includes a set of items assessing psychological factors and pain-related symptoms. The relationship between the perceived threat and the delay due to decision-making was evaluated by means of a multivariate model using LISREL 8 structural equation modelling. The delay significantly correlated with perceived threat, which was mainly related to somatic awareness. It was only slightly related to pain and was not associated with any of the other variables. Perceived threat was also related to psychological upset, fear and health worries, the first of which was considerably influenced by emotional instability. Somatic awareness is the main dimension affecting perceived threat, but subjective pain intensity affects the delay both directly and indirectly. The core of the model is the relationship between perceived threat and the delay due to decision-making. The importance of subjective pain intensity is well documented, but it is still not clear how subjective and objective pain interact.

  5. Correlation study of real delay time and imaginary delay time in 1-dimensional weak disorder optical media

    NASA Astrophysics Data System (ADS)

    Sahay, Peeyush; Almabadi, Huda M.; Pradhan, Prabhakar

    Real delay time (τr) provides a measure of the time spent by photons inside an optical system. The measurement of τr is conducted in terms of energy (E) derivative of the Wigner phase delay (φ) , as τr = dϕ / dE dϕ / cdk k and c represents wavenumber and the speed of light, respectively. The characterization of τr requires interferometric system to measure φ of the light waves scattering from the medium [ R =√{ r} exp (- iϕ) ]. We investigated the possibility of extracting the τr information from the intensity measurement of the backscattered waves. The study was performed on a 1D model of weak disordered optical system and short sample length by numerically evaluating the backscattered light intensity. An imaginary delay time (τi) , defined as τi = dθ / cdk , where θ represents an `imaginary phase', was obtained upon expressing the backscattered intensity as RR* =| R | 2 = r = exp (- θ) . The result shows a strong correlation between r and φ with τr and τi exhibiting similar statistical distribution but with a shift. The magnitude and variation of the mean and std values of τr, and the std values of τi with sample lengths are nearly the same, which indicates about one parameter theory of delay time. This work potentially paves way for extracting phase information from the intensity distribution without using interferometric systems.

  6. Influence of the heart rate and atrioventricular delays on vortex evolution and blood transport inside the left ventricle

    NASA Astrophysics Data System (ADS)

    Hendabadi, Sahar; Martinez-Legazpi, Pablo; Benito, Yolanda; Bermejo, Javier; Del Alamo, Juan Carlos; Shadden, Shawn

    2013-11-01

    Cardiac resynchronization therapy (CRT) is used to help restore coordinated pumping of the ventricles by overcoming delays in electrical conduction due to cardiac disease. This is accomplished by a specialized cardiac pacemaker that is able to adjust the atrioventricular (AV) delay.A major clinical challenge is to adjust the pacing strategy to best coordinate the blood flow mechanics of ventricular filling and ejection. To this end, we have studied the difference in the vortex formation and its evolution inside the left ventricle (LV) for 4 different AV delays in a cohort of patients with implanted pacemakers. A reconstruction algorithm was used to obtain 2D velocity over the apical long-axis view of the LV from color Doppler and B-mode ultrasound data. To study blood transport, we have identified Lagrangian coherent structures to determine moving boundaries of the blood volumes injected to the LV in diastole and ejected to the aorta in systole. In all cases, we have analyzed the differences in filling and ejection patterns and the blood transport during the E-wave and A-wave formation.Finally we have assessed the influence of the AV delay on 2 indices of stasis, direct flow and residence time.The findings shed insight to the optimization of AV delays in patients undergoing CRT. NIH award 5R21HL108268 and grants PIS09/02603 and RD06/0010 from the Plan Nacional de Investigacion Cientifica, Spain.

  7. Sensorimotor responsiveness and resolution in the giraffe.

    PubMed

    More, Heather L; O'Connor, Shawn M; Brøndum, Emil; Wang, Tobias; Bertelsen, Mads F; Grøndahl, Carsten; Kastberg, Karin; Hørlyck, Arne; Funder, Jonas; Donelan, J Maxwell

    2013-03-15

    The ability of an animal to detect and respond to changes in the environment is crucial to its survival. However, two elements of sensorimotor control - the time required to respond to a stimulus (responsiveness) and the precision of stimulus detection and response production (resolution) - are inherently limited by a competition for space in peripheral nerves and muscles. These limitations only become more acute as animal size increases. In this paper, we investigated whether the physiology of giraffes has found unique solutions for maintaining sensorimotor performance in order to compensate for their extreme size. To examine responsiveness, we quantified three major sources of delay: nerve conduction delay, muscle electromechanical delay and force generation delay. To examine resolution, we quantified the number and size distribution of nerve fibers in the sciatic nerve. Rather than possessing a particularly unique sensorimotor system, we found that our measurements in giraffes were broadly comparable to size-dependent trends seen across other terrestrial mammals. Consequently, both giraffes and other large animals must contend with greater sensorimotor delays and lower innervation density in comparison to smaller animals. Because of their unconventional leg length, giraffes may experience even longer delays compared with other animals of the same mass when sensing distal stimuli. While there are certainly advantages to being tall, there appear to be challenges as well - our results suggest that giraffes are less able to precisely and accurately sense and respond to stimuli using feedback alone, particularly when moving quickly.

  8. The use of low-intensity pulsed ultrasound in treating delayed union of fifth metatarsal fractures.

    PubMed

    Teoh, Kar Hao; Whitham, Robert; Wong, Jenny F; Hariharan, Kartik

    2018-01-31

    There are no studies looking at the success rate of low-intensity pulsed ultrasound (LIPUS) in fifth metatarsal fracture delayed unions to our knowledge. The aim of this study is to investigate the use of LIPUS treatment for delayed union of fifth metatarsal fractures. A retrospective review of patients who were treated with LIPUS following a delayed union of fifth metatarsal fracture was conducted over a three-year period. There were thirty patients (9 males, 21 females) in this cohort. The average age was 39.3 years. Type 2 fractures made up 43% of our cohort. Twenty-seven (90%) patients went on to progress to union clinically and radiologically following LIPUS treatment. Smoking (p=0.014) was predictive of non-union. Assuming that there were 10 delayed unions a year and 6 went on to non-union as previously suggested by a systematic review, the cost savings of using LIPUS (90% success rate; 10 LIPUS machine and surgery for 1 non-union) vs operative intervention (surgery for 6 non-union) equates to a cost saving of £7765 a year. There is a role for the use of LIPUS in delayed union of fifth metatarsal fractures and can serve as an adjunct prior to consideration of surgery. The findings of this study also suggest the use of LIPUS to be a cost effective treatment modality compared to surgical management. Level 4. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Data Link Benefits Study: National Sector Survey Update

    DOT National Transportation Integrated Search

    1995-06-15

    Numerous changes have occurred in the National Airspace System since the spring : of 1994 when data was gathered for the original National Sector Survey, : conducted to gauge the effects of ATC delays on system users. This update : reflects those cha...

  10. Characterizing the motor execution stage of speech production: consonantal effects on delayed naming latency and onset duration.

    PubMed

    Rastle, Kathleen; Croot, Karen P; Harrington, Jonathan M; Coltheart, Max

    2005-10-01

    The research described in this article had 2 aims: to permit greater precision in the conduct of naming experiments and to contribute to a characterization of the motor execution stage of speech production. The authors report an exhaustive inventory of consonantal and postconsonantal influences on delayed naming latency and onset acoustic duration, derived from a hand-labeled corpus of single-syllable consonant-vowel utterances. Five talkers produced 6 repetitions each of a set of 168 prepared monosyllables, a set that comprised each of the consonantal onsets of English in 3 vowel contexts. Strong and significant effects associated with phonetic characteristics of initial and noninitial phonemes were observed on both delayed naming latency and onset acoustic duration. Results are discussed in terms of the biomechanical properties of the articulatory system that may give rise to these effects and in terms of their methodological implications for naming experiments.

  11. Understanding Housing Delays and Relocations Within the Housing First Model.

    PubMed

    Zerger, Suzanne; Pridham, Katherine Francombe; Jeyaratnam, Jeyagobi; Hwang, Stephen W; O'Campo, Patricia; Kohli, Jaipreet; Stergiopoulos, Vicky

    2016-01-01

    This study explores factors contributing to delays and relocations during the implementation of the Housing First model in Toronto, Ontario. While interruptions in housing tenure are expected en route to recovery and housing stability, consumer and service provider views on finding and keeping housing remain largely unknown. In-person interviews and focus groups were conducted with 48 study participants, including 23 case managers or housing workers and 25 consumers. The following three factors contributed to housing delays and transfers: (1) the effectiveness of communication and collaboration among consumers and service providers, (2) consumer-driven preferences and ambivalence, and (3) provider prioritization of consumer choice over immediate housing access. Two strategies--targeted communications and consumer engagement in housing searches--supported the housing process. Several factors affect the timing and stability of housing. Communication between and among providers and consumers, and a shared understanding of consumer choice, can further support choice and recovery.

  12. Time-dependent in-vivo effects of interleukin-2 on neurotransmitters in various cortices: relationships with depressive-related and anxiety-like behaviour.

    PubMed

    Karrenbauer, B D; Müller, C P; Ho, Y J; Spanagel, R; Huston, J P; Schwarting, R K W; Pawlak, C R

    2011-08-15

    We investigated the impact of systemically injected IL-2 (2.5 μg/kg, i.p.) on serotonergic and dopaminergic neurotransmission in various cortical areas by in-vivo microdialysis. IL-2 lastingly reduced extracellular 5-HT levels in the medial prefrontal (-75%), occipital (-70%), and temporal cortices (-45%), whereas dopamine was only moderately reduced in the medial prefrontal cortex. Based on the serotonergic time profile, we conducted further experiments to test for acute and delayed (2 h post injection) depressive-related effects of systemic IL-2 (0-5.0 μg/kg) in a forced swim test and delayed effects on anxiety-like behaviour in the elevated plus-maze. IL-2 had dose-dependent effects on depressive-related behaviour after delayed but not acute testing, but no effects on anxiety-like behaviour. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Zika Virus Testing and Outcomes during Pregnancy, Florida, USA, 2016

    PubMed Central

    Shiu, Colette; Starker, Rebecca; Kwal, Jaclyn; Bartlett, Michelle; Crane, Anise; Greissman, Samantha; Gunaratne, Naiomi; Lardy, Meghan; Picon, Michelle; Rodriguez, Patricia; Gonzalez, Ivan

    2018-01-01

    Zika virus infection during pregnancy can lead to congenital Zika syndrome. Implementation of screening programs and interpretation of test results can be particularly challenging during ongoing local mosquitoborne transmission. We conducted a retrospective chart review of 2,327 pregnant women screened for Zika virus in Miami–Dade County, Florida, USA, during 2016. Of these, 86 had laboratory evidence of Zika virus infection; we describe 2 infants with probable congenital Zika syndrome. Delays in receipt of laboratory test results (median 42 days) occurred during the first month of local transmission. Odds of screening positive for Zika virus were higher for women without health insurance or who did not speak English. Our findings indicate the increase in screening for Zika virus can overwhelm hospital and public health systems, resulting in delayed receipt of results of screening and confirmatory tests and the potential to miss cases or delay diagnoses. PMID:29260671

  14. The Subjective Experience of Patients Diagnosed with Hereditary Hemorrhagic Telangiectasia: a Qualitative Study.

    PubMed

    Geerts, Laura; Fantini-Hauwel, Carole; Brugallé, Elodie; Boute, Odile; Frénois, Frédéric; Defrance, Lydie; Manouvrier-Hanu, Sylvie; Petit, Florence; Antoine, Pascal

    2017-06-01

    The aim of the present study was to understand the context and psychological impact for patients diagnosed with hereditary hemorrhagic telangiectasia (HHT). Semi-structured interviews were conducted with 9 patients affected by HHT, and the transcripts were analyzed using interpretative phenomenological analysis. The results of this study allowed us to propose a new hypothesis to explain the delay in diagnosis: the trivialization of symptoms associated with HHT. Moreover, the results showed that a genetic diagnosis of HHT results in emotional shock, uncertainty about the future, and worry about one's children in parents who are confronted with the dilemma of facing the reality of the diagnosis or delaying dealing with the diagnosis until disease onset. Family and personal perceptions of the disease influenced not only the delay in diagnosis but also the emotional and behavioral reactions of patients following a genetic diagnosis.

  15. A Simulation Based Investigation of High Latency Space Systems Operations

    NASA Technical Reports Server (NTRS)

    Li, Zu Qun; Moore, Michael; Bielski, Paul; Crues, Edwin Z.

    2017-01-01

    This study was the first in a series of planned tests to use physics-based subsystem simulations to investigate the interactions between a spacecraft's crew and a ground-based mission control center for vehicle subsystem operations across long communication delays. The simulation models the life support system of a deep space habitat. It contains models of an environmental control and life support system, an electrical power system, an active thermal control systems, and crew metabolic functions. The simulation has three interfaces: 1) a real-time crew interface that can be use to monitor and control the subsystems; 2) a mission control center interface with data transport delays up to 15 minute each way; and 3) a real-time simulation test conductor interface used to insert subsystem malfunctions and observe the interactions between the crew, ground, and simulated vehicle. The study was conducted at the 21st NASA Extreme Environment Mission Operations (NEEMO) mission. The NEEMO crew and ground support team performed a number of relevant deep space mission scenarios that included both nominal activities and activities with system malfunctions. While this initial test sequence was focused on test infrastructure and procedures development, the data collected in the study already indicate that long communication delays have notable impacts on the operation of deep space systems. For future human missions beyond cis-lunar, NASA will need to design systems and support tools to meet these challenges. These will be used to train the crew to handle critical malfunctions on their own, to predict malfunctions and assist with vehicle operations. Subsequent more detailed and involved studies will be conducted to continue advancing NASA's understanding of space systems operations across long communications delays.

  16. A Simulation Based Investigation of High Latency Space Systems Operations

    NASA Technical Reports Server (NTRS)

    Li, Zu Qun; Crues, Edwin Z.; Bielski, Paul; Moore, Michael

    2017-01-01

    This study was the first in a series of planned tests to use physics-based subsystem simulations to investigate the interactions between a spacecraft's crew and a ground-based mission control center for vehicle subsystem operations across long communication delays. The simulation models the life support system of a deep space habitat. It contains models of an environmental control and life support system, an electrical power system, an active thermal control system, and crew metabolic functions. The simulation has three interfaces: 1) a real-time crew interface that can be use to monitor and control the subsystems; 2) a mission control center interface with data transport delays up to 15 minute each way; and 3) a real-time simulation test conductor interface used to insert subsystem malfunctions and observe the interactions between the crew, ground, and simulated vehicle. The study was conducted at the 21st NASA Extreme Environment Mission Operations (NEEMO) mission. The NEEMO crew and ground support team performed a number of relevant deep space mission scenarios that included both nominal activities and activities with system malfunctions. While this initial test sequence was focused on test infrastructure and procedures development, the data collected in the study already indicate that long communication delays have notable impacts on the operation of deep space systems. For future human missions beyond cis-lunar, NASA will need to design systems and support tools to meet these challenges. These will be used to train the crew to handle critical malfunctions on their own, to predict malfunctions, and to assist with vehicle operations. Subsequent more detailed and involved studies will be conducted to continue advancing NASA's understanding of space systems operations across long communications delays.

  17. Comparison of shipborne GNSS-derived precipitable water vapor with radiosonde in the western North Pacific and in the seas adjacent to Japan

    NASA Astrophysics Data System (ADS)

    Shoji, Yoshinori; Sato, Kazutoshi; Yabuki, Masanori; Tsuda, Toshitaka

    2017-11-01

    We installed two global navigation satellite system (GNSS) antennas on a research vessel, the RYOFU MARU of the Japan Meteorological Agency, and conducted experimental observations to assess the GNSS-derived precipitable water vapor (PWV) from October 19, 2016, to August 6, 2017. One antenna was set on the mast (MAST), while another antenna was set on the upper deck (DECK). The GNSS analysis was conducted using the precise point positioning procedure with a real-time GNSS orbit. A quality control (QC) procedure based on the amount of zenith tropospheric delay (ZTD) time variation was proposed. After the QC was applied, the retrieved PWVs were compared to 77 radiosonde observations. The PWVs of MAST agreed with the radiosonde observations with a 1.7 mm root mean square (RMS) difference, a - 0.7-mm bias, and 3.6% rejection rate, while that of DECK showed a 3.2, - 0.8 mm, and 15.7%. The larger RMS and higher rejection rate of DECK imply a stronger multi-path effect on the deck. The differences in the GNSS PWV versus radiosonde observations were compared to the atmospheric delay, the estimated altitude of the GNSS antenna, the vessel's moving speed, the wind speed, and the wave height. The atmospheric delay and GNSS antenna altitude showed moderate correlation with the differences. The results suggest the kinematic PPP's potential for practical water vapor monitoring over oceans worldwide. At the same time, from the growing negative biases with the PWV value and with estimated antenna altitude, it could be inferred that the difficulty grows in separating the signal delay from the vertical coordinate under high-humidity conditions.[Figure not available: see fulltext.

  18. Modeling the influence of the VV delay for CRT on the electrical activation patterns in absence of conduction through the AV node

    NASA Astrophysics Data System (ADS)

    Romero, D. A.; Sebastián, Rafael; Plank, Gernot; Vigmond, Edward J.; Frangi, Alejandro F.

    2008-03-01

    From epidemiological studies, it has been shown that 0.2% of men and 0.1% of women suffer from a degree of atrioventricular (AV) block. In recent years, the palliative treatment for third degree AV block has included Cardiac Resynchronization Therapy (CRT). It was found that patients show more clinical improvement in the long term with CRT compared with single chamber devices. Still, an important group of patients does not improve their hemodynamic function as much as could be expected. A better understanding of the basis for optimizing the devices settings (among which the VV delay) will help to increase the number of responders. In this work, a finite element model of the left and right ventricles was generated using an atlas-based approach for their segmentation, which includes fiber orientation. The electrical activity was simulated with the electrophysiological solver CARP, using the Ten Tusscher et al. ionic model for the myocardium, and the DiFrancesco-Noble for Purkinje fibers. The model is representative of a patient without dilated or ischemic cardiomyopathy. The simulation results were analyzed for total activation times and latest activated regions at different VV delays and pre-activations (RV pre-activated, LV pre-activated). To optimize the solution, simulations are compared against the His-Purkinje network activation (normal physiological conduction), and interventricular septum activation (as collision point for the two wave fronts). The results were analyzed using Pearson's coefficient of correlation for point to point comparisons between simulation cases. The results of this study contribute to gain insight on the VV delay and how its adjustment might influence response to CRT and how it can be used to optimize the treatment.

  19. Effect of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) on Conduction System Disease.

    PubMed

    Dewland, Thomas A; Soliman, Elsayed Z; Davis, Barry R; Magnani, Jared W; Yamal, Jose-Miguel; Piller, Linda B; Haywood, L Julian; Alonso, Alvaro; Albert, Christine M; Marcus, Gregory M

    2016-08-01

    Cardiac conduction abnormalities are associated with an increased risk for morbidity and mortality, and understanding factors that accelerate or delay conduction system disease could help to identify preventive and therapeutic strategies. Antifibrotic and anti-inflammatory properties of angiotensin-converting enzyme inhibitors and treatment for hyperlipidemia may reduce the risk for incident conduction system disease. To identify the effect of pharmacologic therapy randomization and clinical risk factors on the incidence of conduction system disease. This secondary analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) investigation acquired data from 623 North American centers. A total of 21 004 ambulatory individuals 55 years or older with hypertension and at least 1 other cardiac risk factor were included in the analysis. Participants were randomly assigned to receive amlodipine besylate, lisinopril, or chlorthalidone. Individuals with elevated fasting low-density lipoprotein cholesterol levels were also randomized to pravastatin sodium vs usual care. An electrocardiogram (ECG) was obtained at study enrollment and every 2 years of follow-up. The development of incident first-degree atrioventricular block, left anterior fascicular block, incomplete left bundle branch block (LBBB), LBBB, incomplete right bundle branch block (RBBB), RBBB, or intraventricular conduction delay was assessed by serial ECGs. The 21 004 participants (11 758 men [56.0%]; 9246 women [44.0%]; mean [SD] age, 66.5 [7.3] years) underwent a mean (SD) follow-up of 5.0 (1.2) years. Among the 1114 participants who developed any conduction defect, 389 developed LBBB, 570 developed RBBB, and 155 developed intraventricular conduction delay. Compared with chlorthalidone, randomization to lisinopril was associated with a significant 19% reduction in conduction abnormalities (hazard ratio [HR], 0.81; 95% CI, 0.69-0.95; P = .01). Treatment with amlodipine, however, was not associated with a significant difference in conduction outcome events (HR, 0.94; 95% CI, 0.81-1.09; P = .42). Similarly, pravastatin treatment was not associated with a reduced adjusted risk for incident disease compared with usual hyperlipidemia treatment (HR, 1.13; 95% CI, 0.95-1.35; P = .18). Increased age (HR, 1.47; 95% CI, 1.34-1.63; P < .001), male sex (HR, 0.59; 95% CI, 0.50-0.73; P < .001), white race (HR, 0.59; 95% CI, 0.50-0.70; P < .001), diabetes (HR, 1.23; 95% CI, 1.07-1.42; P = .003), and left ventricular hypertrophy (HR, 3.20; 95% CI, 2.61-3.94; P < .001) were also independently associated with increased risk for conduction system disease. Incident conduction system disease is significantly reduced by lisinopril therapy and is independently associated with multiple clinical factors. Further studies are warranted to determine whether pharmacologic treatment affects conduction abnormality outcomes, including pacemaker implantation. clinicaltrials.gov Identifier: NCT00000542.

  20. Time Critical Targeting: Predictive Vs Reactionary Methods An Analysis For The Future

    DTIC Science & Technology

    2002-06-01

    critical targets. To conduct the analysis, a four-step process is used. First, research is conducted to determine which future aircraft, spacecraft , and...the most promising aircraft, spacecraft , and weapons are determined , they are categorized for use in either the reactive or preemptive method. For...no significant delays, 292; Alan Vick et al., 17. 33 Ibid. 12 sensors are Electro-optical (EO) sensors, thermal imagers , and signal intelligence

  1. Defense Acquisitions. Missile Defense Agency Fields Initial Capability but Falls Short of Original Goals

    DTIC Science & Technology

    2006-03-01

    Implementation Plan MAP Missile Defense System Assurance Provisions MDA Missile Defense System NASA National Aeronautics and Space Administration NFIRE ...fourth element, KEI, also delayed some activities related to its Near Field Infrared Experiment ( NFIRE ), which is being conducted to gather data on the...to complete a number of tasks that would have enabled it to conduct the NFIRE experiment. The experiment places sensors aboard a satellite that

  2. Magnetic transit-time flowmeter

    DOEpatents

    Forster, George A.

    1976-07-06

    The flow rate of a conducting fluid in a stream is determined by disposing two permanent-magnet flowmeters in the stream, one downstream of the other. Flow of the conducting fluid causes the generation of both d-c and a-c electrical signals, the a-c comprising flow noise. Measurement of the time delay between similarities in the a-c signals by cross-correlation methods provides a measure of the rate of flow of the fluid.

  3. Delayed nausea and vomiting from carboplatin doublet chemotherapy

    PubMed Central

    Waqar, Saiama N.; Mann, Janelle; Baggstrom, Maria Q.; Waqar, Muhammad Atif; Chitneni, Pooja; Williams, Kristina; Gao, Feng; Morgensztern, Daniel; Govindan, Ramaswamy

    2016-01-01

    Background Delayed nausea and vomiting following administration of carboplatin containing chemotherapy regimen remains a clinically significant problem for patients with cancer despite administration of standard antiemetic prophylaxis comprising of a 5-HT3 antagonist and dexamethasone. We performed a prospective study to define the incidence and risk factors for delayed chemotherapy induced nausea and vomiting (CINV). Methods Previously untreated patients with newly diagnosed cancer scheduled to receive carboplatin containing chemotherapy (AUC 5 or above), but no prophylactic aprepitant were enrolled in the study. The primary endpoint was the incidence of delayed CINV after cycle 1 of chemotherapy. Secondary endpoints included the incidence of CINV with the third chemotherapy cycle and gender differences in incidence of CINV. Patients completed the Functional Living Index Emesis (FLIE) questionnaires 24, 48, 72 and 96 hours after receiving chemotherapy. Telephone interviews were conducted 24–48 hours following chemotherapy to assess the severity and need for breakthrough medications for CINV. Results Between December 2006 and July 2009, 105 patients were enrolled onto this study. Delayed emesis following cycle 1 of carboplatin was observed in 30% of patients. Of these, 14.1%, 22.4% and 23.5% of patients described CINV at 48 hours, 72 hours, and 96 hours respectively. The incidence of delayed CINV following cycle 3 dropped to 12.8%, 14.6% and 16% of patients at 48 hours, 72 hours and 96 hours respectively. No differences were observed in the incidence of CINV between men and women. A total of 20% of patients required use of breakthrough antiemetics with cycle 1. Conclusions Without prophylactic aprepitant administration, 30% of patients receiving carboplatin containing regimen had moderate to severe delayed CINV. PMID:27145068

  4. Teleoperation in surgical robotics--network latency effects on surgical performance.

    PubMed

    Lum, Mitchell J H; Rosen, Jacob; King, Hawkeye; Friedman, Diana C W; Lendvay, Thomas S; Wright, Andrew S; Sinanan, Mika N; Hannaford, Blake

    2009-01-01

    A teleoperated surgical robotic system allows surgical procedures to be conducted across long distances while utilizing wired and wireless communication with a wide spectrum of performance that may affect the outcome. An open architecture portable surgical robotic system (Raven) was developed for both open and minimally invasive surgery. The system has been the subject of an intensive telesurgical experimental protocol aimed at exploring the boundaries of the system and surgeon performance during a series of field experiments in extreme environments (desert and underwater) teleportation between US, Europe, and Japan as well as lab experiments under synthetic fixed time delay. One standard task (block transfer emulating tissue manipulation) of the Fundamentals of Laparoscopic Surgery (FLS) training kit was used for the experimental protocol. Network characterization indicated a typical time delay in the range of 16-172 ms in field experiments. The results of the lab experiments showed that the completion time of the task as well as the length of the tool tip trajectory significantly increased (alpha< 0.02) as time delay increased in the range of 0-0.5 sec increased. For teleoperation with a time delay of 0.25s and 0.5s the task completion time was lengthened by a factor of 1.45 and 2.04 with respect to no time delay, whereas the length of the tools' trajectory was increased by a factor of 1.28 and 1.53 with respect to no time delay. There were no statistical differences between experienced surgeons and non-surgeons in the number of errors (block drooping) as well as the completion time and the tool tip path length at different time delays.

  5. Prehospital delay and independent/interdependent construal of self among Japanese patients with acute myocardial infarction.

    PubMed

    Fukuoka, Yoshimi; Dracup, Kathleen; Rankin, Sally H; Froelicher, Erika Sivarajan; Kobayashi, Fumio; Hirayama, Haro; Ohno, Miyoshi; Matsumoto, David

    2005-05-01

    Reducing the time from symptom onset to reperfusion therapy is an important approach to minimizing myocardial damage and to preventing death from acute myocardial infarction (AMI). Previous studies suggest that certain ethnic or national groups, such as the Japanese, are more likely to delay in accessing care than other groups. The aims of this paper were the following; (1) to examine whether culture (defined as independent and interdependent construal of self) is associated with delay in accessing medical care in Japanese patients experiencing symptoms of AMI; (2) to determine if the relationship between independent and interdependent construal of self and prehospital delay time is mediated by cognitive responses and/or emotional responses; and (3) to determine if independent and interdependent construal of self independently predicts choice of treatment site (clinic vs. hospital). A cross-sectional study was conducted at hospitals in urban areas in Japan. One hundred and forty-five consecutive patients who were admitted with AMI within 72 h of the onset of symptoms were interviewed using the modified response to symptoms questionnaire and the independent and interdependent construal of self scale. The interdependent construal of self scores were significantly associated with prehospital delay time, controlling for demographics, medical history, and symptoms (p<.001). However, the relationship between independent and interdependent self and prehospital delay times was not mediated by cognitive or emotional responses. In multiple logistic regression analysis, patients with high independent construal of self were more likely to seek care at a hospital rather than a clinic compared to those with lower independent construal of self. In conclusion, cultural variation within this Japanese group was observed and was associated with prehospital delay time.

  6. Chromosomal Microarray With Clinical Diagnostic Utility in Children With Developmental Delay or Intellectual Disability.

    PubMed

    Lee, Jin Sook; Hwang, Hee; Kim, Soo Yeon; Kim, Ki Joong; Choi, Jin Sun; Woo, Mi Jung; Choi, Young Min; Jun, Jong Kwan; Lim, Byung Chan; Chae, Jong Hee

    2018-09-01

    Chromosomal microarray (CMA) testing is a first-tier test for patients with developmental delay, autism, or congenital anomalies. It increases diagnostic yield for patients with developmental delay or intellectual disability. In some countries, including Korea, CMA testing is not yet implemented in clinical practice. We assessed the diagnostic utility of CMA testing in a large cohort of patients with developmental delay or intellectual disability in Korea. We conducted a genome-wide microarray analysis of 649 consecutive patients with developmental delay or intellectual disability at the Seoul National University Children's Hospital. Medical records were reviewed retrospectively. Pathogenicity of detected copy number variations (CNVs) was evaluated by referencing previous reports or parental testing using FISH or quantitative PCR. We found 110 patients to have pathogenic CNVs, which included 100 deletions and 31 duplications of 270 kb to 30 Mb. The diagnostic yield was 16.9%, demonstrating the diagnostic utility of CMA testing in clinic. Parental testing was performed in 66 patients, 86.4% of which carried de novo CNVs. In eight patients, pathogenic CNVs were inherited from healthy parents with a balanced translocation, and genetic counseling was provided to these families. We verified five rarely reported deletions on 2p21p16.3, 3p21.31, 10p11.22, 14q24.2, and 21q22.13. This study demonstrated the clinical utility of CMA testing in the genetic diagnosis of patients with developmental delay or intellectual disability. CMA testing should be included as a clinical diagnostic test for all children with developmental delay or intellectual disability. © The Korean Society for Laboratory Medicine.

  7. Randomized Controlled Trial of Early Versus Delayed Statin Therapy in Patients With Acute Ischemic Stroke: ASSORT Trial (Administration of Statin on Acute Ischemic Stroke Patient).

    PubMed

    Yoshimura, Shinichi; Uchida, Kazutaka; Daimon, Takashi; Takashima, Ryuzo; Kimura, Kazuhiro; Morimoto, Takeshi

    2017-11-01

    Several studies suggested that statins during hospitalization were associated with better disability outcomes in patients with acute ischemic stroke, but only 1 small randomized trial is available. We conducted a multicenter, open-label, randomized controlled trial in patients with acute ischemic strokes in 11 hospitals in Japan. Patients with acute ischemic stroke and dyslipidemia randomly received statins within 24 hours after admission in the early group or on the seventh day in the delayed group, in a 1:1 ratio. Statins were administered for 12 weeks. The primary outcome was patient disability assessed by modified Rankin Scale at 90 days. A total of 257 patients were randomized and analyzed (early 131, delayed 126). At 90 days, modified Rankin Scale score distribution did not differ between groups ( P =0.68), and the adjusted common odds ratio of the early statin group was 0.84 (95% confidence interval, 0.53-1.3; P =0.46) compared with the delayed statin group. There were 3 deaths at 90 days (2 in the early group, 1 in the delayed group) because of malignancy. Ischemic stroke recurred in 9 patients (6.9%) in the early group and 5 patients (4.0%) in the delayed group. The safety profile was similar between groups. Our randomized trial involving patients with acute ischemic stroke and dyslipidemia did not show any superiority of early statin therapy within 24 hours of admission compared with delayed statin therapy 7 days after admission to alleviate the degree of disability at 90 days after onset. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02549846. © 2017 American Heart Association, Inc.

  8. Initiation of nutritional support is delayed in critically ill obese patients: a multicenter cohort study.

    PubMed

    Borel, Anne-Laure; Schwebel, Carole; Planquette, Benjamin; Vésin, Aurélien; Garrouste-Orgeas, Maité; Adrie, Christophe; Clec'h, Christophe; Azoulay, Elie; Souweine, Bertrand; Allaouchiche, Bernard; Goldgran-Toledano, Dany; Jamali, Samir; Darmon, Michael; Timsit, Jean-François

    2014-09-01

    A high catabolic rate characterizes the acute phase of critical illness. Guidelines recommend an early nutritional support, regardless of the previous nutritional status. We aimed to assess whether the nutritional status of patients, which was defined by the body mass index (BMI) at admission in an intensive care unit (ICU), affected the time of nutritional support initiation. We conducted a cohort study that reported a retrospective analysis of a multicenter ICU database (OUTCOMEREA) by using data prospectively entered from January 1997 to October 2012. Patients who needed orotracheal intubation within the first 72 h and >3 d were included. Data from 3257 ICU stays were analyzed. The delay before feeding was different according to BMI groups (P = 0.035). The delay was longer in obese patients [BMI (in kg/m²) ≥30; n = 663] than in other patients with either low weight (BMI <20; n = 501), normal weight (BMI ≥20 and <25; n = 1135), or overweight (BMI ≥25 and <30; n = 958). The association between nutritional status and a delay in nutrition initiation was independent of potential confounding factors such as age, sex, and diabetes or other chronic diseases. In comparison with normal weight, the adjusted RR (95% CI) associated with a delayed nutrition initiation was 0.92 (0.86, 0.98) for patients with low weight, 1.00 (0.94, 1.05) for overweight patients, and 1.06 (1.00, 1.12) for obese patients (P = 0.004). The initiation of nutritional support was delayed in obese ICU patients. Randomized controlled trials that address consequences of early compared with delayed beginnings of nutritional support in critically ill obese patients are needed. © 2014 American Society for Nutrition.

  9. Analysis of the diagnostic pathway and delay in patients with amyotrophic lateral sclerosis in the Valencian Community.

    PubMed

    Vázquez-Costa, J F; Martínez-Molina, M; Fernández-Polo, M; Fornés-Ferrer, V; Frasquet-Carrera, M; Sevilla-Mantecón, T

    2018-06-11

    Amyotrophic lateral sclerosis (ALS) is an insidious, clinically heterogeneous neurodegenerative disease associated with a diagnostic delay of approximately 12 months. No study conducted to date has analysed the diagnostic pathway in Spain. We gathered data on variables related to the diagnostic pathway and delay for patients diagnosed with ALS between October 2013 and July 2017. The study included 143 patients with ALS (57% men; 68% spinal onset). Patients were diagnosed in public centres in 86% of cases and in private centres in 14%.The mean diagnostic delay was 13.1 months (median 11.7). Patients were examined by neurologists a mean time of 7.9 months after symptom onset, with diagnosis being made 5.2 months later. Half of all patients underwent unnecessary diagnostic tests and multiple electrophysiological studies before diagnosis was established. Diagnostic delay was longer in cases of spinal onset (P = .008) due to onset of the disease in the lower limbs. No differences were found between the public and private healthcare systems (P = .897). The diagnostic delay in ALS in Spain is similar to that of neighboring countries and seems to depend on disease-related factors, not on the healthcare system. Patients with lower-limb onset ALS constitute the greatest diagnostic challenge. Misdiagnosis is frequent, and partly attributable to an incorrect approach or erroneous interpretation of electrophysiological studies. Specific training programmes for neurologists and general neurophysiologists and early referral to reference centers may help to reduce diagnostic delay. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Lane, Taylor; Parma, Edward J.

    Delayed fission gamma-rays play an important role in determining the time dependent ioniz- ing dose for experiments in the central irradiation cavity of the Annular Core Research Reactor (ACRR). Delayed gamma-rays are produced from both fission product decay and from acti- vation of materials in the core, such as cladding and support structures. Knowing both the delayed gamma-ray emission rate and the time-dependent gamma-ray energy spectrum is nec- essary in order to properly determine the dose contributions from delayed fission gamma-rays. This information is especially important when attempting to deconvolute the time-dependent neutron, prompt gamma-ray, and delayed gamma-ray contribution tomore » the response of a diamond photo-conducting diode (PCD) or fission chamber in time frames of milliseconds to seconds following a reactor pulse. This work focused on investigating delayed gamma-ray character- istics produced from fission products from thermal, fast, and high energy fission of Th-232, U-233, U-235, U-238, and Pu-239. This work uses a modified version of CINDER2008, a transmutation code developed at Los Alamos National Laboratory, to model time and energy dependent photon characteristics due to fission. This modified code adds the capability to track photon-induced transmutations, photo-fission, and the subsequent radiation caused by fission products due to photo-fission. The data is compared against previous work done with SNL- modified CINDER2008 [ 1 ] and experimental data [ 2 , 3 ] and other published literature, includ- ing ENDF/B-VII.1 [ 4 ]. The ability to produce a high-fidelity (7,428 group) energy-dependent photon fluence at various times post-fission can improve the delayed photon characterization for radiation effects tests at research reactors, as well as other applications.« less

  11. High prevalence of developmental delay among children under three years of age in poverty-stricken areas of China.

    PubMed

    Wei, Q W; Zhang, J X; Scherpbier, R W; Zhao, C X; Luo, S S; Wang, X L; Guo, S F

    2015-12-01

    Poverty and its associated factors put children at risk for developmental delay. The aim of this study was to describe the neurodevelopment of children under three years of age in poverty-stricken areas of China and explore possible associated factors. A cross-sectional survey was conducted among 2837 children aged 1-35 months in poverty-stricken areas of China. Characteristics of the child, caregiver, and family were collected through face-to-face caregiver interviews. Developmental delay was explored with the five-domain, structured, parent-completed Ages and Stages Questionnaire. The Zung Self-rating Depression Scale was used to assess depressive symptoms of the caregivers. The Chi-squared test and multivariate logistic regression analyses were used to explore associated factors. Of the children, 39.7% (95% confidence interval, 37.9-41.5) had developmental delay in at least one of the five domains. For the domains of communication, gross motor, fine motor, problem solving, and personal-social skills, the prevalence was 11.5%, 18.5%, 21.4%, 18.4%, and 17.9%, respectively. Significant predictors of increased odds of developmental delay included the child having no toys (odds ratio [OR] = 2.31), the caregiver having depression (OR = 2.24), insufficient learning activities (OR = 1.65), and more children in the family (OR = 1.16). The high prevalence of developmental delay in children younger than three years in poverty-stricken areas of China and the presence of risk factors for developmental delay such as inadequate learning resources and activities in the home, caregiver depression, and low family income highlight the need for early identification and interventions. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Intraspecific priority effects modify compensatory responses to changes in hatching phenology in an amphibian.

    PubMed

    Murillo-Rincón, Andrea P; Kolter, Nora A; Laurila, Anssi; Orizaola, Germán

    2017-01-01

    In seasonal environments, modifications in the phenology of life-history events can alter the strength of time constraints experienced by organisms. Offspring can compensate for a change in timing of hatching by modifying their growth and development trajectories. However, intra- and interspecific interactions may affect these compensatory responses, in particular if differences in phenology between cohorts lead to significant priority effects (i.e. the competitive advantage that early-hatching individuals have over late-hatching ones). Here, we conducted a factorial experiment to determine whether intraspecific priority effects can alter compensatory phenotypic responses to hatching delay in a synchronic breeder by rearing moor frog (Rana arvalis) tadpoles in different combinations of phenological delay and food abundance. Tadpoles compensated for the hatching delay by speeding up their development, but only when reared in groups of individuals with identical hatching phenology. In mixed phenology groups, strong competitive effects by non-delayed tadpoles prevented the compensatory responses and delayed larvae metamorphosed later than in single phenology treatments. Non-delayed individuals gained advantage from developing with delayed larvae by increasing their developmental and growth rates as compared to single phenology groups. Food shortage prolonged larval period and reduced mass at metamorphosis in all treatments, but it did not prevent compensatory developmental responses in larvae reared in single phenology groups. This study demonstrates that strong intraspecific priority effects can constrain the compensatory growth and developmental responses to phenological change, and that priority effects can be an important factor explaining the maintenance of synchronic life histories (i.e. explosive breeding) in seasonal environments. © 2016 The Authors. Journal of Animal Ecology © 2016 British Ecological Society.

  13. Mass Media Campaigns' Influence on Prehospital Behavior for Acute Coronary Syndromes: An Evaluation of the Australian Heart Foundation's Warning Signs Campaign.

    PubMed

    Bray, Janet E; Stub, Dion; Ngu, Philip; Cartledge, Susie; Straney, Lahn; Stewart, Michelle; Keech, Wendy; Patsamanis, Harry; Shaw, James; Finn, Judith

    2015-07-06

    The aim of this study was to examine the awareness of a recent mass media campaign, and its influence on knowledge and prehospital times, in a cohort of acute coronary syndrome (ACS) patients admitted to an Australian hospital. We conducted 199 semistructured interviews with consecutive ACS patients who were aged 35 to 75 years, competent to provide consent, and English speaking. Questions addressed the factors known to predict prehospital delay, awareness of the campaign, and whether it increased knowledge and influenced actions. Multivariable logistic regression was used to examine the association between campaign awareness and a 1-hour delay in deciding to seek medical attention (patient delay) and a 2-hour delay in presenting to hospital (prehospital delay). The median age was 62 years (IQR=53 to 68 years), and 68% (n=136) were male. Awareness of the campaign was reported by 127 (64%) patients, with most of these patients stating the campaign (1) increased their understanding of what is a heart attack (63%), (2) increased their awareness of the signs and symptoms of heart attack (68%), and (3) influenced their actions in response to symptoms (43%). After adjustment for other predictors, awareness of the campaign was significantly associated with patient delay time of ≤1 hour (adjusted odds ratio [AOR]=2.25, 95% CI: 1.03 to 4.91, P=0.04) and prehospital delay time ≤2 hours (AOR=3.11, 95% CI: 1.36 to 7.08, P=0.007). Our study showed reasonably high awareness of the warning signs campaign, which was significantly associated with shorter prehospital decision-making and faster presentation to hospital. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  14. Using the Three Delays Model to Examine Civil Registration Barriers in Indonesia.

    PubMed

    Bennouna, Cyril; Feldman, Brooke; Usman, Rahmadi; Adiputra, Rama; Kusumaningrum, Santi; Stark, Lindsay

    2016-01-01

    The Three Delays Model has proven a useful framework for examining barriers to seeking obstetric care and preventing maternal and child mortality. This article demonstrates the applicability of the Three Delays Model to the case of civil registration in rural Indonesia and examines ways that efforts to strengthen civil registration services can draw on lessons from maternal and child health programming. Twenty focus group discussions were conducted using a participatory ranking exercise in four Indonesian districts. Focus groups were stratified into four groups: (1) government officials involved in civil registration, (2) civil society organization members that assist communities in civil registration, and (3) female and (4) male community members. Transcripts were analyzed using constant comparative method and thematic analysis, revealing barriers that communities commonly faced in accessing civil registration services. In examining the categories and themes related to these barriers, the research team found a significant overlap with the factors and phases of the Three Delays Model. Participants were delayed from seeking registration services by a range of sociocultural factors and by the perceived inaccessibility and poor quality of services. Once they decided to seek care, long distances to services and poor transportation options delayed their access to registration offices. Finally, a series of bottlenecks in service provision created extended delays once applicants reached registration offices. Ownership of civil registration documents in Indonesia remains exceptionally low, with just over half of children and youth possessing a birth certificate. To strengthen civil registration and health systems more generally, it is important to understand the factors that enable and constrain civil registration, how these factors relate to one another, and how they change over a child's life.

  15. Using the Three Delays Model to Examine Civil Registration Barriers in Indonesia

    PubMed Central

    Bennouna, Cyril; Feldman, Brooke; Usman, Rahmadi; Adiputra, Rama; Kusumaningrum, Santi

    2016-01-01

    The Three Delays Model has proven a useful framework for examining barriers to seeking obstetric care and preventing maternal and child mortality. This article demonstrates the applicability of the Three Delays Model to the case of civil registration in rural Indonesia and examines ways that efforts to strengthen civil registration services can draw on lessons from maternal and child health programming. Twenty focus group discussions were conducted using a participatory ranking exercise in four Indonesian districts. Focus groups were stratified into four groups: (1) government officials involved in civil registration, (2) civil society organization members that assist communities in civil registration, and (3) female and (4) male community members. Transcripts were analyzed using constant comparative method and thematic analysis, revealing barriers that communities commonly faced in accessing civil registration services. In examining the categories and themes related to these barriers, the research team found a significant overlap with the factors and phases of the Three Delays Model. Participants were delayed from seeking registration services by a range of sociocultural factors and by the perceived inaccessibility and poor quality of services. Once they decided to seek care, long distances to services and poor transportation options delayed their access to registration offices. Finally, a series of bottlenecks in service provision created extended delays once applicants reached registration offices. Ownership of civil registration documents in Indonesia remains exceptionally low, with just over half of children and youth possessing a birth certificate. To strengthen civil registration and health systems more generally, it is important to understand the factors that enable and constrain civil registration, how these factors relate to one another, and how they change over a child’s life. PMID:27992515

  16. Extracorporeal shock wave therapy in treatment of delayed bone-tendon healing.

    PubMed

    Wang, Lin; Qin, Ling; Lu, Hong-bin; Cheung, Wing-hoi; Yang, Hu; Wong, Wan-nar; Chan, Kai-ming; Leung, Kwok-sui

    2008-02-01

    Extracorporeal shock wave therapy is indicated for treatment of chronic injuries of soft tissues and delayed fracture healing and nonunion. No investigation has been conducted to study the effect of shock wave on delayed healing at the bone-tendon junction. Shock wave promotes osteogenesis, regeneration of fibrocartilage zone, and remodeling of healing tissue in delayed healing of bone-tendon junction surgical repair. Controlled laboratory study. Twenty-eight mature rabbits were used for establishing a delayed healing model at the patella-patellar tendon complex after partial patellectomy and then divided into control and shock wave groups. In the shock wave group, a single shock wave treatment was given at week 6 postoperatively to the patella-patellar tendon healing complex. Seven samples were harvested at week 8 and 7 samples at week 12 for radiologic, densitometric, histologic, and mechanical evaluations. Radiographic measurements showed 293.4% and 185.8% more new bone formation at the patella-patellar tendon healing junction in the shock wave group at weeks 8 and 12, respectively. Significantly better bone mineral status was found in the week 12 shock wave group. Histologically, the shock wave group showed more advanced remodeling in terms of better alignment of collagen fibers and thicker and more mature regenerated fibrocartilage zone at both weeks 8 and 12. Mechanical testing showed 167.7% and 145.1% higher tensile load and strength in the shock wave group at week 8 and week 12, respectively, compared with controls. Extracorporeal shock wave promotes osteogenesis, regeneration of fibrocartilage zone, and remodeling in the delayed bone-to-tendon healing junction in rabbits. These results provide a foundation for future clinical studies toward establishment of clinical indication for treatment of delayed bone-to-tendon junction healing.

  17. On an instability exhibited by the ballistic-diffusive heat conduction model of Xu and Hu

    DOE PAGES

    Christov, I. C.; Jordan, P. M.

    2013-11-13

    We show that the constitutive relation for the thermal flux proposed by Xu & Hu (2011) admits an unconditional instability. We also highlight the difference between mathematical models containing delay and those that include relaxation effects.

  18. 30 CFR 955.14 - Examination.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE CERTIFICATION OF BLASTERS IN FEDERAL PROGRAM STATES...(b) of this chapter, and shall include: (i) Objective questions; (ii) Blasting log problems; and (iii) Initiation system and delay sequence problems. (c) Reexamination. (1) Any person who fails the examination...

  19. Transient current interruption mechanism in a magnetically delayed vacuum switch

    NASA Technical Reports Server (NTRS)

    Morris, Gibson, Jr.; Dougal, Roger A.

    1993-01-01

    The capacity of a magnetically delayed vacuum switch to conduct current depends on the density of plasma injected into the switch. Exceeding the current capacity results in the switch entering a lossy mode of operation characterized by a transient interruption of the main current (opening behavior) and a rapid increase of voltage across the vacuum gap. Streak and framing photographs of the discharge indicate that a decrease of luminosity near the middle of the gap preceeds the transition to the opening phase. The zone of low luminosity propagates toward the cathode. This evidence suggests that the mechanism causing the opening phase is erosion of the background plasma in a manner similar to that in a plasma-opening switch. The resulting ion depletion forces a space-charge-limited conduction mode. The switch inductance maintains a high discharge current even during the space-charge-limited conduction phase, thus producing high internal fields. The high accelerating voltage, in turn, produces electron and ion beams that heat the electrode surfaces. As a result of the heating, jets of electrode vapor issue from the electrodes, either cathode or anode, depending on the selection of electrode materials.

  20. Electrical remodelling of the left and right atria due to rheumatic mitral stenosis.

    PubMed

    John, Bobby; Stiles, Martin K; Kuklik, Pawel; Chandy, Sunil T; Young, Glenn D; Mackenzie, Lorraine; Szumowski, Lukasz; Joseph, George; Jose, Jacob; Worthley, Stephen G; Kalman, Jonathan M; Sanders, Prashanthan

    2008-09-01

    To characterize the atrial remodelling in mitral stenosis (MS). Twenty-four patients with severe MS undergoing commissurotomy and 24 controls were studied. Electrophysiological evaluation was performed in 12 patients in each group by positioning multi-electrode catheters in both atria to determine the following: effective refractory period (ERP) at 10 sites at 600 and 450 ms; conduction time; conduction delay at the crista terminalis (CT); and vulnerability for atrial fibrillation (AF). P-wave duration (PWD) was determined on the surface ECG. In the remaining 12 patients in each group, electroanatomic maps of both atria were created to determine conduction velocity and identify regions of low voltage and electrical silence. Patients with MS had larger left atria (LA) (P < 0.0001); prolonged PWD (P = 0.0007); prolonged ERP in both LA (P < 0.0001) and right atria (RA) (P < 0.0001); reduced conduction velocity in the LA (P = 0.009) and RA (P < 0.0001); greater number (P < 0.0001) and duration (P< 0.0001) of bipoles along the CT with delayed conduction; lower atrial voltage in the LA (P < 0.0001) and RA (P < 0.0001); and more frequent electrical scar (P = 0.001) compared with controls. Five of twelve with MS and none of the controls developed AF with extra-stimulus (P = 0.02). Atrial remodelling in MS is characterized by LA enlargement, loss of myocardium, and scarring associated with widespread and site-specific conduction abnormalities and no change or an increase in ERP. These abnormalities were associated with a heightened inducibility of AF.

  1. Reduced Sodium Current in the Lateral Ventricular Wall Induces Inferolateral J-Waves.

    PubMed

    Meijborg, Veronique M F; Potse, Mark; Conrath, Chantal E; Belterman, Charly N W; De Bakker, Jacques M T; Coronel, Ruben

    2016-01-01

    J-waves in inferolateral leads are associated with a higher risk for idiopathic ventricular fibrillation. We aimed to test potential mechanisms (depolarization or repolarization dependent) responsible for inferolateral J-waves. We hypothesized that inferolateral J-waves can be caused by regional delayed activation of myocardium that is activated late during normal conditions. Computer simulations were performed to evaluate how J-point elevation is influenced by reducing sodium current conductivity (GNa), increasing transient outward current conductivity (Gto), or cellular uncoupling in three predefined ventricular regions (lateral, anterior, or septal). Two pig hearts were Langendorff-perfused with selective perfusion with a sodium channel blocker of lateral or anterior/septal regions. Volume-conducted pseudo-electrocardiograms (ECG) were recorded to detect the presence of J-waves. Epicardial unipolar electrograms were simultaneously recorded to obtain activation times (AT). Simulation data showed that conduction slowing, caused by reduced sodium current, in lateral, but not in other regions induced inferolateral J-waves. An increase in transient outward potassium current or cellular uncoupling in the lateral zone elicited slight J-point elevations which did not meet J-wave criteria. Additional conduction slowing in the entire heart attenuated J-waves and J-point elevations on the ECG, because of masking by the QRS. Experimental data confirmed that conduction slowing attributed to sodium channel blockade in the left lateral but not in the anterior/septal ventricular region induced inferolateral J-waves. J-waves coincided with the delayed activation. Reduced sodium current in the left lateral ventricular myocardium can cause inferolateral J-waves on the ECG.

  2. Roles of hippocampal subfields in verbal and visual episodic memory.

    PubMed

    Zammit, Andrea R; Ezzati, Ali; Zimmerman, Molly E; Lipton, Richard B; Lipton, Michael L; Katz, Mindy J

    2017-01-15

    Selective hippocampal (HC) subfield atrophy has been reported in older adults with mild cognitive impairment and Alzheimer's disease. The goal of this study was to investigate the associations between the volume of hippocampal subfields and visual and verbal episodic memory in cognitively normal older adults. This study was conducted on a subset of 133 participants from the Einstein Aging Study (EAS), a community-based study of non-demented older adults systematically recruited from the Bronx, N.Y. All participants completed comprehensive EAS neuropsychological assessment. Visual episodic memory was assessed using the Complex Figure Delayed Recall subtest from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Verbal episodic memory was assessed using Delayed Recall from the Free and Cued Selective Reminding Test (FCSRT). All participants underwent 3T MRI brain scanning with subsequent automatic measurement of the hemispheric hippocampal subfield volumes (CA1, CA2-CA3, CA4-dente gyrus, presubiculum, and subiculum). We used linear regressions to model the association between hippocampal subfield volumes and visual and verbal episodic memory tests while adjusting for age, sex, education, and total intracranial volume. Participants had a mean age of 78.9 (SD=5.1) and 60.2% were female. Total hippocampal volume was associated with Complex Figure Delayed Recall (β=0.31, p=0.001) and FCSRT Delayed Recall (β=0.27, p=0.007); subiculum volume was associated with Complex Figure Delayed Recall (β=0.27, p=0.002) and FCSRT Delayed Recall (β=0.24, p=0.010); CA1 was associated with Complex Figure Delayed Recall (β=0.26, p<0.002) and FCSRT Delayed Recall (β=0.20, p=0.025). Our findings confirm previous research on the specific roles of CA1 and subiculum in episodic memory. Our results suggest that hippocampal subfields have sensitive roles in the process of visual and verbal episodic memory. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. System dynamics modeling in the evaluation of delays of care in ST-segment elevation myocardial infarction patients within a tiered health system.

    PubMed

    de Andrade, Luciano; Lynch, Catherine; Carvalho, Elias; Rodrigues, Clarissa Garcia; Vissoci, João Ricardo Nickenig; Passos, Guttenberg Ferreira; Pietrobon, Ricardo; Nihei, Oscar Kenji; de Barros Carvalho, Maria Dalva

    2014-01-01

    Mortality rates amongst ST segment elevation myocardial infarction (STEMI) patients remain high, especially in developing countries. The aim of this study was to evaluate the factors related with delays in the treatment of STEMI patients to support a strategic plan toward structural and personnel modifications in a primary hospital aligning its process with international guidelines. The study was conducted in a primary hospital localized in Foz do Iguaçu, Brazil. We utilized a qualitative and quantitative integrated analysis including on-site observations, interviews, medical records analysis, Qualitative Comparative Analysis (QCA) and System Dynamics Modeling (SD). Main cause of delays were categorized into three themes: a) professional, b) equipment and c) transportation logistics. QCA analysis confirmed four main stages of delay to STEMI patient's care in relation to the 'Door-in-Door-out' time at the primary hospital. These stages and their average delays in minutes were: a) First Medical Contact (From Door-In to the first contact with the nurse and/or physician): 7 minutes; b) Electrocardiogram acquisition and review by a physician: 28 minutes; c) ECG transmission and Percutaneous Coronary Intervention Center team feedback time: 76 minutes; and d) Patient's Transfer Waiting Time: 78 minutes. SD baseline model confirmed the system's behavior with all occurring delays and the need of improvements. Moreover, after model validation and sensitivity analysis, results suggested that an overall improvement of 40% to 50% in each of these identified stages would reduce the delay. This evaluation suggests that investment in health personnel training, diminution of bureaucracy, and management of guidelines might lead to important improvements decreasing the delay of STEMI patients' care. In addition, this work provides evidence that SD modeling may highlight areas where health system managers can implement and evaluate the necessary changes in order to improve the process of care.

  4. Does Early Versus Delayed Active Range of Motion Affect Rotator Cuff Healing After Surgical Repair? A Systematic Review and Meta-analysis.

    PubMed

    Kluczynski, Melissa A; Isenburg, Maureen M; Marzo, John M; Bisson, Leslie J

    2016-03-01

    The timing of passive range of motion (ROM) after surgical repair of the rotator cuff (RC) has been shown to affect healing. However, it is unknown if early or delayed active ROM affects healing. To determine whether early versus delayed active ROM affects structural results of RC repair surgery. Systematic review and meta-analysis. A systematic review of articles published between January 2004 and April 2014 was conducted. Structural results were compared for early (<6 weeks after surgery) versus delayed (≥6 weeks after surgery) active ROM using chi-square and Fisher exact tests, as well as relative risks (RRs) and 95% CIs. The analyses were stratified by tear size and repair method. A total of 37 studies (2251 repairs) were included in the analysis, with 10 (649 repairs) in the early group and 27 (1602 repairs) in the delayed group. For tears ≤3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for transosseous plus single-row suture anchor repairs (39.7% vs 24.3%; RR, 1.63 [95% CI, 1.28-2.08]). For tears >3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for suture bridge repairs (48% vs 17.5%; RR, 2.74 [95% CI, 1.59-4.73]) and all repair methods combined (40.5% vs 26.7%; RR, 1.52 [95% CI, 1.17-1.97]). For tears >5 cm, the risk of structural tendon defect was higher in the early versus delayed group for suture bridge repairs (100% vs 16.7%; RR, 6.00 [95% CI, 1.69-21.26]). There were no statistically significant associations for tears measuring ≤1, 1-3, or 3-5 cm. Early active ROM was associated with increased risk of a structural defect for small and large RC tears, and thus might not be advisable after RC repair. © 2015 The Author(s).

  5. Cost-effectiveness of early compared to late inhaled nitric oxide therapy in near-term infants.

    PubMed

    Armstrong, Edward P; Dhanda, Rahul

    2010-12-01

    The purpose of this study was to determine the cost-effectiveness of early versus late inhaled nitric oxide (INO) therapy in neonates with hypoxic respiratory failure initially managed on conventional mechanical ventilation. A decision analytic model was created to compare the use of early INO compared to delayed INO for neonates receiving mechanical ventilation due to hypoxic respiratory failure. The perspective of the model was that of a hospital. Patients who did not respond to either early or delayed INO were assumed to have been treated with extracorporeal membrane oxygenation (ECMO). The effectiveness measure was defined as a neonate discharged alive without requiring ECMO therapy. A Monte Carlo simulation of 10,000 cases was conducted using first and second order probabilistic analysis. Direct medical costs that differed between early versus delayed INO treatment were estimated until time to hospital discharge. The proportion of successfully treated patients and costs were determined from the probabilistic sensitivity analysis. The mean (± SD) effectiveness rate for early INO was 0.75 (± 0.08) and 0.61 (± 0.09) for delayed INO. The mean hospital cost for early INO was $21,462 (± $2695) and $27,226 (± $3532) for delayed INO. In 87% of scenarios, early INO dominated delayed INO by being both more effective and less costly. The acceptability curve between products demonstrated that early INO had over a 90% probability of being the most cost-effective treatment across a wide range of willingness to pay values. This analysis indicated that early INO therapy was cost-effective in neonates with hypoxic respiratory failure requiring mechanical ventilation compared to delayed INO by reducing the probability of developing severe hypoxic respiratory failure. There was a 90% or higher probability that early INO was more cost-effective than delayed INO across a wide range of willingness to pay values in this analysis.

  6. Delays in Post-Remission Chemotherapy for Philadelphia Chromosome Negative Acute Lymphoblastic Leukemia are Associated with Inferior Outcomes in Patients who Undergo Allogeneic Transplant: an Analysis from ECOG 2993/MRC UK ALLXII

    PubMed Central

    Kumar, Anita J.; Rowe, Jacob M.; Goldstone, Anthony H; Fielding, Adele; Marks, David I; Litzow, Mark; Paietta, Elisabeth; Lazarus, Hillard M.; Tallman, Martin S.; Luger, Selina M.; Loren, Alison W.

    2016-01-01

    Adults with acute lymphoblastic leukemia (ALL) have a poorer prognosis than children due to a high risk of relapse. One explanation may be variable adherence to dose-intense chemotherapy. However, little is known about risk factors for delays in therapy and their impact on survival. We conducted an analysis of ECOG 2993/UKALLXII trial to study delays in post-remission chemotherapy in adults with newly-diagnosed ALL. Logistic regression was used to identify risk factors for a very long delay (>4 weeks, VLD) in start of intensification therapy. Cox regression was used to evaluate the impact of delays on overall and event-free survival (OS, EFS). We evaluated 1076 Philadelphia chromosome negative (Ph-) patients who completed induction chemotherapy, achieved complete remission, and started intensification. Factors independently associated with VLD included: duration of hospitalization (Odds Ratio (OR)=1.2, p<0.001) during Phase I; thrombocytopenia during Phase I (OR=1.16, p=0.004) or Phase II (OR 1.13, p=0.001); chemotherapy dose reductions during induction Phase I (OR=1.72, p<0.014); female sex (OR=1.53, p=0.010); Black (OR=3.24, p=0.003) and Asian (OR=2.26, p=0.021) race; and increasing age (OR=1.31, p<0.001). In multivariate Cox regression, patients who underwent allogeneic stem cell transplant (alloHCT) had significantly worse OS (HR 1.4, p=0.03) and EFS (HR 1.4, p=0.02) after experiencing a VLD compared to alloHCT patients who experienced <=4 weeks delay. Specific populations (female, older, Black, and Asian patients) were more likely to experience delays in chemotherapy, as were those with significant toxicity during induction. Very long delays in therapy negatively affected outcomes in patients undergoing allografting. PMID:27468137

  7. Successful strategies for improving operating room efficiency at academic institutions.

    PubMed

    Overdyk, F J; Harvey, S C; Fishman, R L; Shippey, F

    1998-04-01

    In this prospective study, we evaluated the etiology of operating room (OR) delays in an academic institution, examined the impact of multidisciplinary strategies to improve OR efficiency, and established OR timing benchmarks for use in future OR efficiency studies. OR times and delay etiologies were collected for 94 cases during the initial phase of the study. Timing data and delay etiologies were analyzed, and 2 wk of multidisciplinary OR efficiency awareness education was conducted for the nursing, surgical, and anesthesia staff. After the education period, timing data were collected from 1787 cases, and monthly reports listing individual case delays and timing data were sent to the Chiefs of Service. For the first case of the day, patient in room, anesthesia ready, surgical preparation start, and procedure start time were significantly earlier (P < 0.01) in the posteducation period compared with the preeducation period, and the procedure start time for the first case of the day occurred, on average, 22 min earlier than all other procedures. For all cases combined, turnover time decreased, on average, by 16 min. Unavailability of surgeons, anesthesiologists, and residents decreased significantly (P < 0.05) as causes of OR delays. Anesthesia induction times were consistently longer for the vascular and cardiothoracic services, whereas surgical preparation time was increased for the neurosurgical and orthopedic services (P < 0.05). Identification of the etiology of OR inefficiency, combined with multidisciplinary awareness training and personal accountability, can improve OR efficiency. The time savings realized are probably most cost-effective when combined with more flexible OR staffing and improved OR scheduling. We achieved significant improvements in operating room efficiency by analyzing operating room data on causes of delays, devising strategies for minimizing the most common delays, and subsequently measuring delay data. Personal accountability, streamlining of procedures, interdisciplinary team work, and accurate data collection were all important contributors to improved efficiency.

  8. System Dynamics Modeling in the Evaluation of Delays of Care in ST-Segment Elevation Myocardial Infarction Patients within a Tiered Health System

    PubMed Central

    de Andrade, Luciano; Lynch, Catherine; Carvalho, Elias; Rodrigues, Clarissa Garcia; Vissoci, João Ricardo Nickenig; Passos, Guttenberg Ferreira; Pietrobon, Ricardo; Nihei, Oscar Kenji; de Barros Carvalho, Maria Dalva

    2014-01-01

    Background Mortality rates amongst ST segment elevation myocardial infarction (STEMI) patients remain high, especially in developing countries. The aim of this study was to evaluate the factors related with delays in the treatment of STEMI patients to support a strategic plan toward structural and personnel modifications in a primary hospital aligning its process with international guidelines. Methods and Findings The study was conducted in a primary hospital localized in Foz do Iguaçu, Brazil. We utilized a qualitative and quantitative integrated analysis including on-site observations, interviews, medical records analysis, Qualitative Comparative Analysis (QCA) and System Dynamics Modeling (SD). Main cause of delays were categorized into three themes: a) professional, b) equipment and c) transportation logistics. QCA analysis confirmed four main stages of delay to STEMI patient’s care in relation to the ‘Door-in-Door-out’ time at the primary hospital. These stages and their average delays in minutes were: a) First Medical Contact (From Door-In to the first contact with the nurse and/or physician): 7 minutes; b) Electrocardiogram acquisition and review by a physician: 28 minutes; c) ECG transmission and Percutaneous Coronary Intervention Center team feedback time: 76 minutes; and d) Patient’s Transfer Waiting Time: 78 minutes. SD baseline model confirmed the system’s behavior with all occurring delays and the need of improvements. Moreover, after model validation and sensitivity analysis, results suggested that an overall improvement of 40% to 50% in each of these identified stages would reduce the delay. Conclusions This evaluation suggests that investment in health personnel training, diminution of bureaucracy, and management of guidelines might lead to important improvements decreasing the delay of STEMI patients’ care. In addition, this work provides evidence that SD modeling may highlight areas where health system managers can implement and evaluate the necessary changes in order to improve the process of care. PMID:25079362

  9. FDA advisory committees meet January 26 on Salk HIV-1 immunogen.

    PubMed

    1995-01-06

    Two advisory committees of the Food and Drug Administration (FDA) will meet to consider future trials of the HIV-1 immunogen developed by Dr. Jonas Salk. The Immune Response Corporation has already conducted several studies of the immunogen, and has found improvement in various immunological and other blood tests, and no adverse effects. However, the studies have not been large enough to show conclusively that the treatment has clinical benefit in delaying disease progression. The new, larger trials are intended to demonstrate a delay in disease progression and validate the use of blood-test markers of disease progression for studying an immune-based treatment.

  10. Organic solar cells: evaluation of the stability of P3HT using time-delayed degradation

    NASA Astrophysics Data System (ADS)

    Poh, Chung-How; Poh, Chung-Kiak; Bryant, Glenn; Belcher, Warwick; Dastoor, Paul

    2011-12-01

    Despite the fact that the performance of organic solar cells is generally susceptible to degradation by moisture exposure, there has been suggestion that the photoactive layer (P3HT) is surprisingly resilient. This work attempts to confirm the stability of P3HT as an organic solar cell material by deliberately introducing water into the photoactive layer. A dramatic step drop in device performance during cell characterization is observed approximately one day after the device has been fabricated. The time-delayed step drop in output efficiency strongly suggests that moisture has little effect on the P3HT conducting polymer.

  11. Pastoralism and delay in diagnosis of TB in Ethiopia

    PubMed Central

    Gele, Abdi A; Bjune, Gunnar; Abebe, Fekadu

    2009-01-01

    Background Tuberculosis (TB) is a major public health problem in the Horn of Africa with Ethiopia being the most affected where TB cases increase at the rate of 2.6% each year. One of the main contributing factors for this rise is increasing transmission due to large number of untreated patients, serving as reservoirs of the infection within the communities. Reduction of the time between onset of TB symptoms to diagnosis is therefore a prerequisite to bring the TB epidemic under control. The aim of this study was to measure duration of delay among pastoralist TB patients at TB management units in Somali Regional State (SRS) of Ethiopia. Methods A cross sectional study of 226 TB patients with pastoralist identity was conducted in SRS of Ethiopia from June to September 2007. Patients were interviewed using questionnaire based interview. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay), and the time between first visits to the professional health care provider to the date of diagnosis (medical provider's delay) were analyzed. Both pulmonary and extrapulmonary TB patients were included in the study. Result A total of 226 pastoralist TB patients were included in this study; 93 (41.2%) were nomadic pastoralists and 133 (58.8%) were agro-pastoralists. Median patient delay was found to be 60 days with range of 10–1800 days (83 days for nomadic pastoralists and 57 days for agro-pastoralists). Median health care provider's delay was 6 days and median total delay was 70 days in this study. Patient delay constituted 86% of the total delay. In multivariate logistic regression analysis, nomadic pastoralism (aOR. 2.69, CI 1.47–4.91) and having low biomedical knowledge on TB (aOR. 2.02, CI 1.02–3.98) were significantly associated with prolonged patient delay. However, the only observed risk factor for very long patient delay >120 days was distance to health facility (aOR.4.23, CI 1.32–13.54). Extra-pulmonary TB was the only observed predictor for health care providers' delay (aOR. 3.39, CI 1.68–6.83). Conclusion Patient delay observed among pastoralist TB patients in SRS is one of the highest reported so far from developing countries, exceeding two years in some patients. This long patient delay appears to be associated with patient's inadequate knowledge of the disease and distance to health care facility with nomadic pastoralists being the most affected. Regional TB control programmes need to consider the exceptional circumstances of pastoralists, to maximise their access to TB services. PMID:19128498

  12. Microwave bale moisture sensing: Field trial

    USDA-ARS?s Scientific Manuscript database

    A microwave moisture measurement technique was developed for moisture sensing of cotton bales after the bale press. The technique measures the propagation delay of a microwave signal that is transmitted through the cotton bale. This research conducted a field trial to test the sensor in a commercial...

  13. Application of Reflected Global Navigation Satellite System (GNSS-R) Signals in the Estimation of Sea Roughness Effects in Microwave Radiometry

    NASA Technical Reports Server (NTRS)

    Voo, Justin K.; Garrison, James L.; Yueh, Simon H.; Grant, Michael S.; Fore, Alexander G.; Haase, Jennifer S.; Clauss, Bryan

    2010-01-01

    In February-March 2009 NASA JPL conducted an airborne field campaign using the Passive Active L-band System (PALS) and the Ku-band Polarimetric Scatterometer (PolSCAT) collecting measurements of brightness temperature and near surface wind speeds. Flights were conducted over a region of expected high-speed winds in the Atlantic Ocean, for the purposes of algorithm development for salinity retrievals. Wind speeds encountered were in the range of 5 to 25 m/s during the two weeks deployment. The NASA-Langley GPS delay-mapping receiver (DMR) was also flown to collect GPS signals reflected from the ocean surface and generate post-correlation power vs. delay measurements. This data was used to estimate ocean surface roughness and a strong correlation with brightness temperature was found. Initial results suggest that reflected GPS signals, using small low-power instruments, will provide an additional source of data for correcting brightness temperature measurements for the purpose of sea surface salinity retrievals.

  14. Comparison study on disturbance estimation techniques in precise slow motion control

    NASA Astrophysics Data System (ADS)

    Fan, S.; Nagamune, R.; Altintas, Y.; Fan, D.; Zhang, Z.

    2010-08-01

    Precise low speed motion control is important for the industrial applications of both micro-milling machine tool feed drives and electro-optical tracking servo systems. It calls for precise position and instantaneous velocity measurement and disturbance, which involves direct drive motor force ripple, guide way friction and cutting force etc., estimation. This paper presents a comparison study on dynamic response and noise rejection performance of three existing disturbance estimation techniques, including the time-delayed estimators, the state augmented Kalman Filters and the conventional disturbance observers. The design technique essentials of these three disturbance estimators are introduced. For designing time-delayed estimators, it is proposed to substitute Kalman Filter for Luenberger state observer to improve noise suppression performance. The results show that the noise rejection performances of the state augmented Kalman Filters and the time-delayed estimators are much better than the conventional disturbance observers. These two estimators can give not only the estimation of the disturbance but also the low noise level estimations of position and instantaneous velocity. The bandwidth of the state augmented Kalman Filters is wider than the time-delayed estimators. In addition, the state augmented Kalman Filters can give unbiased estimations of the slow varying disturbance and the instantaneous velocity, while the time-delayed estimators can not. The simulation and experiment conducted on X axis of a 2.5-axis prototype micro milling machine are provided.

  15. Determinants of Patient Delay in Seeking Diagnosis and Treatment among Moroccan Women with Cervical Cancer

    PubMed Central

    Hanchi, Zaki; Bekkali, Rachid; Ahid, Samir; Mesfioui, Abdelhalem

    2016-01-01

    Introduction. This study sought to investigate potential determinants of patient delay among Moroccan women with cervical cancer. Methods. A cross-sectional study was conducted from June 2014 to June 2015 at the National Institute of Oncology in Rabat. Data were collected using questionnaire among patients with cervical cancer locally advanced or metastatic (stages IIA–IVB). Medical records were abstracted to complete clinical information. An interval longer than 90 days between discovery of initial symptoms and presentation to a provider was defined as a patient delay. Results. Four hundred and one patients with cervical cancer enrolled in this study. The mean age was 52.4 years (SD = 11.5). 53.6% were illiterate. Abnormal vaginal bleeding was identified for 65.8% of patients. 60.1% were diagnosed at stages IIA-IIB. 55.4% were found having patient delay. The regression analyses showed the association between literacy (p < 0.001), distance of the place of the first consultation (p = 0.031), abnormal vaginal bleeding as an earlier symptom (p < 0.001), stage at diagnosis (p < 0.03), knowledge of symptoms (p < 0.001), knowledge of causes (p = 0.008), and practice of gynecological exam during the last three years (p = 0.018) and the patient delay. Conclusion. Educational messages should aim at increasing awareness of cervical cancer, assisting women in symptom recognition, and encouraging earlier presentation. PMID:27882055

  16. Control of resting membrane potential by delayed rectifier potassium currents in ferret airway smooth muscle cells.

    PubMed Central

    Fleischmann, B K; Washabau, R J; Kotlikoff, M I

    1993-01-01

    1. In order to determine the physiological role of specific potassium currents in airway smooth muscle, potassium currents were measured in freshly dissociated ferret trachealis cells using the nystatin-permeabilized, whole-cell method, at 35 degrees C. 2. The magnitude of the outward currents was markedly increased as bath temperature was increased from 22 to 35 degrees C. This increase was primarily due to the increase in maximum potassium conductance (gK,max), although there was also a small leftward shift in the relationship between gK and voltage at higher temperatures. The maximum conductance and the kinetics of current activation and inactivation were also temperature dependent. At 35 degrees C, gating of the current was steeply voltage dependent between -40 and 0 mV. Current activation was well fitted by fourth-order kinetics; the mean time constants of activation (30 mV clamp step) were 1.09 +/- 0.17 and 1.96 +/- 0.27 ms at 35 and 22 degrees C, respectively. 3. Outward currents using the nystatin method were qualitatively similar to delayed rectifier currents recorded in dialysed cells with high calcium buffering capacity solutions. 4-Aminopyridine (4-AP; 2 mM), a specific blocker of delayed rectifier potassium channels in this tissue, inhibited over 80% of the outward current evoked by voltage-clamp steps to between -10 and +20 mV (n = 6). Less than 5% of the outward current was blocked over the same voltage range by charybdotoxin (100 nM; n = 15), a specific antagonist of large-conductance, calcium-activated potassium channels in this tissue. 4. The degree to which delayed rectifier and calcium-activated potassium conductances control resting membrane potential was examined in current-clamp experiments. The resting membrane potential of current clamped cells was -33.6 +/- 1.0 mV (n = 62). Application of 4-AP (2 mM) resulted in a 14.4 +/- 1.0 mV depolarization (n = 8) and an increase in input resistance. Charybdotoxin (100 nM) had no effect on resting membrane potential (n = 6). 5. Force measurements were made in isolated strips of trachealis muscle to determine the effect of pharmacological blockade of individual potassium conductances on resting tone. In the presence of tetrodotoxin (1 microM) and atropine (1 microM), 4-AP increased baseline tension in a dose-dependent manner, with an EC50 of 1.8 mM (n = 13); application of 5 mM 4-AP increased tone to 86.8 +/- 8.1% of that produced by 1 microM methacholine, and this tone was almost completely inhibited by nifedipine (1 microM).(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8271220

  17. The effects of resonances on time delay estimation for water leak detection in plastic pipes

    NASA Astrophysics Data System (ADS)

    Almeida, Fabrício C. L.; Brennan, Michael J.; Joseph, Phillip F.; Gao, Yan; Paschoalini, Amarildo T.

    2018-04-01

    In the use of acoustic correlation methods for water leak detection, sensors are placed at pipe access points either side of a suspected leak, and the peak in the cross-correlation function of the measured signals gives the time difference (delay) between the arrival times of the leak noise at the sensors. Combining this information with the speed at which the leak noise propagates along the pipe, gives an estimate for the location of the leak with respect to one of the measurement positions. It is possible for the structural dynamics of the pipe system to corrupt the time delay estimate, which results in the leak being incorrectly located. In this paper, data from test-rigs in the United Kingdom and Canada are used to demonstrate this phenomenon, and analytical models of resonators are coupled with a pipe model to replicate the experimental results. The model is then used to investigate which of the two commonly used correlation algorithms, the Basic Cross-Correlation (BCC) function or the Phase Transform (PHAT), is more robust to the undesirable structural dynamics of the pipe system. It is found that time delay estimation is highly sensitive to the frequency bandwidth over which the analysis is conducted. Moreover, it is found that the PHAT is particularly sensitive to the presence of resonances and can give an incorrect time delay estimate, whereas the BCC function is found to be much more robust, giving a consistently accurate time delay estimate for a range of dynamic conditions.

  18. Early and delayed pinhole MIBI SPECT in detecting hyperfunctioning parathyroid glands: a comparison with peroperative γ probe.

    PubMed

    Gültekin, Salih Sinan; Kir, Metin; Tuğ, Tuğbay; Demirer, Seher; Genç, Yasemin

    2011-10-01

    This study was conducted to evaluate the early and delayed pinhole MIBI single photon emission computed tomography (pSPECT) images in detecting hyperfunctioning parathyroid glands, to make a comparison with peroperative γ probe (GP) findings. Planar, early, and delayed pSPECT scans and skin in-vivo and ex-vivo GP counts were obtained in 22 patients with hyperparathyroidism. All data were analyzed statistically on the basis of localization of the lesions, using the histopathological findings as the gold standard. Histopathological examinations revealed 18 of 44 adenomas, 18 of 44 hyperplasic glands, two of 44 lymph nodules, five of 44 thyroid nodules, and one of 44 normal parathyroid glands. Sensitivity and specificity were found to be 36 and 100% for planar, 69 and 75% for early pSPECT, 86 and 88% for delayed pSPECT scans, and similarly, 78 and 75% on skin, 92 and 75% in-vivo and 83 and 100% ex-vivo GP counts, respectively. For distinction ability of GP counts between three groups of lesions, there was a statistically significant difference among the three groups for ex-vivo GP counts but not between groups of adenomas and hyperplasic lesions for in-vivo GP counts. Early and delayed pSPECT scans play a complementary role on the planar scans. Delayed pSPECT scans and in-vivo GP counts are equally valuable to localize both single and multiple hyperfunctioning parathyroid glands. Ex-vivo GP counts seem to be better for making a distinction among types of lesions.

  19. The study on achievement of motor milestones and associated factors among children in rural North India

    PubMed Central

    Gupta, Arti; Kalaivani, Mani; Gupta, Sanjeev Kumar; Rai, Sanjay K.; Nongkynrih, Baridalyne

    2016-01-01

    Background: Nearly 14% of children worldwide do not reach their developmental potential in early childhood. The early identification of delays in achieving milestones is critical. The World Health Organization (WHO) has developed normal age ranges for the achievement of motor milestones by healthy children. This study aimed to assess the gross motor developmental achievements and associated factors among children in rural India. Materials and Methods: A cross-sectional study was conducted with rural children in North India. A pretested questionnaire was used to collect the data. The median age at the time of the highest observed milestone was calculated and compared with the WHO windows of achievement. Results: Overall, 221 children aged 4–18 months were included in the study. The median age of motor development exhibited a 0.1–2.1-month delay compared to the WHO median age of motor milestone achievement. The prevalence of the gross motor milestone achievements for each of the six milestones ranged from 91.6% to 98.4%. Developmental delay was observed in 6.3% of the children. After adjusting for different variables, children with birth order of second or more were found to be significantly associated with the timely achievement of gross motor milestones. Conclusion: The apparently healthy children of the rural area of Haryana achieved gross motor milestones with some delay with respect to the WHO windows of achievement. Although the median value of this delay was low, awareness campaigns should be implemented to promote timely identification of children with development delays. PMID:27843845

  20. Theoretical Prediction of Microgravity Ignition Delay of Polymeric Fuels in Low Velocity Flows

    NASA Technical Reports Server (NTRS)

    Fernandez-Pello, A. C.; Torero, J. L.; Zhou, Y. Y.; Walther, D.; Ross, H. D.

    2001-01-01

    A new flammability apparatus and protocol, FIST (Forced Flow Ignition and Flame Spread Test), is under development. Based on the LIFT (Lateral Ignition and Flame Spread Test) protocol, FIST better reflects the environments expected in spacebased facilities. The final objective of the FIST research is to provide NASA with a test methodology that complements the existing protocol and provides a more comprehensive assessment of material flammability of practical materials for space applications. Theoretical modeling, an extensive normal gravity data bank and a few validation space experiments will support the testing methodology. The objective of the work presented here is to predict the ignition delay and critical heat flux for ignition of solid fuels in microgravity at airflow velocities below those induced in normal gravity. This is achieved through the application of a numerical model previously developed of piloted ignition of solid polymeric materials exposed to an external radiant heat flux. The model predictions will provide quantitative results about ignition of practical materials in the limiting conditions expected in space facilities. Experimental data of surface temperature histories and ignition delay obtained in the KC-135 aircraft are used to determine the critical pyrolysate mass flux for ignition and this value is subsequently used to predict the ignition delay and the critical heat flux for ignition of the material. Surface temperature and piloted ignition delay calculations for Polymethylmethacrylate (PMMA) and a Polypropylene/Fiberglass (PP/GL) composite were conducted under both reduced and normal gravity conditions. It was found that ignition delay times are significantly shorter at velocities below those induced by natural convection.

  1. Persistent Memory in Single Node Delay-Coupled Reservoir Computing.

    PubMed

    Kovac, André David; Koall, Maximilian; Pipa, Gordon; Toutounji, Hazem

    2016-01-01

    Delays are ubiquitous in biological systems, ranging from genetic regulatory networks and synaptic conductances, to predator/pray population interactions. The evidence is mounting, not only to the presence of delays as physical constraints in signal propagation speed, but also to their functional role in providing dynamical diversity to the systems that comprise them. The latter observation in biological systems inspired the recent development of a computational architecture that harnesses this dynamical diversity, by delay-coupling a single nonlinear element to itself. This architecture is a particular realization of Reservoir Computing, where stimuli are injected into the system in time rather than in space as is the case with classical recurrent neural network realizations. This architecture also exhibits an internal memory which fades in time, an important prerequisite to the functioning of any reservoir computing device. However, fading memory is also a limitation to any computation that requires persistent storage. In order to overcome this limitation, the current work introduces an extended version to the single node Delay-Coupled Reservoir, that is based on trained linear feedback. We show by numerical simulations that adding task-specific linear feedback to the single node Delay-Coupled Reservoir extends the class of solvable tasks to those that require nonfading memory. We demonstrate, through several case studies, the ability of the extended system to carry out complex nonlinear computations that depend on past information, whereas the computational power of the system with fading memory alone quickly deteriorates. Our findings provide the theoretical basis for future physical realizations of a biologically-inspired ultrafast computing device with extended functionality.

  2. Analysis of vaccination status of preschool children in Teresina (PI), Brazil.

    PubMed

    Fernandes, Ana Catharina Nunes; Gomes, Keila Rejane Oliveira; de Araújo, Telma Maria Evangelista; Moreira-Araújo, Regilda Saraiva dos Reis

    2015-01-01

    Immunization is a priority action of the Ministry of Health for contributing to reducing child mortality; however, studies show increased vaccination delays and non-vaccination. This study aims to analyze the immunization status of preschool children in Teresina - PI. Cross-sectional study involving 542 children, aged 2-6 years, enrolled in local public schools in four Municipal Childhood Education Centers selected at random, following the proportional division by regions of the city. Data were collected through a pre-coded and pre-tested form, in addition to scanning the children's vaccination card. For univariate descriptive statistical analysis, Pearson's χ2 Test and Fisher's Exact Test were used, and for multivariate analysis, multiple logistic regression was conducted using SPSS version 17.0. The study complied with the ethical aspects in accordance with current legislation. The frequency of delayed vaccination/non-vaccination was 24.9%. The average of non-administered vaccines was 1.7 (SD ± 1.2) and of delayed vaccines was 3.3 (SD ± 1.6). The binomial logistic regression model showed a significant association (p < 0.05) between young caregivers (under 24 years) and low frequency in childcare consultations with delayed vaccination/non-vaccination. There was no association with the variables related to the experience of children in the vaccination room and with the implementation of the Family Health Strategy. Ensuring and strengthening primary healthcare actions are essential tools to reduce non-vaccination and vaccine delays. Professionals who care for children in vaccination rooms need to sensitize themselves to guide and encourage parents/caregivers to meet the vaccination schedules without delays or errors.

  3. Persistent Memory in Single Node Delay-Coupled Reservoir Computing

    PubMed Central

    Pipa, Gordon; Toutounji, Hazem

    2016-01-01

    Delays are ubiquitous in biological systems, ranging from genetic regulatory networks and synaptic conductances, to predator/pray population interactions. The evidence is mounting, not only to the presence of delays as physical constraints in signal propagation speed, but also to their functional role in providing dynamical diversity to the systems that comprise them. The latter observation in biological systems inspired the recent development of a computational architecture that harnesses this dynamical diversity, by delay-coupling a single nonlinear element to itself. This architecture is a particular realization of Reservoir Computing, where stimuli are injected into the system in time rather than in space as is the case with classical recurrent neural network realizations. This architecture also exhibits an internal memory which fades in time, an important prerequisite to the functioning of any reservoir computing device. However, fading memory is also a limitation to any computation that requires persistent storage. In order to overcome this limitation, the current work introduces an extended version to the single node Delay-Coupled Reservoir, that is based on trained linear feedback. We show by numerical simulations that adding task-specific linear feedback to the single node Delay-Coupled Reservoir extends the class of solvable tasks to those that require nonfading memory. We demonstrate, through several case studies, the ability of the extended system to carry out complex nonlinear computations that depend on past information, whereas the computational power of the system with fading memory alone quickly deteriorates. Our findings provide the theoretical basis for future physical realizations of a biologically-inspired ultrafast computing device with extended functionality. PMID:27783690

  4. A position- and time-sensitive photon-counting detector with delay- line read-out

    NASA Astrophysics Data System (ADS)

    Jagutzki, Ottmar; Dangendorf, Volker; Lauck, Ronald; Czasch, Achim; Milnes, James

    2007-05-01

    We have developed image intensifier tubes with delay-anode read-out for time- and position-sensitive photon counting. The timing precision is better than 1 ns with 1000x1000 pixels position resolution and up to one megacounts/s processing rate. Large format detectors of 40 and 75 mm active diameter with internal helical-wire delay-line anodes have been produced and specified. A different type of 40 and 25 mm tubes with semi-conducting screen for image charge read-out allow for an economic and robust tube design and for placing the read-out anodes outside the sealed housing. Two types of external delay-line anodes, i.e. pick-up electrodes for the image charge, have been tested. We present tests of the detector and anode performance. Due to the low background this technique is well suited for applications with very low light intensity and especially if a precise time tagging for each photon is required. As an example we present the application of scintillator read-out in time-of-flight (TOF) neutron radiography. Further applications so far are Fluorescence Life-time Microscopy (FLIM) and Astronomy.

  5. Delay in Diagnosis and Treatment of Breast Cancer among Women Attending a Reference Service in Brazil

    PubMed

    Romeiro Lopes, Tiara Cristina; Gravena, Angela Andréia França; Demitto, Marcela de Oliveira; Borghesan, Deise Helena Pelloso; Dell`Agnolo, Cátia Millene; Brischiliari, Sheila Cristina Rocha; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa

    2017-11-26

    Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group. Creative Commons Attribution License

  6. Variable input observer for structural health monitoring of high-rate systems

    NASA Astrophysics Data System (ADS)

    Hong, Jonathan; Laflamme, Simon; Cao, Liang; Dodson, Jacob

    2017-02-01

    The development of high-rate structural health monitoring methods is intended to provide damage detection on timescales of 10 µs -10ms where speed of detection is critical to maintain structural integrity. Here, a novel Variable Input Observer (VIO) coupled with an adaptive observer is proposed as a potential solution for complex high-rate problems. The VIO is designed to adapt its input space based on real-time identification of the system's essential dynamics. By selecting appropriate time-delayed coordinates defined by both a time delay and an embedding dimension, the proper input space is chosen which allows more accurate estimations of the current state and a reduction of the convergence rate. The optimal time-delay is estimated based on mutual information, and the embedding dimension is based on false nearest neighbors. A simulation of the VIO is conducted on a two degree-of-freedom system with simulated damage. Results are compared with an adaptive Luenberger observer, a fixed time-delay observer, and a Kalman Filter. Under its preliminary design, the VIO converges significantly faster than the Luenberger and fixed observer. It performed similarly to the Kalman Filter in terms of convergence, but with greater accuracy.

  7. Patient Reported Delays in Seeking Treatment for Tuberculosis among Adult and Pediatric TB Patients and TB Patients Co-Infected with HIV in Lima, Peru: A Qualitative Study

    PubMed Central

    Paz-Soldan, Valerie A.; Alban, Rebecca E.; Dimos Jones, Christy; Powell, Amy R.; Oberhelman, Richard A.

    2014-01-01

    Introduction: Tuberculosis (TB) remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness. Objectives: The objective was to understand the complex factors that can impact TB patient health seeking behavior. Methods: In-depth interviews were conducted with adult and parents of pediatric patients receiving TB treatment (n = 43), within that group a sub-group was also co-infected with HIV (n = 11). Results: Almost all of the study participants recognized delays in seeking either their child’s or their own diagnosis of their TB symptoms. The principal reasons for treatment-seeking delays were lack of knowledge and confusion of TB symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention. Conclusion: Health promotion activities that target patient delays have the potential to improve individual patient outcomes and mitigate the spread of TB at a community level. PMID:25566523

  8. Skin testing of guinea pigs and footpad testing of mice with a new antigen for detecting delayed hypersensitivity to Cryptococcus neoformans.

    PubMed

    Murphy, J W; Gregory, J A; Larsh, H W

    1974-02-01

    This study was undertaken to evaluate the potential of a cryptococcal culture filtrate antigen, cryptococcin C184, for detecting delayed hypersensitivity in Cryptococcus neoformans-injected animals. The antigen was tested on guinea pigs which had received saline or C. neoformans and on animals sensitized to Histoplasma capsulatum, Blastomyces dermatitidis, Candida albicans, or Sporothrix schenckii. A delayed-type hypersensitivity response was elicited by cryptococcin C184 in C. neoformans-injected guinea pigs, whereas no indurations or erythemas were seen at 48 h after skin testing of saline controls or heterologously sensitized guinea pigs. Besides being specific for Cryptococcus, the antigen showed a high degree of sensitivity and was reproducible. Footpad tests were conducted with the antigen on mice which had previously received either 10(5) viable C. neoformans cells or saline. Delayed hypersensitivity was indicated in the C. neoformans-injected mice by the increase in thickness of antigen-injected footpads when compared with the saline-injected footpads. In control mice, antigen- and saline-injected footpads were comparable in thickness 24 h after injection. Mice sensitized to B. dermatitidis were footpad tested with C184, and no cross-reactivity was demonstrated.

  9. Measurement method for determining the magnetic hysteresis effects of reluctance actuators by evaluation of the force and flux variation.

    PubMed

    Vrijsen, N H; Jansen, J W; Compter, J C; Lomonova, E A

    2013-07-01

    A measurement method is presented which identifies the magnetic hysteresis effects present in the force of linear reluctance actuators. The measurement method is applied to determine the magnetic hysteresis in the force of an E-core reluctance actuator, with and without pre-biasing permanent magnet. The force measurements are conducted with a piezoelectric load cell (Kistler type 9272). This high-bandwidth force measurement instrument is identified in the frequency domain using a voice-coil actuator that has negligible magnetic hysteresis and eddy currents. Specifically, the phase delay between the current and force of the voice-coil actuator is used for the calibration of the measurement instrument. This phase delay is also obtained by evaluation of the measured force and flux variation in the E-core actuator, both with and without permanent magnet on the middle tooth. The measured magnetic flux variation is used to distinguish the phase delay due to magnetic hysteresis from the measured phase delay between the current and the force of the E-core actuator. Finally, an open loop steady-state ac model is presented that predicts the magnetic hysteresis effects in the force of the E-core actuator.

  10. Air pollution is associated with brainstem auditory nuclei pathology and delayed brainstem auditory evoked potentials.

    PubMed

    Calderón-Garcidueñas, Lilian; D'Angiulli, Amedeo; Kulesza, Randy J; Torres-Jardón, Ricardo; Osnaya, Norma; Romero, Lina; Keefe, Sheyla; Herritt, Lou; Brooks, Diane M; Avila-Ramirez, Jose; Delgado-Chávez, Ricardo; Medina-Cortina, Humberto; González-González, Luis Oscar

    2011-06-01

    We assessed brainstem inflammation in children exposed to air pollutants by comparing brainstem auditory evoked potentials (BAEPs) and blood inflammatory markers in children age 96.3±8.5 months from highly polluted (n=34) versus a low polluted city (n=17). The brainstems of nine children with accidental deaths were also examined. Children from the highly polluted environment had significant delays in wave III (t(50)=17.038; p<0.0001) and wave V (t(50)=19.730; p<0.0001) but no delay in wave I (p=0.548). They also had significantly longer latencies than controls for interwave intervals I-III, III-V, and I-V (all t(50)>7.501; p<0.0001), consisting with delayed central conduction time of brainstem neural transmission. Highly exposed children showed significant evidence of inflammatory markers and their auditory and vestibular nuclei accumulated α synuclein and/or β amyloid(1-42). Medial superior olive neurons, critically involved in BAEPs, displayed significant pathology. Children's exposure to urban air pollution increases their risk for auditory and vestibular impairment. Copyright © 2011 ISDN. Published by Elsevier Ltd. All rights reserved.

  11. Effects of cockpit lateral stick characteristics on handling qualities and pilot dynamics

    NASA Technical Reports Server (NTRS)

    Mitchell, David G.; Aponso, Bimal L.; Klyde, David H.

    1992-01-01

    This report presents the results of analysis of cockpit lateral control feel-system studies. Variations in feel-system natural frequency, damping, and command sensing reference (force and position) were investigated, in combination with variations in the aircraft response characteristics. The primary data for the report were obtained from a flight investigation conducted with a variable-stability airplane, with additional information taken from other flight experiments and ground-based simulations for both airplanes and helicopters . The study consisted of analysis of handling qualities ratings and extraction of open-loop, pilot-vehicle describing functions from sum-of-sines tracking data, including, for a limited subset of these data, the development of pilot models. The study confirms the findings of other investigators that the effects on pilot opinion of cockpit feel-system dynamics are not equivalent to a comparable level of added time delay, and until a more comprehensive set of criteria are developed, it is recommended that feel-system dynamics be considered a delay-inducing element in the aircraft response. The best correlation with time-delay requirements was found when the feel-system dynamics were included in the delay measurements, regardless of the command reference. This is a radical departure from past approaches.

  12. Effect of the glucocorticoid receptor antagonist Org 34850 on fast and delayed feedback of corticosterone release.

    PubMed

    Spiga, Francesca; Harrison, Louise R; Wood, Susan A; MacSweeney, Cliona P; Thomson, Fiona J; Craighead, Mark; Grassie, Morag; Lightman, Stafford L

    2008-02-01

    We investigated the effect of the glucocorticoid receptor (GR) antagonist Org 34850 on fast and delayed inhibition of corticosterone secretion in response to the synthetic glucocorticoid methylprednisolone (MPL). Male rats were implanted with a catheter in the right jugular vein, for blood sampling and MPL administration, and with an s.c. cannula for Org 34850 administration. All experiments were conducted at the diurnal hormonal peak in the late afternoon. Rats were connected to an automated sampling system and blood samples were collected every 5 or 10 min. Org 34850 (10 mg/kg, s.c.) or vehicle (5% mulgofen in saline) was injected at 1630 h; 30 min later, rats received an injection of MPL (500 microg/rat, i.v.) or saline (0.1 ml/rat). We found that an acute administration of MPL rapidly decreased the basal corticosterone secretion and this effect was not prevented by acute pretreatment with Org 34850. However, blockade of GR with Org 34850 prevented delayed inhibition of MPL on corticosterone secretion measured between 4 and 12 h after MPL administration. Our data suggest an involvement of GR in modulating delayed, but not fast, inhibition induced by MPL on basal corticosterone secretion.

  13. Developmental delay in the Amazon: The social determinants and prevalence among rural communities in Peru

    PubMed Central

    Alnasser, Yossef

    2017-01-01

    The consequences of poor child development are becoming increasingly recognized. Programs are being put in place around the world to improve child development by providing healthy and stimulating environments for children. However, these programs often have limited reach and little is known about the prevalence of developmental delay in under-developed communities. The current study set-out to better understand the prevalence of developmental delay in rural communities in the Amazon region of Peru. Also, it explores social determinants that are associated with any delay. Cross-sectional study by evaluating developmental delay in children under 4 years utilizing Ages and Stages Questionnaire (ASQ-3). Additionally, conducting a social determinants questionnaire answered by caretakers to identify social drivers for developmental delay. The data was analyzed with multi-variant analysis to measure association. The prevalence of developmental delay in the Amazonian communities was 26.7% (19.3% in communication, 11.4% in gross motor skills, 8% in both) (N = 596). The multivariate logistic regression analysis revealed significant associations between developmental delay and; level of education (OR 0.64, p = 0.009), age of mother during child’s birth (OR 0.96, p = 0.002), visits by community health agents (OR 0.73, p = 0.013), and river as primary water source (OR 2.39, p = 0.001). The social determinants questionnaire revealed that 39% of the mothers had their first child before the age of 17, nearly half stopped going to school before the age of 12 (52%), 29% gave birth at home, 13% breast fed for less than 7 months, and 50% of the children had diarrhea in the last month. There is still a great need to improve the conditions for child development in the Amazon region of Peru. One-fourth of the children suffer from developmental delay, which will likely impede their potentials for life unless something is done. The impact of education, age of mother at birth of the child, community health agents, and access to clean drinking water were important findings. Improvements can be made in these areas to create a large, cost-effective impact on the well-being of the communities. PMID:29023517

  14. Developmental delay in the Amazon: The social determinants and prevalence among rural communities in Peru.

    PubMed

    Westgard, Christopher; Alnasser, Yossef

    2017-01-01

    The consequences of poor child development are becoming increasingly recognized. Programs are being put in place around the world to improve child development by providing healthy and stimulating environments for children. However, these programs often have limited reach and little is known about the prevalence of developmental delay in under-developed communities. The current study set-out to better understand the prevalence of developmental delay in rural communities in the Amazon region of Peru. Also, it explores social determinants that are associated with any delay. Cross-sectional study by evaluating developmental delay in children under 4 years utilizing Ages and Stages Questionnaire (ASQ-3). Additionally, conducting a social determinants questionnaire answered by caretakers to identify social drivers for developmental delay. The data was analyzed with multi-variant analysis to measure association. The prevalence of developmental delay in the Amazonian communities was 26.7% (19.3% in communication, 11.4% in gross motor skills, 8% in both) (N = 596). The multivariate logistic regression analysis revealed significant associations between developmental delay and; level of education (OR 0.64, p = 0.009), age of mother during child's birth (OR 0.96, p = 0.002), visits by community health agents (OR 0.73, p = 0.013), and river as primary water source (OR 2.39, p = 0.001). The social determinants questionnaire revealed that 39% of the mothers had their first child before the age of 17, nearly half stopped going to school before the age of 12 (52%), 29% gave birth at home, 13% breast fed for less than 7 months, and 50% of the children had diarrhea in the last month. There is still a great need to improve the conditions for child development in the Amazon region of Peru. One-fourth of the children suffer from developmental delay, which will likely impede their potentials for life unless something is done. The impact of education, age of mother at birth of the child, community health agents, and access to clean drinking water were important findings. Improvements can be made in these areas to create a large, cost-effective impact on the well-being of the communities.

  15. Early Versus Delayed Passive Range of Motion After Rotator Cuff Repair: A Systematic Review and Meta-analysis.

    PubMed

    Kluczynski, Melissa A; Nayyar, Samir; Marzo, John M; Bisson, Leslie J

    2015-08-01

    Postoperative rehabilitation has been shown to affect healing of the rotator cuff after surgical repair. However, it is unknown whether an early or delayed rehabilitation protocol is most beneficial for healing. To determine whether early versus delayed passive range of motion (PROM) affects rotator cuff (RC) retear rates after surgery. Systematic review and meta-analysis. A systematic review of the literature published between January 2003 and February 2014 was conducted. Retear rates were compared for early (within 1 week after surgery) versus delayed (3-6 weeks after surgery) PROM using χ(2) or Fisher exact tests as well as relative risks (RR) and 95% CIs. In the first analysis, data from evidence level 1 studies that directly compared early versus delayed PROM were pooled; and in the second analysis, data from level 1 to 4 studies that did not directly compare early versus delayed PROM were pooled. The second analysis was stratified by tear size and repair method. Twenty-eight studies (1729 repairs) were included. The first analysis of level 1 studies did not reveal a significant difference in retear rates for early (13.7%) versus delayed (10.5%) PROM (P = .36; RR = 1.30 [95% CI, 0.74-2.30]). The second analysis revealed that for ≤3 cm tears, the risk of retear was lower for early versus delayed PROM for transosseous (TO) plus single-row anchor (SA) repairs (18.7% vs 28.2%, P = .02; RR = 0.66 [95% CI, 0.47-0.95]). For >5 cm tears, the risk of retear was greater for early versus delayed PROM for double-row anchor (DA) repairs (56.4% vs 20%, P = .002; RR = 2.82 [95% CI, 1.31-6.07]) and for all repair methods combined (52.2% vs 22.6%, P = .01; RR = 2.31 [95% CI, 1.16-4.61]). There were no statistically significant associations for tears measuring <1 cm, 1 to 3 cm, 3 to 5 cm, and >3 cm. Evidence is lacking with regard to the optimal timing of PROM after RC repair; however, this study suggests that tear size may be influential. © 2014 The Author(s).

  16. Determinants of delayed care seeking for TB suggestive symptoms in Seru district, Oromiya region, Ethiopia: a community based unmatched case-control study.

    PubMed

    Yirgu, Robel; Lemessa, Firaol; Hirpa, Selamawit; Alemayehu, Abraham; Klinkenberg, Eveline

    2017-04-20

    Early tuberculosis (TB) case finding and adequate chemotherapy are essential for interrupting disease transmission and preventing complications due to delayed care seeking. This study was undertaken in order to provide insights into the magnitude and determinants of patient delay. The study was conducted in rural Seru district, employing a population based unmatched case-control study design. The WHO standardized TB screening tool was used to identify presumptive TB cases among the district population ages > 15 years. Presumptive TB cases who sought care in a health facility more than 14 days after the onset of symptoms were considered cases while those who sought care within the first 14 days were classified as controls. A structured interview questionnaire was used to capture socio demographic characteristics and health care service utilization related data from the study participants. A multiple binary logistic regression model was used to identify any factor associated with patient care seeking delay. A total of 9,782 individuals were screened, of which 980 (10%, 95% CI; 9.4-10.5%) presumptive TB cases were identified. From these cases 358 (76%, 95% CI; 75.6%-76.4%) sought care within the first 14 days of the onset of symptoms with a median patient delay of 15 days, IQR (5-30 days). The most common TB suggestive symptom mentioned by the participants was night sweat 754 (76.4%) while the least common was a history of contact with a confirmed TB case in the past one year 207 (21.1%). Individuals in the 45-54 age range had lower odds of delay (AOR 0.31, 95%CI 0.15, 0.61) as compared to those 15-24 years old. First TB treatment episode (AOR16.2, 95% CI 9.94, 26.26) and limited access to either traditional or modern modes of transportation (AOR 2.62, 95% CI 1.25, 5.49) were independently associated with patient care delay. Increasing community awareness about the risks of delayed care seeking and the importance of accessing health services close to the community can help decrease patient care delay.

  17. Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens.

    PubMed

    Jat, Tej Ram; Deo, Prakash R; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

    2015-01-01

    Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in maternal health programmes could contribute positively in eliminating avertable maternal deaths. This study was conducted to explore socio-cultural and service delivery-related dimensions of maternal deaths in rural central India using a human rights lens. Social autopsies were conducted for 22 maternal deaths during 2011 in Khargone district in central India. The data were analysed using thematic analysis. The factors associated with maternal deaths were classified by using the 'three delays' framework and were examined by using a human rights lens. All 22 women tried to access medical assistance, but various factors delayed their access to appropriate care. The underestimation of the severity of complications by family members, gender inequity, and perceptions of low-quality delivery services delayed decisions to seek care. Transportation problems and care seeking at multiple facilities delayed reaching appropriate health facilities. Negligence by health staff and unavailability of blood and emergency obstetric care services delayed receiving adequate care after reaching a health facility. The study highlighted various socio-cultural and service delivery-related factors which are violating women's human rights and resulting in maternal deaths in rural central India. This study highlights that, despite the health system's conscious effort to improve maternal health, normative elements of a human rights approach to maternal health (i.e. availability, accessibility, acceptability, and quality of maternal health services) were not upheld. The data and analysis suggest that the deceased women and their relatives were unable to claim their entitlements and that the duty bearers were not successful in meeting their obligations. Based on the findings of our study, we conclude that to prevent maternal deaths, further concentrated efforts are required for better community education, women's empowerment, and health systems strengthening to provide appropriate and timely services, including emergency obstetric care, with good quality.

  18. Interrupted Visual Searches Reveal Volatile Search Memory

    ERIC Educational Resources Information Center

    Shen, Y. Jeremy; Jiang, Yuhong V.

    2006-01-01

    This study investigated memory from interrupted visual searches. Participants conducted a change detection search task on polygons overlaid on scenes. Search was interrupted by various disruptions, including unfilled delay, passive viewing of other scenes, and additional search on new displays. Results showed that performance was unaffected by…

  19. Computer Simulations and Clear Observations Do Not Guarantee Conceptual Understanding

    ERIC Educational Resources Information Center

    Renken, Maggie D.; Nunez, Narina

    2013-01-01

    Evidence for cognitive benefits of simulated versus physical experiments is unclear. Seventh grade participants (n = 147) reported their understanding of two simple pendulum problems (1) before conducting an experiment, (2) immediately following experimentation, and (3) after a 12-week delay. "Problem type" was manipulated within…

  20. Evaluation of an adaptive traffic signal system : route 291 in Lee's Summit, Missouri.

    DOT National Transportation Integrated Search

    2010-03-01

    An adaptive traffic signal system was installed on a 12-signal, 2.5-mi arterial in Lees Summit, Missouri in the Spring : of 2008. An evaluation of travel time, delay, number of stops, fuel consumption, and emissions was conducted, which : compared...

  1. Immediate Postsession Feeding Reduces Operant Responding in Rats

    ERIC Educational Resources Information Center

    Smethells, John R.; Fox, Andrew T.; Andrews, Jennifer J.; Reilly, Mark P.

    2012-01-01

    Three experiments investigated the effects of immediate and delayed postsession feeding on progressive-ratio and variable-interval schedule performance in rats. During Experiments 1 and 2, immediate postsession feeding decreased the breakpoint, or largest completed ratio, under progressive-ratio schedules. Experiment 3 was conducted to extend the…

  2. Correlation of Mechanical Properties in Bulk Metallic Glasses with 27Al NMR Characteristics

    DTIC Science & Technology

    2011-12-01

    recycle delay of 300 ms. Magnetization measurements were conducted at room temperature using a Quantum Design SQUID magne- tometer. The magnetization of...Gangopadhyay A K, et al. First X-ray scattering studies on electrostatically levitated metallic liquids: Demonstrated influence of local icosahedral

  3. Life in the Transition Economies.

    ERIC Educational Resources Information Center

    Lopus, Jane

    1998-01-01

    Reports on interviews conducted with Ukrainian teachers who were asked whether they and others they know are better, or worse, off since Ukrainian independence. Addresses inflation, private enterprise, delayed salaries, and new freedoms. Provides insights into the effects of the transition on people's lives and hopes for the future. (DSK)

  4. An Annotated Bibliography of Hypobaric Decompression Sickness Research Conducted at the Crew Technology Division, USAF School of Aerospace Medicine, Brooks AFB, Texas from 1983 to 1988

    DTIC Science & Technology

    1990-06-01

    AN ANNOTATED BIBLIOGRAPHY OF HYPOBARIC DECOMPRESSION SICKNESS RESEARCH CONDUCTED AT THE CREW TECHNOLOGY DIVISION, USAF SCHOOL OF AEROSPACE MEDICINE...190 man-flights to four selected altitudes (30000, 27500, 25000, and 22500 ft pressure equivalent) in a hypobaric chamber. The subjects’ ages ranged...conditions and two of these developed delayed sy~rtcms. Three of these five subjects underwent hyperbaric oxygen treatment. Conclusion. Female subjects

  5. Haystack Observatory VLBI Correlator

    NASA Technical Reports Server (NTRS)

    Titus, Mike; Cappallo, Roger; Corey, Brian; Dudevoir, Kevin; Niell, Arthur; Whitney, Alan

    2013-01-01

    This report summarizes the activities of the Haystack Correlator during 2012. Highlights include finding a solution to the DiFX InfiniBand timeout problem and other DiFX software development, conducting a DBE comparison test following the First International VLBI Technology Workshop, conducting a Mark IV and DiFX correlator comparison, more broadband delay experiments, more u- VLBI Galactic Center observations, and conversion of RDV session processing to the Mark IV/HOPS path. Non-real-time e-VLBI transfers and engineering support of other correlators continued.

  6. ONE SHAKE GATE FORMER

    DOEpatents

    Kalibjian, R.; Perez-Mendez, V.

    1957-08-20

    An improved circuit for forming square pulses having substantially short and precise durations is described. The gate forming circuit incorporates a secondary emission R. F. pentode adapted to receive input trigger pulses amd having a positive feedback loop comnected from the dynode to the control grid to maintain conduction in response to trigger pulses. A short circuited pulse delay line is employed to precisely control the conducting time of the tube and a circuit for squelching spurious oscillations is provided in the feedback loop.

  7. Computational modelling of internally cooled wet (ICW) electrodes for radiofrequency ablation: impact of rehydration, thermal convection and electrical conductivity.

    PubMed

    Trujillo, Macarena; Bon, Jose; Berjano, Enrique

    2017-09-01

    (1) To analyse rehydration, thermal convection and increased electrical conductivity as the three phenomena which distinguish the performance of internally cooled electrodes (IC) and internally cooled wet (ICW) electrodes during radiofrequency ablation (RFA), (2) Implement a RFA computer model with an ICW which includes these phenomena and (3) Assess their relative influence on the thermal and electrical tissue response and on the coagulation zone size. A 12-min RFA in liver was modelled using an ICW electrode (17 G, 3 cm tip) by an impedance-control pulsing protocol with a constant current of 1.5 A. A model of an IC electrode was used to compare the ICW electrode performance and the computational results with the experimental results. Rehydration and increased electrical conductivity were responsible for an increase in coagulation zone size and a delay (or absence) in the occurrence of abrupt increases in electrical impedance (roll-off). While the increased electrical conductivity had a remarkable effect on enlarging the coagulation zone (an increase of 0.74 cm for differences in electrical conductivity of 0.31 S/m), rehydration considerably affected the delay in roll-off, which, in fact, was absent with a sufficiently high rehydration level. In contrast, thermal convection had an insignificant effect for the flow rates considered (0.05 and 1 mL/min). Computer results suggest that rehydration and increased electrical conductivity were mainly responsible for the absence of roll-off and increased size of the coagulation zone, respectively, and in combination allow the thermal and electrical performance of ICW electrodes to be modelled during RFA.

  8. Delayed Carcass Deboning Results in Significantly Reduced Cook Yields of Boneless Skinless Chicken Thighs

    USDA-ARS?s Scientific Manuscript database

    Boneless skinless chicken thighs are a new deboned poultry product in the retail market. Three trials were conducted to investigate the effect of postmortem carcass deboning time on the cook yields of boneless skinless chicken thighs as well as boneless skinless chicken breasts. Broiler carcasses ...

  9. Efficacy improvement of a bioherbicidal fungus using a formulation-based approach

    USDA-ARS?s Scientific Manuscript database

    Greenhouse experiments were conducted to determine the effects of an invert (water - in - oil) emulsion (IE) on dew period duration and dew delay of Colletotrichum coccodes for biocontrol of the problematic weed, eastern black nightshade (Solanum ptycanthum). Dew periods of 4, 8, or 12 h provided ...

  10. Magnetically excited flexural plate wave apparatus

    DOEpatents

    Martin, Stephen J.; Butler, Michael A.; Frye, Gregory C.; Smith, James H.

    1998-01-01

    A non-piezoelectric flexural plate wave apparatus having meander-line transducers mounted on a non-piezoelectric membrane. A static magnetic field is directed perpendicularly to the conductive legs of the transducers in the plane of the membrane. Single-port, two-port, resonant, non-resonant, eigenmode, and delay-line modes may be employed.

  11. Swithchgrass biomass quality as affected by nitrogen rate, harvest time and storage

    USDA-ARS?s Scientific Manuscript database

    The main purpose of this study was to assess the sustainability of switchgrass biomass quality as affected by storage after harvesting, delaying the harvest time, and applying different rates of nitrogen (N). The present study was conducted at Bristol, South Dakota under switchgrass land previously ...

  12. 12 CFR 509.5 - Authority of the administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... administrative law judge shall have all powers necessary to conduct a proceeding in a fair and impartial manner and to avoid unnecessary delay. (b) Powers. The administrative law judge shall have all powers... following powers: (1) To administer oaths and affirmations; (2) To issue subpoenas, subpoenas duces tecum...

  13. 77 FR 61513 - Voluntary Licensing of Amateur Rocket Operations; Correction; Delay of Effective Date

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ...-0318; Notice No. 400-4] RIN 2120-AK16 Voluntary Licensing of Amateur Rocket Operations; Correction... allow launch operators that conduct certain amateur rocket launches an opportunity to voluntarily apply... final rule entitled, ``Voluntary Licensing of Amateur Rocket Operations'' (77 FR 50584). In this rule...

  14. Children's Recall and Recognition of Sex Role Stereotyped and Discrepant Information.

    ERIC Educational Resources Information Center

    Trepanier-Street, Mary L.; Kropp, Jerri Jaudon

    Two studies were conducted to investigate the influence of differing levels of sex role stereotyped and discrepant information on the immediate and delayed memory of young children. Specifically, kindergarten and 2nd-grade children's recall and recognition of stereotyped, moderately discrepant, and highly discrepant pictures were compared. In…

  15. A Systematic Review of Part C Early Identification Studies

    ERIC Educational Resources Information Center

    Barger, Brian; Rice, Catherine; Simmons, Christina Anne; Wolf, Rebecca

    2018-01-01

    Authors conducted a systematic literature review on early identification steps leading at-risk young children to connect with Part C services. Authors classified data collection settings as primary (settings for general population) or specialized (settings for children at risk of developmental delay) and according to the phases of early…

  16. Real-time estimation of transit OD patterns and delays using low cost-ubiquitous advanced technologies.

    DOT National Transportation Integrated Search

    2017-04-01

    The main objective of this project is to develop and conduct limited testing of novel sensors using Bluetooth technology : (BT) to estimate OD demands and station wait times for users of public transit stations. The NYU research team tested the : fea...

  17. Analysis of Dependencies and Impacts of Metroplex Operations

    NASA Technical Reports Server (NTRS)

    DeLaurentis, Daniel A.; Ayyalasomayajula, Sricharan

    2010-01-01

    This report documents research performed by Purdue University under subcontract to the George Mason University (GMU) for the Metroplex Operations effort sponsored by NASA's Airportal Project. Purdue University conducted two tasks in support of the larger efforts led by GMU: a) a literature review on metroplex operations followed by identification and analysis of metroplex dependencies, and b) the analysis of impacts of metroplex operations on the larger U.S. domestic airline service network. The tasks are linked in that the ultimate goal is an understanding of the role of dependencies among airports in a metroplex in causing delays both locally and network-wide. The Purdue team has formulated a system-of-systems framework to analyze metroplex dependencies (including simple metrics to quantify them) and develop compact models to predict delays based on network structure. These metrics and models were developed to provide insights for planners to formulate tailored policies and operational strategies that streamline metroplex operations and mitigate delays and congestion.

  18. General Relativistic Theory of the VLBI Time Delay in the Gravitational Field of Moving Bodies

    NASA Technical Reports Server (NTRS)

    Kopeikin, Sergei

    2003-01-01

    The general relativistic theory of the gravitational VLBI experiment conducted on September 8, 2002 by Fomalont and Kopeikin is explained. Equations of radio waves (light) propagating from the quasar to the observer are integrated in the time-dependent gravitational field of the solar system by making use of either retarded or advanced solutions of the Einstein field equations. This mathematical technique separates explicitly the effects associated with the propagation of gravity from those associated with light in the integral expression for the relativistic VLBI time delay of light. We prove that the relativistic correction to the Shapiro time delay, discovered by Kopeikin (ApJ, 556, L1, 2001), changes sign if one retains direction of the light propagation but replaces the retarded for the advanced solution of the Einstein equations. Hence, this correction is associated with the propagation of gravity. The VLBI observation measured its speed, and that the retarded solution is the correct one.

  19. Experimental investigations on characteristics of boundary layer and control of transition on an airfoil by AC-DBD

    NASA Astrophysics Data System (ADS)

    Geng, Xi; Shi, Zhiwei; Cheng, Keming; Dong, Hao; Zhao, Qun; Chen, Sinuo

    2018-03-01

    Plasma-based flow control is one of the most promising techniques for aerodynamic problems, such as delaying the boundary layer transition. The boundary layer’s characteristics induced by AC-DBD plasma actuators and applied by the actuators to delay the boundary layer transition on airfoil at Ma = 0.3 were experimentally investigated. The PIV measurement was used to study the boundary layer’s characteristics induced by the plasma actuators. The measurement plane, which was parallel to the surface of the actuators and 1 mm above the surface, was involved in the test, including the perpendicular plane. The instantaneous results showed that the induced flow field consisted of many small size unsteady vortices which were eliminated by the time average. The subsequent oil-film interferometry skin friction measurement was conducted on a NASA SC(2)-0712 airfoil at Ma = 0.3. The coefficient of skin friction demonstrates that the plasma actuators successfully delay the boundary layer transition and the efficiency is better at higher driven voltage.

  20. Injection order effects on efficacy of calcium chloride and sodium tripolyphosphate in controlling the pink color defect in uncured, intact turkey breast.

    PubMed

    Claus, James R; Sawyer, Christopher A; Vogel, Kurt D

    2010-04-01

    An experiment was conducted to test sequential injection of sodium tripolyphosphate (STP; 0.5% meat weight basis, mwb) followed by injection with or without addition of calcium chloride (CaCl(2), 500 ppm mwb), and to test the effect of post-injection delay prior to cooking. A second experiment evaluated the impact of injection order and delay time between independent addition of CaCl(2) (500 ppm mwb) and STP (0.5% mwb). Turkey was formulated without an added pink generating ligand (NONE), with nicotinamide (NIC; 0.1% mwb), or with sodium nitrite (NIT; 10 ppm mwb). A white colloid was observed in the extracellular space of treatments containing both STP and CaCl(2.) Addition of CaCl(2) decreased nitrosylhemochrome but did not reduce levels of nicotinamide hemochrome or CIE a(*) values. Injection order or delay between injections did not contribute to controlling the pink defect in cooked, intact turkey breast. Published by Elsevier Ltd.

  1. Material Targets for Scaling All-Spin Logic

    NASA Astrophysics Data System (ADS)

    Manipatruni, Sasikanth; Nikonov, Dmitri E.; Young, Ian A.

    2016-01-01

    All-spin-logic devices are promising candidates to augment and complement beyond-CMOS integrated circuit computing due to nonvolatility, ultralow operating voltages, higher logical efficiency, and high density integration. However, the path to reach lower energy-delay product performance compared to CMOS transistors currently is not clear. We show that scaling and engineering the nanoscale magnetic materials and interfaces is the key to realizing spin-logic devices that can surpass the energy-delay performance of CMOS transistors. With validated stochastic nanomagnetic and vector spin-transport numerical models, we derive the target material and interface properties for the nanomagnets and channels. We identify promising directions for material engineering and discovery focusing on the systematic scaling of magnetic anisotropy (Hk ) and saturation magnetization (Ms ), the use of perpendicular magnetic anisotropy, and the interface spin-mixing conductance of the ferromagnet-spin-channel interface (Gmix ). We provide systematic targets for scaling a spin-logic energy-delay product toward 2 aJ ns, comprehending the stochastic noise for nanomagnets.

  2. Change or Durability? The Contribution of Metaconceptual Awareness in Preservice Early Childhood Teachers' Learning of Science Concepts

    NASA Astrophysics Data System (ADS)

    Saçkes, Mesut; Trundle, Kathy Cabe

    2017-06-01

    This longitudinal study examined the role of metaconceptual awareness in the change and the durability of preservice teachers' conceptual understandings over the course of several months. Sixteen preservice early childhood teachers participated in the study. Semi-structured interviews were conducted to reveal the participants' conceptual understandings of lunar phases (pre, post, and delayed-post) and level of metaconceptual awareness (delayed-post only). Based on the change and stability in participants' conceptual understandings from pre to post and from post to delayed-post interviews, participants' conceptual understandings were assigned into three groups that described the profile of their long-term conceptual understandings: " decay or stability", " continuous growth", and " growth and stability". The results indicated that participants in the " continuous growth" and " growth and stability" groups had significantly higher metaconceptual awareness scores than participants in the " decay or stability" group. The results provided evidence that metaconceptual awareness plays a more decisive role in the restructuring of conceptual understandings than the durability of conceptual understandings.

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

    Kumar, Kamal; Zhang, Yu; Sung, Chi -Jen

    We study the influence of blending n-butanol on the ignition delay times of n-heptane and iso-octane, the primary reference fuels for gasoline. The ignition delay times are measured using a rapid compression machine, with an emphasis on the low-to-intermediate temperature conditions. The experiments are conducted at equivalence ratios of 0.4 and 1.0, for a compressed pressure of 20 bar, with the temperatures at the end of compression ranging from 613 K to 979 K. The effect of n-butanol addition on the development of the two-stage ignition characteristics for the two primary reference fuels is also examined. The experimental results aremore » compared to predictions obtained using a detailed chemical kinetic mechanism, which has been obtained by a systematic merger of previously reported base models for the combustion of the individual fuel constituents. In conclusion, a sensitivity analysis on the base, and the merged models, is also performed to understand the dependence of autoignition delay times on the model parameters.« less

  4. Twins and virtual twins: Do genetic (as well as experiential) factors affect developmental risks?

    PubMed

    Segal, Nancy L; Tan, Tony Xing; Graham, Jamie L

    2015-08-01

    Factors underlying developmental delays and psychosocial risks are of interest to international adoption communities. The current study administered a Pre-Adoption Adversity (PAA) Questionnaire to mostly American parents raising (a) adopted Chinese twins or (b) same-age unrelated adopted siblings. A goal was to replicate earlier analyses of pre-adoption adversity/adjustment among adopted preschool-age Chinese girls. A second goal was to conduct genetic analyses of four content areas (Developmental Delays at Adoption, Initial Adaptation to Adoption, Crying/Clinging, and Refusal/Avoidance) derived from the PAA Questionnaire. A key finding was that age at adoption added less than other predictors to adoptees' externalizing and internalizing behaviors. Family factors (e.g., parental education) contributed significantly to behavioral outcomes among the adopted Chinese twins. Genetic effects were indicated for all four content areas, with shared environmental effects evident for Developmental Delays at Adoption and Crying/Clinging. Future investigators should consider incorporating genetically sensitive designs into developmental research programs. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. HLW system plan - revision 2

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

    Not Available

    1994-01-14

    The projected ability of the Tank Farm to support DWPF startup and continued operation has diminished somewhat since revision 1 of this Plan. The 13 month delay in DWPF startup, which actually helps the Tank Farm condition in the near term, was more than offset by the 9 month delay in ITP startup, the delay in the Evaporator startups and the reduction to Waste Removal funding. This Plan does, however, describe a viable operating strategy for the success of the HLW System and Mission, albeit with less contingency and operating flexibility than in the past. HLWM has focused resources frommore » within the division on five near term programs: The three evaporator restarts, DWPF melter heatup and completion of the ITP outage. The 1H Evaporator was restarted 12/28/93 after a 9 month shutdown for an extensive Conduct of Operations upgrade. The 2F and 2H Evaporators are scheduled to restart 3/94 and 4/94, respectively. The RHLWE startup remains 11/17/97.« less

  6. A framework to preserve the privacy of electronic health data streams.

    PubMed

    Kim, Soohyung; Sung, Min Kyoung; Chung, Yon Dohn

    2014-08-01

    The anonymization of health data streams is important to protect these data against potential privacy breaches. A large number of research studies aiming at offering privacy in the context of data streams has been recently conducted. However, the techniques that have been proposed in these studies generate a significant delay during the anonymization process, since they concentrate on applying existing privacy models (e.g., k-anonymity and l-diversity) to batches of data extracted from data streams in a period of time. In this paper, we present delay-free anonymization, a framework for preserving the privacy of electronic health data streams. Unlike existing works, our method does not generate an accumulation delay, since input streams are anonymized immediately with counterfeit values. We further devise late validation for increasing the data utility of the anonymization results and managing the counterfeit values. Through experiments, we show the efficiency and effectiveness of the proposed method for the real-time release of data streams. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. A Prospective Study of Ripple Mapping the Post-Infarct Ventricular Scar to Guide Substrate Ablation for Ventricular Tachycardia.

    PubMed

    Luther, Vishal; Linton, Nick W F; Jamil-Copley, Shahnaz; Koa-Wing, Michael; Lim, Phang Boon; Qureshi, Norman; Ng, Fu Siong; Hayat, Sajad; Whinnett, Zachary; Davies, D Wyn; Peters, Nicholas S; Kanagaratnam, Prapa

    2016-06-01

    Post-infarct ventricular tachycardia is associated with channels of surviving myocardium within scar characterized by fractionated and low-amplitude signals usually occurring late during sinus rhythm. Conventional automated algorithms for 3-dimensional electro-anatomic mapping cannot differentiate the delayed local signal of conduction within the scar from the initial far-field signal generated by surrounding healthy tissue. Ripple mapping displays every deflection of an electrogram, thereby providing fully informative activation sequences. We prospectively used CARTO-based ripple maps to identify conducting channels as a target for ablation. High-density bipolar left ventricular endocardial electrograms were collected using CARTO3v4 in sinus rhythm or ventricular pacing and reviewed for ripple mapping conducting channel identification. Fifteen consecutive patients (median age 68 years, left ventricular ejection fraction 30%) were studied (6 month preprocedural implantable cardioverter defibrillator therapies: median 19 ATP events [Q1-Q3=4-93] and 1 shock [Q1-Q3=0-3]). Scar (<1.5 mV) occupied a median 29% of the total surface area (median 540 points collected within scar). A median of 2 ripple mapping conducting channels were seen within each scar (length 60 mm; initial component 0.44 mV; delayed component 0.20 mV; conduction 55 cm/s). Ablation was performed along all identified ripple mapping conducting channels (median 18 lesions) and any presumed interconnected late-activating sites (median 6 lesions; Q1-Q3=2-12). The diastolic isthmus in ventricular tachycardia was mapped in 3 patients and colocated within the ripple mapping conducting channels identified. Ventricular tachycardia was noninducible in 85% of patients post ablation, and 71% remain free of ventricular tachycardia recurrence at 6-month median follow-up. Ripple mapping can be used to identify conduction channels within scar to guide functional substrate ablation. © 2016 American Heart Association, Inc.

  8. NMR relaxometry study of cement hydration in the presence of different oxidic fine fraction materials.

    PubMed

    Nestle, Nikolaus

    2004-01-01

    NMR relaxometry has been applied to study hydrating cements for about 25 years now. The most important advantage over other experimental approaches is the possibility to conduct non-destructive measurements with a time resolution of minutes. NMR relaxometry data thus can help to identify details in the time course of cement hydration that possibly would be overlooked in other experiments with lower temporal resolution. Time-resolved information on cement hydration kinetics can provide interesting insights into the impact of oxidic additive materials on cement hydration. For PbO, a very strong delay was observed which then was systematically studied. An explanation for this delay is suggested.

  9. Constitutional pericentric inversion of chromosome 9 and hematopoietic recovery after allogeneic stem cell transplantation.

    PubMed

    Manola, K N; Harhalakis, N; Symeonidis, A; Rigana, H; Stavropoulou, C; Karakasis, D; Tiniakou, M; Baltathakis, I; Stamouli, M I; Zoumbos, N; Pantelias, G E; Sambani, C

    2006-09-01

    Recent reports suggest that hemopoietic stem cells with constitutional pericentric inversion of chromosome 9 [inv(9)] may be related to delayed engraftment or hemopoietic defect after stem cell transplantation (SCT). We conducted a retrospective study on five allogeneic SCT in which constitutional inv(9) was detected either in the donor or the recipient. The results showed that hematologic recovery was within the expected time range for all our patients. However, one patient exhibited decreasing blood counts between day +45 and +272 after transplantation, possibly due to protracted cytomegalovirus (CMV) infection and gansiclovir and imatinib treatment. Our findings suggest that constitutional inv(9) may not be associated with delayed hemopoietic recovery after SCT.

  10. Experimental evaluation of the performance of pulsed two-color laser-ranging systems

    NASA Technical Reports Server (NTRS)

    Im, Kwaifong E.; Gardner, Chester S.; Abshire, James B.; Mcgarry, Jan F.

    1987-01-01

    Two-color laser-ranging systems can be used to estimate the atmospheric delay by measuring the difference in propagation times between two optical pulses transmitted at different wavelengths. This paper describes horizontal-path ranging experiments that were conducted using flat diffuse targets and cube-corner reflector arrays. Measurements of the timing accuracy of the cross-correlation estimator, atmospheric delay, received pulse shapes, and signal power spectra are presented. The results are in general agreement with theory and indicate that target speckle can be the dominant noise source when the target is small and is located far from the ranging system or when the target consists of a small number of cube-corner reflectors.

  11. A History of the Improvement of Internet Protocols Over Satellites Using ACTS

    NASA Technical Reports Server (NTRS)

    Allman, Mark; Kruse, Hans; Ostermann, Shawn

    2000-01-01

    This paper outlines the main results of a number of ACTS experiments on the efficacy of using standard Internet protocols over long-delay satellite channels. These experiments have been jointly conducted by NASAs Glenn Research Center and Ohio University over the last six years. The focus of our investigations has been the impact of long-delay networks with non-zero bit-error rates on the performance of the suite of Internet protocols. In particular, we have focused on the most widely used transport protocol, the Transmission Control Protocol (TCP), as well as several application layer protocols. This paper presents our main results, as well as references to more verbose discussions of our experiments.

  12. [Vitamin and mineral supplements in the diet of military personnel: effect on the balance of iron, copper and manganese, immune reactivity and physical work-capacity].

    PubMed

    Zaĭtseva, I P; Nosolodin, V V; Zaĭtsev, O N; Gladkikh, I P; Koznienko, I V; Beliakov, R A; Arshinov, N P

    2012-03-01

    Conducted with the participation of 50 students of military educational study the effect of various vitamin and mineral complexes for the provision by the body naturally iron, copper and manganese on the immune and physical status. Found that diets enriched BMV was accompanied by a significant delay in the micro-elements, mainly iron, which indicates a deficiency of these bioelements in chickens Santo during the summer. Under the influence of vitamin-mineral complexes significantly increased rates of natural and specific immunity. As the delay increases significantly increased iron medical indicators of immunological reaction efficiency and physical performance.

  13. Noninvasive, automatic optimization strategy in cardiac resynchronization therapy.

    PubMed

    Reumann, Matthias; Osswald, Brigitte; Doessel, Olaf

    2007-07-01

    Optimization of cardiac resynchronization therapy (CRT) is still unsolved. It has been shown that optimal electrode position,atrioventricular (AV) and interventricular (VV) delays improve the success of CRT and reduce the number of non-responders. However, no automatic, noninvasive optimization strategy exists to date. Cardiac resynchronization therapy was simulated on the Visible Man and a patient data-set including fiber orientation and ventricular heterogeneity. A cellular automaton was used for fast computation of ventricular excitation. An AV block and a left bundle branch block were simulated with 100%, 80% and 60% interventricular conduction velocity. A right apical and 12 left ventricular lead positions were set. Sequential optimization and optimization with the downhill simplex algorithm (DSA) were carried out. The minimal error between isochrones of the physiologic excitation and the therapy was computed automatically and leads to an optimal lead position and timing. Up to 1512 simulations were carried out per pathology per patient. One simulation took 4 minutes on an Apple Macintosh 2 GHz PowerPC G5. For each electrode pair an optimal pacemaker delay was found. The DSA reduced the number of simulations by an order of magnitude and the AV-delay and VV - delay were determined with a much higher resolution. The findings are well comparable with clinical studies. The presented computer model of CRT automatically evaluates an optimal lead position and AV-delay and VV-delay, which can be used to noninvasively plan an optimal therapy for an individual patient. The application of the DSA reduces the simulation time so that the strategy is suitable for pre-operative planning in clinical routine. Future work will focus on clinical evaluation of the computer models and integration of patient data for individualized therapy planning and optimization.

  14. Wind-dragged corolla enhances self-pollination: a new mechanism of delayed self-pollination.

    PubMed

    Qu, Rongming; Li, Xiaojie; Luo, Yibo; Dong, Ming; Xu, Huanli; Chen, Xuan; Dafni, Amots

    2007-12-01

    Delayed self-pollination is a mechanism that allows animal-pollinated plants to outcross while ensuring seed production in the absence of pollinators. This study aims to explore a new mechanism of delayed self-pollination facilitated by wind-driven corolla abscission in Incarvillea sinensis var. sinensis. Floral morphology and development, and the process of delayed self-pollination were surveyed. Experiments dealing with pollinator and wind exclusion, pollination manipulations, and pollinator observations were conducted in the field. Delayed self-pollination occurs when the abscising corolla driven by wind drags the adherent epipetalous stamens, thus leading to contact of anthers with stigma in late anthesis. There is no dichogamy and self-incompatibility in this species. The significantly higher proportion of abscised corolla under natural conditions as compared with that in wind-excluding tents indicates the importance of wind in corolla abscission. When pollinators were excluded, corolla abscission significantly increased the number of pollen grains deposited on the stigma and, as a result, the fruit and seed set. Only half of the flowers in plots were visited by pollinators, and the fruit set of emasculated flowers was significantly lower than that of untreated flowers in open pollination. This species has a sensitive stigma, and its two open stigmatic lobes closed soon after being touched by a pollinator, but always reopened if no or only little pollen was deposited. This delayed self-pollination, which involved the movement of floral parts, the active participation of the wind and sensitive stigma, is quite different from that reported previously. This mechanism provides reproductive assurance for this species. The sensitive stigma contributes to ensuring seed production and reducing the interference of selfing with outcrossing. The pollination pattern, which combines actions by bees with indirect participation by wind, is also a new addition to ambophily.

  15. Diagnosis and treatment delays among elderly breast cancer patients with pre-existing mental illness.

    PubMed

    Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw

    2017-11-01

    This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis. Patients were classified as having no mental illness, anxiety, depression, anxiety and depression, or severe mental illness (bipolar disorder, schizophrenia, and other psychotic disorder). Multivariable binomial regression was used to assess the association between mental illness and delays of ≥60 and ≥90 days after adjustment for confounders. Patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition (RR 1.11; 95% CI 1.00, 1.23), and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis (RR 1.36; 95% CI 1.06, 1.74). Patients with any mental illness experienced an increased risk for adjuvant chemotherapy delay of ≥90 days from last operation (RR 1.13; 95% CI 1.01, 1.26) and each category of mental illness, except depression, showed a non-significant trend for this association. Breast cancer patients with mental illness should be closely managed by a cross-functional care team, including a psychiatrist, a primary care physician, and an oncologist, to ensure adequate care is received within an appropriate timeframe.

  16. Influences on Immunization Decision-Making among US Parents of Young Children.

    PubMed

    Chung, Yunmi; Schamel, Jay; Fisher, Allison; Frew, Paula M

    2017-12-01

    Objectives This study assessed influences on vaccination decisions among parents of young children and examined common vaccination information and advice sources. Methods Using panel samples of parents of children under 7 years, web-based surveys were conducted in 2012 (n = 2603) and 2014 (n = 2518). A vaccine decision-making typology (non-hesitant acceptors, hesitant acceptors, delayers, and refusers) was established and weighted population estimates of potential factors influencing parental vaccination decision (e.g., provider influence, source of information and advice) were computed by year and decision type. Results Delayers and refusers were more likely than acceptors to know someone whose child experienced a severe reaction to a vaccine or delayed/refused vaccine(s). High proportions of delayers (2012: 33.4%, 2014: 33.9%) and refusers (2012: 49.6%, 2014: 58.6%) reported selecting their healthcare provider based on whether the provider would allow them to delay/refuse vaccines. Providers were the most frequently reported trusted vaccine information source among all parents, though more often by acceptors than refusers (2012, 2014: p < 0.01). We found differing patterns of provider advice-seeking and internet as a reliable vaccine information source by group. Among those who had considered delay/refusal, trust in their healthcare provider's advice was the most common reason cited for their decision reversal. Conclusions for Practice Provider trust and communication along with varying degrees of personal-network influences likely contribute to immunization decisions of parents. Vaccine hesitant parents often seek providers amenable to accommodating their vaccine beliefs. Providers may benefit from vaccine communication training as their recommendations may influence hesitant parents to immunize their children.

  17. Effect of delayed diagnosis on disease course and management of Churg-Strauss syndrome: a retrospective study.

    PubMed

    Sokołowska, Barbara; Szczeklik, Wojciech; Mastalerz, Lucyna; Kuczia, Paweł; Wodkowski, Michał; Stodółkiewicz, Edyta; Macioł, Karolina; Musiał, Jacek

    2013-03-01

    Delayed diagnosis in patients with Churg-Strauss syndrome (CSS) is largely attributed to the variable and nonspecific presentation of the disease's initial symptoms. The aim of the study was to evaluate the effect of delayed diagnosis on the course of CSS. We conducted a retrospective study of 30 CSS patients followed up in our department. In each patient, we assessed the delay in CSS diagnosis (the time when patients already fulfilled four out of six of the American College of Rheumatology criteria and the diagnosis was not yet established), the disease activity at the time of diagnosis, and organ involvement during CSS course. A median value of 2 weeks was chosen as the cutoff point after which the diagnosis was considered as delayed. Sixteen patients were diagnosed before (group 1) and 14 patients after this cutoff point (group 2). In group 2, we found a higher Birmingham Vasculitis Activity Score at the moment of diagnosis (20.4 vs 25.1, p < 0.05) and a more severe disease course, resulting in more frequent hospitalization rates (0.64 vs 2.26/year, p < 0.00001), higher corticosteroids dose requirements (5.87 vs 11.57 mg/day converted to methylprednisolone, p < 0.0001), and additional immunosuppressive therapy administration (56.2 vs 92.8 %, p < 0.05) to maintain disease remission. All six perinuclear pattern of antineutrophil cytoplasmic antibobodies (pANCA)-positive patients (20 %) were found in group 1. Concluding, the delay in diagnosis of CSS of more than 2 weeks was found to be associated with a disease course that was more severe. The presence of the pANCA antibodies may occasionally facilitate establishment of the diagnosis.

  18. The long-term outcome of displaced mid-third clavicle fractures on scapular and shoulder function: variations between immediate surgery, delayed surgery, and nonsurgical management.

    PubMed

    George, Daniel M; McKay, Bartholomew P; Jaarsma, Ruurd L

    2015-05-01

    Conservative management for uncomplicated displaced clavicle fractures is common practice. Delay of surgical fixation may result in less favorable outcomes. A retrospective cohort study was conducted of 60 patients with a closed mid-third clavicle fracture that did not meet current operative or nonoperative guidelines; 20 primary (plate fixation <6 weeks), 20 delayed (plate fixation >6 weeks), and 20 matched conservative patients were included. Each patient completed 2 questionnaires, the Disabilities of the Arm, Shoulder, and Hand and the American Shoulder and Elbow Surgeons, as well as visual analog scales for pain, cosmetic satisfaction, and overall satisfaction. In addition, 10 patients from each group underwent clinical review of scapular rotation by the lateral scapular slide test, clinical impingement, range of motion assessment, and radiologic review of clavicle union and length. The American Shoulder and Elbow Surgeons patient self-reported questionnaire demonstrated a median score of 5.5 for the delayed group, 2 for the primary group, and 1 for the conservative group (P = .032). The median Disabilities of the Arm, Shoulder, and Hand score was 7.92 for the delayed group, 3.32 for the primary group, and 1.67 for the conservative group (P = .212). Six patients in the delayed group had scapular malrotation compared with 2 in the primary group and none in the conservative group (P = .008). Flexion and external rotation in 90° abduction were decreased in the conservative group (P = .049 and .041, respectively). We support the conservative management of uncomplicated displaced clavicle fractures but recognize that a lower threshold for early surgery should be considered where optimal shoulder function is required. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  19. Indigenous Ethnicity and Low Maternal Education Are Associated with Delayed Diagnosis and Mortality in Infants with Congenital Heart Defects in Panama

    PubMed Central

    Zúñiga, Julio; Higuera, Gladys; Carrión Donderis, María; Gómez, Beatriz; Motta, Jorge

    2016-01-01

    Background This is the first study in Panama and Central America that has included indigenous populations in an assessment of the association between socioeconomic variables with delayed diagnosis and mortality due to congenital heart defects (CHD). Methods A retrospective observational study was conducted. A sample calculation was performed and 954 infants born from 2010 to 2014 were randomly selected from clinical records of all Panamanian public health institutions with paediatric cardiologists. Critical CHD was defined according to the defects listed as targets of newborn pulse oximetry screening. Diagnoses were considered delayed when made after the third day of life for the critical CHD and after the twentieth day of life for the non-critical. A logistic regression model was performed to examine the association between socioeconomic variables and delayed diagnosis. A Cox proportional hazards model was used to assess the relationship between socioeconomic features and mortality. Results An increased risk of delayed diagnosis was observed in infants with indigenous ethnicity (AOR, 1.56; 95% CI, 1.03–2.37), low maternal education (AOR, 1.57; 95% CI, 1.09–2.25) and homebirth (AOR, 4.32; 95% CI, 1.63–11.48). Indigenous infants had a higher risk of dying due to CHD (HR, 1.43; 95% CI, 1.03–1.99), as did those with low maternal education (HR, 1.95; 95% CI, 1.45–2.62). Conclusion Inequalities in access to health care, conditioned by unfavourable socioeconomic features, may play a key role in delayed diagnosis and mortality of CHD patients. Further studies are required to study the relationship between indigenous ethnicity and these adverse health outcomes. PMID:27648568

  20. Delayed diagnosis of traumatic ureteral injuries.

    PubMed

    Kunkle, David A; Kansas, Bryan T; Pathak, Abhijit; Goldberg, Amy J; Mydlo, Jack H

    2006-12-01

    We review our experience with traumatic ureteral injuries missed at exploration. We also conduct meta-analysis to define factors contributing to missed injury, comparing outcomes of early vs late diagnosis. Our genitourinary trauma database was retrospectively reviewed from 1995 through 2004. A total of 40 ureteral injuries were identified including 5 with delayed diagnosis. Previously published series of ureteral trauma were then analyzed for injuries with delayed diagnosis, with data extracted and collated for meta-analysis. A total of 40 patients with traumatic ureteral injuries was identified, all of whom underwent laparotomy. Five (12.5%) injuries were discovered at a mean of 6.0 +/- 3.0 days after laparotomy. The number of associated injuries for early and delayed diagnosis was 3.2 and 2.6 (p = 0.25), respectively. Mean hospital stay was 19.2 vs 36.6 days (p = 0.18) for those with immediate vs delayed diagnosis, respectively. Only 2 of 5 (40%) patients achieved satisfactory results during initial hospitalization. Literature review revealed 48 missed ureteral injuries, representing 11.1% of all patients with ureteral injuries who underwent laparotomy. Rates of nephrectomy for early and late diagnosis were 2.4% and 18.4% (p = 0.0001). Mortality related to traumatic injuries occurred in 6.1% with early diagnosis and 13.2% with missed injuries (p = 0.089). Despite preoperative studies and intraoperative inspection, ureteral injury may remain undiagnosed until after laparotomy. We report intraoperative exploration to have a sensitivity of 88.9% across multiple series for traumatic ureteral injuries. Delayed diagnosis of ureteral injuries produces an association with prolonged hospital stay, and meta-analysis reveals a statistically significant increase in the rate of nephrectomy when ureteral injury is missed at exploration.

  1. Effect of post-encoding emotion on recollection and familiarity for pictures.

    PubMed

    Wang, Bo; Ren, Yanju

    2017-07-01

    Although prior studies have examined the effect of post-encoding emotional arousal on recognition memory for words, it is unknown whether the enhancement effect observed on words generalizes to pictures. Furthermore, prior studies using words have showed that the effect of emotional arousal can be modulated by stimuli valence and delay in emotion induction, but it is unclear whether such modulation can extend to pictures and whether other factors such as encoding method (incidental vs. intentional encoding) can be modulatory. Five experiments were conducted to answer these questions. In Experiment 1, participants encoded a list of neutral and negative pictures and then watched a 3-min neutral or negative video. The delayed test showed that negative arousal impaired recollection regardless of picture valence but had no effect on familiarity. Experiment 2 replicated the above findings. Experiment 3 was similar to Experiment 1 except that participants watched a 3-min neutral, negative, or positive video and conducted free recall before the recognition test. Unlike the prior two experiments, the impairment effect of negative arousal disappeared. Experiment 4, where the free recall task was eliminated, replicated the results from Experiment 3. Experiment 5 replicated Experiments 1 and 2 and further showed that the impairment effects of negative arousal could be modulated by delay in emotion induction but not by encoding method or stimuli valence. Taken together, the current study suggests that the enhancement effect observed on words may not generalize to pictures.

  2. Incidental Learning: A Brief, Valid Measure of Memory Based on the WAIS-IV Vocabulary and Similarities Subtests.

    PubMed

    Spencer, Robert J; Reckow, Jaclyn; Drag, Lauren L; Bieliauskas, Linas A

    2016-12-01

    We assessed the validity of a brief incidental learning measure based on the Similarities and Vocabulary subtests of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Most neuropsychological assessments for memory require intentional learning, but incidental learning occurs without explicit instruction. Incidental memory tests such as the WAIS-III Symbol Digit Coding subtest have existed for many years, but few memory studies have used a semantically processed incidental learning model. We conducted a retrospective analysis of 37 veterans with traumatic brain injury, referred for outpatient neuropsychological testing at a Veterans Affairs hospital. As part of their evaluation, the participants completed the incidental learning tasks. We compared their incidental learning performance to their performance on traditional memory measures. Incidental learning scores correlated strongly with scores on the California Verbal Learning Test-Second Edition (CVLT-II) and Brief Visuospatial Memory Test-Revised (BVMT-R). After we conducted a partial correlation that controlled for the effects of age, incidental learning correlated significantly with the CVLT-II Immediate Free Recall, CVLT-II Short-Delay Recall, CVLT-II Long-Delay Recall, and CVLT-II Yes/No Recognition Hits, and with the BVMT-R Delayed Recall and BVMT-R Recognition Discrimination Index. Our incidental learning procedures derived from subtests of the WAIS-IV Edition are an efficient and valid way of measuring memory. These tasks add minimally to testing time and capitalize on the semantic encoding that is inherent in completing the Similarities and Vocabulary subtests.

  3. Orienting task effects on EDR and free recall in three age groups.

    PubMed

    Zelinski, E M; Walsh, D A; Thompson, L W

    1978-03-01

    The present investigation was designed to examine the effects of orienting task-controlled processing on electrodermal response and free recall at two delay intervals for 94 young, 49 young-old (age 55 to 70), and 61 old-old (age 71 to 85) individuals. Subjects were presented with a list of 25 words and performed one of the following tasks: semantic, nonsemantic, or passive listening, presented in an incidental memory paradigm, or intentional memorization. Recall was obtained 2 min or 48 hours after list presentation. At the 2-min delay, the pattern of recall across tasks for the young-old and old-old subjects was similar to that of college students. Overall, the old-old recalled fewer words than the young and young-old, while the young-old recalled as many words as the young. After 48 hours, the task-related recall pattern was observed only in the young group. The skin conductance data indicated that task effects were similar across the three age groups and that response magnitude was lower in the old-old than the two younger groups. No differences in skin conductance were found between the young and young-old. Age differences in memory processing suggest that difficulties in delayed retrieval of semantically encoded words may increase during late adult years. Differences in electrodermal responses in the old-old compared to the young and young-old suggest that the range of autonomic responsivitiy to task demands may become restricted in advanced age.

  4. Health seeking and access to care for children with suspected dengue in Cambodia: an ethnographic study.

    PubMed

    Khun, Sokrin; Manderson, Lenore

    2007-09-24

    The continuing contribution of dengue fever to the hospitalization and deaths in hospital of infants and small children in Cambodia is associated with delays in presentation for medical attention, diagnosis and appropriate care. It is important to identify the reasons that influence these delays, in order to develop appropriate interventions to redress the impact of dengue. Data on health seeking were collected during an ethnographic study conducted in two villages in the eastern province of Kampong Cham, Cambodia in 2004. Interviews were conducted with mothers whose children had been infected with suspected dengue fever, or who had been sick for other reasons, in 2003 and 2004. Women selected a therapeutic option based on perceptions of the severity of the child's condition, confidence in the particular modality, service or practitioner, and affordability of the therapy. While they knew what type of health care was required, poverty in combination with limited availability and perceptions of the poor quality of care at village health centers and public referral hospitals deterred them from doing so. Women initially used home remedies, then sought advice from public and private providers, shifting from one sector to another in a pragmatic response to the child's illness. The lack of availability of financial resources for poor people and their continuing lack of confidence in the care provided by government centres combine to delay help seeking and inappropriate treatment of children sick with dengue.

  5. Health seeking and access to care for children with suspected dengue in Cambodia: An ethnographic study

    PubMed Central

    Khun, Sokrin; Manderson, Lenore

    2007-01-01

    Background The continuing contribution of dengue fever to the hospitalization and deaths in hospital of infants and small children in Cambodia is associated with delays in presentation for medical attention, diagnosis and appropriate care. It is important to identify the reasons that influence these delays, in order to develop appropriate interventions to redress the impact of dengue. Methods Data on health seeking were collected during an ethnographic study conducted in two villages in the eastern province of Kampong Cham, Cambodia in 2004. Interviews were conducted with mothers whose children had been infected with suspected dengue fever, or who had been sick for other reasons, in 2003 and 2004. Results Women selected a therapeutic option based on perceptions of the severity of the child's condition, confidence in the particular modality, service or practitioner, and affordability of the therapy. While they knew what type of health care was required, poverty in combination with limited availability and perceptions of the poor quality of care at village health centers and public referral hospitals deterred them from doing so. Women initially used home remedies, then sought advice from public and private providers, shifting from one sector to another in a pragmatic response to the child's illness. Conclusion The lack of availability of financial resources for poor people and their continuing lack of confidence in the care provided by government centres combine to delay help seeking and inappropriate treatment of children sick with dengue. PMID:17892564

  6. Duplication of 17(p11.2p11.2) in a male child with autism and severe language delay.

    PubMed

    Nakamine, Alisa; Ouchanov, Leonid; Jiménez, Patricia; Manghi, Elina R; Esquivel, Marcela; Monge, Silvia; Fallas, Marietha; Burton, Barbara K; Szomju, Barbara; Elsea, Sarah H; Marshall, Christian R; Scherer, Stephen W; McInnes, L Alison

    2008-03-01

    Duplications of 17(p11.2p11.2) have been associated with various behavioral manifestations including attention deficits, obsessive-compulsive symptoms, autistic traits, and language delay. We are conducting a genetic study of autism and are screening all cases for submicroscopic chromosomal abnormalities, in addition to standard karyotyping, and fragile X testing. Using array-based comparative genomic hybridization analysis of data from the Affymetrix GeneChip(R) Human Mapping Array set, we detected a duplication of approximately 3.3 Mb on chromosome 17p11.2 in a male child with autism and severe expressive language delay. The duplication was confirmed by measuring the copy number of genomic DNA using quantitative polymerase chain reaction. Gene expression analyses revealed increased expression of three candidate genes for the Smith-Magenis neurobehavioral phenotype, RAI1, DRG2, and RASD1, in transformed lymphocytes from Case 81A, suggesting gene dosage effects. Our results add to a growing body of evidence suggesting that duplications of 17(p11.2p11.2) result in language delay as well as autism and related phenotypes. As Smith-Magenis syndrome is also associated with language delay, a gene involved in acquisition of language may lie within this interval. Whether a parent of origin effect, gender of the case, the presence of allelic variation, or changes in expression of genes outside the breakpoints influence the resultant phenotype remains to be determined. (c) 2007 Wiley-Liss, Inc.

  7. Perceived efficacy, conscious fear of death and intentions to tan: not all fear appeals are created equal.

    PubMed

    Cooper, Douglas P; Goldenberg, Jamie L; Arndt, Jamie

    2014-02-01

    According to the terror management health model, conscious thoughts of death motivate productive health behaviours when the targeted behaviour is perceived as an effective route for mitigating the threat and removing death-related thought from focal awareness. The present study thus examined whether messages manipulating the efficacy of a health behaviour moderate health outcomes when participants are presented with a fear appeal that makes death thought conscious. A 3 (fear appeal: cancer vs. appearance vs. neutral) × 2 (delay vs. no delay) × 2 (effective vs. non-effective) between-subjects ANOVA was conducted. Beach patrons were randomly assigned to a cancer, appearance, or neutral-threat fear appeal followed by a delay or no delay. Subsequently, they read messages highlighting the effectiveness or ineffectiveness of sun protection behaviours and reported their intentions to engage in those behaviours. When fear appeals primed conscious thoughts of death, framing sun protection as ineffective decreased sun protection intentions relative to framing sun protection as effective. In contrast, fear appeals that did not consciously prime death, or appeals followed by a delay that allowed thoughts of death to fade from consciousness, did not interact with efficacy messages. The findings revealed that messages impacting sun protection efficacy moderated sun protection intentions only when death was conscious. The findings have implications for understanding the conditions that render certain fear appeals, and accompanying messages of efficacy, more influential than others. © 2013 The British Psychological Society.

  8. Delay of Gratification, Delay Discounting and their Associations with Age, Episodic Future Thinking, and Future Time Perspective.

    PubMed

    Göllner, Lars M; Ballhausen, Nicola; Kliegel, Matthias; Forstmeier, Simon

    2017-01-01

    The delay of gratification (DoG) in children is widely investigated with an experimental procedure originally called the "marshmallow test," whereas the studies on self-regulation (SR) in adolescents and adults usually use self-report questionnaires. Delay discounting (DD) measures simplify the DoG procedure and focus on monetary rewards. The aim of this study was to investigate age differences in DoG and DD from childhood to old age using a test that is suitable for both children and adults. Furthermore, investigations were conducted on the association between DoG/DD and two future orientation constructs [future time perspective (FTP) and episodic future thinking (EFT)] as well as age differences in these constructs. Participants from five age groups (9-14, 18-25, 35-55, 65-80, 80+) participated in the study ( N = 96). While we found no age difference for DoG, DD was the lowest [i.e., self-control (SC) was the highest] in young/middle adults; however, it was the highest (i.e., SC was the lowest) in children and old/oldest adults. Furthermore, we found significant age differences for DD and FTP. As predicted, there were strong correlations between DoG and FTP and between DD and FTP, but not between DoG/DD and EFT. These results indicate that age differences in SR vary across the measures used. Individuals who generally think and act in a future-oriented manner have a stronger ability to delay gratification.

  9. Piloted simulator study of allowable time delays in large-airplane response

    NASA Technical Reports Server (NTRS)

    Grantham, William D.; Bert T.?aetingas, Stephen A.dings with ran; Bert T.?aetingas, Stephen A.dings with ran

    1987-01-01

    A piloted simulation was performed to determine the permissible time delay and phase shift in the flight control system of a specific large transport-type airplane. The study was conducted with a six degree of freedom ground-based simulator and a math model similar to an advanced wide-body jet transport. Time delays in discrete and lagged form were incorporated into the longitudinal, lateral, and directional control systems of the airplane. Three experienced pilots flew simulated approaches and landings with random localizer and glide slope offsets during instrument tracking as their principal evaluation task. Results of the present study suggest a level 1 (satisfactory) handling qualities limit for the effective time delay of 0.15 sec in both the pitch and roll axes, as opposed to a 0.10-sec limit of the present specification (MIL-F-8785C) for both axes. Also, the present results suggest a level 2 (acceptable but unsatisfactory) handling qualities limit for an effective time delay of 0.82 sec and 0.57 sec for the pitch and roll axes, respectively, as opposed to 0.20 sec of the present specifications for both axes. In the area of phase shift between cockpit input and control surface deflection,the results of this study, flown in turbulent air, suggest less severe phase shift limitations for the approach and landing task-approximately 50 deg. in pitch and 40 deg. in roll - as opposed to 15 deg. of the present specifications for both axes.

  10. Immediate rather than delayed memory impairment in older adults with latent toxoplasmosis.

    PubMed

    Mendy, Angelico; Vieira, Edgar R; Albatineh, Ahmed N; Gasana, Janvier

    2015-03-01

    The neurotropic parasite Toxoplasma gondii infects one third of the world population, but its effect on memory remains ambiguous. To examine a potential relationship of the infection with immediate and delayed memory, a population-based study was conducted in 4485 participants of the Third National Health and Nutrition Examination Survey aged 60years and older. Serum anti-Toxoplasma IgG antibodies were measured by enzyme immune assay and verbal memory was assessed using the Mini-Mental State Examination and the East Boston Memory Test. The prevalence of latent toxoplasmosis was 41%; in one way analysis of variance, anti-Toxoplasma IgG antibody levels significantly differed across tertiles for immediate (P=0.006) but not delayed memory scores (P=0.22). In multinomial logistic regression adjusting for covariates, Toxoplasma seropositivity was associated with lower immediate memory performance (OR: 0.65, 95% CI: 0.44, 0.97 for medium tertile and OR: 0.61, 95% CI: 0.37, 0.98 for highest tertile in reference to the lowest tertile), especially in non-Hispanic Whites (OR: 0.56, 95% CI: 0.36, 0.88 for medium tertile and OR: 0.51, 95% CI: 0.30, 0.87 for highest tertile in reference to the lowest tertile). However, no relationship with delayed memory was observed. In conclusion, latent toxoplasmosis is widespread in older adults and may primarily affect immediate rather than delayed memory, particularly in White Americans. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Help Seeking Behavior of Women with Self-Discovered Breast Cancer Symptoms: A Meta-Ethnographic Synthesis of Patient Delay

    PubMed Central

    Khakbazan, Zohreh; Taghipour, Ali; Latifnejad Roudsari, Robab; Mohammadi, Eesa

    2014-01-01

    Background and Objective Patient delay makes a critical contribution to late diagnosis and poor survival in cases of breast cancer. Identifying the factors that influence patient delay could provide information for adopting strategies that shorten this delay. The aim of this meta-ethnography was to synthesize existing qualitative evidence in order to gain a new understanding of help seeking behavior in women with self-discovered breast cancer symptoms and to determine the factors that influence patient delay. Methods The design was a meta-ethnography approach. A systematic search of the articles was performed in different databases including Elsevier, PubMed, ProQuest and SCOPUS. Qualitative studies with a focus on help seeking behaviors in women with self-discovered breast cancer symptoms and patient delay, published in the English language between 1990 and 2013 were included. The quality appraisal of the articles was carried out using the Critical Appraisal Skills Programme qualitative research checklist and 13 articles met the inclusion criteria. The synthesis was conducted according to Noblit and Hare’s meta-ethnographic approach (1988), through reciprocal translational analysis and lines-of-argument. Findings The synthesis led to identification of eight repeated key concepts including: symptom detection, initial symptom interpretation, symptom monitoring, social interaction, emotional reaction, priority of medical help, appraisal of health services and personal-environmental factors. Symptom interpretation is identified as the important step of the help seeking process and which changed across the process through active monitoring of their symptoms, social interactions and emotional reactions. The perceived seriousness of the situation, priority to receive medical attention, perceived inaccessibility and unacceptability of the health care system influenced women’s decision-making about utilizing health services. Conclusion Help seeking processes are influenced by multiple factors. Educational programs aimed at correcting misunderstandings, erroneous social beliefs and improving self-awareness could provide key strategies to improve health policy which would reduce patient delay. PMID:25470732

  12. Risk factors for delay in age-appropriate vaccinations among Gambian children.

    PubMed

    Odutola, Aderonke; Afolabi, Muhammed O; Ogundare, Ezra O; Lowe-Jallow, Yamu Ndow; Worwui, Archibald; Okebe, Joseph; Ota, Martin O

    2015-08-28

    Vaccination has been shown to reduce mortality and morbidity due to vaccine-preventable diseases. However, these diseases are still responsible for majority of childhood deaths worldwide especially in the developing countries. This may be due to low vaccine coverage or delay in receipt of age-appropriate vaccines. We studied the timeliness of routine vaccinations among children aged 12-59 months attending infant welfare clinics in semi-urban areas of The Gambia, a country with high vaccine coverage. A cross-sectional survey was conducted in four health centres in the Western Region of the Gambia. Vaccination dates were obtained from health cards and timeliness assessed based on the recommended age ranges for BCG (birth-8 weeks), Diphtheria-Pertussis-Tetanus (6 weeks-4 months; 10 weeks-5 months; 14 weeks-6 months) and measles vaccines (38 weeks-12 months). Risk factors for delay in age-appropriate vaccinations were determined using logistic regression. Analysis was limited to BCG, third dose of Diphtheria-Pertussis -Tetanus (DPT3) and measles vaccines. Vaccination records of 1154 children were studied. Overall, 63.3% (95 % CI 60.6-66.1%) of the children had a delay in the recommended time to receiving at least one of the studied vaccines. The proportion of children with delayed vaccinations increased from BCG [5.8% (95 % CI 4.5-7.0%)] to DPT3 [60.4% (95 % CI 57.9%-63.0%)] but was comparatively low for the measles vaccine [10.8% (95 % CI 9.1%-12.5%)]. Mothers of affected children gave reasons for the delay, and their profile correlated with type of occupation, place of birth and mode of transportation to the health facilities. Despite high vaccination coverage reported in The Gambia, a significant proportion of the children's vaccines were delayed for reasons related to health services as well as profile of mothers. These findings are likely to obtain in several countries and should be addressed by programme managers in order to improve and optimize the impact of the immunization coverage rates.

  13. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

    PubMed

    Mistry, Nerges; Rangan, Sheela; Dholakia, Yatin; Lobo, Eunice; Shah, Shimoni; Patil, Akshaya

    2016-01-01

    Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB) in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai. A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values. The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days) and retreatment patients (25 days). Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation. Achieving positive behavioural changes in providers (especially non-allopaths) and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics would be singularly effective in curbing pathway delays.

  14. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India

    PubMed Central

    Mistry, Nerges; Rangan, Sheela; Dholakia, Yatin; Lobo, Eunice; Shah, Shimoni; Patil, Akshaya

    2016-01-01

    Background Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB) in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai. Methods A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values. Results The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days) and retreatment patients (25 days). Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation. Conclusion Achieving positive behavioural changes in providers (especially non-allopaths) and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics would be singularly effective in curbing pathway delays. PMID:27018589

  15. Delayed but successful response to noninvasive ventilation in COPD patients with acute hypercapnic respiratory failure.

    PubMed

    Lemyze, Malcolm; Bury, Quentin; Guiot, Aurélie; Jonard, Marie; Mohammad, Usman; Van Grunderbeeck, Nicolas; Gasan, Gaelle; Thevenin, Didier; Mallat, Jihad

    2017-01-01

    We evaluated a new noninvasive ventilation (NIV) protocol that allows the pursuit of NIV in the case of persistent severe respiratory acidosis despite a first NIV challenge in COPD patients with acute hypercapnic respiratory failure (AHRF). A prospective observational multicentric pilot study was conducted in three tertiary hospitals over a 12-month study period. A total of 155 consecutive COPD patients who were admitted for AHRF and treated by NIV were enrolled. Delayed response to NIV was defined as a significant clinical improvement in the first 48 h following NIV initiation despite a persistent severe respiratory acidosis (pH <7.30) after the first 2 h of NIV trial. NIV failed in only 10 patients (6.5%). Delayed responders to NIV (n=83, 53%) exhibited similar nutritional status, comorbidities, functional status, frailty score, dyspnea score, and severity score at admission, compared with early responders (n=62, 40%). Only age (66 vs 70 years in early responders; P =0.03) and encephalopathy score (3 [2-4] vs 3 [2-4] in early responders; P =0.015) were different among the responders. Inhospital mortality did not differ between responders to NIV (n=10, 12% for delayed responders vs n=10, 16% for early responders, P =0.49). A second episode of AHRF occurred in 20 responders (14%), equally distributed among early and delayed responders to NIV (n=9, 14.5% in early responders vs n=11, 13% in delayed responders; P =0.83), with a poor survival rate (n=1, 5%). Most of the COPD patients with AHRF have a successful outcome when NIV is pursued despite a persistent severe respiratory acidosis after the first NIV trial. The outcome of delayed responders is similar to the one of the early responders. On the contrary, the second episode of AHRF during the hospital stay carries a poor prognosis.

  16. Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group

    PubMed Central

    2013-01-01

    Background This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program was developed in collaboration with the World Bank with a total budget of US$127.7 million, and targets an estimated 738,000 children aged 0 to 6 years living in approximately 6,000 poor communities. The aim of the program is to increase access to early childhood services with the secondary aim of improving school readiness. Methods/Design The study is being conducted across nine districts. The baseline survey contained 310 villages, of which 100 were originally allocated to the intervention arm, 20 originally allocated to a 9-month delay staggered start, 100 originally allocated to an 18-month delay staggered start and 90 allocated to a matched control group (no intervention). The study consists of two cohorts, one comprising children aged 12 to 23 months and the other comprising children aged 48 to 59 months at baseline. The data collection instruments include child observations and task/game-based assessments as well as a questionnaire suite, village head questionnaire, service level questionnaires, household questionnaire, and child caretaker questionnaire. The baseline survey was conducted from March to April 2009, midline was conducted from April to August 2010 and endline conducted early 2013. The resultant participation rates at both the district and village levels were 90%. At the child level, the participation rate was 99.92%. The retention rate at the child level at midline was 99.67%. Discussion This protocol paper provides a detailed record of the trial design including a discussion regarding difficulties faced with compliance to the randomization, compliance to the dispersion schedule of community block grants, and procurement delays for baseline and midline data collections. Considering the execution of the program and the resultant threats to the study, we discuss our analytical plan and intentions for endline data collection. Trials registration Current Controlled Trials ISRCTN76061874 PMID:23953975

  17. Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group.

    PubMed

    Pradhan, Menno; Brinkman, Sally A; Beatty, Amanda; Maika, Amelia; Satriawan, Elan; de Ree, Joppe; Hasan, Amer

    2013-08-16

    This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program was developed in collaboration with the World Bank with a total budget of US$127.7 million, and targets an estimated 738,000 children aged 0 to 6 years living in approximately 6,000 poor communities. The aim of the program is to increase access to early childhood services with the secondary aim of improving school readiness. The study is being conducted across nine districts. The baseline survey contained 310 villages, of which 100 were originally allocated to the intervention arm, 20 originally allocated to a 9-month delay staggered start, 100 originally allocated to an 18-month delay staggered start and 90 allocated to a matched control group (no intervention). The study consists of two cohorts, one comprising children aged 12 to 23 months and the other comprising children aged 48 to 59 months at baseline. The data collection instruments include child observations and task/game-based assessments as well as a questionnaire suite, village head questionnaire, service level questionnaires, household questionnaire, and child caretaker questionnaire. The baseline survey was conducted from March to April 2009, midline was conducted from April to August 2010 and endline conducted early 2013. The resultant participation rates at both the district and village levels were 90%. At the child level, the participation rate was 99.92%. The retention rate at the child level at midline was 99.67%. This protocol paper provides a detailed record of the trial design including a discussion regarding difficulties faced with compliance to the randomization, compliance to the dispersion schedule of community block grants, and procurement delays for baseline and midline data collections. Considering the execution of the program and the resultant threats to the study, we discuss our analytical plan and intentions for endline data collection. Current Controlled Trials ISRCTN76061874.

  18. Visceral leishmaniasis diagnosis and reporting delays as an obstacle to timely response actions in Nepal and India.

    PubMed

    Boettcher, Jan P; Siwakoti, Yubaraj; Milojkovic, Ana; Siddiqui, Niyamat A; Gurung, Chitra K; Rijal, Suman; Das, Pradeep; Kroeger, Axel; Banjara, Megha R

    2015-02-06

    To eliminate visceral leishmaniasis (VL) in India and Nepal, challenges of VL diagnosis, treatment and reporting need to be identified. Recent data indicate that VL is underreported and patients face delays when seeking treatment. Moreover, VL surveillance data might not reach health authorities on time. This study quantifies delays for VL diagnosis and treatment, and analyses the duration of VL reporting from district to central health authorities in India and Nepal. A cross-sectional study conducted in 12 districts of Terai region, Nepal, and 9 districts of Bihar State, India, in 2012. Patients were interviewed in hospitals or at home using a structured questionnaire, health managers were interviewed at their work place using a semi-structured questionnaire and in-depth interviews were conducted with central level health managers. Reporting formats were evaluated. Data was analyzed using two-tailed Mann-Whitney U or Fisher's exact test. 92 VL patients having experienced 103 VL episodes and 49 district health managers were interviewed. Patients waited in Nepal 30 days (CI 18-42) before seeking health care, 3.75 times longer than in Bihar (8d; CI 4-12). Conversely, the lag time from seeking health care to receiving a VL diagnosis was 3.6x longer in Bihar (90d; CI 68-113) compared to Nepal (25d; CI 13-38). The time span between diagnosis and treatment was short in both countries. VL reporting time was in Nepal 19 days for sentinel sites and 76 days for "District Public Health Offices (DPHOs)". In Bihar it was 28 days for "District Malaria Offices". In Nepal, 73% of health managers entered data into computers compared to 16% in Bihar. In both countries reporting was mainly paper based and standardized formats were rarely used. To decrease the delay between onset of symptoms and getting a proper diagnosis and treatment the approaches in the two countries vary: In Nepal health education for seeking early treatment are needed while in Bihar the use of private and non-formal practitioners has to be discouraged. Reinforcement of VL sentinel reporting in Bihar, reorganization of DPHOs in Nepal, introduction of standardized reporting formats and electronic reporting should be conducted in both countries.

  19. Adaptive Control for Autonomous Navigation of Mobile Robots Considering Time Delay and Uncertainty

    NASA Astrophysics Data System (ADS)

    Armah, Stephen Kofi

    Autonomous control of mobile robots has attracted considerable attention of researchers in the areas of robotics and autonomous systems during the past decades. One of the goals in the field of mobile robotics is development of platforms that robustly operate in given, partially unknown, or unpredictable environments and offer desired services to humans. Autonomous mobile robots need to be equipped with effective, robust and/or adaptive, navigation control systems. In spite of enormous reported work on autonomous navigation control systems for mobile robots, achieving the goal above is still an open problem. Robustness and reliability of the controlled system can always be improved. The fundamental issues affecting the stability of the control systems include the undesired nonlinear effects introduced by actuator saturation, time delay in the controlled system, and uncertainty in the model. This research work develops robustly stabilizing control systems by investigating and addressing such nonlinear effects through analytical, simulations, and experiments. The control systems are designed to meet specified transient and steady-state specifications. The systems used for this research are ground (Dr Robot X80SV) and aerial (Parrot AR.Drone 2.0) mobile robots. Firstly, an effective autonomous navigation control system is developed for X80SV using logic control by combining 'go-to-goal', 'avoid-obstacle', and 'follow-wall' controllers. A MATLAB robot simulator is developed to implement this control algorithm and experiments are conducted in a typical office environment. The next stage of the research develops an autonomous position (x, y, and z) and attitude (roll, pitch, and yaw) controllers for a quadrotor, and PD-feedback control is used to achieve stabilization. The quadrotor's nonlinear dynamics and kinematics are implemented using MATLAB S-function to generate the state output. Secondly, the white-box and black-box approaches are used to obtain a linearized second-order altitude models for the quadrotor, AR.Drone 2.0. Proportional (P), pole placement or proportional plus velocity (PV), linear quadratic regulator (LQR), and model reference adaptive control (MRAC) controllers are designed and validated through simulations using MATLAB/Simulink. Control input saturation and time delay in the controlled systems are also studied. MATLAB graphical user interface (GUI) and Simulink programs are developed to implement the controllers on the drone. Thirdly, the time delay in the drone's control system is estimated using analytical and experimental methods. In the experimental approach, the transient properties of the experimental altitude responses are compared to those of simulated responses. The analytical approach makes use of the Lambert W function to obtain analytical solutions of scalar first-order delay differential equations (DDEs). A time-delayed P-feedback control system (retarded type) is used in estimating the time delay. Then an improved system performance is obtained by incorporating the estimated time delay in the design of the PV control system (neutral type) and PV-MRAC control system. Furthermore, the stability of a parametric perturbed linear time-invariant (LTI) retarded-type system is studied. This is done by analytically calculating the stability radius of the system. Simulation of the control system is conducted to confirm the stability. This robust control design and uncertainty analysis are conducted for first-order and second-order quadrotor models. Lastly, the robustly designed PV and PV-MRAC control systems are used to autonomously track multiple waypoints. Also, the robustness of the PV-MRAC controller is tested against a baseline PV controller using the payload capability of the drone. It is shown that the PV-MRAC offers several benefits over the fixed-gain approach of the PV controller. The adaptive control is found to offer enhanced robustness to the payload fluctuations.

  20. Sleep and cognitive performance of African-Americans and European-Americans before and during circadian misalignment produced by an abrupt 9-h delay in the sleep/wake schedule

    PubMed Central

    Crowley, Stephanie J.; Eastman, Charmane I.

    2017-01-01

    We conducted two studies of circadian misalignment in non-Hispanic African and European-Americans. In the first, the sleep/wake (light/dark) schedule was advanced 9 h, similar to flying east, and in the second these schedules were delayed 9 h, similar to flying west or sleeping during the day after night work. We confirmed that the free-running circadian period is shorter in African-Americans compared to European-Americans, and found differences in the magnitude and direction of circadian rhythm phase shifts which were related to the circadian period. The sleep and cognitive performance data from the first study (published in this journal) documented the impairment in both ancestry groups due to this extreme circadian misalignment. African-Americans slept less and performed slightly worse during advanced/misaligned days than European-Americans. The current analysis is of sleep and cognitive performance from the second study. Participants were 23 African-Americans and 22 European-Americans (aged 18–44 years). Following four baseline days (8 h time in bed, based on habitual sleep), the sleep/wake schedule was delayed by 9 h for three days. Sleep was monitored using actigraphy. During the last two baseline/aligned days and the first two delayed/misaligned days, beginning 2 h after waking, cognitive performance was assessed every 3 h using the Automated Neuropsychological Assessment Metrics (ANAM) battery. Mixed model ANOVAs assessed the effects of ancestry (African-American or European-American) and condition (baseline/aligned or delayed/misaligned) on sleep and performance. There was decreased sleep and impaired cognitive performance in both ancestry groups during the two delayed/misaligned days relative to baseline/aligned days. Sleep and cognitive performance did not differ between African-Americans and European-Americans during either baseline/aligned or delayed/misaligned days. While our previous work showed that an advance in the sleep/wake schedule impaired the sleep of African-Americans more than European-Americans, delaying the sleep/wake schedule impaired the sleep and cognitive performance of African-Americans and European-Americans equally. PMID:29073187

  1. Hydrogen plasma treatment for improved conductivity in amorphous aluminum doped zinc tin oxide thin films

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

    Morales-Masis, M., E-mail: monica.moralesmasis@epfl.ch; Ding, L.; Dauzou, F.

    2014-09-01

    Improving the conductivity of earth-abundant transparent conductive oxides (TCOs) remains an important challenge that will facilitate the replacement of indium-based TCOs. Here, we show that a hydrogen (H{sub 2})-plasma post-deposition treatment improves the conductivity of amorphous aluminum-doped zinc tin oxide while retaining its low optical absorption. We found that the H{sub 2}-plasma treatment performed at a substrate temperature of 50 °C reduces the resistivity of the films by 57% and increases the absorptance by only 2%. Additionally, the low substrate temperature delays the known formation of tin particles with the plasma and it allows the application of the process to temperature-sensitivemore » substrates.« less

  2. Delayed excitatory and inhibitory feedback shape neural information transmission

    NASA Astrophysics Data System (ADS)

    Chacron, Maurice J.; Longtin, André; Maler, Leonard

    2005-11-01

    Feedback circuitry with conduction and synaptic delays is ubiquitous in the nervous system. Yet the effects of delayed feedback on sensory processing of natural signals are poorly understood. This study explores the consequences of delayed excitatory and inhibitory feedback inputs on the processing of sensory information. We show, through numerical simulations and theory, that excitatory and inhibitory feedback can alter the firing frequency response of stochastic neurons in opposite ways by creating dynamical resonances, which in turn lead to information resonances (i.e., increased information transfer for specific ranges of input frequencies). The resonances are created at the expense of decreased information transfer in other frequency ranges. Using linear response theory for stochastically firing neurons, we explain how feedback signals shape the neural transfer function for a single neuron as a function of network size. We also find that balanced excitatory and inhibitory feedback can further enhance information tuning while maintaining a constant mean firing rate. Finally, we apply this theory to in vivo experimental data from weakly electric fish in which the feedback loop can be opened. We show that it qualitatively predicts the observed effects of inhibitory feedback. Our study of feedback excitation and inhibition reveals a possible mechanism by which optimal processing may be achieved over selected frequency ranges.

  3. Stimulus-specific variability in color working memory with delayed estimation.

    PubMed

    Bae, Gi-Yeul; Olkkonen, Maria; Allred, Sarah R; Wilson, Colin; Flombaum, Jonathan I

    2014-04-08

    Working memory for color has been the central focus in an ongoing debate concerning the structure and limits of visual working memory. Within this area, the delayed estimation task has played a key role. An implicit assumption in color working memory research generally, and delayed estimation in particular, is that the fidelity of memory does not depend on color value (and, relatedly, that experimental colors have been sampled homogeneously with respect to discriminability). This assumption is reflected in the common practice of collapsing across trials with different target colors when estimating memory precision and other model parameters. Here we investigated whether or not this assumption is secure. To do so, we conducted delayed estimation experiments following standard practice with a memory load of one. We discovered that different target colors evoked response distributions that differed widely in dispersion and that these stimulus-specific response properties were correlated across observers. Subsequent experiments demonstrated that stimulus-specific responses persist under higher memory loads and that at least part of the specificity arises in perception and is eventually propagated to working memory. Posthoc stimulus measurement revealed that rendered stimuli differed from nominal stimuli in both chromaticity and luminance. We discuss the implications of these deviations for both our results and those from other working memory studies.

  4. Delay to orthopedic consultation for isolated limb injury

    PubMed Central

    Rouleau, Dominique M.; Feldman, Debbie Ehrmann; Parent, Stefan

    2009-01-01

    ABSTRACT OBJECTIVE To describe referral mechanisms for referral to orthopedic surgery for isolated limb injuries in a public health care system and to identify factors affecting access. DESIGN Cross-sectional survey. SETTING Orthopedic surgery service in a level 1 trauma centre in Montreal, Que. PARTICIPANTS We conducted a prospective study of 166 consecutive adults (mean age 48 years) referred to orthopedic surgery for isolated limb injuries during a 4-month period. MAIN OUTCOME MEASURES Self-reported data on the nature of the trauma, the elapsed time between injury and orthopedic consultation, the number and type of previous primary care consultations, sociodemographic characteristics, and the level of satisfaction with care. RESULTS Average time between the injury and orthopedic consultation was 89 hours (range 3 to 642), with an average of 68 hours (range 0 to 642) for delay between primary care consultation and orthopedic consultation. A total of 36% of patients with time-sensitive diagnoses had unacceptable delays to orthopedic consultation according to the Quebec Orthopaedic Association guidelines. Lower limb injury, consulting first at another hospital, living far from the trauma centre, patient perception of low severity, and having a soft tissue injury were associated with longer delays. CONCLUSION Identifying gaps and risk factors for slower access might help improve referral mechanisms for orthopedic consultation. PMID:19826162

  5. Immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures: is it safe enough?

    PubMed

    Acker, A; Perry, Z H; Blum, S; Shaked, G; Korngreen, A

    2018-04-01

    The purpose of this study was to compare the results of immediate and delayed percutaneous sacroiliac screws surgery for unstable pelvic fractures, regarding technical results and complication rate. Retrospective study. The study was conducted at the Soroka University Medical center, Beer Sheva, Israel, which is a level 1 trauma Center. 108 patients with unstable pelvic injuries were operated by the orthopedic department at the Soroka University Medical Center between the years 1999-2010. A retrospective analysis found 50 patients with immediate surgery and 58 patients with delayed surgery. Preoperative and postoperative imaging were analyzed and data was collected regarding complications. All patients were operated on by using the same technique-percutaneous fixation of sacroiliac joint with cannulated screws. The study's primary outcome measure was the safety and quality of the early operation in comparison with the late operation. A total of 156 sacroiliac screws were inserted. No differences were found between the immediate and delayed treatment groups regarding technical outcome measures (P value = 0.44) and complication rate (P value = 0.42). The current study demonstrated that immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures produced equally good technical results, in comparison with the conventional delayed operation, without additional complications.

  6. Shared control on lunar spacecraft teleoperation rendezvous operations with large time delay

    NASA Astrophysics Data System (ADS)

    Ya-kun, Zhang; Hai-yang, Li; Rui-xue, Huang; Jiang-hui, Liu

    2017-08-01

    Teleoperation could be used in space on-orbit serving missions, such as object deorbits, spacecraft approaches, and automatic rendezvous and docking back-up systems. Teleoperation rendezvous and docking in lunar orbit may encounter bottlenecks for the inherent time delay in the communication link and the limited measurement accuracy of sensors. Moreover, human intervention is unsuitable in view of the partial communication coverage problem. To solve these problems, a shared control strategy for teleoperation rendezvous and docking is detailed. The control authority in lunar orbital maneuvers that involves two spacecraft as rendezvous and docking in the final phase was discussed in this paper. The predictive display model based on the relative dynamic equations is established to overcome the influence of the large time delay in communication link. We discuss and attempt to prove via consistent, ground-based simulations the relative merits of fully autonomous control mode (i.e., onboard computer-based), fully manual control (i.e., human-driven at the ground station) and shared control mode. The simulation experiments were conducted on the nine-degrees-of-freedom teleoperation rendezvous and docking simulation platform. Simulation results indicated that the shared control methods can overcome the influence of time delay effects. In addition, the docking success probability of shared control method was enhanced compared with automatic and manual modes.

  7. Ethylene: Response of Fruit Dehiscence to CO2 and Reduced Pressure 1

    PubMed Central

    Lipe, John A.; Morgan, Page W.

    1972-01-01

    These studies were conducted to determine whether ethylene serves as a natural regulator of fruit wall dehiscence, a major visible feature of ripening in some fruits. We employed treatments to inhibit ethylene action or remove ethylene and observed their effect on fruit dehiscence. CO2 (13%), a competitive inhibitor of ethylene action in many systems, readily delayed dehiscence of detached fruits of cotton (Gossypium hirsutum L.), pecan (Carya illinoensis [Wang.] K. Koch), and okra (Hibiscus esculentus L.). The CO2 effect was duplicated by placing fruits under reduced pressure (200 millimeters mercury), to promote the escape of ethylene from the tissue. Dehiscence of detached fruits of these species as well as attached cotton fruits was delayed. The delay of dehiscence of cotton and okra by both treatments was achieved with fruit harvested at intervals from shortly after anthesis until shortly before natural dehiscence. Pecan fruits would not dehisce until approximately 1 month before natural dehiscence, and during that time, CO2 and reduced pressure delayed dehiscence. CO2 and ethylene were competitive in their effects on cotton fruit dehiscence. All of the results are compatible with a hypothetical role of ethylene as a natural regulator of dehiscence, a dominant aspect of ripening of cotton, pecan, and some other fruits. PMID:16658260

  8. Ethylene: Response of Fruit Dehiscence to CO(2) and Reduced Pressure.

    PubMed

    Lipe, J A; Morgan, P W

    1972-12-01

    These studies were conducted to determine whether ethylene serves as a natural regulator of fruit wall dehiscence, a major visible feature of ripening in some fruits. We employed treatments to inhibit ethylene action or remove ethylene and observed their effect on fruit dehiscence. CO(2) (13%), a competitive inhibitor of ethylene action in many systems, readily delayed dehiscence of detached fruits of cotton (Gossypium hirsutum L.), pecan (Carya illinoensis [Wang.] K. Koch), and okra (Hibiscus esculentus L.). The CO(2) effect was duplicated by placing fruits under reduced pressure (200 millimeters mercury), to promote the escape of ethylene from the tissue. Dehiscence of detached fruits of these species as well as attached cotton fruits was delayed. The delay of dehiscence of cotton and okra by both treatments was achieved with fruit harvested at intervals from shortly after anthesis until shortly before natural dehiscence. Pecan fruits would not dehisce until approximately 1 month before natural dehiscence, and during that time, CO(2) and reduced pressure delayed dehiscence. CO(2) and ethylene were competitive in their effects on cotton fruit dehiscence. All of the results are compatible with a hypothetical role of ethylene as a natural regulator of dehiscence, a dominant aspect of ripening of cotton, pecan, and some other fruits.

  9. Dual-user nonlinear teleoperation subjected to varying time delay and bounded inputs.

    PubMed

    Zakerimanesh, Amir; Hashemzadeh, Farzad; Ghiasi, Amir Rikhtehgar

    2017-05-01

    A novel trilateral control architecture for Dual-master/Single-slave teleoperation system with taking account of saturation in actuators, nonlinear dynamics for telemanipulators and bounded varying time delay which affects the transmitted signals in the communication channels, is proposed in this paper. In this research, we will address the stability and desired position coordination problem of trilateral teleoperation system by extension of (nP+D) controller that is used for Single-master/Single-slave teleoperation system. Our proposed controller is weighted summation of nonlinear Proportional plus Damping (nP+D) controller that incorporate gravity compensation and the weights are specified by the dominance factor, which determines the supremacy of each user over the slave robot and over the other user. The asymptotic stability of closed loop dynamics is studied using Lyapunov-Krasovskii functional under conditions on the controller parameters, the actuator saturation characteristics and the maximum values of varying time delays. It is shown that these controllers satisfy the desired position coordination problem in free motion condition. To show the effectiveness of the proposed method, a number of simulations have been conducted on a varying time delay Dual-master/Single-slave teleoperation system using 3-DOF planar robots for each telemanipulator subjected to actuator saturation. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  10. Short-term family-centered workshop for children with developmental delays enhances family functioning and satisfaction: A prospective clinical trial.

    PubMed

    Hsieh, Ru-Lan; Hsieh, Wen-Huei; Lee, Wen-Chung

    2016-08-01

    We investigated the clinical efficacy on family functioning and parental satisfaction of a short-term family-centered workshop for children with developmental delays.A total of 32 children with developmental delays and their parents participated in 2-hour weekly group therapy sessions over 6 weeks. The workshop was conducted by rehabilitation professionals and teachers using a family-centered multidisciplinary approach. Both before and after the 6-week workshop, the parents were administered the Pediatric Quality of Life Inventory (PedsQL) Family Impact Module, the PedsQL Healthcare Satisfaction Module, the Hospital Anxiety and Depression Scale, and the World Health Organization Quality of Life brief assessment instrument. Overall satisfaction with the workshop was also evaluated.Significant improvements were noted in physical aspect (P = 0.03), communication (P = 0.002), and daily activities (P = 0.04) in the PedsQL Family Impact Module, and in communication (P = 0.03) and technical skills (P = 0.05) in the PedsQL Healthcare Satisfaction Module. Overall satisfaction with the workshop was rated as very high. There was no significant effect on psychological distress or quality of life.Short-term family-centered workshops for children with developmental delays improved family functioning and the parental perception of satisfaction, including health care satisfaction.

  11. Factors affecting presentation and delay in patients with testicular cancer: results of a qualitative study.

    PubMed

    Gascoigne, P; Mason, M D; Roberts, E

    1999-01-01

    A qualitative study was undertaken with men treated for testicular tumours, to ascertain how they interpreted their symptoms and the factors which influenced a decision to consult a physician. The research was undertaken with six men who had been diagnosed as having testicular tumours. Interviews were also conducted with four wives and one mother. The findings showed that giving men information on testicular cancer may not guarantee early presentation. Symptoms were not generally attributed to cancer and the one patient who practised self-examination had delayed seeking help for 6 months. The extent to which symptoms affected the patient's lifestyle was also a factor in the decision-making process, as was the checking of symptoms with other family members. Wives were often pivotal in persuading men to seek help. The discovery of testicular symptoms produced emotional responses which included embarrassment and fear of both cancer and castration. There was evidence of strong feelings of masculine identity bound up with the appearance of 'normal' genitals. Provider-delay was identified in four cases and was associated with misattribution of symptoms by physicians and the failure to initiate specialist referral. Delay was under-recorded in the hospital notes in all cases where presentation was not immediate.

  12. Delayed haemolysis secondary to treatment of severe malaria with intravenous artesunate: Report on the experience of a referral centre for tropical infections in Spain.

    PubMed

    Aldámiz-Echevarría Lois, Teresa; López-Polín, Ana; Norman, Francesca F; Monge-Maillo, Begoña; López-Vélez, Rogelio; Perez-Molina, Jose A

    Post-artesunate delayed haemolysis is described as hemolytic anemia presenting days after malaria treatment in hyperparasitemic patients. Physiopathological mechanisms and clinical manifestations have not been thoroughly characterised. We conducted a retrospective study of hospitalised malaria patients who received artemisinin derivatives from January 1, 2010 to December 31, 2015. 21 patients were included in the study: 11 travellers, 8 travellers visiting friends and relatives and 2 immigrants. Median age was 35.5 years (IQR: 25.7-44.8) and 11 were men. Eight patients received oral and 13 received intravenous (IV) artemisinin-based drugs. Follow-up after the malaria episode was available for 15 patients (12 with IV treatment). Four patients presented with delayed haemolysis 9-14 days after artesunate treatment; all had been admitted with severe malaria, were treated IV and had hyperparasitaemia (17%-33%). Other than hyperparasitaemia, no other factors were associated with artesunate haemolysis. Patients' outcomes were favourable and the only additional therapeutic measure needed was a blood transfusion. Delayed haemolysis is a frequent complication in hyperparasitemic malaria treated with IV artesunate. Follow-up is mandatory for at least 2 weeks after treatment initiation. This condition is potentially severe but does not appear to be life threatening. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Steep Delay Discounting and Addictive Behavior: A Meta-Analysis of Continuous Associations

    PubMed Central

    Amlung, Michael; Vedelago, Lana; Acker, John; Balodis, Iris; MacKillop, James

    2016-01-01

    Aims To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. Methods Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates, and gambling) were identified via PubMed, MEDLINE, and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random effects meta-analysis was conducted using Pearson’s r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger’s tests, meta-regression of publication year and effect size, and imputation of missing studies. Results The primary meta-analysis revealed a small magnitude effect size that was highly significant (r = 0.14, p < 10−14). Significantly larger effect sizes were observed for studies examining severity compared with QF (p = 0.01), but not between the type of addictive behavior (p = 0.30) or DRD assessment (p = 0.90). Indices of publication bias suggested a modest impact of unpublished findings. Conclusions Delayed reward discounting is robustly associated with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality. PMID:27450931

  14. A systematic review of barriers to early presentation and diagnosis with breast cancer among black women

    PubMed Central

    Jones, Claire EL; Maben, Jill; Jack, Ruth H; Davies, Elizabeth A; Forbes, Lindsay JL; Lucas, Grace; Ream, Emma

    2014-01-01

    Objective To explore barriers to early presentation and diagnosis with breast cancer among black women. Design Systematic review. Methods We searched multiple bibliographic databases (January 1991–February 2013) for primary research, published in English, conducted in developed countries and investigating barriers to early presentation and diagnosis with symptomatic breast cancer among black women (≥18 years). Studies were excluded if they did not report separate findings by ethnic group or gender, only reported differences in time to presentation/diagnosis, or reported on interventions and barriers to cancer screening. We followed Cochrane and PRISMA guidance to identify relevant research. Findings were integrated through thematic synthesis. Designs of quantitative studies made meta-analysis impossible. Results We identified 18 studies (6183 participants). Delay was multifactorial, individual and complex. Factors contributing to delay included: poor symptom and risk factor knowledge; fear of detecting breast abnormality; fear of cancer treatments; fear of partner abandonment; embarrassment disclosing symptoms to healthcare professionals; taboo and stigmatism. Presentation appears quicker following disclosure. Influence of fatalism and religiosity on delay is unclear from evidence in these studies. We compared older studies (≥10 years) with newer ones (<10 years) to determine changes over time. In older studies, delaying factors included: inaccessibility of healthcare services; competing priorities and concerns about partner abandonment. Partner abandonment was studied in older studies but not in newer ones. Comparisons of healthy women and cancer populations revealed differences between how people perceive they would behave, and actually behave, on finding breast abnormality. Conclusions Strategies to improve early presentation and diagnosis with breast cancer among black women need to address symptom recognition and interpretation of risk, as well as fears of the consequences of cancer. The review is limited by the paucity of studies conducted outside the USA and limited detail reported by published studies preventing comparison between ethnic groups. PMID:24523424

  15. Subjective preference evaluation of sound fields by performing singers

    NASA Astrophysics Data System (ADS)

    Noson, Dennis

    2003-08-01

    A model of the auditory process is proposed for performing singers, which incorporates the added signal from bone conduction, as well as the psychological distance for subjective preference of the performer from the acoustic sound field of the stage. The explanatory power of previous scientific studies of vocal stage acoustics has been limited by a lack of an underlying theory of performer preference. Ando's theory, using the autocorrelation function (ACF) for parametrizing temporal factors, was applied to interpretation of singer sound field preference determined by the pair comparison method. Melisma style singing (no lyrics) was shown to increase the preferred delay time of reflections from a mean of 14 ms with lyrics to 23 ms without (p<0.05). The extent of the shift in preferred time delay was shown to be directly related to minima of the effective duration of the running ACF, (τe)min, calculated from each singer's voice. Voice matching experiments for singers demonstrated a strong overestimate of the voice outside the head compared with the singer's own voice (22.4 dB overestimate, p<0.01). Individual singer melisma singing delay preferences were compared for ``ah'' versus ``hum'' syllables, and the increased delay preference (41 ms) was shown to be correlated with (τe)min (r2<0.68, p<0.01). When the proposed bone conduction model was applied, using the measured overestimate of sound level of the singer's own voice for each singer (9.9 dB mean overestimate difference between ``ah'' and ``hum,'' p<0.01), the relationship of singer preference to (τe)min was improved (r2=0.97, p<0.01). Thesis advisor: Yoichi Ando Copies of this thesis are available from the author by inquiry at BRC Acoustics, 1741 First Avenue South, Seattle, WA 98134 USA. E-mail address: dnoson@brcacoustics.com

  16. [Primary research of early oral feeding after total laryngectomy].

    PubMed

    Huang, N; Zhu, Y M; An, C M; Liu, Y; Xu, Z G; Liu, S Y; Zhang, Z M

    2018-06-07

    Objective: To explore whether early oral feeding after total laryngectomy is safe and effective by evaluating the incidence of pharyngocutaneous fistula (PCF) and the hospital duration. Methods: A retrospective cohort study was conducted, including 52 patients underwent total laryngectomy, plus partial tongue base resection ( n =2), partial pharyngectomy ( n =1), or pedicle flap ( n =2) between January 2012 and October 2017. Patients who had a history of preoperative radiotherapy, chemotherapy or chemoradiotherapy, previous surgery for larynx or pharynx and who had severe complications were excluded. Early oral feeding started between 48 h and 72 h postoperatively, while delayed oral feeding started within postoperative day 8-10. The incidences of PCF in two groups were compared to evaluate whether PCF and early oral feeding was related. Multi-variables analysis was conducted to evaluate risk factors for PCF. Results: PCF rate was 19.2% among all patients, 11.1% in patients with early oral feeding and 23.5% in patients with delayed oral feeding. No significant statistically difference in PCF rate was found between two groups (χ(2)=0.506, P =0.477). Multi-variables analysis showed that oral feeding time (early or delayed) was not a independent risk factor of PCF (Two classification response variable Logistic regression, P =0.200, OR =0.242, 95% CI [0.028-2.118]). But low preoperative albumin level was observed as an independent risk factor for PCF ( P =0.039, OR =0.848, 95% CI [0.726-0.992]). A negative correlation was observed between preoperative albumin level and PCF. And also there was not a significant difference in hospital duration between patients with early oral feeding and delayed oral feeding( U =268, P =0.464). Conclusion: For patients total laryngectomy with no previous history of radiotherapy, chemotherapy, chemoradiotherapy, early oral feeding after surgery is safe and effective.

  17. The effect of timing of incentive payments on response rates for cohort study telephone interviews in primary care setting with cost-minimization analysis, a randomized controlled trial.

    PubMed

    Chin, Weng-Yee; Choi, Edmond P H; Lam, Cindy L K

    2015-10-06

    The effect of timing of incentive payments on the response rate of telephone surveys is unknown. This study examined whether up-front or delayed incentive payments were associated with higher response rates for participation in a telephone interview administered longitudinal cohort study amongst primary care patients with lower urinary tract symptoms, and to compare the costs between the two timing methods. This study was conducted as part of a naturalistic observation study on the health-related quality of life and health outcomes of Chinese primary care patients with lower urinary tract symptoms. The incentive payment was in the form of a supermarket gift voucher to the value of HD$50 (US$6.50) and could be used in lieu of cash at a major supermarket chain.720 subjects with lower urinary tract symptoms were randomly assigned into two groups. One group was offered an incentive of supermarket cash voucher at time of recruitment ('up-front' payment). The other group was told that the voucher would be sent to them after the complete of their 1-year follow-up telephone interview ('delayed' payment). Primary outcomes were the baseline and 1-year follow-up telephone survey response rates. There was no statistical difference in response rates at baseline (p-value = 0.938) or at the 1-year follow-up (p-value = 0.751) between groups. Cost per completed subject interviews for the up-front payment method was USD16.64, whilst cost for the delayed payment was USD 13.85. It appears the timing of incentive payments does not affect response rates for telephone interview surveys conducted on primary care patients in Hong Kong at baseline or at 1-year follow-up. Delayed incentive payments can reduce the overall cost per successful case. ClinicalTrials.gov Identifier: NCT02307929 Registered 28 August 2013.

  18. Immediate postpartum levonorgestrel intrauterine device insertion and breast-feeding outcomes: a noninferiority randomized controlled trial.

    PubMed

    Turok, David K; Leeman, Lawrence; Sanders, Jessica N; Thaxton, Lauren; Eggebroten, Jennifer L; Yonke, Nicole; Bullock, Holly; Singh, Rameet; Gawron, Lori M; Espey, Eve

    2017-12-01

    Immediate postpartum levonorgestrel intrauterine device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. This study examined the effect of immediate vs delayed postpartum levonorgestrel intrauterine device insertion on breast-feeding outcomes. We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel intrauterine device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery <37.0 weeks' gestational age, chorioamnionitis, postpartum hemorrhage, contraindications to levonorgestrel intrauterine device insertion, and medical complications of pregnancy that could affect breast-feeding. We conducted per-protocol analysis as the primary approach, as it is considered the standard for noninferiority studies; we also report the alternative intent-to-treat analysis. We powered the study for the primary outcome, breast-feeding continuation at 8 weeks, to detect a 15% noninferiority margin between groups, requiring 132 participants in each arm. The secondary study outcome, time to lactogenesis, used a validated measure, and was analyzed by survival analysis and log rank test. We followed up participants for ongoing data collection for 6 months. Only the data analysis team was blinded to the intervention. We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate group (79%; 95% confidence interval, 70-86%) was noninferior to that of the delayed group (84%; 95% confidence interval, 76-91%). The 5% difference in breast-feeding continuation at 8 weeks between the groups fell within the noninferiority margin (95% confidence interval, -5.6 to 15%). Time to lactogenesis (mean ± SD) in the immediate group, 65.3 ± 25.7 hours, was noninferior to that of the delayed group, 63.6 ± 21.6 hours. The mean difference between groups was 1.7 hours (95% confidence interval, -4.8 to 8.2 hours), noninferior by log-rank test. A total of 24 intrauterine device expulsions occurred in the immediate group compared to 2 in the delayed group (19% vs 2%, P < .001), consistent with the known higher expulsion rate with immediate vs delayed postpartum intrauterine device insertion. No intrauterine device perforations occurred in either group. Our results of noninferior breast-feeding outcomes between women with immediate and delayed postpartum levonorgestrel intrauterine device insertion suggest that immediate postpartum intrauterine device insertion is an acceptable option for women planning to breast-feed and use the levonorgestrel intrauterine device. Expulsion rates are higher with immediate postpartum levonorgestrel intrauterine device insertion compared to delayed insertion, but this disadvantage may be outweighed by the advantages of immediate initiation of contraception. Providers should offer immediate postpartum intrauterine device insertion to breast-feeding women planning to use the levonorgestrel intrauterine device. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Massed Trials versus Trials Embedded into Game Play: Child Outcomes and Preference

    ERIC Educational Resources Information Center

    Ledford, Jennifer R.; Chazin, Kate T.; Harbin, Emilee R.; Ward, Sarah E.

    2017-01-01

    Limited data are available regarding how response prompting procedures should be used in early childhood settings. The purpose of this study was to compare the efficiency of progressive time delay instruction presented via two trial arrangements: massed and embedded. During massed trial sessions, a short instructional session was conducted,…

  20. Marriage and Fertility in Tianjin, China: Fifty Years of Transition.

    ERIC Educational Resources Information Center

    Pasternak, Burton

    A report of research conducted in Tianjin, People's Republic of China (September 1981-January 1982) describes and analyses changes in family structure, marriage, post-marital residence, and fertility in a neighborhood of factory workers over a 50-year period. Social and economic changes such as delayed marriage, increased access to education, and…

  1. 45 CFR 79.18 - Authority of the ALJ.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Authority of the ALJ. 79.18 Section 79.18 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.18 Authority of the ALJ. (a) The ALJ shall conduct a fair and impartial hearing, avoid delay...

  2. A Position Statement on Rescinded and Deferred Employment Offers.

    ERIC Educational Resources Information Center

    Journal of Career Planning & Employment, 2002

    2002-01-01

    Early in Spring 2001, in the midst of an economic downturn, employers were sometimes forced into rescinding job offers to graduating college students or delaying their start dates. In light of this trend, the National Association of Colleges and Employers (NACE) Principles for Professional Conduct Committee has issued guidelines for employers on…

  3. Chilling and chipping influence plant growth and reproduction of star-of-Bethlehem (Ornithogalum umbellatum)

    USDA-ARS?s Scientific Manuscript database

    Greenhouse studies were conducted on two southern Illinois star-of-Bethlehem biotypes to determine the influence of chilling and bulb chipping on plant growth and reproduction. Chilling was not required for leaf emergence of dormant bulbs, but an increase to 10 weeks of chilling proportionally delay...

  4. 6 CFR 13.18 - Authority of the ALJ.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Authority of the ALJ. 13.18 Section 13.18 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.18 Authority of the ALJ. (a) The ALJ will conduct a fair and impartial hearing, avoid delay...

  5. THE LECTURE, AN ANALYSIS AND REVIEW OF RESEARCH.

    ERIC Educational Resources Information Center

    DICKENSON, GARY; VERNER, COOLIE

    RESEARCH ON THE LECTURE TECHNIQUE CONDUCTED WITH ADULT GROUPS HAS BEEN FAR MORE VARIED THAN PREADULT RESEARCH, WHICH HAS BEEN DONE WITHIN THE LIMITATIONS OF THE CLASSROOM METHOD IN AN INSTITUTIONAL SETTING. STUDIES HAVE BEEN MADE OF IMMEDIATE OR DELAYED RECALL OF FACTUAL INFORMATION, OF MODIFICATION OF ATTITUDES OR BEHAVIOR, OF DELIVERY OVER RADIO…

  6. Impact of the Diagnostic Process on Parents of Infants and Preschool Children. Final Report.

    ERIC Educational Resources Information Center

    Tice, Terrence N.; Hanson, Janice L.

    In an investigation of the impact of the psychological/educational diagnostic process on the parents of young children at risk for developmental delay, 18 families completed questionnaires and were interviewed concerning their child's evaluation. Transcribed interviews conducted 1-2 weeks after the evaluation and 4 months after the evaluations…

  7. 36 CFR 1150.52 - Authority of judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Authority of judge. The judge shall have the duty to conduct a fair hearing, to take all necessary action to avoid delay, and maintain order. He/she shall have all powers necessary to effect these ends, including (but not limited to) the power to: (a) Arrange and issue notice of the date, time, and place of...

  8. 12 CFR 308.108 - Sanctions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... decision within the time period called for in this part 308, absent a finding: (1) That the delay resulted.... Appropriate sanctions may be imposed when any counsel or party has acted, or failed to act, in a manner... contemptuous conduct; (2) Has in a material way injured or prejudiced some other party in terms of substantive...

  9. 14 CFR 382.157 - What are carriers' obligations for recordkeeping and reporting on disability-related complaints?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., storage and delay of assistive device, service animal problem, unsatisfactory information, and other. (d... carrier's or foreign carrier's services. (b) If you are a carrier covered by this part, conducting... disability. Data concerning the alleged discrimination or service problem related to the disability must be...

  10. 14 CFR 382.157 - What are carriers' obligations for recordkeeping and reporting on disability-related complaints?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., storage and delay of assistive device, service animal problem, unsatisfactory information, and other. (d... carrier's or foreign carrier's services. (b) If you are a carrier covered by this part, conducting... disability. Data concerning the alleged discrimination or service problem related to the disability must be...

  11. 14 CFR 302.20 - Formal intervention.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Formal intervention. 302.20 Section 302.20... Proceedings § 302.20 Formal intervention. (a) Who may intervene. Any person who has a statutory right to be... whose intervention will be conducive to the public interest and will not unduly delay the conduct of...

  12. 14 CFR 302.20 - Formal intervention.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Formal intervention. 302.20 Section 302.20... Proceedings § 302.20 Formal intervention. (a) Who may intervene. Any person who has a statutory right to be... whose intervention will be conducive to the public interest and will not unduly delay the conduct of...

  13. 14 CFR 302.20 - Formal intervention.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Formal intervention. 302.20 Section 302.20... Proceedings § 302.20 Formal intervention. (a) Who may intervene. Any person who has a statutory right to be... whose intervention will be conducive to the public interest and will not unduly delay the conduct of...

  14. 14 CFR 302.20 - Formal intervention.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Formal intervention. 302.20 Section 302.20... Proceedings § 302.20 Formal intervention. (a) Who may intervene. Any person who has a statutory right to be... whose intervention will be conducive to the public interest and will not unduly delay the conduct of...

  15. 14 CFR 302.20 - Formal intervention.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Formal intervention. 302.20 Section 302.20... Proceedings § 302.20 Formal intervention. (a) Who may intervene. Any person who has a statutory right to be... whose intervention will be conducive to the public interest and will not unduly delay the conduct of...

  16. Mathematics Practice without Feedback: A Desirable Difficulty in a Classroom Setting

    ERIC Educational Resources Information Center

    Fyfe, Emily R.; Rittle-Johnson, Bethany

    2017-01-01

    Recent research highlights the potential benefits of practice without feedback on learner's strategy knowledge. However, most prior work has been conducted in one-on-one settings with short retention intervals. We compared the effects of mathematics practice with and without correct-answer feedback on immediate and 1-week delayed performance in a…

  17. Successful grafting in poplar species (Populus spp.) breeding

    Treesearch

    A. Assibi Mahama; Brian Sparks; Ronald S., Zalesny; Richard B. Hall

    2006-01-01

    Poor rooting of Populus deltoides Bartr. ex Marsh hardwood cuttings often has contributed to delays in breeding progress as a result of failures of scion wood before and/or after pollination. Seventeen clones were used, and the study was conducted in the greenhouse to test an "intervenous feeding" (IV) method, along with three different...

  18. A failure effects simulation of a low authority flight control augmentation system on a UH-1H helicopter

    NASA Technical Reports Server (NTRS)

    Corliss, L. D.; Talbot, P. D.

    1977-01-01

    A two-pilot moving base simulator experiment was conducted to assess the effects of servo failures of a flight control system on the transient dynamics of a Bell UH-1H helicopter. The flight control hardware considered was part of the V/STOLAND system built with control authorities of from 20-40%. Servo hardover and oscillatory failures were simulated in each control axis. Measurements were made to determine the adequacy of the failure monitoring system time delay and the servo center and lock time constant, the pilot reaction times, and the altitude and attitude excursions of the helicopter at hover and 60 knots. Safe recoveries were made from all failures under VFR conditions. Pilot reaction times were from 0.5 to 0.75 sec. Reduction of monitor delay times below these values resulted in significantly reduced excursion envelopes. A subsequent flight test was conducted on a UH-1H helicopter with the V/STOLAND system installed. Series servo hardovers were introduced in hover and at 60 knots straight and level. Data from these tests are included for comparison.

  19. Delayed P100-Like Latencies in Multiple Sclerosis: A Preliminary Investigation Using Visual Evoked Spread Spectrum Analysis

    PubMed Central

    Kiiski, Hanni S. M.; Ní Riada, Sinéad; Lalor, Edmund C.; Gonçalves, Nuno R.; Nolan, Hugh; Whelan, Robert; Lonergan, Róisín; Kelly, Siobhán; O'Brien, Marie Claire; Kinsella, Katie; Bramham, Jessica; Burke, Teresa; Ó Donnchadha, Seán; Hutchinson, Michael; Tubridy, Niall; Reilly, Richard B.

    2016-01-01

    Conduction along the optic nerve is often slowed in multiple sclerosis (MS). This is typically assessed by measuring the latency of the P100 component of the Visual Evoked Potential (VEP) using electroencephalography. The Visual Evoked Spread Spectrum Analysis (VESPA) method, which involves modulating the contrast of a continuous visual stimulus over time, can produce a visually evoked response analogous to the P100 but with a higher signal-to-noise ratio and potentially higher sensitivity to individual differences in comparison to the VEP. The main objective of the study was to conduct a preliminary investigation into the utility of the VESPA method for probing and monitoring visual dysfunction in multiple sclerosis. The latencies and amplitudes of the P100-like VESPA component were compared between healthy controls and multiple sclerosis patients, and multiple sclerosis subgroups. The P100-like VESPA component activations were examined at baseline and over a 3-year period. The study included 43 multiple sclerosis patients (23 relapsing-remitting MS, 20 secondary-progressive MS) and 42 healthy controls who completed the VESPA at baseline. The follow-up sessions were conducted 12 months after baseline with 24 MS patients (15 relapsing-remitting MS, 9 secondary-progressive MS) and 23 controls, and again at 24 months post-baseline with 19 MS patients (13 relapsing-remitting MS, 6 secondary-progressive MS) and 14 controls. The results showed P100-like VESPA latencies to be delayed in multiple sclerosis compared to healthy controls over the 24-month period. Secondary-progressive MS patients had most pronounced delay in P100-like VESPA latency relative to relapsing-remitting MS and controls. There were no longitudinal P100-like VESPA response differences. These findings suggest that the VESPA method is a reproducible electrophysiological method that may have potential utility in the assessment of visual dysfunction in multiple sclerosis. PMID:26726800

  20. Post-fire Tree Mortality: Heating Increases Vulnerability to Cavitation in Longleaf Pine Branches

    NASA Astrophysics Data System (ADS)

    Lodge, A.; Kavanagh, K.; Dickinson, M. B.

    2016-12-01

    Tree mortality following wild and prescribed fires is of interest to both researchers and land managers. While some models exist that can predict mortality following fires, process-based models that incorporate physiological mechanisms of mortality are still being developed and improved. Delayed post-fire tree mortality has recently received increased attention, in part due to an increased use of prescribed fire as a restoration and management tool. One hypothesized mechanism of delayed mortality in trees is disruption of water transport in xylem due to exposure to the heat plume of a fire. This heat plume rapidly increases the vapor pressure deficit in the tree canopy, quickly increasing the tension on the water held in the xylem and leaves, potentially leading to cavitation. Cavitated xylem conduits can no longer transport water, eventually leading to tree death. We conducted a laboratory experiment examining whether heating stems increases their vulnerability to cavitation. We placed longleaf pine (Pinus palustris) branches in a water bath at sub-lethal temperatures (<60°C) and applied pressure in a cavitation chamber to simulate a range of xylem tension levels that may occur during fire. Percent loss of conductivity was measured following cavitation induced by various levels of applied pressure. When we compared the resulting vulnerability curves of heated branches to those of branches pressurized at room temperature, we observed increased vulnerability to cavitation in the heated samples especially at lower pressures. P50, or the pressure at which 50% of conductivity has been lost, decreased by 18% on branches heated to approximately 54°C. This suggests that stems heated during fires may be more vulnerable to cavitation, and provides some support for hydraulic disruption as a mechanism for post-fire tree mortality. Continued advancement in understanding of the mechanisms leading to delayed mortality will improve models predicting tree mortality.

  1. Programming Cardiac Resynchronization Therapy for Electrical Synchrony: Reaching Beyond Left Bundle Branch Block and Left Ventricular Activation Delay.

    PubMed

    Varma, Niraj; O'Donnell, David; Bassiouny, Mohammed; Ritter, Philippe; Pappone, Carlo; Mangual, Jan; Cantillon, Daniel; Badie, Nima; Thibault, Bernard; Wisnoskey, Brian

    2018-02-06

    QRS narrowing following cardiac resynchronization therapy with biventricular (BiV) or left ventricular (LV) pacing is likely affected by patient-specific conduction characteristics (PR, qLV, LV-paced propagation interval), making a universal programming strategy likely ineffective. We tested these factors using a novel, device-based algorithm (SyncAV) that automatically adjusts paced atrioventricular delay (default or programmable offset) according to intrinsic atrioventricular conduction. Seventy-five patients undergoing cardiac resynchronization therapy (age 66±11 years; 65% male; 32% with ischemic cardiomyopathy; LV ejection fraction 28±8%; QRS duration 162±16 ms) with intact atrioventricular conduction (PR interval 194±34, range 128-300 ms), left bundle branch block, and optimized LV lead position were studied at implant. QRS duration (QRSd) reduction was compared for the following pacing configurations: nominal simultaneous BiV (Mode I: paced/sensed atrioventricular delay=140/110 ms), BiV+SyncAV with 50 ms offset (Mode II), BiV+SyncAV with offset that minimized QRSd (Mode III), or LV-only pacing+SyncAV with 50 ms offset (Mode IV). The intrinsic QRSd (162±16 ms) was reduced to 142±17 ms (-11.8%) by Mode I, 136±14 ms (-15.6%) by Mode IV, and 132±13 ms (-17.8%) by Mode II. Mode III yielded the shortest overall QRSd (123±12 ms, -23.9% [ P <0.001 versus all modes]) and was the only configuration without QRSd prolongation in any patient. QRS narrowing occurred regardless of QRSd, PR, or LV-paced intervals, or underlying ischemic disease. Post-implant electrical optimization in already well-selected patients with left bundle branch block and optimized LV lead position is facilitated by patient-tailored BiV pacing adjusted to intrinsic atrioventricular timing using an automatic device-based algorithm. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  2. High voltage switch triggered by a laser-photocathode subsystem

    DOEpatents

    Chen, Ping; Lundquist, Martin L.; Yu, David U. L.

    2013-01-08

    A spark gap switch for controlling the output of a high voltage pulse from a high voltage source, for example, a capacitor bank or a pulse forming network, to an external load such as a high gradient electron gun, laser, pulsed power accelerator or wide band radar. The combination of a UV laser and a high vacuum quartz cell, in which a photocathode and an anode are installed, is utilized as triggering devices to switch the spark gap from a non-conducting state to a conducting state with low delay and low jitter.

  3. Constitutional rho-kinase regulates atrioventricular nodal conduction and ventricular repolarization of the canine heart.

    PubMed

    Sugiyama, Atsushi; Takahara, Akira; Yatomi, Yutaka; Satoh, Yoshioki; Nakamura, Yuji; Hashimoto, Keitaro

    2003-06-01

    Given the limited information, physiological roles of Rho-kinase in the cardiac conduction system and ventricular repolarization process were assessed in comparison with those in the coronary vascular tone. A specific Rho-kinase inhibitor Y-27632 was administered to the nutrient coronary artery of the canine isolated, blood-perfused atrioventricular node preparation under the monitoring of the ventricular monophasic action potentials. Administration of Y-27632 moderately suppressed the atrioventricular nodal conduction, slightly but significantly accelerated the repolarization process, and potently increased the coronary blood flow, whereas it hardly affected the intraventricular conduction. The estimated concentrations of Y-27632 causing the currently observed effects were enough to inhibit Rho-kinase. These results suggest that constitutional Rho-kinase functions to moderately facilitate the atrioventricular nodal conduction, slightly delay ventricular repolarization process, and significantly increase the coronary vascular tone.

  4. Human in the Loop Simulation Measures of Pilot Response Delay in a Self-Separation Concept of Operations

    NASA Technical Reports Server (NTRS)

    Consiglio, Maria C.; Wilson, Sara R.; Sturdy, James; Murdoch, Jennifer L.; Wing, David J.

    2010-01-01

    A human-in-the-loop (HITL) simulation experiment was conducted by the National Aeronautics and Space Administration (NASA) to assess airline transport pilots performance and reported acceptance of the use of procedures relying on airborne separation assistance and trajectory management tools. This study was part of a larger effort involving two NASA centers that includes multiple HITL experiments planned over the next few years to evaluate the use of automated separation assurance (SA) tools by both air traffic controllers and pilots. This paper presents results of measured pilot response delay that subject pilots incurred when interacting with cockpit tools for SA and discusses possible implications for future concept and procedures design.

  5. Ergonomics perspective for identifying and reducing internal operative flow disruption for laparoscopic urological surgery.

    PubMed

    Al-Hakim, Latif; Xiao, Jiaquan; Sengupta, Shomik

    2017-12-01

    The aim of this study is to examine operative flow disruption that occurs inside the surgical field, (internal operative flow disruption (OFD)), during urological laparoscopies, and to relate those events to external ergonomics environment in terms of monitor location, level of instruments' handles, and location of surgical team members. According to the our best knowledge, this is the first study of its kind. A combination of real and video-aided observational study was conducted in the operating rooms at hospitals in Australia and China. Brain storming sessions were first conducted to identify the main internal OFD events, and the observable reasons, potential external, and latent ergonomic factors were listed. A prospective observational study was then conducted. The observer's records and the related video records of internal surgical fields were analysed. Procedures were categorised into groups based on similarity in ergonomics environment. The mapping process revealed 39 types of internal OFD events resulted from six reasons. A total of 24 procedures were selected and arranged into two groups, each with twelve procedures. Group A was carried out under satisfactory ergonomics environment, while Group B was conducted under unsatisfactory ergonomics environment. A total of 1178 OFD events were detected delaying the total observed operative times (2966 min) by 220 min (7.43%). Average OFD/h in group A was less than 15, while in group B about 29 OFD/h. There are two main latent ergonomics factors affecting the surgeon's performance; non-physiological posture and long-period static posture. The delays and number of internal OFD were nearly doubled where procedures were conducted under unsatisfactory external ergonomics environment. Some events such as stopping operation and irrelevant conversations during long procedures may have a positive influence on the surgeon's performance.

  6. Optimal timing of pulse onset for language mapping with navigated repetitive transcranial magnetic stimulation.

    PubMed

    Krieg, Sandro M; Tarapore, Phiroz E; Picht, Thomas; Tanigawa, Noriko; Houde, John; Sollmann, Nico; Meyer, Bernhard; Vajkoczy, Peter; Berger, Mitchel S; Ringel, Florian; Nagarajan, Srikantan

    2014-10-15

    Within the primary motor cortex, navigated transcranial magnetic stimulation (nTMS) has been shown to yield maps strongly correlated with those generated by direct cortical stimulation (DCS). However, the stimulation parameters for repetitive nTMS (rTMS)-based language mapping are still being refined. For this purpose, the present study compares two rTMS protocols, which differ in the timing of pulse train onset relative to picture presentation onset during object naming. Results were the correlated with DCS language mapping during awake surgery. Thirty-two patients with left-sided perisylvian tumors were examined by rTMS prior to awake surgery. Twenty patients underwent rTMS pulse trains starting at 300 ms after picture presentation onset (delayed TMS), whereas another 12 patients received rTMS pulse trains starting at the picture presentation onset (ONSET TMS). These rTMS results were then evaluated for correlation with intraoperative DCS results as gold standard in terms of differential consistencies in receiver operating characteristics (ROC) statistics. Logistic regression analysis by protocols and brain regions were conducted. Within and around Broca's area, there was no difference in sensitivity (onset TMS: 100%, delayed TMS: 100%), negative predictive value (NPV) (onset TMS: 100%, delayed TMS: 100%), and positive predictive value (PPV) (onset TMS: 55%, delayed TMS: 54%) between the two protocols compared to DCS. However, specificity differed significantly (onset TMS: 67%, delayed TMS: 28%). In contrast, for posterior language regions, such as supramarginal gyrus, angular gyrus, and posterior superior temporal gyrus, early pulse train onset stimulation showed greater specificity (onset TMS: 92%, delayed TMS: 20%), NPV (onset TMS: 92%, delayed TMS: 57%) and PPV (onset TMS: 75%, delayed TMS: 30%) with comparable sensitivity (onset TMS: 75%, delayed TMS: 70%). Logistic regression analysis also confirmed the greater fit of the predictions by rTMS that had the pulse train onset coincident with the picture presentation onset when compared to the delayed stimulation. Analyses of differential disruption patterns of mapped cortical regions were further able to distinguish clusters of cortical regions standardly associated with semantic and pre-vocalization phonological networks proposed in various models of word production. Repetitive nTMS predictions by both protocols correlate well with DCS outcomes especially in Broca's region, particularly with regard to TMS negative predictions. With this study, we have demonstrated that rTMS stimulation onset coincident with picture presentation onset improves the accuracy of preoperative language maps, particularly within posterior language areas. Moreover, immediate and delayed pulse train onsets may have complementary disruption patterns that could differentially capture cortical regions causally necessary for semantic and pre-vocalization phonological networks. Published by Elsevier Inc.

  7. Delayed return of spontaneous circulation (the Lazarus phenomenon) after cessation of out-of-hospital cardiopulmonary resuscitation.

    PubMed

    Kuisma, Markku; Salo, Ari; Puolakka, Jyrki; Nurmi, Jouni; Kirves, Hetti; Väyrynen, Taneli; Boyd, James

    2017-09-01

    The delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR), also known as the Lazarus phenomenon, is a rare event described in several case reports. This study aims to determine the incidence and the time of occurrence of the Lazarus phenomenon after cessation of out-of-hospital CPR. This prospective observational cohort study was conducted in the Helsinki Emergency Medical Service in Finland from 1 January 2011 through 31 December 2016. All out-of-hospital CPR attempts were carefully monitored for 10min after the cessation of CPR in order to detect delayed ROSC. Altogether, 2102 out-of-hospital cardiac arrests occurred during the six-year study period. CPR was attempted in 1376 (65.5%) cases. In 840 cases (61.0% of all attempts) CPR attempts were terminated on site. The Lazarus phenomenon occurred five times, with an incidence of 5.95/1000 (95% CI 2.10-14.30) in field-terminated CPR attempts. Time to delayed ROSC from the cessation of CPR varied from 3 to 8min. Three of the five patients with delayed ROSC died at the scene within 2-15min while two died later in hospital within 1.5 and 26h, respectively. We observed that the Lazarus phenomenon is a real albeit rare event and can occur a few minutes after the cessation of out-of-hospital CPR. We suggest a 10-min monitoring period before diagnosing death. CPR guidelines should be updated to include information of the Lazarus phenomenon and appropriate monitoring for it. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. A Single Mutation in K13 Predominates in Southern China and Is Associated With Delayed Clearance of Plasmodium falciparum Following Artemisinin Treatment.

    PubMed

    Huang, Fang; Takala-Harrison, Shannon; Jacob, Christopher G; Liu, Hui; Sun, Xiaodong; Yang, Henglin; Nyunt, Myaing M; Adams, Matthew; Zhou, Shuisen; Xia, Zhigui; Ringwald, Pascal; Bustos, Maria Dorina; Tang, Linhua; Plowe, Christopher V

    2015-11-15

    Artemisinin resistance in Plasmodium falciparum has emerged in Southeast Asia and poses a threat to malaria control and elimination. Mutations in a P. falciparum gene encoding a kelch protein on chromosome 13 have been associated with delayed parasite clearance following artemisinin treatment elsewhere in the region, but not yet in China. Therapeutic efficacy studies of artesunate and dihydroartemisinin-piperaquine were conducted from 2009 to 2012 in the Yunnan Province of China near the border with Myanmar. K13 mutations were genotyped by capillary sequencing of DNA extracted from dried blood spots collected in these clinical trials and in routine surveillance. Associations between K13 mutations and delayed parasite clearance were tested using regression models. Parasite clearance half-lives were prolonged after artemisinin treatment, with 44% of infections having half-lives >5 hours (n = 109). Fourteen mutations in K13 were observed, with an overall prevalence of 47.7% (n = 329). A single mutation, F446I, predominated, with a prevalence of 36.5%. Infections with F446I were significantly associated with parasitemia on day 3 following artemisinin treatment and with longer clearance half-lives. Plasmodium falciparum infections in southern China displayed markedly delayed clearance following artemisinin treatment. F446I was the predominant K13 mutation and was associated with delayed parasite clearance. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. The Performance Analysis of a Real-Time Integrated INS/GPS Vehicle Navigation System with Abnormal GPS Measurement Elimination

    PubMed Central

    Chiang, Kai-Wei; Duong, Thanh Trung; Liao, Jhen-Kai

    2013-01-01

    The integration of an Inertial Navigation System (INS) and the Global Positioning System (GPS) is common in mobile mapping and navigation applications to seamlessly determine the position, velocity, and orientation of the mobile platform. In most INS/GPS integrated architectures, the GPS is considered to be an accurate reference with which to correct for the systematic errors of the inertial sensors, which are composed of biases, scale factors and drift. However, the GPS receiver may produce abnormal pseudo-range errors mainly caused by ionospheric delay, tropospheric delay and the multipath effect. These errors degrade the overall position accuracy of an integrated system that uses conventional INS/GPS integration strategies such as loosely coupled (LC) and tightly coupled (TC) schemes. Conventional tightly coupled INS/GPS integration schemes apply the Klobuchar model and the Hopfield model to reduce pseudo-range delays caused by ionospheric delay and tropospheric delay, respectively, but do not address the multipath problem. However, the multipath effect (from reflected GPS signals) affects the position error far more significantly in a consumer-grade GPS receiver than in an expensive, geodetic-grade GPS receiver. To avoid this problem, a new integrated INS/GPS architecture is proposed. The proposed method is described and applied in a real-time integrated system with two integration strategies, namely, loosely coupled and tightly coupled schemes, respectively. To verify the effectiveness of the proposed method, field tests with various scenarios are conducted and the results are compared with a reliable reference system. PMID:23955434

  10. Delayed Complications and Long-term Management of Sulfur Mustard Poisoning: Recent Advances by Iranian Researchers (Part I of II)

    PubMed Central

    Darchini-Maragheh, Emadodin; Balali-Mood, Mahdi

    2018-01-01

    Chemical warfare agents are the most brutal weapons among the weapons of mass destruction. Sulfur mustard (SM) is a potent toxic alkylating agent known as “the King of the Battle Gases”. SM has been the most widely used chemical weapon during the wars. It was widely used in World War I. Thereafter, it was extensively employed by the Iraqi troops against the Iranian military personnel and even civilians in the border cities of Iran and Iraq in the period between 1983 and 1988. Long-term incapacitating properties, significant environmental persistence, lack of an effective antidote, and relative ease of manufacturing have kept SM a potential agent for both terrorist and military uses. Even 3 decades after SM exposure, numerous delayed complications among Iranian victims are still being reported by researchers. The most common delayed complications have been observed in the respiratory tracts of chemically injured Iranian war veterans. Also, skin lesions and eye disorders have been observed in most Iranian SM-exposed war veterans in the delayed phase of SM intoxication. Thus, extensive research has been conducted on Iranian war veterans during the past decades. Nevertheless, major gaps still continue to exist in the SM literature. Part I of this paper will discuss the delayed complications and manifestations of exposure to SM among Iranian victims of the Iran–Iraq conflict. Part II, which will appear in the next issue of Iran J Med Sci, will discuss the long-term management and therapy of SM-exposed patients. PMID:29749980

  11. Theoretical basis to measure the impact of short-lasting control of an infectious disease on the epidemic peak

    PubMed Central

    2011-01-01

    Background While many pandemic preparedness plans have promoted disease control effort to lower and delay an epidemic peak, analytical methods for determining the required control effort and making statistical inferences have yet to be sought. As a first step to address this issue, we present a theoretical basis on which to assess the impact of an early intervention on the epidemic peak, employing a simple epidemic model. Methods We focus on estimating the impact of an early control effort (e.g. unsuccessful containment), assuming that the transmission rate abruptly increases when control is discontinued. We provide analytical expressions for magnitude and time of the epidemic peak, employing approximate logistic and logarithmic-form solutions for the latter. Empirical influenza data (H1N1-2009) in Japan are analyzed to estimate the effect of the summer holiday period in lowering and delaying the peak in 2009. Results Our model estimates that the epidemic peak of the 2009 pandemic was delayed for 21 days due to summer holiday. Decline in peak appears to be a nonlinear function of control-associated reduction in the reproduction number. Peak delay is shown to critically depend on the fraction of initially immune individuals. Conclusions The proposed modeling approaches offer methodological avenues to assess empirical data and to objectively estimate required control effort to lower and delay an epidemic peak. Analytical findings support a critical need to conduct population-wide serological survey as a prior requirement for estimating the time of peak. PMID:21269441

  12. Identification of educational and infrastructural barriers to prompt antibiotic delivery in febrile neutropenia: a quality improvement initiative.

    PubMed

    Burry, Erica; Punnett, Angela; Mehta, Ashley; Thull-Freedman, Jennifer; Robinson, Lisa; Gupta, Sumit

    2012-09-01

    Antibiotic administration within 60 minutes of presentation for medical care may be used as a treatment target for febrile neutropenia (FN); however, anecdotal evidence suggests this target is often missed. Few studies have examined the prevalence or causes of delay. We describe the median time to antibiotic administration at our institution, predictors of delay, and barriers to prompt administration to inform quality improvement strategies. A random sample of 50 episodes of FN presenting to the emergency department (ED) between 2008 and 2009 were reviewed. Times between triage, MD assessment, lab results, and antibiotic administration were recorded. Patient and ED variables were examined as possible predictors of delay. In parallel, lean methodology was used to identify system inefficiencies. A trained moderator conducted group interviews with interdisciplinary representatives involved in the emergency care of neutropenic patients to identify process barriers to prompt antibiotics. The median time from triage to antibiotics was 216 minutes (interquartile range [IQR] = 151-274 minutes). The greatest delay occurred following the reporting of lab results (152 minutes, IQR = 84-210 minutes). Only fall season predicted a longer time to antibiotics (P = 0.03). The lean process identified unnecessary areas of delay between departments. Time to antibiotic administration exceeded 1 hour. The chart review and lean process suggested targets for educational and infrastructural interventions, including an ED pre-printed order sheet, targeted combined subspecialty education between emergency and hematology/oncology staff, and family education. A mixed methodology approach represents a model for improving process efficiency and meeting "best-practice" targets in medicine. Copyright © 2011 Wiley Periodicals, Inc.

  13. Screening for Speech and Language Delay in Children 5 Years Old and Younger: A Systematic Review.

    PubMed

    Wallace, Ina F; Berkman, Nancy D; Watson, Linda R; Coyne-Beasley, Tamera; Wood, Charles T; Cullen, Katherine; Lohr, Kathleen N

    2015-08-01

    No recommendation exists for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children through 5 years of age. This review aimed to update the evidence on screening and treating children for speech and language since the 2006 US Preventive Services Task Force systematic review. Medline, the Cochrane Library, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and reference lists. We included studies reporting diagnostic accuracy of screening tools and randomized controlled trials reporting benefits and harms of treatment of speech and language. Two independent reviewers extracted data, checked accuracy, and assigned quality ratings using predefined criteria. We found no evidence for the impact of screening on speech and language outcomes. In 23 studies evaluating the accuracy of screening tools, sensitivity ranged between 50% and 94%, and specificity ranged between 45% and 96%. Twelve treatment studies improved various outcomes in language, articulation, and stuttering; little evidence emerged for interventions improving other outcomes or for adverse effects of treatment. Risk factors associated with speech and language delay were male gender, family history, and low parental education. A limitation of this review is the lack of well-designed, well-conducted studies addressing whether screening for speech and language delay or disorders improves outcomes. Several screening tools can accurately identify children for diagnostic evaluations and interventions, but evidence is inadequate regarding applicability in primary care settings. Some treatments for young children identified with speech and language delays and disorders may be effective. Copyright © 2015 by the American Academy of Pediatrics.

  14. Dancing sprites: Detailed analysis of two case studies

    NASA Astrophysics Data System (ADS)

    Soula, Serge; Mlynarczyk, Janusz; Füllekrug, Martin; Pineda, Nicolau; Georgis, Jean-François; van der Velde, Oscar; Montanyà, Joan; Fabró, Ferran

    2017-03-01

    On 29-30 October 2013, a low-light video camera installed at Pic du Midi (2877 m), recorded transient luminous events above a very active storm over the Mediterranean Sea. The minimum cloud top temperature reached -73°C, while its cloud to ground (CG) flash rate exceeded 30 fl min-1. Some sprite events have long duration and resemble to dancing sprites. We analyze in detail the temporal evolution and estimated location of two series of sprite sequences, as well as the cloud structure, the lightning activity, the electric field radiated in a broad range of low frequencies, and the current moment waveform of the lightning strokes. (i) In each series, successive sprite sequences reflect time and location of corresponding positive lightning strokes across the stratiform region. (ii) The longer time-delayed (>20 ms) sprite elements correspond to the lower impulsive charge moment changes (iCMC) of the parent strokes (<200 C km), and they are shifted few tens of kilometers from their SP + CG stroke. However, both short and long time-delayed sprite elements also occur after strokes that produce a large iCMC and that are followed by a continuing current. (iii) The long time-delayed sprite elements during the continuing current correspond to surges in the current moment waveform. They occur sometimes at an altitude apparently lower than the previous short time-delayed sprite elements, possibly because of changes in the local conductivity. (iv) The largest and brightest sprite elements produce significant current signatures, visible when their delay is not too short ( 3-5 ms).

  15. Delay of Gratification, Delay Discounting and their Associations with Age, Episodic Future Thinking, and Future Time Perspective

    PubMed Central

    Göllner, Lars M.; Ballhausen, Nicola; Kliegel, Matthias; Forstmeier, Simon

    2018-01-01

    The delay of gratification (DoG) in children is widely investigated with an experimental procedure originally called the “marshmallow test,” whereas the studies on self-regulation (SR) in adolescents and adults usually use self-report questionnaires. Delay discounting (DD) measures simplify the DoG procedure and focus on monetary rewards. The aim of this study was to investigate age differences in DoG and DD from childhood to old age using a test that is suitable for both children and adults. Furthermore, investigations were conducted on the association between DoG/DD and two future orientation constructs [future time perspective (FTP) and episodic future thinking (EFT)] as well as age differences in these constructs. Participants from five age groups (9–14, 18–25, 35–55, 65–80, 80+) participated in the study (N = 96). While we found no age difference for DoG, DD was the lowest [i.e., self-control (SC) was the highest] in young/middle adults; however, it was the highest (i.e., SC was the lowest) in children and old/oldest adults. Furthermore, we found significant age differences for DD and FTP. As predicted, there were strong correlations between DoG and FTP and between DD and FTP, but not between DoG/DD and EFT. These results indicate that age differences in SR vary across the measures used. Individuals who generally think and act in a future-oriented manner have a stronger ability to delay gratification. PMID:29422875

  16. Conduction velocity of the uterine contraction in serial magnetomyogram (MMG) data: event based simulation and validation.

    PubMed

    Furdea, Adrian; Preissl, Hubert; Lowery, Curtis L; Eswaran, Hari; Govindan, Rathinaswamy B

    2011-01-01

    We propose a novel approach to calculate the conduction velocity (CV) of the uterine contraction bursts in magnetomyogram (MMG) signals measured using a multichannel SQUID array. For this purpose, we partition the sensor coordinates into four different quadrants and identify the contractile bursts using a previously proposed Hilbert-wavelet transform approach. If contractile burst is identified in more than one quadrant, we calculate the center of gravity (CoG) in each quadrant for each time point as the sum of the product of the sensor coordinates with the Hilbert amplitude of the MMG signals normalized by the sum of the Hilbert amplitude of the signals over all sensors. Following this we compute the delay between the CoGs of all (six) possible quadrant pairs combinations. As a first step, we validate this approach by simulating a stochastic model based on independent second-order autoregressive processes (AR2) and we divide them into 30 second disjoint windows and insert burst activity at specific time instances in preselected sensors. Also we introduce a lag of 5 ± 1 seconds between different quadrants. Using our approach we calculate the CoG of the signals in a quadrant. To this end, we compute the delay between CoGs obtained from different quadrants and show that our approach is able to reliably capture the delay incorporated in the model. We apply the proposed approach to 19 serial MMG data obtained from two subjects and show an increase in the CV as the subjects approached labor.

  17. Identifying postpartum intervention approaches to reduce cardiometabolic risk among American Indian women with prior gestational diabetes, Oklahoma, 2012-2013.

    PubMed

    Jones, Emily J; Peercy, Michael; Woods, J Cedric; Parker, Stephany P; Jackson, Teresa; Mata, Sara A; McCage, Shondra; Levkoff, Sue E; Nicklas, Jacinda M; Seely, Ellen W

    2015-04-02

    Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program. In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women's cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program. Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women's competing priorities. Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population.

  18. Performance Evaluation of Individual Aircraft Based Advisory Concept for Surface Management

    NASA Technical Reports Server (NTRS)

    Gupta, Gautam; Malik, Waqar; Tobias, Leonard; Jung, Yoon; Hong, Ty; Hayashi, Miwa

    2013-01-01

    Surface operations at airports in the US are based on tactical operations, where departure aircraft primarily queue up and wait at the departure runways. NASA's Spot And Runway Departure Advisor (SARDA) tool was developed to address these inefficiencies through Air Traffic Control Tower advisories. The SARDA system is being updated to include collaborative gate hold, either tactically or strategically. This paper presents the results of the human-in-the-loop evaluation of the tactical gate hold version of SARDA in a 360 degree simulated tower setting. The simulations were conducted for the east side of the Dallas/Fort Worth airport. The new system provides gate hold, ground controller and local controller advisories based on a single scheduler. Simulations were conducted with SARDA on and off, the off case reflecting current day operations with no gate hold. Scenarios based on medium (1.2x current levels) and heavy (1.5x current levels) traffic were explored. Data collected from the simulation was analyzed for runway usage, delay for departures and arrivals, and fuel consumption. Further, Traffic Management Initiatives were introduced for a subset of the aircraft. Results indicated that runway usage did not change with the use of SARDA, i.e., there was no loss in runway throughput as compared to baseline. Taxiing delay was significantly reduced with the use of advisory by 45% in medium scenarios and 60% in heavy. Arrival delay was unaffected by the use of advisory. Total fuel consumption was also reduced by 23% in medium traffic and 33% in heavy. TMI compliance appeared unaffected by the advisory

  19. A Qualitative Analysis of Physician Perspectives on Missed and Delayed Outpatient Diagnosis: The Focus on System-Related Factors.

    PubMed

    Sarkar, Urmimala; Simchowitz, Brett; Bonacum, Doug; Strull, William; Lopez, Andrea; Rotteau, Leahora; Shojania, Kaveh G

    2014-10-01

    Delayed and missed diagnoses lead to significant patient harm. Because physician actions are fundamental to the outpatient diagnostic process, a study was conducted to explore physician perspectives on diagnosis. As part of a quality improvement initiative, an integrated health system conducted six physician focus groups in 2004 and 2005. The focus groups included questions about the process of diagnosis, specific factors contributing to missed diagnosis, use of guidelines, atypical vs. typical presentations of disease, diagnostic tools, and follow-up, all with regard to delays in the diagnostic process. The interviews were analyzed (1) deductively, with application of the Systems Engineering Initiative for Patient Safety (SEIPS) model, which addresses systems design, quality management, job design, and technology implementations that affect safety-related patient and organizational and/or staff outcomes, and (2) inductively, with identification of novel themes using content analysis. A total of 25 physicians participated in the six focus groups, which yielded 12 hours of discussion. Providers identified multiple barriers to timely and accurate diagnosis, including organizational culture, information availability, and communication factors. Multiple themes relating to each of the participants in the diagnostic process-health system, provider, and patient-emerged. Concerns about health system structure and providers' interactions with one another and with patients far exceeded discussion of the cognitive factors that might affect the diagnostic process. The results suggest that, at least in physicians' views, improving the diagnostic process requires attention to the organization of the health system in addition to the cognitive aspects of diagnosis.

  20. Performance Evaluation of SARDA: An Individual Aircraft-Based Advisory Concept for Surface Management

    NASA Technical Reports Server (NTRS)

    Jung, Yoon; Malik, Waqar; Tobias, Leonard; Gupta, Gautam; Hoang, Ty; Hayashi, Miwa

    2015-01-01

    Surface operations at airports in the US are based on tactical operations, where departure aircraft primarily queue up and wait at the departure runways. NASAs Spot And Runway Departure Advisor (SARDA) tool was developed to address these inefficiencies through Air Traffic Control Tower advisories. The SARDA system is being updated to include collaborative gate hold, either tactically or strategically. This paper presents the results of the human-in-the-loop evaluation of the tactical gate hold version of SARDA in a 360 degree simulated tower setting. The simulations were conducted for the east side of the Dallas-Fort Worth airport. The new system provides gate hold, ground controller and local controller advisories based on a single scheduler. Simulations were conducted with SARDA on and off, the off case reflecting current day operations with no gate hold. Scenarios based on medium (1.2x current levels) and heavy (1.5x current levels) traffic were explored. Data collected from the simulation was analyzed for runway usage, delay for departures and arrivals, and fuel consumption. Further, Traffic Management Initiatives were introduced for a subset of the aircraft. Results indicated that runway usage did not change with the use of SARDA, i.e., there was no loss in runway throughput as compared to baseline. Taxiing delay was significantly reduced with the use of advisory by 45 in medium scenarios and 60 in heavy. Arrival delay was unaffected by the use of advisory. Total fuel consumption was also reduced by 23 in medium traffic and 33 in heavy. TMI compliance appeared unaffected by the advisory.

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