On the continuous differentiability of inter-spike intervals of synaptically connected cortical spiking neurons in a neuronal network.

PubMed

Kumar, Gautam; Kothare, Mayuresh V

2013-12-01

We derive conditions for continuous differentiability of inter-spike intervals (ISIs) of spiking neurons with respect to parameters (decision variables) of an external stimulating input current that drives a recurrent network of synaptically connected neurons. The dynamical behavior of individual neurons is represented by a class of discontinuous single-neuron models. We report here that ISIs of neurons in the network are continuously differentiable with respect to decision variables if (1) a continuously differentiable trajectory of the membrane potential exists between consecutive action potentials with respect to time and decision variables and (2) the partial derivative of the membrane potential of spiking neurons with respect to time is not equal to the partial derivative of their firing threshold with respect to time at the time of action potentials. Our theoretical results are supported by showing fulfillment of these conditions for a class of known bidimensional spiking neuron models.

Sports practice is related to parasympathetic activity in adolescents

PubMed Central

Cayres, Suziane Ungari; Vanderlei, Luiz Carlos Marques; Rodrigues, Aristides Machado; Coelho e Silva, Manuel João; Codogno, Jamile Sanches; Barbosa, Maurício Fregonesi; Fernandes, Rômulo Araújo

2015-01-01

OBJECTIVE: To analyze the relationship among sports practice, physical education class, habitual physical activity and cardiovascular risk in adolescents. METHODS: Cross-sectional study with 120 schoolchildren (mean: 11.7±0.7 years old), with no regular use of medicines. Sports practice and physical education classes were assessed through face-to-face interview, while habitual physical activity was assessed by pedometers. Bodyweight, height and height-cephalic trunk were used to estimate maturation. The following variables were measured: body fatness, blood pressure, resting heart rate, blood flow velocity, intima-media thickness (carotid and femoral) and heart rate variability (mean between consecutive heartbeats and statistical index in the time domain that show the autonomic parasympathetic nervous system activity root-mean by the square of differences between adjacent normal R-R intervals in a time interval). Statistical treatment used Spearman correlation adjusted by sex, ethnicity, age, body fatness and maturation. RESULTS: Independently of potential confounders, sports practice was positively related to autonomic parasympathetic nervous system activity (β=0.039 [0.01; 0.76]). On the other hand, the relationship between sport practice and mean between consecutive heartbeats (β=0,031 [-0.01; 0.07]) was significantly mediated by biological maturation. CONCLUSIONS: Sport practice was related to higher heart rate variability at rest. PMID:25887927

Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study.

PubMed

Seo, Eun Hee; Kim, Tae Oh; Park, Min Jae; Joo, Hee Rin; Heo, Nae Yun; Park, Jongha; Park, Seung Ha; Yang, Sung Yeon; Moon, Young Soo

2012-03-01

Several factors influence bowel preparation quality. Recent studies have indicated that the time interval between bowel preparation and the start of colonoscopy is also important in determining bowel preparation quality. To evaluate the influence of the preparation-to-colonoscopy (PC) interval (the interval of time between the last polyethylene glycol dose ingestion and the start of the colonoscopy) on bowel preparation quality in the split-dose method for colonoscopy. Prospective observational study. University medical center. A total of 366 consecutive outpatients undergoing colonoscopy. Split-dose bowel preparation and colonoscopy. The quality of bowel preparation was assessed by using the Ottawa Bowel Preparation Scale according to the PC interval, and other factors that might influence bowel preparation quality were analyzed. Colonoscopies with a PC interval of 3 to 5 hours had the best bowel preparation quality score in the whole, right, mid, and rectosigmoid colon according to the Ottawa Bowel Preparation Scale. In multivariate analysis, the PC interval (odds ratio [OR] 1.85; 95% CI, 1.18-2.86), the amount of PEG ingested (OR 4.34; 95% CI, 1.08-16.66), and compliance with diet instructions (OR 2.22l 95% CI, 1.33-3.70) were significant contributors to satisfactory bowel preparation. Nonrandomized controlled, single-center trial. The optimal time interval between the last dose of the agent and the start of colonoscopy is one of the important factors to determine satisfactory bowel preparation quality in split-dose polyethylene glycol bowel preparation. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Influence of Inter-Training Intervals on Intermanual Transfer Effects in Upper-Limb Prosthesis Training: A Randomized Pre-Posttest Study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2015-01-01

Improvement in prosthetic training using intermanual transfer (the transfer of motor skills from the trained, “unaffected” hand to the untrained, “affected” hand) has been shown in previous studies. The aim of this study is to determine the influence of the inter-training interval on the magnitude of the intermanual transfer effects. This was done using a mechanistic, randomized, single-blinded pretest-posttest design. Sixty-four able-bodied, right-handed participants were randomly assigned to the Short and Long Interval Training Groups and the Short and Long Interval Control Groups. The Short and Long Interval Training Groups used a prosthesis simulator in their training program. The Short and Long Interval Control Groups executed a sham training program, that is, a dummy training program in which the same muscles were trained as with the prosthesis simulator. The Short Interval Training Group and the Short Interval Control Groups trained on consecutive days, while the Long Interval Training Group and Long Interval Control Group trained twice a week. To determine the improvement in skills, a test was administered before, immediately after, and at two points in time after the training. Training was performed with the “unaffected” arm; tests were performed with the “affected” arm. The outcome measurements were: the movement time (the time from the beginning of the movement until completion of the task); the duration of maximum hand opening, (the opening of the prosthetic hand while grasping an object); and the grip-force control (the error from the required grip-force during a tracking task). Intermanual transfer was found in movement times, but not in hand opening or grip-force control. The length of the inter-training interval did not affect the magnitude of intermanual transfer effects. No difference in the intermanual transfer effect in upper-limb prosthesis training was found for training on a daily basis as compared to training twice a week. Nederlands Trial Register NTR3888.

Influence of Inter-Training Intervals on Intermanual Transfer Effects in Upper-Limb Prosthesis Training: A Randomized Pre-Posttest Study

PubMed Central

Romkema, Sietske; Bongers, Raoul M.; van der Sluis, Corry K.

2015-01-01

Improvement in prosthetic training using intermanual transfer (the transfer of motor skills from the trained, “unaffected” hand to the untrained, “affected” hand) has been shown in previous studies. The aim of this study is to determine the influence of the inter-training interval on the magnitude of the intermanual transfer effects. This was done using a mechanistic, randomized, single-blinded pretest-posttest design. Sixty-four able-bodied, right-handed participants were randomly assigned to the Short and Long Interval Training Groups and the Short and Long Interval Control Groups. The Short and Long Interval Training Groups used a prosthesis simulator in their training program. The Short and Long Interval Control Groups executed a sham training program, that is, a dummy training program in which the same muscles were trained as with the prosthesis simulator. The Short Interval Training Group and the Short Interval Control Groups trained on consecutive days, while the Long Interval Training Group and Long Interval Control Group trained twice a week. To determine the improvement in skills, a test was administered before, immediately after, and at two points in time after the training. Training was performed with the “unaffected” arm; tests were performed with the “affected” arm. The outcome measurements were: the movement time (the time from the beginning of the movement until completion of the task); the duration of maximum hand opening, (the opening of the prosthetic hand while grasping an object); and the grip-force control (the error from the required grip-force during a tracking task). Intermanual transfer was found in movement times, but not in hand opening or grip-force control. The length of the inter-training interval did not affect the magnitude of intermanual transfer effects. No difference in the intermanual transfer effect in upper-limb prosthesis training was found for training on a daily basis as compared to training twice a week. Trial Registration Nederlands Trial Register NTR3888 PMID:26075396

Amoebae Anticipate Periodic Events

NASA Astrophysics Data System (ADS)

Saigusa, Tetsu; Tero, Atsushi; Nakagaki, Toshiyuki; Kuramoto, Yoshiki

2008-01-01

When plasmodia of the true slime mold Physarum were exposed to unfavorable conditions presented as three consecutive pulses at constant intervals, they reduced their locomotive speed in response to each episode. When the plasmodia were subsequently subjected to favorable conditions, they spontaneously reduced their locomotive speed at the time when the next unfavorable episode would have occurred. This implied the anticipation of impending environmental change. We explored the mechanisms underlying these types of behavior from a dynamical systems perspective.

Resistance to Extinction Following Variable-Interval Reinforcement: Reinforcer Rate and Amount

ERIC Educational Resources Information Center

Shull, Richard L.; Grimes, Julie A.

2006-01-01

Rats obtained food-pellet reinforcers by nose poking a lighted key. Experiment 1 examined resistance to extinction following single-schedule training with different variable-interval schedules, ranging from a mean interval of 16 min to 0.25 min. That is, for each schedule, the rats received 20 consecutive daily baseline sessions and then a session…

Typology of nonlinear activity waves in a layered neural continuum.

PubMed

Koch, Paul; Leisman, Gerry

2006-04-01

Neural tissue, a medium containing electro-chemical energy, can amplify small increments in cellular activity. The growing disturbance, measured as the fraction of active cells, manifests as propagating waves. In a layered geometry with a time delay in synaptic signals between the layers, the delay is instrumental in determining the amplified wavelengths. The growth of the waves is limited by the finite number of neural cells in a given region of the continuum. As wave growth saturates, the resulting activity patterns in space and time show a variety of forms, ranging from regular monochromatic waves to highly irregular mixtures of different spatial frequencies. The type of wave configuration is determined by a number of parameters, including alertness and synaptic conditioning as well as delay. For all cases studied, using numerical solution of the nonlinear Wilson-Cowan (1973) equations, there is an interval in delay in which the wave mixing occurs. As delay increases through this interval, during a series of consecutive waves propagating through a continuum region, the activity within that region changes from a single-frequency to a multiple-frequency pattern and back again. The diverse spatio-temporal patterns give a more concrete form to several metaphors advanced over the years to attempt an explanation of cognitive phenomena: Activity waves embody the "holographic memory" (Pribram, 1991); wave mixing provides a plausible cause of the competition called "neural Darwinism" (Edelman, 1988); finally the consecutive generation of growing neural waves can explain the discontinuousness of "psychological time" (Stroud, 1955).

Prevalence, Risk Factors and In-hospital Outcomes of QTc Interval Prolongation in Liver Cirrhosis.

PubMed

Zhao, Jiancheng; Qi, Xingshun; Hou, Feifei; Ning, Zheng; Zhang, Xintong; Deng, Han; Peng, Ying; Li, Jing; Wang, Xiaoxi; Li, Hongyu; Guo, Xiaozhong

2016-09-01

QTc interval prolongation is an electrocardiographic abnormality in liver cirrhosis. The objective of this study was to evaluate the prevalence, risk factors and in-hospital outcomes of QTc interval prolongation in Chinese patients with liver cirrhosis. This was a retrospective analysis of a total of 1,268 patients with liver cirrhosis who were consecutively admitted to our hospital between January 2011 and June 2014. QTc interval data were collected from the medical records. QTc interval prolongation was defined as QTc interval > 440 milliseconds. The prevalence of QTc interval prolongation was 38.2% (485 of 1268). In the entire cohort, the risk factors for QTc interval prolongation included an older age, a higher proportion of alcohol abuse and ascites, higher bilirubin, blood urea nitrogen, creatinine, prothrombin time, international normalized ratio, Child-Pugh score and model for end-stage liver diseases score, and lower red blood cell (RBC), hemoglobin (Hb), albumin (ALB), alanine aminotransferase and calcium. The in-hospital mortality was not significantly different between patients with and without QTc interval prolongation (2.1% versus 1.3%, P = 0.276). In the subgroup analyses of patients with hepatitis B virus or alcohol alone-related liver cirrhosis, the risk factors included higher bilirubin, creatinine, prothrombin time, international normalized ratio, Child-Pugh score and model for end-stage liver diseases score, and lower RBC, Hb and ALB. In the subgroups analyses of patients with acute upper gastrointestinal bleeding or ascites, the risk factors included lower RBC, Hb and ALB. QTc interval prolongation was frequent in liver cirrhosis. Although QTc interval prolongation was positively associated with alcohol-related liver cirrhosis and more severe liver dysfunction, it did not significantly influence the in-hospital mortality. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Time-based partitioning model for predicting neurologically favorable outcome among adults with witnessed bystander out-of-hospital CPA.

PubMed

Abe, Toshikazu; Tokuda, Yasuharu; Cook, E Francis

2011-01-01

Optimal acceptable time intervals from collapse to bystander cardiopulmonary resuscitation (CPR) for neurologically favorable outcome among adults with witnessed out-of-hospital cardiopulmonary arrest (CPA) have been unclear. Our aim was to assess the optimal acceptable thresholds of the time intervals of CPR for neurologically favorable outcome and survival using a recursive partitioning model. From January 1, 2005 through December 31, 2009, we conducted a prospective population-based observational study across Japan involving consecutive out-of-hospital CPA patients (N = 69,648) who received a witnessed bystander CPR. Of 69,648 patients, 34,605 were assigned to the derivation data set and 35,043 to the validation data set. Time factors associated with better outcomes: the better outcomes were survival and neurologically favorable outcome at one month, defined as category one (good cerebral performance) or two (moderate cerebral disability) of the cerebral performance categories. Based on the recursive partitioning model from the derivation dataset (n = 34,605) to predict the neurologically favorable outcome at one month, 5 min threshold was the acceptable time interval from collapse to CPR initiation; 11 min from collapse to ambulance arrival; 18 min from collapse to return of spontaneous circulation (ROSC); and 19 min from collapse to hospital arrival. Among the validation dataset (n = 35,043), 209/2,292 (9.1%) in all patients with the acceptable time intervals and 1,388/2,706 (52.1%) in the subgroup with the acceptable time intervals and pre-hospital ROSC showed neurologically favorable outcome. Initiation of CPR should be within 5 min for obtaining neurologically favorable outcome among adults with witnessed out-of-hospital CPA. Patients with the acceptable time intervals of bystander CPR and pre-hospital ROSC within 18 min could have 50% chance of neurologically favorable outcome.

Near-Earth-Object identification over apparitions using n-body ranging

NASA Astrophysics Data System (ADS)

Granvik, Mikael; Muinonen, Karri

2007-05-01

Earth-based telescopes can observe Near-Earth objects (NEOs) continuously for a few weeks or months during each apparition. Due to the usually complicated dynamics of the Sun-Earth-NEO triplet, the time interval between consecutive apparitions typically ranges from months to several years. On these timescales single-apparition sets of observations (SASs) having reasonably small observational time-intervals lead to substantial orbital uncertainties. The linking of SASs over apparitions thus becomes a nontrivial task. Of a total of roughly 4,100 NEO observation sets, or orbits, currently known, some 500 are SASs for which the observational time interval is less than 7 days. Either these SASs have not been observed at an apparition following the discovery apparition (some 40% of the above NEO SASs have been obtained in 2005 or later), or the linkage of SASs has failed, an option which should preferably be eliminated. As a continuation to our work on the short-arc linking problem at the discovery moment (Granvik and Muinonen, 2005, Icarus 179, p. 109), we have investigated the possibility of using a similar method for the linking of SASs over apparitions. Assuming that the observational time-interval for SASs of NEOs is typically at least one day (minimum requirement set by the Minor Planet Center), the orbital-element probability density function is constrained as compared to the typical short-arc case with an observational time interval of only a few tens of minutes. Because of the smaller orbital-element uncertainty, we can use the short-arc method (comparison in ephemeris space) for longer time spans, or even do the comparison directly in orbital-element space (Keplerian, equinoctial, etc.), thus allowing us to assess the problem of linking SASs of NEOs. We will present linking results by using both simulated and real NEO SASs.

Association of cardiac implantable electronic devices with survival in bifascicular block and prolonged PR interval on electrocardiogram.

PubMed

Moulki, Naeem; Kealhofer, Jessica V; Benditt, David G; Gravely, Amy; Vakil, Kairav; Garcia, Santiago; Adabag, Selcuk

2018-06-16

Bifascicular block and prolonged PR interval on the electrocardiogram (ECG) have been associated with complete heart block and sudden cardiac death. We sought to determine if cardiac implantable electronic devices (CIED) improve survival in these patients. We assessed survival in relation to CIED status among 636 consecutive patients with bifascicular block and prolonged PR interval on the ECG. In survival analyses, CIED was considered as a time-varying covariate. Average age was 76 ± 9 years, and 99% of the patients were men. A total of 167 (26%) underwent CIED (127 pacemaker only) implantation at baseline (n = 23) or during follow-up (n = 144). During 5.4 ± 3.8 years of follow-up, 83 (13%) patients developed complete or high-degree atrioventricular block and 375 (59%) died. Patients with a CIED had a longer survival compared to those without a CIED in the traditional, static analysis (log-rank p < 0.0001) but not when CIED was considered as a time-varying covariate (log-rank p = 0.76). In the multivariable model, patients with a CIED had a 34% lower risk of death (hazard ratio 0.66, 95% confidence interval 0.52-0.83; p = 0.001) than those without CIED in the traditional analysis but not in the time-varying covariate analysis (hazard ratio 1.05, 95% confidence interval 0.79-1.38; p = 0.76). Results did not change in the subgroup with a pacemaker only. Bifascicular block and prolonged PR interval on ECG are associated with a high incidence of complete atrioventricular block and mortality. However, CIED implantation does not have a significant influence on survival when time-varying nature of CIED implantation is considered.

Concomitant external pneumatic compression treatment with consecutive days of high intensity interval training reduces markers of proteolysis.

PubMed

Haun, Cody T; Roberts, Michael D; Romero, Matthew A; Osburn, Shelby C; Healy, James C; Moore, Angelique N; Mobley, Christopher B; Roberson, Paul A; Kephart, Wesley C; Mumford, Petey W; Goodlett, Michael D; Pascoe, David D; Martin, Jeffrey S

2017-12-01

To compare the effects of external pneumatic compression (EPC) and sham when used concurrently with high intensity interval training (HIIT) on performance-related outcomes and recovery-related molecular measures. Eighteen recreationally endurance-trained male participants (age: 21.6 ± 2.4 years, BMI: 25.7 ± 0.5 kg/m 2 , VO 2peak : 51.3 ± 0.9 mL/kg/min) were randomized to balanced sham and EPC treatment groups. Three consecutive days of HIIT followed by EPC/sham treatment (Days 2-4) and 3 consecutive days of recovery (Days 5-7) with EPC/sham only on Days 5-6 were employed. Venipuncture, flexibility and pressure-to-pain threshold (PPT) measurements were made throughout. Vastus lateralis muscle was biopsied at PRE (i.e., Day 1), 1-h post-EPC/sham treatment on Day 2 (POST1), and 24-h post-EPC/sham treatment on Day 7 (POST2). 6-km run time trial performance was tested at PRE and POST2. No group × time interaction was observed for flexibility, PPT, or serum measures of creatine kinase (CK), hsCRP, and 8-isoprostane. However, there was a main effect of time for serum CK (p = 0.005). Change from PRE in 6-km run times at POST2 were not significantly different between groups. Significant between-groups differences existed for change from PRE in atrogin-1 mRNA (p = 0.018) at the POST1 time point (EPC: - 19.7 ± 8.1%, sham: + 7.7 ± 5.9%) and atrogin-1 protein concentration (p = 0.013) at the POST2 time point (EPC: - 31.8 ± 7.5%, sham: + 96.0 ± 34.7%). In addition, change from PRE in poly-Ub proteins was significantly different between groups at both the POST1 (EPC: - 26.0 ± 10.3%, sham: + 34.8 ± 28.5%; p = 0.046) and POST2 (EPC: - 33.7 ± 17.2%, sham: + 21.4 ± 14.9%; p = 0.037) time points. EPC when used concurrently with HIIT and in subsequent recovery days reduces skeletal muscle markers of proteolysis.

Severity of Vision Loss Interacts With Word-Specific Features to Impact Out-Loud Reading in Glaucoma

PubMed Central

Mathews, Priya M.; Rubin, Gary S.; McCloskey, Michael; Salek, Sherveen; Ramulu, Pradeep Y.

2015-01-01

Purpose. To assess the impact of glaucoma-related vision loss on measures of out-loud reading, including time to say individual words, interval time between consecutive words, lexical errors, skipped words, and repetitions. Methods. Glaucoma subjects (n = 63) with bilateral visual field loss and glaucoma suspect controls (n = 57) were recorded while reading a standardized passage out loud. A masked evaluator determined the start and end of each recorded word and identified reading errors. Results. Glaucoma subjects demonstrated longer durations to recite individual words (265 vs. 243 ms, P < 0.001), longer intervals between words (154 vs. 124 ms, P < 0.001), and longer word/post-word interval complexes (the time spanned by the word and the interval following the word; 419 vs. 367 ms, P < 0.001) than controls. In multivariable analyses, each 0.1 decrement in log contrast sensitivity (logCS) was associated with a 15.0 ms longer word/post-interval complex (95% confidence interval [CI] = 9.6–20.4; P < 0.001). Contrast sensitivity was found to significantly interact with word length, word frequency, and word location at the end of a line with regards to word/post-word interval complex duration (P < 0.05 for all). Glaucoma severity was also associated with more lexical errors (Odds ratio = 1.20 for every 0.1 logCS decrement; 95% CI = 1.02–1.39, P < 0.05), but not with more skipped or repeated words. Conclusions. Glaucoma patients with greater vision loss make more lexical errors, are slower in reciting longer and less frequently used words, and more slowly transition to new lines of text. These problem areas may require special attention when designing methods to rehabilitate reading in patients with glaucoma. PMID:25737150

Adults' age-related differences in strategy perseveration are modulated by response-stimulus intervals and problem features.

PubMed

Lemaire, Patrick; Brun, Fleur

2014-10-01

Ageing results in the tendency of older adults to repeat the same strategy across consecutive problems more often than young adults, even when such strategy perseveration is not appropriate. Here, we examined how these age-related differences in strategy perseveration are modulated by response-stimulus intervals and problem characteristics. We asked participants to select the best strategy while accomplishing a computational estimation task (i.e., provide approximate sums to two-digit addition problems like 38 + 74). We found that participants repeated the same strategy across consecutive problems more often when the duration between their response and next problem display was short (300 ms) than when it was long (1300 ms). We also found more strategy perseverations in older than in young adults under short Response-Stimulus Intervals, but not under long Response-Stimulus Intervals. Finally, age-related differences in strategy perseveration decreased when problem features helped participants to select the best strategy. These modulations of age-related differences in strategy perseveration by response-stimulus intervals and characteristics of target problems are important for furthering our understanding of mechanisms underlying strategy perseveration and, more generally, ageing effects on strategy selection.

An investigation of a hypothermic to ischemic ratio in patients following out-of-hospital cardiac arrest presenting with a shockable rhythm.

PubMed

Sawyer, Kelly N; Kurz, Michael C; Elswick, R K

2014-06-01

Targeted temperature management (TTM) improves outcome after out-of-hospital cardiac arrest (OHCA). We hypothesized that there may be a significant relationship between the dose of hypothermia, the time to return of spontaneous circulation (ROSC), and survival to discharge. Retrospective pilot investigation on 99 consecutive OHCA patients with initial shockable rhythm, surviving to admission, and undergoing TTM between 2008 and 2011. Dose of hypothermia was defined as the sum of the induction interval (time to target temperature [from ROSC to 33°C]); the controlled hypothermia interval (from reaching 33°C until rewarming); and the rewarming interval (from 33°C to 37°C). Time to ROSC was measured from pulselessness or 911 call time to ROSC. The ratio between the two was termed the hypothermic to ischemic ratio. Purposeful variable selection for logistic regression modeling was used to assess the influence of the hypothermic/ischemic ratio on survival. Odds ratios (OR) were used to examine the effects of predictor variables on survival. Of 99 patients, eight were excluded for deviation from protocol, death during protocol, or missing data. From the univariate models, survivors were more likely to be younger, have a shorter time to ROSC, and have a larger hypothermic/ischemic ratio. Survivors also had a nonsignificant trend toward a longer time to target temperature. In multivariable modeling, the hypothermic/ischemic ratio was the most significant predictor for survival (OR 2.161 [95% confidence interval 1.371, 3.404]). In this pilot study, the hypothermic to ischemic ratio was significantly associated with survival to discharge for patients with an initial shockable rhythm. Further investigation of the relationship between the dose of hypothermia and time to ROSC for postresuscitation TTM is needed.

Effectiveness of motor sequential learning according to practice schedules in healthy adults; distributed practice versus massed practice

PubMed Central

Kwon, Yong Hyun; Kwon, Jung Won; Lee, Myoung Hee

2015-01-01

[Purpose] The purpose of the current study was to compare the effectiveness of motor sequential learning according to two different types of practice schedules, distributed practice schedule (two 12-hour inter-trial intervals) and massed practice schedule (two 10-minute inter-trial intervals) using a serial reaction time (SRT) task. [Subjects and Methods] Thirty healthy subjects were recruited and then randomly and evenly assigned to either the distributed practice group or the massed practice group. All subjects performed three consecutive sessions of the SRT task following one of the two different types of practice schedules. Distributed practice was scheduled for two 12-hour inter-session intervals including sleeping time, whereas massed practice was administered for two 10-minute inter-session intervals. Response time (RT) and response accuracy (RA) were measured in at pre-test, mid-test, and post-test. [Results] For RT, univariate analysis demonstrated significant main effects in the within-group comparison of the three tests as well as the interaction effect of two groups × three tests, whereas the between-group comparison showed no significant effect. The results for RA showed no significant differences in neither the between-group comparison nor the interaction effect of two groups × three tests, whereas the within-group comparison of the three tests showed a significant main effect. [Conclusion] Distributed practice led to enhancement of motor skill acquisition at the first inter-session interval as well as at the second inter-interval the following day, compared to massed practice. Consequentially, the results of this study suggest that a distributed practice schedule can enhance the effectiveness of motor sequential learning in 1-day learning as well as for two days learning formats compared to massed practice. PMID:25931727

Does Reducing the Duration from Symptom Onset to Recanalization Improve the Results of Intracranial Mechanical Thrombectomy in the Elderly?

PubMed Central

KOMATSUBARA, Koichiro; DEMBO, Tomohisa; SATO, Eishi; SASAMORI, Hiroki; TORII, Masataka; SHIOKAWA, Yoshiaki; HIRANO, Teruyuki

2017-01-01

Endovascular recanalization for acute major cerebral artery occlusion is effective within a short time after symptom onset. However, its efficacy in the elderly remains unknown. We assessed the efficacy of our comprehensive stroke center’s reduction of this time in 28 consecutive patients for elderly patients (defined as patients aged ≥75 years) with acute major cerebral artery occlusion treated with intravenous injection of tissue plasminogen activator, followed by thrombus retrieval by endovascular therapy. The patients were divided into groups according to whether they were treated before implementation of the time reduction measure (from January 2012 to May 2014) or after (from June 2014 to May 2015). The onset-to-door, onset-to-needle, onset-to-recanalization (O2R), door-to-image (D2I), door-to-needle (D2N), door-to-puncture (D2P), door-to-recanalization (D2R), and puncture-to-recanalization time intervals were compared between the two groups. There were 14 patients (including 8 elderly patients ≥80 years) before and 14 patients (including 10 elderly patients ≥80 years) after the time reduction measure. The mean duration of each of the following time intervals was significantly reduced after the time reduction measure (P < 0.05). To reduce the O2R time, the D2P time is the first time interval that can be reduced. At our center, conferences were regularly held to raise awareness among staff and make specific changes in the workflow, and overall time reduction was achieved. Similar results were obtained in elderly patients. PMID:28132961

Validity and reliability of the de Morton Mobility Index in the subacute hospital setting in a geriatric evaluation and management population.

PubMed

de Morton, Natalie A; Lane, Kylie

2010-11-01

To investigate the clinimetric properties of the de Morton Mobility Index (DEMMI) in a Geriatric Evaluation and Management (GEM) population. A longitudinal validation study (n = 100) and inter-rater reliability study (n = 29) in a GEM population. Consecutive patients admitted to a GEM rehabilitation ward were eligible for inclusion. At hospital admission and discharge, a physical therapist assessed patients with physical performance instruments that included the 6-metre walk test, step test, Clinical Test of Sensory Organization and Balance, Timed Up and Go test, 6-minute walk test and the DEMMI. Consecutively eligible patients were included in an inter-rater reliability study between physical therapists. DEMMI admission scores were normally distributed (mean 30.2, standard deviation 16.7) and other activity limitation instruments had either a floor or a ceiling effect. Evidence of convergent, discriminant and known groups validity for the DEMMI were obtained. The minimal detectable change with 90% confidence was 10.5 (95% confidence interval 6.1-17.9) points and the minimally clinically important difference was 8.4 points on the 100-point interval DEMMI scale. The DEMMI provides clinicians with an accurate and valid method of measuring mobility for geriatric patients in the subacute hospital setting.

Generalized Riemann hypothesis and stochastic time series

NASA Astrophysics Data System (ADS)

Mussardo, Giuseppe; LeClair, André

2018-06-01

Using the Dirichlet theorem on the equidistribution of residue classes modulo q and the Lemke Oliver–Soundararajan conjecture on the distribution of pairs of residues on consecutive primes, we show that the domain of convergence of the infinite product of Dirichlet L-functions of non-principal characters can be extended from down to , without encountering any zeros before reaching this critical line. The possibility of doing so can be traced back to a universal diffusive random walk behavior of a series C N over the primes which underlies the convergence of the infinite product of the Dirichlet functions. The series C N presents several aspects in common with stochastic time series and its control requires to address a problem similar to the single Brownian trajectory problem in statistical mechanics. In the case of the Dirichlet functions of non principal characters, we show that this problem can be solved in terms of a self-averaging procedure based on an ensemble of block variables computed on extended intervals of primes. Those intervals, called inertial intervals, ensure the ergodicity and stationarity of the time series underlying the quantity C N . The infinity of primes also ensures the absence of rare events which would have been responsible for a different scaling behavior than the universal law of the random walks.

The impact of sustained hot weather on risk of acute work-related injury in Melbourne, Australia.

PubMed

McInnes, Judith Anne; MacFarlane, Ewan M; Sim, Malcolm R; Smith, Peter

2018-02-01

It has been reported that weather-related high ambient temperature is associated with an increased risk of work-related injury. Understanding this relationship is important because work-related injuries are a major public health problem, and because projected climate changes will potentially expose workers to hot days, including consecutive hot days, more often. The aim of this study was to quantify the impact of exposure to sustained periods of hot weather on work-related injury risk for workers in Melbourne, Australia. A time-stratified case crossover study design was utilised to examine the association between two and three consecutive days and two and three consecutive nights of hot weather and the risk of work-related injury, using definitions of hot weather ranging from the 60th to the 95th percentile of daily maximum and minimum temperatures for the Melbourne metropolitan area, 2002-2012. Workers' compensation claim data was used to identify cases of acute work-related injury. Overall, two and three consecutive days of hot weather were associated with an increased risk of injury, with this effect becoming apparent at a daily maximum temperature of 27.6 °C (70th percentile). Three consecutive days of high but not extreme temperatures were associated with the strongest effect, with a 15% increased risk of injury (odds ratio 1.15, 95% confidence interval 1.01-1.30) observed when daily maximum temperature was ≥33.3 °C (90th percentile) for three consecutive days, compared to when it was not. At a threshold of 35.5 °C (95th percentile), there was no significant association between temperature and injury for either two or three consecutive days of heat. These findings suggest that warnings to minimise harm to workers from hot weather should be given, and prevention protocol initiated, when consecutive warm days of temperatures lower than extreme heat temperatures are forecast, and well before the upper ranges of ambient daytime temperatures are reached.

The impact of sustained hot weather on risk of acute work-related injury in Melbourne, Australia

NASA Astrophysics Data System (ADS)

McInnes, Judith Anne; MacFarlane, Ewan M.; Sim, Malcolm R.; Smith, Peter

2018-02-01

It has been reported that weather-related high ambient temperature is associated with an increased risk of work-related injury. Understanding this relationship is important because work-related injuries are a major public health problem, and because projected climate changes will potentially expose workers to hot days, including consecutive hot days, more often. The aim of this study was to quantify the impact of exposure to sustained periods of hot weather on work-related injury risk for workers in Melbourne, Australia. A time-stratified case crossover study design was utilised to examine the association between two and three consecutive days and two and three consecutive nights of hot weather and the risk of work-related injury, using definitions of hot weather ranging from the 60th to the 95th percentile of daily maximum and minimum temperatures for the Melbourne metropolitan area, 2002-2012. Workers' compensation claim data was used to identify cases of acute work-related injury. Overall, two and three consecutive days of hot weather were associated with an increased risk of injury, with this effect becoming apparent at a daily maximum temperature of 27.6 °C (70th percentile). Three consecutive days of high but not extreme temperatures were associated with the strongest effect, with a 15% increased risk of injury (odds ratio 1.15, 95% confidence interval 1.01-1.30) observed when daily maximum temperature was ≥33.3 °C (90th percentile) for three consecutive days, compared to when it was not. At a threshold of 35.5 °C (95th percentile), there was no significant association between temperature and injury for either two or three consecutive days of heat. These findings suggest that warnings to minimise harm to workers from hot weather should be given, and prevention protocol initiated, when consecutive warm days of temperatures lower than extreme heat temperatures are forecast, and well before the upper ranges of ambient daytime temperatures are reached.

Verification of a model for the detection of intrauterine growth restriction (IUGR) by receiver operating characteristics (ROC)

NASA Astrophysics Data System (ADS)

Liu, Pengbo; Mongelli, Max; Mondry, Adrian

2004-07-01

The purpose of this study is to verify by Receiver Operating Characteristics (ROC) a mathematical model supporting the hypothesis that IUGR can be diagnosed by estimating growth velocity. The ROC compare computerized simulation results with clinical data from 325 pregnant British women. Each patient had 6 consecutive ultrasound examinations for fetal abdominal circumference (fac). Customized and un-customized fetal weights were calculated according to Hadlock"s formula. IUGR was diagnosed by the clinical standard, i.e. estimated weight below the tenth percentile. Growth velocity was estimated by calculating the changes of fac (Dzfac/dt) at various time intervals from 3 to 10 weeks. Finally, ROC was used to compare the methods. At 3~4 weeks scan interval, the area under the ROC curve is 0.68 for customized data and 0.66 for the uncustomized data with 95% confidence interval. Comparison between simulation data and real pregnancies verified that the model is clinically acceptable.

Subjective and Real Time: Coding Under Different Drug States

PubMed Central

Sanchez-Castillo, Hugo; Taylor, Kathleen M.; Ward, Ryan D.; Paz-Trejo, Diana B.; Arroyo-Araujo, Maria; Castillo, Oscar Galicia; Balsam, Peter D.

2016-01-01

Organisms are constantly extracting information from the temporal structure of the environment, which allows them to select appropriate actions and predict impending changes. Several lines of research have suggested that interval timing is modulated by the dopaminergic system. It has been proposed that higher levels of dopamine cause an internal clock to speed up, whereas less dopamine causes a deceleration of the clock. In most experiments the subjects are first trained to perform a timing task while drug free. Consequently, most of what is known about the influence of dopaminergic modulation of timing is on well-established timing performance. In the current study the impact of altered DA on the acquisition of temporal control was the focal question. Thirty male Sprague-Dawley rats were distributed randomly into three different groups (haloperidol, d-amphetamine or vehicle). Each animal received an injection 15 min prior to the start of every session from the beginning of interval training. The subjects were trained in a Fixed Interval (FI) 16s schedule followed by training on a peak procedure in which 64s non-reinforced peak trials were intermixed with FI trials. In a final test session all subjects were given vehicle injections and 10 consecutive non-reinforced peak trials to see if training under drug conditions altered the encoding of time. The current study suggests that administration of drugs that modulate dopamine do not alter the encoding temporal durations but do acutely affect the initiation of responding. PMID:27087743

Smoked marijuana effects on tobacco cigarette smoking behavior.

PubMed

Kelly, T H; Foltin, R W; Rose, A J; Fischman, M W; Brady, J V

1990-03-01

The effects of marijuana smoke exposure on several measures of tobacco cigarette smoking behavior were examined. Eight healthy adult male volunteers, who smoked both tobacco and marijuana cigarettes, participated in residential studies, lasting 10 to 15 days, designed to measure the effects of marijuana smoke exposure on a range of behavioral variables. Tobacco cigarettes were available throughout the day (9:00 A.M. until midnight). Each day was divided into a private period (9:00 A.M. to 5:00 P.M.), during which subjects were socially isolated, and a social period (5:00 P.M. to midnight), during which subjects could interact. Under blind conditions, subjects smoked placebo and active marijuana cigarettes (0%, 1.3%, 2.3%, or 2.7% delta 9-tetrahydrocannabinol) four times daily (9:45 A.M., 1:30 P.M., 5:00 P.M. and 8:30 P.M.). Each subject was exposed to both placebo and one active dose over 2- to 5-consecutive-day intervals, and dose conditions (i.e., placebo or active) alternated throughout the study. Active marijuana smoking significantly decreased the number of daily tobacco smoking bouts, increased inter-bout intervals and decreased inter-puff intervals. Marijuana decreased the number of tobacco smoking bouts by delaying the initiation of tobacco cigarette smoking immediately after marijuana smoking, whereas decreases in inter-puff intervals were unrelated to the time of marijuana smoking. No consistent interactions between marijuana effects and social or private periods (i.e., time of day) were observed.

Personality traits and ego-network dynamics

PubMed Central

Centellegher, Simone; López, Eduardo; Saramäki, Jari; Lepri, Bruno

2017-01-01

Strong and supportive social relationships are fundamental to our well-being. However, there are costs to their maintenance, resulting in a trade-off between quality and quantity, a typical strategy being to put a lot of effort on a few high-intensity relationships while maintaining larger numbers of less close relationships. It has also been shown that there are persistent individual differences in this pattern; some individuals allocate their efforts more uniformly across their networks, while others strongly focus on their closest relationships. Furthermore, some individuals maintain more stable networks than others. Here, we focus on how personality traits of individuals affect this picture, using mobile phone calls records and survey data from the Mobile Territorial Lab (MTL) study. In particular, we look at the relationship between personality traits and the (i) persistence of social signatures, namely the similarity of the social signature shape of an individual measured in different time intervals; (ii) the turnover in egocentric networks, that is, differences in the set of alters present at two consecutive temporal intervals; and (iii) the rank dynamics defined as the variation of alter rankings in egocentric networks in consecutive intervals. We observe that some traits have effects on the stability of the social signatures as well as network turnover and rank dynamics. As an example, individuals who score highly in the Openness to Experience trait tend to have higher levels of network turnover and larger alter rank variations. On broader terms, our study shows that personality traits clearly affect the ways in which individuals maintain their personal networks. PMID:28253333

Impact of robotics on the outcome of elderly patients with endometrial cancer.

PubMed

Lavoue, Vincent; Zeng, Xing; Lau, Susie; Press, Joshua Z; Abitbol, Jeremie; Gotlieb, Raphael; How, Jeffrey; Wang, Yifan; Gotlieb, Walter H

2014-06-01

To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer. Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery. All consecutive patients ≥70years of age with endometrial cancer who underwent robotic surgery (n=113) were compared with all consecutive patients ≥70years of age (n=50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217minutes, p=0.009) but fewer minor adverse events (17% compared with 60%, p<0.001). The robotics cohort had less estimated mean blood loss (75 vs 334mL, p<0.0001) and shorter mean hospital stay (3 vs 6days, p<0.0001). There was no difference in disease-free survival (p=0.61) during the mean follow-up time of 2years. Transitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Fluctuations in heart rate variability of health care workers during four consecutive extended work shifts and recovery during rest and sleep.

PubMed

Goffeng, Elisabeth M; Nordby, Karl-Christian; Tarvainen, Mika P; Järvelin-Pasanen, Susanna; Wagstaff, Anthony; Goffeng, Lars Ole; Bugge, Merete; Skare, Øivind; Sigstad Lie, Jenny-Anne

2018-04-07

The aim of this study was to investigate fluctuations in heart rate variability (HRV), which reflect autonomic nervous system (ANS) function and potential psychological and physical strain, among 24 health care workers during work and sleep during four consecutive extended work shifts. Data included 24/36/12 h of HRV measurements, two logbooks, and a questionnaire. A cross-shift/cross-week design was applied. HRV was measured during work, leisure time, and sleep. The HRV data included time-domain [mean RR, SD of normal to normal R-R intervals (SDNN), and root mean square of the successive differences (RMSSD)] and frequency-domain [low frequency (LF)/high frequency (HF) ratio] parameters. HRV parameters revealed significant differences among work, leisure time, and sleep. Mean RR, RMSSD, and SDNN values were lower and the LF/HF ratio was higher on the first versus last day of the work period; however, the differences were most prominent in the morning hours. The results indicate higher levels of cardiovascular stress on the first versus fourth day of the working period, and measurements at night indicate a satisfactory recovery from the extended shifts.

Investigation of kinetics and absorption isotherm models for hydroponic phytoremediation of waters contaminated with sulfate.

PubMed

Saber, Ali; Tafazzoli, Milad; Mortazavian, Soroosh; James, David E

2018-02-01

Two common wetland plants, Pampas Grass (Cortaderia selloana) and Lucky Bamboo (Dracaena sanderiana), were used in hydroponic cultivation systems for the treatment of simulated high-sulfate wastewaters. Plants in initial experiments at pH 7.0 removed sulfate more efficiently compared to the same experimental conditions at pH 6.0. Results at sulfate concentrations of 50, 200, 300, 600, 900, 1200, 1500 and 3000 mg/L during three consecutive 7-day treatment periods with 1-day rest intervals, showed decreasing trends of both removal efficiencies and uptake rates with increasing sulfate concentrations from the first to the second to the third 7-day treatment periods. Removed sulfate masses per unit dry plant mass, calculated after 23 days, showed highest removal capacity at 600 mg/L sulfate for both plants. A Langmuir-type isotherm best described sulfate uptake capacity of both plants. Kinetic studies showed that compared to pseudo first-order kinetics, pseudo-second order kinetic models slightly better described sulfate uptake rates by both plants. The Elovich kinetic model showed faster rates of attaining equilibrium at low sulfate concentrations for both plants. The dimensionless Elovich model showed that about 80% of sulfate uptake occurred during the first four days' contact time. Application of three 4-day contact times with 2-day rest intervals at high sulfate concentrations resulted in slightly higher uptakes compared to three 7-day contact times with 1-day rest intervals, indicating that pilot-plant scale treatment systems could be sized with shorter contact times and longer rest-intervals. Copyright © 2017 Elsevier Ltd. All rights reserved.

PREVALENCE OF HELICOBACTER PYLORI TEN YEARS AGO COMPARED TO THE CURRENT PREVALENCE IN PATIENTS UNDERGOING UPPER ENDOSCOPY

PubMed Central

FRUGIS, Sandra; CZECZKO, Nicolau Gregori; MALAFAIA, Osvaldo; PARADA, Artur Adolfo; POLETTI, Paula Bechara; SECCHI, Thiago Festa; DEGIOVANI, Matheus; RAMPANAZZO-NETO, Alécio; D´AGOSTINO, Mariza D.

2016-01-01

ABSTRACT Background: Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. Aim: To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Method: Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. Results: There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). Conclusion: There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples. PMID:27759776

Estimating Time to Event From Longitudinal Categorical Data: An Analysis of Multiple Sclerosis Progression.

PubMed

Mandel, Micha; Gauthier, Susan A; Guttmann, Charles R G; Weiner, Howard L; Betensky, Rebecca A

2007-12-01

The expanded disability status scale (EDSS) is an ordinal score that measures progression in multiple sclerosis (MS). Progression is defined as reaching EDSS of a certain level (absolute progression) or increasing of one point of EDSS (relative progression). Survival methods for time to progression are not adequate for such data since they do not exploit the EDSS level at the end of follow-up. Instead, we suggest a Markov transitional model applicable for repeated categorical or ordinal data. This approach enables derivation of covariate-specific survival curves, obtained after estimation of the regression coefficients and manipulations of the resulting transition matrix. Large sample theory and resampling methods are employed to derive pointwise confidence intervals, which perform well in simulation. Methods for generating survival curves for time to EDSS of a certain level, time to increase of EDSS of at least one point, and time to two consecutive visits with EDSS greater than three are described explicitly. The regression models described are easily implemented using standard software packages. Survival curves are obtained from the regression results using packages that support simple matrix calculation. We present and demonstrate our method on data collected at the Partners MS center in Boston, MA. We apply our approach to progression defined by time to two consecutive visits with EDSS greater than three, and calculate crude (without covariates) and covariate-specific curves.

Identifying causes of laboratory turnaround time delay in the emergency department.

PubMed

Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

2012-12-01

Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

Comparison of psychomotor function between music students and students participating in music training.

PubMed

Chansirinukor, Wunpen; Khemthong, Supalak

2014-07-01

To compare psychomotor function between a music student group who had music education and a non-music student group who participated in music training. Consecutive sampling was used for completing questionnaires, testing reaction times (visual, auditory, and tactile system), measuring electromyography of upper trapezius muscles both sides and taking photos of the Craniovertebral (CV) angle in the sitting position. Data collection was made twice for each student group: the music students at one-hour intervals for resting and conducting nonmusic activities, the non-music students at two-day intervals, 20 minutes/session, and performed music training (by a manual of keyboard notation). The non-music students (n = 65) improved reaction times, but responded slower than the music students except for the tactile system. The music students (n = 28) showed faster reaction times and higher activities of the trapezius muscle than the non-music students at post-test. In addition, the CV angle of the non-music students was significantly improved. The level of musical ability may influence the psychomotor function. Significant improvement was observed in visual, auditory and tactile reaction time, and CV angle in the non-music students. However upper trapezius muscle activities between both student groups were unchanged.

Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics.

PubMed

Chakraborty, Ranjay; Read, Scott A; Collins, Michael J

2011-07-11

To investigate the pattern of diurnal variations in axial length (AL), choroidal thickness, intraocular pressure (IOP), and ocular biometrics over 2 consecutive days. Measurements of ocular biometrics and IOP were collected for 30 young adult subjects (15 myopes, 15 emmetropes) at 10 different times over 2 consecutive days. Five sets of measurements were collected each day at approximately 3-hour intervals, with the first measurement taken at ~9 AM and final measurement at ~9 PM. AL underwent significant diurnal variation (P < 0.0001) that was consistently observed across the 2 measurement days. The longest AL was typically observed at the second measurement session (mean time, 12:26) and the shortest AL at the final session of each day (mean time, 21:06). The mean diurnal change in AL was 0.032 ± 0.018 mm. Choroidal thickness underwent significant diurnal variation (mean change, 0.029 ± 0.016 mm; P < 0.001) and varied approximately in antiphase to the AL changes. Significant diurnal variations were also found in vitreous chamber depth (VCD; mean change, 0.06 ± 0.029 mm; P < 0.0001) and IOP (mean change, 3.54 ± 0.84 mm Hg; P < 0.0001). A positive association was found between the variations of AL and IOP (r(2) = 0.17, P < 0.0001) and AL and VCD (r(2) = 0.31, P < 0.0001) and a negative association between AL and choroidal thickness (r(2) = 0.13, P < 0.0001). There were no significant differences in the magnitude and timing of diurnal variations associated with refractive error. Significant diurnal variations in AL, choroidal thickness, and IOP were consistently observed over 2 consecutive days of testing.

Assessment of atrial electromechanical interval using echocardiography after catheter ablation in patients with persistent atrial fibrillation

PubMed Central

Chen, Xiaodong; Chen, Minglong; Wang, Yingying; Yang, Bing; Ju, Weizhu; Zhang, Fengxiang; Cao, Kejiang

2016-01-01

Abstract We sought to investigate variation of atrial electromechanical interval after catheter ablation procedure in patients with persistent atrial fibrillation using pulse Doppler (PW) and pulse tissue Doppler imaging (PW-TDI). A total of 25 consecutive in-patients with persistent atrial fibrillation, who restored sinus rhythm after ablation procedure, were recruited in our cardiac center. Echocardiography was performed on each patient at 2 hours, 1 day, 5 days, 1 month and 3 months after the ablation therapy, and atrial electromechanical delay was measured simultaneously by PW and PW-TDI. There was no significant difference between PW and TDI in measuring atrial electromechanical delay. However, at postoperative 2 hours, peak A detection rates were mathematically but nonsignificantly greater by PW-TDI than by PW. Second, there was a significant decreasing trend in atrial electromechanical interval from postoperative 2 hours to 3 months, but only postoperative 2-hour atrial electromechanical interval was significantly greater than atrial electromechanical interval at other time. Lastly, patients without postoperative 2-hour atrial electromechanical interval had a significantly longer duration of atrial fibrillation as compared to those with postoperative 2-hour atrial electromechanical interval, by the PW or by PW-TDI, respectively. In patients with persistent atrial fibrillation, atrial electromechanical interval may decrease significantly within the first 24 hours after ablation but remain consistent later, and was significantly related to patients’ duration of atrial fibrillation. Atrial electromechanical interval, as a potential predicted factor, is recommended to be measured by either PW or TDI after 24 hours, when patients had recovered sinus rhythm by radiofrequency ablation. PMID:27924066

Safety of intravenous thrombolysis in stroke mimics: prospective 5-year study and comprehensive meta-analysis.

PubMed

Tsivgoulis, Georgios; Zand, Ramin; Katsanos, Aristeidis H; Goyal, Nitin; Uchino, Ken; Chang, Jason; Dardiotis, Efthimios; Putaala, Jukka; Alexandrov, Anne W; Malkoff, Marc D; Alexandrov, Andrei V

2015-05-01

Shortening door-to-needle time may lead to inadvertent intravenous thrombolysis (IVT) administration in stroke mimics (SMs). We sought to determine the safety of IVT in SMs using prospective, single-center data and by conducting a comprehensive meta-analysis of reported case-series. We prospectively analyzed consecutive IVT-treated patients during a 5-year period at a tertiary care stroke center. A systematic review and meta-analysis of case-series reporting safety of IVT in SMs and confirmed acute ischemic stroke were conducted. Symptomatic intracerebral hemorrhage was defined as imaging evidence of ICH with an National Institutes of Health Stroke scale increase of ≥4 points. Favorable functional outcome at hospital discharge was defined as a modified Rankin Scale score of 0 to 1. Of 516 consecutive IVT patients at our tertiary care center (50% men; mean age, 60±14 years; median National Institutes of Health Stroke scale, 11; range, 3-22), SMs comprised 75 cases. Symptomatic intracerebral hemorrhage occurred in 1 patient, whereas we documented no cases of orolingual edema or major extracranial hemorrhagic complications. In meta-analysis of 9 studies (8942 IVT-treated patients), the pooled rates of symptomatic intracerebral hemorrhage and orolingual edema among 392 patients with SM treated with IVT were 0.5% (95% confidence interval, 0%-2%) and 0.3% (95% confidence interval, 0%-2%), respectively. Patients with SM were found to have a significantly lower risk for symptomatic intracerebral hemorrhage compared with patients with acute ischemic stroke (risk ratio=0.33; 95% confidence interval, 0.14-0.77; P=0.010), with no evidence of heterogeneity or publication bias. Favorable functional outcome was almost 3-fold higher in patients with SM in comparison with patients with acute ischemic stroke (risk ratio=2.78; 95% confidence interval, 2.07-3.73; P<0.00001). Our prospective, single-center experience coupled with the findings of the comprehensive meta-analysis underscores the safety of IVT in SM. © 2015 American Heart Association, Inc.

An effective repetitive training schedule to achieve skill proficiency using a novel robotic virtual reality simulator.

PubMed

Kang, Sung Gu; Ryu, Byung Ju; Yang, Kyung Sook; Ko, Young Hwii; Cho, Seok; Kang, Seok Ho; Patel, Vipul R; Cheon, Jun

2015-01-01

A robotic virtual reality simulator (Mimic dV-Trainer) can be a useful training method for the da Vinci surgical system. Herein, we investigate several repetitive training schedules and determine which is the most effective. A total of 30 medical students were enrolled and were divided into 3 groups according to the training schedule. Group 1 performed the task 1 hour daily for 4 consecutive days, group II performed the task on once per week for 1 hour for 4 consecutive weeks, and group III performed the task for 4 consecutive hours in 1 day. The effects of training were investigated by analyzing the number of repetitions and the time required to complete the "Tube 2" simulation task when the learning curve plateau was reached. The point at which participants reached a stable score was evaluated using the cumulative sum control graph. The average time to complete the task at the learning curve plateau was 150.3 seconds in group I, 171.9 seconds in group II, and 188.5 seconds in group III. The number of task repetitions required to reach the learning curve plateau was 45 repetitions in group I, 36 repetitions in group II, and 39 repetitions in group III. Therefore, there was continuous improvement in the time required to perform the task after 40 repetitions in group I only. There was a significant correlation between improvement in each trial interval and attempt, and the correlation coefficient (0.924) in group I was higher than that in group II (0.899) and group III (0.838). Daily 1-hour practice sessions performed for 4 consecutive days resulted in the best final score, continuous score improvement, and effective training while minimizing fatigue. This repetition schedule can be used for effectively training novices in future. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Evaluation of the principles of distribution of electrocardiographic R-R intervals for elaboration of methods of automated diagnosis of cardiac rhythm disorders].

PubMed

Tsukerman, B M; Finkel'shteĭn, I E

1987-07-01

A statistical analysis of prolonged ECG records has been carried out in patients with various heart rhythm and conductivity disorders. The distribution of absolute R-R duration values and relationships between adjacent intervals have been examined. A two-step algorithm has been constructed that excludes anomalous and "suspicious" intervals from a sample of consecutively recorded R-R intervals, until only the intervals between contractions of veritably sinus origin remain in the sample. The algorithm has been developed into a programme for microcomputer Electronica NC-80. It operates reliably even in cases of complex combined rhythm and conductivity disorders.

Manual asymmetries in bimanual isochronous tapping tasks in children.

PubMed

Faria, Inês; Diniz, Ana; Barreiros, João

2017-01-01

Tapping tasks have been investigated throughout the years, with variations in features such as the complexity of the task, the use of one or both hands, the employ of auditory or visual stimuli, and the characteristics of the subjects. The evaluation of lateral asymmetries in tapping tasks in children offers an insight into the structure of rhythmic movements and handedness at early stages of development. The current study aims to investigate the ability of children (aged six and seven years-old) to maintain a rhythm, in a bimanual tapping task at two different target frequencies, as well as the manual asymmetries displayed while doing so. The analyzed data in this work are the series of the time intervals between successive taps. We suggest several profiles of behavior, regarding the overall performance of children in both tempo conditions. We also propose a new method of quantifying the variability of the performance and the asymmetry of the hands, based on ellipses placed on scatter plots of the non-dominant-dominant series versus the dominant-non-dominant series. We then use running correlations to identify changes of coordination tendencies over time. The main results show that variability is larger in the task with the longer target interval. Furthermore, most children evidence lateral asymmetries, but in general they show the capacity to maintain the mean of consecutive intertap intervals of both hands close to the target interval. Finally, we try to interpret our findings in the light of existing models and timing modes. Copyright © 2016 Elsevier B.V. All rights reserved.

The Effect of Rest Interval Length on Repetition Consistency and Perceived Exertion During Near Maximal Loaded Bench Press Sets.

PubMed

Scudese, Estevão; Willardson, Jeffrey M; Simão, Roberto; Senna, Gilmar; de Salles, Belmiro F; Miranda, Humberto

2015-11-01

The purpose of this study was to compare different rest intervals between sets on repetition consistency and ratings of perceived exertion (RPE) during consecutive bench press sets with an absolute 3RM (3 repetition maximum) load. Sixteen trained men (23.75 ± 4.21 years; 74.63 ± 5.36 kg; 175 ± 4.64 cm; bench press relative strength: 1.44 ± 0.19 kg/kg of body mass) attended 4 randomly ordered sessions during which 5 consecutive sets of the bench press were performed with an absolute 3RM load and 1, 2, 3, or 5 minutes of rest interval between sets. The results indicated that significantly greater bench press repetitions were completed with 2, 3, and 5 minutes vs. 1-minute rest between sets (p ≤ 0.05); no significant differences were noted between the 2, 3, and 5 minutes rest conditions. For the 1-minute rest condition, performance reductions (relative to the first set) were observed commencing with the second set; whereas for the other conditions (2, 3, and 5 minutes rest), performance reductions were not evident until the third and fourth sets. The RPE values before each of the successive sets were significantly greater, commencing with the second set for the 1-minute vs. the 3 and 5 minutes rest conditions. Significant increases were also evident in RPE immediately after each set between the 1 and 5 minutes rest conditions from the second through fifth sets. These findings indicate that when utilizing an absolute 3RM load for the bench press, practitioners may prescribe a time-efficient minimum of 2 minutes rest between sets without significant impairments in repetition performance. However, lower perceived exertion levels may necessitate prescription of a minimum of 3 minutes rest between sets.

Electron beam magnetic switch for a plurality of free electron lasers

DOEpatents

Schlitt, Leland G.

1984-01-01

Apparatus for forming and utilizing a sequence of electron beam segments, each of the same temporal length (substantially 15 nsec), with consecutive beams being separated by a constant time interval of the order of 3 nsec. The beam sequence is used for simultaneous inputs to a plurality of wiggler magnet systems that also accept the laser beams to be amplified by interaction with the co-propagating electron beams. The electron beams are arranged substantially in a circle to allow proper distribution of and simultaneous switching out of the beam segments to their respective wiggler magnets.

Approximate dynamic programming for optimal stationary control with control-dependent noise.

PubMed

Jiang, Yu; Jiang, Zhong-Ping

2011-12-01

This brief studies the stochastic optimal control problem via reinforcement learning and approximate/adaptive dynamic programming (ADP). A policy iteration algorithm is derived in the presence of both additive and multiplicative noise using Itô calculus. The expectation of the approximated cost matrix is guaranteed to converge to the solution of some algebraic Riccati equation that gives rise to the optimal cost value. Moreover, the covariance of the approximated cost matrix can be reduced by increasing the length of time interval between two consecutive iterations. Finally, a numerical example is given to illustrate the efficiency of the proposed ADP methodology.

Subjective versus objective evening chronotypes in bipolar disorder.

PubMed

Gershon, Anda; Kaufmann, Christopher N; Depp, Colin A; Miller, Shefali; Do, Dennis; Zeitzer, Jamie M; Ketter, Terence A

2018-01-01

Disturbed sleep timing is common in bipolar disorder (BD). However, most research is based upon self-reports. We examined relationships between subjective versus objective assessments of sleep timing in BD patients versus controls. We studied 61 individuals with bipolar I or II disorder and 61 healthy controls. Structured clinical interviews assessed psychiatric diagnoses, and clinician-administered scales assessed current mood symptom severity. For subjective chronotype, we used the Composite Scale of Morningness (CSM) questionnaire, using original and modified (1, ¾, ⅔, and ½ SD below mean CSM score) thresholds to define evening chronotype. Objective chronotype was calculated as the percentage of nights (50%, 66.7%, 75%, or 90% of all nights) with sleep interval midpoints at or before (non-evening chronotype) vs. after (evening chronotype) 04:15:00 (4:15:00a.m.), based on 25-50 days of continuous actigraph data. BD participants and controls differed significantly with respect to CSM mean scores and CSM evening chronotypes using modified, but not original, thresholds. Groups also differed significantly with respect to chronotype based on sleep interval midpoint means, and based on the threshold of 75% of sleep intervals with midpoints after 04:15:00. Subjective and objective chronotypes correlated significantly with one another. Twenty-one consecutive intervals were needed to yield an evening chronotype classification match of ≥ 95% with that made using the 75% of sleep intervals threshold. Limited sample size/generalizability. Subjective and objective chronotype measurements were correlated with one another in participants with BD. Using population-specific thresholds, participants with BD had a later chronotype than controls. Copyright © 2017 Elsevier B.V. All rights reserved.

Intrafraction Prostate Translations and Rotations During Hypofractionated Robotic Radiation Surgery: Dosimetric Impact of Correction Strategies and Margins

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

Water, Steven van de, E-mail: s.vandewater@erasmusmc.nl; Valli, Lorella; Alma Mater Studiorum, Department of Physics and Astronomy, Bologna University, Bologna

Purpose: To investigate the dosimetric impact of intrafraction prostate motion and the effect of robot correction strategies for hypofractionated CyberKnife treatments with a simultaneously integrated boost. Methods and Materials: A total of 548 real-time prostate motion tracks from 17 patients were available for dosimetric simulations of CyberKnife treatments, in which various correction strategies were included. Fixed time intervals between imaging/correction (15, 60, 180, and 360 seconds) were simulated, as well as adaptive timing (ie, the time interval reduced from 60 to 15 seconds in case prostate motion exceeded 3 mm or 2° in consecutive images). The simulated extent of robot corrections was alsomore » varied: no corrections, translational corrections only, and translational corrections combined with rotational corrections up to 5°, 10°, and perfect rotational correction. The correction strategies were evaluated for treatment plans with a 0-mm or 3-mm margin around the clinical target volume (CTV). We recorded CTV coverage (V{sub 100%}) and dose-volume parameters of the peripheral zone (boost), rectum, bladder, and urethra. Results: Planned dose parameters were increasingly preserved with larger extents of robot corrections. A time interval between corrections of 60 to 180 seconds provided optimal preservation of CTV coverage. To achieve 98% CTV coverage in 98% of the treatments, translational and rotational corrections up to 10° were required for the 0-mm margin plans, whereas translational and rotational corrections up to 5° were required for the 3-mm margin plans. Rectum and bladder were spared considerably better in the 0-mm margin plans. Adaptive timing did not improve delivered dose. Conclusions: Intrafraction prostate motion substantially affected the delivered dose but was compensated for effectively by robot corrections using a time interval of 60 to 180 seconds. A 0-mm margin required larger extents of additional rotational corrections than a 3-mm margin but resulted in lower doses to rectum and bladder.« less

Subsidence related to groundwater pumping for breweries in Merchtem area (Belgium), highlighted by Persistent Scaterrer Interferometry

NASA Astrophysics Data System (ADS)

Declercq, Pierre-Yves; Gerard, Pierre; Pirard, Eric; Perissin, Daniele; Walstra, Jan; Devleeschouwer, Xavier

2017-12-01

ERS, ENVISAT and TerraSAR-X Synthetic Aperture Radar scenes covering the time span 1992-2014 were processed using a Persistent Scatterer technique to study the ground movements in Merchtem (25 km NW of Brussels, Belgium). The processed datasets, covering three consecutive time intervals, reveal that the investigated area is affected by a global subsidence trend related to the extraction of groundwater in the deeper Cambro-Silurian aquifer. Through time the subsidence pattern is reduced and replaced by an uplift related to the rising water table attested by piezometers located in this aquifer. The subsidence is finally reduced to a zone where currently three breweries are very active and pump groundwater in the Ledo-Paniselian aquifer and in the Cambro-Silurian for process water for the production.

MK-801 and memantine act differently on short-term memory tested with different time-intervals in the Morris water maze test.

PubMed

Duda, Weronika; Wesierska, Malgorzata; Ostaszewski, Pawel; Vales, Karel; Nekovarova, Tereza; Stuchlik, Ales

2016-09-15

N-methyl-d-aspartate receptors (NMDARs) play a crucial role in spatial memory formation. In neuropharmacological studies their functioning strongly depends on testing conditions and the dosage of NMDAR antagonists. The aim of this study was to assess the immediate effects of NMDAR block by (+)MK-801 or memantine on short-term allothetic memory. Memory was tested in a working memory version of the Morris water maze test. In our version of the test, rats underwent one day of training with 8 trials, and then three experimental days when rats were injected intraperitoneally with low- 5 (MeL), high - 20 (MeH) mg/kg memantine, 0.1mg/kg MK-801 or 1ml/kg saline (SAL) 30min before testing, for three consecutive days. On each experimental day there was just one acquisition and one test trial, with an inter-trial interval of 5 or 15min. During training the hidden platform was relocated after each trial and during the experiment after each day. The follow-up effect was assessed on day 9. Intact rats improved their spatial memory across the one training day. With a 5min interval MeH rats had longer latency then all rats during retrieval. With a 15min interval the MeH rats presented worse working memory measured as retrieval minus acquisition trial for path than SAL and MeL and for latency than MeL rats. MK-801 rats had longer latency than SAL during retrieval. Thus, the high dose of memantine, contrary to low dose of MK-801 disrupts short-term memory independent on the time interval between acquisition and retrieval. This shows that short-term memory tested in a working memory version of water maze is sensitive to several parameters: i.e., NMDA receptor antagonist type, dosage and the time interval between learning and testing. Copyright © 2016. Published by Elsevier B.V.

A New Empirical Definition of Major Depressive Episode Recovery and Its Positive Impact on Future Course of Illness.

PubMed

Judd, Lewis L; Schettler, Pamela J; Rush, A John; Coryell, William H; Fiedorowicz, Jess G; Solomon, David A

2016-08-01

To provide the first head-to-head test of the predictive validity of 2 resolution levels included in the current consensus definition of major depressive episode (MDE) recovery and provide an empirically based, clinically useful definition of the end of an MDE. 322 participants entering the National Institute of Mental Health Collaborative Depression Study with MDE (diagnosed by Research Diagnostic Criteria) in 1978-1981, and followed thereafter for up to 31 years, were divided into those with 8 consecutive weeks of asymptomatic MDE recovery or residual subsyndromal depressive symptom (SSD) resolution of their index MDE. These 2 levels of recovery were defined based on weekly symptom status on all depressive conditions, assessed by Longitudinal Interval Follow-Up Evaluation (LIFE) interviews conducted every 6 months. Primary measures of validity of these 2 alternative definitions were first well interval duration and long-term depressive illness burden. Groups were also compared on clinical variables, antidepressant treatment, and psychosocial function. 61.2% of subjects recovered asymptomatically from their index MDE. By survival analysis, they remained free of a depressive episode relapse or recurrence 4.2 times longer than those with SSD resolution (median = 135 vs 32 weeks; χ² = 70.65; P < .0001). This was not attributable to a difference in intensity of antidepressant medication. Compared to asymptomatic recovery, SSD resolution was associated with significantly longer and more severe index MDEs, with more miscellaneous psychopathology as well as increased long-term psychosocial dysfunction and a greater depressive illness burden during the ensuing 10 or 20 years. Asymptomatic MDE resolution was a stronger predictor of time well than any of 18 other predictors, singly or combined. Eight consecutive weeks of asymptomatic recovery had 93% overlap with a 4-week definition and conferred little benefit over 4 weeks. Four consecutive weeks of asymptomatic recovery defines the end of an MDE and the beginning of a stable well state with improved psychosocial function. Residual symptom resolution is a continuation of an active state of the episode, not the end of an MDE. © Copyright 2016 Physicians Postgraduate Press, Inc.

The effects of end-of-day picture review and a sensor-based picture capture procedure on autobiographical memory using SenseCam.

PubMed

Finley, Jason R; Brewer, William F; Benjamin, Aaron S

2011-10-01

Emerging "life-logging" technologies have tremendous potential to augment human autobiographical memory by recording and processing vast amounts of information from an individual's experiences. In this experiment undergraduate participants wore a SenseCam, a small, sensor-equipped digital camera, as they went about their normal daily activities for five consecutive days. Pictures were captured either at fixed intervals or as triggered by SenseCam's sensors. On two of five nights, participants watched an end-of-day review of a random subset of pictures captured that day. Participants were tested with a variety of memory measures at intervals of 1, 3, and 8 weeks. The most fruitful of six measures were recognition rating (on a 1-7 scale) and picture-cued recall length. On these tests, end-of-day review enhanced performance relative to no review, while pictures triggered by SenseCam's sensors showed little difference in performance compared to those taken at fixed time intervals. We discuss the promise of SenseCam as a tool for research and for improving autobiographical memory.

Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study.

PubMed

Chang, Yu-San; Chen, Hsiang-Lan; Wu, Yu-Hsuan; Hsu, Chung-Yao; Liu, Ching-Kuan; Hsu, Chin

2014-08-05

We investigated circadian changes and effects on mood, sleep-related hormones and cognitive performance when nurses worked consecutive night shifts in a rapidly rotating shift system. Daytime cognitive function, sleep propensity and sleep-related hormones (growth hormone, cortisol, prolactin, thyrotropin) were compared after participants worked two and four consecutive night shifts. Twenty-three off-duty nurses, 20 nurses working two consecutive night shifts and 16 nurses working four consecutive night shifts were enrolled. All participants completed the Maintenance of Wakefulness Test, State-Trait Anxiety Inventory, Stanford Sleepiness Scale, visual attention tasks (VAT), Wisconsin Card Sorting Test, and modified Multiple Sleep Latency Test. Hormone levels were also measured four times throughout the day, at 2-h intervals. During the day, the participants in the night shift groups were less able to maintain wakefulness, had poor performance on VAT, and higher thyrotropin levels than did those in the off-duty group. Participants who worked two night shifts were better able to maintain wakefulness, had higher anxiety scale scores, poorer initial performance and lack of learning effect on VAT, and higher prolactin levels compared with those who worked four night shifts. There were no differences in cortisol levels between the two- and four- shift groups. Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and may impact daytime prolactin levels after night shifts. It is possible that the two-shift group had a higher cortisol level than did the four-shift group, which would be consistent with the group's higher state anxiety scores. The negative findings may be due to the small sample size. Further studies on the effects of consecutive night shifts on mood and cortisol levels during the daytime after sleep restriction would be valuable.

Time-dependent migration of citations through PubMed and OvidSP subsets: a study on a series of simultaneous PubMed and OvidSP searches.

PubMed

Boeker, Martin; Vach, Werner; Motschall, Edith

2013-01-01

To quantitatively describe (1) differences between search results derived at consecutive time points with the PubMed and OvidSP literature search interfaces over a five day interval, and (2) the migration of citations through different subsets to estimate the timeliness of OvidSP. PubMed-Identifiers (PMIDs) of the following subsets were retrieved from PubMed and OvidSP simultaneously (within 8 h) at 11 days in March and April 2010 including 5 consecutive days: as supplied by publisher, in process, PubMed not MEDLINE, and OLDMEDLINE. Search results were compared for difference and intersection sets. The migration of citations on individual level was determined by comparison of corresponding sets over several days. The "in process" set was stable with about 446,000 - 452,000 citations; a small fraction of up to 3 % of the total subsets were in PubMed only and OvidSP only subsets. About 96 % of the ca. 10,500 citations in the OvidSP only subset migrated within 2 days out of the "in process" subset. The database of OvidSP is updated within a period of two days.

Quality of Vitamin K Antagonist Anticoagulation in Spain: Prevalence of Poor Control and Associated Factors.

PubMed

Anguita Sánchez, Manuel; Bertomeu Martínez, Vicente; Cequier Fillat, Ángel

2015-09-01

To study the prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain in patients with nonvalvular atrial fibrillation, and to identify associated factors. We studied 1056 consecutive patients seen at 120 cardiology clinics in Spain between November 2013 and March 2014. We analyzed the international normalized ratio from the 6 months prior to the patient's visit, calculating the prevalence of poorly controlled anticoagulation, defined as < 65% time in therapeutic range using the Rosendaal method. Mean age was 73.6 years (standard deviation, 9.8 years); women accounted for 42% of patients. The prevalence of poorly controlled anticoagulation was 47.3%. Mean time in therapeutic range was 63.8% (25.9%). The following factors were independently associated with poorly controlled anticoagulation: kidney disease (odds ratio = 1.53; 95% confidence interval, 1.08-2.18; P = .018), routine nonsteroidal anti-inflammatory drugs (odds ratio = 1.79; 95% confidence interval, 1.20-2.79; P = .004), antiplatelet therapy (odds ratio = 2.16; 95% confidence interval, 1.49-3.12; P < .0001) and absence of angiotensin receptor blockers (odds ratio = 1.39; 95% confidence interval, 1.08-1.79; P = .011). There is a high prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain. Factors associated with poor control are kidney disease, routine nonsteroidal anti-inflammatory drugs, antiplatelet use, and absence of angiotensin receptor blockers. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Survey of Access to GastroEnterology in Canada: The SAGE wait times program

PubMed Central

Leddin, Desmond; Bridges, Ronald J; Morgan, David G; Fallone, Carlo; Render, Craig; Plourde, Victor; Gray, Jim; Switzer, Connie; McHattie, Jim; Singh, Harminder; Walli, Eric; Murray, Iain; Nestel, Anthony; Sinclair, Paul; Chen, Ying; Irvine, E Jan

2010-01-01

BACKGROUND: Assessment of current wait times for specialist health services in Canada is a key method that can assist government and health care providers to plan wisely for future health needs. These data are not readily available. A method to capture wait time data at the time of consultation or procedure has been developed, which should be applicable to other specialist groups and also allows for assessment of wait time trends over intervals of years. METHODS: In November 2008, gastroenterologists across Canada were asked to complete a questionnaire (online or by fax) that included personal demographics and data from one week on at least five consecutive new consultations and five consecutive procedure patients who had not previously undergone a procedure for the same indication. Wait times were collected for 18 primary indications and results were then compared with similar survey data collected in 2005. RESULTS: The longest wait times observed were for screening colonoscopy (201 days) and surveillance of previous colon cancer or polyps (272 days). The shortest wait times were for cancer-likely based on imaging or physical examination (82 days), severe or rapidly progressing dysphagia or odynophagia (83 days), documented iron-deficiency anemia (90 days) and dyspepsia with alarm symptoms (99 days). Compared with 2005 data, total wait times in 2008 were lengthened overall (127 days versus 155 days; P<0.05) and for most of the seven individual indications that permitted data comparison. CONCLUSION: Median wait times for gastroenterology services continue to exceed consensus conference recommended targets and have significantly worsened since 2005. PMID:20186352

A study of the effect of legal settlement on post-concussion symptoms.

PubMed Central

Fee, C R; Rutherford, W H

1988-01-01

Forty-four consecutive patients with concussion for whom a medico-legal report had been written were followed up for 3-4 years after their accidents. Three cases were still pending at the end of the study. Fifty-seven per cent complained of symptoms when the medico-legal reports were written (mean interval from accident 12.9 months), 39% had symptoms at the time of settlement (mean interval 22.1 months) and 34% had symptoms one year later. When these results were compared with a general series from the same department some years earlier, it was found that the symptoms at the time of writing the reports were not significantly different from symptoms at 6 weeks in the earlier series, but the symptoms one year after settlement were almost two-and-a-half times greater than the symptoms at 12 months in the general series. No evidence could be found to suggest any organic basis for the higher symptom rate in the litigation series. It is suggested that the litigation process itself is a factor in the persistence of symptoms and this effect continues after legal settlement has been reached. Early settlement of the cases might significantly reduce morbidity. PMID:3408521

Dyslexics’ faster decay of implicit memory for sounds and words is manifested in their shorter neural adaptation

PubMed Central

Jaffe-Dax, Sagi; Frenkel, Or; Ahissar, Merav

2017-01-01

Dyslexia is a prevalent reading disability whose underlying mechanisms are still disputed. We studied the neural mechanisms underlying dyslexia using a simple frequency-discrimination task. Though participants were asked to compare the two tones in each trial, implicit memory of previous trials affected their responses. We hypothesized that implicit memory decays faster among dyslexics. We tested this by increasing the temporal intervals between consecutive trials, and by measuring the behavioral impact and ERP responses from the auditory cortex. Dyslexics showed a faster decay of implicit memory effects on both measures, with similar time constants. Finally, faster decay of implicit memory also characterized the impact of sound regularities in benefitting dyslexics' oral reading rate. Their benefit decreased faster as a function of the time interval from the previous reading of the same non-word. We propose that dyslexics’ shorter neural adaptation paradoxically accounts for their longer reading times, since it reduces their temporal window of integration of past stimuli, resulting in noisier and less reliable predictions for both simple and complex stimuli. Less reliable predictions limit their acquisition of reading expertise. DOI: http://dx.doi.org/10.7554/eLife.20557.001 PMID:28115055

Time-dependent influence of sensorimotor set on automatic responses in perturbed stance

NASA Technical Reports Server (NTRS)

Chong, R. K.; Horak, F. B.; Woollacott, M. H.; Peterson, B. W. (Principal Investigator)

1999-01-01

These experiments tested the hypothesis that the ability to change sensorimotor set quickly for automatic responses depends on the time interval between successive surface perturbations. Sensorimotor set refers to the influence of prior experience or context on the state of the sensorimotor system. Sensorimotor set for postural responses was influenced by first giving subjects a block of identical backward translations of the support surface, causing forward sway and automatic gastrocnemius responses. The ability to change set quickly was inferred by measuring the suppression of the stretched antagonist gastrocnemius responses to toes-up rotations causing backward sway, following the translations. Responses were examined under short (10-14 s) and long (19-24 s) inter-trial intervals in young healthy subjects. The results showed that subjects in the long-interval group changed set immediately by suppressing gastrocnemius to 51% of translation responses within the first rotation and continued to suppress them over succeeding rotations. In contrast, subjects in the short-interval group did not change set immediately, but required two or more rotations to suppress gastrocnemius responses. By the last rotation, the short-interval group suppressed gastrocnemius responses to 33%, similar to the long-interval group of 29%. Associated surface plantarflexor torque resulting from these responses showed similar results. When rotation and translation perturbations alternated, however, the short-interval group was not able to suppress gastrocnemius responses to rotations as much as the long-interval group, although they did suppress more than in the first rotation trial after a series of translations. Set for automatic responses appears to linger, from one trial to the next. Specifically, sensorimotor set is more difficult to change when surface perturbations are given in close succession, making it appear as if set has become progressively stronger. A strong set does not mean that responses become larger over consecutive trials. Rather, it is inferred by the extent of difficulty in changing a response when it is appropriate to do so. These results suggest that the ability to change sensorimotor set quickly is sensitive to whether the change is required after a long or a short series of a prior different response, which in turn depends on the time interval between successive trials. Different rate of gastrocnemius suppression to toes-up rotation of the support surface have been reported in previous studies. This may be partially explained by different inter-trial time intervals demonstrated in this study.

Between-day reliability of a method for non-invasive estimation of muscle composition.

PubMed

Simunič, Boštjan

2012-08-01

Tensiomyography is a method for valid and non-invasive estimation of skeletal muscle fibre type composition. The validity of selected temporal tensiomyographic measures has been well established recently; there is, however, no evidence regarding the method's between-day reliability. Therefore it is the aim of this paper to establish the between-day repeatability of tensiomyographic measures in three skeletal muscles. For three consecutive days, 10 healthy male volunteers (mean±SD: age 24.6 ± 3.0 years; height 177.9 ± 3.9 cm; weight 72.4 ± 5.2 kg) were examined in a supine position. Four temporal measures (delay, contraction, sustain, and half-relaxation time) and maximal amplitude were extracted from the displacement-time tensiomyogram. A reliability analysis was performed with calculations of bias, random error, coefficient of variation (CV), standard error of measurement, and intra-class correlation coefficient (ICC) with a 95% confidence interval. An analysis of ICC demonstrated excellent agreement (ICC were over 0.94 in 14 out of 15 tested parameters). However, lower CV was observed in half-relaxation time, presumably because of the specifics of the parameter definition itself. These data indicate that for the three muscles tested, tensiomyographic measurements were reproducible across consecutive test days. Furthermore, we indicated the most possible origin of the lowest reliability detected in half-relaxation time. Copyright © 2012 Elsevier Ltd. All rights reserved.

Assessment of atrial electromechanical interval using echocardiography after catheter ablation in patients with persistent atrial fibrillation.

PubMed

Chen, Xiaodong; Chen, Minglong; Wang, Yingying; Yang, Bing; Ju, Weizhu; Zhang, Fengxiang; Cao, Kejiang

2016-11-01

We sought to investigate variation of atrial electromechanical interval after catheter ablation procedure in patients with persistent atrial fibrillation using pulse Doppler (PW) and pulse tissue Doppler imaging (PW-TDI). A total of 25 consecutive in-patients with persistent atrial fibrillation, who restored sinus rhythm after ablation procedure, were recruited in our cardiac center. Echocardiography was performed on each patient at 2 hours, 1 day, 5 days, 1 month and 3 months after the ablation therapy, and atrial electromechanical delay was measured simultaneously by PW and PW-TDI. There was no significant difference between PW and TDI in measuring atrial electromechanical delay. However, at postoperative 2 hours, peak A detection rates were mathematically but nonsignificantly greater by PW-TDI than by PW. Second, there was a significant decreasing trend in atrial electromechanical interval from postoperative 2 hours to 3 months, but only postoperative 2-hour atrial electromechanical interval was significantly greater than atrial electromechanical interval at other time. Lastly, patients without postoperative 2-hour atrial electromechanical interval had a significantly longer duration of atrial fibrillation as compared to those with postoperative 2-hour atrial electromechanical interval, by the PW or by PW-TDI, respectively. In patients with persistent atrial fibrillation, atrial electromechanical interval may decrease significantly within the first 24 hours after ablation but remain consistent later, and was significantly related to patients' duration of atrial fibrillation. Atrial electromechanical interval, as a potential predicted factor, is recommended to be measured by either PW or TDI after 24 hours, when patients had recovered sinus rhythm by radiofrequency ablation. © 2016 by the Journal of Biomedical Research. All rights reserved.

The cyclic and fractal seismic series preceding an mb 4.8 earthquake on 1980 February 14 near the Virgin Islands

USGS Publications Warehouse

Varnes, D.J.; Bufe, C.G.

1996-01-01

Seismic activity in the 10 months preceding the 1980 February 14, mb 4.8 earthquake in the Virgin Islands, reported on by Frankel in 1982, consisted of four principal cycles. Each cycle began with a relatively large event or series of closely spaced events, and the duration of the cycles progressively shortened by a factor of about 3/4. Had this regular shortening of the cycles been recognized prior to the earthquake, the time of the next episode of setsmicity (the main shock) might have been closely estimated 41 days in advance. That this event could be much larger than the previous events is indicated from time-to-failure analysis of the accelerating rise in released seismic energy, using a non-linear time- and slip-predictable foreshock model. Examination of the timing of all events in the sequence shows an even higher degree of order. Rates of seismicity, measured by consecutive interevent times, when plotted on an iteration diagram of a rate versus the succeeding rate, form a triangular circulating trajectory. The trajectory becomes an ascending helix if extended in a third dimension, time. This construction reveals additional and precise relations among the time intervals between times of relatively high or relatively low rates of seismic activity, including period halving and doubling. The set of 666 time intervals between all possible pairs of the 37 recorded events appears to be a fractal; the set of time points that define the intervals has a finite, non-integer correlation dimension of 0.70. In contrast, the average correlation dimension of 50 random sequences of 37 events is significantly higher, dose to 1.0. In a similar analysis, the set of distances between pairs of epicentres has a fractal correlation dimension of 1.52. Well-defined cycles, numerous precise ratios among time intervals, and a non-random temporal fractal dimension suggest that the seismic series is not a random process, but rather the product of a deterministic dynamic system.

Prehospital management and fluid resuscitation in hypotensive trauma patients admitted to Karolinska University Hospital in Stockholm.

PubMed

Talving, Peep; Pålstedt, Joakim; Riddez, Louis

2005-01-01

Few previous studies have been conducted on the prehospital management of hypotensive trauma patients in Stockholm County. The aim of this study was to describe the prehospital management of hypotensive trauma patients admitted to the largest trauma center in Sweden, and to assess whether prehospital trauma life support (PHTLS) guidelines have been implemented regarding prehospital time intervals and fluid therapy. In addition, the effects of the age, type of injury, injury severity, prehospital time interval, blood pressure, and fluid therapy on outcome were investigated. This is a retrospective, descriptive study on consecutive, hypotensive trauma patients (systolic blood pressure < or = 90 mmHg on the scene of injury) admitted to Karolinska University Hospital in Stockholm, Sweden, during 2001-2003. The reported values are medians with interquartile ranges. Basic demographics, prehospital time intervals and interventions, injury severity scores (ISS), type and volumes of prehospital fluid resuscitation, and 30-day mortality were abstracted. The effects of the patient's age, gender, prehospital time interval, type of injury, injury severity, on-scene and emergency department blood pressure, and resuscitation fluid volumes on mortality were analyzed using the exact logistic regression model. In 102 (71 male) adult patients (age > or = 15 years) recruited, the median age was 35.5 years (range: 27-55 years) and 77 patients (75%) had suffered blunt injury. The predominant trauma mechanisms were falls between levels (24%) and motor vehicle crashes (22%) with an ISS of 28.5 (range: 16-50). The on-scene time interval was 19 minutes (range: 12-24 minutes). Fluid therapy was initiated at the scene of injury in the majority of patients (73%) regardless of the type of injury (77 blunt [75%] / 25 penetrating [25%]) or injury severity (ISS: 0-20; 21-40; 41-75). Age (odds ratio (OR) = 1.04), male gender (OR = 3.2), ISS 21-40 (OR = 13.6), and ISS >40 (OR = 43.6) were the significant factors affecting outcome in the exact logistic regression analysis. The time interval at the scene of injury exceeded PHTLS guidelines. The vast majority of the hypotensive trauma patients were fluid-resuscitated on-scene regardless of the type, mechanism, or severity of injury. A predefined fluid resuscitation regimen is not employed in hypotensive trauma victims with different types of injuries. The outcome was worsened by male gender, progressive age, and ISS > 20 in the exact multiple regression analysis.

Cross-modal attention influences auditory contrast sensitivity: Decreasing visual load improves auditory thresholds for amplitude- and frequency-modulated sounds.

PubMed

Ciaramitaro, Vivian M; Chow, Hiu Mei; Eglington, Luke G

2017-03-01

We used a cross-modal dual task to examine how changing visual-task demands influenced auditory processing, namely auditory thresholds for amplitude- and frequency-modulated sounds. Observers had to attend to two consecutive intervals of sounds and report which interval contained the auditory stimulus that was modulated in amplitude (Experiment 1) or frequency (Experiment 2). During auditory-stimulus presentation, observers simultaneously attended to a rapid sequential visual presentation-two consecutive intervals of streams of visual letters-and had to report which interval contained a particular color (low load, demanding less attentional resources) or, in separate blocks of trials, which interval contained more of a target letter (high load, demanding more attentional resources). We hypothesized that if attention is a shared resource across vision and audition, an easier visual task should free up more attentional resources for auditory processing on an unrelated task, hence improving auditory thresholds. Auditory detection thresholds were lower-that is, auditory sensitivity was improved-for both amplitude- and frequency-modulated sounds when observers engaged in a less demanding (compared to a more demanding) visual task. In accord with previous work, our findings suggest that visual-task demands can influence the processing of auditory information on an unrelated concurrent task, providing support for shared attentional resources. More importantly, our results suggest that attending to information in a different modality, cross-modal attention, can influence basic auditory contrast sensitivity functions, highlighting potential similarities between basic mechanisms for visual and auditory attention.

Decreasing triage time: effects of implementing a step-wise ESI algorithm in an EHR.

PubMed

Villa, Stephen; Weber, Ellen J; Polevoi, Steven; Fee, Christopher; Maruoka, Andrew; Quon, Tina

2018-06-01

To determine if adapting a widely-used triage scale into a computerized algorithm in an electronic health record (EHR) shortens emergency department (ED) triage time. Before-and-after quasi-experimental study. Urban, tertiary care hospital ED. Consecutive adult patient visits between July 2011 and June 2013. A step-wise algorithm, based on the Emergency Severity Index (ESI-5) was programmed into the triage module of a commercial EHR. Duration of triage (triage interval) for all patients and change in percentage of high acuity patients (ESI 1 and 2) completing triage within 15 min, 12 months before-and-after implementation of the algorithm. Multivariable analysis adjusted for confounders; interrupted time series demonstrated effects over time. Secondary outcomes examined quality metrics and patient flow. About 32 546 patient visits before and 33 032 after the intervention were included. Post-intervention patients were slightly older, census was higher and admission rate slightly increased. Median triage interval was 5.92 min (interquartile ranges, IQR 4.2-8.73) before and 2.8 min (IQR 1.88-4.23) after the intervention (P < 0.001). Adjusted mean triage interval decreased 3.4 min (95% CI: -3.6, -3.2). The proportion of high acuity patients completing triage within 15 min increased from 63.9% (95% CI 62.5, 65.2%) to 75.0% (95% CI 73.8, 76.1). Monthly time series demonstrated immediate and sustained improvement following the intervention. Return visits within 72 h and door-to-balloon time were unchanged. Total length of stay was similar. The computerized triage scale improved speed of triage, allowing more high acuity patients to be seen within recommended timeframes, without notable impact on quality.

Effect of continuous quality improvement analysis on the delivery of primary percutaneous revascularization for acute myocardial infarction: a community hospital experience.

PubMed

Caputo, Ronald P; Kosinski, Robert; Walford, Gary; Giambartolomei, Alex; Grant, William; Reger, Mark J; Simons, Alan; Esente, Paolo

2005-04-01

As time to reperfusion correlates with outcomes, a door-to-balloon time of 90 +/- 30 min for primary percutaneous coronary revascularization (PCI) for the treatment of acute myocardial infarction has been recently established as a guideline by the ACC/AHA. The purpose of this study is to assess the effects of a continuous quality assurance program designed to expedite primary angioplasty at a community hospital. A database of all primary PCI procedures was created in 1998. Two groups of consecutive patients treated with primary PCI were studied. Group 1 represented patients in the time period between 1 June 1998 to 1 November 1998 and group 2 represented patients in the period between 1 January 2000 and 16 June 2000. Continuous quality assurance analysis was performed. Modifications to the primary angioplasty program were initiated in the latter group. Time intervals to certain treatment landmarks were compared between the groups. Significant decreases in the time intervals from emergency room registration to initial electrocardiogram (8.4 +/- 8.2 vs. 3.7 +/- 19.5 min; P < 0.001), presentation to the catheterization laboratory to arterial access (13.5 +/- 12.9 vs. 11.6 +/- 5.8 min; P < 0.001), and emergency room registration to initial angioplasty balloon inflation (132.0 +/- 69.2 vs. 112 +/- 72.0 min; P < 0.001) were achieved. For the subgroup of patients presenting with diagnostic ST elevation myocardial infarction, a large decrease in the door-to-balloon time interval between group 1 and group 2 was demonstrated (114.15 +/- 9.67 vs. 87.92 +/- 10.93 min; P = NS), resulting in compliance with ACC/AHA guidelines. Continuous quality improvement analysis can expedite care for patients treated by primary PCI in the community hospital setting. Copyright 2005 Wiley-Liss, Inc.

Smooth muscle fatigue due to repeated urinary bladder neurostimulation: an in vivo study.

PubMed

Bross, S; Schumacher, S; Scheepe, J R; Seif, C; Jünemann, K P; Alken, P

1999-01-01

The presented study investigates the influence of different pause lengths between two consecutive stimulations of the S3 roots on intravesical pressure during bladder neurostimulation. In eight male foxhounds (aged 7-18 months), laminectomy and placement of a modified Brindley electrode were performed. In four series with different pause lengths between two consecutive stimulations (1, 3, 5, and 15 min), the maximum intravesical pressure was measured during stimulation. The changes in intravesical pressure were registered in these four series, each series with six stimulations. A 15-min interval elapsed before the commencement of each series. In the series with a pause length of 15 min, the consecutive stimulations did not result in significant changes in maximum intravesical pressure. In the 5-min series, a significant decrease in intravesical pressure was not observed after the third stimulation. In the 3-min series, a significant decrease was seen at almost every stimulation (average decrease of 3.8% per stimulation) and in the 1-min series, a significant decrease was also observed at almost every stimulation (average decrease of 5.9% per stimulation). The results of repeated bladder neurostimulation demonstrate that the maximum intravesical pressure is dependent on the pause length between two consecutive stimulations. The detrusor muscle showed reversible and short-lived signs of fatigue. This implies the importance of a minimum 5-min interval between two subsequent stimulations. A pause length <5 min leads to a falsification of the results and thus to lower validity of the investigation.

Mind the gap: temporal discrimination and dystonia.

PubMed

Sadnicka, A; Daum, C; Cordivari, C; Bhatia, K P; Rothwell, J C; Manohar, S; Edwards, M J

2017-06-01

One of the most widely studied perceptual measures of sensory dysfunction in dystonia is the temporal discrimination threshold (TDT) (the shortest interval at which subjects can perceive that there are two stimuli rather than one). However the elevated thresholds described may be due to a number of potential mechanisms as current paradigms test not only temporal discrimination but also extraneous sensory and decision-making parameters. In this study two paradigms designed to better quantify temporal processing are presented and a decision-making model is used to assess the influence of decision strategy. 22 patients with cervical dystonia and 22 age-matched controls completed two tasks (i) temporal resolution (a randomized, automated version of existing TDT paradigms) and (ii) interval discrimination (rating the length of two consecutive intervals). In the temporal resolution task patients had delayed (P = 0.021) and more variable (P = 0.013) response times but equivalent discrimination thresholds. Modelling these effects suggested this was due to an increased perceptual decision boundary in dystonia with patients requiring greater evidence before committing to decisions (P = 0.020). Patient performance on the interval discrimination task was normal. Our work suggests that previously observed abnormalities in TDT may not be due to a selective sensory deficit of temporal processing as decision-making itself is abnormal in cervical dystonia. © 2017 EAN.

[Comparative studies on the bioavailability of nicergoline from two different steady-state preparations].

PubMed

Kohlenberg-Müller, K; Meier, D H; Kunz, K; Wauschkuhn, C H; Schaffler, K

1991-07-01

Comparative Studies on the Bioavailability of Nicergoline from Two Different Preparations in Steady State The bioavailability of nicergoline (CAS 27848-84-6) in a new 30 mg tablet and a 10 mg dragee formulation (Sermion) was evaluated under steady state conditions in 18 healthy male volunteers between the age of 21 and 37 years. During the run-in phase, the volunteers received on 7 consecutive days 30 mg nicergoline either 1 x 30 mg/d tablet (test substance) or 3 x 10 mg dragees (reference). On day 8, after intake of 1 x 30 mg in a 24 h interval or 1 x 10 mg in a 8 h interval respectively, the plasma concentrations of the nicergoline metabolite 10-methoxy-6-methyl-ergoline-8 beta-methanol (MDL) were measured. The area under the plasma concentrations in the 24 h interval after administering the 30 mg tablet was not 3 times greater as to be expected; it was by a factor of 4 significantly greater than the area under the curve of the 10 mg dragee in the 8 h interval. Therefore, nicergoline has a higher availability in the 30 mg tablet than in the 10 mg dragee form. Both formulations were equally well tolerated.

A Long-Term Dissipation of the EUV He ii (30.4 nm) Segmentation in Full-Disk Solar Images

NASA Astrophysics Data System (ADS)

Didkovsky, Leonid

2018-06-01

Some quiet-Sun days observed by the Atmospheric Imaging Assembly (AIA) on-board the Solar Dynamics Observatory (SDO) during the time interval in 2010 - 2017 were used to continue our previous analyses reported by Didkovsky and Gurman ( Solar Phys. 289, 153, 2014a) and Didkovsky, Wieman, and Korogodina ( Solar Phys. 292, 32, 2017). The analysis consists of determining and comparing spatial spectral ratios (spectral densities over some time interval) from spatial (segmentation-cell length) power spectra. The ratios were compared using modeled compatible spatial frequencies for spectra from the Extreme ultraviolet Imaging Telescope (EIT) on-board the Solar and Heliospheric Observatory (SOHO) and from AIA images. With the new AIA data added to the EIT data we analyzed previously, the whole time interval from 1996 to 2017 reported here is approximately the length of two "standard" solar cycles (SC). The spectral ratios of segmentation-cell dimension structures show a significant and steady increase with no detected indication of SC-related returns to the values that characterize the SC minima. This increase in spatial power at high spatial frequencies is interpreted as a dissipation of medium-size EUV network structures to smaller-size structures in the transition region. Each of the latest ratio changes for 2010 through 2017 spectra calculated for a number of consecutive short-term intervals has been converted into monthly mean ratio (MMR) changes. The MMR values demonstrate variable sign and magnitudes, thus confirming the solar nature of the changes. These changes do not follow a "typical" trend of instrumental degradation or a long-term activity profile from the He ii (30.4 nm) irradiance measured by the Extreme ultraviolet Spectrophotometer (ESP) either. The ESP is a channel of the Extreme ultraviolet Variability Experiment (EVE) on-board SDO.

The effect of methylphenidate and rearing environment on behavioral inhibition in adult male rats.

PubMed

Hill, Jade C; Covarrubias, Pablo; Terry, Joel; Sanabria, Federico

2012-01-01

The ability to withhold reinforced responses-behavioral inhibition-is impaired in various psychiatric conditions including Attention Deficit Hyperactivity Disorder (ADHD). Methodological and analytical limitations have constrained our understanding of the effects of pharmacological and environmental factors on behavioral inhibition. To determine the effects of acute methylphenidate (MPH) administration and rearing conditions (isolated vs. pair-housed) on behavioral inhibition in adult rats. Inhibitory capacity was evaluated using two response-withholding tasks, differential reinforcement of low rates (DRL) and fixed minimum interval (FMI) schedules of reinforcement. Both tasks made sugar pellets contingent on intervals longer than 6 s between consecutive responses. Inferences on inhibitory and timing capacities were drawn from the distribution of withholding times (interresponse times, or IRTs). MPH increased the number of intervals produced in both tasks. Estimates of behavioral inhibition increased with MPH dose in FMI and with social isolation in DRL. Nonetheless, burst responding in DRL and the divergence of DRL data relative to past studies, among other limitations, undermined the reliability of DRL data as the basis for inferences on behavioral inhibition. Inhibitory capacity was more precisely estimated from FMI than from DRL performance. Based on FMI data, MPH, but not a socially enriched environment, appears to improve inhibitory capacity. The highest dose of MPH tested, 8 mg/kg, did not reduce inhibitory capacity but reduced the responsiveness to waiting contingencies. These results support the use of the FMI schedule, complemented with appropriate analytic techniques, for the assessment of behavioral inhibition in animal models.

Spatial Distribution of the Coefficient of Variation for the Paleo-Earthquakes in Japan

NASA Astrophysics Data System (ADS)

Nomura, S.; Ogata, Y.

2015-12-01

Renewal processes, point prccesses in which intervals between consecutive events are independently and identically distributed, are frequently used to describe this repeating earthquake mechanism and forecast the next earthquakes. However, one of the difficulties in applying recurrent earthquake models is the scarcity of the historical data. Most studied fault segments have few, or only one observed earthquake that often have poorly constrained historic and/or radiocarbon ages. The maximum likelihood estimate from such a small data set can have a large bias and error, which tends to yield high probability for the next event in a very short time span when the recurrence intervals have similar lengths. On the other hand, recurrence intervals at a fault depend on the long-term slip rate caused by the tectonic motion in average. In addition, recurrence times are also fluctuated by nearby earthquakes or fault activities which encourage or discourage surrounding seismicity. These factors have spatial trends due to the heterogeneity of tectonic motion and seismicity. Thus, this paper introduces a spatial structure on the key parameters of renewal processes for recurrent earthquakes and estimates it by using spatial statistics. Spatial variation of mean and variance parameters of recurrence times are estimated in Bayesian framework and the next earthquakes are forecasted by Bayesian predictive distributions. The proposal model is applied for recurrent earthquake catalog in Japan and its result is compared with the current forecast adopted by the Earthquake Research Committee of Japan.

Reference intervals and longitudinal changes in copeptin and MR-proADM concentrations during pregnancy.

PubMed

Joosen, Annemiek M C P; van der Linden, Ivon J M; Schrauwen, Lianne; Theeuwes, Alisia; de Groot, Monique J M; Ermens, Antonius A M

2017-11-27

Vasopressin and adrenomedullin and their stable by-products copeptin and midregional part of proadrenomedullin (MR-proADM) are promising biomarkers for the development of preeclampsia. However, clinical use is hampered by the lack of trimester-specific reference intervals. We therefore estimated reference intervals for copeptin and MR-proADM in disease-free Dutch women throughout pregnancy. Apparently healthy low risk pregnant women were recruited. Exclusion criteria included current or past history of endocrine disease, multiple pregnancy, use of medication known to influence thyroid function and current pregnancy as a result of hormonal stimulation. Women who miscarried, developed hyperemesis gravidarum, hypertension, pre-eclampsia, hemolysis elevated liver enzymes and low platelets, diabetes or other disease, delivered prematurely or had a small for gestational age neonate were excluded from analyses. Blood samples were collected at 9-13 weeks (n=98), 27-29 weeks (n=94) and 36-39 weeks (n=91) of gestation and at 4-13 weeks post-partum (PP) (n=89). Sixty-two women had complete data during pregnancy and PP. All analyses were performed on a Kryptor compact plus. Copeptin increases during pregnancy, but 97.5th percentiles remain below the non-pregnant upper reference limit (URL) provided by the manufacturer. MR-proADM concentrations increase as well during pregnancy. In trimesters 2 and 3 the 97.5th percentiles are over three times the non-pregnant URL provided by the manufacturer. Trimester- and assay-specific reference intervals for copeptin and MR-proADM should be used. In addition, consecutive measurements and the time frame between measurements should be considered as the differences seen with or in advance of preeclampsia can be expected to be relatively small compared to the reference intervals.

Use of the radial approach in primary angioplasty: results in 1029 consecutive patients and analyses in unfavorable subgroups.

PubMed

Hernández-Pérez, Francisco J; Blasco-Lobo, Ana; Goicolea, Leire; Muñiz-Lozano, Ana; Fernandez-Díaz, José A; Domínguez, José R; Goicolea-Ruigómez, Javier

2014-01-01

The transradial approach is associated with a reduction in vascular access-related complications after primary percutaneous coronary interventions. The purpose of this study was to examine the feasibility of the routine use of transradial access in primary angioplasty and to evaluate how it affects subgroups with less favorable characteristics. We analyzed 1029 consecutive patients with an ST-segment elevation acute coronary syndrome treated with primary angioplasty. Transradial access was the primary approach in 93.1% of the patients. The success rate of primary angioplasty was 95.9%, and 87.6% of the patients were event-free 30 days after the procedure. Crossover was required in 3.0% of the patients with primary transradial access, and this rate remained stable over the years. Predictors of the need for crossover were age older than 75 years (odds ratio=2.50, 95% confidence interval, 1.09-5.71; P=.03) and a history of ischemic heart disease (odds ratio=2.65; 95% confidence interval, 1.12-6.24; P=.02). Primary transfemoral access use was higher in women older than 75 years. Use of the transradial approach in this subgroup did not affect reperfusion time or the success of angioplasty, although there was a greater need for crossover (10.9% vs 2.6%; P=.006). Among patients in cardiogenic shock, the transradial approach was used in 51.5%; reperfusion times and angioplasty success rates were similar to those obtained with transfemoral access, but there was a greater need for crossover. Transradial access can be used safely and effectively in most primary angioplasty procedures. In older women and in patients in cardiogenic shock, there is a higher crossover requirement, with no detriment to reperfusion time. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Impaired clinical utility of sequential patient GEM blood gas measurements associated with calibration schedule.

PubMed

Cembrowski, George S; Xu, Qian; Cembrowski, Adam R; Mei, Junyi; Sadrzadeh, Hossein

2017-11-01

Within- and/or between-instrument variation may falsely indicate patient trends or obscure real trends. We employ a methodology that transforms sequential intra-patient results into estimates of biologic and analytic variation. We previously derived realistic biologic variation (s b ) of blood gas (BG) and hematology analytes. We extend this methodology to derive the imprecision of two GEM 4000 BG analyzers. A laboratory data repository provided arterial BG, electrolyte and metabolite results generated by two GEM 4000s on ICU patients in 2012-2013. We tabulated consecutive pairs of intra-patient results separated by increasing time interval between consecutive tests. The average between pair variations were regressed against time with the y-intercept representing the sum of the biologic variation and short term analytic variation: y o 2 =s b 2 +s a 2 . Using an equivalent equation for the Radiometer ABL, the imprecision of the two GEMs was calculated: s aGEM =(y oGEM 2 -y oABL 2 +s aABL 2 ) 1/2 . This analysis was performed for nearly all measurements, regardless of time as well for values obtained over two 12h mutually exclusive periods, starting either at 2am or 2pm. Regression graphs were derived from 1800 patients' blood gas results with least 10,000 data pairs grouped into 2h intervals. The calculated s aGEM exceed the directly measured s aABL with many GEM sigma ratios of biologic variation/analytic variation being close to unity. All of the afternoon s aGEM exceeded their morning counterparts with pH, pCO 2 , K and bicarbonate being statistically significant. For many analytes, the average analytical variation of tandem GEMs approximates the biologic variation, indicating impaired clinical usefulness of tandem sequential measurements. A significant component of this variation is due to increased variation of the GEMs between 2pm and 2am. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Atrial Septal Aneurysm and Patent Foramen Ovale as Risk Factors for Cryptogenic Stroke in Patients Less Than 55 Years of Age: A Study using Transesophageal Echocardiography

NASA Technical Reports Server (NTRS)

Cabanes, L.; Mas, J. L.; Cohen, A.; Amarenco, P.; Cabanes, P. A.; Oubary, P.; Chedru, F.; Guerin, F.; Bousser, M. G.; deRecondo, J.

1993-01-01

Background and Purpose: An association between atrial septal aneurysm and embolic events has been suggested. Atrial septal aneurysm has been shown to be associated with patent foramen ovale and,.in some reports, with mitral valve prolapse. These two latter cardiac disorder; have been identified as potential risk factors for ischemic stroke. The aim of this prospective study was to assess the role of atrial septal aneurysm as an independent risk factor for stroke, especially for cryptogenic stroke. Methods: We studied the prevalence of atrial septal aneurysm, patent foramen ovale, and mitral valve prolapse in 100 consecutive patients <55 years of age with ischemic stroke who underwent extensive etiological investigations. We compared these results with those in a control group of 50 consecutive patients. The diagnosis of atrial septal aneurysm and patent foramen ovale relied on transesophageal echocardiography with a contrast study and that of mitral valve prolapse, on two-dimensional transthoracic echocardiography. Results: Stepwise logistic regression analysis showed that atrial septal aneurysm (odds ratio, 4.3; 95% confidence interval, 1.3 to 14.6; P=.01) and patent foramen ovale (odds ratio, 3.9; 95% confidence interval, 1.5 to 10; P=.003) but not mitral valve prolapse were significantly associated with the diagnosis of cryptogenic stroke. The stroke odds of a patient with both atrial septal aneurysm and patent foramen ovale were 33.3 times (95% confidence interval, 4.1 to 270) the stroke odds of a patient with neither of these cardiac disorders. For a patient with atrial septal aneurysm of >lo-mm excursion, the stroke odds were approximately 8 times the stroke odds of a patient with atrial septal aneurysm of <10 mm. Conclusions: This study shows that atrial septal aneurysm and patent foramen ovale are both significantly associated with cryptogenic stroke and that their association has a marked synergistic effect. Atrial septal aneurysms of >lo-mm excursion are associated with a higher risk of stroke. (Stroke. 1993;24:1865-1873.) KEY WORDS aneurysm echocardiography foramen ovale, patent mitral valve prolapse o young adults

What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

PubMed

Eguchi, Kazuo; Kuruvilla, Sujith; Ogedegbe, Gbenga; Gerin, William; Schwartz, Joseph E; Pickering, Thomas G

2009-06-01

To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance. We enrolled 56 patients from a hypertension clinic (mean age: 60 +/- 14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors. The analyses were performed using the second-third HBP readings. The average systolic BP/diastolic BP for the 10-s and 1-min intervals at home were 136.1 +/- 15.8/77.5 +/- 9.5 and 133.2 +/- 15.5/76.9 +/- 9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 +/- 14/79 +/- 10 mmHg) than the 10-s interval readings. There was no significant difference in patients' compliance in taking adequate numbers of readings at the different time intervals. The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval.

What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

PubMed Central

Eguchi, Kazuo; Kuruvilla, Sujith; Ogedegbe, Gbenga; Gerin, William; Schwartz, Joseph E.; Pickering, Thomas G.

2010-01-01

Objectives To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance. Design We enrolled 56 patients from a hypertension clinic (mean age: 60 ±14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors. Results The analyses were performed using the second–third HBP readings. The average systolic BP/diastolic BP for the 10-s and 1-min intervals at home were 136.1 ±15.8/77.5 ±9.5 and 133.2 ±15.5/76.9 ±9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 ±14/79 ±10 mmHg) than the 10-s interval readings. There was no significant difference in patients’ compliance in taking adequate numbers of readings at the different time intervals. Conclusion The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval. PMID:19462492

Novel Screening Tool for Stroke Using Artificial Neural Network.

PubMed

Abedi, Vida; Goyal, Nitin; Tsivgoulis, Georgios; Hosseinichimeh, Niyousha; Hontecillas, Raquel; Bassaganya-Riera, Josep; Elijovich, Lucas; Metter, Jeffrey E; Alexandrov, Anne W; Liebeskind, David S; Alexandrov, Andrei V; Zand, Ramin

2017-06-01

The timely diagnosis of stroke at the initial examination is extremely important given the disease morbidity and narrow time window for intervention. The goal of this study was to develop a supervised learning method to recognize acute cerebral ischemia (ACI) and differentiate that from stroke mimics in an emergency setting. Consecutive patients presenting to the emergency department with stroke-like symptoms, within 4.5 hours of symptoms onset, in 2 tertiary care stroke centers were randomized for inclusion in the model. We developed an artificial neural network (ANN) model. The learning algorithm was based on backpropagation. To validate the model, we used a 10-fold cross-validation method. A total of 260 patients (equal number of stroke mimics and ACIs) were enrolled for the development and validation of our ANN model. Our analysis indicated that the average sensitivity and specificity of ANN for the diagnosis of ACI based on the 10-fold cross-validation analysis was 80.0% (95% confidence interval, 71.8-86.3) and 86.2% (95% confidence interval, 78.7-91.4), respectively. The median precision of ANN for the diagnosis of ACI was 92% (95% confidence interval, 88.7-95.3). Our results show that ANN can be an effective tool for the recognition of ACI and differentiation of ACI from stroke mimics at the initial examination. © 2017 American Heart Association, Inc.

Respiratory variation of systolic and diastolic time intervals within radial arterial waveform: a comparison with dynamic preload index.

PubMed

Park, Ji Hyun; Hwang, Gyu-Sam

2016-08-01

A blood pressure (BP) waveform contains various pieces of information related to respiratory variation. Systolic time interval (STI) reflects myocardial performance, and diastolic time interval (DTI) represents diastolic filling. This study examined whether respiratory variations of STI and DTI within radial arterial waveform are comparable to dynamic indices. During liver transplantation, digitally recorded BP waveform and stroke volume variation (SVV) were retrospectively analyzed. Beat-to-beat STI and DTI were extracted within each BP waveform, which were separated by dicrotic notch. Systolic time variation (STV) was calculated by the average of 3 consecutive respiratory cycles: [(STImax- STImin)/STImean]. Similar formula was used for diastolic time variation (DTV) and pulse pressure variation (PPV). Receiver operating characteristic analysis with area under the curve (AUC) was used to assess thresholds predictive of SVV ≥12% and PPV ≥12%. STV and DTV showed significant correlations with SVV (r= 0.78 and r= 0.67, respectively) and PPV (r= 0.69 and r= 0.69, respectively). Receiver operating characteristic curves demonstrated that STV ≥11% identified to predict SVV ≥12% with 85.7% sensitivity and 89.3% specificity (AUC = 0.935; P< .001). DTV ≥11% identified to predict SVV ≥12% with 71.4% sensitivity and 85.7% specificity (AUC = 0.829; P< .001). STV ≥12% and DTV ≥11% identified to predict PPV ≥12% with an AUC of 0.881 and 0.885, respectively. Respiratory variations of STI and DTI derived from radial arterial contour have a potential to predict hemodynamic response as a surrogate for SVV or PPV. Copyright © 2016 Elsevier Inc. All rights reserved.

'Stroke Room': Diagnosis and Treatment at a Single Location for Rapid Intraarterial Stroke Treatment.

PubMed

Ragoschke-Schumm, Andreas; Yilmaz, Umut; Kostopoulos, Panagiotis; Lesmeister, Martin; Manitz, Matthias; Walter, Silke; Helwig, Stefan; Schwindling, Lenka; Fousse, Mathias; Haass, Anton; Garner, Dominique; Körner, Heiko; Roumia, Safwan; Grunwald, Iris; Nasreldein, Ali; Halmer, Ramona; Liu, Yang; Schlechtriemen, Thomas; Reith, Wolfgang; Fassbender, Klaus

2015-01-01

For patients with acute ischemic stroke, intra-arterial treatment (IAT) is considered to be an effective strategy for removing the obstructing clot. Because outcome crucially depends on time to treatment ('time-is-brain' concept), we assessed the effects of an intervention based on performing all the time-sensitive diagnostic and therapeutic procedures at a single location on the delay before intra-arterial stroke treatment. Consecutive acute stroke patients with large vessel occlusion who obtained IAT were evaluated before and after implementation (April 26, 2010) of an intervention focused on performing all the diagnostic and therapeutic measures at a single site ('stroke room'). After implementation of the intervention, the median intervals between admission and first angiography series were significantly shorter for 174 intervention patients (102 min, interquartile range (IQR) 85-120 min) than for 81 control patients (117 min, IQR 89-150 min; p < 0.05), as were the intervals between admission and clot removal or end of angiography (152 min, IQR 123-185 min vs. 190 min, IQR 163-227 min; p < 0.001). However, no significant differences in clinical outcome were observed. This study shows for the, to our knowledge, first time that for patients with acute ischemic stroke, stroke diagnosis and treatment at a single location ('stroke room') saves crucial time until IAT. © 2015 S. Karger AG, Basel.

The Effects of End-of-Day Picture Review and a Sensor-based Picture Capture Procedure on Autobiographical Memory using SenseCam

PubMed Central

Finley, Jason R.; Brewer, William F.; Benjamin, Aaron S.

2011-01-01

Emerging “life-logging” technologies have tremendous potential to augment human autobiographical memory by recording and processing vast amounts of information from an individual’s experiences. In this experiment undergraduate participants wore a SenseCam, a small, sensor-equipped digital camera, as they went about their normal daily activities for five consecutive days. Pictures were captured either at fixed intervals or as triggered by SenseCam’s sensors. On two of five nights, participants watched an end-of-day review of a random subset of pictures captured that day. Participants were tested with a variety of memory measures at intervals of 1, 3, and 8 weeks. The most fruitful of six measures were recognition rating (on a 1–7 scale) and picture-cued recall length. On these tests, end-of-day review enhanced performance relative to no review, while pictures triggered by SenseCam’s sensors showed little difference in performance compared to those taken at fixed time intervals. We discuss the promise of SenseCam as a tool for research and for improving autobiographical memory. PMID:21229457

Feasibility and effects of a combined adjuvant high-intensity interval/strength training in breast cancer patients: a single-center pilot study.

PubMed

Schulz, Sebastian Viktor Waldemar; Laszlo, Roman; Otto, Stephanie; Prokopchuk, Dmytro; Schumann, Uwe; Ebner, Florian; Huober, Jens; Steinacker, Jürgen Michael

2018-06-01

To evaluate feasibility of an exercise intervention consisting of high-intensity interval endurance and strength training in breast cancer patients. Twenty-six women with nonmetastatic breast cancer were consecutively assigned to the exercise intervention- (n= 15, mean age 51.9 ± 9.8 years) and the control group (n = 11, mean age 56.9 ± 7.0 years). Cardiopulmonary exercise testing that included lactate sampling, one-repetition maximum tests and a HADS-D questionnaire were used to monitor patients both before and after a supervised six weeks period of either combined high-intensity interval endurance and strength training (intervention group, twice a week) or leisure training (control group). Contrarily to the control group, endurance (mean change of VO 2 , peak 12.0 ± 13.0%) and strength performance (mean change of cumulative load 25.9 ± 11.2%) and quality of life increased in the intervention group. No training-related adverse events were observed. Our guided exercise intervention could be used effectively for initiation and improvement of performance capacity and quality of life in breast cancer patients in a relatively short time. This might be especially attractive during medical treatment. Long-term effects have to be evaluated in randomized controlled studies also with a longer follow-up. Implications for Rehabilitation High-intensity interval training allows improvement of aerobic capacity within a comparable short time. Standard leisure training in breast cancer patients is rather suitable for the maintenance of performance capacity and quality of life. Guided high-intensity interval training combined with strength training can be used effectively for the improvement of endurance and strength capacity and also quality of life. After exclusion of contraindications, guided adjuvant high-intensity interval training combined with strength training can be safely used in breast cancer patients.

Microfilarial periodicity of Dirofilaria repens in naturally infested dogs.

PubMed

Di Cesare, Angela; Otranto, Domenico; Di Giulio, Emanuela; Simonato, Giulia; Latrofa, Maria Stefania; La Torre, Francesco; Coccia, Giorgio; Traversa, Donato

2013-12-01

In the past years, canine and human cases of infestation by Dirofilaria repens (Spirurida, Onchocercidae) have been increasingly reported in several European countries. Subcutaneous dirofilariosis by D. repens may either be asymptomatic in dogs or may be characterized by subcutaneous nodules and other symptoms. Information on the periodicity of D. repens microfilariae in naturally infested animals is scant, and this might impair the accurate diagnosis of subcutaneous dirofilariosis and appropriate control plans. In the present study, eight dogs infested with D. repens were sampled twice daily at 12-h intervals for ten consecutive days, and the dog with the highest mean value of microfilariaemia was further sampled every 4 h for four consecutive days. The blood was microscopically and molecularly examined for microfilariae, and, additionally, negative samples were also subjected to a real-time PCR to evaluate the level of circulating DNA. The results demonstrated significant variations in circadian rhythms of D. repens larvae, with higher values of microfilariae per milliliter in the evening samples. A significant variation was also found at the individual level for the dogs with the highest values of microfilariaemia. All samples which were negative at the light microscopy and positive at the real-time PCR displayed levels of circulating parasite DNA <1 microfilaria per milliliter. Biological and clinical implications have been here discussed.

Perceptual basis of evolving Western musical styles

PubMed Central

Rodriguez Zivic, Pablo H.; Shifres, Favio; Cecchi, Guillermo A.

2013-01-01

The brain processes temporal statistics to predict future events and to categorize perceptual objects. These statistics, called expectancies, are found in music perception, and they span a variety of different features and time scales. Specifically, there is evidence that music perception involves strong expectancies regarding the distribution of a melodic interval, namely, the distance between two consecutive notes within the context of another. The recent availability of a large Western music dataset, consisting of the historical record condensed as melodic interval counts, has opened new possibilities for data-driven analysis of musical perception. In this context, we present an analytical approach that, based on cognitive theories of music expectation and machine learning techniques, recovers a set of factors that accurately identifies historical trends and stylistic transitions between the Baroque, Classical, Romantic, and Post-Romantic periods. We also offer a plausible musicological and cognitive interpretation of these factors, allowing us to propose them as data-driven principles of melodic expectation. PMID:23716669

Complications following incident stroke resulting in readmissions: an analysis of data from three Scottish health surveys.

PubMed

Ponomarev, Dmitry; Miller, Claire; Govan, Lindsay; Haig, Caroline; Wu, Olivia; Langhorne, Peter

2015-08-01

Stroke is widely recognized as the major contributor to morbidity and mortality in the United Kingdom. We analyzed the data obtained from the three consecutive Scottish Health Surveys and the Scottish Morbidity records, with the aim of identifying risk factors for, and timing of, common poststroke complications. There were 19434 individuals sampled during three Scottish Health Surveys in 1995, 1998, and 2001. For these individuals their morbidity and mortality outcomes were obtained in 2007. Incident stroke prevalence, risk factors for a range of poststroke complications, and average times until such complications in the sample were established. Of the total of 168 incident stroke admissions (0·86% of the survey), 16·1% people died during incident stroke hospitalization. Of the remaining 141 stroke survivors, 75·2% were rehospitalized at least once. The most frequent reason for readmission after stroke was a cardiovascular complication (28·6%), median time until event 1412 days, followed by infection (17·3%, median 1591 days). The risk of cardiovascular readmission was higher in those with 'poor' self-assessed health (odds ratio 7·70; 95% confidence interval 1·64-43·27), smokers (odds ratio 4·24; 95% confidence interval 1·11-21·59), and doubled with every five years increase in age (odds ratio 1·97; 95% confidence interval 1·46-2·65). 'Poor' self-assessed health increased chance of readmission for infection (odds ratio 14·11; 95% confidence interval 2·27-276·56). Cardiovascular events and infections are the most frequent poststroke complications resulting in readmissions. The time period until event provides a possibility to focus monitoring on those people at risk of readmission and introduce preventative measures, thereby reducing readmission-associated costs. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

Development of schooling behaviour during the downstream migration of Atlantic salmon Salmo salar smolts in a chalk stream.

PubMed

Riley, W D; Ibbotson, A T; Maxwell, D L; Davison, P I; Beaumont, W R C; Ives, M J

2014-10-01

The downstream migratory behaviour of wild Atlantic salmon Salmo salar smolts was monitored using passive integrated transponder (PIT) antennae systems over 10 years in the lower reaches of a small chalk stream in southern England, U.K. The timing of smolt movements and the likely occurrence of schooling were investigated and compared to previous studies. In nine of the 10 consecutive years of study, the observed diel downstream patterns of S. salar smolt migration appeared to be synchronized with the onset of darkness. The distribution of time intervals between successive nocturnal detections of PIT-tagged smolts was as expected if generated randomly from observed hourly rates. There were, however, significantly more short intervals than expected for smolts detected migrating during the day. For each year from 2006 to 2011, the observed 10th percentile of the daytime intervals was <4 s, compared to ≥55 s for the simulated random times, indicating greater incidence of groups of smolts. Groups with the shortest time intervals between successive PIT tag detections originated from numerous parr tagging sites (used as a proxy for relatedness). The results suggest that the ecological drivers influencing daily smolt movements in the lower reaches of chalk stream catchments are similar to those previously reported at the onset of migration for smolts leaving their natal tributaries; that smolts detected migrating during the night are moving independently following initiation by a common environmental factor (presumably darkness), whereas those detected migrating during the day often move in groups, and that such schools may not be site (kin)-structured. The importance of understanding smolt migratory behaviour is considered with reference to stock monitoring programmes and enhancing downstream passage past barriers. © 2014 Crown copyright. Journal of Fish Biology © 2014 The Fisheries Society of the British Isles.

Unfolding large-scale online collaborative human dynamics

PubMed Central

Zha, Yilong; Zhou, Tao; Zhou, Changsong

2016-01-01

Large-scale interacting human activities underlie all social and economic phenomena, but quantitative understanding of regular patterns and mechanism is very challenging and still rare. Self-organized online collaborative activities with a precise record of event timing provide unprecedented opportunity. Our empirical analysis of the history of millions of updates in Wikipedia shows a universal double–power-law distribution of time intervals between consecutive updates of an article. We then propose a generic model to unfold collaborative human activities into three modules: (i) individual behavior characterized by Poissonian initiation of an action, (ii) human interaction captured by a cascading response to previous actions with a power-law waiting time, and (iii) population growth due to the increasing number of interacting individuals. This unfolding allows us to obtain an analytical formula that is fully supported by the universal patterns in empirical data. Our modeling approaches reveal “simplicity” beyond complex interacting human activities. PMID:27911766

Cells anticipate periodic events

NASA Astrophysics Data System (ADS)

Nakagaki, Toshiyuki

2009-03-01

We show that an amoeboid organism can anticipate the timing of periodic events. The plasmodium of the true slime mold Physarum polycephalum moves rapidly under favourable conditions, but stops moving when transferred to less-favourable conditions. Plasmodia exposed to unfavourable conditions, presented in three consecutive pulses at constant intervals, reduced their locomotive speed in response to each episode. When subsequently subjected to favourable conditions, the plasmodia spontaneously reduced their locomotive speed at the time point when the next unfavourable episode would have occurred. This implied anticipation of impending environmental change. After this behaviour had been evoked several times, the locomotion of the plasmodia returned to normal; however, the anticipatory response could subsequently be induced by a single unfavourable pulse, implying recall of the memorized periodicity. We explored the mechanisms underlying these behaviours from a dynamical systems perspective. Our results hint at the cellular origins of primitive intelligence and imply that simple dynamics might be sufficient to explain its emergence.

The Lawrence D. Dorr Surgical Techniques & Technologies Award: "Running Two Rooms" Does Not Compromise Outcomes or Patient Safety in Joint Arthroplasty.

PubMed

Hamilton, William G; Ho, Henry; Parks, Nancy L; Strait, Alexander V; Hopper, Robert H; McDonald, James F; Goyal, Nitin; Fricka, Kevin B; Engh, C Anderson

2018-07-01

Scrutiny from the federal government and the media regarding the safety of 1 surgeon doing cases in 2 operating rooms (ORs) on the same day, prompted us to examine our own institutional data. Over the past 11 years, surgeons at our facility have operated consecutively in 1 OR on a given day or used 2 alternating ORs. This study compares these cases with a focus on revisions and complications in both groups. Six surgeons performed a total of 16,916 primary hip and knee arthroplasties from 2006-2016. 7002 cases (41%) were consecutive cases (CCs) and 9914 cases (59%) were overlapping cases (OCs). Intraoperative complications, component revisions, and postoperative complications within 90 days of surgery were compared between the CC and OC groups. There was no difference in intraoperative complication rates between the two groups (CC 1.6% vs. OC 1.7%, relative risk 1.082, 95% confidence interval 0.852 to 1.375, P = .52). There was no difference in 90-day component revision rates among the CC and OC groups (0.66% vs. 0.85% respectively, relative risk = 1.290, 95% confidence interval 0.901 to 1.845, P = .19). There was also no difference in 90-day complication rates among the CC and OC groups (1.33% vs. 1.45% respectively, relative risk = 1.094, 95% confidence interval 0.844 to 1.417, P = .54). This large study of a single institution with multiple surgeons over an 11-year period shows no compromise in patient safety or outcomes when comparing cases done in either consecutive or overlapping rooms. Copyright © 2018 Elsevier Inc. All rights reserved.

An Integer Batch Scheduling Model for a Single Machine with Simultaneous Learning and Deterioration Effects to Minimize Total Actual Flow Time

NASA Astrophysics Data System (ADS)

Yusriski, R.; Sukoyo; Samadhi, T. M. A. A.; Halim, A. H.

2016-02-01

In the manufacturing industry, several identical parts can be processed in batches, and setup time is needed between two consecutive batches. Since the processing times of batches are not always fixed during a scheduling period due to learning and deterioration effects, this research deals with batch scheduling problems with simultaneous learning and deterioration effects. The objective is to minimize total actual flow time, defined as a time interval between the arrival of all parts at the shop and their common due date. The decision variables are the number of batches, integer batch sizes, and the sequence of the resulting batches. This research proposes a heuristic algorithm based on the Lagrange Relaxation. The effectiveness of the proposed algorithm is determined by comparing the resulting solutions of the algorithm to the respective optimal solution obtained from the enumeration method. Numerical experience results show that the average of difference among the solutions is 0.05%.

Climate effects on historic bluefin tuna captures in the Gibraltar Strait and Western Mediterranean

NASA Astrophysics Data System (ADS)

Ganzedo, Unai; Polanco-Martínez, Josué M.; Caballero-Alfonso, Ángela M.; Faria, Sérgio H.; Li, Jianke; Castro-Hernández, José J.

2016-06-01

Historical capture records of bluefin tuna (Thunnus thynnus; BFT hereafter) from the Gibraltar Strait and Western Mediterranean show pronounced short- and long-term fluctuations. Some of these fluctuations are believed to be associated with biological and ecological process, as well as distinct climate factors. For the period of study (1700-1936) of this work, we found a long-term increasing trend in the BFT captures and in the climate variables. After applying a statistical time series analysis of relevant climate variables and long-term tuna capture records, it is highlighted the role played by sea-surface temperature (SST) on bluefin population variations. The most relevant result of this study is the strong correlation found between the total solar irradiance (TSI) - an external component of the climate system - and bluefin captures. The solar irradiance could have affected storminess during the period under study, mainly during the time interval 1700-1810. We suggest physico-biological mechanisms that explain the BFT catch fluctuations in two consecutive time intervals. In the first period, from 1700 to 1810, this mechanism could be high storm and wind activity, which would have made the BFT fisheries activities more difficult by reducing their efficacy. In contrast, during the interval from 1810 to 1907, the effects of wind and storms could be on spawning behaviour and larval ecology, and hence on year class strength, rather than on fish or fisherman's behaviour. These findings open up a range of new lines of enquiry that are relevant for both, fisheries and climate change research.

Sleep Restriction Impairs Vocabulary Learning when Adolescents Cram for Exams: The Need for Sleep Study.

PubMed

Huang, Sha; Deshpande, Aadya; Yeo, Sing-Chen; Lo, June C; Chee, Michael W L; Gooley, Joshua J

2016-09-01

The ability to recall facts is improved when learning takes place at spaced intervals, or when sleep follows shortly after learning. However, many students cram for exams and trade sleep for other activities. The aim of this study was to examine the interaction of study spacing and time in bed (TIB) for sleep on vocabulary learning in adolescents. In the Need for Sleep Study, which used a parallel-group design, 56 adolescents aged 15-19 years were randomly assigned to a week of either 5 h or 9 h of TIB for sleep each night as part of a 14-day protocol conducted at a boarding school. During the sleep manipulation period, participants studied 40 Graduate Record Examination (GRE)-type English words using digital flashcards. Word pairs were presented over 4 consecutive days (spaced items), or all at once during single study sessions (massed items), with total study time kept constant across conditions. Recall performance was examined 0 h, 24 h, and 120 h after all items were studied. For all retention intervals examined, recall of massed items was impaired by a greater amount in adolescents exposed to sleep restriction. In contrast, cued recall performance on spaced items was similar between sleep groups. Spaced learning conferred strong protection against the effects of sleep restriction on recall performance, whereas students who had insufficient sleep were more likely to forget items studied over short time intervals. These findings in adolescents demonstrate the importance of combining good study habits and good sleep habits to optimize learning outcomes. © 2016 Associated Professional Sleep Societies, LLC.

Perfect Detection of Spikes in the Linear Sub-threshold Dynamics of Point Neurons

PubMed Central

Krishnan, Jeyashree; Porta Mana, PierGianLuca; Helias, Moritz; Diesmann, Markus; Di Napoli, Edoardo

2018-01-01

Spiking neuronal networks are usually simulated with one of three main schemes: the classical time-driven and event-driven schemes, and the more recent hybrid scheme. All three schemes evolve the state of a neuron through a series of checkpoints: equally spaced in the first scheme and determined neuron-wise by spike events in the latter two. The time-driven and the hybrid scheme determine whether the membrane potential of a neuron crosses a threshold at the end of the time interval between consecutive checkpoints. Threshold crossing can, however, occur within the interval even if this test is negative. Spikes can therefore be missed. The present work offers an alternative geometric point of view on neuronal dynamics, and derives, implements, and benchmarks a method for perfect retrospective spike detection. This method can be applied to neuron models with affine or linear subthreshold dynamics. The idea behind the method is to propagate the threshold with a time-inverted dynamics, testing whether the threshold crosses the neuron state to be evolved, rather than vice versa. Algebraically this translates into a set of inequalities necessary and sufficient for threshold crossing. This test is slower than the imperfect one, but can be optimized in several ways. Comparison confirms earlier results that the imperfect tests rarely miss spikes (less than a fraction 1/108 of missed spikes) in biologically relevant settings. PMID:29379430

Consecutive salmonella outbreaks traced to the same bakery.

PubMed Central

Evans, M. R.; Tromans, J. P.; Dexter, E. L.; Ribeiro, C. D.; Gardner, D.

1996-01-01

Two consecutive community outbreaks of Salmonella enteritidis phage type 4 (PT4) traced to the same bakery occurred in Cardiff, Wales during August-September 1992. In the first outbreak, illness was associated with eating custard slices (odds ratio 23.8, 95% confidence interval 6.5-94.4, P < 0.0001), and in the second, with eating fresh cream cakes (odds ratio 15.8, 95% confidence interval 1.6-374, P = 0.004). Environmental investigations implicated cross-contamination during preparation of the cold-custard mix as the cause of the first outbreak, and inadequate cleaning and disinfection of nozzles used for piping cream in the second outbreak. S. enteritidis PT4 was isolated from fresh cream sponge cake retained by a case and from two fresh cream cakes and four environmental swabs obtained at the bakery. This incident illustrates the hazard of widespread environmental contamination with salmonella and the need for thorough environmental cleansing for any premises implicated in an outbreak of food poisoning. PMID:8620907

Intermittent ethanol exposure increases long-lasting behavioral and neurochemical effects of MDMA in adolescent mice.

PubMed

Rodríguez-Arias, Marta; Maldonado, Concepción; Vidal-Infer, Antonio; Guerri, Consuelo; Aguilar, María A; Miñarro, José

2011-11-01

Heavy binge drinking is increasingly frequent among adolescents, while ethanol (EtOH) is often used in combination with 3,4-methylenedioxymethamphetamine (MDMA). The long-lasting effects of intermittent exposure to EtOH and MDMA during adolescence on motor activity, anxiety, and social behavior were evaluated in adult mice. The concentration of brain monoamines in the striatum, cortex, and hippocampus was measured following the behavioral test. Adolescent OF1 mice were exposed to ethanol (1.25 g/kg) on two consecutive days at 48-h intervals over a 14-day period (from PND 29 to 42). A total of eight injections of MDMA (10 or 20 mg/kg) were administered twice daily at 4-h intervals over two consecutive days, and this schedule was repeated 6 days later (PND 33, 34, 41, and 42). Behavioral tests and analysis of brain monoamines took place on PND 64 to 67. Exposure to MDMA during adolescence increased the anxiogenic response in the elevated plus maze, with adult mice spending less time in the open arms of the maze and exhibiting lower concentrations of DA in the striatum. A pattern of ethanol administration modeling binge drinking during adolescence enhanced these effects and undermined the hyperthermic response induced by MDMA. Passive avoidance was affected only when EtOH was administered alone. Juvenile administration of MDMA and alcohol was found to cause a decrease in monoamine levels in adulthood, as well as changes in social interaction behaviors, locomotor activity, increase measures of anxiety in the elevated plus maze (EPM), and decrease step-through latencies in passive avoidance test.

A novel approach to estimation of the time to biomarker threshold: applications to HIV.

PubMed

Reddy, Tarylee; Molenberghs, Geert; Njagi, Edmund Njeru; Aerts, Marc

2016-11-01

In longitudinal studies of biomarkers, an outcome of interest is the time at which a biomarker reaches a particular threshold. The CD4 count is a widely used marker of human immunodeficiency virus progression. Because of the inherent variability of this marker, a single CD4 count below a relevant threshold should be interpreted with caution. Several studies have applied persistence criteria, designating the outcome as the time to the occurrence of two consecutive measurements less than the threshold. In this paper, we propose a method to estimate the time to attainment of two consecutive CD4 counts less than a meaningful threshold, which takes into account the patient-specific trajectory and measurement error. An expression for the expected time to threshold is presented, which is a function of the fixed effects, random effects and residual variance. We present an application to human immunodeficiency virus-positive individuals from a seroprevalent cohort in Durban, South Africa. Two thresholds are examined, and 95% bootstrap confidence intervals are presented for the estimated time to threshold. Sensitivity analysis revealed that results are robust to truncation of the series and variation in the number of visits considered for most patients. Caution should be exercised when interpreting the estimated times for patients who exhibit very slow rates of decline and patients who have less than three measurements. We also discuss the relevance of the methodology to the study of other diseases and present such applications. We demonstrate that the method proposed is computationally efficient and offers more flexibility than existing frameworks. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Multiple Consecutive Infections Might Explain the Lack of Protection by BCG

PubMed Central

Cardona, Pere-Joan; Vilaplana, Cristina

2014-01-01

Although contacts between tuberculosis patients may result in multiple consecutive infections (MCI), no experimental animal models consider this fact when used in basic studies. Moreover, the current TB vaccine (BCG) has demonstrated a limited protection in humans. In this study we evaluate the effect of tuberculosis MCI by way of a simple mathematical analysis using data from the low dose aerosol murine experimental model. The results show that a higher number of, or shorter intervals between, multiple consecutive infections reduce the protective effect of BCG. This is due to both the increase in bacillary load at the stationary level of the infection, and the protective immune response induced by the infection itself. This factor must therefore be taken into account when designing new prophylactic strategies as candidate vaccines for the replacement of BCG. PMID:24740286

Multiple consecutive infections might explain the lack of protection by BCG.

PubMed

Cardona, Pere-Joan; Vilaplana, Cristina

2014-01-01

Although contacts between tuberculosis patients may result in multiple consecutive infections (MCI), no experimental animal models consider this fact when used in basic studies. Moreover, the current TB vaccine (BCG) has demonstrated a limited protection in humans. In this study we evaluate the effect of tuberculosis MCI by way of a simple mathematical analysis using data from the low dose aerosol murine experimental model. The results show that a higher number of, or shorter intervals between, multiple consecutive infections reduce the protective effect of BCG. This is due to both the increase in bacillary load at the stationary level of the infection, and the protective immune response induced by the infection itself. This factor must therefore be taken into account when designing new prophylactic strategies as candidate vaccines for the replacement of BCG.

Within-Session Stability of Short-Term Heart Rate Variability Measurement

PubMed Central

2016-01-01

Abstract The primary aim of this study was to assess the retest stability of the short-term heart rate variability (HRV) measurement performed within one session and without the use of any intervention. Additionally, a precise investigation of the possible impact of intrinsic biological variation on HRV reliability was also performed. First, a single test-retest HRV measurement was conducted with 20-30 min apart from one another. Second, the HRV measurement was repeated in ten non-interrupted consecutive intervals. The lowest typical error (CV = 21.1%) was found for the square root of the mean squared differences of successive RR intervals (rMSSD) and the highest for the low frequency power (PLF) (CV = 93.9%). The standardized changes in the mean were trivial to small. The correlation analysis revealed the highest level for ln rMSSD (ICC = 0.87), while ln PLF represented the worst case (ICC = 0.59). The reliability indices for ln rMSSD in 10 consecutive intervals improved (CV = 9.9%; trivial standardized changes in the mean; ICC = 0.96). In conclusion, major differences were found in the reliability level between the HRV indices. The rMSSD demonstrated the highest reliability level. No substantial influence of intrinsic biological variation on the HRV reliability was observed. PMID:28149345

Detection of multiple blood feeding in Aedes aegypti (Diptera: Culicidae) during a single gonotrophic cycle using a histologic technique.

PubMed

Scott, T W; Clark, G G; Lorenz, L H; Amerasinghe, P H; Reiter, P; Edman, J D

1993-01-01

We evaluated a histologic technique for its usefulness in detecting multiple blood feeding by Aedes aegypti (L.) in a single gonotrophic cycle. To standardize the procedure, we carried out a laboratory study in which 166 mosquitoes imbibed two blood meals at known intervals. Eighty percent (78/98) of the multiple meals were detected when the interval between meals was from 1 to < to = 24 h and the time from the second meal to fixation ranged from 0 to 12 hr. At intervals outside this range, only 34% (23/68) of the multiple meals were detected. Overall, 61% (101/166) of the double meals were detected. Examination of 96 engorged Ae. aegypti collected by aspiration from inside houses in San Juan, Puerto Rico, indicated that 50% had imbibed multiple meals. Most wild-caught mosquitoes took their last meal the day before capture, and most multiple feeders fed twice on consecutive days. A dark line of digested blood, or heme, around the first meal and a physical separation between meals were the most useful histologic parameters for detecting multiple feeding in wild Ae. aegypti. An association of multiple feeding with advanced stages of oocyte development suggests that, at the time of collection, most Ae. aegypti from the study site had fed twice in each gonotrophic cycle. We conclude that, although it is labor intensive, histologic examination is an appropriate technique for a longitudinal, community-wide survey of multiple feeding by Ae. aegypti.

Rational-spline approximation with automatic tension adjustment

NASA Technical Reports Server (NTRS)

Schiess, J. R.; Kerr, P. A.

1984-01-01

An algorithm for weighted least-squares approximation with rational splines is presented. A rational spline is a cubic function containing a distinct tension parameter for each interval defined by two consecutive knots. For zero tension, the rational spline is identical to a cubic spline; for very large tension, the rational spline is a linear function. The approximation algorithm incorporates an algorithm which automatically adjusts the tension on each interval to fulfill a user-specified criterion. Finally, an example is presented comparing results of the rational spline with those of the cubic spline.

Symptomatic Versus Inapparent Outcome in Repeat Dengue Virus Infections Is Influenced by the Time Interval between Infections and Study Year

PubMed Central

Mercado, Juan Carlos; Williams, Katherine L.; Vargas, Maria José; Gutierrez, Gamaliel; Kuan, Guillermina; Gordon, Aubree; Balmaseda, Angel; Harris, Eva

2013-01-01

Four dengue virus serotypes (DENV1-4) circulate globally, causing more human illness than any other arthropod-borne virus. Dengue can present as a range of clinical manifestations from undifferentiated fever to Dengue Fever to severe, life-threatening syndromes. However, most DENV infections are inapparent. Yet, little is known about determinants of inapparent versus symptomatic DENV infection outcome. Here, we analyzed over 2,000 DENV infections from 2004 to 2011 in a prospective pediatric cohort study in Managua, Nicaragua. Symptomatic cases were captured at the study health center, and paired healthy annual samples were examined on a yearly basis using serological methods to identify inapparent DENV infections. Overall, inapparent and symptomatic DENV infections were equally distributed by sex. The mean age of infection was 1.2 years higher for symptomatic DENV infections as compared to inapparent infections. Although inapparent versus symptomatic outcome did not differ by infection number (first, second or third/post-second DENV infections), substantial variation in the proportion of symptomatic DENV infections among all DENV infections was observed across study years. In participants with repeat DENV infections, the time interval between a first inapparent DENV infection and a second inapparent infection was significantly shorter than the interval between a first inapparent and a second symptomatic infection. This difference was not observed in subsequent infections. This result was confirmed using two different serological techniques that measure total anti-DENV antibodies and serotype-specific neutralizing antibodies, respectively. Taken together, these findings show that, in this study, age, study year and time interval between consecutive DENV infections influence inapparent versus symptomatic infection outcome, while sex and infection number had no significant effect. Moreover, these results suggest that the window of cross-protection induced by a first infection with DENV against a second symptomatic infection is approximately 2 years. These findings are important for modeling dengue epidemics and development of vaccines. PMID:23951377

Symptomatic versus inapparent outcome in repeat dengue virus infections is influenced by the time interval between infections and study year.

PubMed

Montoya, Magelda; Gresh, Lionel; Mercado, Juan Carlos; Williams, Katherine L; Vargas, Maria José; Gutierrez, Gamaliel; Kuan, Guillermina; Gordon, Aubree; Balmaseda, Angel; Harris, Eva

2013-01-01

Four dengue virus serotypes (DENV1-4) circulate globally, causing more human illness than any other arthropod-borne virus. Dengue can present as a range of clinical manifestations from undifferentiated fever to Dengue Fever to severe, life-threatening syndromes. However, most DENV infections are inapparent. Yet, little is known about determinants of inapparent versus symptomatic DENV infection outcome. Here, we analyzed over 2,000 DENV infections from 2004 to 2011 in a prospective pediatric cohort study in Managua, Nicaragua. Symptomatic cases were captured at the study health center, and paired healthy annual samples were examined on a yearly basis using serological methods to identify inapparent DENV infections. Overall, inapparent and symptomatic DENV infections were equally distributed by sex. The mean age of infection was 1.2 years higher for symptomatic DENV infections as compared to inapparent infections. Although inapparent versus symptomatic outcome did not differ by infection number (first, second or third/post-second DENV infections), substantial variation in the proportion of symptomatic DENV infections among all DENV infections was observed across study years. In participants with repeat DENV infections, the time interval between a first inapparent DENV infection and a second inapparent infection was significantly shorter than the interval between a first inapparent and a second symptomatic infection. This difference was not observed in subsequent infections. This result was confirmed using two different serological techniques that measure total anti-DENV antibodies and serotype-specific neutralizing antibodies, respectively. Taken together, these findings show that, in this study, age, study year and time interval between consecutive DENV infections influence inapparent versus symptomatic infection outcome, while sex and infection number had no significant effect. Moreover, these results suggest that the window of cross-protection induced by a first infection with DENV against a second symptomatic infection is approximately 2 years. These findings are important for modeling dengue epidemics and development of vaccines.

High intensity interval training in the heat enhances exercise-induced lipid peroxidation, but prevents protein oxidation in physically active men

PubMed Central

Souza-Silva, Ana Angélica; Moreira, Eduardo; de Melo-Marins, Denise; Schöler, Cinthia M.; de Bittencourt, Paulo Ivo Homem; Laitano, Orlando

2016-01-01

ABSTRACT Aim. The purpose of this study was to determine the response of circulating markers of lipid and protein oxidation following an incremental test to exhaustion before and after 4 weeks of high-intensity interval training performed in the heat. Methods. To address this question, 16 physically active men (age = 23 ± 2 years; body mass = 73 ± 12 kg; height = 173 ± 6 cm; % body fat = 12.5 ± 6 %; body mass index = 24 ± 4 kg/m2) were allocated into 2 groups: control group (n = 8) performing high-intensity interval training at 22°C, 55% relative humidity and heat group (n = 8) training under 35°C, 55% relative humidity. Both groups performed high-intensity interval training 3 times per week for 4 consecutive weeks, accumulating a total of 12 training sessions. Before and after the completion of 4 weeks of high-intensity interval training, participants performed an incremental cycling test until exhaustion under temperate environment (22°C, 55% relative humidity) where blood samples were collected after the test for determination of exercise-induced changes in oxidative damage biomarkers (thiobarbituric acid reactive species and protein carbonyls). Results. When high-intensity interval training was performed under control conditions, there was an increase in protein carbonyls (p < 0.05) following the incremental test to exhaustion with no changes in thiobarbituric acid reactive species. Conversely, high-intensity interval training performed in high environmental temperature enhanced the incremental exercise-induced increases in thiobarbituric acid reactive species (p < 0.05) with no changes in protein carbonyls. Conclusion. In conclusion, 4 weeks of high-intensity interval training performed in the heat enhances exercise-induced lipid peroxidation, but prevents protein oxidation following a maximal incremental exercise in healthy active men. PMID:27227083

CI2 for creating and comparing confidence-intervals for time-series bivariate plots.

PubMed

Mullineaux, David R

2017-02-01

Currently no method exists for calculating and comparing the confidence-intervals (CI) for the time-series of a bivariate plot. The study's aim was to develop 'CI2' as a method to calculate the CI on time-series bivariate plots, and to identify if the CI between two bivariate time-series overlap. The test data were the knee and ankle angles from 10 healthy participants running on a motorised standard-treadmill and non-motorised curved-treadmill. For a recommended 10+ trials, CI2 involved calculating 95% confidence-ellipses at each time-point, then taking as the CI the points on the ellipses that were perpendicular to the direction vector between the means of two adjacent time-points. Consecutive pairs of CI created convex quadrilaterals, and any overlap of these quadrilaterals at the same time or ±1 frame as a time-lag calculated using cross-correlations, indicated where the two time-series differed. CI2 showed no group differences between left and right legs on both treadmills, but the same legs between treadmills for all participants showed differences of less knee extension on the curved-treadmill before heel-strike. To improve and standardise the use of CI2 it is recommended to remove outlier time-series, use 95% confidence-ellipses, and scale the ellipse by the fixed Chi-square value as opposed to the sample-size dependent F-value. For practical use, and to aid in standardisation or future development of CI2, Matlab code is provided. CI2 provides an effective method to quantify the CI of bivariate plots, and to explore the differences in CI between two bivariate time-series. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of age and recovery duration on peak power output during repeated cycling sprints.

PubMed

Ratel, S; Bedu, M; Hennegrave, A; Doré, E; Duché, P

2002-08-01

The aim of the present study was to investigate the effects of age and recovery duration on the time course of cycling peak power and blood lactate concentration ([La]) during repeated bouts of short-term high-intensity exercise. Eleven prepubescent boys (9.6 +/- 0.7 yr), nine pubescent boys (15.0 +/- 0.7 yr) and ten men (20.4 +/- 0.8 yr) performed ten consecutive 10 s cycling sprints separated by either 30 s (R30), 1 min (R1), or 5 min (R5) passive recovery intervals against a friction load corresponding to 50 % of their optimal force (50 % Ffopt). Peak power produced at 50 % Ffopt (PP50) was calculated at each sprint including the flywheel inertia of the bicycle. Arterialized capillary blood samples were collected at rest and during the sprint exercises to measure the time course of [La]. In the prepubescent boys, whatever recovery intervals, PP50 remained unchanged during the ten 10 s sprint exercises. In the pubescent boys, PP50 decreased significantly by 18.5 % (p < 0.001) with R30 and by 15.3 % (p < 0.01) with R1 from the first to the tenth sprint but remained unchanged with R5. In the men, PP50 decreased respectively by 28.5 % (p < 0.001) and 11.3 % (p < 0.01) with R30 and R1 and slightly diminished with R5. For each recovery interval, the increase in blood [La] over the ten sprints was significantly lower in the prepubescent boys compared with the pubescent boys and the men. To conclude, the prepubescent boys sustained their PP50 during the ten 10 s sprint exercises with only 30 s recovery intervals. In contrast, the pubescent boys and the men needed 5 min recovery intervals. It was suggested that the faster recovery of PP50 in the prepubescent boys was due to their lower muscle glycolytic activity and their higher muscle oxidative capacity allowing a faster resynthesis in phosphocreatine.

Likelihood of early detection of breast cancer in relation to false-positive risk in life-time mammographic screening: population-based cohort study.

PubMed

Otten, J D M; Fracheboud, J; den Heeten, G J; Otto, S J; Holland, R; de Koning, H J; Broeders, M J M; Verbeek, A L M

2013-10-01

Women require balanced, high-quality information when making an informed decision on screening benefits and harms before attending biennial mammographic screening. The cumulative risk of a false-positive recall and/or (small) screen-detected or interval cancer over 13 consecutive screening examinations for women aged 50 from the start of screening were estimated using data from the Nijmegen programme, the Netherlands. Women who underwent 13 successive screens in the period 1975-1976 had a 5.3% cumulative chance of a screen-detected cancer, with a 4.2% risk of at least one false-positive recall. The risk of being diagnosed with interval cancer was 3.7%. Two decades later, these estimates were 6.9%, 7.3% and 2.9%, respectively. The chance of detection of a small, favourable invasive breast cancer, anticipating a normal life-expectancy, rose from 2.3% to 3.7%. Extrapolation to digital screening mammography indicates that the proportion of false-positive results will rise to 16%. Dutch women about to participate in the screening programme can be reassured that the chance of false-positive recall in the Netherlands is relatively low. A new screening policy and improved mammography have increased the detection of an early screening carcinoma and lowering the risk of interval carcinoma.

Reference Values for TSH and Free Thyroid Hormones in Healthy Pregnant Women in Poland: A Prospective, Multicenter Study.

PubMed

Kostecka-Matyja, Marta; Fedorowicz, Anna; Bar-Andziak, Ewa; Bednarczuk, Tomasz; Buziak-Bereza, Monika; Dumnicka, Paulina; Górska, Maria; Krasnodębska, Małgorzata; Niedźwiedzka, Beata; Pach, Dorota; Ruchała, Marek; Siewko, Katarzyna; Solnica, Bogdan; Sowiński, Jerzy; Szelachowska, Małgorzata; Trofimiuk-Müldner, Małgorzata; Wachowiak-Ochmańska, Katarzyna; Hubalewska-Dydejczyk, Alicja

2017-04-01

The diagnosis and treatment of thyroid diseases in pregnant women remains a challenge. Various medical associations recommend establishing the reference intervals for thyroid hormones by a local laboratory. Considering differences within geophysical, socioeconomic conditions, and iodine prophylaxis in various populations, it is advisable to assess reference intervals for thyroid hormones specific to a region of residence. The objective was to assess trimester-specific reference intervals for TSH, fT 3 , and fT 4 for pregnant women in the Polish population. We conducted a prospective study in 4 centers representing different regions of Poland (Krakow, Warsaw, Poznan, and Bialystok). Our study included consecutive, healthy pregnant women (172 patients), with an age range of 27-47 years. All women had a negative history for thyroid diseases, normal thyroid peroxidase antibody levels, and proper iodine prophylaxis. All newborns had TSH levels in the appropriate reference range. Serum TSH, fT 3 , fT 4 , and thyroid-peroxidase antibodies were measured in each trimester. The reference intervals were calculated using the percentile method, as recommended by the International Federation of Clinical Chemistry. The reference values calculated were 0.009-3.177, 0.05-3.442, and 0.11-3.53 mIU/L for TSH; 3.63-6.55, 3.29-5.45, and 3.1-5.37 pmol/L for fT 3 ; and 11.99-21.89, 10.46-16.67, and 8.96-17.23 pmol/L for fT 4 in consecutive trimesters of pregnancy. Reference intervals for pregnant women when compared to the general population showed a lower concentration of TSH in every trimester of pregnancy and lower fT 4 in the 2nd and 3rd trimesters. Using appropriate trimester-specific reference intervals may improve care of pregnant women by preventing misdiagnosis and inadequate treatment.

The implications of variable remigration intervals for the assessment of population size in marine turtles.

PubMed

Hays, G C

2000-09-21

Sea turtles nest on sandy beaches and tend to show high fidelity to specific nesting areas, but, despite this fidelity, the inter-annual variation in nesting numbers may be large. This variation may reflect the fact that turtles do not usually nest in consecutive years. Here, theoretical models are developed in which the interval between successive nesting years (the remigration interval) reflects conditions encountered on the feeding grounds, with good feeding years leading to a reduction in the remigration interval and vice versa. These simple models produce high levels of inter-annual variation in nesting numbers with, on occasion, almost no turtles nesting in some years even when the population is large and stable. The implications for assessing the size of sea turtle populations are considered. Copyright 2000 Academic Press.

Voiding diary might serve as a useful tool to understand differences between bladder pain syndrome/interstitial cystitis and overactive bladder.

PubMed

Kim, Sung Han; Oh, Shin Ah; Oh, Seung-June

2014-02-01

To identify the voiding characteristics of bladder pain syndrome/interstitial cystitis and overactive bladder. Between September 2005 and June 2010, 3-day voiding diaries of 49 consecutive bladder pain syndrome/interstitial cystitis patients and 301 overactive bladder patients were prospectively collected at an outpatient clinic and retrospectively analyzed. The characteristics of the two groups were not significantly different. However, all voiding variables including volume and frequency were significantly different except for the total voided volume: patients with bladder pain syndrome/interstitial cystitis showed significantly higher voiding frequencies, smaller maximal and mean voided volume, and more constant and narrower ranges of voided volume compared with overactive bladder patients (P < 0.005). Furthermore, mean intervals between voiding in bladder pain syndrome/interstitial cystitis were shorter and more consistent during the day and night (P < 0.001), although mean night-time variances were greater than daytime variances. Logistic regression analysis showed that total night-time frequency, maximal night-time voided volume and mean variance of daytime voiding intervals most significantly differentiated the two groups. Some voiding characteristics of bladder pain syndrome/interstitial cystitis and overactive bladder patients differ significantly according to 3-day voiding diary records. These findings provide additional information regarding the differences between these two diseases in the outpatient clinical setting. © 2013 The Japanese Urological Association.

Fourth-grade children's dietary recall accuracy is influenced by retention interval (target period and interview time).

PubMed

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

2009-05-01

For a 24-hour dietary recall, two possible target periods are the prior 24 hours (24 hours immediately preceding the interview time) and previous day (midnight to midnight of the day before the interview), and three possible interview times are morning, afternoon, and evening. Target period and interview time determine the retention interval (elapsed time between to-be-reported meals and the interview), which, along with intervening meals, can influence reporting accuracy. The effects of target period and interview time on children's accuracy for reporting school meals during 24-hour dietary recalls were investigated. DESIGN AND SUBJECTS/SETTING: During the 2004-2005, 2005-2006, and 2006-2007 school years in Columbia, SC, each of 374 randomly selected fourth-grade children (96% African American) was observed eating two consecutive school meals (breakfast and lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions defined by crossing two target periods with three interview times. Each condition had 62 or 64 children (half boys). Accuracy for reporting school meals was quantified by calculating rates for omissions (food items observed eaten but unreported) and intrusions (food items reported eaten but unobserved); a measure of total inaccuracy combined errors for reporting food items and amounts. For each accuracy measure, analysis of variance was conducted with target period, interview time, their interaction, sex, interviewer, and school year in the model. There was a target-period effect and a target-period by interview-time interaction on omission rates, intrusion rates, and total inaccuracy (six P values <0.004). For prior-24-hour recalls compared to previous-day recalls, and for prior-24-hour recalls in the afternoon and evening compared to previous-day recalls in the afternoon and evening, omission rates were better by one third, intrusion rates were better by one half, and total inaccuracy was better by one third. To enhance children's dietary recall accuracy, target periods and interview times that minimize the retention interval should be chosen.

Setting the Revisit Interval in Primary Care

PubMed Central

Schwartz, Lisa M; Woloshin, Steven; Wasson, John H; Renfrew, Roger A; Welch, H Gilbert

1999-01-01

OBJECTIVE Although longitudinal care constitutes the bulk of primary care, physicians receive little guidance on the fundamental question of how to time follow-up visits. We sought to identify important predictors of the revisit interval and to describe the variability in how physicians set these intervals when caring for patients with common medical conditions. DESIGN Cross-sectional survey of physicians performed at the end of office visits for consecutive patients with hypertension, angina, diabetes, or musculoskeletal pain. PARTICIPANTS/SETTING One hundred sixty-four patients under the care of 11 primary care physicians in the Dartmouth Primary Care Cooperative Research Network. MEASUREMENTS The main outcome measures were the variability in mean revisit intervals across physicians and the proportion of explained variance by potential determinants of revisit intervals. We assessed the relation between the revisit interval (dependent variable) and three groups of independent variables, patient characteristics (e.g., age, physician perception of patient health), identification of individual physician, and physician characterization of the visit (e.g., routine visit, visit requiring a change in management, or visit occurring on a “hectic” day), using multiple regression that accounted for the natural grouping of patients within physician. MAIN RESULTS Revisit intervals ranged from 1 week to over 1 year. The most common intervals were 12 and 16 weeks. Physicians’ perception of fair-poor health status and visits involving a change in management were most strongly related to shorter revisit intervals. In multivariate analyses, patient characteristics explained about 18% of the variance in revisit intervals, and adding identification of the individual provider doubled the explained variance to about 40%. Physician characterization of the visit increased explained variance to 57%. The average revisit interval adjusted for patient characteristics for each of the 11 physicians varied from 4 to 20 weeks. Although all physicians lengthened revisit intervals for routine visits and shortened them when changing management, the relative ranking of mean revisit intervals for each physician changed little for different visit characterizations—some physicians were consistently long and others were consistently short. CONCLUSION Physicians vary widely in their recommendations for office revisits. Patient factors accounted for only a small part of this variation. Although physicians responded to visits in predictable ways, each physician appeared to have a unique set point for the length of the revisits interval. PMID:10203635

Pulmonary 3 T MRI with ultrashort TEs: influence of ultrashort echo time interval on pulmonary functional and clinical stage assessments of smokers.

PubMed

Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Seki, Shinichiro; Obara, Makoto; van Cauteren, Marc; Takahashi, Masaya; Sugimura, Kazuro

2014-04-01

To assess the influence of ultrashort TE (UTE) intervals on pulmonary magnetic resonance imaging (MRI) with UTEs (UTE-MRI) for pulmonary functional loss assessment and clinical stage classification of smokers. A total 60 consecutive smokers (43 men and 17 women; mean age 70 years) with and without COPD underwent thin-section multidetector row computed tomography (MDCT), UTE-MRI, and pulmonary functional measurements. For each smoker, UTE-MRI was performed with three different UTE intervals (UTE-MRI A: 0.5 msec, UTE-MRI B: 1.0 msec, UTE-MRI C: 1.5 msec). By using the GOLD guidelines, the subjects were classified as: "smokers without COPD," "mild COPD," "moderate COPD," and "severe or very severe COPD." Then the mean T2* value from each UTE-MRI and CT-based functional lung volume (FLV) were correlated with pulmonary function test. Finally, Fisher's PLSD test was used to evaluate differences in each index among the four clinical stages. Each index correlated significantly with pulmonary function test results (P < 0.05). CT-based FLV and mean T2* values obtained from UTE-MRI A and B showed significant differences among all groups except between "smokers without COPD" and "mild COPD" groups (P < 0.05). UTE-MRI has a potential for management of smokers and the UTE interval is suggested as an important parameter in this setting. Copyright © 2013 Wiley Periodicals, Inc.

Time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla for evaluation of hemodynamic characteristics of vascular malformations: description of distinct subgroups.

PubMed

Hammer, Simone; Uller, Wibke; Manger, Florentine; Fellner, Claudia; Zeman, Florian; Wohlgemuth, Walter A

2017-01-01

Quantitative evaluation of hemodynamic characteristics of arteriovenous and venous malformations using time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla. Time-resolved MRA with interleaved stochastic trajectories (TWIST) at 3.0 Tesla was studied in 83 consecutive patients with venous malformations (VM) and arteriovenous malformations (AVM). Enhancement characteristics were calculated as percentage increase of signal intensity above baseline over time. Maximum percentage signal intensity increase (signal max ), time intervals between onset of arterial enhancement and lesion enhancement (t onset ), and time intervals between beginning of lesion enhancement and maximum percentage of lesion enhancement (t max ) were analyzed. All AVMs showed a high-flow hemodynamic pattern. Two significantly different (p < 0.001) types of venous malformations emerged: VMs with arteriovenous fistulas (AVF) (median signal max 737 %, IQR [interquartile range] = 511 - 1182 %; median t onset 5 s, IQR = 5 - 10 s; median t max 35 s, IQR = 26 - 40 s) and without AVFs (median signal max 284 %, IQR = 177-432 %; median t onset 23 s, IQR = 15 - 30 s; median t max 60 s, IQR = 55 - 75 s). Quantitative evaluation of time-resolved MRA at 3.0 Tesla provides hemodynamic characterization of vascular malformations. VMs can be subclassified into two hemodynamic subgroups due to presence or absence of AVFs. • Time-resolved MRA at 3.0 Tesla provides quantitative hemodynamic characterization of vascular malformations. • Malformations significantly differ in time courses of enhancement and signal intensity increase. • AVMs show a distinctive high-flow hemodynamic pattern. • Two significantly different types of VMs emerged: VMs with and without AVFs.

Antihypertensive treatment prolongs tissue plasminogen activator door-to-treatment time: secondary analysis of the INSTINCT trial.

PubMed

Skolarus, Lesli E; Scott, Phillip A; Burke, James F; Adelman, Eric E; Frederiksen, Shirley M; Kade, Allison M; Kalbfleisch, Jack D; Ford, Andria L; Meurer, William J

2012-12-01

Identifying modifiable tissue plasminogen activator treatment delays may improve stroke outcomes. We hypothesized that prethrombolytic antihypertensive treatment (AHT) may prolong door-to-treatment time (DTT). We performed an analysis of consecutive tissue plasminogen activator-treated patients at 24 randomly selected community hospitals in the Increasing Stroke Treatment through Interventional Behavior Change Tactics (INSTINCT) trial between 2007 and 2010. DTT among stroke patients who received prethrombolytic AHT were compared with those who did not receive prethrombolytic AHT. We then calculated a propensity score for the probability of receiving prethrombolytic AHT using logistic regression with demographics, stroke risk factors, home medications, stroke severity (National Institutes of Health Stroke Scale), onset-to-door time, admission glucose, pretreatment blood pressure, emergency medical service transport, and location at time of stroke as independent variables. A paired t test was performed to compare the DTT between the propensity-matched groups. Of 534 tissue plasminogen activator-treated stroke patients analyzed, 95 received prethrombolytic AHT. In the unmatched cohort, patients who received prethrombolytic AHT had a longer DTT (mean increase, 9 minutes; 95% confidence interval, 2-16 minutes) than patients who did not. After propensity matching, patients who received prethrombolytic AHT had a longer DTT (mean increase, 10.4 minutes; 95% confidence interval, 1.9-18.8) than patients who did not receive prethrombolytic AHT. Prethrombolytic AHT is associated with modest delays in DTT. This represents a potential target for quality-improvement initiatives. Further research evaluating optimum prethrombolytic hypertension management is warranted.

Do one-time intracompartmental pressure measurements have a high false-positive rate in diagnosing compartment syndrome?

PubMed

Whitney, Augusta; O'Toole, Robert V; Hui, Emily; Sciadini, Marcus F; Pollak, Andrew N; Manson, Theodore T; Eglseder, W Andrew; Andersen, Romney C; Lebrun, Christopher; Doro, Christopher; Nascone, Jason W

2014-02-01

Intracompartmental pressure measurements are frequently used in the diagnosis of compartment syndrome, particularly in patients with equivocal or limited physical examination findings. Little clinical work has been done to validate the clinical use of intracompartmental pressures or identify associated false-positive rates. We hypothesized that diagnosis of compartment syndrome based on one-time pressure measurements alone is associated with a high false-positive rate. Forty-eight consecutive patients with tibial shaft fractures who were not suspected of having compartment syndrome based on physical examinations were prospectively enrolled. Pressure measurements were obtained in all four compartments at a single point in time immediately after induction of anesthesia using a pressure-monitoring device. Preoperative and intraoperative blood pressure measurements were recorded. The same standardized examination was performed by the attending surgeon preoperatively, postoperatively, and during clinical follow-up for 6 months to assess clinical evidence of acute or late compartment syndrome. No clinical evidence of compartment syndrome was observed postoperatively or during follow-up until 6 months after injury. Using the accepted criteria of delta P of 30 mm Hg from preoperative diastolic blood pressure, 35% of cases (n = 16; 95% confidence interval, 21.5-48.5%) met criteria for compartment syndrome. Raising the threshold to delta P of 20 mm Hg reduced the false-positive rate to 24% (n = 11; 95% confidence interval, 11.1-34.9%). Twenty-two percent (n = 10; 95% confidence interval, 9.5-32.5%) exceeded absolute pressure of 45 mm Hg. A 35% false-positive rate was found for the diagnosis of compartment syndrome in patients with tibial shaft fractures who were not thought to have compartment syndrome by using currently accepted criteria for diagnosis based solely on one-time compartment pressure measurements. Our data suggest that reliance on one-time intracompartmental pressure measurements can overestimate the rate of compartment syndrome and raise concern regarding unnecessary fasciotomies. Diagnostic study, level II.

Risk of Pancreatic Cancer After a Primary Episode of Acute Pancreatitis.

PubMed

Rijkers, Anton P; Bakker, Olaf J; Ahmed Ali, Usama; Hagenaars, Julia C J P; van Santvoort, Hjalmar C; Besselink, Marc G; Bollen, Thomas L; van Eijck, Casper H

2017-09-01

Acute pancreatitis may be the first manifestation of pancreatic cancer. The aim of this study was to assess the risk of pancreatic cancer after a first episode of acute pancreatitis. Between March 2004 and March 2007, all consecutive patients with a first episode of acute pancreatitis were prospectively registered. Follow-up was based on hospital records audit, radiological imaging, and patient questionnaires. Outcome was stratified based on the development of chronic pancreatitis. We included 731 patients. The median follow-up time was 55 months. Progression to chronic pancreatitis was diagnosed in 51 patients (7.0%). In this group, the incidence rate per 1000 person-years for developing pancreatic cancer was 9.0 (95% confidence interval, 2.3-35.7). In the group of 680 patients who did not develop chronic pancreatitis, the incidence rate per 1000 person-years for developing pancreatic cancer in this group was 1.1 (95% confidence interval, 0.3-3.3). Hence, the rate ratio of pancreatic cancer was almost 9 times higher in patients who developed chronic pancreatitis compared with those who did not (P = 0.049). Although a first episode of acute pancreatitis may be related to pancreatic cancer, this risk is mainly present in patients who progress to chronic pancreatitis.

Bridge therapy or standard treatment for urgent surgery after coronary stent implantation: Analysis of 314 patients.

PubMed

De Servi, Stefano; Morici, Nuccia; Boschetti, Enrico; Rossini, Roberta; Martina, Paola; Musumeci, Giuseppe; D'Urbano, Maurizio; Lazzari, Ludovico; La Vecchia, Carlo; Senni, Michele; Klugmann, Silvio; Savonitto, Stefano

2016-05-01

Intravenous administration of a short acting glycoprotein IIb/IIIa inhibitor has been proposed as a bridge to surgery in patients on dual antiplatelet treatment, but data in comparison with other treatment options are not available. We conducted a retrospective analysis of consecutive patients who underwent un-deferrable, non-emergency surgery after coronary stenting. The bridge therapy was performed after discontinuation of the oral P2Y12 inhibitor by using i.v. tirofiban infusion. Net Adverse Clinical Events (NACE) was the primary outcome. We analyzed 314 consecutive patients: the bridge strategy was performed in 87 patients, whereas 227 were treated with other treatment options and represent the control group. Thirty-day NACE occurred in 8% of patients in the bridge group and in 22.5% in the control group (p < 0.01). Bridge therapy was associated with decreased 30-day NACE rate [Odds ratio (OR) 0.30; 95% confidence interval (CI) 0.13-0.39; p < 0.01], particularly when the time interval between stenting and surgery was ≤ 60 days (OR 0.09, 95% CI 0.01-0.72; p = 0.02). There were no cases of stent thrombosis in the bridge group and 3 (1.3%) in the control group. Bridge therapy was associated with decreased events rates as compared to both patients with and without P2Y12 inhibitors discontinuation in the control group. After adjustment for the most relevant covariates, the favorable effect of the bridge therapy was not materially modified. In conclusion, perioperative bridge therapy using tirofiban was associated with reduced 30-day NACE rate, particularly when surgery was performed within 60 days after stent implantation.

Mood and Weight Loss in a Behavioral Treatment Program.

ERIC Educational Resources Information Center

Wing, Rena R.; And Others

1983-01-01

Evaluated the relationship between mood and weight loss for 76 patients participating in two consecutive behavioral treatment programs. Weight losses averaged 12.2 pounds (5.55 kg) during the 10-week program. Positive changes in mood were reported during this interval, and these changes appeared to be related to changes in weight. (Author/RC)

GONe: Software for estimating effective population size in species with generational overlap

USGS Publications Warehouse

Coombs, J.A.; Letcher, B.H.; Nislow, K.H.

2012-01-01

GONe is a user-friendly, Windows-based program for estimating effective size (N e) in populations with overlapping generations. It uses the Jorde-Ryman modification to the temporal method to account for age structure in populations. This method requires estimates of age-specific survival and birth rate and allele frequencies measured in two or more consecutive cohorts. Allele frequencies are acquired by reading in genotypic data from files formatted for either GENEPOP or TEMPOFS. For each interval between consecutive cohorts, N e is estimated at each locus and over all loci. Furthermore, N e estimates are output for three different genetic drift estimators (F s, F c and F k). Confidence intervals are derived from a chi-square distribution with degrees of freedom equal to the number of independent alleles. GONe has been validated over a wide range of N e values, and for scenarios where survival and birth rates differ between sexes, sex ratios are unequal and reproductive variances differ. GONe is freely available for download at. ?? 2011 Blackwell Publishing Ltd.

[Effect of the night shift work on micturition patterns of nurses].

PubMed

Wang, Q; Hu, H; Liang, C; Wang, J; Xu, K X

2016-02-18

To compare the effects of rotational night shifts on the micturition patterns of female nurses. A total of 58 nurses without lower urinary tract symptoms were recruited, who worked in the Peking University People's Hospital during January and June in 2014. The nurses aged 20-43 years were divided into two groups, the night-shift group (n=28) and the non-shift group (n=30). The alcohol or coffee intaking were forbidden. In the night-shift group, nurses had worked on rotational shifts for at least 6 months. Their average age was (26.75±4.11) years. In the non-shift group, nurses took regular day-time work, whose average age was (27.80±5.60) years. A voiding diary was kept for 7 consecutive days at the end of 6 months, starting 2 days before their night duties until 4 days after completion of their night duties. For comparison, the non-shift group with regular shifts completed a 7-day voiding diary. In the 7-day recording voiding diary, the nurses were required to have the normal intake of liquid about 1 500-2 000 mL/d. The frequency volume charts of nocturia, the 8-hour interval urine production and frequency were compared between the two groups. Nocturia frequency was increased in the night-shift group [0.5 (0-2.4)] compared with the non-shift group [0 (0-2), P=0.02]. The volume of nocturia was increased in the night-shift group [125 mL (0-660 mL)] compared with the non-shift group [0 mL (0-340 mL), P<0.01]. The 8-hour interval indices showed that urine production changed with shift (P<0.01). In the consecutive 7 days, the nocturnal volume of the night-shift group increased on the day after night shift. When the night-shift nurses returned to daytime duty, the volume of urine decreased but nocturnal urine production remained high, and the frequency of nocturia also increased significantly (P<0.05). Compared with the 8-hour interval indices, the night-shift group's voiding volume [(542.35±204.66) mL] and voiding frequency (2.24±0.69) were more than those of the non-shift group at the afternoon time (from 2 pm to 10 pm). During the 8 h interval night time (from 10 pm to 6 am), the volume of nocturia in the night-shift group [(309.74±162.74) mL] was more than that in the non-shift group [(199.38±153.98) mL, P=0.01]; the frequency of nocturia in the night-shift group (1.31±0.52) was increased than that in the non-shift group (0.82±0.55, P<0.01). The rotational shifts affect the micturition patterns of nurses who go through the night shift work, which increases the volume and frequency of the nocturia.

[Effect of the night shift work on micturition patterns of nurses].

PubMed

Wang, Q; Hu, H; Liang, C; Wang, J; Xu, K X

2016-08-18

To compare the effects of rotational night shifts on the micturition patterns of female nurses. A total of 58 nurses without lower urinary tract symptoms were recruited, who worked in the Peking University People's Hospital during January and June in 2014. The nurses aged 20-43 years were divided into two groups, the night-shift group (n=28) and the non-shift group (n=30). The alcohol or coffee intaking were forbidden. In the night-shift group, nurses had worked on rotational shifts for at least 6 months. Their average age was (26.75±4.11) years. In the non-shift group, nurses took regular day-time work, whose average age was (27.80±5.60) years. A voiding diary was kept for 7 consecutive days at the end of 6 months, starting 2 days before their night duties until 4 days after completion of their night duties. For comparison, the non-shift group with regular shifts completed a 7-day voiding diary. In the 7-day recording voiding diary, the nurses were required to have the normal intake of liquid about 1 500-2 000 mL/d. The frequency volume charts of nocturia, the 8-hour interval urine production and frequency were compared between the two groups. Nocturia frequency was increased in the night-shift group [0.5 (0-2.4)] compared with the non-shift group [0 (0-2), P=0.02]. The volume of nocturia was increased in the night-shift group [125 mL (0-660 mL)] compared with the non-shift group [0 mL (0-340 mL), P<0.01]. The 8-hour interval indices showed that urine production changed with shift (P<0.01). In the consecutive 7 days, the nocturnal volume of the night-shift group increased on the day after night shift. When the night-shift nurses returned to daytime duty, the volume of urine decreased but nocturnal urine production remained high, and the frequency of nocturia also increased significantly (P<0.05). Compared with the 8-hour interval indices, the night-shift group's voiding volume [(542.35±204.66) mL] and voiding frequency (2.24±0.69) were more than those of the non-shift group at the afternoon time (from 2 pm to 10 pm). During the 8 h interval night time (from 10 pm to 6 am), the volume of nocturia in the night-shift group [(309.74±162.74) mL] was more than that in the non-shift group [(199.38±153.98) mL, P=0.01]; the frequency of nocturia in the night-shift group (1.31±0.52) was increased than that in the non-shift group (0.82±0.55, P<0.01). The rotational shifts affect the micturition patterns of nurses who go through the night shift work, which increases the volume and frequency of the nocturia.

Human comment dynamics in on-line social systems

NASA Astrophysics Data System (ADS)

Wu, Ye; Zhou, Changsong; Chen, Maoying; Xiao, Jinghua; Kurths, Jürgen

2010-12-01

Human comment is studied using data from ‘tianya’ which is one of the most popular on-line social systems in China. We found that the time interval between two consecutive comments on the same topic, called inter-event time, follows a power-law distribution. This result shows that there is no characteristic decay time on a topic. It allows for very long periods without comments that separate bursts of intensive comments. Furthermore, the frequency of a different ID commenting on a topic also follows a power-law distribution. It indicates that there are some “hubs” in the topic who lead the direction of the public opinion. Based on the personal comments habit, a model is introduced to explain these phenomena. The numerical simulations of the model fit well with the empirical results. Our findings are helpful for discovering regular patterns of human behavior in on-line society and the evolution of the public opinion on the virtual as well as real society.

Chaotic carrier pulse position modulation communication system and method

DOEpatents

Abarbanel, Henry D. I.; Larson, Lawrence E.; Rulkov, Nikolai F.; Sushchik, Mikhail M.; Tsimring, Lev S.; Volkovskii, Alexander R.

2001-01-01

A chaotic carrier pulse position modulation communication system and method is disclosed. The system includes a transmitter and receiver having matched chaotic pulse regenerators. The chaotic pulse regenerator in the receiver produces a synchronized replica of a chaotic pulse train generated by the regenerator in the transmitter. The pulse train from the transmitter can therefore act as a carrier signal. Data is encoded by the transmitter through selectively altering the interpulse timing between pulses in the chaotic pulse train. The altered pulse train is transmitted as a pulse signal. The receiver can detect whether a particular interpulse interval in the pulse signal has been altered by reference to the synchronized replica it generates, and can therefore detect the data transmitted by the receiver. Preferably, the receiver predicts the earliest moment in time it can expect a next pulse after observation of at least two consecutive pulses. It then decodes the pulse signal beginning at a short time before expected arrival of a pulse.

The electric field changes and UHF radiations caused by the triggered lightning in Japan

NASA Technical Reports Server (NTRS)

Kawasaki, Zen-Ichiro; Kanao, Tadashi; Matsuura, Kenji; Nakano, Minoru; Horii, Kenji; Nakamura, Koichi

1991-01-01

In the rocket triggered lightning experiment of fiscal 1989, researchers observed electromagnetic field changes and UHF electromagnetic radiation accompanying rocket triggered lightning. It was found that no rapid changes corresponding to the return stroke of natural lightning were observed in the electric field changes accompanying rocket triggered lightning. However, continuous currents were present. In the case of rocket triggered lightning to the tower, electromagnetic field changes corresponding to the initiation of triggered lightning showed a bipolar pulse of a relatively large amplitude. In contrast, the rocket triggered lightning to the ground did not have such a bipolar pulse. The UHF radiation accompanying the rocket triggered lightning preceded the waveform portions corresponding to the first changes in electromagnetic fields. The number of isolated pulses in the UHF radiation showed a correlation with the time duration from rocket launching up to triggered lightning. The time interval between consecutive isolated pulses tended to get shorter with the passage of time, just like the stepped leaders of natural lightning.

Introducing Computed Tomography Standards for Age Estimation of Modern Australian Subadults Using Postnatal Ossification Timings of Select Cranial and Cervical Sites(.).

PubMed

Lottering, Nicolene; MacGregor, Donna M; Alston, Clair L; Watson, Debbie; Gregory, Laura S

2016-01-01

Contemporary, population-specific ossification timings of the cranium are lacking in current literature due to challenges in obtaining large repositories of documented subadult material, forcing Australian practitioners to rely on North American, arguably antiquated reference standards for age estimation. This study assessed the temporal pattern of ossification of the cranium and provides recalibrated probabilistic information for age estimation of modern Australian children. Fusion status of the occipital and frontal bones, atlas, and axis was scored using a modified two- to four-tier system from cranial/cervical DICOM datasets of 585 children aged birth to 10 years. Transition analysis was applied to elucidate maximum-likelihood estimates between consecutive fusion stages, in conjunction with Bayesian statistics to calculate credible intervals for age estimation. Results demonstrate significant sex differences in skeletal maturation (p < 0.05) and earlier timings in comparison with major literary sources, underscoring the requisite of updated standards for age estimation of modern individuals. © 2015 American Academy of Forensic Sciences.

The effect of a computerized prescribing and calculating system on hypo- and hyperglycemias and on prescribing time efficiency in neonatal intensive care patients.

PubMed

Maat, Barbara; Rademaker, Carin M A; Oostveen, Marloes I; Krediet, Tannette G; Egberts, Toine C G; Bollen, Casper W

2013-01-01

Prescribing glucose requires complex calculations because glucose is present in parenteral and enteral nutrition and drug vehicles, making it error prone and contributing to the burden of prescribing errors. Evaluation of the impact of a computerized physician order entry (CPOE) system with clinical decision support (CDS) for glucose control in neonatal intensive care patients (NICU) focusing on hypo- and hyperglycemic episodes and prescribing time efficiency. An interrupted time-series design to examine the effect of CPOE on hypo- and hyperglycemias and a crossover simulation study to examine the influence of CPOE on prescribing time efficiency. NICU patients at risk for glucose imbalance hospitalized at the University Medical Center Utrecht during 2001-2007 were selected. The risks of hypo- and hyperglycemias were expressed as incidences per 100 patient days in consecutive 3-month intervals during 3 years before and after CPOE implementation. To assess prescribing time efficiency, time needed to calculate glucose intake with and without CPOE was measured. No significant difference was found between pre- and post-CPOE mean incidences of hypo- and hyperglycemias per 100 hospital days of neonates at risk in every 3-month period (hypoglycemias, 4.0 [95% confidence interval, 3.2-4.8] pre-CPOE and 3.1 [2.7-3.5] post-CPOE, P = .88; hyperglycemias, 6.0 [4.3-7.7] pre-CPOE and 5.0 [3.7-6.3] post-CPOE, P = .75). CPOE led to a significant time reduction of 16% (1.3 [0.3-2.3] minutes) for simple and 60% (8.6 [5.1-12.1] minutes) for complex calculations. CPOE including a special CDS tool preserved accuracy for calculation and control of glucose intake and increased prescribing time efficiency.

Enhancing Heart-Beat-Based Security for mHealth Applications.

PubMed

Seepers, Robert M; Strydis, Christos; Sourdis, Ioannis; De Zeeuw, Chris I

2017-01-01

In heart-beat-based security, a security key is derived from the time difference between consecutive heart beats (the inter-pulse interval, IPI), which may, subsequently, be used to enable secure communication. While heart-beat-based security holds promise in mobile health (mHealth) applications, there currently exists no work that provides a detailed characterization of the delivered security in a real system. In this paper, we evaluate the strength of IPI-based security keys in the context of entity authentication. We investigate several aspects that should be considered in practice, including subjects with reduced heart-rate variability (HRV), different sensor-sampling frequencies, intersensor variability (i.e., how accurate each entity may measure heart beats) as well as average and worst-case-authentication time. Contrary to the current state of the art, our evaluation demonstrates that authentication using multiple, less-entropic keys may actually increase the key strength by reducing the effects of intersensor variability. Moreover, we find that the maximal key strength of a 60-bit key varies between 29.2 bits and only 5.7 bits, depending on the subject's HRV. To improve security, we introduce the inter-multi-pulse interval (ImPI), a novel method of extracting entropy from the heart by considering the time difference between nonconsecutive heart beats. Given the same authentication time, using the ImPI for key generation increases key strength by up to 3.4 × (+19.2 bits) for subjects with limited HRV, at the cost of an extended key-generation time of 4.8 × (+45 s).

Adverse events associated with deep brain stimulation for movement disorders: analysis of 510 consecutive cases.

PubMed

Patel, Daxa M; Walker, Harrison C; Brooks, Rebekah; Omar, Nidal; Ditty, Benjamin; Guthrie, Barton L

2015-03-01

Although numerous studies have focused on the efficacy of deep brain stimulation (DBS) for movement disorders, less is known about surgical adverse events, especially over longer time intervals. Here, we analyze adverse events in 510 consecutive cases from a tertiary movement disorders center at up to 10 years postoperatively. We conducted a retrospective review of adverse events from craniotomies between January 2003 and March 2013. The adverse events were categorized into 2 broad categories--immediate perioperative and time-dependent postoperative events. Across all targets, perioperative mental status change occurred in 18 (3.5%) cases, and symptomatic intracranial hemorrhage occurred in 4 (0.78%) cases. The most common hardware-related event was skin erosion in 13 (2.5%) cases. The most frequent stimulation-related event was speech disturbance in 16 (3.1%) cases. There were no significant differences among surgical targets with respect to the incidence of these events. Time-dependent postoperative events leading to the revision of a given DBS electrode for any reason occurred in 4.7% ± 1.0%, 9.3% ± 1.4%, and 12.4% ± 1.5% of electrodes at 1, 4, and 7 years postoperatively, respectively. Staged bilateral DBS was associated with approximately twice the risk of repeat surgery for electrode replacement vs unilateral surgery (P = .020). These data provide low incidences for adverse events in a large series of DBS surgeries for movement disorders at up to 10 years follow-up. Accurate estimates of adverse events will better inform patients and caregivers about the potential risks and benefits of surgery and provide normative data for process improvement.

Three consecutive days of interval runs to exhaustion affects lymphocyte subset apoptosis and migration.

PubMed

Navalta, James W; Tibana, Ramires Alsamir; Fedor, Elizabeth A; Vieira, Amilton; Prestes, Jonato

2014-01-01

This investigation assessed the lymphocyte subset response to three days of intermittent run exercise to exhaustion. Twelve healthy college-aged males (n = 8) and females (n = 4) (age = 26 ± 4 years; height = 170.2 ± 10 cm; body mass = 75 ± 18 kg) completed an exertion test (maximal running speed and VO2max) and later performed three consecutive days of an intermittent run protocol to exhaustion (30 sec at maximal running speed and 30 sec at half of the maximal running speed). Blood was collected before exercise (PRE) and immediately following the treadmill bout (POST) each day. When the absolute change from baseline was evaluated (i. e., Δ baseline), a significant change in CD4+ and CD8+ for CX3CR1 cells was observed by completion of the third day. Significant changes in both apoptosis and migration were observed following two consecutive days in CD19+ lymphocytes, and the influence of apoptosis persisted following the third day. Given these lymphocyte responses, it is recommended that a rest day be incorporated following two consecutive days of a high-intensity intermittent run program to minimize immune cell modulations and reduce potential susceptibility.

Artificial neural network for normal, hypertensive, and preeclamptic pregnancy classification using maternal heart rate variability indexes.

PubMed

Tejera, Eduardo; Jose Areias, Maria; Rodrigues, Ana; Ramõa, Ana; Manuel Nieto-Villar, Jose; Rebelo, Irene

2011-09-01

A model construction for classification of women with normal, hypertensive and preeclamptic pregnancy in different gestational ages using maternal heart rate variability (HRV) indexes. In the present work, we applied the artificial neural network for the classification problem, using the signal composed by the time intervals between consecutive RR peaks (RR) (n = 568) obtained from ECG records. Beside the HRV indexes, we also considered other factors like maternal history and blood pressure measurements. The obtained result reveals sensitivity for preeclampsia around 80% that increases for hypertensive and normal pregnancy groups. On the other hand, specificity is around 85-90%. These results indicate that the combination of HRV indexes with artificial neural networks (ANN) could be helpful for pregnancy study and characterization.

Remote real-time monitoring of free flaps via smartphone photography and 3G wireless Internet: a prospective study evidencing diagnostic accuracy.

PubMed

Engel, Holger; Huang, Jung Ju; Tsao, Chung Kan; Lin, Chia-Yu; Chou, Pan-Yu; Brey, Eric M; Henry, Steven L; Cheng, Ming Huei

2011-11-01

This prospective study was designed to compare the accuracy rate between remote smartphone photographic assessments and in-person examinations for free flap monitoring. One hundred and three consecutive free flaps were monitored with in-person examinations and assessed remotely by three surgeons (Team A) via photographs transmitted over smartphone. Four other surgeons used the traditional in-person examinations as Team B. The response time to re-exploration was defined as the interval between when a flap was evaluated as compromised by the nurse/house officer and when the decision was made for re-exploration. The accuracy rate was 98.7% and 94.2% for in-person and smartphone photographic assessments, respectively. The response time of 8 ± 3 min in Team A was statistically shorter than the 180 ± 104 min in Team B (P = 0.01 by the Mann-Whitney test). The remote smartphone photography assessment has a comparable accuracy rate and shorter response time compared with in-person examination for free flap monitoring. Copyright © 2011 Wiley Periodicals, Inc.

Software for Improved Extraction of Data From Tape Storage

NASA Technical Reports Server (NTRS)

Cheng, Chiu-Fu

2003-01-01

A computer program has been written to replace the original software of Racal Storeplex Delta tape recorders, which are used at Stennis Space Center. The original software could be activated by a command- line interface only; the present software offers the option of a command-line or graphical user interface. The present software also offers the option of batch-file operation (activation by a file that contains command lines for operations performed consecutively). The present software is also more reliable than was the original software: The original software was plagued by several deficiencies that made it difficult to execute, modify, and test. In addition, when using the original software to extract data that had been recorded within specified intervals of time, the resolution with which one could control starting and stopping times was no finer than about a second (or, in some cases, several seconds). In contrast, the present software is capable of controlling playback times to within 1/100 second of times specified by the user, assuming that the tape-recorder clock is accurate to within 1/100 second.

Software for Improved Extraction of Data From Tape Storage

NASA Technical Reports Server (NTRS)

Cheng, Chiu-Fu

2002-01-01

A computer program has been written to replace the original software of Racal Storeplex Delta tape recorders, which are still used at Stennis Space Center but have been discontinued by the manufacturer. Whereas the original software could be activated by a command-line interface only, the present software offers the option of a command-line or graphical user interface. The present software also offers the option of batch-file operation (activation by a file that contains command lines for operations performed consecutively). The present software is also more reliable than was the original software: The original software was plagued by several deficiencies that made it difficult to execute, modify, and test. In addition, when using the original software to extract data that had been recorded within specified intervals of time, the resolution with which one could control starting and stopping times was no finer than about a second (or, in some cases, several seconds). In contrast, the present software is capable of controlling playback times to within 1/100 second of times specified by the user, assuming that the tape-recorder clock is accurate to within 1/100 second.

Blood lactate concentration at selected of olympic modes weightlifting.

PubMed

Gupta, S; Goswami, A

2001-04-01

This study highlights the blood lactate response of weightlifters (N = 5) in two modes of olympic lifts: Snatch (SN) and Clean & Jerk (CJ), during three types of training namely (1) one repetition lift (ORL), (2) Multiple set session (MSS) and (3) one set session (OSS). In ORL, 30, 40, 50, and 60 kg, each of one repetition only, were lifted with an interval of 5 min between two consecutive loads. Both MSS and OSS consisted of 6 sets of lift: 50% x 6 (i.e. 50% of 1 Repetition Maximum x 6 repetitions), 60% x 5, 70% x 4, 80% x 3, 90% x 2, and 100% x 1. In MSS, 3 to 3.5 min interval was given between two successive sets whereas in OSS the interval was approximately 24 hours. Lactate levels were very low (< 3.5 mM) in ORL. In MSS, lactate reached peak at an intermediate set, but, it was maximum at the first set and then declined gradually in OSS. In most of the cases, however, lactate were significantly higher in CJ than SN. The study concludes that: (a) anaerobic glycolysis is not stimulated considerably when the lifting time is only 4-5 sec, (b) repetition of lift plays more important role, than intensity, in lactate production, (c) CJ is more strenuous than SN for a given %RM.

Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study

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

Varughese, Jobin Kotakkathu, E-mail: jobinv@gmail.com; Wentzel-Larsen, Tore; Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo

2012-10-01

Purpose: Gamma Knife radiosurgery (GKRS) has been increasingly used in the treatment of vestibular schwannoma (VS). Very few studies relate tumor control and post-treatment growth rates to pretreatment growth rates. Methods and Materials: We prospectively included 45 consecutive VS patients who were initially treated conservatively and then received GKRS between 2000 and 2007 because of demonstrated tumor growth. Pretreatment and post-treatment tumor volumes were estimated. Patients underwent audiograms, reported their symptoms, and responded to the Short Form General Health Survey (SF-36) questionnaire on each visit. Results: Volume doubling times before and after treatment were 1.36 years (95% confidence intervals, 1.14-1.68)more » and -13.1 years (95% confidence intervals, -111.0 to -6.94), respectively. Tumor control, defined as a post-GKRS growth rate {<=}0, was achieved in 71.1% of patients, with highest odds for tumor control among older patients and those with larger tumors. The 5-year retreatment-free survival rate was 93.9% (95% confidence intervals, 76.5-98.5). None of the clinical endpoints investigated showed statistically significant changes after GKRS, but improvement was seen in a few SF-36 parameters. Conclusions: GKRS alters the natural course of the tumor by reducing growth. Mathematic models yield poorer tumor control rates than those found by clinical assessment. Symptoms were unaffected by treatment, but quality of life was improved.« less

Monitoring for HHV-6 infection after renal transplantation: evaluation of risk factors for sustained viral replication.

PubMed

Luiz, Claudia R; Machado, Clarisse M; Canto, Cynthia L M; Christ, Silvia C C; Pestana, Jose O M; Kotton, Camille N; Camargo, Luis F A

2013-03-27

Human herpesvirus-6 (HHV-6) is known to reactivate after renal transplantation and has been associated with several clinical manifestations. Risk factors for sustained viral replication, however, remain unclear. Thirty consecutive kidney transplant patients were prospectively followed for HHV-6 replication between February 2007 and February 2008. Plasma samples for DNA detection were collected from the donor and the recipient before transplantation and from the recipient weekly for the first 2 months after transplantation and then every 2 weeks for 2 additional months. HHV-6 active infection was defined as detection of viral DNA in plasma, by polymerase chain reaction, in at least two consecutive samples over an interval of at least 1 week. Active viral infection was detected in 25% of the recipients before transplantation and 27% (8 of 30) of the patients after transplantation. The mean time to onset of viral replication was 28.1 days after transplantation and 7 of 8 (87.5%) were asymptomatic. Risk factors associated with active HHV-6 infection were receiving an organ from a living donor (P=0.028), recipients with IgM antibodies detected before transplantation (P=0.005), and pretransplantation recipient HHV-6 viral load more than 10,000 copies/mL plasma (P=0.034). Active HHV-6 infection occurs early after renal transplantation and is mostly asymptomatic. Donor or recipient infection may occur at the time of transplantation and are related to higher rates of posttransplantation infections.

[Precipitating factors in patients with repetitive exacerbation of chronic left heart failure].

PubMed

Sasaki, T; Yanagitani, Y; Kubo, T; Matsuo, H; Miyatake, K

1998-04-01

The precipitating factors of repetitive exacerbation were investigated in 110 consecutive patients with chronic left heart failure admitted due to acute exacerbation more than twice to the medical emergency ward of National Cardiovascular Center from January, 1992 to December, 1996. The controls were 189 consecutive patients with chronic left heart failure admitted to the ward due to acute exacerbation only once during the same period. Excessive intake of water or sodium, overwork and infection were common precipitating factors in the first decompensation of left heart failure, but the former two factors became less common with repeated admission. Patient mistakes such as excessive intake of water or sodium, overwork and noncompliance with medications, and new onset arrhythmias were common precipitating factors in patients (n = 13) admitted to the ward more than four times. Infection was a common precipitating factor (63%) in patients with a time interval between readmission and the last discharge of longer than 2 years. Despite repeated admission, infection was a common precipitating factor in patients with valvular heart disease (n = 31), patient mistakes were common in heart disease with left ventricular hypertrophy (n = 20), and infection and new onset arrhythmias were common in dilated cardiomyopathy (n = 28) and old myocardial infarction (n = 31). Patient mistakes and new onset arrhythmias were the common factors that led to repetitive exacerbation of left heart failure, and precipitating factors were characterized by the etiology of left heart failure.

An Overview of Heart Rate Variability Metrics and Norms

PubMed Central

Shaffer, Fred; Ginsberg, J. P.

2017-01-01

Healthy biological systems exhibit complex patterns of variability that can be described by mathematical chaos. Heart rate variability (HRV) consists of changes in the time intervals between consecutive heartbeats called interbeat intervals (IBIs). A healthy heart is not a metronome. The oscillations of a healthy heart are complex and constantly changing, which allow the cardiovascular system to rapidly adjust to sudden physical and psychological challenges to homeostasis. This article briefly reviews current perspectives on the mechanisms that generate 24 h, short-term (~5 min), and ultra-short-term (<5 min) HRV, the importance of HRV, and its implications for health and performance. The authors provide an overview of widely-used HRV time-domain, frequency-domain, and non-linear metrics. Time-domain indices quantify the amount of HRV observed during monitoring periods that may range from ~2 min to 24 h. Frequency-domain values calculate the absolute or relative amount of signal energy within component bands. Non-linear measurements quantify the unpredictability and complexity of a series of IBIs. The authors survey published normative values for clinical, healthy, and optimal performance populations. They stress the importance of measurement context, including recording period length, subject age, and sex, on baseline HRV values. They caution that 24 h, short-term, and ultra-short-term normative values are not interchangeable. They encourage professionals to supplement published norms with findings from their own specialized populations. Finally, the authors provide an overview of HRV assessment strategies for clinical and optimal performance interventions. PMID:29034226

Time for actions in lucid dreams: effects of task modality, length, and complexity

PubMed Central

Erlacher, Daniel; Schädlich, Melanie; Stumbrys, Tadas; Schredl, Michael

2014-01-01

The relationship between time in dreams and real time has intrigued scientists for centuries. The question if actions in dreams take the same time as in wakefulness can be tested by using lucid dreams where the dreamer is able to mark time intervals with prearranged eye movements that can be objectively identified in EOG recordings. Previous research showed an equivalence of time for counting in lucid dreams and in wakefulness (LaBerge, 1985; Erlacher and Schredl, 2004), but Erlacher and Schredl (2004) found that performing squats required about 40% more time in lucid dreams than in the waking state. To find out if the task modality, the task length, or the task complexity results in prolonged times in lucid dreams, an experiment with three different conditions was conducted. In the first condition, five proficient lucid dreamers spent one to three non-consecutive nights in the sleep laboratory. Participants counted to 10, 20, and 30 in wakefulness and in their lucid dreams. Lucidity and task intervals were time stamped with left-right-left-right eye movements. The same procedure was used for the second condition where eight lucid dreamers had to walk 10, 20, or 30 steps. In the third condition, eight lucid dreamers performed a gymnastics routine, which in the waking state lasted the same time as walking 10 steps. Again, we found that performing a motor task in a lucid dream requires more time than in wakefulness. Longer durations in the dream state were present for all three tasks, but significant differences were found only for the tasks with motor activity (walking and gymnastics). However, no difference was found for relative times (no disproportional time effects) and a more complex motor task did not result in more prolonged times. Longer durations in lucid dreams might be related to the lack of muscular feedback or slower neural processing during REM sleep. Future studies should explore factors that might be associated with prolonged durations. PMID:24474942

Time for actions in lucid dreams: effects of task modality, length, and complexity.

PubMed

Erlacher, Daniel; Schädlich, Melanie; Stumbrys, Tadas; Schredl, Michael

2013-01-01

The relationship between time in dreams and real time has intrigued scientists for centuries. The question if actions in dreams take the same time as in wakefulness can be tested by using lucid dreams where the dreamer is able to mark time intervals with prearranged eye movements that can be objectively identified in EOG recordings. Previous research showed an equivalence of time for counting in lucid dreams and in wakefulness (LaBerge, 1985; Erlacher and Schredl, 2004), but Erlacher and Schredl (2004) found that performing squats required about 40% more time in lucid dreams than in the waking state. To find out if the task modality, the task length, or the task complexity results in prolonged times in lucid dreams, an experiment with three different conditions was conducted. In the first condition, five proficient lucid dreamers spent one to three non-consecutive nights in the sleep laboratory. Participants counted to 10, 20, and 30 in wakefulness and in their lucid dreams. Lucidity and task intervals were time stamped with left-right-left-right eye movements. The same procedure was used for the second condition where eight lucid dreamers had to walk 10, 20, or 30 steps. In the third condition, eight lucid dreamers performed a gymnastics routine, which in the waking state lasted the same time as walking 10 steps. Again, we found that performing a motor task in a lucid dream requires more time than in wakefulness. Longer durations in the dream state were present for all three tasks, but significant differences were found only for the tasks with motor activity (walking and gymnastics). However, no difference was found for relative times (no disproportional time effects) and a more complex motor task did not result in more prolonged times. Longer durations in lucid dreams might be related to the lack of muscular feedback or slower neural processing during REM sleep. Future studies should explore factors that might be associated with prolonged durations.

Effects of learning with explicit elaboration on implicit transfer of visuomotor sequence learning.

PubMed

Tanaka, Kanji; Watanabe, Katsumi

2013-08-01

Intervals between stimuli and/or responses have significant influences on sequential learning. In the present study, we investigated whether transfer would occur even when the intervals and the visual configurations in a sequence were drastically changed so that participants did not notice that the required sequences of responses were identical. In the experiment, two (or three) sequential button presses comprised a "set," and nine (or six) consecutive sets comprised a "hyperset." In the first session, participants learned either a 2 × 9 or 3 × 6 hyperset by trial and error until they completed it 20 times without error. In the second block, the 2 × 9 (3 × 6) hyperset was changed into the 3 × 6 (2 × 9) hyperset, resulting in different visual configurations and intervals between stimuli and responses. Participants were assigned into two groups: the Identical and Random groups. In the Identical group, the sequence (i.e., the buttons to be pressed) in the second block was identical to that in the first block. In the Random group, a new hyperset was learned. Even in the Identical group, no participants noticed that the sequences were identical. Nevertheless, a significant transfer of performance occurred. However, in the subsequent experiment that did not require explicit trial-and-error learning in the first session, implicit transfer in the second session did not occur. These results indicate that learning with explicit elaboration strengthens the implicit representation of the sequence order as a whole; this might occur independently of the intervals between elements and enable implicit transfer.

Recurrence of gastroesophageal reflux disease correlated with a short dinner-to-bedtime interval.

PubMed

Yang, Jae Hoon; Kang, Ho Suk; Lee, Sun-Young; Kim, Jeong Hwan; Sung, In-Kyung; Park, Hyung Seok; Shim, Chan Sup; Jin, Choon Jo

2014-04-01

Gastroesophageal reflux disease (GERD) can be classified into erosive reflux disease (ERD) and nonerosive gastroesophageal reflux disease (NERD). We aimed to compare the recurrence rates of ERD and NERD and determine the risk factors related to the recurrence. This prospective study comprised 337 consecutive adults who completed questionnaires on their GERD symptoms, height, weight, sleeping position, dinner time, and bedtime. During upper gastrointestinal endoscopy, the presence of a hiatal hernia and mucosal breaks in the low esophagus, esophageal length (the distance between the Z-line and the incisors), and the esophageal length-to-height ratio were recorded. Recurrence was diagnosed when the patient required additional proton pump inhibitor medication after initial recovery with 4-8 weeks of treatment. Recurrence was experienced by 47 (26.0%) of 181 GERD patients. The recurrence rate did not differ between the 48 ERD (27.1%) and 133 NERD (25.6%) patients (P = 0.849). Of the various factors studied, recurrence was found to be correlated with a dinner-to-bedtime interval of less than 3 h (P = 0.002), globus sensation (P = 0.031), and old age (P = 0.047). Logistic regression analysis revealed that a short interval between dinner and bedtime was the only factor significantly related to the recurrence (P = 0.002). Both ERD and NERD patients who sleep within 3 h after eating have a higher risk of GERD recurrence. Our findings highlight the impact of a short dinner-to-bedtime interval on the recurrence of GERD (ClinicalTrials.gov ID: KCT0000134). © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Impact of Rehabilitation on Outcomes in Patients With Ischemic Stroke: A Nationwide Retrospective Cohort Study in Japan.

PubMed

Yagi, Maiko; Yasunaga, Hideo; Matsui, Hiroki; Morita, Kojiro; Fushimi, Kiyohide; Fujimoto, Masashi; Koyama, Teruyuki; Fujitani, Junko

2017-03-01

We aimed to examine the concurrent effects of timing and intensity of rehabilitation on improving activities of daily living (ADL) among patients with ischemic stroke. Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with ischemic stroke at admission who received rehabilitation (n=100 719) from April 2012 to March 2014. Early rehabilitation was defined as that starting within 3 days after admission. The average rehabilitation intensity per day was calculated as the total units of rehabilitation during hospitalization divided by the length of hospital stay. A multivariable logistic regression analysis with multiple imputation and an instrumental variable analysis were performed to examine the association of early and intensive rehabilitation with the proportion of improved ADL score. The proportion of improved ADL score was higher in the early and intensive rehabilitation group. The multivariable logistic regression analysis showed that significant improvements in ADL were observed for early rehabilitation (odds ratio: 1.08; 95% confidence interval: 1.04-1.13; P <0.01) and intensive rehabilitation of >5.0 U/d (odds ratio: 1.87; 95% confidence interval: 1.69-2.07; P <0.01). The instrumental variable analysis showed that an increased proportion of improved ADL was associated with early rehabilitation (risk difference: 2.8%; 95% confidence interval: 2.0-3.4%; P <0.001) and intensive rehabilitation (risk difference: 5.6%; 95% confidence interval: 4.6-6.6%; P <0.001). The present results suggested that early and intensive rehabilitation improved ADL during hospitalization in patients with ischemic stroke. © 2017 American Heart Association, Inc.

Topology of Innovation Spaces in the Knowledge Networks Emerging through Questions-And-Answers

PubMed Central

Andjelković, Miroslav; Tadić, Bosiljka; Mitrović Dankulov, Marija; Rajković, Milan; Melnik, Roderick

2016-01-01

The communication processes of knowledge creation represent a particular class of human dynamics where the expertise of individuals plays a substantial role, thus offering a unique possibility to study the structure of knowledge networks from online data. Here, we use the empirical evidence from questions-and-answers in mathematics to analyse the emergence of the network of knowledge contents (or tags) as the individual experts use them in the process. After removing extra edges from the network-associated graph, we apply the methods of algebraic topology of graphs to examine the structure of higher-order combinatorial spaces in networks for four consecutive time intervals. We find that the ranking distributions of the suitably scaled topological dimensions of nodes fall into a unique curve for all time intervals and filtering levels, suggesting a robust architecture of knowledge networks. Moreover, these networks preserve the logical structure of knowledge within emergent communities of nodes, labeled according to a standard mathematical classification scheme. Further, we investigate the appearance of new contents over time and their innovative combinations, which expand the knowledge network. In each network, we identify an innovation channel as a subgraph of triangles and larger simplices to which new tags attach. Our results show that the increasing topological complexity of the innovation channels contributes to network’s architecture over different time periods, and is consistent with temporal correlations of the occurrence of new tags. The methodology applies to a wide class of data with the suitable temporal resolution and clearly identified knowledge-content units. PMID:27171149

Compressed air massage hastens healing of the diabetic foot.

PubMed

Mars, M; Desai, Y; Gregory, M A

2008-02-01

The management of diabetic foot ulcers remains a problem. A treatment modality that uses compressed air massage has been developed as a supplement to standard surgical and medical treatment. Compressed air massage is thought to improve local tissue oxygenation around ulcers. The aim of this study was to determine whether the addition of compressed air massage influences the rate of healing of diabetic ulcers. Sixty consecutive patients with diabetes, admitted to one hospital for urgent surgical management of diabetic foot ulcers, were randomized into two groups. Both groups received standard medical and surgical management of their diabetes and ulcer. In addition, one group received 15-20 min of compressed air massage, at 1 bar pressure, daily, for 5 days a week, to the foot and the tissue around the ulcer. Healing time was calculated as the time from admission to the time of re-epithelialization. Fifty-seven patients completed the trial; 28 received compressed air massage. There was no difference in the mean age, Wagner score, ulcer size, pulse status, or peripheral sensation in the two groups. The time to healing in the compressed air massage group was significantly reduced: 58.1 +/- 22.3 days (95% confidence interval: 49.5-66.6) versus 82.7 +/- 30.7 days (95% confidence interval: 70.0-94.3) (P = 0.001). No adverse effects in response to compressed air massage were noted. The addition of compressed air massage to standard medical and surgical management of diabetic ulcers appears to enhance ulcer healing. Further studies with this new treatment modality are warranted.

Endoscopists can sustain high performance for the optical diagnosis of colorectal polyps following standardized and continued training.

PubMed

McGill, Sarah K; Soetikno, Roy; Rastogi, Amit; Rouse, Robert V; Sato, Tohru; Bansal, Ajay; McQuaid, Kenneth; Kaltenbach, Tonya

2015-03-01

The learning curve for optical diagnosis of colorectal polyps with the narrow-band imaging (NBI) is unknown. To forego histological analysis of diminutive polyps diagnosed optically with high confidence, guidelines recommend ≥ 90 % negative predictive value (NPV) and concordance of ≥ 90 % for surveillance intervals predicted optically and histologically. We aimed to study the learning of optical diagnosis for colorectal polyps. We studied five endoscopists as part of a randomized multisite trial comparing near-focus and standard-focus views for optical diagnosis. They trained using a computer-based module, followed by 10 real-time colonoscopies with pathology correlation. Endoscopists then optically diagnosed and resected all the polyps found during 558 consecutive colonoscopies, and diagnoses were compared with pathology. Endoscopists repeated the training module at the study midpoint. NPV and concordance of surveillance intervals for diminutive polyps diagnosed optically with high confidence were measured over time. Endoscopists showed high diagnostic performance, with a nonsignificant trend toward higher NPV in the second half of the study. For the 445 polyps in the standard-view arm, the NPV was 88.0 % (95 %CI 75.7 % - 95.5 %) in the first half and 95.8 % (88.3 % - 99.1 %) in the second; P = 0.7. Three endoscopists in the first half and four in the second achieved > 90 % NPV. Concordance of surveillance intervals was identical in the first and second halves at 98.1 % (95 %CI 93.3 % - 99.8 %). High NPV for the prediction of non-neoplasms with NBI was achieved and maintained in this group of endoscopists who participated in standardized and continued training. Both NPV and surveillance interval agreement indicated high performance in the optical diagnosis of colorectal polyps and exceeded thresholds. © Georg Thieme Verlag KG Stuttgart · New York.

Very Similar Spacing-Effect Patterns in Very Different Learning/Practice Domains

PubMed Central

Kornmeier, Jürgen; Spitzer, Manfred; Sosic-Vasic, Zrinka

2014-01-01

Temporally distributed (“spaced”) learning can be twice as efficient as massed learning. This “spacing effect” occurs with a broad spectrum of learning materials, with humans of different ages, with non-human vertebrates and also invertebrates. This indicates, that very basic learning mechanisms are at work (“generality”). Although most studies so far focused on very narrow spacing interval ranges, there is some evidence for a non-monotonic behavior of this “spacing effect” (“nonlinearity”) with optimal spacing intervals at different time scales. In the current study we focused both the nonlinearity aspect by using a broad range of spacing intervals and the generality aspect by using very different learning/practice domains: Participants learned German-Japanese word pairs and performed visual acuity tests. For each of six groups we used a different spacing interval between learning/practice units from 7 min to 24 h in logarithmic steps. Memory retention was studied in three consecutive final tests, one, seven and 28 days after the final learning unit. For both the vocabulary learning and visual acuity performance we found a highly significant effect of the factor spacing interval on the final test performance. In the 12 h-spacing-group about 85% of the learned words stayed in memory and nearly all of the visual acuity gain was preserved. In the 24 h-spacing-group, in contrast, only about 33% of the learned words were retained and the visual acuity gain dropped to zero. The very similar patterns of results from the two very different learning/practice domains point to similar underlying mechanisms. Further, our results indicate spacing in the range of 12 hours as optimal. A second peak may be around a spacing interval of 20 min but here the data are less clear. We discuss relations between our results and basic learning at the neuronal level. PMID:24609081

Two consecutive nationwide outbreaks of Listeriosis in France, October 1999-February 2000.

PubMed

de Valk, H; Vaillant, V; Jacquet, C; Rocourt, J; Le Querrec, F; Stainer, F; Quelquejeu, N; Pierre, O; Pierre, V; Desenclos, J C; Goulet, V

2001-11-15

In France, listeriosis surveillance is based on mandatory notification of all culture-confirmed cases, with systematic typing of isolates and routine collection of the patient's food history. From October 1999 to March 2000, two outbreaks of listeriosis were detected through this enhanced surveillance system. In outbreak 1, analysis of the food histories of cases suggested brand X "rillettes," a pâté-like meat product, as the vehicle of infection, and the outbreak strain of Listeria monocytogenes was subsequently isolated from the incriminated rillettes. In outbreak 2, a case-control study showed that consumption of jellied pork tongue was strongly associated with infection with the outbreak strain (odds ratio = 75.5, 95% confidence interval: 4.7, 1,216.0). However, trace-back results did not permit incrimination of any particular manufacturer of jellied pork tongue, and the outbreak strain was not isolated from the incriminated food or from any production sites. Consumption of jellied pork tongue was discouraged on epidemiologic evidence alone. The consecutive occurrence of these two outbreaks confirms the epidemic potential of listeriosis, even in a context of decreasing incidence, and underlines the importance of timely case-reporting and systematic typing of human L. monocytogenes strains to allow early detection and separate investigation of different clusters.

The impact of junior doctors' worktime arrangements on their fatigue and well-being.

PubMed

Tucker, Philip; Brown, Menna; Dahlgren, Anna; Davies, Gwyneth; Ebden, Philip; Folkard, Simon; Hutchings, Hayley; Akerstedt, Torbjörn

2010-11-01

Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks. Completed by 336 doctors, the questionnaires focused on the respondents' personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work-life balance and psychological strain. Working 7 consecutive nights was associated with greater accumulated fatigue and greater work-life interference, compared with working just 3 or 4 nights. Having only 1 rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work-life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work-life interference and psychological strain. Inter-shift intervals of <10 hours were associated with shorter periods of sleep and increased fatigue. The number of hours worked per week was positively associated with work-life interference and fatigue on night shifts. The current findings identify parameters, in addition to those specified in the EWTD, for designing schedules that limit their impact on doctors' fatigue and well-being.

Effect of altering the intervals between consecutive superovulatory doses of porcine follicle-stimulating hormone on ovarian responses and embryo yields in anestrous ewes.

PubMed

Bartlewski, P M; Murawski, M; Schwarz, T; Oliveira, M E F

2017-05-01

The effect of varying intervals between successive gonadotropin injections on the superovulatory outcomes in anestrous Rideau Arcott ewes superstimulated for ovarian follicular development with multiple doses of porcine FSH (pFSH) was evaluated in a single study. Twenty-five animals received six (1×2.5ml and 5×1.25ml) injections of Folltropin ® -V given at 0800 and 1600h or at 0800 and 2000h in Group 1 (n=9) or Group 2 (n=16), respectively. An i.m. injection of 500 IU of equine chorionic gonadotropin (eCG; Folligon ® ) was given concurrently with the first pFSH dose. Time of estrus was synchronized among ewes with intravaginal sponges containing 60mg of medroxyprogesterone acetate (Veramix ® ) that were left in place for 14days; sponges were removed at the time of the 5th pFSH injection. Six days after insertion of MAP sponges, all ewes received an i.m. injection of estradiol-17β dissolved in 1ml of sesame oil (350μg/ewe) to synchronize follicular wave emergence. Following the last pFSH dose, all animals were given a single i.m. injection of 50μg of gonadotropin-releasing hormone (GnRH; Cystorelin ® ) to induce ovulations before placing in a pen with four fertile rams for 36h. The ovarian responses were assessed and embryos recovered surgically 7days after GnRH injections. The mean number of corpora lutea was greater (P<0.05) in Group 1 compared with Group 2 ewes (21.0±2.9 compared with 10.4±1.6, respectively; mean±SEM) but there was no difference (P>0.05) in the number of transferable embryos (5.4±2.4 compared with 5.4±1.3/ewe, respectively), and Group 1 animals had significantly more degenerated embryos than Group 2 ewes (2.6±1.2 compared with 0.6±0.3/ewe, respectively). A superovulatory protocol wherein pFSH injections were given at 0800 and 1600h was more effective in terms of inducing multiple ovulations than the protocol with 12-h intervals between consecutive pFSH doses, but it was not associated with an increased production of transferable quality embryos by anestrous ewes. Copyright © 2017 Elsevier B.V. All rights reserved.

Fertility of the male alpaca: effect of daily consecutive breeding.

PubMed

Bravo, P W; Solis, P; Ordoñez, C; Alarcon, V

1997-04-01

The fertility of the male alpaca under different frequencies of daily consecutive matings was evaluated. Fifteen adult male Huacaya alpacas were divided randomly into three groups of five each to breed lactating female alpacas. The schedule of daily matings was two, four and six consecutive breeding per group and for nine consecutive days. Ovulation was determined by progesterone at seven days after breeding. Pregnancy was determined by ultrasonography at 15 and 30 days after breeding. Two hundred and eighty females were bred with some males not fulfilling their schedule of breeding. There were differences (P < 0.05) in the fertility rate of males breeding two and four times daily (76%) in contrast to 59% for males breeding six times. There were also differences (P < 0.05) in the fertility of individual males. Length of copulation was affected (P < 0.05) by schedule of matings, day of breeding and male. Ovulation was independent of length of copulation. Overall, it seems the fertility of the male alpaca is affected significantly when consecutive matings are over four times a day and for nine consecutive days.

Dive and beak movement patterns in leatherback turtles Dermochelys coriacea during internesting intervals in French Guiana.

PubMed

Fossette, Sabrina; Gaspar, Philippe; Handrich, Yves; Le Maho, Yvon; Georges, Jean-Yves

2008-03-01

1. Investigating the foraging patterns of free-ranging species is essential to estimate energy/time budgets for assessing their real reproductive strategy. Leatherback turtles Dermochelys coriacea (Vandelli 1761), commonly considered as capital breeders, have been reported recently to prospect actively during the breeding season in French Guiana, Atlantic Ocean. In this study we investigate the possibility of this active behaviour being associated with foraging, by studying concurrently diving and beak movement patterns in gravid females equipped with IMASEN (Inter-MAndibular Angle SENsor). 2. Four turtles provided data for periods varying from 7.3 to 56.1 h while exhibiting continuous short and shallow benthic dives. Beak movement ('b-m') events occurred in 34% of the dives, on average 1.8 +/- 1.4 times per dive. These b-m events lasted between 1.5 and 20 s and occurred as isolated or grouped (two to five consecutive beak movements) events in 96.0 +/- 4.0% of the recorded cases, and to a lesser extent in series (> five consecutive beak movements). 3. Most b-m events occurred during wiggles at the bottom of U- and W-shaped dives and at the beginning and end of the bottom phase of the dives. W-shaped dives were associated most frequently with beak movements (65% of such dives) and in particular with grouped beak movements. 4. Previous studies proposed wiggles to be indicator of predatory activity, U- and W-shaped dives being putative foraging dives. Beak movements recorded in leatherbacks during the first hours of their internesting interval in French Guiana may be related to feeding attempts. 5. In French Guiana, leatherbacks show different mouth-opening patterns for different dive patterns, suggesting that they forage opportunistically on occasional prey, with up to 17% of the dives appearing to be successful feeding dives. 6. This study highlights the contrasted strategies adopted by gravid leatherbacks nesting on the Pacific coasts of Costa Rica, in the deep-water Caribbean Sea and in the French Guianan shallow continental shelf, and may be related to different local prey accessibility among sites. Our results may help to explain recently reported site-specific individual body size and population dynamics.

Hemoglobin Differences in Uncomplicated Monochorionic Twins in Relation to Birth Order and Mode of Delivery.

PubMed

Verbeek, Lianne; Zhao, Depeng P; Te Pas, Arjan B; Middeldorp, Johanna M; Hooper, Stuart B; Oepkes, Dick; Lopriore, Enrico

2016-06-01

To determine the differences in hemoglobin (Hb) levels in the first 2 days after birth in uncomplicated monochorionic twins in relation to birth order and mode of delivery. All consecutive uncomplicated monochorionic pregnancies with two live-born twins delivered at our center were included in this retrospective study. We recorded Hb levels at birth and on day 2, and analyzed Hb levels in association with birth order, mode of delivery, and time interval between delivery of twin 1 and 2. A total of 290 monochorionic twin pairs were analyzed, including 171 (59%) twins delivered vaginally and 119 (41%) twins born by cesarean section (CS). In twins delivered vaginally, mean Hb levels at birth and on day 2 were significantly higher in second-born twins compared to first-born twins: 17.8 versus 16.1 g/dL and 18.0 versus 14.8 g/dL, respectively (p < .01). Polycythemia was detected more often in second-born twins (12%, 20/166) compared to first-born twins (1%, 2/166; p < .01). Hb differences within twin pairs delivered by CS were not statistically or clinically significant. We found no association between inter-twin delivery time intervals and Hb differences. Second-born twins after vaginal delivery have higher Hb levels and more often polycythemia than their co-twin, but not when born by CS.

Virtual reality laparoscopy: which potential trainee starts with a higher proficiency level?

PubMed

Paschold, M; Schröder, M; Kauff, D W; Gorbauch, T; Herzer, M; Lang, H; Kneist, W

2011-09-01

Minimally invasive surgery requires technical skills distinct from those used in conventional surgery. The aim of this prospective study was to identify personal characteristics that may predict the attainable proficiency level of first-time virtual reality laparoscopy (VRL) trainees. Two hundred and seventy-nine consecutive undergraduate medical students without experience attended a standardized VRL training. Performance data of an abstract and a procedural task were correlated with possible predictive factors providing potential competence in VRL. Median global score requirement status was 86.7% (interquartile range (IQR) 75-93) for the abstract task and 74.4% (IQR 67-88) for the procedural task. Unadjusted analysis showed significant increase in the global score in both tasks for trainees who had a gaming console at home and frequently used it as well as for trainees who felt self-confident to assist in a laparoscopic operation. Multiple logistic regression analysis identified frequency of video gaming (often/frequently vs. rarely/not at all, odds ratio: abstract model 2.1 (95% confidence interval 1.2; 3.6), P = 0.009; virtual reality operation procedure 2.4 (95% confidence interval 1.3; 4.2), P = 0.003) as a predictive factor for VRL performance. Frequency of video gaming is associated with quality of first-time VRL performance. Video game experience may be used as trainee selection criteria for tailored concepts of VRL training programs.

Central venous catheter-associated bloodstream infections in a pediatric intensive care unit: effect of the location of catheter insertion.

PubMed

Krishnaiah, Anil; Soothill, James; Wade, Angie; Mok, Quen Q; Ramnarayan, Padmanabhan

2012-05-01

To compare the rate of central venous catheter-associated bloodstream infections between pediatric intensive care unit admissions where central venous catheters were inserted within the same hospital (internal central venous catheters) and those where central venous catheters were inserted before transfer from other hospitals (external central venous catheters). Retrospective analysis of prospectively collected data. A tertiary care pediatric intensive care unit in London, UK. Consecutive pediatric intensive care unit admissions between May 2007 and March 2009. None. Catheter-associated bloodstream infections were identified using a widely accepted surveillance definition. The rate and time to occurrence of catheter-associated bloodstream infection were compared between internal and external nontunneled central venous catheters. A multilevel Cox-regression model was used to study the association between location of central venous catheter insertion and time to catheter-associated bloodstream infection. In total, 382 central venous catheters were studied (245 internal; 137 external) accounting for a total of 1,737 central venous catheter days. There was a higher catheter-associated bloodstream infection incidence density among external central venous catheters (23.1 [95% confidence interval 11.0-35.2] vs. 9.7 [95% confidence interval 3.9-15.5] per 1,000 catheter-days). Multivariable analyses demonstrated higher infection risk with external central venous catheters (hazard ratio 2.65 [95% confidence interval 1.18-5.96]) despite adjustment for confounding variables. The rate of catheter-associated bloodstream infections in the pediatric intensive care unit is significantly affected by external insertion of the central venous catheter. Future interventions to reduce nosocomial infections on pediatric intensive care units will need to be specifically targeted at this high-risk patient group.

Stress-induced ST-segment deviation in relation to the presence and severity of coronary artery disease in patients with normal myocardial perfusion imaging.

PubMed

Weinsaft, Jonathan W; Manoushagian, Shant J; Patel, Taral; Shakoor, Aqsa; Kim, Robert J; Mirchandani, Sunil; Lin, Fay; Wong, Franklin J; Szulc, Massimiliano; Okin, Peter M; Kligfield, Paul D; Min, James K

2009-01-01

To assess the utility of stress electrocardiography (ECG) for identifying the presence and severity of obstructive coronary artery disease (CAD) defined by coronary computed tomographic angiography (CCTA) among patients with normal nuclear myocardial perfusion imaging (MPI). The study population comprised 119 consecutive patients with normal MPI who also underwent CCTA (interval 3.5+/-3.8 months). Stress ECG was performed at the time of MPI. CCTA and MPI were interpreted using established scoring systems, and CCTA was used to define the presence and extent of CAD, which was quantified by a coronary artery jeopardy score. Within this population, 28 patients (24%) had obstructive CAD identified by CCTA. The most common CAD pattern was single-vessel CAD (61%), although proximal vessel involvement was present in 46% of patients. Patients with CAD were nearly three times more likely to have positive standard test responses (1 mm ST-segment deviation) than patients with patent coronary arteries (36 vs. 13%, P=0.007). In multivariate analysis, a positive ST-segment test response was an independent marker for CAD (odds ratio: 2.02, confidence interval: 1.09-3.78, P=0.03) even after adjustment for a composite of clinical cardiac risk factors (odds ratio: 1.85, confidence interval: 1.05-3.23, P=0.03). Despite uniformly normal MPI, mean coronary jeopardy score was three-fold higher among patients with positive compared to those with negative ST-segment response to exercise or dobutamine stress (1.9+/-2.7 vs. 0.5+/-1.4, P=0.03). Stress-induced ST-segment deviation is an independent marker for obstructive CAD among patients with normal MPI. A positive stress ECG identifies patients with a greater anatomic extent of CAD as quantified by coronary jeopardy score.

Relationship between analysis of laser speckle image and Knoop hardness on softening enamel.

PubMed

Koshoji, Nelson H; Prates, Renato A; Bussadori, Sandra K; Bortoletto, Carolina C; de Miranda Junior, Walter G; Librantz, André F H; Leal, Cintia Raquel Lima; Oliveira, Marcelo T; Deana, Alessandro M

2016-09-01

In this study is presented the correlation between laser speckle images and enamel hardness loss. In order to shift the enamel hardness, a dental demineralization model was applied to 32 samples of vestibular bovine teeth. After they were cleaned, cut and polished, the samples were divided into 4 groups and immersed in 30ml of a cola-based soft drink for 10, 20, 30 and 40min twice a day for 7 consecutive days with half the surface protected by two layers of nail polish. Each sample was analyzed by Knoop hardness and laser speckle imaging. Pearson's correlation analysis demonstrated that the laser speckle image technique presents a strong correlation with the hardness loss of the enamel (r=0.7085, p<0.0001). This finding is corroborated by Blend & Altman analysis, in which the data presented a constant behavior throughout the whole interval. For both analyses, more than 95% of the data is within the confidence interval, as expected. This work demonstrates, for the first time to our knowledge, an empirical model for correlating laser speckle images with the loss of tooth enamel hardness. Copyright © 2016. Published by Elsevier B.V.

Comparison of the Efficacy and Efficiency of the Use of Virtual Reality Simulation With High-Fidelity Mannequins for Simulation-Based Training of Fiberoptic Bronchoscope Manipulation.

PubMed

Jiang, Bailin; Ju, Hui; Zhao, Ying; Yao, Lan; Feng, Yi

2018-04-01

This study compared the efficacy and efficiency of virtual reality simulation (VRS) with high-fidelity mannequin in the simulation-based training of fiberoptic bronchoscope manipulation in novices. Forty-six anesthesia residents with no experience in fiberoptic intubation were divided into two groups: VRS (group VRS) and mannequin (group M). After a standard didactic teaching session, group VRS trained 25 times on VRS, whereas group M performed the same process on a mannequin. After training, participants' performance was assessed on a mannequin five consecutive times. Procedure times during training were recorded as pooled data to construct learning curves. Procedure time and global rating scale scores of manipulation ability were compared between groups, as well as changes in participants' confidence after training. Plateaus in the learning curves were achieved after 19 (95% confidence interval = 15-26) practice sessions in group VRS and 24 (95% confidence interval = 20-32) in group M. There was no significant difference in procedure time [13.7 (6.6) vs. 11.9 (4.1) seconds, t' = 1.101, P = 0.278] or global rating scale [3.9 (0.4) vs. 3.8 (0.4), t = 0.791, P = 0.433] between groups. Participants' confidence increased after training [group VRS: 1.8 (0.7) vs. 3.9 (0.8), t = 8.321, P < 0.001; group M = 2.0 (0.7) vs. 4.0 (0.6), t = 13.948, P < 0.001] but did not differ significantly between groups. Virtual reality simulation is more efficient than mannequin in simulation-based training of flexible fiberoptic manipulation in novices, but similar effects can be achieved in both modalities after adequate training.

Temporal patterns of radiographic infiltration in severely traumatized patients with and without adult respiratory distress syndrome.

PubMed

Johnson, K S; Bishop, M H; Stephen, C M; Jorgens, J; Shoemaker, W C; Shori, S K; Ordog, G; Thadepalli, H; Appel, P L; Kram, H B

1994-05-01

We prospectively evaluated the patterns of pulmonary structural and functional changes in 100 consecutive surgical intensive care unit trauma patients who had (1) emergent major surgery, (2) a pelvic fracture, or (3) two or more major long bone fractures. For each patient, arterial blood gas measurements (ABGs), central venous pressure (CVP), pulmonary capillary occlusion pressure (PAOP), thoracic compliance, arterial oxygen tension/fraction of inspired oxygen (PAO2/FIO2), pulmonary venous admixture (Qs/Qt), and portable chest roentgenograms were sequentially tracked. The senior staff radiologist interpreted all chest roentgenograms. Pulmonary infiltration was quantitated in each of six fields using a scale ranging from 0 to 4, with 0 being no infiltration and 4 being the maximum. Adult respiratory distress syndrome (ARDS) was defined as follows: Qs/Qt > or = 20%, PAO2/FIO2 < 250 or both; dependence on mechanical ventilation for life support for > or = 24 hours; PAOP or CVP or both < 20 mm Hg; and thoracic compliance < 50 mL/cm H2O. Time zero (T0) the time of onset of ARDS, was defined as the time these criteria were met. Eighty-three of 100 study group patients had penetrating injuries, and 17 were admitted with blunt trauma. Fifty-one of 100 patients developed ARDS: 36 of 51 died. Only 4 of 49 (8%) patients without ARDS died. The injured lungs of patients with and without ARDS had similar amounts of infiltration over most measured time intervals. The noninjured lungs of the ARDS patients, however, had significantly greater infiltration than those without ARDS at T0 and over subsequent time intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

Ventricular tachyarrhythmias and mortality in patients with an implantable cardioverter defibrillator: impact of depression in the MIDAS cohort.

PubMed

Mastenbroek, Mirjam H; Versteeg, Henneke; Jordaens, Luc; Theuns, Dominic A M J; Pedersen, Susanne S

2014-01-01

We examined whether depression is independently associated with implantable cardioverter defibrillator (ICD) therapy for ventricular tachyarrhythmias and mortality. A cohort of 430 consecutive patients with a first-time ICD (79% men; mean [standard deviation] age = 57.8 [12.1] years) completed the Hospital Anxiety and Depression Scale 1 day before implantation. During follow-up, the ICD was interrogated at 3-month intervals. Cox proportional hazard regression analyses were used to examine the impact of depression on time to first appropriate ICD therapy and all-cause mortality during a median follow-up period of 3.8 years. Of all patients, 108 (25.1%) were depressed. Depression was not associated with time to first appropriate ICD therapy (unadjusted hazard ratio [HR] = 1.07, 95% confidence interval [CI] = 0.73-1.56). However, depression was associated with an increased risk for all-cause mortality (unadjusted HR = 2.18, 95% CI = 1.36-3.49). Depression remained independently associated with all-cause mortality (HR = 1.94, 95% CI = 1.06-3.54, p = .031), after adjusting for demographic and clinical characteristics. Patients who remained depressed during the first 3 months after implantation were at greatest risk for dying (HR = 2.88, 95% CI = 1.29-6.45, p = .010). The current study showed that depression at the time of implant is not associated with time to first appropriate ICD therapy but almost doubled the risk for all-cause mortality in patients with an ICD. Patients with persistent depression during the first 3 months after implantation face the greatest risk of dying. Current evidence indicates that multifactorial interventions are likely to be the most successful in terms of reducing distress. Whether this translates into enhanced survival has yet to be determined.

Development of a novel drug delivery system, time-controlled explosion system (TES). IV. In vivo drug release behavior.

PubMed

Ueda, S; Ibuki, R; Kawamura, A; Murata, S; Takahashi, T; Kimura, S; Hata, T

1994-01-01

Time-Controlled Explosion System (TES) has the time-controlled drug release property with a pre-designed lag time. The drug release from the system is initiated by destruction of the membrane. In this study, metoprolol tartrate was used as a model drug. After five types of TES with different in vitro lag times were orally administrated to dogs, plasma metoprolol concentration was monitored. There existed a good correlation between in vitro and in vivo lag time, while the extent of absorbed metoprolol decreased with prolongation of lag time. Next, the in vivo drug release behavior was directly investigated using five different colored TES with a lag time of two hours. Each TES was consecutively administrated to the fasted dogs at predetermined intervals. The amount of metoprolol released was monitored by recovering the administered TES from the gastrointestinal trace. The in vivo release profile corresponded with the in vitro one. It is demonstrated that TES can release the drug in in vivo conditions similarly to in vitro. Based on these results, the decrease of the absorption is suggested to be caused by increased hepatic first-pass metabolism of the drug due to the retarded release rate with longer lag time.

[Nutrient intake: concepts and international recommendations (first part)].

PubMed

García Gabarra, A

2006-01-01

This revision on nutrient intakes pretends to analyse, compare and evaluate the various concepts and data used by different national and international bodies and authorities, reflecting their turn into legal norms and their evolution in recent years. At the same time it facilitates bibliographic references and Internet websites to those sources and it offers a glossary of used terms and their acronyms. Four geographical territories have been considered, being split in 2 parts. First part: European Union. Second part: Spain, United States of America/Canada and FAO/WHO. Due to the extensive text of this revision there has been necessary to divide it in 2 parts which are being published in consecutive numbers of the journal Nutrici6n Hospitalaria. CONCLUSIONS OF THE 1ST PART: At the European level there should be pointed out the long time interval existing between the publication of recommendations and their legislative implementation. One can observe the resistance of some Member States of the European Community to harmonize the recommendations and the legislation within the Community frame.

Spontaneous brain activity as a source of ideal 1/f noise

NASA Astrophysics Data System (ADS)

Allegrini, Paolo; Menicucci, Danilo; Bedini, Remo; Fronzoni, Leone; Gemignani, Angelo; Grigolini, Paolo; West, Bruce J.; Paradisi, Paolo

2009-12-01

We study the electroencephalogram (EEG) of 30 closed-eye awake subjects with a technique of analysis recently proposed to detect punctual events signaling rapid transitions between different metastable states. After single-EEG-channel event detection, we study global properties of events simultaneously occurring among two or more electrodes termed coincidences. We convert the coincidences into a diffusion process with three distinct rules that can yield the same μ only in the case where the coincidences are driven by a renewal process. We establish that the time interval between two consecutive renewal events driving the coincidences has a waiting-time distribution with inverse power-law index μ≈2 corresponding to ideal 1/f noise. We argue that this discovery, shared by all subjects of our study, supports the conviction that 1/f noise is an optimal communication channel for complex networks as in art or language and may therefore be the channel through which the brain influences complex processes and is influenced by them.

Mechanism of Inhibition of the V-Type Molecular Motor by Tributyltin Chloride

PubMed Central

Takeda, Mizuho; Suno-Ikeda, Chiyo; Shimabukuro, Katsuya; Yoshida, Masasuke; Yokoyama, Ken

2009-01-01

Tributyltin chloride (TBT-Cl) is an endocrine disruptor found in many animal species, and it is also known to be an inhibitor for the V-ATPases that are emerging as potential targets in the treatment of diseases such as osteoporosis and cancer. We demonstrated by using biochemical and single-molecular imaging techniques that TBT-Cl arrests an elementary step for rotary catalysis of the V1 motor domain. In the presence of TBT-Cl, the consecutive rotation of V1 paused for a long duration (∼0.5 s), even at saturated ATP concentrations, and the pausing positions were localized at 120° intervals. Analysis of both the pausing time and moving time revealed that TBT-Cl has little effect on the binding affinity for ATP, but, rather, it arrests the catalytic event(s). This is the first report to demonstrate that an inhibitor arrests an elementary step for rotary catalysis of a V-type ATP-driven rotary motor. PMID:19186155

Effect of spinal needle characteristics on measurement of spinal canal opening pressure.

PubMed

Bellamkonda, Venkatesh R; Wright, Thomas C; Lohse, Christine M; Keaveny, Virginia R; Funk, Eric C; Olson, Michael D; Laack, Torrey A

2017-05-01

A wide variety of spinal needles are used in clinical practice. Little is currently known regarding the impact of needle length, gauge, and tip type on the needle's ability to measure spinal canal opening pressure. This study aimed to investigate the relationship between these factors and the opening-pressure measurement or time to obtain an opening pressure. Thirteen distinct spinal needles, chosen to isolate the effects of length, gauge, and needle-point type, were prospectively tested on a lumbar puncture simulator. The key outcomes were the opening-pressure measurement and the time required to obtain that measure. Pressures were recorded at 10-s intervals until 3 consecutive, identical readings were observed. Time to measure opening pressure increased with increasing spinal needle length, increasing gauge, and the Quincke-type (cutting) point (P<0.001 for all). The time to measurement ranged from 30s to 530s, yet all needle types were able to obtain a consistent opening pressure measure. Although opening pressure estimates are unlikely to vary markedly by needle type, the time required to obtain the measurement increased with increasing needle length and gauge and with Quincke-type needles. Copyright © 2017 Elsevier Inc. All rights reserved.

How to Sync to the Beat of a Persistent Fractal Metronome without Falling Off the Treadmill?

PubMed Central

Roerdink, Melvyn; Daffertshofer, Andreas; Marmelat, Vivien; Beek, Peter J.

2015-01-01

In rehabilitation, rhythmic acoustic cues are often used to improve gait. However, stride-time fluctuations become anti-persistent with such pacing, thereby deviating from the characteristic persistent long-range correlations in stride times of self-paced walking healthy adults. Recent studies therefore experimented with metronomes with persistence in interbeat intervals and successfully evoked persistent stride-time fluctuations. The objective of this study was to examine how participants couple their gait to a persistent metronome, evoking persistently longer or shorter stride times over multiple consecutive strides, without wandering off the treadmill. Twelve healthy participants walked on a treadmill in self-paced, isochronously paced and non-isochronously paced conditions, the latter with anti-persistent, uncorrelated and persistent correlations in interbeat intervals. Stride-to-stride fluctuations of stride times, stride lengths and stride speeds were assessed with detrended fluctuation analysis, in conjunction with an examination of the coupling between stride times and stride lengths. Stride-speed fluctuations were anti-persistent for all conditions. Stride-time and stride-length fluctuations were persistent for self-paced walking and anti-persistent for isochronous pacing. Both stride times and stride lengths changed from anti-persistence to persistence over the four non-isochronous metronome conditions, accompanied by an increasingly stronger coupling between these gait parameters, with peak values for the persistent metronomes. These results revealed that participants were able to follow the beat of a persistent metronome without falling off the treadmill by strongly coupling stride-length fluctuations to the stride-time fluctuations elicited by persistent metronomes, so as to prevent large positional displacements along the treadmill. For self-paced walking, in contrast, this coupling was very weak. In combination, these results challenge the premise that persistent metronomes in gait rehabilitation would evoke stride-to-stride dynamics reminiscent of self-paced walking healthy adults. Future studies are recommended to include an analysis of the interrelation between stride times and stride lengths in addition to the correlational structure of either one in isolation. PMID:26230254

How to Sync to the Beat of a Persistent Fractal Metronome without Falling Off the Treadmill?

PubMed

Roerdink, Melvyn; Daffertshofer, Andreas; Marmelat, Vivien; Beek, Peter J

2015-01-01

In rehabilitation, rhythmic acoustic cues are often used to improve gait. However, stride-time fluctuations become anti-persistent with such pacing, thereby deviating from the characteristic persistent long-range correlations in stride times of self-paced walking healthy adults. Recent studies therefore experimented with metronomes with persistence in interbeat intervals and successfully evoked persistent stride-time fluctuations. The objective of this study was to examine how participants couple their gait to a persistent metronome, evoking persistently longer or shorter stride times over multiple consecutive strides, without wandering off the treadmill. Twelve healthy participants walked on a treadmill in self-paced, isochronously paced and non-isochronously paced conditions, the latter with anti-persistent, uncorrelated and persistent correlations in interbeat intervals. Stride-to-stride fluctuations of stride times, stride lengths and stride speeds were assessed with detrended fluctuation analysis, in conjunction with an examination of the coupling between stride times and stride lengths. Stride-speed fluctuations were anti-persistent for all conditions. Stride-time and stride-length fluctuations were persistent for self-paced walking and anti-persistent for isochronous pacing. Both stride times and stride lengths changed from anti-persistence to persistence over the four non-isochronous metronome conditions, accompanied by an increasingly stronger coupling between these gait parameters, with peak values for the persistent metronomes. These results revealed that participants were able to follow the beat of a persistent metronome without falling off the treadmill by strongly coupling stride-length fluctuations to the stride-time fluctuations elicited by persistent metronomes, so as to prevent large positional displacements along the treadmill. For self-paced walking, in contrast, this coupling was very weak. In combination, these results challenge the premise that persistent metronomes in gait rehabilitation would evoke stride-to-stride dynamics reminiscent of self-paced walking healthy adults. Future studies are recommended to include an analysis of the interrelation between stride times and stride lengths in addition to the correlational structure of either one in isolation.

Clinical study on microsurgical treatment for craniopharyngioma in a single consecutive institutional series of 335 patients.

PubMed

Guo, Fuyou; Wang, Guoqing; Suresh, Vigneyshwar; Xu, Dingkang; Zhang, Xiaoyang; Feng, Mengzhao; Wang, Fang; Liu, Xianzhi; Song, Laijun

2018-04-01

The optimal management of craniopharyngioma is still controversial. The aim of this study is to explore microsurgical outcomes of craniopharyngioma in 335 cases. Clinical data of 335 consecutive patients with craniopharyngioma between March 2011 and March 2017 were retrospectively analyzed. Gross total resection (GTR) was achieved in 265 cases (79.1%), subtotal resection (STR) was obtained in 70 cases (20.9%). The GTR rate was 81.93% in pediatric group and 78.17% in adult group respectively, no significant difference regarding the GTR rate was found in adult group compared with in pediatric group (p > 0.05). However, there was a noticeable difference in the elevated hypothalamic obesity in children group compared with in adult group after operation (p < 0.05). Multivariate analysis indicated that the tumor recurrence and surgical times played a negative role in the resection extent, the odds ratio and 95% confidence interval of the tumor recurrence and surgical times is [0.306 (0.155-0.603), (p < 0.01)] and [2.135 (1.101-4.142), (p < 0.05)] respectively. There was significant difference on panhypopituitarism between GTR and STR group (p < 0.05). However, No significant difference regarding the postoperative visual dysfunction and indepent quality of life respectively between GTR and STR group was found (p > 0.05). Additionally, there were no statistically significant differences for recurrence-free curves between GTR and STR plus adjuvant radiotherapy (p > 0.05). Present findings demonstrated that tumor recurrence and surgical times contribute to negative total resection for craniopharyngioma. Postoperative precise adjuvant radiotherapy was considered in selected cases if pursuit of GTR was rather dangerous under disadvantageous removal factors. Copyright © 2018 Elsevier B.V. All rights reserved.

Epidemiological data on US coal miners' pneumoconiosis, 1960 to 1988.

PubMed

Attfield, M D; Castellan, R M

1992-07-01

Statistics on prevalence of pneumoconiosis among working underground coal miners based on epidemiologic data collected between 1960 and 1988 are presented. The main intent was to examine the time-related trend in prevalence, particularly after 1969, when substantially lower dust levels were mandated by federal act. Data from studies undertaken between 1960 and 1968 were collected and compared. Information for the period 1969 to 1988 was extracted from a large ongoing national epidemiologic study. Tenure-specific prevalence rates and summary statistics derived from the latter data for four consecutive time intervals within the 19-year period were calculated and compared. The results indicate a reduction in pneumoconiosis over time. The trend is similar to that seen in a large radiologic surveillance program of underground miners operated concurrently. Although such factors as x-ray reader variation, changes in x-ray standards, and worker self-selection for examination may have influenced the findings to some extent, adjusted summary rates reveal a reduction in prevalence concurrent with reductions in coal mine dust levels mandated by federal act in 1969.

How to manage thyroid nodules with two consecutive non-diagnostic results on ultrasonography-guided fine-needle aspiration.

PubMed

Moon, Hee Jung; Kwak, Jin Young; Choi, Yoon Seong; Kim, Eun-Kyung

2012-03-01

The aim of this study was to investigate the factors for considering surgery on thyroid nodules that had non-diagnostic results on two consecutive cytology examinations. A total of 104 thyroid nodules with two consecutive non-diagnostic cytology examinations in 104 patients were investigated. Nodules with one or more suspicious ultrasonography (US) features of marked hypoechogenicity, a not well defined margin, microcalcifications, or a taller-than-wide shape were assessed as sonographically suspicious. Those without any suspicious features were assessed as sonographically benign. The clinicopathologic characteristics of patients and US features of the nodules were compared according to malignancy and benignity. The odds ratio for predicting malignancy was calculated. Altogether, 12 nodules were malignant, and 92 were benign. Age, sex, nodule size, and solidness were not associated with malignancy (P = 0.73, 0.92, 0.48, and 0.73, respectively). The malignancy rate of sonographically suspicious nodules was 25.7%, higher than the 4.3% of sonographically benign nodules (P = 0.002). The odds ratio of sonographically suspicious nodules for predicting malignancy was 16.01 (95% confidence interval 2.36-108.54, P = 0.005). Based on sonographic features, surgery can be performed selectively on nodules with two consecutive non-diagnostic cytology results.

Human dynamics in repurchase behavior based on comments mining

NASA Astrophysics Data System (ADS)

Yang, Tian; Feng, Xin; Wu, Ye; Wang, Shengfeng; Xiao, Jinghua

2018-07-01

Hundreds of thousands of individual deals and comments are analyzed to ask: what kinds of patterns appear in their repurchase process? Our results suggest that, in the empirical description, the intervals between two consecutive purchases obey a power-law distribution. Notwithstanding a wide range of individual preferences, shoppers' repurchase behaviors show some similar patterns, called long-scale quiet and short-scale emergence, and the alternating appearance of them form an endless chain in repurchase. In agreement with the empirical results, these short-scale and long-scale patterns suggest an adaptive model with alterable exponents complying with a power-law distribution. And it also implies that each user behaves his own intrinsic pattern such as unique repurchase intensity and silence-emergence cycle, which contributes to customer life-time value from the new view of dynamics and repurchase cycles.

40 CFR 63.7823 - What test methods and other procedures must I use to demonstrate initial compliance with the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... subpart for BOPF shops: (1) For an existing BOPF shop: (i) Using a certified observer, determine the... consecutive observations recorded at 15-second intervals. (2) For a new BOPF shop housing a bottom-blown BOPF... average opacities for each steel production cycle. (3) For a new BOPF shop housing a top-blown BOPF: (i...

40 CFR 63.7823 - What test methods and other procedures must I use to demonstrate initial compliance with the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... subpart for BOPF shops: (1) For an existing BOPF shop: (i) Using a certified observer, determine the... consecutive observations recorded at 15-second intervals. (2) For a new BOPF shop housing a bottom-blown BOPF... average opacities for each steel production cycle. (3) For a new BOPF shop housing a top-blown BOPF: (i...

40 CFR 63.7823 - What test methods and other procedures must I use to demonstrate initial compliance with the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... subpart for BOPF shops: (1) For an existing BOPF shop: (i) Using a certified observer, determine the... consecutive observations recorded at 15-second intervals. (2) For a new BOPF shop housing a bottom-blown BOPF... average opacities for each steel production cycle. (3) For a new BOPF shop housing a top-blown BOPF: (i...

Point Counts Modifications and Breeding Bird Abundances in Central Appalachian Forests

Treesearch

J. Edwards Gates

1995-01-01

The effects of point count duration and radius on detection of breeding birds were compared by recording all birds seen or heard within two consecutive 5-minute intervals and for fixed-radius (within 30 m) or unlimited radius counts. Counts were conducted on Green Ridge State Forest (GRSF) and Savage River State Forest (SRSF) in western Maryland. More than 70 percent...

Sleep Restriction Impairs Vocabulary Learning when Adolescents Cram for Exams: The Need for Sleep Study

PubMed Central

Huang, Sha; Deshpande, Aadya; Yeo, Sing-Chen; Lo, June C.; Chee, Michael W.L.; Gooley, Joshua J.

2016-01-01

Study Objectives: The ability to recall facts is improved when learning takes place at spaced intervals, or when sleep follows shortly after learning. However, many students cram for exams and trade sleep for other activities. The aim of this study was to examine the interaction of study spacing and time in bed (TIB) for sleep on vocabulary learning in adolescents. Methods: In the Need for Sleep Study, which used a parallel-group design, 56 adolescents aged 15–19 years were randomly assigned to a week of either 5 h or 9 h of TIB for sleep each night as part of a 14-day protocol conducted at a boarding school. During the sleep manipulation period, participants studied 40 Graduate Record Examination (GRE)-type English words using digital flashcards. Word pairs were presented over 4 consecutive days (spaced items), or all at once during single study sessions (massed items), with total study time kept constant across conditions. Recall performance was examined 0 h, 24 h, and 120 h after all items were studied. Results: For all retention intervals examined, recall of massed items was impaired by a greater amount in adolescents exposed to sleep restriction. In contrast, cued recall performance on spaced items was similar between sleep groups. Conclusions: Spaced learning conferred strong protection against the effects of sleep restriction on recall performance, whereas students who had insufficient sleep were more likely to forget items studied over short time intervals. These findings in adolescents demonstrate the importance of combining good study habits and good sleep habits to optimize learning outcomes. Citation: Huang S, Deshpande A, Yeo SC, Lo JC, Chee MW, Gooley JJ. Sleep restriction impairs vocabulary learning when adolescents cram for exams: the Need for Sleep Study. SLEEP 2016;39(9):1681–1690. PMID:27253768

No interacting influence of lavender oil preparation silexan on oral contraception using an ethinyl estradiol/levonorgestrel combination.

PubMed

Heger-Mahn, Doris; Pabst, Günther; Dienel, Angelika; Schläfke, Sandra; Klipping, Christine

2014-12-01

Silexan is an oral Lavender oil preparation with proven anxiolytic efficacy. Given the high prevalence of anxiety and restlessness in younger women, oral contraceptives and Silexan will likely be co-administered. A double-blind, randomised, 2-period crossover study was performed to investigate the effects of Silexan on the pharmacokinetics and pharmacodynamics of Microgynon(®), a combination oral contraceptive containing ethinyl estradiol 0.03 mg (EE) and levonorgestrel 0.15 mg (LNG) in healthy, fertile, adult females. During 2 consecutive cycles of 28 days, oral contraception was given for 21 days combined with 1 × 160 mg/day Silexan or placebo. Plasma concentration-time profiles of EE and LNG were obtained on day 18 ± 1 up to 24 h after dosing. The primary outcome measure was the area under the concentration-time curve over a dosing interval of τ = 24 h (AUCτ) for EE and LNG plasma levels. An interaction with Silexan was formally excluded if the 90 % confidence interval for the AUCτ ratio during co-administration with Silexan or placebo was included within the range of 0.80-1.25. Secondary outcomes included EE and LNG peak concentration (C max) and time to C max (t max), follicle size, endometrial thickness, the Hoogland score, and serum levels of estradiol, progesterone, and sex hormone-binding globulin. A total of 24 women (mean age 27.3 years; mean body mass index 22.2 kg/m(2)) participated. The confidence intervals for the EE and LNG AUCτ and C max ratios fell within the pre-specified limits, indicating no interaction (point estimates [Silexan/placebo] AUCτ EE 0.97, LNG 0.94; C max EE 0.99, LNG 0.96). For LNG, t max was slightly delayed. No secondary outcome indicated any impairment of contraceptive efficacy. Co-administration of Silexan did not affect the efficacy of a combination oral contraceptive containing EE and LNG and was well tolerated.

Working disability in Norwegian patients with vestibular schwannoma: vertigo predicts future dependence.

PubMed

Breivik, Cathrine Nansdal; Nilsen, Roy Miodini; Myrseth, Erling; Finnkirk, Monica Katrine; Lund-Johansen, Morten

2013-12-01

We examined whether reduced hearing, tinnitus, dizziness, and unsteadiness affected the patients' ability to maintain work within a time frame of 2-10 years after diagnosis. A total of 434 consecutive patients were followed at regular intervals. Data on symptoms were scored prospectively and dichotomized by visual analog scales for tinnitus and vertigo. Study design is retrospective. Hearing acuity was scored according to the Gardner-Robertson scale, and unsteadiness was measured on a balance platform. Patients were asked about working status, and scored as receiving governmental compensation for disability. Two hundred six patients were eligible for study. Of these, one died and nine were lost to follow-up. Ninety-seven patients received conservative management, 49 patients recieved gamma knife radiosurgery, and 50 patients were treated by microsurgery. Mean follow-up time was 58.7 months (range, 20-132 months). There was a significant increase in the number of individuals receiving compensation during the study period (P < 0.0001). At baseline, the proportion of pension receivers was within same range as that of the age- and sex-matched Norwegian population (5.61% vs. 6.91%; case-control odds ratio, 0.82; 95% confidence interval 0.45-1.49; P = 0.51, not significant). At the final time point, the increase in the number of receivers deviated significantly from the reference population (case-control odds ratio, 3.80; 95% confidence interval 2.71-5.33; P ≤ 0.001). Examining symptoms at first presentation as predictors of future dependence revealed that vertigo and higher mean age were associated with a higher risk (P < 0.001 and P = 0.015, respectively). No other symptoms were predictive of dependence. In a prospectively followed cohort of Norwegian patients with vestibular schwannoma, vestibular complaints were significant predictors for becoming dependant of disability pension. Copyright © 2013 Elsevier Inc. All rights reserved.

Primary percutaneous coronary intervention for acute myocardial infarction in the elderly aged ≥75 years.

PubMed

Sakai, Koyu; Nagayama, Shinya; Ihara, Kasumi; Ando, Kenji; Shirai, Shinichi; Kondo, Katsuhiro; Yokoi, Hiroyoshi; Iwabuchi, Masashi; Nosaka, Hideyuki; Nobuyoshi, Masakiyo

2012-01-01

We aimed to see whether primary percutaneous coronary intervention (PCI) benefits for ST-segment elevation myocardial infarction (STEMI) in the aged could be validated. Primary PCI benefits in elderly patients with STEMI remain uncertain. We reviewed 947 consecutive patients treated with primary PCI for STEMI: 331 were aged ≥75 years (older) and 616 <75 years (younger). The older group had higher percentage of renal insufficiency (7.9% vs. 3.1%, P = 0.0010), prior stroke (9.4% vs. 3.9%, P = 0.0006), 30-day mortality rate (7.6% vs. 3.9%, P = 0.015), and cardiac mortality rate (6.6% vs. 3.7%, P = 0.045). Successful reperfusion rates were similarly high in both groups (90.0% and 92.7%, P = 0.16), despite the higher proportion of patients with door-to-balloon time >90 min (15% vs. 8.4%, P = 0.0016) in older patients. Successful compared with unsuccessful PCI significantly decreased 30-day mortality rates in the older group (6.0% vs. 21%, P = 0.0018) and in the younger group (2.8% vs. 18%, P < 0.0001). When reperfusion was successful, cardiac mortality rate in older patients was not significantly greater than in younger patients (5.4% vs. 2.8%, P = 0.057). By multivariate analysis, unsuccessful reperfusion independently predicted 30-day mortality (odds ratio, 4.04; 95% confidence interval, 1.79-9.12; P = 0.0008), whereas age ≥75 years (odds ratio, 1.00; 95% confidence interval, 0.41-2.41; P = 0.99) and door-to-balloon time >90 min (odds ratio, 1.78; 95% confidence interval, 0.76-4.20; P = 0.19) did not. Pre-existing comorbidities characterize older patients developing STEMI. Aggressive PCI in older patients improves prognosis, and short door-to-balloon time is an important parameter conditioning the prognosis. Copyright © 2011 Wiley Periodicals, Inc.

Xenon does not increase heart rate-corrected cardiac QT interval in volunteers and in patients free of cardiovascular disease.

PubMed

Neukirchen, Martin; Schaefer, Maximilian S; Kern, Carolin; Brett, Sarah; Werdehausen, Robert; Rellecke, Philipp; Reyle-Hahn, Matthias; Kienbaum, Peter

2015-09-01

Impaired cardiac repolarization, indicated by prolonged QT interval, may cause critical ventricular arrhythmias. Many anesthetics increase the QT interval by blockade of rapidly acting potassium rectifier channels. Although xenon does not affect these channels in isolated cardiomyocytes, the authors hypothesized that xenon increases the QT interval by direct and/or indirect sympathomimetic effects. Thus, the authors tested the hypothesis that xenon alters the heart rate-corrected cardiac QT (QTc) interval in anesthetic concentrations. The effect of xenon on the QTc interval was evaluated in eight healthy volunteers and in 35 patients undergoing abdominal or trauma surgery. The QTc interval was recorded on subjects in awake state, after their denitrogenation, and during xenon monoanesthesia (FetXe > 0.65). In patients, the QTc interval was recorded while awake, after anesthesia induction with propofol and remifentanil, and during steady state of xenon/remifentanil anesthesia (FetXe > 0.65). The QTc interval was determined from three consecutive cardiac intervals on electrocardiogram printouts in a blinded manner and corrected with Bazett formula. In healthy volunteers, xenon did not alter the QTc interval (mean difference: +0.11 ms [95% CI, -22.4 to 22.7]). In patients, after anesthesia induction with propofol/remifentanil, no alteration of QTc interval was noted. After propofol was replaced with xenon, the QTc interval remained unaffected (417 ± 32 ms vs. awake: 414 ± 25 ms) with a mean difference of 4.4 ms (95% CI, -4.6 to 13.5). Xenon monoanesthesia in healthy volunteers and xenon/remifentanil anesthesia in patients without clinically relevant cardiovascular disease do not increase QTc interval.

Long range lidar data processing for validating LES of wind turbine wakes

NASA Astrophysics Data System (ADS)

Trabucchi, D.; van Dooren, M.; Vollmer, L.; Schneemann, J.; Trujillo, J. J.; Witha, B.; Kühn, M.

2014-12-01

Scanning wind lidars offer the possibility to compare full-scale measurements in the wake of a wind turbine with LES wind fields calculated for the same test case. Due to the novelty and the peculiarity of lidar measurements, a comparison between experimental data and simulation results is non-trivial and several methods can be applied. This study presents validation methods for single and dual-doppler lidar measurements respectively.Consecutive azimuthal scans - commonly indicated as Plan Position Indicator (PPI) - at a low fixed elevation and centered on the wind turbine wake provide the radial wind speed, i.e. the wind component along the laser beam, on an almost flat polar grid. This data can be directly compared with the radial wind speed evaluated at the measurement point from the simulated wind field. This approach provides a detailed spatial description of the wind field and can be applied to averaged data for steady analysis. For the comparison with LES results, time average and spatial interpolation of the computed wind field are needed. Moreover, a proper wind direction should be chosen to evaluate the radial wind speed.With two lidars performing consecutive PPI scans over the same region from different places it is possible to estimate the horizontal wind field where the scanned regions overlap. Due to the limits in the synchronization of the PPI scans by the lidars, only steady analysis based on time averaged data can be done. A horizontal grid based on the one used for the LES is overlapped to the region covered by the two non-co-planar scans. The horizontal wind field at a considered point can be evaluated solving the system given by at least two non-aligned radial directions about this point. For each node, the data sampled by the lidars in a well defined volume during the considered time interval is used to write this system. Moreover, a discrete approximation of the continuity equation is applied to link the solutions for all the grid nodes. Instead of an interpolation on the LES wind field, this approach requires a temporal and vertical average over the considered time and height intervals.The application of these two approaches to lidar measurements performed in the offshore wind farm »alpha ventus« is presented in this work. The results are going to be used to evaluate different wind turbine wake models applied to LES.

The Effects of Spacing, Naps, and Fatigue on the Acquisition and Retention of Laparoscopic Skills.

PubMed

Spruit, Edward N; Band, Guido P H; van der Heijden, Kristiaan B; Hamming, Jaap F

Earlier research has shown that laparoscopic skills are trained more efficiently on a spaced schedule compared to a massed schedule. The aim of the study was to estimate to what extent the spacing interval, naps, and fatigue influenced the effectiveness of spacing laparoscopy training. Overall 4 groups of trainees (aged 17-41y; 72% female; N massed = 40; N break = 35; N break-nap = 37; N spaced = 37) without prior experience were trained in 3 laparoscopic tasks using a physical box trainer with different scheduling interventions. The first (massed) group received three 100-minute training sessions consecutively on a single day. The second (break) group received the sessions interrupted with two 45-minute breaks. The third (break-nap) group had the same schedule as the second group, but had two 35-minute powernap intervals during the breaks. The fourth (spaced) group had the 3 sessions on 3 consecutive days. A retention session was organized approximately 3 months after training. The results showed an overall pattern of superior performance at the end of training and at retention for the spaced group, followed by the break-nap, break, and massed group, respectively. The spaced and break-nap group significantly outperformed the break and massed group, with effect sizes ranging from 0.20 to 0.37. Spacing laparoscopic training over 3 consecutive days or weeks is superior to massed training, even if the massed training contains breaks. Breaks with sleep opportunity (i.e., lying, inactive, and muted sensory input) enhance performance over training with regular breaks and traditional massed training. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Genetic mapping of QTL for the sizes of eight consecutive leaves below the tassel in maize (Zea mays L.).

PubMed

Yang, Cong; Tang, Dengguo; Qu, Jingtao; Zhang, Ling; Zhang, Lei; Chen, Zhengjie; Liu, Jian

2016-11-01

A set of RIL population was used to detect QTL associated with the sizes of eight consecutive leaves, across different environments, and ten QTL clusters were identified as main QTLs. One of the important parameters of the maize leaf architecture that affects light penetration into the canopy, leaf size, has long attracted breeders' attention for optimizing the plant type of maize and for maximizing the grain yield (GY). In this study, we used 253 RIL lines derived from a cross between B73 and SICAU1212 to investigate the leaf widths (LWs), leaf lengths (LLs), and leaf areas (LAs) of eight consecutive leaves of maize below the tassel and GY across different environments and to identify quantitative traits loci (QTLs) controlling the above-mentioned traits, using inclusive interval mapping for single-environment analysis plus a mixed-model-based composite interval mapping for joint analysis. A total of 171 and 159 putative QTLs were detected through these two mapping methods, respectively. Single-environment mapping revealed that 39 stable QTLs explained more than 10 % of the phenotypic variance, and 35 of the 39 QTLs were also detected by joint analysis. In addition, joint analysis showed that nine of the 159 QTLs exhibited significant QTL × environment interaction and 15 significant epistatic interactions were identified. Approximately 47.17 % of the QTLs for leaf architectural traits in joint analysis were concentrated in ten main chromosomal regions, namely, bins 1.07, 2.02, 3.06, 4.09, 5.01, 5.02, 5.03-5.04, 5.07, 6.07, and 8.05. This study should provide a basis for further fine-mapping of these main genetic regions and improvement of maize leaf architecture.

Coordinated Control of Acoustical Field of View and Flight in Three-Dimensional Space for Consecutive Capture by Echolocating Bats during Natural Foraging.

PubMed

Sumiya, Miwa; Fujioka, Emyo; Motoi, Kazuya; Kondo, Masaru; Hiryu, Shizuko

2017-01-01

Echolocating bats prey upon small moving insects in the dark using sophisticated sonar techniques. The direction and directivity pattern of the ultrasound broadcast of these bats are important factors that affect their acoustical field of view, allowing us to investigate how the bats control their acoustic attention (pulse direction) for advanced flight maneuvers. The purpose of this study was to understand the behavioral strategies of acoustical sensing of wild Japanese house bats Pipistrellus abramus in three-dimensional (3D) space during consecutive capture flights. The results showed that when the bats successively captured multiple airborne insects in short time intervals (less than 1.5 s), they maintained not only the immediate prey but also the subsequent one simultaneously within the beam widths of the emitted pulses in both horizontal and vertical planes before capturing the immediate one. This suggests that echolocating bats maintain multiple prey within their acoustical field of view by a single sensing using a wide directional beam while approaching the immediate prey, instead of frequently shifting acoustic attention between multiple prey. We also numerically simulated the bats' flight trajectories when approaching two prey successively to investigate the relationship between the acoustical field of view and the prey direction for effective consecutive captures. This simulation demonstrated that acoustically viewing both the immediate and the subsequent prey simultaneously increases the success rate of capturing both prey, which is considered to be one of the basic axes of efficient route planning for consecutive capture flight. The bat's wide sonar beam can incidentally cover multiple prey while the bat forages in an area where the prey density is high. Our findings suggest that the bats then keep future targets within their acoustical field of view for effective foraging. In addition, in both the experimental results and the numerical simulations, the acoustic sensing and flights of the bats showed narrower vertical ranges than horizontal ranges. This suggests that the bats control their acoustic sensing according to different schemes in the horizontal and vertical planes according to their surroundings. These findings suggest that echolocating bats coordinate their control of the acoustical field of view and flight for consecutive captures in 3D space during natural foraging.

Coordinated Control of Acoustical Field of View and Flight in Three-Dimensional Space for Consecutive Capture by Echolocating Bats during Natural Foraging

PubMed Central

Sumiya, Miwa; Fujioka, Emyo; Motoi, Kazuya; Kondo, Masaru; Hiryu, Shizuko

2017-01-01

Echolocating bats prey upon small moving insects in the dark using sophisticated sonar techniques. The direction and directivity pattern of the ultrasound broadcast of these bats are important factors that affect their acoustical field of view, allowing us to investigate how the bats control their acoustic attention (pulse direction) for advanced flight maneuvers. The purpose of this study was to understand the behavioral strategies of acoustical sensing of wild Japanese house bats Pipistrellus abramus in three-dimensional (3D) space during consecutive capture flights. The results showed that when the bats successively captured multiple airborne insects in short time intervals (less than 1.5 s), they maintained not only the immediate prey but also the subsequent one simultaneously within the beam widths of the emitted pulses in both horizontal and vertical planes before capturing the immediate one. This suggests that echolocating bats maintain multiple prey within their acoustical field of view by a single sensing using a wide directional beam while approaching the immediate prey, instead of frequently shifting acoustic attention between multiple prey. We also numerically simulated the bats’ flight trajectories when approaching two prey successively to investigate the relationship between the acoustical field of view and the prey direction for effective consecutive captures. This simulation demonstrated that acoustically viewing both the immediate and the subsequent prey simultaneously increases the success rate of capturing both prey, which is considered to be one of the basic axes of efficient route planning for consecutive capture flight. The bat’s wide sonar beam can incidentally cover multiple prey while the bat forages in an area where the prey density is high. Our findings suggest that the bats then keep future targets within their acoustical field of view for effective foraging. In addition, in both the experimental results and the numerical simulations, the acoustic sensing and flights of the bats showed narrower vertical ranges than horizontal ranges. This suggests that the bats control their acoustic sensing according to different schemes in the horizontal and vertical planes according to their surroundings. These findings suggest that echolocating bats coordinate their control of the acoustical field of view and flight for consecutive captures in 3D space during natural foraging. PMID:28085936

Variability in circulating gas emboli after a same scuba diving exposure.

PubMed

Papadopoulou, V; Germonpré, P; Cosgrove, D; Eckersley, R J; Dayton, P A; Obeid, G; Boutros, A; Tang, M-X; Theunissen, S; Balestra, C

2018-06-01

A reduction in ambient pressure or decompression from scuba diving can result in ultrasound-detectable venous gas emboli (VGE). These environmental exposures carry a risk of decompression sickness (DCS) which is mitigated by adherence to decompression schedules; however, bubbles are routinely observed for dives well within these limits and significant inter-personal variability in DCS risk exists. Here, we assess the variability and evolution of VGE for 2 h post-dive using echocardiography, following a standardized pool dive in calm warm conditions. 14 divers performed either one or two (with a 24 h interval) standardized scuba dives to 33 mfw (400 kPa) for 20 min of immersion time at NEMO 33 in Brussels, Belgium. Measurements were performed at 21, 56, 91 and 126 min post-dive: bubbles were counted for all 68 echocardiography recordings and the average over ten consecutive cardiac cycles taken as the bubble score. Significant inter-personal variability was demonstrated despite all divers following the same protocol in controlled pool conditions: in the detection or not of VGE, in the peak VGE score, as well as time to VGE peak. In addition, intra-personal differences in 2/3 of the consecutive day dives were seen (lower VGE counts or faster clearance). Since VGE evolution post-dive varies between people, more work is clearly needed to isolate contributing factors. In this respect, going toward a more continuous evaluation, or developing new means to detect decompression stress markers, may offer the ability to better assess dynamic correlations to other physiological parameters.

The impact of consecutive freshwater trimix dives at altitude on human cardiovascular function.

PubMed

Lozo, Mislav; Madden, Dennis; Gunjaca, Grgo; Ljubkovic, Marko; Marinovic, Jasna; Dujic, Zeljko

2015-03-01

Self-contained underwater breathing apparatus (SCUBA) diving is regularly associated with numerous asymptomatic changes in cardiovascular function. Freshwater SCUBA diving presents unique challenges compared with open sea diving related to differences in water density and the potential for dive locations at altitude. The aim of this study was to evaluate the impact of freshwater trimix diving at altitude on human cardiovascular function. Ten divers performed two dives in consecutive days at 294 m altitude with the surface interval of 24 h. Both dives were at a depth of 45 m with total dive time 29 and 26 min for the first and second dive, respectively. Assessment of venous gas embolization, hydration status, cardiac function and arterial stiffness was performed. Production of venous gas emboli was low, and there were no significant differences between the dives. After the first dive, diastolic blood pressure was significantly reduced, which persisted up to 24 h. Left ventricular stroke volume decreased, and heart rate increased after both dives. Pulse wave velocity was unchanged following the dives. However, the central and peripheral augmentation index became more negative after both dives, indicating reduced wave reflection. Ejection duration and round trip travel time were prolonged 24 h after the first dive, suggesting longer-lasting suppression of cardiac and endothelial function. This study shows that freshwater trimix dives with conservative profiles and low venous gas bubble loads can result in multiple asymptomatic acute cardiovascular changes some of which were present up to 24 h after dive. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Free Interval Duration: Clinical Evidence of the Primary Role of Excitement in Bipolar Disorder.

PubMed

Sani, Gabriele; Simonetti, Alessio; Reginaldi, Daniela; Koukopoulos, Alexia E; Del Casale, Antonio; Manfredi, Giovanni; Kotzalidis, Georgios D; Girardi, Paolo

2017-04-01

Cyclicity is the essential feature of Bipolar disorder, but the effect of different cycle patterns on the clinical features is poorly understood. Moreover, no studies investigated the relationship between mania and depression inside the manic-depressive cycle. The aim of this study is to verify the presence of a relationship between the manic and the depressive phase during the course of bipolar disorder. 160 consecutive patients with BD type I were recruited and followed for a mean period of 10 years. During the follow-up period, four types of euthymic phases were collected: free intervals present between a depressive and a manic/hypomanic episode (D-M); free intervals present between a manic/hypomanic and a depressive episode (M-D); free intervals present between two depressive episodes (D-D); free intervals present between two manic/hypomanic episodes (M-M). One-way ANOVA using the groups as independent variable and the duration of the free intervals as dependent variables was used. Furthermore, ANOVA was followed by Fisher's Protected Least Significant Difference post-hoc test to measure between-group differences. M-D-free interval phases were shorter than D-M-free intervals. M-D intervals were the shortest ones, the D-D and D-M did not differ, and the M-M were the longest. The strict temporal link between manic and depressive phases supports the idea that the manic-depressive cycle usually begins with a manic episode, and that the subsequent depression is often the consequence of subsiding mania.

Implications of the Index Cholecystectomy and Timing of Referral for Radical Resection of Advanced Incidental Gallbladder Cancer

PubMed Central

Ausania, F; White, SA; French, JJ; Jaques, BC; Charnley, RM; Manas, DM

2015-01-01

Introduction Advanced (pT2/T3) incidental gallbladder cancer is often deemed unresectable after restaging. This study assesses the impact of the primary operation, tumour characteristics and timing of management on re-resection. Methods The records of 60 consecutive referrals for incidental gallbladder cancer in a single tertiary centre from 2003 to 2011 were reviewed retrospectively. Decision on re-resection of incidental gallbladder cancer was based on delayed interval restaging at three months following cholecystectomy. Demographics, index cholecystectomy data, primary pathology, CA19–9 tumour marker levels at referral and time from cholecystectomy to referral as well as from referral to restaging were analysed. Results Thirty-seven patients with pT2 and twelve patients with pT3 incidental gallbladder cancer were candidates for radical re-resection. Following interval restaging, 24 patients (49%) underwent radical resection and 25 (51%) were deemed inoperable. The inoperable group had significantly more patients with positive resection margins at cholecystectomy (p=0.002), significantly higher median CA19–9 levels at referral (p=0.018) and were referred significantly earlier (p=0.004) than the patients who had resectable tumours. On multivariate analysis, urgent referral (p=0.036) and incomplete cholecystectomy (p=0.048) were associated significantly with inoperable disease following restaging. Conclusions In patients with incidental, potentially resectable, pT2/T3 gallbladder cancer, inappropriate index cholecystectomy may have a significant impact on tumour dissemination. Early referral of breached tumours is not associated with resectability. PMID:25723690

Association between delay to coronary reperfusion and outcome in patients with acute coronary syndrome undergoing extracorporeal cardiopulmonary resuscitation.

PubMed

Kuroki, Norihiro; Abe, Daisuke; Iwama, Toru; Suzuki, Kou; Sugiyama, Kazuhiro; Akashi, Akiko; Hamabe, Yuichi; Aonuma, Kazutaka; Sato, Akira

2017-05-01

The prognostic effect of early coronary reperfusion therapy with extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest due to acute coronary syndrome (ACS) has yet to be clarified. We investigated the relationship between time interval from collapse to start of ECPR (CtoE) and coronary reperfusion (CtoR) time and neurological outcome in patients with cardiac arrest due to ACS. A cohort of 119 consecutive patients (63±12 years old) with ACS who underwent ECPR and percutaneous coronary intervention(PCI) at our hospital was registered from January 2005 to June 2016. We analyzed patient clinical outcome, which was defined as survival with good neurological outcome at 30 days. We divided the patients into four groups according to CtoR time: Group 1 (time<60min: n=19), Group 2 (60≤time<90min: n=19), Group 3 (time≥90min: n=70) and Group 4 (unsuccessful coronary reperfusion: n=11). One hundred patients (84%) were successful of PCI. A Kaplan-Meier curve showed that Group 1 had the best outcome among the four groups (good neurological outcome at 30 days; 74% vs 37% vs 23% vs 9%, P<0.0001). In receiver operating characteristics analysis for good neurological outcome at 30 days, the cutoff values for CtoE was 40min. The delay CtoE and CtoR time were independent predictors of poor neurological outcome at 30 days after adjusting multiple confounders (CtoE time; Hazard ratio (HR):1.026, 95% confidential intervals(CI): 1.011-1.042, P=0.001), (CtoR time; HR: 1.004, 95% CI: 1.001-1.008, P=0.020). A shorter CtoE and CtoR predicts better clinical outcome in patients with ACS undergoing ECPR. Copyright © 2017 Elsevier B.V. All rights reserved.

Mobile phone technology identifies and recruits trained citizens to perform CPR on out-of-hospital cardiac arrest victims prior to ambulance arrival.

PubMed

Ringh, Mattias; Fredman, David; Nordberg, Per; Stark, Tomas; Hollenberg, Jacob

2011-12-01

In a two-parted study, evaluate a new concept were mobile phone technology is used to dispatch lay responders to nearby out-of-hospital cardiac arrests (OHCAs). Mobile phone positioning systems (MPS) can geographically locate selected mobile phone users at any given moment. A mobile phone service using MPS was developed and named Mobile Life Saver (MLS). Simulation study: 25 volunteers named mobile responders (MRs) were connected to MLS. Ambulance time intervals from 22 consecutive OHCAs in 2005 were used as controls. The MRs randomly moved in Stockholm city centre and were dispatched to simulated OHCAs (identical to controls) if they were within a 350 m distance. Real life study: during 25 weeks 1271-1801 MRs trained in CPR were connected to MLS. MLS was activated at the dispatch centre in parallel with ambulance dispatch when an OHCA was suspected. The MRs were dispatched if they were within 500 m from the suspected OHCA. Simulation study: mean response time for the MRs compared to historical ambulance time intervals was reduced by 2 min 20s (44%), p<0.001, (95% CI, 1 min 5s - 3 min 35s). The MRs reached the simulated OHCA prior to the historical control in 72% of cases. Real life study: the MLS was triggered 92 times. In 45% of all suspected and in 56% of all true OHCAs the MRs arrived prior to ambulance. CPR was performed by MRs in 17% of all true OHCAs and in 30% of all true OHCAs if MRs arrived prior to ambulance. Mobile phone technology can be used to identify and recruit nearby CPR-trained citizens to OHCAs for bystander CPR prior to ambulance arrival. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Evaluation of Patients with Facial Palsy and Ophthalmic Sequelae: A 23-Year Retrospective Review.

PubMed

Joseph, Shannon S; Joseph, Andrew W; Smith, Jane I; Niziol, Leslie M; Musch, David C; Nelson, Christine C

2017-10-01

Facial palsy (FP) can result in serious ophthalmic sequelae including loss of vision. We describe the clinical characteristics of FP patients presenting for ophthalmologic evaluation and the timing for initiating ophthalmologic care. We performed a retrospective review of 96 consecutive FP patients presenting between 1992 and 2015 at a tertiary eye center. The main outcome measures were time interval from the diagnosis of FP and onset of ocular symptoms to the initial ophthalmologic evaluation (IOE), and the severity of exposure keratopathy and eyelid malposition on IOE. The median time interval from the diagnosis of FP to the IOE was 1.6 years (interquartile range; IQR = 0.5-9.2), and from the onset of ocular symptoms to IOE was 0.8 years (IQR = 0.3-2.3). The most common ocular symptoms were dryness (47.9%; n = 46), irritation (39.6%; n = 38), and tearing (30.2%; n = 29). A total of 26.0% (n = 25) of patients were bothered by the appearance of their eyes. Only 13.5% (n = 13) noted change in vision. On IOE, 81.6% (n = 75) of patients had punctate epithelial erosions (PEE), of which 52.3% (n = 35) had moderate to severe PEE, 3.3% (n = 3) had corneal ulcers and 2.2% (n = 2) had corneal abrasions. The average margin-reflex distance 2 was 6.4 mm (SD = 2.4) with average lagophthalmos of 3.5 mm (SD = 3.1). Among FP patients presenting for ophthalmologic evaluation, exposure keratopathy (as evidenced by PEE and corneal ulcers/abrasions) is highly prevalent and moderately severe on IOE, despite only 13.5% of patients noting decreased vision. These findings underscore the importance of timely and thorough ophthalmologic evaluation of FP patients.

Random local temporal structure of category fluency responses.

PubMed

Meyer, David J; Messer, Jason; Singh, Tanya; Thomas, Peter J; Woyczynski, Wojbor A; Kaye, Jeffrey; Lerner, Alan J

2012-04-01

The Category Fluency Test (CFT) provides a sensitive measurement of cognitive capabilities in humans related to retrieval from semantic memory. In particular, it is widely used to assess progress of cognitive impairment in patients with dementia. Previous research shows that, in the first approximation, the intensity of tested individuals' responses within a standard 60-s test period decays exponentially with time, with faster decay rates for more cognitively impaired patients. Such decay rate can then be viewed as a global (macro) diagnostic parameter of each test. In the present paper we focus on the statistical properties of the properly de-trended time intervals between consecutive responses (inter-call times) in the Category Fluency Test. In a sense, those properties reflect the local (micro) structure of the response generation process. We find that a good approximation for the distribution of the de-trended inter-call times is provided by the Weibull Distribution, a probability distribution that appears naturally in this context as a distribution of a minimum of independent random quantities and is the standard tool in industrial reliability theory. This insight leads us to a new interpretation of the concept of "navigating a semantic space" via patient responses.

Short-Lasting Episodes of Torsade de Pointes in the Chronic Atrioventricular Block Dog Model Have a Focal Mechanism, While Longer-Lasting Episodes Are Maintained by Re-Entry.

PubMed

Vandersickel, Nele; Bossu, Alexandre; De Neve, Jan; Dunnink, Albert; Meijborg, Veronique M F; van der Heyden, Marcel A G; Beekman, Jet D M; De Bakker, Jacques M T; Vos, Marc A; Panfilov, Alexander V

2017-12-26

This study investigated the arrhythmogenic mechanisms responsible for torsade de pointes (TdP) in the chronic atrioventricular block dog model, known for its high susceptibility for TdP. The mechanism of TdP arrhythmias has been under debate for many years. Focal activity as well as re-entry have both been mentioned in the initiation and the perpetuation of TdP. In 5 TdP-sensitive chronic atrioventricular block dogs, 56 needle electrodes were evenly distributed transmurally to record 240 unipolar local electrograms simultaneously. Nonterminating (NT) episodes were defibrillated after 10 s. Software was developed to automatically detect activation times and to create 3-dimensional visualizations of the arrhythmia. For each episode of ectopic activity (ranging from 2 beats to NT episodes), a novel methodology was created to construct directed graphs of the wave propagation and detect re-entry loops by using an iterative depth-first-search algorithm. Depending on the TdP definition (number of consecutive ectopic beats), we analyzed 29 to 54 TdP: 29 were longer than 5 beats. In the total group, 9 were NT and 45 were self-terminating. Initiation and termination were always based on focal activity. Re-entry becomes more important in the longer-lasting episodes (>14 beats), whereas in all NT TdP, re-entry was the last active mechanism. During re-entry, excitation fronts were constantly present in the heart, while during focal TdP, there was always a silent interval between 2 consecutive waves (142 ms) during which excitation fronts were absent. Interbeat intervals were significantly smaller for re-entry episodes-220 versus 310 ms in focal. Electrograms recorded in particular areas during NT TdP episodes had significantly smaller amplitude (0.38) than during focal episodes (0.59). TdP can be driven by focal activity as well as by re-entry depending on the duration of the episode. NT episodes are always maintained by re-entry, which can be identified in local unipolar electrograms by shorter interbeat intervals and smaller deflection amplitude. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Association between gestational age and induction-to-abortion interval in mid-trimester pregnancy termination using misoprostol.

PubMed

Vitner, Dana; Deutsch, Michael; Paz, Yuri; Khatib, Nizar; Baltiter, Tania; Rosenberg, Shiran; Lowenstein, Lior

2011-06-01

The study was aimed to evaluate the effectiveness, outcome, and pain intensity of the vaginal administration of misoprostol for the induction of abortion between 13 and 24 gestational weeks. A retrospective study was conducted at our tertiary medical center from January 2006 to December 2009 on 122 consecutive women who underwent termination of pregnancy (TOP) in the mid-trimester. They were given 400 mcg of vaginal misoprostol every 6h, up to four doses. The induction-to-abortion interval and the level of pain experienced during the process were assessed. Success was defined by the fetus being expelled within 48 h. Vaginal misoprostol was effective in 84% (98/122) of patients. The median duration of the induction-to-abortion interval was 16 (5-48)h. The induction-to-abortion interval was correlated with gestational age, while inversely correlated with parity. A correlation was also found between gestational age and pain intensity at 12h from induction. Misoprostol is safe and effective in mid-trimester abortion induction. The induction-to-abortion interval is shorter and abortion less painful with lower gestational age. Higher parity is also associated with shorter induction to abortion interval. Copyright © 2011. Published by Elsevier Ireland Ltd.

[Mammographic screening. An analysis of the characteristics of interval carcinomas observed in the program in the province of Firenze (1989-1991)].

PubMed

Ciatto, S; Rosselli del Turco, M; Bonardi, R; Bianchi, S

1994-04-01

The authors evaluated 30 interval cancers consecutively observed from 1989 to 1991 and compared them to 98 screening-detected cancers observed in the same period. Interval cancers have a more advanced stage (stage I = 13 lesions, stage II + = 17 lesions) with respect to screening-detected cancers (stage 0 = 10 lesions, stage I = 61 lesions, stage II + = 27 lesions). This finding seems unrelated to an intrinsically higher aggressivity of interval cancers (length biased sampling) which do not differ significantly from screening-detected cancers as far as histopathologic characteristics of prognostic value are concerned. Diagnostic delay due to technical or reading error (9 cases), to radiologically occult cancer in clear (10 cases) or dense parenchymal areas (11 cases) is most likely. This seems to be confirmed by the low frequency observed among interval cancers of easily visible lesions such as isolated microcalcifications (3% vs. 35%) or stellate opacities (13% vs. 31%), and by the higher frequency of opacities with irregular margins (57% vs. 26%) which are more likely masked by dense parenchyma. The chances of reducing interval cancer rate by attempting to increase sensitivity or by increasing screening frequency are discussed, as well as the possible negative consequences of such protocols in terms of cost-effectiveness.

The Effect of Information Feedback Upon Psychophysical Judgments

NASA Technical Reports Server (NTRS)

Atkinson, Richard C.; Carterette, Edward C.; Kinchla, Ronald A.

1964-01-01

An analysis was made of the role of presentation schedules and information feedback on performance in a forced-choice signal detection task. The experimental results indicate that information feedback facilitates performance, but only for certain presentation schedules. The present study was designed to assess performance in a signal detection task under two conditions of information feedback. In the I-condition, S was told on each trial whether his detection response was correct or incorrect; in the !-condition S was given no feedback regarding the correctness of his response. The task involved a 2-response, forced-choice auditory detection problem. On each trial 2 temporal intervals were defined and S was required to report which interval he believed contained the signal; i. e., in one interval a tone burst in a background of white noise was presented, while the other interval contained only white noise. A trial will be denoted as s1 or s2, depending on whether the signal was embedded in the 1st or 2nd interval; the S's response will be denoted A1 or A2 to indicate which interval he reported contained the signal. The probability of an s1 trial will be denoted as y. In this study two values of y were used (.50 and.75) and, as indicated above, two conditions of information feedback. Thus there were 4 experimental conditions (501, · 50I, 751, 75I); each S was run under all 4 conditions. Method Gaussian noise was presented binaurally in S's headphones throughout a test session and the signal was a 1000-cps sinusoid tone; the tone was presented for 100 msec. including equal fall and rise times of 20 msec. The ratio of signal energy to noise power in a unit bandwidth was 2.9, and was constant throughout the study. The. S was seated before a stimulus display board. On each trial a red warning light was flashed for 100 msec. Two amber lights then came on successively each for 1 sec.; these lights defined the 2 observation intervals. The onset of the signal occurred 500 msec. after the onset of one of the observation intervals. After the second amber light went off, S indicated his response by pressing 1 of 2 wand switches under cards reading "1st interval" and "2nd interval." For the !-condition a green light flashed on above the correct response key after S's response; the green light was omitted in the !-condition. Each trial lasted 6 sec. The S's were 12 male college students with normal hearing. They were run for two practice sessions followed by 20 test sessions. Test sessions were run on consecutive days, 350 trials/day. Each day S ran on 1 of the 4 experimental conditions; in successive 4-day blocks S ran one day on each of the 4 experimental conditions in a random order. Thus, over 20 days each of the experimental conditions was repeated 5 times.

Evaluating the utility of hexapod species for calculating a confidence interval about a succession based postmortem interval estimate.

PubMed

Perez, Anne E; Haskell, Neal H; Wells, Jeffrey D

2014-08-01

Carrion insect succession patterns have long been used to estimate the postmortem interval (PMI) during a death investigation. However, no published carrion succession study included sufficient replication to calculate a confidence interval about a PMI estimate based on occurrence data. We exposed 53 pig carcasses (16±2.5 kg), near the likely minimum needed for such statistical analysis, at a site in north-central Indiana, USA, over three consecutive summer seasons. Insects and Collembola were sampled daily from each carcass for a total of 14 days, by this time each was skeletonized. The criteria for judging a life stage of a given species to be potentially useful for succession-based PMI estimation were (1) nonreoccurrence (observed during a single period of presence on a corpse), and (2) found in a sufficiently large proportion of carcasses to support a PMI confidence interval. For this data set that proportion threshold is 45/53. Of the 266 species collected and identified, none was nonreoccuring in that each showed at least a gap of one day on a single carcass. If the definition of nonreoccurrence is relaxed to include such a single one-day gap the larval forms of Necrophilaamericana, Fanniascalaris, Cochliomyia macellaria, Phormiaregina, and Luciliaillustris satisfied these two criteria. Adults of Creophilus maxillosus, Necrobiaruficollis, and Necrodessurinamensis were common and showed only a few, single-day gaps in occurrence. C.maxillosus, P.regina, and L.illustris displayed exceptional forensic utility in that they were observed on every carcass. Although these observations were made at a single site during one season of the year, the species we found to be useful have large geographic ranges. We suggest that future carrion insect succession research focus only on a limited set of species with high potential forensic utility so as to reduce sample effort per carcass and thereby enable increased experimental replication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The relationship between quality of sleep and night shift rotation interval.

PubMed

Kim, Jae Youn; Chae, Chang Ho; Kim, Young Ouk; Son, Jun Seok; Kim, Ja Hyun; Kim, Chan Woo; Park, Hyoung Ouk; Lee, Jun Ho; Kwon, Soon Il; Kwon, Sun Il

2015-01-01

Shift work is closely related with workers' health. In particular, sleep is thought to be affected by shift work. In addition, shift work has been reported to be associated with the type or direction of shift rotation, number of consecutive night shifts, and number of off-duty days. We aimed to analyze the association between the night shift rotation interval and the quality of sleep reported by Korean female shift workers. In total, 2,818 female shift workers from the manufacturing industry who received an employee physical examination at a single university hospital from January to August in 2014 were included. Subjects were classified into three groups (A, B, and C) by their night shift rotation interval. The quality of sleep was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI). Descriptive analysis, univariate logistic regression, and multivariate logistic regression were performed. With group A as the reference, the odds ratio (OR) for having a seriously low quality of sleep was 1.456 (95% CI 1.171-1.811) and 2.348 (95% CI 1.852-2.977) for groups B and C, respectively. Thus, group C with the shortest night shift rotation interval was most likely to have a low quality of sleep. After adjustment for age, obesity, smoking status, alcohol consumption, exercise, being allowed to sleep during night shifts, work experience, and shift work experience, groups B and C had ORs of 1.419 (95% CI 1.134-1.777) and 2.238 (95% CI 1.737-2.882), respectively, compared to group A. Our data suggest that a shorter night shift rotation interval does not provide enough recovery time to adjust the circadian rhythm, resulting in a low quality of sleep. Because shift work is influenced by many different factors, future studies should aim to determine the most optimal shift work model and collect accurate, prospective data.

Complication-related removal of totally implantable venous access port systems: Does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients.

PubMed

Kakkos, A; Bresson, L; Hudry, D; Cousin, S; Lervat, C; Bogart, E; Meurant, J P; El Bedoui, S; Decanter, G; Hannebicque, K; Regis, C; Hamdani, A; Penel, N; Tresch-Bruneel, E; Narducci, F

2017-04-01

Totally implantable venous access port systems are widely used in oncology, with frequent complications that sometimes necessitate device removal. The aim of this study is to investigate the impact of the time interval between port placement and initiation of chemotherapy and the neutropenia-inducing potential of the chemotherapy administered upon complication-related port removal. Between January 2010 and December 2013, 4045 consecutive patients were included in this observational, single-center prospective study. The chemotherapy regimens were classified as having a low (<10%), intermediate (10-20%), or high (>20%) risk for inducing neutropenia. The overall removal rate due to complications was 7.2%. Among them, port-related infection (2.5%) and port expulsion (1%) were the most frequent. The interval between port insertion and its first use was shown to be a predictive factor for complication-related removal rates. A cut-off of 6 days was statistically significant (p = 0.008), as the removal rate for complications was 9.4% when this interval was 0-5 days and 5.7% when it was ≥6 days. Another factor associated with port complication rate was the neutropenia-inducing potential of the chemotherapy regimens used, with removal for complications involved in 5.5% of low-risk regimens versus 9.4% for the intermediate- and high-risk regimens (p = 0.003). An interval of 6 days between placement and first use of the port reduces the removal rate from complications. The intermediate- and high-risk for neutropenia chemotherapy regimens are related to higher port removal rates from complications than low-risk regimens. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

An institutional study of time delays for symptomatic carotid endarterectomy.

PubMed

Charbonneau, Philippe; Bonaventure, Paule Lessard; Drudi, Laura M; Beaudoin, Nathalie; Blair, Jean-François; Elkouri, Stéphane

2016-12-01

The aim of this study was to assess time delays between first cerebrovascular symptoms and carotid endarterectomy (CEA) at a single center and to systematically evaluate causes of these delays. Consecutive adult patients who underwent CEAs between January 2010 and September 2011 at a single university-affiliated center (Centre Hospitalier de l'Université Montréal-Hôtel-Dieu Hospital, Montreal) were identified from a clinical database and operative records. Covariates of interest were extracted from electronic medical records. Timing and nature of the first cerebrovascular symptoms were also documented. The first medical contact and pathway of referral were also assessed. When possible, the ABCD 2 score (age, blood pressure, clinical features, duration of symptoms, and diabetes) was calculated to calculate further risk of stroke. The nonparametric Wilcoxon test was used to assess differences in time intervals between two variables. The Kruskal-Wallis test was used to assess differences in time intervals in comparing more than two variables. A multivariate linear regression analysis was performed using covariates that were determined to be statistically significant in our sensitivity analyses. The cohort consisted of 111 patients with documented symptomatic carotid stenosis undergoing surgical intervention. Thirty-nine percent of all patients were operated on within 2 weeks from the first cerebrovascular symptoms. The median time between the occurrence of the first neurologic symptom and the CEA procedure was 25 (interquartile range [IQR], 11-85) days. The patient-dependent delay, defined as the median delay between the first neurologic symptom and the first medical contact, was 1 (IQR, 0-14) day. The medical-dependent delay was defined as the time interval between the first medical contact and CEA. This included the delay between the first medical contact and the request for surgery consultation (median, 3 [IQR, 1-10] days). The multivariate regression model demonstrated that the emergency physician as referral source (P = .0002) was statistically significant for reducing CEA delay. Patients who were investigated as an outpatient (P = .02), first medical contact with a general practitioner (P = .0002), and hospital center I as referral center (P = .045) were also found to be statistically significant to extend CEA delay when the model was adjusted over all covariates. In this center, there was no correlation between ABCD 2 risk score and waiting time for surgery. The majority of our cohort falls short of the recommended 2-week interval to perform CEA. Factors contributing to reduced CEA delay were presentation to an emergency department, in-patient investigations, and a stroke center where a vascular surgeon is available. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Efficacy and immunogenicity of two or three dose rotavirus-vaccine regimen in South African children over two consecutive rotavirus-seasons: a randomized, double-blind, placebo-controlled trial.

PubMed

Madhi, S A; Kirsten, M; Louw, C; Bos, P; Aspinall, S; Bouckenooghe, A; Neuzil, K M; Steele, A D

2012-04-27

Human rotavirus vaccine (HRV; i.e., Rotarix) reduced the incidence of severe rotavirus gastroenteritis (RVGE) by 77% (95% Confidence interval: 56-88%) during the first year of life in South Africa. Persistence of HRV-derived protection against RVGE during subsequent rotavirus seasons, although evident in industrialized settings, remains to be established in African settings. This study reports on the efficacy of HRV against severe RVGE over two consecutive rotavirus seasons in South African children. A prospective, double-blind, placebo controlled multi-centered trial in South Africa and Malawi randomly assigned infants in a 1:1:1 ratio to receive either two (10 and 14 weeks; HRV_2D) or three (6, 10 and 14 weeks; HRV_3D) doses of HRV or placebo. The primary analysis involved pooling of HRV_2D and HRV_3D arms. Episodes of gastroenteritis caused by wild-type rotavirus were identified through active follow-up surveillance and graded by the Vesikari scale. 1339 infants (447 in the HRV_2D group, 447 in the HRV_3D group and 445 in the placebo group) were enrolled in Year 2 of the study, including 1035 (77.3%) who were followed up over two consecutive rotavirus seasons (i.e., Cohort 2 subjects). Rotarix was associated with ongoing protection against severe RVGE, preventing 2.5 episodes per 100 vaccinated children over two consecutive rotavirus seasons; vaccine efficacy: 59% (95% Confidence interval: 1-83%). An exploratory analysis indicated better immunogenicity (among Cohort 1 subjects) and a higher point-efficacy estimate over two seasons in the HRV_3D compared to HRV_2D arms of the study in Cohort 2 subjects. Rotarix is associated with significant reductions in severe gastroenteritis episodes through 2 years of life among South African children. Further research is needed to determine the optimal dosing schedule of Rotarix in providing long-term protection against rotavirus illness in African children. Copyright © 2011 Elsevier Ltd. All rights reserved.

Primary percutaneous coronary intervention for patients presenting with ST-segment elevation myocardial infarction: process improvement in a rural ST-segment elevation myocardial infarction receiving center.

PubMed

Niles, Nathaniel W; Conley, Sheila M; Yang, Rayson C; Vanichakarn, Pantila; Anderson, Tamara A; Butterly, John R; Robb, John F; Jayne, John E; Yanofsky, Norman N; Proehl, Jean A; Guadagni, Donald F; Brown, Jeremiah R

2010-01-01

Rural ST-segment elevation myocardial infarction (STEMI) care networks may be particularly disadvantaged in achieving a door-to-balloon time (D2B) of less than or equal to 90 minutes recommended in current guidelines. ST-ELEVATION MYOCARDIAL INFARCTION PROCESS UPGRADE PROJECT: A multidisciplinary STEMI process upgrade group at a rural percutaneous coronary intervention center implemented evidence-based strategies to reduce time to electrocardiogram (ECG) and D2B, including catheterization laboratory activation triggered by either a prehospital ECG demonstrating STEMI or an emergency department physician diagnosing STEMI, single-call catheterization laboratory activation, catheterization laboratory response time less than or equal to 30 minutes, and prompt data feedback. An ongoing regional STEMI registry was used to collect process time intervals, including time to ECG and D2B, in a consecutive series of STEMI patients presenting before (group 1) and after (group 2) strategy implementation. Significant reductions in time to first ECG in the emergency department and D2B were seen in group 2 compared with group 1. Important improvement in the process of acute STEMI patient care was accomplished in the rural percutaneous coronary intervention center setting by implementing evidence-based strategies. Copyright © 2010 Elsevier Inc. All rights reserved.

Estimating the Seasonal Importance of Precipitation to Plant Source Water over Time and Space with Water Isotopes

NASA Astrophysics Data System (ADS)

Nelson, D. B.; Kahmen, A.

2017-12-01

The stable isotopic composition of hydrogen and oxygen are physical properties of water molecules that can carry information on their sources or transport histories. This provides a useful tool for assessing the importance of rainfall at different times of the year for plant growth, provided that rainwater values vary over time and that waters do not partially evaporate after deposition. We tested the viability of this approach using data from samples collected at nineteen sites throughout Europe at monthly intervals over two consecutive growing seasons in 2014 and 2015. We compared isotope measurements of plant xylem water with soil water from multiple depths, and measured and modeled precipitation isotope values. Paired analyses of oxygen and hydrogen isotope values were used to screen out a limited number of water samples that were influenced by evaporation, with the majority of all water samples indicating meteoric sources. The isotopic composition of soil and xylem waters varied over the course of an individual growing season, with many trending towards more enriched values, suggesting integration of the plant-relevant water pool at a timescale shorter than the annual mean. We then quantified how soil water residence times varied at each site by calculating the interval between measured xylem water and the most recently preceding match in modeled precipitation isotope values. Results suggest a generally increasing interval between rainfall and plant uptake throughout each year, with source water corresponding to dates in the spring, likely reflecting a combination of spring rain, and mixing with winter and summer precipitation. The seasonally evolving spatial distribution of source water-precipitation lag values was then modeled as a function of location and climatology to develop continental-scale predictions. This spatial portrait of the average date for filling the plant source water pool provides insights on the seasonal importance of rainfall for plant growth. It also permits continental scale predictions of monthly plant source water isotope values, with applications to improving isotopic paleoclimate proxies from plants such as tree rings or sedimentary leaf waxes, and for using oxygen and hydrogen isotopes to track the origins of agricultural products.

Assessment of cryopreserved donor skin viability: the experience of the regional tissue bank of Siena.

PubMed

Pianigiani, E; Tognetti, L; Ierardi, F; Mariotti, G; Rubegni, P; Cevenini, G; Perotti, R; Fimiani, M

2016-06-01

Skin allografts from cadaver donors are an important resource for treating extensive burns, slow-healing wounds and chronic ulcers. A high level of cell viability of cryopreserved allografts is often required, especially in burn surgery, in Italy. Thus, we aimed to determine which conditions enable procurement of highly viable skin in our Regional Skin Bank of Siena. For this purpose, we assessed cell viability of cryopreserved skin allografts procured between 2011 and 2013 from 127 consecutive skin donors, before and after freezing (at day 15, 180, and 365). For each skin donor, we collected data concerning clinical history (age, sex, smoking, phototype, dyslipidemia, diabetes, cause of death), donation process (multi-tissue or multi-organ) and timing of skin procurement (assessment of intervals such as death-harvesting, harvesting-banking, death-banking). All these variables were analysed in the whole case study (127 donors) and in different groups (e.g. multi-organ donors, non refrigerated multi-tissue donors, refrigerated multi-tissue donors) for correlations with cell viability. Our results indicated that cryopreserved skin allografts with higher cell viability were obtained from female, non smoker, heartbeating donors died of cerebral haemorrhage, and were harvested within 2 h of aortic clamping and banked within 12 h of harvesting (13-14 h from clamping). Age, cause of death and dyslipidaemia or diabetes did not appear to influence cell viability. To maintain acceptable cell viability, our skin bank needs to reduce the time interval between harvesting and banking, especially for refrigerated donors.

Analysis of Changes of Cardiological Parameters at Middle Latitude Region in Relation to Geomagnetic Disturbances and Cosmic Ray Variations

NASA Astrophysics Data System (ADS)

Papailiou, M.; Dimitrova, S.; Babayev, E. S.; Mavromichalaki, H.

2010-01-01

Collaborating scientific groups from Athens (Greece), Baku (Azerbaijan) and Sofia (Bulgaria) have conducted a research work on the possible effects of geomagnetic field disturbances (GMF) and cosmic ray intensity (CRI) variations on human homeostasis, particularly, the cardio-health state. Electrocardiograms (ECGs) of seven functionally healthy persons were digitally registered at the joint Laboratory of Heliobiology located in the Medical Centre INAM, Baku, on working days and Saturdays. Heart rate values, estimated from ECGs, were analysed in relation to daily values of CRI, as measured by the Neutron Monitor of the University of Athens and daily variations of Dst and Ap geomagnetic indices and some significant results had been revealed in previous studies. Researches were continued by study of additional cardiologic parameters estimated from the same ECG data. In this study digital data of RR interval (the time elapsing between two consecutive R waves in the ECG), namely RRminimum, RRmaximum and RRaverage were analyzed taking into consideration different levels of GMF disturbances (estimated through variations of Dst and Ap indices) and cosmic ray activity (through CRI variations). The data refer to the time period 15 July 2006-31 March 2008. Variations of RR intervals show connection to GMF disturbances and CRI variations. The revealed effects are more pronounced for high levels of geomagnetic activity (when geomagnetic storms occur) and large CRI decreases as well as on the days before and after these variations.

Factors associated with timing of early neurological improvement after thrombolysis for ischaemic stroke.

PubMed

Guettier, S; Cogez, J; Bonnet, A-L; Dean, P; Apoil, M; Tchoumi, T; Dubuc, L; Arzur, J; de la Sayette, V; Kouassi, L-K; Viader, F; Touzé, E

2016-03-01

Early neurological improvement (ENI) after fibrinolysis for ischaemic stroke is strongly associated with recanalization and favourable outcome. However, it remains unknown why some patients recover within the first hour after treatment (very ENI, VENI) whereas others recover later within 24 h. The factors associated with the timing of ENI were assessed. Consecutive stroke patients treated with intravenous recombinant tissue plasminogen activator (rt-PA) within 4.5 h after onset in four stroke centres of our geographical area were retrospectively studied. VENI assessed at 1 h and ENI assessed at 24 h post-treatment were defined by National Institutes of Health Stroke Scale (NIHSS) improvement by 40% from baseline. Of 421 patients, 65 (15%) had VENI and 110 (26%) had ENI. Patients with VENI had significantly lower serum creatinine level than patients with ENI (79 ± 19 vs. 91 ± 35 μmol/l; P = 0.01). After adjustment for age, sex, baseline NIHSS, hypertension and blood glucose level, patients with low serum creatinine level were more likely to have VENI (lowest tertile, odds ratio 3.8, 95% confidence interval 1.5-9.7; intermediate tertile, odds ratio 1.8, 95% confidence interval 0.8-4.3; P for trend <0.01). VENI patients were as likely as ENI patients to have a modified Rankin scale score ≤2 at 3 months. Low serum creatinine levels are associated with VENI, suggesting that swiftness of the efficacy of rt-PA or of neurological recovery may depend on renal function. © 2016 EAN.

The Incremental Effects of Manual Therapy or Booster Sessions in Addition to Exercise Therapy for Knee Osteoarthritis: A Randomized Clinical Trial.

PubMed

Abbott, J Haxby; Chapple, Catherine M; Fitzgerald, G Kelley; Fritz, Julie M; Childs, John D; Harcombe, Helen; Stout, Kirsten

2015-12-01

A factorial randomized controlled trial. To investigate the addition of manual therapy to exercise therapy for the reduction of pain and increase of physical function in people with knee osteoarthritis (OA), and whether "booster sessions" compared to consecutive sessions may improve outcomes. The benefits of providing manual therapy in addition to exercise therapy, or of distributing treatment sessions over time using periodic booster sessions, in people with knee OA are not well established. All participants had knee OA and were provided 12 sessions of multimodal exercise therapy supervised by a physical therapist. Participants were randomly allocated to 1 of 4 groups: exercise therapy in consecutive sessions, exercise therapy distributed over a year using booster sessions, exercise therapy plus manual therapy without booster sessions, and exercise therapy plus manual therapy with booster sessions. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score; 0-240 scale) at 1-year follow-up. Secondary outcome measures were the numeric pain-rating scale and physical performance tests. Of 75 participants recruited, 66 (88%) were retained at 1-year follow-up. Factorial analysis of covariance of the main effects showed significant benefit from booster sessions (P = .009) and manual therapy (P = .023) over exercise therapy alone. Group analysis showed that exercise therapy with booster sessions (WOMAC score, -46.0 points; 95% confidence interval [CI]: -80.0, -12.0) and exercise therapy plus manual therapy (WOMAC score, -37.5 points; 95% CI: -69.7, -5.5) had superior effects compared with exercise therapy alone. The combined strategy of exercise therapy plus manual therapy with booster sessions was not superior to exercise therapy alone. Distributing 12 sessions of exercise therapy over a year in the form of booster sessions was more effective than providing 12 consecutive exercise therapy sessions. Providing manual therapy in addition to exercise therapy improved treatment effectiveness compared to providing 12 consecutive exercise therapy sessions alone. Trial registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000460808).

Long-term memory of color stimuli in the jungle crow (Corvus macrorhynchos).

PubMed

Bogale, Bezawork Afework; Sugawara, Satoshi; Sakano, Katsuhisa; Tsuda, Sonoko; Sugita, Shoei

2012-03-01

Wild-caught jungle crows (n = 20) were trained to discriminate between color stimuli in a two-alternative discrimination task. Next, crows were tested for long-term memory after 1-, 2-, 3-, 6-, and 10-month retention intervals. This preliminary study showed that jungle crows learn the task and reach a discrimination criterion (80% or more correct choices in two consecutive sessions of ten trials) in a few trials, and some even in a single session. Most, if not all, crows successfully remembered the constantly reinforced visual stimulus during training after all retention intervals. These results suggest that jungle crows have a high retention capacity for learned information, at least after a 10-month retention interval and make no or very few errors. This study is the first to show long-term memory capacity of color stimuli in corvids following a brief training that memory rather than rehearsal was apparent. Memory of visual color information is vital for exploitation of biological resources in crows. We suspect that jungle crows could remember the learned color discrimination task even after a much longer retention interval.

A low cost Doppler system for vascular dialysis access surveillance.

PubMed

Molina, P S C; Moraes, R; Baggio, J F R; Tognon, E A

2004-01-01

The National Kidney Foundation guidelines for vascular access recommend access surveillance to avoid morbidity among patients undergoing hemodialysis. Methods to detect access failure based on CW Doppler system are being proposed to implement surveillance programs at lower cost. This work describes a low cost Doppler system implemented in a PC notebook designed to carry out this task. A Doppler board samples the blood flow velocity and delivers demodulated quadrature Doppler signals. These signals are sampled by a notebook sound card. Software for Windows OS (running at the notebook) applies CFFT to consecutive 11.6 ms intervals of Doppler signals. The sonogram is presented on the screen in real time. The software also calculates the maximum and the intensity weighted mean frequency envelopes. Since similar systems employ DSP boards to process the Doppler signals, cost reduction was achieved. The Doppler board electronic circuits and routines to process the Doppler signals are presented.

Generation of chemical movies: FT-IR spectroscopic imaging of segmented flows.

PubMed

Chan, K L Andrew; Niu, X; deMello, A J; Kazarian, S G

2011-05-01

We have previously demonstrated that FT-IR spectroscopic imaging can be used as a powerful, label-free detection method for studying laminar flows. However, to date, the speed of image acquisition has been too slow for the efficient detection of moving droplets within segmented flow systems. In this paper, we demonstrate the extraction of fast FT-IR images with acquisition times of 50 ms. This approach allows efficient interrogation of segmented flow systems where aqueous droplets move at a speed of 2.5 mm/s. Consecutive FT-IR images separated by 120 ms intervals allow the generation of chemical movies at eight frames per second. The technique has been applied to the study of microfluidic systems containing moving droplets of water in oil and droplets of protein solution in oil. The presented work demonstrates the feasibility of the use of FT-IR imaging to study dynamic systems with subsecond temporal resolution.

Protective effect of Panax ginseng in cisplatin-induced cachexia in rats.

PubMed

Lobina, Carla; Carai, Mauro A M; Loi, Barbara; Gessa, Gian Luigi; Riva, Antonella; Cabri, Walter; Petrangolini, Giovanna; Morazzoni, Paolo; Colombo, Giancarlo

2014-05-01

This study investigated the protective effect of a standardized extract of Panax ginseng on multiple cisplatin-induced 'sickness behaviors' (model of cancer-induced cachexia) in rats. Cisplatin was administered twice weekly (1-2 mg/kg, intraperitoneal) for 5 consecutive weeks. Panax ginseng extract (0, 25 and 50 mg/kg, intragastric) was administered daily over the 5-week period of cisplatin exposure. Malaise, bodyweight and temperature, pain sensitivity, and endurance running were recorded at baseline and at 5 weekly intervals. Treatment with cisplatin produced severe signs of malaise, marked loss of bodyweight, hypothermia, hyperalgesia and reduction in running time. Treatment with Panax ginseng extract completely prevented all cisplatin-induced alterations. These data indicate that treatment with Panax ginseng extract exerted a protective effect in a rat model of cachexia and suggest that Panax ginseng extract may be a therapeutic promising tool for supportive care in oncology.

Baseline Predictors of Missed Visits in the Look AHEAD Study

PubMed Central

Fitzpatrick, Stephanie L.; Jeffery, Robert; Johnson, Karen C.; Roche, Cathy C.; Van Dorsten, Brent; Gee, Molly; Johnson, Ruby Ann; Charleston, Jeanne; Dotson, Kathy; Walkup, Michael P.; Hill-Briggs, Felicia; Brancati, Frederick L.

2013-01-01

Objective To identify baseline attributes associated with consecutively missed data collection visits during the first 48 months of Look AHEAD—a randomized, controlled trial in 5145 overweight/obese adults with type 2 diabetes designed to determine the long-term health benefits of weight loss achieved by lifestyle change. Design and Methods The analyzed sample consisted of 5016 participants who were alive at month 48 and enrolled at Look AHEAD sites. Demographic, baseline behavior, psychosocial factors, and treatment randomization were included as predictors of missed consecutive visits in proportional hazard models. Results In multivariate Cox proportional hazard models, baseline attributes of participants who missed consecutive visits (n=222) included: younger age ( Hazard Ratio [HR] 1.18 per 5 years younger; 95% Confidence Interval 1.05, 1.30), higher depression score (HR 1.04; 1.01, 1.06), non-married status (HR 1.37; 1.04, 1.82), never self-weighing prior to enrollment (HR 2.01; 1.25, 3.23), and randomization to minimal vs. intensive lifestyle intervention (HR 1.46; 1.11, 1.91). Conclusions Younger age, symptoms of depression, non-married status, never self-weighing, and randomization to minimal intervention were associated with a higher likelihood of missing consecutive data collection visits, even in a high-retention trial like Look AHEAD. Whether modifications to screening or retention efforts targeted to these attributes might enhance long-term retention in behavioral trials requires further investigation. PMID:23996977

Factors Predictive of 90-Day Morbidity, Readmission, and Costs in Patients Undergoing Pelvic Exenteration.

PubMed

Bogani, Giorgio; Signorelli, Mauro; Ditto, Antonino; Martinelli, Fabio; Casarin, Jvan; Mosca, Lavinia; Leone Roberti Maggiore, Umberto; Chiappa, Valentina; Lorusso, Domenica; Raspagliesi, Francesco

2018-06-01

Pelvic exenteration for recurrent gynecological malignancies is characterized by a high rate of severe complications. Factors predictive of morbidity, readmission, and cost were analyzed. Data of consecutive patients undergoing pelvic exenteration between January 2007 and December 2016 were prospectively evaluated. Fifty-eight patients were included in the analysis. Anterior, posterior, and total exenterations were executed in 39 (67%), 9 (16%), and 10 (17%) patients, respectively. Ten (15.5%) severe complications occurred: 8 (20.5%), 0 (0%), and 1 (10%) after anterior, posterior, and total exenterations, respectively. Radiotherapy dosage, time between radiotherapy and surgery, and previous administration of chemotherapy did not influence 90-day complications and readmission. At multivariable analysis, albumin levels less than 3.5 g/dL (odds ratio, 16.2 [95% confidence interval, 2.85-92.8]; P = 0.002) and history of deep vein thrombosis (odds ratio, 9.6 [95% confidence interval, 0.93-98.2]; P = 0.057) were associated with 90-day morbidity. Low albumin levels independently correlated with readmission (P = 0.011). The occurrence of 90-day postoperative complications and readmission increased costs of a median of +12,500 and +6000 euros, respectively (P < 0.05). Preoperative patient selection is a key point for the reduction of postoperative complications after pelvic exenteration. Further prospective studies are warranted to improve patient selection.

Survival of Alzheimer's disease patients in Korea.

PubMed

Go, Seok Min; Lee, Kang Soo; Seo, Sang Won; Chin, Juhee; Kang, Sue J; Moon, So Young; Na, Duk L; Cheong, Hae-Kwan

2013-01-01

The natural history of Alzheimer's disease (AD) has rarely been studied in the Korean population. Our study on survival analyses in Korean AD patients potentially provides a basis for cross-cultural comparisons. We studied 724 consecutive patients from a memory disorder clinic in a tertiary hospital in Seoul, who were diagnosed as having AD between April 1995 and December 2005. Deaths were identified by the Statistics Korea database. The Kaplan-Meier method was used for survival analysis, and a Cox proportional hazard model was used to assess factors related to patient survival. The overall median survival from the onset of first symptoms and from the time of diagnosis was 12.6 years (95% confidence interval 11.7-13.4) and 9.3 years (95% confidence interval 8.7-9.9), respectively. The age of onset, male gender, history of diabetes mellitus, lower Mini-Mental State Examination score, and higher Clinical Dementia Rating score were negatively associated with survival. There was a reversal of risk of AD between early-onset and later-onset AD, 9.1 years after onset. The results of our study show a different pattern of survival compared to those studies carried out with western AD populations. Mortality risk of early-onset AD varied depending on the duration of follow-up. Copyright © 2013 S. Karger AG, Basel.

Development of Behavioral Toxicology Methodology for Interactive Exposure Regimens.

DTIC Science & Technology

1983-12-01

exposures conducted at weekly Interval had Identical effects. Five consecutive daily exposures resulted In partial tolerance to the disruptive effects...No. 2001C) for which the tap line was also located at the top of the chamber head measured the negative pressure of chamber Interior in relation to...result In partial tolerance development. lIT RESEARCH INSTITUTE 44 Although In contrast to Ator and Merigan’s finding, tolerance was not complete after

Implementation of a clinical pathway based on a computerized physician order entry system for ischemic stroke attenuates off-hour and weekend effects in the ED.

PubMed

Yang, Jong Min; Park, Yoo Seok; Chung, Sung Phil; Chung, Hyun Soo; Lee, Hye Sun; You, Je Sung; Lee, Shin Ho; Park, Incheol

2014-08-01

Admission on weekends and off-hours has been associated with poor outcomes and mortality from acute stroke. The purpose of this study was to investigate whether an organized clinical pathway (CP) for ischemic stroke can effectively reduce the time from arrival to evaluation and treatment in the emergency department (ED) and improve outcomes, regardless of the time from arrival in the ED. We conducted a retrospective analysis of all consecutive patients included in the prospective registry database in the Brain Salvage through Emergency Stroke Therapy program, which uses the computerized physician order entry (CPOE) system. Patients were classified based on their time of arrival in the ED: group 1, normal working hours on weekdays; group 2, off-hours on weekdays; group 3, normal working hours on weekends; and group 4, off-hours on weekends. Clinical outcomes were categorized according to 30 days in-hospital mortality, in-hospital mortality, and the modified Rankin score during a single length of stay (LOS). No time intervals differed significantly among the 4 patient groups who received intravenous administration of tissue plasminogen activator (IV-tPA). Use of IV-tPA (P = .5110) was not affected by arrival in the ED on off-days or weekends. The overall mortality rate was 3.9%, and the median LOS was 7 days (Interquartile range (IQR), 5-10). By Kaplan-Meier analysis, the cumulative probability of mortality and survival did not differ significantly among the 4 groups over 30 days (P = .1557). An organized CP, based on CPOE, for ischemic stroke can effectively attenuate disparities in the time interval between ED arrival to evaluation and treatment regardless of ED arrival time. This pathway may also help to eliminate off-hour and weekend effects on outcomes from ischemic stroke. Copyright © 2014 Elsevier Inc. All rights reserved.

Time-series photometric spot modeling. 2: Fifteen years of photometry of the bright RS CVn binary HR 7275

NASA Technical Reports Server (NTRS)

Strassmeier, K. G.; Hall, D. S.; Henry, G. W.

1994-01-01

We present a time-dependent spot modeling analysis of 15 consecutive years of V-band photometry of the long-period (P(sub orb) = 28.6 days) RS CVn binary HR 7275. This baseline in time is one of the longest, uninterrupted intervals a spotted star has been observed. The spot modeling analysis yields a total of 20 different spots throughout the time span of our observations. The distribution of the observed spot migration rates is consistent with solar-type differential rotation and suggests a lower limit of the differential-rotation coefficient of 0.022 +/-0.004. The observed, maximum lifetime of a single spot (or spot group) is 4.5 years, the minimum lifetime is approximately one year, but an average spot lives for 2.2 years. If we assume that the mechanical shear by differential rotation sets the upper limit to the spot lifetime, the observed maximum lifetime in turn sets an upper limit to the differential-rotation coefficient, namely 0.04 +/- 0.01. This would be differential rotation just 5 to 8 times less than the solar value and one of the strongest among active binaries. We found no conclusive evidence for the existence of a periodic phenomenon that could be attributed to a stellar magnetic cycle.

Circadian occurrence of variceal bleeding in patients with liver cirrhosis.

PubMed

Siringo, S; Bolondi, L; Sofia, S; Hermida, R C; Gramantieri, L; Gaiani, S; Piscaglia, F; Carbone, C; Misitano, B; Corinaldesi, R

1996-12-01

Several clinical events have a rhythmicity over the 24 h period. We assessed the presence of periodic rhythm in the occurrence of haematemesis in patients with liver cirrhosis under different daylight regimens, namely during standard time and during daylight savings. Over a 48 month period there were 212 consecutive admissions of 118 cirrhotics with variceal bleeding. Complete data were available for 181 episodes of bleeding: 121 (66.9%) started with haematemesis and 60 (33.1%) started with melaena. One hundred and two (56%) episodes occurred during daylight savings and 79 (44%) occurred during standard time. The cosinor test showed a 24 h biphasic peak for the occurrence of haematemesis (09.45 and 21.45 h). Moreover, a biphasic diurnal asymmetric frequency was also found by multiple component rhythmometry. The time peaks of onset of variceal haemorrhage did not change significantly during standard time and daylight savings. Patients with more than one haematemesis episode significantly bled over the same time interval. The present study confirms that over the 24 h period variceal bleeding in cirrhotic patients occurs with a predictable rhythmicity that does not seem to be under the control of the light-dark cycle. The finding of a chronorisk for variceal haemorrhage addresses specific questions for pathophysiological studies as well as for new treatment strategies.

Effect of different musical tempo on post-exercise recovery in young adults.

PubMed

Savitha, D; Mallikarjuna, Reddy N; Rao, Chythra

2010-01-01

The role of music in increasing the exercise performance is well recognised. There is very little information about effect of music on time taken for post exercise recovery. We examined the effect of music and different musical tempo on post exercise recovery time, following treadmill work. 30 volunteers (15 male, 15 female) subjected to isotonic exercise (submaximal treadmill work) on three consecutive days. They were allowed to rest in silence on the first day, rest by hearing slow music on second day and rest with fast music on third day. Parameters such as Pulse rate, blood pressure, rating of perceived exertion (RPE) were measured at predetermined intervals. Repeated measures ANOVA test showed that with slow music, recovery time of systolic blood pressure (SBP) (7.9 +/- 2.5), diastolic blood pressure (DBP) (5.5 +/- 3.4) pulse rate recovery (PR) (8.0 +/- 2.3) and recovery from exertion (RPE) (7.7 +/- 2.5) were significantly faster when compared to both no music and fast music. The individual music preference made no significant difference in the relaxation time. The study concluded that music hastens post exercise recovery and slow music has greater relaxation effect than fast or no music, recovery time being independent of the gender and individual music preference.

3D time-lapse Electrical Resistivity Tomography (ERT) to monitor subsurface flow processes during a sprinkling and injection experiment on a mountain slope

NASA Astrophysics Data System (ADS)

Inauen, C.; Green, A.; Rabenstein, L.; Greenhalgh, S.; Kinzelbach, W.; Doetsch, J.; Hertrich, M.; Smoorenburg, M.; Volze, N.

2012-04-01

Understanding the relationships between precipitation volumes, surface runoff and subsurface storage, drainage and flow processes on mountain slopes is critical for flood management in alpine regions. In the Schächen catchment (central Switzerland) an unexpectedly delayed and heavy flood reaction to a long duration rainfall event was observed in 2005. It is believed that the steep creeping landmass slopes with thick soils were responsible for the delay. To better comprehend and visualise water infiltration and runoff formation we conducted a 3D time-lapse ERT experiment during a water sprinkling and injection experiment on the side of a hill in the Schächental region presumed representative of soil and other conditions associated with the delayed flood. Constant sprinkling at a rate of about 10mm/h was applied to a plot of area 30m x 5m. The electrical conductivity of the sprinkled water was approximately that of the pore water (25mS/m). A total of 33 consecutive ERT data sets, each comprising 3521 measured electrode configurations, were recorded with a 96-electrode array over an area of 27.5m x 14m, which included two thirds of the sprinkled area. Each electrode configuration was measured at a repeat interval of 2 to 2.8 hours. The entire 3D ERT monitoring experiment was divided into two separate time intervals: (1) the initial 25 hour period involving only freshwater sprinkling, until steady state was reached, (2) the following 35 hour period during which, in addition to the sprinkling, salt water was injected in two boreholes at a depth of 1m (unsaturated zone). The salt water injections were separated by 17 hours, and monitored until 14 hours after sprinkling stopped. During the first interval all changes in the subsurface resistivity are caused by changes in the water saturation and the temperature of the fluid, whereas in the second interval they are mainly due to changes in salt concentration of the pore fluid. Supplementary measurements of water table elevation and fluid electric conductivity were made in several boreholes. To image the subsurface resistivity changes, we inverted the ratios of time-lapse resistances to their background (pre-sprinkling) values. The sprinkling during time interval 1 allowed us to examine near-surface infiltration. Even from the first time window, the emergence of a shallow wetting front could be observed in the inverted depth sections as a decrease in bulk resistivity. Both salt water plumes during interval 2 were found to move laterally as well as vertically through the soil into a zone of fissured Flysch. Below the water table, the plume could be tracked further as a weaker ERT signal, which shows a flow component parallel to the water table in the downslope direction where it eventually breaks the surface. 3D ERT monitoring has proven to be a powerful tool to monitor water sprinkling and injection experiments. Due to its advantageous ability to resolve changes, both in time and in space, it captured most of the soil moisture and flow dynamics. Processes, such as infiltration and drainage, which are important for the understanding of runoff formation, could be readily visualized.

Oral Contraceptives Attenuate Cardiac Autonomic Responses to Musical Auditory Stimulation: Pilot Study.

PubMed

Milan, Réveni Carmem; Plassa, Bruna Oliveira; Guida, Heraldo Lorena; de Abreu, Luiz Carlos; Gomes, Rayana L; Garner, David M; Valenti, Vitor E

2015-01-01

The literature presents contradictory results regarding the effects of contraceptives on cardiac autonomic regulation. The research team aimed to evaluate the effects of musical auditory stimulation on cardiac autonomic regulation in women who use oral contraceptives. The research team designed a transversal observational pilot study. The setting was the Centro de Estudos do Sistema Nervoso Autônomo (CESNA) in the Departamento de Fonoaudiologia at the Universidade Estadual Paulista (UNESP) in Marília, SP, Brazil. Participants were 22 healthy nonathletic and nonsedentary females, all nonsmokers and aged between 18 and 27 y. Participants were divided into 2 groups: (1) 12 women who were not taking oral contraceptives, the control group; and (2) 10 women who were taking oral contraceptives, the oral contraceptive group. In the first stage, a rest control, the women sat with their earphones turned off for 20 min. After that period, the participants were exposed to 20 min of classical baroque music (ie, "Canon in D Major," Johann Pachelbel), at 63-84 dB. Measurements of the equivalent sound levels were conducted in a soundproof room, and the intervals between consecutive heartbeats (R-R intervals) were recorded, with a sampling rate of 1000 Hz. For calculation of the linear indices, the research team used software to perform an analysis of heart rate variability (HRV). Linear indices of HRV were analyzed in the time domain: (1) the standard deviation of normal-to-normal R-R intervals (SDNN), (2) the root-mean square of differences between adjacent normal R-R intervals in a time interval (RMSSD), and (3) the percentage of adjacent R-R intervals with a difference of duration greater than 50 ms (pNN50). The study also analyzed the frequency domain-low frequency (LF), high frequency (HF), and LF/HF ratio. For the control group, the musical auditory stimulation reduced (1) the SDNN from 52.2 ± 10 ms to 48.4 ± 16 ms (P = .0034); (2) the RMSSD from 45.8 ± 22 ms to 41.2 ± 19 ms (P = .0128); (3) the pNN50 from 25.5 ± 19 to 22.0 ± 18 (P = .0211); and (4) the LF (ms2) from 954.8 ± 457 ms2 to 686.2 ± 491 ms2 (P = .0024). In the oral contraceptive group, no significant changes occurred for the HRV indices during exposure to music. Musical auditory stimulation had a greater influence on cardiac autonomic regulation in women who did not use oral contraceptives.

Myocardial perfusion magnetic resonance imaging using sliding-window conjugate-gradient highly constrained back-projection reconstruction for detection of coronary artery disease.

PubMed

Ma, Heng; Yang, Jun; Liu, Jing; Ge, Lan; An, Jing; Tang, Qing; Li, Han; Zhang, Yu; Chen, David; Wang, Yong; Liu, Jiabin; Liang, Zhigang; Lin, Kai; Jin, Lixin; Bi, Xiaoming; Li, Kuncheng; Li, Debiao

2012-04-15

Myocardial perfusion magnetic resonance imaging (MRI) with sliding-window conjugate-gradient highly constrained back-projection reconstruction (SW-CG-HYPR) allows whole left ventricular coverage, improved temporal and spatial resolution and signal/noise ratio, and reduced cardiac motion-related image artifacts. The accuracy of this technique for detecting coronary artery disease (CAD) has not been determined in a large number of patients. We prospectively evaluated the diagnostic performance of myocardial perfusion MRI with SW-CG-HYPR in patients with suspected CAD. A total of 50 consecutive patients who were scheduled for coronary angiography with suspected CAD underwent myocardial perfusion MRI with SW-CG-HYPR at 3.0 T. The perfusion defects were interpreted qualitatively by 2 blinded observers and were correlated with x-ray angiographic stenoses ≥50%. The prevalence of CAD was 56%. In the per-patient analysis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SW-CG-HYPR was 96% (95% confidence interval 82% to 100%), 82% (95% confidence interval 60% to 95%), 87% (95% confidence interval 70% to 96%), 95% (95% confidence interval 74% to100%), and 90% (95% confidence interval 82% to 98%), respectively. In the per-vessel analysis, the corresponding values were 98% (95% confidence interval 91% to 100%), 89% (95% confidence interval 80% to 94%), 86% (95% confidence interval 76% to 93%), 99% (95% confidence interval 93% to 100%), and 93% (95% confidence interval 89% to 97%), respectively. In conclusion, myocardial perfusion MRI using SW-CG-HYPR allows whole left ventricular coverage and high resolution and has high diagnostic accuracy in patients with suspected CAD. Copyright © 2012 Elsevier Inc. All rights reserved.

Relationship between heart rate and quiescent interval of the cardiac cycle in children using MRI.

PubMed

Zhang, Wei; Bogale, Saivivek; Golriz, Farahnaz; Krishnamurthy, Rajesh

2017-11-01

Imaging the heart in children comes with the challenge of constant cardiac motion. A prospective electrocardiography-triggered CT scan allows for scanning during a predetermined phase of the cardiac cycle with least motion. This technique requires knowing the optimal quiescent intervals of cardiac cycles in a pediatric population. To evaluate high-temporal-resolution cine MRI of the heart in children to determine the relationship of heart rate to the optimal quiescent interval within the cardiac cycle. We included a total of 225 consecutive patients ages 0-18 years who had high-temporal-resolution cine steady-state free-precession sequence performed as part of a magnetic resonance imaging (MRI) or magnetic resonance angiography study of the heart. We determined the location and duration of the quiescent interval in systole and diastole for heart rates ranging 40-178 beats per minute (bpm). We performed the Wilcoxon signed rank test to compare the duration of quiescent interval in systole and diastole for each heart rate group. The duration of the quiescent interval at heart rates <80 bpm and >90 bpm was significantly longer in diastole and systole, respectively (P<.0001 for all ranges, except for 90-99 bpm [P=.02]). For heart rates 80-89 bpm, diastolic interval was longer than systolic interval, but the difference was not statistically significant (P=.06). We created a chart depicting optimal quiescent intervals across a range of heart rates that could be applied for prospective electrocardiography-triggered CT imaging of the heart. The optimal quiescent interval at heart rates <80 bpm is in diastole and at heart rates ≥90 bpm is in systole. The period of quiescence at heart rates 80-89 bpm is uniformly short in systole and diastole.

R-R interval variations influence the degree of mitral regurgitation in dogs with myxomatous mitral valve disease.

PubMed

Reimann, M J; Møller, J E; Häggström, J; Markussen, B; Holen, A E W; Falk, T; Olsen, L H

2014-03-01

Mitral regurgitation (MR) due to myxomatous mitral valve disease (MMVD) is a frequent finding in Cavalier King Charles Spaniels (CKCSs). Sinus arrhythmia and atrial premature complexes leading to R-R interval variations occur in dogs. The aim of the study was to evaluate whether the duration of the R-R interval immediately influences the degree of MR assessed by echocardiography in dogs. Clinical examination including echocardiography was performed in 103 privately-owned dogs: 16 control Beagles, 70 CKCSs with different degree of MR and 17 dogs of different breeds with clinical signs of congestive heart failure due to MMVD. The severity of MR was evaluated in apical four-chamber view using colour Doppler flow mapping (maximum % of the left atrium area) and colour Doppler M-mode (duration in ms). The influence of the ratio between present and preceding R-R interval on MR severity was evaluated in 10 consecutive R-R intervals using a linear mixed model for repeated measurements. MR severity was increased when a short R-R interval was followed by a long R-R interval in CKCSs with different degrees of MR (P<0.005 when adjusted for multiple testing). The relationship was not significant in control dogs with minimal MR and in dogs with severe MR and clinical signs of heart failure. In conclusion, MR severity increases in long R-R intervals when these follow a short R-R interval in CKCSs with different degrees of MR due to asymptomatic MMVD. Thus, R-R interval variations may affect the echocardiographic grading of MR in CKCSs. Copyright © 2014 Elsevier Ltd. All rights reserved.

CO 2 laser treatment system of tinea pedis

NASA Astrophysics Data System (ADS)

Ueda, Masahiro

The CO 2 laser treatment system 'Melase 1000' has been developed for the treatment of Tinea pedis and the efficacy of the treatment using the system and its optimum irradiation condition are studied. The present system enables us to make the healing time of Tinea pedis treatment far shorter than conventional pharmaceuticals. This is in spite of using heat levels low enough for patients not to feel discomfort. Features offered by the system are a safe-and-easy operation and a stable laser power for a prolonged use. The efficacy of the present therapy is excellent; only two treatments a week for three weeks, i.e. six consecutive treatments, attained an improvement rate of 71.8% in the skin findings and a 'usefulness' of 66.2% determined from cases rated as 'useful' or 'better'. The optimum laser irradiation condition for a single treatment found in this experiment is a light fluence of about 3 J/cm 2 and four laser pulses with a time interval between pulses of 1 s for a typical horny layer thinner than 0.5 mm.

Antibody induced by immunization with the Jeryl Lynn mumps vaccine strain effectively neutralizes a heterologous wild-type mumps virus associated with a large outbreak.

PubMed

Rubin, Steven A; Qi, Li; Audet, Susette A; Sullivan, Bradley; Carbone, Kathryn M; Bellini, William J; Rota, Paul A; Sirota, Lev; Beeler, Judy

2008-08-15

Recent mumps outbreaks in older vaccinated populations were caused primarily by genotype G viruses, which are phylogenetically distinct from the genotype A vaccine strains used in the countries affected by the outbreaks. This finding suggests that genotype A vaccine strains could have reduced efficacy against heterologous mumps viruses. The remote history of vaccination also suggests that waning immunity could have contributed to susceptibility. To examine these issues, we obtained consecutive serum samples from children at different intervals after vaccination and assayed the ability of these samples to neutralize the genotype A Jeryl Lynn mumps virus vaccine strain and a genotype G wild-type virus obtained during the mumps outbreak that occurred in the United States in 2006. Although the geometric mean neutralizing antibody titers against the genotype G virus were approximately one-half the titers measured against the vaccine strain, and although titers to both viruses decreased with time after vaccination, antibody induced by immunization with the Jeryl Lynn mumps vaccine strain effectively neutralized the outbreak-associated virus at all time points tested.

Reliability of fully automated versus visually controlled pre- and post-processing of resting-state EEG.

PubMed

Hatz, F; Hardmeier, M; Bousleiman, H; Rüegg, S; Schindler, C; Fuhr, P

2015-02-01

To compare the reliability of a newly developed Matlab® toolbox for the fully automated, pre- and post-processing of resting state EEG (automated analysis, AA) with the reliability of analysis involving visually controlled pre- and post-processing (VA). 34 healthy volunteers (age: median 38.2 (20-49), 82% female) had three consecutive 256-channel resting-state EEG at one year intervals. Results of frequency analysis of AA and VA were compared with Pearson correlation coefficients, and reliability over time was assessed with intraclass correlation coefficients (ICC). Mean correlation coefficient between AA and VA was 0.94±0.07, mean ICC for AA 0.83±0.05 and for VA 0.84±0.07. AA and VA yield very similar results for spectral EEG analysis and are equally reliable. AA is less time-consuming, completely standardized, and independent of raters and their training. Automated processing of EEG facilitates workflow in quantitative EEG analysis. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Investigating the physical properties of outbursts on comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Lin, Z.-Y.; Knollenberg, J.; Vincent, J.-B.; A'Hearn, M. F.; Ip, W.-H.; Sierks, H.; &. The Osiris Team

2017-09-01

Our measurements of outbursts were based on the outburst sequences scheduled by single-filter observation (UV375 filter in WAC or orange filter in NAC) and pairs of consecutive images obtained in short time interval with NAC orange filter. The main results from the analysis of the images of outbursts from July 29 to September 30, 2015 can be summarized as follows: The calculated excess brightness from these outburst plume ranges from a few percent to ˜28%. In some major outbursts, the contributed brightness from the outburst plume can be one or two times larger than the typical coma jet activities. The strongest one is the perihelion outburst detected just a few hours before the comet reached perihelion. By studying the brightness slope of outburst plume, we interpret the detected transient events as the continuous streams of outflowing gas and dust which are triggered by some particular mechanisms and then remain active for some minutes to less than few hours. The mass ejection rate during a large outburst could reach a few percent of the steady state value of the dust coma.

Heart rate variability (HRV) during virtual reality immersion

PubMed Central

Malińska, Marzena; Zużewicz, Krystyna; Bugajska, Joanna; Grabowski, Andrzej

2015-01-01

The goal of the study was assessment of the hour-long training involving handling virtual environment (sVR) and watching a stereoscopic 3D movie on the mechanisms of autonomic heart rate (HR) regulation among the subjects who were not predisposed to motion sickness. In order to exclude predispositions to motion sickness, all the participants (n=19) underwent a Coriolis test. During an exposure to 3D and sVR the ECG signal was continuously recorded using the Holter method. For the twelve consecutive 5-min epochs of ECG signal, the analysis of heart rate variability (HRV) in time and frequency domains was conducted. After 30 min from the beginning of the training in handling the virtual workstation a significant increase in LF spectral power was noted. The values of the sympathovagal LF/HF index while sVR indicated a significant increase in sympathetic predominance in four time intervals, namely between the 5th and the 10th minute, between the 15th and the 20th minute, between the 35th and 40th minute and between the 55th and the 60th minute of exposure. PMID:26327262

Prognostic role of the CDNK1B V109G polymorphism in multiple endocrine neoplasia type 1

PubMed Central

Circelli, Luisa; Ramundo, Valeria; Marotta, Vincenzo; Sciammarella, Concetta; Marciello, Francesca; Del Prete, Michela; Sabatino, Lina; Pasquali, Daniela; Izzo, Francesco; Scala, Stefania; Colao, Annamaria; Faggiano, Antongiulio; Colantuoni, Vittorio

2015-01-01

CDKN1B encodes the cyclin-dependent kinase inhibitor p27/Kip1. CDKN1B mutations and polymorphisms are involved in tumorigenesis; specifically, the V109G single nucleotide polymorphism has been linked to different tumours with controversial results. Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant syndrome, characterized by the development of different types of neuroendocrine tumours and increased incidence of other malignancies. A clear genotype–phenotype correlation in MEN1 has not been established yet. In this study, we assessed whether the CDKN1B V109G polymorphism was associated with the development of aggressive tumours in 55 consecutive patients affected by MEN1. The polymorphism was investigated by PCR amplification of germline DNA followed by direct sequencing. Baseline and follow-up data of tumour types and their severity were collected and associated with the genetic data. MEN1-related aggressive and other malignant tumours of any origin were detected in 16.1% of wild-type and 33.3% of polymorphism allele-bearing patients (P = NS). The time interval between birth and the first aggressive tumour was significantly shorter in patients with the CDKN1B V109G polymorphism (median 46 years) than in those without (median not reached; P = 0.03). Similarly, shorter was the time interval between MEN1 diagnosis and age of the first aggressive tumour (P = 0.02). Overall survival could not be estimated as 96% patients were still alive at the time of the study. In conclusion, CDKN1B V109G polymorphism seems to play a role in the development of aggressive tumours in MEN1. PMID:25824098

Seasonality intensification and long-term winter cooling as a part of the Late Pliocene climate development

NASA Astrophysics Data System (ADS)

Klotz, Stefan; Fauquette, Séverine; Combourieu-Nebout, Nathalie; Uhl, Dieter; Suc, Jean-Pierre; Mosbrugger, Volker

2006-01-01

A mutual climatic range method is applied to the Mediterranean marine pollen record of Semaforo (Vrica section, Calabria, Italy) covering the period from ∼2.46 Ma to ∼2.11 Ma. The method yields detailed information on summer, annual and winter temperatures and on precipitation during the nine obliquity and precession-controlled 'glacial' periods (marine isotope stages 96 to 80) and eight 'interglacial' periods (marine isotope stages 95 to 81) characterising this time interval. The reconstruction reveals higher temperatures of at least 2.8 °C in mean annual and 2.2 °C in winter temperatures, and 500 mm in precipitation during the 'interglacials' as compared to the present-day climate in the study area. During the 'glacials', temperatures are generally lower as compared to the present-day climate in the region, but precipitation is equivalent. Along the consecutive 'interglacials', a trend toward a reduction in annual and winter temperatures by more than 2.3 °C, and toward a higher seasonality is observed. Along the consecutive 'glacials', a trend toward a strong reduction in all temperature parameters of at least 1.6 °C is reconstructed. Climatic amplitudes of 'interglacial-glacial' transitions increase from the older to the younger cycles for summer and annual temperatures. The cross-spectral analyses suggest obliquity related warm/humid-cold/dry 'interglacial-glacial' cycles which are superimposed by precession related warm/dry- cold/humid cycles. A time displacement in the development of temperatures and precipitation is indicated for the obliquity band by temperatures generally leading precipitation change at ∼4 kyr, and on the precession band of ∼9.6 kyr in maximum.

Inhalation reproductive toxicology studies: Sperm morphology study of n-hexane in B6C3F1 mice: Final report

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

Mast, T.J.; Hackett, P.L.; Decker, J.R.

The straight-chain hydrocarbon, n-hexane, is a volatile, ubiquitous solvent routinely used in industrial environments. Although myelinated nerve tissue is the primary target organ of hexane, the testes have also been identified as being sensitive to hexacarbon exposure. The objective of this study was to evaluate the epididymal sperm morphology of male B6D3F1 mice 5 weeks after exposure to 0, 200, 1000, or 5000 ppM n-hexane, 20 h/day for 5 consecutive days. Two concurrent positive control groups of animals were injected intraperitoneally with either 200 or 250 mg/kg ethyl methanesulfonate, a known mutagen, once each day for 5 consecutive days. Themore » mice were weighed just prior to the first day of exposure and at weekly intervals until sacrifice. During the fifth post-exposure week the animals were killed and examined for gross lesions of the reproductive tract and suspensions of the epididymal sperm were prepared for morphological evaluations. The appearance and behavior of the mice were unremarkable throughout the experiment and there were no deaths. No evidence of lesions in any organ was noted at sacrifice. Mean body weights of male mice exposed to n-hexane were not significantly different from those for the 0-ppM animals at any time during the study. Analyses of the sperm morphology data obtained 5 weeks post-exposure (the only time point examined) indicated that exposure of male mice to relatively high concentrations of n-hexane vapor for 5 days produced no significant effects on the morphology of sperm relative to that of the 0-ppM control group. 24 refs., 2 figs., 7 tabs.« less

Reliability of the identification of the systemic inflammatory response syndrome in critically ill infants and children.

PubMed

Juskewitch, Justin E; Prasad, Swati; Salas, Carlos F Santillan; Huskins, W Charles

2012-01-01

To assess interobserver reliability of the identification of episodes of the systemic inflammatory response syndrome in critically ill hospitalized infants and children. Retrospective, cross-sectional study of the application of the 2005 consensus definition of systemic inflammatory response syndrome in infants and children by two independent, trained reviewers using information in the electronic medical record. Eighteen-bed pediatric multidisciplinary medical/surgical pediatric intensive care unit. A randomly selected sample of children admitted consecutively to the pediatric intensive care unit between May 1 and September 30, 2009. None. Sixty infants and children were selected from a total of 343 admitted patients. Their median age was 3.9 yrs (interquartile range, 1.5-12.7), 57% were female, and 68% were Caucasian. Nineteen (32%) children were identified by both reviewers as having an episode of systemic inflammatory response syndrome (88% agreement, 95% confidence interval 78-94; κ = 0.75, 95% confidence interval 0.59-0.92). Among these 19 children, agreement between the reviewers for individual systemic inflammatory response syndrome criteria was: temperature (84%, 95% confidence interval 60-97); white blood cell count (89%, 95% confidence interval 67-99); respiratory rate (84%, 95% confidence interval 60-97); and heart rate (68%, 95% confidence interval 33-87). Episodes of systemic inflammatory response syndrome in critically ill infants and children can be identified reproducibly using the consensus definition.

Surgical management of sentinel lymph node biopsy outside major nodal basin in patients with cutaneous melanoma.

PubMed

Caracò, Corrado; Marone, Ugo; Di Monta, Gianluca; Aloj, Luigi; Caracò, Corradina; Anniciello, Annamaria; Lastoria, Secondo; Botti, Gerardo; Mozzillo, Nicola

2014-01-01

To assess the incidence of nonmajor lymphatic basin sentinel nodes in patients with cutaneous melanoma in order to propose a correct nomenclature and inform appropriate surgical management. This was a retrospective review of 1,045 consecutive patients with cutaneous melanoma who underwent sentinel lymph node biopsy and dynamic lymphoscintigraphy to identify sentinel node site. Nonmajor drainage sites were classified as uncommon (located in a minor lymphatic basin along the lymphatic drainage to a major classical nodal basin) or interval (located anywhere along the lymphatics between the primary tumor site and the nearest lymphatic basin) sentinel nodes. Nonclassical sentinel nodes were identified in 32 patients (3.0 %). Uncommon sentinel nodes were identified in 3.2 % (n = 17) of trunk melanoma primary disease and in 1.5 % (n = 7) of upper and lower extremity sites. Interval sentinel nodes were identified in 1.3 % (n = 7) of trunk primary lesions, with none from upper and lower extremities melanomas. The incidence of tumor-positive sentinel nodes was 24.1 % (245 of 1,013) in classical sites and 12.5 % (4 of 32) in uncommon/interval sites. The definition of uncommon and interval sentinel nodes allows the identification of different lymphatic pathways and inform appropriate surgical treatment. Wider experience with uncommon/interval sentinel nodes will better clarify the clinical implications and surgical management to be adopted in the management of uncommon and interval sentinel node sites.

Determinants of Short Interbirth Interval among Reproductive Age Mothers in Arba Minch District, Ethiopia

PubMed Central

Hailu, Desta; Gulte, Teklemariam

2016-01-01

Background. One of the key strategies to reduce fertility and promote the health status of mothers and their children is adhering to optimal birth spacing. However, women still have shorter birth intervals and studies addressing their determinants were scarce. The objective of this study, therefore, was to assess determinants of birth interval among women who had at least two consecutive live births. Methods. Case control study was conducted from February to April 2014. Cases were women with short birth intervals (<3 years), whereas controls were women having history of optimal birth intervals (3 to 5 years). Bivariate and multivariable analyses were performed. Result. Having no formal education (AOR = 2.36, 95% CL: [1.23–4.52]), duration of breast feeding for less than 24 months (AOR: 66.03, 95% CI; [34.60–126]), preceding child being female (AOR: 5.73, 95% CI; [3.18–10.310]), modern contraceptive use (AOR: 2.79, 95% CI: [1.58–4.940]), and poor wealth index (AOR: 4.89, 95% CI; [1.81–13.25]) of respondents were independent predictors of short birth interval. Conclusion. In equalities in education, duration of breast feeding, sex of the preceding child, contraceptive method use, and wealth index were markers of unequal distribution of inter birth intervals. Thus, to optimize birth spacing, strategies of providing information, education and communication targeting predictor variables should be improved. PMID:27239553

The interval testing procedure: A general framework for inference in functional data analysis.

PubMed

Pini, Alessia; Vantini, Simone

2016-09-01

We introduce in this work the Interval Testing Procedure (ITP), a novel inferential technique for functional data. The procedure can be used to test different functional hypotheses, e.g., distributional equality between two or more functional populations, equality of mean function of a functional population to a reference. ITP involves three steps: (i) the representation of data on a (possibly high-dimensional) functional basis; (ii) the test of each possible set of consecutive basis coefficients; (iii) the computation of the adjusted p-values associated to each basis component, by means of a new strategy here proposed. We define a new type of error control, the interval-wise control of the family wise error rate, particularly suited for functional data. We show that ITP is provided with such a control. A simulation study comparing ITP with other testing procedures is reported. ITP is then applied to the analysis of hemodynamical features involved with cerebral aneurysm pathology. ITP is implemented in the fdatest R package. © 2016, The International Biometric Society.

System implications of the ambulance arrival-to-patient contact interval on response interval compliance.

PubMed

Campbell, J P; Gratton, M C; Salomone, J A; Lindholm, D J; Watson, W A

1994-01-01

In some emergency medical services (EMS) system designs, response time intervals are mandated with monetary penalties for noncompliance. These times are set with the goal of providing rapid, definitive patient care. The time interval of vehicle at scene-to-patient access (VSPA) has been measured, but its effect on response time interval compliance has not been determined. To determine the effect of the VSPA interval on the mandated code 1 (< 9 min) and code 2 (< 13 min) response time interval compliance in an urban, public-utility model system. A prospective, observational study used independent third-party riders to collect the VSPA interval for emergency life-threatening (code 1) and emergency nonlife-threatening (code 2) calls. The VSPA interval was added to the 9-1-1 call-to-dispatch and vehicle dispatch-to-scene intervals to determine the total time interval from call received until paramedic access to the patient (9-1-1 call-to-patient access). Compliance with the mandated response time intervals was determined using the traditional time intervals (9-1-1 call-to-scene) plus the VSPA time intervals (9-1-1 call-to-patient access). Chi-square was used to determine statistical significance. Of the 216 observed calls, 198 were matched to the traditional time intervals. Sixty-three were code 1, and 135 were code 2. Of the code 1 calls, 90.5% were compliant using 9-1-1 call-to-scene intervals dropping to 63.5% using 9-1-1 call-to-patient access intervals (p < 0.0005). Of the code 2 calls, 94.1% were compliant using 9-1-1 call-to-scene intervals. Compliance decreased to 83.7% using 9-1-1 call-to-patient access intervals (p = 0.012). The addition of the VSPA interval to the traditional time intervals impacts system response time compliance. Using 9-1-1 call-to-scene compliance as a basis for measuring system performance underestimates the time for the delivery of definitive care. This must be considered when response time interval compliances are defined.

Reaction Times to Consecutive Automation Failures: A Function of Working Memory and Sustained Attention.

PubMed

Jipp, Meike

2016-12-01

This study explored whether working memory and sustained attention influence cognitive lock-up, which is a delay in the response to consecutive automation failures. Previous research has demonstrated that the information that automation provides about failures and the time pressure that is associated with a task influence cognitive lock-up. Previous research has also demonstrated considerable variability in cognitive lock-up between participants. This is why individual differences might influence cognitive lock-up. The present study tested whether working memory-including flexibility in executive functioning-and sustained attention might be crucial in this regard. Eighty-five participants were asked to monitor automated aircraft functions. The experimental manipulation consisted of whether or not an initial automation failure was followed by a consecutive failure. Reaction times to the failures were recorded. Participants' working-memory and sustained-attention abilities were assessed with standardized tests. As expected, participants' reactions to consecutive failures were slower than their reactions to initial failures. In addition, working-memory and sustained-attention abilities enhanced the speed with which participants reacted to failures, more so with regard to consecutive than to initial failures. The findings highlight that operators with better working memory and sustained attention have small advantages when initial failures occur, but their advantages increase across consecutive failures. The results stress the need to consider personnel selection strategies to mitigate cognitive lock-up in general and training procedures to enhance the performance of low ability operators. © 2016, Human Factors and Ergonomics Society.

Comparison of 2 and 4 Intratympanic Steroid Injections in the Treatment of Idiopathic Sudden Sensorineural Hearing Loss.

PubMed

Suzuki, Hideaki; Wakasugi, Tetsuro; Kitamura, Takuro; Koizumi, Hiroki; Do, Ba Hung; Ohbuchi, Toyoaki

2018-04-01

We studied the effect of intratympanic steroid administration with different total injection times on hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). The subjects were 191 consecutive patients (192 ears) with ISSNHL (hearing level ≥40 dB, interval between onset and treatment ≤30 days). They received systemic prednisolone (100 mg followed by tapered doses) combined with intratympanic injection of dexamethasone (4 mg/ml). Intratympanic injection was performed 4 times (days 1, 2, 4, and 7) in 92 patients (92 ears) or 2 times (days 1 and 2) in 99 patients (100 ears). The hearing outcomes were evaluated at 1 week from the start of treatment and 1 to 2 months after the completion of treatment. There was no significant difference in hearing outcomes between the 4- and 2-injection groups at either time point. Multiple regression analysis also showed that the hearing level after treatment did not depend on the total number of intratympanic steroid injections. These results indicate that a protocol using only 2 intratympanic steroid injections exerts a sufficient effect on the hearing outcomes of ISSNHL. This simplified treatment protocol would be greatly beneficial to relieve the physical and mental stress of patients.

Tp-e Interval, Tp-e/QTc Ratio, and Fragmented QRS Are Correlated with the Severity of Liver Cirrhosis.

PubMed

Akboga, Mehmet Kadri; Yuksel, Mahmut; Balci, Kevser Gulcihan; Kaplan, Mustafa; Cay, Serkan; Gokbulut, Volkan; Yayla, Cagri; Ertem, Ahmet Goktug; Ayhan, Meral Akdogan; Topaloglu, Serkan; Aras, Dursun

2017-01-01

Arrhythmias and electrocardiographic changes are reported in several noncardiac diseases, including liver cirrhosis (LC). We intended to evaluate the interval from the peak to the end of the electrocardiographic T wave (Tp-e), Tp-e/QTc ratio, and fQRS as presumed markers of arrhythmias in LC. In this cross-sectional study, a total of 88 consecutive patients with LC according to clinical, biological, ultrasonographic, or histological criteria and 73 control subjects were enrolled. The severity of cirrhosis was classified according to Pugh-Child's classification and Model for End-Stage Liver Disease (MELD) score. Tp-e interval, Tp-e/QTc ratio, and fQRS rates were measured from the 12-lead electrocardiogram. Tp-e interval, Tp-e/QTc ratio and fQRS rates were significantly increased in parallel to the severity of LC (P < 0.001, P < 0.001, and P = 0.003, respectively). In correlation analysis, Pugh-Child stage showed a significantly positive correlation with Tp-e interval (r = 0.462, P < 0.001), QTc interval (r = 0.373, P < 0.001), Tp-e/QTc ratio (r = 0.352, P < 0.001), and fQRS (r = 0.407, P < 0.001). Furthermore, Tp-e interval (r = 0.414, P < 0.001) and Tp-e/QTc ratio (r = 0.426, P< 0.001) had significant positive correlation with MELD score. Our study demonstrated that Tp-e interval, Tp-e/QTc ratios, and fQRS rates were significantly increased in parallel to the severity of LC. Thus, these findings may implicate that Tp-e interval, Tp-e/QTc ratio, and fQRS may be novel and useful indicators for prediction of arrhythmias in LC. © 2016 Wiley Periodicals, Inc.

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.

Diurnal glycemic profile in obese and normal weight nondiabetic pregnant women.

PubMed

Yogev, Yariv; Ben-Haroush, Avi; Chen, Rony; Rosenn, Barak; Hod, Moshe; Langer, Oded

2004-09-01

A paucity of data exists concerning the normal glycemic profile in nondiabetic pregnancies. Using a novel approach that provides continuous measurement of blood glucose, we sought to evaluate the ambulatory daily glycemic profile in the second half of pregnancy in nondiabetic women. Fifty-seven obese and normal weight nondiabetic subjects were evaluated for 72 consecutive hours with continuous glucose monitoring by measurement interstitial glucose levels in subcutaneous tissue every 5 minutes. Subjects were instructed not to modify their lifestyle or to follow any dietary restriction. For each woman, mean and fasting blood glucose values were determined; for each meal during the study period, the first 180 minutes were analyzed. For the study group, the fasting blood glucose level was 75 +/- 12 mg/dL; the mean blood glucose level was 83.7 +/- 18 mg/dL; the postprandial peak glucose value level was 110 +/- 16 mg/dL, and the time interval that was needed to reach peak postprandial glucose level was 70 +/- 13 minutes. A similar postprandial glycemic profile was obtained for breakfast, lunch, and dinner. Obese women were characterized by a significantly higher postprandial glucose peak value, increased 1- and 2-hour postprandial glucose levels, increased time interval for glucose peak, and significantly lower mean blood glucose during the night. No difference was found in fasting and mean blood glucose between obese and nonobese subjects. Glycemic profile characterization in both obese and normal weight nondiabetic subjects provide a measure for the desired level of glycemic control in pregnancy that is complicated with diabetes mellitus.

Photometric monitoring of three BL Lacertae objects in 1993-1998

NASA Astrophysics Data System (ADS)

Bai, J. M.; Xie, G. Z.; Li, K. H.; Zhang, X.; Liu, W. W.

1999-05-01

The results of optical photometric (BVRI) monitoring of three BL Lac objects over a time interval of about four years are presented. The sources are three classical radio-selected BL Lac objects, BL Lac, OJ 287 and PKS 0735+178. During our observation OJ 287 was in the stage of a large periodic outburst which consisted of at least two peaks. Almost all the observations obtained over consecutive nights detected intranight variations. In 1995 and 1996 BL Lac kept in faint states, with fewer and smaller rapid flares and fluctuations. On the contrary, in late 1997 BL Lac was at the stage of a large outburst, accompanied with much more large amplitude rapid flares and fluctuations. PKS 0735+178 was almost at its faint end from 1994 to early 1998. Over this time interval, the intraday variations and microvariations in PKS 0735+178 were rare and the amplitude was very small, except a rapid darkening of ~ 0.4 mag on 24 January 1995. Previous work by \\cite[Webb et al. (1988);]{web88} \\cite[Wagner et al. (1996);]{wag96} \\cite[Pian et al. (1997)]{pia97} also showed the same behaviour of variability as BL Lac and PKS 0735+178 in BL Lac, S5 0716+714, PKS 2155-304, respectively. We propose that the motion of orientation of the relativistic jet in a BL Lac object be responsible for these variability behaviours. Table~1 is only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/Abstract.html

Features of Heart Rate Variability Capture Regulatory Changes During Kangaroo Care in Preterm Infants.

PubMed

Kommers, Deedee R; Joshi, Rohan; van Pul, Carola; Atallah, Louis; Feijs, Loe; Oei, Guid; Bambang Oetomo, Sidarto; Andriessen, Peter

2017-03-01

To determine whether heart rate variability (HRV) can serve as a surrogate measure to track regulatory changes during kangaroo care, a period of parental coregulation distinct from regulation within the incubator. Nurses annotated the starting and ending times of kangaroo care for 3 months. The pre-kangaroo care, during-kangaroo care, and post-kangaroo care data were retrieved in infants with at least 10 accurately annotated kangaroo care sessions. Eight HRV features (5 in the time domain and 3 in the frequency domain) were used to visually and statistically compare the pre-kangaroo care and during-kangaroo care periods. Two of these features, capturing the percentage of heart rate decelerations and the extent of heart rate decelerations, were newly developed for preterm infants. A total of 191 kangaroo care sessions were investigated in 11 preterm infants. Despite clinically irrelevant changes in vital signs, 6 of the 8 HRV features (SD of normal-to-normal intervals, root mean square of the SD, percentage of consecutive normal-to-normal intervals that differ by >50 ms, SD of heart rate decelerations, high-frequency power, and low-frequency/high-frequency ratio) showed a visible and statistically significant difference (P <.01) between stable periods of kangaroo care and pre-kangaroo care. HRV was reduced during kangaroo care owing to a decrease in the extent of transient heart rate decelerations. HRV-based features may be clinically useful for capturing the dynamic changes in autonomic regulation in response to kangaroo care and other changes in environment and state. Copyright © 2016 Elsevier Inc. All rights reserved.

EVALUATING DISABILITY OVER DISCRETE PERIODS OF TIME

PubMed Central

Gill, Thomas M.; Gahbauer, Evelyne A.

2009-01-01

Background To advance the field of disability assessment, additional developmental work is needed. The objective of this study was to determine the potential value of participant recall when evaluating disability over discrete periods of time. Methods We studied 491 residents of greater New Haven, Connecticut who were aged 76 years or older. Participants completed a comprehensive assessment that included several new questions on disability in four essential activities of daily living (bathing, dressing, transferring, and walking). Participants were also assessed for disability in the same activities during monthly telephone interviews before and after the comprehensive assessment. Chronic disability was defined as a new disability that was present for at least three consecutive months. Results We found that up to half of the incident disability episodes, which would otherwise have been missed, can be ascertained if participants are asked to recall whether they have had disability “at any time” since the prior assessment; that these disability episodes, which are ascertained by participant recall, confer high risk for the subsequent development of chronic disability, with an adjusted hazard ratio of 2.5 (95% confidence interval: 1.1, 5.8); and that participant recall for the absence of disability becomes increasingly inaccurate as the duration of the assessment interval increases, with 2.2%, 6.0%, 6.9% and 9.1% of participants having inaccurate recall at 1, 3, 6, and 12 months, respectively. Conclusions Our results demonstrate both the promise and limitations of participant recall and suggest that additional strategies are needed to more completely and accurately ascertain the occurrence of disability among older persons. PMID:18559633

Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement Significantly Reduces Death and Stroke Compared With Unprotected Procedures.

PubMed

Seeger, Julia; Gonska, Birgid; Otto, Markus; Rottbauer, Wolfgang; Wöhrle, Jochen

2017-11-27

The aim of this study was to evaluate the impact of cerebral embolic protection on stroke-free survival in patients undergoing transcatheter aortic valve replacement (TAVR). Imaging data on cerebral embolic protection devices have demonstrated a significant reduction in number and volume of cerebral lesions. A total of 802 consecutive patients were enrolled. The Sentinel cerebral embolic protection device (Claret Medical Inc., Santa Rosa, California) was used in 34.9% (n = 280) of consecutive patients. In 65.1% (n = 522) of patients TAVR was performed in the identical setting except without cerebral embolic protection. Neurological follow-up was done within 7 days post-procedure. The primary endpoint was a composite of all-cause mortality or all-stroke according to Valve Academic Research Consortium-2 criteria within 7 days. Propensity score matching was performed to account for possible confounders. Both filters of the device were successfully positioned in 280 of 305 (91.8%) consecutive patients. With use of cerebral embolic protection rate of disabling and nondisabling stroke was significantly reduced from 4.6% to 1.4% (p = 0.03; odds ratio: 0.29, 95% confidence interval: 0.10 to 0.93) in the propensity-matched population (n = 560). The primary endpoint occurred significantly less frequently, with 2.1% (n = 6 of 280) in the protected group compared with 6.8% (n = 19 of 280) in the control group (p = 0.01; odds ratio: 0.30; 95% confidence interval: 0.12 to 0.77). In multivariable analysis Society of Thoracic Surgeons score for mortality (p = 0.02) and TAVR without protection (p = 0.02) were independent predictors for the primary endpoint. In patients undergoing TAVR use of a cerebral embolic protection device demonstrated a significant higher rate of stroke-free survival compared with unprotected TAVR. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Working with a fixed operating room team on consecutive similar cases and the effect on case duration and turnover time.

PubMed

Stepaniak, Pieter S; Vrijland, Wietske W; de Quelerij, Marcel; de Vries, Guus; Heij, Christiaan

2010-12-01

If variation in procedure times could be controlled or better predicted, the cost of surgeries could be reduced through improved scheduling of surgical resources. This study on the impact of similar consecutive cases on the turnover, surgical, and procedure times tests the perception that repeating the same manual tasks reduces the duration of these tasks. We hypothesize that when a fixed team works on similar consecutive cases the result will be shorter turnover and procedure duration as well as less variation as compared with the situation without a fixed team. Case-control study. St Franciscus Hospital, a large general teaching hospital in Rotterdam, the Netherlands. Two procedures, inguinal hernia repair and laparoscopic cholecystectomy, were selected and divided across a control group and a study group. Patients were randomly assigned to the study or control group. Preparation time, surgical time, procedure time, and turnover time. For inguinal hernia repair, we found a significantly lower preparation time and 10 minutes less procedure time in the study group, as compared with the control group. Variation in the study group was lower, as compared with the control group. For laparoscopic cholecystectomy, preparation time was significantly lower in the study group, as compared with the control group. For both procedures, there was a significant decrease in turnover time. Scheduling similar consecutive cases and performing with a fixed team results in lower turnover times and preparation times. The procedure time of the inguinal hernia repair decreased significantly and has practical scheduling implications. For more complex surgery, like laparoscopic cholecystectomy, there is no effect on procedure time.

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

PubMed

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

2012-06-01

Cardiac arrest due to torsades de pointes (TdP) is a rare but catastrophic event in hospitals. Patients admitted to cardiac units are at higher risk of drug-induced QT interval prolongation and TdP, due to a preponderance of risk factors. Few data exist regarding the prevalence of QT interval prolongation in patients admitted to cardiac units or the frequency of administering QT interval-prolonging drugs to patients presenting with QT interval prolongation. The aim of this study was to determine the prevalence of Bazett's-corrected QT (QT(c)) interval prolongation upon admission to cardiac units and the proportion of patients presenting with QT(c) interval prolongation who are subsequently administered QT interval-prolonging drugs during hospitalization. This was a prospective, observational study conducted over a 1-year period (October 2008-October 2009) in 1159 consecutive patients admitted to two cardiac units in a large urban academic medical centre located in Indianapolis, IN, USA. Patients were enrolled into the study at the time of admission to the hospital and were followed daily during hospitalization. Exclusion criteria were age <18 years, ECG rhythm of complete ventricular pacing, and patient designation as 'outpatient' in a bed and/or duration of stay <24 hours. Data collected included demographic information, past medical history, daily progress notes, medication administration records, laboratory data, ECGs, telemetry monitoring strips and diagnostic reports. All patients underwent continuous cardiac telemetry monitoring and/or had a baseline 12-lead ECG obtained within 4 hours of admission. QT intervals were determined manually from lead II of 12-lead ECGs or from continuous lead II telemetry monitoring strips. QT(c) interval prolongation was defined as ≥470 ms for males and ≥480 ms for females. In both males and females, QT(c) interval >500 ms was considered abnormally high. A medication was classified as QT interval-prolonging if there were published data indicating that the drug causes QT interval prolongation and/or TdP. Study endpoints were (i) prevalence of QT(c) interval prolongation upon admission to the Cardiac Medical Critical Care Unit (CMCCU) or an Advanced Heart Care Unit (AHCU); (ii) proportion of patients admitted to the CMCCU/AHCU with QT(c) interval prolongation who subsequently were administered QT interval-prolonging drugs during hospitalization; (iii) the proportion of these higher-risk patients in whom TdP risk factor monitoring was performed; (iv) proportion of patients with QT(c) interval prolongation who subsequently received QT-prolonging drugs and who experienced further QT(c) interval prolongation. Of 1159 patients enrolled, 259 patients met exclusion criteria, resulting in a final sample size of 900 patients. mean (± SD) age, 65 ± 15 years; female, 47%; Caucasian, 70%. Admitting diagnoses: heart failure (22%), myocardial infarction (16%), atrial fibrillation (9%), sudden cardiac arrest (3%). QT(c) interval prolongation was present in 27.9% of patients on admission; 18.2% had QT(c) interval >500 ms. Of 251 patients admitted with QT(c) interval prolongation, 87 (34.7%) were subsequently administered QT interval-prolonging drugs. Of 166 patients admitted with QT(c) interval >500 ms, 70 (42.2%) were subsequently administered QT interval-prolonging drugs; additional QT(c) interval prolongation ≥60 ms occurred in 57.1% of these patients. QT(c) interval prolongation is common among patients admitted to cardiac units. QT interval-prolonging drugs are commonly prescribed to patients presenting with QT(c) interval prolongation.

Stability of Early EEG Background Patterns After Pediatric Cardiac Arrest.

PubMed

Abend, Nicholas S; Xiao, Rui; Kessler, Sudha Kilaru; Topjian, Alexis A

2018-05-01

We aimed to determine whether EEG background characteristics remain stable across discrete time periods during the acute period after resuscitation from pediatric cardiac arrest. Children resuscitated from cardiac arrest underwent continuous conventional EEG monitoring. The EEG was scored in 12-hour epochs for up to 72 hours after return of circulation by an electroencephalographer using a Background Category with 4 levels (normal, slow-disorganized, discontinuous/burst-suppression, or attenuated-featureless) or 2 levels (normal/slow-disorganized or discontinuous/burst-suppression/attenuated-featureless). Survival analyses and mixed-effects ordinal logistic regression models evaluated whether the EEG remained stable across epochs. EEG monitoring was performed in 89 consecutive children. When EEG was assessed as the 4-level Background Category, 30% of subjects changed category over time. Based on initial Background Category, one quarter of the subjects changed EEG category by 24 hours if the initial EEG was attenuated-featureless, by 36 hours if the initial EEG was discontinuous or burst-suppression, by 48 hours if the initial EEG was slow-disorganized, and never if the initial EEG was normal. However, regression modeling for the 4-level Background Category indicated that the EEG did not change over time (odds ratio = 1.06, 95% confidence interval = 0.96-1.17, P = 0.26). Similarly, when EEG was assessed as the 2-level Background Category, 8% of subjects changed EEG category over time. However, regression modeling for the 2-level category indicated that the EEG did not change over time (odds ratio = 1.02, 95% confidence interval = 0.91-1.13, P = 0.75). The EEG Background Category changes over time whether analyzed as 4 levels (30% of subjects) or 2 levels (8% of subjects), although regression analyses indicated that no significant changes occurred over time for the full cohort. These data indicate that the Background Category is often stable during the acute 72 hours after pediatric cardiac arrest and thus may be a useful EEG assessment metric in future studies, but that some subjects do have EEG changes over time and therefore serial EEG assessments may be informative.

On the Hausdorff dimension faithfulness connected with Q_{\\infty} -expansion

NASA Astrophysics Data System (ADS)

Liu, Jia; Zhang, Zhenliang

2017-06-01

In this paper, we show that, the family of all possible unions of finitely many consecutive cylinders of the same rank of a Q∞ -expansion is faithful for the Hausdorff dimension calculations. Applying this result, we give a necessary and sufficient condition for the family of all cylinders of the Q∞ -expansion to be faithful for Hausdorff dimension calculation on the unit interval. This answers an open problem mentioned in Albeverio et al (2016 Math. Nachr. at press (https//:doi.org/10.1002/mana.201500471)).

Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel

PubMed Central

McKibbin, M; Devonport, H; Gale, R; Gavin, M; Lotery, A; Mahmood, S; Patel, P J; Ross, A; Sivaprasad, S; Talks, J; Walters, G

2015-01-01

This supplement has been sponsored by Bayer HealthCare. Please see acknowledgements for full disclaimer. Prescribing Information can be found in the appendices. L.GB.COM.05.2015.11280. Date of preparation: June 2015 This paper provides expert recommendations on administration of aflibercept in wet age-related macular degeneration (AMD) after Year 1 (Y1), based on a roundtable discussion held in London, UK in November 2014. The goals of treatment after Y1 are to maintain visual and anatomical gains whilst minimising treatment burden and using resources effectively. The treatment decision should be made at the seventh injection visit (assuming the label has been followed) in Y1, and three approaches are proposed: (a) eyes with active disease on imaging/examination but with stable visual acuity (VA) at the end of Y1 should continue with fixed 8-weekly dosing; (b) eyes with inactive disease on imaging/examination and stable VA should be managed using a ‘treat and extend' (T&E) regimen. T&E involves treating and then extending the interval until the next treatment, by 2-week intervals, to a maximum of 12 weeks, provided the disease remains inactive. If there is new evidence of disease activity, treatment is administered and the interval to the next treatment shortened; and (c) if there has been no disease activity for ≥3 consecutive visits, a trial of monitoring without treatment may be appropriate, initiated at the end of Y1 or at any time during Y2. Where possible, VA testing, OCT imaging and injection should be performed at the same visit. The second eye should be monitored to detect fellow eye involvement. In bilateral disease, the re-treatment interval should be driven by the better-seeing eye or, if the VA is similar, the eye with the more active disease. PMID:26156564

Low-flow characteristics of streams in Virginia

USGS Publications Warehouse

Hayes, Donald C.

1991-01-01

Streamflow data were collected and low-flow characteristics computed for 715 gaged sites in Virginia Annual minimum average 7-consecutive-day flows range from 0 to 2,195 cubic feet per second for a 2-year recurrence interval and from 0 to 1,423 cubic feet per second for a 10-year recurrence interval. Drainage areas range from 0.17 to 7,320 square miles. Existing and discontinued gaged sites are separated into three types: long-term continuous-record sites, short-term continuous-record sites, and partial-record sites. Low-flow characteristics for long-term continuous-record sites are determined from frequency curves of annual minimum average 7-consecutive-day flows . Low-flow characteristics for short-term continuous-record sites are estimated by relating daily mean base-flow discharge values at a short-term site to concurrent daily mean discharge values at nearby long-term continuous-record sites having similar basin characteristics . Low-flow characteristics for partial-record sites are estimated by relating base-flow measurements to daily mean discharge values at long-term continuous-record sites. Information from the continuous-record sites and partial-record sites in Virginia are used to develop two techniques for estimating low-flow characteristics at ungaged sites. A flow-routing method is developed to estimate low-flow values at ungaged sites on gaged streams. Regional regression equations are developed for estimating low-flow values at ungaged sites on ungaged streams. The flow-routing method consists of transferring low-flow characteristics from a gaged site, either upstream or downstream, to a desired ungaged site. A simple drainage-area proration is used to transfer values when there are no major tributaries between the gaged and ungaged sites. Standard errors of estimate for108 test sites are 19 percent of the mean for estimates of low-flow characteristics having a 2-year recurrence interval and 52 percent of the mean for estimates of low-flow characteristics having a 10-year recurrence interval . A more complex transfer method must be used when major tributaries enter the stream between the gaged and ungaged sites. Twenty-four stream networks are analyzed, and predictions are made for 84 sites. Standard errors of estimate are 15 percent of the mean for estimates of low-flow characteristics having a 2-year recurrence interval and 22 percent of the mean for estimates of low-flow characteristics having a 10-year recurrence interval. Regional regression equations were developed for estimating low-flow values at ungaged sites on ungaged streams. The State was divided into eight regions on the basis of physiography and geographic grouping of the residuals computed in regression analyses . Basin characteristics that were significant in the regression analysis were drainage area, rock type, and strip-mined area. Standard errors of prediction range from 60 to139 percent for estimates of low-flow characteristics having a 2-year recurrence interval and 90 percent to 172 percent for estimates of low-flow characteristics having a 10-year recurrence interval.

Implementation of radial arterial access for cardiac interventions: a strong case for quality assurance protocols by the nursing staff.

PubMed

Steffenino, Giuseppe; Fabrizi, Mauro De Benedetto; Baralis, Giorgio; Tomatis, Marilena; Mogna, Aldo; Dutto, Monica; Dutto, Maria Stefania; Conte, Laura; Lice, Giulietta; Cavallo, Simona; Porcedda, Brunella

2011-02-01

Radial arterial access is becoming increasingly popular for coronary angiography and angioplasty. The technique is, however, more demanding than femoral arterial access, and hemostasis is not care-free. A quality assurance program was run by our nursing staff, with patient follow-up, to monitor radial arterial access implementation in our laboratory. In 973 consecutive patients, both a hydrophilic sheath and an inflatable bandage for hemostasis were used. Bandage inflation volume and time were both reduced through subsequent data audit and protocol changes (A = 175 patients; B = 297; C = 501). An increase was achieved in the percentage of patients with neither loss of radial pulse nor hematoma of any size (A = 81.3%, B = 90.9%, C = 92.2%, P < 0.001), and no discomfort at all (A = 44.2%, B = 75.1%, C = 89.3%, P < 0.001). Follow-up was available for 965 patients (99%), and in 956, the access site could be re-inspected at least once. There were no vascular complications. Overall, the radial artery pulse was absent at latest follow-up in 0.6% of cases (95% confidence interval 0.21-1.05%). In 460 consecutive patients with complete assessment in protocol C, a palpable arterial pulse was absent in 5% of cases at about 20 h after hemostasis. Barbeau's test was positive in 26.5% of patients (95% confidence interval 22.5-30.6%). They had a significantly lower body weight, a lower systolic blood pressure at hemostasis, and a higher bandage inflation volume; a hematoma of any size and the report of any discomfort were also more frequent. Barbeau's test returned to normal in 30% of them 3-60 days later. Our nurse-led quality assurance program helped us in reducing minor vascular sequelae and improving patient comfort after radial access. Early occlusion of the radial artery as detected by pulse oxymeter is frequent, often reversible, and may be mostly related to trauma/occlusion of the artery during hemostasis. 2011 Italian Federation of Cardiology.

Comparison of referral and non-referral hypertensive disorders during pregnancy: an analysis of 271 consecutive cases at a tertiary hospital.

PubMed

Liu, Ching-Ming; Chang, Shuenn-Dyh; Cheng, Po-Jen

2005-05-01

This retrospective cohort study analyzed the clinical manifestations in patients with preeclampsia and eclampsia, assessed the risk factors compared to the severity of hypertensive disorders on maternal and perinatal morbidity, and mortality between the referral and non-referral patients. 271 pregnant women with preeclampsia and eclampsia were assessed (1993 to 1997). Chi-square analysis was used for the comparison of categorical variables, and the comparison of the two independent variables of proportions in estimation of confidence intervals and calculated odds ratio of the referral and non-referral groups. Multivariate logistic regression was used for adjusting potential confounding risk factors. Of the 271 patients included in this study, 71 (26.2%) patients were referrals from other hospitals. Most of the 62 (87.3%) referral patients were transferred during the period 21 and 37 weeks of gestation. Univariate analysis revealed that referral patients with hypertensive disorder were significantly associated with SBP > or =180, DBP > or =105, severe preclampsia, haemolysis, elevated liver enzymes, low platelets (HELLP), emergency C/S, maternal complications, and low birth weight babies, as well as poor Apgar score. Multivariate logistic regression analyses revealed that the risk factors identified to be significantly associated with increased risk of referral patients included: diastolic blood pressure above 105 mmHg (adjusted odds ratio, 2.09; 95 percent confidence interval, 1.06 to 4.13; P = 0.034), severe preeclampsia (adjusted odds ratio, 3.46; 95 percent confidence interval, 1.76 to 6.81; P < 0.001), eclampsia (adjusted odds ratio, 2.77; 95 percent confidence interval, 0.92 to 8.35; P = 0.071), HELLP syndrome (adjusted odds ratio, 18.81; 95 percent confidence interval, 2.14 to 164.99; P = 0.008). The significant factors associated with the referral patients with hypertensive disorders were severe preeclampsia, HELLP, and eclampsia. Lack of prenatal care was the major avoidable factor found in referral and high risk patients. Time constraints relating to referral patients and the appropriateness of patient-centered care for patient safety and better quality of health care need further investigation on national and multi-center clinical trials.

Optical diagnosis of small colorectal polyps at routine colonoscopy (Detect InSpect ChAracterise Resect and Discard; DISCARD trial): a prospective cohort study.

PubMed

Ignjatovic, Ana; East, James E; Suzuki, Noriko; Vance, Margaret; Guenther, Thomas; Saunders, Brian P

2009-12-01

Accurate optical diagnosis of small (<10 mm) colorectal polyps in vivo, without formal histopathology, could make colonoscopy more efficient and cost effective. The aim of this study was to assess whether optical diagnosis of small polyps is feasible and safe in routine clinical practice. Consecutive patients with a positive faecal occult blood test or previous adenomas undergoing surveillance at St Mark's Hospital (London, UK), from June 19, 2008, to June 16, 2009, were included in this prospective study. Four colonoscopists with different levels of experience predicted polyp histology using optical diagnosis with high-definition white light, followed by narrow-band imaging without magnification and chromoendoscopy, as required. The primary outcome was accuracy of polyp characterisation using optical diagnosis compared with histopathology, the current gold standard. Accuracy of optical diagnosis to predict the next surveillance interval was also assessed and compared with surveillance intervals predicted by current guidelines using histopathology. This study is registered with ClinicalTrials.gov, NCT00888771. 363 polyps smaller than 10 mm were detected in 130 patients, of which 278 polyps had both optical and histopathological diagnosis. By histology, 198 of these polyps were adenomas and 80 were non-neoplastic lesions (of which 62 were hyperplastic). Optical diagnosis accurately diagnosed 186 of 198 adenomas (sensitivity 0.94; 95% CI 0.90-0.97) and 55 of 62 hyperplastic polyps (specificity 0.89; 0.78-0.95), with an overall accuracy of 241 of 260 (0.93, 0.89-0.96) for polyp characterisation. Using optical diagnosis alone, 82 of 130 patients could be given a surveillance interval immediately after colonoscopy, and the same interval was found after formal histopathology in 80 patients (98%) using British guidelines and in 78 patients (95%) using US multisociety guidelines. For polyps less than 10 mm in size, in-vivo optical diagnosis seems to be an acceptable strategy to assess polyp histopathology and future surveillance intervals. Dispensing with formal histopathology for most small polyps found at colonoscopy could improve the efficiency of the procedure and lead to substantial savings in time and cost. Leigh Family Trust, London, UK.

Bleeding pattern and user satisfaction in second consecutive levonorgestrel-releasing intrauterine system users: results of a prospective 5-year study.

PubMed

Heikinheimo, O; Inki, P; Schmelter, T; Gemzell-Danielsson, K

2014-06-01

What is the bleeding pattern during second consecutive levonorgestrel-releasing intrauterine system (LNG-IUS) use? Consecutive use of LNG-IUS is associated with a predictable bleeding pattern, characterized by the absence of the initial period of irregular bleeding seen after interval insertion of an LNG-IUS and a non-bleeding pattern in the vast majority of women. With increased popularity of the LNG-IUS for long-term birth control and treatment of heavy menstrual bleeding (HMB), consecutive use of the system is becoming more frequent. One previous study showed 60% amenorrhea rate in consecutive IUS users; however, the sample size was small. A prospective multicenter study in four European countries recruited women who wished to continue with LNG-IUS use immediately after the first 5-year period. A total of 204 women were followed up until the end of the first year of the second IUS. Thereafter 170 women continued into the extension phase of the study up to the full 5 years of use of the second IUS and 144 women continued to the end of the study. A total of 170 women (mean age 39 years) who had been using their first LNG-IUS for between 4 years 3 months and 4 years 9 months, either for contraception or for treatment of HMB, and who planned to replace the device with a new LNG-IUS, were recruited and followed up to 5 years of the second IUS use. A total of 17 centers in four European countries were involved in the study. Bleeding patterns were analyzed using daily bleeding diaries using 90-day reference periods (RP) for the first year of the second IUS use and for the last RP of each year during Years 2-5 of use. Approximately 70% of women were free of bleeding during Years 2-5 and up to 49% were amenorrheic. There was a slight increase in the number of bleeding/spotting days of ∼3 days during the first RP immediately after the placement of the second IUS, whereafter the number of bleeding/spotting days returned to the level preceding the second IUS insertion or below that. Absence of bleeding was associated with high overall satisfaction and continuation rates. No serious adverse events assessed as related to the LNG-IUS use occurred during the 5-year period. The cumulative expulsion rate during the 5-year study period was 1.2%. The sample size was large enough to study bleeding patterns, and subjects are likely to represent typical consecutive IUS users, and therefore, the role of chance is small. The women represent a selected group as they had already successfully used their first IUS for almost 5 years and were willing to continue its use-however, this is currently a common clinical situation. The results may therefore not be extrapolated to first-time users of the LNG-IUS. These data are of importance when counseling women who are making decisions concerning long-term contraception. This study was funded by Bayer Pharma AG. P.I. and T.S. are full-time employees of Bayer Pharma AG. O.H. and K. G-D. have received consultancy fees from Bayer Pharma AG. The publication was developed jointly by all authors without third-party involvement and no honoraria were paid for any authors for their contribution to this manuscript. NCT00393198.

Towards a personalized and dynamic CRT-D. A computational cardiovascular model dedicated to therapy optimization.

PubMed

Di Molfetta, A; Santini, L; Forleo, G B; Minni, V; Mafhouz, K; Della Rocca, D G; Fresiello, L; Romeo, F; Ferrari, G

2012-01-01

In spite of cardiac resynchronization therapy (CRT) benefits, 25-30% of patients are still non responders. One of the possible reasons could be the non optimal atrioventricular (AV) and interventricular (VV) intervals settings. Our aim was to exploit a numerical model of cardiovascular system for AV and VV intervals optimization in CRT. A numerical model of the cardiovascular system CRT-dedicated was previously developed. Echocardiographic parameters, Systemic aortic pressure and ECG were collected in 20 consecutive patients before and after CRT. Patient data were simulated by the model that was used to optimize and set into the device the intervals at the baseline and at the follow up. The optimal AV and VV intervals were chosen to optimize the simulated selected variable/s on the base of both echocardiographic and electrocardiographic parameters. Intervals were different for each patient and in most cases, they changed at follow up. The model can well reproduce clinical data as verified with Bland Altman analysis and T-test (p > 0.05). Left ventricular remodeling was 38.7% and left ventricular ejection fraction increasing was 11% against the 15% and 6% reported in literature, respectively. The developed numerical model could reproduce patients conditions at the baseline and at the follow up including the CRT effects. The model could be used to optimize AV and VV intervals at the baseline and at the follow up realizing a personalized and dynamic CRT. A patient tailored CRT could improve patients outcome in comparison to literature data.

Approaches for the accurate definition of geological time boundaries

NASA Astrophysics Data System (ADS)

Schaltegger, Urs; Baresel, Björn; Ovtcharova, Maria; Goudemand, Nicolas; Bucher, Hugo

2015-04-01

Which strategies lead to the most precise and accurate date of a given geological boundary? Geological units are usually defined by the occurrence of characteristic taxa and hence boundaries between these geological units correspond to dramatic faunal and/or floral turnovers and they are primarily defined using first or last occurrences of index species, or ideally by the separation interval between two consecutive, characteristic associations of fossil taxa. These boundaries need to be defined in a way that enables their worldwide recognition and correlation across different stratigraphic successions, using tools as different as bio-, magneto-, and chemo-stratigraphy, and astrochronology. Sedimentary sequences can be dated in numerical terms by applying high-precision chemical-abrasion, isotope-dilution, thermal-ionization mass spectrometry (CA-ID-TIMS) U-Pb age determination to zircon (ZrSiO4) in intercalated volcanic ashes. But, though volcanic activity is common in geological history, ashes are not necessarily close to the boundary we would like to date precisely and accurately. In addition, U-Pb zircon data sets may be very complex and difficult to interpret in terms of the age of ash deposition. To overcome these difficulties we use a multi-proxy approach we applied to the precise and accurate dating of the Permo-Triassic and Early-Middle Triassic boundaries in South China. a) Dense sampling of ashes across the critical time interval and a sufficiently large number of analysed zircons per ash sample can guarantee the recognition of all system complexities. Geochronological datasets from U-Pb dating of volcanic zircon may indeed combine effects of i) post-crystallization Pb loss from percolation of hydrothermal fluids (even using chemical abrasion), with ii) age dispersion from prolonged residence of earlier crystallized zircon in the magmatic system. As a result, U-Pb dates of individual zircons are both apparently younger and older than the depositional age of the ash, therefore masking the true age of deposition. Trace element ratios such as Th/U, Yb/Gd, as well as Hf isotope analysis of dated zircon can be used to decipher the temporal evolution of the magmatic system before the eruption and deposition of the studied ashes, and resolve the complex system behaviour of the zircons. b) Changes in the source of the magma may happen between the deposition of two stratigraphically consecutive ash beds. They result in the modification of the trace element signature of zircon, but also of apatite (Ca5 (F, Cl, OH) (PO4)3). Trace element characteristics in apatite (e.g. Mg, Mn, Fe, F, Cl, Ce, and Y) are a reliable tool for distinguishing chemically similar groups of apatite crystals to unravel the geochemical fingerprint of one single ash bed. By establishing this fingerprint, ash beds of geographically separated geologic sections can be correlated even if they have not all been dated by U-Pb techniques. c) The ultimate goal of quantitative stratigraphy is to establish an age model that predicts the age of a synchronous time line with an associated 95% confidence interval for any such line within a stratigraphic sequence. We show how a Bayesian, non-parametric interpolation approach can be applied to very complex data sets and leads to a well-defined age solution, possibly identifying changes in sedimentation rate. The age of a geological time boundary bracketed by dated samples in such an age model can be defined with an associated uncertainty.

Endoscopic dilation for treatment of anastomotic leaks following transhiatal esophagectomy.

PubMed

Bhasin, D K; Sharma, B C; Gupta, N M; Sinha, S K; Singh, K

2000-06-01

Anastomotic leak is a known complication after transhiatal esophagectomy (THE) and cervical esophagogastric anastomosis. Conservative management takes a long time to heal such leaks. We assessed the role of endoscopic dilation in patients with anastomotic leak following THE. Eight consecutive patients (seven men, one woman; mean age 51) with anastomotic leak following THE were subjected to endoscopic dilation using Savary Gilliard dilators of 7-15 mm diameter. The mean interval between surgery and detection of leak was 9 days (range 5-22 days) and dilation was performed at a mean interval of 11.4 days (range 1-20 days) after detection of the leak. Drainage from fistulas stopped completely after 1-8 days (mean 3 days). X-ray with water soluble contrast showed closure of the fistula in all cases. Duration of follow-up ranged from 2 to 12 months. Anastomotic strictures developed in three patients. These patients required three sessions each of repeat dilation, and were alive at follow-up periods of 2, 4, and 12 months, respectively. One patient developed recurrence of growth at an anastomotic site. Four patients died because of distant metastasis. Bougie dilation of anastomotic sites is a safe and effective technique for the healing of anastomotic leaks following THE. However there is a need for a prospective randomized trial comparing endoscopic dilation with no dilation in patients with anastomotic leaks following THE.

The use of heart rate variability in assessing precompetitive stress in high-standard judo athletes.

PubMed

Morales, J; Garcia, V; García-Massó, X; Salvá, P; Escobar, R; Buscà, B

2013-02-01

The objective of this study is to examine the sensitivity to and changes in heart rate variability (HRV) in stressful situations before judo competitions and to observe the differences among judo athletes according to their competitive standards in both official and unofficial competitions. 24 (10 male and 14 female) national- and international-standard athletes were evaluated. Each participant answered the Revised Competitive State Anxiety Inventory (CSAI-2R) and their HRV was recorded both during an official and unofficial competition. The MANOVA showed significant main effects of the athlete's standard and the type of competition in CSAI-2R, in HRV time domain, in HRV frequency domain and in HRV nonlinear analysis (p<0.05). International-standard judo athletes have lower somatic anxiety, cognitive anxiety, heart rate and low-high frequency ratio than national-standard athletes (p<0.05). International-standard athletes have a higher confidence, mean RR interval, standard deviation of RR, square root of the mean squared difference of successive RR intervals, number of consecutive RR that differ by more than 5 ms, short-term variability, long-term variability, long-range scaling exponents and short-range scaling exponent than national-standard judo athletes. In conclusion, international-standard athletes show less pre-competitive anxiety than the national-standard athletes and HRV analysis is sensitive to changes in pre-competitive anxiety. © Georg Thieme Verlag KG Stuttgart · New York.

Identification of a self-paced hitting task in freely moving rats based on adaptive spike detection from multi-unit M1 cortical signals

PubMed Central

Hammad, Sofyan H. H.; Farina, Dario; Kamavuako, Ernest N.; Jensen, Winnie

2013-01-01

Invasive brain–computer interfaces (BCIs) may prove to be a useful rehabilitation tool for severely disabled patients. Although some systems have shown to work well in restricted laboratory settings, their usefulness must be tested in less controlled environments. Our objective was to investigate if a specific motor task could reliably be detected from multi-unit intra-cortical signals from freely moving animals. Four rats were trained to hit a retractable paddle (defined as a “hit”). Intra-cortical signals were obtained from electrodes placed in the primary motor cortex. First, the signal-to-noise ratio was increased by wavelet denoising. Action potentials were then detected using an adaptive threshold, counted in three consecutive time intervals and were used as features to classify either a “hit” or a “no-hit” (defined as an interval between two “hits”). We found that a “hit” could be detected with an accuracy of 75 ± 6% when wavelet denoising was applied whereas the accuracy dropped to 62 ± 5% without prior denoising. We compared our approach with the common daily practice in BCI that consists of using a fixed, manually selected threshold for spike detection without denoising. The results showed the feasibility of detecting a motor task in a less restricted environment than commonly applied within invasive BCI research. PMID:24298254

Clinical validation of robot simulation of toothbrushing - comparative plaque removal efficacy

PubMed Central

2014-01-01

Background Clinical validation of laboratory toothbrushing tests has important advantages. It was, therefore, the aim to demonstrate correlation of tooth cleaning efficiency of a new robot brushing simulation technique with clinical plaque removal. Methods Clinical programme: 27 subjects received dental cleaning prior to 3-day-plaque-regrowth-interval. Plaque was stained, photographically documented and scored using planimetrical index. Subjects brushed teeth 33–47 with three techniques (horizontal, rotating, vertical), each for 20s buccally and for 20s orally in 3 consecutive intervals. The force was calibrated, the brushing technique was video supported. Two different brushes were randomly assigned to the subject. Robot programme: Clinical brushing programmes were transfered to a 6-axis-robot. Artificial teeth 33–47 were covered with plaque-simulating substrate. All brushing techniques were repeated 7 times, results were scored according to clinical planimetry. All data underwent statistical analysis by t-test, U-test and multivariate analysis. Results The individual clinical cleaning patterns are well reproduced by the robot programmes. Differences in plaque removal are statistically significant for the two brushes, reproduced in clinical and robot data. Multivariate analysis confirms the higher cleaning efficiency for anterior teeth and for the buccal sites. Conclusions The robot tooth brushing simulation programme showed good correlation with clinically standardized tooth brushing. This new robot brushing simulation programme can be used for rapid, reproducible laboratory testing of tooth cleaning. PMID:24996973

Clinical validation of robot simulation of toothbrushing--comparative plaque removal efficacy.

PubMed

Lang, Tomas; Staufer, Sebastian; Jennes, Barbara; Gaengler, Peter

2014-07-04

Clinical validation of laboratory toothbrushing tests has important advantages. It was, therefore, the aim to demonstrate correlation of tooth cleaning efficiency of a new robot brushing simulation technique with clinical plaque removal. Clinical programme: 27 subjects received dental cleaning prior to 3-day-plaque-regrowth-interval. Plaque was stained, photographically documented and scored using planimetrical index. Subjects brushed teeth 33-47 with three techniques (horizontal, rotating, vertical), each for 20s buccally and for 20s orally in 3 consecutive intervals. The force was calibrated, the brushing technique was video supported. Two different brushes were randomly assigned to the subject. Robot programme: Clinical brushing programmes were transfered to a 6-axis-robot. Artificial teeth 33-47 were covered with plaque-simulating substrate. All brushing techniques were repeated 7 times, results were scored according to clinical planimetry. All data underwent statistical analysis by t-test, U-test and multivariate analysis. The individual clinical cleaning patterns are well reproduced by the robot programmes. Differences in plaque removal are statistically significant for the two brushes, reproduced in clinical and robot data. Multivariate analysis confirms the higher cleaning efficiency for anterior teeth and for the buccal sites. The robot tooth brushing simulation programme showed good correlation with clinically standardized tooth brushing.This new robot brushing simulation programme can be used for rapid, reproducible laboratory testing of tooth cleaning.

National Institutes of Health Stroke Scale-Time Score Predicts Outcome after Endovascular Therapy in Acute Ischemic Stroke: A Retrospective Single-Center Study.

PubMed

Todo, Kenichi; Sakai, Nobuyuki; Kono, Tomoyuki; Hoshi, Taku; Imamura, Hirotoshi; Adachi, Hidemitsu; Kohara, Nobuo

2016-05-01

Outcomes after successful endovascular therapy in acute ischemic stroke are associated with onset-to-reperfusion time (ORT) and the National Institutes of Health Stroke Scale (NIHSS) score. In intravenous recombinant tissue plasminogen activator therapy, the NIHSS-time score, calculated by multiplying onset-to-treatment time with the NIHSS score, has been shown to predict clinical outcomes. In this study, we assessed whether a similar combination of the ORT and the NIHSS score can be applied to predict the outcomes after endovascular therapy. We retrospectively reviewed the charts of 128 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy. We analyzed the association of the ORT, the NIHSS score, and the NIHSS-time score with good outcome (modified Rankin Scale score ≤ 2 at 3 months). Good outcome rates for patients with NIHSS-time scores of 84.7 or lower, scores higher than 84.7 up to 127.5 or lower, and scores higher than 127.5 were 72.1%, 44.2%, and 14.3%, respectively (P < .01). Multivariate logistic regression analysis revealed that the NIHSS-time score was an independent predictor of good outcomes (odds ratio, .372; 95% confidence interval, .175-.789) after adjusting for age, sex, internal carotid artery occlusion, plasma glucose level, ORT, and NIHSS score. The NIHSS-time score can predict good clinical outcomes after endovascular treatment. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Impact of the implementation of the Infarction Code strategy in patients with acute myocardial infarction diagnosis in the Hospital de Cardiología of the Centro Médico Nacional Siglo XXI

PubMed

Sánchez, Gabriela Borrayo; Covarrubias, Héctor Álvarez; Rodríguez, Gilberto Pérez; Uribe, Efraín Arizmendi; Ramírez-Arias, Erick; Peralta, Martín Rosas; Dávila, Jesús Arriaga

2017-01-01

To evaluate the impact of the implementation of the Infarction Code strategy in patients with acute myocardial infarction diagnosis. Consecutive patients with ST-elevation acute myocardial infarction ≤12 hours of evolution, were included in the infarction code strategy, before (Group I) and after (Group II). Times of medical attention and major cardiovascular events during hospitalization were analyzed. 1227 patients were included, 919 men (75%) and 308 women (25%) with an average age of 62 ± 11 years. Among Group I and Group II, percutaneous coronary intervention reperfusion therapy changed (16.6% to 42.6%), fibrinolytic therapy (39.3% to 25%), and patients who did not receive any form of reperfusion therapy (44% to 32.6%; p < 0.0001). Times of medical attention decreased significantly (door-to-needle time decreased from 92 to 72 minutes, p = 0.004; door-to-balloon time decreased from 140 to 92 minutes, p < 0.0001). Kidney failure (24.6% vs. 17.9%; p = 0.006), major complications (35.3% to 29.3%), and death (21% vs. 12%; odds ratio: 0.52; 95% confidence interval: 0.38-0.71; p = 0.004). also decreased. The Infarction Code strategy improved treatment, times of medical attention and decreased complications and death in these patients.

Literacy, race, and PSA level among low-income men newly diagnosed with prostate cancer.

PubMed

Wolf, Michael S; Knight, Sara J; Lyons, E Allison; Durazo-Arvizu, Ramón; Pickard, Simon A; Arseven, Adnan; Arozullah, Ahsan; Colella, Kathleen; Ray, Paul; Bennett, Charles L

2006-07-01

Among men with newly diagnosed prostate cancer, prostate-specific antigen (PSA) levels are higher and the cancer stage more advanced for African Americans than for whites. An earlier study found that after adjustment for literacy, race was no longer a significant predictor of advanced stage at presentation. We investigated whether, after adjusting for literacy, race was a significant independent predictor of greater PSA levels among men with newly diagnosed prostate cancer. Consecutive patients with newly diagnosed prostate cancer from four outpatient care facilities in Chicago were interviewed and given a literacy assessment (n = 308). The PSA level at diagnosis was obtained from the medical charts. Logistic regression models were used to identify predictors of high PSA levels (greater than 20 ng/mL) at presentation. African-American men were three times more likely to have low literacy skills (sixth grade or less: 22.9% versus 7.1%; P <0.001) than were white men. In turn, men with low literacy skills were more than twice as likely to have a PSA level greater than 20 ng/mL at diagnosis (33.3% versus 13.5%; P = 0.009). On multivariate analyses, significant predictors of high PSA levels included low literacy (adjusted odds ratio 2.5, 95% confidence interval 1.5 to 4.2) and older age (age 65 to 74 years, adjusted odds ratio 2.6, 95% confidence interval 2.1 to 3.1 versus older than 74 years, adjusted odds ratio 3.4, 95% confidence interval 1.8 to 6.6), but not African-American race. In the current era in which PSA testing is common, low literacy may be an important and potentially overlooked factor associated with higher PSA levels at prostate cancer diagnosis among African-American and white men.

Long-Term Haloperidol Treatment Prolongs QT Interval and Increases Expression of Sigma 1 and IP3 Receptors in Guinea Pig Hearts.

PubMed

Stracina, Tibor; Slaninova, Iva; Polanska, Hana; Axmanova, Martina; Olejnickova, Veronika; Konecny, Petr; Masarik, Michal; Krizanova, Olga; Novakova, Marie

2015-07-01

Haloperidol is a neuroleptic drug used for a medication of various psychoses and deliria. Its administration is frequently accompanied by cardiovascular side effects, expressed as QT interval prolongation and occurrence of even lethal arrhythmias. Despite these side effects, haloperidol is still prescribed in Europe in clinical practice. Haloperidol binds to sigma receptors that are coupled with inositol 1,4,5-trisphosphate (IP3) receptors. Sigma receptors are expressed in various tissues, including heart muscle, and they modulate potassium channels. Together with IP3 receptors, sigma receptors are also involved in calcium handling in various tissues. Therefore, the present work aimed to study the effects of long-term haloperidol administration on the cardiac function. Haloperidol (2 mg/kg once a day) or vehiculum was administered by intraperitoneal injection to guinea pigs for 21 consecutive days. We measured the responsiveness of the hearts isolated from the haloperidol-treated animals to additional application of haloperidol. Expression of the sigma 1 receptor and IP3 receptors was studied by real time-PCR and immunohistochemical analyses. Haloperidol treatment caused the significant decrease in the relative heart rate and the prolongation of QT interval of the isolated hearts from the haloperidol-treated animals, compared to the hearts isolated from control animals. The expression of sigma 1 and IP3 type 1 and type 2 receptors was increased in both atria of the haloperidol-treated animals but not in ventricles. The modulation of sigma 1 and IP3 receptors may lead to altered calcium handling in cardiomyocytes and thus contribute to changed sensitivity of cardiac cells to arrhythmias.

Induction of late LTP-like plasticity in the human motor cortex by repeated non-invasive brain stimulation.

PubMed

Monte-Silva, Katia; Kuo, Min-Fang; Hessenthaler, Silvia; Fresnoza, Shane; Liebetanz, David; Paulus, Walter; Nitsche, Michael A

2013-05-01

Non-invasive brain stimulation enables the induction of neuroplasticity in humans, however, with so far restricted duration of the respective cortical excitability modifications. Conventional anodal transcranial direct current stimulation (tDCS) protocols including one stimulation session induce NMDA receptor-dependent excitability enhancements lasting for about 1 h. We aimed to extend the duration of tDCS effects by periodic stimulation, consisting of two stimulation sessions, since periodic stimulation protocols are able to induce neuroplastic excitability alterations stable for days or weeks, termed late phase long term potentiation (l-LTP), in animal slice preparations. Since both, l-LTP and long term memory formation, require gene expression and protein synthesis, and glutamatergic receptor activity modifications, l-LTP might be a candidate mechanism for the formation of long term memory. The impact of two consecutive tDCS sessions on cortical excitability was probed in the motor cortex of healthy humans, and compared to that of a single tDCS session. The second stimulation was applied without an interval (temporally contiguous tDCS), during the after-effects of the first stimulation (during after-effects; 3, or 20 min interval), or after the after-effects of the first stimulation had vanished (post after-effects; 3 or 24 h interval). The during after-effects condition resulted in an initially reduced, but then relevantly prolonged excitability enhancement, which was blocked by an NMDA receptor antagonist. The other conditions resulted in an abolishment, or a calcium channel-dependent reversal of neuroplasticity. Repeated tDCS within a specific time window is able to induce l-LTP-like plasticity in the human motor cortex. Copyright © 2013 Elsevier Inc. All rights reserved.

Change in Pattern of Relapse After Antiangiogenic Therapy in High-Grade Glioma

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

Narayana, Ashwatha, E-mail: ashwatha.narayana@nyumc.org; Department of Neurosurgery, New York University Langone Medical Center, New York, NY; Kunnakkat, Saroj D.

2012-01-01

Purpose: Local recurrence is the dominant pattern of relapse in high-grade glioma (HGG) after conventional therapy. The recent use of antiangiogenic therapy has shown impressive radiologic and clinical responses in adult HGG. The preclinical data suggesting increased invasiveness after angiogenic blockade have necessitated a detailed analysis of the pattern of recurrence after therapy. Methods and Materials: A total of 162 consecutive patients with HGG, either newly diagnosed (n = 58) or with recurrent disease (n = 104) underwent therapy with bevacizumab at 10 mg/kg every 2 weeks and conventional chemotherapy with or without involved field radiotherapy until disease progression. Themore » pattern of recurrence and interval to progression were the primary aims of the present study. Diffuse invasive recurrence (DIR) was defined as the involvement of multiple lobes with or without crossing the midline. Results: At a median follow-up of 7 months (range, 1-37), 105 patients had recurrence, and 79 patients ultimately developed DIR. The interval to progression was similar in the DIR and local recurrence groups (6.5 and 6.3 months, p = .296). The hazard risk of DIR increased exponentially with time and was similar in those with newly diagnosed and recurrent HGG (R{sup 2} = 0.957). The duration of bevacizumab therapy increased the interval to recurrence (p < .0001) and improved overall survival (p < .0001). However, the pattern of relapse did not affect overall survival (p = .253). Conclusion: Along with an increase in median progression-free survival, bevacizumab therapy increased the risk of DIR in HGG patients. The risk of increased invasion with prolonged angiogenic blockade should be addressed in future clinical trials.« less

Re-irradiation Using Intensity-modulated Radiotherapy for Recurrent and Second Primary Head and Neck Cancer.

PubMed

Choi, Seo Hee; Chang, Jee Suk; Choi, Jinhyun; Park, So Hyun; Keum, Ki Chang; Park, Kyung Ran; Lee, Chang Geol

2018-05-01

Information on re-irradiation (re-RT) for recurrent and second primary head and neck cancer is limited. Herein, a description of our long-term experience of re-RT for previously irradiated head and neck cancer is provided. A retrospective review was performed for 73 consecutive patients re-irradiated for head and neck cancer between 2006 and 2015. Re-RT targets encompassed only the recurrent gross tumor and had tight margins (5-10 mm). Salvage surgery was performed on 28 (38%) patients before re-RT and 53 (73%) patients received chemotherapy concurrent with re-RT. The median interval between initial and re-RT was 31 months and the median cumulative dose of the two irradiations was 126 Gy (biologically equivalent to 2 Gy fractionation). With a median survival of 33 months, locoregional recurrence after re-RT developed in 37 patients (51%; 25 infield, 12 outfield). In multivariate analysis, higher re-RT dose (≥66 Gy), longer time interval (>2 years), and use of concurrent chemotherapy were associated with improved locoregional recurrence-free survival (all p<0.05). Additionally, performance status, additional surgical resection, and longer interval were associated with better overall survival (p=0.006, 0.021, 0.004, respectively). Clinically significant acute and late toxicities occurred in 14% and 22% of evaluable patients, but no grade 5 toxicity was observed. Moderate safety and acceptable toxicity was found after re-RT using tight margins, sufficient radiation dose, and daily image guidance. Encouraging local control and survival were obtained, similar to historical data using 1-2 cm margins. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Modeling time-location patterns of inner-city high school students in New York and Los Angeles using a longitudinal approach with generalized estimating equations.

PubMed

Decastro, B Rey; Sax, Sonja N; Chillrud, Steven N; Kinney, Patrick L; Spengler, John D

2007-05-01

The TEACH Project obtained subjects' time-location information as part of its assessment of personal exposures to air toxics for high school students in two major urban areas. This report uses a longitudinal modeling approach to characterize the association between demographic and temporal predictors and the subjects' time-location behavior for three microenvironments--indoor-home, indoor-school, and outdoors. Such a longitudinal approach has not, to the knowledge of the authors, been previously applied to time-location data. Subjects were 14- to 19-year-old, self reported non-smokers, and were recruited from high schools in New York, NY (31 subjects: nine male, 22 female) and Los Angeles, CA (31 subjects: eight male, 23 female). Subjects reported their time-location in structured 24-h diaries with 15-min intervals for three consecutive weekdays in each of winter and summer-fall seasons in New York and Los Angeles during 1999-2000. The data set contained 15,009 observations. A longitudinal logistic regression model was run for each microenvironment where the binary outcome indicated the subject's presence in a microenvironment during a 15-min period. The generalized estimating equation (GEE) technique with alternating logistic regressions was used to account for the correlation of observations within each subject. The multivariate models revealed complex time-location patterns, with subjects predominantly in the indoor-home microenvironment, but also with a clear influence of the school schedule. The models also found that a subject's presence in a particular microenvironment may be significantly positively correlated for as long as 45 min before the current observation. Demographic variables were also predictive of time-location behavior: for the indoor-home microenvironment, having an after school job (OR=0.67 [95% confidence interval: 0.54:0.85]); for indoor-school, living in New York (0.42 [0.29:0.59]); and for outdoor, being 16-year-old (0.80 [0.67:0.96]), 17-year-old (0.71 [0.54:0.92]), and having an after school job (1.29 [1.07:1.56]).

Hematology and serum clinical chemistry reference intervals for free-ranging Scandinavian gray wolves (Canis lupus).

PubMed

Thoresen, Stein I; Arnemo, Jon M; Liberg, Olof

2009-06-01

Scandinavian free-ranging wolves (Canis lupus) are endangered, such that laboratory data to assess their health status is increasingly important. Although wolves have been studied for decades, most biological information comes from captive animals. The objective of the present study was to establish reference intervals for 30 clinical chemical and 8 hematologic analytes in Scandinavian free-ranging wolves. All wolves were tracked and chemically immobilized from a helicopter before examination and blood sampling in the winter of 7 consecutive years (1998-2004). Seventy-nine blood samples were collected from 57 gray wolves, including 24 juveniles (24 samples), 17 adult females (25 samples), and 16 adult males (30 samples). Whole blood and serum samples were stored at refrigeration temperature for 1-3 days before hematologic analyses and for 1-5 days before serum biochemical analyses. Reference intervals were calculated as 95% confidence intervals except for juveniles where the minimum and maximum values were used. Significant differences were observed between adult and juvenile wolves for RBC parameters, alkaline phosphatase and amylase activities, and total protein, albumin, gamma-globulins, cholesterol, creatinine, calcium, chloride, magnesium, phosphate, and sodium concentrations. Compared with published reference values for captive wolves, reference intervals for free-ranging wolves reflected exercise activity associated with capture (higher creatine kinase activity, higher glucose concentration), and differences in nutritional status (higher urea concentration).

Impact of an audit program and other factors on door-to-balloon times in acute ST-elevation myocardial infarction patients destined for primary coronary intervention.

PubMed

Lai, Chao-Lun; Fan, Chieh-Min; Liao, Pen-Chih; Tsai, Kuang-Chau; Yang, Chi-Yu; Chu, Shu-Hsun; Chien, Kuo-Liong

2009-04-01

This before-after study investigated the association between an audit program and door-to-balloon times in patients with acute ST-elevation myocardial infarction (STEMI) and explored other factors associated with the door-to-balloon time. An audit program that collected time data for essential time intervals in acute STEMI was developed with data feedback to both the Department of Emergency Medicine and the Department of Cardiology. The door-to-balloon times for 76 consecutive acute STEMI patients were collected from February 16, 2007, through October 31, 2007, after the implementation of the audit program, as the intervention group. The control group was defined by 104 consecutive acute STEMI patients presenting from April 1, 2006, through February 15, 2007, before the audit was applied. A multivariate linear regression model was used for analysis of factors associated with the door-to-balloon time. The geometric mean 95% CI of the door-to-balloon time decreased from 164.9 (150.3, 180.9) minutes to 141.9 (127.4, 158.2) minutes (p = 0.039) in the intervention phase. The median door-to-balloon time was 147.5 minutes in the control group and 136.0 minutes in the intervention group (p = 0.09). In the multivariate regression model, the audit program was associated with a shortening of the door-to-balloon time by 35.5 minutes (160.4 minutes vs. 195.9 minutes, p = 0.004); female gender was associated with a mean delay of 58.4 minutes (208.9 minutes vs. 150.5 minutes; p = 0.001); posterolateral wall infarction was associated with a mean delay of 70.5 minutes compared to anterior wall infarction (215.4 minutes vs. 144.9 minutes; p = 0.037) and a mean delay of 69.5 minutes compared to inferior wall infarction (215.4 minutes vs. 145.9 minutes; p = 0.044). The use of a glycoprotein IIb/IIIa inhibitor was associated with a 46.1 minutes mean shortening of door-to-balloon time (155.7 minutes vs. 201.8 minutes; p < 0.001). The implementation of an audit program was associated with a significant reduction in door-to-balloon times among patients with acute STEMI. In addition, female patients, posterolateral wall infarction territory, and nonuse of glycoprotein IIb/IIIa inhibitor were associated with longer door-to-balloon times.

Brainstem cavernous malformations: Natural history versus surgical management.

PubMed

Walcott, Brian P; Choudhri, Omar; Lawton, Michael T

2016-10-01

While brainstem cavernous malformations were once considered inoperable, improvements in patient selection, surgical exposures, intraoperative MRI-guidance, MR tractography, and neurophysiologic monitoring have resulted in good outcomes in the majority of operated patients. In a consecutive series of 104 patients with brainstem cavernous malformations, only 14% of patients experienced cranial nerve or motor dysfunction that was worse at late follow-up, relative to their preoperative condition. Outcomes were predicted by several factors, including larger lesion size, lesions that crossed the midline, the presence of a developmental venous anomaly, older age, and greater time interval from lesion hemorrhage to surgery. The 14% of patients who experienced a persistent neurological deficit as a result of surgery, while substantial from any perspective, compares favorably with the risks of observation based on a recent meta-analysis. Curative resection is a safe and effective treatment for brainstem cavernous malformations that will prevent re-hemorrhage in symptomatic patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cohort Measures of Internal Migration: Understanding Long-Term Trends.

PubMed

Bernard, Aude

2017-12-01

Internal migration intensities fluctuate over time, but both migration levels and trends show great diversity. The dynamics underpinning these trends remain poorly understood because they are analyzed almost exclusively by applying period measures to cross-sectional data. This article proposes 10 cohort measures that can be applied to both prospective and retrospective data to systematically examine long-term trends. To demonstrate their benefits, the proposed measures are applied to retrospective survey data for England that provide residential histories from birth to age 50 for cohorts born between 1918 and 1957. The analysis reveals stable lifetime migration for men but increased lifetime migration for women associated with earlier ages at moving in adulthood and a compression of intervals between consecutive moves. The proposed cohort measures provide a more comprehensive picture of migration behavior and should be used to complement period measures in exploring long-term trends. Increasing availability of retrospective and longitudinal survey data means that researchers can now apply the proposed measures to a wide range of countries.

The Influence of Comprehensive Cardiac Rehabilitation on Heart Rate Variability Indices after CABG is More Effective than after PCI.

PubMed

Szmigielska, Katarzyna; Szmigielska-Kapłon, Anna; Jegier, Anna

2018-02-01

The aim of this study was to evaluate the influence of cardiac rehabilitation (CR) on heart rate variability (HRV) indices in men with coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). The study population consisted of 131 male patients with CAD prospectively and consecutively admitted to CR after PCI n = 72, or CABG n = 59. Participants performed cycle ergometer interval training for 45 min three times a week for 8 weeks. At baseline and after 8 weeks, all patients underwent the HRV assessment. HRV indices in CAGB survivals were significantly lower in comparison to PCI patients at baseline. Significant increases were seen for SDNN, rMSSD, and HF in the CABG group and only in HF component in PCI group after 8 weeks of CR. Eight weeks of CR seems to be more effective in CABG patients than patients after PCI.

Experimental demonstration of non-iterative interpolation-based partial ICI compensation in100G RGI-DP-CO-OFDM transport systems.

PubMed

Mousa-Pasandi, Mohammad E; Zhuge, Qunbi; Xu, Xian; Osman, Mohamed M; El-Sahn, Ziad A; Chagnon, Mathieu; Plant, David V

2012-07-02

We experimentally investigate the performance of a low-complexity non-iterative phase noise induced inter-carrier interference (ICI) compensation algorithm in reduced-guard-interval dual-polarization coherent-optical orthogonal-frequency-division-multiplexing (RGI-DP-CO-OFDM) transport systems. This interpolation-based ICI compensator estimates the time-domain phase noise samples by a linear interpolation between the CPE estimates of the consecutive OFDM symbols. We experimentally study the performance of this scheme for a 28 Gbaud QPSK RGI-DP-CO-OFDM employing a low cost distributed feedback (DFB) laser. Experimental results using a DFB laser with the linewidth of 2.6 MHz demonstrate 24% and 13% improvement in transmission reach with respect to the conventional equalizer (CE) in presence of weak and strong dispersion-enhanced-phase-noise (DEPN), respectively. A brief analysis of the computational complexity of this scheme in terms of the number of required complex multiplications is provided. This practical approach does not suffer from error propagation while enjoying low computational complexity.

Value of positive myocardial technetium-99m-pyrophosphate scintigraphy in the noninvasive diagnosis of cardiac amyloidosis

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

Wizenberg, T.A.; Muz, J.; Sohn, Y.H.

1982-04-01

Ten consecutive patients with tissue-proven amyloidosis, seven of whom presented with congestive heart failure, were found to exhibit intense diffuse uptake of technetium-99m-pyrophosphate (Tc-99m-PYP) on cardiac radionuclide imaging. The patients exhibited echocardiographic and systolic time interval abnormalities suggesting combined restrictive and congestive cardiomyopathic changes. On M-mode echocardiograms, there was symmetrically increased thickness of the interventricular septum and left ventricular (LV) posterior wall in diastole (10 of 10), decreased fractional shortening of the LV minor axis diameter in systole (eight of nine), and decreased percent thickening of the LV minor axis diameter in systole (eight of nine) and LV posterior wallmore » (10 of 10) in systole. Three patients demonstrated enlarged LV end-diastolic diameter. All 10 patients had abnormal PEP/LVET and eight had shortened LVETI. When combined with noninvasive tests of LV performance, positive myocardial pyrophosphate (PYP) scanning provides a new and useful adjunct in the diagnosis of amyloid heart disease.« less

Benefits of mitigated ambient air quality due to transportation control on childhood asthma hospitalization during the 2002 summer Asian games in Busan, Korea.

PubMed

Lee, Jong-Tae; Son, Ji-Young; Cho, Yong-Sung

2007-08-01

The objective of this study is to see whether there were any health benefits of mitigated air pollution concentration due to reduced traffic flow during a citywide intervention for the 2002 Summer Asian Games. Relative risks of hospitalization for childhood asthma during the post-Asian Game period compared with the baseline period were estimated using a time-series analysis of the generalized additive Poisson model. Fourteen consecutive days of traffic volume control in Busan during the Games reduced all regulated air pollutant levels by 1-25%. The estimated relative risk of hospitalization during the post-Games period over the baseline period was 0.73 (95% confidence interval [CI] = 0.49, 1.11). We observed that this reduced air pollution was unique in 2002 when the traffic volume reduction program was applied during the Games period. This empirical data provides epidemiologic evidence of the health benefits resulting from environmental interventions to reduce ambient air pollution.

Risk stratified usage of antibiotic-loaded bone cement for primary total knee arthroplasty: short term infection outcomes with a standardized cement protocol.

PubMed

Qadir, Rabah; Sidhu, Sanbir; Ochsner, J Lockwood; Meyer, Mark S; Chimento, George F

2014-08-01

Efficacy of antibiotic cement (ALBC) in primary knee arthroplasty (pTKA) has been debated. The study's purpose was to examine efficacy of ALBC versus plain cement (PBC) in preventing infection in high-risk patients undergoing pTKA. 3292 consecutive pTKAs were divided into three cohorts: (1) patients receiving only PBC, (2) patients receiving only ALBC, and (3) only high-risk patients receiving ALBC. Cohorts' infections were compared. The 30-day infection rates for cohorts 1, 2, 3 were 0.29%, 0.20%, and 0.13% respectively. 6-month rates were 0.39%, 0.54% and 0.38%. 1-year rates were 0.78%, 0.61%, and 0.64%. Differences in infection rates at all time intervals were not statistically significant. The study supports that even judicious risk-stratified usage of ALBC may not confer added benefit in decreasing infection at one year. Copyright © 2014 Elsevier Inc. All rights reserved.

[Retrospective study of 50 ileostomies at the Salvador Zubirán National Institute of Nutrition].

PubMed

Granados-García, J; Takahashi, T; Tapia, M; Hoyos, C; Villalobos, J J

1996-01-01

To establish the diseases that motivated an ileostomy and the short and long-term morbi-mortality of the procedure. Retrospective analysis of 50 consecutive cases of ileostomies performed from 1989-1993 at a referral center in Mexico City. Most ileostomies were temporary (92%); the most frequent diagnoses were multiple familial polyposis, inflammatory bowel disease, and diverse intra-abdominal inflammatory complications. Operative mortality was 22%, caused mainly by the severity of the disease that motivated the ileostomy. A reoperation was required in 14% of the cases because of stomal complications (stricture, prolapse); 6% presented peristomal dermatitis, 4% high output, and 4% associated depression. With a mean time interval of three months, 32 patients were subjected to intestinal reconnection with a morbidity of 19% but no mortality. Ileostomy remains a necessary procedure mainly on a temporary basis. It is convenient to prevent complications by means of adequate surgical techniques, and a better rehabilitation by a multidisciplinary team.

Bone and fall-related fracture risks in women and men with a recent clinical fracture.

PubMed

van Helden, Svenhjalmar; van Geel, Antonia C M; Geusens, Piet P; Kessels, Alfons; Nieuwenhuijzen Kruseman, Arie C; Brink, Peter R G

2008-02-01

Worldwide fracture rates are increasing as a result of the aging population, and prevention, both primary and secondary, is an important public health goal. Therefore, we systematically analyzed risk factors in subjects with a recent clinical fracture. All men and women over fifty years of age who had been treated in the emergency department of, or hospitalized at, our institution because of a recent fracture during a one-year period were offered the opportunity to undergo an evidence-based bone and fall-related risk-factor assessment and bone densitometry. The women included in this study were also compared with a group of postmenopausal women without a fracture history who had been included in another cohort study. Of the 940 consecutive patients, 797 (85%) were eligible for this study and 568 (60%) agreed to participate. The prevalence of fall-related risk factors (75% [95% confidence interval = 71% to 78%]; n = 425) and the prevalence of bone-related risk factors (53% [95% confidence interval = 49% to 57%]; n = 299) at the time of fracture were higher than the prevalence of osteoporosis (35% [95% confidence interval = 31% to 39%]; n = 201) as defined by a dual x-ray absorptiometry T score of

Image phase shift invariance based cloud motion displacement vector calculation method for ultra-short-term solar PV power forecasting

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

Wang, Fei; Zhen, Zhao; Liu, Chun

Irradiance received on the earth's surface is the main factor that affects the output power of solar PV plants, and is chiefly determined by the cloud distribution seen in a ground-based sky image at the corresponding moment in time. It is the foundation for those linear extrapolation-based ultra-short-term solar PV power forecasting approaches to obtain the cloud distribution in future sky images from the accurate calculation of cloud motion displacement vectors (CMDVs) by using historical sky images. Theoretically, the CMDV can be obtained from the coordinate of the peak pulse calculated from a Fourier phase correlation theory (FPCT) method throughmore » the frequency domain information of sky images. The peak pulse is significant and unique only when the cloud deformation between two consecutive sky images is slight enough, which is likely possible for a very short time interval (such as 1?min or shorter) with common changes in the speed of cloud. Sometimes, there will be more than one pulse with similar values when the deformation of the clouds between two consecutive sky images is comparatively obvious under fast changing cloud speeds. This would probably lead to significant errors if the CMDVs were still only obtained from the single coordinate of the peak value pulse. However, the deformation estimation of clouds between two images and its influence on FPCT-based CMDV calculations are terrifically complex and difficult because the motion of clouds is complicated to describe and model. Therefore, to improve the accuracy and reliability under these circumstances in a simple manner, an image-phase-shift-invariance (IPSI) based CMDV calculation method using FPCT is proposed for minute time scale solar power forecasting. First, multiple different CMDVs are calculated from the corresponding consecutive images pairs obtained through different synchronous rotation angles compared to the original images by using the FPCT method. Second, the final CMDV is generated from all of the calculated CMDVs through a centroid iteration strategy based on its density and distance distribution. Third, the influence of different rotation angle resolution on the final CMDV is analyzed as a means of parameter estimation. Simulations under various scenarios including both thick and thin clouds conditions indicated that the proposed IPSI-based CMDV calculation method using FPCT is more accurate and reliable than the original FPCT method, optimal flow (OF) method, and particle image velocimetry (PIV) method.« less

Image phase shift invariance based cloud motion displacement vector calculation method for ultra-short-term solar PV power forecasting

DOE PAGES

Wang, Fei; Zhen, Zhao; Liu, Chun; ...

2017-12-18

Irradiance received on the earth's surface is the main factor that affects the output power of solar PV plants, and is chiefly determined by the cloud distribution seen in a ground-based sky image at the corresponding moment in time. It is the foundation for those linear extrapolation-based ultra-short-term solar PV power forecasting approaches to obtain the cloud distribution in future sky images from the accurate calculation of cloud motion displacement vectors (CMDVs) by using historical sky images. Theoretically, the CMDV can be obtained from the coordinate of the peak pulse calculated from a Fourier phase correlation theory (FPCT) method throughmore » the frequency domain information of sky images. The peak pulse is significant and unique only when the cloud deformation between two consecutive sky images is slight enough, which is likely possible for a very short time interval (such as 1?min or shorter) with common changes in the speed of cloud. Sometimes, there will be more than one pulse with similar values when the deformation of the clouds between two consecutive sky images is comparatively obvious under fast changing cloud speeds. This would probably lead to significant errors if the CMDVs were still only obtained from the single coordinate of the peak value pulse. However, the deformation estimation of clouds between two images and its influence on FPCT-based CMDV calculations are terrifically complex and difficult because the motion of clouds is complicated to describe and model. Therefore, to improve the accuracy and reliability under these circumstances in a simple manner, an image-phase-shift-invariance (IPSI) based CMDV calculation method using FPCT is proposed for minute time scale solar power forecasting. First, multiple different CMDVs are calculated from the corresponding consecutive images pairs obtained through different synchronous rotation angles compared to the original images by using the FPCT method. Second, the final CMDV is generated from all of the calculated CMDVs through a centroid iteration strategy based on its density and distance distribution. Third, the influence of different rotation angle resolution on the final CMDV is analyzed as a means of parameter estimation. Simulations under various scenarios including both thick and thin clouds conditions indicated that the proposed IPSI-based CMDV calculation method using FPCT is more accurate and reliable than the original FPCT method, optimal flow (OF) method, and particle image velocimetry (PIV) method.« less

Interval Timing Is Preserved Despite Circadian Desynchrony in Rats: Constant Light and Heavy Water Studies.

PubMed

Petersen, Christian C; Mistlberger, Ralph E

2017-08-01

The mechanisms that enable mammals to time events that recur at 24-h intervals (circadian timing) and at arbitrary intervals in the seconds-to-minutes range (interval timing) are thought to be distinct at the computational and neurobiological levels. Recent evidence that disruption of circadian rhythmicity by constant light (LL) abolishes interval timing in mice challenges this assumption and suggests a critical role for circadian clocks in short interval timing. We sought to confirm and extend this finding by examining interval timing in rats in which circadian rhythmicity was disrupted by long-term exposure to LL or by chronic intake of 25% D 2 O. Adult, male Sprague-Dawley rats were housed in a light-dark (LD) cycle or in LL until free-running circadian rhythmicity was markedly disrupted or abolished. The rats were then trained and tested on 15- and 30-sec peak-interval procedures, with water restriction used to motivate task performance. Interval timing was found to be unimpaired in LL rats, but a weak circadian activity rhythm was apparently rescued by the training procedure, possibly due to binge feeding that occurred during the 15-min water access period that followed training each day. A second group of rats in LL were therefore restricted to 6 daily meals scheduled at 4-h intervals. Despite a complete absence of circadian rhythmicity in this group, interval timing was again unaffected. To eliminate all possible temporal cues, we tested a third group of rats in LL by using a pseudo-randomized schedule. Again, interval timing remained accurate. Finally, rats tested in LD received 25% D 2 O in place of drinking water. This markedly lengthened the circadian period and caused a failure of LD entrainment but did not disrupt interval timing. These results indicate that interval timing in rats is resistant to disruption by manipulations of circadian timekeeping previously shown to impair interval timing in mice.

Microvascular Anastomosis: Proposition of a Learning Curve.

PubMed

Mokhtari, Pooneh; Tayebi Meybodi, Ali; Benet, Arnau; Lawton, Michael T

2018-04-14

Learning to perform a microvascular anastomosis is one of the most difficult tasks in cerebrovascular surgery. Previous studies offer little regarding the optimal protocols to maximize learning efficiency. This failure stems mainly from lack of knowledge about the learning curve of this task. To delineate this learning curve and provide information about its various features including acquisition, improvement, consistency, stability, and recall. Five neurosurgeons with an average surgical experience history of 5 yr and without any experience in bypass surgery performed microscopic anastomosis on progressively smaller-caliber silastic tubes (Biomet, Palm Beach Gardens, Florida) during 24 consecutive sessions. After a 1-, 2-, and 8-wk retention interval, they performed recall test on 0.7-mm silastic tubes. The anastomoses were rated based on anastomosis patency and presence of any leaks. Improvement rate was faster during initial sessions compared to the final practice sessions. Performance decline was observed in the first session of working on a smaller-caliber tube. However, this rapidly improved during the following sessions of practice. Temporary plateaus were seen in certain segments of the curve. The retention interval between the acquisition and recall phase did not cause a regression to the prepractice performance level. Learning the fine motor task of microvascular anastomosis adapts to the basic rules of learning such as the "power law of practice." Our results also support the improvement of performance during consecutive sessions of practice. The objective evidence provided may help in developing optimized learning protocols for microvascular anastomosis.

Correlation among ultrasound, cross-sectional anatomy, and histology of the sciatic nerve: a review.

PubMed

Moayeri, Nizar; van Geffen, Geert J; Bruhn, Jörgen; Chan, Vincent W; Groen, Gerbrand J

2010-01-01

Efficient identification of the sciatic nerve (SN) requires a thorough knowledge of its topography in relation to the surrounding structures. Anatomic cross sections in similar oblique planes as observed during SN ultrasonography are lacking. A survey of sonoanatomy matched with ultrasound views of the major SN block sites will be helpful in pattern recognition, especially when combined with images that show the internal architecture of the nerve. From 1 cadaver, consecutive parts of the upper leg corresponding to the 4 major blocks sites were sectioned and deeply frozen. Using cryomicrotomy, consecutive transverse sections were acquired and photographed at 78-microm intervals, along with histologic sections at 5-mm intervals. Multiplanar reformatting was done to reconstruct the optimal planes for an accurate comparison of ultrasonography and gross anatomy. The anatomic and histologic images were matched with ultrasound images that were obtained from 2 healthy volunteers. By simulating the exact position and angulation as in the ultrasonographic images, detailed anatomic overviews of SN and adjacent structures were reconstructed in the gluteal, subgluteal, midfemoral, and popliteal regions. Throughout its trajectory, SN contains numerous fascicles with connective and adipose tissues. In this study, we provide an optimal matching between histology, anatomic cross sections, and short-axis ultrasound images of SN. Reconstructing ultrasonographic planes with this high-resolution digitized anatomy not only enables an overview but also shows detailed views of the architecture of internal SN. The undulating course of the nerve fascicles within SN may explain its varying echogenic appearance during probe manipulation.

Paced QT interval as a risk factor for new-onset left ventricular systolic dysfunction and cardiac death after permanent pacemaker implantation.

PubMed

Cho, Eun Jeong; Park, Seung-Jung; Park, Kyoung Min; On, Young Keun; Kim, June Soo

2016-01-15

Prolongation of corrected QT (QTc) interval reflects an increased risk of fatal arrhythmia and cardiac death in various populations. However, it is not clear whether the paced-QTc (p-QTc) interval is associated with new-onset left ventricular systolic dysfunction (new-LVSD) or cardiac death. In 491 consecutive patients (64 ± 14 years) with preserved LV ejection fraction (64 ± 7%), the p-QTc interval was measured within 2 weeks after PPM implantation. We assessed the rates of new-LVSD and cardiac death based on the degree of p-QTc interval. During the follow-up period (78 ± 51 months), new-LVSD and cardiac death were identified in 53 (10.8%) and 26 (5.3%) patients, respectively. Patients with new-LVSD had more frequent atrioventricular block (P=0.041), a higher percentage of ventricular pacing (P=0.005), a longer p-QRS duration (P<0.001), and more prolonged p-QTc interval (P<0.001) compared to those without new-LVSD. There was a graded increase in the rates of new-LVSD (P<0.001) and cardiac death (P=0.001) from the patients in the lowest to those in the highest tertile of the p-QTc interval. Additionally, the incidence of cardiac death was significantly elevated especially in the patients with new-LVSD and wider p-QTc interval. In Cox regression analyses, the p-QTc interval was independently associated with new-LVSD and cardiac death even after adjusted with various relevant confounding factors. Prolonged p-QTc interval was closely associated with new-LVSD and cardiac death after PPM implantation in patients with preserved LV systolic function. The rate of cardiac death significantly increased especially in patients who showed more p-QTc widening along with new-LVSD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Fecal markers of inflammation, protein loss, and microbial changes in dogs with the acute hemorrhagic diarrhea syndrome (AHDS).

PubMed

Heilmann, Romy M; Guard, Melissa M; Steiner, Jörg M; Suchodolski, Jan S; Unterer, Stefan

2017-09-01

Idiopathic acute hemorrhagic diarrhea syndrome (AHDS) is characterized by acute onset of bloody diarrhea, severe dehydration, and increased vascular and intestinal mucosal permeability. Markers of gastrointestinal inflammation, protein loss, and changes in the intestinal microbiota have not been studied extensively in dogs with AHDS. For 3 consecutive days, feces were collected from dogs with AHDS, and assayed for calprotectin and S100A12 (both markers of inflammation), α 1 -proteinase inhibitor (a marker of gastrointestinal protein loss), and the presence of selected species of bacteria. Concentrations of all assayed markers were significantly greater than the institutional reference intervals at the time of presentation, and all decreased significantly by Day 3 of treatment. Abundances of selected bacterial groups (Ruminococcaceae, Faecalibacterium spp., Bifidobacterium spp., and Proteobacteria) at the time of diagnosis were consistent with an intestinal bacterial dysbiosis. No differences in the abundance of bacterial groups over time was seen, except for a mild but significant decrease in Ruminococcaceae at Day 3. These results suggest that canine AHDS is associated with a significant but transient gastrointestinal loss of protein and intestinal inflammation. The intestinal bacterial dysbiosis appears to outlast the protein loss and inflammation. © Veterinary Emergency and Critical Care Society 2017.

Training in rapid auditory processing ameliorates auditory comprehension in aphasic patients: a randomized controlled pilot study.

PubMed

Szelag, Elzbieta; Lewandowska, Monika; Wolak, Tomasz; Seniow, Joanna; Poniatowska, Renata; Pöppel, Ernst; Szymaszek, Aneta

2014-03-15

Experimental studies have often reported close associations between rapid auditory processing and language competency. The present study was aimed at improving auditory comprehension in aphasic patients following specific training in the perception of temporal order (TO) of events. We tested 18 aphasic patients showing both comprehension and TO perception deficits. Auditory comprehension was assessed by the Token Test, phonemic awareness and Voice-Onset-Time Test. The TO perception was assessed using auditory Temporal-Order-Threshold, defined as the shortest interval between two consecutive stimuli, necessary to report correctly their before-after relation. Aphasic patients participated in eight 45-minute sessions of either specific temporal training (TT, n=11) aimed to improve sequencing abilities, or control non-temporal training (NT, n=7) focussed on volume discrimination. The TT yielded improved TO perception; moreover, a transfer of improvement was observed from the time domain to the language domain, which was untrained during the training. The NT did not improve either the TO perception or comprehension in any language test. These results are in agreement with previous literature studies which proved ameliorated language competency following the TT in language-learning-impaired or dyslexic children. Our results indicated for the first time such benefits also in aphasic patients. Copyright © 2013 Elsevier B.V. All rights reserved.

Protoplasmic Computing to Memorize and Recall Periodic Environmental Events

NASA Astrophysics Data System (ADS)

Tero, Atsushi; Saigusa, Tetsu; Nakagaki, Toshiyuki

Single-celled organisms might be more intelligent than previously envisaged [1]-[5]. The acts of anticipating and recalling events are higher functions performed by the brains of higher animals; their evolutionary origins and the way they self-organize, however, remain open questions. Here we show that an amoeboid organism can anticipate the timing of periodic events. The plasmodium of the true slime mold Physarum polycephalum moves rapidly under favorable conditions, but stops moving when transferred to less-favorable conditions. For example, plasmodia exposed to low temperature and low humidity, presented in three consecutive pulses at constant intervals, reduced their locomotive speed in response to each episode. When favorable conditions were subsequently reintroduced, the plasmodia spontaneously reduced their locomotive speed at the point in time when the next unfavorable episode would have occurred. This implies that the plasmodia are able to anticipate impending environmental change. After this anticipatory response had been evoked several times, the locomotion of the plasmodia returned to normal speed; however, the slowing down could subsequently be induced by a single unfavorable pulse, implying recall of the periodicity that had been memorized. We have explored the mechanisms underlying this behavior from a dynamical systems perspective. Our results suggest that this primitive intelligence is of cellular origin and that simple dynamics might be sufficient to explain its emergence. abstract environment.

What is the preferred number of consecutive night shifts? results from a crossover intervention study among police officers in Denmark.

PubMed

Nabe-Nielsen, Kirsten; Jensen, Marie Aarrebo; Hansen, Åse Marie; Kristiansen, Jesper; Garde, Anne Helene

2016-10-01

Among police officers in Denmark, we studied (i) how many consecutive night shifts participants preferred at baseline; (ii) preferences regarding three intervention conditions (two, four, and seven consecutive night shifts followed by the same number of days off/day shifts: '2 + 2', '4 + 4', '7 + 7') at follow-up; (iii) characteristics of participants preferring each of these intervention conditions. Questionnaire data from a crossover intervention study were used (baseline: n = 73; follow-up: n = 68). At baseline, 49% preferred four consecutive night shifts. At follow-up, 57% preferred '4 + 4', 26% preferred '2 + 2' and 26% preferred '7 + 7'. Participants, who preferred longer spells of night work experienced that night work was less demanding, found it easier to sleep at different times of the day, and were more frequently evening types compared with participants who preferred shorter spells of night work. The participants' preferences are likely to be influenced by their previous shift work experience. Practitioner Summary: We investigated police officers' preferences regarding the number of consecutive night shifts. The majority preferred four consecutive night shifts. Those who preferred the longer spells of night work found night work less demanding, found it easier to sleep at different times of the day, and were more frequently evening types.

Sexual risk trajectories among MSM in the United States: implications for pre-exposure prophylaxis delivery

PubMed Central

Pines, Heather A.; Gorbach, Pamina M.; Weiss, Robert E.; Shoptaw, Steve; Landovitz, Raphael J.; Javanbakht, Marjan; Ostrow, David G.; Stall, Ron D.; Plankey, Michael

2014-01-01

Background Despite evidence supporting pre-exposure prophylaxis (PrEP) efficacy, there are concerns regarding the feasibility of widespread PrEP implementation among men who have sex with men (MSM). To inform the development of targeted PrEP delivery guidelines, we characterized sexual risk trajectories among HIV-negative MSM. Methods At semiannual visits from 2003–2011, HIV-negative MSM (N=419) participating in the Multicenter AIDS Cohort Study provided data on sexual risk behaviors since their last visit. Based on reported behaviors, participants were assigned a sexual risk behavior (SRB) score at each visit as follows: (0) no insertive or receptive anal intercourse (IAI/RAI), (1) no unprotected IAI/RAI (UIAI/URAI), (2) only UIAI, (3) URAI with 1 HIV-negative partner, (4) condom-serosorting, (5) condom-seropositioning, and (6) no seroadaptive behaviors. Group-based trajectory modeling was used to examine SRB scores (<4 vs. ≥4) and identify groups with distinct sexual risk trajectories. Results Three sexual risk trajectory groups were identified: low risk (N=264; 63.0%), moderate risk (N=96; 22.9%; mean duration of consecutive high risk intervals~1 year), and high risk (N=59; 14.1%; mean duration of consecutive high risk intervals~2 years). Compared to low risk group membership, high risk group membership was associated with younger age (in years) (adjusted odds ratio [AOR]=0.92, 95% confidence interval [CI]: 0.88–0.96), being White (AOR=3.67, 95% CI: 1.48–9.11), earning an income ≥$20,000 (AOR=4.98, 95% CI: 2.13–11.64), distress/depression symptoms (CESD≥16) (AOR=2.36, 95% CI: 1.14–4.92), and substance use (AOR=2.00, 95% CI: 1.01–3.97). Conclusion Screening for the socio-demographic and behavioral factors described above may facilitate targeted PrEP delivery during high risk periods among MSM. PMID:24378726

Tachyphylaxis after intravitreal bevacizumab for exudative age-related macular degeneration.

PubMed

Forooghian, Farzin; Cukras, Catherine; Meyerle, Catherine B; Chew, Emily Y; Wong, Wai T

2009-06-01

To describe tachyphylaxis to intravitreal bevacizumab (IVB) in patients with exudative age-related macular degeneration (AMD). We retrospectively reviewed the records of 59 consecutive patients treated with IVB at the National Eye Institute over a 14-month period and identified cases demonstrating loss of treatment efficacy as revealed by spectral domain optical coherence tomography. We defined tachyphylaxis as a loss of therapeutic response to IVB 28 +/- 7 days after administration in an eye that had previously demonstrated a therapeutic response in the same time interval. Five patients (six eyes) were identified as developing tachyphylaxis after repeated treatment with IVB. High-dose IVB (2.50 mg) did not restore therapeutic response in these patients. Bilateral tachyphylaxis to IVB was seen after an episode of unilateral postinjection anterior uveitis. After the first treatment of IVB, the median time taken to develop tachyphylaxis was 100 weeks (range: 31-128 weeks), and the median number of IVB treatments to the development of tachyphylaxis was 8 treatments (range: 5-10 treatments). Tachyphylaxis can occur after long-term intravitreal use of bevacizumab in patients with AMD. The precise mechanism of tachyphylaxis is unclear, but both local and/or systemic factors may be involved.

Tachyphylaxis Following Intravitreal Bevacizumab for Exudative Age-Related Macular Degeneration

PubMed Central

Forooghian, Farzin; Cukras, Catherine; Meyerle, Catherine B.; Chew, Emily Y.; Wong, Wai T.

2009-01-01

Purpose To describe tachyphylaxis to intravitreal bevacizumab (IVB) in patients with exudative age-related macular degeneration (AMD). Methods We retrospectively reviewed the records of 59 consecutive patients treated with IVB at the National Eye Institute over a 14 month period, and identified cases demonstrating loss of treatment efficacy as revealed by spectral domain optical coherence tomography. We defined tachyphylaxis as a loss of therapeutic response to IVB 28±7 days after administration in an eye which had previously demonstrated a therapeutic response in the same time interval. Results Five patients (6 eyes) were identified as developing tachyphylaxis following repeated treatment with IVB. High-dose IVB (2.50mg) did not restore therapeutic response in these patients. Bilateral tachyphylaxis to IVB was seen following an episode of unilateral post-injection anterior uveitis. After the first treatment of IVB, the median time taken to develop tachyphylaxis was 100 weeks (range: 31-128 weeks), and the median number of IVB treatments to the development of tachyphylaxis was 8 treatments (range: 5-10). Conclusion Tachyphylaxis can occur following long-term intravitreal use of bevacizumab in patients with AMD. The precise mechanism of tachyphylaxis is unclear, but both local and/or systemic factors may be involved. PMID:19516114

Concordance and interchangeability of biometric measurements of ocular axial length in patients awaiting cataract surgery.

PubMed

Martín-Serrano, María José; Roman-Ortiz, Carmen; Villa-Sáez, M Luz; Labrador-Castellanos, M Purificación; Blanco-Carrasco, Rosario; Lozano-Ballesteros, Felicidad; Pedraza-Martín, Carmen; José-Herrero, M Teresa San; López-Ropero, Ana M; Tenías Burillo, José María

2014-01-01

To estimate in patients awaiting cataract surgery the concordance and interchangeability of axial eye length measurements performed with the aid of various biometric methods (optical or ultrasonic) by different operators (nurses) at different times during the period prior to surgery. We selected 182 consecutive eyes from 91 patients.Ocular axial length was measured with the aid of 2 methods (IOLMaster® and Ocuscan®) by 9 randomly allocated technicians at 2 different times during the waiting period. The concordance between measurements was evaluated by means of the intraclass correlation coefficient (ICC); the interchangeability of the results was assessed with Bland Altman plots and Passing and Bablok regression. The measurements were consistent between biometric methods (ICC 0.975, 95% confidence interval [CI] 0.968 to 0.980) and measurement dates (ICC 0.996, 95% CI 0.995 to 0.997). Interobserver agreement was more heterogeneous (ICC range 0.844 to 0.998). No systematic errors were observed among the various biometric methods and measurement dates. Because measurement of axial length in phakic patients may be technician-dependent, the technician's experience should be noted in the protocols of ophthalmology services.

The psychosocial work environment is associated with risk of stroke at working age.

PubMed

Jood, Katarina; Karlsson, Nadine; Medin, Jennie; Pessah-Rasmussen, Hélène; Wester, Per; Ekberg, Kerstin

2017-07-01

Objective The aim of this study was to explore the relation between the risk of first-ever stroke at working age and psychological work environmental factors. Methods A consecutive multicenter matched 1:2 case-control study of acute stroke cases (N=198, age 30-65 years) who had been working full-time at the time of their stroke and 396 sex- and age-matched controls. Stroke cases and controls answered questionnaires on their psychosocial situation during the previous 12 months. The psychosocial work environment was assessed using three different measures: the job-control-demand model, the effort-reward imbalance (ERI) score, and exposures to conflict at work. Results Among 198 stroke cases and 396 controls, job strain [odds ratio (OR) 1.30, 95% confidence interval (95% CI) 1.05-1.62], ERI (OR 1.28, 95% CI 1.01-1.62), and conflict at work (OR 1.75, 95% CI 1.07-2.88) were independent risk factors of stroke in multivariable regression models. Conclusions Adverse psychosocial working conditions during the past 12 months were more frequently observed among stroke cases. Since these factors are presumably modifiable, interventional studies targeting job strain and emotional work environment are warranted.

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

Ballermann, B.J.

To enable serial measurements of plasma atrial natriuretic peptide (ANP) concentrations in the rat, a microradioreceptor assay (RRA) for this hormone was developed. Glomerular microsomes bearing ANP receptors were used to bind ANP. The smallest quantity of ANP detectable by this method was 0.2 fmol/sample. By contrast, a radioimmunoassay for ANP was sensitive to 2.4 fmol/sample. The intra- and interassay coefficients of variation for the RRA were 4.1 and 11.6%, respectively. Recovery of 10, 20, 50, and 100 pM synthetic ANP added to unextracted rat plasma was essentially 100%. Biologically inactive, synthetic amino- and carboxy-terminal ANP fragments added to ratmore » plasma were not detected. Plasma ANP was stable when measured four consecutive times at 90-min intervals in 10 fasting rats. In a separate group of rats, fasting plasma ANP levels averaged 34 {plus minus} 3 and rose to 57 {plus minus} 5 pM in the postprandial state, whereas levels in fasting time controls remained constant. It is concluded that the RRA for ANP described here detects ANP in microliter quantities of unextracted rat plasma. Thus serial measurements of ANP concentrations can be undertaken in rats without inducing major changes in the volume status.« less

A comparison of direct and two-stage transportation of patients to hospital in Poland.

PubMed

Rosiek, Anna; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz; Leksowski, Krzysztof

2015-04-24

The rapid international expansion of telemedicine reflects the growth of technological innovations. This technological advancement is transforming the way in which patients can receive health care. The study was conducted in Poland, at the Department of Cardiology of the Regional Hospital of Louis Rydygier in Torun. The researchers analyzed the delay in the treatment of patients with acute coronary syndrome. The study was conducted as a survey and examined 67 consecutively admitted patients treated invasively in a two-stage transport system. Data were analyzed statistically. Two-stage transportation does not meet the timeframe guidelines for the treatment of patients with acute myocardial infarction. Intervals for the analyzed group of patients were statistically significant (p < 0.0001). Direct transportation of the patient to a reference center with interventional cardiology laboratory has a significant impact on reducing in-hospital delay in case of patients with acute coronary syndrome. This article presents the results of two-stage transportation of the patient with acute coronary syndrome. This measure could help clinicians who seek to assess time needed for intervention. It also shows how time from the beginning of pain in chest is important and may contribute to patient disability, death or well-being.

Impacts of sampling design and estimation methods on nutrient leaching of intensively monitored forest plots in the Netherlands.

PubMed

de Vries, W; Wieggers, H J J; Brus, D J

2010-08-05

Element fluxes through forest ecosystems are generally based on measurements of concentrations in soil solution at regular time intervals at plot locations sampled in a regular grid. Here we present spatially averaged annual element leaching fluxes in three Dutch forest monitoring plots using a new sampling strategy in which both sampling locations and sampling times are selected by probability sampling. Locations were selected by stratified random sampling with compact geographical blocks of equal surface area as strata. In each sampling round, six composite soil solution samples were collected, consisting of five aliquots, one per stratum. The plot-mean concentration was estimated by linear regression, so that the bias due to one or more strata being not represented in the composite samples is eliminated. The sampling times were selected in such a way that the cumulative precipitation surplus of the time interval between two consecutive sampling times was constant, using an estimated precipitation surplus averaged over the past 30 years. The spatially averaged annual leaching flux was estimated by using the modeled daily water flux as an ancillary variable. An important advantage of the new method is that the uncertainty in the estimated annual leaching fluxes due to spatial and temporal variation and resulting sampling errors can be quantified. Results of this new method were compared with the reference approach in which daily leaching fluxes were calculated by multiplying daily interpolated element concentrations with daily water fluxes and then aggregated to a year. Results show that the annual fluxes calculated with the reference method for the period 2003-2005, including all plots, elements and depths, lies only in 53% of the cases within the range of the average +/-2 times the standard error of the new method. Despite the differences in results, both methods indicate comparable N retention and strong Al mobilization in all plots, with Al leaching being nearly equal to the leaching of SO(4) and NO(3) with fluxes expressed in mol(c) ha(-1) yr(-1). This illustrates that Al release, which is the clearest signal of soil acidification, is mainly due to the external input of SO(4) and NO(3).

Factors related to consultation time: Experience in Slovenia

PubMed Central

Petek Šter, Marija; Švab, Igor; Živčec Kalan, Gordana

2008-01-01

Objective Consultation time has a serious impact on physicians’ work and patient satisfaction. No systematic study of consultation time in general practice in Slovenia has yet been carried out. The aim of the present study was to measure consultation time, to identify the factors influencing it, and to study the influence of the workload of general practitioners on consultation time. Design A total of 42 general practitioners participated in this cross-sectional study. Each physician collected data from 300 consecutive consultations and measured the length of the visit. Setting Forty-two randomly selected general practices in Slovenia. Subjects Patients of 42 general practices. Main outcome measures Average consultation time in general practice in Slovenia; factors influencing consultation time in Slovenia. Results Data from 12 501 visits to the surgery were collected. A quarter of all visits (25.5%) were administrative. The mean consultation time was 6.9 minutes (median 6.0 minutes, 5%–95% interval: 1.0–16.0 minutes). Longer consultation time was predicted by: patient-related factors (female gender, higher age, higher level of education, higher number of health problems, change of physician within the last year), physician-related factors (higher age), physicians’ workload (absence of high workload), and the type of visit (consultation and/or clinical examination). Conclusion Consultation time in general practice is short, and depends on the characteristics of the patient and the physician, the physician's workload, and the type of visit. A reduction of high workload in general practice should be one of the priorities of the healthcare system. PMID:18297560

Macrobenthic turnover in the subtidal Wadden Sea: The Norderaue revisited after 60 years

NASA Astrophysics Data System (ADS)

Reise, K.; Schubert, A.

1987-03-01

The benthic macrofauna of a tidal inlet in the northern Wadden Sea was sampled with grab and dredge in 1924 1926 (Hagmeier & Kändler, 1927), and again in 1985 and 1986. The comparison of surveys from consecutive years, as well as observations from an adjacent area, are employed to separate spurious from real long-term changes. Several epibenthic species of the 1920s became rare or absent in the 1980s. Oyster beds and reefs of the colonial polychaete Sabellaria spinulosa have disappeared completely. On the other hand, mussel beds have extended their range, and the abundance of mobile infauna has increased. The total number of species has remained approximately the same. Compared to surveys from consecutive years, the 60-year interval has doubled the species turnover rate, and has decreased the similarity in relative abundances by one third. The observed losses are best explained by the impact of dredging and trawling on the benthic fauna, while gains seem to indicate coastal eutrophication.

Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study.

PubMed

Ferraioli, Giovanna; Tinelli, Carmine; Dal Bello, Barbara; Zicchetti, Mabel; Filice, Gaetano; Filice, Carlo

2012-12-01

Real-time shear wave elastography (SWE) is a novel, noninvasive method to assess liver fibrosis by measuring liver stiffness. This single-center study was conducted to assess the accuracy of SWE in patients with chronic hepatitis C (CHC), in comparison with transient elastography (TE), by using liver biopsy (LB) as the reference standard. Consecutive patients with CHC scheduled for LB by referring physicians were studied. One hundred and twenty-one patients met inclusion criteria. On the same day, real-time SWE using the ultrasound (US) system, Aixplorer (SuperSonic Imagine S.A., Aix-en-Provence, France), TE using FibroScan (Echosens, Paris, France), and US-assisted LB were consecutively performed. Fibrosis was staged according to the METAVIR scoring system. Analyses of receiver operating characteristic (ROC) curve were performed to calculate optimal area under the ROC curve (AUROC) for F0-F1 versus F2-F4, F0- F2 versus F3-F4, and F0-F3 versus F4 for both real-time SWE and TE. Liver stiffness values increased in parallel with degree of liver fibrosis, both with SWE and TE. AUROCs were 0.92 (95% confidence interval [CI]: 0.85-0.96) for SWE and 0.84 (95% CI: 0.76-0.90) for TE (P = 0.002), 0.98 (95% CI: 0.94-1.00) for SWE and 0.96 (95% CI: 0.90-0.99) for TE (P = 0.14), and 0.98 (95% CI: 0.93-1.00) for SWE and 0.96 (95% CI: 0.91-0.99) for TE (P = 0.48), when comparing F0-F1 versus F2- F4, F0- F2 versus F3-F4, and F0 -F3 versus F4, respectively. The results of this study show that real-time SWE is more accurate than TE in assessing significant fibrosis (≥ F2). With respect to TE, SWE has the advantage of imaging liver stiffness in real time while guided by a B-mode image. Thus, the region of measurement can be guided with both anatomical and tissue stiffness information. Copyright © 2012 American Association for the Study of Liver Diseases.

Improving the water use efficiency of olive trees growing in water harvesting systems

NASA Astrophysics Data System (ADS)

Berliner, Pedro; Leake, Salomon; Carmi, Gennady; Agam, Nurit

2017-04-01

Water is a primary limiting factor for agricultural development in many arid and semi-arid regions in which a runoff generation is a rather frequent event. If conveyed to dyke surrounded plots and ponded, runoff water can thereafter be used for tree production. One of the most promising runoff collection configurations is that of micro-catchments in which water is collected close to the area in which runoff was generated and stored in adjacent shallow pits. The objective of this work was to assess the effect of the geometry of runoff water collection area (shallow pit or trench) on direct evaporative water losses and on the water use efficiency of olive trees grown in them. The study was conducted during the summer of 2013 and 2014. In this study regular micro-catchments with basins of 9 m2 (3 x 3 m) by 0.1 m deep were compared with trenches of one meter deep and one meter wide. Each configuration was replicated three times. One tree was planted in each shallow basin and the distance between trees in the 12 m long trench was four meters. Access tubes for neutron probes were installed in the micro-catchments and trenches (four and seven, respectively) to depths of 2.5 m. Soil water content in the soil profile was monitored periodically throughout drying periods in between simulated runoff events. Transpiration of the trees was estimated from half-hourly sap flow measurements using a Granier system. Total transpiration fluxes were computed for time intervals corresponding to consecutive soil water measurements. During the first year, a large runoff event was simulated by applying once four cubic meters to each plot; and in the second year the same volume of water was split into four applications, simulating a series of small runoff events. In both geometries, trees received the same amount of water per tree. Evaporation from trenches and micro-catchments was estimated as the difference between evapotranspiration obtained computing the differences in total soil water content between two consecutive measurements and transpiration for this interval estimated from sap flow measurements. In both years the evaporation from micro-catchments was significantly larger than that of trenches. The fractional loss due to evaporation from the total applied water for the second year for example, was 53% and 22% for micro-catchments and trenches, respectively. This indicates that a trench geometry reduces the amount of water lost to direct evaporation from the soil, and is thus more efficient in utilizing harvested runoff water.

Using Web-Based Questionnaires to Assess Medication Use During Pregnancy: A Validation Study in 2 Prospectively Enrolled Cohorts.

PubMed

van Gelder, Marleen M H J; Vorstenbosch, Saskia; Te Winkel, Bernke; van Puijenbroek, Eugène P; Roeleveld, Nel

2018-02-01

Medication use is often underreported in paper-based questionnaires or interviews. Web-based questionnaires may improve recall of medication use, but data on their validity are currently lacking. Participants in the Pregnancy and Infant Development (PRIDE) Study (2014-2016; n = 557) and the Pregnancy Drug Registry (pREGnant) (2015-2016; n = 169) completed a 6-week paper-based medication diary during gestational weeks 19-24 or 26-31. In week 34, they completed a Web-based questionnaire with questions on medication names, time period and frequency of use, and quantity taken. To assess the degree of underreporting, we calculated the questionnaire's sensitivity using the medication diary as the reference standard. Sensitivity was high for many medication groups, including antiepileptic medication (sensitivity (Sn) = 0.96, 95% confidence interval (CI): 0.89, 1.00), antacids (Sn = 0.89, 95% CI: 0.86, 0.93), and iron preparations (Sn = 0.81, 95% CI: 0.64, 0.98). However, medications for short-term use were underreported more frequently, with sensitivities of 0.54 (95% CI: 0.35, 0.72) for antihistamines, 0.63 (95% CI: 0.57, 0.69) for analgesic and antipyretic agents, and 0.57 (95% CI: 0.51, 0.64) for acetaminophen. Shortening the period of time between exposure and questionnaire administration increased sensitivity substantially. In conclusion, underreporting in Web-based questionnaires is limited for many medication groups. In prospective studies, underreporting of medications for short-term use may be reduced by decreasing the interval between consecutive questionnaires. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Portrayal of alcohol consumption in movies and drinking initiation in low-risk adolescents.

PubMed

Hanewinkel, Reiner; Sargent, James D; Hunt, Kate; Sweeting, Helen; Engels, Rutger C M E; Scholte, Ron H J; Mathis, Federica; Florek, Ewa; Morgenstern, Matthis

2014-06-01

To investigate the hypothesis that exposure to alcohol consumption in movies affects the likelihood that low-risk adolescents will start to drink alcohol. Longitudinal study of 2346 adolescent never drinkers who also reported at baseline intent to not to do so in the next 12 months (mean age 12.9 years, SD = 1.08). Recruitment was carried out in 2009 and 2010 in 112 state-funded schools in Germany, Iceland, Italy, Netherlands, Poland, and Scotland. Exposure to movie alcohol consumption was estimated from 250 top-grossing movies in each country in the years 2004 to 2009. Multilevel mixed-effects Poisson regressions assessed the relationship between baseline exposure to movie alcohol consumption and initiation of trying alcohol, and binge drinking (≥ 5 consecutive drinks) at follow-up. Overall, 40% of the sample initiated alcohol use and 6% initiated binge drinking by follow-up. Estimated mean exposure to movie alcohol consumption was 3653 (SD = 2448) occurrences. After age, gender, family affluence, school performance, TV screen time, personality characteristics, and drinking behavior of peers, parents, and siblings were controlled for, exposure to each additional 1000 movie alcohol occurrences was significantly associated with increased relative risk for trying alcohol, incidence rate ratio = 1.05 (95% confidence interval, 1.02-1.08; P = .003), and for binge drinking, incidence rate ratio = 1.13 (95% confidence interval, 1.06-1.20; P < .001). Seeing alcohol depictions in movies is an independent predictor of drinking initiation, particularly for more risky patterns of drinking. This result was shown in a heterogeneous sample of European youths who had a low affinity for drinking alcohol at the time of exposure. Copyright © 2014 by the American Academy of Pediatrics.

Increased prevalence of gallbladder polyps in acromegaly.

PubMed

Annamalai, Anand K; Gayton, Emma L; Webb, Alison; Halsall, David J; Rice, Caiomhe; Ibram, Ferda; Chaudhry, Afzal N; Simpson, Helen L; Berman, Laurence; Gurnell, Mark

2011-07-01

Several studies have suggested an increased prevalence of benign and malignant tumors in acromegaly, particularly colonic neoplasms. The gallbladder's epithelial similarity to the colon raises the possibility that gallbladder polyps (GBP) may occur more frequently in acromegaly. Thirty-one patients with newly diagnosed acromegaly (14 females, 17 males; mean age 54.7 yr, range 27-76 yr) were referred to our center between 2004 and 2008. All had pituitary adenomas and were treated with somatostatin analogs prior to transsphenoidal surgery. Biliary ultrasonography was performed at the time of referral. In a retrospective case-cohort study, we compared the prevalence of GBP in these scans with those of 13,234 consecutive patients (age range 20-80 yr) presenting at the hospital for abdominal/biliary ultrasound during the same time interval. Associations between GH and IGF-I levels and GBP in acromegaly were also examined. There was a higher prevalence of GBP in patients with acromegaly compared with controls (29.03 vs 4.62%, P = 0.000008); relative risk was 6.29 (95% confidence interval 3.61-10.96). Eight of nine patients with acromegaly and GBP were older than 50 yr of age. GH levels were higher in those with GBP (median 30.8 μg/liter, interquartile range 10.9-39.1) than those without (8.2 μg/liter, interquartile range 6.0-16.0), but IGF-I levels were comparable. This is the first study to demonstrate an increased prevalence of GBP in patients with newly diagnosed acromegaly. Further studies are required to determine whether these patients are at increased risk of developing gallbladder carcinoma and to define the role, if any, of biliary ultrasound surveillance.

Revisiting profile of deliberate self-harm at a tertiary care hospital after an interval of 10 years.

PubMed

Singh, Paramjeet; Shah, Raghav; Midha, Purav; Soni, Ajitabh; Bagotia, Sunil; Gaur, Kusum Lata

2016-01-01

Sociocultural factors complement psychopathological factors that result in deliberate self-harm (DSH). A study of change in these factors over time is essential for preventive action. To identify factors influencing DSH, which have shown significant variation over a period of 10 years. Two hospital-based cross-sectional analytic types of observational studies were performed at two different times at an interval of 10 years. Sociodemographic profile, factors related to DSH, stressful life events, and psychiatric disorders were assessed in two groups of patients drawn from the same tertiary care hospital, 100 consecutive patients in 2002 and 117 in 2012. The observations were compared to identify factors that have undergone significant change. Descriptive statistics along with Chi-square test was used in this study. A significant decrease in the overall number of married subjects (60% vs. 43%) and an increase in the number of unmarried females (34% vs. 61%) were seen. A significant increase in the overall number of rural subjects (17% vs. 34%) and especially in a number of rural females (7% vs. 23%) was also seen. An increase in subjects from middle socioeconomic class (15% vs. 29%) and education up to secondary school (9% vs. 25%) was also seen. A significantly higher number of subjects had a psychiatric disorder (50% vs. 81%) with a significant increase in diagnoses of depression (36% vs. 67%). Family and social issues remain the most common antecedent stressful events. Chemical methods are still the most preferred means, but a higher number (8% vs. 18%) report a history of self-harm. Variations in factors responsible for DSH identified in this comparative study have preventive implications.

Extracorporeal Cardiopulmonary Resuscitation: Predictors of Survival

PubMed Central

Kim, Dong Hee; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

2016-01-01

Background The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients. PMID:27525236

Human turnover dynamics during sleep: statistical behavior and its modeling.

PubMed

Yoneyama, Mitsuru; Okuma, Yasuyuki; Utsumi, Hiroya; Terashi, Hiroo; Mitoma, Hiroshi

2014-03-01

Turnover is a typical intermittent body movement while asleep. Exploring its behavior may provide insights into the mechanisms and management of sleep. However, little is understood about the dynamic nature of turnover in healthy humans and how it can be modified in disease. Here we present a detailed analysis of turnover signals that are collected by accelerometry from healthy elderly subjects and age-matched patients with neurodegenerative disorders such as Parkinson's disease. In healthy subjects, the time intervals between consecutive turnover events exhibit a well-separated bimodal distribution with one mode at ⩽10 s and the other at ⩾100 s, whereas such bimodality tends to disappear in neurodegenerative patients. The discovery of bimodality and fine temporal structures (⩽10 s) is a contribution that is not revealed by conventional sleep recordings with less time resolution (≈30 s). Moreover, we estimate the scaling exponent of the interval fluctuations, which also shows a clear difference between healthy subjects and patients. We incorporate these experimental results into a computational model of human decision making. A decision is to be made at each simulation step between two choices: to keep on sleeping or to make a turnover, the selection of which is determined dynamically by comparing a pair of random numbers assigned to each choice. This decision is weighted by a single parameter that reflects the depth of sleep. The resulting simulated behavior accurately replicates many aspects of observed turnover patterns, including the appearance or disappearance of bimodality and leads to several predictions, suggesting that the depth parameter may be useful as a quantitative measure for differentiating between normal and pathological sleep. These findings have significant clinical implications and may pave the way for the development of practical sleep assessment technologies.

Human turnover dynamics during sleep: Statistical behavior and its modeling

NASA Astrophysics Data System (ADS)

Yoneyama, Mitsuru; Okuma, Yasuyuki; Utsumi, Hiroya; Terashi, Hiroo; Mitoma, Hiroshi

2014-03-01

Turnover is a typical intermittent body movement while asleep. Exploring its behavior may provide insights into the mechanisms and management of sleep. However, little is understood about the dynamic nature of turnover in healthy humans and how it can be modified in disease. Here we present a detailed analysis of turnover signals that are collected by accelerometry from healthy elderly subjects and age-matched patients with neurodegenerative disorders such as Parkinson's disease. In healthy subjects, the time intervals between consecutive turnover events exhibit a well-separated bimodal distribution with one mode at ⩽10 s and the other at ⩾100 s, whereas such bimodality tends to disappear in neurodegenerative patients. The discovery of bimodality and fine temporal structures (⩽10 s) is a contribution that is not revealed by conventional sleep recordings with less time resolution (≈30 s). Moreover, we estimate the scaling exponent of the interval fluctuations, which also shows a clear difference between healthy subjects and patients. We incorporate these experimental results into a computational model of human decision making. A decision is to be made at each simulation step between two choices: to keep on sleeping or to make a turnover, the selection of which is determined dynamically by comparing a pair of random numbers assigned to each choice. This decision is weighted by a single parameter that reflects the depth of sleep. The resulting simulated behavior accurately replicates many aspects of observed turnover patterns, including the appearance or disappearance of bimodality and leads to several predictions, suggesting that the depth parameter may be useful as a quantitative measure for differentiating between normal and pathological sleep. These findings have significant clinical implications and may pave the way for the development of practical sleep assessment technologies.

Change in blood pressure variability in patients with acute ischemic stroke and its effect on early neurologic outcome

PubMed Central

Hong, Jeong-Ho; Jang, Min Uk; Choi, Nack Cheon; Lee, Ji Sung; Kim, Beom Joon; Han, Moon-Ku; Bae, Hee-Joon

2017-01-01

Background How short-term blood pressure variability (BPV) is affected in the acute stage of ischemic stroke and whether BPV is associated with early neurologic outcomes remains unclear. Methods Patients who admitted for ischemic stroke within 24 h of symptom onset were consecutively identified between January 2010 and January 2015. BP profiles measured in real-time were summarized into short-term, 24-h time intervals, based on standard deviation (SD) and mean of systolic BP (SBPSD) during the first 3 days. The primary outcome was daily assessment of early neurological deterioration (END). The associations between short-term SBPSD values and the secular trend for primary outcome were examined. Results A total of 2,545 subjects (mean age, 67.1 ± 13.5 years old and median baseline National Institutes of Health Stroke Scale score, 3) arrived at the hospital an average of 6.1 ± 6.6 h after symptom onset. SBPSD values at day 1 (SD#D1), SD#D2, and SD#D3 were 14.4 ± 5.0, 12.5 ± 4.5, and 12.2 ± 4.6 mmHg, respectively. Multivariable analyses showed that SD#D2 was independently associated with onset of END at day 2 (adjusted odds ratio, 1.08; 95% confidence interval, 1.03–1.13), and SD#D3 was independently associated with END#D3 (1.07, 1.01–1.14), with adjustments for predetermined covariates, SBPmean, and interactions with daily SBPSD. Conclusion Short-term BPV changed and stabilized from the first day of ischemic stroke. Daily high BPV may be associated with neurological deterioration independent of BPV on the previous day. PMID:29252991

Portrayal of Alcohol Consumption in Movies and Drinking Initiation in Low-Risk Adolescents

PubMed Central

Sargent, James D.; Hunt, Kate; Sweeting, Helen; Engels, Rutger C.M.E.; Scholte, Ron H.J.; Mathis, Federica; Florek, Ewa; Morgenstern, Matthis

2014-01-01

OBJECTIVES: To investigate the hypothesis that exposure to alcohol consumption in movies affects the likelihood that low-risk adolescents will start to drink alcohol. METHODS: Longitudinal study of 2346 adolescent never drinkers who also reported at baseline intent to not to do so in the next 12 months (mean age 12.9 years, SD = 1.08). Recruitment was carried out in 2009 and 2010 in 112 state-funded schools in Germany, Iceland, Italy, Netherlands, Poland, and Scotland. Exposure to movie alcohol consumption was estimated from 250 top-grossing movies in each country in the years 2004 to 2009. Multilevel mixed-effects Poisson regressions assessed the relationship between baseline exposure to movie alcohol consumption and initiation of trying alcohol, and binge drinking (≥ 5 consecutive drinks) at follow-up. RESULTS: Overall, 40% of the sample initiated alcohol use and 6% initiated binge drinking by follow-up. Estimated mean exposure to movie alcohol consumption was 3653 (SD = 2448) occurrences. After age, gender, family affluence, school performance, TV screen time, personality characteristics, and drinking behavior of peers, parents, and siblings were controlled for, exposure to each additional 1000 movie alcohol occurrences was significantly associated with increased relative risk for trying alcohol, incidence rate ratio = 1.05 (95% confidence interval, 1.02–1.08; P = .003), and for binge drinking, incidence rate ratio = 1.13 (95% confidence interval, 1.06–1.20; P < .001). CONCLUSIONS: Seeing alcohol depictions in movies is an independent predictor of drinking initiation, particularly for more risky patterns of drinking. This result was shown in a heterogeneous sample of European youths who had a low affinity for drinking alcohol at the time of exposure. PMID:24799536

Reproductive Strategies of Aedes albopictus (Diptera: Culicidae) and Implications for the Sterile Insect Technique

PubMed Central

Oliva, Clelia F.; Damiens, David; Vreysen, Marc J. B.; Lemperière, Guy; Gilles, Jérémie

2013-01-01

Male insects are expected to optimize their reproductive strategy according to the availability of sperm or other ejaculatory materials, and to the availability and reproductive status of females. Here, we investigated the reproductive strategy and sperm management of male and virgin female Aedes albopictus, a mosquito vector of chikungunya and dengue viruses. The dynamics of semen transfer to the female bursa inseminalis and spermathecae were observed. Double-mating experiments were conducted to study the effect of time lapsed or an oviposition event between two copulations on the likelihood of a female double-insemination and the use of sperm for egg fertilization; untreated fertile males and radio-sterilised males were used for this purpose. Multiple inseminations and therefore the possibility of sperm competition were limited to matings closely spaced in time. When two males consecutively mated the same female within a 40 min interval, in ca. 15% of the cases did both males sire progeny. When the intervals between the copulations were longer, all progeny over several gonotrophic cycles were offspring of the first male. The mating behavior of males was examined during a rapid sequence of copulations. Male Ae. albopictus were parceling sperm allocation over several matings; however they would also attempt to copulate with females irrespective of the available sperm supply or accessory gland secretion material. During each mating, they transferred large quantities of sperm that was not stored for egg fertilization, and they attempted to copulate with mated females with a low probability of transferring their genes to the next generation. The outcomes of this study provided in addition some essential insights with respect to the sterile insect technique (SIT) as a vector control method. PMID:24236062

Resource Planning in Glaucoma: A Tool to Evaluate Glaucoma Service Capacity.

PubMed

Batra, Ruchika; Sharma, Hannah E; Elaraoud, Ibrahim; Mohamed, Shabbir

2017-12-28

The National Patient Safety Agency (2009) publication advising timely follow-up of patients with established glaucoma followed several reported instances of visual loss due to postponed appointments and patients lost to follow-up. The Royal College of Ophthalmologists Quality Standards Development Group stated that all hospital appointments should occur within 15% of the intended follow-up period. To determine whether: 1. Glaucoma follow-up appointments at a teaching hospital occur within the requested time 2. Appointments are requested at appropriate intervals based on the NICE Guidelines 3. The capacity of the glaucoma service is adequate Methods: A two-part audit was undertaken of 98 and 99 consecutive patients respectively attending specialist glaucoma clinics. In the first part, the reasons for delayed appointments were recorded. In the second part the requested follow-up was compared with NICE guidelines where applicable. Based on the findings, changes were implemented and a re-audit of 100 patients was carried out. The initial audit found that although clinical decisions regarding follow-up intervals were 100% compliant with NICE guidelines where applicable, 24% of appointments were delayed beyond 15% of the requested period, due to administrative errors and inadequate capacity, leading to significant clinical deterioration in two patients. Following the introduction of an electronic appointment tracker and increased clinical capacity created by extra clinics and clinicians, the re-audit found a marked decrease in the percentage of appointments being delayed (9%). This audit is a useful tool to evaluate glaucoma service provision, assist in resource planning for the service and bring about change in a non-confrontational way. It can be widely applied and adapted for use in other medical specialities.

Electrocardiographic Predictors of Long-Term Cardiac Pacing Dependency Following Transcatheter Aortic Valve Implantation.

PubMed

Naveh, Sivan; Perlman, Gidon Y; Elitsur, Yair; Planer, David; Gilon, Dan; Leibowitz, David; Lotan, Chaim; Danenberg, Haim; Alcalai, Ronny

2017-02-01

Conduction disorders requiring permanent pacemaker (PPM) implantation are a known complication of transcatheter aortic valve implantation (TAVI). Indications for permanent pacing in this setting are still controversial. The study aim was to characterize the natural history of conduction disorders related to TAVI, and to identify predictors for long-term pacing dependency. Consecutive patients who underwent TAVI were included in this prospective observational study. The conduction system was investigated by reviewing 12-lead ECGs during hospitalization and up to 1-year follow-up and by analyzing pacemaker interrogation data. Multivariate analysis was performed in order to identify independent predictors for pacemaker dependency. Of 110 patients included in the analysis, 38 (34.5%) underwent PPM implantation. Of those, 26 (68.4%) had a long-term pacing dependency (required PPM), while 12 (31.6%) did not (not-required PPM). Logistic regression revealed that baseline RBBB (P = 0.01, OR = 18.0), baseline PR interval (P = 0.019, OR = 1.14), post-TAVI PR interval and the change in PR interval from baseline (P < 0.001 for both, OR = 1.17 for each 10 milliseconds increment) were independent predictors for long-term pacing dependency. A PR interval increment of greater than 28 milliseconds had the best accuracy in predicting pacemaker dependency. Increased pre- and postprocedural PR intervals and pre-existing RBBB are reliable predictors for long-term PPM dependency, while left bundle branch block or QRS width are misleading factors. Our study suggests that the decision for implanting PPM after TAVI should be based mostly on the prolongation of the PR interval. © 2016 Wiley Periodicals, Inc.

Water-resources investigations in Wisconsin, 1999

USGS Publications Warehouse

Maertz, D. E.

1999-01-01

Low flows occurred at 21 gaging stations where the annual minimum 7-consecutive day average flows (Q7) had recurrence intervals of 5 or more years. Precipitation was well below normal from July through September in northern Wisconsin. Monthly precipitation values were 4.46, 5.69, and 4.24 inches below normal in northwestern, north central, and northeastern Wisconsin, respectively, in the July through September period (from tables provided by Lyle Anderson, Program Assistant, UW-Extension, Geological and Natural History Survey, written commun., 1999). The precipitation for the April to October period was

Differential Effect of CD4+Foxp3+ T-regulatory Cells on the B and T Helper Cell Responses to Influenza Virus Vaccination

DTIC Science & Technology

2010-01-01

for a suppres- sogenic effect ofT-regs on the anti-viral immune responses (7-1 0 ]. Early studies on the mechanisms by which A/ Puerto Rico /8/34 (Hl...USA). Mice were considered diabetic after two consecutive readings of glycemia higher than 200 mg/dL In some experiments, ]. Surls et al./ Vacdne...interval of confidence. The relevance of differences in survival and diabetes incidence of RAG2 KO, RIP-PR8/HA mice infused with T-cells from

Temporal Dependency and the Structure of Early Looking.

PubMed

Messinger, Daniel S; Mattson, Whitney I; Todd, James Torrence; Gangi, Devon N; Myers, Nicholas D; Bahrick, Lorraine E

2017-01-01

Although looking time is used to assess infant perceptual and cognitive processing, little is known about the temporal structure of infant looking. To shed light on this temporal structure, 127 three-month-olds were assessed in an infant-controlled habituation procedure and presented with a pre-recorded display of a woman addressing the infant using infant-directed speech. Previous individual look durations positively predicted subsequent look durations over a six look window, suggesting a temporal dependency between successive infant looks. The previous look duration continued to predict the subsequent look duration after accounting for habituation-linked declines in look duration, and when looks were separated by an inter-trial interval in which no stimulus was displayed. Individual differences in temporal dependency, the strength of associations between consecutive look durations, are distinct from individual differences in mean infant look duration. Nevertheless, infants with stronger temporal dependency had briefer mean look durations, a potential index of stimulus processing. Temporal dependency was evident not only between individual infant looks but between the durations of successive habituation trials (total looking within a trial). Finally, temporal dependency was evident in associations between the last look at the habituation stimulus and the first look at a novel test stimulus. Thus temporal dependency was evident across multiple timescales (individual looks and trials comprised of multiple individual looks) and persisted across conditions including brief periods of no stimulus presentation and changes from a familiar to novel stimulus. Associations between consecutive look durations over multiple timescales and stimuli suggest a temporal structure of infant attention that has been largely ignored in previous work on infant looking.

Temporal Dependency and the Structure of Early Looking

PubMed Central

Messinger, Daniel S.; Mattson, Whitney I.; Todd, James Torrence; Gangi, Devon N.; Myers, Nicholas D.; Bahrick, Lorraine E.

2017-01-01

Although looking time is used to assess infant perceptual and cognitive processing, little is known about the temporal structure of infant looking. To shed light on this temporal structure, 127 three-month-olds were assessed in an infant-controlled habituation procedure and presented with a pre-recorded display of a woman addressing the infant using infant-directed speech. Previous individual look durations positively predicted subsequent look durations over a six look window, suggesting a temporal dependency between successive infant looks. The previous look duration continued to predict the subsequent look duration after accounting for habituation-linked declines in look duration, and when looks were separated by an inter-trial interval in which no stimulus was displayed. Individual differences in temporal dependency, the strength of associations between consecutive look durations, are distinct from individual differences in mean infant look duration. Nevertheless, infants with stronger temporal dependency had briefer mean look durations, a potential index of stimulus processing. Temporal dependency was evident not only between individual infant looks but between the durations of successive habituation trials (total looking within a trial). Finally, temporal dependency was evident in associations between the last look at the habituation stimulus and the first look at a novel test stimulus. Thus temporal dependency was evident across multiple timescales (individual looks and trials comprised of multiple individual looks) and persisted across conditions including brief periods of no stimulus presentation and changes from a familiar to novel stimulus. Associations between consecutive look durations over multiple timescales and stimuli suggest a temporal structure of infant attention that has been largely ignored in previous work on infant looking. PMID:28076362

Molecular Tools for Diagnosis of Visceral Leishmaniasis: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy

PubMed Central

de Ruiter, C. M.; van der Veer, C.; Leeflang, M. M. G.; Deborggraeve, S.; Lucas, C.

2014-01-01

Molecular methods have been proposed as highly sensitive tools for the detection of Leishmania parasites in visceral leishmaniasis (VL) patients. Here, we evaluate the diagnostic accuracy of these tools in a meta-analysis of the published literature. The selection criteria were original studies that evaluate the sensitivities and specificities of molecular tests for diagnosis of VL, adequate classification of study participants, and the absolute numbers of true positives and negatives derivable from the data presented. Forty studies met the selection criteria, including PCR, real-time PCR, nucleic acid sequence-based amplification (NASBA), and loop-mediated isothermal amplification (LAMP). The sensitivities of the individual studies ranged from 29 to 100%, and the specificities ranged from 25 to 100%. The pooled sensitivity of PCR in whole blood was 93.1% (95% confidence interval [CI], 90.0 to 95.2), and the specificity was 95.6% (95% CI, 87.0 to 98.6). The specificity was significantly lower in consecutive studies, at 63.3% (95% CI, 53.9 to 71.8), due either to true-positive patients not being identified by parasitological methods or to the number of asymptomatic carriers in areas of endemicity. PCR for patients with HIV-VL coinfection showed high diagnostic accuracy in buffy coat and bone marrow, ranging from 93.1 to 96.9%. Molecular tools are highly sensitive assays for Leishmania detection and may contribute as an additional test in the algorithm, together with a clear clinical case definition. We observed wide variety in reference standards and study designs and now recommend consecutively designed studies. PMID:24829226

Impact of Dual Use of Department of Veterans Affairs and Medicare Part D Drug Benefits on Potentially Unsafe Opioid Use.

PubMed

Gellad, Walid F; Thorpe, Joshua M; Zhao, Xinhua; Thorpe, Carolyn T; Sileanu, Florentina E; Cashy, John P; Hale, Jennifer A; Mor, Maria K; Radomski, Thomas R; Hausmann, Leslie R M; Donohue, Julie M; Gordon, Adam J; Suda, Katie J; Stroupe, Kevin T; Hanlon, Joseph T; Cunningham, Francesca E; Good, Chester B; Fine, Michael J

2018-02-01

To estimate the prevalence and consequences of receiving prescription opioids from both the Department of Veterans Affairs (VA) and Medicare Part D. Among US veterans enrolled in both VA and Part D filling 1 or more opioid prescriptions in 2012 (n = 539 473), we calculated 3 opioid safety measures using morphine milligram equivalents (MME): (1) proportion receiving greater than 100 MME for 1 or more days, (2) mean days receiving greater than 100 MME, and (3) proportion receiving greater than 120 MME for 90 consecutive days. We compared these measures by opioid source. Overall, 135 643 (25.1%) veterans received opioids from VA only, 332 630 (61.7%) from Part D only, and 71 200 (13.2%) from both. The dual-use group was more likely than the VA-only group to receive greater than 100 MME for 1 or more days (34.3% vs 10.9%; adjusted risk ratio [ARR] = 3.0; 95% confidence interval [CI] = 2.9, 3.1), have more days with greater than 100 MME (42.5 vs 16.9 days; adjusted difference = 16.4 days; 95% CI = 15.7, 17.2), and to receive greater than 120 MME for 90 consecutive days (7.8% vs 3.1%; ARR = 2.2; 95% CI = 2.1, 2.3). Among veterans dually enrolled in VA and Medicare Part D, dual use of opioids was associated with more than 2 to 3 times the risk of high-dose opioid exposure.

Delays in the diagnosis of oesophagogastric cancer: a consecutive case series.

PubMed Central

Martin, I. G.; Young, S.; Sue-Ling, H.; Johnston, D.

1997-01-01

OBJECTIVES: To examine the time taken to diagnose oesophageal or gastric cancer, identify the source of delay, and assess its clinical importance. DESIGN: Study of all new patients presenting to one surgical unit with carcinoma of the oesophagus or stomach. SETTING: University department of surgery in a large teaching hospital. SUBJECTS: 115 consecutive patients (70 men, mean age 66 years) with carcinoma of the oesophagus (27) or stomach (88). MAIN OUTCOME MEASURES: Interval from the onset of symptoms to histological diagnosis, final pathological stage of the tumour, and whether potentially curative resection was possible. RESULTS: The median delay from first symptoms to histological diagnosis was 17 weeks (range 1 to 168 weeks). 25% (29/115) of patients had a delay of over 28 weeks (median 39 weeks). Total delay was made up of the following components: delay in consulting a doctor (29%), delay in referral (23%), delay in being seen at hospital (16%), and delay in establishing the diagnosis at the hospital (32%). No relation was found between delay in diagnosis and tumour stage in patients with gastric cancer, but for oesophageal cancer those with stage I and II disease were diagnosed within 7 weeks compared with 21 weeks (P < 0.02) for those with stage III and IV disease. CONCLUSIONS: Long delays still occur in the diagnosis of patients with cancer of the stomach or oesophagus. Streamlined referral and investigation pathways are needed if patients with gastric and oesophageal carcinomas are to be diagnosed early in the course of the disease. PMID:9056794

Medium to long-term results of the UNIX uncemented unicompartmental knee replacement.

PubMed

Hall, Matthew J; Connell, David A; Morris, Hayden G

2013-10-01

We report the first non-designer study of the Unix uncemented unicompartmental knee prosthesis. Eighty-five consecutive UKRs were carried out with sixty-five available for follow-up. Oxford Knee Scores, WOMAC questionnaire and radiological assessment were completed. The mean Oxford Knee Score was thirty-eight and WOMAC Score was twenty. Overall Kaplan Meier survival estimate is 76% (95% confidence interval 60%-97%) at 12years and 88% (95% confidence interval 76-100%) with aseptic loosening as the endpoint. Radiographic assessment showed lysis in the tibia in 6% of patients with no lysis evident around the central fin. Survivorship is comparable to other published series of UKRs. We suggest the central fin design is key to dissipating large forces throughout the proximal tibia, resulting in low levels of tibial loosening. Level of evidence IV. Copyright © 2012 Elsevier B.V. All rights reserved.

Improved Data Acquisition Methods for Uninterrupted Signal Monitoring and Ultra-Fast Plasma Diagnostics in LHD

NASA Astrophysics Data System (ADS)

Nakanishi, Hideya; Imazu, Setsuo; Ohsuna, Masaki; Kojima, Mamoru; Nonomura, Miki; Shoji, Mamoru; Emoto, Masahiko; Yoshida, Masanobu; Iwata, Chie; Miyake, Hitoshi; Nagayama, Yoshio; Kawahata, Kazuo

To deal with endless data streams acquired in LHD steady-state experiments, the LHD data acquisition system was designed with a simple concept that divides a long pulse into a consecutive series of 10-s “subshots”. Latest digitizers applying high-speed PCI-Express technology, however, output nonstop gigabyte per second data streams whose subshot intervals would be extremely long if 10-s rule was applied. These digitizers need shorter subshot intervals, less than 10-s long. In contrast, steady-state fusion plants need uninterrupted monitoring of the environment and device soundness. They adopt longer subshot lengths of either 10 min or 1 day. To cope with both uninterrupted monitoring and ultra-fast diagnostics, the ability to vary the subshot length according to the type of operation is required. In this study, a design modification that enables variable subshot lengths was implemented and its practical effectiveness in LHD was verified.

Realization of transient memory-loss with NiO-based resistive switching device

NASA Astrophysics Data System (ADS)

Hu, S. G.; Liu, Y.; Chen, T. P.; Liu, Z.; Yu, Q.; Deng, L. J.; Yin, Y.; Hosaka, Sumio

2012-11-01

A resistive switching device based on a nickel-rich nickel oxide thin film, which exhibits inherent learning and memory-loss abilities, is reported in this work. The conductance of the device gradually increases and finally saturates with the number of voltage pulses (or voltage sweepings), which is analogous to the behavior of the short-term and long-term memory in the human brain. Furthermore, the number of the voltage pulses (or sweeping cycles) required to achieve a given conductance state increases with the interval between two consecutive voltage pulses (or sweeping cycles), which is attributed to the heat diffusion in the material of the conductive filaments formed in the nickel oxide thin film. The phenomenon resembles the behavior of the human brain, i.e., forgetting starts immediately after an impression, a larger interval of the impressions leads to more memory loss, thus the memorization needs more impressions to enhance.

Determinants and consequences of short birth interval in rural Bangladesh: a cross-sectional study.

PubMed

de Jonge, Hendrik C C; Azad, Kishwar; Seward, Nadine; Kuddus, Abdul; Shaha, Sanjit; Beard, James; Costello, Anthony; Houweling, Tanja A J; Fottrell, Ed

2014-12-24

Short birth intervals are known to have negative effects on pregnancy outcomes. We analysed data from a large population surveillance system in rural Bangladesh to identify predictors of short birth interval and determine consequences of short intervals on pregnancy outcomes. The study was conducted in three districts of Bangladesh - Bogra, Moulavibazar and Faridpur (population 282,643, 54,668 women of reproductive age). We used data between January 2010 and June 2011 from a key informant surveillance system that recorded all births, deaths and stillbirths. Short birth interval was defined as an interval between consecutive births of less than 33 months. Initially, risk factors of a short birth interval were determined using a multivariate mixed effects logistic regression model. Independent risk factors were selected using a priori knowledge from literature review. An adjusted mixed effects logistic regression model was then used to determine the effect of up to 21-, 21-32-, 33-44- and 45-month and higher birth-to-birth intervals on pregnancy outcomes controlling for confounders selected through a directed acyclic graph. We analysed 5,571 second or higher order deliveries. Average birth interval was 55 months and 1368/5571 women (24.6%) had a short birth interval (<33 months). Younger women (AOR 1.11 95% CI 1.08-1.15 per year increase in age), women who started their reproductive life later (AOR 0.95, 0.92-0.98 per year) and those who achieve higher order parities were less likely to experience short birth intervals (AOR 0.28, 0.19-0.41 parity 4 compared to 1). Women who were socioeconomically disadvantaged were more likely to experience a short birth interval (AOR 1.42, 1.22-1.65) and a previous adverse outcome was an important determinant of interval (AOR 2.10, 1.83-2.40). Very short birth intervals of less than 21 months were associated with increased stillbirth rate (AOR 2.13, 95% CI 1.28-3.53) and neonatal mortality (AOR 2.28 95% CI 1.28-4.05). Birth spacing remains a reproductive health problem in Bangladesh. Disadvantaged women are more likely to experience short birth intervals and to have increased perinatal deaths. Research into causal pathways and strategies to improve spacing between pregnancies should be intensified.

Timescale- and Sensory Modality-Dependency of the Central Tendency of Time Perception.

PubMed

Murai, Yuki; Yotsumoto, Yuko

2016-01-01

When individuals are asked to reproduce intervals of stimuli that are intermixedly presented at various times, longer intervals are often underestimated and shorter intervals overestimated. This phenomenon may be attributed to the central tendency of time perception, and suggests that our brain optimally encodes a stimulus interval based on current stimulus input and prior knowledge of the distribution of stimulus intervals. Two distinct systems are thought to be recruited in the perception of sub- and supra-second intervals. Sub-second timing is subject to local sensory processing, whereas supra-second timing depends on more centralized mechanisms. To clarify the factors that influence time perception, the present study investigated how both sensory modality and timescale affect the central tendency. In Experiment 1, participants were asked to reproduce sub- or supra-second intervals, defined by visual or auditory stimuli. In the sub-second range, the magnitude of the central tendency was significantly larger for visual intervals compared to auditory intervals, while visual and auditory intervals exhibited a correlated and comparable central tendency in the supra-second range. In Experiment 2, the ability to discriminate sub-second intervals in the reproduction task was controlled across modalities by using an interval discrimination task. Even when the ability to discriminate intervals was controlled, visual intervals exhibited a larger central tendency than auditory intervals in the sub-second range. In addition, the magnitude of the central tendency for visual and auditory sub-second intervals was significantly correlated. These results suggest that a common modality-independent mechanism is responsible for the supra-second central tendency, and that both the modality-dependent and modality-independent components of the timing system contribute to the central tendency in the sub-second range.

High resolution data acquisition

DOEpatents

Thornton, G.W.; Fuller, K.R.

1993-04-06

A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock, pulse train, and analog circuitry for generating a triangular wave synchronously with the pulse train (as seen in diagram on patent). The triangular wave has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter counts the clock pulse train during the interval to form a gross event interval time. A computer then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

High resolution data acquisition

DOEpatents

Thornton, Glenn W.; Fuller, Kenneth R.

1993-01-01

A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock (38) pulse train (37) and analog circuitry (44) for generating a triangular wave (46) synchronously with the pulse train (37). The triangular wave (46) has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter (18, 32) forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter (26) counts the clock pulse train (37) during the interval to form a gross event interval time. A computer (52) then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

34 CFR 682.216 - Teacher loan forgiveness program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... serves low-income families as a full-time teacher for five consecutive complete academic years. The... elementary or secondary school may be counted toward the required five consecutive complete academic years only if at least one year of teaching was after the 1997-1998 academic year. (iii) Teaching at an...

34 CFR 685.217 - Teacher loan forgiveness program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... serves low-income families as a full-time teacher for five consecutive complete academic years. The... elementary or secondary school may be counted toward the required five consecutive complete academic years only if at least one year of teaching was after the 1997-1998 academic year. (iii) Teaching at an...

Measuring the EMS patient access time interval and the impact of responding to high-rise buildings.

PubMed

Morrison, Laurie J; Angelini, Mark P; Vermeulen, Marian J; Schwartz, Brian

2005-01-01

To measure the patient access time interval and characterize its contribution to the total emergency medical services (EMS) response time interval; to compare the patient access time intervals for patients located three or more floors above ground with those less than three floors above or below ground, and specifically in the apartment subgroup; and to identify barriers that significantly impede EMS access to patients in high-rise apartments. An observational study of all patients treated by an emergency medical technician paramedics (EMT-P) crew was conducted using a trained independent observer to collect time intervals and identify potential barriers to access. Of 118 observed calls, 25 (21%) originated from patients three or more floors above ground. The overall median and 90th percentile (95% confidence interval) patient access time intervals were 1.61 (1.27, 1.91) and 3.47 (3.08, 4.05) minutes, respectively. The median interval was 2.73 (2.22, 3.03) minutes among calls from patients located three or more stories above ground compared with 1.25 (1.07, 1.55) minutes among those at lower levels. The patient access time interval represented 23.5% of the total EMS response time interval among calls originating less than three floors above or below ground and 32.2% of those located three or more stories above ground. The most frequently encountered barriers to access included security code entry requirements, lack of directional signs, and inability to fit the stretcher into the elevator. The patient access time interval is significantly long and represents a substantial component of the total EMS response time interval, especially among ambulance calls originating three or more floors above ground. A number of barriers appear to contribute to delayed paramedic access.

A theoretically consistent stochastic cascade for temporal disaggregation of intermittent rainfall

NASA Astrophysics Data System (ADS)

Lombardo, F.; Volpi, E.; Koutsoyiannis, D.; Serinaldi, F.

2017-06-01

Generating fine-scale time series of intermittent rainfall that are fully consistent with any given coarse-scale totals is a key and open issue in many hydrological problems. We propose a stationary disaggregation method that simulates rainfall time series with given dependence structure, wet/dry probability, and marginal distribution at a target finer (lower-level) time scale, preserving full consistency with variables at a parent coarser (higher-level) time scale. We account for the intermittent character of rainfall at fine time scales by merging a discrete stochastic representation of intermittency and a continuous one of rainfall depths. This approach yields a unique and parsimonious mathematical framework providing general analytical formulations of mean, variance, and autocorrelation function (ACF) for a mixed-type stochastic process in terms of mean, variance, and ACFs of both continuous and discrete components, respectively. To achieve the full consistency between variables at finer and coarser time scales in terms of marginal distribution and coarse-scale totals, the generated lower-level series are adjusted according to a procedure that does not affect the stochastic structure implied by the original model. To assess model performance, we study rainfall process as intermittent with both independent and dependent occurrences, where dependence is quantified by the probability that two consecutive time intervals are dry. In either case, we provide analytical formulations of main statistics of our mixed-type disaggregation model and show their clear accordance with Monte Carlo simulations. An application to rainfall time series from real world is shown as a proof of concept.

Idiopathic hypersomnia with and without long sleep time: a controlled series of 75 patients.

PubMed

Vernet, Cyrille; Arnulf, Isabelle

2009-06-01

To characterize the clinical, psychological, and sleep pattern of idiopathic hypersomnia with and without long sleep time, and provide normative values for 24-hour polysomnography. University Hospital. Controlled, prospective cohort. 75 consecutive patients (aged 34 +/- 12 y) with idiopathic hypersomnia and 30 healthy matched controls. Patients and controls underwent during 48 hours a face-to-face interview, questionnaires, human leukocyte antigen genotype, a night polysomnography and multiple sleep latency test (MSLT), followed by 24-h ad libitum sleep monitoring. Hypersomniacs had more fatigue, higher anxiety and depression scores, and more frequent hypnagogic hallucinations (24%), sleep paralysis (28%), sleep drunkenness (36%), and unrefreshing naps (46%) than controls. They were more frequently evening types. DQB1*0602 genotype was similarly found in hypersomniacs (24.2%) and controls (19.2%). Hypersomniacs had more frequent slow wave sleep after 06:00 than controls. During 24-h polysomnography, the 95% confidence interval for total sleep time was 493-558 min in controls, versus 672-718 min in hypersomniacs. There were 40 hypersomniacs with and 35 hypersomniacs without long ( > 600 min) sleep time. The hypersomniacs with long sleep time were younger (29 +/- 10 vs 40 +/- 13 y, P = 0.0002), slimmer (body mass index: 26 +/- 5 vs 23 +/- 4 kg/m2; P = 0.005), and had lower Horne-Ostberg scores and higher sleep efficiencies than those without long sleep time. MSLT latencies were normal (> 8 min) in 71% hypersomniacs with long sleep time. Hypersomnia, especially with long sleep time, is frequently associated with evening chronotype and young age. It is inadequately diagnosed using MSLT.

Modulation of human time processing by subthalamic deep brain stimulation.

PubMed

Wojtecki, Lars; Elben, Saskia; Timmermann, Lars; Reck, Christiane; Maarouf, Mohammad; Jörgens, Silke; Ploner, Markus; Südmeyer, Martin; Groiss, Stefan Jun; Sturm, Volker; Niedeggen, Michael; Schnitzler, Alfons

2011-01-01

Timing in the range of seconds referred to as interval timing is crucial for cognitive operations and conscious time processing. According to recent models of interval timing basal ganglia (BG) oscillatory loops are involved in time interval recognition. Parkinsońs disease (PD) is a typical disease of the basal ganglia that shows distortions in interval timing. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a powerful treatment of PD which modulates motor and cognitive functions depending on stimulation frequency by affecting subcortical-cortical oscillatory loops. Thus, for the understanding of BG-involvement in interval timing it is of interest whether STN-DBS can modulate timing in a frequency dependent manner by interference with oscillatory time recognition processes. We examined production and reproduction of 5 and 15 second intervals and millisecond timing in a double blind, randomised, within-subject repeated-measures design of 12 PD-patients applying no, 10-Hz- and ≥ 130-Hz-STN-DBS compared to healthy controls. We found under(re-)production of the 15-second interval and a significant enhancement of this under(re-)production by 10-Hz-stimulation compared to no stimulation, ≥ 130-Hz-STN-DBS and controls. Milliseconds timing was not affected. We provide first evidence for a frequency-specific modulatory effect of STN-DBS on interval timing. Our results corroborate the involvement of BG in general and of the STN in particular in the cognitive representation of time intervals in the range of multiple seconds.

Modulation of Human Time Processing by Subthalamic Deep Brain Stimulation

PubMed Central

Timmermann, Lars; Reck, Christiane; Maarouf, Mohammad; Jörgens, Silke; Ploner, Markus; Südmeyer, Martin; Groiss, Stefan Jun; Sturm, Volker; Niedeggen, Michael; Schnitzler, Alfons

2011-01-01

Timing in the range of seconds referred to as interval timing is crucial for cognitive operations and conscious time processing. According to recent models of interval timing basal ganglia (BG) oscillatory loops are involved in time interval recognition. Parkinsońs disease (PD) is a typical disease of the basal ganglia that shows distortions in interval timing. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a powerful treatment of PD which modulates motor and cognitive functions depending on stimulation frequency by affecting subcortical-cortical oscillatory loops. Thus, for the understanding of BG-involvement in interval timing it is of interest whether STN-DBS can modulate timing in a frequency dependent manner by interference with oscillatory time recognition processes. We examined production and reproduction of 5 and 15 second intervals and millisecond timing in a double blind, randomised, within-subject repeated-measures design of 12 PD-patients applying no, 10-Hz- and ≥130-Hz-STN-DBS compared to healthy controls. We found under(re-)production of the 15-second interval and a significant enhancement of this under(re-)production by 10-Hz-stimulation compared to no stimulation, ≥130-Hz-STN-DBS and controls. Milliseconds timing was not affected. We provide first evidence for a frequency-specific modulatory effect of STN-DBS on interval timing. Our results corroborate the involvement of BG in general and of the STN in particular in the cognitive representation of time intervals in the range of multiple seconds. PMID:21931767

Second-line therapy with levofloxacin after failure of treatment to eradicate helicobacter pylori infection: time trends in a Spanish Multicenter Study of 1000 patients.

PubMed

Gisbert, Javier P; Pérez-Aisa, Angeles; Bermejo, Fernando; Castro-Fernández, Manuel; Almela, Pedro; Barrio, Jesús; Cosme, Angel; Modolell, Inés; Bory, Felipe; Fernández-Bermejo, Miguel; Rodrigo, Luis; Ortuño, Jesús; Sánchez-Pobre, Pilar; Khorrami, Sam; Franco, Alejandro; Tomas, Albert; Guerra, Iván; Lamas, Eloisa; Ponce, Julio; Calvet, Xavier

2013-02-01

Second-line bismuth-containing quadruple therapy is complex and frequently induces adverse effects. A triple rescue regimen containing levofloxacin is a potential alternative; however, resistance to quinolones is rapidly increasing. To evaluate the efficacy and tolerability of a second-line triple-regimen-containing levofloxacin in patients whose Helicobacter pylori eradication treatment failed and to assess whether the efficacy of the regimen decreases with time. Prospective multicenter study. In whom treatment with a regimen comprising a proton-pump inhibitor, clarithromycin, and amoxicillin had failed. Levofloxacin (500 mg bid), amoxicillin (1 g bid), and omeprazole (20 mg bid) for 10 days. Eradication was confirmed using the C-urea breath test 4 to 8 weeks after therapy. Compliance/tolerance: Compliance was determined through questioning and recovery of empty medication envelopes. Incidence of adverse effects was evaluated by means of a questionnaire. The study sample comprised 1000 consecutive patients (mean age, 49 ± 15 y, 42% men, 33% peptic ulcer) of whom 97% took all medications correctly. Per-protocol and intention-to-treat eradication rates were 75.1% (95% confidence interval, 72%-78%) and 73.8% (95% confidence interval, 71%-77%). Efficacy (intention-to-treat) was 76% in the year 2006, 68% in 2007, 70% in 2008, 76% in 2009, 74% in 2010, and 81% in 2011. In the multivariate analysis, none of the studied variables (including diagnosis and year of treatment) were associated with success of eradication. Adverse effects were reported in 20% of patients, most commonly nausea (7.9%), metallic taste (3.9%), myalgia (3.1%), and abdominal pain (2.9%). Ten-day levofloxacin-containing therapy is an encouraging second-line strategy, providing a safe and simple alternative to quadruple therapy in patients whose previous standard triple therapy has failed. The efficacy of this regimen remains stable with time.

Influence of hang time and location on bacterial contamination of intravenous bags in a veterinary emergency and critical care setting.

PubMed

Guillaumin, Julien; Olp, Nichole M; Magnusson, Karissa D; Butler, Amy L; Daniels, Joshua B

2017-09-01

To assess the rate of bacterial contamination of fluid and ports in intravenous bags in a veterinary emergency room (ER) and intensive care unit (ICU). Experimental model. Ninety intravenous fluid bags of lactated balanced-electrolytes solution (1 L) hung in a university hospital. Bags were hung in 2 different locations in the ER (sink and bins) and one location in the ICU (sink) for 11 days. Bags were punctured 3 times daily with a sterile needle to simulate clinical use. Injection ports were swabbed and 50 mL of fluid were collected in duplicates on days 0, 2, 4, 7, and 10. Aerobic bacterial cultures were performed on the fluid and injection port. Contamination was defined as bacterial growth of a similar phenotype across 2 consecutive times. Increase in the fluid contamination rate from day 0 was tested using an exact binomial test. Port contamination rate between locations was tested using Fisher's exact test. Combined bacterial growth on injection ports reached a mean (95% confidence interval) of 8.1 (0.005-16.2) cfu/port on day 10. The combined port contamination was 3.3%, 11.1%, 17.8%, and 31.1% on days 0, 2, 4, and 7, respectively. Port contamination was similar between ER and ICU. However, port contamination was higher in the sink versus the bins area (38.3% vs 16.7%, P = 0.032). No fluid bag was contaminated at days 0 and 2. The contamination rate of fluid bag was 1.1% and 4.4% on days 4 and 7, respectively. All bags with contaminated fluid were in the ER (6.7%, 95% exact binomial confidence interval 1.9-16.2%). Injection port contamination reached 31.1% on day 7. Contamination was more likely when the bags were hung next to a sink. In our model of bag puncture, fluid contamination occurred between days 2 and 4. © Veterinary Emergency and Critical Care Society 2017.

Prognostic role of the CDNK1B V109G polymorphism in multiple endocrine neoplasia type 1.

PubMed

Circelli, Luisa; Ramundo, Valeria; Marotta, Vincenzo; Sciammarella, Concetta; Marciello, Francesca; Del Prete, Michela; Sabatino, Lina; Pasquali, Daniela; Izzo, Francesco; Scala, Stefania; Colao, Annamaria; Faggiano, Antongiulio; Colantuoni, Vittorio

2015-07-01

CDKN1B encodes the cyclin-dependent kinase inhibitor p27/Kip1. CDKN1B mutations and polymorphisms are involved in tumorigenesis; specifically, the V109G single nucleotide polymorphism has been linked to different tumours with controversial results. Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant syndrome, characterized by the development of different types of neuroendocrine tumours and increased incidence of other malignancies. A clear genotype-phenotype correlation in MEN1 has not been established yet. In this study, we assessed whether the CDKN1B V109G polymorphism was associated with the development of aggressive tumours in 55 consecutive patients affected by MEN1. The polymorphism was investigated by PCR amplification of germline DNA followed by direct sequencing. Baseline and follow-up data of tumour types and their severity were collected and associated with the genetic data. MEN1-related aggressive and other malignant tumours of any origin were detected in 16.1% of wild-type and 33.3% of polymorphism allele-bearing patients (P = NS). The time interval between birth and the first aggressive tumour was significantly shorter in patients with the CDKN1B V109G polymorphism (median 46 years) than in those without (median not reached; P = 0.03). Similarly, shorter was the time interval between MEN1 diagnosis and age of the first aggressive tumour (P = 0.02). Overall survival could not be estimated as 96% patients were still alive at the time of the study. In conclusion, CDKN1B V109G polymorphism seems to play a role in the development of aggressive tumours in MEN1. © 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Feasibility and utility of an integrated medical imaging and informatics smartphone system for management of acute stroke.

PubMed

Shkirkova, Kristina; Akam, Eftitan Y; Huang, Josephine; Sheth, Sunil A; Nour, May; Liang, Conrad W; McManus, Michael; Trinh, Van; Duckwiler, Gary; Tarpley, Jason; Vinuela, Fernando; Saver, Jeffrey L

2017-12-01

Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center. Results From May 2014 to October 2014, the Synapse ERm application was used by 33 stroke team members in 84 Code Stroke alerts. Patient age was 69.6 (±17.1), with 41.5% female. Final diagnosis was: ischemic stroke 64.6%, transient ischemic attack 7.3%, intracerebral hemorrhage 6.1%, and cerebrovascular-mimic 22.0%. Each patient Synapse ERm record was viewed by a median of 10 (interquartile range 6-18) times by a median of 3 (interquartile range 2-4) team members. The most used feature was computerized tomography, magnetic resonance, and catheter angiography image display. In-app tweet team, communications were sent by median 1 (interquartile range 0-1, range 0-13) users per case and viewed by median 1 (interquartile range 0-3, range 0-44) team members. Use of the system was associated with rapid treatment times, faster than national guidelines, including median door-to-needle 51.0 min (interquartile range 40.5-69.5) and median door-to-groin 94.5 min (interquartile range 85.5-121.3). In user surveys, the mobile information platform was judged easy to employ in 91% (95% confidence interval 65%-99%) of uses and of added help in stroke management in 50% (95% confidence interval 22%-78%). Conclusion The Synapse ERm mobile platform for stroke team distribution and integration of clinical and imaging data was feasible to implement, showed high ease of use, and moderate perceived added utility in therapeutic management.

Predicting 30-Day Hospital Readmissions in Acute Myocardial Infarction: The AMI "READMITS" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score.

PubMed

Nguyen, Oanh Kieu; Makam, Anil N; Clark, Christopher; Zhang, Song; Das, Sandeep R; Halm, Ethan A

2018-04-17

Readmissions after hospitalization for acute myocardial infarction (AMI) are common. However, the few currently available AMI readmission risk prediction models have poor-to-modest predictive ability and are not readily actionable in real time. We sought to develop an actionable and accurate AMI readmission risk prediction model to identify high-risk patients as early as possible during hospitalization. We used electronic health record data from consecutive AMI hospitalizations from 6 hospitals in north Texas from 2009 to 2010 to derive and validate models predicting all-cause nonelective 30-day readmissions, using stepwise backward selection and 5-fold cross-validation. Of 826 patients hospitalized with AMI, 13% had a 30-day readmission. The first-day AMI model (the AMI "READMITS" score) included 7 predictors: renal function, elevated brain natriuretic peptide, age, diabetes mellitus, nonmale sex, intervention with timely percutaneous coronary intervention, and low systolic blood pressure, had an optimism-corrected C-statistic of 0.73 (95% confidence interval, 0.71-0.74) and was well calibrated. The full-stay AMI model, which included 3 additional predictors (use of intravenous diuretics, anemia on discharge, and discharge to postacute care), had an optimism-corrected C-statistic of 0.75 (95% confidence interval, 0.74-0.76) with minimally improved net reclassification and calibration. Both AMI models outperformed corresponding multicondition readmission models. The parsimonious AMI READMITS score enables early prospective identification of high-risk AMI patients for targeted readmissions reduction interventions within the first 24 hours of hospitalization. A full-stay AMI readmission model only modestly outperformed the AMI READMITS score in terms of discrimination, but surprisingly did not meaningfully improve reclassification. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Selecting patients during the "learning curve" of endoscopic Totally Extraperitoneal (TEP) hernia repair.

PubMed

Schouten, N; Elshof, J W M; Simmermacher, R K J; van Dalen, T; de Meer, S G A; Clevers, G J; Davids, P H P; Verleisdonk, E J M M; Westers, P; Burgmans, J P J

2013-12-01

Totally Extraperitoneal (TEP) hernia surgery is associated with little postoperative pain and a fast recovery, but is a technically demanding operative procedure. Apart from the surgeon's expertise, patient characteristics and hernia-related variations may also affect the operative time and outcome. Patient-related factors predictive of perioperative complications, conversion to open anterior repair, and operative time were studied in a cohort of consecutive patients undergoing TEP hernia repair from 2005 to 2009. A total of 3,432 patients underwent TEP. The mean operative time was 26 min (SD ± 10.9), TEP was converted into an open anterior approach in 26 patients (0.8 %), and perioperative complications were observed in 55 (1.6 %) patients. Multivariable regression analysis showed that a history of abdominal surgery (OR 1.76, 95 per cent confidence interval 1.01-3.06; p = 0.05), and the presence of a scrotal (OR 5.31, 1.20-23.43; p = 0.03) or bilateral hernia (OR 2.25, 1.25-4.06; p = 0.01) were independent predictive factors of perioperative complications. Female gender (OR 5.30. 1.52-18.45; p = 0.01), a history of abdominal surgery (OR 3.96, 1.72- 9.12; p = 0.001), and the presence of a scrotal hernia (OR 34.84, 10.42-116.51, p < 0.001) were predictive factors for conversion. A BMI ≥ 25 (effect size (ES) 1.78, 95 % confidence interval 1.09-2.47; p < 0.001) and the presence of a scrotal (ES 5.81, 1.93-9.68; p = 0.003), indirect (ES 2.78, 2.05- 3.50, p < 0.001) or bilateral hernia (ES 10.19, 9.20-11.08; p < 0.001) were associated with a longer operative time. Certain patient characteristics are, even in experienced TEP surgeons, associated with an increased risk of conversion and complications and a longer operative time. For the surgeon gaining experience with TEP, it seems advisable to select relatively young and slender male patients with a unilateral (non-scrotal) hernia and no previous abdominal surgery to enhance patient safety and 'surgeon comfort'.

The Effectiveness of Progressive Aerobic Interval Training in Cardiac Rehabilitation.

PubMed

Lee, Leanna S; Tsai, Ming-Chang; Oh, Paul I; Brooks, Dina

2018-05-01

Aerobic interval training (AIT) has recently emerged as a more effective strategy than moderate-intensity continuous exercise (MICE) for improving peak oxygen consumption (V˙O2peak) in coronary artery disease (CAD) patients. The primary purpose of this retrospective study was to describe the change in V˙O2peak, and cardiovascular (CV) risk profile characteristics (secondary outcomes) after progressive AIT practiced in the largest, outpatient cardiac rehabilitation (CR) program in North America compared with usual care CR involving MICE. Electronic database records were retrieved from consecutively enrolled patients with CAD who attended the Toronto Rehabilitation Institute, between January 1, 2005, and December 31, 2015. Patients were then separated into two, age and sex propensity score-matched groups: 772 patients were prescribed 26 wk of MICE (60%-80% of V˙O2peak, five times per week) as per usual care CR (56.0 ± 9.2 yr; 12% female/88% male; V˙O2peak: 20.8 ± 5.9 mL·kg·min), and 772 patients were prescribed 26 wk of progressive walk/jog intervals (15 min·mile walking pace, 12 min·mile jogging pace, five times per week) (55.9 ± 9.3 yr; 12% female/88% male; V˙O2peak: 24.8 ± 5.7 mL·kg ·min). Treatment effect analysis of AIT on V˙O2peak and CV risk profile characteristics was performed using multiple regression with baseline values as covariates. Treatment effect analysis revealed a 3.84-mL·kg·min superior improvement in V˙O2peak in the AIT group compared to usual care MICE group (P < 0.001). Furthermore, AIT significantly improved BMI, triglycerides, hip and abdominal girth, and depression score compared with MICE (P < 0.023 for all). Progressive AIT performed in a standard, outpatient CR program appears to be superior to usual care MICE for improving V˙O2peak, CV risk profile characteristics, and depression score in stable CAD patients. These findings may have important implications for exercise training guidelines in the rehabilitation setting, and in future studies.

Non-Stationary Effects and Cross Correlations in Solar Activity

NASA Astrophysics Data System (ADS)

Nefedyev, Yuri; Panischev, Oleg; Demin, Sergey

2016-07-01

In this paper within the framework of the Flicker-Noise Spectroscopy (FNS) we consider the dynamic properties of the solar activity by analyzing the Zurich sunspot numbers. As is well-known astrophysics objects are the non-stationary open systems, whose evolution are the quite individual and have the alternation effects. The main difference of FNS compared to other related methods is the separation of the original signal reflecting the dynamics of solar activity into three frequency bands: system-specific "resonances" and their interferential contributions at lower frequencies, chaotic "random walk" ("irregularity-jump") components at larger frequencies, and chaotic "irregularity-spike" (inertial) components in the highest frequency range. Specific parameters corresponding to each of the bands are introduced and calculated. These irregularities as well as specific resonance frequencies are considered as the information carriers on every hierarchical level of the evolution of a complex natural system with intermittent behavior, consecutive alternation of rapid chaotic changes in the values of dynamic variables on small time intervals with small variations of the values on longer time intervals ("laminar" phases). The jump and spike irregularities are described by power spectra and difference moments (transient structural functions) of the second order. FNS allows revealing the most crucial points of the solar activity dynamics by means of "spikiness" factor. It is shown that this variable behaves as the predictor of crucial changes of the sunspot number dynamics, particularly when the number comes up to maximum value. The change of averaging interval allows revealing the non-stationary effects depending by 11-year cycle and by inside processes in a cycle. To consider the cross correlations between the different variables of solar activity we use the Zurich sunspot numbers and the sequence of corona's radiation energy. The FNS-approach allows extracting the information about cross correlation dynamics between the signals from separate points of the studied system. The 3D cross correlators and their plain projections allow revealing the periodic laws of solar evolution. Work was supported by grants RFBR 15-02-01638-a and 16-02-00496-a.

Persistence of nondysplastic Barrett's esophagus identifies patients at lower risk for esophageal adenocarcinoma: results from a large multicenter cohort.

PubMed

Gaddam, Srinivas; Singh, Mandeep; Balasubramanian, Gokulakrishnan; Thota, Prashanthi; Gupta, Neil; Wani, Sachin; Higbee, April D; Mathur, Sharad C; Horwhat, John D; Rastogi, Amit; Young, Patrick E; Cash, Brooks D; Bansal, Ajay; Vargo, John J; Falk, Gary W; Lieberman, David A; Sampliner, Richard E; Sharma, Prateek

2013-09-01

Recent population-based studies have shown a low risk of esophageal adenocarcinoma (EAC) in patients with nondysplastic Barrett's esophagus (NDBE). We evaluated whether persistence of NDBE over multiple consecutive surveillance endoscopic examinations could be used in risk stratification of patients with Barrett's esophagus (BE). We performed a multicenter outcomes study of a large cohort of patients with BE. Based on the number of consecutive surveillance endoscopies showing NDBE, we identified 5 groups of patients. Patients in group 1 were found to have NDBE at their first esophagogastroduodenoscopy (EGD). Patients in group 2 were found to have NDBE on their first 2 consecutive EGDs. Similarly, patients in groups 3, 4, and 5 were found to have NDBE on 3, 4, and 5 consecutive surveillance EGDs. A logistic regression model was built to determine whether persistence of NDBE independently protected against development of cancer. Of a total of 3515 patients with BE, 1401 patients met the inclusion criteria (93.3% white; 87.5% men; median age, 60 ±17 years). The median follow-up period was 5 ± 3.9 years (7846 patient-years). The annual risk of EAC in groups 1 to 5 was 0.32%, 0.27%, 0.16%, 0.2%, and 0.11%, respectively (P for trend = .03). After adjusting for age, sex, and length of BE, persistence of NDBE, based on multiple surveillance endoscopies, was associated with a gradually lower likelihood of progression to EAC. Persistence of NDBE over several endoscopic examinations identifies patients who are at low risk for development of EAC. These findings support lengthening surveillance intervals or discontinuing surveillance of patients with persistent NDBE. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

A 100 Mfps image sensor for biological applications

NASA Astrophysics Data System (ADS)

Etoh, T. Goji; Shimonomura, Kazuhiro; Nguyen, Anh Quang; Takehara, Kosei; Kamakura, Yoshinari; Goetschalckx, Paul; Haspeslagh, Luc; De Moor, Piet; Dao, Vu Truong Son; Nguyen, Hoang Dung; Hayashi, Naoki; Mitsui, Yo; Inumaru, Hideo

2018-02-01

Two ultrahigh-speed CCD image sensors with different characteristics were fabricated for applications to advanced scientific measurement apparatuses. The sensors are BSI MCG (Backside-illuminated Multi-Collection-Gate) image sensors with multiple collection gates around the center of the front side of each pixel, placed like petals of a flower. One has five collection gates and one drain gate at the center, which can capture consecutive five frames at 100 Mfps with the pixel count of about 600 kpixels (512 x 576 x 2 pixels). In-pixel signal accumulation is possible for repetitive image capture of reproducible events. The target application is FLIM. The other is equipped with four collection gates each connected to an in-situ CCD memory with 305 elements, which enables capture of 1,220 (4 x 305) consecutive images at 50 Mfps. The CCD memory is folded and looped with the first element connected to the last element, which also makes possible the in-pixel signal accumulation. The sensor is a small test sensor with 32 x 32 pixels. The target applications are imaging TOF MS, pulse neutron tomography and dynamic PSP. The paper also briefly explains an expression of the temporal resolution of silicon image sensors theoretically derived by the authors in 2017. It is shown that the image sensor designed based on the theoretical analysis achieves imaging of consecutive frames at the frame interval of 50 ps.

Expressing breast milk at home for 24-h periods provides viable samples for macronutrient analysis.

PubMed

Anderssen, Sven-Harald; Løvlund, Emma E; Nygaard, Egil A; Selberg, Terje R; Størdal, Ketil

2015-01-01

This study aimed to evaluate the reproducibility of macronutrient measurements of domestic pooled human milk from mothers with preterm infants and to see how the results affected human milk fortifications. We asked 28 new mothers to express their breast milk for 24 h on two consecutive days and repeat the process at weekly intervals. The samples were analysed using mid-infrared technology to calculate the differences between the milk collected on two consecutive days for reproducibility and the total protein supply with standard fortification. There was a significant linear correlation between the two consecutive days with regard to protein (r = 0.94, p < 0.001), lipids (r = 0.86, p < 0.001), lactose (r = 0.91, p < 0.001) and 24-h volume (r = 0.96, p < 0.001). The percentage of the samples that would provide a protein supply of 3.5-4.5 g/kg/d with a fortification of 0.6 and 1.2 g protein/100 mL at a volume of 170 mL/kg were 28% and 41%, respectively. The domestic pooling of 24-h expressed human milk for macronutrient analysis was a simple and reliable way of obtaining representative data. Standard fortification implies there is a risk of under- and over-nutrition, and individual fortification may improve the nutrition of preterm infants. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

The Siesta Habit is Associated with a Decreased Risk of Rupture of Intracranial Aneurysms.

PubMed

Kang, Huibin; Feng, Xin; Zhang, Baorui; Guo, Erkang; Wang, Luyao; Qian, Zenghui; Liu, Peng; Wen, Xiaolong; Xu, Wenjuan; Li, Youxiang; Jiang, Chuhan; Wu, Zhongxue; Zhang, Hongbing; Liu, Aihua

2017-01-01

Previous studies have examined an association between the siesta habit and hypertension, as well as coronary heart disease. However, the relationship between a siesta and the risk of rupture of an intracranial aneurysm (IA) has not yet been established. We aimed to investigate the effects of a siesta on the risk of rupture of IAs. We prospectively enrolled consecutive patients diagnosed with IAs at our hospital between January 2016 and December 2016. Univariate and multivariate logistic regression analysis were performed to identify independent risk factors associated with IA rupture. We studied 581 consecutive patients with 514 unruptured and 120 ruptured aneurysms. Univariate analysis demonstrated that hypertension, hyperlipidemia, diabetes mellitus, cigarette smoking, location, size, as well as shape and aspect ratio were associated with the risk of rupture of IAs. Multivariate analysis identified hypertension [odds ratio (OR) 1.68, 95% confidence interval (CI) 1.03-2.73], hyperlipidemia (OR 0.25, 95% CI 0.08-0.72), current cigarette smoking ≥20 cigarettes/day (d) (OR 3.48, 95% CI 1.63-7.47), siesta (siesta time <1 h, OR 0.49, 95% CI 0.24-0.98 and siesta time ≥1 h, OR 0.32, 95% CI 0.19-0.57), location of largest aneurysm on the anterior communicating and internal carotid-posterior communicating artery (PCOM) (anterior communicating artery OR 16.27, 95% CI 7.40-35.79 and PCOM OR 11.21, 95% CI 5.15-24.43), and size of aneurysm ≥7 mm (OR 2.19, 95% CI 1.21-3.97) as independent strong risk factors associated with risk of aneurysm rupture. In the present study, we found that a habitual siesta is a new predictive factor to assess the risk of rupture of an IA. We found the siesta habit may reduce the risk of aneurysm rupture. We also found that hypertension, hyperlipidemia, cigarette smoking, location, and size of aneurysm were associated with the risk of rupture of IAs.

Nonparametric methods for analyzing recurrent gap time data with application to infections after hematopoietic cell transplant.

PubMed

Lee, Chi Hyun; Luo, Xianghua; Huang, Chiung-Yu; DeFor, Todd E; Brunstein, Claudio G; Weisdorf, Daniel J

2016-06-01

Infection is one of the most common complications after hematopoietic cell transplantation. Many patients experience infectious complications repeatedly after transplant. Existing statistical methods for recurrent gap time data typically assume that patients are enrolled due to the occurrence of an event of interest, and subsequently experience recurrent events of the same type; moreover, for one-sample estimation, the gap times between consecutive events are usually assumed to be identically distributed. Applying these methods to analyze the post-transplant infection data will inevitably lead to incorrect inferential results because the time from transplant to the first infection has a different biological meaning than the gap times between consecutive recurrent infections. Some unbiased yet inefficient methods include univariate survival analysis methods based on data from the first infection or bivariate serial event data methods based on the first and second infections. In this article, we propose a nonparametric estimator of the joint distribution of time from transplant to the first infection and the gap times between consecutive infections. The proposed estimator takes into account the potentially different distributions of the two types of gap times and better uses the recurrent infection data. Asymptotic properties of the proposed estimators are established. © 2015, The International Biometric Society.

Nonparametric methods for analyzing recurrent gap time data with application to infections after hematopoietic cell transplant

PubMed Central

Lee, Chi Hyun; Huang, Chiung-Yu; DeFor, Todd E.; Brunstein, Claudio G.; Weisdorf, Daniel J.

2015-01-01

Summary Infection is one of the most common complications after hematopoietic cell transplantation. Many patients experience infectious complications repeatedly after transplant. Existing statistical methods for recurrent gap time data typically assume that patients are enrolled due to the occurrence of an event of interest, and subsequently experience recurrent events of the same type; moreover, for one-sample estimation, the gap times between consecutive events are usually assumed to be identically distributed. Applying these methods to analyze the post-transplant infection data will inevitably lead to incorrect inferential results because the time from transplant to the first infection has a different biological meaning than the gap times between consecutive recurrent infections. Some unbiased yet inefficient methods include univariate survival analysis methods based on data from the first infection or bivariate serial event data methods based on the first and second infections. In this paper, we propose a nonparametric estimator of the joint distribution of time from transplant to the first infection and the gap times between consecutive infections. The proposed estimator takes into account the potentially different distributions of the two types of gap times and better uses the recurrent infection data. Asymptotic properties of the proposed estimators are established. PMID:26575402

Quality of reporting of studies evaluating time to diagnosis: a systematic review in paediatrics.

PubMed

Launay, Elise; Morfouace, Michele; Deneux-Tharaux, Catherine; Gras le-Guen, Christèle; Ravaud, Philippe; Chalumeau, Martin

2014-03-01

An ever-increasing number of studies analyses the distribution, determinants and consequences of time to diagnosis and delays. Weaknesses in their reporting can impede the assessment of the risks of bias and variation and thus create a risk of invalid conclusions and counterproductive clinical and public health efforts. This study sought to assess systematically the quality of reporting of articles about time to diagnosis in paediatrics. Two authors identified and analysed the quality of reporting of 50 consecutive articles assessing these intervals published from 2005 through October 2011, according to a checklist we developed of 35 items potentially associated with risks of bias and variation. Frequency of articles reporting each item. Symptoms that should trigger a diagnostic procedure were reported in 28% of the articles; only two articles reported whether all patients with these symptoms underwent that procedure. Only 44% of the articles defined the beginning of the illness, 46% the date of diagnosis and 60% the distribution of time to diagnosis. Two studies met the criteria for all 11 items considered essential for assessing the risks of bias and variation in this type of study. This study identified many weaknesses in the quality of reporting of studies of time to diagnosis in paediatrics, especially for items potentially related to risks of bias and variation. This finding underlines the need for the development of new (or the refinement of existing) guidelines for reporting this type of study.

Clinical Validation of Heart Rate Apps: Mixed-Methods Evaluation Study

PubMed Central

Stans, Jelle; Mortelmans, Christophe; Van Haelst, Ruth; Van Schelvergem, Gertjan; Pelckmans, Caroline; Smeets, Christophe JP; Lanssens, Dorien; De Cannière, Hélène; Storms, Valerie; Thijs, Inge M; Vaes, Bert; Vandervoort, Pieter M

2017-01-01

Background Photoplethysmography (PPG) is a proven way to measure heart rate (HR). This technology is already available in smartphones, which allows measuring HR only by using the smartphone. Given the widespread availability of smartphones, this creates a scalable way to enable mobile HR monitoring. An essential precondition is that these technologies are as reliable and accurate as the current clinical (gold) standards. At this moment, there is no consensus on a gold standard method for the validation of HR apps. This results in different validation processes that do not always reflect the veracious outcome of comparison. Objective The aim of this paper was to investigate and describe the necessary elements in validating and comparing HR apps versus standard technology. Methods The FibriCheck (Qompium) app was used in two separate prospective nonrandomized studies. In the first study, the HR of the FibriCheck app was consecutively compared with 2 different Food and Drug Administration (FDA)-cleared HR devices: the Nonin oximeter and the AliveCor Mobile ECG. In the second study, a next step in validation was performed by comparing the beat-to-beat intervals of the FibriCheck app to a synchronized ECG recording. Results In the first study, the HR (BPM, beats per minute) of 88 random subjects consecutively measured with the 3 devices showed a correlation coefficient of .834 between FibriCheck and Nonin, .88 between FibriCheck and AliveCor, and .897 between Nonin and AliveCor. A single way analysis of variance (ANOVA; P=.61 was executed to test the hypothesis that there were no significant differences between the HRs as measured by the 3 devices. In the second study, 20,298 (ms) R-R intervals (RRI)–peak-to-peak intervals (PPI) from 229 subjects were analyzed. This resulted in a positive correlation (rs=.993, root mean square deviation [RMSE]=23.04 ms, and normalized root mean square error [NRMSE]=0.012) between the PPI from FibriCheck and the RRI from the wearable ECG. There was no significant difference (P=.92) between these intervals. Conclusions Our findings suggest that the most suitable method for the validation of an HR app is a simultaneous measurement of the HR by the smartphone app and an ECG system, compared on the basis of beat-to-beat analysis. This approach could lead to more correct assessments of the accuracy of HR apps. PMID:28842392

Factors associated with the development of cytomegalovirus infection following solid organ transplantation.

PubMed

da Cunha-Bang, Caspar; Sørensen, Søren S; Iversen, Martin; Sengeløv, Henrik; Hillingsø, Jens G; Rasmussen, Allan; Mortensen, Svend A; Fox, Zoe V; Kirkby, Nikolai S; Christiansen, Claus B; Lundgren, Jens D

2011-05-01

Infection with cytomegalovirus (CMV) remains a potentially serious complication in transplant patients. In this study we explored the risk factors for CMV infection in the 12 months following a solid organ transplantation (n = 242) in patients monitored for CMV infection from 2004 to 2007. CMV infection was defined as 2 consecutive quantifiable CMV-polymerase chain reaction (PCR) values or 1 measurement of >3000 copies/ml. Data describing pre- and post-transplantation variables were extracted from electronic health records. Time to CMV infection was investigated using Cox proportional hazards analysis. Overall, 31% (75/242) of solid organ transplant patients developed CMV infection: 4/8 (50.0%) heart, 15/43 (34.9%) liver, 30/89 (33.7%) lung and 26/102 (25.5%) kidney transplant patients. The risk of CMV infection according to donor (D)/recipient (R) CMV serostatus (positive + or negative-) was highest for D+/R-(adjusted hazard ratio 2.6, 95% confidence interval 1.6-4.2) vs D+/R+, and was reduced for D-/R+(adjusted hazard ratio 0.2, 95% confidence interval 0.2-0.8) vs D+/R+. Positive donor CMV-serostatus is a major risk factor for CMV-infection in CMV-na ve recipients, but also in recipients with positive CMV-serostatus. Conversely, if donor is CMV serostatus is negative, the risk of CMV infection is low, irrespective of recipients CMV-serostatus. These findings suggest poorer immune function towards donor-induced strains of CMV versus recipient own latent strains.

Hyperoxia is Associated with Increased Mortality in Patients Treated with Mild Therapeutic Hypothermia after Sudden Cardiac Arrest

PubMed Central

Janz, David R.; Hollenbeck, Ryan D.; Pollock, Jeremy S.; McPherson, John A.; Rice, Todd W.

2012-01-01

Objective To determine if higher levels of partial pressure of arterial oxygen are associated with in-hospital mortality and poor neurologic status at hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. Design Retrospective analysis of a prospective cohort study Patients A total of 170 consecutive patients treated with therapeutic hypothermia in the cardiovascular care unit of an academic tertiary care hospital. Interventions None. Measurements and Main Results Of 170 patients, 77 (45.2%) survived to hospital discharge. Survivors had a significantly lower maximum partial pressure of arterial oxygen(198 mmHg, IQR 152.5–282) measured in the first 24 hours following cardiac arrest compared to nonsurvivors (254 mmHg, IQR 172–363, p = .022). A multivariable analysis including age, time to return of spontaneous circulation, the presence of shock, bystander CPR, and initial rhythm revealed that higher levels of the partial pressure of arterial oxygen were significantly associated with increased in-hospital mortality (odds ratio 1.439, 95% confidence interval 1.028–2.015, p = 0.034) and poor neurologic status at hospital discharge (odds ratio 1.485, 95% confidence interval 1.032–2.136, p = 0.033). Conclusions Higher levels of the maximum measured partial pressure of arterial oxygen are associated with increased in-hospital mortality and poor neurologic status on hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. PMID:22971589

[Changes in the demand for paediatric neurology care in a spanish tertiary care hospital over a 20-year period].

PubMed

Monge Galindo, L; López-Pisón, J; Samper Villagrasa, P; Peña Segura, J L

2014-01-01

The purpose of this study is to determine the profile of the demand for paediatric neurology care in a Spanish tertiary hospital over the past 20 years. We studied epidemiological data, reasons for consultation, diagnoses and complementary tests from all patients examined by our Paediatric Neurology Unit in its 20 years of service (from May 1990 to March 2010). We also reviewed data from patients whose first visit took place within the last five years (2005-2010) and compared them to data obtained from a prior study carried out in this Unit from 1990 to 1995. To compare the first 5 years (group 1) with the last 5 years (group 2), we calculated confidence intervals, P<.05, for the frequency distribution (%) in each category. Main reasons for consultation and principal diagnoses for the 12726 patients evaluated in the 20-year period, as well as results from group 1 (2046 patients) and group 2 (4488 patients) corresponding to first and the last 5 years of activity respectively, are presented with their confidence intervals in a series of tables. Variations in the reasons for consultation, diagnoses and complementary tests over time reflect changes determined by medical, scientific and social progress, and organisational changes specific to each hospital. This explains the difficulty of comparing different patient series studied consecutively, which are even more pronounced between different hospitals. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

First impression at stroke onset plays an important role in early hospital arrival.

PubMed

Iguchi, Yasuyuki; Wada, Kuniyasu; Shibazaki, Kensaku; Inoue, Takeshi; Ueno, Yuji; Yamashita, Shinji; Kimura, Kazumi

2006-01-01

Treatment for acute ischemic stroke should be administered as soon as possible after symptom onset. The aim of this study was to investigate whether or not the patient's and bystander's first impression at stroke onset was associated with hospital arrival time. To investigate the factors influencing the prehospital delay, we prospectively interviewed consecutive stroke patients and bystanders about their first impression at the stroke onset and assessed the methods of transportation, and clinical characteristics. Early arrival was defined as a hospital arrival of within 2 h from stroke onset. One hundred thirty patients were enrolled: 82% were ischemic stroke and 18% were cerebral hemorrhage. The median interval between symptom onset and the hospital arrival was 7.5 h and 30% of patients presented within 2 h of stroke onset. First impression of stroke (odds ratios [OR] 4.56, 95% confidence interval [CI] 1.54-13.5, p=0.006), presence of consciousness disturbance (OR 4.29, CI 1.39-13.3, p=0.011), arrival through other facilities (OR 0.25, CI 0.08-0.76, p=0.015), a history of diabetes (OR 0.23, CI 0.06-0.80, p=0.028) and nocturnal onset (OR 0.19, CI 0.04-0.88, p=0.042) independently contributed to the early arrival. The first impression of patients and bystanders at stroke onset is important in order to reach hospital earlier in Japan. Public educational systems such as those, which advertise stroke warning signs, are necessary.

Measuring the accelerating effect of the planetary-scale waves on Venus observed with UVI/AKATSUKI and ground-based telescopes

NASA Astrophysics Data System (ADS)

Imai, M.; Kouyama, T.; Takahashi, Y.; Watanabe, S.; Yamazaki, A.; Yamada, M.; Nakamura, M.; Satoh, T.; Imamura, T.; Nakaoka, T.; Kawabata, M.; Yamanaka, M.; Kawabata, K. S.

2017-12-01

Venus has a global cloud layer, and the atmosphere rotates with the speed over 100 m/s. The scattering of solar radiance and absorber in clouds cause the strong dark and bright contrast in 365 nm unknown absorption bands. The Japanese Venus orbiter AKATSUKI and the onboard instrument UVI capture 100 km mesoscale cloud features over the entire visible dayside area. In contrast, planetary-scale features are observed when the orbiter is at the moderate distance from Venus and when the Sun-Venus-orbiter phase angle is smaller than 45 deg. Cloud top wind velocity was measured with the mesoscale cloud tracking technique, however, observations of the propagation velocity and its variation of the planetary-scale feature are not well conducted because of the limitation of the observable area. The purpose of the study is measuring the effect of wind acceleration by planetary-scale waves. Each cloud motion can be represented as the wind and phase velocity of the planetary-scale waves, respectively. We conducted simultaneous observations of the zonal motion of both mesoscale and planetary-scale feature using UVI/AKATSUKI and ground-based Pirka and Kanata telescopes in Japan. Our previous ground-based observation revealed the periodicity change of planetary-scale waves with a time scale of a couple of months. For the initial analysis of UVI images, we used the time-consecutive images taken in the orbit #32. During this orbit (from Nov. 13 to 20, 2016), 7 images were obtained with 2 hr time-interval in a day whose spatial resolution ranged from 10-35 km. To investigate the typical mesoscale cloud motion, the Gaussian-filters with sigma = 3 deg. were used to smooth geometrically mapped images with 0.25 deg. resolution. Then the amount of zonal shift for each 5 deg. latitudinal bands between the pairs of two time-consecutive images were estimated by searching the 2D cross-correlation maximum. The final wind velocity (or rotation period) for mesoscale features were determined with a small error about +/- 0.1-day period in equatorial region (Figure 2). The same method will be applied for planetary-scale features captured by UVI, and ground-based observations compensate the discontinuity in UVI data. At the presentation, the variability in winds and wave propagation velocity with the time scale of a couple of months will be shown.

Characterizing the Recurrence of Hydrologic Droughts

NASA Astrophysics Data System (ADS)

Cancelliere, A.; Salas, J. D.

2002-12-01

Characterizing periods of deficit and drought has been an important aspect in planning and management of water resources systems for many decades. An extreme drought is a complex phenomenon that evolves through time and space in a random fashion. It may be characterized by its initiation, duration, severity (magnitude or intensity), spatial extent, and termination. These characteristics may be determined by comparing the water supply time series versus the corresponding water demand series in the area of consideration. Because the water supply quantities such as rainfall and streamflow are stochastic variables the ensuing drought characteristics are random and must be described in probabilistic terms. Let us consider a periodic stochastic water supply and a variable water demand series. A drought event is defined as a succession of consecutive periods (run) in which the water supply remains below the water demand. Thus, the drought length L (negative run length) is the number of consecutive time intervals (seasons) in which the water supply remains below the water demand, preceded and followed by (at least one season where) the water supply is equal or greater than the demand. Likewise, the difference between the water demand and the supply at time t is the magnitude of the deficit at time t so that the accumulated deficit D (drought magnitude) is the sum of the deficits over the drought duration L. In the study reported herein, the probability density functions (pdf) of drought length and drought magnitude and their low order moments are derived assuming that the underlying water supply series after is clipped by a constant or periodic water demand results in a periodic dependent binary series that is represented by a periodic two-state Markov chain. The derived pdfs allow estimating the occurrence probabilities of droughts of a given length where either the drought begins in a given season or regardless of the initial season. In addition, the return periods of droughts (based on length and magnitude) are determined. The applicability of the drought formulations is illustrated using several series of precipitation and streamflow in Sicily, Italy and Colorado, USA. The results obtained show an excellent agreement between the observed and theoretical results. In conclusion, the proposed methods appear to be a useful addition for drought analysis and characterization using stochastic methods.

Assessment of tolerance to the effects of methamphetamine on daytime and nighttime activity evaluated with actigraphy in rhesus monkeys.

PubMed

Berro, Laís F; Andersen, Monica L; Howell, Leonard L

2017-08-01

Methamphetamine is one of the most largely consumed illicit drugs, and its use is associated with abuse liability and several adverse health effects, such as sleep impairment. Importantly, sleep quality can influence addiction treatment outcomes. Evidence suggests that tolerance can develop to the sleep-disrupting effects of stimulant drugs. The aim of the present study was to investigate the development of tolerance to the actigraphy-based sleep-disrupting and stimulant effects of methamphetamine self-administration in rhesus monkeys. Methamphetamine (0.03 mg/kg/inf, i.v.) self-administration was carried out following three different protocols: 14 consecutive days of self-administration, 5 days/week for 3 weeks, with a 2-day interval between 5-day blocks of self-administration, and 3 days/week for 3 weeks, with a 4-day interval between 3-day blocks of self-administration. Daytime activity and activity-based sleep measures were evaluated with Actiwatch monitors a week before (baseline parameters) and throughout each protocol. Methamphetamine self-administration markedly disrupted sleep-like measures and increased daytime activity. Tolerance developed to those effects with repeated methamphetamine intake exceeding five consecutive days. Inclusion of washout periods (2 or 4 days) between blocks of methamphetamine self-administration attenuated the development of tolerance, with longer breaks from methamphetamine intake being more effective in maintaining the sleep-disrupting and stimulant effects of methamphetamine. Tolerance can develop to the stimulant and sleep-disrupting effects of methamphetamine self-administration. Interruption of drug intake extends the effects of methamphetamine on sleep-like measures and daytime activity.

Usefulness of Electrocardiographic QT Interval to Predict Left Ventricular Diastolic Dysfunction

PubMed Central

Wilcox, Jane E.; Rosenberg, Jonathan; Vallakati, Ajay; Gheorghiade, Mihai; Shah, Sanjiv J.

2013-01-01

Whether a normal electrocardiogram excludes left ventricular (LV) diastolic dysfunction (DD) and whether electrocardiographic parameters are associated with DD is unknown. We therefore sought to investigate the relation between electrocardiographic parameters and DD. We first evaluated 75 consecutive patients referred for echocardiography for clinical suspicion of heart failure (phase 1). Electrocardiography and comprehensive echocardiography were performed on all patients and were analyzed separately in a blinded fashion. Receiver operating characteristic curves and multivariate regression analyses were used to determine which electrocardiographic parameters were most closely associated with DD. Next, we prospectively validated our results in 100 consecutive, unselected patients undergoing echocardiography (phase 2). In phase 1 of our study, the mean age was 59 ± 14 years, 41% were women, 31% had coronary disease, 53% had hypertension, and 25% had diabetes. The mean ejection fraction was 54 ± 15%, and 64% had DD. Of all the electrocardiographic parameters, the QTc interval was most closely associated with DD. QTc was inversely associated with E′ velocity (r = −0.54, p <0.0001), and the area under the receiver operating characteristic curve for QTc as a predictor of DD was 0.82. QTc prolongation was independently associated with reduced E′ velocity (p = 0.021 after adjustment for age, gender, medications, QRS duration, and ejection fraction). In phase 2 of our study QTc was the electrocardiographic parameter most associated with reduced E′ velocity (435 ± 31 vs 419 ± 24 ms; p = 0.004), confirming our phase 1 study findings. In conclusion, QTc prolongation was the electrocardiographic marker most predictive of DD and was independently associated with DD. PMID:21907948

Incidence and risk factors of synchronous colorectal cancer in patients with esophageal cancer: an analysis of 480 consecutive colonoscopies before surgery.

PubMed

Yoshida, Naoya; Tamaoki, Yuka; Baba, Yoshifumi; Sakamoto, Yasuo; Miyamoto, Yuji; Iwatsuki, Masaaki; Shono, Takashi; Miyamoto, Hideaki; Imuta, Masanori; Kurashige, Junji; Sawayama, Hiroshi; Tokunaga, Ryuma; Watanabe, Masayuki; Sasaki, Yutaka; Yamashita, Yasuyuki; Baba, Hideo

2016-12-01

The precise incidence rates of multiple primary colorectal cancers in esophageal cancer patients are unknown. In total, 480 consecutive patients with esophageal cancers surgically resected in the Kumamoto University Hospital received preoperative total colonoscopy for the assessment of colorectal disease between April 2005 and February 2016. We retrospectively investigated the occurrence of synchronous colorectal cancer with esophageal cancer. In addition, we examined the risk factors for the incidence of multiple primary colorectal cancers. Of the 480 patients, 14 (2.9 %) had synchronous colorectal cancers, 13 had well-differentiated tubular adenocarcinomas, and 1 had papillary adenocarcinoma. Other 14 patients had metachronous colorectal cancer. The current incidence rates of synchronous and total (both synchronous and metachronous) colorectal cancers outnumbered those in normal healthy population and those in esophageal cancer patients which previously reported by The Japan Esophageal Society. The age ≥70 years (hazard ratio 4.82, 95 % confidence interval 1.473-15.78; p = 0.009) and Brinkman index ≥800 (hazard ratio 3.47, 95 % confidence interval 1.056-11.37; p = 0.040) were the independent risk factors for the incidence of synchronous colorectal cancer. They were also the independent risk factors for the incidence of total colorectal cancer. The results of the present study suggested that pretreatment screening with total colonoscopy is meaningful for patients with esophageal cancer, because the frequency of synchronous colorectal cancer was not negligible. Particularly, in patients >70 years and with history of heavy smoking, pretreatment colonoscopy might be necessary.

Department of Defense Precise Time and Time Interval program improvement plan

NASA Technical Reports Server (NTRS)

Bowser, J. R.

1981-01-01

The United States Naval Observatory is responsible for ensuring uniformity in precise time and time interval operations including measurements, the establishment of overall DOD requirements for time and time interval, and the accomplishment of objectives requiring precise time and time interval with minimum cost. An overview of the objectives, the approach to the problem, the schedule, and a status report, including significant findings relative to organizational relationships, current directives, principal PTTI users, and future requirements as currently identified by the users are presented.

Ovum pick-up interval in buffalo (Bubalus bubalis) managed under wetland conditions in Argentina: Effect on follicular population, oocyte recovery, and in vitro embryo development.

PubMed

Konrad, J; Clérico, G; Garrido, M J; Taminelli, G; Yuponi, M; Yuponi, R; Crudeli, G; Sansinena, M

2017-08-01

The excellent adaptation of water buffalo (Bubalis bubalis) to swampy environments means that animals are frequently managed in areas with restricted access for reproductive procedures. The objective of this study was to evaluate the effect of the ovum pick-up (OPU) interval on follicular population, oocyte recovery, oocyte quality and in vitro embryo production. Twelve Murrah buffaloes were subjected to two consecutive dominant follicle reductions, and randomly assigned to either 7-day (n=6) or 14-day (n=6) OPU interval groups. Although there was no significant difference in the average number of small (<3mm) and large (>8mm) diameter follicles available per OPU, a higher proportion of medium-sized follicles (3-8mm) were observed in the 14-day interval group (5.129 vs 3.267; p<0.05). The number of recovered oocytes per donor was also significantly higher (4.51 vs. 2.8; p<0.05) in the 14-day interval group, although this was attributed to an increase in the proportion of lower quality oocytes (grades III and IV). After in vitro fertilization, embryo developmental competence from grade I and II oocytes was superior to that from grade III and IV oocytes, irrespective of OPU interval group. There was no significant difference in the proportion of grade I and II oocytes cleaved after sperm co-incubation; however, there was a higher proportion of blastocysts produced in 14-day interval group (28 vs. 6%, p<0.05). No blastocysts were produced from grade III and IV oocytes. This study indicates it is possible to use a 14-day interval for oocyte collection in water buffalo; this approach could be considered as an alternative when access to animals is restricted. Copyright © 2017 Elsevier B.V. All rights reserved.

Periodic Accretion-powered Flares from Colliding EMRIs as TDE Imposters

NASA Astrophysics Data System (ADS)

Metzger, Brian D.; Stone, Nicholas C.

2017-07-01

When a main-sequence star undergoes Roche lobe overflow onto a supermassive black hole (SMBH) in a circular extreme mass ratio inspiral (EMRI), a phase of steady mass transfer ensues. Over millions of years, the binary evolves to a period minimum before reversing course and migrating outward as a brown dwarf. Because the time interval between consecutive EMRIs is comparable to the mass-transfer timescale, the semimajor axes of two consecutive mass-transferring EMRIs will cross on a radial scale of less than a few au. We show that such EMRI crossing events are inevitably accompanied by a series of mildly relativistic, grazing physical collisions between the stars. Each collision strips a small quantity of mass, primarily from the more massive star, which generally increases their radial separation to set up the next collision after a delay of decades to centuries (or longer) set by further gravitational radiation. Depending on the mass of the SMBH, this interaction can result in {N}{{c}}˜ 1{--}{10}4 gas production events of mass ˜ {M}⊙ /{N}{{c}}, thus powering a quasi-periodic sequence of SMBH accretion-powered flares over a total duration of thousands of years or longer. Although the EMRI rate is 2-3 orders of magnitude lower than the rate of tidal disruption events (TDEs), the ability of a single interacting EMRI pair to produce a large number of luminous flares—and to make more judicious use of the available stellar fuel—could make their observed rate competitive with the TDE rate, enabling them to masquerade as “TDE imposters.” Gas produced by EMRI collisions is easier to circularize than the highly eccentric debris streams produced in TDEs. We predict flares with bolometric luminosities that decay both as power laws shallower than {t}-5/3 and as decaying exponentials in time. Viscous spreading of the gaseous disks produced by the accumulation of previous mass-stripping events will place a substantial mass of gas on radial scales ≳ 10{--}100 {au} at the time of a given flare, providing a possible explanation for the “reprocessing blanket” required to explain the unexpectedly high optical luminosities of some candidate TDE flares.

Reliability of fitness tests using methods and time periods common in sport and occupational management.

PubMed

Burnstein, Bryan D; Steele, Russell J; Shrier, Ian

2011-01-01

Fitness testing is used frequently in many areas of physical activity, but the reliability of these measurements under real-world, practical conditions is unknown. To evaluate the reliability of specific fitness tests using the methods and time periods used in the context of real-world sport and occupational management. Cohort study. Eighteen different Cirque du Soleil shows. Cirque du Soleil physical performers who completed 4 consecutive tests (6-month intervals) and were free of injury or illness at each session (n = 238 of 701 physical performers). Performers completed 6 fitness tests on each assessment date: dynamic balance, Harvard step test, handgrip, vertical jump, pull-ups, and 60-second jump test. We calculated the intraclass coefficient (ICC) and limits of agreement between baseline and each time point and the ICC over all 4 time points combined. Reliability was acceptable (ICC > 0.6) over an 18-month time period for all pairwise comparisons and all time points together for the handgrip, vertical jump, and pull-up assessments. The Harvard step test and 60-second jump test had poor reliability (ICC < 0.6) between baseline and other time points. When we excluded the baseline data and calculated the ICC for 6-month, 12-month, and 18-month time points, both the Harvard step test and 60-second jump test demonstrated acceptable reliability. Dynamic balance was unreliable in all contexts. Limit-of-agreement analysis demonstrated considerable intraindividual variability for some tests and a learning effect by administrators on others. Five of the 6 tests in this battery had acceptable reliability over an 18-month time frame, but the values for certain individuals may vary considerably from time to time for some tests. Specific tests may require a learning period for administrators.

Ratio-based lengths of intervals to improve fuzzy time series forecasting.

PubMed

Huarng, Kunhuang; Yu, Tiffany Hui-Kuang

2006-04-01

The objective of this study is to explore ways of determining the useful lengths of intervals in fuzzy time series. It is suggested that ratios, instead of equal lengths of intervals, can more properly represent the intervals among observations. Ratio-based lengths of intervals are, therefore, proposed to improve fuzzy time series forecasting. Algebraic growth data, such as enrollments and the stock index, and exponential growth data, such as inventory demand, are chosen as the forecasting targets, before forecasting based on the various lengths of intervals is performed. Furthermore, sensitivity analyses are also carried out for various percentiles. The ratio-based lengths of intervals are found to outperform the effective lengths of intervals, as well as the arbitrary ones in regard to the different statistical measures. The empirical analysis suggests that the ratio-based lengths of intervals can also be used to improve fuzzy time series forecasting.

Labtracker+, a medical smartphone app for the interpretation of consecutive laboratory results: an external validation study.

PubMed

Hilderink, Judith M; Rennenberg, Roger J M W; Vanmolkot, Floris H M; Bekers, Otto; Koopmans, Richard P; Meex, Steven J R

2017-09-01

When monitoring patients over time, clinicians may struggle to distinguish 'real changes' in consecutive blood parameters from so-called natural fluctuations. In practice, they have to do so by relying on their clinical experience and intuition. We developed Labtracker+ , a medical app that calculates the probability that an increase or decrease over time in a specific blood parameter is real, given the time between measurements. We presented patient cases to 135 participants to examine whether there is a difference between medical students, residents and experienced clinicians when it comes to interpreting changes between consecutive laboratory results. Participants were asked to interpret if changes in consecutive laboratory values were likely to be 'real' or rather due to natural fluctuations. The answers of the study participants were compared with the calculated probabilities by the app Labtracker+ and the concordance rates were assessed. Medical students (n=92), medical residents from the department of internal medicine (n=19) and internists (n=24) at a Dutch University Medical Centre. Concordance rates between the study participants and the calculated probabilities by the app Labtracker+ were compared. Besides, we tested whether physicians with clinical experience scored better concordance rates with the app Labtracker+ than inexperienced clinicians. Medical residents and internists showed significantly better concordance rates with the calculated probabilities by the app Labtracker+ than medical students, regarding their interpretation of differences between consecutive laboratory results (p=0.009 and p<0.001, respectively). The app Labtracker+ could serve as a clinical decision tool in the interpretation of consecutive laboratory test results and could contribute to rapid recognition of parameter changes by physicians. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Importance of the Time Interval between Bowel Preparation and Colonoscopy in Determining the Quality of Bowel Preparation for Full-Dose Polyethylene Glycol Preparation

PubMed Central

Kim, Tae Kyung; Kim, Hyung Wook; Kim, Su Jin; Ha, Jong Kun; Jang, Hyung Ha; Hong, Young Mi; Park, Su Bum; Choi, Cheol Woong; Kang, Dae Hwan

2014-01-01

Background/Aims The quality of bowel preparation (QBP) is the important factor in performing a successful colonoscopy. Several factors influencing QBP have been reported; however, some factors, such as the optimal preparation-to-colonoscopy time interval, remain controversial. This study aimed to determine the factors influencing QBP and the optimal time interval for full-dose polyethylene glycol (PEG) preparation. Methods A total of 165 patients who underwent colonoscopy from June 2012 to August 2012 were prospectively evaluated. The QBP was assessed using the Ottawa Bowel Preparation Scale (Ottawa) score according to several factors influencing the QBP were analyzed. Results Colonoscopies with a time interval of 5 to 6 hours had the best Ottawa score in all parts of the colon. Patients with time intervals of 6 hours or less had the better QBP than those with time intervals of more than 6 hours (p=0.046). In the multivariate analysis, the time interval (odds ratio, 1.897; 95% confidence interval, 1.006 to 3.577; p=0.048) was the only significant contributor to a satisfactory bowel preparation. Conclusions The optimal time was 5 to 6 hours for the full-dose PEG method, and the time interval was the only significant contributor to a satisfactory bowel preparation. PMID:25368750

Genus Ranges of 4-Regular Rigid Vertex Graphs

PubMed Central

Buck, Dorothy; Dolzhenko, Egor; Jonoska, Nataša; Saito, Masahico; Valencia, Karin

2016-01-01

A rigid vertex of a graph is one that has a prescribed cyclic order of its incident edges. We study orientable genus ranges of 4-regular rigid vertex graphs. The (orientable) genus range is a set of genera values over all orientable surfaces into which a graph is embedded cellularly, and the embeddings of rigid vertex graphs are required to preserve the prescribed cyclic order of incident edges at every vertex. The genus ranges of 4-regular rigid vertex graphs are sets of consecutive integers, and we address two questions: which intervals of integers appear as genus ranges of such graphs, and what types of graphs realize a given genus range. For graphs with 2n vertices (n > 1), we prove that all intervals [a, b] for all a < b ≤ n, and singletons [h, h] for some h ≤ n, are realized as genus ranges. For graphs with 2n − 1 vertices (n ≥ 1), we prove that all intervals [a, b] for all a < b ≤ n except [0, n], and [h, h] for some h ≤ n, are realized as genus ranges. We also provide constructions of graphs that realize these ranges. PMID:27807395

Interresponse Time Structures in Variable-Ratio and Variable-Interval Schedules

ERIC Educational Resources Information Center

Bowers, Matthew T.; Hill, Jade; Palya, William L.

2008-01-01

The interresponse-time structures of pigeon key pecking were examined under variable-ratio, variable-interval, and variable-interval plus linear feedback schedules. Whereas the variable-ratio and variable-interval plus linear feedback schedules generally resulted in a distinct group of short interresponse times and a broad distribution of longer…

TSAT is a better predictor than ferritin of hemoglobin response to Epoetin alfa in US dialysis patients

PubMed Central

Gaweda, Adam E; Bhat, Premila; Maglinte, Gregory A; Chang, Chun-Lan; Hill, Jerrold; Park, Grace S; Ashfaq, Akhtar; Gitlin, Matthew

2014-01-01

Clinical guidelines recommend concurrent treatment of anemia in end-stage renal disease with erythropoiesis-stimulating agents (ESAs) and iron. However, there are mixed data about optimal iron supplementation. To help address this gap, the relationship between iron markers and hemoglobin (Hb) response to ESA (Epoetin alfa) dose was examined. Electronic medical records of 1902 US chronic hemodialysis patients were analyzed over a 12-month period between June 2009 and June 2010. The analysis included patients who had at least one Hb value during each 4-week interval for four consecutive intervals (k − 2, k − 1, k, and k + 1; k is the index interval), received at least one ESA dose during intervals k − 1 or k, had at least one transferrin saturation (TSAT) value at interval k, and at least one ferritin value during intervals k − 2, k − 1, or k. Effect modification by TSAT and ferritin on Hb response was evaluated using the generalized estimating equations approach. Patients had a mean (standard deviation) age of 62 (15) years; 41% were Caucasian, 34% African American, 65% had hypertension, and 39% diabetes. Transferrin saturation, but not ferritin, had a statistically significant (P < 0.05) modifying effect on Hb response. Maximum Hb response was achieved when TSAT was 34%, with minimal incremental effect beyond these levels. Of the two standard clinical iron markers, TSAT should be used as the primary marker of the modifying effect of iron on Hb response to ESA. Long-term safety of iron use to improve Hb response to ESA warrants further study. PMID:23968235

Optimal reconstruction interval in dual source CT coronary angiography: a single-center experience in 285 patients

PubMed Central

Akgöz, Ayça; Akata, Deniz; Hazırolan, Tuncay; Karçaaltıncaba, Muşturay

2014-01-01

PURPOSE We aimed to evaluate the visibility of coronary arteries and bypass-grafts in patients who underwent dual source computed tomography (DSCT) angiography without heart rate (HR) control and to determine optimal intervals for image reconstruction. MATERIALS AND METHODS A total of 285 consecutive cases who underwent coronary (n=255) and bypass-graft (n=30) DSCT angiography at our institution were identified retrospectively. Patients with atrial fibrillation were excluded. Ten datasets in 10% increments were reconstructed in all patients. On each dataset, the visibility of coronary arteries was evaluated using the 15-segment American Heart Association classification by two radiologists in consensus. RESULTS Mean HR was 76±16.3 bpm, (range, 46–127 bpm). All coronary segments could be visualized in 277 patients (97.19%). On a segment-basis, 4265 of 4275 (99.77%) coronary artery segments were visible. All segments of 56 bypass-grafts in 30 patients were visible (100%). Total mean segment visibility scores of all coronary arteries were highest at 70%, 40%, and 30% intervals for all HRs. The optimal reconstruction intervals to visualize the segments of all three coronary arteries in descending order were 70%, 60%, 80%, and 30% intervals in patients with a mean HR <70 bpm; 40%, 70%, and 30% intervals in patients with a mean HR 70–100 bpm; and 40%, 50%, and 30% in patients with a mean HR >100 bpm. CONCLUSION Without beta-blocker administration, DSCT coronary angiography offers excellent visibility of vascular segments using both end-systolic and mid-late diastolic reconstructions at HRs up to 100 bpm, and only end-systolic reconstructions at HRs over 100 bpm. PMID:24834490

Can mumps vaccine induce remission in recurrent respiratory papilloma?

PubMed

Pashley, Nigel R T

2002-07-01

To describe our experience using laser excision and locally injected mumps vaccine to induce remission in patients with recurrent respiratory papilloma (RRP). Tertiary care regional medical center. Initially, 11 children with RRP treated in a pilot study with laser excision at regular intervals for at least a year without adjuvant therapy; later, a series of 18 children and 20 adults with RRP, some of whom had used various adjuvant therapy with interval laser excision. Both patient groups continued their same interval laser excision with the same or similar laser, same clinical setting, and same surgeon. Locally injected mumps vaccine was then administered into the excision site after each laser removal of papilloma. Larynx and trachea were microphotographed with each treatment. Two consecutive disease-free intervals and a follow-up of at least 1 year were required criteria for remission. In the pilot study, remission was induced in 9 (82%) of 11 patients by 1 to 10 injections, with follow-up of 5 to 19 years. In the subsequent series, remission was induced in 29 (76%) of 38 patients by 4 to 26 injections, and follow-up was 2 to 5 years. Combined with serial laser excision, mumps vaccine positively influences induction of remission in children with RRP. The mechanisms of this effect are unclear, but the treatment is readily available, inexpensive, and has a low risk of adverse effects.

Legislative change enabling use of early part-time sick leave enhanced return to work and work participation in Finland.

PubMed

Viikari-Juntura, Eira; Virta, Lauri J; Kausto, Johanna; Autti-Rämö, Ilona; Martimo, Kari-Pekka; Laaksonen, Mikko; Leinonen, Taina; Husgafvel-Pursiainen, Kirsti; Burdorf, Alex; Solovieva, Svetlana

2017-09-01

Objectives The aim of the study was to assess the effectiveness of the use of part-time sick leave at the early (first 12 weeks) stage of work disability due to mental disorder or musculoskeletal disease on sustained return to work (RTW) and overall work participation. Methods In a nation-wide register-based quasi-experimental study, we compared sustained RTW (ie, ≥28 consecutive days at work) and 2-year work participation between the part- and full-time sickness absence (SA) benefit groups (N=1878 in each group) using propensity-score matching. Persons who received partial or full SA benefit due to musculoskeletal diseases or mental disorders between January 1, 2010 and December 31, 2011 were eligible as cases or controls, respectively. Results A higher proportion showed sustained RTW after part- compared to full-time sick leave [absolute risk difference 8.0%, 95% confidence interval (95% CI) 5.3-10.9]. Moreover, the proportion of time at work was at a 10.5% higher level in the part- compared to full-time sick leave group. The prevalence of full disability retirement was almost three-fold among the full- compared to part-time sick leave group, whereas partial disability retirement was 4.5-fold more prevalent in the part- compared to full-time sick leave group. Conclusions The use of part-time sick leave during the first three months of SA enhances RTW and overall work participation during two years among persons with mental disorders and musculoskeletal diseases. The prescription of part-time sick leave can be recommended at an early stage of work disability.

Not All Prehospital Time is Equal: Influence of Scene Time on Mortality

PubMed Central

Brown, Joshua B.; Rosengart, Matthew R.; Forsythe, Raquel M.; Reynolds, Benjamin R.; Gestring, Mark L.; Hallinan, William M.; Peitzman, Andrew B.; Billiar, Timothy R.; Sperry, Jason L.

2016-01-01

Background Trauma is time-sensitive and minimizing prehospital (PH) time is appealing. However, most studies have not linked increasing PH time with worse outcomes, as raw PH times are highly variable. It is unclear whether specific PH time patterns affect outcomes. Our objective was to evaluate the association of PH time interval distribution with mortality. Methods Patients transported by EMS in the Pennsylvania trauma registry 2000-2013 with total prehospital time (TPT)≥20min were included. TPT was divided into three PH time intervals: response, scene, and transport time. The number of minutes in each PH time interval was divided by TPT to determine the relative proportion each interval contributed to TPT. A prolonged interval was defined as any one PH interval contributing ≥50% of TPT. Patients were classified by prolonged PH interval or no prolonged PH interval (all intervals<50% of TPT). Patients were matched for TPT and conditional logistic regression determined the association of mortality with PH time pattern, controlling for confounders. PH interventions were explored as potential mediators, and prehospital triage criteria used identify patients with time-sensitive injuries. Results There were 164,471 patients included. Patients with prolonged scene time had increased odds of mortality (OR 1.21; 95%CI 1.02–1.44, p=0.03). Prolonged response, transport, and no prolonged interval were not associated with mortality. When adjusting for mediators including extrication and PH intubation, prolonged scene time was no longer associated with mortality (OR 1.06; 0.90–1.25, p=0.50). Together these factors mediated 61% of the effect between prolonged scene time and mortality. Mortality remained associated with prolonged scene time in patients with hypotension, penetrating injury, and flail chest. Conclusions Prolonged scene time is associated with increased mortality. PH interventions partially mediate this association. Further study should evaluate whether these interventions drive increased mortality because they prolong scene time or by another mechanism, as reducing scene time may be a target for intervention. Level of Evidence IV, prognostic study PMID:26886000

Time interval measurement device based on surface acoustic wave filter excitation, providing 1 ps precision and stability.

PubMed

Panek, Petr; Prochazka, Ivan

2007-09-01

This article deals with the time interval measurement device, which is based on a surface acoustic wave (SAW) filter as a time interpolator. The operating principle is based on the fact that a transversal SAW filter excited by a short pulse can generate a finite signal with highly suppressed spectra outside a narrow frequency band. If the responses to two excitations are sampled at clock ticks, they can be precisely reconstructed from a finite number of samples and then compared so as to determine the time interval between the two excitations. We have designed and constructed a two-channel time interval measurement device which allows independent timing of two events and evaluation of the time interval between them. The device has been constructed using commercially available components. The experimental results proved the concept. We have assessed the single-shot time interval measurement precision of 1.3 ps rms that corresponds to the time of arrival precision of 0.9 ps rms in each channel. The temperature drift of the measured time interval on temperature is lower than 0.5 ps/K, and the long term stability is better than +/-0.2 ps/h. These are to our knowledge the best values reported for the time interval measurement device. The results are in good agreement with the error budget based on the theoretical analysis.

Predictors of fecundability and conception waits among the Dogon of Mali.

PubMed

Strassmann, B I; Warner, J H

1998-02-01

Surprisingly little is known about the mechanisms that underlie variation in female fertility in humans. Data on this topic are nonetheless vital to a number of pragmatic and theoretical enterprises, including population planning, infertility treatment and prevention, and evolutionary ecology. Here we study female fertility by focusing on one component of the interbirth interval: the waiting time to conception during menstrual cycling. Our study population is a Dogon village of 460 people in Mali, West Africa. This population is pronatalist and noncontracepting. In accordance with animist beliefs, the women spend five nights sleeping at a menstrual hut during menses. By censusing the women present at the menstrual huts in the study village on each of 736 consecutive nights, we were able to monitor women's conception waits prospectively. Hormonal profiles confirm the accuracy of the data on conception waits obtained from the menstrual hut census (Strassmann [1996], Behavioral Ecology 7:304-315). Using survival analysis, we identified significant predictors of the waiting time to conception: wife's age (years), husband's age (< 35, 35-49, > 49 years), marital duration (years), gravidity (number of prior pregnancies), and breast-feeding status. Additional variables were not significant, including duration of postpartum amenorrhea, sex of the last child, nutritional status, economic status, polygyny, and marital status (fiancée vs. married). We fit both continuous and discrete time survival models, but the former appeared to be a better choice for these data.

Study on acute toxicity of compound coggygria oral liquid

NASA Astrophysics Data System (ADS)

Su, Feng; Wen, Zhonghua; Sun, Jianhua; Hao, Shaojun; Xie, Guoqi; Li, Xianyu; Zhang, Zhengchen

2018-04-01

To observe the effect of compound oral liquid on acute toxicity of mice cotinus coggygria. Forty mice were randomly divided into two groups: compound Cotinus coggygria oral solution group and blank control group, 20 rats in each group, half male and half female. The mice fasted for 12 hours. Coggygria oral liquid concentrated solution. In the blank control group, normal saline was administered at the maximum volume of 0.4ml/10 g. The mice were given normal diet for 4 consecutive times in 1st, each time at intervals of 6 hours. On the day of administration, the mice in each group were observed continuously after administration and after administration. Observe continuously for 3 hours, observe every hour thereafter. Fast on the 13th day 12 hours, weigh the mice on the 14th day, then kill the mice, dissect the mice. During the observation period of 14 days after administration, there was no death in mice. The activity of mice decreased slightly after initial administration, decreased after the second and third administration, and generally returned to normal after 2h of administration. No abnormalities of heart, liver, spleen, lung, kidney, stomach, brain and so on were observed. Conclusion: the oral toxicity of compound Cotinus coggygria is very small. In 1st, the mice did not die, and the cumulative maximum tolerance dose was 320ml/kg per day, which was 320 times of the clinical dosage.

Worklife expectancies of fixed-term Finnish employees in 1997-2006.

PubMed

Nurminen, Markku

2008-04-01

Fixed-term employment is prevalent in the Finnish labor force. This form of employment contract is marked by fragmentary work periods, demands for flexibility in workhours, and concern for multiple insecurities. A nonpermanent employee may also incur adverse health consequences. Yet there exist no exact statistics on the duration of fixed-term employment. This paper estimated the future duration of the time that a Finn is expected to be engaged in irregular work. Multistate regression modeling and stochastic analysis were applied to aggregated data from surveys conducted among the labor force by Statistics Finland in 1997-2006. In 2006, a Finnish male was expected to work a total of 3.8 years in fixed-term employment, combined over consecutive or separate time spans; this time amounts to 8% of his remaining work career from entry into the work force until final retirement. For a woman the expectancy was greater, 6.5 years or 13%. For the age interval 20-29 years, the total was 16% for men and 23% for women. The type and duration of employment is influenced by security factors and economic cycles, both of which affect men and women differently. Over the past decade, fixed-term employment increased consistently in the female labor contingent, and it was more pronounced during economic slowdowns. This labor market development calls for standards for flexibility and guarantees for security in the fragmented future worklives of fixed-term employees.

In vivo effect of Commiphora swynnertonii ethanolic extracts on Trypanosoma congolense and selected immunological components in mice.

PubMed

Nagagi, Yakob P; Silayo, Richard S; Luziga, Claudius; Kweka, Eliningaya J

2017-05-23

The search for alternative trypanocidal compounds which can be available at affordable price is of paramount importance for control of trypanosomosis in human and animals. The current study evaluates the in vivo activity of ethanolic stem bark extracts on Trypanosoma congolense and selected immunological components in an inbred Swiss albino mouse model. Groups of mice infected with T. congolense were treated with the stem bark extracts at a rate of 1000 mg/kg, 1500 mg/kg, and 2000 mg/kg, twice a day in one set and thrice a day in another setting for three days consecutively. Negative (infected and untreated) and positive (infected treated with diminazene diaceturate at 3.5 mg/kg) control groups were used. Levels of parasitaemia were monitored daily for the first 10 days and thereafter 2-3 times per week to the end of experiment. In the other setting, uninfected mice, randomized in groups were treated with the extract but categorized as: thorough mixed extract (TME) and supernatant extract (SE) each at 500 mg/kg and 1500 mg/kg, in 8 hourly intervals respectively for three days consecutively. Control group was administered with phosphate buffered saline with glucose at 0.1 ml/10 g in a similar manner as for the extract. Whole blood and spleen were taken 24 h after the last treatment for hematological and histopathological analysis. The groups that received the extracts at 8 hourly intervals drastically reduced the parasitaemia. The higher dose of SE significantly reduced the percentage of lymphocytes (P < 0.05). Both high and low dose of TME significantly reduced lymphocytes percent (P < 0.05) while percent of neutrophils and monocytes increased significantly (P < 0.05). Histopathological changes of the spleen in the mice treated with higher concentrations of the extract of C. swynnertonii were suggestive of lymphocytes toxicity. The current study has provided evidence that, in vivo trypanocidal activity of ethanolic bark extracts of C. swynnertonii is probably affected by its negative effect on humoral mediated immune response. Further studies are recommended to determine its potential as an alternative source of lead compounds for trypanocidal drug discovery.

Reproducibility of Heart Rate Variability Is Parameter and Sleep Stage Dependent.

PubMed

Herzig, David; Eser, Prisca; Omlin, Ximena; Riener, Robert; Wilhelm, Matthias; Achermann, Peter

2017-01-01

Objective: Measurements of heart rate variability (HRV) during sleep have become increasingly popular as sleep could provide an optimal state for HRV assessments. While sleep stages have been reported to affect HRV, the effect of sleep stages on the variance of HRV parameters were hardly investigated. We aimed to assess the variance of HRV parameters during the different sleep stages. Further, we tested the accuracy of an algorithm using HRV to identify a 5-min segment within an episode of slow wave sleep (SWS, deep sleep). Methods: Polysomnographic (PSG) sleep recordings of 3 nights of 15 healthy young males were analyzed. Sleep was scored according to conventional criteria. HRV parameters of consecutive 5-min segments were analyzed within the different sleep stages. The total variance of HRV parameters was partitioned into between-subjects variance, between-nights variance, and between-segments variance and compared between the different sleep stages. Intra-class correlation coefficients of all HRV parameters were calculated for all sleep stages. To identify an SWS segment based on HRV, Pearson correlation coefficients of consecutive R-R intervals (rRR) of moving 5-min windows (20-s steps). The linear trend was removed from the rRR time series and the first segment with rRR values 0.1 units below the mean rRR for at least 10 min was identified. A 5-min segment was placed in the middle of such an identified segment and the corresponding sleep stage was used to assess the accuracy of the algorithm. Results: Good reproducibility within and across nights was found for heart rate in all sleep stages and for high frequency (HF) power in SWS. Reproducibility of low frequency (LF) power and of LF/HF was poor in all sleep stages. Of all the 5-min segments selected based on HRV data, 87% were accurately located within SWS. Conclusions: SWS, a stable state that, in contrast to waking, is unaffected by internal and external factors, is a reproducible state that allows reliable determination of heart rate, and HF power, and can satisfactorily be detected based on R-R intervals, without the need of full PSG. Sleep may not be an optimal condition to assess LF power and LF/HF power ratio.

Reproducibility of Heart Rate Variability Is Parameter and Sleep Stage Dependent

PubMed Central

Herzig, David; Eser, Prisca; Omlin, Ximena; Riener, Robert; Wilhelm, Matthias; Achermann, Peter

2018-01-01

Objective: Measurements of heart rate variability (HRV) during sleep have become increasingly popular as sleep could provide an optimal state for HRV assessments. While sleep stages have been reported to affect HRV, the effect of sleep stages on the variance of HRV parameters were hardly investigated. We aimed to assess the variance of HRV parameters during the different sleep stages. Further, we tested the accuracy of an algorithm using HRV to identify a 5-min segment within an episode of slow wave sleep (SWS, deep sleep). Methods: Polysomnographic (PSG) sleep recordings of 3 nights of 15 healthy young males were analyzed. Sleep was scored according to conventional criteria. HRV parameters of consecutive 5-min segments were analyzed within the different sleep stages. The total variance of HRV parameters was partitioned into between-subjects variance, between-nights variance, and between-segments variance and compared between the different sleep stages. Intra-class correlation coefficients of all HRV parameters were calculated for all sleep stages. To identify an SWS segment based on HRV, Pearson correlation coefficients of consecutive R-R intervals (rRR) of moving 5-min windows (20-s steps). The linear trend was removed from the rRR time series and the first segment with rRR values 0.1 units below the mean rRR for at least 10 min was identified. A 5-min segment was placed in the middle of such an identified segment and the corresponding sleep stage was used to assess the accuracy of the algorithm. Results: Good reproducibility within and across nights was found for heart rate in all sleep stages and for high frequency (HF) power in SWS. Reproducibility of low frequency (LF) power and of LF/HF was poor in all sleep stages. Of all the 5-min segments selected based on HRV data, 87% were accurately located within SWS. Conclusions: SWS, a stable state that, in contrast to waking, is unaffected by internal and external factors, is a reproducible state that allows reliable determination of heart rate, and HF power, and can satisfactorily be detected based on R-R intervals, without the need of full PSG. Sleep may not be an optimal condition to assess LF power and LF/HF power ratio. PMID:29367845

External Validation of the Universal Termination of Resuscitation Rule for Out-of-Hospital Cardiac Arrest in British Columbia.

PubMed

Grunau, Brian; Taylor, John; Scheuermeyer, Frank X; Stenstrom, Robert; Dick, William; Kawano, Takahisa; Barbic, David; Drennan, Ian; Christenson, Jim

2017-09-01

The Universal Termination of Resuscitation Rule (TOR Rule) was developed to identify out-of-hospital cardiac arrests eligible for field termination of resuscitation, avoiding futile transportation to the hospital. The validity of the rule in emergency medical services (EMS) systems that do not routinely transport out-of-hospital cardiac arrest patients to the hospital is unknown. We seek to validate the TOR Rule in British Columbia. This study included consecutive, nontraumatic, adult, out-of-hospital cardiac arrests treated by EMS in British Columbia from April 2011 to September 2015. We excluded patients with active do-not-resuscitate orders and those with missing data. Following consensus guidelines, we examined the validity of the TOR Rule after 6 minutes of resuscitation (to approximate three 2-minute cycles of resuscitation). To ascertain rule performance at the different time junctures, we recalculated TOR Rule classification accuracy at subsequent 1-minute resuscitation increments. Of 6,994 consecutive, adult, EMS-treated, out-of-hospital cardiac arrests, overall survival was 15%. At 6 minutes of resuscitation, rule performance was sensitivity 0.72, specificity 0.91, positive predictive value 0.98, and negative predictive value 0.36. The TOR Rule recommended care termination for 4,367 patients (62%); of these, 92 survived to hospital discharge (false-positive rate 2.1%; 95% confidence interval 1.7% to 2.5%); however, this proportion steadily decreased with later application. The TOR Rule recommended continuation of resuscitation in 2,627 patients (38%); of these, 1,674 died (false-negative rate 64%; 95% confidence interval 62% to 66%). Compared with 6-minute application, test characteristics at 30 minutes demonstrated nearly perfect positive predictive value (1.0) and specificity (1.0) but a lower sensitivity (0.46) and negative predictive value (0.25). In this cohort of adult out-of-hospital cardiac arrest patients, the TOR Rule applied at 6 minutes falsely recommended care termination for 2.1% of patients; however, this decreased with later application. Systems using the TOR Rule to cease resuscitation in the field should consider rule application at points later than 6 minutes. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Interval Timing Accuracy and Scalar Timing in C57BL/6 Mice

PubMed Central

Buhusi, Catalin V.; Aziz, Dyana; Winslow, David; Carter, Rickey E.; Swearingen, Joshua E.; Buhusi, Mona C.

2010-01-01

In many species, interval timing behavior is accurate—appropriate estimated durations—and scalar—errors vary linearly with estimated durations. While accuracy has been previously examined, scalar timing has not been yet clearly demonstrated in house mice (Mus musculus), raising concerns about mouse models of human disease. We estimated timing accuracy and precision in C57BL/6 mice, the most used background strain for genetic models of human disease, in a peak-interval procedure with multiple intervals. Both when timing two intervals (Experiment 1) or three intervals (Experiment 2), C57BL/6 mice demonstrated varying degrees of timing accuracy. Importantly, both at individual and group level, their precision varied linearly with the subjective estimated duration. Further evidence for scalar timing was obtained using an intraclass correlation statistic. This is the first report of consistent, reliable scalar timing in a sizable sample of house mice, thus validating the PI procedure as a valuable technique, the intraclass correlation statistic as a powerful test of the scalar property, and the C57BL/6 strain as a suitable background for behavioral investigations of genetically engineered mice modeling disorders of interval timing. PMID:19824777

Assessment of cardiac time intervals using high temporal resolution real-time spiral phase contrast with UNFOLDed-SENSE.

PubMed

Kowalik, Grzegorz T; Knight, Daniel S; Steeden, Jennifer A; Tann, Oliver; Odille, Freddy; Atkinson, David; Taylor, Andrew; Muthurangu, Vivek

2015-02-01

To develop a real-time phase contrast MR sequence with high enough temporal resolution to assess cardiac time intervals. The sequence utilized spiral trajectories with an acquisition strategy that allowed a combination of temporal encoding (Unaliasing by fourier-encoding the overlaps using the temporal dimension; UNFOLD) and parallel imaging (Sensitivity encoding; SENSE) to be used (UNFOLDed-SENSE). An in silico experiment was performed to determine the optimum UNFOLD filter. In vitro experiments were carried out to validate the accuracy of time intervals calculation and peak mean velocity quantification. In addition, 15 healthy volunteers were imaged with the new sequence, and cardiac time intervals were compared to reference standard Doppler echocardiography measures. For comparison, in silico, in vitro, and in vivo experiments were also carried out using sliding window reconstructions. The in vitro experiments demonstrated good agreement between real-time spiral UNFOLDed-SENSE phase contrast MR and the reference standard measurements of velocity and time intervals. The protocol was successfully performed in all volunteers. Subsequent measurement of time intervals produced values in keeping with literature values and good agreement with the gold standard echocardiography. Importantly, the proposed UNFOLDed-SENSE sequence outperformed the sliding window reconstructions. Cardiac time intervals can be successfully assessed with UNFOLDed-SENSE real-time spiral phase contrast. Real-time MR assessment of cardiac time intervals may be beneficial in assessment of patients with cardiac conditions such as diastolic dysfunction. © 2014 Wiley Periodicals, Inc.

Self-Cutting: Patient Characteristics Compared with Self-Poisoners

ERIC Educational Resources Information Center

Hawton, Keith; Harriss, Louise; Simkin, Sue; Bale, Elizabeth; Bond, Alison

2004-01-01

A large (n = 14,892) consecutive sample of deliberate self-harm (attempted suicide) patients who presented to a general hospital in the United Kingdom during a 23-year study period was examined (over two consecutive time periods) in order to compare the characteristics of those who used self-cutting (n = 428) and those who self-poisoned (n =…

49 CFR 395.5 - Maximum driving time for passenger-carrying vehicles.

Code of Federal Regulations, 2010 CFR

2010-10-01

... hours in any 7 consecutive days if the employing motor carrier does not operate commercial motor vehicles every day of the week; or (2) Having been on duty 70 hours in any period of 8 consecutive days if the employing motor carrier operates commercial motor vehicles every day of the week. [70 FR 50073...

77 FR 31684 - Hours of Service of Drivers: RockTenn, Exemption Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... 14th hour of coming on duty. This exemption will allow these individuals to occasionally work up to 16 consecutive hours and be allowed to return to work with less than the mandatory 10 consecutive hours off duty... public road--Compress Street--an average of forty times per day to travel between its manufacturing...

VARIABLE TIME-INTERVAL GENERATOR

DOEpatents

Gross, J.E.

1959-10-31

This patent relates to a pulse generator and more particularly to a time interval generator wherein the time interval between pulses is precisely determined. The variable time generator comprises two oscillators with one having a variable frequency output and the other a fixed frequency output. A frequency divider is connected to the variable oscillator for dividing its frequency by a selected factor and a counter is used for counting the periods of the fixed oscillator occurring during a cycle of the divided frequency of the variable oscillator. This defines the period of the variable oscillator in terms of that of the fixed oscillator. A circuit is provided for selecting as a time interval a predetermined number of periods of the variable oscillator. The output of the generator consists of a first pulse produced by a trigger circuit at the start of the time interval and a second pulse marking the end of the time interval produced by the same trigger circuit.

Time-related patterns of ventricular shunt failure.

PubMed

Kast, J; Duong, D; Nowzari, F; Chadduck, W M; Schiff, S J

1994-11-01

Proximal obstruction is reported to be the most common cause of ventriculoperitoneal (VP) shunt failure, suggesting that imperfect ventricular catheter placement and inadequate valve mechanisms are major causes. This study retrospectively examined patterns of shunt failure in 128 consecutive patients with symptoms of shunt malfunction over a 2-year period. Factors analyzed included site of failure, time from shunt placement or last revision to failure, age of patient at time of failure, infections, and primary etiology of the hydrocephalus. One hundred of these patients required revisions; 14 revisions were due to infections. In this series there was a higher incidence of distal (43%) than of proximal (35%) failure. The difference was not statistically significant when the overall series was considered; however, when factoring time to failure as a variable, marked differences were noted regardless of the underlying cause of hydrocephalus or the age of the patient. Of the 49 patients needing a shunt revision or replacement within 2 years of the previous operation, 50% had proximal malfunction, 14% distal, and 10% had malfunctions attributable directly to the valve itself. Also, 12 of the 14 infections occurred during this time interval. In sharp contrast, of the 51 patients having shunt failure from 2 to more than 12 years after the previous procedure, 72% had distal malfunction, 21% proximal, and only 6% had a faulty valve or infection. This difference between time to failure for proximal versus distal failures was statistically significant (P < 0.00001 for both Student's t-test and non-parametric Mann-Whitney U-test).(ABSTRACT TRUNCATED AT 250 WORDS)

Reintervention for stent occlusion after bilateral self-expandable metallic stent placement for malignant hilar biliary obstruction.

PubMed

Inoue, Tadahisa; Naitoh, Itaru; Okumura, Fumihiro; Ozeki, Takanori; Anbe, Kaiki; Iwasaki, Hiroyasu; Nishie, Hirotada; Mizushima, Takashi; Sano, Hitoshi; Nakazawa, Takahiro; Yoneda, Masashi; Joh, Takashi

2016-11-01

Endoscopic reintervention for stent occlusions following bilateral self-expandable metallic stent (SEMS) placement for malignant hilar biliary obstruction (MHBO) is challenging, and time to recurrent biliary obstruction (RBO) of the revisionary stent remains unclear. We aimed to clarify a suitable reintervention method for stent occlusions following bilateral SEMS placement for MHBO. Between 2002 and 2014, 52 consecutive patients with MHBO who underwent endoscopic reintervention for stent occlusion after bilateral SEMS placement were enrolled at two university hospitals and one tertiary care referral center. We retrospectively evaluated the technical and functional success rates of the reinterventions, and the time to RBO of the revisionary stents. Technical and functional success rates of the reinterventions were 92% (48/52) and 90% (43/48), respectively. Univariate analysis did not determine any significant predictive factors for technical and functional failures. Median time to RBO of the revisionary stents was 68 days. Median time to RBO was significantly longer for revisionary SEMS placement than for plastic stent placement (131 days vs 47 days, respectively; log-rank test, P = 0.005). Revisionary SEMS placement was the only independent factor that was significantly associated with a longer time to RBO of the revisionary stent in the multivariate Cox proportional hazards analysis (hazard ratio 0.37; 95% confidence interval 0.14-0.95; P = 0.039). Revisionary SEMS placement is a suitable endoscopic reintervention method for stent occlusion following bilateral SEMS placement from the perspective of time to RBO of the revisionary stent. © 2016 Japan Gastroenterological Endoscopy Society.

Alberta Stroke Program Early CT Score-Time Score Predicts Outcome after Endovascular Therapy in Patients with Acute Ischemic Stroke: A Retrospective Single-Center Study.

PubMed

Todo, Kenichi; Sakai, Nobuyuki; Kono, Tomoyuki; Hoshi, Taku; Imamura, Hirotoshi; Adachi, Hidemitsu; Yamagami, Hiroshi; Kohara, Nobuo

2018-04-01

Clinical outcomes after successful endovascular therapy in patients with acute ischemic stroke are associated with several factors including onset-to-reperfusion time (ORT), the National Institute of Health Stroke Scale (NIHSS) score, and the Alberta Stroke Program Early CT Score (ASPECTS). The NIHSS-time score, calculated as follows: [NIHSS score] × [onset-to-treatment time (h)] or [NIHSS score] × [ORT (h)], has been reported to predict clinical outcomes after intravenous recombinant tissue plasminogen activator therapy and endovascular therapy for acute stroke. The objective of the current study was to assess whether the combination of the ASPECTS and the ORT can predict the outcomes after endovascular therapy. The charts of 117 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy were retrospectively reviewed. We analyzed the association of ORT, ASPECTS, and ASPECTS-time score with clinical outcome. ASPECTS-time score was calculated as follows: [11 - ASPECTS] × [ORT (h)]. Rates of good outcome for patients with ASPECTS-time scores of tertile values, scores 5.67 or less, scores greater than 5.67 to 10.40 or less, and scores greater than 10.40, were 66.7%, 56.4%, and 33.3%, respectively (P < .05). Ordinal logistic regression analysis showed that the ASPECTS-time score (per category increase) was an independent predictor for better outcome (common odds ratio: .374; 95% confidence interval: .150-0.930; P < .05). A lower ASPECTS-time score may predict better clinical outcomes after endovascular treatment. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Agreement between auricular and rectal measurements of body temperature in healthy cats.

PubMed

Sousa, Marlos G; Carareto, Roberta; Pereira-Junior, Valdo A; Aquino, Monally C C

2013-04-01

Measurement of body temperature is a routine part of the clinical assessment of a patient. However, this procedure may be time-consuming and stressful to most animals because the standard site of temperature acquisition remains the rectal mucosa. Although an increasing number of clinicians have been using auricular temperature to estimate core body temperature, evidence is still lacking regarding agreement between these two methods in cats. In this investigation, we evaluated the agreement between temperatures measured in the rectum and ear in 29 healthy cats over a 2-week period. Temperatures were measured in the rectum (using digital and mercury-in-glass thermometers) and ear once a day for 14 consecutive days, producing 406 temperature readings for each thermometer. Mean temperature and confidence intervals were similar between methods, and Bland-Altman plots showed small biases and narrow limits of agreement acceptable for clinical purposes. The interobserver variability was also checked, which indicated a strong correlation between two near-simultaneous temperature readings. Results are consistent with auricular thermometry being a reliable alternative to rectal thermometry for assessing core body temperature in healthy cats.

Sex versus parthenogenesis; immune function in a facultatively parthenogenetic phasmatid (Extatosoma tiaratum).

PubMed

Alavi, Yasaman; Elgar, Mark Adrian; Jones, Therésa Melanie

2017-07-01

Facultative parthenogenetic species, in which females can alternate between sex and parthenogenesis, are useful models to investigate the costs and benefits of sex and parthenogenesis, an ongoing issue in biology. The necessary empirical studies comparing the outcomes of alternative reproductive modes on life history traits are rare and focus mainly on traits directly associated with reproductive fitness. Immune function determines the ability of individuals to defend themselves against injury and disease and is therefore likely to have a significant impact on fitness. Here, we used the facultatively parthenogenetic Australian phasmatid, Extatosoma tiaratum, to investigate the effect of both maternal and offspring mode of conception (sexual or parthenogenetic) on offspring immune function (haemocyte concentration, lytic activity and phenoloxidase activity). We show that when parthenogenesis persists beyond one generation, it has negative effects on immune response in terms of haemocyte concentration and lytic activity. Phenoloxidase activity positively correlates with the level of microsatellite heterozygosity. Moreover, immune response decreases across consecutive sampling weeks, suggesting there are physiological constraints with respect to mounting immune responses in close time intervals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Helmet use and associated factors among Thai motorcyclists during Songkran festival.

PubMed

Siviroj, Penprapa; Peltzer, Karl; Pengpid, Supa; Morarit, Sompong

2012-09-10

The aim of this study was to assess helmet use and associated factors among motorcycle riders during Songkran festival in Thailand. A cross-sectional survey was conducted to determine the prevalence of helmet use among Thai motorcycle riders (sample size = 18,998) during four days of the Songkran festival. For this sample, the population of motorcycle riders was consecutively selected using quota sampling from 12 petrol stations in four provinces from each of the four main geographical regions of Thailand. The study was conducted at petrol stations at roads in town, outside town and highway at different time intervals when trained field staff administered a structured questionnaire and performed an observation checklist. Results indicate that 44.2% of the motorcycle riders and 72.5% of the motorcycle passengers had not been using a helmet. In multivariable analysis demographics, environmental factors, helmet use experiences and attitudes and recalling a lower exposure to road safety awareness (RSA) campaign were associated with non-helmet use among motorcyclists. It appears that the RSA campaign may have some positive effect on reducing non-helmet use among motorcycle riders during the Songkran festival.

ECG on the road: robust and unobtrusive estimation of heart rate.

PubMed

Wartzek, Tobias; Eilebrecht, Benjamin; Lem, Jeroen; Lindner, Hans-Joachim; Leonhardt, Steffen; Walter, Marian

2011-11-01

Modern automobiles include an increasing number of assistance systems to increase the driver's safety. This feasibility study investigated unobtrusive capacitive ECG measurements in an automotive environment. Electrodes integrated into the driving seat allowed to measure a reliable ECG in 86% of the drivers; when only (light) cotton clothing was worn by the drivers, this value increased to 95%. Results show that an array of sensors is needed that can adapt to the different drivers and sitting positions. Measurements while driving show that traveling on the highway does not distort the signal any more than with the car engine turned OFF, whereas driving in city traffic results in a lowered detection rate due to the driver's heavier movements. To enable robust and reliable estimation of heart rate, an algorithm is presented (based on principal component analysis) to detect and discard time intervals with artifacts. This, then, allows a reliable estimation of heart rate of up to 61% in city traffic and up to 86% on the highway: as a percentage of the total driving period with at least four consecutive QRS complexes.

Strain rate dependence in the nanoindentation-induced deformation of Mg-Al intermetallic compounds produced by packed powder diffusion coating

NASA Astrophysics Data System (ADS)

Chang, Haiwei; Lu, Mingyuan; Zhang, Mingxing; Atrens, Andrej; Huang, Han

2015-09-01

Nanoindentation was performed on τ-Mg32(Al, Zn)49 and β-Mg17Al12 intermetallic coatings and on a AZ91E Mg alloy substrate using loading rates of 0.03 to 30 mNs-1. Pop-in phenomenon was observed during loading in the two intermetallic coatings and in the substrate. Both the magnitude of the pop-ins and the time interval between two consecutive pop-ins increased with increasing loads. The phenomenon was attributed to plastic instability, which is known as the Portevin-Le Châtelier effect. The morphologies of the indent impressions at different strain rates on the t phase, the β phase and the substrate were also investigated using atomic force microscopy. Pile-up occurred in the τ and β phases and was found independent of the strain rate; no obvious pile-up occurred on the AZ91E substrate. The AZ91E substrate exhibited creep rates greater than those of the intermetallic phases, and all of the creep rates increased with the loading rate.

No holds barred sport fighting: a 10 year review of mixed martial arts competition.

PubMed

Buse, G J

2006-02-01

To identify the most salient medical issues that may be associated with mixed martial arts competition by determining the types and proportions of match stoppages. Publicly available video footage of 1284 men competing in 642 consecutive televised matches from November 1993 to November 2003 was reviewed to determine the reasons for which matches were stopped. Matches were sanctioned by either a United States or Japan based mixed martial arts organisation. Of the 642 matches, 182 (28.3+/-3.4%) were stopped because of head impact, 106 (16.5+/-2.9%) because of musculoskeletal stress, 91 (14.1+/-2.7%) because of neck choke, 83 (12.9+/-2.6%) because of miscellaneous trauma, 173 (27.0+/-3.4%) because of expiration of match time, and seven (1.0+/-0.8%) because of disqualification, where the values in parentheses are percentages+/-95% confidence interval. Blunt force to the head resulted in the highest proportion of match stoppages. Further research is warranted to delineate the morbidity associated with participation in mixed martial arts.

No holds barred sport fighting: a 10 year review of mixed martial arts competition

PubMed Central

Buse, G J

2006-01-01

Objective To identify the most salient medical issues that may be associated with mixed martial arts competition by determining the types and proportions of match stoppages. Methods Publicly available video footage of 1284 men competing in 642 consecutive televised matches from November 1993 to November 2003 was reviewed to determine the reasons for which matches were stopped. Matches were sanctioned by either a United States or Japan based mixed martial arts organisation. Results Of the 642 matches, 182 (28.3±3.4%) were stopped because of head impact, 106 (16.5±2.9%) because of musculoskeletal stress, 91 (14.1±2.7%) because of neck choke, 83 (12.9±2.6%) because of miscellaneous trauma, 173 (27.0±3.4%) because of expiration of match time, and seven (1.0±0.8%) because of disqualification, where the values in parentheses are percentages±95% confidence interval. Conclusions Blunt force to the head resulted in the highest proportion of match stoppages. Further research is warranted to delineate the morbidity associated with participation in mixed martial arts. PMID:16432006

Analysis of long term heart rate variability: methods, 1/f scaling and implications

NASA Technical Reports Server (NTRS)

Saul, J. P.; Albrecht, P.; Berger, R. D.; Cohen, R. J.

1988-01-01

The use of spectral techniques to quantify short term heart rate fluctuations on the order of seconds to minutes has helped define the autonomic contributions to beat-to-beat control of heart rate. We used similar techniques to quantify the entire spectrum (0.00003-1.0 Hz) of heart rate variability during 24 hour ambulatory ECG monitoring. The ECG from standard Holter monitor recordings from normal subjects was sampled with the use of a phase locked loop, and a heart rate time series was constructed at 3 Hz. Frequency analysis of the heart rate signal was performed after a nonlinear filtering algorithm was used to eliminate artifacts. A power spectrum of the entire 24 hour record revealed power that was inversely proportional to frequency, 1/f, over 4 decades from 0.00003 to 0.1 Hz (period approximately 10 hours to 10 seconds). Displaying consecutive spectra calculated at 5 minute intervals revealed marked variability in the peaks at all frequencies throughout the 24 hours, probably accounting for the lack of distinct peaks in the spectra of the entire records.

High-Frequency Measurements of Tree Methane Fluxes Indicate a Primary Souce Inside Tree Tissue

NASA Astrophysics Data System (ADS)

Brewer, P.; Megonigal, P.

2017-12-01

Methane emissions from the boles and shoots of living upland trees is a recent discovery with significant implications for methane budgets. Forest soil methane uptake is the greatest terrestrial methane sink, but studies have shown this may be partially for fully offset by tree methane sources. However, our ability to quantify the tree source has been hampered because the ultimate biological source(s) of methane is unclear. We measured methane fluxes from two species of living tree boles in an Eastern North American deciduous forest over 100 consecutive days. Our two hour sampling intervals allowed us to characterize diurnal patterns and seasonal dynamics. We observed wide intraspecific differences in average flux rates and diurnal dynamics, even between adjacent individuals. This and other properties of the fluxes indicates the primary methane source is likely within the tree tissues, not in soil or groundwater. Emissions of methane from trees offset approximately 10% of soil uptake on average, but at times tree fluxes were much higher. Preliminary analyses indicate the highest rates are related to tree life history, tree growth, temperature, ground-water depth, and soil moisture.

Infrared spectroscopy study of the influence of inhaled vapors/smoke produced by cigarettes of active smokers

NASA Astrophysics Data System (ADS)

Popa, Cristina

2015-05-01

While much is known about the effect of smoke and vapors on the composition of blood, little is known about their impact on the composition of breath. When tobacco from traditional cigarettes (T) is burned, it produces harmful smoke compared with the vapor produced when using electronic cigarettes (E). Using a noninvasive, safe, and rapid CO2 laser-photoacoustic method, this study aimed to examine the ethylene changes at different time intervals in the exhaled breath composition of E-cigarette smokers and T-cigarette smokers, before and after the consecutive exposures to cigarettes. Oxidative stress from exposure to tobacco smoke has a role in the pathogenic process, leading to chronic obstructive pulmonary disease. The evidence on the mechanisms by which T-smoking causes damage indicates that there is no risk-free level of exposure to tobacco smoke. The study revealed that the ethylene level (in the E-cigarette smoker's case) was found to be in smaller concentrations (compared with T-cigarette smoker's case) and that E-cigarettes may provide an alternative to T-cigarette smoking.

Infrared spectroscopy study of the influence of inhaled vapors/smoke produced by cigarettes of active smokers.

PubMed

Popa, Cristina

2015-05-01

While much is known about the effect of smoke and vapors on the composition of blood, little is known about their impact on the composition of breath. When tobacco from traditional cigarettes (T) is burned, it produces harmful smoke compared with the vapor produced when using electronic cigarettes (E). Using a noninvasive, safe, and rapid CO2 laser-photoacoustic method, this study aimed to examine the ethylene changes at different time intervals in the exhaled breath composition of E-cigarette smokers and T-cigarette smokers, before and after the consecutive exposures to cigarettes. Oxidative stress from exposure to tobacco smoke has a role in the pathogenic process, leading to chronic obstructive pulmonary disease. The evidence on the mechanisms by which T-smoking causes damage indicates that there is no risk-free level of exposure to tobacco smoke. The study revealed that the ethylene level (in the E-cigarette smoker's case) was found to be in smaller concentrations (compared with T-cigarette smoker's case) and that E-cigarettes may provide an alternative to T-cigarette smoking.

Pressure sores and hip fractures.

PubMed

Haleem, S; Heinert, G; Parker, M J

2008-02-01

Development of pressure sores during hospital admission causes morbidity and distress to the patient, increases strain on nursing resources, delaying discharge and possibly increasing mortality. A hip fracture in elderly patients is a known high-risk factor for development of pressure sores. We aimed to determine the current incidence of pressure sores and identify those factors which were associated with an increased risk of pressure sores. We retrospectively analysed prospectively collected data of 4654 consecutive patients admitted to a single unit. One hundred and seventy-eight (3.8%) of our patients developed pressure sores. Patient factors that increased the risk of pressure sores were increased age, diabetes mellitus, a lower mental test score, a lower mobility score, a higher ASA score, lower admission haemoglobin and an intra-operative drop in blood pressure. The risk was higher in patients with an extracapsular neck of femur fracture and patients with an increased time interval between admission to hospital and surgery. Our studies indicate that while co-morbidities constitute a substantial risk in an elderly population, the increase in incidence of pressure sores can be reduced by minimising delays to surgery.

Evolutionary algorithm for vehicle driving cycle generation.

PubMed

Perhinschi, Mario G; Marlowe, Christopher; Tamayo, Sergio; Tu, Jun; Wayne, W Scott

2011-09-01

Modeling transit bus emissions and fuel economy requires a large amount of experimental data over wide ranges of operational conditions. Chassis dynamometer tests are typically performed using representative driving cycles defined based on vehicle instantaneous speed as sequences of "microtrips", which are intervals between consecutive vehicle stops. Overall significant parameters of the driving cycle, such as average speed, stops per mile, kinetic intensity, and others, are used as independent variables in the modeling process. Performing tests at all the necessary combinations of parameters is expensive and time consuming. In this paper, a methodology is proposed for building driving cycles at prescribed independent variable values using experimental data through the concatenation of "microtrips" isolated from a limited number of standard chassis dynamometer test cycles. The selection of the adequate "microtrips" is achieved through a customized evolutionary algorithm. The genetic representation uses microtrip definitions as genes. Specific mutation, crossover, and karyotype alteration operators have been defined. The Roulette-Wheel selection technique with elitist strategy drives the optimization process, which consists of minimizing the errors to desired overall cycle parameters. This utility is part of the Integrated Bus Information System developed at West Virginia University.

Floods of January and February 1980 in California

USGS Publications Warehouse

Wahl, Kenneth L.; Crippen, John R.; Knott, J.M.

1980-01-01

During January and February 1980, storms caused substantial rises in streamflow throughout much of California. In mid-January flooding occurred in the foothills of the Sierra Nevada and in the central coast area. In late January and mid-February, high floodflows in streams in coastal southern California caused much damage and several deaths. The Tijuana River in northern Baja California (Mexico) and southern San Diego County flooded many square miles of lowlands as its flow during two separate flooding episodes exceeded all records. Most reservoirs in San Diego County spilled, several for the first time since their completion. Lake Elsinore, in eastern Riverside County, caused much damage to lakeside property as it filled to an elevation not reached since 1916. The February flooding in southern California was caused by a series of storms separated by short intervals. Some peaks of record were observed, and streamflow throughout the area remained high for a relatively long period. In many streams, the volumes of sustained flow for periods of 7 and 15 consecutive days were the greatest that have occurred during the period of record.

Geometrical Determinants of Neuronal Actin Waves.

PubMed

Tomba, Caterina; Braïni, Céline; Bugnicourt, Ghislain; Cohen, Floriane; Friedrich, Benjamin M; Gov, Nir S; Villard, Catherine

2017-01-01

Hippocampal neurons produce in their early stages of growth propagative, actin-rich dynamical structures called actin waves. The directional motion of actin waves from the soma to the tip of neuronal extensions has been associated with net forward growth, and ultimately with the specification of neurites into axon and dendrites. Here, geometrical cues are used to control actin wave dynamics by constraining neurons on adhesive stripes of various widths. A key observable, the average time between the production of consecutive actin waves, or mean inter-wave interval (IWI), was identified. It scales with the neurite width, and more precisely with the width of the proximal segment close to the soma. In addition, the IWI is independent of the total number of neurites. These two results suggest a mechanistic model of actin wave production, by which the material conveyed by actin waves is assembled in the soma until it reaches the threshold leading to the initiation and propagation of a new actin wave. Based on these observations, we formulate a predictive theoretical description of actin wave-driven neuronal growth and polarization, which consistently accounts for different sets of experiments.

Geometrical Determinants of Neuronal Actin Waves

PubMed Central

Tomba, Caterina; Braïni, Céline; Bugnicourt, Ghislain; Cohen, Floriane; Friedrich, Benjamin M.; Gov, Nir S.; Villard, Catherine

2017-01-01

Hippocampal neurons produce in their early stages of growth propagative, actin-rich dynamical structures called actin waves. The directional motion of actin waves from the soma to the tip of neuronal extensions has been associated with net forward growth, and ultimately with the specification of neurites into axon and dendrites. Here, geometrical cues are used to control actin wave dynamics by constraining neurons on adhesive stripes of various widths. A key observable, the average time between the production of consecutive actin waves, or mean inter-wave interval (IWI), was identified. It scales with the neurite width, and more precisely with the width of the proximal segment close to the soma. In addition, the IWI is independent of the total number of neurites. These two results suggest a mechanistic model of actin wave production, by which the material conveyed by actin waves is assembled in the soma until it reaches the threshold leading to the initiation and propagation of a new actin wave. Based on these observations, we formulate a predictive theoretical description of actin wave-driven neuronal growth and polarization, which consistently accounts for different sets of experiments. PMID:28424590

Determination of Porosity in Shale by Double Headspace Extraction GC Analysis.

PubMed

Zhang, Chun-Yun; Li, Teng-Fei; Chai, Xin-Sheng; Xiao, Xian-Ming; Barnes, Donald

2015-11-03

This paper reports on a novel method for the rapid determination of the shale porosity by double headspace extraction gas chromatography (DHE-GC). Ground core samples of shale were placed into headspace vials and DHE-GC measurements of released methane gas were performed at a given time interval. A linear correlation between shale porosity and the ratio of consecutive GC signals was established both theoretically and experimentally by comparing with the results from the standard helium pycnometry method. The results showed that (a) the porosity of ground core samples of shale can be measured within 30 min; (b) the new method is not significantly affected by particle size of the sample; (c) the uncertainties of measured porosities of nine shale samples by the present method range from 0.31 to 0.46 p.u.; and (d) the results obtained by the DHE-GC method are in a good agreement with those from the standard helium pycnometry method. In short, the new DHE-GC method is simple, rapid, and accurate, making it a valuable tool for shale gas-related research and applications.

Mood spillover and crossover among dual-earner couples: a cell phone event sampling study.

PubMed

Song, Zhaoli; Foo, Maw-Der; Uy, Marilyn A

2008-03-01

In this study, the authors examined affective experiences of dual-earner couples. More specifically, the authors explored how momentary moods can spill over between work and family and cross over from one spouse to another. Fifty couples used their cell phones to provide reports of their momentary moods over 8 consecutive days. Results show significant spillover and crossover effects for both positive and negative moods. Work orientation moderated negative mood spillover from work to home, and the presence of children in the family decreased negative mood crossover between spouses. Crossover was observed when spouses were physically together and when the time interval between the spouses' reports was short. With this study, the authors contribute to the work and family research by examining the nature of mood transfers among dual-earner couples, including the direction, valence, and moderators of these transfers across work and family domains. The authors also contribute to the event sampling methodology by introducing a new method of using cell phones to collect momentary data. Copyright 2008 APA

Hospital factors impact variation in emergency department length of stay more than physician factors.

PubMed

Krall, Scott P; Cornelius, Angela P; Addison, J Bruce

2014-03-01

To analyze the correlation between the many different emergency department (ED) treatment metric intervals and determine if the metrics directly impacted by the physician correlate to the "door to room" interval in an ED (interval determined by ED bed availability). Our null hypothesis was that the cause of the variation in delay to receiving a room was multifactorial and does not correlate to any one metric interval. We collected daily interval averages from the ED information system, Meditech©. Patient flow metrics were collected on a 24-hour basis. We analyzed the relationship between the time intervals that make up an ED visit and the "arrival to room" interval using simple correlation (Pearson Correlation coefficients). Summary statistics of industry standard metrics were also done by dividing the intervals into 2 groups, based on the average ED length of stay (LOS) from the National Hospital Ambulatory Medical Care Survey: 2008 Emergency Department Summary. Simple correlation analysis showed that the doctor-to-discharge time interval had no correlation to the interval of "door to room (waiting room time)", correlation coefficient (CC) (CC=0.000, p=0.96). "Room to doctor" had a low correlation to "door to room" CC=0.143, while "decision to admitted patients departing the ED time" had a moderate correlation of 0.29 (p <0.001). "New arrivals" (daily patient census) had a strong correlation to longer "door to room" times, 0.657, p<0.001. The "door to discharge" times had a very strong correlation CC=0.804 (p<0.001), to the extended "door to room" time. Physician-dependent intervals had minimal correlation to the variation in arrival to room time. The "door to room" interval was a significant component to the variation in "door to discharge" i.e. LOS. The hospital-influenced "admit decision to hospital bed" i.e. hospital inpatient capacity, interval had a correlation to delayed "door to room" time. The other major factor affecting department bed availability was the "total patients per day." The correlation to the increasing "door to room" time also reflects the effect of availability of ED resources (beds) on the patient evaluation time. The time that it took for a patient to receive a room appeared more dependent on the system resources, for example, beds in the ED, as well as in the hospital, than on the physician.

Intact interval timing in circadian CLOCK mutants.

PubMed

Cordes, Sara; Gallistel, C R

2008-08-28

While progress has been made in determining the molecular basis for the circadian clock, the mechanism by which mammalian brains time intervals measured in seconds to minutes remains a mystery. An obvious question is whether the interval-timing mechanism shares molecular machinery with the circadian timing mechanism. In the current study, we trained circadian CLOCK +/- and -/- mutant male mice in a peak-interval procedure with 10 and 20-s criteria. The mutant mice were more active than their wild-type littermates, but there were no reliable deficits in the accuracy or precision of their timing as compared with wild-type littermates. This suggests that expression of the CLOCK protein is not necessary for normal interval timing.

Association of functional genetic variants of A-kinase anchoring protein 10 with QT interval length in full-term Polish newborns.

PubMed

Łoniewska, Beata; Kaczmarczyk, Mariusz; Clark, Jeremy Simon; Gorący, Iwona; Horodnicka-Józwa, Anita; Ciechanowicz, Andrzej

2015-03-16

A-Kinase Anchoring Proteins (AKAPs) coordinate the specificity of protein kinase A signaling by localizing the kinase to subcellular sites. The 1936G (V646) AKAP10 allele has been associated in adults with low cholinergic/vagus nerve sensitivity, shortened PR intervals in ECG recording and in newborns with increased blood pressure and higher cholesterol cord blood concentration. The aim of the study was to answer the question of whether 1936A > G AKAP10 polymorphism is associated with the newborn electrocardiographic variables. Electrocardiograms were recorded from 114 consecutive healthy Polish newborns (55 females, 59 males), born after 37 gestational weeks to healthy women with uncomplicated pregnancies. All recordings were made between 3(rd) and 7(th) day of life to avoid QT variability. The heart rate per minute and duration of PR, QRS, RR and QT intervals were usually measured. The ECGs were evaluated independently by three observers. At birth, cord blood of neonates was obtained for isolation of genomic DNA. The distribution of anthropometric and electrocardiographic variables in our cohort approached normality (skewness < 2 for all variables). No significant differences in anthropometric variables and electrocardiographic traits with respect to AKAP10 genotype were found. Multiple regression analysis with adjustment for gender, gestational age and birth mass revealed that QTc interval in GG AKAP10 homozygotes was significantly longer, but in range, when compared with A alleles carriers (AA + AG, recessive mode of inheritance). No rhythm disturbances were observed. Results demonstrate possible association between AKAP10 1936A > G variant and QTc interval in Polish newborns.

Anti-hypertensive treatment prolongs tPA door-to-treatment time: Secondary analysis of the INSTINCT trial.

PubMed Central

Skolarus, Lesli E.; Scott, Phillip A.; Burke, James F.; Adelman, Eric E.; Frederiksen, Shirley M.; Kade, Allison M.; Kalbfleisch, Jack D.; Ford, Andria L.; Meurer, William J.

2012-01-01

Background/Purpose Identifying modifiable tPA treatment delays may improve stroke outcomes. We hypothesized that pre-thrombolytic anti-hypertensive treatment (AHT) may prolong door-to-treatment time (DTT). Methods Analysis of consecutive tPA-treated patients at 24 randomly selected community hospitals in the INSTINCT trial between 2007-2010. DTTs among stroke patients who received pre-thrombolytic AHT were compared to those that did not receive pre-thrombolytic AHT. We then calculated a propensity score for the probability of receiving pre-thrombolytic AHT using logistic regression with demographics, stroke risk factors, home medications, stroke severity (NIHSS), onset-to-door time, admission glucose, pretreatment blood pressure, EMS transport and location at time of stroke as independent variables. A paired t-test was performed to compare the DTTs between the propensity matched groups. Results Of 534 tPA treated stroke patients analyzed, 95 received pre-thrombolytic AHT. In the unmatched cohort, patients who received pre-thrombolytic AHT had a longer DTT (mean increase 9 minutes; 95% confidence interval (CI) 2-16 minutes) than patients who did not. After propensity matching, patients who received pre-thrombolytic AHT had a longer DTT (mean increase 10.4 minutes, 95% CI 1.9 - 18.8) than patients who did not receive pre-thrombolytic AHT. Conclusion Pre-thrombolytic AHT is associated with modest delays in DTT. This represents a potential target for quality improvement initiatives. Further research evaluating optimum pre-thrombolytic hypertension management is warranted. PMID:23033348

Clinical performance of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced pediatric abdominal MR angiography.

PubMed

Zhang, Tao; Yousaf, Ufra; Hsiao, Albert; Cheng, Joseph Y; Alley, Marcus T; Lustig, Michael; Pauly, John M; Vasanawala, Shreyas S

2015-10-01

Pediatric contrast-enhanced MR angiography is often limited by respiration, other patient motion and compromised spatiotemporal resolution. To determine the reliability of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography method for depicting abdominal arterial anatomy in young children. With IRB approval and informed consent, we retrospectively identified 27 consecutive children (16 males and 11 females; mean age: 3.8 years, range: 14 days to 8.4 years) referred for contrast-enhanced MR angiography at our institution, who had undergone free-breathing spatiotemporally accelerated time-resolved contrast-enhanced MR angiography studies. A radio-frequency-spoiled gradient echo sequence with Cartesian variable density k-space sampling and radial view ordering, intrinsic motion navigation and intermittent fat suppression was developed. Images were reconstructed with soft-gated parallel imaging locally low-rank method to achieve both motion correction and high spatiotemporal resolution. Quality of delineation of 13 abdominal arteries in the reconstructed images was assessed independently by two radiologists on a five-point scale. Ninety-five percent confidence intervals of the proportion of diagnostically adequate cases were calculated. Interobserver agreements were also analyzed. Eleven out of 13 arteries achieved acceptable image quality (mean score range: 3.9-5.0) for both readers. Fair to substantial interobserver agreement was reached on nine arteries. Free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography frequently yields diagnostic image quality for most abdominal arteries in young children.

Fast adaptation of the internal model of gravity for manual interceptions: evidence for event-dependent learning.

PubMed

Zago, Myrka; Bosco, Gianfranco; Maffei, Vincenzo; Iosa, Marco; Ivanenko, Yuri P; Lacquaniti, Francesco

2005-02-01

We studied how subjects learn to deal with two conflicting sensory environments as a function of the probability of each environment and the temporal distance between repeated events. Subjects were asked to intercept a visual target moving downward on a screen with randomized laws of motion. We compared five protocols that differed in the probability of constant speed (0g) targets and accelerated (1g) targets. Probability ranged from 9 to 100%, and the time interval between consecutive repetitions of the same target ranged from about 1 to 20 min. We found that subjects systematically timed their responses consistent with the assumption of gravity effects, for both 1 and 0g trials. With training, subjects rapidly adapted to 0g targets by shifting the time of motor activation. Surprisingly, the adaptation rate was independent of both the probability of 0g targets and their temporal distance. Very few 0g trials sporadically interspersed as catch trials during immersive practice with 1g trials were sufficient for learning and consolidation in long-term memory, as verified by retesting after 24 h. We argue that the memory store for adapted states of the internal gravity model is triggered by individual events and can be sustained for prolonged periods of time separating sporadic repetitions. This form of event-related learning could depend on multiple-stage memory, with exponential rise and decay in the initial stages followed by a sample-and-hold module.

Relation between volatility correlations in financial markets and Omori processes occurring on all scales

NASA Astrophysics Data System (ADS)

Weber, Philipp; Wang, Fengzhong; Vodenska-Chitkushev, Irena; Havlin, Shlomo; Stanley, H. Eugene

2007-07-01

We analyze the memory in volatility by studying volatility return intervals, defined as the time between two consecutive fluctuations larger than a given threshold, in time periods following stock market crashes. Such an aftercrash period is characterized by the Omori law, which describes the decay in the rate of aftershocks of a given size with time t by a power law with exponent close to 1. A shock followed by such a power law decay in the rate is here called Omori process. We find self-similar features in the volatility. Specifically, within the aftercrash period there are smaller shocks that themselves constitute Omori processes on smaller scales, similar to the Omori process after the large crash. We call these smaller shocks subcrashes, which are followed by their own aftershocks. We also show that the Omori law holds not only after significant market crashes as shown by Lillo and Mantegna [Phys. Rev. E 68, 016119 (2003)], but also after “intermediate shocks.” By appropriate detrending we remove the influence of the crashes and subcrashes from the data, and find that this procedure significantly reduces the memory in the records. Moreover, when studying long-term correlated fractional Brownian motion and autoregressive fractionally integrated moving average artificial models for volatilities, we find Omori-type behavior after high volatilities. Thus, our results support the hypothesis that the memory in the volatility is related to the Omori processes present on different time scales.

Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis

PubMed Central

Xu, Jianglin; Suri, Rita S.; Nesrallah, Gihad; Lindsay, Robert; Garg, Amit X.; Lester, Keith; Ofsthun, Norma; Lazarus, Michael; Hakim, Raymond M.

2012-01-01

Whether the duration of hemodialysis treatments improves outcomes remains controversial. Here, we evaluated survival and clinical changes associated with converting from conventional hemodialysis (mean=3.75 h/treatment) to in-center nocturnal hemodialysis (mean=7.85 h/treatment). All 959 consecutive patients who initiated nocturnal hemodialysis for the first time in 77 Fresenius Medical Care facilities during 2006 and 2007 were eligible. We used Cox models to compare risk for mortality during 2 years of follow-up in a 1:3 propensity score–matched cohort of 746 nocturnal and 2062 control patients on conventional hemodialysis. Two-year mortality was 19% among nocturnal hemodialysis patients compared with 27% among conventional patients. Nocturnal hemodialysis associated with a 25% reduction in the risk for death after adjustment for age, body mass index, and dialysis vintage (hazard ratio=0.75, 95% confidence interval=0.61–0.91, P=0.004). With respect to clinical features, interdialytic weight gain, albumin, hemoglobin, dialysis dose, and calcium increased on nocturnal therapy, whereas postdialysis weight, predialysis systolic blood pressure, ultrafiltration rate, phosphorus, and white blood cell count declined (all P<0.001). In summary, notwithstanding the possibility of residual selection bias, conversion to treatment with nocturnal hemodialysis associates with favorable clinical features, laboratory biomarkers, and improved survival compared with propensity score–matched controls. The potential impact of extended treatment time on clinical outcomes while maintaining a three times per week hemodialysis schedule requires evaluation in future clinical trials. PMID:22362905

Triggering of acute myocardial infarction by different means of transportation.

PubMed

Peters, Annette; von Klot, Stephanie; Mittleman, Murray A; Meisinger, Christine; Hörmann, Allmut; Kuch, Bernhard; Wichmann, H Erich

2013-10-01

Prior studies have reported an association between traffic-related air pollution in urban areas and exacerbation of cardiovascular disease. We assess here whether time spent in different modes of transportation can trigger the onset of acute myocardial infarction (AMI). We performed a case-crossover study. We interviewed consecutive cases of AMI in the KORA Myocardial Infarction Registry in Augsburg, Southern Germany between February 1999 and December 2003 eliciting data on potential triggers in the four days preceding myocardial infarction onset. A total of 1459 cases with known date and time of AMI symptom onset, who had survived 24 hours after the onset, completed the registry's standard interview on potential triggers of AMI. An association between exposure to traffic and AMI onset 1 hour later was observed (odds ratio: 3.2; 95% confidence interval [CI]: 2.7-3.9, p < 0.001). Using a car was the most common source of traffic exposure; nevertheless, times spent in public transport or on a bicycle were similarly associated with AMI onset 1 hour later. While the highest risk for AMI onset was within 1 hour of exposure to traffic, the elevated risk persisted for up to 6 hours. Women, patients aged 65 years or older, patients not part of the workforce, and those with a history of angina or diabetes exhibited the largest associations between times spent in traffic and AMI onset 1 hour later. The data suggest that transient exposure to traffic regardless of the means of transportation may increase the risk of AMI transiently.

Sunward-propagating Solar Energetic Electrons inside Multiple Interplanetary Flux Ropes

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

Gómez-Herrero, Raúl; Hidalgo, Miguel A.; Carcaboso, Fernando

2017-05-10

On 2013 December 2 and 3, the SEPT and STE instruments on board STEREO-A observed two solar energetic electron events with unusual sunward-directed fluxes. Both events occurred during a time interval showing typical signatures of interplanetary coronal mass ejections (ICMEs). The electron timing and anisotropies, combined with extreme-ultraviolet solar imaging and radio wave spectral observations, are used to confirm the solar origin and the injection times of the energetic electrons. The solar source of the ICME is investigated using remote-sensing observations and a three-dimensional reconstruction technique. In situ plasma and magnetic field data combined with energetic electron observations and amore » flux-rope model are used to determine the ICME magnetic topology and the interplanetary electron propagation path from the Sun to 1 au. Two consecutive flux ropes crossed the STEREO-A location and each electron event occurred inside a different flux rope. In both cases, the electrons traveled from the solar source to 1 au along the longest legs of the flux ropes still connected to the Sun. During the December 2 event, energetic electrons propagated along the magnetic field, while during the December 3 event they were propagating against the field. As found by previous studies, the energetic electron propagation times are consistent with a low number of field line rotations N < 5 of the flux rope between the Sun and 1 au. The flux rope model used in this work suggests an even lower number of rotations.« less

Visual processing during natural reading

PubMed Central

Weiss, Béla; Knakker, Balázs; Vidnyánszky, Zoltán

2016-01-01

Reading is a unique human ability that plays a pivotal role in the development and functioning of our modern society. However, its neural basis remains poorly understood since previous research was focused on reading words with fixed gaze. Here we developed a methodological framework for single-trial analysis of fixation onset-related EEG activity (FOREA) that enabled us to investigate visual information processing during natural reading. To reveal the effect of reading skills on orthographic processing during natural reading, we measured how altering the configural properties of the written text by modifying inter-letter spacing affects FOREA. We found that orthographic processing is reflected in FOREA in three consecutive time windows (120–175 ms, 230–265 ms, 345–380 ms after fixation onset) and the magnitude of FOREA effects in the two later time intervals showed a close association with the participants’ reading speed: FOREA effects were larger in fast than in slow readers. Furthermore, these expertise-driven configural effects were clearly dissociable from the FOREA signatures of visual perceptual processes engaged to handle the increased crowding (155–220 ms) as a result of decreasing letter spacing. Our findings revealed that with increased reading skills orthographic processing becomes more sensitive to the configural properties of the written text. PMID:27231193

Therapeutic potency of saponin rich aqueous extract of Scoparia dulcis L. in alloxan induced diabetes in rats.

PubMed

Perumal, P Saravana; Anaswara, P V; Muthuraman, A; Krishan, S

2014-04-01

Diabetes mellitus is major metabolic disorders of carbohydrate metabolism. This leads to alter the multiple organ system. To investigate the antidiabetic and antioxidant effects of the saponin rich aqueous extract of Scoparia dulcis (SRE-SD) using alloxan-induced hyperglycemic rat model. The single dose of alloxan was injected for the induction of diabetes in rats. The SRE-SD and glibenclamide were administered for 15 consecutive days from the 3(rd) day of alloxan administration. Quantity of food and water intake was measured at day 0, and 18. Further, body weight was recorded and blood samples were collected at different time intervals that is, day 0, 3, 8, 13, and 18. The oxidative biomarkers (i.e. thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH) and nitrite (NO(2-)) levels were also estimated in the serum sample. The SRE-SD showed a remarkable dose and time-dependent changes in alloxan-induced rise in the level of food consumption and water intake, serum glucose level, TBARS, NO(2-) and fall in the level of GSH. Further, significant attenuation was observed at 20 and 30 mg/kg of SRE-SD treated group. These findings demonstrate that SRE-SD has both antidiabetic and antioxidant effects on the experimental model of diabetes in rat.

Effects of GABA, Neural Regulation, and Intrinsic Cardiac Factors on Heart Rate Variability in Zebrafish Larvae.

PubMed

Vargas, Rafael Antonio

2017-04-01

Heart rate (HR) is a periodic activity that is variable over time due to intrinsic cardiac factors and extrinsic neural control, largely by the autonomic nervous system. Heart rate variability (HRV) is analyzed by measuring consecutive beat-to-beat intervals. This variability can contain information about the factors regulating cardiac activity under normal and pathological conditions, but the information obtained from such analyses is not yet fully understood. In this article, HRV in zebrafish larvae was evaluated under normal conditions and under the effect of substances that modify intrinsic cardiac activity and cardiac activity modulated by the nervous system. We found that the factors affecting intrinsic activity have negative chronotropic and arrhythmogenic effects at this stage of development, whereas neural modulatory factors have a lesser impact. The results suggest that cardiac activity largely depends on the intrinsic properties of the heart tissue in the early stages of development and, to a lesser extent, in the maturing nervous system. We also report, for the first time, the influence of the neurotransmitter gamma amino butyric acid on HRV. The results demonstrate the larval zebrafish model as a useful tool in the study of intrinsic cardiac activity and its role in heart diseases.

Solvable continuous-time random walk model of the motion of tracer particles through porous media.

PubMed

Fouxon, Itzhak; Holzner, Markus

2016-08-01

We consider the continuous-time random walk (CTRW) model of tracer motion in porous medium flows based on the experimentally determined distributions of pore velocity and pore size reported by Holzner et al. [M. Holzner et al., Phys. Rev. E 92, 013015 (2015)PLEEE81539-375510.1103/PhysRevE.92.013015]. The particle's passing through one channel is modeled as one step of the walk. The step (channel) length is random and the walker's velocity at consecutive steps of the walk is conserved with finite probability, mimicking that at the turning point there could be no abrupt change of velocity. We provide the Laplace transform of the characteristic function of the walker's position and reductions for different cases of independence of the CTRW's step duration τ, length l, and velocity v. We solve our model with independent l and v. The model incorporates different forms of the tail of the probability density of small velocities that vary with the model parameter α. Depending on that parameter, all types of anomalous diffusion can hold, from super- to subdiffusion. In a finite interval of α, ballistic behavior with logarithmic corrections holds, which was observed in a previously introduced CTRW model with independent l and τ. Universality of tracer diffusion in the porous medium is considered.

Preexposure to Olive Oil Polyphenols Extract Increases Oxidative Load and Improves Liver Mass Restoration after Hepatectomy in Mice via Stress-Sensitive Genes

PubMed Central

Marinić, Jelena; Broznić, Dalibor; Milin, Čedomila

2016-01-01

Polyphenols can act as oxidants in some conditions, inducing redox-sensitive genes. We investigated the effect of preexposure to the olive oil polyphenols extract (PFE) on time-dependent changes in the hepatic oxidative state in a model of liver regeneration—a process in which oxidative stress associated with the metabolic overload accounts for the early events that contribute to the onset of liver self-repair. Liver regeneration was induced by one-third hepatectomy in mice. Prior to hepatectomy, mice were intraperitoneally given either PFE (50 mg/kg body weight) or saline for seven consecutive days, while respective controls received vehicle alone. Redox state-regulating enzymes and thiol proteins along with the mRNA levels of Nrf2 gene and its targets γ-glutamylcysteine synthetase and heme oxygenase-1 were determined at different time intervals after hepatectomy. The liver mass restoration was calculated to assess hepatic regeneration. The resulting data demonstrate the effectiveness of preexposure to PFE in stimulating liver regeneration in a model of a small tissue loss which may be ascribed to the transient increase in oxidant load during the first hours after hepatectomy and associated induction of stress response gene-profiles under the control of Nrf2. PMID:26925195

Damping of collective modes and the echo effect in a confined Bose-Einstein condensate

NASA Astrophysics Data System (ADS)

Kuklov, A. B.; Chencinski, N.

1998-04-01

We discuss the reversible nature of two mechanisms of the apparent damping of the collective modes of a confined Bose-Einstein condensate -- Landau Damping (LD) and a dephasing caused by thermal fluctuations of the normal component. The reversibility of the damping in both cases can be tested by the echo effect, when two consecutive external pulses modulate the potential trapping the condensate and induce a third pulse -- the echo -- at the time approximately equal to twice the time interval between the first two pulses. This effect is similar to the phonon echo in powders (Koji Kajimura in Physical Acoustics), ed. W.P. Mason, V.XVI, Academic Press, NY, Toronto 1982.. Parameters of the echo for the isotropic condensate are calculated analytically in the adiabatic approximation for the case of the small external pulses. Numerical simulations for the arbitrary pulses are also presented. The echo in an anisotropic condensate, where the adaibatic approximation is not valid because of the LD, is described in terms of the model of a single oscillator interacting with a quasi-continuum of modes which constitutes the normal component. In both cases in the weak echo limit the echo amplitude turns out to be proportional to the amplitudes of the external pulses. We suggest to test these predictions experimentally.

Agreement and repeatability of objective systems for assessment of the tear film.

PubMed

Fernández, Joaquín; Rodríguez-Vallejo, Manuel; Martínez, Javier; Tauste, Ana; García-Montesinos, Javier; Piñero, David P

2018-04-18

To assess the agreement and repeatability of two objective systems for measuring the tear film stability. Retrospective analysis of the tear film stability of 99 healthy right eyes measured with a videokeratoscope (VK) and the Optical Quality Analysis System (OQAS, Visiometrics). Two consecutive measures were taken with both systems, with an interval of 10 min between them. Variables included in the study were first and mean non-invasive break-up times (NIBUT and MNIBUT) measured with VK, and mean and standard deviation of the optical scattering index (OSIm and OSIsd) measured with OQAS. The agreement and repeatability of grading scales provided by both devices were also evaluated using the Cohen's k with quadratic weights. The Ocular Surface Disease index (OSDI) questionnaire was also passed out to all subjects. Correlations and associations between subjective and objective metrics were analyzed. Significant differences were found between consecutive measurements of NIBUT (p = 0.04) and MNIBUT (p = 0.01), but not for OSIm (p = 0.11) and OSIsd (p = 0.50). Grading scales resulted in fair (k = 0.20) or poor agreement (k = 0.04) between systems depending if the first or second trial was considered. The repeatability of the grading scale was good for OQAS (k = 0.59) and fair for VK (k = 0.37). No significant correlations or associations were found between OSDI and any of the metrics obtained with both devices (p ≥ 0.36). The two devices evaluated cannot be used interchangeably for the assessment of tear film stability. Good intrasession repeatability was obtained for tear film grading of the OQAS whereas it was fair for VK.

Molecular tools for diagnosis of visceral leishmaniasis: systematic review and meta-analysis of diagnostic test accuracy.

PubMed

de Ruiter, C M; van der Veer, C; Leeflang, M M G; Deborggraeve, S; Lucas, C; Adams, E R

2014-09-01

Molecular methods have been proposed as highly sensitive tools for the detection of Leishmania parasites in visceral leishmaniasis (VL) patients. Here, we evaluate the diagnostic accuracy of these tools in a meta-analysis of the published literature. The selection criteria were original studies that evaluate the sensitivities and specificities of molecular tests for diagnosis of VL, adequate classification of study participants, and the absolute numbers of true positives and negatives derivable from the data presented. Forty studies met the selection criteria, including PCR, real-time PCR, nucleic acid sequence-based amplification (NASBA), and loop-mediated isothermal amplification (LAMP). The sensitivities of the individual studies ranged from 29 to 100%, and the specificities ranged from 25 to 100%. The pooled sensitivity of PCR in whole blood was 93.1% (95% confidence interval [CI], 90.0 to 95.2), and the specificity was 95.6% (95% CI, 87.0 to 98.6). The specificity was significantly lower in consecutive studies, at 63.3% (95% CI, 53.9 to 71.8), due either to true-positive patients not being identified by parasitological methods or to the number of asymptomatic carriers in areas of endemicity. PCR for patients with HIV-VL coinfection showed high diagnostic accuracy in buffy coat and bone marrow, ranging from 93.1 to 96.9%. Molecular tools are highly sensitive assays for Leishmania detection and may contribute as an additional test in the algorithm, together with a clear clinical case definition. We observed wide variety in reference standards and study designs and now recommend consecutively designed studies. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

First experience with early dynamic (18)F-NaF-PET/CT in patients with chronic osteomyelitis.

PubMed

Freesmeyer, Martin; Stecker, Franz F; Schierz, Jan-Henning; Hofmann, Gunther O; Winkens, Thomas

2014-05-01

This study investigates whether early dynamic positron emission tomography/computed tomography (edPET/CT) using (18)F-sodium fluoride-((18)F-NaF) is feasible in depicting early phases of radiotracer distribution in patients with chronic osteomyelitis (COM). A total of 12 ed(18)F-NaF-PET/CT examinations were performed on 11 consecutive patients (2 female, 9 male; age 53 ± 12 years) in list mode over 5 min starting with radiopharmaceutical injection before standard late (18)F-NaF-PET/CT. Eight consecutive time intervals (frames) were reconstructed for each patient: four 15 s, then four 60 s. Several volumes of interest (VOI) were selected, representing the affected area as well as different reference areas within the bone and soft tissue. Maximum and mean ed standardized uptake values (edSUVmax, edSUVmean, respectively) were calculated in each VOI during each frame to measure early fluoride influx and accumulation. Results were compared between affected and non-affected (contralateral) bones. Starting in the 31-45 s frame, the affected bone area showed significantly higher edSUVmax and edSUVmean compared to the healthy contralateral region. The affected bone areas also significantly differed from non-affected contralateral regions in conventional late (18)F-NaF-PET/CT. This pilot study suggests that, in patients with COM, ed(18)F-NaF -PET offers additional information about early radiotracer distribution to standard (18)F-NaF -PET/CT, similar to a three-phase bone scan. The results should be validated in larger trials which directly compare ed(18)F-NaF-PET to a three-phase bone scan.

Concordance analysis of paired cancer antigen (CA) 15-3 and 27.29 testing.

PubMed

Lin, David C; Genzen, Jonathan R

2018-01-01

Cancer antigens (CA) 15-3 and 27.29 are used in the clinical management of many breast cancer patients. Given that immunoassays for CA 15-3 and CA 27.29 target epitopes on the same glycoprotein-Mucin 1 (MUC1)-the present analysis was conducted to evaluate the potential concordance of tumor marker results when both tests were ordered by providers on the same specimens. A retrospective limited dataset of paired CA 15-3 (Roche Diagnostics) and CA 27.29 (Siemens Diagnostics) test results was obtained from a national clinical reference laboratory. Concordance according to reference interval (RI) status and percent (%) change between consecutive test results was analyzed. 37,652 paired results from 12,470 distinct patients were obtained. The correlation between CA 15-3 and CA 27.29 results was high (correlation coefficient: Pearson, 0.967), although across the dataset a significant difference between CA 15-3 and CA 27.29 results was observed (P < 0.05). RI concordance between CA 15-3 and CA 27.29 results was observed in 93.7% of pairs (35,280 of 37,652). Correlation was also observed in the % change of CA 15-3 and CA 27.29 results between consecutive specimens for individual patients. Using doubling or halving thresholds (i.e., 100% increase or 50% decrease), concordance in % change was observed between CA 15-3 and CA 27.29 in approximately 90% of cases. Individual patient results trended similarly across both markers over time. While generally concordant, CA 15-3 and CA 27.29 results should not be used interchangeably. The present report provides no evidence for added value in performing both tests routinely for individual patients.

Nutrient restriction induces failure of reproductive function and molecular changes in hypothalamus-pituitary-gonadal axis in postpubertal gilts.

PubMed

Zhou, Dongsheng; Zhuo, Yong; Che, Lianqiang; Lin, Yan; Fang, Zhengfeng; Wu, De

2014-07-01

People on a diet to lose weight may be at risk of reproductive failure. To investigate the effects of nutrient restriction on reproductive function and the underlying mechanism, changes of reproductive traits, hormone secretions and gene expressions in hypothalamus-pituitary-gonadal axis were examined in postpubertal gilts at anestrus induced by nutrient restriction. Gilts having experienced two estrus cycles were fed a normal (CON, 2.86 kg/d) or nutrient restricted (NR, 1 kg/d) food regimens to expect anestrus. NR gilts experienced another three estrus cycles, but did not express estrus symptoms at the anticipated fourth estrus. Blood samples were collected at 5 days' interval for consecutive three times for measurement of hormone concentrations at the 23th day of the fourth estrus cycle. Individual progesterone concentrations of NR gilts from three consecutive blood samples were below 1.0 ng/mL versus 2.0 ng/mL in CON gilts, which was considered anestrus. NR gilts had impaired development of reproductive tract characterized by absence of large follicles (diameter ≥ 6 mm), decreased number of corepus lutea and atrophy of uterus and ovary tissues. Circulating concentrations of IGF-I, kisspeptin, estradiol, progesterone and leptin were significantly lower in NR gilts than that in CON gilts. Nutrient restriction down-regulated gene expressions of kiss-1, G-protein coupled protein 54, gonadotropin-releasing hormone, estrogen receptor α, progesterone receptor, leptin receptor, follicle-stimulating hormone and luteinizing hormone and insulin-like growth factor I in hypothalamus-pituitary-gonadal axis of gilts. Collectively, nutrient restriction resulted in impairment of reproductive function and changes of hormone secretions and gene expressions in hypothalamus-pituitary-gonadal axis, which shed light on the underlying mechanism by which nutrient restriction influenced reproductive function.

Review of guidance on recurrence risk management for general practitioners in breast cancer, colorectal cancer and melanoma guidelines.

PubMed

Spronk, Inge; Korevaar, Joke C; Burgers, Jako S; Albreht, Tit; Schellevis, François G

2017-04-01

General practitioners (GPs) will face cancer recurrences more frequently due to the rising number of cancer survivors and greater involvement of GPs in the follow-up care. Currently, GPs are uncertain about managing recurrence risks and may need more guidance. To explore what guidance is available for GPs on managing recurrence risks for breast cancer, colorectal cancer and melanoma, and to examine whether recurrence risk management differs between these tumour types. Breast cancer, colorectal cancer and melanoma clinical practice guidelines were identified via searches on internet and the literature, and experts were approached to identify guidelines. Guidance on recurrence risk management that was (potentially) relevant for GPs was extracted and summarized into topics. We included 24 breast cancer, 21 colorectal cancer and 15 melanoma guidelines. Identified topics on recurrence risk management were rather similar among the three tumour types. The main issue in the guidelines was recurrence detection through consecutive diagnostic testing. Guidelines agree on both routine and nonroutine tests, but, recommended frequencies for follow-up are inconsistent, except for mammography screening for breast cancer. Only six guidelines provided targeted guidance for GPs. This inventory shows that recurrence risk management has overlapping areas between tumour types, making it more feasible for GPs to provide this care. However, few guidance on recurrence risk management is specific for GPs. Recommendations on time intervals of consecutive diagnostic tests are inconsistent, making it difficult for GPs to manage recurrence risks and illustrating the need for more guidance targeted for GPs. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparative Analgesic Efficacy of Pregabalin Administered According to Either a Prevention Protocol or an Intervention Protocol in Rats with Cisplatin-induced Peripheral Neuropathy.

PubMed

Han, F Y; Kuo, A; Nicholson, J R; Corradinni, L; Smith, M T

2018-05-21

Chemotherapy-induced peripheral neuropathy (CIPN) is a type of peripheral neuropathic pain that may be dose-limiting in patients administered potentially curative cancer chemotherapy dosing regimens. In cancer survivors, persistent CIPN adversely affects patient quality of life and so adjuvant drugs (anticonvulsants e.g. pregabalin or antidepressants e.g. amitriptyline) are recommended for the relief of CIPN. However, most studies in rodent models of CIPN involve administration of single bolus doses of adjuvant drugs to assess pain-relieving efficacy. Hence this study was designed to assess the efficacy of pregabalin administered to CIPN-rats according to either a prevention or an intervention protocol. Groups of male Sprague-Dawley rats received four single intraperitoneal bolus doses of cisplatin at 3 mg/kg at once-weekly intervals to induce CIPN. For the prevention protocol, oral pregabalin (or vehicle) was administered to CIPN-rats once-daily for 21 consecutive days from day 0 to day 20 inclusive. For the intervention protocol, oral pregabalin was administered once-daily for 21 consecutive days from day 28 to day 48 inclusive. Mechanical allodynia and mechanical hyperalgesia in the bilateral hindpaws were assessed just prior to each dose of cisplatin and at least once-weekly until study completion (day 27, prevention protocol; or day 48, intervention protocol). Mechanical allodynia and mechanical hyperalgesia were also determined at the time of peak effect at ~2 h post- pregabalin/vehicle administration once-weekly until study completion. For the prevention protocol in CIPN-rats, pregabalin alleviated mechanical hyperalgesia but not mechanical allodynia. For the intervention protocol, pregabalin alleviated both mechanical allodynia and mechanical hyperalgesia in the hindpaws. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Wound healing and all-cause mortality in 958 wound patients treated in home care.

PubMed

Zarchi, Kian; Martinussen, Torben; Jemec, Gregor B E

2015-09-01

Skin wounds are associated with significant morbidity and mortality. Data are, however, not readily available for benchmarking, to allow prognostic evaluation, and to suggest when involvement of wound-healing experts is indicated. We, therefore, conducted an observational cohort study to investigate wound healing and all-cause mortality associated with different types of skin wounds. Consecutive skin wound patients who received wound care by home-care nurses from January 2010 to December 2011 in a district in Eastern Denmark were included in this study. Patients were followed until wound healing, death, or the end of follow-up on December 2012. In total, 958 consecutive patients received wound care by home-care nurses, corresponding to a 1-year prevalence of 1.2% of the total population in the district. During the study, wound healing was achieved in 511 (53.3%), whereas 90 (9.4%) died. During the first 3 weeks of therapy, healing was most likely to occur in surgical wounds (surgical vs. other wounds: adjusted hazard ratio [AHR] 2.21, 95% confidence interval 1.50-3.23), while from 3 weeks to 3 months of therapy, cancer wounds, and pressure ulcers were least likely to heal (cancer vs. other wounds: AHR 0.12, 0.03-0.50; pressure vs. other wounds: AHR 0.44, 0.27-0.74). Cancer wounds and pressure ulcers were further associated with a three times increased probability of mortality compared with other wounds (cancer vs. other wounds: AHR 3.19, 1.35-7.50; pressure vs. other wounds: AHR 2.91, 1.56-5.42). In summary, the wound type was found to be a significant predictor of healing and mortality with cancer wounds and pressure ulcers being associated with poor prognosis. © 2015 by the Wound Healing Society.

Screening Intervals for Diabetic Retinopathy and Implications for Care.

PubMed

Scanlon, Peter H

2017-09-05

The purpose of this study is to review the evidence that lower risk groups who could safely be screened less frequently for sight-threatening diabetic retinopathy (DR) than annually. Data have demonstrated that people with no DR in either eye are at a low risk of progression to sight-threatening DR over a 2-year period (event rate 4.8 per 1000 person years), irrespective of whether the screening method is one-field non-mydriatic or two-field mydriatic digital photography. Low risk has been defined as no retinopathy on two consecutive screening episodes or no retinopathy on one screening episode combined with risk factor data. The risk of an extension to 2 years is less than 5 per 1000 person years in a population with a national screening programme, and the general standard of diabetes care is relatively good, whether low risk is defined as no retinopathy on two consecutive screening episodes or no retinopathy on one screening episode combined with other risk factor data. The definition used in different populations is likely to depend on the availability of data.

Femtosecond Laser Flap Creation for Laser In Situ Keratomileusis in the Setting of Previous Radial Keratotomy.

PubMed

Rush, Sloan W; Rush, Ryan B

2015-01-01

The aim of the study was to report the outcomes of laser in situ keratomileusis (LASIK) in subjects with previous radial keratotomy (RK) using a novel femtosecond laser setting on a proprietary femtosecond laser platform. This was a retrospective, consecutive chart review of patients at a single private practice institution. The medical records of 16 eyes of 8 subjects who underwent femtosecond-assisted LASIK for consecutive hyperopia after RK were retrospectively reviewed. The preoperative characteristics, intraoperative details, and postoperative outcomes were analyzed. All 16 eyes had successful femtosecond laser flap creation without significant intraoperative or postoperative complications. Uncorrected visual acuity significantly improved postoperatively (P = 0.0142) and remained stable through the final follow-up interval at 9 to 12 months postoperatively. None of the subjects lost any lines of best spectacle-corrected visual acuity in the postoperative period. The novel femtosecond laser technique described in this study can provide a safe and effective method for patients undergoing LASIK after previous RK. Future investigations are required to further validate the findings reported in this study.

Estimated survival probability of the Spotorno total hip arthroplasty after a 15- to 21-year follow-up: one surgeon's results.

PubMed

Terré, Ricardo A

2010-01-01

We retrospectively assess 171 consecutive total hip arthroplasties (THAs) with a Spotorno CLS uncemented prosthesis implanted through a Hardinge approach. The mean follow-up was 17.9 years. All consecutive operations were performed by 1 surgeon. Eight patients had been lost to follow-up, and 77 had died for unrelated causes. Overall, 4 stems and 19 cups underwent revision. The cumulative survival rate at 21 years was 79.02% (95% confidence interval [95% CI], 45.98-100.00%) for the acetabular component and 96.71% (95% CI, 60.71-100.00%) for the stem. We can conclude that failure of the Spotorno CLS THA is mainly due to its acetabular component (relative risk 4.5). Survival results for the Spotorno CLS stem exceed the patients? life expectancies in the 60- to 70-year-old population in our area. Loosening with or without fatigue fracture of the component and the learning curve for proper implantation have been the main causes for the expansion cup failure.

The Anaesthetic-ECT Time Interval in Electroconvulsive Therapy Practice--Is It Time to Time?

PubMed

Gálvez, Verònica; Hadzi-Pavlovic, Dusan; Wark, Harry; Harper, Simon; Leyden, John; Loo, Colleen K

2016-01-01

Because most common intravenous anaesthetics used in ECT have anticonvulsant properties, their plasma-brain concentration at the time of seizure induction might affect seizure expression. The quality of ECT seizure expression has been repeatedly associated with efficacy outcomes. The time interval between the anaesthetic bolus injection and the ECT stimulus (anaesthetic-ECT time interval) will determine the anaesthetic plasma-brain concentration when the ECT stimulus is administered. The aim of this study was to examine the effect of the anaesthetic-ECT time interval on ECT seizure quality and duration. The anaesthetic-ECT time interval was recorded in 771 ECT sessions (84 patients). Right unilateral brief pulse ECT was applied. Anaesthesia given was propofol (1-2 mg/kg) and succinylcholine (0.5-1.0 mg/kg). Seizure quality indices (slow wave onset, amplitude, regularity, stereotypy and post-ictal suppression) and duration were rated through a structured rating scale by a single blinded trained rater. Linear Mixed Effects Models analysed the effect of the anaesthetic-ECT time interval on seizure quality indices, controlling for propofol dose (mg), ECT charge (mC), ECT session number, days between ECT, age (years), initial seizure threshold (mC) and concurrent medication. Longer anaesthetic-ECT time intervals lead to significantly higher quality seizures (p < 0.001 for amplitude, regularity, stereotypy and post-ictal suppression). These results suggest that the anaesthetic-ECT time interval is an important factor to consider in ECT practice. This time interval should be extended to as long as practically possible to facilitate the production of better quality seizures. Close collaboration between the anaesthetist and the psychiatrist is essential. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of Human Immunodeficiency Virus Type 1 Tropism Profiles in Clinical Samples by the Trofile and MT-2 Assays▿

PubMed Central

Coakley, Eoin; Reeves, Jacqueline D.; Huang, Wei; Mangas-Ruiz, Marga; Maurer, Irma; Harskamp, Agnes M.; Gupta, Soumi; Lie, Yolanda; Petropoulos, Christos J.; Schuitemaker, Hanneke; van 't Wout, Angélique B.

2009-01-01

The recent availability of CCR5 antagonists as anti-human immunodeficiency virus (anti-HIV) therapeutics has highlighted the need to accurately identify CXCR4-using variants in patient samples when use of this new drug class is considered. The Trofile assay (Monogram Biosciences) has become the method that is the most widely used to define tropism in the clinic prior to the use of a CCR5 antagonist. By comparison, the MT-2 assay has been used since early in the HIV epidemic to define tropism in clinical specimens. Given that there are few data from direct comparisons of these two assays, we evaluated the performance of the plasma-based Trofile assay and the peripheral blood mononuclear cell (PBMC)-based MT-2 assay for the detection of CXCR4 use in defining the tropism of HIV isolates derived from clinical samples. The various samples used for this comparison were derived from participants of the Amsterdam Cohort Studies on HIV infection and AIDS who underwent consecutive MT-2 assay testing of their PBMCs at approximately 3-month intervals. This unique sample set was specifically selected because consecutive MT-2 assays had demonstrated a shift from negative to positive in PBMCs, reflecting the first emergence of CXCR4-using virus in PBMCs above the level of detection of the assay in these individuals. Trofile testing was performed with clonal HIV type 1 (HIV-1) variants (n = 21), MT-2 cell culture-derived cells (n = 20) and supernatants (n = 42), and plasma samples (n = 76). Among the clonal HIV-1 variants and MT-2 cell culture-derived samples, the results of the Trofile and MT-2 assays demonstrated a high degree of concordance (95% to 98%). Among consecutive plasma samples, detection of CXCR4-using virus was at or before the time of first detection by the MT-2 assay in 5/10 patients by the original Trofile assay and in 9/10 patients by the enhanced-sensitivity Trofile assay. Differences in the time to the first detection of CXCR4 use between the MT-2 assay (PBMCs) and the original Trofile assay (plasma) were greatly reduced by the enhanced-sensitivity Trofile assay, suggesting that sensitivity for the detection of minor CXCR4-using variants may be a more important determinant of discordant findings than compartmentalization. The similarities in performance of the enhanced-sensitivity Trofile and MT-2 assays suggest that either may be an appropriate methodology to define tropism in patient specimens. PMID:19687240

Comparison of human immunodeficiency virus type 1 tropism profiles in clinical samples by the Trofile and MT-2 assays.

PubMed

Coakley, Eoin; Reeves, Jacqueline D; Huang, Wei; Mangas-Ruiz, Marga; Maurer, Irma; Harskamp, Agnes M; Gupta, Soumi; Lie, Yolanda; Petropoulos, Christos J; Schuitemaker, Hanneke; van 't Wout, Angélique B

2009-11-01

The recent availability of CCR5 antagonists as anti-human immunodeficiency virus (anti-HIV) therapeutics has highlighted the need to accurately identify CXCR4-using variants in patient samples when use of this new drug class is considered. The Trofile assay (Monogram Biosciences) has become the method that is the most widely used to define tropism in the clinic prior to the use of a CCR5 antagonist. By comparison, the MT-2 assay has been used since early in the HIV epidemic to define tropism in clinical specimens. Given that there are few data from direct comparisons of these two assays, we evaluated the performance of the plasma-based Trofile assay and the peripheral blood mononuclear cell (PBMC)-based MT-2 assay for the detection of CXCR4 use in defining the tropism of HIV isolates derived from clinical samples. The various samples used for this comparison were derived from participants of the Amsterdam Cohort Studies on HIV infection and AIDS who underwent consecutive MT-2 assay testing of their PBMCs at approximately 3-month intervals. This unique sample set was specifically selected because consecutive MT-2 assays had demonstrated a shift from negative to positive in PBMCs, reflecting the first emergence of CXCR4-using virus in PBMCs above the level of detection of the assay in these individuals. Trofile testing was performed with clonal HIV type 1 (HIV-1) variants (n = 21), MT-2 cell culture-derived cells (n = 20) and supernatants (n = 42), and plasma samples (n = 76). Among the clonal HIV-1 variants and MT-2 cell culture-derived samples, the results of the Trofile and MT-2 assays demonstrated a high degree of concordance (95% to 98%). Among consecutive plasma samples, detection of CXCR4-using virus was at or before the time of first detection by the MT-2 assay in 5/10 patients by the original Trofile assay and in 9/10 patients by the enhanced-sensitivity Trofile assay. Differences in the time to the first detection of CXCR4 use between the MT-2 assay (PBMCs) and the original Trofile assay (plasma) were greatly reduced by the enhanced-sensitivity Trofile assay, suggesting that sensitivity for the detection of minor CXCR4-using variants may be a more important determinant of discordant findings than compartmentalization. The similarities in performance of the enhanced-sensitivity Trofile and MT-2 assays suggest that either may be an appropriate methodology to define tropism in patient specimens.

Adaption of the temporal correlation coefficient calculation for temporal networks (applied to a real-world pig trade network).

PubMed

Büttner, Kathrin; Salau, Jennifer; Krieter, Joachim

2016-01-01

The average topological overlap of two graphs of two consecutive time steps measures the amount of changes in the edge configuration between the two snapshots. This value has to be zero if the edge configuration changes completely and one if the two consecutive graphs are identical. Current methods depend on the number of nodes in the network or on the maximal number of connected nodes in the consecutive time steps. In the first case, this methodology breaks down if there are nodes with no edges. In the second case, it fails if the maximal number of active nodes is larger than the maximal number of connected nodes. In the following, an adaption of the calculation of the temporal correlation coefficient and of the topological overlap of the graph between two consecutive time steps is presented, which shows the expected behaviour mentioned above. The newly proposed adaption uses the maximal number of active nodes, i.e. the number of nodes with at least one edge, for the calculation of the topological overlap. The three methods were compared with the help of vivid example networks to reveal the differences between the proposed notations. Furthermore, these three calculation methods were applied to a real-world network of animal movements in order to detect influences of the network structure on the outcome of the different methods.

Bleeding pattern and user satisfaction in second consecutive levonorgestrel-releasing intrauterine system users: results of a prospective 5-year study

PubMed Central

Heikinheimo, O.; Inki, P.; Schmelter, T.; Gemzell-Danielsson, K.

2014-01-01

STUDY QUESTION What is the bleeding pattern during second consecutive levonorgestrel-releasing intrauterine system (LNG-IUS) use? SUMMARY ANSWER Consecutive use of LNG-IUS is associated with a predictable bleeding pattern, characterized by the absence of the initial period of irregular bleeding seen after interval insertion of an LNG-IUS and a non-bleeding pattern in the vast majority of women. WHAT IS KNOWN ALREADY With increased popularity of the LNG-IUS for long-term birth control and treatment of heavy menstrual bleeding (HMB), consecutive use of the system is becoming more frequent. One previous study showed 60% amenorrhea rate in consecutive IUS users; however, the sample size was small. STUDY DESIGN, SIZE, DURATION A prospective multicenter study in four European countries recruited women who wished to continue with LNG-IUS use immediately after the first 5-year period. A total of 204 women were followed up until the end of the first year of the second IUS. Thereafter 170 women continued into the extension phase of the study up to the full 5 years of use of the second IUS and 144 women continued to the end of the study. PARTICIPANTS, SETTING, METHODS A total of 170 women (mean age 39 years) who had been using their first LNG-IUS for between 4 years 3 months and 4 years 9 months, either for contraception or for treatment of HMB, and who planned to replace the device with a new LNG-IUS, were recruited and followed up to 5 years of the second IUS use. A total of 17 centers in four European countries were involved in the study. Bleeding patterns were analyzed using daily bleeding diaries using 90-day reference periods (RP) for the first year of the second IUS use and for the last RP of each year during Years 2–5 of use. MAIN RESULTS AND THE ROLE OF CHANCE Approximately 70% of women were free of bleeding during Years 2–5 and up to 49% were amenorrheic. There was a slight increase in the number of bleeding/spotting days of ∼3 days during the first RP immediately after the placement of the second IUS, whereafter the number of bleeding/spotting days returned to the level preceding the second IUS insertion or below that. Absence of bleeding was associated with high overall satisfaction and continuation rates. No serious adverse events assessed as related to the LNG-IUS use occurred during the 5-year period. The cumulative expulsion rate during the 5-year study period was 1.2%. The sample size was large enough to study bleeding patterns, and subjects are likely to represent typical consecutive IUS users, and therefore, the role of chance is small. LIMITATIONS, REASONS FOR CAUTION The women represent a selected group as they had already successfully used their first IUS for almost 5 years and were willing to continue its use—however, this is currently a common clinical situation. The results may therefore not be extrapolated to first-time users of the LNG-IUS. WIDER IMPLICATIONS OF THE FINDINGS These data are of importance when counseling women who are making decisions concerning long-term contraception. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Bayer Pharma AG. P.I. and T.S. are full-time employees of Bayer Pharma AG. O.H. and K. G-D. have received consultancy fees from Bayer Pharma AG. The publication was developed jointly by all authors without third-party involvement and no honoraria were paid for any authors for their contribution to this manuscript. TRIAL REGISTRATION NUMBER NCT00393198. PMID:24682613

Reducing Surface Clutter in Cloud Profiling Radar Data

NASA Technical Reports Server (NTRS)

Tanelli, Simone; Pak, Kyung; Durden, Stephen; Im, Eastwood

2008-01-01

An algorithm has been devised to reduce ground clutter in the data products of the CloudSat Cloud Profiling Radar (CPR), which is a nadir-looking radar instrument, in orbit around the Earth, that measures power backscattered by clouds as a function of distance from the instrument. Ground clutter contaminates the CPR data in the lowest 1 km of the atmospheric profile, heretofore making it impossible to use CPR data to satisfy the scientific interest in studying clouds and light rainfall at low altitude. The algorithm is based partly on the fact that the CloudSat orbit is such that the geodetic altitude of the CPR varies continuously over a range of approximately 25 km. As the geodetic altitude changes, the radar timing parameters are changed at intervals defined by flight software in order to keep the troposphere inside a data-collection time window. However, within each interval, the surface of the Earth continuously "scans through" (that is, it moves across) a few range bins of the data time window. For each radar profile, only few samples [one for every range-bin increment ((Delta)r = 240 m)] of the surface-clutter signature are available around the range bin in which the peak of surface return is observed, but samples in consecutive radar profiles are offset slightly (by amounts much less than (Delta)r) with respect to each other according to the relative change in geodetic altitude. As a consequence, in a case in which the surface area under examination is homogenous (e.g., an ocean surface), a sequence of consecutive radar profiles of the surface in that area contains samples of the surface response with range resolution (Delta)p much finer than the range-bin increment ((Delta)p << r). Once the high-resolution surface response has thus become available, the profile of surface clutter can be accurately estimated by use of a conventional maximum-correlation scheme: A translated and scaled version of the high-resolution surface response is fitted to the observed low-resolution profile. The translation and scaling factors that optimize the fit in a maximum-correlation sense represent (1) the true position of the surface relative to the sampled surface peak and (2) the magnitude of the surface backscatter. The performance of this algorithm has been tested on CloudSat data acquired over an ocean surface. A preliminary analysis of the test data showed a surface-clutter-rejection ratio over flat surfaces of >10 dB and a reduction of the contaminated altitude over ocean from about 1 km to about 0.5 km (over the ocean). The algorithm has been embedded in CloudSat L1B processing as of Release 04 (July 2007), and the estimated flat surface clutter is removed in L2B-GEOPROF product from the observed profile of reflectivity (see CloudSat product documentation for details and performance at http://www.cloudsat.cira.colostate.edu/ dataSpecs.php?prodid=1).

Factors associated with favorable response to hyperbaric oxygen therapy among patients presenting with iatrogenic cerebral arterial gas embolism.

PubMed

Tekle, Wondwossen G; Adkinson, Cheryl D; Chaudhry, Saqib A; Jadhav, Vikram; Hassan, Ameer E; Rodriguez, Gustavo J; Qureshi, Adnan I

2013-04-01

Iatrogenic cerebral arterial gas embolism (CAGE) is an uncommon but potentially a fatal condition. Hyperbaric oxygen (HBO2) therapy is the only definitive treatment for patients with CAGE presenting with acute neurologic deficits. We reviewed medical records and neuroimaging of consecutive CAGE patients treated with HBO2 at a state referral hyperbaric facility over a 22-year period. We analyzed the effect of demographics, source of intra-arterial gas, signs and symptoms, results of imaging studies, time between event and HBO2 treatment, and response to HBO2 treatment in 36 consecutive patients. Favorable outcome was defined by complete resolution or improvement of CAGE signs and symptoms at 24 h after HBO2 treatment. Unfavorable outcome was defined by unchanged or worsened neurologic signs and symptoms or in hospital death. A total of 26 (72%) of the 36 patients had favorable outcome. Patients with favorable outcome were younger compared to those with unfavorable outcome (mean age [years, SD] 44.7 ± 17.8 vs. 58.1 ± 24.1, p = 0.08). Cardiopulmonary symptoms were significantly more common in CAGE related to venous source of gas compared to arterial source (p = 0.024) but did not influence the rate of favorable outcomes. Adjusted multivariate analysis demonstrated that time from event to HBO2 ≤ 6 h (positively) and the presence of infarct/edema on head computerized tomography (CT)/magnetic resonance imaging (MRI) before HBO2 (negatively) were independent predictors of favorable outcome at 24 h after HBO2 treatment [odds ratio (OR) 9.08 confidence interval (CI) (1.13-72.69), p = 0.0376, and (OR) 0.034 (CI) (0.002-0.58), p = 0.0200, respectively]. Two of the 36 patients were treated with thrombolytics because of acute focal deficits and suspected ischemia-one with intravenous and the second with intra-arterial thrombolysis. The latter patient developed fatal intracerebral hemorrhage. A high proportion of CAGE patients treated with HBO2 had favorable outcomes. Time-to-HBO2 ≤ 6 h increased the odds of favorable outcome, whereas the presence of infarct/edema on CT/MRI scan before HBO2 reduced the odds of a favorable outcome. Timely diagnosis and differentiation from thrombo-embolic ischemic events appears to be an important determinant of successful HBO2 treatment.

Inappropriately Timed Pediatric Orthopaedic Referrals From the Emergency Department Result in Unnecessary Appointments and Financial Burden for Patients.

PubMed

Jackson, Taylor J; Blumberg, Todd J; Shah, Apurva S; Sankar, Wudbhav N

2018-03-01

Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. We sought to elucidate the cost of premature musculoskeletal follow-up visits to the patients, families, and the health care system. We performed a retrospective review of pediatric patients with acute musculoskeletal injuries referred from our ED (without a formal orthopaedic consult) to our outpatient clinic. Patients were retrospectively reviewed in a consecutive fashion. The appropriateness of the recommended follow-up time interval was determined for each patient, and the direct and indirect cost of the inappropriate services were calculated utilizing a combination of traditional cost accounting techniques and time-driven activity-based costing. The characteristics of patients with appropriate and untimely follow-up referrals were compared. Two hundred consecutive referrals from the ED were reviewed. Overall, 96.5% of the follow-up visits recommended by the ED were premature, which led 106 (53%) patients to require a second visit to complete their clinical care. Patients who required a second visit were significantly younger (P=0.005), more likely to be male (P=0.042), more likely to have a fracture (P<0.001), and less likely to have a sprain (P<0.001) or dislocation/subluxation (P<0.001). Over 40% of second visits were accounted for by 3 diagnoses (distal radius buckle fractures, nondisplaced Salter-Harris 1 fractures of the ankle, and buckle fractures of the finger). Across the whole cohort, the total financial impact of untimely visits was $36,265.78, representing an average cost of $342.93 per patient. Untimely referrals for follow-up of acute pediatric musculoskeletal conditions are very common and represent a significant financial burden to patients, families, and the health care system. Over 40% of unnecessary visits resulted from just 3 diagnoses. Improved orthopaedic follow-up guidelines, particularly for these readily recognizable conditions, and feedback to referring providers may reduce poorly timed clinic visits and decrease costs in the treatment of common orthopaedic injuries in pediatric patients. Level III.

Salvage HDR Brachytherapy for Recurrent Prostate Cancer After Previous Definitive Radiation Therapy: 5-Year Outcomes

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

Chen, Chien Peter; Weinberg, Vivian; Shinohara, Katsuto

Purpose: Evaluate efficacy and toxicity of salvage high-dose-rate brachytherapy (HDRB) for locally recurrent prostate cancer after definitive radiation therapy (RT). Methods and Materials: We retrospectively analyzed 52 consecutively accrued patients undergoing salvage HDRB between 1998 and 2009 for locally recurrent prostate cancer after previous definitive RT. After pathologic confirmation of locally recurrent disease, patients received 36 Gy in 6 fractions. Twenty-four patients received neoadjuvant hormonal therapy before salvage, and no patients received adjuvant hormonal therapy. Determination of biochemical failure after salvage HDRB was based on the Phoenix definition. Overall survival (OS) and bF distributions were calculated using the Kaplan-Meier method.more » Univariate analyses were performed to identify predictors of biochemical control. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities, based on Common Terminology Criteria for Adverse Events (version 4), were documented. Results: Median follow-up after salvage HDRB was 59.6 months. The 5-year OS estimate was 92% (95% confidence interval [CI]: 80%-97%) with median survival not yet reached. Five-year biochemical control after salvage was 51% (95% CI: 34%-66%). Median PSA nadir postsalvage was 0.1 (range: 0-7.2) reached at a median of 10.2 months after completing HDRB. As for complications, acute and late grade 3 GU toxicities were observed in only 2% and 2%, respectively. No grade 2 or higher acute GI events and 4% grade 2 GI late events were observed. On univariate analysis, disease-free interval after initial definitive RT (P=.07), percent of positive cores at the time of diagnosis (P=.08), interval from first recurrence to salvage HDRB (P=.09), and pre-HDRB prostate-specific antigen (P=.07) were each of borderline significance in predicting biochemical control after salvage HDRB. Conclusions: Prostate HDRB is an effective salvage modality with relatively few long-term toxicities. We provide potential predictors of biochemical control for prostate salvage HDRB.« less

Burden of Intracranial Atherosclerosis Is Associated With Long-Term Vascular Outcome in Patients With Ischemic Stroke.

PubMed

Kim, Byung-Su; Chung, Pil-Wook; Park, Kwang-Yeol; Won, Hong-Hee; Bang, Oh Young; Chung, Chin-Sang; Lee, Kwang Ho; Kim, Gyeong-Moon

2017-10-01

Ischemic stroke patients often have intracranial atherosclerosis (ICAS), despite heterogeneity in the cause of stroke. We tested the hypothesis that ICAS burden can independently reflect the risk of long-term vascular outcome. This was a retrospective cohort study analyzing data from a prospective stroke registry enrolling consecutive patients with acute ischemic stroke or transient ischemic attack. A total of 1081 patients were categorized into no ICAS, single ICAS, and advanced ICAS (ICAS ≥2 different intracranial arteries) groups. Primary and secondary end points were time to occurrence of recurrent ischemic stroke and composite vascular outcome, respectively. Study end points by ICAS burden were compared using Cox proportional hazards models in overall and propensity-matched patients. ICAS was present in 405 patients (37.3%). During a median 5-year follow-up, recurrent stroke and composite vascular outcome occurred in 6.8% and 16.8% of patients, respectively. As the number of ICAS increased, the risk for study end points increased after adjustment of potential covariates (hazard ratio per 1 increase in ICAS, 1.19; 95% confidence interval, 1.01-1.42 for recurrent ischemic stroke and hazard ratio, 1.18; 95% confidence interval, 1.05-1.33 for composite vascular outcome). The hazard ratios (95% confidence interval) for recurrent stroke and composite vascular outcome in patients with advanced ICAS compared with those without ICAS were 1.56 (0.88-2.74) and 1.72 (1.17-2.53), respectively, in the overall patients. The corresponding values in the propensity-matched patients were 1.28 (0.71-2.30) and 1.95 (1.27-2.99), respectively. ICAS burden was independently associated with the risk of subsequent composite vascular outcome in patients with ischemic stroke. These findings suggest that ICAS burden can reflect the risk of long-term vascular outcome. © 2017 American Heart Association, Inc.

The climatic characteristics of extreme precipitations for short-term intervals in the watershed of Lake Maggiore

NASA Astrophysics Data System (ADS)

Saidi, Helmi; Ciampittiello, Marzia; Dresti, Claudia; Ghiglieri, Giorgio

2013-07-01

Alpine and Mediterranean areas are undergoing a profound change in the typology and distribution of rainfall. In particular, there has been an increase in consecutive non-rainy days, and an escalation of extreme rainy events. The climatic characteristic of extreme precipitations over short-term intervals is an object of study in the watershed of Lake Maggiore, the second largest freshwater basin in Italy (located in the north-west of the country) and an important resource for tourism, fishing and commercial flower growing. The historical extreme rainfall series with high-resolution from 5 to 45 min and above: 1, 2, 3, 6, 12 and 24 h collected at different gauges located at representative sites in the watershed of Lake Maggiore, have been computed to perform regional frequency analysis of annual maxima precipitation based on the L-moments approach, and to produce growth curves for different return-period rainfall events. Because of different rainfall-generating mechanisms in the watershed of Lake Maggiore such as elevation, no single parent distribution could be found for the entire study area. This paper concerns an investigation designed to give a first view of the temporal change and evolution of annual maxima precipitation, focusing particularly on both heavy and extreme events recorded at time intervals ranging from few minutes to 24 h and also to create and develop an extreme storm precipitation database, starting from historical sub-daily precipitation series distributed over the territory. There have been two-part changes in extreme rainfall events occurrence in the last 23 years from 1987 to 2009. Little change is observed in 720 min and 24-h precipitations, but the change seen in 5, 10, 15, 20, 30, 45, 60, 120, 180 and 360 min events is significant. In fact, during the 2000s, growth curves have flattened and annual maxima have decreased.

Subclinical hyperthyroidism is a risk factor for poor functional outcome after ischemic stroke.

PubMed

Wollenweber, Frank Arne; Zietemann, Vera; Gschwendtner, Andreas; Opherk, Christian; Dichgans, Martin

2013-05-01

Subclinical hyperthyroidism is associated with adverse cardiovascular events, including stroke and atrial fibrillation. However, its impact on functional outcome after stroke remains unexplored. A total of 165 consecutively recruited patients admitted for ischemic stroke were included in this observational prospective study. Blood samples were taken in the morning within 3 days after symptom onset, and patients were divided into the following 3 groups: subclinical hyperthyroidism (0.1< thyroid-stimulating hormone ≤ 0.44 μU/mL), subclinical hypothyroidism (2.5 ≤ thyroid-stimulating hormone <20 μU/mL), and euthyroid state (0.44< thyroid-stimulating hormone <2.5 μU/mL). Patients with overt thyroid dysfunction were excluded. Follow-up took place 3 months after stroke. Primary outcome was functional disability (modified Rankin Scale), and secondary outcome was level of dependency (Barthel Index). Ordinal logistic regression analysis was used to adjust for possible confounders. Variables previously reported to be affected by thyroid function, such as atrial fibrillation, total cholesterol, or body mass index, were included in an additional model. Nineteen patients (11.5%) had subclinical hyperthyroidism, and 23 patients (13.9%) had subclinical hypothyroidism. Patients with subclinical hyperthyroidism had a substantially increased risk of functional disability 3 months after stroke compared with subjects with euthyroid state (odds ratio, 2.63; 95% confidence interval, 1.02-6.82, adjusted for age, sex, smoking status, and time of blood sampling). The association remained significant, when including the baseline NIHSS, TIA, serum CRP, atrial fibrillation, body mass index, and total cholesterol as additional variables (odds ratio, 3.95; 95% confidence interval, 1.25-12.47), and was confirmed by the secondary outcome (Barthel Index: odds ratio, 9.12; 95% confidence interval, 2.08-39.89). Subclinical hyperthyroidism is a risk factor for poor outcome 3 months after ischemic stroke.

Reducing time delays in the management of ischemic stroke patients in Northern Italy.

PubMed

Vidale, Simone; Arnaboldi, Marco; Bezzi, Giacomo; Bono, Giorgio; Grampa, Giampiero; Guidotti, Mario; Perrone, Patrizia; Salmaggi, Andrea; Zarcone, Davide; Zoli, Alberto; Agostoni, Elio

2016-07-15

Thrombolysis represents the best therapy for ischemic stroke but the main limitation of its administration is time. The avoidable delay is a concept reflecting the effectiveness of management pathway. For this reason, we projected a study concerning the detection of main delays with following introduction of corrective factors. In this paper we describe the results after these corrections. Consecutive patients admitted for ischemic stroke during a 3-months period to 35 hospitals of a macro-area of Northern Italy were enrolled. Each time of management was registered, identifying three main intervals: pre-hospital, in-hospital and total times. Previous corrective interventions were: 1.increasing of population awareness to use the Emergency Medical Service (EMS); 2.pre-notification of Emergency Department; 3.use of high urgency codes; 4.use of standardised operational algorithm. Statistical analysis was conducted using time-to-event analysis and Cox proportional hazard regression. 1084 patients were enrolled. EMS was alerted for 56.3% of subjects, mainly in females and severe strokes (p<0.001). Thrombolytic treatment was performed in 4.7% of patients. Median pre-hospital and in-hospital times were 113 and 105min, while total time was 240. High urgency codes at transport contributed to reduce pre-hospital and in-hospital time (p<0.05). EMS use and high urgency codes promoted thrombolysis. Treatment within 4.5hours from symptom onset was performed in 14% of patients more than the first phase of study. The implementation of an organizational system based on EMS and concomitant high urgency codes use was effective to reduce avoidable delay and to increase thrombolysis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Technical Performance Scores are strongly associated with early mortality, postoperative adverse events, and intensive care unit length of stay-analysis of consecutive discharges for 2 years.

PubMed

Nathan, Meena; Karamichalis, John; Liu, Hua; Gauvreau, Kimberley; Colan, Steven; Saia, Matthew; Pigula, Frank; Fynn-Thompson, Francis; Emani, Sitaram; Baird, Christopher; Mayer, John E; del Nido, Pedro J

2014-01-01

Previous work in our institution has indicated that the Technical Performance Score (TPS) is highly associated with early outcomes in select subsets of procedures and age groups. We hypothesized that the TPS could predict early outcomes in a wide range of diagnoses and age groups. Consecutive patients discharged from January 2011 to March 2013 were prospectively evaluated. The TPS was assigned according to the discharge echocardiographic findings and the need for reinterventions in the anatomic area of interest. Case complexity was determined using Risk Adjustment for Congenital Heart Surgery (RACHS-1) categories. Early mortality and postoperative adverse events were recorded. Relationships between the TPS and outcomes were assessed after adjusting for the baseline patient characteristics. The median age of the 1926 patients was 1.8 years (range, 0 days to 68 years). Bypass was used in 1740 (90%); 322 (17%) were neonates, 520 (27%) infants, 873 (45%) children, 211 (11%) adults. TPS was class 1 (optimal) in 956 (50%), class 2 (adequate) in 584 (30%), and class 3 (inadequate) in 226 (12%); 160 patients (8%) could not be scored. A total of 51 early deaths (2.6%) and 111 adverse events (5.7%) occurred. On univariate analysis, age, RACHS-1 category, and TPS were significantly associated with mortality and the occurrence of adverse events. On multivariate modeling, class 3 (inadequate) TPS was strongly associated with mortality (odds ratio, 16.9; 95% confidence interval, 6.7-42.9; P < .001), adverse events (odds ratio, 6.9; 95% confidence interval, 4.1-11.6; P < .001), and postoperative intensive care unit length of stay (coefficient, 2.3; 95% confidence interval, 2.0-2.6; P < .001) after adjusting for other covariates. The TPS is strongly associated with early outcomes across a wide range of ages and disease complexity and can serve as important tool for self-assessment and quality improvement. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

A reformed surgical treatment modality for children with giant cystic craniopharyngioma.

PubMed

Zhu, Wanchun; Li, Xiang; He, Jintao; Sun, Tao; Li, Chunde; Gong, Jian

2017-09-01

Surgical removal plays an important role in treating children's craniopharyngioma. For a safe and minimally invasive craniotomy, a reformed surgical modality was proposed in this paper by combining the insertion of an Ommaya reservoir system (ORS) by stereotactic puncture, aspiration of cystic fluid in 2-day interval for consecutive 7-10 days, and the delayed tumor resection. Eleven patients (aged from 5 to 9 years old) with giant cystic craniopharyngiomas who had undergone the reformed surgical modality during November 2014 and December 2015 were collected as group A. In contrast, seven patients (aged from 5 to 11 years old) who had undergone the traditional directed operation without any prior management from January 2014 to October 2014 were collected into group B. A retrospective analysis was performed for both groups at one institution. The preoperative and postoperative clinical presentations, neuroimaging, early postoperative outcome, and the surgery-related complications of both groups were reviewed. For group A, the mean value of the maximum tumor diameters shank from 52.36 to 23.82 mm after implementing aspiration of the cystic fluid in 1-day interval for consecutive 8.23 days. Eight patients (72.73%) in group A underwent a gross total resection (GTR), while two (28.57%) patients underwent GTR in group B. The postoperative electrolyte disturbance rate and endocrine disorder rate of group B were significantly higher than those of group A (42.86 vs 36.36%; 71.43 vs 45.45%). Postoperative long-term diabetes insipidus only occurred in one patient of group B, and postoperative visual deterioration occurred in two patients of group B. Besides, one patient of group B died of severe postoperative hypothalamus dysfunction. Patients with residual tumors were applied with additional adjuvant radiotherapy, and no recurrence was observed in follow-up examinations. A favorable outcome can be achieved by combining the insertion of an ORS by stereotactic puncture, aspiration of cystic fluid in 2-day interval for continuously 7-10 days, and the delayed tumor resection. This combined treatment modality maybe an effective method to treat children with giant cystic craniopharyngiomas.

Effect of Tumor Complexity and Technique on Efficacy and Complications after Percutaneous Microwave Ablation of Stage T1a Renal Cell Carcinoma: A Single-Center, Retrospective Study.

PubMed

Klapperich, Marki E; Abel, E Jason; Ziemlewicz, Timothy J; Best, Sara; Lubner, Meghan G; Nakada, Stephen Y; Hinshaw, J Louis; Brace, Christopher L; Lee, Fred T; Wells, Shane A

2017-07-01

Purpose To evaluate the effects of tumor complexity and technique on early and midterm oncologic efficacy and rate of complications for 100 consecutive biopsy-proved stage T1a renal cell carcinomas (RCCs) treated with percutaneous microwave ablation. Materials and Methods This HIPAA-compliant, single-center retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived. Ninety-six consecutive patients (68 men, 28 women; mean age, 66 years ± 9.4) with 100 stage T1a N0M0 biopsy-proved RCCs (median diameter, 2.6 cm ± 0.8) underwent percutaneous microwave ablation between March 2011 and June 2015. Patient and procedural data were collected, including body mass index, comorbidities, tumor histologic characteristics and grade, RENAL nephrometry score, number of antennas, generator power, and duration of ablation. Technical success, local tumor progression, and presence of complications were assessed at immediate and follow-up imaging. The Kaplan-Meier method was used for survival analyses. Results Technical success was achieved for all 100 tumors (100%), including 47 moderately and five highly complex RCCs. Median clinical and imaging follow-up was 17 months (range, 0-48 months) and 15 months (range, 0-44 months), respectively. No change in estimated glomerular filtration rate was noted after the procedure (P = .49). There were three (3%) procedure-related complications and six (6%) delayed complications, all urinomas. One case of local tumor progression (1%) was identified 25 months after the procedure. Three-year local progression-free survival, cancer-specific survival, and overall survival were 88% (95% confidence interval: 0.52%, 0.97%), 100% (95% confidence interval: 1.0%, 1.0%), and 91% (95% confidence interval: 0.51%, 0.99%), respectively. Conclusion Percutaneous microwave ablation is an effective and safe treatment option for stage T1a RCC, regardless of tumor complexity. Long-term follow-up is needed to establish durable oncologic efficacy and survival relative to competing ablation modalities and surgery. © RSNA, 2017.

49 CFR 395.1 - Scope of rules in this part.

Code of Federal Regulations, 2010 CFR

2010-10-01

... from work within 12 consecutive hours; (iii)(A) A property-carrying commercial motor vehicle driver has...-berth and off-duty time amounting to at least 10 hours; or (4) The equivalent of at least 10 consecutive... paragraph (g)(1)(i)(A)(1) through (4) of this section; and (C) May not drive after the 14th hour after...

49 CFR 395.3 - Maximum driving time for property-carrying vehicles.

Code of Federal Regulations, 2010 CFR

2010-10-01

... on duty 60 hours in any period of 7 consecutive days if the employing motor carrier does not operate commercial motor vehicles every day of the week; or (2) Having been on duty 70 hours in any period of 8 consecutive days if the employing motor carrier operates commercial motor vehicles every day of the week. (c...

Comparing the Effectiveness of Two Models of Initial Teacher Education Programmes in Israel: Concurrent vs. Consecutive

ERIC Educational Resources Information Center

Zuzovsky, Ruth; Donitsa-Schmidt, Smadar

2017-01-01

The purpose of the present study was to examine the effectiveness of two common models of initial teacher education programmes that are prevalent in many countries, including Israel. The two are: the concurrent model, in which disciplinary studies and pedagogical studies are integrated and taught at the same time; and the consecutive model, which…

Intact Interval Timing in Circadian CLOCK Mutants

PubMed Central

Cordes, Sara; Gallistel, C. R.

2008-01-01

While progress has been made in determining the molecular basis for the circadian clock, the mechanism by which mammalian brains time intervals measured in seconds to minutes remains a mystery. An obvious question is whether the interval timing mechanism shares molecular machinery with the circadian timing mechanism. In the current study, we trained circadian CLOCK +/− and −/− mutant male mice in a peak-interval procedure with 10 and 20-s criteria. The mutant mice were more active than their wild-type littermates, but there were no reliable deficits in the accuracy or precision of their timing as compared with wild-type littermates. This suggests that expression of the CLOCK protein is not necessary for normal interval timing. PMID:18602902

Conducted electrical weapon (TASER) use against minors: a shocking analysis.

PubMed

Gardner, Alison R; Hauda, William E; Bozeman, William P

2012-09-01

Conducted electrical weapons (CEWs) such as the TASER are often used by law enforcement (LE) personnel during suspect apprehension. Previous studies have reported an excellent safety profile and few adverse outcomes with CEW use in adults. We analyzed the safety and injury profile of CEWs when used during LE apprehension of children and adolescents, a potentially vulnerable population. Consecutive CEW uses by LE officers against criminal suspects were tracked at 10 LE agencies and entered into a database as part of an ongoing multicenter injury surveillance program. All CEW uses against minors younger than 18 years were retrieved for analysis. Primary outcomes included the incidence and type of mild, moderate, and severe CEW-related injury, as assessed by physician reviewers in each case. Ultimate outcomes, suspect demographics, and circumstances surrounding LE involvement are reported secondarily. Of 2026 consecutive CEW uses, 100 (4.9%) were uses against minor suspects. Suspects ranged from 13 to 17 years, with a mean age of 16.1 (SD, 0.99) years (median, 16 years). There were no significant (moderate or severe) injuries reported (0%; 97.5% confidence interval, 0.0%-3.6%). Twenty suspects (20%; 95% confidence interval, 12.7%-29.1%) were noted to sustain 34 mild injuries. The majority of these injuries (67.6%) were expected superficial punctures from CEW probes. Other mild injuries included superficial abrasions and contusions in 7 cases (7%). None of the minor suspects studied sustained significant injury, and only 20% reported minor injuries, mostly from the expected probe puncture sites. These data suggest that adolescents are not at a substantially higher risk than adults for serious injuries after CEW use.

Post-thyroidectomy complications. The role of the device: bipolar vs ultrasonic device: Collection of data from 1,846 consecutive patients undergoing thyroidectomy.

PubMed

De Palma, Maurizio; Rosato, Ludovico; Zingone, Fabiana; Orlando, Giulio; Antonino, Antonio; Vitale, Mario; Puzziello, Alessandro

2016-07-01

Specific complications after thyroid surgery, such as recurrent laryngeal nerve injury (RLN) or hypoparathyroidism, are feared because they may give rise to a lifelong disability for the patient. The aim of this study was to evaluate the possible association between the types of device used (bipolar vs ultrasound-based harmonic scalpel defined Harmonic Focus) and major postoperative complications. During a 1-year period, between October 2010 and October 2011, Italian Endocrine Surgery Units affiliated with the Italian Endocrine Surgery Units Association collected data on all consecutive patients older than 18 years who had undergone primary total thyroidectomy, near total thyroidectomy, and completion thyroidectomy. The data were included in a dataset, listing demographic variables, details on the surgical procedure, and 2 major complications of the thyroid surgery: postoperative RLN palsy/hypomobility and hypocalcemia. Our population comprised 1,846 subjects (78.6% women, median age 52 years). Six hundred four (32.7%) subjects underwent thyroidectomy by bipolar forceps and 1,242 (67.3%) by ultrasonic device. The risk of hypocalcemia in subjects undergoing thyroidectomy by ultrasonic device was similar to those undergoing thyroidectomy by bipolar after adjusting for sex, type of thyroidectomy, and central lymphadenectomy (odds ratio .94, 95% confidence interval .76 to 1.17). Subjects who underwent thyroidectomy by ultrasonic device had a lower risk of RLN paralysis compared with those undergoing thyroidectomy by bipolar forceps also after adjusting for central lymphadenectomy (odds ratio .39, 95% confidence interval .2 to .7). This multicenter study acknowledges the value of the ultrasonic device as a protective factor only for RLN palsy, confirming nodal dissection as a risk factor for postoperative hypocalcemia and vocal folds disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

Hawk Eyes II: Diurnal Raptors Differ in Head Movement Strategies When Scanning from Perches

PubMed Central

O'Rourke, Colleen T.; Pitlik, Todd; Hoover, Melissa; Fernández-Juricic, Esteban

2010-01-01

Background Relatively little is known about the degree of inter-specific variability in visual scanning strategies in species with laterally placed eyes (e.g., birds). This is relevant because many species detect prey while perching; therefore, head movement behavior may be an indicator of prey detection rate, a central parameter in foraging models. We studied head movement strategies in three diurnal raptors belonging to the Accipitridae and Falconidae families. Methodology/Principal Findings We used behavioral recording of individuals under field and captive conditions to calculate the rate of two types of head movements and the interval between consecutive head movements. Cooper's Hawks had the highest rate of regular head movements, which can facilitate tracking prey items in the visually cluttered environment they inhabit (e.g., forested habitats). On the other hand, Red-tailed Hawks showed long intervals between consecutive head movements, which is consistent with prey searching in less visually obstructed environments (e.g., open habitats) and with detecting prey movement from a distance with their central foveae. Finally, American Kestrels have the highest rates of translational head movements (vertical or frontal displacements of the head keeping the bill in the same direction), which have been associated with depth perception through motion parallax. Higher translational head movement rates may be a strategy to compensate for the reduced degree of eye movement of this species. Conclusions Cooper's Hawks, Red-tailed Hawks, and American Kestrels use both regular and translational head movements, but to different extents. We conclude that these diurnal raptors have species-specific strategies to gather visual information while perching. These strategies may optimize prey search and detection with different visual systems in habitat types with different degrees of visual obstruction. PMID:20877650

Hawk eyes II: diurnal raptors differ in head movement strategies when scanning from perches.

PubMed

O'Rourke, Colleen T; Pitlik, Todd; Hoover, Melissa; Fernández-Juricic, Esteban

2010-09-22

Relatively little is known about the degree of inter-specific variability in visual scanning strategies in species with laterally placed eyes (e.g., birds). This is relevant because many species detect prey while perching; therefore, head movement behavior may be an indicator of prey detection rate, a central parameter in foraging models. We studied head movement strategies in three diurnal raptors belonging to the Accipitridae and Falconidae families. We used behavioral recording of individuals under field and captive conditions to calculate the rate of two types of head movements and the interval between consecutive head movements. Cooper's Hawks had the highest rate of regular head movements, which can facilitate tracking prey items in the visually cluttered environment they inhabit (e.g., forested habitats). On the other hand, Red-tailed Hawks showed long intervals between consecutive head movements, which is consistent with prey searching in less visually obstructed environments (e.g., open habitats) and with detecting prey movement from a distance with their central foveae. Finally, American Kestrels have the highest rates of translational head movements (vertical or frontal displacements of the head keeping the bill in the same direction), which have been associated with depth perception through motion parallax. Higher translational head movement rates may be a strategy to compensate for the reduced degree of eye movement of this species. Cooper's Hawks, Red-tailed Hawks, and American Kestrels use both regular and translational head movements, but to different extents. We conclude that these diurnal raptors have species-specific strategies to gather visual information while perching. These strategies may optimize prey search and detection with different visual systems in habitat types with different degrees of visual obstruction.

Ethnic Comparison of Clinical Characteristics and Ischemic Stroke Subtypes Among Young Adult Patients With Stroke in Hawaii.

PubMed

Nakagawa, Kazuma; Ito, Cherisse S; King, Sage L

2017-01-01

Native Hawaiians and other Pacific Islanders (NHOPI) with ischemic stroke have younger age of stroke onset compared with whites. However, ethnic differences in stroke subtypes in this population have been inadequately studied. Consecutive young adult patients (aged ≤55 years) who were hospitalized for ischemic stroke between 2006 and 2012 at a tertiary center in Honolulu were studied. Clinical characteristics and stroke subtypes based on pathophysiological TOAST classification (Trial of Org 10172) of NHOPI and Asians were compared with whites. A total of 427 consecutive young adult (mean age, 46.7±7.8 years) patients (NHOPI 45%, Asians 38%, and whites 17%) were studied. NHOPI had a higher prevalence of hypertension, diabetes mellitus, prosthetic valve, higher body mass index, hemoglobin A1c, and lower high-density lipoprotein than whites (all P<0.05). Stroke subtype distribution was not different between the ethnic groups. Specifically, the prevalence of small-vessel disease was similar between NHOPI (26.6%), whites (28.4%), and Asians (24.8%). In the univariate analyses, the use of intravenous tissue-type plasminogen activator was lower among NHOPI (4.7%; P=0.01) and Asians (3.1%; P=0.002) than among whites (12.5%). In the multivariable model, NHOPI (odds ratio, 0.35; 95% confidence interval, 0.12-0.98) and Asians (odds ratio, 0.23; 95% confidence interval, 0.07-0.74) were less likely to be treated with intravenous tissue-type plasminogen activator than whites. NHOPI have greater cardiovascular risk factors than whites, but there were no differences in stroke subtypes between the ethnic groups. Furthermore, NHOPI and Asians may be less likely to be treated with intravenous tissue-type plasminogen activator than whites. © 2016 American Heart Association, Inc.

Reproducibility for Heart Rate Variability Analysis during 6-Min Walk Test in Patients with Heart Failure and Agreement between Devices.

PubMed

Braga, Lays Magalhães; Prado, Gustavo Faibischew; Umeda, Iracema Ioco Kikuchi; Kawauchi, Tatiana Satie; Taboada, Adriana Marques Fróes; Azevedo, Raymundo Soares; Pereira Filho, Horacio Gomes; Grupi, César José; Souza, Hayala Cristina Cavenague; Moreira, Dalmo Antônio Ribeiro; Nakagawa, Naomi Kondo

2016-01-01

Heart rate variability (HRV) analysis is a useful method to assess abnormal functioning in the autonomic nervous system and to predict cardiac events in patients with heart failure (HF). HRV measurements with heart rate monitors have been validated with an electrocardiograph in healthy subjects but not in patients with HF. We explored the reproducibility of HRV in two consecutive six-minute walk tests (6MW), 60-minute apart, using a heart rate monitor (PolarS810i) and a portable electrocardiograph (called Holter) in 50 HF patients (mean age 59 years, NYHA II, left ventricular ejection fraction ~35%). The reproducibility for each device was analysed using a paired t-test or the Wilcoxon signed-rank test. Additionally, we assessed the agreement between the two devices based on the HRV indices at rest, during the 6MW and during recovery using concordance correlation coefficients (CCC), 95% confidence intervals and Bland-Altman plots. The test-retest for the HRV analyses was reproducible using Holter and PolarS810i at rest but not during recovery. In the second 6MW, patients showed significant increases in rMSSD and walking distance. The PolarS810i measurements had remarkably high concordance correlation [0.86

Risk Factors to Predict Postoperative Fever After Coil Embolization of Ruptured Intracranial Aneurysms.

PubMed

Cai, Kefu; Xu, Tian; Shen, Lihua; Ni, Yaohui; Ji, Qiuhong

2016-04-01

To investigate risk factors to predict postoperative fever after endovascular treatment of ruptured intracranial aneurysms. Patients undergoing endovascular coiling to treat subarachnoid hemorrhage in Nantong University between November 2011 and September 2014 were retrospectively reviewed. Postoperative temperature and patient demographic data, admission status, characteristic features of aneurysms, and endovascular coiling procedure were documented and analyzed. There were 336 consecutive patients included in this study, and 111 were classified as febrile (tympanic temperature >38.3°C for at least 2 consecutive days). Univariate analysis demonstrated that age, interval from onset of subarachnoid hemorrhage to operation, history of hypertension and smoking, Hunt and Hess grade, Fisher grade, temperature before coiling, leukocyte count on admission, and infectious complications were correlated with postoperative fever. Five variables were independent risk factors to predict fever by multivariate logistic regression: age >70 years (odds ratio [OR] = 2.6, 95% confidence interval [CI] = 1.2-5.6), Fisher grade 3 or 4 (OR = 2.2, 95% CI = 1.1-4.3), leukocyte count >10,000/mm(3) on admission (OR = 2.3, 95% CI = 1.3-4.0), temperature >37.5°C before coiling (OR = 4.6, 95% CI = 2.0-10.7), and infectious complications (OR = 4.4, 95% CI = 2.2-8.6). Postoperative fever after coil embolization was predicted by changeable and unchangeable risk factors in subarachnoid hemorrhage. However, characteristic features of aneurysms and the coiling procedure had no impact on development of postoperative fever. Preventing any infectious complications, lowering temperature before embolization, and draining bloody cerebrospinal fluid may assist in the prevention of subsequent fever. Copyright © 2016 Elsevier Inc. All rights reserved.

Acute effects of countermovement jumping and sprinting on shot put performance.

PubMed

Terzis, Gerasimos; Karampatsos, Giorgos; Kyriazis, Thomas; Kavouras, Stavros A; Georgiadis, Giorgos

2012-03-01

The purpose of this study was to investigate the acute effects of countermovement jumping and sprinting on shot put performance in experienced shot putters. Ten shot putters (best performance 13.16-20.36 m) participated in the study. After a standard warm-up including jogging, stretching, and 4-6 submaximal puts, they performed 3 shot put attempts with maximum effort, separated with 1.5-minute interval. Three minutes later, they performed 3 maximal consecutive countermovement jumps (CMJs). Immediately after jumping, they performed 3 shot put attempts with maximum effort, separated with a 1.5-minute interval. One week later, they carried out a similar protocol, at similar external conditions, but they performed a bout of 20-m sprinting instead of the CMJs, to potentiate shot put performance. Muscular strength (1 repetition maximum in squat, snatch, bench press, incline bench press) and body composition (dual x-ray absorptiometry) were measured during the same training period (±10 days from the jumping and sprinting protocols). Shot put performance was significantly increased after the CMJs (15.45 ± 2.36 vs. 15.85 ± 2.41 m, p = 0.0003). Similarly, shot put performance was significantly increased after sprinting (15.34 ± 2.41 vs. 15.90 ± 2.46 m, p = 0.0007). The increase in performance after sprinting was significantly higher compared with the increase after jumping (2.64 ± 1.59 vs. 3.74 ± 1.88%, p = 0.02). In conclusion, the results of this study indicate that a standard warm-up protocol followed by 3 maximal bouts of shot put and either 3 consecutive countermovement jumps or a bout of 20-m sprinting induce an acute increase in shot put performance in experienced shot putters.

Working times of elastomeric impression materials determined by dimensional accuracy.

PubMed

Tan, E; Chai, J; Wozniak, W T

1996-01-01

The working times of five poly(vinyl siloxane) impression materials were estimated by evaluating the dimensional accuracy of stone dies of impressions of a standard model made at successive time intervals. The stainless steel standard model was represented by two abutments having known distances between landmarks in three dimensions. Three dimensions in the x-, y-, and z-axes of the stone dies were measured with a traveling microscope. A time interval was rejected as being within the working time if the percentage change of the resultant dies, in any dimension, was statistically different from those measured from stone dies from previous time intervals. The absolute dimensions of those dies from the rejected time interval also must have exceeded all those from previous time intervals. Results showed that the working times estimated with this method generally were about 30 seconds longer than those recommended by the manufacturers.

Mandibular growth changes and cervical vertebral maturation. a cephalometric implant study.

PubMed

Gu, Yan; McNamara, James A

2007-11-01

To evaluate mandibular dimensional changes and regional remodeling occurring during five intervals of circumpubertal growth. This investigation evaluated a unique sample of subjects in whom tantalum implants were placed into the craniofacial complex during childhood. The sample was obtained from the Mathews and Ware implant study originally conducted at the University of California San Francisco in the 1970s, with longitudinal cephalometric records of 20 subjects (13 female, 7 male) available for evaluation. Cephalograms at six consecutive stages of cervical vertebral maturation (CS1 through CS6) were analyzed. Peak mandibular growth was noted during the interval from CS3 to CS4. Forward rotation of the mandible was due to greater mandibular growth posteriorly than anteriorly. Progressive closure of the condylar-ramus-occlusal (CRO) angle resulted in a forward and upward orientation of the ramus relative to the corpus of the mandible due to increased vertical growth of the condyle. A peak in mandibular growth at puberty was substantiated. Mandibular remodeling and condylar rotation continue to occur after the growth spurt.

Preliminary report of associated factors in wound infection after major head and neck neoplasm operations--does the duration of prophylactic antibiotic matter?

PubMed

Liu, S-A; Tung, K-C; Shiao, J-Y; Chiu, Y-T

2008-04-01

The aim of this study was to investigate whether an extended course of prophylactic antibiotic could reduce the wound infection rate in a subtropical country. Fifty-three consecutive cases scheduled to receive major head and neck operations were randomised into one-day or three-day prophylactic antibiotic groups. Thirteen cases (24.5 per cent) developed wound infections after operations. The duration of prophylactic antibiotic was not related to the surgical wound infection. However, pre-operative haemoglobulin less than 10.5 g/dl (odds ratio: 7.24, 95 per cent confidence interval: 1.28-41.0) and reconstruction with a free flap or pectoris major myocutaneous flap during the operation (odds ratio: 11.04, 95 per cent confidence interval: 1.17-104.7) were associated factors significantly influencing post-operative wound infection. Therefore, one day of prophylactic antibiotic was effective in major head and neck procedures but should not be substituted for proper aseptic and meticulous surgical techniques.

Self-organized criticality in asymmetric exclusion model with noise for freeway traffic

NASA Astrophysics Data System (ADS)

Nagatani, Takashi

1995-02-01

The one-dimensional asymmetric simple-exclusion model with open boundaries for parallel update is extended to take into account temporary stopping of particles. The model presents the traffic flow on a highway with temporary deceleration of cars. Introducing temporary stopping into the asymmetric simple-exclusion model drives the system asymptotically into a steady state exhibiting a self-organized criticality. In the self-organized critical state, start-stop waves (or traffic jams) appear with various sizes (or lifetimes). The typical interval < s>between consecutive jams scales as < s> ≃ Lv with v = 0.51 ± 0.05 where L is the system size. It is shown that the cumulative jam-interval distribution Ns( L) satisfies the finite-size scaling form ( Ns( L) ≃ L- vf( s/ Lv). Also, the typical lifetime ≃ Lv‧ with v‧ = 0.52 ± 0.05. The cumulative distribution Nm( L) of lifetimes satisfies the finite-size scaling form Nm( L)≃ L-1g( m/ Lv‧).

Characterizing the response of a scintillator-based detector to single electrons.

PubMed

Sang, Xiahan; LeBeau, James M

2016-02-01

Here we report the response of a high angle annular dark field scintillator-based detector to single electrons. We demonstrate that care must be taken when determining the single electron intensity as significant discrepancies can occur when quantifying STEM images with different methods. To account for the detector response, we first image the detector using very low beam currents (∼8fA), and subsequently model the interval between consecutive single electrons events. We find that single electrons striking the detector present a wide distribution of intensities, which we show is not described by a simple function. Further, we present a method to accurately account for the electrons within the incident probe when conducting quantitative imaging. The role detector settings play on determining the single electron intensity is also explored. Finally, we extend our analysis to describe the response of the detector to multiple electron events within the dwell interval of each pixel. Copyright © 2015 Elsevier B.V. All rights reserved.

Single-channel autocorrelation functions: the effects of time interval omission.

PubMed Central

Ball, F G; Sansom, M S

1988-01-01

We present a general mathematical framework for analyzing the dynamic aspects of single channel kinetics incorporating time interval omission. An algorithm for computing model autocorrelation functions, incorporating time interval omission, is described. We show, under quite general conditions, that the form of these autocorrelations is identical to that which would be obtained if time interval omission was absent. We also show, again under quite general conditions, that zero correlations are necessarily a consequence of the underlying gating mechanism and not an artefact of time interval omission. The theory is illustrated by a numerical study of an allosteric model for the gating mechanism of the locust muscle glutamate receptor-channel. PMID:2455553

Post-exercise Ingestion of Carbohydrate, Protein and Water: A Systematic Review and Meta-analysis for Effects on Subsequent Athletic Performance.

PubMed

McCartney, Danielle; Desbrow, Ben; Irwin, Christopher

2018-02-01

Athletes may complete consecutive exercise sessions with limited recovery time between bouts (e.g. ≤ 4 h). Nutritional strategies that optimise post-exercise recovery in these situations are therefore important. This two-part review investigated the effect of consuming carbohydrate (CHO) and protein with water (W) following exercise on subsequent athletic (endurance/anaerobic exercise) performance. Studies were identified by searching the online databases SPORTDiscus, PubMed, Web of Science and Scopus. Investigations that measured endurance performance (≥ 5 min duration) ≤ 4 h after a standardised exercise bout (any type) under the following control vs. intervention conditions were included: Part 1: W vs. CHO ingested with an equal volume of W (CHO + W); and, Part 2: CHO + W vs. protein (PRO) ingested with CHO and an equal volume of W (PRO + CHO + W), where CHO or energy intake was matched. Publications were examined for bias using the Rosendal scale. Random-effects meta-analyses and meta-regression analyses were conducted to evaluate intervention efficacy. The quality assessment yielded a Rosendal score of 63 ± 9% (mean ± standard deviation). Part 1: 45 trials (n = 486) were reviewed. Ingesting CHO + W (102 ± 50 g CHO; 0.8 ± 0.6 g CHO kg -1  h -1 ) improved exercise performance compared with W (1.6 ± 0.7 L); % Δ mean power output = 4.0, 95% confidence interval 3.2-4.7 (I 2  = 43.9). Improvement was attenuated when participants were 'Fed' (a meal 2-4 h prior to the initial bout) as opposed to 'Fasted' (p = 0.012). Part 2: 13 trials (n = 125) were reviewed. Ingesting PRO + CHO + W (35 ± 26 g PRO; 0.5 ± 0.4 g PRO kg -1 ) did not affect exercise performance compared with CHO + W (115 ± 61 g CHO; 0.6 ± 0.3 g CHO·kg body mass -1  h -1 ; 1.2 ± 0.6 L); % Δ mean power output = 0.5, 95% confidence interval - 0.5 to 1.6 (I 2  = 72.9). Athletes with limited time for recovery between consecutive exercise sessions should prioritise CHO and fluid ingestion to enhance subsequent athletic performance. PROSPERO REGISTRATION NUMBER: CRD42016046807.

Time interval between primary radiotherapy and salvage laryngectomy: a predictor of pharyngocutaneous fistula formation.

PubMed

Scotton, William J; Nixon, I J; Pezier, T F; Cobb, R; Joshi, A; Urbano, T Guerrero; Oakley, R; Jeannon, J P; Simo, R S

2014-08-01

Salvage laryngectomy (SL) is associated with high levels of morbidity. Rates of pharyngocutaneous fistulae (PCF) are as high as 35 % in some series. Patients at highest risk of such complications may be candidates for altered surgical management in terms of additional tissue transfer, or delayed tracheoesophageal puncture. This study investigates the relationship between the time from primary radiotherapy (RT) to salvage surgery and the development of PCF. 26 consecutive patients who underwent SL between 2000 and 2010 were identified from our institutional database. Demographic, staging, treatment and complication data were collected. Subgroup analysis was performed using the Student's t test or Mann-Whitney U test for continuous variables and either Chi-squared test or Fisher's Exact test for categorical variables. 26 patients underwent SL between October 2003 and July 2010. Of these, 15 (58 %) developed a PCF. On analysis of the time between pre-operative RT and surgery, a significant difference was seen, with a mean time of 19.5 months in those who developed a PCF versus 47.0 months in those who did not (p = 0.02). Patient characteristics, treatment, and pathology results were comparable between the two groups. There was no significant difference in distribution of the other covariates between the PCF and non-PCF groups. We reported a high rate of PCF and identified an association between PCF and a short time from primary treatment to salvage surgery. Identifying factors associated with higher rates of post-operative morbidity allows surgeons to adapt surgical planning in an attempt to minimize rates of PCF.

Adolescents' sleep in low-stress and high-stress (exam) times: a prospective quasi-experiment.

PubMed

Dewald, Julia F; Meijer, Anne Marie; Oort, Frans J; Kerkhof, Gerard A; Bögels, Susan M

2014-01-01

This prospective quasi-experiment (N = 175; mean age = 15.14 years) investigates changes in adolescents' sleep from low-stress (regular school week) to high-stress times (exam week), and examines the (moderating) role of chronic sleep reduction, baseline stress, and gender. Sleep was monitored over three consecutive weeks using actigraphy. Adolescents' sleep was more fragmented during the high-stress time than during the low-stress time, meaning that individuals slept more restless during stressful times. However, sleep efficiency, total sleep time, and sleep onset latency remained stable throughout the three consecutive weeks. High chronic sleep reduction was related to later bedtimes, later sleep start times, later sleep end times, later getting up times, and more time spent in bed. Furthermore, low chronic sleep reduction and high baseline stress levels were related to more fragmented sleep during stressful times. This study shows that stressful times can have negative effects on adolescents' sleep fragmentation, especially for adolescents with low chronic sleep reduction or high baseline stress levels.

The time-of-day that breaks occur between consecutive duty periods affects the sleep strategies used by shiftworkers.

PubMed

Roach, Gregory D; Dawson, Drew; Reid, Kathryn J; Darwent, David; Sargent, Charli

The aim of this study was to examine the sleep strategies used in breaks between consecutive shifts. For two weeks, 253 shiftworkers collected data regarding the timing of all shifts and sleeps. The final dataset included 395 between-shift breaks that had a standard duration (i.e. ~16 h). If a break included an entire night, participants had a single sleep on 80-93% of occasions, but if a break occurred predominantly during the daytime, participants had more than one sleep on 41-50% of occasions. These data indicate that the sleep strategy employed is influenced by the time-of-day that a break occurs.

Mode of delivery and the probability of subsequent childbearing: a population-based register study.

PubMed

Elvander, C; Dahlberg, J; Andersson, G; Cnattingius, S

2015-11-01

To investigate the relationship between mode of first delivery and probability of subsequent childbearing. Population-based study. Nationwide study in Sweden. A cohort of 771 690 women who delivered their first singleton infant in Sweden between 1992 and 2010. Using Cox's proportional-hazards regression models, risks of subsequent childbearing were compared across four modes of delivery. Hazard ratios (HRs) were calculated, using 95% confidence intervals (95% CIs). Probability of having a second and third child; interpregnancy interval. Compared with women who had a spontaneous vaginal first delivery, women who delivered by vacuum extraction were less likely to have a second pregnancy (HR 0.96, 95% CI 0.95-0.97), and the probabilities of a second childbirth were substantially lower among women with a previous emergency caesarean section (HR 0.85, 95% CI 0.84-0.86) or an elective caesarean section (HR 0.82, 95% CI 0.80-0.83). There were no clinically important differences in the median time between first and second pregnancy by mode of first delivery. Compared with women younger than 30 years of age, older women were more negatively affected by a vacuum extraction with respect to the probability of having a second child. A primary vacuum extraction decreased the probability of having a third child by 4%, but having two consecutive vacuum extraction deliveries did not further alter the probability. A first delivery by vacuum extraction does not reduce the probability of subsequent childbearing to the same extent as a first delivery by emergency or elective caesarean section. © 2014 Royal College of Obstetricians and Gynaecologists.

Location of civilian ballistic femoral fracture indicates likelihood of arterial injury.

PubMed

Gitajn, Leah; Perdue, Paul; Hardcastle, John; O'Toole, Robert V

2014-10-01

We evaluated whether the location of a ballistic femoral fracture helps predict the presence of arterial injury. We hypothesized that fractures located in the distal third of the femur are associated with a higher rate of arterial injury. We conducted a retrospective review of electronic medical records at our level I trauma centre and found 133 consecutive patients with femoral fractures from civilian gunshots from 2002 to 2007, 14 of whom sustained arterial injury. Fracture extent was measured with computerized viewing software and recorded with a standard technique, calculating proximal, distal, and central locations of the fracture as a function of overall length of the bone. Analyses were conducted with Student's t, Chi-squared, and Fisher's exact tests. The location of any fracture line in the distal third of the femur was associated with increased risk of arterial injury (P<0.05). The odds ratio for the presence of arterial injury when the proximal fracture line was in the distal third of the femur was 5.63 (95% confidence interval, 1.7-18.6; P<0.05) and when the distal fracture line was in the distal third of the femur was 6.72 (95% confidence interval, 1.78-25.44; P<0.05). A fracture line in the distal third of the femur after ballistic injury is six times more likely to be associated with arterial injury and warrants careful evaluation. Our data show that fracture location can help alert clinicians to possible arterial injury after ballistic femoral fracture. Copyright © 2014 Elsevier Ltd. All rights reserved.

Introducing the Event Related Fixed Interval Area (ERFIA) Multilevel Technique: a Method to Analyze the Complete Epoch of Event-Related Potentials at Single Trial Level

PubMed Central

Vossen, Catherine J.; Vossen, Helen G. M.; Marcus, Marco A. E.; van Os, Jim; Lousberg, Richel

2013-01-01

In analyzing time-locked event-related potentials (ERPs), many studies have focused on specific peaks and their differences between experimental conditions. In theory, each latency point after a stimulus contains potentially meaningful information, regardless of whether it is peak-related. Based on this assumption, we introduce a new concept which allows for flexible investigation of the whole epoch and does not primarily focus on peaks and their corresponding latencies. For each trial, the entire epoch is partitioned into event-related fixed-interval areas under the curve (ERFIAs). These ERFIAs, obtained at single trial level, act as dependent variables in a multilevel random regression analysis. The ERFIA multilevel method was tested in an existing ERP dataset of 85 healthy subjects, who underwent a rating paradigm of 150 painful and non-painful somatosensory electrical stimuli. We modeled the variability of each consecutive ERFIA with a set of predictor variables among which were stimulus intensity and stimulus number. Furthermore, we corrected for latency variations of the P2 (260 ms). With respect to known relationships between stimulus intensity, habituation, and pain-related somatosensory ERP, the ERFIA method generated highly comparable results to those of commonly used methods. Notably, effects on stimulus intensity and habituation were also observed in non-peak-related latency ranges. Further, cortical processing of actual stimulus intensity depended on the intensity of the previous stimulus, which may reflect pain-memory processing. In conclusion, the ERFIA multilevel method is a promising tool that can be used to study event-related cortical processing. PMID:24224018

Randomized clinical trial of expressive writing on wound healing following bariatric surgery.

PubMed

Koschwanez, Heidi; Robinson, Hayley; Beban, Grant; MacCormick, Andrew; Hill, Andrew; Windsor, John; Booth, Roger; Jüllig, Mia; Broadbent, Elizabeth

2017-07-01

Writing emotionally about upsetting life events (expressive writing) has been shown to speed healing of punch-biopsy wounds compared to writing objectively about daily activities. We aimed to investigate whether a presurgical expressive writing intervention could improve surgical wound healing. Seventy-six patients undergoing elective laparoscopic bariatric surgery were randomized either to write emotionally about traumatic life events (expressive writing) or to write objectively about how they spent their time (daily activities writing) for 20 min a day for 3 consecutive days beginning 2 weeks prior to surgery. A wound drain was inserted into a laparoscopic port site and wound fluid analyzed for proinflammatory cytokines collected over 24 hr postoperatively. Expanded polytetrafluoroethylene tubes were inserted into separate laparoscopic port sites during surgery and removed after 14 days. Tubes were analyzed for hydroxyproline deposition (the primary outcome), a major component of collagen and marker of healing. Fifty-four patients completed the study. Patients who wrote about daily activities had significantly more hydroxyproline than did expressive writing patients, t(34) = -2.43, p = .020, 95% confidence interval [-4.61, -0.41], and higher tumor necrosis factor-alpha, t(29) = -2.42, p = .022, 95% confidence interval [-0.42, -0.04]. Perceived stress significantly reduced in both groups after surgery. Expressive writing prior to bariatric surgery was not effective at increasing hydroxyproline at the wound site 14 days after surgery. However, writing about daily activities did predict such an increase. Future research needs to replicate these findings and investigate generalizability to other surgical groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Mortality after endophthalmitis following contemporary phacoemulsification cataract surgery.

PubMed

Crosby, Niall; Polkinghorne, Philip J; Kim, Bia; McGhee, Charles; Welch, Sarah; Riley, Andrew

2018-04-24

To determine if endophthalmitis following cataract surgery is linked to increased mortality. Increased mortality has been linked to patients with cataract and cataract surgery. We tested the hypothesis that post-cataract endophthalmitis has a greater risk of death than pseudophakes who do not develop this complication. Case-control study conducted in a tertiary public hospital. The study group comprised 50 consecutive patients with post-cataract endophthalmitis, and these were matched with selected controls. Patients with endophthalmitis following cataract surgery were identified from a prospective electronic surgical database. Subsequently, it was determined if the patient was deceased at the time of sequestration (September 2015), and the date of death was recorded. A previously described population who had undergone cataract surgery in the same facility was selected as a control group, and the population was case-matched in terms age, gender, presence or absence of diabetes and/or hypertension. The median survival rates were determined for the control group and the patients with post-cataract endophthalmitis. Fifty patients were identified as undergoing endophthalmitis post-cataract surgery, and 48 (n = 48) met inclusion criteria (mean age 72 years ±12 SD with 30:18 F:M); 17% were diabetic, and 50% had systemic hypertension. No statistically significant difference in median survival between the study and control cases was identified (100 months (95% confidence interval 86-114) vs. 106 months (95% confidence interval 66-146), respectively, P = 0.756). Post-cataract endophthalmitis was not associated with an increased rate of mortality in this study. © 2018 Royal Australian and New Zealand College of Ophthalmologists.