The impact of intra-operative interruptions on surgeons' perceived workload: an observational study in elective general and orthopedic surgery.

PubMed

Weigl, Matthias; Antoniadis, Sophia; Chiapponi, Costanza; Bruns, Christiane; Sevdalis, Nick

2015-01-01

Surgeons' intra-operative workload is critical for effective and safe surgical performance. Detrimental conditions in the operating room (OR) environment may add to perceived workload and jeopardize surgical performance and outcomes. This study aims to evaluate the impact of different intra-operative workflow interruptions on surgeons' capacity to manage their workload safely and efficiently. This was an observational study of intra-operative interruptions and self-rated workload in two surgical specialties (general, orthopedic/trauma surgery). Intra-operative interruptions were assessed via expert observation using a well-validated observation tool. Surgeons, nurses, and anesthesiologists assessed their intra-operative workload directly after case completion based on three items of the validated Surgery Task Load Index (mental demand, situational stress, distraction). A total of 56 elective cases (35 open, 21 laparoscopic) with 94 workload ratings were included. Mean intra-operative duration was 1 h 37 min. Intra-operative interruptions were on average observed 9.78 times per hour. People who entered/exited the OR (30.6 %) as well as telephone-/beeper-related disruptions (23.6 %) occurred most often. Equipment and OR environment-related interruptions were associated with highest interference with team functioning particularly in laparoscopic procedures. After identifying task and procedural influences, partial correlational analyses revealed that case-irrelevant communications were negatively associated with surgeons' mental fatigue and situational stress, whereas surgeons' reported distraction was increased by case-irrelevant communication and procedural disruptions. OR nurses' and anesthesiologists' perceived workload was also related to intra-operative interruption events. Our study documents the unique contribution of different interruptions on surgeons' workload; whereas case-irrelevant communications may be beneficial for mental fatigue and stress in routine cases, procedural interruptions and case-irrelevant communication may contribute to surgeons' mental focus deteriorating. Well-designed OR environments, surgical leadership, and awareness can help to control unnecessary interruptions for effective and safe surgical care.

Evaluation of Borama tuberculosis control program in Somaliland, Somalia.

PubMed

Qayad, Mohamed Gedi; Tarsitani, Gianfranco

2017-02-28

The Borama TB program in Somalia lost resources for TB operations in 2003. We evaluated the impact of the loss on the program. Pre-event (2002-2003) and post-event (2007) design were used. All TB patients registered in Borama and a sample of four months from Hargeisa (comparison) TB patients in both periods were abstracted. The following TB treatment outcomes were estimated: treatment success, treatment failure, case fatality, treatment interruption and transfer rates, along with percentage of patients with sputum specimen prior to treatment, percentage of patients from neighboring countries, and monthly average patients enrolled in treatment. The pre-event to post-event outcomes and measures were compared using descriptive and multivariate analyses. In total, 3,367 TB cases were abstracted. In Borama, the TB treatment success rate increased 6% in the post-event. The treatment failure and interruption rates both declined 75%. Monthly average TB patients declined 55%. Percentage of patients smear tested prior to the initiation of the treatment declined 9%. Percentage of TB patients from neighboring countries and other parts of Somalia declined 51%. Treatment interruption/transfer rates declined significantly in the post-event, compared to the pre-event period. Treatment failure/death rate did not change in the post-event period. In Hargeisa, the treatment success, failure/death, and interruption/transfer rates were similar in both periods. The RR did not change in these measures after adjusting for age and gender. This study indicates a significant setback to the Borama TB control program in the majority of measures evaluated, except the TB success rate.

GPS: Public Utility or Software Platform

DTIC Science & Technology

2016-09-01

major occurrences that could interrupt GPS’s operation for an extended period of time . Despite these safeguards, the U.S. government has...in the event of a GPS interruption .178 2. GPS Infrastructure is designed to Prevent and Minimize Disruption Like a public utility, GPS is designed ...production and distribution while at the same time minimizing the likelihood of signal interruptions . Each of GPS’s operational satellites are

Valsalva maneuver in obstetrics: the influence of peripheral circulatory changes on function of the pulse oximeter.

PubMed

Woods, A M; Queen, J S; Lawson, D

1991-12-01

Strenuous expulsive efforts involving sequential Valsalva maneuvers may result in maternal hypoxemia during the second stage of labor. Pulse oximetry has been used to assess oxygen saturation in laboring parturients, and this study was undertaken to evaluate the performance of the pulse oximeter (Nellcor) during the Valsalva maneuver. In both pregnant patients and nonpregnant volunteers, there were consistent interruptions in the transmission of oxygen saturation data during the Valsalva maneuver. To determine the physiologic events associated with this monitoring interruption, occlusive venous impedance plethysmographs and pulse volume amplitude recordings were obtained in volunteers performing the Valsalva maneuver. A marked decrease in pulse volume amplitude was noted, which adversely affected the oximeter's ability to distinguish physiologic arterial pulsations from background noise. Each Valsalva maneuver was associated with abrupt and transient changes in peripheral vascular volumes, thus presenting the oximeter with a rapidly changing signal for analysis that violated predetermined software criteria for pulse uniformity and caused an interruption in data transmission. The authors conclude that the Valsalva maneuver interferes with the ability of pulse oximeter technology to provide useful oxygen saturation data.

[Anticoagulation and peripartum management].

PubMed

Philippe, A; Ruivard, M; Auclair, C; Accoceberry, M; Bonnin, M; Pouly, J-L; Lémery, D; Philippe, P; Gallot, D

2015-03-01

To compare peripartum management of anticoagulated patients concerning locoregional analgesia, post-partum hemorrhage and thrombotic events according to planified interruption or not of antithrombotic therapy. We conducted a single tertiary care center retrospective study of all deliveries associated with antithrombotic therapy from January 2005 to September 2011. We identified 120 cases with prophylactic (71%) or curative (29%) anticoagulation. Two thrombotic events occurred. In case of curative therapy, the use of locoregional analgesia was lower (P<0.0001) and post-partum hemorrhage occurred more frequently (P=0.07) compared to prophylactic therapy. According to planified interruption or not of antithrombotic therapy, we observed a more prolonged duration of therapeutic interruption before delivery (55.6h±63.3 vs 26.4 h±11.6, P<0.0001), higher use of locoregional analgesia (83% vs 71%, P=0.02) but no difference concerning cesarean rate (35% vs 39%, P=0.8) or post-partum hemorrhage (13% vs 14%, P=0.9). In case of curative anticoagulation, plannified interruption favours the use of perimedullar analgesia after 24hour delay. In case of preventive anticoagulation, plannified interruption appears unnecessary as the 12hour delay is easier to reach. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Water supply facility damage and water resource operation at disaster base hospitals in miyagi prefecture in the wake of the Great East Japan Earthquake.

PubMed

Matsumura, Takashi; Osaki, Shizuka; Kudo, Daisuke; Furukawa, Hajime; Nakagawa, Atsuhiro; Abe, Yoshiko; Yamanouchi, Satoshi; Egawa, Shinichi; Tominaga, Teiji; Kushimoto, Shigeki

2015-04-01

The aim of this study was to shed light on damage to water supply facilities and the state of water resource operation at disaster base hospitals in Miyagi Prefecture (Japan) in the wake of the Great East Japan Earthquake (2011), in order to identify issues concerning the operational continuity of hospitals in the event of a disaster. In addition to interview and written questionnaire surveys to 14 disaster base hospitals in Miyagi Prefecture, a number of key elements relating to the damage done to water supply facilities and the operation of water resources were identified from the chronological record of events following the Great East Japan Earthquake. Nine of the 14 hospitals experienced cuts to their water supplies, with a median value of three days (range=one to 20 days) for service recovery time. The hospitals that could utilize well water during the time that water supply was interrupted were able to obtain water in quantities similar to their normal volumes. Hospitals that could not use well water during the period of interruption, and hospitals whose water supply facilities were damaged, experienced significant disruption to dialysis, sterilization equipment, meal services, sanitation, and outpatient care services, though the extent of disruption varied considerably among hospitals. None of the hospitals had determined the amount of water used for different purposes during normal service or formulated a plan for allocation of limited water in the event of a disaster. The present survey showed that it is possible to minimize the disruption and reduction of hospital functions in the event of a disaster by proper maintenance of water supply facilities and by ensuring alternative water resources, such as well water. It is also clear that it is desirable to conclude water supply agreements and formulate strategic water allocation plans in preparation for the eventuality of a long-term interruption to water services.

Sticks and stones can break my bones but words can also hurt me: The relationship between customer verbal aggression and employee incivility.

PubMed

Walker, David D; van Jaarsveld, Danielle D; Skarlicki, Daniel P

2017-02-01

Customer service employees tend to react negatively to customer incivility by demonstrating incivility in return, thereby likely reducing customer service quality. Research, however, has yet to uncover precisely what customers do that results in employee incivility. Through transcript and computerized text analysis in a multilevel, multisource, mixed-method field study of customer service events (N = 434 events), we found that employee incivility can occur as a function of customer (a) aggressive words, (b) second-person pronoun use (e.g., you, your), (c) interruptions, and (d) positive emotion words. First, the positive association between customer aggressive words and employee incivility was more pronounced when the verbal aggression included second-person pronouns, which we label targeted aggression. Second, we observed a 2-way interaction between targeted aggression and customer interruptions such that employees demonstrated more incivility when targeted customer verbal aggression was accompanied by more (vs. fewer) interruptions. Third, this 2-way interaction predicting employee incivility was attenuated when customers used positive emotion words. Our results support a resource-based explanation, suggesting that customer verbal aggression consumes employee resources potentially leading to self-regulation failure, whereas positive emotion words from customers can help replenish employee resources that support self-regulation. The present study highlights the advantages of examining what occurs within customer-employee interactions to gain insight into employee reactions to customer incivility. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Stressful Life Events in Children With Functional Defecation Disorders.

PubMed

Philips, Elise M; Peeters, Babette; Teeuw, Arianne H; Leenders, Arnold G E; Boluyt, Nicole; Brilleslijper-Kater, Sonja N; Benninga, Marc A

2015-10-01

The aim of the study was to determine the prevalence of stressful life events including (sexual) abuse in children with functional defecation disorders by performing a systematic review. We searched MEDLINE, EMBASE, and PsycINFO for cohort, case-control and cross-sectional studies investigating the prevalence of stressful life events, including (sexual) abuse in children with functional defecation disorders. The search yielded 946 articles, of which 8 were included with data from 654 children with functional constipation and 1931 children with (constipation-associated) fecal incontinence (FI). Overall, children with functional defecation disorders had been significantly more exposed to stressful life events than healthy children, with prevalence rates ranging from 1.6% to 90.9%. Being bullied, being a relational victim, interruption of toilet training, punishment by parents during toilet training, and hospitalization were significantly related to FI, whereas separation from the best friend, failure in an examination, severe illness in a close family member, loss of job by a parent, frequent punishment, and living in a war-affected area were significantly related to constipation. Only 1 study measured the prevalence of child abuse, which reported a significantly higher prevalence of child (sexual) abuse in children with FI compared with controls. The prevalence of stressful life events, including (sexual) abuse is significantly higher in children with functional defecation disorders compared with healthy children. To gain more insight into the true prevalence of child (sexual) abuse in children with functional defecation disorders, more studies are clearly needed.

An architecture for intelligent task interruption

NASA Technical Reports Server (NTRS)

Sharma, D. D.; Narayan, Srini

1990-01-01

In the design of real time systems the capability for task interruption is often considered essential. The problem of task interruption in knowledge-based domains is examined. It is proposed that task interruption can be often avoided by using appropriate functional architectures and knowledge engineering principles. Situations for which task interruption is indispensable, a preliminary architecture based on priority hierarchies is described.

Breast cancer: complete response with the combination of sunitinib and trastuzumab in a patient with grade III ductal carcinoma.

PubMed

Puente, Javier; Manzano, Aranzazu; Martin, Miguel; López-Tarruella, Sonia; Díaz-Rubio, Eduardo

2010-01-01

In August 2000, a previously healthy postmenopausal 52-year-old woman was diagnosed with grade III invasive ductal carcinoma. The tumor had an ER -, PR -, and HER2 + profile. Adjuvant treatment with FEC was initiated followed by radiotherapy. In October 2004, the patient presented a clinically asymptomatic supraclavicular and mediastinal lymph node recurrence and treatment with paclitaxel and trastuzumab was initiated. A complete response was achieved after 20 weeks of treatment, and in January 2006 treatment was interrupted due to toxicity. After a 34-month free-of-relapse period, a local recurrence was detected in the chest wall. In September 2007, the patient joined a phase II trial with sunitinib (37.5 mg once a day in 28 days cycles) and trastuzumab (6 mg/kg every 3 weeks), after having verified a normal cardiac function. After two courses, a partial cutaneous response and a complete radiological response were obtained. The most relevant toxicities included cutaneous hyperpigmentation, dysgeusia, mucositis, grade II diarrhea and hypertension. The development of grade III diarrhea led to sunitinib dose reduction (25mg/day). In January 2008, the patient developed hypothyroidism and a significant drop in the left ventricular ejection fraction that led to treatment interruption. In March 2008, once cardiac function was recovered, treatment at the same dose was reinitiated. After two months of treatment, a new descent in cardiac function was noted which led to the suspension of sunitinib, and the interruption of the trastuzumab treatment until recovery of normal cardiac function. In July 2008, trastuzumab monotherapy was resumed and since then no cardiac events have been reported, while maintaining a radiological and clinical response.

Volcanic eruption induced WWVB transmission path interruption

NASA Astrophysics Data System (ADS)

Buckmaster, H. A.; Hansen, C. H.

1985-07-01

It is reported that the 60 kHz transmission of WWVB from Fort Collins, Colorado, was not received in Calgary, Alberta, Canada, for about 11 h from 1109 UT to 2153 UT on July 23, 1980. It is suggested that this transmission path interruption is correlated with the 15 km height ash cloud due to the July 22, 1980 volcanic eruption of Mount St. Helens as it drifted eastward interrupting both the ground- and first hop sky-wave paths and that this ash cloud is the source of the conductivity and/or ionization necessary to produce this interruption. Small phase retardations are also reported which could be correlated with other Mount St. Helens volcanic events during May-July 1980.

A Prospective Randomized Trial of Apixaban Dosing During Atrial Fibrillation Ablation: The AEIOU Trial.

PubMed

Reynolds, Matthew R; Allison, J Scott; Natale, Andrea; Weisberg, Ian L; Ellenbogen, Kenneth A; Richards, Mark; Hsieh, Wen-Hua; Sutherland, Julie; Cannon, Christopher P

2018-05-01

This study sought to determine whether uninterrupted apixaban would have similar rates of bleeding and thromboembolic events as does minimally interrupted apixaban at the time of atrial fibrillation (AF) ablation and to compare those results with rates in historical patients treated with uninterrupted warfarin. The safety, efficacy, and optimal dosing regimen for apixaban at the time of AF ablation are uncertain. This prospective, multicenter clinical trial enrolled 306 patients undergoing catheter ablation for nonvalvular AF and randomized 300 to uninterrupted versus minimally interrupted (holding 1 dose) periprocedural apixaban. A retrospective cohort of patients treated with uninterrupted warfarin at the same centers was matched to the apixaban-treated subjects for comparison. Endpoints included clinically significant bleeding, major bleeding, and nonhemorrhagic stroke or systemic embolism (SE) from the time of ablation through 30 days. There were no stroke or SE events. Clinically significant bleeding occurred in 11.3% of 150 evaluable patients on uninterrupted apixaban and 9.7% of 145 evaluable patients on interrupted apixaban (risk difference: 1.7% [95% confidence interval: -5.5% to 8.8%]; p = NS). Rates of major bleeding were 1.3% with uninterrupted apixaban, and 2.1% with interrupted (risk difference: -0.7%; p = NS). The rates of clinically significant and major bleeding were similar for all apixaban patients combined (10.5% and 1.7%), compared with the matched warfarin group (9.8% and 1.4%). Both uninterrupted and minimally interrupted apixaban at the time of AF ablation were associated with a very low rate of thromboembolic events, and rates of both major (<2%) and clinically significant bleeding were similar to uninterrupted warfarin. (Apixaban Evaluation of Interrupted Or Uninterrupted Anticoagulation for Ablation of Atrial Fibrillation [AEIOU]; NCT02608099). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Analysis of disruptive events and precarious situations caused by interaction with neurosurgical microscope.

PubMed

Eivazi, Shahram; Afkari, Hoorieh; Bednarik, Roman; Leinonen, Ville; Tukiainen, Markku; Jääskeläinen, Juha E

2015-07-01

Developments in micro-neurosurgical microscopes have improved operating precision and ensured the quality of outcomes. Using the stereoscopic magnified view, however, necessitates frequent manual adjustments to the microscope during an operation. This article reports on an investigation of the interaction details concerning a state-of-the-art micro-neurosurgical microscope. The video data from detailed observations of neurosurgeons' interaction patterns with the microscope were analysed to examine disruptive events caused by adjusting the microscope. The primary findings show that interruptions caused by adjusting the microscope handgrips and mouth switch prolong the surgery time up to 10%. Surgeons, we observed, avoid interaction with the microscope's controls, settings, and configurations by working at the edge of the view, operating on a non-focused view, and assuming unergonomic body postures. The lack of an automatic method for adjusting the microscope is a major problem that causes interruptions during micro-neurosurgery. From this understanding of disruptive events, we discuss the opportunities and limitations of interactive technologies that aim to reduce the frequency or shorten the duration of interruptions caused by microscope adjustment.

30 CFR 250.402 - When and how must I secure a well?

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.402 When and how must I secure a well? Whenever you interrupt drilling...) Among the events that may cause you to interrupt drilling operations are: (1) Evacuation of the drilling...

30 CFR 250.402 - When and how must I secure a well?

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.402 When and how must I secure a well? Whenever you interrupt drilling...) Among the events that may cause you to interrupt drilling operations are: (1) Evacuation of the drilling...

30 CFR 250.402 - When and how must I secure a well?

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.402 When and how must I secure a well? Whenever you interrupt drilling...) Among the events that may cause you to interrupt drilling operations are: (1) Evacuation of the drilling...

Coping with interruptions in clinical nursing-A qualitative study.

PubMed

Laustsen, Sussie; Brahe, Liselotte

2018-04-01

To gain knowledge on how nurses' cope with interruptions in clinical practice. Interruptions may delay work routines and result in wasted time, disorganised planning and ineffective working procedures, affecting nurses' focus and overview in different ways. Research has identified a growing problem linking errors or adverse events with interruptions. It may affect patient safety if nurses are not paying attention to interruptions. Little is known about how nurses cope with interruptions DESIGN: The study was inspired by ethnographic fieldwork with a hermeneutical phenomenological approach. Observations were performed combined with semi-structured qualitative interviews. Managing interruptions depend on level of competence, working environment, dialogue and matching of expectations, collegial roles and implicit rules. Working procedures impact on how nurses are exposed to unnecessary interruptions. The latter affects overview and the ability to put the foot down and decline being interrupted. Professional competencies for example prioritising, keeping focus and collaborating across disciplines are needed to cope with interruptions. Culture work and matching of expectations are important to reflect on and discuss personal- and group behaviour caused by interruptions. We need to focus on the role of each nurse in the professional team, types of personality and unspoken rules. Professional competencies for example prioritising, keeping focus and cooperating across disciplines are needed to cope with interruptions. Coping with interruptions is important for the nursing profession, quality of care and patient safety. Changing practice requires multidisciplinary cooperation accepting different agendas at personal, group and organisational levels. Nurses must understand the meaning and nature of different types of interruptions to develop coping strategies and maintain quality in care and patient safety in multidisciplinary teamwork. © 2018 John Wiley & Sons Ltd.

Antecedent occipital alpha band activity predicts the impact of oculomotor events in perceptual switching

PubMed Central

Nakatani, Hironori; van Leeuwen, Cees

2013-01-01

Oculomotor events such as blinks and saccades transiently interrupt the visual input and, even though this mostly goes undetected, these brief interruptions could still influence the percept. In particular, both blinking and saccades facilitate switching in ambiguous figures such as the Necker cube. To investigate the neural state antecedent to these oculomotor events during the perception of an ambiguous figure, we measured the human scalp electroencephalogram (EEG). When blinking led to perceptual switching, antecedent occipital alpha band activity exhibited a transient increase in amplitude. When a saccade led to switching, a series of transient increases and decreases in amplitude was observed in the antecedent occipital alpha band activity. Our results suggest that the state of occipital alpha band activity predicts the impact of oculomotor events on the percept. PMID:23745106

Adverse events and treatment interruption in tuberculosis patients with and without HIV co‐infection

PubMed Central

Breen, R A M; Miller, R F; Gorsuch, T; Smith, C J; Schwenk, A; Holmes, W; Ballinger, J; Swaden, L; Johnson, M A; Cropley, I; Lipman, M C I

2006-01-01

Background Serious treatment associated adverse events are thought to occur more frequently in individuals with tuberculosis (TB) who are co‐infected with HIV. A study was undertaken to assess the frequency of serious (grade III/IV) adverse events and interruption of anti‐TB treatment in the era of effective antiretroviral therapy. Methods The incidence of serious adverse events was retrospectively compared in 312 individuals treated for TB, 156 of whom were co‐infected with HIV. Results 111 HIV infected individuals (71%) received highly active antiretroviral therapy at the same time as anti‐TB treatment. Serious adverse events were recorded in 40% HIV infected and 26% HIV uninfected individuals (p = 0.008). Peripheral neuropathy and persistent vomiting were more common in co‐infected patients (p<0.001; p = 0.006), although all cause interruption of anti‐TB treatment occurred with similar frequency in the two groups (13% in HIV infected patients and 15% in HIV uninfected patients; p = 0.74). In 85% of HIV infected patients and 87% of HIV uninfected individuals this was due to hepatotoxicity, which typically presented within 2 months of starting treatment. The median delay in restarting treatment was 4 weeks, so most individuals required full TB re‐treatment. Conclusion Despite a greater rate of serious (grade III/IV) adverse events among HIV infected individuals, discontinuation of anti‐TB treatment occurred with a similar frequency in HIV infected and HIV uninfected individuals. PMID:16844730

Updated Value of Service Reliability Estimates for Electric Utility Customers in the United States

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

Sullivan, Michael; Schellenberg, Josh; Blundell, Marshall

2015-01-01

This report updates the 2009 meta-analysis that provides estimates of the value of service reliability for electricity customers in the United States (U.S.). The meta-dataset now includes 34 different datasets from surveys fielded by 10 different utility companies between 1989 and 2012. Because these studies used nearly identical interruption cost estimation or willingness-to-pay/accept methods, it was possible to integrate their results into a single meta-dataset describing the value of electric service reliability observed in all of them. Once the datasets from the various studies were combined, a two-part regression model was used to estimate customer damage functions that can bemore » generally applied to calculate customer interruption costs per event by season, time of day, day of week, and geographical regions within the U.S. for industrial, commercial, and residential customers. This report focuses on the backwards stepwise selection process that was used to develop the final revised model for all customer classes. Across customer classes, the revised customer interruption cost model has improved significantly because it incorporates more data and does not include the many extraneous variables that were in the original specification from the 2009 meta-analysis. The backwards stepwise selection process led to a more parsimonious model that only included key variables, while still achieving comparable out-of-sample predictive performance. In turn, users of interruption cost estimation tools such as the Interruption Cost Estimate (ICE) Calculator will have less customer characteristics information to provide and the associated inputs page will be far less cumbersome. The upcoming new version of the ICE Calculator is anticipated to be released in 2015.« less

77 FR 3543 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-24

... discuss the results of a circumstance in which there is a CBOE System outage or other interruption of... Exchange proposes to add a stipulation that in the event of a CBOE System outage or other interruption of... has twenty trading days, but a CBOE System outage occurs for one-half of one trading day, and a TPH...

Are the London Declaration's 2020 goals sufficient to control Chagas disease?: Modeling scenarios for the Yucatan Peninsula.

PubMed

Lee, Bruce Y; Bartsch, Sarah M; Skrip, Laura; Hertenstein, Daniel L; Avelis, Cameron M; Ndeffo-Mbah, Martial; Tilchin, Carla; Dumonteil, Eric O; Galvani, Alison

2018-03-01

The 2020 Sustainable Development goals call for 100% certified interruption or control of the three main forms of Chagas disease transmission in Latin America. However, how much will achieving these goals to varying degrees control Chagas disease; what is the potential impact of missing these goals and if they are achieved, what may be left? We developed a compartmental simulation model that represents the triatomine, human host, and non-human host populations and vector-borne, congenital, and transfusional T. cruzi transmission between them in the domestic and peridomestic settings to evaluate the impact of limiting transmission in a 2,000 person virtual village in Yucatan, Mexico. Interruption of domestic vectorial transmission had the largest impact on T. cruzi transmission and prevalence in all populations. Most of the gains were achieved within the first few years. Controlling vectorial transmission resulted in a 46.1-83.0% relative reduction in the number of new acute Chagas cases for a 50-100% interruption in domestic vector-host contact. Only controlling congenital transmission led to a 2.4-8.1% (30-100% interruption) relative reduction in the total number of new acute cases and reducing only transfusional transmission led to a 0.1-0.3% (30-100% reduction). Stopping all three forms of transmission resulted in 0.5 total transmission events over five years (compared to 5.0 with no interruption); interrupting all forms by 30% resulted in 3.4 events over five years per 2,000 persons. While reducing domestic vectorial, congenital, and transfusional transmission can successfully reduce transmission to humans (up to 82% in one year), achieving the 2020 goals would still result in 0.5 new acute cases per 2,000 over five years. Even if the goals are missed, major gains can be achieved within the first few years. Interrupting transmission should be combined with other efforts such as a vaccine or improved access to care, especially for the population of already infected individuals.

SHIPMO5: An Updated User’s Manual Incorporating New Wave Spectra and Ship-Referenced Forces

DTIC Science & Technology

1992-04-01

equipment sliding, or of personnel loss-of- balance events, termed motion-induced interruptions. First consider an object on deck and suppose that the object...lateral force estimator in Reference 5. In the present work , this quantity will be called the port sliding estimator function, and denoted by Sport...0.170 , TIME FOR OPERATION " 60.0 a HEADING *$.LATE.LL*$$ **LONGITUDIILL*s TOTAL LFE NIl LFE Nil NI DEG G G 0.0 0.000 0.000 0.001 0.000 0.000 30.0 0.061

Mitigating Upsets in SRAM-Based FPGAs from the Xilinx Virtex 2 Family

NASA Technical Reports Server (NTRS)

Swift, G. M.; Yui, C. C.; Carmichael, C.; Koga, R.; George, J. S.

2003-01-01

Static random access memory (SRAM) upset rates in field programmable gate arrays (FPGAs) from the Xilinx Virtex 2 family have been tested for radiation effects on configuration memory, block RAM and the power-on-reset (POR) and SelectMAP single event functional interrupts (SEFIs). Dynamic testing has shown the effectiveness and value of Triple Module Redundancy (TMR) and partial reconfiguration when used in conjunction. Continuing dynamic testing for more complex designs and other Virtex 2 capabilities (i.e., I/O standards, digital clock managers (DCM), etc.) is scheduled.

Temporal and spatial aspects of peatland initiation following deglaciation in North America

USGS Publications Warehouse

Gorham, E.; Lehman, C.; Dyke, A.; Janssens, J.; Dyke, L.

2007-01-01

A set of simple ecological models accounts well for the cumulative initiation of peatlands throughout North America in relation to glacial retreat. The most parsimonious form incorporates, first, a delay term to account for the lag during which newly deglaciated land became suitable for peatland initiation and, second, an intrinsic rate of initiation related to the probability of migration and establishment of plant propagules from elsewhere. The goodness of fit of the models, based on 1680 basal-peat dates throughout the continent, allows projection of past trends into the future. Factors contributing to the lag of about 4000 years between deglaciation and peatland initiation are suggested and data on colonization of deglaciated land by beavers (known to initiate peatlands) are presented. The rate of peatland initiation peaked between 7000 and 8000 years ago, but remains appreciable today. A marked depression of peatland initiation (8360-8040 BP) interrupted the peak rate. The time of the interruption matches the 8200 BP cold-dry event recorded in Greenland ice cores, and suggests that this event caused a substantial, continent-wide depression of an important ecosystem function, i.e., carbon sequestration from the atmosphere by peat deposition. Spontaneous initiation of new peatlands is projected to continue for millennia to come. ?? 2006 Elsevier Ltd. All rights reserved.

The Chronic Detrimental Impact of Interruptions in a Simulated Submarine Track Management Task.

PubMed

Loft, Shayne; Sadler, Andreas; Braithwaite, Janelle; Huf, Samuel

2015-12-01

The objective of this article is to examine the extent to which interruptions negatively impact situation awareness and long-term performance in a submarine track management task where pre- and postinterruption display scenes remained essentially identical. Interruptions in command and control task environments can degrade performance well beyond the first postinterruption action typically measured for sequential static tasks, because individuals need to recover their situation awareness for multiple unfolding display events. Participants in the current study returned to an unchanged display scene following interruption and therefore could be more immune to such long-term performance deficits. The task required participants to monitor a display to detect contact heading changes and to make enemy engagement decisions. Situation awareness (Situation Present Assessment Method) and subjective workload (NASA-Task Load Index) were measured. The interruption replaced the display for 20 s with a blank screen, during which participants completed a classification task. Situation awareness after returning from interruption was degraded. Participants were slower to make correct engagement decisions and slower and less accurate in detecting heading changes, despite these task decisions being made at least 40 s following the interruption. Interruptions negatively impacted situation awareness and long-term performance because participants needed to redetermine the location and spatial relationship between the displayed contacts when returning from interruption, either because their situation awareness for the preinterruption scene decayed or because they did not encode the preinterruption scene. Interruption in work contexts such as submarines is unavoidable, and further understanding of how operators are affected is required to improve work design and training. © 2015, Human Factors and Ergonomics Society.

Medication administration and interruptions in nursing homes: A qualitative observational study.

PubMed

Odberg, Kristian Ringsby; Hansen, Britt Saetre; Aase, Karina; Wangensteen, Sigrid

2018-03-01

To contribute in-depth knowledge of the characteristics of medication administration and interruptions in nursing homes. The following research questions guided the study: How can the medication administration process in nursing homes be described? How can interruptions during the medication administration process in nursing homes be characterized? Medication administration is a vital process across healthcare settings, and earlier research in nursing homes is sparse. The medication administration process is prone to interruptions that may lead to adverse drug events. On the other hand, interruptions may also have positive effects on patient safety. A qualitative observational study design was applied. Data were collected using partial participant observations. An inductive content analysis was performed. Factors that contributed to the observed complexity of medication administration in nursing homes were the high number of single tasks, varying degree of linearity, the variability of technological solutions, demands regarding documentation and staff's apparent freedom as to how and where to perform medication-related activities. Interruptions during medication administration are prevalent and can be characterised as passive (e.g., alarm and background noises), active (e.g., discussions) or technological interruptions (e.g., use of mobile applications). Most interruptions have negative outcomes, while some have positive outcomes. A process of normalisation has taken place whereby staff put up with second-rate technological solutions, noise and interruptions when they are performing medication-related tasks. Before seeking to minimise interruptions during the medication administration process, it is important to understand the interconnectivity of the elements using a systems approach. Staff and management need to be aware of the normalisation of interruptions. Knowledge of the complexity of medication administration may raise awareness and highlight the importance of maintaining and enhancing staff competence. © 2017 John Wiley & Sons Ltd.

A Verification Method of Inter-Task Cooperation in Embedded Real-time Systems and its Evaluation

NASA Astrophysics Data System (ADS)

Yoshida, Toshio

In software development process of embedded real-time systems, the design of the task cooperation process is very important. The cooperating process of such tasks is specified by task cooperation patterns. Adoption of unsuitable task cooperation patterns has fatal influence on system performance, quality, and extendibility. In order to prevent repetitive work caused by the shortage of task cooperation performance, it is necessary to verify task cooperation patterns in an early software development stage. However, it is very difficult to verify task cooperation patterns in an early software developing stage where task program codes are not completed yet. Therefore, we propose a verification method using task skeleton program codes and a real-time kernel that has a function of recording all events during software execution such as system calls issued by task program codes, external interrupts, and timer interrupt. In order to evaluate the proposed verification method, we applied it to the software development process of a mechatronics control system.

Strengths of the Northwell Health Laboratory Service Line

PubMed Central

Balfour, Erika; Stallone, Robert; Castagnaro, Joseph; Poczter, Hannah; Schron, Deborah; Martone, James; Breining, Dwayne; Simpkins, Henry; Neglia, Tom; Kalish, Paul

2016-01-01

From 2009 to 2015, the laboratories of the 19-hospital North Shore-LIJ Health System experienced 5 threatened interruptions in service and supported 2 regional health-care providers with threatened interruptions in their laboratory service. We report our strategies to maintain laboratory performance during these events, drawing upon the strengths of our integrated laboratory service line. Established in 2009, the laboratory service line has unified medical and administrative leadership and system-wide divisional structure, quality management, and standardization of operations and procedures. Among many benefits, this governance structure enabled the laboratories to respond to a series of unexpected events. Specifically, at our various service sites, the laboratories dealt with pandemic (2009), 2 floods (2010, 2012), 2 fires (2010, 2015), and laboratory floor subsidence (2013). We were also asked to provide support for a regional physician network facing abrupt loss of testing services from closure of another regional clinical laboratory (2010) and to intervene for a non-health system hospital threatened with closure owing to noncompliance of laboratory operations (2012). In all but a single instance, patient care was served without interruption in service. In the last instance, fire interrupted laboratory services for 30 minutes. We conclude that in a large integrated health system, threats to continuous laboratory operations are not infrequent when measured on an annual basis. While most threats are from external physical circumstances, some emanate from unexpected administrative events. A strong laboratory governance mechanism that includes unified medical and administrative leadership across the entirety of the laboratory service line enables successful responses to these threats. PMID:28725768

Program For Simulation Of Trajectories And Events

NASA Technical Reports Server (NTRS)

Gottlieb, Robert G.

1992-01-01

Universal Simulation Executive (USE) program accelerates and eases generation of application programs for numerical simulation of continuous trajectories interrupted by or containing discrete events. Developed for simulation of multiple spacecraft trajectories with events as one spacecraft crossing the equator, two spacecraft meeting or parting, or firing rocket engine. USE also simulates operation of chemical batch processing factory. Written in Ada.

A Contrast-Based Computational Model of Surprise and Its Applications.

PubMed

Macedo, Luis; Cardoso, Amílcar

2017-11-19

We review our work on a contrast-based computational model of surprise and its applications. The review is contextualized within related research from psychology, philosophy, and particularly artificial intelligence. Influenced by psychological theories of surprise, the model assumes that surprise-eliciting events initiate a series of cognitive processes that begin with the appraisal of the event as unexpected, continue with the interruption of ongoing activity and the focusing of attention on the unexpected event, and culminate in the analysis and evaluation of the event and the revision of beliefs. It is assumed that the intensity of surprise elicited by an event is a nonlinear function of the difference or contrast between the subjective probability of the event and that of the most probable alternative event (which is usually the expected event); and that the agent's behavior is partly controlled by actual and anticipated surprise. We describe applications of artificial agents that incorporate the proposed surprise model in three domains: the exploration of unknown environments, creativity, and intelligent transportation systems. These applications demonstrate the importance of surprise for decision making, active learning, creative reasoning, and selective attention. Copyright © 2017 Cognitive Science Society, Inc.

Surveying DNA Elements within Functional Genes of Heterocyst-Forming Cyanobacteria

PubMed Central

Hilton, Jason A.; Meeks, John C.; Zehr, Jonathan P.

2016-01-01

Some cyanobacteria are capable of differentiating a variety of cell types in response to environmental factors. For instance, in low nitrogen conditions, some cyanobacteria form heterocysts, which are specialized for N2 fixation. Many heterocyst-forming cyanobacteria have DNA elements interrupting key N2 fixation genes, elements that are excised during heterocyst differentiation. While the mechanism for the excision of the element has been well-studied, many questions remain regarding the introduction of the elements into the cyanobacterial lineage and whether they have been retained ever since or have been lost and reintroduced. To examine the evolutionary relationships and possible function of DNA sequences that interrupt genes of heterocyst-forming cyanobacteria, we identified and compared 101 interruption element sequences within genes from 38 heterocyst-forming cyanobacterial genomes. The interruption element lengths ranged from about 1 kb (the minimum able to encode the recombinase responsible for element excision), up to nearly 1 Mb. The recombinase gene sequences served as genetic markers that were common across the interruption elements and were used to track element evolution. Elements were found that interrupted 22 different orthologs, only five of which had been previously observed to be interrupted by an element. Most of the newly identified interrupted orthologs encode proteins that have been shown to have heterocyst-specific activity. However, the presence of interruption elements within genes with no known role in N2 fixation, as well as in three non-heterocyst-forming cyanobacteria, indicates that the processes that trigger the excision of elements may not be limited to heterocyst development or that the elements move randomly within genomes. This comprehensive analysis provides the framework to study the history and behavior of these unique sequences, and offers new insight regarding the frequency and persistence of interruption elements in heterocyst-forming cyanobacteria. PMID:27206019

Surveying DNA Elements within Functional Genes of Heterocyst-Forming Cyanobacteria.

PubMed

Hilton, Jason A; Meeks, John C; Zehr, Jonathan P

2016-01-01

Some cyanobacteria are capable of differentiating a variety of cell types in response to environmental factors. For instance, in low nitrogen conditions, some cyanobacteria form heterocysts, which are specialized for N2 fixation. Many heterocyst-forming cyanobacteria have DNA elements interrupting key N2 fixation genes, elements that are excised during heterocyst differentiation. While the mechanism for the excision of the element has been well-studied, many questions remain regarding the introduction of the elements into the cyanobacterial lineage and whether they have been retained ever since or have been lost and reintroduced. To examine the evolutionary relationships and possible function of DNA sequences that interrupt genes of heterocyst-forming cyanobacteria, we identified and compared 101 interruption element sequences within genes from 38 heterocyst-forming cyanobacterial genomes. The interruption element lengths ranged from about 1 kb (the minimum able to encode the recombinase responsible for element excision), up to nearly 1 Mb. The recombinase gene sequences served as genetic markers that were common across the interruption elements and were used to track element evolution. Elements were found that interrupted 22 different orthologs, only five of which had been previously observed to be interrupted by an element. Most of the newly identified interrupted orthologs encode proteins that have been shown to have heterocyst-specific activity. However, the presence of interruption elements within genes with no known role in N2 fixation, as well as in three non-heterocyst-forming cyanobacteria, indicates that the processes that trigger the excision of elements may not be limited to heterocyst development or that the elements move randomly within genomes. This comprehensive analysis provides the framework to study the history and behavior of these unique sequences, and offers new insight regarding the frequency and persistence of interruption elements in heterocyst-forming cyanobacteria.

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

Schneider, Kevin; Tuffner, Frank; Elizondo, Marcelo

Regulated electricity utilities are required to provide safe and reliable service to their customers at a reasonable cost. To balance the objectives of reliable service and reasonable cost, utilities build and operate their systems to operate under typical historic conditions. As a result, when abnormal events such as major storms or disasters occur, it is not uncommon to have extensive interruptions in service to the end-use customers. Because it is not cost effective to make the existing electrical infrastructure 100% reliable, society has come to expect disruptions during abnormal events. However, with the increasing number of abnormal weather events, themore » public is becoming less tolerant of these disruptions. One possible solution is to deploy microgrids as part of a coordinated resiliency plan to minimize the interruption of power to essential loads. This paper evaluates the feasibility of using microgrids as a resiliency resource, including their possible benefits and the associated technical challenges. A use-case of an operational microgrid is included.« less

The Role of Action Coordination for Prospective Memory: Task-Interruption Demands Affect Intention Realization

ERIC Educational Resources Information Center

Rummel, Jan; Wesslein, Ann-Katrin; Meiser, Thorsten

2017-01-01

Event-based prospective memory (PM) is the ability to remember to perform an intention in response to an environmental cue. Recent microstructure models postulate four distinguishable stages of successful event-based PM fulfillment. That is, (a) the event must be noticed, (b) the intention must be retrieved, (c) the context must be verified, and…

Are the London Declaration’s 2020 goals sufficient to control Chagas disease?: Modeling scenarios for the Yucatan Peninsula

PubMed Central

Bartsch, Sarah M.; Skrip, Laura; Hertenstein, Daniel L.; Ndeffo-Mbah, Martial; Dumonteil, Eric O.; Galvani, Alison

2018-01-01

Background The 2020 Sustainable Development goals call for 100% certified interruption or control of the three main forms of Chagas disease transmission in Latin America. However, how much will achieving these goals to varying degrees control Chagas disease; what is the potential impact of missing these goals and if they are achieved, what may be left? Methods We developed a compartmental simulation model that represents the triatomine, human host, and non-human host populations and vector-borne, congenital, and transfusional T. cruzi transmission between them in the domestic and peridomestic settings to evaluate the impact of limiting transmission in a 2,000 person virtual village in Yucatan, Mexico. Results Interruption of domestic vectorial transmission had the largest impact on T. cruzi transmission and prevalence in all populations. Most of the gains were achieved within the first few years. Controlling vectorial transmission resulted in a 46.1–83.0% relative reduction in the number of new acute Chagas cases for a 50–100% interruption in domestic vector-host contact. Only controlling congenital transmission led to a 2.4–8.1% (30–100% interruption) relative reduction in the total number of new acute cases and reducing only transfusional transmission led to a 0.1–0.3% (30–100% reduction). Stopping all three forms of transmission resulted in 0.5 total transmission events over five years (compared to 5.0 with no interruption); interrupting all forms by 30% resulted in 3.4 events over five years per 2,000 persons. Conclusions While reducing domestic vectorial, congenital, and transfusional transmission can successfully reduce transmission to humans (up to 82% in one year), achieving the 2020 goals would still result in 0.5 new acute cases per 2,000 over five years. Even if the goals are missed, major gains can be achieved within the first few years. Interrupting transmission should be combined with other efforts such as a vaccine or improved access to care, especially for the population of already infected individuals. PMID:29554086

Oral anticoagulation management in patients with atrial fibrillation undergoing cardiac implantable electronic device implantation.

PubMed

Black-Maier, Eric; Kim, Sunghee; Steinberg, Benjamin A; Fonarow, Gregg C; Freeman, James V; Kowey, Peter R; Ansell, Jack; Gersh, Bernard J; Mahaffey, Kenneth W; Naccarelli, Gerald; Hylek, Elaine M; Go, Alan S; Peterson, Eric D; Piccini, Jonathan P

2017-09-01

Oral anticoagulation (OAC) therapy is associated with increased periprocedural risks after cardiac implantable electronic device (CIED) implantation. Patterns of anticoagulation management involving non-vitamin K antagonist oral anticoagulants (NOACs) have not been characterized. Anticoagulation strategies and outcomes differ by anticoagulant type in patients undergoing CIED implantation. Using the nationwide Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we assessed how atrial fibrillation (AF) patients undergoing CIED implantation were cared for and their subsequent outcomes. Outcomes were compared by oral anticoagulant therapy (none, warfarin, or NOAC) as well as by anticoagulation interruption status. Among 9129 AF patients, 416 (5%) underwent CIED implantation during a median follow-up of 30 months (interquartile range, 24-36). Of these, 60 (14%) had implantation on a NOAC. Relative to warfarin therapy, those on a NOAC were younger (70.5 years [range, 65-77.5 years] vs 77 years [range, 70-82 years]), had less valvular heart disease (15.0% vs 31.3%), higher creatinine clearance (67.3 [range, 59.7-99.0] vs 65.8 [range, 50.0-91.6]), were more likely to have persistent AF (26.7% vs 22.9%), and use concomitant aspirin (51.7% vs 35.2%). OAC therapy was commonly interrupted for CIED in 64% (n = 183 of 284) of warfarin patients and 65% (n = 39 of 60) of NOAC patients. Many interrupted patients received intravenous bridging anticoagulation: 33/183 (18%) interrupted warfarin and 4/39 (10%) interrupted NOAC patients. Thirty-day periprocedure bleeding and stroke adverse events were infrequent. Management of anticoagulation among AF patients undergoing CIED implantation is highly variable, with OAC being interrupted in more than half of both warfarin- and NOAC-treated patients. Bleeding and stroke events were infrequent in both warfarin and NOAC-treated patients. © 2017 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.

Recognizing the Ordinary as Extraordinary: Insight Into the "Way We Work" to Improve Patient Safety Outcomes.

PubMed

Henneman, Elizabeth A

2017-07-01

The Institute of Medicine (now National Academy of Medicine) reports "To Err is Human" and "Crossing the Chasm" made explicit 3 previously unappreciated realities: (1) Medical errors are common and result in serious, preventable adverse events; (2) The majority of medical errors are the result of system versus human failures; and (3) It would be impossible for any system to prevent all errors. With these realities, the role of the nurse in the "near miss" process and as the final safety net for the patient is of paramount importance. The nurse's role in patient safety is described from both a systems perspective and a human factors perspective. Critical care nurses use specific strategies to identify, interrupt, and correct medical errors. Strategies to identify errors include knowing the patient, knowing the plan of care, double-checking, and surveillance. Nursing strategies to interrupt errors include offering assistance, clarifying, and verbally interrupting. Nurses correct errors by persevering, being physically present, reviewing/confirming the plan of care, or involving another nurse or physician. Each of these strategies has implications for education, practice, and research. Surveillance is a key nursing strategy for identifying medical errors and reducing adverse events. Eye-tracking technology is a novel approach for evaluating the surveillance process during common, high-risk processes such as blood transfusion and medication administration. Eye tracking has also been used to examine the impact of interruptions to care caused by bedside alarms as well as by other health care personnel. Findings from this safety-related eye-tracking research provide new insight into effective bedside surveillance and interruption management strategies. ©2017 American Association of Critical-Care Nurses.

Unique Conformation in a Natural Interruption Sequence of Type XIX Collagen Revealed by Its High-Resolution Crystal Structure.

PubMed

Xu, Tingting; Zhou, Cong-Zhao; Xiao, Jianxi; Liu, Jinsong

2018-02-20

Naturally occurring interruptions in nonfibrillar collagen play key roles in molecular flexibility, collagen degradation, and ligand binding. The structural feature of the interruption sequences and the molecular basis for their functions have not been well studied. Here, we focused on a G5G type natural interruption sequence G-POALO-G from human type XIX collagen, a homotrimer collagen, as this sequence possesses distinct properties compared with those of a pathological similar Gly mutation sequence in collagen mimic peptides. We determined the crystal structures of the host-guest peptide (GPO) 3 -GPOALO-(GPO) 4 to 1.03 Å resolution in two crystal forms. In these structures, the interruption zone brings localized disruptions to the triple helix and introduces a light 6-8° bend with the same directional preference to the whole molecule, which may correspond structurally to the first physiological kink site in type XIX collagen. Furthermore, at the G5G interruption site, the presence of Ala and Leu residues, both with free N-H groups, allows the formation of more direct and water-mediated interchain hydrogen bonds than in the related Gly → Ala structure. These could partly explain the difference in thermal stability between the different interruptions. In addition, our structures provide a detailed view of the dynamic property of such an interrupted zone with respect to hydrogen bonding topology, torsion angles, and helical parameters. Our results, for the first time, also identified the binding of zinc to the end of the triple helix. These findings will shed light on how the interruption sequence influences the conformation of the collagen molecule and provide a structural basis for further functional studies.

Deleterious effects of interruption followed by reintroduction of enzyme replacement therapy on a lysosomal storage disorder.

PubMed

Schneider, Ana Paula; Matte, Ursula; Pasqualim, Gabriela; Tavares, Angela Maria Vicente; Mayer, Fabiana Quoos; Martinelli, Barbara; Ribas, Graziela; Vargas, Carmen Regla; Giugliani, Roberto; Baldo, Guilherme

2016-10-01

Temporary interruption of enzyme replacement therapy (ERT) in patients with different lysosomal storage disorders may happen for different reasons (adverse reactions, issues with reimbursement, logistic difficulties, and so forth), and the impact of the interruption is still uncertain. In the present work, we studied the effects of the interruption of intravenous ERT (Laronidase, Genzyme) followed by its reintroduction in mice with the prototypical lysosomal storage disorder mucopolysaccharidosis type I, comparing to mice receiving continuous treatment, untreated mucopolysaccharidosis type I mice, and normal mice. In the animals which treatment was temporarily interrupted, we observed clear benefits of treatment in several organs (liver, lung, heart, kidney, and testis) after reintroduction, but a worsening in the thickness of the aortic wall was detected. Furthermore, these mice had just partial improvements in behavioral tests, suggesting some deterioration in the brain function. Despite worsening is some disease aspects, urinary glycosaminoglycans levels did not increase during interruption, which indicates that this biomarker commonly used to monitor treatment in patients should not be used alone to assess treatment efficacy. The deterioration observed was not caused by the development of serum antienzyme antibodies. All together our results suggest that temporary ERT interruption leads to deterioration of function in some organs and should be avoided whenever possible. Copyright © 2016 Elsevier Inc. All rights reserved.

Does interruption of the artery of Adamkiewicz during total en bloc spondylectomy affect neurologic function?

PubMed

Murakami, Hideki; Kawahara, Norio; Tomita, Katsuro; Demura, Satoru; Kato, Satoshi; Yoshioka, Katsuhito

2010-10-15

A retrospective review of patients with interruption of the artery of Adamkiewicz during total en bloc spondylectomy (TES). To assess neurologic function after interruption of the artery of Adamkiewicz in TES. The most important feeding artery of the thoracolumbar spinal cord is the great anterior radiculomedullary artery, also called the artery of Adamkiewicz. The artery of Adamkiewicz supplies the lower two-thirds of the spinal cord via the anterior spinal artery. It is naturally believed among spine surgeons that interruption of the artery of Adamkiewicz during surgeries is absolutely contraindicated. However, it is necessary to sacrifice the artery of Adamkiewicz during TES, when the tumor, by chance, exists at the level of the artery of Adamkiewicz. Between 1990 and 2009, we have performed 180 cases of TES. All cases except for few emergency cases received preoperative embolization. The artery of Adamkiewicz was verified by angiography of the segmental arteries. There were 15 patients in which the artery of Adamkiewicz was found at the levels of resected vertebrae. Interruption of the artery was performed during surgery in these 15 cases. Neurologic function was analyzed retrospectively. Of the 15 patients, the Frankel grade before surgery was C in 1, D in 5, and E in 9. At follow-up, the Frankel grade was D in 1 and E in 14. There were no cases of neurologic deterioration or paralysis after TES. On the basis of our results of TES on up to 3 vertebrae, interruption of the artery of Adamkiewicz for TES does not adversely affect neurologic function. We advocate strongly that our surgeons are allowed to sacrifice up to 3 pairs of segmental arteries, even including the artery of Adamkiewicz, if necessary.

Interrupted Monosyllabic Words: The Effects of Ten Interruption Locations on Recognition Performance by Older Listeners with Sensorineural Hearing Loss.

PubMed

Wilson, Richard H; Sharrett, Kadie C

2017-01-01

Two previous experiments from our laboratory with 70 interrupted monosyllabic words demonstrated that recognition performance was influenced by the temporal location of the interruption pattern. The interruption pattern (10 interruptions/sec, 50% duty cycle) was always the same and referenced word onset; the only difference between the patterns was the temporal location of the on- and off-segments of the interruption cycle. In the first study, both young and older listeners obtained better recognition performances when the initial on-segment coincided with word onset than when the initial on-segment was delayed by 50 msec. The second experiment with 24 young listeners detailed recognition performance as the interruption pattern was incremented in 10-msec steps through the 0- to 90-msec onset range. Across the onset conditions, 95% of the functions were either flat or U-shaped. To define the effects that interruption pattern locations had on word recognition by older listeners with sensorineural hearing loss as the interruption pattern incremented, re: word onset, from 0 to 90 msec in 10-msec steps. A repeated-measures design with ten interruption patterns (onset conditions) and one uninterruption condition. Twenty-four older males (mean = 69.6 yr) with sensorineural hearing loss participated in two 1-hour sessions. The three-frequency pure-tone average was 24.0 dB HL and word recognition was ≥80% correct. Seventy consonant-vowel nucleus-consonant words formed the corpus of materials with 25 additional words used for practice. For each participant, the 700 interrupted stimuli (70 words by 10 onset conditions), the 70 words uninterrupted, and two practice lists each were randomized and recorded on compact disc in 33 tracks of 25 words each. The data were analyzed at the participant and word levels and compared to the results obtained earlier on 24 young listeners with normal hearing. The mean recognition performance on the 70 words uninterrupted was 91.0% with an overall mean performance on the ten interruption conditions of 63.2% (range: 57.9-69.3%), compared to 80.4% (range: 73.0-87.7%) obtained earlier on the young adults. The best performances were at the extremes of the onset conditions. Standard deviations ranged from 22.1% to 28.1% (24 participants) and from 9.2% to 12.8% (70 words). An arithmetic algorithm categorized the shapes of the psychometric functions across the ten onset conditions. With the older participants in the current study, 40% of the functions were flat, 41.4% were U-shaped, and 18.6% were inverted U-shaped, which compared favorably to the function shapes by the young listeners in the earlier study of 50.0%, 41.4%, and 8.6%, respectively. There were two words on which the older listeners had 40% better performances. Collectively, the data are orderly, but at the individual word or participant level, the data are somewhat volatile, which may reflect auditory processing differences between the participant groups. The diversity of recognition performances by the older listeners on the ten interruption conditions with each of the 70 words supports the notion that the term hearing loss is inclusive of processes well beyond the filtering produced by end-organ sensitivity deficits. American Academy of Audiology

Effects of Interrupting Children's Sedentary Behaviors With Activity on Metabolic Function: A Randomized Trial.

PubMed

Belcher, Britni R; Berrigan, David; Papachristopoulou, Alexia; Brady, Sheila M; Bernstein, Shanna B; Brychta, Robert J; Hattenbach, Jacob D; Tigner, Ira L; Courville, Amber B; Drinkard, Bart E; Smith, Kevin P; Rosing, Douglas R; Wolters, Pamela L; Chen, Kong Y; Yanovski, Jack A

2015-10-01

Limited data suggest that interrupting sedentary behaviors with activity improves metabolic parameters in adults. We tested whether interrupting sitting with short, moderate-intensity walking bouts improved glucose tolerance in children. Participants underwent two experimental conditions in random order on different days: continuous sitting for 3 hours or sitting interrupted by walking (3 min of moderate-intensity walking every 30 min). Insulin, C-peptide, glucose, and free fatty acids were measured every 30 minutes for 3 hours during an oral glucose tolerance test. Area under the curve (AUC) was calculated from hormone and substrate measurements. Children were given a buffet meal after each condition. The study was conducted at the National Institutes of Health Hatfield Clinical Research Center. Twenty-eight normal-weight 7-11 year olds participated. Patterns of substrate/hormone secretion and AUC, as well as energy intake, were examined by experimental condition. Interrupting sitting resulted in a 32% lower insulin AUC (P < .001), 17% lower C-peptide AUC (P < .001), and 7% lower glucose AUC (P = .018) vs continuous sitting. Mixed model results indicated that insulin (P = .036) and free fatty acid concentrations (P = .009) were significantly lower in the interrupted vs the continuous sitting condition. Lunchtime buffet meal energy intake did not significantly differ between the conditions (975 ± 387 vs 963 ± 309 kcal; P = .85). Interrupting sedentary time with brief moderate-intensity walking improved short-term metabolic function in non-overweight children without increasing subsequent energy intake. These findings suggest that interrupting sedentary behavior may be a promising prevention strategy for reducing cardiometabolic risk in children.

Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive.

PubMed

Madden, Gregory R; German Mesner, Ian; Cox, Heather L; Mathers, Amy J; Lyman, Jason A; Sifri, Costi D; Enfield, Kyle B

2018-06-01

We hypothesized that a computerized clinical decision support tool for Clostridium difficile testing would reduce unnecessary inpatient tests, resulting in fewer laboratory-identified events. Census-adjusted interrupted time-series analyses demonstrated significant reductions of 41% fewer tests and 31% fewer hospital-onset C. difficile infection laboratory-identified events following this intervention.Infect Control Hosp Epidemiol 2018;39:737-740.

A Quantitative Assessment of Utility Reporting Practices for Reporting Electric Power Distribution Events

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

Hamachi La Commare, Kristina

Metrics for reliability, such as the frequency and duration of power interruptions, have been reported by electric utilities for many years. This study examines current utility practices for collecting and reporting electricity reliability information and discusses challenges that arise in assessing reliability because of differences among these practices. The study is based on reliability information for year 2006 reported by 123 utilities in 37 states representing over 60percent of total U.S. electricity sales. We quantify the effects that inconsistencies among current utility reporting practices have on comparisons of System Average Interruption Duration Index (SAIDI) and System Average Interruption Frequency Indexmore » (SAIFI) reported by utilities. We recommend immediate adoption of IEEE Std. 1366-2003 as a consistent method for measuring and reporting reliability statistics.« less

An Anatomy of a Seismic Sequence in a Deep Gold Mine

NASA Astrophysics Data System (ADS)

Gibowicz, S. J.

1997-12-01

An unusual swarm-like seismic sequence occurred in April 1993 at the Western Deep Levels gold mine, South Africa. Altogether 199 events with moment magnitude from -0.5 to 3.1 were recorded and located by the mine seismic network. The sequence lasted 12 days and was composed in fact of four main shock-aftershocks sequences, closely following each other in space and time. The events were confined to a volume of rock extending to 670 m in the N-S, 630 m in the E-W, and 390 m in the vertical directions. The first sequence lasted 179 hours and the second only 13 hours, being interrupted by the third sequence which lasted 31 hours, being in turn interrupted by the fourth sequence. The parameter p, describing the rate of occurrence of aftershocks, ranged from 0.7 to 1. The first sequence is characterized by the lowest value of the fractal correlation dimension D = 1.75 and the second by the highest value of D = 2.4, whereas the third and fourth sequences are characterized by the middle value of D = 1.9.¶The corner frequencies of P and S waves are in close proximity and range from 14 to 220 Hz. A display of source parameters as a function of time shows that the four main shocks are most distinctly marked by their source radius. For 46 events a moment tensor inversion was performed. In most cases the double-couple component is dominant, ranging from 60 to 90 percent of the solution. The double-couple solutions correspond to the same number of normal and reverse faults and oblique-slip focal mechanisms. An analysis of space distribution of P, T and B axes reveals that the distribution of B axes is the most regular.

SEE Transient Response of Crane Interpoint Single Output Point of Load DC-DC Converters

NASA Technical Reports Server (NTRS)

Sanders, Anthony B.; Chen, Dakai; Kim, Hak S.; Phan, Anthony M.

2011-01-01

This study was undertaken to determine the single event effect and transient susceptibility of the Crane Interpoint Maximum Flexible Power (MFP) Single Output Point of Load DC/DC Converters for transient interruptions in the output signal and for destructive and non destructive events induced by exposing it to a heavy ion beam..

Action Interrupted: Movement and Breakpoints in the Processing of Motion Violations in Toddlers and Adults

ERIC Educational Resources Information Center

Friend, Margaret; Pace, Amy E.

2016-01-01

From early in development, segmenting events unfolding in the world in meaningful ways renders input more manageable and facilitates interpretation and prediction. Yet, little is known about how children process action structure in events composed of multiple coarse-grained actions. More importantly, little is known about the time course of action…

Prematurity and Programming Contribution of neonatal (NICU) interventions

PubMed Central

Kalhan, Satish C; Wilson-Costello, Dee

2014-01-01

Contemporary clinical practice for the care of the prematurely born babies has markedly improved their rates of survival so that most of these babies are expected to grow up to live a healthy functional life. Since the clinical follow up is of short duration (years), only limited data are available to relate non-communicable diseases in adult life to events and interventions in the neonatal period. The major events that could have a programming effect include (1) Intrauterine growth restriction (2) Interruption of pregnancy with change in redox and reactive oxygen species injury (3) Nutritional and pharmacological protocols for Clinical care (4) Nutritional care in the first two years resulting in accelerated weight gain. The available data are discussed in the context of perturbations in one carbon (methyl transfer) metabolism and its possible programming effects. Although direct evidence for genomic methylation is not available, clinical and experimental data on impact of redox and ROS, of low protein intake, excess methionine load and vitamin A, on methyl transfers are reviewed. The consequences of antenatal and postnatal administration of glucocorticoids are presented. Analysis of the correlates of insulin sensitivity at older age, suggests that premature birth is the major contributor, and is compounded by gain in weight during infancy. We speculate that premature interruption of pregnancy and neonatal interventions by effecting one carbon metabolism may cause programming effects on the immature baby. These can be additive to the effects of intrauterine environment (growth restriction) and are compounded by accelerated growth in early infancy. PMID:25054678

Outcomes of Propofol Sedation During Emergency Endoscopy Performed for Upper Gastrointestinal Bleeding.

PubMed

Park, Chan Hyuk; Han, Dong Soo; Jeong, Jae Yoon; Eun, Chang Soo; Yoo, Kyo-Sang; Jeon, Yong Cheol; Sohn, Joo Hyun

2016-03-01

Although propofol-based sedation can be used during emergency endoscopy for upper gastrointestinal bleeding (UGIB), there is a potential risk of sedation-related adverse events, especially in patients with variceal bleeding. We compared adverse events related to propofol-based sedation during emergency endoscopy between patients with non-variceal and variceal bleeding. Clinical records of patients who underwent emergency endoscopy for UGIB under sedation were reviewed. Adverse events, including shock, hypoxia, and paradoxical reaction, were compared between the non-variceal and variceal bleeding groups. Of 703 endoscopies, 539 and 164 were performed for non-variceal and variceal bleeding, respectively. Shock was more common in patients with variceal bleeding compared to those with non-variceal bleeding (12.2 vs. 3.5%, P < 0.001). All patients except one recovered from shock after normal saline hydration, and emergency endoscopy could be finished without interruption in most cases. The incidence of hypoxia and paradoxical reaction did not differ based on the source of bleeding (non-variceal bleeding vs. variceal bleeding: hypoxia, 3.5 vs. 1.8%, P = 0.275; paradoxical reaction interfering with the procedure, 4.1 vs. 5.5%, P = 0.442). Although shock was more common in patients with variceal bleeding compared to those with non-variceal bleeding, most cases could be controlled without procedure interruption. Paradoxical reaction, rather than shock or hypoxia, was the most common cause of procedure interruption in patients with variceal bleeding, but the rate did not differ between patients with non-variceal and variceal bleeding.

Inducing amnesia through systemic suppression

PubMed Central

Hulbert, Justin C.; Henson, Richard N.; Anderson, Michael C.

2016-01-01

Hippocampal damage profoundly disrupts the ability to store new memories of life events. Amnesic windows might also occur in healthy people due to disturbed hippocampal function arising during mental processes that systemically reduce hippocampal activity. Intentionally suppressing memory retrieval (retrieval stopping) reduces hippocampal activity via control mechanisms mediated by the lateral prefrontal cortex. Here we show that when people suppress retrieval given a reminder of an unwanted memory, they are considerably more likely to forget unrelated experiences from periods surrounding suppression. This amnesic shadow follows a dose-response function, becomes more pronounced after practice suppressing retrieval, exhibits characteristics indicating disturbed hippocampal function, and is predicted by reduced hippocampal activity. These findings indicate that stopping retrieval engages a suppression mechanism that broadly compromises hippocampal processes and that hippocampal stabilization processes can be interrupted strategically. Cognitively triggered amnesia constitutes an unrecognized forgetting process that may account for otherwise unexplained memory lapses following trauma. PMID:26977589

Effects of elevated temperatures during interruption of irradiation on Harwell Red 4034 PMMA and Kodak Biomax alanine film dosimetry systems

NASA Astrophysics Data System (ADS)

Sidereas, P.; Patil, D. S.; Garcia, R.; Tracy, R. P.; Holzman, J. M.

2007-11-01

In the industrial setting it is not uncommon for a process interruption to occur during irradiation. In this event, dosimeters may be exposed to prolonged periods of elevated temperature without exposure to ionizing radiation. Once the process is restarted, the same dosimeters are exposed to ionizing radiation in order to achieve target dose. The goal of this experiment was to simulate a process interruption within limits and quantify the effects of a combination of factors (heat, time, and fractionation) on dosimeter response. We present an in-depth experimental study on the response of dosimeters that have been irradiated, stored for a fixed period of time at several temperatures, and then re-irradiated. This study was performed using Harwell Red 4034 polymethylmethacrylate (PMMA) and Kodak BioMax alanine film dosimeters.

Development of High Interruption Capability Vacuum Circuit Breaker -Technology of Vacuum Arc Control-

NASA Astrophysics Data System (ADS)

Niwa, Yoshimitsu; Kaneko, Eiji

Vacuum circuit breakers (VCB) have been widely used for power distribution systems. Vacuum Interrupters, which are the current interruption unit, have been increased its interruption capability with the development of vacuum arc control technology by magnetic field. There are three major type electrodes: disk shaped electrodes, radial magnetic field electrodes, axial magnetic field (AMF) electrodes. In the disk shaped electrode, the vacuum arc between the electrodes is not controlled. In the AMF electrode, the vacuum arc is diffused and stabilized by an axial magnetic field, which is parallel to the arc current. In the last type of electrodes, the vacuum arc column is rotated by magnetic force generated by the current flowing in the electrodes. The interruption current and the voltage of one break VCB is increased to 100 kA, 144 kV respectively. This paper describes basic configurations and functions of VCB, vacuum arc control technology in vacuum interrupters, recent researches and applications of VCB.

Radiation therapy interruption in a poor resource setting: causes and management..

PubMed

Akinlade, B I; Folasire, A M; Elumelu-Kupoluyi, T N; Adenipekun, A A; Iyobosa, U B; Campbell, O B

2014-12-01

Treatment interruption is the failure to execute approved treatment plan of a patient. This adversely affects treatment outcomeif not properly managed. This retrospective study causes and management of radiation treatment interruptions during High Dose Rate Brachytherapy(HDRB) for carcinoma of the cervix in a teaching hospital in Nigeria. Five hundred patients with cervical carcinoma, who received HDRB, post external beam radiotherapy, between August, 2008 and July, 2013 were assessed. They were grouped into (A): those who experienced treatment interruption and (B): those who did not. Each patient was scheduled to receive three fractions of HDRB over 3 weeks. Those in groups A were assessed for the exact treatment fraction missed, the cause and duration of treatment interruption and the actions taken to compensate for non-execution of treatment. A total of 90 patients fall into group A and most (41) of them experienced interruptions in the third fraction of their treatment. The most frequent (44%) causes of treatment interruptions observed among them were patient-related. Record of compensation for treatment interruption was not found in patients' treatment folders. This action may be due to lack of functional procedures for managing treatment interruptions and insufficient follow-up of patients, who never came back for consideration for compensation. This study showed that radiation oncology centres need to review their policies for managing treatment interruptions and documentation. Also, the mechanism for patients' follow-up should be strengthened to a reasonable extent to achieve better radiotherapy care.

Impact of a planned dose interruption of dacomitinib in the treatment of advanced non-small-cell lung cancer (ARCHER 1042)

PubMed Central

Kim, Dong-Wan; Garon, Edward B.; Jatoi, Aminah; Keefe, Dorothy M.; Lacouture, Mario E.; Sonis, Stephen; Gernhardt, Diana; Wang, Tao; Giri, Nagdeep; Doherty, Jim P.; Nadanaciva, Sashi; O’Connell, Joseph; Sbar, Eric; Cho, Byoung Chul

2017-01-01

Objectives Dacomitinib is a pan-HER inhibitor for advanced non-small-cell lung cancer (NSCLC). We explored the impact of a planned 4-day dacomitinib dose interruption on plasma exposure of dacomitinib and adverse events (AEs) of interest in Cohort III of the ARCHER 1042 study. Materials and methods Patients, treatment-naïve for advanced NSCLC with EGFR activating mutations, received oral dacomitinib 45 mg QD (once daily). A planned dose interruption occurred in Cycle 1 from Days 11 through 14. The primary endpoint was the pharmacokinetic (PK) characteristics of dacomitinib in Cycle 1 Day 10 and during dose interruption. Secondary endpoints included safety and concomitant medications used to treat AEs of interest. Results Cohort III enrolled 25 patients. Median plasma Cmax of dacomitinib in Cycle 1 Day 10 was 83.40 ng/mL. Average median plasma dacomitinib concentration during the 4-day dose interruption was 42.63 ng/mL. In the first 8 weeks of treatment 1) 80% of patients used concomitant medications for dermatologic AEs, 76% for diarrhea, and 44% for stomatitis, and 2) all patients experienced treatment-emergent AEs and 28% had all-causality Grade 3 AEs. Conclusion At 45 mg QD dosing, PK parameters of plasma dacomitinib in Cycle 1 Day 10 were comparable to that obtained in Cycle 1 Day 14 from other dacomitinib studies. Average median plasma dacomitinib concentration during the 4-day dose interruption was approximately half of the median plasma Cmax of dacomitinib observed prior to dose interruption. The toxicity profile was consistent with that from other studies of dacomitinib. PMID:28285698

The role of domain expertise and judgment in dealing with unexpected events

NASA Astrophysics Data System (ADS)

Kochan, Janeen Adrion

Unexpected events, particularly those creating surprise, interrupt ongoing mental and behavioral processes, creating an increased potential for unwanted outcomes to the situation. Human reactions to unexpected events vary. One can hypothesize a number of reasons for this variation, including level of domain expertise, previous experience with similar events, emotional connotation, and the contextual surround of the event. Whereas interrupting ongoing activities and focusing attention temporarily on a surprising event may be a useful evolutionary response to a threatening situation, the same process may be maladaptive in today's highly dynamic world. The purpose of this study was to investigate how different aspects of expertise affected one's ability to detect and react to an unexpected event. It was hypothesized that there were two general types of expertise, domain expertise and judgment (Hammond, 2000), which influenced one's performance on dealing with an unexpected event. The goal of the research was to parse out the relative contribution of domain expertise, so the role of judgment could be revealed. The research questions for this study were: (a) Can we identify specific knowledges and skills which enhance one's ability to deal with unexpected events? (b) Are these skills "automatically" included in domain expertise? (c) How does domain expertise improve or deter one's reaction and response to unexpected events? (d) What role does judgment play in responding to surprise? The general hypothesis was that good judgment would influence the process of surprise at different stages and in different ways than would domain expertise. The conclusions from this research indicated that good judgment had a significant positive effect in helping pilots deal with unexpected events. This was most pronounced when domain expertise was low.

The effect of interruptions during training on the time to the first trial and race start in Thoroughbred racehorses.

PubMed

Bolwell, C F; Rogers, C W; French, N P; Firth, E C

2013-02-01

Few studies have investigated the effect of having interruptions during training on future training and racing performance in Thoroughbred racehorses. The aim of this paper was to investigate the effect of having an interruption before the first trial on starting in a trial or a race. A prospective cohort study was used to record the training activity of a cohort of Thoroughbred racehorses, over two racing seasons. Fourteen racehorse trainers recorded information on the distances worked at canter and at fast speeds (<15s/200 m) and provided reasons for horses not training, or for having interruptions (break from training). Trial and racing results were obtained from the New Zealand Thoroughbred Racing online database. A Cox proportional hazards regression model was used to investigate two outcome measures of performance: (1) time to the first trial and (2) time to the first race. The type of interruption that had occurred before the first trial was the main exposure of interest, and was grouped into: no interruption, voluntary (no known condition or disease present) and involuntary interruptions (due to the presence of a condition or disease). A total of 160/200 (80%) horses started in at least one trial and 100/205 (48%) horses started in at least one race during the study period. The median time to starting in a trial or a race differed significantly (p<0.001) with the type of interruption. The hazard of starting in a trial was lower for horses experiencing voluntary and involuntary interruptions (p<0.001) but there was no association with starting in a race, after adjusting for confounding variables. As age at the start of training increased the hazard of starting in a trial decreased. Horses accumulating longer distances at 15s/200 m had a higher hazard of starting in a trial, whilst horses accumulating fewer events at high speed and fewer trials had a reduced hazard of starting in a race. There was significant clustering at the trainer level for both the outcomes investigated. Interruptions to training had an effect on the time to, and hazard of, a trial but not a race start. The timing of these interruptions may have implications for future racing success and career longevity. Copyright © 2012 Elsevier B.V. All rights reserved.

Effectiveness of infliximab after adalimumab failure in Crohn's disease.

PubMed

Chaparro, María; Andreu, Montserrat; Barreiro-de Acosta, Manuel; García-Planella, Esther; Ricart, Elena; Domènech, Eugeni; Esteve, María; Merino, Olga; Nos, Pilar; Peñalva, Mireia; Gisbert, Javier P

2012-10-07

To evaluate the effectiveness of infliximab as a second-line therapy in Crohn's disease patients after adalimumab failure. A historical cohort study in a community-based gastroenterology practice evaluated Crohn's disease patients treated with infliximab (induction plus maintenance) after adalimumab failure. Patients were identified using a large Spanish database (ENEIDA). We included 15 Crohn's disease patients who received infliximab after adalimumab failure. Five patients discontinued adalimumab due to loss of response, 3 due to adverse events and 7 due to partial response. After infliximab therapy was started, all patients who had interrupted adalimumab due to loss of efficacy regained response. All patients who discontinued adalimumab due to adverse events responded to infliximab and maintained this response; one of these patients had an uneventful course on infliximab, but 2 developed adverse events. None of the 7 patients who interrupted adalimumab due to partial response reached remission with infliximab. Switching from adalimumab to infliximab may be useful in patients who develop adverse effects or loss of response, however, the benefit of infliximab in primary nonresponders was not established.

Effectiveness of infliximab after adalimumab failure in Crohn's disease

PubMed Central

Chaparro, María; Andreu, Montserrat; Barreiro-de Acosta, Manuel; García-Planella, Esther; Ricart, Elena; Domènech, Eugeni; Esteve, María; Merino, Olga; Nos, Pilar; Peñalva, Mireia; Gisbert, Javier P

2012-01-01

AIM: To evaluate the effectiveness of infliximab as a second-line therapy in Crohn’s disease patients after adalimumab failure. METHODS: A historical cohort study in a community-based gastroenterology practice evaluated Crohn’s disease patients treated with infliximab (induction plus maintenance) after adalimumab failure. Patients were identified using a large Spanish database (ENEIDA). RESULTS: We included 15 Crohn’s disease patients who received infliximab after adalimumab failure. Five patients discontinued adalimumab due to loss of response, 3 due to adverse events and 7 due to partial response. After infliximab therapy was started, all patients who had interrupted adalimumab due to loss of efficacy regained response. All patients who discontinued adalimumab due to adverse events responded to infliximab and maintained this response; one of these patients had an uneventful course on infliximab, but 2 developed adverse events. None of the 7 patients who interrupted adalimumab due to partial response reached remission with infliximab. CONCLUSION: Switching from adalimumab to infliximab may be useful in patients who develop adverse effects or loss of response, however, the benefit of infliximab in primary nonresponders was not established. PMID:23066316

Using a Counterfactual Process to Identify the Applicability of Emerging Technology

DTIC Science & Technology

2014-09-01

conditions that must exist for the antecedent to happen.129 Crafting a 126 Michael W. Morris and...opportunities of interrupting the sequence of events. For example, if the bombers were identified on Monday then the events that unfold on Tuesday ...www.telegraph.co.uk/news/worldnews/northamerica/usa/10006491/Boston- marathon-bombings-Dzhokhar-Tsarnaev-pictured-behind-eight-year-old- victim.html Morris , Michael

Plasmacytoid dendritic cell and functional HIV Gag p55-specific T cells before treatment interruption can inform set-point plasma HIV viral load after treatment interruption in chronically suppressed HIV-1(+) patients.

PubMed

Papasavvas, Emmanouil; Foulkes, Andrea; Yin, Xiangfan; Joseph, Jocelin; Ross, Brian; Azzoni, Livio; Kostman, Jay R; Mounzer, Karam; Shull, Jane; Montaner, Luis J

2015-07-01

The identification of immune correlates of HIV control is important for the design of immunotherapies that could support cure or antiretroviral therapy (ART) intensification-related strategies. ART interruptions may facilitate this task through exposure of an ART partially reconstituted immune system to endogenous virus. We investigated the relationship between set-point plasma HIV viral load (VL) during an ART interruption and innate/adaptive parameters before or after interruption. Dendritic cell (DC), natural killer (NK) cell and HIV Gag p55-specific T-cell functional responses were measured in paired cryopreserved peripheral blood mononuclear cells obtained at the beginning (on ART) and at set-point of an open-ended interruption from 31 ART-suppressed chronically HIV-1(+) patients. Spearman correlation and linear regression modeling were used. Frequencies of plasmacytoid DC (pDC), and HIV Gag p55-specific CD3(+)  CD4(-)  perforin(+)  IFN-γ(+) cells at the beginning of interruption associated negatively with set-point plasma VL. Inclusion of both variables with interaction into a model resulted in the best fit (adjusted R(2)  = 0·6874). Frequencies of pDC or HIV Gag p55-specific CD3(+)  CD4(-)  CSFE(lo)  CD107a(+) cells at set-point associated negatively with set-point plasma VL. The dual contribution of pDC and anti-HIV T-cell responses to viral control, supported by our models, suggests that these variables may serve as immune correlates of viral control and could be integrated in cure or ART-intensification strategies. © 2015 John Wiley & Sons Ltd.

Exposure to Violence During Ferguson Protests: Mental Health Effects for Law Enforcement and Community Members.

PubMed

Galovski, Tara E; Peterson, Zoë D; Beagley, Marin C; Strasshofer, David R; Held, Philip; Fletcher, Thomas D

2016-08-01

There is little information available on the mental health effects of exposure to shared community violence such as the August 2014 violence that occurred in Ferguson, Missouri. This study sought to examine the relationship between proximity to community violence and mental health in both community members and police officers. We recruited 565 adults (community, n = 304, and police, n = 261) exposed to the violence in Ferguson to complete measures of proximity to violence, posttraumatic stress, depression, and anger. Using structural equation modeling, we assessed aspects of proximity to violence-connectedness, direct exposure, fear from exposure, media exposure, reactions to media, and life interruption-as correlates of posttraumatic stress disorder (PTSD) symptoms, depression, and anger. The final model yielded (n = 432), χ(2) (d = 12) = 7.4, p = .830; comparative fit index = 1.0, root mean square error of approximation = 0 [0, .04]. All aspects of proximity except direct exposure were associated with mental health outcomes. There was no moderation as a function of community versus police. Race moderated the relationship between life interruptions and negative outcomes; interruption was related to distress for White, but not Black community members. Based on group comparisons, community members reported more symptoms of PTSD and depression than law enforcement (ηp (2) = .06 and .02, respectively). Black community members reported more PTSD and depression than White community members (ηp (2) = .05 and .02, respectively). Overall, distress was high, and mental health interventions are likely indicated for some individuals exposed to the Ferguson events. Copyright © 2016 International Society for Traumatic Stress Studies.

Single-Event Effect Performance of a Conductive-Bridge Memory EEPROM

NASA Technical Reports Server (NTRS)

Chen, Dakai; Wilcox, Edward; Berg, Melanie; Kim, Hak; Phan, Anthony; Figueiredo, Marco; Seidleck, Christina; LaBel, Kenneth

2015-01-01

We investigated the heavy ion single-event effect (SEE) susceptibility of the industry’s first stand-alone memory based on conductive-bridge memory (CBRAM) technology. The device is available as an electrically erasable programmable read-only memory (EEPROM). We found that single-event functional interrupt (SEFI) is the dominant SEE type for each operational mode (standby, dynamic read, and dynamic write/read). SEFIs occurred even while the device is statically biased in standby mode. Worst case SEFIs resulted in errors that filled the entire memory space. Power cycle did not always clear the errors. Thus the corrupted cells had to be reprogrammed in some cases. The device is also vulnerable to bit upsets during dynamic write/read tests, although the frequency of the upsets are relatively low. The linear energy transfer threshold for cell upset is between 10 and 20 megaelectron volts per square centimeter per milligram, with an upper limit cross section of 1.6 times 10(sup -11) square centimeters per bit (95 percent confidence level) at 10 megaelectronvolts per square centimeter per milligram. In standby mode, the CBRAM array appears invulnerable to bit upsets.

Results of antiretroviral treatment interruption and intensification in advanced multi-drug resistant HIV infection from the OPTIMA trial.

PubMed

Holodniy, Mark; Brown, Sheldon T; Cameron, D William; Kyriakides, Tassos C; Angus, Brian; Babiker, Abdel; Singer, Joel; Owens, Douglas K; Anis, Aslam; Goodall, Ruth; Hudson, Fleur; Piaseczny, Mirek; Russo, John; Schechter, Martin; Deyton, Lawrence; Darbyshire, Janet

2011-03-31

Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR) and limited retreatment options. We assessed two novel antiretroviral (ARV) treatment approaches in this setting. We conducted a 2×2 factorial randomized open label controlled trial in patients with a CD4 count≤300 cells/µl who had ARV treatment (ART) failure requiring retreatment, to two options (a) re-treatment with either standard (≤4 ARVs) or intensive (≥5 ARVs) ART and b) either treatment starting immediately or after a 12-week monitored ART interruption. Primary outcome was time to developing a first AIDS-defining event (ADE) or death from any cause. Analysis was by intention to treat. From 2001 to 2006, 368 patients were randomized. At baseline, mean age was 48 years, 2% were women, median CD4 count was 106/µl, mean viral load was 4.74 log(10) copies/ml, and 59% had a prior AIDS diagnosis. Median follow-up was 4.0 years in 1249 person-years of observation. There were no statistically significant differences in the primary composite outcome of ADE or death between re-treatment options of standard versus intensive ART (hazard ratio 1.17; CI 0.86-1.59), or between immediate retreatment initiation versus interruption before re-treatment (hazard ratio 0.93; CI 0.68-1.30), or in the rate of non-HIV associated serious adverse events between re-treatment options. We did not observe clinical benefit or harm assessed by the primary outcome in this largest and longest trial exploring both ART interruption and intensification in advanced MDR HIV infection with poor retreatment options. Clinicaltrials.gov NCT00050089.

Results of Antiretroviral Treatment Interruption and Intensification in Advanced Multi-Drug Resistant HIV Infection from the OPTIMA Trial

PubMed Central

Holodniy, Mark; Brown, Sheldon T.; Cameron, D. William; Kyriakides, Tassos C.; Angus, Brian; Babiker, Abdel; Singer, Joel; Owens, Douglas K.; Anis, Aslam; Goodall, Ruth; Hudson, Fleur; Piaseczny, Mirek; Russo, John; Schechter, Martin; Deyton, Lawrence; Darbyshire, Janet

2011-01-01

Background Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR) and limited retreatment options. We assessed two novel antiretroviral (ARV) treatment approaches in this setting. Methods and Findings We conducted a 2×2 factorial randomized open label controlled trial in patients with a CD4 count ≤300 cells/µl who had ARV treatment (ART) failure requiring retreatment, to two options (a) re-treatment with either standard (≤4 ARVs) or intensive (≥5 ARVs) ART and b) either treatment starting immediately or after a 12-week monitored ART interruption. Primary outcome was time to developing a first AIDS-defining event (ADE) or death from any cause. Analysis was by intention to treat. From 2001 to 2006, 368 patients were randomized. At baseline, mean age was 48 years, 2% were women, median CD4 count was 106/µl, mean viral load was 4.74 log10 copies/ml, and 59% had a prior AIDS diagnosis. Median follow-up was 4.0 years in 1249 person-years of observation. There were no statistically significant differences in the primary composite outcome of ADE or death between re-treatment options of standard versus intensive ART (hazard ratio 1.17; CI 0.86–1.59), or between immediate retreatment initiation versus interruption before re-treatment (hazard ratio 0.93; CI 0.68–1.30), or in the rate of non-HIV associated serious adverse events between re-treatment options. Conclusions We did not observe clinical benefit or harm assessed by the primary outcome in this largest and longest trial exploring both ART interruption and intensification in advanced MDR HIV infection with poor retreatment options. Trial Registration Clinicaltrials.gov NCT00050089 PMID:21483491

Community mapping of sex work criminalization and violence: impacts on HIV treatment interruptions among marginalized women living with HIV in Vancouver, Canada.

PubMed

Goldenberg, Shira M; Deering, Kathleen; Amram, Ofer; Guillemi, Silvia; Nguyen, Paul; Montaner, Julio; Shannon, Kate

2017-09-01

Despite the high HIV burden faced by sex workers, data on access and retention in antiretroviral therapy (ART) are limited. Using an innovative spatial epidemiological approach, we explored how the social geography of sex work criminalization and violence impacts HIV treatment interruptions among sex workers living with HIV in Vancouver over a 3.5-year period. Drawing upon data from a community-based cohort (AESHA, 2010-2013) and linked external administrative data on ART dispensation, GIS mapping and multivariable logistic regression with generalized estimating equations to prospectively examine the effects of spatial criminalization and violence near women's places of residence on 2-day ART interruptions. Analyses were restricted to 66 ART-exposed women who contributed 208 observations and 83 ART interruption events. In adjusted multivariable models, heightened density of displacement due to policing independently correlated with HIV treatment interruptions (AOR: 1.02, 95%CI: 1.00-1.04); density of legal restrictions (AOR: 1.30, 95%CI: 0.97-1.76) and a combined measure of criminalization/violence (AOR: 1.00, 95%CI: 1.00-1.01) were marginally correlated. The social geography of sex work criminalization may undermine access to essential medicines, including HIV treatment. Interventions to promote 'enabling environments' (e.g. peer-led models, safer living/working spaces) should be explored, alongside policy reforms to ensure uninterrupted treatment access.

Complex cardiac defects after ethanol exposure during discrete cardiogenic events in zebrafish: Prevention with folic acid

PubMed Central

Sarmah, Swapnalee; Marrs, James A.

2014-01-01

BACKGROUND Fetal alcohol spectrum disorder (FASD) describes a range of birth defects including various congenital heart defects (CHDs). Mechanisms of FASD-associated CHDs are not understood. Whether alcohol interferes with a single critical event or with multiple events in heart formation is not known. RESULTS Our zebrafish embryo experiments showed that ethanol interrupts different cardiac regulatory networks and perturbed multiple steps of cardiogenesis (specification, myocardial migration, looping, chamber morphogenesis and endocardial cushion formation). Ethanol exposure during gastrulation until cardiac specification or during myocardial midline migration did not produce severe or persistent heart development defects. However, exposure comprising gastrulation until myocardial precursor midline fusion or during heart patterning stages produced aberrant heart looping and defective endocardial cushions. Continuous exposure during entire cardiogenesis produced complex cardiac defects leading to severely defective myocardium, endocardium, and endocardial cushions. Supplementation of retinoic acid with ethanol partially rescued early heart developmental defects, but the endocardial cushions did not form correctly. In contrast, supplementation of folic acid rescued normal heart development, including the endocardial cushions. CONCLUSIONS Our results indicate that ethanol exposure interrupted divergent cardiac morphogenesis events causing heart defects. Folic acid supplementation was effective in preventing a wide spectrum of ethanol-induced heart developmental defects. PMID:23832875

Using Exponential Smoothing to Specify Intervention Models for Interrupted Time Series.

ERIC Educational Resources Information Center

Mandell, Marvin B.; Bretschneider, Stuart I.

1984-01-01

The authors demonstrate how exponential smoothing can play a role in the identification of the intervention component of an interrupted time-series design model that is analogous to the role that the sample autocorrelation and partial autocorrelation functions serve in the identification of the noise portion of such a model. (Author/BW)

Radiation Tolerant Intelligent Memory Stack (RTIMS)

NASA Technical Reports Server (NTRS)

Ng, Tak-kwong; Herath, Jeffrey A.

2006-01-01

The Radiation Tolerant Intelligent Memory Stack (RTIMS), suitable for both geostationary and low earth orbit missions, has been developed. The memory module is fully functional and undergoing environmental and radiation characterization. A self-contained flight-like module is expected to be completed in 2006. RTIMS provides reconfigurable circuitry and 2 gigabits of error corrected or 1 gigabit of triple redundant digital memory in a small package. RTIMS utilizes circuit stacking of heterogeneous components and radiation shielding technologies. A reprogrammable field programmable gate array (FPGA), six synchronous dynamic random access memories, linear regulator, and the radiation mitigation circuitries are stacked into a module of 42.7mm x 42.7mm x 13.00mm. Triple module redundancy, current limiting, configuration scrubbing, and single event function interrupt detection are employed to mitigate radiation effects. The mitigation techniques significantly simplify system design. RTIMS is well suited for deployment in real-time data processing, reconfigurable computing, and memory intensive applications.

To the Die Smartly: Heavy Ion Testing of PEMs on COTS Boards Through the Plastic

NASA Technical Reports Server (NTRS)

Wert, J. L.; Normand, E.; Oberg, D. L.; Stevens, L.; Blumer, J.; Fisher, E.; Wode, G.

1999-01-01

Seven commercial off the shelf (COTS) boards containing electronic devices (all in plastic packages, PEMS), under consideration for use in a spacecraft subsystem, were exposed to beams of very high energy ions at the National Superconducting Cyclotron Laboratory (MSU). The ion energies were high enough that an entire board could be exposed in air, and it could still penetrate through the plastic and reach the silicon die. A total of about 300 runs were made, and for each, the LET of the ion entering the silicon die had to be determined, based on the thickness of the plastic lid and the thickness of overlaying materials (e.g., aluminum degraders). Single event latchup (SEL) and functional interrupt (SEFI) were determined during each run, the SEFI by means of simple programs being continuously written to and read from the boards to monitor functionality, while each part was being exposed to the heavy ions.

Efficacy and safety of sorafenib for advanced renal cell carcinoma: real-world data of patients with renal impairment.

PubMed

Tatsugami, Katsunori; Oya, Mototsugu; Kabu, Koki; Akaza, Hideyuki

2018-04-10

We retrospectively analysed the efficacy and safety of sorafenib in patients with advanced renal cell carcinoma with renal impairment. Patients were divided into two groups by an estimated glomerular filtration rate (eGFR) cut-off of 45 mL/min/1.73 m 2 . Background factors considered to affect prognosis were well balanced by propensity score matching between the groups. Demographics, dose modification, adverse events, tumour response, progression-free survival, and renal function (eGFR) were evaluated. Among 935 and 2008 patients with an eGFR of <45 and ≥45, respectively, 613 pairs were matched. The mean starting dose was significantly lower in patients with an eGFR of <45; however, the mean daily dose, median treatment duration, progression-free survival, and tumour response were similar between the groups. In terms of safety, no significant differences were found in serious adverse events, although cytopaenia (16.6% vs 10.6%) and renal dysfunction (4.4% vs 0.7%) were higher in patients with an eGFR of <45 than ≥45 in all adverse events. There were also no differences in dose modification, including dose reduction, dose interruption, and treatment discontinuation. Throughout the 12-month observation period, sorafenib in patients with an eGFR of <45 and ≥45 showed similar safety and efficacy, and treatment was continued without affecting renal function.

Distress among young adult cancer survivors: a cohort study.

PubMed

Yanez, Betina; Garcia, Sofia F; Victorson, David; Salsman, John M

2013-09-01

Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p < .05). Young adult cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

Xenon Formal Security Policy Model

DTIC Science & Technology

2007-08-14

munication primitives such as locks or semaphores , machine instruction results, hypercall results, traps, and interrupts. For an informal example...communicated on the corresponding side of the parallel oper- ator. Events that are in X ∪ Y are synchronized over the two processes. So if we define

ICE System: Interruptible control expert system. M.S. Thesis

NASA Technical Reports Server (NTRS)

Vezina, James M.

1990-01-01

The Interruptible Control Expert (ICE) System is based on an architecture designed to provide a strong foundation for real-time production rule expert systems. Three principles are adopted to guide the development of ICE. A practical delivery platform must be provided, no specialized hardware can be used to solve deficiencies in the software design. Knowledge of the environment and the rule-base is exploited to improve the performance of a delivered system. The third principle of ICE is to respond to the most critical event, at the expense of the more trivial tasks. Minimal time is spent on classifying the potential importance of environmental events with the majority of the time used for finding the responses. A feature of the system, derived from all three principles, is the lack of working memory. By using a priori information, a fixed amount of memory can be specified for the hardware platform. The absence of working memory removes the dangers of garbage collection during the continuous operation of the controller.

Safety and tolerance of efavirenz in different antiretroviral regimens: results from a national multicenter prospective study in 1,033 HIV-infected patients.

PubMed

Pérez-Molina, José A

2002-01-01

To evaluate the incidence and severity of adverse events (AEs) and treatment interruption (TI) with efavirenz in a population with a high rate of intravenous drug use (IVDU). This was a national, multicenter, and observational study of HIV-infected adult patients who were starting an efavirenz-containing regimen. Evaluations of AEs were made in routine clinical practice at baseline and at least 3 months later. A total of 1,033 patients were included from 60 participating hospitals; 20% were antiretroviral naive. The risk factor for HIV infection was IVDU in 62.3%, and 6.6% of participants were on methadone. AEs affected 29.3% of participants, and treatment was interrupted in 8.23%. The most frequent AEs were CNS disturbances that affected 24.1% participants; these AEs were considered related to efavirenz in 18.5% patients. AEs were not severe, and treatment had to be interrupted in 6% of patients. Other AEs were cutaneous rash (incidence of 5.9%; 2.4% of TI), gastrointestinal disturbances (1.45%; no TI), and elevation of liver function test (0.68%; no TI). Patients taking methadone had more AEs (39.7%), mainly CNS disturbances, and TI (19.1%). Cutaneous rash was more frequent among women. Psychoactive drug consumption, previous history of psychiatric disorders, antiretroviral experience, or previous nevirapine intolerance were not associated with higher incidence of AEs. Safety and tolerance of efavirenz is good in most patients, even in a population with a high rate of IVDU. The most common AEs are CNS disturbances; they are not severe and rarely lead to TI.

The interruption of thyroid and interrenal and the inter-hormonal interference in fish: does it promote physiologic adaptation or maladaptation?

PubMed

Peter, Valsa S; Peter, M C Subhash

2011-12-01

Endocrines, the chief components of chemical centers which produce hormones in tune with intrinsic and extrinsic clues, create a chemical bridge between the organism and the environment. In fishes also hormones integrate and modulate many physiologic functions and its synthesis, release, biological actions and metabolic clearance are well regulated. Consequently, thyroid hormones (THs) and cortisol, the products of thyroid and interrenal axes, have been identified for their common integrative actions on metabolic and osmotic functions in fish. On the other hand, many anthropogenic chemical substances, popularly known as endocrine disrupting chemicals, have been shown to disrupt the hormone-receptor signaling pathways in a number fish species. These chemicals which are known for their ability to induce endocrine disruption particularly on thyroid and interrenals can cause malfunction or maladaptation of many vital processes which are involved in the development, growth and reproduction in fish. On the contrary, evidence is presented that the endocrine interrupting agents (EIAs) can cause interruption of thyroid and interrenals, resulting in physiologic compensatory mechanisms which can be adaptive, though such hormonal interactions are less recognized in fishes. The EIAs of physical, chemical and biological origins can specifically interrupt and modify the hormonal interactions between THs and cortisol, resulting in specific patterns of inter-hormonal interference. The physiologic analysis of these inter-hormonal interruptions during acclimation and post-acclimation to intrinsic or extrinsic EIAs reveals that combinations of anti-hormonal, pro-hormonal or stati-hormonal interference may help the fish to fine-tune their metabolic and osmotic performances as part of physiologic adaptation. This novel hypothesis on the phenomenon of inter-hormonal interference and its consequent physiologic interference during thyroid and interrenal interruption thus forms the basis of physiologic acclimation. This interfering action of TH and cortisol during hormonal interruption may subsequently promote ecological adaptation in fish as these physiologic processes ultimately favor them to survive in their hostile environment. Copyright © 2011 Elsevier Inc. All rights reserved.

Traditions of research into interruptions in healthcare: A conceptual review.

PubMed

McCurdie, Tara; Sanderson, Penelope; Aitken, Leanne M

2017-01-01

Researchers from diverse theoretical backgrounds have studied workplace interruptions in healthcare, leading to a complex and conflicting body of literature. Understanding pre-existing viewpoints may advance the field more effectively than attempts to remove bias from investigations. To identify research traditions that have motivated and guided interruptions research, and to note research questions posed, gaps in approach, and possible avenues for future research. A critical review was conducted of research on interruptions in healthcare. Two researchers identified core research communities based on the community's motivations, philosophical outlook, and methods. Among the characteristics used to categorise papers into research communities were the predominant motivation for studying interruptions, the research questions posed, and key contributions to the body of knowledge on interruptions in healthcare. In cases where a paper approached an equal number of characteristics from two traditions, it was placed in a blended research community. A total of 141 papers were identified and categorised; all papers identified were published from 1994 onwards. Four principal research communities emerged: epidemiology, quality improvement, cognitive systems engineering (CSE), and applied cognitive psychology. Blends and areas of mutual influence between the research communities were identified that combine the benefits of individual traditions, but there was a notable lack of blends incorporating quality improvement initiatives. The question most commonly posed by researchers across multiple communities was: what is the impact of interruptions? Impact was measured as a function of task time or risk in the epidemiology tradition, situation awareness in the CSE tradition, or resumption lag (time to resume an interrupted task) in the applied cognitive psychology tradition. No single question about interruptions in healthcare was shared by all four of the core communities. Much research on workplace interruptions in healthcare can be described in terms of fundamental values of four distinct research traditions and the communities that bring the values and methods: of those research traditions to their investigations. Blends between communities indicate that mutual influence has occurred as interruptions research has progressed. It is clear from this review that there is no single or privileged perspective to study interruptions. Instead, these findings suggest that researchers investigating interruptions in healthcare would benefit from being more aware of different perspectives from their own, especially when they consider workplace interventions to reduce interruptions. Copyright © 2016. Published by Elsevier Ltd.

China’s New Relationships With It’s Neighbors

DTIC Science & Technology

2004-01-01

denied a visit request to Taiwan’s first lady, and denied an Asiana airlines flight to Ulan Bator to the Dalai Lama. The Forum attributes both to...reunion in 1995.10 Following that exchange, the event that spawned great anxiety was the 1995-1996 Taiwan Straits Crisis , during which the People’s...years of negotiations, the events of Tiananmen and the Taiwan Straits crisis not only interrupted the proceedings, but added fuel for those seeking

Management Retreats Provide Forum to Resolve Major Operational Issues

ERIC Educational Resources Information Center

Archambault, Dennis R.

1977-01-01

The retreat at the University of California in Los Angeles provides an environment completely away from the bookstore where major issues can be addressed at length without interruption. For two days focus is on store policies, goals, personnel requirements, budgets, review of the previous year, upcoming schedule and events. (LBH)

30 CFR 18.48 - Circuit-interrupting devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., AND APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Construction and.... Such a switch shall be designed to prevent electrical connection to the machine frame when the cable is... motor in the event the belt is stopped, or abnormally slowed down. Note: Short transfer-type conveyors...

Handling cycle slips in GPS data during ionospheric plasma bubble events

NASA Astrophysics Data System (ADS)

Banville, S.; Langley, R. B.; Saito, S.; Yoshihara, T.

2010-12-01

During disturbed ionospheric conditions such as the occurrence of plasma bubbles, the phase and amplitude of the electromagnetic waves transmitted by GPS satellites undergo rapid fluctuations called scintillation. When this phenomenon is observed, GPS receivers are more prone to signal tracking interruptions, which prevent continuous measurement of the total electron content (TEC) between a satellite and the receiver. In order to improve TEC monitoring, a study was conducted with the goal of reducing the effects of signal tracking interruptions by correcting for "cycle slips," an integer number of carrier wavelengths not measured by the receiver during a loss of signal lock. In this paper, we review existing cycle-slip correction methods, showing that the characteristics associated with ionospheric plasma bubbles (rapid ionospheric delay fluctuations, data gaps, increased noise, etc.) prevent reliable correction of cycle slips. Then, a reformulation of the "geometry-free" model conventionally used for ionospheric studies with GPS is presented. Geometric information is used to obtain single-frequency estimates of TEC variations during momentary L2 signal interruptions, which also provides instantaneous cycle-slip correction capabilities. The performance of this approach is assessed using data collected on Okinawa Island in Japan during a plasma bubble event that occurred on 23 March 2004. While an improvement in the continuity of TEC time series is obtained, we question the reliability of any cycle-slip correction technique when discontinuities on both GPS legacy frequencies occur simultaneously for more than a few seconds.

Effects of the terrorist attacks of 9/11/01 on employee attitudes.

PubMed

Ryan, Ann Marie; West, Bradley J; Carr, Jennifer Z

2003-08-01

Much has been stated in the popular press about the effects of the events of 9/11/01 on employee attitudes about work. This study examined a large sample (N = 70,671) of employees of a multinational manufacturer whose annual employee survey data collection was interrupted by the events. After demonstrating measurement equivalence across time and countries, changes in attitudes pre- and post-9/11 were examined. Only negligible differences were found in Job Satisfaction, Supervisor Evaluation, Stress, and Organizational Commitment to Diversity for U.S. employees or for employees worldwide. Demographic differences in response to events were not found. Implications for understanding effects of stressful external events on employee perceptions of work are discussed.

Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation

PubMed Central

Mark, K P; Kerner, I

2016-01-01

Promescent is a lidocaine-based ejaculation delaying spray that absorbs into the skin of the penis prior to sexual activity. This article aimed to evaluate the effect of Promescent on the experience of orgasm, ejaculatory latency time and quality of sexual experience (QSE). Additionally, we assessed ease of application of Promescent and the extent to which it enhanced or interrupted the sexual experience. The analytic sample consisted of 91 men with self-reported subjective premature ejaculation who were sent a sample of Promescent and completed a 14-day internet-based prospective daily electronic report. Average ejaculatory latency time was 11.16 min during product use events, compared with 6.81 min during product non-use events. Both members of the couple had an orgasm 65.6% of the time when they used the product, compared with 44.1% when they did not use the product. QSE was significantly improved on product use days (P<0.05). Quality also significantly improved each subsequent time the product was used (P<0.01). The product was reported as easy to use and did not interrupt the sexual experience. Findings suggest that the use of this topical spray significantly improves QSE and perception of partner experience, and that these improve with longer duration of use. PMID:27557610

Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation.

PubMed

Mark, K P; Kerner, I

2016-11-01

Promescent is a lidocaine-based ejaculation delaying spray that absorbs into the skin of the penis prior to sexual activity. This article aimed to evaluate the effect of Promescent on the experience of orgasm, ejaculatory latency time and quality of sexual experience (QSE). Additionally, we assessed ease of application of Promescent and the extent to which it enhanced or interrupted the sexual experience. The analytic sample consisted of 91 men with self-reported subjective premature ejaculation who were sent a sample of Promescent and completed a 14-day internet-based prospective daily electronic report. Average ejaculatory latency time was 11.16 min during product use events, compared with 6.81 min during product non-use events. Both members of the couple had an orgasm 65.6% of the time when they used the product, compared with 44.1% when they did not use the product. QSE was significantly improved on product use days (P<0.05). Quality also significantly improved each subsequent time the product was used (P<0.01). The product was reported as easy to use and did not interrupt the sexual experience. Findings suggest that the use of this topical spray significantly improves QSE and perception of partner experience, and that these improve with longer duration of use.

MO19390 (SAiL): bleeding events in a phase IV study of first-line bevacizumab with chemotherapy in patients with advanced non-squamous NSCLC.

PubMed

Dansin, Eric; Cinieri, Saverio; Garrido, Pilar; Griesinger, Frank; Isla, Dolores; Koehler, Manfred; Kohlhaeufl, Martin

2012-06-01

The clinical benefit and safety profile associated with first-line bevacizumab with doublet chemotherapy in patients with advanced non-squamous non-small cell lung cancer (NSCLC) was established in two large phase III studies, E4599 and AVAiL. SAiL, a single-arm phase IV study, was conducted to evaluate bevacizumab with a range of first-line chemotherapy regimens in a routine oncology practice setting. This analysis of the SAiL data was undertaken to specifically evaluate bleeding adverse events (AEs) in this study, and to explore potential associations between bleeding and baseline patient and disease characteristics. In total, 2212 patients were evaluated. Bleeding AEs (any grade) occurred in 38.2% of patients (grade ≥ 3 bleeding AEs: 3.6%). Grade ≥ 3 pulmonary hemorrhage and central nervous system bleeding events were observed in 0.7% and 0.1% of patients, respectively. The incidence of grade ≥ 3 bleeding AEs was comparable across patient subgroups defined by central tumor location, tumor cavitation, histology, concomitant anticoagulation therapy and age. The majority (88.6%) of bleeding events resolved or improved, 10.2% persisted and 1.3% led to death; 10.2% of bleeding events required bevacizumab interruption or discontinuation. This analysis from the SAiL trial reaffirms a comparable incidence of clinically significant bleeding associated with first-line bevacizumab and chemotherapy as previous phase III studies in NSCLC patients despite less stringent first-line selection criteria. Grade ≥ 3 bleeding appears to be comparable when analyzed for patient and tumor characteristics, including tumor cavitation and concomitant anticoagulation therapy. Most bleeding events resolved or improved, and interruption/discontinuation of bevacizumab was infrequent in a standard oncology practice setting. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Influence of chemoradiotherapy on nutritional status, functional capacity, quality of life and toxicity of treatment for patients with cervical cancer.

PubMed

Aredes, Mariah A; Garcez, Marcelly R; Chaves, Gabriela V

2018-02-21

Assess the influence of chemoradiotherapy on the nutritional status, functional capacity and quality of life (QoL), associating these indicators at baseline with toxicity and interruption of oncologic treatment in women with cervical cancer. Prospective cohort study performed on 49 women diagnosed with cervical cancer, who underwent treatment between August 2015 and January 2016. For data collection, two appointments were conducted by the lead researcher: the first occurred the day before the first chemotherapy session (T0) and the other at the end of chemotherapy session (T1). Nutritional status was measured by anthropometry (weight, height, mid-upper arm circumference and triceps skinfold thickness) and computed tomography (skeletal muscle index-SMI), functional capacity by handgrip strength (HGS) and Karnofsky Performance Status (KPS), and application of QoL questionnaire (EORTC QLQ-C30). The average age was 45 ± 13.8 years and 81.6% of the women were diagnosed in stages II and III. There was significant reduction in HGS, KPS and QoL between T0 and T1, in addition to a significant QoL reduction according to worsening nutritional status. The interruption of chemotherapy was significantly associated with the variables of nutritional status assessed at baseline. Women who interrupted treatment due to acute toxicity also had a significant lower median SMI than those who concluded the treatment and 83% of these patients presented cachexia. Chemoradiotherapy treatment in patients with cervical cancer had changed negative nutritional parameters, function capacity and QoL, and poor nutritional status at baseline was associated with chemotherapy interruption. © 2018 Dietitians Association of Australia.

Single Event Transients in Voltage Regulators for FPGA Power Supply Applications

NASA Technical Reports Server (NTRS)

Poivey, Christian; Sanders, Anthony; Kim, Hak; Phan, Anthony; Forney, Jim; LaBel, Kenneth A.; Karsh, Jeremy; Pursley, Scott; Kleyner, Igor; Katz, Richard

2006-01-01

As with other bipolar analog devices, voltage regulators are known to be sensitive to single event transients (SET). In typical applications, large output capacitors are used to provide noise immunity. Therefore, since SET amplitude and duration are generally small, they are often of secondary importance due to this capacitance filtering. In low voltage applications, however, even small SET are a concern. Over-voltages may cause destructive conditions. Under-voltages may cause functional interrupts and may also trigger electrical latchup conditions. In addition, internal protection circuits which are affected by load as well as internal thermal effects can also be triggered from heavy ions, causing dropouts or shutdown ranging from milliseconds to seconds. In the case of FPGA power supplies applications, SETS are critical. For example, in the case of Actel FPGA RTAX family, core power supply voltage is 1.5V. Manufacturer specifies an absolute maximum rating of 1.6V and recommended operating conditions between 1.425V and 1.575V. Therefore, according to the manufacturer, any transient of amplitude greater than 75 mV can disrupt normal circuit functions, and overvoltages greater than 100 mV may damage the FPGA. We tested five low dropout voltage regulators for SET sensitivity under a large range of circuit application conditions.

A Study of the Quantity of Time for Teaching Reading.

ERIC Educational Resources Information Center

Florida Reading Association.

A study was conducted to provide descriptive information about the quantity of classroom time used for teaching reading and the interruptive events that occur during the scheduled reading time. Data were gathered from 148 public and private school teachers representing all grade levels and a wide range of teaching experience. The subjects each…

Evaluation of a Decentralized Wastewater Treatment Technology. INTERNATIONAL WASTEWATER SYSTEMS, INC. MODEL 6000 SEQUENCING BATCH REACTOR SYSTEM

EPA Science Inventory

Evaluation of the IWS Model 6000 SBR began in April 2004 when one SBR was taken off line and cleaned. The verification testing started July 1, 2004 and proceeded without interruption through June 30, 2005. All sixteen four-day sampling events were completed as scheduled, yielding...

Acute effects of aircraft noise on cardiovascular admissions - an interrupted time-series analysis of a six-day closure of London Heathrow Airport caused by volcanic ash.

PubMed

Pearson, Tim; Campbell, Michael J; Maheswaran, Ravi

2016-08-01

Acute noise exposure may acutely increase blood pressure but the hypothesis that acute exposure to aircraft noise may trigger cardiovascular events has not been investigated. This study took advantage of a six-day closure of a major airport in April 2010 caused by volcanic ash to examine if there was a decrease in emergency cardiovascular hospital admissions during or immediately after the closure period, using an interrupted daily time-series study design. The population living within the 55dB(A) noise contour was substantial at 0.7 million. The average daily admission count was 13.9 (SD 4.4). After adjustment for covariates, there was no evidence of a decreased risk of hospital admission from cardiovascular disease during the closure period (relative risk 0.97 (95% CI 0.75-1.26)). Using lags of 1-7 days gave similar results. Further studies are needed to investigate if transient aircraft noise exposure can trigger acute cardiovascular events. Copyright © 2016. Published by Elsevier Ltd.

Photochromic molecules as building blocks for molecular electronics.

PubMed

Peter, Belser

2010-01-01

Energy and electron transfer processes can be easily induced by a photonic excitation of a donor metal complex ([Ru(bpy)3]2), which is connected via a wire-type molecular fragment to an acceptor metal complex ([Os(bpy)3]2+). The rate constant for the transfer process can be determined by emission measurements of the two connected metal complexes. The system can be modified by incorporation of a switching unit or an interrupter into the wire, influencing the transfer process. Such a molecular device corresponds to an interrupter, mimic the same function applied in molecular electronics. We have used organic switches, which show photochromic properties. By irradiation with light of different wavelengths, the switch changes its functionality by a photochemical reaction from an OFF- to an ON-state and vice versa. The ON- respectively OFF-state is manifested by a color change but also in different conductivity properties for energy and electron transfer processes. Therefore, the mentioned molecular device can work as a simple interrupter, controlling the rate of the transfer processes.

What We Know About Tuberculosis Transmission: An Overview.

PubMed

Churchyard, Gavin; Kim, Peter; Shah, N Sarita; Rustomjee, Roxana; Gandhi, Neel; Mathema, Barun; Dowdy, David; Kasmar, Anne; Cardenas, Vicky

2017-11-03

Tuberculosis remains a global health problem with an enormous burden of disease, estimated at 10.4 million new cases in 2015. To stop the tuberculosis epidemic, it is critical that we interrupt tuberculosis transmission. Further, the interventions required to interrupt tuberculosis transmission must be targeted to high-risk groups and settings. A simple cascade for tuberculosis transmission has been proposed in which (1) a source case of tuberculosis (2) generates infectious particles (3) that survive in the air and (4) are inhaled by a susceptible individual (5) who may become infected and (6) then has the potential to develop tuberculosis. Interventions that target these events will interrupt tuberculosis transmission and accelerate the decline in tuberculosis incidence and mortality. The purpose of this article is to provide a high-level overview of what is known about tuberculosis transmission, using the tuberculosis transmission cascade as a framework, and to set the scene for the articles in this series, which address specific aspects of tuberculosis transmission. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Unemployment and work interruption among African American single mothers: effects on parenting and adolescent socioemotional functioning.

PubMed

McLoyd, V C; Jayaratne, T E; Ceballo, R; Borquez, J

1994-04-01

Using interview data from a sample of 241 single African American mothers and their seventh- and eighth-grade children, this study tests a model of how 2 economic stressors, maternal unemployment and work interruption, influence adolescent socioemotional functioning. In general, these economic stressors affected adolescent socioemotional functioning indirectly, rather than directly, through their impact on mothers' psychological functioning and, in turn, parenting behavior and mother-child relations. Current unemployment, but not past work interruption, had a direct effect on depressive symptomatology in mothers. As expected, depressive symptomatology in mothers predicted more frequent maternal punishment of adolescents, and this relation was fully mediated by mothers' negative perceptions of the maternal role. More frequent maternal punishment was associated with increased cognitive distress and depressive symptoms in adolescents, and consistent with predictions, these relations were partially mediated by adolescents' perceptions of the quality of relations with their mothers. Increased availability of instrumental support, as perceived by mothers, predicted fewer depressive symptoms in mothers, less punishment of adolescents, and less negativity about the maternal role. Both economic stressors were associated with higher levels of perceived financial strain in mothers, which in turn predicted adolescents' perceptions of economic hardship. Adolescents who perceived their families as experiencing more severe economic hardship reported higher anxiety, more cognitive distress, and lower self-esteem.

Integrating an incident management system within a continuity of operations programme: case study of the Bank of Canada.

PubMed

Loop, Carole

2013-01-01

Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.

Challenges to validity in single-group interrupted time series analysis.

PubMed

Linden, Ariel

2017-04-01

Single-group interrupted time series analysis (ITSA) is a popular evaluation methodology in which a single unit of observation is studied; the outcome variable is serially ordered as a time series, and the intervention is expected to "interrupt" the level and/or trend of the time series, subsequent to its introduction. The most common threat to validity is history-the possibility that some other event caused the observed effect in the time series. Although history limits the ability to draw causal inferences from single ITSA models, it can be controlled for by using a comparable control group to serve as the counterfactual. Time series data from 2 natural experiments (effect of Florida's 2000 repeal of its motorcycle helmet law on motorcycle fatalities and California's 1988 Proposition 99 to reduce cigarette sales) are used to illustrate how history biases results of single-group ITSA results-as opposed to when that group's results are contrasted to those of a comparable control group. In the first example, an external event occurring at the same time as the helmet repeal appeared to be the cause of a rise in motorcycle deaths, but was only revealed when Florida was contrasted with comparable control states. Conversely, in the second example, a decreasing trend in cigarette sales prior to the intervention raised question about a treatment effect attributed to Proposition 99, but was reinforced when California was contrasted with comparable control states. Results of single-group ITSA should be considered preliminary, and interpreted with caution, until a more robust study design can be implemented. © 2016 John Wiley & Sons, Ltd.

Accommodating interruptions: A grounded theory of young people with asthma.

PubMed

Hughes, Mary; Savage, Eileen; Andrews, Tom

2018-01-01

The aim of this study was to develop an explanatory theory on the lives of young people with asthma, issues affecting them and the impact of asthma on their day-to-day lives. Accommodating Interruptions is a theory that explains young people's concerns about living with asthma. Although national and international asthma management guidelines exist, it is accepted that the symptom control of asthma among the young people population is poor. This study was undertaken using Classic Grounded Theory. Data were collected through in-depth interviews and clinic consultations with young people aged 11-16 years who had asthma for over 1 year. Data were also collected from participant diaries. Constant comparative analysis, theoretical coding and memo writing were used to develop the substantive theory. The theory explains how young people resolve their main concern of being restricted by Accommodating Interruptions in their lives. They do this by assimilating behaviours in balance finding, moderating influence, fitting in and assuming control minimising the effects of asthma on their everyday lives. The theory of Accommodating Interruptions explains young people's asthma management behaviours in a new way. It allows us to understand how and why young people behave the way they do because they want to participate and be included in everyday activities, events and relationships. The theory adds to the body of knowledge on how young people with asthma live their day-to-day lives and it challenges some existing viewpoints in the literature regarding their behaviours. The findings have implications for developing services to support young people in a more meaningful way as they accommodate the interruptions associated with asthma in their lives. © 2017 John Wiley & Sons Ltd.

Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD.

PubMed

Jiamsakul, Awachana; Kerr, Stephen J; Ng, Oon Tek; Lee, Man Po; Chaiwarith, Romanee; Yunihastuti, Evy; Van Nguyen, Kinh; Pham, Thuy Thanh; Kiertiburanakul, Sasisopin; Ditangco, Rossana; Saphonn, Vonthanak; Sim, Benedict L H; Merati, Tuti Parwati; Wong, Wingwai; Kantipong, Pacharee; Zhang, Fujie; Choi, Jun Yong; Pujari, Sanjay; Kamarulzaman, Adeeba; Oka, Shinichi; Mustafa, Mahiran; Ratanasuwan, Winai; Petersen, Boondarika; Law, Matthew; Kumarasamy, Nagalingeswaran

2016-05-01

Treatment interruptions (TIs) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Patients initiating cART between 2006 and 2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Covariables with P < 0.10 in univariable analyses were included in multivariable analyses, where P < 0.05 was considered statistically significant. Of 4549 patients from 13 countries in Asia, 3176 (69.8%) were male and the median age was 34 years. A total of 111 (2.4%) had TIs due to AEs and 135 (3.0%) had TIs for other reasons. Median interruption times were 22 days for AE and 148 days for non-AE TIs. In multivariable analyses, interruptions >30 days were associated with failure (31-180 days HR = 2.66, 95%CI (1.70-4.16); 181-365 days HR = 6.22, 95%CI (3.26-11.86); and >365 days HR = 9.10, 95% CI (4.27-19.38), all P < 0.001, compared to 0-14 days). Reasons for previous TI were not statistically significant (P = 0.158). Duration of interruptions of more than 30 days was the key factor associated with large increases in subsequent risk of treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption. © 2016 John Wiley & Sons Ltd.

Effects of unplanned treatment interruptions on HIV treatment failure– results from TAHOD

PubMed Central

Jiamsakul, Awachana; Kerr, Stephen J.; Ng, Oon Tek; Lee, Man Po; Chaiwarith, Romanee; Yunihastuti, Evy; Van Nguyen, Kinh; Pham, Thuy Thanh; Kiertiburanakul, Sasisopin; Ditangco, Rossana; Saphonn, Vonthanak; Sim, Benedict L. H.; Merati, Tuti Parwati; Wong, Wingwai; Kantipong, Pacharee; Zhang, Fujie; Choi, Jun Yong; Pujari, Sanjay; Kamarulzaman, Adeeba; Oka, Shinichi; Mustafa, Mahiran; Ratanasuwan, Winai; Petersen, Boondarika; Law, Matthew; Kumarasamy, Nagalingeswaran

2016-01-01

Objectives Treatment interruptions (TI) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Methods Patients initiating cART between 2006-2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Co-variables with p<0.10 in univariable analyses were included in multivariable analyses, where p<0.05 was considered statistically significant. Results Of 4549 patients from 13 countries in Asia, 3176 (69.8%) were male and the median age was 34 years. A total of 111 (2.4%) had TIs due to AEs and 135 (3.0%) had TIs for other reasons. Median interruption times were 22 days for AE and 148 days for non-AE TIs. In multivariable analyses, interruptions >30 days were associated with failure (31-180 days HR=2.66, 95%CI (1.70-4.16); 181-365 days HR=6.22, 95%CI (3.26-11.86); and >365 days HR=9.10, 95% CI (4.27-19.38), all p<0.001, compared to 0-14 days). Reasons for previous TI were not statistically significant (p=0.158). Conclusions Duration of interruptions of more than 30 days was the key factor associated with large increases in subsequent risk of treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption. PMID:26950901

A Model for Assessment and Mitigation of Threats on the College Campus

ERIC Educational Resources Information Center

Keller, Eileen Weisenbach; Hughes, Stephanie; Hertz, Giles

2011-01-01

Purpose: An increase in the number of disruptive and violent events on college and university campuses instigated this review of the methods used to interrupt the trend, with the goal of identifying a preliminary model for systematic management of such threats. The intent is to instigate research, review and discussion in order to decrease the…

Academic Continuity: Staying True to Teaching Values and Objectives in the Face of Course Interruptions

ERIC Educational Resources Information Center

Day, Terence

2015-01-01

Academic continuity planning is an emerging tool for dealing with class cancellation associated with natural disasters, acts of violence and the threat of pandemics. However, academic continuity can also be an issue with respect to less dramatic events, such as power outages, inclement weather, or the temporary unavailability of an instructor,…

Any sleep is a dream far away: a nominal group study assessing how gout affects sleep.

PubMed

Singh, Jasvinder A

2018-02-23

There are no qualitative studies of sleep in gout; the aim of this study was to examine the impact of gout on sleep. Nine nominal groups were conducted, oversampling for African-Americans and women with gout. Patients discussed and rank-ordered their concerns. Nine nominal groups with 46 gout patients were conducted with mean age, 61 years (s.d. 10.6) and gout duration, 14.9 years (s.d. 12); 63% were men, 46% African-American, 52% married, 46% retired and 63% were allopurinol users. The most frequently cited highly ranked concerns could be divided into three categories. The first category, character of sleep interruption, included the concerns: severe and complete sleep interruption by gout flare pain (nine groups); and inability to get rapid eye movement sleep (one group). The second category, causes of sleep interruption, included: inability to get into a comfortable position during sleep (six groups); anxiety and depression associated with severe gout pain (seven groups); sleep interruption by moderate chronic joint pain (three groups); frequent trips to the bathroom interfering with sleep (two groups); gout medication side effects (four groups); frequent trips to the emergency room (one group); joint swelling with physical/functional deficit interfering with sleep (two groups); and flare pain interfering with sleep apnoea management (two groups). The final category, consequences of sleep interruption, included: effect on daily functioning (two groups); worsens other health conditions, which then affect sleep (four groups); and cumulative effect on sleep (one group). Gout has significant impact on sleep quantity, quality and architecture. Sleep disruption due to gout has several pathways and significant consequences.

Preliminary analysis of the implications of natural radiations on geostationary operations

NASA Technical Reports Server (NTRS)

Wilson, J. W.; Denn, F. M.

1976-01-01

The natural radiations present at geostationary orbit are discussed. Low-level galactic cosmic rays are important for careers spending a year or more at geostationary altitude. Trapped radiation will on occasion require interruption of extravehicular activity (EVA). The spacesuit shield requirements are strongly affected by the number of interruptions allowed. EVA cannot proceed during a large solar event and maximum allowable doses are exceeded in a few hours unless a heavily shielded area is provided. A shelter of 10 g/sq cm with personal shielding for the eyes and testes would contain exposure to within the presently accepted exposure constraints. Since radiation levels can increase unexpectedly to serious levels, an onboard radiation monitoring system with rate and integration capabilities is required for both surface-dose and depth-dose monitoring.

Divergent genome evolution caused by regional variation in DNA gain and loss between human and mouse

PubMed Central

Kortschak, R. Daniel

2018-01-01

The forces driving the accumulation and removal of non-coding DNA and ultimately the evolution of genome size in complex organisms are intimately linked to genome structure and organisation. Our analysis provides a novel method for capturing the regional variation of lineage-specific DNA gain and loss events in their respective genomic contexts. To further understand this connection we used comparative genomics to identify genome-wide individual DNA gain and loss events in the human and mouse genomes. Focusing on the distribution of DNA gains and losses, relationships to important structural features and potential impact on biological processes, we found that in autosomes, DNA gains and losses both followed separate lineage-specific accumulation patterns. However, in both species chromosome X was particularly enriched for DNA gain, consistent with its high L1 retrotransposon content required for X inactivation. We found that DNA loss was associated with gene-rich open chromatin regions and DNA gain events with gene-poor closed chromatin regions. Additionally, we found that DNA loss events tended to be smaller than DNA gain events suggesting that they were able to accumulate in gene-rich open chromatin regions due to their reduced capacity to interrupt gene regulatory architecture. GO term enrichment showed that mouse loss hotspots were strongly enriched for terms related to developmental processes. However, these genes were also located in regions with a high density of conserved elements, suggesting that despite high levels of DNA loss, gene regulatory architecture remained conserved. This is consistent with a model in which DNA gain and loss results in turnover or “churning” in regulatory element dense regions of open chromatin, where interruption of regulatory elements is selected against. PMID:29677183

Haemoglobin and anaemia in the SMART study

PubMed Central

Mocroft, A; Lifson, AR; Touloumi, G; Neuhaus, J; Fox, Z; Palfreeman, A; Vjecha, M; Hodder, S; De Wit, S; Lundgren, JD; Phillips, AN

2014-01-01

Background Data from randomized trials on the development of anaemia after interruption of therapy is not well described. Methods 2248 patients from the SMART study were included. We used Cox proportional hazards models to investigate development of new (≤12 mg/dl for females, ≤14 mg/dl for males) or worsening (≤8 mg/dl if anaemic at randomization) anaemia and poisson regression analyses to explore the relationship between anaemia and the development of AIDS, death or non-AIDS events. Results 759 patients developed new or worsening anaemia; 420/1106 (38.0%) in the drug conservation (DC) arm and 339/1127 (30.1%) in the virologic suppression (VS) arm; p<0.0001. At 4 months after randomization, patients in the DC arm had a significantly increased risk of developing new or worsening anaemia (adjusted relative hazard 1.56, 95% CI 1.28–1.89). Currently anaemic patients had an increased incidence of AIDS (adjusted IRR 2.31; 95% CI 1.34–3.98), death (2.19; 95% CI 1.23–3.87) and non-AIDS events (2.98; 95% CI 2.01–4.40) compared to non-anaemic patients. Conclusions Patients who interrupted cART had a higher risk of new or worsening anaemia. Anaemic patients had a higher incidence of AIDS, non-AIDS defining events or deaths, possibly due to deteriorating health and subclinical disease. PMID:21555815

Numerical modeling of high-voltage circuit breaker arcs and their interraction with the power system

NASA Astrophysics Data System (ADS)

Orama, Lionel R.

In this work the interaction between series connected gas and vacuum circuit breaker arcs has been studied. The breakdown phenomena in vacuum interrupters during the post arc current period have been of special interest. Numerical models of gas and vacuum arcs were developed in the form of black box models. Especially, the vacuum post arc model was implemented by combining the existing transition model with an ion density function and expressions for the breakdown mechanisms. The test series studied reflect that for electric fields on the order of 10sp7V/m over the anode, the breakdown of the vacuum gap can result from a combination of both thermal and electrical stresses. For a particular vacuum device, the vacuum model helps to find the interruption limits of the electric field and power density over the anode. The series connection of gas and vacuum interrupters always performs better than the single gas device. Moreover, to take advantage of the good characteristics of both devices, the time between the current zero crossing in each interrupter can be changed. This current zero synchronization is controlled by changing the capacitance in parallel to the gas device. This gas/vacuum interrupter is suitable for interruption of very stressful short circuits in which the product of the dI/dt before current zero and the dV/dt after current zero is very high. Also, a single SF6 interrupter can be replaced by an air circuit breaker of the same voltage rating in series with a vacuum device without compromising the good performance of the SF6 device. Conceptually, a series connected vacuum device can be used for high voltage applications with equal distribution of electrical stresses between the individual interrupters. The equalization can be made by a sequential opening of the individual contact pairs, beginning with the interruptors that are closer to ground potential. This could eliminate the use of grading capacitors.

Errors on interrupter tasks presented during spatial and verbal working memory performance are linearly linked to large-scale functional network connectivity in high temporal resolution resting state fMRI.

PubMed

Magnuson, Matthew Evan; Thompson, Garth John; Schwarb, Hillary; Pan, Wen-Ju; McKinley, Andy; Schumacher, Eric H; Keilholz, Shella Dawn

2015-12-01

The brain is organized into networks composed of spatially separated anatomical regions exhibiting coherent functional activity over time. Two of these networks (the default mode network, DMN, and the task positive network, TPN) have been implicated in the performance of a number of cognitive tasks. To directly examine the stable relationship between network connectivity and behavioral performance, high temporal resolution functional magnetic resonance imaging (fMRI) data were collected during the resting state, and behavioral data were collected from 15 subjects on different days, exploring verbal working memory, spatial working memory, and fluid intelligence. Sustained attention performance was also evaluated in a task interleaved between resting state scans. Functional connectivity within and between the DMN and TPN was related to performance on these tasks. Decreased TPN resting state connectivity was found to significantly correlate with fewer errors on an interrupter task presented during a spatial working memory paradigm and decreased DMN/TPN anti-correlation was significantly correlated with fewer errors on an interrupter task presented during a verbal working memory paradigm. A trend for increased DMN resting state connectivity to correlate to measures of fluid intelligence was also observed. These results provide additional evidence of the relationship between resting state networks and behavioral performance, and show that such results can be observed with high temporal resolution fMRI. Because cognitive scores and functional connectivity were collected on nonconsecutive days, these results highlight the stability of functional connectivity/cognitive performance coupling.

A prenatal interruption of DISC1 function in the brain exhibits a lasting impact on adult behaviors, brain metabolism, and interneuron development.

PubMed

Deng, Dazhi; Jian, Chongdong; Lei, Ling; Zhou, Yijing; McSweeney, Colleen; Dong, Fengping; Shen, Yilun; Zou, Donghua; Wang, Yonggang; Wu, Yuan; Zhang, Limin; Mao, Yingwei

2017-10-17

Mental illnesses like schizophrenia (SCZ) and major depression disorder (MDD) are devastating brain disorders. The SCZ risk gene, disrupted in schizophrenia 1 ( DISC1 ), has been associated with neuropsychiatric conditions. However, little is known regarding the long-lasting impacts on brain metabolism and behavioral outcomes from genetic insults on fetal NPCs during early life. We have established a new mouse model that specifically interrupts DISC1 functions in NPCs in vivo by a dominant-negative DISC1 (DN-DISC1) with a precise temporal and spatial regulation. Interestingly, prenatal interruption of mouse Disc1 function in NPCs leads to abnormal depression-like deficit in adult mice. Here we took a novel unbiased metabonomics approach to identify brain-specific metabolites that are significantly changed in DN-DISC1 mice. Surprisingly, the inhibitory neurotransmitter, GABA, is augmented. Consistently, parvalbumin (PV) interneurons are increased in the cingulate cortex, retrosplenial granular cortex, and motor cortex. Interestingly, somatostatin (SST) positive and neuropeptide Y (NPY) interneurons are decreased in some brain regions, suggesting that DN-DISC1 expression affects the localization of interneuron subtypes. To further explore the cellular mechanisms that cause this change, DN-DISC1 suppresses proliferation and promotes the cell cycle exit of progenitors in the medial ganglionic eminence (MGE), whereas it stimulates ectopic proliferation of neighboring cells through cell non-autonomous effect. Mechanistically, it modulates GSK3 activity and interrupts Dlx2 activity in the Wnt activation. In sum, our results provide evidence that specific genetic insults on NSCs at a short period of time could lead to prolonged changes of brain metabolism and development, eventually behavioral defects.

Digenic Inheritance of PROKR2 and WDR11 Mutations in Pituitary Stalk Interruption Syndrome.

PubMed

McCormack, Shana E; Li, Dong; Kim, Yeon Joo; Lee, Ji Young; Kim, Soo-Hyun; Rapaport, Robert; Levine, Michael A

2017-07-01

Pituitary stalk interruption syndrome (PSIS, ORPHA95496) is a congenital defect of the pituitary gland characterized by the triad of a very thin/interrupted pituitary stalk, an ectopic (or absent) posterior pituitary gland, and hypoplasia or aplasia of the anterior pituitary gland. Complex genetic patterns of inheritance of this disorder are increasingly recognized. The objective of this study was to identify a genetic cause of PSIS in an affected child. Whole exome sequencing (WES) was performed by using standard techniques, with prioritized genetic variants confirmed via Sanger sequencing. To investigate the effects of one candidate variant on mutant WDR11 function, Western blotting and coimmunofluorescence were used to assess binding capacity, and leptomycin B exposure along with immunofluorescence was used to assess nuclear localization. We describe a child who presented in infancy with combined pituitary hormone deficiencies and whose brain imaging demonstrated a small anterior pituitary, ectopic posterior pituitary, and a thin, interrupted stalk. WES demonstrated heterozygous missense mutations in two genes required for pituitary development, a known loss-of-function mutation in PROKR2 (c.253C>T;p.R85C) inherited from an unaffected mother, and a WDR11 (c.1306A>G;p.I436V) mutation inherited from an unaffected father. Mutant WDR11 loses its capacity to bind to its functional partner, EMX1, and to localize to the nucleus. WES in a child with PSIS and his unaffected family implicates a digenic mechanism of inheritance. In cases of hypopituitarism in which there is incomplete segregation of a monogenic genotype with the phenotype, the possibility that a second genetic locus is involved should be considered. Copyright © 2017 Endocrine Society

Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter?

PubMed Central

Friedman, Esther M.; Montez, Jennifer Karas; Sheehan, Connor McDevitt; Guenewald, Tara L.; Seeman, Teresa E.

2015-01-01

Objective Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. Method We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health. Results The best-fitting specification of quantity of events was a linear measure reflecting a dose–response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women’s risk of heart disease. Discussion Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures. PMID:25903978

Small explosions interrupt 3-year quiescence at Mount St. Helens, Washington

USGS Publications Warehouse

Myers, B.

1992-01-01

These ash-producing explosions are part of a series of at least 28 explosion-like seismic events that began on August 24, 989. Seismic signals from these events resemble those associated with confirmed ash-producing explosions in April-May 1986. Yet not all of the 1989-1991 events produced ash plumes. Excellent visual observations during four of the events indicated that neither a steam nor ash plume was generated. There is little information about the other events because they occurred when the mountain was not visible, nor was there physical evidence of ashfall or surface changes when scientists visited the crater days to weeks alter. Considerable deformation of the north side of the dome occurred during the series of explosion-like seismic events. Sections of the dome slumped northward and two new vents were formed. However, monitoring the changes associated with individual events was often impossible because several key electronic-distance-meter (EDM) targets and tiltmeters were destroyed by the series of events. 

A genetic method for sex determination in Ovis spp. by interruption of the zinc finger protein, Y-linked (ZFY) gene on the Y chromosome.

PubMed

Zhang, Yong Sheng; Du, Ying Chun; Sun, Li Rong; Wang, Xu Hai; Liu, Shuai Bing; Xi, Ji Feng; Li, Chao Cheng; Ying, Rui Wen; Jiang, Song; Wang, Xiang Zu; Shen, Hong; Jia, Bin

2018-03-06

The mammalian Y chromosome plays a critical role in spermatogenesis. However, the exact functions of each gene on the Y chromosome have not been completely elucidated, due, in part, to difficulties in gene targeting analysis of the Y chromosome. The zinc finger protein, Y-linked (ZFY) gene was first proposed to be a sex determination factor, although its function in spermatogenesis has recently been elucidated. Nevertheless, ZFY gene targeting analysis has not been performed to date. In the present study, RNA interference (RNAi) was used to generate ZFY-interrupted Hu sheep by injecting short hairpin RNA (shRNA) into round spermatids. The resulting spermatozoa exhibited abnormal sperm morphology, including spermatozoa without tails and others with head and tail abnormalities. Quantitative real-time polymerase chain reaction analysis showed that ZFY mRNA expression was decreased significantly in Hu sheep with interrupted ZFY compared with wild-type Hu sheep. The sex ratio of lambs also exhibited a bias towards females. Together, the experimental strategy and findings of the present study reveal that ZFY also functions in spermatogenesis in Hu sheep and facilitate the use of RNAi in the control of sex in Hu sheep.

Worsening of left ventricular end-systolic volume and mitral regurgitation without increase in left ventricular dyssynchrony on acute interruption of cardiac resynchronization therapy.

PubMed

Kuppahally, Suman S; Fowler, Michael B; Vagelos, Randall; Wang, Paul; Al-Ahmad, Amin; Paloma, Allan; Liang, David

2009-08-01

Responders to cardiac resynchronization therapy (CRT) have greater left ventricular (LV) dyssynchrony than nonresponders prior to CRT. We conducted this study to see whether the long term responders have more worsening of LV dyssynchrony and LV function on acute interruption of CRT. We identified 22 responders and 13 nonresponders who received CRT as per standard criteria for 23.73 +/- 7.9 months (median 24.5 months). We assessed the acute change in LV function, mitral regurgitation (MR) and compared LV dyssynchrony in CRT on and off modes. On turning off CRT, there was no significant worsening of LV dyssynchrony in both responders and nonresponders. The dyssynchrony measurements by SPWMD, TDI and 3D echocardiography did not correlate significantly. LVESV increased (p = 0.02) and MR (p = 0.01) worsened in CRT-off mode in responders only without significant change in LVEF or LV dimensions. In long-term responders to CRT, there is alteration in the function of remodeled LV with acute interruption of CRT, without significant worsening of LV dyssynchrony. The role of different echocardiographic parameters in the assessment of LV dyssynchrony remains controversial. Even after long-term CRT reversely remodels the LV, the therapy needs to be continued uninterrupted for sustained benefits.

A Survey of Higher Education, 1916-1918. Bulletin, 1919, No. 22

ERIC Educational Resources Information Center

Capen, Samuel P.; John, Walton C.

1919-01-01

The year 1916-17 undoubtedly marks the close of an important epoch in the history of higher education in the United States. It is impossible to foretell as yet what changes will be wrought in the purposes, methods, and control of higher institutions by the war. But the events mentioned in the closing sections in this review have interrupted the…

No Evidence of Suicide Increase Following Terrorist Attacks in the United States: An Interrupted Time-Series Analysis of September 11 and Oklahoma City

ERIC Educational Resources Information Center

Pridemore, William Alex; Trahan, Adam; Chamlin, Mitchell B.

2009-01-01

There is substantial evidence of detrimental psychological sequelae following disasters, including terrorist attacks. The effect of these events on extreme responses such as suicide, however, is unclear. We tested competing hypotheses about such effects by employing autoregressive integrated moving average techniques to model the impact of…

Ecological investigations to select mitigation options to reduce vehicle-caused mortality of a threatened butterfly

Treesearch

Sara B. Zielin; Jalene Littlejohn; Catherine E. de Rivera; Winston P. Smith; Sandra L. Jacobson

2016-01-01

Whereas roads that bisect habitat are known to decrease population size through animal-vehicle collisions or interruption of key life history events, it is not always obvious how to reduce such impacts, especially for flying organisms. We needed a quick, cost-efficient and effective way to determine how best to decrease vehicle-caused mortality while maintaining...

42 CFR 484.235 - Methodology used for the calculation of the partial episode payment adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... partial episode payment adjustment. (a) CMS makes a PEP adjustment to the original 60-day episode payment that is interrupted by an intervening event described in § 484.205(d). (b) The original 60-day episode... partial episode payment is calculated by determining the actual days served by the original HHA as a...

Interrupted breeding in a songbird migrant triggers development of nocturnal locomotor activity.

PubMed

Mukhin, Andrey; Kobylkov, Dmitry; Kishkinev, Dmitry; Grinkevich, Vitaly

2018-04-03

Long-distance avian migrants, e.g. Eurasian reed warblers (Acrocephalus scirpaceus), can precisely schedule events of their annual cycle. However, the proximate mechanisms controlling annual cycle and their interplay with environmental factors are poorly understood. We artificially interrupted breeding in reed warblers by bringing them into captivity and recording birds' locomotor activity for 5-7 days. Over this time, most of the captive birds gradually developed nocturnal locomotor activity not observed in breeding birds. When the birds were later released and radio-tracked, the individuals with highly developed caged activity performed nocturnal flights. We also found that reed warblers kept indoors without access to local cues developed a higher level of nocturnal activity compared to the birds kept outdoors with an access to the familiar environment. Also, birds translocated from a distant site (21 km) had a higher motivation to fly at night-time after release compared to the birds captured within 1 km of a study site. Our study suggests that an interrupted breeding triggers development of nocturnal locomotor activity in cages, and the level of activity is correlated with motivation to perform nocturnal flights in the wild, which can be restrained by familiar environment.

Neglect in human communication: quantifying the cost of cell-phone interruptions in face to face dialogs.

PubMed

Lopez-Rosenfeld, Matías; Calero, Cecilia I; Fernandez Slezak, Diego; Garbulsky, Gerry; Bergman, Mariano; Trevisan, Marcos; Sigman, Mariano

2015-01-01

There is a prevailing belief that interruptions using cellular phones during face to face interactions may affect severely how people relate and perceive each other. We set out to determine this cost quantitatively through an experiment performed in dyads, in a large audience in a TEDx event. One of the two participants (the speaker) narrates a story vividly. The listener is asked to deliberately ignore the speaker during part of the story (for instance, attending to their cell-phone). The speaker is not aware of this treatment. We show that total amount of attention is the major factor driving subjective beliefs about the story and the conversational partner. The effects are mostly independent on how attention is distributed in time. All social parameters of human communication are affected by attention time with a sole exception: the perceived emotion of the story. Interruptions during day-to-day communication between peers are extremely frequent. Our data should provide a note of caution, by indicating that they have a major effect on the perception people have about what they say (whether it is interesting or not . . .) and about the virtues of the people around them.

Neglect in Human Communication: Quantifying the Cost of Cell-Phone Interruptions in Face to Face Dialogs

PubMed Central

Lopez-Rosenfeld, Matías; Calero, Cecilia I.; Fernandez Slezak, Diego; Garbulsky, Gerry; Bergman, Mariano; Trevisan, Marcos; Sigman, Mariano

2015-01-01

There is a prevailing belief that interruptions using cellular phones during face to face interactions may affect severely how people relate and perceive each other. We set out to determine this cost quantitatively through an experiment performed in dyads, in a large audience in a TEDx event. One of the two participants (the speaker) narrates a story vividly. The listener is asked to deliberately ignore the speaker during part of the story (for instance, attending to their cell-phone). The speaker is not aware of this treatment. We show that total amount of attention is the major factor driving subjective beliefs about the story and the conversational partner. The effects are mostly independent on how attention is distributed in time. All social parameters of human communication are affected by attention time with a sole exception: the perceived emotion of the story. Interruptions during day-to-day communication between peers are extremely frequent. Our data should provide a note of caution, by indicating that they have a major effect on the perception people have about what they say (whether it is interesting or not . . .) and about the virtues of the people around them. PMID:26039326

Pacemaker or defibrillator surgery without interruption of anticoagulation.

PubMed

Birnie, David H; Healey, Jeff S; Wells, George A; Verma, Atul; Tang, Anthony S; Krahn, Andrew D; Simpson, Christopher S; Ayala-Paredes, Felix; Coutu, Benoit; Leiria, Tiago L L; Essebag, Vidal

2013-05-30

Many patients requiring pacemaker or implantable cardioverter-defibrillator (ICD) surgery are taking warfarin. For patients at high risk for thromboembolic events, guidelines recommend bridging therapy with heparin; however, case series suggest that it may be safe to perform surgery without interrupting warfarin treatment. There have been few results from clinical trials to support the safety and efficacy of this approach. We randomly assigned patients with an annual risk of thromboembolic events of 5% or more to continued warfarin treatment or to bridging therapy with heparin. The primary outcome was clinically significant device-pocket hematoma, which was defined as device-pocket hematoma that necessitated prolonged hospitalization, interruption of anticoagulation therapy, or further surgery (e.g., hematoma evacuation). The data and safety monitoring board recommended termination of the trial after the second prespecified interim analysis. Clinically significant device-pocket hematoma occurred in 12 of 343 patients (3.5%) in the continued-warfarin group, as compared with 54 of 338 (16.0%) in the heparin-bridging group (relative risk, 0.19; 95% confidence interval, 0.10 to 0.36; P<0.001). Major surgical and thromboembolic complications were rare and did not differ significantly between the study groups. They included one episode of cardiac tamponade and one myocardial infarction in the heparin-bridging group and one stroke and one transient ischemic attack in the continued-warfarin group. As compared with bridging therapy with heparin, a strategy of continued warfarin treatment at the time of pacemaker or ICD surgery markedly reduced the incidence of clinically significant device-pocket hematoma. (Funded by the Canadian Institutes of Health Research and the Ministry of Health and Long-Term Care of Ontario; BRUISE CONTROL ClinicalTrials.gov number, NCT00800137.).

Trial of Continuous or Interrupted Chest Compressions during CPR.

PubMed

Nichol, Graham; Leroux, Brian; Wang, Henry; Callaway, Clifton W; Sopko, George; Weisfeldt, Myron; Stiell, Ian; Morrison, Laurie J; Aufderheide, Tom P; Cheskes, Sheldon; Christenson, Jim; Kudenchuk, Peter; Vaillancourt, Christian; Rea, Thomas D; Idris, Ahamed H; Colella, Riccardo; Isaacs, Marshal; Straight, Ron; Stephens, Shannon; Richardson, Joe; Condle, Joe; Schmicker, Robert H; Egan, Debra; May, Susanne; Ornato, Joseph P

2015-12-03

During cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest, the interruption of manual chest compressions for rescue breathing reduces blood flow and possibly survival. We assessed whether outcomes after continuous compressions with positive-pressure ventilation differed from those after compressions that were interrupted for ventilations at a ratio of 30 compressions to two ventilations. This cluster-randomized trial with crossover included 114 emergency medical service (EMS) agencies. Adults with non-trauma-related cardiac arrest who were treated by EMS providers received continuous chest compressions (intervention group) or interrupted chest compressions (control group). The primary outcome was the rate of survival to hospital discharge. Secondary outcomes included the modified Rankin scale score (on a scale from 0 to 6, with a score of ≤3 indicating favorable neurologic function). CPR process was measured to assess compliance. Of 23,711 patients included in the primary analysis, 12,653 were assigned to the intervention group and 11,058 to the control group. A total of 1129 of 12,613 patients with available data (9.0%) in the intervention group and 1072 of 11,035 with available data (9.7%) in the control group survived until discharge (difference, -0.7 percentage points; 95% confidence interval [CI], -1.5 to 0.1; P=0.07); 7.0% of the patients in the intervention group and 7.7% of those in the control group survived with favorable neurologic function at discharge (difference, -0.6 percentage points; 95% CI, -1.4 to 0.1, P=0.09). Hospital-free survival was significantly shorter in the intervention group than in the control group (mean difference, -0.2 days; 95% CI, -0.3 to -0.1; P=0.004). In patients with out-of-hospital cardiac arrest, continuous chest compressions during CPR performed by EMS providers did not result in significantly higher rates of survival or favorable neurologic function than did interrupted chest compressions. (Funded by the National Heart, Lung, and Blood Institute and others; ROC CCC ClinicalTrials.gov number, NCT01372748.).

Servicing a globally broadcast interrupt signal in a multi-threaded computer

DOEpatents

Attinella, John E.; Davis, Kristan D.; Musselman, Roy G.; Satterfield, David L.

2015-12-29

Methods, apparatuses, and computer program products for servicing a globally broadcast interrupt signal in a multi-threaded computer comprising a plurality of processor threads. Embodiments include an interrupt controller indicating in a plurality of local interrupt status locations that a globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include a thread determining that a local interrupt status location corresponding to the thread indicates that the globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include the thread processing one or more entries in a global interrupt status bit queue based on whether global interrupt status bits associated with the globally broadcast interrupt signal are locked. Each entry in the global interrupt status bit queue corresponds to a queued global interrupt.

Monitoring and Management of Toxicities of Novel B Cell Signaling Agents.

PubMed

Rhodes, Joanna; Mato, Anthony; Sharman, Jeff P

2018-04-11

B cell signaling agents, including ibrutinib, idelalisib, and the BCL-2 inhibitor venetoclax have become an integral part of therapy for patients with non-Hodgkin's lymphomas. The toxicity profiles of these medications is distinct from chemoimmunotherapy. Here, we will review the mechanism of action of these drugs, their efficacy, and toxicity management. Ibrutinib use is associated with increased risk of atrial fibrillation and bleeding which can be managed using dose interruptions and modifications. Patients on idelalisib require close clinical and frequent laboratory monitoring, particularly of liver function tests to ensure there are no serious adverse events. Monitoring for infections is important in patients on both idelalisib and ibrutinib. Venetoclax requires close clinical and laboratory monitoring to prevent significant tumor lysis. Targeted B cell receptor therapies each have unique side effect profiles which require careful clinical monitoring. As we continue to use these therapies, optimal management strategies will continue to be elucidated.

Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney-What We Know and What the Future May Hold.

PubMed

Manohar, Sandhya; Nasr, Samih H; Leung, Nelson

2018-05-03

To update and evaluate the current knowledge on pathogenesis and management of light chain cast nephropathy. Light chain cast nephropathy (LCCN) is the leading cause of acute renal failure in patients with multiple myeloma and is currently recognized as a myeloma defining event. The immunoglobulin free light chain plays an integral role in the pathogenesis of LCCN. The level of free light chain (FLC) in the blood and urine is directly associated with the risk of developing LCCN. Recovery of renal function is related to the speed and degree of the serum FLC reduction. Recently, two randomized trials using high cutoff dialyzer for the removal of serum FLC produced different results in terms of renal recovery. FLC plays a key role in the development and resolution of LCCN. Future therapies will aim to rapidly reduce its concentration or interrupt its interaction with Tamm-Horsfall protein.

On the globality of motor suppression: unexpected events and their influence on behavior and cognition

PubMed Central

Wessel, Jan R.; Aron, Adam R.

2016-01-01

SUMMARY Unexpected events are part of everyday experience. They come in several varieties – action errors, unexpected action outcomes, and unexpected perceptual events – and they lead to motor slowing and cognitive distraction. While different varieties of unexpected events have been studied largely independently, and many different mechanisms are thought to explain their effects on action and cognition, we suggest a unifying theory. We propose that unexpected events recruit a fronto-basal-ganglia network for stopping. This network includes specific prefrontal cortical nodes and is posited to project to the subthalamic nucleus, with a putative global suppressive effect on basal-ganglia output. We argue that unexpected events interrupt action and impact cognition, partly at least, by recruiting this global suppressive network. This provides a common mechanistic basis for different types of unexpected events, links the literatures on motor inhibition, performance-monitoring, attention, and working memory, and is relevant for understanding clinical symptoms of distractibility and mental inflexibility. PMID:28103476

On the Globality of Motor Suppression: Unexpected Events and Their Influence on Behavior and Cognition.

PubMed

Wessel, Jan R; Aron, Adam R

2017-01-18

Unexpected events are part of everyday experience. They come in several varieties-action errors, unexpected action outcomes, and unexpected perceptual events-and they lead to motor slowing and cognitive distraction. While different varieties of unexpected events have been studied largely independently, and many different mechanisms are thought to explain their effects on action and cognition, we suggest a unifying theory. We propose that unexpected events recruit a fronto-basal-ganglia network for stopping. This network includes specific prefrontal cortical nodes and is posited to project to the subthalamic nucleus, with a putative global suppressive effect on basal-ganglia output. We argue that unexpected events interrupt action and impact cognition, partly at least, by recruiting this global suppressive network. This provides a common mechanistic basis for different types of unexpected events; links the literatures on motor inhibition, performance monitoring, attention, and working memory; and is relevant for understanding clinical symptoms of distractibility and mental inflexibility. Copyright © 2017 Elsevier Inc. All rights reserved.

Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms

PubMed Central

Requião-Moura, Lúcio Roberto; Durão, Marcelino de Souza; de Matos, Ana Cristina Carvalho; Pacheco-Silva, Alvaro

2015-01-01

Ischemia and reperfusion injury is an inevitable event in renal transplantation. The most important consequences are delayed graft function, longer length of stay, higher hospital costs, high risk of acute rejection, and negative impact of long-term follow-up. Currently, many factors are involved in their pathophysiology and could be classified into two different paradigms for education purposes: hemodynamic and immune. The hemodynamic paradigm is described as the reduction of oxygen delivery due to blood flow interruption, involving many hormone systems, and oxygen-free radicals produced after reperfusion. The immune paradigm has been recently described and involves immune system cells, especially T cells, with a central role in this injury. According to these concepts, new strategies to prevent ischemia and reperfusion injury have been studied, particularly the more physiological forms of storing the kidney, such as the pump machine and the use of antilymphocyte antibody therapy before reperfusion. Pump machine perfusion reduces delayed graft function prevalence and length of stay at hospital, and increases long-term graft survival. The use of antilymphocyte antibody therapy before reperfusion, such as Thymoglobulin™, can reduce the prevalence of delayed graft function and chronic graft dysfunction. PMID:25993079

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

Attinella, John E.; Davis, Kristan D.; Musselman, Roy G.

Methods, apparatuses, and computer program products for servicing a globally broadcast interrupt signal in a multi-threaded computer comprising a plurality of processor threads. Embodiments include an interrupt controller indicating in a plurality of local interrupt status locations that a globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include a thread determining that a local interrupt status location corresponding to the thread indicates that the globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include the thread processing one or more entries in a global interrupt status bit queue based on whethermore » global interrupt status bits associated with the globally broadcast interrupt signal are locked. Each entry in the global interrupt status bit queue corresponds to a queued global interrupt.« less

Optimizing the process of recovery after road network break-up

NASA Astrophysics Data System (ADS)

Bíl, Michal; Vodák, Rostislav; Křivánková, Zuzana

2016-04-01

A functioning road network provides accessibility to municipalities, important services and facilities. This basic role of the network can be disrupted by natural disasters which usually affect large areas and cause temporal blockages or even destruction of many roads at the same time. This often leads to road network break-up, when a number of disconnected parts emerge. These parts are often of varying importance to society. Some of them may contain large cities or important facilities such as hospitals. This should be reflected during reconnection works when the most important parts of the network should be reconnected among the first in order to reduce the impact of the event. Decision makers and crisis managers, however, do still not have any dynamic tool which might help them with prioritizing the necessary steps. In our presentation we introduce an algorithm and examples of suitable loss functions which enable us to rapidly identify isolated parts of the network, evaluate them and consequently establish an optimal ranked sequence of interrupted links which have to be repaired to reduce the consequences of the disasters.

Generalized run-and-turn motions: From bacteria to Lévy walks

NASA Astrophysics Data System (ADS)

Detcheverry, François

2017-07-01

Swimming bacteria exhibit a repertoire of motility patterns, in which persistent motion is interrupted by turning events. What are the statistical properties of such random walks? If some particular instances have long been studied, the general case where turning times do not follow a Poisson process has remained unsolved. We present a generic extension of the continuous time random walks formalism relying on operators and noncommutative calculus. The approach is first applied to a unimodal model of bacterial motion. We examine the existence of a minimum in velocity correlation function and discuss the maximum of diffusivity at an optimal value of rotational diffusion. The model is then extended to bimodal patterns and includes as particular cases all swimming strategies: run-and-tumble, run-stop, run-reverse and run-reverse-flick. We characterize their velocity correlation functions and investigate how bimodality affects diffusivity. Finally, the wider applicability of the method is illustrated by considering curved trajectories and Lévy walks. Our results are relevant for intermittent motion of living beings, be they swimming micro-organisms or crawling cells.

The Impact of a Case of Ebola Virus Disease on Emergency Department Visits in Metropolitan Dallas-Fort Worth, TX, July, 2013-July, 2015: An Interrupted Time Series Analysis.

PubMed

Molinari, Noelle-Angelique M; LeBlanc, Tanya Telfair; Stephens, William

2018-03-20

The first Ebola virus disease (EVD) case in the United States (US) was confirmed September 30, 2014 in a man 45 years old. This event created considerable media attention and there was fear of an EVD outbreak in the US. This study examined whether emergency department (ED) visits changed in metropolitan Dallas-Fort Worth--, Texas (DFW) after this EVD case was confirmed. Using Texas Health Services Region 2/3 syndromic surveillance data and focusing on DFW, interrupted time series analyses were conducted using segmented regression models with autoregressive errors for overall ED visits and rates of several chief complaints, including fever with gastrointestinal distress (FGI). Date of fatal case confirmation was the "event." Results indicated the event was highly significant for ED visits overall (P<0.05) and for the rate of FGI visits (P<0.0001). An immediate increase in total ED visits of 1,023 visits per day (95% CI: 797.0, 1,252.8) was observed, equivalent to 11.8% (95% CI: 9.2%, 14.4%) increase ED visits overall. Visits and the rate of FGI visits in DFW increased significantly immediately after confirmation of the EVD case and remained elevated for several months even adjusting for seasonality both within symptom specific chief complaints as well as overall. These results have implications for ED surge capacity as well as for public health messaging in the wake of a public health emergency.

Functional Communication Training and Chained Schedules of Reinforcement to Treat Challenging Behavior Maintained by Terminations of Activity Interruptions

ERIC Educational Resources Information Center

Falcomata, Terry S.; Roane, Henry S.; Muething, Colin S.; Stephenson, Kasey M.; Ing, Anna D.

2012-01-01

In this article, the authors evaluated functional communication training (FCT) and a chained schedule of reinforcement for the treatment of challenging behavior exhibited by two individuals diagnosed with Asperger syndrome and autism, respectively. Following a functional analysis with undifferentiated results, the authors demonstrated that…

[No interrupted surgical defects of the white upper lip: repair by a combined advancement and rotation flap in the lip subunit].

PubMed

Guillot, P

2013-01-01

A solid understanding of anatomy, basic surgical principles, and tissue movement is essential when undertaking the reconstruction of facial cutaneous surgical defects. Aesthetic facial reconstruction requires understanding ability to use the tissue adjacent to the defect to create a reconstruction that preserves the function of the area and the cosmetic facial units and subunits. The closure of non interrupted white upper lip defects by using a combined advancement and rotation flap is preferred for defects not overtaking 2.5 cm in diameter.

FPGA based control system for space instrumentation

NASA Astrophysics Data System (ADS)

Di Giorgio, Anna M.; Cerulli Irelli, Pasquale; Nuzzolo, Francesco; Orfei, Renato; Spinoglio, Luigi; Liu, Giovanni S.; Saraceno, Paolo

2008-07-01

The prototype for a general purpose FPGA based control system for space instrumentation is presented, with particular attention to the instrument control application software. The system HW is based on the LEON3FT processor, which gives the flexibility to configure the chip with only the necessary HW functionalities, from simple logic up to small dedicated processors. The instrument control SW is developed in ANSI C and for time critical (<10μs) commanding sequences implements an internal instructions sequencer, triggered via an interrupt service routine based on a HW high priority interrupt.

Predictors of perioperative major bleeding in patients who interrupt warfarin for an elective surgery or procedure: Analysis of the BRIDGE trial.

PubMed

Clark, Nathan P; Douketis, James D; Hasselblad, Vic; Schulman, Sam; Kindzelski, Andrei L; Ortel, Thomas L

2018-01-01

The use of low-molecular weight heparin bridge therapy during warfarin interruption for elective surgery/procedures increases bleeding. Other predictors of bleeding in this setting are not well described. BRIDGE was a randomized, double-blind, placebo-controlled trial of bridge therapy with dalteparin 100 IU/kg twice daily in patients with atrial fibrillation requiring warfarin interruption. Bleeding outcomes were documented from the time of warfarin interruption until up to 37 days postprocedure. Multiple logistic regression and time-dependent hazard models were used to identify major bleeding predictors. We analyzed 1,813 patients of whom 895 received bridging and 918 received placebo. Median patient age was 72.6 years, and 73.3% were male. Forty-one major bleeding events occurred at a median time of 7.0 days (interquartile range, 4.0-18.0 days) postprocedure. Bridge therapy was a baseline predictor of major bleeding (odds ratio [OR]=2.4, 95% CI: 1.2-4.8), as were a history of renal disease (OR=2.9, 95% CI: 1.4-6.0), and high-bleeding risk procedures (vs low-bleeding risk procedures) (OR=2.9, 95% CI: 1.4-5.9). Perioperative aspirin use (OR=3.6, 95% CI: 1.1-11.9) and postprocedure international normalized ratio >3.0 (OR=2.1, 95% CI: 1.5-3.1) were time-dependent predictors of major bleeding. Major bleeding was most common in the first 10 days compared with 11-37 days postprocedure (OR=3.5, 95% CI: 1.8-6.9). In addition to bridge therapy, perioperative aspirin use, postprocedure international normalized ratio >3.0, a history of renal failure, and having a high-bleeding risk procedure increase the risk of major bleeding around the time of an elective surgery/procedure requiring warfarin interruption. Copyright © 2017 Elsevier Inc. All rights reserved.

The efficacy and safety of alectinib in the treatment of ALK+ NSCLC: a systematic review and meta-analysis

PubMed Central

Chen, Yuqing; Qian, Ruolan; Liu, Sihan; You, Danming; Zhang, Jian; Luo, Peng

2018-01-01

Background Alectinib is a second-generation anaplastic lymphoma kinase (ALK) inhibitor approved by the US Food and Drug Administration to treat crizotinib-refractory non-small cell lung cancer. We performed this meta-analysis to synthesize the results of different clinical trials to evaluate the efficacy and safety of alectinib. Methods A search of 3 databases, including PubMed, Web of Science, and the Cochrane Library, was performed from the inception of each database through September 5, 2017. We have pooled the overall response rate (ORR), disease control rate, progression-free survival, and intracranial ORR to evaluate the efficacy of alectinib. Discontinuation rate, rate of dose reduction or interruption due to adverse events as well as the incidence of several adverse events were aggregated to evaluate its safety. Results A total of 8 studies with 626 patients have been included in our study. The pooled efficacy parameters are as follows: ORR 70% (95% CI: 57% to 82%), disease control rate 88% (95% CI: 82% to 94%), progression-free survival 9.36 months (95% CI: 7.38% to 11.34%), and intracranial ORR 52% (95% CI: 45% to 59%). ALK inhibitor-naïve patients tend to have better responses than crizotinib-pretreated patients. The aggregate discontinuation rate is 7% (95% CI: 4% to 10%), and the pooled rate of dose reduction or interruption is 33% (95% CI: 24% to 42%). The incidences of most adverse events were relatively low, while the incidences of 2 frequently reported adverse events, myalgia (18%) and anemia (25%), were even higher than with the first-generation ALK inhibitor crizotinib. Conclusion Generally, alectinib is a drug with preferable efficacy and tolerable adverse effects, and it is suitable for the treatment of intracranial metastases. PMID:29535535

The efficacy and safety of alectinib in the treatment of ALK+ NSCLC: a systematic review and meta-analysis.

PubMed

Fan, Junsheng; Xia, Zengfei; Zhang, Xiaoli; Chen, Yuqing; Qian, Ruolan; Liu, Sihan; You, Danming; Zhang, Jian; Luo, Peng

2018-01-01

Alectinib is a second-generation anaplastic lymphoma kinase (ALK) inhibitor approved by the US Food and Drug Administration to treat crizotinib-refractory non-small cell lung cancer. We performed this meta-analysis to synthesize the results of different clinical trials to evaluate the efficacy and safety of alectinib. A search of 3 databases, including PubMed, Web of Science, and the Cochrane Library, was performed from the inception of each database through September 5, 2017. We have pooled the overall response rate (ORR), disease control rate, progression-free survival, and intracranial ORR to evaluate the efficacy of alectinib. Discontinuation rate, rate of dose reduction or interruption due to adverse events as well as the incidence of several adverse events were aggregated to evaluate its safety. A total of 8 studies with 626 patients have been included in our study. The pooled efficacy parameters are as follows: ORR 70% (95% CI: 57% to 82%), disease control rate 88% (95% CI: 82% to 94%), progression-free survival 9.36 months (95% CI: 7.38% to 11.34%), and intracranial ORR 52% (95% CI: 45% to 59%). ALK inhibitor-naïve patients tend to have better responses than crizotinib-pretreated patients. The aggregate discontinuation rate is 7% (95% CI: 4% to 10%), and the pooled rate of dose reduction or interruption is 33% (95% CI: 24% to 42%). The incidences of most adverse events were relatively low, while the incidences of 2 frequently reported adverse events, myalgia (18%) and anemia (25%), were even higher than with the first-generation ALK inhibitor crizotinib. Generally, alectinib is a drug with preferable efficacy and tolerable adverse effects, and it is suitable for the treatment of intracranial metastases.

The response of southern California ecosystems to Younger Dryas-like rapid climate change: Comparison of glacial terminations 1 and 5.

NASA Astrophysics Data System (ADS)

Heusser, L. E.; Hendy, I. L.

2015-12-01

The Younger Dryas is a well-known rapid climatic cooling that interrupted the Marine Isotope Stage (MIS) 1-2 deglacial warming of Termination 1. This cool event has been associated with ice sheet readvance, meridional overturning, circulation changes, and southward movement of the Intertropical Convergence Zone. In Southern California, the Younger Dryas has been associated with cooler SST, low marine productivity, a well-ventilated oxygen minimum zone, and a wetter climate. Similar rapid cooling events have been found at other terminations including Termination 5 at the MIS 11-12 deglaciation (~425 Ka) identified by ice rafting events in the North Atlantic. Here we present new pollen census data from a unique suite of cores taken from the sub-oxic sediments of Santa Barbara Basin (MV0508-15JC, MV0805-20JC, MV0508-33JC, 29JC and 21JC). These short cores, collected on a truncated anticline within SBB, provide the opportunity to examine the response of southern California terrestrial and marine ecosystems to rapid climate change during the MIS 11-12 deglaciation (Termination 5), which is identified by a bioturbated interval within a sequence of laminated sediments. During Termination 1, changes in Southern California precipitation are reflected in pollen- based reconstructions Southern California vegetation. The high precipitation of glacial montane-coniferous assemblages of pine (Pinus) and Juniper (Juniperus/Calocedrus) transitions into interglacial drought, as expresssed by arid oak (Quercus)/chaparral vegetation. The Younger Dryas interrupts the transition as a high-amplitude pulse in pine associated with increased Gramineae (grass). Termination 5 differs, as the high precipitation of glacial montane-coniferous assemblages do not transition into arid oak/chaparral vegetation. However, a Younger Dryas-like rapid climate event was associated with increased pine and grass.

Understanding Emergency Medicine Physicians Multitasking Behaviors Around Interruptions.

PubMed

Fong, Allan; Ratwani, Raj M

2018-06-11

Interruptions can adversely impact human performance, particularly in fast-paced and high-risk environments such as the emergency department (ED). Understanding physician behaviors before, during, and after interruptions is important to the design and promotion of safe and effective workflow solutions. However, traditional human factors based interruption models do not accurately reflect the complexities of real-world environments like the ED and may not capture multiple interruptions and multitasking. We present a more comprehensive framework for understanding interruptions that is composed of three phases, each with multiple levels: Interruption Start Transition, Interruption Engagement, and Interruption End Transition. This three-phase framework is not constrained to discrete task transitions, providing a robust method to categorize multitasking behaviors around interruptions. We apply this framework in categorizing 457 interruption episodes. 457 interruption episodes were captured during 36 hours of observation. The interrupted task was immediately suspended 348 (76.1%) times. Participants engaged in new self-initiated tasks during the interrupting task 164 (35.9%) times and did not directly resume the interrupted task in 284 (62.1%) interruption episodes. Using this framework provides a more detailed description of the types of physician behaviors in complex environments. Understanding the different types of interruption and resumption patterns, which may have a different impact on performance, can support the design of interruption mitigation strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Large-scale data analysis of power grid resilience across multiple US service regions

NASA Astrophysics Data System (ADS)

Ji, Chuanyi; Wei, Yun; Mei, Henry; Calzada, Jorge; Carey, Matthew; Church, Steve; Hayes, Timothy; Nugent, Brian; Stella, Gregory; Wallace, Matthew; White, Joe; Wilcox, Robert

2016-05-01

Severe weather events frequently result in large-scale power failures, affecting millions of people for extended durations. However, the lack of comprehensive, detailed failure and recovery data has impeded large-scale resilience studies. Here, we analyse data from four major service regions representing Upstate New York during Super Storm Sandy and daily operations. Using non-stationary spatiotemporal random processes that relate infrastructural failures to recoveries and cost, our data analysis shows that local power failures have a disproportionally large non-local impact on people (that is, the top 20% of failures interrupted 84% of services to customers). A large number (89%) of small failures, represented by the bottom 34% of customers and commonplace devices, resulted in 56% of the total cost of 28 million customer interruption hours. Our study shows that extreme weather does not cause, but rather exacerbates, existing vulnerabilities, which are obscured in daily operations.

Differential diagnosis of apneas in preterm infants.

PubMed

Paul, Karel; Melichar, Jan; Miletín, Jan; Dittrichová, Jaroslava

2009-02-01

Clinically relevant apneas, which are common in preterm infants, may adversely affect later neuropsychological condition in this group of patients. Pharmacotherapy to stimulate respiratory functions may be unsuccessful. Polygraphic recording may help in the differential diagnosis of these clinically relevant events. Twenty-nine preterm neonates born before 36 weeks of gestational age were examined using polygraphic recording (respiration--two channels, perioral electromyography, oxygen saturation, heart rate, electroencephalography, electrocardiography, electrooculography). The examination was ordered by the attending physician after an unsuccessful treatment of apnea by Aminophylline, and it should contribute to the clarification of the causes of these events. In the course of the polygraphic examinations, altogether 63 episodes were recorded during which the pulse oximeter alarm signal was set off. In 42 cases, the alarm signal was set off in events during which SaO(2) fell below 85%. In the remaining 21 cases, the alarm signal was set off in episodes during which early bradycardia below 90/min occurred. The onset of apnea was very often associated with the phasic increase of the perioral electromyography and with electroencephalography arousal reaction. Because of suspicion that these apneas may be triggered by episodes of gastroesophageal reflux, the interruption of the Aminophylline treatment and setting up an antireflux regimen were recommended. These therapeutic measures had a positive effect: The frequency of alarm signals decreased within 48 h by a statistically significant 50%. In cases where the pharmacotherapy of apnea by stimulation of respiratory functions is not successful, differential diagnostic analysis should be performed. Polygraphy may contribute to the clarification of the causes underlying clinically relevant apneas in a view of newly described polygraphic signs. It is feasible to suspect, based on these signs, that gastroesophageal reflux is the cause for clinically significant apneas in that case.

A Tsunami Model for Chile for (Re) Insurance Purposes

NASA Astrophysics Data System (ADS)

Arango, Cristina; Rara, Vaclav; Puncochar, Petr; Trendafiloski, Goran; Ewing, Chris; Podlaha, Adam; Vatvani, Deepak; van Ormondt, Maarten; Chandler, Adrian

2014-05-01

Catastrophe models help (re)insurers to understand the financial implications of catastrophic events such as earthquakes and tsunamis. In earthquake-prone regions such as Chile,(re)insurers need more sophisticated tools to quantify the risks facing their businesses, including models with the ability to estimate secondary losses. The 2010 (M8.8) Maule (Chile) earthquake highlighted the need for quantifying losses from secondary perils such as tsunamis, which can contribute to the overall event losses but are not often modelled. This paper presents some key modelling aspects of a new earthquake catastrophe model for Chile developed by Impact Forecasting in collaboration with Aon Benfield Research partners, focusing on the tsunami component. The model has the capability to model tsunami as a secondary peril - losses due to earthquake (ground-shaking) and induced tsunamis along the Chilean coast are quantified in a probabilistic manner, and also for historical scenarios. The model is implemented in the IF catastrophe modelling platform, ELEMENTS. The probabilistic modelling of earthquake-induced tsunamis uses a stochastic event set that is consistent with the seismic (ground shaking) hazard developed for Chile, representing simulations of earthquake occurrence patterns for the region. Criteria for selecting tsunamigenic events (from the stochastic event set) are proposed which take into consideration earthquake location, depth and the resulting seabed vertical displacement and tsunami inundation depths at the coast. The source modelling software RuptGen by Babeyko (2007) was used to calculate static seabed vertical displacement resulting from earthquake slip. More than 3,600 events were selected for tsunami simulations. Deep and shallow water wave propagation is modelled using the Delft3D modelling suite, which is a state-of-the-art software developed by Deltares. The Delft3D-FLOW module is used in 2-dimensional hydrodynamic simulation settings with non-steady flow. Earthquake-induced static seabed vertical displacement is used as an input boundary condition to the model. The model is hierarchically set up with three nested domain levels; with 250 domains in total covering the entire Chilean coast. Spatial grid-cell resolution is equal to the native SRTM resolution of approximately 90m. In addition to the stochastic events, the 1960 (M9.5) Valdivia and 2010 (M8.8) Maule earthquakes are modelled. The modelled tsunami inundation map for the 2010 Maule event is validated through comparison with real observations. The vulnerability component consists of an extensive damage curves database, including curves for buildings, contents and business interruption for 21 occupancies, 24 structural types and two secondary modifies such as building height and period of construction. The building damage curves are developed by use of load-based method in which the building's capacity to resist tsunami loads is treated as equivalent to the design earthquake load capacity. The contents damage and business interruption curves are developed by use of deductive approach i.e. HAZUS flood vulnerability and business function restoration models are adapted for detailed occupancies and then assigned to the dominant structural types in Chile. The vulnerability component is validated through model overall back testing by use of observed aggregated earthquake and tsunami losses for client portfolios for 2010 Maule earthquake.

A socio-technical systems approach to studying interruptions: understanding the interrupter's perspective.

PubMed

Rivera, A Joy

2014-05-01

The purpose of this study was to understand the cognitive processes underlying nurses' decision to interrupt other nurses. The Institute of Medicine (2000) reported that interruptions are likely contributors to medical errors. Unfortunately, the research to date has been quite homogenous, focusing only on the healthcare provider being interrupted, ignoring the true complexities of interruptions. This study took a socio-technical approach being the first to examine interruptions from the viewpoint of the interrupting nurse. Over 15 h of observations and 10 open-ended interviews with expert nurses in a Neuroscience Surgical Intensive Care Unit were conducted. It was found that nurses conduct a quick cost-benefit assessment to determine the interruptibility of other nurses and whether an interruption is value-added vs. non-value added. To complete the assessment, nurses consider several conditional factors related to the interruptee, the interrupter, and the nature of the interruption content, and different potential consequences of the interruption. Published by Elsevier Ltd.

Acute gastrointestinal illness following a prolonged community-wide water emergency.

PubMed

Gargano, J W; Freeland, A L; Morrison, M A; Stevens, K; Zajac, L; Wolkon, A; Hightower, A; Miller, M D; Brunkard, J M

2015-10-01

The drinking water infrastructure in the United States is ageing; extreme weather events place additional stress on water systems that can lead to interruptions in the delivery of safe drinking water. We investigated the association between household exposures to water service problems and acute gastrointestinal illness (AGI) and acute respiratory illness (ARI) in Alabama communities that experienced a freeze-related community-wide water emergency. Following the water emergency, investigators conducted a household survey. Logistic regression models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for self-reported AGI and ARI by water exposures. AGI was higher in households that lost water service for ⩾7 days (aPR 2·4, 95% CI 1·1-5·2) and experienced low water pressure for ⩾7 days (aPR 3·6, 95% CI 1·4-9·0) compared to households that experienced normal service and pressure; prevalence of AGI increased with increasing duration of water service interruptions. Investments in the ageing drinking water infrastructure are needed to prevent future low-pressure events and to maintain uninterrupted access to the fundamental public health protection provided by safe water supplies. Households and communities need to increase their awareness of and preparedness for water emergencies to mitigate adverse health impacts.

Not Just the 8.2 event: Dynamic Early Holocene Climate in Arctic Canada

NASA Astrophysics Data System (ADS)

Axford, Y.; Briner, J. P.; Miller, G. H.; Francis, D. R.

2006-12-01

Temperature reconstructions from a lake in the eastern Canadian Arctic indicate that peak warmth in the early Holocene was interrupted by two abrupt, short-lived temperature reversals at ~9.l and ~8.5 ka. Summer temperatures at Lake CF8, Baffin Island (~500 km west of Greenland) are inferred from subfossil midge (Chironomidae) assemblages. Our results indicate that the site, like others on Baffin Island, experienced exceptionally warm summers (almost 5°C warmer than present) through much of the early Holocene, presumably in response to enhanced summer insolation. After 1000 years of very warm, stable climate, warmth was interrupted by two discrete cold reversals at ~9.1 and ~8.5 ka, during which multiple cold-stenothermous midge taxa appeared in the lake and summer temperatures dropped more than 3°C. These two clearly-defined reversals, well beyond the range of background variability, were of similar amplitude and duration, and were separated by several centuries of near-peak warmth. The only Holocene events of comparable amplitude at this site are the rapid onset of Holocene warmth, and the more gradual Neoglacial cooling after 8 ka. Abrupt cooling events over the Baffin region are consistent with model simulations of the impacts of freshwater outbursts into the Labrador Sea, such as the Lake Agassiz outburst flood that occurred ~8.4 ka. That there are two discrete events recorded at this site indicates that the "8.2 event" was not uniquely significant in this region; rather, the period between approximately ~9.2 and 8 ka was characterized by repeated climate fluctuations forced by multiple outburst floods or other mechanisms. Thus global correlations among paleoclimate records need not assume that climate perturbations during this time period necessarily correlate with the draining of Lake Agassiz or the 8.2 ka cooling in central Greenland.

Solar-Panel Dust Accumulation and Cleanings

NASA Technical Reports Server (NTRS)

2005-01-01

Air-fall dust accumulates on the solar panels of NASA's Mars Exploration Rovers, reducing the amount of sunlight reaching the solar arrays. Pre-launch models predicted steady dust accumulation. However, the rovers have been blessed with occasional wind events that clear significant amounts of dust from the solar panels.

This graph shows the effects of those panel-cleaning events on the amount of electricity generated by Spirit's solar panels. The horizontal scale is the number of Martian days (sols) after Spirit's Jan. 4, 2005, (Universal Time) landing on Mars. The vertical scale indicates output from the rover's solar panels as a fraction of the amount produced when the clean panels first opened. Note that the gradual declines are interrupted by occasional sharp increases, such as a dust-cleaning event on sol 420.

A Catalog of Coronal "EIT Wave" Transients

NASA Technical Reports Server (NTRS)

Thompson, B. J.; Myers, D. C.

2005-01-01

SOHO Extreme Ultraviolet Imaging Telescope (EIT) data have been visually searched for coronal "EIT wave" transients over the period beginning 24 March 1997 extending through 24 June 1998. The dates covered start at the beginning of regular high-cadence (more than 1 image every 20 minutes) observations, ending at the 4-month interruption of SOHO observations in mid-1998. 176 events are included in this catalog. The observations range from "candidate" events, which were either weak or had insufficient data coverage, to events which were well-defined and were clearly distinguishable in the data. Included in the catalog are times of the EIT images in which the events are observed, diagrams indicating the observed locations of the wavefronts and associated active regions, and the speeds of the wavefronts. The measured speeds of the wavefronts varied from less than 50 to over 700 km/sec with "typical" speeds of 200-400 Msec.

New Approaches to Chemotherapy of Viral Diseases.

DTIC Science & Technology

1978-04-19

interruptions/k minutes ; SM-l2l3 treated : 277 li g ht beam interruptions/k minutes) and thus the drug does not appear to have a depressant effect ...the In teraction of SM-lZi3 with i~~uncmoduIetory stressors; end (b)the effects of 511-1213 on macrophage function . Psychosocial stress Induced by... effects on lumtedlate and delayed type hypersensitivity r.spons.~ to R8C~~~~— DO ,, 1473 £DITIpN 0? I NOV 55 I GIb lETS S/R oioS-oi4-uO i I SECURItY

Improving Societal Resilience Through Enhanced Reconnection Speed of Damaged Networks

NASA Astrophysics Data System (ADS)

Vodák, Rostislav; Bíl, Michal

2017-04-01

Road networks rank among the foundations of civilization. They enable people, services and goods to be transported to arbitrary places at any time. Its functioning can be impacted by various events, not only by natural hazards and their combinations. This can lead to the concurrent interruption of a number of roads and even cut-off parts of the network from vital services. The impact of these events can be reduced by various measures, but cannot be fully eliminated. We are aware of the fact that extreme events which result in road network break up will occur regardless of the ongoing process of hazard reduction using, for example, the improvement of the structural robustness of roads. The next problem is that many of the events are unpredictable and thus the needed costs of the improvement can easily spiral out of control. We therefore focus on the speed of the recovery process which can be optimized. This means that the time during which the damaged network is reconnected again will be as short as possible. The result of the optimization procedure is a sequence of road links which represent the routes of the repair units. The optimization process is, however, highly nontrivial because of the large number of possible routes for repair units. This prevents anyone from finding an optimal solution. We consequently introduce an approach based on the Ant Colony Optimization algorithm which is able to suggest an almost optimal solution under various constraints which can be established by the administrator of the network. We will also demonstrate its results and variability with several case examples.

An eye movement analysis of the effect of interruption modality on primary task resumption.

PubMed

Ratwani, Raj; Trafton, J Gregory

2010-06-01

We examined the effect of interruption modality (visual or auditory) on primary task (visual) resumption to determine which modality was the least disruptive. Theories examining interruption modality have focused on specific periods of the interruption timeline. Preemption theory has focused on the switch from the primary task to the interrupting task. Multiple resource theory has focused on interrupting tasks that are to be performed concurrently with the primary task. Our focus was on examining how interruption modality influences task resumption.We leverage the memory-for-goals theory, which suggests that maintaining an associative link between environmental cues and the suspended primary task goal is important for resumption. Three interruption modality conditions were examined: auditory interruption with the primary task visible, auditory interruption with a blank screen occluding the primary task, and a visual interruption occluding the primary task. Reaction time and eye movement data were collected. The auditory condition with the primary task visible was the least disruptive. Eye movement data suggest that participants in this condition were actively maintaining an associative link between relevant environmental cues on the primary task interface and the suspended primary task goal during the interruption. These data suggest that maintaining cue association is the important factor for reducing the disruptiveness of interruptions, not interruption modality. Interruption-prone computing environments should be designed to allow for the user to have access to relevant primary task cues during an interruption to minimize disruptiveness.

Safety and Efficacy of Bridging With Low-Molecular-Weight Heparin During Temporary Interruptions of Warfarin: A Register-Based Cohort Study.

PubMed

Sjögren, Vilhelm; Grzymala-Lubanski, Bartosz; Renlund, Henrik; Svensson, Peter J; Själander, Anders

2017-11-01

Low-molecular-weight heparin (LMWH) is often recommended as a bridging therapy during temporary interruptions in warfarin treatment, despite lack of evidence. The aim of this study was to see whether we could find benefit from LMWH bridging. We studied all planned interruptions of warfarin within the Swedish anticoagulation register Auricula during 2006 to 2011. Low-molecular-weight heparin bridging was compared to nonbridging (control) after propensity score matching. Complications were identified in national clinical registers for 30 days following warfarin cessation, and defined as all-cause mortality, bleeding (intracranial, gastrointestinal, or other), or thrombosis (ischemic stroke or systemic embolism, venous thromboembolism, or myocardial infarction) that was fatal or required hospital care. Of the 14 556 identified warfarin interruptions, 12 659 with a known medical background had a mean age of 69 years, 61% were males, mean CHADS 2 (1 point for each of congestive heart failure, hypertension, age ≥75 years, diabetes, and 2 points for stroke or transient ischemic attack) score was 1.7, and CHA 2 DS 2 -VASc score was 3.4. The total number of LMWH bridgings was 7021. Major indications for anticoagulation were mechanical heart valve prostheses 4331, atrial fibrillation 1097, and venous thromboembolism 1331. Bridging patients had a higher rate of thrombotic events overall. Total risk of any complication did not differ significantly between bridging (1.5%) and nonbridging (1.2%). Regardless of indication for warfarin treatment, we found no benefit from bridging. The type of procedure prompting bridging was not known, and the likely reason for the observed higher risk of thrombosis with LMWH bridging is that low-risk procedures more often meant no bridging. Results from randomized trials are needed, especially for patients with mechanical heart valves.

Intelligent behavior generator for autonomous mobile robots using planning-based AI decision making and supervisory control logic

NASA Astrophysics Data System (ADS)

Shah, Hitesh K.; Bahl, Vikas; Martin, Jason; Flann, Nicholas S.; Moore, Kevin L.

2002-07-01

In earlier research the Center for Self-Organizing and Intelligent Systems (CSOIS) at Utah State University (USU) have been funded by the US Army Tank-Automotive and Armaments Command's (TACOM) Intelligent Mobility Program to develop and demonstrate enhanced mobility concepts for unmanned ground vehicles (UGVs). One among the several out growths of this work has been the development of a grammar-based approach to intelligent behavior generation for commanding autonomous robotic vehicles. In this paper we describe the use of this grammar for enabling autonomous behaviors. A supervisory task controller (STC) sequences high-level action commands (taken from the grammar) to be executed by the robot. It takes as input a set of goals and a partial (static) map of the environment and produces, from the grammar, a flexible script (or sequence) of the high-level commands that are to be executed by the robot. The sequence is derived by a planning function that uses a graph-based heuristic search (A* -algorithm). Each action command has specific exit conditions that are evaluated by the STC following each task completion or interruption (in the case of disturbances or new operator requests). Depending on the system's state at task completion or interruption (including updated environmental and robot sensor information), the STC invokes a reactive response. This can include sequencing the pending tasks or initiating a re-planning event, if necessary. Though applicable to a wide variety of autonomous robots, an application of this approach is demonstrated via simulations of ODIS, an omni-directional inspection system developed for security applications.

Improving the effectiveness of an interruption lag by inducing a memory-based strategy.

PubMed

Morgan, Phillip L; Patrick, John; Tiley, Leyanne

2013-01-01

The memory for goals model (Altmann & Trafton, 2002) posits the importance of a short delay (the 'interruption lag') before an interrupting task to encode suspended goals for retrieval post-interruption. Two experiments used the theory of soft constraints (Gray, Simms, Fu & Schoelles, 2006) to investigate whether the efficacy of an interruption lag could be improved by increasing goal-state access cost to induce a more memory-based encoding strategy. Both experiments used a copying task with three access cost conditions (Low, Medium, and High) and a 5-s interruption lag with a no lag control condition. Experiment 1 found that the participants in the High access cost condition resumed more interrupted trials and executed more actions correctly from memory when coupled with an interruption lag. Experiment 2 used a prospective memory test post-interruption and an eyetracker recorded gaze activity during the interruption lag. The participants in the High access cost condition with an interruption lag were best at encoding target information during the interruption lag, evidenced by higher scores on the prospective memory measure and more gaze activity on the goal-state during the interruption lag. Theoretical and practical issues regarding the use of goal-state access cost and an interruption lag are discussed. Copyright © 2012. Published by Elsevier B.V.

Do interruptions affect quality of work?

PubMed

Foroughi, Cyrus K; Werner, Nicole E; Nelson, Erik T; Boehm-Davis, Deborah A

2014-11-01

The aim of this study was to determine if interruptions affect the quality of work. Interruptions are commonplace at home and in the office. Previous research in this area has traditionally involved time and errors as the primary measures of disruption. Little is known about the effect interruptions have on quality of work. Fifty-four students outlined and wrote three essays using a within-subjects design. During Condition 1, interruptions occurred while participants were outlining. During Condition 2, interruptions occurred while they were writing. No interruptions occurred in Condition 3. Quality of work was significantly reduced in both interruption conditions when compared to the non-interruption condition. The number of words produced was significantly reduced when participants were interrupted while writing the essay but not when outlining the essay. This research represents a crucial first step in understanding the effect interruptions have on quality of work. Our research suggests that interruptions negatively impact quality of work during a complex, creative writing task. Since interruptions are such a prevalent part of daily life, more research needs to be conducted to determine what other tasks are negatively impacted. Moreover, the underlying mechanism(s) causing these decrements needs to be identified. Finally, strategies and systems need to be designed and put in place to help counteract the decline in quality of work caused by interruptions.

Investigating Interruptions: Implications for Flightdeck Performance

NASA Technical Reports Server (NTRS)

Latorella, Kara A.

1999-01-01

A fundamental aspect of multiple task management is attending to new stimuli and integrating associated task requirements into an ongoing task set; this is "interruption management" (IM). Anecdotal evidence and field studies indicate the frequency and consequences of interruptions, however experimental investigations of mechanisms influencing IM are scarce. Interruptions on commercial flightdecks are numerous, of various forms, and have been cited as contributing factors in many aviation incident and accident reports. This research grounds an experimental investigation of flightdeck interruptions in a proposed IM stage model. This model organizes basic research, identifies influencing mechanisms, and suggests appropriate dependent measures for IM. Fourteen airline pilots participated in a flightdeck simulation experiment to investigate the general effects of performing an interrupting task and interrupted procedure, and the effects of specific task factors: (1) modality; (2) embeddedness, or goal-level, of an interruption; (3) strength of association, or coupling-strength, between interrupted tasks; (4) semantic similarity; and (5) environmental stress. General effects of interruptions were extremely robust. All individual task factors significantly affected interruption management, except "similarity." Results extend the Interruption Management model, and are interpreted for their implications for interrupted flightdeck performance and intervention strategies for mitigating their effects on the flightdeck.

Digital mobile telephones and interference of ophthalmic equipment.

PubMed

Ang, G S; Lian, P; Ng, W S; Whyte, I; Ong, J M

2007-01-01

To assess the effect of mobile telephone electromagnetic interference on electronic ophthalmic equipment. Prospective audit with mobile telephones placed at distances of 3 m, 1 m, and 30 cm from, and in contact with, electronic ophthalmic equipment. Any interruption or cessation of the function of the ophthalmic device was assessed with the mobile telephones in standby, and in dialling or receiving modes. Any alterations of displayed digital figures or numbers were also assessed. A total of 23 electronic ophthalmic devices in two hospital ophthalmology outpatient departments were evaluated. All six mobile telephones used, and 22 (95.7%) of the 23 ophthalmic equipment evaluated had the Conformité Européene (CE) mark. No device showed any interruption or cessation of function. There were no alterations of displayed digital figures or numbers. The only effect of any kind was found with four instruments (1 non-CE marked), where there was temporary flickering on the screen, and only occurred when the mobile telephones were dialling or receiving at a distance of 30 cm or less from the instruments. This study shows that among the electronic ophthalmic devices tested, none suffered failure or interruption of function, from mobile telephone interference. Although not comprehensive for all ophthalmic equipment, the results question the need for a complete ban of mobile telephones in ophthalmic departments. It highlights the need for a controlled, objectively measured study of the clinically relevant effects of mobile telephones in the ophthalmology outpatient setting.

An Assessment of the Global War on Terrorism, 2001-2010

DTIC Science & Technology

2010-12-01

2001, issue 14134. 63 Ibid. 30 Islamique du Salut, FIS, which was a peaceful Islamic organization that won the democratic election in 1991. The...ammunition and finance ) for their next battle with the regime. Crises events soon interrupted this phase, when the military establishment cancelled the...videotapes. They do not the core organization’s finances or detailed plans. Marc Sageman argues that 78 percent of all terrorist plots between 2004 and 2009

Adverse Events in Robotic Surgery: A Retrospective Study of 14 Years of FDA Data

PubMed Central

Alemzadeh, Homa; Raman, Jaishankar; Leveson, Nancy; Kalbarczyk, Zbigniew; Iyer, Ravishankar K.

2016-01-01

Background Use of robotic systems for minimally invasive surgery has rapidly increased during the last decade. Understanding the causes of adverse events and their impact on patients in robot-assisted surgery will help improve systems and operational practices to avoid incidents in the future. Methods By developing an automated natural language processing tool, we performed a comprehensive analysis of the adverse events reported to the publicly available MAUDE database (maintained by the U.S. Food and Drug Administration) from 2000 to 2013. We determined the number of events reported per procedure and per surgical specialty, the most common types of device malfunctions and their impact on patients, and the potential causes for catastrophic events such as patient injuries and deaths. Results During the study period, 144 deaths (1.4% of the 10,624 reports), 1,391 patient injuries (13.1%), and 8,061 device malfunctions (75.9%) were reported. The numbers of injury and death events per procedure have stayed relatively constant (mean = 83.4, 95% confidence interval (CI), 74.2–92.7 per 100,000 procedures) over the years. Surgical specialties for which robots are extensively used, such as gynecology and urology, had lower numbers of injuries, deaths, and conversions per procedure than more complex surgeries, such as cardiothoracic and head and neck (106.3 vs. 232.9 per 100,000 procedures, Risk Ratio = 2.2, 95% CI, 1.9–2.6). Device and instrument malfunctions, such as falling of burnt/broken pieces of instruments into the patient (14.7%), electrical arcing of instruments (10.5%), unintended operation of instruments (8.6%), system errors (5%), and video/imaging problems (2.6%), constituted a major part of the reports. Device malfunctions impacted patients in terms of injuries or procedure interruptions. In 1,104 (10.4%) of all the events, the procedure was interrupted to restart the system (3.1%), to convert the procedure to non-robotic techniques (7.3%), or to reschedule it (2.5%). Conclusions Despite widespread adoption of robotic systems for minimally invasive surgery in the U.S., a non-negligible number of technical difficulties and complications are still being experienced during procedures. Adoption of advanced techniques in design and operation of robotic surgical systems and enhanced mechanisms for adverse event reporting may reduce these preventable incidents in the future. PMID:27097160

The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis.

PubMed

Branas, Charles C; Kastanaki, Anastasia E; Michalodimitrakis, Manolis; Tzougas, John; Kranioti, Elena F; Theodorakis, Pavlos N; Carr, Brendan G; Wiebe, Douglas J

2015-02-02

To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. Greece from 1 January 1983 to 31 December 2012. A total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. In 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (-27.1%, p<0.05). This is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public messaging of these policies and related events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis

PubMed Central

Branas, Charles C; Kastanaki, Anastasia E; Michalodimitrakis, Manolis; Tzougas, John; Kranioti, Elena F; Theodorakis, Pavlos N; Carr, Brendan G; Wiebe, Douglas J

2015-01-01

Objectives To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. Setting Greece from 1 January 1983 to 31 December 2012. Participants A total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. Primary and secondary outcomes National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. Results In 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (−27.1%, p<0.05). Conclusions This is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public messaging of these policies and related events. PMID:25643700

Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration.

PubMed

Flynn, Fran; Evanish, Julie Q; Fernald, Josephine M; Hutchinson, Dawn E; Lefaiver, Cheryl

2016-08-01

Because of the high frequency of interruptions during medication administration, the effectiveness of strategies to limit interruptions during medication administration has been evaluated in numerous quality improvement initiatives in an effort to reduce medication administration errors. To evaluate the effectiveness of evidence-based strategies to limit interruptions during scheduled, peak medication administration times in 3 progressive cardiac care units (PCCUs). A secondary aim of the project was to evaluate the impact of limiting interruptions on medication errors. The percentages of interruptions and medication errors before and after implementation of evidence-based strategies to limit interruptions were measured by using direct observations of nurses on 2 PCCUs. Nurses in a third PCCU served as a comparison group. Interruptions (P < .001) and medication errors (P = .02) decreased significantly in 1 PCCU after implementation of evidence-based strategies to limit interruptions. Avoidable interruptions decreased 83% in PCCU1 and 53% in PCCU2 after implementation of the evidence-based strategies. Implementation of evidence-based strategies to limit interruptions in PCCUs decreases avoidable interruptions and promotes patient safety. ©2016 American Association of Critical-Care Nurses.

Effect of extended and daily short-term starvation/shut-down events on the performance of a biofilter treating toluene vapors.

PubMed

Jiménez, Lucero; Arriaga, Sonia; Muñoz, Raúl; Aizpuru, Aitor

2017-12-01

Industrial emissions of Volatile Organic Compounds are usually discontinuous. To assess the impact of interruptions in pollutant supply on the performance of biological treatment systems, two identical biofilters previously operated under continuous toluene loadings were subjected for 110 days to extended (12, 24, 36, 48, 60, 72, 84 and 96 h) and for a week to daily (8 h on, 16 h off) toluene starvation/shutdown events. One biofilter was operated under complete shutdowns (both air and toluene supply were interrupted), while the other maintained the air supply under toluene starvation. The biofilter operated under complete shutdowns was able to withstand both the extended and daily pollutant interruptions, while starvation periods >24 h severely impacted the performance of the other biofilter, with a removal efficiency decrease from 97.7 ± 0.1% to 45.4 ± 6.7% at the end of the extended starvation periods. This deterioration was likely due to a reduction in liquid lixiviation (from a total volume of 2380 mL to 1800 mL) mediated by the countercurrent airflow during the starvation periods. The presence of air under toluene starvation also favored the accumulation of inactive biomass, thus increasing the pressure drop from 337 to 700 mm H 2 O.m -1 , while decreasing the wash out of acidic by-products with a significantly higher pH of leachates (Student paired t-test <0.05). This study confirmed the need to prevent the accumulation of inhibitory compounds produced during process perturbation in order to increase biofiltration robustness. Process operation with sufficient drainage in the packing material and the absence of countercurrent airflow are highly recommended during toluene deprivation periods. Copyright © 2017. Published by Elsevier Ltd.

Biomarkers of inflammation, coagulation and microbial translocation in HIV/HCV co-infected patients in the SMART study.

PubMed

Peters, Lars; Neuhaus, Jacqueline; Duprez, Daniel; Neaton, James D; Tracy, Russel; Klein, Marina B; Mocroft, Amanda; Rockstroh, Jürgen; Dore, Gregory; Lundgren, Jens D

2014-07-01

Previous results from the SMART study showed that HIV/viral hepatitis co-infected persons with impaired liver function are at increased risk of death following interruption of antiretroviral therapy (ART). To investigate the influence of fibrosis and ART interruption on levels of biomarkers of inflammation, coagulation and microbial translocation in HIV/HCV co-infected persons in the SMART study. All HIV/HCV co-infected persons with stored plasma at study entry and at six months of follow-up were included (N=362). D-dimer, IL-6, sCD14 and hepatic synthesized coagulation markers were measured and compared according to the liver fibrosis marker hyaluronic acid (HA) at study entry. Percent difference in changes in biomarker levels from study entry to month 6 was compared between randomization groups and according to study entry HA levels. At study entry, persons with elevated HA (>75ng/mL vs. ≤75ng/mL) had higher median (IQR) levels of IL-6 [4.14pg/mL (2.60-6.32) vs. 2.74pg/mL (1.88-3.97)] and soluble CD14 [2163ng/mL (1952-2916) vs. 1979ng/mL (1742-2310)] (p<0.001). Elevated HA was also associated with alterations of both pro- and anti-coagulation markers but the overall coagulation profile was not affected. Interruption of ART lead to a particularly pronounced increase in IL-6 levels in persons with elevated HA levels (p=0.01 for interaction between randomization group and continuous HA level). HIV/HCV co-infected persons with impaired liver function are in an enhanced pro-inflammatory state which is further exacerbated upon interruption of ART. Copyright © 2014 Elsevier B.V. All rights reserved.

The Double-Edged Sword of Pedagogy: Instruction Limits Spontaneous Exploration and Discovery

ERIC Educational Resources Information Center

Bonawitz, Elizabeth; Shafto, Patrick; Gweon, Hyowon; Goodman, Noah D.; Spelke, Elizabeth; Schulz, Laura

2011-01-01

Motivated by computational analyses, we look at how teaching affects exploration and discovery. In Experiment 1, we investigated children's exploratory play after an adult pedagogically demonstrated a function of a toy, after an interrupted pedagogical demonstration, after a naive adult demonstrated the function, and at baseline. Preschoolers in…

The time-course of recovery from interruption during reading: eye movement evidence for the role of interruption lag and spatial memory.

PubMed

Cane, James E; Cauchard, Fabrice; Weger, Ulrich W

2012-01-01

Two experiments examined how interruptions impact reading and how interruption lags and the reader's spatial memory affect the recovery from such interruptions. Participants read paragraphs of text and were interrupted unpredictably by a spoken news story while their eye movements were monitored. Time made available for consolidation prior to responding to the interruption did not aid reading resumption. However, providing readers with a visual cue that indicated the interruption location did aid task resumption substantially in Experiment 2. Taken together, the findings show that the recovery from interruptions during reading draws on spatial memory resources and can be aided by processes that support spatial memory. Practical implications are discussed.

Reception thresholds for sentences in quiet, continuous noise, and interrupted noise in school-age children.

PubMed

Stuart, Andrew

2008-02-01

Sentence recognition in noise was employed to investigate the development of temporal resolution in school-age children. Eighty children aged 6 to 15 years and 16 young adults participated. Reception thresholds for sentences (RTSs) were determined in quiet and in backgrounds of competing continuous and interrupted noise. In the noise conditions, RTSs were determined with a fixed noise level. RTSs were higher in quiet for six- to seven-year-old children (p = .006). Performance was better in the interrupted noise evidenced by lower RTS signal-to-noise ratios (S/Ns) relative to continuous noise (p < .0001). An effect of age was found in noise (p < .0001) where RTS S/Ns decreased with increasing age. Specifically, children under 14 years performed worse than adults. "Release from masking" was computed by subtracting RTS S/Ns in interrupted noise from continuous noise for each participant. There was no significant difference in RTS S/N difference scores as a function of age (p = .057). Children were more adversely affected by noise and needed greater S/Ns in order to perform as well as adults. Since there was no effect of age on the amount of release from masking, one can suggest that school-age children have inherently poorer processing efficiency rather than temporal resolution.

77 FR 22384 - Petition To Modify an Exemption of a Previously Approved Antitheft Device; Porsche

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-13

... passive, microprocessor-based device which includes a starter interrupt function, transponder key and a.... Porsche stated that the antitheft system consists of two major subsystems: a microprocessor-based...

Interruption as a test of the user-computer interface

NASA Technical Reports Server (NTRS)

Kreifeldt, J. G.; Mccarthy, M. E.

1981-01-01

In order to study the effects different logic systems might have on interrupted operation, an algebraic calculator and a reverse polish notation calculator were compared when trained users were interrupted during problem entry. The RPN calculator showed markedly superior resistance to interruption effects compared to the AN calculator although no significant differences were found when the users were not interrupted. Causes and possible remedies for interruption effects are speculated. It is proposed that because interruption is such a common occurrence, it be incorporated into comparative evaluation tests of different logic system and control/display system and that interruption resistance be adopted as a specific design criteria for such design.

Improving Flood Damage Assessment Models in Italy

NASA Astrophysics Data System (ADS)

Amadio, M.; Mysiak, J.; Carrera, L.; Koks, E.

2015-12-01

The use of Stage-Damage Curve (SDC) models is prevalent in ex-ante assessments of flood risk. To assess the potential damage of a flood event, SDCs describe a relation between water depth and the associated potential economic damage over land use. This relation is normally developed and calibrated through site-specific analysis based on ex-post damage observations. In some cases (e.g. Italy) SDCs are transferred from other countries, undermining the accuracy and reliability of simulation results. Against this background, we developed a refined SDC model for Northern Italy, underpinned by damage compensation records from a recent flood event. Our analysis considers both damage to physical assets and production losses from business interruptions. While the first is calculated based on land use information, production losses are measured through the spatial distribution of Gross Value Added (GVA). An additional component of the model assesses crop-specific agricultural losses as a function of flood seasonality. Our results show an overestimation of asset damage from non-calibrated SDC values up to a factor of 4.5 for tested land use categories. Furthermore, we estimate that production losses amount to around 6 per cent of the annual GVA. Also, maximum yield losses are less than a half of the amount predicted by the standard SDC methods.

A series on optimizing satellite systems. I - Restoring interruptions of communications sattelite service: Logistical and cost comparisons of mature and newly operational systems

NASA Astrophysics Data System (ADS)

Snow, Marcellus S.

1989-09-01

A mathematical model is presented of costs and operational factors involved in provision for service interruptions of both a mature and typically large incumbent satellite system and of a smaller, more recently operational system. The equation expresses the required launch frequency for the new system as a function of the launch spacing of the mature system; the time disparity between the inauguration of the two systems; and the rate of capacity depreciation. In addition, a technique is presented to compare the relative extent to which the discounted costs of the new system exceed those of the mature system in furnishing the same effective capacity in orbit, and thus the same service liability, at a given point in time. It is determined that a mature incumbent communications satellite system, having more capacity in orbit, will on balance have a lower probability of service interruption than a newer, smaller system.

Effect of irrigation regimes on mobilization of nonreactive tracers and dissolved and particulate phosphorus in slurry-injected soils

NASA Astrophysics Data System (ADS)

GlæSner, Nadia; Kjaergaard, Charlotte; RubæK, Gitte H.; Magid, Jakob

2011-12-01

Understanding the mobilization processes of phosphorus (P) in the plow layer are essential to quantify potential P losses and suggest management strategies to reduce P losses. This study is aimed at examining nonequilibrium exchange dynamics on the mobilization of slurry-amended Br-, and dissolved and particulate P in slurry-injected soils. We compared leaching from intact soil columns (20 cm diam., 20 cm high) under unsaturated flow (suction at the lower boundary of 5 hPa) subjected to continuous irrigation at 2 mm hr-1, and intermittent irrigation at 2 mm hr-1 and 10 mm hr-1 to with interruptions of 10 h duration simulate periodic precipitation events. Suction was increased to 20 hPa during interruptions to allow drainage of the largest pores. Irrigation interruptions induced fluctuations in leaching of nonreactive tracers, particles, and particulate P indicating nonequilibrium transport. A nonreactive tracer, 3H2O, applied with irrigation water, diffused from mobile to less mobile pore regions during interruptions, leading to a lower mass recovery during low-intermittent (76.4%) compared with continuous irrigation (86.6%). In contrast, mass recovery of slurry-injected Br- increased as Br- diffused from less mobile to mobile pore regions during low-intermittent (53%-64%) compared with continuous irrigation (42%-47%). Despite high fluctuations during the leaching of particles and particulate P during low-intermittent irrigation, accumulated values did not differ from continuous irrigation. Increased preferential flow during high-intermittent irrigation lowered the mass exchange between pore regions of nonreactive tracers, particles, and particulate P compared with low-intermittent irrigation. The leaching of dissolved inorganic and organic P was low during all of the experiments and scarcely affected by the irrigation regime. These results highlight that nonequilibrium exchange dynamics are important when evaluating processes affecting mobilization and transport in structured soils. Leaching experiments, including cycles of irrigation interruptions and gravitational drainage, thus, adds significantly to the understanding and interpretation of processes affecting mobilization and transport under natural conditions.

Effect of arch length on the functional well-being of dentate adults.

PubMed

Montero, J; Bravo, M; Hernández, L A; Dib, A

2009-05-01

The aim of this study was to assess the influence of arch length and the number of occlusal units on the oral functions and general satisfaction perceived by dentate adults without dentures who had all their aesthetic units intact. We performed an epidemiological study at randomly chosen health centres on populations of adults without dentures. The subjects (n = 624) were classified as complete dental arch (CDA), interrupted dental arch (IDA) or shortened dental arches (SDA), depending on the length and continuity of the dental arches. We gathered clinical data and data on functional ability and oral satisfaction, plotting them on a scale of 0-10. The individuals with a shortened dental arch were found to have longer-lasting, more frequent and more severe functional limitations upon chewing, smiling and speaking than those with a complete or interrupted arch. The prevalance rate ratio (95% CI) of functional limitations in the SDA group was higher than in the aggregated CDA-IDA group, the values ranging between 1.56 (1.22-12.01) as regards chewing and 2.35 (1.45-3.85) in the case of smiling. However, in general all groups were satisfied with their oral status.

Spliced DNA Sequences in the Paramecium Germline: Their Properties and Evolutionary Potential

PubMed Central

Catania, Francesco; McGrath, Casey L.; Doak, Thomas G.; Lynch, Michael

2013-01-01

Despite playing a crucial role in germline-soma differentiation, the evolutionary significance of developmentally regulated genome rearrangements (DRGRs) has received scant attention. An example of DRGR is DNA splicing, a process that removes segments of DNA interrupting genic and/or intergenic sequences. Perhaps, best known for shaping immune-system genes in vertebrates, DNA splicing plays a central role in the life of ciliated protozoa, where thousands of germline DNA segments are eliminated after sexual reproduction to regenerate a functional somatic genome. Here, we identify and chronicle the properties of 5,286 sequences that putatively undergo DNA splicing (i.e., internal eliminated sequences [IESs]) across the genomes of three closely related species of the ciliate Paramecium (P. tetraurelia, P. biaurelia, and P. sexaurelia). The study reveals that these putative IESs share several physical characteristics. Although our results are consistent with excision events being largely conserved between species, episodes of differential IES retention/excision occur, may have a recent origin, and frequently involve coding regions. Our findings indicate interconversion between somatic—often coding—DNA sequences and noncoding IESs, and provide insights into the role of DNA splicing in creating potentially functional genetic innovation. PMID:23737328

Causes and occurrences of interruptions during ED triage.

PubMed

Johnson, Kimberly D; Motavalli, Michele; Gray, Dean; Kuehn, Connie

2014-09-01

Interruptions have been shown to cause errors and delays in the treatment of emergency patients and pose a real threat during the triage process. Missteps during the triage assessment can send a patient down the wrong treatment path and lead to delays. The purpose of this project was to identify the types and frequency of interruptions during the ED triage interview process. A focus group of emergency nurses was organized to identify the types of interruptions that commonly occur during the triage interview. These interruptions would be validated through observations in triage. A tally sheet was developed and implemented to determine how often each interruption occurred during an 8-hour shift. Triage nurses completed the tally sheets while working the first shift (7 am to 3 pm). This shift was selected because patient intake in the US Department of Veterans Affairs Emergency Department is highest during this time. The categories of interruptions identified included provision of conveniences to visitors, coworker-related interruptions, patient care-related interruptions, locating of family members in the emergency department, and other miscellaneous interruptions. Tally sheets were completed by the triage nurses during 10 shifts. On average, triage nurses were interrupted 48.2 times during an 8-hour shift (7 interruptions per hour). After reviewing the data, we found that only 22% of interruptions were related to patient care. More frequently, the causes of interruptions were not related to patient care: opening the door (33%), providing conveniences to visitors (21%), waiting patients or family members asking "How much longer?" (14%), and other causes (10%). Frequent interruptions can interfere with concentration and may affect patient care. Non-patient care-related interruptions not only can be frustrating to the triage nurse but also can be offensive to triage patients; they ultimately delay care and may even affect the quality of care. However, because scarce research is available regarding interruptions during ED triage, the effects on patient outcomes are unclear. Additional research needs to be conducted to explore the causes and effects of interruptions to the triage process. Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Evaluation and Impact of Workflow Interruptions During Robot-assisted Surgery.

PubMed

Allers, Jenna C; Hussein, Ahmed A; Ahmad, Nabeeha; Cavuoto, Lora; Wing, Joseph F; Hayes, Robin M; Hinata, Nobuyuki; Bisantz, Ann M; Guru, Khurshid A

2016-06-01

To analyze and categorize causes for interruptions during robot-assisted surgery. We analyzed 10 robot-assisted prostatectomies that were performed by 3 surgeons from October 2014 to June 2015. Interruptions to surgery were defined in terms of duration, stage of surgery, personnel involved, reasons, and impact of the interruption on the surgical workflow. The main reasons for interruptions included the following: console surgeons switching (29%); preparation of the surgical equipment, such as cleaning or changing the camera (29%) or an instrument (27%); or when a suture, stapler, or clip was needed (12%). The most common interruption duration was 10-29 seconds (47.6%), and the least common interruption duration was greater than 90 seconds (3.6%). Additionally, about 14% of the interruptions were considered avoidable, whereas the remaining 86% of interruptions were necessary for surgery. By identifying and analyzing interruptions, we can develop evidence-based strategies to improve operating room efficiency, lower costs, and advance patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.

Functional expression of SCL/TAL1 interrupting locus (Stil) protects retinal dopaminergic cells from neurotoxin-induced degeneration.

PubMed

Li, Jingling; Li, Ping; Carr, Aprell; Wang, Xiaokai; DeLaPaz, April; Sun, Lei; Lee, Eric; Tomei, Erika; Li, Lei

2013-01-11

We previously isolated a dominant mutation, night blindness b (nbb), which causes a late onset of retinal dopaminergic cell degeneration in zebrafish. In this study, we cloned the zebrafish nbb locus. Sequencing results revealed that nbb is a homolog of the vertebrate SCL/TAL1 interrupting locus (Stil). The Stil gene has been shown to play important roles in the regulation of vertebrate embryonic neural development and human cancer cell proliferation. In this study, we demonstrate that functional expression of Stil is also required for neural survival. In zebrafish, decreased expression of Stil resulted in increased toxic susceptibility of retinal dopaminergic cells to 6-hydroxydopamine. Increases in Stil-mediated Shh signaling transduction (i.e. by knocking down the Shh repressor Sufu) prevented dopaminergic cell death induced by neurotoxic insult. The data suggest that the oncogene Stil also plays important roles in neural protection.

Assessment of teacher interruptions on learners during oral case presentations.

PubMed

Yang, Glen; Chin, Rachel

2007-06-01

Studies have only recently begun to investigate the effects of interruptions on physicians in the emergency department (ED). To determine the frequency and nature of interruptions by the training physician that occur when medical trainees do oral case presentations (OCPs) in the ED. This was an observational study. Learner OCPs to attending emergency physicians were observed in the ED of an urban Level 1 trauma center at a major teaching hospital. A single investigator followed attending physicians blinded to the study objective in a nonrandomized convenience sampling of all ED shifts, recording information regarding teacher interruptions during new patient presentations. Learners completed a brief questionnaire after each OCP. A total of 196 OCPs were observed. The mean (+/-SD) duration of OCPs was 3.30 (+/-1.85) minutes, and the mean (+/-SD) number of interruptions was 0.75 (+/-0.60) per minute and 2.49 (+/-1.95) per OCP. The number of interruptions (per OCP) and duration of OCP varied by learner level of training, with more experienced learners giving shorter presentations and being interrupted less often. Frequency (per minute) of interruptions did not vary by learner level. In 40.3% of OCPs, attending physicians interrupted to give an assessment and/or a plan before the learner had done so, but 8.3% of interrupted learners believed that teacher interruptions were "disruptive" to their OCP. Attending emergency physicians frequently interrupt learners during new patient OCPs, with the number of interruptions varying by learner level of training. Teacher interruptions appear to have minimal, if any, detrimental effect on the perceived effectiveness of OCPs as a learning experience.

Effects of a Brief Team Training Program on Surgical Teams' Nontechnical Skills: An Interrupted Time-Series Study.

PubMed

Gillespie, Brigid M; Harbeck, Emma; Kang, Evelyn; Steel, Catherine; Fairweather, Nicole; Panuwatwanich, Kriengsak; Chaboyer, Wendy

2017-04-27

Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS. Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program. We observed 179 surgical procedures with cardiac, vascular, upper gastrointestinal, and hepatobiliary teams. Mean posttest NOTECHS scores increased across teams, showing special cause variation. There were also significant before and after improvements in NOTECHS scores in respect to professional role and in the use of the Surgical Safety Checklist. Our results suggest associated improvements in teams' NOTSS after implementation of the team training program.

Performance analysis of local area networks

NASA Technical Reports Server (NTRS)

Alkhatib, Hasan S.; Hall, Mary Grace

1990-01-01

A simulation of the TCP/IP protocol running on a CSMA/CD data link layer was described. The simulation was implemented using the simula language, and object oriented discrete event language. It allows the user to set the number of stations at run time, as well as some station parameters. Those parameters are the interrupt time and the dma transfer rate for each station. In addition, the user may configure the network at run time with stations of differing characteristics. Two types are available, and the parameters of both types are read from input files at run time. The parameters include the dma transfer rate, interrupt time, data rate, average message size, maximum frame size and the average interarrival time of messages per station. The information collected for the network is the throughput and the mean delay per packet. For each station, the number of messages attempted as well as the number of messages successfully transmitted is collected in addition to the throughput and mean packet delay per station.

Testing Of Choiced Ceramics Cutting Tools At Irregular Interrupted Cut

NASA Astrophysics Data System (ADS)

Kyncl, Ladislav; Malotová, Šárka; Nováček, Pavel; Nicielnik, Henryk; Šoková, Dagmar; Hemžský, Pavel; Pitela, David; Holubjak, Jozef

2015-12-01

This article discusses the test of removable ceramic cutting inserts during machining irregular interrupted cut. Tests were performed on a lathe, with the preparation which simulated us the interrupted cut. By changing the number of plates mounted in a preparation it simulate us a regular or irregular interrupted cut. When with four plates it was regular interrupted cut, the remaining three variants were already irregular cut. It was examined whether it will have the irregular interrupted cutting effect on the insert and possibly how it will change life of inserts during irregular interrupted cut (variable delay between shocks).

Improvement of Thermal Interruption Capability in Self-blast Interrupting Chamber for New 245kV-50kA GCB

NASA Astrophysics Data System (ADS)

Shinkai, Takeshi; Koshiduka, Tadashi; Mori, Tadashi; Uchii, Toshiyuki; Tanaka, Tsutomu; Ikeda, Hisatoshi

Current zero measurements are performed for 245kV-50kA-60Hz short line fault (L90) interruption tests with a self-blast interrupting chamber (double volume system) which has the interrupting capability up to 245kV-50kA-50Hz L90. Lower L90 interruption capability is observed for longer arcing time although very high pressure rise is obtained. It may be caused by higher blowing temperature and lower blowing density for longer arcing time. Interruption criteria and a optimization method of the chamber design are discussed to improve L90 interruption capability with it. The new chambers are designed at 245kV-50kA-60Hz to improve gas density in thermal volume for long arcing time. 245kV-50kA-60Hz L90 interruptions are performed with the new chamber. The suggested optimization method is an efficient tool for the self-blast interrupting chamber design although study of computing methods is required to calculate arc conductance around current zero as a direct criterion for L90 interruption capability with higher accuracy.

Hemodialysis without Systemic Anticoagulation: A Prospective Randomized Trial to Evaluate 3 Strategies in Patients at Risk of Bleeding

PubMed Central

Guéry, Bruno; Alberti, Corinne; Servais, Aude; Harrami, Elarbi; Bererhi, Lynda; Zins, Brigitte; Touam, Malik; Joly, Dominique

2014-01-01

Objective In this clinical trial, we aimed to compare three means of performing chronic hemodialysis in patients with contra-indication to systemic heparinization. Methods This open-label monocentric randomized « n-of-one » trial, conducted in a single tertiary care center, recruited chronic hemodialysis patients with a contra-indication to systemic heparinization for at least 3 consecutive sessions. All patients underwent hemodialysis with an AN69ST dialyzer, and were administered three alternative dialysis procedures in a random sequence: intermittent saline flushes, constant saline infusion, or pre-dialysis heparin coating of the membrane. The primary outcome was the need to interrupt the dialysis session because of clotting events due to either (i) a complete coagulation of the circuit; (ii) a partial coagulation of the circuit; (iii) a>50% rise over baseline in the venous pressure. Results At the end of the inclusion period (May, 2007 to December, 2008), the number of patients to include (n = 75) was not reached: only 46 patients were included and underwent randomization. The study was terminated, and statistical analysis took into account 224 hemodialysis sessions performed in 44 patients with analyzable data. Heparin adsorption was associated with a significant reduction of the need to interrupt the dialysis session because of clotting events: odds ratio 0.3 (CI 95% 0.2 to 0.6; p<0.001, versus intermittent saline flushes). Heparin adsorption was also associated with higher odds for performing >3 h dialysis sessions and for having complete blood restitution. There were no significant effects of the dialysis procedure on weight loss, online ionic dialysance, and adverse events. Conclusion Heparin-coated AN69ST dialysis membrane is a safe and effective method to avoid or delay per-dialytic clotting events in patients with contra-indication to systemic anticoagulation. However, results are not generalizable safely to patients with active bleeding, since weak heparinemia, not assessed in this study, may occur. Trial Registration ClinicalTrials.gov NCT00473109. PMID:24825343

Driven to distraction: The nature and apparent purpose of interruptions in critical care and implications for HIT.

PubMed

Mamykina, Lena; Carter, Eileen J; Sheehan, Barbara; Stanley Hum, R; Twohig, Bridget C; Kaufman, David R

2017-05-01

To examine the apparent purpose of interruptions in a Pediatric Intensive Care Unit and opportunities to reduce their burden with informatics solutions. In this prospective observational study, researchers shadowed clinicians in the unit for one hour at a time, recording all interruptions participating clinicians experienced or initiated, their starting time, duration, and a short description that could help to infer their apparent purpose. All captured interruptions were classified inductively on their source and apparent purpose and on the optimal representational media for fulfilling their apparent purpose. The researchers observed thirty-four one-hour sessions with clinicians in the unit, including 21 nurses and 13 residents and house physicians. The physicians were interrupted on average 11.9 times per hour and interrupted others 8.8 times per hour. Nurses were interrupted 8.6 times per hour and interrupted others 5.1 times per hour. The apparent purpose of interruptions included Information Seeking and Sharing (n=259, 46.3%), Directives and Requests (n=70, 12%), Shared Decision-Making (n=49, 8.8%), Direct Patient Care (n=36, 6.4%), Social (n=71, 12.7%), Device Alarms (n=28, 5%), and Non-Clinical (n=10, 1.8%); 6.6% were not classified due to insufficient description. Of all captured interruptions, 29.5% were classified as being better served with informational displays or computer-mediated communication. Deeper understanding of the purpose of interruptions in critical care can help to distinguish between interruptions that require face-to-face conversation and those that can be eliminated with informatics solutions. The proposed taxonomy of interruptions and representational analysis can be used to further advance the science of interruptions in clinical care. Copyright © 2017 Elsevier Inc. All rights reserved.

The Voltage Distribution Characteristics of a Hybrid Circuit Breaker During High Current Interruption

NASA Astrophysics Data System (ADS)

Cheng, Xian; Duan, Xiongying; Liao, Minfu; Huang, Zhihui; Luo, Yan; Zou, Jiyan

2013-08-01

Hybrid circuit breaker (HCB) technology based on a vacuum interrupter and a SF6 interrupter in series has become a new research direction because of the low-carbon requirements for high voltage switches. The vacuum interrupter has an excellent ability to deal with the steep rising part of the transient recovery voltage (TRV), while the SF6 interrupter can withstand the peak part of the voltage easily. An HCB can take advantage of the interrupters in the current interruption process. In this study, an HCB model based on the vacuum ion diffusion equations, ion density equation, and modified Cassie-Mayr arc equation is explored. A simulation platform is constructed by using a set of software called the alternative transient program (ATP). An HCB prototype is also designed, and the short circuit current is interrupted by the HCB under different action sequences of contacts. The voltage distribution of the HCB is analyzed through simulations and tests. The results demonstrate that if the vacuum interrupter withstands the initial TRV and interrupts the post-arc current first, then the recovery speed of the dielectric strength of the SF6 interrupter will be fast. The voltage distribution between two interrupters is determined by their post-arc resistance, which happens after current-zero, and subsequently, it is determined by the capacitive impedance after the post-arc current decays to zero.

The Effect of Interruption Duration and Demand on Resuming Suspended Goals

ERIC Educational Resources Information Center

Monk, Christopher A.; Trafton, J. Gregory; Boehm-Davis, Deborah A.

2008-01-01

The time to resume task goals after an interruption varied depending on the duration and cognitive demand of interruptions, as predicted by the memory for goals model (Altmann & Trafton, 2002). Three experiments using an interleaved tasks interruption paradigm showed that longer and more demanding interruptions led to longer resumption times in a…

A Catalog of Coronal "EIT Wave" Transients

NASA Technical Reports Server (NTRS)

Thompson, B. J.; Myers, D. C.

2009-01-01

Solar and Heliospheric Observatory (SOHO) Extreme ultraviolet Imaging Telescope (EIT) data have been visually searched for coronal "EIT wave" transients over the period beginning from 1997 March 24 and extending through 1998 June 24. The dates covered start at the beginning of regular high-cadence (more than one image every 20 minutes) observations, ending at the four-month interruption of SOHO observations in mid-1998. One hundred and seventy six events are included in this catalog. The observations range from "candidate" events, which were either weak or had insufficient data coverage, to events which were well defined and were clearly distinguishable in the data. Included in the catalog are times of the EIT images in which the events are observed, diagrams indicating the observed locations of the wave fronts and associated active regions, and the speeds of the wave fronts. The measured speeds of the wave fronts varied from less than 50 to over 700 km s(exp -1) with "typical" speeds of 200-400 km s(exp -1).

Opioid interruptions, pain, and withdrawal symptoms in nursing home residents.

PubMed

Redding, Sarah E; Liu, Sophia; Hung, William W; Boockvar, Kenneth S

2014-11-01

Interruptions in opioid use have the potential to cause pain relapse and withdrawal symptoms. The objectives of this study were to observe patterns of opioid interruption during acute illness in nursing home residents and examine associations between interruptions and pain and withdrawal symptoms. Patients from 3 nursing homes in a metropolitan area who were prescribed opioids were assessed for symptoms of pain and withdrawal by researchers blinded to opioid dosage received, using the Brief Pain Inventory Scale and the Clinical Opioid Withdrawal Scale, respectively, during prespecified time periods. The prespecified time periods were 2 weeks after onset of acute illness (eg, urinary tract infection), and 2 weeks after hospital admission and nursing home readmission, if they occurred. Opioid dosing was recorded and a significant interruption was defined as a complete discontinuation or a reduction in dose of >50% for ≥1 day. The covariates age, sex, race, comorbid conditions, initial opioid dose, and initial pain level were recorded. Symptoms pre- and post-opioid interruptions were compared and contrasted with those in a group without opioid interruptions. Sixty-six patients receiving opioids were followed for a mean of 10.9 months and experienced a total of 104 acute illnesses. During 64 (62%) illnesses, patients experienced any reduction in opioid dosing, with a mean (SD) dose reduction of 63.9% (29.9%). During 39 (38%) illnesses, patients experienced a significant opioid interruption. In a multivariable model, residence at 1 of the 3 nursing homes was associated with a lower risk of interruption (odds ratio = 0.073; 95% CI, 0.009 to 0.597; P < 0.015). In patients with interruptions, there were statistically insignificant changes in mean (SD) pain score (difference -0.50 [2.66]; 95% CI, -3.16 to 2.16) and withdrawal score (difference -0.91 [3.12]; 95% CI, -4.03 to 2.21) after the interruption as compared with before interruption. However, when compared with patients without interruptions, patients with interruptions experienced larger increases in pain scores during the follow-up periods (difference 0.09 points per day; 95% CI, -0.01 to 0.019; P = 0.08). In particular, patients who received the highest quartile of opioid dose before interruption experienced increases in pain scores over time that were 0.22 points per day larger (95% CI, 0.02 to 0.41; P = 0.03) than those without interruption. Withdrawal scores were not associated with opioid interruption regardless of dose before interruption. Nursing home patients often experience interruptions in opioid dosing, which can be associated with worse pain, but not withdrawal symptoms, during acute illnesses. Clinicians should be aware of the potential risks and effects of opioid interruptions during acute illnesses in this patient group. Published by Elsevier Inc.

ARkStorm@Tahoe: Stakeholder perspectives on vulnerabilities and preparedness for an extreme storm event in the greater Lake Tahoe, Reno, and Carson City region

USGS Publications Warehouse

Albano, Christine M.; Cox, Dale A.; Dettinger, Michael; Shaller, Kevin; Welborn, Toby L.; McCarthy, Maureen

2014-01-01

Atmospheric rivers (ARs) are strongly linked to extreme winter precipitation events in the Western U.S., accounting for 80 percent of extreme floods in the Sierra Nevada and surrounding lowlands. In 2010, the U.S. Geological Survey developed the ARkStorm extreme storm scenario for California to quantify risks from extreme winter storms and to allow stakeholders to better explore and mitigate potential impacts. To explore impacts on natural resources and communities in montane and adjacent environments, we downscaled the scenario to the greater Lake Tahoe, Reno and Carson City region of northern Nevada and California. This ArkStorm@Tahoe scenario was presented at six stakeholder meetings, each with a different geographic and subject matter focus. Discussions were facilitated by the ARkStorm@Tahoe team to identify social and ecological vulnerabilities to extreme winter storms, science and information needs, and proactive measures that might minimize impacts from this type of event. Information collected in these meetings was used to develop a tabletop emergency response exercise and set of recommendations for increasing resilience to extreme winter storm events in both Tahoe and the downstream communities of Northern Nevada.Over 300 individuals participated in ARkStorm@Tahoe stakeholder meetings and the emergency response exercise, including representatives from emergency response, natural resource and ecosystem management, health and human services, public utilities, and businesses. Interruption of transportation, communications, and lack of power and backup fuel supplies were identified as the most likely and primary points of failure across multiple sectors and geographies, as these interruptions have cascading effects on natural and human systems by impeding emergency response efforts. Other key issues that arose in discussions included contamination risks to water supplies and aquatic ecosystems, especially in the Tahoe Basin and Pyramid Lake, interagency coordination, credentialing, flood management, and coordination of health and human services during such an event. Mitigation options were identified for each of the key issues. Several science needs were identified, particularly the need for improved flood inundation maps. Finally, key lessons learned were identified and may help to increase preparedness, response and recovery from extreme storms in the future.

Communication patterns in a UK emergency department.

PubMed

Woloshynowych, Maria; Davis, Rachel; Brown, Ruth; Vincent, Charles

2007-10-01

Good communication is important in patient care and plays an essential part of teamwork and patient safety. Communication in the emergency department (ED) can be chaotic, with the potential for error resulting from communication overload and problems of communication. The nurse in charge of the ED plays a crucial role in maintaining communication flow. The aims of this study are to identify the features of the communication load on the nurse in charge of the ED. This was an observational, nonexperimental study, building on the methods of observation and analysis developed by Coiera. It was carried out in an inner-city hospital ED in London. The nurse in charge of the ED was observed. The following factors were studied: the level of communication, interruptions, and simultaneous events; the channel and purpose of communication; interaction types; unresolved communications and annoying aspects of the observed periods; and the effect of weekday, staffing, and patient levels on the level of communication. Eleven nurses were observed during 18 observation periods during a total of 20 hours. Analysis revealed that there were 2,019 communication events in 20 hours and that 1,183 (59%) were initiated by the nurse in charge. Two hundred eighty-six (14%) simultaneous events/tasks were identified by the observer. One thousand five hundred twenty-eight (76%) communications involving the nurse in charge were face to face, 144 (7%) were by telephone, 107 (5%) concerned the use of the computer, and 104 (5%) concerned the use of the whiteboard. The largest purpose of communication events was related to patient management (48%). There was a slight relationship between junior medical staff and the level of communication and a moderate relationship between communication load and the number of patients in the ED. In addition, a greater number of nurses on duty were associated with fewer communication events with the nurse in charge. These findings are an important measure of communication load, which can disrupt memory and lead to mistakes. Improving communication between health care staff by reducing the levels of interruptions and minimizing the volume of irrelevant or unnecessary information exchange could therefore have important implications for patient safety.

Avoidable interruptions during drug administration in an intensive rehabilitation ward: improvement project.

PubMed

Buchini, Sara; Quattrin, Rosanna

2012-04-01

To record the frequency of interruptions and their causes, to identify 'avoidable' interruptions and to build an improvement project to reduce 'avoidable' interruptions. In Italy each year 30,000-35,000 deaths per year are attributed to health-care system errors, of which 19% are caused by medication errors. The factors that contribute to drug management error also include interruptions and carelessness during treatment administration. A descriptive study design was used to record the frequency of interruptions and their causes and to identify 'avoidable' interruptions in an intensive rehabilitation ward in Northern Italy. A data collection grid was used to record the data over a 6-month period. A total of 3000 work hours were observed. During the study period 1170 interruptions were observed. The study identified 14 causes of interruption. The study shows that of the 14 cases of interruptions at least nine can be defined as 'avoidable'. An improvement project has been proposed to reduce unnecessary interruptions and distractions to avoid making errors. An additional useful step to reduce the incidence of treatment errors would be to implement the use of a single patient medication sheet for the recording of drug prescription, preparation and administration and also the incident reporting. © 2011 Blackwell Publishing Ltd.

Analysis of Smartphone Interruptions on Academic General Internal Medicine Wards. Frequent Interruptions may cause a 'Crisis Mode' Work Climate.

PubMed

Vaisman, Alon; Wu, Robert C

2017-01-04

Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014. We also calculated the number of times these interruptions exceeded a pre-specified threshold per hour, termed 'crisis mode', defined as at least five interruptions in 30 minutes. We analyzed the correlation between interruptions and date, site, and patient volumes. A total of 187,049 interruptions were collected over an 18-month period. Daily weekday interruptions rose sharply in the morning, peaking between 11 AM to 12 PM and measuring 4.8 and 3.7 mean interruptions/hour at each site, respectively. Mean daily interruptions per team totaled 46.2 ± 3.6 at Site 1 and 39.2 ± 4.2 at Site 2. The 'crisis mode' threshold was exceeded, on average, 2.3 times/day per GIM team during weekdays. In a multivariable linear regression analysis, site (β6.43 CI95% 5.44 - 7.42, p<0.001), day of the week (with Friday having the most interruptions) (β0.481 CI95% 0.236 - 0.730, p<0.05) and patient census (β1.55 CI95% 1.42 - 1.67, p<0.05) were all predictive of daily interruption volume although there was a significant interaction effect between site and patient census (β-0.941 CI95% -1.18 - -0.703, p<0.05). Interruptions were related to site-specific features, including volume, suggesting that future interventions should target the culture of individual hospitals. Excessive interruptions may have implications for patient safety especially when exceeding a maximal threshold over short periods of time.

Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption

PubMed Central

Hoffman, Matthew R.; Jiang, Jack J.; Rieves, Adam L.; McElveen, Kelsey A.B.; Ford, Charles N.

2009-01-01

Objective To measure the laryngeal resistance (RL), subglottal pressure (Ps), and mean flow rate (MFR) of adductor (ADSD) and abductor (ABSD) spasmodic dysphonia patients using the airflow interrupter. Methods The RL of six ABSD and seven ADSD patients was measured using the airflow interrupter, a noninvasive device designed to measure MFR and Ps via mechanical balloon valve interruption. Subjects performed ten trials at each of two intensity levels, with each trial consisting of a sustained /a/ during which phonation was interrupted for 500 ms. Laryngeal resistance was calculated as subglottal pressure divided by airflow. Results Mean RL for the ADSD and ABSD subtypes at 65 dB were 24.78 cmH2O/l/s and 14.51 cmH2O/l/s, respectively (p = 0.04). Mean RL at 70 dB were 40.02 cmH2O/l/s and 15.84 cmH2O/l/s (p = 0.014). Ps for the ADSD and ABSD subtypes at 65 dB were 10.23 cmH2O and 8.32 cmH2O, respectively (p = 0.582). At the 70 dB level, Ps were 12.39 cmH2O and 11.78 cmH2O (p = 0.886). MFR for the ADSD and ABSD subtypes at 65 dB were 435 ml/s and 746 ml/s (p = 0.205). Mean MFR at 70 dB were 518 ml/s and 848 ml/s (p = 0.198). Conclusion Noninvasive measurements of RL may be useful for differentiating between ADSD and ABSD. This simple objective test which produces a quantitative output could be used to evaluate laryngeal function in patients with spasmodic dysphonia. PMID:19554636

The Effects of Career Interruptions on Young Men and Women.

ERIC Educational Resources Information Center

Shorten, Brett; Lewis, Donald E.

1991-01-01

Data from a sample of 5,837 Australians showed that (1) women had longer career interruptions; (2) regardless of number of interruptions, men had higher wages; (3) longer interruptions had a negative effect on reentry wages; and (4) 1985-88 growth in wages for males was enhanced by increased numbers and length of interruptions, with the opposite…

Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay

PubMed Central

Bentancor, Ana; Hernández, Ana Laura; Godoy, Yamile; Dapueto, Juan J

2016-01-01

ABSTRACT OBJECTIVE To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. METHODS In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: structure, process, and results. RESULTS Between December 2012 and November 2013, a total of 6,676 voluntary interruptions of pregnancy were reported in Uruguay; out of these, 80 were conducted at the Hospital de Clínicas. The patients’ demographic data agreed with those reported at the national level: Of the total patients, 81.0% were aged over 19 years; 6.2% decided to continue with the pregnancy; and only 70.0% attended the subsequent control and received advice on contraception. CONCLUSIONS In its implementation year in Uruguay, we can assess the experience as positive from the point of view of women’s health. Our experience as a mental health team at the Hospital de Clínicas, inserted into the multidisciplinary voluntary interruption of pregnancy team, is in the process of assessment and reformulation of practices. PMID:27384969

A video event trigger for high frame rate, high resolution video technology

NASA Astrophysics Data System (ADS)

Williams, Glenn L.

1991-12-01

When video replaces film the digitized video data accumulates very rapidly, leading to a difficult and costly data storage problem. One solution exists for cases when the video images represent continuously repetitive 'static scenes' containing negligible activity, occasionally interrupted by short events of interest. Minutes or hours of redundant video frames can be ignored, and not stored, until activity begins. A new, highly parallel digital state machine generates a digital trigger signal at the onset of a video event. High capacity random access memory storage coupled with newly available fuzzy logic devices permits the monitoring of a video image stream for long term or short term changes caused by spatial translation, dilation, appearance, disappearance, or color change in a video object. Pretrigger and post-trigger storage techniques are then adaptable for archiving the digital stream from only the significant video images.

A video event trigger for high frame rate, high resolution video technology

NASA Technical Reports Server (NTRS)

Williams, Glenn L.

1991-01-01

When video replaces film the digitized video data accumulates very rapidly, leading to a difficult and costly data storage problem. One solution exists for cases when the video images represent continuously repetitive 'static scenes' containing negligible activity, occasionally interrupted by short events of interest. Minutes or hours of redundant video frames can be ignored, and not stored, until activity begins. A new, highly parallel digital state machine generates a digital trigger signal at the onset of a video event. High capacity random access memory storage coupled with newly available fuzzy logic devices permits the monitoring of a video image stream for long term or short term changes caused by spatial translation, dilation, appearance, disappearance, or color change in a video object. Pretrigger and post-trigger storage techniques are then adaptable for archiving the digital stream from only the significant video images.

PAs reduce rounding interruptions in the pediatric intensive care unit.

PubMed

Hascall, Rebecca L; Perkins, R Serene; Kmiecik, Lauren; Gupta, Priya R; Shelak, Carolyn F; Demirel, Shaban; Buchholz, Mark T

2018-06-01

We investigated the proportion of encounters that were interrupted during family-centered rounds in the pediatric intensive care unit (PICU) to determine whether the use of a physician assistant (PA) significantly affected the proportion of interrupted encounters. We evaluated 2,657 rounding encounters in our 24-bed regional referral unit. The duration of each rounding encounter and total rounding duration were recorded. The presence or absence of a PA during each rounding encounter, the occurrence of an interruption, and other potential predictors of interruptions were recorded. The presence of a PA during PICU rounds was significantly associated (P < .001) with a 35.4% lower likelihood of an interruption. Family-centered rounds in the PICU are less likely to be interrupted when a PA is present. PAs help physicians and improve rounding efficiency by safely and effectively handling certain interruptions.

A systematic review of the psychological literature on interruption and its patient safety implications.

PubMed

Li, Simon Y W; Magrabi, Farah; Coiera, Enrico

2012-01-01

To understand the complex effects of interruption in healthcare. As interruptions have been well studied in other domains, the authors undertook a systematic review of experimental studies in psychology and human-computer interaction to identify the task types and variables influencing interruption effects. 63 studies were identified from 812 articles retrieved by systematic searches. On the basis of interruption profiles for generic tasks, it was found that clinical tasks can be distinguished into three broad types: procedural, problem-solving, and decision-making. Twelve experimental variables that influence interruption effects were identified. Of these, six are the most important, based on the number of studies and because of their centrality to interruption effects, including working memory load, interruption position, similarity, modality, handling strategies, and practice effect. The variables are explained by three main theoretical frameworks: the activation-based goal memory model, prospective memory, and multiple resource theory. This review provides a useful starting point for a more comprehensive examination of interruptions potentially leading to an improved understanding about the impact of this phenomenon on patient safety and task efficiency. The authors provide some recommendations to counter interruption effects. The effects of interruption are the outcome of a complex set of variables and should not be considered as uniformly predictable or bad. The task types, variables, and theories should help us better to identify which clinical tasks and contexts are most susceptible and assist in the design of information systems and processes that are resilient to interruption.

A Chinese cave links climate change, social impacts, and human adaptation over the last 500 years.

PubMed

Tan, Liangcheng; Cai, Yanjun; An, Zhisheng; Cheng, Hai; Shen, Chuan-Chou; Breitenbach, Sebastian F M; Gao, Yongli; Edwards, R Lawrence; Zhang, Haiwei; Du, Yajuan

2015-08-13

The collapse of some pre-historical and historical cultures, including Chinese dynasties were presumably linked to widespread droughts, on the basis of synchronicities of societal crises and proxy-based climate events. Here, we present a comparison of ancient inscriptions in Dayu Cave from Qinling Mountains, central China, which described accurate times and detailed impacts of seven drought events during the period of 1520-1920 CE, with high-resolution speleothem records from the same cave. The comparable results provide unique and robust tests on relationships among speleothem δ(18)O changes, drought events, and societal unrest. With direct historical evidences, our results suggest that droughts and even modest events interrupting otherwise wet intervals can cause serious social crises. Modeling results of speleothem δ(18)O series suggest that future precipitation in central China may be below the average of the past 500 years. As Qinling Mountain is the main recharge area of two large water transfer projects and habitats of many endangered species, it is imperative to explore an adaptive strategy for the decline in precipitation and/or drought events.

A Chinese cave links climate change, social impacts, and human adaptation over the last 500 years

PubMed Central

Tan, Liangcheng; Cai, Yanjun; An, Zhisheng; Cheng, Hai; Shen, Chuan-Chou; Breitenbach, Sebastian F. M.; Gao, Yongli; Edwards, R. Lawrence; Zhang, Haiwei; Du, Yajuan

2015-01-01

The collapse of some pre-historical and historical cultures, including Chinese dynasties were presumably linked to widespread droughts, on the basis of synchronicities of societal crises and proxy-based climate events. Here, we present a comparison of ancient inscriptions in Dayu Cave from Qinling Mountains, central China, which described accurate times and detailed impacts of seven drought events during the period of 1520–1920 CE, with high-resolution speleothem records from the same cave. The comparable results provide unique and robust tests on relationships among speleothem δ18O changes, drought events, and societal unrest. With direct historical evidences, our results suggest that droughts and even modest events interrupting otherwise wet intervals can cause serious social crises. Modeling results of speleothem δ18O series suggest that future precipitation in central China may be below the average of the past 500 years. As Qinling Mountain is the main recharge area of two large water transfer projects and habitats of many endangered species, it is imperative to explore an adaptive strategy for the decline in precipitation and/or drought events. PMID:26270656

Sinomenine attenuates renal fibrosis through Nrf2-mediated inhibition of oxidative stress and TGFβ signaling

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

Qin, Tian

Renal fibrosis is the common feature of chronic kidney disease and mainly mediated by TGFβ-associated pro-fibrogenic signaling, which causes excessive extracellular matrix accumulation and successive loss of kidney functions. Sinomenine (SIN), an alkaloid derived from medicinal herb extensively used in treatment of rheumatoid arthritis and various inflammatory disorders, displays renal protective properties in experimental animals; however its pharmacological potency against renal fibrosis is not explored. In this study we report that SIN possesses strong anti-renal fibrosis functions in kidney cell and in mouse fibrotic kidney. SIN beneficially modulated the pro-fibrogenic protein expression in TGFβ-treated kidney cells and attenuated the renalmore » fibrotic pathogenesis incurred by unilateral ureteral obstruction (UUO), which correlated with its activation of Nrf2 signaling - the key defender against oxidative stress with anti-fibrotic potentials. Further investigation on its regulation of Nrf2 downstream events revealed that SIN significantly balanced oxidative stress via improving the expression and activity of anti-oxidant and detoxifying enzymes, and interrupted the pro-fibrogenic signaling of TGFβ/Smad and Wnt/β-catenin. Even more impressively SIN achieved its anti-fibrotic activities in an Nrf2-dependent manner, suggesting that SIN regulation of Nrf2-associated anti-fibrotic activities constitutes a critical component of SIN's renoprotective functions. Collectively our studies have demonstrated a novel anti-fibrotic property of SIN and its upstream events and provided a molecular basis for SIN's potential applications in treatment of renal fibrosis-associated kidney disorders. - Highlights: • Sinomenine has strong potency of inhibiting renal fibrosis in UUO mouse kidney. • Sinomenine attenuates the expression of profibrogenic proteins. • Sinomenine balances renal fibrosis-associated oxidative stress. • Sinomenine mitigates profibrogenic signaling of TGBβ/Smad and Wnt/β-catenin. • Sinomenine exerts anti-renal fibrotic functions mainly via activating Nrf2 pathways.« less

Interruptions in emergency medicine: things are not always what they seem.

PubMed

Walter, Scott R

2018-06-20

We have all felt the cognitive disjuncture of being interrupted during an important task. Most ED physicians will readily proffer the high frequency and/or burden of interruptions during their work, and of the many observational studies of interruptions in healthcare EDs do indeed have high interruption rates[2]. In experimental psychology, where many of these ideas originated, there is plenty of evidence that interruptions negatively affect performance. Interruptions have been associated with reduced performance on complex tasks[3,4], increased sequence errors[5], increased task completion time and augmented annoyance and anxiety[6]. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Characteristics of Interruptions During Medication Administration:An Integrative Review of Direct Observational Studies.

PubMed

Schroers, Ginger

2018-06-26

The purpose of this review was to synthesize and summarize data gathered by direct observation of the characteristics of interruptions in the context of nursing medication administration in hospital settings. Interruptions are prevalent during the medication administration process performed by nurses in hospital settings and have been found to be associated with an increase in frequency and severity of nursing medication administration errors. In addition, interruptions decrease task efficiency, leading to longer medication administration completion times. Integrative review. The electronic databases Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMED, PsyARTICLES, and Google Scholar were searched using the terms "interruptions" AND "medication administration" AND "direct observation". Nine articles met the inclusion criteria. Interruptions are likely to occur at least once during nursing medication administration processes in hospital settings. This finding applies to medication administered to one patient, termed a medication pass, and medication administered to multiple patients, termed a mediation round. Interruptions are most commonly caused by another nurse, staff member, or are self-initiated, and last approximately one minute in length. A raised awareness among staff of the most common sources of interruptions may encourage changes that lead to a decrease in the occurrence of interruptions. In addition, nurse leaders can apply an understanding of the common characteristics of interruptions to guide research, policies, and educational methods aimed at interruption management strategies. The findings from this review can be used to guide the identification and development of targeted interventions and strategies that would have the most substantial impact to reduce and manage interruptions during medication administration. Interruption management strategies have the potential to lead to a decrease in medication errors and an increase in task efficiency. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Analysis of Smartphone Interruptions on Academic General Internal Medicine Wards

PubMed Central

C.Wu, Robert

2017-01-01

Summary Introduction Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a ‘crisis mode’ climate. Methods We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014. We also calculated the number of times these interruptions exceeded a pre-specified threshold per hour, termed ‘crisis mode’, defined as at least five interruptions in 30 minutes. We analyzed the correlation between interruptions and date, site, and patient volumes. Results A total of 187,049 interruptions were collected over an 18-month period. Daily weekday interruptions rose sharply in the morning, peaking between 11 AM to 12 PM and measuring 4.8 and 3.7 mean interruptions/hour at each site, respectively. Mean daily interruptions per team totaled 46.2 ± 3.6 at Site 1 and 39.2 ± 4.2 at Site 2. The ‘crisis mode’ threshold was exceeded, on average, 2.3 times/day per GIM team during weekdays. In a multivariable linear regression analysis, site (β6.43 CI95% 5.44 – 7.42, p<0.001), day of the week (with Friday having the most interruptions) (β0.481 CI95% 0.236 – 0.730, p<0.05) and patient census (β1.55 CI95% 1.42 – 1.67, p<0.05) were all predictive of daily interruption volume although there was a significant interaction effect between site and patient census (β-0.941 CI95% -1.18 – -0.703, p<0.05). Conclusion Interruptions were related to site-specific features, including volume, suggesting that future interventions should target the culture of individual hospitals. Excessive interruptions may have implications for patient safety especially when exceeding a maximal threshold over short periods of time. PMID:28066851

Importation and outbreak of wild polioviruses from 2000 to 2014 and interruption of transmission in Cameroon.

PubMed

Endegue-Zanga, Marie Claire; Sadeuh-Mba, Serge Alain; Iber, Jane; Burns, Cara C; Moeletsi, Nicksy Gumede; Baba, Marycelin; Bukbuk, David; Delpeyroux, Francis; Mengouo, Marcellin Nimpa; Demanou, Maurice; Vernet, Guy; Etoa, François-Xavier; Njouom, Richard

2016-06-01

Efficient implementation of the global eradication strategies consisting of Acute Flaccid Paralysis (AFP) surveillance and mass immunization campaigns led to interruption of indigenous wild poliovirus transmission in Cameroon in 1999. This study describes type 1 and type 3 wild poliovirus (WPV) importation, incidence, geographic distribution and control since the original interruption of transmission in Cameroon. Stool samples from AFP patients under the age of 15 years in Cameroon were collected nationwide and subjected to virus isolation on RD and L20B cell cultures. Resulting virus isolates were typed by intratypic differentiation (ITD) and analysis of the VP1 coding sequence of the viral genome. Surveillance data originating from Cameroon between 2000 and 2014 were considered for retrospective descriptive analyses. From 2003 to 2009, multiple WPV importation events from neighboring countries affected mainly in the northern regions of Cameroon but did not led to sustained local transmission. Throughout this period, 16 WPV1 and 5 WPV3 were detected and identified as members of multiple clusters within type-specific West Africa B genotypes (WEAF-B). In 2013-2014, a polio outbreak associated to a highly evolved ("orphan") WPV1 affected four southern regions of Cameroon. The appearance of highly evolved lineage of type 1 WPV suggests potential surveillance gap and underscore the need to maintain comprehensive polio immunization activities and sensitive surveillance systems in place as long as any country in the world remains endemic for WPV. Copyright © 2016 Elsevier B.V. All rights reserved.

Resident perceptions of the impact of paging on intraoperative education.

PubMed

Rose, Joel S; Waibel, Brett H; Schenarts, Paul J

2012-06-01

Our purpose was to evaluate the impact of paging on perceptions of intraoperative learning. Intraoperative logs of pager interruptions were kept by surgical residents at a university hospital over a 30-day period. The postgraduate year, number of pages, category of caller, reason for call, and level of urgency were recorded during each operation. At the conclusion of each operation, residents also completed a two-item survey with responses on a 5-point scale (1 = strongly disagree to 5 = strongly agree), querying if interruptions negatively impacted the intraoperative experience and if a message taken by a third party was effective in limiting interruptions. Logs were completed for 124 of 204 operations. Fifty-five per cent of operations were interrupted at least once with 49 per cent interrupted two to five times and 6 per cent were interrupted six or more times. Junior residents had 69 per cent of their operations interrupted compared with 39 per cent of senior residents (P = 0.001). Ninety-two per cent of pages were nonurgent. Residents did not perceive pager interruptions negatively impacted their educational experience (mean 2.3) but were neutral with respect if messages taken by a third party decreased interruptions (mean 3.8). Although our hypothesis was that pager interruptions were frequent and disrupt resident education, our data demonstrate the opposite.

Workflow interruptions and mental workload in hospital pediatricians: an observational study.

PubMed

Weigl, Matthias; Müller, Andreas; Angerer, Peter; Hoffmann, Florian

2014-09-24

Pediatricians' workload is increasingly thought to affect pediatricians' quality of work life and patient safety. Workflow interruptions are a frequent stressor in clinical work, impeding clinicians' attention and contributing to clinical malpractice. We aimed to investigate prospective associations of workflow interruptions with multiple dimensions of mental workload in pediatricians during clinical day shifts. In an Academic Children's Hospital a prospective study of 28 full shift observations was conducted among pediatricians providing ward coverage. The prevalence of workflow interruptions was based on expert observation using a validated observation instrument. Concurrently, Pediatricians' workload ratings were assessed with three workload dimensions of the well-validated NASA-Task Load Index: mental demands, effort, and frustration. Observed pediatricians were, on average, disrupted 4.7 times per hour. Most frequent were interruptions by colleagues (30.2%), nursing staff (29.7%), and by telephone/beeper calls (16.3%). Interruption measures were correlated with two workload outcomes of interest: frequent workflow interruptions were related to less cognitive demands, but frequent interruptions were associated with increased frustration. With regard to single sources, interruptions by colleagues showed the strongest associations to workload. The findings provide insights into specific pathways between different types of interruptions and pediatricians' mental workload. These findings suggest further research and yield a number of work and organization re-design suggestions for pediatric care.

A Fire Department Community Health Intervention to Prevent Carbon Monoxide Poisoning Following a Hurricane

PubMed Central

Levy, Matthew; Jenkins, J Lee; Seaman, Kevin

2014-01-01

Portable generators are commonly used during electrical service interruptions that occur following large storms such as hurricanes. Nearly all portable generators use carbon based fuels and produce deadly carbon monoxide gas. Despite universal warnings to operate these generators outside only, the improper placement of generators makes these devices the leading cause of engine related carbon monoxide deaths in the United States. The medical literature reports many cases of Carbon Monoxide (CO) toxicity associated with generator use following hurricanes and other weather events. This paper describes how Howard County, Maryland Fire and Rescue (HCFR) Services implemented a public education program that focused on prevention of Carbon Monoxide poisoning from portable generator use in the wake of events where electrical service interruptions occurred or had the potential to occur. A major challenge faced was communication with those members of the population who were almost completely dependent upon electronic and wireless technologies and were without redundancies. HCFR utilized several tactics to overcome this challenge including helicopter based surveillance and the use of geocoded information from the electrical service provider to identify outage areas. Once outage areas were identified, HCFR personnel conducted a door-to-door canvasing of effected communities, assessing for hazards and distributing information flyers about the dangers of generator use. This effort represents one of the first reported examples of a community-based endeavor by a fire department to provide proactive interventions designed to prevent carbon monoxide illness. PMID:24596660

Late Quaternary Climate and Vegetation of the Sudanian Zone of Northeast Nigeria

NASA Astrophysics Data System (ADS)

Salzmann, Ulrich; Hoelzmann, Philipp; Morczinek, Irena

2002-07-01

The Lake Tilla crater lake in northeastern Nigeria (10°23'N, 12°08'E) provides a ca. 17,000 14C yr multiproxy record of the environmental history of a Sudanian savanna in West Africa. Evaluation of pollen, diatoms, and sedimentary geochemistry from cores suggests that dry climatic conditions prevailed throughout the late Pleistocene. Before the onset of the Holocene, the slow rise in lake levels was interrupted by a distinct dry event between ca. 10,900 and 10,500 14C yr B.P., which may coincide with the Younger Dryas episode. The onset of the Holocene is marked by an abrupt increase in lake levels and a subsequent spread of Guinean and Sudanian tree taxa into the open grass savanna that predominated throughout the Late Pleistocene. The dominance of the mountain olive Olea hochstetteri suggests cool climatic conditions prior to ca. 8600 14C yr B.P. The early to mid-Holocene humid period culminated between ca. 8500 and 7000 14C yr B.P. with the establishment of a dense Guinean savanna during high lake levels. Frequent fires were important in promoting the open character of the vegetation. The palynological and palaeolimnological data demonstrate that the humid period terminated after ca. 7000 14C yr B.P. in a gradual decline of the precipitation/evaporation ratio and was not interrupted by abrupt climatic events. The aridification trend intensified after ca. 3800 14C yr B.P. and continued until the present.

A combined intervention to reduce interruptions during medication preparation and double-checking: a pilot-study evaluating the impact of staff training and safety vests.

PubMed

Huckels-Baumgart, Saskia; Niederberger, Milena; Manser, Tanja; Meier, Christoph R; Meyer-Massetti, Carla

2017-10-01

The aim was to evaluate the impact of staff training and wearing safety vests as a combined intervention on interruptions during medication preparation and double-checking. Interruptions and errors during the medication process are common and an important issue for patient safety in the hospital setting. We performed a pre- and post-intervention pilot-study using direct structured observation of 26 nurses preparing and double-checking 431 medication doses (225 pre-intervention and 206 post-intervention) for 36 patients (21 pre-intervention and 15 post-intervention). With staff training and the introduction of safety vests, the interruption rate during medication preparation was reduced from 36.8 to 28.3 interruptions per hour and during double-checking from 27.5 to 15 interruptions per hour. This pilot-study showed that the frequency of interruptions decreased during the critical tasks of medication preparation and double-checking after the introduction of staff training and wearing safety vests as part of a quality improvement process. Nursing management should acknowledge interruptions as an important factor potentially influencing medication safety. Unnecessary interruptions can be successfully reduced by considering human and system factors and increasing both staff and nursing managers' awareness of 'interruptive communication practices' and implementing physical barriers. This is the first pilot-study specifically evaluating the impact of staff training and wearing safety vests on the reduction of interruptions during medication preparation and double-checking. © 2017 John Wiley & Sons Ltd.

A work observation study of nuclear medicine technologists: interruptions, resilience and implications for patient safety

PubMed Central

Larcos, George; Prgomet, Mirela; Georgiou, Andrew; Westbrook, Johanna

2017-01-01

Background Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. Methods We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. Results Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. Conclusions Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine. PMID:27707869

The culture contributing to interruptions in the nursing work environment: An ethnography.

PubMed

Hopkinson, Susan G; Wiegand, Debra L

2017-12-01

To understand the occurrence of interruptions within the culture of the medical nursing unit work environment. Interruptions may lead to errors in nursing work. Little is known about how the culture of the nursing work environment contributes to interruptions. A micro-focused ethnographic study was conducted. Data collection involved extensive observation of a nursing unit, 1:1 observations of nurses and follow-up interviews with the nurses. Data were analysed from unstructured field notes and interview transcripts. The definitions of interruption and culture guided coding, categorising and identification of themes. A framework was developed that describes the medical nursing unit as a complex culture full of unpredictable, nonlinear changes that affect the entire interconnected system, often in the form of an interruption. The cultural elements contributing to interruptions included (i) the value placed on excellence in patient care and meeting personal needs, (ii) the beliefs that the nurses had to do everything by themselves and that every phone call was important, (iii) the patterns of changing patients, patient transport and coordination of resources and (iv) the normative practices of communicating and adapting. Interruptions are an integral part of the culture of a medical nursing unit. Uniformly decreasing interruptions may disrupt current practices, such as communication to coordinate care, that are central to nursing work. In future research, the nursing work environment must be looked at through the lens of a complex system. Interventions to minimise the negative impact of interruptions must take into account the culture of the nursing as a complex adaptive system. Nurses should be educated on their own contribution to interruptions and issues addressed at a system level, rather than isolating the interruption as the central issue. © 2017 John Wiley & Sons Ltd.

Technology-mediated awareness: facilitating the handling of (un)wanted interruptions in a hospital setting.

PubMed

Klemets, Joakim; Evjemo, Tor Erik

2014-09-01

Nurses' work in hospital departments is highly collaborative and includes communication with a variety of actors. To further support nurses' communications, wireless phones, on which nurses receive both nurse calls and ordinary phone calls, have been introduced. However, while they ensure high availability among the mobile nurses, these phones also contribute to an increased number of interruptions. This paper aims to discover whether all interruptions caused by the wireless phones are unwanted. Further, it investigates how nurses handle these interruptions in a hospital setting in order to construct a foundation for guidelines to use in designing these types of systems. Qualitative and ethnographically inspired fieldwork, including workshops with both ordinary and student nurses from a Norwegian hospital, was undertaken. Patients from two hospital departments were interviewed. Nurses struggle to handle interruptions caused by the wireless nurse call system. Deciding whether to abort an activity or not to respond to an interruption is regarded as stressful. The decision is further complicated by the complex nature of the interruptions. At the same time, patients anticipate that nurses are able to make these judgements with limited information. Nurses' work is highly collaborative, and nurses depend on one another to carry out their work and manage interruptions. The dual nature of the interruptions is complex, and whether an interruption is wanted or unwanted depends on many factors. Nurses manage interruptions mainly by making their own activities visible and monitoring colleagues' work. Therefore, nurses' awareness of colleagues' activities is a key factor in how they handle interruptions in the form of nurse calls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Peri-procedural interrupted oral anticoagulation for atrial fibrillation ablation: comparison of aspirin, warfarin, dabigatran, and rivaroxaban

PubMed Central

Winkle, Roger A.; Mead, R. Hardwin; Engel, Gregory; Kong, Melissa H.; Patrawala, Rob A.

2014-01-01

Aims Atrial fibrillation ablation requires peri-procedural oral anticoagulation (OAC) to prevent thromboembolic events. There are several options for OAC. We evaluate peri-procedural AF ablation complications using a variety of peri-procedural OACs. Methods and results We examined peri-procedural OAC and groin, bleeding, and thromboembolic complications for 2334 consecutive AF ablations using open irrigated-tip radiofrequency (RF) catheters. Pre-ablation OAC was warfarin in 1113 (47.7%), dabigatran 426 (18.3%), rivaroxaban 187 (8.0%), aspirin 472 (20.2%), and none 136 (5.8%). Oral anticoagulation was always interrupted and intraprocedural anticoagulation was unfractionated heparin (activated clotting time, ACT = 237 ± 26 s). Pre- and post-OAC drugs were the same for 1591 (68.2%) and were different for 743 (31.8%). Following ablation, 693 (29.7%) were treated with dabigatran and 291 (12.5%) were treated with rivaroxaban. There were no problems changing from one OAC pre-ablation to another post-ablation. Complications included 12 (0.51%) pericardial tamponades [no differences for dabigatran (P = 0.457) or rivaroxaban (P = 0.163) compared with warfarin], 12 (0.51%) groin complications [no differences for rivaroxaban (P = 0.709) and fewer for dabigatran (P = 0.041) compared with warfarin]. Only 5 of 2334 (0.21%) required blood transfusions. There were two strokes (0.086%) and no transient ischaemic attacks (TIAs) in the first 48 h post-ablation. Three additional strokes (0.13%), and two TIAs (0.086%) occurred from 48 h to 30 days. Only one stroke had a residual deficit. Compared with warfarin, the neurologic event rate was not different for dabigatran (P = 0.684) or rivaroxaban (P = 0.612). Conclusion Using interrupted OAC, low target intraprocedural ACT, and irrigated-tip RF, the rate of peri-procedural groin, haemorrhagic, and thromboembolic complications was extremely low. There were only minimal differences between OACs. Low-risk patients may remain on aspirin/no OAC pre-ablation. There are no problems changing from one OAC pre-ablation to another post-ablation. PMID:25115168

Discovery of the most ancient NATECH in Europe?

NASA Astrophysics Data System (ADS)

Ranguelov, B.; Nikolov, V.

2009-04-01

5400 BC, the Neolithic people started to produce salt to meet their needs, at a place called now Provadia. A large salt body rediscovered recently in 1917 served as a source of this prehistoric factory that produced the most valuable item in prehistory - the salt, the most important and vital product of the early farmers. This unique site in Europe excavated by the team of Prof. Vassil Nikolov shows the history of this place. Huge industry for this prehistoric period was developed and functioned more then 1000 years. Thick walled pots and hearths for the brine evaporation have intensively been produced, and can be seen now. After the rediscovery of the salt body, new and more sophisticated techniques of salt production (the biggest raw material source for the nearby huge industry unit) have been applied in mid 1950s. Recent production of salt by leaching of the salt body through drillings cause the so called NATECH: natural hazards triggered technological, i.e. technological exploitation triggered a lot of seismic events called induced seismicity. Is it possible to consider the prehistoric earthquake that occurred about 7,000 years ago and destroyed the Chalcolithic dry-stone fortifications as a natural hazard interrupting for some time the salt production? Possibly YES! A lot of facts, evidence and a hypothesis about such an event are presented to support this conjecture.

Coupled Land-Atmosphere Dynamics Govern Long Duration Floods: A Pilot Study in Missouri River Basin Using a Bayesian Hierarchical Model

NASA Astrophysics Data System (ADS)

Najibi, N.; Lu, M.; Devineni, N.

2017-12-01

Long duration floods cause substantial damages and prolonged interruptions to water resource facilities and critical infrastructure. We present a novel generalized statistical and physical based model for flood duration with a deeper understanding of dynamically coupled nexus of the land surface wetness, effective atmospheric circulation and moisture transport/release. We applied the model on large reservoirs in the Missouri River Basin. The results indicate that the flood duration is not only a function of available moisture in the air, but also the antecedent condition of the blocking system of atmospheric pressure, resulting in enhanced moisture convergence, as well as the effectiveness of moisture condensation process leading to release. Quantifying these dynamics with a two-layer climate informed Bayesian multilevel model, we explain more than 80% variations in flood duration. The model considers the complex interaction between moisture transport, synoptic-to-large-scale atmospheric circulation pattern, and the antecedent wetness condition in the basin. Our findings suggest that synergy between a large low-pressure blocking system and a higher rate of divergent wind often triggers a long duration flood, and the prerequisite for moisture supply to trigger such event is moderate, which is more associated with magnitude than duration. In turn, this condition causes an extremely long duration flood if the surface wetness rate advancing to the flood event was already increased.

Randomized, Controlled Trial of Therapy Interruption in Chronic HIV-1 Infection

PubMed Central

Papasavvas, Emmanouil; Kostman, Jay R; Mounzer, Karam; Grant, Robert M; Gross, Robert; Gallo, Cele; Azzoni, Livio; Foulkes, Andrea; Thiel, Brian; Pistilli, Maxwell; Mackiewicz, Agnieszka; Shull, Jane; Montaner, Luis J

2004-01-01

Background Approaches to limiting exposure to antiretroviral therapy (ART) drugs are an active area of HIV therapy research. Here we present longitudinal follow-up of a randomized, open-label, single-center study of the immune, viral, and safety outcomes of structured therapy interruptions (TIs) in patients with chronically suppressed HIV-1 infection as compared to equal follow-up of patients on continuous therapy and including a final therapy interruption in both arms. Methods and Findings Forty-two chronically HIV-infected patients on suppressive ART with CD4 counts higher than 400 were randomized 1:1 to either (1) three successive fixed TIs of 2, 4, and 6 wk, with intervening resumption of therapy with resuppression for 4 wk before subsequent interruption, or (2) 40 wk of continuous therapy, with a final open-ended TI in both treatment groups. Main outcome was analysis of the time to viral rebound (>5,000 copies/ml) during the open-ended TI. Secondary outcomes included study-defined safety criteria, viral resistance, therapy failure, and retention of immune reconstitution. There was no difference between the groups in time to viral rebound during the open-ended TI (continuous therapy/single TI, median [interquartile range] = 4 [1–8] wk, n = 21; repeated TI, median [interquartile range] = 5 [4–8] wk, n = 21; p = 0.36). No differences in study-related adverse events, viral set point at 12 or 20 wk of open-ended interruption, viral resistance or therapy failure, retention of CD4 T cell numbers on ART, or retention of lymphoproliferative recall antigen responses were noted between groups. Importantly, resistance detected shortly after initial viremia following the open-ended TI did not result in a lack of resuppression to less than 50 copies/ml after reinitiation of the same drug regimen. Conclusion Cycles of 2- to 6-wk time-fixed TIs in patients with suppressed HIV infection failed to confer a clinically significant benefit with regard to viral suppression off ART. Also, secondary analysis showed no difference between the two strategies in terms of safety, retention of immune reconstitution, and clinical therapy failure. Based on these findings, we suggest that further clinical research on the long-term consequences of TI strategies to decrease drug exposure is warranted. PMID:15630469

Early limited antiretroviral therapy is superior to deferred therapy in HIV-infected South African infants: results from the CHER (Children with HIV Early antiRetroviral) Randomized Trial

PubMed Central

Cotton, Mark F; Violari, Avy; Otwombe, Kennedy; Panchia, Ravindre; Dobbels, Els; Rabie, Helena; Josipovic, Deirdre; Liberty, Afaff; Lazarus, Erica; Innes, Steve; van Rensburg, Anita Janse; Pelser, Wilma; Truter, Handre; Madhi, Shabir A; Handelsman, Edward; Jean-Philippe, Patrick; McIntyre, James A; Gibb, Diana M; Babiker, Abdel G

2014-01-01

Background Interim results from the CHER trial showed that early antiretroviral therapy (ART) was life-saving for HIV-infected infants. Given limited options and potential for toxicity with life-long ART, CHER compared early limited ART with deferred ART. Methods CHER was an open 3-arm trial in HIV-infected asymptomatic infants aged <12 weeks with CD4% ≥25%. Infants were randomized to deferred (ART-Def) or immediate ART for 40weeks (ART-40W) or 96weeks (ART-96W), followed by interruption. Criteria for ART initiation in ART-Def and re-initiation after interruption were CD4% <25% in infancy; otherwise <20% or CDC severe stage B or stage C disease. Lopinavir-ritonavir, zidovudine, lamivudine was the first-line regimen at ART initiation and re-initiation. The primary endpoint was time-to-failure of first-line ART (immunological/clinical/virological) or death. Comparisons were by intent-to-treat, using time-to-event methods. Findings 377 infants were enrolled: median age 7.4weeks; CD4% 35% and HIV RNA log 5.7copies/ml. Median follow-up was 4.8 years; 34 (9%) were lost-to-follow-up. Median time to ART initiation in ART-Def was 20 (IQR 16–25) weeks. Time to restarting ART after interruption was 33 (26–45) weeks in ART-40W and 70 (35–109) weeks in ART-96W; at trial end 19% and 32% respectively, remained off ART. Proportions of follow-up time spent on ART were 81%, 70% and 69% in ART-Def, ART-40W and ART-96W arms. 48/125(38%), 32/126(25%) and 26/126(21%) children reached the primary endpoint; hazard ratio (95%CI), relative to ART-Def, was 0.59(0.38-0.93, p=0.02) for ART-40W and 0.47(0.27-0.76, p=0.002) for ART-96W. Seven children (3 ART-Def, 3 ART-40W, 1 ART-96W) switched to second-line ART. Interpretation Early limited ART had superior clinical/immunological outcome with no evidence of excess disease progression during subsequent interruption and less overall ART exposure than deferred ART. Longer time on primary ART permits longer subsequent interruption with marginally better outcomes. PMID:24209829

Interruptions in a level one trauma center: a case study.

PubMed

Brixey, Juliana J; Tang, Zhihua; Robinson, David J; Johnson, Craig W; Johnson, Todd R; Turley, James P; Patel, Vimla L; Zhang, Jiajie

2008-04-01

The emergency department has been characterized as interrupt-driven. Government agencies and patient safety organizations recognize that interruptions contribute to medical errors. The purpose of this study was to observe, record, and contextualize activities and interruptions experienced by physicians and Registered Nurses (RNs) working in a Level One Trauma Center. A case study that relied on an ethnographic study design using the shadowing method. A convenience sample of physicians and RNs, each with at least 6 months of experience in the Emergency Department (ED), were asked to participate. In these kinds of detailed qualitative investigations, it is quite common to have a small sample size. Ethical approval: Approval was obtained from institutional ethic committees prior to initiating the study. Community consent was obtained from the ED staff through in-service education. All observations were made in the trauma section of the ED of a tertiary teaching hospital. The hospital is situated in a major medical center in the Gulf Coast region of the United States of America (USA). Five attending ED physicians were observed for a total of 29h, 31min. Eight RNs were shadowed for a total of 40 h, 9min. Interruptions and activities were categorized using the Hybrid Method to Categorize Interruptions and Activities (HyMCIA). Registered Nurses received slightly more interruptions per hour than physicians. People, pagers, and telephones were identified as mediums through which interruptions were delivered. The physical environment was found to contribute to interruptions in workflow because of physical design and when supplies were not available. Physicians and RNs usually returned to the original, interrupted activity more often than leaving the activity unfinished. This research provides an enhanced understanding of interruptions in workflow in the ED, the identification of work constraints, and the need to develop interventions to manage interruptions. It is crucial that interruptions be delivered in such a way that there is minimal negative impact on performance. The significance and importance of the interruption must always be weighed against the negative impact that it has on smooth, efficient workflow.

Improving Catastrophe Modeling for Business Interruption Insurance Needs.

PubMed

Rose, Adam; Huyck, Charles K

2016-10-01

While catastrophe (CAT) modeling of property damage is well developed, modeling of business interruption (BI) lags far behind. One reason is the crude nature of functional relationships in CAT models that translate property damage into BI. Another is that estimating BI losses is more complicated because it depends greatly on public and private decisions during recovery with respect to resilience tactics that dampen losses by using remaining resources more efficiently to maintain business function and to recover more quickly. This article proposes a framework for improving hazard loss estimation for BI insurance needs. Improved data collection that allows for analysis at the level of individual facilities within a company can improve matching the facilities with the effectiveness of individual forms of resilience, such as accessing inventories, relocating operations, and accelerating repair, and can therefore improve estimation accuracy. We then illustrate the difference this can make in a case study example of losses from a hurricane. © 2016 Society for Risk Analysis.

Selective attention as a protagonist in contemporary workplace stress: implications for the interruption age.

PubMed

Tams, Stefan; Thatcher, Jason; Grover, Varun; Pak, Richard

2015-01-01

The ubiquity of instant messages and email notifications in contemporary work environments has opened a Pandora's Box. This box is filled with countless interruptions coming from laptops, smartphones, and other devices, all of which constantly call for employees' attention. In this interruption era, workplace stress is a pervasive problem. To examine this problem, the present study hypothesizes that the three-way interaction among the frequency with which interrupting stimuli appear, their salience, and employees' deficits in inhibiting attentional responses to them impacts mental workload perceptions, ultimately leading to stress. The study, further, probes a related form of self-efficacy as a potential suppressor of interruption-based stress. The study used a 2 (low vs. high frequency) × 2 (low vs. high salience) mixed model design. The 128 subjects completed a test of their inhibitory deficits and rated their mental workload perceptions and experiences of stress following a computer-based task. Inhibitory deficits and increased interruption salience can alter the perception of mental workload in contemporary work environments for the worse, but interruption self-efficacy can help offset any resulting interruption-based stress. This study extends the literatures on work interruptions as well as on stress and coping in the workplace.

Two color interferometric electron density measurement in an axially blown arc

NASA Astrophysics Data System (ADS)

Stoller, Patrick; Carstensen, Jan; Galletti, Bernardo; Doiron, Charles; Sokolov, Alexey; Salzmann, René; Simon, Sandor; Jabs, Philipp

2016-09-01

High voltage circuit breakers protect the power grid by interrupting the current in case of a short circuit. To do so an arc is ignited between two contacts as they separate; transonic gas flow is used to cool and ultimately extinguish the arc at a current-zero crossing of the alternating current. A detailed understanding of the arc interruption process is needed to improve circuit breaker design. The conductivity of the partially ionized gas remaining after the current-zero crossing, a key parameter in determining whether the arc will be interrupted or not, is a function of the electron density. The electron density, in turn, is a function of the detailed dynamics of the arc cooling process, which does not necessarily occur under local thermodynamic equilibrium (LTE) conditions. In this work, we measure the spatially resolved line-integrated index of refraction in a near-current-zero arc stabilized in an axial flow of synthetic air with two nanosecond pulsed lasers at wavelengths of 532 nm and 671 nm. Generating a stable, cylindrically symmetric arc enables us to determine the three-dimensional index of refraction distribution using Abel inversion. Due to the wavelength dependence of the component of the index of refraction related to the free electrons, the information at two different wavelengths can be used to determine the electron density. This information allows us to determine how important it is to take into account non-equilibrium effects for accurate modeling of the physics of decaying arcs.

A rare variant P507L in TPP1 interrupts TPP1-TIN2 interaction, influences telomere length, and confers colorectal cancer risk in Chinese population.

PubMed

Li, Jiaoyuan; Chang, Jiang; Tian, Jianbo; Ke, Juntao; Zhu, Ying; Yang, Yang; Gong, Yajie; Zou, Danyi; Peng, Xiating; Yang, Nan; Mei, Shufang; Wang, Xiaoyang; Cheng, Liming; Hu, Weiguo; Gong, Jing; Zhong, Rong; Miao, Xiaoping

2018-06-11

Telomere dysfunction triggers cellular senescence and constitutes a driving force for cancer initiation. Genetic variants in genes involved in telomere maintenance may contribute to colorectal cancer (CRC) susceptibility. In this study, we firstly captured germline mutations in 192 CRC patients by sequencing the coding regions of 13 core components implicated in telomere biology. Five potential functional variants were then genotyped and assessed in a case-control set with 3,761 CRC cases and 3,839 healthy controls. The promising association was replicated in additional 6,765 cases and 6,906 controls. Functional experiments were used to further clarify the potential function of the significant variant and uncover the underlying mechanism in CRC development. The two-stage association studies showed that a rare missense variant rs149418249 (c.C1520T, p.P507L) in the 11th exon of TPP1 (also known as ACD, gene ID 65057) was significantly associated with CRC risk with the ORs being 2.90 (95% CI:1.04-8.07, P=0.041), 2.50 (95% CI:1.04-6.04, P=0.042), and 2.66 (95%CI:1.36-5.18, P=0.004) in discovery, replication, and the combined samples, respectively. Further functional annotation indicated that the TPP1 P507L substitution interrupted TPP1-TIN2 interaction, impaired telomerase processivity, and shortened telomere length, which subsequently facilitated cell proliferation and promoted CRC development. A rare variant P507L in TPP1 confers increased risk of CRC through interrupting TPP1-TIN2 interaction, impairing telomerase processivity, and shrinking telomere length. These findings emphasize the important role of telomere dysfunction in CRC development, and provide new insights about the prevention of this type of cancer. Copyright ©2018, American Association for Cancer Research.

Demyelinating and ischemic brain diseases: detection algorithm through regular magnetic resonance images

NASA Astrophysics Data System (ADS)

Castillo, D.; Samaniego, René; Jiménez, Y.; Cuenca, L.; Vivanco, O.; Rodríguez-Álvarez, M. J.

2017-09-01

This work presents the advance to development of an algorithm for automatic detection of demyelinating lesions and cerebral ischemia through magnetic resonance images, which have contributed in paramount importance in the diagnosis of brain diseases. The sequences of images to be used are T1, T2, and FLAIR. Brain demyelination lesions occur due to damage of the myelin layer of nerve fibers; and therefore this deterioration is the cause of serious pathologies such as multiple sclerosis (MS), leukodystrophy, disseminated acute encephalomyelitis. Cerebral or cerebrovascular ischemia is the interruption of the blood supply to the brain, thus interrupting; the flow of oxygen and nutrients needed to maintain the functioning of brain cells. The algorithm allows the differentiation between these lesions.

THE EFFECTS OF MATCHED STIMULATION AND RESPONSE INTERRUPTION AND REDIRECTION ON VOCAL STEREOTYPY

PubMed Central

Love, Jessica J; Miguel, Caio F; Fernand, Jonathan K; LaBrie, Jillian K

2012-01-01

Stereotypy has been classified as repetitive behavior that does not serve any apparent function. Two procedures that have been found to reduce rates of vocal stereotypy effectively are response interruption and redirection (RIRD) and noncontingent access to matched stimulation (MS). The purpose of the current study was to evaluate the effects of RIRD alone, MS alone, and MS combined with RIRD. One participant's results suggested similar suppressive effects on vocal stereotypy across treatment conditions. For the second participant, a slightly greater suppression of stereotypy was associated with MS + RIRD. In addition, both participants emitted a greater frequency of appropriate vocalizations in conditions with RIRD. Data suggest that the addition of MS might facilitate the implementation of RIRD in applied settings. PMID:23060668

A computational fluid dynamics simulation of high- and low-current arcs in self-blast circuit breakers

NASA Astrophysics Data System (ADS)

Claessens, M.; Möller, K.; Thiel, H. G.

1997-07-01

Computational fluid dynamics calculations for high- and low-current arcs in an interrupter of the self-blast type have been performed. The mixing process of the hot PTFE cloud with the cold 0022-3727/30/13/011/img6 in the pressure chamber is strongly inhomogeneous. The existence of two different species has been taken into account by interpolation of the material functions according to their mass fraction in each grid cell. Depending on the arcing time, fault current and interrupter geometry, blow temperatures of up to 2000 K have been found. The simulation results for a decaying arc immediately before current zero yield a significantly reduced arc cooling at the stagnation point for high blow temperatures.

Adaptation of superconducting fault current limiter to high-speed reclosing

NASA Astrophysics Data System (ADS)

Koyama, T.; Yanabu, S.

2009-10-01

Using a high temperature superconductor, we constructed and tested a model superconducting fault current limiter (SFCL). The superconductor might break in some cases because of its excessive generation of heat. Therefore, it is desirable to interrupt early the current that flows to superconductor. So, we proposed the SFCL using an electromagnetic repulsion switch which is composed of a superconductor, a vacuum interrupter and a by-pass coil, and its structure is simple. Duration that the current flow in the superconductor can be easily minimized to the level of less than 0.5 cycle using this equipment. On the other hand, the fault current is also easily limited by large reactance of the parallel coil. There is duty of high-speed reclosing after interrupting fault current in the electric power system. After the fault current is interrupted, the back-up breaker is re-closed within 350 ms. So, the electromagnetic repulsion switch should return to former state and the superconductor should be recovered to superconducting state before high-speed reclosing. Then, we proposed the SFCL using an electromagnetic repulsion switch which employs our new reclosing function. We also studied recovery time of the superconductor, because superconductor should be recovered to superconducting state within 350 ms. In this paper, the recovery time characteristics of the superconducting wire were investigated. Also, we combined the superconductor with the electromagnetic repulsion switch, and we did performance test. As a result, a high-speed reclosing within 350 ms was proven to be possible.

Evaluation of Interruption Behavior by Naive Encoders.

ERIC Educational Resources Information Center

Coon, Christine A.; Schwanenflugel, Paula J.

1996-01-01

Determines the characteristics of interactions that influence judgments of interruption behavior in naive observers. Asks subjects to decide whether an example of an interruption was an interruption and then rate it in terms of how "good" or "bad" it was. Finds that naive observers use some of the same features described in…

The regulatory cliff edge between contraception and abortion: the legal and moral significance of implantation

PubMed Central

Sheldon, Sally

2015-01-01

In regulating the voluntary interruption of pregnancy, English law has accorded particular significance to two biological events. First, ‘viability’, the moment when a fetus is said to acquire the capacity for independent life, plays an important role in grounding restrictions on access to legal abortion later in pregnancy. Second, equally significantly but far less frequently discussed, ‘implantation’ marks the point in pregnancy from which abortion laws apply. This paper focuses on this earlier biological event. It suggests that an unquestioning reliance on implantation as marking an appropriate moment of transition between two radically different legal frameworks is deeply problematic and is rendered still less sustainable in the light of the development of new technologies that potentially operate shortly after the moment of implantation. PMID:26085334

Two-dimensional electron density characterisation of arc interruption phenomenon in current-zero phase

NASA Astrophysics Data System (ADS)

Inada, Yuki; Kamiya, Tomoki; Matsuoka, Shigeyasu; Kumada, Akiko; Ikeda, Hisatoshi; Hidaka, Kunihiko

2018-01-01

Two-dimensional electron density imaging over free burning SF6 arcs and SF6 gas-blast arcs was conducted at current zero using highly sensitive Shack-Hartmann type laser wavefront sensors in order to experimentally characterise electron density distributions for the success and failure of arc interruption in the thermal reignition phase. The experimental results under an interruption probability of 50% showed that free burning SF6 arcs with axially asymmetric electron density profiles were interrupted with a success rate of 88%. On the other hand, the current interruption of SF6 gas-blast arcs was reproducibly achieved under locally reduced electron densities and the interruption success rate was 100%.

Panel Estimates of Male-Female Earnings Functions.

ERIC Educational Resources Information Center

Kim, Moon-Kak; Polachek, Solomon W.

1994-01-01

Application of single and simultaneous equation fixed-effects and random-effects shows that earnings appreciation with experience and depreciation with labor market interruptions are comparable for men and women. Adjusting for heterogeneity reduces the wage gap to 20%; adjusting for endogeneity reduces it nearly to zero. (SK)

Object-oriented millisecond timers for the PC.

PubMed

Hamm, J P

2001-11-01

Object-oriented programming provides a useful structure for designing reusable code. Accurate millisecond timing is essential for many areas of research. With this in mind, this paper provides a Turbo Pascal unit containing an object-oriented millisecond timer. This approach allows for multiple timers to be running independently. The timers may also be set at different levels of temporal precision, such as 10(-3) (milliseconds) or 10(-5) sec. The object also is able to store the time of a flagged event for later examination without interrupting the ongoing timing operation.

Developments in Radiation-Hardened Electronics Applicable to the Vision for Space Exploration

NASA Technical Reports Server (NTRS)

Keys, Andrew S.; Frazier, Donald O.; Patrick , Marshall C.; Watson, Michael D.; Johnson, Michael A.; Cressler, John D.; Kolawa, Elizabeth A.

2007-01-01

The Radiation Hardened Electronics for Space Exploration (RHESE) project develops the advanced technologies required to produce radiation hardened electronics, processors, and devices in support of the anticipated requirements of NASA's Constellation program. Methods of protecting and hardening electronics against the encountered space environment are discussed. Critical stages of a spaceflight mission that are vulnerable to radiation-induced interruptions or failures are identified. Solutions to mitigating the risk of radiation events are proposed through the infusion of RHESE technology products and deliverables into the Constellation program's spacecraft designs.

Isolation contactor state control system

DOEpatents

Bissontz, Jay E.

2017-05-16

A controller area network (CAN) installed on a hybrid electric vehicle provides one node with control of high voltage power distribution system isolation contactors and the capacity to energize a secondary electro-mechanical relay device. The output of the secondary relay provides a redundant and persistent backup signal to the output of the node. The secondary relay is relatively immune to CAN message traffic interruptions and, as a result, the high voltage isolation contactor(s) are less likely to transition open in the event that the intelligent output driver should fail.

Electrical breakdown detection system for dielectric elastomer actuators

NASA Astrophysics Data System (ADS)

Ghilardi, Michele; Busfield, James J. C.; Carpi, Federico

2017-04-01

Electrical breakdown of dielectric elastomer actuators (DEAs) is an issue that has to be carefully addressed when designing systems based on this novel technology. Indeed, in some systems electrical breakdown might have serious consequences, not only in terms of interruption of the desired function but also in terms of safety of the overall system (e.g. overheating and even burning). The risk for electrical breakdown often cannot be completely avoided by simply reducing the driving voltages, either because completely safe voltages might not generate sufficient actuation or because internal or external factors might change some properties of the actuator whilst in operation (for example the aging or fatigue of the material, or an externally imposed deformation decreasing the distance between the compliant electrodes). So, there is the clear need for reliable, simple and cost-effective detection systems that are able to acknowledge the occurrence of a breakdown event, making DEA-based devices able to monitor their status and become safer and "selfaware". Here a simple solution for a portable detection system is reported that is based on a voltage-divider configuration that detects the voltage drop at the DEA terminals and assesses the occurrence of breakdown via a microcontroller (Beaglebone Black single-board computer) combined with a real-time, ultra-low-latency processing unit (Bela cape an open-source embedded platform developed at Queen Mary University of London). The system was used to both generate the control signal that drives the actuator and constantly monitor the functionality of the actuator, detecting any breakdown event and discontinuing the supplied voltage accordingly, so as to obtain a safer controlled actuation. This paper presents preliminary tests of the detection system in different scenarios in order to assess its reliability.

Interruption of the Tower of London Task: Support for a Goal-Activation Approach

ERIC Educational Resources Information Center

Hodgetts, Helen M.; Jones, Dylan M.

2006-01-01

Unexpected interruptions introduced during the execution phase of simple Tower of London problems incurred a time cost when the interrupted goal was retrieved, and this cost was exacerbated the longer the goal was suspended. Furthermore, time taken to retrieve goals was greater following a more complex interruption, indicating the processing…

Determining the Overall Impact of Interruptions during Online Testing

ERIC Educational Resources Information Center

Sinharay, Sandip; Wan, Ping; Whitaker, Mike; Kim, Dong-In; Zhang, Litong; Choi, Seung W.

2014-01-01

With an increase in the number of online tests, interruptions during testing due to unexpected technical issues seem unavoidable. For example, interruptions occurred during several recent state tests. When interruptions occur, it is important to determine the extent of their impact on the examinees' scores. There is a lack of research on this…

The Medical Hazards of Flame-Suppressant Atmospheres

DTIC Science & Technology

1991-04-19

the external and middle earcavities. Graph B shows inward distension of the may need to be interrupted or slowed to eardrum produced by higher...experiments were performed by mental function, muscular coordination, military scientists (see ACKNOW- night vision, visual contrast sensitivity, LEDGEMENTS) in...task of muscular posure to change any of the visual coordination was slightly function tests (Luria & Knight, degraded during the first 4 h of 1987). the

Auditory training of speech recognition with interrupted and continuous noise maskers by children with hearing impairment

PubMed Central

Sullivan, Jessica R.; Thibodeau, Linda M.; Assmann, Peter F.

2013-01-01

Previous studies have indicated that individuals with normal hearing (NH) experience a perceptual advantage for speech recognition in interrupted noise compared to continuous noise. In contrast, adults with hearing impairment (HI) and younger children with NH receive a minimal benefit. The objective of this investigation was to assess whether auditory training in interrupted noise would improve speech recognition in noise for children with HI and perhaps enhance their utilization of glimpsing skills. A partially-repeated measures design was used to evaluate the effectiveness of seven 1-h sessions of auditory training in interrupted and continuous noise. Speech recognition scores in interrupted and continuous noise were obtained from pre-, post-, and 3 months post-training from 24 children with moderate-to-severe hearing loss. Children who participated in auditory training in interrupted noise demonstrated a significantly greater improvement in speech recognition compared to those who trained in continuous noise. Those who trained in interrupted noise demonstrated similar improvements in both noise conditions while those who trained in continuous noise only showed modest improvements in the interrupted noise condition. This study presents direct evidence that auditory training in interrupted noise can be beneficial in improving speech recognition in noise for children with HI. PMID:23297921

Forgetting induced speeding: Can prospective memory failure account for drivers exceeding the speed limit?

PubMed

Bowden, Vanessa K; Visser, Troy A W; Loft, Shayne

2017-06-01

It is generally assumed that drivers speed intentionally because of factors such as frustration with the speed limit or general impatience. The current study examined whether speeding following an interruption could be better explained by unintentional prospective memory (PM) failure. In these situations, interrupting drivers may create a PM task, with speeding the result of drivers forgetting their newly encoded intention to travel at a lower speed after interruption. Across 3 simulated driving experiments, corrected or uncorrected speeding in recently reduced speed zones (from 70 km/h to 40 km/h) increased on average from 8% when uninterrupted to 33% when interrupted. Conversely, the probability that participants traveled under their new speed limit in recently increased speed zones (from 40 km/h to 70 km/h) increased from 1% when uninterrupted to 23% when interrupted. Consistent with a PM explanation, this indicates that interruptions lead to a general failure to follow changed speed limits, not just to increased speeding. Further testing a PM explanation, Experiments 2 and 3 manipulated variables expected to influence the probability of PM failures and subsequent speeding after interruptions. Experiment 2 showed that performing a cognitively demanding task during the interruption, when compared with unfilled interruptions, increased the probability of initially speeding from 1% to 11%, but that participants were able to correct (reduce) their speed. In Experiment 3, providing participants with 10s longer to encode the new speed limit before interruption decreased the probability of uncorrected speeding after an unfilled interruption from 30% to 20%. Theoretical implications and implications for road design interventions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Tsunami-Induced Nearshore Hydrodynamic Modeling using a 3D VOF Method: A Gulf of Mexico Case Study

NASA Astrophysics Data System (ADS)

Kian, R.; Horrillo, J. J.; Fang, N. Z.

2017-12-01

Long-term morphology changes can be interrupted by extreme events such as hurricanes and tsunamis. In particular, the impact of tsunamis on coastal erosion and accretion patterns is presently not well understood. In order to understand the sediment movement during coastal tsunami impact a numerical sediment transport model is added to a 3D VOF model. This model allows for spatially varying bottom sediment characteristics and entails functions for entrainment, bedload, and suspended load transport. As a case study, a Gulf of Mexico (GOM) coastal study site is selected to investigate the effect of a landslide-tsunami on the coastal morphology. The GOM is recognized as a vast and productive body of water with great ecologic and economic value. The morphodynamic response of the nearshore environment to the tsunami hydrodynamic forcing is influenced by many factors including bathymetry, topography, tsunami wave and current magnitude, and the characteristics of the local bottom substrate. The 3D model addition can account for all these factors. Finally, necessary strategies for reduction of the potential tsunami impact and management of the morphological changes are discussed.

Corrugator activity confirms immediate negative affect in surprise

PubMed Central

Topolinski, Sascha; Strack, Fritz

2015-01-01

The emotion of surprise entails a complex of immediate responses, such as cognitive interruption, attention allocation to, and more systematic processing of the surprising stimulus. All these processes serve the ultimate function to increase processing depth and thus cognitively master the surprising stimulus. The present account introduces phasic negative affect as the underlying mechanism responsible for this switch in operating mode. Surprising stimuli are schema-discrepant and thus entail cognitive disfluency, which elicits immediate negative affect. This affect in turn works like a phasic cognitive tuning switching the current processing mode from more automatic and heuristic to more systematic and reflective processing. Directly testing the initial elicitation of negative affect by surprising events, the present experiment presented high and low surprising neutral trivia statements to N = 28 participants while assessing their spontaneous facial expressions via facial electromyography. High compared to low surprising trivia elicited higher corrugator activity, indicative of negative affect and mental effort, while leaving zygomaticus (positive affect) and frontalis (cultural surprise expression) activity unaffected. Future research shall investigate the mediating role of negative affect in eliciting surprise-related outcomes. PMID:25762956

Corrugator activity confirms immediate negative affect in surprise.

PubMed

Topolinski, Sascha; Strack, Fritz

2015-01-01

The emotion of surprise entails a complex of immediate responses, such as cognitive interruption, attention allocation to, and more systematic processing of the surprising stimulus. All these processes serve the ultimate function to increase processing depth and thus cognitively master the surprising stimulus. The present account introduces phasic negative affect as the underlying mechanism responsible for this switch in operating mode. Surprising stimuli are schema-discrepant and thus entail cognitive disfluency, which elicits immediate negative affect. This affect in turn works like a phasic cognitive tuning switching the current processing mode from more automatic and heuristic to more systematic and reflective processing. Directly testing the initial elicitation of negative affect by surprising events, the present experiment presented high and low surprising neutral trivia statements to N = 28 participants while assessing their spontaneous facial expressions via facial electromyography. High compared to low surprising trivia elicited higher corrugator activity, indicative of negative affect and mental effort, while leaving zygomaticus (positive affect) and frontalis (cultural surprise expression) activity unaffected. Future research shall investigate the mediating role of negative affect in eliciting surprise-related outcomes.

Physiological importance of RNA and protein mobility in the cell nucleus

PubMed Central

2007-01-01

Trafficking of proteins and RNAs is essential for cellular function and homeostasis. While it has long been appreciated that proteins and RNAs move within cells, only recently has it become possible to visualize trafficking events in vivo. Analysis of protein and RNA motion within the cell nucleus have been particularly intriguing as they have revealed an unanticipated degree of dynamics within the organelle. These methods have revealed that the intranuclear trafficking occurs largely by energy-independent mechanisms and is driven by diffusion. RNA molecules and non-DNA binding proteins undergo constrained diffusion, largely limited by the spatial constraint imposed by chromatin, and chromatin binding proteins move by a stop-and-go mechanism where their free diffusion is interrupted by random association with the chromatin fiber. The ability and mode of motion of proteins and RNAs has implications for how they find nuclear targets on chromatin and in nuclear subcompartments and how macromolecular complexes are assembled in vivo. Most importantly, the dynamic nature of proteins and RNAs is emerging as a means to control physiological cellular responses and pathways. PMID:17994245

Spliceosome Profiling Visualizes Operations of a Dynamic RNP at Nucleotide Resolution.

PubMed

Burke, Jordan E; Longhurst, Adam D; Merkurjev, Daria; Sales-Lee, Jade; Rao, Beiduo; Moresco, James J; Yates, John R; Li, Jingyi Jessica; Madhani, Hiten D

2018-05-03

Tools to understand how the spliceosome functions in vivo have lagged behind advances in the structural biology of the spliceosome. Here, methods are described to globally profile spliceosome-bound pre-mRNA, intermediates, and spliced mRNA at nucleotide resolution. These tools are applied to three yeast species that span 600 million years of evolution. The sensitivity of the approach enables the detection of canonical and non-canonical events, including interrupted, recursive, and nested splicing. This application of statistical modeling uncovers independent roles for the size and position of the intron and the number of introns per transcript in substrate progression through the two catalytic stages. These include species-specific inputs suggestive of spliceosome-transcriptome coevolution. Further investigations reveal the ATP-dependent discard of numerous endogenous substrates after spliceosome assembly in vivo and connect this discard to intron retention, a form of splicing regulation. Spliceosome profiling is a quantitative, generalizable global technology used to investigate an RNP central to eukaryotic gene expression. Copyright © 2018 Elsevier Inc. All rights reserved.

Radio Links for the NASA ABTS

NASA Technical Reports Server (NTRS)

Jeutter, Dean C.

1996-01-01

The closed loop prototype has operational bi-directional wireless links. The Wideband PCM-FSK receiver has been designed and characterized. Now that both links function, communication performance can be addressed. For example, noise problems with the received outlink signal that caused the PC program to lockup were just recently revealed and minimized by software "enhancements" to the Windows based PC program. A similar problem with inlink communication was uncovered several days before this report: A noise spike or dropout (expected events in the animal Habitat) caused an interrupt to the implant microcontroller which halted outlink transmission. Recovery of outlink transmission did not reliably occur. The problem has been defined and implant software is being modified to better recognize noise from data by changing the timing associated with valid data packet identification and by better utilizing the error flags generated by the microcontroller's SCI circuits. Excellent inlink performance will also require improvements in the implant's receiver. The biggest performance improvement can be provided by antenna design for the Habitat. The quarter wavelength whip antennas used with the demo prototype inlink leave much to be desired.

Capabilities of a Global 3D MHD Model for Monitoring Extremely Fast CMEs

NASA Astrophysics Data System (ADS)

Wu, C. C.; Plunkett, S. P.; Liou, K.; Socker, D. G.; Wu, S. T.; Wang, Y. M.

2015-12-01

Since the start of the space era, spacecraft have recorded many extremely fast coronal mass ejections (CMEs) which have resulted in severe geomagnetic storms. Accurate and timely forecasting of the space weather effects of these events is important for protecting expensive space assets and astronauts and avoiding communications interruptions. Here, we will introduce a newly developed global, three-dimensional (3D) magnetohydrodynamic (MHD) model (G3DMHD). The model takes the solar magnetic field maps at 2.5 solar radii (Rs) and intepolates the solar wind plasma and field out to 18 Rs using the algorithm of Wang and Sheeley (1990, JGR). The output is used as the inner boundary condition for a 3D MHD model. The G3DMHD model is capable of simulating (i) extremely fast CME events with propagation speeds faster than 2500 km/s; and (ii) multiple CME events in sequence or simultaneously. We will demonstrate the simulation results (and comparison with in-situ observation) for the fastest CME in record on 23 July 2012, the shortest transit time in March 1976, and the well-known historic Carrington 1859 event.

A work observation study of nuclear medicine technologists: interruptions, resilience and implications for patient safety.

PubMed

Larcos, George; Prgomet, Mirela; Georgiou, Andrew; Westbrook, Johanna

2017-06-01

Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effectiveness of a 'Do not interrupt' bundled intervention to reduce interruptions during medication administration: a cluster randomised controlled feasibility study.

PubMed

Westbrook, Johanna I; Li, Ling; Hooper, Tamara D; Raban, Magda Z; Middleton, Sandy; Lehnbom, Elin C

2017-09-01

To evaluate the effectiveness of a 'Do not interrupt' bundled intervention to reduce non-medication-related interruptions to nurses during medication administration. A parallel eight cluster randomised controlled study was conducted in a major teaching hospital in Adelaide, Australia. Four wards were randomised to the intervention which comprised wearing a vest when administering medications; strategies for diverting interruptions; clinician and patient education; and reminders. Control wards were blinded to the intervention. Structured direct observations of medication administration processes were conducted. The primary outcome was non-medication-related interruptions during individual medication dose administrations. The secondary outcomes were total interruption and multitasking rates. A survey of nurses' experiences was administered. Over 8 weeks and 364.7 hours, 227 nurses were observed administering 4781 medications. At baseline, nurses experienced 57 interruptions/100 administrations, 87.9% were unrelated to the medication task being observed. Intervention wards experienced a significant reduction in non-medication-related interruptions from 50/100 administrations (95% CI 45 to 55) to 34/100 (95% CI 30 to 38). Controlling for clustering, ward type and medication route showed a significant reduction of 15 non-medication-related interruptions/100 administrations compared with control wards. A total of 88 nurses (38.8%) completed the poststudy survey. Intervention ward nurses reported that vests were time consuming, cumbersome and hot. Only 48% indicated that they would support the intervention becoming hospital policy. Nurses experienced a high rate of interruptions. Few were related to the medication task, demonstrating considerable scope to reduce unnecessary interruptions. While the intervention was associated with a statistically significant decline in non-medication-related interruptions, the magnitude of this reduction and its likely impact on error rates should be considered, relative to the effectiveness of alternate interventions, associated costs, likely acceptability and long-term sustainability of such interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Description of real-time Ada software implementation of a power system monitor for the Space Station Freedom PMAD DC testbed

NASA Technical Reports Server (NTRS)

Ludwig, Kimberly; Mackin, Michael; Wright, Theodore

1991-01-01

The authors describe the Ada language software developed to perform the electrical power system monitoring functions for the NASA Lewis Research Center's Power Management and Distribution (PMAD) DC testbed. The results of the effort to implement this monitor are presented. The PMAD DC testbed is a reduced-scale prototype of the electric power system to be used in Space Station Freedom. The power is controlled by smart switches known as power control components (or switchgear). The power control components are currently coordinated by five Compaq 386/20e computers connected through an 802.4 local area network. The power system monitor algorithm comprises several functions, including periodic data acquisition, data smoothing, system performance analysis, and status reporting. Data are collected from the switchgear sensors every 100 ms, then passed through a 2-Hz digital filter. System performance analysis includes power interruption and overcurrent detection. The system monitor required a hardware timer interrupt to activate the data acquisition function. The execution time of the code was optimized by using an assembly language routine. The routine allows direct vectoring of the processor to Ada language procedures that perform periodic control activities.

Economic Impact Analyses of Interdisciplinary Multi-hazard Scenarios: ShakeOut and ARkStorm

NASA Astrophysics Data System (ADS)

Wein, A. M.; Rose, A.; Sue Wing, I.; Wei, D.

2011-12-01

U. S. Geological Survey (USGS) scientists are using an interdisciplinary strategy to develop and analyze multi-hazard scenarios to help communities enhance resilience to natural hazard disasters. Two such scenarios are the southern California ShakeOut earthquake and the California ARkStorm winter storm. Both scenarios are multi-hazard: Shakeout ground motions trigger landslides and liquefaction and ARkStorm involves wind, flood, landslide, and coastal hazards. A collaborative scenario-process engages partners and stakeholders throughout the development and use of the scenarios, In doing so, community resilience is enhanced by educating communities about hazards and hazard interdependencies, building networks from scientists to decision makers, exercising emergency management strategies, identifying emergency management issues, and motivating solutions prior to an event. In addition, interdisciplinary scenarios stimulate research on the various steps of analysis (e.g., natural hazard processes, physical damages, societal consequences, and policy connections). In particular, USGS scientists have collaborated with economists to advance methods to estimate the economic impacts (business interruption losses) of disasters. Our economic impact analyses evolved from the economic module in the Federal Emergency Management Agency's loss-estimation tool, HAZUS-MH, to a more encompassing input-output analysis for ShakeOut, to a more sophisticated Computable General Equilibrium model for ARkStorm. The analyses depend on physical damage and restoration time estimates from engineers and geographic analyses of economic assets in hazard zones. Economic resilience strategies are incorporated to represent resourcefulness and ingenuity that avoids potential losses during and after an event. Such strategies operate at three levels of the economy: micro (e.g., ability to catch up on lost production time), meso (e.g., coordination within a sector to share resources), and macro (e.g., price adjustments to redistribute scarce resources). A sensitivity analysis of the ARkStorm economic impact model explores the effects of 1) the magnitude of the shocks (e.g., flood damages to buildings and infrastructure, agricultural productivity, and lifeline service disruptions), 2) the sustainability of the economic resilience strategies, and 3) the amount, timing, and source of reconstruction funds. The inclusion of an economic analysis in ShakeOut and ARkStorm broadens the range of interest in the scenario results. For example, the relative contribution of ShakeOut economic shocks to business interruption losses emphasized the need to reduce the impacts of fire following earthquake and water service disruption. Based on the magnitude and duration of the economic impacts for the ARkStorm scenario, policy experts surmised that business interruption policy time elements would be exceeded and business interruptions would be largely unfunded calling attention to the need for innovative funding solutions. Finally, economic impact analyses inform the question of paying now to mitigate or paying more later to recover.

Embedding resilience in the design of the electricity supply for industrial clients

PubMed Central

Moura, Márcio das Chagas; Diniz, Helder Henrique Lima; da Cunha, Beatriz Sales; Lins, Isis Didier; Simoni, Vicente Ribeiro

2017-01-01

This paper proposes an optimization model, using Mixed-Integer Linear Programming (MILP), to support decisions related to making investments in the design of power grids serving industrial clients that experience interruptions to their energy supply due to disruptive events. In this approach, by considering the probabilities of the occurrence of a set of such disruptive events, the model is used to minimize the overall expected cost by determining an optimal strategy involving pre- and post-event actions. The pre-event actions, which are considered during the design phase, evaluate the resilience capacity (absorption, adaptation and restoration) and are tailored to the context of industrial clients dependent on a power grid. Four cases are analysed to explore the results of different probabilities of the occurrence of disruptions. Moreover, two scenarios, in which the probability of occurrence is lowest but the consequences are most serious, are selected to illustrate the model’s applicability. The results indicate that investments in pre-event actions, if implemented, can enhance the resilience of power grids serving industrial clients because the impacts of disruptions either are experienced only for a short time period or are completely avoided. PMID:29190777

Embedding resilience in the design of the electricity supply for industrial clients.

PubMed

Moura, Márcio das Chagas; Diniz, Helder Henrique Lima; Droguett, Enrique López; da Cunha, Beatriz Sales; Lins, Isis Didier; Simoni, Vicente Ribeiro

2017-01-01

This paper proposes an optimization model, using Mixed-Integer Linear Programming (MILP), to support decisions related to making investments in the design of power grids serving industrial clients that experience interruptions to their energy supply due to disruptive events. In this approach, by considering the probabilities of the occurrence of a set of such disruptive events, the model is used to minimize the overall expected cost by determining an optimal strategy involving pre- and post-event actions. The pre-event actions, which are considered during the design phase, evaluate the resilience capacity (absorption, adaptation and restoration) and are tailored to the context of industrial clients dependent on a power grid. Four cases are analysed to explore the results of different probabilities of the occurrence of disruptions. Moreover, two scenarios, in which the probability of occurrence is lowest but the consequences are most serious, are selected to illustrate the model's applicability. The results indicate that investments in pre-event actions, if implemented, can enhance the resilience of power grids serving industrial clients because the impacts of disruptions either are experienced only for a short time period or are completely avoided.

Individual Differences in Working-Memory Capacity and Task Resumption Following Interruptions

ERIC Educational Resources Information Center

Foroughi, Cyrus K.; Werner, Nicole E.; McKendrick, Ryan; Cades, David M.; Boehm-Davis, Deborah A.

2016-01-01

Previous research has shown that there is a time cost (i.e., a resumption lag) associated with resuming a task following an interruption and that the longer the duration of the interruption, the greater the time cost (i.e., resumption lag increases as interruption duration increases). The memory-for-goals model (Altmann & Trafton, 2002)…

Assessing Individual-Level Impact of Interruptions during Online Testing

ERIC Educational Resources Information Center

Sinharay, Sandip; Wan, Ping; Choi, Seung W.; Kim, Dong-In

2015-01-01

With an increase in the number of online tests, the number of interruptions during testing due to unexpected technical issues seems to be on the rise. For example, interruptions occurred during several recent state tests. When interruptions occur, it is important to determine the extent of their impact on the examinees' scores. Researchers such as…

DC Interruption Characteristic on Vacuum Circuit Breaker

NASA Astrophysics Data System (ADS)

Odaka, Hiromi; Yamada, Masataka; Sakuma, Ryohei; Ding, Cuie; Kaneko, Eiji; Yanabu, Satoru

A high speed vacuum circuit breaker (HSVCB) has been investigated. HSVCB makes high frequency current superimposed on a fault current so that the current is forced to be zero and is interrupted. Its interruption performance is considered to be dependent on a rate of change of the current (di/dt). As a fundamental research, we investigated the di/dt-dv/dt characteristics and the insulation recovery characteristic after interrupting the counter-pulse current for various contact materials of AgWC, CuW, and CuCr. The results revealed that the case where gap length is larger is better in a current interruption performance. Moreover, it was found that di/dt is not dependent on the insulation recovery characteristics, but the magnitude of interruption current influences greatly.

Direct current hybrid breakers: A design and its realization

NASA Astrophysics Data System (ADS)

Atmadji, Ali Mahfudz Surya

2000-12-01

The use of semiconductors for electric power circuit breakers instead of conventional breakers remains a utopia when designing fault current interrupters for high power networks. The major problems concerning power semiconductor circuit breakers are the excessive heat losses and their sensitivity to transients. However, conventional breakers are capable of dealing with such matters. A combination of the two methods, or so-called `hybrid breakers', would appear to be a solution; however, hybrid breakers use separate parallel branches for conducting the main current and interrupting the short-circuit current. Such breakers are intended for protecting direct current (DC) traction systems. In this thesis hybrid switching techniques for current limitation and purely solidstate current interruption are investigated for DC breakers. This work analyzes the transient behavior of hybrid breakers and compares their operations with conventional breakers and similar solid-state devices in DC systems. Therefore a hybrid breaker was constructed and tested in a specially designed high power test circuit. A vacuum breaker was chosen as the main breaker in the main conducting path; then a commutation path was connected across the vacuum breaker where it provided current limitation and interruption. The commutation path operated only during any current interruption and the process required additional circuits. These included a certain energy storage, overvoltage suppressor and commutation switch. So that when discharging this energy, a controlled counter-current injection could be produced. That counter-current opposed the main current in the breaker by superposition in order to create a forced current-zero. One-stage and two-stage commutation circuits have been treated extensively. This study project contains both theoretical and experimental investigations. A direct current shortcircuit source was constructed capable of delivering power equivalent to a fault. It supplied a direct voltage of 1kVDC which was rectified having been obtained from a 3-phase lOkV/380V supply. The source was successfully tested to deliver a fault current of 7kA with a time constant of 5ms. The hybrid breaker that was developed could provide protection for 750VDC traction systems. The breaker was equipped with a fault- recognizing circuit based on a current level triggering. An electronic circuit was built for this need and was included in the system. It monitored the system continuously and took action by generating trip signals when a fault was recognized. Interruption was followed by a suitable timing of the fast contact separation in the main breaker and the current-zero creation. An electrodynamically driven mechanism was successfully tested having a dead-time of 300μs to separate the main breaker contacts. Furthermore, a maximum peak current injection of RA at a frequency of 500Hz could be obtained in order to produce an artificial current-zero in the vacuum breaker. A successful current interruption with a prospective value of RA was achieved by the hybrid switching technique. In addition, measures were taken to prevent overvoltages. Experimentally, the concept of a hybrid breaker was compared with the functioning of all mechanical (air breaker) and all electronical (IGCT breaker) versions. Although a single stage interrupting method was verified experimentally, two two-stage interrupting methods were analyzed theoretically.

Dietary and plant polyphenols exert neuroprotective effects and improve cognitive function in cerebral ischemia

USDA-ARS?s Scientific Manuscript database

Cerebral ischemia is caused by an interruption of blood flow to the brain which generally leads to irreversible brain damage. Ischemic injury is associated with vascular leakage, inflammation, tissue injury, and cell death. Cellular changes associated with ischemia include impairment of metabolism, ...

Neural Responses to Heartbeats in the Default Network Encode the Self in Spontaneous Thoughts.

PubMed

Babo-Rebelo, Mariana; Richter, Craig G; Tallon-Baudry, Catherine

2016-07-27

The default network (DN) has been consistently associated with self-related cognition, but also to bodily state monitoring and autonomic regulation. We hypothesized that these two seemingly disparate functional roles of the DN are functionally coupled, in line with theories proposing that selfhood is grounded in the neural monitoring of internal organs, such as the heart. We measured with magnetoencephalograhy neural responses evoked by heartbeats while human participants freely mind-wandered. When interrupted by a visual stimulus at random intervals, participants scored the self-relatedness of the interrupted thought. They evaluated their involvement as the first-person perspective subject or agent in the thought ("I"), and on another scale to what degree they were thinking about themselves ("Me"). During the interrupted thought, neural responses to heartbeats in two regions of the DN, the ventral precuneus and the ventromedial prefrontal cortex, covaried, respectively, with the "I" and the "Me" dimensions of the self, even at the single-trial level. No covariation between self-relatedness and peripheral autonomic measures (heart rate, heart rate variability, pupil diameter, electrodermal activity, respiration rate, and phase) or alpha power was observed. Our results reveal a direct link between selfhood and neural responses to heartbeats in the DN and thus directly support theories grounding selfhood in the neural monitoring of visceral inputs. More generally, the tight functional coupling between self-related processing and cardiac monitoring observed here implies that, even in the absence of measured changes in peripheral bodily measures, physiological and cognitive functions have to be considered jointly in the DN. The default network (DN) has been consistently associated with self-processing but also with autonomic regulation. We hypothesized that these two functions could be functionally coupled in the DN, inspired by theories according to which selfhood is grounded in the neural monitoring of internal organs. Using magnetoencephalography, we show that heartbeat-evoked responses (HERs) in the DN covary with the self-relatedness of ongoing spontaneous thoughts. HER amplitude in the ventral precuneus covaried with the "I" self-dimension, whereas HER amplitude in the ventromedial prefrontal cortex encoded the "Me" self-dimension. Our experimental results directly support theories rooting selfhood in the neural monitoring of internal organs. We propose a novel functional framework for the DN, where self-processing is coupled with physiological monitoring. Copyright © 2016 Babo-Rebelo et al.

Neural Responses to Heartbeats in the Default Network Encode the Self in Spontaneous Thoughts

PubMed Central

Babo-Rebelo, Mariana; Richter, Craig G.

2016-01-01

The default network (DN) has been consistently associated with self-related cognition, but also to bodily state monitoring and autonomic regulation. We hypothesized that these two seemingly disparate functional roles of the DN are functionally coupled, in line with theories proposing that selfhood is grounded in the neural monitoring of internal organs, such as the heart. We measured with magnetoencephalograhy neural responses evoked by heartbeats while human participants freely mind-wandered. When interrupted by a visual stimulus at random intervals, participants scored the self-relatedness of the interrupted thought. They evaluated their involvement as the first-person perspective subject or agent in the thought (“I”), and on another scale to what degree they were thinking about themselves (“Me”). During the interrupted thought, neural responses to heartbeats in two regions of the DN, the ventral precuneus and the ventromedial prefrontal cortex, covaried, respectively, with the “I” and the “Me” dimensions of the self, even at the single-trial level. No covariation between self-relatedness and peripheral autonomic measures (heart rate, heart rate variability, pupil diameter, electrodermal activity, respiration rate, and phase) or alpha power was observed. Our results reveal a direct link between selfhood and neural responses to heartbeats in the DN and thus directly support theories grounding selfhood in the neural monitoring of visceral inputs. More generally, the tight functional coupling between self-related processing and cardiac monitoring observed here implies that, even in the absence of measured changes in peripheral bodily measures, physiological and cognitive functions have to be considered jointly in the DN. SIGNIFICANCE STATEMENT The default network (DN) has been consistently associated with self-processing but also with autonomic regulation. We hypothesized that these two functions could be functionally coupled in the DN, inspired by theories according to which selfhood is grounded in the neural monitoring of internal organs. Using magnetoencephalography, we show that heartbeat-evoked responses (HERs) in the DN covary with the self-relatedness of ongoing spontaneous thoughts. HER amplitude in the ventral precuneus covaried with the “I” self-dimension, whereas HER amplitude in the ventromedial prefrontal cortex encoded the “Me” self-dimension. Our experimental results directly support theories rooting selfhood in the neural monitoring of internal organs. We propose a novel functional framework for the DN, where self-processing is coupled with physiological monitoring. PMID:27466329

Down-regulated PAR-2 is associated in part with interrupted melanosome transfer in pigmented basal cell epithelioma.

PubMed

Sakuraba, Kazuko; Hayashi, Nobukazu; Kawashima, Makoto; Imokawa, Genji

2004-08-01

In pigmented basal cell epithelioma (BCE), there seems to be an abnormal transfer of melanized melanosomes from proliferating melanocytes to basaloid tumor cells. In this study, the interruption of that melanosome transfer was studied with special respect to the altered function of a phagocytic receptor, protease-activated receptor (PAR)-2 in the basaloid tumor cells. We used electron microscopy to clarify the disrupted transfer at the ultrastructural level and then performed immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) to examine the regulation of a phagocytic receptor, PAR-2, expressed on basaloid tumor cells. Electron microscopic analysis revealed that basaloid tumor cells of pigmented BCE have a significantly lower population of melanosomes ( approximately 16.4%) than do normal keratinocytes located in the perilesional normal epidermis ( approximately 91.0%). In contrast, in pigmented seborrheic keratosis (SK), a similarly pigmented epidermal tumor, the distribution of melanin granules does not differ between the lesional ( approximately 93.9%) and the perilesional normal epidermis ( approximately 92.2 %), indicating that interrupted melanosome transfer occurs in BCE but not in all pigmented epithelial tumors. RT-PCR analysis demonstrated that the expression of PAR-2 mRNA transcripts in basaloid cells is significantly decreased in pigmented BCE compared with the perilesional normal epidermis. In contrast, in pigmented SK, where melanosome transfer to basaloid tumor cells is not interrupted, the expression of PAR-2 mRNA transcripts is comparable between the basaloid tumor cells and the perilesional normal epidermis. Immunohistochemistry demonstrated that basaloid cells in pigmented BCE have less immunostaining for PAR-2 than do keratinocytes in the perilesional normal epidermis whereas in pigmented SK, there is no difference in immunostaining for PAR-2 between the basaloid tumor and the perilesional normal epidermis. These findings suggest that the decreased expression of PAR-2 in the basaloid cells is associated in part with the observed interruption of melanosome transfer in pigmented BCE.

Inheritance patterns of ATCCT repeat interruptions in spinocerebellar ataxia type 10 (SCA10) expansions.

PubMed

Landrian, Ivette; McFarland, Karen N; Liu, Jilin; Mulligan, Connie J; Rasmussen, Astrid; Ashizawa, Tetsuo

2017-01-01

Spinocerebellar ataxia type 10 (SCA10), an autosomal dominant cerebellar ataxia disorder, is caused by a non-coding ATTCT microsatellite repeat expansion in the ataxin 10 gene. In a subset of SCA10 families, the 5'-end of the repeat expansion contains a complex sequence of penta- and heptanucleotide interruption motifs which is followed by a pure tract of tandem ATCCT repeats of unknown length at its 3'-end. Intriguingly, expansions that carry these interruption motifs correlate with an epileptic seizure phenotype and are unstable despite the theory that interruptions are expected to stabilize expanded repeats. To examine the apparent contradiction of unstable, interruption-positive SCA10 expansion alleles and to determine whether the instability originates outside of the interrupted region, we sequenced approximately 1 kb of the 5'-end of SCA10 expansions using the ATCCT-PCR product in individuals across multiple generations from four SCA10 families. We found that the greatest instability within this region occurred in paternal transmissions of the allele in stretches of pure ATTCT motifs while the intervening interrupted sequences were stable. Overall, the ATCCT interruption changes by only one to three repeat units and therefore cannot account for the instability across the length of the disease allele. We conclude that the AT-rich interruptions locally stabilize the SCA10 expansion at the 5'-end but do not completely abolish instability across the entire span of the expansion. In addition, analysis of the interruption alleles across these families support a parsimonious single origin of the mutation with a shared distant ancestor.

Geometry of the Paleo-Nueces River Incised-Valley, Corpus Christi Bay, Texas as it Relates to Quaternary Sea Level History

NASA Astrophysics Data System (ADS)

Lugrin, L.; Gulick, S. S.; Goff, J. A.

2012-12-01

CHIRP subbottom seismic data were collected on the 2009 and 2011 Marine Geophysics Field courses at the University of Texas at Austin within the Corpus Christi Bay along the central Texas coast in order to study the geometry of the ancestral Nueces River incised valley and its evolution over Quaternary sea level history. Since the late Pleistocene, the Nueces River valley experienced a gradual infill due to sea level rise, interrupted by two major flooding events that represent periods of rapid sediment influx. These flooding events are recognizable based on abrupt changes in seismic facies. Discontinuous, chaotic fluvial lag deposits present underneath a fairly continuous, stratified, sub-horizontal estuarine coastal plain facies mark what is interpreted to be the Pleistocene/Holocene unconformity. Above the P/H boundary, oyster reefs thrive within the estuary until capped by a strong reflector, marking the second flooding surface that allowed enough incoming sediment to discontinue oyster reef growth. The estuarine deposits within the paleo-Nueces river valley exhibit a landward migration as the Holocene transgression proceeded. As infill continued, the bay-head delta prograded seaward and the flood-tidal delta extended progressively further up the estuary until the central estuarine basin was capped. The earlier flooding events provide strong reflectors that can be linked to the draining of Lake Agassiz around 8.2 k.a.. This event flooded the Gulf of Mexico with freshwater, and interrupted the estuarine infilling of the Nueces paleo-channel. Cores from previous studies have found at least two species of oyster reefs in Corpus Christi Bay: euryhaline species Crassostrea virginica, and Ostrea equestris, a species known to thrive in higher salinity waters. The presence of both species at the flooding boundary suggests the sudden pulse of freshwater mixed with higher salinity oceanic water. The second flooding surface is interpreted to be associated with an increase in freshwater and sediment influx that can be linked to a soil denudation event in central Texas around 4.8 k.a.. At this time, reef growth ceased in Corpus Christi Bay. A sudden flux of freshwater or saltwater would allow one oyster species to flourish over the other; however, no species of oysters can accommodate sudden intense pulses of sediment. Furthermore, around this same time the bayhead delta seaward progradation accelerated.

An Assessment of Instant Messaging Interruptions on Knowledge Workers' Task Performance in E-Learning-Based Training

ERIC Educational Resources Information Center

Mansi, Gary R.

2011-01-01

The modern workplace environment is filled with interruptions due to the necessity of coworkers to communicate with each other. Studies have revealed that interruptions can disrupt the ability of a knowledge worker to concentrate on a task, which can impact task performance (TP). Communication interruptions are due, in part, to the unavoidable…

Further evaluation of response interruption and redirection as treatment for stereotypy.

PubMed

Ahrens, Erin N; Lerman, Dorothea C; Kodak, Tiffany; Worsdell, April S; Keegan, Courtney

2011-01-01

The effects of 2 forms of response interruption and redirection (RIRD)-motor RIRD and vocal RIRD-were examined with 4 boys with autism to evaluate further the effects of this intervention and its potential underlying mechanisms. In Experiment 1, the effects of motor RIRD and vocal RIRD on vocal stereotypy and appropriate vocalizations were compared for 2 participants. In Experiment 2, the effects of both RIRD procedures on both vocal and motor stereotypy and appropriate vocalizations were compared with 2 additional participants. Results suggested that RIRD was effective regardless of the procedural variation or topography of stereotypy and that vocal RIRD functioned as a punisher. This mechanism was further explored with 1 participant by manipulating the schedule of RIRD in Experiment 3. Results were consistent with the punishment interpretation.

FURTHER EVALUATION OF RESPONSE INTERRUPTION AND REDIRECTION AS TREATMENT FOR STEREOTYPY

PubMed Central

Ahrens, Erin N; Lerman, Dorothea C; Kodak, Tiffany; Worsdell, April S; Keegan, Courtney

2011-01-01

The effects of 2 forms of response interruption and redirection (RIRD)—motor RIRD and vocal RIRD—were examined with 4 boys with autism to evaluate further the effects of this intervention and its potential underlying mechanisms. In Experiment 1, the effects of motor RIRD and vocal RIRD on vocal stereotypy and appropriate vocalizations were compared for 2 participants. In Experiment 2, the effects of both RIRD procedures on both vocal and motor stereotypy and appropriate vocalizations were compared with 2 additional participants. Results suggested that RIRD was effective regardless of the procedural variation or topography of stereotypy and that vocal RIRD functioned as a punisher. This mechanism was further explored with 1 participant by manipulating the schedule of RIRD in Experiment 3. Results were consistent with the punishment interpretation. PMID:21541130

Collaborative Protection and Control Schemes for Shipboard Electrical Systems

DTIC Science & Technology

2007-03-26

VSCs ) for fault current limiting and interruption. Revisions needed on the VSCs to perform these functions have been identified, and feasibility of this...disturbances very fast - less than 3-4 ms [3]. Next section summarizes the details of the agent based protection scheme that uses the VSC as the...fault currents. In our previous work [2, 3], it has been demonstrated that this new functionally for VSC can be achieved by proper selection of

The Felbertauern landslide of 2013: Traffic disruption, regional economic consequences and policy decisions

NASA Astrophysics Data System (ADS)

Pfurtscheller, Clemens; Genovese, Elisabetta

2016-04-01

The Felbertauern landslide of May 2013 caused the total destruction of approximately 100 meters of road including an avalanche gallery, generating several direct and indirect impacts on the regional-economy. The Felbertauern road, an important traffic arteria for the whole NUTS-3 region East-Tyrol (Austria), was totally blocked for several weeks. Short after the event, regional decision makers were hardly in need for an estimation of the regional-economic impacts of the road blockage to opt for alternatives to reopen the road. So, two weeks after the event, an analysis of the possible effects was carried out using only scattered information and statistical data. The analysis is based on a three-month interruption scenario. Retrospectively the road blockage was only two months. Due to the fact that short after the event no up-to-date data on regional-economics at necessary scales was available, impacts on tourism by analysing overnight stays, additional transportation costs and time losses for the local companies were calculated. Using these numbers, a cost-benefit-analysis was carried out for a projected bypass, a mid-term 1.5 kilometer long route as an alternative to the destroyed road. Finally, the impacts on the local companies were severe, due to additional transportation costs of approx. Euro 1.4 million and Euro 76 000 additional time costs using an alternative approach. The impacts on regional tourism were calculated with Euro 7.7 to 10.7 million - that means 0.6 to 0.8% of the total economic output of the region. The study shows the strong impact of indirect and business interruption costs on regional economies and describes the major problems faced during the study - in particular the low availability of input data. The results of consistent cost assessment are critical for decision makers who are responsible for the development of policies to prevent the impacts on societies.

Effects of mental demands during dispensing on perceived medication safety and employee well being: A study of workload in pediatric hospital pharmacies

PubMed Central

Holden, Richard J.; Patel, Neal R.; Scanlon, Matthew C.; Shalaby, Theresa M.; Arnold, Judi M.; Karsh, Ben-Tzion

2009-01-01

Background Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes such as job satisfaction. Objectives This study sought to measure the effect of workload on safety and employee outcomes in two pediatric hospitals and to do so using a novel approach to pharmacy workload measurement. Methods Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks. The effects of external (interruptions, divided attention, rushing) and internal (concentration, effort) task demands on perceived medication error likelihood, adverse drug event likelihood, job dissatisfaction, and burnout were statistically estimated using multiple linear and logistic regression. Results Pharmacists and pharmacy technicians reported high levels of external and internal mental demands during dispensing. The study supported the hypothesis that external demands (interruptions, divided attention, rushing) negatively impacted medication safety and employee well being outcomes. However, as hypothesized, increasing levels of internal demands (concentration and effort) were not associated with greater perceived likelihood of error, adverse drug events, or burnout, and even had a positive effect on job satisfaction. Conclusion Replicating a prior study in nursing, this study shows that new conceptualizations and measures of workload can generate important new findings about both detrimental and beneficial effects of workload on patient safety and employee well being. This study discusses what those findings imply for policy, management, and design concerning automation, cognition, and staffing. PMID:21111387

Effects of mental demands during dispensing on perceived medication safety and employee well-being: a study of workload in pediatric hospital pharmacies.

PubMed

Holden, Richard J; Patel, Neal R; Scanlon, Matthew C; Shalaby, Theresa M; Arnold, Judi M; Karsh, Ben-Tzion

2010-12-01

Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes, such as job satisfaction. This study sought to measure the effect of workload on safety and employee outcomes in 2 pediatric hospitals and to do so using a novel approach to pharmacy workload measurement. Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks. The effects of external (interruptions, divided attention, and rushing) and internal (concentration and effort) task demands on perceived medication error likelihood, adverse drug event likelihood, job dissatisfaction, and burnout were statistically estimated using multiple linear and logistic regression. Pharmacists and pharmacy technicians reported high levels of external and internal mental demands during dispensing. The study supported the hypothesis that external demands (interruptions, divided attention, and rushing) negatively impacted medication safety and employee well-being outcomes. However, as hypothesized, increasing levels of internal demands (concentration and effort) were not associated with greater perceived likelihood of error, adverse drug events, or burnout and even had a positive effect on job satisfaction. Replicating a prior study in nursing, this study shows that new conceptualizations and measures of workload can generate important new findings about both detrimental and beneficial effects of workload on patient safety and employee well-being. This study discusses what those findings imply for policy, management, and design concerning automation, cognition, and staffing. Copyright © 2010 Elsevier Inc. All rights reserved.

No evidence of suicide increase following terrorist attacks in the United States: an interrupted time-series analysis of September 11 and Oklahoma City.

PubMed

Pridemore, William Alex; Trahan, Adam; Chamlin, Mitchell B

2009-12-01

There is substantial evidence of detrimental psychological sequelae following disasters, including terrorist attacks. The effect of these events on extreme responses such as suicide, however, is unclear. We tested competing hypotheses about such effects by employing autoregressive integrated moving average techniques to model the impact of September 11 and the Oklahoma City bombing on monthly suicide counts at the local, state, and national level. Unlike prior studies that provided conflicting evidence, rigorous time series techniques revealed no support for an increase or decrease in suicides following these events. We conclude that while terrorist attacks produce subsequent psychological morbidity and may affect self and collective efficacy well beyond their immediate impact, these effects are not strong enough to influence levels of suicide mortality.

Detection of emerging sunspot regions in the solar interior.

PubMed

Ilonidis, Stathis; Zhao, Junwei; Kosovichev, Alexander

2011-08-19

Sunspots are regions where strong magnetic fields emerge from the solar interior and where major eruptive events occur. These energetic events can cause power outages, interrupt telecommunication and navigation services, and pose hazards to astronauts. We detected subsurface signatures of emerging sunspot regions before they appeared on the solar disc. Strong acoustic travel-time anomalies of an order of 12 to 16 seconds were detected as deep as 65,000 kilometers. These anomalies were associated with magnetic structures that emerged with an average speed of 0.3 to 0.6 kilometer per second and caused high peaks in the photospheric magnetic flux rate 1 to 2 days after the detection of the anomalies. Thus, synoptic imaging of subsurface magnetic activity may allow anticipation of large sunspot regions before they become visible, improving space weather forecast.

[Current situation of enteral nutrition interruptions in sepsis children in pediatric intensive care unit].

PubMed

Fang, B L; Qian, S Y; Jia, X L; Li, Z; Liu, J

2016-09-01

To analyze the interruptions of enteral nutrition (EN) and it's relationship to prognosis in children with sepsis in pediatric intensive care unit (PICU). Daily EN intake and reasons for EN interruptions were prospectively observed and recorded in children with sepsis who were admitted to our PICU from November 2012 to April 2013. Clinical prognosis was compared between children with and without EN interruptions by t, rank-sum and χ(2) tests. Totally 60 consecutive children were included, 42 males, median age 9.67 (5.36, 37.0) months; 50 children suffered from EN interruptions, while 10 children did not. Median time to EN initiation was 2.59 (1.53, 3.67) h; EN was interrupted in 83% (50/60) of children, for a total of 108 times and 696 h, the most common reasons were fibrobronchoscopy and radiologic procedures, 27 and 29 times respectively. Children spent 0.04 (0.02, 0.08) of their total observation period without EN nutrition due to EN interruptions, and was not correlated with pediatric critically ill score (r=0.12, P=0.38). Children with EN interruptions suffered from longer PICU duration ((12±7) vs. (7±4) d, t=2.18, P=0.03), but there was no significant difference in the 28(th) hospital day's mortality between these two groups (6 cases vs. 1 case, χ(2)=0.00, P=1.00). EN is frequently interrupted due to procedures needed fasting, EN intolerance and other reasons in children with sepsis. EN interruptions may have something to do with prolonged PICU length of stay, but the relationship needs to be examined in future studies.

Controller Chips Preserve Microprocessor Function

NASA Technical Reports Server (NTRS)

2012-01-01

Above the Atlantic Ocean, off the coast of Brazil, there is a dip in the Earth s surrounding magnetic field called the South Atlantic Anomaly. Here, space radiation can reach into Earth s upper atmosphere to interfere with the functioning of satellites, aircraft, and even the International Space Station. "The South Atlantic Anomaly is a hot spot of radiation that the space station goes through at a certain point in orbit," Miria Finckenor, a physicist at Marshall Space Flight Center, describes, "If there s going to be a problem with the electronics, 90 percent of that time, it is going to be in that spot." Space radiation can cause physical damage to microchips and can actually change the software commands in computers. When high-energy particles penetrate a satellite or other spacecraft, the electrical components can absorb the energy and temporarily switch off. If the energy is high enough, it can cause the device to enter a hung state, which can only be addressed by restarting the system. When space radiation affects the operational status of microprocessors, the occurrence is called single event functional interrupt (SEFI). SEFI happens not only to the computers onboard spacecraft in Earth orbit, but to the computers on spacecraft throughout the solar system. "One of the Mars rovers had this problem in the radiation environment and was rebooting itself several times a day. On one occasion, it rebooted 40 times in one day," Finckenor says. "It s hard to obtain any data when you have to constantly reboot and start over."

Regional transportation network blocked by snowdrifts: assessment of risk reduction strategies by the example of the wind event of February 2015 in the Canton of Vaud, Switzerland

NASA Astrophysics Data System (ADS)

Voumard, Jérémie; Jaboyedoff, Michel; Derron, Marc-Henri

2016-04-01

The 5-8th February, a meteorological situation characterized by a strong wind coming from the North generated many snowdrifts on roads and railways in the Canton of Vaud, Switzerland. The affected region, about 900 km2, is located on the Swiss Plateau. More than thirty roads and few railways were blocked during the event. On some areas, too many roads and railways tracks were closed to assure the school transports making obligatory the total closure of seven schools and the partial closure of three schools affecting 8'000 students, which is almost 10% of students of the Canton of Vaud. Over hundred vehicles blocked in the snowdrifts had to be unobstructed. Over 150 snowplows drivers were requisitioned but the wind with gusts of over 80 km/h was too strong to release the roads from the snow accumulation. The boat transport on the Lake Geneva was interrupted during three days because of the danger generated by the strong wind during the berths. This interruption generated up to 100 km deviation for commuting traffic. The county police recommended to the population to limit their travels on the road. The last roads closures due to snowdrifts in the Canton of Vaud occurred ten years ago, in 2005. This particular event that affected considerably the accessibility of a large area of the Canton of Vaud is interesting because results of a "simple" meteorological situation that strongly reduced the accessibility during four days of an area with a population of about 340'000. It raises several questions as for examples: how the emergency services accessibility is assured; what are the tools that can reduce the roads closures; what is the best road management to follow during such an event (which roads must be priority cleaned, which roads can be left covered by snow); how to prevent such an event, are snow fences enough to avoid snowdrifts or is there another way to limit their creation? To try obtaining answers to those questions, we assess the most critical infrastructures where an accessibility is crucial to be maintained. We analyze then the road network to highlight the roads vulnerability from snowdrifts with topographic and meteorological indicators. We also assess the ratio cost/benefit of different measures limiting snowdrifts. We finally discuss strategies to reduce the risk of this winter meteorological event.

Predictability of Interruptions During Medication Administration With Related Behavioral Management Strategies.

PubMed

Johnson, Maree; Weidemann, Gabrielle; Adams, Rebecca; Manias, Elizabeth; Levett-Jones, Tracy; Aguilar, Vicki; Everett, Bronwyn

The aim of this qualitative study was to examine the nature of interruptions during medication administration. Focus groups were conducted with medical/surgical nurses (n = 15), critical care nurses (n = 13), and nurse managers/educators/specialists (n = 6). Most interruptions (78%) were predictable. Nurse-adopted strategies included blocking, engaging, mediating, multitasking, and preventing. Educational content was developed that relates behavioral strategies to respond to predictable and unpredictable interruptions.

Neural and behavioral correlates of selective stopping: Evidence for a different strategy adoption.

PubMed

Sánchez-Carmona, Alberto J; Albert, Jacobo; Hinojosa, José A

2016-10-01

The present study examined the neural and behavioral correlates of selective stopping, a form of inhibition that has scarcely been investigated. The selectivity of the inhibitory process is needed when individuals have to deal with an environment filled with multiple stimuli, some of which require inhibition and some of which do not. The stimulus-selective stop-signal task has been used to explore this issue assuming that all participants interrupt their ongoing responses selectively to stop but not to ignore signals. However, recent behavioral evidence suggests that some individuals do not carry out the task as experimenters expect, since they seemed to interrupt their response non-selectively to both signals. In the present study, we detected and controlled the cognitive strategy adopted by participants (n=57) when they performed a stimulus-selective stop-signal task before comparing brain activation between conditions. In order to determine both the onset and the end of the response cancellation process underlying each strategy and to fully take advantage of the precise temporal resolution of event-related potentials, we used a mass univariate approach. Source localization techniques were also employed to estimate the neural underpinnings of the effects observed at the scalp level. Our results from scalp and source level analysis support the behavioral-based strategy classification. Specific effects were observed depending on the strategy adopted by participants. Thus, when contrasting successful stop versus ignore conditions, increased activation was only evident for subjects who were classified as using a strategy whereby the response interruption process was selective to stop trials. This increased activity was observed during the P3 time window in several left-lateralized brain regions, including middle and inferior frontal gyri, as well as parietal and insular cortices. By contrast, in those participants who used a strategy characterized by stopping non-selectively, no activation differences between successful stop and ignore conditions were observed at the estimated time at which response interruption process occurs. Overall, results from the current study highlight the importance of controlling for the different strategies adopted by participants to perform selective stopping tasks before analyzing brain activation patterns. Copyright © 2016 Elsevier Inc. All rights reserved.

Apparatus for and method of testing an electrical ground fault circuit interrupt device

DOEpatents

Andrews, L.B.

1998-08-18

An apparatus for testing a ground fault circuit interrupt device includes a processor, an input device connected to the processor for receiving input from an operator, a storage media connected to the processor for storing test data, an output device connected to the processor for outputting information corresponding to the test data to the operator, and a calibrated variable load circuit connected between the processor and the ground fault circuit interrupt device. The ground fault circuit interrupt device is configured to trip a corresponding circuit breaker. The processor is configured to receive signals from the calibrated variable load circuit and to process the signals to determine a trip threshold current and/or a trip time. A method of testing the ground fault circuit interrupt device includes a first step of providing an identification for the ground fault circuit interrupt device. Test data is then recorded in accordance with the identification. By comparing test data from an initial test with test data from a subsequent test, a trend of performance for the ground fault circuit interrupt device is determined. 17 figs.

Apparatus for and method of testing an electrical ground fault circuit interrupt device

DOEpatents

Andrews, Lowell B.

1998-01-01

An apparatus for testing a ground fault circuit interrupt device includes a processor, an input device connected to the processor for receiving input from an operator, a storage media connected to the processor for storing test data, an output device connected to the processor for outputting information corresponding to the test data to the operator, and a calibrated variable load circuit connected between the processor and the ground fault circuit interrupt device. The ground fault circuit interrupt device is configured to trip a corresponding circuit breaker. The processor is configured to receive signals from the calibrated variable load circuit and to process the signals to determine a trip threshold current and/or a trip time. A method of testing the ground fault circuit interrupt device includes a first step of providing an identification for the ground fault circuit interrupt device. Test data is then recorded in accordance with the identification. By comparing test data from an initial test with test data from a subsequent test, a trend of performance for the ground fault circuit interrupt device is determined.

Fast interrupt platform for extended DOS

NASA Technical Reports Server (NTRS)

Duryea, T. W.

1995-01-01

Extended DOS offers the unique combination of a simple operating system which allows direct access to the interrupt tables, 32 bit protected mode access to 4096 MByte address space, and the use of industry standard C compilers. The drawback is that fast interrupt handling requires both 32 bit and 16 bit versions of each real-time process interrupt handler to avoid mode switches on the interrupts. A set of tools has been developed which automates the process of transforming the output of a standard 32 bit C compiler to 16 bit interrupt code which directly handles the real mode interrupts. The entire process compiles one set of source code via a make file, which boosts productivity by making the management of the compile-link cycle very simple. The software components are in the form of classes written mostly in C. A foreground process written as a conventional application which can use the standard C libraries can communicate with the background real-time classes via a message passing mechanism. The platform thus enables the integration of high performance real-time processing into a conventional application framework.

Demonstration program for Omega receiver prototype microcomputer data processing

NASA Technical Reports Server (NTRS)

Lilley, R. W.

1976-01-01

The JOLT (TM) commercial microcomputer, based on the MOS Technology 6502 processor chip, for use in Omega navigation system is evaluated. A computer program was prepared in hand-assembled code to demonstrate receiver operation. The processor provides binary processing with interrupts enabled, a carriage return is given to initialize the teleprinter, and a jump is performed to enter the program loop to wait for an interrupt. The program loop operates continuously testing the interrupt flag. The interrupt routine reads the receiver status word and determines whether the current time-slot is the A slot. If so, the interrupt flag, which is also the data index pointer, is reset to zero. The status word is stored in the status buffer. If the time-slot is not A, the interrupt flag/pointer is incremented by one to index the phase and status to the proper buffer words for later use by the print routine.

Effect of current vehicle’s interruption on traffic stability in cooperative car-following theory

NASA Astrophysics Data System (ADS)

Zhang, Geng; Liu, Hui

2017-12-01

To reveal the impact of the current vehicle’s interruption information on traffic flow, a new car-following model with consideration of the current vehicle’s interruption is proposed and the influence of the current vehicle’s interruption on traffic stability is investigated through theoretical analysis and numerical simulation. By linear analysis, the linear stability condition of the new model is obtained and the negative influence of the current vehicle’s interruption on traffic stability is shown in the headway-sensitivity space. Through nonlinear analysis, the modified Korteweg-de Vries (mKdV) equation of the new model near the critical point is derived and it can be used to describe the propagating behavior of the traffic density wave. Finally, numerical simulation confirms the analytical results, which shows that the current vehicle’s interruption information can destabilize traffic flow and should be considered in real traffic.

Dynamic Visual Acuity: a Functionally Relevant Research Tool

NASA Technical Reports Server (NTRS)

Peters, Brian T.; Brady, Rachel A.; Miller, Chris A.; Mulavara, Ajitkumar P.; Wood, Scott J.; Cohen, Helen S.; Bloomberg, Jacob J.

2010-01-01

Coordinated movements between the eyes and head are required to maintain a stable retinal image during head and body motion. The vestibulo-ocular reflex (VOR) plays a significant role in this gaze control system that functions well for most daily activities. However, certain environmental conditions or interruptions in normal VOR function can lead to inadequate ocular compensation, resulting in oscillopsia, or blurred vision. It is therefore possible to use acuity to determine when the environmental conditions, VOR function, or the combination of the two is not conductive for maintaining clear vision. Over several years we have designed and tested several tests of dynamic visual acuity (DVA). Early tests used the difference between standing and walking acuity to assess decrements in the gaze stabilization system after spaceflight. Supporting ground-based studies measured the responses from patients with bilateral vestibular dysfunction and explored the effects of visual target viewing distance and gait cycle events on walking acuity. Results from these studies show that DVA is affected by spaceflight, is degraded in patients with vestibular dysfunction, changes with target distance, and is not consistent across the gait cycle. We have recently expanded our research to include studies in which seated subjects are translated or rotated passively. Preliminary results from this work indicate that gaze stabilization ability may differ between similar active and passive conditions, may change with age, and can be affected by the location of the visual target with respect to the axis of motion. Use of DVA as a diagnostic tool is becoming more popular but the functional nature of the acuity outcome measure also makes it ideal for identifying conditions that could lead to degraded vision. By doing so, steps can be taken to alter the problematic environments to improve the man-machine interface and optimize performance.

Granulatic breccia clasts and feldspathic melt breccia clasts from North Ray crater breccia 67975 - Precursors and petrogenesis

NASA Technical Reports Server (NTRS)

Mcgee, J. J.

1989-01-01

A petrologic study of crystalline lithic clasts from feldspathic breccia 67975, collected on the rim of North Ray crater at the Apollo 16 site, is presented. A light gray group has been identified as granulitic breccias, and a dark gray group has been identified as feldspathic microporphyritic melt breccias. It is suggested that complete homogenization of the minerology of the granulitic breccias may have been prevented by their incorporation into the 67975 fragmental breccia, and that metamorphism of the clasts may have been interrupted by this breccia forming event.

Ultrasonic fatigue of SiC particle reinforced aluminum in the VHCF-regime

NASA Astrophysics Data System (ADS)

Wolf, M.; Wagner, G.; Eifler, D.

At the WKK ultrasonic testing facilities (UTF) are used to perform fatigue experiments in the VHCF regime with a frequency of 20 kHz. These systems allow an on-line characterization of the actual fatigue state by changes of different process parameters such as generator power, displacement, temperature or frequency-response characteristic. Moreover the experiments can be interrupted at user defined events in order to investigate variations of the surface microstructure or changes in the electrical resistance of the specimens. The fatigue tests were realized as load increase tests as well as constant amplitude tests.

Separate Medication Preparation Rooms Reduce Interruptions and Medication Errors in the Hospital Setting: A Prospective Observational Study.

PubMed

Huckels-Baumgart, Saskia; Baumgart, André; Buschmann, Ute; Schüpfer, Guido; Manser, Tanja

2016-12-21

Interruptions and errors during the medication process are common, but published literature shows no evidence supporting whether separate medication rooms are an effective single intervention in reducing interruptions and errors during medication preparation in hospitals. We tested the hypothesis that the rate of interruptions and reported medication errors would decrease as a result of the introduction of separate medication rooms. Our aim was to evaluate the effect of separate medication rooms on interruptions during medication preparation and on self-reported medication error rates. We performed a preintervention and postintervention study using direct structured observation of nurses during medication preparation and daily structured medication error self-reporting of nurses by questionnaires in 2 wards at a major teaching hospital in Switzerland. A volunteer sample of 42 nurses was observed preparing 1498 medications for 366 patients over 17 hours preintervention and postintervention on both wards. During 122 days, nurses completed 694 reporting sheets containing 208 medication errors. After the introduction of the separate medication room, the mean interruption rate decreased significantly from 51.8 to 30 interruptions per hour (P < 0.01), and the interruption-free preparation time increased significantly from 1.4 to 2.5 minutes (P < 0.05). Overall, the mean medication error rate per day was also significantly reduced after implementation of the separate medication room from 1.3 to 0.9 errors per day (P < 0.05). The present study showed the positive effect of a hospital-based intervention; after the introduction of the separate medication room, the interruption and medication error rates decreased significantly.

The impact of public transportation strikes on use of a bicycle share program in London: interrupted time series design.

PubMed

Fuller, Daniel; Sahlqvist, Shannon; Cummins, Steven; Ogilvie, David

2012-01-01

To investigate the immediate and sustained effects of two London Underground strikes on use of a public bicycle share program. An interrupted time series design was used to examine the impact of two 24 hour strikes on the total number of trips per day and mean trip duration per day on the London public bicycle share program. The strikes occurred on September 6th and October 4th 2010 and limited service on the London Underground. The mean total number of trips per day over the whole study period was 14,699 (SD=5390) while the mean trip duration was 18.5 minutes (SD=3.7). Significant increases in daily trip count were observed following strike 1 (3864: 95% CI 125 to 7604) and strike 2 (11,293: 95% CI 5169 to 17,416). Events that greatly constrain the primary motorised mode of transportation for a population may have unintended short-term effects on travel behaviour. These findings suggest that limiting transportation options may have the potential to increase population levels of physical activity by promoting the use of cycling. Copyright © 2011 Elsevier Inc. All rights reserved.

Breaking Symmetry in Viral Icosahedral Capsids as Seen through the Lenses of X-ray Crystallography and Cryo-Electron Microscopy

PubMed Central

Parent, Kristin N.; Schrad, Jason R.; Cingolani, Gino

2018-01-01

The majority of viruses on Earth form capsids built by multiple copies of one or more types of a coat protein arranged with 532 symmetry, generating an icosahedral shell. This highly repetitive structure is ideal to closely pack identical protein subunits and to enclose the nucleic acid genomes. However, the icosahedral capsid is not merely a passive cage but undergoes dynamic events to promote packaging, maturation and the transfer of the viral genome into the host. These essential processes are often mediated by proteinaceous complexes that interrupt the shell’s icosahedral symmetry, providing a gateway through the capsid. In this review, we take an inventory of molecular structures observed either internally, or at the 5-fold vertices of icosahedral DNA viruses that infect bacteria, archea and eukaryotes. Taking advantage of the recent revolution in cryo-electron microscopy (cryo-EM) and building upon a wealth of crystallographic structures of individual components, we review the design principles of non-icosahedral structural components that interrupt icosahedral symmetry and discuss how these macromolecules play vital roles in genome packaging, ejection and host receptor-binding. PMID:29414851

Sex Differences in Children's Conversation.

ERIC Educational Resources Information Center

Esposito, Anita

1979-01-01

The recorded conversations of 40 preschool children in small groups were analyzed for interruptions, overlaps, lapses, and gaps. Significant differences were found between heterogeneous and homogeneous groups for interruptions, with boys interrupting girls at a two to one ratio. (Author/RL)

How to Interrupt Oppressive Behavior.

ERIC Educational Resources Information Center

McClintock, Mary

1990-01-01

Describes continuum of responses to examples of race-, handicap-, and sex discrimination by participants and staff of camping programs. Recommends following actions toward social justice: educating oneself; interrupting negative behavior; interrupting and educating; supporting proactive response; and initiating proactive response. Includes…

Monitoring the capacity of working memory: Executive control and effects of listening effort

PubMed Central

Amichetti, Nicole M.; Stanley, Raymond S.; White, Alison G.

2013-01-01

In two experiments, we used an interruption-and-recall (IAR) task to explore listeners’ ability to monitor the capacity of working memory as new information arrived in real time. In this task, listeners heard recorded word lists with instructions to interrupt the input at the maximum point that would still allow for perfect recall. Experiment 1 demonstrated that the most commonly selected segment size closely matched participants’ memory span, as measured in a baseline span test. Experiment 2 showed that reducing the sound level of presented word lists to a suprathreshold but effortful listening level disrupted the accuracy of matching selected segment sizes with participants’ memory spans. The results are discussed in terms of whether online capacity monitoring may be subsumed under other, already enumerated working memory executive functions (inhibition, set shifting, and memory updating). PMID:23400826

Multiprocessor architectural study

NASA Technical Reports Server (NTRS)

Kosmala, A. L.; Stanten, S. F.; Vandever, W. H.

1972-01-01

An architectural design study was made of a multiprocessor computing system intended to meet functional and performance specifications appropriate to a manned space station application. Intermetrics, previous experience, and accumulated knowledge of the multiprocessor field is used to generate a baseline philosophy for the design of a future SUMC* multiprocessor. Interrupts are defined and the crucial questions of interrupt structure, such as processor selection and response time, are discussed. Memory hierarchy and performance is discussed extensively with particular attention to the design approach which utilizes a cache memory associated with each processor. The ability of an individual processor to approach its theoretical maximum performance is then analyzed in terms of a hit ratio. Memory management is envisioned as a virtual memory system implemented either through segmentation or paging. Addressing is discussed in terms of various register design adopted by current computers and those of advanced design.

Targeting Allosteric Control Mechanisms in Heat Shock Protein 70 (Hsp70).

PubMed

Li, Xiaokai; Shao, Hao; Taylor, Isabelle R; Gestwicki, Jason E

2016-01-01

Heat shock protein 70 (Hsp70) is a molecular chaperone that plays critical roles in protein homeostasis. Hsp70's chaperone activity is coordinated by intra-molecular interactions between its two domains, as well as inter-molecular interactions between Hsp70 and its co-chaperones. Each of these contacts represents a potential opportunity for the development of chemical inhibitors. To illustrate this concept, we review three classes of recently identified molecules that bind distinct pockets on Hsp70. Although all three compounds share the ability to interrupt core biochemical functions of Hsp70, they stabilize different conformers. Accordingly, each compound appears to interrupt a specific subset of inter- and intra-molecular interactions. Thus, an accurate definition of an Hsp70 inhibitor may require a particularly detailed understanding of the molecule's binding site and its effects on protein-protein interactions.

Low Insertion HVDC Circuit Breaker: Magnetically Pulsed Hybrid Breaker for HVDC Power Distribution Protection

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

None

2012-01-09

GENI Project: General Atomics is developing a direct current (DC) circuit breaker that could protect the grid from faults 100 times faster than its alternating current (AC) counterparts. Circuit breakers are critical elements in any electrical system. At the grid level, their main function is to isolate parts of the grid where a fault has occurred—such as a downed power line or a transformer explosion—from the rest of the system. DC circuit breakers must interrupt the system during a fault much faster than AC circuit breakers to prevent possible damage to cables, converters and other grid-level components. General Atomics’ high-voltagemore » DC circuit breaker would react in less than 1/1,000th of a second to interrupt current during a fault, preventing potential hazards to people and equipment.« less

Risk of Vascular Thrombotic Events Following Discontinuation of Antithrombotics After Peptic Ulcer Bleeding.

PubMed

Kim, Seung Young; Hyun, Jong Jin; Suh, Sang Jun; Jung, Sung Woo; Jung, Young Kul; Koo, Ja Seol; Yim, Hyung Joon; Park, Jong Jae; Chun, Hoon Jai; Lee, Sang Woo

2016-04-01

To evaluate whether the risk of cardiovascular events increases when antithrombotics are discontinued after ulcer bleeding. Peptic ulcer bleeding associated with antithrombotics has increased due to the increase in the proportion of elderly population. Little is known about the long-term effects of discontinuing antithrombotics after peptic ulcer bleeding. The aim of this study was to evaluate whether the risk of cardiovascular events increases when antithrombotics are discontinued after ulcer bleeding. We reviewed the medical records of patients with ulcer bleeding who were taking antiplatelet agents or anticoagulants at the time of ulcer bleeding. Cox-regression model was used to adjust for potential confounders, and analyzed association between discontinuation of antithrombotic drugs after ulcer bleeding and thrombotic events such as ischemic heart disease or stroke. Of the 544 patients with ulcer bleeding, 72 patients who were taking antithrombotics and followed up for >2 months were analyzed. Forty patients discontinued antithrombotics after ulcer bleeding (discontinuation group) and 32 patients continued antithrombotics with or without transient interruption (continuation group). Thrombotic events developed more often in discontinuation group than in the continuation group [7/32 (21.9%) vs. 1/40 (2.5%), P=0.019]. Hazard ratio for thrombotic event when antithrombotics were continuously discontinued was 10.9 (95% confidence interval, 1.3-89.7). There were no significant differences in recurrent bleeding events between the 2 groups. Discontinuation of antithrombotics after peptic ulcer bleeding increases the risk of cardiovascular events. Therefore, caution should be taken when discontinuing antithrombotics after ulcer bleeding.

Stent Repair for Complex Coarctation of Aorta.

PubMed

Suárez de Lezo, José; Romero, Miguel; Pan, Manuel; Suárez de Lezo, Javier; Segura, José; Ojeda, Soledad; Pavlovic, Djordje; Mazuelos, Francisco; López Aguilera, José; Espejo Perez, Simona

2015-08-24

This study sought to determine whether several anatomic or evolving characteristics of the coarctation may create challenging conditions for treatment. Stent repair of coarctation of aorta is an alternative to surgical correction. We analyzed our 21-year experience in the percutaneous treatment of complex coarctation of aorta. Adverse conditions for treatment were as follow: 1) complete interruption of the aortic arch (n = 11); 2) associated aneurysm (n = 18); 3) complex stenosis (n = 30); and 4) the need for re-expansion and/or restenting (n = 21). Twenty patients (33%) belonged to more than 1 group. Ten interruptions were type A and 1 was type B. The mean length of the interrupted aorta was 9 ± 11 mm. The associated aneurysms were native in 8 patients and after previous intervention in 10 patients. Aneurysm shapes were fusiform in 8 patients and saccular in 10. The following characteristics defined complex stenosis as long diffuse stenosis, very tortuous coarctation, or stenosis involving a main branch or an unusual location. Patients previously stented at an early age, required re-expansion and/or restenting after reaching 16 ± 5 years of age. Two patients had died by 1-month follow-up. The remaining 58 patients did well and were followed-up for a mean period of 10 ± 6 years. Late adverse events occurred in 3 patients (5%). All remaining patients are symptom-free, with normal baseline blood pressure. Imaging techniques revealed good patency at follow-up without associated aneurysm or restenosis. The actuarial survival free probability of all complex patients at 15 years was 92%. Stent repair of complex coarctation of aorta is feasible and safe. Initial results are maintained at later follow-up. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Reducing the Disruptive Effects of Interruptions With Noninvasive Brain Stimulation.

PubMed

Blumberg, Eric J; Foroughi, Cyrus K; Scheldrup, Melissa R; Peterson, Matthew S; Boehm-Davis, Debbie A; Parasuraman, Raja

2015-09-01

The authors determine whether transcranial direct current stimulation (tDCS) can reduce resumption time when an ongoing task is interrupted. Interruptions are common and disruptive. Working memory capacity has been shown to predict resumption lag (i.e., time to successfully resume a task after interruption). Given that tDCS applied to brain areas associated with working memory can enhance performance, tDCS has the potential to improve resumption lag when a task is interrupted. Participants were randomly assigned to one of four groups that received anodal (active) stimulation of 2 mA tDCS to one of two target brain regions, left and right dorsolateral prefrontal cortex (DLPFC), or to one of two control areas, active stimulation of the left primary motor cortex or sham stimulation of the right DLPFC, while completing a financial management task that was intermittently interrupted with math problem solving. Anodal stimulation to the right and left DLPFC significantly reduced resumption lags compared to the control conditions (sham and left motor cortex stimulation). Additionally, there was no speed-accuracy tradeoff (i.e., the improvement in resumption time was not accompanied by an increased error rate). Noninvasive brain stimulation can significantly decrease resumption lag (improve performance) after a task is interrupted. Noninvasive brain stimulation offers an easy-to-apply tool that can significantly improve interrupted task performance. © 2014, Human Factors and Ergonomics Society.

Source Inversion of Seismic Events Associated with the Sinkhole at Napoleonville Salt Dome, Louisiana using a 3D Velocity Model

NASA Astrophysics Data System (ADS)

Nayak, Avinash; Dreger, Douglas S.

2018-05-01

The formation of a large sinkhole at the Napoleonville salt dome (NSD), Assumption Parish, Louisiana, caused by the collapse of a brine cavern, was accompanied by an intense and complex sequence of seismic events. We implement a grid-search approach to compute centroid locations and point-source moment tensor (MT) solutions of these seismic events using ˜0.1-0.3 Hz displacement waveforms and synthetic Green's functions computed using a 3D velocity model of the western edge of the NSD. The 3D model incorporates the currently known approximate geometry of the salt dome and the overlying anhydrite-gypsum cap rock, and features a large velocity contrast between the high velocity salt dome and low velocity sediments overlying and surrounding it. For each possible location on the source grid, Green's functions (GFs) to each station were computed using source-receiver reciprocity and the finite-difference seismic wave propagation software SW4. We also establish an empirical method to rigorously assess uncertainties in the centroid location, MW and source type of these events under evolving network geometry, using the results of synthetic tests with hypothetical events and real seismic noise. We apply the methods on the entire duration of data (˜6 months) recorded by the temporary US Geological Survey network. During an energetic phase of the sequence from 24-31 July 2012 when 4 stations were operational, the events with the best waveform fits are primarily located at the western edge of the salt dome at most probable depths of ˜0.3-0.85 km, close to the horizontal positions of the cavern and the future sinkhole. The data are fit nearly equally well by opening crack MTs in the high velocity salt medium or by isotropic volume-increase MTs in the low velocity sediment layers. We find that data recorded by 6 stations during 1-2 August 2012, right before the appearance of the sinkhole, indicate that some events are likely located in the lower velocity media just outside the salt dome at slightly shallower depth ˜0.35-0.65 km, with preferred isotropic volume-increase MT solutions. We find that GFs computed using the 3D velocity model generally result in better fits to the data than GFs computed using 1D velocity models, especially for the smaller amplitude tangential and vertical components, and result in better resolution of event locations. The dominant seismicity during 24-30 July 2012 is characterized by steady occurrence of seismic events with similar locations and MT solutions at a near-characteristic inter-event time. The steady activity is sometimes interrupted by tremor-like sequences of multiple events in rapid succession, followed by quiet periods of little of no seismic activity, in turn followed by the resumption of seismicity with a reduced seismic moment-release rate. The dominant volume-increase MT solutions and the steady features of the seismicity indicate a crack-valve-type source mechanism possibly driven by pressurized natural gas.

Safety and efficacy of first-line bevacizumab-based therapy in advanced non-squamous non-small-cell lung cancer (SAiL, MO19390): a phase 4 study.

PubMed

Crinò, Lucio; Dansin, Eric; Garrido, Pilar; Griesinger, Frank; Laskin, Janessa; Pavlakis, Nick; Stroiakovski, Daniel; Thatcher, Nick; Tsai, Chun-Ming; Wu, Yi-long; Zhou, Caicun

2010-08-01

Results of two phase 3 trials have shown first-line bevacizumab in combination with chemotherapy improves clinical outcomes in patients with advanced or recurrent non-squamous non-small-cell lung cancer (NSCLC). The SAiL (MO19390) study was undertaken to assess the safety and efficacy of first-line bevacizumab combined with standard chemotherapy regimens in clinical practice. Between August, 2006, and June, 2008, patients with untreated locally advanced, metastatic, or recurrent non-squamous NSCLC were recruited to this open-label, single group, phase 4 study from centres in 40 countries. Eligible patients had histologically or cytologically documented inoperable, locally advanced, metastatic, or recurrent disease (stage IIIB-IV); an Eastern Cooperative Oncology Group performance status of 0-2; and adequate haematological, hepatic, and renal function. Patients received bevacizumab (7.5 or 15 mg/kg every 3 weeks) plus standard chemotherapy for up to six cycles, followed by single-agent bevacizumab until disease progression. The primary endpoint was safety; analysis was by intention to treat (ITT). This study is registered with ClinicalTrials.gov, number NCT00451906. At the final data cutoff (July 24, 2009), an ITT population of 2212 patients was assessed. The incidence of clinically significant (grade > or = 3) adverse events of special interest was generally low; thromboembolism occurred in 172 (8%) patients, hypertension in 125 (6%), bleeding in 80 (4%), proteinuria in 67 (3%), and pulmonary haemorrhage in 15 (1%). 57 (3%) patients died because of these adverse events, with thromboembolism (26 patients, 1%) and bleeding (17, 1%) as the most common causes. The most common grade 3 or higher serious adverse events deemed by investigators to be associated with bevacizumab were pulmonary embolism (28 patients; 1%) and epistaxis, neutropenia, febrile neutropenia, and deep vein thrombosis (all of which occurred in 13 patients [1%]). Bevacizumab was temporarily interrupted after 28 (2%) of 1347 bleeding events and 72 (7%) of 1025 hypertension events, and permanently discontinued after 110 (8%) bleeding events and 40 (4%) hypertension events. No new safety signals were reported. Our results confirm the manageable safety profile of first-line bevacizumab in combination with various standard chemotherapy regimens for treatment of advanced non-squamous NSCLC. F Hoffmann-La Roche Ltd. 2010 Elsevier Ltd. All rights reserved.

The effects of the CXCR2 antagonist, MK-7123, on bone marrow functions in healthy subjects.

PubMed

Hastrup, Nina; Khalilieh, Sauzanne; Dale, David C; Hanson, Lars G; Magnusson, Peter; Tzontcheva, Anjela; Tseng, Jack; Huyck, Susan; Rosenberg, Elizabeth; Krogsgaard, Kim

2015-04-01

The CXCR2 antagonist MK-7123 causes dose-dependent reductions in absolute neutrophil counts (ANC) and decreases neutrophil tissue responses, but its effects on bone marrow functions are not yet known. We conducted a double-blind, randomized study in 18 healthy subjects comparing the effects of either MK-7123 (30mg, po, daily for 28days) or placebo on peripheral blood counts and bone marrow myeloid cell populations. MK-7123 caused a reversible decrease (approximately 50%) in the ANC as demonstrated on days 1 and 28, the first and last days of the treatment period. Bone marrow aspirate smears and biopsy imprints did not differ in the proportion of mature neutrophils in pretreatment, day 28, day 56 or placebo samples. There were no treatment effects on biopsy or aspirate clot cellularity, myeloid to erythroid or myeloid post-mitotic to mitotic ratios; flow-cytometric analyses of aspirate cells; or bone marrow fat to cell balance as assessed by MRI. MK-7123 was generally well tolerated with neutropenia being the most common adverse event; however, there were no clinical symptoms associated with decreased ANCs. These findings indicate that the CXCR2 antagonist MK-7123 causes rapidly reversible decrease in the ANC without measurable myelosuppressive effects. The results support the development of CXCR2 antagonists as potentially useful anti-inflammatory agents, primarily interrupting neutrophil trafficking. Copyright © 2015. Published by Elsevier Ltd.

Salinity anomaly as a trigger for ENSO events

PubMed Central

Zhu, Jieshun; Huang, Bohua; Zhang, Rong-Hua; Hu, Zeng-Zhen; Kumar, Arun; Balmaseda, Magdalena A.; Marx, Lawrence; Kinter III, James L.

2014-01-01

According to the classical theories of ENSO, subsurface anomalies in ocean thermal structure are precursors for ENSO events and their initial specification is essential for skillful ENSO forecast. Although ocean salinity in the tropical Pacific (particularly in the western Pacific warm pool) can vary in response to El Niño events, its effect on ENSO evolution and forecasts of ENSO has been less explored. Here we present evidence that, in addition to the passive response, salinity variability may also play an active role in ENSO evolution, and thus important in forecasting El Niño events. By comparing two forecast experiments in which the interannually variability of salinity in the ocean initial states is either included or excluded, the salinity variability is shown to be essential to correctly forecast the 2007/08 La Niña starting from April 2007. With realistic salinity initial states, the tendency to decay of the subsurface cold condition during the spring and early summer 2007 was interrupted by positive salinity anomalies in the upper central Pacific, which working together with the Bjerknes positive feedback, contributed to the development of the La Niña event. Our study suggests that ENSO forecasts will benefit from more accurate salinity observations with large-scale spatial coverage. PMID:25352285

Salinity anomaly as a trigger for ENSO events.

PubMed

Zhu, Jieshun; Huang, Bohua; Zhang, Rong-Hua; Hu, Zeng-Zhen; Kumar, Arun; Balmaseda, Magdalena A; Marx, Lawrence; Kinter, James L

2014-10-29

According to the classical theories of ENSO, subsurface anomalies in ocean thermal structure are precursors for ENSO events and their initial specification is essential for skillful ENSO forecast. Although ocean salinity in the tropical Pacific (particularly in the western Pacific warm pool) can vary in response to El Niño events, its effect on ENSO evolution and forecasts of ENSO has been less explored. Here we present evidence that, in addition to the passive response, salinity variability may also play an active role in ENSO evolution, and thus important in forecasting El Niño events. By comparing two forecast experiments in which the interannually variability of salinity in the ocean initial states is either included or excluded, the salinity variability is shown to be essential to correctly forecast the 2007/08 La Niña starting from April 2007. With realistic salinity initial states, the tendency to decay of the subsurface cold condition during the spring and early summer 2007 was interrupted by positive salinity anomalies in the upper central Pacific, which working together with the Bjerknes positive feedback, contributed to the development of the La Niña event. Our study suggests that ENSO forecasts will benefit from more accurate salinity observations with large-scale spatial coverage.

Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water

PubMed Central

Oswald, William E.; Hunter, Gabrielle C.; Lescano, Andres G.; Cabrera, Lilia; Leontsini, Elli; Pan, William K.; Soldan, Valerie Paz; Gilman, Robert H.

2014-01-01

Summary OBJECTIVE To document frequency of hygiene practices of mothers and children in a shantytown in Lima, Peru. METHODS Continuous monitoring over three 12-h sessions in households without in-house water connections to measure: (i) water and soap use of 32 mothers; (ii) frequency of interrupting faecal-hand contamination by washing; and (iii) the time until faecal-hand contamination became a possible transmission event. RESULTS During 1008 h of observation, 55% (65/119) of mothers’ and 69% (37/54) of children's faecal-hand contamination events were not followed within 15 min by handwashing or bathing. Nearly 40% (67/173) of faecal-hand contamination events became possible faecal-oral transmission events. There was no difference in the time-until-transmission between mothers and children (P = 0.43). Potential transmission of faecal material to food or mouth occurred in 64% of cases within 1 h of hand contamination. Mean water usage (6.5 l) was low compared to international disaster relief standards. CONCLUSIONS We observed low volumes of water usage, inadequate handwashing, and frequent opportunities for faecal contamination and possible transmission in this water-scarce community. PMID:19055623

Modelling approaches: the case of schizophrenia.

PubMed

Heeg, Bart M S; Damen, Joep; Buskens, Erik; Caleo, Sue; de Charro, Frank; van Hout, Ben A

2008-01-01

Schizophrenia is a chronic disease characterized by periods of relative stability interrupted by acute episodes (or relapses). The course of the disease may vary considerably between patients. Patient histories show considerable inter- and even intra-individual variability. We provide a critical assessment of the advantages and disadvantages of three modelling techniques that have been used in schizophrenia: decision trees, (cohort and micro-simulation) Markov models and discrete event simulation models. These modelling techniques are compared in terms of building time, data requirements, medico-scientific experience, simulation time, clinical representation, and their ability to deal with patient heterogeneity, the timing of events, prior events, patient interaction, interaction between co-variates and variability (first-order uncertainty). We note that, depending on the research question, the optimal modelling approach should be selected based on the expected differences between the comparators, the number of co-variates, the number of patient subgroups, the interactions between co-variates, and simulation time. Finally, it is argued that in case micro-simulation is required for the cost-effectiveness analysis of schizophrenia treatments, a discrete event simulation model is best suited to accurately capture all of the relevant interdependencies in this chronic, highly heterogeneous disease with limited long-term follow-up data.

Neonatal nursery noise: practice-based learning and improvement.

PubMed

Hassanein, Sahar M A; El Raggal, Nehal M; Shalaby, Amani A

2013-03-01

To study the impact of interrupted loud noise in Neonatal Intensive Care Unit (NICU) on neonatal physiologic parameters, and apply methods to alleviate noise sources through teaching NICU's staff. Noise level measured at different day times and during different noisy events in the NICU. Changes in the heart rate, respiratory rate and oxygen saturation were recorded just before and immediately after providing noisy events for 36 preterm and 26 full-term neonates. Focused training, guided by sound-level-meter, was provided to the NICU's staff to minimize noise. The highest mean baseline noise level, 60.5 decibel (dB), was recorded in the NICU critical care area at 12:00 am. The lowest level, 55.2 dB was recorded at 10:00 pm. Noise level inside the incubators was significantly lower than outside, p < 0.001. Noisy events resulted in a significant increase in heart and respiratory rates in preterm neonates as compared to full-terms, p < 0.05. Noise in our NICU exceeded the international permissible levels. Noisy events are numerous, which altered the neonates' physiologic stability especially preterm infants. Staff education is mandatory in ameliorating noise pollution with its deleterious effects on neonatal physiologic homeostasis.

Insulation Technology in Dry Air and Vacuum for a 72kV Low Pressured Dry Air Insulated Switchgear

NASA Astrophysics Data System (ADS)

Yoshida, Tadahiro; Koga, Hiromi; Harada, Takakazu; Miki, Shinichi; Arioka, Masahiro; Sato, Shinji; Yoshida, Satoru; Inoue, Naoaki; Maruyama, Akihiko; Takeuchi, Toshie

A new 72kV rated low pressured dry air insulated switchgear applying electromagnetic actuation and function that supports CBM has been developed. First, dielectric characteristics in dry air under lightning impulse application has been investigated at bare and insulator covered electrodes. Dependence of the breakdown electric field strength on the effective area has been clarified to apply the configuration design of the insulation mold for the vacuum interrupter. In addition, moisture volume dependence on surface resistance has been clarified to decide moisture volume in gas pressure tank. Next, a new vacuum circuit breaker (VCB) has been designed. To keep dimensions from former 72kV SF6 gas insulated switchgear, distance between contacts in vacuum interrupter is needed to be shorter than that of former switchgear. Voltage withstand capability between electrodes practically designed for vacuum interrupter has been investigated under dc voltage application simulated the small capacitive current breaking test. Gap configuration including contacts and slits has been optimized and distance has been shortened 11% from former switchgear. As a result, the new low pressured dry air insulated switchgear has been designed comparably in outer size to former SF6 gas insulated switchgear. Using dry air as an insulation medium with low pressure has been able to reduce the environmental burden.

CD4+ T-cell-guided structured treatment interruptions of antiretroviral therapy in HIV disease: projecting beyond clinical trials.

PubMed

Yazdanpanah, Yazdan; Wolf, Lindsey L; Anglaret, Xavier; Gabillard, Delphine; Walensky, Rochelle P; Moh, Raoul; Danel, Christine; Sloan, Caroline E; Losina, Elena; Freedberg, Kenneth A

2010-01-01

International trials have shown that CD4+ T-cell-guided structured treatment interruptions (STI) of antiretroviral therapy (ART) lead to worse outcomes than continuous treatment. We simulated continuous ART and STI strategies with higher CD4+ T-cell interruption/reintroduction thresholds than those assessed in actual trials. Using a model of HIV, we simulated cohorts of African adults with different baseline CD4+ T-cell counts (< or = 200; 201-350; and 351-500 cells/microl). We varied ART initiation criteria (immediate; CD4+ T-cell count < 350 cells/microl or > or = 350 cells/microl with severe HIV-related disease; and CD4+ T-cell count <200 cells/microl or > or = 200 cells/microl with severe HIV-related disease), and ART interruption/reintroduction thresholds (350/250; 500/350; and 700/500 cells/microl). First-line therapy was non-nucleoside reverse transcriptase inhibitor (NNRTI)-based and second-line therapy was protease inhibitor (PI)-based. STI generally reduced life expectancy compared with continuous ART. Life expectancy increased with earlier ART initiation and higher interruption/reintroduction thresholds. STI reduced life expectancy by 48-69 and 11-30 months compared with continuous ART when interruption/reintroduction thresholds were 350/250 and 500/350 cells/microl, depending on ART initiation criteria. When patients interrupted/reintroduced ART at 700/500 cells/microl, life expectancies ranged from 2 months lower to 1 month higher than continuous ART. STI-related life expectancy increased with decreased risk of virological resistance after ART interruptions. STI with NNRTI-based regimens was almost always less effective than continuous treatment, regardless of interruption/reintroduction thresholds. The risks associated with STI decrease only if patients start ART earlier, interrupt/reintroduce treatment at very high CD4+ T-cell thresholds (700/500 cells/microl) and use first-line medications with higher resistance barriers, such as PIs.

Global interrupt and barrier networks

DOEpatents

Blumrich, Matthias A.; Chen, Dong; Coteus, Paul W.; Gara, Alan G.; Giampapa, Mark E; Heidelberger, Philip; Kopcsay, Gerard V.; Steinmacher-Burow, Burkhard D.; Takken, Todd E.

2008-10-28

A system and method for generating global asynchronous signals in a computing structure. Particularly, a global interrupt and barrier network is implemented that implements logic for generating global interrupt and barrier signals for controlling global asynchronous operations performed by processing elements at selected processing nodes of a computing structure in accordance with a processing algorithm; and includes the physical interconnecting of the processing nodes for communicating the global interrupt and barrier signals to the elements via low-latency paths. The global asynchronous signals respectively initiate interrupt and barrier operations at the processing nodes at times selected for optimizing performance of the processing algorithms. In one embodiment, the global interrupt and barrier network is implemented in a scalable, massively parallel supercomputing device structure comprising a plurality of processing nodes interconnected by multiple independent networks, with each node including one or more processing elements for performing computation or communication activity as required when performing parallel algorithm operations. One multiple independent network includes a global tree network for enabling high-speed global tree communications among global tree network nodes or sub-trees thereof. The global interrupt and barrier network may operate in parallel with the global tree network for providing global asynchronous sideband signals.

A qualitative, exploratory study of nurses' decision-making when interrupted during medication administration within the Paediatric Intensive Care Unit.

PubMed

Bower, Rachel A; Coad, Jane E; Manning, Joseph C; Pengelly, Theresa A

2018-02-01

In the paediatric intensive care unit (PICU), medication administration is challenging. Empirical studies demonstrate that interruptions occur frequently and that nurses are fundamental in the delivery of medication. However, little is known about nurse's decision making when interrupted during medication administration. Therefore, the objective is to understand decision making when interrupted during medication administration within the PICU. A qualitative study incorporating non-participant observation and audio recorded semi-structured interviews. A convenience sample of ten PICU nurses were interviewed. Each interview schedule was informed by two hours of observation which involved a further 29 PICU nurses. Data was analysed using Framework Analysis. A regional PICU located in a university teaching hospital in the United Kingdom. Analysis resulted in four overarching themes: (1) Guiding the medication process, (2) Concentration, focus and awareness, (3) Influences on interruptions (4) Impact and recovery CONCLUSION: Medication administration within the PICU is an essential but complex activity. Interruptions can impact on focus and concentration which can contribute to patient harm. Decision making by PICU nurses is influenced by interruption awareness, fluctuating levels of concentration, and responding to critically ill patient and families' needs. Copyright © 2017 Elsevier Ltd. All rights reserved.

43 CFR 3481.4 - Temporary interruption in coal severance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Temporary interruption in coal severance... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES General Provisions § 3481.4 Temporary interruption in coal severance. ...

43 CFR 3481.4 - Temporary interruption in coal severance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Temporary interruption in coal severance... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES General Provisions § 3481.4 Temporary interruption in coal severance. ...

43 CFR 3481.4 - Temporary interruption in coal severance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Temporary interruption in coal severance... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES General Provisions § 3481.4 Temporary interruption in coal severance. ...

43 CFR 3481.4 - Temporary interruption in coal severance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Temporary interruption in coal severance... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES General Provisions § 3481.4 Temporary interruption in coal severance. ...

On Line Digitizer Software.

DTIC Science & Technology

1984-06-01

UNSOLINTERRUPT: ; Dismiss unsolicited Interrupt. POPR M<RI,RI,R2,R3,R4,R5> ; Restore RZ-R5 REI ; Return from interrupt. .SBTTL AVCANCEL. Cancel I/O routine...Dismiss unsolicited Interrupt. POPR M<R8,RI.R2,R3,R4,R5> ; Restore RN-R5 REI ; Return from interrupt. .SBTTL ODCANCEL, Cancel I/0 routine ++ I ODCANCEL...output buffer. ODREGDU4P: i Dump device registers MOVZBL ODNUMREGS,(Rg)+ i Store device register count. NOVZWL UCBSWODBYTCNT(RS),- aStore BYTE count

Assessment and Treatment of Foot-Shoe Fetish Displayed by a Man with Autism

ERIC Educational Resources Information Center

Dozier, Claudia L.; Iwata, Brian A.; Worsdell, April S.

2011-01-01

Results of a functional analysis indicated that a man diagnosed with autism engaged in bizarre sexual behavior in the presence of women wearing sandals. Several treatments proved to be ineffective or impractical. By contrast, a response-interruption/time-out procedure quickly eliminated the problem behavior in multiple settings. (Contains 1…

Metabolic pathway interruption: CRISPR/Cas9-mediated knockout of tryptophan 2,3-oxygenase in Tribolium castaneum

USDA-ARS?s Scientific Manuscript database

The Tribolium castaneum vermilion gene encodes tryptophan 2,3-dioxygenase, a pivotal enzyme in the ommochrome pathway that is responsible for the black eye color. T. castaneum strains with a loss-of-function mutation, vermilion white (vw), lack both the promoter and the first 80% of the vermilion co...

Change, Priorities, and the College English Department.

ERIC Educational Resources Information Center

Farrell, Edmund J.

The functioning of the college English department during a period of rapid societal change is important. English programs can and have been interrupted by student activists. Such crises in formal education are small in comparison with the overriding issues of whether or not man can survive as a species past the turn of the next century and of what…

Quantifying and Monetizing Renewable Energy Resiliency

DOE PAGES

Anderson, Kate H.; Laws, Nicholas D.; Marr, Spencer; ...

2018-03-23

Energy resiliency has been thrust to the forefront by recent severe weather events and natural disasters. Billions of dollars are lost each year due to power outages. This article highlights the unique value renewable energy hybrid systems (REHS), comprised of solar, energy storage, and generators, provide in increasing resiliency. We present a methodology to quantify the amount and value of resiliency provided by REHS, and ways to monetize this resiliency value through insurance premium discounts. A case study of buildings in New York City demonstrates how implementing REHS in place of traditional backup diesel generators can double the amount ofmore » outage survivability, with an added value of $781,200. For a Superstorm Sandy type event, results indicate that insurance premium reductions could support up to 4% of the capital cost of REHS, and the potential exists to prevent up to $2.5 billion in business interruption losses with increased REHS deployment.« less

Constitutional Flavonoids Derived from Epimedium Dose-Dependently Reduce Incidence of Steroid-Associated Osteonecrosis Not via Direct Action by Themselves on Potential Cellular Targets

PubMed Central

Xie, Xin-Hui; He, Yi-Xin; Yao, Xin-Sheng; Li, Zi-Rong; Lee, Kwong-Man; He, Wei; Leung, Kwok-Sui; Qin, Ling

2009-01-01

Intravascular-thrombosis and extravascular-lipid-deposit are the two key pathogenic events considered to interrupt intraosseous blood supply during development of steroid-associated osteonecrosis (ON). However, there are no clinically employed agents capable of simultaneously targeting these two key pathogenic events. The present experimental study demonstrated that constitutional flavonoid glycosides derived from herb Epimedium (EF, composed of seven flavonoid compounds with common stem nuclear) exerted dose-dependent effect on inhibition of both thrombosis and lipid-deposition and accordingly reducing incidence of steroid-associated ON in rabbits, which was not via direct action by themselves rather by their common metabolite on potential cellular targets involved in the two pathogenic pathways. The underlying mechanism could be explained by counteracting endothelium injury and excessive adipogenesis. These findings encourage designing clinical trials to investigate potential of EF in prevention of steroid-associated ON. PMID:19641620

Quantifying and Monetizing Renewable Energy Resiliency

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

Anderson, Kate H.; Laws, Nicholas D.; Marr, Spencer

Energy resiliency has been thrust to the forefront by recent severe weather events and natural disasters. Billions of dollars are lost each year due to power outages. This article highlights the unique value renewable energy hybrid systems (REHS), comprised of solar, energy storage, and generators, provide in increasing resiliency. We present a methodology to quantify the amount and value of resiliency provided by REHS, and ways to monetize this resiliency value through insurance premium discounts. A case study of buildings in New York City demonstrates how implementing REHS in place of traditional backup diesel generators can double the amount ofmore » outage survivability, with an added value of $781,200. For a Superstorm Sandy type event, results indicate that insurance premium reductions could support up to 4% of the capital cost of REHS, and the potential exists to prevent up to $2.5 billion in business interruption losses with increased REHS deployment.« less

Checklist interruption and resumption: A linguistic study

NASA Technical Reports Server (NTRS)

Linde, Charlotte; Goguen, Joseph

1987-01-01

This study forms part of a project investigating the relationships among the formal structure of aviation procedures, the ways in which the crew members are taught to execute them, and the ways in which thet are actually performed in flight. Specifically, this report examines the interactions between the performance of checklists and interruptions, considering both interruptions by radio communications and by other crew members. The data consists of 14 crews' performance of a full mission simulation of a higher ratio of checklist speech acts to all speech acts within the span of the performance of the checklist. Further, it is not number of interruptions but length of interruptions which is associated with crew performance quality. Use of explicit holds is also associated with crew performance.

Career Interruptions and Subsequent Earnings: A Reexamination Using Swedish Data.

ERIC Educational Resources Information Center

Albrecht, James W.; Edin, Per-Anders; Sundstrom, Marianne; Vroman, Susan B.

1999-01-01

Cross-sectional and panel estimations of Swedish data reveal that different types of career interruptions have different effects on wages, varying by gender. Therefore, human capital depreciation does not entirely account for the negative effect of career interruptions on subsequent wages. (SK)

14 CFR 135.417 - Mechanical interruption summary report.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Mechanical interruption summary report. 135... Maintenance, Preventive Maintenance, and Alterations § 135.417 Mechanical interruption summary report. Each... unscheduled stop or diversion from a route, caused by known or suspected mechanical difficulties or...

The Relationship between the Current Waveform just before the Current Zero and the Interruption Ability in the High-speed VCB

NASA Astrophysics Data System (ADS)

Niwa, Yoshimitsu; Matsuzaki, Jun; Yokokura, Kunio

The high-speed vacuum circuit breaker, which forced the fault current to zero was investigated. The test circuit breaker consisted of a vacuum interrupter and a high frequency current source. The vacuum interrupter, which had the axial magnetic field electrode and the disk shape electrode, was tested. The arcing period of the high-speed vacuum circuit breaker is much shorter than that of conventional circuit breaker. The arc behavior of the test electrodes immediately after the contact separation was observed by a high-speed video camcorder. The relation between the current waveform just before the current zero and the interruption ability by varying the high frequency current source was investigated experimentally. The results demonstrate the interruption ability and the arc behavior of the high-speed vacuum circuit breaker. The high current interruption was made possible by the low current period just before the current zero, although the arcing time is short and the arc is concentrated.

Implementation of an Antimicrobial Stewardship Program in a Neonatal Intensive Care Unit.

PubMed

Nzegwu, Nneka I; Rychalsky, Michelle R; Nallu, Loren A; Song, Xuemei; Deng, Yanhong; Natusch, Amber M; Baltimore, Robert S; Paci, George R; Bizzarro, Matthew J

2017-10-01

OBJECTIVE To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP). DESIGN Quasi-experimental, interrupted time-series study. SETTING A 54-bed, level IV NICU in a regional academic and tertiary referral center. PATIENTS AND PARTICIPANTS All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion. INTERVENTION Implementation of a NICU-specific ASP beginning July 2012. METHODS We convened a multidisciplinary team and developed guidelines for common infections, with a focus on prescriber audit and feedback. We conducted an interrupted time-series analysis to evaluate the effects of our ASP. Our primary outcome measure was days of antibiotic therapy (DOT) per 1,000 patient days for all and for select antimicrobials. Secondary outcomes included provider-specific antimicrobial prescription events for suspected late-onset sepsis (blood or cerebrospinal fluid infection at >72 hours of life) and guideline compliance. RESULTS Antibiotic utilization decreased by 14.7 DOT per 1,000 patient days during the stewardship period, although this decrease was not statistically significant (P=.669). Use of ampicillin, the most commonly antimicrobial prescribed in our NICU, decreased significantly, declining by 22.5 DOT per 1,000 patient days (P=.037). Late-onset sepsis evaluation and prescription events per 100 NICU days of clinical service decreased significantly (P<.0001), with an average reduction of 2.65 evaluations per year per provider. Clinical guidelines were adhered to 98.75% of the time. CONCLUSIONS Implementation of a NICU-specific antimicrobial stewardship program is feasible and can improve antibiotic prescribing practices. Infect Control Hosp Epidemiol 2017;38:1137-1143.

Limiting the effects of earthquakes on gravitational-wave interferometers

NASA Astrophysics Data System (ADS)

Coughlin, Michael; Earle, Paul; Harms, Jan; Biscans, Sebastien; Buchanan, Christopher; Coughlin, Eric; Donovan, Fred; Fee, Jeremy; Gabbard, Hunter; Guy, Michelle; Mukund, Nikhil; Perry, Matthew

2017-02-01

Ground-based gravitational wave interferometers such as the Laser Interferometer Gravitational-wave Observatory (LIGO) are susceptible to ground shaking from high-magnitude teleseismic events, which can interrupt their operation in science mode and significantly reduce their duty cycle. It can take several hours for a detector to stabilize enough to return to its nominal state for scientific observations. The down time can be reduced if advance warning of impending shaking is received and the impact is suppressed in the isolation system with the goal of maintaining stable operation even at the expense of increased instrumental noise. Here, we describe an early warning system for modern gravitational-wave observatories. The system relies on near real-time earthquake alerts provided by the U.S. Geological Survey (USGS) and the National Oceanic and Atmospheric Administration (NOAA). Preliminary low latency hypocenter and magnitude information is generally available in 5 to 20 min of a significant earthquake depending on its magnitude and location. The alerts are used to estimate arrival times and ground velocities at the gravitational-wave detectors. In general, 90% of the predictions for ground-motion amplitude are within a factor of 5 of measured values. The error in both arrival time and ground-motion prediction introduced by using preliminary, rather than final, hypocenter and magnitude information is minimal. By using a machine learning algorithm, we develop a prediction model that calculates the probability that a given earthquake will prevent a detector from taking data. Our initial results indicate that by using detector control configuration changes, we could prevent interruption of operation from 40 to 100 earthquake events in a 6-month time-period.

Limiting the effects of earthquakes on gravitational-wave interferometers

USGS Publications Warehouse

Coughlin, Michael; Earle, Paul; Harms, Jan; Biscans, Sebastien; Buchanan, Christopher; Coughlin, Eric; Donovan, Fred; Fee, Jeremy; Gabbard, Hunter; Guy, Michelle; Mukund, Nikhil; Perry, Matthew

2017-01-01

Ground-based gravitational wave interferometers such as the Laser Interferometer Gravitational-wave Observatory (LIGO) are susceptible to ground shaking from high-magnitude teleseismic events, which can interrupt their operation in science mode and significantly reduce their duty cycle. It can take several hours for a detector to stabilize enough to return to its nominal state for scientific observations. The down time can be reduced if advance warning of impending shaking is received and the impact is suppressed in the isolation system with the goal of maintaining stable operation even at the expense of increased instrumental noise. Here, we describe an early warning system for modern gravitational-wave observatories. The system relies on near real-time earthquake alerts provided by the U.S. Geological Survey (USGS) and the National Oceanic and Atmospheric Administration (NOAA). Preliminary low latency hypocenter and magnitude information is generally available in 5 to 20 min of a significant earthquake depending on its magnitude and location. The alerts are used to estimate arrival times and ground velocities at the gravitational-wave detectors. In general, 90% of the predictions for ground-motion amplitude are within a factor of 5 of measured values. The error in both arrival time and ground-motion prediction introduced by using preliminary, rather than final, hypocenter and magnitude information is minimal. By using a machine learning algorithm, we develop a prediction model that calculates the probability that a given earthquake will prevent a detector from taking data. Our initial results indicate that by using detector control configuration changes, we could prevent interruption of operation from 40 to 100 earthquake events in a 6-month time-period.

Stochastic and cyclic deposition of multiple subannual laminae in an urban lake (Twin Lake, Golden Valley, Minnesota, USA)

NASA Astrophysics Data System (ADS)

Myrbo, A.; Ustipak, K.; Demet, B.

2013-12-01

Twin Lake, a small, deep, meromictic urban lake in Minneapolis, Minnesota, annually deposits two to 10 laminae that are distinguished from one another by composition and resulting color. Sediment sources are both autochthonous and allochthonous, including pure and mixed laminae of authigenic calcite, algal organic matter, and diatoms, as well as at least three distinct types of sediment gravity flow deposits. Diagenetic iron sulfide and iron phosphate phases are minor components, but can affect color out of proportion to their abundance. We used L*a*b* color from digital images of a freeze core slab, and petrographic smear slides of individual laminae, to categorize 1080 laminae deposited between 1963 and 2010 CE (based on lead-210 dating). Some causal relationships exist between the ten categories identified: diatom blooms often occur directly above the debris of gravity flows that probably disrupt the phosphate-rich monimolomnion and fertilize the surface waters; calcite whitings only occur after diatom blooms that increase calcite saturation. Stochastic events, as represented by laminae rich in siliciclastics and other terrigenous material, or shallow-water microfossils and carbonate morphologies, are the dominant sediment source. The patterns of cyclic deposition (e.g., summer and winter sedimentation) that produce 'normal' varve couplets in some lakes are continually interrupted by these stochastic events, to such an extent that spectral analysis finds only a weak one-year cycle. Sediments deposited before about 1900, and extending through the entire Holocene sequence (~10m) are varve couplets interrupted by thick (20-90 cm) debris layers, indicating that gravity flows were lower in frequency but greater in magnitude before the historical period, probably due to an increased frequency of disturbance under urban land-use.

An overview of natural hazard impacts to railways and urban transportation systems

NASA Astrophysics Data System (ADS)

Bíl, Michal; Nezval, Vojtěch; Bílová, Martina; Andrášik, Richard; Kubeček, Jan

2017-04-01

We present an overview and two case studies of natural hazard impacts on rail transportation systems in the Czech Republic. Flooding, landsliding, heavy snowfall, windstorms and glaze (black ice) are the most common natural processes which occur in this region. Whereas flooding and landsliding usually cause direct damage to the transportation infrastructure, other hazards predominantly cause indirect losses. Railway and urban tramline networks are almost fully dependent on electricity which is provided by a system of overhead lines (electric lines above the tracks). These lines are extremely susceptible to formation of glaze which blocks conduction of electric current. A December 2014 glaze event caused significant indirect losses in the largest Czech cities and railways due to the above-mentioned process. Details of this event will be provided during the presentation. Windstorms usually cause tree falls which can affect overhead lines and physically block railway tracks. Approximately 30 % of the Czech railway network is closer than 50 m from the nearest forest. This presents significant potential for transport interruption due to falling trees. Complicated legal relations among the owners of the plots of land along railways, the environment (full-grown trees and related habitat), and the railway administrator are behind many traffic interruptions due to falling trees. We have registered 2040 tree falls between 2012 and 2015 on the railway network. A model of the fallen tree hazard was created for the entire Czech railway network. Both above-mentioned case studies provide illustrative examples of the increased fragility of the modern transportation systems which fully rely on electricity. Natural processes with a low destructive power are thereby able to cause network wide service cut-offs.

A performance-based approach to landslide risk analysis

NASA Astrophysics Data System (ADS)

Romeo, R. W.

2009-04-01

An approach for the risk assessment based on a probabilistic analysis of the performance of structures threatened by landslides is shown and discussed. The risk is a possible loss due to the occurrence of a potentially damaging event. Analytically the risk is the probability convolution of hazard, which defines the frequency of occurrence of the event (i.e., the demand), and fragility that defines the capacity of the system to withstand the event given its characteristics (i.e., severity) and those of the exposed goods (vulnerability), that is: Risk=p(D>=d|S,V) The inequality sets a damage (or loss) threshold beyond which the system's performance is no longer met. Therefore a consistent approach to risk assessment should: 1) adopt a probabilistic model which takes into account all the uncertainties of the involved variables (capacity and demand), 2) follow a performance approach based on given loss or damage thresholds. The proposed method belongs to the category of the semi-empirical ones: the theoretical component is given by the probabilistic capacity-demand model; the empirical component is given by the observed statistical behaviour of structures damaged by landslides. Two landslide properties alone are required: the area-extent and the type (or kinematism). All other properties required to determine the severity of landslides (such as depth, speed and frequency) are derived via probabilistic methods. The severity (or intensity) of landslides, in terms of kinetic energy, is the demand of resistance; the resistance capacity is given by the cumulative distribution functions of the limit state performance (fragility functions) assessed via damage surveys and cards compilation. The investigated limit states are aesthetic (of nominal concern alone), functional (interruption of service) and structural (economic and social losses). The damage probability is the probabilistic convolution of hazard (the probability mass function of the frequency of occurrence of given severities) and vulnerability (the probability of a limit state performance be reached, given a certain severity). Then, for each landslide all the exposed goods (structures and infrastructures) within the landslide area and within a buffer (representative of the maximum extension of a landslide given a reactivation), are counted. The risk is the product of the damage probability and the ratio of the exposed goods of each landslide to the whole assets exposed to the same type of landslides. Since the risk is computed numerically and by the same procedure applied to all landslides, it is free from any subjective assessment such as those implied in the qualitative methods.

Improving memory after interruption: exploiting soft constraints and manipulating information access cost.

PubMed

Morgan, Phillip L; Patrick, John; Waldron, Samuel M; King, Sophia L; Patrick, Tanya

2009-12-01

Forgetting what one was doing prior to interruption is an everyday problem. The recent soft constraints hypothesis (Gray, Sims, Fu, & Schoelles, 2006) emphasizes the strategic adaptation of information processing strategy to the task environment. It predicts that increasing information access cost (IAC: the time, and physical and mental effort involved in accessing information) encourages a more memory-intensive strategy. Like interruptions, access costs are also intrinsic to most work environments, such as when opening documents and e-mails. Three experiments investigated whether increasing IAC during a simple copying task can be an effective method for reducing forgetting following interruption. IAC was designated Low (all information permanently visible), Medium (a mouse movement to uncover target information), or High (an additional few seconds to uncover such information). Experiment 1 found that recall improved across all three levels of IAC. Subsequent experiments found that High IAC facilitated resumption after interruption, particularly when interruption occurred on half of all trials (Experiment 2), and improved prospective memory following two different interrupting tasks, even when one involved the disruptive effect of using the same type of resource as the primary task (Experiment 3). The improvement of memory after interruption with increased IAC supports the prediction of the soft constraints hypothesis. The main disadvantage of a high access cost was a reduction in speed of task completion. The practicality of manipulating IAC as a design method for inducing a memory-intensive strategy to protect against forgetting is discussed. Copyright 2009 APA

Interrupted Visual Searches Reveal Volatile Search Memory

ERIC Educational Resources Information Center

Shen, Y. Jeremy; Jiang, Yuhong V.

2006-01-01

This study investigated memory from interrupted visual searches. Participants conducted a change detection search task on polygons overlaid on scenes. Search was interrupted by various disruptions, including unfilled delay, passive viewing of other scenes, and additional search on new displays. Results showed that performance was unaffected by…

14 CFR 91.1417 - CAMP: Mechanical interruption summary report.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false CAMP: Mechanical interruption summary... Ownership Operations Program Management § 91.1417 CAMP: Mechanical interruption summary report. Each program... route, caused by known or suspected mechanical difficulties or malfunctions that are not required to be...

Rapid classification of hippocampal replay content for real-time applications

PubMed Central

Liu, Daniel F.; Karlsson, Mattias P.; Frank, Loren M.; Eden, Uri T.

2016-01-01

Sharp-wave ripple (SWR) events in the hippocampus replay millisecond-timescale patterns of place cell activity related to the past experience of an animal. Interrupting SWR events leads to learning and memory impairments, but how the specific patterns of place cell spiking seen during SWRs contribute to learning and memory remains unclear. A deeper understanding of this issue will require the ability to manipulate SWR events based on their content. Accurate real-time decoding of SWR replay events requires new algorithms that are able to estimate replay content and the associated uncertainty, along with software and hardware that can execute these algorithms for biological interventions on a millisecond timescale. Here we develop an efficient estimation algorithm to categorize the content of replay from multiunit spiking activity. Specifically, we apply real-time decoding methods to each SWR event and then compute the posterior probability of the replay feature. We illustrate this approach by classifying SWR events from data recorded in the hippocampus of a rat performing a spatial memory task into four categories: whether they represent outbound or inbound trajectories and whether the activity is replayed forward or backward in time. We show that our algorithm can classify the majority of SWR events in a recording epoch within 20 ms of the replay onset with high certainty, which makes the algorithm suitable for a real-time implementation with short latencies to incorporate into content-based feedback experiments. PMID:27535369

76 FR 27637 - Supplemental Priorities for Discretionary Grant Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-12

.... Interrupted time series design means a type of quasi-experimental study (as defined in this notice) in which... design is an adaptation of an interrupted time series design that relies on the comparison of treatment... notice), interrupted time series designs (as defined in this notice), or regression discontinuity designs...

75 FR 47284 - Secretary's Priorities for Discretionary Grant Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-05

... the most currently available data. Interrupted time series design \\4\\ means a type of quasi... findings. \\4\\ A single subject or single case design is an adaptation of an interrupted time series design...), interrupted time series designs (as defined in this notice), or regression discontinuity designs (as defined...

77 FR 26579 - Certain Ground Fault Circuit Interrupters and Products Containing Same; Notice of Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-739] Certain Ground Fault Circuit... importation of certain ground fault circuit interrupters and products containing the same by reason of... entry of ground fault circuit interrupters and products containing the same that infringe one or more of...

The Interrupted Intercourse in the Election Communication: Pragmatic Aspect

ERIC Educational Resources Information Center

Andryuchshenko, Olga K.; Suyunova, Gulnara S.; Nygmetova, Bibigul Dz.; Garanina, Ekaterina P.

2016-01-01

The article provides analysis of the interrupted communication as part of the communication in the election discourse. The authors explored the most typical reasons for the interrupted communication in the electoral discourse analyzed communication failures as a kind of ineffective communication. Communication failures are presented as a result of…

Interruption of a dry-type transformer in no-load by a vacuum circuit-breaker

NASA Astrophysics Data System (ADS)

Vandenheuvel, W. M. C.; Daalder, J. E.; Boone, M. J. M.; Wilmes, L. A. H.

1983-08-01

Overvoltages generated during interruption of a dry type delta-star connected transformer in no load by a vacuum breaker were studied. During interruption of inrush current 37% of the phase-to-ground overvoltages were 5 pu, and 6% 7 pu. Comparison of experimental and theoretical results using Boyle's model shows no discrepancy for inrush currents and clean overvoltages from the steady-state interruption. Overvoltages due to repetitive reignitions (not covered by Boyle's model) are higher than the calculated values during steady-state switching.

Microelectromechanical safe arm device

DOEpatents

Roesler, Alexander W [Tijeras, NM

2012-06-05

Microelectromechanical (MEM) apparatus and methods for operating, for preventing unintentional detonation of energetic components comprising pyrotechnic and explosive materials, such as air bag deployment systems, munitions and pyrotechnics. The MEM apparatus comprises an interrupting member that can be moved to block (interrupt) or complete (uninterrupt) an explosive train that is part of an energetic component. One or more latching members are provided that engage and prevent the movement of the interrupting member, until the one or more latching members are disengaged from the interrupting member. The MEM apparatus can be utilized as a safe and arm device (SAD) and electronic safe and arm device (ESAD) in preventing unintentional detonations. Methods for operating the MEM apparatus include independently applying drive signals to the actuators coupled to the latching members, and an actuator coupled to the interrupting member.

Suicide Risk Characteristics among Aborted, Interrupted, and Actual Suicide Attempters

PubMed Central

Burke, Taylor A.; Hamilton, Jessica L.; Ammerman, Brooke A.; Stange, Jonathan P.; Alloy, Lauren B.

2017-01-01

Few studies have investigated suicide risk characteristics associated with interrupted and aborted suicide attempts. The present study aimed to empirically examine whether assessing a history of interrupted and aborted suicide attempts is valuable when assessing suicide risk, given the relative lack of literature in this area to date. To inform this question, the current study examined differences in risk factors for suicidal behavior among individuals who have carried out a suicide attempt, individuals who report having a history of only interrupted and/or aborted suicide attempts, and non-attempter controls. Approximately 447 undergraduates (M = 21.10 years; SD = 4.16; 77.6% female) completed measures of carried out suicide attempts, interrupted suicide attempts, aborted suicide attempts, acquired capability for suicide, suicide likelihood, depressive symptoms, suicidal ideation, and non-suicidal self-injury. Results suggest that a faction of individuals endorse interrupted and/or aborted suicide attempts (8.7%), but do not endorse carried out suicide attempts, even in non-clinical samples. Furthermore, results suggest that there are few clinically meaningful differences between those with a history of carried out suicide attempts and interrupted/aborted suicide attempts, suggesting that individuals with a history of these lesser studied suicidal behaviors are an important group to target for suicide risk intervention. PMID:27344029

Sex differences in directional brain responses to infant hunger cries.

PubMed

De Pisapia, Nicola; Bornstein, Marc H; Rigo, Paola; Esposito, Gianluca; De Falco, Simona; Venuti, Paola

2013-02-13

Infant cries are a critical survival mechanism that draw the attention of adult caregivers, who can then satisfy the basic needs of otherwise helpless infants. Here, we used functional neuroimaging to determine the effects of infant hunger cries on the brain activity of adults who were in a cognitively nondemanding mental state of awake rest. We found that the brains of men and women, independent of parental status (parent or nonparent), reacted differently to infant cries. Specifically, the dorsal medial prefrontal and posterior cingulate areas, known to be involved in mind wandering (the stream of thought typical of awake rest), remained active in men during exposure to infant cries, whereas in women, activity in these regions decreased. These results show sex-dependent modulation of brain responses to infant requests to be fed, and specifically, they indicate that women interrupt mind wandering when exposed to the sounds of infant hunger cries, whereas men carry on without interruption.

Targeting Allosteric Control Mechanisms in Heat Shock Protein 70 (Hsp70)

PubMed Central

Li, Xiaokai; Shao, Hao; Taylor, Isabelle R.; Gestwicki, Jason E.

2017-01-01

Heat shock protein 70 (Hsp70) is a molecular chaperone that plays critical roles in protein homeostasis. Hsp70’s chaperone activity is coordinated by intra-molecular interactions between its two domains, as well as inter-molecular interactions between Hsp70 and its co-chaperones. Each of these contacts represents a potential opportunity for the development of chemical inhibitors. To illustrate this concept, we review three classes of recently identified molecules that bind distinct pockets on Hsp70. Although all three compounds share the ability to interrupt core biochemical functions of Hsp70, they stabilize different conformers. Accordingly, each compound appears to interrupt a specific subset of inter- and intra-molecular interactions. Thus, an accurate definition of an Hsp70 inhibitor may require a particularly detailed understanding of the molecule’s binding site and its effects on protein-protein interactions. PMID:27072701

Threshold-based insulin-pump interruption for reduction of hypoglycemia.

PubMed

Bergenstal, Richard M; Klonoff, David C; Garg, Satish K; Bode, Bruce W; Meredith, Melissa; Slover, Robert H; Ahmann, Andrew J; Welsh, John B; Lee, Scott W; Kaufman, Francine R

2013-07-18

The threshold-suspend feature of sensor-augmented insulin pumps is designed to minimize the risk of hypoglycemia by interrupting insulin delivery at a preset sensor glucose value. We evaluated sensor-augmented insulin-pump therapy with and without the threshold-suspend feature in patients with nocturnal hypoglycemia. We randomly assigned patients with type 1 diabetes and documented nocturnal hypoglycemia to receive sensor-augmented insulin-pump therapy with or without the threshold-suspend feature for 3 months. The primary safety outcome was the change in the glycated hemoglobin level. The primary efficacy outcome was the area under the curve (AUC) for nocturnal hypoglycemic events. Two-hour threshold-suspend events were analyzed with respect to subsequent sensor glucose values. A total of 247 patients were randomly assigned to receive sensor-augmented insulin-pump therapy with the threshold-suspend feature (threshold-suspend group, 121 patients) or standard sensor-augmented insulin-pump therapy (control group, 126 patients). The changes in glycated hemoglobin values were similar in the two groups. The mean AUC for nocturnal hypoglycemic events was 37.5% lower in the threshold-suspend group than in the control group (980 ± 1200 mg per deciliter [54.4 ± 66.6 mmol per liter] × minutes vs. 1568 ± 1995 mg per deciliter [87.0 ± 110.7 mmol per liter] × minutes, P<0.001). Nocturnal hypoglycemic events occurred 31.8% less frequently in the threshold-suspend group than in the control group (1.5 ± 1.0 vs. 2.2 ± 1.3 per patient-week, P<0.001). The percentages of nocturnal sensor glucose values of less than 50 mg per deciliter (2.8 mmol per liter), 50 to less than 60 mg per deciliter (3.3 mmol per liter), and 60 to less than 70 mg per deciliter (3.9 mmol per liter) were significantly reduced in the threshold-suspend group (P<0.001 for each range). After 1438 instances at night in which the pump was stopped for 2 hours, the mean sensor glucose value was 92.6 ± 40.7 mg per deciliter (5.1 ± 2.3 mmol per liter). Four patients (all in the control group) had a severe hypoglycemic event; no patients had diabetic ketoacidosis. This study showed that over a 3-month period the use of sensor-augmented insulin-pump therapy with the threshold-suspend feature reduced nocturnal hypoglycemia, without increasing glycated hemoglobin values. (Funded by Medtronic MiniMed; ASPIRE ClinicalTrials.gov number, NCT01497938.).

Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study.

PubMed

Westbrook, Johanna I; Raban, Magdalena Z; Walter, Scott R; Douglas, Heather

2018-01-09

Interruptions and multitasking have been demonstrated in experimental studies to reduce individuals' task performance. These behaviours are frequently used by clinicians in high-workload, dynamic clinical environments, yet their effects have rarely been studied. To assess the relative contributions of interruptions and multitasking by emergency physicians to prescribing errors. 36 emergency physicians were shadowed over 120 hours. All tasks, interruptions and instances of multitasking were recorded. Physicians' working memory capacity (WMC) and preference for multitasking were assessed using the Operation Span Task (OSPAN) and Inventory of Polychronic Values. Following observation, physicians were asked about their sleep in the previous 24 hours. Prescribing errors were used as a measure of task performance. We performed multivariate analysis of prescribing error rates to determine associations with interruptions and multitasking, also considering physician seniority, age, psychometric measures, workload and sleep. Physicians experienced 7.9 interruptions/hour. 28 clinicians were observed prescribing 239 medication orders which contained 208 prescribing errors. While prescribing, clinicians were interrupted 9.4 times/hour. Error rates increased significantly if physicians were interrupted (rate ratio (RR) 2.82; 95% CI 1.23 to 6.49) or multitasked (RR 1.86; 95% CI 1.35 to 2.56) while prescribing. Having below-average sleep showed a >15-fold increase in clinical error rate (RR 16.44; 95% CI 4.84 to 55.81). WMC was protective against errors; for every 10-point increase on the 75-point OSPAN, a 19% decrease in prescribing errors was observed. There was no effect of polychronicity, workload, physician gender or above-average sleep on error rates. Interruptions, multitasking and poor sleep were associated with significantly increased rates of prescribing errors among emergency physicians. WMC mitigated the negative influence of these factors to an extent. These results confirm experimental findings in other fields and raise questions about the acceptability of the high rates of multitasking and interruption in clinical environments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An inclined plane system with microcontroller to determine limb motor function of laboratory animals.

PubMed

Chang, Ming-Wen; Young, Ming-Shing; Lin, Mao-Tsun

2008-02-15

This study describes a high-accuracy inclined plane test system for quantitative measurement of the limb motor function of laboratory rats. The system is built around a microcontroller and uses a stepping motor to drive a ball screw, which changes the angle of the inclined plane. Any of the seven inclination speeds can be selected by the user. Two infrared (IR) LED/detector pairs function as interrupt sensors for objective determination of the moment that the rat loses its grip on the textured flooring of the starting area and slips down the plane. Inclination angle at the moment of IR interrupt (i.e. rat slip) is recorded. A liquid crystal display module shows the inclination speed and the inclination angle. The system can function as a stand alone device but a RS232 port allows connection to a personal computer (PC), so data can be sent directly to hard disk for storage and analysis. Experiments can be controlled by a local keypad or by the connected PC. Advantages of the presented system include easy operation, high accuracy, non-dependence on human observation for determination of slip angle, stand-alone capability, low cost and easy modification of the controlling software for different types of experiments. A fully functional prototype of the system is described. The prototype was used experimentally by a hospital group testing traumatic brain injury experiments, and some of their results are presented for system verification. It is found that the system is stable, accurate and easily used by investigators.

Bilateral Cervical Contusion Spinal Cord Injury in Rats

PubMed Central

Anderson, Kim D.; Sharp, Kelli G.; Steward, Oswald

2009-01-01

There is increasing motivation to develop clinically relevant experimental models for cervical SCI in rodents and techniques to assess deficits in forelimb function. Here we describe a bilateral cervical contusion model in rats. Female Sprague-Dawley rats received mild or moderate cervical contusion injuries (using the Infinite Horizons device) at C5, C6, or C7/8. Forelimb motor function was assessed using a Grip Strength Meter (GSM); sensory function was assessed by the von Frey hair test; the integrity of the corticospinal tract (CST) was assessed by biotinylated dextran amine (BDA) tract tracing. Mild contusions caused primarily dorsal column (DC) and gray matter (GM) damage while moderate contusions produced additional damage to lateral and ventral tissue. Forelimb and hindlimb function was severely impaired immediately post-injury, but all rats regained the ability to use their hindlimbs for locomotion. Gripping ability was abolished immediately after injury but recovered partially, depending upon the spinal level and severity of the injury. Rats exhibited a loss of sensation in both fore- and hindlimbs that partially recovered, and did not exhibit allodynia. Tract tracing revealed that the main contingent of CST axons in the DC was completely interrupted in all but one animal whereas the dorsolateral CST (dlCST) was partially spared, and dlCST axons gave rise to axons that arborized in the GM caudal to the injury. Our data demonstrate that rats can survive significant bilateral cervical contusion injuries at or below C5 and that forepaw gripping function recovers after mild injuries even when the main component of CST axons in the dorsal column is completely interrupted. PMID:19559699

Interrupting Everyday Life: Public Interventionist Art as Critical Public Pedagogy

ERIC Educational Resources Information Center

Desai, Dipti; Darts, David

2016-01-01

In this article we explore two urban interventions art projects in the public sphere designed by our Masters' students at New York University as they set the stage for a discussion on how urban art interventions can function as a form of critical public pedagogy. We argue that these kinds of public art projects provided a space for dialogue with…

Role of stretch reflex in voluntary movements. [of human foot

NASA Technical Reports Server (NTRS)

Gottlieb, G. L.; Agarwal, G. C.

1975-01-01

The stretch reflex is often described as a spinal servomechanism, a device for assisting in the regulation of muscle length. Observation of the EMG response to mechanical interruption of voluntary movements fails to demonstrate a significant role for spinal reflexes at 40 msec latency. Two functional responses with latencies of 120 msec and 200 msec, implying supraspinal mediation, are observed.

Thermodynamic perspectives on genetic instructions, the laws of biology and diseased states.

PubMed

Trevors, Jack T; Saier, Milton H

2011-01-01

This article examines in a broad perspective entropy and some examples of its relationship to evolution, genetic instructions and how we view diseases. Living organisms are programmed by functional genetic instructions (FGI), through cellular communication pathways, to grow and reproduce by maintaining a variety of hemistable, ordered structures (low entropy). Living organisms are far from equilibrium with their surrounding environmental systems, which tends towards increasing disorder (increasing entropy). Organisms free themselves from high entropy (high disorder) to maintain their cellular structures for a period of time sufficient to allow reproduction and the resultant offspring to reach reproductive ages. This time interval varies for different species. Bacteria, for example need no sexual parents; dividing cells are nearly identical to the previous generation of cells, and can begin a new cell cycle without delay under appropriate conditions. By contrast, human infants require years of care before they can reproduce. Living organisms maintain order in spite of their changing surrounding environment that decreases order according to the second law of thermodynamics. These events actually work together since living organisms create ordered biological structures by increasing local entropy. From a disease perspective, viruses and other disease agents interrupt the normal functioning of cells. The pressure for survival may result in mechanisms that allow organisms to resist attacks by viruses, other pathogens, destructive chemicals and physical agents such as radiation. However, when the attack is successful, the organism can be damaged until the cell, tissue, organ or entire organism is no longer functional and entropy increases. Copyright © 2010 Académie des sciences. Published by Elsevier SAS. All rights reserved.

Short desynchronization episodes prevail in synchronous dynamics of human brain rhythms.

PubMed

Ahn, Sungwoo; Rubchinsky, Leonid L

2013-03-01

Neural synchronization is believed to be critical for many brain functions. It frequently exhibits temporal variability, but it is not known if this variability has a specific temporal patterning. This study explores these synchronization/desynchronization patterns. We employ recently developed techniques to analyze the fine temporal structure of phase-locking to study the temporal patterning of synchrony of the human brain rhythms. We study neural oscillations recorded by electroencephalograms in α and β frequency bands in healthy human subjects at rest and during the execution of a task. While the phase-locking strength depends on many factors, dynamics of synchrony has a very specific temporal pattern: synchronous states are interrupted by frequent, but short desynchronization episodes. The probability for a desynchronization episode to occur decreased with its duration. The transition matrix between synchronized and desynchronized states has eigenvalues close to 0 and 1 where eigenvalue 1 has multiplicity 1, and therefore if the stationary distribution between these states is perturbed, the system converges back to the stationary distribution very fast. The qualitative similarity of this patterning across different subjects, brain states and electrode locations suggests that this may be a general type of dynamics for the brain. Earlier studies indicate that not all oscillatory networks have this kind of patterning of synchronization/desynchronization dynamics. Thus, the observed prevalence of short (but potentially frequent) desynchronization events (length of one cycle of oscillations) may have important functional implications for the brain. Numerous short desynchronizations (as opposed to infrequent, but long desynchronizations) may allow for a quick and efficient formation and break-up of functionally significant neuronal assemblies.

Short desynchronization episodes prevail in synchronous dynamics of human brain rhythms

NASA Astrophysics Data System (ADS)

Ahn, Sungwoo; Rubchinsky, Leonid L.

2013-03-01

Neural synchronization is believed to be critical for many brain functions. It frequently exhibits temporal variability, but it is not known if this variability has a specific temporal patterning. This study explores these synchronization/desynchronization patterns. We employ recently developed techniques to analyze the fine temporal structure of phase-locking to study the temporal patterning of synchrony of the human brain rhythms. We study neural oscillations recorded by electroencephalograms in α and β frequency bands in healthy human subjects at rest and during the execution of a task. While the phase-locking strength depends on many factors, dynamics of synchrony has a very specific temporal pattern: synchronous states are interrupted by frequent, but short desynchronization episodes. The probability for a desynchronization episode to occur decreased with its duration. The transition matrix between synchronized and desynchronized states has eigenvalues close to 0 and 1 where eigenvalue 1 has multiplicity 1, and therefore if the stationary distribution between these states is perturbed, the system converges back to the stationary distribution very fast. The qualitative similarity of this patterning across different subjects, brain states and electrode locations suggests that this may be a general type of dynamics for the brain. Earlier studies indicate that not all oscillatory networks have this kind of patterning of synchronization/desynchronization dynamics. Thus, the observed prevalence of short (but potentially frequent) desynchronization events (length of one cycle of oscillations) may have important functional implications for the brain. Numerous short desynchronizations (as opposed to infrequent, but long desynchronizations) may allow for a quick and efficient formation and break-up of functionally significant neuronal assemblies.

PolyQ repeat expansions in ATXN2 associated with ALS are CAA interrupted repeats.

PubMed

Yu, Zhenming; Zhu, Yongqing; Chen-Plotkin, Alice S; Clay-Falcone, Dana; McCluskey, Leo; Elman, Lauren; Kalb, Robert G; Trojanowski, John Q; Lee, Virginia M-Y; Van Deerlin, Vivianna M; Gitler, Aaron D; Bonini, Nancy M

2011-03-29

Amyotrophic lateral sclerosis (ALS) is a devastating, rapidly progressive disease leading to paralysis and death. Recently, intermediate length polyglutamine (polyQ) repeats of 27-33 in ATAXIN-2 (ATXN2), encoding the ATXN2 protein, were found to increase risk for ALS. In ATXN2, polyQ expansions of ≥ 34, which are pure CAG repeat expansions, cause spinocerebellar ataxia type 2. However, similar length expansions that are interrupted with other codons, can present atypically with parkinsonism, suggesting that configuration of the repeat sequence plays an important role in disease manifestation in ATXN2 polyQ expansion diseases. Here we determined whether the expansions in ATXN2 associated with ALS were pure or interrupted CAG repeats, and defined single nucleotide polymorphisms (SNPs) rs695871 and rs695872 in exon 1 of the gene, to assess haplotype association. We found that the expanded repeat alleles of 40 ALS patients and 9 long-repeat length controls were all interrupted, bearing 1-3 CAA codons within the CAG repeat. 21/21 expanded ALS chromosomes with 3CAA interruptions arose from one haplotype (GT), while 18/19 expanded ALS chromosomes with <3CAA interruptions arose from a different haplotype (CC). Moreover, age of disease onset was significantly earlier in patients bearing 3 interruptions vs fewer, and was distinct between haplotypes. These results indicate that CAG repeat expansions in ATXN2 associated with ALS are uniformly interrupted repeats and that the nature of the repeat sequence and haplotype, as well as length of polyQ repeat, may play a role in the neurological effect conferred by expansions in ATXN2.

Interruptions disrupt reading comprehension.

PubMed

Foroughi, Cyrus K; Werner, Nicole E; Barragán, Daniela; Boehm-Davis, Deborah A

2015-06-01

Previous research suggests that being interrupted while reading a text does not disrupt the later recognition or recall of information from that text. This research is used as support for Ericsson and Kintsch's (1995) long-term working memory (LT-WM) theory, which posits that disruptions while reading (e.g., interruptions) do not impair subsequent text comprehension. However, to fully comprehend a text, individuals may need to do more than recognize or recall information that has been presented in the text at a later time. Reading comprehension often requires individuals to connect and synthesize information across a text (e.g., successfully identifying complex topics such as themes and tones) and not just make a familiarity-based decision (i.e., recognition). The goal for this study was to determine whether interruptions while reading disrupt reading comprehension when the questions assessing comprehension require participants to connect and synthesize information across the passage. In Experiment 1, interruptions disrupted reading comprehension. In Experiment 2, interruptions disrupted reading comprehension but not recognition of information from the text. In Experiment 3, the addition of a 15-s time-out prior to the interruption successfully removed these negative effects. These data suggest that the time it takes to process the information needed to successfully comprehend text when reading is greater than that required for recognition. Any interference (e.g., an interruption) that occurs during the comprehension process may disrupt reading comprehension. This evidence supports the need for transient activation of information in working memory for successful text comprehension and does not support LT-WM theory. (c) 2015 APA, all rights reserved).

77 FR 18229 - Applications for New Awards; Investing in Innovation Fund, Validation Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... the appearance of a conflict of interest. Interrupted time series design \\8\\ means a type of quasi... single case design is an adaptation of an interrupted time series design that relies on the comparison of... notice), interrupted time series designs (as defined in this notice), or regression discontinuity designs...

76 FR 32148 - Applications for New Awards; Investing in Innovation Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

.... Interrupted time series design \\5\\ means a type of quasi- experimental study in which the outcome of interest... interrupted time series design that relies on the comparison of treatment effects on a single subject or group... matched comparison group designs (as defined in this notice), interrupted time series designs (as defined...

77 FR 18216 - Applications for New Awards; Investing in Innovation Fund, Scale-Up Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... evaluation and prevents even the appearance of a conflict of interest. Interrupted time series design \\8... findings. \\8\\ A single subject or single case design is an adaptation of an interrupted time series design... matched comparison group designs (as defined in this notice), interrupted time series designs (as defined...

76 FR 32171 - Applications for New Awards; Investing in Innovation Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... conflict of interest. Interrupted time series design \\5\\ means a type of quasi- experimental study in... single case design is an adaptation of an interrupted time series design that relies on the comparison of...), interrupted time series designs (as defined in this notice), or regression discontinuity designs (as defined...

76 FR 32159 - Applications for New Awards; Investing in Innovation Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... conflict of interest. Interrupted time series design \\5\\ means a type of quasi- experimental study in which... design is an adaptation of an interrupted time series design that relies on the comparison of treatment...), interrupted time series designs (as defined in this notice), or regression discontinuity designs (as defined...

Interruptions and Failure in Higher Education: Evidence from ISEG-UTL

ERIC Educational Resources Information Center

Chagas, Margarida; Fernandaes, Graca Leao

2011-01-01

Failure in higher education (HE) is the outcome of multiple time-dependent determinants. Interruptions in students' individual school trajectories are one of them, and that is why research on this topic has been attracting much attention these days. From an individual point of view, it is expected that interruptions in school trajectory, whatever…

Arterial Cannulation and Cerebral Perfusion Strategies for Aortic Arch Operations.

PubMed

Foley, Lisa S; Yamanaka, Katsuhiro; Reece, T Brett

2016-12-01

Neurologic injuries following aortic arch operations can be devastating, with stroke occurring in up to 12% of elective operations and significant cerebral dysfunction occurring in up to 25% of cases. The primary challenge unique to aortic arch operations involves interruption of direct perfusion of the brachiocephalic vessels during arch reconstruction. For this reason, neuroprotection is paramount. The 2 main modes of protection are (1) reducing metabolic demand through hypothermia and (2) limiting, or even eliminating, the ischemic period. Preoperative selection of the cerebral perfusion plan for each operation is imperative to maintain maximal diffuse cerebral protection and prevent focal neurologic events. © The Author(s) 2016.

HIV models for treatment interruption: Adaptation and comparison

NASA Astrophysics Data System (ADS)

Hillmann, Andreas; Crane, Martin; Ruskin, Heather J.

2017-10-01

In recent years, Antiretroviral Therapy (ART) has become commonplace for treating HIV infections, although a cure remains elusive, given reservoirs of replicating latently-infected cells, which are resistant to normal treatment regimes. Treatment interruptions, whether ad hoc or structured, are known to cause a rapid increase in viral production to detectable levels, but numerous clinical trials remain inconclusive on the dangers inherent in this resurgence. In consequence, interest in examining interruption strategies has recently been rekindled. This overview considers modelling approaches, which have been used to explore the issue of treatment interruption. We highlight their purpose and the formalisms employed and examine ways in which clinical data have been used. Implementation of selected models is demonstrated, illustrative examples provided and model performance compared for these cases. Possible extensions to bottom-up modelling techniques for treatment interruptions are briefly discussed.

Preventing messaging queue deadlocks in a DMA environment

DOEpatents

Blocksome, Michael A; Chen, Dong; Gooding, Thomas; Heidelberger, Philip; Parker, Jeff

2014-01-14

Embodiments of the invention may be used to manage message queues in a parallel computing environment to prevent message queue deadlock. A direct memory access controller of a compute node may determine when a messaging queue is full. In response, the DMA may generate and interrupt. An interrupt handler may stop the DMA and swap all descriptors from the full messaging queue into a larger queue (or enlarge the original queue). The interrupt handler then restarts the DMA. Alternatively, the interrupt handler stops the DMA, allocates a memory block to hold queue data, and then moves descriptors from the full messaging queue into the allocated memory block. The interrupt handler then restarts the DMA. During a normal messaging advance cycle, a messaging manager attempts to inject the descriptors in the memory block into other messaging queues until the descriptors have all been processed.

Physicians interrupted by mobile devices in hospitals: understanding the interaction between devices, roles, and duties.

PubMed

Solvoll, Terje; Scholl, Jeremiah; Hartvigsen, Gunnar

2013-03-07

A common denominator of modern hospitals is a variety of communication problems. In particular, interruptions from mobile communication devices are a cause of great concern for many physicians. To characterize how interruptions from mobile devices disturb physicians in their daily work. The gathered knowledge will be subsequently used as input for the design and development of a context-sensitive communication system for mobile communications suitable for hospitals. This study adheres to an ethnographic and interpretive field research approach. The data gathering consisted of participant observations, non-structured and mostly ad hoc interviews, and open-ended discussions with a selected group of physicians. Eleven physicians were observed for a total of 135 hours during May and June 2009. The study demonstrates to what degree physicians are interrupted by mobile devices in their daily work and in which situations they are interrupted, such as surgery, examinations, and during patients/relatives high-importance level conversations. The participants in the study expected, and also indicated, that wireless phones probably led to more interruptions immediately after their introduction in a clinic, when compared to a pager, but this changed after a short while. The unpleasant feeling experienced by the caller when interrupting someone by calling them differs compared to sending a page message, which leaves it up to the receiver when to return the call. Mobile devices, which frequently interrupt physicians in hospitals, are a problem for both physicians and patients. The results from this study contribute to knowledge being used as input for designing and developing a prototype for a context-sensitive communication system for mobile communication suitable for hospitals. We combined these findings with results from earlier studies and also involved actual users to develop the prototype, CallMeSmart. This system intends to reduce such interruptions and at the same time minimize the number of communication devices needed per user.

Interrupted intracarotid artery cold saline infusion as an alternative method for neuroprotection after ischemic stroke.

PubMed

Ji, Ya-Bin; Wu, Yong-Ming; Ji, Zhong; Song, Wei; Xu, Sui-Yi; Wang, Yao; Pan, Su-Yue

2012-07-01

Intracarotid artery cold saline infusion (ICSI) is an effective method for protecting brain tissue, but its use is limited because of undesirable secondary effects, such as severe decreases in hematocrit levels, as well as its relatively brief duration. In this study, the authors describe and investigate the effects of a novel ICSI pattern (interrupted ICSI) relative to the traditional method (uninterrupted ICSI). Ischemic strokes were induced in 85 male Sprague-Dawley rats by occluding the middle cerebral artery for 3 hours using an intraluminal filament. Uninterrupted infusion groups received an infusion at 15 ml/hour for 30 minutes continuously. The same infusion speed was used in the interrupted infusion groups, but the whole duration was divided into trisections, and there was a 20-minute interval without infusion between sections. Forty-eight hours after reperfusion, H & E and silver nitrate staining were utilized for morphological assessment. Infarct sizes and brain water contents were determined using H & E staining and the dry-wet weight method, respectively. Levels of neuron-specific enolase (NSE), S100β protein, and matrix metalloproteinase 9 (MMP-9) in the serum were determined using enzyme-linked immunosorbent assay. Neurological deficits were also evaluated. Histology showed that interrupted ICSI did not affect neurons or fibers in rat brains, which suggests that this method is safe for brain tissues with ischemia. The duration of hypothermia induced by interrupted ICSI was longer than that induced via the traditional method, and the decrease in hematocrit levels was less pronounced. There were no differences in infarct size or brain water content between uninterrupted and interrupted ICSI groups, but neuron-specific enolase and matrix metalloproteinase 9 serum levels were more reduced after interrupted ICSI than after the traditional method. Interrupted ICSI is a safe method. Compared with traditional ICSI, the interrupted method has a longer duration of hypothermia and less effect on hematocrit and offers more potentially improved neuroprotection, thereby making it more attractive as an infusion technique in the clinic.

Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting.

PubMed

Prakash, Varuna; Koczmara, Christine; Savage, Pamela; Trip, Katherine; Stewart, Janice; McCurdie, Tara; Cafazzo, Joseph A; Trbovich, Patricia

2014-11-01

Nurses are frequently interrupted during medication verification and administration; however, few interventions exist to mitigate resulting errors, and the impact of these interventions on medication safety is poorly understood. The study objectives were to (A) assess the effects of interruptions on medication verification and administration errors, and (B) design and test the effectiveness of targeted interventions at reducing these errors. The study focused on medication verification and administration in an ambulatory chemotherapy setting. A simulation laboratory experiment was conducted to determine interruption-related error rates during specific medication verification and administration tasks. Interventions to reduce these errors were developed through a participatory design process, and their error reduction effectiveness was assessed through a postintervention experiment. Significantly more nurses committed medication errors when interrupted than when uninterrupted. With use of interventions when interrupted, significantly fewer nurses made errors in verifying medication volumes contained in syringes (16/18; 89% preintervention error rate vs 11/19; 58% postintervention error rate; p=0.038; Fisher's exact test) and programmed in ambulatory pumps (17/18; 94% preintervention vs 11/19; 58% postintervention; p=0.012). The rate of error commission significantly decreased with use of interventions when interrupted during intravenous push (16/18; 89% preintervention vs 6/19; 32% postintervention; p=0.017) and pump programming (7/18; 39% preintervention vs 1/19; 5% postintervention; p=0.017). No statistically significant differences were observed for other medication verification tasks. Interruptions can lead to medication verification and administration errors. Interventions were highly effective at reducing unanticipated errors of commission in medication administration tasks, but showed mixed effectiveness at reducing predictable errors of detection in medication verification tasks. These findings can be generalised and adapted to mitigate interruption-related errors in other settings where medication verification and administration are required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting

PubMed Central

Prakash, Varuna; Koczmara, Christine; Savage, Pamela; Trip, Katherine; Stewart, Janice; McCurdie, Tara; Cafazzo, Joseph A; Trbovich, Patricia

2014-01-01

Background Nurses are frequently interrupted during medication verification and administration; however, few interventions exist to mitigate resulting errors, and the impact of these interventions on medication safety is poorly understood. Objective The study objectives were to (A) assess the effects of interruptions on medication verification and administration errors, and (B) design and test the effectiveness of targeted interventions at reducing these errors. Methods The study focused on medication verification and administration in an ambulatory chemotherapy setting. A simulation laboratory experiment was conducted to determine interruption-related error rates during specific medication verification and administration tasks. Interventions to reduce these errors were developed through a participatory design process, and their error reduction effectiveness was assessed through a postintervention experiment. Results Significantly more nurses committed medication errors when interrupted than when uninterrupted. With use of interventions when interrupted, significantly fewer nurses made errors in verifying medication volumes contained in syringes (16/18; 89% preintervention error rate vs 11/19; 58% postintervention error rate; p=0.038; Fisher's exact test) and programmed in ambulatory pumps (17/18; 94% preintervention vs 11/19; 58% postintervention; p=0.012). The rate of error commission significantly decreased with use of interventions when interrupted during intravenous push (16/18; 89% preintervention vs 6/19; 32% postintervention; p=0.017) and pump programming (7/18; 39% preintervention vs 1/19; 5% postintervention; p=0.017). No statistically significant differences were observed for other medication verification tasks. Conclusions Interruptions can lead to medication verification and administration errors. Interventions were highly effective at reducing unanticipated errors of commission in medication administration tasks, but showed mixed effectiveness at reducing predictable errors of detection in medication verification tasks. These findings can be generalised and adapted to mitigate interruption-related errors in other settings where medication verification and administration are required. PMID:24906806

SU-E-T-171: Missing Dose in Integrated EPID Images.

PubMed

King, B; Seymour, E; Nitschke, K

2012-06-01

A dosimetric artifact has been observed with Varian EPIDs in the presence of beam interrupts. This work determines the root cause and significance of this artifact. Integrated mode EPID images were acquired both with and without a manual beam interrupt for rectangular, sliding gap IMRT fields. Simultaneously, the individual frames were captured on a separate computer using a frame-grabber system. Synchronization of the individual frames with the integrated images allowed the determination of precisely how the EPID behaved during regular operation as well as when a beam interrupt was triggered. The ability of the EPID to reliably monitor a treatment in the presence of beam interrupts was tested by comparing the difference between the interrupt and non-interrupt images. The interrupted images acquired in integrated acquisition mode displayed unanticipated behaviour in the region of the image where the leaves were located when the beam interrupt was triggered. Differences greater than 5% were observed as a result of the interrupt in some cases, with the discrepancies occurring in a non-uniform manner across the imager. The differences measured were not repeatable from one measurement to another. Examination of the individual frames showed that the EPID was consistently losing a small amount of dose at the termination of every exposure. Inclusion of one additional frame in every image rectified the unexpected behaviour, reducing the differences to 1% or less. Although integrated EPID images nominally capture the entire dose delivered during an exposure, a small amount of dose is consistently being lost at the end of every exposure. The amount of missing dose is random, depending on the exact beam termination time within a frame. Inclusion of an extra frame at the end of each exposure effectively rectifies the problem, making the EPID more suitable for clinical dosimetry applications. The authors received support from Varian Medical Systems in the form of software and equipment loans as well as technical support. © 2012 American Association of Physicists in Medicine.

Thrombus formation in the interrupted segment of the aorta.

PubMed

Karavelioğlu, Yusuf; Kalçık, Macit; Yetim, Mucahit; Doğan, Tolga; Gölbaşı, Zehra

2017-06-01

Interrupted aorta is a very rare heart defect in which there is a gap between the ascending and the descending thoracic aorta. It is usually associated with other cardiac anomalies, including ventricular septal defect, ductus arteriosus, and truncus arteriosus. Severe cases present with serious complications such as hypertension, heart failure, or intracranial hemorrhage. Neurological complications are very rare form of presentation and commonly associated with intracranial aneurysms. We have reported a case of interrupted aorta who presented with transient ischemic attack due to thrombus formation in the interrupted segment of the aorta. © 2017, Wiley Periodicals, Inc.

Operating characteristics of superconducting fault current limiter using 24kV vacuum interrupter driven by electromagnetic repulsion switch

NASA Astrophysics Data System (ADS)

Endo, M.; Hori, T.; Koyama, K.; Yamaguchi, I.; Arai, K.; Kaiho, K.; Yanabu, S.

2008-02-01

Using a high temperature superconductor, we constructed and tested a model Superconducting Fault Current Limiter (SFCL). SFCL which has a vacuum interrupter with electromagnetic repulsion mechanism. We set out to construct high voltage class SFCL. We produced the electromagnetic repulsion switch equipped with a 24kV vacuum interrupter(VI). There are problems that opening speed becomes late. Because the larger vacuum interrupter the heavier weight of its contact. For this reason, the current which flows in a superconductor may be unable to be interrupted within a half cycles of current. In order to solve this problem, it is necessary to change the design of the coil connected in parallel and to strengthen the electromagnetic repulsion force at the time of opening the vacuum interrupter. Then, the design of the coil was changed, and in order to examine whether the problem is solvable, the current limiting test was conducted. We examined current limiting test using 4 series and 2 parallel-connected YBCO thin films. We used 12-centimeter-long YBCO thin film. The parallel resistance (0.1Ω) is connected with each YBCO thin film. As a result, we succeed in interrupting the current of superconductor within a half cycle of it. Furthermore, series and parallel-connected YBCO thin film could limit without failure.

Program interruptions and short-stay transfers represent potential targets for inpatient rehabilitation care-improvement efforts

PubMed Central

Middleton, Addie; Graham, James E.; Krishnan, Shilpa; Ottenbacher, Kenneth J.

2016-01-01

Objective To present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation following stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Design Retrospective cohort study of Medicare beneficiaries with any of the three conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012 and November 15, 2013. Results In the final sample (stroke: n=71 769; TBI: n=7109; SCI: n=659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI). 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke, 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Conclusions Broad healthcare policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions. PMID:27631389

Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts.

PubMed

Middleton, Addie; Graham, James E; Krishnan, Shilpa; Ottenbacher, Kenneth J

2016-11-01

The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.

Impact of Frequent Interruption on Nurses' Patient-Controlled Analgesia Programming Performance.

PubMed

Campoe, Kristi R; Giuliano, Karen K

2017-12-01

The purpose was to add to the body of knowledge regarding the impact of interruption on acute care nurses' cognitive workload, total task completion times, nurse frustration, and medication administration error while programming a patient-controlled analgesia (PCA) pump. Data support that the severity of medication administration error increases with the number of interruptions, which is especially critical during the administration of high-risk medications. Bar code technology, interruption-free zones, and medication safety vests have been shown to decrease administration-related errors. However, there are few published data regarding the impact of number of interruptions on nurses' clinical performance during PCA programming. Nine acute care nurses completed three PCA pump programming tasks in a simulation laboratory. Programming tasks were completed under three conditions where the number of interruptions varied between two, four, and six. Outcome measures included cognitive workload (six NASA Task Load Index [NASA-TLX] subscales), total task completion time (seconds), nurse frustration (NASA-TLX Subscale 6), and PCA medication administration error (incorrect final programming). Increases in the number of interruptions were associated with significant increases in total task completion time ( p = .003). We also found increases in nurses' cognitive workload, nurse frustration, and PCA pump programming errors, but these increases were not statistically significant. Complex technology use permeates the acute care nursing practice environment. These results add new knowledge on nurses' clinical performance during PCA pump programming and high-risk medication administration.

Perceptual weighting of the envelope and fine structure across frequency bands for sentence intelligibility: Effect of interruption at the syllabic-rate and periodic-rate of speech

PubMed Central

Fogerty, Daniel

2011-01-01

Listeners often only have fragments of speech available to understand the intended message due to competing background noise. In order to maximize successful speech recognition, listeners must allocate their perceptual resources to the most informative acoustic properties. The speech signal contains temporally-varying acoustics in the envelope and fine structure that are present across the frequency spectrum. Understanding how listeners perceptually weigh these acoustic properties in different frequency regions during interrupted speech is essential for the design of assistive listening devices. This study measured the perceptual weighting of young normal-hearing listeners for the envelope and fine structure in each of three frequency bands for interrupted sentence materials. Perceptual weights were obtained during interruption at the syllabic rate (i.e., 4 Hz) and the periodic rate (i.e., 128 Hz) of speech. Potential interruption interactions with fundamental frequency information were investigated by shifting the natural pitch contour higher relative to the interruption rate. The availability of each acoustic property was varied independently by adding noise at different levels. Perceptual weights were determined by correlating a listener’s performance with the availability of each acoustic property on a trial-by-trial basis. Results demonstrated similar relative weights across the interruption conditions, with emphasis on the envelope in high-frequencies. PMID:21786914

Clostridium perfringens: insight into virulence evolution and population structure.

PubMed

Sawires, Youhanna S; Songer, J Glenn

2006-02-01

Clostridium perfringens is an important pathogen in veterinary and medical fields. Diseases caused by this organism are in many cases life threatening or fatal. At the same time, it is part of the ecological community of the intestinal tract of man and animals. Virulence in this species is not fully understood and it does seem that there is erratic distribution of the toxin/enzyme genes within C. perfringens population. We used the recently developed multiple-locus variable-number tandem repeat analysis (MLVA) scheme to investigate the evolution of virulence and population structure of this species. Analysis of the phylogenetic signal indicates that acquisition of the major toxin genes as well as other plasmid-borne toxin genes is a recent evolutionary event and their maintenance is essentially a function of the selective advantage they confer in certain niches under different conditions. In addition, it indicates the ability of virulent strains to cause disease in different host species. More interestingly, there is evidence that certain normal flora strains are virulent when they gain access to a different host species. Analysis of the population structure indicates that recombination events are the major tool that shapes the population and this panmixia is interrupted by frequent clonal expansion that mostly corresponds to disease processes. The signature of positive selection was detected in alpha toxin gene, suggesting the possibility of adaptive alleles on the other chromosomally encoded determinants. Finally, C. perfringens proved to have a dynamic population and availability of more genome sequences and use of comparative proteomics and animal modeling would provide more insight into the virulence of this organism.

Causal Inference and the Comparative Interrupted Time Series Design: Findings from Within-Study Comparisons

ERIC Educational Resources Information Center

St. Clair, Travis; Hallberg, Kelly; Cook, Thomas D.

2014-01-01

Researchers are increasingly using comparative interrupted time series (CITS) designs to estimate the effects of programs and policies when randomized controlled trials are not feasible. In a simple interrupted time series design, researchers compare the pre-treatment values of a treatment group time series to post-treatment values in order to…

78 FR 65904 - Permanent Discontinuance or Interruption in Manufacturing of Certain Drug or Biological Products

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... in the manufacture of the drug or an interruption in the manufacturing of the drug that is likely to... Manufacturing of Certain Drug or Biological Products AGENCY: Food and Drug Administration, HHS. ACTION: Proposed... permanent discontinuance or an interruption in manufacturing of the product that is likely to lead to a...

77 FR 11087 - Applications for New Awards; Investing in Innovation Fund, Development Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

... prevents even the appearance of a conflict of interest. Interrupted time series design \\8\\ means a type of.... \\8\\ A single subject or single case design is an adaptation of an interrupted time series design that... matched comparison group designs (as defined in this notice), interrupted time series designs (as defined...

75 FR 12072 - Office of Innovation and Improvement; Overview Information: Investing in Innovation Fund; Notice...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... matched comparison group designs (as defined in this notice), interrupted time series designs (as defined... reading skills administered in the same way to both groups). Interrupted time series design \\3\\ means a... findings. \\3\\ A single subject or single case design is an adaptation of an interrupted time series design...

76 FR 41491 - Applications for New Awards; Arts in Education National Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

... the arts as a core academic subject in the school curriculum. Interrupted time series design means a... interrupted time series design that relies on the comparison of treatment effects on a single subject or group.... That is, the series should show an ``interruption'' of the prior situation at the time when the program...

Pardon Me, Can I Talk Now?: A Look at the Roles of Interruptions in Conversation.

ERIC Educational Resources Information Center

Ringer, R. Jeffrey

Several theories exist to explain the differences in the interruptive behavior of men and women. Early research suggested that men interrupt more than women, and this finding was attributed to the dominant/submissive relationship traditional in relationships among men and women. Later studies, however, found that either there were no significant…

30 Do nice guys finish last?

PubMed

Turner, Chris; Turner, Jake

2017-12-01

: Emergency medicine is widely recognised as an intense specialty. Interruptions are known to derail thoughts, increasing cognitive load and result in longer periods before deep thought is re-established. Although approachability and warmth are regarded as important factors in clinicians we wondered what impact these characteristics had on the number of interruptions. A team of 6 medical students were trained in the use of abespoke tool to record shop floor activities. Over 4 months we conducted 100 hours of minute by minute time and motion study of emergency medicine consultants during their clinical shifts, and noted how often they were interrupted. At the end of shifts the assessors were asked a set of qualitative questions on the behaviour and attitudes of the consultants. These questions were completed in seclusion and in an anonymous format, to minimise the chance of bias/influence. QUESTIONS INCLUDED: 'How friendly was the consultant with other staff?' 'How friendly was this consultant with patients?' And, 'How would you rate this consultant's 'general positivity'?'We then assessed whether consultants that scored 'higher' inthese areas were more likely to be interrupted. Our hypothesis was that consultants who were more friendly were less intimidating for juniors and nurses to approach with questions, and so may suffer from an increase in cognitive load due to being interrupted and questioned more frequently than consultants who were felt to be less approachable.We found that consultants who scored 1(highest) in friendliness had an average of 7.38 interruptions per hour, compared to consultants who scored 3 or greater, who had an average of 3.59. Our average interruptions were close to those found in previous publications (between 6 and 9 interruptions per hour), however there was a large amount of inter-consultant variability, with one consultant during one shift being interrupted over 12 times per hour on average. If the results of this study are replicable, then it may raise questions about how best to manage this extra cognitive load. Although some may argue that being seen as slightly less friendly has an advantage in the reduction of interruptions, this may come at a cost to patient safety. There is clearly a fine balance to be made.emermed;34/12/A879-c/F1F1F1Figure 1Average interruptions per hour by friendliness score. © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cyclic fatigue resistance of two nickel-titanium rotary instruments in interrupted rotation.

PubMed

Pedullà, E; Lizio, A; Scibilia, M; Grande, N M; Plotino, G; Boninelli, S; Rapisarda, E; Lo Giudice, G

2017-02-01

To investigate the influence of interrupted rotation on cyclic fatigue of two nickel-titanium rotary instruments. Cyclic fatigue of 300 new ProTaper Next size X1; X2 and Mtwo size 10, .04 taper; size 15, .05 taper; size 20, .06 taper and size 25, .06 taper instruments was tested in continuous or interrupted rotation. Fifty files of the same brand and size were randomly assigned to five groups (n = 10). Group 1 instruments were tested in continuous rotation; groups 2 and 3 in paused rotation for 1 s every 10 or 20 s, respectively; groups 4 and 5 in interrupted rotation for 5 s every 10 or 20 s, respectively. Cyclic fatigue was expressed in time to fracture (TtF) in an artificial canal with 60° angle and 5 mm radius of curvature. The fracture surface was examined with a scanning electron microscope (SEM). Data were evaluated by two-way analysis of variance. Cyclic fatigue of groups 2 and 4 of ProTaper Next X2 and Mtwo size 25, .06 taper was significantly lower than that of group 1 of the same instruments (P < 0.01). ProTaper Next X2 had significantly reduced cyclic fatigue in groups 3 and 5 (P < 0.05). No differences were found by interrupting the rotation for 1 or 5 s in all instruments (P > 0.05). Fatigue of other instruments was not affected by interrupted rotation (P > 0.05). Interrupted rotation reduced cyclic fatigue resistance of ProTaper Next X2 and Mtwo size 25, .06 taper, especially when a higher number of interruptions was performed. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Increased soluble vascular cell adhesion molecule-1 plasma levels and soluble intercellular adhesion molecule-1 during antiretroviral therapy interruption and retention of elevated soluble vascular cellular adhesion molecule-1 levels following resumption of antiretroviral therapy.

PubMed

Papasavvas, Emmanouil; Azzoni, Livio; Pistilli, Maxwell; Hancock, Aidan; Reynolds, Griffin; Gallo, Cecile; Ondercin, Joe; Kostman, Jay R; Mounzer, Karam; Shull, Jane; Montaner, Luis J

2008-06-19

We investigated the effect of short viremic episodes on soluble markers associated with endothelial stress and cardiovascular disease risk in chronically HIV-1-infected patients followed during continuous antiretroviral therapy, antiretroviral therapy interruption and antiretroviral therapy resumption. We assessed changes in plasma levels of von Willebrand factor, soluble vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 by enzyme-linked immunosorbent assay, as well as T-cell activation (CD8+/CD38+, CD8+/HLA-DR+ and CD3+/CD95+) by flow cytometry, in 36 chronically HIV-1-infected patients participating in a randomized study. Patients were divided into the following three groups: a, on continuous antiretroviral therapy; b, on a 6-week antiretroviral therapy interruption; or c, on antiretroviral therapy interruption extended to the achievement of viral set point. Although all measurements remained stable over a 40-week follow-up on antiretroviral therapy, plasma levels of soluble vascular cell adhesion molecule-1 (P < 0.0001) and soluble intercellular adhesion molecule-1 (P = 0.003) increased during treatment interruption in correlation with viral rebound and T-cell activation. No significant changes in von Willebrand factor were observed in any of the groups. After resuming antiretroviral therapy, soluble vascular cell adhesion molecule-1 levels remained elevated even after achievement of viral suppression to less than 50 copies/ml. The prompt rise in plasma soluble vascular cell adhesion molecule-1 and soluble intercellular adhesion molecule-1 upon viral rebound suggests an acute increase in endothelial stress upon treatment interruption, which may persists after viral resuppression of virus. Thus, viral replication during short-term treatment interruption may increase the overall cardiovascular risk during and beyond treatment interruption.

Monitoring As A Helpful Means In Forensic Analysis Of Dams Static Instability Events

NASA Astrophysics Data System (ADS)

Solimene, Pellegrino

2013-04-01

Monitoring is a means of controlling the behavior of a structure, which during its operational life is subject to external actions as ordinary loading conditions and disturbing ones; these factors overlap with the random manner defined by the statistical parameter of the return period. The analysis of the monitoring data is crucial to gain a reasoned opinion on the reliability of the structure and its components, and also allows to identify, in the overall operational scenario, the time when preparing interventions aimed at maintaining the optimum levels of functionality and safety. The concept of monitoring in terms of prevention is coupled with the activity of Forensic Engineer who, by Judiciary appointment for the occurrence of an accident, turns its experience -the "Scientific knowledge"- in an "inverse analysis" in which he summed up the results of a survey, which also draws on data sets arising in the course of the constant control of the causes and effects, so to determine the correlations between these factors. His activity aims at giving a contribution to the identification of the typicality of an event, which represents, together with "causal link" between the conduct and events and contra-juridical, the factors judging if there an hypothesis of crime, and therefore liable according to law. In Italy there are about 10,000 dams of varying sizes, but only a small portion of them are considered "large dams" and subjected to a rigorous program of regular inspections and monitoring, in application of specific rules. The rest -"small" dams, conventionally defined as such by the standard, but not for the impact on the area- is affected by a heterogeneous response from the local authorities entrusted with this task: there is therefore a high potential risk scenario, as determined by the presence of not completely controlled structures that insist even on areas heavily populated. Risk can be traced back to acceptable levels if they were implemented with the necessary uniformity of procedures usually adopted for major works, and, therefore, is intended to emphasize the importance to have a more complete cognitive picture of the issues affecting the dams, especially so-called "minor" and their relationship with the embedding territory. This contribution consists of a brief digression on dams, their characteristics, functions performed by them and their relationship with the territory in terms of risk and benefit. After, it is discussed the concept of risk factors that characterize the importance of monitoring extended to the crisis management with a focus to the fast verification of structural reliability after a crisis event. A case study of the vulnerability of a dam under seismic action by "Event tree analysis" is presented, based on data acquired in the course of constant surveillance and control. Some considerations about the monitoring actions related specifically to earthquakes and weather events are presented in order to emphasize its function with regard to risk mitigation through early warning procedures. Finally, the results of a survey on the main accidents involving Italian and USA dams are presented even as a factor pushing to improve the national regulatory framework . Finally, we will discuss some anomalies in the regional rules, leading to interruption in the technical management of the dams by the Public Authority, holding the function of supervision and control over these works and the role of reference for the management of flood mitigation for the hydraulic system. Several hints are provided to contribute towards overcoming the problems that emerged, necessary and urgent to provide answer to the question of security of civil society.

Mental health impacts of flooding: a controlled interrupted time series analysis of prescribing data in England

PubMed Central

Milojevic, Ai; Armstrong, Ben; Wilkinson, Paul

2017-01-01

Background There is emerging evidence that people affected by flooding suffer adverse impacts on their mental well-being, mostly based on self-reports. Methods We examined prescription records for drugs used in the management of common mental disorder among primary care practices located in the vicinity of recent large flood events in England, 2011–2014. A controlled interrupted time series analysis was conducted of the number of prescribing items for antidepressant drugs in the year before and after the flood onset. Pre–post changes were compared by distance of the practice from the inundated boundaries among 930 practices located within 10 km of a flood. Results After control for deprivation and population density, there was an increase of 0.59% (95% CI 0.24 to 0.94) prescriptions in the postflood year among practices located within 1 km of a flood over and above the change observed in the furthest distance band. The increase was greater in more deprived areas. Conclusions This study suggests an increase in prescribed antidepressant drugs in the year after flooding in primary care practices close to recent major floods in England. The degree to which the increase is actually concentrated in those flooded can only be determined by more detailed linkage studies. PMID:28860201

Inhibition of single Shaker K channels by kappa-conotoxin-PVIIA.

PubMed Central

Naranjo, David

2002-01-01

kappa-Conotoxin-PVIIA (kappa-PVIIA) is a 27-residue basic (+4) peptide from the venom of the predator snail Conus purpurascens. A single kappa-PVIIA molecule interrupts ion conduction by binding to the external mouth of Shaker K channels. The blockade of Shaker by kappa-PVIIA was studied at the single channel level in membrane patches from Xenopus oocytes. The amplitudes of blocked and closed events were undistinguishable, suggesting that the toxin interrupts ion conduction completely. Between -20 and 40 mV kappa-PVIIA increased the latency to the first opening by one order of magnitude in a concentration-independent fashion. Because kappa-PVIIA has higher affinity for the closed channels at high enough concentration to block >90% of the resting channels, the dissociation rate could be estimated from the analysis of the first latency. At 0 mV, the dissociation rate was 20 s(-1) and had an effective valence of 0.64. The apparent closing rate increased linearly with [kappa-PVIIA] indicating an association rate of 56 microM(-1) s(-1). The toxin did not modify the fraction of null traces. This result suggests that the structural rearrangements in the external mouth contributing to the slow inactivation preserve the main geometrical features of the toxin-receptor interaction. PMID:12023223

Respiratory sound recordings for detection of sleep apnea

NASA Astrophysics Data System (ADS)

Waldemark, Karina E.; Agehed, Kenneth I.; Lindblad, Thomas

1999-03-01

Sleep apnea is characterized by frequent prolonged interruptions of breathing during sleep. This syndrome causes severe sleep disorders and is often responsible for development of other diseases such as heart problems, high blood pressure and daytime fatigue, etc. After diagnosis, sleep apnea is often successfully treated by applying positive air pressure (CPAP) to the mouth and nose. Although effective, the (CPAP) equipment takes up a lot of space and the connected mask causes a lot of inconvenience for the patients. This raised interest in developing new techniques for treatment of sleep apnea syndrome. Several studies indicated that electrical stimulation of the hypoglossal nerve and muscle in the tongue may be a useful method for treating patients with severe sleep apnea. In order to be able to successfully prevent the occurrence of apnea it is necessary to have some technique for early and fast on-line detection or prediction of the apnea events. This paper suggests using measurements of respiratory airflow (mouth temperature). The signal processing for this task includes the use of a window short-FFT technique and uses an artificial back propagation neural net to model or predict the occurrence of apneas. The results show that early detection of respiratory interruption is possible and that the delay time for this is small.

Detection of apnea using a short-window FFT technique and an artificial neural network

NASA Astrophysics Data System (ADS)

Waldemark, Karina E.; Agehed, Kenneth I.; Lindblad, Thomas; Waldemark, Joakim T. A.

1998-03-01

Sleep apnea is characterized by frequent prolonged interruptions of breathing during sleep. This syndrome causes severe sleep disorders and is often responsible for development of other diseases such as heart problems, high blood pressure and daytime fatigue, etc. After diagnosis, sleep apnea is often successfully treated by applying positive air pressure (CPAP) to the mouth and nose. Although effective, the (CPAP) equipment takes up a lot of space and the connected mask causes a lot of inconvenience for the patients. This raised interest in developing new techniques for treatment of sleep apnea syndrome. Several studies have indicated that electrical stimulation of the hypoglossal nerve and muscle in the tongue may be a useful method for treating patients with severe sleep apnea. In order to be able to successfully prevent the occurrence of apnea it is necessary to have some technique for early and fast on-line detection or prediction of the apnea events. This paper suggests using measurements of respiratory airflow (mouth temperature). The signal processing for this task includes the use of a short window FFT technique and uses an artificial back propagation neural net to model or predict the occurrence of apneas. The results show that early detection of respiratory interruption is possible and that the delay time for this is small.

Multidisciplinary distinction of mass-movement and flood-induced deposits in lacustrine environments: implications for Holocene palaeohydrology and natural hazards (Lake Ledro, Southern Alps, Italy)

NASA Astrophysics Data System (ADS)

Simonneau, A.; Chapron, E.; Vannière, B.; Wirth, S. B.; Gilli, A.; Di Giovanni, C.; Anselmetti, F. S.; Desmet, M.; Magny, M.

2012-08-01

High-resolution seismic profiles and sediment cores from Lake Ledro combined with soil and river-bed samples from the lake's catchment area are used to assess the recurrence of natural hazards (earthquakes and flood events) in the southern Italian Alps during the Holocene. Two well-developed deltas and a flat central basin are identified on seismic profiles in Lake Ledro. Lake sediments are finely laminated in the basin since 9000 cal. yr BP and frequently interrupted by two types of sedimentary events: light-coloured massive layers and dark-coloured graded beds. Optical analysis (quantitative organic petrography) of the organic matter occurring in soils, river beds and lacustrine samples together with lake-sediment bulk density and grain-size analysis illustrate that light-coloured layers consist of a mixture of lacustrine sediments and mainly contain algal particles similar to the ones observed in background sediments. Light-coloured layers thicker than 1.5 cm in the main basin of Lake Ledro are dense and synchronous to numerous coeval mass-wasting deposits remoulding the slopes of the basin. They are interpreted as subaquatic mass movements triggered by historical and pre-historical regional earthquakes dated to 2005 AD, 1891 AD, 1045 AD and 1260, 2545, 2595, 3350, 3815, 4740, 7190, 9185 and 11495 cal. yr BP. Dark-coloured sedimentary event are dense and develop high-amplitude reflections in front of the deltas and in the deep central basin. These beds are mainly made of terrestrial organic matter (soils and ligno-cellulosic debris) and are interpreted as resulting from intense hyperpycnal flood events. Mapping and quantifying the amount of soil material accumulated in the Holocene hyperpycnal flood deposits of the sequence and applying the De Ploey erosion model allow estimating that the equivalent soil thickness eroded over the catchment area reached up to 4 mm during the largest Holocene flood events. Such significant soil erosion is interpreted as resulting from the combination of heavy rainfall and snowmelt. The recurrence of flash-flood events during the Holocene was however not high enough to affect pedogenesis processes and highlight several wet regional periods during the Holocene. The Holocene period is divided into four phases of environmental evolution. Over the first half of the Holocene, a progressive stabilization of the soils present through the catchment of Lake Ledro was associated with a progressive reforestation of the area and only interrupted during the wetter 8.2 event when the soil destabilization was particularly important. Lower soil erosion was recorded during the Mid-Holocene climatic optimum (8000-4200 cal. yr BP) and associated with higher algal production. Between 4200 and 3100 cal. yr BP, both wetter climate and human activities within the drainage basin drastically increased soil erosion rates. Finally, from 3100 cal. yr BP to the present-day, results suggest increasing and changing human land-use.

The cAMP Pathway as Therapeutic Target in Autoimmune and Inflammatory Diseases

PubMed Central

Raker, Verena Katharina; Becker, Christian; Steinbrink, Kerstin

2016-01-01

Nucleotide signaling molecules contribute to the regulation of cellular pathways. In the immune system, cyclic adenosine monophosphate (cAMP) is well established as a potent regulator of innate and adaptive immune cell functions. Therapeutic strategies to interrupt or enhance cAMP generation or effects have immunoregulatory potential in autoimmune and inflammatory disorders. Here, we provide an overview of the cyclic AMP axis and its role as a regulator of immune functions and discuss the clinical and translational relevance of interventions with these processes. PMID:27065076

Practice increases procedural errors after task interruption.

PubMed

Altmann, Erik M; Hambrick, David Z

2017-05-01

Positive effects of practice are ubiquitous in human performance, but a finding from memory research suggests that negative effects are possible also. The finding is that memory for items on a list depends on the time interval between item presentations. This finding predicts a negative effect of practice on procedural performance under conditions of task interruption. As steps of a procedure are performed more quickly, memory for past performance should become less accurate, increasing the rate of skipped or repeated steps after an interruption. We found this effect, with practice generally improving speed and accuracy, but impairing accuracy after interruptions. The results show that positive effects of practice can interact with architectural constraints on episodic memory to have negative effects on performance. In practical terms, the results suggest that practice can be a risk factor for procedural errors in task environments with a high incidence of task interruption. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Increasing available FIFO space to prevent messaging queue deadlocks in a DMA environment

DOEpatents

Blocksome, Michael A [Rochester, MN; Chen, Dong [Croton On Hudson, NY; Gooding, Thomas [Rochester, MN; Heidelberger, Philip [Cortlandt Manor, NY; Parker, Jeff [Rochester, MN

2012-02-07

Embodiments of the invention may be used to manage message queues in a parallel computing environment to prevent message queue deadlock. A direct memory access controller of a compute node may determine when a messaging queue is full. In response, the DMA may generate an interrupt. An interrupt handler may stop the DMA and swap all descriptors from the full messaging queue into a larger queue (or enlarge the original queue). The interrupt handler then restarts the DMA. Alternatively, the interrupt handler stops the DMA, allocates a memory block to hold queue data, and then moves descriptors from the full messaging queue into the allocated memory block. The interrupt handler then restarts the DMA. During a normal messaging advance cycle, a messaging manager attempts to inject the descriptors in the memory block into other messaging queues until the descriptors have all been processed.

Nested Interrupt Analysis of Low Cost and High Performance Embedded Systems Using GSPN Framework

NASA Astrophysics Data System (ADS)

Lin, Cheng-Min

Interrupt service routines are a key technology for embedded systems. In this paper, we introduce the standard approach for using Generalized Stochastic Petri Nets (GSPNs) as a high-level model for generating CTMC Continuous-Time Markov Chains (CTMCs) and then use Markov Reward Models (MRMs) to compute the performance for embedded systems. This framework is employed to analyze two embedded controllers with low cost and high performance, ARM7 and Cortex-M3. Cortex-M3 is designed with a tail-chaining mechanism to improve the performance of ARM7 when a nested interrupt occurs on an embedded controller. The Platform Independent Petri net Editor 2 (PIPE2) tool is used to model and evaluate the controllers in terms of power consumption and interrupt overhead performance. Using numerical results, in spite of the power consumption or interrupt overhead, Cortex-M3 performs better than ARM7.

A time-varying subjective quality model for mobile streaming videos with stalling events

NASA Astrophysics Data System (ADS)

Ghadiyaram, Deepti; Pan, Janice; Bovik, Alan C.

2015-09-01

Over-the-top mobile video streaming is invariably influenced by volatile network conditions which cause playback interruptions (stalling events), thereby impairing users' quality of experience (QoE). Developing models that can accurately predict users' QoE could enable the more efficient design of quality-control protocols for video streaming networks that reduce network operational costs while still delivering high-quality video content to the customers. Existing objective models that predict QoE are based on global video features, such as the number of stall events and their lengths, and are trained and validated on a small pool of ad hoc video datasets, most of which are not publicly available. The model we propose in this work goes beyond previous models as it also accounts for the fundamental effect that a viewer's recent level of satisfaction or dissatisfaction has on their overall viewing experience. In other words, the proposed model accounts for and adapts to the recency, or hysteresis effect caused by a stall event in addition to accounting for the lengths, frequency of occurrence, and the positions of stall events - factors that interact in a complex way to affect a user's QoE. On the recently introduced LIVE-Avvasi Mobile Video Database, which consists of 180 distorted videos of varied content that are afflicted solely with over 25 unique realistic stalling events, we trained and validated our model to accurately predict the QoE, attaining standout QoE prediction performance.

Evaluating the Performance of the IEEE Standard 1366 Method for Identifying Major Event Days

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

Eto, Joseph H.; LaCommare, Kristina Hamachi; Sohn, Michael D.

IEEE Standard 1366 offers a method for segmenting reliability performance data to isolate the effects of major events from the underlying year-to-year trends in reliability. Recent analysis by the IEEE Distribution Reliability Working Group (DRWG) has found that reliability performance of some utilities differs from the expectations that helped guide the development of the Standard 1366 method. This paper proposes quantitative metrics to evaluate the performance of the Standard 1366 method in identifying major events and in reducing year-to-year variability in utility reliability. The metrics are applied to a large sample of utility-reported reliability data to assess performance of themore » method with alternative specifications that have been considered by the DRWG. We find that none of the alternatives perform uniformly 'better' than the current Standard 1366 method. That is, none of the modifications uniformly lowers the year-to-year variability in System Average Interruption Duration Index without major events. Instead, for any given alternative, while it may lower the value of this metric for some utilities, it also increases it for other utilities (sometimes dramatically). Thus, we illustrate some of the trade-offs that must be considered in using the Standard 1366 method and highlight the usefulness of the metrics we have proposed in conducting these evaluations.« less

Adding Design Elements to Improve Time Series Designs: No Child Left behind as an Example of Causal Pattern-Matching

ERIC Educational Resources Information Center

Wong, Manyee; Cook, Thomas D.; Steiner, Peter M.

2015-01-01

Some form of a short interrupted time series (ITS) is often used to evaluate state and national programs. An ITS design with a single treatment group assumes that the pretest functional form can be validly estimated and extrapolated into the postintervention period where it provides a valid counterfactual. This assumption is problematic. Ambiguous…

Mathematical modeling of inhalation exposure

NASA Technical Reports Server (NTRS)

Fiserova-Bergerova, V.

1976-01-01

The paper presents a mathematical model of inhalation exposure in which uptake, distribution and excretion are described by exponential functions, while rate constants are determined by tissue volumes, blood perfusion and by the solubility of vapors (partition coefficients). In the model, tissues are grouped into four pharmokinetic compartments. The model is used to study continuous and interrupted chronic exposures and is applied to the inhalation of Forane and methylene chloride.

Properties of Traffic Risk Coefficient

NASA Astrophysics Data System (ADS)

Tang, Tie-Qiao; Huang, Hai-Jun; Shang, Hua-Yan; Xue, Yu

2009-10-01

We use the model with the consideration of the traffic interruption probability (Physica A 387(2008)6845) to study the relationship between the traffic risk coefficient and the traffic interruption probability. The analytical and numerical results show that the traffic interruption probability will reduce the traffic risk coefficient and that the reduction is related to the density, which shows that this model can improve traffic security.

Protective Factors Interrupting the Continuity from School Bullying to Later Internalizing and Externalizing Problems: A Systematic Review of Prospective Longitudinal Studies

ERIC Educational Resources Information Center

Ttofi, Maria M.; Bowes, Lucy; Farrington, David P.; Lösel, Friedrich

2014-01-01

A systematic review is presented, based on prospective longitudinal studies, on protective factors that interrupt the continuity from bullying perpetration at school to externalizing problem behaviors later in life; and from bullying victimization to later internalizing problems. Some common factors were established, which seem to interrupt the…

41 CFR 301-70.501 - Does per diem continue when an employee interrupts a travel assignment because of an...

Code of Federal Regulations, 2011 CFR

2011-07-01

... when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70... Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury § 301-70.501 Does per diem continue when an employee interrupts a travel assignment because of an incapacitating illness or...

41 CFR 301-70.501 - Does per diem continue when an employee interrupts a travel assignment because of an...

Code of Federal Regulations, 2013 CFR

2013-07-01

... when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70... Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury § 301-70.501 Does per diem continue when an employee interrupts a travel assignment because of an incapacitating illness or...

41 CFR 301-70.501 - Does per diem continue when an employee interrupts a travel assignment because of an...

Code of Federal Regulations, 2012 CFR

2012-07-01

... when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70... Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury § 301-70.501 Does per diem continue when an employee interrupts a travel assignment because of an incapacitating illness or...

41 CFR 301-70.501 - Does per diem continue when an employee interrupts a travel assignment because of an...

Code of Federal Regulations, 2014 CFR

2014-07-01

... when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70... Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury § 301-70.501 Does per diem continue when an employee interrupts a travel assignment because of an incapacitating illness or...

41 CFR 301-70.501 - Does per diem continue when an employee interrupts a travel assignment because of an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70... Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury § 301-70.501 Does per diem continue when an employee interrupts a travel assignment because of an incapacitating illness or...

Algorithm Design of CPCI Backboard's Interrupts Management Based on VxWorks' Multi-Tasks

NASA Astrophysics Data System (ADS)

Cheng, Jingyuan; An, Qi; Yang, Junfeng

2006-09-01

This paper begins with a brief introduction of the embedded real-time operating system VxWorks and CompactPCI standard, then gives the programming interfaces of Peripheral Controller Interface (PCI) configuring, interrupts handling and multi-tasks programming interface under VxWorks, and then emphasis is placed on the software frameworks of CPCI interrupt management based on multi-tasks. This method is sound in design and easy to adapt, ensures that all possible interrupts are handled in time, which makes it suitable for data acquisition systems with multi-channels, a high data rate, and hard real-time high energy physics.

Asymptomatic Interrupted Aortic Arch, Severe Tricuspid Regurgitation, and Bicuspid Aortic Valve in a 76-Year-Old Woman.

PubMed

Tajdini, Masih; Sardari, Akram; Forouzannia, Seyed Khalil; Baradaran, Abdolvahab; Hosseini, Seyed Mohammad Reza; Kassaian, Seyed Ebrahim

2016-10-01

Interrupted aortic arch is a rare congenital abnormality with a high infancy mortality rate. The principal finding is loss of luminal continuity between the ascending and descending portions of the aorta. Because of the high mortality rate in infancy, interrupted aortic arch is very rare among adults. In this report, we describe the case of a 76-year-old woman with asymptomatic interrupted aortic arch, severe tricuspid regurgitation, and bicuspid aortic valve. To our knowledge, she is the oldest patient ever reported with this possibly unique combination of pathologic conditions. In addition to reporting her case, we review the relevant medical literature.

When daily planning improves employee performance: The importance of planning type, engagement, and interruptions.

PubMed

Parke, Michael R; Weinhardt, Justin M; Brodsky, Andrew; Tangirala, Subrahmaniam; DeVoe, Sanford E

2018-03-01

Does planning for a particular workday help employees perform better than on other days they fail to plan? We investigate this question by identifying 2 distinct types of daily work planning to explain why and when planning improves employees' daily performance. The first type is time management planning (TMP)-creating task lists, prioritizing tasks, and determining how and when to perform them. We propose that TMP enhances employees' performance by increasing their work engagement, but that these positive effects are weakened when employees face many interruptions in their day. The second type is contingent planning (CP) in which employees anticipate possible interruptions in their work and plan for them. We propose that CP helps employees stay engaged and perform well despite frequent interruptions. We investigate these hypotheses using a 2-week experience-sampling study. Our findings indicate that TMP's positive effects are conditioned upon the amount of interruptions, but CP has positive effects that are not influenced by the level of interruptions. Through this study, we help inform workers of the different planning methods they can use to increase their daily motivation and performance in dynamic work environments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Prediction of SFL Interruption Performance from the Results of Arc Simulation during High-Current Phase

NASA Astrophysics Data System (ADS)

Lee, Jong-Chul; Lee, Won-Ho; Kim, Woun-Jea

2015-09-01

The design and development procedures of SF6 gas circuit breakers are still largely based on trial and error through testing although the development costs go higher every year. The computation cannot cover the testing satisfactorily because all the real processes arc not taken into account. But the knowledge of the arc behavior and the prediction of the thermal-flow inside the interrupters by numerical simulations are more useful than those by experiments due to the difficulties to obtain physical quantities experimentally and the reduction of computational costs in recent years. In this paper, in order to get further information into the interruption process of a SF6 self-blast interrupter, which is based on a combination of thermal expansion and the arc rotation principle, gas flow simulations with a CFD-arc modeling are performed during the whole switching process such as high-current period, pre-current zero period, and current-zero period. Through the complete work, the pressure-rise and the ramp of the pressure inside the chamber before current zero as well as the post-arc current after current zero should be a good criterion to predict the short-line fault interruption performance of interrupters.

An evaluation of interrupted and uninterrupted measurement of vocal stereotypy on perceived treatment outcomes.

PubMed

Carroll, Regina A; Kodak, Tiffany

2014-01-01

The type of procedure used to measure a target behavior may directly influence the perceived treatment outcomes. In the present study, we examined the influence of different data-analysis procedures on the outcomes of two commonly used treatments on the vocal stereotypy of 2 children with an autism spectrum disorder. In Study 1, we compared an interrupted and uninterrupted data-analysis procedure to measure vocal stereotypy during the implementation of response interruption and redirection (RIRD). The results showed that the interrupted data-analysis procedure overestimated the effectiveness of RIRD. In Study 2, we examined the influence of different data-analysis procedures on the interpretation of the relative effects of 2 different treatments for vocal stereotypy. Specifically, we compared interrupted and uninterrupted data-analysis procedures during the implementation of RIRD and noncontingent reinforcement (NCR) as a treatment for vocal stereotypy. The results showed that, as in Study 1, the interrupted data-analysis procedure overestimated the effectiveness of RIRD; however, this effect was not apparent with NCR. These findings suggest that different types of data analysis can influence the perceived success of a treatment. © Society for the Experimental Analysis of Behavior.

The mythology of anticoagulation therapy interruption for dental surgery.

PubMed

Wahl, Michael J

2018-01-01

Continuous anticoagulation therapy is used to prevent heart attacks, strokes, and other embolic complications. When patients receiving anticoagulation therapy undergo dental surgery, a decision must be made about whether to continue anticoagulation therapy and risk bleeding complications or briefly interrupt anticoagulation therapy and increase the risk of developing embolic complications. Results from decades of studies of thousands of dental patients receiving anticoagulation therapy reveal that bleeding complications requiring more than local measures for hemostasis have been rare and never fatal. However, embolic complications (some of which were fatal and others possibly permanently debilitating) sometimes have occurred in patients whose anticoagulation therapy was interrupted for dental procedures. Although there is now virtually universal consensus among national medical and dental groups and other experts that anticoagulation therapy should not be interrupted for most dental surgery, there are still some arguments made supporting anticoagulation therapy interruption. An analysis of these arguments shows them to be based on a collection of myths and half-truths rather than on logical scientific conclusions. The time has come to stop anticoagulation therapy interruption for dental procedures. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

Investigating lexical competition and the cost of phonemic restoration.

PubMed

Balling, Laura Winther; Morris, David Jackson; Tøndering, John

2017-12-01

Due to phonemic restoration, listeners can reliably perceive words when a phoneme is replaced with noise. The cost associated with this process was investigated along with the effect of lexical uniqueness on phonemic restoration, using data from a lexical decision experiment where noise replaced phonemes that were either uniqueness points (the phoneme at which a word deviates from all nonrelated words that share the same onset) or phonemes immediately prior to these. A baseline condition was also included with no noise-interrupted stimuli. Results showed a significant cost of phonemic restoration, with 100 ms longer word identification times and a 14% decrease in word identification accuracy for interrupted stimuli compared to the baseline. Regression analysis of response times from the interrupted conditions showed no effect of whether the interrupted phoneme was a uniqueness point, but significant effects for several temporal attributes of the stimuli, including the duration and position of the interrupted segment. These results indicate that uniqueness points are not distinct breakpoints in the cohort reduction that occurs during lexical processing, but that temporal properties of the interrupted stimuli are central to auditory word recognition. These results are interpreted in the context of models of speech perception.

[Deliberate interruptions and changes of dose of inhaled corticosteroids by asthma patients: "a community pharmacy study"].

PubMed

Laforest, L; Van Ganse, É; Devouassoux, G; Chatté, G; Tamberou, C; Belhassen, M; Chamba, G

2015-01-01

Adherence to inhaled corticosteroids (ICS) remains a major issue for asthma management, even among patients receiving a regular prescription from their doctor. The frequency of deliberate interruption of ICS, and of spontaneous changes of dose, were studied in a population of asthma patients recruited in community pharmacies. Asthma patients (aged 18-50) recruited in community pharmacies reported in self-administered questionnaires their spontaneous interruptions and changes of doses of ICS during the past 3 months. The characteristics of patients who interrupted their therapy or who modified the dose were compared with other patients. The studied population included 252 patients (mean age 35 year-old, females: 59%), of whom 62% had inadequately controlled asthma. Among these patients, 25% had interrupted ICS therapy during the past 3 months, while 21% spontaneously changed the dose. The most reported reason for interrupting ICS was the cessation of symptoms (50%). In multivariate analysis, interrupting ICS was mainly associated with inadequate asthma control (OR=3.1, 95% CI 1.5-6.4), while the strongest association with changing ICS doses was the patients' perception of asthma as a concern in their lives (OR=3.2, 95% CI 1.2-8.4). These results underline a poor understanding of the purpose of ICS therapy by patients. They also highlight the need of therapeutic education to improve the management of the disease. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Calm to chaos: Engaging undergraduate nursing students with the complex nature of interruptions during medication administration.

PubMed

Hayes, Carolyn; Jackson, Debra; Davidson, Patricia M; Daly, John; Power, Tamara

2017-12-01

To describe undergraduate student nurse responses to a simulated role-play experience focussing on managing interruptions during medication administration. Improving patient safety requires that we find creative and innovative methods of teaching medication administration to undergraduate nurses in real-world conditions. Nurses are responsible for the majority of medication administrations in health care. Incidents and errors associated with medications are a significant patient safety issue and often occur as a result of interruptions. Undergraduate nursing students are generally taught medication administration skills in a calm and uninterrupted simulated environment. However, in the clinical environment medication administration is challenged by multiple interruptions. A qualitative study using convenience sampling was used to examine student perceptions of a simulated role-play experience. Data were collected from 451 of a possible 528 student written reflective responses and subject to thematic analysis. Students reported an increased understanding of the impacts of interruptions while administering medications and an improved awareness of how to manage disruptions. This study reports on one of three emergent themes: "Calm to chaos: engaging with the complex nature of clinical practice." Interrupting medication administration in realistic and safe settings facilitates awareness, allows for students to begin to develop management strategies in relation to interruption and increases their confidence. Students were given the opportunity to consolidate and integrate prior and new knowledge and skills through this role-play simulation. © 2017 John Wiley & Sons Ltd.

41 CFR 301-10.8 - What is my liability if, for personal convenience, I travel by an indirect route or interrupt...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What is my liability if, for personal convenience, I travel by an indirect route or interrupt travel by a direct route? 301-10....8 What is my liability if, for personal convenience, I travel by an indirect route or interrupt...

Interruption Practice Reduces Errors

DTIC Science & Technology

2014-01-01

dangers of errors at the PCS. Electronic health record systems are used to reduce certain errors related to poor- handwriting and dosage...10.16, MSE =.31, p< .05, η2 = .18 A significant interaction between the number of interruptions and interrupted trials suggests that trials...the variance when calculating whether a memory has a higher signal than interference. If something in addition to activation contributes to goal

Caring Is Not Enough: Teachers' Enactment of Ethical Care for Adolescent Students with Limited or Interrupted Formal Education (SLIFE) in a Newcomer Classroom

ERIC Educational Resources Information Center

Hos, Rabia

2016-01-01

The educational landscape for schools in the United States is continuing to shift with the arrival of refugee students with limited or interrupted formal education, especially at the secondary schools. As refugee students with limited or interrupted formal education (SLIFE) adjust to schools in the United States, they may experience acculturative…

Method of and system for classifying emergency locating transmitters and emergency positions indicating radio beacons

NASA Technical Reports Server (NTRS)

Wren, Paul E. (Inventor)

1983-01-01

During a distress call, a distress location transmitter 10 generates a high frequency carrier signal 40 that is modulated by a predetermined distress waveform characteristic 29. The classification of user associated with the distress call is identified by periodically interrupting modulation 42; user classification is determined by the repetition rate of the interruptions, the interruption periods, or both.

Assessment of lower urinary tract function in children with Down syndrome.

PubMed

Kitamura, Atsuko; Kondoh, Tatsuro; Noguchi, Mitsuru; Hatada, Teppei; Tohbu, Shohei; Mori, Ken-Ichi; Matsuo, Manabu; Kunitsugu, Ichiro; Kanetake, Hiroshi; Moriuchi, Hiroyuki

2014-12-01

Despite the fact that functional lower urinary tract symptoms are common among people with Down syndrome (DS), their voiding function has not been studied precisely. Our goal was to assess the lower urinary tract functions in DS. Fifty-five DS children aged 5-15 years old and 35 age-matched control children were evaluated by ultrasonography and uroflowmetry. Eleven (20%) DS children had no uresiesthesia, 21 (38%) were urinated under guidance, nine (16%) urinated fewer than three times a day, two (4%) urinated more than 10 times a day, three (5%) used diapers, and 26 (47%) had urinary incontinence. Seven (13%), 15 (27%), and 10 (18%) DS children had weak, prolonged and intermittent urination, respectively, and seven (13%) had urination with straining. In contrast, none of the control subjects had urinary problems. In the uroflowmetrical analysis, 10 (18%), 20 (37%), 11 (20%) and five (9%) DS children showed "bell-shaped," "plateau," "staccato" and "interrupted" patterns, respectively; the remaining nine (16%) could not be analyzed. In contrast, 21 (60%), one (3%), four (11%), three (9%) and two (6%) control subjects showed bell-shaped, tower-shaped, plateau, staccato and interrupted patterns, respectively; the remaining four (11%) could not be analyzed. Residual urine was demonstrated in four (7%) DS children and one (3%) control child. Lower urinary tract symptoms and abnormal uroflowmetry findings, which can lead to further progressive renal and urinary disorders, are common in DS children. Therefore, lower urinary tract functions should be assessed at the life-long regular medical check-ups for subjects with DS. © 2014 The Authors. Pediatrics International published by Wiley Publishing Asia Pty Ltd on behalf of Japan Pediatric Society.

Virological outcome after structured interruption of antiretroviral therapy for human immunodeficiency virus infection is associated with the functional profile of virus-specific CD8+ T cells.

PubMed

Daucher, Marybeth; Price, David A; Brenchley, Jason M; Lamoreaux, Laurie; Metcalf, Julia A; Rehm, Catherine; Nies-Kraske, Elizabeth; Urban, Elizabeth; Yoder, Christian; Rock, Diane; Gumkowski, Julie; Betts, Michael R; Dybul, Mark R; Douek, Daniel C

2008-04-01

A clear understanding of the antiviral effects of CD8(+) T cells in the context of chronic human immunodeficiency virus (HIV) infection is critical for the development of prophylactic vaccines and therapeutics designed to support T-cell-mediated immunity. However, defining the potential correlates of effective CD8(+) T-cell immunity has proven difficult; notably, comprehensive analyses have demonstrated that the size and shape of the CD8(+) T-cell response are not necessarily indicative of efficacy determined by measures of plasma viral load. Here, we conducted a detailed quantitative and qualitative analysis of CD8(+) T-cell responses to autologous virus in a cohort of six HIV-infected individuals with a history of structured interruption of antiretroviral therapy (ART) (SIT). The magnitude and breadth of the HIV-specific response did not, by themselves, explain the changes observed in plasma virus levels after the cessation of ART. Furthermore, mutational escape from targeted epitopes could not account for the differential virological outcomes in this cohort. However, the functionality of HIV-specific CD8(+) T-cell populations upon antigen encounter, determined by the simultaneous and independent measurement of five CD8(+) T-cell functions (degranulation and gamma interferon, macrophage inflammatory protein 1beta, tumor necrosis factor alpha, and interleukin-2 levels) reflected the emergent level of plasma virus, with multiple functions being elicited in those individuals with lower levels of viremia after SIT. These data show that the quality of the HIV-specific CD8(+) T-cell response, rather than the quantity, is associated with the dynamics of viral replication in the absence of ART and suggest that the effects of SIT can be assessed by measuring the functional profile of HIV-specific CD8(+) T cells.

Acute glucoregulatory and vascular outcomes of three strategies for interrupting prolonged sitting time in postmenopausal women: A pilot, laboratory-based, randomized, controlled, 4-condition, 4-period crossover trial.

PubMed

Kerr, Jacqueline; Crist, Katie; Vital, Daniela G; Dillon, Lindsay; Aden, Sabrina A; Trivedi, Minaxi; Castellanos, Luis R; Godbole, Suneeta; Li, Hongying; Allison, Matthew A; Khemlina, Galina L; Takemoto, Michelle L; Schenk, Simon; Sallis, James F; Grace, Megan; Dunstan, David W; Natarajan, Loki; LaCroix, Andrea Z; Sears, Dorothy D

2017-01-01

Prolonged sitting is associated with cardiometabolic and vascular disease. Despite emerging evidence regarding the acute health benefits of interrupting prolonged sitting time, the effectiveness of different modalities in older adults (who sit the most) is unclear. In preparation for a future randomized controlled trial, we enrolled 10 sedentary, overweight or obese, postmenopausal women (mean age 66 years ±9; mean body mass index 30.6 kg/m2 ±4.2) in a 4-condition, 4-period crossover feasibility pilot study in San Diego to test 3 different sitting interruption modalities designed to improve glucoregulatory and vascular outcomes compared to a prolonged sitting control condition. The interruption modalities included: a) 2 minutes standing every 20 minutes; b) 2 minutes walking every hour; and c) 10 minutes standing every hour. During each 5-hr condition, participants consumed two identical, standardized meals. Blood samples, blood pressure, and heart rate were collected every 30 minutes. Endothelial function of the superficial femoral artery was measured at baseline and end of each 5-hr condition using flow-mediated dilation (FMD). Participants completed each condition on separate days, in randomized order. This feasibility pilot study was not powered to detect statistically significant differences in the various outcomes, however, analytic methods (mixed models) were used to test statistical significance within the small sample size. Nine participants completed all 4 study visits, one participant completed 3 study visits and then was lost to follow up. Net incremental area under the curve (iAUC) values for postprandial plasma glucose and insulin during the 5-hr sitting interruption conditions were not significantly different compared to the control condition. Exploratory analyses revealed that the 2-minute standing every 20 minutes and the 2-minute walking every hour conditions were associated with a significantly lower glycemic response to the second meal compared to the first meal (i.e., condition-matched 2-hour post-lunch glucose iAUC was lower than 2-hour post-breakfast glucose iAUC) that withstood Bonferroni correction (p = 0.0024 and p = 0.0084, respectively). Using allometrically scaled data, the 10-minute standing every hour condition resulted in an improved FMD response, which was significantly greater than the control condition after Bonferroni correction (p = 0.0033). This study suggests that brief interruptions in prolonged sitting time have modality-specific glucoregulatory and vascular benefits and are feasible in an older adult population. Larger laboratory and real-world intervention studies of pragmatic and effective methods to change sitting habits are needed. ClinicalTrials.gov NCT02743286.

Resident training in a teaching hospital: How do attendings teach in the real operative environment?

PubMed

Glarner, Carly E; Law, Katherine E; Zelenski, Amy B; McDonald, Robert J; Greenberg, Jacob A; Foley, Eugene F; Wiegmann, Douglas A; Greenberg, Caprice C

2017-07-01

The study aim was to explore the nature of intraoperative education and its interaction with the environment where surgical education occurs. Video and audio recording captured teaching interactions between colorectal surgeons and general surgery residents during laparoscopic segmental colectomies. Cases and collected data were analyzed for teaching behaviors and workflow disruptions. Flow disruptions (FDs) are considered deviations from natural case progression. Across 10 cases (20.4 operative hours), attendings spent 11.2 hours (54.7%) teaching, using directing (M = 250.1), and confirming (M = 236.1) most. FDs occurred 410 times, accounting for 4.4 hours of case time (21.57%). Teaching occurred with FD events for 2.4 hours (22.2%), whereas 77.8% of teaching happened outside FD occurrence. Teaching methods shifted from active to passive during FD events to compensate for patient safety. Understanding how FDs impact operative learning will inform faculty development in managing interruptions and improve its integration into resident education. Copyright © 2016. Published by Elsevier Inc.

Origin of the 2016 QBO Disruption and Its Relationship to Extreme El Niño Events

NASA Astrophysics Data System (ADS)

Barton, C. A.; McCormack, J. P.

2017-11-01

The descent of the westerly phase of the quasi-biennial oscillation (QBO) in equatorial stratospheric zonal wind was interrupted by the development of easterlies near 40 hPa ( 23 km altitude) in early 2016. We use tropical meteorological analyses of wind and temperature to describe in detail the special circumstances by which equatorward-propagating planetary waves produced this unprecedented disruption in the QBO. Our findings show that the subtropical easterly jet in the winter lower stratosphere during the 2015-2016 winter was anomalously weak owing to (1) the timing of the QBO relative to the annual cycle and (2) an extreme El Niño event. The weak jet allowed an unusually large flux of westward momentum to propagate from the extratropical Northern Hemisphere to the equator near the 40 hPa level. Consequently, the QBO westerlies at that level experienced sustained easterly acceleration from extratropical wave breaking, leading to the observed wind reversal.

Managing Cassini Safe Mode Attitude at Saturn

NASA Technical Reports Server (NTRS)

Burk, Thomas A.

2010-01-01

The Cassini spacecraft was launched on October 15, 1997 and arrived at Saturn on June 30, 2004. It has performed detailed observations and remote sensing of Saturn, its rings, and its satellites since that time. In the event safe mode interrupts normal orbital operations, Cassini has flight software fault protection algorithms to detect, isolate, and recover to a thermally safe and commandable attitude and then wait for further instructions from the ground. But the Saturn environment is complex, and safety hazards change depending on where Cassini is in its orbital trajectory around Saturn. Selecting an appropriate safe mode attitude that insures safe operation in the Saturn environment, including keeping the star tracker field of view clear of bright bodies, while maintaining a quiescent, commandable attitude, is a significant challenge. This paper discusses the Cassini safe table management strategy and the key criteria that must be considered, especially during low altitude flybys of Titan, in deciding what spacecraft attitude should be used in the event of safe mode.

Workflow interruptions, cognitive failure and near-accidents in health care.

PubMed

Elfering, Achim; Grebner, Simone; Ebener, Corinne

2015-01-01

Errors are frequent in health care. A specific model was tested that affirms failure in cognitive action regulation to mediate the influence of nurses' workflow interruptions and safety conscientiousness on near-accidents in health care. One hundred and sixty-five nurses from seven Swiss hospitals participated in a questionnaire survey. Structural equation modelling confirmed the hypothesised mediation model. Cognitive failure in action regulation significantly mediated the influence of workflow interruptions on near-accidents (p < .05). An indirect path from conscientiousness to near-accidents via cognitive failure in action regulation was also significant (p < .05). Compliance with safety regulations was significantly related to cognitive failure and near-accidents; moreover, cognitive failure mediated the association between compliance and near-accidents (p < .05). Contrary to expectations, compliance with safety regulations was not related to workflow interruptions. Workflow interruptions caused by colleagues, patients and organisational constraints are likely to trigger errors in nursing. Work redesign is recommended to reduce cognitive failure and improve safety of nurses and patients.

Applying social network analysis to the examination of interruptions in healthcare.

PubMed

McCurdie, Tara; Sanderson, Penelope; Aitken, Leanne M

2018-02-01

Examinations of interruptions in healthcare often focus on a single clinical discipline, and solutions are targeted accordingly. This approach does not take into account the inter-disciplinary dependencies and other sociotechnical aspects that make up the healthcare work system, and suggested solutions may not meet the needs of all stakeholders. In this article a sociotechnical systems perspective is used to uncover the interdependencies between 16 unique work roles that result in interruptions in an intensive care unit (ICU). By applying social network analysis techniques to data collected using the Dual Perspectives Method, we identified targeted systems-based interventions that may reduce unnecessary interruptions while avoiding unintended consequences that impose additional burden on ICU staff. The rich insights gained into the interruptive communication patterns in the ICU work system stand in contrast to findings that would have otherwise been obtained by focusing only on a single clinical discipline or a single perspective. Copyright © 2017. Published by Elsevier Ltd.

Causal role for the subthalamic nucleus in interrupting behavior

PubMed Central

Fife, Kathryn H; Gutierrez-Reed, Navarre A; Zell, Vivien; Bailly, Julie; Lewis, Christina M; Aron, Adam R; Hnasko, Thomas S

2017-01-01

Stopping or pausing in response to threats, conflicting information, or surprise is fundamental to behavior. Evidence across species has shown that the subthalamic nucleus (STN) is activated by scenarios involving stopping or pausing, yet evidence that the STN causally implements stops or pauses is lacking. Here we used optogenetics to activate or inhibit mouse STN to test its putative causal role. We first demonstrated that optogenetic stimulation of the STN excited its major projection targets. Next we showed that brief activation of STN projection neurons was sufficient to interrupt or pause a self-initiated bout of licking. Finally, we developed an assay in which surprise was used to interrupt licking, and showed that STN inhibition reduced the disruptive effect of surprise. Thus STN activation interrupts behavior, and blocking the STN blunts the interruptive effect of surprise. These results provide strong evidence that the STN is both necessary and sufficient for such forms of behavioral response suppression. DOI: http://dx.doi.org/10.7554/eLife.27689.001 PMID:28742497

Control of molting in crustacea

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

Skinner, D.M.; Graham, D.E.; Holland, C.A.

1982-01-01

The single, overriding event that occurs during all proecdysial periods in crustaceans is the synthesis of a new exoskeleton that encompasses an enlarged animal when the old shell is cast off. Regeneration of missing appendages and larval or puberty metamorphoses also occur during proecdysis. Proecdysial periods have been divided into substages defined by the occurrence of specific events. Although a number of factors must be postulated to account for individual proecdysial events, only the molting hormone, 20-hydroxyecdysone, has been identified and isolated. Much evidence indicates that the X-organ sinus glands complex, a neurosecretory tissue located in the eyestalks, is themore » source of a molt inhibiting hormone (MIH) responsible for maintaining animals in anecdysis. An exuviation factor has been proposed to support the extrication of the animal from the old exoskeleton. There is evidence for a limb growth inhibitory factor (LGIF) that affects the rate of growth of regenerating limbs. We are proposing an anecdysial limb autotomy factor (LAF/sub an/) that propels into precocious molts anecdysial limb autotomy factor (LAF/sub pro/) that interrupts the proecdysial period of animals that lose one or more normal or partially regenerated pereopods before a critical time in proecdysis.« less

Effects of the I-PASS Nursing Handoff Bundle on communication quality and workflow.

PubMed

Starmer, Amy J; Schnock, Kumiko O; Lyons, Aimee; Hehn, Rebecca S; Graham, Dionne A; Keohane, Carol; Landrigan, Christopher P

2017-12-01

Handoff communication errors are a leading source of sentinel events. We sought to determine the impact of a handoff improvement programme for nurses. We conducted a prospective pre-post intervention study on a paediatric intensive care unit in 2011-2012. The I-PASS Nursing Handoff Bundle intervention consisted of educational training, verbal handoff I-PASS mnemonic implementation, and visual materials to provide reinforcement and sustainability. We developed handoff direct observation and time motion workflow assessment tools to measure: (1) quality of the verbal handoff, including interruption frequency and presence of key handoff data elements; and (2) duration of handoff and other workflow activities. I-PASS implementation was associated with improvements in verbal handoff communications, including inclusion of illness severity assessment (37% preintervention vs 67% postintervention, p=0.001), patient summary (81% vs 95%, p=0.05), to do list (35% vs 100%, p<0.001) and an opportunity for the receiving nurse to ask questions (34% vs 73%, p<0.001). Overall, 13/21 (62%) of verbal handoff data elements were more likely to be present following implementation whereas no data elements were less likely present. Implementation was associated with a decrease in interruption frequency pre versus post intervention (67% vs 40% of handoffs with interruptions, p=0.005) without a change in the median handoff duration (18.8 min vs 19.9 min, p=0.48) or changes in time spent in direct or indirect patient care activities. Implementation of the I-PASS Nursing Handoff Bundle was associated with widespread improvements in the verbal handoff process without a negative impact on nursing workflow. Implementation of I-PASS for nurses may therefore have the potential to significantly reduce medical errors and improve patient safety. © 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.

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus Telephone-Basic Life Support Training Program in Middle-Aged and Elderly Housewives: A Randomized Simulation Study.

PubMed

Kim, Tae Han; Lee, Yu Jin; Lee, Eui Jung; Ro, Young Sun; Lee, KyungWon; Lee, Hyeona; Jang, Dayea Beatrice; Song, Kyoung Jun; Shin, Sang Do; Myklebust, Helge; Birkenes, Tonje Søraas

2018-02-01

For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation. Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P < 0.01). Median cumulative interruption time and median number of interruption events during BLS at initial simulation and 6-month follow-up simulation were significantly shorter in the T-BLS than in the S-BLS group (1.0 vs. 9.5, P < 0.01, and 1.0 vs. 10.5, P = 0.02, respectively). Participants trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.

HIV-1 Transmission During Recent Infection and During Treatment Interruptions as Major Drivers of New Infections in the Swiss HIV Cohort Study.

PubMed

Marzel, Alex; Shilaih, Mohaned; Yang, Wan-Lin; Böni, Jürg; Yerly, Sabine; Klimkait, Thomas; Aubert, Vincent; Braun, Dominique L; Calmy, Alexandra; Furrer, Hansjakob; Cavassini, Matthias; Battegay, Manuel; Vernazza, Pietro L; Bernasconi, Enos; Günthard, Huldrych F; Kouyos, Roger D; Aubert, V; Battegay, M; Bernasconi, E; Böni, J; Bucher, H C; Burton-Jeangros, C; Calmy, A; Cavassini, M; Dollenmaier, G; Egger, M; Elzi, L; Fehr, J; Fellay, J; Furrer, H; Fux, C A; Gorgievski, M; Günthard, H F; Haerry, D; Hasse, B; Hirsch, H H; Hoffmann, M; Hösli, I; Kahlert, C; Kaiser, L; Keiser, O; Klimkait, T; Kouyos, R D; Kovari, H; Ledergerber, B; Martinetti, G; de Tejada, B Martinez; Metzner, K; Müller, N; Nadal, D; Nicca, D; Pantaleo, G; Rauch, A; Regenass, S; Rickenbach, M; Rudin, C; Schöni-Affolter, F; Schmid, P; Schüpbach, J; Speck, R; Tarr, P; Trkola, A; Vernazza, P L; Weber, R; Yerly, S

2016-01-01

Reducing the fraction of transmissions during recent human immunodeficiency virus (HIV) infection is essential for the population-level success of "treatment as prevention". A phylogenetic tree was constructed with 19 604 Swiss sequences and 90 994 non-Swiss background sequences. Swiss transmission pairs were identified using 104 combinations of genetic distance (1%-2.5%) and bootstrap (50%-100%) thresholds, to examine the effect of those criteria. Monophyletic pairs were classified as recent or chronic transmission based on the time interval between estimated seroconversion dates. Logistic regression with adjustment for clinical and demographic characteristics was used to identify risk factors associated with transmission during recent or chronic infection. Seroconversion dates were estimated for 4079 patients on the phylogeny, and comprised between 71 (distance, 1%; bootstrap, 100%) to 378 transmission pairs (distance, 2.5%; bootstrap, 50%). We found that 43.7% (range, 41%-56%) of the transmissions occurred during the first year of infection. Stricter phylogenetic definition of transmission pairs was associated with higher recent-phase transmission fraction. Chronic-phase viral load area under the curve (adjusted odds ratio, 3; 95% confidence interval, 1.64-5.48) and time to antiretroviral therapy (ART) start (adjusted odds ratio 1.4/y; 1.11-1.77) were associated with chronic-phase transmission as opposed to recent transmission. Importantly, at least 14% of the chronic-phase transmission events occurred after the transmitter had interrupted ART. We demonstrate a high fraction of transmission during recent HIV infection but also chronic transmissions after interruption of ART in Switzerland. Both represent key issues for treatment as prevention and underline the importance of early diagnosis and of early and continuous treatment. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Emergency preparedness for genetics centers, laboratories, and patients: the Southeast Region Genetics Collaborative strategic plan.

PubMed

Andersson, Hans C; Perry, William; Bowdish, Bruce; Floyd-Browning, Phaidra

2011-10-01

Emergencies occur unpredictably and interrupt routine genetic care. The events after hurricanes Katrina and Rita have led to the recognition that a coherent plan is necessary to ensure continuity of operations for genetic centers and laboratories, including newborn screening. No geographic region is protected from the effects of a variety of potential emergencies. Regional and national efforts have begun to address the need for such preparedness, but a plan for ensuring continuity of operations by creating an emergency preparedness plan must be developed for each genetic center and laboratory, with attention to the interests of patients. This article describes the first steps in development of an emergency preparedness plan for individual centers.

Implementation Plan for Flexible Automation in U.S. Shipyards

DTIC Science & Technology

1985-01-01

process steps, cramped work sites, interrupted geometries , irregular or novel shapes, and other factors that affect automatability. We also try to...held by 2 hands in awkward places. Interrupt geometry of plates and beams. Cannot predict outcome. Creates need to measure and recut. Automation, if...of standard. enough over time I every job. I Rearrange work.Redefine work units. Too many interruptions Time, space, geometry only a little work gets

[Influence of abortions and interruptions of pregnancies on subsequent deliveries. III. After-labor-period and puerperium].

PubMed

Knorre, P

1976-01-01

In the third stage of labour we must expect an increase of blood lost and placental retentions after preceded interruption. An accumulation of manual detaching of placenta we ascertained for preceded abortion only. In the childbed we found an certained increase of disturbances in uterine involution. We think, that some consequences for medical care in pregnancies, following abortion and interruption, are very important.

Supply and demand: application of Lean Six Sigma methods to improve drug round efficiency and release nursing time.

PubMed

Kieran, Maríosa; Cleary, Mary; De Brún, Aoife; Igoe, Aileen

2017-10-01

To improve efficiency, reduce interruptions and reduce the time taken to complete oral drug rounds. Lean Six Sigma methods were applied to improve drug round efficiency using a pre- and post-intervention design. A 20-bed orthopaedic ward in a large teaching hospital in Ireland. Pharmacy, nursing and quality improvement staff. A multifaceted intervention was designed which included changes in processes related to drug trolley organization and drug supply planning. A communications campaign aimed at reducing interruptions during nurse-led during rounds was also developed and implemented. Average number of interruptions, average drug round time and variation in time taken to complete drug round. At baseline, the oral drug round took an average of 125 min. Following application of Lean Six Sigma methods, the average drug round time decreased by 51 min. The average number of interruptions per drug round reduced from an average of 12 at baseline to 11 following intervention, with a 75% reduction in drug supply interruptions. Lean Six Sigma methodology was successfully employed to reduce interruptions and to reduce time taken to complete the oral drug round. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Interrupted time series analysis in drug utilization research is increasing: systematic review and recommendations.

PubMed

Jandoc, Racquel; Burden, Andrea M; Mamdani, Muhammad; Lévesque, Linda E; Cadarette, Suzanne M

2015-08-01

To describe the use and reporting of interrupted time series methods in drug utilization research. We completed a systematic search of MEDLINE, Web of Science, and reference lists to identify English language articles through to December 2013 that used interrupted time series methods in drug utilization research. We tabulated the number of studies by publication year and summarized methodological detail. We identified 220 eligible empirical applications since 1984. Only 17 (8%) were published before 2000, and 90 (41%) were published since 2010. Segmented regression was the most commonly applied interrupted time series method (67%). Most studies assessed drug policy changes (51%, n = 112); 22% (n = 48) examined the impact of new evidence, 18% (n = 39) examined safety advisories, and 16% (n = 35) examined quality improvement interventions. Autocorrelation was considered in 66% of studies, 31% reported adjusting for seasonality, and 15% accounted for nonstationarity. Use of interrupted time series methods in drug utilization research has increased, particularly in recent years. Despite methodological recommendations, there is large variation in reporting of analytic methods. Developing methodological and reporting standards for interrupted time series analysis is important to improve its application in drug utilization research, and we provide recommendations for consideration. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Photodiode-based cutting interruption sensor for near-infrared lasers.

PubMed

Adelmann, B; Schleier, M; Neumeier, B; Hellmann, R

2016-03-01

We report on a photodiode-based sensor system to detect cutting interruptions during laser cutting with a fiber laser. An InGaAs diode records the thermal radiation from the process zone with a ring mirror and optical filter arrangement mounted between a collimation unit and a cutting head. The photodiode current is digitalized with a sample rate of 20 kHz and filtered with a Chebyshev Type I filter. From the measured signal during the piercing, a threshold value is calculated. When the diode signal exceeds this threshold during cutting, a cutting interruption is indicated. This method is applied to sensor signals from cutting mild steel, stainless steel, and aluminum, as well as different material thicknesses and also laser flame cutting, showing the possibility to detect cutting interruptions in a broad variety of applications. In a series of 83 incomplete cuts, every cutting interruption is successfully detected (alpha error of 0%), while no cutting interruption is reported in 266 complete cuts (beta error of 0%). With this remarkable high detection rate and low error rate, the possibility to work with different materials and thicknesses in combination with the easy mounting of the sensor unit also to existing cutting machines highlight the enormous potential for this sensor system in industrial applications.

Disability affects the 6-minute walking distance in obese subjects (BMI>40 kg/m(2)).

PubMed

Donini, Lorenzo Maria; Poggiogalle, Eleonora; Mosca, Veronica; Pinto, Alessandro; Brunani, Amelia; Capodaglio, Paolo

2013-01-01

In obese subjects, the relative reduction of the skeletal muscle strength, the reduced cardio-pulmonary capacity and tolerance to effort, the higher metabolic costs and, therefore, the increased inefficiency of gait together with the increased prevalence of co-morbid conditions might interfere with walking. Performance tests, such as the six-minute walking test (6MWT), can unveil the limitations in cardio-respiratory and motor functions underlying the obesity-related disability. Therefore the aims of the present study were: to explore the determinants of the 6-minute walking distance (6MWD) and to investigate the predictors of interruption of the walk test in obese subjects. Obese patients [body mass index (BMI)>40 kg/m(2)] were recruited from January 2009 to December 2011. Anthropometry, body composition, specific questionnaire for Obesity-related Disabilities (TSD-OC test), fitness status and 6MWT data were evaluated. The correlation between the 6MWD and the potential independent variables (anthropometric parameters, body composition, muscle strength, flexibility and disability) were analysed. The variables which were singularly correlated with the response variable were included in a multivariated regression model. Finally, the correlation between nutritional and functional parameters and test interruption was investigated. 354 subjects (87 males, mean age 48.5 ± 14 years, 267 females, mean age 49.8 ± 15 years) were enrolled in the study. Age, weight, height, BMI, fat mass and fat free mass indexes, handgrip strength and disability were significantly correlated with the 6MWD and considered in the multivariate analysis. The determination coefficient of the regression analysis ranged from 0.21 to 0.47 for the different models. Body weight, BMI, waist circumference, TSD-OC test score and flexibility were found to be predictors of the 6MWT interruption. The present study demonstrated the impact of disability in obese subjects, together with age, anthropometric data, body composition and strength, on the 6-minute walking distance.

Disability Affects the 6-Minute Walking Distance in Obese Subjects (BMI>40 kg/m2)

PubMed Central

Donini, Lorenzo Maria; Poggiogalle, Eleonora; Mosca, Veronica; Pinto, Alessandro; Brunani, Amelia; Capodaglio, Paolo

2013-01-01

Introduction In obese subjects, the relative reduction of the skeletal muscle strength, the reduced cardio-pulmonary capacity and tolerance to effort, the higher metabolic costs and, therefore, the increased inefficiency of gait together with the increased prevalence of co-morbid conditions might interfere with walking. Performance tests, such as the six-minute walking test (6MWT), can unveil the limitations in cardio-respiratory and motor functions underlying the obesity-related disability. Therefore the aims of the present study were: to explore the determinants of the 6-minute walking distance (6MWD) and to investigate the predictors of interruption of the walk test in obese subjects. Methods Obese patients [body mass index (BMI)>40 kg/m2] were recruited from January 2009 to December 2011. Anthropometry, body composition, specific questionnaire for Obesity-related Disabilities (TSD-OC test), fitness status and 6MWT data were evaluated. The correlation between the 6MWD and the potential independent variables (anthropometric parameters, body composition, muscle strength, flexibility and disability) were analysed. The variables which were singularly correlated with the response variable were included in a multivariated regression model. Finally, the correlation between nutritional and functional parameters and test interruption was investigated. Results 354 subjects (87 males, mean age 48.5±14 years, 267 females, mean age 49.8±15 years) were enrolled in the study. Age, weight, height, BMI, fat mass and fat free mass indexes, handgrip strength and disability were significantly correlated with the 6MWD and considered in the multivariate analysis. The determination coefficient of the regression analysis ranged from 0.21 to 0.47 for the different models. Body weight, BMI, waist circumference, TSD-OC test score and flexibility were found to be predictors of the 6MWT interruption. Discussion The present study demonstrated the impact of disability in obese subjects, together with age, anthropometric data, body composition and strength, on the 6-minute walking distance. PMID:24146756

Simulation-Based Testing of Pager Interruptions During Laparoscopic Cholecystectomy.

PubMed

Sujka, Joseph A; Safcsak, Karen; Bhullar, Indermeet S; Havron, William S

2018-01-30

To determine if pager interruptions affect operative time, safety, or complications and management of pager issues during a simulated laparoscopic cholecystectomy. Twelve surgery resident volunteers were tested on a Simbionix Lap Mentor II simulator. Each resident performed 6 randomized simulated laparoscopic cholecystectomies; 3 with pager interruptions (INT) and 3 without pager interruptions (NO-INT). The pager interruptions were sent in the form of standardized patient vignettes and timed to distract the resident during dissection of the critical view of safety and clipping of the cystic duct. The residents were graded on a pass/fail scale for eliciting appropriate patient history and management of the pager issue. Data was extracted from the simulator for the following endpoints: operative time, safety metrics, and incidence of operative complications. The Mann-Whitney U test and contingency table analysis were used to compare the 2 groups (INT vs. NO-INT). Level I trauma center; Simulation laboratory. Twelve general surgery residents. There was no significant difference between the 2 groups in any of the operative endpoints as measured by the simulator. However, in the INT group, only 25% of the time did the surgery residents both adequately address the issue and provide effective patient management in response to the pager interruption. Pager interruptions did not affect operative time, safety, or complications during the simulated procedure. However, there were significant failures in the appropriate evaluations and management of pager issues. Consideration for diversion of patient care issues to fellow residents not operating to improve quality and safety of patient care outside the operating room requires further study. Copyright © 2018. Published by Elsevier Inc.

Structured intermittent interruption of chronic HIV infection treatment with highly active antiretroviral therapy: effects on leptin and TNF-alpha.

PubMed

Arjona, M Montes de Oca; Pérez-Cano, R; Garcia-Juárez, R; Martín-Aspas, A; del Alamo, C Fernández Gutiérrez; Girón-González, J A

2006-04-01

The changes in nutritional parameters and adipocytokines after structured intermittent interruption of highly active antiretroviral treatment of patients with chronic HIV infection are analyzed. Twenty-seven patients with chronic HIV infection (median CD4+ T cell count/microl: nadir, 394; at the beginning of structured interruptions, 1041; HIV viral load: nadir, 41,521 copies/ml; at the beginning of structured interruptions <50 copies/ml; median time of previous treatment: 60 months) were evaluated during three cycles of intermittent interruptions of therapy (8 weeks on/4 weeks off). CD4+ T cell count, HIV viral load, anthropometric measures, and serum concentrations of triglycerides, cholesterol, leptin, and tumor necrosis factor and its soluble receptors I and II were determined. After the three cycles of intermittent interruptions of therapy, no significant differences in CD4+ T cell count/microl, viral load, or serum concentrations of cholesterol or triglycerides with reference to baseline values were found. A near-significant higher fatty mass (skinfold thicknesses, at the end, 121 mm, at the beginning, 100 mm, p = 0.100), combined with a significant increase of concentration of leptin (1.5 vs. 4.7 ng/ml, p = 0,044), as well as a decrease in serum concentrations of soluble receptors of tumor necrosis factor (TNFRI, 104 vs. 73 pg/ml, p = 0.022; TNFRII 253 vs. 195 pg/ml, p = 0.098) were detected. Structured intermittent interruption of highly active antiretroviral treatment of patients with chronic HIV infection induces a valuable positive modification in markers of lipid turnover and adipose tissue mass.

Mediated interruptions of anaesthesia providers using predictions of workload from anaesthesia information management system data.

PubMed

Epstein, R H; Dexter, F

2012-09-01

Perioperative interruptions generated electronically from anaesthesia information management systems (AIMS) can provide useful feedback, but may adversely affect task performance if distractions occur at inopportune moments. Ideally such interruptions would occur only at times when their impact would be minimal. In this study of AIMS data, we evaluated the times of comments, drugs, fluids and periodic assessments (e.g. electrocardiogram diagnosis and train-of-four) to develop recommendations for the timing of interruptions during the intraoperative period. The 39,707 cases studied were divided into intervals between: 1) enter operating room; 2) induction; 3) intubation; 4) surgical incision; and 5) end surgery. Five-minute intervals of no documentation were determined for each case. The offsets from the start of each interval when >50% of ongoing cases had completed initial documentation were calculated (MIN50). The primary endpoint for each interval was the percentage of all cases still ongoing at MIN50. Results were that the intervals from entering the operating room to induction and from induction to intubation were unsuitable for interruptions confirming prior observational studies of anaesthesia workload. At least 13 minutes after surgical incision was the most suitable time for interruptions with 92% of cases still ongoing. Timing was minimally affected by the type of anaesthesia, surgical facility, surgical service, prone positioning or scheduled case duration. The implication of our results is that for mediated interruptions, waiting at least 13 minutes after the start of surgery is appropriate. Although we used AIMS data, operating room information system data is also suitable.

Managing Multiple Tasks in Complex, Dynamic Environments

NASA Technical Reports Server (NTRS)

Freed, Michael; Null, Cynthia H. (Technical Monitor)

1998-01-01

Sketchy planners are designed to achieve goals in realistically complex, time-pressured, and uncertain task environments. However, the ability to manage multiple, potentially interacting tasks in such environments requires extensions to the functionality these systems typically provide. This paper identifies a number of factors affecting how interacting tasks should be prioritized, interrupted, and resumed, and then describes a sketchy planner called APEX that takes account of these factors when managing multiple tasks.

Investigation of the ADA Language Implementation of the Hellenic Command Control and Information System.

DTIC Science & Technology

1982-06-01

libary packages which support machine dependent physical interfaces, interrupt structures or special devices. Thus, programs and libraries written in...obtains real-time data, makes and imple- ments decisions and receives and originates digital messages. The major equipment items which are appropriate...maintenance. g. Provide digital communications access processing. Each microcomputer can be programmed to perform a specific set of functions using prepared

Landslide: Systematic Dynamic Race Detection in Kernel Space

DTIC Science & Technology

2012-05-01

schedule_in_flight← true; CAUSE_TIMER_INTERRUPT(); end if end function Thread Scheduling Finally, the Landslide scheduler is responsible for managing ...child process vanish() simultaneously. • double_wait: Tests interactions of multiple waiters on a single child. • double_thread_fork: Tests for...conditions using Landslide. We describe them here. • Too many waiters allowed. Using the double_wait test case, Group 1 found a bug in which more threads

Microsatellite Interruptions Stabilize Primate Genomes and Exist as Population-Specific Single Nucleotide Polymorphisms within Individual Human Genomes

PubMed Central

Ananda, Guruprasad; Hile, Suzanne E.; Breski, Amanda; Wang, Yanli; Kelkar, Yogeshwar; Makova, Kateryna D.; Eckert, Kristin A.

2014-01-01

Interruptions of microsatellite sequences impact genome evolution and can alter disease manifestation. However, human polymorphism levels at interrupted microsatellites (iMSs) are not known at a genome-wide scale, and the pathways for gaining interruptions are poorly understood. Using the 1000 Genomes Phase-1 variant call set, we interrogated mono-, di-, tri-, and tetranucleotide repeats up to 10 units in length. We detected ∼26,000–40,000 iMSs within each of four human population groups (African, European, East Asian, and American). We identified population-specific iMSs within exonic regions, and discovered that known disease-associated iMSs contain alleles present at differing frequencies among the populations. By analyzing longer microsatellites in primate genomes, we demonstrate that single interruptions result in a genome-wide average two- to six-fold reduction in microsatellite mutability, as compared with perfect microsatellites. Centrally located interruptions lowered mutability dramatically, by two to three orders of magnitude. Using a biochemical approach, we tested directly whether the mutability of a specific iMS is lower because of decreased DNA polymerase strand slippage errors. Modeling the adenomatous polyposis coli tumor suppressor gene sequence, we observed that a single base substitution interruption reduced strand slippage error rates five- to 50-fold, relative to a perfect repeat, during synthesis by DNA polymerases α, β, or η. Computationally, we demonstrate that iMSs arise primarily by base substitution mutations within individual human genomes. Our biochemical survey of human DNA polymerase α, β, δ, κ, and η error rates within certain microsatellites suggests that interruptions are created most frequently by low fidelity polymerases. Our combined computational and biochemical results demonstrate that iMSs are abundant in human genomes and are sources of population-specific genetic variation that may affect genome stability. The genome-wide identification of iMSs in human populations presented here has important implications for current models describing the impact of microsatellite polymorphisms on gene expression. PMID:25033203

General bulk service queueing system with N-policy, multiplevacations, setup time and server breakdown without interruption

NASA Astrophysics Data System (ADS)

Sasikala, S.; Indhira, K.; Chandrasekaran, V. M.

2017-11-01

In this paper, we have considered an MX / (a,b) / 1 queueing system with server breakdown without interruption, multiple vacations, setup times and N-policy. After a batch of service, if the size of the queue is ξ (< a), then the server immediately takes a vacation. Upon returns from a vacation, if the queue is less than N, then the server takes another vacation. This process continues until the server finds atleast N customers in the queue. After a vacation, if the server finds at least N customers waiting for service, then the server needs a setup time to start the service. After a batch of service, if the amount of waiting customers in the queue is ξ (≥ a) then the server serves a batch of min(ξ,b) customers, where b ≥ a. We derived the probability generating function of queue length at arbitrary time epoch. Further, we obtained some important performance measures.

Ebselen and congeners inhibit NADPH oxidase 2-dependent superoxide generation by interrupting the binding of regulatory subunits.

PubMed

Smith, Susan M E; Min, Jaeki; Ganesh, Thota; Diebold, Becky; Kawahara, Tsukasa; Zhu, Yerun; McCoy, James; Sun, Aiming; Snyder, James P; Fu, Haian; Du, Yuhong; Lewis, Iestyn; Lambeth, J David

2012-06-22

NADPH oxidases (Nox) are a primary source of reactive oxygen species (ROS), which function in normal physiology and, when overproduced, in pathophysiology. Recent studies using mice deficient in Nox2 identify this isoform as a novel target against Nox2-implicated inflammatory diseases. Nox2 activation depends on the binding of the proline-rich domain of its heterodimeric partner p22phox to p47phox. A high-throughput screen that monitored this interaction via fluorescence polarization identified ebselen and several of its analogs as inhibitors. Medicinal chemistry was performed to explore structure-activity relationships and to optimize potency. Ebselen and analogs potently inhibited Nox1 and Nox2 activity but were less effective against other isoforms. Ebselen also blocked translocation of p47phox to neutrophil membranes. Thus, ebselen and its analogs represent a class of compounds that inhibit ROS generation by interrupting the assembly of Nox2-activating regulatory subunits. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mechanisms of Working Memory Disruption by External Interference

PubMed Central

Rubens, Michael T.; Gazzaley, Adam

2010-01-01

The negative impact of external interference on working memory (WM) performance is well documented; yet, the mechanisms underlying this disruption are not sufficiently understood. In this study, electroencephalogram and functional magnetic resonance imaging (fMRI) data were recorded in separate experiments that each introduced different types of visual interference during a period of WM maintenance: distraction (irrelevant stimuli) and interruption (stimuli that required attention). The data converged to reveal that regardless of the type of interference, the magnitude of processing interfering stimuli in the visual cortex (as rapidly as 100 ms) predicted subsequent WM recognition accuracy for stored items. fMRI connectivity analyses suggested that in the presence of distraction, encoded items were maintained throughout the delay period via connectivity between the middle frontal gyrus and visual association cortex, whereas memoranda were not maintained when subjects were interrupted but rather reactivated in the postinterruption period. These results elucidate the mechanisms of external interference on WM performance and highlight similarities and differences of distraction and multitasking. PMID:19648173

"You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema.

PubMed

Winch, Caleb J; Sherman, Kerry A; Smith, Katriona M; Koelmeyer, Louise A; Mackie, Helen; Boyages, John

2016-09-01

Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sleep disturbance caused by meaningful sounds and the effect of background noise

NASA Astrophysics Data System (ADS)

Namba, Seiichiro; Kuwano, Sonoko; Okamoto, Takehisa

2004-10-01

To study noise-induced sleep disturbance, a new procedure called "noise interrupted method"has been developed. The experiment is conducted in the bedroom of the house of each subject. The sounds are reproduced with a mini-disk player which has an automatic reverse function. If the sound is disturbing and subjects cannot sleep, they are allowed to switch off the sound 1 h after they start to try to sleep. This switch off (noise interrupted behavior) is an important index of sleep disturbance. Next morning they fill in a questionnaire in which quality of sleep, disturbance of sounds, the time when they switched off the sound, etc. are asked. The results showed a good relationship between L and the percentages of the subjects who could not sleep in an hour and between L and the disturbance reported in the questionnaire. This suggests that this method is a useful tool to measure the sleep disturbance caused by noise under well-controlled conditions.

Measuring the economic effects of Japan's Mikawa Port: Pre- and-post disaster assessments

NASA Astrophysics Data System (ADS)

Shibusawa, Hiroyuki; Miyata, Yuzuru

2017-10-01

This study examines the economic effects of Japan's Mikawa Port on Aichi Prefecture before and after a natural disaster interrupts its operations for one year. Using a regional input-output model, backward and forward linkage impacts are calculated along the waterfront where the auto industry is concentrated. In addition, economic damage from natural disasters is estimated. We assess the economic implications on the hinterland of Mikawa Port. Density functions of the backward and forward linkage impacts are derived. A production stoppage along the waterfront of Mikawa Port generates large indirect negative effects on the regional economy. Results found that density functions of the total impacts are decreasing function of distance but that several sectors are characterized by non-decreasing functions.

Inference in randomized trials with death and missingness.

PubMed

Wang, Chenguang; Scharfstein, Daniel O; Colantuoni, Elizabeth; Girard, Timothy D; Yan, Ying

2017-06-01

In randomized studies involving severely ill patients, functional outcomes are often unobserved due to missed clinic visits, premature withdrawal, or death. It is well known that if these unobserved functional outcomes are not handled properly, biased treatment comparisons can be produced. In this article, we propose a procedure for comparing treatments that is based on a composite endpoint that combines information on both the functional outcome and survival. We further propose a missing data imputation scheme and sensitivity analysis strategy to handle the unobserved functional outcomes not due to death. Illustrations of the proposed method are given by analyzing data from a recent non-small cell lung cancer clinical trial and a recent trial of sedation interruption among mechanically ventilated patients. © 2016, The International Biometric Society.

Characterizing Speech Intelligibility in Noise After Wide Dynamic Range Compression.

PubMed

Rhebergen, Koenraad S; Maalderink, Thijs H; Dreschler, Wouter A

The effects of nonlinear signal processing on speech intelligibility in noise are difficult to evaluate. Often, the effects are examined by comparing speech intelligibility scores with and without processing measured at fixed signal to noise ratios (SNRs) or by comparing the adaptive measured speech reception thresholds corresponding to 50% intelligibility (SRT50) with and without processing. These outcome measures might not be optimal. Measuring at fixed SNRs can be affected by ceiling or floor effects, because the range of relevant SNRs is not know in advance. The SRT50 is less time consuming, has a fixed performance level (i.e., 50% correct), but the SRT50 could give a limited view, because we hypothesize that the effect of most nonlinear signal processing algorithms at the SRT50 cannot be generalized to other points of the psychometric function. In this article, we tested the value of estimating the entire psychometric function. We studied the effect of wide dynamic range compression (WDRC) on speech intelligibility in stationary, and interrupted speech-shaped noise in normal-hearing subjects, using a fast method-based local linear fitting approach and by two adaptive procedures. The measured performance differences for conditions with and without WDRC for the psychometric functions in stationary noise and interrupted speech-shaped noise show that the effects of WDRC on speech intelligibility are SNR dependent. We conclude that favorable and unfavorable effects of WDRC on speech intelligibility can be missed if the results are presented in terms of SRT50 values only.

mCSF1, a nucleus-encoded CRM protein required for the processing of many mitochondrial introns, is involved in the biogenesis of respiratory complexes I and IV in Arabidopsis.

PubMed

Zmudjak, Michal; Colas des Francs-Small, Catherine; Keren, Ido; Shaya, Felix; Belausov, Eduard; Small, Ian; Ostersetzer-Biran, Oren

2013-07-01

The coding regions of many mitochondrial genes in plants are interrupted by intervening sequences that are classified as group II introns. Their splicing is essential for the expression of the genes they interrupt and hence for respiratory function, and is facilitated by various protein cofactors. Despite the importance of these cofactors, only a few of them have been characterized. CRS1-YhbY domain (CRM) is a recently recognized RNA-binding domain that is present in several characterized splicing factors in plant chloroplasts. The Arabidopsis genome encodes 16 CRM proteins, but these are largely uncharacterized. Here, we analyzed the intracellular location of one of these hypothetical proteins in Arabidopsis, mitochondrial CAF-like splicing factor 1 (mCSF1; At4 g31010), and analyzed the growth phenotypes and organellar activities associated with mcsf1 mutants in plants. Our data indicated that mCSF1 resides within mitochondria and its functions are essential during embryogenesis. Mutant plants with reduced mCSF1 displayed inhibited germination and retarded growth phenotypes that were tightly associated with reduced complex I and IV activities. Analogously to the functions of plastid-localized CRM proteins, analysis of the RNA profiles in wildtype and mcsf1 plants showed that mCSF1 acts in the splicing of many of the group II intron RNAs in Arabidopsis mitochondria. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

Tradeoffs in Flight Design Upset Mitigation in State of the Art FPGAs: Hardened by Design vs. Design Level Hardening

NASA Technical Reports Server (NTRS)

Swift, Gary M.; Roosta, Ramin

2004-01-01

This presentation compares and contrasts the effectiveness and the system/designer impacts of the two main approaches to upset hardening: the Actel approach (RTSX-S and RTAX-S) of low-level (inside each flip-flop) triplication and the Xilinx approach (Virtex and Virtex2) of design-level triplication of both functional blocks and voters. The effectiveness of these approaches is compared using measurements made in conjunction with each of the FPGAs' manufacturer: for Actel, published data [1] and for Xilinx, recent results from the Xilinx SEE Test Consortium (note that the author is an active and founding member). The impacts involve Actel advantages in the areas of transistor-utilization efficiency and minimizing designer involvement in the triplication while the Xilinx advantages relate to the ability to custom tailor upset hardness and the flexibility of re-configurability. Additionally, there are currently clear Xilinx advantages in available features such as the number of I/O's, logic cells, and RAM blocks as well as speed. However, the advantage of the Actel anti-fuses for configuration over the Xilinx SRAM cells is that the latter need additional functionality and external circuitry (PROMs and, at least a watchdog timer) for configuration and configuration scrubbing. Further, although effectively mitigated if done correctly, the proton upset-ability of the Xilinx FPGAs is a concern in severe proton-rich environments. Ultimately, both manufacturers' upset hardening is limited by SEFI (single-event functional interrupt) rates where it appears the Actel results are better although the Xilinx Virtex2-family result of about one SEFI in 65 device-years in solar-min GCR (the more intense part of the galactic cosmic-ray background) should be acceptable to most missions

Thermodynamic perspectives on genetic instructions, the laws of biology, diseased states and human population control

PubMed Central

Saier, M. H.

2014-01-01

This article examines in a broad perspective entropy and some examples of its relationship to evolution, genetic instructions and how we view diseases. Many knowledge gaps abound, hence our understanding is still fragmented and incomplete. Living organisms are programmed by functional genetic instructions (FGI), through cellular communication pathways, to grow and reproduce by maintaining a variety of hemistable, ordered structures (low entropy). Living organisms are far from equilibrium with their surrounding environmental systems, which tends towards increasing disorder (increasing entropy). Organisms must free themselves from high entropy (high disorder) to maintain their cellular structures for a period of time sufficient enough to allow reproduction and the resultant offspring to reach reproductive ages. This time interval varies for different species. Bacteria, for example need no sexual parents; dividing cells are nearly identical to the previous generation of cells, and can begin a new cell cycle without delay under appropriate conditions. By contrast, human infants require years of care before they can reproduce. Living organisms maintain order in spite of their changing surrounding environment, that decreases order according to the second law of thermodynamics. These events actually work together since living organisms create ordered biological structures by increasing local entropy. From a disease perspective, viruses and other disease agents interrupt the normal functioning of cells. The pressure for survival may result in mechanisms that allow organisms to resist attacks by viruses, other pathogens, destructive chemicals and physical agents such as radiation. However, when the attack is successful, the organism can be damaged until the cell, tissue, organ or entire organism is no longer functional and entropy increases. PMID:21262480

A Cognitive Paradigm to Investigate Interference in Working Memory by Distractions and Interruptions

PubMed Central

Janowich, Jacki; Mishra, Jyoti; Gazzaley, Adam

2015-01-01

Goal-directed behavior is often impaired by interference from the external environment, either in the form of distraction by irrelevant information that one attempts to ignore, or by interrupting information that demands attention as part of another (secondary) task goal. Both forms of external interference have been shown to detrimentally impact the ability to maintain information in working memory (WM). Emerging evidence suggests that these different types of external interference exert different effects on behavior and may be mediated by distinct neural mechanisms. Better characterizing the distinct neuro-behavioral impact of irrelevant distractions versus attended interruptions is essential for advancing an understanding of top-down attention, resolution of external interference, and how these abilities become degraded in healthy aging and in neuropsychiatric conditions. This manuscript describes a novel cognitive paradigm developed the Gazzaley lab that has now been modified into several distinct versions used to elucidate behavioral and neural correlates of interference, by to-be-ignored distractors versus to-be-attended interruptors. Details are provided on variants of this paradigm for investigating interference in visual and auditory modalities, at multiple levels of stimulus complexity, and with experimental timing optimized for electroencephalography (EEG) or functional magnetic resonance imaging (fMRI) studies. In addition, data from younger and older adult participants obtained using this paradigm is reviewed and discussed in the context of its relationship with the broader literatures on external interference and age-related neuro-behavioral changes in resolving interference in working memory. PMID:26273742

Epidemiology of functional dyspepsia.

PubMed

Kumar, Arvind; Pate, Jignesh; Sawant, Prabha

2012-03-01

Functional dyspepsia (FD) is the most common cause of dyspeptic symptoms. It refers to a heterogeneous group of symptoms located in the upper abdomen. The prevalence of dyspepsia is variable in different populations and is related to the different definitions of dyspepsia as inclusion criterias, variation in survey population and environmental factors. Epidemiologically some risk factors have been identified and underlying psychological disturbances have been shown to be important factors in FD. Age and ethnicity do not appear to be predictive of dyspepsia. A majority of patients suffering from significant levels of abdominal pain that interrupt daily activities and treatment remains unsatisfactory in this chronic condition.

Temporary targeted renal blood flow interruption using a reverse thermosensitive polymer to facilitate bloodless partial nephrectomy: a swine survival study.

PubMed

Harty, Niall J; Laskey, Daniel H; Moinzadeh, Alireza; Flacke, Sebastian; Benn, James A; Villani, Rosanna; Kalra, Aarti; Libertino, John A; Madras, Peter N

2012-09-01

What's known on the subject? and What does the study add? Lumagel™ is a reverse thermosensitive polymer (RTP) that has previously been described in the literature as providing temporary vascular occlusion to allow for bloodless partial nephrectomy (PN) while maintaining blood flow to the untargeted portion of the kidney. At body temperature, Lumagel™ has the consistency of a viscous gel but upon cooling rapidly converts to a liquid state and does not reconstitute thereafter. This property has allowed for it to be used in situations requiring temporary vascular occlusion. Previous experience with similar RTPs in coronary arteries proved successful, with no detectable adverse events. We have previously described our technique for temporary vascular occlusion of the main renal artery, as well as segmental and sub-segmental renal branches, to allow for bloodless PN in either an open or minimally invasive approach. These experiments were performed in the acute setting. This study is a two-armed survival trial to assess whether this RTP is as safe as hilar clamping for bloodless PN. Surviving animals showed normal growth after using the RTP, absence of toxicity, no organ dysfunction, and no pathological changes attributable to the RTP. We conclude that Lumagel™ is as safe as conventional PN with hilar clamping, while adding the advantage of uninterrupted perfusion during renal resection. To examine whether randomly selected regions of the kidney could undergo temporary flow interruption with a reverse thermosensitive polymer (RTP), Lumagel™ (Pluromed, Inc., Woburn, MA, USA), followed by partial nephrectomy (PN), without adding risks beyond those encountered in the same procedure with the use of hilar clamping. A two-armed (RTP vs hilar clamp), 6-week swine survival study was performed. Four swine underwent PN using hilar clamps, while six underwent PN with flow interruption using the RTP. The RTP, administered angiographically, was used for intraluminal occlusion of segmental or subsegmental arteries and was compared with main renal artery clamping with hilar clamps. The resection site was randomized for each swine. Laboratory studies were performed preoperatively, and at weeks 1, 3 and 6. Before killing the swine, repeat angiography was performed with emphasis on the site of previous flow interruption. Gross and microscopic examination of kidney, liver, lung, heart, skeletal muscle was later performed, and the vessel that had supported the previous plug was examined. All animals survived. No abnormal chemistry or haematology results were encountered over the 6 weeks. There were no surgical complications in either group. Using angiography we found 100% patency of vessels that had been occluded with the polymer 6 weeks previously for PN. The only gross or microscopic abnormalities were related to the renal resection and scar formation, and were similar in the two groups. Targeted flow interruption with the RTP added no additional risk to PN while allowing bloodless resection and uninterrupted flow to untargeted renal tissue. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Mass-movement and flood-induced deposits in Lake Ledro, southern Alps, Italy: implications for Holocene palaeohydrology and natural hazards

NASA Astrophysics Data System (ADS)

Simonneau, A.; Chapron, E.; Vannière, B.; Wirth, S. B.; Gilli, A.; Di Giovanni, C.; Anselmetti, F. S.; Desmet, M.; Magny, M.

2013-03-01

High-resolution seismic profiles and sediment cores from Lake Ledro combined with soil and riverbed samples from the lake's catchment area are used to assess the recurrence of natural hazards (earthquakes and flood events) in the southern Italian Alps during the Holocene. Two well-developed deltas and a flat central basin are identified on seismic profiles in Lake Ledro. Lake sediments have been finely laminated in the basin since 9000 cal. yr BP and frequently interrupted by two types of sedimentary events (SEs): light-coloured massive layers and dark-coloured graded beds. Optical analysis (quantitative organic petrography) of the organic matter present in soil, riverbed and lacustrine samples together with lake sediment bulk density and grain-size analysis illustrate that light-coloured layers consist of a mixture of lacustrine sediments and mainly contain algal particles similar to the ones observed in background sediments. Light-coloured layers thicker than 1.5 cm in the main basin of Lake Ledro are synchronous to numerous coeval mass-wasting deposits remoulding the slopes of the basin. They are interpreted as subaquatic mass-movements triggered by historical and pre-historical regional earthquakes dated to AD 2005, AD 1891, AD 1045 and 1260, 2545, 2595, 3350, 3815, 4740, 7190, 9185 and 11 495 cal. yr BP. Dark-coloured SEs develop high-amplitude reflections in front of the deltas and in the deep central basin. These beds are mainly made of terrestrial organic matter (soils and lignocellulosic debris) and are interpreted as resulting from intense hyperpycnal flood event. Mapping and quantifying the amount of soil material accumulated in the Holocene hyperpycnal flood deposits of the sequence allow estimating that the equivalent soil thickness eroded over the catchment area reached up to 5 mm during the largest Holocene flood events. Such significant soil erosion is interpreted as resulting from the combination of heavy rainfall and snowmelt. The recurrence of flash flood events during the Holocene was, however, not high enough to affect pedogenesis processes and highlight several wet regional periods during the Holocene. The Holocene period is divided into four phases of environmental evolution. Over the first half of the Holocene, a progressive stabilization of the soils present through the catchment of Lake Ledro was associated with a progressive reforestation of the area and only interrupted during the wet 8.2 event when the soil destabilization was particularly important. Lower soil erosion was recorded during the mid-Holocene climatic optimum (8000-4200 cal. yr BP) and associated with higher algal production. Between 4200 and 3100 cal. yr BP, both wetter climate and human activities within the drainage basin drastically increased soil erosion rates. Finally, from 3100 cal. yr BP to the present-day, data suggest increasing and changing human land use.

Side effects of therapy with prostaglandin E1 in infants with critical congenital heart disease.

PubMed

Lewis, A B; Freed, M D; Heymann, M A; Roehl, S L; Kensey, R C

1981-11-01

The case reports of 492 infants with critical congenital cardiac disease treated with prostaglandin E1 (PGE1) were reviewed to determine the nature and incidence of intercurrent medical events. Forty-three percent of the infants had at least one such event, but only half of these were related to PGE1 and the majority required only minor changes in management. Cardiovascular events were the most common (18% incidence), with cutaneous vasodilation and edema occurring more frequently during intraaortic infusion than during i.v. infusion. Central nervous system events were reported in 16% of the patients. Respiratory depression was reported in 12%, and was particularly common in infants weighing less than 2.0 kg at birth (42%). Hematologic, infectious and renal events appeared for the most part to be unrelated to PGE1. The overall mortality (excluding 19 patients with hypoplastic left-heart syndrome) was 31%; the mortality for the patients with critical coarctation or interruption of the aortic arch was nearly twice that for the cyanotic infants (50% vs 27%). No death was attributed to PGE1 administration. During infusion of PGE1, arterial blood pressure and respiratory activity should be monitored carefully and appropriate supportive steps taken if hypotension or respiratory depression occurs. The development of fever or jitteriness may require reduction of the infusion rate and, in view of the possible increased incidence of infections, the prophylactic use of antibiotics is recommended.

Investigating Holocene Glacial and Pluvials Events in the Sierra Nevada of California

NASA Astrophysics Data System (ADS)

Ashford, J.; Sickman, J. O.; Lucero, D. M.; Kirby, M.; Gray, A. B.

2016-12-01

Understanding interannual and decadal variation in snowfall and extreme hydrologic events in the Sierra Nevada is hampered by short instrumental record and uncertainty caused by extrapolating paleoclimate data from lower elevation systems to the alpine snow deposition zone. Longer paleo records from high elevation systems are necessary to provide a more accurate record of snow water content and extreme precipitation events over millennial timescales that can be used to test hypotheses regarding teleconnections between Pacific climate variability and water supply and flood risk in California. In October 2013 we collected sediment cores from Pear Lake, an alpine lake in Sequoia National Park. The cores were split and characterized by P-wave velocity, magnetic susceptibility and density scanning along with grain-size analysis at 1-2 cm increments. Radiocarbon dates indicate that the Pear Lake cores contain a 13.5K year record of lake sediment. In contrast to other Sierra Nevada lakes previously cored by our group, high-resolution scanning revealed alternating fine grained, light-dark bands (1 mm to 5 mm thick) for most of the Pear Lake core length. This pattern was interrupted at intervals by homogenous clasts (up to 75 mm thick) ranging in grain size from sand to gravel up to 1 cm diameter. The sand to gravel sized clasts are most likely associated with extreme precipitation events. Preliminary grain-size analysis results show evidence of isolated extreme hydrologic events and sections of increased event frequency which we hypothesize are the result of atmospheric rivers intersecting the southern Sierra Nevada outside of the snow covered period.

Microstructural characterization and strengthening behavior of nanometer sized carbides in Ti–Mo microalloyed steels during continuous cooling process

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

Chen, Chih-Yuan, E-mail: chen6563@gmail.com; Department of Materials Science and Engineering, National Taiwan University, Taipei 10617, Taiwan; Yang, Jer-Ren, E-mail: jryang@ntu.edu.tw

Nanometer-sized carbides that precipitated in a Ti–Mo bearing steel after interrupted continuous cooling in a temperature range of 620–700 °C with or without hot deformation were investigated by field-emission-gun transmission electron microscopy. The nanometer-sized carbides were identified as randomly homogeneous precipitation carbides and interphase precipitation carbides coexisting in the ferrite matrix. It is found that this dual precipitation morphology of carbides in the steel leads to the non-uniform mechanical properties of individual ferrite grains. Vickers hardness data mainly revealed that, in the specimens cooled at a rate of 0.5 °C/s without hot deformation, the range of Vickers hardness distribution wasmore » 230–340 HV 0.1 when cooling was interrupted at 680 °C, and 220–360 HV 0.1 when cooling was interrupted at 650 °C. For the specimens cooled at a rate of 0.5 °C/s with hot deformation, the range of Vickers hardness distribution was 290–360 HV 0.1 when cooling was interrupted at 680 °C, and 280–340 HV 0.1 when cooling was interrupted at 650 °C. Therefore, a narrower range of hardness distribution occurred in the specimens that underwent hot deformation and were then cooled with a lower interrupted cooling temperature. The uniform precipitation status in each ferrite grain can lead to ferrite grains with a narrower Vickers hardness distribution. On the other hand, interrupted cooling produced a maximum Vickers hardness of 320–330 HV 0.1 for the hot deformed specimens and 290–310 HV 0.1 for the non-deformed specimens with cooling interrupted in the temperature range of 660–670 °C. The maximum Vickers hardness obtained in such a temperature range can be ascribed to the full precipitation of the microalloying elements in the supersaturated ferrite matrix with a tiny size (~ 4–7 nm). - Highlight: • The interrupted continuous cooling temperatures were 620 °C to 700 °C. • Precipitation carbides with dual dispersed morphology coexisted in the matrix. • Heavy hot deformation narrowed the range of hardness distribution. • Full precipitation of nano-sized carbides achieved maximum hardening.« less

Perceptual Learning of Interrupted Speech

PubMed Central

Benard, Michel Ruben; Başkent, Deniz

2013-01-01

The intelligibility of periodically interrupted speech improves once the silent gaps are filled with noise bursts. This improvement has been attributed to phonemic restoration, a top-down repair mechanism that helps intelligibility of degraded speech in daily life. Two hypotheses were investigated using perceptual learning of interrupted speech. If different cognitive processes played a role in restoring interrupted speech with and without filler noise, the two forms of speech would be learned at different rates and with different perceived mental effort. If the restoration benefit were an artificial outcome of using the ecologically invalid stimulus of speech with silent gaps, this benefit would diminish with training. Two groups of normal-hearing listeners were trained, one with interrupted sentences with the filler noise, and the other without. Feedback was provided with the auditory playback of the unprocessed and processed sentences, as well as the visual display of the sentence text. Training increased the overall performance significantly, however restoration benefit did not diminish. The increase in intelligibility and the decrease in perceived mental effort were relatively similar between the groups, implying similar cognitive mechanisms for the restoration of the two types of interruptions. Training effects were generalizable, as both groups improved their performance also with the other form of speech than that they were trained with, and retainable. Due to null results and relatively small number of participants (10 per group), further research is needed to more confidently draw conclusions. Nevertheless, training with interrupted speech seems to be effective, stimulating participants to more actively and efficiently use the top-down restoration. This finding further implies the potential of this training approach as a rehabilitative tool for hearing-impaired/elderly populations. PMID:23469266

A Matter of Urgency: Reducing Clinical Text Message Interruptions During Educational Sessions.

PubMed

Mendel, Arielle; Lott, Anthony; Lo, Lisha; Wu, Robert

2018-04-25

Text messaging is increasingly replacing paging as a tool to reach physicians on medical wards. However, this phenomenon has resulted in high volumes of nonurgent messages that can disrupt the learning climate. Our objective was to reduce nonurgent educational interruptions to residents on general internal medicine. This was a quality improvement project conducted at an academic hospital network. Measurements and interventions took place on 8 general internal medicine inpatient teaching teams. Interventions included (1) refining the clinical communication process in collaboration with nursing leadership; (2) disseminating guidelines with posters at nursing stations; (3) introducing a noninterrupting option for message senders; (4) audit and feedback of messages; (5) adding an alert for message senders advising if a message would interrupt educational sessions; and (6) training and support to nurses and residents. Interruptions (text messages, phone calls, emails) received by institution-supplied team smartphones were tracked during educational hours using statistical process control charts. A 1-month record of text message content was analyzed for urgency at baseline and following the interventions. The interruption frequency decreased from a mean of 0.92 (95% CI, 0.88 to 0.97) to 0.59 (95% CI, 0.51 to0.67) messages per team per educational hour from January 2014 to December 2016. The proportion of nonurgent educational interruptions decreased from 223/273 (82%) messages over one month to 123/182 (68%; P < .01). Creation of communication guidelines and modification of text message interface with feedback from end-users were associated with a reduction in nonurgent educational interruptions. Continuous audit and feedback may be necessary to minimize nonurgent messages that disrupt educational sessions. © 2018 Society of Hospital Medicine.

Basal insulin initiation use and experience among people with type 2 diabetes mellitus with different patterns of persistence: results from a multi-national survey.

PubMed

Perez-Nieves, Magaly; Ivanova, Jasmina I; Hadjiyianni, Irene; Zhao, Chen; Cao, Dachuang; Schmerold, Luke; Kalirai, Samaneh; King, Sarah; DeLozier, Amy M; Birnbaum, Howard G; Peyrot, Mark

2017-10-01

People with type 2 diabetes mellitus (T2DM) often interrupt basal insulin treatment soon after initiation. This study aimed to describe the experiences during and after basal insulin initiation among people with T2DM with different persistence patterns. Adults with T2DM from France, Germany, Spain, UK, US, Brazil, and Japan were identified from consumer panels for an online survey. Respondents who initiated basal insulin 3-24 months prior to survey date were categorized as continuers (no gaps of ≥7 days in insulin treatment); interrupters (first gap ≥7 days within 6 months of initiation and restarted insulin); and discontinuers (stopped insulin for ≥7 days within 6 months of initiation without restarting). Among 942 participants, continuers were older than interrupters and discontinuers (46, 37, and 38 years, respectively, p < .01). Continuers reported having fewer concerns before and after insulin initiation than interrupters and discontinuers, while interrupters had the most concerns. Continuers also reported fewer challenges during the first week of insulin use. Continuers were more likely to respond that insulin use had a positive impact on specific aspects of life than interrupters and discontinuers, for example on glycemic control (73.0%, 63.0%, and 61.8%, respectively; p < .01 vs. continuers). Among people with T2DM with different persistence patterns after basal insulin initiation there were significant differences in patient characteristics and experience during and after insulin initiation. Interrupters and discontinuers more frequently reported having concerns and challenges during the initiation process, negative impacts after initiation, and less improvement in glycemic control than continuers.

Dendritic cell immunotherapy followed by cART interruption during HIV-1 infection induces plasma protein markers of cellular immunity and neutrophil recruitment

PubMed Central

Cooper, Jason D.; Tomasik, Jakub; Bahn, Sabine; Aerts, Joeri L.; Osterhaus, Albert D. M. E.; Gruters, Rob A.; Andeweg, Arno C.

2018-01-01

Objectives To characterize the host response to dendritic cell-based immunotherapy and subsequent combined antiretroviral therapy (cART) interruption in HIV-1-infected individuals at the plasma protein level. Design An autologous dendritic cell (DC) therapeutic vaccine was administered to HIV-infected individuals, stable on cART. The effect of vaccination was evaluated at the plasma protein level during the period preceding cART interruption, during analytical therapy interruption and at viral reactivation. Healthy controls and post-exposure prophylactically treated healthy individuals were included as controls. Methods Plasma marker (‘analyte’) levels including cytokines, chemokines, growth factors, and hormones were measured in trial participants and control plasma samples using a multiplex immunoassay. Analyte levels were analysed using principle component analysis, cluster analysis and limma. Blood neutrophil counts were analysed using linear regression. Results Plasma analyte levels of HIV-infected individuals are markedly different from those of healthy controls and HIV-negative individuals receiving post-exposure prophylaxis. Viral reactivation following cART interruption also affects multiple analytes, but cART interruption itself only has only a minor effect. We find that Thyroxine-Binding Globulin (TBG) levels and late-stage neutrophil numbers correlate with the time off cART after DC vaccination. Furthermore, analysis shows that cART alters several regulators of blood glucose levels, including C-peptide, chromogranin-A and leptin. HIV reactivation is associated with the upregulation of CXCR3 ligands. Conclusions Chronic HIV infection leads to a change in multiple plasma analyte levels, as does virus reactivation after cART interruption. Furthermore, we find evidence for the involvement of TBG and neutrophils in the response to DC-vaccination in the setting of HIV-infection. PMID:29389978

Tracheal intubation during pediatric cardiopulmonary resuscitation: A videography-based assessment in an emergency department resuscitation room.

PubMed

Donoghue, Aaron; Hsieh, Ting-Chang; Nishisaki, Akira; Myers, Sage

2016-02-01

To describe procedural characteristics of tracheal intubation (TI) during cardiopulmonary resuscitation (CPR) in a pediatric emergency department, and to characterize interruptions in CPR associated with TI performance. Retrospective single center case series. Resuscitations in a pediatric ED are videorecorded for quality improvement. Children who underwent TI while receiving chest compressions were eligible for inclusion. Intubations done by methods other than direct laryngoscopy were excluded. Background data included patient age and training background of intubator. Data on intubation attempts (success, laryngoscopy time) and chest compressions (interruptions, duration of pauses) were collected. Between December 2012 and February 2014, 32 patients had 59 TI attempts performed during CPR. Overall first attempt success at TI was 15/32 (47%); a median of 2 attempts were made per patient (range 1 to 4). Median laryngoscopy time was 47s (range 8-115s). 32/59 (54%) TI attempts had an associated interruption in CPR; the median interruption duration was 25s (range 3-64s). TI attempts without interruption in CPR were successful in 20/32 (63%) compared to 11/27 (41%) when CPR was paused (p=0.09). Laryngoscopy time was not significantly different between TI attempts with (47±21s) and without (47±26s; p=0.2) interruptions in compressions. 25/32 (78%) of pauses exceeded 10s in duration. TI during pediatric CPR results in significant interruptions in chest compressions. Procedural outcomes were not significantly different between attempts with and without compressions paused. In children receiving CPR, TI should be performed without pausing chest compressions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Dendritic cell immunotherapy followed by cART interruption during HIV-1 infection induces plasma protein markers of cellular immunity and neutrophil recruitment.

PubMed

van den Ham, Henk-Jan; Cooper, Jason D; Tomasik, Jakub; Bahn, Sabine; Aerts, Joeri L; Osterhaus, Albert D M E; Gruters, Rob A; Andeweg, Arno C

2018-01-01

To characterize the host response to dendritic cell-based immunotherapy and subsequent combined antiretroviral therapy (cART) interruption in HIV-1-infected individuals at the plasma protein level. An autologous dendritic cell (DC) therapeutic vaccine was administered to HIV-infected individuals, stable on cART. The effect of vaccination was evaluated at the plasma protein level during the period preceding cART interruption, during analytical therapy interruption and at viral reactivation. Healthy controls and post-exposure prophylactically treated healthy individuals were included as controls. Plasma marker ('analyte') levels including cytokines, chemokines, growth factors, and hormones were measured in trial participants and control plasma samples using a multiplex immunoassay. Analyte levels were analysed using principle component analysis, cluster analysis and limma. Blood neutrophil counts were analysed using linear regression. Plasma analyte levels of HIV-infected individuals are markedly different from those of healthy controls and HIV-negative individuals receiving post-exposure prophylaxis. Viral reactivation following cART interruption also affects multiple analytes, but cART interruption itself only has only a minor effect. We find that Thyroxine-Binding Globulin (TBG) levels and late-stage neutrophil numbers correlate with the time off cART after DC vaccination. Furthermore, analysis shows that cART alters several regulators of blood glucose levels, including C-peptide, chromogranin-A and leptin. HIV reactivation is associated with the upregulation of CXCR3 ligands. Chronic HIV infection leads to a change in multiple plasma analyte levels, as does virus reactivation after cART interruption. Furthermore, we find evidence for the involvement of TBG and neutrophils in the response to DC-vaccination in the setting of HIV-infection.

Recovery after Work: The Role of Work Beliefs in the Unwinding Process

PubMed Central

Zoupanou, Zoe; Cropley, Mark; Rydstedt, Leif W.

2013-01-01

According to the Effort-Recovery model, mental or physical detachment from work is an important mechanism of work related recovery, as delayed recovery has been associated with range of negative health symptoms. In this paper, we examine whether recovery from work (in the form of mentally disengagement from work) is affected by the concept of ‘work ethic’, which refers to beliefs workers hold about their work and leisure and the effects of experiencing interruptions at work. Two indices of post-work recovery were utilized: problem solving pondering and psychological detachment. The study was conducted with 310 participants employed from diverse occupational sectors. Main effects of positive and negative appraisal of work interruption and beliefs were analysed using mediated and moderated regression analysis on problem-solving pondering and detachment. Weakened belief in wasted time as a partial mediator, reduced problem-solving pondering post work when interruptions were appraised as positive, and a high evaluation of leisure partially mediated problem-solving pondering when interruptions were appraised as positive. The results also showed that a high evaluation of centrality of work and leisure moderated the effect of negative appraisal of work interruption on elevated problem-solving pondering. Positive appraisal of work interruption was related to problem-solving pondering, and the strength of this association was further moderated by a strong belief in delay of gratification. In addition, employees' positive appraisal of work interruption was related to work detachment, and the strength of this association was further moderated by strong beliefs in hard work and self-reliance. These findings are discussed in terms of their theoretical and practical implications for employees who are strongly influenced by such work beliefs. PMID:24349060

Pregnancy interruption after second trimester diagnosis of fetal structural anomalies: the New Jersey Fetal Abnormalities Registry.

PubMed

Rauch, Eden R; Smulian, John C; DePrince, Kristin; Ananth, Cande V; Marcella, Stephen W

2005-10-01

The purpose of this study was to identify factors that predict a decision to interrupt a pregnancy in which there are fetal anomalies in the second trimester. The New Jersey Fetal Abnormalities Registry prospectively recruits and collects information on pregnancies (> or = 15 weeks of gestation) from New Jersey residents in whom a fetal structural anomaly has been suspected by maternal-fetal medicine specialists. Enrolled pregnancies that have major fetal structural abnormalities identified from 15 to 23 weeks of gestation were included. Outcomes were classified as either elective interruption or a natural pregnancy course, which might include a spontaneous fetal death or live birth. Predictors of elective interruption of pregnancy were examined with univariable and multivariable logistic regression analyses. Of the 97 cases, 33% of the women (n = 32) interrupted the pregnancy. Significant variables in the regression model that were associated with a decision to interrupt a pregnancy were earlier identification of fetal anomalies (19.0 +/- 2 weeks of gestation vs 20.5 +/- 2 weeks of gestation; P = .003), the presence of multiple anomalies (78% [25/32] vs 52% [33/63]; P = .01], and a presumption of lethality (56% [18/32] vs 14% [9/65]; P = .0001). These variables corresponded to an odds ratio for pregnancy interruption of 4.2 (95% CI, 1.0, 17.0) for multiple anomalies, 0.8 (95% CI, 0.7, 1.0) for each week of advancing gestational age, and 36.1 (95% CI, 2.9, 450.7) for presumed lethal abnormalities. Early diagnosis, the identification of multiple abnormalities, and an assessment of likely lethality of fetal anomalies are important factors for the optimization of parental autonomy in deciding pregnancy management.

Recovery after work: the role of work beliefs in the unwinding process.

PubMed

Zoupanou, Zoe; Cropley, Mark; Rydstedt, Leif W

2013-01-01

According to the Effort-Recovery model, mental or physical detachment from work is an important mechanism of work related recovery, as delayed recovery has been associated with range of negative health symptoms. In this paper, we examine whether recovery from work (in the form of mentally disengagement from work) is affected by the concept of 'work ethic', which refers to beliefs workers hold about their work and leisure and the effects of experiencing interruptions at work. Two indices of post-work recovery were utilized: problem solving pondering and psychological detachment. The study was conducted with 310 participants employed from diverse occupational sectors. Main effects of positive and negative appraisal of work interruption and beliefs were analysed using mediated and moderated regression analysis on problem-solving pondering and detachment. Weakened belief in wasted time as a partial mediator, reduced problem-solving pondering post work when interruptions were appraised as positive, and a high evaluation of leisure partially mediated problem-solving pondering when interruptions were appraised as positive. The results also showed that a high evaluation of centrality of work and leisure moderated the effect of negative appraisal of work interruption on elevated problem-solving pondering. Positive appraisal of work interruption was related to problem-solving pondering, and the strength of this association was further moderated by a strong belief in delay of gratification. In addition, employees' positive appraisal of work interruption was related to work detachment, and the strength of this association was further moderated by strong beliefs in hard work and self-reliance. These findings are discussed in terms of their theoretical and practical implications for employees who are strongly influenced by such work beliefs.

Late Holocene environmental reconstructions and the implications on flood events, typhoon patterns, and agriculture activities in NE Taiwan

NASA Astrophysics Data System (ADS)

Wang, L.-C.; Behling, H.; Lee, T.-Q.; Li, H.-C.; Huh, C.-A.; Shiau, L.-J.; Chang, Y.-P.

2014-05-01

In this study, we reconstructed the paleoenvironmental changes from a sediment archive of the floodplain lake in Ilan Plain of NE Taiwan on multi-decadal resolution for the last ca. 1900 years. On the basis of pollen and diatom records, we evaluated the record of past vegetation, floods, typhoons and agriculture activities of this area, which is sensitive to the hydrological conditions of the West Pacific. High sedimentation rates with low microfossil preservations reflected multiple flood events and humid climatic conditions during 100-1400 AD. A shortly interrupted dry phase can be found during 940-1010 AD. The driest phase corresponds to the Little Ice Age phase 1 (LIA1, 1400-1620 AD) with less disturbance by flood events, which enhanced the occurrence of wetlands (Cyperaceae) and diatom depositions. Humid phases with frequent typhoons are inferred by high percentages of Lagerstroemia and high ratios of planktonic/benthic diatoms, respectively, during 500-700 AD and Little Ice Age phase 2 (LIA2, 1630-1850 AD). The occurrences of cultivated Poaceae (Oryza) during 1250-1300 AD and the last ~400 years, reflect agriculture activities, which seems to implicate strongly with the environmental stability. Finally, we found flood events which dominated during the El Niño-like stage, but dry events as well as frequent typhoon events happened during the La Niña-like stage. After comparing our results with the reconstructed proxy for tropical hydrological conditions, we suggested that the local hydrology in coastal East Asia were strongly affected by the typhoon-triggered heavy rainfalls which were influenced by the variation of global temperature, expansion of the Pacific warm pool and intensification of ENSO events.

Effect of Hospital Closures on Acute Care Outcomes in British Columbia, Canada: An Interrupted Time Series Study.

PubMed

Panagiotoglou, Dimitra; Law, Michael R; McGrail, Kimberlyn

2017-01-01

In 2002 British Columbia, Canada began redistributing its hospital services. We used administrative data and interrupted time series analyses to determine how recent hospital closures affected patient outcomes. All adult acute myocardial infarction (AMI), stroke, and trauma events in British Columbia between fiscal years 1999 and 2013. Cases were patients whose closest hospital closed. Controls were matched by condition, year of event, and condition-specific hospital volume where treatment was received. Thirty-day mortality and hospital bypass rates. We matched 3267 AMI, 2852 stroke, and 6318 trauma cases to 1996, 1604, and 3640 controls, respectively. The 30-day mortality rate at baseline was 7.0% [95% confidence interval (CI), 4.0%-10.1%] for AMI, 5.3% (95% CI, 2.4%-8.1%) for stroke, and 1.2% (95% CI, 0.3%-2.1%) for trauma controls. The 30-day mortality rate for cases was 14.3% (95% CI, 7.1%-21.7%) for AMI, 12.0% (95% CI, 5.1%-18.9%) for stroke, and 3.1% for trauma (95% CI, 0.9%-5.2%) cases. There was no significant change in 30-day mortality for cases, and no significant difference in change in mortality rates between cases and controls following the intervention. The difference in hospital bypass rates between cases and controls was 50.1% (95% CI, 42.3%-57.9%) for AMI, 36.2% (95% CI, 27.4%-44.9%) for stroke, and 32.2% (95% CI, 27.7%-36.8%) for trauma cases preintervention. Following the intervention, the difference in bypass rates dropped by 15.5% (95% CI, 3.5%-27.5%) for AMI, 25.3% (95% CI, 11.7%-38.8%) for stroke, and 22.7% (95% CI, 15.7%-29.6%) for trauma cases. Hospital closures did not affect patient mortality.

Safety and feasibility of sublingual microcirculation assessment in the emergency department for civilian and military patients with traumatic haemorrhagic shock: a prospective cohort study

PubMed Central

Naumann, David N; Mellis, Clare; Smith, Iain M; Mamuza, Jasna; Skene, Imogen; Harris, Tim; Midwinter, Mark J; Hutchings, Sam D

2016-01-01

Objectives Sublingual microcirculatory monitoring for traumatic haemorrhagic shock (THS) may predict clinical outcomes better than traditional blood pressure and cardiac output, but is not usually performed until the patient reaches the intensive care unit (ICU), missing earlier data of potential importance. This pilot study assessed for the first time the feasibility and safety of sublingual video-microscopy for THS in the emergency department (ED), and whether it yields useable data for analysis. Setting A safety and feasibility assessment was undertaken as part of the prospective observational MICROSHOCK study; sublingual video-microscopy was performed at the UK-led Role 3 medical facility at Camp Bastion, Afghanistan, and in the ED in 3 UK Major Trauma Centres. Participants There were 15 casualties (2 military, 13 civilian) who presented with traumatic haemorrhagic shock with a median injury severity score of 26. The median age was 41; the majority (n=12) were male. The most common injury mechanism was road traffic accident. Primary and secondary outcome measures Safety and feasibility were the primary outcomes, as measured by lack of adverse events or clinical interruptions, and successful acquisition and storage of data. The secondary outcome was the quality of acquired video clips according to validated criteria, in order to determine whether useful data could be obtained in this emergency context. Results Video-microscopy was successfully performed and stored for analysis for all patients, yielding 161 video clips. There were no adverse events or episodes where clinical management was affected or interrupted. There were 104 (64.6%) video clips from 14 patients of sufficient quality for analysis. Conclusions Early sublingual microcirculatory monitoring in the ED for patients with THS is safe and feasible, even in a deployed military setting, and yields videos of satisfactory quality in a high proportion of cases. Further investigations of early microcirculatory behaviour in this context are warranted. Trial registration number NCT02111109. PMID:28003301

Three Drug Combinations for Late-Stage Trypanosoma brucei gambiense Sleeping Sickness: A Randomized Clinical Trial in Uganda

PubMed Central

Priotto, Gerardo; Fogg, Carole; Balasegaram, Manica; Erphas, Olema; Louga, Albino; Checchi, Francesco; Ghabri, Salah; Piola, Patrice

2006-01-01

Objectives: Our objective was to compare the efficacy and safety of three drug combinations for the treatment of late-stage human African trypanosomiasis caused by Trypanosoma brucei gambiense. Design: This trial was a randomized, open-label, active control, parallel clinical trial comparing three arms. Setting: The study took place at the Sleeping Sickness Treatment Center run by Médecins Sans Frontières at Omugo, Arua District, Uganda Participants: Stage 2 patients diagnosed in Northern Uganda were screened for inclusion and a total of 54 selected. Interventions: Three drug combinations were given to randomly assigned patients: melarsoprol-nifurtimox (M+N), melarsoprol-eflornithine (M+E), and nifurtimox-eflornithine (N+E). Dosages were uniform: intravenous (IV) melarsoprol 1.8 mg/kg/d, daily for 10 d; IV eflornithine 400 mg/kg/d, every 6 h for 7 d; oral nifurtimox 15 (adults) or 20 (children <15 y) mg/kg/d, every 8 h for 10 d. Patients were followed up for 24 mo. Outcome Measures: Outcomes were cure rates and adverse events attributable to treatment. Results: Randomization was performed on 54 patients before enrollment was suspended due to unacceptable toxicity in one of the three arms. Cure rates obtained with the intention to treat analysis were M+N 44.4%, M+E 78.9%, and N+E 94.1%, and were significantly higher with N+E (p = 0.003) and M+E (p = 0.045) than with M+N. Adverse events were less frequent and less severe with N+E, resulting in fewer treatment interruptions and no fatalities. Four patients died who were taking melarsoprol-nifurtimox and one who was taking melarsoprol-eflornithine. Conclusions: The N+E combination appears to be a promising first-line therapy that may improve treatment of sleeping sickness, although the results from this interrupted study do not permit conclusive interpretations. Larger studies are needed to continue the evaluation of this drug combination in the treatment of T. b. gambiense sleeping sickness. PMID:17160135

Implementation of Intraoperative Neurophysiological Monitoring during Endovascular Procedures in the Central Nervous System.

PubMed

Martinez Piñeiro, Alicia; Cubells, Carles; Garcia, Pablo; Castaño, Carlos; Dávalos, Antonio; Coll-Canti, Jaume

2015-03-01

Intraoperative monitoring (IOM) has been used in different surgical disciplines since the 1980s. Nonetheless, regular routine use of IOM in interventional neuroradiology units has only been reported in a few centers. The aim of this study is to report our experience, 1 year after deciding to implement standardized IOM during endovascular treatment of vascular abnormalities of the central nervous system. Basic recordings included somatosensory-evoked potentials (SEPs) and motor-evoked potentials (MEPs). Corticobulbar motor-evoked potentials and flash-visual-evoked potentials were also recorded depending on the topography of the lesion. Intra-arterial provocative tests (PTs) with amobarbital and lidocaine were also performed. All patients except 1 were under total intravenous anesthesia. Clinical outcome was assessed prospectively and correlated with IOM events. Twelve patients and 15 procedures were monitored during the inclusion period. Significant IOM events were detected during 3 of the 15 procedures (20%). We observed temporary MEP changes in 2 cases which resolved after interruption of the embolization or application of corrective measures, leaving no postoperative neurological deficits. In 1 case, persistent SEP and MEP deterioration was detected secondary to a frontal hematoma, resulting in mild sensory-motor deficit in the right upper extremity after the procedure. Overall, 12 PTs (4 spinal cord and 8 brain abnormalities) were performed using lidocaine and sodium amytal injections. One positive result occurred after the injection of lidocaine. No false negatives were detected. IOM may provide continuous real-time data about the functional status of eloquent areas and pathways of the central nervous system in patients under general anesthesia. It therefore allows us to detect early neurological damage in time to perform specific actions that may prevent irreversible neurological deficits.

Khat Use, PTSD and Psychotic Symptoms among Somali Refugees in Nairobi – A Pilot Study

PubMed Central

Widmann, Marina; Warsame, Abdulkadir Hussein; Mikulica, Jan; von Beust, Johannes; Isse, Maimuna Mohamud; Ndetei, David; al’Absi, Mustafa; Odenwald, Michael G.

2014-01-01

In East-African and Arab countries, khat leaves are traditionally chewed in social settings. They contain the amphetamine-like alkaloid cathinone. Especially among Somali refugees, khat use has been associated with psychiatric symptoms. We assessed khat-use patterns and psychiatric symptoms among male Somali refugees living in a disadvantaged urban settlement area in Kenya, a large group that has not yet received scientific attention. We wanted to explore consume patterns and study the associations between khat use, traumatic experiences, and psychotic symptoms. Using privileged access sampling, we recruited 33 healthy male khat chewers and 15 comparable non-chewers. Based on extensive preparatory work, we assessed khat use, khat dependence according to DSM-IV, traumatic experiences, posttraumatic stress disorder (PTSD), and psychotic symptoms using standardized diagnostic instruments that had been adapted to the Somali language and culture. Hazardous use patterns like chewing for more than 24 h without interruption were frequently reported. All khat users fulfilled the DSM-IV-criteria for dependence and 85% reported functional khat use, i.e., that khat helps them to forget painful experiences. We found that the studied group was heavily burdened by traumatic events and posttraumatic symptoms. Khat users had experienced more traumatic events and had more often PTSD than non-users. Most khat users experience khat-related psychotic symptoms and in a quarter of them we found true psychotic symptoms. In contrast, among control group members no psychotic symptoms could be detected. We found first evidence for the existence and high prevalence of severely hazardous use patterns, comorbid psychiatric symptoms, and khat use as a self-medication of trauma-consequences among male Somali refugees in urban Kenyan refugee settlements. There is a high burden by psychopathology and adequate community-based interventions urgently need to be developed. PMID:25072043

Human Papillomavirus Genome Integration and Head and Neck Cancer.

PubMed

Pinatti, L M; Walline, H M; Carey, T E

2018-06-01

We conducted a critical review of human papillomavirus (HPV) integration into the host genome in oral/oropharyngeal cancer, reviewed the literature for HPV-induced cancers, and obtained current data for HPV-related oral and oropharyngeal cancers. In addition, we performed studies to identify HPV integration sites and the relationship of integration to viral-host fusion transcripts and whether integration is required for HPV-associated oncogenesis. Viral integration of HPV into the host genome is not required for the viral life cycle and might not be necessary for cellular transformation, yet HPV integration is frequently reported in cervical and head and neck cancer specimens. Studies of large numbers of early cervical lesions revealed frequent viral integration into gene-poor regions of the host genome with comparatively rare integration into cellular genes, suggesting that integration is a stochastic event and that site of integration may be largely a function of chance. However, more recent studies of head and neck squamous cell carcinomas (HNSCCs) suggest that integration may represent an additional oncogenic mechanism through direct effects on cancer-related gene expression and generation of hybrid viral-host fusion transcripts. In HNSCC cell lines as well as primary tumors, integration into cancer-related genes leading to gene disruption has been reported. The studies have shown that integration-induced altered gene expression may be associated with tumor recurrence. Evidence from several studies indicates that viral integration into genic regions is accompanied by local amplification, increased expression in some cases, interruption of gene expression, and likely additional oncogenic effects. Similarly, reported examples of viral integration near microRNAs suggest that altered expression of these regulatory molecules may also contribute to oncogenesis. Future work is indicated to identify the mechanisms of these events on cancer cell behavior.