Knowledge Management and the Academy

ERIC Educational Resources Information Center

Cain, Timothy J.; Branin, Joseph J.; Sherman, W. Michael

2008-01-01

Universities and colleges generate extraordinary quantities of knowledge and innovation, but in many ways the academy struggles to keep pace with the digital revolution. Growing pressures are reshaping how universities must do business--students expecting enhanced access and support, administrators eager to make data-driven strategic decisions,…

Visual aided pacing in respiratory maneuvers

NASA Astrophysics Data System (ADS)

Rambaudi, L. R.; Rossi, E.; Mántaras, M. C.; Perrone, M. S.; Siri, L. Nicola

2007-11-01

A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

Revisiting nurse turnover costs: adjusting for inflation.

PubMed

Jones, Cheryl Bland

2008-01-01

Organizational knowledge of nurse turnover costs is important, but gathering these data frequently may not always be feasible in today's fast-paced and complex healthcare environment. The author presents a method to inflation adjust baseline nurse turnover costs using the Consumer Price Index. This approach allows nurse executives to gain current knowledge of organizational nurse turnover costs when primary data collection is not practical and to determine costs and potential savings if nurse retention investments are made.

Open Science: tools, approaches, and implications.

PubMed

Neylon, Cameron; Wu, Shirley

2009-01-01

Open Science is gathering pace both as a grass roots effort amongst scientists to enable them to share the outputs of their research more effectively, and as a policy initiative for research funders to gain a greater return on their investment. In this workshop, we will discuss the current state of the art in collaborative research tools, the social challenges facing those adopting and advocating more openness, and the development of standards, policies and best practices for Open Science.

Trace-Based Microanalytic Measurement of Self-Regulated Learning Processes

ERIC Educational Resources Information Center

Siadaty, Melody; Gaševic, Dragan; Hatala, Marek

2016-01-01

To keep pace with today's rapidly growing knowledge-driven society, productive self-regulation of one's learning processes are essential. We introduce and discuss a trace-based measurement protocol to measure the effects of scaffolding interventions on self-regulated learning (SRL) processes. It guides tracing of learners' actions in a learning…

Customer Service in the Self-Service Era

ERIC Educational Resources Information Center

Quinet, Bart

2011-01-01

It can be difficult for any customer service environment to keep up with the whirlwind pace of change in today's technology-centric world. The challenge can be particularly daunting in an institutional setting accustomed to deliberative, consensus-driven change. The Office of the Registrar at Indiana University Bloomington (IUB) has a…

A vision and strategy for exposure modelling at the U.S. EPA Office of Research and Development

EPA Science Inventory

Traditional, hazard-driven, single-chemical risk assessment practices cannot keep pace with the vast and growing numbers of chemicals in commerce. A well-defined, quantitative, and defensible means of identifying those with the greatest risk potential is needed, with exposure con...

Knowledge Sharing at Work: An Examination of Organizational Antecedents

ERIC Educational Resources Information Center

Behnke, Tricia M.

2010-01-01

With the rapid pace of today's knowledge-driven industries, organizations are turning to successful knowledge management initiatives to obtain sustainable competitive advantage. As a result, one facet of knowledge management, knowledge sharing at work, has received increased researcher and practitioner attention in the last decade. However, in the…

A Suggested Model for a Working Cyberschool.

ERIC Educational Resources Information Center

Javid, Mahnaz A.

2000-01-01

Suggests a model for a working cyberschool based on a case study of Kamiak Cyberschool (Washington), a technology-driven public high school. Topics include flexible hours; one-to-one interaction with teachers; a supportive school environment; use of computers, interactive media, and online resources; and self-paced, project-based learning.…

Computational challenges in modeling gene regulatory events.

PubMed

Pataskar, Abhijeet; Tiwari, Vijay K

2016-10-19

Cellular transcriptional programs driven by genetic and epigenetic mechanisms could be better understood by integrating "omics" data and subsequently modeling the gene-regulatory events. Toward this end, computational biology should keep pace with evolving experimental procedures and data availability. This article gives an exemplified account of the current computational challenges in molecular biology.

Challenges to Christian Higher Education at a Time of Increasing Emphasis on Research

ERIC Educational Resources Information Center

Hemmings, Brian; Hill, Doug

2014-01-01

In Australia, both Christian and non-Christian higher education institutions (HEIs) have experienced a rapidly changing external environment that is becoming more performance-driven, particularly in relation to faculty research. Academics working in Australian Christian HEIs often feel pressure to keep pace with their counterparts in non-Christian…

SERVMO: A Measure for Service-Driven Market Orientation in Higher Education

ERIC Educational Resources Information Center

Voon, B. H.

2008-01-01

With the intensified pace of globalization and increasing customer expectations, the higher education sector, like other economy sectors, faces increasing competition in terms of serving customers better. Service has been recognized as an effective tool for a competitive advantage. Thus, there is always a need for a more effective way of improving…

Primary Science Education in China

ERIC Educational Resources Information Center

Pook, Gayle

2013-01-01

Consider the extent to which primary science teaching has evolved since it became a core subject in England with the introduction of the National Curriculum in 1988, and the pace at which theory-driven classroom practice has advanced. It is no wonder that, given the recent economic restructuring and boom in technological development in China,…

Using the Flipped Classroom to Enhance EFL Learning

ERIC Educational Resources Information Center

Chen Hsieh, Jun Scott; Wu, Wen-Chi Vivian; Marek, Michael W.

2017-01-01

Instruction in English is a priority around the globe, but instructional methodologies have not always kept pace with the changing needs of students. To explore the benefits of the flipped classroom model for learners of English as a Foreign Language, the researchers used flipped learning and Wen's Output-driven/Input-enabled model to design a…

Academic Procrastinators, Strategic Delayers and Something Betwixt and Between: An Interview Study

ERIC Educational Resources Information Center

Lindblom-Ylänne, Sari; Saariaho, Emmi; Inkinen, Mikko; Haarala-Muhonen, Anne; Hailikari, Telle

2015-01-01

The study explored university undergraduates' dilatory behaviour, more precisely, procrastination and strategic delaying. Using qualitative interview data, we applied a theory-driven and person-oriented approach to test the theoretical model of Klingsieck (2013). The sample consisted of 28 Bachelor students whose study pace had been slow during…

Data-Driven Planning: Using Assessment in Strategic Planning

ERIC Educational Resources Information Center

Bresciani, Marilee J.

2010-01-01

Data-driven planning or evidence-based decision making represents nothing new in its concept. For years, business leaders have claimed they have implemented planning informed by data that have been strategically and systematically gathered. Within higher education and student affairs, there may be less evidence of the actual practice of…

Cardiac pacing and aviation.

PubMed

Toff, W D; Edhag, O K; Camm, A J

1992-12-01

Certain applicants with stable disturbances of rhythm or conduction requiring cardiac pacing, in whom no other disqualifying condition is present, may be considered fit for medical certification restricted to multi-crew operations. The reliability of modern pacing systems appears adequate to permit restricted certification even in pacemaker dependent subjects except for certain models of pacemakers and leads known to be at increased risk of failure. These are to be avoided. There is little evidence to suggest that newer devices are any more reliable than their predecessors. Single and dual chamber systems appear to have similar reliability up to 4 years, after which time significant attrition of dual chamber devices occurs, principally due to battery depletion. All devices require increased scrutiny as they approach their end of life as predicted from longevity data and pacing characteristics. Unipolar and bipolar leads are of similar reliability, apart from a number of specific bipolar polyurethane leads which have been identified. Atrial leads, particularly those without active fixation, are less secure than ventricular leads and applicants who are dependent on atrial sensing or pacing should be denied certification. Bipolar leads are to be preferred due to the lower risk of myopotential and exogenous EMI. Sensor-driven adaptive-rate pacing systems using active sensors may have reduced longevity and require close scrutiny. Activity-sensing devices using piezoelectric crystal sensors may be subject to significant rate rises in rotary wing aircraft. The impracticality of restricted certification in helicopters will, in any event, preclude certification. Such devices would best be avoided in hovercraft (air cushioned vehicle) pilots. Only minor rate rises are likely in fixed-wing aircraft which are unlikely to be of significance. Anti-tachycardia devices and implanted defibrillators are inconsistent with any form of certification to fly.

Multi-rater feedback with gap analysis: an innovative means to assess communication skill and self-insight.

PubMed

Calhoun, Aaron W; Rider, Elizabeth A; Peterson, Eleanor; Meyer, Elaine C

2010-09-01

Multi-rater assessment with gap analysis is a powerful method for assessing communication skills and self-insight, and enhancing self-reflection. We demonstrate the use of this methodology. The Program for the Approach to Complex Encounters (PACE) is an interdisciplinary simulation-based communication skills program. Encounters are assessed using an expanded Kalamazoo Consensus Statement Essential Elements Checklist adapted for multi-rater feedback and gap analysis. Data from a representative conversation were analyzed. Likert and forced-choice data with gap analysis are used to assess performance. Participants were strong in Demonstrating Empathy and Providing Closure, and needed to improve Relationship Building, Gathering Information, and understanding the Patient's/Family's Perspective. Participants under-appraised their abilities in Relationship Building, Providing Closure, and Demonstrating Empathy, as well as their overall performance. The conversion of these results into verbal feedback is discussed. We describe an evaluation methodology using multi-rater assessment with gap analysis to assess communication skills and self-insight. This methodology enables faculty to identify undervalued skills and perceptual blind spots, provide comprehensive, data driven, feedback, and encourage reflection. Implementation of graphical feedback forms coupled with one-on-one discussion using the above methodology has the potential to enhance trainee self-awareness and reflection, improving the impact of educational programs. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Computational challenges in modeling gene regulatory events

PubMed Central

Pataskar, Abhijeet; Tiwari, Vijay K.

2016-01-01

ABSTRACT Cellular transcriptional programs driven by genetic and epigenetic mechanisms could be better understood by integrating “omics” data and subsequently modeling the gene-regulatory events. Toward this end, computational biology should keep pace with evolving experimental procedures and data availability. This article gives an exemplified account of the current computational challenges in molecular biology. PMID:27390891

A Survey of ICT Competencies among Students in Teacher Preparation Programmes at the University of Benin, Benin City, Nigeria

ERIC Educational Resources Information Center

Danner, R. B.; Pessu, C. O. A.

2013-01-01

Today's fast-paced world is becoming increasingly characterized by technology driven communication, which has transformed the world into a large global connected community with ever-increasing outreach of information and communication technology (ICT). Technology plays an increasingly important role in people's lives, and it is envisaged that…

Data-Driven Decision Making as a Tool to Improve Software Development Productivity

ERIC Educational Resources Information Center

Brown, Mary Erin

2013-01-01

The worldwide software project failure rate, based on a survey of information technology software manager's view of user satisfaction, product quality, and staff productivity, is estimated to be between 24% and 36% and software project success has not kept pace with the advances in hardware. The problem addressed by this study was the limited…

Effective Management of High-Use/High-Demand Space Using Restaurant-Style Pagers

ERIC Educational Resources Information Center

Gonzalez, Adriana

2012-01-01

The library landscape is changing at a fast pace, with an increase in the demand for study space including quiet, individualized study space; open group study space; and as enclosed group study space. In large academic libraries, managing limited high-demand resources is crucial and is partially being driven by the greater emphasis on group…

Student-Created Fund Helps Raise Money to Cover Unmet Need

ERIC Educational Resources Information Center

Simmons, Cody

2010-01-01

Today's fast-paced and Internet-driven society provides a lot of opportunities for innovation in the college financial aid world. As tuition costs continue to rise faster than average incomes, more students are turning to private lenders and other third-party organizations to finance their educations. While the power of online micro-giving has…

Data Science in Supply Chain Management: Data-Related Influences on Demand Planning

ERIC Educational Resources Information Center

Jin, Yao

2013-01-01

Data-driven decisions have become an important aspect of supply chain management. Demand planners are tasked with analyzing volumes of data that are being collected at a torrential pace from myriad sources in order to translate them into actionable business intelligence. In particular, demand volatilities and planning are vital for effective and…

Handbook of Research on Innovative Technology Integration in Higher Education

ERIC Educational Resources Information Center

Nafukho, Fredrick Muyia, Ed.; Irby, Beverly J., Ed.

2015-01-01

Our increasingly globalized world is driven by shared knowledge, and nowhere is that knowledge more important than in education. Now more than ever, there is a demand for technology that will assist in the spread of knowledge through customized, self-paced, and on-demand learning. The Handbook of Research on Innovative Technology Integration in…

Application of Universal Design for Learning in Corporate Technical Training Design: A Quantitative Study

ERIC Educational Resources Information Center

Irbe, Aina G.

2016-01-01

With the rise of a globalized economy and an overall increase in online learning, corporate organizations have increased training through the online environment at a rapid pace. Providing effective training the employee can immediately apply to the job has driven a need to improve online training programs. Numerous studies have identified that the…

[Technical options of electrotherapy in patients with vasovagal syncope].

PubMed

Bałczewska, Daria; Kaczmarek, Krzysztof; Ptaszyński, Paweł; Wranicz, Jerzy Krzysztof; Cygankiewicz, Iwona

2016-10-19

Syncope is a symptom of the disease with diverse etiology and can be evidence of both benign and very serious life-threatening conditions. Vasovagal syncope(VVS), with prevalence about 35% of the general population, is most frequent causes of transient loss of consciousness (T-LOC). Most cases of vasovagal syncope requires conservative treatment. Although cardioinhibitory type of VVS characterized by a significant bradycardia or pause of the heart rate and can be treated with continuous electrotherapy. This article discuss cardiac pacing and technical solutions for the treatment of VVS. Available cardiac pacing methods used to detect and break VVS such as Rate Drop Response (RDR), Closed Loop Stimulation (CLS) and rate response driven by variations of myocardial contractility like Peak Endocardial Acceleration (PEA), has been presented.

Access under Siege: Are the Gains of Open Education Keeping Pace with the Growing Barriers to University Access?

ERIC Educational Resources Information Center

Olcott, Don, Jr.

2013-01-01

Traditional and affordable access to a university education is under siege from all sides. National realpolitiks and global economic downturns have driven open education into the mainstream to stand against educational elitism, the growing digital divide, and to support the core values that give education its fundamental credence as a human right.…

Curricula and Pedagogic Potentials When Educating Diverse Students in Higher Education: Students' "Funds of Knowledge" as a Bridge to Disciplinary Learning

ERIC Educational Resources Information Center

Daddow, Angela

2016-01-01

With the massification of higher education in a knowledge-driven economy, Western universities have struggled to keep pace with the cultural, linguistic, educational and economic diversity of university students and the complex realities of their lifeworlds. This has generated systemic inequities for diverse or "non-traditional"…

Beyond naturalness: Adapting wilderness stewardship to an era of rapid global change

Treesearch

David N. Cole

2012-01-01

Climate change and its effects are writ large across wilderness landscapes. They always have been and always will be (see Figure 1). But contemporary change is different. For the first time, the pace and direction of climate change appear to be driven significantly by human activities (IPCC 2007), and this change is playing out across landscapes already affected by...

A Comprehensive Analysis of High School Genetics Standards: Are States Keeping Pace with Modern Genetics?

ERIC Educational Resources Information Center

Dougherty, M. J.; Pleasants, C.; Solow, L.; Wong, A.; Zhang, H.

2011-01-01

Science education in the United States will increasingly be driven by testing and accountability requirements, such as those mandated by the No Child Left Behind Act, which rely heavily on learning outcomes, or "standards," that are currently developed on a state-by-state basis. Those standards, in turn, drive curriculum and instruction.…

Convenience experimentation.

PubMed

Krohs, Ulrich

2012-03-01

Systems biology aims at explaining life processes by means of detailed models of molecular networks, mainly on the whole-cell scale. The whole cell perspective distinguishes the new field of systems biology from earlier approaches within molecular cell biology. The shift was made possible by the high throughput methods that were developed for gathering 'omic' (genomic, proteomic, etc.) data. These new techniques are made commercially available as semi-automatic analytic equipment, ready-made analytic kits and probe arrays. There is a whole industry of supplies for what may be called convenience experimentation. My paper inquires some epistemic consequences of strong reliance on convenience experimentation in systems biology. In times when experimentation was automated to a lesser degree, modeling and in part even experimentation could be understood fairly well as either being driven by hypotheses, and thus proceed by the testing of hypothesis, or as being performed in an exploratory mode, intended to sharpen concepts or initially vague phenomena. In systems biology, the situation is dramatically different. Data collection became so easy (though not cheap) that experimentation is, to a high degree, driven by convenience equipment, and model building is driven by the vast amount of data that is produced by convenience experimentation. This results in a shift in the mode of science. The paper shows that convenience driven science is not primarily hypothesis-testing, nor is it in an exploratory mode. It rather proceeds in a gathering mode. This shift demands another shift in the mode of evaluation, which now becomes an exploratory endeavor, in response to the superabundance of gathered data. Copyright © 2011 Elsevier Ltd. All rights reserved.

Leaving A Legacy: Parental Migration and School Outcomes Among Young Children in the Philippines

PubMed Central

Asis, Maruja M.B.; Ruiz-Marave, Cecilia

2014-01-01

This article examines the link between parental migration and young children’s education using data from the Philippine country study of the Child Health and Migrant Parents in South-East Asia (CHAMPSEA) Project. The key research question probed here is: what difference does parental migration make to the school outcomes of young children? Specifically, it looks at factors that explain children’s school progression (school pacing) and academic performance (school achievement) using multiple regression analysis. These questions are explored using CHAMPSEA data gathered from a survey of children under 12 years of age and their households in Laguna and Batangas (n=487). The concern that parental absence due to migration can negatively affect the school performance of children is not supported by the study. If parental migration affects school outcomes, it is associated with positive outcomes, or with outcomes which show that children in transnational households are not doing worse than children living with both parents. Positive school outcomes are best associated with a migrant-carer arrangement where fathers work abroad and mothers stay home as carers –children in these households fare very well when it comes to school pacing and school achievement. The study concludes that families and households need to provide both economic and psychological support to enhance the chances that children are at pace with their schooling and are doing well at school. PMID:24954962

Assessment Data-Driven Inquiry: A Review of How to Use Assessment Results to Inform Chemistry Teaching

ERIC Educational Resources Information Center

Harshman, Jordan; Yezierski, Ellen

2017-01-01

With abundant access to assessments of all kinds, many high school chemistry teachers have the opportunity to gather data from their students on a daily basis. This data can serve multiple purposes, such as informing teachers of students' content difficulties and guiding instruction in a process of data-driven inquiry. In this paper, 83 resources…

Creating a System for Data-Driven Decision-Making: Applying the Principal-Agent Framework

ERIC Educational Resources Information Center

Wohlstetter, Priscilla; Datnow, Amanda; Park, Vicki

2008-01-01

The purpose of this article is to improve our understanding of data-driven decision-making strategies that are initiated at the district or system level. We apply principal-agent theory to the analysis of qualitative data gathered in a case study of 4 urban school systems. Our findings suggest educators at the school level need not only systemic…

Self-paced brain-computer interface control of ambulation in a virtual reality environment.

PubMed

Wang, Po T; King, Christine E; Chui, Luis A; Do, An H; Nenadic, Zoran

2012-10-01

Spinal cord injury (SCI) often leaves affected individuals unable to ambulate. Electroencephalogram (EEG) based brain-computer interface (BCI) controlled lower extremity prostheses may restore intuitive and able-body-like ambulation after SCI. To test its feasibility, the authors developed and tested a novel EEG-based, data-driven BCI system for intuitive and self-paced control of the ambulation of an avatar within a virtual reality environment (VRE). Eight able-bodied subjects and one with SCI underwent the following 10-min training session: subjects alternated between idling and walking kinaesthetic motor imageries (KMI) while their EEG were recorded and analysed to generate subject-specific decoding models. Subjects then performed a goal-oriented online task, repeated over five sessions, in which they utilized the KMI to control the linear ambulation of an avatar and make ten sequential stops at designated points within the VRE. The average offline training performance across subjects was 77.2 ± 11.0%, ranging from 64.3% (p = 0.001 76) to 94.5% (p = 6.26 × 10(-23)), with chance performance being 50%. The average online performance was 8.5 ± 1.1 (out of 10) successful stops and 303 ± 53 s completion time (perfect = 211 s). All subjects achieved performances significantly different than those of random walk (p < 0.05) in 44 of the 45 online sessions. By using a data-driven machine learning approach to decode users' KMI, this BCI-VRE system enabled intuitive and purposeful self-paced control of ambulation after only 10 minutes training. The ability to achieve such BCI control with minimal training indicates that the implementation of future BCI-lower extremity prosthesis systems may be feasible.

The Art and Practice of Gratitude: Practicing an Overlooked Skill to Help Undergraduate Biology Students Become Successful Professionals

ERIC Educational Resources Information Center

Halpin, Patricia A.; Landon, Jennifer

2015-01-01

In a fast-paced, technology-driven world, the age-old custom and etiquette of writing a thank-you note may often be forgotten. Educators need to provide students with the opportunity to master this important professional skill. One might assume that undergraduate biology students have mastered the art of crafting a thoughtful and articulate…

Atrial fibrillation driven by micro-anatomic intramural re-entry revealed by simultaneous sub-epicardial and sub-endocardial optical mapping in explanted human hearts.

PubMed

Hansen, Brian J; Zhao, Jichao; Csepe, Thomas A; Moore, Brandon T; Li, Ning; Jayne, Laura A; Kalyanasundaram, Anuradha; Lim, Praise; Bratasz, Anna; Powell, Kimerly A; Simonetti, Orlando P; Higgins, Robert S D; Kilic, Ahmet; Mohler, Peter J; Janssen, Paul M L; Weiss, Raul; Hummel, John D; Fedorov, Vadim V

2015-09-14

The complex architecture of the human atria may create physical substrates for sustained re-entry to drive atrial fibrillation (AF). The existence of sustained, anatomically defined AF drivers in humans has been challenged partly due to the lack of simultaneous endocardial-epicardial (Endo-Epi) mapping coupled with high-resolution 3D structural imaging. Coronary-perfused human right atria from explanted diseased hearts (n = 8, 43-72 years old) were optically mapped simultaneously by three high-resolution CMOS cameras (two aligned Endo-Epi views (330 µm2 resolution) and one panoramic view). 3D gadolinium-enhanced magnetic resonance imaging (GE-MRI, 80 µm3 resolution) revealed the atrial wall structure varied in thickness (1.0 ± 0.7-6.8 ± 2.4 mm), transmural fiber angle differences, and interstitial fibrosis causing transmural activation delay from 23 ± 11 to 43 ± 22 ms at increased pacing rates. Sustained AF (>90 min) was induced by burst pacing during pinacidil (30-100 µM) perfusion. Dual-sided sub-Endo-sub-Epi optical mapping revealed that AF was driven by spatially and temporally stable intramural re-entry with 107 ± 50 ms cycle length and transmural activation delay of 67 ± 31 ms. Intramural re-entrant drivers were captured primarily by sub-Endo mapping, while sub-Epi mapping visualized re-entry or 'breakthrough' patterns. Re-entrant drivers were anchored on 3D micro-anatomic tracks (15.4 ± 2.2 × 6.0 ± 2.3 mm2, 2.9 ± 0.9 mm depth) formed by atrial musculature characterized by increased transmural fiber angle differences and interstitial fibrosis. Targeted radiofrequency ablation of the tracks verified these re-entries as drivers of AF. Integrated 3D structural-functional mapping of diseased human right atria ex vivo revealed that the complex atrial microstructure caused significant differences between Endo vs. Epi activation during pacing and sustained AF driven by intramural re-entry anchored to fibrosis-insulated atrial bundles. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Atrial fibrillation driven by micro-anatomic intramural re-entry revealed by simultaneous sub-epicardial and sub-endocardial optical mapping in explanted human hearts

PubMed Central

Hansen, Brian J.; Zhao, Jichao; Csepe, Thomas A.; Moore, Brandon T.; Li, Ning; Jayne, Laura A.; Kalyanasundaram, Anuradha; Lim, Praise; Bratasz, Anna; Powell, Kimerly A.; Simonetti, Orlando P.; Higgins, Robert S.D.; Kilic, Ahmet; Mohler, Peter J.; Janssen, Paul M.L.; Weiss, Raul; Hummel, John D.; Fedorov, Vadim V.

2015-01-01

Aims The complex architecture of the human atria may create physical substrates for sustained re-entry to drive atrial fibrillation (AF). The existence of sustained, anatomically defined AF drivers in humans has been challenged partly due to the lack of simultaneous endocardial–epicardial (Endo–Epi) mapping coupled with high-resolution 3D structural imaging. Methods and results Coronary-perfused human right atria from explanted diseased hearts (n = 8, 43–72 years old) were optically mapped simultaneously by three high-resolution CMOS cameras (two aligned Endo–Epi views (330 µm2 resolution) and one panoramic view). 3D gadolinium-enhanced magnetic resonance imaging (GE-MRI, 80 µm3 resolution) revealed the atrial wall structure varied in thickness (1.0 ± 0.7–6.8 ± 2.4 mm), transmural fiber angle differences, and interstitial fibrosis causing transmural activation delay from 23 ± 11 to 43 ± 22 ms at increased pacing rates. Sustained AF (>90 min) was induced by burst pacing during pinacidil (30–100 µM) perfusion. Dual-sided sub-Endo–sub-Epi optical mapping revealed that AF was driven by spatially and temporally stable intramural re-entry with 107 ± 50 ms cycle length and transmural activation delay of 67 ± 31 ms. Intramural re-entrant drivers were captured primarily by sub-Endo mapping, while sub-Epi mapping visualized re-entry or ‘breakthrough’ patterns. Re-entrant drivers were anchored on 3D micro-anatomic tracks (15.4 ± 2.2 × 6.0 ± 2.3 mm2, 2.9 ± 0.9 mm depth) formed by atrial musculature characterized by increased transmural fiber angle differences and interstitial fibrosis. Targeted radiofrequency ablation of the tracks verified these re-entries as drivers of AF. Conclusions Integrated 3D structural–functional mapping of diseased human right atria ex vivo revealed that the complex atrial microstructure caused significant differences between Endo vs. Epi activation during pacing and sustained AF driven by intramural re-entry anchored to fibrosis-insulated atrial bundles. PMID:26059724

Stimulus rate increases lateralisation in linguistic and non-linguistic tasks measured by functional transcranial Doppler sonography

PubMed Central

Payne, Heather; Gutierrez-Sigut, Eva; Subik, Joanna; Woll, Bencie; MacSweeney, Mairéad

2016-01-01

Studies to date that have used fTCD to examine language lateralisation have predominantly used word or sentence generation tasks. Here we sought to further assess the sensitivity of fTCD to language lateralisation by using a metalinguistic task which does not involve novel speech generation: rhyme judgement in response to written words. Line array judgement was included as a non-linguistic visuospatial task to examine the relative strength of left and right hemisphere lateralisation within the same individuals when output requirements of the tasks are matched. These externally paced tasks allowed us to manipulate the number of stimuli presented to participants and thus assess the influence of pace on the strength of lateralisation. In Experiment 1, 28 right-handed adults participated in rhyme and line array judgement tasks and showed reliable left and right lateralisation at the group level for each task, respectively. In Experiment 2 we increased the pace of the tasks, presenting more stimuli per trial. We measured laterality indices (LIs) from 18 participants who performed both linguistic and non-linguistic judgement tasks during the original ‘slow’ presentation rate (5 judgements per trial) and a fast presentation rate (10 judgements per trial). The increase in pace led to increased strength of lateralisation in both the rhyme and line conditions. Our results demonstrate for the first time that fTCD is sensitive to the left lateralised processes involved in metalinguistic judgements. Our data also suggest that changes in the strength of language lateralisation, as measured by fTCD, are not driven by articulatory demands alone. The current results suggest that at least one aspect of task difficulty, the pace of stimulus presentation, influences the strength of lateralisation during both linguistic and non-linguistic tasks. PMID:25908491

Special Operations Forces: Opportunities Exist to Improve Transparency of Funding and Assess Potential to Lessen Some Deployments

DTIC Science & Technology

2015-07-01

pace of special operations deployments, but opportunities may exist to better balance the workload across the joint force because activities...executes funding in operation and maintenance; procurement; research , development, test, and evaluation; and military construction accounts.13 SOCOM...regional awareness. Moreover, officials noted that increases in civilian positions were driven partly by DOD’s attempts to rebalance workload and become a

Data-driven advice for applying machine learning to bioinformatics problems

PubMed Central

Olson, Randal S.; La Cava, William; Mustahsan, Zairah; Varik, Akshay; Moore, Jason H.

2017-01-01

As the bioinformatics field grows, it must keep pace not only with new data but with new algorithms. Here we contribute a thorough analysis of 13 state-of-the-art, commonly used machine learning algorithms on a set of 165 publicly available classification problems in order to provide data-driven algorithm recommendations to current researchers. We present a number of statistical and visual comparisons of algorithm performance and quantify the effect of model selection and algorithm tuning for each algorithm and dataset. The analysis culminates in the recommendation of five algorithms with hyperparameters that maximize classifier performance across the tested problems, as well as general guidelines for applying machine learning to supervised classification problems. PMID:29218881

Making time for soil: Technoscientific futurity and the pace of care.

PubMed

de la Bellacasa, Maria Puig

2015-10-01

The dominant drive for understanding soil has been to pace its fertility with human demand. Today, warnings about soil's exhaustion and endangered ecology raise concerns marked by fears of gloomy environmental futures, prompting scientists and soil practitioners urgently to develop better ways of taking care of soils. Yet the pace required by ecological soil care could be at odds with the predominant temporal orientation of technoscientific intervention, which is driven by an inherently progressivist, productionist and restless mode of futurity. Through a conceptual and historical approach to the soil sciences and other domains of soil knowledge, this article looks for soil ontologies and relations to soil care that are obscured by the predominant timescape. Contemporary discussions of the future of the soil sciences expose tensions between 'progress as usual'--by intensifying productivity--and the need to protect the pace of soil renewal. The intimate relation of soil science with productionism is being interrogated, as ecology attempts to engage with soil as a living community rather than a receptacle for crops. In this context, and beyond science, the 'foodweb' model of soil ecology has become a figure of alternative human-soil relations that involve environmental practitioners in the soil community. Reading these ways of making time for soil as a form of 'care time' helps to reveal a diversity of more-than-human interdependent temporalities, disrupting the anthropocentric appeal of predominant timescales of technoscientific futurity and their reductive notion of innovation.

Personally Driven Professional Development: Reflective Self-Study as a Way for Teachers to Take Control of Their Own Professional Development

ERIC Educational Resources Information Center

Attard, Karl

2017-01-01

This article is about personally driven professional development through the use of reflective self-study. The argument that teachers need to take responsibility for their own learning while also taking decisions on how and in what areas to develop is strongly made throughout the article. Data for this article were gathered over a 10-year period…

Integrative pathway knowledge bases as a tool for systems molecular medicine.

PubMed

Liang, Mingyu

2007-08-20

There exists a sense of urgency to begin to generate a cohesive assembly of biomedical knowledge as the pace of knowledge accumulation accelerates. The urgency is in part driven by the emergence of systems molecular medicine that emphasizes the combination of systems analysis and molecular dissection in the future of medical practice and research. A potentially powerful approach is to build integrative pathway knowledge bases that link organ systems function with molecules.

Quantifying the role of trees as Critical Zone architects employing crowbars, wedges and other tools of soil production

NASA Astrophysics Data System (ADS)

Marshall, J. A.; Anderson, R. S.; Dawson, T. E.; Dietrich, W. E.; Sklar, L. S.

2016-12-01

The Critical Zone (CZ) supports diverse functions such as water routing, net primary productivity, carbon storage, and mineral supplies for the geochemical reactor. The detailed architecture of the CZ, and the pace at which it evolves, are strongly influenced by the rate at which bedrock is converted to mobile material (the soil production rate). While trees serve as rebar-like soil stabilizers over short time scales, over longer time scales tree-driven forces can damage, disrupt and detach bedrock, and hence play a key role in soil production. Root growth and tree throw then can both release rock from the underlying bedrock and contribute to the downslope transport of the mobile material. Thus, the physical mechanisms controlling tree-driven soil production may set the pace and style of both the production and transport of soil. However, we know little about how or how often trees damage rock, create fractures, or expand existing fractures in competent bedrock or saprolite. Measurement of the relevant forces at the bedrock-root interface is difficult. Here we present preliminary data from a novel technique that allows us to document both root-growth and wind-induced forces at the rock-root interface at the Boulder Creek and Eel River Critical Zone Observatories. By combining force measurements with wind speed and wind-driven tree sway data, we quantify the magnitude and frequency of tree-driven soil-production mechanisms at two sites with differing climates and lithologies. In addition, we describe physical experiments in which we grow tree roots within pre-instrumented, manufactured fractures to measure the potential for root growth forces to induce crack tip propagation, to induce stress fatigue or to exceed the tensile or compressive strength of weak bedrock. Combined, these field and laboratory measurements provide mechanistic insight into the roles of trees as architects of the Critical Zone.

Policy Makers, Information and Learning.

ERIC Educational Resources Information Center

Beers, Pieter J.; van Asselt, Marjolein B. A.; Vermunt, Jan D.; Kirschner, Paul A.

2003-01-01

Interviews explored the information needs of seven Dutch policymakers dealing with global sustainability. They sought information on cultural perspectives and linkages. Information gathering emphasized filtering to find specific information. Most used an application-oriented working style that, combined with policy-driven information seeking, was…

Measurements of coastal storm surge by the U.S. Geological Survey

USGS Publications Warehouse

DelCharco, Michael J.

1998-01-01

In the wake of a storm, local, state, and federal emergency planners needed storm surge elevation data as quickly as possible. These data are used by officials to decide what areas are in the greatest need of assistance and what areas qualify for special designations. To accelerate the pace at which storm surge data can be gathered and released, the US geological survey (USGC) has established a network of coastal water elevation gages that are linked to satellite networks. These data are made available in real-time on the World Wide Web. While Internet access is usually fast and reliable, this process can be augmented by cellular phone, two-way radio, and other data communication techniques.

Medical intelligence, security and global health: the foundations of a new health agenda.

PubMed

Bowsher, G; Milner, C; Sullivan, R

2016-07-01

Medical intelligence, security and global health are distinct fields that often overlap, especially as the drive towards a global health security agenda gathers pace. Here, we outline some of the ways in which this has happened in the recent past during the recent Ebola epidemic in West Africa and in the killing of Osama Bin laden by US intelligence services. We evaluate medical intelligence and the role it can play in global health security; we also attempt to define a framework that illustrates how medical intelligence can be incorporated into foreign policy action in order delineate the boundaries and scope of this growing field. © The Royal Society of Medicine.

SPHERES

NASA Image and Video Library

2013-08-08

ISS036-E-029522 (7 Aug. 2013) --- In the International Space Station’s Kibo laboratory, NASA astronaut Karen Nyberg, Expedition 36 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Nyberg and NASA astronaut Chris Cassidy (not pictured) put the miniature satellites through their paces for a dry run of the SPHERES Zero Robotics tournament scheduled for Aug. 13. Teams of middle school students from Florida, Georgia, Idaho and Massachusetts will gather at the Massachusetts Institute of Technology in Cambridge to see which teams’ algorithms do the best job of commanding the free-flying robots through a series of maneuvers and objectives.

SPHERES

NASA Image and Video Library

2013-08-08

ISS036-E-029521 (7 Aug. 2013) --- In the International Space Station’s Kibo laboratory, NASA astronaut Karen Nyberg, Expedition 36 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Nyberg and NASA astronaut Chris Cassidy (not pictured) put the miniature satellites through their paces for a dry run of the SPHERES Zero Robotics tournament scheduled for Aug. 13. Teams of middle school students from Florida, Georgia, Idaho and Massachusetts will gather at the Massachusetts Institute of Technology in Cambridge to see which teams’ algorithms do the best job of commanding the free-flying robots through a series of maneuvers and objectives.

SPHERES

NASA Image and Video Library

2013-08-08

ISS036-E-029545 (7 Aug. 2013) --- In the International Space Station’s Kibo laboratory, NASA astronaut Karen Nyberg, Expedition 36 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Nyberg and NASA astronaut Chris Cassidy (not pictured) put the miniature satellites through their paces for a dry run of the SPHERES Zero Robotics tournament scheduled for Aug. 13. Teams of middle school students from Florida, Georgia, Idaho and Massachusetts will gather at the Massachusetts Institute of Technology in Cambridge to see which teams’ algorithms do the best job of commanding the free-flying robots through a series of maneuvers and objectives.

SPHERES

NASA Image and Video Library

2013-08-08

ISS036-E-029539 (7 Aug. 2013) --- In the International Space Station’s Kibo laboratory, NASA astronaut Karen Nyberg, Expedition 36 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Nyberg and NASA astronaut Chris Cassidy (not pictured) put the miniature satellites through their paces for a dry run of the SPHERES Zero Robotics tournament scheduled for Aug. 13. Teams of middle school students from Florida, Georgia, Idaho and Massachusetts will gather at the Massachusetts Institute of Technology in Cambridge to see which teams’ algorithms do the best job of commanding the free-flying robots through a series of maneuvers and objectives.

Development of a Computational Framework for Big Data-Driven Prediction of Long-Term Bridge Performance and Traffic Flow

DOT National Transportation Integrated Search

2018-04-01

Consistent efforts with dense sensor deployment and data gathering processes for bridge big data have accumulated profound information regarding bridge performance, associated environments, and traffic flows. However, direct applications of bridge bi...

Synchronized personalized music audio-playlists to improve adherence to physical activity among patients participating in a structured exercise program: a proof-of-principle feasibility study.

PubMed

Alter, David A; O'Sullivan, Mary; Oh, Paul I; Redelmeier, Donald A; Marzolini, Susan; Liu, Richard; Forhan, Mary; Silver, Michael; Goodman, Jack M; Bartel, Lee R

2015-01-01

Preference-based tempo-pace synchronized music has been shown to reduce perceived physical activity exertion and improve exercise performance. The extent to which such strategies can improve adherence to physical activity remains unknown. The objective of the study is to explore the feasibility and efficacy of tempo-pace synchronized preference-based music audio-playlists on adherence to physical activity among cardiovascular disease patients participating in a cardiac rehabilitation. Thirty-four cardiac rehabilitation patients were randomly allocated to one of two strategies: (1) no music usual-care control and (2) tempo-pace synchronized audio-devices with personalized music playlists + usual-care. All songs uploaded onto audio-playlist devices took into account patient personal music genre and artist preferences. However, actual song selection was restricted to music whose tempos approximated patients' prescribed exercise walking/running pace (steps per minute) to achieve tempo-pace synchrony. Patients allocated to audio-music playlists underwent further randomization in which half of the patients received songs that were sonically enhanced with rhythmic auditory stimulation (RAS) to accentuate tempo-pace synchrony, whereas the other half did not. RAS was achieved through blinded rhythmic sonic-enhancements undertaken manually to songs within individuals' music playlists. The primary outcome consisted of the weekly volume of physical activity undertaken over 3 months as determined by tri-axial accelerometers. Statistical methods employed an intention to treat and repeated-measures design. Patients randomized to personalized audio-playlists with tempo-pace synchrony achieved higher weekly volumes of physical activity than did their non-music usual-care comparators (475.6 min vs. 370.2 min, P  < 0.001). Improvements in weekly physical activity volumes among audio-playlist recipients were driven by those randomized to the RAS group which attained weekly exercise volumes that were nearly twofold greater than either of the two other groups (average weekly minutes of physical activity of 631.3 min vs. 320 min vs. 370.2 min, personalized audio-playlists with RAS vs. personalized audio-playlists without RAS vs. non-music usual-care controls, respectively, P  < 0.001). Patients randomized to music with RAS utilized their audio-playlist devices more frequently than did non-RAS music counterparts ( P  < 0.001). The use of tempo-pace synchronized preference-based audio-playlists was feasibly implemented into a structured exercise program and efficacious in improving adherence to physical activity beyond the evidence-based non-music usual standard of care. Larger clinical trials are required to validate these findings. ClinicalTrials.gov ID (NCT01752595).

Science Overview Document Indirect and Semi-Direct Aerosol Campaign (ISDAC) April 2008

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

SJ Ghan; B Schmid; JM Hubbe

2007-11-01

The ARM Climate Research Facility’s (ACRF) Aerial Vehicle Program (AVP) will deploy an intensive cloud and aerosol observing system to the ARM North Slope of Alaska (NSA) locale for a five week Indirect and Semi-Direct Aerosol Campaign (ISDAC) during period 29 March through 30 April 2008. The deployment period is within the International Polar Year, thus contributing to and benefiting from the many ancillary observing systems collecting data synergistically. We will deploy the Canadian National Research Council Convair 580 aircraft to measure temperature, humidity, total particle number, aerosol size distribution, single particle composition, concentrations of cloud condensation nuclei and icemore » nuclei, optical scattering and absorption, updraft velocity, cloud liquid water and ice contents, cloud droplet and crystal size distributions, cloud particle shape, and cloud extinction. In addition to these aircraft measurements, ISDAC will deploy two instruments at the ARM site in Barrow: a spectroradiometer to retrieve cloud optical depth and effective radius, and a tandem differential mobility analyzer to measure the aerosol size distribution and hygroscopicity. By using many of the same instruments used during Mixed-Phase Arctic Cloud Experiment (M-PACE), conducted in October 2004, we will be able to contrast the arctic aerosol and cloud properties during the fall and spring transitions. The aerosol measurements can be used in cloud models driven by objectively analyzed boundary conditions to test whether the cloud models can simulate the aerosol influence on the clouds. The influence of aerosol and boundary conditions on the simulated clouds can be separated by running the cloud models with all four combinations of M-PACE and ISDAC aerosol and boundary conditions: M-PACE aerosol and boundary conditions, M-PACE aerosol and ISDAC boundary conditions, ISDAC aerosol and M-PACE boundary conditions, and ISDAC aerosol and boundary conditions. ISDAC and M-PACE boundary conditions are likely to be very different because of the much more extensive ocean water during M-PACE. The uniformity of the surface conditions during ISDAC greatly simplifies the objective analysis (surface fluxes and precipitation are very weak), so that it can largely rely on the European Centre for Medium-Range Weather Forecasts analysis. The aerosol measurements can also be used as input to the cloud models and to evaluate the aerosol retrievals. By running the cloud models with and without solar absorption by the aerosols, we can determine the semidirect effect of the aerosol on the clouds.« less

Using broadband spatially resolved NIRS to assess muscle oxygenation during altered running protocols

NASA Astrophysics Data System (ADS)

Koukourakis, Georg; Vafiadou, Maria; Steimers, André; Geraskin, Dmitri; Neary, Patrick; Kohl-Bareis, Matthias

2009-07-01

We used spatially resolved near-infrared spectroscopy (SRS-NIRS) to assess calf and thigh muscle oxygenation during running on a motor-driven treadmill. Two protocols were used: An incremental speed protocol (velocity = 6 - 12 km/h, ▵v = 2 km/h) was performed in 3 minute stages, while a pacing paradigm modulated step frequency alternatively (2.3 Hz [SLow]; 3.3 Hz [SHigh]) during a constant velocity for 2 minutes each. A SRS-NIRS broadband system (600 - 1000 nm) was used to measure total haemoglobin concentration and oxygen saturation (SO2). An accelerometer was placed on the hip joints to measure limb acceleration through the experiment. The data showed that the calf (SO2 58 to 42%) desaturated to a significantly lower level than the thigh (61 to 54%). During the pacing protocol, SO2 was significantly different between the SLow vs. SHigh trials. Additionally, physiological data as measured by spirometry were different between the SLow vs. SHigh pacing trials (VO2 (2563+/- 586 vs. 2503 +/- 605 mL/min). Significant differences in VO2 at the same workload (speed) indicate alterations in mechanical efficiency. These data suggest that SRS broadband NIRS can be used to discern small changes in muscle oxygenation, making this device useful for metabolic exercise studies in addition to spirometry and movement monitoring by accelerometers.

Fuelling a National Innovation System in Colombia

ERIC Educational Resources Information Center

Lucio-Arias, Diana

2006-01-01

This presentation of the innovation-driven environment in Colombia derives from important national efforts to gather and store pertinent information. Two large surveys have tested the "innovative behaviour" of Colombian manufacturing firms--the more recent of these was in 2005. Another information source is the Scienti platform, an…

Acting to gain information

NASA Technical Reports Server (NTRS)

Rosenchein, Stanley J.; Burns, J. Brian; Chapman, David; Kaelbling, Leslie P.; Kahn, Philip; Nishihara, H. Keith; Turk, Matthew

1993-01-01

This report is concerned with agents that act to gain information. In previous work, we developed agent models combining qualitative modeling with real-time control. That work, however, focused primarily on actions that affect physical states of the environment. The current study extends that work by explicitly considering problems of active information-gathering and by exploring specialized aspects of information-gathering in computational perception, learning, and language. In our theoretical investigations, we analyzed agents into their perceptual and action components and identified these with elements of a state-machine model of control. The mathematical properties of each was developed in isolation and interactions were then studied. We considered the complexity dimension and the uncertainty dimension and related these to intelligent-agent design issues. We also explored active information gathering in visual processing. Working within the active vision paradigm, we developed a concept of 'minimal meaningful measurements' suitable for demand-driven vision. We then developed and tested an architecture for ongoing recognition and interpretation of visual information. In the area of information gathering through learning, we explored techniques for coping with combinatorial complexity. We also explored information gathering through explicit linguistic action by considering the nature of conversational rules, coordination, and situated communication behavior.

Distal impacts of aquarium trade: Exploring the emerging sandhopper (Orchestoidea tuberculata) artisanal shore gathering fishery in Chile.

PubMed

Tapia-Lewin, Sebastián; Vergara, Karina; De La Barra, Christian; Godoy, Natalio; Castilla, Juan Carlos; Gelcich, Stefan

2017-10-01

Artisanal fishery activities support the livelihoods of millions of people worldwide, particularly in developing countries. Within these fisheries, distal global drivers can promote switching between alternative target resources. These drivers can promote the rapid development of new, unregulated and previously unexploited fisheries that pose a threat to the sustainability of ecosystems. In this paper, we describe a new artisanal shore gathering activity that targets a previously unexploited resource: the sandhopper (Orchestoidea tuberculata). The activity is driven by aquarium trade demand for food. We used mixed methods to describe the activity, assessed basic socio-economic incentives, and estimated Catches per Unit Effort. Results show that the sandhopper plays an important role for the livelihoods of shore gatherers engaged in the activity. Gatherers have adapted and developed two main extraction methods with different degrees of investment and extraction rates. Furthermore, gatherers have developed local knowledge regarding the ecology and management of the resource. Results show that economic incentives can motivate a rapid expansion of this unregulated activity. Future research gaps and management options to address the development of this fishery are discussed in light of these findings.

Escherichia coli as a glycoprotein production host: recent developments and challenges.

PubMed

Jaffé, Stephen R P; Strutton, Benjamin; Levarski, Zdenko; Pandhal, Jagroop; Wright, Phillip C

2014-12-01

Chinese Hamster Ovary cells are the most popular host expression system for the large-scale production of human therapeutic glycoproteins, but, the race to engineer Escherichia coli to perform glycosylation is gathering pace. The successful functional transfer of an N-glycosylation pathway from Campylobacter jejuni to Escherichia coli in 2002 can be considered as the crucial first engineering step. Here, we discuss the recent advancements in the field of N-glycosylation of recombinant therapeutic proteins in E. coli cells, from the manipulation of glycan composition, to the improvement in glycosylation efficiency, along with the challenges that remain before E. coli can be available as an industry host cell for economically viable glycoprotein production. Copyright © 2014 Elsevier Ltd. All rights reserved.

Teaching with Vision: Culturally Responsive Teaching in Standards-Based Classrooms

ERIC Educational Resources Information Center

Sleeter, Christine E., Ed.; Cornbleth, Catherine, Ed.

2011-01-01

In "Teaching with Vision," two respected scholars in teaching for social justice have gathered teachers from across the country to describe rich examples of extraordinary practice. This collection showcases the professional experience and wisdom of classroom teachers who have been navigating standards- and test-driven teaching environments in…

Developing an Observation Instrument to Support Authentic Independent Reading Time during School in a Data-Driven World

ERIC Educational Resources Information Center

Williams, Lunetta M.; Hall, Katrina W.; Hedrick, Wanda B.; Lamkin, Marcia; Abendroth, Jennifer

2013-01-01

The purpose of the present study was to develop an instrument to measure reading during in-school independent reading (ISIR). Procedures to establish validity and reliability of the instrument included videotaping and observing students during ISIR, gathering feedback from literacy experts, establishing interrater reliability, crosschecking…

A Web-Based Resource for Investigating Environmental Change: The Emigrant Pass Observatory

ERIC Educational Resources Information Center

Davis, Michael G.; Chapman, David S.

2012-01-01

We present a user-friendly, data-driven Web site (http://thermal.gg.utah.edu/facilities/epo/) for a geothermal, climate change observatory that is educational for the general public, students, and researchers alike. The Emigrant Pass Observatory (EPO), located in the Grouse Creek Mountains in northwestern Utah, gathers both meteorological data…

Instrumental Analysis of Biodiesel Content in Commercial Diesel Blends: An Experiment for Undergraduate Analytical Chemistry

ERIC Educational Resources Information Center

Feng, Z. Vivian; Buchman, Joseph T.

2012-01-01

The potential of replacing petroleum fuels with renewable biofuels has drawn significant public interest. Many states have imposed biodiesel mandates or incentives to use commercial biodiesel blends. We present an inquiry-driven experiment where students are given the tasks to gather samples, develop analytical methods using various instrumental…

How Is European Governance Configuring the EHEA?

ERIC Educational Resources Information Center

Magalhães, António; Veiga, Amélia; Sousa, Sofia; Ribeiro, Filipa

2012-01-01

This article focuses on the interaction between the European dimension driven by the creation of the European Higher Education Area (EHEA) and the development of national reforms to fulfil that objective. On the basis of data gathered in eight countries involved in EuroHESC project TRUE (Transforming European Universities), the curricular and the…

Climate-driven environmental changes around 8,200 years ago favoured increases in cetacean strandings and Mediterranean hunter-gatherers exploited them

NASA Astrophysics Data System (ADS)

Mannino, Marcello A.; Talamo, Sahra; Tagliacozzo, Antonio; Fiore, Ivana; Nehlich, Olaf; Piperno, Marcello; Tusa, Sebastiano; Collina, Carmine; di Salvo, Rosaria; Schimmenti, Vittoria; Richards, Michael P.

2015-11-01

Cetacean mass strandings occur regularly worldwide, yet the compounded effects of natural and anthropogenic factors often complicate our understanding of these phenomena. Evidence of past stranding episodes may, thus, be essential to establish the potential influence of climate change. Investigations on bones from the site of Grotta dell’Uzzo in North West Sicily (Italy) show that the rapid climate change around 8,200 years ago coincided with increased strandings in the Mediterranean Sea. Stable isotope analyses on collagen from a large sample of remains recovered at this cave indicate that Mesolithic hunter-gatherers relied little on marine resources. A human and a red fox dating to the 8.2-kyr-BP climatic event, however, acquired at least one third of their protein from cetaceans. Numerous carcasses should have been available annually, for at least a decade, to obtain these proportions of meat. Our findings imply that climate-driven environmental changes, caused by global warming, may represent a serious threat to cetaceans in the near future.

Climate-driven environmental changes around 8,200 years ago favoured increases in cetacean strandings and Mediterranean hunter-gatherers exploited them.

PubMed

Mannino, Marcello A; Talamo, Sahra; Tagliacozzo, Antonio; Fiore, Ivana; Nehlich, Olaf; Piperno, Marcello; Tusa, Sebastiano; Collina, Carmine; Di Salvo, Rosaria; Schimmenti, Vittoria; Richards, Michael P

2015-11-17

Cetacean mass strandings occur regularly worldwide, yet the compounded effects of natural and anthropogenic factors often complicate our understanding of these phenomena. Evidence of past stranding episodes may, thus, be essential to establish the potential influence of climate change. Investigations on bones from the site of Grotta dell'Uzzo in North West Sicily (Italy) show that the rapid climate change around 8,200 years ago coincided with increased strandings in the Mediterranean Sea. Stable isotope analyses on collagen from a large sample of remains recovered at this cave indicate that Mesolithic hunter-gatherers relied little on marine resources. A human and a red fox dating to the 8.2-kyr-BP climatic event, however, acquired at least one third of their protein from cetaceans. Numerous carcasses should have been available annually, for at least a decade, to obtain these proportions of meat. Our findings imply that climate-driven environmental changes, caused by global warming, may represent a serious threat to cetaceans in the near future.

Climate-driven environmental changes around 8,200 years ago favoured increases in cetacean strandings and Mediterranean hunter-gatherers exploited them

PubMed Central

Mannino, Marcello A.; Talamo, Sahra; Tagliacozzo, Antonio; Fiore, Ivana; Nehlich, Olaf; Piperno, Marcello; Tusa, Sebastiano; Collina, Carmine; Di Salvo, Rosaria; Schimmenti, Vittoria; Richards, Michael P.

2015-01-01

Cetacean mass strandings occur regularly worldwide, yet the compounded effects of natural and anthropogenic factors often complicate our understanding of these phenomena. Evidence of past stranding episodes may, thus, be essential to establish the potential influence of climate change. Investigations on bones from the site of Grotta dell’Uzzo in North West Sicily (Italy) show that the rapid climate change around 8,200 years ago coincided with increased strandings in the Mediterranean Sea. Stable isotope analyses on collagen from a large sample of remains recovered at this cave indicate that Mesolithic hunter-gatherers relied little on marine resources. A human and a red fox dating to the 8.2-kyr-BP climatic event, however, acquired at least one third of their protein from cetaceans. Numerous carcasses should have been available annually, for at least a decade, to obtain these proportions of meat. Our findings imply that climate-driven environmental changes, caused by global warming, may represent a serious threat to cetaceans in the near future. PMID:26573384

Data Albums: An Event Driven Search, Aggregation and Curation Tool for Earth Science

NASA Technical Reports Server (NTRS)

Ramachandran, Rahul; Kulkarni, Ajinkya; Maskey, Manil; Bakare, Rohan; Basyal, Sabin; Li, Xiang; Flynn, Shannon

2014-01-01

Approaches used in Earth science research such as case study analysis and climatology studies involve discovering and gathering diverse data sets and information to support the research goals. To gather relevant data and information for case studies and climatology analysis is both tedious and time consuming. Current Earth science data systems are designed with the assumption that researchers access data primarily by instrument or geophysical parameter. In cases where researchers are interested in studying a significant event, they have to manually assemble a variety of datasets relevant to it by searching the different distributed data systems. This paper presents a specialized search, aggregation and curation tool for Earth science to address these challenges. The search rool automatically creates curated 'Data Albums', aggregated collections of information related to a specific event, containing links to relevant data files [granules] from different instruments, tools and services for visualization and analysis, and information about the event contained in news reports, images or videos to supplement research analysis. Curation in the tool is driven via an ontology based relevancy ranking algorithm to filter out non relevant information and data.

Macrocognition in Day-To-Day Police Incident Response

PubMed Central

Baber, Chris; McMaster, Richard

2016-01-01

Using examples of incidents that UK Police Forces deal with on a day-to-day basis, we explore the macrocognition of incident response. Central to our analysis is the idea that information relating to an incident is translated from negotiated to structured and actionable meaning, in terms of the Community of Practice of the personnel involved in incident response. Through participant observation of, and interviews with, police personnel, we explore the manner in which these different types of meaning shift over the course of incident. In this way, macrocognition relates to gathering, framing, and sharing information through the collaborative sensemaking practices of those involved. This involves two cycles of macrocognition, which we see as ‘informal’ (driven by information gathering as the Community of Practice negotiates and actions meaning) and ‘formal’ (driven by the need to assign resources to the response and the need to record incident details). The examples illustrate that these cycles are often intertwined, as are the different forms of meaning, in situation-specific ways that provide adaptive response to the demands of the incident. PMID:27014117

Macrocognition in Day-To-Day Police Incident Response.

PubMed

Baber, Chris; McMaster, Richard

2016-01-01

Using examples of incidents that UK Police Forces deal with on a day-to-day basis, we explore the macrocognition of incident response. Central to our analysis is the idea that information relating to an incident is translated from negotiated to structured and actionable meaning, in terms of the Community of Practice of the personnel involved in incident response. Through participant observation of, and interviews with, police personnel, we explore the manner in which these different types of meaning shift over the course of incident. In this way, macrocognition relates to gathering, framing, and sharing information through the collaborative sensemaking practices of those involved. This involves two cycles of macrocognition, which we see as 'informal' (driven by information gathering as the Community of Practice negotiates and actions meaning) and 'formal' (driven by the need to assign resources to the response and the need to record incident details). The examples illustrate that these cycles are often intertwined, as are the different forms of meaning, in situation-specific ways that provide adaptive response to the demands of the incident.

Orbital pacing and ocean circulation-induced collapses of the Mesoamerican monsoon over the past 22,000 y.

PubMed

Lachniet, Matthew S; Asmerom, Yemane; Bernal, Juan Pablo; Polyak, Victor J; Vazquez-Selem, Lorenzo

2013-06-04

The dominant controls on global paleomonsoon strength include summer insolation driven by precession cycles, ocean circulation through its influence on atmospheric circulation, and sea-surface temperatures. However, few records from the summer North American Monsoon system are available to test for a synchronous response with other global monsoons to shared forcings. In particular, the monsoon response to widespread atmospheric reorganizations associated with disruptions of the Atlantic Meridional Overturning Circulation (AMOC) during the deglacial period remains unconstrained. Here, we present a high-resolution and radiometrically dated monsoon rainfall reconstruction over the past 22,000 y from speleothems of tropical southwestern Mexico. The data document an active Last Glacial Maximum (18-24 cal ka B.P.) monsoon with similar δ(18)O values to the modern, and that the monsoon collapsed during periods of weakened AMOC during Heinrich stadial 1 (ca. 17 ka) and the Younger Dryas (12.9-11.5 ka). The Holocene was marked by a trend to a weaker monsoon that was paced by orbital insolation. We conclude that the Mesoamerican monsoon responded in concert with other global monsoon regions, and that monsoon strength was driven by variations in the strength and latitudinal position of the Intertropical Convergence Zone, which was forced by AMOC variations in the North Atlantic Ocean. The surprising observation of an active Last Glacial Maximum monsoon is attributed to an active but shallow AMOC and proximity to the Intertropical Convergence Zone. The emergence of agriculture in southwestern Mexico was likely only possible after monsoon strengthening in the Early Holocene at ca. 11 ka.

Orbital pacing and ocean circulation-induced collapses of the Mesoamerican monsoon over the past 22,000 y

PubMed Central

Lachniet, Matthew S.; Asmerom, Yemane; Bernal, Juan Pablo; Polyak, Victor J.; Vazquez-Selem, Lorenzo

2013-01-01

The dominant controls on global paleomonsoon strength include summer insolation driven by precession cycles, ocean circulation through its influence on atmospheric circulation, and sea-surface temperatures. However, few records from the summer North American Monsoon system are available to test for a synchronous response with other global monsoons to shared forcings. In particular, the monsoon response to widespread atmospheric reorganizations associated with disruptions of the Atlantic Meridional Overturning Circulation (AMOC) during the deglacial period remains unconstrained. Here, we present a high-resolution and radiometrically dated monsoon rainfall reconstruction over the past 22,000 y from speleothems of tropical southwestern Mexico. The data document an active Last Glacial Maximum (18–24 cal ka B.P.) monsoon with similar δ18O values to the modern, and that the monsoon collapsed during periods of weakened AMOC during Heinrich stadial 1 (ca. 17 ka) and the Younger Dryas (12.9–11.5 ka). The Holocene was marked by a trend to a weaker monsoon that was paced by orbital insolation. We conclude that the Mesoamerican monsoon responded in concert with other global monsoon regions, and that monsoon strength was driven by variations in the strength and latitudinal position of the Intertropical Convergence Zone, which was forced by AMOC variations in the North Atlantic Ocean. The surprising observation of an active Last Glacial Maximum monsoon is attributed to an active but shallow AMOC and proximity to the Intertropical Convergence Zone. The emergence of agriculture in southwestern Mexico was likely only possible after monsoon strengthening in the Early Holocene at ca. 11 ka. PMID:23690596

Murine Electrophysiological Models of Cardiac Arrhythmogenesis

PubMed Central

2016-01-01

Cardiac arrhythmias can follow disruption of the normal cellular electrophysiological processes underlying excitable activity and their tissue propagation as coherent wavefronts from the primary sinoatrial node pacemaker, through the atria, conducting structures and ventricular myocardium. These physiological events are driven by interacting, voltage-dependent, processes of activation, inactivation, and recovery in the ion channels present in cardiomyocyte membranes. Generation and conduction of these events are further modulated by intracellular Ca2+ homeostasis, and metabolic and structural change. This review describes experimental studies on murine models for known clinical arrhythmic conditions in which these mechanisms were modified by genetic, physiological, or pharmacological manipulation. These exemplars yielded molecular, physiological, and structural phenotypes often directly translatable to their corresponding clinical conditions, which could be investigated at the molecular, cellular, tissue, organ, and whole animal levels. Arrhythmogenesis could be explored during normal pacing activity, regular stimulation, following imposed extra-stimuli, or during progressively incremented steady pacing frequencies. Arrhythmic substrate was identified with temporal and spatial functional heterogeneities predisposing to reentrant excitation phenomena. These could arise from abnormalities in cardiac pacing function, tissue electrical connectivity, and cellular excitation and recovery. Triggering events during or following recovery from action potential excitation could thereby lead to sustained arrhythmia. These surface membrane processes were modified by alterations in cellular Ca2+ homeostasis and energetics, as well as cellular and tissue structural change. Study of murine systems thus offers major insights into both our understanding of normal cardiac activity and its propagation, and their relationship to mechanisms generating clinical arrhythmias. PMID:27974512

Astronomical pacing of the global silica cycle recorded in Mesozoic bedded cherts.

PubMed

Ikeda, Masayuki; Tada, Ryuji; Ozaki, Kazumi

2017-06-07

The global silica cycle is an important component of the long-term climate system, yet its controlling factors are largely uncertain due to poorly constrained proxy records. Here we present a ∼70 Myr-long record of early Mesozoic biogenic silica (BSi) flux from radiolarian chert in Japan. Average low-mid-latitude BSi burial flux in the superocean Panthalassa is ∼90% of that of the modern global ocean and relative amplitude varied by ∼20-50% over the 100 kyr to 30 Myr orbital cycles during the early Mesozoic. We hypothesize that BSi in chert was a major sink for oceanic dissolved silica (DSi), with fluctuations proportional to DSi input from chemical weathering on timescales longer than the residence time of DSi (<∼100 Kyr). Chemical weathering rates estimated by the GEOCARBSULFvolc model support these hypotheses, excluding the volcanism-driven oceanic anoxic events of the Early-Middle Triassic and Toarcian that exceed model limits. We propose that the Mega monsoon of the supercontinent Pangea nonlinearly amplified the orbitally paced chemical weathering that drove BSi burial during the early Mesozoic greenhouse world.

Astronomical pacing of the global silica cycle recorded in Mesozoic bedded cherts

NASA Astrophysics Data System (ADS)

Ikeda, Masayuki; Tada, Ryuji; Ozaki, Kazumi

2017-06-01

The global silica cycle is an important component of the long-term climate system, yet its controlling factors are largely uncertain due to poorly constrained proxy records. Here we present a ~70 Myr-long record of early Mesozoic biogenic silica (BSi) flux from radiolarian chert in Japan. Average low-mid-latitude BSi burial flux in the superocean Panthalassa is ~90% of that of the modern global ocean and relative amplitude varied by ~20-50% over the 100 kyr to 30 Myr orbital cycles during the early Mesozoic. We hypothesize that BSi in chert was a major sink for oceanic dissolved silica (DSi), with fluctuations proportional to DSi input from chemical weathering on timescales longer than the residence time of DSi (<~100 Kyr). Chemical weathering rates estimated by the GEOCARBSULFvolc model support these hypotheses, excluding the volcanism-driven oceanic anoxic events of the Early-Middle Triassic and Toarcian that exceed model limits. We propose that the Mega monsoon of the supercontinent Pangea nonlinearly amplified the orbitally paced chemical weathering that drove BSi burial during the early Mesozoic greenhouse world.

Do Demographics and Functional Abilities Influence Vehicle Type Driven by Older Canadians?

PubMed

Vrkljan, Brenda; Crizzle, Alexander; Villeneuve, Simon; Porter, Michelle; Koppel, Sjaan; Mazer, Barbara L; Naglie, Gary; Bédard, Michel; Tuokko, Holly A; Gélinas, Isabelle; Marshall, Shawn C; Rapoport, Mark J

2016-06-01

In this study, we examined the Candrive baseline data (n = 928; aged 70 to 94; 62% were men) to determine whether driver characteristics (i.e., age, gender, height, weight, BMI) and certain functional abilities (i.e., Rapid Paced Walk, Timed Up and Go) influenced the types of vehicles driven. There were significant differences with respect to type of vehicle and mean driver age (F = 3.58, p = 0.003), height, (F = 13.32, p < 0.001), weight (F = 14.31, p < 0.001), and BMI (F = 4.40, p = 0.001). A greater proportion of drivers with osteoporosis (χ2 = 21.23, p = 0.020) and osteo/rheumatoid arthritis (χ2 = 21.23, p = 0.020) drove small and medium-sized cars compared to larger ones. Further research is needed to examine older driver-vehicle interactions, and the relationship to demographics and functional abilities, given the vulnerability of this age group to automotive-related injuries.

Data Driven Quality Improvement of Health Professions Education: Design and Development of CLUE - An Interactive Curriculum Data Visualization Tool.

PubMed

Canning, Claire Ann; Loe, Alan; Cockett, Kathryn Jane; Gagnon, Paul; Zary, Nabil

2017-01-01

Curriculum Mapping and dynamic visualization is quickly becoming an integral aspect of quality improvement in support of innovations which drive curriculum quality assurance processes in medical education. CLUE (Curriculum Explorer) a highly interactive, engaging and independent platform was developed to support curriculum transparency, enhance student engagement, and enable granular search and display. Reflecting a design based approach to meet the needs of the school's varied stakeholders, CLUE employs an iterative and reflective approach to drive the evolution of its platform, as it seeks to accommodate the ever-changing needs of our stakeholders in the fast pace world of medicine and medical education today. CLUE exists independent of institutional systems and in this way, is uniquely positioned to deliver a data driven quality improvement resource, easily adaptable for use by any member of our health care professions.

Abstract knowledge versus direct experience in processing of binomial expressions

PubMed Central

Morgan, Emily; Levy, Roger

2016-01-01

We ask whether word order preferences for binomial expressions of the form A and B (e.g. bread and butter) are driven by abstract linguistic knowledge of ordering constraints referencing the semantic, phonological, and lexical properties of the constituent words, or by prior direct experience with the specific items in questions. Using forced-choice and self-paced reading tasks, we demonstrate that online processing of never-before-seen binomials is influenced by abstract knowledge of ordering constraints, which we estimate with a probabilistic model. In contrast, online processing of highly frequent binomials is primarily driven by direct experience, which we estimate from corpus frequency counts. We propose a trade-off wherein processing of novel expressions relies upon abstract knowledge, while reliance upon direct experience increases with increased exposure to an expression. Our findings support theories of language processing in which both compositional generation and direct, holistic reuse of multi-word expressions play crucial roles. PMID:27776281

Dynamics of energetic particle driven modes and MHD modes in wall-stabilized high-β plasmas on JT-60U and DIII-D

NASA Astrophysics Data System (ADS)

Matsunaga, G.; Okabayashi, M.; Aiba, N.; Boedo, J. A.; Ferron, J. R.; Hanson, J. M.; Hao, G. Z.; Heidbrink, W. W.; Holcomb, C. T.; In, Y.; Jackson, G. L.; Liu, Y. Q.; Luce, T. C.; McKee, G. R.; Osborne, T. H.; Pace, D. C.; Shinohara, K.; Snyder, P. B.; Solomon, W. M.; Strait, E. J.; Turnbull, A. D.; Van Zeeland, M. A.; Watkins, J. G.; Zeng, L.; the DIII-D Team; the JT-60 Team

2013-12-01

In the wall-stabilized high-β plasmas in JT-60U and DIII-D, interactions between energetic particle (EP) driven modes (EPdMs) and edge localized modes (ELMs) have been observed. The interaction between the EPdM and ELM are reproducibly observed. Many EP diagnostics indicate a strong correlation between the distorted waveform of the EPdM and the EP transport to the edge. The waveform distortion is composed of higher harmonics (n ⩾ 2) and looks like a density snake near the plasma edge. According to statistical analyses, ELM triggering by the EPdMs requires a finite level of waveform distortion and pedestal recovery. ELM pacing by the EPdMs occurs when the repetition frequency of the EPdMs is higher than the natural ELM frequency. EPs transported by EPdMs are thought to contribute to change the edge stability.

QoS Challenges and Opportunities in Wireless Sensor/Actuator Networks

PubMed Central

Xia, Feng

2008-01-01

A wireless sensor/actuator network (WSAN) is a group of sensors and actuators that are geographically distributed and interconnected by wireless networks. Sensors gather information about the state of physical world. Actuators react to this information by performing appropriate actions. WSANs thus enable cyber systems to monitor and manipulate the behavior of the physical world. WSANs are growing at a tremendous pace, just like the exploding evolution of Internet. Supporting quality of service (QoS) will be of critical importance for pervasive WSANs that serve as the network infrastructure of diverse applications. To spark new research and development interests in this field, this paper examines and discusses the requirements, critical challenges, and open research issues on QoS management in WSANs. A brief overview of recent progress is given. PMID:27879755

Empirical Research on Native Chinese Speakers Reading in English: Data Driven Issues and Challenges

ERIC Educational Resources Information Center

Brantmeier, Cindy; Xiucheng, Yu

2014-01-01

Mastery of English in China has gathered increased prominence due to the need to foster cultural, political, and economic connections worldwide. Reading is an obvious skill of vital importance for advancing efforts as a player in the world economy. The present article examines research published in academic journals in Chinese and English to…

Social Studies Fresh Frontier for Standards

ERIC Educational Resources Information Center

Gewertz, Catherine

2011-01-01

Feeling that social studies has been sidelined by a test-driven focus on math and English/language arts, subject-matter specialists from more than a dozen states met last week with representatives of content-area groups to brainstorm ways to improve academic standards in that subject. The two-day gathering in Charlotte, N.C., is the third convened…

Optimal pacing modes after cardiac transplantation: is synchronisation of recipient and donor atria beneficial?

PubMed Central

Parry, Gareth; Malbut, Katie; Dark, John H; Bexton, Rodney S

1992-01-01

Objective—To investigate the response of the transplanted heart to different pacing modes and to synchronisation of the recipient and donor atria in terms of cardiac output at rest. Design—Doppler derived cardiac output measurements at three pacing rates (90/min, 110/min and 130/min) in five pacing modes: right ventricular pacing, donor atrial pacing, recipient-donor synchronous pacing, donor atrial-ventricular sequential pacing, and synchronous recipient-donor atrial-ventricular sequential pacing. Patients—11 healthy cardiac transplant recipients with three pairs of epicardial leads inserted at transplantation. Results—Donor atrial pacing (+11% overall) and donor atrial-ventricular sequential pacing (+8% overall) were significantly better than right ventricular pacing (p < 0·001) at all pacing rates. Synchronised pacing of recipient and donor atrial segments did not confer additional benefit in either atrial or atrial-ventricular sequential modes of pacing in terms of cardiac output at rest at these fixed rates. Conclusions—Atrial pacing or atrial-ventricular sequential pacing appear to be appropriate modes in cardiac transplant recipients. Synchronisation of recipient and donor atrial segments in this study produced no additional benefit. Chronotropic competence in these patients may, however, result in improved exercise capacity and deserves further investigation. PMID:1389737

From Monolithics to Tethers to Freeflyers: The Spectrum of Large Aperture Sensing from Space

NASA Technical Reports Server (NTRS)

Leitner, Jesse; Quinn, David; Bauer, Frank (Technical Monitor)

2002-01-01

As part of NASA's endeavor to push the envelope and go where we have never been before, the Space Science Enterprise has laid out a vision which includes several missions that revolutionize the collection of scientific data from space. Many of the missions designed to meet the objectives of these programs depend heavily on the ability to perform space-based interferometry, which has recently become a rapidly growing field of investigation for both the scientific and engineering communities. While scientists are faced with the challenges of designing high fidelity optical systems capable of making detailed observations, engineers wrestle with the problem of providing s-pace-based platforms that can permit this data gathering to occur. Observational data gathering is desired at's variety of spectral wavelengths and resolutions, calling for interferometers with a range of baseline requirements. Approaches to configuration design are as varied as the missions themselves from large monolithic spacecraft to multiple free-flying small spacecraft and everything in between. As will be discussed, no one approach provides a 'panacea' of solutions rather each has its place in terms of the mission requirements. The purpose here is to identify the advantages and disadvantages of the various approaches, to discuss the driving factors in design selection and determine the relative range of applicability of each design approach.

Presentation Time Concerning System-Paced Multimedia Instructions and the Superiority of Learner Pacing

ERIC Educational Resources Information Center

Stiller, Klaus D.; Petzold, Kirstin; Zinnbauer, Peter

2011-01-01

The superiority of learner-paced over system-paced instructions was demonstrated in multiple experiments. In these experiments, the system-paced presentations were highly speeded, causing cognitive overload, while the learner-paced instructions allowed adjustments of the presentational flow to the learner's needs by pacing facilities, mostly…

The Museum Wearable: Real-Time Sensor-Driven Understanding of Visitors' Interests for Personalized Visually-Augmented Museum Experiences.

ERIC Educational Resources Information Center

Sparacino, Flavia

This paper describes the museum wearable: a wearable computer that orchestrates an audiovisual narration as a function of the visitors' interests gathered from their physical path in the museum and length of stops. The wearable consists of a lightweight and small computer that people carry inside a shoulder pack. It offers an audiovisual…

Temporary atrial epicardial pacing as prophylaxis against atrial fibrillation after heart surgery: a meta-analysis.

PubMed

Daoud, Emile G; Snow, Rick; Hummel, John D; Kalbfleisch, Steven J; Weiss, Raul; Augostini, Ralph

2003-02-01

Recent studies have reported the use of temporary epicardial atrial pacing as prophylaxis for postoperative atrial fibrillation (AF). The aim of this study was to assess the effect of pacing therapies for prevention of postoperative AF using meta-analysis. Using a computerized MEDLINE search, eight pacing prophylaxis trials with 776 patients were included in the meta-analysis. Trials compared control patients to patients randomized to right atrial, left atrial, or biatrial pacing used in conjunction with either fixed high-rate pacing or overdrive pacing. Overdrive biatrial pacing (OR 2.6, CI 1.4-4.8), overdrive right atrial pacing (OR 1.8, CI 1.1-2.7), and fixed high-rate biatrial pacing (OR 2.5, CI 1.3-5.1) demonstrated a significant antiarrhythmic effect for prevention of AF after open heart surgery. Furthermore, studies investigating overdrive left atrial pacing and fixed high-rate right atrial pacing have been underpowered to assess efficacy. Biatrial overdrive and fixed high-rate pacing and right atrial fixed high-rate pacing reduced the risk of new-onset AF after open heart surgery, and the relative risk reduction is approximately 2.5-fold. These results imply that various pacing algorithms are useful as a nonpharmacologic method to prevent postoperative AF.

Astronomical pacing of the global silica cycle recorded in Mesozoic bedded cherts

PubMed Central

Ikeda, Masayuki; Tada, Ryuji; Ozaki, Kazumi

2017-01-01

The global silica cycle is an important component of the long-term climate system, yet its controlling factors are largely uncertain due to poorly constrained proxy records. Here we present a ∼70 Myr-long record of early Mesozoic biogenic silica (BSi) flux from radiolarian chert in Japan. Average low-mid-latitude BSi burial flux in the superocean Panthalassa is ∼90% of that of the modern global ocean and relative amplitude varied by ∼20–50% over the 100 kyr to 30 Myr orbital cycles during the early Mesozoic. We hypothesize that BSi in chert was a major sink for oceanic dissolved silica (DSi), with fluctuations proportional to DSi input from chemical weathering on timescales longer than the residence time of DSi (<∼100 Kyr). Chemical weathering rates estimated by the GEOCARBSULFvolc model support these hypotheses, excluding the volcanism-driven oceanic anoxic events of the Early-Middle Triassic and Toarcian that exceed model limits. We propose that the Mega monsoon of the supercontinent Pangea nonlinearly amplified the orbitally paced chemical weathering that drove BSi burial during the early Mesozoic greenhouse world. PMID:28589958

42 CFR 460.60 - PACE organizational structure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false PACE organizational structure. 460.60 Section 460.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... ELDERLY (PACE) PACE Administrative Requirements § 460.60 PACE organizational structure. (a) A PACE...

Physiologic pacing: new modalities and pacing sites.

PubMed

Padeletti, Luigi; Lieberman, Randy; Valsecchi, Sergio; Hettrick, Douglas A

2006-12-01

Right ventricular (RV) apical pacing impairs left ventricular function by inducing dys-synchronous contraction and relaxation. Chronic RV apical pacing is associated with an increased risk of atrial fibrillation, morbidity, and even mortality. These observations have raised questions regarding the appropriate pacing mode and site, leading to the introduction of algorithms and new pacing modes to reduce the ventricular pacing burden in dual chamber devices, and a shift of the pacing site away from the RV apex. However, further investigations are required to assess the long-term results of pacing from alternative sites in the right ventricle, because long-term results so far are equivocal. The potential benefit of prophylactic biventricular, mono-chamber left ventricular, and bifocal RV pacing should be explored in selected patients with a narrow QRS complex, especially those with impaired left ventricular function. His bundle pacing is a promising and evolving technique that requires improvements in lead technology.

Places to Go, Things to See

NASA Technical Reports Server (NTRS)

2009-01-01

Since leaving 'Victoria Crater,' Opportunity has picked up the pace of driving. In the 90 sols (Martian days) since exiting the crater, Opportunity has driven more than 1,800 meters (1.1 miles), three times the distance that was required for the original prime mission. Scientists expect to encounter younger rocks the farther south the rover travels. They also expect to find small rocks ejected onto the landscape during formation of nearby craters. To reach these things, the rover must avoid sand traps as much as possible.

Opportunity acquired this mosaic with the navigation camera on the rover's 1,683rd Martian day, or sol (Oct. 18, 2008), of exploration.

The timescales of global surface-ocean connectivity.

PubMed

Jönsson, Bror F; Watson, James R

2016-04-19

Planktonic communities are shaped through a balance of local evolutionary adaptation and ecological succession driven in large part by migration. The timescales over which these processes operate are still largely unresolved. Here we use Lagrangian particle tracking and network theory to quantify the timescale over which surface currents connect different regions of the global ocean. We find that the fastest path between two patches--each randomly located anywhere in the surface ocean--is, on average, less than a decade. These results suggest that marine planktonic communities may keep pace with climate change--increasing temperatures, ocean acidification and changes in stratification over decadal timescales--through the advection of resilient types.

The timescales of global surface-ocean connectivity

PubMed Central

Jönsson, Bror F.; Watson, James R.

2016-01-01

Planktonic communities are shaped through a balance of local evolutionary adaptation and ecological succession driven in large part by migration. The timescales over which these processes operate are still largely unresolved. Here we use Lagrangian particle tracking and network theory to quantify the timescale over which surface currents connect different regions of the global ocean. We find that the fastest path between two patches—each randomly located anywhere in the surface ocean—is, on average, less than a decade. These results suggest that marine planktonic communities may keep pace with climate change—increasing temperatures, ocean acidification and changes in stratification over decadal timescales—through the advection of resilient types. PMID:27093522

42 CFR 460.6 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Basis... enrolled in a PACE program. PACE stands for programs of all-inclusive care for the elderly. PACE center is... care for the elderly that is operated by an approved PACE organization and that provides comprehensive...

42 CFR 460.6 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Basis... enrolled in a PACE program. PACE stands for programs of all-inclusive care for the elderly. PACE center is... care for the elderly that is operated by an approved PACE organization and that provides comprehensive...

42 CFR 460.180 - Medicare payment to PACE organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Medicare payment to PACE organizations. 460.180... FOR THE ELDERLY (PACE) Payment § 460.180 Medicare payment to PACE organizations. (a) Principle of payment. Under a PACE program agreement, CMS makes a prospective monthly payment to the PACE organization...

Clicker Evolution: Seeking Intelligent Design

PubMed Central

Barber, Maryfran

2007-01-01

Two years after the first low-cost radio-frequency audience response system using clickers was introduced for college classrooms, at least six different systems are on the market. Their features and user-friendliness are evolving rapidly, driven by competition and improving technology. The proliferation of different systems is putting pressure on universities to standardize or otherwise limit the number of different clickers a student is expected to acquire. To facilitate that choice, the strengths and weaknesses of six systems (eInstruction Classroom Performance System, Qwizdom, TurningPoint, Interwrite PRS, iClicker, and H-ITT) are compared, and the factors that should be considered in making a selection are discussed. In our opinion, the selection of a clicker system should be driven by the faculty, although students and the relevant teaching and technology support units of the university must also participate in the dialogue. Given the pace of development, it is also wise to reconsider the choice of a clicker system at regular intervals. PMID:17339388

Climate change-driven cliff and beach evolution at decadal to centennial time scales

USGS Publications Warehouse

Erikson, Li; O'Neill, Andrea; Barnard, Patrick; Vitousek, Sean; Limber, Patrick

2017-01-01

Here we develop a computationally efficient method that evolves cross-shore profiles of sand beaches with or without cliffs along natural and urban coastal environments and across expansive geographic areas at decadal to centennial time-scales driven by 21st century climate change projections. The model requires projected sea level rise rates, extrema of nearshore wave conditions, bluff recession and shoreline change rates, and cross-shore profiles representing present-day conditions. The model is applied to the ~470-km long coast of the Southern California Bight, USA, using recently available projected nearshore waves and bluff recession and shoreline change rates. The results indicate that eroded cliff material, from unarmored cliffs, contribute 11% to 26% to the total sediment budget. Historical beach nourishment rates will need to increase by more than 30% for a 0.25 m sea level rise (~2044) and by at least 75% by the year 2100 for a 1 m sea level rise, if evolution of the shoreline is to keep pace with rising sea levels.

Aging affects the balance of neural entrainment and top-down neural modulation in the listening brain

PubMed Central

Henry, Molly J.; Herrmann, Björn; Kunke, Dunja; Obleser, Jonas

2017-01-01

Healthy aging is accompanied by listening difficulties, including decreased speech comprehension, that stem from an ill-understood combination of sensory and cognitive changes. Here, we use electroencephalography to demonstrate that auditory neural oscillations of older adults entrain less firmly and less flexibly to speech-paced (∼3 Hz) rhythms than younger adults’ during attentive listening. These neural entrainment effects are distinct in magnitude and origin from the neural response to sound per se. Non-entrained parieto-occipital alpha (8–12 Hz) oscillations are enhanced in young adults, but suppressed in older participants, during attentive listening. Entrained neural phase and task-induced alpha amplitude exert opposite, complementary effects on listening performance: higher alpha amplitude is associated with reduced entrainment-driven behavioural performance modulation. Thus, alpha amplitude as a task-driven, neuro-modulatory signal can counteract the behavioural corollaries of neural entrainment. Balancing these two neural strategies may present new paths for intervention in age-related listening difficulties. PMID:28654081

What Would a Leader Do? A Self-Study Examining How Building Capacity Impacts Others

ERIC Educational Resources Information Center

Brown, LaKimbre

2010-01-01

The purpose of this self-study was to document and analyze principal actions and their impact on the school culture. This study was a systemic manner to gather data that can lead to changes in administrator practice. The rationale for this study is driven from a desire to understand the impact of a positive principal disposition on school morale.…

Toward a more data-driven supervision of collegiate counseling centers.

PubMed

Varlotta, Lori E

2012-01-01

Hearing the national call for higher education accountability, the author of this tripartite article urges university administrators to move towards a more data-driven approach to counseling center supervision. Toward that end, the author first examines a key factor--perceived increase in student pathology--that appears to shape budget and staffing decisions in many university centers. Second, she reviews the emerging but conflicting research of clinician-scholars who are trying to empirically verify or refute that perception; their conflicting results suggest that no study alone should be used as the "final word" in evidence-based decision-making. Third, the author delineates the campus-specific data that should be gathered to guide staffing and budgeting decisions on each campus. She concludes by reminding readers that data-driven decisions can and should foster high-quality care that is concurrently efficient, effective, and in sync with the needs of a particular university and student body.

Large-scale deep learning for robotically gathered imagery for science

NASA Astrophysics Data System (ADS)

Skinner, K.; Johnson-Roberson, M.; Li, J.; Iscar, E.

2016-12-01

With the explosion of computing power, the intelligence and capability of mobile robotics has dramatically increased over the last two decades. Today, we can deploy autonomous robots to achieve observations in a variety of environments ripe for scientific exploration. These platforms are capable of gathering a volume of data previously unimaginable. Additionally, optical cameras, driven by mobile phones and consumer photography, have rapidly improved in size, power consumption, and quality making their deployment cheaper and easier. Finally, in parallel we have seen the rise of large-scale machine learning approaches, particularly deep neural networks (DNNs), increasing the quality of the semantic understanding that can be automatically extracted from optical imagery. In concert this enables new science using a combination of machine learning and robotics. This work will discuss the application of new low-cost high-performance computing approaches and the associated software frameworks to enable scientists to rapidly extract useful science data from millions of robotically gathered images. The automated analysis of imagery on this scale opens up new avenues of inquiry unavailable using more traditional manual or semi-automated approaches. We will use a large archive of millions of benthic images gathered with an autonomous underwater vehicle to demonstrate how these tools enable new scientific questions to be posed.

Direct His bundle pacing post AVN ablation.

PubMed

Lakshmanadoss, Umashankar; Aggarwal, Ashim; Huang, David T; Daubert, James P; Shah, Abrar

2009-08-01

Atrioventricular nodal (AVN) ablation with concomitant pacemaker implantation is one of the strategies that reduce symptoms in patients with atrial fibrillation (AF). However, the long-term adverse effects of right ventricular (RV) apical pacing have led to the search for alternating sites of pacing. Biventricular pacing produces a significant improvement in functional capacity over RV pacing in patients undergoing AVN ablation. Another alternative site for pacing is direct His bundle to reduce the adverse outcome of RV pacing. Here, we present a case of direct His bundle pacing using steerable lead delivery system in a patient with symptomatic paroxysmal AF with concurrent AVN ablation.

42 CFR 460.34 - Duration of PACE program agreement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.34 Duration of PACE program agreement. An agreement is...

42 CFR 460.34 - Duration of PACE program agreement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.34 Duration of PACE program agreement. An agreement is...

Canine left ventricle electromechanical behavior under different pacing modes.

PubMed

Vo Thang, Thanh-Thuy; Thibault, Bernard; Finnerty, Vincent; Pelletier-Galarneau, Matthieu; Khairy, Paul; Grégoire, Jean; Harel, François

2012-10-01

Cardiac resynchronization therapy may improve survival and quality of life in patients suffering from heart failure with left ventricular (LV) contraction dyssynchrony. While several studies have investigated electrical or mechanical determinants of synchronous contraction, few have focused on activation contraction coupling at a macroscopic level. The objective of the study was to characterize LV electromechanical behavior and response to pacing in a heart failure model. We analyzed data from 3D electroanatomic non-contact mapping and blood pool SPECT for 12 dogs with right ventricular (RV) tachycardia pacing-induced dilated cardiomyopathy. Surfaces generated by the two modalities were registered. Electrical signals were analyzed, and endocardial wall displacement curves were portrayed. Rapid pacing decreased the mean LV ejection fraction (LVEF) to 20.9 % and prolonged the QRS duration to 79 ± 10 ms (normal range: 40-50 ms). QRS duration remained unchanged with biventricular pacing (88.5 ms), while single site pacing further prolonged the QRS duration (113.3 ms for RV pacing and 111.6 ms for LV pacing). No trend was observed in LV systolic function. Activation duration time was significantly increased with all pacing modes compared to baseline. Finally, electromechanical delay, as defined by the delay between electrical activation and mechanical response, was increased by single site pacing (172.9 ms for RV pacing and 174.6 ms for LV pacing) but not by biventricular pacing (162.4 ms). Combined temporal and spatial coregistration electroanatomic maps and baseline gated blood pool SPECT imaging allowed us to quantify activation duration time, electromechanical delay, and LVEF for different pacing modes. Even if pacing modes did not significantly modify LVEF or activation duration, they produced alterations in electromechanical delay, with biventricular pacing significantly decreasing the electromechanical delay as measured by surface tracings and endocardial non-contact mapping.

Bachmann's Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing.

PubMed

Sławuta, Agnieszka; Kliś, Magdalena; Skoczyński, Przemysław; Bańkowski, Tomasz; Moszczyńska-Stulin, Joanna; Gajek, Jacek

2016-01-01

Patients treated for sick sinus syndrome may have interatrial conduction disorder leading to atrial fibrillation. This study was aimed to assess the influence of the atrial pacing site on interatrial and atrioventricular conduction as well as the percentage of ventricular pacing in patients with sick sinus syndrome implanted with atrioventricular pacemaker. The study population: 96 patients (58 females, 38 males) aged 74.1 ± 11.8 years were divided in two groups: Group 1 (n = 44) with right atrial appendage pacing and group 2 (n = 52) with Bachmann's area pacing. We assessed the differences in atrioventricular conduction in sinus rhythm and atrial 60 and 90 bpm pacing, P-wave duration and percentage of ventricular pacing. No differences in baseline P-wave duration in sinus rhythm between the groups (102.4 ± 17 ms vs. 104.1 ± 26 ms, p = ns.) were noted. Atrial pacing 60 bpm resulted in longer P-wave in group 1 vs. group 2 (138.3 ± 21 vs. 106.1 ± 15 ms, p < 0.01). The differences between atrioventricular conduction time during sinus rhythm and atrial pacing at 60 and 90 bpm were significantly longer in patients with right atrial appendage vs. Bachmann's pacing (44.1 ± 17 vs. 9.2 ± 7 ms p < 0.01 and 69.2 ± 31 vs. 21.4 ± 12 ms p < 0.05, respectively). The percentage of ventricular pacing was higher in group 1 (21 vs. 4%, p < 0.01). Bachmann's bundle pacing decreases interatrial and atrioventricular conduction delay. Moreover, the frequency-dependent atrioventricular conduction lengthening is much less pronounced during Bachmann's bundle pacing. Right atrial appendage pacing in sick sinus syndrome patients promotes a higher percentage of ventricular pacing.

42 CFR 460.32 - Content and terms of PACE program agreement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.32 Content and terms of PACE program agreement. (a...

42 CFR 460.90 - PACE benefits under Medicare and Medicaid.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...

Multi-Leu PACE4 Inhibitor Retention within Cells Is PACE4 Dependent and a Prerequisite for Antiproliferative Activity

PubMed Central

Ly, Kévin; Levesque, Christine; Kwiatkowska, Anna; Ait-Mohand, Samia; Desjardins, Roxane; Guérin, Brigitte; Day, Robert

2015-01-01

The overexpression as well as the critical implication of the proprotein convertase PACE4 in prostate cancer progression has been previously reported and supported the development of peptide inhibitors. The multi-Leu peptide, a PACE4-specific inhibitor, was further generated and its capability to be uptaken by tumor xenograft was demonstrated with regard to its PACE4 expression status. To investigate whether the uptake of this inhibitor was directly dependent of PACE4 levels, uptake and efflux from cancer cells were evaluated and correlations were established with PACE4 contents on both wild type and PACE4-knockdown cell lines. PACE4-knockdown associated growth deficiencies were established on the knockdown HepG2, Huh7, and HT1080 cells as well as the antiproliferative effects of the multi-Leu peptide supporting the growth capabilities of PACE4 in cancer cells. PMID:26114115

Astronomical Pacing of Relative Sea Level through OAE2 from the Expanded SH#1 Core, Southern Utah

NASA Astrophysics Data System (ADS)

Jones, M. M.; Sageman, B. B.; Oakes, R. L.; Bralower, T. J.; Parker, A. L.; Leckie, R. M.

2017-12-01

Proximal marine strata of the North American Western Interior Basin (WIB) preserve a rich record of faunal turnover linked to Oceanic Anoxic Event 2 (OAE2 - 94 Ma), a pronounced Late Cretaceous carbon cycle perturbation interpreted to reflect global warming and possible ocean acidification. To develop a more robust synthesis of paleobiologic and geochemical datasets spanning this major Earth-life transition, we drilled a 131-meter core (SH#1) on the Kaiparowits Plateau of southern Utah, recovering the Cenomanian-Turonian Boundary (CTB) interval of the Tropic Shale. A 17.5-meter positive excursion in high-resolution bulk carbon isotope chemostratigraphy (δ13Corg) of SH#1 characterizes the most expanded and detailed record of OAE2 recovered from the WIB. Additionally, we detect statistically significant evidence for astronomical cycles in a companion δ13Ccarb dataset, using advanced spectral techniques (evolutive average spectral misfit). Bandpass filtering and tracing of the short eccentricity cycle (97 ka) permit development of a floating astronomical time scale (ATS) for the CTB interval. The presence of radioisotopic dates within the time series provides an independent check on astrochronologic interpretations. We attribute some depleted δ13Ccarb values in SH#1, which cyclically punctuate the OAE2 excursion, to preferential carbonate diagenesis driven by periodic sea level oscillations. Accordingly, major flooding surfaces in SH#1 correlate well to an existing sequence stratigraphic framework from shoreface facies of the Markagunt Plateau ( 100 km west). Comparing the ATS and sequence stratigraphic surfaces in SH#1, we observe that stable eccentricity cycles (405 ka) pace stratigraphic sequences and associated saw-toothed trends in sedimentation rate estimates through OAE2. Furthermore, short eccentricity cycles pace nested parasequences. These results confirm astronomical and, therefore, climatic pacing of relative sea level trends during OAE2 in the WIB. The ATS, δ13C chemostratigraphy, and basin-wide correlation of the CTB interval provide an expanded, temporally-resolved record of OAE2 within the chronostratigraphic framework of the WIB, and help to resolve rates of paleobiologic and paleoenvironmental change in the context of oscillating relative sea levels.

Comparing Photovoltaic (PV) Costs and Deployment Drivers in the Japanese and U.S. Residential and Commercial Markets

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

Friedman, B.; Margolis, R.; Seel, J.

Japan has re-emerged in 2013 as one of the world's fastest-growing and largest photovoltaic (PV) markets (Renewable Energy World 2013). Year-over-year growth in Japanese installed capacity in the first half of 2013 was about 270%. Japan's PV market was on pace to triple in 2013 compared with 2012, with approximately 2.7 GW installed during the first half of 2013 (compared to about 1.6 GW in the United States). This places Japan's market among the world's largest PV markets, along with China, Germany, and the United States. This report explores details of the rapidly changing Japanese market, and similarities and differencesmore » between the Japanese and U.S. markets. We collected data from a diverse group of Japanese PV installers, and we gathered additional Japanese and U.S. data from published sources as well as internal analyses.« less

Mutual adaptation of a membrane protein and its lipid bilayer during conformational changes.

PubMed

Sonntag, Yonathan; Musgaard, Maria; Olesen, Claus; Schiøtt, Birgit; Møller, Jesper Vuust; Nissen, Poul; Thøgersen, Lea

2011-01-01

The structural elucidation of membrane proteins continues to gather pace, but we know little about their molecular interactions with the lipid environment or how they interact with the surrounding bilayer. Here, with the aid of low-resolution X-ray crystallography, we present direct structural information on membrane interfaces as delineated by lipid phosphate groups surrounding the sarco(endo)plasmic reticulum Ca(2+)-ATPase (SERCA) in its phosphorylated and dephosphorylated Ca(2+)-free forms. The protein-lipid interactions are further analysed using molecular dynamics simulations. We find that SERCA adapts to membranes of different hydrophobic thicknesses by inducing local deformations in the lipid bilayers and by undergoing small rearrangements of the amino-acid side chains and helix tilts. These mutually adaptive interactions allow smooth transitions through large conformational changes associated with the transport cycle of SERCA, a strategy that may be of general nature for many membrane proteins.

Enhanced recovery programmes: do these have a role in gynaecology?

PubMed

Bell, A; Relph, S; Sivashanmugarajan, V; Yoong, W

2013-08-01

Enhanced recovery (ER) has become increasingly ubiquitous in most surgical specialities and its use is gathering pace. It has been proven to be a safe and effective means of managing patients perioperatively, while also improving patient outcomes, and its use in gynaecology has recently been supported by the Royal College of Obstetricians and Gynaecologists (RCOG). ER is gaining popularity, despite being a diversion from the traditional surgical approach, demanding an orchestration of primary, secondary, social and auxillary care teams to work effectively. ER has been heralded as improving clinical outcomes and patient satisfaction, while simultaneously allowing increased patient turnover. This has potentially massive impacts on service provision within the NHS and is likely to become a proof of concept that the NHS can adapt. ER can be championed as a flexible and contemporary healthcare model, which can be improved as patients' needs and NHS resources change.

Influence of automatic frequent pace-timing adjustments on effective left ventricular pacing during cardiac resynchronization therapy.

PubMed

Varma, Niraj; Stadler, Robert W; Ghosh, Subham; Kloppe, Axel

2017-05-01

Cardiac resynchronization therapy (CRT) requires effective left ventricular (LV) pacing (i.e. sufficient energy and appropriate timing to capture). The AdaptivCRT™ (aCRT) algorithm serves to maintain ventricular fusion during LV or biventricular pacing. This function was tested by comparing the morphological consistency of ventricular depolarizations and percentage effective LV pacing in CRT patients randomized to aCRT vs. echo-optimization. Continuous recordings (≥20 h) of unipolar LV electrograms from aCRT (n = 38) and echo-optimized patients (n = 22) were analysed. Morphological consistency was determined by the correlation coefficient between each beat and a template beat. Effective LV pacing of paced beats was assessed by algorithmic analysis of negative initial EGM deflection in each evoked response. The %CRT pacing delivered, %effective LV pacing (i.e. % of paced beats with effective LV pacing), and overall %effective CRT (i.e. product of %CRT pacing and %effective LV pacing) were compared between aCRT and echo-optimized patients. Demographics were similar between groups. The mean correlation coefficient between individual beats and template was greater for aCRT (0.96 ± 0.03 vs. 0.91 ± 0.13, P = 0.07). Although %CRT pacing was similar for aCRT and echo-optimized (median 97.4 vs. 98.6%, P = 0.14), %effective LV pacing was larger for aCRT [99.6%, (99.1%, 99.9%) vs. 94.3%, (24.3%, 99.8%), P=0.03]. For aCRT vs. echo-optimized groups, the proportions of patients with ≥90% effective LV pacing was 92 vs. 55% (P = 0.002), and with ≥90% effective CRT was 79 vs. 45%, respectively (P = 0.018). AdaptivCRT™ significantly increased effective LV pacing over echo-optimized CRT. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Influence of Pacing by Periodic Auditory Stimuli on Movement Continuation: Comparison with Self-regulated Periodic Movement

PubMed Central

Ito, Masanori; Kado, Naoki; Suzuki, Toshiaki; Ando, Hiroshi

2013-01-01

[Purpose] The purpose of this study was to investigate the influence of external pacing with periodic auditory stimuli on the control of periodic movement. [Subjects and Methods] Eighteen healthy subjects performed self-paced, synchronization-continuation, and syncopation-continuation tapping. Inter-onset intervals were 1,000, 2,000 and 5,000 ms. The variability of inter-tap intervals was compared between the different pacing conditions and between self-paced tapping and each continuation phase. [Results] There were no significant differences in the mean and standard deviation of the inter-tap interval between pacing conditions. For the 1,000 and 5,000 ms tasks, there were significant differences in the mean inter-tap interval following auditory pacing compared with self-pacing. For the 2,000 ms syncopation condition and 5,000 ms task, there were significant differences from self-pacing in the standard deviation of the inter-tap interval following auditory pacing. [Conclusion] These results suggest that the accuracy of periodic movement with intervals of 1,000 and 5,000 ms can be improved by the use of auditory pacing. However, the consistency of periodic movement is mainly dependent on the inherent skill of the individual; thus, improvement of consistency based on pacing is unlikely. PMID:24259932

Indications for permanent pacing and pacing mode prescription from 1989 to 2006. Experience of a single academic centre in Northern Greece.

PubMed

Styliadis, Ioannis H; Mantziari, Aggeliki P; Gouzoumas, Nikolaos I; Vassilikos, Vasilios P; Paraskevaidis, Stelios A; Mochlas, Sotirios T; Boufidou, Amalia I; Parcharidis, Georgios E

2008-01-01

Indications for pacing and pacing mode prescription have changed in the past decades following advances in pacemaker technology. The aim of the present study was to evaluate changes in indications for pacing and pacing modes during the years 1989-2006 in a single academic pacemaker centre in Northern Greece. Archives of permanent pacemaker implantation procedures were studied retrospectively and data from all implants, first or replacements, were retrieved. Data from 2078 procedures were found, 78.7% of which were first implantations. Patients were 54% male with mean age 72.5 years. Main indications for pacing were atrioventricular block (AVB, 45.7%), sick sinus syndrome (SSS, 32.8%), and atrial fibrillation (12.1%). Almost half (48.9%) of the AVB cases were complete AVB, while the most common types of SSS were tachy-brady syndrome (44.1%) and asystole (27.1%). Rare indications for pacing were carotid sinus syndrome (5.0%), heart failure (3.3%) and hypertrophic obstructive cardiomyopathy (1.0%). The two most frequently used pacing modes were VVI (38.5%) and DDD (25.8%). However, pacing modes have changed greatly over the years, with a marked increase in dual-chamber pacing after 1997 and a preference for rate responsive units after 2002. Biventricular systems were also used in selected patients with heart failure from 2002 on. Indications for pacing and pacing mode prescription in our centre are similar to other pacemaker registries and reflect the global trend in pacing for mimicking the physiological activity of the heart and for addressing problems other than symptomatic bradycardia.

Functional characteristics of left ventricular synchronization via right ventricular outflow-tract pacing detected by two-dimensional strain echocardiography.

PubMed

Hirayama, Yasutaka; Kawamura, Yuichiro; Sato, Nobuyuki; Saito, Tatsuya; Tanaka, Hideichi; Saijo, Yasuaki; Kikuchi, Kenjiro; Ohori, Katsumi; Hasebe, Naoyuki

2017-02-01

Recently, due to the detrimental effects on the ventricular function associated with right ventricular apical (RVA) pacing, right ventricular septal (RVS) pacing has become the preferred pacing method. However, the term RVS pacing refers to both right ventricular outflow-tract (RVOT) and mid-septal (RVMS) pacing, leading to a misinterpretation of the results of clinical studies. The purpose of this study, therefore, was to elucidate the functional differences of RVA, RVOT, and RVMS pacing in patients with atrioventricular block. We compared the QRS duration, global longitudinal strain (GLS), and left ventricular (LV) synchronization parameters at the three pacing sites in 47 patients. The peak systolic strain (PSS) time delay between the earliest and latest segments among the 18 LV segments and standard deviation (SD) of the time to the PSS were also calculated for the 18 LV segments at each pacing site using two-dimensional (2D) strain echocardiography. RVMS pacing was associated with a significantly shorter QRS duration compared with RVA and RVOT pacing (154.4±21.4 vs 186.5±19.9 and 171.1±21.5 ms, P <0.001). In contrast, RVOT pacing revealed a greater GLS (-14.69±4.92 vs -13.12±4.76 and -13.51±4.81%, P <0.001), shorter PSS time delay between the earliest and latest segments (236.0±87.9 vs 271.3±102.9 and 281.9±126.6%, P =0.007), and shorter SD of the time to the PSS (70.8±23.8 vs 82.7±30.8 and 81.5±33.7 ms, P =0.002) compared with RVA and RVMS pacing. These results suggest that the functional characteristics of RVOT pacing may be a more optimal pacing site than RVMS, regardless of the pacing QRS duration, in patients with atrioventricular conduction disorders.

[Role of cyclic adenosine monophosphate response element binding protein in ventricular pacing induced cardiac electrical remodeling in a canine model].

PubMed

Chen, Xuesi; Chen, Xingxing; Cheng, Junhua; Hong, Jun; Zheng, Cheng; Zhao, Jinglin; Li, Jin; Lin, Jiafeng

2015-04-01

This project is designed to explore the potential role of cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) in cardiac electrical remodeling induced by pacing at different ventricular positions in dogs. An animal model by implanting the pacemakers in beagles was established. According to the different pacing positions, the animals were divided into 4 groups:conditional control group (n=6), left ventricle pacing group (n=6), right ventricle pacing group (n=6) and bi-ventricle pacing group (n=6). Cardiac and electrical remodeling were observed by echocardiography, electrocardiogram and plasma BNP. Myocardial pathology and protein expression of extracellular regulated protein kinases1/2 (ERK1/2), P38 mitogen activated protein kinases (P38 MAPK) and CREB were examined at 4 weeks post pacing. Cardiac structure and plasma BNP level were similar among 4 groups (all P>0.05). Electrocardiogram derived Tp-Te interval was significantly prolonged post pacing (92±11, 91±10, and 79±13 ms vs. 60±12 ms), and the Tp-Te interval in bi-ventricle pacing group was shorter than in left or right ventricle pacing group (P < 0.05). Western blot results showed that the expression of p-ERK1/2 in left ventricular myocardium of left ventricle pacing group, right ventricular myocardium of right ventricle pacing group and bi-ventricular myocardium of bi-ventricle pacing group was 2.7±0.4, 2.4±0.2, 1.7±0.1 and 1.9±0.2, respectively, the expression of p-P38 MAPK was 1.9±0.3, 1.7±0.2, 0.8±0.1 and 1.1±0.1, respectively, and the expression of p-CREB was 2.1±0.2, 2.0±0.2, 2.7±0.4 and 2.6±0.3, respectively. The p-ERK1/2 and p-P38 MAPK expression of bi-ventricle pacing group was lower,but the p-CREB expression was higher compared to the other pacing groups (P < 0.05). Ventricular pacing could induce electrical remodeling evidenced by prolonged Tp-Te interval and increased phosphorylation of ERK1/2 and p38 MAPK and reduced phosphorylation of CREB. Compared with single ventricle pacing, bi-ventricle pacing could attenuate electrical remodeling in this model.

Rewards-driven control of robot arm by decoding EEG signals.

PubMed

Tanwani, Ajay Kumar; del R Millan, Jose; Billard, Aude

2014-01-01

Decoding the user intention from non-invasive EEG signals is a challenging problem. In this paper, we study the feasibility of predicting the goal for controlling the robot arm in self-paced reaching movements, i.e., spontaneous movements that do not require an external cue. Our proposed system continuously estimates the goal throughout a trial starting before the movement onset by online classification and generates optimal trajectories for driving the robot arm to the estimated goal. Experiments using EEG signals of one healthy subject (right arm) yield smooth reaching movements of the simulated 7 degrees of freedom KUKA robot arm in planar center-out reaching task with approximately 80% accuracy of reaching the actual goal.

Hot topics in biodiversity and climate change research

PubMed Central

Brook, Barry W.; Fordham, Damien A.

2015-01-01

With scientific and societal interest in biodiversity impacts of climate change growing enormously over the last decade, we analysed directions and biases in the recent most highly cited data papers in this field of research (from 2012 to 2014). The majority of this work relied on leveraging large databases of already collected historical information (but not paleo- or genetic data), and coupled these to new methodologies for making forward projections of shifts in species’ geographical ranges, with a focus on temperate and montane plants. A consistent finding was that the pace of climate-driven habitat change, along with increased frequency of extreme events, is outpacing the capacity of species or ecological communities to respond and adapt. PMID:26594350

Nanomaterials for renewable energy production and storage.

PubMed

Chen, Xiaobo; Li, Can; Grätzel, Michaël; Kostecki, Robert; Mao, Samuel S

2012-12-07

Over the past decades, there have been many projections on the future depletion of the fossil fuel reserves on earth as well as the rapid increase in green-house gas emissions. There is clearly an urgent need for the development of renewable energy technologies. On a different frontier, growth and manipulation of materials on the nanometer scale have progressed at a fast pace. Selected recent and significant advances in the development of nanomaterials for renewable energy applications are reviewed here, and special emphases are given to the studies of solar-driven photocatalytic hydrogen production, electricity generation with dye-sensitized solar cells, solid-state hydrogen storage, and electric energy storage with lithium ion rechargeable batteries.

The joint center for energy storage research: A new paradigm for battery research and development

NASA Astrophysics Data System (ADS)

Crabtree, George

2015-03-01

The Joint Center for Energy Storage Research (JCESR) seeks transformational change in transportation and the electricity grid driven by next generation high performance, low cost electricity storage. To pursue this transformative vision JCESR introduces a new paradigm for battery research: integrating discovery science, battery design, research prototyping and manufacturing collaboration in a single highly interactive organization. This new paradigm will accelerate the pace of discovery and innovation and reduce the time from conceptualization to commercialization. JCESR applies its new paradigm exclusively to beyond-lithium-ion batteries, a vast, rich and largely unexplored frontier. This review presents JCESR's motivation, vision, mission, intended outcomes or legacies and first year accomplishments.

A comparison of Data Driven models of solving the task of gender identification of author in Russian language texts for cases without and with the gender deception

NASA Astrophysics Data System (ADS)

Sboev, A.; Moloshnikov, I.; Gudovskikh, D.; Rybka, R.

2017-12-01

In this work we compare several data-driven approaches to the task of author’s gender identification for texts with or without gender imitation. The data corpus has been specially gathered with crowdsourcing for this task. The best models are convolutional neural network with input of morphological data (fl-measure: 88%±3) for texts without imitation, and gradient boosting model with vector of character n-grams frequencies as input data (f1-measure: 64% ± 3) for texts with gender imitation. The method to filter the crowdsourced corpus using limited reference sample of texts to increase the accuracy of result is discussed.

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

Riensche, Roderick M.; Paulson, Patrick R.; Danielson, Gary R.

We describe a methodology and architecture to support the development of games in a predictive analytics context. These games serve as part of an overall family of systems designed to gather input knowledge, calculate results of complex predictive technical and social models, and explore those results in an engaging fashion. The games provide an environment shaped and driven in part by the outputs of the models, allowing users to exert influence over a limited set of parameters, and displaying the results when those actions cause changes in the underlying model. We have crafted a prototype system in which we aremore » implementing test versions of games driven by models in such a fashion, using a flexible architecture to allow for future continuation and expansion of this work.« less

Altering Pace Control and Pace Regulation: Attentional Focus Effects during Running.

PubMed

Brick, Noel E; Campbell, Mark J; Metcalfe, Richard S; Mair, Jacqueline L; Macintyre, Tadhg E

2016-05-01

To date, there are no published studies directly comparing self-controlled (SC) and externally controlled (EC) pace endurance tasks. However, previous research suggests pace control may impact on cognitive strategy use and effort perceptions. The primary aim of this study was to investigate the effects of manipulating perception of pace control on attentional focus, physiological, and psychological outcomes during running. The secondary aim was to determine the reproducibility of self-paced running performance when regulated by effort perceptions. Twenty experienced endurance runners completed four 3-km time trials on a treadmill. Subjects completed two SC pace trials, one perceived exertion clamped (PE) trial, and one EC pace time trial. PE and EC were completed in a counterbalanced order. Pacing strategy for EC and perceived exertion instructions for PE replicated the subjects' fastest SC time trial. Subjects reported a greater focus on cognitive strategies such as relaxing and optimizing running action during EC than during SC. The mean HR was 2% lower during EC than that during SC despite an identical pacing strategy. Perceived exertion did not differ between the three conditions. However, increased internal sensory monitoring coincided with elevated effort perceptions in some subjects during EC and a 10% slower completion time for PE (13.0 ± 1.6 min) than that for SC (11.8 ± 1.2 min). Altering pace control and pace regulation impacted on attentional focus. External control over pacing may facilitate performance, particularly when runners engage attentional strategies conducive to improved running efficiency. However, regulating pace based on effort perceptions alone may result in excessive monitoring of bodily sensations and a slower running speed. Accordingly, attentional focus interventions may prove beneficial for some athletes to adopt task-appropriate attentional strategies to optimize performance.

Accelerated graft dysfunction in heart transplant patients with persistent atrioventricular conduction block.

PubMed

Lee, William; Tay, Andre; Walker, Bruce D; Kuchar, Dennis L; Hayward, Christopher S; Spratt, Phillip; Subbiah, Rajesh N

2016-12-01

Bradyarrhythmia following heart transplantation is common-∼7.5-24% of patients require permanent pacemaker (PPM) implantation. While overall mortality is similar to their non-paced counterparts, the effects of chronic right ventricular pacing (CRVP) in heart transplant patients have not been studied. We aim to examine the effects of CRVP on heart failure and mortality in heart transplant patients. Records of heart transplant recipients requiring PPM at St Vincent's Hospital, Sydney, Australia between January 1990 and January 2015 were examined. Patient's without a right ventricular (RV) pacing lead or a follow-up time of <1 year were excluded. Patients with pre-existing abnormal left ventricular function (<50%) were analysed separately. Patients were grouped by pacing dependence (100% pacing dependent vs. non-pacing dependent). The primary endpoint was clinical or echocardiographic heart failure (<35%) in the first 5 years post-PPM. Thirty-three of 709 heart transplant recipients were studied. Two patients had complete RV pacing dependence, and the remaining 31 patients had varying degrees of pacing requirement, with an underlying ventricular escape rhythm. The primary endpoint occurred significantly more in the pacing-dependent group; 2 (100%) compared with 2 (6%) of the non pacing dependent group (P < 0.0001 by log-rank analysis, HR = 24.58). Non-pacing-dependent patients had reversible causes for heart failure, unrelated to pacing. In comparison, there was no other cause of heart failure in the pacing-dependent group. Permanent atrioventricular block is rare in the heart transplant population. We have demonstrated CRVP as a potential cause of accelerated graft failure in pacing-dependent heart transplant patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Prospective randomized study to assess the efficacy of site and rate of atrial pacing on long-term progression of atrial fibrillation in sick sinus syndrome: Septal Pacing for Atrial Fibrillation Suppression Evaluation (SAFE) Study.

PubMed

Lau, Chu-Pak; Tachapong, Ngarmukos; Wang, Chun-Chieh; Wang, Jing-Feng; Abe, Haruhiko; Kong, Chi-Woon; Liew, Reginald; Shin, Dong-Gu; Padeletti, Luigi; Kim, You-Ho; Omar, Razali; Jirarojanakorn, Kreingkrai; Kim, Yoon-Nyun; Chen, Mien-Cheng; Sriratanasathavorn, Charn; Munawar, Muhammad; Kam, Ruth; Chen, Jan-Yow; Cho, Yong-Keun; Li, Yi-Gang; Wu, Shu-Lin; Bailleul, Christophe; Tse, Hung-Fat

2013-08-13

Atrial-based pacing is associated with lower risk of atrial fibrillation (AF) in sick sinus syndrome compared with ventricular pacing; nevertheless, the impact of site and rate of atrial pacing on progression of AF remains unclear. We evaluated whether long-term atrial pacing at the right atrial (RA) appendage versus the low RA septum with (ON) or without (OFF) a continuous atrial overdrive pacing algorithm can prevent the development of persistent AF. We randomized 385 patients with paroxysmal AF and sick sinus syndrome in whom a pacemaker was indicated to pacing at RA appendage ON (n=98), RA appendage OFF (n=99), RA septum ON (n=92), or RA septum OFF (n=96). The primary outcome was the occurrence of persistent AF (AF documented at least 7 days apart or need for cardioversion). Demographic data were homogeneous across both pacing site (RA appendage/RA septum) and atrial overdrive pacing (ON/OFF). After a mean follow-up of 3.1 years, persistent AF occurred in 99 patients (25.8%; annual rate of persistent AF, 8.3%). Alternative site pacing at the RA septum versus conventional RA appendage (hazard ratio=1.18; 95% confidence interval, 0.79-1.75; P=0.65) or continuous atrial overdrive pacing ON versus OFF (hazard ratio=1.17; 95% confidence interval, 0.79-1.74; P=0.69) did not prevent the development of persistent AF. In patients with paroxysmal AF and sick sinus syndrome requiring pacemaker implantation, an alternative atrial pacing site at the RA septum or continuous atrial overdrive pacing did not prevent the development of persistent AF. URL: http://www.clinicaltrials.gov. UNIQUE IDENTIFIER: NCT00419640.

Constant DI pacing suppresses cardiac alternans formation in numerical cable models

NASA Astrophysics Data System (ADS)

Zlochiver, S.; Johnson, C.; Tolkacheva, E. G.

2017-09-01

Cardiac repolarization alternans describe the sequential alternation of the action potential duration (APD) and can develop during rapid pacing. In the ventricles, such alternans may rapidly turn into life risking arrhythmias under conditions of spatial heterogeneity. Thus, suppression of alternans by artificial pacing protocols, or alternans control, has been the subject of numerous theoretical, numerical, and experimental studies. Yet, previous attempts that were inspired by chaos control theories were successful only for a short spatial extent (<2 cm) from the pacing electrode. Previously, we demonstrated in a single cell model that pacing with a constant diastolic interval (DI) can suppress the formation of alternans at high rates of activation. We attributed this effect to the elimination of feedback between the pacing cycle length and the last APD, effectively preventing restitution-dependent alternans from developing. Here, we extend this idea into cable models to study the extent by which constant DI pacing can control alternans during wave propagation conditions. Constant DI pacing was applied to ventricular cable models of up to 5 cm, using human kinetics. Our results show that constant DI pacing significantly shifts the onset of both cardiac alternans and conduction blocks to higher pacing rates in comparison to pacing with constant cycle length. We also demonstrate that constant DI pacing reduces the propensity of spatially discordant alternans, a precursor of wavebreaks. We finally found that the protective effect of constant DI pacing is stronger for increased electrotonic coupling along the fiber in the sense that the onset of alternans is further shifted to higher activation rates. Overall, these results support the potential clinical applicability of such type of pacing in improving protocols of implanted pacemakers, in order to reduce the risk of life-threatening arrhythmias. Future research should be conducted in order to experimentally validate these promising results.

42 CFR 460.90 - PACE benefits under Medicare and Medicaid.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false PACE benefits under Medicare and Medicaid. 460.90 Section 460.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...

Safety of the Wearable Cardioverter Defibrillator (WCD) in Patients with Implanted Pacemakers.

PubMed

Schmitt, Joern; Abaci, Guezine; Johnson, Victoria; Erkapic, Damir; Gemein, Christopher; Chasan, Ritvan; Weipert, Kay; Hamm, Christian W; Klein, Helmut U

2017-03-01

The wearable cardioverter defibrillator (WCD) is an important approach for better risk stratification, applied to patients considered to be at high risk of sudden arrhythmic death. Patients with implanted pacemakers may also become candidates for use of the WCD. However, there is a potential risk that pacemaker signals may mislead the WCD detection algorithm and cause inappropriate WCD shock delivery. The aim of the study was to test the impact of different types of pacing, various right ventricular (RV) lead positions, and pacing modes for potential misleading of the WCD detection algorithm. Sixty patients with implanted pacemakers received the WCD for a short time and each pacing mode (AAI, VVI, and DDD) was tested for at least 30 seconds in unipolar and bipolar pacing configuration. In case of triggering the WCD detection algorithm and starting the sequence of arrhythmia alarms, shock delivery was prevented by pushing of the response buttons. In six of 60 patients (10%), continuous unipolar pacing in DDD mode triggered the WCD detection algorithm. In no patient, triggering occurred with bipolar DDD pacing, unipolar and bipolar AAI, and VVI pacing. Triggering was independent of pacing amplitude, RV pacing lead position, and pulse generator implantation site. Unipolar DDD pacing bears a high risk of false triggering of the WCD detection algorithm. Other types of unipolar pacing and all bipolar pacing modes do not seem to mislead the WCD detection algorithm. Therefore, patients with no reprogrammable unipolar DDD pacing should not become candidates for the WCD. © 2016 Wiley Periodicals, Inc.

Risk of Resource Failure and Toolkit Variation in Small-Scale Farmers and Herders

PubMed Central

Collard, Mark; Ruttle, April; Buchanan, Briggs; O’Brien, Michael J.

2012-01-01

Recent work suggests that global variation in toolkit structure among hunter-gatherers is driven by risk of resource failure such that as risk of resource failure increases, toolkits become more diverse and complex. Here we report a study in which we investigated whether the toolkits of small-scale farmers and herders are influenced by risk of resource failure in the same way. In the study, we applied simple linear and multiple regression analysis to data from 45 small-scale food-producing groups to test the risk hypothesis. Our results were not consistent with the hypothesis; none of the risk variables we examined had a significant impact on toolkit diversity or on toolkit complexity. It appears, therefore, that the drivers of toolkit structure differ between hunter-gatherers and small-scale food-producers. PMID:22844421

Social curiosity and gossip: related but different drives of social functioning.

PubMed

Hartung, Freda-Marie; Renner, Britta

2013-01-01

The present online-questionnaire study examined two fundamental social behaviors, social curiosity and gossip, and their interrelations in an English (n = 218) and a German sample (n = 152). Analyses showed that both samples believed that they are less gossipy but more curious than their peers. Multidimensional SEM of self and trait conceptions indicated that social curiosity and gossip are related constructs but with different patterns of social functions. Gossip appears to serve predominantly entertainment purposes whereas social curiosity appears to be more driven by a general interest in gathering information about how other people feel, think, and behave and the need to belong. Relationships to other personality traits (N, E, O) provided additional evidence for divergent validity. The needs for gathering and disseminating social information might represent two interlinked but different drives of cultural learning.

Social Curiosity and Gossip: Related but Different Drives of Social Functioning

PubMed Central

Hartung, Freda-Marie; Renner, Britta

2013-01-01

The present online-questionnaire study examined two fundamental social behaviors, social curiosity and gossip, and their interrelations in an English (n = 218) and a German sample (n = 152). Analyses showed that both samples believed that they are less gossipy but more curious than their peers. Multidimensional SEM of self and trait conceptions indicated that social curiosity and gossip are related constructs but with different patterns of social functions. Gossip appears to serve predominantly entertainment purposes whereas social curiosity appears to be more driven by a general interest in gathering information about how other people feel, think, and behave and the need to belong. Relationships to other personality traits (N, E, O) provided additional evidence for divergent validity. The needs for gathering and disseminating social information might represent two interlinked but different drives of cultural learning. PMID:23936130

A Comprehensive Analysis of High School Genetics Standards: Are States Keeping Pace with Modern Genetics?

PubMed Central

Dougherty, M.J.; Pleasants, C.; Solow, L.; Wong, A.; Zhang, H.

2011-01-01

Science education in the United States will increasingly be driven by testing and accountability requirements, such as those mandated by the No Child Left Behind Act, which rely heavily on learning outcomes, or “standards,” that are currently developed on a state-by-state basis. Those standards, in turn, drive curriculum and instruction. Given the importance of standards to teaching and learning, we investigated the quality of life sciences/biology standards with respect to genetics for all 50 states and the District of Columbia, using core concepts developed by the American Society of Human Genetics as normative benchmarks. Our results indicate that the states’ genetics standards, in general, are poor, with more than 85% of the states receiving overall scores of Inadequate. In particular, the standards in virtually every state have failed to keep pace with changes in the discipline as it has become genomic in scope, omitting concepts related to genetic complexity, the importance of environment to phenotypic variation, differential gene expression, and the differences between inherited and somatic genetic disease. Clearer, more comprehensive genetics standards are likely to benefit genetics instruction and learning, help prepare future genetics researchers, and contribute to the genetic literacy of the U.S. citizenry. PMID:21885828

Variables affecting the manifestation of and intensity of pacing behavior: A preliminary case study in zoo-housed polar bears.

PubMed

Cless, Isabelle T; Lukas, Kristen E

2017-09-01

High-speed video analysis was used to quantify two aspects of gait in 10 zoo-housed polar bears. These two variables were then examined as to how they differed in the conditions of pacing versus locomoting for each bear. Percent difference calculations measured the difference between pacing and locomoting data for each bear. We inferred that the higher the percent difference between pacing and locomoting in a given subject, the more intense the pacing may be. The percent difference values were analyzed alongside caregiver survey data defining the locations, frequency, and anticipatory nature of pacing in each bear, as well as each bear's age and sex, to determine whether any variables were correlated. The frequency and intensity of pacing behavior were not correlated. However, location of pacing was significantly correlated both with the subjects' age and whether or not the subject was classified as an anticipatory pacer. Bears appeared to select specific spots within their exhibits to pace, and the location therefore seemed tied to underlying motivation for the behavior. Additionally, bears that were classified in the survey as pacing anticipatorily displayed significantly more intense pacing behavior as quantified by gait analysis. © 2017 Wiley Periodicals, Inc.

Continuous quality improvement at work: the first team--Part II.

PubMed

Bolt, B J; Lehany-Trese, A M; Williams, T P

1995-01-01

This second part of a two-part article follows Cape Canaveral Hospital's first continuous quality improvement team through the processes of goal setting, system analysis, data gathering, and problem resolution in the area of patients' assignment to observation status. The team's primary goal was data-driven improvement. As detailed here, the team's solution to improve the use of observation status is both time-efficient and offers opportunities for financial gain.

42 CFR 460.122 - PACE organization's appeals process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.122 PACE organization's appeals process. For purposes...

42 CFR 460.122 - PACE organization's appeals process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.122 PACE organization's appeals process. For purposes...

42 CFR 460.170 - Reinstatement in PACE.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.170 Reinstatement in PACE. (a) A previously...

42 CFR 460.170 - Reinstatement in PACE.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.170 Reinstatement in PACE. (a) A previously...

Effects of pacing magnitudes and forms on bistability width in a modeled ventricular tissue

NASA Astrophysics Data System (ADS)

Huang, Xiaodong; Liu, Xuemei; Zheng, Lixian; Mi, Yuanyuan; Qian, Yu

2013-07-01

Bistability in periodically paced cardiac tissue is relevant to cardiac arrhythmias and its control. In the present paper, one-dimensional tissue of the phase I Luo-Rudy model is numerically investigated. The effects of various parameters of pacing signals on bistability width are studied. The following conclusions are obtained: (i) Pacing can be classified into two types: pulsatile and sinusoidal types. Pulsatile pacing reduces bistability width as its magnitude is increased. Sinusoidal pacing increases the width as its amplitude is increased. (ii) In a pacing period the hyperpolarizing part plays a more important role than the depolarizing part. Variations of the hyperpolarizing ratio in a period evidently change the width of bistability and its variation tendency. (iii) A dynamical mechanism is proposed to qualitatively explain the phenomena, which reveals the reason for the different effects of pulsatile and sinusoidal pacing on bistability. The methods for changing bistability width by external pacing may help control arrhythmias in cardiology.

Predictors of temporary epicardial pacing wires use after valve surgery

PubMed Central

2014-01-01

Background Although temporary cardiac pacing is infrequently needed, temporary epicardial pacing wires are routinely inserted after valve surgery. As they are associated with infrequent, but life threatening complications, and the decreased need for postoperative pacing in a group of low risk patients; this study aims to identify the predictors of temporary cardiac pacing after valve surgery. Methods A retrospective analysis of data collected prospectively on 400 consecutive valve surgery patients between May 2002 and December 2012 was performed. Patients were grouped according to avoidance or insertion of temporary pacing wires, and were further subdivided according to temporary cardiac pacing need. Multiple logistic regression was used to determine the predictors of temporary cardiac pacing. Results 170 (42.5%) patients did not have insertion of temporary pacing wires and none of them needed temporary pacing. 230 (57.5%) patients had insertion of temporary pacing wires and among these, only 55 (23.9%) required temporary pacing who were compared with the remaining 175 (76.1%) patients in the main analysis. The determinants of temporary cardiac pacing (adjusted odds ratios; 95% confidence interval) were as follows: increased age (1.1; 1.1, 1.3, p = 0.002), New York Heart Association class III- IV (5.6; 1.6, 20.2, p = 0.008) , pulmonary artery pressure ≥ 50 mmHg (22.0; 3.4, 142.7, p = 0.01), digoxin use (8.0; 1.3, 48.8, p = 0.024), multiple valve surgery (13.5; 1.5, 124.0, p = 0.021), aorta cross clamp time ≥ 60 minutes (7.8; 1.6, 37.2, p = 0.010), and valve annulus calcification (7.9; 2.0, 31.7, p = 0.003). Conclusion Although limited by sample size, the present results suggest that routine use of temporary epicardial pacing wires after valve surgery is only necessary for high risk patients. Preoperative identification and aggressive management of predictors of temporary cardiac pacing and the possible modulation of intraoperative techniques can decrease the need of temporary cardiac pacing. Prospective randomized controlled studies on a larger number of patients are necessary to draw solid conclusions regarding the selective use of temporary epicardial pacing wires in valve surgery. PMID:24521215

42 CFR 460.30 - Program agreement requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.30 Program agreement requirement. (a) A PACE organization must...

42 CFR 460.30 - Program agreement requirement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.30 Program agreement requirement. (a) A PACE organization must...

42 CFR 460.50 - Termination of PACE program agreement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.50 Termination of PACE...

42 CFR 460.50 - Termination of PACE program agreement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.50 Termination of PACE...

42 CFR 460.180 - Medicare payment to PACE organizations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Payment § 460.180 Medicare payment to PACE organizations. (a) Principle of...

DefenseLink Special: Travels with Pace, March 2006

Science.gov Websites

Us Travels with Pace Chairman of the Joint Chiefs of Staff Marine Gen. Peter Pace U.S. Marine Gen . Peter Pace, chairman of the Joint Chiefs of Staff, speaks to students attending the Turkish War College U.S. Air Force Staff Sgt. D. Myles Cullen Hi-Res Pace Wraps Up Visit to Allied Nations WASHINGTON

Effect of short-term rapid ventricular pacing followed by pacing interruption on arterial blood pressure in healthy pigs and pigs with tachycardiomyopathy.

PubMed

Skrzypczak, P; Zyśko, D; Pasławska, U; Noszczyk-Nowak, A; Janiszewski, A; Gajek, J; Nicpoń, J; Kiczak, L; Bania, J; Zacharski, M; Tomaszek, A; Jankowska, E A; Ponikowski, P; Witkiewicz, W

2014-01-01

Ventricular tachycardia may lead to haemodynamic deterioration and, in the case of long term persistence, is associated with the development of tachycardiomyopathy. The effect of ventricular tachycardia on haemodynamics in individuals with tachycardiomyopathy, but being in sinus rhythm has not been studied. Rapid ventricular pacing is a model of ventricular tachycardia. The aim of this study was to determine the effect of rapid ventricular pacing on blood pressure in healthy animals and those with tachycardiomyopathy. A total of 66 animals were studied: 32 in the control group and 34 in the study group. The results of two groups of examinations were compared: the first performed in healthy animals (133 examinations) and the second performed in animals paced for at least one month (77 examinations). Blood pressure measurements were taken during chronic pacing--20 min after onset of general anaesthesia, in baseline conditions (20 min after pacing cessation or 20 min after onset of general anaesthesia in healthy animals) and immediately after short-term rapid pacing. In baseline conditions significantly higher systolic and diastolic blood pressure was found in healthy animals than in those with tachycardiomyopathy. During an event of rapid ventricular pacing, a significant decrease in systolic and diastolic blood pressure was found in both groups of animals. In the group of chronically paced animals the blood pressure was lower just after restarting ventricular pacing than during chronic pacing. Cardiovascular adaptation to ventricular tachycardia develops with the length of its duration. Relapse of ventricular tachycardia leads to a blood pressure decrease more pronounced than during chronic ventricular pacing.

Anatomical approach to permanent His bundle pacing: Optimizing His bundle capture.

PubMed

Vijayaraman, Pugazhendhi; Dandamudi, Gopi

2016-01-01

Permanent His bundle pacing is a physiological alternative to right ventricular pacing. In this article we describe our approach to His bundle pacing in patients with AV nodal and intra-Hisian conduction disease. It is essential for the implanters to understand the anatomic variations of the His bundle course and its effect on the type of His bundle pacing achieved. We describe several case examples to illustrate our anatomical approach to permanent His bundle pacing in this article. Copyright © 2016 Elsevier Inc. All rights reserved.

Higher sympathetic nerve activity during ventricular (VVI) than during dual-chamber (DDD) pacing

NASA Technical Reports Server (NTRS)

Taylor, J. A.; Morillo, C. A.; Eckberg, D. L.; Ellenbogen, K. A.

1996-01-01

OBJECTIVES: We determined the short-term effects of single-chamber ventricular pacing and dual-chamber atrioventricular (AV) pacing on directly measured sympathetic nerve activity. BACKGROUND: Dual-chamber AV cardiac pacing results in greater cardiac output and lower systemic vascular resistance than does single-chamber ventricular pacing. However, it is unclear whether these hemodynamic advantages result in less sympathetic nervous system outflow. METHODS: In 13 patients with a dual-chamber pacemaker, we recorded the electrocardiogram, noninvasive arterial pressure (Finapres), respiration and muscle sympathetic nerve activity (microneurography) during 3 min of underlying basal heart rate and 3 min of ventricular and AV pacing at rates of 60 and 100 beats/min. RESULTS: Arterial pressure was lowest and muscle sympathetic nerve activity was highest at the underlying basal heart rate. Arterial pressure increased with cardiac pacing and was greater with AV than with ventricular pacing (change in mean blood pressure +/- SE: 10 +/- 3 vs. 2 +/- 2 mm Hg at 60 beats/min; 21 +/- 5 vs. 14 +/- 2 mm Hg at 100 beats/min; p < 0.05). Sympathetic nerve activity decreased with cardiac pacing and the decline was greater with AV than with ventricular pacing (60 beats/min -40 +/- 11% vs. -17 +/- 7%; 100 beats/min -60 +/- 9% vs. -48 +/- 10%; p < 0.05). Although most patients showed a strong inverse relation between arterial pressure and muscle sympathetic nerve activity, three patients with severe left ventricular dysfunction (ejection fraction < or = 30%) showed no relation between arterial pressure and sympathetic activity. CONCLUSIONS: Short-term AV pacing results in lower sympathetic nerve activity and higher arterial pressure than does ventricular pacing, indicating that cardiac pacing mode may influence sympathetic outflow simply through arterial baroreflex mechanisms. We speculate that the greater incidence of adverse outcomes in patients treated with single-chamber ventricular rather than dual-chamber pacing may be due in part to increased sympathetic nervous outflow.

Optimizing local capture of atrial fibrillation by rapid pacing: study of the influence of tissue dynamics.

PubMed

Uldry, Laurent; Virag, Nathalie; Jacquemet, Vincent; Vesin, Jean-Marc; Kappenberger, Lukas

2010-12-01

While successful termination by pacing of organized atrial tachycardias has been observed in patients, rapid pacing of AF can induce a local capture of the atrial tissue but in general no termination. The purpose of this study was to perform a systematic evaluation of the ability to capture AF by rapid pacing in a biophysical model of the atria with different dynamics in terms of conduction velocity (CV) and action potential duration (APD). Rapid pacing was applied during 30 s at five locations on the atria, for pacing cycle lengths in the range 60-110% of the mean AF cycle length (AFCL(mean)). Local AF capture could be achieved using rapid pacing at pacing sites located distal to major anatomical obstacles. Optimal pacing cycle lengths were found in the range 74-80% AFCL(mean) (capture window width: 14.6 ± 3% AFCL(mean)). An increase/decrease in CV or APD led to a significant shrinking/stretching of the capture window. Capture did not depend on AFCL, but did depend on the atrial substrate as characterized by an estimate of its wavelength, a better capture being achieved at shorter wavelengths. This model-based study suggests that a proper selection of the pacing site and cycle length can influence local capture results and that atrial tissue properties (CV and APD) are determinants of the response to rapid pacing.

Right Ventricular Outflow Tract Septal Pacing Is Superior to Right Ventricular Apical Pacing

PubMed Central

Zou, Cao; Song, Jianping; Li, Hui; Huang, Xingmei; Liu, Yuping; Zhao, Caiming; Shi, Xin; Yang, Xiangjun

2015-01-01

Background The effects of right ventricular apical pacing (RVAP) and right ventricular outflow tract (RVOT) septal pacing on atrial and ventricular electrophysiology have not been thoroughly compared. Methods and Results To identify a more favorable pacing strategy with fewer adverse effects, 80 patients who had complete atrioventricular block with normal cardiac function and who were treated with either RVAP (n=42) or RVOT septal pacing (n=38) were recruited after an average of 2 years of follow‐up. The data from electrocardiography and echocardiography performed before pacemaker implantation and at the end of follow‐up were collected. The patients in the RVOT septal pacing and RVAP groups showed similar demographic and clinical characteristics before pacing treatments. After a mean follow‐up of 2 years, the final maximum P‐wave duration; P‐wave dispersion; Q‐, R‐, and S‐wave complex duration; left atrial volume index; left ventricular end‐systolic diameter; ratio of transmitral early diastolic filling velocity to mitral annular early diastolic velocity; and interventricular mechanical delay in the RVOT septal pacing group were significantly less than those in the RVAP group (P<0.05). The final left ventricular ejection fraction of the RVOT septal pacing group was significantly higher than that of the RVAP group (P<0.05). Conclusions Compared with RVAP, RVOT septal pacing has fewer adverse effects regarding atrial electrical activity and structure in patients with normal cardiac function. PMID:25896891

42 CFR 460.24 - Limit on number of PACE program agreements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.24 Limit on number of...

42 CFR 460.24 - Limit on number of PACE program agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.24 Limit on number of...

Mechanisms of arrhythmogenesis related to calcium-driven alternans in a model of human atrial fibrillation

NASA Astrophysics Data System (ADS)

Chang, Kelly C.; Trayanova, Natalia A.

2016-11-01

The occurrence of atrial fibrillation (AF) is associated with progressive changes in the calcium handling system of atrial myocytes. Calcium cycling instability has been implicated as an underlying mechanism of electrical alternans observed in patients who experience AF. However, the extent to which calcium-induced alternation of electrical activity in the atria contributes to arrhythmogenesis is unknown. In this study, we investigated the effects of calcium-driven alternans (CDA) on arrhythmia susceptibility in a biophysically detailed, 3D computer model of the human atria representing electrical and structural remodeling secondary to chronic AF. We found that elevated propensity to CDA rendered the atria vulnerable to ectopy-induced arrhythmia. It also increased the complexity and persistence of arrhythmias induced by fast pacing, with unstable scroll waves meandering and frequently breaking up to produce multiple wavelets. Our results suggest that calcium-induced electrical instability may increase arrhythmia vulnerability and promote increasing disorganization of arrhythmias in the chronic AF-remodeled atria, thus playing an important role in the progression of the disease.

Effect of Right Ventricular versus Biventricular Pacing on Electrical Remodeling in the Normal Heart

PubMed Central

Saba, Samir; Mehdi, Haider; Mathier, Michael A.; Islam, M. Zahadul; Salama, Guy; London, Barry

2010-01-01

Background Biventricular (BIV) pacing can improve cardiac function in heart failure by altering the mechanical and electrical substrates. We investigated the effect of BIV versus right ventricular (RV) pacing on the normal heart. Methods and Results Male New Zealand White rabbits (n=33) were divided into 3 groups: sham-operated (control), RV pacing, and BIV pacing groups. Four weeks after surgery, the native QT (p=0.004) interval was significantly shorter in the BIV group compared to the RV or sham-operated groups. Also, compared to rabbits in the RV group, rabbits in the BIV group had shorter RV ventricular effective refractory period (VERP) at all cycle lengths, and shorter LV paced QT interval during the drive train of stimuli and close to refractoriness (p<0.001 for all comparisons). Protein expression of the KVLQT1 was significantly increased in the BIV group compared to the RV and control groups, while protein expression of SCN5A and connexin43 was significantly decreased in the RV compared to the other study groups. Erg protein expression was significantly increased in both pacing groups compared to the controls. Conclusions In this rabbit model, we demonstrate a direct effect of BIV but not RV pacing on shortening the native QT interval as well as the paced QT interval during burst pacing and close to the VERP. These findings underscore the fact that the effect of BIV pacing is partially mediated through direct electrical remodeling and may have implications as to the effect of BIV pacing on arrhythmia incidence and burden. PMID:20042767

Interatrial septum versus right atrial appendage pacing for prevention of atrial fibrillation : A meta-analysis of randomized controlled trials.

PubMed

Zhang, L; Jiang, H; Wang, W; Bai, J; Liang, Y; Su, Y; Ge, J

2017-07-28

Interatrial septum (IAS) pacing seems to be a promising strategy for the prevention of atrial fibrillation (AF); however, studies have yielded conflicting results. This meta-analysis was to compare IAS with right atrial appendage (RAA) pacing on the prevention of postpacing AF occurrence. Pubmed, MEDLINE, EMBASE and Web of Science databases were searched through October 2016 for randomized controlled trials comparing IAS with RAA pacing on the prevention of AF. Data concerning study design, patient characteristics and outcomes were extracted. Risk ratio (RR), weighted mean differences (WMD) or standardized mean differences (SMD) were calculated using fixed or random effects models. A total of 12 trials involving 1146 patients with dual-chamber pacing were included. Although IAS was superior to RAA pacing in terms of reducing the number of AF episodes (SMD = -0.29, P = 0.05), AF burden (SMD = -0.41, P = 0.008) and P -wave duration (WMD = -34.45 ms, P < 0.0001), neither permanent AF occurrence (RR = 0.94, P = 0.58) nor recurrences of AF (RR = 0.88, P = 0.36) were reduced by IAS pacing. Nevertheless, no differences were observed concerning all-cause death (RR = 1.04, P = 0.88), procedure-related events (RR = 1.17, P = 0.69) and pacing parameters between IAS and RAA pacing in the follow-up period. IAS pacing is safe and as well tolerated as RAA pacing. Although IAS pacing may fail to prevent permanent AF occurrence and recurrences of AF, it is able to not only improve interatrial conduction, but also reduce AF burden.

Effects of septal pacing on P wave characteristics: the value of three-dimensional echocardiography.

PubMed

Szili-Torok, Tamas; Bruining, Nico; Scholten, Marcoen; Kimman, Geert-Jan; Roelandt, Jos; Jordaens, Luc

2003-01-01

Interatrial septum (IAS) pacing has been proposed for the prevention of paroxysmal atrial fibrillation. IAS pacing is usually guided by fluoroscopy and P wave analysis. The authors have developed a new approach for IAS pacing using intracardiac echocardiography (ICE), and examined its effects on P wave characteristics. Cross-sectional images are acquired during pullback of the ICE transducer from the superior vena cava into the inferior vena cava by an electrocardiogram- and respiration-gated technique. The right atrium and IAS are then three-dimensionally reconstructed, and the desired pacing site is selected. After lead placement and electrical testing, another three-dimensional reconstruction is performed to verify the final lead position. The study included 14 patients. IAS pacing was achieved at seven suprafossal (SF) and seven infrafossal (IF) lead locations, all confirmed by three-dimensional imaging. IAS pacing resulted in a significant reduction of P wave duration as compared to sinus rhythm (99.7 +/- 18.7 vs 140.4 +/- 8.8 ms; P < 0.01). SF pacing was associated with a greater reduction of P wave duration than IF pacing (56.1 +/- 9.9 vs 30.2 +/- 13.6 ms; P < 0.01). P wave dispersion remained unchanged during septal pacing as compared to sinus rhythm (21.4 +/- 16.1 vs 13.5 +/- 13.9 ms; NS). Three-dimensional intracardiac echocardiography can be used to guide IAS pacing. SF pacing was associated with a greater decrease in P wave duration, suggesting that it is a preferable location to decrease interatrial conduction delay.

Current Trends in the Detection of Sociocultural Signatures: Data-Driven Models

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

Sanfilippo, Antonio P.; Bell, Eric B.; Corley, Courtney D.

The harvesting of behavioral data and their analysis through evidence-based reasoning enable the detection of sociocultural signatures in their context to support situation awareness and decision making. Harvested data are used as training materials from which to infer computational models of sociocultural behaviors or calibrate parameters for such models. Harvested data also serve as evidence input that the models use to provide insights about observed and future behaviors for targets of interest. The harvested data is often the result of assembling diverse data types and aggregating them into a form suitable for analysis. Data need to be analyzed to bringmore » out the categories of content that are relevant to the domain being addressed in order to train or run a model. If, for example, we are modeling the intent of a group to engage in violent behavior using messages that the group has broadcasted, then these messages need to be processed to extract and measure indicators of violent intent. The extracted indicators and the associated measurements (e.g. rates or counts of occurrence) can then be used to train/calibrate and run computational models that assess the propensity for violence expressed in the source message. Ubiquitous access to the Internet, mobile telephony and technologies such as digital photography and digital video have enabled social media application platforms such as Facebook, YouTube, and Twitter that are altering the nature of human social interaction. The fast increasing pace of online social interaction introduces new challenges and opportunities for gathering sociocultural data. Challenges include the development of harvesting and processing techniques tailored to new data environments and formats (e.g. Twitter, Facebook), the integration of social media content with traditional media content, and the protection of personal privacy. As these and other challenges are addressed, a new wealth of behavioral data and data analysis methods becomes available that are shaping social computing as a strongly data-driven experimental discipline with an increasingly stronger impact on the decision-making process of groups and individuals alike. In this chapter, we review current advances and trends in the detection of sociocultural signatures. Specific embodiments of the issues discussed are provided with respect to the assessment of violent intent and sociopolitical contention. We begin by reviewing current approaches to the detection of sociocultural signatures in these domains. Next, we turn to the review of novel data harvesting methods for social media content. Finally, we discuss the application of sociocultural models to social media content, and conclude by commenting on current challenges and future developments.« less

Pacing a data transfer operation between compute nodes on a parallel computer

DOEpatents

Blocksome, Michael A [Rochester, MN

2011-09-13

Methods, systems, and products are disclosed for pacing a data transfer between compute nodes on a parallel computer that include: transferring, by an origin compute node, a chunk of an application message to a target compute node; sending, by the origin compute node, a pacing request to a target direct memory access (`DMA`) engine on the target compute node using a remote get DMA operation; determining, by the origin compute node, whether a pacing response to the pacing request has been received from the target DMA engine; and transferring, by the origin compute node, a next chunk of the application message if the pacing response to the pacing request has been received from the target DMA engine.

Meta-Analysis of Single-Case Research Design Studies on Instructional Pacing.

PubMed

Tincani, Matt; De Mers, Marilyn

2016-11-01

More than four decades of research on instructional pacing has yielded varying and, in some cases, conflicting findings. The purpose of this meta-analysis was to synthesize single-case research design (SCRD) studies on instructional pacing to determine the relative benefits of brisker or slower pacing. Participants were children and youth with and without disabilities in educational settings, excluding higher education. Tau-U, a non-parametric statistic for analyzing data in SCRD studies, was used to determine effect size estimates. The article extraction yielded 13 instructional pacing studies meeting contemporary standards for high quality SCRD research. Eleven of the 13 studies reported small to large magnitude effects when two or more pacing parameters were compared, suggesting that instructional pacing is a robust instructional variable. Brisker instructional pacing with brief inter-trial interval (ITI) produced small increases in correct responding and medium to large reductions in challenging behavior compared with extended ITI. Slower instructional pacing with extended wait-time produced small increases in correct responding, but also produced small increases in challenging behavior compared with brief wait-time. Neither brief ITI nor extended wait-time meets recently established thresholds for evidence-based practice, highlighting the need for further instructional pacing research. © The Author(s) 2016.

Relationship between left atrium catheter contact force and pacing threshold.

PubMed

Barrio-López, Teresa; Ortiz, Mercedes; Castellanos, Eduardo; Lázaro, Carla; Salas, Jefferson; Madero, Sergio; Almendral, Jesús

2017-08-01

The purpose of this study is to analyze the relationship between contact force (CF) and pacing threshold in left atrium (LA). Six to ten LA sites were studied in 28 consecutive patients with atrial fibrillation undergoing pulmonary vein isolation. Median CF, bipolar and unipolar electrogram voltage, impedance, and bipolar and unipolar thresholds for consistent constant capture and for consistent intermittent capture were measured at each site. Pacing threshold measurements were performed at 188 LA sites. Both unipolar and bipolar pacing thresholds correlated significantly with median CF; however, unipolar pacing threshold correlated better (unipolar: Pearson R -0.45; p < 0.001; Spearman Rho -0.62; p < 0.001, bipolar: Pearson R -0.39; p < 0.001; Spearman Rho -0.52; p < 0.001). Consistent constant capture threshold had better correlation with median CF than consistent intermittent capture threshold for both unipolar and bipolar pacing (Pearson R -0.45; p < 0.001 and Spearman Rho -0.62; p < 0.001 vs. Pearson R -0.35; p < 0.001; Spearman Rho -0.52; p < 0.001). The best pacing threshold cutoff point to detect a good CF (>10 g) was 3.25 mA for unipolar pacing with 69% specificity and 73% sensitivity. Both increased to 80% specificity and 74% sensitivity for sites with normal bipolar voltage and a pacing threshold cutoff value of 2.85 mA. Pacing thresholds correlate with CF in human not previously ablated LA. Since the combination of a normal bipolar voltage and a unipolar pacing threshold <2.85 mA provide reasonable parameters of validity, pacing threshold could be of interest as a surrogate for CF in LA.

Triple-site pacing for cardiac resynchronization in permanent atrial fibrillation - Acute phase results from a prospective observational study.

PubMed

Marques, Pedro; Nobre Menezes, Miguel; Lima da Silva, Gustavo; Bernardes, Ana; Magalhães, Andreia; Cortez-Dias, Nuno; Carpinteiro, Luís; de Sousa, João; Pinto, Fausto J

2016-06-01

Multi-site pacing is emerging as a new method for improving response to cardiac resynchronization therapy (CRT), but has been little studied, especially in patients with atrial fibrillation. We aimed to assess the effects of triple-site (Tri-V) vs. biventricular (Bi-V) pacing on hemodynamics and QRS duration. This was a prospective observational study of patients with permanent atrial fibrillation and ejection fraction <40% undergoing CRT implantation (n=40). One right ventricular (RV) lead was implanted in the apex and another in the right ventricular outflow tract (RVOT) septal wall. A left ventricular (LV) lead was implanted in a conventional venous epicardial position. Cardiac output (using the FloTrac™ Vigileo™ system), mean QRS and ejection fraction were calculated. Mean cardiac output was 4.81±0.97 l/min with Tri-V, 4.68±0.94 l/min with RVOT septal and LV pacing, and 4.68±0.94 l/min with RV apical and LV pacing (p<0.001 for Tri-V vs. both BiV). Mean pre-implantation QRS was 170±25 ms, 123±18 ms with Tri-V, 141±25 ms with RVOT septal pacing and LV pacing and 145±19 with RV apical and LV pacing (p<0.001 for Tri-V vs. both BiV and pre-implantation). Mean ejection fraction was significantly higher with Tri-V (30±11%) vs. Bi-V pacing (28±12% with RVOT septal and LV pacing and 28±11 with RV apical and LV pacing) and pre-implantation (25±8%). Tri-V pacing produced higher cardiac output and shorter QRS duration than Bi-V pacing. This may have a significant impact on the future of CRT. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Risk perception influences athletic pacing strategy.

PubMed

Micklewright, Dominic; Parry, David; Robinson, Tracy; Deacon, Greg; Renfree, Andrew; St Clair Gibson, Alan; Matthews, William J

2015-05-01

The objective of this study is to examine risk taking and risk perception associations with perceived exertion, pacing, and performance in athletes. Two experiments were conducted in which risk perception was assessed using the domain-specific risk taking (DOSPERT) scale in 20 novice cyclists (experiment 1) and 32 experienced ultramarathon runners (experiment 2). In experiment 1, participants predicted their pace and then performed a 5-km maximum effort cycling time trial on a calibrated Kingcycle mounted bicycle. Split times and perceived exertion were recorded every kilometer. In experiment 2, each participant predicted their split times before running a 100-km ultramarathon. Split times and perceived exertion were recorded at seven checkpoints. In both experiments, higher and lower risk perception groups were created using median split of DOSPERT scores. In experiment 1, pace during the first kilometer was faster among lower risk perceivers compared with higher risk perceivers (t(18) = 2.0, P = 0.03) and faster among higher risk takers compared with lower risk takers (t(18) = 2.2, P = 0.02). Actual pace was slower than predicted pace during the first kilometer in both the higher risk perceivers (t(9) = -4.2, P = 0.001) and lower risk perceivers (t(9) = -1.8, P = 0.049). In experiment 2, pace during the first 36 km was faster among lower risk perceivers compared with higher risk perceivers (t(16) = 2.0, P = 0.03). Irrespective of risk perception group, actual pace was slower than predicted pace during the first 18 km (t(16) = 8.9, P < 0.001) and from 18 to 36 km (t(16) = 4.0, P < 0.001). In both experiments, there was no difference in performance between higher and lower risk perception groups. Initial pace is associated with an individual's perception of risk, with low perceptions of risk being associated with a faster starting pace. Large differences between predicted and actual pace suggest that the performance template lacks accuracy, perhaps indicating greater reliance on momentary pacing decisions rather than preplanned strategy.

The effect of visitor number and spice provisioning in pacing expression by jaguars evaluated through a case study.

PubMed

Vidal, L S; Guilherme, F R; Silva, V F; Faccio, M C S R; Martins, M M; Briani, D C

2016-06-01

Captive animals exhibit stereotypic pacing in response to multiple causes, including the inability to escape from human contact. Environmental enrichment techniques can minimize pacing expression. By using an individual-based approach, we addressed whether the amount of time two males and a female jaguar (Panthera onca) devote to pacing varied with the number of visitors and tested the effectiveness of cinnamon and black pepper in reducing pacing. The amount of time that all jaguars engaged in pacing increased significantly with the number of visitors. Despite the difference between the males regarding age and housing conditions, both devoted significantly less time to pacing following the addition of both spices, which indicates their suitability as enrichment techniques. Mean time devoted to pacing among the treatments did not differ for the female. Our findings pointed out to the validity of individual-based approaches, as they can reveal how suitable olfactory stimuli are to minimizing stereotypies irrespective of particular traits.

The joint center for energy storage research: A new paradigm for battery research and development

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

Crabtree, George

2015-03-30

The Joint Center for Energy Storage Research (JCESR) seeks transformational change in transportation and the electricity grid driven by next generation high performance, low cost electricity storage. To pursue this transformative vision JCESR introduces a new paradigm for battery research: integrating discovery science, battery design, research prototyping and manufacturing collaboration in a single highly interactive organization. This new paradigm will accelerate the pace of discovery and innovation and reduce the time from conceptualization to commercialization. JCESR applies its new paradigm exclusively to beyond-lithium-ion batteries, a vast, rich and largely unexplored frontier. This review presents JCESR's motivation, vision, mission, intended outcomesmore » or legacies and first year accomplishments.« less

Experiences with Deriva: An Asset Management Platform for Accelerating eScience.

PubMed

Bugacov, Alejandro; Czajkowski, Karl; Kesselman, Carl; Kumar, Anoop; Schuler, Robert E; Tangmunarunkit, Hongsuda

2017-10-01

The pace of discovery in eScience is increasingly dependent on a scientist's ability to acquire, curate, integrate, analyze, and share large and diverse collections of data. It is all too common for investigators to spend inordinate amounts of time developing ad hoc procedures to manage their data. In previous work, we presented Deriva, a Scientific Asset Management System, designed to accelerate data driven discovery. In this paper, we report on the use of Deriva in a number of substantial and diverse eScience applications. We describe the lessons we have learned, both from the perspective of the Deriva technology, as well as the ability and willingness of scientists to incorporate Scientific Asset Management into their daily workflows.

Prevention of Adverse Electrical and Mechanical Remodeling with Bi-Ventricular Pacing in a Rabbit Model of Myocardial Infarction

PubMed Central

Saba, Samir; Mathier, Michael A.; Mehdi, Haider; Gursoy, Erdal; Liu, Tong; Choi, Bum-Rak; Salama, Guy; London, Barry

2008-01-01

Background: Biventricular (BIV) pacing can improve cardiac function in heart failure (HF). Objective: To investigate the mechanisms of benefit of BIV pacing using a rabbit model of myocardial infarction (MI). Methods: New Zealand White rabbits were divided into 4 groups: sham-operated (C), MI with no pacing (MI), MI with right ventricular pacing (MI+RV), and MI with BIV pacing (MI+BIV), and underwent serial electrocardiograms and echocardiograms. At 4 weeks, hearts were excised and tissue was extracted from various areas of the left ventricle (LV). Results: Four weeks after coronary ligation, BIV pacing prevented systolic and diastolic dilation of the LV as well as the reduction in its fractional shortening, restored the QRS width and the rate-dependent QT intervals to their baseline values, and prevented the decline of the ether-a-go-go (erg) protein levels. This prevention of remodeling was not documented in the MI+RV groups. Conclusions: In this rabbit model of BIV pacing and MI, we demonstrate prevention of adverse mechanical and electrical remodeling of the heart. These changes may underlie some of the benefits seen with BIV pacing in HF patients with more severe LV dysfunction. PMID:18180026

The efficacy of self-paced study in multitrial learning.

PubMed

de Jonge, Mario; Tabbers, Huib K; Pecher, Diane; Jang, Yoonhee; Zeelenberg, René

2015-05-01

In 2 experiments we investigated the efficacy of self-paced study in multitrial learning. In Experiment 1, native speakers of English studied lists of Dutch-English word pairs under 1 of 4 imposed fixed presentation rate conditions (24 × 1 s, 12 × 2 s, 6 × 4 s, or 3 × 8 s) and a self-paced study condition. Total study time per list was equated for all conditions. We found that self-paced study resulted in better recall performance than did most of the fixed presentation rates, with the exception of the 12 × 2 s condition, which did not differ from the self-paced condition. Additional correlational analyses suggested that the allocation of more study time to difficult pairs than to easy pairs might be a beneficial strategy for self-paced learning. Experiment 2 was designed to test this hypothesis. In 1 condition, participants studied word pairs in a self-paced fashion without any restrictions. In the other condition, participants studied word pairs in a self-paced fashion but total study time per item was equated. The results showed that allowing self-paced learners to freely allocate study time over items resulted in better recall performance. (c) 2015 APA, all rights reserved).

42 CFR 460.102 - Interdisciplinary team.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Interdisciplinary team. 460.102 Section 460.102... ELDERLY (PACE) PACE Services § 460.102 Interdisciplinary team. (a) Basic requirement. A PACE organization must meet the following requirements: (1) Establish an interdisciplinary team at each Pace center to...

42 CFR 460.102 - Interdisciplinary team.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Interdisciplinary team. 460.102 Section 460.102... ELDERLY (PACE) PACE Services § 460.102 Interdisciplinary team. (a) Basic requirement. A PACE organization must meet the following requirements: (1) Establish an interdisciplinary team at each Pace center to...

42 CFR 460.102 - Interdisciplinary team.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Interdisciplinary team. 460.102 Section 460.102... ELDERLY (PACE) PACE Services § 460.102 Interdisciplinary team. (a) Basic requirement. A PACE organization must meet the following requirements: (1) Establish an interdisciplinary team at each Pace center to...

42 CFR 460.102 - Interdisciplinary team.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Interdisciplinary team. 460.102 Section 460.102... ELDERLY (PACE) PACE Services § 460.102 Interdisciplinary team. (a) Basic requirement. A PACE organization must meet the following requirements: (1) Establish an interdisciplinary team at each Pace center to...

42 CFR 460.102 - Interdisciplinary team.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Interdisciplinary team. 460.102 Section 460.102... ELDERLY (PACE) PACE Services § 460.102 Interdisciplinary team. (a) Basic requirement. A PACE organization must meet the following requirements: (1) Establish an interdisciplinary team at each Pace center to...

Spatial resolution of pace mapping of idiopathic ventricular tachycardia/ectopy originating in the right ventricular outflow tract.

PubMed

Bogun, Frank; Taj, Majid; Ting, Michael; Kim, Hyungjin Myra; Reich, Stephen; Good, Eric; Jongnarangsin, Krit; Chugh, Aman; Pelosi, Frank; Oral, Hakan; Morady, Fred

2008-03-01

Pace mapping has been used to identify the site of origin of focal ventricular arrhythmias. The spatial resolution of pace mapping has not been adequately quantified using currently available three-dimensional mapping systems. The purpose of this study was to determine the spatial resolution of pace mapping in patients with idiopathic ventricular tachycardia or premature ventricular contractions originating in the right ventricular outflow tract. In 16 patients with idiopathic ventricular tachycardia/ectopy from the right ventricular outflow tract, comparisons and classifications of pace maps were performed by two observers (good pace map: match >10/12 leads; inadequate pace map: match < or =10/12 leads) and a customized MATLAB 6.0 program (assessing correlation coefficient and normalized root mean square of the difference (nRMSd) between test and template signals). With an electroanatomic mapping system, the correlation coefficient of each pace map was correlated with the distance between the pacing site and the effective ablation site. The endocardial area within the 10-ms activation isochrone was measured. The ablation procedure was effective in all patients. Sites with good pace maps had a higher correlation coefficient and lower nRMSd than sites with inadequate pace maps (correlation coefficient: 0.96 +/- 0.03 vs 0.76 +/- 0.18, P <.0001; nRMSd: 0.41 +/- 0.16 vs 0.89 +/- 0.39, P <.0001). Using receiver operating characteristic curves, appropriate cutoff values were >0.94 for correlation coefficient (sensitivity 81%, specificity 89%) and < or =0.54 for nRMSd (sensitivity 76%, specificity 80%). Good pace maps were located a mean of 7.3 +/- 5.0 mm from the effective ablation site and had a mean activation time of -24 +/- 7 ms. However, in 3 (18%) of 16 patients, the best pace map was inadequate at the effective ablation site, with an endocardial activation time at these sites of -25 +/- 12 ms. Pace maps with correlation coefficient > or =0.94 were confined to an area of 1.8 +/- 0.6 cm2. The 10-ms isochrone measured 1.2 +/- 0.7 cm2. The spatial resolution of a good pace map for targeting ventricular tachycardia/ectopy is 1.8 cm2 in the right ventricular outflow tract and therefore is inferior to the spatial resolution of activation mapping as assessed by isochronal activation. In approximately 20% of patients, pace mapping is unreliable in identifying the site of origin, possibly due a deeper site of origin and preferential conduction via fibers connecting the focus to the endocardial surface.

Feasibility of dual-chamber (DDD) pacing via a single-pass (VDD) pacing lead employing a floating atrial ring (dipole): case series, future considerations, and refinements.

PubMed

Kassotis, John; Voigt, Louis; Mongwa, Mbu; Reddy, C V R

2005-01-01

The objective of this study was to assess the feasibility of DDD pacing from a standard single-pass VDD pacemaker system. Over the past 2 decades significant advances have been made in the development of single-pass VDD pacing systems. These have been shown in long-term prospective studies to effectively preserve atrioventricular (AV)synchrony in patients with AV block and normal sinus node function. What remains problematic is the development of a single-pass pacing system capable of DDD pacing. Such a lead configuration would be useful in those patients with peripheral venous anomalies and in younger patients with congenital anomalies, which may require lead revisions in the future. In addition, with the increased use of resynchronization (biventricular pacing) therapy, the availability of a reliable single-pass lead will minimize operative time, enhance patient safety, and minimize the amount of hardware within the heart. The feasibility of DDD pacing via a Medtronic Capsure VDD-2 (Model #5038) pacing lead was evaluated. Twenty patients who presented with AV block and normal sinus node function were recruited for this study. Atrial pacing thresholds and sensitivities were assessed intraoperatively in the supine position with various respiratory maneuvers. Five patients who agreed to participate in long-term follow-up received a dual-chamber generator and were evaluated periodically over a 12-month period. Mean atrial sensitivity was 2.35 +/- 0.83 mV at the time of implantation. Effective atrial stimulation was possible in all patients at the time of implantation (mean stimulation threshold 3.08 +/- 1.04 V at 0.5 ms [bipolar], 3.34 +/- 0.95 V at 0.5 ms [unipolar]). Five of the 20 patients received a Kappa KDR701 generator, and atrial electrical properties were followed up over a 1-year period. There was no significant change in atrial pacing threshold or incidence of phrenic nerve stimulation over the 1-year follow-up. A standard single-pass VDD pacing lead system was capable of DDD pacing intraoperatively and during long-term follow-up. Despite higher than usual thresholds via the atrial dipole, pacemaker telemetry revealed < 10% use of atrial pacing dipole over a 12-month period, which would minimally deplete the pacemaker's battery. In addition, the telemetry confirmed appropriate sensing and pacing of the atrial dipole throughout the study period. At this time such systems can serve as back-up DDD pacing systems with further refinements required to optimize atrial thresholds in all patients.

Comparison of DDD versus VVIR pacing modes in elderly patients with atrioventricular block.

PubMed

Kılıçaslan, Barış; Vatansever Ağca, Fahriye; Kılıçaslan, Esin Evren; Kınay, Ozan; Tigen, Kürşat; Cakır, Cayan; Nazlı, Cem; Ergene, Oktay

2012-06-01

Dual-chamber pacing is believed to have an advantage over single-chamber ventricular pacing. The aim of this study was to determine whether elderly patients who have implanted pacemakers for complete atrioventricular block gain significant benefits from dual-chamber (DDD) pacemakers compared with single chamber ventricular (VVIR) pacemakers. This study was designed as a randomized, two-period crossover study-each pacing mode was maintained for 1 month. Thirty patients (16 men, mean age 68.87 ± 6.89 years) with implanted DDD pacemakers were submitted to a standard protocol, which included an interview, pacemaker syndrome assessment, health related quality of life (HRQoL) questionnaires assessed by an SF-36 test, 6-minute walk test (6MWT), and transthoracic echocardiographic examinations. All of these parameters were obtained on both DDD and VVIR mode pacing. Paired data were compared. HRQoL scores were similar, and 6MWT results did not differ between the two groups. VVIR pacing elicited significant enlargement of the left atrium and impaired left ventricular diastolic functions as compared with DDD pacing. Two patients reported subclinical pacemaker syndrome, but this was not statistically significant. Our study revealed that in active elderly patients with complete heart block, DDD pacing and VVIR pacing yielded similar improvements in QoL and exercise performance. However, after a short follow-up period, we noted that VVIR pacing caused significant left atrial enlargement and impaired left ventricular diastolic functions.

Symptoms of chronic fatigue syndrome/myalgic encephalopathy are not determined by activity pacing when measured by the chronic pain coping inventory.

PubMed

Thompson, D P; Antcliff, D; Woby, S R

2018-03-01

Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) is a chronic illness which can cause significant fatigue, pain and disability. Activity pacing is frequently advocated as a beneficial coping strategy, however, it is unclear whether pacing is significantly associated with symptoms in people with CFS/ME. The first aim of this study was therefore to explore the cross-sectional associations between pacing and levels of pain, disability and fatigue. The second aim was to explore whether changes in activity pacing following participation in a symptom management programme were related to changes in clinical outcomes. Cross-sectional study exploring the relationships between pacing, pain, disability and fatigue (n=114) and pre-post treatment longitudinal study of a cohort of patients participating in a symptom management programme (n=35). Out-patient physiotherapy CFS/ME service. One-hundred and fourteen adult patients with CFS/ME. Pacing was assessed using the chronic pain coping inventory. Pain was measured using a Numeric Pain Rating Scale, fatigue with the Chalder Fatigue Scale and disability with the Fibromyalgia Impact Questionnaire. No significant associations were observed between activity pacing and levels of pain, disability or fatigue. Likewise, changes in pacing were not significantly associated with changes in pain, disability or fatigue following treatment. Activity pacing does not appear to be a significant determinant of pain, fatigue or disability in people with CFS/ME when measured with the chronic pain coping index. Consequently, the utility and measurement of pacing require further investigation. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Influence of pacing site characteristics on response to cardiac resynchronization therapy.

PubMed

Wong, Jorge A; Yee, Raymond; Stirrat, John; Scholl, David; Krahn, Andrew D; Gula, Lorne J; Skanes, Allan C; Leong-Sit, Peter; Klein, George J; McCarty, David; Fine, Nowell; Goela, Aashish; Islam, Ali; Thompson, Terry; Drangova, Maria; White, James A

2013-07-01

Transmural scar occupying left ventricular (LV) pacing regions has been associated with reduced response to cardiac resynchronization therapy (CRT). However, spatial influences of lead tip delivery relative to scar at both pacing sites remain poorly explored. This study evaluated scar distribution relative to LV and right ventricular (RV) lead tip placement through coregistration of late gadolinium enhancement MRI and cardiac computed tomographic (CT) findings. Influences on CRT response were assessed by serial echocardiography. Sixty patients receiving CRT underwent preimplant late gadolinium enhancement MRI, postimplant cardiac CT, and serial echocardiography. Blinded segmental evaluations of mechanical delay, percentage scar burden, and lead tip location were performed. Response to CRT was defined as a reduction in LV end-systolic volume ≥15% at 6 months. The mean age and LV ejection fraction were 64±9 years and 25±7%, respectively. Mean scar volume was higher among CRT nonresponders for both the LV (23±23% versus 8±14% [P=0.01]) and RV pacing regions (40±32% versus 24±30% [P=0.04]). Significant pacing region scar was identified in 13% of LV pacing regions and 37% of RV pacing regions. Absence of scar in both regions was associated with an 81% response rate compared with 55%, 25%, and 0%, respectively, when the RV, LV, or both pacing regions contained scar. LV pacing region dyssynchrony was not predictive of response. Myocardial scar occupying the LV pacing region is associated with nonresponse to CRT. Scar occupying the RV pacing region is encountered at higher frequency and seems to provide a more intermediate influence on CRT response.

DDD versus VVIR pacing in patients, ages 70 and over, with complete heart block.

PubMed

Ouali, Sana; Neffeti, Elyes; Ghoul, Karima; Hammas, Sami; Kacem, Slim; Gribaa, Rim; Remedi, Fahmi; Boughzela, Essia

2010-05-01

Dual-chamber pacing is believed to have an advantage over single-chamber ventricular pacing. The aim of the study was to determine whether elderly patients with implanted pacemaker for complete atrioventricular block gain significant benefit from dual-chamber (DDD) compared with single-chamber ventricular demand (VVIR). The study was designed as a double-blind randomized two-period crossover study-each pacing mode was maintained for 3 months. Thirty patients (eight men, mean age 76.5 +/- 4.3 years) with implanted PM were submitted to a standard protocol, which included an interview, functional class assessment, quality of life (QoL) questionnaires, 6-minute walk test, and transthoracic echocardiographic examinations. QoL was measured by the SF-36. All these parameters were obtained on DDD mode pacing and VVIR mode pacing. Paired data were compared. QoL was significantly different between the two groups and showed the best values in DDD. Overall, no patient preferred VVIR mode, 18 preferred DDD mode, and 12 expressed no preference. No differences in mean walking distances were observed between patients with single-chamber and dual-chamber pacing. VVI pacing elicited marked decrease in left ventricle ejection fraction and significant enlargement of the left atrium. DDD pacing resulted in significant increase of the peak systolic velocities in lateral mitral annulus and septal mitral annulus. Early diastolic velocities on both sides of mitral annulus did not change. In active elderly patients with complete heart block, DDD pacing is associated with improved quality of life and systolic ventricular function compared with VVI pacing.

42 CFR 460.186 - PACE premiums.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false PACE premiums. 460.186 Section 460.186 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE...

"U-Pace" Instruction: Improving Student Success by Integrating Content Mastery and Amplified Assistance

ERIC Educational Resources Information Center

Reddy, Diane M.; Pfeiffer, Heidi M.; Fleming, Raymond; Ports, Katie A.; Pedrick, Laura E.; Barnack-Tavlaris, Jessica L.; Jirovec, Danielle L.; Helion, Alicia M.; Swain, Rodney A.

2013-01-01

"U-Pace," an instructional intervention, has potential for widespread implementation because student behavior recorded in any learning management system is used by "U-Pace" instructors to tailor coaching of student learning based on students' strengths and motivations. "U-Pace" utilizes an online learning environment…

Unintended Outcomes of University-Community Partnerships: Building Organizational Capacity with PACE International Partners

ERIC Educational Resources Information Center

Lloyd, Kate; Clark, Lindie; Hammersley, Laura; Baker, Michaela; Rawlings-Sanaei, Felicity; D'ath, Emily

2015-01-01

Professional and Community Engagement (PACE) at Macquarie University provides experiential opportunities for students and staff to contribute to more just, inclusive and sustainable societies by engaging in activities with partner organizations. PACE International offers a range of opportunities with partners overseas. Underpinning PACE is a…

On the role and origin of isochrony in human rhythmic entrainment.

PubMed

Merker, Bjorn H; Madison, Guy S; Eckerdal, Patricia

2009-01-01

Wherever human beings live, and however they may organise their affairs, they gather from time to time to sing and dance together, often in a ritual setting. In doing so they synchronise their voices and bodily movements to a shared, repeating interval of time, the musical pulse, beat or tactus. We take this capacity to "entrain" to an evenly paced stimulus (isochrony) so much for granted that it may come as a surprise to learn that from a biological point of view such behaviour is exceptional. But it is not altogether unique. There are a number of other species, none of them closely related to humans, that also engage in group synchrony of behaviour through entrainment to an isochronous pulse. Despite their evolutionary distance from us their life circumstances throw an interesting light on the possible origin and nature of our own entrainment capacity. Here we consider this capacity in terms of its possible origin, functional mechanisms, and ontogenetic development.

Recommendations for reducing ambiguity in written procedures.

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

Matzen, Laura E.

Previous studies in the nuclear weapons complex have shown that ambiguous work instructions (WIs) and operating procedures (OPs) can lead to human error, which is a major cause for concern. This report outlines some of the sources of ambiguity in written English and describes three recommendations for reducing ambiguity in WIs and OPs. The recommendations are based on commonly used research techniques in the fields of linguistics and cognitive psychology. The first recommendation is to gather empirical data that can be used to improve the recommended word lists that are provided to technical writers. The second recommendation is to havemore » a review in which new WIs and OPs and checked for ambiguities and clarity. The third recommendation is to use self-paced reading time studies to identify any remaining ambiguities before the new WIs and OPs are put into use. If these three steps are followed for new WIs and OPs, the likelihood of human errors related to ambiguity could be greatly reduced.« less

Evaluation of the cognitive effects of travel technique in complex real and virtual environments.

PubMed

Suma, Evan A; Finkelstein, Samantha L; Reid, Myra; V Babu, Sabarish; Ulinski, Amy C; Hodges, Larry F

2010-01-01

We report a series of experiments conducted to investigate the effects of travel technique on information gathering and cognition in complex virtual environments. In the first experiment, participants completed a non-branching multilevel 3D maze at their own pace using either real walking or one of two virtual travel techniques. In the second experiment, we constructed a real-world maze with branching pathways and modeled an identical virtual environment. Participants explored either the real or virtual maze for a predetermined amount of time using real walking or a virtual travel technique. Our results across experiments suggest that for complex environments requiring a large number of turns, virtual travel is an acceptable substitute for real walking if the goal of the application involves learning or reasoning based on information presented in the virtual world. However, for applications that require fast, efficient navigation or travel that closely resembles real-world behavior, real walking has advantages over common joystick-based virtual travel techniques.

Trends in salaries of obstetrics-gynecology faculty, 2000-01 to 2008-09.

PubMed

Rayburn, William F; Fullilove, Anne M; Scroggs, James A; Schrader, Ronald M

2011-01-01

We sought to determine whether downward trends in inflation-adjusted salaries (1989-99) continued for obstetrics and gynecology faculty. Data were gathered from the Faculty Salary Survey from the Association of American Medical Colleges for academic years 2001 through 2009. We compared median physician salaries adjusted for inflation according to rank and specialty. While faculty compensation increased by 24.8% (2.5% annually), change in salaries was comparable to the cumulative inflation rate (21.3%). Salaries were consistently highest among faculty in gynecologic oncology (P < .001), next highest among maternal-fetal medicine specialists (P < .001), and were not significantly different between general obstetrics-gynecology and reproductive-endocrinology-infertility. Inflation-adjusted growth of salaries in general obstetrics-gynecology was not significantly different from that in general internal medicine and pediatrics. Growth in salaries of physician faculty in obstetrics and gynecology increased from 2000-01 through 2008-09 with real purchasing power keeping pace with inflation. Copyright © 2011 Mosby, Inc. All rights reserved.

Continual evolution: the experience over three semesters of a librarian embedded in an online evidence-based medicine course for physician assistant students.

PubMed

Kealey, Shannon

2011-01-01

This column examines the experience, over three years, of a librarian embedded in an online Epidemiology and Evidence-based Medicine course, which is a requirement for students pursuing a Master of Science in Physician Assistant Studies at Pace University. Student learning outcomes were determined, a video lecture was created, and student learning was assessed via a five-point Blackboard test during year one. For years two and three, the course instructor asked the librarian to be responsible for two weeks of course instruction and a total of 15 out of 100 possible points for the course. This gave the librarian flexibility to measure additional outcomes and gather more in-depth assessment data. The librarian then used the assessment data to target areas for improvement in the lessons and Blackboard tests. Revisions made by the librarian positively affected student achievement of learning outcomes, as measured by the assessment conducted the subsequent semester. Plans for further changes are also discussed.

Pacing for neurally mediated syncope: is placebo powerless?

PubMed

Brignole, M; Sutton, R

2007-01-01

After two recent controlled trials failed to prove superiority of cardiac pacing over placebo in patients affected by neurally mediated syncope, a widely accepted opinion is that cardiac pacing therapy is not very effective and that a strong placebo effect exists. To measure the effect of placebo pacing therapy. We compared the recurrence rate of syncope during placebo vs. no treatment in controlled trials of drug or pacing therapy. Syncope recurred in 38% of 252 patients randomized to placebo pooled from five trials vs. 34% of 881 patients randomized to no treatment pooled from eight trials. The corresponding recurrence rate with active cardiac pacing was 15% in 203 patients from six trials. Placebo is not an effective therapy for neurally mediated syncope. Different selection criteria in patients who are candidates for cardiac pacing-for example, presence, absence, or severity of the cardioinhibitory reflex may separate positive from negative trials.

International Soil Carbon Network (ISCN) Database v3-1

DOE Data Explorer

Nave, Luke [University of Michigan] (ORCID:0000000182588335); Johnson, Kris [USDA-Forest Service; van Ingen, Catharine [Microsoft Research; Agarwal, Deborah [Lawrence Berkeley National Laboratory] (ORCID:0000000150452396); Humphrey, Marty [University of Virginia; Beekwilder, Norman [University of Virginia

2016-01-01

The ISCN is an international scientific community devoted to the advancement of soil carbon research. The ISCN manages an open-access, community-driven soil carbon database. This is version 3-1 of the ISCN Database, released in December 2015. It gathers 38 separate dataset contributions, totalling 67,112 sites with data from 71,198 soil profiles and 431,324 soil layers. For more information about the ISCN, its scientific community and resources, data policies and partner networks visit: http://iscn.fluxdata.org/.

Engagement of Metal Debris into Gear Mesh

NASA Technical Reports Server (NTRS)

handschuh, Robert F.; Krantz, Timothy L.

2010-01-01

A series of bench-top experiments was conducted to determine the effects of metallic debris being dragged through meshing gear teeth. A test rig that is typically used to conduct contact fatigue experiments was used for these tests. Several sizes of drill material, shim stock and pieces of gear teeth were introduced and then driven through the meshing region. The level of torque required to drive the "chip" through the gear mesh was measured. From the data gathered, chip size sufficient to jam the mechanism can be determined.

A Theoretically Driven Investigation of the Efficacy of an Immersive Interactive Avatar Rich Virtual Environment in Pre-deployment Nursing Knowledge and Teamwork Skills Training

DTIC Science & Technology

2013-05-01

estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data... pedagogy , and instructional quality. Measures of effectiveness data is minimal and often has not been conducted in a rigorous manner. To be clear...instructional pedagogy and instructional quality between the programs offered. Efficacy studies beyond student satisfaction scores have not been done in a

PACE (Revised). Resource Guide. Research & Development Series No. 240D.

ERIC Educational Resources Information Center

Ashmore, M. Catherine; Pritz, Sandra G.

This resource guide contains information on the Program for Acquiring Competence in Entrepreneurship (PACE) materials, a glossary, and listings of sources of information. Introductory materials include a description of PACE, information on use of PACE materials, and objectives of the 18 units for all three levels at which they are developed. An…

A Study of Instructional Methods Used in Fast-Paced Classes

ERIC Educational Resources Information Center

Lee, Seon-Young; Olszewski-Kubilius, Paula

2006-01-01

This study involved 15 secondary-level teachers who taught fast-paced classes at a university based summer program and similar regularly paced classes in their local schools in order to examine how teachers differentiate or modify instructional methods and content selections for fast-paced classes. Interviews were conducted with the teachers…

Predicting Successful Completion Using Student Delay Indicators in Undergraduate Self-Paced Online Courses

ERIC Educational Resources Information Center

Lim, Janine M.

2016-01-01

Self-paced online courses meet flexibility and learning needs of many students, but skepticism persists regarding the quality and the tendency for students to procrastinate in self-paced courses. Research is needed to understand procrastination and delay patterns of students in online self-paced courses to predict successful completion and…

Further evidence for the role of gap junctions in the delayed antiarrhythmic effect of cardiac pacing.

PubMed

Miskolczi, Gottfried; Gönczi, Márton; Kovács, Mária; Seprényi, György; Végh, Ágnes

2015-07-01

The objective of this study was to provide evidence that gap junctions are involved in the delayed antiarrhythmic effect of cardiac pacing. Twenty-four dogs were paced through the right ventricle (4 × 5 min, rate of 240 beats/min) 24 h prior to a 25 min occlusion of the left anterior descending coronary artery. Some of these paced dogs were infused with 50 (n = 7) or 100 μmol/L (n = 7) of the gap junction uncoupler carbenoxolone (CBX), prior to and during the occlusion. Ten sham-paced dogs, subjected only to occlusion, served as the controls. Cardiac pacing markedly reduced the number of ectopic beats and episodes of ventricular tachycardia (VT), as well the incidence of VT and ventricular fibrillation during occlusion. The changes in severity of ischaemia and tissue electrical resistance were also less marked compared with the unpaced controls. Pacing also preserved the permeability of gap junctions, the phosphorylation of connexin43, and the structural integrity of the intercalated discs. The closing of gap junctions with CBX prior to and during ischaemia markedly attenuated or even abolished these protective effects of pacing. Our results support the previous findings that gap junctions play a role in the delayed antiarrhythmic effect of cardiac pacing.

Differential effects of film on preschool children's behaviour dependent on editing pace.

PubMed

Kostyrka-Allchorne, Katarzyna; Cooper, Nicholas R; Gossmann, Anna Maria; Barber, Katy J; Simpson, Andrew

2017-05-01

Evidence on how the pace of television and film editing affects children's behaviour and attention is inconclusive. We examined whether a fast-paced film affected how preschool-aged children interacted with toys. The study comprised 70 children (36 girls) aged two to four-and-a-half years who attended preschools in Essex, United Kingdom. The children were paired up and tested with either a fast- or a slow-paced film of a narrator reading a children's story. The fast-paced version had 102 camera cuts and 16 still images, and the slow-paced version had 22 camera cuts and four still images. Each dyad took part in two video-recorded free-play sessions, before and after they watched one of the specially edited four-minute films. The number of toys the children played with before and after the film sessions was recorded. Before they watched the films, the children's behaviour did not differ between the groups. However, after watching the film, the children in the fast-paced group shifted their attention between toys more frequently than the children who watched the slow-paced film. Even a brief exposure to differently paced films had an immediate effect on how the children interacted with their toys. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Body position and activity, but not heart rate, affect pump flows in patients with continuous-flow left ventricular assist devices.

PubMed

Muthiah, Kavitha; Gupta, Sunil; Otton, James; Robson, Desiree; Walker, Robyn; Tay, Andre; Macdonald, Peter; Keogh, Anne; Kotlyar, Eugene; Granger, Emily; Dhital, Kumud; Spratt, Phillip; Jansz, Paul; Hayward, Christopher S

2014-08-01

The aim of this study was to determine the contribution of pre-load and heart rate to pump flow in patients implanted with continuous-flow left ventricular assist devices (cfLVADs). Although it is known that cfLVAD pump flow increases with exercise, it is unclear if this increment is driven by increased heart rate, augmented intrinsic ventricular contraction, or enhanced venous return. Two studies were performed in patients implanted with the HeartWare HVAD. In 11 patients, paced heart rate was increased to approximately 40 beats/min above baseline and then down to approximately 30 beats/min below baseline pacing rate (in pacemaker-dependent patients). Ten patients underwent tilt-table testing at 30°, 60°, and 80° passive head-up tilt for 3 min and then for a further 3 min after ankle flexion exercise. This regimen was repeated at 20° passive head-down tilt. Pump parameters, noninvasive hemodynamics, and 2-dimensional echocardiographic measures were recorded. Heart rate alteration by pacing did not affect LVAD flows or LV dimensions. LVAD pump flow decreased from baseline 4.9 ± 0.6 l/min to approximately 4.5 ± 0.5 l/min at each level of head-up tilt (p < 0.0001 analysis of variance). With active ankle flexion, LVAD flow returned to baseline. There was no significant change in flow with a 20° head-down tilt with or without ankle flexion exercise. There were no suction events. Centrifugal cfLVAD flows are not significantly affected by changes in heart rate, but they change significantly with body position and passive filling. Previously demonstrated exercise-induced changes in pump flows may be related to altered loading conditions, rather than changes in heart rate. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Pacing and Self-regulation: Important Skills for Talent Development in Endurance Sports.

PubMed

Elferink-Gemser, Marije T; Hettinga, Florentina J

2017-07-01

Pacing has been characterized as a multifaceted goal-directed process of decision making in which athletes need to decide how and when to invest their energy during the race, a process essential for optimal performance. Both physiological and psychological characteristics associated with adequate pacing and performance are known to develop with age. Consequently, the multifaceted skill of pacing might be under construction throughout adolescence, as well. Therefore, the authors propose that the complex skill of pacing is a potential important performance characteristic for talented youth athletes that needs to be developed throughout adolescence. To explore whether pacing is a marker for talent and how talented athletes develop this skill in middle-distance and endurance sports, they aim to bring together literature on pacing and literature on talent development and self-regulation of learning. Subsequently, by applying the cyclical process of self-regulation to pacing, they propose a practical model for the development of performance in endurance sports in youth athletes. Not only is self-regulation essential throughout the process of reaching the long-term goal of athletic excellence, but it also seems crucial for the development of pacing skills within a race and the development of a refined performance template based on previous experiences. Coaches and trainers are advised to incorporate pacing as a performance characteristic in their talent-development programs by stimulating their athletes to reflect, plan, monitor, and evaluate their races on a regular basis to build performance templates and, as such, improve their performance.

Interatrial septum pacing guided by three-dimensional intracardiac echocardiography.

PubMed

Szili-Torok, Tamas; Kimman, Geert Jan P; Scholten, Marcoen F; Ligthart, Jurgen; Bruining, Nico; Theuns, Dominic A M J; Klootwijk, Peter J; Roelandt, Jos R T C; Jordaens, Luc J

2002-12-18

Currently, the interatrial septum (IAS) pacing site is indirectly selected by fluoroscopy and P-wave analysis. The aim of the present study was to develop a novel approach for IAS pacing using intracardiac echocardiography (ICE). Interatrial septum pacing may be beneficial for the prevention of paroxysmal atrial fibrillation. Cross-sectional images are acquired during a pull-back of the ICE transducer from the superior vena cava into the inferior vena cava by an electrocardiogram- and respiration-gated technique. Both atria are then reconstructed using three-dimensional (3D) imaging. Using an "en face" view of the IAS, the desired pacing site is selected. Following lead placement and electrical testing, another 3D reconstruction is performed to verify the final lead position. Twelve patients were included in this study. The IAS pacing was achieved in all patients including six suprafossal (SF) and six infrafossal (IF) lead locations all confirmed by 3D imaging. The mean duration times of atrial lead implantation and fluoroscopy were 70 +/- 48.9 min and 23.7 +/- 20.6 min, respectively. The IAS pacing resulted in a significant reduction of the P-wave duration as compared to sinus rhythm (98.9 +/- 19.3 ms vs. 141.3 +/- 8.6 ms; p < 0.002). The SF pacing showed a greater reduction of the P-wave duration than IF pacing (59.4 +/- 6.6 ms vs. 30.2 +/- 13.6 ms; p < 0.004). Three-dimensional ICE is a feasible tool for guiding IAS pacing.

PACE4 is an important driver of ZR-75-1 estrogen receptor-positive breast cancer proliferation and tumor progression.

PubMed

Panet, François; Couture, Frédéric; Kwiatkowska, Anna; Desjardins, Roxane; Guérin, Brigitte; Day, Robert

2017-08-01

Breast cancer is the most frequent and deadly malignancy in women worldwide. Despite national screening programs combined with new treatments relapse rate remain high and new therapies are needed. From previous work, we identified PACE4, a member of the proprotein convertase (PCs) family of endoproteases, as a novel therapeutic target in prostate cancer. In the present study we asked the question if PACE4 could also be a potential target in breast cancer. In clinical samples of breast adenocarcinoma, we observed a specific overexpression of PACE4 in the estrogen-receptor (ER) positive subtype. We therefore looked for a breast cancer cell line model which would be representative and thus focused on the ZR-75-1 since it both expresses PACE4 and is estrogen-receptor positive. We compared stable knockdowns of furin, PACE4 and PC7 in the estrogen-receptor-positive cell line ZR-75-1 to evaluate their respective contribution to cell growth and tumor progression. PACE4 was the only PC displaying an impact on cell growth. A PACE4 peptide-based inhibitor (C23) was tested and shown to decrease proliferation of ZR-75-1 cells in cell based assays. C23 also had potent effects of tumor progression in vivo on xenografts of the ZR-75-1 cell line in athymic nude mice. Thus, PACE4-silencing and systemic administration of a PACE4 inhibitor resulted in hindered tumor progression with reduction in proliferative indices and increased cell quiescence assessed with biomarkers. Our results suggest that PACE4 is a promising target for estrogen-receptor-positive breast cancer. Copyright © 2017 Elsevier GmbH. All rights reserved.

Impact of high-grade Atrioventricular block and cumulative frequent pacing on atrial arrhythmias.

PubMed

Wali, Eisha; Deshmukh, Amrish; Bukari, Abdallah; Broman, Michael; Aziz, Zaid; Beaser, Andrew; Upadhyay, Gaurav; Nayak, Hemal M; Tung, Roderick; Ozcan, Cevher

2018-06-21

The relationship between high-grade AV block (HGAVB) with cumulative frequent pacing and risk of atrial arrhythmias (AAs) has not been well characterized. We hypothesized HGAVB and pacing may have significant impact on incidence and prevalence of AAs by modulating atrial substrate. To determine impact of HGAVB and pacing on AAs including atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia (AT). All consecutive patients who underwent dual chamber pacemaker implantation for HGAVB from 2005 to 2011 at the University of Chicago were included. AAs and percent of pacing were detected through device interrogation. Patients' data were collected from electronic medical records and clinic visits. A total of 166 patients (mean age 71±15 years; 54% female, 56% African-American) were studied. AF was documented in 27% of patients before pacemaker implantation. During a mean 5.8±2.2 years of follow-up, 47% had device-detected AF, 10% AFL and 26% AT. New-onset AF was documented in 40 of the 122 patients without prior AF (33%). Continuous (≥99%) right ventricular pacing was associated with significantly decreased AF prevalence (34% versus 59%, p = 0.005), and correlated with lower incidence (26% versus 41%, p = 0.22). Pacing suppressed AF in 14% of patients with baseline AF; those patients had lower atrial pacing (3.2% versus 45%, p < 0.0001). Left atrial dilation was the only independent predictor of AF with frequent pacing (p = 0.009). HGAVB is associated with high incidence and prevalence of AAs with and without pacing. Cumulative frequent (≥99%) ventricular pacing reduces risk of AF in patients with HGAVB. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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

PubMed

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

2007-09-01

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

Is there a right place to pace the right ventricle? Evaluation of apical and septal positions in a pacemaker population: study protocol for a prospective intervention-control trial.

PubMed

Muto, Carmine; Calvi, Valeria; Botto, Giovanni Luca; Pecora, Domenico; Ciaramitaro, Gianfranco; Valsecchi, Sergio; Malacrida, Maurizio; Maglia, Giampiero

2014-11-01

The main objective of research in pacemaker therapy has been to provide the best physiologic way to pace the heart. Despite the good results provided by right ventricular pacing minimization and by biventricular pacing in specific subsets of heart failure patients, these options present many limitations for standard pacemaker recipients. In these patients, pacing the right ventricle at alternative sites could result in a lower degree of left intraventricular dyssynchrony. Despite the lack of strong evidence and the difficulty in placing and accurately classifying the final lead position, pacing at alternative right ventricular sites seems to have become a standard procedure at many implanting centers. The RIGHT PACE study is a multi-center, prospective, single-blind, double-arm, intervention-control trial comparing right ventricular pacing from the apex and from the septal site in terms of left intraventricular dyssynchrony. A total of 408 patients with indications for cardiac pacing but without indications for ICD and/or CRT will be enrolled. Investigators will be divided on the basis of their prior experience of selective site pacing lead implantation and patients will be treated according to the clinical practice of the centers. After device implantation, they will be followed up for 24 months through evaluation of clinical, echocardiographic and safety/system-performance variables. This study might provide important information about the impact of the right ventricular pacing on the left ventricular dyssynchrony, and about acute and chronic responses to selective site pacing, as adopted in current clinical practice. This trial is registered at ClinicalTrials.gov (ID:NCT01647490). Right Ventricular Lead Placement in a Pacemaker Population: Evaluation of apical and alternative position. ClinicalTrials.gov: NCT01647490. Copyright © 2014 Elsevier Inc. All rights reserved.

Temporary epicardial cardiac resynchronisation versus conventional right ventricular pacing after cardiac surgery: study protocol for a randomised control trial.

PubMed

Russell, Stuart J; Tan, Christine; O'Keefe, Peter; Ashraf, Saeed; Zaidi, Afzal; Fraser, Alan G; Yousef, Zaheer R

2012-02-20

Heart failure patients with stable angina, acute coronary syndromes and valvular heart disease may benefit from revascularisation and/or valve surgery. However, the mortality rate is increased- 5-30%. Biventricular pacing using temporary epicardial wires after surgery is a potential mechanism to improve cardiac function and clinical endpoints. A multi-centred, prospective, randomised, single-blinded, intervention-control trial of temporary biventricular pacing versus standard pacing. Patients with ischaemic cardiomyopathy, valvular heart disease or both, an ejection fraction ≤ 35% and a conventional indication for cardiac surgery will be recruited from 2 cardiac centres. Baseline investigations will include: an electrocardiogram to confirm sinus rhythm and measure QRS duration; echocardiogram to evaluate left ventricular function and markers of mechanical dyssynchrony; dobutamine echocardiogram for viability and blood tests for renal function and biomarkers of myocardial injury- troponin T and brain naturetic peptide. Blood tests will be repeated at 18, 48 and 72 hours. The principal exclusions will be subjects with permanent atrial arrhythmias, permanent pacemakers, infective endocarditis or end-stage renal disease.After surgery, temporary pacing wires will be attached to the postero-lateral wall of the left ventricle, the right atrium and right ventricle and connected to a triple chamber temporary pacemaker. Subjects will be randomised to receive either temporary biventricular pacing or standard pacing (atrial inhibited pacing or atrial-synchronous right ventricular pacing) for 48 hours.The primary endpoint will be the duration of level 3 care. In brief, this is the requirement for invasive ventilation, multi-organ support or more than one inotrope/vasoconstrictor. Haemodynamic studies will be performed at baseline, 6, 18 and 24 hours after surgery using a pulmonary arterial catheter. Measurements will be taken in the following pacing modes: atrial inhibited; right ventricular only; atrial synchronous-right ventricular; atrial synchronous-left ventricular and biventricular pacing. Optimisation of the atrioventricular and interventricular delay will be performed in the biventricular pacing group at 18 hours. The effect of biventricular pacing on myocardial injury, post operative arrhythmias and renal function will also be quantified. ClinicalTrials.gov: NCT01027299.

The COGNITION study rationale and design: influence of closed loop stimulation on cognitive performance in pacemaker patients.

PubMed

Wiegand, Uwe; Nuernberg, Michael; Maier, Sebastian K G; Weiss, Christian; Sancho-Tello, María-José; Hartmann, Andreas; Schuchert, Andreas; Maier, Petra; Chan, Ngai-Yin

2008-06-01

Several studies showed the beneficial effect of pacemaker implantation on cognitive performance in patients with bradycardia. But it has never been investigated if patients with chronotropic incompetence may improve their cognitive performance if treated by a rate-adaptive system reacting to mental stress in comparison to the most frequently used accelerometer-driven pacing. The randomized, single-blind, multicenter COGNITION study evaluates if closed loop stimulation (CLS) offers incremental benefit in the speed of cognitive performance and the overall well-being of elderly patients with bradycardia compared with accelerometer-based pacing. Four hundred chronotropically incompetent patients older than 55 years will be randomized 3-6 weeks after implantation to CLS or accelerometer sensor. Follow-up visits are performed after 12 and 24 months. The speed of cognitive performance, which is the underlying function influencing all other aspects of cognitive performance, will be assessed by the number connection test, a standardized psychometric test for the elderly. Secondary endpoints include patient self-assessment of different aspects of health (by visual analogue scales), quality of life (by SF-8 health survey), the incidence of atrial fibrillation (episodes lasting for longer than 24 hours), and the frequency of serious adverse events. In the ongoing COGNITION study, we aim at long-term comparison of two rate-adaptive systems, focusing on the cognitive performance of the patients, which was neglected in the past evaluation of pacemaker sensors.

How war, drought, and management impact water supply in the Tigris/Euphrates

NASA Astrophysics Data System (ADS)

Hasan, M.; Moody, A.; Benninger, L. K.

2017-12-01

The fast-paced conflicts in the Middle East have the potential to disrupt management and supply of water resources in the region, particularly on structures such as Mosul and Haditha dams, and the Ramadi and Falluja Barrages, all of which have experienced threats or changes in sovereignty. Water supply is also under pressure from upstream dam management and drought. In this research, we use the normalized difference water index (NDWI) applied to Landsat imagery in order to monitor changes in the extent of various water bodies (1985-present). We looked to see if significant anomalies from expected surface area were best explained by conflict, drought, or dam management. Conflict (though not every conflict) produced the greatest sudden changes in water supply; drought produced the greatest absolute changes, but at a gentle pace. Drought impacts are strongest in the furthest downstream reservoirs. Conflict-driven changes were tied to very specific human manipulations in water supply in order to either advance military objectives, "punish" civilians on the wrong side of the fight, or to prevent humanitarian catastrophe. Satellite images allow for an objective analysis of how strong these manipulations were. The information may not be as exact as on-the-ground information, but when the flow of information is disrupted by war, satellite data can be an alternative source of insights into water supply changes.

Pacing, Pixels, and Paper: Flexibility in Learning Words from Flashcards

ERIC Educational Resources Information Center

Sage, Kara; Rausch, Joseph; Quirk, Abigail; Halladay, Lauren

2016-01-01

The present study focused on how self-control over pace might help learners successfully extract information from digital learning aids. Past research has indicated that too much control over pace can be overwhelming, but too little control over pace can be ineffective. Within the popular self-testing domain of flashcards, we sought to elucidate…

Effects of Modality and Pace on Achievement, Mental Effort, and Positive Affect in Multimedia Learning Environments

ERIC Educational Resources Information Center

Izmirli, Serkan; Kurt, Adile Askim

2016-01-01

The purpose of the study was to examine the effects of instruction given with different multimedia modalities (written text + animation or narration + animation) on the academic achievement, cognitive load, and positive affect in different paces (learner-paced or system-paced); 97 freshmen university students divided into four groups taught in…

Minimal invasive epicardial lead implantation: optimizing cardiac resynchronization with a new mapping device for epicardial lead placement.

PubMed

Maessen, J G; Phelps, B; Dekker, A L A J; Dijkman, B

2004-05-01

To optimize resynchronization in biventricular pacing with epicardial leads, mapping to determine the best pacing site, is a prerequisite. A port access surgical mapping technique was developed that allowed multiple pace site selection and reproducible lead evaluation and implantation. Pressure-volume loops analysis was used for real time guidance in targeting epicardial lead placement. Even the smallest changes in lead position revealed significantly different functional results. Optimizing the pacing site with this technique allowed functional improvement up to 40% versus random pace site selection.

The effects of husbandry training on stereotypic pacing in captive African wild dogs (Lycaon pictus).

PubMed

Shyne, Amanda; Block, Martin

2010-01-01

To examine the effects of operant conditioning on stereotypic pacing in 3 female African wild dogs located at the Franklin Park Zoo in Boston, this study made recordings of pacing behavior immediately following individual sessions of husbandry training and 2 no-training conditions. The study found significant differences in the percentage of observations spent in stereotypic pacing behaviors for all 3 dogs among the 3 different conditions. The authors discuss the data in terms of the contribution of motivated tasks to the effects and the role of food deprivation in the expression of stereotypic pacing. The study suggests that even short periods of training may improve the African wild dogs' welfare by reducing stereotypic pacing following the conditioning sessions.

Rate-dependent Loss of Capture during Ventricular Pacing.

PubMed

Wang, Jingfeng; Chen, Haiyan; Su, Yangang; Ge, Junbo

2015-01-01

A 63-year-old patient who had undergone atrial septal defect surgical repair received implantation of a single chamber VVI pacemaker for long RR intervals during atrial fibrillation. One week later, an intermittent loss of capture and sensing failure was detected at a pacing rate of 70 beats/min. However, a successful capture was observed during rapid pacing. Consequently, the pacing rate was temporarily adjusted to 90 beats/min. At the 3-month follow-up, the pacemaker was shown to be functioning properly independent of the pacing rate. An echocardiogram showed that the increased pacing rates were accompanied by a reduction in the right ventricular outflow tract dimension. The pacemaker was then permanently programmed at a lower rate of 60 beats/min.

Using PHP/MySQL to Manage Potential Mass Impacts

NASA Technical Reports Server (NTRS)

Hager, Benjamin I.

2010-01-01

This paper presents a new application using commercially available software to manage mass properties for spaceflight vehicles. PHP/MySQL(PHP: Hypertext Preprocessor and My Structured Query Language) are a web scripting language and a database language commonly used in concert with each other. They open up new opportunities to develop cutting edge mass properties tools, and in particular, tools for the management of potential mass impacts (threats and opportunities). The paper begins by providing an overview of the functions and capabilities of PHP/MySQL. The focus of this paper is on how PHP/MySQL are being used to develop an advanced "web accessible" database system for identifying and managing mass impacts on NASA's Ares I Upper Stage program, managed by the Marshall Space Flight Center. To fully describe this application, examples of the data, search functions, and views are provided to promote, not only the function, but the security, ease of use, simplicity, and eye-appeal of this new application. This paper concludes with an overview of the other potential mass properties applications and tools that could be developed using PHP/MySQL. The premise behind this paper is that PHP/MySQL are software tools that are easy to use and readily available for the development of cutting edge mass properties applications. These tools are capable of providing "real-time" searching and status of an active database, automated report generation, and other capabilities to streamline and enhance mass properties management application. By using PHP/MySQL, proven existing methods for managing mass properties can be adapted to present-day information technology to accelerate mass properties data gathering, analysis, and reporting, allowing mass property management to keep pace with today's fast-pace design and development processes.

Risk Stratification of Future Left Ventricular Dysfunction for Patients with Indications for Right Ventricular Pacing due to Bradycardia.

PubMed

Ooka, Junichi; Tanaka, Hidekazu; Hatani, Yutaka; Hatazawa, Keiko; Matsuzoe, Hiroki; Shimoura, Hiroyuki; Sano, Hiroyuki; Sawa, Takuma; Motoji, Yoshiki; Mochizuki, Yasuhide; Ryo-Koriyama, Keiko; Matsumoto, Kensuke; Fukuzawa, Koji; Hirata, Ken-Ichi

2017-10-21

Although right ventricular (RV) pacing is the only effective treatment for patients with symptomatic bradycardia, it creates left ventricular (LV) dyssynchrony, which can induce LV dysfunction and heart failure. The current criterion for consideration of cardiac resynchronization therapy (CRT) is LV ejection fraction (LVEF) ≤ 35%, but indication for CRT in patients required for RV pacing with LVEF > 35% remains unclear.We studied 40 patients, all LVEF ≥ 35%, who had undergone implantable cardioverter-defibrillator implantation with RV pacing < 5%. Echocardiography was performed at baseline and during RV pacing. LV dyssynchrony was defined as anteroseptal-to-posterior wall delay from the mid-LV short-axis view using two-dimensional speckle-tracking radial strain (significant: ≥ 130 ms). Patients were divided into two groups based on baseline LVEF: normal LVEF ( ≥ 50%; n = 20) and mildly reduced LVEF (35-50%; n = 20).LVEF and LV dyssynchrony in patients with mildly reduced LVEF deteriorated significantly during RV pacing compared to those in patients with normal LVEF. Moreover, changes in LV dyssynchrony during RV pacing significantly correlated with changes in LVEF (r = -0.44, P < 0.01). Multivariate logistic regression analysis showed that baseline LVEF was the only independent predictor and baseline LVEF < 48% predictive of significant LV dyssynchrony during RV pacing.The extent of RV pacing-induced LV dysfunction may be associated with baseline LV function. These adverse effects on patients with mildly reduced LVEF of 35-50% and indications for RV pacing due to bradycardia can thus be prevented by CRT.

Catheter Ablation of Focal Atrial Tachycardia Using Remote Magnetic Navigation.

PubMed

Webster, Mark; Pasupati, Sanjeevan; Lever, Nigel; Stiles, Martin

2018-05-01

This first-in-human study evaluated the safety and technical feasibility of the Tempo temporary cardiac pacing lead (BioTrace Medical), which includes a novel fixation mechanism and soft tip. Complications of temporary pacing leads include dislodgment, arrhythmias, and ventricular perforation. Temporary pacing applications have increased with transcatheter aortic valve replacement (TAVR) growth, for rapid pacing during balloon valvuloplasty (BAV) and valve deployment, and for periprocedural bradyarrhythmia support. Eligible patients required temporary pacing for TAVR, BAV, or electrophysiology (EP) procedures. Transthoracic echocardiograms were obtained at baseline and 24 hours after lead removal. Safety was defined as freedom from pericardial effusion requiring intervention or evidence of tamponade. Technical feasibility involved successful intracardiac delivery and pace capture. Additional evaluations included pacing threshold (PCT), rapid pacing, dislodgment, or sustained ventricular arrhythmias. Follow-up was to 30 days. Twenty-five patients (60% female; mean age, 64 ± 19 years) underwent 13 TAVRs (7 Sapien 3 valves [Edwards Lifesciences], 4 CoreValves [Medtronic], and 2 Lotus valves [Boston Scientific]), 11 EP procedures, and 1 BAV at two New Zealand centers from January 2016 to June 2016. Safety was met in all patients, with no device-related adverse events. Technical feasibility was achieved in 23 cases (92%); 2 patients had unsuitable anatomy. No patient had lead dislodgment or sustained ventricular arrhythmias, and the final procedural PCT was 0.7 ± 0.5 mA. Rapid pacing was successful in all cases. Five patients had successful postprocedural use up to 5 days. This first-in-human study demonstrates the safety and technical feasibility of the Tempo lead, providing stable periprocedural temporary pacing support.

Right atrial pacing impairs cardiac function during resynchronization therapy: acute effects of DDD pacing compared to VDD pacing.

PubMed

Bernheim, Alain; Ammann, Peter; Sticherling, Christian; Burger, Peter; Schaer, Beat; Brunner-La Rocca, Hans Peter; Eckstein, Jens; Kiencke, Stephanie; Kaiser, Christoph; Linka, Andre; Buser, Peter; Pfisterer, Matthias; Osswald, Stefan

2005-05-03

We aimed to compare the hemodynamic effects of right-atrial-paced (DDD) and right-atrial-sensed (VDD) biventricular paced rhythm on cardiac resynchronization therapy (CRT). Cardiac resynchronization therapy improves hemodynamics in patients with severe heart failure and left ventricular (LV) dyssynchrony. However, the impact of active right atrial pacing on resynchronization therapy is unknown. Seventeen CRT patients were studied 10 months (range: 1 to 46 months) after implantation. At baseline, the programmed atrioventricular delay was optimized by timing LV contraction properly at the end of atrial contraction. In both modes the acute hemodynamic effects were assessed by multiple Doppler echocardiographic parameters. Compared to DDD pacing, VDD pacing resulted in much better improvement of intraventricular dyssynchrony assessed by the septal-to-posterior wall motion delay (VDD 106 +/- 83 ms vs. DDD 145 +/- 95 ms; p = 0.001), whereas the interventricular mechanical delay (difference between onset of pulmonary and aortic outflow) did not differ (VDD 20 +/- 21 ms vs. DDD 18 +/- 17 ms; p = NS). Furthermore, VDD pacing significantly prolonged the rate-corrected LV filling period (VDD 458 +/- 123 ms vs. DDD 371 +/- 94 ms; p = 0.0001) and improved the myocardial performance index (VDD 0.60 +/- 0.18 vs. DDD 0.71 +/- 0.23; p < 0.01). Our findings suggest that avoidance of right atrial pacing results in a higher degree of LV resynchronization, in a substantial prolongation of the LV filling period, and in an improved myocardial performance. Thus, the VDD mode seems to be superior to the DDD mode in CRT patients.

Pacing: a concept analysis of the chronic pain intervention.

PubMed

Jamieson-Lega, Kathryn; Berry, Robyn; Brown, Cary A

2013-01-01

The intervention of pacing is regularly recommended for chronic pain patients. However, pacing is poorly defined and appears to be interpreted in varying, potentially contradictory manners within the field of chronic pain. This conceptual lack of clarity has implications for effective service delivery and for researchers' ability to conduct rigorous study. An examination of the background literature demonstrates that while pacing is often one part of a multidisciplinary pain management program, outcome research is hindered by a lack of a clear and shared definition of this currently ill-defined construct. To conduct a formal concept analysis of the term 'pacing'. A standardized concept analysis process (including literature scoping to identify all uses of the concept, analysis to determine defining attributes of the concept and identification of model, borderline and contrary cases) was used to determine what the concept of pacing does and does not represent within the current evidence base. A conceptual model including the core attributes of action, time, balance, learning and self-management emerged. From these attributes, an evidence-based definition for pacing was composed and distributed to stakeholders for review. After consideration of stakeholder feedback, the emergent definition of pacing was finalized as follows: "Pacing is an active self-management strategy whereby individuals learn to balance time spent on activity and rest for the purpose of achieving increased function and participation in meaningful activities". The findings of the present concept analysis will help to standardize the use and definition of the term pacing across disciplines for the purposes of both pain management and research.

A Closer Look at Split Visual Attention in System- and Self-Paced Instruction in Multimedia Learning

ERIC Educational Resources Information Center

Schmidt-Weigand, Florian; Kohnert, Alfred; Glowalla, Ulrich

2010-01-01

Two experiments examined visual attention distribution in learning from text and pictures. Participants watched a 16-step multimedia instruction on the formation of lightning. In Experiment 1 (N=90) the instruction was system-paced (fast, medium, slow pace), while it was self-paced in Experiment 2 (N=31). In both experiments the text modality was…

Helping Girls Get Back on Track: An Implementation Study of the PACE Center for Girls

ERIC Educational Resources Information Center

Treskon, Louisa; Millenky, Megan; Freedman, Lily

2017-01-01

PACE Center for Girls is a unique program that provides academic and social services to girls ages 11 to 18. Girls eligible for PACE exhibit multiple health, safety, and delinquency risk factors, such as poor academic performance, exposure to abuse or violence, truancy, risky sexual behavior, and substance abuse. PACE seeks to help them onto a…

What Pace Is Best? Assessing Adults' Learning from Slideshows and Video

ERIC Educational Resources Information Center

Sage, Kara

2014-01-01

When acquiring information from a 2D platform, self-control and/or optimal pacing may help reduce cognitive load and enhance learning outcomes. In the present research, adults viewed novel action sequences via one of four learning media: (1) self-paced slideshows, where viewers advanced through slides at their own pace by clicking a mouse, (2)…

77 FR 28900 - Amended Certification Regarding Eligibility to Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... Enterprises, Inc., Fitzgerald, Georgia TA-W-81,004C Pace American Enterprises, Inc., Lebanon, Oregon TA-W-81... Enterprises, Inc., Lebanon, Oregon (TA-W- 81,004C); and Pace American Enterprises, Inc., Hurricane, Utah (TA-W...., Fitzgerald, Georgia (TA-W-81,004B), Pace American Enterprises, Inc., Lebanon, Oregon (TA-W-81,004C), Pace...

The Manipulation of Pace within Endurance Sport

PubMed Central

Skorski, Sabrina; Abbiss, Chris R.

2017-01-01

In any athletic event, the ability to appropriately distribute energy is essential to prevent premature fatigue prior to the completion of the event. In sport science literature this is termed “pacing.” Within the past decade, research aiming to better understand the underlying mechanisms influencing the selection of an athlete's pacing during exercise has dramatically increased. It is suggested that pacing is a combination of anticipation, knowledge of the end-point, prior experience and sensory feedback. In order to better understand the role each of these factors have in the regulation of pace, studies have often manipulated various conditions known to influence performance such as the feedback provided to participants, the starting strategy or environmental conditions. As with all research there are several factors that should be considered in the interpretation of results from these studies. Thus, this review aims at discussing the pacing literature examining the manipulation of: (i) energy expenditure and pacing strategies, (ii) kinematics or biomechanics, (iii) exercise environment, and (iv) fatigue development. PMID:28289392

Forms of work organization and associations with shoulder disorders: Results from a French working population.

PubMed

Bodin, Julie; Garlantézec, Ronan; Costet, Nathalie; Descatha, Alexis; Fouquet, Natacha; Caroly, Sandrine; Roquelaure, Yves

2017-03-01

The aim of this study was to identify forms of work organization in a French region and to study associations with the occurrence of symptomatic and clinically diagnosed shoulder disorders in workers. Workers were randomly included in this cross-sectional study from 2002 to 2005. Sixteen organizational variables were assessed by a self-administered questionnaire: i.e. shift work, job rotation, repetitiveness of tasks, paced work/automatic rate, work pace dependent on quantified targets, permanent controls or surveillance, colleagues' work and customer demand, and eight variables measuring decision latitude. Five forms of work organization were identified using hierarchical cluster analysis (HCA) of variables and HCA of workers: low decision latitude with pace constraints, medium decision latitude with pace constraints, low decision latitude with low pace constraints, high decision latitude with pace constraints and high decision latitude with low pace constraints. There were significant associations between forms of work organization and symptomatic and clinically-diagnosed shoulder disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Optimal pacing for right ventricular and biventricular devices: minimizing, maximizing, and right ventricular/left ventricular site considerations.

PubMed

Gillis, Anne M

2014-10-01

The results from numerous clinical studies provide guidance for optimizing outcomes related to RV or biventricular pacing in the pacemaker and ICD populations. (1) Programming algorithms to minimize RV pacing is imperative in patients with dual-chamber pacemakers who have intrinsic AV conduction or intermittent AV conduction block. (2) Dual-chamber ICDs should be avoided in candidates without an indication for bradycardia pacing. (3) Alternate RV septal pacing sites may be considered at the time of pacemaker implantation. (4) Biventricular pacing may be beneficial in some patients with mild LV dysfunction. (5) LV lead placement at the site of latest LV activation is desirable. (6) Programming CRT systems to achieve biventricular/LV pacing >98.5% is important. (7) Protocols for AV and VV optimization in patients with CRT are not recommended after device implantation but may be considered for CRT nonresponders. (8) Novel algorithms to maximize the benefit of CRT are in evolution further.

42 CFR 460.162 - Voluntary disenrollment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A PACE...

42 CFR 460.162 - Voluntary disenrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A PACE...

Transferring PACE Assessments Upon Home Sale

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

National Renewable Energy Laboratory; Coughlin, Jason; Fuller, Merrian

A significant barrier to investing in renewable energy and comprehensive energy efficiency improvements to homes across the country is the initial capital cost. Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing this upfront cost issue. Recently, the White House cited PACE programs as an important element of its 'Recovery through Retrofit' plan. The residential PACE model involves the creation of a special clean energy financing district that homeowners elect to opt into. Once opted in, the local government (usually at the city or county level) finances the upfrontmore » investment of the renewable energy installation and/or energy efficiency improvements. A special lien is attached to the property and the assessment is paid back as a line item on the property tax bill. As of April 2010, 17 states have passed legislation to allow their local governments to create PACE programs, two already have the authority to set up PACE programs, and over 10 additional states are actively developing enabling legislation. This policy brief analyzes one of the advantages of PACE, which is the transferability of the special assessment from one homeowner to the next when the home is sold. This analysis focuses on the potential for the outstanding lien to impact the sales negotiation process, rather than the legal nature of the lien transfer itself. The goal of this paper is to consider what implications a PACE lien may have on the home sales negotiation process so that it can be addressed upfront rather than risk a future backlash to PACE programs. If PACE programs do expand at a rapid rate, the chances are high that there will be other cases where prospective buyers uses PACE liens to negotiate lower home prices or require repayment of the lien as a condition of sale. As a result, PACE programs should highlight this issue as a potential risk factor for the sake of full disclosure. A good example of this is in Boulder County where the following statement is included in the ClimateSmart PACE program materials: 'Please Note: There is no legal requirement that the loan be paid off when you refinance or sell your home. However, this may be an item subject to negotiation with a future buyer and may also be a matter of negotiation with the mortgage lender.' Such candid disclosure for what might be a low risk event can be debated. However, a selling point of PACE programs is the transferability of the lien to the new homeowner. To the degree this benefit is questioned, PACE programs may end up looking more like home equity loan financing, with the associated debt repaid at closing, rather than property-based financing that remains with the improved home. While it is possible that upfront disclosure might negatively impact participation rates in PACE programs, it also will protect the integrity of a PACE program in later years if such situations come to pass. Ideally, this will become less of an issue over time as more homebuyers understand the positive economic and societal benefits of owning a home with clean energy features.« less

Netwar

NASA Astrophysics Data System (ADS)

Keen, Arthur A.

2006-04-01

This paper describes technology being developed at 21st Century Technologies to automate Computer Network Operations (CNO). CNO refers to DoD activities related to Attacking and Defending Computer Networks (CNA & CND). Next generation cyber threats are emerging in the form of powerful Internet services and tools that automate intelligence gathering, planning, testing, and surveillance. We will focus on "Search-Engine Hacks", queries that can retrieve lists of router/switch/server passwords, control panels, accessible cameras, software keys, VPN connection files, and vulnerable web applications. Examples include "Titan Rain" attacks against DoD facilities and the Santy worm, which identifies vulnerable sites by searching Google for URLs containing application-specific strings. This trend will result in increasingly sophisticated and automated intelligence-driven cyber attacks coordinated across multiple domains that are difficult to defeat or even understand with current technology. One traditional method of CNO relies on surveillance detection as an attack predictor. Unfortunately, surveillance detection is difficult because attackers can perform search engine-driven surveillance such as with Google Hacks, and avoid touching the target site. Therefore, attack observables represent only about 5% of the attacker's total attack time, and are inadequate to provide warning. In order to predict attacks and defend against them, CNO must also employ more sophisticated techniques and work to understand the attacker's Motives, Means and Opportunities (MMO). CNO must use automated reconnaissance tools, such as Google, to identify information vulnerabilities, and then utilize Internet tools to observe the intelligence gathering, planning, testing, and collaboration activities that represent 95% of the attacker's effort.

[Management of surgery patients with implanted cardiac pacemakers].

PubMed

Ugljen, R; Dadić, D; Ferek-Petrić, B; Jelić, I; Letica, D; Anić, D; Husar, J

1995-01-01

Patients having cardiac pacemaker implanted may be subjected to various general surgery procedures. Application of electrosurgery for the purpose of resection and coagulation, provides a high frequency electric field which produces electric voltage on the electrodes of the pacing system. This voltage may be detected within the pacing system, and various arrhythmias can be provoked in correlation with underlying rhythm and mode of pacing. Preoperative patient control and proper pacemaker programming can prevent the pacing malfunctions due to the electrosurgery application. Appropriate positioning of the neutral electrode in relation to the pacing system avoids the electric fields intersection and decreases their interference.

Enact legislation supporting residential property assessed clean energy financing (PACE)

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

Saha, Devashree

Congress should enact legislation that supports residential property assessed clean energy (PACE) programs in the nation’s states and metropolitan areas. Such legislation should require the Federal Housing Finance Agency (FHFA) to allow Fannie Mae and Freddie Mac to purchase residential mortgages with PACE assessments while at the same time providing responsible underwriting standards and a set of benchmarks for residential PACE assessments in order to minimize financial risks to mortgage holders. Congressional support of residential PACE financing will improve energy efficiency, encourage job creation, and foster economic growth in the nation’s state and metropolitan areas.

Bachmann bundle pacing reduces atrial electromechanical delay in type 1 myotonic dystrophy patients.

PubMed

Russo, Vincenzo; Rago, Anna; Papa, Andrea Antonio; Arena, Giulia; Politano, Luisa; Nigro, Gerardo

2018-04-01

Atrial electromechanical delay (AEMD) is an echocardiographic parameter correlated with the onset of supraventricular arrhythmias in several clinical conditions. Inter-atrial septal pacing in the region of Bachmann's bundle (BB) has been shown to be safe and feasible in myotonic dystrophy type 1 (DM1) patients, with a low rate of sensing and pacing defects. The aim of this study was to assess the impact of temporary BB pacing compared with right atrial appendage (RAA) pacing on AEMD in DM1 patients undergoing pacemaker (PM) implantation for cardiac rhythm abnormalities. The study enrolled 70 consecutive DM1 patients undergoing PM implantation for cardiac rhythm abnormalities in accordance with the current guidelines. Seventy age- and sex-matched non-DM1 patients undergoing dual-chamber PM implantation for cardiac rhythm abnormalities were used as controls. The atrial pacing lead was temporarily positioned in the RAA and on the right side of the inter-atrial septum in the region of Bachmann's bundle. For each site (BB and RAA), temporary atrial pacing in the AAI mode was established at 10 beats per minute above the sinus rate and a detailed trans-thoracic echocardiogram with tissue Doppler (TDI) analysis was recorded after at least 10 min of atrial pacing to evaluate AEMD. Temporary RAA pacing did not show statistically significant differences in inter-AEMD (48.2 ± 17.8 vs 50.5 ± 16.5 ms; P = 0.8), intra-left AEMD (43.3 ± 15.5 vs 44.6 ± 15.8 ms; P = 0.1), or intra-right-AEMD (14.1 ± 4.2 vs 15.4 ± 5.8 ms; P = 0.9), in comparison with sinus rhythm. Temporary BB pacing determined a significantly lower inter-AEMD (36.1 ± 17.1 vs 50.5 ± 16.5 ms; P = 0.001) and intra-left AEMD (32.5 ± 15.2 vs 44.6 ± 15.8 ms; P = 0.001) values in comparison with temporary RAA pacing. No statistically significant difference was found in intra-right AEMD (12.2 ± 4.6 vs 15.4 ± 5.8 ms; P = 0.2). In the control group, neither temporary RAA pacing nor temporary BB pacing showed statistically significant differences in inter-AEMD, intra-left AEMD, or intra-right AEMD values in comparison with sinus rhythm. In DM1 patients undergoing dual-chamber PM implantation, atrial pacing in the Bachmann bundle region is associated with significantly lower echocardiographic indices of atrial electromechanical delay (inter-AEMD and intra-left AEMD) in comparison with RAA pacing.

42 CFR 460.12 - Application requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.12 Application requirements. (a...

42 CFR 460.104 - Participant assessment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.104 Participant assessment. (a) Initial comprehensive assessment—(1...

42 CFR 460.12 - Application requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.12 Application requirements. (a...

The effect of aging on pacing strategies of cross-country skiers and the role of performance level.

PubMed

Nikolaidis, Pantelis Theodoros; Villiger, Elias; Rosemann, Thomas; Knechtle, Beat

2018-01-01

The participation of master cross-country (XC) skiers in training and competition has increased during the last decades; however, little is known yet about whether these athletes differ from their younger counterparts in aspects of performance such as pacing. Therefore, the aim of the present study was to examine the combined effect of age and performance (race time) on pacing in cross-country (XC) skiing. We analyzed all finishers ( n  = 79,722) in 'Vasaloppet' from 2012 to 2017, the largest cross-country skiing race in the world, classified according to their race time into 10 groups: 3-4 h, 4-5 h, ..., 12-13 h. A trivial main effect of sex on total pace range was observed ( p  < 0.001, η 2  = 0.002), where women (44.1 ± 10.2%) had larger total pace range than men (40.9 ± 11.8%). A large main effect of performance group on total pace range was shown ( p  < 0.001, η 2  = 0.160), where the smallest total pace range was 21.8 ± 1.9% (3-4 h group) and the largest 50.1 ± 9.9% (10-11 h group). A trivial sex×performance group interaction on total pace range was found ( p  < 0.001, η 2  = 0.001) with the largest sex difference in pacing shown in 9-10 h group. A trivial and small main effect of age was found in women ( p  < 0.001, η 2  = 0.005) and men ( p  < 0.001, η 2  = 0.011), respectively, where the masters had smaller total pace range than their younger counterparts. A trivial age group×performance group interaction on total pace range was observed in both women ( p  < 0.001, η 2  = 0.008) and men ( p  < 0.001, η 2  = 0.006) with smaller differences among age groups in the faster performance groups. In summary, master XC skiers adopted a relatively even pacing independently from their race time and the differences in pacing from the younger XC skiers were more pronounced in the slower masters. These findings suggest that exercise attenuates the decline of performance in master XC skiers as shown by the similar pacing strategies between fast master XC skiers and their younger counterparts.

42 CFR 460.172 - Documentation of disenrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.172 Documentation of disenrollment. A PACE...

Helping Girls Get Back on Track: An Implementation Study of the PACE Center for Girls. Executive Summary

ERIC Educational Resources Information Center

Treskon, Louisa; Millenky, Megan; Freedman, Lily

2017-01-01

PACE Center for Girls is a unique program that provides academic and social services to girls ages 11 to 18. Girls eligible for PACE exhibit multiple health, safety, and delinquency risk factors, such as poor academic performance, exposure to abuse or violence, truancy, risky sexual behavior, and substance abuse. PACE seeks to help them onto a…

Assessing the PACE of California residential solar deployment: Impacts of Property Assessed Clean Energy programs on residential solar photovoltaic deployment in California, 2010-2015

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

Deason, Jeff; Murphy, Sean

A new study by Berkeley Lab found that residential Property Assessed Clean Energy (R-PACE) programs increased deployment of residential solar photovoltaic (PV) systems in California, raising it by about 7-12% in cities that adopt these programs. R-PACE is a financing mechanism that uses a voluntary property tax assessment, paid off over time, to facilitate energy improvements and, in some jurisdictions, water and resilience measures. While previous studies demonstrated that early, regional R-PACE programs increased solar PV deployment, this new analysis is the first to demonstrate these impacts from the large, statewide R-PACE programs dominating the California market today, which usemore » private capital to fund the upfront costs of the improvements. Berkeley Lab estimated the impacts using econometric techniques on two samples: -Large cities only, allowing annual demographic and economic data as control variables -All California cities, without these annual data Analysis of both samples controls for several factors other than R-PACE that would be expected to drive solar PV deployment. We infer that on average, cities with R-PACE programs were associated with greater solar PV deployment in our study period (2010-2015). In the large cities sample, solar PV deployment in jurisdictions with R-PACE programs was higher by 1.1 watts per owner-occupied household per month, or 12%. Across all cities, solar PV deployment in jurisdictions with R-PACE programs was higher by 0.6 watts per owner-occupied household per month, or 7%. The large cities results are statistically significant at conventional levels; the all-cities results are not. The estimates imply that the majority of solar PV deployment financed by R-PACE programs would likely not have occurred in their absence. Results suggest that R-PACE programs have increased PV deployment in California even in relatively recent years, as R-PACE programs have grown in market share and as alternate approaches for financing solar PV have developed. The U.S. Department of Energy’s Building Technologies Office supported this research.« less

Increased base rate of atrial pacing for prevention of atrial fibrillation after implantation of a dual-chamber pacemaker: insights from the Atrial Overdrive Pacing Study.

PubMed

Kantharia, Bharat K; Freedman, Roger A; Hoekenga, David; Tomassoni, Gery; Worley, Seth; Sorrentino, Robert; Steinhaus, David; Wolkowicz, Joel M; Syed, Zaffer A

2007-11-01

Different pacing sites and various algorithms have been utilized to prevent atrial fibrillation (AF) in pacemaker recipients. However, the optimal pacing rate settings have not yet been established. In this randomized, prospective, multicentre, single-blinded, cross over study, rate-adaptive pacing at a high base rate (BR) in patients, age 60 years or above, or a history of paroxysmal AF, who underwent dual-chamber (DDD) pacemaker implantation for standard pacing indications, was evaluated for prevention of AF. In the study cohort of 145 patients implanted with DDD pacemakers with a programmable rest rate (RR) feature, the BR/RR settings were sequentially but randomly adjusted as follows: 60 bpm/Off for the baseline quarter (initial 3 months) and then to either 'A-B-C' or 'C-B-A' settings (A = 70/65 bpm, B = 70/Off, C = 80/65 bpm) for the subsequent quarters each of 3 months duration. Data on automatic mode switch episodes, device diagnostics, and a questionnaire evaluating pacemaker awareness and palpitations were collected. Ninety-nine patients, mean age 77 +/- 10 years, who completed the study protocol and followed for 12 months did not show significant differences in the number of mode switch episodes between any settings used. The percentage of atrial pacing was lower during baseline pacing compared to settings A, B, and C (P < 0.0001). Setting C produced a higher percentage of atrial pacing than A and B (P < 0.01). Although a higher percentage of atrial pacing correlated with a lower incidence of mode switch episodes, there was no statistically significant difference in the number of mode switch episodes between settings A, B, and C. There were no significant differences in the questionnaire scores relating to pacemaker awareness or palpitation. Overdrive single-site pacing in the right atrium achieved by programming analysed settings in the present study did not reduce AF as assessed by mode switch episodes. Additionally, no change in the symptoms of arrhythmia or awareness of pacing was seen.

Left ventricular epicardial activation increases transmural dispersion of repolarization in healthy, long QT, and dilated cardiomyopathy dogs.

PubMed

Bai, Rong; Lü, Jiagao; Pu, Jun; Liu, Nian; Zhou, Qiang; Ruan, Yanfei; Niu, Huiyan; Zhang, Cuntai; Wang, Lin; Kam, Ruth

2005-10-01

Benefits of cardiac resynchronization therapy (CRT) are well established. However, less is understood concerning its effects on myocardial repolarization and the potential proarrhythmic risk. Healthy dogs (n = 8) were compared to a long QT interval (LQT) model (n = 8, induced by cesium chloride, CsCl) and a dilated cardiomyopathy with congestive heart failure (DCM-CHF, induced by rapid ventricular pacing, n = 5). Monophasic action potential (MAP) recordings were obtained from the subendocardium, midmyocardium, subepicardium, and the transmural dispersion of repolarization (TDR) was calculated. The QT interval and the interval from the peak to the end of the T wave (T(p-e)) were measured. All these characteristics were compared during left ventricular epicardial (LV-Epi), right ventricular endocardial (RV-Endo), and biventricular (Bi-V) pacing. In healthy dogs, TDR prolonged to 37.54 ms for Bi-V pacing and to 47.16 ms for LV-Epi pacing as compared to 26.75 ms for RV-Endo pacing (P < 0.001), which was parallel to an augmentation in T(p-e) interval (Bi-V pacing, 64.29 ms; LV-Epi pacing, 57.89 ms; RV-Endo pacing, 50.29 ms; P < 0.01). During CsCl exposure, Bi-V and LV-Epi pacing prolonged MAPD, TDR, and T(p-e) interval as compared to RV-Endo pacing. The midmyocardial MAPD (276.30 ms vs 257.35 ms, P < 0.0001) and TDR (33.80 ms vs 27.58 ms, P=0.002) were significantly longer in DCM-CHF dogs than those in healthy dogs. LV-Epi and Bi-V pacing further prolonged the MAPD and TDR in this model. LV-Epi and Bi-V pacing result in prolongation of ventricular repolarization time, and increase of TDR accounted for a parallel augmentation of the T(p-e) interval, which provides evidence that T(p-e) interval accurately represents TDR. These effects are magnified in the LQT and DCM-CHF canine models in addition to their intrinsic transmural heterogeneity in the intact heart. This mechanism may contribute to the development of malignant ventricular arrhythmias, such as torsades de pointes (TdP) in congestive heart failure (CHF) patients treated with CRT.

Dynamic and dual-site atrial pacing in the prevention of atrial fibrillation: The STimolazione Atrial DInamica Multisito (STADIM) Study.

PubMed

De Simone, Antonio; Senatore, Gaetano; Donnici, Giovanni; Turco, Pietro; Romano, Enrico; Gazzola, Carlo; Stabile, G

2007-01-01

The impact of new algorithms to consistently pace the atrium on the prevention of atrial fibrillation (AF) remains unclear. Our randomized, crossover study compared the efficacy of single- and dual-site atrial pacing, with versus without dynamic atrial overdrive pacing in preventing AF. We studied 72 patients (mean age = 69.6 +/- 6.5 years, 34 men) with sick sinus syndrome (SSS) and paroxysmal or persistent AF, who received dual-chamber pacemakers (PM) equipped with an AF prevention algorithm and two atrial leads placed in the right atrial appendage (RAA), by passive fixation, and in the coronary sinus ostium (CS), by active fixation, respectively. At implant, the patients were randomly assigned to unipolar CS versus RAA pacing. The PM was programmed in DDDR mode 1 month after implant. Each patient underwent four study phases of equal duration: (1) unipolar, single site (CS or RAA) pacing with the AF algorithm ON (atrial lower rate = 0 ppm); (2) unipolar, single site pacing with the AF algorithm OFF (atrial lower rate = 70 bpm); (3) bipolar, dual-site pacing with AF algorithm ON; (4) bipolar, dual-site pacing with the AF algorithm OFF. Among 40 patients (56%), who completed the follow-up (15 +/- 4 months) no difference was observed in the mean number of automatic mode switch (AMS) corrected for the duration of follow-up, in unipolar (5.6 +/- 22.8 vs 2.6 +/- 5.5) or bipolar mode (3.3 +/- 12.7 vs 2.1 +/- 4.9) with, respectively, the algorithm OFF or ON. With the AF prevention algorithm ON, the percentage of atrial pacing increased significantly from 78.7 +/- 22.1% to 92.4 +/- 4.9% (P < 0.001), while the average ventricular heart rate was significantly lower with the algorithm ON (62.4 +/- 17.5 vs 79.9 +/- 3 bpm (P < 0.001). The AF prevention algorithm increased the percentage of atrial pacing significantly, regardless of the atrial pulse configuration and pacing site, while maintaining a slower ventricular heart rate. It had no impact on the number of AMS in the unipolar and bipolar modes in patients with SSS.

Advances on Aryldiazonium Salt Chemistry Based Interfacial Fabrication for Sensing Applications.

PubMed

Cao, Chaomin; Zhang, Yin; Jiang, Cheng; Qi, Meng; Liu, Guozhen

2017-02-15

Aryldiazonium salts as coupling agents for surface chemistry have evidenced their wide applications for the development of sensors. Combined with advances in nanomaterials, current trends in sensor science and a variety of particular advantages of aryldiazonium salt chemistry in sensing have driven the aryldiazonium salt-based sensing strategies to grow at an astonishing pace. This review focuses on the advances in the use of aryldiazonium salts for modifying interfaces in sensors and biosensors during the past decade. It will first summarize the current methods for modification of interfaces with aryldiazonium salts, and then discuss the sensing applications of aryldiazonium salts modified on different transducers (bulky solid electrodes, nanomaterials modified bulky solid electrodes, and nanoparticles). Finally, the challenges and perspectives that aryldiazonium salt chemistry is facing in sensing applications are critically discussed.

Dementia and Robotics: People with Advancing Dementia and Their Carers Driving an Exploration into an Engineering Solution to Maintaining Safe Exercise Regimes.

PubMed

Cooper, Carol; Penders, Jacques; Procter, Paula M

2016-01-01

The merging of the human world and the information technology world is advancing at a pace, even for those with dementia there are many useful smart 'phone applications including reminders, family pictures display, GPS functions and video communications. This paper will report upon initial collaborative work developing a robotic solution to engaging individuals with advancing dementia in safe exercise regimes. The research team has been driven by the needs of people with advancing dementia and their carers through a focus group methodology, the format, discussions and outcomes of these groups will be reported. The plans for the next stage of the research will be outlined including the continuing collaboration with advancing dementia and their carers.

Genomic signals of selection predict climate-driven population declines in a migratory bird.

PubMed

Bay, Rachael A; Harrigan, Ryan J; Underwood, Vinh Le; Gibbs, H Lisle; Smith, Thomas B; Ruegg, Kristen

2018-01-05

The ongoing loss of biodiversity caused by rapid climatic shifts requires accurate models for predicting species' responses. Despite evidence that evolutionary adaptation could mitigate climate change impacts, evolution is rarely integrated into predictive models. Integrating population genomics and environmental data, we identified genomic variation associated with climate across the breeding range of the migratory songbird, yellow warbler ( Setophaga petechia ). Populations requiring the greatest shifts in allele frequencies to keep pace with future climate change have experienced the largest population declines, suggesting that failure to adapt may have already negatively affected populations. Broadly, our study suggests that the integration of genomic adaptation can increase the accuracy of future species distribution models and ultimately guide more effective mitigation efforts. Copyright © 2018, American Association for the Advancement of Science.

Privacy and anonymity in the information society - challenges for the European Union.

PubMed

Tsoukalas, Ioannis A; Siozos, Panagiotis D

2011-03-01

Electronic information is challenging traditional views on property and privacy. The explosion of digital data, driven by novel web applications, social networking, and mobile devices makes data security and the protection of privacy increasingly difficult. Furthermore, biometric data and radiofrequency identification applications enable correlations that are able to trace our cultural, behavioral, and emotional states. The concept of privacy in the digital realm is transformed and emerges as one of the biggest risks facing today's Information Society. In this context, the European Union (EU) policy-making procedures strive to adapt to the pace of technological advancement. The EU needs to improve the existing legal frameworks for privacy and data protection. It needs to work towards a "privacy by education" approach for the empowerment of "privacy-literate" European digital citizens.

Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial.

PubMed

Boriani, Giuseppe; Manolis, Antonis S; Tukkie, Raymond; Mont, Lluis; Pürerfellner, Helmut; Santini, Massimo; Inama, Giuseppe; Serra, Paolo; Gulizia, Michele; Samoilenko, Igor Vasilyevich; Wolff, Claudia; Holbrook, Reece; Gavazza, Federica; Padeletti, Luigi

2015-06-01

Many patients who suffer from bradycardia and need cardiac pacing also have atrial fibrillation (AF). New pacemaker algorithms, such as atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), have been specifically designed to reduce AF occurrence and duration and to minimize the detrimental effects of right ventricular pacing. The randomized MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial established that DDDRP + MVP pacing modality reduced permanent AF in bradycardia patients as compared with standard dual-chamber pacing (DDDR). The aim of this study was to estimate the cost savings due to lower AF-related health care utilization events based on health care costs from the United States and the European Union. Dual-chamber pacemaker patients with a history of paroxysmal or persistent AF were randomly assigned to receive DDDR (n = 385) or the advanced features (DDDRP + MVP; n = 383). We used published health care costs from the United States and the European Union (Italy, Spain, and the United Kingdom) to estimate the costs associated with AF-related hospitalizations and emergency visits. The rate of AF-related hospitalizations was significantly lower in the DDDRP + MVP group than in the conventional pacemaker group (DDDR group; 42% reduction; incidence rate ratio 0.58). Similarly, a significant reduction of 68% was observed for AF-related emergency department visits (incidence rate ratio 0.32; P < .001). As a consequence, DDDRP + MVP could potentially reduce health care costs by 40%-44%. Over a ten-year period, the cost savings per 100 patients ranged from $35,702 in the United Kingdom to $121,831 in the United States. New pacing algorithms such as DDDRP + MVP used in the MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial successfully reduced AF-related health care utilization, resulting in significant cost savings to payers. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

The effect of atrial-based pacing on exercise capacity as measured by the 6-minute walk test: a substudy of the Canadian Trial of Physiological Pacing (CTOPP).

PubMed

Baranchuk, Adrian; Healey, Jeff S; Thorpe, Kevin E; Morillo, Carlos A; Nair, Girish; Crystal, Eugene; Kerr, Charles R; Connolly, Stuart J

2007-08-01

Although several randomized trials have detected no reduction in major cardiovascular events with the routine use of dual-chamber as opposed to ventricular pacemakers, many individuals continue to advocate their use as a means of improving exercise capacity. The Canadian Trial of Physiological Pacing (CTOPP) trial is the largest trial comparing ventricular pacing to atrial-based pacing (atrial or dual-chamber) in patients with bradycardia. All patients in this trial were asked to complete a 6-minute hall walk test (6MWT) at the time of their first study follow-up. The distance walked in 6 minutes and the patient's heart rate before and immediately after the walk were recorded. Of the 2568 patients in the CTOPP, 76% completed the 6MWT. The mean distance walked was 350 +/- 127 m in the ventricular pacing group and 356 +/- 127 m in the atrial-based group (P = NS). Similarly, there was no difference in the change in heart rate between the two groups (17 +/- 13 vs. 18 +/- 12 bpm: P = NS). However, among patients with an unpaced heart rate of

42 CFR 460.116 - Explanation of rights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.116 Explanation of rights. (a) Written policies. A PACE...

42 CFR 460.116 - Explanation of rights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.116 Explanation of rights. (a) Written policies. A PACE...

Caspian sea-level changes during the last millennium: historical and geological evidence from the south Caspian Sea

NASA Astrophysics Data System (ADS)

Naderi Beni, A.; Lahijani, H.; Mousavi Harami, R.; Arpe, K.; Leroy, S. A. G.; Marriner, N.; Berberian, M.; Andrieu-Ponel, V.; Djamali, M.; Mahboubi, A.; Reimer, P. J.

2013-07-01

Historical literature may constitute a valuable source of information to reconstruct sea-level changes. Here, historical documents and geological records have been combined to reconstruct Caspian sea-level (CSL) changes during the last millennium. In addition to a comprehensive literature review, new data from two short sediment cores were obtained from the south-eastern Caspian coast to identify coastal change driven by water-level changes and to compare the results with other geological and historical findings. The overall results indicate a high-stand during the Little Ice Age, up to -21 m (and extra rises due to manmade river avulsion), with a -28 m low-stand during the Medieval Climate Anomaly, while presently the CSL stands at -26.5 m. A comparison of the CSL curve with other lake systems and proxy records suggests that the main sea-level oscillations are essentially paced by solar irradiance. Although the major controller of the long-term CSL changes is driven by climatological factors, the seismicity of the basin creates local changes in base level. These local base-level changes should be considered in any CSL reconstruction.

Caspian Sea level changes during the last millennium: historical and geological evidences from the south Caspian Sea

NASA Astrophysics Data System (ADS)

Naderi Beni, A.; Lahijani, H.; Mousavi Harami, R.; Arpe, K.; Leroy, S. A. G.; Marriner, N.; Berberian, M.; Andrieu-Ponel, V.; Djamali, M.; Mahboubi, A.

2013-03-01

Historical literature may constitute a valuable source of information to reconstruct sea level changes. Here, historical documents and geological records have been combined to reconstruct Caspian sea-level (CSL) changes during the last millennium. In addition to a literature survey, new data from two short sediment cores were obtained from the south-eastern Caspian coast to identify coastal change driven by water-level changes. Two articulated bivalve shells from the marine facies were radiocarbon dated and calibrated to establish a chronology and to compare them with historical findings. The overall results indicate a high-stand during the Little Ice Age, up to -19 m, with a -28 m low-stand during the Medieval Climate Anomaly, while presently the CSL stands at -26.5 m. A comparison of the CSL curve with other lake systems and proxy records suggests that the main sea-level oscillations are essentially paced by solar irradiance. Although the major controller of the long-term CSL changes is driven by climatological factors, the seismicity of the basin could create locally changes in base level. These local base-level changes should be considered in any CSL reconstruction.

A Unified Data-Driven Approach for Programming In Situ Analysis and Visualization

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

Aiken, Alex

The placement and movement of data is becoming the key limiting factor on both performance and energy efficiency of high performance computations. As systems generate more data, it is becoming increasingly difficult to actually move that data elsewhere for post-processing, as the rate of improvements in supporting I/O infrastructure is not keeping pace. Together, these trends are creating a shift in how we think about exascale computations, from a viewpoint that focuses on FLOPS to one that focuses on data and data-centric operations as fundamental to the reasoning about, and optimization of, scientific workflows on extreme-scale architectures. The overarching goalmore » of our effort was the study of a unified data-driven approach for programming applications and in situ analysis and visualization. Our work was to understand the interplay between data-centric programming model requirements at extreme-scale and the overall impact of those requirements on the design, capabilities, flexibility, and implementation details for both applications and the supporting in situ infrastructure. In this context, we made many improvements to the Legion programming system (one of the leading data-centric models today) and demonstrated in situ analyses on real application codes using these improvements.« less

Strong expectations cancel locality effects: evidence from Hindi.

PubMed

Husain, Samar; Vasishth, Shravan; Srinivasan, Narayanan

2014-01-01

Expectation-driven facilitation (Hale, 2001; Levy, 2008) and locality-driven retrieval difficulty (Gibson, 1998, 2000; Lewis & Vasishth, 2005) are widely recognized to be two critical factors in incremental sentence processing; there is accumulating evidence that both can influence processing difficulty. However, it is unclear whether and how expectations and memory interact. We first confirm a key prediction of the expectation account: a Hindi self-paced reading study shows that when an expectation for an upcoming part of speech is dashed, building a rarer structure consumes more processing time than building a less rare structure. This is a strong validation of the expectation-based account. In a second study, we show that when expectation is strong, i.e., when a particular verb is predicted, strong facilitation effects are seen when the appearance of the verb is delayed; however, when expectation is weak, i.e., when only the part of speech "verb" is predicted but a particular verb is not predicted, the facilitation disappears and a tendency towards a locality effect is seen. The interaction seen between expectation strength and distance shows that strong expectations cancel locality effects, and that weak expectations allow locality effects to emerge.

Strong Expectations Cancel Locality Effects: Evidence from Hindi

PubMed Central

Husain, Samar; Vasishth, Shravan; Srinivasan, Narayanan

2014-01-01

Expectation-driven facilitation (Hale, 2001; Levy, 2008) and locality-driven retrieval difficulty (Gibson, 1998, 2000; Lewis & Vasishth, 2005) are widely recognized to be two critical factors in incremental sentence processing; there is accumulating evidence that both can influence processing difficulty. However, it is unclear whether and how expectations and memory interact. We first confirm a key prediction of the expectation account: a Hindi self-paced reading study shows that when an expectation for an upcoming part of speech is dashed, building a rarer structure consumes more processing time than building a less rare structure. This is a strong validation of the expectation-based account. In a second study, we show that when expectation is strong, i.e., when a particular verb is predicted, strong facilitation effects are seen when the appearance of the verb is delayed; however, when expectation is weak, i.e., when only the part of speech “verb” is predicted but a particular verb is not predicted, the facilitation disappears and a tendency towards a locality effect is seen. The interaction seen between expectation strength and distance shows that strong expectations cancel locality effects, and that weak expectations allow locality effects to emerge. PMID:25010700

Helminths and the microbiota: parts of the hygiene hypothesis

PubMed Central

Loke, P’ng; Lim, Yvonne A.L.

2015-01-01

In modern societies, diseases that are driven by dysregulated immune responses are increasing at an alarming pace, such as inflammatory bowel diseases and diabetes. There is an urgent need to understand these epidemiological trends, which are likely to be driven by the changing environment of the last few decades. There are complex interactions between human genetic factors and this changing environment that is leading to the increasing prevalence of metabolic and inflammatory diseases. Alterations to human gut bacterial communities (the microbiota) and lowered prevalence of helminth infections are potential environmental factors contributing to immune dysregulation. Helminths have co-evolved with the gut microbiota and their mammalian hosts. This three-way interaction is beginning to be characterized and the knowledge gained may enable the design of new therapeutic strategies to treat metabolic and inflammatory diseases. However, these complex interactions need to be carefully investigated in the context of host genetic backgrounds in order to identify optimal treatment strategies. The complex nature of these interactions raises the possibility that only with highly personalized treatment, with knowledge of individual genetic and microbiota communities, will therapeutic interventions be successful for a majority of the individuals suffering from these complex diseases of immune dysregulation. PMID:25869420

Characterizing Urban Household Waste Generation and Metabolism Considering Community Stratification in a Rapid Urbanizing Area of China.

PubMed

Xiao, Lishan; Lin, Tao; Chen, Shaohua; Zhang, Guoqin; Ye, Zhilong; Yu, Zhaowu

2015-01-01

The relationship between social stratification and municipal solid waste generation remains uncertain under current rapid urbanization. Based on a multi-object spatial sampling technique, we selected 191 households in a rapidly urbanizing area of Xiamen, China. The selected communities were classified into three types: work-unit, transitional, and commercial communities in the context of housing policy reform in China. Field survey data were used to characterize household waste generation patterns considering community stratification. Our results revealed a disparity in waste generation profiles among different households. The three community types differed with respect to family income, living area, religious affiliation, and homeowner occupation. Income, family structure, and lifestyle caused significant differences in waste generation among work-unit, transitional, and commercial communities, respectively. Urban waste generation patterns are expected to evolve due to accelerating urbanization and associated community transition. A multi-scale integrated analysis of societal and ecosystem metabolism approach was applied to waste metabolism linking it to particular socioeconomic conditions that influence material flows and their evolution. Waste metabolism, both pace and density, was highest for family structure driven patterns, followed by lifestyle and income driven. The results will guide community-specific management policies in rapidly urbanizing areas.

Helminths and the microbiota: parts of the hygiene hypothesis.

PubMed

Loke, P; Lim, Y A L

2015-06-01

In modern societies, diseases that are driven by dysregulated immune responses are increasing at an alarming pace, such as inflammatory bowel diseases and diabetes. There is an urgent need to understand these epidemiological trends, which are likely to be driven by the changing environment of the last few decades. There are complex interactions between human genetic factors and this changing environment that is leading to the increasing prevalence of metabolic and inflammatory diseases. Alterations to human gut bacterial communities (the microbiota) and lowered prevalence of helminth infections are potential environmental factors contributing to immune dysregulation. Helminths have co-evolved with the gut microbiota and their mammalian hosts. This three-way interaction is beginning to be characterized, and the knowledge gained may enable the design of new therapeutic strategies to treat metabolic and inflammatory diseases. However, these complex interactions need to be carefully investigated in the context of host genetic backgrounds to identify optimal treatment strategies. The complex nature of these interactions raises the possibility that only with highly personalized treatment, with knowledge of individual genetic and microbiota communities, will therapeutic interventions be successful for a majority of the individuals suffering from these complex diseases of immune dysregulation. © 2015 John Wiley & Sons Ltd.

Left Ventricular Reverse Remodeling With Biventricular Versus Right Ventricular Pacing in Patients With Atrioventricular Block and Heart Failure in the BLOCK HF Trial.

PubMed

St John Sutton, Martin; Plappert, Ted; Adamson, Philip B; Li, Pei; Christman, Shelly A; Chung, Eugene S; Curtis, Anne B

2015-05-01

Biventricular pacing in heart failure (HF) improves survival, relieves symptoms, and attenuates left ventricular (LV) remodeling. However, little is known about biventricular pacing in HF patients with atrioventricular block because they are typically excluded from biventricular trials. The Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) trial randomized patients with atrioventricular block, New York Heart Association symptom classes I to III HF, and LV ejection fraction ≤50% to biventricular or right ventricular pacing. Doppler echocardiograms were obtained at randomization (after 30 to 60 days of right ventricular pacing postimplant) and every 6 months through 24 months. Data analysis comparing changes in 10 prespecified echo parameters over time was conducted using a Bayesian design. LV end systolic volume index was also evaluated as a predictor of mortality/morbidity. Of 691 randomized subjects, 624 had paired Doppler echocardiogram data for ≥1 analyses at 6, 12, 18, or 24 months. Biventricular pacing significantly reduced LV volume indices and intraventricular mechanical delay, and improved LV ejection fraction, consistent with LV reverse remodeling. These parameters showed little change with right ventricular pacing alone, indicating no systematic reverse remodeling with right ventricular pacing. LV end systolic volume index was predictive of mortality/morbidity; the estimated risk increased up to 1% for every 1 mL/m(2) increase in LV end systolic volume index. LV end systolic volume index is a significant predictor of mortality/morbidity in this population. Cardiac structure and function are improved with biventricular pacing for patients with atrioventricular block and LV systolic dysfunction. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00267098. © 2015 American Heart Association, Inc.

The Effect of Right Ventricular Apical and Nonapical Pacing on the Short- and Long-Term Changes in Left Ventricular Ejection Fraction: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials.

PubMed

Hussain, Mohammad Akhtar; Furuya-Kanamori, Luis; Kaye, Gerald; Clark, Justin; Doi, Suhail A R

2015-09-01

The right ventricular apex (RVA) is the traditional lead site for chronic pacing but in some patients may cause impaired left ventricular (LV) systolic function over time. Comparisons with right ventricular nonapical (RVNA) pacing sites have generated inconsistent results and recent meta-analyses have demonstrated unclear benefit due to heterogeneity across studies. A systematic search for randomized controlled trials that compared LV ejection fraction (LVEF) outcomes between RVNA and RVA pacing was performed up to October 2014. Twenty-four studies (n = 1,628 patients) met the inclusion criteria. To avoid between study heterogeneity two homogenous groups were created; group 1 where studies reported a difference (in favor of RVNA pacing) and group 2 where studies reported no difference between pacing sites. For group 1, weighted mean difference between RVNA and RVA pacing in terms of LVEF at follow-up was 5.40% (95% confidence interval [CI]: 3.94-6.87), related in part to group one's RVA arm demonstrating a significant reduction (mean loss -3.31%; 95% CI: -6.19 to -0.43) in LVEF between study baseline and end of follow-up. Neither of these finding were seen in group 2. Weighted regression modeling demonstrated that inclusion of poor baseline LVEF (<40%) in combination with greater than 12 months follow-up was three times more common in group 1 compared to group 2 (weighted relative risk 2.82; 95% CI: 1.03-7.72; P = 0.043). In patients requiring chronic right ventricular pacing where there is inclusion of impaired baseline LVEF (<40%), RVA pacing is associated with deterioration in LV function relative to RVNA pacing. © 2015 Wiley Periodicals, Inc.

Validation of criteria for selective his bundle and para-hisian permanent pacing.

PubMed

Cantù, F; De Filippo, P; Cardano, P; De Luca, A; Gavazzi, A

2006-12-01

His Bundle (HB) pacing is a valid alternative to right ventricular pacing for patients with preserved His-ventricle conduction who are candidates for permanent stimulation. Permanent pacing in the HB area enables Selective HB pacing (SHBP) or para-Hisian pacing (PHP) to be achieved. The aim of our study was to draw up a set of easy criteria to differentiate and validate the two kinds of stimulations according to the pacing output and the ECG/EKG signals. From February to July 2005, 17 patients eligible for a pacemaker (PM) procedure underwent implantation with the Medtronic SelectSecure lead (Medtronic, Minneapolis, MN, USA) screwed into the HB area.SHBP was defined when the intrinsic QRS was equal, in both duration and morphology, to the paced QRS, the His-Ventricular (H-V) interval was equal to Pace-Ventricular interval (Vp-V) and, at low output, only the HB was captured, while increasing the output resulted in both the HB and right ventricular (RV) being captured (widening of QRS at high output). Conversely, PHP was defined when the intrinsic QRS differed from the paced one, either in morphology or in duration and, at high output, both the RV and HB were captured (non-SHBP), while decreasing the output resulted in losing HB capture (widening of QRS at low output). According to these criteria, SHBP was achieved in 11 patients, while in the remaining 6, PHP was obtained. No adverse events were reported. The above criteria enabled SHBP and PHP to be validated easily and clearly. A longer follow-up will be needed in order to ascertain whether the clinical outcome of these two approaches differs.

A proteomic approach reveals transient association of reticulocalbin-3, a novel member of the CREC family, with the precursor of subtilisin-like proprotein convertase, PACE4

PubMed Central

Tsuji, Akihiko; Kikuchi, Yayoi; Sato, Yukimi; Koide, Shizuyo; Yuasa, Keizo; Nagahama, Masami; Matsuda, Yoshiko

2006-01-01

SPCs (subtilisin-like proprotein convertases) are a family of seven structurally related serine endoproteases that are involved in the proteolytic activation of proproteins. In an effort to examine the substrate protein for PACE4 (paired basic amino-acid-cleaving enzyme-4), an SPC, a potent protein inhibitor of PACE4, an α1-antitrypsin RVRR (Arg-Val-Arg-Arg) variant, was expressed in GH4C1 cells. Ectopic expression of the RVRR variant caused accumulation of the 48 kDa protein in cells. Sequence analysis indicates that the 48 kDa protein is a putative Ca2+-binding protein, RCN-3 (reticulocalbin-3), which had previously been predicted by bioinformatic analysis of cDNA from the human hypothalamus. RCN-3 is a member of the CREC (Cab45/reticulocalbin/ERC45/calumenin) family of multiple EF-hand Ca2+-binding proteins localized to the secretory pathway. The most interesting feature of the RCN-3 sequence is the presence of five Arg-Xaa-Xaa-Arg motifs, which represents the target sequence of SPCs. Biosynthetic studies showed that RCN-3 is transiently associated with proPACE4, but not with mature PACE4. Inhibition of PACE4 maturation by a Ca2+ ionophore resulted in accumulation of the proPACE4–RCN-3 complex in cells. Furthermore, autoactivation and secretion of PACE4 was increased upon co-expression with RCN-3. Our findings suggest that selective and transient association of RCN-3 with the precursor of PACE4 plays an important role in the biosynthesis of PACE4. PMID:16433634

Role of apamin-sensitive small conductance calcium-activated potassium currents in long-term cardiac memory in rabbits.

PubMed

Yin, Dechun; Chen, Mu; Yang, Na; Wu, Adonis Z; Xu, Dongzhu; Tsai, Wei-Chung; Yuan, Yuan; Tian, Zhipeng; Chan, Yi-Hsin; Shen, Changyu; Chen, Zhenhui; Lin, Shien-Fong; Weiss, James N; Chen, Peng-Sheng; Everett, Thomas H

2018-05-01

Apamin-sensitive small conductance calcium-activated K current (I KAS ) is up-regulated during ventricular pacing and masks short-term cardiac memory (CM). The purpose of this study was to determine the role of I KAS in long-term CM. CM was created with 3-5 weeks of ventricular pacing and defined by a flat or inverted T wave off pacing. Epicardial optical mapping was performed in both paced and normal ventricles. Action potential duration (APD 80 ) was determined during right atrial pacing. Ventricular stability was tested before and after I KAS blockade. Four paced hearts and 4 normal hearts were used for western blotting and histology. There were no significant differences in either echocardiographic parameters or fibrosis levels between groups. Apamin induced more APD 80 prolongation in CM than in normal ventricles (mean [95% confidence interval]: 9.6% [8.8%-10.5%] vs 3.1% [1.9%-4.3%]; P <.001). Apamin significantly lengthened APD 80 in the CM model at late activation sites, indicating significant I KAS up-regulation at those sites. The CM model also had altered Ca 2+ handling, with the 50% Ca 2+ transient duration and amplitude increased at distal sites compared to a proximal site (near the pacing site). After apamin, the CM model had increased ventricular fibrillation (VF) inducibility (paced vs control: 33/40 (82.5%) vs 7/20 (35%); P <.001) and longer VF durations (124 vs 26 seconds; P <.001). Chronic ventricular pacing increases Ca 2+ transients at late activation sites, which activates I KAS to maintain repolarization reserve. I KAS blockade increases VF vulnerability in chronically paced rabbit ventricles. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Pulmonary vein isolation using a pace-capture-guided versus an adenosine-guided approach: effect on dormant conduction and long-term freedom from recurrent atrial fibrillation--a prospective study.

PubMed

Andrade, Jason G; Pollak, Scott J; Monir, George; Khairy, Paul; Dubuc, Marc; Roy, Denis; Talajic, Mario; Deyell, Marc; Rivard, Léna; Thibault, Bernard; Guerra, Peter G; Nattel, Stanley; Macle, Laurent

2013-12-01

Atrial fibrillation recurrence after pulmonary vein (PV) isolation is associated with PV to left atrium reconduction. We prospectively studied the use of 2 procedural techniques designed to facilitate identification of residual gaps within the index ablation line. After wide circumferential PV isolation, 40 patients received additional ablation targeted at locations of left atrial capture during high-output pacing (pace-capture group), while 40 patients underwent adenosine testing with targeted ablation at sites of dormant conduction (adenosine group). Patients were followed up at 3, 6, and 12 months. After PV isolation, high-output pace-capture was documented in 39 PVs (25%; 50% of patients) in the pace-capture group. Dormant conduction was unmasked in 34 PVs (22%; 53% of patients) in the adenosine group. A subset of 25 patients in the pace-capture group underwent adenosine testing without targeted ablation of dormant conduction. In these patients, only 10 out of 86 PVs (11.6%; 24% of patients) demonstrated dormant conduction after the elimination of local pace-capture. At a follow-up of 329±124 days, the single procedure off antiarrhythmic drug freedom from recurrent atrial fibrillation was 67.5% in the adenosine group and 65.0% in the pace-capture group (P=0.814). Procedure duration and fluoroscopy time were significantly longer in the pace-capture group (P=0.002 and P<0.001), whereas radiofrequency ablation time was comparable (P=0.192). The use of high-output pacing post-PV isolation results in a significant reduction in the incidence of dormant conduction with a comparable long-term freedom from recurrent atrial fibrillation (versus adenosine-guided ablation). The use of these approaches requires evaluation in a long-term prospective randomized study. [corrected].

Climate Change driven evolution of hazards to Europe's transport infrastructure throughout the twenty-first century

NASA Astrophysics Data System (ADS)

Matulla, Christoph; Hollósi, Brigitta; Andre, Konrad; Gringinger, Julia; Chimani, Barbara; Namyslo, Joachim; Fuchs, Tobias; Auerbach, Markus; Herrmann, Carina; Sladek, Brigitte; Berghold, Heimo; Gschier, Roland; Eichinger-Vill, Eva

2017-06-01

Road authorities, freight, and logistic industries face a multitude of challenges in a world changing at an ever growing pace. While globalization, changes in technology, demography, and traffic, for instance, have received much attention over the bygone decades, climate change has not been treated with equal care until recently. However, since it has been recognized that climate change jeopardizes many business areas in transport, freight, and logistics, research programs investigating future threats have been initiated. One of these programs is the Conference of European Directors of Roads' (CEDR) Transnational Research Programme (TRP), which emerged about a decade ago from a cooperation between European National Road Authorities and the EU. This paper presents findings of a CEDR project called CliPDaR, which has been designed to answer questions from road authorities concerning climate-driven future threats to transport infrastructure. Pertaining results are based on two potential future socio-economic pathways of mankind (one strongly economically oriented "A2" and one more balanced scenario "A1B"), which are used to drive global climate models (GCMs) producing global and continental scale climate change projections. In order to achieve climate change projections, which are valid on regional scales, GCM projections are downscaled by regional climate models. Results shown here originate from research questions raised by European Road Authorities. They refer to future occurrence frequencies of severely cold winter seasons in Fennoscandia, to particularly hot summer seasons in the Iberian Peninsula and to changes in extreme weather phenomena triggering landslides and rutting in Central Europe. Future occurrence frequencies of extreme winter and summer conditions are investigated by empirical orthogonal function analyses of GCM projections driven with by A2 and A1B pathways. The analysis of future weather phenomena triggering landslides and rutting events requires downscaled climate change projections. Hence, corresponding results are based on an ensemble of RCM projections, which was available for the A1B scenario. All analyzed risks to transport infrastructure are found to increase over the decades ahead with accelerating pace towards the end of this century. Mean Fennoscandian winter temperatures by the end of this century may match conditions of rather warm winter season experienced in the past and particularly warm future winter temperatures have not been observed so far. This applies in an even more pronounced manner to summer seasons in the Iberian Peninsula. Occurrence frequencies of extreme climate phenomena triggering landslides and rutting events in Central Europe are also projected to rise. Results show spatially differentiated patterns and indicate accelerated rates of increases.

42 CFR 460.18 - CMS evaluation of applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.18 CMS evaluation of applications...

42 CFR 460.22 - Service area designation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.22 Service area designation. (a) An...

42 CFR 460.20 - Notice of CMS determination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.20 Notice of CMS determination. (a...

42 CFR 460.71 - Oversight of direct participant care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.71 Oversight of direct participant care...

42 CFR 460.94 - Required services for Medicare participants.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.94 Required services for Medicare participants. (a) Except...

42 CFR 460.18 - CMS evaluation of applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.18 CMS evaluation of applications...

42 CFR 460.22 - Service area designation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.22 Service area designation. (a) An...

42 CFR 460.94 - Required services for Medicare participants.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.94 Required services for Medicare participants. (a) Except...

42 CFR 460.20 - Notice of CMS determination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.20 Notice of CMS determination. (a...

Factors influencing pacing in triathlon

PubMed Central

Wu, Sam SX; Peiffer, Jeremiah J; Brisswalter, Jeanick; Nosaka, Kazunori; Abbiss, Chris R

2014-01-01

Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing) within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon. PMID:25258562

Capture of activation during ventricular arrhythmia using distributed stimulation.

PubMed

Meunier, Jason M; Ramalingam, Sanjiv; Lin, Shien-Fong; Patwardhan, Abhijit R

2007-04-01

Results of previous studies suggest that pacing strength stimuli can capture activation during ventricular arrhythmia locally near pacing sites. The existence of spatio-temporal distribution of excitable gap during arrhythmia suggests that multiple and timed stimuli delivered over a region may permit capture over larger areas. Our objective in this study was to evaluate the efficacy of using spatially distributed pacing (DP) to capture activation during ventricular arrhythmia. Data were obtained from rabbit hearts which were placed against a lattice of parallel wires through which biphasic pacing stimuli were delivered. Electrical activity was recorded optically. Pacing stimuli were delivered in sequence through the parallel wires starting with the wire closest to the apex and ending with one closest to the base. Inter-stimulus delay was based on conduction velocity. Time-frequency analysis of optical signals was used to determine variability in activation. A decrease in standard deviation of dominant frequencies of activation from a grid of locations that spanned the captured area and a concurrence with paced frequency were used as an index of capture. Results from five animals showed that the average standard deviation decreased from 0.81 Hz during arrhythmia to 0.66 Hz during DP at pacing cycle length of 125 ms (p = 0.03) reflecting decreased spatio-temporal variability in activation during DP. Results of time-frequency analysis during these pacing trials showed agreement between activation and paced frequencies. These results show that spatially distributed and timed stimulation can be used to modify and capture activation during ventricular arrhythmia.

A Low-Cost Simulation Model for R-Wave Synchronized Atrial Pacing in Pediatric Patients with Postoperative Junctional Ectopic Tachycardia

PubMed Central

Michel, Miriam; Egender, Friedemann; Heßling, Vera; Dähnert, Ingo; Gebauer, Roman

2016-01-01

Background Postoperative junctional ectopic tachycardia (JET) occurs frequently after pediatric cardiac surgery. R-wave synchronized atrial (AVT) pacing is used to re-establish atrioventricular synchrony. AVT pacing is complex, with technical pitfalls. We sought to establish and to test a low-cost simulation model suitable for training and analysis in AVT pacing. Methods A simulation model was developed based on a JET simulator, a simulation doll, a cardiac monitor, and a pacemaker. A computer program simulated electrocardiograms. Ten experienced pediatric cardiologists tested the model. Their performance was analyzed using a testing protocol with 10 working steps. Results Four testers found the simulation model realistic; 6 found it very realistic. Nine claimed that the trial had improved their skills. All testers considered the model useful in teaching AVT pacing. The simulation test identified 5 working steps in which major mistakes in performance test may impede safe and effective AVT pacing and thus permitted specific training. The components of the model (exclusive monitor and pacemaker) cost less than $50. Assembly and training-session expenses were trivial. Conclusions A realistic, low-cost simulation model of AVT pacing is described. The model is suitable for teaching and analyzing AVT pacing technique. PMID:26943363

Right Ventricular Pacing for Assessment of Cavo-Tricuspid Isthmus Block.

PubMed

Venkataraman, Ganesh; Wish, Marc; Friehling, Ted; Strickberger, S Adam

2016-01-01

Background: Cavo-tricuspid isthmus (CTI) dependent atrial flutter is typically treated with cardiac ablation. Standard techniques to assess CTI block after ablation can be technically challenging. Right ventricular (RV) pacing may allow for another technique to assess CTI block after ablation. Objective: The purpose of this study was to evaluate RV pacing as a method to assess CTI block after ablation of CTI dependent atrial flutter, and define endpoints of ablation using this technique. Methods: 28 patients undergoing ablation of CTI dependent atrial flutter with intact ventriculoatrial (VA) conduction were prospectively enrolled in this study and underwent the RV pacing protocol, as well as standard coronary sinus (CS) pacing techniques to assess CTI block. Results: The mean trans-isthmus conduction interval during CS pacing (TICI CS ) at 600 and 400ms after CTI ablation was 168 +/- 9ms and 175 +/- 18ms, respectively. The mean trans-isthmus conduction interval during RV pacing (TICI RV ) at 600ms and 400ms after CTI ablation was 109 +/- 5ms and 111 +/- 5ms, respectively. A TICI RV >100ms was associated with a successful outcome after CTI ablation. Conclusions: RV pacing may add incremental value in the assessment of CTI block in patients undergoing ablation of CTI dependent atrial flutter.

Kinematic hand parameters in front crawl at different paces of swimming.

PubMed

Samson, Mathias; Monnet, Tony; Bernard, Anthony; Lacouture, Patrick; David, Laurent

2015-11-05

The aim of this study was to investigate the evolution of kinematic hand parameters (sweepback angle, angle of attack, velocity, acceleration and orientation of the hand relative to the absolute coordinate system) throughout an aquatic stroke and to study the possible modifications caused by a variation of the swimming pace. Seventeen competitive swimmers swam at long distance, middle distance and sprint paces. Parameters were calculated from the trajectory of seven markers on the hand measured with an optoelectronic system. Results showed that kinematic hand parameters evolve differently depending on the pace. Angle of attack, sweepback angle, acceleration and orientation of the hand do not vary significantly. The velocity of the hand increases when the pace increases, but only during the less propulsive phases (entry and stretch and downsweep to catch). The more the pace increases and the more the absolute durations of the entry and stretch and downsweep to catch phases decrease. Absolute durations of the insweep and upsweep phases remain constant. During these phases, the propulsive hand forces calculated do not vary significantly when the pace increases. The increase of swimming pace is then explained by the swimmer's capacity to maintain propulsive phases rather than increasing the force generation within each cycle. Copyright © 2015 Elsevier Ltd. All rights reserved.

PACE and the Medicare+Choice risk-adjusted payment model.

PubMed

Temkin-Greener, H; Meiners, M R; Gruenberg, L

2001-01-01

This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.

Implantable cardioverter defibrillator does not cure the heart.

PubMed

Sławuta, Agnieszka; Boczar, Krzysztof; Ząbek, Andrzej; Gajek, Jacek; Lelakowski, Jacek; Vijayaraman, Pugazhendhi; Małecka, Barbara

2018-01-23

A man with non-ischemic cardiomyopathy, EF 22%, permanent AF and ICD was admitted for elective device replacement. The need for the optimization of the ventricular rate and avoidance of right ventricular pacing made it necessary to up-grade the existing pacing system using direct His bundle pacing and dual chamber ICD. This enabled the regularization of ventricular rate, avoiding the RV pacing and optimize the beta-blocker dose. The one month follow-up already showed reduction in left ventricle diameter, improvement in ejection fraction, NYHA class decrease to II. The His bundle pacing enabled the optimal treatment of the patient resulting in excellent clinical improvement.

The PACE trial: It's time to broaden perceptions and move on.

PubMed

Petrie, Keith J; Weinman, John

2017-08-01

The continued critiques of the PACE trial highlight how differing beliefs about the causes of chronic fatigue syndrome still influence how scientific studies in this area are accepted and evaluated. Causal beliefs about chronic fatigue syndrome and a modern version of Cartesian dualism are important in understanding the reaction to the PACE trial. The continued debate on the PACE trial seems to miss the fact that science is incremental. An unfortunate outcome of the PACE controversy and intimidation of researchers may be less research in the area. It is time to move on from criticism and collect more data on effective treatments.

42 CFR 460.150 - Eligibility to enroll in a PACE program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.150 Eligibility to enroll in a...

42 CFR 460.28 - Notice of CMS determination on waiver requests.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.28 Notice of...

42 CFR 460.28 - Notice of CMS determination on waiver requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.28 Notice of...

42 CFR 460.150 - Eligibility to enroll in a PACE program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.150 Eligibility to enroll in a...

Colony pace: a life-history trait affecting social insect epidemiology.

PubMed

Buechel, Séverine Denise; Schmid-Hempel, Paul

2016-01-13

Among colonies of social insects, the worker turnover rate (colony 'pace') typically shows considerable variation. This has epidemiological consequences for parasites, because in 'fast-paced' colonies, with short-lived workers, the time of parasite residence in a given host will be reduced, and further transmission may thus get less likely. Here, we test this idea and ask whether pace is a life-history strategy against infectious parasites. We infected bumblebees (Bombus terrestris) with the infectious gut parasite Crithidia bombi, and experimentally manipulated birth and death rates to mimic slow and fast pace. We found that fewer workers and, importantly, fewer last-generation workers that are responsible for rearing sexuals were infected in colonies with faster pace. This translates into increased fitness in fast-paced colonies, as daughter queens exposed to fewer infected workers in the nest are less likely to become infected themselves, and have a higher chance of founding their own colonies in the next year. High worker turnover rate can thus act as a strategy of defence against a spreading infection in social insect colonies. © 2016 The Author(s).

PACE4 regulates proliferation, migration and invasion in human breast cancer MDA-MB-231 cells.

PubMed

Wang, Feifei; Wang, Lin; Pan, Jihong

2015-01-01

PACE4 is one of the proprotein convertases (PC) that participate in the post-translational activation of inactive proteins, leading to mature, biologically active proteins. The processing reactions occur in pairs of basic amino acids. PACE4 is an extracellular PC that binds to growth factors and several components of the extracellular matrix contributing to tumor progression. In the present study, the PACE4 gene was silenced by small interfering RNA (siRNA), and the knockdown human breast cancer MDA-MB-231 cells showed significantly reduced proliferation, migration and invasion rates. Flow cytometry analysis indicated that downregulation of PACE4 increases the percentage of cells arrested at the G0/G1 phase. Moreover, the expression of genes involved in cell growth, invasion and adhesion, i.e., IGF-2, MMP9 and MPZL2 was significantly decreased following siRNA-mediated silencing of PACE4. Taken together, these results indicate that PACE4 plays an important role in human breast cancer, and that it might represent a novel target for breast cancer therapy.

Caspase-3 controls AML1-ETO-driven leukemogenesis via autophagy modulation in a ULK1-dependent manner.

PubMed

Man, Na; Tan, Yurong; Sun, Xiao-Jian; Liu, Fan; Cheng, Guoyan; Greenblatt, Sarah M; Martinez, Camilo; Karl, Daniel L; Ando, Koji; Sun, Ming; Hou, Dan; Chen, Bingyi; Xu, Mingjiang; Yang, Feng-Chun; Chen, Zhu; Chen, Saijuan; Nimer, Stephen D; Wang, Lan

2017-05-18

AML1-ETO (AE), a fusion oncoprotein generated by t(8;21), can trigger acute myeloid leukemia (AML) in collaboration with mutations including c-Kit, ASXL1/2, FLT3, N-RAS, and K-RAS. Caspase-3, a key executor among its family, plays multiple roles in cellular processes, including hematopoietic development and leukemia progression. Caspase-3 was revealed to directly cleave AE in vitro, suggesting that AE may accumulate in a Caspase-3-compromised background and thereby accelerate leukemogenesis. Therefore, we developed a Caspase-3 knockout genetic mouse model of AML and found that loss of Caspase-3 actually delayed AML1-ETO9a (AE9a)-driven leukemogenesis, indicating that Caspase-3 may play distinct roles in the initiation and/or progression of AML. We report here that loss of Caspase-3 triggers a conserved, adaptive mechanism, namely autophagy (or macroautophagy), which acts to limit AE9a-driven leukemia. Furthermore, we identify ULK1 as a novel substrate of Caspase-3 and show that upregulation of ULK1 drives autophagy initiation in leukemia cells and that inhibition of ULK1 can rescue the phenotype induced by Caspase-3 deletion in vitro and in vivo. Collectively, these data highlight Caspase-3 as an important regulator of autophagy in AML and demonstrate that the balance and selectivity between its substrates can dictate the pace of disease. © 2017 by The American Society of Hematology.

A Novel Interdisciplinary Approach to Socio-Technical Complexity

NASA Astrophysics Data System (ADS)

Bassetti, Chiara

The chapter presents a novel interdisciplinary approach that integrates micro-sociological analysis into computer-vision and pattern-recognition modeling and algorithms, the purpose being to tackle socio-technical complexity at a systemic yet micro-grounded level. The approach is empirically-grounded and both theoretically- and analytically-driven, yet systemic and multidimensional, semi-supervised and computable, and oriented towards large scale applications. The chapter describes the proposed approach especially as for its sociological foundations, and as applied to the analysis of a particular setting --i.e. sport-spectator crowds. Crowds, better defined as large gatherings, are almost ever-present in our societies, and capturing their dynamics is crucial. From social sciences to public safety management and emergency response, modeling and predicting large gatherings' presence and dynamics, thus possibly preventing critical situations and being able to properly react to them, is fundamental. This is where semi/automated technologies can make the difference. The work presented in this chapter is intended as a scientific step towards such an objective.

Recommendations for pacemaker implantation for the treatment of atrial tachyarrhythmias and resynchronisation therapy for heart failure: A report from the task force on pacemaker indications of the Dutch Working Group on Cardiac Pacing.

PubMed

van Hemel, N M; Dijkman, B; de Voogt, W G; Beukema, W P; Bosker, H A; de Cock, C C; Jordaens, L J L M; van Gelder, I C; van Gelder, L M; van Mechelen, R; Ruiter, J H; Sedney, M I; Slegers, L C

2004-01-01

Today, new pacing algorithms and stimulation methods for the prevention and interruption of atrial tachyarrhythmias can be applied on patients who need bradycardia pacing for conventional reasons. In addition, biventricular pacing as additive treatment for patients with severe congestive heart failure due to ventricular systolic dysfunction and prolonged intraventricular conduction has shown to improve symptoms and reduce hospital admissions. These new pacing technologies and the optimising of the pacing programmes are complex, expensive and time-consuming. Based on many clinical studies the indications for these devices are beginning to emerge. To support the cardiologist's decision-making and to prevent waste of effort and resources, the 'ad hoc committee' has provided preliminary recommendations for implantable devices to treat atrial tachyarrhythmias and to extend the treatment of congestive heart failure respectively.

The Dynamics of the Mississippi River Plume: Impact of Topography, Wind and Offshore Forcing on the Fate of Plume Waters

DTIC Science & Technology

2011-06-30

aspects of the oceanography of the Gulf of Mexico using satellite and in situ data , J. Geophys. Res., 84, 7749–7768, doi:10.1029/ JC084iC12p07749. Walker, N...nested in a data ‐assimilative regional Gulf of Mexico HYCOM model) reveals that the offshore removal is a frequent plume pathway. Eastward wind‐driven...estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data

The 'CommTech' Methodology: A Demand-Driven Approach to Efficient, Productive and Measurable Technology Transfer

NASA Technical Reports Server (NTRS)

Horsham, Gray A. P.

1998-01-01

Market research sources were used to initially gather primary technological problems and needs data from non-aerospace companies in targeted industry sectors. The company-supplied information served as input data to activate or start-up an internal, phased match-making process. This process was based on technical-level relationship exploration followed by business-level agreement negotiations, and culminated with project management and execution. Space Act Agreements represented near-term outputs. Company product or process commercialization derived from Lewis support and measurable economic effects represented far-term outputs.

Model driven mobile care for patients with type 1 diabetes.

PubMed

Skrøvseth, Stein Olav; Arsand, Eirik; Godtliebsen, Fred; Joakimsen, Ragnar M

2012-01-01

We gathered a data set from 30 patients with type 1 diabetes by giving the patients a mobile phone application, where they recorded blood glucose measurements, insulin injections, meals, and physical activity. Using these data as a learning data set, we describe a new approach of building a mobile feedback system for these patients based on periodicities, pattern recognition, and scale-space trends. Most patients have important patterns for periodicities and trends, though better resolution of input variables is needed to provide useful feedback using pattern recognition.

Engagement of Metal Debris into a Gear Mesh

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Krantz, Timothy L.

2010-01-01

A series of bench top experiments was conducted to determine the effects of metallic debris being dragged through meshing gear teeth. A test rig that is typically used to conduct contact fatigue experiments was used for these tests. Several sizes of drill material, shim stock, and pieces of gear teeth were introduced and then driven through the meshing region. The level of torque required to drive the "chip" through the gear mesh was measured. From the data gathered, chip size sufficient to jam the mechanism can be determined.

Emergent Structural Mechanisms for High-Density Collective Motion Inspired by Human Crowds

NASA Astrophysics Data System (ADS)

Bottinelli, Arianna; Sumpter, David T. J.; Silverberg, Jesse L.

2016-11-01

Collective motion of large human crowds often depends on their density. In extreme cases like heavy metal concerts and black Friday sales events, motion is dominated by physical interactions instead of conventional social norms. Here, we study an active matter model inspired by situations when large groups of people gather at a point of common interest. Our analysis takes an approach developed for jammed granular media and identifies Goldstone modes, soft spots, and stochastic resonance as structurally driven mechanisms for potentially dangerous emergent collective motion.

Loss of pace capture on the ablation line: a new marker for complete radiofrequency lesions to achieve pulmonary vein isolation.

PubMed

Steven, Daniel; Reddy, Vivek Y; Inada, Keiichi; Roberts-Thomson, Kurt C; Seiler, Jens; Stevenson, William G; Michaud, Gregory F

2010-03-01

Catheter ablation procedures for atrial fibrillation (AF) often involve circumferential antral isolation of pulmonary veins (PV). Inability to reliably identify conduction gaps on the ablation line necessitates placing additional lesions within the intended lesion set. This pilot study investigated the relationship between loss of pace capture directly along the ablation line and electrogram criteria for PV isolation (PVI). Using a 3-dimensional anatomic mapping system and irrigated-tip radiofrequency (RF) ablation catheter, lesions were placed in the PV antra to encircle ipsilateral vein pairs until pace capture at 10 mA/2 ms no longer occurred along the line. During ablation, a circular mapping catheter was placed in an ipsilateral PV, but the electrograms were not revealed until loss-of-pace capture. The procedural end point was PVI (entrance and exit block). Thirty patients (57 +/- 12 years; 15 male [50%]) undergoing PVI in 2 centers (3 primary operators) were included (left atrial diameter 40 +/- 4 mm, left ventricular ejection fraction 60 +/- 7%). All patients reached the end points of complete PVI and loss of pace capture. When PV electrograms were revealed after loss of pace capture along the line, PVI was present in 57 of 60 (95%) vein pairs. In the remaining 3 of 60 (5%) PV pairs, further RF applications achieved PVI. The procedure duration was 237 +/- 46 minutes, with a fluoroscopy time of 23 +/- 9 minutes. Analysis of the blinded PV electrograms revealed that even after PVI was achieved, additional sites of pace capture were present on the ablation line in 30 of 60 (50%) of the PV pairs; 10 +/- 4 additional RF lesions were necessary to fully achieve loss of pace capture. After ablation, the electrogram amplitude was lower at unexcitable sites (0.25 +/- 0.15 mV vs. 0.42 +/- 0.32 mV, P < .001), but there was substantial overlap with pace capture sites, suggesting that electrogram amplitude lacks specificity for identifying pace capture sites. Complete loss of pace capture directly along the circumferential ablation line correlates with entrance block in 95% of vein pairs and can be achieved without circular mapping catheter guidance. Thus, pace capture along the ablation line can be used to identify conduction gaps. Interestingly, more RF ablation energy was required to achieve loss of pace capture along the ablation line than for entrance block into PVs. Further study is warranted to determine whether this method results in more durable ablation lesions that reduce recurrence of AF. Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Optogenetic pacing in Drosophila melanogaster (Conference Presentation)

NASA Astrophysics Data System (ADS)

Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

2016-03-01

A non-invasive, contact-less cardiac pacing technology can be a powerful tool in basic cardiac research and in clinics. Currently, electrical pacing is the gold standard for cardiac pacing. Although highly effective in controlling the cardiac function, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its capabilities. Optical pacing of heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids shortcomings in electrical stimulation. Optical coherence tomography has been proved to be an effective technique in non-invasive imaging in vivo with ultrahigh resolution and imaging speed. In the last several years, non-invasive specific optical pacing in animal hearts has been reported in quail, zebrafish, and rabbit models. However， Drosophila Melanogaster, which is a significant model with orthologs of 75% of human disease genes, has rarely been studied concerning their optical pacing in heart. Here, we combined optogenetic control of Drosophila heartbeat with optical coherence microscopy (OCM) technique for the first time. The light-gated cation channel, channelrhodopsin-2 (ChR2) was specifically expressed by transgene as a pacemaker in drosophila heart. By stimulating the pacemaker with 472 nm pulsed laser light at different frequencies, we achieved non-invasive and more specific optical control of the Drosophila heart rhythm, which demonstrates the wide potential of optical pacing for studying cardiac dynamics and development. Imaging capability of our customized OCM system was also involved to observe the pacing effect visually. No tissue damage was found after long exposure to laser pulses, which proved the safety of optogenetic control of Drosophila heart.

Pacing-induced chronic atrial fibrillation impairs sinus node function in dogs. Electrophysiological remodeling.

PubMed

Elvan, A; Wylie, K; Zipes, D P

1996-12-01

We assessed the effects of pacing-induced chronic atrial fibrillation (AF) on sinus node function, intra-atrial conduction, and atrial refractoriness. In 15 mongrel dogs (20 to 30 kg), AV nodal block was produced by radiofrequency catheter ablation, and a ventricular-inhibited (VVI) pacemaker (Minix 8330, Medtronic) was implanted and programmed to pace at 80 pulses per minute. In 11 of these dogs, right atrial endocardial pacing leads were connected to a pulse generator (Itrel 7432, Medtronic) and set at a rate of 20 Hz to induce AF. Corrected sinus node recovery time, P-wave duration, 24-hour Holter ECG to assess AF duration, maximal heart rate in response to isoproterenol (10 micrograms/min), intrinsic heart rate after administration of atropine (0.04 mg/kg) and propranolol (0.1 mg/kg), and atrial effective refractory periods (ERPs) were obtained at baseline (EPS-1) and after 2 to 6 weeks (EPS-2) of VVI pacing alone (n = 4) or VVI pacing and rapid atrial pacing (n = 11). At EPS-2, corrected sinus node recovery time and P-wave duration were prolonged, maximal heart rate and intrinsic heart rate were decreased, atrial ERPs were shortened, and the duration of AF was increased significantly compared with EPS-1. These changes partially reversed toward baseline 1 week after conversion to sinus rhythm. Sinus node function and AF inducibility observed in the control dogs that underwent ventricular pacing alone (n = 4) did not change. Pacing-induced chronic AF induces sinus node dysfunction, prolongs intra-atrial conduction time, shortens atrial refractoriness, and perpetuates AF, changes that reverse gradually after termination of AF.

Pacing: A concept analysis of a chronic pain intervention

PubMed Central

Jamieson-Lega, Kathryn; Berry, Robyn; Brown, Cary A

2013-01-01

BACKGROUND: The intervention of pacing is regularly recommended for chronic pain patients. However, pacing is poorly defined and appears to be interpreted in varying, potentially contradictory manners within the field of chronic pain. This conceptual lack of clarity has implications for effective service delivery and for researchers’ ability to conduct rigorous study. An examination of the background literature demonstrates that while pacing is often one part of a multidisciplinary pain management program, outcome research is hindered by a lack of a clear and shared definition of this currently ill-defined construct. OBJECTIVES: To conduct a formal concept analysis of the term ‘pacing’. METHODS: A standardized concept analysis process (including literature scoping to identify all uses of the concept, analysis to determine defining attributes of the concept and identification of model, borderline and contrary cases) was used to determine what the concept of pacing does and does not represent within the current evidence base. RESULTS: A conceptual model including the core attributes of action, time, balance, learning and self-management emerged. From these attributes, an evidence-based definition for pacing was composed and distributed to stakeholders for review. After consideration of stakeholder feedback, the emergent definition of pacing was finalized as follows: “Pacing is an active self-management strategy whereby individuals learn to balance time spent on activity and rest for the purpose of achieving increased function and participation in meaningful activities”. CONCLUSION: The findings of the present concept analysis will help to standardize the use and definition of the term pacing across disciplines for the purposes of both pain management and research. PMID:23717825

Determination of the optimal atrioventricular interval in sick sinus syndrome during DDD pacing.

PubMed

Kato, Masaya; Dote, Keigo; Sasaki, Shota; Goto, Kenji; Takemoto, Hiroaki; Habara, Seiji; Hasegawa, Daiji; Matsuda, Osamu

2005-09-01

Although the AAI pacing mode has been shown to be electromechanically superior to the DDD pacing mode in sick sinus syndrome (SSS), there is evidence suggesting that during AAI pacing the presence of natural ventricular activation pattern is not enough for hemodynamic benefit to occur. Myocardial performance index (MPI) is a simply measurable Doppler-derived index of combined systolic and diastolic myocardial performance. The aim of this study was to investigate whether AAI pacing mode is electromechanically superior to the DDD mode in patients with SSS by using Doppler-derived MPI. Thirty-nine SSS patients with dual-chamber pacing devices were evaluated by using Doppler echocardiography in AAI mode and DDD mode. The optimal atrioventricular (AV) interval in DDD mode was determined and atrial stimulus-R interval was measured in AAI mode. The ratio of the atrial stimulus-R interval to the optimal AV interval was defined as relative AV interval (rAVI) and the ratio of MPI in AAI mode to that in DDD mode was defined as relative MPI (rMPI). The rMPI was significantly correlated with atrial stimulus-R interval and rAVI (r = 0.57, P = 0.0002, and r = 0.67, P < 0.0001, respectively). A cutoff point of 1.73 for rAVI provided optimum sensitivity and specificity for rMPI >1 based on the receiver operator curves. Even though the intrinsic AV conduction is moderately prolonged, some SSS patients with dual-chamber pacing devices benefit from the ventricular pacing with optimal AV interval. MPI is useful to determine the optimal pacing mode in acute experiment.

The role of pCO2 in astronomically-paced climate and carbon cycle variations in the Middle Miocene

NASA Astrophysics Data System (ADS)

Penman, D. E.; Hull, P. M.; Scher, H.; Kirtland Turner, S.; Ridgwell, A.

2017-12-01

The pace of Earth's background climate variability is known to be driven by the Milankovitch cycles, variations in Earth's orbital parameters and axial tilt. While the Milankovitch (orbital) theory of climate change is very nearly universally accepted, the climate system mechanisms and feedbacks responsible for amplifying orbital cycles preserved in the geologic record remain uncertain. For the late Pleistocene, the ice core-derived record of atmospheric carbon dioxide (pCO2) is strongly coupled with global temperature on orbital time scales, indicating that internal feedbacks involving the carbon cycle amplify or even cause the large changes in global temperature during orbitally driven glacial-interglacial cycles. However, for earlier time periods beyond the range of ice cores (the last 800 kyr), it is not possible to directly compare records of pCO2 to orbital climate cycles because there are no high-resolution (orbitally resolved) records of pCO2 before the Pliocene. We address this deficiency with a high-resolution ( 5-10 kyr spacing) record of planktonic foraminiferal d11B-derived surface seawater pH (as well as d13C and trace metal analyses) over a 500 kyr time window in a sedimentary record with known Milankovitch-scale climate and carbon cycle oscillations: the Middle Miocene (14.0 - 14.5 Ma) at ODP Site 926 (subtropical North Atlantic). The resulting pH record can be used to constrain atmospheric pCO2, allowing comparison of the timescale and magnitude of carbon cycle changes during a period of eccentricity-dominated variability in the response of the global climate system (the Late Pleistocene) with a period of obliquity-dominance (the middle Miocene). These new records of planktic d11B and d13C will then be used to guide simulations of astronomical climate forcing in Earth System models, resulting in refined estimates of pCO2 changes over orbital cycles and providing quantitative constraints on the mechanisms and feedbacks responsible for the Milankovitch control of climate and carbon cycling.

Pace Speaks Across America - February 21 2007 - U.S. Department of Defense

Science.gov Websites

Washington State, Oregon, Alaska and Florida. Pace Discusses Force Levels, Military Challenges WASHINGTON Iraq, force levels or tour lengths, Marine Gen. Peter Pace is eager to answer frankly and completely

Right heart failure due to loss of right ventricular capture in a patient with atrioventricular junction ablation and biventricular pacing.

PubMed

Raffa, Santi; Fantoni, Cecilia; Restauri, Luigia; Auricchio, Angelo

2005-10-01

We describe the case of a patient with atrioventricular (AV) junction ablation and chronic biventricular pacing in which intermittent dysfunction of the right ventricular (RV) lead resulted in left ventricular (LV) stimulation alone and onset of severe right heart failure. Restoration of biventricular pacing by increasing device output and then performing lead revision resolved the issue. This case provides evidence that LV pacing alone in patients with AV junction ablation may lead to severe right heart failure, most likely as a result of iatrogenic mechanical dyssynchrony within the RV. Thus, probably this pacing mode should be avoided in pacemaker-dependent patients with heart failure.

The Challenge of City-Level Data-Gathering for Implementing SDG 11 in Africa

NASA Astrophysics Data System (ADS)

Elias, P. O.

2017-12-01

Implementing sustainable development goal 11 in Africa which includes measuring and monitoring social and economic welfare indicators at the city-level requires data of the best quality. In recent years, there have been progress in national statistics and censuses survey yet data gathering in many African countries are not accurate, timely, disaggregated and widely usable. This often diminish the capability of governments to tackle urban development challenges, which are particularly exacerbated by inequality, poverty and uncontrolled development especially in cities. To support knowledge driven decisions and policies there is need to improve data-gathering systems about health, education, and safety, economy and poverty, land, housing and environment, trade and commerce, population and demography. Also, the underlying dynamics, processes, distributions, patterns, trends or disparities inherent in African cities require the breaking down of aggregated data into their component parts or smaller units, which underscores urban data revolution towards achieving SDG 11. In Africa, the process of bringing together diverse data communities to embrace a diverse range of data sources, tools, and innovative technologies, to provide disaggregated data for decision-making, service delivery and citizen engagement is still emerging. Several factors are inhibiting urban data revolution and need to be overturned before we can provide more evidence, more data and more certainty for decision makers towards achieving urban development targets and sustainable cities for Africa. The paper examines the challenge of city-level data-gathering for implementing SDG 11 in Africa. Specifically, it examines the role of cities in implementing SDG 11 in Africa and the need to disaggregate data at city-level; it assesses existing data sources, compilation and dissemination channels as well as the challenges of deploying innovative techniques and strategies including digital and social media platforms and concludes with suggesting sustainable options for evolving cutting-edge strategies for integrating diverse data communities for responsible city-level data-gathering that is reliable, timely, disaggregated and widely usable.

Non-invasive red light optogenetic pacing and optical coherence microscopy (OCM) imaging for drosophila melanogaster (Conference Presentation)

NASA Astrophysics Data System (ADS)

Men, Jing; Li, Airong; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

2017-02-01

Cardiac pacing could be a powerful tool for investigating mammalian cardiac electrical conduction systems as well as for treatment of certain cardiac pathologies. However, traditional electrical pacing using pacemaker requires an invasive surgical procedure. Electrical currents from the implanted electrodes can also cause damage to heart tissue, further restricting its utility. Optogenetic pacing has been developed as a promising, non-invasive alternative to electrical stimulation for controlling animal heart rhythms. It induces heart contractions by shining pulsed light on transgene-generated microbial opsins, which in turn activate the light gated ion channels in animal hearts. However, commonly used opsins in optogenetic pacing, such as channelrhodopsin-2 (ChR2), require short light wavelength stimulation (475 nm), which is strongly absorbed and scattered by tissue. Here, we performed optogenetic pacing by expression of recently engineered red-shifted microbial opsins, ReaChR and CsChrimson, in a well-established animal model, Drosophila melanogaster, using the 617 nm stimulation light pulses. The OCM technique enables non-invasive optical imaging of animal hearts with high speed and ultrahigh axial and transverse resolutions. We integrated a customized OCM system with the optical stimulation system to monitor the optogenetic pacing noninvasively. The use of red-sifted opsins enabled deeper penetration of simulating light at lower power, which is promising for applications of optogenetic pacing in mammalian cardiac pathology studies or clinical treatments in the future.

[Clinical experiences with four newly developed, surface modified stimulation electrodes].

PubMed

Winter, U J; Fritsch, J; Liebing, J; Höpp, H W; Hilger, H H

1993-05-01

Newly developed pacing electrodes with so-called porous surfaces promise a significantly improved post-operative pacing and sensing threshold. We therefore investigated four newly developed leads (ELA-PMCF-860 n = 10; Biotronik-60/4-DNP n = 10, CPI-4010 n = 10, Intermedics-421-03-Biopore n = 6) connected to two different pacing devices (Intermedics NOVA II, Medtronic PASYS) in 36 patients (18 men, 18 women, age: 69.7 +/- 9.8 years) suffering from symptomatic bradycardia. The individual electrode maturation process was investigated by means of repeated measurements of pacing threshold, electrode impedance in acute, subacute, and chronic phase, as well as energy consumption and sensing behavior in the chronic phase. However, with the exception of the 4010, the investigated leads showed largely varying values of the pacing threshold with individual peaks occurring from the second up to the 13th week. All leads had nearly similar chronic pacing thresholds (PMCF 0.13 +/- 0.07; DNP 0.25 +/- 0.18; Biopore 0.15 +/- 0.05; 4010 0.14 +/- 0.05 ms). Impedance measurements revealed higher, but not significantly different values for the DNP (PMCF 582 +/- 112, DNP 755 +/- 88, Biopore 650 +/- 15, 4010 718 +/- 104 Ohm). Despite differing values for pacing threshold and impedance, the energy consumption in the chronic phase during threshold-adapted, but secure stimulation (3 * impulse-width at pacing threshold) were comparable.

Staying Connected on the Road: A Comparison of Different Types of Smart Phone Use in a Driving Simulator

PubMed Central

McNabb, Jaimie; Gray, Rob

2016-01-01

Previous research on smart phone use while driving has primarily focused on phone calls and texting. Drivers are now increasingly using their phone for other activities during driving, in particular social media, which have different cognitive demands. The present study compared the effects of four different smart phone tasks on car-following performance in a driving simulator. Phone tasks were chosen that vary across two factors: interaction medium (text vs image) and task pacing (self-paced vs experimenter-paced) and were as follows: Text messaging with the experimenter (text/other-paced), reading Facebook posts (text/self-paced), exchanging photos with the experimenter via Snapchat (image, experimenter -paced), and viewing updates on Instagram (image, experimenter -paced). Drivers also performed a driving only baseline. Brake reaction times (BRTs) were significantly greater in the text-based conditions (Mean = 1.16 s) as compared to both the image-based conditions (Mean = 0.92 s) and the baseline (0.88 s). There was no significant difference between BRTs in the image-based and baseline conditions and there was no significant effect of task-pacing. Similar results were obtained for Time Headway variability. These results are consistent with the picture superiority effect found in memory research and suggest that image-based interfaces could provide safer ways to “stay connected” while driving than text-based interfaces. PMID:26886099

Antiarrhythmic properties of atrial pacing.

PubMed

Kliś, Magdalena; Sławuta, Agnieszka; Gajek, Jacek

2017-01-01

Bradycardia, atrial stretch and dilatation, autonomic nervous system disorders, and the presence of triggers such as atrial premature contractions, are factors which predispose a person to paroxysmal AF. Atrial pacing not only eliminates bradycardia but also prevents atrial premature contractions and dispersion of refractoriness, which are a substrate for atrial fibrillation. As the prolonged duration of atrial activation during pacing, especially from locations changing the physiological pattern of this activation (right atrium lateral wall, right atrium appendage), negatively influences both a mechanical and an electrical function of the atria, the atrial pacing site affects an atrial arrhythmogenesis. A conventional atrial lead location in the right atrium appendage causes non-physiological activation propagation, resulting in a prolongation of the activation time of both atria. This location is optimal according to a passive fixation of the atrial lead but the available contemporary active fixation leads could potentially be located in any area of the atrium. There is growing evidence of the benefit of pacing, imitating the physiological propagation of impulses within the atria. It seems that the Bachmann's bundle pacing is the best pacing site within the atria, not only positively influencing the atrial mechanical function but also best fulfilling the so-called atrial resynchronization function, in particular in patients with interatrial conduction delay. It can be effectively achieved using only one atrial electrode, and the slight shortening of atrioventricular conduction provides an additional benefit of this atrial pacing site.

Interaction between spiral and paced waves in cardiac tissue

PubMed Central

Agladze, Konstantin; Kay, Matthew W.; Krinsky, Valentin; Sarvazyan, Narine

2010-01-01

For prevention of lethal arrhythmias, patients at risk receive implantable cardioverter-defibrillators, which use high-frequency antitachycardia pacing (ATP) to convert tachycardias to a normal rhythm. One of the suggested ATP mechanisms involves paced-induced drift of rotating waves followed by their collision with the boundary of excitable tissue. This study provides direct experimental evidence of this mechanism. In monolayers of neonatal rat cardiomyocytes in which rotating waves of activity were initiated by premature stimuli, we used the Ca2+-sensitive indicator fluo 4 to observe propagating wave patterns. The interaction of the spiral tip with a paced wave was then monitored at a high spatial resolution. In the course of the experiments, we observed spiral wave pinning to local heterogeneities within the myocyte layer. High-frequency pacing led, in a majority of cases, to successful termination of spiral activity. Our data show that 1) stable spiral waves in cardiac monolayers tend to be pinned to local heterogeneities or areas of altered conduction, 2) overdrive pacing can shift a rotating wave from its original site, and 3) the wave break, formed as a result of interaction between the spiral tip and a paced wave front, moves by a paced-induced drift mechanism to an area where it may become unstable or collide with a boundary. The data were complemented by numerical simulations, which was used to further analyze experimentally observed behavior. PMID:17384124

Staying Connected on the Road: A Comparison of Different Types of Smart Phone Use in a Driving Simulator.

PubMed

McNabb, Jaimie; Gray, Rob

2016-01-01

Previous research on smart phone use while driving has primarily focused on phone calls and texting. Drivers are now increasingly using their phone for other activities during driving, in particular social media, which have different cognitive demands. The present study compared the effects of four different smart phone tasks on car-following performance in a driving simulator. Phone tasks were chosen that vary across two factors: interaction medium (text vs image) and task pacing (self-paced vs experimenter-paced) and were as follows: Text messaging with the experimenter (text/other-paced), reading Facebook posts (text/self-paced), exchanging photos with the experimenter via Snapchat (image, experimenter-paced), and viewing updates on Instagram (image, experimenter-paced). Drivers also performed a driving only baseline. Brake reaction times (BRTs) were significantly greater in the text-based conditions (Mean = 1.16 s) as compared to both the image-based conditions (Mean = 0.92 s) and the baseline (0.88 s). There was no significant difference between BRTs in the image-based and baseline conditions and there was no significant effect of task-pacing. Similar results were obtained for Time Headway variability. These results are consistent with the picture superiority effect found in memory research and suggest that image-based interfaces could provide safer ways to "stay connected" while driving than text-based interfaces.

42 CFR 460.76 - Transportation services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Transportation services. 460.76 Section 460.76... ELDERLY (PACE) PACE Administrative Requirements § 460.76 Transportation services. (a) Safety, accessibility, and equipment. A PACE organization's transportation services must be safe, accessible, and...

42 CFR 460.76 - Transportation services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Transportation services. 460.76 Section 460.76... ELDERLY (PACE) PACE Administrative Requirements § 460.76 Transportation services. (a) Safety, accessibility, and equipment. A PACE organization's transportation services must be safe, accessible, and...

42 CFR 460.76 - Transportation services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Transportation services. 460.76 Section 460.76... ELDERLY (PACE) PACE Administrative Requirements § 460.76 Transportation services. (a) Safety, accessibility, and equipment. A PACE organization's transportation services must be safe, accessible, and...

Merits and limitations of the mode switching rate stabilization pacing algorithms in the implantable cardioverter defibrillator.

PubMed

Dijkman, B; Wellens, H J

2001-09-01

The 7250 Jewel AF Medtronic model of ICD is the first implantable device in which both therapies for atrial arrhythmias and pacing algorithms for atrial arrhythmia prevention are available. Feasibility of that extensive atrial arrhythmia management requires correct and synergic functioning of different algorithms to control arrhythmias. The ability of the new pacing algorithms to stabilize the atrial rate following termination of treated atrial arrhythmias was evaluated in the marker channel registration of 600 spontaneously occurring episodes in 15 patients with the Jewel AF. All patients (55+/-15 years) had structural heart disease and documented atrial and ventricular arrhythmias. Dual chamber rate stabilization pacing was present in 245 (41 %) of episodes following arrhythmia termination and was a part of the mode switching operation during which pacing was provided in the dynamic DDI mode. This algorithm could function as the atrial rate stabilization pacing only when there was a slow spontaneous atrial rhythm or in presence of atrial premature beats conducted to the ventricles with a normal AV time. In case of atrial premature beats with delayed or absent conduction to the ventricles and in case of ventricular premature beats, the algorithm stabilized the ventricular rate. The rate stabilization pacing in DDI mode during sinus rhythm following atrial arrhythmia termination was often extended in time due to the device-based definition of arrhythmia termination. This was also the case in patients, in whom the DDD mode with true atrial rate stabilization algorithm was programmed. The rate stabilization algorithms in the Jewel AF applied after atrial arrhythmia termination provide pacing that is not based on the timing of atrial events. Only under certain circumstances the algorithm can function as atrial rate stabilization pacing. Adjustments in availability and functioning of the rate stabilization algorithms might be of benefit for the clinical performance of pacing as part of device therapy for atrial arrhythmias.

Effect of right ventricular pacing lead site on left ventricular function in patients with high-grade atrioventricular block: results of the Protect-Pace study.

PubMed

Kaye, Gerald C; Linker, Nicholas J; Marwick, Thomas H; Pollock, Lucy; Graham, Laura; Pouliot, Erika; Poloniecki, Jan; Gammage, Michael

2015-04-07

Chronic right ventricle (RV) apical (RVA) pacing is standard treatment for an atrioventricular (AV) block but may be deleterious to left ventricle (LV) systolic function. Previous clinical studies of non-apical pacing have produced conflicting results. The aim of this randomized, prospective, international, multicentre trial was to compare change in LV ejection fraction (LVEF) between right ventricular apical and high septal (RVHS) pacing over a 2-year study period. We randomized 240 patients (age 74 ± 11 years, 67% male) with a high-grade AV block requiring >90% ventricular pacing and preserved baseline LVEF >50%, to receive pacing at the RVA (n = 120) or RVHS (n = 120). At 2 years, LVEF decreased in both the RVA (57 ± 9 to 55 ± 9%, P = 0.047) and the RVHS groups (56 ± 10 to 54 ± 10%, P = 0.0003). However, there was no significant difference in intra-patient change in LVEF between confirmed RVA (n = 85) and RVHS (n = 83) lead position (P = 0.43). There were no significant differences in heart failure hospitalization, mortality, the burden of atrial fibrillation, or plasma brain natriutetic peptide levels between the two groups. A significantly greater time was required to place the lead in the RVHS position (70 ± 25 vs. 56 ± 24 min, P < 0.0001) with longer fluoroscopy times (11 ± 7 vs. 5 ± 4 min, P < 0.0001). In patients with a high-grade AV block and preserved LV function requiring a high percentage of ventricular pacing, RVHS pacing does not provide a protective effect on left ventricular function over RVA pacing in the first 2 years. ClinicalTrials.gov number NCT00461734. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Declines in low-elevation subalpine tree populations outpace growth in high-elevation populations with warming

DOE PAGES

Conlisk, Erin; Castanha, Cristina; Germino, Matthew J.; ...

2017-02-08

Species distribution shifts in response to climate change require that recruitment increase beyond current range boundaries. For trees with long life spans, the importance of climate-sensitive seedling establishment to the pace of range shifts has not been demonstrated quantitatively. Using spatially explicit, stochastic population models combined with data from long-term forest surveys, we explored whether the climate-sensitivity of recruitment observed in climate manipulation experiments was sufficient to alter populations and elevation ranges of two widely distributed, high-elevation North American conifers. Empirically observed, warming-driven declines in recruitment led to rapid modelled population declines at the low-elevation, ‘warm edge’ of subalpine forestmore » and slow emergence of populations beyond the high-elevation, ‘cool edge’. Because population declines in the forest occurred much faster than population emergence in the alpine, we observed range contraction for both species. For Engelmann spruce, this contraction was permanent over the modelled time horizon, even in the presence of increased moisture. For limber pine, lower sensitivity to warming may facilitate persistence at low elevations – especially in the presence of increased moisture – and rapid establishment above tree line, and, ultimately, expansion into the alpine. Synthesis. Assuming 21st century warming and no additional moisture, population dynamics in high-elevation forests led to transient range contractions for limber pine and potentially permanent range contractions for Engelmann spruce. Thus, limitations to seedling recruitment with warming can constrain the pace of subalpine tree range shifts.« less

Declines in low-elevation subalpine tree populations outpace growth in high-elevation populations with warming

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

Conlisk, Erin; Castanha, Cristina; Germino, Matthew J.

Species distribution shifts in response to climate change require that recruitment increase beyond current range boundaries. For trees with long life spans, the importance of climate-sensitive seedling establishment to the pace of range shifts has not been demonstrated quantitatively. Using spatially explicit, stochastic population models combined with data from long-term forest surveys, we explored whether the climate-sensitivity of recruitment observed in climate manipulation experiments was sufficient to alter populations and elevation ranges of two widely distributed, high-elevation North American conifers. Empirically observed, warming-driven declines in recruitment led to rapid modelled population declines at the low-elevation, ‘warm edge’ of subalpine forestmore » and slow emergence of populations beyond the high-elevation, ‘cool edge’. Because population declines in the forest occurred much faster than population emergence in the alpine, we observed range contraction for both species. For Engelmann spruce, this contraction was permanent over the modelled time horizon, even in the presence of increased moisture. For limber pine, lower sensitivity to warming may facilitate persistence at low elevations – especially in the presence of increased moisture – and rapid establishment above tree line, and, ultimately, expansion into the alpine. Synthesis. Assuming 21st century warming and no additional moisture, population dynamics in high-elevation forests led to transient range contractions for limber pine and potentially permanent range contractions for Engelmann spruce. Thus, limitations to seedling recruitment with warming can constrain the pace of subalpine tree range shifts.« less

Declines in low-elevation subalpine tree populations outpace growth in high-elevation populations with warming

USGS Publications Warehouse

Conlisk, Erin; Castanha, Cristina; Germino, Matthew J.; Veblen, Thomas T; Smith, Jeremy M.; Kueppers, Lara M.

2017-01-01

Species distribution shifts in response to climate change require that recruitment increase beyond current range boundaries. For trees with long life spans, the importance of climate-sensitive seedling establishment to the pace of range shifts has not been demonstrated quantitatively.Using spatially explicit, stochastic population models combined with data from long-term forest surveys, we explored whether the climate-sensitivity of recruitment observed in climate manipulation experiments was sufficient to alter populations and elevation ranges of two widely distributed, high-elevation North American conifers.Empirically observed, warming-driven declines in recruitment led to rapid modelled population declines at the low-elevation, ‘warm edge’ of subalpine forest and slow emergence of populations beyond the high-elevation, ‘cool edge’. Because population declines in the forest occurred much faster than population emergence in the alpine, we observed range contraction for both species. For Engelmann spruce, this contraction was permanent over the modelled time horizon, even in the presence of increased moisture. For limber pine, lower sensitivity to warming may facilitate persistence at low elevations – especially in the presence of increased moisture – and rapid establishment above tree line, and, ultimately, expansion into the alpine.Synthesis. Assuming 21st century warming and no additional moisture, population dynamics in high-elevation forests led to transient range contractions for limber pine and potentially permanent range contractions for Engelmann spruce. Thus, limitations to seedling recruitment with warming can constrain the pace of subalpine tree range shifts.

A Pilot Study on the Effects of Slow Paced Breathing on Current Food Craving.

PubMed

Meule, Adrian; Kübler, Andrea

2017-03-01

Heart rate variability biofeedback (HRV-BF) involves slow paced breathing (approximately six breaths per minute), thereby maximizing low-frequent heart rate oscillations and baroreflex gain. Mounting evidence suggests that HRV-BF promotes symptom reductions in a variety of physical and mental disorders. It may also positively affect eating behavior by reducing food cravings. The aim of the current study was to investigate if slow paced breathing can be useful for attenuating momentary food craving. Female students performed paced breathing either at six breaths per minute (n = 32) or at nine breaths per minute (n = 33) while watching their favorite food on the computer screen. Current food craving decreased during a first resting period, increased during paced breathing, and decreased during a second resting period in both conditions. Although current hunger increased in both conditions during paced breathing as well, it remained elevated after the second resting period in the nine breaths condition only. Thus, breathing rate did not influence specific food craving, but slow paced breathing appeared to have a delayed influence on state hunger. Future avenues are suggested for the study of HRV-BF in the context of eating behavior.

Optogenetic pacing in Drosophila melanogaster

PubMed Central

Alex, Aneesh; Li, Airong; Tanzi, Rudolph E.; Zhou, Chao

2015-01-01

Electrical stimulation is currently the gold standard for cardiac pacing. However, it is invasive and nonspecific for cardiac tissues. We recently developed a noninvasive cardiac pacing technique using optogenetic tools, which are widely used in neuroscience. Optogenetic pacing of the heart provides high spatial and temporal precisions, is specific for cardiac tissues, avoids artifacts associated with electrical stimulation, and therefore promises to be a powerful tool in basic cardiac research. We demonstrated optogenetic control of heart rhythm in a well-established model organism, Drosophila melanogaster. We developed transgenic flies expressing a light-gated cation channel, channelrhodopsin-2 (ChR2), specifically in their hearts and demonstrated successful optogenetic pacing of ChR2-expressing Drosophila at different developmental stages, including the larva, pupa, and adult stages. A high-speed and ultrahigh-resolution optical coherence microscopy imaging system that is capable of providing images at a rate of 130 frames/s with axial and transverse resolutions of 1.5 and 3.9 μm, respectively, was used to noninvasively monitor Drosophila cardiac function and its response to pacing stimulation. The development of a noninvasive integrated optical pacing and imaging system provides a novel platform for performing research studies in developmental cardiology. PMID:26601299

Heart rate autonomic regulation system at rest and during paced breathing among patients with CRPS as compared to age-matched healthy controls.

PubMed

Bartur, Gadi; Vatine, Jean-Jacques; Raphaely-Beer, Noa; Peleg, Sara; Katz-Leurer, Michal

2014-09-01

The objective of this study is to assess the autonomic nerve heart rate regulation system at rest and its immediate response to paced breathing among patients with complex regional pain syndrome (CRPS) as compared with age-matched healthy controls. Quasiexperimental. Outpatient clinic. Ten patients with CRPS and 10 age- and sex-matched controls. Participants underwent Holter ECG (NorthEast Monitoring, Inc., Maynard, MA, USA) recording during rest and biofeedback-paced breathing session. Heart rate variability (HRV), time, and frequency measures were assessed. HRV and time domain values were significantly lower at rest among patients with CRPS as compared with controls. A significant association was noted between pain rank and HRV frequency measures at rest and during paced breathing; although both groups reduced breathing rate significantly during paced breathing, HRV time domain parameters increased only among the control group. The increased heart rate and decreased HRV at rest in patients with CRPS suggest a general autonomic imbalance. The inability of the patients to increase HRV time domain values during paced breathing may suggest that these patients have sustained stress response with minimal changeability in response to slow-paced breathing stimuli. Wiley Periodicals, Inc.

Positive pacing in elite IRONMAN triathletes.

PubMed

Angehrn, Nicole; Rüst, Christoph A.; Nikolaidis, Pantelis T.; Rosemann, Thomas; Knechtle, Beat

2016-12-31

Pacing is known to influence athletic performance. For the Ironman triathlon program, a positive pacing strategy, i.e., the continuous decrease of speed over time was recommended. By analyzing split times, we assessed the pacing strategies of the top 100 finishers of the cycling part of 13 Ironman races and of the running part of 11 Ironman races taking place in 2014. Furthermore, sex-associated differences in performance and pacing strategies were calculated. We analyzed 7,687 cycling and 11,894 running split times of 1,392 triathletes (1,263 men, 129 women). Changes in speed were assessed using mixed-effects regression analyses. A continuous decrease in speed was observed during cycling in 10/13 races, and during running in 11/11 races. In 6/13 races, women decreased their speed during cycling significantly more than men. The running part showed no significant difference of changes in speed between the sexes. In summary, in the Ironman races evaluated, a positive pacing strategy was adopted in most races. Women were slower than men in 6/13 cycling races, but there was no difference between men and women in the run splits. Women used the same pacing strategy as men.

Towards PACE Atmospheric Correction, Aerosol and Cloud Products: Making Use of Expanded Spectral, Angular and Polarimetric Information.

NASA Astrophysics Data System (ADS)

Remer, L. A.; Boss, E.; Ahmad, Z.; Cairns, B.; Chowdhary, J.; Coddington, O.; Davis, A. B.; Dierssen, H. M.; Diner, D. J.; Franz, B. A.; Frouin, R.; Gao, B. C.; Garay, M. J.; Heidinger, A.; Ibrahim, A.; Kalashnikova, O. V.; Knobelspiesse, K. D.; Levy, R. C.; Omar, A. H.; Meyer, K.; Platnick, S. E.; Seidel, F. C.; van Diedenhoven, B.; Werdell, J.; Xu, F.; Zhai, P.; Zhang, Z.

2017-12-01

NASA's Science Team for the Plankton, Aerosol, Clouds, ocean Ecosystem (PACE) mission is concluding three years of study exploring the science potential of expanded spectral, angular and polarization capability for space-based retrievals of water leaving radiance, aerosols and clouds. The work anticipates future development of retrievals to be applied to the PACE Ocean Color Instrument (OCI) and/or possibly a PACE Multi-Angle Polarimeter (MAP). In this presentation we will report on the Science Team's accomplishments associated with the atmosphere (significant efforts are also directed by the ST towards the ocean). Included in the presentation will be sensitivity studies that explore new OCI capabilities for aerosol and cloud layer height, aerosol absorption characterization, cloud property retrievals, and how we intend to move from heritage atmospheric correction algorithms to make use of and adjust to OCI's hyperspectral and UV wavelengths. We will then address how capabilities will improve with the PACE MAP, how these capabilities from both OCI and MAP correspond to specific societal benefits from the PACE mission, and what is still needed to close the gaps in our understanding before the PACE mission can realize its full potential.

Is Self-Paced Instruction Really Worth It?

ERIC Educational Resources Information Center

Roberson, J. A.; Crowe, C. T.

1975-01-01

Describes a self-paced, learning-for-mastery course in undergraduate fluid mechanics. Includes the method of course assessment, method of student evaluation, and a description of the instructor's role and work load. Summarizes aspects of self-paced instruction considered favorable and unfavorable. (GS)

42 CFR 460.76 - Transportation services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.76 Transportation services. (a) Safety... participants. (2) Handling emergency situations. (e) Changes in care plan. As part of the interdisciplinary...

42 CFR 460.76 - Transportation services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.76 Transportation services. (a) Safety... participants. (2) Handling emergency situations. (e) Changes in care plan. As part of the interdisciplinary...

42 CFR 460.62 - Governing body.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE... patient care responsibilities. (5) Fiscal operations. (6) Development of policies on participant health and safety, including a comprehensive, systemic operational plan to ensure the health and safety of...

Notation system and overlay diagrams for the analysis of paced electrocardiograms.

PubMed

Bernstein, A D; Parsonnet, V

1983-01-01

With the advent of adaptive dual-chamber pacing, the interaction between the pacemaker and the heart is becoming increasingly complex and the interpretation of paced electrocardiograms more difficult. We have developed a set of notation conventions for use in teaching and rhythm-strip analysis. Easily-drawn symbols delineate successful, unsuccessful, and inhibited pacing and sensing events as well as refractory and blanking periods. Another application is to generate movable transparent overlays after programming a pacemaker, to be used in interpreting subsequent rhythm strips.

Using left-ventricular-only pacing to eliminate T-wave oversensing in a biventricular implantable cardiac defibrillator.

PubMed

Khoo, Clarence; Bennett, Matthew; Chakrabarti, Santabhanu; LeMaitre, John; Tung, Stanley K K

2013-02-01

A man aged 75 years and with nonischemic cardiomyopathy had implantation of a biventricular implantable cardiac defibrillator (ICD). Consistent biventricular pacing was limited by intermittent T-wave oversensing (TWOS). A strategy of left-ventricular-only pacing was used to eliminate TWOS. This strategy obviates the need to reduce ventricular sensitivity and thus may be an effective alternative to biventricular pacing complicated by TWOS. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Comparison of right ventricular septal pacing and right ventricular apical pacing in patients receiving cardiac resynchronization therapy defibrillators: the SEPTAL CRT Study

PubMed Central

Leclercq, Christophe; Sadoul, Nicolas; Mont, Lluis; Defaye, Pascal; Osca, Joaquim; Mouton, Elisabeth; Isnard, Richard; Habib, Gilbert; Zamorano, Jose; Derumeaux, Genevieve; Fernandez-Lozano, Ignacio; Dupuis, Jean-Marc; Rouleau, Frédéric; Tassin, Aude; Bordachar, Pierre; Clémenty, Jacques; Lafitte, Stephane; Ploux, Sylvan; Reant, Patricia; Ritter, Philippe; Defaye, Pascal; Jacon, Peggy; Mondesert, Blandine; Saunier, Carole; Vautrin, Estelle; Kacet, Salem; Guedon-Moreau, Laurence; Klug, Didier; Kouakam, Claude; Marechaux, Sylvestre; Marquie, Christelle; Polge, Anne Sophie; Richardson, Marjorie; Chevallier, Philippe; De Breyne, Brigitte; Lotek, Marcin M.; Nonin, Emilie; Pineau, Julien; Deharo, Jean-Claude; Bastard, Emilie; Franceschi, Frédéric; Habib, Gilbert; Jego, Christophe; Peyrouse, Eric; Prevot, Sebastien; Saint-Joseph, Hôpital; Bremondy, Michel; Faure, Jacques; Ferracci, Ange; Lefevre, Jean; Pisapia, Andre; Davy, Jean-Marc; Cransac, Frederic; Cung, Tien Tri; Georger, Frederic; Pasquie, Jean-Luc; Raczka, Franck; Sportouch-Dukhan, Catherine; Sadoul, Nicolas; Blangy, Hugues; Bruntz, Jean-François; Freysz, Luc; Groben, Laurent; Huttin, Olivier; Bammert, Antoine; Burban, Marc; Cebron, Jean-Pierre; Gras, Daniel; Frank, Robert; Duthoit, Guillaume; Hidden-Lucet, Françoise; Himbert, Caroline; Isnard, Richard; Lacotte, Jérôme; Pousset, Françoise; Zerah, Thierry; Leclercq, Christophe; Bellouin, Annaïk; Crocq, Christophe; Deplace, Christian; Donal, Erwan; Hamon, Cécile; Mabo, Philippe; Romain, Olivier; Solnon, Aude; Frederic, Anselme; Bauer, Fabrice; Bernard, Mathieu; Godin, Benedicte; Kurtz, Baptiste; Savoure, Arnaud; Copie, Xavier; Lascault, Gilles; Paziaud, Olivier; Piot, Olivier; Touche, Thierry; Delay, Toulouse Marc; Chilon, Talia; Detis, Nicolas; Duparc, Alexandre; Hebrard, Aurélien; Massabuau, Pierre; Maury, Philippe; Mondoly, Pierre; Rumeau, Philippe; Pasteur, Clinique; Boveda, Serge; Adrover, Laurence; Combes, Nicolas; Deplagne, Antoine; Marco-Baertich, Isabelle; Fondard, Olivier; Martínez, Juan Gabriel; Ibañez Criado, José Luis; Ortuño, Diego; Mont, Lluis; Berruezo, Antonio; Eduard, Belu; Martín, Ana; Merschon, Franco M.; Sitges, Marta; Tolosana, José María; Vidal, Bárbara; Hebron, H. Valle; i Mitjans, Angel Moya; Rodriguez, Oscar Alcalde; Rodriguez Palomares, José Fernando; Rivas, Nuria; Teixidó, Gisela; de Hierro, H. Puerta; Lozano, Ignacio Fernández; Ruiz Bautista, Maria Lorena; Castro, Victor; Cavero, Miguel Angel; Gutierrez, Carlos; Ros, Natalia; de la Victoria, H. Virgen; Alzueta Rodriguez, Francisco Javier; Cabrera, Fernando; Cordero, Alberto Barrera; Peña, José Luis; de Valme Sevilla, H.; Gonzáles, Juan Lealdel Ojo; Garcia Medina, Mª Dolores; Jiménez, Ricardo Pavón; Villagomez, David; de la Salud Toledo, H. Virgen; Castellanos Martinez, Eduardo; Alcalá, Juan; Maicas, Carolina; Arias Palomares, Miguel Angel; Puchol, Alberto; Valencia, H. La Fé; OscaAsensi, Joaquim; Carmona, Anastasio Quesada; De Carranza, Mª José Sancho-Tello; De Ros, José Olagüe; Pareja, Enrique Castro; Pérez, Oscar Cano; Saez, Ana Osa; Hortega, H. Rio; Guilarte, Benito Herreros; Muñoz San Jose, Juan Francisco; Pérez Sanz, Teresa Myriam; Logeart, Damien; Gil, Maria Lopez; Leclercq, Christophe; Lozano, Ignacio Fernandez; de Hierro, H. Puerta; Derumeaux, Genevieve

2016-01-01

Abstract Aims Cardiac resynchronization therapy (CRT) is a recommended treatment of heart failure (HF) patients with depressed left ventricular ejection fraction and wide QRS. The optimal right ventricular (RV) lead position being a matter of debate, we sought to examine whether RV septal (RVS) pacing was not inferior to RV apical (RVA) pacing on left ventricular reverse remodelling in patients receiving a CRT-defibrillator. Methods and results Patients (n = 263, age = 63.4 ± 9.5 years) were randomly assigned in a 1:1 ratio to RVS (n = 131) vs. RVA (n = 132) pacing. Left ventricular end-systolic volume (LVESV) reduction between baseline and 6 months was not different between the two groups (−25.3 ± 39.4 mL in RVS group vs. −29.3 ± 44.5 mL in RVA group, P = 0.79). Right ventricular septal pacing was not non-inferior (primary endpoint) to RVA pacing with regard to LVESV reduction (average difference = −4.06 mL; P = 0.006 with a −20 mL non-inferiority margin). The percentage of ‘echo-responders’ defined by LVESV reduction >15% between baseline and 6 months was similar in both groups (50%) with no difference in the time to first HF hospitalization or death (P = 0.532). Procedural or device-related serious adverse events occurred in 68 patients (RVS = 37) with no difference between the two groups (P = 0.401). Conclusion This study demonstrates that septal RV pacing in CRT is non-inferior to apical RV pacing for LV reverse remodelling at 6 months with no difference in the clinical outcome. No recommendation for optimal RV lead position can hence be drawn from this study. ClinicalTrials. gov number NCT 00833352. PMID:26374852

Reduction in unnecessary ventricular pacing fails to affect hard clinical outcomes in patients with preserved left ventricular function: a meta-analysis.

PubMed

Shurrab, Mohammed; Healey, Jeff S; Haj-Yahia, Saleem; Kaoutskaia, Anna; Boriani, Giuseppe; Carrizo, Aldo; Botto, Gianluca; Newman, David; Padeletti, Luigi; Connolly, Stuart J; Crystal, Eugene

2017-02-01

Several pacing modalities across multiple manufacturers have been introduced to minimize unnecessary right ventricular pacing. We conducted a meta-analysis to assess whether ventricular pacing reduction modalities (VPRM) influence hard clinical outcomes in comparison to standard dual-chamber pacing (DDD). An electronic search was performed using Cochrane Central Register, PubMed, Embase, and Scopus. Only randomized controlled trials (RCT) were included in this analysis. Outcomes of interest included: frequency of ventricular pacing (VP), incident persistent/permanent atrial fibrillation (PerAF), all-cause hospitalization and all-cause mortality. Odds ratios (OR) were reported for dichotomous variables. Seven RCTs involving 4119 adult patients were identified. Ventricular pacing reduction modalities were employed in 2069 patients: (MVP, Medtronic Inc.) in 1423 and (SafeR, Sorin CRM, Clamart) in 646 patients. Baseline demographics and clinical characteristics were similar between VPRM and DDD groups. The mean follow-up period was 2.5 ± 0.9 years. Ventricular pacing reduction modalities showed uniform reduction in VP in comparison to DDD groups among all individual studies. The incidence of PerAF was similar between both groups {8 vs. 10%, OR 0.84 [95% confidence interval (CI) 0.57; 1.24], P = 0.38}. Ventricular pacing reduction modalities showed no significant differences in comparison to DDD for all-cause hospitalization or all-cause mortality [9 vs. 11%, OR 0.82 (95% CI 0.65; 1.03), P= 0.09; 6 vs. 6%, OR 0.97 (95% CI 0.74; 1.28), P = 0.84, respectively]. Novel VPRM measures effectively reduce VP in comparison to standard DDD. When actively programmed, VPRM did not improve clinical outcomes and were not superior to standard DDD programming in reducing incidence of PerAF, all-cause hospitalization, or all-cause mortality.

Angiotensin-converting enzyme and matrix metalloproteinase inhibition with developing heart failure: comparative effects on left ventricular function and geometry

NASA Technical Reports Server (NTRS)

McElmurray, J. H. 3rd; Mukherjee, R.; New, R. B.; Sampson, A. C.; King, M. K.; Hendrick, J. W.; Goldberg, A.; Peterson, T. J.; Hallak, H.; Zile, M. R.;

Correlation between the sudden jump-like increases of the atrio-Hisian interval induced during burst atrial pacing and during programmed atrial stimulation in patients with atrioventricular nodal reentrant tachycardia.

PubMed

Bayraktarova, Iskra H; Stoyanov, Milko K; Kunev, Boyan T; Shalganov, Tchavdar N

To study the correlation between the sudden prolongations of the atrio-Hisian (AH) interval with ≥50 ms during burst and programmed atrial stimulation, and to define whether the AH jump during burst atrial pacing is a reliable diagnostic criterion for dual AV nodal physiology. Retrospective data on 304 patients with preliminary ECG diagnosis of AV nodal reentrant tachycardia (AVNRT), confirmed during electrophysiological study, was analyzed for the presence of AH jump during burst and programmed atrial stimulation, and for correlation between the pacing modes for inducing the jump. Wilcoxon signed-ranks test and Spearman's bivariate correlation coefficient were applied, significant was P-value <0.05. The population was aged 48.5 ± 15.7 (12-85) years; males were 38.5%. AH jump occurred during burst atrial pacing in 81% of the patients, and during programmed stimulation - in 78%, P = 0.366. In 63.2% AH jump was induced by both pacing modes; in 17.8% - only by burst pacing; in 14.8% - only by programmed pacing; in 4.2% there was no inducible jump. There was negative correlation between both pacing modes, ρ = -0.204, Р<0.001. Burst and programmed atrial stimulation separately prove the presence of dual AV nodal physiology in 81 and 78% of the patients with AVNRT, respectively. There is negative correlation between the two pacing modes, allowing the combination of the two methods to prove diagnostic in 95.8% of the patients. Copyright © 2017 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.

DDD(R)-pacing, but not AAI(R)-pacing induces left ventricular desynchronization in patients with sick sinus syndrome: tissue-Doppler and 3D echocardiographic evaluation in a randomized controlled comparison.

PubMed

Albertsen, Andi Eie; Nielsen, Jens Cosedis; Poulsen, Steen Hvitfeldt; Mortensen, Peter Thomas; Pedersen, Anders Kirstein; Hansen, Peter Steen; Jensen, Henrik Kjaerulf; Egeblad, Henrik

2008-02-01

Increasing evidence from randomized trials and experimental studies indicates that right ventricular (RV) pacing may induce congestive heart failure. We studied regional left ventricular (LV) dyssynchrony and global LV function in 50 consecutive patients with sick sinus syndrome (SSS) randomized to either atrial pacing [AAI(R)] or dual chamber RV-pacing [DDD(R)]. Fifty consecutive patients were randomized to AAI(R) or DDD(R)-pacing. Tissue-Doppler imaging was used to quantify LV dyssynchrony in terms of number of segments with delayed longitudinal contraction (DLC). Left ventricular ejection fraction (LVEF) was measured using three-dimensional echocardiography. Dyssynchrony was more pronounced in the DDD(R)-group than in the AAI(R)-group at the 12 months follow-up (P < 0.05). This reflected a significant increase of dyssynchrony in the DDD(R)-group from baseline to the 12 months follow-up (1.3 +/- 1 to 2.1 +/- 1 segments displaying DLC per patient), P < 0.05. No change was observed in the AAI(R)-group (1.6 +/- 2 to 1.3 +/- 2 segments displaying DLC per patient, NS). No difference in LVEF, NYHA or NT-proBNP was observed between AAI(R)- and DDD(R)-mode after 12 months of pacing although LVEF decreased significantly in the DDD(R)-group from baseline (63.1 +/- 8%) to the 12 months follow-up (59.3 +/- 8%, P < 0.05), while LVEF remained unchanged in the AAI(R)-group (61.5 +/- 11% at baseline vs. 62.3 +/- 7% after 12 months, NS. In patients with SSS, DDD(R)-pacing but not AAI(R)-pacing induces significant LV desynchronization and reduction of LVEF.

Comparison of right ventricular septal pacing and right ventricular apical pacing in patients receiving cardiac resynchronization therapy defibrillators: the SEPTAL CRT Study.

PubMed

Leclercq, Christophe; Sadoul, Nicolas; Mont, Lluis; Defaye, Pascal; Osca, Joaquim; Mouton, Elisabeth; Isnard, Richard; Habib, Gilbert; Zamorano, Jose; Derumeaux, Genevieve; Fernandez-Lozano, Ignacio

2016-02-01

Cardiac resynchronization therapy (CRT) is a recommended treatment of heart failure (HF) patients with depressed left ventricular ejection fraction and wide QRS. The optimal right ventricular (RV) lead position being a matter of debate, we sought to examine whether RV septal (RVS) pacing was not inferior to RV apical (RVA) pacing on left ventricular reverse remodelling in patients receiving a CRT-defibrillator. Patients (n = 263, age = 63.4 ± 9.5 years) were randomly assigned in a 1:1 ratio to RVS (n = 131) vs. RVA (n = 132) pacing. Left ventricular end-systolic volume (LVESV) reduction between baseline and 6 months was not different between the two groups (-25.3 ± 39.4 mL in RVS group vs. -29.3 ± 44.5 mL in RVA group, P = 0.79). Right ventricular septal pacing was not non-inferior (primary endpoint) to RVA pacing with regard to LVESV reduction (average difference = -4.06 mL; P = 0.006 with a -20 mL non-inferiority margin). The percentage of 'echo-responders' defined by LVESV reduction >15% between baseline and 6 months was similar in both groups (50%) with no difference in the time to first HF hospitalization or death (P = 0.532). Procedural or device-related serious adverse events occurred in 68 patients (RVS = 37) with no difference between the two groups (P = 0.401). This study demonstrates that septal RV pacing in CRT is non-inferior to apical RV pacing for LV reverse remodelling at 6 months with no difference in the clinical outcome. No recommendation for optimal RV lead position can hence be drawn from this study. NCT 00833352. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

Different regions of latest electrical activation during left bundle-branch block and right ventricular pacing in cardiac resynchronization therapy patients determined by coronary venous electro-anatomic mapping.

PubMed

Mafi Rad, Masih; Blaauw, Yuri; Dinh, Trang; Pison, Laurent; Crijns, Harry J; Prinzen, Frits W; Vernooy, Kevin

2014-11-01

Current targeted left ventricular (LV) lead placement strategy is directed at the latest activated region during intrinsic activation. However, cardiac resynchronization therapy (CRT) is most commonly applied by simultaneous LV and right ventricular (RV) pacing without contribution from intrinsic conduction. Therefore, targeting the LV lead to the latest activated region during RV pacing might be more appropriate. We investigated the difference in LV electrical activation sequence between left bundle-branch block (LBBB) and RV apex (RVA) pacing using coronary venous electro-anatomic mapping (EAM). Twenty consecutive CRT candidates with LBBB underwent intra-procedural coronary venous EAM during intrinsic activation and RVA pacing using EnSite NavX. Left ventricular lead placement was aimed at the latest activated region during LBBB according to current recommendations. In all patients, LBBB was associated with a circumferential LV activation pattern, whereas RVA pacing resulted in activation from the apex of the heart to the base. In 10 of 20 patients, RVA pacing shifted the latest activated region relative to LBBB. In 18 of 20 patients, the LV lead was successfully positioned in the latest activated region during LBBB. For the whole study population, LV lead electrical delay, expressed as percentage of QRS duration, was significantly shorter during RVA pacing than during LBBB (72 ± 13 vs. 82 ± 5%, P = 0.035). Right ventricular apex pacing alters LV electrical activation pattern in CRT patients with LBBB, and shifts the latest activated region in a significant proportion of these patients. These findings warrant reconsideration of the current practice of LV lead targeting for CRT. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

Kinetics of atrial repolarization alternans in a free-behaving ovine model.

PubMed

Jousset, Florian; Tenkorang, Joanna; Vesin, Jean-Marc; Pascale, Patrizio; Ruchat, Patrick; Rollin, Anne Garderes; Fromer, Martin; Narayan, Sanjiv M; Pruvot, Etienne

2012-09-01

Kinetics of Atrial Repolarization Alternans. Repolarization alternans (Re-ALT), a beat-to-beat alternation in action potential repolarization, promotes dispersion of repolarization, wavebreaks, and reentry. Recently, Re-ALT has been shown to play an important role in the transition from rapid pacing to atrial fibrillation (AF) in humans. The detailed kinetics of atrial Re-ALT, however, has not been reported so far. We developed a chronic free-behaving ovine pacing model to study the kinetics of atrial Re-ALT as a function of pacing rate. Thirteen sheep were chronically implanted with 2 pacemakers for the recording of broadband right atrial unipolar electrograms and delivery of rapid pacing protocols. Beat-to-beat differences in the atrial T-wave apex amplitude as a measure of Re-ALT and activation time were analyzed at incremental pacing rates until the effective refractory period (ERP) defined as stable 2:1 capture. Atrial Re-ALT appeared intermittently but without periodicity, and increased in amplitude as a function of pacing rate until ERP. Intermittent 2:1 atrial capture was observed at pacing cycle lengths 40 ms above ERP, and increased in duration as a function of pacing rate. Episodes of rapid pacing-induced AF were rare, and were preceded by Re-ALT or complex oscillations of atrial repolarization, but without intermittent capture. We show in vivo that atrial Re-ALT developed and increased in magnitude with rate until stable 2:1 capture. In rare instances where capture failure did not occur, Re-ALT and complex oscillations of repolarization surged and preceded AF initiation. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1003-1012, September 2012). © 2012 Wiley Periodicals, Inc.

Cardiac pacing for severe childhood neurally mediated syncope with reflex anoxic seizures

PubMed Central

McLeod, K; Wilson, N; Hewitt, J; Norrie, J; Stephenson, J

1999-01-01

OBJECTIVE—To determine whether permanent cardiac pacing could prevent syncope and seizures in children with frequent severe neurally mediated syncope, and if so whether dual chamber pacing was superior to single chamber ventricular pacing.
METHODS—Dual chamber pacemakers were implanted into 12 children (eight male, four female) aged 2-14 years (median 2.8 years) with frequent episodes of reflex anoxic seizures and a recorded prolonged asystole during an attack. The pacemaker was programmed to sensing only (ODO), single chamber ventricular pacing with hysteresis (VVI), and dual chamber pacing with rate drop response (DDD) for four month periods, with each patient allocated to one of the six possible sequences of these modes, according to chronological order of pacemaker implantation. The parent and patient were blinded to the pacemaker mode and asked to record all episodes of syncope or presyncope ("near miss" events). The doctor analysing the results was blinded to the patient and pacemaker mode.
RESULTS—One patient was withdrawn from the study after the pacemaker was removed because of infection. In the remaining children, both dual chamber and single chamber pacing significantly reduced the number of syncopal episodes compared with sensing only (p = 0.0078 for both). VVI was as effective as DDD for preventing syncope, but DDD was superior to VVI in reducing near miss events (p = 0.016).
CONCLUSIONS—Permanent pacing is an effective treatment for children with severe neurally mediated syncope and reflex anoxic seizures. VVI is as effective as DDD in preventing syncope and seizures, but DDD is superior in preventing overall symptoms.


Keywords: syncope; reflex anoxic seizures; pacing; paediatric cardiology PMID:10573501

77 FR 3958 - Mortgage Assets Affected by PACE Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... of home improvement projects (e.g., home insulation, solar panels, geothermal energy units, etc... (``ANPR'') concerning mortgage assets affected by Property Assessed Clean Energy (``PACE'') programs and... February 28, 2011, that deal with property assessed clean energy (PACE) programs.'' In response to and...

On the Effectiveness of a Neural Network for Adaptive External Pacing.

ERIC Educational Resources Information Center

Montazemi, Ali R.; Wang, Feng

1995-01-01

Proposes a neural network model for an intelligent tutoring system featuring adaptive external control of student pacing. An experiment was conducted, and students using adaptive external pacing experienced improved mastery learning and increased motivation for time management. Contains 66 references. (JKP)

A self-paced brain-computer interface for controlling a robot simulator: an online event labelling paradigm and an extended Kalman filter based algorithm for online training.

PubMed

Tsui, Chun Sing Louis; Gan, John Q; Roberts, Stephen J

2009-03-01

Due to the non-stationarity of EEG signals, online training and adaptation are essential to EEG based brain-computer interface (BCI) systems. Self-paced BCIs offer more natural human-machine interaction than synchronous BCIs, but it is a great challenge to train and adapt a self-paced BCI online because the user's control intention and timing are usually unknown. This paper proposes a novel motor imagery based self-paced BCI paradigm for controlling a simulated robot in a specifically designed environment which is able to provide user's control intention and timing during online experiments, so that online training and adaptation of the motor imagery based self-paced BCI can be effectively investigated. We demonstrate the usefulness of the proposed paradigm with an extended Kalman filter based method to adapt the BCI classifier parameters, with experimental results of online self-paced BCI training with four subjects.

Electrocardiograms with pacemakers: accuracy of computer reading.

PubMed

Guglin, Maya E; Datwani, Neeta

2007-04-01

We analyzed the accuracy with which a computer algorithm reads electrocardiograms (ECGs) with electronic pacemakers (PMs). Electrocardiograms were screened for the presence of electronic pacing spikes. Computer-derived interpretations were compared with cardiologists' readings. Computer-drawn interpretations required revision by cardiologists in 61.3% of cases. In 18.4% of cases, the ECG reading algorithm failed to recognize the presence of a PM. The misinterpretation of paced beats as intrinsic beats led to multiple secondary errors, including myocardial infarctions in varying localization. The most common error in computer reading was the failure to identify an underlying rhythm. This error caused frequent misidentification of the PM type, especially when the presence of normal sinus rhythm was not recognized in a tracing with a DDD PM tracking the atrial activity. The increasing number of pacing devices, and the resulting number of ECGs with pacing spikes, mandates the refining of ECG reading algorithms. Improvement is especially needed in the recognition of the underlying rhythm, pacing spikes, and mode of pacing.

Pace of shifts in climate regions increases with global temperature

NASA Astrophysics Data System (ADS)

Mahlstein, Irina; Daniel, John S.; Solomon, Susan

2013-08-01

Human-induced climate change causes significant changes in local climates, which in turn lead to changes in regional climate zones. Large shifts in the world distribution of Köppen-Geiger climate classifications by the end of this century have been projected. However, only a few studies have analysed the pace of these shifts in climate zones, and none has analysed whether the pace itself changes with increasing global mean temperature. In this study, pace refers to the rate at which climate zones change as a function of amount of global warming. Here we show that present climate projections suggest that the pace of shifting climate zones increases approximately linearly with increasing global temperature. Using the RCP8.5 emissions pathway, the pace nearly doubles by the end of this century and about 20% of all land area undergoes a change in its original climate. This implies that species will have increasingly less time to adapt to Köppen zone changes in the future, which is expected to increase the risk of extinction.

Cardiac optogenetic pacing in drosophila melanogaster using red-shifted opsins (Conference Presentation)

NASA Astrophysics Data System (ADS)

Men, Jing; Li, Airong; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

2017-02-01

Electrical pacing is the current gold standard for investigation of mammalian cardiac electrical conduction systems as well as for treatment of certain cardiac pathologies. However, this method requires an invasive surgical procedure to implant the pacing electrodes. Recently, optogenetic pacing has been developed as an alternative, non-invasive method for heartbeat pacing in animals. It induces heartbeats by shining pulsed light on transgene-generated microbial opsins which in turn activate light gated ion channels in animal hearts. However, commonly used opsins, such as channelrhodopsin-2 (ChR2), require short light wavelength stimulation (475 nm), which is strongly absorbed and scattered by tissue. Here, we expressed recently engineered red-shifted opsins, ReaChR and CsChrimson, in the heart of a well-developed animal model, Drosophila melanogaster, for the first time. Optogenetic pacing was successfully conducted in both ReaChR and CsChrimson flies at their larval, pupal, and adult stages using 617 nm excitation light pulse, enabling a much deeper tissue penetration compared to blue stimulation light. A customized high speed and ultrahigh resolution OCM system was used to non-invasively monitor the heartbeat pacing in Drosophila. Compared to previous studies on optogenetic pacing of Drosophila, higher penetration depth of optogenetic excitation light was achieved in opaque late pupal flies. Lower stimulating power density is needed for excitation at each developmental stage of both groups, which improves the safety of this technique for heart rhythm studies.

Sensors for rate responsive pacing

PubMed Central

Dell'Orto, Simonetta; Valli, Paolo; Greco, Enrico Maria

2004-01-01

Advances in pacemaker technology in the 1980s have generated a wide variety of complex multiprogrammable pacemakers and pacing modes. The aim of the present review is to address the different rate responsive pacing modalities presently available in respect to physiological situations and pathological conditions. Rate adaptive pacing has been shown to improve exercise capacity in patients with chronotropic incompetence. A number of activity and metabolic sensors have been proposed and used for rate control. However, all sensors used to optimize pacing rate metabolic demands show typical limitations. To overcome these weaknesses the use of two sensors has been proposed. Indeed an unspecific but fast reacting sensor is combined with a more specific but slower metabolic one. Clinical studies have demonstrated that this methodology is suitable to reproduce normal sinus behavior during different types and loads of exercise. Sensor combinations require adequate sensor blending and cross checking possibly controlled by automatic algorithms for sensors optimization and simplicity of programming. Assessment and possibly deactivation of some automatic functions should be also possible to maximize benefits from the dual sensor system in particular conditions. This is of special relevance in patient whose myocardial contractility is limited such as in subjects with implantable defibrillators and biventricular pacemakers. The concept of closed loop pacing, implementing a negative feedback relating pacing rate and the control signal, will provide new opportunities to optimize dual-sensors system and deserves further investigation. The integration of rate adaptive pacing into defibrillators is the natural consequence of technical evolution. PMID:16943981

[The effect of atrial pacing on left ventricular diastolic function and BNP levels in patients with DDD pacemaker].

PubMed

Apali, Zeynep; Bayata, Serdar; Yeşil, Murat; Arikan, Erdinç; Postaci, Nursen

2010-08-01

We aimed to investigate the effect of atrial pacing on left ventricular diastolic function and brain natriuretic peptide (BNP) levels in patients with DDD pacemaker. Thirty patients with complete atrio-ventricular (AV) block and DDD pacemaker were included. All patients had normal left ventricular systolic function. Echocardiographic diastolic function parameters (transmitral and tissue Doppler velocities during early (E and E') and late (A and A') filling) and NT-pro-BNP levels were evaluated prospectively during atrial sensing and pacing periods. Echocardiographic data were compared with paired sample t test and NT-pro-BNP levels were compared with Wilcoxon test. Echocardiographic E/A, E'/A', E/E' ratios were calculated as 0.72+/-0.34, 0.61+/-0.21 and 8.76+/-2.58 during atrial sensing period. Same parameters were found as 0.71+/-0.23, 0.64+/-0.16 and 8.93+/-3.16 respectively during atrial pacing period. Echocardiographic left ventricular diastolic function parameters were not significantly different during atrial pacing and atrial sensing periods. Median plasma NT-pro-BNP levels were measured as 142 pg/ml (min-max 47-563 pg/ml) and 147 pg/ml (min-max 33-1035 pg/ml) during atrial sensing and pacing periods respectively. These levels were not significantly different (p=0.86). The result of this study has shown that, atrial pacing has not any additional detrimental effect on left ventricular diastolic function parameters in paced patients with normal left ventricular systolic function.

Wall Thickness, Pulmonary Hypertension, and Diastolic Filling Abnormalities Predict Response to Postoperative Biventricular Pacing

PubMed Central

Brusen, Robin M.; Hahn, Rebecca; Cabreriza, Santos E.; Cheng, Bin; Wang, Daniel Y.; Truong, Wanda; Spotnitz, Henry M.

2017-01-01

Objective Post-cardiopulmonary bypass biventricular pacing improves hemodynamics but without clearly defined predictors of response. Based on preclinical studies and prior observations, it was suspected that diastolic dysfunction or pulmonary hypertension is predictive of hemodynamic benefit. Design Randomized controlled study of temporary biventricular pacing after cardiopulmonary bypass. Setting Single-center study at university-affiliated tertiary care hospital. Interventions Patients who underwent bypass with pre-operative ejection fraction ≤40% and QRS duration ≥100 ms or double-valve surgery were enrolled. At 3 time points between separation from bypass and postoperative day 1, pacing delays were varied to optimize hemodynamics. Participants Data from 43 patients were analyzed. Measurements and Main Results Cardiac output and arterial pressure were measured under no pacing, atrial pacing, and biventricular pacing. Preoperative echocardiograms and pulmonary artery catheterizations were reviewed, and measures of both systolic and diastolic function were compared to hemodynamic response. Early after separation, improvement in cardiac output was positively correlated with pulmonary vascular resistance (R2 = 0.97, p < 0.001), ventricle wall thickness (R2 = 0.72, p = 0.002)), and E/e′, a measure of abnormal diastolic ventricular filling velocity (R2 = 0.56, p = 0.04). Similar trends were seen with mean arterial pressure. QRS duration and ejection fraction did not correlate significantly with improvements in hemodynamics. Conclusions There may be an effect of biventricular pacing related to amelioration of abnormal diastolic filling patterns rather than electrical resynchronization in the postoperative state. PMID:25998068

42 CFR 460.16 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false [Reserved] 460.16 Section 460.16 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.66 - Training.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Training. 460.66 Section 460.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.14 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false [Reserved] 460.14 Section 460.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.16 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false [Reserved] 460.16 Section 460.16 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.66 - Training.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Training. 460.66 Section 460.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.14 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false [Reserved] 460.14 Section 460.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.10 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Purpose. 460.10 Section 460.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.10 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Purpose. 460.10 Section 460.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

The Student Experience of PACE at Macquarie University: Understanding Motivations for Learning

ERIC Educational Resources Information Center

McLachlan, Kath; Rawlings-Sanaei, Felicity; Mason, Colina; Haski-Levanthal, Debbie; Nabeel, Hussein

2017-01-01

Professional and Community Engagement (PACE) at Macquarie University offers undergraduate students experiential learning opportunities with local, regional and international partners. Through PACE, students work on mutually beneficial projects that both meet the partner's organizational goals and enable students to strengthen graduate capabilities…

Self-Paced Economics Instruction: A Large-Scale Disaggregated Evaluation

ERIC Educational Resources Information Center

Soper, John C.; Thorton, Richard M.

1976-01-01

This paper reports on an evaluation of the Sterling Institute self-paced macroeconomics course at Northern Illinois University. Results show that a completely self-paced teaching format for macroeconomics is inferior to a well-directed, concept-oriented, graduate-student instructed, lecture-discussion taught course. (Author/RM)

A Simple Evacuation Modeling and Simulation Tool for First Responders

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

Koch, Daniel B; Payne, Patricia W

2015-01-01

Although modeling and simulation of mass evacuations during a natural or man-made disaster is an on-going and vigorous area of study, tool adoption by front-line first responders is uneven. Some of the factors that account for this situation include cost and complexity of the software. For several years, Oak Ridge National Laboratory has been actively developing the free Incident Management Preparedness and Coordination Toolkit (IMPACT) to address these issues. One of the components of IMPACT is a multi-agent simulation module for area-based and path-based evacuations. The user interface is designed so that anyone familiar with typical computer drawing tools canmore » quickly author a geospatially-correct evacuation visualization suitable for table-top exercises. Since IMPACT is designed for use in the field where network communications may not be available, quick on-site evacuation alternatives can be evaluated to keep pace with a fluid threat situation. Realism is enhanced by incorporating collision avoidance into the simulation. Statistics are gathered as the simulation unfolds, including most importantly time-to-evacuate, to help first responders choose the best course of action.« less

Web Tools: Keeping Learners on Pace

ERIC Educational Resources Information Center

Kosloski, Mickey

2016-01-01

One of the greatest challenges in teaching technology and engineering is pacing. Some students grasp new technological concepts quickly, while others need repetition and may struggle to keep pace. This poses an obstacle for the technology and engineering teacher, and is particularly true when teaching students to build a website. However, there…

Achievement Monitoring of Individually Paced Instruction. Final Report.

ERIC Educational Resources Information Center

Pinsky, Paul D.

A study was made to monitor achievement of individually paced instruction. The project concentrated on designing testing procedures in group paced instructional programs to provide information to student, teachers, parents and administrators which could be used in both a formative and summative evaluation. The three objectives of the project were:…

A Meta-Analysis of Individualized Instruction in Dental Education.

ERIC Educational Resources Information Center

Dacanay, Lakshmi S; Cohen, Peter A.

1992-01-01

Meta-analysis of 34 comparative studies on conventional vs. individualized instruction (II) found most favored the latter but with small-moderate overall effect. Pacing had significant effect, with teacher-pacing more effective than student-paced learning. On average, II required less time than conventional teaching. Additional research on this…

42 CFR 460.64 - Personnel qualifications for staff with direct participant contact.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.64 Personnel... frail or elderly population; (4) Meet a standardized set of competencies for the specific position...

42 CFR 460.106 - Plan of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Plan of care. 460.106 Section 460.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE...

42 CFR 460.64 - Personnel qualifications for staff with direct participant contact.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.64 Personnel... frail or elderly population; (4) Meet a standardized set of competencies for the specific position...

A review of optical pacing with infrared light

NASA Astrophysics Data System (ADS)

Ford, S. M.; Watanabe, M.; Jenkins, M. W.

2018-02-01

Optical pacing (OP) uses pulsed infrared light to initiate heartbeats in electrically excitable cardiac tissues without employing exogenous agents. OP is an alternative approach to electrical pacing that may overcome some its disadvantages for some applications. In this review, we discuss the initial demonstrations, mechanisms, safety, advantages and applications of OP.

42 CFR 460.100 - Emergency care.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Emergency care. 460.100 Section 460.100 Public...) PACE Services § 460.100 Emergency care. (a) Written plan. A PACE organization must establish and maintain a written plan to handle emergency care. The plan must ensure that CMS, the State, and PACE...

42 CFR 460.100 - Emergency care.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Emergency care. 460.100 Section 460.100 Public...) PACE Services § 460.100 Emergency care. (a) Written plan. A PACE organization must establish and maintain a written plan to handle emergency care. The plan must ensure that CMS, the State, and PACE...

42 CFR 460.100 - Emergency care.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Emergency care. 460.100 Section 460.100 Public...) PACE Services § 460.100 Emergency care. (a) Written plan. A PACE organization must establish and maintain a written plan to handle emergency care. The plan must ensure that CMS, the State, and PACE...

Pacing from the right ventricular septum: is there a danger to the coronary arteries?

PubMed

Teh, Andrew W; Medi, Caroline; Rosso, Raphael; Lee, Geoffrey; Gurvitch, Ronen; Mond, Harry G

2009-07-01

Pacing from right ventricular (RV) septal sites has been suggested as an alternative to RV apical pacing in an attempt to avoid long-term adverse consequences on left ventricular function. Concern has been raised as to the relationship of the left anterior descending coronary artery (LAD) to pacing leads in these positions. We retrospectively analyzed three cases in which patients with RV active-fixation leads in situ also had coronary angiography. Multiple fluoroscopic views were used to determine the relationship of the lead tip at various pacing sites to the coronary arteries. A lead placed on the anterior wall was in close proximity to the LAD, whereas septal and free wall positioning was not. Placement of RV active-fixation leads on the septum avoids potential coronary artery compromise.

A self-paced motor imagery based brain-computer interface for robotic wheelchair control.

PubMed

Tsui, Chun Sing Louis; Gan, John Q; Hu, Huosheng

2011-10-01

This paper presents a simple self-paced motor imagery based brain-computer interface (BCI) to control a robotic wheelchair. An innovative control protocol is proposed to enable a 2-class self-paced BCI for wheelchair control, in which the user makes path planning and fully controls the wheelchair except for the automatic obstacle avoidance based on a laser range finder when necessary. In order for the users to train their motor imagery control online safely and easily, simulated robot navigation in a specially designed environment was developed. This allowed the users to practice motor imagery control with the core self-paced BCI system in a simulated scenario before controlling the wheelchair. The self-paced BCI can then be applied to control a real robotic wheelchair using a protocol similar to that controlling the simulated robot. Our emphasis is on allowing more potential users to use the BCI controlled wheelchair with minimal training; a simple 2-class self paced system is adequate with the novel control protocol, resulting in a better transition from offline training to online control. Experimental results have demonstrated the usefulness of the online practice under the simulated scenario, and the effectiveness of the proposed self-paced BCI for robotic wheelchair control.

Did recent world record marathon runners employ optimal pacing strategies?

PubMed

Angus, Simon D

2014-01-01

We apply statistical analysis of high frequency (1 km) split data for the most recent two world-record marathon runs: Run 1 (2:03:59, 28 September 2008) and Run 2 (2:03:38, 25 September 2011). Based on studies in the endurance cycling literature, we develop two principles to approximate 'optimal' pacing in the field marathon. By utilising GPS and weather data, we test, and then de-trend, for each athlete's field response to gradient and headwind on course, recovering standardised proxies for power-based pacing traces. The resultant traces were analysed to ascertain if either runner followed optimal pacing principles; and characterise any deviations from optimality. Whereas gradient was insignificant, headwind was a significant factor in running speed variability for both runners, with Runner 2 targeting the (optimal) parallel variation principle, whilst Runner 1 did not. After adjusting for these responses, neither runner followed the (optimal) 'even' power pacing principle, with Runner 2's macro-pacing strategy fitting a sinusoidal oscillator with exponentially expanding envelope whilst Runner 1 followed a U-shaped, quadratic form. The study suggests that: (a) better pacing strategy could provide elite marathon runners with an economical pathway to significant performance improvements at world-record level; and (b) the data and analysis herein is consistent with a complex-adaptive model of power regulation.

Effect of right ventricular pacing on cardiac apex rotation assessed by a gyroscopic sensor.

PubMed

Marcelli, Emanuela; Cercenelli, Laura; Parlapiano, Mario; Fumero, Roberto; Bagnoli, Paola; Costantino, Maria Laura; Plicchi, Gianni

2007-01-01

To quantify cardiac apex rotation (CAR), the authors recently proposed the use of a Coriolis force sensor (gyroscope) as an alternative to other complex techniques. The aim of this study was to evaluate the effects of right ventricular (RV) pacing on CAR. A sheep heart was initially paced from the right atrium to induce a normal activation sequence at a fixed heart rate (AAI mode) and then an atrioventricular pacing was performed (DOO mode, AV delay = 60 ms). A small gyroscope was epicardially glued on the cardiac apex to measure the angular velocity (Ang V). From AAI to DOO pacing mode, an increase (+9.2%, p < 0.05) of the maximum systolic twisting velocity (Ang VMAX) and a marked decrease (-19.9%, p < 0.05) of the maximum diastolic untwisting velocity (Ang VMIN) resulted. RV pacing had negligible effects (-3.1%, p = 0.09) on the maximum angle of CAR, obtained by integrating Ang V. The hemodynamic parameters of systolic (LVdP/dtMAX) and diastolic (LVdP/dtMIN) cardiac function showed slight variations (-3.8%, p < 0.05 and +3.9%, p < 0.05, respectively). Results suggest that cardiac dyssynchrony induced by RV pacing can alter the normal physiological ventricular twist patterns, particularly affecting diastolic untwisting velocity.

Feasibility of Leadless Cardiac Pacing Using Injectable Magnetic Microparticles

PubMed Central

Rotenberg, Menahem Y.; Gabay, Hovav; Etzion, Yoram; Cohen, Smadar

2016-01-01

A noninvasive, effective approach for immediate and painless heart pacing would have invaluable implications in several clinical scenarios. Here we present a novel strategy that utilizes the well-known mechano-electric feedback of the heart to evoke cardiac pacing, while relying on magnetic microparticles as leadless mechanical stimulators. We demonstrate that after localizing intravenously-injected magnetic microparticles in the right ventricular cavity using an external electromagnet, the application of magnetic pulses generates mechanical stimulation that provokes ventricular overdrive pacing in the rat heart. This temporary pacing consistently managed to revert drug-induced bradycardia, but could only last up to several seconds in the rat model, most likely due to escape of the particles between the applied pulses using our current experimental setting. In a pig model with open chest, MEF-based pacing was induced by banging magnetic particles and has lasted for a longer time. Due to overheating of the electromagnet, we intentionally terminated the experiments after 2 min. Our results demonstrate for the first time the feasibility of external leadless temporary pacing, using injectable magnetic microparticles that are manipulated by an external electromagnet. This new approach can have important utilities in clinical settings in which immediate and painless control of cardiac rhythm is required. PMID:27091192

Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery.

PubMed

Levin, Ricardo; Leacche, Marzia; Petracek, Michael R; Deegan, Robert J; Eagle, Susan S; Thompson, Annemarie; Pretorius, Mias; Solenkova, Nataliya V; Umakanthan, Ramanan; Brewer, Zachary E; Byrne, John G

2010-08-01

In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. A retrospective study. A single institutional university hospital. Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping. Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker. In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications. Copyright 2010 Elsevier Inc. All rights reserved.

Transdiaphragmatic pressure in quadriplegic individuals ventilated by diaphragmatic pacemaker.

PubMed Central

Garrido-García, H.; Martín-Escribano, P.; Palomera-Frade, J.; Arroyo, O.; Alonso-Calderón, J. L.; Mazaira-Alvarez, J.

1996-01-01

BACKGROUND: Electrophrenic pacing can be used in the management of ventilatory failure in quadriplegic patients. A study was undertaken to determine the pattern of transdiaphragmatic pressure (PDI) during the conditioning phase of electrophrenic pacing to see if it had a possible role in optimising the process of conditioning. METHODS: The tidal volume (TV) and PDI were measured in a group of six quadriplegic patients commencing ventilation by low frequency pulse stimulation (7-10 Hz) and low respiratory rate stimulation (< 10 breaths/min). RESULTS: Tidal volume increased between baseline and month 1 (4.33 ml/kg, p < 0.001) and between months 1 and 2 (3.00 ml/kg, p < 0.05) and then stabilised. PDI was higher during bilateral diaphragmatic pacing (mean (SD) 1.73 (0.30) kPa) than with either left (1.15 (0.34) kPa) or right (0.86 (0.37) kPa) unilateral pacing. PDI varied throughout the observation period, probably by interaction between recovery of the diaphragmatic fibres and the pacing regimen. CONCLUSIONS: Patients with quadriplegia due to high spinal injury can be maintained with ventilation by continuous electrophrenic pacing. The control criteria used in this study for pacing were tidal volume and the patient's tolerance, and the PDI measurement did not contribute any additional information to help with managing the conditioning process. PMID:8733497

Time-Resolved Transposon Insertion Sequencing Reveals Genome-Wide Fitness Dynamics during Infection.

PubMed

Yang, Guanhua; Billings, Gabriel; Hubbard, Troy P; Park, Joseph S; Yin Leung, Ka; Liu, Qin; Davis, Brigid M; Zhang, Yuanxing; Wang, Qiyao; Waldor, Matthew K

2017-10-03

Transposon insertion sequencing (TIS) is a powerful high-throughput genetic technique that is transforming functional genomics in prokaryotes, because it enables genome-wide mapping of the determinants of fitness. However, current approaches for analyzing TIS data assume that selective pressures are constant over time and thus do not yield information regarding changes in the genetic requirements for growth in dynamic environments (e.g., during infection). Here, we describe structured analysis of TIS data collected as a time series, termed pattern analysis of conditional essentiality (PACE). From a temporal series of TIS data, PACE derives a quantitative assessment of each mutant's fitness over the course of an experiment and identifies mutants with related fitness profiles. In so doing, PACE circumvents major limitations of existing methodologies, specifically the need for artificial effect size thresholds and enumeration of bacterial population expansion. We used PACE to analyze TIS samples of Edwardsiella piscicida (a fish pathogen) collected over a 2-week infection period from a natural host (the flatfish turbot). PACE uncovered more genes that affect E. piscicida 's fitness in vivo than were detected using a cutoff at a terminal sampling point, and it identified subpopulations of mutants with distinct fitness profiles, one of which informed the design of new live vaccine candidates. Overall, PACE enables efficient mining of time series TIS data and enhances the power and sensitivity of TIS-based analyses. IMPORTANCE Transposon insertion sequencing (TIS) enables genome-wide mapping of the genetic determinants of fitness, typically based on observations at a single sampling point. Here, we move beyond analysis of endpoint TIS data to create a framework for analysis of time series TIS data, termed pattern analysis of conditional essentiality (PACE). We applied PACE to identify genes that contribute to colonization of a natural host by the fish pathogen Edwardsiella piscicida. PACE uncovered more genes that affect E. piscicida 's fitness in vivo than were detected using a terminal sampling point, and its clustering of mutants with related fitness profiles informed design of new live vaccine candidates. PACE yields insights into patterns of fitness dynamics and circumvents major limitations of existing methodologies. Finally, the PACE method should be applicable to additional "omic" time series data, including screens based on clustered regularly interspaced short palindromic repeats with Cas9 (CRISPR/Cas9). Copyright © 2017 Yang et al.

Effects of gastric pacing on gastric emptying and plasma motilin

PubMed Central

Yang, Min; Fang, Dian-Chun; Li, Qian-Wei; Sun, Nian-Xu; Long, Qing-Lin; Sui, Jian-Feng; Gan, Lu

2004-01-01

AIM: To investigate the effects of gastric pacing on gastric emptying and plasma motilin level in a canine model of gastric motility disorders and the correlation between gastric emptying and plasma motilin level. METHODS: Ten healthy Mongrel dogs were divided into: experimental group of six dogs and control group of four dogs. A model of gastric motility disorders was established in the experimental group undergone truncal vagotomy combined with injection of glucagon. Gastric half-emptying time (GEt1/2) was monitored with single photon emission computerized tomography (SPECT), and the half-solid test meal was labeled with an isotope 99mTc sulfur colloid. Plasma motilin concentration was measured with radioimmunoassay (RIA) kit. Surface gastric pacing at 1.1-1.2 times the intrinsic slow-wave frequency and a superimposed series of high frequency pulses (10-30 Hz) was performed for 45 min daily for a month in conscious dogs. RESULTS: After surgery, GEt1/2 in dogs undergone truncal vagotomy was increased significantly from 56.35 ± 2.99 min to 79.42 ± 1.91 min (P < 0.001), but surface gastric pacing markedly accelerated gastric emptying and significantly decreased GEt1/2 to 64.94 ± 1.75 min (P < 0.001) in animals undergone vagotomy. There was a significant increase of plasma level of motilin at the phase of IMCIII (interdigestive myoelectrical complex, IMCIII) in the dogs undergone bilateral truncal vagotomy (baseline vs vagotomy, 184.29 ± 9.81 pg/ml vs 242.09 ± 17.22 pg/ml; P < 0.01). But plasma motilin concentration (212.55 ± 11.20 pg/ml; P < 0.02) was decreased significantly after a long-term treatment with gastric pacing. Before gastric pacing, GEt1/2 and plasma motilin concentration of the dogs undergone vagotomy showed a positive correlation (r = 0.867, P < 0.01), but after a long-term gastric pacing, GEt1/2 and motilin level showed a negative correlation (r = -0.733, P < 0.04). CONCLUSION: Surface gastric pacing with optimal pacing parameters can improve gastric emptying parameters and significantly accelerate gastric emptying and can resume or alter motor function in a canine model of motility disorders. Gastric emptying is correlated well with plasma motilin level before and after pacing, which suggests that motilin can modulate the mechanism of gastric pacing by altering gastric motility. PMID:14760770

Study protocol for improving asthma outcomes through cross-cultural communication training for physicians: a randomized trial of physician training.

PubMed

Patel, Minal R; Thomas, Lara J; Hafeez, Kausar; Shankin, Matthew; Wilkin, Margaret; Brown, Randall W

2014-06-16

Massive resources are expended every year on cross-cultural communication training for physicians. Such training is a focus of continuing medical education nationwide and is part of the curriculum of virtually every medical school in America. There is a pressing need for evidence regarding the effects on patients of cross-cultural communication training for physicians. There is a need to understand the added benefit of such training compared to more general communication. We know of no rigorous study that has assessed whether cross-cultural communication training for physicians results in better health outcomes for their patients. The current study aims to answer this question by enhancing the Physician Asthma Care Education (PACE) program to cross cultural communication (PACE Plus), and comparing the effect of the enhanced program to PACE on the health outcomes of African American and Latino/Hispanic children with asthma. A three-arm randomized control trial is used to compare PACE Plus, PACE, and usual care. Both PACE and PACE Plus are delivered in two, two-hour sessions over a period of two weeks to 5-10 primary care physicians who treat African American and Latino/Hispanic children with asthma. One hundred twelve physicians and 1060 of their pediatric patients were recruited who self-identify as African American or Latino/Hispanic and experience persistent asthma. Physicians were randomized into receiving either the PACE Plus or PACE intervention or into the control group. The comparative effectiveness of PACE and PACE Plus on clinician's therapeutic and communication practices with the family/patient, children's urgent care use for asthma, asthma control, and quality of life, and parent/caretaker satisfaction with physician performance will be assessed. Data are collected via telephone survey and medical record review at baseline, 9 months following the intervention, and 21 months following the intervention. This study aims to reduce disparities in asthma outcomes among African American and Latino/Hispanic children through cross-cultural communication training of their physicians and assessing the added value of this training compared to general communication. The results of this study will provide important information about the value of cross-cultural training in helping to address persistent racial disparities in outcomes. ClinicalTrials.gov: NCT01251523 December 1, 2010.

A New Model of Orbital Pacing for Pliocene Glaciations

NASA Astrophysics Data System (ADS)

Herbert, T.; Dowsett, H. J.; Caballero-Gill, R. P.

2015-12-01

The earth's climate system has gone through major changes over time that serve as natural experiments to test our understanding of linkages and feedbacks that may come into play if the Earth continues to warm, as expected from greenhouse gas forcing. Our project investigates patterns of climate change between the northern and southern hemispheres during the mid-Pliocene epoch (~3-4 Myr ago) when the overall climate state was warmer than today. Critically, evidence suggests that the amount of ice on Antarctica was similar to today, but that there was little or no permanent ice on land in the northern hemisphere. Most climate scientists have therefore supposed that orbitally-paced climate change would initiate in the region around the Antarctic, and be driven primarily by the 41,000 year obliquity cycle. Using distributed data sets on both sea surface temperature and the combination of deep sea temperature and global ice volume recorded by ð18O, we find a pervasive influence of eccentricity/precession on Pliocene paleoclimate that has been under-appreciated. We tentatively constrain the phase of the climate response by calibrating temperature patterns to the precessional "clock" of the Mediterranean sapropel sequence. Large Pliocene glacial events were paced by precession, and coincide with minimum northern hemisphere summer insolation. This mode is in many ways the opposite of the late Pleistocene, where climate positively follows the envelope of northern hemisphere precession. In the Pliocene case, glacial periods instead followed the lower envelope of precession and nodes of low precessional variance supported peak interglacial conditions. The observations can be explained by positing that during the warmer Pliocene, the high latitudes of the northern hemisphere could only support cryosphere expansion during times of minimal summer insolation. While the presence of ice-rafted debris in the North Atlantic and North Pacific unambiguously confirm a northern hemisphere component to peak Pliocene glaciations, the amplitude of the ð18O excursions in features such as isotope stage M2 almost certainly requires a significant coupling to Antarctic ice volume as well.

Prevention of atrial fibrillation by inter-atrial septum pacing guided by electrophysiological testing, in patients with delayed interatrial conduction.

PubMed

Manolis, A G; Katsivas, A G; Vassilopoulos, C; Koutsogeorgis, D; Louvros, N E

2002-04-01

Interatrial septum (IAS) pacing seems efficient in synchronizing atrial depolarization in patients (pts) with delayed inter-atrial conduction, but its clinical role in preventing atrial tachyarrhythmias is still debated. This study was conducted in order to evaluate the clinical efficacy of IAS pacing guided by pace mapping of the IAS, as an alternative treatment modality in pts with drug refractory paroxysmal atrial fibrillation (PAF). We evaluated 29 pts (13 male, 16 female, 60 +/- 11 years), with drug refractory PAF, normal sinus node function and prolonged inter-atrial conduction time (P wave 142 +/- 10 ms). Multipolar catheters were inserted and the electrograms from the high right atrium (HRA) and proximal, middle and distal coronary sinus (CS) were recorded. The IAS was paced from multiple sites. The site of IAS where the timing between HRA and distal CS was <20 ms was considered the most suitable for synchronizing the atria. This site was found to be superior to the CS os. near the fossa ovalis in all pts. An active fixation atrial lead was positioned at this site and a standard lead was placed in the right ventricle. During IAS pacing, the P wave duration decreased significantly to 107 +/- 15 ms (P<0.001). At implant, the atrial sensing was 2.3 +/- 0.7 mV, the atrial pacing threshold was 0.95 +/- 0.15 V (0.5 ms) and the impedance was 760 +/- 80 Ohm. We evaluated the pts during four periods of 3 months duration each. The first period (control) was before pacemaker implantation, while the pts were under antiarrhythmic treatment. During the subsequent two periods, we evaluated the clinical efficacy of IAS pacing to prevent PAF recurrences, in AAT (75 bpm) and AAIR (75-140 bpm) mode, with random selection of the order and after discontinuation of antiarrhythmic treatment. During the fourth period, the same AAIR mode was assessed, but antiarrhythmic drugs were also administered. We compared the arrhythmia free interval among the four periods. The proportion of atrial paced beats in AAIR pacing mode plus antiarrhythmics was significantly higher compared with the drug-free period in AAIR mode (57 +/- 9% and 49 +/- 9% respectively, P=0017) and with AAT pacing mode (44 +/- 10%,(, P<0.001). In AAT mode, the arrhythmia free interval was 24.2 +/- 5.1 days, while it was 26.2 +/- 5.7 days in AAIR mode. These intervals did not differ significantly from the pre-implantation period (24.1 +/- 6.3 days). The arrhythmia free interval in AAIR pacing in combination with antiarrhythmic drug therapy was 38.7 +/- 8.1 days and this was significantly longer than the previous periods (P<0.05). Atrial septal pacing in combination with antiarrhythmic drug therapy reduced the incidence of PAF in pts with prolonged inter-atrial conduction times. Pace mapping of the IAS is an attractive technique to assess the shortest atrial activation time between HRA and distal CS. Whether placement of the atrial lead based on the shortest HRA--distal CS time is the best place in the IAS to prevent PAF still remains to be proven.

PACE: Pharmacists use the power of communication in paediatric asthma.

PubMed

Elaro, Amanda; Shah, Smita; Pomare, Luca N; L Armour, Carol; Z Bosnic-Anticevich, Sinthia

2014-10-01

Paediatric asthma is a public health burden in Australia despite the availability of national asthma guidelines. Community pharmacy interventions focusing on paediatric asthma are scarce. Practitioner Asthma Communication and Education (PACE) is an evidence-based program, developed in the USA for general practice physicians, aimed at addressing the issues of poor clinician-patient communication in the management of paediatric asthma. This program has been shown to improve paediatric asthma management practices of general practitioners in the USA and Australia. The development of a PACE program for community pharmacists will fill a void in the current armamentarium for pharmacist-patient care. To adapt the educational program, PACE, to the community pharmacy setting. To test the feasibility of the new program for pharmacy and to explore its potential impact on pharmacists' communication skills and asthma related practices. Community pharmacies located within the Sydney metropolitan. The PACE framework was reviewed by the research team and amended in order to ensure its relevance within the pharmacy context, thereby developing PACE for Pharmacy. Forty-four pharmacists were recruited and trained in small groups in the PACE for Pharmacy workshops. Pharmacists' satisfaction and acceptability of the workshops, confidence in using communication strategies pre- and post-workshop and self-reported behaviour change post workshop were evaluated. Pharmacist self-reported changes in communication and teaching behaviours during a paediatric asthma consultation. All 44 pharmacists attended both workshops, completed pre- and post-workshop questionnaires and provided feedback on the workshops (100 % retention). The participants reported a high level of satisfaction and valued the interactive nature of the workshops. Following the PACE for Pharmacy program, pharmacists reported significantly higher levels in using the communication strategies, confidence in their application and their helpfulness. Pharmacists checked for written asthma self-management plan possession and inhaler device technique more regularly, and provided verbal instructions more frequently to paediatric asthma patients/carers at the initiation of a new medication. This study provides preliminary evidence that the PACE program can be translated into community pharmacy. PACE for Pharmacy positively affected self-reported communication and education behaviours of pharmacists. The high response rate shows that pharmacists are eager to expand on their clinical role in primary healthcare.

Additional electrodes on the Quartet™ LV lead provide more programmable pacing options than bipolar and tripolar equivalents.

PubMed

O'Donnell, David; Sperzel, Johannes; Thibault, Bernard; Rinaldi, Christopher A; Pappone, Carlo; Gutleben, Klaus-Jürgen; Leclercq, Christopher; Razavi, Hedi; Ryu, Kyungmoo; Mcspadden, Luke C; Fischer, Avi; Tomassoni, Gery

2017-04-01

The aim of this study was to evaluate any benefits to the number of viable pacing vectors and maximal spatial coverage with quadripolar left ventricular (LV) leads when compared with tripolar and bipolar equivalents in patients receiving cardiac resynchronization therapy (CRT). A meta-analysis of five previously published clinical trials involving the Quartet™ LV lead (St Jude Medical, St Paul, MN, USA) was performed to evaluate the number of viable pacing vectors defined as capture thresholds ≤2.5 V and no phrenic nerve stimulation and maximal spatial coverage of viable vectors in CRT patients at pre-discharge (n = 370) and first follow-up (n = 355). Bipolar and tripolar lead configurations were modelled by systematic elimination of two and one electrode(s), respectively, from the Quartet lead. The Quartet lead with its four pacing electrodes exhibited the greatest number of pacing vectors per patient when compared with the best bipolar and the best tripolar modelled equivalents. Similarly, the Quartet lead provided the highest spatial coverage in terms of the distance between two furthest viable pacing cathodes when compared with the best bipolar and the best tripolar configurations (P < 0.05). Among the three modelled bipolar configurations, the lead configuration with the two most distal electrodes resulted in the highest number of viable pacing vectors. Among the four modelled tripolar configurations, elimination of the second proximal electrode (M3) resulted in the highest number of viable pacing options per patient. There were no significant differences observed between pre-discharge and first follow-up analyses. The Quartet lead with its four electrodes and the capability to pace from four anatomical locations provided the highest number of viable pacing vectors at pre-discharge and first follow-up visits, providing more flexibility in device programming and enabling continuation of CRT in more patients when compared with bipolar and tripolar equivalents. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Use of epicardial pacing wires after coronary artery bypass surgery.

PubMed

Sorensen, E R; Manna, D; McCourt, K

1994-01-01

To replicate a previous study that described the incidence and characteristics of patients after coronary artery bypass graft surgery who required the use of epicardial pacing wires and to explore the reasons for epicardial pacing wire use in this patient population. Ex post facto descriptive correlational. Cardiothoracic intensive care and step down units of a 500-bed medical center. Convenience sample of 196 patients after coronary artery bypass graft surgery, 165 who did not use the epicardial pacing wires and 31 who used the epicardial pacing wires to augment cardiac output, diagnose dysrhythmias, suppress dysrhythmias, or treat heart block. Patients receiving other surgical techniques in combination with coronary artery bypass graft surgery were not included. Recording of demographic and clinical data for all of the sample population, with additional data collected when the epicardial pacing wires were used. Independent t test and chi-square analysis were used to determine significance between the means and frequencies in the variables of the patients who used the epicardial pacing wires and those who did not. The significance level was set at 0.05. There were no statistically significant differences between the groups in terms of age or previous or recent myocardial infarction, which was opposite of the replicated study's findings. A statistically significant difference (p < 0.001) was found between the groups for the use of inotropic support, which was also opposite of the findings of that study. The group requiring epicardial pacing wire utilization demonstrated a greater need for diuretics in the preoperative phase than those who did not (p < 0.01), as well as a higher use of digitalis therapy before surgery (p < 0.01). Additionally, those who were paced experienced a greater cardiac output (p = 0.013) and cardiac index (p = 0.018) after pacing was initiated. The variation in findings between this study and the one replicated may be the result of variations in the patient populations, treatment practices, or preoperative condition. Replication of this study at a future date may reveal variables not identified here.

Validation of electromechanical wave imaging in a canine model during pacing and sinus rhythm.

PubMed

Grondin, Julien; Costet, Alexandre; Bunting, Ethan; Gambhir, Alok; Garan, Hasan; Wan, Elaine; Konofagou, Elisa E

2016-11-01

Accurate determination of regional areas of arrhythmic triggers is of key interest to diagnose arrhythmias and optimize their treatment. Electromechanical wave imaging (EWI) is an ultrasound technique that can image the transient deformation in the myocardium after electrical activation and therefore has the potential to detect and characterize location of triggers of arrhythmias. The objectives of this study were to investigate the relationship between the electromechanical and the electrical activation of the left ventricular (LV) endocardial surface during epicardial and endocardial pacing and during sinus rhythm as well as to map the distribution of electromechanical delays. In this study, 6 canines were investigated. Two external electrodes were sutured onto the epicardial surface of the LV. A 64-electrode basket catheter was inserted through the apex of the LV. Ultrasound channel data were acquired at 2000 frames/s during epicardial and endocardial pacing and during sinus rhythm. Electromechanical and electrical activation maps were synchronously obtained from the ultrasound data and the basket catheter, respectively. The mean correlation coefficient between electromechanical and electrical activation was 0.81 for epicardial anterior pacing, 0.79 for epicardial lateral pacing, 0.69 for endocardial pacing, and 0.56 for sinus rhythm. The electromechanical activation sequence determined by EWI follows the electrical activation sequence and more specifically in the case of pacing. This finding is of key interest in the role that EWI can play in the detection of the anatomical source of arrhythmias and the planning of pacing therapies such as cardiovascular resynchronization therapy. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Validation of Electromechanical Wave Imaging in a canine model during pacing and sinus rhythm

PubMed Central

Grondin, Julien; Costet, Alexandre; Bunting, Ethan; Gambhir, Alok; Garan, Hasan; Wan, Elaine; Konofagou, Elisa E.

2016-01-01

Background Accurate determination of regional areas of arrhythmic triggers is of key interest to diagnose arrhythmias and optimize their treatment. Electromechanical wave imaging (EWI) is an ultrasound technique that can image the transient deformation in the myocardium following electrical activation and therefore has the potential to detect and characterize location of triggers of arrhythmias. Objectives The objectives of this study are to investigate the relationship between electromechanical and electrical activation of the left-ventricular (LV) endocardial surface during epicardial and endocardial pacing as well as during sinus rhythm and also to investigate the distribution of electromechanical delays. Methods In this study, six canines were investigated. Two external electrodes were sutured onto the epicardial surface of the left ventricle (LV). A 64-electrode basket catheter was inserted through the apex of the LV. Ultrasound channel data were acquired at 2000 frames/s during epicardial and endocardial pacing as well as during sinus rhythm. Electromechanical and electrical activation maps were synchronously obtained from the ultrasound data and the basket catheter respectively. Results The mean correlation coefficient between electromechanical and electrical activation was R=0.81 for epicardial anterior pacing, R=0.79 for epicardial lateral pacing, R=0.69 for endocardial pacing and R=0.56 for sinus rhythm. Conclusions The electromechanical activation sequence determined by EWI follows the electrical activation sequence and more specifically in the case of pacing. This finding is of key interest in the role that EWI can play in the detection of the anatomical source of arrhythmias and the planning of pacing therapies such as cardiovascular resynchronization therapy. PMID:27498277

Randomized, double-blind trial of simultaneous right and left atrial epicardial pacing for prevention of post-open heart surgery atrial fibrillation.

PubMed

Daoud, E G; Dabir, R; Archambeau, M; Morady, F; Strickberger, S A

2000-08-15

The purpose of this study was to assess simultaneous right and left atrial pacing as prophylaxis for postoperative atrial fibrillation. In a double-blind, randomized fashion, 118 patients who underwent open heart surgery were assigned to right atrial pacing at 45 bpm (RA-AAI; n=39), right atrial triggered pacing at a rate of >/=85 bpm (RA-AAT; n=38), or simultaneous right and left atrial triggered pacing at a rate of >/=85 bpm (Bi-AAT; n=41). Holter monitoring was performed for 4. 8+/-1.4 days after surgery to assess for episodes of atrial fibrillation lasting >5 minutes. The prevalence of postoperative atrial fibrillation was significantly less in the patients randomized to biatrial AAT pacing when compared with the other 2 pacing regimens (P=0.02). An episode of atrial fibrillation occurred in 4 (10%) of 41 patients in the Bi-AAT group compared with 11 (28%) of 39 patients in the RA-AAI group (P=0.03 versus Bi-AAT) and 12 (32%) of 38 patients in the RA-AAT group (P=0.01 versus Bi-AAT). There was no difference in the occurrence of atrial fibrillation between the right atrial AAI and AAT groups (P=0.8). There was no significant difference among the 3 groups with regard to the number of postoperative hospital days (7.3+/-4.2 days), morbidity (5.1%), or mortality rate (2.5%). Simultaneous right and left atrial triggered pacing is well tolerated and significantly reduces the prevalence of post-open heart surgery atrial fibrillation.

Increased cardiac output elicits higher V̇O2max in response to self-paced exercise.

PubMed

Astorino, Todd Anthony; McMillan, David William; Edmunds, Ross Montgomery; Sanchez, Eduardo

2015-03-01

Recently, a self-paced protocol demonstrated higher maximal oxygen uptake versus the traditional ramp protocol. The primary aim of the current study was to further explore potential differences in maximal oxygen uptake between the ramp and self-paced protocols using simultaneous measurement of cardiac output. Active men and women of various fitness levels (N = 30, mean age = 26.0 ± 5.0 years) completed 3 graded exercise tests separated by a minimum of 48 h. Participants initially completed progressive ramp exercise to exhaustion to determine maximal oxygen uptake followed by a verification test to confirm maximal oxygen uptake attainment. Over the next 2 sessions, they performed a self-paced and an additional ramp protocol. During exercise, gas exchange data were obtained using indirect calorimetry, and thoracic impedance was utilized to estimate hemodynamic function (stroke volume and cardiac output). One-way ANOVA with repeated measures was used to determine differences in maximal oxygen uptake and cardiac output between ramp and self-paced testing. Results demonstrated lower (p < 0.001) maximal oxygen uptake via the ramp (47.2 ± 10.2 mL·kg(-1)·min(-1)) versus the self-paced (50.2 ± 9.6 mL·kg(-1)·min(-1)) protocol, with no interaction (p = 0.06) seen for fitness level. Maximal heart rate and cardiac output (p = 0.02) were higher in the self-paced protocol versus ramp exercise. In conclusion, data show that the traditional ramp protocol may underestimate maximal oxygen uptake compared with a newly developed self-paced protocol, with a greater cardiac output potentially responsible for this outcome.

To pace or not to pace: a pilot study of four- and five-gaited Icelandic horses homozygous for the DMRT3 'Gait Keeper' mutation.

PubMed

Jäderkvist Fegraeus, K; Hirschberg, I; Árnason, T; Andersson, L; Velie, B D; Andersson, L S; Lindgren, G

2017-12-01

The Icelandic horse is a breed known mainly for its ability to perform the ambling four-beat gait 'tölt' and the lateral two-beat gait pace. The natural ability of the breed to perform these alternative gaits is highly desired by breeders. Therefore, the discovery that a nonsense mutation (C>A) in the DMRT3 gene was the main genetic factor for horses' ability to perform gaits in addition to walk, trot and canter was of great interest. Although several studies have demonstrated that homozygosity for the DMRT3 mutation is important for the ability to pace, only about 70% of the homozygous mutant (AA) Icelandic horses are reported to pace. The aim of the study was to genetically compare four- and five-gaited (i.e. horses with and without the ability to pace) AA Icelandic horses by performing a genome-wide association (GWA) analysis. All horses (n = 55) were genotyped on the 670K Axiom Equine Genotyping Array, and a GWA analysis was performed using the genabel package in r. No SNP demonstrated genome-wide significance, implying that the ability to pace goes beyond the presence of a single gene variant. Despite its limitations, the current study provides additional information regarding the genetic complexity of pacing ability in horses. However, to fully understand the genetic differences between four- and five-gaited AA horses, additional studies with larger sample materials and consistent phenotyping are needed. © 2017 Stichting International Foundation for Animal Genetics.

Dual-dye optical mapping after myocardial infarction: does the site of ventricular stimulation alter the properties of electrical propagation?

PubMed

Saba, Samir; Mathier, Michael A; Mehdi, Haider; Liu, Tong; Choi, Bum-Rak; London, Barry; Salama, Guy

2008-02-01

Myocardial infarction (MI) disrupts electrical conduction in affected ventricular areas. We investigated the effect of MI on the regional voltage and calcium (Ca) signals and their propagation properties, with special attention to the effect of the site of ventricular pacing on these properties. New Zealand White rabbits were divided into four study groups: sham-operated (C, n = 6), MI with no pacing (MI, n = 7), MI with right ventricular pacing (MI + RV, n = 6), and MI with BIV pacing (MI + BIV, n = 7). At 4 weeks, hearts were excised, perfused, and optically mapped. As previously shown, systolic and diastolic dilation of the LV were prevented by BIV pacing, as was the reduction in LV fractional shortening. Four weeks after MI, optical mapping revealed markedly reduced action potential amplitudes and conduction velocities (CV) in MI zones, and these increased gradually in the border zone and normal myocardial areas. Also, Ca transients were absent in the infarcted areas and increased gradually 3-5 mm from the border of the normal zone. Neither BIV nor RV pacing affected these findings in any of the MI, border, or normal zones. MI has profound effects on the regional electrical and Ca signals and on their propagation properties in this rabbit model. The absence of differences in these parameters by study group suggests that altering the properties of myocardial electrical conduction and Ca signaling are unlikely mechanisms by which BIV pacing confers its benefits. Further studies into the regional, cellular, and molecular benefits of BIV pacing are therefore warranted.

Influence of atrial substrate on local capture induced by rapid pacing of atrial fibrillation.

PubMed

Rusu, Alexandru; Jacquemet, Vincent; Vesin, Jean-Marc; Virag, Nathalie

2014-05-01

Preliminary studies showed that the septum area was the only location allowing local capture of both the atria during rapid pacing of atrial fibrillation (AF) from a single site. The present model-based study investigated the influence of atrial substrate on the ability to capture AF when pacing the septum. Three biophysical models of AF with an identical anatomy from human atria but with different AF substrates were used: (i) AF based on multiple wavelets, (ii) AF based on heterogeneities in vagal activation, (iii) AF based on heterogeneities in repolarization. A fourth anatomical model without Bachmann's bundle (BB) was also implemented. Rapid pacing was applied from the septum at pacing cycle lengths in the range of 50-100% of AF cycle length. Local capture was automatically assessed with 24 pairs of electrodes evenly distributed on the atrial surface. The results were averaged over 16 AF simulations. In the homogeneous substrate, AF capture could reach 80% of the atrial surface. Heterogeneities degraded the ability to capture during AF. In the vagal substrate, the capture tended to be more regular and the degradation of the capture was not directly related to the spatial extent of the heterogeneities. In the third substrate, heterogeneities induced wave anchorings and wavebreaks even in areas close to the pacing site, with a more dramatic effect on AF capture. Finally, BB did not significantly affect the ability to capture. Atrial fibrillation substrate had a significant effect on rapid pacing outcomes. The response to therapeutic pacing may therefore be specific to each patient.

Difference Between Dormant Conduction Sites Revealed by Adenosine Triphosphate Provocation and Unipolar Pace-Capture Sites Along the Ablation Line After Pulmonary Vein Isolation.

PubMed

Kogawa, Rikitake; Okumura, Yasuo; Watanabe, Ichiro; Sonoda, Kazumasa; Sasaki, Naoko; Takahashi, Keiko; Iso, Kazuki; Nagashima, Koichi; Ohkubo, Kimie; Nakai, Toshiko; Kunimoto, Satoshi; Hirayama, Atsushi

2016-01-01

Dormant pulmonary vein (PV) conduction revealed by adenosine/adenosine triphosphate (ATP) provocation test and exit block to the left atrium by pacing from the PV side of the ablation line ("pace and ablate" method) are used to ensure durable pulmonary vein isolation (PVI). However, the mechanistic relation between ATP-provoked PV reconnection and the unexcitable gap along the ablation line is unclear.Forty-five patients with atrial fibrillation (AF) (paroxysmal: 31 patients, persistent: 14 patients; age: 61.1 ± 9.7 years) underwent extensive encircling PVI (EEPVI, 179 PVs). After completion of EEPVI, an ATP provocation test (30 mg, bolus injection) and unipolar pacing (output, 10 mA; pulse width, 2 ms) were performed along the previous EEPVI ablation line to identify excitable gaps. Dormant conduction was revealed in 29 (34 sites) of 179 PVs (16.2%) after EEP-VI (22/45 patients). Pace capture was revealed in 59 (89 sites) of 179 PVs (33.0%) after EEPVI (39/45 patients), and overlapping sites, ie, sites showing both dormant conduction and pace capture, were observed in 22 of 179 (12.3%) PVs (17/45 patients).Some of the ATP-provoked dormant PV reconnection sites were identical to the sites with excitable gaps revealed by pace capture, but most of the PV sites were differently distributed, suggesting that the main underling mechanism differs between these two forms of reconnection. These findings also suggest that performance of the ATP provocation test followed by the "pace and ablate" method can reduce the occurrence of chronic PV reconnections.

Atrial septal pacing in small dogs: a pilot study.

PubMed

Jones, Ashley E; Estrada, Amara H; Pariaut, Romain; Sosa-Samper, Ivan; Shih, Andre C; Mincey, Brandy D; Moïse, N Sydney

2014-09-01

To determine the feasibility of atrial septal pacing via a delivery catheter-guided small non-retracting helix pacing lead. Six healthy beagles (8.3-12.9 kg). Using single plane fluoroscopic guidance, Medtronic(®) 3830 SelectSecure leads were connected to the atrial septum via Medtronic® Attain Select® II standard 90 Left Heart delivery catheter. Pacing threshold and lead impedance were measured at implantation. The Wenckebach point was tested via atrial pacing up to 220 paced pulses per minute (ppm). Thoracic radiographs were performed following implantation to identify the lead position, and repeated at 24 h, 1 month, and 3 months post-operatively. Macro-lead dislodgement occurred in two dogs at 24 h and in three dogs at one-month post-implantation. Lead impedance, measured at the time of implantation, ranged from 583 to 1421 Ω. The Wenckebach point was >220 ppm in four of the six dogs. The remaining two dogs had Wenckebach points of 120 and 190 ppm. This pilot study suggests the selected implantation technique and lead system were inadequate for secure placement in the atrial septum of these dogs. The possible reasons for inadequate stability include unsuitable lead design for this location, inadequate lead slack at the time of implantation and inadequate seating of the lead as evidenced by low impedance at the time of implantation. Other implantation techniques and/or pacing leads should be investigated to determine the optimal way of pacing the atria in small breed dogs that are prone to sinus node dysfunction. Copyright © 2014 Elsevier B.V. All rights reserved.

Improving pacemaker therapy in congenital heart disease: contractility and resynchronization.

PubMed

Karpawich, Peter P

2015-01-01

Designed as effective therapy for patients with symptomatic bradycardia, implantable cardiac pacemakers initially served to improve symptoms and survival. With initial applications to the elderly and those with severe myocardial disease, extended longevity was not a major concern. However, with design technology advances in leads and generators since the 1980s, pacemaker therapy is now readily applicable to all age patients, including children with congenital heart defects. As a result, emphasis and clinical interests have advanced beyond simply quantity to quality of life. Adverse cardiac effects of pacing from right ventricular apical or epicardial sites with resultant left bundle branch QRS configurations have been recognized. As a result, and with the introduction of newer catheter-delivered pacing leads, more recent studies have focused on alternative or select pacing sites such as septal, outflow tract, and para-bundle of His. This is especially important in dealing with pacemaker therapy among younger patients and those with congenital heart disease, with expected decades of artificial cardiac stimulation, in which adverse myocellular changes secondary to pacing itself have been reported. As a correlate to these alternate or select pacing sites, applications of left ventricular pacing, either via the coronary sinus, intraseptal or epicardial, alone or in combination with right ventricular pacing, have gained interest for patients with heart failure. Although cardiac resynchronization pacing has, to date, had limited clinical applications among patients with congenital heart disease, the few published reports do indicate potential benefits as a bridge to cardiac transplant. Copyright © 2015 Elsevier Inc. All rights reserved.

Long-Term Outcome of Single-Chamber Atrial Pacing Compared with Dual-Chamber Pacing in Patients with Sinus-Node Dysfunction and Intact Atrioventricular Node Conduction

PubMed Central

Kim, Won Ho; Joung, Boyoung; Shim, Jaemin; Park, Jong Sung; Hwang, Eui-Seock; Pak, Hui-Nam; Kim, Sungsoon

2010-01-01

Purpose The optimal pacing mode with either single chamber atrial pacemaker (AAI or AAIR) or dual chamber pacemaker (DDD or DDDR) is still not clear in sinus-node dysfunction (SND) and intact atrioventricular (AV) conduction. Materials and Methods Patients who were implanted with permanent pacemaker using AAI(R) (n = 73) or DDD(R) (n = 113) were compared. Results The baseline characteristics were comparable between the two groups, with a mean follow-up duration of 69 months. The incidence of death did not show statistical difference. However, the incidence of hospitalization for congestive heart failure (CHF) was significantly lower in the AAI(R) group (0%) than the DDD(R) group (8.8%, p = 0.03). Also, atrial fibrillation (AF) was found in 2.8% in the AAI(R) group, which was statistically different from 15.2% of patients in the DDD(R) group (p = 0.01). Four patients (5.5%) with AAI(R) developed AV block, and subsequently switched to DDD(R) pacing. The risk of AF was lower in the patients implanted with AAI(R) than those with DDD(R) [hazard ratio (HR), 0.84; 95% confidence interval, 0.72 to 0.97, p = 0.02]. Conclusion In patients with SND and intact AV conduction, AAI(R) pacing can achieve a better clinical outcome in terms of occurrence of CHF and AF than DDD(R) pacing. These findings support AAI(R) pacing as the preferred pacing mode in patients with SND and intact AV conduction. PMID:20879047

Visual Benefits in Apparent Motion Displays: Automatically Driven Spatial and Temporal Anticipation Are Partially Dissociated

PubMed Central

Ahrens, Merle-Marie; Veniero, Domenica; Gross, Joachim; Harvey, Monika; Thut, Gregor

2015-01-01

Many behaviourally relevant sensory events such as motion stimuli and speech have an intrinsic spatio-temporal structure. This will engage intentional and most likely unintentional (automatic) prediction mechanisms enhancing the perception of upcoming stimuli in the event stream. Here we sought to probe the anticipatory processes that are automatically driven by rhythmic input streams in terms of their spatial and temporal components. To this end, we employed an apparent visual motion paradigm testing the effects of pre-target motion on lateralized visual target discrimination. The motion stimuli either moved towards or away from peripheral target positions (valid vs. invalid spatial motion cueing) at a rhythmic or arrhythmic pace (valid vs. invalid temporal motion cueing). Crucially, we emphasized automatic motion-induced anticipatory processes by rendering the motion stimuli non-predictive of upcoming target position (by design) and task-irrelevant (by instruction), and by creating instead endogenous (orthogonal) expectations using symbolic cueing. Our data revealed that the apparent motion cues automatically engaged both spatial and temporal anticipatory processes, but that these processes were dissociated. We further found evidence for lateralisation of anticipatory temporal but not spatial processes. This indicates that distinct mechanisms may drive automatic spatial and temporal extrapolation of upcoming events from rhythmic event streams. This contrasts with previous findings that instead suggest an interaction between spatial and temporal attention processes when endogenously driven. Our results further highlight the need for isolating intentional from unintentional processes for better understanding the various anticipatory mechanisms engaged in processing behaviourally relevant stimuli with predictable spatio-temporal structure such as motion and speech. PMID:26623650

Social Interaction in Self-Paced Distance Education

ERIC Educational Resources Information Center

Anderson, Terry; Upton, Lorne; Dron, Jon; Malone, Judi; Poelhuber, Bruno

2015-01-01

In this paper we present a case study of a self-paced university course that was originally designed to support independent, self-paced study at distance. We developed a social media intervention, in design-based research terms, that allows these independent students to contribute archived content to enhance the course, to engage in discussions…

42 CFR 423.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the term in § 422.2 of this chapter. MA-PD plan means an MA plan that provides qualified prescription... prescription drug plan, an MA-PD plan, a PACE Plan offering qualified prescription drug coverage, or a cost... PDP sponsor, MA organization offering a MA-PD plan, a PACE organization offering a PACE plan including...

The Positive Alternative Credit Experience (PACE) Program a Quantitative Comparative Study

ERIC Educational Resources Information Center

Warren, Rebecca Anne

2011-01-01

The purpose of this quantitative comparative study was to evaluate the Positive Alternative Credit Experience (PACE) Program using an objectives-oriented approach to a formative program evaluation. The PACE Program was a semester-long high school alternative education program designed to serve students at-risk for academic failure or dropping out…

PACE Instructor Guide. Level 1. Research & Development Series No. 240A.

ERIC Educational Resources Information Center

Ashmore, M. Catherine; Pritz, Sandra G.

This teaching guide is designed for use in implementing the first level of a comprehensive entrepreneurship curriculum entitled: A Program for Acquiring Competence in Entrepreneurship (PACE). Designed for use with secondary students, the first level of PACE consists of 18 lessons that introduce students to the concepts involved in entrepreneurship…

Application of PACE Principles for Population Health Management of Frail Older Adults.

PubMed

Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

2015-10-01

To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

Acquired tricuspid valve stenosis due to intentionally redundant transvenous lead placement for VDD pacing in two small dogs.

PubMed

Gunther-Harrington, Catherine T; Michel, Adam O; Stern, Joshua A

2015-12-01

Placement of an endocardial VDD pacing lead in small dogs (<12 kg) may necessitate a redundant lead remaining looped in the right atrium for appropriate sensing and pacing. This report documented acquired tricuspid valve stenosis in two small dogs between 8 months and 4 years after VDD pacemaker placement for third-degree atrioventricular block. Echocardiography and Doppler echocardiography identified elevated transtricuspid flow velocities, prolonged pressure half-times, decreased valve leaflet excursions, and tricuspid regurgitation in both cases. Both cases were euthanized secondary to this pacing complication. Necropsy was performed in one case and confirmed adherence between the redundant lead loop, atrial and valve tissue. While VDD pacing in dogs has proven hemodynamic benefits, these benefits have not been demonstrated in terms of survival benefit or clinical signs. The requirement of redundant lead placement in small dogs for appropriate VDD lead function creates potential deleterious effects that should be weighed against the possible clinical value of VDD pacing in these patients. Copyright © 2015 Elsevier B.V. All rights reserved.

Left heart pacing lead implantation using subxiphoid videopericardioscopy.

PubMed

Zenati, Marco A; Bonanomi, Gianluca; Chin, Albert K; Schwartzman, David

2003-09-01

Recent clinical data support the utility of left heart pacing. The transvenous approach for left heart pacing lead implantation is imperfect. A direct epicardial approach may have advantages, but heretofore its utility has been limited because of the requirement for thoracotomy. We sought to examine the feasibility of a method for epicardial lead implantation that did not require thoracotomy. In five large swine, percutaneous access to the epicardium was achieved with subxiphoid videopericardioscopy, using a device that marries endoscopy with a port through which pacing leads could be introduced. In each animal, standard, active fixation pacing leads were implanted onto the left atrium and ventricle. The atrial lead was implanted at the base of the appendage. The ventricular lead was implanted on the anterior, lateral, and inferior walls. Continuous direct visualization of the epicardium provided guidance for lead localization and fixation, including avoidance of complications such as trauma to epicardial coronary vessels. Capture thresholds were uniformly low. Postmortem examination demonstrated anatomically accurate, uncomplicated lead fixation. Using subxiphoid videopericardioscopy, uncomplicated, anatomically accurate left heart epicardial pacing lead implantation can be achieved without thoracotomy.

Ocean Heat Uptake Slows 21st Century Surface Warming Driven by Extratropical Cloud Feedbacks

NASA Astrophysics Data System (ADS)

Frey, W.; Maroon, E.; Pendergrass, A. G.; Kay, J. E.

2017-12-01

Equilibrium climate sensitivity (ECS), the warming in response to instantaneously doubled CO2, has long been used to compare climate models. In many models, ECS is well correlated with warming produced by transient forcing experiments. Modifications to cloud phase at high latitudes in a state-of-the-art climate model, the Community Earth System Model (CESM), produce a large increase in ECS (1.5 K) via extratropical cloud feedbacks. However, only a small surface warming increase occurs in a realistic 21st century simulation including a full-depth dynamic ocean and the "business as usual" RCP8.5 emissions scenario. In fact, the increase in surface warming is only barely above the internal variability-generated range in the CESM Large Ensemble. The small change in 21st century warming is attributed to subpolar ocean heat uptake in both hemispheres. In the Southern Ocean, the mean-state circulation takes up heat while in the North Atlantic a slowdown in circulation acts as a feedback to slow surface warming. These results show the importance of subpolar ocean heat uptake in controlling the pace of warming and demonstrate that ECS cannot be used to reliably infer transient warming when it is driven by extratropical feedbacks.

A quantum relaxation-time approximation for finite fermion systems

NASA Astrophysics Data System (ADS)

Reinhard, P.-G.; Suraud, E.

2015-03-01

We propose a relaxation time approximation for the description of the dynamics of strongly excited fermion systems. Our approach is based on time-dependent density functional theory at the level of the local density approximation. This mean-field picture is augmented by collisional correlations handled in relaxation time approximation which is inspired from the corresponding semi-classical picture. The method involves the estimate of microscopic relaxation rates/times which is presently taken from the well established semi-classical experience. The relaxation time approximation implies evaluation of the instantaneous equilibrium state towards which the dynamical state is progressively driven at the pace of the microscopic relaxation time. As test case, we consider Na clusters of various sizes excited either by a swift ion projectile or by a short and intense laser pulse, driven in various dynamical regimes ranging from linear to strongly non-linear reactions. We observe a strong effect of dissipation on sensitive observables such as net ionization and angular distributions of emitted electrons. The effect is especially large for moderate excitations where typical relaxation/dissipation time scales efficiently compete with ionization for dissipating the available excitation energy. Technical details on the actual procedure to implement a working recipe of such a quantum relaxation approximation are given in appendices for completeness.

Characterizing Urban Household Waste Generation and Metabolism Considering Community Stratification in a Rapid Urbanizing Area of China

PubMed Central

Xiao, Lishan; Lin, Tao; Chen, Shaohua; Zhang, Guoqin; Ye, Zhilong; Yu, Zhaowu

2015-01-01

The relationship between social stratification and municipal solid waste generation remains uncertain under current rapid urbanization. Based on a multi-object spatial sampling technique, we selected 191 households in a rapidly urbanizing area of Xiamen, China. The selected communities were classified into three types: work-unit, transitional, and commercial communities in the context of housing policy reform in China. Field survey data were used to characterize household waste generation patterns considering community stratification. Our results revealed a disparity in waste generation profiles among different households. The three community types differed with respect to family income, living area, religious affiliation, and homeowner occupation. Income, family structure, and lifestyle caused significant differences in waste generation among work-unit, transitional, and commercial communities, respectively. Urban waste generation patterns are expected to evolve due to accelerating urbanization and associated community transition. A multi-scale integrated analysis of societal and ecosystem metabolism approach was applied to waste metabolism linking it to particular socioeconomic conditions that influence material flows and their evolution. Waste metabolism, both pace and density, was highest for family structure driven patterns, followed by lifestyle and income driven. The results will guide community-specific management policies in rapidly urbanizing areas. PMID:26690056

[Influence of pacing site on myocardial transmural dispersion of repolarization in intact normal and dilated cardiomyopathy dogs].

PubMed

Bai, Rong; Pu, Jun; Liu, Nian; Lu, Jia-Gao; Zhou, Qiang; Ruan, Yan-Fei; Niu, Hui-Yan; Wang, Lin

2003-12-25

In order to verify the hypothesis that left ventricular epicardial (LV-Epi) pacing and biventricular (BiV) pacing unavoidably influence the myocardial electrophysiological characters and may result in high risk of malignant ventricular arrhythmia, we calculated, in both normal mongrel dogs and dog models with rapid-right-ventricular-pacing induced dilated cardiomyopathy congestive heart failure (DCM-CHF), the monophasic action potential duration (MAPD) and the transmural dispersion of repolarization (TDR) in intracardiac electrogram together with the QT interval and T(peak)-T(end) (T(p(-T(e)) interval in surface electrocardiogram (ECG) during LV-Epi and BiV pacing, compared with those during right ventricular endocardial (RV-Endo) pacing. To prepare the DCM-CHF dog model, rapid right ventricular pacing (250 bpm) was performed for 23.6+/-2.57 days to the dog. All the normal and DCM-CHF dogs were given radio frequency catheter ablation (RFCA) to His bundle with the guide of X-ray fluoroscopy. After the RFCA procedures, the animals were under the situation of complete atrioventricular block so that the canine heart rates could be voluntarily controlled in the following experiments. After a thoracotomy, ECG and monophasic action potentials (MAP) of subendocardial, subepicardial and mid-layer myocardium were recorded synchronously in 8 normal and 5 DCM-CHF dogs during pacing from endocardium of RV apex (RV-Endo), epicardium of LV anterior wall (LV-Epi) and simultaneously both of the above (biventricular, BiV), the later was similar to the ventricular resynchronization therapy to congestive heart failure patients in clinic. The Tp-Te) meant the interval from the peak to the end of T wave, which was a representative index of TDR in surface ECG. The TDR was defined as the difference between the longest and the shortest MAPD of subendocardial, subepicardial and mid-layer myocardium. Our results showed that in normal dogs, pacing participating of LV (LV-Epi, BiV) prolonged MAPD of all the three layers of the myocardium (P<0.05) with the character that mid-layer MAPD was the longest and subepicardial MAPD was the shortest following subendocardial MAPD. At the same time, TDR prolonged from 26.75 ms at RV-Endo pacing to 37.54 ms at BiV pacing and to 47.16 ms at LV-Epi pacing (P<0.001). Meanwhile in surface ECG, BiV and LV-Epi pacing resulted in a longer Tp-Te) interval compared with RV-Endo pacing (P<0.01), without parallel QT interval prolongation. Furthermore, all the DCM-CHF model dogs showed manifestations of congestive heart failure and enlargement of left ventricles. Based on the lengthening of mid-layer MAPD from 257.35 ms to 276.30 ms (P<0.0001) and increase of TDR from 27.58 ms to 33.80 ms (P equals;0.002) in DCM-CHF model due to the structural disorders of myocardium compared with the normal dog, LV-Epi and BiV pacing also led to the effect of prolonging MAPD of three layers of the myocardium and enlarging TDR. From these results we make the conclusions that prolongation of MAPD of subendocardial, subepicardial and mid-layer myocardium and increase in TDR during pacing participating of LV (LV-Epi, BiV) may contribute to the formation of unidirectional block and reentry, which play roles or at least are the high risk factors in the development of malignant ventricular arrhythmia, especially in case of structural disorders of myocardium. These findings must be considered seriously when ventricular resynchronization therapy is performed to congestive heart failure patients.

Solder Joint Health Monitoring Testbed

NASA Technical Reports Server (NTRS)

Delaney, Michael M.; Flynn, James; Browder, Mark

2009-01-01

A method of monitoring the health of selected solder joints, called SJ-BIST, has been developed by Ridgetop Group Inc. under a Small Business Innovative Research (SBIR) contract. The primary goal of this research program is to test and validate this method in a flight environment using realistically seeded faults in selected solder joints. An additional objective is to gather environmental data for future development of physics-based and data-driven prognostics algorithms. A test board is being designed using a Xilinx FPGA. These boards will be tested both in flight and on the ground using a shaker table and an altitude chamber.

Molecular evidence of stereo-specific lactoferrin dimers in solution.

PubMed

Persson, Björn A; Lund, Mikael; Forsman, Jan; Chatterton, Dereck E W; Akesson, Torbjörn

2010-10-01

Gathering experimental evidence suggests that bovine as well as human lactoferrin self-associate in aqueous solution. Still, a molecular level explanation is unavailable. Using force field based molecular modeling of the protein-protein interaction free energy we demonstrate (1) that lactoferrin forms highly stereo-specific dimers at neutral pH and (2) that the self-association is driven by a high charge complementarity across the contact surface of the proteins. Our theoretical predictions of dimer formation are verified by electrophoretic mobility and N-terminal sequence analysis on bovine lactoferrin. 2010 Elsevier B.V. All rights reserved.

The data life cycle applied to our own data.

PubMed

Goben, Abigail; Raszewski, Rebecca

2015-01-01

Increased demand for data-driven decision making is driving the need for librarians to be facile with the data life cycle. This case study follows the migration of reference desk statistics from handwritten to digital format. This shift presented two opportunities: first, the availability of a nonsensitive data set to improve the librarians' understanding of data-management and statistical analysis skills, and second, the use of analytics to directly inform staffing decisions and departmental strategic goals. By working through each step of the data life cycle, library faculty explored data gathering, storage, sharing, and analysis questions.

Recommendations for pacemaker implantation for the treatment of atrial tachyarrhythmias and resynchronisation therapy for heart failure

PubMed Central

van Hemel, N.M.; Dijkman, B.; de Voogt, W.G.; Beukema, W.P.; Bosker, H.A.; de Cock, C.C.; Jordaens, L.J.L.M.; van Gelder, I.C.; van Gelder, L.M.; van Mechelen, R.; Ruiter, J.H.; Sedney, M.I.; Slegers, L.C.

2004-01-01

Today, new pacing algorithms and stimulation methods for the prevention and interruption of atrial tachyarrhythmias can be applied on patients who need bradycardia pacing for conventional reasons. In addition, biventricular pacing as additive treatment for patients with severe congestive heart failure due to ventricular systolic dysfunction and prolonged intraventricular conduction has shown to improve symptoms and reduce hospital admissions. These new pacing technologies and the optimising of the pacing programmes are complex, expensive and time-consuming. Based on many clinical studies the indications for these devices are beginning to emerge. To support the cardiologist's decision-making and to prevent waste of effort and resources, the 'ad hoc committee' has provided preliminary recommendations for implantable devices to treat atrial tachyarrhythmias and to extend the treatment of congestive heart failure respectively. PMID:25696255

Conservation law for self-paced movements.

PubMed

Huh, Dongsung; Sejnowski, Terrence J

2016-08-02

Optimal control models of biological movements introduce external task factors to specify the pace of movements. Here, we present the dual to the principle of optimality based on a conserved quantity, called "drive," that represents the influence of internal motivation level on movement pace. Optimal control and drive conservation provide equivalent descriptions for the regularities observed within individual movements. For regularities across movements, drive conservation predicts a previously unidentified scaling law between the overall size and speed of various self-paced hand movements in the absence of any external tasks, which we confirmed with psychophysical experiments. Drive can be interpreted as a high-level control variable that sets the overall pace of movements and may be represented in the brain as the tonic levels of neuromodulators that control the level of internal motivation, thus providing insights into how internal states affect biological motor control.

Acquired tricuspid valve stenosis associated with two ventricular endocardial pacing leads in a dog.

PubMed

Tompkins, Emily; Dulake, Michelle I; Ghaffari, Shadie; Nakamura, Reid K

2015-01-01

Acquired tricuspid valve stenosis (TVS) is a rare complication of endocardial pacing lead implantation in humans that has only been described once previously in the veterinary literature in a dog with excessive lead redundancy. A 12 yr old terrier presented with right-sided congestive heart failure 6 mo after implantation of a second ventricular endocardial pacing lead. The second lead was placed due to malfunction of the first lead, which demonstrated abnormally low impedance. Transthoracic echocardiography identified hyperechoic tissue associated with the pacing leads as they crossed the tricuspid valve annulus as well as a stenotic tricuspid inflow pattern via spectral Doppler interrogation. Medical management was ultimately unsuccessful and the dog was euthanized 6 wk after TVS was diagnosed. The authors report the first canine case of acquired TVS associated with two ventricular endocardial pacing leads.

Ocean-atmosphere science from the NASA Plankton, Aerosol, Cloud, ocean Ecosystem (PACE) mission

NASA Astrophysics Data System (ADS)

Werdell, J.

2016-12-01

The new NASA Plankton, Aerosol, Cloud, ocean Ecosystem (PACE) mission is a strategic climate continuity activity that will not only extend key heritage ocean color, cloud, and aerosol data records, but also enable new insight into oceanographic and atmospheric responses to Earth's changing climate. The primary PACE instrument will be a spectroradiometer that spans the ultraviolet to shortwave infrared region at 5 nm resolution with a ground sample distance of 1 km at nadir. This payload will likely be complemented by a multi-angle polarimeter with a similar spectral range. Scheduled for launch in 2022, this PACE instrument pair will revolutionize studies of global biogeochemistry and carbon cycles in the ocean-atmosphere system. Here, I present a PACE mission overview, with focus on instrument characteristics, core and advanced data products, and overarching science objectives.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

Different horse's paces during hippotherapy on spatio-temporal parameters of gait in children with bilateral spastic cerebral palsy: A feasibility study.

PubMed

Antunes, Fabiane Nunes; Pinho, Alexandre Severo do; Kleiner, Ana Francisca Rozin; Salazar, Ana Paula; Eltz, Giovana Duarte; de Oliveira Junior, Alcyr Alves; Cechetti, Fernanda; Galli, Manuela; Pagnussat, Aline Souza

2016-12-01

Hippotherapy is often carried out for the rehabilitation of children with Cerebral Palsy (CP), with the horse riding at a walking pace. This study aimed to explore the immediate effects of a hippotherapy protocol using a walk-trot pace on spatio-temporal gait parameters and muscle tone in children with Bilateral Spastic CP (BS-CP). Ten children diagnosed with BS-CP and 10 healthy aged-matched children (reference group) took part in this study. The children with BS-CP underwent two sessions of hippotherapy for one week of washout between them. Two protocols (lasting 30min) were applied on separate days: Protocol 1: the horse's pace was a walking pace; and Protocol 2: the horse's pace was a walk-trot pace. Children from the reference group were not subjected to treatment. A wireless inertial measurement unit measured gait spatio-temporal parameters before and after each session. The Modified Ashworth Scale was applied for muscle tone measurement of hip adductors. The participants underwent the gait assessment on a path with surface irregularities (ecological context). The comparisons between BS-CP and the reference group found differences in all spatio-temporal parameters, except for gait velocity. Within-group analysis of children with BS-CP showed that the swing phase did not change after the walk pace and after the walk-trot pace. The percentage of rolling phase and double support improved after the walk-trot. The spasticity of the hip adductors was significantly reduced as an immediate result of both protocols, but this decrease was more evident after the walk-trot. The walk-trot protocol is feasible and is able to induce an immediate effect that improves the gait spatio-temporal parameters and the hip adductors spasticity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Can body surface microvolt T-wave alternans distinguish concordant and discordant intracardiac alternans?

PubMed

Floré, Vincent; Claus, Piet; Symons, Rolf; Smith, Godfrey L; Sipido, Karin R; Willems, Rik

2013-08-01

There is convincing experimental evidence that cellular action potential duration (APD) alternans is arrhythmogenic but its relationship with body surface microvolt T-wave alternans (MTWA) remains unclear. We investigated the relationship between MTWA and APD alternans induced by alternating cycle length (CL) pacing in a pig model. In 10 pigs, catheters in the right atrium (RA) and right (RV) and left ventricle (LV) allowed pacing and recording of monophasic action potentials (MAP). During RA pacing at stable 500-ms CL, LV was paced at alternating CL (505 ms and 495 ms). Changing the alternating LV (A-LV) pacing delay changes the size of the region with alternating ventricular activation. Spectral analysis of intracardiac MAP was correlated with body surface MTWA. In a similar setup (during alternating pacing in RV and LV), we investigated concordant versus discordant APD alternans. Pacing the LV with subtle alternating cycle lengths at short A-LV delay leads to broad QRS (97 ± 10 ms), body surface MTWA (mean Valt 4.2 ± 1.8 µV), and positive RR-interval alternans. At longer A-LV delay, not resulting in QRS widening (68 ± 5 ms), body surface RR alternans was absent but MTWA remained detectable and was even more pronounced (8.7 ± 5.1 µV, P < 0.01). During both concordant and discordant pacing MTWA was present. The precordial leads were better for detecting discordant APD alternans (8.0 ± 2.9 µV and 12.8 ± 4.52 µV, P = 0.02). MTWA is a potent technique to detect subtle and isolated intracardiac APD alternans that is artificially induced by alternating pacing. In the same model, discordant activation alternans can only be discriminated from concordant when using a quantifying approach of MTWA analysis. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

The Dyad-Adaptive Paced Auditory Serial Addition Test (DA-PASAT): Normative data and the effects of repeated testing, simulated malingering, and traumatic brain injury

PubMed Central

Wyma, John M.; Herron, Timothy J.; Yund, E. William; Reed, Bruce

2018-01-01

The Paced Auditory Serial Addition Test (PASAT) is widely used to evaluate processing speed and executive function in patients with multiple sclerosis, traumatic brain injury, and other neurological disorders. In the PASAT, subjects listen to sequences of digits while continuously reporting the sum of the last two digits presented. Four different stimulus onset asynchronies (SOAs) are usually tested, with difficulty increasing as SOAs are reduced. Ceiling effects are common at long SOAs, while the digit delivery rate often exceeds the subject’s processing capacity at short SOAs, causing some subjects to stop performing altogether. In addition, subjects may adopt an “alternate answer” strategy at short SOAs, which reduces the test’s demands on working-memory and processing speed. Consequently, studies have shown that the number of dyads (consecutive correct answers) is a more sensitive measure of PASAT performance than the overall number of correct sums. Here, we describe a 2.5-minute computerized test, the Dyad-Adaptive PASAT (DA-PASAT), where SOAs are adjusted with a 2:1 staircase, decreasing after each pair of correct responses and increasing after misses. Processing capacity is reflected in the minimum SOA (minSOA) achieved in 54 trials. Experiment 1 gathered normative data in two large populations: 1617 subjects in New Zealand ranging in age from 18 to 65 years, and 214 Californians ranging in age from 18 to 82 years. Minimum SOAs were influenced by age, education, and daily hours of computer-use. Minimum SOA z-scores, calculated after factoring out the influence of these factors, were virtually identical in the two control groups, as were response times (RTs) and dyad ratios (the proportion of hits occurring in dyads). Experiment 2 measured the test-retest reliability of the DA-PASAT in 44 young subjects who underwent three test sessions at weekly intervals. High intraclass correlation coefficients (ICCs) were found for minSOAs (0.87), response times (0.76), and dyad ratios (0.87). Performance improved across test sessions for all measures. Experiment 3 investigated the effects of simulated malingering in 50 subjects: 42% of simulated malingerers produced abnormal (p< 0.05) minSOA z-scores. Simulated malingerers with abnormal scores were distinguished with 87% sensitivity and 69% specificity from control subjects with abnormal scores by excessive differences between training performance and the actual test. Experiment 4 investigated patients with traumatic brain injury (TBI): patients with mild TBI performed within the normal range while patients with severe TBI showed deficits. The DA-PASAT reduces the time and stress of PASAT assessment while gathering sensitive measures of dyad processing that reveal the effects of aging, malingering, and traumatic brain injury on performance. PMID:29677192

Ventilation patterns mimicking COPD in patients with diaphragmatic pacing for Ondine's curse. [/sup 133/Xe

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

Makhija, M.C.; Bronfman, H.J.; Lange, R.C.

1978-10-01

Ventilation was studied with /sup 133/Xe in 18 patients with central hypoventilation (Ondine's Curse) in whom diaphragmatic pacers were implanted. Three distinct patterns emerged: Type I, improvement in ventilation on the paced side (11 of 18 patients); Type II, improvement on both the paced and unpaced side (4 of 18); and Type III, no improvement (3 of 18). With the pacer off, many of these patients have patterns that mimic chronic obstructive pulmonary disease and that revert to normal with pacing. This retention, clearly reversible, cannot reflect permanent airways or airspace disease.

Sawtooth pacing by real-time auxiliary power control in a tokamak plasma.

PubMed

Goodman, T P; Felici, F; Sauter, O; Graves, J P

2011-06-17

In the standard scenario of tokamak plasma operation, sawtooth crashes are the main perturbations that can trigger performance-degrading, and potentially disruption-generating, neoclassical tearing modes. This Letter demonstrates sawtooth pacing by real-time control of the auxiliary power. It is shown that the sawtooth crash takes place in a reproducible manner shortly after the removal of that power, and this can be used to precisely prescribe, i.e., pace, the individual sawteeth. In combination with preemptive stabilization of the neoclassical tearing modes, sawtooth pacing provides a new sawtooth control paradigm for improved performance in burning plasmas.

High frequency pacing of edge localized modes by injection of lithium granules in DIII-D H-mode discharges

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

Bortolon, A.; Maingi, R.; Mansfield, D. K.

A newly installed Lithium Granule Injector (LGI) was used to pace edge localized modes (ELM) in DIII-D. ELM pacing efficiency was studied injecting lithium granules of nominal diameter 0.3–0.9mm, speed of 50–120 m s -1 and average injection rates up to 100 Hz for 0.9mm granules and up to 700 Hz for 0.3mm granules. The efficiency of ELM triggering was found to depend strongly on size of the injected granules, with triggering efficiency close to 100% obtained with 0.9mm diameter granules, lower with smaller sizes, and weakly depending on granule velocity. Robust ELM pacing was demonstrated in ITER-like plasmas formore » the entire shot length, at ELM frequencies 3–5 times larger than the ‘natural’ ELM frequency observed in reference discharges. Within the range of ELM frequencies obtained, the peak ELM heat flux at the outer strike point was reduced with increasing pacing frequency. The peak heat flux reduction at the inner strike point appears to saturate at high pacing frequency. Lithium was found in the plasma core, with a concurrent reduction of metallic impurities and carbon. Altogether, high frequency ELM pacing using the lithium granule injection appears to be compatible with both H-mode energy confinement and attractive H-mode pedestal characteristics, but further assessment is need« less

Optimal pacing strategy: from theoretical modelling to reality in 1500-m speed skating.

PubMed

Hettinga, F J; De Koning, J J; Schmidt, L J I; Wind, N A C; Macintosh, B R; Foster, C

2011-01-01

Athletes are trained to choose the pace which is perceived to be correct during a specific effort, such as the 1500-m speed skating competition. The purpose of the present study was to "override" self-paced (SP) performance by instructing athletes to execute a theoretically optimal pacing profile. Seven national-level speed-skaters performed a SP 1500-m which was analysed by obtaining velocity (every 100 m) and body position (every 200 m) with video to calculate total mechanical power output. Together with gross efficiency and aerobic kinetics, obtained in separate trials, data were used to calculate aerobic and anaerobic power output profiles. An energy flow model was applied to SP, simulating a range of pacing strategies, and a theoretically optimal pacing profile was imposed in a second race (IM). Final time for IM was ∼2 s slower than SP. Total power distribution per lap differed, with a higher power over the first 300 m for IM (637.0 (49.4) vs 612.5 (50.0) W). Anaerobic parameters did not differ. The faster first lap resulted in a higher aerodynamic drag coefficient and perhaps a less effective push-off. Experienced athletes have a well-developed performance template, and changing pacing strategy towards a theoretically optimal fast start protocol had negative consequences on speed-skating technique and did not result in better performance.

Will the Conscious-Subconscious Pacing Quagmire Help Elucidate the Mechanisms of Self-Paced Exercise? New Opportunities in Dual Process Theory and Process Tracing Methods.

PubMed

Micklewright, Dominic; Kegerreis, Sue; Raglin, John; Hettinga, Florentina

2017-07-01

The extent to which athletic pacing decisions are made consciously or subconsciously is a prevailing issue. In this article we discuss why the one-dimensional conscious-subconscious debate that has reigned in the pacing literature has suppressed our understanding of the multidimensional processes that occur in pacing decisions. How do we make our decisions in real-life competitive situations? What information do we use and how do we respond to opponents? These are questions that need to be explored and better understood, using smartly designed experiments. The paper provides clarity about key conscious, preconscious, subconscious and unconscious concepts, terms that have previously been used in conflicting and confusing ways. The potential of dual process theory in articulating multidimensional aspects of intuitive and deliberative decision-making processes is discussed in the context of athletic pacing along with associated process-tracing research methods. In attempting to refine pacing models and improve training strategies and psychological skills for athletes, the dual-process framework could be used to gain a clearer understanding of (1) the situational conditions for which either intuitive or deliberative decisions are optimal; (2) how intuitive and deliberative decisions are biased by things such as perception, emotion and experience; and (3) the underlying cognitive mechanisms such as memory, attention allocation, problem solving and hypothetical thought.

The effect of hyperkalaemia on cardiac rhythm devices.

PubMed

Barold, S Serge; Herweg, Bengt

2014-04-01

In patients with pacemakers, hyperkalaemia causes three important abnormalities that usually become manifest when the K level exceeds 7 mEq/L: (i) widening of the paced QRS complex from delayed intraventricular conduction velocity, (ii) Increased atrial and ventricular pacing thresholds that may cause failure to capture. In this respect, the atria are more susceptible to loss of capture than the ventricles, and (iii) Increased latency (usually with ventricular pacing) manifested by a greater delay of the interval from the pacemaker stimulus to the onset of depolarization. First-degree ventricular pacemaker exit block may progress to second-degree Wenckebach (type I) exit block characterized by gradual prolongation of the interval from the pacemaker stimulus to the onset of the paced QRS complex ultimately resulting in an ineffectual stimulus. The disturbance may then progress to 2 : 1, 3 : 1 pacemaker exit block, etc., and eventually to complete exit block with total lack of capture. Ventricular undersensing is uncommonly observed because of frequent antibradycardia pacing. During managed ventricular pacing, hyperkalaemia-induced marked first-degree atrioventricular block may induce a pacemaker syndrome. With implantable cardioverter-defibrillators (ICDs) oversensing of the paced or spontaneous T-wave may occur. The latter may cause inappropriate shocks. A raised impedance from the right ventricular coil to the superior vena cava coil may become an important sign of hyperkalaemia in the asymptomatic or the minimally symptomatic ICD patient.

High frequency pacing of edge localized modes by injection of lithium granules in DIII-D H-mode discharges

DOE PAGES

Bortolon, A.; Maingi, R.; Mansfield, D. K.; ...

2016-04-08

A newly installed Lithium Granule Injector (LGI) was used to pace edge localized modes (ELM) in DIII-D. ELM pacing efficiency was studied injecting lithium granules of nominal diameter 0.3–0.9mm, speed of 50–120 m s -1 and average injection rates up to 100 Hz for 0.9mm granules and up to 700 Hz for 0.3mm granules. The efficiency of ELM triggering was found to depend strongly on size of the injected granules, with triggering efficiency close to 100% obtained with 0.9mm diameter granules, lower with smaller sizes, and weakly depending on granule velocity. Robust ELM pacing was demonstrated in ITER-like plasmas formore » the entire shot length, at ELM frequencies 3–5 times larger than the ‘natural’ ELM frequency observed in reference discharges. Within the range of ELM frequencies obtained, the peak ELM heat flux at the outer strike point was reduced with increasing pacing frequency. The peak heat flux reduction at the inner strike point appears to saturate at high pacing frequency. Lithium was found in the plasma core, with a concurrent reduction of metallic impurities and carbon. Altogether, high frequency ELM pacing using the lithium granule injection appears to be compatible with both H-mode energy confinement and attractive H-mode pedestal characteristics, but further assessment is need« less

PACE and the Federal Housing Finance Agency (FHFA)

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

Zimring, Mark; Fuller, Merrian

The FHFA regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On June 18, 2009, James B. Lockhart III, then Director of FHFA, released a letter expressing concern about the negative impact of energy loan tax assessment programs (ELTAPs) - also known as Property Assessed Clean Energy (PACE) programs - on both the housing finance system and homeowner program participants. Subsequently, a number of PACE proponents responded to the concerns laid out in the FHFA letter. In early Fall 2009, word circulated that FHFA was planning to follow its June letter withmore » guidance to other agencies, possibly including Fannie Mae and Freddie Mac, discouraging them from buying loans on properties subject to PACE-type assessment liens. This triggered a second round of stakeholder letters, several of which were addressed to President Obama. On October 18, 2009, the White House, in what some believe was an attempt to obviate the need for FHFA guidance, released a Policy Framework for PACE Financing Programs that outlined best practices guidance for homeowner and lender protection. As of February 2010, FHFA and the GSEs have agreed to monitor PACE programs and work with stakeholders and the Administration to consider additional guidance beyond the Policy Framework and to collect more information on PACE program efficacy and risks. A summary of the communications timeline and highlights of the communications are provided.« less

Modeling Parenting Programs as an Interim Service for Families Waiting for Children's Mental Health Treatment.

PubMed

Cunningham, Charles E; Rimas, Heather; Chen, Yvonne; Deal, Ken; McGrath, Patrick; Lingley-Pottie, Patricia; Reid, Graham J; Lipman, Ellen; Corkum, Penny

2015-01-01

Using a discrete choice conjoint experiment, we explored the design of parenting programs as an interim strategy for families waiting for children's mental health treatment. Latent class analysis yielded 4 segments with different design preferences. Simulations predicted the Fast-Paced Personal Contact segment, 22.1% of the sample, would prefer weekly therapist-led parenting groups. The Moderate-Paced Personal Contact segment (24.7%) preferred twice-monthly therapist-led parenting groups with twice-monthly lessons. The Moderate-Paced E-Contact segment (36.3%), preferred weekly to twice-monthly contacts, e-mail networking, and a program combining therapist-led sessions with the support of a computerized telephone e-coach. The Slow-Paced E-Contact segment (16.9%) preferred an approach combining monthly therapist-led sessions, e-coaching, and e-mail networking with other parents. Simulations predicted 45.3% of parents would utilize an option combining 5 therapist coaching calls with 5 e-coaching calls, a model that could reduce costs and extend the availability of interim services. Although 41.0% preferred weekly pacing, 58% were predicted to choose an interim parenting service conducted at a twice-monthly to monthly pace. The results of this study suggest that developing interim services reflecting parental preferences requires a choice of formats that includes parenting groups, telephone-coached distance programs, and e-coaching options conducted at a flexible pace.

Farewell to the Chairman - Marine Gen. Peter Pace

Science.gov Websites

oath of office from Marine Gen. Peter Pace, who retired after more than 40 years active duty military wife Lynne after giving the general his retirement certificate. Defense Dept. photo by Cherie A solutions, Marine Gen. Peter Pace said here today as he retired from the Marine Corps after more than 40

Challenge of Engaging All Students via Self-Paced Interactive Electronic Learning Tutorials for Introductory Physics

ERIC Educational Resources Information Center

DeVore, Seth; Marshman, Emily; Singh, Chandralekha

2017-01-01

As research-based, self-paced electronic learning tools become increasingly available, a critical issue educators encounter is implementing strategies to ensure that all students engage with them as intended. Here, we first discuss the effectiveness of electronic learning tutorials as self-paced learning tools in large enrollment brick and mortar…

Interaction Equivalency in Self-Paced Online Learning Environments: An Exploration of Learner Preferences

ERIC Educational Resources Information Center

Rhode, Jason F.

2009-01-01

This mixed methods study explored the dynamics of interaction within a self-paced online learning environment. It used rich media and a mix of traditional and emerging asynchronous computer-mediated communication tools to determine what forms of interaction learners in a self-paced online course value most and what impact they perceive interaction…

How Pacing of Multimedia Instructions Can Influence Modality Effects: A Case of Superiority of Visual Texts

ERIC Educational Resources Information Center

Stiller, Klaus D.; Freitag, Annika; Zinnbauer, Peter; Freitag, Christian

2009-01-01

"Present text accompanying pictures aurally to promote learning" is a well established principle of instructional design. But recently, it was shown that under certain conditions visual texts can be preferable. Instructional pacing seems to be one of these conditions that mediate effects. Especially, enabling learners to pace an…

Meeting the Needs of Able Learners through Flexible Pacing. ERIC Digest #464.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Handicapped and Gifted Children, Reston, VA.

This information sheet, based on "Flexible Pacing for Able Learners" by Neil Daniel and June Cox, defines flexible pacing as any program in which students are taught material that is appropriately challenging for their ability and allows them to move forward in the curriculum as they master content and skill. The document outlines…

Consistency of Students' Pace in Online Learning

ERIC Educational Resources Information Center

Hershkovitz, Arnon; Nachmias, Rafi

2009-01-01

The purpose of this study is to investigate the consistency of students' behavior regarding their pace of actions over sessions within an online course. Pace in a session is defined as the number of logged actions divided by session length (in minutes). Log files of 6,112 students were collected, and datasets were constructed for examining pace…

Child and Parental Outcomes Following Involvement in a Preventive Intervention: Efficacy of the PACE Program

ERIC Educational Resources Information Center

Begle, Angela Moreland; Dumas, Jean E.

2011-01-01

This study evaluated whether engagement (i.e., attendance and quality of participation) in the Parenting our Children to Excellence (PACE) program predicted positive child and parent outcomes. PACE in an 8-week preventive intervention aimed at parents of preschool children. The study investigated the relation of engagement to outcomes in an…

Development of a Student-Paced Course in General Pathology Utilizing a Computer Managed Evaluation System.

ERIC Educational Resources Information Center

Kent, Thomas H.; And Others

The advantages, feasibility and problems associated with a student-paced course were investigated, and a computer managed evaluation system compared to paper and pencil testing mode. The development of a self-paced course was facilitated by explicit behavior objectives, a variety of learning materials referenced to the objectives and a large pool…

The Relationship between Successful Completion and Sequential Movement in Self-Paced Distance Courses

ERIC Educational Resources Information Center

Lim, Janine M.

2016-01-01

A course design question for self-paced courses includes whether or not technological measures should be used in course design to force students to follow the sequence intended by the course author. This study examined learner behavior to understand whether the sequence of student assignment submissions in a self-paced distance course is related…

Effect of "U-Pace" Instruction on Academic Success, Learning, and Perceptions in Younger and Older Undergraduates

ERIC Educational Resources Information Center

Fleming, Raymond; Barth, Dylan; Weber, Nicole; Pedrick, Laura E.; Kienzler, Sarah E.; Reddy, Diane M.

2018-01-01

A randomized controlled trial was conducted to determine the efficacy of "U-Pace" instruction for older undergraduates, ages 25 and older, and younger undergraduates, ages 18 to 24. Additionally, change in learner perceptions across the semester, an outcome not reported in the literature on "U-Pace" instruction, was…

Keeping Pace with K-12 Online & Blended Learning: An Annual Review of Policy and Practice, 2013

ERIC Educational Resources Information Center

Watson, John; Murin, Amy; Vashaw, Lauren; Gemin, Butch; Rapp, Chris

2013-01-01

This is the 10th annual "Keeping Pace" report. "Keeping Pace" has several goals: (1) add to the body of knowledge about online education policy and practice, and make recommendations for advances; (2) serve as a reference source for information about programs and policies across the country, both for policymakers and…

Pacing strategies during the swim, cycle and run disciplines of sprint, Olympic and half-Ironman triathlons.

PubMed

Wu, Sam Shi Xuan; Peiffer, Jeremiah J; Brisswalter, Jeanick; Nosaka, Kazunori; Lau, Wing Yin; Abbiss, Chris R

2015-05-01

This study investigated the influence of distance on self-selected pacing during the swim, cycle and run disciplines of sprint, Olympic and half-Ironman (HIM) distance triathlon races. Eight trained male triathletes performed the three individual races in <2 months. Participants' bikes were fitted with Schoberer Rad Meßtechnik to monitor speed, power output and heart rate during the cycle discipline. Global positioning system was worn to determine speed and heart rate during the swim and run disciplines. An even swim pacing strategy was adopted across all distances. A more stochastic pacing was observed during the HIM cycle [standard deviation of exposure variation analysis (EVASD) = 3.21 ± 0.61] when compared with the sprint cycle discipline (EVASD = 3.84 ± 0.44, p = 0.018). Only 20.9 ± 4.1 % of the cycling time was spent more than 10 % above the mean power output in the HIM, compared with 43.8 ± 2.9 % (p = 0.002) and 37.7 ± 11.1 % (p = 0.039) during the sprint and Olympic distance triathlons, respectively. Conversely, 13.6 ± 5.1 % of the cycling time was spent 5-10 % below the mean power output during the HIM, compared with 5.9 ± 1.2 % (p = 0.034) and 8.0 ± 5.1 % (p = 0.045) during the sprint and Olympic distance triathlons, respectively. A negative pacing strategy was adopted during the sprint distance run, compared with positive pacing strategy during the Olympic and HIM. Results of this study suggest that pacing strategies during triathlon are highly influenced by distance and discipline, and highlight the importance of developing pacing strategies based on distance, strengths and individual fitness.

Early performance of a miniaturized leadless cardiac pacemaker: the Micra Transcatheter Pacing Study.

PubMed

Ritter, Philippe; Duray, Gabor Z; Steinwender, Clemens; Soejima, Kyoko; Omar, Razali; Mont, Lluís; Boersma, Lucas V A; Knops, Reinoud E; Chinitz, Larry; Zhang, Shu; Narasimhan, Calambur; Hummel, John; Lloyd, Michael; Simmers, Timothy Alexander; Voigt, Andrew; Laager, Verla; Stromberg, Kurt; Bonner, Matthew D; Sheldon, Todd J; Reynolds, Dwight

2015-10-01

Permanent cardiac pacing is the only effective treatment for symptomatic bradycardia, but complications associated with conventional transvenous pacing systems are commonly related to the pacing lead and pocket. We describe the early performance of a novel self-contained miniaturized pacemaker. Patients having Class I or II indication for VVI pacing underwent implantation of a Micra transcatheter pacing system, from the femoral vein and fixated in the right ventricle using four protractible nitinol tines. Prespecified objectives were >85% freedom from unanticipated serious adverse device events (safety) and <2 V 3-month mean pacing capture threshold at 0.24 ms pulse width (efficacy). Patients were implanted (n = 140) from 23 centres in 11 countries (61% male, age 77.0 ± 10.2 years) for atrioventricular block (66%) or sinus node dysfunction (29%) indications. During mean follow-up of 1.9 ± 1.8 months, the safety endpoint was met with no unanticipated serious adverse device events. Thirty adverse events related to the system or procedure occurred, mostly due to transient dysrhythmias or femoral access complications. One pericardial effusion without tamponade occurred after 18 device deployments. In 60 patients followed to 3 months, mean pacing threshold was 0.51 ± 0.22 V, and no threshold was ≥2 V, meeting the efficacy endpoint (P < 0.001). Average R-wave was 16.1 ± 5.2 mV and impedance was 650.7 ± 130 ohms. Early assessment shows the transcatheter pacemaker can safely and effectively be applied. Long-term safety and benefit of the pacemaker will further be evaluated in the trial. ClinicalTrials.gov ID NCT02004873. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

The Longitudinal Study of Aging in Human Young Adults: Knowledge Gaps and Research Agenda.

PubMed

Moffitt, Terrie E; Belsky, Daniel W; Danese, Andrea; Poulton, Richie; Caspi, Avshalom

2017-02-01

To prevent onset of age-related diseases and physical and cognitive decline, interventions to slow human aging and extend health span must eventually be applied to people while they are still young and healthy. Yet most human aging research examines older adults, many with chronic disease, and little is known about aging in healthy young humans. This article explains how this knowledge gap is a barrier to extending health span and puts forward the case that geroscience should invest in researching the pace of aging in young adults. As one illustrative example, we describe an initial effort to study the pace of aging in a young-adult birth cohort by using repeated waves of biomarkers collected across the third and fourth decades to quantify the pace of coordinated physiological deterioration across multiple organ systems (eg, pulmonary, periodontal, cardiovascular, renal, hepatic, metabolic, and immune function). Findings provided proof of principle that it is possible to quantify individual variation in the pace of aging in young adults still free of age-related diseases. This article articulates research needs to improve longitudinal measurement of the pace of aging in young people, to pinpoint factors that slow or speed the pace of aging, to compare pace of aging against genomic clocks, to explain slow-aging young adults, and to apply pace of aging in preventive clinical trials of antiaging therapies. This article puts forward a research agenda to fill the knowledge gap concerning lifelong causes of aging. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Detecting Outliers in Marathon Data by Means of the Andrews Plot

NASA Astrophysics Data System (ADS)

Stehlík, Milan; Wald, Helmut; Bielik, Viktor; Petrovič, Juraj

2011-09-01

For an optimal race performance, it is important, that the runner keeps steady pace during most of the time of the competition. First time runners or athletes without many competitions often experience an "blow out" after a few kilometers of the race. This could happen, because of strong emotional experiences or low control of running intensity. Competition pace of half marathon of the middle level recreational athletes is approximately 10 sec quicker than their training pace. If an athlete runs the first third of race (7 km) at a pace that is 20 sec quicker than is his capacity (trainability), he would experience an "blow out" in the last third of the race. This would be reflected by reducing the running intensity and inability to keep steady pace in the last kilometers of the race and in the final time as well. In sports science, there are many diagnostic methods ([3], [2], [6]) that are used for prediction of optimal race pace tempo and final time. Otherwise there is lacking practical evidence of diagnostics methods and its use in the field (competition, race). One of the conditions that needs to be carried out is that athletes have not only similar final times, but it is important that they keep constant pace as much as possible during whole race. For this reason it is very important to find outliers. Our experimental group consisted of 20 recreational trained athletes (mean age 32,6 years±8,9). Before the race the athletes were instructed to run on the basis of their subjective feeling and previous experience. The data (running pace of each kilometer, average and maximal heart rate of each kilometer) were collected by GPS-enabled personal trainer Forerunner 305.

An algorithm for verifying biventricular capture based on evoked-response morphology.

PubMed

Diotallevi, Paolo; Ravazzi, Pier Antonio; Gostoli, Enrico; De Marchi, Giuseppe; Militello, Carmelo; Kraetschmer, Hannes

2005-01-01

Cardiac resynchronization therapy relies on consistent beat-by-beat myocardial capture in both ventricles. A pacemaker ensuring right (RV) and left ventricular (LV) capture through reliable capture verification and automatic output adjustment would contribute to patients' safety and quality of life. We studied the feasibility of an algorithm based on evoked-response (ER) morphology for capture verification in both the ventricles. RV and LV ER signals were recorded in 20 patients (mean age 72.5 years, range 64.3-80.4 years, 4 females and 16 males) during implantation of biventricular (BiV) pacing systems. Leads of several manufacturers were tested. Pacing and intracardiac electrogram (IEGM) recording were performed using an external pulse generator. IEGM and surface-lead electrocardiogram (ECG) signals were recorded under different pacing conditions for 10 seconds each: RV pacing only, LV pacing only, and BiV pacing with several interventricular delays. Based on morphology characteristics, ERs were classified manually for capture and failure to capture, and the validity of the classification was assessed by reference to the ECG. A total of 3,401 LV- and 3,345 RV-paced events were examined. In the RV and LV, the sensitivities of the algorithm were 95.6% and 96.1% in the RV and LV, respectively, and the corresponding specificities were 91.4% and 95.2%, respectively. The lower sensitivity in the RV was attributed to signal blanking in both channels during BiV pacing with a nonzero interventricular delay. The analysis revealed that the algorithm for identifying capture and failure to capture based on the ER-signal morphology was safe and effective in each ventricle with all leads tested in the study.

Biventricular pacing preserves left ventricular performance in patients with high-grade atrio-ventricular block: a randomized comparison with DDD(R) pacing in 50 consecutive patients.

PubMed

Albertsen, Andi E; Nielsen, Jens C; Poulsen, Steen H; Mortensen, Peter T; Pedersen, Anders K; Hansen, Peter S; Jensen, Henrik K; Egeblad, Henrik

2008-03-01

We aimed to investigate whether biventricular (BiV) pacing minimizes left ventricular (LV) dyssynchrony and preserves LV ejection fraction (LVEF) as compared with standard dual-chamber DDD(R) pacing in consecutive patients with high-grade atrio-ventricular (AV) block. Fifty patients were randomized to DDD(R) pacing or BiV pacing. LVEF was measured using three-dimensional echocardiography. Tissue-Doppler imaging was used to quantify LV dyssynchrony in terms of number of segments with delayed longitudinal contraction (DLC). LVEF was not different between groups after 12 months (P = 0.18). In the DDD(R) group LVEF decreased significantly from 59.7(57.4-61.4)% at baseline to 57.2(52.1-60.6)% at 12 months of follow-up (P = 0.03), whereas LVEF remained unchanged in the BiV group [58.9(47.1-61.7)% at baseline vs. 60.1(55.2-63.3)% after 12 months (P = 0.15)]. Dyssynchrony was more prominent in the DDD(R) group than in the BiV group at baseline (2.2 +/- 2.2 vs. 1.4 +/- 1.3 segments with DLC per patient, P = 0.10); and at 12 month follow-up (1.8 +/- 1.9 vs. 0.8 +/- 0.9 segments with DLC per patient, P = 0.02). NT-proBNP was unchanged in the DDD(R) group during follow-up (122 +/- 178 pmol/L vs. 91 +/- 166 pmol/L, NS) but decreased significantly in the BiV-group (from 198 +/- 505 pmol/L to 86 +/- 95 pmol/L after 12 months, P = 0.02). BiV pacing minimizes LV dyssynchrony, preserves LV function, and reduces NT-proBNP in contrast to DDD(R) pacing in patients with high-grade AV block.

Pacing-induced congenital heart defects assessed by OCT (Conference Presentation)

NASA Astrophysics Data System (ADS)

Ford, Stephanie M.; McPheeters, Matt T.; Wang, Yves T.; Gu, Shi; Doughman, Yong Qiu; Strainic, James P.; Rollins, Andrew M.; Watanabe, Michiko; Jenkins, Michael W.

2016-03-01

The role of hemodynamics in early heart development is poorly understood. In order to successfully assess the impact of hemodynamics on development, we need to monitor and perturb blood flow, and quantify the resultant effects on morphology. Here, we have utilized cardiac optical pacing to create regurgitant flow in embryonic hearts and OCT to quantify regurgitation percentage and resultant morphology. Embryonic quail in a shell-less culture were optically paced at 3 Hz (well above the intrinsic rate or 1.33-1.67 Hz) on day 2 of development (3-4 weeks human) for 5 minutes. The pacing fatigued the heart and led to a prolonged period (> 1 hour) of increased regurgitant flow. Embryos were kept alive until day 3 (cardiac looping - 4-5 weeks human) or day 8 (4 chambered heart - 8 weeks human) to quantify resultant morphologic changes with OCT. All paced embryos imaged at day 3 displayed cardiac defects. The extent of regurgitant flow immediately after pacing was correlated with cardiac cushion size 24-hours post pacing (p-value < 0.01) with higher regurgitation leading to smaller cushions. Almost all embryos (16/18) surviving to day 8 exhibited congenital heart defects (CHDs) including 11/18 with valve defects, 5/18 with ventricular septal defects and 5/18 with hypoplastic right ventricles. Our data suggests that regurgitant flow leads to smaller cushions, which develop into abnormal valves and septa. Our model produces similar phenotypes as found in our fetal alcohol syndrome and velo-cardio-facial/DiGeorge syndrome models suggesting that hemodynamics plays a role in these syndromes as well. Utilizing OCT and optical pacing to understand hemodynamics in development is an important step towards determining CHD mechanisms and ultimately developing earlier treatments.

Understanding pacing postconditioning-mediated cardiac protection: a role of oxidative stress and a synergistic effect of adenosine.

PubMed

Babiker, Fawzi A; Al-Jarallah, Aishah; Joseph, Shaji

2017-05-01

We and others have demonstrated a protective role for pacing postconditioning (PPC) against ischemia/reperfusion (I/R) injury in the heart; however, the underlying mechanisms behind these protective effects are not completely understood. In this study, we wanted to further characterize PPC-mediated cardiac protection, specifically identify optimal pacing sites; examine the role of oxidative stress; and test the existence of a potential synergistic effect between PPC and adenosine. Isolated rat hearts were subjected to coronary occlusion followed by reperfusion. PPC involved three, 30 s, episodes of alternating left ventricular (LV) and right atrial (RA) pacing. Multiple pacing protocols with different pacing electrode locations were used. To test the involvement of oxidative stress, target-specific agonists or antagonists were infused at the beginning of reperfusion. Hemodynamic data were digitally recorded, and cardiac enzymes, oxidant, and antioxidant status were chemically measured. Pacing at the LV or RV but not at the heart apex or base significantly (P < 0.001) protected against ischemia-reperfusion injury. PPC-mediated protection was completely abrogated in the presence of reactive oxygen species (ROS) scavenger, ebselen; peroxynitrite (ONOO - ) scavenger, uric acid; and nitric oxide synthase inhibitor, L-NAME. Nitric oxide (NO) donor, snap, however significantly (P < 0.05) protected the heart against I/R injury in the absence of PPC. The protective effects of PPC were significantly improved by adenosine. PPC-stimulated protection can be achieved by alternating LV and RA pacing applied at the beginning of reperfusion. NO, ROS, and the product of their interaction ONOO - play a significant role in PPC-induced cardiac protection. Finally, the protective effects of PPC can be synergized with adenosine.

Demonstration of a full volume 3D pre-stack depth migration in the Garden Banks area using massively parallel processor (MPP) technology

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

Solano, M.; Chang, H.; VanDyke, J.

1996-12-31

This paper describes the implementation and results of portable, production-scale 3D Pre-stack Kirchhoff depth migration software. Full volume pre-stack imaging was applied to a six million trace (46.9 Gigabyte) data set from a subsalt play in the Garden Banks area in the Gulf of Mexico. The velocity model building and updating, were derived using image depth gathers and an image-driven strategy. After three velocity iterations, depth migrated sections revealed drilling targets that were not visible in the conventional 3D post-stack time migrated data set. As expected from the implementation of the migration algorithm, it was found that amplitudes are wellmore » preserved and anomalies associated with known reservoirs, conform to petrophysical predictions. Image gathers for velocity analysis and the final depth migrated volume, were generated on an 1824 node Intel Paragon at Sandia National Laboratories. The code has been successfully ported to a CRAY (T3D) and Unix workstation Parallel Virtual Machine environments (PVM).« less

The evolution of Rare Pride: using evaluation to drive adaptive management in a biodiversity conservation organization.

PubMed

Jenks, Brett; Vaughan, Peter W; Butler, Paul J

2010-05-01

Rare Pride is a social marketing program that stimulates human behavior change in order to promote biodiversity conservation in critically threatened regions in developing countries. A series of formal evaluation studies, networking strategies, and evaluative inquiries have driven a 20-year process of adaptive management that has resulted in extensive programmatic changes within Pride. This paper describes the types of evaluation that Rare used to drive adaptive management and the changes it caused in Pride's theory-of-change and programmatic structure. We argue that (a) qualitative data gathered from partners and staff through structured interviews is most effective at identifying problems with current programs and procedures, (b) networking with other organizations is the most effective strategy for learning of new management strategies, and (c) quantitative data gathered through surveys is effective at measuring program impact and quality. Adaptive management has allowed Rare to increase its Pride program from implementing about two campaigns per year in 2001 to more than 40 per year in 2009 while improving program quality and maintaining program impact. Copyright 2009 Elsevier Ltd. All rights reserved.

[The use of auto mode switching in patients with sick sinus syndrome].

PubMed

Vlasínová, J

2005-01-01

At present the dual chamber pacing, originally developed for patients with AV blockades, is widely used also for patients with Sick sinus syndrome (tachycardic-bradycardic type). But these patients often cause therapeutical problems to their physicians. In these cases either antiarrhythmic therapy is necessary to prevent recurrent supraventricular tachycardias (which are cause of rapid ventricular pacing) or in the case of failure of AA therapy the pacing mode has to be changed to DDI/R, which excludes physiological VAT pacing. The Auto Mode Switching (AMS) function ensures adequate ventricular pacing rate in the time of SV arrhythmias. Effects of dual chamber pacemakers equipped with AMS were studied in a group of patients with paroxysmal atrial fibrilation and/or atrial flutter. Therapy brings effects in lower of expenses due to less frequent visits at the physician, lower rate of rehospitalizations and lower need for powerful AA therapy.

A Self-paced Course in Pharmaceutical Mathematics Using Web-based Databases

PubMed Central

Bourne, David W.A.; Davison, A. Machelle

2006-01-01

Objective To transform a pharmaceutical mathematics course to a self-paced instructional format using Web-accessed databases for student practice and examination preparation. Design The existing pharmaceutical mathematics course was modified from a lecture style with midsemester and final examinations to a self-paced format in which students had multiple opportunities to complete online, nongraded self-assessments as well as in-class module examinations. Assessment Grades and course evaluations were compared between students taking the class in lecture format with midsemester and final examinations and students taking the class in the self-paced instructional format. The number of times it took students to pass examinations was also analyzed. Conclusions Based on instructor assessment and student feedback, the course succeeded in giving students who were proficient in pharmaceutical mathematics a chance to progress quickly and students who were less skillful the opportunity to receive instruction at their own pace and develop mathematical competence. PMID:17149445

The PACES Summer Science Trek: A Pre-College Science

NASA Technical Reports Server (NTRS)

Smith, Michelle B.

1997-01-01

The University of Texas at El Paso (UTEP) received five-year funding to form the Pan American Center for Earth and Environmental Studies (PACES) in July 1995. PACES has as its goals to conduct research contributing to NASA's Mission to Planet Earth and to develop skilled scientists and engineers. PACES seeks to gain a more comprehensive understanding of geological, ecological and environmental processes and changes taking place in the southwestern United States and northern Mexico region. The PACES center has collaborative ties with two NASA field center (Goddard Space Flight Center and Ames Research Center) and the Jet Propulsion Laboratory. The original proposal contained no provision for outreach programs. However, at a meeting in the fall of 1995, Dan Goldin, NASA Administrator, issued the challenge that in order to accomplish NASA's goals to educate more of the citizenry in science and engineering, the Centers should take a broader perspective aimed at younger children.

A self-paced course in pharmaceutical mathematics using web-based databases.

PubMed

Bourne, David W A; Davison, A Machelle

2006-10-15

To transform a pharmaceutical mathematics course to a self-paced instructional format using Web-accessed databases for student practice and examination preparation. The existing pharmaceutical mathematics course was modified from a lecture style with midsemester and final examinations to a self-paced format in which students had multiple opportunities to complete online, nongraded self-assessments as well as in-class module examinations. Grades and course evaluations were compared between students taking the class in lecture format with midsemester and final examinations and students taking the class in the self-paced instructional format. The number of times it took students to pass examinations was also analyzed. Based on instructor assessment and student feedback, the course succeeded in giving students who were proficient in pharmaceutical mathematics a chance to progress quickly and students who were less skillful the opportunity to receive instruction at their own pace and develop mathematical competence.

The Future of Health Care Reform: What Is Driving Enrollment?

PubMed

Callaghan, Timothy H; Jacobs, Lawrence R

2017-04-01

Against a backdrop of ongoing operational challenges, insurance market turbulence, and the ever present pull of partisanship, enrollment in the ACA's programs has soared and significant variations have developed across states in terms of their pace of coverage expansion. Our article explores why ACA enrollment has varied so dramatically across states. We explore the potential influence of party control, presidential cueing, administrative capacity, the reverberating effects of ACA policy decisions, affluence, and unemployment on enrollment. Our multivariate analysis finds that party control dominated early state decision making, but that relative enrollment in insurance exchanges and the Medicaid expansion are driven by a changing mix of political and administrative factors. Health politics is entering a new era as Republicans replace the ACA and devolve significant discretion to states to administer Medicaid and other programs. Our findings offer insights into future directions in health reform and in learning and diffusion. Copyright © 2017 by Duke University Press.

Nuclear envelope and genome interactions in cell fate

PubMed Central

Talamas, Jessica A.; Capelson, Maya

2015-01-01

The eukaryotic cell nucleus houses an organism’s genome and is the location within the cell where all signaling induced and development-driven gene expression programs are ultimately specified. The genome is enclosed and separated from the cytoplasm by the nuclear envelope (NE), a double-lipid membrane bilayer, which contains a large variety of trans-membrane and associated protein complexes. In recent years, research regarding multiple aspects of the cell nucleus points to a highly dynamic and coordinated concert of efforts between chromatin and the NE in regulation of gene expression. Details of how this concert is orchestrated and how it directs cell differentiation and disease are coming to light at a rapid pace. Here we review existing and emerging concepts of how interactions between the genome and the NE may contribute to tissue specific gene expression programs to determine cell fate. PMID:25852741

Why we need more basic biology research, not less.

PubMed

Botstein, David

2012-11-01

Much of the spectacular progress in biomedical science over the last half-century is the direct consequence of the work of thousands of basic scientists whose primary goal was understanding of the fundamental working of living things. Despite this, many politicians, funders, and even scientists have come to believe that the pace of successful applications to medical diagnosis and therapy is limited by our willingness to focus directly on human health, rather than a continuing deficit of understanding. By this theory, curiosity-driven research, aimed at understanding, is no longer important or even useful. What is advocated instead is "translational" research aimed directly at treating disease. I believe this idea to be deeply mistaken. Recent history suggests instead that what we have learned in the last 50 years is only the beginning. The way forward is to invest more in basic science, not less.

Rapid acquisition but slow extinction of an attentional bias in space.

PubMed

Jiang, Yuhong V; Swallow, Khena M; Rosenbaum, Gail M; Herzig, Chelsey

2013-02-01

Substantial research has focused on the allocation of spatial attention based on goals or perceptual salience. In everyday life, however, people also direct attention using their previous experience. Here we investigate the pace at which people incidentally learn to prioritize specific locations. Participants searched for a T among Ls in a visual search task. Unbeknownst to them, the target was more often located in one region of the screen than in other regions. An attentional bias toward the rich region developed over dozens of trials. However, the bias did not rapidly readjust to new contexts. It persisted for at least a week and for hundreds of trials after the target's position became evenly distributed. The persistence of the bias did not reflect a long window over which visual statistics were calculated. Long-term persistence differentiates incidentally learned attentional biases from the more flexible goal-driven attention. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Changing Curriculum: A Critical Inquiry into the Revision of the British Columbia Science Curriculum For Grades K-9

NASA Astrophysics Data System (ADS)

Searchfield, Mary A.

In 2010 British Columbia's Ministry of Education started the process of redesigning the provincial school curriculum, Kindergarten to Grade 12. Mandatory implementation of the new curriculum was set for the 2016/17 school year for Grades K-9, and 2017/18 for Grades 10-12. With a concerted emphasis on personalized learning and through the frame of a Know-Do-Understand curriculum model, the new curriculum aims to meet the needs of today's learners, described as living in a technology-rich, fast-paced and ever-changing world, through a concept-based and competency-driven emphasis. This thesis is a critical analysis of the BC K-9 Science curriculum as written and published, looking specifically at how science is treated as a form of knowledge, its claimed presentation as a story, and on whether the intentions claimed by the designers are matched in the curriculum's final form.

Direct observation of grain rotations during coarsening of a semisolid Al–Cu alloy

PubMed Central

Dake, Jules M.; Oddershede, Jette; Sørensen, Henning O.; Werz, Thomas; Shatto, J. Cole; Uesugi, Kentaro; Schmidt, Søren; Krill, Carl E.

2016-01-01

Sintering is a key technology for processing ceramic and metallic powders into solid objects of complex geometry, particularly in the burgeoning field of energy storage materials. The modeling of sintering processes, however, has not kept pace with applications. Conventional models, which assume ideal arrangements of constituent powders while ignoring their underlying crystallinity, achieve at best a qualitative description of the rearrangement, densification, and coarsening of powder compacts during thermal processing. Treating a semisolid Al–Cu alloy as a model system for late-stage sintering—during which densification plays a subordinate role to coarsening—we have used 3D X-ray diffraction microscopy to track the changes in sample microstructure induced by annealing. The results establish the occurrence of significant particle rotations, driven in part by the dependence of boundary energy on crystallographic misorientation. Evidently, a comprehensive model for sintering must incorporate crystallographic parameters into the thermodynamic driving forces governing microstructural evolution. PMID:27671639

Can you hear me now? Teaching listening skills.

PubMed

Nemec, Patricia B; Spagnolo, Amy Cottone; Soydan, Anne Sullivan

2017-12-01

This column provides an overview of methods for training to improve service provider active listening and reflective responding skills. Basic skills in active listening and reflective responding allow service providers to gather information about and explore the needs, desires, concerns, and preference of people using their services-activities that are of critical importance if services are to be truly person-centered and person-driven. Sources include the personal experience of the authors as well as published literature on the value of basic counseling skills and best practices in training on listening and other related soft skills. Training in listening is often needed but rarely sought by behavioral health service providers. Effective curricula exist, providing content and practice opportunities that can be incorporated into training, supervision, and team meetings. When providers do not listen well to the people who use their services, the entire premise of recovery-oriented person-driven services is undermined. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Managing the Finances. PACE Revised. Level 1. Unit 16. Research & Development Series No. 240AB16.

ERIC Educational Resources Information Center

Ashmore, M. Catherine; Pritz, Sandra G.

This lesson on competent financial management, the 16th in a series of 18 units, is part of the first level of a comprehensive entrepreneurship curriculum entitled: A Program for Acquiring Competence in Entrepreneurship (PACE). (Designed for use with secondary students, the first level of PACE introduces students to the concepts involved in…

Planning the Marketing Strategy. PACE Revised. Level 1. Unit 6. Research & Development Series No. 240AB6.

ERIC Educational Resources Information Center

Ashmore, M. Catherine; Pritz, Sandra G.

This lesson on planning a marketing strategy, the sixth in a series of 18 units, is part of the first level of a comprehensive entrepreneurship curriculum entitled: A Program for Acquiring Competence in Entrepreneurship (PACE). (Designed for use with secondary students, the first level of PACE introduces students to the concepts involved in…

Systematic Studies of Modified Vocalization: The Effect of Speech Rate on Speech Production Measures during Metronome-Paced Speech in Persons Who Stutter

ERIC Educational Resources Information Center

Davidow, Jason H.

2014-01-01

Background: Metronome-paced speech results in the elimination, or substantial reduction, of stuttering moments. The cause of fluency during this fluency-inducing condition is unknown. Several investigations have reported changes in speech pattern characteristics from a control condition to a metronome-paced speech condition, but failure to control…

Self-Paced Instruction in a Cognitively Oriented Skills Course: Supplyman, MOS 76Y10. Technical Report No. 75-20.

ERIC Educational Resources Information Center

Hungerland, Jacklyn E.; Taylor, John E.

As part of the Army's adoption of performance-oriented instruction in Army Training centers, a study was conducted to determine the feasibility of using sefl-paced instruction without programed texts in a clerical and computational skills course. Course organization, course management, and effective instructional techniques for self-paced training…

Financing the Business. PACE Revised. Level 1. Unit 8. Research & Development Series No. 240AB8.

ERIC Educational Resources Information Center

Ashmore, M. Catherine; Pritz, Sandra G.

This lesson on financing a business, the eighth in a series of 18 units, is part of the first level of a comprehensive entrepreneurship curriculum entitled: A Program for Acquiring Competence in Entrepreneurship (PACE). (Designed for use with secondary students, the first level of PACE introduces students to the concepts involved in…

Protecting the Business. PACE Revised. Level 1. Unit 18. Research & Development Series No. 240AB18.

ERIC Educational Resources Information Center

Ashmore, M. Catherine; Pritz, Sandra G.

This unit on protecting a business, the 18th in a series of 18 units, is part of the first level of a comprehensive entrepreneurship curriculum entitled: A Program for Acquiring Competence in Entrepreneurship (PACE). (Designed for use with secondary students, the first level of PACE introduces students to the concepts involved in entrepreneurship…

Managing Human Resources. PACE Revised. Level 1. Unit 12. Research & Development Series No. 240AB12.

ERIC Educational Resources Information Center

Ashmore, M. Catherine; Pritz, Sandra G.

This lesson on managing human resources, the 12th in a series of 18 units, is part of the first level of a comprehensive entrepreneurship curriculum entitled: A Program for Acquiring Competence in Entrepreneurship (PACE). (Designed for use with secondary students, the first level of PACE introduces students to the concepts involved in…

Earlier Right Ventricular Pacing in Cardiac Resynchronization Therapy for a Patient with Right Axis Deviation.

PubMed

Hattori, Yusuke; Ishibashi, Kohei; Noda, Takashi; Okamura, Hideo; Kanzaki, Hideaki; Anzai, Toshihisa; Yasuda, Satoshi; Kusano, Kengo

2017-09-01

We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective.

Pacing threshold changes after transvenous catheter countershock.

PubMed

Yee, R; Jones, D L; Klein, G J

1984-02-01

The serial changes in pacing threshold and R-wave amplitude were examined after insertion of a countershock catheter in 12 patients referred for management of recurrent ventricular tachyarrhythmias. In 6 patients, values before and immediately after catheter countershock were monitored. Pacing threshold increased (from 1.4 +/- 0.2 to 2.4 +/- 0.5 V, mean +/- standard error of the mean, p less than 0.05) while the R-wave amplitude decreased (bipolar R wave from 5.9 +/- 1.1 to 3.4 +/- 0.7 mV, p less than 0.01; unipolar R wave recorded from the distal ventricular electrode from 8.9 +/- 1.8 to 4.6 +/- 1.2 mV, p less than 0.01; and proximal ventricular electrode from 7.7 +/- 1.5 to 5.0 +/- 1.0 mV, p less than 0.01). A return to control values occurred within 10 minutes. In all patients, pacing threshold increased by 154 +/- 30% (p less than 0.001) during the first 7 days that the catheter was in place. It is concluded that catheter countershock causes an acute increase in pacing threshold and decrease in R-wave amplitude. A catheter used for countershock may not be acceptable as a backup pacing catheter.

Paced mating behavior is affected by clitoral-vaginocervical lidocaine application in combination with sexual experience.

PubMed

Meerts, Sarah H; Strnad, Helen K; Schairer, Rosemary S

2015-03-01

The present study tested the effects of lidocaine anesthetic ointment applied to the vaginocervical (Experiment 1) or clitoral-vaginocervical (Experiment 2) areas on the display of paced mating behavior over the course of five weekly tests in ovariectomized, hormone-primed, Long-Evans rats. Experiment 3 tested whether rats that acquired sexual experience without ointment application would exhibit altered paced mating behavior on a fifth test under clitoral-vaginocervical lidocaine or vehicle application. Although rats in Experiment 1 and Experiment 2 exhibited shorter contact-return latencies after intromission and reduced likelihood of leaving the male compartment following mounts and intromissions after gaining sexual experience, only rats that received clitoral-vaginocervical lidocaine exhibited altered paced mating behavior relative to vehicle. Specifically, clitoral-vaginocervical lidocaine resulted in shorter contact-return latency to ejaculation and greater percentage of time with the male. Paced mating behavior of sexually experienced rats in Experiment 3 was not disrupted when tested after clitoral-vaginocervical lidocaine treatment. Together, these studies suggest that the sensory input during repeated mating encounters affects the pattern of paced mating behavior that develops with sexual experience. Copyright © 2014 Elsevier Inc. All rights reserved.

Pacing profiles of senior men and women at the 2017 IAAF World Cross Country Championships.

PubMed

Hanley, Brian

2018-06-01

The purpose of this study was to analyse and compare pacing profiles of senior men and women competing in the 2017 World Cross Country Championships. Finishing and split times were collated for 118 men and 81 women competing over the newly introduced race distance of 10 km (five laps of approximately 2 km). Athletes were grouped according to finishing time, and changes in pace measured using lap times, except between Laps 1 and 2 because of a shorter first lap (times relative to the winner were used instead). Within both men's and women's races, groups slowed during the early stages, but then either sped up or maintained pace during the last lap. There were few differences between groups with regard to overall pacing profiles, or between sexes. The men's fast finish contrasted with slower finishes found in previous editions (over 12 km), and the degree to which women were slower than men (approximately 12%) was very similar to track racing and showed the decision to equalise the distances run by both sexes was sound. As in other distance events, athletes are recommended to try to achieve an even pace throughout, an approach that proved beneficial to both gold medallists.

An inappropriate pacing threshold increase after repeated electrical storm in a patient with implantable cardioverter defibrillator.

PubMed

Zhu, Ye; Gu, Xiang; Xu, Chao

2017-10-16

Implantable cardioverter defibrillators (ICD) are capable of effectively terminating malignant ventricular arrhythmia and are the most effective way to prevent sudden cardiac death. However, some evidences demonstrated that both anti-tachycardia pacing (ATP) and ICD shock can also bring adverse prognosis. A 66-year-old Han Chinese man with prior ICD implantation was admitted to our hospital because of frequent ICD shocks. Although intravenous amiodarone and esmolol succinate were administered daily, the patient suffered 155 episodes of VT/VF during 8 weeks after implantation. After repeated discharge of the device, the pacing threshold of the patient increased gradually. Considering the inappropriate increase of the pacing threshold, we decided to reposition the right ventricular (RV) lead with good sensing and threshold parameters confirmed. Subsequent 22 months interrogation follow-up revealed a stable lead position and electrical specifications. Furthermore, antiarrhythmic drugs were maximally increased, while ATP burst was remarkably decreased and the inappropriate ICD shock never occurred until now. An inappropriate pacing threshold was increased secondary to repeated ICD electrical storm. A timely active lead position adjustment reduced the pacing threshold and eliminated the risk of premature battery depletion.

Pacing in Swimming: A Systematic Review.

PubMed

McGibbon, Katie E; Pyne, D B; Shephard, M E; Thompson, K G

2018-03-20

Pacing strategy, or how energy is distributed during exercise, can substantially impact athletic performance and is considered crucial for optimal performance in many sports. This is particularly true in swimming given the highly resistive properties of water and low mechanical efficiency of the swimming action. The aim of this systematic review was to determine the pacing strategies utilised by competitive swimmers in competition and their reproducibility, and to examine the impact of different pacing strategies on kinematic, metabolic and performance variables. This will provide valuable and practical information to coaches and sports science practitioners. The databases Web of Science, Scopus, SPORTDiscus and PubMed were searched for published articles up to 1 August 2017. A total of 23 studies examining pool-based swimming competitions or experimental trials in English-language and peer-reviewed journals were included in this review. In short- and middle-distance swimming events maintenance of swimming velocity is critical, whereas in long-distance events a low lap-to-lap variability and the ability to produce an end spurt in the final lap(s) are key. The most effective strategy in the individual medley (IM) is to conserve energy during the butterfly leg to optimise performance in subsequent legs. The pacing profiles of senior swimmers remain relatively stable irrespective of opponents, competition stage or type, and performance time. Implementing event-specific pacing strategies should benefit the performance of competitive swimmers. Given differences between swimmers, there is a need for greater individualisation when considering pacing strategy selection across distances and strokes.

Chronic exposure to cocaine binging predisposes to an accelerated course of dilated cardiomyopathy in conscious dogs following rapid ventricular pacing.

PubMed

Parikh, Pratik; Nikolaidis, Lazaros A; Stolarski, Carol; Shen, You-Tang; Shannon, Richard P

2005-12-01

Despite extensive study, the extent to which cocaine use predisposes to cardiac injury remains unknown. We hypothesized that chronic cocaine binging would increase susceptibility to a subsequent cardiac insult, even in the absence of demonstrable effects on baseline hemodynamics. We studied progression of dilated cardiomyopathy (DCM) induced by rapid ventricular pacing (240 beats per minute) in five conscious, chronically instrumented dogs, after exposure to repetitive cocaine binging (COC) in the form of four consecutive 1 mg/kg i.v. boluses daily for 8 days, to simulate human cocaine abuse. We compared the results with nine control dogs (CON) undergoing the exact pacing protocol, without prior cocaine exposure. Baseline hemodynamics were not significantly altered by chronic cocaine exposure. Following 2 weeks of pacing, COC dogs exhibited accelerated progression to DCM, depressed plasma nitric oxide levels (CON, 17 +/- 2 microM; COC, 10 +/- 2 microM, p < 0.05), and a significantly greater increase in plasma epinephrine (CON, 33 +/- 6 pg/ml; COC, 104 +/- 24 pg/ml). After only 2 weeks of pacing, COC dogs demonstrated progressive DCM of a magnitude comparable with end-stage pacing-induced DCM. Chronic cocaine binging increases susceptibility to a subsequent myocardial insult and accelerates progression of DCM in conscious dogs following rapid pacing. These data suggest that although chronic cocaine use alone may not affect myocardial function, it predisposes to greater susceptibility to a superimposed insult.

Changes of serum neurohormone after renal sympathetic denervation in dogs with pacing-induced heart failure.

PubMed

Zhao, Qingyan; Huang, He; Wang, Xule; Wang, Xiaozhan; Dai, Zixuan; Wan, Peixing; Guo, Zongwen; Yu, Shengbo; Tang, Yanhong; Huang, Congxin

2014-01-01

Neurohormonal activation is a commonly cited array of phenomena in the body's physiologic response to heart failure (HF). The aim of the present study was to determine the change law of serum neurohormones after renal sympathetic denervation (RSD) in dogs with pacing-induced HF. Twenty-eight beagles were randomly divided into control group, RSD group, HF group and HF + RSD group. The control group was implanted pacemakers without pacing; the RSD group underwent renal artery ablation without pacing; the HF group was implanted pacemakers with ventricular pacing at 240 bpm for 3 weeks; and HF + RSD group underwent renal artery ablation and with ventricular pacing at 240 bpm for 3 weeks. Blood samples were taken at baseline, and 3, 6, 9, 12, 15, 18, 21 days in all the dogs for neurohormones measurement. After 3 weeks, the systolic femoral artery pressures in the HF and HF + RSD groups were reduced after pacing 3 weeks. There was an increase significantly in BNP, angiotensin II, aldosterone, endothelin-1 and decrease in renalase after 3 weeks when compared with baseline in HF group. RSD significantly suppressed the changes of plasma neurohormones concentration in experimental HF, but RSD had not obviously impact on the levels of plasma neurohormones during 3 weeks in RSD group. RSD attenuates the changes of levels of plasma neurohormones in the activated renin-angiotensin-aldosterone system (RAAS) but had not obviously effect in the normal physiology of RAAS.

Effect of the Pacing Strategies on the Open Water 10km World Swimming Championships Performances.

PubMed

Rodriguez, Luis; Veiga, Santiago

2017-10-16

The aim of the present research was 1) to compare the pacing strategies of different level open water swimmers during the 10km race of the FINA 2015 World Swimming Championships (WCH), and 2) to relate these pacing strategies to the race performance. Final and intermediate split times as well as intermediate race positions from the 10-kilometer race participants (69 men and 51 women) were collected from the public domain and were divided into five groups (G1 to G5) depending on their finishing positions. Medalists and finalists (G1 and G2, respectively) presented an even pacing profile with similar swimming velocities to the less successful swimmers (G3 to G5) on the initial and mid stages of the race but a 1.5-3% increase in swimming velocity in the last quarter of the race. This fast end spurt was largely related to the race performance and was not observed in the G3 and G4 (even-paced profile) or in the G5 (positive pacing profile) groups. Intermediate race positions and lap rankings were negatively related to finishing position indicating a delayed positioning of the most successful swimmers at 25%, 50% and 75% of race distance. The adoption of a conservative starting strategy by open water swimmers with a negative pacing profile and delayed partial positioning seems to increase the chances of overall race success as it allows a fast end spurt that is highly related to successful finishing race positions.

A review of cognitive therapy in acute medical settings. Part I: therapy model and assessment.

PubMed

Levin, Tomer T; White, Craig A; Kissane, David W

2013-04-01

Although cognitive therapy (CT) has established outpatient utility, there is no integrative framework for using CT in acute medical settings where most psychosomatic medicine (P-M) clinicians practice. Biopsychosocial complexity challenges P-M clinicians who want to use CT as the a priori psychotherapeutic modality. For example, how should clinicians modify the data gathering and formulation process to support CT in acute settings? Narrative review methodology is used to describe the framework for a CT informed interview, formulation, and assessment in acute medical settings. Because this review is aimed largely at P-M trainees and educators, exemplary dialogues model the approach (specific CT strategies for common P-M scenarios appear in the companion article.) Structured data gathering needs to be tailored by focusing on cognitive processes informed by the cognitive hypothesis. Agenda setting, Socratic questioning, and adaptations to the mental state examination are necessary. Specific attention is paid to the CT formulation, Folkman's Cognitive Coping Model, self-report measures, data-driven evaluations, and collaboration (e.g., sharing the formulation with the patient.) Integrative CT-psychopharmacological approaches and the importance of empathy are emphasized. The value of implementing psychotherapy in parallel with data gathering because of time urgency is advocated, but this is a significant departure from usual outpatient approaches in which psychotherapy follows evaluation. This conceptual approach offers a novel integrative framework for using CT in acute medical settings, but future challenges include demonstrating clinical outcomes and training P-M clinicians so as to demonstrate fidelity.