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

PubMed

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

2011-01-01

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

High resolution time interval meter

DOEpatents

Martin, A.D.

1986-05-09

Method and apparatus are provided for measuring the time interval between two events to a higher resolution than reliability available from conventional circuits and component. An internal clock pulse is provided at a frequency compatible with conventional component operating frequencies for reliable operation. Lumped constant delay circuits are provided for generating outputs at delay intervals corresponding to the desired high resolution. An initiation START pulse is input to generate first high resolution data. A termination STOP pulse is input to generate second high resolution data. Internal counters count at the low frequency internal clock pulse rate between the START and STOP pulses. The first and second high resolution data are logically combined to directly provide high resolution data to one counter and correct the count in the low resolution counter to obtain a high resolution time interval measurement.

The Anaesthetic-ECT Time Interval in Electroconvulsive Therapy Practice--Is It Time to Time?

PubMed

Gálvez, Verònica; Hadzi-Pavlovic, Dusan; Wark, Harry; Harper, Simon; Leyden, John; Loo, Colleen K

2016-01-01

Because most common intravenous anaesthetics used in ECT have anticonvulsant properties, their plasma-brain concentration at the time of seizure induction might affect seizure expression. The quality of ECT seizure expression has been repeatedly associated with efficacy outcomes. The time interval between the anaesthetic bolus injection and the ECT stimulus (anaesthetic-ECT time interval) will determine the anaesthetic plasma-brain concentration when the ECT stimulus is administered. The aim of this study was to examine the effect of the anaesthetic-ECT time interval on ECT seizure quality and duration. The anaesthetic-ECT time interval was recorded in 771 ECT sessions (84 patients). Right unilateral brief pulse ECT was applied. Anaesthesia given was propofol (1-2 mg/kg) and succinylcholine (0.5-1.0 mg/kg). Seizure quality indices (slow wave onset, amplitude, regularity, stereotypy and post-ictal suppression) and duration were rated through a structured rating scale by a single blinded trained rater. Linear Mixed Effects Models analysed the effect of the anaesthetic-ECT time interval on seizure quality indices, controlling for propofol dose (mg), ECT charge (mC), ECT session number, days between ECT, age (years), initial seizure threshold (mC) and concurrent medication. Longer anaesthetic-ECT time intervals lead to significantly higher quality seizures (p < 0.001 for amplitude, regularity, stereotypy and post-ictal suppression). These results suggest that the anaesthetic-ECT time interval is an important factor to consider in ECT practice. This time interval should be extended to as long as practically possible to facilitate the production of better quality seizures. Close collaboration between the anaesthetist and the psychiatrist is essential. Copyright © 2015 Elsevier Inc. All rights reserved.

Generalization of Turbulent Pair Dispersion to Large Initial Separations

NASA Astrophysics Data System (ADS)

Shnapp, Ron; Liberzon, Alex; International Collaboration for Turbulence Research

2018-06-01

We present a generalization of turbulent pair dispersion to large initial separations (η

High resolution time interval counter

DOEpatents

Condreva, Kenneth J.

1994-01-01

A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured.

High resolution time interval counter

DOEpatents

Condreva, K.J.

1994-07-26

A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured. 3 figs.

Magnitude of increase in QTc interval after initiation of dofetilide in patients with persistent atrial fibrillation is associated with increased rates of pharmacological cardioversion and long-term freedom from recurrent atrial fibrillation.

PubMed

Huang, Henry D; Waks, Jonathan W; Steinhaus, Daniel A; Zimetbaum, Peter

2016-07-01

Dofetilide is a class III antiarrhythmic drug approved for the treatment of atrial fibrillation (AF). Dofetilide-induced corrected QT (QTc) interval prolongation is a surrogate for the degree of drug effect, but the relationships between drug-induced QTc interval prolongation, pharmacological cardioversion (PCV), and freedom from recurrent AF are unclear. The purpose of this study was to assess associations between QTc interval change during dofetilide initiation and PCV and long-term AF recurrence. We performed retrospective analyses of a prospective cohort of patients with AF admitted for dofetilide initiation between 2001 and 2014. Clinical characteristics and electrocardiographic variables were assessed. We evaluated outcomes of successful PCV in patients with persistent AF and time to recurrence of AF in patients with paroxysmal and persistent AF. During the study, 243 patients with persistent AF and 176 patients with paroxysmal AF initiated dofetilide. PCV occurred in 93/243 (41.7%) patients with persistent AF. After multivariable adjustment, QTc interval change was associated with PCV (adjusted odds ratio 1.21; P = .003 per 10-ms QTc increase). Inhospital QTc interval change was associated with long-term freedom from AF in patients with persistent AF (adjusted hazard ratio 0.92; P = .011 at 4 years per 10-ms QTc increase), but not in patients with paroxysmal AF. In patients with persistent AF, PCV was also associated with long-term freedom from recurrent AF (adjusted hazard ratio 0.62; P = .009 at 4 years). The magnitude of QTc interval prolongation during dofetilide initiation is an independent predictor of successful PCV and long-term freedom from arrhythmia in patients with persistent AF. QTc interval change had no association with AF recurrence in patients with paroxysmal AF, suggesting that different mechanisms of arrhythmogenesis may be operant in different AF types. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Bayesian lead time estimation for the Johns Hopkins Lung Project data.

PubMed

Jang, Hyejeong; Kim, Seongho; Wu, Dongfeng

2013-09-01

Lung cancer screening using X-rays has been controversial for many years. A major concern is whether lung cancer screening really brings any survival benefits, which depends on effective treatment after early detection. The problem was analyzed from a different point of view and estimates were presented of the projected lead time for participants in a lung cancer screening program using the Johns Hopkins Lung Project (JHLP) data. The newly developed method of lead time estimation was applied where the lifetime T was treated as a random variable rather than a fixed value, resulting in the number of future screenings for a given individual is a random variable. Using the actuarial life table available from the United States Social Security Administration, the lifetime distribution was first obtained, then the lead time distribution was projected using the JHLP data. The data analysis with the JHLP data shows that, for a male heavy smoker with initial screening ages at 50, 60, and 70, the probability of no-early-detection with semiannual screens will be 32.16%, 32.45%, and 33.17%, respectively; while the mean lead time is 1.36, 1.33 and 1.23 years. The probability of no-early-detection increases monotonically when the screening interval increases, and it increases slightly as the initial age increases for the same screening interval. The mean lead time and its standard error decrease when the screening interval increases for all age groups, and both decrease when initial age increases with the same screening interval. The overall mean lead time estimated with a random lifetime T is slightly less than that with a fixed value of T. This result is hoped to be of benefit to improve current screening programs. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

A game theoretic approach to a finite-time disturbance attenuation problem

NASA Technical Reports Server (NTRS)

Rhee, Ihnseok; Speyer, Jason L.

1991-01-01

A disturbance attenuation problem over a finite-time interval is considered by a game theoretic approach where the control, restricted to a function of the measurement history, plays against adversaries composed of the process and measurement disturbances, and the initial state. A zero-sum game, formulated as a quadratic cost criterion subject to linear time-varying dynamics and measurements, is solved by a calculus of variation technique. By first maximizing the quadratic cost criterion with respect to the process disturbance and initial state, a full information game between the control and the measurement residual subject to the estimator dynamics results. The resulting solution produces an n-dimensional compensator which expresses the controller as a linear combination of the measurement history. A disturbance attenuation problem is solved based on the results of the game problem. For time-invariant systems it is shown that under certain conditions the time-varying controller becomes time-invariant on the infinite-time interval. The resulting controller satisfies an H(infinity) norm bound.

Conformal symmetries of Einstein's field equations and initial data

NASA Astrophysics Data System (ADS)

Sharma, Ramesh

2005-04-01

This paper examines the initial data for the evolution of the space-time solution of Einstein's equations admitting a conformal symmetry. Under certain conditions on the extrinsic curvature of the initial complete spacelike hypersurface and sectional curvature of the space-time with respect to sections containing the normal vector field, we have shown that the initial hypersurface is conformally diffeomorphic to a sphere or a flat space or a hyperbolic space or the product of an open real interval and a complete 2-manifold. It has been further shown that if the initial hypersurface is compact, then it is conformally diffeomorphic to a sphere. Finally, the conformal symmetries of a generalized Robertson-Walker space-time have been described.

On the Boussinesq-Burgers equations driven by dynamic boundary conditions

NASA Astrophysics Data System (ADS)

Zhu, Neng; Liu, Zhengrong; Zhao, Kun

2018-02-01

We study the qualitative behavior of the Boussinesq-Burgers equations on a finite interval subject to the Dirichlet type dynamic boundary conditions. Assuming H1 ×H2 initial data which are compatible with boundary conditions and utilizing energy methods, we show that under appropriate conditions on the dynamic boundary data, there exist unique global-in-time solutions to the initial-boundary value problem, and the solutions converge to the boundary data as time goes to infinity, regardless of the magnitude of the initial data.

49 CFR 572.133 - Neck assembly and test procedure.

Code of Federal Regulations, 2012 CFR

2012-10-01

... pendulum's longitudinal centerline between 77 degrees and 91 degrees. During the time interval while the... respect to the pendulum's longitudinal centerline between 99 degrees and 114 degrees. During the time... force to occipital condyle. (3) Time-zero is defined as the time of initial contact between the pendulum...

49 CFR 572.133 - Neck assembly and test procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... pendulum's longitudinal centerline between 77 degrees and 91 degrees. During the time interval while the... respect to the pendulum's longitudinal centerline between 99 degrees and 114 degrees. During the time... force to occipital condyle. (3) Time-zero is defined as the time of initial contact between the pendulum...

49 CFR 572.133 - Neck assembly and test procedure.

Code of Federal Regulations, 2013 CFR

2013-10-01

... pendulum's longitudinal centerline between 77 degrees and 91 degrees. During the time interval while the... respect to the pendulum's longitudinal centerline between 99 degrees and 114 degrees. During the time... force to occipital condyle. (3) Time-zero is defined as the time of initial contact between the pendulum...

49 CFR 572.133 - Neck assembly and test procedure.

Code of Federal Regulations, 2014 CFR

2014-10-01

... pendulum's longitudinal centerline between 77 degrees and 91 degrees. During the time interval while the... respect to the pendulum's longitudinal centerline between 99 degrees and 114 degrees. During the time... force to occipital condyle. (3) Time-zero is defined as the time of initial contact between the pendulum...

49 CFR 572.133 - Neck assembly and test procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... pendulum's longitudinal centerline between 77 degrees and 91 degrees. During the time interval while the... respect to the pendulum's longitudinal centerline between 99 degrees and 114 degrees. During the time... force to occipital condyle. (3) Time-zero is defined as the time of initial contact between the pendulum...

Delay of Treatment Initiation Does Not Adversely Affect Survival Outcome in Breast Cancer.

PubMed

Yoo, Tae-Kyung; Han, Wonshik; Moon, Hyeong-Gon; Kim, Jisun; Lee, Jun Woo; Kim, Min Kyoon; Lee, Eunshin; Kim, Jongjin; Noh, Dong-Young

2016-07-01

Previous studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment. This study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups. A total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS. Our results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.

Long Time to Diagnosis of Medulloblastoma in Children Is Not Associated with Decreased Survival or with Worse Neurological Outcome

PubMed Central

Brasme, Jean-Francois; Grill, Jacques; Doz, Francois; Lacour, Brigitte; Valteau-Couanet, Dominique; Gaillard, Stephan; Delalande, Olivier; Aghakhani, Nozar; Puget, Stéphanie; Chalumeau, Martin

2012-01-01

Background The long time to diagnosis of medulloblastoma, one of the most frequent brain tumors in children, is the source of painful remorse and sometimes lawsuits. We analyzed its consequences for tumor stage, survival, and sequelae. Patients and Methods This retrospective population-based cohort study included all cases of pediatric medulloblastoma from a region of France between 1990 and 2005. We collected the demographic, clinical, and tumor data and analyzed the relations between the interval from symptom onset until diagnosis, initial disease stage, survival, and neuropsychological and neurological outcome. Results The median interval from symptom onset until diagnosis for the 166 cases was 65 days (interquartile range 31–121, range 3–457). A long interval (defined as longer than the median) was associated with a lower frequency of metastasis in the univariate and multivariate analyses and with a larger tumor volume, desmoplastic histology, and longer survival in the univariate analysis, but not after adjustment for confounding factors. The time to diagnosis was significantly associated with IQ score among survivors. No significant relation was found between the time to diagnosis and neurological disability. In the 62 patients with metastases, a long prediagnosis interval was associated with a higher T stage, infiltration of the fourth ventricle floor, and incomplete surgical resection; it nonetheless did not influence survival significantly in this subgroup. Conclusions We found complex and often inverse relations between time to diagnosis of medulloblastoma in children and initial severity factors, survival, and neuropsychological and neurological outcome. This interval appears due more to the nature of the tumor and its progression than to parental or medical factors. These conclusions should be taken into account in the information provided to parents and in expert assessments produced for malpractice claims. PMID:22485143

Association between first airborne cedar pollen level peak and pollinosis symptom onset: a web-based survey.

PubMed

Bando, Harumi; Sugiura, Hiroaki; Ohkusa, Yasushi; Akahane, Manabu; Sano, Tomomi; Jojima, Noriko; Okabe, Nobuhiko; Imamura, Tomoaki

2015-01-01

Cedar pollinosis in Japan affects nearly 25 % of Japanese citizens. To develop a treatment for cedar pollinosis, it is necessary to understand the relationship between the time of its occurrence and the amount of airborne cedar pollen. In the spring of 2009, we conducted daily Internet-based epidemiologic surveys, which included 1453 individuals. We examined the relationship between initial date of onset of pollinosis symptoms and daily amount of airborne cedar pollen to which subjects were exposed. Approximately 35.2 % of the subjects experienced the onset of pollinosis during a one-week interval in which the middle day coincided with the peak pollen count. The odds ratio for this one-week time interval was 4.03 (95 % confidence interval: 3.34-4.86). The predicted date of the cedar pollen peak can be used to determine the appropriate date for initiation of self-medication with anti-allergy drugs and thus avoid development of sustained and severe pollinosis.

Evaluating dedicated and intrinsic models of temporal encoding by varying context

PubMed Central

Spencer, Rebecca M.C.; Karmarkar, Uma; Ivry, Richard B.

2009-01-01

Two general classes of models have been proposed to account for how people process temporal information in the milliseconds range. Dedicated models entail a mechanism in which time is explicitly encoded; examples include clock–counter models and functional delay lines. Intrinsic models, such as state-dependent networks (SDN), represent time as an emergent property of the dynamics of neural processing. An important property of SDN is that the encoding of duration is context dependent since the representation of an interval will vary as a function of the initial state of the network. Consistent with this assumption, duration discrimination thresholds for auditory intervals spanning 100 ms are elevated when an irrelevant tone is presented at varying times prior to the onset of the test interval. We revisit this effect in two experiments, considering attentional issues that may also produce such context effects. The disruptive effect of a variable context was eliminated or attenuated when the intervals between the irrelevant tone and test interval were made dissimilar or the duration of the test interval was increased to 300 ms. These results indicate how attentional processes can influence the perception of brief intervals, as well as point to important constraints for SDN models. PMID:19487188

Evaluation of the Trail Making Test and interval timing as measures of cognition in healthy adults: comparisons by age, education, and gender.

PubMed

Płotek, Włodzimierz; Łyskawa, Wojciech; Kluzik, Anna; Grześkowiak, Małgorzata; Podlewski, Roland; Żaba, Zbigniew; Drobnik, Leon

2014-02-03

Human cognitive functioning can be assessed using different methods of testing. Age, level of education, and gender may influence the results of cognitive tests. The well-known Trail Making Test (TMT), which is often used to measure the frontal lobe function, and the experimental test of Interval Timing (IT) were compared. The methods used in IT included reproduction of auditory and visual stimuli, with the subsequent production of the time intervals of 1-, 2-, 5-, and 7-seconds durations with no pattern. Subjects included 64 healthy adult volunteers aged 18-63 (33 women, 31 men). Comparisons were made based on age, education, and gender. TMT was performed quickly and was influenced by age, education, and gender. All reproduced visual and produced intervals were shortened and the reproduction of auditory stimuli was more complex. Age, education, and gender have more pronounced impact on the cognitive test than on the interval timing test. The reproduction of the short auditory stimuli was more accurate in comparison to other modalities used in the IT test. The interval timing, when compared to the TMT, offers an interesting possibility of testing. Further studies are necessary to confirm the initial observation.

Entanglement negativity after a local quantum quench in conformal field theories

NASA Astrophysics Data System (ADS)

Wen, Xueda; Chang, Po-Yao; Ryu, Shinsei

2015-08-01

We study the time evolution of the entanglement negativity after a local quantum quench in (1 + 1)-dimensional conformal field theories (CFTs), which we introduce by suddenly joining two initially decoupled CFTs at their end points. We calculate the negativity evolution for both adjacent intervals and disjoint intervals explicitly. For two adjacent intervals, the entanglement negativity grows logarithmically in time right after the quench. After developing a plateau-like feature, the entanglement negativity drops to the ground-state value. For the case of two spatially separated intervals, a light-cone behavior is observed in the negativity evolution; in addition, a long-range entanglement, which is independent of the distance between two intervals, can be created. Our results agree with the heuristic picture that quasiparticles, which carry entanglement, are emitted from the joining point and propagate freely through the system. Our analytical results are confirmed by numerical calculations based on a critical harmonic chain.

Effects Of Reinforcement History On Response Rate And Response Pattern In Periodic Reinforcement

PubMed Central

López, Florente; Menez, Marina

2005-01-01

Several researchers have suggested that conditioning history may have long-term effects on fixed-interval performances of rats. To test this idea and to identify possible factors involved in temporal control development, groups of rats initially were exposed to different reinforcement schedules: continuous, fixed-time, and random-interval. Afterwards, half of the rats in each group were studied on a fixed-interval 30-s schedule of reinforcement and the other half on a fixed-interval 90-s schedule of reinforcement. No evidence of long-term effects attributable to conditioning history on either response output or response patterning was found; history effects were transitory. Different tendencies in trajectory across sessions were observed for measures of early and late responding within the interreinforcer interval, suggesting that temporal control is the result of two separate processes: one involved in response output and the other in time allocation of responding and not responding. PMID:16047607

On the long-period evolution of the sun-synchronous orbits

NASA Astrophysics Data System (ADS)

Kuznetsov, E. D.; Jasim, A. T.

2016-05-01

The dynamic evolution of sun-synchronous orbits at a time interval of 20 years is considered. The numerical motion simulation has been carried out using the Celestial Mechanics software package developed at the Institute of Astronomy of the University of Bern. The dependence of the dynamic evolution on the initial value of the ascending node longitude is examined for two families of sun-synchronous orbits with altitudes of 751 and 1191 km. Variations of the semimajor axis and orbit inclination are obtained depending on the initial value of the ascending node longitude. Recommendations on the selection of orbits, in which spent sun-synchronous satellites can be moved, are formulated. Minimal changes of elements over a time interval of 20 years have been observed for orbits in which at the initial time the angle between the orbit ascending node and the direction of the Sun measured along the equator have been close to 90° or 270°. In this case, the semimajor axis of the orbit is not experiencing secular perturbations arising from the satellite's passage through the Earth's shadow.

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

PubMed

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

2014-06-01

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

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

PubMed

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

2005-04-01

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

Effect of time to initiation of postoperative radiation therapy on survival in surgically managed head and neck cancer.

PubMed

Graboyes, Evan M; Garrett-Mayer, Elizabeth; Ellis, Mark A; Sharma, Anand K; Wahlquist, Amy E; Lentsch, Eric J; Nussenbaum, Brian; Day, Terry A

2017-12-15

The objective of this study was to determine the effects of National Comprehensive Cancer Network (NCCN) guideline-adherent initiation of postoperative radiation therapy (PORT) and different time-to-PORT intervals on the overall survival (OS) of patients with head and neck squamous cell carcinoma (HNSCC). The National Cancer Data Base was reviewed for the period of 2006-2014, and patients with HNSCC undergoing surgery and PORT were identified. Kaplan-Meier survival estimates, Cox regression analysis, and propensity score matching were used to determine the effects of initiating PORT within 6 weeks of surgery and different time-to-PORT intervals on survival. This study included 41,291 patients. After adjustments for covariates, starting PORT >6 weeks postoperatively was associated with decreased OS (adjusted hazard ratio [aHR], 1.13; 99% confidence interval [CI], 1.08-1.19). This finding remained in the propensity score-matched subset (hazard ratio, 1.21; 99% CI, 1.15-1.28). In comparison with starting PORT 5 to 6 weeks postoperatively, initiating PORT earlier was not associated with improved survival (aHR for ≤ 4 weeks, 0.93; 99% CI, 0.85-1.02; aHR for 4-5 weeks, 0.92; 99% CI, 0.84-1.01). Increasing durations of delay beyond 7 weeks were associated with small, progressive survival decrements (aHR, 1.09, 1.10, and 1.12 for 7-8, 8-10, and >10 weeks, respectively). Nonadherence to NCCN guidelines for initiating PORT within 6 weeks of surgery was associated with decreased survival. There was no survival benefit to initiating PORT earlier within the recommended 6-week timeframe. Increasing durations of delay beyond 7 weeks were associated with small, progressive survival decrements. Cancer 2017;123:4841-50. © 2017 American Cancer Society. © 2017 American Cancer Society.

Impact of Time to Treatment Initiation in Patients with Human Papillomavirus-positive and -negative Oropharyngeal Squamous Cell Carcinoma.

PubMed

Grønhøj, C; Jensen, D; Dehlendorff, C; Nørregaard, C; Andersen, E; Specht, L; Charabi, B; von Buchwald, C

2018-06-01

The distinct difference in disease phenotype of human papillomavirus-positive (HPV+) and -negative (HPV-) oropharyngeal squamous cell cancer (OPSCC) patients might also be apparent when assessing the effect of time to treatment initiation (TTI). We assessed the overall survival and progression-free survival (PFS) effect from increasing TTI for HPV+ and HPV- OPSCC patients. We examined patients who received curative-intended therapy for OPSCC in eastern Denmark between 2000 and 2014. TTI was the number of days from diagnosis to the initiation of curative treatment. Overall survival and PFS were measured from the start of treatment and estimated with the Kaplan-Meier estimator. Hazard ratios and 95% confidence intervals were estimated with Cox proportional hazard regression. At a median follow-up of 3.6 years (interquartile range 1.86-6.07 years), 1177 patients were included (59% HPV+). In the adjusted analysis for the HPV+ and HPV- patient population, TTI influenced overall survival and PFS, most evident in the HPV- group, where TTI >60 days statistically significantly influenced overall survival but not PFS (overall survival: hazard ratio 1.60; 95% confidence interval 1.04-2.45; PFS: hazard ratio 1.46; 95% confidence interval 0.96-2.22). For patients with a TTI >60 days in the HPV+ group, TTI affected overall survival and PFS similarly, with slightly lower hazard ratio estimates of 1.44 (95% confidence interval 0.83-2.51) and 1.15 (95% confidence interval 0.70-1.88), respectively. For patients treated for a HPV+ or HPV- OPSCC, TTI affects outcome, with the strongest effect for overall survival among HPV- patients. Reducing TTI is an important tool to improve the prognosis. Copyright © 2018. Published by Elsevier Ltd.

The Isolation of Motivational, Motoric, and Schedule Effects on Operant Performance: A Modeling Approach

PubMed Central

Brackney, Ryan J; Cheung, Timothy H. C; Neisewander, Janet L; Sanabria, Federico

2011-01-01

Dissociating motoric and motivational effects of pharmacological manipulations on operant behavior is a substantial challenge. To address this problem, we applied a response-bout analysis to data from rats trained to lever press for sucrose on variable-interval (VI) schedules of reinforcement. Motoric, motivational, and schedule factors (effort requirement, deprivation level, and schedule requirements, respectively) were manipulated. Bout analysis found that interresponse times (IRTs) were described by a mixture of two exponential distributions, one characterizing IRTs within response bouts, another characterizing intervals between bouts. Increasing effort requirement lengthened the shortest IRT (the refractory period between responses). Adding a ratio requirement increased the length and density of response bouts. Both manipulations also decreased the bout-initiation rate. In contrast, food deprivation only increased the bout-initiation rate. Changes in the distribution of IRTs over time showed that responses during extinction were also emitted in bouts, and that the decrease in response rate was primarily due to progressively longer intervals between bouts. Taken together, these results suggest that changes in the refractory period indicate motoric effects, whereas selective alterations in bout initiation rate indicate incentive-motivational effects. These findings support the use of response-bout analyses to identify the influence of pharmacological manipulations on processes underlying operant performance. PMID:21765544

Estrogen Plus Progestin Therapy and Breast Cancer in Recently Postmenopausal Women

PubMed Central

Prentice, Ross L.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Manson, JoAnn E.; Pettinger, Mary; Hendrix, Susan L.; Hubbell, F. Allan; Kooperberg, Charles; Kuller, Lewis H.; Lane, Dorothy S.; McTiernan, Anne; O’Sullivan, Mary Jo; Rossouw, Jacques E.; Anderson, Garnet L.

2009-01-01

The Women’s Health Initiative trial found a modestly increased risk of invasive breast cancer with daily 0.625-mg conjugated equine estrogens plus 2.5-mg medroxyprogesterone acetate, with most evidence among women who had previously received postmenopausal hormone therapy. In comparison, observational studies mostly report a larger risk increase. To explain these patterns, the authors examined the effects of this regimen in relation to both prior hormone therapy and time from menopause to first use of postmenopausal hormone therapy (“gap time”) in the Women’s Health Initiative trial and in a corresponding subset of the Women’s Health Initiative observational study. Postmenopausal women with a uterus enrolled at 40 US clinical centers during 1993–1998. The authors found that hazard ratios agreed between the two cohorts at a specified gap time and time from hormone therapy initiation. Combined trial and observational study data support an adverse effect on breast cancer risk. Women who initiate use soon after menopause, and continue for many years, appear to be at particularly high risk. For example, for a woman who starts soon after menopause and adheres to this regimen, estimated hazard ratios are 1.64 (95% confidence interval: 1.00, 2.68) over a 5-year period of use and 2.19 (95% confidence interval: 1.56, 3.08) over a 10-year period of use. PMID:18372396

Prognostic factors for cases with no extracranial metastasis in whom brain metastasis is detected after resection of non-small cell lung cancer.

PubMed

Bae, Mi Kyung; Yu, Woo Sik; Byun, Go Eun; Lee, Chang Young; Lee, Jin Gu; Kim, Dae Joon; Chung, Kyung Young

2015-05-01

This study aimed to determine prognostic factors associated with postrecurrence survival in cases with postoperative brain metastasis but with no extracranial metastasis in non-small cell lung cancer (NSCLC). Between 1992 and 2012, a total of 2832 patients underwent surgical resection for NSCLC. Among those, 86 patients had postoperative brain metastasis as the initial recurrence. Those patients were retrospectively reviewed. The median follow-up time after the initial lung resection was 24.0 months (range, 2.0-126.0 months). The median overall survival after initial lung cancer resection was 25.0 months and the median overall postrecurrence survival was 11 months. An initial lesion of adenocarcinoma (hazard ratio, 0.548; 95% confidence interval, 0.318 to 0.946; p=0.031), non-pneumonectomy, and a disease-free interval longer than 10.0 months (hazard ratio, 0.565; 95% confidence interval, 0.321-0.995; p=0.048) from the initial lung resection to the diagnosis of brain metastasis positively related to a good postrecurrence survival. Solitary brain metastasis and a size of less than 3 cm for the largest brain lesion were also positive factors for postrecurrence survival. Systemic chemotherapy for brain metastasis (hazard ratio, 0.356; 95% confidence interval, 0.189-0.670; p=0.001) and local treatment of surgery and/or stereotactic radiosurgery (SRS) for brain lesions (hazard ratio, 0.321; 95% confidence interval, 0.138-0.747; p=0.008) were positive factors for better postrecurrence survival. In patients with brain metastasis after resection for NSCLC with no extracranial metastasis, adenocarcinoma histologic type, longer disease-free interval, systemic chemotherapy for brain metastasis and local treatment of surgery and/or SRS for brain metastasis are independent positive prognostic factors for postrecurrence survival. Copyright © 2015. Published by Elsevier Ireland Ltd.

Combustion in a Bomb with a Fuel-Injection System

NASA Technical Reports Server (NTRS)

Cohn, Mildred; Spencer, Robert C

1935-01-01

Fuel injected into a spherical bomb filled with air at a desired density and temperature could be ignited with a spark a few thousandths of a second after injection, an interval comparable with the ignition lag in fuel-injection engines. The effect of several variables on the extent and rate of combustion was investigated: time intervals between injection and ignition of fuel of 0.003 to 0.06 second and one of 5 minutes; initial air temperatures of 100 degrees C. to 250 degrees C.; initial air densities equivalent to 5, 10, and 15 absolute atmospheres pressure at 100 degrees C.; and air-fuel ratios of 5 to 25.

Sensitivity and specificity of mammographic screening as practised in Vermont and Norway

PubMed Central

Hofvind, S; Geller, B M; Skelly, J; Vacek, P M

2012-01-01

Objective The aim of this study was to examine the sensitivity and specificity of screening mammography as performed in Vermont, USA, and Norway. Methods Incident screening data from 1997 to 2003 for female patients aged 50–69 years from the Vermont Breast Cancer Surveillance System (116 996 subsequent screening examinations) and the Norwegian Breast Cancer Screening Program (360 872 subsequent screening examinations) were compared. Sensitivity and specificity estimates for the initial (based on screening mammogram only) and final (screening mammogram plus any further diagnostic imaging) interpretations were directly adjusted for age using 5-year age intervals for the combined Vermont and Norway population, and computed for 1 and 2 years of follow-up, which ended at the time of the next screening mammogram. Results For the 1-year follow-up, sensitivities for initial assessments were 82.0%, 88.2% and 92.5% for 1-, 2- and >2-year screening intervals, respectively, in Vermont (p=0.022). For final assessments, the values were 73.6%, 83.3% and 81.2% (p=0.047), respectively. For Norway, sensitivities for initial assessments were 91.0% and 91.3% (p=0.529) for 2- and >2-year intervals, and 90.7% and 91.3%, respectively, for final assessments (p=0.630). Specificity was lower in Vermont than in Norway for each screening interval and for all screening intervals combined, for both initial (90.6% vs 97.8% for all intervals; p<0.001) and final (98.8% vs 99.5% for all intervals; p<0.001) assessments. Conclusion Our study showed higher sensitivity and specificity in a biennial screening programme with an independent double reading than in a predominantly annual screening program with a single reading. Advances in knowledge This study demonstrates that higher recall rates and lower specificity are not always associated with higher sensitivity of screening mammography. Differences in the screening processes in Norway and Vermont suggest potential areas for improvement in the latter. PMID:22993383

Modeling of the static recrystallization for 7055 aluminum alloy by cellular automaton

NASA Astrophysics Data System (ADS)

Zhang, Tao; Lu, Shi-hong; Zhang, Jia-bin; Li, Zheng-fang; Chen, Peng; Gong, Hai; Wu, Yun-xin

2017-09-01

In order to simulate the flow behavior and microstructure evolution during the pass interval period of the multi-pass deformation process, models of static recovery (SR) and static recrystallization (SRX) by the cellular automaton (CA) method for the 7055 aluminum alloy were established. Double-pass hot compression tests were conducted to acquire flow stress and microstructure variation during the pass interval period. With the basis of the material constants obtained from the compression tests, models of the SR, incubation period, nucleation rate and grain growth were fitted by least square method. A model of the grain topology and a statistical computation of the CA results were also introduced. The effects of the pass interval time, temperature, strain, strain rate and initial grain size on the microstructure variation for the SRX of the 7055 aluminum alloy were studied. The results show that a long pass interval time, large strain, high temperature and large strain rate are beneficial for finer grains during the pass interval period. The stable size of the static recrystallized grain is not concerned with the initial grain size, but mainly depends on the strain rate and temperature. The SRX plays a vital role in grain refinement, while the SR has no effect on the variation of microstructure morphology. Using flow stress and microstructure comparisons of the simulated and experimental CA results, the established CA models can accurately predict the flow stress and microstructure evolution during the pass interval period, and provide guidance for the selection of optimized parameters for the multi-pass deformation process.

Estimation of Initial and Response Times of Laser Dew-Point Hygrometer by Measurement Simulation

NASA Astrophysics Data System (ADS)

Matsumoto, Sigeaki; Toyooka, Satoru

1995-10-01

The initial and the response times of the laser dew-point hygrometer were evaluated by measurement simulation. The simulation was based on loop computations of the surface temperature of a plate with dew deposition, the quantity of dew deposited and the intensity of scattered light from the surface at each short interval of measurement. The initial time was defined as the time necessary for the hygrometer to reach a temperature within ±0.5° C of the measured dew point from the start time of measurement, and the response time was also defined for stepwise dew-point changes of +5° C and -5° C. The simulation results are in approximate agreement with the recorded temperature and intensity of scattered light of the hygrometer. The evaluated initial time ranged from 0.3 min to 5 min in the temperature range from 0° C to 60° C, and the response time was also evaluated to be from 0.2 min to 3 min.

Effects of Heterogeneity and Uncertainties in Sources and Initial and Boundary Conditions on Spatiotemporal Variations of Groundwater Levels

NASA Astrophysics Data System (ADS)

Zhang, Y. K.; Liang, X.

2014-12-01

Effects of aquifer heterogeneity and uncertainties in source/sink, and initial and boundary conditions in a groundwater flow model on the spatiotemporal variations of groundwater level, h(x,t), were investigated. Analytical solutions for the variance and covariance of h(x, t) in an unconfined aquifer described by a linearized Boussinesq equation with a white noise source/sink and a random transmissivity field were derived. It was found that in a typical aquifer the error in h(x,t) in early time is mainly caused by the random initial condition and the error reduces as time goes to reach a constant error in later time. The duration during which the effect of the random initial condition is significant may last a few hundred days in most aquifers. The constant error in groundwater in later time is due to the combined effects of the uncertain source/sink and flux boundary: the closer to the flux boundary, the larger the error. The error caused by the uncertain head boundary is limited in a narrow zone near the boundary but it remains more or less constant over time. The effect of the heterogeneity is to increase the variation of groundwater level and the maximum effect occurs close to the constant head boundary because of the linear mean hydraulic gradient. The correlation of groundwater level decreases with temporal interval and spatial distance. In addition, the heterogeneity enhances the correlation of groundwater level, especially at larger time intervals and small spatial distances.

Power-Efficient Beacon Recognition Method Based on Periodic Wake-Up for Industrial Wireless Devices.

PubMed

Song, Soonyong; Lee, Donghun; Jang, Ingook; Choi, Jinchul; Son, Youngsung

2018-04-17

Energy harvester-integrated wireless devices are attractive for generating semi-permanent power from wasted energy in industrial environments. The energy-harvesting wireless devices may have difficulty in their communication with access points due to insufficient power supply for beacon recognition during network initialization. In this manuscript, we propose a novel method of beacon recognition based on wake-up control to reduce instantaneous power consumption in the initialization procedure. The proposed method applies a moving window for the periodic wake-up of the wireless devices. For unsynchronized wireless devices, beacons are always located in the same positions within each beacon interval even though the starting offsets are unknown. Using these characteristics, the moving window checks the existence of the beacon associated withspecified resources in a beacon interval, checks again for neighboring resources at the next beacon interval, and so on. This method can reduce instantaneous power and generates a surplus of charging time. Thus, the proposed method alleviates the problems of power insufficiency in the network initialization. The feasibility of the proposed method is evaluated using computer simulations of power shortage in various energy-harvesting conditions.

Normal reference intervals and the effects of time and feeding on serum bile acid concentrations in llamas.

PubMed

Andreasen, C B; Pearson, E G; Smith, B B; Gerros, T C; Lassen, E D

1998-04-01

Fifty clinically healthy llamas, 0.5-13 years of age (22 intact males, 10 neutered males, 18 females), with no biochemical evidence of liver disease or hematologic abnormalities, were selected to establish serum bile acid reference intervals. Serum samples submitted to the clinical pathology laboratory were analyzed using a colorimetric enzymatic assay to establish bile acid reference intervals. A nonparametric distribution of llama bile acid concentrations was 1-23 micromol/liter for llamas >1 year of age and 10-44 micromol/liter for llamas < or = 1 year of age. A significant difference was found between these 2 age groups. No correlation was detected between gender and bile acid concentrations. The reference intervals were 1.1-22.9 micromol/liter for llamas >1 year of age and 1.8-49.8 micromol/liter for llamas < or = 1 year of age. Additionally, a separate group of 10 healthy adult llamas (5 males, 5 females, 5-11 years of age) without biochemical or hematologic abnormalities was selected to assess the effects of feeding and time intervals on serum bile acid concentrations. These 10 llamas were provided fresh water and hay ad libitum, and serum samples were obtained via an indwelling jugular catheter hourly for 11 hours. Llamas were then kept from food overnight (12 hours), and subsequent samples were taken prior to feeding (fasting baseline time, 23 hours after trial initiation) and postprandially at 0.5, 1, 2, 4, and 8 hours. In feeding trials, there was no consistent interaction between bile acid concentrations and time, feeding, or 12-hour fasting. Prior feeding or time of day did not result in serum bile acid concentrations outside the reference interval, but concentrations from individual llamas varied within this interval over time.

Components of the Motor Program: The Cerebellum as an Internal Clock. Cognitive Science Program, Technical Report No 86-7.

ERIC Educational Resources Information Center

Ivry, Richard B.; Keele, Steven W.

This report summarizes the initial phase of research with neurological patients on timing functions. Parkinsonian, cerebellar, cortical and peripheral neuropathy patients as well as college aged and elderly control subjects were tested on two separate measures of timing functions. The first task involved the production of timed intervals and used…

Wait Times Experienced by Lung Cancer Patients in the BC Southern Interior to Obtain Oncologic Care: Exploration of the Intervals from First Abnormal Imaging to Oncologic Treatment

PubMed Central

Chowdhury, Rezwan; Boyce, Andrew; Halperin, Ross

2015-01-01

Background: Lung cancer is associated with rapid disease progression, which can significantly progress over a duration of four to eight weeks. This study examines the time interval lung cancer patients from the interior of British Columbia (BC) experience while undergoing diagnostic evaluation, biopsy, staging, and preparation for treatment. Methods: A chart review of lung cancer patients (n=231) referred to the BC Cancer Agency Centre for the Southern Interior between January 1, 2010 and December 31, 2011 was performed. Time zero was defined as the date of the first abnormal chest imaging. Time intervals, expressed as median averages, to specialist consult, biopsy, oncologic referral, initial oncology consultation, and commencement of oncologic treatment were obtained. Results: The median time interval from first abnormal chest imaging to a specialist consultation was 18 days (interquartile range, IQR, 7-36). An additional nine days elapsed prior to biopsy in the form of bronchoscopy, CT-guided biopsy, or sputum cytology (median; IQR, 3-21); if lobectomy was required, 18 days elapsed (median; IQR, 9-28). Eight days were required for pathologic diagnosis and subsequent referral to the cancer centre (median; IQR, 3-16.5). Once referral was received, 10 days elapsed prior to consultation with either a medical or radiation oncologist (median, IQR 5-18). Finally, eight days was required for initiation of radiation and/or chemotherapy (median; IQR, 1-15). The median wait time from detection of lung cancer on imaging to oncologic treatment in the form of radiation and/or chemotherapy was 65.5 days (IQR, 41.5-104.3).  Interpretation: Patients in the BC Southern Interior experience considerable delays in accessing lung cancer care. During this time, the disease has the potential to significantly progress and it is possible that a subset of patients may lose their opportunity for curative intent treatment. PMID:26543688

It's time to fear! Interval timing in odor fear conditioning in rats

PubMed Central

Shionoya, Kiseko; Hegoburu, Chloé; Brown, Bruce L.; Sullivan, Regina M.; Doyère, Valérie; Mouly, Anne-Marie

2013-01-01

Time perception is crucial to goal attainment in humans and other animals, and interval timing also guides fundamental animal behaviors. Accumulating evidence has made it clear that in associative learning, temporal relations between events are encoded, and a few studies suggest this temporal learning occurs very rapidly. Most of these studies, however, have used methodologies that do not permit investigating the emergence of this temporal learning. In the present study we monitored respiration, ultrasonic vocalization (USV) and freezing behavior in rats in order to perform fine-grain analysis of fear responses during odor fear conditioning. In this paradigm an initially neutral odor (the conditioned stimulus, CS) predicted the arrival of an aversive unconditioned stimulus (US, footshock) at a fixed 20-s time interval. We first investigated the development of a temporal pattern of responding related to CS-US interval duration. The data showed that during acquisition with odor-shock pairings, a temporal response pattern of respiration rate was observed. Changing the CS-US interval duration from 20-s to 30-s resulted in a shift of the temporal response pattern appropriate to the new duration thus demonstrating that the pattern reflected the learning of the CS-US interval. A temporal pattern was also observed during a retention test 24 h later for both respiration and freezing measures, suggesting that the animals had stored the interval duration in long-term memory. We then investigated the role of intra-amygdalar dopaminergic transmission in interval timing. For this purpose, the D1 dopaminergic receptors antagonist SCH23390 was infused in the basolateral amygdala before conditioning. This resulted in an alteration of timing behavior, as reflected in differential temporal patterns between groups observed in a 24 h retention test off drug. The present data suggest that D1 receptor dopaminergic transmission within the amygdala is involved in temporal processing. PMID:24098277

Characterization of petroleum reservoirs in the Eocene Green River Formation, Central Uinta Basin, Utah

USGS Publications Warehouse

Morgan, C.D.; Bereskin, S.R.

2003-01-01

The oil-productive Eocene Green River Formation in the central Uinta Basin of northeastern Utah is divided into five distinct intervals. In stratigraphically ascending order these are: 1) Uteland Butte, 2) Castle Peak, 3) Travis, 4) Monument Butte, and 5) Beluga. The reservoir in the Uteland Butte interval is mainly lacustrine limestone with rare bar sandstone beds, whereas the reservoirs in the other four intervals are mainly channel and lacustrine sandstone beds. The changing depositional environments of Paleocene-Eocene Lake Uinta controlled the characteristics of each interval and the reservoir rock contained within. The Uteland Butte consists of carbonate and rare, thin, shallow-lacustrine sandstone bars deposited during the initial rise of the lake. The Castle Peak interval was deposited during a time of numerous and rapid lake-level fluctuations, which developed a simple drainage pattern across the exposed shallow and gentle shelf with each fall and rise cycle. The Travis interval records a time of active tectonism that created a steeper slope and a pronounced shelf break where thick cut-and-fill valleys developed during lake-level falls and rises. The Monument Butte interval represents a return to a gentle, shallow shelf where channel deposits are stacked in a lowstand delta plain and amalgamated into the most extensive reservoir in the central Uinta Basin. The Beluga interval represents a time of major lake expansion with fewer, less pronounced lake-level falls, resulting in isolated single-storied channel and shallow-bar sandstone deposits.

Bilateral Wilms' tumor with anaplasia: lessons from the National Wilms' Tumor Study.

PubMed

Hamilton, Thomas E; Green, Daniel M; Perlman, Elizabeth J; Argani, Pedram; Grundy, Paul; Ritchey, Michael L; Shamberger, Robert C

2006-10-01

The purpose of this study was to evaluate whether initial diagnostic technique influenced the ability to identify anaplastic histology, to determine the time interval to diagnosis of anaplasia, and to delineate the incidence of discordant pathology in bilateral Wilms' tumor. We hypothesized that delay in diagnosis of anaplasia could affect time to appropriate surgery and intensive multimodality therapy. One hundred eight-nine children were enrolled in the fourth National Wilms' Tumor Study with synchronous bilateral tumors, 27 of whom were eventually shown to have anaplastic histology. Initial diagnostic technique, time interval to diagnosis of anaplasia, and the incidence of discordant pathology were determined. Anaplasia was identified in 0 of 7 tumors by core needle biopsy, 3 of 9 tumors by open wedge biopsy, and in 7 of 9 cases by partial or complete nephrectomy. The mean duration of first chemotherapy regimen (DD or EE) was 20, 39, and 36 weeks, respectively, before anaplasia was identified at second surgery. Discordant pathology between bilateral tumors was identified on final tissue diagnosis in 20 patients. Only 4 patients had anaplastic tumors in both kidneys. Core needle biopsy did not identify anaplasia in 7 of 7 children. Open biopsy or partial/complete nephrectomy identified anaplasia at initial diagnostic procedure in 10 of 18 children. Twenty of 24 patients at final tissue diagnosis had discordant pathology between the 2 kidneys. Earlier interval incisional biopsy or resection may identify anaplastic histology and limit the duration of chemotherapy targeted to favorable histology for children with bilateral Wilms' tumor and anaplasia.

Long-time uncertainty propagation using generalized polynomial chaos and flow map composition

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

Luchtenburg, Dirk M., E-mail: dluchten@cooper.edu; Brunton, Steven L.; Rowley, Clarence W.

2014-10-01

We present an efficient and accurate method for long-time uncertainty propagation in dynamical systems. Uncertain initial conditions and parameters are both addressed. The method approximates the intermediate short-time flow maps by spectral polynomial bases, as in the generalized polynomial chaos (gPC) method, and uses flow map composition to construct the long-time flow map. In contrast to the gPC method, this approach has spectral error convergence for both short and long integration times. The short-time flow map is characterized by small stretching and folding of the associated trajectories and hence can be well represented by a relatively low-degree basis. The compositionmore » of these low-degree polynomial bases then accurately describes the uncertainty behavior for long integration times. The key to the method is that the degree of the resulting polynomial approximation increases exponentially in the number of time intervals, while the number of polynomial coefficients either remains constant (for an autonomous system) or increases linearly in the number of time intervals (for a non-autonomous system). The findings are illustrated on several numerical examples including a nonlinear ordinary differential equation (ODE) with an uncertain initial condition, a linear ODE with an uncertain model parameter, and a two-dimensional, non-autonomous double gyre flow.« less

HIV testing, care referral and linkage to care intervals affect time to engagement in care for newly diagnosed HIV-infected adolescents in fifteen adolescent medicine clinics in the United States

PubMed Central

Philbin, Morgan M.; Tanner, Amanda E.; DuVal, Anna; Ellen, Jonathan M.; Xu, Jiahong; Kapogiannis, Bill; Bethel, Jim; Fortenberry, J. Dennis

2016-01-01

Objective To examine how the time from HIV testing to care referral and from referral to care linkage influenced time to care engagement for newly diagnosed HIV-infected adolescents. Methods We evaluated the Care Initiative, a care linkage and engagement program for HIV-infected adolescents in 15 U.S. clinics. We analyzed client-level factors, provider type and intervals from HIV testing to care referral and from referral to care linkage as predictors of care engagement. Engagement was defined as a second HIV-related medical visit within 16 weeks of initial HIV-related medical visit (linkage). Results At 32 months, 2,143 youth had been referred. Of these, 866 were linked to care through the Care Initiative within 42 days and thus eligible for study inclusion. Of the linked youth, 90.8% were ultimately engaged in care. Time from HIV testing to referral (e.g., ≤7 days versus >365 days) was associated with engagement (AOR=2.91; 95% CI: 1.43–5.94) and shorter time to engagement (Adjusted HR=1.41; 95% CI: 1.11–1.79). Individuals with shorter care referral to linkage intervals (e.g., ≤7 days versus 22–42 days) engaged in care faster (Adjusted HR=2.90; 95% CI: 2.34–3.60) and more successfully (AOR=2.01; 95% CI: 1.04–3.89). Conclusions These data address a critical piece of the care continuum, and can offer suggestions of where and with whom to intervene in order to best achieve the care engagement goals outlined in the U.S. National HIV/AIDS Strategy. These results may also inform programs and policies that set concrete milestones and strategies for optimal care linkage timing for newly diagnosed adolescents. PMID:26885804

Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach.

PubMed

Kapur, Ajay; Adair, Nilda; O'Brien, Mildred; Naparstek, Nikoleta; Cangelosi, Thomas; Zuvic, Petrina; Joseph, Sherin; Meier, Jason; Bloom, Beatrice; Potters, Louis

Modern external beam radiation therapy treatment delivery processes potentially increase the number of tasks to be performed by therapists and thus opportunities for errors, yet the need to treat a large number of patients daily requires a balanced allocation of time per treatment slot. The goal of this work was to streamline the underlying workflow in such time-interval constrained processes to enhance both execution efficiency and active safety surveillance using a Kaizen approach. A Kaizen project was initiated by mapping the workflow within each treatment slot for 3 Varian TrueBeam linear accelerators. More than 90 steps were identified, and average execution times for each were measured. The time-consuming steps were stratified into a 2 × 2 matrix arranged by potential workflow improvement versus the level of corrective effort required. A work plan was created to launch initiatives with high potential for workflow improvement but modest effort to implement. Time spent on safety surveillance and average durations of treatment slots were used to assess corresponding workflow improvements. Three initiatives were implemented to mitigate unnecessary therapist motion, overprocessing of data, and wait time for data transfer defects, respectively. A fourth initiative was implemented to make the division of labor by treating therapists as well as peer review more explicit. The average duration of treatment slots reduced by 6.7% in the 9 months following implementation of the initiatives (P = .001). A reduction of 21% in duration of treatment slots was observed on 1 of the machines (P < .001). Time spent on safety reviews remained the same (20% of the allocated interval), but the peer review component increased. The Kaizen approach has the potential to improve operational efficiency and safety with quick turnaround in radiation therapy practice by addressing non-value-adding steps characteristic of individual department workflows. Higher effort opportunities are identified to guide continual downstream quality improvements. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Vehicle speed affects both pre-skid braking kinematics and average tire/roadway friction.

PubMed

Heinrichs, Bradley E; Allin, Boyd D; Bowler, James J; Siegmund, Gunter P

2004-09-01

Vehicles decelerate between brake application and skid onset. To better estimate a vehicle's speed and position at brake application, we investigated how vehicle deceleration varied with initial speed during both the pre-skid and skidding intervals on dry asphalt. Skid-to-stop tests were performed from four initial speeds (20, 40, 60, and 80 km/h) using three different grades of tire (economy, touring, and performance) on a single vehicle and a single road surface. Average skidding friction was found to vary with initial speed and tire type. The post-brake/pre-skid speed loss, elapsed time, distance travelled, and effective friction were found to vary with initial speed. Based on these data, a method using skid mark length to predict vehicle speed and position at brake application rather than skid onset was shown to improve estimates of initial vehicle speed by up to 10 km/h and estimates of vehicle position at brake application by up to 8 m compared to conventional methods that ignore the post-brake/pre-skid interval. Copyright 2003 Elsevier Ltd.

Changes in food insecurity, nutritional status, and physical health status after antiretroviral therapy initiation in rural Uganda.

PubMed

Weiser, Sheri D; Gupta, Reshma; Tsai, Alexander C; Frongillo, Edward A; Grede, Nils; Kumbakumba, Elias; Kawuma, Annet; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R

2012-10-01

To investigate whether time on antiretroviral therapy (ART) is associated with improvements in food security and nutritional status, and the extent to which associations are mediated by improved physical health status. The Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of HIV-infected adults newly initiating ART in Mbarara, Uganda. Participants initiating ART underwent quarterly structured interview and blood draws. The primary explanatory variable was time on ART, constructed as a set of binary variables for each 3-month period. Outcomes were food insecurity, nutritional status, and PHS. We fit multiple regression models with cluster-correlated robust estimates of variance to account for within-person dependence of observations over time, and analyses were adjusted for clinical and sociodemographic characteristics. Two hundred twenty-eight ART-naive participants were followed for up to 3 years, and 41% were severely food insecure at baseline. The mean food insecurity score progressively declined (test for linear trend P < 0.0001), beginning with the second quarter (b = -1.6; 95% confidence interval: -2.7 to -0.45) and ending with the final quarter (b = -6.4; 95% confidence interval: -10.3 to -2.5). PHS and nutritional status improved in a linear fashion over study follow-up (P < 0.001). Inclusion of PHS in the regression model attenuated the relationship between ART duration and food security. Among HIV-infected individuals in Uganda, food insecurity decreased and nutritional status and PHS improved over time after initiation of ART. Changes in food insecurity were partially explained by improvements in PHS. These data support early initiation of ART in resource-poor settings before decline in functional status to prevent worsening food insecurity and its detrimental effects on HIV treatment outcomes.

Reaction time in pilots during intervals of high sustained g.

PubMed

Truszczynski, Olaf; Lewkowicz, Rafal; Wojtkowiak, Mieczyslaw; Biernacki, Marcin P

2014-11-01

An important problem for pilots is visual disturbances occurring under +Gz acceleration. Assessment of the degree of intensification of these disturbances is generally accepted as the acceleration tolerance level (ATL) criterion determined in human centrifuges. The aim of this research was to evaluate the visual-motor responses of pilots during rapidly increasing acceleration contained in cyclic intervals of +6 Gz to the maximum ATL. The study involved 40 male pilots ages 32-41 yr. The task was a quick and faultless response to the light stimuli presented on a light bar during exposure to acceleration until reaching the ATL. Simple response time (SRT) measurements were performed using a visual-motor analysis system throughout the exposures which allowed assessment of a pilot's ATL. There were 29 pilots who tolerated the initial phase of interval acceleration and achieved +6 Gz, completing the test at ATL. Relative to the control measurements, the obtained results indicate a significant effect of the applied acceleration on response time. SRT during +6 Gz exposure was not significantly longer compared with the reaction time between each of the intervals. SRT and erroneous reactions indicated no statistically significant differences between the "lower" and "higher" ATL groups. SRT measurements over the +6-Gz exposure intervals did not vary between "lower" and "higher" ATL groups and, therefore, are not useful in predicting pilot performance. The gradual exposure to the maximum value of +6 Gz with exposure to the first three intervals on the +6-Gz plateau effectively differentiated pilots.

Different target-discrimination times can be followed by the same saccade-initiation timing in different stimulus conditions during visual searches

PubMed Central

Tanaka, Tomohiro; Nishida, Satoshi

2015-01-01

The neuronal processes that underlie visual searches can be divided into two stages: target discrimination and saccade preparation/generation. This predicts that the length of time of the prediscrimination stage varies according to the search difficulty across different stimulus conditions, whereas the length of the latter postdiscrimination stage is stimulus invariant. However, recent studies have suggested that the length of the postdiscrimination interval changes with different stimulus conditions. To address whether and how the visual stimulus affects determination of the postdiscrimination interval, we recorded single-neuron activity in the lateral intraparietal area (LIP) when monkeys (Macaca fuscata) performed a color-singleton search involving four stimulus conditions that differed regarding luminance (Bright vs. Dim) and target-distractor color similarity (Easy vs. Difficult). We specifically focused on comparing activities between the Bright-Difficult and Dim-Easy conditions, in which the visual stimuli were considerably different, but the mean reaction times were indistinguishable. This allowed us to examine the neuronal activity when the difference in the degree of search speed between different stimulus conditions was minimal. We found that not only prediscrimination but also postdiscrimination intervals varied across stimulus conditions: the postdiscrimination interval was longer in the Dim-Easy condition than in the Bright-Difficult condition. Further analysis revealed that the postdiscrimination interval might vary with stimulus luminance. A computer simulation using an accumulation-to-threshold model suggested that the luminance-related difference in visual response strength at discrimination time could be the cause of different postdiscrimination intervals. PMID:25995344

Hypothesis testing for the validation of the kinetic spectrophotometric methods for the determination of lansoprazole in bulk and drug formulations via Fe(III) and Zn(II) chelates.

PubMed

Rahman, Nafisur; Kashif, Mohammad

2010-03-01

Point and interval hypothesis tests performed to validate two simple and economical, kinetic spectrophotometric methods for the assay of lansoprazole are described. The methods are based on the formation of chelate complex of the drug with Fe(III) and Zn(II). The reaction is followed spectrophotometrically by measuring the rate of change of absorbance of coloured chelates of the drug with Fe(III) and Zn(II) at 445 and 510 nm, respectively. The stoichiometric ratio of lansoprazole to Fe(III) and Zn(II) complexes were found to be 1:1 and 2:1, respectively. The initial-rate and fixed-time methods are adopted for determination of drug concentrations. The calibration graphs are linear in the range 50-200 µg ml⁻¹ (initial-rate method), 20-180 µg ml⁻¹ (fixed-time method) for lansoprazole-Fe(III) complex and 120-300 (initial-rate method), and 90-210 µg ml⁻¹ (fixed-time method) for lansoprazole-Zn(II) complex. The inter-day and intra-day precision data showed good accuracy and precision of the proposed procedure for analysis of lansoprazole. The point and interval hypothesis tests indicate that the proposed procedures are not biased. Copyright © 2010 John Wiley & Sons, Ltd.

On the use and the performance of software reliability growth models

NASA Technical Reports Server (NTRS)

Keiller, Peter A.; Miller, Douglas R.

1991-01-01

We address the problem of predicting future failures for a piece of software. The number of failures occurring during a finite future time interval is predicted from the number failures observed during an initial period of usage by using software reliability growth models. Two different methods for using the models are considered: straightforward use of individual models, and dynamic selection among models based on goodness-of-fit and quality-of-prediction criteria. Performance is judged by the relative error of the predicted number of failures over future finite time intervals relative to the number of failures eventually observed during the intervals. Six of the former models and eight of the latter are evaluated, based on their performance on twenty data sets. Many open questions remain regarding the use and the performance of software reliability growth models.

Schedule-induced drinking as functions of interpellet interval and draught size in the Java macaque1

PubMed Central

Allen, Joseph D.; Kenshalo, Dan R.

1978-01-01

Three Java monkeys received food pellets that were assigned by both ascending and descending series of fixed-time schedules whose values varied between 8 and 256 seconds. The draught size dispensed by a concurrently available water-delivery tube was systematically varied between 1.0 and 0.3 milliliter per lick at various fixed-time values during the second and third series determinations. Session water intake was bitonically related to the interpellet interval and was determined by the interaction of (1) the probability of initiating a drinking bout, which fell off at the highest interpellet intervals and, (2) the size of the bout, which increased directly with increases in interpellet interval. Variations in draught size had little effect on total session intakes, but reduced bout size at draught sizes of 0.5 milliliter and below. Thus, a volume-regulation process of schedule-induced drinking operated generally at the session-intake level, but was limited to higher draught sizes at the bout level. PMID:16812093

Schedule-induced drinking as functions of interpellet interval and draught size in the Java macaque.

PubMed

Allen, J D; Kenshalo, D R

1978-09-01

Three Java monkeys received food pellets that were assigned by both ascending and descending series of fixed-time schedules whose values varied between 8 and 256 seconds. The draught size dispensed by a concurrently available water-delivery tube was systematically varied between 1.0 and 0.3 milliliter per lick at various fixed-time values during the second and third series determinations. Session water intake was bitonically related to the interpellet interval and was determined by the interaction of (1) the probability of initiating a drinking bout, which fell off at the highest interpellet intervals and, (2) the size of the bout, which increased directly with increases in interpellet interval. Variations in draught size had little effect on total session intakes, but reduced bout size at draught sizes of 0.5 milliliter and below. Thus, a volume-regulation process of schedule-induced drinking operated generally at the session-intake level, but was limited to higher draught sizes at the bout level.

Biodegradation and attenuation of steroidal hormones and alkylphenols by stream biofilms and sediments

USGS Publications Warehouse

Writer, Jeffrey; Barber, Larry B.; Ryan, Joseph N.; Bradley, Paul M.

2011-01-01

Biodegradation of select endocrine-disrupting compounds (17β-estradiol, estrone, 17α-ethynylestradiol, 4-nonylphenol, 4-nonylphenolmonoexthoylate, and 4-nonylphenoldiethoxylate) was evaluated in stream biofilm, sediment, and water matrices collected from locations upstream and downstream from a wastewater treatment plant effluent discharge. Both biologically mediated transformation to intermediate metabolites and biologically mediated mineralization were evaluated in separate time interval experiments. Initial time intervals (0–7 d) evaluated biodegradation by the microbial community dominant at the time of sampling. Later time intervals (70 and 185 d) evaluated the biodegradation potential as the microbial community adapted to the absence of outside energy sources. The sediment matrix was more effective than the biofilm and water matrices at biodegrading 4-nonylphenol and 17β-estradiol. Biodegradation by the sediment matrix of 17α-ethynylestradiol occurred at later time intervals (70 and 185 d) and was not observed in the biofilm or water matrices. Stream biofilms play an important role in the attenuation of endocrine-disrupting compounds in surface waters due to both biodegradation and sorption processes. Because sorption to stream biofilms and bed sediments occurs on a faster temporal scale (<1 h) than the potential to biodegrade the target compounds (50% mineralization at >185 d), these compounds can accumulate in stream biofilms and sediments.

Power-Efficient Beacon Recognition Method Based on Periodic Wake-Up for Industrial Wireless Devices

PubMed Central

Lee, Donghun; Jang, Ingook; Choi, Jinchul; Son, Youngsung

2018-01-01

Energy harvester-integrated wireless devices are attractive for generating semi-permanent power from wasted energy in industrial environments. The energy-harvesting wireless devices may have difficulty in their communication with access points due to insufficient power supply for beacon recognition during network initialization. In this manuscript, we propose a novel method of beacon recognition based on wake-up control to reduce instantaneous power consumption in the initialization procedure. The proposed method applies a moving window for the periodic wake-up of the wireless devices. For unsynchronized wireless devices, beacons are always located in the same positions within each beacon interval even though the starting offsets are unknown. Using these characteristics, the moving window checks the existence of the beacon associated withspecified resources in a beacon interval, checks again for neighboring resources at the next beacon interval, and so on. This method can reduce instantaneous power and generates a surplus of charging time. Thus, the proposed method alleviates the problems of power insufficiency in the network initialization. The feasibility of the proposed method is evaluated using computer simulations of power shortage in various energy-harvesting conditions. PMID:29673206

Evaluation of a patient navigation program.

PubMed

Koh, Catherine; Nelson, Joan M; Cook, Paul F

2011-02-01

This study examined the value and effectiveness of a patient navigation program in terms of timeliness of access to cancer care, resolution of barriers, and satisfaction in 55 patients over a six-month period. Although not statistically significant, the time interval between diagnostic biopsy to first consultation with a cancer specialist after program implementation was reduced from an average of 14.6 days to 12.8 days. The time interval between diagnostic biopsy to initiation of cancer treatment also was reduced from 30 days to 26.2 days (not statistically significant). In addition, 71% of patient barriers were resolved by the time treatment was initiated. Overall, patients were highly satisfied with their navigated care experience. Consistent evaluation and monitoring of quality-of-care indicators are critical to further develop the program and to direct resource allocation. Oncology nurses participating in patient navigation programs should be encouraged to evaluate their importance and impact in this developing concept. Nurses should seek roles that allow them to optimize the effective use of their specialized knowledge and skills to the benefit of patients along the cancer care continuum.

Characterization of cracking behavior using posttest fractographic analysis

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

Kobayashi, T.; Shockey, D.A.

A determination of time to initiation of stress corrosion cracking in structures and test specimens is important for performing structural failure analysis and for setting inspection intervals. Yet it is seldom possible to establish how much of a component's lifetime represents the time to initiation of fracture and how much represents postinitiation crack growth. This exploratory research project was undertaken to examine the feasibility of determining crack initiation times and crack growth rates from posttest examination of fracture surfaces of constant-extension-rate-test (CERT) specimens by using the fracture reconstruction applying surface topography analysis (FRASTA) technique. The specimens used in this studymore » were Type 304 stainless steel fractured in several boiling water reactor (BWR) aqueous environments. 2 refs., 25 figs., 2 tabs.« less

Comet and Asteroid Hazard to the Terrestrial Planets

NASA Technical Reports Server (NTRS)

Ipatov, S. I.; Mather, J. C.; Oegerle, William (Technical Monitor)

2002-01-01

We made computer simulations of orbital evolution for intervals of at least 5-10 Myr of N=2000 Jupiter-crossing objects (JCOs) with initial orbits close to those of real comets with period P less than 10 yr, 500 objects with orbits close to that of Comet 10P, and the asteroids initially located at the 3:1 and 5:2 resonances with Jupiter at initial eccentricity e(sub 0)=0.15 and initial inclination i(sub 0)=10(sup 0). The gravitational influence of all planets, except for Mercury and Pluto, was taken into account (without dissipative factors). We calculated the probabilities of collisions of bodies with the terrestrial planets, using orbital elements obtained with a step equal to 500 yr, and then summarized the results for all bodies, obtaining, the total probability Psigma of collisions with a planet and the total time interval Tsigma during which perihelion distance q of bodies was less than a semimajor axis of the planet. The values of p(sub r) =10(exp 6)Psigma/N and T(sub r)=T/1000 yr (where T=Tsigma/N) are presented in a table together with the ratio r of the total time interval when orbits were of Apollo type (at a greater than 1 AU, q less than 1.017 AU, e less than 0.999) to that of Amor type (1.017 less than q less than 1.33 AU), r(sub 2) is the same as r but for Apollo objects with e less than 0.9. For asteroids we present only results obtained by direct integration, as a symplectic method can give large errors for these resonances.

On solving wave equations on fixed bounded intervals involving Robin boundary conditions with time-dependent coefficients

NASA Astrophysics Data System (ADS)

van Horssen, Wim T.; Wang, Yandong; Cao, Guohua

2018-06-01

In this paper, it is shown how characteristic coordinates, or equivalently how the well-known formula of d'Alembert, can be used to solve initial-boundary value problems for wave equations on fixed, bounded intervals involving Robin type of boundary conditions with time-dependent coefficients. A Robin boundary condition is a condition that specifies a linear combination of the dependent variable and its first order space-derivative on a boundary of the interval. Analytical methods, such as the method of separation of variables (SOV) or the Laplace transform method, are not applicable to those types of problems. The obtained analytical results by applying the proposed method, are in complete agreement with those obtained by using the numerical, finite difference method. For problems with time-independent coefficients in the Robin boundary condition(s), the results of the proposed method also completely agree with those as for instance obtained by the method of separation of variables, or by the finite difference method.

Foraminiferal Stable Isotope Record at Millville, NJ: Implications for the onset of the PETM

NASA Astrophysics Data System (ADS)

Wright, J. D.; Miller, K. G.

2016-12-01

Traditional paleoceanographic tools (magneto-biostratigraphy, orbital cycles) are insufficient to assign rates to the initial release of carbon during the rapid onset of the PETM (<10 kyr). The ODP Leg 174AX Millville, NJ PETM section (70 m paleodepth) is >10 times more expanded relative to the thickest open ocean sites (e.g., Site 690). The onset interval at Millville is defined by a bulk carbonate δ13C of 3.5‰ across 25 cm interval. Two groups used the geochemical changes to constrain the timing for the initial pulse of carbon. Wright and Schaller (2013) focused on the differential responses in δ13C and %CaCO3 arguing that the release was fast (<1 year). Conversely, Zeebe et al. (2016) assumed the initial covariance in δ18O and δ13C represented equilibrium conditions, modeling a 4 kyr duration for the release. We generated planktonic and benthic foraminiferal stable isotope records across the onset of the PETM CIE at Millville. Most of the δ13C change recorded by foraminifera occurred over the 25 cm onset interval. However, foraminiferal δ18O values continue to decrease for another 1.5 m above the initial δ13C decrease contradicting Zeebe et al.'s assumption of equilibrium conditions. The foraminiferal stable isotope pattern is similar to the modeled response following a large, instantaneous release of light carbon to the atmosphere, that produces a rapid (decadal) scale warming in the surface air masses followed by continued warming but at a slower rate. Differential responses in δ13C, δ18O, and %CaCO3 at the onset of the PETM are consistent with an instantaneous initial release of carbon with centennial-scale warming that continued well after the initial carbon pulse similar to that predicted by climate models. Fitting the Millville isotope records to these models suggests that peak warmth followed the initial release by 100 to 200 years. The mid-shelf location of Millville a made it responsive to atmospheric changes unlike open ocean sites where thermal inertia dampens the larger atmosphere changes.

Lifetime Estimation of the Upper Stage of GSAT-14 in Geostationary Transfer Orbit.

PubMed

Jeyakodi David, Jim Fletcher; Sharma, Ram Krishan

2014-01-01

The combination of atmospheric drag and lunar and solar perturbations in addition to Earth's oblateness influences the orbital lifetime of an upper stage in geostationary transfer orbit (GTO). These high eccentric orbits undergo fluctuations in both perturbations and velocity and are very sensitive to the initial conditions. The main objective of this paper is to predict the reentry time of the upper stage of the Indian geosynchronous satellite launch vehicle, GSLV-D5, which inserted the satellite GSAT-14 into a GTO on January 05, 2014, with mean perigee and apogee altitudes of 170 km and 35975 km. Four intervals of near linear variation of the mean apogee altitude observed were used in predicting the orbital lifetime. For these four intervals, optimal values of the initial osculating eccentricity and ballistic coefficient for matching the mean apogee altitudes were estimated with the response surface methodology using a genetic algorithm. It was found that the orbital lifetime from these four time spans was between 144 and 148 days.

Lifetime Estimation of the Upper Stage of GSAT-14 in Geostationary Transfer Orbit

PubMed Central

Jeyakodi David, Jim Fletcher; Sharma, Ram Krishan

2014-01-01

The combination of atmospheric drag and lunar and solar perturbations in addition to Earth's oblateness influences the orbital lifetime of an upper stage in geostationary transfer orbit (GTO). These high eccentric orbits undergo fluctuations in both perturbations and velocity and are very sensitive to the initial conditions. The main objective of this paper is to predict the reentry time of the upper stage of the Indian geosynchronous satellite launch vehicle, GSLV-D5, which inserted the satellite GSAT-14 into a GTO on January 05, 2014, with mean perigee and apogee altitudes of 170 km and 35975 km. Four intervals of near linear variation of the mean apogee altitude observed were used in predicting the orbital lifetime. For these four intervals, optimal values of the initial osculating eccentricity and ballistic coefficient for matching the mean apogee altitudes were estimated with the response surface methodology using a genetic algorithm. It was found that the orbital lifetime from these four time spans was between 144 and 148 days. PMID:27437491

Flight Deck Data Link Displays: An Evaluation of Textual and Graphical Implementations

NASA Technical Reports Server (NTRS)

McGann, Alison; Lozito, Sandy; Corker, Kevin; Ashford, Rose (Technical Monitor)

2001-01-01

In Experiment 1, 16 pilots participated in a part-task simulation study that evaluated pilot data link communication for short and long message types and for two textual formats. No differences were found between the two textual formats when evaluating data link transaction times and pilot performance on a secondary task. Pilots initiated flight changes more quickly with the T-Scan format, where location of clearance information roughly corresponded to the cockpit instrument layout. Longer messages were less problematic than two short messages sent in close succession as pilots required more verbal clarification for closely spaced messages. 24 pilots participated in a second experiment that evaluated pilot communication performance for textual data link, two implementations of graphical data link, and a combined graphical and textual information modality. The two modalities incorporating text resulted in significantly faster transaction times and better performance on the secondary task than the two graphical-only implementations. The interval between messages was also more systematically varied in Experiment 2, and a short interval between messages significantly increased the access time for the second message. This delay in access was long enough to increase significantly the total transaction time of the second message, and this effect was exaggerated for the graphical-only implementations. Time to view the message before acknowledgement and time to initiate flight changes were not affected by the interval manipulation, This suggests that pilots adopt a sequential message handling strategy, and presenting messages closely in succession may present operational problems in a data link Air Traffic Control (ATC) environment. The results of this study also indicate that the perceived importance of message content is currently a crucial element in pilot data link communication.

Evaluation of serum biochemical marker concentrations and survival time in dogs with protein-losing enteropathy.

PubMed

Equilino, Mirjam; Théodoloz, Vincent; Gorgas, Daniela; Doherr, Marcus G; Heilmann, Romy M; Suchodolski, Jan S; Steiner, Jörg M; Burgener Dvm, Iwan A

2015-01-01

To evaluate serum concentrations of biochemical markers and survival time in dogs with protein-losing enteropathy (PLE). Prospective study. 29 dogs with PLE and 18 dogs with food-responsive diarrhea (FRD). Data regarding serum concentrations of various biochemical markers at the initial evaluation were available for 18 of the 29 dogs with PLE and compared with findings for dogs with FRD. Correlations between biochemical marker concentrations and survival time (interval between time of initial evaluation and death or euthanasia) for dogs with PLE were evaluated. Serum C-reactive protein concentration was high in 13 of 18 dogs with PLE and in 2 of 18 dogs with FRD. Serum concentration of canine pancreatic lipase immunoreactivity was high in 3 dogs with PLE but within the reference interval in all dogs with FRD. Serum α1-proteinase inhibitor concentration was less than the lower reference limit in 9 dogs with PLE and 1 dog with FRD. Compared with findings in dogs with FRD, values of those 3 variables in dogs with PLE were significantly different. Serum calprotectin (measured by radioimmunoassay and ELISA) and S100A12 concentrations were high but did not differ significantly between groups. Seventeen of the 29 dogs with PLE were euthanized owing to this disease; median survival time was 67 days (range, 2 to 2,551 days). Serum C-reactive protein, canine pancreatic lipase immunoreactivity, and α1-proteinase inhibitor concentrations differed significantly between dogs with PLE and FRD. Most initial biomarker concentrations were not predictive of survival time in dogs with PLE.

Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation.

PubMed

Merenstein, Daniel; Yang, Yang; Schneider, Michael F; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M; Sharp, Gerald B; Gandhi, Monica; Liu, Chenglong

2008-01-01

To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)-infected participants of the Women's Interagency HIV Study. Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non-CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. MAIN OUTCOME AND EXPOSURES: Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non-CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non-CAM users. Female CAM users initiated HAART regimens earlier than non-CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression.

Automated Algorithm for J-Tpeak and Tpeak-Tend Assessment of Drug-Induced Proarrhythmia Risk

DOE PAGES

Johannesen, Lars; Vicente, Jose; Hosseini, Meisam; ...

2016-12-30

Prolongation of the heart rate corrected QT (QTc) interval is a sensitive marker of torsade de pointes risk; however it is not specific as QTc prolonging drugs that block inward currents are often not associated with torsade. Recent work demonstrated that separate analysis of the heart rate corrected J-T peakc (J-T peakc) and T peak-T end intervals can identify QTc prolonging drugs with inward current block and is being proposed as a part of a new cardiac safety paradigm for new drugs (the “CiPA” initiative). In this work, we describe an automated measurement methodology for assessment of the J-T peakcmore » and T peak-T end intervals using the vector magnitude lead. The automated measurement methodology was developed using data from one clinical trial and was evaluated using independent data from a second clinical trial. Comparison between the automated and the prior semi-automated measurements shows that the automated algorithm reproduces the semi-automated measurements with a mean difference of single-deltas <1 ms and no difference in intra-time point variability (p for all > 0.39). In addition, the time-profile of the baseline and placebo-adjusted changes are within 1 ms for 63% of the time-points (86% within 2 ms). Importantly, the automated results lead to the same conclusions about the electrophysiological mechanisms of the studied drugs. We have developed an automated algorithm for assessment of J-T peakc and T peak-T end intervals that can be applied in clinical drug trials. Under the CiPA initiative this ECG assessment would determine if there are unexpected ion channel effects in humans compared to preclinical studies. In conclusion, the algorithm is being released as open-source software.« less

Automated Algorithm for J-Tpeak and Tpeak-Tend Assessment of Drug-Induced Proarrhythmia Risk

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

Johannesen, Lars; Vicente, Jose; Hosseini, Meisam

Prolongation of the heart rate corrected QT (QTc) interval is a sensitive marker of torsade de pointes risk; however it is not specific as QTc prolonging drugs that block inward currents are often not associated with torsade. Recent work demonstrated that separate analysis of the heart rate corrected J-T peakc (J-T peakc) and T peak-T end intervals can identify QTc prolonging drugs with inward current block and is being proposed as a part of a new cardiac safety paradigm for new drugs (the “CiPA” initiative). In this work, we describe an automated measurement methodology for assessment of the J-T peakcmore » and T peak-T end intervals using the vector magnitude lead. The automated measurement methodology was developed using data from one clinical trial and was evaluated using independent data from a second clinical trial. Comparison between the automated and the prior semi-automated measurements shows that the automated algorithm reproduces the semi-automated measurements with a mean difference of single-deltas <1 ms and no difference in intra-time point variability (p for all > 0.39). In addition, the time-profile of the baseline and placebo-adjusted changes are within 1 ms for 63% of the time-points (86% within 2 ms). Importantly, the automated results lead to the same conclusions about the electrophysiological mechanisms of the studied drugs. We have developed an automated algorithm for assessment of J-T peakc and T peak-T end intervals that can be applied in clinical drug trials. Under the CiPA initiative this ECG assessment would determine if there are unexpected ion channel effects in humans compared to preclinical studies. In conclusion, the algorithm is being released as open-source software.« less

Precise time technology for selected Air Force systems: Present status and future requirements

NASA Technical Reports Server (NTRS)

Yannoni, N. F.

1981-01-01

Precise time and time interval (PTTI) technology is becoming increasingly significant to Air Force operations as digital techniques find expanded utility in military missions. Timing has a key role in the function as well as in navigation. A survey of the PTTI needs of several Air Force systems is presented. Current technology supporting these needs was reviewed and new requirements are emphasized for systems as they transfer from initial development to final operational deployment.

Factors Associated with Timing of Initiation of Antiretroviral Therapy among HIV-1 Infected Adults in the Niger Delta Region of Nigeria

PubMed Central

Ogoina, Dimie

2015-01-01

Introduction Based on growing evidence mainly from countries outside Sub-Saharan Africa, the World Health Organisation (WHO) now recommends initiation of antiretroviral therapy (ART) in HIV-infected individuals in developing countries when CD4 cell count (CD4+) is ≤ 500cells/ul. Nigeria accounts for about 14% of the estimated HIV/AIDS burden in Sub-Saharan Africa. We evaluated the factors associated with timing of initiation of ART among treatment-ineligible HIV-infected adults from Nigeria. Methods We retrospectively reviewed the hospital records of ART ineligible HIV-infected adults who enrolled into HIV care between January 2008 and December 2012 at two major tertiary hospitals in Bayelsa State, South-South Nigeria. Demographic, clinical and laboratories data were obtained at presentation, at each subsequent visit at 6 monthly intervals and at time of initiation of ART. Cox proportional regression and Kaplan-Meier survival analysis were used to evaluate independent predictors of time to initiation of ART. Results Amongst the 280 study participants, 70.6% were females, 62.6% had CD4+ ≥500cells/ul, 48.4% had WHO HIV Stage 1 disease and 34.3% were lost to follow up. In a cohort of 180 participants followed up for ≥3months, participants with CD4+ of 351-500cells/ul and stage 2 disease were more likely to start ART earlier than those with CD4+ > 500cells/ul (Hazard ratio [HR]-1.7, 95% confidence interval [CI] of 1.0-2.9) and stage 1 disease (HR-2.3 (95% CI-1.3-4.2) respectively. HIV-infected adults with faster CD4+ decay required earlier ART initiation, especially in the first year of follow up. Conclusion ART-ineligible HIV-infected adults on follow up in South-South Nigeria are more likely to require earlier initiation of ART if they have stage 2 HIV disease or CD4+ ≤500cells/ul at presentation. Our findings suggest faster progression of HIV-disease in these groups of individuals and corroborate the growing evidence in support for earlier initiation of ART. PMID:25933356

Waking and scrambling in holographic heating up

NASA Astrophysics Data System (ADS)

Ageev, D. S.; Aref'eva, I. Ya.

2017-10-01

Using holographic methods, we study the heating up process in quantum field theory. As a holographic dual of this process, we use absorption of a thin shell on a black brane. We find the explicit form of the time evolution of the quantum mutual information during heating up from the temperature Ti to the temperature T f in a system of two intervals in two-dimensional space-time. We determine the geometric characteristics of the system under which the time dependence of the mutual information has a bell shape: it is equal to zero at the initial instant, becomes positive at some subsequent instant, further attains its maximum, and again decreases to zero. Such a behavior of the mutual information occurs in the process of photosynthesis. We show that if the distance x between the intervals is less than log 2/2π T i, then the evolution of the holographic mutual information has a bell shape only for intervals whose lengths are bounded from above and below. For sufficiently large x, i.e., for x < log 2/2π T i, the bell-like shape of the time dependence of the quantum mutual information is present only for sufficiently large intervals. Moreover, the zone narrows as T i increases and widens as T f increases.

Stability of Early EEG Background Patterns After Pediatric Cardiac Arrest.

PubMed

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

2018-05-01

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

Effects of varied doses of psilocybin on time interval reproduction in human subjects.

PubMed

Wackermann, Jirí; Wittmann, Marc; Hasler, Felix; Vollenweider, Franz X

2008-04-11

Action of a hallucinogenic substance, psilocybin, on internal time representation was investigated in two double-blind, placebo-controlled studies: Experiment 1 with 12 subjects and graded doses, and Experiment 2 with 9 subjects and a very low dose. The task consisted in repeated reproductions of time intervals in the range from 1.5 to 5s. The effects were assessed by parameter kappa of the 'dual klepsydra' model of internal time representation, fitted to individual response data and intra-individually normalized with respect to initial values. The estimates kappa were in the same order of magnitude as in earlier studies. In both experiments, kappa was significantly increased by psilocybin at 90 min from the drug intake, indicating a higher loss rate of the internal duration representation. These findings are tentatively linked to qualitative alterations of subjective time in altered states of consciousness.

Timing of initiation of enzyme replacement therapy after diagnosis of type 1 Gaucher disease: effect on incidence of avascular necrosis

PubMed Central

Mistry, Pramod K; Deegan, Patrick; Vellodi, Ashok; Cole, J Alexander; Yeh, Michael; Weinreb, Neal J

2009-01-01

Data from the International Collaborative Gaucher Group Gaucher Registry were analysed to assess the relationship between enzyme replacement therapy with imiglucerase (ERT) and incidence of avascular necrosis (AVN) in type 1 Gaucher disease (GD1), and to determine whether the time interval between diagnosis and initiation of ERT influences the incidence rate of AVN. All patients with GD1 enrolled in the Gaucher Registry who received ERT and did not report AVN prior to starting therapy (n = 2700) were included. The incidence rate of AVN following initiation of ERT was determined. An incidence rate of AVN of 13·8 per 1000 person-years was observed in patients receiving ERT. Patients who initiated ERT within 2 years of diagnosis had an incidence rate of 8·1 per 1000 person-years; patients who started ERT ≥2 years after diagnosis had an incidence rate of 16·6 per 1000 person-years. The adjusted incidence rate ratio was 0·59 [95% confidence interval (CI) 0·36–0·96, P = 0·0343]. Splenectomy was an independent risk factor for AVN (adjusted incidence rate ratio 2·23, 95% CI 1·61–3·08, P < 0·0001). In conclusion, the risk of AVN was reduced among patients who initiated ERT within 2 years of diagnosis, compared to initiating treatment ≥2 years after diagnosis. A higher risk of AVN was observed among patients who had previously undergone splenectomy. PMID:19732054

Recognition of student names past: a longitudinal study with N = 1.

PubMed

Huang, I N

1997-01-01

Recognition of names of former students taught at different times by a middle-aged college professor was tested, to investigate recognition memory over a time span ranging from 6 months to 26.5 years. The relationship between the d', a measure of strength of memory, and the retention interval can be best described by a logarithmic function characterized by a rapid initial drop followed by a slow forgetting rate. The correct responses (hits and rejections) had higher confidence and shorter response time than did the incorrect responses (false alarms and misses). The results show that an ecologically realistic longitudinal study with N = 1 can provide a valuable means in the study of human memory with very long retention intervals, which have not yet been investigated in the laboratory.

RISMA: A Rule-based Interval State Machine Algorithm for Alerts Generation, Performance Analysis and Monitoring Real-Time Data Processing

NASA Astrophysics Data System (ADS)

Laban, Shaban; El-Desouky, Aly

2013-04-01

The monitoring of real-time systems is a challenging and complicated process. So, there is a continuous need to improve the monitoring process through the use of new intelligent techniques and algorithms for detecting exceptions, anomalous behaviours and generating the necessary alerts during the workflow monitoring of such systems. The interval-based or period-based theorems have been discussed, analysed, and used by many researches in Artificial Intelligence (AI), philosophy, and linguistics. As explained by Allen, there are 13 relations between any two intervals. Also, there have also been many studies of interval-based temporal reasoning and logics over the past decades. Interval-based theorems can be used for monitoring real-time interval-based data processing. However, increasing the number of processed intervals makes the implementation of such theorems a complex and time consuming process as the relationships between such intervals are increasing exponentially. To overcome the previous problem, this paper presents a Rule-based Interval State Machine Algorithm (RISMA) for processing, monitoring, and analysing the behaviour of interval-based data, received from real-time sensors. The proposed intelligent algorithm uses the Interval State Machine (ISM) approach to model any number of interval-based data into well-defined states as well as inferring them. An interval-based state transition model and methodology are presented to identify the relationships between the different states of the proposed algorithm. By using such model, the unlimited number of relationships between similar large numbers of intervals can be reduced to only 18 direct relationships using the proposed well-defined states. For testing the proposed algorithm, necessary inference rules and code have been designed and applied to the continuous data received in near real-time from the stations of International Monitoring System (IMS) by the International Data Centre (IDC) of the Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO). The CLIPS expert system shell has been used as the main rule engine for implementing the algorithm rules. Python programming language and the module "PyCLIPS" are used for building the necessary code for algorithm implementation. More than 1.7 million intervals constitute the Concise List of Frames (CLF) from 20 different seismic stations have been used for evaluating the proposed algorithm and evaluating stations behaviour and performance. The initial results showed that proposed algorithm can help in better understanding of the operation and performance of those stations. Different important information, such as alerts and some station performance parameters, can be derived from the proposed algorithm. For IMS interval-based data and at any period of time it is possible to analyze station behavior, determine the missing data, generate necessary alerts, and to measure some of station performance attributes. The details of the proposed algorithm, methodology, implementation, experimental results, advantages, and limitations of this research are presented. Finally, future directions and recommendations are discussed.

Duration of Group A Streptococcus PCR positivity following antibiotic treatment of pharyngitis.

PubMed

Homme, Jason H; Greenwood, Corryn S; Cronk, Lisa B; Nyre, Lisa M; Uhl, James R; Weaver, Amy L; Patel, Robin

2018-02-01

Polymerase chain reaction (PCR) has high sensitivity and specificity for detection of group A streptococcus (GAS) in throat swabs and is routinely used for GAS pharyngitis diagnosis at our institution. Herein we defined the natural history of throat swab GAS PCR and culture positivity during and following treatment of GAS pharyngitis. Fifty children with a PCR positive GAS throat swab were recruited for participation. Four additional throat swabs were collected over 2 weeks following the initial positive PCR result (during and following a standard course of antibiotic therapy) and tested for GAS using rapid real-time PCR and culture. After the initial positive swab, 45% had a positive PCR 2-4 days, 20% 5-7 days, 18% 8-10 days, 25% 11-13days, and 20% 14-18days later. The median time to a negative PCR was 4 days with the nadir in positive PCR results approximating the end of a typical 10-day treatment interval. Seven subjects remained persistently PCR positive. Culture results remained positive at a stable rate for each time interval, ranging from 5-10%. If a patient presents with symptoms of GAS pharyngitis after previous positive GAS PCR testing and treatment with appropriate antibiotics, it is reasonable to use PCR testing for GAS pharyngitis testing beginning one week after initial testing. Further studies are warranted to determine if this time frame can be applied to PCR testing used to detect other infections. Copyright © 2017 Elsevier Inc. All rights reserved.

Out-of-range INR values and outcomes among new warfarin patients with non-valvular atrial fibrillation.

PubMed

Nelson, Winnie W; Wang, Li; Baser, Onur; Damaraju, Chandrasekharrao V; Schein, Jeffrey R

2015-02-01

Although efficacious in stroke prevention in non-valvular atrial fibrillation, many warfarin patients are sub-optimally managed. To evaluate the association of international normalized ratio control and clinical outcomes among new warfarin patients with non-valvular atrial fibrillation. Adult non-valvular atrial fibrillation patients (≥18 years) initiating warfarin treatment were selected from the US Veterans Health Administration dataset between 10/2007 and 9/2012. Valid international normalized ratio values were examined from the warfarin initiation date through the earlier of the first clinical outcome, end of warfarin exposure or death. Each patient contributed multiple in-range and out-of-range time periods. The relative risk ratios of clinical outcomes associated with international normalized ratio control were estimated. 34,346 patients were included for analysis. During the warfarin exposure period, the incidence of events per 100 person-years was highest when patients had international normalized ratio <2:13.66 for acute coronary syndrome; 10.30 for ischemic stroke; 2.93 for transient ischemic attack; 1.81 for systemic embolism; and 4.55 for major bleeding. Poisson regression confirmed that during periods with international normalized ratio <2, patients were at increased risk of developing acute coronary syndrome (relative risk ratio: 7.9; 95 % confidence interval 6.9-9.1), ischemic stroke (relative risk ratio: 7.6; 95 % confidence interval 6.5-8.9), transient ischemic attack (relative risk ratio: 8.2; 95 % confidence interval 6.1-11.2), systemic embolism (relative risk ratio: 6.3; 95 % confidence interval 4.4-8.9) and major bleeding (relative risk ratio: 2.6; 95 % confidence interval 2.2-3.0). During time periods with international normalized ratio >3, patients had significantly increased risk of major bleeding (relative risk ratio: 1.5; 95 % confidence interval 1.2-2.0). In a Veterans Health Administration non-valvular atrial fibrillation population, exposure to out-of-range international normalized ratio values was associated with significantly increased risk of adverse clinical outcomes.

Risk of emergent bradycardia associated with the use of carvedilol and metoprolol in routine clinical practice.

PubMed

Shin, Jaekyu; Pletcher, Mark J

2013-09-01

Large randomized trials have reported mixed results regarding the risk of bradycardia between metoprolol and carvedilol. We compared the incidence of emergent bradycardia (measured by an emergency department visit or hospitalization due to bradycardia) for patients initiating metoprolol and carvedilol. Adult beneficiaries of Medi-Cal, the State of California Medicaid program, without a diagnosis of bradycardia who initiated metoprolol or carvedilol between May 1, 2004, and November 1, 2009, were included. Cox proportional hazard regression analysis was performed to model the time to first occurrence of emergent bradycardia after initiation of the study drugs as a dependent variable and the study drug (metoprolol vs carvedilol) as the primary predictor with adjustments for total daily metoprolol-equivalent dose, formulations, and use of nonstudy drugs as time-varying covariates, as well as demographics and comorbidities. Among 38,186 subjects, 77.7% initiated metoprolol and 22.3% initiated carvedilol. The incidence of emergent bradycardia was low and comparable between the drugs (18.1 per 1000 person-years using metoprolol vs 17.7 per 100 person-years using carvedilol; unadjusted hazard ratio, 1.07; 95% confidence interval, 0.76-1.49). However, carvedilol users had substantially different population characteristics compared with metoprolol users. After adjustments for demographics, comorbidities, metoprolol-equivalent dose, formulations, and use of nonstudy drugs, initiation of metoprolol was associated with an increased risk of emergent bradycardia compared with that of carvedilol (adjusted hazard ratio, 1.64; 95% confidence interval, 1.14-2.36). Initiation of metoprolol is associated with an increased risk of emergent bradycardia compared with carvedilol, although the overall incidence of emergent bradycardia is low in routine clinical practice. Copyright © 2013 Elsevier Inc. All rights reserved.

PMTCT Option B+ Does Not Increase Preterm Birth Risk and May Prevent Extreme Prematurity: A Retrospective Cohort Study in Malawi.

PubMed

Chagomerana, Maganizo B; Miller, William C; Pence, Brian W; Hosseinipour, Mina C; Hoffman, Irving F; Flick, Robert J; Tweya, Hannock; Mumba, Soyapi; Chimbwandira, Frank; Powers, Kimberly A

2017-04-01

To estimate preterm birth risk among infants of HIV-infected women in Lilongwe, Malawi, according to maternal antiretroviral therapy (ART) status and initiation time under Option B+. A retrospective cohort study of HIV-infected women delivering at ≥27 weeks of gestation, April 2012 to November 2015. Among women on ART at delivery, we restricted our analysis to those who initiated ART before 27 weeks of gestation. We defined preterm birth as a singleton live birth at ≥27 and <37 weeks of gestation, with births at <32 weeks classified as extremely to very preterm. We used log-binomial models to estimate risk ratios and 95% confidence intervals for the association between ART and preterm birth. Among 3074 women included in our analyses, 731 preterm deliveries were observed (24%). Overall preterm birth risk was similar in women who had initiated ART at any point before 27 weeks and those who never initiated ART (risk ratio = 1.14; 95% confidence interval: 0.84 to 1.55), but risk of extremely to very preterm birth was 2.33 (1.39 to 3.92) times as great in those who never initiated ART compared with those who did at any point before 27 weeks. Among women on ART before delivery, ART initiation before conception was associated with the lowest preterm birth risk. ART during pregnancy was not associated with preterm birth, and it may in fact be protective against severe adverse outcomes accompanying extremely to very preterm birth. As preconception ART initiation appears especially protective, long-term retention on ART should be a priority to minimize preterm birth in subsequent pregnancies.

Mediated interruptions of anaesthesia providers using predictions of workload from anaesthesia information management system data.

PubMed

Epstein, R H; Dexter, F

2012-09-01

Perioperative interruptions generated electronically from anaesthesia information management systems (AIMS) can provide useful feedback, but may adversely affect task performance if distractions occur at inopportune moments. Ideally such interruptions would occur only at times when their impact would be minimal. In this study of AIMS data, we evaluated the times of comments, drugs, fluids and periodic assessments (e.g. electrocardiogram diagnosis and train-of-four) to develop recommendations for the timing of interruptions during the intraoperative period. The 39,707 cases studied were divided into intervals between: 1) enter operating room; 2) induction; 3) intubation; 4) surgical incision; and 5) end surgery. Five-minute intervals of no documentation were determined for each case. The offsets from the start of each interval when >50% of ongoing cases had completed initial documentation were calculated (MIN50). The primary endpoint for each interval was the percentage of all cases still ongoing at MIN50. Results were that the intervals from entering the operating room to induction and from induction to intubation were unsuitable for interruptions confirming prior observational studies of anaesthesia workload. At least 13 minutes after surgical incision was the most suitable time for interruptions with 92% of cases still ongoing. Timing was minimally affected by the type of anaesthesia, surgical facility, surgical service, prone positioning or scheduled case duration. The implication of our results is that for mediated interruptions, waiting at least 13 minutes after the start of surgery is appropriate. Although we used AIMS data, operating room information system data is also suitable.

Effect of intravenous gadolinium-DTPA on diffusion-weighted imaging of brain tumors: a short temporal interval assessment.

PubMed

Li, Xiang; Qu, Jin-Rong; Luo, Jun-Peng; Li, Jing; Zhang, Hong-Kai; Shao, Nan-Nan; Kwok, Keith; Zhang, Shou-Ning; Li, Yan-le; Liu, Cui-Cui; Zee, Chi-Shing; Li, Hai-Liang

2014-09-01

To determine the effect of intravenous administration of gadolinium (Gd) contrast medium (Gd-DTPA) on diffusion-weighted imaging (DWI) for the evaluation of normal brain parenchyma vs. brain tumor following a short temporal interval. Forty-four DWI studies using b values of 0 and 1000 s/mm(2) were performed before, immediately after, 1 min after, 3 min after, and 5 min after the administration of Gd-DTPA on 62 separate lesions including 15 meningioma, 17 glioma and 30 metastatic lesions. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and apparent diffusion coefficient (ADC) values of the brain tumor lesions and normal brain tissues were measured on pre- and postcontrast images. Statistical analysis using paired t-test between precontrast and postcontrast data were obtained on three brain tumors and normal brain tissue. The SNR and CNR of brain tumors and the SNR of normal brain tissue showed no statistical differences between pre- and postcontrast (P > 0.05). The ADC values on the three cases of brain tumors demonstrated significant initial increase on the immediate time point (P < 0.01) and decrease on following the 1 min time point (P < 0.01) after contrast. Significant decrease of ADC value was still found at 3min and 5min time point in the meningioma group (P < 0.01) with gradual normalization over time. The ADC values of normal brain tissues demonstrated significant initial elevation on the immediately postcontrast DWI sequence (P < 0.01). Contrast medium can cause a slight but statistically significant change on the ADC value within a short temporal interval after the contrast administration. The effect is both time and lesion-type dependent. © 2013 Wiley Periodicals, Inc.

Microcomputer Application of Aerospace Asset Surface Search Planning.

DTIC Science & Technology

1984-12-14

National SAR School faculty members ran numerous school and real- world problems to test program limits and accuracy. The result -- in each case the search...0212 (Verifies legitimate date/time/group data input.) 6213 8214 procedure VerifyDT6 ( War DateTime real); 6215 3216 var Tamp, {Used as a...0543 I := 1; (initialize) 8544 8545 repeat (until I N1 a%6 I := I + 0547 8 (Find days and times of intervals in each period) 0549 IindsOverTime[l

CACA-2: revised version of CACA-a heavy isotope and fission-product concentration calculational code for experimental irradiation capsules

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

Allen, E.J.

1976-02-01

A computer program is described which calculates nuclide concentration histories, power or neutron flux histories, burnups, and fission-product birthrates for fueled experimental capsules subjected to neutron irradiations. Seventeen heavy nuclides in the chain from $sup 232$Th to $sup 242$Pu and a user- specified number of fission products are treated. A fourth-order Runge-Kutta calculational method solves the differential equations for nuclide concentrations as a function of time. For a particular problem, a user-specified number of fuel regions may be treated. A fuel region is described by volume, length, and specific irradiation history. A number of initial fuel compositions may be specifiedmore » for each fuel region. The irradiation history for each fuel region can be divided into time intervals, and a constant power density or a time-dependent neutron flux is specified for each time interval. Also, an independent cross- section set may be selected for each time interval in each irradiation history. The fission-product birthrates for the first composition of each fuel region are summed to give the total fission-product birthrates for the problem.« less

Monitoring viability of seeds in gene banks: developing software tools to increase efficiency

USDA-ARS?s Scientific Manuscript database

Monitoring the decline of seed viability is essential for effective long term seed storage in ex situ collections. Recent FAO Genebank Standards recommend monitoring intervals at one-third the time predicted for viability to fall to 85% of initial viability. This poster outlines the development of ...

40 CFR 61.271 - Emission standard.

Code of Federal Regulations, 2010 CFR

2010-07-01

... provide a projection below the liquid surface. Except for automatic bleeder vents, rim space vents, roof... floating roof means a cover that rests on the liquid surface (but not necessarily in complete contact with... floating on the liquid surface at all times, except during initial fill and during those intervals when the...

40 CFR 60.112b - Standard for volatile organic compounds (VOC).

Code of Federal Regulations, 2010 CFR

2010-07-01

... for Volatile Organic Liquid Storage Vessels (Including Petroleum Liquid Storage Vessels) for Which... specifications: (i) The internal floating roof shall rest or float on the liquid surface (but not necessarily in... be floating on the liquid surface at all times, except during initial fill and during those intervals...

40 CFR 60.112b - Standard for volatile organic compounds (VOC).

Code of Federal Regulations, 2012 CFR

2012-07-01

... for Volatile Organic Liquid Storage Vessels (Including Petroleum Liquid Storage Vessels) for Which... specifications: (i) The internal floating roof shall rest or float on the liquid surface (but not necessarily in... be floating on the liquid surface at all times, except during initial fill and during those intervals...

40 CFR 61.271 - Emission standard.

Code of Federal Regulations, 2014 CFR

2014-07-01

... provide a projection below the liquid surface. Except for automatic bleeder vents, rim space vents, roof... floating roof means a cover that rests on the liquid surface (but not necessarily in complete contact with... floating on the liquid surface at all times, except during initial fill and during those intervals when the...

40 CFR 60.112b - Standard for volatile organic compounds (VOC).

Code of Federal Regulations, 2014 CFR

2014-07-01

... for Volatile Organic Liquid Storage Vessels (Including Petroleum Liquid Storage Vessels) for Which... specifications: (i) The internal floating roof shall rest or float on the liquid surface (but not necessarily in... be floating on the liquid surface at all times, except during initial fill and during those intervals...

40 CFR 60.112b - Standard for volatile organic compounds (VOC).

Code of Federal Regulations, 2013 CFR

2013-07-01

... for Volatile Organic Liquid Storage Vessels (Including Petroleum Liquid Storage Vessels) for Which... specifications: (i) The internal floating roof shall rest or float on the liquid surface (but not necessarily in... be floating on the liquid surface at all times, except during initial fill and during those intervals...

40 CFR 60.112b - Standard for volatile organic compounds (VOC).

Code of Federal Regulations, 2011 CFR

2011-07-01

... for Volatile Organic Liquid Storage Vessels (Including Petroleum Liquid Storage Vessels) for Which... specifications: (i) The internal floating roof shall rest or float on the liquid surface (but not necessarily in... be floating on the liquid surface at all times, except during initial fill and during those intervals...

Time Course of Loss of Information Regarding Pattern Analyzing Operations

ERIC Educational Resources Information Center

Kolers, Paul A.; Ostry, David J.

1974-01-01

A study is reported in which subjects were shown sentences, some of which they had read previously, after intervals ranging from a few minutes to 32 days. Results show that information about typography can be recovered for at least 32 days after initial reading. Implications are discussed. (Author/RM)

Determinants of choice for pigeons and humans on concurrent-chains schedules of reinforcement.

PubMed

Belke, T W; Pierce, W D; Powell, R A

1989-09-01

Concurrent-chains schedules of reinforcement were arranged for humans and pigeons. Responses of humans were reinforced with tokens exchangeable for money, and key pecks of 4 birds were reinforced with food. Variable-interval 30-s and 40-s schedules operated in the terminal links of the chains. Condition 1 exposed subjects to variable-interval 90-s and variable-interval 30-s initial links, respectively. Conditions 2 and 3 arranged equal initial-link schedules of 40 s or 120 s. Experimental conditions tested the descriptive adequacy of five equations: reinforcement density, delay reduction, modified delay reduction, matching and maximization. Results based on choice proportions and switch rates during the initial links showed that pigeons behaved in accord with delay-reduction models, whereas humans maximized overall rate of reinforcement. As discussed by Logue and associates in self-control research, different types of reinforcement may affect sensitivity to delay differentially. Pigeons' responses were reinforced with food, a reinforcer that is consumable upon presentation. Humans' responses were reinforced with money, a reinforcer exchanged for consumable reinforcers after it was earned. Reinforcers that are immediately consumed may generate high sensitivity to delay and behavior described as delay reduction. Reinforces with longer times to consumption may generate low sensitivity to delay and behavior that maximizes overall payoff.

Timing and Causality in the Generation of Learned Eyelid Responses

PubMed Central

Sánchez-Campusano, Raudel; Gruart, Agnès; Delgado-García, José M.

2011-01-01

The cerebellum-red nucleus-facial motoneuron (Mn) pathway has been reported as being involved in the proper timing of classically conditioned eyelid responses. This special type of associative learning serves as a model of event timing for studying the role of the cerebellum in dynamic motor control. Here, we have re-analyzed the firing activities of cerebellar posterior interpositus (IP) neurons and orbicularis oculi (OO) Mns in alert behaving cats during classical eyeblink conditioning, using a delay paradigm. The aim was to revisit the hypothesis that the IP neurons (IPns) can be considered a neuronal phase-modulating device supporting OO Mns firing with an emergent timing mechanism and an explicit correlation code during learned eyelid movements. Optimized experimental and computational tools allowed us to determine the different causal relationships (temporal order and correlation code) during and between trials. These intra- and inter-trial timing strategies expanding from sub-second range (millisecond timing) to longer-lasting ranges (interval timing) expanded the functional domain of cerebellar timing beyond motor control. Interestingly, the results supported the above-mentioned hypothesis. The causal inferences were influenced by the precise motor and pre-motor spike timing in the cause-effect interval, and, in addition, the timing of the learned responses depended on cerebellar–Mn network causality. Furthermore, the timing of CRs depended upon the probability of simulated causal conditions in the cause-effect interval and not the mere duration of the inter-stimulus interval. In this work, the close relation between timing and causality was verified. It could thus be concluded that the firing activities of IPns may be related more to the proper performance of ongoing CRs (i.e., the proper timing as a consequence of the pertinent causality) than to their generation and/or initiation. PMID:21941469

The Time Course of the Probability of Transition Into and Out of REM Sleep

PubMed Central

Bassi, Alejandro; Vivaldi, Ennio A.; Ocampo-Garcés, Adrián

2009-01-01

Study Objectives: A model of rapid eye movement (REM) sleep expression is proposed that assumes underlying regulatory mechanisms operating as inhomogenous Poisson processes, the overt results of which are the transitions into and out of REM sleep. Design: Based on spontaneously occurring REM sleep episodes (“Episode”) and intervals without REM sleep (“Interval”), 3 variables are defined and evaluated over discrete 15-second epochs using a nonlinear logistic regression method: “Propensity” is the instantaneous rate of into-REM transition occurrence throughout an Interval, “Volatility” is the instantaneous rate of out-of-REM transition occurrence throughout an Episode, and “Opportunity” is the probability of being in non-REM (NREM) sleep at a given time throughout an Interval, a requisite for transition. Setting: 12:12 light:dark cycle, isolated boxes. Participants: Sixteen male Sprague-Dawley rats Interventions: None. Spontaneous sleep cycles. Measurements and Results: The highest levels of volatility and propensity occur, respectively, at the very beginning of Episodes and Intervals. The new condition stabilizes rapidly, and variables reach nadirs at minute 1.25 and 2.50, respectively. Afterward, volatility increases markedly, reaching values close to the initial level. Propensity increases moderately, the increment being stronger through NREM sleep bouts occurring at the end of long Intervals. Short-term homeostasis is evidenced by longer REM sleep episodes lowering propensity in the following Interval. Conclusions: The stabilization after transitions into Episodes or Intervals and the destabilization after remaining for some time in either condition may be described as resulting from continuous processes building up during Episodes and Intervals. These processes underlie the overt occurrence of transitions. Citation: Bassi A; Vivaldi EA; Ocampo-Garcées A. The time course of the probability of transition into and out of REM sleep. SLEEP 2009;32(5):655-669 PMID:19480233

Willingness to pay for flexible working conditions of people with type 2 diabetes: discrete choice experiments.

PubMed

Nexo, M A; Cleal, B; Hagelund, Lise; Willaing, I; Olesen, K

2017-12-15

The increasing number of people with chronic diseases challenges workforce capacity. Type 2 diabetes (T2D) can have work-related consequences, such as early retirement. Laws of most high-income countries require workplaces to provide accommodations to enable people with chronic disabilities to manage their condition at work. A barrier to successful implementation of such accommodations can be lack of co-workers' willingness to support people with T2D. This study aimed to examine the willingness to pay (WTP) of people with and without T2D for five workplace initiatives that help individuals with type 2 diabetes manage their diabetes at work. Three samples with employed Danish participants were drawn from existing online panels: a general population sample (n = 600), a T2D sample (n = 693), and a matched sample of people without diabetes (n = 539). Participants completed discrete choice experiments eliciting their WTP (reduction in monthly salary, €/month) for five hypothetical workplace initiatives: part-time job, customized work, extra breaks with pay, and time off for medical consultations with and without pay. WTP was estimated by conditional logits models. Bootstrapping was used to estimate confidence intervals for WTP. There was an overall WTP for all initiatives. Average WTP for all attributes was 34 €/month (95% confidence interval [CI]: 27-43] in the general population sample, 32 €/month (95% CI: 26-38) in the T2D sample, and 55 €/month (95% CI: 43-71) in the matched sample. WTP for additional breaks with pay was considerably lower than for the other initiatives in all samples. People with T2D had significantly lower WTP than people without diabetes for part-time work, customized work, and time off without pay, but not for extra breaks or time off with pay. For people with and without T2D, WTP was present for initiatives that could improve management of diabetes at the workplace. WTP was lowest among people with T2D. Implementation of these initiatives seems feasible and may help unnecessary exclusion of people with T2D from work.

Use of water-soluble contrast medium (gastrografin) does not decrease the need for operative intervention nor the duration of hospital stay in uncomplicated acute adhesive small bowel obstruction? A multicenter, randomized, clinical trial (Adhesive Small Bowel Obstruction Study) and systematic review.

PubMed

Scotté, Michel; Mauvais, Francois; Bubenheim, Michael; Cossé, Cyril; Suaud, Leslie; Savoye-Collet, Celine; Plenier, Isabelle; Péquignot, Aurelien; Yzet, Thierry; Regimbeau, Jean Marc

2017-05-01

This study evaluated the association between oral gastrografin administration and the need for operative intervention in patients with presumed adhesive small bowel obstruction. Between October 2006 and August 2009, 242 patients with uncomplicated acute adhesive small bowel obstruction were included in a randomized, controlled trial (the Adhesive Small Bowel Obstruction Study, NCT00389116) and allocated to a gastrografin arm or a saline solution arm. The primary end point was the need for operative intervention within 48 hours of randomization. The secondary end points were the resection rate, the time interval between the initial computed tomography and operative intervention, the time interval between oral refeeding and discharge, risk factors for the failure of nonoperative management, in-hospital mortality, duration of stay, and recurrence or death after discharge. We performed a systematic review of the literature in order to evaluate the relationship between use of gastrografin as a diagnostic/therapeutic measure, the need for operative intervention, and the duration of stay. In the gastrografin and saline solution arms, the rate of operative intervention was 24% and 20%, respectively, the bowel resection rate was 8% and 4%, the time interval between the initial computed tomography and operative intervention, and the time interval between oral refeeding and discharge were similar in the 2 arms. Only age was identified as a potential risk factor for the failure of nonoperative management. The in-hospital mortality was 2.5%, the duration of stay was 3.8 days for patients in the gastrografin arm and 3.5 days for those in the saline solution arm (P = .19), and the recurrence rate of adhesive small bowel obstruction was 7%. These results and those of 10 published studies suggest that gastrografin did not decrease either the rate of operative intervention (21% in the saline solution arm vs 26% in the gastrografin arm) or the number of days from the initial computed tomography to discharge (3.5 vs 3.5; P = NS for both). The results of the present study and those of our systematic review suggest that gastrografin administration is of no benefit in patients with adhesive small bowel obstruction. Copyright © 2016 Elsevier Inc. All rights reserved.

A simple method to calculate first-passage time densities with arbitrary initial conditions

NASA Astrophysics Data System (ADS)

Nyberg, Markus; Ambjörnsson, Tobias; Lizana, Ludvig

2016-06-01

Numerous applications all the way from biology and physics to economics depend on the density of first crossings over a boundary. Motivated by the lack of general purpose analytical tools for computing first-passage time densities (FPTDs) for complex problems, we propose a new simple method based on the independent interval approximation (IIA). We generalise previous formulations of the IIA to include arbitrary initial conditions as well as to deal with discrete time and non-smooth continuous time processes. We derive a closed form expression for the FPTD in z and Laplace-transform space to a boundary in one dimension. Two classes of problems are analysed in detail: discrete time symmetric random walks (Markovian) and continuous time Gaussian stationary processes (Markovian and non-Markovian). Our results are in good agreement with Langevin dynamics simulations.

On cell resistance and immune response time lag in a model for the HIV infection

NASA Astrophysics Data System (ADS)

Solovey, Guillermo; Peruani, Fernando; Ponce Dawson, Silvina; Maria Zorzenon dos Santos, Rita

2004-11-01

Recently, a cellular automata model has been introduced (Phys. Rev. Lett. 87 (2001) 168102) to describe the spread of the HIV infection among target cells in lymphoid tissues. The model reproduces qualitatively the entire course of the infection displaying, in particular, the two time scales that characterize its dynamics. In this work, we investigate the robustness of the model against changes in three of its parameters. Two of them are related to the resistance of the cells to get infected. The other one describes the time interval necessary to mount specific immune responses. We have observed that an increase of the cell resistance, at any stage of the infection, leads to a reduction of the latency period, i.e., of the time interval between the primary infection and the onset of AIDS. However, during the early stages of the infection, when the cell resistance increase is combined with an increase in the initial concentration of infected cells, the original behavior is recovered. Therefore we find a long and a short latency regime (eight and one year long, respectively) depending on the value of the cell resistance. We have obtained, on the other hand, that changes on the parameter that describes the immune system time lag affects the time interval during which the primary infection occurs. Using different extended versions of the model, we also discuss how the two-time scale dynamics is affected when we include inhomogeneities on the cells properties, as for instance, on the cell resistance or on the time interval to mount specific immune responses.

ASSOCIATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY INITIATION

PubMed Central

Merenstein, Daniel; Yang, Yang; Schneider, Michael F.; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M.; Sharp, Gerald B.; Gandhi, Monica; Liu, Chenglong

2009-01-01

Objective To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)–infected participants of the Women’s Interagency HIV Study. Study Methods Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non–CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. Main Outcome and Exposures Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. Results One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non–CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non–CAM users. Conclusion Female CAM users initiated HAART regimens earlier than non–CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression. PMID:18780580

Clinical Decision Support Improves Initial Dosing and Monitoring of Tobramycin and Amikacin

PubMed Central

Cox, Zachary L.; Nelsen, Cori L.; Waitman, Lemuel R.; McCoy, Jacob A.; Peterson, Josh F.

2010-01-01

Purpose Clinical decision support (CDS) systems could be valuable tools in reducing aminoglycoside prescribing errors. We evaluated the impact of CDS on initial dosing, interval, and pharmacokinetic outcomes of amikacin and tobramycin therapy. Methods A complex CDS advisor to provide guidance on initial dosing and monitoring, using both traditional and extended interval dosing strategies, was integrated into computerized provider order entry (CPOE) and compared to a control group which featured close pharmacy monitoring of all aminoglycoside orders. A random sample of 118 patients from an academic, tertiary care medical center prescribed amikacin and tobramycin prior to advisor implementation was compared to 98 patients admitted following advisor implementation. Primary outcome was an initial dose within 10% of a dose calculated to be adherent to published dose guidelines. Secondary outcomes were a guideline-adherent interval, trough and peak concentrations in goal range, and incidence of nephrotoxicity. Results Of 216 patients studied, 97 were prescribed amikacin and 119 were prescribed tobramycin. The primary outcome of initial dosing consistent with guideline-based care increased from 40% in the pre-advisor arm to 80% in the post-advisor arm (p<0.001), with a number needed to treat of 3 patients to prevent one incorrect dose. Correct initial interval based on renal function also increased from 63% to 87% (p<0.001). The changes in initial dosing and interval resulted in an increase of trough concentrations in the goal range from 59% pre-advisor to 89% post-advisor implementation (p=0.0004). There was no significant difference in peak concentrations in goal range or incidence of nephrotoxicity (25% vs. 17%, p=0.2). Conclusion An advisor for aminoglycoside dosing and monitoring integrated into CPOE significantly improves initial dosing, selection of interval, and trough concentrations at goal compared to unassisted physician dosing. PMID:21411805

Initial hydrologic and geomorphic response following a wildfire in the Colorado front range

USGS Publications Warehouse

Moody, J.A.; Martin, D.A.

2001-01-01

A wildfire in May 1996 burned 4690 hectares in two watersheds forested by ponderosa pine and Douglas fir in a steep, mountainous landscape with a summer, convective thunderstorm precipitation regime. The wildfire lowered the erosion threshold in the watersheds, and consequently amplified the subsequent erosional response to shorter time interval episodic rainfall and created both erosional and depositional features in a complex pattern throughout the watersheds. The initial response during the first four years was an increase in runoff and erosion rates followed by decreases toward pre-fire rates. The maximum unit-area peak discharge was 24 m3 s-1 km-2 for a rainstorm in 1996 with a rain intensity of 90 mm h-1. Recovery to pre-fire conditions seems to have occured by 2000 because for a maximum 30-min rainfall intensity of 50 mm h-1, the unit-area peak discharge in 1997 was 6.6 m3 s-1 km-2, while in 2000 a similar intensity produced only 0.11 m3 s-1 km-2. Rill erosion accounted for 6 per cent, interrill erosion for 14 per cent, and drainage erosion for 80 per cent of the initial erosion in 1996. This represents about a 200-fold increase in erosion rates on hillslopes which had a recovery or relaxation time of about three years. About 67 per cent of the initially eroded sediment is still stored in the watersheds after four years with an estimated residence time greater than 300 years. This residence time is much greater than the fire recurrence interval so erosional and depositional features may become legacies from the wildfire and may affect landscape evolution by acting as a new set of initial conditions for subsequent wildfire and flood sequences. Published in 2001 by John Wiley and Sons, Ltd.

GraphPrints: Towards a Graph Analytic Method for Network Anomaly Detection

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

Harshaw, Chris R; Bridges, Robert A; Iannacone, Michael D

This paper introduces a novel graph-analytic approach for detecting anomalies in network flow data called \\textit{GraphPrints}. Building on foundational network-mining techniques, our method represents time slices of traffic as a graph, then counts graphlets\\textemdash small induced subgraphs that describe local topology. By performing outlier detection on the sequence of graphlet counts, anomalous intervals of traffic are identified, and furthermore, individual IPs experiencing abnormal behavior are singled-out. Initial testing of GraphPrints is performed on real network data with an implanted anomaly. Evaluation shows false positive rates bounded by 2.84\\% at the time-interval level, and 0.05\\% at the IP-level with 100\\% truemore » positive rates at both.« less

A Comparative Study of Interval Management Control Law Capabilities

NASA Technical Reports Server (NTRS)

Barmore, Bryan E.; Smith, Colin L.; Palmer, Susan O.; Abbott, Terence S.

2012-01-01

This paper presents a new tool designed to allow for rapid development and testing of different control algorithms for airborne spacing. This tool, Interval Management Modeling and Spacing Tool (IM MAST), is a fast-time, low-fidelity tool created to model the approach of aircraft to a runway, with a focus on their interactions with each other. Errors can be induced between pairs of aircraft by varying initial positions, winds, speed profiles, and altitude profiles. Results to-date show that only a few of the algorithms tested had poor behavior in the arrival and approach environment. The majority of the algorithms showed only minimal variation in performance under the test conditions. Trajectory-based algorithms showed high susceptibility to wind forecast errors, while performing marginally better than the other algorithms under other conditions. Trajectory-based algorithms have a sizable advantage, however, of being able to perform relative spacing operations between aircraft on different arrival routes and flight profiles without employing ghosting. methods. This comes at the higher cost of substantially increased complexity, however. Additionally, it was shown that earlier initiation of relative spacing operations provided more time for corrections to be made without any significant problems in the spacing operation itself. Initiating spacing farther out, however, would require more of the aircraft to begin spacing before they merge onto a common route.

Support for the existence of invertible maps between electronic densities and non-analytic 1-body external potentials in non-relativistic time-dependent quantum mechanics

NASA Astrophysics Data System (ADS)

Mosquera, Martín A.

2017-10-01

Provided the initial state, the Runge-Gross theorem establishes that the time-dependent (TD) external potential of a system of non-relativistic electrons determines uniquely their TD electronic density, and vice versa (up to a constant in the potential). This theorem requires the TD external potential and density to be Taylor-expandable around the initial time of the propagation. This paper presents an extension without this restriction. Given the initial state of the system and evolution of the density due to some TD scalar potential, we show that a perturbative (not necessarily weak) TD potential that induces a non-zero divergence of the external force-density, inside a small spatial subset and immediately after the initial propagation time, will cause a change in the density within that subset, implying that the TD potential uniquely determines the TD density. In this proof, we assume unitary evolution of wavefunctions and first-order differentiability (which does not imply analyticity) in time of the internal and external force-densities, electronic density, current density, and their spatial derivatives over the small spatial subset and short time interval.

Pretreatment costs of care and time to initial treatment for patients with cancer of unknown primary.

PubMed

Walker, Mark S; Weinstein, Laura; Luo, Roger; Marino, Ingrid

2018-06-01

Time to treatment and pretreatment costs may be affected by unknown primary tumor site. This retrospective study used electronic medical record data from patients in ten US community oncology practices. Eligible patients were ≥18 years, diagnosed with cancer of unknown primary (CUP) or known metastatic solid tumor, and presented between 1 January 2012 and 30 June 2014. Patients with CUP (n = 294) had a longer interval than non-CUP patients (n = 92) from presentation to treatment initiation (1.18 vs 0.49 months, p < 0.0001), and had higher pretreatment costs (US$27,882 vs US$20,449, p = 0.0075). When analyzed as monthly cost, the difference between groups in log-cost per month was nonsignificant. Higher pretreatment costs in CUP patients appeared attributable to significantly longer time to initiation of therapy.

Exact closed-form solution of the hyperbolic equation of string vibrations with material relaxation properties taken into account

NASA Astrophysics Data System (ADS)

Kudinov, I. V.; Kudinov, V. A.

2014-09-01

The differential equation of damped string vibrations was obtained with the finite speed of extension and strain propagation in the Hooke's law formula taken into account. In contrast to the well-known equations, the obtained equation contains the first and third time derivatives of the displacement and the mixed derivative with respect to the space and time variables. Separation of variables was used to obtain its exact closed-form solution, whose analysis showed that, for large values of the relaxation coefficient, the string return to the initial state after its escape from equilibrium is accompanied by high-frequency low-amplitude damped vibrations, which occur on the initial time interval only in the region of positive displacements. And in the limit, for some large values of the relaxation coefficient, the string return to the initial state occurs practically without any oscillatory process.

Incorporating temporal and clinical reasoning in a new measure of continuity of care.

PubMed Central

Spooner, S. A.

1994-01-01

Previously described quantitative methods for measuring continuity of care have assumed that perfect continuity exists when a patient sees only one provider, regardless of the temporal pattern and clinical context of the visits. This paper describes an implementation of a new operational model of continuity--the Temporal Continuity Index--that takes into account time intervals between well visits in a pediatric residency continuity clinic. Ideal continuity in this model is achieved when intervals between visits are appropriate based on the age of the patient and clinical context of the encounters. The fundamental concept in this model is the expectation interval, which contains the length of the maximum ideal follow-up interval for a visit and the maximum follow-up interval. This paper describes an initial implementation of the TCI model and compares TCI calculations to previous quantitative methods and proposes its use as part of the assessment of resident education in outpatient settings. PMID:7950019

Novel Screening Tool for Stroke Using Artificial Neural Network.

PubMed

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

2017-06-01

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

Temporal Context in Concurrent Chains: I. Terminal-Link Duration

ERIC Educational Resources Information Center

Grace, Randolph C.

2004-01-01

Two experiments are reported in which the ratio of the average times spent in the terminal and initial links ("Tt/Ti") in concurrent chains was varied. In Experiment 1, pigeons responded in a three-component procedure in which terminal-link variable-interval schedules were in constant ratio, but their average duration increased across components…

Preharvest Interval Periods and their relation to fruit growth stages and pesticide formulations.

PubMed

Alister, Claudio; Araya, Manuel; Becerra, Kevin; Saavedra, Jorge; Kogan, Marcelo

2017-04-15

The aim of this study was to evaluate the effect of pesticide formulations and fruit growth stages on the Pre-harvest Interval Period (PHI). Results showed that pesticide formulations did not affect the initial deposit and dissipation rate. However, the fruit growth stage at the application time showed a significant effect on the above-mentioned parameters. Fruit diameter increases in one millimeter pesticide dissipation rates were reduced in -0.033mgkg -1 day -1 (R 2 =0.87; p<0.001) for grapes and -0.014mgkg -1 day -1 (R 2 =0.85; p<0.001) for apples. The relation between solar radiation, air humidity and temperature, and pesticide dissipation rates were dependent on fruit type. PHI could change according to the application time, because of the initial amount of pesticide deposit in the fruits and change in the dissipation rates. Because Maximum Residue Level are becoming more restrictive, it is more important to consider the fruit growth stage effects on pesticide when performing dissipation studies to define PHI. Copyright © 2016. Published by Elsevier Ltd.

Characterizing the Severe Turbulence Environments Associated With Commercial Aviation Accidents: A Real-Time Turbulence Model (RTTM) Designed for the Operational Prediction of Hazardous Aviation Turbulence Environments

NASA Technical Reports Server (NTRS)

Kaplan, Michael L.; Lux, Kevin M.; Cetola, Jeffrey D.; Huffman, Allan W.; Riordan, Allen J.; Slusser, Sarah W.; Lin, Yuh-Lang; Charney, Joseph J.; Waight, Kenneth T.

2004-01-01

Real-time prediction of environments predisposed to producing moderate-severe aviation turbulence is studied. We describe the numerical model and its postprocessing system designed for said prediction of environments predisposed to severe aviation turbulence as well as presenting numerous examples of its utility. The numerical model is MASS version 5.13, which is integrated over three different grid matrices in real time on a university work station in support of NASA Langley Research Center s B-757 turbulence research flight missions. The postprocessing system includes several turbulence-related products, including four turbulence forecasting indices, winds, streamlines, turbulence kinetic energy, and Richardson numbers. Additionally, there are convective products including precipitation, cloud height, cloud mass fluxes, lifted index, and K-index. Furthermore, soundings, sounding parameters, and Froude number plots are also provided. The horizontal cross-section plot products are provided from 16 000 to 46 000 ft in 2000-ft intervals. Products are available every 3 hours at the 60- and 30-km grid interval and every 1.5 hours at the 15-km grid interval. The model is initialized from the NWS ETA analyses and integrated two times a day.

Electronic system

DOEpatents

Robison, G H; Dickson, J F

1960-11-15

An electronic system is designed for indicating the occurrence of a plurality of electrically detectable events within predetermined time intervals. The system comprises separate input means electrically associated with the events under observation an electronic channel associated with each input means, including control means and indicating means; timing means adapted to apply a signal from the input means after a predetermined time to the control means to deactivate each of the channels; and means for resetting the system to its initial condition after the observation of each group of events. (D.L.C.)

Investigating Changes in the High-Latitude Topside Ionosphere During Large Magnetic Storms

NASA Technical Reports Server (NTRS)

Fainberg, Joseph; Benson, Robert F.; Osherovich, Vladimir; Truhlik, Vladimir; Wang, Yongli; Fung, Shing; Bilitza, Dieter

2009-01-01

A search was conducted to locate periods of nearly simultaneous solar-wind and high latitude topside-ionospheric data during magnetic storms. The focus was on the 20-yr interval from 1965 to 1985 when both solar-wind and Alouette/ISIS topside-sounder data are potentially available. The search yielded 125 large magnetic storms (minimum Dst less than 100) and 280 moderate magnetic storms (minimum Dst between -60 and -100). Solar wind data were available for most, but not all, of these storms. A search of the available high-latitude topside electron-density Ne(h) profiles available from the National Space Science Data Center (NSSDC), both from manual inspection of 35-mm film ionograms in the 1960s and more recent auto-processing of ISIS-2 topside digital ionograms using the TOPIST software, during 9-day intervals associated with the 125 large magnetic storm minimum Dst times yielded the following results: 31 intervals had 10 or more manual-scaled profiles (21 intervals had more than 100 profiles and 5 of these had more than 1,000 profiles), and 34 intervals had 10 or more TOPIST profiles (2 intervals had more than 100 profiles). In addition, a search of the available Alouette-2, ISIS-1 and ISIS-2 digital ionograms during the above periods has yielded encouraging initial results in that many ISIS-1 ionograms were found for the early time intervals. Future work will include the search for 35-mm film ionograms during selected intervals. This presentation will illustrate the results of this investigation to date.

Competition between skin-sensitizing chemicals in the mouse

PubMed Central

Wallington, T. B.; Jones, J. Verrier

1974-01-01

The skin contact sensitivity responses to picryl chloride in CBA mice can be reduced by prior sensitization with oxazolone. Initial experiments showed this reduction to be significant when the interval between skin paintings was 7 days. In further experiments to study the time course of this effect, the depression was found to be maximal when the interval between skin paintings was between 3 and 7 days. Prior painting with a non-immunogenic chemical irritant, oil of turpentine, did not depress responses to picryl chloride. The relation of this phenomenon to antigenic competition in antibody production is discussed. PMID:4851120

Urinary tract infection-like symptom is associated with worse bladder cancer outcomes in the Medicare population: Implications for sex disparities.

PubMed

Richards, Kyle A; Ham, Sandra; Cohn, Joshua A; Steinberg, Gary D

2016-01-01

To determine the time to bladder cancer diagnosis from initial infection-like symptoms and its impact on cancer outcomes. Using Surveillance, Epidemiology and End Results-Medicare, we designed a retrospective cohort study identifying beneficiaries aged ≥ 66 years diagnosed with bladder cancer from 2007 to 2009. Patients were required to have a hematuria or urinary tract infection claim within 1 year of bladder cancer diagnosis (n = 21 216), and have 2 years of prior Medicare data (n = 18 956) without any precedent hematuria, bladder cancer or urinary tract infection claims (n = 12 195). The number of days to bladder cancer diagnosis was measured, as well as the impact of sex and presenting symptom on time to diagnosis, pathology, and oncological outcomes. The mean time to bladder cancer diagnosis was 72.2 days in women versus 58.9 days in men (P < 0.001). A logistic regression model identified the greatest predictors of ≥ pT2 pathology were both women (odds ratio 2.08, 95% confidence interval 1.70-2.55) and men (odds ratio 1.71, 95% confidence interval 1.49-1.97) presenting with urinary tract infection. Cox proportional hazards analysis identified an increased risk of mortality from bladder cancer and all causes in women presenting with urinary tract infection (hazard ratio 1.37, 95% confidence interval 1.10-1.71, and hazard ratio 1.47, 95% confidence interval 1.28-1.69) compared with women with hematuria. Women have a longer interval from urinary tract infection to diagnosis of bladder cancer. Urinary tract infection presentation can adversely affect time to diagnosis, pathology and survival. Time to diagnosis seems not to be an independent predictor of bladder cancer outcomes. © 2015 The Japanese Urological Association.

Assessment of an apparent relationship between availability of soluble carbohydrates and reduced nitrogen during floral initiation in tobacco

NASA Technical Reports Server (NTRS)

Raper, C. D. Jr; Thomas, J. F.; Tolley-Henry, L.; Rideout, J. W.; Raper CD, J. r. (Principal Investigator)

1988-01-01

Daily relative accumulation rate of soluble carbohydrates (RARS) and reduced nitrogen (RARN) in the shoot, as estimates of source strength, were compared with daily relative growth rates (RGR) of the shoot, as an estimate of sink demand, during floral transformation in apical meristems of tobacco (Nicotiana tabacum 'NC 2326') grown at day/night temperatures of 18/14, 22/18, 26/22, 30/26, and 34/30 C. Source strength was assumed to exceed sink demand for either carbohydrates or nitrogen when the ratio of RARS/RGR or RARN/RGR was greater than unity, and sink demand was assumed to exceed source strength when the ratio was less than unity. Time of floral initiation, which was delayed up to 21 days with increases in temperature over the experimental range, was associated with intervals in which source strength of either carbohydrate or nitrogen exceeded sink demand, while sink demand for the other exceeded source strength. Floral initiation was not observed during intervals in which source strengths of both carbohydrates and nitrogen were greater than or less than sink demand. These results indicate that floral initiation is responsive to an imbalance in the relative availabilities of carbohydrate and nitrogen.

Quantification of gross tumour volume changes between simulation and first day of radiotherapy for patients with locally advanced malignancies of the lung and head/neck.

PubMed

Kishan, Amar U; Cui, Jing; Wang, Pin-Chieh; Daly, Megan E; Purdy, James A; Chen, Allen M

2014-10-01

To quantify changes in gross tumour volume (GTV) between simulation and initiation of radiotherapy in patients with locally advanced malignancies of the lung and head/neck. Initial cone beam computed tomography (CT) scans from 12 patients with lung cancer and 12 with head/neck cancer (head and neck squamous cell carcinoma (HNSCC)) treated with intensity-modulated radiotherapy with image guidance were rigidly registered to the simulation CT scans. The GTV was demarcated on both scans. The relationship between percent GTV change and variables including time interval between simulation and start, tumour (T) stage, and absolute weight change was assessed. For lung cancer patients, the GTV increased a median of 35.06% (range, -16.63% to 229.97%) over a median interval of 13 days (range, 7-43), while for HNSCC patients, the median GTV increase was 16.04% (range, -8.03% to 47.41%) over 13 days (range, 7-40). These observed changes are statistically significant. The magnitude of this change was inversely associated with the size of the tumour on the simulation scan for lung cancer patients (P < 0.05). However, the observed changes in GTV did not correlate with the duration of the interval for either disease site. Similarly, T stage, absolute weight change and histologic type (the latter for lung cancer cases) did not correlate with degree of GTV change (P > 0.1). While the observed changes in GTV were moderate from the time of simulation to start of radiotherapy, these findings underscore the importance of image guidance for target localisation and verification, particularly for smaller tumours. Minimising the delay between simulation and treatment initiation may also be beneficial. © 2014 The Royal Australian and New Zealand College of Radiologists.

Kinetics and components of the flash photocurrent of isolated retinal rods of the larval salamander, Ambystoma tigrinum.

PubMed Central

Cobbs, W H; Pugh, E N

1987-01-01

1. Membrane currents initiated by intense, 20 microseconds flashes (photocurrents) were recorded from isolated salamander rods by combined extracellular suction electrodes and intracellular tight-seal electrodes either in current or voltage clamp mode. The magnitudes (mean +/- 2 S.E.M.) of the maximal photoresponses recorded by the suction and by the intracellular electrode respectively were 40 +/- 5 pA (n = 18) and 35 +/- 7 mV (n = 8) for current clamp at zero current; 43 +/- 9 pA and 66 +/- 13 (n = 11) pA for voltage clamp at the zero-current holding potential, -24 +/- 3 mV. 2. Photocurrents initiated by flashes isomerizing 0.1% or more of the outer segment's rhodopsin achieved a saturated velocity and were 95% complete in less than 50 ms. The effect of incrementing flash intensity above 0.1% isomerization can be described as a translation of the photocurrent along the time axis towards the origin. Within the interval 0-50 ms the latter two-thirds of the velocity-saturated photocurrent is well described as a single-exponential decay. The decay was much faster in voltage clamp (2.8 +/- 1.2 ms, n = 11) than in current clamp mode (17 +/- 5 ms, n = 17). 3. The initial third of the velocity-saturated photocurrent, occurring over the interval from the flash to the onset of exponential decay, followed about the same time course in current and voltage clamp. The time interval occupied by this initial 'latent' phase decreased with increasing flash intensity and attained an apparent minimum of about 7 ms in response to flashes isomerizing 10% or more of the rhodopsin at ca. 22 degrees C. 4. The hypothesis that the decay of outer segment light-sensitive membrane current is the same in current and voltage clamp was supported by an analysis of the difference between outer segment currents measured successively in the two recording modes. First, the tail of the difference current decayed exponentially with a time constant approximately equal to R x C, where R and C are independently estimated slope resistance and capacitance of the rod. Secondly, the integral of the difference current, when divided by outer segment capacitance, closely approximated the hyperpolarizing light response measured under current clamp. Thus, displacement current accounted for the difference between photocurrents measured in current and voltage clamp.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2832596

Time to first take-back operation predicts successful primary fascial closure in patients undergoing damage control laparotomy.

PubMed

Pommerening, Matthew J; DuBose, Joseph J; Zielinski, Martin D; Phelan, Herb A; Scalea, Thomas M; Inaba, Kenji; Velmahos, George C; Whelan, James F; Wade, Charles E; Holcomb, John B; Cotton, Bryan A

2014-08-01

Failure to achieve primary fascial closure (PFC) after damage control laparotomy is costly and carries great morbidity. We hypothesized that time from the initial laparotomy to the first take-back operation would be predictive of successful PFC. Trauma patients managed with open abdominal techniques after damage control laparotomy were prospectively followed at 14 Level 1 trauma centers during a 2-year period. Time to the first take-back was evaluated as a predictor of PFC using hierarchical multivariate logistic regression analysis. A total of 499 patients underwent damage control laparotomy and were included in this analysis. PFC was achieved in 327 (65.5%) patients. Median time to the first take-back operation was 36 hours (interquartile range 24-48). After we adjusted for patient demographics, resuscitation volumes, and operative characteristics, increasing time to the first take-back was associated with a decreased likelihood of PFC. Specifically, each hour delay in return to the operating room (24 hours after initial laparotomy) was associated with a 1.1% decrease in the odds of PFC (odds ratio 0.989; 95% confidence interval 0.978-0.999; P = .045). In addition, there was a trend towards increased intra-abdominal complications in patients returning after 48 hours (odds ratio 1.80; 95% confidence interval 1.00-3.25; P = .05). Data from this prospective, multicenter study demonstrate that delays in returning to the operating room after damage control laparotomy are associated with reductions in PFC. These findings suggest that emphasis should be placed on returning to the operating room within 24 hours after the initial laparotomy if possible (and no later than 48 hours). Copyright © 2014 Mosby, Inc. All rights reserved.

Timely initiation of breastfeeding and associated factors among mothers of infants under 12 months in South Gondar zone, Amhara regional state, Ethiopia; 2013.

PubMed

Mekonen, Liyew; Seifu, Wubareg; Shiferaw, Zemenu

2018-01-01

Timely initiation of breastfeeding is defined as putting the newborn to the breast within one hour of birth. Significant benefits in reducing neonatal mortality and morbidity can be attained with effective promotion of timely initiation of breastfeeding and exclusive breastfeeding during the first months of life. Therefore, this study was conducted to assess timely initiation of breastfeeding and associated factors among mothers in South Gondar, Amhara regional state, Northern Ethiopia. A community based cross-sectional study was employed. A multistage stratified sampling technique was used to select the sample of 845 mothers with 97.4% response rate. Moreover, data were collected by face to face interview using a semi structured questionnaire. The prevalence of timely initiation of breastfeeding was 48.7% (54.7% in urban and 25.1% in rural areas). The odds of initiation of breastfeeding within one hour was higher for urban mothers (Adjusted Odds Ratio [AOR] 2.1; 95% Confidence Interval [CI] 1.4, 3.3), multiparous mothers (AOR 2.8; 95% CI 2.0, 3.8), mothers who had antenatal care (AOR 3.2; 95% CI 2.0, 5.2), mothers delivered in health institution (AOR 3.1; 95% CI 2.2, 4.6) and mothers delivered vaginally (AOR 4.1; 95% CI 1.7, 9.8) than their respective counterparts. This study depicts the rate of timely initiation of breastfeeding was low in south Gondar zone. Factors which were positively associated with timely initiation of breastfeeding include urban residence, multiparity, having antenatal care, mother deliver in health institution and vaginal mode of delivery. Therefore, South Gondar health office and healthcare providers have to provide breastfeeding information during antenatal care by giving special emphasis to rural and primiparous mothers in which timely initiation of breastfeeding is poorly practiced. Further study is needed to assess the implementation of policies on timely initiation of breastfeeding.

Remembering September 11th: the role of retention interval and rehearsal on flashbulb and event memory.

PubMed

Shapiro, Lauren R

2006-02-01

Retention interval and rehearsal effects on flashbulb and event memory for 11th September 2001 (9/11) were examined. In Experiment 1, college students were assessed three times (Groups 1 and 2) or once (Group 3) over 11 weeks. In Experiment 2, three new groups assessed initially at 23 weeks (Group 4), 1 year (Group 5), or 2 years (Group 6) were compared at 1 year and at 2 years with subsamples of those assessed previously. No effects of retention interval length or rehearsal were found for flashbulb memory, which contained details at each assessment. Event memory, but not consistency, was detrimentally affected by long retention intervals, but improved with rehearsal. Recall was higher for the reception event than for the main events. Also, consistency from 1 day to 11 weeks, but not 1 year to 2 years, was higher for flashbulb memory than for event memory. Event recall was enhanced when respondents conceived of their memory as vivid, frozen, and encompassing a longer period of time. Positive correlations were found for event memory with confidence in accuracy and with rehearsal through discussion at 2 years.

Mobile pediatric neurosurgery: rapid response neurosurgery for remote or urgent pediatric patients.

PubMed

Owler, Brian K; Carmo, Kathryn A Browning; Bladwell, Wendy; Fa'asalele, T Arieta; Roxburgh, Jane; Kendrick, Tina; Berry, Andrew

2015-09-01

Time-critical neurosurgical conditions require urgent operative treatment to prevent death or neurological deficits. In New South Wales/Australian Capital Territory patients' distance from neurosurgical care is often great, presenting a challenge in achieving timely care for patients with acute neurosurgical conditions. A protocol was developed to facilitate consultant neurosurgery locally. Children with acute, time-critical neurosurgical emergencies underwent operations in hospitals that do not normally offer neurosurgery. The authors describe the developed protocol, the outcome of its use, and the lessons learned in the 9 initial cases where the protocol has been used. Three cases are discussed in detail. Nine children were treated by a neurosurgeon at 5 rural hospitals, and 2 children were treated at a smaller metropolitan hospital. Road ambulance, fixed wing aircraft, and medical helicopters were used to transport the Newborn and Paediatric Emergency Transport Service (NETS) team, neurosurgeon, and patients. In each case, the time to definitive neurosurgical intervention was significantly reduced. The median interval from triage at the initial hospital to surgical start time was 3:55 hours, (interquartile range [IQR] 03:29-05:20 hours). The median distance traveled to reach a patient was 232 km (range 23-637 km). The median interval from the initial NETS call requesting patient retrieval to surgical start time was 3:15 hours (IQR 00:47-03:37 hours). The estimated median "time saved" was approximately 3:00 hours (IQR 1:44-3:15 hours) compared with the travel time to retrieve the child to the tertiary center: 8:31 hours (IQR 6:56-10:08 hours). Remote urgent neurosurgical interventions can be performed safely and effectively. This practice is relevant to countries where distance limits urgent access for patients to tertiary pediatric care. This practice is lifesaving for some children with head injuries and other acute neurosurgical conditions.

Preemptive Deceased Donor Kidney Transplantation: Considerations of Equity and Utility

PubMed Central

Chen, B. Po-Han; Coresh, Josef; Segev, Dorry L.

2013-01-01

Summary Background and objectives There exists gross disparity in national deceased donor kidney transplant availability and practice: waiting times exceed 6 years in some regions, but some patients receive kidneys before they require dialysis. This study aimed to quantify and characterize preemptive deceased donor kidney transplant recipients and compare their outcomes with patients transplanted shortly after dialysis initiation. Design, setting, participants, & measurements Using the Scientific Registry of Transplant Recipients database, first-time adult deceased donor kidney transplant recipients between 1995 and 2011 were classified as preemptive, early (on dialysis≤1 year), or late recipients. Random effects logistic regression and multivariate Cox proportional hazards regression were used to identify characteristics of preemptive deceased donor kidney transplant and evaluate survival in preemptive and early recipients, respectively. Results Preemptive recipients were 9.0% of the total recipient population. Patients with private insurance (adjusted odds ratio=3.15, 95% confidence interval=3.01–3.29, P<0.001), previous (nonkidney) transplant (adjusted odds ratio=1.94, 95% confidence interval=1.67–2.26, P<0.001), and zero-antigen mismatch (adjusted odds ratio=1.45, 95% confidence interval=1.37–1.54, P<0.001; Caucasians only) were more likely to receive preemptive deceased donor kidney transplant, even after accounting for center-level clustering. African Americans were less likely to receive preemptive deceased donor kidney transplant (adjusted odds ratio=0.44, 95% confidence interval=0.41–0.47, P<0.001). Overall, patients transplanted preemptively had similar survival compared with patients transplanted within 1 year after initiating dialysis (adjusted hazard ratio=1.06, 95% confidence interval=0.99–1.12, P=0.07). Conclusions Preemptive deceased donor kidney transplant occurs most often among Caucasians with private insurance, and survival is fairly similar to survival of recipients on dialysis for <1 year. PMID:23371953

Five Weeks of Sprint and High-Intensity Interval Training Improves Paddling Performance in Adolescent Surfers.

PubMed

Farley, Oliver R L; Secomb, Josh L; Parsonage, Joanna R; Lundgren, Lina E; Abbiss, Chris R; Sheppard, Jeremy M

2016-09-01

Farley, ORL, Secomb, JL, Parsonage, JR, Lundgren, LE, Abbiss, CR, and Sheppard, JM. Five weeks of sprint and high-intensity interval training improves paddling performance in adolescent surfers. J Strength Cond Res 30(9): 2446-2452, 2016-The purpose of our study was to examine the effects of sprint interval training (SIT; 10 seconds) and high-intensity interval training (HIT; 30 seconds) on surfing athletes paddling performance (400-m time trial and repeat-sprint paddle performance). Twenty-four competitive adolescent surfers (19 male, 5 female; age = 14.4 ± 1.3 years, mass: 50.1 ± 10.7 kg, and stature: 159.9 ± 10.3 cm) were assigned to perform either 5 weeks of SIT and HIT. Participants completed a repeated-sprint paddle ability test (RSPT, 15-m surfboard sprint paddle initiated every 40 seconds × 10 bouts) and 400-m endurance surfboard paddle time trial before and after training. High-intensity interval training decreased the total time to complete the 400 m by 15.8 ± 16.1 seconds (p = 0.03), and SIT decreased the total time to complete the RSPT by 6.5 ± 4.3 seconds (p = 0.02). Fatigue index during the RSPT (first-slowest effort) was lower after HIT and SIT (p ≤ 0.001 and p = 0.02, respectively). There were no significant differences in performance changes in the 400 m (total time) and RSPT (total time, fastest 15 m time, and peak velocity) between HIT and SIT. Our study indicates that HIT and SIT may be implemented to the training program of surfers to improve aerobic and repeat-sprint paddle ability, both of which are identified as key aspects of the sport. In addition, these findings indicate that 400-m paddle and RSPT can discriminate between aerobic and anaerobic training adaptations, with aerobic gains likely from HIT and anaerobic gains from SIT.

Decision Makers Calibrate Behavioral Persistence on the Basis of Time-Interval Experience

ERIC Educational Resources Information Center

McGuire, Joseph T.; Kable, Joseph W.

2012-01-01

A central question in intertemporal decision making is why people reverse their own past choices. Someone who initially prefers a long-run outcome might fail to maintain that preference for long enough to see the outcome realized. Such behavior is usually understood as reflecting preference instability or self-control failure. However, if a…

Concurrence of three Jaynes-Cummings systems

NASA Astrophysics Data System (ADS)

Qiang, Wen-Chao; Sun, Guo-Hua; Dong, Qian; Camacho-Nieto, Oscar; Dong, Shi-Hai

2018-04-01

We apply genuine multipartite concurrence to investigate entanglement properties of three Jaynes-Cummings systems. Three atoms are initially put in GHZ-like state and locally interact with three independent cavities, respectively. We present analytical concurrence expressions for various subsystems including three-atom, three-cavity and some atom-cavity mixed systems. We also examine the global system and illustrate the evolution of its concurrence. Except for the sudden death of entanglement, we find for some initial entanglement parameter θ , the concurrence of the global system may maintain unchanged in some time intervals.

Evaluation of quality improvement initiative in pediatric oncology: implementation of aggressive hydration protocol.

PubMed

Fratino, Lisa M; Daniel, Denise A; Cohen, Kenneth J; Chen, Allen R

2009-01-01

Our goal was to improve the efficiency of chemotherapy administration for pediatric oncology patients. We identified prechemotherapy hydration as the process that most often delayed chemotherapy administration. An aggressive hydration protocol, supported by fluid order sets, was developed for patients receiving planned chemotherapy. The mean interval from admission to achieving adequate hydration status was reduced significantly from 4.9 to 1.4 hours with a minor reduction in the time to initiate chemotherapy from 9.6 to 8.6 hours. Chemotherapy availability became the new rate-limiting process.

Cholesterol, Cholesterol-Lowering Medication Use, and Breast Cancer Outcome in the BIG 1-98 Study.

PubMed

Borgquist, Signe; Giobbie-Hurder, Anita; Ahern, Thomas P; Garber, Judy E; Colleoni, Marco; Láng, István; Debled, Marc; Ejlertsen, Bent; von Moos, Roger; Smith, Ian; Coates, Alan S; Goldhirsch, Aron; Rabaglio, Manuela; Price, Karen N; Gelber, Richard D; Regan, Meredith M; Thürlimann, Beat

2017-04-10

Purpose Cholesterol-lowering medication (CLM) has been reported to have a role in preventing breast cancer recurrence. CLM may attenuate signaling through the estrogen receptor by reducing levels of the estrogenic cholesterol metabolite 27-hydroxycholesterol. The impact of endocrine treatment on cholesterol levels and hypercholesterolemia per se may counteract the intended effect of aromatase inhibitors. Patients and Methods The Breast International Group (BIG) conducted a randomized, phase III, double-blind trial, BIG 1-98, which enrolled 8,010 postmenopausal women with early-stage, hormone receptor-positive invasive breast cancer from 1998 to 2003. Systemic levels of total cholesterol and use of CLM were measured at study entry and every 6 months up to 5.5 years. Cumulative incidence functions were used to describe the initiation of CLM in the presence of competing risks. Marginal structural Cox proportional hazards modeling investigated the relationships between initiation of CLM during endocrine therapy and outcome. Three time-to-event end points were considered: disease-free-survival, breast cancer-free interval, and distant recurrence-free interval. Results Cholesterol levels were reduced during tamoxifen therapy. Of 789 patients who initiated CLM during endocrine therapy, the majority came from the letrozole monotherapy arm (n = 318), followed by sequential tamoxifen-letrozole (n = 189), letrozole-tamoxifen (n = 176), and tamoxifen monotherapy (n = 106). Initiation of CLM during endocrine therapy was related to improved disease-free-survival (hazard ratio [HR], 0.79; 95% CI, 0.66 to 0.95; P = .01), breast cancer-free interval (HR, 0.76; 95% CI, 0.60 to 0.97; P = .02), and distant recurrence-free interval (HR, 0.74; 95% CI, 0.56 to 0.97; P = .03). Conclusion Cholesterol-lowering medication during adjuvant endocrine therapy may have a role in preventing breast cancer recurrence in hormone receptor-positive early-stage breast cancer. We recommend that these observational results be addressed in prospective randomized trials.

ParaExp Using Leapfrog as Integrator for High-Frequency Electromagnetic Simulations

NASA Astrophysics Data System (ADS)

Merkel, M.; Niyonzima, I.; Schöps, S.

2017-12-01

Recently, ParaExp was proposed for the time integration of linear hyperbolic problems. It splits the time interval of interest into subintervals and computes the solution on each subinterval in parallel. The overall solution is decomposed into a particular solution defined on each subinterval with zero initial conditions and a homogeneous solution propagated by the matrix exponential applied to the initial conditions. The efficiency of the method depends on fast approximations of this matrix exponential based on recent results from numerical linear algebra. This paper deals with the application of ParaExp in combination with Leapfrog to electromagnetic wave problems in time domain. Numerical tests are carried out for a simple toy problem and a realistic spiral inductor model discretized by the Finite Integration Technique.

Metastability versus collapse following a quench in attractive Bose-Einstein condensates

NASA Astrophysics Data System (ADS)

Golde, Jake; Ruhl, Joanna; Olshanii, Maxim; Dunjko, Vanja; Datta, Sumita; Malomed, Boris A.

2018-05-01

We consider a Bose-Einstein condensate (BEC) with attractive two-body interactions in a cigar-shaped trap, initially prepared in its ground state for a given negative scattering length, which is quenched to a larger absolute value of the scattering length. Using the mean-field approximation, we compute numerically, for an experimentally relevant range of aspect ratios and initial strengths of the coupling, two critical values of quench. One corresponds to the weakest attraction strength, the quench to which causes the system to collapse before completing even a single return from the narrow configuration (pericenter) in its breathing cycle. The other is a similar critical point for the occurrence of collapse before completing two returns. In the latter case, we also compute the limiting value, as we keep increasing the strength of the postquench attraction towards its critical value, of the time interval between the first two pericenters. We also use a Gaussian variational model to estimate the critical quenched attraction strength below which the system is stable against the collapse for long times. These time intervals and critical attraction strengths, apart from being fundamental properties of nonlinear dynamics of self-attractive BECs, may provide clues to the design of upcoming experiments that are trying to create robust BEC breathers.

Large capacity storage of integrated objects before change blindness.

PubMed

Landman, Rogier; Spekreijse, Henk; Lamme, Victor A F

2003-01-01

Normal people have a strikingly low ability to detect changes in a visual scene. This has been taken as evidence that the brain represents only a few objects at a time, namely those currently in the focus of attention. In the present study, subjects were asked to detect changes in the orientation of rectangular figures in a textured display across a 1600 ms gray interval. In the first experiment, change detection improved when the location of a possible change was cued during the interval. The cue remained effective during the entire interval, but after the interval, it was ineffective, suggesting that an initially large representation was overwritten by the post-change display. To control for an effect of light intensity during the interval on the decay of the representation, we compared performance with a gray or a white interval screen in a second experiment. We found no difference between these conditions. In the third experiment, attention was occasionally misdirected during the interval by first cueing the wrong figure, before cueing the correct figure. This did not compromise performance compared to a single cue, indicating that when an item is attentionally selected, the representation of yet unchosen items remains available. In the fourth experiment, the cue was shown to be effective when changes in figure size and orientation were randomly mixed. At the time the cue appeared, subjects could not know whether size or orientation would change, therefore these results suggest that the representation contains features in their 'bound' state. Together, these findings indicate that change blindness involves overwriting of a large capacity representation by the post-change display.

Laser pulse stretcher method and apparatus

DOEpatents

Hawkins, Jon K.; Williams, William A.

1990-01-01

The output of an oscillator stage of a laser system is monitored by a photocell which is coupled to a feedback section to control a Pockels Cell and change the light output of the oscillator stage. A synchronizing pulse is generated in timed relation to the initiation of operation of the oscillator stage and is applied to a forward feed section which cooperates with the feedback section to maintain the light output constant for an extended time interval.

Cytogenetics-based risk prediction of blastic transformation of chronic myeloid leukemia in the era of TKI therapy

PubMed Central

Gong, Zimu; Medeiros, L. Jeffrey; Cortes, Jorge E.; Chen, Zi; Zheng, Lan; Li, Yan; Bai, Shi; Lin, Pei; Miranda, Roberto N.; Jorgensen, Jeffrey L.; McDonnell, Timothy J.; Wang, Wei; Kantarjian, Hagop M.

2017-01-01

The high fatality of patients with blast phase (BP) chronic myeloid leukemia (CML) necessitates identification of high-risk (HR) patients to prevent onset of BP. Here, we investigated the risk of BP based on additional chromosomal abnormality (ACA) profiles in a cohort of 2326 CML patients treated with tyrosine kinase inhibitors (TKIs). We examined the time intervals from initial diagnosis to ACA emergence (interval 1), from ACA emergence to onset of BP (interval 2), and survival after onset of BP (interval 3). Based on BP risk associated with each ACA, patients were stratified into intermediate-1, intermediate-2, and HR groups, with a median duration of interval 2 of unreached, 19.2 months, and 1.9 months, respectively. There was no difference in durations of intervals 1 or 3 among 3 groups. Including patients without ACAs who formed the standard-risk group, the overall 5-year cumulative probability of BP was 9.8%, 28.0%, 41.7%, and 67.4% for these 4 groups, respectively. The pre-BP disease course in those who developed BP was similar regardless of cytogenetic alterations, and 84.4% of BP patients developed BP within the first 5 years of diagnosis. In summary, interval 2 is the predominant determinant of BP risk and patient outcome. By prolonging the duration of interval 2, TKI therapy mitigates BP risk associated with low-risk ACAs or no ACAs but does not alter the natural course of CML with HR ACAs. Thus, we have identified a group of patients who have HR of BP and may benefit from timely alternative treatment to prevent onset of BP. PMID:29296906

The interval between cancer diagnosis among mothers and offspring in a population-based cohort.

PubMed

Paltiel, Ora; Friedlander, Yehiel; Deutsch, Lisa; Yanetz, Rebecca; Calderon-Margalit, Ronit; Tiram, Efrat; Hochner, Hagit; Barchana, Micha; Harlap, Susan; Manor, Orly

2007-01-01

Familial cancers may be due to shared genes or environment, or chance aggregation. We explored the possibility that ascertainment bias influences cancer detection in families, bearing upon the time interval between diagnosis of affected mothers and offspring. The Jerusalem Perinatal Study (JPS) comprises all mothers (n = 39,734) from Western Jerusalem who gave birth 1964 -1976 and their offspring (n = 88,829). After linking identification numbers with Israel's Cancer Registry we measured the absolute time interval between initial cancer diagnoses in affected mother-offspring pairs. We tested the probability of obtaining intervals as short as those observed by chance alone, using a permutation test on the median interval. By June 2003 cancer had developed in 105 mother-offspring pairs within the cohort. Common sites among mothers were breast (47%), colorectal (9%), non-Hodgkin lymphoma (NHL) (8%) and cervix (7%), while for offspring in affected pairs common cancers were leukemia (12.4%), thyroid (13.3%), NHL (10.5%), breast (10.5%) and melanoma (7.6%). The median interval between diagnoses was 5.9 years, but for 33% of affected pairs the interval was < or =3 years. The probability of this occurring by chance alone was 0.03. This held true whether the offspring's or mother's diagnosis was first (P < 0.01). In a population-based cohort followed for three decades, the absolute interval between the diagnosis of cancer in mothers and their offspring is shorter than expected by chance. Explanations include shared environmental exposures or the possibility that cancer ascertainment in one pair member affects health behaviors in the other resulting in early diagnosis. The latter may bias the estimation of anticipation and survival in familial cancers.

Efficacy and Safety of Second-Line 5-Day Dactinomycin in Case of Methotrexate Failure for Gestational Trophoblastic Neoplasia.

PubMed

Prouvot, Catherine; Golfier, François; Massardier, Jérôme; You, Benoit; Lotz, Jean-Pierre; Patrier, Sophie; Devouassoux, Mojgan; Schott, Anne-Marie; Hajri, Touria; Bolze, Pierre-Adrien

2018-06-01

The objective of this study was to evaluate the characteristics and outcomes of patients treated for gestational trophoblastic neoplasia (GTN) with second-line 5-day dactinomycin after failed first-line 8-day methotrexate. From 1999 to 2017, patients with methotrexate resistant GTN treated with second line dactinomycin were identified at the French Trophoblastic Disease Reference Center. Using univariate and multivariate analysis, we identified significant predictive factors of second line dactinomycin failure. A total of 877 GTN patients were treated with first-line 8-day methotrexate, of which 103 required second-line 5-day dactinomycin for methotrexate failure. Complete response was observed in 78 patients (75.7% [95% confidence interval, 66.3-83.6]; P < 0.0001), whereas 25 needed third-line treatment, 13 for dactinomycin resistance and 12 for post-dactinomycin relapse. Overall survival of patients treated with dactinomycin was 100%. An interval of greater than or equal to 7 months between antecedent pregnancy termination and methotrexate initiation was a predictive factor significantly associated with second-line dactinomycin failure in multivariate analysis (exact odds ratio, 9.17 [95% confidence interval, 1.98-50.70]; P = 0.0029). No grades 4 and 5 adverse effects were experienced and the most common toxicity being grade 1 nausea (14.6%). Given a 75.7% complete response rate in methotrexate failed low-risk GTN patients treated with second-line dactinomycin and an overall survival rate of 100% after third-line treatment, the use of dactinomycin should be favored as second-line, regardless of human chorionic gonadotropin level at the time of dactinomycin initiation. However, an interval between the termination of the antecedent pregnancy and methotrexate initiation longer than 6 months should encourage considering alternative therapeutic strategies.

Evaluation of force degradation characteristics of orthodontic latex elastics in vitro and in vivo.

PubMed

Wang, Tong; Zhou, Gang; Tan, Xianfeng; Dong, Yaojun

2007-07-01

To evaluate the characteristics of force degradation of latex elastics in clinical applications and in vitro studies. Samples of 3/16-inch latex elastics were investigated, and 12 students between the ages of 12 and 15 years were selected for the intermaxillary and intramaxillary tractions. The elastics in the control groups were set in artificial saliva and dry room conditions and were stretched 20 mm. The repeated-measure two-way analysis of variance and nonlinear regression analysis were used to identify statistical significance. Overall, there were statistically significant differences between the different methods and observation intervals. At 24- and 48-hour time intervals, the force decreased during in vivo testing and in artificial saliva (P < .001), whereas there were no significant differences in dry room conditions (P > .05). In intermaxillary traction the percentage of initial force remaining after 48 hours was 61%. In intramaxillary traction and in artificial saliva the percentage of initial force remaining was 71%, and in room conditions 86% of initial force remained. Force degradation of latex elastics was different according to their environmental conditions. There was significantly more force degradation in intermaxillary traction than in intramaxillary traction. The dry room condition caused the least force loss. There were some differences among groups in the different times to start wearing elastics in intermaxillary traction but no significant differences in intramaxillary traction.

Portrayal of alcohol consumption in movies and drinking initiation in low-risk adolescents.

PubMed

Hanewinkel, Reiner; Sargent, James D; Hunt, Kate; Sweeting, Helen; Engels, Rutger C M E; Scholte, Ron H J; Mathis, Federica; Florek, Ewa; Morgenstern, Matthis

2014-06-01

To investigate the hypothesis that exposure to alcohol consumption in movies affects the likelihood that low-risk adolescents will start to drink alcohol. Longitudinal study of 2346 adolescent never drinkers who also reported at baseline intent to not to do so in the next 12 months (mean age 12.9 years, SD = 1.08). Recruitment was carried out in 2009 and 2010 in 112 state-funded schools in Germany, Iceland, Italy, Netherlands, Poland, and Scotland. Exposure to movie alcohol consumption was estimated from 250 top-grossing movies in each country in the years 2004 to 2009. Multilevel mixed-effects Poisson regressions assessed the relationship between baseline exposure to movie alcohol consumption and initiation of trying alcohol, and binge drinking (≥ 5 consecutive drinks) at follow-up. Overall, 40% of the sample initiated alcohol use and 6% initiated binge drinking by follow-up. Estimated mean exposure to movie alcohol consumption was 3653 (SD = 2448) occurrences. After age, gender, family affluence, school performance, TV screen time, personality characteristics, and drinking behavior of peers, parents, and siblings were controlled for, exposure to each additional 1000 movie alcohol occurrences was significantly associated with increased relative risk for trying alcohol, incidence rate ratio = 1.05 (95% confidence interval, 1.02-1.08; P = .003), and for binge drinking, incidence rate ratio = 1.13 (95% confidence interval, 1.06-1.20; P < .001). Seeing alcohol depictions in movies is an independent predictor of drinking initiation, particularly for more risky patterns of drinking. This result was shown in a heterogeneous sample of European youths who had a low affinity for drinking alcohol at the time of exposure. Copyright © 2014 by the American Academy of Pediatrics.

Intrinsic Predictive Factors of Noncontact Lateral Ankle Sprain in Collegiate Athletes

PubMed Central

Kobayashi, Takumi; Yoshida, Masahiro; Yoshida, Makoto; Gamada, Kazuyoshi

2013-01-01

Background: Lateral ankle sprain (LAS) is one of the most common injuries in sports. Despite extensive research, intrinsic factors that predict initial and recurrent noncontact LAS remain undefined. Purpose: To identify the predictive factors of initial and recurrent noncontact LAS, focusing on ankle flexibility and/or alignment in collegiate athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 191 athletes were assessed during the preseason for factors predictive of noncontact LAS. The baseline measurements included weightbearing dorsiflexion range of motion (ROM), leg-heel angle, foot internal rotation angle in plantar flexion, classification according to the mortise test, and navicular–medial malleolus (NMM) distance. Occurrence of noncontact LAS and participation in practice and games were prospectively recorded for 11 months. Results: Of the 191 athletes assessed, 169 (145 males, 24 females) completed the study; 125 athletes had a history of ankle sprain. During the observational period, 16 athletes suffered noncontact LAS (0.58 per 1000 athlete-exposures) consisting of 4 initial sprains and 12 recurrences. The hazard ratio estimated by a Cox regression analysis showed that athletes with an NMM distance ≥4.65 cm were 4.14 times more likely to suffer an initial noncontact LAS than were athletes with a shorter NMM distance (95% confidence interval, 1.12-14.30) and that athletes with a weightbearing dorsiflexion ROM >49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS compared with athletes with a lower ROM (95% confidence interval, 1.05-1.20). Conclusion: NMM distance predicts initial noncontact LAS, and weightbearing dorsiflexion ROM predicts recurrent noncontact LAS. PMID:26535263

Portrayal of Alcohol Consumption in Movies and Drinking Initiation in Low-Risk Adolescents

PubMed Central

Sargent, James D.; Hunt, Kate; Sweeting, Helen; Engels, Rutger C.M.E.; Scholte, Ron H.J.; Mathis, Federica; Florek, Ewa; Morgenstern, Matthis

2014-01-01

OBJECTIVES: To investigate the hypothesis that exposure to alcohol consumption in movies affects the likelihood that low-risk adolescents will start to drink alcohol. METHODS: Longitudinal study of 2346 adolescent never drinkers who also reported at baseline intent to not to do so in the next 12 months (mean age 12.9 years, SD = 1.08). Recruitment was carried out in 2009 and 2010 in 112 state-funded schools in Germany, Iceland, Italy, Netherlands, Poland, and Scotland. Exposure to movie alcohol consumption was estimated from 250 top-grossing movies in each country in the years 2004 to 2009. Multilevel mixed-effects Poisson regressions assessed the relationship between baseline exposure to movie alcohol consumption and initiation of trying alcohol, and binge drinking (≥ 5 consecutive drinks) at follow-up. RESULTS: Overall, 40% of the sample initiated alcohol use and 6% initiated binge drinking by follow-up. Estimated mean exposure to movie alcohol consumption was 3653 (SD = 2448) occurrences. After age, gender, family affluence, school performance, TV screen time, personality characteristics, and drinking behavior of peers, parents, and siblings were controlled for, exposure to each additional 1000 movie alcohol occurrences was significantly associated with increased relative risk for trying alcohol, incidence rate ratio = 1.05 (95% confidence interval, 1.02–1.08; P = .003), and for binge drinking, incidence rate ratio = 1.13 (95% confidence interval, 1.06–1.20; P < .001). CONCLUSIONS: Seeing alcohol depictions in movies is an independent predictor of drinking initiation, particularly for more risky patterns of drinking. This result was shown in a heterogeneous sample of European youths who had a low affinity for drinking alcohol at the time of exposure. PMID:24799536

Marginal Structural Models for Case-Cohort Study Designs to Estimate the Association of Antiretroviral Therapy Initiation With Incident AIDS or Death

PubMed Central

Cole, Stephen R.; Hudgens, Michael G.; Tien, Phyllis C.; Anastos, Kathryn; Kingsley, Lawrence; Chmiel, Joan S.; Jacobson, Lisa P.

2012-01-01

To estimate the association of antiretroviral therapy initiation with incident acquired immunodeficiency syndrome (AIDS) or death while accounting for time-varying confounding in a cost-efficient manner, the authors combined a case-cohort study design with inverse probability-weighted estimation of a marginal structural Cox proportional hazards model. A total of 950 adults who were positive for human immunodeficiency virus type 1 were followed in 2 US cohort studies between 1995 and 2007. In the full cohort, 211 AIDS cases or deaths occurred during 4,456 person-years. In an illustrative 20% random subcohort of 190 participants, 41 AIDS cases or deaths occurred during 861 person-years. Accounting for measured confounders and determinants of dropout by inverse probability weighting, the full cohort hazard ratio was 0.41 (95% confidence interval: 0.26, 0.65) and the case-cohort hazard ratio was 0.47 (95% confidence interval: 0.26, 0.83). Standard multivariable-adjusted hazard ratios were closer to the null, regardless of study design. The precision lost with the case-cohort design was modest given the cost savings. Results from Monte Carlo simulations demonstrated that the proposed approach yields approximately unbiased estimates of the hazard ratio with appropriate confidence interval coverage. Marginal structural model analysis of case-cohort study designs provides a cost-efficient design coupled with an accurate analytic method for research settings in which there is time-varying confounding. PMID:22302074

Characterization and Uncertainty Analysis of a Reference Pressure Measurement System for Wind Tunnels

NASA Technical Reports Server (NTRS)

Amer, Tahani; Tripp, John; Tcheng, Ping; Burkett, Cecil; Sealey, Bradley

2004-01-01

This paper presents the calibration results and uncertainty analysis of a high-precision reference pressure measurement system currently used in wind tunnels at the NASA Langley Research Center (LaRC). Sensors, calibration standards, and measurement instruments are subject to errors due to aging, drift with time, environment effects, transportation, the mathematical model, the calibration experimental design, and other factors. Errors occur at every link in the chain of measurements and data reduction from the sensor to the final computed results. At each link of the chain, bias and precision uncertainties must be separately estimated for facility use, and are combined to produce overall calibration and prediction confidence intervals for the instrument, typically at a 95% confidence level. The uncertainty analysis and calibration experimental designs used herein, based on techniques developed at LaRC, employ replicated experimental designs for efficiency, separate estimation of bias and precision uncertainties, and detection of significant parameter drift with time. Final results, including calibration confidence intervals and prediction intervals given as functions of the applied inputs, not as a fixed percentage of the full-scale value are presented. System uncertainties are propagated beginning with the initial reference pressure standard, to the calibrated instrument as a working standard in the facility. Among the several parameters that can affect the overall results are operating temperature, atmospheric pressure, humidity, and facility vibration. Effects of factors such as initial zeroing and temperature are investigated. The effects of the identified parameters on system performance and accuracy are discussed.

Pediatric extracorporeal cardiopulmonary resuscitation during nights and weekends.

PubMed

Burke, Christopher R; Chan, Titus; Brogan, Thomas V; McMullan, D Michael

2017-05-01

Extracorporeal cardiopulmonary resuscitation (ECPR) is a lifesaving rescue therapy for patients with refractory cardiac arrest. Previous studies suggest that maintaining a 24/7 in-house surgical team may reduce ECPR initiation time and improve survival in adult patients. However, an association between cardiac arrest occurring during off-hours and ECPR outcome has not been established in children. This is a single institution, retrospective review of all pediatric patients who received ECPR from December 2008 to August 2015. During the study period, ECPR was performed 54 times in 53 patients (20 weekday, 34 night/weekend). Interval from ECPR activation to initiation of extracorporeal life support was significantly longer during night/weekends (49min night/weekend vs. 33min weekday, p<0.001) as was the interval from ECPR activation to incision for cannulation (26min night/weekend vs. 14min Weekday, p<0.001). Rate of central nervous system (CNS) injury was higher in the night/weekend group (43% night/weekend vs. 15% weekday, p=0.04), with associated 75% mortality prior to hospital discharge. Time of arrest did not impact survival to hospital discharge (44% night/weekend vs. 55% weekday, p=0.57), one-year survival (33% night/weekend vs. 44% weekday, p=0.44), or neurologic outcome (Pediatric Cerebral Performance Score at 1-year post-ECPR, 1.45 weekday vs. 1.50 night/weekend, p=0.82). Cardiac arrest occurring at night or during weekend hours is associated with a longer ECPR initiation time and higher rates of CNS injury. However, prolonged pre-ECPR support associated with off-hours cardiac arrest does not appear to impact survival or functional outcome in pediatric patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Anticipation of delayed action-effects: learning when an effect occurs, without knowing what this effect will be.

PubMed

Dignath, David; Janczyk, Markus

2017-09-01

According to the ideomotor principle, behavior is controlled via a retrieval of the sensory consequences that will follow from the respective movement ("action-effects"). These consequences include not only what will happen, but also when something will happen. In fact, recollecting the temporal duration between response and effect takes time and prolongs the initiation of the response. We investigated the associative structure of action-effect learning with delayed effects and asked whether participants acquire integrated action-time-effect episodes that comprise a compound of all three elements or whether they acquire separate traces that connect actions to the time until an effect occurs and actions to the effects that follow them. In three experiments, results showed that participants retrieve temporal intervals that follow from their actions even when the identity of the effect could not be learned. Furthermore, retrieval of temporal intervals in isolation was not inferior to retrieval of temporal intervals that were consistently followed by predictable action-effects. More specifically, when tested under extinction, retrieval of action-time and action-identity associations seems to compete against each other, similar to overshadowing effects reported for stimulus-response conditioning. Together, these results suggest that people anticipate when the consequences of their action will occur, independently from what the consequences will be.

Description and comparison of excretory urography performed during radiography and computed tomography for evaluation of the urinary system in healthy New Zealand White rabbits (Oryctolagus cuniculus).

PubMed

Vilalta, Laura; Altuzarra, Raul; Espada, Yvonne; Dominguez, Elisabet; Novellas, Rosa; Martorell, Jaime

2017-04-01

OBJECTIVE To evaluate the usefulness of excretory urography performed during radiography (REU) and CT (CTEU) in healthy rabbits, determine timings of urogram phases, and compare sensitivities of REU and CTEU for detection of these phases. ANIMALS 13 New Zealand White rabbits (Oryctolagus cuniculus). PROCEDURES Rabbits were screened for signs of systemic and urinary tract disease. An REU examination of each was performed, followed ≥ 5 days later by a CTEU examination. Contrast images from each modality were evaluated for quality of opacification and intervals between initiation of contrast medium administration and detection of various urogram phases. RESULTS Excretory urograms of excellent diagnostic quality were achieved with both imaging modalities. For all rabbits, the nephrographic phase of the urogram appeared in the first postcontrast REU image (obtained between 34 and 40 seconds after initiation of contrast medium administration) and at a median interval of 20 seconds in CTEU images. The pyelographic phase began at a median interval of 1.63 minutes with both imaging modalities. Contrast medium was visible within the urinary bladder at a median interval of 2.20 minutes. Median interval to the point at which the nephrogram and pyelogram were no longer visible in REU images was 8 hours and 2.67 hours, respectively. The CTEU technique was better than the REU technique for evaluating renal parenchyma. CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that REU and, particularly, CTEU may be valuable tools for the diagnosis of renal and urinary tract disease in rabbits; however, additional evaluation in diseased rabbits is required.

Retrospective study evaluating dose standards for infliximab in patients with rheumatoid arthritis at Hospital Israelita Albert Einstein, São Paulo, Brazil.

PubMed

Scheinberg, Morton; Goldenberg, José; Feldman, Daniel P; Nóbrega, João Luiz

2008-08-01

We determined, in our surrounding environment, the proportion of patients being treated with infliximab who required a therapeutic scheme escalation (an infliximab dose increase surpassing the level of 3 mg/kg every 8 weeks and/or a decrease on the current between infusions' interval). This was a study of the retrospective analysis of data from the 41 rheumatoid arthritis (RA) patients receiving an infliximab therapy at the Albert Einstein Israelita Hospital, from January 2001 up to December 2005. A questionnaire was applied to these patients, assessing their clinical and laboratory data, adverse events, and individual information regarding the infliximab administration. Therapeutic dose information was available in 68% (28/41) of the RA patients, with 46% of these (13/28) receiving a dose increase, and 30% (8/27) experiencing a shortening of the between infusions' interval. The average final infliximab dose (4.21 mg/kg) was significantly greater than their average initial dose (3.29 mg/kg). The average time intervals between the initial and final infusions, though shortened, were not significantly different. A proportion of 73% (30/41) of these patients demonstrated improvement in at least one of the assessed clinical parameters, and 50% of these patients (15/30) experienced a dose increase, while 20% (6/30) experienced shortening of the between treatments' interval. A total of 20% (8/41) of the original patients experienced adverse events. Although infliximab is effective in the control of RA, dose adjustment and/or shortening of the between treatments' interval is frequently required.

Relationship between functional electrical stimulation duty cycle and fatigue in wrist extensor muscles of patients with hemiparesis.

PubMed

Packman-Braun, R

1988-01-01

The purpose of this study was to investigate, in a sample of patients with hemiparesis secondary to cerebrovascular accident, the relationship between the ratio of stimulus on time to off time and muscle fatigue using a commercial electrical stimulation unit. An experimental model was used to test the hypothesis that the smaller the stimulus off time relative to stimulus on time, the greater will be the muscle fatigue over time. The wrist extensor muscles of 18 patients with hemiparesis were stimulated electrically, and isometric force output was recorded continuously using an adapted strain gauge-recorder apparatus. For each testing session, peak on time of the electrical stimulus was set at 5 seconds, and off time was set at 5, 15, or 25 seconds. Six randomly assigned treatment groups participated in three separate treatment sessions in a different order at 48-hour intervals. Treatment sessions were continued either until wrist extensor muscle force output decreased to 50% of its initial value or for a maximum of 30 minutes. Data analysis revealed that significant differences in muscle tension developed among all duty cycles (p less than .01). Duty-cycle ratios of 1:1, 1:3, and 1:5 were shown to be progressively less fatiguing. Within the limits of this investigation, the 1:5 duty-cycle ratio was determined to be the best suited for initial use in programs of prolonged stimulation to the wrist extensor muscles of patients with hemiparesis. The hypothesis was accepted that the smaller the stimulus off time (rest interval) with respect to the stimulus on time, the greater will be the muscle fatigue over time.

Impact of generic antiretroviral therapy (ART) and free ART programs on time to initiation of ART at a tertiary HIV care center in Chennai, India.

PubMed

Solomon, Sunil S; Lucas, Gregory M; Kumarasamy, Nagalingeswaran; Yepthomi, Tokugha; Balakrishnan, Pachamuthu; Ganesh, Aylur K; Anand, Santhanam; Moore, Richard D; Solomon, Suniti; Mehta, Shruti H

2013-08-01

Antiretroviral therapy (ART) access in the developing world has improved, but whether increased access has translated to more rapid treatment initiation among those who need it is unknown. We characterize time to ART initiation across three eras of ART availability in Chennai, India (1996-1999: pregeneric; 2000-2003: generic; 2004-2007: free rollout). Between 1996 and 2007, 11,171 patients registered for care at the YR Gaitonde Centre for AIDS Research and Education (YRGCARE), a tertiary HIV referral center in southern India. Of these, 5726 patients became eligible for ART during this period as per Indian guidelines for initiation of ART. Generalized gamma survival models were used to estimate relative times (RT) to ART initiation by calendar periods of eligibility. Time to initiation of ART among patients in Chennai, India was also compared to an HIV clinical cohort in Baltimore, USA. Median age of the YRGCARE patients was 34 years; 77% were male. The median CD4 at presentation was 140 cells/µl. After adjustment for demographics, CD4 and WHO stage, persons in the pregeneric era took 3.25 times longer (95% confidence interval [CI]: 2.53-4.17) to initiate ART versus the generic era and persons in the free rollout era initiated ART more rapidly than the generic era (RT: 0.73; 95% CI: 0.63-0.83). Adjusting for differences across centers, patients at YRGCARE took longer than patients in the Johns Hopkins Clinical Cohort (JHCC) to initiate ART in the pregeneric era (RT: 4.90; 95% CI: 3.37-7.13) but in the free rollout era, YRGCARE patients took only about a quarter of the time (RT: 0.31; 95% CI: 0.22-0.44). These data demonstrate the benefits of generic ART and government rollouts on time to initiation of ART in one developing country setting and suggests that access to ART may be comparable to developed country settings.

Cascaded processing in written compound word production

PubMed Central

Bertram, Raymond; Tønnessen, Finn Egil; Strömqvist, Sven; Hyönä, Jukka; Niemi, Pekka

2015-01-01

In this study we investigated the intricate interplay between central linguistic processing and peripheral motor processes during typewriting. Participants had to typewrite two-constituent (noun-noun) Finnish compounds in response to picture presentation while their typing behavior was registered. As dependent measures we used writing onset time to assess what processes were completed before writing and inter-key intervals to assess what processes were going on during writing. It was found that writing onset time was determined by whole word frequency rather than constituent frequencies, indicating that compound words are retrieved as whole orthographic units before writing is initiated. In addition, we found that the length of the first syllable also affects writing onset time, indicating that the first syllable is fully prepared before writing commences. The inter-key interval results showed that linguistic planning is not fully ready before writing, but cascades into the motor execution phase. More specifically, inter-key intervals were largest at syllable and morpheme boundaries, supporting the view that additional linguistic planning takes place at these boundaries. Bigram and trigram frequency also affected inter-key intervals with shorter intervals corresponding to higher frequencies. This can be explained by stronger memory traces for frequently co-occurring letter sequences in the motor memory for typewriting. These frequency effects were even larger in the second than in the first constituent, indicating that low-level motor memory starts to become more important during the course of writing compound words. We discuss our results in the light of current models of morphological processing and written word production. PMID:25954182

Cascaded processing in written compound word production.

PubMed

Bertram, Raymond; Tønnessen, Finn Egil; Strömqvist, Sven; Hyönä, Jukka; Niemi, Pekka

2015-01-01

In this study we investigated the intricate interplay between central linguistic processing and peripheral motor processes during typewriting. Participants had to typewrite two-constituent (noun-noun) Finnish compounds in response to picture presentation while their typing behavior was registered. As dependent measures we used writing onset time to assess what processes were completed before writing and inter-key intervals to assess what processes were going on during writing. It was found that writing onset time was determined by whole word frequency rather than constituent frequencies, indicating that compound words are retrieved as whole orthographic units before writing is initiated. In addition, we found that the length of the first syllable also affects writing onset time, indicating that the first syllable is fully prepared before writing commences. The inter-key interval results showed that linguistic planning is not fully ready before writing, but cascades into the motor execution phase. More specifically, inter-key intervals were largest at syllable and morpheme boundaries, supporting the view that additional linguistic planning takes place at these boundaries. Bigram and trigram frequency also affected inter-key intervals with shorter intervals corresponding to higher frequencies. This can be explained by stronger memory traces for frequently co-occurring letter sequences in the motor memory for typewriting. These frequency effects were even larger in the second than in the first constituent, indicating that low-level motor memory starts to become more important during the course of writing compound words. We discuss our results in the light of current models of morphological processing and written word production.

Comparison of Prolonged Atrial Electromechanical Delays with Different Definitions in the Discrimination of Patients with Non-Valvular Paroxysmal Atrial Fibrillation

PubMed Central

Lee, Dong Hyun; Choi, Sun Young; Seo, Jeong-Min; Choi, Jae-Hyuk; Cho, Young-Rak; Park, Kyungil; Kim, Moo Hyun; Kim, Young-Dae

2015-01-01

Background and Objectives Previous studies have evaluated atrial electromechanical delays (AEMDs) with a number of different definitions to discriminate patients with paroxysmal atrial fibrillation (PAF) from controls without PAF. However, their discriminative values for PAF have not previously been directly compared. Subjects and Methods A total of 65 PAF patients and 130 control subjects matched for age, sex, history of hypertension, and diabetes mellitus were selected. The AEMDi and AEMDp were defined as the time intervals from the initiation of the P wave on the surface electrocardiogram to the initiation and peak of the late diastolic transmitral inflow on pulsed wave Doppler images, respectively. The AEMDim and AEMDpm were defined as the time intervals from the initiation of the P wave on the surface electrocardiogram to the initiation and peak of the late diastolic lateral mitral annular motion on tissue Doppler images, respectively. Results There were no significant differences in the clinical characteristics between the two groups. All 4 AEMDs were consistently longer in the PAF group, and proven effective to differentiate the PAF patients from the controls. The AEMDi measurement had a larger area under the curve (AUC) than the other AEMDs, left atrial volume index, and P wave amplitude. However, the AEMDp, AEMDim, and AEMDpm measurements had AUCs similar to those of the left atrial volume index and P wave amplitude. Conclusion The findings suggest that the AEMDi is better than the other AEMDs for the discrimination of PAF patients from the controls. PMID:26617650

Patterns of prospective memory impairment among individuals with depression: the influence of cue type and delay interval.

PubMed

Li, Yanqi Ryan; Weinborn, Michael; Loft, Shayne; Maybery, Murray

2013-07-01

The present study investigated the impact of cue type and delay interval on prospective memory performance in depressed, compared to non-depressed, individuals using a clinically relevant measure, the Memory for Intentions Screening Test. The depressed group demonstrated impaired performance on time-based, but not event-based, prospective memory tasks relative to the nondepressed group. The depressed group also demonstrated impaired prospective memory on tasks with longer delay intervals (15 min), but not on tasks with shorter delay intervals (2 min). These data support theoretical frameworks that posit that depression is associated with deficits in cognitive initiative (i.e., reduced ability to voluntarily direct attention to relevant tasks) and thus that depressed individuals are susceptible to poor performance on strategically demanding tasks. The results also raise multiple avenues for developing interventions (e.g., implementation intentions) to improve prospective memory performance among individuals with depression, with potential implications for medication and other treatment adherence.

Post-nuclear disaster evacuation and survival amongst elderly people in Fukushima: A comparative analysis between evacuees and non-evacuees.

PubMed

Nomura, Shuhei; Blangiardo, Marta; Tsubokura, Masaharu; Nishikawa, Yoshitaka; Gilmour, Stuart; Kami, Masahiro; Hodgson, Susan

2016-01-01

Considering the health impacts of evacuation is fundamental to disaster planning especially for vulnerable elderly populations; however, evacuation-related mortality risks have not been well-investigated. We conducted an analysis to compare survival of evacuated and non-evacuated residents of elderly care facilities, following the Great East Japan Earthquake and subsequent Fukushima Dai-ichi nuclear power plant incident on 11th March 2011. To assess associations between evacuation and mortality after the Fukushima nuclear incident; and to present discussion points on disaster planning, with reference to vulnerable elderly populations. The study population comprised 1,215 residents admitted to seven elderly care facilities located 20-40km from the nuclear plant in the five years before the incident. Demographic and clinical characteristics were obtained from medical records. Evacuation histories were tracked until mid 2013. Main outcome measures are hazard ratios in evacuees versus non-evacuees using random-effects Cox proportional hazards models, and pre- and post-disaster survival probabilities and relative mortality incidence. Experiencing the disasters did not have a significant influence on mortality (hazard ratio 1.10, 95% confidence interval: 0.84-1.43). Evacuation was associated with 1.82 times higher mortality (95% confidence interval: 1.22-2.70) after adjusting for confounders, with the initial evacuation from the original facility associated with 3.37 times higher mortality risk (95% confidence interval: 1.66-6.81) than non evacuation. The government should consider updating its requirements for emergency planning for elderly facilities and ensure that, in a disaster setting, these facilities have the capacity and support to shelter in place for at least sufficient time to adequately prepare initial evacuation. Copyright © 2015 Elsevier Inc. All rights reserved.

Value of Conditioned Reinforcers as a Function of Temporal Context

ERIC Educational Resources Information Center

O'Daly, Matthew; Meyer, Steven; Fantino, Edmund

2005-01-01

In two experiments, pigeons were trained on a multiple-chain schedule, in which the initial link for one chain was a variable-interval (VI) 100s schedule and for the other chain a VI 10s schedule. The terminal links were both fixed-time 30s schedules signaled by differently colored stimuli. Following training, the pigeons had their preference for…

Distribution of pre-course BLS/AED manuals does not influence skill acquisition and retention in lay rescuers: a randomised study.

PubMed

Papadimitriou, Lila; Xanthos, Theodoros; Bassiakou, Eleni; Stroumpoulis, Kostantinos; Barouxis, Dimitrios; Iacovidou, Nicolleta

2010-03-01

The present study aims to investigate whether the distribution of the Basic Life Support and Automated External Defibrillation (BLS/AED) manual, 4 weeks prior to the course, has an effect on skill acquisition, theoretical knowledge and skill retention, compared with courses where manuals were not distributed. A total of 303 laypeople were included in the present study. The courses were randomised with sealed envelopes in 12 courses, where manuals were distributed to participants (group A) and in 12 courses, where manuals were not distributed to participants (group B). The participants were formally evaluated at the end of the course, and at 1, 3 and 6 months after each course. The evaluation procedure was the same at all time intervals and consisted of two distinct parts: a written test and a simulated cardiac arrest scenario. No significant difference was observed between the two groups in skill acquisition at the time of initial training. Furthermore, there was no significant difference between the groups in performing BLS/AED skills at 1, 3 and 6 months after initial training. Theoretical knowledge in either group at the specified time intervals did not exhibit any significant difference. Significant deterioration of skills was observed in both groups between initial training and at 1 month after the course, as well as between the first and third month after the course. The present study shows that distribution of BLS/AED manuals 1 month prior to the course has no effect on theoretical knowledge, skill acquisition and skill retention in laypeople. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

TH-A-9A-05: Initial Setup Accuracy Comparison Between Frame-Based and Frameless Stereotactic Radiosurgery

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

Tseng, T; Sheu, R; Todorov, B

2014-06-15

Purpose: To evaluate initial setup accuracy for stereotactic radiosurgery (SRS) between Brainlab frame-based and frameless immobilization system, also to discern the magnitude frameless system has on setup parameters. Methods: The correction shifts from the original setup were compared for total 157 SRS cranial treatments (69 frame-based vs. 88 frameless). All treatments were performed on a Novalis linac with ExacTrac positioning system. Localization box with isocenter overlay was used for initial setup and correction shift was determined by ExacTrac 6D auto-fusion to achieve submillimeter accuracy for treatment. For frameless treatments, mean time interval between simulation and treatment was 5.7 days (rangemore » 0–13). Pearson Chi-Square was used for univariate analysis. Results: The correctional radial shifts (mean±STD, median) for the frame and frameless system measured by ExacTrac were 1.2±1.2mm, 1.1mm and 3.1±3.3mm, 2.0mm, respectively. Treatments with frameless system had a radial shift >2mm more often than those with frames (51.1% vs. 2.9%; p<.0001). To achieve submillimeter accuracy, 85.5% frame-based treatments did not require shift and only 23.9% frameless treatment could succeed with initial setup. There was no statistical significant system offset observed in any direction for either system. For frameless treatments, those treated ≥ 3 days from simulation had statistically higher rates of radial shifts between 1–2mm and >2mm compared to patients treated in a shorter amount of time from simulation (34.3% and 56.7% vs. 28.6% and 33.3%, respectively; p=0.006). Conclusion: Although image-guided positioning system can also achieve submillimeter accuracy for frameless system, users should be cautious regarding the inherent uncertainty of its capability of immobilization. A proper quality assurance procedure for frameless mask manufacturing and a protocol for intra-fraction imaging verification will be crucial for frameless system. Time interval between simulation and treatment was influential to initial setup accuracy. A shorter time frame for frameless SRS treatment could be helpful in minimizing uncertainties in localization.« less

Development of the probability of return of spontaneous circulation in intervals without chest compressions during out-of-hospital cardiac arrest: an observational study.

PubMed

Gundersen, Kenneth; Kvaløy, Jan Terje; Kramer-Johansen, Jo; Steen, Petter Andreas; Eftestøl, Trygve

2009-02-06

One of the factors that limits survival from out-of-hospital cardiac arrest is the interruption of chest compressions. During ventricular fibrillation and tachycardia the electrocardiogram reflects the probability of return of spontaneous circulation associated with defibrillation. We have used this in the current study to quantify in detail the effects of interrupting chest compressions. From an electrocardiogram database we identified all intervals without chest compressions that followed an interval with compressions, and where the patients had ventricular fibrillation or tachycardia. By calculating the mean-slope (a predictor of the return of spontaneous circulation) of the electrocardiogram for each 2-second window, and using a linear mixed-effects statistical model, we quantified the decline of mean-slope with time. Further, a mapping from mean-slope to probability of return of spontaneous circulation was obtained from a second dataset and using this we were able to estimate the expected development of the probability of return of spontaneous circulation for cases at different levels. From 911 intervals without chest compressions, 5138 analysis windows were identified. The results show that cases with the probability of return of spontaneous circulation values 0.35, 0.1 and 0.05, 3 seconds into an interval in the mean will have probability of return of spontaneous circulation values 0.26 (0.24-0.29), 0.077 (0.070-0.085) and 0.040(0.036-0.045), respectively, 27 seconds into the interval (95% confidence intervals in parenthesis). During pre-shock pauses in chest compressions mean probability of return of spontaneous circulation decreases in a steady manner for cases at all initial levels. Regardless of initial level there is a relative decrease in the probability of return of spontaneous circulation of about 23% from 3 to 27 seconds into such a pause.

Nonequilibrium Probabilistic Dynamics of the Logistic Map at the Edge of Chaos

NASA Astrophysics Data System (ADS)

Borges, Ernesto P.; Tsallis, Constantino; Añaños, Garín F.; de Oliveira, Paulo Murilo

2002-12-01

We consider nonequilibrium probabilistic dynamics in logisticlike maps xt+1=1-a|xt|z, (z>1) at their chaos threshold: We first introduce many initial conditions within one among W>>1 intervals partitioning the phase space and focus on the unique value qsen<1 for which the entropic form Sq≡(1- ∑i=1Wpqi)/(q-1) linearly increases with time. We then verify that Sqsen(t)-Sqsen(∞) vanishes like t-1/[qrel(W)-1] [qrel(W)>1]. We finally exhibit a new finite-size scaling, qrel(∞)-qrel(W)~W- |qsen|. This establishes quantitatively, for the first time, a long pursued relation between sensitivity to the initial conditions and relaxation, concepts which play central roles in nonextensive statistical mechanics.

Variability of Anticipatory Postural Adjustments During Gait Initiation in Individuals With Parkinson Disease.

PubMed

Lin, Cheng-Chieh; Creath, Robert A; Rogers, Mark W

2016-01-01

In people with Parkinson disease (PD), difficulties with initiating stepping may be related to impairments of anticipatory postural adjustments (APAs). Increased variability in step length and step time has been observed in gait initiation in individuals with PD. In this study, we investigated whether the ability to generate consistent APAs during gait initiation is compromised in these individuals. Fifteen subjects with PD and 8 healthy control subjects were instructed to take rapid forward steps after a verbal cue. The changes in vertical force and ankle marker position were recorded via force platforms and a 3-dimensional motion capture system, respectively. Means, standard deviations, and coefficients of variation of both timing and magnitude of vertical force, as well as stepping variables, were calculated. During the postural phase of gait initiation the interval was longer and the force modulation was smaller in subjects with PD. Both the variability of timing and force modulation were larger in subjects with PD. Individuals with PD also had a longer time to complete the first step, but no significant differences were found for the variability of step time, length, and speed between groups. The increased variability of APAs during gait initiation in subjects with PD could affect posture-locomotion coupling, and lead to start hesitation, and even falls. Future studies are needed to investigate the effect of rehabilitation interventions on the variability of APAs during gait initiation in individuals with PD.Video abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A119).

Breast-feeding initiation time and neonatal mortality risk among newborns in South India.

PubMed

Garcia, C R; Mullany, L C; Rahmathullah, L; Katz, J; Thulasiraj, R D; Sheeladevi, S; Coles, C; Tielsch, J M

2011-06-01

To examine the association between breast-feeding initiation time and neonatal mortality in India, where breast-feeding initiation varies widely from region to region. Data were collected as part of a community-based, randomized, placebo-controlled trial of the impact of vitamin A supplementation in rural villages of Tamil Nadu, India. Multivariate binomial regression analysis was used to estimate the association between neonatal mortality and breast-feeding initiation time (<12 h, 12 to 24 h, >24 h) among infants surviving a minimum of 48 h. Among 10 464 newborns, 82.1% were first breast-fed before 12 h, 13.8% were breast-fed between 12 and 24 h, and 4.1% were breast-fed after 24 h. After adjusting for birth weight, gestational age and other covariates, late initiators (>24 h) were at ∼78% higher risk of death (relative risk=1.78 (95% confidence interval (CI)=1.03 to 3.10)). There was no difference in mortality risk when comparing babies fed in the first 12 h compared with the second 1  h after birth. Late (>24 h) initiation of breast-feeding is associated with a higher risk of neonatal mortality in Tamil Nadu. Emphasis on breast-feeding promotion programs in low-resource settings of India where early initiation is low could significantly reduce neonatal mortality.

The extent to which tobacco marketing and tobacco use in films contribute to children's use of tobacco: a meta-analysis.

PubMed

Wellman, Robert J; Sugarman, David B; DiFranza, Joseph R; Winickoff, Jonathan P

2006-12-01

To quantify the effect of exposure on initiation of tobacco use among adolescents. A systematic literature search of MEDLINE, PsychINFO, ABI/INFORM, and Business Source Premier through October/November 2005 was conducted. Unpublished studies were solicited from researchers. Of 401 citations initially identified, 51 (n = 141 949 participants) met the inclusion criteria: reporting on exposure and tobacco use outcomes and participants younger than 18 years. Included studies reported 146 effects; 89 were conceptually independent effects. Data were extracted independently by 3 of us using a standardized tool. Weighted averages were calculated using a linear mixed-effects model. Heterogeneity and publication bias were assessed. Main Exposures Exposures (tobacco advertising, promotions, and samples and pro-tobacco depictions in films, television, and videos) were categorized as low or high engagement based on the degree of psychological involvement required. Outcomes were categorized as cognitive (attitudes or intentions) or behavioral (initiation, tobacco use status, or progression of use). Exposure to pro-tobacco marketing and media increases the odds of youth holding positive attitudes toward tobacco use (odds ratio, 1.51; 95% confidence interval, 1.08-2.13) and more than doubles the odds of initiating tobacco use (odds ratio, 2.23; 95% confidence interval, 1.79-2.77). Highly engaging marketing and media are more effective at promoting use (odds ratio, 2.67; 95% confidence interval, 2.19-3.25). These effects are observed across time, in different countries, with different study designs and measures of exposure and outcome. Pro-tobacco marketing and media stimulate tobacco use among youth. A ban on all tobacco promotions is warranted to protect children.

Use of the 2010 McDonald criteria can facilitate early diagnosis of pediatric multiple sclerosis in a predominantly black cohort.

PubMed

Williams, Mitchel T; Tapos, Daniela O; Juhász, Csaba

2014-12-01

Pediatric-onset multiple sclerosis represents around 3-5% of all patients with multiple sclerosis. Both the 2005 and 2010 McDonald criteria for multiple sclerosis have been suggested for the possible use in pediatric-onset multiple sclerosis. Modifications incorporated into the 2010 criteria enabled the fulfillment of dissemination in time to be met with the initial magnetic resonance imaging. The present study was designed to compare the diagnostic sensitivity of these criteria at initial presentation, the time to fulfilling them, and secondary effects of ethnicity in pediatric-onset multiple sclerosis. Twenty-five children with clinically definite multiple sclerosis (mean age, 14.6 ± 3.1 years; 15 girls) from a single center between 2005 and 2012 were analyzed using both the 2005 and 2010 McDonald criteria based on initial clinical presentation and neuroimaging findings comparing diagnostic sensitivity, time interval to meet diagnosis, and ethnicity. Initial multiple sclerosis diagnosis rates applying the 2005 McDonald criteria were 32% compared with 92% for the 2010 criteria (P = 0.0003). The mean time after initial signs until the 2005 and 2010 McDonald criteria for multiple sclerosis were met was 5.0 vs 0.7 months, respectively (P = 0.001). Time to diagnosis using the 2010 criteria was shorter in black children than the European white (P = 0.005). The 2010 McDonald criteria are an appropriate tool for the timely diagnosis of pediatric multiple sclerosis, especially in black children, potentially allowing an earlier initiation of disease-modifying therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

The natural history of untreated Chlamydia trachomatis infection in the interval between screening and returning for treatment.

PubMed

Geisler, William M; Wang, Chengbin; Morrison, Sandra G; Black, Carolyn M; Bandea, Claudiu I; Hook, Edward W

2008-02-01

Studies of the natural history of genital chlamydial infections in humans are sparse and have had study design limitations. An improved understanding of chlamydial natural history may influence recommendations for elements of control efforts such as chlamydia screening frequency or time parameters for partner notification. Addressing limitations of prior studies in part, we are prospectively studying chlamydial natural history in sexually transmitted diseases clinic patients in the interval between screening and returning for treatment of positive chlamydial tests. Results of repeat chlamydial testing and clinical outcomes and their associated predictors are being evaluated. In the initial 129 subjects, 89% were female, 88% were black, median age was 21 years, and the median interval between screening and treatment was 13 days. Based on nucleic acid amplification testing at treatment, spontaneous resolution of chlamydia occurred in 18%. Resolution was somewhat more common in subjects with longer intervals between screening and treatment. Persisting infections more often progressed to develop clinical signs at the time of treatment (e.g., urethritis or cervicitis). Two women and one man developed chlamydial complications between screening and treatment. Our findings demonstrate that although spontaneous resolution of chlamydia is common, many persons with persisting chlamydia progress to develop signs of infection and some develop complications.

Odors Bias Time Perception in Visual and Auditory Modalities

PubMed Central

Yue, Zhenzhu; Gao, Tianyu; Chen, Lihan; Wu, Jiashuang

2016-01-01

Previous studies have shown that emotional states alter our perception of time. However, attention, which is modulated by a number of factors, such as emotional events, also influences time perception. To exclude potential attentional effects associated with emotional events, various types of odors (inducing different levels of emotional arousal) were used to explore whether olfactory events modulated time perception differently in visual and auditory modalities. Participants were shown either a visual dot or heard a continuous tone for 1000 or 4000 ms while they were exposed to odors of jasmine, lavender, or garlic. Participants then reproduced the temporal durations of the preceding visual or auditory stimuli by pressing the spacebar twice. Their reproduced durations were compared to those in the control condition (without odor). The results showed that participants produced significantly longer time intervals in the lavender condition than in the jasmine or garlic conditions. The overall influence of odor on time perception was equivalent for both visual and auditory modalities. The analysis of the interaction effect showed that participants produced longer durations than the actual duration in the short interval condition, but they produced shorter durations in the long interval condition. The effect sizes were larger for the auditory modality than those for the visual modality. Moreover, by comparing performance across the initial and the final blocks of the experiment, we found odor adaptation effects were mainly manifested as longer reproductions for the short time interval later in the adaptation phase, and there was a larger effect size in the auditory modality. In summary, the present results indicate that odors imposed differential impacts on reproduced time durations, and they were constrained by different sensory modalities, valence of the emotional events, and target durations. Biases in time perception could be accounted for by a framework of attentional deployment between the inducers (odors) and emotionally neutral stimuli (visual dots and sound beeps). PMID:27148143

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

PubMed

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

2018-02-01

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

Metoclopramide: an analgesic adjunct to patient-controlled analgesia.

PubMed

Rosenblatt, W H; Cioffi, A M; Sinatra, R; Saberski, L R; Silverman, D G

1991-11-01

This randomized, double-blind trial evaluated the effect of metoclopramide on the pain and analgesic requirements associated with prostaglandin-induced labor for second-trimester termination of pregnancy. After receiving intrauterine prostaglandin, seven women were given intravenous metoclopramide (10 mg), and eight received saline, concurrent with initiation of patient controlled analgesia (PCA). Group differences were assessed with serial visual analogue scale for pain, interval PCA-morphine consumption, and time to fetal delivery. The metoclopramide group used 54% less PCA morphine (24.1 vs 52.0 mg), had lower visual analogue scale scores, and interval morphine consumption at 2, 4, and 6 h after PCA had been initiated, as well as earlier delivery of the fetus when compared with the control group (P less than 0.05). We conclude that a single dose of metoclopramide reduces the pain and PCA-morphine requirements of patients undergoing prostaglandin-induced labor and may facilitate passage of the fetus. Metoclopramide may have a similar application in treating other types of gynecologic pain.

Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

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

Cattaneo, Richard; Hanna, Rabbie K.; Jacobsen, Gordon

Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval onmore » recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after hysterectomy was associated with worse survival endpoints. Our data suggest that shorter time interval between hysterectomy and start of RT may be beneficial.« less

Subjective and Real Time: Coding Under Different Drug States

PubMed Central

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

2016-01-01

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

The Correlation of the Initial Rate of I131 Uptake in the Thyroid with the Clinical Evaluation of the Thyroid Function,

DTIC Science & Technology

1950-10-01

the need for definitive treatment of the patient suspected of having hyperthyroidism . These studies are time-consuming. At the suggestion of A.V.H in...curve in differentiating the normal from the hyperthyroid patient. The rate of uptake of I131 in the thyroid during the interval of a few hours after

Smoked marijuana effects on tobacco cigarette smoking behavior.

PubMed

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

1990-03-01

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

Intracellular Calcium and the Mechanism of Anodal Supernormal Excitability in Langendorff Perfused Rabbit Ventricles

PubMed Central

Joung, Boyoung; Park, Hyung-Wook; Maruyama, Mitsunori; Tang, Liang; Song, Juan; Han, Seongwook; Piccirillo, Gianfranco; Weiss, James N.; Lin, Shien-Fong; Chen, Peng-Sheng

2012-01-01

Background Anodal stimulation hyperpolarizes cell membrane and increases intracellular Ca2+ (Cai) transient. This study tested the hypothesis that The maximum slope of Cai decline (–(dCai/dt)max) corresponds to the timing of anodal dip on the strength-interval curve and the initiation of repetitive responses and ventricular fibrillation (VF) after a premature stimulus (S2). Methods and Results We simultaneously mapped membrane potential (Vm) and Cai in 23 rabbit ventricles. A dip was observed on the anodal strength-interval curve. During the anodal dip, ventricles were captured by anodal break excitation directly under the S2 electrode. The Cai following anodal stimuli is larger than that following cathodal stimuli. The S1-S2 intervals of the anodal dip (203 ± 10 ms) coincided with the -(dCai/dt)max (199 ± 10 ms, p=NS). BAPTA-AM (n=3), INCX inhibition by low extracellular Na+ (n=3), and combined ryanodine and thapsigargin infusion (n=2) eliminated the anodal supernormality. Strong S2 during the relative refractory period (n=5) induced 29 repetitive responses and 10 VF episodes. The interval between S2 and the first non-driven beat was coincidental with the time of -(dCai/dt)max. Conclusions Larger Cai transient and INCX activation induced by anodal stimulation produces anodal supernormality. Time of maximum INCX activation is coincidental to the induction of non- driven beats from the Cai sinkhole after a strong premature stimulation. PMID:21301131

The relationship between initial route of heroin administration and speed of transition to daily heroin use.

PubMed

Hines, Lindsey A; Lynskey, Michael; Morley, Katherine I; Griffiths, Paul; Gossop, Michael; Powis, Beverly; Strang, John

2017-09-01

The effect of heroin administration route on speed of transition to regular use is unknown. This paper aims to determine whether the speed of transition from initiation of heroin use to daily heroin use differs by route of administration (injecting, chasing/inhaling or snorting). Privileged access interviewer survey of purposively selected sample of 395 current people who use heroin (both in and not in treatment) in London, UK (historical sample from 1991). Data on age and year of initiation, time from initiation to daily use and routes of administration were collected by means of a structured questionnaire. Generalised ordered logistic models were used to test the relationship between route of initial administration of heroin and speed of transition to daily heroin use. Analyses were adjusted for gender, ethnicity, daily use of other drug(s) at time of initiation, year of initiation and treatment status at interview. After adjustment, participants whose initial administration route was injecting had a 4.71 (95% confidence interval 1.34-16.5) increase in likelihood of progressing to daily use within 1-3 weeks of initiation, compared to those whose initial administration route was non-injecting. The speed of transition from first use to daily heroin use is faster if the individual injects heroin at initiation of use. Those who initiate heroin use through injecting have a shorter time frame for intervention before drug use escalation. [Hines LA, Lynskey M, Morley KI, Griffiths P, Gossop M, Powis B, Strang J. The relationship between initial route of heroin administration and speed of transition to daily heroin use. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Robust fixed-time synchronization for uncertain complex-valued neural networks with discontinuous activation functions.

PubMed

Ding, Xiaoshuai; Cao, Jinde; Alsaedi, Ahmed; Alsaadi, Fuad E; Hayat, Tasawar

2017-06-01

This paper is concerned with the fixed-time synchronization for a class of complex-valued neural networks in the presence of discontinuous activation functions and parameter uncertainties. Fixed-time synchronization not only claims that the considered master-slave system realizes synchronization within a finite time segment, but also requires a uniform upper bound for such time intervals for all initial synchronization errors. To accomplish the target of fixed-time synchronization, a novel feedback control procedure is designed for the slave neural networks. By means of the Filippov discontinuity theories and Lyapunov stability theories, some sufficient conditions are established for the selection of control parameters to guarantee synchronization within a fixed time, while an upper bound of the settling time is acquired as well, which allows to be modulated to predefined values independently on initial conditions. Additionally, criteria of modified controller for assurance of fixed-time anti-synchronization are also derived for the same system. An example is included to illustrate the proposed methodologies. Copyright © 2017 Elsevier Ltd. All rights reserved.

A case series of re-establishment of neuromuscular block with rocuronium after sugammadex reversal.

PubMed

Iwasaki, Hajime; Sasakawa, Tomoki; Takahoko, Kenichi; Takagi, Shunichi; Nakatsuka, Hideki; Suzuki, Takahiro; Iwasaki, Hiroshi

2016-06-01

We report the use of rocuronium to re-establish neuromuscular block after reversal with sugammadex. The aim of this study was to investigate the relationship between the dose of rocuronium needed to re-establish neuromuscular block and the time interval between sugammadex administration and re-administration of rocuronium. Patients who required re-establishment of neuromuscular block within 12 h after the reversal of rocuronium-induced neuromuscular block with sugammadex were included. After inducing general anesthesia and placing the neuromuscular monitor, the protocol to re-establish neuromuscular block was as follows. An initial rocuronium dose of 0.6 mg/kg was followed by additional 0.3 mg/kg doses every 2 min until train-of-four responses were abolished. A total of 11 patients were enrolled in this study. Intervals between sugammadex and second rocuronium were 12-465 min. Total dose of rocuronium needed to re-establish neuromuscular block was 0.6-1.2 mg/kg. 0.6 mg/kg rocuronium re-established neuromuscular block in all patients who received initial sugammadex more than 3 h previously. However, when the interval between sugammadex and second rocuronium was less than 2 h, more than 0.6 mg/kg rocuronium was necessary to re-establish neuromuscular block.

ELECTRONIC SYSTEM

DOEpatents

Robison, G.H. et al.

1960-11-15

An electronic system is described for indicating the occurrence of a plurality of electrically detectable events within predetermined time intervals. It is comprised of separate input means electrically associated with the events under observation: an electronic channel associated with each input means including control means and indicating means; timing means associated with each of the input means and the control means and adapted to derive a signal from the input means and apply it after a predetermined time to the control means to effect deactivation of each of the channels; and means for resetting the system to its initial condition after observation of each group of events.

Confirmation of Romer's Gap as a low oxygen interval constraining the timing of initial arthropod and vertebrate terrestrialization

PubMed Central

Ward, Peter; Labandeira, Conrad; Laurin, Michel; Berner, Robert A.

2006-01-01

The first terrestrialization of species that evolved from previously aquatic taxa was a seminal event in evolutionary history. For vertebrates, one of the most important terrestrialized groups, this event was interrupted by a time interval known as Romer's Gap, for which, until recently, few fossils were known. Here, we argue that geochronologic range data of terrestrial arthropods show a pattern similar to that of vertebrates. Thus, Romer's Gap is real, occupied an interval from 360 million years before present (MYBP) to 345 MYBP, and occurred when environmental conditions were unfavorable for air-breathing, terrestrial animals. These model results suggest that atmospheric oxygen levels were the major driver of successful terrestrialization, and a low-oxygen interval accounts for Romer's Gap. Results also show that terrestrialization among members of arthropod and vertebrate clades occurred in two distinct phases. The first phase was a 65-million-year (My) interval from 425 to 360 MYBP, representing an earlier, prolonged event of complete arthropod terrestrialization of smaller-sized forms (425–385 MYBP) and a subsequent, modest, and briefer event of incipient terrestrialization of larger-sized, aquatic vertebrates (385–360 MYBP). The second phase began at 345 MYBP, characterized by numerous new terrestrial species emerging in both major clades. The first and second terrestrialization phases bracket Romer's Gap, which represents a depauperate spectrum of major arthropod and vertebrate taxa before a major Late Paleozoic colonization of terrestrial habitats. PMID:17065318

Impact of heart disease and calibration interval on accuracy of pulse transit time-based blood pressure estimation.

PubMed

Ding, Xiaorong; Zhang, Yuanting; Tsang, Hon Ki

2016-02-01

Continuous blood pressure (BP) measurement without a cuff is advantageous for the early detection and prevention of hypertension. The pulse transit time (PTT) method has proven to be promising for continuous cuffless BP measurement. However, the problem of accuracy is one of the most challenging aspects before the large-scale clinical application of this method. Since PTT-based BP estimation relies primarily on the relationship between PTT and BP under certain assumptions, estimation accuracy will be affected by cardiovascular disorders that impair this relationship and by the calibration frequency, which may violate these assumptions. This study sought to examine the impact of heart disease and the calibration interval on the accuracy of PTT-based BP estimation. The accuracy of a PTT-BP algorithm was investigated in 37 healthy subjects and 48 patients with heart disease at different calibration intervals, namely 15 min, 2 weeks, and 1 month after initial calibration. The results showed that the overall accuracy of systolic BP estimation was significantly lower in subjects with heart disease than in healthy subjects, but diastolic BP estimation was more accurate in patients than in healthy subjects. The accuracy of systolic and diastolic BP estimation becomes less reliable with longer calibration intervals. These findings demonstrate that both heart disease and the calibration interval can influence the accuracy of PTT-based BP estimation and should be taken into consideration to improve estimation accuracy.

Initial Systolic Time Interval (ISTI) as a Predictor of Intradialytic Hypotension (IDH)

NASA Astrophysics Data System (ADS)

Biesheuvel, J. D.; Vervloet, M. G.; Verdaasdonk, R. M.; Meijer, J. H.

2013-04-01

In haemodialysis treatment the clearance and volume control by the kidneys of a patient are partially replaced by intermittent haemodialysis. Because this artificial process is performed on a limited time scale, unphysiological imbalances in the fluid compartments of the body occur, that can lead to intradialytic hypotensions (IDH). An IDH endangers the efficacy of the haemodialysis session and is associated with dismal clinical endpoints, including mortality. A diagnostic method that predicts the occurrence of these drops in blood pressure could facilitate timely measures for the prevention of IDH. The present study investigates whether the Initial Systolic Time Interval (ISTI) can provide such a diagnostic method. The ISTI is defined as the time difference between the R-peak in the electrocardiogram (ECG) and the C-wave in the impedance cardiogram (ICG) and is considered to be a non-invasive assessment of the time delay between the electrical and mechanical activity of the heart. This time delay has previously been found to depend on autonomic nervous function as well as preload of the heart. Therefore, it can be expected that ISTI may predict an imminent IDH caused by a low circulating blood volume. This ongoing observational clinical study investigates the relationship between changes in ISTI and subsequent drops in blood pressure during haemodialysis. A registration of a complicated dialysis showed a significant correlation between a drop in blood pressure, a decrease in relative blood volume and a substantial increase in ISTI. An uncomplicated dialysis, in which also a considerable amount of fluid was removed, showed no correlations. Both, blood pressure and ISTI remained stable. In conclusion, the preliminary results of the present study show a substantial response of ISTI to haemodynamic instability, indicating an application in optimization and individualisation of the dialysis process.

Novel method for high-throughput phenotyping of sleep in mice.

PubMed

Pack, Allan I; Galante, Raymond J; Maislin, Greg; Cater, Jacqueline; Metaxas, Dimitris; Lu, Shan; Zhang, Lin; Von Smith, Randy; Kay, Timothy; Lian, Jie; Svenson, Karen; Peters, Luanne L

2007-01-17

Assessment of sleep in mice currently requires initial implantation of chronic electrodes for assessment of electroencephalogram (EEG) and electromyogram (EMG) followed by time to recover from surgery. Hence, it is not ideal for high-throughput screening. To address this deficiency, a method of assessment of sleep and wakefulness in mice has been developed based on assessment of activity/inactivity either by digital video analysis or by breaking infrared beams in the mouse cage. It is based on the algorithm that any episode of continuous inactivity of > or =40 s is predicted to be sleep. The method gives excellent agreement in C57BL/6J male mice with simultaneous assessment of sleep by EEG/EMG recording. The average agreement over 8,640 10-s epochs in 24 h is 92% (n = 7 mice) with agreement in individual mice being 88-94%. Average EEG/EMG determined sleep per 2-h interval across the day was 59.4 min. The estimated mean difference (bias) per 2-h interval between inactivity-defined sleep and EEG/EMG-defined sleep was only 1.0 min (95% confidence interval for mean bias -0.06 to +2.6 min). The standard deviation of differences (precision) was 7.5 min per 2-h interval with 95% limits of agreement ranging from -13.7 to +15.7 min. Although bias significantly varied by time of day (P = 0.0007), the magnitude of time-of-day differences was not large (average bias during lights on and lights off was +5.0 and -3.0 min per 2-h interval, respectively). This method has applications in chemical mutagenesis and for studies of molecular changes in brain with sleep/wakefulness.

Initiating/maintaining long-acting injectable antipsychotics in schizophrenia/schizoaffective or bipolar disorder - expert consensus survey part 2.

PubMed

Sajatovic, Martha; Ross, Ruth; Legacy, Susan N; Byerly, Matthew; Kane, John M; DiBiasi, Faith; Fitzgerald, Heather; Correll, Christoph U

2018-01-01

The aim of this study was to provide recommendations on initiating and maintaining long-acting injectable antipsychotics (LAIs) in individuals with schizophrenia/schizoaffective or bipolar disorder. A 50-question survey comprising 916 response options was completed by 34 expert researchers and high prescribers with extensive LAI experience, rating relative appropriateness/importance on a 9-point scale. Consensus was determined using chi-square test of score distributions. Results of 21 questions comprising 339 response options regarding LAI initiation, maintenance treatment, adequate trial definition, identifying treatment nonresponse, and switching are reported. Experts agreed that the most important LAI selection factor was patient response/tolerability to previous antipsychotics. An adequate therapeutic LAI trial was defined as the time to steady state ± 1-2 injection cycles. Experts suggested that oral efficacy and tolerability should be established before switching to an LAI, without consensus on the required time, and that the time for oral supplementation and next injection interval should be determined by the time to attainment of therapeutic LAI levels. Most experts agreed that ≥1 adequate LAI trial is needed to identify the lack of efficacy. There was little agreement about strategies for switching between LAIs. Expert guidance may aid clinicians in their decisions regarding initiating/maintaining LAIs in individuals with schizophrenia/schizoaffective or bipolar disorder.

Assessment of Micro-Basin Tillage as a Soil and Water Conservation Practice in the Black Soil Region of Northeast China.

PubMed

Sui, Yuanyuan; Ou, Yang; Yan, Baixing; Xu, Xiaohong; Rousseau, Alain N; Zhang, Yu

2016-01-01

Micro-basin tillage is a soil and water conservation practice that requires building individual earth blocks along furrows. In this study, plot experiments were conducted to assess the efficiency of micro-basin tillage on sloping croplands between 2012 and 2013 (5°and 7°). The conceptual, optimal, block interval model was used to design micro-basins which are meant to capture the maximum amount of water per unit area. Results indicated that when compared to the up-down slope tillage, micro-basin tillage could increase soil water content and maize yield by about 45% and 17%, and reduce runoff, sediment and nutrients loads by about 63%, 96% and 86%, respectively. Meanwhile, micro-basin tillage could reduce the peak runoff rates and delay the initial runoff-yielding time. In addition, micro-basin tillage with the optimal block interval proved to be the best one among all treatments with different intervals. Compared with treatments of other block intervals, the optimal block interval treatments increased soil moisture by around 10% and reduced runoff rate by around 15%. In general, micro-basin tillage with optimal block interval represents an effective soil and water conservation practice for sloping farmland of the black soil region.

Assessment of Micro-Basin Tillage as a Soil and Water Conservation Practice in the Black Soil Region of Northeast China

PubMed Central

Sui, Yuanyuan; Ou, Yang; Yan, Baixing; Xu, Xiaohong; Rousseau, Alain N.; Zhang, Yu

2016-01-01

Micro-basin tillage is a soil and water conservation practice that requires building individual earth blocks along furrows. In this study, plot experiments were conducted to assess the efficiency of micro-basin tillage on sloping croplands between 2012 and 2013 (5°and 7°). The conceptual, optimal, block interval model was used to design micro-basins which are meant to capture the maximum amount of water per unit area. Results indicated that when compared to the up-down slope tillage, micro-basin tillage could increase soil water content and maize yield by about 45% and 17%, and reduce runoff, sediment and nutrients loads by about 63%, 96% and 86%, respectively. Meanwhile, micro-basin tillage could reduce the peak runoff rates and delay the initial runoff-yielding time. In addition, micro-basin tillage with the optimal block interval proved to be the best one among all treatments with different intervals. Compared with treatments of other block intervals, the optimal block interval treatments increased soil moisture by around 10% and reduced runoff rate by around 15%. In general, micro-basin tillage with optimal block interval represents an effective soil and water conservation practice for sloping farmland of the black soil region. PMID:27031339

Convergence of the Full Compressible Navier-Stokes-Maxwell System to the Incompressible Magnetohydrodynamic Equations in a Bounded Domain II: Global Existence Case

NASA Astrophysics Data System (ADS)

Fan, Jishan; Li, Fucai; Nakamura, Gen

2018-06-01

In this paper we continue our study on the establishment of uniform estimates of strong solutions with respect to the Mach number and the dielectric constant to the full compressible Navier-Stokes-Maxwell system in a bounded domain Ω \\subset R^3. In Fan et al. (Kinet Relat Models 9:443-453, 2016), the uniform estimates have been obtained for large initial data in a short time interval. Here we shall show that the uniform estimates exist globally if the initial data are small. Based on these uniform estimates, we obtain the convergence of the full compressible Navier-Stokes-Maxwell system to the incompressible magnetohydrodynamic equations for well-prepared initial data.

Bioactivity of gelatin coated magnetic iron oxide nanoparticles: in vitro evaluation.

PubMed

Gaihre, Babita; Khil, Myung Seob; Kang, Hyo Kyoung; Kim, Hak Yong

2009-02-01

Current research explores formation of bone like apatite on gelatin coated magnetic iron oxide nanoparticles (GIOPs) to evaluate the bioactivity of the material. The GIOPs were soaked in simulated body fluid (SBF) and the apatite formation on the surface was investigated in regular interval of time. Fourier transform-infrared (FT-IR) and x-ray diffraction spectroscopic (XRD) analyses were done to investigate the chemical changes and field emission-scanning electron microscopic (FE-SEM) analysis was done to investigate the morphological changes occurring on the surface of the GIOPs after soaking in different time intervals. The kinetic studies of the apatite growth in SBF suggest that initially calcium and phosphorous ions were deposited to the surface of the GIOPs from the SBF leading to formation of amorphous Ca/P particles. Later, after 9 days of the incubation the amorphous particles were fused to form needle and blade like crystalline structures of bone like apatite.

Application of carbon nanotube hold-off voltage for determining gas composition

NASA Technical Reports Server (NTRS)

Schipper, John F. (Inventor); Li, Jing (Inventor)

2009-01-01

Method and system for determining chemical composition of a single-component or multiple-component gas, using a discharge holdoff mechanism. A voltage difference V between two spaced apart electrodes is brought to a selected value and held, the holdoff time interval .DELTA.t(V;ho) required before gas discharge occurs is measured, and the associated electrical current or cumulative electrical charge is measured. As the voltage difference V increases, the time interval length .DELTA.t(V;ho) decreases monotonically. Particular voltage values, V.sub..infin. and V.sub.0, correspond to initial appearance of discharge (.DELTA.t.apprxeq..infin.) and prompt discharge (.DELTA.t.apprxeq.0). The values V.sub..infin. and V.sub.0 and the rate of decrease of .DELTA.t(V;ho) and/or the rate of increase of current or cumulative charge with increasing V are characteristic of one or more gas components present.

Does the risk of peritoneal dialysis-associated peritonitis vary by time on treatment?

PubMed

Perl, Jeffrey; Parpia, Sameer; Nessim, Sharon J

2016-04-01

Early retraining of patients/caregivers at 3 months after peritoneal dialysis (PD) initiation is recommended to prevent peritonitis. We sought to better understand if the risk of peritonitis was highest early after the initiation of PD and if the risk varied by time on therapy and by organism. Using the multicenter Canadian Baxter POET database, we studied 4,247 incident PD patients. Time on dialysis was divided into 3-month intervals over the first 2 years on PD, with 0 - 3 months serving as the reference period. After creating several organism categories (all organisms, coagulase-negative staphylococcus (CNS), Staphylococcus aureus, streptococcus, Gramnegative, culture-negative, and yeast), time to first peritonitis was analyzed by Kaplan-Meier analysis and using smooth hazard plots. The risk of peritonitis for each of these categories over time was then analyzed in a multivariable model after adjusting for potential confounding variables. The overall risk of peritonitis (all organisms) was greatest in the first 3 months on PD compared with all subsequent 3-month intervals (p = 0.001). Organism-specific analyses revealed an increased risk of culture-negative peritonitis in the first 3 months (p < 0.001) but no increased risk of CNS peritonitis or any of the other pre-specified organism categories. The overall risk of peritonitis was greatest in the first 3 months on PD and was largely driven by an increased risk of culture-negative peritonitis but not by CNS. Better understanding of this increased early peritonitis risk is warranted in order to develop strategies aimed at its prevention.

Supporting Building Portfolio Investment and Policy Decision Making through an Integrated Building Utility Data Platform

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

Aziz, Azizan; Lasternas, Bertrand; Alschuler, Elena

The American Recovery and Reinvestment Act stimulus funding of 2009 for smart grid projects resulted in the tripling of smart meters deployment. In 2012, the Green Button initiative provided utility customers with access to their real-time1 energy usage. The availability of finely granular data provides an enormous potential for energy data analytics and energy benchmarking. The sheer volume of time-series utility data from a large number of buildings also poses challenges in data collection, quality control, and database management for rigorous and meaningful analyses. In this paper, we will describe a building portfolio-level data analytics tool for operational optimization, businessmore » investment and policy assessment using 15-minute to monthly intervals utility data. The analytics tool is developed on top of the U.S. Department of Energy’s Standard Energy Efficiency Data (SEED) platform, an open source software application that manages energy performance data of large groups of buildings. To support the significantly large volume of granular interval data, we integrated a parallel time-series database to the existing relational database. The time-series database improves on the current utility data input, focusing on real-time data collection, storage, analytics and data quality control. The fully integrated data platform supports APIs for utility apps development by third party software developers. These apps will provide actionable intelligence for building owners and facilities managers. Unlike a commercial system, this platform is an open source platform funded by the U.S. Government, accessible to the public, researchers and other developers, to support initiatives in reducing building energy consumption.« less

Associated factors for treatment delay in pulmonary tuberculosis in HIV-infected individuals: a nested case-control study.

PubMed

Coimbra, Isabella; Maruza, Magda; Militão-Albuquerque, Maria de Fátima Pessoa; Moura, Líbia Vilela; Diniz, George Tadeu Nunes; Miranda-Filho, Demócrito de Barros; Lacerda, Heloísa Ramos; Rodrigues, Laura Cunha; Ximenes, Ricardo Arraes de Alencar

2012-09-07

The delay in initiating treatment for tuberculosis (TB) in HIV-infected individuals may lead to the development of a more severe form of the disease, with higher rates of morbidity, mortality and transmissibility. The aim of the present study was to estimate the time interval between the onset of symptoms and initiating treatment for TB in HIV-infected individuals, and to identify the factors associated to this delay. A nested case-control study was undertaken within a cohort of HIV-infected individuals, attended at two HIV referral centers, in the state of Pernambuco, Brazil. Delay in initiating treatment for TB was defined as the period of time, in days, which was greater than the median value between the onset of cough and initiating treatment for TB. The study analyzed biological, clinical, socioeconomic, and lifestyle factors as well as those related to HIV and TB infection, potentially associated to delay. The odds ratios were estimated with the respective confidence intervals and p-values. From a cohort of 2365 HIV-infected adults, 274 presented pulmonary TB and of these, 242 participated in the study. Patients were already attending 2 health services at the time they developed a cough (period range: 1 - 552 days), with a median value of 41 days. Factors associated to delay were: systemic symptoms asthenia, chest pain, use of illicit drugs and sputum smear-negative. The present study indirectly showed the difficulty of diagnosing TB in HIV-infected individuals and indicated the need for a better assessment of asthenia and chest pain as factors that may be present in co-infected patients. It is also necessary to discuss the role played by negative sputum smear results in diagnosing TB/HIV co-infection as well as the need to assess the best approach for drug users with TB/HIV.

A multicenter randomized trial indicates initial prednisolone treatment for childhood nephrotic syndrome for two months is not inferior to six-month treatment.

PubMed

Yoshikawa, Norishige; Nakanishi, Koichi; Sako, Mayumi; Oba, Mari S; Mori, Rintaro; Ota, Erika; Ishikura, Kenji; Hataya, Hiroshi; Honda, Masataka; Ito, Shuichi; Shima, Yuko; Kaito, Hiroshi; Nozu, Kandai; Nakamura, Hidefumi; Igarashi, Takashi; Ohashi, Yasuo; Iijima, Kazumoto

2015-01-01

In this multicenter, open-label, randomized controlled trial, we determined whether 2-month prednisolone therapy for steroid-sensitive nephrotic syndrome was inferior or not to 6-month therapy despite significantly less steroid exposure. The primary end point was time from start of initial treatment to start of frequently relapsing nephrotic syndrome. The pre-specified non-inferiority margin was a hazard ratio of 1.3 with one-sided significance of 5%. We randomly assigned 255 children with an initial episode of steroid-sensitive nephrotic syndrome to either 2 - or 6-month treatment of which 246 were eligible for final analysis. The total prednisolone exposure counted both initial and relapse prednisolone treatment administered over 24 months. Median follow-up in months was 36.7 in the 2-month and 38.2 in the 6-month treatment group. Time to frequent relaps was similar in both groups; however, the median was reached only in the 6-month group (799 days). The hazard ratio was 0.86 (90% confidence interval, 0.64-1.16) and met the non-inferior margin. Time to first relapse was also similar in both groups: median day 242 (2-month) and 243 (6-month). Frequency and severity of adverse events were similar in both groups. Most adverse events were transient and occurred during initial or relapse therapy. Thus, 2 months of initial prednisolone therapy for steroid-sensitive nephrotic syndrome, despite less prednisolone exposure, is not inferior to 6 months of initial therapy in terms of time to onset of frequently relapsing nephrotic syndrome.

Early appendectomy reduces costs in children with perforated appendicitis.

PubMed

Church, Joseph T; Klein, Edwin J; Carr, Benjamin D; Bruch, Steven W

2017-12-01

Perforated appendicitis can be managed with early appendectomy, or nonoperative management followed by interval appendectomy. We aimed to identify the strategy with the lowest health care utilization and cost. We retrospectively reviewed the medical records of all children ≤18 years old with perforated appendicitis admitted to a single institution between January 2009 and March 2016. After excluding immunosuppressed patients and transfers from outside hospitals, we grouped the remaining patients by early or interval appendectomy. Cost accounting data were obtained from our institutional database. The primary outcome was total hospital cost over 2 y from initial admission for appendicitis. Other outcomes analyzed included initial admission costs, number of admissions, emergency room and clinic visits, percutaneous procedures, cross-sectional and overall imaging studies, and length of stay. A total of 203 children with perforated appendicitis were identified. After exclusion of immunosuppressed patients and outside hospital transfers, 94 patients were included in the study. Thirty-nine underwent early appendectomy and 55 initial nonoperative management; of these, 54 underwent elective interval appendectomy. Five of 55 patients (9%) failed initial nonoperative management and required earlier-than-planned appendectomy. Total cost over 2 y was significantly lower with early appendectomy than initial nonoperative management ($19,300 ± 14,300 versus $26,000 ± 17,500; P = 0.05). Early appendectomy resulted in fewer hospital admissions, clinic visits, invasive procedures, and imaging studies. Early appendectomy results in lower hospital costs and less health care utilization compared with initial nonoperative management with elective interval appendectomy. A prospective study will shed more light on this question and can assess the role of nonoperative management without interval appendectomy in children with perforated appendicitis. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of an additional early visit to routine postpartum care on initiation of long-acting reversible contraception: a randomized trial.

PubMed

Bernard, Caitlin; Wan, Leping; Peipert, Jeffrey F; Madden, Tessa

2018-05-17

To investigate whether an early 3-week postpartum visit in addition to the standard 6-week visit increases LARC initiation by 8weeks postpartum compared to the routine 6-week visit alone. We enrolled pregnant and immediate postpartum women into a prospective randomized, non-blinded trial comparing a single 6-week postpartum visit (routine care) to two visits at 3 and 6weeks postpartum (intervention), with initiation of contraception at the 3-week visit, if desired. All participants received structured contraceptive counseling. Participants completed surveys in-person at baseline and at the time of each postpartum visit. A sample size of 200 total participants was needed to detect a 2-fold difference in LARC initiation (20% vs. 40%). Between May 2016 and March 2017, 200 participants enrolled; outcome data are available for 188. The majority of LARC initiation occurred immediately postpartum (25% of the intervention arm and 27% of the routine care arm). By 8weeks postpartum,34% of participants in the intervention arm initiated LARC, compared to 41% in the routine care arm (p=.35). Overall contraceptive initiation by 8weeks was 83% and84% in the intervention and routine care arms, respectively (p=.79). There was no difference between the arms in the proportion of women who attended at least one postpartum visit (70% vs. 74%, p=.56). The addition of a 3-week postpartum visit to routine care does not increase LARC initiation by 8weeks postpartum. The majority of LARC users desired immediate rather than interval postpartum initiation. Clinicaltrials.govNCT02769676 Implications. The addition of a 3-week postpartum visit to routine care does not increase LARC or overall contraceptive initiation by 8weeks post-partum when the option of immediate postpartum placement is available. The majority of LARC users desired immediate rather than interval postpartum initiation. Copyright © 2018. Published by Elsevier Inc.

Risk of fractures requiring hospitalization after an initial prescription for zolpidem, alprazolam, lorazepam, or diazepam in older adults.

PubMed

Finkle, William D; Der, Jane S; Greenland, Sander; Adams, John L; Ridgeway, Gregory; Blaschke, Terrance; Wang, Zixia; Dell, Richard M; VanRiper, Kurt B

2011-10-01

To determine whether zolpidem is a safer alternative to benzodiazepines. Retrospective cohort study. Community based. Health maintenance organization members with an initial prescription for zolpidem (n = 43,343), alprazolam (n = 103,790), lorazepam (n = 150,858), or diazepam (n = 93,618). Zolpidem and benzodiazepine prescriptions were identified from pharmacy databases. Rates of nonvertebral fractures and hip fractures requiring hospitalization were compared before and after an initial prescription for each treatment, adjusting for confounders using doubly robust estimation. In patients aged 65 and older, the rates of nonvertebral fractures and dislocations were similar in the pre- treatment intervals. The rate ratios (RRs) for the 90-day posttreatment interval relative to the pretreatment interval were 2.55 (95% confidence interval (CI) = 1.78-3.65; P < .001) for zolpidem, 1.14 (95% CI = 0.80-1.64; P = .42) for alprazolam, 1.53 (95% CI = 1.23-1.91; P < .001) for lorazepam, and 1.97 (95% CI = 1.22-3.18; P = .01) for diazepam. The ratio of RRs (RRR)-the RR in the posttreatment period adjusted for the corresponding RR in the pretreatment period-were 2.23 (95% CI = 1.36-3.66; P = .006) for zolpidem relative to alprazolam, 1.68 (95% CI = 1.12-2.53; P = .02) for zolpidem relative to lorazepam, and 1.29 (95% CI = 0.72-2.30; P = .32) for zolpidem relative to diazepam. The RRs decreased with time from the initial prescription (trend P < .001), as would be expected if the association is causal. In older adults, the risk of injury with zolpidem exceeded that with alprazolam and lorazepam and was similar to that with diazepam. If the associations are causal, then the high incidence of these fractures implies that these treatment induce a substantial number of fractures and consequential costs. Further study of the association is imperative. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

An apparatus for sequentially combining microvolumes of reagents by infrasonic mixing.

PubMed

Camien, M N; Warner, R C

1984-05-01

A method employing high-speed infrasonic mixing for obtaining timed samples for following the progress of a moderately rapid chemical reaction is described. Drops of 10 to 50 microliter each of two reagents are mixed to initiate the reaction, followed, after a measured time interval, by mixing with a drop of a third reagent to quench the reaction. The method was developed for measuring the rate of denaturation of covalently closed, circular DNA in NaOH at several temperatures. For this purpose the timed samples were analyzed by analytical ultracentrifugation. The apparatus was tested by determination of the rate of hydrolysis of 2,4-dinitrophenyl acetate in an alkaline buffer. The important characteristics of the method are (i) it requires very small volumes of sample and reagents; (ii) the components of the reaction mixture are pre-equilibrated and mixed with no transfer outside the prescribed constant temperature environment; (iii) the mixing is very rapid; and (iv) satisfactorily precise measurements of relatively short time intervals (approximately 2 sec minimum) between sequential mixings of the components are readily obtainable.

An Intervention to Reduce the Time Interval Between Hospital Entry and Emergency Coronary Angiography in Patients with ST-Elevation Myocardial Infarction.

PubMed

Karkabi, Basheer; Jaffe, Ronen; Halon, David A; Merdler, Amnon; Khader, Nader; Rubinshtein, Ronen; Goldstein, Jacob; Zafrir, Barak; Zissman, Keren; Ben-Dov, Nissan; Gabrielly, Michael; Fuks, Alex; Shiran, Avinoam; Adawi, Salim; Hellman, Yaron; Shahla, Johny; Halabi, Salim; Flugelman, Moshe Y; Cohen, Shai; Bergman, Irina; Kassem, Sameer; Shapira, Chen

2017-09-01

Outcomes of patients with acute ST-elevation myocardial infarction (STEMI) are strongly correlated to the time interval from hospital entry to primary percutaneous coronary intervention (PPCI). Current guidelines recommend a door to balloon time of < 90 minutes. To reduce the time from hospital admission to PPCI and to increase the proportion of patients treated within 90 minutes. In March 2013 the authors launched a seven-component intervention program:  Direct patient evacuation by out-of-hospital emergency medical services to the coronary intensive care unit or catheterization laboratory Education program for the emergency department staff Dissemination of information regarding the urgency of the PPCI decision Activation of the catheterization team by a single phone call Reimbursement for transportation costs to on-call staff who use their own cars Improvement in the quality of medical records Investigation of failed cases and feedback. During the 14 months prior to the intervention, initiation of catheterization occurred within 90 minutes of hospital arrival in 88/133 patients(65%); during the 18 months following the start of the intervention, the rate was 181/200 (90%) (P < 0.01). The respective mean/median times to treatment were 126/67 minutes and 52/47 minutes (P < 0.01). Intervention also resulted in shortening of the time interval from hospital entry to PPCI on nights and weekends. Following implementation of a comprehensive intervention, the time from hospital admission to PPCI of STEMI patients shortened significantly, as did the proportion of patients treated within 90 minutes of hospital arrival.

Proceedings of Annual Precise Time and Time Interval (PTTI) Applications and Planning Meeting (23rd) held in Pasadena, California on December 3-5, 1991

DTIC Science & Technology

1991-12-05

second overshoot. Automatic steering was turned off for 9 days following the initial undershoot ( 48120 to 48129) and turned off from 48160 to the end...35780 0.08 A A 0.04 AA A A A35776 AA A A A AA A A A AL’ AA I- A 12 ,- U.U A __,, 0.00 . A A k 35772 I I I I I I -0.04 48000 48030 48060 48090 48120

Cost trend analysis of initial cancer treatment in Taiwan.

PubMed

Li, Tsai-Yun; Hsieh, Jan-Sing; Lee, King-Teh; Hou, Ming-Feng; Wu, Chia-Ling; Kao, Hao-Yun; Shi, Hon-Yi

2014-01-01

Despite the high cost of initial cancer care, that is, care in the first year after diagnosis, limited information is available for specific categories of cancer-related costs, especially costs for specific services. This study purposed to identify causes of change in cancer treatment costs over time and to perform trend analyses of the percentage of cancer patients who had received a specific treatment type and the mean cost of care for patients who had received that treatment. The analysis of trends in initial treatment costs focused on cancer-related surgery, chemotherapy, radiation therapy, and treatments other than active treatments. For each cancer-specific trend, slopes were calculated for regression models with 95% confidence intervals. Analyses of patients diagnosed in 2007 showed that the National Health Insurance (NHI) system paid, on average, $10,780 for initial care of a gastric cancer patient and $10,681 for initial care of a lung cancer patient, which were inflation-adjusted increases of $6,234 and $5,522, respectively, over the 1996 care costs. During the same interval, the mean NHI payment for initial care for the five specific cancers increased significantly (p<0.05). Hospitalization costs comprised the largest portion of payments for all cancers. During 1996-2007, the use of chemotherapy and radiation therapy significantly increased in all cancer types (p<0.05). In 2007, NHI payments for initial care for these five cancers exceeded $12 billion, and gastric and lung cancers accounted for the largest share. In addition to the growing number of NHI beneficiaries with cancer, treatment costs and the percentage of patients who undergo treatment are growing. Therefore, the NHI must accurately predict the economic burden of new chemotherapy agents and radiation therapies and may need to develop programs for stratifying patients according to their potential benefit from these expensive treatments.

E-Cigarettes and Future Cigarette Use

PubMed Central

Urman, Robert; Berhane, Kiros; Unger, Jennifer B.; Cruz, Tess Boley; Pentz, Mary Ann; Samet, Jonathan M.; Leventhal, Adam M.; McConnell, Rob

2016-01-01

BACKGROUND: There has been little research examining whether e-cigarette use increases the risk of cigarette initiation among adolescents in the transition to adulthood when the sale of cigarettes becomes legal. METHODS: The Children’s Health Study is a prospectively followed cohort in Southern California. Data on e-cigarette use were collected in 11th and 12th grade (mean age = 17.4); follow-up data on tobacco product use were collected an average of 16 months later from never-smoking e-cigarette users at initial evaluation (n = 146) and from a sample of never-smoking, never e-cigarette users (n = 152) frequency matched to e-cigarette users on gender, ethnicity, and grade. RESULTS: Cigarette initiation during follow-up was reported by 40.4% of e-cigarette users (n = 59) and 10.5% of never users (n = 16). E-cigarette users had 6.17 times (95% confidence interval: 3.30–11.6) the odds of initiating cigarettes as never e-cigarette users. Results were robust to adjustment for potential confounders and in analyses restricted to never users of any combustible tobacco product. Associations were stronger in adolescents with no intention of smoking at initial evaluation. E-cigarette users were also more likely to initiate use of any combustible product (odds ratio = 4.98; 95% confidence interval: 2.37–10.4), including hookah, cigars, or pipes. CONCLUSIONS: E-cigarette use in never-smoking youth may increase risk of subsequent initiation of cigarettes and other combustible products during the transition to adulthood when the purchase of tobacco products becomes legal. Stronger associations in participants with no intention of smoking suggests that e-cigarette use was not simply a marker for individuals who would have gone on to smoke regardless of e-cigarette use. PMID:27296866

E-Cigarettes and Future Cigarette Use.

PubMed

Barrington-Trimis, Jessica L; Urman, Robert; Berhane, Kiros; Unger, Jennifer B; Cruz, Tess Boley; Pentz, Mary Ann; Samet, Jonathan M; Leventhal, Adam M; McConnell, Rob

2016-07-01

There has been little research examining whether e-cigarette use increases the risk of cigarette initiation among adolescents in the transition to adulthood when the sale of cigarettes becomes legal. The Children's Health Study is a prospectively followed cohort in Southern California. Data on e-cigarette use were collected in 11th and 12th grade (mean age = 17.4); follow-up data on tobacco product use were collected an average of 16 months later from never-smoking e-cigarette users at initial evaluation (n = 146) and from a sample of never-smoking, never e-cigarette users (n = 152) frequency matched to e-cigarette users on gender, ethnicity, and grade. Cigarette initiation during follow-up was reported by 40.4% of e-cigarette users (n = 59) and 10.5% of never users (n = 16). E-cigarette users had 6.17 times (95% confidence interval: 3.30-11.6) the odds of initiating cigarettes as never e-cigarette users. Results were robust to adjustment for potential confounders and in analyses restricted to never users of any combustible tobacco product. Associations were stronger in adolescents with no intention of smoking at initial evaluation. E-cigarette users were also more likely to initiate use of any combustible product (odds ratio = 4.98; 95% confidence interval: 2.37-10.4), including hookah, cigars, or pipes. E-cigarette use in never-smoking youth may increase risk of subsequent initiation of cigarettes and other combustible products during the transition to adulthood when the purchase of tobacco products becomes legal. Stronger associations in participants with no intention of smoking suggests that e-cigarette use was not simply a marker for individuals who would have gone on to smoke regardless of e-cigarette use. Copyright © 2016 by the American Academy of Pediatrics.

Evaluating Protocol Lifecycle Time Intervals in HIV/AIDS Clinical Trials

PubMed Central

Schouten, Jeffrey T.; Dixon, Dennis; Varghese, Suresh; Cope, Marie T.; Marci, Joe; Kagan, Jonathan M.

2014-01-01

Background Identifying efficacious interventions for the prevention and treatment of human diseases depends on the efficient development and implementation of controlled clinical trials. Essential to reducing the time and burden of completing the clinical trial lifecycle is determining which aspects take the longest, delay other stages, and may lead to better resource utilization without diminishing scientific quality, safety, or the protection of human subjects. Purpose In this study we modeled time-to-event data to explore relationships between clinical trial protocol development and implementation times, as well as identify potential correlates of prolonged development and implementation. Methods We obtained time interval and participant accrual data from 111 interventional clinical trials initiated between 2006 and 2011 by NIH’s HIV/AIDS Clinical Trials Networks. We determined the time (in days) required to complete defined phases of clinical trial protocol development and implementation. Kaplan-Meier estimates were used to assess the rates at which protocols reached specified terminal events, stratified by study purpose (therapeutic, prevention) and phase group (pilot/phase I, phase II, and phase III/ IV). We also examined several potential correlates to prolonged development and implementation intervals. Results Even though phase grouping did not determine development or implementation times of either therapeutic or prevention studies, overall we observed wide variation in protocol development times. Moreover, we detected a trend toward phase III/IV therapeutic protocols exhibiting longer developmental (median 2 ½ years) and implementation times (>3years). We also found that protocols exceeding the median number of days for completing the development interval had significantly longer implementation. Limitations The use of a relatively small set of protocols may have limited our ability to detect differences across phase groupings. Some timing effects present for a specific study phase may have been masked by combining protocols into phase groupings. Presence of informative censoring, such as withdrawal of some protocols from development if they began showing signs of lost interest among investigators, complicates interpretation of Kaplan-Meier estimates. Because this study constitutes a retrospective examination over an extended period of time, it does not allow for the precise identification of relative factors impacting timing. Conclusions Delays not only increase the time and cost to complete clinical trials, but they also diminish their usefulness by failing to answer research questions in time. We believe that research analyzing the time spent traversing defined intervals across the clinical trial protocol development and implementation continuum can stimulate business process analyses and reengineering efforts that could lead to reductions in the time from clinical trial concept to results, thereby accelerating progress in clinical research. PMID:24980279

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

PubMed

Talving, Peep; Pålstedt, Joakim; Riddez, Louis

2005-01-01

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

Incidence and timing of cancer in HIV-infected individuals following initiation of combination antiretroviral therapy.

PubMed

Yanik, Elizabeth L; Napravnik, Sonia; Cole, Stephen R; Achenbach, Chad J; Gopal, Satish; Olshan, Andrew; Dittmer, Dirk P; Kitahata, Mari M; Mugavero, Michael J; Saag, Michael; Moore, Richard D; Mayer, Kenneth; Mathews, W Christopher; Hunt, Peter W; Rodriguez, Benigno; Eron, Joseph J

2013-09-01

Cancer is an important cause of morbidity and mortality in individuals infected with human immunodeficiency virus (HIV), but patterns of cancer incidence after combination antiretroviral therapy (ART) initiation remain poorly characterized. We evaluated the incidence and timing of cancer diagnoses among patients initiating ART between 1996 and 2011 in a collaboration of 8 US clinical HIV cohorts. Poisson regression was used to estimate incidence rates. Cox regression was used to identify demographic and clinical characteristics associated with cancer incidence after ART initiation. At initiation of first combination ART among 11 485 patients, median year was 2004 (interquartile range [IQR], 2000-2007) and median CD4 count was 202 cells/mm(3) (IQR, 61-338). Incidence rates for Kaposi sarcoma (KS) and lymphomas were highest in the first 6 months after ART initiation (P < .001) and plateaued thereafter, while incidence rates for all other cancers combined increased from 416 to 615 cases per 100 000 person-years from 1 to 10 years after ART initiation (average 7% increase per year; 95% confidence interval, 2%-13%). Lower CD4 count at ART initiation was associated with greater risk of KS, lymphoma, and human papillomavirus-related cancer. Calendar year of ART initiation was not associated with cancer incidence. KS and lymphoma rates were highest immediately following ART initiation, particularly among patients with low CD4 cell counts, whereas other cancers increased with time on ART, likely reflecting increased cancer risk with aging. Our results underscore recommendations for earlier HIV diagnosis followed by prompt ART initiation along with ongoing aggressive cancer screening and prevention efforts throughout the course of HIV care.

The orbital evolution of the AMOR asteroidal group during 11,550 years

NASA Astrophysics Data System (ADS)

Babadzhanov, P. B.; Zausaev, A. F.; Pushkaryov, A. N.

The orbital evolution of twenty seven Amor asteroids was determined by the Everhart method for the time interval from 2250 AD to 9300 BC. Closest encounters with terrestrial planets are calculated in the evolution process. Stable resonances with Venus, Earth and Jupiter over the period from 2250 AD to 9300 BC have been obtained. Theoretical coordinates of radiants on initial and final moments of integrating were calculated.

Effect of Light/Dark Cycle on Wheel Running and Responding Reinforced by the Opportunity to Run Depends on Postsession Feeding Time

ERIC Educational Resources Information Center

Belke, T. W.; Mondona, A. R.; Conrad, K. M.; Poirier, K. F.; Pickering, K. L.

2008-01-01

Do rats run and respond at a higher rate to run during the dark phase when they are typically more active? To answer this question, Long Evans rats were exposed to a response-initiated variable interval 30-s schedule of wheel-running reinforcement during light and dark cycles. Wheel-running and local lever-pressing rates increased modestly during…

A string of Peregrine rogue waves in the nonlocal nonlinear Schrödinger equation with parity-time symmetric self-induced potential

NASA Astrophysics Data System (ADS)

Gupta, Samit Kumar

2018-03-01

Dynamic wave localization phenomena draw fundamental and technological interests in optics and photonics. Based on the recently proposed (Ablowitz and Musslimani, 2013) continuous nonlocal nonlinear Schrödinger system with parity-time symmetric Kerr nonlinearity (PTNLSE), a numerical investigation has been carried out for two first order Peregrine solitons as the initial ansatz. Peregrine soliton, as an exact solution to the PTNLSE, evokes a very potent question: what effects does the interaction of two first order Peregrine solitons have on the overall optical field dynamics. Upon numerical computation, we observe the appearance of Kuznetsov-Ma (KM) soliton trains in the unbroken PT-phase when the initial Peregrine solitons are in phase. In the out of phase condition, it shows repulsive nonlinear waves. Quite interestingly, our study shows that within a specific range of the interval factor in the transverse co-ordinate there exists a string of high intensity well-localized Peregrine rogue waves in the PT unbroken phase. We note that the interval factor as well as the transverse shift parameter play important roles in the nonlinear interaction and evolution dynamics of the optical fields. This could be important in developing fundamental understanding of nonlocal non-Hermitian NLSE systems and dynamic wave localization behaviors.

Response of the everglades ridge and slough landscape to climate variability and 20th-century water management

USGS Publications Warehouse

Bernhardt, C.E.; Willard, D.A.

2009-01-01

The ridge and slough landscape of the Florida Everglades consists of a mosaic of linear sawgrass ridges separated by deeper-water sloughs with tree islands interspersed throughout the landscape. We used pollen assemblages from transects of sediment cores spanning sawgrass ridges, sloughs, and ridge-slough transition zones to determine the timing of ridge and slough formation and to evaluate the response of components of the ridge and slough landscape to climate variability and 20th-century water management. These pollen data indicate that sawgrass ridges and sloughs have been vegetationally distinct from one another since initiation of the Everglades wetland in mid-Holocene time. Although the position and community composition of sloughs have remained relatively stable throughout their history, modern sawgrass ridges formed on sites that originally were occupied by marshes. Ridge formation and maturation were initiated during intervals of drier climate (the Medieval Warm Period and the Little Ice Age) when the mean position of the Intertropical Convergence Zone shifted southward. During these drier intervals, marsh taxa were more common in sloughs, but they quickly receded when precipitation increased. Comparison with regional climate records suggests that slough vegetation is strongly influenced by North Atlantic Oscillation variability, even under 20th-century water management practices. ?? 2009 by the Ecological Society of America.

Monthly and annual percentage levels of wind speed differences computed by using FPS-16 radar/Jimsphere wind profile data from Cape Kennedy, Florida

NASA Technical Reports Server (NTRS)

Susko, M.; Kaufman, J. W.

1973-01-01

The percentage levels of wind speed differences are presented computed from sequential FPS-16 radar/Jimsphere wind profiles. The results are based on monthly profiles obtained from December 1964 to July 1970 at Cape Kennedy, Florida. The profile sequences contain a series of three to ten Jimspheres released at approximately 1.5-hour intervals. The results given are the persistence analysis of wind speed difference at 1.5-hour intervals to a maximum time interval of 12 hours. The monthly percentage of wind speed differences and the annual percentage of wind speed differences are tabulated. The percentage levels are based on the scalar wind speed changes calculated over an altitude interval of approximately 50 meters and printed out every 25 meters as a function of initial wind speed within each five-kilometer layer from near sea level to 20 km. In addition, analyses were made of the wind speed difference for the 0.2 to 1 km layer as an aid for studies associated with take-off and landing of the space shuttle.

Insurance-Based Differences in Time to Diagnostic Follow-up after Positive Screening Mammography.

PubMed

Durham, Danielle D; Robinson, Whitney R; Lee, Sheila S; Wheeler, Stephanie B; Reeder-Hayes, Katherine E; Bowling, J Michael; Olshan, Andrew F; Henderson, Louise M

2016-11-01

Insurance may lengthen or inhibit time to follow-up after positive screening mammography. We assessed the association between insurance status and time to initial diagnostic follow-up after a positive screening mammogram. Using 1995-2010 data from a North Carolina population-based registry of breast imaging and cancer outcomes, we identified women with a positive screening mammogram. We compared receipt of follow-up within 60 days of screening using logistic regression and evaluated time to follow-up initiation using Cox proportional hazards regression. Among 43,026 women included in the study, 73% were <65 years and 27% were 65+ years. Median time until initial diagnostic follow-up was similar by age group and insurance status. In the adjusted model for women <65, uninsured women experienced a longer time to initiation of diagnostic follow-up [HR, 0.47; 95% confidence interval (CI), 0.25-0.89] versus women with private insurance. There were increased odds of these uninsured women not meeting the Centers for Disease Control and Prevention guideline for follow-up within 60 days (OR, 1.59; 95% CI, 1.31-1.94). Among women ages 65+, women with private insurance experienced a faster time to follow-up (adjusted HR, 2.09; 95% CI, 1.27-3.44) than women with Medicare and private insurance. Approximately 10% of women had no follow-up by 365 days. We found differences in time to initial diagnostic follow-up after a positive screening mammogram by insurance status and age group. Uninsured women younger than 65 years at a positive screening event had delayed follow-up. Replication of these findings and examination of their clinical significance warrant additional investigation. Cancer Epidemiol Biomarkers Prev; 25(11); 1474-82. ©2016 AACR. ©2016 American Association for Cancer Research.

Validation of Models Used to Inform Colorectal Cancer Screening Guidelines: Accuracy and Implications.

PubMed

Rutter, Carolyn M; Knudsen, Amy B; Marsh, Tracey L; Doria-Rose, V Paul; Johnson, Eric; Pabiniak, Chester; Kuntz, Karen M; van Ballegooijen, Marjolein; Zauber, Ann G; Lansdorp-Vogelaar, Iris

2016-07-01

Microsimulation models synthesize evidence about disease processes and interventions, providing a method for predicting long-term benefits and harms of prevention, screening, and treatment strategies. Because models often require assumptions about unobservable processes, assessing a model's predictive accuracy is important. We validated 3 colorectal cancer (CRC) microsimulation models against outcomes from the United Kingdom Flexible Sigmoidoscopy Screening (UKFSS) Trial, a randomized controlled trial that examined the effectiveness of one-time flexible sigmoidoscopy screening to reduce CRC mortality. The models incorporate different assumptions about the time from adenoma initiation to development of preclinical and symptomatic CRC. Analyses compare model predictions to study estimates across a range of outcomes to provide insight into the accuracy of model assumptions. All 3 models accurately predicted the relative reduction in CRC mortality 10 years after screening (predicted hazard ratios, with 95% percentile intervals: 0.56 [0.44, 0.71], 0.63 [0.51, 0.75], 0.68 [0.53, 0.83]; estimated with 95% confidence interval: 0.56 [0.45, 0.69]). Two models with longer average preclinical duration accurately predicted the relative reduction in 10-year CRC incidence. Two models with longer mean sojourn time accurately predicted the number of screen-detected cancers. All 3 models predicted too many proximal adenomas among patients referred to colonoscopy. Model accuracy can only be established through external validation. Analyses such as these are therefore essential for any decision model. Results supported the assumptions that the average time from adenoma initiation to development of preclinical cancer is long (up to 25 years), and mean sojourn time is close to 4 years, suggesting the window for early detection and intervention by screening is relatively long. Variation in dwell time remains uncertain and could have important clinical and policy implications. © The Author(s) 2016.

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

PubMed

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

1994-01-01

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

Control of Initiation of DNA Replication in Bacillus subtilis and Escherichia coli

PubMed Central

Jameson, Katie H.; Wilkinson, Anthony J.

2017-01-01

Initiation of DNA Replication is tightly regulated in all cells since imbalances in chromosomal copy number are deleterious and often lethal. In bacteria such as Bacillus subtilis and Escherichia coli, at the point of cytokinesis, there must be two complete copies of the chromosome to partition into the daughter cells following division at mid-cell during vegetative growth. Under conditions of rapid growth, when the time taken to replicate the chromosome exceeds the doubling time of the cells, there will be multiple initiations per cell cycle and daughter cells will inherit chromosomes that are already undergoing replication. In contrast, cells entering the sporulation pathway in B. subtilis can do so only during a short interval in the cell cycle when there are two, and only two, chromosomes per cell, one destined for the spore and one for the mother cell. Here, we briefly describe the overall process of DNA replication in bacteria before reviewing initiation of DNA replication in detail. The review covers DnaA-directed assembly of the replisome at oriC and the multitude of mechanisms of regulation of initiation, with a focus on the similarities and differences between E. coli and B. subtilis. PMID:28075389

Study of weak substorms observed during December 8, 1990, geospace environment modeling campaign: Timing of different types of substorm onsets

NASA Astrophysics Data System (ADS)

Mishin, V. M.; Russell, C. T.; Saifudinova, T. I.; Bazarzhapov, A. D.

2000-10-01

We define an expansion onset (synonymous with the main breakup) to be one with sufficient signatures of open tail reconnection. Earlier onsets, which we term initial onsets, occur before the expansion onset, without the signatures of open tail reconnection but with other signs of a clear substorm onset. These two types of substorm onsets and their timing are discussed herein in a study of selected substorm-like events. During the 10-hour interval studied, five impulses of the Perreault-Akasofu index ɛ were observed with comparable peak values. However, the observed magnetospheric responses were very different in terms of equatorward motion and poleward expansion of the auroral oval. We conclude that the occurrence either of an initial onset or of a full onset (under similar boundary conditions) depends on the amount of stored free energy, proportional to the tail length, which is controlled by the input power. The earlier or initial onset marks a sudden change in the convection pattern in the nightside. This onset could mark the initiation of reconnection on closed field lines while the expansion onset could mark the initiation of reconnection on open field lines.

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan.

PubMed

Hanaki, Nao; Yamashita, Kazuto; Kunisawa, Susumu; Imanaka, Yuichi

2016-12-09

In Japan, ambulance staff sometimes must make request calls to find hospitals that can accept patients because of an inadequate information sharing system. This study aimed to quantify effects of the number of request calls on the time interval between an emergency call and hospital arrival. A cross-sectional study of an ambulance records database in Nara prefecture, Japan. A total of 43 663 patients (50% women; 31.2% aged 80 years and over): (1) transported by ambulance from April 2013 to March 2014, (2) aged 15 years and over, and (3) with suspected major illness. The time from call to hospital arrival, defined as the time interval from receipt of an emergency call to ambulance arrival at a hospital. The mean time interval from emergency call to hospital arrival was 44.5 min, and the mean number of requests was 1.8. Multilevel linear regression analysis showed that ∼43.8% of variations in transportation times were explained by patient age, sex, season, day of the week, time, category of suspected illness, person calling for the ambulance, emergency status at request call, area and number of request calls. A higher number of request calls was associated with longer time intervals to hospital arrival (addition of 6.3 min per request call; p<0.001). In an analysis dividing areas into three groups, there were differences in transportation time for diseases needing cardiologists, neurologists, neurosurgeons and orthopaedists. The study revealed 6.3 additional minutes needed in transportation time for every refusal of a request call, and also revealed disease-specific delays among specific areas. An effective system should be collaboratively established by policymakers and physicians to ensure the rapid identification of an available hospital for patient transportation in order to reduce the time from the initial emergency call to hospital arrival. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan

PubMed Central

Hanaki, Nao; Yamashita, Kazuto; Kunisawa, Susumu; Imanaka, Yuichi

2016-01-01

Objectives In Japan, ambulance staff sometimes must make request calls to find hospitals that can accept patients because of an inadequate information sharing system. This study aimed to quantify effects of the number of request calls on the time interval between an emergency call and hospital arrival. Design and setting A cross-sectional study of an ambulance records database in Nara prefecture, Japan. Cases A total of 43 663 patients (50% women; 31.2% aged 80 years and over): (1) transported by ambulance from April 2013 to March 2014, (2) aged 15 years and over, and (3) with suspected major illness. Primary outcome measures The time from call to hospital arrival, defined as the time interval from receipt of an emergency call to ambulance arrival at a hospital. Results The mean time interval from emergency call to hospital arrival was 44.5 min, and the mean number of requests was 1.8. Multilevel linear regression analysis showed that ∼43.8% of variations in transportation times were explained by patient age, sex, season, day of the week, time, category of suspected illness, person calling for the ambulance, emergency status at request call, area and number of request calls. A higher number of request calls was associated with longer time intervals to hospital arrival (addition of 6.3 min per request call; p<0.001). In an analysis dividing areas into three groups, there were differences in transportation time for diseases needing cardiologists, neurologists, neurosurgeons and orthopaedists. Conclusions The study revealed 6.3 additional minutes needed in transportation time for every refusal of a request call, and also revealed disease-specific delays among specific areas. An effective system should be collaboratively established by policymakers and physicians to ensure the rapid identification of an available hospital for patient transportation in order to reduce the time from the initial emergency call to hospital arrival. PMID:27940625

Determining optimal parameters in magnetic spacecraft stabilization via attitude feedback

NASA Astrophysics Data System (ADS)

Bruni, Renato; Celani, Fabio

2016-10-01

The attitude control of a spacecraft using magnetorquers can be achieved by a feedback control law which has four design parameters. However, the practical determination of appropriate values for these parameters is a critical open issue. We propose here an innovative systematic approach for finding these values: they should be those that minimize the convergence time to the desired attitude. This a particularly diffcult optimization problem, for several reasons: 1) such time cannot be expressed in analytical form as a function of parameters and initial conditions; 2) design parameters may range over very wide intervals; 3) convergence time depends also on the initial conditions of the spacecraft, which are not known in advance. To overcome these diffculties, we present a solution approach based on derivative-free optimization. These algorithms do not need to write analytically the objective function: they only need to compute it in a number of points. We also propose a fast probing technique to identify which regions of the search space have to be explored densely. Finally, we formulate a min-max model to find robust parameters, namely design parameters that minimize convergence time under the worst initial conditions. Results are very promising.

Remote effects of aversive contingencies: Disruption of appetitive behavior by adjacent avoidance sessions

PubMed Central

Hackenberg, Timothy D.; Hineline, Philip N.

1987-01-01

Disruption of ongoing appetitive behavior before and after daily avoidance sessions was examined. After baselines of appetitive responding were established under a fixed-interval 180-s schedule of food presentation, 4 rats were exposed to 40-min sessions of the appetitive schedule just prior to 100-min sessions of electric shock postponement, while another 4 rats received the 40-min appetitive sessions just following daily sessions of shock postponement. In all 8 subjects, fixed-interval response rates decreased relative to baseline levels, the effect being somewhat more pronounced when the avoidance sessions immediately followed. The disruption of fixed-interval responding was only partially reversed when avoidance sessions were discontinued. During the initial exposure to the avoidance sessions, patterns of responding under the fixed-interval schedule were differentially sensitive to disruption, with high baseline response rates generally more disturbed than low rates. These disruptions were not systematically related to changes in reinforcement frequency, which remained fairly high and invariant across all conditions of the experiment; they were also not systematically related to the response rates or to the shock rates of the adjacent avoidance sessions. The results, while qualitatively resembling patterns of conditioned suppression as typically studied, occurred on a greatly expanded time scale. As disruption of behavior extending over time, the present data suggest that some forms of conditioned suppression are perhaps best viewed within a larger temporal context. PMID:16812486

Effect of inter-train interval on the induction of repetition suppression of motor-evoked potentials using transcranial magnetic stimulation.

PubMed

Pitkänen, Minna; Kallioniemi, Elisa; Julkunen, Petro

2017-01-01

Repetition suppression (RS) is evident as a weakened response to repeated stimuli after the initial response. RS has been demonstrated in motor-evoked potentials (MEPs) induced with transcranial magnetic stimulation (TMS). Here, we investigated the effect of inter-train interval (ITI) on the induction of RS of MEPs with the attempt to optimize the investigative protocols. Trains of TMS pulses, targeted to the primary motor cortex by neuronavigation, were applied at a stimulation intensity of 120% of the resting motor threshold. The stimulus trains included either four or twenty pulses with an inter-stimulus interval (ISI) of 1 s. The ITI was here defined as the interval between the last pulse in a train and the first pulse in the next train; the ITIs used here were 1, 3, 4, 6, 7, 12, and 17 s. RS was observed with all ITIs except with the ITI of 1 s, in which the ITI was equal to ISI. RS was more pronounced with longer ITIs. Shorter ITIs may not allow sufficient time for a return to baseline. RS may reflect a startle-like response to the first pulse of a train followed by habituation. Longer ITIs may allow more recovery time and in turn demonstrate greater RS. Our results indicate that RS can be studied with confidence at relatively short ITIs of 6 s and above.

Safe and effective error rate monitors for SS7 signaling links

NASA Astrophysics Data System (ADS)

Schmidt, Douglas C.

1994-04-01

This paper describes SS7 error monitor characteristics, discusses the existing SUERM (Signal Unit Error Rate Monitor), and develops the recently proposed EIM (Error Interval Monitor) for higher speed SS7 links. A SS7 error monitor is considered safe if it ensures acceptable link quality and is considered effective if it is tolerant to short-term phenomena. Formal criteria for safe and effective error monitors are formulated in this paper. This paper develops models of changeover transients, the unstable component of queue length resulting from errors. These models are in the form of recursive digital filters. Time is divided into sequential intervals. The filter's input is the number of errors which have occurred in each interval. The output is the corresponding change in transmit queue length. Engineered EIM's are constructed by comparing an estimated changeover transient with a threshold T using a transient model modified to enforce SS7 standards. When this estimate exceeds T, a changeover will be initiated and the link will be removed from service. EIM's can be differentiated from SUERM by the fact that EIM's monitor errors over an interval while SUERM's count errored messages. EIM's offer several advantages over SUERM's, including the fact that they are safe and effective, impose uniform standards in link quality, are easily implemented, and make minimal use of real-time resources.

Hospitalization, frequency of interventions, and quality of life after endoscopic, surgical, or conservative treatment in patients with chronic pancreatitis.

PubMed

Rutter, Karoline; Ferlitsch, A; Sautner, T; Püspök, A; Götzinger, P; Gangl, A; Schindl, M

2010-11-01

Patients with chronic pancreatitis usually have a long and debilitating history of disease with frequent hospital admissions, episodes of intractable pain and multiple interventions. The sequences of treatment at initial presentation, endoscopy, surgery, or conservative treatment may affect the time course and admissions needed for disease control, thereby determining quality of life and overall outcome. A total of 292 patients with initial endoscopic, surgical, or conservative pharmacological treatment were retrospectively analyzed regarding frequency of interventions, days in hospital, symptom-free intervals, morbidity, and mortality. Quality of life (QoL) at the latest follow-up was measured by two standardized quality of life questionnaires (EORTC C30 and PAN26). Endoscopic treatment was initially performed in 150 (51.4%) patients, whereas 99 (33.9%) underwent surgery and 43 (14.7%) patients were treated conservatively at their initial presentation. Patients who underwent surgery had a significantly shorter time in the hospital (25.3 ± 24.6, 34.4 ± 35.1, 61.1 ± 37.9; P < 0.001), fewer subsequent therapies (0.43 ± 1.0, 2.1 ± 2.4, 3.1 ± 3.0; P ≤ 0.001), and a longer relapse-free interval (P = 0.004) compared with endoscopically treated patients. The overall complication rate was 32% both after surgery and endoscopy. Infectious-related complications occurred more often after surgical treatment (P ≤ 0.001), whereas patients after endoscopic intervention developed acute or chronic pancreatitis or pseudocyst formation (P = 0.023). Patients who undergo surgery as their initial treatment for chronic pancreatitis require less consecutive interventions, a shorter hospital stay, and have a better quality of life compared with any other treatment. Surgery should therefore be considered early for the treatment of chronic pancreatitis, when endoscopic or conservative treatment fails and patients require further intervention.

Retention of sequential drug discriminations under fixed-interval schedules for long time periods without training.

PubMed

Li, Mi; McMillan, Donald E

2003-08-22

The experiments showed that sequential drug discriminations can be learned and retained under a fixed-interval (FI) schedule for more than 18 months without additional training under a complex three-choice procedure. Pigeons were trained to discriminate among 5 mg/kg pentobarbital, 2 mg/kg D-amphetamine, and saline. After responding stabilized, dose-response curves were determined for other drugs. Subsequently, pentobarbital was replaced with 5 mg/kg morphine as a training drug, and D-amphetamine was replaced with 30 mg/kg caffeine. After the pigeons learned these new discriminations, dose-response curves were redetermined. Initially, chlordiazepoxide substituted for pentobarbital, cocaine substituted for D-amphetamine, and nicotine partially substituted for D-amphetamine. Morphine, Delta9-tetrahydrocannabinol, and caffeine did not substitute for either drug. After retraining with morphine and caffeine, responding occurred on the pentobarbital/morphine key after pentobarbital, chlordiazepoxide and morphine and on the D-amphetamine/caffeine key after D-amphetamine, cocaine and caffeine. After nicotine and Delta9-tetrahyrdocannabinol, responding occurred on the saline key. These data show that drug discriminations learned under fixed-interval schedules are retained for long time periods, even when discrimination training with other drugs occurs during the retention period.

Seawater and Detrital Marine Pb Isotopes as Monitors of Antarctic Weathering Following Ice Sheet Development

NASA Astrophysics Data System (ADS)

Fenn, C.; Martin, E. E.; Basak, C.

2011-12-01

Comparisons of seawater and detrital Pb isotopes from sites proximal to Antarctica at the Eocene/Oligocene transition (EOT) are being used to understand variations in continental weathering associated with the development of the East Antarctic Ice Sheet (EAIS). Previous work has shown that seawater and detrital archives yield similar isotopic values during Eocene warmth, which is interpreted to record congruent chemical weathering of the continent. In contrast, distinct isotopic values for the two phases at the EOT represents increased incongruent mechanical weathering during growth of the ice sheet. For this study we expanded beyond the initial glaciation at the EOT to determine whether less dramatic changes in ice volume and climate also produce variations in weathering and intensity that are recorded by seawater and detrital Pb isotopes. We collected Nd and Pb isotope data from extractions of Fe-Mn oxide coatings of bulk decarbonated marine sediments, which preserve seawater isotopic values, and from complete dissolutions of the remaining silicate fraction for Ocean Drilling Program Site 748 on Kerguelen Plateau (1300 m modern water depth). The data spans an interval of deglaciation from ~23.5-27 Ma documented by δ18O that has been equated to a ~30% decrease in ice volume on Antarctica (Pekar and Christie-Blick, 2008, Palaeogeogr., Palaeoclim., Palaeoecol.). Initial results from Site 748 include the first ɛNd values for intermediate waters in the Oligocene Southern Ocean and reveal a value of ~-8 over the entire 3.5 my interval, which is consistent with values reported for deep Indian Ocean sites at this time and similar to deeper Southern Ocean sites. Corresponding detrital ɛNd values are less radiogenic and decrease from -9 to -13 during the study interval. Detrital 206Pb/204Pb values also decrease during the warming interval, while seawater 206Pb/204Pb values increase. The decrease in detrital values indicates the composition of source materials entering the ocean changed as the ice sheet waned. Increasing seawater 206Pb/204Pb may record enhanced chemical weathering under conditions of greater water availability and warmer temperatures combined with abundant rock flour created during the preceding glacial advance. As previous studies have documented initial weathering leachates tend to be more radiogenic than the parent rock composition. Alternatively, seawater values during warming in the late Oligocene approach values recorded during initial ice sheet expansion at the EOT in Site 738, which may suggest Pb isotope variations in seawater and detrital residues are not sensitive to less dramatic intervals of climate change and ice sheet dynamics. We plan to continue this study into the Pliocene to see if we can identify the timing of the transition from a wet-based to dry-based EAIS, an event that is likely to have profound consequences for weathering on Antarctica and the offset between the two Pb isotope archives.

Characterizing detonator output using dynamic witness plates

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

Murphy, Michael John; Adrian, Ronald J

2009-01-01

A sub-microsecond, time-resolved micro-particle-image velocimetry (PIV) system is developed to investigate the output of explosive detonators. Detonator output is directed into a transparent solid that serves as a dynamic witness plate and instantaneous shock and material velocities are measured in a two-dimensional plane cutting through the shock wave as it propagates through the solid. For the case of unloaded initiators (e.g. exploding bridge wires, exploding foil initiators, etc.) the witness plate serves as a surrogate for the explosive material that would normally be detonated. The velocity-field measurements quantify the velocity of the shocked material and visualize the geometry of themore » shocked region. Furthermore, the time-evolution of the velocity-field can be measured at intervals as small as 10 ns using the PIV system. Current experimental results of unloaded exploding bridge wire output in polydimethylsiloxane (PDMS) witness plates demonstrate 20 MHz velocity-field sampling just 300 ns after initiation of the wire.« less

Triatomine Infestation in Guatemala: Spatial Assessment after Two Rounds of Vector Control

PubMed Central

Manne, Jennifer; Nakagawa, Jun; Yamagata, Yoichi; Goehler, Alexander; Brownstein, John S.; Castro, Marcia C.

2012-01-01

In 2000, the Guatemalan Ministry of Health initiated a Chagas disease program to control Rhodnius prolixus and Triatoma dimidiata by periodic house spraying with pyrethroid insecticides to characterize infestation patterns and analyze the contribution of programmatic practices to these patterns. Spatial infestation patterns at three time points were identified using the Getis-Ord Gi*(d) test. Logistic regression was used to assess predictors of reinfestation after pyrethroid insecticide administration. Spatial analysis showed high and low clusters of infestation at three time points. After two rounds of spray, 178 communities persistently fell in high infestation clusters. A time lapse between rounds of vector control greater than 6 months was associated with 1.54 (95% confidence interval = 1.07–2.23) times increased odds of reinfestation after first spray, whereas a time lapse of greater than 1 year was associated with 2.66 (95% confidence interval = 1.85–3.83) times increased odds of reinfestation after first spray compared with localities where the time lapse was less than 180 days. The time lapse between rounds of vector control should remain under 1 year. Spatial analysis can guide targeted vector control efforts by enabling tracking of reinfestation hotspots and improved targeting of resources. PMID:22403315

Catalytic Reduction of 4-Nitrophenol: A Quantitative Assessment of the Role of Dissolved Oxygen in Determining the Induction Time.

PubMed

Menumerov, Eredzhep; Hughes, Robert A; Neretina, Svetlana

2016-12-14

The reduction of 4-nitrophenol to 4-aminophenol by borohydride is one of the foremost model catalytic reactions because it allows for a straightforward assessment of catalysts using the kinetic parameters extracted from the real-time spectroscopic monitoring of an aqueous solution. Crucial to its standing as a model reaction is a comprehensive mechanistic framework able to explain the entire time evolution of the reaction. While much of this framework is in place, there is still much debate over the cause of the induction period, an initial time interval where no reaction seemingly occurs. Here, we report on the simultaneous monitoring of the spectroscopic signal and the dissolved oxygen content within the aqueous solution. It reveals that the induction period is the time interval required for the level of dissolved oxygen to fall below a critical value that is dependent upon whether Au, Ag, or Pd nanoparticles are used as the catalyst. With this understanding, we are able to exert complete control over the induction period, being able to eliminate it, extend it indefinitely, or even induce multiple induction periods over the course of a single reaction. Moreover, we have determined that the reaction product, 4-aminophenol, in the presence of the same catalyst reacts with dissolved oxygen to form 4-nitrophenolate. The implication of these results is that the induction period relates, not to some activation of the catalyst, but to a time interval where the reaction product is being rapidly transformed back into a reactant by a side reaction.

Empirical Model of the Location of the Main Ionospheric Trough

NASA Astrophysics Data System (ADS)

Deminov, M. G.; Shubin, V. N.

2018-05-01

The empirical model of the location of the main ionospheric trough (MIT) is developed based on an analysis of data from CHAMP satellite measured at the altitudes of 350-450 km during 2000-2007; the model is presented in the form of the analytical dependence of the invariant latitude of the trough minimum Φm on the magnetic local time (MLT), the geomagnetic activity, and the geographical longitude for the Northern and Southern Hemispheres. The time-weighted average index Kp(τ), the coefficient of which τ = 0.6 is determined by the requirement of the model minimum deviation from experimental data, is used as an indicator of geomagnetic activity. The model has no limitations, either in local time or geomagnetic activity. However, the initial set of MIT minima mainly contains data dealing with an interval of 16-08 MLT for Kp(τ) < 6; therefore, the model is rather qualitative outside this interval. It is also established that (a) the use of solar local time (SLT) instead of MLT increases the model error no more than by 5-10%; (b) the amplitude of the longitudinal effect at the latitude of MIT minimum in geomagnetic (invariant) coordinates is ten times lower than that in geographical coordinates.

[Recovery in aphasia (Part 1)].

PubMed

Hojo, K; Watanabe, S; Tasaki, H; Sato, T; Metoki, H; Saito, M

1985-08-01

In order to elucidate the factors which have an influence on the prognosis of aphasia, a correlation was studied in 76 right-handed aphasic patients between recovery rates and various factors: i.e. aphasia type, age, educational level, time between onset of aphasia and institution of therapy and initial severity. Initial evaluations on Standard Language Test of Aphasia (SLTA) were obtained within 5 months after the cerebrovascular accident and reevaluations were obtained 3 months after the initial evaluation. Recovery rates were determined by comparing scores of these 2 tests in order to coincide with clinical impression. The results obtained were as follows: Aphasia type: The highest recovery rates were seen in conduction aphasics, followed by amnestic, Wernicke, and Broca aphasics. Global aphasics had significantly lower recovery rates. It was suggested that anarthria in Broca's aphasia and jargon in Wernicke's aphasia had a significant ratarding effect on recovery rates. Age: Age and recovery rates showed a significant negative correlation: younger patients recovered better, and this trend was remarkable in Wernicke aphasics but not Broca aphasics. Education: Patients with more education tended to improve more, and this trend was most remarkable in amnestic aphasics. Time between onset of aphasia and institution of therapy: Time elapsed from onset and recovery rates showed a significant negative correlation; recovery rates decreased as the time interval from onset increased. Initial severity: Correlation between the initial severity of aphasia, measured by the initial SLTA scores and recovery rates was very high; severily affected aphasics recovered to a lesser extent than mildly affected ones and this trend was remarkable in Wernicke and Broca aphasics.

Experimental study of the space-time development of the particle production process in hadron-nucleon collisions, using massive target nucleus as a detector

NASA Technical Reports Server (NTRS)

Strugalski, Z.

1985-01-01

Experimental study of the space-time development of the particle production process in hadronic collisions at its initial stage was performed. Massive target nuclei have been used as fine detectors of properties of the particle production process development within time intervals smaller than 10 to the 22nd power s and spatial distances smaller than 10 to the 12th power cm. In hadron-nucleon collisions, in particular in nucleon-nucleon collisions, the particle production process goes through intermediate objects in 2 yields 2 type endoergic reactions. The objects decay into commonly observed resonances and paricles.

Testing for time-based correlates of perceived gender discrimination.

PubMed

Blau, Gary; Tatum, Donna Surges; Ward-Cook, Kory; Dobria, Lidia; McCoy, Keith

2005-01-01

Using a sample of 201 medical technologists (MTs) over a five-year period, this study extends initial findings on perceived gender discrimination (PGD) by Blau and Tatum (2000) by applying organizational justice variables and internal-external locus of control as hypothesized correlates of PGD. Three types of organizational justice were measured: distributive, procedural, and interactional. General relationships found include locus of control being related to PGD such that internals perceived lower PGD. Also, distributive, procedural, and interactional justice were negatively related to PGD. However, increasing the time interval between these correlates weakened their relationships. The relationship of interactional justice to PGD remained the most "resistant" to attenuation over time.

On the Transition from Initial Leader to Stepped Leader in Negative Cloud-to-ground Lightning

NASA Astrophysics Data System (ADS)

Stolzenburg, M.; Marshall, T. C.; Karunarathne, S.; Orville, R. E.

2017-12-01

High-speed video and electric field change (E-change) data are used to describe the first 5 ms of a natural negative cloud-to-ground (CG) flash. These observations reveal differences in appearance of both the video luminosity and the E-change pulses before the leader transitions to propagating as a negative stepped leader (SL). During the initial breakdown (IB) stage, the initial leader advances intermittently forward in jumps of 78-175 m, at intervals of 100-280 μs, and in separate bursts that are bright for a few 20-μs video frames. The IB pulses accompanying these luminosity bursts have long duration, large amplitude, and a characteristic bipolar shape in nearby E-change observations. In the time between IB pulses, the initial leader is very dim or not visible during the earliest 1-2 ms of the IB stage. Over the next few milliseconds, the leader propagation transitions to an early SL phase, in which the leader tips advance 20-59 m forward at more regular intervals of 40-80 μs during relatively dim and brief steps. In the E-change data, the accompanying SL pulses have very short duration, small amplitude, and are typically unipolar. These data indicate that when the entire initial leader length behind the lower end begins to remain illuminated between bursts, the propagation mode changes from IB bursts to SL steps, and the IB stage ends. Additional differences in initial leader character are evident during the return stroke, as its luminosity speed decreases sharply upon reaching the topmost initial leader section of the channel, and that section of channel does not saturate the video intensity. Results of these analyses support a prior hypothesis that the early initial leader development occurs in the absence of a continuously hot channel, and consequently, the initial leader propagation is unlike the self-propagating advance of the later stepped leader.

The oral bioavailability and toxicokinetics of methylmercury in common loon (Gavia immer) chicks

USGS Publications Warehouse

Fournier, F.; Karasov, W.H.; Kenow, K.P.; Meyer, M.W.; Hines, R.K.

2002-01-01

We compared the toxicokinetics of methylmercury in captive common loon chicks during two time intervals to assess the impact of feather growth on the kinetics of mercury. We also determined the oral bioavailability of methylmercury during these trials to test for age-related changes. The blood concentration-time curves for individuals dosed during feather development (initiated 35 days post hatch) were best described by a one-compartment toxicokinetic model with an elimination half-life of 3 days. The data for birds dosed following completion of feather growth (84 days post hatch) were best fitted by a two-compartment elimination model that includes an initial rapid distribution phase with a half-life of 0.9 days, followed by a slow elimination phase with a half-life of 116 days. We determined the oral bioavailability of methylmercury during the first dosing interval by comparing the ratios of the area under the blood concentration-time curves (AUC0→∞) for orally and intravenously dosed chicks. The oral bioavailability of methylmercury during the first dosing period was 0.83. We also determined bioavailability during both dosing periods using a second measure because of irregularities with intravenous results in the second period. This second bioavailability measure estimated the percentage of the dose that was deposited in the blood volume (f), and the results show that there was no difference in bioavailability among dosing periods. The results of this study highlight the importance of feather growth on the toxicokinetics of methylmercury.

Effect of transportation during periods of high ambient temperature on physiologic and behavioral indices of beef heifers.

PubMed

Theurer, Miles E; White, Brad J; Anderson, David E; Miesner, Matt D; Mosier, Derek A; Coetzee, Johann F; Amrine, David E

2013-03-01

To determine the effect of transportation during periods of high ambient temperature on physiologic and behavioral indices of beef heifers. 20 heifers (mean body weight, 217.8 kg). Ten heifers were transported 518 km when the maximum ambient temperature was ≥ 32.2°C while the other 10 heifers served as untransported controls. Blood samples were collected from transported heifers at predetermined intervals during the transportation period. For all heifers, body weights, nasal and rectal temperatures, and behavioral indices were measured at predetermined intervals for 3 days after transportation. A week later, the entire process was repeated such that each group was transported twice and served as the control twice. Transported heifers spent more time near the hay feeder on the day of transportation, had lower nasal and rectal temperatures for 24 hours after transportation, and spent more time lying down for 2 days after transportation, compared with those indices for control heifers. Eight hours after transportation, the weight of transported heifers decreased 6%, whereas that of control heifers increased 0.6%. At 48 hours after initiation of transportation, weight, rectal temperature, and time spent at various pen locations did not differ between transported and control heifers. Cortisol concentrations were higher 4 hours after initiation of transportation, compared with those determined just prior to transportation. Results indicated transportation during periods of high ambient temperatures caused transient changes in physiologic and behavioral indices of beef heifers.

Measuring the rebound resilience of a bouncing ball

NASA Astrophysics Data System (ADS)

Wadhwa, Ajay

2012-09-01

Some balls which are made of high-quality rubber (an elastomeric) material, such as tennis or squash balls, could be used for the determination of an important property of such materials called resilience. Since a bouncing ball involves a single impact we call this property 'rebound resilience' and express it as the ratio of the rebound height to the initial drop height of the ball. We determine the rebound resilience for three different types of ball by calculating the coefficient of restitution of the ball-surface combination from the experimentally measurable physical quantities, such as initial drop height and time interval between successive bounces. Using these we also determine the contact time of balls with the surface of impact. For measurements we have used audio, motion and surface-temperature sensors that were interfaced through a USB port with a computer.

Single file diffusion into a semi-infinite tube.

PubMed

Farrell, Spencer G; Brown, Aidan I; Rutenberg, Andrew D

2015-11-23

We investigate single file diffusion (SFD) of large particles entering a semi-infinite tube, such as luminal diffusion of proteins into microtubules or flagella. While single-file effects have no impact on the evolution of particle density, we report significant single-file effects for individually tracked tracer particle motion. Both exact and approximate ordering statistics of particles entering semi-infinite tubes agree well with our stochastic simulations. Considering initially empty semi-infinite tubes, with particles entering at one end starting from an initial time t = 0, tracked particles are initially super-diffusive after entering the system, but asymptotically diffusive at later times. For finite time intervals, the ratio of the net displacement of individual single-file particles to the average displacement of untracked particles is reduced at early times and enhanced at later times. When each particle is numbered, from the first to enter (n = 1) to the most recent (n = N), we find good scaling collapse of this distance ratio for all n. Experimental techniques that track individual particles, or local groups of particles, such as photo-activation or photobleaching of fluorescently tagged proteins, should be able to observe these single-file effects. However, biological phenomena that depend on local concentration, such as flagellar extension or luminal enzymatic activity, should not exhibit single-file effects.

The orbital evolution of the Apollo asteroid group over 11,550 years

NASA Astrophysics Data System (ADS)

Zausaev, A. F.; Pushkarev, A. N.

1992-08-01

The Everhard method was used to monitor the orbital evolution of 20 Apollo asteroids in the time interval from 2250 A.D. to 9300 B.C. The closest encounters with large planets in the evolution process are calculated. Stable resonances with Venus and Earth over the period from 2250 A.D. to 9300 B.C. are obtained. Theoretical coordinates of radiants on initial and final moments of integration are calculated.

Optimal Interval for Repeated Gastric Cancer Screening in Normal-Risk Healthy Korean Adults: A Retrospective Cohort Study

PubMed Central

Bae, Jong-Myon; Shin, Sang Yop; Kim, Eun Hee

2015-01-01

Purpose This retrospective cohort study was conducted to estimate the optimal interval for gastric cancer screening in Korean adults with initial negative screening results. Materials and Methods This study consisted of voluntary Korean screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative in the baseline screening performed between January 2007 and December 2011. A new case was defined as the presence of gastric cancer cells in biopsy specimens obtained upon gastroscopy. The follow-up periods were calculated during the months between the date of baseline screening gastroscopy and positive findings upon subsequent screenings, stratified by sex and age group. The mean sojourn time (MST) for determining the screening interval was estimated using the prevalence/incidence ratio. Results Of the 293,520 voluntary screenees for the gastric cancer screening program, 91,850 (31.29%) underwent subsequent screening gastroscopies between January 2007 and December 2011. The MSTs in men and women were 21.67 months (95% confidence intervals [CI], 17.64 to 26.88 months) and 15.14 months (95% CI, 9.44 to 25.85 months), respectively. Conclusion These findings suggest that the optimal interval for subsequent gastric screening in both men and women is 24 months, supporting the 2-year interval recommended by the nationwide gastric cancer screening program. PMID:25687874

A candidate secular variation model for IGRF-12 based on Swarm data and inverse geodynamo modelling

NASA Astrophysics Data System (ADS)

Fournier, Alexandre; Aubert, Julien; Thébault, Erwan

2015-05-01

In the context of the 12th release of the international geomagnetic reference field (IGRF), we present the methodology we followed to design a candidate secular variation model for years 2015-2020. An initial geomagnetic field model centered around 2014.3 is first constructed, based on Swarm magnetic measurements, for both the main field and its instantaneous secular variation. This initial model is next fed to an inverse geodynamo modelling framework in order to specify, for epoch 2014.3, the initial condition for the integration of a three-dimensional numerical dynamo model. The initialization phase combines the information contained in the initial model with that coming from the numerical dynamo model, in the form of three-dimensional multivariate statistics built from a numerical dynamo run unconstrained by data. We study the performance of this novel approach over two recent 5-year long intervals, 2005-2010 and 2009-2014. For a forecast horizon of 5 years, shorter than the large-scale secular acceleration time scale (˜10 years), we find that it is safer to neglect the flow acceleration and to assume that the flow determined by the initialization is steady. This steady flow is used to advance the three-dimensional induction equation forward in time, with the benefit of estimating the effects of magnetic diffusion. The result of this deterministic integration between 2015.0 and 2020.0 yields our candidate average secular variation model for that time frame, which is thus centered on 2017.5.

A longitudinal study of exposure to retail cigarette advertising and smoking initiation.

PubMed

Henriksen, Lisa; Schleicher, Nina C; Feighery, Ellen C; Fortmann, Stephen P

2010-08-01

Accumulating evidence suggests that widespread advertising for cigarettes at the point of sale encourages adolescents to smoke; however, no longitudinal study of exposure to retail tobacco advertising and smoking behavior has been reported. A school-based survey included 1681 adolescents (aged 11-14 years) who had never smoked. One measure of exposure assessed the frequency of visiting types of stores that contain the most cigarette advertising. A more detailed measure combined data about visiting stores near school with observations of cigarette advertisements and pack displays in those stores. Follow-up surveys 12 and 30 months after baseline (retention rate: 81%) documented the transition from never to ever smoking, even just a puff. After 12 months, 18% of adolescents initiated smoking, but the incidence was 29% among students who visited convenience, liquor, or small grocery stores at least twice per week and 9% among those who reported the lowest visit frequency (less than twice per month). Adjusting for multiple risk factors, the odds of initiation remained significantly higher (odds ratio: 1.64 [95% confidence interval: 1.06-2.55]) for adolescents who reported moderate visit frequency (0.5-1.9 visits per week), and the odds of initiation more than doubled for those who visited > or = 2 times per week (odds ratio: 2.58 [95% confidence interval: 1.68-3.97]). Similar associations were observed for the more detailed exposure measure and persisted at 30 months. Exposure to retail cigarette advertising is a risk factor for smoking initiation. Policies and parenting practices that limit adolescents' exposure to retail cigarette advertising could improve smoking prevention efforts.

Botulinum Toxin Dosing Trends in Spasmodic Dysphonia Over a 20-year Period.

PubMed

Namin, Arya W; Christopher, Kara M; Eisenbeis, John F

2017-01-01

The study aims to (1) identify the botulinum toxin (BTX) dosing trend in a cohort of patients who received at least 20 injections for the treatment of adductor spasmodic dysphonia (ADSD), (2) describe two distinct BTX dosing trends in treating ADSD (a "classic" dosing trend that initially decreases before stabilizing, and a "fluctuating" dosing trend), and (3) determine if patients with the "classic" dosing trend differed in age or in dosing intervals from those with the "fluctuating" dosing trend. This is a retrospective case series. Of 149 patients who received a total of 2484 BTX injections for the treatment of spasmodic dysphonia in 1993-2013, 49 patients received at least 20 injections. The BTX dose and the interval between doses were recorded. The mean dose of injections 1-20 was determined. The age at initial injection, initial dose, and interval in days between treatments were compared for the "fluctuating" and "classic" groups. The cohort exhibits a significant decrease in dose during the first 10-15 injections. The "fluctuating" group had a significantly shorter interval between injections (mean interval = 97.09 days, SD = 29.41; mean interval = 136.90 days, SD = 43.76, P = 0.002). The mean age at initial dose was not significantly different between the "classic" and "fluctuating" groups. The average BTX dose of patients with ADSD who receive long-term injections significantly decreases during the initial 10-15 injections before stabilizing. Patients who exhibit the "fluctuating" dosing pattern have a significantly shorter interval between injections than those with the "classic" dosing pattern. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Initial Dosing and Taper Complexity of Methadone and Morphine for Treatment of Neonatal Abstinence Syndrome

PubMed Central

Ibach, Bethany W.; Johnson, Peter N.; Ernst, Kimberly D.; Harrison, Donald; Miller, Jamie L.

2016-01-01

Background: Methadone and morphine are commonly used to treat neonatal abstinence syndrome (NAS). Limited data exist to describe the most appropriate initial doses and taper regimens of these agents. Objectives: Describe the median initial dose and frequency of methadone and morphine for NAS. Compare dose adjustments, time to symptom relief, and taper complexity between groups. Methods: Retrospective study of neonates receiving enteral methadone or morphine for NAS over a 4-year period. Data collection included medication regimen, abstinence scores based on the Modified Finnegan Neonatal Abstinence Scoring Tool, and adverse events. Planned home taper complexity was assessed using the Medication Taper Complexity Score–Revised (MTCS-R). The primary outcome was initial opioid dose. Secondary outcomes included number of dose adjustments, time to symptom relief, and MTCS-R score. Results: Fifty neonates were initially treated for NAS with methadone (n = 36) or morphine (n = 14). The median initial dose was 0.09 mg/kg (range = 0.03-0.2) for methadone and 0.04 mg/kg (range = 0.03-0.4) for morphine. The most common initial dosing interval was q8h for methadone versus q3h for morphine. Number of dose adjustments and time to symptom relief were similar between groups. Median MTCS-R scores were similar between groups. There was no difference in adverse events between groups. Limitations included small sample size, preference toward methadone use, and variability of initial opioid dosing and titration. Conclusions: There was significant variability in initial doses of both agents. Neonates receiving methadone required less frequent dosing than morphine, which may result in easier administration and may allow for safer outpatient administration.

Cardiopulmonary resuscitation duration and survival in out-of-hospital cardiac arrest patients.

PubMed

Adnet, Frederic; Triba, Mohamed N; Borron, Stephen W; Lapostolle, Frederic; Hubert, Hervé; Gueugniaud, Pierre-Yves; Escutnaire, Josephine; Guenin, Aurelien; Hoogvorst, Astrid; Marbeuf-Gueye, Carol; Reuter, Paul-Georges; Javaud, Nicolas; Vicaut, Eric; Chevret, Sylvie

2017-02-01

Relationship between cardiopulmonary arrest and resuscitation (CPR) durations and survival after out-of-hospital cardiac arrest (OHCA) remain unclear. Our primary aim was to determine the association between survival without neurologic sequelae and cardiac arrest intervals in the setting of witnessed OHCA. We analyzed 27,301 non-traumatic, witnessed OHCA patients in France included in the national registry from June 1, 2011 through December 1, 2015. We analyzed cardiac arrest intervals, designated as no-flow (NF; from collapse to start of CPR) and low-flow (LF; from start of CPR to cessation of resuscitation) in relation to 30-day survival without sequelae. We determined the influence of recognized prognostic factors (age, gender, initial rhythm, location of cardiac arrest) on this relation. For the entire cohort, the area delimited by a value of NF greater than 12min (95% confidence interval: 11-13min) and LF greater than 33min (95% confidence interval: 29-45min), yielded a probability of 30-day survival of less than 1%. These sets of values were greatly influenced by initial cardiac arrest rhythm, age, sex and location of cardiac arrest. Extended CPR duration (greater than 40min) in the setting of initial shockable cardiac rhythm is associated with greater than 1% survival with NF less than 18min. The NF interval was highly influential on the LF interval regardless of outcome, whether return of spontaneous circulation (p<0.001) or death (p<0.001). NF duration must be considered in determining CPR duration in OHCA patients. The knowledge of (NF, LF) curves as function of age, initial rhythm, location of cardiac arrest or gender may aid in decision-making vis-à-vis the termination of CPR or employment of advanced techniques. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Safety and Efficacy of a Progressively Prolonged Maintenance Interval of Venom Immunotherapy.

PubMed

Kontou-Fili, Kalliopi; Pitsios, Constantinos; Kompoti, Evangelia; Giannakopoulos, Dionysios; Kouridakis, Spyros

2018-01-01

The long-term protection provided by venom immunotherapy (VIT) is related to the dose administered and to its long duration; the latter, however, becomes inconvenient for patients in countries like Greece, with many islanders or inhabitants of distant mountainous areas. Maintenance interval prolongation reduces the number of office visits - saving time and money - and as a consequence contributes to the patients' compliance. The aim of this prospective study was to evaluate the safety and efficacy of VIT on a progressively prolonged maintenance interval (PPMI). 450 venom-allergic patients were reviewed for participation in our study; all of them were initially treated with a modified rush or an ultrarush protocol using freshly reconstituted, pure venoms. Upon reaching the maintenance dose, the VIT interval was scheduled to be gradually prolonged - by 1 week each time - aiming at a maximal interval of 26 weeks. 267/450 patients consented to participate in our VIT PPMI protocol: 98 were treated with vespid(s) venom, 142 with honeybee venom, and 27 with both. The mean duration of patient follow-up was 9.1 ± 4.2 years. The majority of systemic reactions due to VIT injections occurred up to the 8-weeks PPMI; few additional reactions were documented in a small fraction (2.9%) of our patient population beyond 9 weeks and up to 16 weeks; all were caused by honeybee VIT. No reactions were observed during VIT administration at the 26-week interval. Ninety-six patients reported 204 field sting occurrences by the culprit insect. Ten systemic reactions (8 mild and 2 moderate in severity) were registered between the 9- and 18-week PPMI; the honeybee was the culprit insect in all cases. 108 field stings by the offending insect were sustained beyond the 20- and up to the 26-week PPMI; there were no reactions at all. Progressively prolonging the VIT maintenance interval up to 26 weeks appears to be safe and efficacious. © 2018 S. Karger AG, Basel.

Twenty-one-year development of Douglas-fir stands repeatedly thinned at varying intervals.

Treesearch

Donald L. Reukema

1972-01-01

Douglas-fir stands first thinned at about age 38 have been observed for 21 years. Four treatments were compared; no thinning, light thinning at 3-year intervals, moderate thinning at 6-year intervals, and heavy thinning at 9-year intervals. Eighteen years after initial thinnings (the first common end to all thinning cycles), all thinned stands had virtually the same...

Nearsightedness (Myopia)

MedlinePlus

... the American Academy of Ophthalmology recommends the following intervals for regular eye exams: Adults If you're ... glaucoma, get an eye exam at the following intervals: An initial exam at 40 Every two to ...

Hemostatic efficacy of local chitosan linear polymer granule in an experimental sheep model with severe bleeding of arteria and vena femoralis.

PubMed

Ersoy, Gürkan; Rodoplu, Ülkümen; Yılmaz, Osman; Gökmen, Necati; Doğan, Alper; Dikme, Özgür; Aydınoğlu, Aslı; Orhon, Okyanus

2016-05-01

The aim of the present study was to evaluate the hemostatic effect of chitosan linear polymer in a sheep model with femoral bleeding. Following induction of anesthesia and intubation of sheep, groin injury was induced to initiate hemorrhage. Animals were randomly assigned to study and control groups. In the control group, absorbent pads were packed on the wound, and pressure was supplied by a weight placed over the dressing. In the study group, chitosan linear polymer was poured onto the bleeding site; absorbent pads and pressure were applied in the same manner. At 5-min intervals, bleeding was evaluated. Primary endpoint was time to hemostasis. Bleeding had stopped by the 1st interval in 5 members of the study group, and by the 2nd interval in 1 member. One sheep was excluded. The bleeding stopped after the 1st interval in 1 member of the control group and after the 2nd interval in 4 members. Bleeding stopped in 2 cases following ligation of the bleeding vessel. Hemostasis was achieved earlier in the study group, compared to the control group, and the difference was statistically significant. Hemostasis was achieved earlier following application of chitosan linear polymer.

Association between GFR Estimated by Multiple Methods at Dialysis Commencement and Patient Survival

PubMed Central

Wong, Muh Geot; Pollock, Carol A.; Cooper, Bruce A.; Branley, Pauline; Collins, John F.; Craig, Jonathan C.; Kesselhut, Joan; Luxton, Grant; Pilmore, Andrew; Harris, David C.

2014-01-01

Summary Background and objectives The Initiating Dialysis Early and Late study showed that planned early or late initiation of dialysis, based on the Cockcroft and Gault estimation of GFR, was associated with identical clinical outcomes. This study examined the association of all-cause mortality with estimated GFR at dialysis commencement, which was determined using multiple formulas. Design, setting, participants, & measurements Initiating Dialysis Early and Late trial participants were stratified into tertiles according to the estimated GFR measured by Cockcroft and Gault, Modification of Diet in Renal Disease, or Chronic Kidney Disease-Epidemiology Collaboration formula at dialysis commencement. Patient survival was determined using multivariable Cox proportional hazards model regression. Results Only Initiating Dialysis Early and Late trial participants who commenced on dialysis were included in this study (n=768). A total of 275 patients died during the study. After adjustment for age, sex, racial origin, body mass index, diabetes, and cardiovascular disease, no significant differences in survival were observed between estimated GFR tertiles determined by Cockcroft and Gault (lowest tertile adjusted hazard ratio, 1.11; 95% confidence interval, 0.82 to 1.49; middle tertile hazard ratio, 1.29; 95% confidence interval, 0.96 to 1.74; highest tertile reference), Modification of Diet in Renal Disease (lowest tertile hazard ratio, 0.88; 95% confidence interval, 0.63 to 1.24; middle tertile hazard ratio, 1.20; 95% confidence interval, 0.90 to 1.61; highest tertile reference), and Chronic Kidney Disease-Epidemiology Collaboration equations (lowest tertile hazard ratio, 0.93; 95% confidence interval, 0.67 to 1.27; middle tertile hazard ratio, 1.15; 95% confidence interval, 0.86 to 1.54; highest tertile reference). Conclusion Estimated GFR at dialysis commencement was not significantly associated with patient survival, regardless of the formula used. However, a clinically important association cannot be excluded, because observed confidence intervals were wide. PMID:24178976

Time course of degradation of cardiac troponin I in patients with acute ST-elevation myocardial infarction: the ASSENT-2 troponin substudy.

PubMed

Madsen, Lene H; Christensen, Geir; Lund, Terje; Serebruany, Victor L; Granger, Chris B; Hoen, Ingvild; Grieg, Zanina; Alexander, John H; Jaffe, Allan S; Van Eyk, Jennifer E; Atar, Dan

2006-11-10

Although measurement of troponin is widely used for diagnosing acute myocardial infarction (AMI), its diagnostic potential may be increased by a more complete characterization of its molecular appearance and degradation in the blood. The aim of this study was to define the time course of cardiac troponin I (cTnI) degradation in patients with acute ST-elevation myocardial infarction (STEMI). In the ASSENT-2 substudy, 26 males hospitalized with STEMI were randomized to 2 different thrombolytic drugs within 6 hours after onset of symptoms. Blood samples were obtained just before initiation of thrombolysis and at 30 minutes intervals (7 samples per patient). Western blot analysis was performed using anti-cTnI antibodies and compared with serum concentrations of cTnI. All patients exceeded the cTnI cutoff for AMI during the sampling period; at initiation of therapy, 23 had elevated cTnI values. All patients demonstrated 2 bands on immunoblot: intact cTnI and a single degradation product as early as 90 minutes after onset of symptoms. On subsequent samples, 15 of 26 patients showed multiple degradation products with up to 7 degradation bands. The appearance of fragments was correlated with higher levels of cTnI (P<0.001) and time to initiation of treatment (P=0.058). This study defines for the first time the initial time course of cTnI degradation in STEMI. Intact cTnI and a single degradation product were detectable on immunoblot as early as 90 minutes after onset of symptoms with further degradation after 165 minutes. Infarct size and time to initiation of treatment was the major determinant for degradation.

Forensic use of a subtropical blowfly: the first case indicating minimum postmortem interval (mPMI) in southern Brazil and first record of Sarconesia chlorogaster from a human corpse.

PubMed

Vairo, Karine P; Corrêa, Rodrigo C; Lecheta, Melise C; Caneparo, Maria F; Mise, Kleber M; Preti, Daniel; de Carvalho, Claudio J B; Almeida, Lucia M; Moura, Mauricio O

2015-01-01

Southern Brazil is unique due to its subtropical climate. Here, we report on the first forensic entomology case and the first record of Sarconesia chlorogaster (Wiedemann) in a human corpse in this region. Flies' samples were collected from a body indoors at 20°C. Four species were found, but only Chrysomya albiceps (Wiedemann) and S. chlorogaster were used to estimate the minimum postmortem interval (mPMI). The mPMI was calculated using accumulated degree hour (ADH) and developmental time. The S. chlorogaster puparium collected was light in color, so we used an experiment to establish a more accurate estimate for time since initiation of pupation where we found full tanning after 3 h. Development of C. albiceps at 20°C to the end of the third instar is 7.4 days. The mPMI based on S. chlorogaster (developmental time until the third instar with no more than 3 h of pupae development) was 7.6 days. © 2014 American Academy of Forensic Sciences.

A MATLAB-based graphical user interface for the identification of muscular activations from surface electromyography signals.

PubMed

Mengarelli, Alessandro; Cardarelli, Stefano; Verdini, Federica; Burattini, Laura; Fioretti, Sandro; Di Nardo, Francesco

2016-08-01

In this paper a graphical user interface (GUI) built in MATLAB® environment is presented. This interactive tool has been developed for the analysis of superficial electromyography (sEMG) signals and in particular for the assessment of the muscle activation time intervals. After the signal import, the tool performs a first analysis in a totally user independent way, providing a reliable computation of the muscular activation sequences. Furthermore, the user has the opportunity to modify each parameter of the on/off identification algorithm implemented in the presented tool. The presence of an user-friendly GUI allows the immediate evaluation of the effects that the modification of every single parameter has on the activation intervals recognition, through the real-time updating and visualization of the muscular activation/deactivation sequences. The possibility to accept the initial signal analysis or to modify the on/off identification with respect to each considered signal, with a real-time visual feedback, makes this GUI-based tool a valuable instrument in clinical, research applications and also in an educational perspective.

Cystic Fibrosis Colorectal Cancer Screening Consensus Recommendations.

PubMed

Hadjiliadis, Denis; Khoruts, Alexander; Zauber, Ann G; Hempstead, Sarah E; Maisonneuve, Patrick; Lowenfels, Albert B

2018-02-01

Improved therapy has substantially increased survival of persons with cystic fibrosis (CF). But the risk of colorectal cancer (CRC) in adults with CF is 5-10 times greater compared to the general population, and 25-30 times greater in CF patients after an organ transplantation. To address this risk, the CF Foundation convened a multi-stakeholder task force to develop CRC screening recommendations. The 18-member task force consisted of experts including pulmonologists, gastroenterologists, a social worker, nurse coordinator, surgeon, epidemiologist, statistician, CF adult, and a parent. The committee comprised 3 workgroups: Cancer Risk, Transplant, and Procedure and Preparation. A guidelines specialist at the CF Foundation conducted an evidence synthesis February-March 2016 based on PubMed literature searches. Task force members conducted additional independent searches. A total of 1159 articles were retrieved. After initial screening, the committee read 198 articles in full and analyzed 123 articles to develop recommendation statements. An independent decision analysis evaluating the benefits of screening relative to harms and resources required was conducted by the Department of Public Health at Erasmus Medical Center, Netherlands using the Microsimulation Screening Analysis model from the Cancer Innervation and Surveillance Modeling Network. The task force included recommendation statements in the final guideline only if they reached an 80% acceptance threshold. The task force makes 10 CRC screening recommendations that emphasize shared, individualized decision-making and familiarity with CF-specific gastrointestinal challenges. We recommend colonoscopy as the preferred screening method, initiation of screening at age 40 years, 5-year re-screening and 3-year surveillance intervals (unless shorter interval is indicated by individual findings), and a CF-specific intensive bowel preparation. Organ transplant recipients with CF should initiate CRC screening at age 30 years within 2 years of the transplantation because of the additional risk for colon cancer associated with immunosuppression. These recommendations aim to help CF adults, families, primary care physicians, gastroenterologists, and CF and transplantation centers address the issue of CRC screening. They differ from guidelines developed for the general population with respect to the recommended age of screening initiation, screening method, preparation, and the interval for repeat screening and surveillance. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

Sampling and Control Circuit Board for an Inertial Measurement Unit

NASA Technical Reports Server (NTRS)

Chelmins, David T (Inventor); Sands, Obed (Inventor); Powis, Richard T., Jr. (Inventor)

2016-01-01

A circuit board that serves as a control and sampling interface to an inertial measurement unit ("IMU") is provided. The circuit board is also configured to interface with a local oscillator and an external trigger pulse. The circuit board is further configured to receive the external trigger pulse from an external source that time aligns the local oscillator and initiates sampling of the inertial measurement device for data at precise time intervals based on pulses from the local oscillator. The sampled data may be synchronized by the circuit board with other sensors of a navigation system via the trigger pulse.

Chromatographic evaluation of self-immobilized stationary phases for reversed-phase liquid chromatography.

PubMed

Bottoli, Carla B G; Collins, Kenneth E; Collins, Carol H

2003-02-14

The preparation of stationary phases for HPLC using polymers deposited on silica usually includes an immobilization step involving cross-linking by free radicals induced by ionizing radiation or by other radical initiators. The present paper reports changes which occur at ambient temperature in the character of poly(methyloctylsiloxane) deposited on porous silica particles as a function of the time interval between particle loading and column packing. Column performance and retention factors increase with time and these changes are attributed to rearrangement (self-assembly) which result in "self-immobilization" of the polymer molecules on the silica surface.

Timely initiation of complementary feeding and associated factors among children aged 6 to 12 months in Northern Ethiopia: an institution-based cross-sectional study

PubMed Central

2013-01-01

Background Exclusive breastfeeding (EBF) for the first six months of life is critical for the wellbeing of the child. In the mean while, timely initiation and starting nutritionally-adequate, safe, age-appropriate complementary feeding at six months is recommended for the better health and development of infants. According to the Ethiopian Demographic and Health Survey 2011, timely initiation of complementary feeding in Ethiopia at the 6th month was only 51%. The purpose of this study is to determine the magnitude of timely initiation of complementary feeding and associated factors in Mekelle town, Northern Ethiopia. Methods An institutional based cross-sectional study design was conducted among 422 mothers of infants aged from six months to one year selected from six public health facilities. Sample size proportional to the patient flow rate of each institution was allocated and systematic random sampling method was used to get the study participant. An exit interview using structured questionnaire was conducted about their experience on complementary feeding and related experience. The questionnaire was pretested among 21 mothers. Data were entered with EPI info version 3.5.1 and cleaning and analysis was done by using SPSS version 16. Frequencies distribution, binary and multiple logistic regressions were done. OR and 95% confidence interval was computed. Result The prevalence of timely initiation of complementary feeding at sixth month was 62.8% (265/422, 95% C.I: 58.1, 67.31%). Educational level, occupation of mother, parity, having ANC follow up, and birth preparedness were found to be independent predictor of timely initiation of complementary feeding. Conclusions Almost two-third of mothers initiated complementary feeding at six month of child’ age as recommended. This was relatively higher prevalence than most developing countries. However, significant proportion of mothers still did not initiate complementary feeding timely. Mothers who are illiterate and completed only primary school need more attention. All mothers must be encouraged to make antenatal care follow up. PMID:24195592

Comparison of Selegiline and Rasagiline Therapies in Parkinson Disease: A Real-life Study

PubMed Central

Peretz, Chava; Segev, Hagar; Rozani, Violet; Gurevich, Tanya; El-Ad, Baruch; Tsamir, Judith; Giladi, Nir

2016-01-01

Background We aimed to compare indicators of Parkinson disease (PD) progression between patients first prescribed either selegiline or rasagiline as their antiparkinsonian drugs (APDs) on the basis of real-life data. Methods Pharmacy data on members of a large Israeli health maintenance organization, treated as patients with PD during 2001–2012 and prescribed selegiline or rasagiline as their first APD, were analyzed. The first APD was selegiline for 349 patients (2001–2006) and rasagiline for 485 patients (2007–2012). Time from monoamine oxidase type B inhibitor prescription until initiating treatment with dopamine agonists (DAs) or levodopa was compared between the groups using Cox regression adjusted to sex and age at initiation of APD. Results The selegiline group was significantly older at first monoamine oxidase type B inhibitor purchase. In a similar follow-up time (3.0 [1.7] year for selegiline group, 3.1 y [1.4] for rasagiline group), the time to initiation of levodopa treatment did not differ between the 2 groups (adjusted hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.86–1.31). The time to initiation of DA treatment was longer in the selegiline group (adjusted HR, 1.93; 95% CI, 1.49–2.53). For those who were treated with DA before levodopa (n = 276), the time to initiation of levodopa treatment was longer in the rasagiline group (adjusted HR, 0.77; 95% CI, 0.56–1.07). Conclusions The similarity in time to levodopa in both groups suggests no differences between selegiline and rasagiline in their effect on the natural history of PD. A possible interaction effect between rasagiline and DA might exist. A better symptomatic profile of selegiline more than that of rasagiline in the earlier stages of PD may explain the difference between the 2 groups in time to DA initiation. PMID:27438181

In-well time-of-travel approach to evaluate optimal purge duration during low-flow sampling of monitoring wells

USGS Publications Warehouse

Harte, Philip T.

2017-01-01

A common assumption with groundwater sampling is that low (<0.5 L/min) pumping rates during well purging and sampling captures primarily lateral flow from the formation through the well-screened interval at a depth coincident with the pump intake. However, if the intake is adjacent to a low hydraulic conductivity part of the screened formation, this scenario will induce vertical groundwater flow to the pump intake from parts of the screened interval with high hydraulic conductivity. Because less formation water will initially be captured during pumping, a substantial volume of water already in the well (preexisting screen water or screen storage) will be captured during this initial time until inflow from the high hydraulic conductivity part of the screened formation can travel vertically in the well to the pump intake. Therefore, the length of the time needed for adequate purging prior to sample collection (called optimal purge duration) is controlled by the in-well, vertical travel times. A preliminary, simple analytical model was used to provide information on the relation between purge duration and capture of formation water for different gross levels of heterogeneity (contrast between low and high hydraulic conductivity layers). The model was then used to compare these time–volume relations to purge data (pumping rates and drawdown) collected at several representative monitoring wells from multiple sites. Results showed that computation of time-dependent capture of formation water (as opposed to capture of preexisting screen water), which were based on vertical travel times in the well, compares favorably with the time required to achieve field parameter stabilization. If field parameter stabilization is an indicator of arrival time of formation water, which has been postulated, then in-well, vertical flow may be an important factor at wells where low-flow sampling is the sample method of choice.

Comparison of the two cerebral hemispheres in inhibitory processes operative during movement preparation

PubMed Central

Klein, Pierre-Alexandre; Duque, Julie; Labruna, Ludovica; Ivry, Richard B.

2015-01-01

Neuroimaging and neuropsychological studies suggest that in right-handed individuals, the left hemisphere plays a dominant role in praxis, relative to the right hemisphere. However hemispheric asymmetries assessed with transcranial magnetic stimulation (TMS) has not shown consistent differences in corticospinal (CS) excitability of the two hemispheres during movements. In the current study, we systematically explored hemispheric asymmetries in inhibitory processes that are manifest during movement preparation and initiation. Single-pulse TMS was applied over the left or right primary motor cortex (M1LEFT and M1RIGHT, respectively) to elicit motor-evoked potentials (MEPs) in the contralateral hand while participants performed a two-choice reaction time task requiring a cued movement of the left or right index finger. In Experiments 1 and 2, TMS probes were obtained during a delay period following the presentation of the preparatory cue that provided partial or full information about the required response. MEPs were suppressed relative to baseline regardless of whether they were elicited in a cued or uncued hand. Importantly, the magnitude of these inhibitory changes in CS excitability was similar when TMS was applied over M1LEFT or M1RIGHT, irrespective of the amount of information carried by the preparatory cue. In Experiment 3, there was no preparatory cue and TMS was applied at various time points after the imperative signal. When CS excitability was probed in the cued effector, MEPs were initially inhibited and then rose across the reaction time interval. This function was similar for M1LEFT and M1RIGHT TMS. When CS excitability was probed in the uncued effector, MEPs remained inhibited throughout the RT interval. However, MEPs in right FDI became more inhibited during selection and initiation of a left hand movement, whereas MEPs in left FDI remained relatively invariant across RT interval for the right hand. In addition to these task-specific effects, there was a global difference in CS excitability across experiments between the two hemispheres. When the intensity of stimulation was set to 115% of the resting threshold, MEPs were larger when the TMS probe was applied over the M1LEFT than over M1RIGHT. In summary, while the latter result suggests that M1LEFT is more excitable than M1RIGHT, the recruitment of preparatory inhibitory mechanisms is similar within the two cerebral hemispheres. PMID:26458519

Partitioned-Interval Quantum Optical Communications Receiver

NASA Technical Reports Server (NTRS)

Vilnrotter, Victor A.

2013-01-01

The proposed quantum receiver in this innovation partitions each binary signal interval into two unequal segments: a short "pre-measurement" segment in the beginning of the symbol interval used to make an initial guess with better probability than 50/50 guessing, and a much longer segment used to make the high-sensitivity signal detection via field-cancellation and photon-counting detection. It was found that by assigning as little as 10% of the total signal energy to the pre-measurement segment, the initial 50/50 guess can be improved to about 70/30, using the best available measurements such as classical coherent or "optimized Kennedy" detection.

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

PubMed

Petersen, Christian C; Mistlberger, Ralph E

2017-08-01

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

Fuel optimal maneuvers for spacecraft with fixed thrusters

NASA Technical Reports Server (NTRS)

Carter, T. C.

1982-01-01

Several mathematical models, including a minimum integral square criterion problem, were used for the qualitative investigation of fuel optimal maneuvers for spacecraft with fixed thrusters. The solutions consist of intervals of "full thrust" and "coast" indicating that thrusters do not need to be designed as "throttleable" for fuel optimal performance. For the primary model considered, singular solutions occur only if the optimal solution is "pure translation". "Time optimal" singular solutions can be found which consist of intervals of "coast" and "full thrust". The shape of the optimal fuel consumption curve as a function of flight time was found to depend on whether or not the initial state is in the region admitting singular solutions. Comparisons of fuel optimal maneuvers in deep space with those relative to a point in circular orbit indicate that qualitative differences in the solutions can occur. Computation of fuel consumption for certain "pure translation" cases indicates that considerable savings in fuel can result from the fuel optimal maneuvers.

Targeting SRC Family Kinases and HSP90 in Lung Cancer

DTIC Science & Technology

2016-12-01

inhalation of Adeno-Cre, followed by MRI imaging at regular intervals to detect tumor initiation and growth, followed by euthanasia and processing of...experimental endpoint. 10 mice were used per time point Representative MRI data describing tumor volume (TV) are shown in Figure 1. Quantification of data is...dasatinib, we were able to make several conclusions. Figure 1. Representative MRI images from Nedd9wt or Nedd9 null Kras mutant mice, treated with

Celestial mechanics solutions that escape

NASA Astrophysics Data System (ADS)

Gingold, Harry; Solomon, Daniel

2017-08-01

We establish the existence of an open set of initial conditions through which pass solutions without singularities to Newton's gravitational equations in R3 on a semi-infinite interval in forward time, for which every pair of particles separates like At , A > 0, as t → ∞. The solutions are constructable as series with rapid uniform convergence and their asymptotic behavior to any order is prescribed. We show that this family of solutions depends on 6N parameters subject to certain constraints.

Simulation Results for Airborne Precision Spacing along Continuous Descent Arrivals

NASA Technical Reports Server (NTRS)

Barmore, Bryan E.; Abbott, Terence S.; Capron, William R.; Baxley, Brian T.

2008-01-01

This paper describes the results of a fast-time simulation experiment and a high-fidelity simulator validation with merging streams of aircraft flying Continuous Descent Arrivals through generic airspace to a runway at Dallas-Ft Worth. Aircraft made small speed adjustments based on an airborne-based spacing algorithm, so as to arrive at the threshold exactly at the assigned time interval behind their Traffic-To-Follow. The 40 aircraft were initialized at different altitudes and speeds on one of four different routes, and then merged at different points and altitudes while flying Continuous Descent Arrivals. This merging and spacing using flight deck equipment and procedures to augment or implement Air Traffic Management directives is called Flight Deck-based Merging and Spacing, an important subset of a larger Airborne Precision Spacing functionality. This research indicates that Flight Deck-based Merging and Spacing initiated while at cruise altitude and well prior to the Terminal Radar Approach Control entry can significantly contribute to the delivery of aircraft at a specified interval to the runway threshold with a high degree of accuracy and at a reduced pilot workload. Furthermore, previously documented work has shown that using a Continuous Descent Arrival instead of a traditional step-down descent can save fuel, reduce noise, and reduce emissions. Research into Flight Deck-based Merging and Spacing is a cooperative effort between government and industry partners.

Are polygonal faults the keystone for better understanding the timing of fluid migration in sedimentary basins?

NASA Astrophysics Data System (ADS)

Gay, Aurélien

2017-06-01

The initial sediment lithification starts with complex interactions involving minerals, surface water, decomposing organic matter and living organisms. This is the eogenesis domain (0 to 2 km below the seafloor) in which the sediments are subject to physical, chemical and mechanical transformations defining the early fabric of rocks. This interval is intensively prospected for its energy/mining resources (hydrocarbons, metal deposits, geothermal energy). In most basins worldwide it is composed of very fine-grained sediments and it is supposed to play the role of a seal for fluids migration. However, it is affected by polygonal faulting due to a volume loss during burial by contraction of clay sediments with a high smectite content. This process is of high interest for fractured reservoirs and/or cover integrity but it is not well constrained giving an uncertainty as this interval can either promote the migration of deeper fluids and the mineralized fluids intensifies diagenesis in the fracture planes, rendering this interval all the more impermeable. The next challenge will be to define where, when and how does this polygonal fault interval occur and this can only be done by understanding the behavior of clay grains and fluids during early burial.

Dynamic symmetries and quantum nonadiabatic transitions

DOE PAGES

Li, Fuxiang; Sinitsyn, Nikolai A.

2016-05-30

Kramers degeneracy theorem is one of the basic results in quantum mechanics. According to it, the time-reversal symmetry makes each energy level of a half-integer spin system at least doubly degenerate, meaning the absence of transitions or scatterings between degenerate states if the Hamiltonian does not depend on time explicitly. Here we generalize this result to the case of explicitly time-dependent spin Hamiltonians. We prove that for a spin system with the total spin being a half integer, if its Hamiltonian and the evolution time interval are symmetric under a specifically defined time reversal operation, the scattering amplitude between anmore » arbitrary initial state and its time reversed counterpart is exactly zero. Lastly, we also discuss applications of this result to the multistate Landau–Zener (LZ) theory.« less

Effects of pill burden on discontinuation of the initial HAART regimen in minority female patients prescribed 1 pill/day versus any other pill burden.

PubMed

Hill, Seth; Kavookjian, Jan; Qian, Jingjing; Chung, Allison; Vandewaa, John

2014-01-01

Highly active antiretroviral therapy (HAART) is a mainstay of treatment for patients with Human Immunodeficiency Virus (HIV). Since second line HAART therapies can be costlier and less effective, it is essential to understand the duration of initial HAART therapies. The overall aim of this study was to estimate the effects of daily pill burden on the time to discontinuation of the initial HAART regimen. Patients were initially identified through the clinic's CAREWARE database. A chart review was conducted for data collection, where only adult, female, HIV-positive patients initiating therapy at the study clinic between 1 January 2001 and 31 December 2011 were included. All study subjects were followed up from the initiation of HAART to treatment discontinuation. A Kaplan-Meier curve was generated to describe time to discontinuation by regimens, and a Cox proportional hazards model was developed to assess the impact of different regimen and patient demographic characteristics on the hazard of discontinuation of the initial regimen. A total of 498 charts were initially reviewed. After assessment of these patients for inclusion criteria, a cohort of 115 adult female patients who initiated HAART at the study clinic was included. Patients treated with 1 pill/day regimen had a significantly longer time to discontinuation than regimens of >1 pills/day (mean duration of initial therapy was 1062.56 days vs. 631.70 days, respectively, p = 0.003). Compared to 1 pill/day regimens, >1 pills/day regimens were associated with a higher hazard of discontinuation (hazard ratio (HR) =3.44 with 95% confidence interval (CI) = 1.25, 9.48). A higher viral load and patients without insurance were also found to be significantly associated with increased hazards of discontinuation. Overall, female HIV patients initiating therapy with the 1 pill/day HAART regimen were less likely to discontinue their treatment compared to patients initiating with >1 pills/day HAART regimen.

A new stochastic model considering satellite clock interpolation errors in precise point positioning

NASA Astrophysics Data System (ADS)

Wang, Shengli; Yang, Fanlin; Gao, Wang; Yan, Lizi; Ge, Yulong

2018-03-01

Precise clock products are typically interpolated based on the sampling interval of the observational data when they are used for in precise point positioning. However, due to the occurrence of white noise in atomic clocks, a residual component of such noise will inevitable reside within the observations when clock errors are interpolated, and such noise will affect the resolution of the positioning results. In this paper, which is based on a twenty-one-week analysis of the atomic clock noise characteristics of numerous satellites, a new stochastic observation model that considers satellite clock interpolation errors is proposed. First, the systematic error of each satellite in the IGR clock product was extracted using a wavelet de-noising method to obtain the empirical characteristics of atomic clock noise within each clock product. Then, based on those empirical characteristics, a stochastic observation model was structured that considered the satellite clock interpolation errors. Subsequently, the IGR and IGS clock products at different time intervals were used for experimental validation. A verification using 179 stations worldwide from the IGS showed that, compared with the conventional model, the convergence times using the stochastic model proposed in this study were respectively shortened by 4.8% and 4.0% when the IGR and IGS 300-s-interval clock products were used and by 19.1% and 19.4% when the 900-s-interval clock products were used. Furthermore, the disturbances during the initial phase of the calculation were also effectively improved.

The Effect of Birthrate Granularity on the Release- to- Birth Ratio for the AGR-1 In-core Experiment

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

Dawn Scates; John Walter

The AGR-1 Advanced Gas Reactor (AGR) tristructural-isotropic-particle fuel experiment underwent 13 irradiation intervals from December 2006 until November 2009 within the Idaho National Laboratory Advanced Test Reactor in support of the Next Generation Nuclear Power Plant program. During this multi-year experiment, release-to-birth rate ratios were computed at the end of each operating interval to provide information about fuel performance. Fission products released during irradiation were tracked daily by the Fission Product Monitoring System using 8-hour measurements. Birth rates calculated by MCNP with ORIGEN for as-run conditions were computed at the end of each irradiation interval. Each time step in MCNPmore » provided neutron flux, reaction rates and AGR-1 compact composition, which were used to determine birth rates using ORIGEN. The initial birth-rate data, consisting of four values for each irradiation interval at the beginning, end, and two intermediate times, were interpolated to obtain values for each 8-hour activity. The problem with this method is that any daily changes in heat rates or perturbations, such as shim control movement or core/lobe power fluctuations, would not be reflected in the interpolated data and a true picture of the system would not be presented. At the conclusion of the AGR-1 experiment, great efforts were put forth to compute daily birthrates, which were reprocessed with the 8-hour release activity. The results of this study are presented in this paper.« less

The effect of birthrate granularity on the release-to-birth ratio for the AGR-1 in-core experiment

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

D. M. Scates; J. B. Walter; J. T. Maki

The AGR-1 Advanced Gas Reactor (AGR) tristructural-isotropic-particle fuel experiment underwent 13 irradiation intervals from December 2006 until November 2009 within the Idaho National Laboratory Advanced Test Reactor in support of the Next Generation Nuclear Power Plant program. During this multi-year experiment, release-to-birth rate ratios were computed at the end of each operating interval to provide information about fuel performance. Fission products released during irradiation were tracked daily by the Fission Product Monitoring System using 8-h measurements. Birth rate calculated by MCNP with ORIGEN for as-run conditions were computed at the end of each irradiation interval. Each time step in MCNPmore » provided neutron flux, reaction rates and AGR-1 compact composition, which were used to determine birth rate using ORIGEN. The initial birth-rate data, consisting of four values for each irradiation interval at the beginning, end, and two intermediate times, were interpolated to obtain values for each 8-h activity. The problem with this method is that any daily changes in heat rates or perturbations, such as shim control movement or core/lobe power fluctuations, would not be reflected in the interpolated data and a true picture of the system would not be presented. At the conclusion of the AGR-1 experiment, great efforts were put forth to compute daily birthrates, which were reprocessed with the 8-h release activity. The results of this study are presented in this paper.« less

Lexical stress encoding in single word production estimated by event-related brain potentials.

PubMed

Schiller, Niels O

2006-09-27

An event-related brain potentials (ERPs) experiment was carried out to investigate the time course of lexical stress encoding in language production. Native speakers of Dutch viewed a series of pictures corresponding to bisyllabic names which were either stressed on the first or on the second syllable and made go/no-go decisions on the lexical stress location of those picture names. Behavioral results replicated a pattern that was observed earlier, i.e. faster button-press latencies to initial as compared to final stress targets. The electrophysiological results indicated that participants could make a lexical stress decision significantly earlier when picture names had initial than when they had final stress. Moreover, the present data suggest the time course of lexical stress encoding during single word form formation in language production. When word length is corrected for, the temporal interval for lexical stress encoding specified by the current ERP results falls into the time window previously identified for phonological encoding in language production.

A cloud masking algorithm for EARLINET lidar systems

NASA Astrophysics Data System (ADS)

Binietoglou, Ioannis; Baars, Holger; D'Amico, Giuseppe; Nicolae, Doina

2015-04-01

Cloud masking is an important first step in any aerosol lidar processing chain as most data processing algorithms can only be applied on cloud free observations. Up to now, the selection of a cloud-free time interval for data processing is typically performed manually, and this is one of the outstanding problems for automatic processing of lidar data in networks such as EARLINET. In this contribution we present initial developments of a cloud masking algorithm that permits the selection of the appropriate time intervals for lidar data processing based on uncalibrated lidar signals. The algorithm is based on a signal normalization procedure using the range of observed values of lidar returns, designed to work with different lidar systems with minimal user input. This normalization procedure can be applied to measurement periods of only few hours, even if no suitable cloud-free interval exists, and thus can be used even when only a short period of lidar measurements is available. Clouds are detected based on a combination of criteria including the magnitude of the normalized lidar signal and time-space edge detection performed using the Sobel operator. In this way the algorithm avoids misclassification of strong aerosol layers as clouds. Cloud detection is performed using the highest available time and vertical resolution of the lidar signals, allowing the effective detection of low-level clouds (e.g. cumulus humilis). Special attention is given to suppress false cloud detection due to signal noise that can affect the algorithm's performance, especially during day-time. In this contribution we present the details of algorithm, the effect of lidar characteristics (space-time resolution, available wavelengths, signal-to-noise ratio) to detection performance, and highlight the current strengths and limitations of the algorithm using lidar scenes from different lidar systems in different locations across Europe.

Comparative effectiveness of generic versus brand-name antiepileptic medications.

PubMed

Gagne, Joshua J; Kesselheim, Aaron S; Choudhry, Niteesh K; Polinski, Jennifer M; Hutchins, David; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

2015-11-01

The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. We used linked electronic medical and pharmacy claims data to identify Medicare beneficiaries who initiated one of five AEDs (clonazepam, gabapentin, oxcarbazepine, phenytoin, zonisamide). We matched initiators of generic versus brand-name versions of these drugs using a propensity score that accounted for demographic, clinical, and health service utilization variables. We used a Cox proportional hazards model to compare rates of seizure-related emergency room (ER) visit or hospitalization (primary outcome) and ER visit for bone fracture or head injury (secondary outcome) between the matched generic and brand-name initiators. We also compared treatment persistence, measured as time to first 14-day treatment gap, between generic and brand-name initiators. We identified 19,760 AED initiators who met study eligibility criteria; 18,306 (93%) initiated a generic AED. In the matched cohort, we observed 47 seizure-related hospitalizations and ER visits among brand-name initiators and 31 events among generic initiators, corresponding to a hazard ratio of 0.53 (95% confidence interval, 0.30 to 0.96). Similar results were observed for the secondary clinical endpoint and across sensitivity analyses. Mean time to first treatment gap was 124.2 days (standard deviation [sd], 125.8) for brand-name initiators and 137.9 (sd, 148.6) for generic initiators. Patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions. Copyright © 2015 Elsevier Inc. All rights reserved.

Rural Patient Access to Primary Percutaneous Coronary Intervention Centers is Improved by a Novel Integrated Telemedicine Prehospital System.

PubMed

Tanguay, Alain; Dallaire, Renée; Hébert, Denise; Bégin, François; Fleet, Richard

2015-11-01

As per American Heart Association/American College of Cardiology guidelines, the delay between first medical contact and balloon inflation should not exceed 90 min for primary percutaneous coronary intervention (PCI). In North America, few prehospital systems have been developed to grant rural populations timely access to PCI. The objective of the present study was to evaluate the ability of an ST-segment elevation myocardial infarction (STEMI) system serving suburban and rural populations to achieve the recommended 90-min interval benchmark for PCI. A prehospital telemedicine program was implemented in a rural and suburban region of the Quebec province. Three patient groups with STEMI were created according to trajectory: 1) patients already en route to a PCI center, 2) patients initially directed to the nearest hospital who were subsequently diverted to a PCI center during transport, and 3) patients directed to the nearest hospital without transfer for PCI. Time intervals were compared across groups. Of the 208 patients diagnosed with STEMI, 14.9% were already on their way to a hospital with PCI capabilities, 75.0% were rerouted to a PCI center, and 10.1% were directed to the nearest local hospital. All patients but one arrived at the PCI center within the 60-min prehospital care interval, considering an additional 30 min for balloon inflation at the PCI center. This study demonstrated that a regionalized prehospital system for STEMI patients could achieve the recommended 90-min interval benchmark for PCI, while giving timely access to PCI to rural populations that would not otherwise have access to this treatment. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The impact of ultra-brief chest compression-only CPR video training on responsiveness, compression rate, and hands-off time interval among bystanders in a shopping mall.

PubMed

Panchal, Ashish R; Meziab, Omar; Stolz, Uwe; Anderson, Wes; Bartlett, Mitchell; Spaite, Daniel W; Bobrow, Bentley J; Kern, Karl B

2014-09-01

Recent studies have demonstrated higher-quality chest compressions (CCs) following a 60 s ultra-brief video (UBV) on compression-only CPR (CO-CPR). However, the effectiveness of UBVs as a CPR-teaching tool for lay bystanders in public venues remains unknown. Determine whether an UBV is effective in teaching laypersons CO-CPR in a public setting and if viewing leads to superior responsiveness and CPR skills. Adult lay bystanders were enrolled in a public shopping mall and randomized to: (1) Control (CTR): sat idle for 60 s; (2) UBV: watched a 60 s UBV on CO-CPR. Subjects were read a scenario detailing a sudden collapse in the mall and asked to do what they "thought was best" on a mannequin. Performance measures were recorded for 2 min: responsiveness (time to call 911 and first CCs) and CPR quality [CC depth, rate, hands-off interval (time without CC after first CC)]. One hundred subjects were enrolled. Demographics were similar between groups. UBV subjects called 911 more frequently (percent difference: 31%) and initiated CCs sooner in the arrest scenario (median difference (MD): 5 s). UBV cohort had increased CC rate (MD: 19 cpm) and decreased hands-off interval (MD: 27 s). There was no difference in CC depth. Bystanders with UBV training in a shopping mall had significantly improved responsiveness, CC rate, and decreased hands-off interval. Given the short length of training, UBV may have potential as a ubiquitous intervention for public venues to help improve bystander reaction to arrest and CO-CPR performance. Published by Elsevier Ireland Ltd.

Intracellular calcium and the mechanism of anodal supernormal excitability in langendorff perfused rabbit ventricles.

PubMed

Joung, Boyoung; Park, Hyung-Wook; Maruyama, Mitsunori; Tang, Liang; Song, Juan; Han, Seongwook; Piccirillo, Gianfranco; Weiss, James N; Lin, Shien-Fong; Chen, Peng-Sheng

2011-01-01

Anodal stimulation hyperpolarizes the cell membrane and increases the intracellular Ca(2+) (Ca(i)) transient. This study tested the hypothesis that the maximum slope of the Ca(i) decline (-(dCa(i)/dt)(max)) corresponds to the timing of anodal dip on the strength-interval curve and the initiation of repetitive responses and ventricular fibrillation (VF) after a premature stimulus (S(2)). We simultaneously mapped the membrane potential (V(m)) and Ca(i) in 23 rabbit ventricles. A dip in the anodal strength-interval curve was observed. During the anodal dip, ventricles were captured by anodal break excitation directly under the S(2) electrode. The Ca(i) following anodal stimuli is larger than that following cathodal stimuli. The S(1)-S(2) intervals of the anodal dip (203±10 ms) coincided with the -(dCa(i)/dt)(max) (199±10 ms, P=NS). BAPTA-AM (n=3), inhibition of the electrogenic Na(+)-Ca(2+) exchanger current (I(NCX)) by low extracellular Na(+) (n=3), and combined ryanodine and thapsigargin infusion (n=2) eliminated the anodal supernormality. Strong S(2) during the relative refractory period (n=5) induced 29 repetitive responses and 10 VF episodes. The interval between S(2) and the first non-driven beat was coincidental with the time of -(dCa(i)/dt)(max). Larger Ca(i) transient and I(NCX) activation induced by anodal stimulation produces anodal supernormality. The time of maximum I(NCX) activation is coincidental to the induction of non-driven beats from the Ca(i) sinkhole after a strong premature stimulation. All rights are reserved to the Japanese Circulation Society.

Self-similar space-time evolution of an initial density discontinuity

NASA Astrophysics Data System (ADS)

Rekaa, V. L.; Pécseli, H. L.; Trulsen, J. K.

2013-07-01

The space-time evolution of an initial step-like plasma density variation is studied. We give particular attention to formulate the problem in a way that opens for the possibility of realizing the conditions experimentally. After a short transient time interval of the order of the electron plasma period, the solution is self-similar as illustrated by a video where the space-time evolution is reduced to be a function of the ratio x/t. Solutions of this form are usually found for problems without characteristic length and time scales, in our case the quasi-neutral limit. By introducing ion collisions with neutrals into the numerical analysis, we introduce a length scale, the collisional mean free path. We study the breakdown of the self-similarity of the solution as the mean free path is made shorter than the system length. Analytical results are presented for charge exchange collisions, demonstrating a short time collisionless evolution with an ensuing long time diffusive relaxation of the initial perturbation. For large times, we find a diffusion equation as the limiting analytical form for a charge-exchange collisional plasma, with a diffusion coefficient defined as the square of the ion sound speed divided by the (constant) ion collision frequency. The ion-neutral collision frequency acts as a parameter that allows a collisionless result to be obtained in one limit, while the solution of a diffusion equation is recovered in the opposite limit of large collision frequencies.

Discrete conservation laws and the convergence of long time simulations of the mkdv equation

NASA Astrophysics Data System (ADS)

Gorria, C.; Alejo, M. A.; Vega, L.

2013-02-01

Pseudospectral collocation methods and finite difference methods have been used for approximating an important family of soliton like solutions of the mKdV equation. These solutions present a structural instability which make difficult to approximate their evolution in long time intervals with enough accuracy. The standard numerical methods do not guarantee the convergence to the proper solution of the initial value problem and often fail by approaching solutions associated to different initial conditions. In this frame the numerical schemes that preserve the discrete invariants related to some conservation laws of this equation produce better results than the methods which only take care of a high consistency order. Pseudospectral spatial discretization appear as the most robust of the numerical methods, but finite difference schemes are useful in order to analyze the rule played by the conservation of the invariants in the convergence.

Funding policies and postabortion long-acting reversible contraception: results from a cluster randomized trial.

PubMed

Rocca, Corinne H; Thompson, Kirsten M J; Goodman, Suzan; Westhoff, Carolyn L; Harper, Cynthia C

2016-06-01

Almost one-half of women having an abortion in the United States have had a previous procedure, which highlights a failure to provide adequate preventive care. Provision of intrauterine devices and implants, which have high upfront costs, can be uniquely challenging in the abortion care setting. We conducted a study of a clinic-wide training intervention on long-acting reversible contraception and examined the effect of the intervention, insurance coverage, and funding policies on the use of long-acting contraceptives after an abortion. This subanalysis of a cluster, randomized trial examines data from the 648 patients who had undergone an abortion who were recruited from 17 reproductive health centers across the United States. The trial followed participants 18-25 years old who did not desire pregnancy for a year. We measured the effect of the intervention, health insurance, and funding policies on contraceptive outcomes, which included intrauterine device and implant counseling and selection at the abortion visit, with the use of logistic regression with generalized estimating equations for clustering. We used survival analysis to model the actual initiation of these methods over 1 year. Women who obtained abortion care at intervention sites were more likely to report intrauterine device and implant counseling (70% vs 41%; adjusted odds ratio, 3.83; 95% confidence interval, 2.37-6.19) and the selection of these methods (36% vs 21%; adjusted odds ratio, 2.11; 95% confidence interval, 1.39-3.21). However, the actual initiation of methods was similar between study arms (22/100 woman-years each; adjusted hazard ratio, 0.88; 95% confidence interval, 0.51-1.51). Health insurance and funding policies were important for the initiation of intrauterine devices and implants. Compared with uninsured women, those women with public health insurance had a far higher initiation rate (adjusted hazard ratio, 2.18; 95% confidence interval, 1.31-3.62). Women at sites that provide state Medicaid enrollees abortion coverage also had a higher initiation rate (adjusted hazard ratio, 1.73; 95% confidence interval, 1.04-2.88), as did those at sites with state mandates for private health insurance to cover contraception (adjusted hazard ratio, 1.80; 95% confidence interval, 1.06-3.07). Few of the women with private insurance used it to pay for the abortion (28%), but those who did initiated long-acting contraceptive methods at almost twice the rate as women who paid for it themselves or with donated funds (adjusted hazard ratio, 1.94; 95% confidence interval, 1.10-3.43). The clinic-wide training increased long-acting reversible contraceptive counseling and selection but did not change initiation for abortion patients. Long-acting method use after abortion was associated strongly with funding. Restrictions on the coverage of abortion and contraceptives in abortion settings prevent the initiation of desired long-acting methods. Copyright © 2015 Elsevier Inc. All rights reserved.

The Initial Development of Transient Volcanic Plumes as a Function of Source Conditions

NASA Astrophysics Data System (ADS)

Tournigand, Pierre-Yves; Taddeucci, Jacopo; Gaudin, Damien; Peña Fernández, Juan José; Del Bello, Elisabetta; Scarlato, Piergiorgio; Kueppers, Ulrich; Sesterhenn, Jörn; Yokoo, Akihiko

2017-12-01

Transient volcanic plumes, having similar eruption duration and rise timescales, characterize many unsteady Strombolian to Vulcanian eruptions. Despite being more common, such plumes are less studied than their steady state counterpart from stronger eruptions. Here we investigate the initial dynamics of transient volcanic plumes using high-speed (visible light and thermal) and high-resolution (visible light) videos from Strombolian to Vulcanian eruptions of Stromboli (Italy), Fuego (Guatemala), and Sakurajima (Japan) volcanoes. Physical parameterization of the plumes has been performed by defining their front velocity, velocity field, volume, and apparent surface temperature. We also characterized the ejection of the gas-pyroclast mixture at the vent, in terms of number, location, duration, and frequency of individual ejection pulses and of time-resolved mass eruption rate of the ejecta's ash fraction. Front velocity evolves along two distinct trends related to the initial gas-thrust phase and later buoyant phase. Plumes' velocity field, obtained via optical flow analysis, highlights different features, including initial jets and the formation and/or merging of ring vortexes at different scales. Plume volume increases over time following a power law trend common to all volcanoes and affected by discharge history at the vent. Time-resolved ash eruption rates range between 102 and 107 kg/s and may vary up to 2 orders of magnitude within the first seconds of eruption. Our results help detailing how the number, location, angle, duration, velocity, and time interval between ejection pulses at the vents crucially control the initial (first tens of second), and possibly later, evolution of transient volcanic plumes.

Overuse of short-interval bone densitometry: assessing rates of low-value care.

PubMed

Morden, N E; Schpero, W L; Zaha, R; Sequist, T D; Colla, C H

2014-09-01

We evaluated the prevalence and geographic variation of short-interval (repeated in under 2 years) dual-energy X-ray absorptiometry tests (DXAs) among Medicare beneficiaries. Short-interval DXA use varied across regions (coefficient of variation = 0.64), and unlike other DXAs, rates decreased with payment cuts. The American College of Rheumatology, through the Choosing Wisely initiative, identified measuring bone density more often than every 2 years as care "physicians and patients should question." We measured the prevalence and described the geographic variation of short-interval (repeated in under 2 years) DXAs among Medicare beneficiaries and estimated the cost of this testing and its responsiveness to payment change. Using 100 % Medicare claims data, 2006-2011, we identified DXAs and short-interval DXAs for female Medicare beneficiaries over age 66. We determined the population rate of DXAs and short-interval DXAs, as well as Medicare spending on short-interval DXAs, nationally and by hospital referral region (HRR). DXA use was stable 2008-2011 (12.4 to 11.5 DXAs per 100 women). DXA use varied across HRRs: in 2011, overall DXA use ranged from 6.3 to 23.0 per 100 women (coefficient of variation = 0.18), and short-interval DXAs ranged from 0.3 to 8.0 per 100 women (coefficient of variation = 0.64). Short-interval DXA use fluctuated substantially with payment changes; other DXAs did not. Short-interval DXAs, which represented 10.1 % of all DXAs, cost Medicare approximately US$16 million in 2011. One out of ten DXAs was administered in a time frame shorter than recommended and at a substantial cost to Medicare. DXA use varied across regions. Short-interval DXA use was responsive to reimbursement changes, suggesting carefully designed policy and payment reform may reduce this care identified by rheumatologists as low value.

Centralized and decentralized global outer-synchronization of asymmetric recurrent time-varying neural network by data-sampling.

PubMed

Lu, Wenlian; Zheng, Ren; Chen, Tianping

2016-03-01

In this paper, we discuss outer-synchronization of the asymmetrically connected recurrent time-varying neural networks. By using both centralized and decentralized discretization data sampling principles, we derive several sufficient conditions based on three vector norms to guarantee that the difference of any two trajectories starting from different initial values of the neural network converges to zero. The lower bounds of the common time intervals between data samples in centralized and decentralized principles are proved to be positive, which guarantees exclusion of Zeno behavior. A numerical example is provided to illustrate the efficiency of the theoretical results. Copyright © 2015 Elsevier Ltd. All rights reserved.

a New Approach to Physiologic Triggering in Medical Imaging Using Multiple Heart Sounds Alone.

NASA Astrophysics Data System (ADS)

Groch, Mark Walter

A new method for physiological synchronization of medical image acquisition using both the first and second heart sound has been developed. Heart sounds gating (HSG) circuitry has been developed which identifies, individually, both the first (S1) and second (S2) heart sounds from their timing relationship alone, and provides two synchronization points during the cardiac cycle. Identification of first and second heart sounds from their timing relationship alone and application to medical imaging has, heretofore, not been performed in radiology or nuclear medicine. The heart sounds are obtained as conditioned analog signals from a piezoelectric transducer microphone placed on the patient's chest. The timing relationships between the S1 to S2 pulses and the S2 to S1 pulses are determined using a logic scheme capable of distinguishing the S1 and S2 pulses from the heart sounds themselves, using their timing relationships, and the assumption that initially the S1-S2 interval will be shorter than the S2-S1 interval. Digital logic circuitry is utilized to continually track the timing intervals and extend the S1/S2 identification to heart rates up to 200 beats per minute (where the S1-S2 interval is not shorter than the S2-S1 interval). Clinically, first heart sound gating may be performed to assess the systolic ejection portion of the cardiac cycle, with S2 gating utilized for reproduction of the diastolic filling portion of the cycle. One application of HSG used for physiologic synchronization is in multigated blood pool (MGBP) imaging in nuclear medicine. Heart sounds gating has been applied to twenty patients who underwent analysis of ventricular function in Nuclear Medicine, and compared to conventional ECG gated MGBP. Left ventricular ejection fractions calculated from MGBP studies using a S1 and a S2 heart sound trigger correlated well with conventional ECG gated acquisitions in patients adequately gated by HSG and ECG. Heart sounds gating provided superior definition of the diastolic filling phase of the cardiac cycle by qualitative assessment of the left ventricular volume time -activity curves. Heart sounds physiological synchronization has potential to be used in other imaging modalities, such as magnetic resonance imaging, where the ECG is distorted due to the electromagnetic environment within the imager.

Maternal employment and breast-feeding initiation: findings from the Millennium Cohort Study.

PubMed

Hawkins, Summer S; Griffiths, Lucy J; Dezateux, Carol; Law, Catherine

2007-05-01

Maternal employment rates have increased rapidly in recent years and little is known about how this influences whether women start breast feeding. We examined data from the Millennium Cohort Study to determine whether a mother's employment status (full-time, part-time, self-employed, on leave, not employed/student) and employment characteristics are related to breast-feeding initiation. This analysis comprised 14 830 white mothers from Britain and Ireland (6917 employed) with singleton babies, born from 2000 to 2002. Information was obtained on infant feeding history and mother's employment when the cohort child was 9 months old. We found that women employed full-time were less likely to initiate breast feeding than mothers who were not employed/students, after adjustment for confounding factors [adjusted rate ratio (aRR) = 0.92; 95% confidence interval (CI) 0.89, 0.96]; however, there were no differences in breast-feeding initiation between mothers employed part-time, self-employed, or on leave and mothers who were not employed/students. Among employed mothers, those who returned to work within 4 months postpartum were less likely to start breast feeding than women who returned at 5 or 6 months [aRR = 0.95; 95% CI 0.92, 0.99], and women who returned within the first 6 weeks were much less likely to start breast feeding [aRR = 0.85; 95% CI 0.77, 0.94]. Mothers returning for financial reasons were also less likely to initiate breast feeding [aRR = 0.96; 95% CI 0.93, 0.99] than those who returned for other reasons. Policies to increase breast feeding should address how both the time and circumstances of a mother's return to employment postpartum influence whether she decides to start breast feeding.

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

PubMed

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

2017-10-01

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

High-Intensity Interval Training Elicits Higher Enjoyment than Moderate Intensity Continuous Exercise

PubMed Central

Thum, Jacob S.; Parsons, Gregory; Whittle, Taylor

2017-01-01

Exercise adherence is affected by factors including perceptions of enjoyment, time availability, and intrinsic motivation. Approximately 50% of individuals withdraw from an exercise program within the first 6 mo of initiation, citing lack of time as a main influence. Time efficient exercise such as high intensity interval training (HIIT) may provide an alternative to moderate intensity continuous exercise (MICT) to elicit substantial health benefits. This study examined differences in enjoyment, affect, and perceived exertion between MICT and HIIT. Twelve recreationally active men and women (age = 29.5 ± 10.7 yr, VO2max = 41.4 ± 4.1 mL/kg/min, BMI = 23.1 ± 2.1 kg/m2) initially performed a VO2max test on a cycle ergometer to determine appropriate workloads for subsequent exercise bouts. Each subject returned for two additional exercise trials, performing either HIIT (eight 1 min bouts of cycling at 85% maximal workload (Wmax) with 1 min of active recovery between bouts) or MICT (20 min of cycling at 45% Wmax) in randomized order. During exercise, rating of perceived exertion (RPE), affect, and blood lactate concentration (BLa) were measured. Additionally, the Physical Activity Enjoyment Scale (PACES) was completed after exercise. Results showed higher enjoyment (p = 0.013) in response to HIIT (103.8 ± 9.4) versus MICT (84.2 ± 19.1). Eleven of 12 participants (92%) preferred HIIT to MICT. However, affect was lower (p<0.05) and HR, RPE, and BLa were higher (p<0.05) in HIIT versus MICT. Although HIIT is more physically demanding than MICT, individuals report greater enjoyment due to its time efficiency and constantly changing stimulus. Trial Registration: NCT:02981667. PMID:28076352

High-Intensity Interval Training Elicits Higher Enjoyment than Moderate Intensity Continuous Exercise.

PubMed

Thum, Jacob S; Parsons, Gregory; Whittle, Taylor; Astorino, Todd A

2017-01-01

Exercise adherence is affected by factors including perceptions of enjoyment, time availability, and intrinsic motivation. Approximately 50% of individuals withdraw from an exercise program within the first 6 mo of initiation, citing lack of time as a main influence. Time efficient exercise such as high intensity interval training (HIIT) may provide an alternative to moderate intensity continuous exercise (MICT) to elicit substantial health benefits. This study examined differences in enjoyment, affect, and perceived exertion between MICT and HIIT. Twelve recreationally active men and women (age = 29.5 ± 10.7 yr, VO2max = 41.4 ± 4.1 mL/kg/min, BMI = 23.1 ± 2.1 kg/m2) initially performed a VO2max test on a cycle ergometer to determine appropriate workloads for subsequent exercise bouts. Each subject returned for two additional exercise trials, performing either HIIT (eight 1 min bouts of cycling at 85% maximal workload (Wmax) with 1 min of active recovery between bouts) or MICT (20 min of cycling at 45% Wmax) in randomized order. During exercise, rating of perceived exertion (RPE), affect, and blood lactate concentration (BLa) were measured. Additionally, the Physical Activity Enjoyment Scale (PACES) was completed after exercise. Results showed higher enjoyment (p = 0.013) in response to HIIT (103.8 ± 9.4) versus MICT (84.2 ± 19.1). Eleven of 12 participants (92%) preferred HIIT to MICT. However, affect was lower (p<0.05) and HR, RPE, and BLa were higher (p<0.05) in HIIT versus MICT. Although HIIT is more physically demanding than MICT, individuals report greater enjoyment due to its time efficiency and constantly changing stimulus. NCT:02981667.

Effects of fire frequency and season on resprouting of woody plants in southeastern US pine-grassland communities.

PubMed

Robertson, Kevin M; Hmielowski, Tracy L

2014-03-01

Past studies suggest that rates of woody plant resprouting following a "topkilling" disturbance relate to timing of disturbance because of temporal patterns of below-ground carbohydrate storage. Accordingly, we hypothesized that fire-return interval (1 or 2 years) and season of burn (late dormant or early growing season) would influence the change in resprout growth rate from one fire-free interval to the next (Δ growth rate) for broadleaf woody plants in a pine-grassland in Georgia, USA. Resprout growth rate during one fire-free interval strongly predicted growth rate during the following fire-free interval, presumably reflecting root biomass. Length of fire-free interval did not have a significant effect on mean Δ growth rate. Plants burned in the late dormant season (February-March) had a greater positive Δ growth rate than those burned in the early growing season (April-June), consistent with the presumption that root carbohydrates are depleted and thus limiting during spring growth. Plants with resprout growth rates above a certain level had zero or negative Δ growth rates, indicating an equilibrium of maximum resprout size under a given fire-return interval. This equilibrium, as well as relatively reduced resprout growth rate following growing season fires, provide insight into how historic lightning-initiated fires in the early growing season limited woody plant dominance and maintained the herb-dominated structure of pine-grassland communities. Results also indicate tradeoffs between applying prescribed fire at 1- versus 2-year intervals and in the dormant versus growing seasons with the goal of limiting woody vegetation.

Florida Initiative for Quality Cancer Care: improvements on colorectal cancer quality of care indicators during a 3-year interval.

PubMed

Siegel, Erin M; Jacobsen, Paul B; Lee, Ji-Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Smith, Jesusa Corazon R; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry-Jennifer; Shibata, David

2014-01-01

The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥ 12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level. Copyright © 2014. Published by Elsevier Inc.

Direct measurement of time-dependent anesthetized in vivo human pulp temperature.

PubMed

Runnacles, Patrício; Arrais, Cesar Augusto Galvão; Pochapski, Marcia Thais; dos Santos, Fábio André; Coelho, Ulisses; Gomes, João Carlos; De Goes, Mário Fernando; Gomes, Osnara Maria Mongruel; Rueggeberg, Frederick Allen

2015-01-01

Human intrapupal tooth temperature is considered to be similar to that of the body (≈37 °C), although the actual temperature has never been measured. This study evaluated the in vivo, human, basal, coronal intrapulpal temperature of anesthetized upper first premolars. After approval of the local Ethics Committee was obtained (protocol no. 255,945), upper right and left first premolars requiring extraction for orthodontic reasons from 8 volunteers, ranging from 12 to 30 years old, received infiltrative and intraligamental anesthesia. The teeth (n=15) were isolated using rubber dam and a small, occlusal preparation was made using high-speed handpiece, under constant air-water spray, until a minute pulp exposure was attained. The sterile probe from a wireless, NIST-traceable, temperature acquisition system (Thermes WFI) was inserted directly into the coronal pulp. Once the probe was properly positioned and stable, real-time temperature data were continuously acquired for approximately 25 min. Data (°C) were subjected to 2-tailed, paired t-test (α=0.05), and the 95% confidence intervals for the initial and 25-min mean temperatures were also determined. The initial pulp temperature value (31.8±1.5 °C) was significantly lower than after 25-min (35.3±0.7 °C) (p<0.05). The 95% confidence interval for the initial temperature ranged from 31.0 to 32.6 °C and from 35.0 to 35.7 °C after 25 min. A slow, gradual temperature increase was observed after probe insertion until the pulp temperature reached a plateau, usually after 15 min. Consistent coronal, human, in vivo temperature values were observed and were slightly, but significantly below that of body core temperature. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Sex disparities in diagnosis of bladder cancer after initial presentation with hematuria: a nationwide claims-based investigation.

PubMed

Cohn, Joshua A; Vekhter, Benjamin; Lyttle, Christopher; Steinberg, Gary D; Large, Michael C

2014-02-15

Women have disproportionately higher mortality rates relative to incidence for bladder cancer. Multiple etiologies have been proposed, including delayed diagnosis and treatment. Guidelines recommend ruling out malignancy in men and women presenting with hematuria. This study sought to determine the difference in timing from presentation with hematuria to diagnosis of bladder cancer in women versus men. This is a retrospective population-based study examining the timing from presentation with hematuria to diagnosis of bladder cancer, based on data from the MarketScan databases, which include enrollees of more than 100 health insurance plans of approximately 40 large US employers from 2004 through 2010. All study patients presented with hematuria and were subsequently diagnosed with bladder cancer. The primary outcome measure was number of days between initial presentation with hematuria and diagnosis of bladder cancer by sex. A total of 5416 men and 2233 women met inclusion criteria. Mean days from initial hematuria claim to bladder cancer claim was significantly longer in women (85.4 versus 73.6 days, P < .001), and the proportion of women with >6 month delay in bladder cancer diagnosis was significantly higher (17.3% versus 14.1%, P < .001). Women were more likely to be diagnosed with urinary tract infection (odds ratio = 2.32, 95% confidence interval = 2.07-2.59) and less likely to undergo abdominal or pelvic imaging (odds ratio = 0.80, 95% confidence interval = 0.71-0.89). Both men and women experience significant delays between presentation with hematuria and diagnosis of bladder cancer, with longer delays for women. This may be partly responsible for the sex-based discrepancy in outcomes associated with bladder cancer. © 2013 American Cancer Society.

A Historical Perspective on Presentations of Hypertensive Acute Heart Failure.

PubMed

Darling, Chad E; Sun, Jiaoyuan Elisabeth; Goldberg, Jordan; Pang, Peter; Baugh, Christopher W; Lessard, Darleen; McManus, David D

2017-05-01

The initial systolic blood pressure (SBP) in patients presenting to the hospital with acute heart failure (AHF) informs prognosis, diagnosis, and guides initial treatment. However, over time AHF presentations with elevated SBP appear to have declined. The present study examined whether the frequency of AHF presentations with systolic hypertension (SBP >160 mmHg) declined over a nearly two-decade time interval. This study compares four historical, cross-sectional cohorts with AHF who were admitted to tertiary care medical centres in the North-eastern USA in 1995, 2000, 2006, and 2011-13. The main outcome was the proportion of AHF patients presenting with an initial SBP >160 mmHg. 2,366 patients comprised the study sample. The average age was 77 years, 55% were female, 94% white, and 75% had prior heart failure. In 1995, 34% of AHF patients presented with an initial SBP >160 mmHg compared to 20% in 2011-2013 (p<0.01). Multivariate logistic regression demonstrated reduced odds of presenting with a SBP >160 mmHg in 2006 (0.64, 95% CI 0.42-0.96) and 2011-13 (0.46, 95% CI 0.28-0.74) compared with patients in 1995. The proportion of patients with AHF and initial SBP >160 mmHg significantly declined over the study time period. There are several potential reasons for this observation and these findings highlight the need for ongoing surveillance of patients with AHF as changing clinical characteristics can impact early treatment decisions.

Data for Figures in Rainfall-induced release of microbes from manure: model development, parameter estimation, and uncertainty evaluation on small plots

EPA Pesticide Factsheets

? Figure 1. Ratio of cumulative released cells to cells initially present in the manure at Week 0 as they vary by time, manure type and age, microbe, and Event (i.e., season). The 95% confidence intervals of the observed median number of cells in microbial runoff are shown as the shaded area.? Figure 2. Typical observed and simulated cumulative microbial runoff for Plots A403 and C209 with individual plot calibration.? Figure 3. Observed versus simulated microbial runoff associated with the Approach 1, adjusted for cumulative results by manure type and Event. Results accounted for counts associated with field monitoring time intervals described in Section 2.1 Field method. NS=Nash-Sutcliffe modeling efficiency, EC=E. coli, En=enterococci, FC= fecal coliforms.? Figure 4. Ratio of cumulative released cells/mass to cells/mass initially present in the aged manure by time and component (e.g., microbe) for solid manure (a) and (b), and amended, dry litter, and slurry manure (c). Solid lines (Equation (11) correspond to values in Table 3 for solid manure, and dry litter and slurry manure, respectively: (a) uses individual b values, and (b) and (c) use the combined values for b. Bounds of first and third quartiles associated with the present study??s results for cattle. Bounds of first and third quartiles associated with the present study??s results for poultry and swine. The full color versions of all figures are available in the online version of this paper, at ht

Retention in HIV Care During Pregnancy and the Postpartum Period in the Option B+ Era: Systematic Review and Meta-Analysis of Studies in Africa.

PubMed

Knettel, Brandon A; Cichowitz, Cody; Ngocho, James Samwel; Knippler, Elizabeth T; Chumba, Lilian N; Mmbaga, Blandina T; Watt, Melissa H

2018-04-15

Under Option B+ guidelines for prevention of mother-to-child transmission of HIV, pregnant and breastfeeding women initiate antiretroviral therapy for lifelong use. The objectives of this study were: (1) to synthesize data on retention in care over time in option B+ programs in Africa, and (2) to identify factors associated with retention in care. PubMed, EMBASE, and African Index Medicus were systematically searched from January 2012 to June 2017. Pooled estimates of the proportion of women retained were generated and factors associated with retention were analyzed thematically. Thirty-five articles were included in the final review; 22 reported retention rates (n = 60,890) and 25 reported factors associated with retention. Pooled estimates of retention were 72.9% (95% confidence interval: 66.4% to 78.9%) at 6 months for studies reporting <12 months of follow-up and 76.4% (95% confidence interval: 69.0% to 83.1%) at 12 months for studies reporting ≥12 months of follow-up. Data on undocumented clinic transfers were largely absent. Risk factors for poor retention included younger age, initiating antiretroviral therapy on the same day as diagnosis, initiating during pregnancy versus breastfeeding, and initiating late in the pregnancy. Retention was compromised by stigma, fear of disclosure, and lack of social support. Retention rates in prevention of mother-to-child transmission under option B+ were below those of the general adult population, necessitating interventions targeting the complex circumstances of women initiating care under option B+. Improved and standardized procedures to track and report retention are needed to accurately represent care engagement and capture undocumented transfers within the health system.

A Longitudinal Study of Exposure to Retail Cigarette Advertising and Smoking Initiation

PubMed Central

Henriksen, Lisa; Schleicher, Nina C.; Feighery, Ellen C.; Fortmann, Stephen P.

2011-01-01

OBJECTIVES Accumulating evidence suggests that widespread advertising for cigarettes at the point of sale encourages adolescents to smoke; however, no longitudinal study of exposure to retail tobacco advertising and smoking behavior has been reported. METHODS A school-based survey included 1681 adolescents (aged 11–14 years) who had never smoked. One measure of exposure assessed the frequency of visiting types of stores that contain the most cigarette advertising. A more detailed measure combined data about visiting stores near school with observations of cigarette advertisements and pack displays in those stores. Follow-up surveys 12 and 30 months after baseline (retention rate: 81%) documented the transition from never to ever smoking, even just a puff. RESULTS After 12 months, 18% of adolescents initiated smoking, but the incidence was 29% among students who visited convenience, liquor, or small grocery stores at least twice per week and 9% among those who reported the lowest visit frequency (less than twice per month). Adjusting for multiple risk factors, the odds of initiation remained significantly higher (odds ratio: 1.64 [95% confidence interval: 1.06–2.55]) for adolescents who reported moderate visit frequency (0.5–1.9 visits per week), and the odds of initiation more than doubled for those who visited ≥2 times per week (odds ratio: 2.58 [95% confidence interval: 1.68–3.97]). Similar associations were observed for the more detailed exposure measure and persisted at 30 months. CONCLUSIONS Exposure to retail cigarette advertising is a risk factor for smoking initiation. Policies and parenting practices that limit adolescents’ exposure to retail cigarette advertising could improve smoking prevention efforts. PMID:20643725

Development of measurement simulation of the laser dew-point hygrometer using an optical fiber cable

NASA Astrophysics Data System (ADS)

Matsumoto, Shigeaki

2005-02-01

In order to improve the initial and the response times of the Laser Dew-Point Hygrometer (LDH), the measurement simulation was developed on the basis of the loop computation of the surface temperature of a gold plate for dew depostition, the quantity of deposited dew and the intensity of scattered light from the surface of the plate at time interval of 5 sec during measurement. A more detailed relationship between the surface temperature of the plate and the cooling current, and the time constant of the integrator in the control circuit of the LDH were introduced in the simulation program as a function of atmospheric temperature. The simulation was more close to the actual measurement by the LDH. The simulation results indicated the possibility of improving both the times of teh LDH by the increase of the sensitivity of dew and that of the mass transfer coefficient of dew deposited on the plate surface. It was concluded that the initial and the response times could be improved to below 100sec and 120 sec, respectively in the dew-point range at room temperature, that are almost half of the those times of the original LDH.

The Greenwich Photo-heliographic Results (1874 - 1976): Initial Corrections to the Printed Publications

NASA Astrophysics Data System (ADS)

Erwin, E. H.; Coffey, H. E.; Denig, W. F.; Willis, D. M.; Henwood, R.; Wild, M. N.

2013-11-01

A new sunspot and faculae digital dataset for the interval 1874 - 1955 has been prepared under the auspices of the NOAA National Geophysical Data Center (NGDC). This digital dataset contains measurements of the positions and areas of both sunspots and faculae published initially by the Royal Observatory, Greenwich, and subsequently by the Royal Greenwich Observatory (RGO), under the title Greenwich Photo-heliographic Results ( GPR) , 1874 - 1976. Quality control (QC) procedures based on logical consistency have been used to identify the more obvious errors in the RGO publications. Typical examples of identifiable errors are North versus South errors in specifying heliographic latitude, errors in specifying heliographic (Carrington) longitude, errors in the dates and times, errors in sunspot group numbers, arithmetic errors in the summation process, and the occasional omission of solar ephemerides. Although the number of errors in the RGO publications is remarkably small, an initial table of necessary corrections is provided for the interval 1874 - 1917. Moreover, as noted in the preceding companion papers, the existence of two independently prepared digital datasets, which both contain information on sunspot positions and areas, makes it possible to outline a preliminary strategy for the development of an even more accurate digital dataset. Further work is in progress to generate an extremely reliable sunspot digital dataset, based on the long programme of solar observations supported first by the Royal Observatory, Greenwich, and then by the Royal Greenwich Observatory.

Non-local correlations via Wigner-Yanase skew information in two SC-qubit having mutual interaction under phase decoherence

NASA Astrophysics Data System (ADS)

Mohamed, Abdel-Baset A.

2017-10-01

An analytical solution of the master equation that describes a superconducting cavity containing two coupled superconducting charge qubits is obtained. Quantum-mechanical correlations based on Wigner-Yanase skew information, as local quantum uncertainty and uncertainty-induced quantum non-locality, are compared to the concurrence under the effects of the phase decoherence. Local quantum uncertainty exhibits sudden changes during its time evolution and revival process. Sudden death and sudden birth occur only for entanglement, depending on the initial state of the two coupled charge qubits, while the correlations of skew information does not vanish. The quantum correlations of skew information are found to be sensitive to the dephasing rate, the photons number in the cavity, the interaction strength between the two qubits, and the qubit distribution angle of the initial state. With a proper initial state, the stationary correlation of the skew information has a non-zero stationary value for a long time interval under the phase decoherence, that it may be useful in quantum information and computation processes.

A Dual Power Law Distribution for the Stellar Initial Mass Function

NASA Astrophysics Data System (ADS)

Hoffmann, Karl Heinz; Essex, Christopher; Basu, Shantanu; Prehl, Janett

2018-05-01

We introduce a new dual power law (DPL) probability distribution function for the mass distribution of stellar and substellar objects at birth, otherwise known as the initial mass function (IMF). The model contains both deterministic and stochastic elements, and provides a unified framework within which to view the formation of brown dwarfs and stars resulting from an accretion process that starts from extremely low mass seeds. It does not depend upon a top down scenario of collapsing (Jeans) masses or an initial lognormal or otherwise IMF-like distribution of seed masses. Like the modified lognormal power law (MLP) distribution, the DPL distribution has a power law at the high mass end, as a result of exponential growth of mass coupled with equally likely stopping of accretion at any time interval. Unlike the MLP, a power law decay also appears at the low mass end of the IMF. This feature is closely connected to the accretion stopping probability rising from an initially low value up to a high value. This might be associated with physical effects of ejections sometimes (i.e., rarely) stopping accretion at early times followed by outflow driven accretion stopping at later times, with the transition happening at a critical time (therefore mass). Comparing the DPL to empirical data, the critical mass is close to the substellar mass limit, suggesting that the onset of nuclear fusion plays an important role in the subsequent accretion history of a young stellar object.

The Influence of Prior Choices on Current Choice

PubMed Central

de la Piedad, Xochitl; Field, Douglas; Rachlin, Howard

2006-01-01

Three pigeons chose between random-interval (RI) and tandem, continuous-reinforcement, fixed-interval (crf-FI) reinforcement schedules by pecking either of two keys. As long as a pigeon pecked on the RI key, both keys remained available. If a pigeon pecked on the crf-FI key, then the RI key became unavailable and the crf-FI timer began to time out. With this procedure, once the RI key was initially pecked, the prospective value of both alternatives remained constant regardless of time spent pecking on the RI key without reinforcement (RI waiting time). Despite this constancy, the rate at which pigeons switched from the RI to the crf-FI decreased sharply as RI waiting time increased. That is, prior choices influenced current choice—an exercise effect. It is argued that such influence (independent of reinforcement contingencies) may serve as a sunk-cost commitment device in self-control situations. In a second experiment, extinction was programmed if RI waiting time exceeded a certain value. Rate of switching to the crf-FI first decreased and then increased as the extinction point approached, showing sensitivity to both prior choices and reinforcement contingencies. In a third experiment, crf-FI availability was limited to a brief window during the RI waiting time. When constrained in this way, switching occurred at a high rate regardless of when, during the RI waiting time, the crf-FI became available. PMID:16602373

Quasiperiodicity in time evolution of the Bloch vector under the thermal Jaynes-Cummings model

NASA Astrophysics Data System (ADS)

Azuma, Hiroo; Ban, Masashi

2014-07-01

We study a quasiperiodic structure in the time evolution of the Bloch vector, whose dynamics is governed by the thermal Jaynes-Cummings model (JCM). Putting the two-level atom into a certain pure state and the cavity field into a mixed state in thermal equilibrium at initial time, we let the whole system evolve according to the JCM Hamiltonian. During this time evolution, motion of the Bloch vector seems to be in disorder. Because of the thermal photon distribution, both a norm and a direction of the Bloch vector change hard at random. In this paper, taking a different viewpoint compared with ones that we have been used to, we investigate quasiperiodicity of the Bloch vector’s trajectories. Introducing the concept of the quasiperiodic motion, we can explain the confused behaviour of the system as an intermediate state between periodic and chaotic motions. More specifically, we discuss the following two facts: (1) If we adjust the time interval Δt properly, figures consisting of plotted dots at the constant time interval acquire scale invariance under replacement of Δt by sΔt, where s(>1) is an arbitrary real but not transcendental number. (2) We can compute values of the time variable t, which let |Sz(t)| (the absolute value of the z-component of the Bloch vector) be very small, with the Diophantine approximation (a rational approximation of an irrational number).

Training with video imaging improves the initial intubation success rates of paramedic trainees in an operating room setting.

PubMed

Levitan, R M; Goldman, T S; Bryan, D A; Shofer, F; Herlich, A

2001-01-01

Video imaging of intubation as seen by the laryngoscopist has not been a part of traditional instruction methods, and its potential impact on novice intubation success rates has not been evaluated. We prospectively tracked the success rates of novice intubators in paramedic classes who were required to watch a 26-minute instructional videotape made with a direct laryngoscopy imaging system (video group). We compared the prospectively obtained intubation success rate of the video group against retrospectively collected data from prior classes of paramedic students (traditional group) in the same training program. All classes received the same didactic airway instruction, same mannequin practice time, same paramedic textbook, and were trained in the same operating room with the same teaching staff. The traditional group (n=113, total attempts 783) had a mean individual intubation success rate of 46.7% (95% confidence interval 42.2% to 51.3%). The video group (n=36, total attempts 102) had a mean individual intubation success rate of 88.1% (95% confidence interval 79.6% to 96.5%). The difference in mean intubation success rates between the 2 groups was 41.4% (95% confidence interval 31.1% to 50.7%, P <.0001). The 2 groups did not differ in respect to age, male sex, or level of education. An instructional videotape made with the direct laryngoscopy video system significantly improved the initial success rates of novice intubators in an operating room setting.

Synthesis and characterization of polypyrrole grafted chitin

NASA Astrophysics Data System (ADS)

Ramaprasad, A. T.; Latha, D.; Rao, Vijayalakshmi

2017-05-01

Synthesis and characterization of chitin grafted with polypyrrole (PPy) is reported in this paper. Chitin is soaked in pyrrole solution of various concentrations for different time intervals and polymerized using ammonium peroxy disulphate (APS) as an initiator. Grafting percentage of polypyrrole onto chitin is calculated from weight of chitin before and after grafting. Grafting of polymer is further verified by dissolution studies. The grafted polymer samples are characterized by FTIR, UV-Vis absorption spectrum, XRD, DSC, TGA, AFM, SEM and conductivity studies.

Engineering studies of vectorcardiographs in blood pressure measuring systems

NASA Technical Reports Server (NTRS)

Mark, R. G.

1975-01-01

The following projects involving cardiovascular instrumentation were conducted: (1) the development and fabrication of a three-dimensional display measurement system for vectorcardiograms, (2) the development and fabrication of a cardiovascular monitoring system to noninvasively monitor beat-by-beat the blood pressure and heart rate using aortic pulse wave velocity, (3) the development of software for an interactive system to analyze systolic time interval data, and (4) the development of microprocessor-based physiologic instrumentation, focussing initially on EKG rhythm analysis. Brief descriptions of these projects were given.

Two-qubit correlations via a periodic plasmonic nanostructure

NASA Astrophysics Data System (ADS)

Iliopoulos, Nikos; Terzis, Andreas F.; Yannopapas, Vassilios; Paspalakis, Emmanuel

2016-02-01

We theoretically investigate the generation of quantum correlations by using two distant qubits in free space or mediated by a plasmonic nanostructure. We report both entanglement of formation as well as quantum discord and classical correlations. We have found that for proper initial state of the two-qubit system and distance between the two qubits we can produce quantum correlations taking significant value for a relatively large time interval so that it can be useful in quantum information and computation processes.

Experimental Analysis of Heat Transfer Characteristics and Pressure Drop through Screen Regenerative Heat Exchangers

DTIC Science & Technology

1993-12-01

of fluid T1 initial temperature of matrix and fluid Tf1 average inlet temperature after the step change Tii average inlet temperature before the step...respectively, of the regenerator. The horizontal distances shown with Tf1 , Tj, and T,2 illustrate the time interval for which the average values were...temperature was not a true step function, the investigator made an approximation. The approximation was based on an average temperature. Tf1 was the

Two-qubit correlations via a periodic plasmonic nanostructure

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

Iliopoulos, Nikos; Terzis, Andreas F.; Yannopapas, Vassilios

2016-02-15

We theoretically investigate the generation of quantum correlations by using two distant qubits in free space or mediated by a plasmonic nanostructure. We report both entanglement of formation as well as quantum discord and classical correlations. We have found that for proper initial state of the two-qubit system and distance between the two qubits we can produce quantum correlations taking significant value for a relatively large time interval so that it can be useful in quantum information and computation processes.

The influence of interpregnancy interval on infant mortality.

PubMed

McKinney, David; House, Melissa; Chen, Aimin; Muglia, Louis; DeFranco, Emily

2017-03-01

In Ohio, the infant mortality rate is above the national average and the black infant mortality rate is more than twice the white infant mortality rate. Having a short interpregnancy interval has been shown to correlate with preterm birth and low birthweight, but the effect of short interpregnancy interval on infant mortality is less well established. We sought to quantify the population impact of interpregnancy interval on the risk of infant mortality. This was a statewide population-based retrospective cohort study of all births (n = 1,131,070) and infant mortalities (n = 8152) using linked Ohio birth and infant death records from January 2007 through September 2014. For this study we analyzed 5 interpregnancy interval categories: 0-<6, 6-<12, 12-<24, 24-<60, and ≥60 months. The primary outcome for this study was infant mortality. During the study period, 3701 infant mortalities were linked to a live birth certificate with an interpregnancy interval available. We calculated the frequency and relative risk of infant mortality for each interval compared to a referent interval of 12-<24 months. Stratified analyses by maternal race were also performed. Adjusted risks were estimated after accounting for statistically significant and biologically plausible confounding variables. Adjusted relative risk was utilized to calculate the attributable risk percent of short interpregnancy intervals on infant mortality. Short interpregnancy intervals were common in Ohio during the study period. Of all multiparous births, 20.5% followed an interval of <12 months. The overall infant mortality rate during this time was 7.2 per 1000 live births (6.0 for white mothers and 13.1 for black mothers). Infant mortalities occurred more frequently for births following short intervals of 0-<6 months (9.2 per 1000) and 6-<12 months (7.1 per 1000) compared to 12-<24 months (5.6 per 1000) (P < .001 and <.001). The highest risk for infant mortality followed interpregnancy intervals of 0-<6 months (adjusted relative risk, 1.32; 95% confidence interval, 1.17-1.49) followed by interpregnancy intervals of 6-<12 months (adjusted relative risk, 1.16; 95% confidence interval, 1.04-1.30). Analysis stratified by maternal race revealed similar findings. Attributable risk calculation showed that 24.2% of infant mortalities following intervals of 0-<6 months and 14.1% with intervals of 6-<12 months are attributable to the short interpregnancy interval. By avoiding short interpregnancy intervals of ≤12 months we estimate that in the state of Ohio 31 infant mortalities (20 white and 8 black) per year could have been prevented and the infant mortality rate could have been reduced from 7.2-7.0 during this time frame. An interpregnancy interval of 12-60 months (1-5 years) between birth and conception of next pregnancy is associated with lowest risk of infant mortality. Public health initiatives and provider counseling to optimize birth spacing has the potential to significantly reduce infant mortality for both white and black mothers. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

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

2018-06-01

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

A new method for determining the optimal lagged ensemble

PubMed Central

DelSole, T.; Tippett, M. K.; Pegion, K.

2017-01-01

Abstract We propose a general methodology for determining the lagged ensemble that minimizes the mean square forecast error. The MSE of a lagged ensemble is shown to depend only on a quantity called the cross‐lead error covariance matrix, which can be estimated from a short hindcast data set and parameterized in terms of analytic functions of time. The resulting parameterization allows the skill of forecasts to be evaluated for an arbitrary ensemble size and initialization frequency. Remarkably, the parameterization also can estimate the MSE of a burst ensemble simply by taking the limit of an infinitely small interval between initialization times. This methodology is applied to forecasts of the Madden Julian Oscillation (MJO) from version 2 of the Climate Forecast System version 2 (CFSv2). For leads greater than a week, little improvement is found in the MJO forecast skill when ensembles larger than 5 days are used or initializations greater than 4 times per day. We find that if the initialization frequency is too infrequent, important structures of the lagged error covariance matrix are lost. Lastly, we demonstrate that the forecast error at leads ≥10 days can be reduced by optimally weighting the lagged ensemble members. The weights are shown to depend only on the cross‐lead error covariance matrix. While the methodology developed here is applied to CFSv2, the technique can be easily adapted to other forecast systems. PMID:28580050

Timescale- and Sensory Modality-Dependency of the Central Tendency of Time Perception.

PubMed

Murai, Yuki; Yotsumoto, Yuko

2016-01-01

When individuals are asked to reproduce intervals of stimuli that are intermixedly presented at various times, longer intervals are often underestimated and shorter intervals overestimated. This phenomenon may be attributed to the central tendency of time perception, and suggests that our brain optimally encodes a stimulus interval based on current stimulus input and prior knowledge of the distribution of stimulus intervals. Two distinct systems are thought to be recruited in the perception of sub- and supra-second intervals. Sub-second timing is subject to local sensory processing, whereas supra-second timing depends on more centralized mechanisms. To clarify the factors that influence time perception, the present study investigated how both sensory modality and timescale affect the central tendency. In Experiment 1, participants were asked to reproduce sub- or supra-second intervals, defined by visual or auditory stimuli. In the sub-second range, the magnitude of the central tendency was significantly larger for visual intervals compared to auditory intervals, while visual and auditory intervals exhibited a correlated and comparable central tendency in the supra-second range. In Experiment 2, the ability to discriminate sub-second intervals in the reproduction task was controlled across modalities by using an interval discrimination task. Even when the ability to discriminate intervals was controlled, visual intervals exhibited a larger central tendency than auditory intervals in the sub-second range. In addition, the magnitude of the central tendency for visual and auditory sub-second intervals was significantly correlated. These results suggest that a common modality-independent mechanism is responsible for the supra-second central tendency, and that both the modality-dependent and modality-independent components of the timing system contribute to the central tendency in the sub-second range.

High resolution data acquisition

DOEpatents

Thornton, G.W.; Fuller, K.R.

1993-04-06

A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock, pulse train, and analog circuitry for generating a triangular wave synchronously with the pulse train (as seen in diagram on patent). The triangular wave has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter counts the clock pulse train during the interval to form a gross event interval time. A computer then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

High resolution data acquisition

DOEpatents

Thornton, Glenn W.; Fuller, Kenneth R.

1993-01-01

A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock (38) pulse train (37) and analog circuitry (44) for generating a triangular wave (46) synchronously with the pulse train (37). The triangular wave (46) has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter (18, 32) forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter (26) counts the clock pulse train (37) during the interval to form a gross event interval time. A computer (52) then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

Effect of specialized diagnostic assessment units on the time to diagnosis in screen-detected breast cancer patients.

PubMed

Jiang, L; Gilbert, J; Langley, H; Moineddin, R; Groome, P A

2015-05-26

The duration of the cancer diagnostic process has considerable influence on patients' psychosocial well-being. Breast diagnostic assessment units (DAUs) in Ontario, Canada are designed to improve the quality and timeliness of care during a breast cancer diagnosis. We compared the diagnostic duration of patients diagnosed through a DAU vs usual care (UC). Retrospective population-based cohort study of 2499 screen-detected breast cancers (2011) using administrative health-care databases linked to the Ontario Cancer Registry. The diagnostic interval was measured from the initial screen to cancer diagnosis. Diagnostic assessment unit use was based on the biopsy and/or surgery hospital. We compared the length of the diagnostic interval between the DAU groups using multivariable quantile regression. Diagnostic assessment units had a higher proportion of patients diagnosed within the 7-week target compared with UC (79.1% vs 70.2%, P<0.001). The median time to diagnosis at DAUs was 26 days, which was 9 days shorter compared with UC (95% CI: 6.4-11.6). This effect was reduced to 8.3 days after adjusting for all study covariates. Adjusted DAU differences were similar at the 75th and 90th percentiles of the diagnostic interval distribution. Diagnosis through an Ontario DAU was associated with a reduced time to diagnosis for screen-detected breast cancer patients, which likely reduces the anxiety and distress associated with waiting for a diagnosis.

Electropermeabilization by uni- or bipolar nanosecond electric pulses: The impact of extracellular conductivity.

PubMed

Gianulis, Elena C; Casciola, Maura; Xiao, Shu; Pakhomova, Olga N; Pakhomov, Andrei G

2018-02-01

Cellular effects caused by nanosecond electric pulses (nsEP) can be reduced by an electric field reversal, a phenomenon known as bipolar cancellation. The reason for this cancellation effect remains unknown. We hypothesized that assisted membrane discharge is the mechanism for bipolar cancellation. CHO-K1 cells bathed in high (16.1mS/cm; HCS) or low (1.8mS/cm; LCS) conductivity solutions were exposed to either one unipolar (300-ns) or two opposite polarity (300+300-ns; bipolar) nsEP (4-40kV/cm) with increasing interpulse intervals (0.1-50μs). Time-lapse YO-PRO-1 (YP) uptake revealed enhanced membrane permeabilization in LCS compared to HCS at all tested voltages. The time-dependence of bipolar cancellation was similar in both solutions, using either identical (22kV/cm) or isoeffective nsEP treatments (12 and 32kV/cm for LCS and HCS, respectively). However, cancellation was significantly stronger in LCS when the bipolar nsEP had no, or very short (<1μs), interpulse intervals. Finally, bipolar cancellation was still present with interpulse intervals as long as 50μs, beyond the time expected for membrane discharge. Our findings do not support assisted membrane discharge as the mechanism for bipolar cancellation. Instead they exemplify the sustained action of nsEP that can be reversed long after the initial stimulus. Copyright © 2017 Elsevier B.V. All rights reserved.

Magnetic Resonance Fingerprinting with short relaxation intervals.

PubMed

Amthor, Thomas; Doneva, Mariya; Koken, Peter; Sommer, Karsten; Meineke, Jakob; Börnert, Peter

2017-09-01

The aim of this study was to investigate a technique for improving the performance of Magnetic Resonance Fingerprinting (MRF) in repetitive sampling schemes, in particular for 3D MRF acquisition, by shortening relaxation intervals between MRF pulse train repetitions. A calculation method for MRF dictionaries adapted to short relaxation intervals and non-relaxed initial spin states is presented, based on the concept of stationary fingerprints. The method is applicable to many different k-space sampling schemes in 2D and 3D. For accuracy analysis, T 1 and T 2 values of a phantom are determined by single-slice Cartesian MRF for different relaxation intervals and are compared with quantitative reference measurements. The relevance of slice profile effects is also investigated in this case. To further illustrate the capabilities of the method, an application to in-vivo spiral 3D MRF measurements is demonstrated. The proposed computation method enables accurate parameter estimation even for the shortest relaxation intervals, as investigated for different sampling patterns in 2D and 3D. In 2D Cartesian measurements, we achieved a scan acceleration of more than a factor of two, while maintaining acceptable accuracy: The largest T 1 values of a sample set deviated from their reference values by 0.3% (longest relaxation interval) and 2.4% (shortest relaxation interval). The largest T 2 values showed systematic deviations of up to 10% for all relaxation intervals, which is discussed. The influence of slice profile effects for multislice acquisition is shown to become increasingly relevant for short relaxation intervals. In 3D spiral measurements, a scan time reduction of 36% was achieved, maintaining the quality of in-vivo T1 and T2 maps. Reducing the relaxation interval between MRF sequence repetitions using stationary fingerprint dictionaries is a feasible method to improve the scan efficiency of MRF sequences. The method enables fast implementations of 3D spatially resolved MRF. Copyright © 2017 Elsevier Inc. All rights reserved.

Levonorgestrel release rates over 5 years with the Liletta® 52-mg intrauterine system.

PubMed

Creinin, Mitchell D; Jansen, Rolf; Starr, Robert M; Gobburu, Joga; Gopalakrishnan, Mathangi; Olariu, Andrea

2016-10-01

To understand the potential duration of action for Liletta®, we conducted this study to estimate levonorgestrel (LNG) release rates over approximately 5½years of product use. Clinical sites in the U.S. Phase 3 study of Liletta collected the LNG intrauterine systems (IUSs) from women who discontinued the study. We randomly selected samples within 90-day intervals after discontinuation of IUS use through 900days (approximately 2.5years) and 180-day intervals for the remaining duration through 5.4years (1980days) to evaluate residual LNG content. We also performed an initial LNG content analysis using 10 randomly selected samples from a single lot. We calculated the average ex vivo release rate using the residual LNG content over the duration of the analysis. We analyzed 64 samples within 90-day intervals (range 6-10 samples per interval) through 900days and 36 samples within 180-day intervals (6 samples per interval) for the remaining duration. The initial content analysis averaged 52.0±1.8mg. We calculated an average initial release rate of 19.5mcg/day that decreased to 17.0, 14.8, 12.9, 11.3 and 9.8mcg/day after 1, 2, 3, 4 and 5years, respectively. The 5-year average release rate is 14.7mcg/day. The estimated initial LNG release rate and gradual decay of the estimated release rate are consistent with the target design and function of the product. The calculated LNG content and release rate curves support the continued evaluation of Liletta as a contraceptive for 5 or more years of use. Liletta LNG content and release rates are comparable to published data for another LNG 52-mg IUS. The release rate at 5years is more than double the published release rate at 3years with an LNG 13.5-mg IUS, suggesting continued efficacy of Liletta beyond 5years. Copyright © 2016 Elsevier Inc. All rights reserved.

An investigation of routes to cancer diagnosis in 10 international jurisdictions, as part of the International Cancer Benchmarking Partnership: survey development and implementation

PubMed Central

Weller, David; Vedsted, Peter; Anandan, Chantelle; Zalounina, Alina; Fourkala, Evangelia Ourania; Desai, Rakshit; Liston, William; Jensen, Henry; Barisic, Andriana; Gavin, Anna; Grunfeld, Eva; Lambe, Mats; Law, Rebecca-Jane; Malmberg, Martin; Neal, Richard D; Kalsi, Jatinderpal; Turner, Donna; White, Victoria; Bomb, Martine

2016-01-01

Objectives This paper describes the methods used in the International Cancer Benchmarking Partnership Module 4 Survey (ICBPM4) which examines time intervals and routes to cancer diagnosis in 10 jurisdictions. We present the study design with defining and measuring time intervals, identifying patients with cancer, questionnaire development, data management and analyses. Design and setting Recruitment of participants to the ICBPM4 survey is based on cancer registries in each jurisdiction. Questionnaires draw on previous instruments and have been through a process of cognitive testing and piloting in three jurisdictions followed by standardised translation and adaptation. Data analysis focuses on comparing differences in time intervals and routes to diagnosis in the jurisdictions. Participants Our target is 200 patients with symptomatic breast, lung, colorectal and ovarian cancer in each jurisdiction. Patients are approached directly or via their primary care physician (PCP). Patients’ PCPs and cancer treatment specialists (CTSs) are surveyed, and ‘data rules’ are applied to combine and reconcile conflicting information. Where CTS information is unavailable, audit information is sought from treatment records and databases. Main outcomes Reliability testing of the patient questionnaire showed that agreement was complete (κ=1) in four items and substantial (κ=0.8, 95% CI 0.333 to 1) in one item. The identification of eligible patients is sufficient to meet the targets for breast, lung and colorectal cancer. Initial patient and PCP survey response rates from the UK and Sweden are comparable with similar published surveys. Data collection was completed in early 2016 for all cancer types. Conclusion An international questionnaire-based survey of patients with cancer, PCPs and CTSs has been developed and launched in 10 jurisdictions. ICBPM4 will help to further understand international differences in cancer survival by comparing time intervals and routes to cancer diagnosis. PMID:27456325

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

PubMed

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

2014-10-01

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

High-rate operant behavior in two mouse strains: a response-bout analysis.

PubMed

Johnson, Joshua E; Pesek, Erin F; Newland, M Christopher

2009-06-01

Operant behavior sometimes occurs in bouts characterized by an initiation rate, within-bout response rate, and bout length. The generality of this structure was tested using high-rate nose-poking in mice. Reinforcement of short interresponse times produced high response rates while a random-interval schedule held reinforcement rates constant. BALB/c mice produced bouts that were more frequent, longer, and contained a higher within-bout rate of responding (nine nose-pokes/s) than did the C57BL/6 mice (five nose-pokes/s). Adding a running wheel decreased total nose-pokes and bout length, and increased bout-initiation rate. Free-feeding reduced nose-poking by decreasing bout-initiation rate. Photoperiod reversal decreased bout-initiation rate but not total nose-poke rate. Despite strain differences in bout structure, both strains responded similarly to the interventions. The three bout measures were correlated with overall rate but not with each other. Log-survival analyses provided independent descriptors of the structure of high-rate responding in these two strains.

Active and Inactive Leg Hemodynamics during Sequential Single-Leg Interval Cycling.

PubMed

Gordon, Nicole; Abbiss, Chris R; Ihsan, Mohammed; Maiorana, Andrew J; Peiffer, Jeremiah J

2018-06-01

Leg order during sequential single-leg cycling (i.e., exercising both legs independently within a single session) may affect local muscular responses potentially influencing adaptations. This study examined the cardiovascular and skeletal muscle hemodynamic responses during double-leg and sequential single-leg cycling. Ten young healthy adults (28 ± 6 yr) completed six 1-min double-leg intervals interspersed with 1 min of passive recovery and, on a separate occasion, 12 (six with one leg followed by six with the other leg) 1-min single-leg intervals interspersed with 1 min of passive recovery. Oxygen consumption, heart rate, blood pressure, muscle oxygenation, muscle blood volume, and power output were measured throughout each session. Oxygen consumption, heart rate, and power output were not different between sets of single-leg intervals, but the average of both sets was lower than the double-leg intervals. Mean arterial pressure was higher during double-leg compared with sequential single-leg intervals (115 ± 9 vs 104 ± 9 mm Hg, P < 0.05) and higher during the initial compared with second set of single-leg intervals (108 ± 10 vs 101 ± 10 mm Hg, P < 0.05). The increase in muscle blood volume from baseline was similar between the active single leg and the double leg (267 ± 150 vs 214 ± 169 μM·cm, P = 0.26). The pattern of change in muscle blood volume from the initial to second set of intervals was significantly different (P < 0.05) when the leg was active in the initial (-52.3% ± 111.6%) compared with second set (65.1% ± 152.9%). These data indicate that the order in which each leg performs sequential single-leg cycling influences the local hemodynamic responses, with the inactive muscle influencing the stimulus experienced by the contralateral leg.

IODP Expedition 351 Lithostratigraphy: Volcaniclastic Record of Izu-Bonin-Mariana (IBM) Arc Initiation

NASA Astrophysics Data System (ADS)

Barth, A. P.; Brandl, P. A.; Li, H.; Hickey-Vargas, R.; Jiang, F.; Kanayama, K.; Kusano, Y.; Marsaglia, K. M.; McCarthy, A.; Meffre, S.; Savov, I. P.; Tepley, F. J., III; Yogodzinski, G. M.

2014-12-01

The destruction of lithospheric plates by subduction is a fundamentally important process leading to arc magmatism and the creation of continental crust, yet subduction initiation and early magmatic arc evolution remain poorly understood. For many arc systems, onset of arc volcanism and early evolution are obscured by metamorphism or the record is deeply buried; however, initial products of arc systems may be preserved in forearc and backarc sedimentary records. IODP Expedition 351 recovered this history from the dispersed ash and pyroclast record in the proximal rear-arc of the northern IBM system west of the Kyushu-Palau Ridge. Drilling at Site U1438 in the Amami Sankaku Basin recovered a thick volcaniclastic record of subduction initiation and the early evolution of the Izu-Bonin Arc. A 160-m thick section of Neogene sediment overlies 1.3 kilometers of Paleogene volcaniclastic rocks with andesitic average composition; this volcaniclastic section was deposited on mafic volcanic basement rocks. The thin upper sediment layer is primarily terrigenous, biogenic and volcaniclastic mud and ooze with interspersed ash layers. The underlying Eocene to Oligocene volcaniclastic rocks are 33% tuffaceous mudstone, 61% tuffaceous sandstone, and 6% conglomerate with volcanic and rare sedimentary clasts commonly up to pebble and rarely to cobble size. The clastic section is characterized by repetitive conglomerate and sandstone-dominated intervals with intervening mudstone-dominated intervals, reflecting waxing and waning of coarse arc-derived sediment inputs through time. Volcanic lithic clasts in sandstones and conglomerates range from basalt to rhyolite in composition and include well-preserved pumice, reflecting a lithologically diverse and compositionally variable arc volcanic source.

Retreatment with bortezomib alone or in combination for patients with multiple myeloma following an initial response to bortezomib.

PubMed

Sood, Raman; Carloss, Harry; Kerr, Robert; Lopez, Jose; Lee, Martin; Druck, Mark; Walters, Ian B; Noga, Stephen J

2009-10-01

This clinical trial was conducted to determine the safety and efficacy of bortezomib retreatment in patients with multiple myeloma (MM) who had previously responded to bortezomib. Patients with progressive MM who had previously tolerated bortezomib as a single agent or in combination with other drugs, with a minimum of partial response (PR; >or=50% M-protein reduction) for >or=4 months, who had not received intervening MM therapy, were retreated with bortezomib (days 1, 4, 8, and 11 of a 21-day cycle) with a starting dose being the dose at which the patient ended the initial treatment. Patients were allowed to receive bortezomib on retreatment in combination with dexamethasone, thalidomide, or doxorubicin. Thirty-two patients received bortezomib retreatment (most with added dexamethasone). The median treatment-free interval (last dose of initial bortezomib treatment to first dose of retreatment) was 9.9 (range 2.5-34.0) months. The median duration of retreatment was 2.8 (<1-7.9) months; median total duration of bortezomib treatment was 6.7 (2.5-19.8) months. Based on the investigators' assessment of best response, the overall response rate (complete plus PR) was 50%. The median time from start of retreatment to progressive disease (PD) was 6.6 (95% confidence interval: 5.1-9.6) months. Thirteen patients (41%) experienced PN; bortezomib-related SAEs were reported in four patients. Retreatment with bortezomib alone or in combination is effective and well tolerated in patients with MM who have responded to their initial bortezomib treatment. (c) 2009 Wiley-Liss, Inc.

Costs and consequences of direct-to-consumer advertising for clopidogrel in Medicaid.

PubMed

Law, Michael R; Soumerai, Stephen B; Adams, Alyce S; Majumdar, Sumit R

2009-11-23

Direct-to-consumer advertising (DTCA) is assumed to be a major driver of rising pharmaceutical costs. Yet, research on how it affects costs is limited. Therefore, we studied clopidogrel, a commonly used and heavily marketed antiplatelet agent, which was first sold in 1998 and first direct-to-consumer advertised in 2001. We examined pharmacy data from 27 Medicaid programs from 1999 through 2005. We used interrupted time series analysis to analyze changes in the number of units dispensed, cost per unit dispensed, and total pharmacy expenditures after DTCA initiation. In 1999 and 2000, there was no DTCA for clopidogrel; from 2001 through 2005, DTCA spending exceeded $350 million. Direct-to-consumer advertising did not change the preexisting trend in the number of clopidogrel units dispensed per 1000 enrollees (P = .10). However, there was a sudden and sustained increase in cost per unit of $0.40 after DTCA initiation (95% confidence interval, $0.31-$0.49; P < .001), leading to an additional $40.58 of pharmacy costs per 1000 enrollees per quarter thereafter (95% confidence interval, $22.61-$58.56; P < .001). Overall, this change resulted in an additional $207 million in total pharmacy expenditures. Direct-to-consumer advertising was not associated with an increase in clopidogrel use over and above preexisting trends. However, Medicaid pharmacy expenditures increased substantially after the initiation of DTCA because of a concomitant increase in the cost per unit. If drug price increases after DTCA initiation are common, there are important implications for payers and for policy makers in the United States and elsewhere.

Live Dynamics of 53BP1 Foci Following Simultaneous Induction of Clustered and Dispersed DNA Damage in U2OS Cells

PubMed Central

Sollazzo, Alice; Brzozowska, Beata; Cheng, Lei; Lundholm, Lovisa; Scherthan, Harry

2018-01-01

Cells react differently to clustered and dispersed DNA double strand breaks (DSB). Little is known about the initial reaction to simultaneous induction of DSBs with different complexities. Here, we used live cell microscopy to analyse the behaviour of 53BP1-GFP (green fluorescence protein) foci formation at DSBs induced in U2OS cells by alpha particles, X-rays or mixed beams over a 75 min period post irradiation. X-ray-induced foci rapidly increased and declined over the observation interval. After an initial increase, mixed beam-induced foci remained at a constant level over the observation interval, similarly as alpha-induced foci. The average areas of radiation-induced foci were similar for mixed beams and X-rays, being significantly smaller than those induced by alpha particles. Pixel intensities were highest for mixed beam-induced foci and showed the lowest level of variability over time as compared to foci induced by alphas and X-rays alone. Finally, mixed beam-exposed foci showed the lowest level of mobility as compared to alpha and X-ray exposure. The results suggest paralysation of chromatin around foci containing clustered DNA damage. PMID:29419809

Measuring the EMS patient access time interval and the impact of responding to high-rise buildings.

PubMed

Morrison, Laurie J; Angelini, Mark P; Vermeulen, Marian J; Schwartz, Brian

2005-01-01

To measure the patient access time interval and characterize its contribution to the total emergency medical services (EMS) response time interval; to compare the patient access time intervals for patients located three or more floors above ground with those less than three floors above or below ground, and specifically in the apartment subgroup; and to identify barriers that significantly impede EMS access to patients in high-rise apartments. An observational study of all patients treated by an emergency medical technician paramedics (EMT-P) crew was conducted using a trained independent observer to collect time intervals and identify potential barriers to access. Of 118 observed calls, 25 (21%) originated from patients three or more floors above ground. The overall median and 90th percentile (95% confidence interval) patient access time intervals were 1.61 (1.27, 1.91) and 3.47 (3.08, 4.05) minutes, respectively. The median interval was 2.73 (2.22, 3.03) minutes among calls from patients located three or more stories above ground compared with 1.25 (1.07, 1.55) minutes among those at lower levels. The patient access time interval represented 23.5% of the total EMS response time interval among calls originating less than three floors above or below ground and 32.2% of those located three or more stories above ground. The most frequently encountered barriers to access included security code entry requirements, lack of directional signs, and inability to fit the stretcher into the elevator. The patient access time interval is significantly long and represents a substantial component of the total EMS response time interval, especially among ambulance calls originating three or more floors above ground. A number of barriers appear to contribute to delayed paramedic access.

Comparison of oral and intramuscular recombinant canine distemper vaccination in African wild dogs (Lycaon pictus).

PubMed

Connolly, Maren; Thomas, Patrick; Woodroffe, Rosie; Raphael, Bonnie L

2013-12-01

A series of three doses of recombinant canary-pox-vectored canine distemper virus vaccine was administered at 1-mo intervals, orally (n = 8) or intramuscularly (n = 13), to 21 previously unvaccinated juvenile African wild dogs (Lycaon pictus) at the Wildlife Conservation Society's Bronx Zoo. Titers were measured by serum neutralization at each vaccination and at intervals over a period of 3.5-21.5 mo after the initial vaccination. All postvaccination titers were negative for orally vaccinated animals at all sampling time points. Of the animals that received intramuscular vaccinations, 100% had presumed protective titers by the end of the course of vaccination, but only 50% of those sampled at 6.5 mo postvaccination had positive titers. None of the three animals sampled at 21.5 mo postvaccination had positive titers.

Progress on the Cluster Mission

NASA Technical Reports Server (NTRS)

Kivelson, Margaret; Khurana, Krishan; Acuna, Mario (Technical Monitor)

2002-01-01

Prof M. G. Kivelson and Dr. K. K. Khurana (UCLA (University of California, Los Angeles)) are co-investigators on the Cluster Magnetometer Consortium (CMC) that provided the fluxgate magnetometers and associated mission support for the Cluster Mission. The CMC designated UCLA as the site with primary responsibility for the inter-calibration of data from the four spacecraft and the production of fully corrected data critical to achieving the mission objectives. UCLA will also participate in the analysis and interpretation of the data. The UCLA group here reports its excellent progress in developing fully intra-calibrated data for large portions of the mission and an excellent start in developing inter-calibrated data for selected time intervals, especially extended intervals in August, 2001 on which a workshop held at ESTEC in March, 2002 focused. In addition, some scientific investigations were initiated and results were reported at meetings.

Double dynamic scaling in human communication dynamics

NASA Astrophysics Data System (ADS)

Wang, Shengfeng; Feng, Xin; Wu, Ye; Xiao, Jinhua

2017-05-01

In the last decades, human behavior has been deeply understanding owing to the huge quantities data of human behavior available for study. The main finding in human dynamics shows that temporal processes consist of high-activity bursty intervals alternating with long low-activity periods. A model, assuming the initiator of bursty follow a Poisson process, is widely used in the modeling of human behavior. Here, we provide further evidence for the hypothesis that different bursty intervals are independent. Furthermore, we introduce a special threshold to quantitatively distinguish the time scales of complex dynamics based on the hypothesis. Our results suggest that human communication behavior is a composite process of double dynamics with midrange memory length. The method for calculating memory length would enhance the performance of many sequence-dependent systems, such as server operation and topic identification.

Long-term outcome of 56 dogs with nasal tumours treated with four doses of radiation at intervals of seven days.

PubMed

Mellanby, R J; Stevenson, R K; Herrtage, M E; White, R A S; Dobson, J M

2002-08-31

A retrospective study was undertaken on 56 dogs treated for nasal tumours by megavoltage radiotherapy with a hypofractionated schedule consisting of four doses of 9 Gy given at intervals of seven days. The dogs were followed until they died or were euthanased. The clinical signs had improved in 53 of the 56 dogs by the end of the treatment schedule. Mild acute radiation side effects were observed in the majority of the dogs but late radiation side effects were rare. Kaplan-Meier survival analysis revealed a median survival time after the final dose of radiation of 212 days. The one- and two-year survival rates were 45 per cent and 15 per cent. Fifty of the dogs were euthanased because the initial clinical signs recurred.

Induction of labor using prostaglandin E2 (PGE2) vaginal gel in triacetin base. An efficacy study comparing two dosage regimens.

PubMed

Seeras, R C; Olatunbosun, O A; Pierson, R A; Turnell, R W

1995-01-01

To compare two dosage regimens for the administration of vaginal prostaglandin gel in triacetin base for induction of labor. Seventy subjects planned for elective induction of labor at term were randomized to treatment with PGE2 vaginal gel every 6 or 12 hours. The 6-hourly group received an initial dose of 1 mg, followed by 2 mg at 6 hour intervals for a maximum of two additional doses if not in active labor. The 12-hourly group had an initial dose of 2 mg followed by two additional doses at 12 hour intervals if not in active labor. Successful induction rate was higher in the 12-hourly as compared to 6-hourly gel regimen (100% vs. 91%, P > 0.05). Twelve hours after the initial dose, delivery occurred in 34% delivery had occurred in 57% and 37% respectively (P < 0.01). We found no difference in the induction-active labor interval (P > 0.05), and the induction-delivery interval (P > 0.05) between the two groups. Active labor followed a single dose of gel in 66% of the 12-hourly group compared to 40% of the 6-hourly group (P < 0.01). Syntocinon augmentation was needed in 6% of subjects in the 12-hourly group as compared to 26% in the 6-hourly group (P < 0.01). The cesarean section rate was similar in both groups. Uterine hyperstimulation occurred less frequently in the 12-hourly group (P < 0.05). The perinatal outcome was similar in both groups. The 12-hourly regimen was more effective than the 6-hourly regimen in initiating labor. The majority of the subjects in the 12 hourly group achieved labor following a single dose of gel. Induction delivery interval, however, was similar in both groups.

Modulation of human time processing by subthalamic deep brain stimulation.

PubMed

Wojtecki, Lars; Elben, Saskia; Timmermann, Lars; Reck, Christiane; Maarouf, Mohammad; Jörgens, Silke; Ploner, Markus; Südmeyer, Martin; Groiss, Stefan Jun; Sturm, Volker; Niedeggen, Michael; Schnitzler, Alfons

2011-01-01

Timing in the range of seconds referred to as interval timing is crucial for cognitive operations and conscious time processing. According to recent models of interval timing basal ganglia (BG) oscillatory loops are involved in time interval recognition. Parkinsońs disease (PD) is a typical disease of the basal ganglia that shows distortions in interval timing. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a powerful treatment of PD which modulates motor and cognitive functions depending on stimulation frequency by affecting subcortical-cortical oscillatory loops. Thus, for the understanding of BG-involvement in interval timing it is of interest whether STN-DBS can modulate timing in a frequency dependent manner by interference with oscillatory time recognition processes. We examined production and reproduction of 5 and 15 second intervals and millisecond timing in a double blind, randomised, within-subject repeated-measures design of 12 PD-patients applying no, 10-Hz- and ≥ 130-Hz-STN-DBS compared to healthy controls. We found under(re-)production of the 15-second interval and a significant enhancement of this under(re-)production by 10-Hz-stimulation compared to no stimulation, ≥ 130-Hz-STN-DBS and controls. Milliseconds timing was not affected. We provide first evidence for a frequency-specific modulatory effect of STN-DBS on interval timing. Our results corroborate the involvement of BG in general and of the STN in particular in the cognitive representation of time intervals in the range of multiple seconds.

Modulation of Human Time Processing by Subthalamic Deep Brain Stimulation

PubMed Central

Timmermann, Lars; Reck, Christiane; Maarouf, Mohammad; Jörgens, Silke; Ploner, Markus; Südmeyer, Martin; Groiss, Stefan Jun; Sturm, Volker; Niedeggen, Michael; Schnitzler, Alfons

2011-01-01

Timing in the range of seconds referred to as interval timing is crucial for cognitive operations and conscious time processing. According to recent models of interval timing basal ganglia (BG) oscillatory loops are involved in time interval recognition. Parkinsońs disease (PD) is a typical disease of the basal ganglia that shows distortions in interval timing. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a powerful treatment of PD which modulates motor and cognitive functions depending on stimulation frequency by affecting subcortical-cortical oscillatory loops. Thus, for the understanding of BG-involvement in interval timing it is of interest whether STN-DBS can modulate timing in a frequency dependent manner by interference with oscillatory time recognition processes. We examined production and reproduction of 5 and 15 second intervals and millisecond timing in a double blind, randomised, within-subject repeated-measures design of 12 PD-patients applying no, 10-Hz- and ≥130-Hz-STN-DBS compared to healthy controls. We found under(re-)production of the 15-second interval and a significant enhancement of this under(re-)production by 10-Hz-stimulation compared to no stimulation, ≥130-Hz-STN-DBS and controls. Milliseconds timing was not affected. We provide first evidence for a frequency-specific modulatory effect of STN-DBS on interval timing. Our results corroborate the involvement of BG in general and of the STN in particular in the cognitive representation of time intervals in the range of multiple seconds. PMID:21931767

The Amount of Time Dilation for Visual Flickers Corresponds to the Amount of Neural Entrainments Measured by EEG.

PubMed

Hashimoto, Yuki; Yotsumoto, Yuko

2018-01-01

The neural basis of time perception has long attracted the interests of researchers. Recently, a conceptual model consisting of neural oscillators was proposed and validated by behavioral experiments that measured the dilated duration in perception of a flickering stimulus (Hashimoto and Yotsumoto, 2015). The model proposed that flickering stimuli cause neural entrainment of oscillators, resulting in dilated time perception. In this study, we examined the oscillator-based model of time perception, by collecting electroencephalography (EEG) data during an interval-timing task. Initially, subjects observed a stimulus, either flickering at 10-Hz or constantly illuminated. The subjects then reproduced the duration of the stimulus by pressing a button. As reported in previous studies, the subjects reproduced 1.22 times longer durations for flickering stimuli than for continuously illuminated stimuli. The event-related potential (ERP) during the observation of a flicker oscillated at 10 Hz, reflecting the 10-Hz neural activity phase-locked to the flicker. Importantly, the longer reproduced duration was associated with a larger amplitude of the 10-Hz ERP component during the inter-stimulus interval, as well as during the presentation of the flicker. The correlation between the reproduced duration and the 10-Hz oscillation during the inter-stimulus interval suggested that the flicker-induced neural entrainment affected time dilation. While the 10-Hz flickering stimuli induced phase-locked entrainments at 10 Hz, we also observed event-related desynchronizations of spontaneous neural oscillations in the alpha-frequency range. These could be attributed to the activation of excitatory neurons while observing the flicker stimuli. In addition, neural activity at approximately the alpha frequency increased during the reproduction phase, indicating that flicker-induced neural entrainment persisted even after the offset of the flicker. In summary, our results suggest that the duration perception is mediated by neural oscillations, and that time dilation induced by flickering visual stimuli can be attributed to neural entrainment.

Rural and urban breastfeeding initiation trends in low-income women in North Carolina from 2003 to 2007.

PubMed

Lynch, Suzanne; Bethel, Jeffrey; Chowdhury, Najmul; Moore, Justin B

2012-05-01

Breastfeeding has extensive health benefits for both infants and mothers. Despite these benefits, a significant number of women, disproportionately low-income women, do not initiate breastfeeding. Previous research has also demonstrated that breastfeeding prevalence varies by urbanicity level. The objective was to examine race/ethnicity and urbanicity trends in breastfeeding initiation among low-income women in North Carolina from 2003 to 2007. Breastfeeding initiation data from the North Carolina Pregnancy Nutrition Surveillance System were utilized, with responses from 240,054 women over the 5-year period. Overall, 65.4% of women in mixed-urban counties and 62.1% of women in urban counties initiated breastfeeding compared to only 49.8% of women in rural counties. The disparity between rural and urban counties widened over time, with urban and mixed-urban counties making significantly greater gains in breastfeeding initiation than rural counties. Hispanic and non-Hispanic white women had 6.17 (95% confidence interval [CI], 5.99-6.36) and 1.4 (95% CI, 1.46-1.53) times the odds of initiating breastfeeding as non-Hispanic blacks, respectively. Finally, stratified multivariate regression models identified that the association between race/ethnicity and breastfeeding varied by urbanicity level. The current study provides a clearer picture of rural and urban breastfeeding trends within North Carolina and has implications for states with similar racial/ethnic and urbanicity levels. The research determined that women in rural areas, particularly non-Hispanic blacks, are less likely to initiate breastfeeding. Increased emphasis should be placed on developing breastfeeding interventions for rural communities, particularly targeting the non-Hispanic black population.

Initial Steroid Sensitivity in Children with Steroid-Resistant Nephrotic Syndrome Predicts Post-Transplant Recurrence

PubMed Central

Ding, Wen Y.; Koziell, Ania; McCarthy, Hugh J.; Bierzynska, Agnieszka; Bhagavatula, Murali K.; Dudley, Jan A.; Inward, Carol D.; Coward, Richard J.; Tizard, Jane; Reid, Christopher; Antignac, Corinne; Boyer, Olivia

2014-01-01

Of children with idiopathic nephrotic syndrome, 10%–20% fail to respond to steroids or develop secondary steroid resistance (termed initial steroid sensitivity) and the majority progress to transplantation. Although 30%–50% of these patients suffer disease recurrence after transplantation, with poor long-term outcome, no reliable indicator of recurrence has yet been identified. Notably, the incidence of recurrence after transplantation appears reduced in patients with steroid-resistant nephrotic syndrome (SRNS) due to monogenic disorders. We reviewed 150 transplanted patients with SRNS to identify biomarkers that consistently predict outcome of SRNS after transplantation. In all, 25 children had genetic or familial SRNS and did not experience post-transplant recurrence. We reviewed phenotypic factors, including initial steroid sensitivity, donor type, age, ethnicity, time to ESRD, and time on dialysis, in the remaining 125 children. Of these patients, 57 (45.6%) developed post-transplant recurrence; 26 of 28 (92.9%) patients with initial steroid sensitivity recurred after transplantation, whereas only 26 of 86 (30.2%) patients resistant from the outset recurred (odds ratio, 30; 95% confidence interval, 6.62 to 135.86; P<0.001). We were unable to determine recurrence in two patients (one with initial steroid sensitivity), and nine patients did not receive initial steroids. Our data show that initial steroid sensitivity is highly predictive of post-transplant disease recurrence in this pediatric patient population. Because a pathogenic circulating permeability factor in nephrotic syndrome remains to be confirmed, we propose initial steroid sensitivity as a surrogate marker for post-transplant recurrence. PMID:24511128

An augmented SMS intervention to improve access to antenatal CD4 testing and ART initiation in HIV-infected pregnant women: a cluster randomized trial.

PubMed

Dryden-Peterson, Scott; Bennett, Kara; Hughes, Michael D; Veres, Adrian; John, Oaitse; Pradhananga, Rosina; Boyer, Matthew; Brown, Carolyn; Sakyi, Bright; van Widenfelt, Erik; Keapoletswe, Koona; Mine, Madisa; Moyo, Sikhulile; Asmelash, Aida; Siedner, Mark; Mmalane, Mompati; Shapiro, Roger L; Lockman, Shahin

2015-01-01

Less than one-third of HIV-infected pregnant women eligible for combination antiretroviral therapy (ART) globally initiate treatment prior to delivery, with lack of access to timely CD4 results being a principal barrier. We evaluated the effectiveness of an SMS-based intervention to improve access to timely antenatal ART. We conducted a stepped-wedge cluster randomized trial of a low-cost programmatic intervention in 20 antenatal clinics in Gaborone, Botswana. From July 2011-April 2012, 2 clinics were randomly selected every 4 weeks to receive an ongoing clinic-based educational intervention to improve CD4 collection and to receive CD4 results via an automated SMS platform with active patient tracing. CD4 testing before 26 weeks gestation and ART initiation before 30 weeks gestation were assessed. Three-hundred-sixty-six ART-naïve women were included, 189 registering for antenatal care under Intervention and 177 under Usual Care periods. Of CD4-eligible women, 100 (59.2%) women under Intervention and 79 (50.6%) women under Usual Care completed CD4 phlebotomy before 26 weeks gestation, adjusted odds ratio (aOR, adjusted for time that a clinic initiated Intervention) 0.87 (95% confidence interval [CI]0.47-1.63, P = 0.67). The SMS-based platform reduced time to clinic receipt of CD4 test result from median of 16 to 6 days (P<0.001), was appreciated by clinic staff, and was associated with reduced operational cost. However, rates of ART initiation remained low, with 56 (36.4%) women registering under Intervention versus 37 (24.2%) women under Usual Care initiating ART prior to 30 weeks gestation, aOR 1.06 (95%CI 0.53-2.13, P = 0.87). The augmented SMS-based intervention delivered CD4 results more rapidly and efficiently, and this type of SMS-based results delivery platform may be useful for a variety of tests and settings. However, the intervention did not appear to improve access to timely antenatal CD4 testing or ART initiation, as obstacles other than CD4 impeded ART initiation during pregnancy.

Persistent opioid use following Cesarean delivery: patterns and predictors among opioid naïve women

PubMed Central

Bateman, Brian T.; Franklin, Jessica M.; Bykov, Katsiaryna; Avorn, Jerry; Shrank, William H.; Brennan, Troyen A.; Landon, Joan E.; Rathmell, James P.; Huybrechts, Krista F.; Fischer, Michael A.; Choudhry, Niteesh K.

2016-01-01

Background The incidence of opioid-related death in women has increased five-fold over the past decade. For many women, their initial opioid exposure will occur in the setting of routine medical care. Approximately 1 in 3 deliveries in the U.S. is by Cesarean and opioids are commonly prescribed for post-surgical pain management. Objective The objective of this study was to determine the risk that opioid naïve women prescribed opioids after Cesarean delivery will subsequently become consistent prescription opioid users in the year following delivery, and to identify predictors for this behavior. Study Design We identified women in a database of commercial insurance beneficiaries who underwent Cesarean delivery and who were opioid-naïve in the year prior to delivery. To identify persistent users of opioids, we used trajectory models, which group together patients with similar patterns of medication filling during follow-up, based on patterns of opioid dispensing in the year following Cesarean delivery. We then constructed a multivariable logistic regression model to identify independent risk factors for membership in the persistent user group. Results 285 of 80,127 (0.36%, 95% confidence interval 0.32 to 0.40), opioid-naïve women became persistent opioid users (identified using trajectory models based on monthly patterns of opioid dispensing) following Cesarean delivery. Demographics and baseline comorbidity predicted such use with moderate discrimination (c statistic = 0.73). Significant predictors included a history of cocaine abuse (risk 7.41%; adjusted odds ratio 6.11, 95% confidence interval 1.03 to 36.31) and other illicit substance abuse (2.36%; adjusted odds ratio 2.78, 95% confidence interval 1.12 to 6.91), tobacco use (1.45%; adjusted odds ratio 3.04, 95% confidence interval 2.03 to 4.55), back pain (0.69%; adjusted odds ratio 1.74, 95% confidence interval 1.33 to 2.29), migraines (0.91%; adjusted odds ratio 2.14, 95% confidence interval 1.58 to 2.90), antidepressant use (1.34%; adjusted odds ratio 3.19, 95% confidence interval 2.41 to 4.23) and benzodiazepine use (1.99%; adjusted odds ratio 3.72, 95% confidence interval 2.64 to 5.26) in the year prior to Cesarean delivery. Conclusions A very small proportion of opioid-naïve women (approximately 1 in 300) become persistent prescription opioid users following Cesarean delivery. Pre-existing psychiatric comorbidity, certain pain conditions, and substance use/abuse conditions identifiable at the time of initial opioid prescribing were predictors of persistent use. PMID:26996986

An individual differences approach to the suggestibility of memory over time.

PubMed

Frost, Peter; Nussbaum, Gregory; Loconto, Taylor; Syke, Richard; Warren, Casey; Muise, Christina

2013-04-01

We examined how certain personality traits might relate to the formation of suggestive memory over time. We hypothesised that compliance and trust relate to initial acceptance of misinformation as memory, whereas fantasy proneness might relate to integration of misinformation into memory after later intervals (relative to the time of exposure to misinformation). Participants watched an excerpt from a movie--the simulated eyewitness event. They next answered a recall test that included embedded misinformation about the movie. Participants then answered a yes/no recognition test. A week later, participants answered a second yes/no recognition test about the movie (each yes/no recognition test included different questions). Before both recognition tests, participants were warned about the misinformation shown during recall and were asked to base their answer on the movie excerpt only. After completing the second recognition test, participants answered questions from the Neuroticism Extroversion Openness Personality Inventory-3 (McCrae, Costa, & Martin, 2005) and Creative Experiences Questionnaire (Merckelbach, Horselenberg, & Muris, 2001). While compliance correlated with misinformation effects immediately after exposure to misinformation, fantasy-prone personality accounted for more of the variability in false recognition rates than compliance after a 1-week interval.

Floquet Engineering in Quantum Chains

NASA Astrophysics Data System (ADS)

Kennes, D. M.; de la Torre, A.; Ron, A.; Hsieh, D.; Millis, A. J.

2018-03-01

We consider a one-dimensional interacting spinless fermion model, which displays the well-known Luttinger liquid (LL) to charge density wave (CDW) transition as a function of the ratio between the strength of the interaction U and the hopping J . We subject this system to a spatially uniform drive which is ramped up over a finite time interval and becomes time periodic in the long-time limit. We show that by using a density matrix renormalization group approach formulated for infinite system sizes, we can access the large-time limit even when the drive induces finite heating. When both the initial and long-time states are in the gapless (LL) phase, the final state has power-law correlations for all ramp speeds. However, when the initial and final state are gapped (CDW phase), we find a pseudothermal state with an effective temperature that depends on the ramp rate, both for the Magnus regime in which the drive frequency is very large compared to other scales in the system and in the opposite limit where the drive frequency is less than the gap. Remarkably, quantum defects (instantons) appear when the drive tunes the system through the quantum critical point, in a realization of the Kibble-Zurek mechanism.

Exponential Sum-Fitting of Dwell-Time Distributions without Specifying Starting Parameters

PubMed Central

Landowne, David; Yuan, Bin; Magleby, Karl L.

2013-01-01

Fitting dwell-time distributions with sums of exponentials is widely used to characterize histograms of open- and closed-interval durations recorded from single ion channels, as well as for other physical phenomena. However, it can be difficult to identify the contributing exponential components. Here we extend previous methods of exponential sum-fitting to present a maximum-likelihood approach that consistently detects all significant exponentials without the need for user-specified starting parameters. Instead of searching for exponentials, the fitting starts with a very large number of initial exponentials with logarithmically spaced time constants, so that none are missed. Maximum-likelihood fitting then determines the areas of all the initial exponentials keeping the time constants fixed. In an iterative manner, with refitting after each step, the analysis then removes exponentials with negligible area and combines closely spaced adjacent exponentials, until only those exponentials that make significant contributions to the dwell-time distribution remain. There is no limit on the number of significant exponentials and no starting parameters need be specified. We demonstrate fully automated detection for both experimental and simulated data, as well as for classical exponential-sum-fitting problems. PMID:23746510

The Influence of Interpregnancy Interval on Infant Mortality

PubMed Central

MCKINNEY, David; HOUSE, Melissa; CHEN, Aimin; MUGLIA, Louis; DEFRANCO, Emily

2017-01-01

Background In Ohio the infant mortality rate is above the national average and the black infant mortality rate is more than twice the white infant mortality rate. Having a short interpregnancy interval has been shown to correlate with preterm birth and low birth weight, but the effect of short interpregnancy interval on infant mortality is less well established. Objective To quantify the population impact of interpregnancy interval on the risk of infant mortality. Study Design This was a statewide population-based retrospective cohort study of all births (n=1,131,070) and infant mortalities (n=8,152) using linked Ohio birth and infant death records from 1/2007 through 9/2014. For this study we analyzed 5 interpregnancy interval categories: 0 to < 6 months, 6 to < 12 months, 12 to < 24 months, 24 to < 60 months, and ≥ 60 months. The primary outcome for this study was infant mortality. During the study period, 3701 infant mortalities were linked to a live birth certificate with an interpregnancy interval available. We calculated the frequency and relative risk (RR) of infant mortality for each interval compared to a referent interval of 12 to < 24 months. Stratified analyses by maternal race were also performed. Adjusted risks were estimated after accounting for statistically significant and biologically plausible confounding variables. Adjusted relative risk was utilized to calculate the attributable risk percent of short interpregnancy intervals on infant mortality. Results Short interpregnancy intervals were common in Ohio during the study period. 20.5% of all multiparous births followed an interval of < 12 months. The overall infant mortality rate during this time was 7.2 per 1000 live births (6.0 for white mothers and 13.1 for black mothers). Infant mortalities occurred more frequently for births that occurred following short intervals of 0 to < 6 months (9.2 per 1000) and 6 to < 12 months (7.1 per 1000) compared to 12 to < 24 months (5.6 per 1000), (p= <0.001 and <0.001). The highest risk for infant mortality followed interpregnancy intervals of 0 to < 6 months, adjRR 1.32 (95% CI 1.17–1.49) followed by interpregnancy intervals of 6 to < 12 months, adjRR 1.16 (95% CI 1.04–1.30). Analysis stratified by maternal race revealed similar findings. Attributable risk calculation showed that 24.2% of infant mortalities following intervals of 0 to < 6 months and 14.1% with intervals of 6 to < 12 months are attributable to the short interpregnancy interval. By avoiding short interpregnancy intervals of 12 months or less we estimate that in the state of Ohio 31 infant mortalities (20 white and 8 black) per year could have been prevented and the infant mortality rate could have been reduced from 7.2 to 7.0 during this time frame. Conclusion An interpregnancy interval of 12–60 months (1–5 years) between birth and conception of next pregnancy is associated with lowest risk of infant mortality. Public health initiatives and provider counseling to optimize birth spacing has the potential to significantly reduce infant mortality for both white and black mothers. PMID:28034653

Does MRI scan acceleration affect power to track brain change?

PubMed

Ching, Christopher R K; Hua, Xue; Hibar, Derrek P; Ward, Chadwick P; Gunter, Jeffrey L; Bernstein, Matt A; Jack, Clifford R; Weiner, Michael W; Thompson, Paul M

2015-01-01

The Alzheimer's Disease Neuroimaging Initiative recently implemented accelerated T1-weighted structural imaging to reduce scan times. Faster scans may reduce study costs and patient attrition by accommodating people who cannot tolerate long scan sessions. However, little is known about how scan acceleration affects the power to detect longitudinal brain change. Using tensor-based morphometry, no significant difference was detected in numerical summaries of atrophy rates from accelerated and nonaccelerated scans in subgroups of patients with Alzheimer's disease, early or late mild cognitive impairment, or healthy controls over a 6- and 12-month scan interval. Whole-brain voxelwise mapping analyses revealed some apparent regional differences in 6-month atrophy rates when comparing all subjects irrespective of diagnosis (n = 345). No such whole-brain difference was detected for the 12-month scan interval (n = 156). Effect sizes for structural brain changes were not detectably different in accelerated versus nonaccelerated data. Scan acceleration may influence brain measures but has minimal effects on tensor-based morphometry-derived atrophy measures, at least over the 6- and 12-month intervals examined here. Copyright © 2015 Elsevier Inc. All rights reserved.

A Hydraulic Tomography Experiment in Fractured Sedimentary Rocks, Newark Basin, New Jersey, USA

NASA Astrophysics Data System (ADS)

Tiedeman, C. R.; Barrash, W.; Thrash, C. J.; Johnson, C. D.

2015-12-01

Hydraulic tomography was performed in July 2015 in contaminated fractured mudstone beds at the former Naval Air Warfare Center (NAWC) in the Newark Basin near Trenton, NJ using seven existing wells. The spatial arrangement of wells (in a circle of 9 m radius with one central well), the use of packers to divide the wells into multiple monitoring intervals, and the deployment of fiber optic pressure transducers enabled collection of a hydraulic tomography dataset comprising high-resolution drawdown observations at an unprecedented level of spatial detail for fractured rocks. The experiment involved 45-minute cross-hole aquifer tests, conducted by pumping from a given packer-isolated well interval and continuously monitoring drawdowns in all other well intervals. The collective set of drawdown data from all tests and intervals displays a wide range of behavior suggestive of highly heterogeneous hydraulic conductivity (K) within the tested volume, such as: drawdown curves for different well intervals crossing one another on drawdown-time plots; variable drawdown curve shapes, including linear segments on log-log plots; variable order and magnitude of time-lag and/or drawdown for intervals of a given well in response to pumping from similar fractures or stratigraphic units in different wells; and variable groupings of wells and intervals showing similar responses for different pumping tests. The observed behavior is consistent with previous testing at the NAWC indicating that K within and across individual mudstone beds can vary by orders of magnitude over scales of meters. Preliminary assessment of the drawdown data together with a rich set of geophysical logs suggests an initial conceptual model that includes densely distributed fractures of moderate K at the shallowest depths of the tested volume, connected high-K bedding-plane-parting fractures at intermediate depths, and sparse low-K fractures in the deeper rocks. Future work will involve tomographic inversion of the data to estimate the K distribution at a scale of ~1 m3 in the upper two-thirds of the investigated volume where observation density is greatest.

Department of Defense Precise Time and Time Interval program improvement plan

NASA Technical Reports Server (NTRS)

Bowser, J. R.

1981-01-01

The United States Naval Observatory is responsible for ensuring uniformity in precise time and time interval operations including measurements, the establishment of overall DOD requirements for time and time interval, and the accomplishment of objectives requiring precise time and time interval with minimum cost. An overview of the objectives, the approach to the problem, the schedule, and a status report, including significant findings relative to organizational relationships, current directives, principal PTTI users, and future requirements as currently identified by the users are presented.

The timing of wing molt in tundra swans: energetic and non-energetic constraints

USGS Publications Warehouse

Earnst, S.L.

1992-01-01

Date of wing molt initiation, based on the regression of tenth primary length on capture date, was calculated for breeding and nonbreeding Tundra Swans (Cygnus columbianus columbianus) on the Colville River Delta, Alaska. Breeding females initiated wing molt significantly later than breeding males and nonbreeding males and females; the molt of breeding females was correlated with the date on which their eggs hatched. Breeding males did not differ significantly from nonbreeding males and females in the date of molt initiation. Timing of molt in breeding males and females was consistent with the views that females delay molt while replenishing energy spent on reproduction, but was also consistent with the breeding pair's need for primaries to defend territories and to defend and brood young. Other results, including an increase in an index of female body condition throughout most of the molt period, and a positive correlation between clutch size and female hatch-to-molt interval, were not predicted by the hypothesis that past energy expenditures constrain the timing of molt. Patterns of wing molt within and among other Northern Hemisphere geese and swans are also difficult to explain on the basis of energetics alone. For example, breeding females initiate molt before breeding males in many species. Also, there is extreme asynchrony between mates in two swan species; one of those species also exhibits variation in which sex initiates wing molt first. Both patterns suggest that asynchrony, per se, is important, probably to facilitate brood protection or territory defense. In Tundra Swans and other northern breeding geese and swans, the non-energetic demands of territory defense, brood defense, and brooding are probably important constraints on the timing of wing molt.

Methylphenidate bioavailability in adults when an extended-release multiparticulate formulation is administered sprinkled on food or as an intact capsule.

PubMed

Pentikis, Helen S; Simmons, Roy D; Benedict, Michael F; Hatch, Simon J

2002-04-01

To determine the single-dose bioavailability of 20-mg Metadate CD (methylphenidate HCI, USP) Extended-Release Capsules sprinkled onto 1 level tablespoon (15 mL) of applesauce relative to an intact capsule under fasted conditions in healthy adults. This was a single-center, open-label, single-dose, randomized, two-way crossover study with a 6-day washout period between doses, in healthy male and female subjects (N= 26), aged 21-40 years. Plasma concentration-time data for methylphenidate were used to calculate the pharmacokinetic parameters for each treatment. The pharmacokinetic profile for Metadate CD exhibited biphasic release characteristics with a sharp initial slope and a second rising portion. For Cmax (maximum observed concentration), AUC(0-infinity) (area under the plasma concentration curve from time 0 to infinity) and AUC(0-infinity) (area under the plasma concentration curve from time 0 to the last measurable time point), the geometric least squares mean ratios and 90% confidence intervals were within the 80% to 125% confidence interval for bioequivalence. Adverse events were similar to those reported for methylphenidate. The bioavailability of methylphenidate was not altered when Metadate CD capsules were administered by sprinkling their contents onto a small amount of applesauce.

Impact of Transcranial Doppler Ultrasound on Logistics and Outcomes in Stroke Thrombolysis: Results From the SITS-ISTR.

PubMed

Mazya, Michael V; Ahmed, Niaz; Azevedo, Elsa; Davalos, Antoni; Dorado, Laura; Karlinski, Michal; Lorenzano, Svetlana; Neumann, Jiří; Toni, Danilo; Moreira, Tiago P

2018-07-01

Diagnostic transcranial Doppler ultrasound (TCD) is commonly used in patients with acute stroke before or during treatment with intravenous thrombolysis (IVT). We aimed to assess how much TCD delays IVT initiation and whether TCD influences outcomes. We analyzed data from the SITS-ISTR (Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register) collected from December 2002 to December 2011. Outcomes were door-to-needle time, symptomatic intracerebral hemorrhage, functional outcome per the modified Rankin Scale, and mortality at 3 months. In hospitals performing any TCD pre-IVT, 1701 of 11 265 patients (15%) had TCD before IVT initiation. Door-to-needle time was higher in patients with pre-IVT TCD (74 versus 60 minutes; P <0.001). At hospitals performing any TCD during IVT infusion, of 9044 patients with IVT, 747 were examined with TCD during IVT. No treatment delay was seen with TCD during IVT. After multivariate adjustment, TCD during IVT was independently associated with modestly increased excellent functional outcome (modified Rankin Scale, 0-1; adjusted odds ratio, 1.28; 95% confidence interval, 1.06-1.55; P =0.012) and lower mortality (adjusted odds ratio, 0.73; 95% confidence interval, 0.55-0.95; P =0.022). We recommend that TCD, if performed, should be done during IVT infusion, to avoid treatment delay. The association of hyperacute TCD with beneficial outcomes suggests potential impact on patient management, which warrants further study. © 2018 American Heart Association, Inc.

Evaluation of measles and rubella integrated surveillance system in Apulia region, Italy, 3 years after its introduction.

PubMed

Turiac, I A; Fortunato, F; Cappelli, M G; Morea, A; Chironna, M; Prato, Rosa; Martinelli, D

2018-04-01

This study aimed at evaluating the integrated measles and rubella surveillance system (IMRSS) in Apulia region, Italy, from its introduction in 2013 to 30 June 2016. Measles and rubella case reports were extracted from IMRSS. We estimated system sensitivity at the level of case reporting, using the capture-recapture method for three data sources. Data quality was described as the completeness of variables and timeliness of notification as the median-time interval from symptoms onset to initial alert. The proportion of suspected cases with laboratory investigation, the rate of discarded cases and the origin of infection were also computed. A total of 127 measles and four rubella suspected cases were reported to IMRSS and 82 were laboratory confirmed. Focusing our analysis on measles, IMRSS sensitivity was 82% (95% CI: 75-87). Completeness was >98% for mandatory variables and 57% for 'genotyping'. The median-time interval from symptoms onset to initial alert was 4.5 days, with a timeliness of notification of 33% (41 cases reported ⩽48 h). The proportion of laboratory investigation was 87%. The rate of discarded cases was 0.1 per 100 000 inhabitants per year. The origin of infection was identified for 85% of cases. It is concluded that IMRSS provides good quality data and has good sensitivity; still efforts should be made to improve the completeness of laboratory-related variables, timeliness and to increase the rate of discarded cases.

Mammography interval and breast cancer mortality in women over the age of 75.

PubMed

Simon, Michael S; Wassertheil-Smoller, Sylvia; Thomson, Cynthia A; Ray, Roberta M; Hubbell, F Allan; Lessin, Lawrence; Lane, Dorothy S; Kuller, Lew H

2014-11-01

The purpose of this study is to evaluate the relationship between mammography interval and breast cancer mortality among older women with breast cancer. The study population included 1,914 women diagnosed with invasive breast cancer at age 75 or later during their participation in the Women's health initiative, with an average follow-up of 4.4 years (3.1 SD). Cause of death was based on medical record review. Mammography interval was defined as the time between the last self-reported mammogram 7 or more months prior to diagnosis, and the date of diagnosis. Multivariable adjusted hazard ratios (HR) and 95 % confidence intervals (CIs) for breast cancer mortality and all-cause mortality were computed from Cox proportional hazards analyses. Prior mammograms were reported by 73.0 % of women from 7 months to ≤2 year of diagnosis (referent group), 19.4 % (>2 to <5 years), and 7.5 % (≥5 years or no prior mammogram). Women with the longest versus shortest intervals had more poorly differentiated (28.5 % vs. 22.7 %), advanced stage (25.7 % vs. 22.9 %), and estrogen receptor negative tumors (20.9 % vs. 13.1 %). Compared to the referent group, women with intervals of >2 to <5 years or ≥5 years had an increased risk of breast cancer mortality (HR 1.62, 95 % CI 1.03-2.54) and (HR 2.80, 95 % CI 1.57-5.00), respectively, p trend = 0.0002. There was no significant relationship between mammography interval and other causes of death. These results suggest a continued role for screening mammography among women 75 years of age and older.

Microjet Generator for Highly Viscous Fluids

NASA Astrophysics Data System (ADS)

Onuki, Hajime; Oi, Yuto; Tagawa, Yoshiyuki

2018-01-01

This paper describes a simple system for generating a highly viscous microjet. The jet is produced inside a wettable thin tube partially submerged in a liquid. The gas-liquid interface inside the tube, which is initially concave, is kept much deeper than that outside the tube. An impulsive force applied at the bottom of a liquid container leads to significant acceleration of the liquid inside the tube followed by flow focusing due to the concave interface. The jet generation process can be divided into two parts that occur in different time scales, i.e., the impact interval [impact duration ≤O (10-4) s ] and the focusing interval [focusing duration ≫O (10-4) s ]. During the impact interval, the liquid accelerates suddenly due to the impact. During the focusing interval, the microjet emerges due to flow focusing. In order to explain the sudden acceleration inside the tube during the impact interval, we develop a physical model based on a pressure impulse approach. Numerical simulations confirm the proposed model, indicating that the basic mechanism of the acceleration of the liquid due to the impulsive force is elucidated. Remarkably, the viscous effect is negligible during the impact interval. In contrast, during the focusing interval, the viscosity plays an important role in the microjet generation. We experimentally and numerically investigate the velocity of microjets with various viscosities. We find that higher viscosities lead to reduction of the jet velocity, which can be described by using the Reynolds number (the ratio between the inertia force and the viscous force). This device may be a starting point for next-generation technologies, such as high-viscosity inkjet printers including bioprinters and needle-free injection devices for minimally invasive medical treatments.

Progression and prognosis in multiple system atrophy: an analysis of 230 Japanese patients.

PubMed

Watanabe, Hirohisa; Saito, Yufuko; Terao, Shinichi; Ando, Tetsuo; Kachi, Teruhiko; Mukai, Eiichiro; Aiba, Ikuko; Abe, Yuji; Tamakoshi, Akiko; Doyu, Manabu; Hirayama, Masaaki; Sobue, Gen

2002-05-01

We investigated the disease progression and survival in 230 Japanese patients with multiple system atrophy (MSA; 131 men, 99 women; 208 probable MSA, 22 definite; mean age at onset, 55.4 years). Cerebellar dysfunction (multiple system atrophy-cerebellar; MSA-C) predominated in 155 patients, and parkinsonism (multiple system atrophy-parkinsonian; MSA-P) in 75. The median time from initial symptom to combined motor and autonomic dysfunction was 2 years (range 1-10). Median intervals from onset to aid-requiring walking, confinement to a wheelchair, a bedridden state and death were 3, 5, 8 and 9 years, respectively. Patients manifesting combined motor and autonomic involvement within 3 years of onset had a significantly increased risk of not only developing advanced disease stage but also shorter survival (P < 0.01). MSA-P patients had more rapid functional deterioration than MSA-C patients (aid-requiring walking, P = 0.03; confinement to a wheelchair, P < 0.01; bedridden state, P < 0.01), but showed similar survival. Onset in older individuals showed increased risk of confinement to a wheelchair (P < 0.05), bedridden state (P = 0.03) and death (P < 0.01). Patients initially complaining of motor symptoms had accelerated risk of aid-requiring walking (P < 0.01) and confinement to a wheelchair (P < 0.01) compared with those initially complaining of autonomic symptoms, while the time until confinement to a bedridden state and survival were no worse. Gender was not associated with differences in worsening of function or survival. On MRI, a hyperintense rim at the lateral edge of the dorsolateral putamen was seen in 34.5% of cases, and a 'hot cross bun' sign in the pontine basis (PB) in 63.3%. These putaminal and pontine abnormalities became more prominent as MSA-P and MSA-C features advanced. The atrophy of the cerebellar vermis and PB showed a significant correlation particularly with the interval following the appearance of cerebellar symptoms in MSA-C (r = 0.71, P < 0.01, r = 0.76 and P < 0.01, respectively), but the relationship between atrophy and functional status was highly variable among the individuals, suggesting that other factors influenced the functional deterioration. Atrophy of the corpus callosum was seen in a subpopulation of MSA, suggesting hemispheric involvement in a subgroup of MSA patients. The present study suggested that many factors are involved in the progression of MSA but, most importantly, the interval from initial symptom to combined motor and autonomic dysfunction can predict functional deterioration and survival in MSA.

Lateral vegetation growth rates exert control on coastal foredune hummockiness and coalescing time

NASA Astrophysics Data System (ADS)

Goldstein, Evan B.; Moore, Laura J.; Durán Vinent, Orencio

2017-08-01

Coastal foredunes form along sandy, low-sloped coastlines and range in shape from continuous dune ridges to hummocky features, which are characterized by alongshore-variable dune crest elevations. Initially scattered dune-building plants and species that grow slowly in the lateral direction have been implicated as a cause of foredune hummockiness. Our goal in this work is to explore how the initial configuration of vegetation and vegetation growth characteristics control the development of hummocky coastal dunes including the maximum hummockiness of a given dune field. We find that given sufficient time and absent external forcing, hummocky foredunes coalesce to form continuous dune ridges. Model results yield a predictive rule for the timescale of coalescing and the height of the coalesced dune that depends on initial plant dispersal and two parameters that control the lateral and vertical growth of vegetation, respectively. Our findings agree with previous observational and conceptual work - whether or not hummockiness will be maintained depends on the timescale of coalescing relative to the recurrence interval of high-water events that reset dune building in low areas between hummocks. Additionally, our model reproduces the observed tendency for foredunes to be hummocky along the southeast coast of the US where lateral vegetation growth rates are slower and thus coalescing times are likely longer.

Rapid and accurate prediction of degradant formation rates in pharmaceutical formulations using high-performance liquid chromatography-mass spectrometry.

PubMed

Darrington, Richard T; Jiao, Jim

2004-04-01

Rapid and accurate stability prediction is essential to pharmaceutical formulation development. Commonly used stability prediction methods include monitoring parent drug loss at intended storage conditions or initial rate determination of degradants under accelerated conditions. Monitoring parent drug loss at the intended storage condition does not provide a rapid and accurate stability assessment because often <0.5% drug loss is all that can be observed in a realistic time frame, while the accelerated initial rate method in conjunction with extrapolation of rate constants using the Arrhenius or Eyring equations often introduces large errors in shelf-life prediction. In this study, the shelf life prediction of a model pharmaceutical preparation utilizing sensitive high-performance liquid chromatography-mass spectrometry (LC/MS) to directly quantitate degradant formation rates at the intended storage condition is proposed. This method was compared to traditional shelf life prediction approaches in terms of time required to predict shelf life and associated error in shelf life estimation. Results demonstrated that the proposed LC/MS method using initial rates analysis provided significantly improved confidence intervals for the predicted shelf life and required less overall time and effort to obtain the stability estimation compared to the other methods evaluated. Copyright 2004 Wiley-Liss, Inc. and the American Pharmacists Association.

Cost-Effectiveness of Osteoporosis Screening Strategies for Men

PubMed Central

Nayak, Smita; Greenspan, Susan L.

2016-01-01

Osteoporosis affects many men, with significant morbidity and mortality. However, the best osteoporosis screening strategies for men are unknown. We developed an individual-level state-transition cost-effectiveness model with a lifetime time horizon to identify the cost-effectiveness of different osteoporosis screening strategies for U.S. men involving various screening tests (dual-energy x-ray absorptiometry (DXA); the Osteoporosis Self-Assessment Tool (OST); or a fracture risk assessment strategy using age, femoral neck bone mineral density (BMD), and Vertebral Fracture Assessment (VFA)); screening initiation ages (50, 60, 70, or 80); and repeat screening intervals (5 years or 10 years). In base-case analysis, no screening was a less effective option than all other strategies evaluated; furthermore, no screening was more expensive than all strategies that involved screening with DXA or the OST risk assessment instrument, and thus no screening was “dominated” by screening with DXA or OST at all evaluated screening initiation ages and repeat screening intervals. Screening strategies that most frequently appeared as most cost-effective in base-case analysis and one-way sensitivity analyses when assuming willingness-to-pay of $50,000/QALY or $100,000/QALY included screening initiation at age 50 with the fracture risk assessment strategy and repeat screening every 10 years; screening initiation at age 50 with fracture risk assessment and repeat screening every 5 years; and screening initiation at age 50 with DXA and repeat screening every 5 years. In conclusion, expansion of osteoporosis screening for U.S. men to initiate routine screening at age 50 or 60 would be expected to be effective and of good value for improving health outcomes. A fracture risk assessment strategy using variables of age, femoral neck BMD, and VFA is likely to be the most effective of the evaluated strategies within accepted cost-effectiveness parameters. DXA and OST are also reasonable screening options, albeit likely slightly less effective than the evaluated fracture risk assessment strategy. PMID:26751984

Immunity against influenza A(H1N1) infections is determined by age at the time of initial strain circulation.

PubMed

Delabre, R M; Salez, N; Lapidus, N; Lemaitre, M; Leruez-Ville, M; de Lamballerie, X; Carrat, F

2017-01-01

We explored age-dependent patterns in haemagglutination inhibition (HI) titre to seasonal [1956 A(H1N1), 1977 A(H1N1), 2007 A(H1N1)] and pandemic [A(H1N1)pdm09] influenza strains using serological data collected from an adult French influenza cohort. Subjects were recruited by their general practitioners from 2008 to 2009 and followed until 2010. We explored age-related differences between strain-specific HI titres using 1053 serological samples collected over the study period from 398 unvaccinated subjects. HI titres against the tested seasonal and pandemic strains were determined using the HI technique. Geometric mean titres (GMTs) were estimated using regression models for interval-censored data. Generalized additive mixed models were fit to log-transformed HI estimates to study the relationship between HI titre and age (age at inclusion and/or age at initial strain circulation). GMT against one strain was consistently highest in the birth cohort exposed to that strain during childhood, with peak titres observed in subjects aged 7-8 years at the time of initial strain circulation. Our results complete previous findings on influenza A(H3N2) strains and identify a strain-dependent relationship between HI titre and age at initial strain circulation.

Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

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

McMillan, Matthew T.; Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Ojerholm, Eric

Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiationmore » therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 months, P=.001; 39 vs 47%, P=.005); OS worsened with each cumulative week of delay (P<.0004). On multivariable analysis, prolonged RTT was associated with inferior OS (hazard ratio 1.2, P=.002); the intervals from surgery to radiation therapy initiation or completion were not. Prolonged RTT was particularly detrimental in patients with node positivity, inadequate nodal staging (<15 nodes examined), and those undergoing a cycle of chemotherapy before chemoradiation therapy. Conclusions: Delays during adjuvant radiation therapy appear to negatively impact survival in gastric cancer. Efforts to minimize cumulative interruptions to <7 days should be considered.« less

Ratio-based lengths of intervals to improve fuzzy time series forecasting.

PubMed

Huarng, Kunhuang; Yu, Tiffany Hui-Kuang

2006-04-01

The objective of this study is to explore ways of determining the useful lengths of intervals in fuzzy time series. It is suggested that ratios, instead of equal lengths of intervals, can more properly represent the intervals among observations. Ratio-based lengths of intervals are, therefore, proposed to improve fuzzy time series forecasting. Algebraic growth data, such as enrollments and the stock index, and exponential growth data, such as inventory demand, are chosen as the forecasting targets, before forecasting based on the various lengths of intervals is performed. Furthermore, sensitivity analyses are also carried out for various percentiles. The ratio-based lengths of intervals are found to outperform the effective lengths of intervals, as well as the arbitrary ones in regard to the different statistical measures. The empirical analysis suggests that the ratio-based lengths of intervals can also be used to improve fuzzy time series forecasting.

[Cardiovascular recovery during intermittent exercise in highly-adherent partic pants with hypertension and type 2 diabetes mellitus].

PubMed

Cano-Montoya, Johnattan; Álvarez, Cristian; Martínez, Cristian; Salas, Andrés; Sade, Farid; Ramírez-Campillo, Rodrigo

2016-09-01

Despite the evidence supporting metabolic benefits of high intensity interval exercise (HIIT), there is little information about the cardiovascular response to this type of exercise in patients with type 2 diabetes (T2D) and hypertension (HTA). To analyze the changes in heart rate at rest, at the onset and at the end of each interval of training, after twelve weeks of a HIIT program in T2D and HTA patients. Twenty-three participants with T2D and HTA (20 women) participated in a controlled HIIT program. Fourteen participants attended 90% of more session of exercise and were considered as adherent. Adherent and non-adherent participants had similar body mass index (BMI), and blood pressure. A “1x2x10” (work: rest-time: intervals) HIIT exercise protocol was used both as a test and as training method during twelve weeks. The initial and finishing heart rate (HR) of each of the ten intervals before and after the intervention were measured. After twelve weeks of HIIT intervention, adherent participants had a significant reduction in the heart rate at the onset of exercise, and during intervals 4, 5, 8 and 10. A reduction in the final heart rate was observed during intervals 8 and 10. In the same participants the greatest magnitude of reduction, at the onset or end of exercise was approximately 10 beats/min. No significant changes in BMI, resting heart rate and blood pressure were observed. A HIIT program reduces the cardiovascular effort to a given work-load and improves cardiovascular recovery after exercise.

Correlation of Mohawkian (Ordovician) K-bentonites in post-Black River rocks of Ohio, Kentucky, and Michigan

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

Schumacher, G.A.; Carlton, R.W.; Bergstroem, S.M.

1992-01-01

One to 10 K-bentonites are recognized in the Curdsville and Logana Members of the Lexington Limestone of Kentucky and southwestern Ohio and in coeval strata in west-central and northwestern Ohio and southeastern Michigan. These beds occur in the Phragmodus undatus and Amorphognathus tyaerensis conodont zones and the Orthograptus ruedemanni and Climacograptus spiniferus graptolite zones. Individual beds range in thickness from 1 mm to 30 cm and occur 16 cm to 19 m above the base of the Lexington Limestone and equivalents. Seventy-five percent of the observed K-bentonites occur in three narrow stratigraphic intervals. Some K-bentonites are traceable over parts ofmore » Ohio but insufficient data from northern Kentucky and west-central Ohio complicate regional lithostratigraphic correlation. Conodont biostratigraphy suggests that each k-bentonite complex is correlative regionally. Most conodont species range throughout all, or most, of the study interval but the ranges of Belodina compressa, Polyplacognathus ramosus, and Amorphognathus tyaerensis show only minor overlap. Preliminary correlation suggests that the oldest K- bentonite complex occurs in the interval characterized by B. compressa, the second complex in the P. Ramosus interval, and the third complex in the A. tyaerensis interval. This study provides the basis for potential correlation with coeval K-bentonites in areas outside of the study area. Also it provides an enhanced understanding of the lithostratigraphy and conodont biofacies of this complex stratigraphic interval. The K-bentonite succession also adds information on the timing of the initiation of the Sebree Trough.« less

Importance of the Time Interval between Bowel Preparation and Colonoscopy in Determining the Quality of Bowel Preparation for Full-Dose Polyethylene Glycol Preparation

PubMed Central

Kim, Tae Kyung; Kim, Hyung Wook; Kim, Su Jin; Ha, Jong Kun; Jang, Hyung Ha; Hong, Young Mi; Park, Su Bum; Choi, Cheol Woong; Kang, Dae Hwan

2014-01-01

Background/Aims The quality of bowel preparation (QBP) is the important factor in performing a successful colonoscopy. Several factors influencing QBP have been reported; however, some factors, such as the optimal preparation-to-colonoscopy time interval, remain controversial. This study aimed to determine the factors influencing QBP and the optimal time interval for full-dose polyethylene glycol (PEG) preparation. Methods A total of 165 patients who underwent colonoscopy from June 2012 to August 2012 were prospectively evaluated. The QBP was assessed using the Ottawa Bowel Preparation Scale (Ottawa) score according to several factors influencing the QBP were analyzed. Results Colonoscopies with a time interval of 5 to 6 hours had the best Ottawa score in all parts of the colon. Patients with time intervals of 6 hours or less had the better QBP than those with time intervals of more than 6 hours (p=0.046). In the multivariate analysis, the time interval (odds ratio, 1.897; 95% confidence interval, 1.006 to 3.577; p=0.048) was the only significant contributor to a satisfactory bowel preparation. Conclusions The optimal time was 5 to 6 hours for the full-dose PEG method, and the time interval was the only significant contributor to a satisfactory bowel preparation. PMID:25368750

Timeliness of lung cancer care in Victoria: a retrospective cohort study.

PubMed

Evans, Sue M; Earnest, Arul; Bower, Wendy; Senthuren, Meera; McLaughlin, Peta; Stirling, Rob

2016-02-01

To assess factors associated with second-line delays in the management of patients diagnosed with lung cancer. A retrospective cohort study, conducted in six public and two private Victorian hospitals, of 1417 patients aged 18 years or more who were diagnosed between July 2011 and October 2014 with an incident case of lung cancer identified by International Classification of Diseases, 10th revision codes (C34.0-C34.9, Z85.1, Z85.2) on the basis of either a clinical or pathological diagnosis. Time intervals between referral, diagnosis and initial definitive management. The median time from referral to diagnosis was 15 days (interquartile range [IQR], 5-36); from diagnosis to initial definitive management, 30 days (IQR, 6-84); and from referral to initial definitive management, 53 days (IQR, 25-106). Factors that were significantly associated with delay between referral and initial definitive management include declining or not being referred to palliative care (hazard ratio [HR], v patients referred for palliation, 0.73; 95% CI, 0.62-0.86; P < 0.001), and being treated in a public hospital (HR, v patients managed in a private hospital, 0.55; 95% CI, 0.48-0.64; P < 0.001). The median time from referral to initial definitive management in public and private hospitals was 61 days (IQR, 35-118) and 30 days (IQR, 13-76) respectively; 48% of patients in public hospitals waited longer than the British National Health Service target of a maximum 62 days between referral and first definitive treatment. There are significant delays at various stages of the patient journey after referral for initial definitive management. Having a greater understanding of these delays will enable strategies to be developed that improve the timeliness of care for patients with lung cancer.

Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women

PubMed Central

Onoya, Dorina; Sineke, Tembeka; Brennan, Alana T.; Long, Lawrence; Fox, Matthew P.

2017-01-01

Objectives: We assessed the association between the timing of pregnancy with the risk of postpartum virologic failure and loss from HIV care in South Africa. Design: This is a retrospective cohort study of 6306 HIV-positive women aged 15–49 at antiretroviral therapy (ART) initiation, initiated on ART between January 2004 and December 2013 in Johannesburg, South Africa. Methods: The incidence of virologic failure (two consecutive viral load measurements of >1000 copies/ml) and loss to follow-up (>3 months late for a visit) during 24 months postpartum were assessed using Cox proportional hazards modelling. Results: The rate of postpartum virologic failure was higher following an incident pregnancy on ART [adjusted hazard ratio 1.8, 95% confidence interval (CI): 1.1–2.7] than among women who initiated ART during pregnancy. This difference was sustained among women with CD4+ cell count less than 350 cells/μl at delivery (adjusted hazard ratio 1.8, 95% CI: 1.1–3.0). Predictors of postpartum virologic failure were being viremic, longer time on ART, being 25 or less years old and low CD4+ cell count and anaemia at delivery, as well as initiating ART on stavudine-containing or abacavir-containing regimen. There was no difference postpartum loss to follow-up rates between the incident pregnancies group (hazard ratio 0.9, 95% CI: 0.7–1.1) and those who initiated ART in pregnancy. Conclusion: The risk of virologic failure remains high among postpartum women, particularly those who conceive on ART. The results highlight the need to provide adequate support for HIV-positive women with fertility intention after ART initiation and to strengthen monitoring and retention efforts for postpartum women to sustain the benefits of ART. PMID:28463877

Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women.

PubMed

Onoya, Dorina; Sineke, Tembeka; Brennan, Alana T; Long, Lawrence; Fox, Matthew P

2017-07-17

We assessed the association between the timing of pregnancy with the risk of postpartum virologic failure and loss from HIV care in South Africa. This is a retrospective cohort study of 6306 HIV-positive women aged 15-49 at antiretroviral therapy (ART) initiation, initiated on ART between January 2004 and December 2013 in Johannesburg, South Africa. The incidence of virologic failure (two consecutive viral load measurements of >1000 copies/ml) and loss to follow-up (>3 months late for a visit) during 24 months postpartum were assessed using Cox proportional hazards modelling. The rate of postpartum virologic failure was higher following an incident pregnancy on ART [adjusted hazard ratio 1.8, 95% confidence interval (CI): 1.1-2.7] than among women who initiated ART during pregnancy. This difference was sustained among women with CD4 cell count less than 350 cells/μl at delivery (adjusted hazard ratio 1.8, 95% CI: 1.1-3.0). Predictors of postpartum virologic failure were being viremic, longer time on ART, being 25 or less years old and low CD4 cell count and anaemia at delivery, as well as initiating ART on stavudine-containing or abacavir-containing regimen. There was no difference postpartum loss to follow-up rates between the incident pregnancies group (hazard ratio 0.9, 95% CI: 0.7-1.1) and those who initiated ART in pregnancy. The risk of virologic failure remains high among postpartum women, particularly those who conceive on ART. The results highlight the need to provide adequate support for HIV-positive women with fertility intention after ART initiation and to strengthen monitoring and retention efforts for postpartum women to sustain the benefits of ART.

The PREVAIL trial of enzalutamide in men with chemotherapy-naïve, metastatic castration-resistant prostate cancer: Post hoc analysis of Korean patients.

PubMed

Kim, Choung-Soo; Theeuwes, Ad; Kwon, Dong Deuk; Choi, Young Deuk; Chung, Byung Ha; Lee, Hyun Moo; Lee, Kang Hyun; Lee, Sang Eun

2016-05-01

This post hoc analysis evaluated treatment effects, safety, and pharmacokinetics of enzalutamide in Korean patients in the phase 3, double-blind, placebo-controlled PREVAIL trial. Asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer that progressed on androgen deprivation therapy received 160 mg/d oral enzalutamide or placebo (1:1) until death or discontinuation due to radiographic progression or skeletal-related event and initiation of subsequent therapy. Coprimary end points were centrally assessed radiographic progression-free survival (rPFS) and overall survival (OS). Secondary end points included investigator-assessed rPFS, time to initiation of chemotherapy, time to prostate-specific antigen (PSA) progression, PSA response (≥50% decline), and time to skeletal-related event. Of 1,717 total patients, 78 patients were enrolled in Korea (enzalutamide, n=40; placebo, n=38). Hazard ratios (95% confidence interval) for enzalutamide versus placebo were 0.23 (0.02-2.24) for centrally assessed rPFS, 0.77 (0.28-2.15) for OS, 0.21 (0.08-0.51) for time to chemotherapy, and 0.31 (0.17-0.56) for time to PSA progression. A PSA response was observed in 70.0% of enzalutamide-treated and 10.5% of placebo-treated Korean patients. Adverse events of grade ≥3 occurred in 33% of enzalutamide-treated and 11% of placebo-treated Korean patients, with median treatment durations of 13.0 and 5.1 months, respectively. At 13 weeks, the plasma concentration of enzalutamide plus N-desmethyl enzalutamide was similar in Korean and non-Korean patients (geometric mean ratio, 1.04; 90% confidence interval, 0.97-1.10). In Korean patients, treatment effects and safety of enzalutamide were consistent with those observed in the overall PREVAIL study population (ClinicalTrials.gov Identifier: NCT01212991).

The PREVAIL trial of enzalutamide in men with chemotherapy-naïve, metastatic castration-resistant prostate cancer: Post hoc analysis of Korean patients

PubMed Central

Theeuwes, Ad; Kwon, Dong Deuk; Choi, Young Deuk; Chung, Byung Ha; Lee, Hyun Moo; Lee, Kang Hyun; Lee, Sang Eun

2016-01-01

Purpose This post hoc analysis evaluated treatment effects, safety, and pharmacokinetics of enzalutamide in Korean patients in the phase 3, double-blind, placebo-controlled PREVAIL trial. Materials and Methods Asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer that progressed on androgen deprivation therapy received 160 mg/d oral enzalutamide or placebo (1:1) until death or discontinuation due to radiographic progression or skeletal-related event and initiation of subsequent therapy. Coprimary end points were centrally assessed radiographic progression-free survival (rPFS) and overall survival (OS). Secondary end points included investigator-assessed rPFS, time to initiation of chemotherapy, time to prostate-specific antigen (PSA) progression, PSA response (≥50% decline), and time to skeletal-related event. Results Of 1,717 total patients, 78 patients were enrolled in Korea (enzalutamide, n=40; placebo, n=38). Hazard ratios (95% confidence interval) for enzalutamide versus placebo were 0.23 (0.02–2.24) for centrally assessed rPFS, 0.77 (0.28–2.15) for OS, 0.21 (0.08–0.51) for time to chemotherapy, and 0.31 (0.17–0.56) for time to PSA progression. A PSA response was observed in 70.0% of enzalutamide-treated and 10.5% of placebo-treated Korean patients. Adverse events of grade ≥3 occurred in 33% of enzalutamide-treated and 11% of placebo-treated Korean patients, with median treatment durations of 13.0 and 5.1 months, respectively. At 13 weeks, the plasma concentration of enzalutamide plus N-desmethyl enzalutamide was similar in Korean and non-Korean patients (geometric mean ratio, 1.04; 90% confidence interval, 0.97–1.10). Conclusions In Korean patients, treatment effects and safety of enzalutamide were consistent with those observed in the overall PREVAIL study population (ClinicalTrials.gov Identifier: NCT01212991). PMID:27195316

Enzalutamide in Japanese patients with chemotherapy-naïve, metastatic castration-resistant prostate cancer: A post-hoc analysis of the placebo-controlled PREVAIL trial.

PubMed

Kimura, Go; Yonese, Junji; Fukagai, Takashi; Kamba, Tomomi; Nishimura, Kazuo; Nozawa, Masahiro; Mansbach, Hank; Theeuwes, Ad; Beer, Tomasz M; Tombal, Bertrand; Ueda, Takeshi

2016-05-01

To evaluate the treatment effects, safety and pharmacokinetics of enzalutamide in Japanese patients. This was a post-hoc analysis of the phase 3, double-blind, placebo-controlled PREVAIL trial. Asymptomatic or mildly symptomatic chemotherapy-naïve patients with metastatic castration-resistant prostate cancer progressing on androgen deprivation therapy were randomized one-to-one to 160 mg/day oral enzalutamide or placebo until discontinuation on radiographic progression or skeletal-related event and initiation of subsequent antineoplastic therapy. Coprimary end-points were centrally assessed radiographic progression-free survival and overall survival. Secondary end-points were investigator-assessed radiographic progression-free survival, time to initiation of chemotherapy, time to prostate-specific antigen progression, prostate-specific antigen response (≥50% decline) and time to skeletal-related event. Of 1717 patients, 61 were enrolled in Japan (enzalutamide, n = 28; placebo, n = 33); hazard ratios (95% confidence interval) of 0.30 for centrally assessed radiographic progression-free survival (0.03-2.95), 0.59 for overall survival (0.20-1.8), 0.46 for time to chemotherapy (0.22-0.96) and 0.36 for time to prostate-specific antigen progression (0.17-0.75) showed the treatment benefit of enzalutamide over the placebo. Prostate-specific antigen responses were observed in 60.7% of enzalutamide-treated men versus 21.2% of placebo-treated men. Plasma concentrations of enzalutamide were higher in Japanese patients: the geometric mean ratio of Japanese/non-Japanese patients was 1.126 (90% confidence interval 1.018-1.245) at 13 weeks. Treatment-related adverse events grade ≥3 occurred in 3.6% of enzalutamide- and 6.1% of placebo-treated Japanese patients. Treatment effects and safety in Japanese patients were generally consistent with the overall results from PREVAIL. © 2016 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association.

Assessing predictability of a hydrological stochastic-dynamical system

NASA Astrophysics Data System (ADS)

Gelfan, Alexander

2014-05-01

The water cycle includes the processes with different memory that creates potential for predictability of hydrological system based on separating its long and short memory components and conditioning long-term prediction on slower evolving components (similar to approaches in climate prediction). In the face of the Panta Rhei IAHS Decade questions, it is important to find a conceptual approach to classify hydrological system components with respect to their predictability, define predictable/unpredictable patterns, extend lead-time and improve reliability of hydrological predictions based on the predictable patterns. Representation of hydrological systems as the dynamical systems subjected to the effect of noise (stochastic-dynamical systems) provides possible tool for such conceptualization. A method has been proposed for assessing predictability of hydrological system caused by its sensitivity to both initial and boundary conditions. The predictability is defined through a procedure of convergence of pre-assigned probabilistic measure (e.g. variance) of the system state to stable value. The time interval of the convergence, that is the time interval during which the system losses memory about its initial state, defines limit of the system predictability. The proposed method was applied to assess predictability of soil moisture dynamics in the Nizhnedevitskaya experimental station (51.516N; 38.383E) located in the agricultural zone of the central European Russia. A stochastic-dynamical model combining a deterministic one-dimensional model of hydrothermal regime of soil with a stochastic model of meteorological inputs was developed. The deterministic model describes processes of coupled heat and moisture transfer through unfrozen/frozen soil and accounts for the influence of phase changes on water flow. The stochastic model produces time series of daily meteorological variables (precipitation, air temperature and humidity), whose statistical properties are similar to those of the corresponding series of the actual data measured at the station. Beginning from the initial conditions and being forced by Monte-Carlo generated synthetic meteorological series, the model simulated diverging trajectories of soil moisture characteristics (water content of soil column, moisture of different soil layers, etc.). Limit of predictability of the specific characteristic was determined through time of stabilization of variance of the characteristic between the trajectories, as they move away from the initial state. Numerical experiments were carried out with the stochastic-dynamical model to analyze sensitivity of the soil moisture predictability assessments to uncertainty in the initial conditions, to determine effects of the soil hydraulic properties and processes of soil freezing on the predictability. It was found, particularly, that soil water content predictability is sensitive to errors in the initial conditions and strongly depends on the hydraulic properties of soil under both unfrozen and frozen conditions. Even if the initial conditions are "well-established", the assessed predictability of water content of unfrozen soil does not exceed 30-40 days, while for frozen conditions it may be as long as 3-4 months. The latter creates opportunity for utilizing the autumn water content of soil as the predictor for spring snowmelt runoff in the region under consideration.

Did intense volcanism trigger the first Late Ordovician icehouse?

USGS Publications Warehouse

Buggisch, Werner; Joachimski, Michael M.; Lehnert, Oliver; Bergstrom, S. M.; Repetski, John E.

2009-01-01

Oxygen isotopes measured on Late Ordovician conodonts from Minnesota and Kentucky (United States) were studied to reconstruct the paleotemperature history during late Sandbian to Katian (Mohawkian–Cincinnatian) time. This time interval was characterized by intense volcanism, as shown by the prominent Deicke, Millbrig, and other K-bentonite beds. A prominent carbon isotope excursion (Guttenberg δ13C excursion, GICE) postdates the Millbrig volcanic eruptions, and has been interpreted to reflect a drawdown of atmospheric carbon dioxide and climatic cooling. The oxygen isotope record in conodont apatite contradicts this earlier interpretation. An increase in δ18O of 1.5‰ (Vienna standard mean ocean water) just above the Deicke K-bentonite suggests an abrupt and short-lived cooling that possibly initiated a first short-term glacial episode well before the major Hirnantian glaciation. The decrease in δ18O immediately after the mega-eruptions indicates warming before the GICE, and no cooling is shown in the GICE interval. The coincidence of the Deicke mega-eruption with a cooling event suggests that this major volcanic event had a profound effect on Late Ordovician (late Mohawkian) climate.

Did intense volcanism trigger the first Late Ordovician icehouse?

USGS Publications Warehouse

Buggisch, Werner; Joachimski, Michael M.; Lehnert, Oliver; Bergström, Stig M.; Repetski, John E.; Webers, Gerald F.

2010-01-01

Oxygen isotopes measured on Late Ordovician conodonts from Minnesota and Kentucky (United States) were studied to reconstruct the paleotemperature history during late Sandbian to Katian (Mohawkian–Cincinnatian) time. This time interval was characterized by intense volcanism, as shown by the prominent Deicke, Millbrig, and other K-bentonite beds. A prominent carbon isotope excursion (Guttenberg δ13C excursion, GICE) postdates the Millbrig volcanic eruptions, and has been interpreted to reflect a drawdown of atmospheric carbon dioxide and climatic cooling. The oxygen isotope record in conodont apatite contradicts this earlier interpretation. An increase in δ18O of 1.5‰ (Vienna standard mean ocean water) just above the Deicke K-bentonite suggests an abrupt and short-lived cooling that possibly initiated a first short-term glacial episode well before the major Hirnantian glaciation. The decrease in δ18O immediately after the mega-eruptions indicates warming before the GICE, and no cooling is shown in the GICE interval. The coincidence of the Deicke mega-eruption with a cooling event suggests that this major volcanic event had a profound effect on Late Ordovician (late Mohawkian) climate.

Means and method for calibrating a photon detector utilizing electron-photon coincidence

NASA Technical Reports Server (NTRS)

Srivastava, S. K. (Inventor)

1984-01-01

An arrangement for calibrating a photon detector particularly applicable for the ultraviolet and vacuum ultraviolet regions is based on electron photon coincidence utilizing crossed electron beam atom beam collisions. Atoms are excited by electrons which lose a known amount of energy and scatter with a known remaining energy, while the excited atoms emit photons of known radiation. Electrons of the known remaining energy are separated from other electrons and are counted. Photons emitted in a direction related to the particular direction of scattered electrons are detected to serve as a standard. Each of the electrons is used to initiate the measurements of a time interval which terminates with the arrival of a photon exciting the photon detector. Only the number of time intervals related to the coincidence correlation and of electrons scattered in the particular direction with the known remaining energy and photons of a particular radiation level emitted due to the collisions of such scattered electrons are counted. The detector calibration is related to the number of counted electrons and photons.

Conservative management of extradural hematoma: A report of sixty-two cases.

PubMed

Zwayed, A Rahim H; Lucke-Wold, Brandon

2018-06-01

Extradural hematomas (EDH) are considered life threatening in that the risk for brain herniation is significant. The current accepted understanding within the literature is to treat EDH via surgical evacuation of the hematoma. In this case-series we report 62 cases of EDH managed conservatively without surgical intervention. Inclusion criteria were: Glasgow comma scale score 13-15, extradural hematoma confirmed by CT being less than 40 mm, less than 6 mm of midline shift, and no other surgical lesions present. Patients were initially observed in a surgical intensive care unit prior to discharge and had closely scheduled follow-up. Of the 62 cases none required emergent intervention and the majority had interval resolution of the epidural hematoma over time. Resolution was apparent by 21 days and definitive by 3 to 6 months. Patients with EDH who have a high Glasgow comma scale score 13-15, volume <40 mm, and less than 6 mm of midline shift should be considered for conservative management. Our study indicates that these patients will have interval resolution of hematoma over time without worsening of symptoms.

Interresponse Time Structures in Variable-Ratio and Variable-Interval Schedules

ERIC Educational Resources Information Center

Bowers, Matthew T.; Hill, Jade; Palya, William L.

2008-01-01

The interresponse-time structures of pigeon key pecking were examined under variable-ratio, variable-interval, and variable-interval plus linear feedback schedules. Whereas the variable-ratio and variable-interval plus linear feedback schedules generally resulted in a distinct group of short interresponse times and a broad distribution of longer…

Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation

PubMed Central

Laguna, Mariola; Purc, Ewelina

2016-01-01

The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans’ formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning. PMID:27909414

Personality Traits and Training Initiation Process: Intention, Planning, and Action Initiation.

PubMed

Laguna, Mariola; Purc, Ewelina

2016-01-01

The article aims at investigating the role of personality traits in relation to training initiation. Training initiation is conceptualized as a goal realization process, and explained using goal theories. There are three stages of the process analyzed: intention to undertake training, plan formulation, and actual training undertaking. Two studies tested the relationships between five personality traits, defined according to the five factor model, and the stages of the goal realization process. In Study 1, which explains training intention and training plans' formulation, 155 employees participated. In Study 2, which was time-lagged with two measurement points, and which explains intention, plans, and training actions undertaken, the data from 176 employees was collected at 3 month intervals. The results of these studies show that personality traits, mainly openness to experience, predict the training initiation process to some degree: intention, plans, and actual action initiation. The findings allow us to provide recommendations for practitioners responsible for human resource development. The assessment of openness to experience in employees helps predict their motivation to participate in training activities. To increase training motivation it is vital to strengthen intentions to undertake training, and to encourage training action planning.

A Historical Perspective on Presentations of Hypertensive Acute Heart Failure

PubMed Central

Darling, Chad E; Sun, Jiaoyuan Elisabeth; Goldberg, Jordan; Pang, Peter; Baugh, Christopher W; Lessard, Darleen; McManus, David D

2017-01-01

Background The initial systolic blood pressure (SBP) in patients presenting to the hospital with acute heart failure (AHF) informs prognosis, diagnosis, and guides initial treatment. However, over time AHF presentations with elevated SBP appear to have declined. The present study examined whether the frequency of AHF presentations with systolic hypertension (SBP >160 mmHg) declined over a nearly two-decade time interval. Methods This study compares four historical, cross-sectional cohorts with AHF who were admitted to tertiary care medical centres in the North-eastern USA in 1995, 2000, 2006, and 2011–13. The main outcome was the proportion of AHF patients presenting with an initial SBP >160 mmHg. Results 2,366 patients comprised the study sample. The average age was 77 years, 55% were female, 94% white, and 75% had prior heart failure. In 1995, 34% of AHF patients presented with an initial SBP >160 mmHg compared to 20% in 2011–2013 (p<0.01). Multivariate logistic regression demonstrated reduced odds of presenting with a SBP >160 mmHg in 2006 (0.64, 95% CI 0.42–0.96) and 2011–13 (0.46, 95% CI 0.28–0.74) compared with patients in 1995. Conclusion The proportion of patients with AHF and initial SBP >160 mmHg significantly declined over the study time period. There are several potential reasons for this observation and these findings highlight the need for ongoing surveillance of patients with AHF as changing clinical characteristics can impact early treatment decisions. PMID:28824930

Effect of glomerular filtration rate at dialysis initiation on survival in patients with advanced chronic kidney disease: what is the effect of lead-time bias?

PubMed Central

Janmaat, Cynthia J; van Diepen, Merel; Krediet, Raymond T; Hemmelder, Marc H; Dekker, Friedo W

2017-01-01

Purpose Current clinical guidelines recommend to initiate dialysis in the presence of symptoms or signs attributable to kidney failure, often with a glomerular filtration rate (GFR) of 5–10 mL/min/1.73 m2. Little evidence exists about the optimal kidney function to start dialysis. Thus far, most observational studies have been limited by lead-time bias. Only a few studies have accounted for lead-time bias, and showed contradictory results. We examined the effect of GFR at dialysis initiation on survival in chronic kidney disease patients, and the role of lead-time bias therein. We used both kidney function based on 24-hour urine collection (measured GFR [mGFR]) and estimated GFR (eGFR). Materials and methods A total of 1,143 patients with eGFR data at dialysis initiation and 852 patients with mGFR data were included from the NECOSAD cohort. Cox regression was used to adjust for potential confounders. To examine the effect of lead-time bias, survival was counted from the time of dialysis initiation or from a common starting point (GFR 20 mL/min/1.73 m2), using linear interpolation models. Results Without lead-time correction, no difference between early and late starters was present based on eGFR (hazard ratio [HR] 1.03, 95% confidence interval [CI] 0.81–1.3). However, after lead-time correction, early initiation showed a survival disadvantage (HR between 1.1 [95% CI 0.82–1.48] and 1.33 [95% CI 1.05–1.68]). Based on mGFR, the potential survival benefit for early starters without lead-time correction (HR 0.8, 95% CI 0.62–1.03) completely disappeared after lead-time correction (HR between 0.94 [95% CI 0.65–1.34] and 1.21 [95% CI 0.95–1.56]). Dialysis start time differed about a year between early and late initiation. Conclusion Lead-time bias is not only a methodological problem but also has clinical impact when assessing the optimal kidney function to start dialysis. Therefore, lead-time bias is extremely important to correct for. Taking account of lead-time bias, this controlled study showed that early dialysis initiation (eGFR >7.9, mGFR >6.6 mL/min/1.73 m2) was not associated with an improvement in survival. Based on kidney function, this study suggests that in some patients, dialysis could be started even later than an eGFR <5.7 and mGFR <4.3 mL/min/1.73 m2. PMID:28442934

Discharge behavior of motor units in knee extensors during the initial stage of constant-force isometric contraction at low force level.

PubMed

Kamo, Mifuyu

2002-03-01

To elucidate the strategy of the activity of motor units (MUs) to maintain a constant-force isometric contraction, I examined the behavior of MUs in knee extensor muscles [(vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF)] during a sustained contraction at 5% of maximal voluntary contraction for 5 min. In all cases, the spike interval exhibited an elongating trend, and two discharge patterns were observed, continuous discharge and decruitment. In continuous-discharge MUs, the trend slope was steep immediately after the onset of constant force (steep phase), and then became gentle (gentle phase). Decruitments were observed frequently during each phase, and additional MU recruitment was observed throughout the contraction. The mean value of recruitment threshold force did not differ among the extensors. The mean spike interval at the onset of constant-force isometric contractions was shorter in RF than in VL. However, there were no differences in the duration and extent of the elongating trend, decruitment time and recruitment time among the extensors. The electromyogram of the antagonist biceps femoris muscle revealed no compensatory change for extensor activity. These results indicated that at a low force level, the strategy employed by the central nervous system to maintain constant force appears to involve cooperation among elongating trends in the spike interval, decruitment following elongation, and additional MU recruitment in synergistic muscles.

New precession expressions, valid for long time intervals

NASA Astrophysics Data System (ADS)

Vondrák, J.; Capitaine, N.; Wallace, P.

2011-10-01

Context. The present IAU model of precession, like its predecessors, is given as a set of polynomial approximations of various precession parameters intended for high-accuracy applications over a limited time span. Earlier comparisons with numerical integrations have shown that this model is valid only for a few centuries around the basic epoch, J2000.0, while for more distant epochs it rapidly diverges from the numerical solution. In our preceding studies we also obtained preliminary developments for the precessional contribution to the motion of the equator: coordinates X,Y of the precessing pole and precession parameters ψA,ωA, suitable for use over long time intervals. Aims: The goal of the present paper is to obtain upgraded developments for various sets of precession angles that would fit modern observations near J2000.0 and at the same time fit numerical integration of the motions of solar system bodies on scales of several thousand centuries. Methods: We used the IAU 2006 solutions to represent the precession of the ecliptic and of the equator close to J2000.0 and, for more distant epochs, a numerical integration using the Mercury 6 package and solutions by Laskar et al. (1993, A&A, 270, 522) with upgraded initial conditions and constants to represent the ecliptic, and general precession and obliquity, respectively. From them, different precession parameters were calculated in the interval ± 200 millennia from J2000.0, and analytical expressions are found that provide a good fit for the whole interval. Results: Series for the various precessional parameters, comprising a cubic polynomial plus from 8 to 14 periodic terms, are derived that allow precession to be computed with an accuracy comparable to IAU 2006 around the central epoch J2000.0, a few arcseconds throughout the historical period, and a few tenths of a degree at the ends of the ± 200 millennia time span. Computer algorithms are provided that compute the ecliptic and mean equator poles and the precession matrix. The Appendix containing the computer code is available in electronic form at http://www.aanda.org

Not All Prehospital Time is Equal: Influence of Scene Time on Mortality

PubMed Central

Brown, Joshua B.; Rosengart, Matthew R.; Forsythe, Raquel M.; Reynolds, Benjamin R.; Gestring, Mark L.; Hallinan, William M.; Peitzman, Andrew B.; Billiar, Timothy R.; Sperry, Jason L.

2016-01-01

Background Trauma is time-sensitive and minimizing prehospital (PH) time is appealing. However, most studies have not linked increasing PH time with worse outcomes, as raw PH times are highly variable. It is unclear whether specific PH time patterns affect outcomes. Our objective was to evaluate the association of PH time interval distribution with mortality. Methods Patients transported by EMS in the Pennsylvania trauma registry 2000-2013 with total prehospital time (TPT)≥20min were included. TPT was divided into three PH time intervals: response, scene, and transport time. The number of minutes in each PH time interval was divided by TPT to determine the relative proportion each interval contributed to TPT. A prolonged interval was defined as any one PH interval contributing ≥50% of TPT. Patients were classified by prolonged PH interval or no prolonged PH interval (all intervals<50% of TPT). Patients were matched for TPT and conditional logistic regression determined the association of mortality with PH time pattern, controlling for confounders. PH interventions were explored as potential mediators, and prehospital triage criteria used identify patients with time-sensitive injuries. Results There were 164,471 patients included. Patients with prolonged scene time had increased odds of mortality (OR 1.21; 95%CI 1.02–1.44, p=0.03). Prolonged response, transport, and no prolonged interval were not associated with mortality. When adjusting for mediators including extrication and PH intubation, prolonged scene time was no longer associated with mortality (OR 1.06; 0.90–1.25, p=0.50). Together these factors mediated 61% of the effect between prolonged scene time and mortality. Mortality remained associated with prolonged scene time in patients with hypotension, penetrating injury, and flail chest. Conclusions Prolonged scene time is associated with increased mortality. PH interventions partially mediate this association. Further study should evaluate whether these interventions drive increased mortality because they prolong scene time or by another mechanism, as reducing scene time may be a target for intervention. Level of Evidence IV, prognostic study PMID:26886000

Visceral Leishmaniasis on the Indian Subcontinent: Modelling the Dynamic Relationship between Vector Control Schemes and Vector Life Cycles.

PubMed

Poché, David M; Grant, William E; Wang, Hsiao-Hsuan

2016-08-01

Visceral leishmaniasis (VL) is a disease caused by two known vector-borne parasite species (Leishmania donovani, L. infantum), transmitted to man by phlebotomine sand flies (species: Phlebotomus and Lutzomyia), resulting in ≈50,000 human fatalities annually, ≈67% occurring on the Indian subcontinent. Indoor residual spraying is the current method of sand fly control in India, but alternative means of vector control, such as the treatment of livestock with systemic insecticide-based drugs, are being evaluated. We describe an individual-based, stochastic, life-stage-structured model that represents a sand fly vector population within a village in India and simulates the effects of vector control via fipronil-based drugs orally administered to cattle, which target both blood-feeding adults and larvae that feed on host feces. Simulation results indicated efficacy of fipronil-based control schemes in reducing sand fly abundance depended on timing of drug applications relative to seasonality of the sand fly life cycle. Taking into account cost-effectiveness and logistical feasibility, two of the most efficacious treatment schemes reduced population peaks occurring from April through August by ≈90% (applications 3 times per year at 2-month intervals initiated in March) and >95% (applications 6 times per year at 2-month intervals initiated in January) relative to no control, with the cumulative number of sand fly days occurring April-August reduced by ≈83% and ≈97%, respectively, and more specifically during the summer months of peak human exposure (June-August) by ≈85% and ≈97%, respectively. Our model should prove useful in a priori evaluation of the efficacy of fipronil-based drugs in controlling leishmaniasis on the Indian subcontinent and beyond.

A Comparison Between the Conventional and the Laryngoscope-Assisted Lightwand Intubation Techniques in Patients With Cervical Immobilization: A Prospective Randomized Study.

PubMed

Kim, Eugene; Kim, Byung-Gun; Lim, Young-Jin; Jeon, Young-Tae; Hwang, Jung-Won; Lee, Seo-Yun; Park, Hee-Pyoung

2017-09-01

Positioning of a lightwand in the midline of the oral cavity can be challenging in patients with cervical immobilization. Direct laryngoscopy may permit the lightwand tip to more easily access the glottic opening. We tested our hypothesis that a laryngoscope-assisted lightwand technique allows more successful endotracheal intubation than does a conventional lightwand approach. A total of 162 patients requiring cervical immobilization during intubation for cervical spine surgery were allocated randomly to 2 groups. The conventional lightwand technique (group C, n = 80) or the laryngoscope-assisted lightwand technique (group L, n = 82) was used for endotracheal intubation. In the group L, a Macintosh laryngoscope was inserted into the oral cavity, advanced until the epiglottis tip was visible, but not used to lift the epiglottis tip. The lightwand tip was placed below the epiglottis under direct view of the epiglottis tip. The primary outcome (the initial intubation success rate) and secondary outcomes (intubation time, hemodynamic changes, and postoperative airway complications) were evaluated. The initial intubation success rate was significantly lower (75% vs 89%; relative risk [95% confidence interval]: 1.2 [1.0-1.4]; P = .034) in group C than group L. The intubation time (22 ± 13 vs 24 ± 12 seconds; mean difference [98.33% confidence interval]: 2.4 [-2.3 to 7.2]; P = .217) did not differ between groups. Postoperative sore throat score, incidences of hypertension and tachycardia, postoperative oral mucosal bleeding, and hoarseness also did not differ between groups. Laryngoscope-assisted lightwand intubation did not increase intubation time, and it increased first attempt intubation rates compared with traditional lightwand intubation in patients requiring cervical immobilization for cervical spine surgery.

A monitor for continuous measurement of temperature, pH, and conductance of wet precipitation: Preliminary results from the Adirondack Mountains, New York

USGS Publications Warehouse

Johnsson, P.A.; Reddy, M.M.

1990-01-01

This report describes a continuous wet-only precipitation monitor designed by the U.S. Geological Survey to record variations in rainfall temperature, pH, and specific conductance at 1-min intervals over the course of storms. Initial sampling in the Adirondack Mountains showed that rainfall acidity varied over the course of summer storms, with low initial pH values increasing as storm intensity increased.This report describes a continuous wet-only precipitation monitor designed by the U.S. Geological Survey to record variations in rainfall temperature, pH, and specific conductance at 1-min intervals over the course of storms. Initial sampling in the Adirondack Mountains showed that rainfall acidity varied over the course of summer storms, with low initial pH values increasing as storm intensity increased.

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment.

PubMed

Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

2017-01-01

To evaluate full-thickness macular hole (MH) formation in the postoperative period after initial vitrectomy for rhegmatogenous retinal detachment (rRD). We retrospectively reviewed the medical records of 4 consecutive eyes that required additional vitrectomy for full-thickness MH between April 2013 and March 2016 after undergoing an initial vitrectomy for rRD. Epiretinal membrane (ERM) was identified by preoperative optical coherence tomography or intraoperative dye staining in each case. Photocoagulation of retinal breaks prior to initial vitrectomy was performed in Cases 1, 2, and 3 (4-16 days), with yttrium-aluminum-garnet capsulotomy after cataract extraction also performed prior to the retinal break formation in Case 3. At the initial vitrectomy, there was a superior retinal break which crossed the equator in Case 2, and an intentional hole was created in Cases 1 and 4. The mean interval from the initial vitrectomy until MH formation was 27.5 ± 15.8 months. As with Case 2, the intervals in Cases 1 and 4, in which an intentional hole was created, were clearly shorter than in those in Case 3. Finally, MH closure was achieved after an additional vitrectomy (removal of the internal limiting membrane with ERM and gas tamponade) and best-corrected visual acuity improved in each case. ERM was identified in the cases examined in our study. The presence of an intentional hole might shorten the interval of MH formation after vitrectomy for rRD.

Time interval measurement device based on surface acoustic wave filter excitation, providing 1 ps precision and stability.

PubMed

Panek, Petr; Prochazka, Ivan

2007-09-01

This article deals with the time interval measurement device, which is based on a surface acoustic wave (SAW) filter as a time interpolator. The operating principle is based on the fact that a transversal SAW filter excited by a short pulse can generate a finite signal with highly suppressed spectra outside a narrow frequency band. If the responses to two excitations are sampled at clock ticks, they can be precisely reconstructed from a finite number of samples and then compared so as to determine the time interval between the two excitations. We have designed and constructed a two-channel time interval measurement device which allows independent timing of two events and evaluation of the time interval between them. The device has been constructed using commercially available components. The experimental results proved the concept. We have assessed the single-shot time interval measurement precision of 1.3 ps rms that corresponds to the time of arrival precision of 0.9 ps rms in each channel. The temperature drift of the measured time interval on temperature is lower than 0.5 ps/K, and the long term stability is better than +/-0.2 ps/h. These are to our knowledge the best values reported for the time interval measurement device. The results are in good agreement with the error budget based on the theoretical analysis.

The effect of time on CPR and automated external defibrillator skills in the Public Access Defibrillation Trial

PubMed Central

Christenson, Jim; Nafziger, Sarah; Compton, Scott; Vijayaraghavan, Kris; Slater, Brian; Ledingham, Robert; Powell, Judy; McBurnie, Mary Ann

2009-01-01

Background The time to skill deterioration between primary training/retraining and further retraining in Cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) for lay-persons is unclear. The Public Access Defibrillation (PAD) Trial was a multi-center randomized controlled trial evaluating survival after CPR-only vs. CPR+AED delivered by onsite non-medical volunteer responders in out-of-hospital cardiac arrest. Aims This sub-study evaluated the relationship of time between primary training/retraining and further retraining on volunteer performance during pretest AED and CPR skill evaluation. Methods Volunteers at 1260 facilities in 24 North American regions underwent training/retraining according to facility randomization, which included an initial session and a refresher session at approximately 6 months. Before the next retraining, a CPR and AED skill test was completed for 2729 volunteers. Primary outcome for the study was assessment of global competence of CPR or AED performance (adequate vs not adequate) using Chi-square tests for trends by time interval (3, 6, 9, and 12 months). Confirmatory (GEE) logistic regression analysis, adjusted for site and potential confounders. Results The proportion of volunteers judged to be competent did not diminish by interval (3,6,9,12 months) for either CPR or AED skills. After adjusting for site and potential confounders, longer intervals before to further retraining was associated with a slightly lower likelihood of performing adequate CPR but not with AED scores. Conclusions After primary training/retraining, the CPR skills of targeted lay responders deteriorate nominally but 80% remain competent up to one year. AED skills do not significantly deteriorate and 90% of volunteers remain competent up to one year. PMID:17303309

Characterization and referral patterns of ST-elevation myocardial infarction patients admitted to chest pain units rather than directly to catherization laboratories. Data from the German Chest Pain Unit Registry.

PubMed

Schmidt, Frank P; Perne, Andrea; Hochadel, Matthias; Giannitsis, Evangelos; Darius, Harald; Maier, Lars S; Schmitt, Claus; Heusch, Gerd; Voigtländer, Thomas; Mudra, Harald; Gori, Tommaso; Senges, Jochen; Münzel, Thomas

2017-03-15

Direct transfer to the catheterization laboratory for primary percutaneous coronary intervention (PCI) is standard of care for patients with ST-segment elevation myocardial infarction (STEMI). Nevertheless, a significant number of STEMI-patients are initially treated in chest pain units (CPUs) of admitting hospitals. Thus, it is important to characterize these patients and to define why an important deviation from recommended clinical pathways occurs and in particular to quantify the impact of deviation on critical time intervals. 1679 STEMI patients admitted to a CPU in the period from 2010 to 2015 were enrolled in the German CPU registry (8.5% of 19,666). 55.9% of the patients were delivered by an emergency medical system (EMS), 16.1% transferred from other hospitals and 15.2% referred by a general practitioner (GP). 12.7% were self-referrals. 55% did not get a pre-hospital ECG. Compared to the EMS, referral by GPs markedly delayed critical time intervals while a pre-hospital ECG demonstrating ST-segment elevation reduced door-to-balloon time. When compared to STEMI patients (n=21,674) enrolled in the ALKK-registry, CPU-STEMI patients had a lower risk profile, their treatment in the CPU was guideline-conform and in-hospital mortality was low (1.5%). CPU-STEMI patients represent a numerically significant group because a pre-hospital ECG was not documented. Treatment in the CPU is guideline-conform and the intra-hospital mortality is low. The lack of a pre-hospital ECG and admission via the GP substantially delay critical time intervals suggesting that in patients with symptoms suggestive an ACS, the EMS should be contacted and not the GP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Intravenous parecoxib and continuous femoral block for postoperative analgesia after total knee arthroplasty. A randomized, double-blind, prospective trial.

PubMed

Sarridou, Despoina G; Chalmouki, Georgia; Braoudaki, Maria; Koutsoupaki, Anna; Mela, Argiro; Vadalouka, Athina

2015-01-01

Up until now, the optimal strategy for postoperative pain management after total knee arthroplasty (TKA) remains to be elucidated. The current investigation aimed to examine the analgesic efficacy and the opioid sparing effects of intravenous parecoxib in combination with continuous femoral blockade. Randomized, double-blind, prospective trial. University hospital in the United Kingdom. In total, 90 patients underwent TKA under subarachnoid anesthesia and received continuous femoral block initially as a bolus with 20 mL of ropivacaine 0.75%. Infusion of 0.2% on 10 mL/h followed. Patients were randomized into 2 groups. Group D and Group P received parecoxib and placebo, respectively at 12 hour time intervals. Visual analog scale (VAS) pain scores were obtained at different time intervals including 4, 8, 12, 24 and 36 hours. The pain scores were measured with patients in a resting position. Morphine could also be administered with a patient controlled analgesia (PCA) pump if the specified analgesia was deemed inadequate (VAS > 5). None of the patients were withdrawn from the study. Parecoxib provided greater relief than placebo following TKA. The VAS pain scores measured at rest were statistically significantly lower in parecoxib-treated patients compared to the placebo group (P = 0.007) at 4 (P = 0.044), 12 (P = 0.001), and 24 hours (P = 0.012), postoperatively. Patients receiving parecoxib consumed less morphine at all time intervals than patients receiving placebo, with borderline statistical significance (P = 0.054). In each time period, all patients receiving continuous femoral block irrespectively of the treatment group, required low morphine doses. Current protocol did not answer question as to functional recovery. According to our findings intravenous parecoxib in combination with continuous femoral block provided superior analgesic efficacy and opioid sparing effects in patients undergoing TKA.

Use of a clinical pathway to improve the acute management of vaso-occlusive crisis pain in pediatric sickle cell disease.

PubMed

Ender, Katherine L; Krajewski, Jennifer A; Babineau, John; Tresgallo, Mary; Schechter, William; Saroyan, John M; Kharbanda, Anupam

2014-04-01

The most common, debilitating morbidity of sickle cell disease (SCD) is vaso-occlusive crisis (VOC) pain. Although guidelines exist for its management, they are generally not well-followed, and research in other pediatric diseases has shown that clinical pathways improve care. The purpose of our study was to determine whether a clinical pathway improves the acute management of sickle cell vaso-occlusive crisis (VOC) pain in the pediatric emergency department (PED). Pain management practices were prospectively investigated before and after the initiation of a clinical pathway in the PED of an urban, tertiary care center with 50,000 ED visits per year and approximately 200 active sickle cell patients. The pathway included instructions for triage, monitoring, medication administration, and timing of assessments and interventions. Data were eligible from 35 pre-pathway and 33 post-pathway visits. Primary outcome was time interval to administration of first analgesic medication. Statistical analysis was by Student's t-test, using natural-log-transformed data for outcomes with skewed distribution curves. Time interval to first analgesic improved from 74 to 42 minutes (P = 0.012) and to first opioid from 94 to 46 minutes (P = 0.013). The percentage of patients who received ketorolac increased from 57% to 82% (P = 0.03). Decrease in time interval to subsequent pain score assessment was not statistically significant (110 to 72 minutes (P = 0.07)), and change in pain score was not different (P = 0.25). The use of a clinical pathway for sickle cell VOC in the PED can improve important aspects of pain management and merits further investigation and implementation. © 2013 Wiley Periodicals, Inc.

In vivo gamma-rays induced initial DNA damage and the effect of famotidine in mouse leukocytes as assayed by the alkaline comet assay.

PubMed

Mozdarani, Hossein; Nasirian, Borzo; Haeri, S Abolghasem

2007-03-01

Ionizing radiation induces a variety of lesions in DNA, each of which can be used as a bio-indicator for biological dosimetry or the study of the radioprotective effects of substances. To assess gamma ray-induced DNA damage in vivo in mouse leukocytes at various doses and the effect of famotidine, blood was collected from Balb/c male mice after irradiation with 4 Gy gamma-rays at different time intervals post-irradiation. To assess the response, mice were irradiated with doses of gamma-rays at 1 to 4 Grays. Famotidine was injected intra-peritoneally (i.p) at a dose of 5 mg/kg at various time intervals before irradiation. Four slides were prepared from each sample and alkaline comet assay was performed using standard protocols. Results obtained show that radiation significantly increases DNA damage in leukocytes in a dose dependent manner (p < 0.01) when using appropriate sampling time after irradiation, because increasing sampling time after irradiation resulted in a time dependent disappearance of DNA damage. Treatment with only 5 mg/kg famotidine before 4 Gy irradiation led to almost 50% reduction in DNA damage when compared with those animals which received radiation alone. The radioprotective capability of famotidine might be attributed to radical scavenging properties and an anti-oxidation mechanism.

Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women's Health Study.

PubMed

Griswold, Michele K; Crawford, Sybil L; Perry, Donna J; Person, Sharina D; Rosenberg, Lynn; Cozier, Yvette C; Palmer, Julie R

2018-02-12

Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated. This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration. This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regression for the initiation outcomes (N = 2705) and multinomial logistic regression for the duration outcomes (N = 2172). Racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months. Racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 and 6 months. Being born in the USA or having a parent born in the USA predicted lower odds of breastfeeding initiation and duration. Living in a segregated neighborhood (primarily black residents) as a child was associated with decreased breastfeeding initiation and duration relative to growing up in a predominantly white neighborhood. Experiences of institutionalized racism influenced breastfeeding initiation and duration. Structural-level interventions are critical to close the gap of racial inequity in breastfeeding rates in the USA.

Interval Timing Accuracy and Scalar Timing in C57BL/6 Mice

PubMed Central

Buhusi, Catalin V.; Aziz, Dyana; Winslow, David; Carter, Rickey E.; Swearingen, Joshua E.; Buhusi, Mona C.

2010-01-01

In many species, interval timing behavior is accurate—appropriate estimated durations—and scalar—errors vary linearly with estimated durations. While accuracy has been previously examined, scalar timing has not been yet clearly demonstrated in house mice (Mus musculus), raising concerns about mouse models of human disease. We estimated timing accuracy and precision in C57BL/6 mice, the most used background strain for genetic models of human disease, in a peak-interval procedure with multiple intervals. Both when timing two intervals (Experiment 1) or three intervals (Experiment 2), C57BL/6 mice demonstrated varying degrees of timing accuracy. Importantly, both at individual and group level, their precision varied linearly with the subjective estimated duration. Further evidence for scalar timing was obtained using an intraclass correlation statistic. This is the first report of consistent, reliable scalar timing in a sizable sample of house mice, thus validating the PI procedure as a valuable technique, the intraclass correlation statistic as a powerful test of the scalar property, and the C57BL/6 strain as a suitable background for behavioral investigations of genetically engineered mice modeling disorders of interval timing. PMID:19824777

Assessment of cardiac time intervals using high temporal resolution real-time spiral phase contrast with UNFOLDed-SENSE.

PubMed

Kowalik, Grzegorz T; Knight, Daniel S; Steeden, Jennifer A; Tann, Oliver; Odille, Freddy; Atkinson, David; Taylor, Andrew; Muthurangu, Vivek

2015-02-01

To develop a real-time phase contrast MR sequence with high enough temporal resolution to assess cardiac time intervals. The sequence utilized spiral trajectories with an acquisition strategy that allowed a combination of temporal encoding (Unaliasing by fourier-encoding the overlaps using the temporal dimension; UNFOLD) and parallel imaging (Sensitivity encoding; SENSE) to be used (UNFOLDed-SENSE). An in silico experiment was performed to determine the optimum UNFOLD filter. In vitro experiments were carried out to validate the accuracy of time intervals calculation and peak mean velocity quantification. In addition, 15 healthy volunteers were imaged with the new sequence, and cardiac time intervals were compared to reference standard Doppler echocardiography measures. For comparison, in silico, in vitro, and in vivo experiments were also carried out using sliding window reconstructions. The in vitro experiments demonstrated good agreement between real-time spiral UNFOLDed-SENSE phase contrast MR and the reference standard measurements of velocity and time intervals. The protocol was successfully performed in all volunteers. Subsequent measurement of time intervals produced values in keeping with literature values and good agreement with the gold standard echocardiography. Importantly, the proposed UNFOLDed-SENSE sequence outperformed the sliding window reconstructions. Cardiac time intervals can be successfully assessed with UNFOLDed-SENSE real-time spiral phase contrast. Real-time MR assessment of cardiac time intervals may be beneficial in assessment of patients with cardiac conditions such as diastolic dysfunction. © 2014 Wiley Periodicals, Inc.

Sample entropy predicts lifesaving interventions in trauma patients with normal vital signs.

PubMed

Naraghi, L; Mejaddam, A Y; Birkhan, O A; Chang, Y; Cropano, C M; Mesar, T; Larentzakis, A; Peev, M; Sideris, A C; Van der Wilden, G M; Imam, A M; Hwabejire, J O; Velmahos, G C; Fagenholz, P J; Yeh, D; de Moya, M A; King, D R

2015-08-01

Heart rate complexity, commonly described as a "new vital sign," has shown promise in predicting injury severity, but its use in clinical practice is not yet widely adopted. We previously demonstrated the ability of this noninvasive technology to predict lifesaving interventions (LSIs) in trauma patients. This study was conducted to prospectively evaluate the utility of real-time, automated, noninvasive, instantaneous sample entropy (SampEn) analysis to predict the need for an LSI in a trauma alert population presenting with normal vital signs. Prospective enrollment of patients who met criteria for trauma team activation and presented with normal vital signs was conducted at a level I trauma center. High-fidelity electrocardiogram recording was used to calculate SampEn and SD of the normal-to-normal R-R interval (SDNN) continuously in real time for 2 hours with a portable, handheld device. Patients who received an LSI were compared to patients without any intervention (non-LSI). Multivariable analysis was performed to control for differences between the groups. Treating clinicians were blinded to results. Of 129 patients enrolled, 38 (29%) received 136 LSIs within 24 hours of hospital arrival. Initial systolic blood pressure was similar in both groups. Lifesaving intervention patients had a lower Glasgow Coma Scale. The mean SampEn on presentation was 0.7 (0.4-1.2) in the LSI group compared to 1.5 (1.1-2.0) in the non-LSI group (P < .0001). The area under the curve with initial SampEn alone was 0.73 (95% confidence interval [CI], 0.64-0.81) and increased to 0.93 (95% CI, 0.89-0.98) after adding sedation to the model. Sample entropy of less than 0.8 yields sensitivity, specificity, negative predictive value, and positive predictive value of 58%, 86%, 82%, and 65%, respectively, with an overall accuracy of 76% for predicting an LSI. SD of the normal-to-normal R-R interval had no predictive value. In trauma patients with normal presenting vital signs, decreased SampEn is an independent predictor of the need for LSI. Real-time SampEn analysis may be a useful adjunct to standard vital signs monitoring. Adoption of real-time, instantaneous SampEn monitoring for trauma patients, especially in resource-constrained environments, should be considered. Copyright © 2015 Elsevier Inc. All rights reserved.

Serial Sampling of High-Sensitivity Cardiac Troponin T May Not Be Required for Prediction of Acute Myocardial Infarction Diagnosis in Chest Pain Patients with Highly Abnormal Concentrations at Presentation.

PubMed

Mueller-Hennessen, Matthias; Mueller, Christian; Giannitsis, Evangelos; Biener, Moritz; Vafaie, Mehrshad; deFilippi, Christopher R; Christ, Michael; Ordóñez-Llanos, Jorge; Panteghini, Mauro; Plebani, Mario; Verschuren, Franck; Melki, Dina; French, John K; Christenson, Robert H; Body, Richard; McCord, James; Dinkel, Carina; Katus, Hugo A; Lindahl, Bertil

2017-02-01

Guidelines for diagnosing acute myocardial infarction (AMI) recommend adding kinetic changes to the initial cardiac troponin (cTn) blood concentration to improve AMI diagnosis. We hypothesized that kinetic changes may not be required in patients presenting with highly abnormal cTn. Patients presenting with suspected AMI to the emergency department were enrolled in a prospective diagnostic study. We assessed the positive predictive value (PPV) of initial high-sensitivity cardiac troponin T (hs-cTnT) blood concentrations alone and in combination with kinetic changes for AMI. Predefined relative changes (δ change of ≥20%) and absolute changes (Δ change ≥9.2 ng/L) within different time intervals (1 h, 2 h, and 4-14 h after presentation) were assessed. The final diagnosis was adjudicated by 2 independent cardiologists. Among 1282 patients, 213 (16.6%) patients had a final diagnosis of AMI. For AMI prediction, PPVs increased from 48.8% for an initial hs-cTnT >14 ng/L to 87.2% for >60 ng/L, whereas PPVs remained unchanged for higher hs-cTnT concentrations at baseline (87.1% for both >80 ng/L and >100 ng/L). With addition of 20% relative Δ change, PPVs were not further improved in patients with baseline hs-cTnT >80 ng/L using the 1-h (84.0%) and 2-h (88.9%) intervals, and only minimally when extending the interval to 4-14 h (91.2% for >80 ng/L and 90.4% for >100 ng/L, respectively). Similar findings were observed when applying absolute changes. In chest pain patients with highly abnormal hs-cTnT concentrations at presentation, subsequent blood draws may not be required, as they do not provide incremental diagnostic value for prediction of AMI diagnosis. © 2016 American Association for Clinical Chemistry.

Long-term hematotoxicity after peptide receptor radionuclide therapy with 177Lu-octreotate.

PubMed

Sabet, Amir; Ezziddin, Khaled; Pape, Ulrich-Frank; Ahmadzadehfar, Hojjat; Mayer, Karin; Pöppel, Thorsten; Guhlke, Stefan; Biersack, Hans-Jürgen; Ezziddin, Samer

2013-11-01

Myelosuppression may be the dose-limiting toxicity in peptide receptor radionuclide therapy (PRRT). The aim of this study was to investigate the incidence, severity, and reversibility of long-term hematotoxicity in a large cohort of patient undergoing PRRT with (177)Lu-octreotate for metastatic neuroendocrine tumors. The impact of potential risk factors, including initial cytopenia, advanced bone metastatic disease, previous chemotherapy, and cumulative administered activity, and the protective effects of splenectomy were of particular interest. A total of 632 PRRT courses were performed in 203 patients with metastatic neuroendocrine tumors. A mean activity of 7.9 GBq of (177)Lu-octreotate was administered per treatment cycle, with a goal of 4 courses at standard intervals of 3 mo. Hematologic parameters were determined before each treatment course, at 2- to 4-wk intervals between the courses, 8-12 wk after the last course of PRRT, and at 3-month intervals for further follow-up. Toxicity was recorded with Common Terminology Criteria for Adverse Events (version 3.0). Myelodysplastic syndrome as a delayed adverse event was documented in 3 patients (1.4%). Relevant but reversible hematotoxicity (grade 3 or 4) occurred in 23 patients (11.3%) and 29 administrations (4.6%), with leukopenia in 2.7% and thrombocytopenia in 1.7%. The mean time to blood count recovery was 12 mo after the termination of PRRT (range, 3-22 mo). The only preexisting factor that contributed to hematotoxicity was initial cytopenia (P < 0.001). A high level of cumulative administered activity (>29.6 GBq) was associated with relevant leukopenia (P < 0.001). None of the patients with a history of splenectomy developed grade 3 or 4 hematotoxicity, and splenectomy was inversely associated with the incidence and degree of leukopenia (P = 0.02) and thrombocytopenia (P = 0.03). PRRT-induced myelosuppression is almost invariably reversible and rarely requires clinical measures. Administered activity and initial cytopenia are the only factors contributing to myelosuppression, whereas splenectomy may exert a protective effect.

Diffusion with stochastic resetting at power-law times.

PubMed

Nagar, Apoorva; Gupta, Shamik

2016-06-01

What happens when a continuously evolving stochastic process is interrupted with large changes at random intervals τ distributed as a power law ∼τ^{-(1+α)};α>0? Modeling the stochastic process by diffusion and the large changes as abrupt resets to the initial condition, we obtain exact closed-form expressions for both static and dynamic quantities, while accounting for strong correlations implied by a power law. Our results show that the resulting dynamics exhibits a spectrum of rich long-time behavior, from an ever-spreading spatial distribution for α<1, to one that is time independent for α>1. The dynamics has strong consequences on the time to reach a distant target for the first time; we specifically show that there exists an optimal α that minimizes the mean time to reach the target, thereby offering a step towards a viable strategy to locate targets in a crowded environment.

Continuous detection of the self-initiated walking pre-movement state from EEG correlates without session-to-session recalibration

NASA Astrophysics Data System (ADS)

Ioana Sburlea, Andreea; Montesano, Luis; Minguez, Javier

2015-06-01

Objective. Brain-computer interfaces (BCI) as a rehabilitation tool have been used to restore functions in patients with motor impairments by actively involving the central nervous system and triggering prosthetic devices according to the detected pre-movement state. However, since EEG signals are highly variable between subjects and recording sessions, typically a BCI is calibrated at the beginning of each session. This process is inconvenient especially for patients suffering locomotor disabilities in maintaining a bipedal position for a longer time. This paper presents a continuous EEG decoder of a pre-movement state in self-initiated walking and the usage of this decoder from session to session without recalibrating. Approach. Ten healthy subjects performed a self-initiated walking task during three sessions, with an intersession interval of one week. The implementation of our continuous decoder is based on the combination of movement-related cortical potential (MRCP) and event-related desynchronization (ERD) features with sparse classification models. Main results. During intrasession our technique detects the pre-movement state with 70% accuracy. Moreover this decoder can be applied from session to session without recalibration, with a decrease in performance of about 4% on a one- or two-week intersession interval. Significance. Our detection model operates in a continuous manner, which makes it a straightforward asset for rehabilitation scenarios. By using both temporal and spectral information we attained higher detection rates than the ones obtained with the MRCP and ERD detection models, both during the intrasession and intersession conditions.

Melanoma risk prediction using a multilocus genetic risk score in the Women's Health Initiative cohort.

PubMed

Cho, Hyunje G; Ransohoff, Katherine J; Yang, Lingyao; Hedlin, Haley; Assimes, Themistocles; Han, Jiali; Stefanick, Marcia; Tang, Jean Y; Sarin, Kavita Y

2018-07-01

Single-nucleotide polymorphisms (SNPs) associated with melanoma have been identified though genome-wide association studies. However, the combined impact of these SNPs on melanoma development remains unclear, particularly in postmenopausal women who carry a lower melanoma risk. We examine the contribution of a combined polygenic risk score on melanoma development in postmenopausal women. Genetic risk scores were calculated using 21 genome-wide association study-significant SNPs. Their combined effect on melanoma development was evaluated in 19,102 postmenopausal white women in the clinical trial and observational study arms of the Women's Health Initiative dataset. Compared to the tertile of weighted genetic risk score with the lowest genetic risk, the women in the tertile with the highest genetic risk were 1.9 times more likely to develop melanoma (95% confidence interval 1.50-2.42). The incremental change in c-index from adding genetic risk scores to age were 0.075 (95% confidence interval 0.041-0.109) for incident melanoma. Limitations include a lack of information on nevi count, Fitzpatrick skin type, family history of melanoma, and potential reporting and selection bias in the Women's Health Initiative cohort. Higher genetic risk is associated with increased melanoma prevalence and incidence in postmenopausal women, but current genetic information may have a limited role in risk prediction when phenotypic information is available. Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Outcomes of extended oral contraceptive regimens with a shortened hormone-free interval to manage breakthrough bleeding.

PubMed

Sulak, Patricia J; Carl, Jenny; Gopalakrishnan, Isai; Coffee, Andrea; Kuehl, Thomas J

2004-10-01

To evaluate in a clinical practice setting the acceptance, continuation and variability of extending the active interval of oral contraceptives (OCs) with introduction of a shortened hormone-free interval (HFI) to manage breakthrough bleeding. A retrospective review was undertaken of patients seen by one obstetrician/gynecologist and counseled on extending the active interval of OCs with a shortened HFI of 3-4 days to manage bleeding. Electronic medical records were searched for the phrase "extending the number of active pills" for patients counseled between January 1, 2000, and January 31, 2003, with follow-up through January 31, 2004. A structured query of each patient's initial and follow-up records was performed. The 220 patients counseled on the extended regimen were 14-52 years of age (mean 36.4, SD 9.3 years). At initial counseling before extending, the majority of patients cited more than one reason for using OCs in the standard fashion with 59% using OCs for noncontraceptive reasons. Reasons for extending the active interval of OCs included premenstrual symptoms (45%), dysmenorrhea/pelvic pain (40%), heavy withdrawal bleeding (36%), menstrual associated headaches (35%), convenience (13%), acne associated with menses (10%) and other (15%). Of the 181 patients with follow-up data, 174 (96%) attempted an extended regimen with 121 (67%) continuing to do so at last follow-up. Follow-up intervals ranged from 0.3 to 3.8 years (mean 1.6 years). Using Kaplan-Meier product limit survival analysis, 60% of patients continued using extended patterns of OCs for more than 2 years. For 121 currently extending, the HFI varied from 0 to 7 days with 88% utilizing a 0 to 4 day HFI. Sixty percent of patients offered extending the active interval and shortening the HFI of OCs initiate and continue this pattern for more than 2 years without serious sequelae or pregnancy while individually directing both the number of days of continuous pills and the length of the HFI. Copyright 2004 Elsevier Inc.

Impact of time of initiation of once-monthly paliperidone palmitate in hospitalized Asian patients with acute exacerbation of schizophrenia: a post hoc analysis from the PREVAIL study

PubMed Central

Li, Huafang; Li, Yan; Feng, Yu; Zhuo, Jianmin; Turkoz, Ibrahim; Mathews, Maju; Tan, Wilson

2018-01-01

Purpose To evaluate the differences in efficacy and safety outcomes in acute exacerbating schizophrenia patients between 2 subgroups (≤1 week and >1 week), differing in time interval from hospitalization to time of initiation of once-monthly paliperidone palmitate. Patients and methods PREVAIL was a multicenter, single-arm, open-label, prospective Phase IV study in hospitalized Asian patients (either sex, aged 18–65 years) diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Change from baseline to week 13 in primary (Positive and Negative Syndrome Scale [PANSS] total score), secondary endpoints (PANSS responder rate, PANSS subscale, PANSS Marder factor, Clinical Global Impression-Severity, and Personal and Social Performance scale scores, readiness for hospital discharge questionnaire) and safety were assessed in this post hoc analysis. Results Significant mean reduction from baseline to week 13 in the PANSS total score, 30% PANSS responder rates (P≤0.01), PANSS subscales (positive and general psychopathology; all P≤0.01), PANSS Marder factor (positive symptoms, uncontrolled hostility, and excitement and anxiety/depression; all P≤0.01), Personal and Social Performance scale scores (P≤0.05) and Clinical Global Impression-Severity categorical summary (P≤0.05) were significantly greater in the ≤1 week subgroup versus >1 week subgroup (P≤0.05). The readiness for hospital discharge questionnaire improved over time for the overall study population, but remained similar between subgroups at all-time points. Treatment-emergent adverse events were similar between the subgroups. Conclusion Early initiation of once-monthly paliperidone palmitate in hospitalized patients with acute exacerbation of schizophrenia led to greater improvements in psychotic symptoms with comparable safety than treatment initiation following 1 week of hospitalization. PMID:29731633

Impact of time of initiation of once-monthly paliperidone palmitate in hospitalized Asian patients with acute exacerbation of schizophrenia: a post hoc analysis from the PREVAIL study.

PubMed

Li, Huafang; Li, Yan; Feng, Yu; Zhuo, Jianmin; Turkoz, Ibrahim; Mathews, Maju; Tan, Wilson

2018-01-01

To evaluate the differences in efficacy and safety outcomes in acute exacerbating schizophrenia patients between 2 subgroups (≤1 week and >1 week), differing in time interval from hospitalization to time of initiation of once-monthly paliperidone palmitate. PREVAIL was a multicenter, single-arm, open-label, prospective Phase IV study in hospitalized Asian patients (either sex, aged 18-65 years) diagnosed with schizophrenia ( Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition). Change from baseline to week 13 in primary (Positive and Negative Syndrome Scale [PANSS] total score), secondary endpoints (PANSS responder rate, PANSS subscale, PANSS Marder factor, Clinical Global Impression-Severity, and Personal and Social Performance scale scores, readiness for hospital discharge questionnaire) and safety were assessed in this post hoc analysis. Significant mean reduction from baseline to week 13 in the PANSS total score, 30% PANSS responder rates ( P ≤0.01), PANSS subscales (positive and general psychopathology; all P ≤0.01), PANSS Marder factor (positive symptoms, uncontrolled hostility, and excitement and anxiety/depression; all P ≤0.01), Personal and Social Performance scale scores ( P ≤0.05) and Clinical Global Impression-Severity categorical summary ( P ≤0.05) were significantly greater in the ≤1 week subgroup versus >1 week subgroup ( P ≤0.05). The readiness for hospital discharge questionnaire improved over time for the overall study population, but remained similar between subgroups at all-time points. Treatment-emergent adverse events were similar between the subgroups. Early initiation of once-monthly paliperidone palmitate in hospitalized patients with acute exacerbation of schizophrenia led to greater improvements in psychotic symptoms with comparable safety than treatment initiation following 1 week of hospitalization.

Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study

PubMed Central

Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A.; Stengel, Bénédicte

2017-01-01

Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32–1.56), diabetes (OR 1.28, 95% CI 1.15–1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09–1.49, and 1.31, 1.05–1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98–0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients’ comorbidity profiles may improve functional AV access rates. PMID:28749967

Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

PubMed

Alencar de Pinho, Natalia; Coscas, Raphael; Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A; Stengel, Bénédicte

2017-01-01

Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56), diabetes (OR 1.28, 95% CI 1.15-1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

Diminishing availability of publicly funded slots for antiretroviral initiation among HIV-infected ART-eligible patients in Uganda.

PubMed

Geng, Elvin H; Bwana, Mwebesa B; Kabakyenga, Jerome; Muyindike, Winnie; Emenyonu, Nneka I; Musinguzi, Nicholas; Mugyenyi, Peter; Martin, Jeffrey N; Bangsberg, David R

2010-11-24

The impact of flat-line funding in the global scale up of antiretroviral therapy (ART) for HIV-infected patients in Africa has not yet been well described. We evaluated ART-eligible patients and patients starting ART at a prototypical scale up ART clinic in Mbarara, Uganda between April 1, 2009 and May 14, 2010 where four stakeholders sponsor treatment - two PEPFAR implementing organizations, the Ugandan Ministry of Health - Global Fund (MOH-GF) and a private foundation named the Family Treatment Fund (FTF). We assessed temporal trends in the number of eligible patients, the number starting ART and tabulated the distribution of the stakeholders supporting ART initiation by month and quartile of time during this interval. We used survival analyses to assess changes in the rate of ART initiation over calendar time. A total of 1309 patients who were eligible for ART made visits over the 14 month period of the study and of these 819 started ART. The median number of ART eligible patients each month was 88 (IQR: 74 to 115). By quartile of calendar time, PEPFAR and MOH sponsored 290, 192, 180, and 49 ART initiations whereas the FTF started 1, 2, 1 and 104 patients respectively. By May of 2010 (the last calendar month of observation) FTF sponsored 88% of all ART initiations. Becoming eligible for ART in the 3(rd) (HR = 0.58, 95% 0.45-0.74) and 4(th) quartiles (HR = 0.49, 95% CI: 0.36-0.65) was associated with delay in ART initiation compared to the first quartile in multivariable analyses. During a period of flat line funding from multinational donors for ART programs, reductions in the number of ART initiations by public programs (i.e., PEPFAR and MOH-GF) and delays in ART initiation became apparent at the a large prototypical scale-up ART clinic in Uganda.

Time to Initiation of Antiretroviral Therapy Among Patients Who Are ART Eligible in Rwanda: Improvement Over Time

PubMed Central

Teasdale, Chloe A.; Wang, Chunhui; Francois, Uwinkindi; d’Amour Ndahimana, Jean; Vincent, Mutabazi; Sahabo, Ruben; El-Sadr, Wafaa M.; Abrams, Elaine J.

2016-01-01

Background Delayed initiation of antiretroviral therapy (ART) in eligible patients is a concern in resource-limited countries. Methods We analyzed data on HIV-positive patients ≥15 years enrolled at 41 ICAP-supported health care facilities in Rwanda, 2005–2010, to determine time to ART initiation among patients eligible at enrollment compared with those ineligible or of indeterminate eligibility who become eligible during follow-up. ART eligibility was based on CD4+ cell count (CD4+) and WHO staging; patients lacking CD4+ and WHO stage were considered indeterminate. Cumulative incidence of reaching ART eligibility and to ART initiation after eligibility was generated using competing risk estimators. Results A total of 31,033 ART-naive adults were enrolled; 64.2% were female. At enrollment, 10,158 (32.7%) patients were ART eligible, 13,372 (43.1%) were ineligible for ART, and 7503 (24.2%) patients were indeterminate. Among patients retained in care pre-ART eligibility, 17.9% [95% confidence interval (CI): 17.2 to 18.6] of ineligible and 22.8% (95% CI: 21.7 to 23.8) of indeterminate patients at enrollment reached ART eligibility within 12 months. Cumulative incidence of ART initiation within 3 months for patients eligible at enrollment was 77.2% (95% CI: 76.4 to 78.0) compared with 67.9% (95% CI: 66.4 to 69.3) for ineligible and 63.8% (95% CI: 61.9 to 65.8) for patients with indeterminate eligibility at enrollment (P < 0.05). Over the study period, there was more rapid ART initiation for patients who became ART eligible. Conclusions We found higher rates of ART initiation within 3 months among patients who were ART eligible at enrollment compared with those who reached eligibility during follow-up. From 2006 to 2011, earlier initiation of ART after eligibility was observed likely reflecting improved program quality. PMID:25415291

Motor power factor controller with a reduced voltage starter

NASA Technical Reports Server (NTRS)

Nola, F. J. (Inventor)

1981-01-01

A power factor type motor controller is disclosed in which the conventional power factor constant voltage command signal is replaced during a starting interval with a graduated control voltage. This continuation-impart of a pending patent application (Serial No. 199, 765: Three Phase Factor Controller) provides a means for modifying the operation of the system for a motor start-up interval of 5 to 30 second. Using a ramp generators, an initial ramp-like signal replaces a constant power factor signal supplied by a potentiometer. The ramp-like signal is applied to a 15 terminal where it is summed with an operating power factor signal from phase detectors in order to obtain a control signal for ultimately controlling SCR devices. The SCR devices are turned on at an advancing rate with time responsive to the combination signal described rather than simply a function of a ramp-like signal alone.

A flash photolysis-resonance fluorescence study of the formation of O(D-1) in the photolysis of water and reaction of O(D-1) with H2, Ar and He

NASA Technical Reports Server (NTRS)

Stief, L. J.; Payne, W. A.; Klemm, R. B.

1974-01-01

The relative importance of two primary processes in the photolyis of water: (1) H2O + h (nu) yields H + OH, and (2) H2O + h (nu) yields H2 + OD-1 were determined in a direct manner by time resolved detection (via resonance fluorescence) of H and O formed in processes 1 and 2 respectively. The initially formed OD-1 was deactivated to ground state OP-3 prior to detection via resonance fluorescence. The relative quantum yields for processes 1 and 2 are 0.89 and 0.11 for the wavelength interval 105 to 145nm and = to or greater than 0.99, and = to or less than 0.01 for the wavelength interval 145 to 185nm. Rate constants at 300 K for the reactions OD-1 + H2, + Ar, and + He are presented.

VARIABLE TIME-INTERVAL GENERATOR

DOEpatents

Gross, J.E.

1959-10-31

This patent relates to a pulse generator and more particularly to a time interval generator wherein the time interval between pulses is precisely determined. The variable time generator comprises two oscillators with one having a variable frequency output and the other a fixed frequency output. A frequency divider is connected to the variable oscillator for dividing its frequency by a selected factor and a counter is used for counting the periods of the fixed oscillator occurring during a cycle of the divided frequency of the variable oscillator. This defines the period of the variable oscillator in terms of that of the fixed oscillator. A circuit is provided for selecting as a time interval a predetermined number of periods of the variable oscillator. The output of the generator consists of a first pulse produced by a trigger circuit at the start of the time interval and a second pulse marking the end of the time interval produced by the same trigger circuit.

Methane oxidation behind reflected shock waves: Ignition delay times measured by pressure and flame band emission

NASA Technical Reports Server (NTRS)

Brabbs, T. A.; Robertson, T. F.

1986-01-01

Ignition delay data were recorded for three methane-oxygen-argon mixtures (phi = 0.5, 1.0, 2.0) for the temperature range 1500 to 1920 K. Quiet pressure trances enabled us to obtain delay times for the start of the experimental pressure rise. These times were in good agreement with those obtained from the flame band emission at 3700 A. The data correlated well with the oxygen and methane dependence of Lifshitz, but showed a much stronger temperature dependence (phi = 0.5 delta E = 51.9, phi = 1.0 delta = 58.8, phi = 2.0 delta E = 58.7 Kcal). The effect of probe location on the delay time measurement was studied. It appears that the probe located 83 mm from the reflecting surface measured delay times which may not be related to the initial temperature and pressure. It was estimated that for a probe located 7 mm from the reflecting surface, the measured delay time would be about 10 microseconds too short, and it was suggested that delay times less than 100 microsecond should not be used. The ignition period was defined as the time interval between start of the experimental pressure rise and 50 percent of the ignition pressure. This time interval was measured for three gas mixtures and found to be similar (40 to 60 micro sec) for phi = 1.0 and 0.5 but much longer (100 to 120) microsecond for phi = 2.0. It was suggested that the ignition period would be very useful to the kinetic modeler in judging the agreement between experimental and calculated delay times.

Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges

PubMed Central

Britton, Jeffrey W.; Rajasekaran, Vijayalakshmi; Fabris, Rachel R.; Cherian, Perumpillichira J.; Kelly-Williams, Kristen M.; So, Elson L.; Nickels, Katherine C.; Wong-Kisiel, Lily C.; Lagerlund, Terrence D.; Cascino, Gregory D.; Worrell, Gregory A.; Wirrell, Elaine C.

2016-01-01

Objective: To compare the yield of epileptiform abnormalities on 30-minute recordings with those greater than 45 minutes. Methods: We performed a prospective observational cross-sectional study of all outpatient routine EEGs comparing the rate of interictal epileptiform discharges (IEDs) and clinical events during the initial 30 minutes (routine) with those occurring in the remaining 30–60 minutes (extended). A relative increase of 10% was considered clinically significant. Results: EEGs from 1,803 patients were included; overall EEG duration was 59.4 minutes (SD ±6.5). Of 426 patients with IEDs at any time during the EEG, 81 (19.1%, 95% confidence interval 15.6–23) occurred only after the initial 30 minutes. The rate of late IEDs was not associated with age, indication, IED type, or sleep deprivation. Longer recording times also increased event capture rate by approximately 30%. Conclusions: The yield of IED and event detection is increased in extended outpatient EEGs compared to 30-minute studies. PMID:26984946

Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges.

PubMed

Burkholder, David B; Britton, Jeffrey W; Rajasekaran, Vijayalakshmi; Fabris, Rachel R; Cherian, Perumpillichira J; Kelly-Williams, Kristen M; So, Elson L; Nickels, Katherine C; Wong-Kisiel, Lily C; Lagerlund, Terrence D; Cascino, Gregory D; Worrell, Gregory A; Wirrell, Elaine C

2016-04-19

To compare the yield of epileptiform abnormalities on 30-minute recordings with those greater than 45 minutes. We performed a prospective observational cross-sectional study of all outpatient routine EEGs comparing the rate of interictal epileptiform discharges (IEDs) and clinical events during the initial 30 minutes (routine) with those occurring in the remaining 30-60 minutes (extended). A relative increase of 10% was considered clinically significant. EEGs from 1,803 patients were included; overall EEG duration was 59.4 minutes (SD ±6.5). Of 426 patients with IEDs at any time during the EEG, 81 (19.1%, 95% confidence interval 15.6-23) occurred only after the initial 30 minutes. The rate of late IEDs was not associated with age, indication, IED type, or sleep deprivation. Longer recording times also increased event capture rate by approximately 30%. The yield of IED and event detection is increased in extended outpatient EEGs compared to 30-minute studies. © 2016 American Academy of Neurology.

Expert systems tools for Hubble Space Telescope observation scheduling

NASA Technical Reports Server (NTRS)

Miller, Glenn; Rosenthal, Don; Cohen, William; Johnston, Mark

1987-01-01

The utility of expert systems techniques for the Hubble Space Telescope (HST) planning and scheduling is discussed and a plan for development of expert system tools which will augment the existing ground system is described. Additional capabilities provided by these tools will include graphics-oriented plan evaluation, long-range analysis of the observation pool, analysis of optimal scheduling time intervals, constructing sequences of spacecraft activities which minimize operational overhead, and optimization of linkages between observations. Initial prototyping of a scheduler used the Automated Reasoning Tool running on a LISP workstation.

Discrete Morse flow for Ricci flow and porous medium equation

NASA Astrophysics Data System (ADS)

Ma, Li; Witt, Ingo

2018-06-01

In this paper, we study the discrete Morse flow for the Ricci flow on the American football, which is the 2-sphere with the north and south poles removed and equipped with a metric g0 of constant scalar curvature, and for the porous medium equation on a bounded regular domain in the plane. We show that under suitable assumptions on the initial metric g(0) one has a weak approximate discrete Morse flow for the approximated Ricci flow and porous medium equation on any time interval.

Quasi-neutral limit of Euler–Poisson system of compressible fluids coupled to a magnetic field

NASA Astrophysics Data System (ADS)

Yang, Jianwei

2018-06-01

In this paper, we consider the quasi-neutral limit of a three-dimensional Euler-Poisson system of compressible fluids coupled to a magnetic field. We prove that, as Debye length tends to zero, periodic initial-value problems of the model have unique smooth solutions existing in the time interval where the ideal incompressible magnetohydrodynamic equations has smooth solution. Meanwhile, it is proved that smooth solutions converge to solutions of incompressible magnetohydrodynamic equations with a sharp convergence rate in the process of quasi-neutral limit.

TRACALS Evaluation Report. Initial Evaluation Report (AN/GPN-24) Nellis AFB, Nevada, 10 December 1979-6 Mar 1980.

DTIC Science & Technology

1980-05-16

Scott AFB, IL 62225 1 1842 EEG /EEIT, Scott AFB, IL 62225 1 1843 EES/EIELT, H-ickam AFB, H-I 96853 1 1844 EES/EIELT, Griffiss AFB, NY 13441 I HQ AFCC/DAPL...Time Control TDC Target Data Computer TO Technical Order TRACALS Traffic Cortrol and Landing Systems TSDA Transfer Switch Drawer Assembly TWT Traveling...the designated targets. The error detector outputs are fed to the TDC to update the beam position data during the next track interval. (b) Processor

An empirical comparison of SPM preprocessing parameters to the analysis of fMRI data.

PubMed

Della-Maggiore, Valeria; Chau, Wilkin; Peres-Neto, Pedro R; McIntosh, Anthony R

2002-09-01

We present the results from two sets of Monte Carlo simulations aimed at evaluating the robustness of some preprocessing parameters of SPM99 for the analysis of functional magnetic resonance imaging (fMRI). Statistical robustness was estimated by implementing parametric and nonparametric simulation approaches based on the images obtained from an event-related fMRI experiment. Simulated datasets were tested for combinations of the following parameters: basis function, global scaling, low-pass filter, high-pass filter and autoregressive modeling of serial autocorrelation. Based on single-subject SPM analysis, we derived the following conclusions that may serve as a guide for initial analysis of fMRI data using SPM99: (1) The canonical hemodynamic response function is a more reliable basis function to model the fMRI time series than HRF with time derivative. (2) Global scaling should be avoided since it may significantly decrease the power depending on the experimental design. (3) The use of a high-pass filter may be beneficial for event-related designs with fixed interstimulus intervals. (4) When dealing with fMRI time series with short interstimulus intervals (<8 s), the use of first-order autoregressive model is recommended over a low-pass filter (HRF) because it reduces the risk of inferential bias while providing a relatively good power. For datasets with interstimulus intervals longer than 8 seconds, temporal smoothing is not recommended since it decreases power. While the generalizability of our results may be limited, the methods we employed can be easily implemented by other scientists to determine the best parameter combination to analyze their data.

Hospital factors impact variation in emergency department length of stay more than physician factors.

PubMed

Krall, Scott P; Cornelius, Angela P; Addison, J Bruce

2014-03-01

To analyze the correlation between the many different emergency department (ED) treatment metric intervals and determine if the metrics directly impacted by the physician correlate to the "door to room" interval in an ED (interval determined by ED bed availability). Our null hypothesis was that the cause of the variation in delay to receiving a room was multifactorial and does not correlate to any one metric interval. We collected daily interval averages from the ED information system, Meditech©. Patient flow metrics were collected on a 24-hour basis. We analyzed the relationship between the time intervals that make up an ED visit and the "arrival to room" interval using simple correlation (Pearson Correlation coefficients). Summary statistics of industry standard metrics were also done by dividing the intervals into 2 groups, based on the average ED length of stay (LOS) from the National Hospital Ambulatory Medical Care Survey: 2008 Emergency Department Summary. Simple correlation analysis showed that the doctor-to-discharge time interval had no correlation to the interval of "door to room (waiting room time)", correlation coefficient (CC) (CC=0.000, p=0.96). "Room to doctor" had a low correlation to "door to room" CC=0.143, while "decision to admitted patients departing the ED time" had a moderate correlation of 0.29 (p <0.001). "New arrivals" (daily patient census) had a strong correlation to longer "door to room" times, 0.657, p<0.001. The "door to discharge" times had a very strong correlation CC=0.804 (p<0.001), to the extended "door to room" time. Physician-dependent intervals had minimal correlation to the variation in arrival to room time. The "door to room" interval was a significant component to the variation in "door to discharge" i.e. LOS. The hospital-influenced "admit decision to hospital bed" i.e. hospital inpatient capacity, interval had a correlation to delayed "door to room" time. The other major factor affecting department bed availability was the "total patients per day." The correlation to the increasing "door to room" time also reflects the effect of availability of ED resources (beds) on the patient evaluation time. The time that it took for a patient to receive a room appeared more dependent on the system resources, for example, beds in the ED, as well as in the hospital, than on the physician.

Effect of gender and sports on the risk of full-thickness articular cartilage lesions in anterior cruciate ligament-injured knees: a nationwide cohort study from Sweden and Norway of 15 783 patients.

PubMed

Røtterud, Jan Harald; Sivertsen, Einar A; Forssblad, Magnus; Engebretsen, Lars; Årøen, Asbjørn

2011-07-01

The presence of an articular cartilage lesion in anterior cruciate ligament-injured knees is considered a predictor of osteoarthritis. This study was undertaken to evaluate risk factors for full-thickness articular cartilage lesions in anterior cruciate ligament-injured knees, in particular the role of gender and the sport causing the initial injury. Cohort study (prognosis); Level of evidence, 2. Primary unilateral anterior cruciate ligament reconstructions prospectively registered in the Swedish and the Norwegian National Knee Ligament Registry during 2005 through 2008 were included (N = 15 783). Logistic regression analyses were used to evaluate risk factors for cartilage lesions. A total of 1012 patients (6.4%) had full-thickness cartilage lesions. The median time from injury to surgery was 9 months (range, 0 days-521 months). Male patients had an increased odds of full-thickness cartilage lesions compared with females (odds ratio = 1.22; 95% confidence interval, 1.04-1.42). In males, team handball had an increase in the odds of full-thickness cartilage lesions compared with soccer (odds ratio = 2.36; 95% confidence interval, 1.33-4.19). Among female patients, no sport investigated showed a significant decrease or increase in the odds of full-thickness cartilage lesions. The odds of a full-thickness cartilage lesion increased by 1.006 (95% confidence interval, 1.005-1.008) for each month elapsed from time of injury until anterior cruciate ligament reconstruction when all patients were considered, while time from injury to surgery did not affect the odds significantly in those patients reconstructed within 1 year of injury (odds ratio = 0.98; 95% confidence interval, 0.95-1.02). Previous surgery increased the odds of having a full-thickness cartilage lesion (odds ratio = 1.40; 95% confidence interval, 1.21-1.63). One year of increasing patient age also increased the odds (odds ratio = 1.05; 95% confidence interval, 1.05-1.06). Male gender is associated with an increased risk of full-thickness articular cartilage lesions in anterior cruciate ligament-injured knees. Male team handball players had an increased risk of full-thickness lesions. No other sports investigated were found to have significant effect on the risk in either gender. Furthermore, age, previous surgery, and time from injury to surgery exceeding 12 months are risk factors for full-thickness cartilage lesions.

Intact interval timing in circadian CLOCK mutants.

PubMed

Cordes, Sara; Gallistel, C R

2008-08-28

While progress has been made in determining the molecular basis for the circadian clock, the mechanism by which mammalian brains time intervals measured in seconds to minutes remains a mystery. An obvious question is whether the interval-timing mechanism shares molecular machinery with the circadian timing mechanism. In the current study, we trained circadian CLOCK +/- and -/- mutant male mice in a peak-interval procedure with 10 and 20-s criteria. The mutant mice were more active than their wild-type littermates, but there were no reliable deficits in the accuracy or precision of their timing as compared with wild-type littermates. This suggests that expression of the CLOCK protein is not necessary for normal interval timing.

Simulations of isoprene: Ozone reactions for a general circulation/chemical transport model

NASA Technical Reports Server (NTRS)

Makar, P. A.; Mcconnell, J. C.

1994-01-01

A parameterized reaction mechanism has been created to examine the interactions between isoprene and other tropospheric gas-phase chemicals. Tests of the parameterization have shown that its results match those of a more complex reaction set to a high degree of accuracy. Comparisons between test runs have shown that the presence of isoprene at the start of a six day interval can enhance later ozone concentrations by as much as twenty-nine percent. The test cases used no input fluxes beyond the initial time, implying that a single input of a biogenic hydrocarbon to an airmass can alter its ozone chemistry over a time scale on the order of a week.

Stochastic model for fatigue crack size and cost effective design decisions. [for aerospace structures

NASA Technical Reports Server (NTRS)

Hanagud, S.; Uppaluri, B.

1975-01-01

This paper describes a methodology for making cost effective fatigue design decisions. The methodology is based on a probabilistic model for the stochastic process of fatigue crack growth with time. The development of a particular model for the stochastic process is also discussed in the paper. The model is based on the assumption of continuous time and discrete space of crack lengths. Statistical decision theory and the developed probabilistic model are used to develop the procedure for making fatigue design decisions on the basis of minimum expected cost or risk function and reliability bounds. Selections of initial flaw size distribution, NDT, repair threshold crack lengths, and inspection intervals are discussed.

Adaptation and survivors in a random Boolean network.

PubMed

Nakamura, Ikuo

2002-04-01

We introduce the competitive agent with imitation strategy in a random Boolean network, in which the agent plays a competitive game that rewards those in minority. After a long time interval, the worst performer changes its strategy to the one of the best and the process is repeated. The network, initially in a chaotic state, evolves to an intermittent state and finally reaches a frozen state. Time series of survived species (whose strategies are imitated by other agents) in the system depend on the connectivity of each agent. In a system with various connectivity groups, the low connectivity groups win the minority game over the high connectivity groups. We also compared the result with mutation strategy system.

A Newton-Krylov solver for fast spin-up of online ocean tracers

NASA Astrophysics Data System (ADS)

Lindsay, Keith

2017-01-01

We present a Newton-Krylov based solver to efficiently spin up tracers in an online ocean model. We demonstrate that the solver converges, that tracer simulations initialized with the solution from the solver have small drift, and that the solver takes orders of magnitude less computational time than the brute force spin-up approach. To demonstrate the application of the solver, we use it to efficiently spin up the tracer ideal age with respect to the circulation from different time intervals in a long physics run. We then evaluate how the spun-up ideal age tracer depends on the duration of the physics run, i.e., on how equilibrated the circulation is.

Effects of strabismic amblyopia and strabismus without amblyopia on visuomotor behavior: III. Temporal eye-hand coordination during reaching.

PubMed

Niechwiej-Szwedo, Ewa; Goltz, Herbert C; Chandrakumar, Manokaraananthan; Wong, Agnes M F

2014-11-11

To examine the effects of strabismic amblyopia and strabismus only, without amblyopia, on the temporal patterns of eye-hand coordination during both the planning and execution stages of visually-guided reaching. Forty-six adults (16 with strabismic amblyopia, 14 with strabismus only, and 16 visually normal) executed reach-to-touch movements toward targets presented randomly 5° or 10° to the left or right of central fixation. Viewing conditions were binocular, monocular viewing with the amblyopic eye, and monocular viewing with the fellow eye (dominant and nondominant viewing for participants without amblyopia). Temporal coordination between eye and hand movements was examined during reach planning (interval between the initiation of saccade and reaching, i.e., saccade-to-reach planning interval) and reach execution (interval between the initiation of saccade and reach peak velocity [PV], i.e., saccade-to-reach PV interval). The frequency and dynamics of secondary reach-related saccades were also examined. The temporal patterns of eye-hand coordination prior to reach initiation were comparable among participants with strabismic amblyopia, strabismus only, and visually normal adults. However, the reach acceleration phase of participants with strabismic amblyopia and those with strabismus only were longer following target fixation (saccade-to-reach PV interval) than that of visually normal participants (P < 0.05). This effect was evident under all viewing conditions. The saccade-to-reach planning interval and the saccade-to-reach PV interval were not significantly different among participants with amblyopia with different levels of acuity and stereo acuity loss. Participants with strabismic amblyopia and strabismus only initiated secondary reach-related saccades significantly more frequently than visually normal participants. The amplitude and peak velocity of these saccades were significantly greater during amblyopic eye viewing in participants with amblyopia who also had negative stereopsis. Adults with strabismic amblyopia and strabismus only showed an altered pattern of temporal eye-hand coordination during the reach acceleration phase, which might affect their ability to modify reach trajectory using early online control. Secondary reach-related saccades may provide a compensatory mechanism with which to facilitate the late online control process in order to ensure relatively good reaching performance during binocular and fellow eye viewing. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Evolution of the entanglement of the N00N-type of states in a coupled two cavity system via an adiabatic approximation

NASA Astrophysics Data System (ADS)

Chakrabarti, R.; Sreekumari, G.; Yogesh, V.

2018-06-01

We study a system of two cavities each encapsulating a qubit and an oscillator degrees of freedom. An ultrastrong interaction between the qubit and the oscillator is assumed, and the photons are allowed to hop between the cavities. A partition of the time scale between the fast-moving oscillator and the slow moving qubit allows us to set up an adiabatic approximation procedure where we employ the delocalized degrees of freedom to diagonalize the Hamiltonian. The time evolution of the N00N-type initial states now furnishes, for instance, the reduced density matrix of a bipartite system of two qubits. For a macroscopic size of the N00N component of the initial state the sudden death of the entanglement between the qubits and its continued null value are prominently manifest as the information percolates to the qubits after long intervals. For the low photon numbers of the initial states the dynamics produces almost maximally entangled two-qubit states, which by utilizing the Hilbert–Schmidt distance between the density matrices, are observed to be nearly pure generalized Bell states.

Bacteriologic monitoring of multidrug-resistant tuberculosis patients in five DOTS-Plus pilot projects.

PubMed

Gammino, V M; Taylor, A B; Rich, M L; Bayona, J; Becerra, M C; Bonilla, C; Gelmanova, I; Hollo, V; Jaramillo, E; Keshavjee, S; Leimane, V; Mitnick, C D; Quelapio, M I D; Riektsina, V; Tupasi, T E; Wells, C D; Zignol, M; Cegielski, P J

2011-10-01

Multidrug-resistant tuberculosis programs in DOTS-Plus pilot sites in five countries. To calculate sputum conversion time and its relationship to treatment outcome, document the frequency of culture reversions and examine concordance of smear and culture to assess the potential consequences of monitoring by smear microscopy alone. Retrospective cohort analysis of 1926 patients receiving individualized, second-line therapy. Among 1385 sputum culture-positive cases at baseline, 1146 (83%) experienced at least one culture conversion during treatment. Conversion, however, was not sustained in all patients: 201 (15%) experienced initial culture conversion and at least one subsequent culture reversion to positive; 1064 (77%) achieved sustained culture conversion. Median time to culture conversion was 3 months. Among 206 patients whose nal conversion occurred 7-18 months after the initiation of therapy, 71% were cured or had completed treatment. Prolonged treatment for patients with delayed conversion may be beneficial, as 71% of late converters still achieved cure or completed treatment. This has implications for programs with de ned end points for treatment failure. The interval between rst and nal conversion among patients whose initial con- version is not sustained raises concern with respect to the ongoing debate regarding duration of treatment and the definition of cure.

Risk factors for metachronous colorectal cancer following a primary colorectal cancer: A prospective cohort study.

PubMed

Jayasekara, Harindra; Reece, Jeanette C; Buchanan, Daniel D; Rosty, Christophe; Dashti, S Ghazaleh; Ait Ouakrim, Driss; Winship, Ingrid M; Macrae, Finlay A; Boussioutas, Alex; Giles, Graham G; Ahnen, Dennis J; Lowery, Jan; Casey, Graham; Haile, Robert W; Gallinger, Steven; Le Marchand, Loic; Newcomb, Polly A; Lindor, Noralane M; Hopper, John L; Parry, Susan; Jenkins, Mark A; Win, Aung Ko

2016-09-01

Individuals diagnosed with colorectal cancer (CRC) are at risk of developing a metachronous CRC. We examined the associations between personal, tumour-related and lifestyle risk factors, and risk of metachronous CRC. A total of 7,863 participants with incident colon or rectal cancer who were recruited in the USA, Canada and Australia to the Colon Cancer Family Registry during 1997-2012, except those identified as high-risk, for example, Lynch syndrome, were followed up approximately every 5 years. We estimated the risk of metachronous CRC, defined as the first new primary CRC following an interval of at least one year after the initial CRC diagnosis. Observation time started at the age at diagnosis of the initial CRC and ended at the age at diagnosis of the metachronous CRC, last contact or death whichever occurred earliest, or were censored at the age at diagnosis of any metachronous colorectal adenoma. Cox regression was used to derive hazard ratios (HRs) and 95% confidence intervals (CIs). During a mean follow-up of 6.6 years, 142 (1.81%) metachronous CRCs were diagnosed (mean age at diagnosis 59.8; incidence 2.7/1,000 person-years). An increased risk of metachronous CRC was associated with the presence of a synchronous CRC (HR = 2.73; 95% CI: 1.30-5.72) and the location of cancer in the proximal colon at initial diagnosis (compared with distal colon or rectum, HR = 4.16; 95% CI: 2.80-6.18). The presence of a synchronous CRC and the location of the initial CRC might be useful for deciding the intensity of surveillance colonoscopy for individuals diagnosed with CRC. © 2016 UICC.

A Review of the Factors Associated With the Timely Initiation of Breastfeeding and Exclusive Breastfeeding in the Middle East

PubMed Central

Alzaheb, Riyadh A

2017-01-01

Background: Breastfeeding supplies all the nutrients that infants need for their healthy development. Breastfeeding practice is multifactorial, and numerous variables influence mothers’ decisions and ability to breastfeed. This review identifies the factors potentially affecting the timely initiation of breastfeeding within an hour after birth and exclusive breastfeeding in the first 6 months in Middle Eastern countries. Methods: The Medline, ScienceDirect, and Web of Science databases were keyword-searched for primary studies meeting the following inclusion criteria: (1) publication in the English language between January 2001 and May 2017, (2) original research articles reporting primary data on the factors influencing the timely initiation of breastfeeding and/or exclusive breastfeeding, (3) the use of World Health Organization definitions, and (4) Middle Eastern research contexts. A random effect model was used to establish the average prevalence of the timely initiation of breastfeeding and exclusive breastfeeding in the Middle East. Results: The review identified 19 studies conducted in Saudi Arabia (7), Iran (3), Egypt (2), Turkey (2), Kuwait (1), the United Arab Emirates (1), Qatar (1), Lebanon (1), and Syria (1). The meta-analysis established that 34.3% (confidence interval [CI]: 20.2%-51.9%) of Middle Eastern newborns received breastfeeding initiated within an hour of birth, and only 20.5% (CI: 14.5%-28.2%) were fed only breast milk for the first 6 months. The 8 studies exploring breastfeeding initiation most commonly associated it with the following: delivery mode, maternal employment, rooming-in, and prelacteal feeding. The 17 studies investigating exclusive breastfeeding most frequently linked it to the following: maternal age, maternal education, maternal employment, and delivery mode. Conclusions: Middle Eastern health care organizations should fully understand all the determinants of breastfeeding identified by this review to provide suitable practical guidance and advice to help new mothers to overcome barriers where possible and to contribute to improving infant and maternal health in the region. PMID:29317851

Time to relapse after epilepsy surgery in children: AED withdrawal policies are a contributing factor.

PubMed

Boshuisen, Kim; Schmidt, Dieter; Uiterwaal, Cuno S P M; Arzimanoglou, Alexis; Braun, Kees P J; Study Group, TimeToStop

2014-09-01

It was recently suggested that early postoperative seizure relapse implicates a failure to define and resect the epileptogenic zone, that late recurrences reflect the persistence or re-emergence of epileptogenic pathology, and that early recurrences are associated with poor treatment response. Timing of antiepileptic drugs withdrawal policies, however, have never been taken into account when investigating time to relapse following epilepsy surgery. Of the European paediatric epilepsy surgery cohort from the "TimeToStop" study, all 95 children with postoperative seizure recurrence following antiepileptic drug (AED) withdrawal were selected. We investigated how time intervals from surgery to AED withdrawal, as well as other previously suggested determinants of (timing of) seizure recurrence, related to time to relapse and to relapse treatability. Uni- and multivariable linear and logistic regression models were used. Based on multivariable analysis, a shorter interval to AED reduction was the only independent predictor of a shorter time to relapse. Based on univariable analysis, incomplete resection of the epileptogenic zone related to a shorter time to recurrence. Timing of recurrence was not related to the chance of regaining seizure freedom after reinstallation of medical treatment. For children in whom AED reduction is initiated following epilepsy surgery, the time to relapse is largely influenced by the timing of AED withdrawal, rather than by disease or surgery-specific factors. We could not confirm a relationship between time to recurrence and treatment response. Timing of AED withdrawal should be taken into account when studying time to relapse following epilepsy surgery, as early withdrawal reveals more rapidly whether surgery had the intended curative effect, independently of the other factors involved.

Antiretroviral drug costs and prescription patterns in British Columbia, Canada: 1996-2011.

PubMed

Nosyk, Bohdan; Montaner, Julio S G; Yip, Benita; Lima, Viviane D; Hogg, Robert S

2014-04-01

Treatment options and therapeutic guidelines have evolved substantially since highly active antiretroviral treatment (HAART) became the standard of HIV care in 1996. We conducted the present population-based analysis to characterize the determinants of direct costs of HAART over time in British Columbia, Canada. We considered individuals ever receiving HAART in British Columbia from 1996 to 2011. Linear mixed-effects regression models were constructed to determine the effects of demographic indicators, clinical stage, and treatment characteristics on quarterly costs of HAART (in 2010$CDN) among individuals initiating in different temporal periods. The least-square mean values were estimated by CD4 category and over time for each temporal cohort. Longitudinal data on HAART recipients (N = 9601, 17.6% female, mean age at initiation = 40.5) were analyzed. Multiple regression analyses identified demographics, treatment adherence, and pharmacological class to be independently associated with quarterly HAART costs. Higher CD4 cell counts were associated with modestly lower costs among pre-HAART initiators [least-square means (95% confidence interval), CD4 > 500: 4674 (4632-4716); CD4: 350-499: 4765 (4721-4809) CD4: 200-349: 4826 (4780-4871); CD4 <200: 4809 (4759-4859)]; however these differences were not significant among post-2003 HAART initiators. Population-level mean costs increased through 2006 and stabilized post-2003 HAART initiators incurred quarterly costs up to 23% lower than pre-2000 HAART initiators in 2010. Our results highlight the magnitude of the temporal changes in HAART costs, and disparities between recent and pre-HAART initiators. This methodology can improve the precision of economic modeling efforts by using detailed cost functions for annual, population-level medication costs according to the distribution of clients by clinical stage and era of treatment initiation.

Post-repolarization refractoriness increases vulnerability to block and initiation of reentrant impulses in heterogeneous infarcted myocardium.

PubMed

Cabo, Candido

2015-10-01

Myocardial infarction causes remodeling of the tissue structure and the density and kinetics of several ion channels in the cell membrane. Heterogeneities in refractory period (ERP) have been shown to occur in the infarct border zone and have been proposed to lead to initiation of arrhythmias. The purpose of this study is to quantify the window of vulnerability (WV) to block and initiation of reentrant impulses in myocardium with ERP heterogeneities using computer simulations. We found that ERP transitions at the border between normal ventricular cells (NZ) with different ERPs are smooth, whereas ERP transitions between NZ and infarct border zone cells (IZ) are abrupt. The profile of the ERP transitions is a combination of electrotonic interaction between NZ and IZ cells and the characteristic post-repolarization refractoriness (PRR) of IZ cells. ERP heterogeneities between NZ and IZ cells are more vulnerable to block and initiation of reentrant impulses than ERP heterogeneities between NZ cells. The relationship between coupling intervals of premature impulses (V1V2) and coupling intervals between premature and first reentrant impulses (V2T1) at NZ/NZ and NZ/IZ borders is inverse (i.e. the longer the coupling intervals of premature impulses the shorter the coupling interval between the premature and first reentrant impulses); this is in contrast with the reported V1V2/V2T1 relationship measured during initiation of reentrant impulses in canine infarcted hearts which is direct. (1) ERP transitions at the NZ-IZ border are abrupt as a consequence of PRR; (2) PRR increases the vulnerability to block and initiation of reentrant impulses in heterogeneous myocardium; (3) V1V2/V2T1 relationships measured at ERP heterogeneities in the computer model and in experimental canine infarcts are not consistent. Therefore, it is likely that other mechanisms like micro and/or macro structural heterogeneities also contribute to initiation of reentrant impulses in infarcted hearts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of aspirin in pregnant women is dependent on increase in bleeding time.

PubMed

Dumont, A; Flahault, A; Beaufils, M; Verdy, E; Uzan, S

1999-01-01

Randomized trials with low-dose aspirin to prevent preeclampsia and intrauterine growth restriction have yielded conflicting results. In particular, 3 recent large trials were not conclusive. Study designs, however, varied greatly regarding selection of patients, dose of aspirin, and timing of treatment, all of which can be determinants of the results. Retrospectively analyzing the conditions associated with failure or success of aspirin may therefore help to draw up new hypotheses and prepare for more specific randomized trials. We studied a historical cohort of 187 pregnant women who were considered at high risk for preeclampsia, intrauterine growth restriction, or both and were therefore treated with low-dose aspirin between 1989 and 1994. Various epidemiologic, clinical, and laboratory data were extracted from the files. Univariate and multivariate analyses were performed to search for independent parameters associated with the outcome of pregnancy. Age, parity, weight, height, and race had no influence on the outcome. The success rate was higher when treatment was given because of previous poor pregnancy outcomes than when it was given for other indications, and the patients with successful therapy had started aspirin earlier than had those with therapy failure (17.7 vs 20.0 weeks' gestation, P =.04). After multivariate analysis an increase in Ivy bleeding time after 10 days of treatment by >2 minutes was an independent predictor of a better outcome (odds ratio 0.22, 95% confidence interval 0.09-0.51). Borderline statistical significance was observed for aspirin initiation before 17 weeks' gestation (odds ratio 0.44, 95% confidence interval 0.18-1. 08). Abnormal uterine artery Doppler velocimetric scan at 20-24 weeks' gestation (odds ratio 3.31, 95% confidence interval 1.41-7.7), abnormal umbilical artery Doppler velocimetric scan after 26 weeks' gestation (odds ratio 37.6, 95% confidence interval 3.96-357), and use of antihypertensive therapy (odds ratio 6.06, 95% confidence interval 2.45-15) were independent predictors of poor outcome. Efficacy of aspirin seems optimal when bleeding time increases >/=2 minutes with treatment, indicating a more powerful antiplatelet effect. This suggests that the dose of aspirin should be adjusted according to a biologic marker of the antiplatelet effect. A prospective trial is warranted to test this hypothesis.

Determination of necking time in tensile test specimens, under high-temperature creep conditions, subjected to distribution of stresses over the cross-section

NASA Astrophysics Data System (ADS)

Lokoshchenko, A.; Teraud, W.

2018-04-01

The work describes an experimental research of creep of cylindrical tensile test specimens made of aluminum alloy D16T at a constant temperature of 400°C. The issue to be examined was the necking at different values of initial tensile stresses. The use of a developed noncontacting measuring system allowed us to see variations in the specimen shape and to estimate the true stress in various times. Based on the obtained experimental data, several criteria were proposed for describing the point of time at which the necking occurs (necking point). Calculations were carried out at various values of the parameters in these criteria. The relative interval of deformation time in which the test specimen is uniformly stretched was also determined.

The Theory of Quantized Fields. III

DOE R&D Accomplishments Database

Schwinger, J.

1953-05-01

In this paper we discuss the electromagnetic field, as perturbed by a prescribed current. All quantities of physical interest in various situations, eigenvalues, eigenfunctions, and transformation probabilities, are derived from a general transformation function which is expressed in a non-Hermitian representation. The problems treated are: the determination of the energy-momentum eigenvalues and eigenfunctions for the isolated electromagnetic field, and the energy eigenvalues and eigenfunctions for the field perturbed by a time-independent current that departs from zero only within a finite time interval, and for a time-dependent current that assumes non-vanishing time-independent values initially and finally. The results are applied in a discussion of the intra-red catastrophe and of the adiabatic theorem. It is shown how the latter can be exploited to give a uniform formulation for all problems requiring the evaluation of transition probabilities or eigenvalue displacements.

Ontogenetic behavior, migration, and social behavior of pallid sturgeon, Scaphirhynchus albus, and shovelnose sturgeon, S. platorynchus, with notes on the adaptive significance of body color

USGS Publications Warehouse

Kynard, B.; Henyey, E.; Horgan, M.

2002-01-01

We conducted laboratory studies on the ontogenetic behavior of free embryos (first life interval after hatching) and larvae (first feeding interval) of pallid and shovelnose sturgeon. Migration styles of both species were similar for timing of migration (initiation by embryos on day 0 after hatching and cessation by larvae on days 12-13 at 236-243 cumulative temperature degree units), migration distance (about 13 km), life interval when most distance was moved (embryo), and diel behavior of embryos (diurnal). However, the species differed for two behaviors: movement characteristics of embryos (peak movement rate of pallid sturgeon was only one-half the peak rate of shovelnose sturgeon, but pallid sturgeon continued the lower rate for twice as long) and diel behavior of larvae (pallid sturgeon were diurnal and shovelnose sturgeon were nocturnal). Thus, the species used different methods to move the same distance. Migrating as poorly developed embryos suggests a migration style to avoid predation at the spawning site, but moving from spawning habitat to rearing habitat before first feeding could also be important. Migrants of both species preferred bright habitat (high illumination intensity and white substrate), a behavioral preference that may characterize the migrants of many species of sturgeon. Both species were remarkably similar for swimming height above the bottom by age, and day 7 and older migrants may swim far above the bottom and move far downstream. A migration of 12 or 13 days will probably not distribute larvae throughout the population's range, so an older life interval likely initiates a second longer downstream migration (2-step migration). By day 2, individuals of both species were a black-tail phenotype (light grey body with a black-tail that moved conspicuously during swimming). Aggregation behavior suggests that black-tail is a visual signal used for group cohesion.

A study on reproductive performance and related factors of zebu cows in pastoral herds in a semi-arid area of Tanzania.

PubMed

Kanuya, N L; Matiko, M K; Kessy, B M; Mgongo, F O; Ropstad, E; Reksen, O

2006-06-01

A prospective longitudinal study was carried out from September 2001 to June 2004 in three adjacent villages in a semi-arid area of Tanzania. The objectives of this study were to measure the intervals between calving and either resumption of cyclical activity or confirmation of pregnancy, to estimate calving intervals, and to investigate the effect of factors assumed to be related to postpartum reproductive performance. A total of 275 lactation periods from 177 Tanzanian Shorthorn Zebu cows managed in a traditional pastoral system in 46 households were initially included. Animals were initially screened for brucelosis and thereafter examined by palpation per rectum at 2-week intervals. Body condition score (scale 1 to 5) was assessed and girth measurement (cm) taken. Occurrence of other reproductive events such as calving, abortion, death of calf, culling and reason for culling were recorded. In a subset of 98 lactation periods from 91 cows milk samples for progesterone (P4) determination were collected twice per week from day 7 after calving to the time of confirmed pregnancy or until milk production ceased before pregnancy. The data were analysed both univariately and in multivariable Cox proportional hazard (frailty) models. The mean (+/-S.E.M.) calving interval was 500+/-13.6 days. Positive reactors in the brucellosis test were 15.6% of the tested animals. Milk P4 analysis showed the rate of abortion/late embryo loss to be 14.3%. Calf mortality rates varied between 14.6 and 17.4%. A positive relationship was found between the outcome variables likelihood of cyclical activity and likelihood of pregnancy in the Cox model, and the explanatory variables: parity and body condition score (BCS) at calving. A negative relationship was found between the outcome variables, and the explanatory variables: maximum BCS loss and calf survival/mortality. Calving in the rainy season was associated with an increased likelihood of pregnancy.

Timelines in the management of adrenal crisis - targets, limits and reality.

PubMed

Hahner, Stefanie; Hemmelmann, Nina; Quinkler, Marcus; Beuschlein, Felix; Spinnler, Christina; Allolio, Bruno

2015-04-01

To evaluate current management timelines in adrenal crisis (AC) and to establish time targets and time limits for emergency treatment. Patients from a prospective study who had reported an AC (n = 46) were contacted and asked about management of their AC. A survey among 24 European endocrinologists collected expert recommendations concerning time targets and time limits for contact-arrival time of emergency health professionals and presentation of emergency card-glucocorticoid (GC) injection time. Median time targets and time limits regarded by experts as adequate for contact-arrival time were 45 and 90 min, respectively, and for card-injection time 15 and 30 min, respectively. Thirty-seven of 46 patients could be interviewed. All patients were equipped with an emergency card but only 23 (62%) with an emergency kit. Seven patients (19%) were trained in GC self-injection. The median time interval between contacting a health professional and arrival was 20 min (range 2-2880 min); ≤45 min: n = 32 (86%), <90 min: n = 34 (92%). The median time interval between arrival and administration of GC was 30 min (range 2-2400 min); ≤15 min: n = 17 (46%), ≤30 min: n = 20 (54%). While the time between contacting health professionals and their arrival was within the limits set by experts, initiation of GC administration was delayed in 46% of patients. Thus, improved management of AC needs to focus on shortening the presentation of card-injection time. Given the current reality in the management of AC, promotion of self-injection of GC (s.c. or i.m.) is warranted. © 2014 John Wiley & Sons Ltd.

Report on studies to monitor the interactions between offshore geophysical exploration activities and bowhead whales in the Alaskan Beaufort Sea, Fall 1982

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

Reeves, R.; Ljungblad, D.; Clarke, J.T.

1983-07-01

A total of 34 survey flights were initiated between 27 August and 4 October 1982 to assess the potential effects of marine geophysical survey work on westward migrating bowhead whales (Balaena mysticetus). No overt changes in whale behavior were observed that could unequivocally be interpreted as responses to seismic noise, with the possible exception of huddling behavior observed on 14-15 September that may have been caused by the onset of seismic sounds. Statistical analyses were performed on four categories of respiratory behavior (blows per surfacing, mean blow interval per surfacing, surface times and dive times) to test for differences betweenmore » times when whales were and were not exposed to seismic sounds.« less

A comparison of the accuracy of patterns processed from an inlay casting wax, an auto-polymerized resin and a light-cured resin pattern material.

PubMed

Rajagopal, Praveen; Chitre, Vidya; Aras, Meena A

2012-01-01

Traditionally, inlay casting waxes have been used to fabricate patterns for castings. Newer resin pattern materials offer greater rigidity and strength, allowing easier laboratory and intraoral adjustment without the fear of pattern damage. They also claim to possess a greater dimensional stability when compared to inlay wax. This study attempted to determine and compare the marginal accuracy of patterns fabricated from an inlay casting wax, an autopolymerized pattern resin and a light polymerized pattern resin on storage off the die for varying time intervals. Ten patterns each were fabricated from an inlay casting wax (GC Corp., Tokyo, Japan), an autopolymerized resin pattern material (Pattern resin, GC Corp, Tokyo, Japan) and a light-cured resin pattern material (Palavit GLC, Hereaus Kulzer GmbH, Germany). The completed patterns were stored off the die at room temperature. Marginal gaps were evaluated by reseating the patterns on their respective dies and observing it under a stereomicroscope at 1, 12, and 24 h intervals after pattern fabrication. The results revealed that the inlay wax showed a significantly greater marginal discrepancy at the 12 and 24 h intervals. The autopolymerized resin showed an initial (at 1 h) marginal discrepancy slightly greater than inlay wax, but showed a significantly less marginal gap (as compared to inlay wax) at the other two time intervals. The light-cured resin proved to be significantly more dimensionally stable, and showed minimal change during the storage period. The resin pattern materials studied, undergo a significantly less dimensional change than the inlay waxes on prolonged storage. They would possibly be a better alternative to inlay wax in situations requiring high precision or when delayed investment (more than 1 h) of patterns can be expected.

Ex vivo 12 h bactericidal activity of oral co-amoxiclav (1.125 g) against beta-lactamase-producing Haemophilus influenzae.

PubMed

Bronner, S; Pompei, D; Elkhaïli, H; Dhoyen, N; Monteil, H; Jehl, F

2001-10-01

The aim of the study was to evaluate the in vitro/ex vivo bactericidal activity of a new coamoxiclav single-dose sachet formulation (1 g amoxicillin + 0.125 g clavulanic acid) against a beta-lactamase-producing strain of Haemophilus influenzae. The evaluation covered the 12 h period after antibiotic administration. Serum specimens from the 12 healthy volunteers included in the pharmacokinetic study were pooled by time point and in equal volumes. Eight of 12 pharmacokinetic sampling time points were included in the study. At time points 0.5, 0.75, 1, 1.5, 2.5, 5, 8 and 12 h post-dosing, the kinetics of bactericidal activity were determined for each of the serial dilutions. Each specimen was serially diluted from 1:2 to 1:256. The index of surviving bacteria (ISB) was subsequently determined for each pharmacokinetic time point. For all the serum samples, bactericidal activity was fast (3-6 h), marked (3-6 log(10) reduction in the initial inoculum) and sustained over the 12 h between-dosing interval. The results obtained also confirmed that the potency of the amoxicillin plus clavulanic acid combination was time dependent against the species under study and that the time interval over which the concentrations were greater than the MIC (t > MIC) was 100% for the strain under study. The data thus generated constitute an interesting prerequisite with a view to using co-amoxiclav 1.125 g in a bd oral regimen.

A New Method to Compare Statistical Tree Growth Curves: The PL-GMANOVA Model and Its Application with Dendrochronological Data

PubMed Central

Ricker, Martin; Peña Ramírez, Víctor M.; von Rosen, Dietrich

2014-01-01

Growth curves are monotonically increasing functions that measure repeatedly the same subjects over time. The classical growth curve model in the statistical literature is the Generalized Multivariate Analysis of Variance (GMANOVA) model. In order to model the tree trunk radius (r) over time (t) of trees on different sites, GMANOVA is combined here with the adapted PL regression model Q = A·T+E, where for and for , A =  initial relative growth to be estimated, , and E is an error term for each tree and time point. Furthermore, Ei[–b·r]  = , , with TPR being the turning point radius in a sigmoid curve, and at is an estimated calibrating time-radius point. Advantages of the approach are that growth rates can be compared among growth curves with different turning point radiuses and different starting points, hidden outliers are easily detectable, the method is statistically robust, and heteroscedasticity of the residuals among time points is allowed. The model was implemented with dendrochronological data of 235 Pinus montezumae trees on ten Mexican volcano sites to calculate comparison intervals for the estimated initial relative growth . One site (at the Popocatépetl volcano) stood out, with being 3.9 times the value of the site with the slowest-growing trees. Calculating variance components for the initial relative growth, 34% of the growth variation was found among sites, 31% among trees, and 35% over time. Without the Popocatépetl site, the numbers changed to 7%, 42%, and 51%. Further explanation of differences in growth would need to focus on factors that vary within sites and over time. PMID:25402427

Large time behavior of entropy solutions to one-dimensional unipolar hydrodynamic model for semiconductor devices

NASA Astrophysics Data System (ADS)

Huang, Feimin; Li, Tianhong; Yu, Huimin; Yuan, Difan

2018-06-01

We are concerned with the global existence and large time behavior of entropy solutions to the one-dimensional unipolar hydrodynamic model for semiconductors in the form of Euler-Poisson equations in a bounded interval. In this paper, we first prove the global existence of entropy solution by vanishing viscosity and compensated compactness framework. In particular, the solutions are uniformly bounded with respect to space and time variables by introducing modified Riemann invariants and the theory of invariant region. Based on the uniform estimates of density, we further show that the entropy solution converges to the corresponding unique stationary solution exponentially in time. No any smallness condition is assumed on the initial data and doping profile. Moreover, the novelty in this paper is about the unform bound with respect to time for the weak solutions of the isentropic Euler-Poisson system.

Program Monitoring with LTL in EAGLE

NASA Technical Reports Server (NTRS)

Barringer, Howard; Goldberg, Allen; Havelund, Klaus; Sen, Koushik

2004-01-01

We briefly present a rule-based framework called EAGLE, shown to be capable of defining and implementing finite trace monitoring logics, including future and past time temporal logic, extended regular expressions, real-time and metric temporal logics (MTL), interval logics, forms of quantified temporal logics, and so on. In this paper we focus on a linear temporal logic (LTL) specialization of EAGLE. For an initial formula of size m, we establish upper bounds of O(m(sup 2)2(sup m)log m) and O(m(sup 4)2(sup 2m)log(sup 2) m) for the space and time complexity, respectively, of single step evaluation over an input trace. This bound is close to the lower bound O(2(sup square root m) for future-time LTL presented. EAGLE has been successfully used, in both LTL and metric LTL forms, to test a real-time controller of an experimental NASA planetary rover.

Predicting Operator Execution Times Using CogTool

NASA Technical Reports Server (NTRS)

Santiago-Espada, Yamira; Latorella, Kara A.

2013-01-01

Researchers and developers of NextGen systems can use predictive human performance modeling tools as an initial approach to obtain skilled user performance times analytically, before system testing with users. This paper describes the CogTool models for a two pilot crew executing two different types of a datalink clearance acceptance tasks, and on two different simulation platforms. The CogTool time estimates for accepting and executing Required Time of Arrival and Interval Management clearances were compared to empirical data observed in video tapes and registered in simulation files. Results indicate no statistically significant difference between empirical data and the CogTool predictions. A population comparison test found no significant differences between the CogTool estimates and the empirical execution times for any of the four test conditions. We discuss modeling caveats and considerations for applying CogTool to crew performance modeling in advanced cockpit environments.

Intact Interval Timing in Circadian CLOCK Mutants

PubMed Central

Cordes, Sara; Gallistel, C. R.

2008-01-01

While progress has been made in determining the molecular basis for the circadian clock, the mechanism by which mammalian brains time intervals measured in seconds to minutes remains a mystery. An obvious question is whether the interval timing mechanism shares molecular machinery with the circadian timing mechanism. In the current study, we trained circadian CLOCK +/− and −/− mutant male mice in a peak-interval procedure with 10 and 20-s criteria. The mutant mice were more active than their wild-type littermates, but there were no reliable deficits in the accuracy or precision of their timing as compared with wild-type littermates. This suggests that expression of the CLOCK protein is not necessary for normal interval timing. PMID:18602902

Short-Term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment With Antihypertensive Medication.

PubMed

Shimbo, Daichi; Barrett Bowling, C; Levitan, Emily B; Deng, Luqin; Sim, John J; Huang, Lei; Reynolds, Kristi; Muntner, Paul

2016-05-01

Antihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls after antihypertensive medication initiation and intensification. We examined the association between initiating and intensifying antihypertensive medication and serious fall injuries in a case-crossover study of 90 127 Medicare beneficiaries who were ≥65 years old and had a serious fall injury between July 1, 2007, and December 31, 2012, based on emergency department and inpatient claims. Antihypertensive medication initiation was defined by a prescription fill with no fills in the previous year. Intensification was defined by the addition of a new antihypertensive class, and separately, titration by the addition of a new class or increase in dosage of a current class. Exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall, 272, 1508, and 3113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days after antihypertensive medication initiation (odds ratio, 1.36 [95% confidence interval, 1.19-1.55]), adding a new class (odds ratio, 1.16 [95% confidence interval, 1.10-1.23]), and titration [odds ratio, 1.13 [95% confidence interval, 1.08-1.18]). These associations were attenuated beyond 15 days. Antihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults. © 2016 American Heart Association, Inc.

Working times of elastomeric impression materials determined by dimensional accuracy.

PubMed

Tan, E; Chai, J; Wozniak, W T

1996-01-01

The working times of five poly(vinyl siloxane) impression materials were estimated by evaluating the dimensional accuracy of stone dies of impressions of a standard model made at successive time intervals. The stainless steel standard model was represented by two abutments having known distances between landmarks in three dimensions. Three dimensions in the x-, y-, and z-axes of the stone dies were measured with a traveling microscope. A time interval was rejected as being within the working time if the percentage change of the resultant dies, in any dimension, was statistically different from those measured from stone dies from previous time intervals. The absolute dimensions of those dies from the rejected time interval also must have exceeded all those from previous time intervals. Results showed that the working times estimated with this method generally were about 30 seconds longer than those recommended by the manufacturers.

Single-channel autocorrelation functions: the effects of time interval omission.

PubMed Central

Ball, F G; Sansom, M S

1988-01-01

We present a general mathematical framework for analyzing the dynamic aspects of single channel kinetics incorporating time interval omission. An algorithm for computing model autocorrelation functions, incorporating time interval omission, is described. We show, under quite general conditions, that the form of these autocorrelations is identical to that which would be obtained if time interval omission was absent. We also show, again under quite general conditions, that zero correlations are necessarily a consequence of the underlying gating mechanism and not an artefact of time interval omission. The theory is illustrated by a numerical study of an allosteric model for the gating mechanism of the locust muscle glutamate receptor-channel. PMID:2455553

A cross-syndrome study of the differential effects of sleep on declarative memory consolidation in children with neurodevelopmental disorders.

PubMed

Ashworth, Anna; Hill, Catherine M; Karmiloff-Smith, Annette; Dimitriou, Dagmara

2017-03-01

Sleep plays an active role in memory consolidation. Because children with Down syndrome (DS) and Williams syndrome (WS) experience significant problems with sleep and also with learning, we predicted that sleep-dependent memory consolidation would be impaired in these children when compared to typically developing (TD) children. This is the first study to provide a cross-syndrome comparison of sleep-dependent learning in school-aged children. Children with DS (n = 20) and WS (n = 22) and TD children (n = 33) were trained on the novel Animal Names task where they were taught pseudo-words as the personal names of ten farm and domestic animals, e.g. Basco the cat, with the aid of animal picture flashcards. They were retested following counterbalanced retention intervals of wake and sleep. Overall, TD children remembered significantly more words than both the DS and WS groups. In addition, their performance improved following night-time sleep, whereas performance over the wake retention interval remained stable, indicating an active role of sleep for memory consolidation. Task performance of children with DS did not significantly change following wake or sleep periods. However, children with DS who were initially trained in the morning continued to improve on the task at the following retests, so that performance on the final test was greater for children who had initially trained in the morning than those who trained in the evening. Children with WS improved on the task between training and the first retest, regardless of whether sleep or wake occurred during the retention interval. This suggests time-dependent rather than sleep-dependent learning in children with WS, or tiredness at the end of the first session and better performance once refreshed at the start of the second session, irrespective of the time of day. Contrary to expectations, sleep-dependent learning was not related to baseline level of performance. The findings have significant implications for educational strategies, and suggest that children with DS should be taught more important or difficult information in the morning when they are better able to learn, whilst children with WS should be allowed a time delay between learning phases to allow for time-dependent memory consolidation, and frequent breaks from learning so that they are refreshed and able to perform at their best. © 2015 The Authors. Developmental Science Published by John Wiley & Sons Ltd.

Integrating Behavioral Health in Primary Care Using Lean Workflow Analysis: A Case Study

PubMed Central

van Eeghen, Constance; Littenberg, Benjamin; Holman, Melissa D.; Kessler, Rodger

2016-01-01

Background Primary care offices are integrating behavioral health (BH) clinicians into their practices. Implementing such a change is complex, difficult, and time consuming. Lean workflow analysis may be an efficient, effective, and acceptable method for integration. Objective Observe BH integration into primary care and measure its impact. Design Prospective, mixed methods case study in a primary care practice. Measurements Change in treatment initiation (referrals generating BH visits within the system). Secondary measures: primary care visits resulting in BH referrals, referrals resulting in scheduled appointments, time from referral to scheduled appointment, and time from referral to first visit. Providers and staff were surveyed on the Lean method. Results Referrals increased from 23 to 37/1000 visits (P<.001). Referrals resulted in more scheduled (60% to 74%, P<.001) and arrived visits (44% to 53%, P=.025). Time from referral to first scheduled visit decreased (Hazard Ratio (HR) 1.60; 95% Confidence Interval (CI) 1.37, 1.88; P<0.001) as did time to first arrived visit (HR 1.36; 95% CI 1.14, 1.62; P=0.001). Surveys and comments were positive. Conclusions This pilot integration of BH showed significant improvements in treatment initiation and other measures. Strengths of Lean included workflow improvement, system perspective, and project success. Further evaluation is indicated. PMID:27170796

Lower hospital mortality and complications after pediatric hematopoietic stem cell transplantation.

PubMed

Bratton, Susan L; Van Duker, Heather; Statler, Kimberly D; Pulsipher, Michael A; McArthur, Jennifer; Keenan, Heather T

2008-03-01

To assess protective and risk factors for mortality among pediatric patients during initial care after hematopoietic stem cell transplantation (HSCT) and to evaluate changes in hospital mortality. Retrospective cohort using the 1997, 2000, and 2003 Kids Inpatient Database, a probabilistic sample of children hospitalized in the United States with a procedure code for HSCT. Hospitalized patients in the United States submitted to the database. Age, <19 yrs. None. Hospital mortality significantly decreased from 12% in 1997 to 6% in 2003. Source of stem cells changed with increased use of cord blood. Rates of sepsis, graft versus host disease, and mechanical ventilation significantly decreased. Compared with autologous HSCT, patients who received an allogenic HSCT without T-cell depletion were more likely to die (adjusted odds ratio, 2.4; 95% confidence interval, 1.5, 3.9), while children who received cord blood HSCT were at the greatest risk of hospital death (adjusted odds ratio, 4.8; 95% confidence interval, 2.6, 9.1). Mechanical ventilation (adjusted odds ratio, 26.32; 95% confidence interval, 16.3-42.2), dialysis (adjusted odds ratio, 12.9; 95% confidence interval, 4.7-35.4), and sepsis (adjusted odds ratio, 3.9; 95% confidence interval, 2.5-6.1) were all independently associated with death, while care in 2003 was associated with decreased risk (adjusted odds ratio, 0.4; 95% confidence interval, 0.2-0.7) of death. Hospital mortality after HSCT in children decreased over time as did complications including need for mechanical ventilation, graft versus host disease, and sepsis. Prevention of complications is essential as the need for invasive support continues to be associated with high mortality risk.

Six-minute-walk distance and accelerometry predict outcomes in chronic obstructive pulmonary disease independent of Global Initiative for Chronic Obstructive Lung Disease 2011 Group.

PubMed

Durheim, Michael T; Smith, Patrick J; Babyak, Michael A; Mabe, Stephanie K; Martinu, Tereza; Welty-Wolf, Karen E; Emery, Charles F; Palmer, Scott M; Blumenthal, James A

2015-03-01

The 2011 combined Global Initiative for Chronic Obstructive Lung Disease (GOLD) assessment incorporates symptoms, exacerbation history, and spirometry in discriminating risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Six-minute-walk distance (6MWD) and accelerometry also have been used to assess disease severity in COPD. The association between these measures and the risks of hospitalization and mortality in the context of GOLD 2011 is unknown. To describe changes in exercise tolerance and physical activity over time in patients with COPD and to test the hypothesis that lower baseline 6MWD or accelerometry step count is associated with increased risk of COPD-related hospitalization or all-cause mortality, independent of GOLD 2011 group. Physical function and medical outcomes were prospectively assessed in 326 patients with moderate to severe COPD in INSPIRE-II, a randomized controlled trial of a coping skills training intervention. Cox models were used to determine if GOLD 2011 group, 6MWD, or accelerometry steps were associated with risk of COPD-related hospitalization or all-cause mortality. Physical function declined over time in GOLD group D but remained stable in groups A, B, and C. GOLD classification was associated with time to death or first COPD-related hospitalization. Baseline 6MWD was more strongly associated with time to death or first COPD-related hospitalization (hazard ratio, 0.50 [95% confidence interval, 0.34, 0.73] per 150 m, P=0.0003) than GOLD 2011 classification. A similar relationship was observed for accelerometry steps (hazard ratio, 0.80 [95% confidence interval, 0.70, 0.92] per 1,000 steps, P=0.002). Exercise tolerance and daily physical activity are important predictors of hospitalization and mortality in COPD, independent of GOLD 2011 classification. Physical function may represent a modifiable risk factor that warrants increased attention as a target for interventions to improve clinically meaningful outcomes in COPD.

Absence of equifinality of hand position in a double-step unloading task.

PubMed

Norouzi-Gheidari, Nahid; Archambault, Philippe

2010-08-01

Equifinality, during arm reaching movements, relates to the capacity of the neuromuscular system to attain the same final position in the presence or absence of transient perturbations. There have been several controversies regarding equifinality in the literature. A brief elastic perturbation, applied during a fast arm movement or just before its initiation, typically does not affect final arm position. On the other hand, several experiments have shown that velocity-dependent perturbations, such as Coriolis force or negative damping, while transient in nature, have a significant effect on final arm position when compared to unperturbed movements. In this study, an unloading paradigm was used to study the role of reflexes with respect to equifinality. The effects on final arm position of suddenly decreasing a static load maintained by fourteen subjects were analyzed. Subjects maintained an initial load produced by a double-joint manipulandum moving in the horizontal plane. The load was suddenly decreased, either in one or in two successive steps with different time intervals, resulting in a rapid reflex-mediated change in arm position. Unloading led to short-latency changes in the activity of shoulder and elbow muscles and significant variations in tonic activity. It was found that the final hand position was shorter for double- versus single-step unloading if the time between two successive changes in load was greater than 100 ms. With a shorter time interval, the final hand positions were the same. This difference in final hand positions was inversely proportional to the hand velocity at the time of the second change in load. Further, agonist/antagonist co-activation increased in double-step unloading. Thus, the change in both the load and the movement velocity may influence the magnitude of the unloading reflex. This may be indicative of a dependence of stretch reflexes on velocity. Perturbation may cause a reflex-mediated increase in joint stiffness, which could explain why equifinality is not preserved after some perturbations, such as velocity-dependant external forces.

Medication adherence and persistence over time with self-administered TNF-alpha inhibitors among young adult, middle-aged, and older patients with rheumatologic conditions.

PubMed

Calip, Gregory S; Adimadhyam, Sruthi; Xing, Shan; Rincon, Julian C; Lee, Wan-Ju; Anguiano, Rebekah H

2017-10-01

Self-injectable TNF inhibitors are increasingly used early in the chronic treatment of moderate to severe rheumatologic conditions. We estimated medication adherence/persistence over time following initiation in young adult and older adult patients with rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis. We conducted a retrospective cohort study of patients aged 18+ years newly initiating etanercept, adalimumab, certolizumab pegol, or golimumab using the Truven Health MarketScan Database between 2009 and 2013. Pharmacy dispensing data were used to calculate 12-month medication possession ratios (MPR) and determine adherence (MPR ≥ 0.80) for up to 3 years after starting therapy. Persistence over each 12-month interval was defined as not having a ≥92-day treatment gap. Multivariable generalized estimating equation models were used to calculate odds ratios (OR) and robust 95% confidence intervals (CI) for associations between patient characteristics and repeated adherence/persistence measures over time. Among 53,477 new users, 14% were young adults (18-34 years), 49% middle-aged (35-54 years), and 37% older adults (55+ years). Overall, 37% of patients were adherent and 83% were persistent in the first year of therapy. The lowest adherence (17%) and persistence (70%) were observed among young adult patients by Year +3. Compared to older adults, middle-aged (OR = 0.73, 95% CI: 0.71-0.76) and young adults (OR = 0.50, 95% CI: 0.47-0.53) were less likely to be adherent. Higher Charlson comorbidity scores, hospitalizations, and emergency department visits were associated with non-adherence/non-persistence. We observed low adherence to self-administered TNF inhibitors but most patients remained persistent over time. Further efforts to improve adherence in young adults and patients with greater comorbidity are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of factors associated with second remission in dogs with lymphoma undergoing retreatment with a cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy protocol: 95 cases (2000-2007).

PubMed

Flory, Andrea B; Rassnick, Kenneth M; Erb, Hollis N; Garrett, Laura D; Northrup, Nicole C; Selting, Kim A; Phillips, Brenda S; Locke, Jennifer E; Chretin, John D

2011-02-15

To evaluate factors associated with second remission in dogs with lymphoma retreated with a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) protocol after relapse following initial treatment with a first-line 6-month CHOP protocol. Retrospective case series. 95 dogs with lymphoma. Medical records were reviewed. Remission duration was estimated by use of the Kaplan-Meier method. Factors potentially associated with prognosis were examined. Median remission duration after the first-line CHOP protocol was 289 days (range, 150 to 1,457 days). Overall, 78% (95% confidence interval [CI], 69% to 86%) of dogs achieved a complete remission following retreatment, with a median second remission duration of 159 days (95% CI, 126 to 212 days). Duration of time off chemotherapy was associated with likelihood of response to retreatment; median time off chemotherapy was 140 days for dogs that achieved a complete remission after retreatment and 84 days for dogs that failed to respond to retreatment. Second remission duration was associated with remission duration after initial chemotherapy; median second remission duration for dogs with initial remission duration ≥ 289 days was 214 days (95% CI, 168 to 491 days), compared with 98 days (95% CI, 70 to 144 days) for dogs with initial remission duration < 289 days. Findings suggested that retreatment with the CHOP protocol can be effective in dogs with lymphoma that successfully complete an initial 6-month CHOP protocol.

Perception and the strongest sensory memory trace of multi-stable displays both form shortly after the stimulus onset.

PubMed

Pastukhov, Alexander

2016-02-01

We investigated the relation between perception and sensory memory of multi-stable structure-from-motion displays. The latter is an implicit visual memory that reflects a recent history of perceptual dominance and influences only the initial perception of multi-stable displays. First, we established the earliest time point when the direction of an illusory rotation can be reversed after the display onset (29-114 ms). Because our display manipulation did not bias perception towards a specific direction of illusory rotation but only signaled the change in motion, this means that the perceptual dominance was established no later than 29-114 ms after the stimulus onset. Second, we used orientation-selectivity of sensory memory to establish which display orientation produced the strongest memory trace and when this orientation was presented during the preceding prime interval (80-140 ms). Surprisingly, both estimates point towards the time interval immediately after the display onset, indicating that both perception and sensory memory form at approximately the same time. This suggests a tighter integration between perception and sensory memory than previously thought, warrants a reconsideration of its role in visual perception, and indicates that sensory memory could be a unique behavioral correlate of the earlier perceptual inference that can be studied post hoc.

Gender and socio-cultural determinants of delay to diagnosis of TB in Bangladesh, India and Malawi.

PubMed

Gosoniu, G D; Ganapathy, S; Kemp, J; Auer, C; Somma, D; Karim, F; Weiss, M G

2008-07-01

Tuberculosis (TB) control programmes in Bangladesh, India and Malawi. To compare the interval from symptom onset to diagnosis of TB for men and women, and to assess socio-cultural and gender-related features of illness explaining diagnostic delay. Semi-structured Explanatory Model Interview Catalogue (EMIC) interviews were administered to 100 or more patients at each site, assessing categories of distress, perceived causes and help seeking. Based on time from initial symptoms to diagnosis of TB, patients were classified with problem delay (>90 days), timely diagnosis (< or =30 days) or moderate delay. EMIC interview data were analysed to explain problem delay. The median interval from symptom onset to diagnosis was longest in India and shortest in Malawi. With adjustment for confounding, female sex (Bangladesh), and status of married woman (India) and housewife (Malawi) were associated with problem delay. Prominent non-specific symptoms--chest pain (Bangladesh) and breathlessness (Malawi)--were also significant. Cough in India, widely associated with TB, was associated with timely diagnosis. Sanitation as a perceived cause linked to poor urban conditions was associated with delayed diagnosis in India. Specific prior help seeking with circuitous referral patterns was identified. The study identified gender- and illness-related features of diagnostic delay. Further research distinguishing patient and provider delay is needed.

The relative roles of types of extracurricular activity on smoking and drinking initiation among tweens.

PubMed

Adachi-Mejia, Anna M; Gibson Chambers, Jennifer J; Li, Zhigang; Sargent, James D

2014-01-01

Youth involvement in extracurricular activities may help prevent smoking and drinking initiation. However, the relative roles of types of extracurricular activity on these risks are unclear. Therefore, we examined the association between substance use and participation in team sports with a coach, other sports without a coach, music, school clubs, and other clubs in a nationally representative sample of U.S. tweens. We conducted telephone surveys with 6522 U.S. students (ages 10 to 14 years) in 2003. We asked participants if they had ever tried smoking or drinking, and we asked them about their participation in extracurricular activities. We used sample weighting to produce response estimates that were representative of the population of adolescents aged 10 to 14 years at the time of data collection. Logistic regression models that adjusted for appropriate sampling weights using jackknife variance estimation tested associations with trying smoking and drinking, controlling for sociodemographics, child and parent characteristics, friend/sibling/parent substance use, and media use. A little over half of the students reported participating in team sports with a coach (55.5%) and without a coach (55.4%) a few times per week or more. Most had minimal to no participation in school clubs (74.2%); however, most reported being involved in other clubs (85.8%). A little less than half participated in music, choir, dance, and/or band lessons. Over half of participants involved in religious activity did those activities a few times per week or more. In the multiple regression analysis, team sport participation with a coach was the only extracurricular activity associated with lower risk of trying smoking (adjusted odds ratio 0.68, 95% confidence interval 0.49, 0.96) compared to none or minimal participation. Participating in other clubs was the only extracurricular activity associated with lower risk of trying drinking (adjusted odds ratio 0.56, 95% confidence interval 0.32, 0.99) compared to none or minimal participation. Type of extracurricular involvement may be associated with risk of youth smoking and drinking initiation. Future research should seek to better understand the underlying reasons behind these differences. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Salvage radiotherapy in patients with recurrent esophageal carcinoma.

PubMed

Fakhrian, K; Gamisch, N; Schuster, T; Thamm, R; Molls, M; Geinitz, H

2012-02-01

The feasibility and effectiveness of radiotherapy in the management of recurrent esophageal carcinoma (REC) is reported. A consecutive cohort of 54 patients with rcT1-4, rcN0-1, or cM0 recurrent esophageal carcinoma (69% squamous cell carcinoma, 31% adenocarcinoma) was treated between 1988 and 2010. The initial treatment for these patients was definitive radiochemotherapy, surgery alone, or neoadjuvant radiochemotherapy + surgical resection in 8 (15%), 33 (61%), and 13 (24%) patients, respectively. The median time to recurrence from initial treatment was 19 months (range 4-79 months). The site of the recurrence was anastomotic or local, nodal, or both in 63%, 30%, and 7% of patients, respectively. Salvage radio(chemo)therapy was carried out with a median dose of 45 Gy (range 30-68 Gy). Median follow-up time for surviving patients from the start of R(C)T was 38 months (range 10-105 months). Relief of symptoms was achieved in 19 of 28 symptomatic patients (68%). The median survival time was 12 months (95% confidence interval (CI) 7-17 months) and the median recurrence-free interval was 8 months (95% CI 4-12 months). The survival rates at 1, 2, and 3 years were 55 ± 7%, 29 ± 6%, and 19 ± 5%, respectively. The recurrence-free survival rates at 1, 2, and 3 years were 44 ± 7%, 22 ± 6%, and 15 ± 5%, respectively. A radiation dose ≥ 45 Gy and conformal RT were associated with a better prognosis. RT is feasible and effective in the management of recurrent esophageal carcinoma, especially for relief of symptoms. Toxicity is in an acceptable range. The outcome of REC is poor; however, long-term survival of patients with recurrent esophageal carcinoma after radiochemotherapy might be possible, even with a previous history of radiotherapy in the initial treatment. If re-irradiation of esophageal carcinoma is contemplated, three-dimensional conformal techniques and a minimum total dose of 45 Gy are recommended.

Pharmacists' role in opioid overdose: Kentucky pharmacists' willingness to participate in naloxone dispensing.

PubMed

Freeman, Patricia R; Goodin, Amie; Troske, SuZanne; Strahl, Audra; Fallin, Amanda; Green, Traci C

To assess pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified pharmacists to dispense naloxone under a physician-approved protocol. Electronic survey (e-mail) gauging perception of pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing. All Kentucky pharmacists with active licenses in 2015. Ordinal logistic regression was used to estimate the impact of pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community pharmacists reported barriers to naloxone access at higher rates than pharmacists from other practice settings. Kentucky pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing pharmacist confidence through appropriately designed education programs could facilitate pharmacist participation in naloxone dispensing. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Pressure effects on the relaxation of an excited nitromethane molecule in an argon bath

NASA Astrophysics Data System (ADS)

Rivera-Rivera, Luis A.; Wagner, Albert F.; Sewell, Thomas D.; Thompson, Donald L.

2015-01-01

Classical molecular dynamics simulations were performed to study the relaxation of nitromethane in an Ar bath (of 1000 atoms) at 300 K and pressures 10, 50, 75, 100, 125, 150, 300, and 400 atm. The molecule was instantaneously excited by statistically distributing 50 kcal/mol among the internal degrees of freedom. At each pressure, 1000 trajectories were integrated for 1000 ps, except for 10 atm, for which the integration time was 5000 ps. The computed ensemble-averaged rotational energy decay is ˜100 times faster than the vibrational energy decay. Both rotational and vibrational decay curves can be satisfactorily fit with the Lendvay-Schatz function, which involves two parameters: one for the initial rate and one for the curvature of the decay curve. The decay curves for all pressures exhibit positive curvature implying the rate slows as the molecule loses energy. The initial rotational relaxation rate is directly proportional to density over the interval of simulated densities, but the initial vibrational relaxation rate decreases with increasing density relative to the extrapolation of the limiting low-pressure proportionality to density. The initial vibrational relaxation rate and curvature are fit as functions of density. For the initial vibrational relaxation rate, the functional form of the fit arises from a combinatorial model for the frequency of nitromethane "simultaneously" colliding with multiple Ar atoms. Roll-off of the initial rate from its low-density extrapolation occurs because the cross section for collision events with L Ar atoms increases with L more slowly than L times the cross section for collision events with one Ar atom. The resulting density-dependent functions of the initial rate and curvature represent, reasonably well, all the vibrational decay curves except at the lowest density for which the functions overestimate the rate of decay. The decay over all gas phase densities is predicted by extrapolating the fits to condensed-phase densities.

Pressure effects on the relaxation of an excited nitromethane molecule in an argon bath

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

Rivera-Rivera, Luis A.; Wagner, Albert F.; Sewell, Thomas D.

2015-01-07

Classical molecular dynamics simulations were performed to study the relaxation of nitromethane in an Ar bath (of 1000 atoms) at 300 K and pressures 10, 50, 75, 100, 125, 150, 300, and 400 atm. The molecule was instantaneously excited by statistically distributing 50 kcal/mol among the internal degrees of freedom. At each pressure, 1000 trajectories were integrated for 1000 ps, except for 10 atm, for which the integration time was 5000 ps. The computed ensemble-averaged rotational energy decay is similar to 100 times faster than the vibrational energy decay. Both rotational and vibrational decay curves can be satisfactorily fit withmore » the Lendvay-Schatz function, which involves two parameters: one for the initial rate and one for the curvature of the decay curve. The decay curves for all pressures exhibit positive curvature implying the rate slows as the molecule loses energy. The initial rotational relaxation rate is directly proportional to density over the interval of simulated densities, but the initial vibrational relaxation rate decreases with increasing density relative to the extrapolation of the limiting low-pressure proportionality to density. The initial vibrational relaxation rate and curvature are fit as functions of density. For the initial vibrational relaxation rate, the functional form of the fit arises from a combinatorial model for the frequency of nitromethane "simultaneously" colliding with multiple Ar atoms. Roll-off of the initial rate from its low-density extrapolation occurs because the cross section for collision events with L Ar atoms increases with L more slowly than L times the cross section for collision events with one Ar atom. The resulting density-dependent functions of the initial rate and curvature represent, reasonably well, all the vibrational decay curves except at the lowest density for which the functions overestimate the rate of decay. The decay over all gas phase densities is predicted by extrapolating the fits to condensed-phase densities. (C) 2015 AIP Publishing LLC.« less

Pressure effects on the relaxation of an excited nitromethane molecule in an argon bath.

PubMed

Rivera-Rivera, Luis A; Wagner, Albert F; Sewell, Thomas D; Thompson, Donald L

2015-01-07

Classical molecular dynamics simulations were performed to study the relaxation of nitromethane in an Ar bath (of 1000 atoms) at 300 K and pressures 10, 50, 75, 100, 125, 150, 300, and 400 atm. The molecule was instantaneously excited by statistically distributing 50 kcal/mol among the internal degrees of freedom. At each pressure, 1000 trajectories were integrated for 1000 ps, except for 10 atm, for which the integration time was 5000 ps. The computed ensemble-averaged rotational energy decay is ∼100 times faster than the vibrational energy decay. Both rotational and vibrational decay curves can be satisfactorily fit with the Lendvay-Schatz function, which involves two parameters: one for the initial rate and one for the curvature of the decay curve. The decay curves for all pressures exhibit positive curvature implying the rate slows as the molecule loses energy. The initial rotational relaxation rate is directly proportional to density over the interval of simulated densities, but the initial vibrational relaxation rate decreases with increasing density relative to the extrapolation of the limiting low-pressure proportionality to density. The initial vibrational relaxation rate and curvature are fit as functions of density. For the initial vibrational relaxation rate, the functional form of the fit arises from a combinatorial model for the frequency of nitromethane "simultaneously" colliding with multiple Ar atoms. Roll-off of the initial rate from its low-density extrapolation occurs because the cross section for collision events with L Ar atoms increases with L more slowly than L times the cross section for collision events with one Ar atom. The resulting density-dependent functions of the initial rate and curvature represent, reasonably well, all the vibrational decay curves except at the lowest density for which the functions overestimate the rate of decay. The decay over all gas phase densities is predicted by extrapolating the fits to condensed-phase densities.

Pressure effects on the relaxation of an excited nitromethane molecule in an argon bath

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

Rivera-Rivera, Luis A.; Sewell, Thomas D.; Thompson, Donald L.

2015-01-07

Classical molecular dynamics simulations were performed to study the relaxation of nitromethane in an Ar bath (of 1000 atoms) at 300 K and pressures 10, 50, 75, 100, 125, 150, 300, and 400 atm. The molecule was instantaneously excited by statistically distributing 50 kcal/mol among the internal degrees of freedom. At each pressure, 1000 trajectories were integrated for 1000 ps, except for 10 atm, for which the integration time was 5000 ps. The computed ensemble-averaged rotational energy decay is ∼100 times faster than the vibrational energy decay. Both rotational and vibrational decay curves can be satisfactorily fit with the Lendvay-Schatzmore » function, which involves two parameters: one for the initial rate and one for the curvature of the decay curve. The decay curves for all pressures exhibit positive curvature implying the rate slows as the molecule loses energy. The initial rotational relaxation rate is directly proportional to density over the interval of simulated densities, but the initial vibrational relaxation rate decreases with increasing density relative to the extrapolation of the limiting low-pressure proportionality to density. The initial vibrational relaxation rate and curvature are fit as functions of density. For the initial vibrational relaxation rate, the functional form of the fit arises from a combinatorial model for the frequency of nitromethane “simultaneously” colliding with multiple Ar atoms. Roll-off of the initial rate from its low-density extrapolation occurs because the cross section for collision events with L Ar atoms increases with L more slowly than L times the cross section for collision events with one Ar atom. The resulting density-dependent functions of the initial rate and curvature represent, reasonably well, all the vibrational decay curves except at the lowest density for which the functions overestimate the rate of decay. The decay over all gas phase densities is predicted by extrapolating the fits to condensed-phase densities.« less

Reirradiation of Large-Volume Recurrent Glioma With Pulsed Reduced-Dose-Rate Radiotherapy

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

Adkison, Jarrod B.; Tome, Wolfgang; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI

2011-03-01

Purpose: Pulsed reduced-dose-rate radiotherapy (PRDR) is a reirradiation technique that reduces the effective dose rate and increases the treatment time, allowing sublethal damage repair during irradiation. Patients and Methods: A total of 103 patients with recurrent glioma underwent reirradiation using PRDR (86 considered to have Grade 4 at PRDR). PRDR was delivered using a series of 0.2-Gy pulses at 3-min intervals, creating an apparent dose rate of 0.0667 Gy/min to a median dose of 50 Gy (range, 20-60) delivered in 1.8-2.0-Gy fractions. The mean treatment volume was 403.5 {+-} 189.4 cm{sup 3} according to T{sub 2}-weighted magnetic resonance imaging andmore » a 2-cm margin. Results: For the initial or upgraded Grade 4 cohort (n = 86), the median interval from the first irradiation to PRDR was 14 months. Patients undergoing PRDR within 14 months of the first irradiation (n = 43) had a median survival of 21 weeks. Those treated {>=}14 months after radiotherapy had a median survival of 28 weeks (n = 43; p = 0.004 and HR = 1.82 with a 95% CI ranging from 1.25 to 3.10). These data compared favorably to historical data sets, because only 16% of the patients were treated at first relapse (with 46% treated at the second relapse, 32% at the third or fourth relapse, and 4% at the fourth or fifth relapse). The median survival since diagnosis and retreatment was 6.3 years and 11.4 months for low-grade, 4.1 years and 5.6 months for Grade 3, and 1.6 years and 5.1 months for Grade 4 tumors, respectively, according to the initial histologic findings. Multivariate analysis revealed age at the initial diagnosis, initial low-grade disease, and Karnofsky performance score of {>=}80 to be significant predictors of survival after initiation of PRDR. Conclusion: PRDR allowed for safe retreatment of larger volumes to high doses with palliative benefit.« less

A Real-Time Safety and Quality Reporting System: Assessment of Clinical Data and Staff Participation

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

Rahn, Douglas A.; Kim, Gwe-Ya; Mundt, Arno J.

Purpose: To report on the use of an incident learning system in a radiation oncology clinic, along with a review of staff participation. Methods and Materials: On September 24, 2010, our department initiated an online real-time voluntary reporting system for safety issues, called the Radiation Oncology Quality Reporting System (ROQRS). We reviewed these reports from the program's inception through January 18, 2013 (2 years, 3 months, 25 days) to assess error reports (defined as both near-misses and incidents of inaccurate treatment). Results: During the study interval, there were 60,168 fractions of external beam radiation therapy and 955 brachytherapy procedures. There were 298 entriesmore » in the ROQRS system, among which 108 errors were reported. There were 31 patients with near-misses reported and 27 patients with incidents of inaccurate treatment reported. These incidents of inaccurate treatment occurred in 68 total treatment fractions (0.11% of treatments delivered during the study interval). None of these incidents of inaccurate treatment resulted in deviation from the prescription by 5% or more. A solution to the errors was documented in ROQRS in 65% of the cases. Errors occurred as repeated errors in 22% of the cases. A disproportionate number of the incidents of inaccurate treatment were due to improper patient setup at the linear accelerator (P<.001). Physician participation in ROQRS was nonexistent initially, but improved after an education program. Conclusions: Incident learning systems are a useful and practical means of improving safety and quality in patient care.« less

Saccadic performance in questionnaire-identified schizotypes over time.

PubMed

Gooding, Diane C; Shea, Heather B; Matts, Christie W

2005-02-28

In the present study, 121 young adults (mean age=19 years), hypothesized to be at varying levels of risk for psychosis on the basis of their psychometric profiles, were administered saccadic (antisaccade and refixation) tasks at two separate assessments. At Time 1, individuals posited to be at heightened risk for the later development of schizophrenia-spectrum disorders (i.e., those individuals with elevated Social Anhedonia Scale [SAS] scores) produced significantly more antisaccade task errors than the controls. Despite apparent improvement in antisaccade task performance from initial testing to the follow-up (mean test-retest interval=59 months) across all groups, the Social Anhedonia (SocAnh) group continued to produce significantly more errors than the control group. The antisaccade task performance of the control group showed good temporal stability (Pearson's r=0.70, ICC=0.52), and the SocAnh group's performance showed excellent temporal stability (Pearson's r=0.85, ICC=0.83). The results of this investigation are twofold: First, antisaccade task performance is temporally stable, even in psychometrically identified schizotypes over long test-retest intervals; and secondly, Social Anhedonia Scale scores as well as Time 1 antisaccade task accuracy accounted for much of the variability in Time 2 antisaccade task performance. These findings add to the growing body of literature suggesting that antisaccade task deficits may serve as an endophenotypic marker of a schizophrenia diathesis.

Initial Validation of NDVI time seriesfrom AVHRR, VEGETATION, and MODIS

NASA Technical Reports Server (NTRS)

Morisette, Jeffrey T.; Pinzon, Jorge E.; Brown, Molly E.; Tucker, Jim; Justice, Christopher O.

2004-01-01

The paper will address Theme 7: Multi-sensor opportunities for VEGETATION. We present analysis of a long-term vegetation record derived from three moderate resolution sensors: AVHRR, VEGETATION, and MODIS. While empirically based manipulation can ensure agreement between the three data sets, there is a need to validate the series. This paper uses atmospherically corrected ETM+ data available over the EOS Land Validation Core Sites as an independent data set with which to compare the time series. We use ETM+ data from 15 globally distributed sites, 7 of which contain repeat coverage in time. These high-resolution data are compared to the values of each sensor by spatially aggregating the ETM+ to each specific sensors' spatial coverage. The aggregated ETM+ value provides a point estimate for a specific site on a specific date. The standard deviation of that point estimate is used to construct a confidence interval for that point estimate. The values from each moderate resolution sensor are then evaluated with respect to that confident interval. Result show that AVHRR, VEGETATION, and MODIS data can be combined to assess temporal uncertainties and address data continuity issues and that the atmospherically corrected ETM+ data provide an independent source with which to compare that record. The final product is a consistent time series climate record that links historical observations to current and future measurements.

Measuring happiness in individuals with profound multiple disabilities.

PubMed

Darling, Joseph A; Circo, Deborah K

2015-12-01

This quantitative study assessed whether presentation of preferred items and activities during multiple periods of the day (and over multiple days) increased indices of happiness (over time/sustained) in individuals with PMD. A multiple baseline design across participants was utilized to measure changes in indices of happiness of the participants. Participants were recruited from an adult day activity program specializing in providing assistance to individuals with disabilities. For Mary, baseline indices of happiness were 26.67% of intervals, increasing 6.76% during intervention to 33.43%. For Caleb, baseline indices of happiness were 20.84% of intervals, increasing 6.34% during intervention to 27.18%. For Mark, baseline indices of happiness were 40.00% of intervals, increasing 12.75% during intervention to 52.75%. Overall interobserver agreement was 82.8%, with interobserver agreement observations occurring during 63.04% of the observations. The results of the investigation demonstrated that presenting preferred items and activities increased the indices of happiness compared to baseline rates of indices of happiness. Results may have been more robust if the participants were assessed for overall responsiveness patterns prior to the initiation of measurement of indices of happiness. Copyright © 2015 Elsevier Ltd. All rights reserved.

Suggestion of an oral hygiene program for orthodontic patients with cleft lip and palate: findings of a pilot study.

PubMed

Brasil, Juliana Marcelina Plácido; de Almeida Pernambuco, Renata; da Silva Dalben, Gisele

2007-11-01

To evaluate the efficacy of an oral hygiene program for orthodontic patients with cleft lip and palate. Retrospective pilot study. Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Brazil. One hundred twenty-two patients with complete cleft lip and palate undergoing orthodontic treatment. Orientation on toothbrushing and flossing, plaque disclosure, and scoring according to an especially designed index. Statistical comparison of variation in plaque index between sessions; correlation of intervals between sessions and variation in plaque index. Mean scores were reduced significantly, from 2.17 to 1.75 between first and second, 2.18 to 1.62 between first and third, and 1.93 to 1.62 between second and third sessions. Plaque reduction was inversely proportional to the time interval. The program demonstrated a significant plaque reduction. The highest reduction between the first and second sessions reveals the need to reinforce the initial instructions at all sessions. The greatest reduction observed at shorter intervals highlights the need for regular follow up. More controlled studies on larger samples should be encouraged to evaluate the validity of the index and the efficacy of similar programs worldwide.

Lightning-Discharge Initiation as a Noise-Induced Kinetic Transition

NASA Astrophysics Data System (ADS)

Iudin, D. I.

2017-10-01

The electric fields observed in thunderclouds have the peak values one order of magnitude smaller than the electric strength of air. This fact renders the issue of the lightning-discharge initiation one of the most intriguing problems of thunderstorm electricity. In this work, the lightning initiation in a thundercloud is considered as a noise-induced kinetic transition. The stochastic electric field of the charged hydrometeors is the noise source. The considered kinetic transition has some features which distinguish it from other lightning-initiation mechanisms. First, the dynamic realization of this transition, which is due to interaction of the electron and ion components, is extended for a time significantly exceeding the spark-discharge development time. In this case, the fast attachment of electrons generated by supercritical bursts of the electric field of hydrometeors is balanced during long-term time intervals by the electron-release processes when the negative ions are destroyed. Second, an important role in the transition kinetics is played by the stochastic drift of electrons and ions caused by the small-scale fluctuations of the field of charged hydrometeors. From the formal mathematical viewpoint, this stochastic drift is indistinguishable from the scalar-impurity advection in a turbulent flow. In this work, it is shown that the efficiency of "advective mixing" is several orders of magnitude greater than that of the ordinary diffusion. Third, the considered transition leads to a sharp increase in the conductivity in the exponentially rare compact regions of space against the background of the vanishingly small variations in the average conductivity of the medium. In turn, the spots with increased conductivity are polarized in the mean field followed by the streamer initiation and discharge contraction.

Medical Records Flag for Suicide Risk: Predictors and Subsequent Use of Care Among Veterans With Substance Use Disorders.

PubMed

Berg, Joanna M; Malte, Carol A; Reger, Mark A; Hawkins, Eric J

2018-06-08

The U.S. Department of Veterans Affairs (VA) health care system established policies to include patient record flags (PRFs) for high suicide risk in the electronic medical record to alert providers and to increase health care contacts. This study identified predictors of new PRFs and described health care utilization before and after PRF initiation among VA patients with substance use disorders. The sample included patients ages ≥18 who received a substance use disorder diagnosis in 2012 (N=474,946). Demographic, clinical, and utilization predictors of PRFs were identified by multivariable logistic regression. Changes in short-term (three months) and longer-term (12 months) health care utilization before and after PRF initiation were compared by negative binomial regression. A total of 8,913 patients received PRFs. Demographic predictors of PRF initiation included being younger than 35, white, and homeless. Clinical predictors were cocaine, opioid, and sedative use disorders; posttraumatic stress, psychotic, bipolar, and depressive disorders; and diagnosis of a suicide attempt. Patients with PRFs averaged 1.33 (95% confidence interval [CI]=1.29-1.38) times more primary care visits, 2.29 (CI=2.24-2.34) times more mental health visits, 4.10 (CI=3.80-4.42) times more substance use visits, and fewer (incidence rate ratio=.55, CI=.53-.58) emergency department visits in the three months following compared with the three months before PRF initiation. Modest increases in mental health- and substance use--related days hospitalized were observed. Veterans received significantly more health care services after PRF initiation. Further research is warranted on the effects of PRFs on clinical outcomes, such as suicide behaviors.

No Risk of Myocardial Infarction Associated With Initial Antiretroviral Treatment Containing Abacavir: Short and Long-Term Results from ACTG A5001/ALLRT

PubMed Central

Benson, Constance A.; Zheng, Yu; Koletar, Susan L.; Collier, Ann C.; Lok, Judith J.; Smurzynski, Marlene; Bosch, Ronald J.; Bastow, Barbara; Schouten, Jeffrey T.

2011-01-01

Background. Observational and retrospective clinical trial cohorts have reported conflicting results for the association of abacavir use with risk of myocardial infarction (MI), possibly related to issues that may bias estimation of treatment effects, such as time-varying confounders, informative dropout, and cohort loss due to competing events. Methods. We analyzed data from 5056 individuals initiating randomized antiretroviral treatment (ART) in AIDS Clinical Trials Group studies; 1704 started abacavir therapy. An intent-to-treat analysis adjusted for pretreatment covariates and weighting for informative censoring was used to estimate the hazard ratio (HR) of MIs after initiation of a regimen with or without abacavir. Results. Through 6 years after ART initiation, 36 MI events were observed in 17,404 person-years of follow-up. No evidence of an increased hazard of MI in subjects using abacavir versus no abacavir was seen (over a 1-year period: P = .50; HR, 0.7 [95% confidence interval {CI}, 0.2-2.4]); over a 6-year period: P = .24; HR, 0.6 [95% CI, 0.3-1.4]); these results were robust over as-treated and sensitivity analyses. Although the risk of MI decreased over time, there was no evidence to suggest a time-dependent abacavir effect. Classic cardiovascular disease (CVD) risk factors were the strongest predictors of MI. Conclusion. We find no evidence to suggest that initial ART containing abacavir increases MI risk over short-term and long-term periods in this population with relatively low MI risk. Traditional CVD risk factors should be the main focus in assessing CVD risk in individuals with human immunodeficiency virus infection. PMID:21427402

No risk of myocardial infarction associated with initial antiretroviral treatment containing abacavir: short and long-term results from ACTG A5001/ALLRT.

PubMed

Ribaudo, Heather J; Benson, Constance A; Zheng, Yu; Koletar, Susan L; Collier, Ann C; Lok, Judith J; Smurzynski, Marlene; Bosch, Ronald J; Bastow, Barbara; Schouten, Jeffrey T

2011-04-01

Observational and retrospective clinical trial cohorts have reported conflicting results for the association of abacavir use with risk of myocardial infarction (MI), possibly related to issues that may bias estimation of treatment effects, such as time-varying confounders, informative dropout, and cohort loss due to competing events. We analyzed data from 5056 individuals initiating randomized antiretroviral treatment (ART) in AIDS Clinical Trials Group studies; 1704 started abacavir therapy. An intent-to-treat analysis adjusted for pretreatment covariates and weighting for informative censoring was used to estimate the hazard ratio (HR) of MIs after initiation of a regimen with or without abacavir. Through 6 years after ART initiation, 36 MI events were observed in 17,404 person-years of follow-up. No evidence of an increased hazard of MI in subjects using abacavir versus no abacavir was seen (over a 1-year period: P=.50; HR, 0.7 [95% confidence interval {CI}, 0.2-2.4]); over a 6-year period: P=.24; HR, 0.6 [95% CI, 0.3-1.4]); these results were robust over as-treated and sensitivity analyses. Although the risk of MI decreased over time, there was no evidence to suggest a time-dependent abacavir effect. Classic cardiovascular disease (CVD) risk factors were the strongest predictors of MI. We find no evidence to suggest that initial ART containing abacavir increases MI risk over short-term and long-term periods in this population with relatively low MI risk. Traditional CVD risk factors should be the main focus in assessing CVD risk in individuals with human immunodeficiency virus infection. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

Initial Misdiagnosis of Proximal Pancreatic Adenocarcinoma Is Associated with Delay in Diagnosis and Advanced Stage at Presentation.

PubMed

Swords, Douglas S; Mone, Mary C; Zhang, Chong; Presson, Angela P; Mulvihill, Sean J; Scaife, Courtney L

2015-10-01

Delay in diagnosis of pancreatic ductal adenocarcinoma (PDAC) is associated with decreased survival. The effect of an initial misdiagnosis on delay in diagnosis and stage of PDAC is unknown. This study is a retrospective review (2000-2010) from a University-based cancer center of new diagnoses of proximal PDAC. Of 313 patients, 98 (31.3 %) had an initial misdiagnosis. Misdiagnosed patients were younger, 62.8 ± 12.6 vs. 68.0 ± 10.1 (p < 0.001). The most common initial misdiagnoses were: gallbladder disease, gastroesophageal reflux disease, and peptic ulcer disease. After excluding patients with prior cholecystectomy, 14.2 % were misdiagnosed with gallbladder disease and underwent cholecystectomy before PDAC diagnosis. Misdiagnosed patients had higher rates of abdominal pain (p < 0.001), weight loss (p = 0.04), and acute pancreatitis (p < 0.001) and lower rate of jaundice (p < 0.001). Median time between symptoms to PDAC diagnosis was longer in misdiagnosed: 4.2 months vs. 1.4 (p < 0.001). Median time from contact with medical provider to axial imaging was longer in misdiagnosed (p < 0.001). Rate of stages III-IV disease at diagnosis was higher in misdiagnosed: 61.2 vs. 43.7 % (p = 0.004), with a 1.4 (95 % confidence interval (CI), 1.12-1.74) higher risk of stages III-IV disease at diagnosis; however, there was no difference in median overall survival in misdiagnosed patients (9.6 months in misdiagnosed vs. 10.3 months in correctly diagnosed, p = 0.69). Initial misdiagnosis of patients with proximal PDAC is associated with delay in diagnosis and higher risk of locally advanced or advanced disease at time of PDAC diagnosis.

An Augmented SMS Intervention to Improve Access to Antenatal CD4 Testing and ART Initiation in HIV-Infected Pregnant Women: A Cluster Randomized Trial

PubMed Central

Dryden-Peterson, Scott; Bennett, Kara; Hughes, Michael D.; Veres, Adrian; John, Oaitse; Pradhananga, Rosina; Boyer, Matthew; Brown, Carolyn; Sakyi, Bright; van Widenfelt, Erik; Keapoletswe, Koona; Mine, Madisa; Moyo, Sikhulile; Asmelash, Aida; Siedner, Mark; Mmalane, Mompati; Shapiro, Roger L.; Lockman, Shahin

2015-01-01

Background Less than one-third of HIV-infected pregnant women eligible for combination antiretroviral therapy (ART) globally initiate treatment prior to delivery, with lack of access to timely CD4 results being a principal barrier. We evaluated the effectiveness of an SMS-based intervention to improve access to timely antenatal ART. Methods We conducted a stepped-wedge cluster randomized trial of a low-cost programmatic intervention in 20 antenatal clinics in Gaborone, Botswana. From July 2011-April 2012, 2 clinics were randomly selected every 4 weeks to receive an ongoing clinic-based educational intervention to improve CD4 collection and to receive CD4 results via an automated SMS platform with active patient tracing. CD4 testing before 26 weeks gestation and ART initiation before 30 weeks gestation were assessed. Results Three-hundred-sixty-six ART-naïve women were included, 189 registering for antenatal care under Intervention and 177 under Usual Care periods. Of CD4-eligible women, 100 (59.2%) women under Intervention and 79 (50.6%) women under Usual Care completed CD4 phlebotomy before 26 weeks gestation, adjusted odds ratio (aOR, adjusted for time that a clinic initiated Intervention) 0.87 (95% confidence interval [CI]0.47–1.63, P = 0.67). The SMS-based platform reduced time to clinic receipt of CD4 test result from median of 16 to 6 days (P<0.001), was appreciated by clinic staff, and was associated with reduced operational cost. However, rates of ART initiation remained low, with 56 (36.4%) women registering under Intervention versus 37 (24.2%) women under Usual Care initiating ART prior to 30 weeks gestation, aOR 1.06 (95%CI 0.53–2.13, P = 0.87). Conclusions The augmented SMS-based intervention delivered CD4 results more rapidly and efficiently, and this type of SMS-based results delivery platform may be useful for a variety of tests and settings. However, the intervention did not appear to improve access to timely antenatal CD4 testing or ART initiation, as obstacles other than CD4 impeded ART initiation during pregnancy. PMID:25693050

Disease progression in Chinese chronic hepatitis C patients with persistently normal alanine aminotransaminase levels.

PubMed

Hui, C-K; Zhang, H-Y; Shek, T; Yao, H; Yueng, Y-H; Leung, K-W; Lai, S-T; Lai, J-Y; Leung, N; Lau, G K

2007-06-01

Although chronic hepatitis C virus-infected patients with persistently normal alanine aminotransaminase levels usually have mild liver disease, disease progression can still occur. However, it is uncertain which group of patients is at risk of disease progression. To examine the severity of liver disease on liver biopsy in Chinese patients with persistently normal alanine aminotransaminase levels, and their disease progression over time. Eighty-two patients with persistently normal alanine aminotransaminase levels were followed up longitudinally. The median time of follow-up was 8.1 years. Forty-seven of the 82 patients (57.3%) had a second liver biopsy. At the time of analysis, six of the 82 patients (7.3%) developed decompensated liver cirrhosis. Patients with an initial fibrosis stage F2 or F3 [6/23 (26.1%) vs. 0/59 (0%), P < 0.0001] or inflammatory grade A2 or A3 [5/40 (12.5%) vs. 1/42 (2.4%), P = 0.04] were more likely to develop decompensated liver cirrhosis. On multivariate analysis, initial fibrosis stage F2 or F3 was independently associated with progression to decompensated liver cirrhosis (relative risk 2.3, 95% confidence interval 0.03-2.5, P = 0.02). Chinese chronic hepatitis C virus patients with persistently normal alanine aminotransaminase levels with moderate to severe fibrosis at initial evaluation are more likely to develop decompensated liver cirrhosis.

Long-Term Survival after Gamma Knife Radiosurgery in a Case of Recurrent Glioblastoma Multiforme: A Case Report and Review of the Literature

PubMed Central

Thumma, Sudheer R.; Elaimy, Ameer L.; Daines, Nathan; Mackay, Alexander R.; Lamoreaux, Wayne T.; Fairbanks, Robert K.; Demakas, John J.; Cooke, Barton S.; Lee, Christopher M.

2012-01-01

The management of recurrent glioblastoma is highly challenging, and treatment outcomes remain uniformly poor. Glioblastoma is a highly infiltrative tumor, and complete surgical resection of all microscopic extensions cannot be achieved at the time of initial diagnosis, and hence local recurrence is observed in most patients. Gamma Knife radiosurgery has been used to treat these tumor recurrences for select cases and has been successful in prolonging the median survival by 8–12 months on average for select cases. We present the unique case of a 63-year-old male with multiple sequential recurrences of glioblastoma after initial standard treatment with surgery followed by concomitant external beam radiation therapy and chemotherapy (temozolomide). The patient was followed clinically as well as with surveillance MRI scans at every 2-3-month intervals. The patient underwent Gamma Knife radiosurgery three times for 3 separate tumor recurrences, and the patient survived for seven years following the initial diagnosis with this aggressive treatment. The median survival in patients with recurrent glioblastoma is usually 8–12 months after recurrence, and this unique case illustrates that aggressive local therapy can lead to long-term survivors in select situations. We advocate that each patient treatment at the time of recurrence should be tailored to each clinical situation and desire for quality of life and improved longevity. PMID:22548078

German "National Cancer Aid Monitoring" 2015-2019 - study protocol and initial results.

PubMed

Schneider, Sven; Görig, Tatiana; Schilling, Laura; Breitbart, Eckhard W; Greinert, Rüdiger; Diehl, Katharina

2017-09-01

The National Cancer Aid Monitoring of Tanning Bed Use (NCAM) project is a major German study that aims to observe the most significant risk factors for skin cancer: natural sunlight and artificial UV radiation. NCAM is a nationwide cross-sectional survey that will initially involve four rounds of data collection (so-called waves) between 2015 and 2018. Every year, a representative nationwide sample consisting of 3,000 individuals aged between 14 and 45 years will be surveyed. The cross-sectional survey will be complemented by a panel of n  =  450 current tanning bed users. The initial wave in 2015 shows an overall prevalence of tanning bed use of 29.5 %. Eleven percent of all participants had used a tanning bed within the past twelve months. Determinants of current tanning bed use included younger age, female gender, and full-time/part-time employment. The main motivations for tanning bed use reported were relaxation and increased attractiveness. NCAM is the first study worldwide to monitor skin cancer risk factors at one-year intervals using a large, nationally representative sample. Initial results indicate that, despite WHO warnings, millions of Germans use tanning beds, and that many of these users are adolescents despite legal restrictions aimed at preventing minors from using tanning beds. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Variations in rupture process with recurrence interval in a repeated small earthquake

USGS Publications Warehouse

Vidale, J.E.; Ellsworth, W.L.; Cole, A.; Marone, Chris

1994-01-01

In theory and in laboratory experiments, friction on sliding surfaces such as rock, glass and metal increases with time since the previous episode of slip. This time dependence is a central pillar of the friction laws widely used to model earthquake phenomena. On natural faults, other properties, such as rupture velocity, porosity and fluid pressure, may also vary with the recurrence interval. Eighteen repetitions of the same small earthquake, separated by intervals ranging from a few days to several years, allow us to test these laboratory predictions in situ. The events with the longest time since the previous earthquake tend to have about 15% larger seismic moment than those with the shortest intervals, although this trend is weak. In addition, the rupture durations of the events with the longest recurrence intervals are more than a factor of two shorter than for the events with the shortest intervals. Both decreased duration and increased friction are consistent with progressive fault healing during the time of stationary contact.In theory and in laboratory experiments, friction on sliding surfaces such as rock, glass and metal increases with time since the previous episode of slip. This time dependence is a central pillar of the friction laws widely used to model earthquake phenomena. On natural faults, other properties, such as rupture velocity, porosity and fluid pressure, may also vary with the recurrence interval. Eighteen repetitions of the same small earthquake, separated by intervals ranging from a few days to several years, allow us to test these laboratory predictions in situ. The events with the longest time since the previous earthquake tend to have about 15% larger seismic moment than those with the shortest intervals, although this trend is weak. In addition, the rupture durations of the events with the longest recurrence intervals are more than a factor of two shorter than for the events with the shortest intervals. Both decreased duration and increased friction are consistent with progressive fault healing during the time of stationary contact.

Increasing time to postoperative stereotactic radiation therapy for patients with resected brain metastases: investigating clinical outcomes and identifying predictors associated with time to initiation.

PubMed

Yusuf, Mehran B; Amsbaugh, Mark J; Burton, Eric; Nelson, Megan; Williams, Brian; Koutourousiou, Maria; Nauta, Haring; Woo, Shiao

2018-02-01

We sought to determine the impact of time to initiation (TTI) of post-operative radiosurgery on clinical outcomes for patients with resected brain metastases and to identify predictors associated with TTI. All patients with resected brain metastases treated with postoperative SRS or fractionated stereotactic radiation therapy (fSRT) from 2012 to 2016 at a single institution were reviewed. TTI was defined as the interval from resection to first day of radiosurgery. Receiver operating characteristic (ROC) curves were used to identify an optimal threshold for TTI with respect to local failure (LF). Survival outcomes were estimated using the Kaplan-Meier method and analyzed using the log-rank test and Cox proportional hazards models. Logistic regression models were used to identify factors associated with ROC-determined TTI covariates. A total of 79 resected lesions from 73 patients were evaluated. An ROC curve of LF and TTI identified an optimal threshold for TTI of 30.5 days, with an area under the curve of 0.637. TTI > 30 days was associated with an increased hazard of LF (HR 4.525, CI 1.239-16.527) but was not significantly associated with survival (HR 1.002, CI 0.547-1.823) or distant brain failure (DBF, HR 1.943, CI 0.989-3.816). Fifteen patients (20.5%) required post-operative inpatient rehabilitation. Post-operative rehabilitation was associated with TTI > 30 days (OR 1.48, CI 1.142-1.922). In our study of resected brain metastases, longer time to initiation of post-operative radiosurgery was associated with increased local failure. Ideally, post-op SRS should be initiated within 30 days of resection if feasible.

Impact of biologic agents with and without concomitant methotrexate and at reduced doses in older rheumatoid arthritis patients.

PubMed

Zhang, Jie; Xie, Fenglong; Delzell, Elizabeth; Yun, Huifeng; Lewis, James D; Haynes, Kevin; Chen, Lang; Beukelman, Timothy; Saag, Kenneth G; Curtis, Jeffrey R

2015-05-01

To examine whether concomitant methotrexate (MTX) use is associated with better biologic persistence and whether self-administered anti-tumor necrosis factor (anti-TNF) therapies are used at reduced doses in real-world clinical care settings, not just clinical trials. We conducted a retrospective cohort study among rheumatoid arthritis (RA) patients using Medicare claims data from 2006 to 2012. Subjects were new initiators of etanercept, infliximab, adalimumab, abatacept, and tocilizumab with at least 12 months of continuous medical and pharmacy coverage after treatment initiation. We examined the association between concomitant MTX use and persistence on biologic agents using Cox proportional hazards regression, adjusting for demographics and baseline comorbidities. We further identified a subgroup of patients who initiated and were adherent on etanercept or adalimumab for at least 12 months and examined the proportion of patients who subsequently used these therapies at reduced doses continuously for an additional 12, 18, and 24 months. Of 26,510 eligible RA patients, 10,511 initiated biologic monotherapy. Overall, patients who initiated biologic monotherapy were 1.4 (95% confidence interval [95% CI] 1.3-1.5) times more likely to discontinue at 1 year compared to those who initiated combination therapy, and 1.8 (95% CI 1.7-2.0) times more likely if starting infliximab monotherapy. Approximately 10-20% of patients who initiated and adhered to etanercept and adalimumab for ≥12 months subsequently received reduced-dose therapy for an 12 additional months and beyond. In real-world practice, concomitant MTX was associated with improved persistence on biologic therapy, especially for infliximab users; reduced-dose injectable anti-TNF therapy was used by a substantial proportion of RA patients. © 2015, American College of Rheumatology.